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Sample records for aortoiliac occlusive disease

  1. Totally laparoscopic bypass surgery for aortoiliac occlusive disease in China

    Institute of Scientific and Technical Information of China (English)

    GUO Lian-rui; GU Yong-quan; QI Li-xing; TONG Zhu; WU Xin; GUO Jian-ming; ZHANG Jian

    2013-01-01

    Background Totally laparoscopic aortic surgery is still in its infancy in China.One of the factors preventing adoption of this technique is its steep learning curve.The objective of this study was to evaluate the feasibility and safety of laparoscopic surgery for aortoiliac occlusive disease (AIOD).Methods From November 2008 to November 2012,12 patients were treated for severe AIOD with a totally laparoscopic bypass surgery at our university hospital.The demographic data,operative data,postoperative recovery data,morbidity and mortality were analyzed and compared with those of conventional open approach.Results Twelve totally laparoscopic aortic surgery procedures,including two iliofemoral bypasses (IFB),three unilateral aortofemoral bypasses (UAFB),and seven aortobifemoral bypasses (ABFB),were performed.Conversion to open procedures was required in three patients.The mean operation time was 518 (range,325-840) minutes,mean blood loss was 962 (range,400-2500) ml,and mean aortic anastomosis time was 75 (range,40-150) minutes.Compared with conventional open approach for aortofemoral bypasses performed concomitantly during this period,laparoscopic patients required fewer narcotics and a shorter in-hospital stay and earlier recovery.Postoperative complications developed in four patients,including a single patient with transient left hydronephrosis,ischemic colonic fistula and pneumonia,residual aortic stenosis proximal to the anastomotic site,and asymptomatic partial left renal infarction.All patients recovered and were discharged on postoperative Days 7-14 except one patient that died of respiratory failure on Day 46.All grafts were patent with follow-up imaging performed by Duplex examination,with a mean follow-up time of 10.7 (range,2-61) months.Conclusion Totally laparoscopic bypass surgery is a feasible and safe procedure forAIOD,but attention needs to be paid to improve laparoscopic skills of vascular surgery in order to minimize morbidity during the learning

  2. Successful endovascular treatment for high take off aorto-iliac occlusive disease.

    Science.gov (United States)

    Nomura, Akihiro; Nagashima, Michio; Tomoi, Yusuke; Tosaka, Atsushi; Soga, Yoshimitsu

    2015-01-01

    A 73-year-old man with a history of intermittent claudication for the previous six years visited our hospital. His ankle-brachial index (ABI) was very low on both sides, and computed tomography (CT) indicated bilateral aorto-iliac occlusive disease (AIOD). As he refused to undergo open surgery, endovascular treatment (EVT) was administered. After the first and second EVT sessions, the intermittent claudication improved completely. In addition, the ABI normalized (right: 1.01, left: 0.99), and CT demonstrated full expansion of the stents. His post-EVT course was uneventful for 18 months. The use of EVT to treat AIOD is technically feasible and may serve as a potential treatment option for patients with an inoperable condition. PMID:25876573

  3. Endovascular treatment for long-segment aortoiliac arterial occlusion:its technical skill and therapeutic effect

    International Nuclear Information System (INIS)

    Aortoiliac arterial occlusion is the most common arterial occlusive disease. The therapeutic options include the basic treatment with the medication as the principal part, the establishment of a bypass through an open surgery and the newly-developed endovascular revascularization technique. With the advantages of endovascular management being deeply understood by the clinicians and patients, the endovascular revascularization technique has become the therapy of first choice for long-segment aortoiliac arterial occlusion. This paper aims to make a comprehensive review about the technical skill and therapeutic effect of the newly-developed endovascular revascularization technique. (authors)

  4. AORTOILIAC AND AORTOFEMORAL RECONSTRUCTION OF OBSTRUCTIVE DISEASE

    NARCIS (Netherlands)

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

    1994-01-01

    This retrospective study evaluates our strategy to limit prosthetic reconstructions for aortoiliac obstructive disease to the diseased segments in 518 patients. There were 363 (70%) reconstructions without femoral anastomotic sites (FEM-0), 107 (21%) reconstructions with one femoral anastomotic site

  5. Use of multi-detector CT angiography in identification and classification of aorto-iliac diseases; clinical and surgical application

    Directory of Open Access Journals (Sweden)

    Reda Abdelsamie Alarabawy

    2016-03-01

    Conclusions: MDCT angiography is excellent noninvasive scanning technique for patients suspected of having aorto-iliac occlusive disease, with higher spatial resolution and faster acquisition times, allowing assessment of the aorta and its branches with greater accuracy than other modalities.

  6. Stent Graft in Managing Juxta-Renal Aortoiliac Occlusion

    International Nuclear Information System (INIS)

    Endovascular procedures are frequently used as an alternative to surgical bypass in aortic and iliac occlusion. Stents have revolutionized the scope of such endovascular procedures, but there are few reports of stents or stent grafts in occlusive juxta-renal aortic occlusion. We present a case where such occlusion was managed by use of a stent graft with successful outcome

  7. Aortoiliac interventions

    International Nuclear Information System (INIS)

    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

  8. Estudo comparativo de eco-Doppler com arteriografia na avaliação da doença oclusiva aorto-ilíaca Comparative study of Doppler ultrasonography with arteriography in the evaluation of aortoiliac occlusive disease

    Directory of Open Access Journals (Sweden)

    Ricardo Cesar Rocha Moreira

    2009-03-01

    timos em todos os segmentos aorto-ilíacos. Conclusão: A eco-Doppler apresenta elevados índices de validade e ótimos coeficientes de correlação com a AC na avaliação de pacientes com suspeita de DOAI.Background: Contrast arteriography (CA has been the traditional method of evaluation of patients with suspected aortoiliac occlusive disease (AIOD. Recently, less invasive methods, such as Doppler ultrasonography, have been used for the same purpose. Objective: The present study prospectively compares Doppler ultrasonography with CA and direct arterial manometry (DAM in the preoperative evaluation of patients with suspected AIOD. Methods: A total of 125 patients admitted for treatment of arterial occlusive disease of the lower extremities underwent Doppler ultrasonography and CA, comparatively evaluating 552 aortic, common iliac e external iliac segments. The lesions found were classified into five categories: 1 normal and mild stenosis (0-19%; 2 moderate stenosis (20-49%; 3 significant stenosis (50-79%; 4 critical stenosis (80-99%; and 5 total occlusion. DAM was used in 19 segments of 15 patients to classify borderline lesions. Validity indexes (sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were calculated to distinguish hemodynamically significant from non-significant stenosis and to discriminate critical stenosis from total occlusions. The gold standard was CA, supplemented by DAM. Correlation coefficients (kappa statistics between arteriography and Doppler ultrasonography were also calculated for the whole sample of aortoiliac segments. Results: Clinically relevant lesions (stenoses between 50-99% and total occlusions were observed on Doppler ultrasonography in 163 segments (29.5% and on CA in 158 segments (28.6%. Doppler ultrasonography showed high validity indexes to distinguish hemodynamically significant from non-significant lesions (overall accuracy = 92%; kappa = 0.81 and an overall accuracy of 86% (kappa

  9. Endovascular revascularization for aortoiliac atherosclerotic disease

    Science.gov (United States)

    Aggarwal, Vikas; Waldo, Stephen W; Armstrong, Ehrin J

    2016-01-01

    Atherosclerotic iliac artery disease is increasingly being treated with endovascular techniques. A number of new stent technologies can be utilized with high long-term patency, including self-expanding stents, balloon-expandable stents, and covered stents, but comparative data on these stent types and in more complex lesions are lacking. This article provides a review of currently available iliac stent technologies, as well as complex procedural aspects of iliac artery interventions, including approaches to the treatment of iliac bifurcation disease, long segment occlusions, choice of stent type, and treatment of iliac artery in-stent restenosis. PMID:27099509

  10. 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

    Energy Technology Data Exchange (ETDEWEB)

    Ierardi, Anna Maria; Duka, Ejona [University of Insubria, Interventional Radiology, Department of Radiology (Italy); Radaelli, Alessandro [Philips Healthcare (Netherlands); Rivolta, Nicola; Piffaretti, Gabriele [University of Insubria, Vascular Surgery Department (Italy); Carrafiello, Gianpaolo, E-mail: gcarraf@gmail.com [University of Insubria, Interventional Radiology, Department of Radiology (Italy)

    2016-01-15

    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.

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

    International Nuclear Information System (INIS)

    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

  12. Don't Forget the Pulses! Aortoiliac Peripheral Artery Disease Masquerading as Lumbar Radiculopathy-A Report of 3 Cases.

    Science.gov (United States)

    Lin, James D; Morrissey, Nicholas J; Levine, William N

    2016-01-01

    Orthopedic surgeons commonly encounter patients with lumbar radiculopathy. These patients typically seek treatment for lower back or buttock pain radiating down the leg. It can be challenging to differentiate between orthopedic, neurologic, and vascular causes of leg pain, such as peripheral artery disease (PAD), especially aortoiliac PAD, which can present with hip, buttock, and thigh pain. To our knowledge, this is the first report on a series of patients with thigh pain initially diagnosed as radiculopathy who underwent unproductive diagnostic tests and procedures, and ultimately were given delayed diagnoses of aortoiliac PAD. PMID:27552456

  13. Pulmonary veno-occlusive disease

    Science.gov (United States)

    Pulmonary vaso-occlusive disease ... common among children and young adults. As the disease gets worse, it causes narrowed pulmonary veins, pulmonary artery hypertension , and congestion and swelling ...

  14. Open and Endovascular Treatment of Trans-Atlantic Inter-Society Consensus Ⅱ D Aortoiliac Occlusive Lesions: What Determines the Rate of Restenosis?

    Institute of Scientific and Technical Information of China (English)

    Chen-Yang Shen; Yun-Feng Liu; Qing-Le Li; Yong-Bao Zhang; Yang Jiao; Miltiadis E Krokidis; Xiao-Ming Zhang

    2015-01-01

    Background: Open surgery is the preferred approach for the treatment of type D lesions according to the Trans-Atlantic Inter-Society Consensus (TASC) Ⅱ guideline, but endovascular solutions also appear to be a valid option in selected patients.The study aimed to identify the risk factors of restenosis after open and endovascular reconstruction of symptomatic TASC Ⅱ D aortoiliac occlusive lesions (AIOLs).Methods: Fifty-six patients (82 limbs) who underwent open repair and endovascular treatment (ET) for symptomatic TASC ⅡD AIOLs between March 2005 and December 2012 were retrospectively reviewed.Baseline characteristics, preoperative and postoperative imaging,and operation procedure reports were reviewed and analyzed.Restenosis after revascularization was assessed by duplex ultrasound or computed tomography angiogram.Kaplan-Meier survival analysis, Log-rank test, and multivariate Cox regression were used to evaluate the relevance between risk factors and patency.Results: The mean duration of follow-up was 42.8 ± 23.5 months (ranging from 3 to 90 months).Primary patency rates at 1-, 3-, 5-,and 7-year were 93.6%, 89.3%, 87.0%, and 70.3%, respectively.Restenosis after revascularization occurred in 11 limbs.Kaplan-Meier survival analysis and the Log-rank test revealed that diabetes, Rutherford classification ≥5th and concurrent femoropopliteal TASC Ⅱ type C/D lesions were significantly related to the duration of primary patency.According to the result of Cox regression, diabetes and femoropopliteal TASC Ⅱ type C/D lesions were identified as the risk factors for restenosis after revascularization.Conclusion: This study demonstrated that diabetes and femoropopliteal TASC Ⅱ type C/D lesions are risk factors associated with restenosis after open and ET of TASC Ⅱ D AIOLs.

  15. 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. PMID:27009171

  16. 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

    preoperative risk factors. METHODS: Data on patients with chronic limb ischemia were prospectively collected during a 20-year period (1993 to 2012). The data were obtained from the Danish Vascular Registry, assessed, and merged with data from The Danish Civil Registration System. RESULTS: We identified 3623...

  17. Genetics Home Reference: pulmonary veno-occlusive disease

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions pulmonary veno-occlusive disease pulmonary veno-occlusive disease Enable Javascript to view the ... Disease Control and Prevention: Pulmonary Hypertension Fact Sheet Disease InfoSearch: Pulmonary venoocclusive ... pulmonary venoocclusive disease Orphanet: Pulmonary ...

  18. Analysis of operation-related complications of totally laparoscopic aortoiliac surgery

    Institute of Scientific and Technical Information of China (English)

    Qi Lixing; Gu Yongquan; Guo Lianrui; Li Xuefeng; Wu Yingfeng; Cui Shijun; Tong Zhu

    2014-01-01

    Background Totally laparoscopic aortoiliac surgery has been newly developed in China.It is known as the most complex laparoscopic technique to learn because of its high-risk procedures.Analysis of the operation-related complications of this surgery is supposed to be helpful for the early success of this technique.Methods Twelve male patients (56-70 years old) with aortoiliac occlusive disease underwent totally laparoscopic aortoiliac bypass surgery (TLABS) in our institute.Clinical data and operation-related complications were retrospectively analyzed.Results Of the 12 patients,TLABS succeeded in nine and conversion to open surgery occurred in three.One of the converted patients finally died of pulmonary infection.Operation-related complications included bleeding from arterial injury,perforation from colonic injury,graft embolism,residual aortic stenosis,and hydronephrosis.Bleeding in two patients and colonic perforation in one patient resulted in three conversions to open surgery.Intraoperative graft embolectomy and postoperative aortic stenting were performed to resolve the thrombus/embolus-referring complications.Left hydronephrosis,which was thought to result from intraoperative injury and treated with ureteric intubation drainage,recovered 6 months after TLABS.Conclusions Good understanding and avoidance of operation-related complications are important to guarantee the technical success of TLABS.Immediate conversion to open surgery is necessary for saving the patient's life in case of lifethreatening complications.

  19. Intracranial Large Artery Occlusive Disease

    Institute of Scientific and Technical Information of China (English)

    Wong KS; Li H; Kay R

    2000-01-01

    @@Intracranial large artery stenosis is the most commonly found vascular lesion in stroke patient of Chinese, Hispanic and African ancestry. There .have been few studies on the epidemiology, pathophysiology, treatment and prognosis of this important disease. Recent advances in technology provide safe and reliable investigation for studying large number of patients. Transcranial Doppler is an easily accessible, cheap and reliable method to diagnose intracranial stenosis. It is suitable for screening for and monitoring the progress of intracranial stenosis. Magnetic resonance angiography and CT angiography provide the morphology of lumenal stenosis but are less accessible.

  20. Cognitive impairments in patients with cerebrovascular steno-occlusive disease

    Institute of Scientific and Technical Information of China (English)

    石丹

    2012-01-01

    Objective To explore the relationship between cerebrovascular steno-occlusive disease and neuropsychological performance by cognitive function assessment. Methods Using a case-control study,45 patients with cerebrovascular steno-occlusive lesions (patient group) and 59 control subjects without cerebrovascular

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

    Energy Technology Data Exchange (ETDEWEB)

    Rademaker, J. [Department of Radiology I, Medical School Hannover (Germany)

    1998-10-01

    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.) With 1 fig., 4 refs.

  2. Relationship between retinal vascular occlusions and incident cerebrovascular diseases

    Science.gov (United States)

    Zhou, Yue; Zhu, Wengen; Wang, Changyun

    2016-01-01

    Abstract Several studies investigating the role of retinal vascular occlusions, on cerebrovascular diseases (CVD) have been reported, but the results are still inconsistent. We therefore sought to evaluate the relationship between retinal vascular occlusions and CVD. We systematically searched the Cochrane Library, PubMed, and ScienceDirect databases through January 31, 2016 for studies evaluating the effect of retinal vascular occlusions on the risk of CVD. Data were abstracted using predefined criteria, and then pooled by RevMan 5.3 software. A total of 9 retrospective studies were included in this meta-analysis. When compared with individuals without retinal vascular occlusions, both individuals with retinal artery occlusion (RAO) (odds ratio [OR] = 2.01, 95% confidence interval [CI]: 1.21–3.34; P = 0.005) and individuals with retinal vein occlusion (RVO) (OR = 1.37, 95% CI: 1.24–1.50; P < 0.00001) had higher risks of developing CVD. Additionally, both individuals with central retinal artery occlusion (CRAO) (OR = 2.00, 95% CI: 1.12–3.56; P = 0.02) and branch retinal artery occlusion (BRAO) (OR = 1.60, 95% CI: 1.03–1.48; P = 0.04) were significantly associated with increased risk of CVD. Published literatures support both RVO and RAO are associated with increased risks of CVD. Further prospective studies are needed to confirm these findings. PMID:27368050

  3. 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.

  4. Scintigraphic patterns of veno-occlusive disease in liver transplantation.

    Science.gov (United States)

    Bernstine, Hanna; Mor, Eytan; Ben Ari, Ziv; Belinki, Alexander; Hardoff, Ruth

    2004-05-01

    Venous vascular complications in liver transplant recipients are rare. Diagnosis is usually based on clinical criteria and typical findings on liver biopsy. The scintigraphic patterns of posttransplant liver veno-occlusive disease are described, and the value of follow-up studies is suggested. The authors present 2 patients who developed posttransplantation hepatic veno-occlusive disease. The first patient had a severe form of the disease and a fatal outcome. The second patient had a mild to moderate form of this disorder with complete resolution following treatment. PMID:15069326

  5. Peripheral Arterial Occlusive Disease - an Interdisciplinary Approach

    OpenAIRE

    Groechenig E

    2003-01-01

    Vascular diseases are the most common diseases and the most common causes of death in developed countries. Many medical disciplines deal with vascular diseases and there is no strict and clear concept in education and training of these physicians. In German-speaking countries "angiology" was established several years ago. The angiologist is a highly qualified physician, who, in most cases, comes from internal medicine (a minority from dermatology). Although peripheral arterial disease (PAD) i...

  6. Infrarenal Aortic Occlusion

    Science.gov (United States)

    Traverso, L. W.; Baker, J. D.; Dainko, E. A.; Machleder, H. I.

    1978-01-01

    Twenty-eight patients with total occlusion of the infrarenal aorta have been seen at the UCLA Hospitals in the past 11 years. Claudication was the presenting complaint in all but one patient, with one-third having ischemic rest pain. The average age of these patients was 54 years, and their histories revealed a surprising absence of myocardial infarction, stroke, or diabetes, although 40% had essential hypertension. Heavy tobacco use, however, was characteristic of the entire group. Arteriography proved valuable in identifying and characterizing the vascular abnormalities, but posed problems in technique and interpretation. Significant distal arterial disease was detected radiographically in only 21% of these patients. Operative correction of the aortic occlusion was performed on 26 patients, 18 by aortic bypass grafts and eight by aorto-iliac endarterectomy, with one early postoperative death. Although the thrombus extended to the renal artery origins in 77% of the cases, a well-designed technical approach did not require renal artery occlusion. Using serial creatinine determinations, one case of renal insufficiency was detected which was associated with prolonged postoperative hypotension. Although the extent of distal disease was more severe in those who underwent bypass, symptoms of claudication returned earlier and were more prominent in the endarterectomy group. This recurrence of systems was not favorably altered by sympathectomy performed concomitantly with the initial procedure. Even though this condition seems to pose difficult technical obstacles and has a poor prognosis, infrarenal aortic occlusion can be successfully treated by aortic bypass, with favorable long-term results, if particular attention is paid to elements of the preoperative evaluation and the intraoperative technical requirements peculiar to this relatively uncommon disease entity. ImagesFig. 1.Fig. 2.Fig. 3. PMID:646479

  7. 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

  8. Major Artery Occlusion: a Rare Complication of Sickle Cell Disease

    OpenAIRE

    AGHA, Adnan; Al-Hakami, Mohammad; Shabbir, Ghulam

    2010-01-01

    Sickle cell disease is hereditary hemoglobinopathy which causes haemolytic anemia, vaso-occlusive crisis, ischemic injuries and many other morbidities like cerebral infarction. In this report, we describe a case of a young patient with sickle cell disease presenting with right-sided weakness and slurring of speech with examination confirming right-sided hemiparesis with motor aphasia. On further investigation, she was found to have frontotemporal infarction. On magnetic resonance imaging with...

  9. Major Artery Occlusion: a Rare Complication of Sickle Cell Disease

    OpenAIRE

    Adnan Agha

    2010-01-01

    Abstract: Sickle cell disease is hereditary hemoglobinopathy which causes haemolytic anemia, vaso-occlusive crisis, ischemic injuries and many other morbidities like cerebral infarction.  In this report, we describe a case of a young patient with sickle cell disease presenting with right-sided weakness and slurring of speech with examination confirming right-sided hemiparesis with motor aphasia. On further investigation, she was found to have frontotemporal infarction.  On magnetic resonance ...

  10. Dual-energy CT angiography in peripheral arterial occlusive disease - accuracy of maximum intensity projections in clinical routine and subgroup analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kau, Thomas [Klinikum Klagenfurt, General Hospital of Klagenfurt, Institute of Diagnostic and Interventional Radiology, Klagenfurt (Austria); Klinikum Klagenfurt am Worthersee, Radiologie, Klagenfurt (Austria); Eicher, Wolfgang; Reiterer, Christian; Niedermayer, Martin; Rabitsch, Egon; Hausegger, Klaus A. [Klinikum Klagenfurt, General Hospital of Klagenfurt, Institute of Diagnostic and Interventional Radiology, Klagenfurt (Austria); Senft, Birgit [Section of Statistics, Reha Clinic for Mental Health, Klagenfurt (Austria)

    2011-08-15

    To evaluate the accuracy of dual-energy CT angiography (DE-CTA) maximum intensity projections (MIPs) in symptomatic peripheral arterial occlusive disease (PAOD). In 58 patients, DE-CTA of the lower extremities was performed on dual-source CT. In a maximum of 35 arterial segments, severity of the most stenotic lesion was graded (<10%, 10-49% and 50-99% luminal narrowing or occlusion) independently by two radiologists, with DSA serving as the reference standard. In DSA, 52.3% of segments were significantly stenosed or occluded. Agreement of DE-CTA MIPs with DSA was good in the aorto-iliac and femoro-popliteal regions ({kappa} = 0.72; {kappa} = 0.66), moderate in the crural region ({kappa} = 0.55), slight in pedal arteries ({kappa} = 0.10) and very good in bypass segments ({kappa} = 0.81). Accuracy was 88%, 78%, 74%, 55% and 82% for the respective territories and moderate (75%) overall, with good sensitivity (84%) and moderate specificity (67%). Sensitivity and specificity was 82% and 76% in claudicants and 84% and 61% in patients with critical limb ischaemia. While correlating well with DSA above the knee, accuracy of DE-CTA MIPs appeared to be moderate in the calf and largely insufficient in calcified pedal arteries, especially in patients with critical limb ischaemia. (orig.)

  11. Peripheral Arterial Occlusive Disease - an Interdisciplinary Approach

    Directory of Open Access Journals (Sweden)

    Groechenig E

    2003-01-01

    Full Text Available Vascular diseases are the most common diseases and the most common causes of death in developed countries. Many medical disciplines deal with vascular diseases and there is no strict and clear concept in education and training of these physicians. In German-speaking countries "angiology" was established several years ago. The angiologist is a highly qualified physician, who, in most cases, comes from internal medicine (a minority from dermatology. Although peripheral arterial disease (PAD is the most frequent disease angiology deals with, the angiologist has to have a broad knowledge of general vascular medicine and has to be qualified in all diagnostic and therapeutic procedures. PAD is just like the tip of an iceberg and has to be mentioned as a severe disease with a bad overall prognosis similar to that of Duke-B colon carcinoma. So, global access with staging and grading of atherosclerosis, evaluation of concomitant diseases, control of risk factors and adequate treatment of PAD is the gold standard. Therefore, several medical specialities are involved with the angiologist functioning as the integrative "general manager" between the disciplines for the welfare of the patient. Periphere arterielle Verschlußkrankheit - ein interdisziplinärer Ansatz. Gefäßkrankheiten sind die häufigsten Erkrankungs- und Todesursachen in den industrialisierten Ländern. Gefäßerkrankungen können sich an verschiedensten Organen manifestieren und dazu führen, daß unterschiedliche medizinische Disziplinen damit beschäftigt werden, ohne daß häufig eine gefäßspezifische Ausbildung vorhanden ist. Um diesem Umstand Rechnung zu tragen, wurde in den deutschsprachigen Ländern vor einigen Jahren der Additivfacharzt für Angiologie eingeführt. Der Angiologe ist ein hochqualifizierter Spezialist mit einer internistischen (seltener dermatologischen Basisausbildung. Der Angiologe hat einerseits ein breites Wissen über die allgemeine Gefäßpathologie und

  12. Mapping white matter diffusion and cerebrovascular reactivity in carotid occlusive disease

    NARCIS (Netherlands)

    Conklin, J.; Fierstra, J.; Crawley, A. P.; Han, J. S.; Poublanc, J.; Silver, F. L.; Tymianski, M.; Fisher, J. A.; Mandell, D. M.; Mikulis, D. J.

    2011-01-01

    Objective: To characterize the relationship between cerebrovascular reactivity (CVR) and white matter (WM) diffusion in patients with internal carotid artery (ICA) occlusive disease. Methods: In this exploratory observational study, 41 patients with severe stenosis or occlusion of the extracranial I

  13. Subintimal angioplasty for femoro-popliteal occlusive disease.

    Science.gov (United States)

    Markose, George; Miller, Fiona N A C; Bolia, Amman

    2010-11-01

    There has been a longstanding debate about the roles of surgical bypass graft, percutaneous transluminal angioplasty, subintimal angioplasty, and conservative management for femoro-popliteal occlusive disease. Subintimal angioplasty was first described in 1987 as a method of performing an endovascular arterial bypass. The subintimal space at the start of the occlusion is entered with a catheter and a wire loop is used to cross the occlusion and reenter the vessel lumen distally. In patients with critical limb ischemia, there is high quality evidence demonstrating that the limb salvage rate and amputation-free survival rates for surgery and endovascular treatment are similar, but surgery is more expensive than angioplasty in the short term. In patients with intermittent claudication, surgical bypass using an autologous saphenous vein graft is currently believed to be the gold standard, but this is increasingly questioned in the light of recent advances in endovascular techniques. Surgical bypass with vein graft offers a 2-year patency of 81%, compared with 67% for a polytetrafluoroethylene (PTFE) graft and at best 67% for subintimal angioplasty. The better patency offered by surgery must be balanced against a higher morbidity and mortality. To conclude, subintimal angioplasty is an extremely valuable technique in the management of critical limb ischemia. Based on the evidence to date, this technique is likely to have an increasing role in the management of intermittent claudication over the coming years, particularly if the risk of general anaesthesia is high or there is no suitable vein.

  14. The history of surgical treatment for occlusive carotid artery diseases

    Directory of Open Access Journals (Sweden)

    Ding-biao ZHOU

    2014-01-01

    Full Text Available In this article, the history of surgical treatment for occlusive carotid artery diseases is briefly reviewed. It is emphasized that, after the results of large cohort, multicenter, randomized clinical trials, including North American Symptomatic Carotid Endarterectomy Trial (NASCET and European Carotid Surgery Trial (ECST, were reported in 1991, the important role of carotid endarterectomy (CEA for the surgical treatment of carotid atherosclerosis had already been confirmed. Although it has a late start in China, CEA has a bright and promising future.

  15. The Role of Hyperlipidaemia in Peripheral Arterial Occlusive Disease

    Directory of Open Access Journals (Sweden)

    Drexel H

    2003-01-01

    Full Text Available A recent report from the Physicians' Health Study proved elevated plasma cholesterol, elevated triglycerides, and low HDL-cholesterol predictive of the incidence of peripheral arterial occlusive disease. The strongest predictor was the cholesterol/HDL-cholesterol ratio. In contrast, new risk factors, eg lipoprotein (a, homocysteine and apolipoproteins A and B did not have additional predictive power for peripheral arterial occlusive disease, whereas C-reactive protein and fibrinogen were independently predictive of its incidence. Earlier cross-sectional studies also found lipoprotein lipids closely associated with arterial disease: VLDL-cholesterol, IDL-cholesterol, and LDL-cholesterol were directly, and HDL-cholesterol, HDL2-cholesterol as well as HDL3-cholesterol inversely related to the prevalence of peripheral arterial occlusive disease. Treatment recommendations are the same as have been established for other secondary preventive settings, eg coronary artery disease. Die Bedeutung der Hyperlipidämie als Risikofaktor für die periphere arterielle Verschlußkrankheit. Neue Daten aus der Physicians' Health Study zeigen, daß erhöhtes Plasmacholesterin, erhöhte Triglyzeride und niedriges HDL-Cholesterin das Auftreten von PAVK voraussagen. Der beste Prädiktor ist der Cholesterin/HDL-Cholesterin-Quotient. Im Gegensatz dazu zeigten neuere Risikofaktoren - wie Lipoprotein A, Homocystein und Apolipoprotein A und B - keine zusätzliche Vorhersagekraft für periphere Verschlußkrankheiten. C-reaktives Protein und Fibrinogen waren andererseits wieder unabhängige Prädiktoren für die Krankheitsinzidenz. Diese prospektiven Daten ergänzen frühere Literaturberichte von Querschnittstudien, in welchen ebenfalls der Lipoproteinstoffwechsel eng mit der peripheren arteriellen Verschlußkrankheit assoziiert war: VLDL-Cholesterin, IDL-Cholesterin und LDL-Cholesterin waren direkt, HDL-Cholesterin, HDL2-Cholesterin sowie HDL3-Cholesterin invers mit der Pr

  16. Aortic replacement in aorto-occlusive disease: an observational study

    Directory of Open Access Journals (Sweden)

    Winter Richard K

    2008-10-01

    Full Text Available Abstract Background For many patients with aorto-occlusive disease, where stent deployment is not possible, surgery remains the only treatment option available. The aim of this study was to assess the results of aortic reconstruction surgery performed in patients with critical ischaemia. Methods All patients with critical ischaemia undergoing surgery during 1991–2004 were identified from a prospectively maintained database. Mortality data was verified against death certificate data. Demographic and clinical data were obtained from the clinical notes and the radiology database. Disease was classified as: type I – limited to aorta and common iliac arteries; type II – external iliac disease and type III combined aortic, iliac and infra-inguinal disease. Results 86 patients underwent aortic replacement surgery all of whom had critical ischaemia consisting of: type I (n = 16; type II (n = 37 and type III (n = 33. The 30-day mortality rate was 10.4%, the one-year patient survival was 80%, and the 1-year graft survival was 80%. At 2 years the actual patient survival was 73% and no additional graft losses were identified. All patients surviving 30 days reported excellent symptomatic relief. Early, complications occurred in 6 (7% patients: thrombosis within diseased superficial femoral arteries (n = 4; haemorrhage and subsequent death (n = 2. Ten (14% late complications (> 12 months occurred in the 69 surviving patients and included: anastomotic stenosis (n = 3; graft thrombosis (n = 4, graft infection (n = 3. Four patients developed claudication as a result of more distal disease in the presence of a patent graft, and 1 patient who continued smoking required an amputation for progressive distal disease. Conclusion Aortic reconstruction for patients with extensive aorto-occlussive disease provides long-standing symptomatic relief for the majority of patients. After the first year, there is continued patient attrition due to co

  17. Endovascular Revascularization of Symptomatic Infrapopliteal Arteriosclerotic Occlusive Disease: Comparison of Atherectomy and Angioplasty

    OpenAIRE

    Tan, Tze-Woei; Semaan, Elie; Nasr, Wael; Eberhardt, Robert T.; Hamburg, Naomi; Doros, Gheorghe; Rybin, Denis; Shaw, Palma M; Farber, Alik

    2011-01-01

    The preferred method for revascularization of symptomatic infrapopliteal arterial occlusive disease (IPAD) has traditionally been open vascular bypass. Endovascular techniques have been increasingly applied to treat tibial disease with mixed results. We evaluated the short-term outcome of percutaneous infrapopliteal intervention and compared the different techniques used. A retrospective analysis of consecutive patients undergoing endovascular treatment for infrapopliteal arterial occlusive l...

  18. [Supra-aortic trunks occlusive disease: three different treatment approaches].

    Science.gov (United States)

    Dias, P; Almeida, P; Sampaio, S; Silva, A; Leite-Moreira, A; Pinho, P; Roncon de Albuquerque, R

    2010-01-01

    Unlike carotid bifurcation atherosclerotic stenosis, supra-aortic trunks (SAT) occlusive disease is rare and its revascularization uncommon, accouting for less than 10% of the operations performed on the extracranial brain-irrigating arteries. There are three different treatment approaches: transthoracic, extra-anatomic cervical and endovascular. Endovascular repair is gaining popularity as first-line therapy for proximal lesions with favorable anatomy because of its low morbidity and rare mortality. Extra-anatomic bypass is a safe and durable reconstruction and should be considered in patients with single vessel disease, with cardiopulmonary high-risk or with limited life expectancy. If cardiac surgery is needed, central transthoracic reconstruction is preferable, and the two procedures should be combined. The long-term patency of bypasses with aortic origin, specially when multiple vessels are involved, is superior to other repair techniques. We present three clinical cases that illustrate each of these therapeutic strategies: central brachiocephalic revascularization and synchronous cardiac surgery in a patient with complex SAT atherosclerosis disease; subclavian-carotid transposition for disabling upper limb claudication; and subclavian artery stenting for subclavian-steal syndrome. Surgical approach selection should be based on the individual patient's anatomy and operative risk.

  19. Distal arterial occlusive disease in diabetes is related to medial arterial calcification.

    Science.gov (United States)

    Chantelau, E; Lee, K M; Jungblut, R

    1997-01-01

    In diabetes mellitus, peripheral arterial occlusive disease predominantly affects the lower leg (tibial and peroneal vessel disease). Our study suggests that this feature is related to the presence of forefoot medial arterial calcification.

  20. Lower Extremity Arterial Occlusive Disease As a Rare Complication of Crohn's Disease

    Institute of Scientific and Technical Information of China (English)

    Wei-wei Wu; Xue-ying Jiang; Chang-wei Liu; Yong-jun Li; Rong Zeng

    2009-01-01

    Objective To investigate the dinical characteristics and treatment strategy of lower extremity arterial occlusive disease in patients with Crohn's disease(CD).Methods Clinical information of 9 cases suffering from lower extremity arterial occlusion and CD was investigated retrospectively.Results All the cases were less than 50 years old and the most were females(8/9).Arterial occlusions occurred in either active(5/9)or inactive(4/9)stage of CD.Besides the arteries of lower extremities,other arteries could also be involved such as aorta,iliac artery,renal artery or mesentery artery.Seven cases had atherosclerotic imaging findings(4 had aortic plaques and 6 had iliac artery stenoses).Embolectomy or thromboendarterectomy were mostly performed.Four(44.4% )cases had recurrent lower limb ischemia.Conclusions Arterial occlusive disease is a rare extraintestinal manifestation of CD.A thorough inspection of aorta is necessary.Embolectomy is mostly preferred.Anticoagulation treatment is highly recommended after the operation.

  1. Gene and stem cell therapy in peripheral arterial occlusive disease.

    Science.gov (United States)

    Kalka, C; Baumgartner, Iris

    2008-01-01

    Peripheral arterial occlusive disease (PAOD) is a manifestation of systemic atherosclerosis strongly associated with a high risk of cardiovascular morbidity and mortality. In a considerable proportion of patients with PAOD, revascularization either by endovascular means or by open surgery combined with best possible risk factor modification does not achieve limb salvage or relief of ischaemic rest pain. As a consequence, novel therapeutic strategies have been developed over the last two decades aiming to promote neovascularization and remodelling of collaterals. Gene and stem cell therapy are the main directions for clinical investigation concepts. For both, preclinical studies have shown promising results using a wide variety of genes encoding for growth factors and populations of adult stem cells, respectively. As a consequence, clinical trials have been performed applying gene and stem cell-based concepts. However, it has become apparent that a straightforward translation into humans is not possible. While several trials reported relief of symptoms and functional improvement, other trials did not confirm this early promise of efficacy. Ongoing clinical trials with an improved study design are needed to confirm the potential that gene and cell therapy may have and to prevent the gaps in our scientific knowledge that will jeopardize the establishment of angiogenic therapy as an additional medical treatment of PAOD. This review summarizes the experimental background and presents the current status of clinical applications and future perspectives of the therapeutic use of gene and cell therapy strategies for PAOD.

  2. Weber-Christian disease producing splenic vein occlusion and bleeding gastric varices: successful treatment with sclerotherapy.

    OpenAIRE

    Heseltine, D.; Bramble, M.; Cole, A.; Clarke, D; Castle, W

    1990-01-01

    A 48 year old woman with intra-abdominal Weber-Christian disease presented with bleeding gastric varices and evidence of splenic vein occlusion. We describe the problems encountered in making this diagnosis and subsequent treatment.

  3. Impairment of coronary flow reserve in orthotopic cardiac transplant recipients with minor coronary occlusive disease

    OpenAIRE

    Mullins, P. A.; Chauhan, A.; Sharples, L; Cary, N R; Large, S R; Wallwork, J; Schofield, P M

    1992-01-01

    Objective—Coronary occlusive disease is the major long-term complication after cardiac transplantation. The relation between minor angiographic abnormalities and myocardial perfusion has not been previously assessed in a large number of cardiac transplant patients.

  4. Relationship between retinal vascular occlusions and incident cerebrovascular diseases: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhou, Yue; Zhu, Wengen; Wang, Changyun

    2016-06-01

    Several studies investigating the role of retinal vascular occlusions, on cerebrovascular diseases (CVD) have been reported, but the results are still inconsistent. We therefore sought to evaluate the relationship between retinal vascular occlusions and CVD.We systematically searched the Cochrane Library, PubMed, and ScienceDirect databases through January 31, 2016 for studies evaluating the effect of retinal vascular occlusions on the risk of CVD. Data were abstracted using predefined criteria, and then pooled by RevMan 5.3 software.A total of 9 retrospective studies were included in this meta-analysis. When compared with individuals without retinal vascular occlusions, both individuals with retinal artery occlusion (RAO) (odds ratio [OR] = 2.01, 95% confidence interval [CI]: 1.21-3.34; P = 0.005) and individuals with retinal vein occlusion (RVO) (OR = 1.37, 95% CI: 1.24-1.50; P < 0.00001) had higher risks of developing CVD. Additionally, both individuals with central retinal artery occlusion (CRAO) (OR = 2.00, 95% CI: 1.12-3.56; P = 0.02) and branch retinal artery occlusion (BRAO) (OR = 1.60, 95% CI: 1.03-1.48; P = 0.04) were significantly associated with increased risk of CVD.Published literatures support both RVO and RAO are associated with increased risks of CVD. Further prospective studies are needed to confirm these findings. PMID:27368050

  5. SPECT with N-isopropyl-p iodoamphetamine in occlusive cerebrovascular diseases.

    Science.gov (United States)

    Higa, T; Tanaka, T; Ikekubo, K; Komatsu, T; Torizuka, K

    1986-12-01

    The role of SPECT imaging with N-isopropyl-p iodoamphetamine (I-123 IMP) in the detection of angiographically documented occlusive cerebrovascular diseases was evaluated in 24 patients, and the results of regional cerebral blood flow (rCBF) were compared with x-ray CT. Twelve patients had internal carotid occlusion, ten had intracranial occlusion beyond the circle of Willis, one had common carotid occlusion, and one had basilar artery occlusion. SPECT images were obtained with a gamma camera, which was rotated 360 degrees around the patient's head 30 minutes after an intravenous injection of 3 mCi of I-123 IMP. CT images in the transverse plane were obtained, and the regions of reduced attenuation were identified for comparison of topographic extension of the lesion with the regions of decreased rCBF seen on SPECT. In six cases, the lesions seen on the SPECT images were distinctly more extensive than those seen on CT. In the remaining 18 cases, the extent of the lesion was identical on both CT and SPECT images. Radiochemical and radionuclide impurities, the distance of the detector from the head, and the nature of the collimator affected the SPECT results. I-123 IMP SPECT imaging complements CT findings in detecting the ischemic zones beyond the regions identified on CT images, and may have a major rule in the management of patients with occlusive cerebrovascular diseases.

  6. Tratamento convencional e endovascular para rara associação de doenças: síndrome de veia cava superior e aneurisma aorto-ilíaco - controle após 12 meses Conventional and endovascular treatment for a rare combination of diseases: superior vena cava syndrome and aortoiliac aneurysm - control after 12 months

    Directory of Open Access Journals (Sweden)

    Gustavo Petorossi Solano

    2011-09-01

    Full Text Available A associação entre a síndrome de veia cava superior e uma dilatação aneurismática das artérias aorta e ilíacas não é comum. A abordagem de cada uma destas patologias pode ser efetuada através do modo convencional, com cirurgia aberta ou pela técnica endovascular. Neste trabalho, relatamos as duas modalidades de intervenção cirúrgica executadas e discutimos suas indicações e os resultados deste caso em particular.The association between superior vena cava syndrome and an aorto-iliac aneurysm is not common. The approach to each of theses diseases can be either by the conventional way with open surgery or by endovascular techniques. We report the two methods of surgical intervention and discuss their indications and results in this particular case.

  7. 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

    AIM: Para-anastomotic aneurysms, leakage due to anastomotic failure, aorto- and arterioenteric fistulas are some of the serious complications after aorto-iliac surgical reconstructions. Treatment of these complications is challenging and is either done by open surgery or by endovascular therapy....... 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......-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...

  8. 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.

  9. Endovascular Treatment of Veno-Occlusive Behcet's Disease

    Energy Technology Data Exchange (ETDEWEB)

    Tekbas, Guven, E-mail: drgtekbas@gmail.com [Dicle University School of Medicine, Department of Radiology (Turkey); Oguzkurt, Levent, E-mail: loguzkurt@yahoo.com; Gur, Serkan, E-mail: mserkangur@yahoo.com [Baskent University School of Medicine, Department of Interventional Radiology, Adana Hospital (Turkey); Onder, Hakan, E-mail: drhakanonder@hotmail.com [Dicle University School of Medicine, Department of Radiology (Turkey); Andic, Cagatay, E-mail: cagatayandic@gmail.com [Baskent University School of Medicine, Department of Interventional Radiology, Adana Hospital (Turkey)

    2012-08-15

    Purpose: To retrospectively evaluate the outcome of endovascular treatments for patients with chronic veno-occlusive disease in different vascular beds secondary to Behcet's disease (BD). There are few case reports on the subject, and this is the largest study to date. Materials and Methods: From January 2001 through October 2009, chronic venous occlusions were treated in 10 patients (all male [age range 18-76 years]) with BD using percutaneous transluminal angioplasty and/or stent placement. All patients were symptomatic and had chronic iliofemoral deep venous thrombosis (DVT; n = 5), central venous occlusion (n = 3), or Budd-Chiari syndrome (BCS; n = 2). All patients met criteria of the International Study Group on Behcet's Disease. Results: Two of five patients with DVT had unsuccessful recanalization attempts. Three patients had successful recanalization with stent placement. All three veins were occluded within 1 month with unsuccessful reinterventions. Three patients with chronic central venous occlusion had successful recanalization with percutaneous transluminal angioplasty (n = 1) and stent placement (n = 2). Two patients had reocclusion with successful reintervention. Two BCS patients had successful treatment with stent placements. Overall technical success was 69%, and no procedural complications were encountered. None of the patients with chronic DVT had patent veins; however, all patients with central venous occlusion or BCS had patent veins on color Doppler ultrasonography at follow-up ranging from 3 to 48 months after intervention. Conclusion: Endovenous treatment for chronic iliofemoral DVT due to BD had a poor outcome. However, long-term outcome after endovenous treatment for upper-extremity central venous occlusion and BCS syndrome was good.

  10. Superselective Urokinase Infusion Therapy for Dorsalis Pedis Artery Occlusion in Buerger's Disease

    International Nuclear Information System (INIS)

    Occlusion of the proximal left dorsalis pedis artery (DPA) in a patient with Buerger's disease was treated by continuous urokinase intraarterial infusion using a microcatheter. Recanalization of the DPA and healing of a toe ulcer were achieved. The patient remains asymptomatic during a 4-year follow-up

  11. Diagnosis of arterial occlusive disease of the lower extremities by laser Doppler flowmetry.

    Science.gov (United States)

    Van den Brande, P; Welch, W

    1988-01-01

    Laser Doppler Flowmetry offers the possibility of non-invasive and continuous recording of tissue blood flow. Skin blood flux in resting state and during postocclusive reactive hyperemia was measured at the pulpa of the toe in 21 normal lower limbs and in 58 limbs with arterial occlusive disease. Proper assessment of postischemic flux- and time- parameters (beginning of reactive hyperemia, peak flux, time of peak flux and duration of hyperemic flux) permits accurate separation of healthy and diseased limbs. PMID:3058833

  12. Influence of chronic kidney disease on the outcome of patients with chronic total occlusion

    OpenAIRE

    Zhang, Qing-Bin; Chen, Li-Ming; Min LI; Cui, Yu-Qi; Zhao, Chuan-Yan; Cui, Lian-Qun

    2016-01-01

    Objective: Chronic kidney disease (CKD) predicted a poor prognosis in patients with coronary artery disease. There is a paucity of data on outcomes after revascularization in patients with chronic total occlusion (CTO) and CKD. This study aims to investigate the impact of CKD on the revascularization of CTO. Methods: This study enrolled 1,092 CTO patients received treatments in our hospital between February 2009 and January 2014. Major adverse cardiac and cerebrovascular events (MACCE) and al...

  13. 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

    Systolic blood pressures at toe and ankle were measured in 459 consecutive patients with occlusive arterial disease. Fifty-eight per cent had intermittent claudication with arterial disease of all degrees of severity. Seventeen per cent complained of rest pain having toe systolic pressures below 30...... 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....

  14. EVAR for aortoiliac aneurysms, including iliac branched grafts

    NARCIS (Netherlands)

    Paraskevas, K.; Moellendorf, C.; Fernandes, R. Fernandes E.; Tielliu, I.; Verhoeven, E.

    2012-01-01

    For aortoiliac aneurysms involving the common iliac arteries several treatment options have been developed. In the early stages of the endovascular era the internal iliac artery was usually overstented with or without embolization. Thereafter relocation or bypass techniques were used in an attempt t

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

    International Nuclear Information System (INIS)

    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)

  16. Hemodynamic effects of intravenous PGE1 on patients with arterial occlusive disease of the leg.

    Science.gov (United States)

    Hirai, M; Nanki, M; Nakayama, R

    1985-07-01

    In 42 patients with arterial occlusive disease of the leg, the hemodynamic effects of prostaglandin E1 (PGE1) given intravenously were studied. Blood pressure of the leg and crest time of the pulse wave did not change significantly, while increases in blood flow at the calf and foot, amplitude of the pulse wave, velocity, and skin temperature at the foot and toes were significant. Skin temperature of the calf dropped significantly. The increase in blood flow, velocity, and skin temperature was significantly more dominant in the distal part of the leg than that in the proximal part. In separate observation of individuals, 12 of the 66 legs with arterial occlusive disease (18%) showed a decrease in skin temperature at the toes. The steal phenomenon was observed most frequently in limbs with rest pain, gangrene, or both.

  17. [Perioperative myocardial ischemia in patients with peripheral arterial occlusive diseases].

    Science.gov (United States)

    Rapp, H J; Buselmeier, P; Gasteiger, P; Hoberg, E; Striebel, J P

    1990-04-01

    Patients with peripheral vascular disease (PVD) often have coronary artery disease (CAD) which means an increased risk during anesthesia. The prevalence of CAD is nearly 50% among such patients. Owing to claudication, diagnostic stress tests can rarely be performed in PVD patients. In order to evaluate the frequency of transient perioperative myocardial ischemia, Holter monitoring was performed in 30 consecutive PVD patients with ASA II-III and AVK scale (Fontaine) II-IV who were undergoing femoropopliteal bypass surgery. Patients who had left bundle branch block and left ventricular hypertrophy or were taking digitalis medication were excluded from Holter monitoring. The ST-segment analysis of the frequency modulated recordings (n = 19) revealed episodes of myocardial ischemia in 26% of the patients. Most (75%) of the episodes occurred preoperatively, and 25%, during or after the anesthesia or during preparation for it. Risk factors for CAD were more often found in patients with ST segment alterations than in patients without ST segment deviations, even though the preoperative antianginal medication administered was comparable in the two subgroups. It is concluded that in a considerable subset of PVD patients silent myocardial ischemia occurs, which can be related to the different perioperative intervals by means of ST segment analyses of Holter recordings. The ST segment may allow a better insight into the cardiac state of PVD patients. Further studies are necessary in larger populations to test our suspicion.

  18. Clinical significance of posterior cerebral artery stenosis/occlusion in moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Satoshi; Ishikawa, Tatsuya; Iwasaki, Yoshinobu [Hokkaido Univ., Sapporo (Japan). Graduate School of Medicine; Houkin, Kiyohiro [Sapporo Medical Univ. (Japan)

    2002-12-01

    The present study was aimed at clarifying the clinical significance of posterior cerebral artery (PCA) stenosis/occlusion in pediatric and adult moyamoya disease. This study included a total of 132 patients (52 children and 80 adults) who were diagnosed as by cerebral angiography having moyamoya disease. CT or MRI was performed to examine the location of cerebral infarction in all subjects. Cerebral blood flow and vasoreactivity to acetazolamide were measured in 80 patients before surgery, using single photon emission computed tomography (SPECT). Three-dimensional MR angiography (3D-MRA) was repeated in 32 pediatric patients after surgery in order to clarify the natural course of the PCA stenosis/occlusion. Of 264 sides in 132 patients, PCA stenosis/occlusion was observed in 50 sides of 40 patients (30.3%). Its incidence was significantly higher in ischemic-type patients than in hemorrhagic-type and asymptomatic patients, and was higher in patients in the advanced stage of the disease. The hemisphere ipsilateral to PCA stenosis/occlusion had higher incidence of ischemic symptoms, cerebral infarction, and impaired cerebral hemodynamics. Transient ischemic attack (TIA) (hemianopsia) or cerebral infarction in the occipital lobe was noted in 4 (10%) of 40 patients during follow-up periods after bypass surgery for anterior circulation. Of 32 pediatric patients, none showed progression of PCA stenosis on 3D-MRA during follow-up periods. The present study showed that the involvement of PCA could increase the risk of TIA and/or cerebral infarction in both anterior and posterior circulation areas, suggesting that the PCA plays an important collateral role in moyamoya disease. (author)

  19. Pulmonary veno-occlusive disease: an uncommon cause of pulmonary hypertension

    OpenAIRE

    Masters, Kyle; Bennett, Steven

    2013-01-01

    Pulmonary veno-occlusive disease (PVOD) is a rare and challenging cause of pulmonary hypertension. Clinical presentation is non-specific, including dyspnoea, cough and fatigue. Diagnosis of PVOD is typically based on high clinical suspicion with a definitive diagnosis confirmed by histology. Our case involves a healthy 21-year-old man who developed dyspnoea on exertion at an elevated altitude during deployment to Afghanistan. His work-up included an echocardiogram, a high-resolution CT scan, ...

  20. Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease

    OpenAIRE

    Zhou M; Huang D; Liu C; Liu Z.; Zhang M; Qiao T; Liu CJ

    2014-01-01

    Min Zhou, Dian Huang, Chen Liu, Zhao Liu, Min Zhang, Tong Qiao, Chang-Jian Liu Department of Vascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China Objective: To compare outcomes of hybrid (combined surgical and endovascular) procedures (HYBRID) with open surgical reconstructions (OPEN) in patients with multilevel infrainguinal artery occlusive diseases. Design: Case series study with retrospective analysis of pro...

  1. 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

    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...... dysfunction and a longer length of stay in patients with aortic aneurysm compared with aortic occlusive disease. DESIGN: Cohort observational study based on prospective registrations from national databases. SETTING: Eight Danish hospitals, including four university and four non-university centres, from 1...... or inotropes, ICU stay more than 24 h, hospital length of stay and mortality. RESULTS: Compared with aortic occlusive disease, more patients with aortic aneurysm disease had ICU stays more than 24 h (62 vs. 45%, P ...

  2. S5-5: Dynamic Occlusion Deficiency in Patients with Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Nam-Gyoon Kim

    2012-10-01

    Full Text Available At the core of Gibson's ecological psychology is the notion of invariant—specifically, an invariant pattern in the changing energy flux. Among the invariants identified to date are texture gradients, horizon ratio, optic flow, and tau. Gibson considered his discovery of the occluding edge the most radical because observers can perceive the layout of the environment (both unprojected and projected surfaces; and the accretion and deletion of optical texture, or dynamic occlusion, at the occluding edge resulting from observer movement produces an invariant pattern. Here I present the results of an experiment demonstrating diminished sensitivity to dynamic occlusion in Alzheimer's disease (AD that led to their reduced capacity to recover 3D shape from motion. Young controls, age-matched elderly controls, and AD patients participated in the study. Participants watched computer simulations of an object, depicted as either transparent or opaque, rotating about the vertical axis against a background rendered in random dot texture. Young controls were most accurate, followed by elderly controls and AD patients. Both control groups identified opaque objects better than transparent objects, but AD patients identified both objects equally poorly. These results demonstrate the facilitating effect of the dynamic occlusion invariant to recover 3D shape from motion, the capacity of which is severely impaired in AD.

  3. QUALITY OF LIFE IN PATIENTS WITH PERIPHERAL ARTERIAL OCCLUSIVE DISEASE ATTENDING TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Rahul J

    2013-12-01

    Full Text Available Peripheral arterial occlusive disease (PAOD is a prevalent atherosclerotic disorder characterized by exertional limb pain , loss of limband a high mortality rate.All the aspects of health status , life style , life satisfaction , mental state or well - being to gether reflect the multi - dimensional nature of Quality of Life in an individual . MATERIAL &METHODS: A cross sectional study was conducted over a period of 6 months from October 2012 to march 2013. P atients with signs and symptoms of peripheral arterial occlusive disease were ref erred for further evaluation by Color Doppler Ultrasonography to the Department of Radiodiagnosis. The evaluation of QO L in respondents with PAOD was performed , by means of WHO QOL - BREF questionnaire , after obtaining clearance from the Institution’s Ethics Committee. RESULTS: - The mean scores in each of the four domains for both men and women were found to be similar. The difference between men and women was not found to be statist ically significant for any of the four domains.The mean scores of the gangrene absent groups and gangrene present groups were found to differ significantly inthe domainsof physical (p=0.025 , psychological (p=0.031 , environmental(p=0.048and social relatio ns (p=0.017. The mean scores of the age groups of 70 years were found to differ significantly in the domains of physical (p=0.046 , psychological (p=0.037.The mean scores , of thegroups according to the Stage of PAD in accordance with Fontaine classification , were found to differ significantly in thedomains of physical (p=0.0316 , psychological (p=0.0241 , environmental(p=0.0472and social relations (p=0.0126. KEYWORDS: - Quality of life (QOL , WHOQOL BREF , Peripheral arterial occlusive disease ( PAOD

  4. Pulmonary Veno-Occlusive Disease: A Newly Recognized Cause of Severe Pulmonary Hypertension in Dogs.

    Science.gov (United States)

    Williams, K; Andrie, K; Cartoceti, A; French, S; Goldsmith, D; Jennings, S; Priestnall, S L; Wilson, D; Jutkowitz, A

    2016-07-01

    Pulmonary hypertension is a well-known though poorly characterized disease in veterinary medicine. In humans, pulmonary veno-occlusive disease (PVOD) is a rare cause of severe pulmonary hypertension with a mean survival time of 2 years without lung transplantation. Eleven adult dogs (5 males, 6 females; median age 10.5 years, representing various breeds) were examined following the development of severe respiratory signs. Lungs of affected animals were evaluated morphologically and with immunohistochemistry for alpha smooth muscle actin, desmin, CD31, CD3, CD20, and CD204. All dogs had pulmonary lesions consistent with PVOD, consisting of occlusive remodeling of small- to medium-sized pulmonary veins, foci of pulmonary capillary hemangiomatosis (PCH), and accumulation of hemosiderophages; 6 of 11 dogs had substantial pulmonary arterial medial and intimal thickening. Ultrastructural examination and immunohistochemistry showed that smooth muscle cells contributed to the venous occlusion. Increased expression of CD31 was evident in regions of PCH indicating increased numbers of endothelial cells in these foci. Spindle cells strongly expressing alpha smooth muscle actin and desmin co-localized with foci of PCH; similar cells were present but less intensely labeled elsewhere in non-PCH alveoli. B cells and macrophages, detected by immunohistochemistry, were not co-localized with the venous lesions of canine PVOD; small numbers of CD3-positive T cells were occasionally in and around the wall of remodeled veins. These findings indicate a condition in dogs with clinically severe respiratory disease and pathologic features resembling human PVOD, including foci of pulmonary venous remodeling and PCH.

  5. Pulmonary Veno-Occlusive Disease: A Newly Recognized Cause of Severe Pulmonary Hypertension in Dogs.

    Science.gov (United States)

    Williams, K; Andrie, K; Cartoceti, A; French, S; Goldsmith, D; Jennings, S; Priestnall, S L; Wilson, D; Jutkowitz, A

    2016-07-01

    Pulmonary hypertension is a well-known though poorly characterized disease in veterinary medicine. In humans, pulmonary veno-occlusive disease (PVOD) is a rare cause of severe pulmonary hypertension with a mean survival time of 2 years without lung transplantation. Eleven adult dogs (5 males, 6 females; median age 10.5 years, representing various breeds) were examined following the development of severe respiratory signs. Lungs of affected animals were evaluated morphologically and with immunohistochemistry for alpha smooth muscle actin, desmin, CD31, CD3, CD20, and CD204. All dogs had pulmonary lesions consistent with PVOD, consisting of occlusive remodeling of small- to medium-sized pulmonary veins, foci of pulmonary capillary hemangiomatosis (PCH), and accumulation of hemosiderophages; 6 of 11 dogs had substantial pulmonary arterial medial and intimal thickening. Ultrastructural examination and immunohistochemistry showed that smooth muscle cells contributed to the venous occlusion. Increased expression of CD31 was evident in regions of PCH indicating increased numbers of endothelial cells in these foci. Spindle cells strongly expressing alpha smooth muscle actin and desmin co-localized with foci of PCH; similar cells were present but less intensely labeled elsewhere in non-PCH alveoli. B cells and macrophages, detected by immunohistochemistry, were not co-localized with the venous lesions of canine PVOD; small numbers of CD3-positive T cells were occasionally in and around the wall of remodeled veins. These findings indicate a condition in dogs with clinically severe respiratory disease and pathologic features resembling human PVOD, including foci of pulmonary venous remodeling and PCH. PMID:26926086

  6. COMBINED INTRAOPERATIVE ILIAC ARTERY STENTS AND FEMORO-POPLITEAL BYPASS FOR MULTILEVEL ATHEROSCLEROTIC OCCLUSIVE DISEASE

    Institute of Scientific and Technical Information of China (English)

    刘昌伟; 管珩; 李拥军; 郑曰宏; 刘卫

    2001-01-01

    Objective. To review our preliminary experience and evaluate our early results of a combined intraoperative iliac angioplasty and stenting with infrainguinal revascularization in multilevel atherosclerotic occlusive disease.``Methods. From July 1999 to April 2000, intraoperative iliac angioplasty and stenting combined with simultaneous femoro-popliteal bypass were performed on 12 lower extremities of 10 patients suffering from multilevel atherosclerotic occlusive disease. There were 8 men and 2 women, average 72 years. The indications for procedures included disabling claudication in 3 and rest pain in 7 patients.``Results. Eleven iliac angioplasty and stent procedures combined with simultaneous 9 femoro-popliteal bypass and 3 femoro-femoral-popliteal bypass were performed in 12 limbs of 10 patients. Angioplasty and stent placement was technically successful in all patients. One contralateral femoral-popliteal bypass was failure after femorofemoral-popliteal bypass. There were no additional instances of procedural or postoperative morbidity or mortality. Mean follow-up was 5 months (range 1 ~ 10 months). During the follow-up period, one femoro-infrapoplitealgraft became occluded after 7 months and above-knee amputation was required. The cumulative primary patency rate of stented iliac arteries, femoro-femoral bypass grafts and femoro-popliteal bypass grafts were 100% ( 11 /11), 100% (3/3) and 90. 9% (10/11) in the follow-up period, respectively. The amputation rate was 8.3%(1/12).``Conclusions. Intraoperative iliac artery PTA and stent placement can be safely and effectively performed simultaneously with infrainguinal revascularization for multilevel atherosclerotic occlusive disease by skilled vascular surgeon, using a prtable C arm fluoroscopy in the operating room. Furthermore, iliac artery PTA and stenting was valuable adjunct to distal bypass either to improve inflow and outflow, or to reduce the extent of traditional surgical intervention, and also, any

  7. COMBINED INTRAOPERATIVE ILIAC ARTERY STENTSAND FEMORO-POPLITEAL BYPASS FOR MULTILEVEL ATHEROSCLEROTIC OCCLUSIVE DISEASE

    Institute of Scientific and Technical Information of China (English)

    刘昌伟; 管珩; 李拥军; 郑曰宏; 刘卫

    2001-01-01

    Objective. To review our preliminary experience and evaluate our early results of a combined intraopemtive iliac angioplasty and stenting with infrainguinal revascularization in multilevel atherosclerotic occlusive disease. Methods. From July 1999 to April 2000, intraoperative iliac angiOplasty and stenting combined with simultaneous femoro-pepliteal bypass were pedormed on 12 lower extremities of 10 patients suffering from multilevel athemsclemtic occlusive disease. There were 8 men and 2 women, average 72 years. The indicationsf or procedures included disabling claudication in 3 and rest pain in 7 patients. Results. Eleven iliac angioplasty and stem procedures combined with simultaneous 9 femoro-popliteal by-pass and 3 femoro-femoral-popliteal bypass were performed in 12 limbs of 10 patients. Angioplasty and stem placement was technically successful in all patients. One contralateral femoral-popliteal bypass was failure after femoro-femoral-popliteal bypass. There were no additional instances of procedural or postoperative morbidity or mortality. Mean follow-up was 5 months (range 1 -10 months). During the follow-up period, one femoro-infrapoplitealgraft became occluded after 7 months and above-knee amputation was required. The cumulative primary patencyrate of stented iliac arteries, femoro-femoral bypass grafts and femoro-popliteal bypass grafts were 100% (11/11), 100% (3/3) and 90. 9% (10/11) in the follow-up period, respectivdy. The amputation rate was 8. 3%(1/12). Conclusions. Intraoperative iliac artery PTA and stent placement can be safely and effectively pedormed simultaneously with infrainguinal revascularization for multilevel atherosclerotic occlusive disease by skilled vascular surgeon, using a portable C ann fluoroscopy in the operating room. Furthermore, iliac artery PTA and stenting was valuable adjunct to distal bypass either to improve inflow and outflow, or to reduce the extent of traditionalsurgical intervention, and also, any angioplasty and

  8. Short-term results of carotid stenting for the treatment of extracranial carotid occlusive disease

    Institute of Scientific and Technical Information of China (English)

    FU Wei-guo; ZHU Ting; CHEN Bin; JIANG Jun-hao; YANG Jue; SHI Zhen-yu

    2006-01-01

    @@ Carotid artery angioplasty and stenting (CAS) has been performed with increasing frequency for the treatment of extracranial carotid occlusive diseases (ECOD) in recent years. Its feasibility and safety are supported by the Stenting and Angioplasty with Protection in Patient at High Risk for Endarterectomy (SAPPHIRE) trial,1 which revealed a lower incidence of death, stroke and myocardial infarction compared with carotid endarterectomy (CEA) in high-risk patients. However, it is a pity that up to now, initial results of this endovascular procedure have yet been infrequently documented in China. This retrospective study was to analyze the short-term results of CAS to treat ECOD in a single medical center.

  9. How does subintimal angioplasty compare to transluminal angioplasty for the treatment of femoral occlusive disease?

    Science.gov (United States)

    Klimach, S G; Gollop, N D; Ellis, J; Cathcart, P

    2014-01-01

    A best evidence topic in surgery was written according to a structured protocol. The question addressed how subintimal angioplasty (SIA) compares to transluminal angioplasty (TA) for the treatment of femoral occlusive disease. One hundred and thirty two papers were found using the reported search; the 5 which represented the best evidence to answer the question are discussed. The evidence on this subject is limited; there are no randomised controlled trials (RCTs) comparing SIA to TA for pathologically equivalent lesions. However SIA remains a safe and effective alternative to surgical bypass grafting when TA cannot be performed.

  10. Multiple de novo vascular malformations in relation to diffuse venous occlusive disease: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Desal, H.A. [Hopital Laennec, University of Nantes, Department of Neuroradiology, Nantes (France); Toronto Western Hospital, Department of Medical Imaging, University Health Network, Toronto, Ont. (Canada); Lee, S.K.; Kim, B.S.; TerBrugge, K.G. [Toronto Western Hospital, Department of Medical Imaging, University Health Network, Toronto, Ont. (Canada); Raoul, S.; Tymianski, M. [Toronto Western Hospital, Department of Neurosurgery, University Health Network, Toronto, Ont. (Canada)

    2005-01-01

    Brain vascular malformations are dynamic disorders. Although mostly considered to be of congenital origin, the improvement of clinical imaging and vasculogenesis knowledge has shown that they might also result from a biological dysfunction of the remodeling process after birth. Venous occlusive disease and ishemia may represent powerful revealing triggers and support the capillary venous origin of some vascular malformations. We report a unique case of the development of multiple de novo vascular malformations (transverse sinus dural fistula and posterior fossa cavernomas) following acoustic neuroma surgery. (orig.)

  11. An autopsy case of multiple myeloma with veno-occlusive disease of the liver induced by ionizing radiation

    International Nuclear Information System (INIS)

    An autopsy case of multiple myeloma which accompanied radiation-induced veno-occlusion of the liver is presented. A 62-year-old woman with a chief complaint of low back pain was diagnosed as having multiple myeloma. Approximately one year later, the patient was treated with chemotherapy, consisting of VCR, MCNU, ADR, PSL, and CPA, and X-irradiation of 30 Gy to the bilateral trunk for medically intractable rib pain. The irradiation field included the entire liver. Six months later, she was admitted to the hospital due to abdominal distention and massive amounts of ascites. Various examinations failed to make a qualitative diagnosis. Postmortem examination revealed fibrotic occlusion of the central vein which is typical for veno-occlusion disease of the liver. This finding was restricted to the area that was not shielded, irrespective of anatomical structure, strongly suggesting radiation-induced veno-occlusion of the liver. (N.K.)

  12. Clinical utilization of microembolus detection by transcranial Doppler sonography in intracranial stenosis-occlusive disease

    Institute of Scientific and Technical Information of China (English)

    WU Xiu-juan; XING Ying-qi; WANG Juan; LIU Kang-ding

    2013-01-01

    Objective To discuss the clinical ultiliazation and significance of microembolus detection by transcranial Doppler (TCD) sonography in intracranial stenosis-occlusive disease.Data sources All related articles in this review were mainly searched from PubMed published in English from 1996 to 2012 using the terms of microembolic signal,transcranial Doppler,intracranial stenosis,stroke.Study selection Original articles and reviews were selected if they were related to the clinical utilization of microembolus detection in intracranial stenosis-occlusive disease.Results Intracranial stenosis is a significant cause of cerebral emboli,and microembolus detection by TCD sonography were widely used in exploring the mechanisms of ischemic stroke with intracranial stenosis (including the middle cerebral artery stenosis and the vertebral-basilar stenosis),evaluating the prognosis of acute stroke,evaluating the therapeutic effects,and predicting the recurrent events of stroke.Conclusion Microembolus detection by TCD sonography plays an important role in the cerebral ischemic stroke patients with intracranial stenosis.

  13. 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)

  14. 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

  15. End Stage Renal Disease as a Potential Risk Factor for Retinal Vein Occlusion.

    Science.gov (United States)

    Chen, San-Ni; Yang, Te-Cheng; Lin, Jian-Teng; Lian, Ie-Bin

    2015-11-01

    End stage renal disease (ESRD) has been reported to be an important risk factor for systemic vascular disease. Retinal vein occlusion (RVO) is closely related with cardiovascular diseases; however, its association with ESRD had not been reported. The aim of the study was to investigate whether ESRD is a risk factor for RVO, including central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). This population-based study is based on the longitudinal data from Taiwan National Health Insurance Research Database. The study cohort comprised 5344 patients with diagnosis of ESRD on hemodialysis or peritoneal dialysis during the period from January 1996 to December 2011. For each ESRD patient, we selected 20 non-ESRD patients matched on age and sex. Each ESRD patient and his/her controls were followed from the initiation of renal dialysis until either the diagnosis of RVO or censorship. Kaplan-Meier method was used to compare the hazard of RVO between cohorts. Stratified Cox proportional hazard models were applied to estimate the hazard ratio (HR) adjusted by the comorbidities of RVO including diabetes mellitus (DM), hypertension, hypercholesteremia, and hypertriglyceridemia. After stratifying by DM status, the statistics were applied again to examine the associations among the DM cohort and non-DM cohort.The 16-year RVO cumulative incidence for ESRD cohort was 2-fold to the non-ESRD (1.01% vs 0.46%). After matching with age, sex, hypertension, and hypercholesteremia, the adjusted HR was 1.46 (95% confidence interval = 1.07-2.01, P value = 0.018). By further excluding patients with DM, the adjusted HR escalated to 2.43 (95% confidence interval = 1.54-3.83, P < 0.001). In contrast, there was no significant risk of ESRD on RVO in the DM patients (HR = 1.03). We conclude that among the non-DM patients, ESRD cases had significantly higher RVO rate than the non-ESRD, which indicates that ESRD maybe a potential risk factor for the development of RVO in

  16. Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease

    Directory of Open Access Journals (Sweden)

    Zhou M

    2014-09-01

    Full Text Available Min Zhou, Dian Huang, Chen Liu, Zhao Liu, Min Zhang, Tong Qiao, Chang-Jian Liu Department of Vascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China Objective: To compare outcomes of hybrid (combined surgical and endovascular procedures (HYBRID with open surgical reconstructions (OPEN in patients with multilevel infrainguinal artery occlusive diseases. Design: Case series study with retrospective analysis of prospectively collected nonrandomized data.Methods: Between 2008 and 2012, 64 patients underwent OPEN and 43 underwent HYBRID. Patient characteristics, technique success, clinical improvement, and procedure-related morbidity were reviewed and compared. Patency rates and limb salvages were analyzed and compared using Kaplan–Meier life tables. Cox regression analyses were used to assess the influence of various risk factors on primary patency.Results: HYBRID patients were older and presented with worse New York Heart Association function compared with OPEN patients. The increase in the ankle-brachial index and improvement of Ruthford category after procedures were equivalent between two groups, but HYBRID patients had shorter hospital length of stay (7.6±12.0 versus 15.5±17.3; P= 0.018 and less overall perioperative morbidity (12% versus 28%; P=0.042 compared with OPEN patients. No statistically significant difference in 36-month primary (47.1%±7.1% versus 50.1%±9.4%; P=0.418, assisted primary (57.0%±7.9% versus 62.4%±9.2%; P=0.517, or secondary (82.0%±6.8% versus 83.1%±7.3%; P=0.445 patency was seen between the two groups. Limb salvage rates of HYBRID vs OPEN at 3 years were similar (76.3%±9.3% versus 80.4%±8.2%; P=0.579. Critical limb ischemia was a negative predictor of long-term patency of patients in both the HYBRID and OPEN groups (P=0.012 and P<0.001, respectively, and the presence of diabetes and renal insufficiency were another two independent predictors

  17. Veno-occlusive disease in children after intensive chemo- and radiotherapy and repeated halothane anesthesias

    International Nuclear Information System (INIS)

    Two cases of veno-occlusive disease (VOD) occurring in metastatic neuroblastoma patients are reported. Treatment included a remission induction by conventional chemotherapy and surgery followed by an early consolidation with massive chemotherapy, total body irradiation and cleared autologous bone marrow transplantation (ABMT). Both patients had multiple halothane anesthesias. Liver complications occurred 10 and 21 days respectively after ABMT. The first patient had a precocious and severe clinical and biological VOD, heparinotherapy and symptomatic treatment were ineffective and he died 12 days after ABMT. The second patient had a moderate and later syndrome which was controlled by heparin therapy (100 U/kg/day) delivered by continous infusion; he is now alive free of hepatic disturbance 28 months after ABMT. The potential iatrogenic factors are discussed, with special focus on the use of halogenated anesthetic drugs. (orig.)

  18. Hepatic veno-occlusive disease induced by Gymura segetum:report of two cases

    Institute of Scientific and Technical Information of China (English)

    Hui-Fen Dai; Yuan Gao; Ming Yang; Chao-Hui Yu; Zhu-Ying Gu; Wei-Xing Chen

    2006-01-01

    BACKGROUND: Hepatic veno-occlusive disease (VOD) or sinusoidal obstruction syndrome is associated with a high mortality because of its severity. Gymura segetum, a Chinese herbal medicine, is always used to cure injury and bleeding in rural areas in China. This study was undertaken to better understand VOD and its relations to the effect of Gymura segetum. METHODS: Between 2000 and 2002, two patients were admitted to our department because of VOD. Before admission, both of them had been injured and taken oral decoction of patent drug Gymura segetum. We analyzed the clinical manifestations, diagnosis and therapy of the two patients. RESULTS:Pyrrolizidine in Panax notginseng was proved to induce VOD. The diagnosis of VOD depended on hepatic biopsy. CONCLUSION: Gymura segetum can induce VOD. More attention should be paid to its unsuscepted side effects.

  19. 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....

  20. Non-invasive diagnostic modality for peripheral arterial occlusive disease in hemodialysis patients

    International Nuclear Information System (INIS)

    Peripheral arterial occlusive disease (PAOD) has impacts on mortality and quality of life of hemodialysis (HD) patients. Although ankle-brachial pressure index (ABPI) is widely used to detect PAOD as screening measurement, it yields false negative results due to calcified lesions of vascular walls. Multidetector-row computed tomography (MDCT) was performed in 36 HD patients. Then, we compared these two non-invasive methods: ABPI or skin perfusion pressure (SPP) and MDCT by calculating the sensitivity and specificity to detect PAOD. The sensitivity of ABPI was only 29.9%, while SPP was more accurate with the sensitivity of 84.9% and the specificity of 76.9%. Our findings suggest that SPP is a useful tool to detect PAOD even in HD patients. (author)

  1. Assessment of bilateral photoplethysmography for lower limb peripheral vascular occlusive disease using color relation analysis classifier.

    Science.gov (United States)

    Lin, Chia-Hung

    2011-09-01

    This paper proposes the assessment of bilateral photoplethysmography (PPG) for lower limb peripheral vascular occlusive disease (PVOD) using a color relation analysis (CRA) classifier. PPG signals are non-invasively recorded from the right and left sides at the big toe sites. With the time-domain technique, the right-to-left side difference is studied by comparing the subject's PPG data. The absolute bilateral differences construct various diminishing and damping patterns. These difference patterns in amplitude and shape distortion relate to the grades of PVOD, including the normal condition, lower-grade disease, and higher-grade disease. A CRA classifier is used to recognize the various patterns for PVOD assessment. Its concept is derived from the HSV color model and uses the hue, saturation, and value to depict the disease grades using the natural primary colors of red, green, and blue. PPG signals are obtained from 21 subjects aged 24-65 years using an optical measurement technique. The proposed CRA classifier is tested using the physiological measurements, and the tests reveal its practicality for monitoring PPG signals. PMID:20674063

  2. Micronutrients and sickle cell disease, effects on growth, infection and vaso-occlusive crisis: a systematic review.

    Science.gov (United States)

    Dekker, Louise H; Fijnvandraat, Karin; Brabin, Bernard J; van Hensbroek, Michael Boele

    2012-08-01

    Patients with Sickle cell disease (SCD) exhibit signs of poor growth, increased susceptibility to infection and recurrent episodes of painful vaso-occlusive crises. Micronutrient deficiencies may increase susceptibility to these outcomes. We conducted a systematic review to assess the strength of evidence for improved outcomes related to micronutrient interventions. Six randomized-controlled trials of moderate quality met the inclusion criteria. Zinc supplementation was associated with improved growth and decreased incidence of infection and is a promising intervention in the management of SCD patients. Omega-3 fatty acid supplementation was associated with limited reduction in vaso occlusive crises. This review identifies key knowledge gaps, which are important research priorities for nutritional interventions.

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

    International Nuclear Information System (INIS)

    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 (tmax), slope to maximum (m), vascular response after occlusion (AUCpost), 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.

  4. Occupational exposure to organic solvents: a risk factor for pulmonary veno-occlusive disease.

    Science.gov (United States)

    Montani, David; Lau, Edmund M; Descatha, Alexis; Jaïs, Xavier; Savale, Laurent; Andujar, Pascal; Bensefa-Colas, Lynda; Girerd, Barbara; Zendah, Inès; Le Pavec, Jerome; Seferian, Andrei; Perros, Frédéric; Dorfmüller, Peter; Fadel, Elie; Soubrier, Florent; Sitbon, Oliver; Simonneau, Gérald; Humbert, Marc

    2015-12-01

    Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension characterised by predominant remodelling of pulmonary venules. Bi-allelic mutations in the eukaryotic translation initiation factor 2α kinase 4 (EIF2AK4) gene were recently described as the major cause of heritable PVOD, but risk factors associated with PVOD remain poorly understood. Occupational exposures have been proposed as a potential risk factor for PVOD, but epidemiological studies are lacking.A case-control study was conducted in consecutive PVOD (cases, n=33) and pulmonary arterial hypertension patients (controls, n=65). Occupational exposure was evaluated via questionnaire interview with blinded assessments using an expert consensus approach and a job exposure matrix (JEM).Using the expert consensus approach, PVOD was significantly associated with occupational exposure to organic solvents (adjusted OR 12.8, 95% CI 2.7-60.8), with trichloroethylene being the main agent implicated (adjusted OR 8.2, 95% CI 1.4-49.4). JEM analysis independently confirmed the association between PVOD and trichloroethylene exposure. Absence of significant trichloroethylene exposure was associated with a younger age of disease (54.8±21.4 years, p=0.037) and a high prevalence of harbouring bi-allelic EIF2AK4 mutations (41.7% versus 0%, p=0.015).Occupational exposure to organic solvents may represent a novel risk factor for PVOD. Genetic background and environmental exposure appear to influence the phenotypic expression of the disease. PMID:26541523

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

    Directory of Open Access Journals (Sweden)

    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

  6. Drug-eluting stents remain the golden standard for below-the-knee occlusive disease.

    Science.gov (United States)

    Mosquera Arochena, Nilo J

    2016-10-01

    Peripheral arterial disease (PAD) is a chronic condition; an increasing number of patients affected. Infrapopliteal disease is related to critical limb ischemia (CLI). Amputation-free survival in these situations is the goal to achieve; it is well-known that life expectancy and quality of live are reduced by this condition. PAD is rarely isolated in one anatomical region when a CLI condition exists. The endovascular approach to lower limb infrapopliteal disease (BTK) has been constantly increasing in the last years trying to prevent a potential amputation. Even with the current endovascular armamentarium, BTK disease remains challenging, long and even midterm results remain uncertain. The rationale behind using drug-eluting stent (DES) at BTK is similar to other regions; deal with elastic recoil, treat potential dissections, deliver drug to the intima to prevent restenosis and reduce late lumen loss. Current evidence comprehensive review of the latest published results has been performed as well a comparison with other available reviews and meta-analyses. There is an increasing evidence for the use of DES in BTK disease, multiple platforms with different drugs had been evaluated and some good initial results had been published and presented recently. The safety of DES used in BTK occlusive has been clearly proven over the different studies performed in the last years. Good primary patency has been reported for balloon expandable DES but available studies focused on short/focal lesions. Current results support the use of DES in BTK region when a stent is necessary (bail-out) or the total lesion length is short. There is a clear benefit for primary patency, potential clinical benefits and, under these conditions, DES treatment seems to be cost-effective. Further investigation and technology improvement is required to apply these good results to longer and more diffuse lesions. PMID:27332679

  7. Protein Z polymorphisms associated with vaso-occlusive crisis in young sickle cell disease patients.

    Science.gov (United States)

    Mahdi, Najat; Abu-Hijleh, Tala M; Abu-Hijleh, Farah M; Sater, Mai S; Al-Ola, Khadija; Almawi, Wassim Y

    2012-08-01

    We investigated the association of protein Z (PZ) promoter (rs3024718, rs3024719, and rs3024731) and intron (rs3024735; G79A) SNPs with sickle cell disease (SCD) vaso-occlusive crisis (VOC). Study subjects included 239 SCD patients with VOC and 138 pain-free SCD control patients. PZ genotyping was done by allelic discrimination (real-time PCR) assays. The minor allele frequency of rs3024718 (P=0.03), rs3024719 (P=0.02), rs3024731 (Phaplotypes analysis demonstrated increased frequency of GAAA (P=0.024), AGAA (P=0.011), and GGTG (P=0.002), and reduced frequency of AGTG haplotype (P=0.001) in VOC than in steady-state control patients, thereby conferring disease susceptibility and protective nature to these haplotypes, respectively. Of these, only AGTG (P(c)=0.001) and GGTG (P(c)=0.018) remained significant after applying the Bonferroni correction. In conclusion, specific PZ variants and haplotypes are significantly associated with SCD VOC. PMID:22576309

  8. Transplantation of mobilized peripheral blood mononuclear cells for peripheral arterial occlusive disease of the lower extremity

    Institute of Scientific and Technical Information of China (English)

    Xiaofeng YANG; Yanxiang WU; Hongmei WANG; Yifeng XU; Bo XU; Xin LU; Yibin ZANG; Fa WANG; Yue ZHANG

    2006-01-01

    Objectives To assess the clinical efficacy, safety, and feasibility of autologous transplantation of mobilized peripheral blood mononuclear cells (PBMNCs) for patients with peripheral arterial occlusive disease (PAOD) of the lower extremity. Methods A total of 152 patients with PAOD of the lower extremity were enrolled into this non-controlled observational study from November 2003 to March 2006. All patients received subcutaneous injections of recombinant human granulocyte colony-stimulating factor (G-CSF, 450600 μg/day) for 5 days in order to mobilize stem/progenitor cells; their PBMNCs were collected and transplanted by multiple intramuscular injections into ischemic limbs. Patients were followed up for at least 12 weeks. Results At 12 weeks, primarymanifestations,including lower limb pain and coldness, were significantly improved in 137 (90.1%) of the patients; limb ulcers improved or healed in 46 (86.8%) of the 53 patients, while 25 of the 48 (47.9%) patients with limb gangrene remained steady or improved. Ankle-brachial index (ABI) improved in 33 (22%) of the cases, and TcPO2 increased in 45 (30%) of the cases. Angiography before treatment, and at 12 weeks after treatment, was performed in 10 of the patients and showed formation of new collateral vessels. No severe adverse effects or complications specifically related to cell transplantation were observed. Conclusion Autologous transplantation of G-CSF-mobilized PBMNCs might be a safe and effective treatment for lower limb ischemic disorder.(J Geriatr Cardiol 2006; 3:178-80.)

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

    International Nuclear Information System (INIS)

    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)

  10. Retinal artery occlusion

    Science.gov (United States)

    ... artery occlusion; Branch retinal artery occlusion; CRAO; BRAO Images Retina References Sanborn GE, Magargal LE. Arterial obstructive disease ... A.M. Editorial team. Related MedlinePlus Health Topics ... audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among ...

  11. The comparative study of 64-slices spiral CT angiography with DSA in lower extremity arterial occlusive diseases

    International Nuclear Information System (INIS)

    Objective: To study the clinical value of 64-slices spiral CTA with DSA comparatively in diagnosis of lower extremity arterial occlusive diseases. Methods: 31 patients with lower extremity arterial occlusive diseases underwent 64-slice spiral CT angiography of lower extremity arteries and they also underwent digital subtraction angiography (DSA)two weeks later. Reconstruction by maximum intensity projection (MIP), volume render (VR)and multiplanar reformatting (MPR)in working-station was undertaken comparing with the bolus chase DSA and traditional DSA for diagnostic accuracy. Results: The 216 arterial segments of lower extremity were selected, including 157 segments with consistent results in demonstrating degree of stenosis by both examinations. On CT angiography, 5 segmental stenosis were overestimated and 9 were underestimated. When stenosis of detected segments is more than 50%, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CTA were 98.21%, 96.15%, 97.22%, 96.49%, and 98.04%, respectively. Conclusion: 64-slices spiral CT angiography is an effective and reliable method for evaluating the lower extremity arterial occlusive diseases and may provide precious information for planning interventional therapy. (authors)

  12. 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.

  13. 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.

  14. Early detection of asymptomatic carotid disease in patients with arteriosclerotic occlusive disease of the lower extremities

    Directory of Open Access Journals (Sweden)

    Rančić Zoran S.

    2002-01-01

    Full Text Available Prevalence of asymptomatic carotid artery stenosis in patients with lower extremities atherosclerosis is relatively high. Limiting screening of specific subgroups for any demographic or medical characteristics is ineffective. Screening for asymptomatic carotid artery stenosis is indicated in all patients with lower extremities atherosclerosis except in whom prophylactic carotid endarterectomy is not recommended because of comorbid disease or extreme age.

  15. 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.

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

    International Nuclear Information System (INIS)

    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

  17. Heel-rise test in the assessment of individuals with peripheral arterial occlusive disease

    Directory of Open Access Journals (Sweden)

    Monteiro DP

    2013-01-01

    Full Text Available Débora Pantuso Monteiro,1 Raquel Rodrigues Britto,2 Ana Clara Ribeiro Lages,3 Marluce Lopes Basílio,3 Monize Cristine de Oliveira Pires,3 Maria Luiza Vieira Carvalho,1 Ricardo Jayme Procópio,4 Danielle Aparecida Gomes Pereira21Rehabilitation Sciences of the Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil; 2Physiotherapy Department of the School of Physical Education, Physiotherapy and Occupational Therapy of the Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil; 3Private Practice, Belo Horizonte-MG, Brazil; 4Hospital das Clínicas of the Universidade Federal de Minas Gerais, Belo Horizonte-MG, BrazilIntroduction: The Heel-Rise Test (HRT is a clinical instrument relevant to vascular rehabilitation that has been proposed to assess the function of the triceps surae muscle. To use HRT in the assessment of individuals with peripheral arterial occlusive disease (PAOD, its ability to detect differences in the functional performance of patients with PAOD must be verified.Aim: To verify whether the test is sensitive in differentiating between individuals with PAOD with distinct functional capacities.Materials and methods: A transversal study in which individuals with PAOD were assessed using the HRT, the Walking Impairment Questionnaire (WIQ, and the Shuttle Walk Test. The following variables were analyzed: number of plantar flexions performed in the HRT (time in seconds and velocity (plantar flexions per second when performing plantar flexions up to the point of volunteer fatigue, maximum distance walked in the Shuttle Walk Test, and scores obtained in each WIQ domain.Results: Twenty-five individuals (14 male were included in the study, with a mean age of 63.36 ± 9.83 years. The variables number of plantar flexions and time to perform the HRT were sensitive enough to differentiate between distinct functional capacities in individuals with PAOD (P = 0.003 and P = 0.009, respectively. However, this result was not found

  18. Surgical Revascularization Reverses Cerebral Cortical Thinning in Patients With Severe Cerebrovascular Steno-Occlusive Disease

    NARCIS (Netherlands)

    Fierstra, Jorn; MacLean, David B.; Fisher, Joseph A.; Han, Jay S.; Mandell, Daniel M.; Conklin, John; Poublanc, Julien; Crawley, Adrian P.; Regli, Luca; Mikulis, David J.; Tymianski, Michael

    2011-01-01

    Background and Purpose-Chronic deficiencies in regional blood flow lead to cerebral cortical thinning without evidence of gross tissue loss at the same time as potentially negatively impacting on neurological and cognitive performance. This is most pronounced in patients with severe occlusive cerebr

  19. 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.

  20. 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.

  1. Endovascular treatment of superficial femoral artery occlusive disease with stents coated with diamond-like carbon

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, O. E-mail: schaefer@mrs1.ukl.uni-freiburg.de; Lohrmann, C.; Winterer, J.; Kotter, E.; Langer, M

    2004-12-01

    A major consideration in the reduction of early stent thrombosis and in-stent restenosis is the improvement of biocompatibility of the devices. Diamond-like carbon is a novel material for coating stent surfaces in order to increase biocompatibility. The authors report on the endovascular treatment of two individuals with superficial femoral artery occlusions, using stents coated with diamond-like carbon. Technical and clinical success was achieved in both cases, with primary patency rates of 100% 12 months after intervention.

  2. Endovascular treatment of superficial femoral artery occlusive disease with stents coated with diamond-like carbon

    International Nuclear Information System (INIS)

    A major consideration in the reduction of early stent thrombosis and in-stent restenosis is the improvement of biocompatibility of the devices. Diamond-like carbon is a novel material for coating stent surfaces in order to increase biocompatibility. The authors report on the endovascular treatment of two individuals with superficial femoral artery occlusions, using stents coated with diamond-like carbon. Technical and clinical success was achieved in both cases, with primary patency rates of 100% 12 months after intervention

  3. 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.

  4. Hemorheological risk factors of acute chest syndrome and painful vaso-occlusive crisis in children with sickle cell disease. : Blood rheology in sickle cell disease

    OpenAIRE

    Lamarre, Yann; Romana, Marc; Waltz, Xavier; Lalanne-Mistrih, Marie-Laure; Tressières, Benoît; Divialle-Doumdo, Lydia; Hardy-Dessources, Marie-Dominique; Vent-Schmidt, Jens; Petras, Marie; Broquere, Cedric; Maillard, Frederic; Tarer, Vanessa; Etienne-Julan, Maryse; Connes, Philippe

    2012-01-01

    International audience BACKGROUND: Little is known about the effects of blood rheology on the occurrence of acute chest syndrome and painful vaso-occlusive crises in children with sickle cell anemia and hemoglobin SC disease. DESIGN AND METHODS: To address this issue, steady-state hemorheological profiles (blood viscosity, red blood cell deformability, aggregation properties) and hematologic parameters were assessed in 44 children with sickle cell anemia and 49 children with hemoglobin SC ...

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

    Energy Technology Data Exchange (ETDEWEB)

    Kamano, Hironori; Yoshiura, Takashi; Hiwatashi, Akio; Abe, Koichiro; Yamashita, Koji; Honda, Hiroshi [Dept. of Clinical Radiology, Graduate School of Medical Sciences, Kyushu Univ., Fukuoka (Japan)], e-mail: tsu@radiol.med.kyushu-u.ac.jp; Togao, Osamu [Dept. of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu Univ., Fukuoka (Japan)

    2013-02-15

    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 {sup 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

  6. [Interpretation and consideration of the Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities management of asymptomatic disease and claudication].

    Science.gov (United States)

    Shen, Chenyang; Li, Weihao

    2016-02-01

    Atherosclerotic occlusive disease of the lower extremities (ASO-LE) has the third highest rate among systematic atherosclerosis obliterans, ranking after coronary heart disease and stoke, and the disease burden of ASO-LE has been continuously increasing. Invasive revascularizations, which is presented by endovascular therapy technique, has undergone a dramatic development in the past couples of decades. However, controversy concerned about the surgical management and operative indications has heated up in the meanwhile. Thus Society for Vascular Surgery (SVS) published the practice guidelines for ASO-LE with asymptomatic disease and claudication in March, 2015. At the first time the guideline definitely opposed the aggressive invasive revascularization for ASO-LE patients with asymptomatic disease or claudication under satisfied tolerance. Instead, it posed the extreme emphasis on the pharmacotherapy with risk reduction of atherosclerosis at the core and the exercise therapy with supervised or home-based exercise program at the core for ASO-LE patients with asymptomatic disease and claudication.

  7. 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......Analysis of cerebral autoregulation by measuring spontaneous oscillations in the low frequency spectrum of cerebral cortical vessels might be a useful tool for assessing risk and investigating different treatment strategies in carotid artery disease and stroke. Near infrared spectroscopy (NIRS...... analysis ABP-oxyHb phase shift and gain as well as inter-hemispheric phase shift and amplitude ratio were assessed. We found that inter-hemispheric amplitude ratio was significantly altered in hypoperfusion patients compared to healthy controls (P = 0.010), because of relatively lower amplitude...

  8. 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.

  9. CABG surgery in a patient with left iliac artery occlusion

    Directory of Open Access Journals (Sweden)

    Oscar F. De La Peña Brush

    2015-09-01

    Full Text Available We present the case of an 82 years old male with Congestive Heart Failure (Left Ventricle Ejection Fraction: 20% and Acute Pulmonary Edema secondary to Acute Myocardial Infarction that required Coronary Artery Bypass Graft (CABG surgery. Past Medical History included Aortoiliac Occlusive Ddisease with total occlusion of the Left Iliac Artery and collateral circulation to the left inferior limb through the Left Internal Mammary Artery (LIMA. CABG was perfomed without harvesting the LIMA due to high risk of leg ischemia. An attempt to revascularize the left limb previous to the cardiac surgery in other to do so. Would have been too risky in this case. After 2 months follow up, patient showed good clinical outcomes.

  10. Hyperbaric oxygenation effects determination in the therapy of chronic occlusive lower extremities arteries disease by the use of perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Zoranović Uroš

    2010-01-01

    Full Text Available Background/Aim. Hyperbaric oxygenation (HBO is a medical treatment of a patient with 100% oxygen inspiration under the pressure higher than atmospheric in a special unit designed to let the whole patient's body rest in a chamber. The aim of the study was to determine the effect of the application of HBO treatment on the patient's lower extremities with chonic inoperabile occlusive disease by measning the parameters of perfusion scintigraphy (perfusion reserve, relative perfusion. Methods. This investigation included 22 patients (19 males and 3 famales. Following clinical assessment of lower extremities condition according to the skin appearance and its adnexa, claudication distance was performed. Clinical condition was graded by the use of 5-point nominal scale. In all of the patients 99mTctetraphosmine lower extremities scintigraphy was done ten days prior to the treatment start and ten days after the treatment with HBO. Lower legs were imaged from the posterior view. Prior to imaging the patients were obligatory lying approximately half an hour. Results. In 18 (86% of the patients there was an improvement manifested as better subjective condition and better skin and its adnexa appearance. Following HBO treatment there was a statistically significant change in collecting the radiopharmac at rest. This finding indicates an increased viability of muscles as well as an increased perfusion reserve. Perfusion reserve mean values increased from 39.99 to 50.86%, and from 38.46 to 49.33% for the right and the left lower leg, respectively. This parameter clearly indicates favorable effects of HBO treatment pertaining neoangiogenesis and, consequently, increased viability of the lower leg muscles. It was also obvious in visual analysis of the obtained images. Conclusion. The obtained results confirm that muscle perfusion measured by the parameters of perfusion scintigraphy using 99mTc-tetrophosmine (perfusion reserve, relative perfusion in patients with

  11. High b-value diffusion tensor imaging of unilateral middle cerebral artery occlusive disease: evaluation of white matter injury

    International Nuclear Information System (INIS)

    Objective: To investigate the value of diffusion tensor imaging (DTI) at high b value for unilateral middle cerebral artery (MCA) occlusive disease in patients without obvious infarct lesions on conventional MR imaging. Methods: DTI at high b value (2200 s/mm2) was performed using a 3.0 Tesla MR scanner in 34 patients with unilateral middle cerebral artery occlusion, who had no obvious infarct lesions on conventional MR imaging. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (eigenvalue λ1) and radial diffusivity (eigenvalues λ2, λ3) were measured at the ipsilateral and contralateral corona radiata, anterior and posterior limbs of the internal capsule, cerebral peduncle and pons in all subjects. Mean ADC, FA, λ1, λ2 and λ3 values of corona radiata, anterior and posterior limbs of the internal capsule, cerebral peduncle and pons were compared between the ipsilateral and contralateral MCA territory by t test. Results: Among the 34 patients, left MCA occlusion in M1 segment occurred in 16 patients and right MCA occlusion in Ml segment occurred in 18 patients. At the ipsilateral corona radiata, mean FA, ADC, λ1, λ2 and λ3 were 0.419 ±0.032, (5.975 ±0.272) × 10-3, (5.704 ±0.365) ×10-3, (6.412 ±0.368) × 10-3 and (6.605 ±0.343) × 10-3 mm2/s, respectively. At the contralateral corona radiata, mean FA, ADC, λ1, λ2 and λ3 were 0.443 ± 0.033, (5.804 ± 0.282) × 10-3,(5.651 ±0.350) × 10-3, (6.099 ±0.353) × 10-3 and (6.372 ±0.355) × 10-3 mm2/s, respectively. At the ipsilateral corona radiata, mean FA was significantly decreased (t=11.614, P<0.01), and mean ADC (t=12.421, P<0.01), λ1 (t=7.447, P<0.01), λ2 (t=10.244, P<0.01) and λ3 (t=9.890, P<0.01) were significantly increased. At the ipsilateral anterior and posterior limb of the internal capsule,mean FA were 0.609 ±0.026 and 0.674 ±0.033, λ1 were (5.330 ±0.462) × 10-3 and(5.171 ±0.456) ×10-3 mm2/s, respectively. At the contralateral anterior and

  12. Ultrasound contrast-agent improves imaging of lower limb occlusive disease

    DEFF Research Database (Denmark)

    Eiberg, J P; Hansen, M A; Jensen, F;

    2003-01-01

    to evaluate if ultrasound contrast-agent infusion could improve duplex-ultrasound imaging of peripheral arterial disease (PAD) and increase the agreement with digital subtraction arteriography (DSA).......to evaluate if ultrasound contrast-agent infusion could improve duplex-ultrasound imaging of peripheral arterial disease (PAD) and increase the agreement with digital subtraction arteriography (DSA)....

  13. 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.

  14. Three-dimensional CT angiographic assessment of pelvic and lower-extremity occlusive disease using single detector-row and multidetector-row CT scanners

    International Nuclear Information System (INIS)

    Three-dimensional CT angiography (3D-CTA) using a single detector-row CT (SDCT) scanner has become an important technique in the evaluation of the vascular system. A multidetector-row CT (MDCT) scanner, that is, a more advanced CT scanner which can acquire up to four channels of data simultaneously, has been recently introduced. With the use of this robust CT scanner, it is expected that more efficient 3D-CTAs will be obtained thanks to the superior temporal and spatial resolution provided by this technology. The purpose of this study was to assess the usefulness of 3D-CTA reconstructed from the data sets obtained using both SDCT and MDCT scanners, and to evaluate new software which was originally developed for the assessment of vascular wall pathology and vessel tortuosity. Twenty patients with pelvic arterial occlusive disease underwent 3D-CTA using a SDCT scanner. For stenoses and occlusions, 3D-CTA had a sensitivity of 93%, and a specificity of 89% as compared to digital subtraction angiography. Long anatomical range 3D-CT angiographic evaluations, from the pelvic artery to the lower legs, were performed in five patients with peripheral arterial occlusive disease using an MDCT scanner. All significant stenoses and occlusions were nicely depicted by the 3D-CTAs using the MDCT scanner. A new method for semiautomatically produced, curvedplanar reconstructed images along the vessel length based on a virtual CT endoscopic technique (CEV-CPR method) provided smoothly reformatted longitudinal images of the vessel. Using a new technique for assessing vessel tortuosity, we were able to quantitatively evaluate vessel tortuosity by calculating vessel curvature. In conclusion, 3D-CTA using SDCT and MDCT scanners and newly developed software provided useful qualitative and quantitative information concerning vascular pathology in patients with pelvic and lower-extremity occlusive disease. (author)

  15. Concomitant Superior Mesenteric, Celiac, Renal, and Aortoiliac Aneurysm; Ultrasonography, CT and MRA Findings in A Case Report

    Directory of Open Access Journals (Sweden)

    S. A. Nabavizadeh

    2008-01-01

    Full Text Available Introduction: Visceral artery aneurysms are rare vas-cular diseases whose pathogenesis and natural history remain incompletely understood. Herein we describe an 80 year-old man with concomitant superior mes-enteric, celiac, renal, and aorto-iliac aneurysms. To the best of our knowledge this constellation of arte-rial aneurysms has not been described yet."nCase Presentation: An 80-year-old man was referred to our institution due to presence of tarry stool and one episode of vomiting of coffee ground material. The patient underwent an upper GI endoscopy which revealed esophageal varicosities. Due to presence of esophageal varicosities and clinical suspicion of portal vein thrombosis an ultrasonographic Doppler study of portal venous system was performed in this patient which revealed normal diameter and flow in portal and splenic veins with no evidence of thrombosis; however incidentally aneurismal dilatation of celiac and superior mesenteric arteries and lower part of abdominal aorta and both iliac arteries were found during the ultrasonographic examination. Abdominal CT scan was performed in this patient, which re-vealed aneurismal dilatation of main celiac artery and its main branches. There was also aneurismal dilata-tion of superior mesenteric artery. Aneurismal dilata-tion of distal abdominal aorta with extension to both side common, external, and internal iliac arteries was also seen. MRA of abdomen was also performed which revealed the previous findings plus apparent dilatation of proximal part of right main renal artery which was not considered in previous abdominal CT scan. Since then; he has remained asymptomatic and stable, with no evidence of further expansion of his aneurysms in routine sonographic examinations."nDiscussion: Our patient was a hypertensive hyperlip-idemic old man with history of previous TIA and atherosclerotic carotid plaques, so the most important predisposing factor seemed to be atherosclerosis. Sev-eral work

  16. 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. PMID:27594906

  17. 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. PMID:27594906

  18. 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.

  19. 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.)

  20. 3D multislice CT angiography for the assessment of relevant stenoses in patients with peripheral artery occlusive disease

    International Nuclear Information System (INIS)

    Method/Materials: For this study we examined 31 patients with peripheral artery occlusive disease. All patients received a multislice helical CT angiography and arterial digital subtraction angiography. Multislice CT angiography was performed with a Somatom Plus 4 Volume Zoom (Siemens, Erlangen, Germany). After test bolus injection of 20 ml Ultravist 370 (Schering AG, Berlin) additional 150 ml were applied with a flow rate of 3 ml/sec and a scan delay between 20-35 sec depending on individual blood circulation time. Collimation was 4x2.5 mm with a pitch of 6. Reconstructed slice thickness was 3 mm. 3D reconstructions of arteries of pelvic and lower extremity arteries were performed in volume rendering technique on a 3D Virtuoso workstation (Siemens, Erlangen). Results: For the assessment of therapeutically relevant stenoses (over 50% reduction of luminal diameter) multislice CT achieved the following results compared to conventional angiography for the diagnosis of stenosis: sensitivity of 86%, specifity of 86% and an accuracy of 72%. (orig.)

  1. Three-dimensional gadolinium-enhanced MR venography to evaluate central venous steno-occlusive disease in hemodialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Gao, K.; Jiang, H.; Zhai, R.Y.; Wang, J.F.; Wei, B.J. [Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing (China); Huang, Q., E-mail: hq0713@163.com [Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing (China)

    2012-06-15

    Aim: To determine the agreement and diagnostic accuracy of three-dimensional gadolinium-enhanced magnetic resonance venography (3D-Gd-MRV) in central venous steno-occlusive disease (CVSD) in haemodialysis patients. Materials and methods: Fourteen consecutive haemodialysis patients underwent interventional procedures to evaluate or treat CVSD. 3D-Gd-MRV was performed before the procedures and the results were compared with digital subtraction angiography (DSA). Results: DSA showed >50% stenosis in all 14 patients, 13 of whom were diagnosed correctly using 3D-Gd-MRV. Moderate stenosis was missed at 3D-Gd-MRV in one case whereby the indwelling dialysis central venous catheter may have caused an artefact on the images and hindered the accuracy of the result. The sensitivity of 3D-Gd-MRV in revealing stenosis was 93% (13/14). No complications caused by contrast agent toxicity occurred in any patient. Conclusion: 3D-Gd-MRV employing a non-breath-hold technique is highly sensitive in the diagnosis of CVSD and may be an alternative technique to DSA for the visualization of central veins.

  2. Diagnostic accuracy of MR angiography in the detection of intracranial occlusive vascular lesions and usefulness of MR angiography in patients with ischemic cerebrovascular disease

    International Nuclear Information System (INIS)

    Forty-nine patients with ischemic cerebrovascular disease and twenty-six with central nervous system lesions were evaluated with three-dimensional Fourier transformation time-of-flight MRA and digital subtraction angiography (DSA). MRA and DSA were compared at the C1-C4 of the internal carotid artery (lCA), the M1-proximal site of M2 of the middle cerebral artery (MCA), and the P1-P3 of the posterior cerebral artery (PCA). Regarding to the sensitivity of MRA to occlusive vascular lesions, the overall sensitivity was satisfactory (85.7%), although sensitivity to the PCA was slightly inferior to that of MCA and ICA. Specificity was high, reaching 95% overall. Occlusive lesions were frequently detected in C2, (C3), M1, P2 (and P3). False positive findings were observed in 17 arteries; these were frequently observed in (C2), C3, (M1), the bifurcation of MCA, P2 and P3. False negative findings were observed in 5 arteries; these were observed in C2-C4, P2 and P3. Occlusive lesions were detected in 18 (36.7%) of the patients with ischemic cerebrovascular disease, and MRA was sensitive in 16 of 18 (88.9%) patients and specific in 27 of 31 (87.1%) patients. Although the sensitivity to the PCA was inferior to that of MCA and ICA, the overall sensitivity was 25 of 30 (83.3%), and was considered satisfactory. There was no significant difference in specificity among ICA, MCA and PCA. The overall specificity was high at 245 of 259 (94.6%). MRA seemed to have relatively high reliability in detecting occlusive vascular lesions around the circle of Willis. Occlusive lesions were frequently detected in C2 (and C3), M1, P2 (and P3), but special attention should be paid to interpreting MRA, because false positive and false negative findings may be observed at flexed sites. (K.H.)

  3. Diagnostic accuracy of MR angiography in the detection of intracranial occlusive vascular lesions and usefulness of MR angiography in patients with ischemic cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Todoroki, Koji [Kagoshima Univ. (Japan). Faculty of Medicine

    1996-05-01

    Forty-nine patients with ischemic cerebrovascular disease and twenty-six with central nervous system lesions were evaluated with three-dimensional Fourier transformation time-of-flight MRA and digital subtraction angiography (DSA). MRA and DSA were compared at the C1-C4 of the internal carotid artery (lCA), the M1-proximal site of M2 of the middle cerebral artery (MCA), and the P1-P3 of the posterior cerebral artery (PCA). Regarding to the sensitivity of MRA to occlusive vascular lesions, the overall sensitivity was satisfactory (85.7%), although sensitivity to the PCA was slightly inferior to that of MCA and ICA. Specificity was high, reaching 95% overall. Occlusive lesions were frequently detected in C2, (C3), M1, P2 (and P3). False positive findings were observed in 17 arteries; these were frequently observed in (C2), C3, (M1), the bifurcation of MCA, P2 and P3. False negative findings were observed in 5 arteries; these were observed in C2-C4, P2 and P3. Occlusive lesions were detected in 18 (36.7%) of the patients with ischemic cerebrovascular disease, and MRA was sensitive in 16 of 18 (88.9%) patients and specific in 27 of 31 (87.1%) patients. Although the sensitivity to the PCA was inferior to that of MCA and ICA, the overall sensitivity was 25 of 30 (83.3%), and was considered satisfactory. There was no significant difference in specificity among ICA, MCA and PCA. The overall specificity was high at 245 of 259 (94.6%). MRA seemed to have relatively high reliability in detecting occlusive vascular lesions around the circle of Willis. Occlusive lesions were frequently detected in C2 (and C3), M1, P2 (and P3), but special attention should be paid to interpreting MRA, because false positive and false negative findings may be observed at flexed sites. (K.H.)

  4. The evaluation of asymptomatic arterial occlusive disease of the legs using an exercise test.

    Directory of Open Access Journals (Sweden)

    Usui,Yoshiyuki

    1984-12-01

    Full Text Available The Doppler-derived ankle pressure index (API is a useful indicator of the necessity for peripheral vascular reconstruction of the lower extremities. But the API at rest dose not reflect the functional capacity of leg circulation, especially in the early stage of disease. Therefore, an asymptomatic but hemodynamically significant lesion in one leg is sometimes missed by pressure measurement at rest when there is a severe lesion with symptoms in the other leg. In this study, the API not only at rest but also after exercise was measured in twenty normal subjects and thirty-two patients with angiographically proven arteriosclerosis obliterans. About 60% of the patients had unilateral symptoms, although they had significant disease bilaterally. The API after exercise proved to be more sensitive than the API at rest and may be useful in assessing asymptomatic legs of such patients and determining their surgical indication.

  5. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  7. 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

    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......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...

  8. Cytomegalovirus retinitis after central retinal vein occlusion in a patient on systemic immunosuppression: does venooclusive disease predispose to cytomegalovirus retinitis in patients already at risk?

    Directory of Open Access Journals (Sweden)

    Welling JD

    2012-04-01

    Full Text Available John D Welling, Ahmad B Tarabishy, John ChristoforidisDepartment of Ophthalmology, Havener Eye Institute, Ohio State University, Columbus, OH, USAAbstract: Cytomegalovirus (CMV retinitis remains the most common opportunistic ocular infection in immunocompromised patients. Patients with immunocompromising diseases, such as acquired immunodeficiency syndrome, inherited immunodeficiency states, malignancies, and those on systemic immunosuppressive therapy, are known to be at risk. Recently, it has been suggested that patients undergoing intravitreal injection of immunosuppressive agents may also be predisposed. One previous case report speculated that there may be an additional risk for CMV retinitis in acquired immunodeficiency syndrome patients with venoocclusive disease. This case study presents a case of CMV retinitis following central retinal vein occlusion in a patient on systemic immunosuppressants.Keywords: cytomegalovirus retinitis, central retinal vein occlusion, immunosuppression, solid organ transplant, venous stasis, risk factor

  9. Less veno-occlusive disease after intravenous versus oral busulfan for autologous haematopoietic stem cell transp.l antation: the Belgian paediatric experlence

    OpenAIRE

    Huybrechts, S; Beguin, Yves; Bordon, V; DRESSE, Marie-Françoise; Dupont, S.; Ferster, A; Laureys, G.; Meyts, I.; Renard, M; Vermylen, C

    2012-01-01

    Busulfan is commonly used in preparative conditioning regimens prior to haematopoietic stem cell transplantation in children and young adults for malignant and non-malignant disorders. For many years busulfan was only available in oral form, resulting in large inter- and intra-patients variability in plasma exposure, associated with higher graft failure rate as weil as higher toxicity such as veno-occlusive disease. With the development of an intravenous formulation of busulfan, a more acc...

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

    Energy Technology Data Exchange (ETDEWEB)

    Struffert, Tobias; Engelhorn, Tobias; Richter, Gregor; Doerfler, Arnd [University of Erlangen-Nuremberg, Department of Neuroradiology, Erlangen (Germany); Koehrmann, Martin; Nowe, Tim; Schellinger, Peter D.; Schwab, Stefan [University of Erlangen-Nuremberg, Department of Neurology, Erlangen (Germany)

    2009-09-15

    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.)

  11. Non-contrast-enhanced MR angiography at 3 Tesla in patients with advanced peripheral arterial occlusive disease.

    Directory of Open Access Journals (Sweden)

    Kolja M Thierfelder

    Full Text Available PURPOSE: The aim of this study was to assess the diagnostic performance of ECG-gated non-contrast-enhanced quiescent interval single-shot (QISS magnetic resonance angiography at a magnetic field strength of 3 Tesla in patients with advanced peripheral arterial occlusive disease (PAOD. METHOD AND MATERIALS: A total of 21 consecutive patients with advanced PAOD (Fontaine stage IIb and higher referred for peripheral magnetic resonance angiography (MRA were included. Imaging was performed on a 3 T whole body MR. Image quality and stenosis diameter were evaluated in comparison to contrast-enhanced continuous table and TWIST MRA (CE-MRA as standard of reference. QISS images were acquired with a thickness of 1.5 mm each (high-resolution QISS, HR-QISS. Two blinded readers rated the image quality and the degree of stenosis for both HR-QISS and CE-MRA in 26 predefined arterial vessel segments on 5-point Likert scales. RESULTS: With CE-MRA as the reference standard, HR-QISS showed high sensitivity (94.1%, specificity (97.8%, positive (95.1%, and negative predictive value (97.2% for the detection of significant (≥ 50% stenosis. Interreader agreement for stenosis assessment of both HR-QISS and CE-MRA was excellent (κ-values of 0.951 and 0.962, respectively. As compared to CR-MRA, image quality of HR-QISS was significantly lower for the distal aorta, the femoral and iliac arteries (each with p<0.01, while no significant difference was found in the popliteal (p = 0.09 and lower leg arteries (p = 0.78. CONCLUSION: Non-enhanced ECG-gated HR-QISS performs very well in subjects with severe PAOD and is a good alternative for patients with a high risk of nephrogenic systemic fibrosis.

  12. 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.)

  13. Primary Infrarenal Aortic Stenting With or Without Iliac Stenting for Isolated and Aortoiliac Stenoses: Single-Centre Experience With Long-Term Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Tapping, C. R.; Ahmed, M.; Scott, P. M.; Lakshminarayan, R.; Robinson, G. J.; Ettles, D. F.; Shrivastava, V., E-mail: vivek.shrivastava@hey.nhs.uk [Hull Royal Infirmary, Hull and East Yorkshire Hospitals NHS Trust, Department of Radiology (United Kingdom)

    2013-02-15

    The purpose of this study was to evaluate the technical success, complications, long-term clinical outcome, and patency after primary infrarenal aortic stenting for aortic and aortoiliac stenosis. Between January 1999 and January 2006, 22 consecutive patients underwent endovascular treatment because of infrarenal aortic stenosis with and without common iliac stenosis (10 men; mean age 64 {+-} 14 years). Eleven (11 of 22) patients had an isolated aortic stenosis, whereas 11 of 22 had aortic stenosis that extended into the common iliac arteries (CIAs). Thirteen patients were Rutherford classification type 3, and 9 patients were type 4. Statistical analysis included paired Student t test and Kaplan-Meier life table analysis; p < 0.05 was considered significant. Technical and initial clinical success was achieved in all patients. There were three (14 %) procedure-related complications, which included two access-point pseudoaneurysms and one non-flow-limiting left external iliac dissection. Patients were followed-up for a mean period of 88 months (range 60-132). Mean preprocedure ankle brachial pressure indexes (ABPI) were 0.60 {+-} -0.15 (right) and 0.61 {+-} -0.16 (left). After the procedure they were 0.86 {+-} -0.07 (right) and 0.90 {+-} -0.09 (left). The increase in ABPI was significant (p < 0.05), and this continued throughout follow-up. Four (18 %) patients had recurrence of symptoms during follow-up. These occurred at 36, 48, 48, and 50 months after the original procedure. All four patients were successfully treated with repeat angioplasty procedures. There was a significant difference in primary patency between isolated aortic stenosis (100 %) and aortoiliac stenosis (60 %) (p = 0.031). Cumulative follow-up was 1920 months yielding a reintervention rate of 0.025/events/year. Primary stenting of infrarenal stenosis is safe and successful with a low reintervention rate. It should be considered as first-line treatment for patients with infrarenal aortic stenotic

  14. 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

  15. Endovascular repair of aortoiliac aneurysm with a hybrid technique to preserve pelvic perfusion

    Institute of Scientific and Technical Information of China (English)

    WU Wei-wei; JIANG Xue-ying; LIU Bao; CHEN Yu; LIU Chang-wei

    2011-01-01

    Endovascular aneurysm repair (EVAR) has been proven to be an effective and safe technique for abdominal or iliac artery aneurysm.However,for aneurysms extending to both iliac bifurcations,routine EVAR will occlude both internal iliac arteries (IIAs),which may increase the risk for pelvic ischemia.New endovascular techniques have been developed to preserve the pelvic perfusion in EVAR for such situation.This article reports an endovascular repair of an aortoiliac aneurysm with an external iliac artery (EIA) to the IIA endograft to preserve the pelvic perfusion.First,an endograft was advanced into the left IIA under the help of an inflated aortic balloon.Coils were deployed to embolize the distal type-1 endoleak from the tunnel around the endograft,and an aortouniiliac endograft and an iliac extension were deployed below the renal arteries extending to the right EIA.Finally,a right-to-left femoro-femoral artery bypass was constructed.Angiography at completion and computed tomography after 6 months demonstrated patency of all grafts and complete exclusion of the aneurysm without any endoleak.Endovascular repair with an EIA-to-IIA endograft to preserve the pelvic inflow is a feasible and effective technique for aortoiliac aneurysms.Coil embolization might be an option to repair the distal type of endoleak.The balloon assisted U-turn technique may help advance the endovascular device over a sharp-angled vessel bifurcation.

  16. 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...

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

    OpenAIRE

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

    2015-01-01

    Objectives: 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. Background: 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...

  18. 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 femoral artery segments. Rest pain or gangrene was present in 74 limbs. In 26 other limbs simultaneous aortoiliac and femoral artery reconstructions were performed. The changes in both toe and ankle pressures could be confidently predicted from the preoperative data. A predicted toe pressure of lower than...... 25 mm Hg was associated with a high probability that amputation would be required. The chances of an amputation were less than 3% if a toe pressure higher than 40 mm Hg was predicted. If the predicted ankle pressure index was lower than 0.56, there was a 90% chance that intermittent claudication...

  19. Cerebral perfusion MR imaging using FAIR-HASTE in chronic carotid occlusive disease: comparison with dynamic susceptibility contrast-perfusion MR imaging.

    Directory of Open Access Journals (Sweden)

    Ida,Kentaro

    2006-08-01

    Full Text Available 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.

  20. S3 guidelines for diagnostics and treatment of peripheral arterial occlusive disease; S3-Leitlinien zur Diagnostik und Therapie der peripheren arteriellen Verschlusskrankheit

    Energy Technology Data Exchange (ETDEWEB)

    Huppert, P. [Klinikum Darmstadt, Institut fuer Diagnostische und Interventionelle Radiologie, Darmstadt (Germany); Tacke, J. [Klinikum Passau, Institut fuer Diagnostische und Interventionelle Radiologie, Passau (Germany); Lawall, H. [SRH Klinikum Karlsbad-Langensteinbach, Innere Abteilung/Abteilung Gefaessmedizin, Karlsbad-Langensteinbach (Germany)

    2010-01-15

    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.) [German] Dieser Beitrag stellt die wesentlichsten Aspekte der im Maerz 2009 fertiggestellten neuen S3-Leitlinie zur Diagnostik und Therapie der peripheren arteriellen Verschlusskrankheit (PAVK) dar. Diese betreffen die Definition und Epidemiologie der PAVK, die Diagnostik mittels klinisch-angiologischer Methoden, apparativer angiologischer sowie bildgebender Verfahren, die Therapie mittels konservativer, interventioneller und chirurgischer Methoden sowie die Nachsorge der Patienten. In Kernaussagen werden Empfehlungen gegeben, deren Empfehlungsgrad von der wissenschaftlichen Evidenz, d. h. von den Ergebnissen klinisch-wissenschaftlicher Studien und anderer Literaturberichte abgeleitet wurde. (orig.)

  1. Bone Subtraction 3-Dimension CT Angiography Using 64-Slice Multidetector CT for the Evaluation of Steno-Occlusive Intra- and Extracranial Vascular Diseases: Comparison with Digital Subtraction Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Eun; Choi, Dae Seob; Shin, Hwa Seon; You, Jin Jong; Park, Mi Jung; Cho, Jae Min; Choi, Ho Cheol; Son, Seung Nam [Gyeongsang National University School of Medicine, Jinju (Korea, Republic of); Ryu, Jae Wook [Dept. of Radiology, Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2012-09-15

    To investigate the efficacy of bone subtraction CT angiography (BSCTA) for the evaluation of steno-occlusive intra- and extracranial vascular diseases. Fifty-six patients were examined using 64-slice multidetector CT and digital subtraction angiography (DSA). For BSCTA, both nonenhanced CT and enhanced CT angiography (CTA) data sets were obtained. The stenotic degree of each vascular segment was assessed and classified into 5 grades. With DSA as the standard, CTA images were compared. For the evaluation of the extracranial vessels, 370 arterial segments were analyzed, and the stenotic degree revealed by CTA and DSA agreed in 359 (97.0%). There was a significant correlation between CTA and DSA (Rs = 0.974). For depiction of {>=} 50% stenosis, the sensitivity, specificity, and diagnostic accuracy of BSCTA were 100%, 98.2%, and 98.6%, respectively. For the intracranial arteries, 1029 segments were analyzed, and CTA agreed with DSA in 966 (93.9%). There was a significant correlation between CTA and DSA for stenotic degree (Rs = 0.880). For the depiction of {>=} 50% stenosis, the sensitivity, specificity, and diagnostic accuracy of CTA were 100%, 95.8%, and 96.0%, respectively. In all 74 segments of disagreement, the degree of stenosis was overestimated on CTA. BSCTA is comparable to DSA for the evaluation of steno-occlusive intra- and extracranial vascular diseases. However, the stenotic degree tends to be overestimated on BSCTA, especially in cases of wall calcifications.

  2. 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

    . Relative change in blood flow in the leg during tilt was estimated by changes in arterio-venous oxygen differences and by the indicator dilution technique in nine patients. Head-up tilt caused a decrease in leg blood flow of 36% corresponding to an increase in total vascular resistance of 57%. Tilt did...... 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...

  3. Morphological, histochemical, and interstitial pressure changes in the tibialis anterior muscle before and after aortofemoral bypass in patients with peripheral arterial occlusive disease

    Directory of Open Access Journals (Sweden)

    Grigoriadis Nikolaos

    2002-02-01

    Full Text Available Abstract Background Morphological and electrophysiological studies of ischemic muscles in peripheral arterial disease disclosed evidence of denervation and fibre atrophy. The purpose of the present study is to describe morphological changes in ischemic muscles before and after reperfusion surgery in patients with peripheral occlusive arterial disease, and to provide an insight into the effect of reperfusion on the histochemistry of the reperfused muscle. Methods Muscle biopsies were obtained from the tibialis anterior of 9 patients with chronic peripheral arterial occlusive disease of the lower extremities, before and after aortofemoral bypass, in order to evaluate the extent and type of muscle fibre changes during ischemia and after revascularization. Fibre type content and muscle fibre areas were quantified using standard histological and histochemical methods and morphometric analysis. Each patient underwent concentric needle electromyography, nerve conduction velocity studies, and interstitial pressure measurements. Results Preoperatively all patients showed muscle fibre atrophy of both types, type II fibre area being more affected. The mean fibre cross sectional area of type I was 3,745 μm2 and of type II 4,654 μm2 . Fibre-type grouping, great variation in fibre size and angular fibres were indicative of chronic dennervation-reinnervation, in the absence of any clinical evidence of a neuropathic process. Seven days after the reperfusion the areas of both fibre types were even more reduced, being 3,086 μm2 for type I and 4,009 μm2 for type II, the proportion of type I fibres, and the interstitial pressure of tibialis anterior were increased. Conclusions The findings suggest that chronic ischemia of the leg muscles causes compensatory histochemical changes in muscle fibres resulting from muscle hypoxia, and chronic dennervation-reinnervation changes, resulting possibly from ischemic neuropathy. Reperfusion seems to bring the oxidative

  4. Hydrogel based occlusion systems

    OpenAIRE

    Stam, F.A.; Jackson, N.; Dubruel, P.; Adesanya, K.; Embrechts, A.; Mendes, E.; Neves, H.P.; Herijgers, P.; Verbrugghe, Y.; Shacham, Y; Engel, L.; Krylov, V.

    2013-01-01

    A hydrogel based occlusion system, a method for occluding vessels, appendages or aneurysms, and a method for hydrogel synthesis are disclosed. The hydrogel based occlusion system includes a hydrogel having a shrunken and a swollen state and a delivery tool configured to deliver the hydrogel to a target occlusion location. The hydrogel is configured to permanently occlude the target occlusion location in the swollen state. The hydrogel may be an electro-activated hydrogel (EAH) which could be ...

  5. 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. PMID:26402988

  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...... comparisons by an additive ANOVA model showed that carbogen significantly increased CBF by 7.51 + or - 1.62 ml/100 g/min while oxygen tended to reduce it by -3.22 + or - 1.62 ml/100 g/min. A separate analysis of the hemisphere contralateral to the hypoperfused hemisphere showed that carbogen significantly...

  7. Soluble CD163 in young sickle cell disease patients and their trait siblings: a biomarker for pulmonary hypertension and vaso-occlusive complications.

    Science.gov (United States)

    Tantawy, Azza Abdel Gawad; Adly, Amira Abdel Moneam; Ismail, Eman Abdel Rahman

    2012-10-01

    CD163 is expressed on cells of monocyte-macrophage lineage and is the main hemoglobin-haptoglobin receptor. Inflammation and monocyte activation are predisposing factors to vaso-occlusion and pulmonary hypertension, which are serious complications in sickle cell disease (SCD). Siblings of SCD patients may have the same pathophysiology without displaying symptoms. We assessed soluble CD163 (sCD163) levels in 60 children with SCD and 30 sickle cell trait (SCT) siblings compared with 30 healthy controls as a potential marker for disease severity and treatment response. Patients were studied stressing on the presence of pulmonary hypertension by Dopplar-Echocardiography, sickling crisis, transfusion requirements, hydroxyurea response, hematological profile, high sensitivity C-reactive protein (hs-CRP) and serum sCD163. sCD163 was significantly elevated in SCD patients and SCT siblings compared with controls and the highest levels were in untreated SCD patients (P < 0.001). sCD163 was higher in patients with pulmonary hypertension, acute chest syndrome or stroke as well as in patients who developed sickling crisis during the study period (P < 0.05). Hydroxyurea-treated patients had lower sCD163 compared with untreated patients (P < 0.001). sCD163 was positively correlated to leukocyte count, HbS, hs-CRP, pulmonary artery pressure and tricuspid regurgitant velocity whereas inversely correlated to hemoglobin and HbF levels. The cut-off value of sCD163 at 1400 ng/ml could be considered a predictor for vaso-occlusive crisis in SCD with a sensitivity of 92.3% and specificity of 94.1%. sCD163 can be considered a biomarker for pulmonary hypertension, early crisis prediction and monitoring hydroxyurea response in SCD patients. Elevated sCD163 in trait siblings could reflect increased risk of sickling in challenging situations.

  8. 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.

  9. Cognitive impairments in patients with cerebrovascular steno-occlusive disease%脑血管狭窄患者的认知功能损害

    Institute of Scientific and Technical Information of China (English)

    石丹; 冯治中; 李建军

    2012-01-01

    Objective To explore the relationship between cerebrovascular steno-occlusive disease and neuropsychological performance by cognitive function assessment.Methods Using a case-control study,45 patients with cerebrovascular steno-occlusive lesions (patient group) and 59 control subjects without cerebrovascular steno-occlusive disease were included,36 simple hypertension (hypertension group)and 34 simple diabetes mellitus subjects (diabetes mellitus group) without cerebrovascular steno-occlusive disease were also included.A battery of neuropsychological was performed in all subjects.The test battery included tests of memory,executive functions,mental speed,visuospatial ability and visuoconstructive skill,anxietas and depression.Results Patient group showed impairments in multiple cognitive domains compared with other three groups.The immediate recall of auditory verbal learning test (controls 56.8 ± 6.5 ;patient group 48.5 ± 10.1 ;hypertension group 53.5 ±9.0 ;diabetes mellitus group 55.9 ± 7.9;t =-3.57-4.822,P =0.000-0.021) were impaired seriously.Moreover,visual memory Modified Rey-Osterrieth Complex Figure Test immediate recall,long time delayed recall and executive function California cards sorting test were also impaired.Patient group was divided into two subgroups,and neuropsychological tests of these subgroups were compared.Multiple stenosis subgroup had significantly worse performance in tests of verbal memory and some executive functions than the single artery stenosis subgroup.Conclusions Cerebrovascular steno-occlusive disease was associated with poorer neuropsychological performance,which could not be explained by vascular risk factors.Multiple stenosis subgroup had lower performance levels in neuropsychological tests than simple stenosis subgroup.Ischemia or hypoperfusion caused by steno-occlusive disease might be responsible for these cognitive impairments.%目的 探讨脑血管狭窄或闭塞与认知功能损害的关系.方法 为病例对照研

  10. Zapora mrežničnih ven: Retinal vein occlusion:

    OpenAIRE

    Jaki, Polona; Mavri, Alenka; Štalc, Monika

    2011-01-01

    Retinal vein occlusion is a common disease, especially in the elderly, and is associated with significant visual morbidity, as a consequence of persistent macular oedema, macular ischemia, and in the advanced stages of the disease, due to retinal or iris neovascularisation with vitreal haemorrhages or neovascular glaucoma. There are two types of retinal vein occlusion with respect to the site of occlusion: branch retinal vein occlusion and central retinal vein occlusion. The obstruction is ma...

  11. Permanent, bilateral common carotid artery occlusion in the rat : A model for chronic cerebral hypoperfusion-related neurodegenerative diseases

    NARCIS (Netherlands)

    Farkas, Eszter; Luiten, Paul G. M.; Bari, Ferenc

    2007-01-01

    Chronic cerebral hypoperfusion has been associated with cognitive decline in aging and Alzheimer's disease. Moreover, the pattern of cerebral blood flow in mild cognitive impairment has emerged as a predictive marker for the progression into Alzheimer's disease. The reconstruction of a pathological

  12. 多功能周围血管检查与双功彩超评价下肢动脉闭塞症%Comparison of Personal Vascular Laboratory and Color Duplex Ultrasonography in Assessing Peripheral Arterial Occlusive Disease

    Institute of Scientific and Technical Information of China (English)

    朱雯霞; 陆信武; 徐科蓉; 蒋米尔

    2001-01-01

    Objective To evaluate personal vascular laboratory (PVL) and color duplex ultrasonography in detecting peripheral arterial occlusive disease. Methods Twenty nine patients with arterial occlusion were assessed by personal vascular laboratory, color duplex ultrasonography and DSA, and their results were compared. Results The accuracy of PVL in evaluating peripheral arterial occlusive disease was 73.9% compared with that of DSA. Color duplex ultrasonography and DSA for evaluating peripheral arterial occlusive disease were not significantly different. Conclusion PVL is often used as the preliminary test for peripheral arterial occlusive disease. Color duplex ultrasonography can provide accurate information for treatment of the patients.%目的评价多功能周围血管检查(personal vascular laboratory,PVL)与双功彩超在检测下肢动脉闭塞症中的优缺点和相对适应征。方法对29例下肢动脉闭塞症患者,术前应用PVL、双功彩超和动脉数字减影血管造影(DSA)的方法进行检测,并对检测结果作比较分析。结果与动脉DSA相比,PVL检测下肢动脉闭塞症的符合率为73.9%;双功彩超与动脉DSA检测下肢动脉闭塞症的结果无显著性差异。结论 PVL仍不失为诊断下肢动脉闭塞症的初步筛选方法;双功彩超可为下肢动脉闭塞症患者的治疗提供更为精确的信息。

  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)

    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. Endovascular treatment for aorto-bi-iliac artery total occlusive disease%主-双髂动脉全闭塞的介入治疗

    Institute of Scientific and Technical Information of China (English)

    王雪平; 叶炜; 马亮亮; 赫建平; 刘昌伟

    2015-01-01

    Objective To investigate the feasibility, safety and efficiency of endovascular treatment for patients with aorto-bilateral-iliac artery total occlusive disease.Methods A total of 35 patients with aorto-bi-iliac artery total occlusive disease treated with endovascular therapy in Peking Union Medical College Hospital and the First Hospital of Shijiazhuang between Jan 2012 and Dec 2013 were retrospectively analyzed.Results There were 33 males and 2 females, mean age (67 ± 6) years treated during the study period.Technical success rate was 100%.129 bare stents and 4 covered stents were implanted.There were no peri-operative death.Postoperative leg ankle brachial index (ABI) improved significantly (0.86 vs.0.28, P < 0.28).Postoperative complications occurred in 2 patients (5.7%), including brachial artery thrombosis and rupture of external iliac artery post-dilation.The mean follow-up period was 16.5 months (2-28 months).Two patients (5.7%) were lost to follow up.Re-intervention was performed in 3 patients (8.6%) due to reocclusion of the stents.Primary patency was 91% (30/33) Conclusions Endovascular treatment is effective for aorto-bi-iliac artery total occlusive disease with low complications and acceptable mid-term patent rate.%目的 探讨介入治疗主-双髂动脉全闭塞性病变的可行性、安全性及疗效.方法 回顾性分析2012年1月至2013年12月北京协和医院和石家庄市第一医院采用介入治疗主-双髂动脉全闭塞性疾病35例患者的临床资料,评价其治疗的可行性、安全性及近中期疗效.结果 本组35例,男33例,女2例,平均年龄(67 ±6)岁.手术成功率100%,共置入裸支架129枚,覆膜支架4枚.无围手术期死亡,术后下肢踝肱指数(ABI)0.86 ±0.18,较术前0.28 ±0.17明显改善(P<0.001).围手术期并发症2例,肱动脉血栓和髂动脉扩张后破裂各1例,发生率为5.7%.术后随访2 ~ 28个月,平均随访(16.5±2.3)个月,2例(5.7%)失访,3例(8.6%)

  15. Occlusive thrombi arise in mammals but not birds in response to arterial injury: evolutionary insight into human cardiovascular disease

    OpenAIRE

    Schmaier, Alec A.; Stalker, Timothy J.; Runge, Jeffrey J.; Lee, Dooyoung; Nagaswami, Chandrasekaran; Mericko, Patricia; Chen, Mei; Cliché, Simon; Gariépy, Claude; Brass, Lawrence F.; Hammer, Daniel A.; Weisel, John W.; Rosenthal, Karen; Kahn, Mark L.

    2011-01-01

    Mammalian platelets are small, anuclear circulating cells that form tightly adherent, shear-resistant thrombi to prevent blood loss after vessel injury. Platelet thrombi that form in coronary and carotid arteries also underlie common vascular diseases such as myocardial infarction and stroke and are the target of drugs used to treat these diseases. Birds have high-pressure cardiovascular systems like mammals but generate nucleated thrombocytes rather than platelets. Here, we show that avian t...

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  17. 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...

  18. 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...

  19. Hydrogel based occlusion systems

    NARCIS (Netherlands)

    Stam, F.A.; Jackson, N.; Dubruel, P.; Adesanya, K.; Embrechts, A.; Mendes, E.; Neves, H.P.; Herijgers, P.; Verbrugghe, Y.; Shacham, Y.; Engel, L.; Krylov, V.

    2013-01-01

    A hydrogel based occlusion system, a method for occluding vessels, appendages or aneurysms, and a method for hydrogel synthesis are disclosed. The hydrogel based occlusion system includes a hydrogel having a shrunken and a swollen state and a delivery tool configured to deliver the hydrogel to a tar

  20. Development of radiolabelled compound using reactor producted RI - Evaluation of Ho-166 endovascular therapy to prevent restenosis after PTCA or stenting for occlusive coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Hee; Choi, Byung Il; Kim, Han Soo [Ajou University, Suwon (Korea)

    2000-04-01

    Occlusive coronary artery disease is managed successfully by percutaneous transfemoral coronary angioplasty (PTCA) or stenting with 95% success rate. However, restenosis after PTCA is not uncommon and the reported incidence of reocclusion is about 30 {approx} 40%. Therefore, the objective of the research was to develop endovascular brachytherapy using liquid form of Ho-166 in order to inhibit neointimal hyperplasia responsible for restenosis following PTCA or stenting. Our research was carried out in 3 stages: First stage - The effectiveness of radiation was confirmed by using animal model. Following over-sized balloon injury to rat carotid artery and porcine coronary artery, various external radiation doses were delivered. Second stage - For radiation dose distribution within the coronary artery and its surrounding tissues, Gafchromic film was used. In vitro dose distribution of Ho-166 utilizing water phantom and Gafchromic film was measured. Third stage - None uniform dose distribution from Ho-166 within the balloon caused by small air bubbles was eliminated by negative suction method. More accurate dose distribution was also possible using newly developed micrometer by our physicist. Limited number of human trial was performed without adverse effect. 40 refs. (Author)

  1. Spontaneous occlusion of the circle of Willis in a young woman with epilepsy: epileptic-type moyamoya disease

    OpenAIRE

    Shrivastava, Makardhwaj Sarvadaman; Khullar, Vikas; Singh, Mini; Haneef, Mohammed; Nag, Nalin

    2012-01-01

    The authors report a case of a 31-year-old woman from India with history of seizure disorder who presented with sudden onset right hemiparesis and right-sided upper motor neuron type facial palsy. No identifiable risk factors were noted on admission and all laboratory investigations were negative. MR angiography helped in arriving at the diagnosis of moyamoya disease as the aetiology of her symptoms.

  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. PMID:20938213

  3. 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

  4. 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...

  5. T2’-Imaging to Assess Cerebral Oxygen Extraction Fraction in Carotid Occlusive Disease: Influence of Cerebral Autoregulation and Cerebral Blood Volume

    Science.gov (United States)

    Deichmann, Ralf; Pfeilschifter, Waltraud; Hattingen, Elke; Singer, Oliver C.; Wagner, Marlies

    2016-01-01

    Purpose Quantitative T2'-mapping detects regional changes of the relation of oxygenated and deoxygenated hemoglobin (Hb) by using their different magnetic properties in gradient echo imaging and might therefore be a surrogate marker of increased oxygen extraction fraction (OEF) in cerebral hypoperfusion. Since elevations of cerebral blood volume (CBV) with consecutive accumulation of Hb might also increase the fraction of deoxygenated Hb and, through this, decrease the T2’-values in these patients we evaluated the relationship between T2’-values and CBV in patients with unilateral high-grade large-artery stenosis. Materials and Methods Data from 16 patients (13 male, 3 female; mean age 53 years) with unilateral symptomatic or asymptomatic high-grade internal carotid artery (ICA) or middle cerebral artery (MCA) stenosis/occlusion were analyzed. MRI included perfusion-weighted imaging and high-resolution T2’-mapping. Representative relative (r)CBV-values were analyzed in areas of decreased T2’ with different degrees of perfusion delay and compared to corresponding contralateral areas. Results No significant elevations in cerebral rCBV were detected within areas with significantly decreased T2’-values. In contrast, rCBV was significantly decreased (pperfusion delay and decreased T2’. Furthermore, no significant correlation between T2’- and rCBV-values was found. Conclusions rCBV is not significantly increased in areas of decreased T2’ and in areas of restricted perfusion in patients with unilateral high-grade stenosis. Therefore, T2’ should only be influenced by changes of oxygen metabolism, regarding our patient collective especially by an increase of the OEF. T2’-mapping is suitable to detect altered oxygen consumption in chronic cerebrovascular disease. PMID:27560515

  6. 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.

  7. Cilostazol attenuates the severity of peripheral arterial occlusive disease in patients with type 2 diabetes: the role of plasma soluble receptor for advanced glycation end-products.

    Science.gov (United States)

    Liu, Jhih-Syuan; Chuang, Tsung-Ju; Chen, Jui-Hung; Lee, Chien-Hsing; Hsieh, Chang-Hsun; Lin, Tsung-Kun; Hsiao, Fone-Ching; Hung, Yi-Jen

    2015-08-01

    Recent studies have demonstrated that the plasma soluble receptor for advanced glycation end-products (sRAGE) play a major role in developing macrovascular complications of type 2 diabetes, including peripheral arterial occlusion disease (PAOD). Cilostazol is an antiplatelet, antithrombotic agent, which has been used for the treatment of PAOD. We hypothesized that cilostazol attenuates the severity of PAOD in patients with type 2 diabetes through the augmentation of plasma sRAGE. Ninety type 2 diabetic patients with PAOD defined as intermittent claudication with ankle-brachial index (ABI) ≦0.9 were recruited for an open-labeled, placebo-controlled study for 52 weeks with oral cilostazol 100 mg twice daily (n = 45) or placebo (n = 45). Fasting plasma sRAGE, endothelial variables of E-selectin, soluble vascular cell adhesion molecule-1 (sVCAM-1), and inflammatory markers of high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor-α (TNF-α) were determined. After completely the 52-week treatment program, the ABI values were elevated in cilostazol group (P < 0.001). The plasma sRAGE was significantly increased (P = 0.007), and hsCRP, sVCAM, and E-selectin concentrations were significantly decreased (P = 0.028, <0.001 and <0.001, respectively) with cilostazol treatment. In a partial correlation analysis with adjustments for sex and age, the net change of sRAGE significantly correlated with the change of ABI in the cilostazol group (P = 0.043). In a stepwise multiple regression model, only the change with regards to sRAGE was significantly associated with the change of ABI (P = 0.046). Our results suggest that cilostazol may effectively attenuate the severity of PAOD in patients with type 2 diabetes. Plasma sRAGE plays a role as an independent predictor for improving the index of PAOD. PMID:25666934

  8. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-09-01

    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 by-pass 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.

  10. Defibrotide for Treatment of Severe Veno-Occlusive Disease in Pediatrics and Adults: An Exploratory Analysis Using Data from the Center for International Blood and Marrow Transplant Research.

    Science.gov (United States)

    Strouse, Christopher; Richardson, Paul; Prentice, Grant; Korman, Sandra; Hume, Robin; Nejadnik, Bijan; Horowitz, Mary M; Saber, Wael

    2016-07-01

    Veno-occlusive disease (VOD) is an early and serious complication of hematopoietic cell transplantation (HCT) that is associated with inferior survival, particularly when it is complicated by multiorgan failure (severe VOD). We evaluated the efficacy of defibrotide in the treatment of severe VOD using observational data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Eight thousand three hundred forty-one patients treated by HCT between 2008 and 2011 were identified from the CIBMTR clinical database; 3.2% met criteria for VOD and 1.2% met criteria for severe VOD. Patients with a diagnosis of VOD as reported to the CIBMTR by their transplanting centers, who had no prior history of cirrhosis, and who had a maximum total bilirubin level > 2.0 mg/dL by day +100 post-HCT were selected for study. Severe VOD was defined as VOD occurring in the setting of renal impairment requiring dialysis or any noninfectious pulmonary abnormality. Patients with severe VOD were divided into 2 groups for analysis: those treated with defibrotide (n = 41) and those not treated with defibrotide (n = 55). Patients in the nondefibrotide group were older, were more likely to be male, were more likely to have a history of previous fungal infection, and had a higher proportion of clinically significant pre-existing disease or organ impairment. Survival rate at day +100 was 39% (95% CI, 24.8% to 54.3%) in patients receiving defibrotide and 30.9% (95% CI, 19.5% to 43.6%) in those not receiving defibrotide. Resolution rate of VOD at day +100 was 51% in the defibrotide group and 29% in the nondefibrotide group (difference, 22.1%; 95% CI, 2.6% to 42%). The results of our study are consistent with previously reported experiences with defibrotide, confirm the poor outcome of this syndrome, and suggest defibrotide is effective in the treatment of severe VOD.

  11. Retrograde Approach Using Surgical Cutdown Technique for Limb Salvage in a Case of Critical Limb Ischemia With Severely Calcified Tibial Occlusive Disease.

    Science.gov (United States)

    Shiraki, Tatsuya; Iida, Osamu; Suemitsu, Kotaro; Tsuji, Yoriko; Uematsu, Masaaki

    2016-05-01

    We here report a successful angioplasty for tibial artery occlusion using direct tibial puncture and subsequent retrograde approach under surgical cutdown technique. An 82-year-old man with ulcer/gangrene in first and second digits was referred to our hospital for endovascular therapy (EVT) of lower extremity ischemia. Diagnostic angiogram revealed anterior tibial artery (ATA) occlusion with severe calcification. Subintimal angioplasty was attempted using a 0.014-inch hydrophilic guidewire but was unsuccessful. A retrograde approach was subsequently attempted for ATA recanalization. However, because of severe calcification of dorsal pedis artery (DPA), percutaneous distal puncture was also unsuccessful. Direct puncture under surgical cutdown technique for DPA was subsequently performed and was successful. A 0.014-inch hydrophilic wire was advanced in retrograde fashion across the ATA occlusion and was used to access the microcatheter positioned at the proximal ATA via antegrade approach. Angioplasty of the ATA occlusion was performed using a 2.5-/3.0-mm tapered balloon. Completion angiogram revealed restoration of flow without dissection. Skin perfusion pressure was dramatically improved. Complete wound healing was achieved 5 months after EVT. PMID:27207678

  12. PERIPHERAL ARTERIAL DISEASE IN THE LEG

    Directory of Open Access Journals (Sweden)

    Nair P

    2014-09-01

    Full Text Available INTRODUCTION: Peripheral arterial disease (PAD is a condition characterized by atherosclerotic occlusive disease of the lower extremities. While PAD is a major risk factor for lower-extremity amputation, it is also accompanied by a high likelihood for symptomatic cardiovascular and cerebrovascular disease. Atherosclerosis accounts for more than 90% of cases of PAD, and uncommon vascular syndromes account for the remaining 10%. The femoral and popliteal arteries are affected in 80% to 90% of symptomatic PAD patients, the tibial and peroneal arteries in 40% to 50%, and the aortoiliac arteries in 30%.Although 65–75% of patients with PAD are asymptomatic, the classic presenting symptom is usually described as muscle cramps, fatigue or pain in the lower legs induced by exercise and rapidly relieved by rest; often the symptom location indicates the level of arterial involvement. RISK FACTORS: Diabetes and smoking are the strongest risk factors for PAD. Other well-known risk factors are advanced age, hypertension, and hyperlipidemia. DIAGNOSIS: PAD can be easily and accurately diagnosed by calculating the ankle-brachial index (ABI.The ABI is defined as the ratio of the systolic blood pressure in the ankle divided by the systolic blood pressure at the arm. The tools required to perform the ABI measurement include a hand-held 5–10 MHz Doppler probe and a blood pressure cuff. MANAGEMENT: Most patients' symptoms improve with optimal medical treatment and invasive intervention is often not required. Smoking cessation and exercise are considered the two most important treatments for PAD. CONCLUSION: Symptomatic PAD often impairs a patient's quality of life and untreated disease can lead to limb loss. Aggressive management of atherosclerotic risk factors, a structured exercise program, use of antiplatelet agents and when indicated percutaneous or surgical revascularizations are the keys for successful management.

  13. 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)

  14. Common Carotid Artery Occlusion: A Case Series

    OpenAIRE

    Zoltán Bajkó; Rodica Bălaşa; Anca Moţăţăianu; Smaranda Maier; Octavia Claudia Chebuţ; Szabolcs Szatmári

    2013-01-01

    Subjects and Methods. We analysed 5000 cerebrovascular ultrasound records. A total of 0.4% of the patients had common carotid artery occlusion (CCAO). Results. The mean age was 59.8 ± 14.2 years, and the male/female ratio was 2.33. The most frequent risk factors were hypertension, ischaemic heart disease, dyslipidemia, diabetes mellitus, and smoking. Right-sided and left-sided CCAO occurred in 65% and 30% of the cases, respectively, and bilateral occlusion was detected in one case (5%). Paten...

  15. Retinal vein occlusion

    Science.gov (United States)

    ... decrease the risk of retinal vein occlusion. These measures include: Eating a low-fat diet Getting regular exercise Maintaining an ideal weight Not smoking Aspirin or other blood thinners may help prevent blockages in the other eye. Controlling diabetes may ...

  16. 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.

  17. 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. PMID:22945724

  18. 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.

  19. The lingualized occlusion of complete denture

    Institute of Scientific and Technical Information of China (English)

    BEN Wei-hong; Eleni Roumanas

    2008-01-01

    This article reviews the literatures dealing with the lingualized occlusion of complete denture including the origin,development and research. Lingualized occlusion is a valuable concept because many advantages of anatomic and nonanatomic occlusions are retained,satisfactory occlusion is easily obtained,balanced occlusion can be accomplished.

  20. Bilateral Central Retinal Vein Occlusions Combined with Artery Occlusions in A Patient with Acquired Immune Deficiency Syndrome

    Institute of Scientific and Technical Information of China (English)

    Feng Wen; Xuemei Chen; Haitai Li; Ruiduan Liao; Dezheng Wu

    2002-01-01

    Purpose: This is the first report of a bilateral nonischemic central retinal vein occlusionscombined with artery occlusions in a patient with acquired immune deficiency syndrome(AIDS). Methods: Case report. Results: A 22-year-old Chinese(male) with a positive human immunodeficiency virus(HIV) infection developed bilateral nonischemic central retinal vein occlusions combinedwith artery occlusions and severe vision loss. The manifestations of the fundus andfluorescein angiography were similar in both eyes.Conclusion: This case report provides the evidences that central retinal vein and arteryocclusions are probably part of the spectrum of AIDS vascular diseases.

  1. Trauma from occlusion — An orthodontist’s perspective

    OpenAIRE

    R. Saravanan; Babu, Prajeeth J.; Rajakumar, P.

    2010-01-01

    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.

  2. 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

    digit (strain gauge technique). The two different methods correlated statistically significant at all four levels, but the systolic blood pressures were higher than the SPP in particular in diabetic legs; (3) Angiograms in 35 legs with AOD showed that the SPP on the ankle was only consistently decreased......The skin perfusion pressure (SPP) measured as the isotope washout cessation external pressure is valuable in selection of major amputation level. Five methodological investigations important to clinical use were carried out: (1) In five normal legs and 10 legs with arterial occlusive disease (AOD......Hg (range 18-98) (P less than 0.02). The average washout constant for the three different tracers were approximately equal and correlated statistically significant with the SPP; (2) In 59 legs with AOD, segmental SPP was compared to segmental systolic blood pressures on the thigh, calf, ankle and first...

  3. Biomechanics of occlusion--implications for oral rehabilitation.

    Science.gov (United States)

    Peck, C C

    2016-03-01

    The dental occlusion is an important aspect of clinical dentistry; there are diverse functional demands ranging from highly precise tooth contacts to large crushing forces. Further, there are dogmatic, passionate and often diverging views on the relationship between the dental occlusion and various diseases and disorders including temporomandibular disorders, non-carious cervical lesions and tooth movement. This study provides an overview of the biomechanics of the masticatory system in the context of the dental occlusion's role in function. It explores the adaptation and precision of dental occlusion, its role in bite force, jaw movement, masticatory performance and its influence on the oro-facial musculoskeletal system. Biomechanics helps us better understand the structure and function of biological systems and consequently an understanding of the forces on, and displacements of, the dental occlusion. Biomechanics provides insight into the relationships between the dentition, jaws, temporomandibular joints, and muscles. Direct measurements of tooth contacts and forces are difficult, and biomechanical models have been developed to better understand the relationship between the occlusion and function. Importantly, biomechanical research will provide knowledge to help correct clinical misperceptions and inform better patient care. The masticatory system demonstrates a remarkable ability to adapt to a changing biomechanical environment and changes to the dental occlusion or other components of the musculoskeletal system tend to be well tolerated. PMID:26371622

  4. 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).

  5. 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.

  6. Celiac artery stenosis/occlusion treated by interventional radiology

    International Nuclear Information System (INIS)

    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. 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

  8. Laser photocoagulation for retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova

    2015-03-01

    Full Text Available Retinal vein occlusion (RVO is one of the leading causes of permanent vision loss. In adults, central retinal vein occlusion (CRVO occurs in 1.8% while branch retinal vein occlusion (BRVO occurs in 0.2%. Treatment strategy and disease prognosis are determined by RVO type (ischemic/non-ischemic. Despite numerous studies and many current CRVO and BRVO treatment approaches, the management of these patients is still being debated. Intravitreal injections of steroids (triamcinolone acetate, dexamethasone and vascular endothelial growth factor (VEGF inhibitors (bevacizumab, ranibizumab were shown to be fairly effective. However, it is unclear whether anti-VEGF agents are reasonable in ischemic RVOs. Laser photocoagulation remains the only effective treatment of optic nerve head and/or retinal neovascularization. Laser photocoagulation is also indicated for the treatment of macular edema. Both threshold and sub-threshold photocoagulation may be performed. Photocoagulation performed with argon (514 nm, krypton (647 nm, or diode (810 nm laser for macular edema provides similar results (no significant differences. The treatment may be complex and include medication therapy and/or surgery. Medication therapy includes anti-aggregant agents and antioxidants, i.e., emoxypine which may be used in acute RVO as well as in post-thrombotic retinopathy. 

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

    OpenAIRE

    Rohina S Aggarwal; Mishra, Vineet V; Somesh V Aggarwal

    2013-01-01

    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 pred...

  10. Detection of misery perfusion in the cerebral hemisphere with chronic unilateral major cerebral artery steno-occlusive disease using crossed cerebellar hypoperfusion: comparison of brain SPECT and PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Yoshiyasu; Ogasawara, Kuniaki; Saito, Hideo; Takahashi, Yoshihiro; Ogasawara, Yasushi; Kobayashi, Masakazu; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Terasaki, Kazunori [Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Yoshida, Kenji; Beppu, Takaaki; Kubo, Yoshitaka; Fujiwara, Shunrou [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Tsushima, Eiki [Hirosaki University, Graduate School of Health Sciences, Hirosaki (Japan)

    2013-10-15

    In patients with unilateral internal carotid or middle cerebral artery (ICA or MCA) occlusive disease, the degree of crossed cerebellar hypoperfusion that is evident within a few months after the onset of stroke may reflect cerebral metabolic rate of oxygen in the affected cerebral hemisphere relative to that in the contralateral cerebral hemisphere. The aim of the present study was to determine whether the ratio of blood flow asymmetry in the cerebellar hemisphere to blood flow asymmetry in the cerebral hemisphere on positron emission tomography (PET) and single photon emission computed tomography (SPECT) correlates with oxygen extraction fraction (OEF) asymmetry in the cerebral hemisphere on PET in patients with chronic unilateral ICA or MCA occlusive disease and whether this blood flow ratio on SPECT detects misery perfusion in the affected cerebral hemisphere in such patients. Brain blood flow and OEF were assessed using {sup 15}O-PET and N-isopropyl-p-[{sup 123}I]iodoamphetamine ({sup 123}I-IMP) SPECT, respectively. All images were anatomically standardized using SPM2. A region of interest (ROI) was automatically placed in the bilateral MCA territories and in the bilateral cerebellar hemispheres using a three-dimensional stereotaxic ROI template, and affected-to-contralateral asymmetry in the MCA territory or contralateral-to-affected asymmetry in the cerebellar hemisphere was calculated. Sixty-three patients with reduced blood flow in the affected cerebral hemisphere on {sup 123}I-IMP SPECT were enrolled in this study. A significant correlation was observed between MCA ROI asymmetry of PET OEF and the ratio of cerebellar hemisphere asymmetry of blood flow to MCA ROI asymmetry of blood flow on PET (r = 0.381, p = 0.0019) or SPECT (r = 0.459, p = 0.0001). The correlation coefficient was higher when reanalyzed in a subgroup of 43 patients undergoing a PET study within 3 months after the last ischemic event (r = 0.541, p = 0.0001 for PET; r = 0.609, p < 0

  11. Endovascular repair of an aorto-iliac aneurysm succeeded by kidney transplantation Tratamento endovascular de aneurisma aorto-ilíaco sucedido por transplante renal

    Directory of Open Access Journals (Sweden)

    Marcelo Bellini Dalio

    2010-09-01

    Full Text Available We present the case of aorto-iliac aneurysm in a patient with chronic renal failure requiring dialysis who were treated with an endovascular stent graft and, later on, submitted to kidney transplantation. A 53-year-old male with renal failure requiring dialysis presented with an asymptomatic abdominal aorto-iliac aneurysm measuring 5.0cm of diameter. He was treated with endovascular repair technique, being used an endoprosthesis Excluder®. After four months, he was successfully submitted to kidney transplantation (dead donor, with anastomosis of the graft renal artery in the external iliac artery distal to the endoprosthesis. The magnetic resonance imaging, carried out 30 days after the procedure, showed a good positioning of the endoprosthesis and adequate perfusion of the renal graft. In the follow-up, the patient presented improvement of nitrogenous waste, good positioning of the endoprosthesis without migration or endoleak. The endovascular repair of aorto-iliac aneurysm in a patient with end-stage renal failure under hemodialysis treatment showed to be feasible, safe and efficient, as it did not prevent the success of the posterior kidney transplantation.Apresentamos o caso de aneurisma aortoilíaco em um paciente com insuficiência renal crônica dialítica tratado com uma endoprótese vascular, sendo, após, submetido a transplante renal. Um homem de 53 anos com insuficiência renal dialítica apresentava um aneurisma abdominal aortoilíaco assintomático com 5,0cm de diâmetro. Foi tratado com técnica endovascular com uma endoprótese Excluderâ. Após quatro meses, foi submetido a transplante renal (doador cadáver com sucesso, com anastomose da artéria renal do enxerto na artéria ilíaca externa distal à endoprótese. A ressonância magnética 30 dias após o procedimento mostrou a endoprótese bem posicionada e o enxerto renal bem perfundido. No seguimento, o paciente evoluiu com melhora das escórias nitrogenadas, bom

  12. Effect of Multivessel Coronary Disease With or Without Concurrent Chronic Total Occlusion on One-Year Mortality in Patients Treated With Primary Percutaneous Coronary Intervention for Cardiogenic Shock

    NARCIS (Netherlands)

    R.J. van der Schaaf; B.E. Claessen; M.M. Vis; L.P. Hoebers; K.T. Koch; J.,Jr Baan; M. Meuwissen; A.E. Engstrom; W.J. Kikkert; J.G.P. Tijssen; R.J. de Winter; J.J. Piek; J.P.S. Henriques

    2010-01-01

    Despite early revascularization, mortality remains high in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock. It has been shown that the effect of multivessel disease (MVD) on mortality in patients with STEM I treated with primary percutaneous coronary

  13. 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.

  14. 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)

    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)

  15. Extracranial-intracranial bypass for internal carotid/middle cerebral atherosclerotic steno-occlusive diseases in conjunction with carotid endarterectomy for contralateral cervical carotid stenosis: clinical results and cognitive performance.

    Science.gov (United States)

    Inoue, Tomohiro; Ohwaki, Kazuhiro; Tamura, Akira; Tsutsumi, Kazuo; Saito, Isamu; Saito, Nobuhito

    2016-10-01

    Clinical results as well as cognitive performances after extracranial to intracranial (EC-IC) bypass in conjunction with contralateral carotid endarterectomy (CEA) are poorly understood. Data from 14 patients who underwent unilateral EC-IC bypass for atherosclerotic internal carotid artery (ICA)/middle cerebral artery (MCA) steno-occlusive disease in conjunction with CEA for contralateral cervical carotid stenosis were retrospectively reviewed. Postoperative results were evaluated by MRI imagings. Nine patients also underwent neuropsychological examinations (NPEs), including assessment by the Wechsler Adult Intelligence Scale-Third Edition and the Wechsler Memory Scale-Revised (WMS-R) before and about 6 months after bilateral surgeries. Postoperative MRI follow-up (median, 8 months; interquartile range, 7-8 months) confirmed successful bypass in all patients, with no additional ischemic lesions on T2WI when compared with preoperative imaging. Further, MRA showed patent bypass and contralateral smooth patency at CEA portion in all patients. In the group rate analysis, all five postoperative NPE scores (Verbal IQ, Performance IQ, WMS-memory, WMS-attention, and Average scores of all those four scores) were improved relative to preoperative NPE scores. Performance IQ and Average score improvements were statistically significant. Clinical results after EC-IC bypass in conjunction with contralateral CEA were feasible. Based on the group rate analysis, we conclude that successful unilateral EC-IC bypass and contralateral carotid endarterectomy does not adversely affect postoperative cognitive function.

  16. Endograft Limb Occlusion in EVAR

    DEFF Research Database (Denmark)

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

    2014-01-01

    occlusions were recorded and compared with a defined control group. Three different indices were used to describe the tortuosity of the iliac vessels based on preoperative CTA: pelvic artery index of tortuosity (PAI), common iliac artery index of tortuosity (CAI), and a visual description of vessel......, subsequently, duplex ultrasound imaging was performed. Patients with limb occlusions were identified. For each index patient, two controls were obtained, one immediately preceding and one following the index patient in the consecutive cohort of EVAR patients. METHODS: Demographics and CTA data on limb graft......% 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...

  17. Metabolic syndrome and central retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Kosanović-Jaković Natalija

    2005-01-01

    Full Text Available Background. The accumulation of risk factors for central retinal artery occlusion can be seen in a single person and might be explained by the metabolic syndrome. Case report. We presented the case of a 52-year-old man with no light perception in his right eye. The visual loss was monocular and painless, fundoscopy showed central retinal artery occlusion and the laboratory investigation showed the raised erythrocyte sedimentation rate of 105 mm/h and the raised C-reactive protein of 22 mg/l. Specific laboratory investigations and fluorescein angiography excluded the presence of vasculitis, collagen vascular diseases, hypercoagulable state and antiphospholipid syndrome. Conclusion. The patient met all the five of the National Cholesterol Education Program (NCEP criteria for the metabolic syndrome: hypertension, abnormal lipid profile, abnormal glucose metabolism, obesity and hyperuricemia. Measurement of C-reactive protein is useful for the assessment of therapeutic systemic effect on any abnormality in the metabolic syndrome. Individual therapy for all risk factors in the metabolic syndrome is necessary to prevent complications such as cardiovascular, retinal vascular diseases and stroke.

  18. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  20. Gastroesophageal reflux diagnosed by occlusal splint tintion.

    Science.gov (United States)

    Cebrián-Carretero, José Luis; López-Arcas-Calleja, José María

    2006-01-01

    The gastroesophageal reflux (GER) disease is a very frequent digestive disorder, mainly characterised by the reflux of the gastric acidic content to the esophage in abnormal quantities. There are different situations that favour this situation but almost in all of them rely an incompetence of the esophagic sphincter. The clinical consequences are many, including oral manifestations. Among all of them the most frequent is the esophagitis followed by symptoms at the pharynx or larynx and finally, the oral cavity. At this level fundamentally we will find enamel and oral mucosa erosions. We report the case of a patient who was indirectly diagnosed of her esophague disease by the observation of the alterations in the occlusal splint induced by the gastric reflux. We review the literature concerning the above topic and its possible association with the miofascial syndrome.

  1. 下肢动脉硬化闭塞症合并无症状性颈动脉狭窄229例%Peripheral arterial occlusive disease complicating asymptomatic carotid stenosis

    Institute of Scientific and Technical Information of China (English)

    张华; 潘仲杰; 赵奇; 栗力

    2014-01-01

    Objective To evaluate the incidence of asymptomatic carotid stenosis (ACS) in patients with peripheral arterial occlusive disease (PAOD) who was admitted for revascularization.Methods 229 PAOD patients were evaluated by carotid ultrasound preoperatively and divided into severe ACS group (ACS ≥ 70%) and non severe ACS group (ACS < 70%).The clinical characteristics and associated risk factors of the two groups were analyzed.Results The incidence of severe ACS was 19.7%,age,blood pressure,total cholesterol and fibrinogen levels in severe ACS group were significantly higher than those in non-severe ACS group (P < 0.05),the more severe the symptoms of PAOD are,the higher is the incidence of severe ACS.Age,hypertension and hypercholesterolemia were all predictors of severe ACS.Conclusions The severity of PAOD is positively correlated with the incidence of severe ACS.Age,hypertension and hypercholesterolemia are independent risk factors for severe ACS.%目的 总结下肢动脉硬化闭塞症(peripheral arterial occlusive disease,PAOD)需血管重建术患者无症状重度颈动脉狭窄(asymptomatic carotid stenosis,ACS)发生率、临床特点及其相关危险因素,探讨PAOD术前行颈动脉超声筛查重度ACS的临床价值.方法 回顾性分析229例需血管重建术治疗的重度PAOD患者的临床资料,术前均行颈动脉超声检查筛查ACS,并将PAOD患者分为重度ACS组(ACS ≥70%)和非重度ACS组(ACS< 70%),对2组患者临床特点及相关危险因素进行分析.结果 229例患者中,重度ACS发生率为19.7%;重度ACS组患者年龄、血压、总胆固醇和纤维蛋白原水平明显高于非重度ACS组,差异有统计学意义(P<0.05);PAOD症状越重的患者重度ACS的发生率越高;多因素Logistic回归分析显示高龄、高血压以及高胆固醇血症是重度ACS预测指标.结论 PAOD症状严重程度与重度ACS发生率呈正相关且高龄、高血压以及高胆固醇血症是重度ACS的独立危险因素.

  2. CT-guided thoracal sympathicolysis for the treatment of peripheral arterial occlusive disease and chronic thoracal pain syndromes in 6 patients; CT-gesteuerte thorakale Sympathikolyse zur Behandlung der peripheren arteriellen Verschlusskrankheit und thorakaler Schmerzen in 6 Faellen

    Energy Technology Data Exchange (ETDEWEB)

    Finkenzeller, T.; Techert, J.; Lenhart, M.; Link, J.; Feuerbach, S. [Klinikum der Univ. Regensburg (Germany). Abt. Roentgendiagnostik

    2001-10-01

    Purpose: Retrospective evaluation of the safety and effectivity of CT-guided percutaneous thoracal sympathicolysis (CT-TSL) in the treatment of patients with peripheral arterial occlusive disease (PAOD) of the upper limb and chronic thoracal pain syndromes. Comparison of our own experience with literature reports. Material and Methods: Between 6/96 and 12/99, 4 patients with PAOD of the upper limb and two with chronic thoracal pain syndromes caused by herpes zoster were treated by unilateral CT-TSL. Results: 18, 21 and 32 months after the intervention 3 out of 4 patients treated for PAOD reported subjective improvements, and one remained unchanged. Two patients treated for pain syndromes showed no long-term benefit of the procedure. There were no serious complications. Conclusion: The CT-TSL is an alternative method in the treatment of PAOD in patients who are unsuitable for treatment by revascularization. (orig.) [German] Ziel: Retrospektive Betrachtung der Sicherheit und Effektivitaet der CT-gesteuerten thorakalen Sympathikolyse (CT-TSL) bei der Behandlung von Patienten mit peripherer arterieller Verschlusskrankheit (AVK) der oberen Extremitaet oder chronischer thorakaler Schmerzsyndrome, und Vergleich der eigenen Erfahrungen mit der Literatur. Material und Methoden: Von 6/96 bis 12/99 wurden 4 Patienten mit AVK der oberen Extremitaet und zwei mit chronischen thorakalen Herpes-zoster-Neuralgien mittels jeweils unilateral durchgefuehrter CT-TSL behandelt. Ergebnisse: 3 von 4 der wegen AVK behandelten Patienten gaben im Verlauf nach 18, 21 und 32 Monaten eine subjektiv empfundene Besserung an, ein Patient hatte unveraendert Beschwerden. Beide Schmerzpatienten zeigten nur kurzfristig eine Verbesserung ihrer Beschwerdesymptomatik. Es traten keine relevanten Komplikationen auf. Schlussfolgerung: Die CT-TSL ist eine alternative Moeglichkeit zur Behandlung der AVK der oberen Extremitaet bei Patienten, die keinem revaskularisierenden Eingriff unterzogen werden koennen

  3. Interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery%介入治疗股浅动脉硬化闭塞19例分析

    Institute of Scientific and Technical Information of China (English)

    祝慧鹏; 周艺琳; 冯翔; 李鸣; 包俊敏; 景在平

    2009-01-01

    Objective To explore the methods and mid-term results of interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery(SFA).Methods From January 2005 to August 2008,Nineteen cases with 22 diseased lower limbs were admitted.According to Fontaine stage system,there were 6 stage Ⅱb limbs(moderate to severe intermittent claudication),8 stage Ⅲ limbs(rest pain),and 8 stage Ⅳ limbs(6 with ulcer and 2 with gangrene).The mean lesion length was 8.8 cm(5~13 cm).On the basis of the TransAtlantic Inter-Society Consensus(TASC)femoropopliteal classification,the lesions were classified as type B in 4 limbs,type C in 17,and D in 1.Follow up examinations with color duplex ultrasound and/or arteriography were carried out to determine the patency.The improvement of clinical symptoms after operation was analyzed.Results 17 limbs were revascularization successfully,2 limbs were turned to bypass operation,3 limbs were judged untreatable.The technical success rate is 77.3%,and the clinical improvement of symptoms was achieved in 100% of the 17 limbs on which the procedure was successful.The 17 limbs were followed up for a mean of 12.5 months(range 3-33 months).One patient died of cardia infarction one month postoperatively.SFA occlusion happened in 4 limbs.At one year postoperatively,the patency rate was 75%(13/17)after primary operation.Conclusions Primary endovascular treatment of SFA occlusion diseases is a safe,minimally invasive,and effective method.%目的 探讨股浅动脉硬化闭塞介入治疗的方法和疗效.方法 回顾性分析2005年1月至2008年8月介入治疗的19例(22条下肢)股浅动脉硬化闭塞症患者的临床资料.其中Fontaine Ⅱb期(中、重度间歇跛行)6条,Ⅲ期(静息痛)8条,Ⅳ期(组织缺损)8条(其中足部溃疡6条,足趾坏疽2条).股浅动脉病变的平均长度8.8 cm(5.0~13 cm).病变TASC分型B型4条,C型17条,D型1条.通过彩色血管超声和(或)动脉造影观察病变段动脉

  4. 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

  5. Tracking facial features with occlusions

    Institute of Scientific and Technical Information of China (English)

    MARKIN Evgeny; PRAKASH Edmond C.

    2006-01-01

    Facial expression recognition consists of determining what kind of emotional content is presented in a human face.The problem presents a complex area for exploration, since it encompasses face acquisition, facial feature tracking, facial expression classification. Facial feature tracking is of the most interest. Active Appearance Model (AAM) enables accurate tracking of facial features in real-time, but lacks occlusions and self-occlusions. In this paper we propose a solution to improve the accuracy of fitting technique. The idea is to include occluded images into AAM training data. We demonstrate the results by running ex periments using gradient descent algorithm for fitting the AAM. Our experiments show that using fitting algorithm with occluded training data improves the fitting quality of the algorithm.

  6. 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.

  7. Central retinal vein occlusion: A patient with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Karadžić Jelena

    2016-01-01

    Full Text Available Introduction. Scleroderma (systemic sclerosis is a severe chronic connective tissue disease, which results in involvement of numerous internal organs. Changes in the eye are the consequences of organ-specific manifestations of scleroderma or adverse effects of immunosuppressive treatment applied. Case report. We reported a 42-year-old woman with systemic sclerosis and acute deterioration of vision in the left eye, with visual acuity 0.9. After thorough clinical examination, including fluorescein angiography and optical coherence tomography, the diagnosis of nonischemic central retinal vein occlusion was made. Further biochemical, rheumatological and immunological investigation, apart from inactive systemic sclerosis, showed normal findings. Therefore, the cause of central retinal vein occlusion could only be attributed to the microvascular changes in systemic sclerosis. After three months, visual acuity deteriorated to 0.6 due to the development of cystoid macular edema. The patient received intravitreal injection of bevacizumab and after a single dose visual acuity improved to 0.9. After a 6- month follow-up, macular edema resolved and visual acuity stabilized. Conclusion. According to our knowledge and current data from the literature, central retinal vein occlusion is a rare vision threatening manifestation of scleroderma. There are only few published case reports on central vein occlusion in scleroderma patients. Examination of the ocular fundus is recommended for evaluation of vascular disease in patients with systemic sclerosis.

  8. Occlusal status among Yemeni children

    OpenAIRE

    Nabil M Al-Zubair; Ibrahim A Ghandour

    2014-01-01

    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 (crowd...

  9. Occlusal status among Yemeni children

    Directory of Open Access Journals (Sweden)

    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.

  10. Pathology of Coronary Chronic Total Occlusion

    Directory of Open Access Journals (Sweden)

    Kenichi Sakakura

    2016-06-01

    Full Text Available There is an increasing need for percutaneous revascularization procedures of coronary Chronic Total Occlusion (CTO, because many patients with severe coronary artery disease have limited options for revascularization. Although the success rate of percutaneous revascularization of CTOs was unsatisfactory from the 1990s to the 2000s, recent technological advances in interventional strategies have improved the success rate to 85%. Detailed histological assessment of human autopsy studies of CTO has contributed significantly to the refinement in Percutaneous Coronary Intervention (PCI techniques and device development. We have recently reported the pathological findings and characteristics of CTOs that occur in different clinical scenarios. In this review, we discuss the pathology of CTOs to facilitate greater understanding of revascularization strategies for CTOs.

  11. Evaluation of Haemodynamic Changes of Proximal Arterial Occlusion in the Lower Extremities by Spectrum Doppler Ultrasonography

    Directory of Open Access Journals (Sweden)

    Z Wang

    2015-06-01

    Full Text Available Objective: The objective is to analyse the changes of haemodynamic and Doppler ultrasonography spectrum in the proximal arterial occlusion of lower extremities, and to explore the value of spectrum Doppler ultrasonography in the diagnosis of lower extremity arterial occlusive disease. Methods: Thirty-four patients (thirty-nine occlusion arteries were examined with two-dimensional ultrasound combined with colour Doppler flow imaging (CDFI, and the results were compared. Result: The waveform shape in the artery proximal to the occlusion shows that blood flow velocity becomes slower, and diastolic reverse wave slowly disappears even upward. Systolic waveform records a steep upstroke, a slow downstroke and a shoulder on the downstroke. The appearance of the shoulder on the downstroke is earlier than the diastolic upward wave. The differences of peak systolic velocity, acceleration time, deceleration time, systolic acceleration, deceleration, diastolic reverse flow velocity, systolic acceleration time/systolic duration and systolic deceleration time/systolic duration in the proximal occlusion segment compared with the control group are statistically significant (p < 0.05. Conclusion: Artery occlusion can lead to haemodynamic response and spectrum waveform change. Timely discovery of the changes of the spectrum can be of clinical significance in the diagnosis of lower extremity arterial occlusive disease.

  12. Study on changes of risk factors and serum level of high sensitivity C-reactive protein (hs-CRP) in patients with intracranial and extracranial arteries occlusive diseases.%颅内外大动脉闭塞性脑梗死患者危险因素和hs-CRP的变化

    Institute of Scientific and Technical Information of China (English)

    谢聃; 邓丽; 刘晓冬; 张拥波; 李继梅

    2012-01-01

    Objective To study the changes in risk factors and serum level of high sensitivity C - reactive protein ( hs - CRP ) in patients with intracranial and extracranial arteries occlusive diseases. Methods This study was a retrospective case - control study. The total numbers of patients were 276, including 89 patients with ICAO, 74 patients with MCAO, 29 patients with 1CAO and MCAO, and 84 ischemic stroke patients without large artery occlusion ( control group ). The risk factors and serum level of hs - CRP within 3 days after admission were examined and recorded , combined with TCD, CTA and MRA and other imaging and clinical data, its characteristics were analyzed and summarized, and statistical analysis had been made. Results Compared with control group, patients with intracranial and extracranial arteries occlusive diseases had higher percentage of history of stroke and coronary heart diseases( P < 0. 01 ) , and 23. 6% ~ 31. 0% of patients had more than three risk factors , and incidence rate of control group was only 3.6%. The level of hs - CRP was also higher ( P < 0. 01 ) in patients with intracranial and extracranial arteries occlusive diseases. Conclusion Stroke patients with intracranial and extracranial arteries occlusive diseases have more risk factors and higher percentage of history of stroke and coronary heart diseases. The hs - CRP, as an important inflammatory factor, may be involved in the patho-physiological process of intracranial or extracranial artery occlusion, and they may play an important role in changes of clinical biochemistry.%目的 分析颅内外大动脉闭塞患者的危险因素及血液中超敏C反应蛋白(hs-CRP)的变化.方法 回顾性病例-对照研究276例患者,其中颈内动脉闭塞89例,大脑中动脉闭塞74例,颈内动脉合并大脑中动脉闭塞29例,除外颅内外大动脉闭塞的脑缺血患者84例.记录其危险因素及入院后3天内hs-CRP水平,并进行统计学分析.结果 与非闭塞的脑缺

  13. 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.

  14. Branch Retinal Vein Occlusion and Its Management

    Institute of Scientific and Technical Information of China (English)

    Desmond; Archer

    1992-01-01

    The natural course of Branch Retinal Vein Occlusion is determined by the site and completeness of the occlusion, the integrity of arterial perfusion to the affected sector and the efficiency of the developing collateral circulation. Most patients with tributary vein occlusion have some capillary fall out and microvascular incompetence in the distribution of the affected retina and vision is significantly compromised in over 50% of patients who have either chronic macular oedema or ischemia involving the...

  15. Occlusion: A Contemporary Overview and Recommendations.

    Science.gov (United States)

    Racich, Michael J

    2015-01-01

    Dental occlusal concepts have developed over time, essentially by trial and error. Most have stood the test of observation, and more recently science has verified some of the viewed occlusal successes. The purpose of this article is to examine and distill, in an evidence-based manner, the commonalities that allow practitioners of one occlusal philosophy or another to achieve consistent success. Medline and the Cochrane Collaboration were used to procure relevant articles. PMID:26509980

  16. Multiple-object tracking under occlusion conditions

    Science.gov (United States)

    Jung, Young-Kee; Ho, Yo-Sung

    2000-05-01

    This paper describes an algorithm for multiple object tracking that takes a new occlusion reasoning approach. In order to track individual objects under occlusion conditions, we design a 2D token-based tracking system using Kalman filtering. The proposed tracking system consists of two parts: object detection and tracking, and occlusion reasoning using feature matching. The object detection and tracking part finds moving objects from their background. For object detection, we develop an adaptive background update technique. By tracking individual objects with segmentation information, we generate motion trajectories. Computer simulation of the proposed scheme demonstrates its robustness to various occlusion conditions for several test sequences.

  17. Acute occlusion of the left subclavian artery with artery dissection

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Subclavian steal syndrome is cerebral or brain stem ischemia resulting from diversion of blood flow from the basilar artery to the subclavian artery, which is caused by occlusive disease of either the subclavian artery or the innominate artery before they branch off at the vertebral artery. In the patients with subclavian steal syndrome the subclavian artery is fed by retrograde flow from the vertebral artery via the carotids and the circle of Willis.

  18. 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; Fragebogen zur gesundheitsbezogenen Lebensqualitaet von Patienten mit peripherer arterieller Verschlusskrankheit (pAVK) im Stadium kritischer Ischaemie (FLeQKI) - methodische Entwicklung eines krankheitsspezifischen Messinstruments und psychometrische Bestimmung seiner Validitaet und Reliabilitaet. T. 1

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, W.A.; Bohndorf, K.; Kirchhof, K. [Klinikum Augsburg (Germany). Klinik fuer Diagnostische Radiologie und Neuroradiologie; Olbricht, W. [Bayreuth Univ. (Germany). Lehrstuhl fuer Mathematik VII; Klarmann, S. [Klinikum Augsburg (Germany). Klinik fuer Neurologie und Klinische Neurophysiologie; Engelhardt, M. [Bundeswehrkrankenhaus Ulm (Germany). Klinik fuer Gefaesschirurgie; Freitag, M.H. [Bayreuth Univ. (Germany). Inst. fuer Medizinmanagement und Gesundheitswissenschaften; Woelfle, K. [Klinikum Augsburg (Germany). Klinik fuer Gefaesschirurgie

    2007-12-15

    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 {alpha} 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 {alpha} = 0.54 - 0.93) and for test-retest reliability (r = 0.44 - 0

  19. Macrophage depletion reduced brain injury following middle cerebral artery occlusion in mice

    OpenAIRE

    Ma, Yuanyuan; Li, Yaning; Jiang, Lu; Wang, Liping; Jiang, Zhen; Wang, Yongting; Zhang, Zhijun; Yang, Guo-Yuan

    2016-01-01

    Background Macrophages are involved in demyelination in many brain diseases. However, the role of macrophages in the recovery phase of the ischemic brain is unknown. The present study aims to explore the role of macrophages in the ischemic brain injury and tissue repair following a 90-min transient middle cerebral artery occlusion in mice. Methods Clodronate liposomes were injected into mice to deplete periphery macrophages. These mice subsequently underwent middle cerebral artery occlusion. ...

  20. 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.

  1. 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...

  2. Objective evaluation of upper limb claudication: use of isokinetic dynamometry Avaliação objetiva da isquemia de membros superiores: uso do dinamômetro isocinético

    OpenAIRE

    Lívio Nakano; Nelson Wolosker; Ruben Ayzin Rosoki; Baptista Muraco Netto; Pedro Puech-Leão

    2006-01-01

    OBJECTIVE: The objective of this work is to present an objective, practical, and reproducible method for evaluating the functional limitation caused by occlusive arterial disease in upper limbs: a stress test using an isokinetic dynamometer. METHODS: Twenty-three patients with unilateral subclavian artery occlusive disease were included in the study, forming group 1. Seven patients of similar age, with atherosclerotic or Takayasu's disease in the aorto-iliac segment, without subclavian artery...

  3. Contrast-Enhanced MR Angiography (CEMRA) in Peripheral Arterial Occlusive Disease (PAOD): conventional moving table technique versus hybrid technique; Kontrastverstaerkte MR-Angiographie (CEMRA) bei peripherer AVK (pAVK): konventionelle Tischverschiebetechnik versus Hybrid-Technik

    Energy Technology Data Exchange (ETDEWEB)

    Kalle, T. von; Gerlach, A.; Hatopp, A.; Klinger, S.; Prodehl, P.; Arlat, I.P. [Katharinenhospital, Stuttgart (Germany). Radiologisches Inst.

    2004-01-01

    Patients and Methods: 80 patients (males n = 60, females n = 20, median age = 70 years, diabetics n = 27) with PAOD were examined with a 1,5T system (40 mT/m) using a dedicated phased array peripheral vascular coil. Protocol A consisted of a single injection of Gd-BOPTA with consecutive craniocaudal image acquisition and protocol B of two injections, with the first injection of Gd-BOPTA followed by image acquisition of the popliteocrural and pedal segments and the second injection followed by acquiring the aortoiliac and femoral segments (hybrid technique). The evaluation of the arterial system was directed to the iliac, femoral, popliteocrural and pedal arteries. Results: The visualization of the entire aortopedal vascular system was of diagnostically good or satisfactory quality in 16 of 40 patients using protocol A and in 29 of 40 patients using protocol B (iliac 40 vs. 37, femoral 40 vs. 40, popliteocrural 35 vs. 37, pedal 16 vs. 29); without the pedal station the number increased to 35 of 40 patients for both protocols. The reason of diagnostic limitations was an arteriovenous overlap in 24 of 80 cases, with 19 of 40 cases for protocol A and 5 of 40 for protocol B, located exclusively in the cruropedal region. Conclusion: Moving table hybrid CEMRA is superior to conventional technique in craniocaudal direction by producing less venous overlap of arteries and is especially more suitable for the diagnostic evaluation of the cruropedal region. (orig.) [German] Patienten und Methodik: Untersucht wurden 80 Patienten (maennl. n = 60, weibl. n = 20, mittl. Alter 70 J., Diabetiker n = 27) mit pAVK an einem 1,5-Tesla-Geraet (40 mT/m) mit dedizierter Phased-Array-Oberflaechen-Gefaessspule. Protokoll A beinhaltete eine Kontrastmittel-Injektion (Gd-BOPTA) mit konsekutiver kraniokaudaler Bildakquisition. In Protokoll B erfolgte die Akquisition zunaechst der Unterschenkel- und Fussetage mittels einer ersten, anschliessend der Abdomen-Becken- und Oberschenkeletage mittels

  4. Virtual occlusion in planning orthognathic surgical procedures.

    Science.gov (United States)

    Nadjmi, N; Mollemans, W; Daelemans, A; Van Hemelen, G; Schutyser, F; Bergé, S

    2010-05-01

    Accurate preoperative planning is mandatory for orthognathic surgery. One of the most important aims of this planning process is obtaining good postoperative dental occlusion. Recently, 3D image-based planning systems have been introduced that enable a surgeon to define different osteotomy planes preoperatively and to assess the result of moving different bone fragments in a 3D virtual environment, even for soft tissue simulation of the face. Although the use of these systems is becoming more accepted in orthognathic surgery, few solutions have been proposed for determining optimal occlusion in the 3D planning process. In this study, a 3D virtual occlusion tool is presented that calculates a realistic interaction between upper and lower dentitions. It enables the surgeon to obtain an optimal and physically possible occlusion easily. A validation study, including 11 patient data sets, demonstrates that the differences between manually and virtually defined occlusions are small, therefore the presented system can be used in clinical practice.

  5. Study on the relationship between severe peripheral arterial occlusive disease and diabetic foot%严重下肢动脉病变与糖尿病足的相关性研究

    Institute of Scientific and Technical Information of China (English)

    李秋; 张海清; 陈青; 梁波; 廖琳; 管庆波; 赵家军

    2009-01-01

    Objective To investigate the prevalence of peripheral arterial occlusive disease(PAD)and diabetic foot among in-patients with diabetes,and to analyze the relation between these two complications.Methods Five-hundred and twenty-three patients with type 2 diabetes were enrolled.Fasting and postprandial plasma glucose,HbA_(1C),serum lipid profile and urinary albumin were determined.Femoral artery,profunda femoraJ artery.popliteal anory,anterior tibial artery,posterior tibial artery,and peroneal artery were checked by Doppler ultrasonographv.The patients were then subdivided into groups with non-PAD,mild PAD(artery stenesis<50%)and severe PAD(anery stenosis≥50%).Diabetic foot was diagnosed using Wagner criterion.Results Among the 523 palients.95 patients were afflicted with diabetic foot,311 patients with PAD in which 131 with severe PAD.As many as 55 severe PAD cases were found in diabetic foot patients.Multivariate logistic regression analysis revealed that severe PAD was significantly associated with diabetic foot(OR=5.00),other risk factors included smoking habit, hypertension and neuropathy. Conclusion Severe PAD seems to be the most important risk factor related to diabetic foot.%目的 调查住院病人糖尿病足(DF)和下肢动脉病变(PAD)的发病情,分析两者之间的相关性.方法 测定523例住院糖尿病病人空腹及餐后血糖、HbA_(1C)血脂分析和尿微量白蛋白浓度等.应用多普勒超声技术评估所有糖尿病住院病人PAD病情,检查股动脉、股浅动脉、胭动脉、胫前动脉、胫后动脉和腓动脉.根据检查结果分为3组:无病变组、轻度病变组(血管狭窄<50%)和重度病变组(血管狭窄≥50%).糖尿病足诊断按照Wagner标准.结果 在凶糖尿病住院523例病人中,DF 95例(18.2%).PAD 311例(59.5%),其中重度PAD 131例(25.0%).95例DF病人中重度PAD 55例(57.9%).Log9istic回归分析显示,严重PAD(OR=5.00)是DF的独立危险因素.其他危险因素包括吸烟、高血

  6. The clinical and sonographic manifestation of hepatic veno-occlusive disease after allogeneic haemopoietic stem cell transplantation%异基因造血干细胞移植后肝静脉闭塞病及超声表现

    Institute of Scientific and Technical Information of China (English)

    王茜; 张川莉; 马步云; 向兵; 时莹瑜

    2011-01-01

    Objective To explore the clinical and sonographic manifestation of hepatic veno-occlusive disease (HVOD) after allogeneic haemopoietic stem cell transplantation (allo-HSCT). Methods In the pre and post allo-HSCT,the abdomen ultrasound was performed for each patient. The changes of sonographic manifestation of abdomen organs were observed. The clinical and sonographic data of HVOD patients underwent allo-HSCT were retrospectively analyzed.Results There were 7 patients with HVOD after allo-HSCT (7/137,5. 1%). The times of happened was 7 to 23 days.The serum bilirubin was 65 to 271 umol/L. The clinical manifestation included right hypochondrial region(5/7,71.4%),hepatomegaly (6/7,85.7 %), weight gain ( 7/7,100 % ), and ascites ( 7/7,100 % ). Contrast to pre-transplantation, the sonographic manifestation of patients with HVOD were significantly differenced by hepatomegaly, hepatic vein tenuous,spleen volume augmentation, and ascites (P<0.05). On the other hand, the sonographic manifestation of patients with HVOD were unsignificantly differenced by hepatic parenchyma impairment and gallbladder wall thickening (P>0. 05).Conclusion The patients who have weight gain and ascites without definite reason should be considered HVOD after alloHSCT. The bedsides abdominal ultrasound examination is essential for diagnoses and treatments of HVOD patients.%目的 探讨异基因造血干细胞移植(allo-HSCT)后肝静脉闭塞病(HVOD)的临床及超声表现.方法 时allo-HSCT前后的患者进行腹部超声检查,观察腹腔脏器的超声图像改变,并将发生HVOD患者的临床和超声资料进行回顾性分析.结果 移植后进行超声检查的患者共137例,发生HVOD患者7例,发生率5.1%,发生时间7~23天,血清胆红素65~271/μmol/L,部分患者出现右上腹痛(517/71.4%),肝大(6/7,85.7%),体重增加(7/7,100%),腹水(7/7,100%).同移植前比较,患者在移植后发生肝大、肝静脉纤细、脾体积增大及腹水等变

  7. Analysis of risk factors of peripheral arterial occlusive disease in dialysis patients%透析患者下肢动脉闭塞症的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    樊晓红; 李雪梅; 李学旺; 袁志娟; 陈丽萌; 葛广礼; 曾勇; 周紫娟; 陶建瓴; 徐红; 孙阳

    2010-01-01

    紊乱、高血压以及动脉硬化是ESRD患者出现下肢动脉阻塞的危险因素.%Objective To investigate the morbidity of peripheral arterial occlusive disease (PAOD) in dialysis patients and the associated risk factors of PAOD.Methods Two hundred patients including 95 on hemodialysis,55 on peritoneal dialysis and 50 with stage 2-3 chronic kidney disease (CKD) in Peking Union Medical College Hospital were enrolled in this study.Brachial-ankle pulse wave velocity (baPWV) and ankle-brachial BP index (ABPI) were detected by device (VP1000,Japan Colin).Clinical data of these patients were collected.Plasma CRP,Scr,BUN,Hb,Ca,P,iPTH,Alb,Palb,Cho,TG,LDL,HDL were measured.Lower extremity arteries ultrasonography and CT angiography (CTA) were performed in the patients with ABPI<0.9.Results (1) The morbidity of PAOD (ABPI <0.9)was significantly higher in dialysis patients as compared to CKD patients (11.33% vs 0,P=0.016),and was also significantly higher in CAPD patients as compared to HD patients (20.0% vs 6.3%,P=0.011).Superficial femoral artery,anterior tibial artery and posterior tibial artery were common occlusive sites.23.1% patients complained the intermittent claudications.(2) Correlation analysis revealed that ABPI was associated with dialysis mode (X~2=6.491,P=0.011),age (r=-0.338,P=0.000),TC (r=-0.185,P= 0.028),HDL (r=0.179,P=0.035),Scr (r=0.244,P=0.003),BUN (r=0.280,P= 0.001),Kt/V (r=-0.275,P=0.001),nPCR (r=0.269,P=0.001),DBP of upper limb (r=0.267,P=0.001),MAP (r=0.225,P=0.006),SBP of lower limb (r=0.593,P=0.000),DBP of lower limb (r=0.215,P= 0.009),PWV (r=0.202,P=0.014).(3) Multiple linear regression revealed that dialysis mode,HDL,Alb,DBP of upper limb,SBP of lower limb and baPWV were independent risk factors of ABPI.Conclusions The morbidity of PAOD in dialysis patients is significantly higher than that in CKD patients.Malnutrition,dyslipidemia,hypertension and arterial stiffness are independent risk factors of PAOD in dialysis patients.

  8. Treatment of lower extremity arterial occlusive through retrograde access

    International Nuclear Information System (INIS)

    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)

  9. Internal carotid pseudo-occlusion: early and late results.

    Science.gov (United States)

    Pulli, R; Frosini, P; Gatti, M; Narcetti, S; Bernacchi, R; Pratesi, C

    1997-02-01

    Internal carotid pseudo-occlusion (ICP) is a pathology of difficult diagnostic evaluation and treatment in the group of extracranial carotid diseases. The authors report the results of 24 ICP(S) surgically treated in the last five years. No perioperative death was reported. The neurological morbility rate was as low as 4% (1/24), which is quite a good results for this high-risk pathology. Clinical and instrumental follow-up was performed (at 1-3-6-12-24 months from surgery). Six early asymptomatic thromboses (25%) were observed, and the remaining patients showed patent vessels and no symptoms at all. In conclusion surgical treatment of ICP is often able to prevent cerebral ischaemia, and the high rate of early occlusion should not limit surgical indication. PMID:9128116

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-10-01

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

  11. Workflow Optimization in Vertebrobasilar Occlusion

    International Nuclear Information System (INIS)

    Objective: In vertebrobasilar occlusion, rapid recanalization is the only substantial means to improve the prognosis. We introduced a standard operating procedure (SOP) for interventional therapy to analyze the effects on interdisciplinary time management. Methods: Intrahospital time periods between hospital admission and neuroradiological intervention were retrospectively analyzed, together with the patients’ outcome, before (n = 18) and after (n = 20) implementation of the SOP. Results: After implementation of the SOP, we observed statistically significant improvement of postinterventional patient neurological status (p = 0.017). In addition, we found a decrease of 5:33 h for the mean time period from hospital admission until neuroradiological intervention. The recanalization rate increased from 72.2% to 80% after implementation of the SOP. Conclusion: Our results underscore the relevance of SOP implementation and analysis of time management for clinical workflow optimization. Both may trigger awareness for the need of efficient interdisciplinary time management. This could be an explanation for the decreased time periods and improved postinterventional patient status after SOP implementation.

  12. Smile line and occlusion: An epidemiological study

    Directory of Open Access Journals (Sweden)

    Mahsa Harati

    2013-01-01

    Conclusion: Within the limitations of such studies, it might be concluded that there is a significant and important relation between some occlusal parameters and smile design, which must be considered.

  13. Retinal Artery Occlusion Treatment with Hyperbaric Oxygen

    Directory of Open Access Journals (Sweden)

    Harun Cakmak

    2016-01-01

    Full Text Available Retinal artery occlusion is one of the vision-threating emergency situations in ophthalmology. In this paper, a case of retinal artery occlusion is presented. Fifty seven year- old female patient presented with a sudden onset visual loss in her left eye. Best corrected visual acuity (BCVA levels were 1.0 and 0.7 in the right and left eye, respectiveley. Dilated fundus examination revealed no pathological finding in the right eye. Whereas calcified plaque was seen in upper arquat artery bifurcation in the left eye. Pallorness with retinal edema was seen in this arterial trace. Retinal artery occlusion was diagnosed and patient was referred for hyperbaric oxygen therapy. After a total of 20 sessions of hyperbaric oxygen therapy, the calcified plaques disappeared and her BCVA increased to 20/20. Hyperbaric oxygen treatment is vision-saving method which should be considered in retinal artery occlusion.

  14. Retinal vein occlusion in Benin City, Nigeria

    OpenAIRE

    Uhumwangho, Odarosa M.; Darlingtess Oronsaye

    2016-01-01

    Background: Retinal vein occlusion (RVO) is the most common occlusive retinal vascular disorder and results in varying degrees of visual loss. Aim: To determine the pattern of presentation, risk factors, and treatment outcomes in a group of patients with RVO seen in a tertiary hospital in Nigeria. Materials and Methods: Medical records of patients who presented to the University of Benin Teaching Hospital, Benin City, Nigeria in whom a diagnosis of RVO was made over a 5 years period were revi...

  15. Short-term efficacy of semicircular canal occlusion in the treatment of intractable Meniere's disease%半规管阻塞术治疗顽固性梅尼埃病的短期疗效分析

    Institute of Scientific and Technical Information of China (English)

    樊兆民; 张道宫; 韩月臣; 王海波

    2012-01-01

    目的 观察半规管阻塞术治疗顽固性梅尼埃病的短期疗效,评价其有效性和安全性.方法 回顾性分析17例行半规管阻塞手术的梅尼埃病患者资料,均为确诊单侧梅尼埃病,行规范化药物保守治疗至少1年以上,眩晕仍反复发作者.全麻下经乳突进路行三个半规管阻塞术,术后随访6~13个月,平均10个月.术前及术后3个月采用纯音测听、冷热试验和前庭诱发的肌源性电位检查( vestibular evoked myogenic potential,VEMP)进行听力学和前庭功能评价.结果 17例梅尼埃病患者,术前按听力进行分期,Ⅱ期(平均听阈25~40 dBHL)2例,Ⅲ期(41~70 dBHL)15例.术后随访期内均无眩晕发作,眩晕控制率为100% (17/17).同期行内淋巴囊减压术的25例梅尼埃病患者,眩晕控制率为72.0%( 18/25),半规管阻塞术的眩晕控制率高于内淋巴囊减压术(x2=3.87,P<0.05).术后3个月12例患者纯音平均听阈与术前相比无明显变化,5例听阈提高,但均小于20 dBHL,听力下降率29.4% (5/17).术后所有患者均出现短时间眩晕及平衡障碍,眩晕均在术后3d内消失,10例患者术后1~2周内恢复平衡功能,7例患者术后2个月内平衡障碍完全消失,平衡恢复时间平均12.6d.术后3个月复查,全部病例冷热试验均提示半规管功能丧失,VEMP检查示球囊功能无变化.所有患者均无面神经麻痹、脑脊液漏等并发症发生.结论 半规管阻塞术治疗顽固性梅尼埃病短期疗效确切,听力保留率高,不影响耳石器功能,无严重并发症,有望成为治疗存在中度以上听力损失的顽固性梅尼埃病患者安全有效的手术方法.%Objective To investigate the short-term efficacy and safety of triple semicircular canal occlusion (TSCO) in the treatment of intractable Meniere's disease ( MD),so as to provide an alternative surgical procedure for treating MD.Methods Seventeen patients,who had received standardized conservative

  16. Epulis and pyogenic granuloma with occlusal interference

    Directory of Open Access Journals (Sweden)

    Widowati Witjaksono

    2005-06-01

    Full Text Available In dental clinic of Hospital University Science Malaysia (HUSM, there were cases with Localized Gingival Enlargement (LGE in the oral cavity with occlusal interference. In this study, three cases were observed. They were a 13 - year- old female with fibrous lge around 31 and 32 with occlusal interference in protrusive movement due to X bite, a 15 - year – old female with pyogenic granuloma near 11 & 21 with occlusal interference due to deep bite; and a 24 – year – old female who was eight months in pregnancy with pyogenic granuloma on the 34-35 and severe generalized pregnancy gingivitis with occlusal interference in centric occlusion and lateral movement. Clinical and histopathological diagnosis of the first case showed fibrous epulis, whereas the second and third cases disclosed pyogenic granuloma. Chronic trauma of the gingiva due to occlusal interference was assumed to be the cause of those LGE in case 1 and 2, while in case 3 poor oral hygiene and chronic trauma were assumed to be the etiologic factors.

  17. Concomitant multiple myeloma spectrum diagnosis in a central retinal vein occlusion: a case report and review.

    Science.gov (United States)

    Borgman, Christopher J

    2016-07-01

    Multiple myeloma is a neoplastic plasma-cell disorder resulting from malignant plasma cells in the bone marrow. It can cause a hyperviscosity syndrome secondary to the paraproteinaemia associated with the disease. The increased hyperviscosity can lead to retinal vein occlusions and other ocular problems that may challenge clinicians. In patients with multiple myeloma and hypertension and/or diabetes mellitus, retinal changes appear similar and changes due to one disease or the other may be difficult to determine. A 48-year-old white female presented to the clinic with a complaint of blurry vision in her left eye. A full comprehensive ocular examination revealed a central retinal vein occlusion presumably from the patient's history of hypertension, diabetes mellitus and hypercholesterolaemia. Further bloodwork revealed monoclonal protein in the patient's serum and an increased percentage of plasma cells in the bone marrow. She was diagnosed with monoclonal gammopathy of undetermined significance, part of the multiple myeloma disease spectrum. She was referred to a retinal specialist for initiation of intravitreal injections of anti-vascular endothelial growth factor. Multiple myeloma has been implicated in younger patients as an underlying cause of retinal vein occlusions. Multiple myeloma should be considered as a differential diagnosis in young patients with retinal vein occlusions, even if other risk factors for venous occlusion like hypertension, diabetes mellitus and hypercholesterolaemia are present. Timely referral to the patient's primary care physician and haematologist is important for appropriate treatment and control of underlying systemic conditions. PMID:27079282

  18. Progression from stenosis to occlusion in the proximal native coronary artery after coronary artery bypass grafting.

    Science.gov (United States)

    Tanaka, Akihito; Ishii, Hideki; Oshima, Hideki; Shibata, Yohei; Tatami, Yosuke; Osugi, Naohiro; Ota, Tomoyuki; Kawamura, Yoshihiro; Suzuki, Susumu; Usui, Akihiko; Murohara, Toyoaki

    2016-07-01

    Coronary artery bypass grafting (CABG) is an established treatment for multivessel coronary artery disease. However, problematic situations are occasionally encountered after CABG, such as disease progression in the native coronary artery with graft occlusion, which causes difficulty in revascularization. The purpose of this study was to evaluate changes in the native coronary artery after CABG. Between 2009 and 2012 in our institution, 351 patients underwent CABG, and 768 bypass grafts were anastomosed to non-occluded coronary arteries. Of these, 489 bypass grafts had available early postoperative angiographic results (≤6 months) suitable for assessment in this study. We defined malignant graft failure after CABG to be bypass graft occlusion and de novo complete occlusion of the target native coronary artery proximal to the graft anastomosis site. In the early angiographic results, 17 grafts were occluded (17/489; 3.5 %). Two of the grafts displayed malignant graft failure (a saphenous vein graft to the right coronary artery and a saphenous vein graft to the diagonal branch) (2 of 17 occluded grafts, and 2 of 489 studied grafts). Of the patent bypass grafts, 24 involved progression to occlusion in the proximal native coronary artery (19 saphenous vein grafts, 4 left internal thoracic artery grafts, and 1 right internal thoracic artery graft). Malignant graft failure was uncommon during short-term follow-up after CABG. At the same time, disease progression in the proximal native coronary artery from stenosis to occlusion following patent bypass grafting was relatively common, especially for vein grafts.

  19. Retinal artery occlusions in children.

    Science.gov (United States)

    Dharmasena, Aruna; Wallis, Simon

    2014-01-01

    The purpose of this study is to present a case of RAO in a 13 year old girl with a preceding history of hyperextension of the neck at her hairdressers for a long duration and use of her mobile phone handset resting it against the side of her neck presumably exerting some pressure on carotids during the same time. Materials and methods of this study was reported as case report and review of literature. A 13 year-old girl presented with the left supero-nasal scotoma due to an inferior temporal branch retinal artery occlusion (BRAO). She underwent extensive investigations and no underlying cause was discovered. She gave a history of cervical extension over a long period of time while having the hair coloured twice in the preceding week. She also mentioned that she was using her mobile phone more or less continuously during both these occasions keeping it against her neck. Given the above history it is possible that the pressure on the ipsilateral carotid arteries or the prolong neck extension may have been responsible for the formation of a platelet embolus resulting in the BRAO. In conclusion, although cerebro-vascular accidents due to 'beauty parlor stroke syndrome' (JAMA 269:2085-2086, 1993) have been reported previously it has not been reported in children to our knowledge. On the other hand, 'beauty parlor stroke syndrome' occurs due to a dissection of the vertebral arteries or due to mechanical compression of the vertebral arteries during the prolonged hyperextension of the neck. The central retinal artery originates from the internal carotid circulation and it is highly unlikely for an embolus to enter the retinal circulation from the vertebral arteries. Therefore, the authors favour the possibility that the compulsive use of a mobile phone exerting pressure on the carotid arteries for a long time may have led to the formation of an embolus and subsequent RAO in this case.

  20. 半规管阻塞术治疗顽固性梅尼埃病的远期疗效%Long-term efficacy of triple semicircular canal occlusion in the treatment of intractable Meniere's disease

    Institute of Scientific and Technical Information of China (English)

    张道宫; 樊兆民; 韩月臣; 李亚伟; 王海波

    2015-01-01

    目的 观察半规管阻塞术治疗顽固性梅尼埃病的远期疗效,评估其有效性和安全性.方法 回顾性分析2010年12月至2012年7月山东大学附属省立医院49例行半规管阻塞术的梅尼埃病患者的临床资料.参照梅尼埃病的诊断依据和疗效评估(2006年,贵阳)标准,所有患者均临床诊断为单侧梅尼埃病,行规范化药物保守治疗至少1年以上,但眩晕仍反复发作.其中44例为首次手术,5例为内淋巴囊乳突引流术术后眩晕复发患者.全麻下经乳突进路行三个半规管阻塞术,术后均随访2年以上.采用纯音测听、前庭双温试验和颈源性前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)进行听力学和前庭功能评估,通过内耳MRI膜迷路水成像观察阻塞术后膜迷路的形态学改变.结果 49例梅尼埃病患者术前按听力进行分期,Ⅱ期(平均听阈25~40 dBHL)2例,Ⅲ期(41 ~ 70 dBHL)40例,Ⅳ期(>70 dBHL)7例.眩晕控制总有效率达100%,其中眩晕控制A级40例(81.6%),眩晕控制B级9例(18.4%);听力下降率为30.6% (15/49).术后所有患者均出现短时问眩晕及平衡障碍,眩晕均在术后3~5d内消失,平衡障碍恢复时间平均为13.5 d;所有患者均无面神经麻痹、脑脊液漏等并发症发生.术后2年复查前庭双温试验提示术侧半规管功能丧失;cVEMP检查示球囊功能无明显变化;内耳MRI膜迷路水成像检查发现三半规管阻塞区域无显影.结论 半规管阻塞术控制眩晕远期疗效确切,是治疗顽固性梅尼埃病安全、有效的方法,主要适用于存在重度以上听力损失或内淋巴囊手术后复发的患者.%Objective To explore the long-term efficacy and safety of triple semicircular canal occlusion (TSCO) in the treatment of intractable Meniere's disease (MD) so as to provide an alternative surgical procedure for treating this disorder.Methods Data from Forty-nine patients,who were referred

  1. Quantitative and qualitative evaluation of the influence of different table feeds on visualization of peripheral arteries in CT angiography of aortoiliac and lower extremity arteries

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, B.C.; Oldenburg, A.; Frericks, B.B.; Ribbe, C.; Wolf, K.J.; Albrecht, T. [Charite-University Hospital, Campus Benjamin Franklin, Department of Radiology and Nuclear medicine, Berlin (Germany); Hopfenmueller, W. [Charite-University Hospital, Campus Benjamin Franklin, Department of Biometry and Clinical Epidemiology, Berlin (Germany)

    2008-08-15

    The influence of different table feeds (TF) on vascular enhancement and image quality in patients undergoing lower extremity runoff-CTA for peripheral artery occlusive disease (PAOD), acute ischemia (AI) or abdominal aortic aneurysm (AAA) with PAOD was investigated retrospectively. One hundred eighty-five patients (PAOD: n=132; AI: n=40; AAA: n=13) underwent 16-detector runoff-CTA (120 kV; 140 mAs; rotation time 0.5 s, collimation 16 x 1.5 mm) using different TF (30 mm/s: n=25; 40 mm/s: n=91; 48 mm/s: n=36; 56 mm/s: n=33). Vascular enhancement of the large arteries was measured every 10cm along the z-axis from the upper abdomen to the toe. Arterial enhancement in the distal lower leg was compared (ANOVA, Bonferroni post-test). Qualitative assessment of bolus timing was performed independently by two radiologists. The study was IRB approved. In patients with PAOD or AI, enhancement of calf arteries using a TF of 48 mm/s (278{+-}79 HU) was significantly higher in comparison to two slower TF (30 mm/s: 201{+-}70 HU, P<0.001; 40 mm/s: 251{+-}79 HU, P<0.05; 56 mm/s: 261{+-}57 HU, NS) and the fewest noninterpretable arterial segments below the knee were observed with a TF of 48 mm/s (reader 1: 5/12=4.1%; reader 2: 4/121=3.3%). In patients with AAA, the fewest nondiagnostic segments occurred with a TF of 30 mm/s (2/12=17%, both readers) and 40 mm/s (4/24=17%, both readers). A TF of 48 mm/s provided the best synchronization of CT data acquisition and contrast bolus propagation and thus the best image quality in patients with PAOD and AI. In patients with AAA, a slower TF of 30 mm/s provided better image quality than faster CT protocols. (orig.)

  2. Epinephrine-induced activation of LW-mediated sickle cell adhesion and vaso-occlusion in vivo

    OpenAIRE

    Zennadi, Rahima; Moeller, Benjamin J; Whalen, Erin J.; Batchvarova, Milena; Xu, Ke; Shan, Siqing; Delahunty, Martha; Dewhirst, Mark W.; Telen, Marilyn J.

    2007-01-01

    Sickle red cell (SS RBC) adhesion is believed to contribute to the process of vaso-occlusion in sickle cell disease (SCD). We previously found that the LW RBC adhesion receptor can be activated by epinephrine to mediate SS RBC adhesion to endothelial αvβ3 integrin. To determine the contribution of LW activation to vaso-occlusive events in vivo, we investigated whether in vitro treatment of SS RBCs by epinephrine resulted in vaso-occlusion in intact microvasculature after RBC infusion into nud...

  3. Latin American Consensus on Retinal Vein Occlusion

    Directory of Open Access Journals (Sweden)

    Francisco J. Rodriguez

    2016-01-01

    Full Text Available The introduction of anti-VEGF agents has allowed unprecedented progress in the management and treatment of ophthalmologic conditions characterized by an increased vascular permeability and intraocular neovascularization. One of these conditions is retinal vein occlusion (RVO.  RVO is one of the most common causes of reduced vision due to retinal vascular disease. Without timely treatment, macular edema, macular ischemia, neovascularization and other potential sequelae of RVO can lead to photoreceptor cell death and consequently to irreversible vision loss.   Treatments for this indication that have been recently approved by several regulatory agencies throughout the world include: the VEGF inhibitor ranibizumab (Lucentis, Genentech, the VEGF and placental growth factor inhibitor aflibercept (Eylea, Regeneron Pharmaceuticals and Bayer HealthCare, and a slow release intravitreal implant of dexamethasone (Ozurdex, Allergan. In addition bevacizumab (Avastin, Genentech has been used extensively in an off-label manner.   These new treatments allow us to preserve vision for many RVO patients who could not have expected such favorable results just 5 or 6 years ago. However, not every treatment is effective for every patient, and whether one option is superior to another or a combination of options is superior to monotherapy, have yet to be definitively determined.   A growing body of literature with strong evidence supports the use of these new treatments. However, in several instances the literature is not conclusive to support unified management of RVO. This document is a summary analysis on RVO assembled by a group of specialists summoned by the Pan-American Vitreo-Retinal Society (SPRV to participate in this Latin American consensus.

  4. 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.

  5. A survey of occlusion detection method for visual object

    Institute of Scientific and Technical Information of China (English)

    张世辉

    2016-01-01

    Occlusion problem is one of the challenging issues in vision field for a long time , and the occlu-sion phenomenon of visual object will be involved in many vision research fields .Once the occlusion occurs in a visual system , it will affect the effects of object recognition , tracking, observation and operation , so detecting occlusion autonomously should be one of the abilities for an intelligent vision system .The research on occlusion detection method for visual object has increasingly attracted atten-tions of scholars .First, the definition and classification of the occlusion problem are presented . Then, the characteristics and deficiencies of the occlusion detection methods based on the intensity image and the depth image are analyzed respectively , and the existing occlusion detection methods are compared.Finally, the problems of existing occlusion detection methods and possible research directions are pointed out .

  6. Posterior circulation revascularization to manage vertebrobasilar occlusion

    Directory of Open Access Journals (Sweden)

    SHANG Yan-guo

    2012-06-01

    Full Text Available Objective To discuss the technique and effect of posterior circulation revascularization to manage vertebrobasilar occlusion. Methods Nine patients with vertebrobasilar occlusion were treated by using occipital artery-posterior inferior cerebellar artery bypass, superficial temporal artery-superior cerebellar artery bypass, superficial temporal artery-posterior cerebral artery bypass and occipital artery-vertebral artery bypass with radial artery graft. Results Intraoperative indocyanine green angiography showed all the bypass arteries were patent. Postoperative DSA or CTA showed bypass arteries patent in 8 patients, among whom seven patients got obvious improvement on MR or CT perfusion. One patient died of heart failure on the 15th day postoperative. During the follow-up of eight patients, no stroke reoccurred, four patients got back to nearly normal life. Conclusion Most of the patients with vertebrobasilar occlusion could benefit from the posterior circulation revascularization, which should be confirmed by randomized controlled clinical trials in the future.

  7. Case Report: Calcific Aortic Valve Stenosis Due to Central Retinal Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Ender Sener

    2013-10-01

    Full Text Available In this case, it was reported that a 48 year old male patient with spontaneous central retinal artery occlusion (CRAO due to calcific aortic valve stenosis. He had no other systemic disease. CRAO usually occurs in elder patients with systemic risk factors. CRAO results in sudden, painless and severe vision loss. Altough, CRAO is seen rarely under 50 year old, it may appear in younger patient with aortic valve disease and calcific aortic valve stenosis caused cardiac disease.

  8. Evaluation of occlusal factors in patients with temporomandibular joint disorder

    Directory of Open Access Journals (Sweden)

    Max Dória Costa

    2012-12-01

    Full Text Available OBJECTIVE: The aim of this study was to determine the prevalence and the relation between the main occlusal factors and the temporomandibular disorder (TMD. METHODS: We analyzed 100 patients (50 diagnosed with TMD and 50 asymptomatic volunteers, control group through a questionnaire that classified TMD as absent, mild, moderate and severe. Then, an evaluation was made of intraoral occlusal factors: Absence of posterior teeth, wear facets, overjet, overbite, open bite, posterior crossbite, sagittal relationship (Class I, II and III, centric relation discrepancy for maximum intercuspation, anterior guidance and balancing occlusal interference. The c² examined the association between TMD and considered occlusal variables. RESULTS: The prevalence of studied occlusal factors was higher in patients with moderate and severe TMD. Statistically significant results were found on: Absence of five or more posterior teeth, overbite and overjet greater than 5 mm, edge-to-edge bite, posterior crossbite, Class II and III, the absence of effective anterior guide and balancing side interferences. CONCLUSIONS: Indeed, it is concluded that there is a relationship between TMD and occlusal factors, however it can not be told to what extent these factors are predisposing, precipitating or perpetuating the disease. Therefore, despite its multifactorial etiology, one can not neglect the occlusal analysis of these patients.OBJETIVO: o presente estudo teve como objetivo verificar a prevalência e relação dos principais fatores oclusais com a disfunção temporomandibular. MÉTODOS: foram analisados 100 pacientes (50 com diagnóstico de DTM e 50 voluntários assintomáticos, grupo controle através de um questionário para classificação do grau de DTM, em ausente, leve, moderada e severa. Em seguida, foi realizada uma avaliação intrabucal dos fatores oclusais ausência de dentes posteriores, facetas de desgaste, overjet, overbite, mordida aberta anterior, mordida

  9. Metabolic syndrome and central retinal artery occlusion

    OpenAIRE

    Kosanović-Jaković Natalija; Petrović Lidija; Risimić Dijana; Milenković Svetislav; Matić Danica

    2005-01-01

    Background. The accumulation of risk factors for central retinal artery occlusion can be seen in a single person and might be explained by the metabolic syndrome. Case report. We presented the case of a 52-year-old man with no light perception in his right eye. The visual loss was monocular and painless, fundoscopy showed central retinal artery occlusion and the laboratory investigation showed the raised erythrocyte sedimentation rate of 105 mm/h and the raised C-reactive protein of 22 mg/l. ...

  10. A case of difficult catheterization of the contralateral limb of the Ovation Abdominal Stent Graft System in challenging aortoiliac anatomy, facilitated through the brachial access: a word of caution.

    Science.gov (United States)

    Georgakarakos, Efstratios; Ioannou, Chris V; Kontopodis, Nikolaos; Tsetis, Dimitrios

    2015-02-01

    The Ovation Stent Graft System is a new trimodular endoprosthesis for the treatment of abdominal aortic aneurysms. A long nitinol stent with anchors serves the suprarenal fixation, whereas inflatable rings in the main body achieve sealing. This dissociation precludes the presence of a nitinol skeleton in the endograft, thus, avoiding competing for the same space within the delivery system, enabling the latter to achieve ultra-low profiles. However, the lack of nitinol support may render the endograft's docking limb prone to collapse in cases of narrow aortoiliac anatomy. We present a case of challenging contralateral limb catheterization, facilitated effectively through the brachial access. Preparing for the brachial route remains a useful and time-sparing adjunctive measure that guarantees the device's safety and effectiveness in challenging anatomies. PMID:25433281

  11. Pulmonary interstitial emphysema: selective bronchial occlusion with a Swan-Ganz catheter.

    OpenAIRE

    Lewis, S; Pelausa, E; Ojah, C; Paes, B.

    1988-01-01

    A 26 week preterm infant ventilated for hyaline membrane disease developed severe pulmonary interstitial emphysema with extensive right sided bullous formation, mediastinal shift, and subsequent left sided atelectasis. A paediatric Swan-Ganz catheter was used for selective bronchial occlusion with dramatic improvement in the infant's clinical condition and radiographic findings.

  12. Cardioembolic occlusion of the internal carotid artery presented with infarction in the posterior cerebral artery territory

    Institute of Scientific and Technical Information of China (English)

    XUE Su-fang; JIA Jian-ping

    2010-01-01

    @@ Posterior circulation stroke may rarely be associated with occlusive disease in the anterior circulation, such as in the context of a direct (fetal) origin of the posterior cerebral artery (PCA) from the internal carotid artery (ICA), or in the presence of a persistent trigeminal artery (PTA) or persistent hypoglossal artery (PHA).1,2

  13. 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.

  14. Occlusal Caries: Biological Approach for Its Diagnosis and Management

    DEFF Research Database (Denmark)

    Christina Carvalho, Joana; Dige, Irene; Machiulskiene, Vita;

    2016-01-01

    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...... caries should explore the relationship between the function and the structural composition of these biofilms to understand the role of occlusal biofilms in caries development. State-of-the-art measures to evaluate risk for occlusal caries lesion activity, caries incidence, and progression should include...... the assessment of the occlusal biofilm and the stage of tooth eruption. Careful clinical examination of non-cavitated lesions, including assessment of the lesion activity status, remains the major tool to determine the immediate treatment need and to follow on the non-operative treatment outcome. Even medium...

  15. Virtual occlusion in planning orthognathic surgical procedures.

    NARCIS (Netherlands)

    Nadjmi, N.; Mollemans, W.; Daelemans, A.; Hemelen, G. Van; Schutyser, F.A.C.; Berge, S.J.

    2010-01-01

    Accurate preoperative planning is mandatory for orthognathic surgery. One of the most important aims of this planning process is obtaining good postoperative dental occlusion. Recently, 3D image-based planning systems have been introduced that enable a surgeon to define different osteotomy planes pr

  16. Virtual occlusal definition for orthognathic surgery.

    Science.gov (United States)

    Liu, X J; Li, Q Q; Zhang, Z; Li, T T; Xie, Z; Zhang, Y

    2016-03-01

    Computer-assisted surgical simulation is being used increasingly in orthognathic surgery. However, occlusal definition is still undertaken using model surgery with subsequent digitization via surface scanning or cone beam computed tomography. A software tool has been developed and a workflow set up in order to achieve a virtual occlusal definition. The results of a validation study carried out on 60 models of normal occlusion are presented. Inter- and intra-user correlation tests were used to investigate the reproducibility of the manual setting point procedure. The errors between the virtually set positions (test) and the digitized manually set positions (gold standard) were compared. The consistency in virtual set positions performed by three individual users was investigated by one way analysis of variance test. Inter- and intra-observer correlation coefficients for manual setting points were all greater than 0.95. Overall, the median error between the test and the gold standard positions was 1.06mm. Errors did not differ among teeth (F=0.371, P>0.05). The errors were not significantly different from 1mm (P>0.05). There were no significant differences in the errors made by the three independent users (P>0.05). In conclusion, this workflow for virtual occlusal definition was found to be reliable and accurate.

  17. 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 visualizatio

  18. 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 i

  19. Cilioretinal artery occlusion following intranasal cocaine insufflations

    Directory of Open Access Journals (Sweden)

    Balaji Kannan

    2011-01-01

    Full Text Available Cocaine is used to produce a euphoric effect by abusers, who may be unaware of the devastating systemic and ocular side effects of this drug. We describe the first known case of cilioretinal artery occlusion after intranasal cocaine abuse.

  20. 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.

  1. Clinical Practice Guidelines for intestinal occlusion.

    OpenAIRE

    Rudis Miguel Monzón Rodríguez; Carlos Jaime Geroy Gómez; Francisco García Valdéz; Jorge Luis Ulloa Capestany; Maribel Misas Menéndez

    2009-01-01

    Clinical Practice Guidelines for intestinal occlusion. This document includes the main aspects related with classification, physiopathology, clinical diagnosis, complementary examinations and therapy aimed at the post-operatory treatment. It includes assessment guidelines focused on the most important aspects to be accomplished.

  2. Virtual occlusal definition for orthognathic surgery.

    Science.gov (United States)

    Liu, X J; Li, Q Q; Zhang, Z; Li, T T; Xie, Z; Zhang, Y

    2016-03-01

    Computer-assisted surgical simulation is being used increasingly in orthognathic surgery. However, occlusal definition is still undertaken using model surgery with subsequent digitization via surface scanning or cone beam computed tomography. A software tool has been developed and a workflow set up in order to achieve a virtual occlusal definition. The results of a validation study carried out on 60 models of normal occlusion are presented. Inter- and intra-user correlation tests were used to investigate the reproducibility of the manual setting point procedure. The errors between the virtually set positions (test) and the digitized manually set positions (gold standard) were compared. The consistency in virtual set positions performed by three individual users was investigated by one way analysis of variance test. Inter- and intra-observer correlation coefficients for manual setting points were all greater than 0.95. Overall, the median error between the test and the gold standard positions was 1.06mm. Errors did not differ among teeth (F=0.371, P>0.05). The errors were not significantly different from 1mm (P>0.05). There were no significant differences in the errors made by the three independent users (P>0.05). In conclusion, this workflow for virtual occlusal definition was found to be reliable and accurate. PMID:26701322

  3. Combined central retinal artery and vein occlusion secondary to systemic non-Hodgkin′s lymphoma

    Directory of Open Access Journals (Sweden)

    Shukla Dhananjay

    2006-01-01

    Full Text Available We report a rare case of low-grade systemic B-cell non-Hodgkin′s lymphoma (NHL causing central retinal artery and vein occlusion, which was the only manifestation of disease recurrence. A young man with resolved systemic NHL underwent fluorescein angiography, magnetic resonance imaging and computed tomography to investigate a severe unilateral visual loss. A combined vascular occlusion was observed in the right eye. Neuroimaging detected optic nerve infiltration; but no systemic/ central nervous system involvement was observed. The patient was treated with high-doses of corticosteroids and optic nerve irradiation. The optic neuropathy and vascular occlusion were resistant to treatment. The subsequent neovascular glaucoma was treated by panretinal photocoagulation, which relieved the pain, but vision was not recovered. No further recurrence was observed over the following year.

  4. Sequential bilateral central retinal artery occlusion as the primary manifestation of systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    ZOU Xuan; ZHUANG Yan; DONG Fang-tian; ZHANG Fan; CHEN You-xin

    2012-01-01

    Bilateral central retinal artery occlusion (CRAO) has been rarely reported as the primary manifestation in patients with systemic lupus erythematosus (SLE).The severe retinal vaso-occlusive diseases usually cause devastating and permanent damage to visual function in spite of vigorous treatment.A 42-year-old Chinese woman presented with abrupt bilateral vision loss.The diagnosis of bilateral CRAO was suggested by the ocular presentation and fluorescein angiography.Laboratory studies showed positive results of antinuclear antibody,anti-Ro/SSA anti-La/SSB; decreased levels of C3,C4 complement and normal levels of antiphospholipides antibodies (APAs).Her visual acuity deteriorated despite systemic steroid and immunosuppressant treatment.Severe vaso-occlusive retinopathy may be an earlier manifestation of SLE without elevated level of APAs.

  5. Different Occlusal Schemes in a Persistent Protruding Complete Denture Wearer

    OpenAIRE

    Carolina Mayumi Iegami; Danilo de Melo Lopes; Atlas Edson Moleros Nakamae; Priscila Nakasone Uehara; Regina Tamaki

    2016-01-01

    Different types of artificial teeth and occlusal designs can be used in complete dentures. Bilateral balanced occlusion, lingualized occlusion, canine guidance, and monoplane are the main occlusal designs; however there is no agreement on which tooth arrangement is ideal for achieving success in complete dentures. This report presents an alternative for persistent involuntary protruding complete denture wearers through the use of artificial teeth with higher cusps. Due to an old and worn pair...

  6. Longitudinal occlusal changes from primary to permanent dentition in children with normal primary occlusion.

    Science.gov (United States)

    Legovic, M; Mady, L

    1999-06-01

    This purpose of this research was to examine the stability of normal occlusion during the transition from primary to permanent dentition. The sample consisted of 128 children (83 boys and 45 girls) 4.5 to 5.5 years old with normal occlusion in the primary dentition. The subjects were reexamined at 12.5 to 13.5 years. None had received orthodontic treatment. Although all the subjects had normal occlusion in the primary dentition, 72.7% (73.5% boys and 71.1% girls) had developed anomalies following eruption of the permanent teeth. These anomalies included crowding, Class II Division 1 or Class II Division 2 malocclusion, mesial occlusion complex, lateral crossbite, anterior crossbite, premature tooth loss, openbite or other anomalies.

  7. Combined iliac artery stenting and open femoral endarterectomy in the treatment of multi-level iliac and common femoral occlusive disease%髂动脉支架联合股动脉内膜剥脱术治疗多节段髂股动脉闭塞症

    Institute of Scientific and Technical Information of China (English)

    周敏; 刘昭; 刘晨; 乔彤; 黄佃; 冉峰; 王炜; 张明; 刘长建

    2013-01-01

    目的 探讨多节段髂股动脉闭塞症的治疗手段及临床疗效.方法 选择2008年1月2011年6月间采用髂动脉支架植入联合股动脉内膜剥脱+补片成形术治疗的多节段髂股动脉硬化闭塞症36例患者,其中男性26例,女性10例;年龄49~ 87岁,平均65岁.对患者的随访结果进行回顾性分析,评价术前、后患者临床症状改善情况,采用Kaplan-Meier生存分析比较不同Fontaine分级患者间一期通畅率的差异,采用Cox回归分析筛选影响一期通畅率的独立因素等.结果 本组患者手术均获成功,术后34例(94.4%)临床症状得到明显改善.平均随访24.2个月,一期通畅率为72.2%,辅助一期通畅率为83.3%,二期通畅率为94.4%.生存分析显示FontaineⅡ级患者一期通畅率明显高于Ⅲ、Ⅳ级患者(P =0.041、0.012).Cox回归分析未发现影响术后一期通畅率的独立因素.结论 髂动脉支架植入联合股动脉内膜剥脱+补片成形术是治疗多节段髂股动脉闭塞症的有效方法,随访结果良好.%Objective To evaluate the feasibility and efficacy of hybrid procedure for the treatment of multi-level iliac and common femoral occlusive disease.Methods From January 2008 to June 2011,36 lower limbs with sever iliac and common femoral occlusive diseases were treated by iliac artery stenting combined with open femoral endarterectomy.The mean age of the whole study population was 65 years (range 49 to 87 years) with a male predominance (26 males,72.2%).The early clinical results were determined by ankle brachial index and intermittent claudication distance.Patency analyses were performed using Kaplan-Meier life tables.Univariate and multivariate analysis were used to assess the influence of various risk factors on primary patency.Results All lower limbs underwent successful hybrid surgical and endovascular therapy.Clinical improvement was seen in 94.4% of patients.The mean duration of follow-up was 24.2 months

  8. Chronic total occlusion:To treat or not to treat

    Institute of Scientific and Technical Information of China (English)

    Alfredo; Bardají; Judit; Rodriguez-López; Mauricio; Torres-Sánchez

    2014-01-01

    Over the last two decades,there has been increasing interest in new techniques for the percutaneous treatment of coronary chronic total occlusions(CTO),which have a success rate that is much higher than that of a few years ago.The rise in percutaneous treatment for these lesions is due to its ability to improve the symptoms and prognosis of patients in the chronic and stable phase of coronary disease.Current data suggest that successful percutaneous coronary intervention for CTO is associated with improvement in patient symptoms,quality of life,left ventricular function,and survival,compared with those with unsuccessful CTO PCI.However,all the scientific evidence supporting this treatment comes from observational studies,and no randomized study comparing percutaneous treatment with medical treatment has yet been published.A major limitation of these studies is their observational design,with limited information with regard to potential baseline differences between the successful vs unsuccessful cohorts.Pending randomized studies,patients should be selected very carefully,especially if they are asymptomatic or very few symptoms,and the benefits obtained in terms of complications during the procedure,the quality of life obtained and further ischemic events avoided should be evaluated systematically.In this review,we will consider the available information supporting percutaneous treatment for chronic occlusions,as well as the areas of uncertainty where more research projects are required.

  9. Endoscopic bronchial occlusion with silicone spigots under virtual bronchoscopic navigation

    Science.gov (United States)

    Sato, Shingo; Shiroyama, Takayuki; Nishida, Takuji; Nishihara, Takashi; Okamoto, Norio

    2016-01-01

    Abstract A 68‐year‐old woman with interstitial lung disease related to dermatomyositis and systemic scleroderma was admitted to our hospital with fever and dyspnoea. Although the fever was reduced after antibiotic therapy, a left pneumothorax suddenly occurred on day 27 after admission. A continuous air leak persisted despite chest drainage with three tubes and repeated pleurodesis. Chest computed tomography (CT) images showed a cavitary lesion with a pinhole in the left upper division, which was suspected to be the affected lesion with the air leak. Virtual bronchoscopic navigation images were constructed from CT data. Bronchial occlusion with Endobronchial Watanabe Spigots (EWSs) was performed on day 52. Two medium‐sized EWSs were inserted into the left B1 + 2a and B1 + 2b, and the air leak stopped immediately. No procedure‐related adverse events occurred. All three chest tubes were successfully removed by day 60. This case demonstrates that virtual bronchoscopic navigation can improve bronchial occlusion procedures using EWSs. PMID:27512560

  10. Occlusion Handling in Videos Object Tracking: A Survey

    Science.gov (United States)

    Lee, B. Y.; Liew, L. H.; Cheah, W. S.; Wang, Y. C.

    2014-02-01

    Object tracking in video has been an active research since for decades. This interest is motivated by numerous applications, such as surveillance, human-computer interaction, and sports event monitoring. Many challenges related to tracking objects still remain, this can arise due to abrupt object motion, changing appearance patterns of objects and the scene, non-rigid object structures and most significant are occlusion of tracked object be it object-to-object or object-to-scene occlusions. Generally, occlusion in object tracking occur under three situations: self-occlusion, inter-object occlusion by background scene structure. Self-occlusion occurs most frequently while tracking articulated objects when one part of the object occludes another. Inter-object occlusion occurs when two objects being tracked occlude each other whereas occlusion by the background occurs when a structure in the background occludes the tracked objects. Typically, tracking methods handle occlusion by modelling the object motion using linear and non-linear dynamic models. The derived models will be used to continuously predicting the object location when a tracked object is occluded until the object reappears. Example of these method are Kalman filtering and Particle filtering trackers. Researchers have also utilised other features to resolved occlusion, for example, silhouette projections, colour histogram and optical flow. We will present some result from a previously conducted experiment when tracking single object using Kalman filter, Particle filter and Mean Shift trackers under various occlusion situation in this paper. We will also review various other occlusion handling methods that involved using multiple cameras. In a nutshell, the goal of this paper is to discuss in detail the problem of occlusion in object tracking and review the state of the art occlusion handling methods, classify them into different categories, and identify new trends. Moreover, we discuss the important

  11. Occlusion Handling in Videos Object Tracking: A Survey

    International Nuclear Information System (INIS)

    Object tracking in video has been an active research since for decades. This interest is motivated by numerous applications, such as surveillance, human-computer interaction, and sports event monitoring. Many challenges related to tracking objects still remain, this can arise due to abrupt object motion, changing appearance patterns of objects and the scene, non-rigid object structures and most significant are occlusion of tracked object be it object-to-object or object-to-scene occlusions. Generally, occlusion in object tracking occur under three situations: self-occlusion, inter-object occlusion by background scene structure. Self-occlusion occurs most frequently while tracking articulated objects when one part of the object occludes another. Inter-object occlusion occurs when two objects being tracked occlude each other whereas occlusion by the background occurs when a structure in the background occludes the tracked objects. Typically, tracking methods handle occlusion by modelling the object motion using linear and non-linear dynamic models. The derived models will be used to continuously predicting the object location when a tracked object is occluded until the object reappears. Example of these method are Kalman filtering and Particle filtering trackers. Researchers have also utilised other features to resolved occlusion, for example, silhouette projections, colour histogram and optical flow. We will present some result from a previously conducted experiment when tracking single object using Kalman filter, Particle filter and Mean Shift trackers under various occlusion situation in this paper. We will also review various other occlusion handling methods that involved using multiple cameras. In a nutshell, the goal of this paper is to discuss in detail the problem of occlusion in object tracking and review the state of the art occlusion handling methods, classify them into different categories, and identify new trends. Moreover, we discuss the important

  12. Dental Occlusion Influences the Standing Balance on an Unstable Platform.

    Science.gov (United States)

    Julià-Sánchez, Sonia; Álvarez-Herms, Jesús; Gatterer, Hannes; Burtscher, Martin; Pagès, Teresa; Viscor, Ginés

    2015-10-01

    Contradictory results are still reported on the influence of dental occlusion on the balance control. We attempted to determine whether there are differences in balance between opposed dental occlusion (Intercuspal position (ICP)/"Cotton rolls" mandibular position [CR]) for two extreme levels of stability (stable/ unstable). Twenty-five subjects were monitored under both dental occlusion and level of stability conditions using an unstable platform Balance System SD. The resulting stability index suggests that body balance is significantly better when dental occlusion is set in CR (p crowding (p = .006), midline deviation (p dental occlusion for the balance control comes strongly into effect in unstable conditions. PMID:25674772

  13. Concepts of occlusion in prosthodontics: A literature review, part I

    Science.gov (United States)

    Rangarajan, V.; Gajapathi, B.; Yogesh, P. B.; Ibrahim, M. Mohamed; Kumar, R. Ganesh; Karthik, Prasanna

    2015-01-01

    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. PMID:26929513

  14. Diagnosis and treatment of hepatic veno-occlusive disease induced by sedum aizoon in HBsAg positive patients%土三七致HBsAg阳性患者肝小静脉闭塞病的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    陈华忠; 董米连; 邵辉; 张智勤; 朱坚胜; 甘梅富; 阮冰

    2010-01-01

    Objective To review the diagnosis and treatment of hepatic veno-occlusive disease(HVOD)induced by sedum aizoon in HBsAg positive patients. Methods Clinical data of 35 HBsAg positive cases who took sedum aizoon decoction and developed HVOD were collected, the clinical manifestation, imaging examination, histological examination of liver puncture biopsy, and the outcomes of patients were reviewed. Results Hepatomegaly, liver dysfunction, abdominal effusion and map-like density changes in liver CT scan were observed in 35 patients. Liver biopsy wag performed in 17 patients. In histopathological examination, the swelling and point-like necrosis of liver cells, expansion and congestion of sinus, endothelial swelling, wall thickening, incomplete lumen occlusion of small liver vascular were observed. Map-like density changes in liver CT scan were found in all 17 patients who were diagnosed by histological examination. Fifteen patients presented small amount of ascites within 4 weeks of onset, 13 of whom recovered or improved after treated with low-molecular weight heparin and albumin; while among the remaining 20 patients. only half of them were benefited from the same treatments. Conclusion HVOD can be diagnosed by liver CT scan instead of histological examination; treatment of patients in early stage may improve the outcome.%目的 总结乙型肝炎表面抗原(HBsAg)阳性患者服用土三七致肝小静脉闭塞病(hepatic veno-occlusive disease,HVOD)的诊断和治疗经验.方法 对35例HBsAg阳性HVOD患者的临床表现、影像学检查和肝组织活检结果,以及治疗效果进行分析.结果 35例患者均有肝脏肿大、肝功能异常和腹腔积液等临床表现,肝脏CT有地图状密度改变.17例患者进行了肝组织活检,病理表现为肝细胞肿胀伴点状坏死;肝窦明显扩张、淤血;汇管区肝小静脉内皮肿胀,管壁增厚,管腔不完全闭塞.17例肝组织活检确诊的HVOD患者肝脏CT检查均

  15. 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).

  16. 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.

  17. Photoacoustic removal of occlusions from blood vessels

    Science.gov (United States)

    Visuri, Steven R.; Da Silva, Luiz B.; Celliers, Peter M.; London, Richard A.; Maitland, IV, Duncan J.; Esch, Victor C.

    2002-01-01

    Partial or total occlusions of fluid passages within the human body are removed by positioning an array of optical fibers in the passage and directing treatment radiation pulses along the fibers, one at a time, to generate a shock wave and hydrodynamics flows that strike and emulsify the occlusions. A preferred application is the removal of blood clots (thrombin and embolic) from small cerebral vessels to reverse the effects of an ischemic stroke. The operating parameters and techniques are chosen to minimize the amount of heating of the fragile cerebral vessel walls occurring during this photo acoustic treatment. One such technique is the optical monitoring of the existence of hydrodynamics flow generating vapor bubbles when they are expected to occur and stopping the heat generating pulses propagated along an optical fiber that is not generating such bubbles.

  18. Comparison of contrast-enhanced MR angiography of the aortoiliac vessels using a 1.0 molar contrast agent at 1.0T with intra-arterial digital subtraction angiography; Ergebnisse der kontrastverstaerkten MR-Angiographie der aortoiliakalen Gefaesse mit einem 1-molaren Kontrastmittel bei 1,0 T; Vergleich zur i.a. DSA

    Energy Technology Data Exchange (ETDEWEB)

    Mohrs, O.K. [Klinik und Poliklinik fuer Radiologie, Johannes Gutenberg-Univ. Mainz (Germany); Cardioangiologisches Centrum Bethanien, Frankfurt/Main (Germany); Oberholzer, K.; Bernhard, S.; Kalden, P.; Thelen, M.; Kreitner, K.F. [Klinik und Poliklinik fuer Radiologie, Johannes Gutenberg-Univ. Mainz (Germany); Krummenauer, F. [Inst. fuer Med. Biometrie, Epidemiologie und Informatik, Johannes Gutenberg-Univ. Mainz (Germany); Neufang, A. [Klinik fuer Herz- und Thoraxchirurgie, Johannes Gutenberg-Univ. Mainz (Germany)

    2004-07-01

    Purpose: To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE-MRA) using a 1.0 molar contrast agent at 1.0 T for the diagnosis of abdominal aortic aneurysms and stenoses of renal or iliac arteries in comparison to intraarterial digital subtraction angiography (DSA). Materials and Methods: A total of 19 patients with the suspicion of abdominal aortic aneurysm or stenosis of renal or iliac arteries were examined with CE-MRA at 1.0 T. Intra-arterial DAS served as reference in all cases. After test bolus tracking, 10 or 8 ml of the 1.0 molar contrast agent Gadobutrol corresponding to a dose of 0.1-0.15 mmol/kg bw were injected and imaging performed using a FLASH-3D sequence. To evaluate the interobserver-variability, the blinded images were analyzed by two radiologists. Besides the rating of overall image quality on a 4-point-scale, the images were evaluated for aneurysms and arteriosclerotic lesions with a stenosis of < 50% or > 50% or occlusion. Results: A total of 144 segments were analyzed. The mean value of the CE-MRA image quality was 3.4 on a 4-point scale. The sensitivity of CE-MRA in depicting relevant pathological findings was 96% and the specifity 99%. The positive predictive value was 96% and the negative predictive value 99%. Inter-observer variability was low with a kappa value of 0.82. Conclusion: CE-MRA using a 1.0 molar contrast agent at 1.0 Tenables an excellent diagnosis or exclusion of pathologies of the aortoiliac vessels. (orig.) [German] Ziel: Vergleich der MR-Angiographie (ce-MRA) der aortoiliakalen Gefaesse unter Verwendung eines 1-molaren, paramagnetischen Kontrastmittels bei 1,0 T zur intraarteriellen digitalen Subtraktionsangiographie (i.a. DSA). Material und Methoden: Es wurden 19 Patienten mit Verdacht auf ein infrarenales Aortenaneurysma bzw. eine Stenose der Nieren- oder Iliakalarterien untersucht. Die Messungen erfolgten bei 1,0 T unter Verwendung des 1-molaren, paramagnetischen Kontrastmittels Gadobutrol

  19. 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

  20. Tracking multiple mice through severe occlusions

    OpenAIRE

    Branson, Kristin

    2007-01-01

    In this thesis, I address the problem of tracking multiple identical mice through severe occlusions from video of a side of their cage. A solution to this problem would greatly benefit medical research because of the key role animal testing plays in medical research. As the majority of visual tracking algorithms are intended for tracking people or cars, they are not directly applicable to the mouse tracking problem. Mice are extremely deformable, unconstrained three-dimensional objects. They ...

  1. Dental Occlusion and Ophthalmology: A Literature Review

    Science.gov (United States)

    Marchili, Nicola; Ortu, Eleonora; Pietropaoli, Davide; Cattaneo, Ruggero; Monaco, Annalisa

    2016-01-01

    Stomatognathic system is strictly correlated to other anatomical regions; many studies investigated relationship between temporomandibular joint and posture, several articles describe cranio-facial pain from dental causes, such as trigger points. Until now less interest has been given to connections between dental occlusion and ophthalmology, even if they are important and involving. Clinical experience in dental practice claims that mandibular latero-deviation is connected both to eye dominance and to defects of ocular convergence. The trigeminal nerve is the largest and most complex of the twelve cranial nerves. The trigeminal system represents the connection between somitic structures and those derived from the branchial arches, collecting the proprioception from both somitic structures and oculomotor muscles. The intermedius nucleus of the medulla is a small perihypoglossal brainstem nucleus, which acts to integrate information from the head and neck and relays it on to the nucleus of the solitary tract where autonomic responses are generated. This intriguing neurophysiological web led our research group to investigate anatomical and functional associations between dental occlusion and vision. In conclusion, nervous system and functional pathways strictly connect vision and dental occlusion, and in the future both dentists and oculists should be more and more aware of this correlation for a better diagnosis and therapy. PMID:27733873

  2. Comparison of angiographic and clinical outcomes of coronary stenting of chronic total occlusions versus subtotal occlusions.

    Science.gov (United States)

    Moussa, I; Di Mario, C; Moses, J; Reimers, B; Di Francesco, L; Blengino, S; Colombo, A

    1998-01-01

    The objective of this study was to assess the short- and long-term outcome of patients undergoing coronary stenting for chronic total occlusions compared with a control patient population with nonocclusive stenoses. A total of 789 consecutive patients (1,043 lesions) underwent coronary stenting using a high-pressure stent optimization technique. The study population was divided into total occlusion group (94 consecutive patients [95 lesions] with chronic total occlusions) and subtotal occlusion group (695 consecutive patients [948 lesions] with nonocclusive stenoses). There was no difference in post-procedure angiographic minimum lumen diameter (3.13 +/- 0.48 vs 3.15 +/- 0.57 mm, p = 0.72) and minimum intrastent cross-sectional area by intravascular ultrasound (7.31 +/- 2.06 vs 7.64 +/- 2.53 mm2, p = 0.26) between the total and subtotal groups, respectively. Subacute thrombosis occurred in 2 patients (2.1%) in the total group compared with 9 patients (1.3%) in the subtotal group (p = 0.63). Angiographic restenosis occurred in 27% vs 22% (p = 0.40) and repeat angioplasty in 15% vs 13% (p = 0.62) in the total and subtotal groups, respectively. Thus, coronary stenting of chronic total occlusions after successful recanalization could be performed with a high success rate. In addition, the incidence of stent thrombosis, angiographic restenosis, and the need for target lesion revascularization is comparable to that of an unselected cohort of patients with nonocclusive stenoses.

  3. 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

  4. Relationship of Occlusal Schemes with the Occurrence of Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Dina H. Sugiaman

    2013-07-01

    Full Text Available Masticatory system is a complex functional unit of the body responsible for mastication, speech, and deglutition process. Temporomandibular disorders (TMD is used to describe all functional disturbances of the masticatory system. The etiology of TMD is multifactorial, such as occlusal disharmony and emotional stress. The relationship between occlusion and TMD has been highly debated in dentistry, one of the occlusal factors is the occlusal scheme. Occlusal schemes are defined as bilateral canine guidance, unilateral canine guidance, group function and balanced occlusion. However, studies about the relationship of occlusal schemes and the occurrence of the TMD are still limited and remained controversial. Objective: To investigate the relationship of occlusal schemes witht he occurrence of TMD. Methods: A cross-sectional study was conducted at the Faculty of Dentistry, Uniiversitas Indonesia. A total of 127 students were included in this study. Subjects were examined based on Clinical Helkimo Index and divided into TMD and non-TMD groups. Subjects were categorized as non-TMD groups if the value of the clinical Helkimo index was 0 and as TMD group when the value ranged between 1-25. Results: Balanced occlusion schemes has a greater risk of TMD occurrence with odds ratio value 5.6 and 95% confidence interval 1.188 to 26.331 (p=0.021. Conclusion: Balanced occlusion has a significant relationship with the occurrence of TMD.

  5. Occlusion and weight change in a patient after esophagectomy: success derived from restoration of occlusal support.

    Science.gov (United States)

    Yamanaka, Reiko; Soga, Yoshihiko; Minakuchi, Mami; Nawachi, Kumiko; Maruyama, Takayuki; Kuboki, Takuo; Morita, Manabu

    2013-01-01

    Occlusal support may be an important factor affecting nutritional support after major surgery. This report presents a patient who gained body weight after receiving a new prosthesis. The patient was an 82-year-old man with thoracic esophageal carcinoma. He did not have occlusal support because of multiple caries lesions. His body weight slowly increased after surgery, but almost stopped in the period of 54 to 68 days after surgery. After treatment with dentures (day 72 postsurgery), body weight gain was observed again, although his medical treatment had not changed. An appropriate prosthesis could contribute to perioperative nutrition support and may lead to earlier recovery after surgery. PMID:24179973

  6. Other cardiovascular disease

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005198 Study on the relationship of plasma fib-rinogen, platelet aggregation rate ad peripheral arterial occlusive disease. WANG Jie(王洁), et al. Dept Emerg, Gene Hosp Chin People’s Armed Police Forces, Beijing 100039. Chin J Epidemiol, 2005; 26 (1):1-4. Objective: To detect the relationship of plasma fibrinogen, platelet aggregation rate and peripheral arterial occlusive disease (PAOD) in the elderly.

  7. 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.

  8. Occlusal adjustment in the treatment of primary traumatic injury

    Directory of Open Access Journals (Sweden)

    Raulino Naves Borges

    2011-01-01

    Full Text Available A major concern in dentistry is the correct distribution of occlusal forces to promote balance among the elements of the stomatognathic system. Occlusal trauma may develop in situations where the magnitude of the load exerted by occlusion exceeds the ability of the periodontium surrounding the involved teeth to resist and distribute the resulting forces without moving. A 41-year-old female patient was referred to the Occlusion and Orofacial Pain Research Center at the School of Dentistry, Universidade Federal de Goiás, Brazil, with headache, temporomandibular joint pain, toothache, and bone resorption on the distal aspect of tooth #33. During clinical examination, a 2-mm difference between centric relation and habitual occlusion was detected, with interference between teeth #28 and #38, causing anterior projection of the mandible to the right. Probing depth of the lower canine was within normal limits, with a positive pulp vitality test. We concluded that pain and (grade II mobility in tooth #33 were caused by interference of third molars, which exerted a distal pressure on the lower canine, characterizing primary occlusal trauma. Occlusal adjustment by selective grinding was then indicated to eliminate premature contact. Ten sessions were required to obtain optimal occlusion. Three months after treatment, follow-up radiograph showed newly formed bone tissue between teeth #33 and #34, with absence of mobility and symptoms. The case reported here indicates that occlusal adjustment is recommended for the treatment of periodontal injuries caused by traumatic occlusion. The treatment allows the achievement of an optimal occlusion by directing occlusal forces to the long axis of the teeth.

  9. Occlusal adjustment in the treatment of secondary traumatic injury

    Directory of Open Access Journals (Sweden)

    Raulino Naves Borges

    2011-01-01

    Full Text Available The success of the rehabilitation treatment is associated with the relationship between occlusion and periodontal status. When occlusal loads exceed the ability of the periodontium to resist and distribute the resulting forces, injuries may develop, leading to failures in dental practice. A 35-year-old female patient presented at the Occlusion and Orofacial Pain Research Center at the School of Dentistry, Universidade Federal de Goiás, Brazil, complaining of pain and mobility in the maxillary central incisors and sensitivity in the mandibular left incisors and canine. Symptoms began after cast metal restoration was performed in tooth #27. Clinical examination revealed a signifi cant difference of 1 mm between centric relation and habitual occlusion, presence of a periodontal pocket 5 mm deep in the mesial aspect of tooth #11, and an increased vertical dimension of occlusion caused by occlusal interference between teeth #27 and #37. Radiographic examination detected vertical bone loss between teeth #21 and #11, on the mesial aspect of tooth #33 and between the lower incisors. The lower teeth also showed radiographic evidence of periapical lesions. Occlusal interference caused anterior projection of the mandible to the right, overloading the incisors. Treatment by occlusal adjustment was performed to promote an equal incidence of forces on all aspects of the teeth. Twelve sessions were required to achieve a balanced occlusion and restore the physiological vertical dimension of occlusion. Six months after treatment, there was radiographic evidence of newly formed bone tissue between teeth #11 and #21, regression of apical periodontitis in the lower teeth, and a decrease in mobility and all associated symptoms. Secondary traumatic injury may be responsible for changes in apical tooth structures. Occlusal adjustment may favor the direction of occlusal forces to the long axis of the teeth.

  10. Local Intra-Arterial Fibrinolysis in Acute Basilar Artery Occlusion

    OpenAIRE

    Enomoto, Y.; Yoshimura, S.; Kitajima, H.; Tamakawa, N.; Iwama, T

    2007-01-01

    Acute basilar artery (BA) occlusion is typically associated with poor outcome; however newer diagnostic and treatment modalities have the potential to improve prognosis. In this study, six patients with acute BA occlusion were followed and the effectiveness of local intra-arterial fibrinolysis (LIF) and subsequent percutaneous transluminal angioplasty (PTA) with a balloon catheter were assessed. Of the six patients with BA occlusion observed in this study, two had extended brain stem infarcti...

  11. Electro-oculogram of Retinal Vein Occlusion

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    Twenty five cases, including 26 eyes with retinal vein occlusion (RVO) were examined by means of the electro-oculogram. The results showed that 23 of the 26 eyes suffering from RVO exhibited abnormalities of the electro-oculogram (EOG). The potential difference and Arden ratio in the RVO eyes were lower than those in the normal eyes (P<0.01). The more the visual acuity of ill eyes was decreased, the higher the abnormal rate of EOG in ill eyes was. 14 eyes had the visual acuity less than 0.1, whose EOGs ...

  12. Arterial gas occlusions in operating heat pipes

    Science.gov (United States)

    Saaski, E. W.

    1975-01-01

    The effect of noncondensable gases on high performance arterial heat pipes has been investigated both analytically and experimentally. Models have been generated which characterize the dissolution of gases in condensate and the diffusional loss of dissolved gases from condensate in arterial flow. These processes, and others, have been used to postulate stability criteria for arterial heat pipes. Experimental observations of gas occlusions were made using a stainless steel heat pipe equipped with viewing ports, and the working fluids methanol and ammonia with the gas additives helium, argon, and xenon. Observations were related to gas transport models.

  13. 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....

  14. Successful percutaneous coronary intervention for chronic total occlusion of right coronary artery in patient with dextrocardia.

    Science.gov (United States)

    Munawar, Muhammad; Hartono, Beny; Iskandarsyah, Kurniawan; Nguyen, Thach N

    2013-07-01

    Situs inversus with dextrocardia is rare congenital anomaly. Coronary artery disease in such patients is quite rare. We reported a 52-year-old man with dextrocardia and chronic total occlusion at the proximal right coronary artery just after conus branch and severe stenosis at the proximal left anterior descending artery. He underwent successful percutaneous coronary intervention with stenting of total occluded right coronary artery and simultaneously stenting of the proximal left anterior descending artery.

  15. Dental occlusion: modern concepts and their application in implant prosthodontics.

    Science.gov (United States)

    Carlsson, Gunnar E

    2009-01-01

    The aim of this article was to review the literature on various aspects of occlusion related to implant prosthodontics, using PubMed and the Cochrane library. Even if the number of studies on implants and prosthodontics is very large, no randomized controlled trials or Cochrane reviews were found on the possible influence of occlusal design or characteristics of occlusion on treatment outcome. Therefore, studies and articles of a lower evidence level were accepted as the main part of the review. The widely spread opinion that implants are superior to natural teeth was refuted by two recent consensus conferences, which concluded that the long-term outcome of implant restorations is not better than that of natural teeth. No controlled studies on the optimal features of a harmonious natural and/or restored occlusion, including implant prostheses, were found. Nor was there any evidence that more sophisticated methods in jaw registration, e.g., using face-bows and adjustable articulators, compared with simpler methods, will yield better clinical prosthodontic results. This article discusses, among other things, concepts of occlusion of implant-supported restorations, occlusal material, cantilevers, and occlusal risk factors. Within the limitations of the review, it was concluded that many factors can influence implant failure and peri-implant bone loss but that little is known of the relative importance of such factors. Most probably, however, occlusal factors and details of occlusion are in general of minor importance for the outcome of implant restorations. Occlusion can be managed successfully by using simple methods for jaw registration and different occlusal concepts.

  16. Non-invasive investigation on endothelium-dependent and endothelium-independent dilation of peripheral arterial occlusive disease in the elderly%老年周围动脉闭塞性疾病内皮和非内皮依赖性舒张功能的分析

    Institute of Scientific and Technical Information of China (English)

    曹剑; 李小鹰; 刘涛

    2003-01-01

    Aim To evaluate the endothelium-dependent dilation(i.e. flow-mediated dilation,FMD)and endothelium-independent dilation( i.e.nitroglycerin-mediated dilation,NMD) of peripheral arterial occlusive disease (PAOD)in the elderly and to investigate the relative factors associated with FMD and NMD respectively.Methods Both FMD and NMD of the brachial artery in 33 old PAOD patients were detected by the color Doppler ultrasonograph and compared with 40 old healthly controls and 30 old non-PAOD patients with cardiovascular risk factors respectively.Results ① Both FMD and NMD of the brachial artery in 33 old PAOD patients were less than those of 40 old healthly controls and 30 old non-PAOD patients with cardiovascular risk factors significantly( t=- 2.2358- 2.7317, P< 0.01) . ② The basic vascular diameter,systolic blood pressure and the blood concentration of LDL-C related with brachial FMD negatively .③ FMD related with NMD positively,but the basic vascular diameter had negative relationship with NMD.Conclusion Both FMD and NMD of the old PAOD patients were impaired . The basic vascular diameter,systolic blood pressure and the concentration of LDL-C may be independent predictors of brachial FMD.%目的通过探讨老年周围动脉闭塞性疾病( peripheral arterial occlusive disease, PAOD)内皮依赖性舒张功能,即血流介导的血管扩张功能( flow-mediated dilation,FMD)和硝酸甘油介导的非内皮依赖性舒张功能( nitroglycerin-mediated dilation,NMD)状况,了解其相关因素.方法采用超声多普勒检测 33例已确诊为 PAOD的老年患者肱动脉 FMD及 NMD,并分别与 40例健康老人及 30例具有心血管危险因素的老年非 PAOD患者进行对照研究.结果老年 PAOD患者 FMD及 NMD均显著低于对照组( t=- 2.2358~ 2.7317, P< 0.01),;肱动脉基础内径、收缩压、低密度脂蛋白胆固醇与 FMD呈负相关 (相关系数 r分别为- 0.632,- 0.479,- 0.608, P值分别为 0.0001, 0.02, 0.001); FMD与 NMD

  17. 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.

  18. 老年周围动脉闭塞性疾病内皮和非内皮依赖性舒张功能的无创研究%Non-invasive investigation on vasodilation in peripheral arterial occlusive disease of the elderly

    Institute of Scientific and Technical Information of China (English)

    曹剑; 李小鹰; 赵沙沙; 刘涛

    2003-01-01

    目的探讨老年周围动脉闭塞性疾病(peripheral arterial occlusive disease,PAOD)内皮依赖性舒张功能,即血流介导的血管扩张功能(flow-mediated dilation,FMD)和硝酸甘油介导的非内皮依赖性舒张功能(nitroglycerin-mediated dilation,NMD)状况及其相关因素.方法采用超声多普勒检测33例已确诊为PAOD的老年患者肱动脉FMD及NMD,并分别与40例健康老年人及30例具有心血管危险因素的老年非PAOD患者进行对照研究.结果老年PAOD患者FMD及MD均显著低于对照组;肱动脉基础内径、收缩压、低密度脂蛋白胆固醇与FMD呈负相关;FMD与NMD呈正相关,肱动脉基础内径与NMD呈负相关.结论老年PAOD患者FMD及NMD均受损;肱动脉基础内径、收缩压、低密度脂蛋白胆固醇可能是FMD独立的预测因子;而FMD及肱动脉基础内径与NMD密切相关.

  19. The clinical value of cardio-ankle vascular index (CAVI) and ankle brachial index (ABI) in evaluation on therapeutic efficacy to lower limbs arterial occlusive disease%心踝血管指数和踝肱指数在下肢动脉闭塞介入治疗的应用价值

    Institute of Scientific and Technical Information of China (English)

    尹波; 黄光明; 张红霞; 张娟; 刘伟峰; 张卉; 张秀明; 王军

    2012-01-01

    目的 探讨心踝血管指数(Cardio-Ankle Vascular Index,CAVI)和踝肱指数(Ankle-Brachial Index,ABI)在下肢动脉闭塞性病变(lower limbs arterial occlusive disease,LAOD)介入治疗前评估和治疗后疗效评价中的应用价值及指标间的相关性.方法 2010年1~12月在我院行介入治疗的LAOD患者35例,所有患者均符合《下肢动脉粥样硬化性疾病诊治中国专家建议(2007)》对LAOD的诊断标准,应用血压脉搏测量装置检测CAVI和ABI作为治疗前评估和治疗后疗效的评价及随访的指标.结果 CAVI和ABI在介入治疗后和治疗前分别为(5.20±2.85)、(6.65±2.78)(P<0.05);(0.35±0.18)、(0.85±0.13)(P< 0.05).介入治疗前CAVI与ABI相关分析显示呈正相关(r=0.648,P<0.05),介入治疗后CAVI与ABI无明显相关性.结论 CAVI和ABI测定在LAOD介入治疗前评估和治疗后疗效评价中有较高的应用价值.

  20. Transluminal Recanalization of Chronic Total Occlusion of Radial Artery Using Rendezvous Technique: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Mohammad Arabi

    2014-01-01

    Full Text Available Although endovascular management of lower extremity peripheral arterial disease (PAD is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.

  1. Dorzolamide increases retinal oxygen tension after branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Noergaard, Michael Hove; Bach-Holm, Daniella; Scherfig, Erik;

    2008-01-01

    To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs.......To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs....

  2. 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...

  3. 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

  4. Effect of glove occlusion on the skin barrier

    DEFF Research Database (Denmark)

    Tiedemann, Daniel; Clausen, Maja Lisa; John, Swen Malthe;

    2016-01-01

    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...

  5. Comorbidity in patients with branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Linneberg, Allan; Rosenberg, Thomas;

    2012-01-01

    To evaluate comorbidity before and after the diagnosis of branch retinal vein occlusion to determine whether it is a consequence of arterial thickening and therefore could serve as a diagnostic marker for other comorbidities and to evaluate the risk factors for the development of such occlusion....

  6. Relationship of acute left main coronary artery occlusion and ST-segmentelevation in lead aVR

    Institute of Scientific and Technical Information of China (English)

    于富军; 傅向华; 卫亚丽; 李寿霖; 肖蕴陟; 丁超; 赵战勇

    2004-01-01

    @@It is well known that acute left main coronary artery (LMCA) occlusion is one of the most severe lesions associated with coronary artery disease. A large number of LMCA patients die suddenly at the very beginning of a heart attack. Noninvasive identification of acute LMCA occlusion is very important for patient prognosis and survival, especially to predict the need of the invasive procedure of coronary artery reconstruction. In this study, we sought to evaluate retrospectively the value of ST-segment elevation in lead aVR in predicting acute myocardial infarction (AMI) and acute LMCA obstruction.

  7. Clinical application of hepatic venous occlusion for hepatectomy

    Institute of Scientific and Technical Information of China (English)

    PAN Ze-ya; YANG Yuan; ZHOU Wei-ping; LI Ai-jun; FU Si-yuan; WU Meng-chao

    2008-01-01

    Background Most liver resections require clamping of the hepatic pedicle (Pringle maneuver) to avoid excessive blood loss. But Pringle maneuver can not control backflow bleeding of hepatic vein, Resection of liver tumors involving hepatic veins may cause massive hemorrhage or air embolism from the injuries of the hepatic veins. Although total hepatic vascular exclusion can prevent bleeding of the hepatic veins effectively, it also may result in systemic hemodynamic disturbance because of the inferior vena cava being clamped. Hepatic venous occlusion, a new technique, can control the inflow and outflow of the liver without clamping the vena cava.Methods A total of 71 cases of liver tumors underwent resection with occlusion of more than one of the main hepatic veins. All tumors involved the second porta hepatis and at least one main hepatic vein. Ligation or occlusion with serrefines, tourniquets and auricular clamps were used in hepatic venous occlusion.Results Of the 71 patients, ligation of the hepatic veins was used in 28 cases, occlusion with a tourniquet in 26, and occlusion with a serrefine in 17. Right hepatic veins were occluded in 38 cases, both right and middle hepatic veins in 2,the common trunk of the left and middle hepatic veins in 24, branches of the left and middle hepatic veins in 2, and all three hepatic veins in 5. Thirty-five cases underwent hemihepatic vascular occlusion, 4 alternate hemihepatic vascular occlusion, 23 portal triad clamping plus selective hepatic vein occlusion, and 9 portal triad clamping plus total hepatic vein occlusion. The third porta hepatis was isolated in 26 cases. The amount of intraoperative blood loss averaged (540±283) (range 100 to 1000) ml in the group of total hemihepatic vascular occlusion and in the group of alternate hemihepatic vascular occlusion, (620±317) (range 200-6000) ml in the group of portal triad clamping plus selective or total hepatic vein occlusion. All tumors were completely removed

  8. The Electroretinogram in Patients with Retinal Vascular Occlusion

    Institute of Scientific and Technical Information of China (English)

    Shizhou Huang; Lezheng Wu; Taiqing Luo; De-Zheng Wu; Futian Jiang; Guangwei Luo; Juanmei Ma

    2001-01-01

    Purpose: to measure and analyze the electroretinogram (ERG) in patients with retinal vascular occlusion. Method: fifty-eight cases (59 eyes) of retinal vascular occlusion and the fellow eyes of 47 cases were tested with Ganzfeld ERG. The scotopic and photopic ERG, and oscillatory potentials were tested according to the ERG standard of ISCEV. Results: The abnormal rates of Ops and b wave were higher in retinal vascular occlusion. The abnormal ERG appeared mostly in CRVO among four types of retinal vascular occlusion. The comparisons of some amplitudes and latencies between the fellow eyes and the affected eyes showed statistically significant difference. Conclusion: The oscillatory potentials and b waves have important roles in evaluating the retinal function of patients with retinal vascular occlusions. There are some clinical significance for comparing ERG between the affected eye and the fellow eye. Eye Science 2001; 17: 50 ~ 53.

  9. Local histograms and image occlusion models

    CERN Document Server

    Massar, Melody L; Fickus, Matthew; Kovacevic, Jelena

    2011-01-01

    The local histogram transform of an image is a data cube that consists of the histograms of the pixel values that lie within a fixed neighborhood of any given pixel location. Such transforms are useful in image processing applications such as classification and segmentation, especially when dealing with textures that can be distinguished by the distributions of their pixel intensities and colors. We, in particular, use them to identify and delineate biological tissues found in histology images obtained via digital microscopy. In this paper, we introduce a mathematical formalism that rigorously justifies the use of local histograms for such purposes. We begin by discussing how local histograms can be computed as systems of convolutions. We then introduce probabilistic image models that can emulate textures one routinely encounters in histology images. These models are rooted in the concept of image occlusion. A simple model may, for example, generate textures by randomly speckling opaque blobs of one color on ...

  10. Robust visual tracking with contiguous occlusion constraint

    Science.gov (United States)

    Wang, Pengcheng; Qian, Weixian; Chen, Qian

    2016-02-01

    Visual tracking plays a fundamental role in video surveillance, robot vision and many other computer vision applications. In this paper, a robust visual tracking method that is motivated by the regularized ℓ1 tracker is proposed. We focus on investigating the case that the object target is occluded. Generally, occlusion can be treated as some kind of contiguous outlier with the target object as background. However, the penalty function of the ℓ1 tracker is not robust for relatively dense error distributed in the contiguous regions. Thus, we exploit a nonconvex penalty function and MRFs for outlier modeling, which is more probable to detect the contiguous occluded regions and recover the target appearance. For long-term tracking, a particle filter framework along with a dynamic model update mechanism is developed. Both qualitative and quantitative evaluations demonstrate a robust and precise performance.

  11. Acute aortic occlusion presenting as flaccid paraplegia.

    Science.gov (United States)

    Kilany, Ayman; Al-Hashel, Jasem Y; Rady, Azza

    2015-01-01

    A 67-year-old male known to be hypertensive and diabetic had a sudden onset of severe low back pain and flaccid paraplegia with no sensory level or bladder affection and the distal pulsations were felt. Acute compressive myelopathy was excluded by MRI of the dorsal and lumbar spines. The nerve conduction study and CSF analysis was suggestive of acute demyelinating polyneuropathy. The patient developed ischemic changes of the lower limb and CT angiography revealed severe stenosis of the abdominal aorta and both common iliac arteries. We emphasize the importance of including acute aortic occlusion in the differential diagnosis of acute flaccid paraplegia especially in the presence of severe back pain even if the distal pulsations were felt. PMID:25866688

  12. Retinal vein occlusion in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Odarosa M Uhumwangho

    2016-01-01

    Full Text Available Background: Retinal vein occlusion (RVO is the most common occlusive retinal vascular disorder and results in varying degrees of visual loss. Aim: To determine the pattern of presentation, risk factors, and treatment outcomes in a group of patients with RVO seen in a tertiary hospital in Nigeria. Materials and Methods: Medical records of patients who presented to the University of Benin Teaching Hospital, Benin City, Nigeria in whom a diagnosis of RVO was made over a 5 years period were reviewed. Data obtained were analyzed with the GraphPad Instat Software, Inc. version V2.05a program, San Diego, Califonia and a P < 0.05 considered significant. Results: There were 20 patients made of 14 (70.0% males and 6 (30.0% females with a mean age of 62.7 ± 10.4 years. There were 15 (68.2% eyes with central RVO, 3 (13.6% eyes with branch RVO, and 4 (18.2% eyes with hemi RVO. Bilateral involvement occurred in 2 (10.0% patients. Risk factors included hypertension 14 (70.0%, diabetes mellitus 9 (45.0%, and glaucoma 5 (22.7%. Multiple risk factors were present in 14 (70.0% patients. Complications included macula edema 15 (68.2%, retinal neovascularization 5 (22.7%, neovascular glaucoma 3 (13.6%, and vitreous hemorrhage 2 (9.1%. Eyes which had definitive treatment with intravitreal antivascular endothelial growth factors and laser photocoagulation for macula edema and retinal neovascularization, respectively, had better visual acuity compared to eyes which did not receive these treatment, P = 0.002. Conclusion: The incidence and visual loss that occurs from RVO can be reduced by modifying known risk factors and early institution of appropriate therapy for complications that occur.

  13. Coherent spatial and temporal occlusion generation

    Science.gov (United States)

    Klein Gunnewiek, R.; Berretty, R.-P. M.; Barenbrug, B.; Magalhães, J. P.

    2009-02-01

    A vastly growing number of productions from the entertainment industry are aiming at 3D movie theatres. These productions use a two-view format, primarily intended for eye-wear assisted viewing in a well defined environment. To get this 3D content into the home environment, where a large variety of 3D viewing conditions exists (e.g different display sizes, display types, viewing distance), we need a flexible 3D format that can adjust the depth effect. Such a format is the image plus depth format in which a video frame is enriched with depth information of all pixels in the video. This format can be extended with an additional layer for occluded video and associated depth, that contains what is behind objects in the video. To produce 3D content in this extended format, one has to deduce what is behind objects. There are various axes along which this occluded data can be obtained. This paper presents a method to automatically detect and fill the occluded areas exploiting the temporal axis. To get visually pleasing results, it is of utmost importance to make the inpainting globally consistent. To do so, we start by analyzing data along the temporal axis and compute a confidence for each pixel. Then pixels from the future and the past that are not visible in the current frame are weighted and accumulated based on computed confidences. These results are then fed to a generic multi-source framework that computes the occlusion layer based on the available confidences and occlusion data.

  14. A Case of Incomplete Central Retinal Artery Occlusion Associated with Short Posterior Ciliary Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Shinji Makino

    2013-01-01

    Full Text Available To our knowledge, incomplete central retinal artery occlusion associated with short posterior ciliary artery occlusion is extremely rare. Herein, we describe a case of a 62-year-old man who was referred to our hospital with of transient blindness in his right eye. At initial examination, the patient’s best-corrected visual acuity was 18/20 in the right eye. Fundus examination showed multiple soft exudates around the optic disc and mild macular retinal edema in his right eye; however, a cherry red spot on the macula was not detected. Fluorescein angiography revealed delayed dye inflow into the nasal choroidal hemisphere that is supplied by the short posterior ciliary artery. The following day, the patient’s visual acuity improved to 20/20. Soft exudates around the optic disc increased during observation and gradually disappeared. His hemodynamic parameters revealed subclavian steal syndrome as examined by cervical ultrasonography and digital subtraction angiography. We speculate that his transient blindness was due to ophthalmic artery spasms. In this particular case, spasms of the ophthalmic artery and occlusion of the short posterior ciliary artery occurred simultaneously. As the short posterior ciliary artery branches from the ophthalmic artery, the anatomical location of the lesion might be near the branching of both arteries.

  15. Correlation of Functional Values of Left Ventricular Myocardium and the Data of Subjective State of Patients with Chronic Coronary Occlusion

    Directory of Open Access Journals (Sweden)

    Shakhov Е.B.

    2012-03-01

    Full Text Available The aim of the investigation is to study the correlation of functional values of left ventricular myocardium and the data of subjective state of patients with chronic coronary occlusion according to echocardiography findings and a new technique of subjective state assessment of patients with incomplete myocardial revascularization. Materials and Methods. The treatment results of 74 patients with coronary occlusion were analyzed. The 1st group consisted of 35 (47% patients with chronic occlusion localized in the right coronary artery, the 2nd ­— 15 (20% patients with chronic occlusion in anterior descending artery, the 3rd — 24 (33% patients with chronic occlusion of circumflex branch of coronary artery. All the patients underwent complete clinical and instrumental examination including echocardiography, angiography and history taking of subjective state of patients. Subjective state of patients was assessed by an original technique three times: preoperatively, a day after admission; on the 3rd day after the operation, and 3 months after surgery. The results obtained were correlated with the effect of the disease and X-ray endovascular treatment on physical, psychological, emotional and social states of a person. Conclusion. According to the technique of subjective state assessment of patients developed by the authors, incomplete X-ray endovascular myocardial revascularization contributes to the increase of psychological and social level functioning in early postoperative periods. In accordance with the echocardiography findings, complete recovery of left ventricular myocardial function in arterial occlusive disease can fail to be observed in early postoperative periods due to collateral myocardial hypoperfusion in the zone of chronic ischemia.

  16. Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

    Science.gov (United States)

    2010-01-01

    Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs). However, a recent report described a discrepancy between the habitual occlusal position (HOP) and the bite plate-induced occlusal position (BPOP) and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP) as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI) and the Helkimo Clinical Dysfunction Index (CDI) before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p 0.1). Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted. PMID:20346167

  17. Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

    Directory of Open Access Journals (Sweden)

    Chiwata Ichiro

    2010-03-01

    Full Text Available Abstract Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs. However, a recent report described a discrepancy between the habitual occlusal position (HOP and the bite plate-induced occlusal position (BPOP and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI and the Helkimo Clinical Dysfunction Index (CDI before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p 0.1. Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted.

  18. 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...... cannot be ruled out by clinical assessment alone and that preoperative determination of the SPP can be used in determining the chance of healing in BK amputations....

  19. Preliminary experience with transabdominal chemical sympatectomy in arterial occlusion of lower extremities using computerized tomography targeting

    International Nuclear Information System (INIS)

    Twenty transabdominal unilateral lumbar sympatectomies were performed using a Chiba needle under computerized tomography control. The intervention was made for advanced occlusive disease of the lower extremities, where reconstruction surgery was not possible. Out of nine patients under evaluation, an excellent effect was seen in two, a significant effect in two others, an uncertain effect in another patient while no improvement was seen in four patients. An alcohol solution containing a local long-acting anaesthetic and a contrast medium was used as the blocking agent. The method may be useful even in advanced disease stages and extends the range of diapeutic methods. (author). 4 figs., 8 refs

  20. 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.

  1. 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.

  2. 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.

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

    Science.gov (United States)

    Stagnitti, Franco

    2009-01-01

    Intestinal occlusion is defined as an independent predictive factor of intra-abdominal hypertension (IAH) which represents an independent predictor of mortality. Baggot in 1951 classified patients operated with intestinal occlusion as being at risk for IAH ("abdominal blow-out"), recommending them for open abdomen surgery proposed by Ogilvie. Abdominal surgery provokes IAH in 44.7% of cases with mortality which, in emergency, triples with respect to elective surgery (21.9% vs 6.8%). In particular, IAH is present in 61.2% of ileus and bowel distension and is responsible for 52% of mortality (54.8% in cases with intra-abdominal infection). These patients present with an increasing intra-abdominal pressure (IAP) which, over 20-25 mmHg, triggers an Abdominal Compartment Syndrome (ACS) with altered functions in some organs arriving at Multiple Organ Dysfunction Syndrome (MODS). The intestine normally covers 58% of abdominal volume but when there is ileus distension, intestinal pneumatosis develops (third space) which can occupy up to 90% of the entire cavity. At this moment, Gastro Intestinal Failure (GIF) can appear, which is a specific independent risk factor of mortality, motor of "Organ Failure". The pathophysiological evolution has many factors in 45% of cases: intestinal pneumatosis is associated with mucosal and serous edema, capillary leakage with an increase in extra-cellular volume and peritoneal fluid collections (fourth space). The successive loss of the mucous barrier permits a bacterial translocation which includes bacteria, toxins, pro-inflammatory factors and oxygen free radicals facilitating the passage from an intra-abdominal to inter-systemic vicious cyrcle. IAH provokes the raising of the diaphragm, and vascular and visceral compressions which induce hypertension in the various spaces with compartmental characteristics. These trigger hypertension in the renal, hepatic, pelvic, thoracic, cardiac, intracranial, orbital and lower extremity areas, giving

  4. A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

    Institute of Scientific and Technical Information of China (English)

    Mei Jin; Yong-Mei Liang; Xiao-Fang Wang; Bao-Jing Guo; Ke Zheng; Yan Gu; Zhen-Yu Lyu

    2015-01-01

    Background: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.Methods: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.Results: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,l 0.08 ± 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%).Conclusions: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.

  5. HYBRIDIZATION TECHNIQUE IN THE TREATMENT OF VASCULAR PROSTHESIS BYPASS GRAFT THROMBOSIS IN PATIENTS WITH LOWER EXTREMITY ARTERIAL OCCLUSIVE DISEASE%杂交技术治疗下肢动脉人工血管旁路术后再闭塞的效果

    Institute of Scientific and Technical Information of China (English)

    杨牟; 张居文; 陈萍; 车海杰; 孙林; 勇俊; 李鲁滨; 宋富波

    2012-01-01

    Objective To summarize the experience on using hybridization technique for thrombosis of prosthetic bypass in patients with ischemic disease of lower extremity, and explore a possible therapy of this condition. Methods Clinical data of 16 patients treated in our department for embolism after vascular prosthesis bypass, during the period from December 2006 to July 2010, were analyzed retrospectively. Of whom, six were treated with simple thrombectomy, and 10 underwent thrombectomy plus intracavitary anastomotic plasty. Results All the surgery was successful. Operation time was (40±15) min, with blood loss less then 100 mL. A follow-up one year after surgery showed that the prothesis was unobstructed in 13 patients, the extremity was retained in 15 patients. Conclusion Hybridization tecnique plays an important role in treating re-occlusion of vascular prothesis, in keeping its potency rate and retaining the affected extremity.%目的 总结杂交技术治疗下肢动脉人工血管旁路术后再闭塞的体会,探索合理的治疗方法.方法 2006年12月-2010年7月,我科应用杂交技术治疗下肢动脉人工血管旁路术后再闭塞病人16例,回顾性分析其临床资料,其中行单纯人工血管取栓6例,人工血管取栓+腔内吻合口成形术10例.结果 16例手术均获得成功,手术时间为(40±15)min,出血量均<100 mL.术后1年随访时人工血管通畅13例,保肢15例.结论 杂交技术治疗下肢动脉人工血管旁路术后再闭塞,对提高人工血管术后通畅率和保肢率有重要作用.

  6. Hybrid surgical and endovascular therapy in TASC type D atherosclerotic occlusive disease: a retrospective analysis of 48 cases%杂交手术治疗TASC D型下肢动脉硬化闭塞症的临床分析

    Institute of Scientific and Technical Information of China (English)

    周敏; 刘长建; 乔彤; 刘晨; 黄佃; 冉峰; 王炜; 张明

    2010-01-01

    Objective To retrospectively analyze 4-year results after hybrid (combined surgicalendovascular) therapy in patients with complex peripheral TASC type D atherosclerotic occlusive disease.Methods From January 2006 to December 2009, 48 lower limbs in 46 patients with TASC type D atherosclerotic occlusive disease were treated by hybrid surgical and endovascular therapy. There were 32 male and 16 female, age ranged from 54 to 85 years with an average of 67 years. The early clinical results were determined by ankle brachial index (ABI) and intermittent claudication distance. Patency analyses were performed using Kaplan-Meier life tables. Univariate and multivariate analyses were used to assess the influence of various risk factors on primary patency. Results All lower limbs underwent successful hybrid surgical and endovascular therapy. The average ABI before and after hybrid therapy were 0. 63 ±0. 18 and 0. 24 ± 0. 13 (P <0. 05). The average intermittent claudication distance significantly increased from (87 ±48 ) m to (247 ± 62) m ( P < 0. 05 ). The mean duration of follow-up was 21.7 months ( ranging 1 to 46 months). Over all, the primary patency rates, primary assisted patency rates and second patency rates were 79.2%, 83. 3% and 95. 8% respectively. The primary patency rate for intermittent claudication was significantly higher than that for critical limb ischemia ( P < 0. 05 ). Primary patency rates were lower in patients who underwent open surgery with both proximal and distal endoluminal procedures when compared with endovascular reconstruction proximal or distal to the site of open reconstruction ( P < 0. 05 ). The presence of diabetes and dyslipidaemia were independent predictors of decreased primary patency rate ( P =0. 013 and P = 0. 008, respectively). Conclusions Hybrid procedures provide an effective treatment management of selected patients with multilevel lower extremity arterial disease.%目的 评价杂交手术治疗TASC D型下肢动脉

  7. 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.

  8. Vertebrobasilar occlusions. Pathophysiology, diagnostics and treatment

    International Nuclear Information System (INIS)

    Acute vertebrobasilar occlusions (VBO) are dramatic clinical events with a mortality of up to 90% under standard medical treatment. If VBO is suspected a diagnosis of the vessel status has to be achieved immediately. For this purpose CT/CTA and MRI/MRA are equivalent diagnostic tools in the emergency setting. In contrast to the anterior circulation, local endovascular treatment is the established therapy for the posterior circulation as an underlying arteriosclerotic stenosis remains in 50% of the cases after intravenous fibrinolysis. Nevertheless, systemic fibrinolysis is considered the preferred option in cases where a neurointerventional center cannot be reached within a reasonable time frame and the patient can subsequently be transported for local therapy of a residual stenosis in order to prevent reocclusion (''drip and ship''). Profound clinical and pathophysiological knowledge is the absolute prerequisite for the correct application of state-of-the-art neurointerventional therapy. This review paper focuses on the clinical and pathophysiological details that are crucial for decision-making. (orig.)

  9. Fetal MRI in experimental tracheal occlusion

    International Nuclear Information System (INIS)

    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

  10. Clinical trials in branch retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Tandava Krishnan Panakanti

    2016-01-01

    Full Text Available Branch retinal vein occlusion (BRVO is the second most common retinal vascular disorder. The management of macular edema has changed considerably over time. The laser is considered the gold standard treatment for over two decades. However, visual recovery with laser is usually slow and incomplete. The advent of intravitreal agents, specifically anti-vascular endothelial growth factors (VEGF have heralded a new era which promises rapid recovery of vision and quality of vision. Randomized clinical trials have reported optimal results with anti-VEGF agents (ranibizumab, bevacizumab, and aflibercept compared to laser therapy or steroids. However, nearly 50% of the patients require repeat intravitreal anti-VEGF therapy up to 4 years after initiating therapy to sustain the visual gains. The adverse events (systemic and ocular of these agents are minimal. Monotherapy with anti-VEGF agents have been found to provide better results than any combination with laser. This review article summarizes evidence from randomized controlled trials evaluating treatment options for the treatment of macular edema secondary to BRVO with a special focus on anti-VEGF therapy.

  11. 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.

  12. Taurolidine lock is superior to heparin lock in the prevention of catheter related bloodstream infections and occlusions.

    Directory of Open Access Journals (Sweden)

    Evelyn D Olthof

    Full Text Available BACKGROUND AND AIMS: Patients on home parenteral nutrition (HPN are at risk for catheter-related complications; mainly infections and occlusions. We have previously shown in HPN patients presenting with catheter sepsis that catheter locking with taurolidine dramatically reduced re-infections when compared with heparin. Our HPN population therefore switched from heparin to taurolidine in 2008. The aim of the present study was to compare long-term effects of this catheter lock strategy on the occurrence of catheter-related bloodstream infections and occlusions in HPN patients. METHODS: Data of catheter-related complications were retrospectively collected from 212 patients who received HPN between January 2000 and November 2011, comprising 545 and 200 catheters during catheter lock therapy with heparin and taurolidine, respectively. We evaluated catheter-related bloodstream infection and occlusion incidence rates using Poisson-normal regression analysis. Incidence rate ratios were calculated by dividing incidence rates of heparin by those of taurolidine, adjusting for underlying disease, use of anticoagulants or immune suppressives, frequency of HPN/fluid administration, composition of infusion fluids, and duration of HPN/fluid use before catheter creation. RESULTS: Bloodstream infection incidence rates were 1.1/year for heparin and 0.2/year for taurolidine locked catheters. Occlusion incidence rates were 0.2/year for heparin and 0.1/year for taurolidine locked catheters. Adjusted incidence ratios of heparin compared to taurolidine were 5.9 (95% confidence interval, 3.9-8.7 for bloodstream infections and 1.9 (95% confidence interval, 1.1-3.1 for occlusions. CONCLUSIONS: Given that no other procedural changes than the catheter lock strategy were implemented during the observation period, these data strongly suggest that taurolidine decreases catheter-related bloodstream infections and occlusions in HPN patients compared with heparin.

  13. Choice PTTM guidewire for recanalization of total occlusive coronary arteries

    Institute of Scientific and Technical Information of China (English)

    OUYANG Ping; HE Shi-hua; CHEN Wei-Kang; WOO Carrie

    2002-01-01

    Objective: To evaluate the therapeutic effects of 0. 014″Choice PTTM wire in chronic total occlusion angioplasty. Methods: Balloon angioplasty was attempted in 25 arteries with chronic total occlusion,with the mean time of occlusion of 17±13 months (ranging from 2 to 84 months) and mean length of 14±6mm (ranging from 5 to 25 mm). The morphology of the lesions included bridging collaterals (4 cases), calcification (3 cases) and major side branch at the lesion (4 cases) . Choice PTTM wire was used electively in all the cases. Results: Lesion was crossed successfully in 92% (23/25) cases, without incidences of dissection of the coronary artery with subintimal entry. Balloon angioplasy and stenting (n=21) were performed with good immediate angiograghic results. Acute myocardial infarction or death occurred in none of the patients.Conclusion Successful recanalization of chronic coronary total occlusions using Choice PTTM wire can be achieved with good safety.

  14. 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.

  15. 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.

  16. Height Gradient Approach for Occlusion Detection in Uav Imagery

    Science.gov (United States)

    Oliveira, H. C.; Habib, A. F.; Dal Poz, A. P.; Galo, M.

    2015-08-01

    The use of Unmanned Aerial Vehicle (UAV) significantly increased in the last years. It is used for several different applications, such as mapping, publicity, security, natural disasters assistance, environmental monitoring, 3D building model generation, cadastral survey, etc. The imagery obtained by this kind of system has a great potential. To use these images in true orthophoto generation projects related to urban scenes or areas where buildings are present, it is important to consider the occlusion caused by surface height variation, platform attitude, and perspective projection. Occlusions in UAV imagery are usually larger than in conventional airborne dataset due to the low-altitude and excessive change in orientation due to the low-weight and wind effects during the flight mission. Therefore, this paper presents a method for occlusion detection together with some obtained results for images acquired by a UAV platform. The proposed method shows potential in occlusion detection and true orthophoto generation.

  17. Different Occlusal Schemes in a Persistent Protruding Complete Denture Wearer

    Directory of Open Access Journals (Sweden)

    Carolina Mayumi Iegami

    2016-01-01

    Full Text Available Different types of artificial teeth and occlusal designs can be used in complete dentures. Bilateral balanced occlusion, lingualized occlusion, canine guidance, and monoplane are the main occlusal designs; however there is no agreement on which tooth arrangement is ideal for achieving success in complete dentures. This report presents an alternative for persistent involuntary protruding complete denture wearers through the use of artificial teeth with higher cusps. Due to an old and worn pair of complete dentures, the patient had the habit of protruding. New dentures were made with Biotone artificial teeth and in the trial session, the patient would still protrude. A new set was made with Premium artificial teeth, which present higher cusps. With these dentures, the involuntary protrusion did not occur. From the delivery to the follow-up sessions, the patient stopped protruding.

  18. Different Occlusal Schemes in a Persistent Protruding Complete Denture Wearer.

    Science.gov (United States)

    Iegami, Carolina Mayumi; Lopes, Danilo de Melo; Nakamae, Atlas Edson Moleros; Uehara, Priscila Nakasone; Tamaki, Regina

    2016-01-01

    Different types of artificial teeth and occlusal designs can be used in complete dentures. Bilateral balanced occlusion, lingualized occlusion, canine guidance, and monoplane are the main occlusal designs; however there is no agreement on which tooth arrangement is ideal for achieving success in complete dentures. This report presents an alternative for persistent involuntary protruding complete denture wearers through the use of artificial teeth with higher cusps. Due to an old and worn pair of complete dentures, the patient had the habit of protruding. New dentures were made with Biotone artificial teeth and in the trial session, the patient would still protrude. A new set was made with Premium artificial teeth, which present higher cusps. With these dentures, the involuntary protrusion did not occur. From the delivery to the follow-up sessions, the patient stopped protruding. PMID:27069698

  19. 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.

  20. Early rethrombosis in femoropopliteal occlusions treated with percutaneous transluminal angioplasty

    DEFF Research Database (Denmark)

    Jørgensen, B; Meisner, S; Holstein, P;

    1990-01-01

    success as well as vascular patency were evaluated. The results were grouped into the following subsets: the indication for PTA, the severity of the vascular lesion, the crural run-off and the length of lesion. The results were in every respect poor with total occlusions when compared with stenoses....... This was explained by a high incidence (41%) of rethrombosis within hours of dilatation. Early rethrombosis was seen with all lengths of occlusion (1-27 cm) with no statistically significant difference from other subsets. This study concludes that conventional PTA in femoropopliteal occlusions should be reserved...... for cases of limb salvage, preferably in patients who are technically inoperable. We suggest a new technique of segmentally enclosed thrombolysis to prevent early rethrombosis after PTA in femoropopliteal occlusions....

  1. 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

  2. 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.

  3. 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.

  4. Influence of occlusal splint thickness on the position of mandible

    Institute of Scientific and Technical Information of China (English)

    CHEN Yong-jin; Nagashima T; Nokubi T

    2005-01-01

    Objective: To investigate the influence of occlusal splint thickness on mandibular movement. Methods: Stabilization occlusal splints of 3, 5 and 7 mm thickness were respectively used during clenching from light contact in intercuspal position and the movement of condyles and incisor point were recorded in 5 healthy subjects. Results:The condyles moved anteriorly and superiorly without wearing occlusal splint. When wearing the occlusal splints the condyles displaced anteriorly and inferiorly. The distance of displacement increased gradually with raising the thickness of splint, though the significant difference was just found in right condyle in superior- inferior movement. The condyles went again on a path of anterior and superior direction when subjects clenched from the displaced position. In right condyle the displacement was significantly greater at 7 mm splint than that at 3 mm splint both in anterior-posterior and inferior-superior direction, while in left condyle only in anterior-posterior direction. Meanwhile, the incisal point movement was larger at 7 mm splint than at 3 mm splint in inferior-superior direction. In tapping movement there were no significant differences in condyle movement between the different thickness of occlusal splint. However, the coefficient of variation in total cycle time was the greatest when wearing the splint of 7 mm. Conclusion: Occlusal splint of 7 mm has greater effect than that of 3 mm on condyle movement, but no obvious difference with occlusal splint of 5 mm. When occlusal splint of 7 mm is inserted, the stability of condyle might be influenced during tapping movement.

  5. Effect of Different Occlusion on Facial Expressions Recognition

    OpenAIRE

    Ankita Vyas; Ramchand Hablani

    2014-01-01

    Occlusions around facial parts complicate the task of recognizing facial expressions from their facial images. We propose facial expressions recognition method based on local facial regions, which provides better recognition rate in the presence of facial occlusions. Proposed method uses Uniform Local Binary pattern as a feature extractor, which extract discriminative features from some important parts of facial image. Feature vectors are classified using simplest classifier th...

  6. Prevalence of Orthodontic Treatment Need and Occlusal Traits in Schoolchildren

    OpenAIRE

    Jamilian, Abdolreza; Darnahal, Alireza; Damani, Elnaz; Talaeipour, Maziar; Kamali, Zinat

    2014-01-01

    Background. Widespread use of the IOTN along with detailed study of occlusal traits is suitable for planning community dental health resources. Objectives. The aim of current study was to assess the need for orthodontic treatment among school children of Tehran by means of the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and also to evaluate the occlusal traits of the subjects. Methods. 684 (343 boys and 341 girls) school children, 15 to 17 years of age, wer...

  7. Plain abdominal film and abdominal ultrasound in intestine occlusion

    International Nuclear Information System (INIS)

    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

  8. Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing

    Directory of Open Access Journals (Sweden)

    Arai H

    2014-04-01

    Full Text Available Haruka Arai,1 Tsutomu Sakai,1 Kiichiro Okano,1 Ranko Aoyagi,1 Ayano Imai,2 Hiroshi Takase,2 Manabu Mochizuki,2 Hiroshi Tsuneoka11Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, JapanAbstract: Central retinal artery occlusion (CRAO and multifocal retinitis with perivascular sheathing are rare in ocular toxoplasmosis. We report a case of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. A healthy 83-year-old male developed left panuveitis. Funduscopic examination of the left eye showed a swollen optic disc and sheathing of the retinal artery with a dense vitreous haze and a white retinal lesion. Serum anti-toxoplasma antibodies were positive in a latex agglutination assay. Vitrectomy was performed to improve visualization of the retinal lesions and for examination of causative microorganisms. A postoperative fundus examination revealed CRAO with optic disc involvement and multifocal retinitis with perivascular sheathing. Qualitative multiplex polymerase chain reaction detected the Toxoplasma gondii B1 gene in ocular fluid from both the aqueous and vitreous humor. The presumed diagnosis of ocular toxoplasmosis was made and treatment was started with prednisone and acetylspiramycin with subsequent improvement. Two months later, the patient developed active retinochoroiditis in the left eye. After 6 weeks of anti-toxoplasma therapy, the disease involuted. Retinal vascular occlusions and multifocal retinitis with perivascular sheathing are rare in toxoplasmosis. This is the first case report of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. The diagnosis of ocular toxoplasmosis should be considered in patients with retinal artery occlusions and multifocal retinitis with perivascular sheathing associated with inflammation.Keywords: ocular toxoplasmosis, toxoplasma retinochoroiditis

  9. [Moyamoya disease].

    Science.gov (United States)

    Esin, R G; Isayeva, Yu N; Gorobets, E A; Tokareva, N V; Esin, O R

    2016-01-01

    Moya-moya is a rare cerebrovascular disease characterized by the progressive occlusion of cerebral vessels with partial switching off the circle of Willis and arteries that feed it. The article provides a review of literature, modern diagnostic criteria and a description of a single clinical case. The onset of the disease in this patient was characterized by headache and speech disorders.An analysis of speech disorders showed that they were systemic. They were registered at all language levels (phonetic, lexical,morphological, syntactic). A long diagnostic search may be explained by clinical manifestations that are atypical for other cerebrovascular diseases and by the rarity of the disease. PMID:27386589

  10. 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.

  11. A Randomized Clinical study of Domestic Clopidogrel Lipoic acid and Cilostazol in Treatment of Peripheral Arterial Occlusive Disease%硫酸氢氯吡格雷治疗糖尿病下肢动脉闭塞症的随机对照临床试验研究

    Institute of Scientific and Technical Information of China (English)

    李林; 何永城; 李旭盛; 李群

    2015-01-01

    目的:观察硫酸氢氯吡格雷治疗2型糖尿病( T2DM)下肢动脉闭塞( PAD)的有效及安全性。方法:入选94例糖尿病性PAD患者,按照随机数列表分为对照组48例,住院期间给予前列地尔、甲钴胺、羟基红花素注射液、西洛他唑联合治疗7~14天,出院后单独给予西洛他唑口服12周。治疗组在对照组基础上住院或出院均给予首次600mg,后150mg/d连续7天,后改为75mg/d连续8周。评价氯吡格雷治疗DM所致的PAD的临床效果、血流动力学及下肢溃疡坏死率。结果:治疗组显效率(75.0%vs 54.3%, P=0.036)、总有效率(95.8%vs 80.4%, P=0.020)均显著高于对照组,治疗组6个月内再次发生溃疡坏疽发生率为2.0%,对照组为13.0%,2组发生率具有统计学差异(P<0.05)。另外治疗组ABI改善程度(0.94±0.23 vs 0.72±0.31)、足背动脉血流速度(38.2±3.9 vs 33.5±2.8),腘动脉血流速度(68.2±8.9 vs 56.8±5.8)改善均优于对照组,2组血小板聚集率分别为(27.3±14.8%vs 38.4±12.6%),2组比较具有统计学差异(P<0.05)。治疗过程中,2组发生的不良反应无明显的统计学差异(P>0.05)。结论:氯吡格雷治疗DM所致的PAD具有一定的疗效,可用于预防下肢溃疡发生率。%Objective:To evaluate clopidogrel bisulfate cilostazol treatment of lower extremity arterial occlusive disease ( PAD) is ef-fective and safe sex .Methods:84 cases were randomly selected transluminal angioplasty or vascular reconstructive surgery is not the line of lower extremity arterial occlusive disease patients, all patients were treated conservatively , given lipoic acid mecobalamin + + +Danhong alprostadil injection , are intravenous administration, while the control group given cilostazol , clopidogrel therapy in the treat-ment group were given on the basis of the

  12. Influence of balanced occlusion in complete dentures on the decrease in reduction of an edentulous ridge

    OpenAIRE

    Poštić Srđan D.

    2012-01-01

    Background/Aim. Balanced occlusal arrangement of artificial teeth and balanced occlusion is a specific type of occlusion that preserves the stability of complete dentures. Balanced occlusion comprises realization of tooth contacts at the working side as well as at the balancing side, at the same time. The aim of this study was to assess the influence of balanced occlusal arrangement of artificial teeth on the decrease in reduction of edentulous alveolar ridge. Methods. A longitudinal st...

  13. Guiding occlusal development with functional appliances.

    Science.gov (United States)

    Nielsen, I L

    1996-10-01

    considerable individual response to treatment, and that the occlusal correction occurred through a combination of skeletal and dentoalveolar changes.

  14. 高扩散梯度因子值扩散张量成像在评价单侧大脑中动脉闭塞供血区及远隔部位脑白质中的应用价值%High b-value diffusion tensor imaging of unilateral middle cerebral artery occlusive disease: evaluation of white matter injury

    Institute of Scientific and Technical Information of China (English)

    孟祥水; 宋法亮; 侯金文; 王青; 张晓明; 王茜; 于蓉; 马祥兴

    2012-01-01

    Objective To investigate the value of diffusion tensor imaging (DTI) at high b value for unilateral middle cerebral artery (MCA) occlusive disease in patients without obvious infarct lesions on conventional MR imaging.Methods DTI at high b value (2200 s/mm2 ) was performed using a 3.0 Tesla MR scanner in 34 patients with unilateral middle cerebral artery occlusion,who had no obvious infarct lesions on conventional MR imaging. Fractional anisotropy (FA),apparent diffusion coefficient (ADC),axial diffusivity (eigenvalue λ1) and radial diffusivity (eigenvalues λ2,λ3) were measured at the ipsilateral and contralateral corona radiata,anterior and posterior limbs of the internal capsule,cerebral peduncle and pons in all subjects.Mean ADC,FA,λ1,λ2 and λ3 values of corona radiata,anterior and posterior limbs of the internal capsule,cerebral peduncle and pons were compared between the ipsilateral and contralateral MCA territory by t test. Results Among the 34 patients,left MCA occlusion in M1 segment occurred in 16 patients and right MCA occlusion in Ml segment occurred in 18 patients.At the ipsilateral corona radiata,mean FA,ADC,λ1,λ2 and λ3 were 0.419 ±0.032,(5.975 ±0.272) × 10 3,(5.704 ±0.365) ×10-3,(6.412 ±0.368) × 10-3 and (6.605 ±0.343) × 10-3 mm2/s,respectively.At the contralateral corona radiata,mean FA,ADC,λ1,λ2 and λ3 were 0.443 ± 0.033,(5.804 ± 0.282) × 10 -3,(5.651 ±0.350) × 10-3,(6.099 ±0.353) × 10-3 and(6.372 ±0.355) × 10-3 mm2/s,respectively.At the ipsilateral corona radiata,mean FA was significantly decreased(t =11.614,P <0.01),and mean ADC (t=12.421,P<0.01),λ1(t =7.447,P<0.01),λ2(t=10.244,P<0.01) and λ3(t=9.890,P<0.01) were significantly increased.At the ipsilateral anterior and posterior limb of the internal capsule,mean FA were 0.609 ±0.026 and 0.674 ±0.033,λ1 were(5.330 ±0.462) × 10 -3 and(5.171 ±0.456) ×10-3 mm2/s,respectively.At the contralateral anterior and posterior limb of the internal capsule

  15. Sickle Cell Vaso-occlusive Crisis Induces the Release of Circulating Serum Heat Shock Protein-70

    OpenAIRE

    Adewoye, Adeboye H; Klings, Elizabeth S.; Farber, Harrison W.; Palaima, Elizabeth; Bausero, Maria A.; McMahon, Lillian; Odhiambo, Adam; Surinder, Safaya; Yoder, Mark; Martin H Steinberg; Asea, Alexzander

    2005-01-01

    Inflammation may play an important role in the pathophysiology of sickle cell disease (SCD), and recent studies have identified the 70-kDa heat shock protein (Hsp70) as an important mediator of inflammatory responses. Here we demonstrate a significant increase in circulating serum Hsp70 level in SCD during vaso-occlusive crisis (VOC) as compared with baseline steady-state levels (P < 0.05) and a significant increase in Hsp70 levels in SCD at baseline compared with normal controls (P < 0.05). ...

  16. 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.

  17. Mechanism of vaso-occlusion in sickle cell anemia

    Science.gov (United States)

    Lei, Huan; Karniadakis, George

    2012-11-01

    Vaso-occlusion crisis is one of the key hallmark of sickle cell anemia. While early studies suggested that the crisis is caused by blockage of a single elongated cell, recent experimental investigations indicate that vaso-occlusion is a complex process triggered by adhesive interactions among different cell groups in multiple stages. Based on dissipative particle dynamics, a multi-scale model for the sickle red blood cells (SS-RBCs), accounting for diversity in both shapes and cell rigidities, is developed to investigate the mechanism of vaso-occlusion crisis. Using this model, the adhesive dynamics of single SS-RBC was investigated in arterioles. Simulation results indicate that the different cell groups (deformable SS2 RBCs, rigid SS4 RBCs, leukocytes, etc.) exhibit heterogeneous adhesive behavior due to the different cell morphologies and membrane rigidities. We further simulate the tube flow of SS-RBC suspensions with different cell fractions. The more adhesive SS2 cells interact with the vascular endothelium and further trap rigid SS4 cells, resulting in vaso-occlusion in vessels less than 15 μm . Under inflammation, adherent leukocytes may also trap SS4 cells, resulting in vaso-occlusion in even larger vessels. This work was supported by the NSF grant CBET-0852948 and the NIH grant R01HL094270.

  18. Occlusal Grinding Pattern during Sleep Bruxism and Temporomandibular Disorder

    Directory of Open Access Journals (Sweden)

    Yeni Wijaya

    2013-09-01

    Full Text Available Sleep Bruxism is a significant etiology of temporomandibular disorder (TMD and causes many dental or oral problems such as tooth wear or facet. There is no study analyzing the relationship between sleep bruxism and TMD. Objective: To investigate any relationship between occlusal grinding pattern during sleep bruxism and temporomandibular disorder. Methods: A cross-sectional study involving 30 sleep bruxism patients attended the Faculty Dentistry Universitas Indonesia Teaching Hospital (RSGMP FKG UI. Completion of 2 forms of ID-TMD index and questionnaire from American Academy of Sleep Medicine were done. BruxChecker was fabricated and used for two nights to record the occlusal grinding pattern. The occlusal grinding pattern was categorized into laterotrusive grinding (LG and mediotrusive side. Further divisons of LG were: incisor-canine (IC, incisor-caninepremolar (ICP and incisor-canine-premolar-molar (ICPM. Mediotrusive side was classified as mediotrusive contact (MC and mediotrusive grinding (MG. Results: It was found that occlusal grinding pattern in non-TMD subjects were IC+MC, in subjects with mild TMD were ICP+MG and in subjects with moderate TMD were ICP+MG and ICPM+MG. TMJ was more significantly affected by ICP and ICPM grinding pattern than that of IC. Conclusion: There was a significant relationship between occlusal grinding pattern during sleep bruxism and TMD.DOI: 10.14693/jdi.v20i2.149

  19. Evaluation of a hemostatic device with percutaneous collagen application (VasoSeal {sup trademark}) compared to a mechanical compression system (Compressar {sup trademark} -) after transfemoral catheterization of patients suffering from arterial occlusive disease; Evaluation eines Verschlusssystems mit perkutaner Kollageneinbringung (VasoSeal {sup trademark}) im Vergleich zu einem mechanischen Kompressionssystem (Compressar {sup trademark} -) nach Femoralispunktion bei Patienten mit AVK

    Energy Technology Data Exchange (ETDEWEB)

    Neudecker, A.; Lenhart, M.; Zorger, N.; Paetzel, C.; Feuerbach, S.; Link, J. [Inst. fuer Roentgendiagnostik, Klinikum der Univ. Regensburg (Germany); Manke, C. [Klinik fuer Diagnostische und Interventionelle Radiologie, Klinikum Fulda (Germany)

    2003-05-01

    Purpose: Comparison of the efficacy of VasoSeal {sup trademark} and a mechanical compression system (Compressar {sup trademark}) for percutaneous hemostasis after femoral arterial catheterization of patients with arterial occlusive disease. Materials and Methods: 60 patients underwent either diagnostic angiography or interventional procedures. The level of anticoagulation, blood pressure, and activation clotting time were recorded, and the time to hemostasis after sheath removal was measured. VasoSeal {sup trademark} application was considered ''successful'' if the compression time was less than two minutes. On the subsequent day as well as 4 months later, color coded Doppler ultrasound was performed to register treatment success and potential (late) complications. Results: 57 patients qualified for inclusion in this study. In 21 of the 26 patients who underwent the procedure with the VasoSeal {sup trademark}, immediate hemostasis was achieved within 1.75 minutes. In all 31 patients who had the Compressar {sup trademark} applied, hemostasis was successful with a mean compression time of 17.4 minutes. Thus, VasoSeal {sup trademark} significantly reduced hemostasis time irrespective of anticoagulation status, but it had a much higher incidence of minor local complications (bleeding, hematoma) compared to the control group (34.6% vs. 5.8%). The technical success was lower with VasoSeal {sup trademark} than with Compressar {sup trademark} (81% vs. 100%). Both groups had no severe or late complications. Conclusion: According to our results, VasoSeal {sup trademark} does not provide a suitable alternative compared to the effective, safe and cheap application of Compressar {sup trademark} as a hemostatic device. (orig.) [German] Ziel: Effizienz von VasoSeal trademark als perkutanes Verschlusssystem nach Punktion der Femoralarterie bei Patienten mit AVK im Vergleich zur mechanischen Kompressionshilfe Compressar trademark. Material und Methoden

  20. Orphan drugs for sickle vaso-occlusion: dawn of a new era of targeted treatment

    Directory of Open Access Journals (Sweden)

    Dampier C

    2015-11-01

    Full Text Available Carlton Dampier1,2 1Emory University School of Medicine, Emory University, 2AFLAC Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA Abstract: While an orphan disease in the USA, sickle cell disease (SCD, a group of genetic disorders of hemoglobin structure and function, is a major public health problem in much of the rest of the world, particularly sub-Saharan Africa. The pathophysiology of SCD stems from the formation of sickle hemoglobin polymers that deform the erythrocyte into a characteristic sickle shape, the rapidity of which is regulated by its intracellular hemoglobin concentration. Subsequent vaso-occlusion is dependent on adhesion of sickled erythrocytes, and perhaps other cellular elements, including leucocytes and platelets, to abnormal vascular endothelium using a number of receptor–ligand pairs. This propensity for vaso-occlusion may be enhanced by altered vascular tone from excessive amounts of vaso-constrictive factors or diminished amounts of vasodilatory factors. Acute pain is the hallmark symptom caused by sickle polymer formation and subsequent vaso-occlusion, and is represented in the endpoints of most previous and current clinical trial designs. Numerous failures of prior investigational agents have frustrated clinicians and patients alike. Hydroxyurea is currently the only US Food and Drug Administration-approved drug for SCD and reduces the frequency of vaso-occlusive complications in many individuals. A considerable therapeutic need remains as hydroxyurea usage is currently not approved for all types of SCD, is not always clinically effective, and requires frequent monitoring. Recent improvements in our understanding of SCD pathophysiology have generated many new therapeutic targets and associated investigational agents. For example, a number of more specific fetal hemoglobin inducers and several therapies to reduce sickle polymer formation are being tested in preclinical and early

  1. Ambient Occlusion Effects for Combined Volumes and Tubular Geometry

    KAUST Repository

    Schott, M.

    2013-06-01

    This paper details a method for interactive direct volume rendering 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 algorithm extends the recently presented the 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. Stream tube geometries are computed using an effective spline-based interpolation and approximation scheme that avoids self-intersection and maintains coherent orientation of the stream tube segments to avoid surface deforming twists. Furthermore, strategies to reduce the geometric and specular aliasing of the stream tubes are discussed.

  2. New methodology for studying the structural ecology of occlusal caries

    DEFF Research Database (Denmark)

    Dige, Irene; Grønkjær, Lene; Nyvad, Bente

    Microbiological studies of occlusal dental biofilms have hitherto been hampered by inaccessibility to the sampling site and demolition of the original biofilm architecture. The aim of the present study was to explore the spatial distribution of bacterial taxa in vivo at various stages of occusal...... caries, applying a new methodology involving preparation of embedded hard dental tissue slices for fluorescence in situ hybridization (FISH) and confocal microscopy. 11 extracted teeth were included in the study and classified according to their occlusal caries status (active/inactive/sound; cavitated...... to histological features of lesion penetration. The sites showed distinct differences in the bacterial composition and fluorescence intensity between different ecological niches in occlusal caries. Biofilm observed along the entrance of fissures showed an inner layer of microorganisms organized in palisades often...

  3. Hierarchical Template Matching for Robust Visual Tracking with Severe Occlusions

    Institute of Scientific and Technical Information of China (English)

    Lizuo Jin; Tirui Wu; Feng Liu; Gang Zeng

    2012-01-01

    To tackle the problem of severe occlusions in visual tracking, we propose a hierarchical template-matching method based on a layered appearance model. This model integrates holistic- and part-region matching in order to locate an object in a coarse-to-fine manner. Furthermore, in order to reduce ambiguity in object localization, only the discriminative parts of an object' s appearance template are chosen for similarity computing with respect to their cornerness measurements. The similarity between parts is computed in a layer-wise manner, and from this, occlusions can be evaluated. When the object is partly occluded, it can be located accurately by matching candidate regions with the appearance template. When it is completely occluded, its location can be predicted from its historical motion information using a Kalman filter. The proposed tracker is tested on several practical image sequences, and the experimental results show that it can consistently provide accurate object location for stable tracking, even for severe occlusions.

  4. The effects of naris occlusion on mouse nasal turbinate development.

    Science.gov (United States)

    Coppola, David M; Craven, Brent A; Seeger, Johannes; Weiler, Elke

    2014-06-15

    Unilateral naris occlusion, a standard method for causing odor deprivation, also alters airflow on both sides of the nasal cavity. We reasoned that manipulating airflow by occlusion could affect nasal turbinate development given the ubiquitous role of environmental stimuli in ontogenesis. To test this hypothesis, newborn mice received unilateral occlusion or sham surgery and were allowed to reach adulthood. Morphological measurements were then made of paraffin sections of the whole nasal cavity. Occlusion significantly affected the size, shape and position of turbinates. In particular, the nasoturbinate, the focus of our quantitative analysis, had a more delicate appearance on the occluded side relative to the open side. Occlusion also caused an increase in the width of the dorsal meatus within the non-occluded and occluded nasal fossae, compared with controls, and the position of most turbinates was altered. These results suggest that a mechanical stimulus from respiratory airflow is necessary for the normal morphological development of turbinates. To explore this idea, we estimated the mechanical forces on turbinates caused by airflow during normal respiration that would be absent as a result of occlusion. Magnetic resonance imaging scans were used to construct a three-dimensional model of the mouse nasal cavity that provided the input for a computational fluid dynamics simulation of nasal airflow. The simulation revealed maximum shear stress values for the walls of turbinates in the 1 Pa range, a magnitude that causes remodeling in other biological tissues. These observations raise the intriguing possibility that nasal turbinates develop partly under the control of respiratory mechanical forces.

  5. Mechanisms of Biliary Plastic Stent Occlusion and Efforts at Prevention.

    Science.gov (United States)

    Kwon, Chang-Il; Lehman, Glen A

    2016-03-01

    Biliary stenting via endoscopic retrograde cholangiopancreatography has greatly improved the quality of patient care over the last 30 years. Plastic stent occlusion limits the life span of such stents. Attempts to improve plastic stent patency duration have mostly failed. Metal stents (self-expandable metal stents [SEMSs]) have therefore replaced plastic stents, especially for malignant biliary strictures. SEMS are at least 10 times more expensive than plastic stents. In this focused review, we will discuss basic mechanisms of plastic stent occlusion, along with a systematic summary of previous efforts and related studies to improve stent patency and potential new techniques to overcome existing limitations. PMID:27000422

  6. Endovascular Sharp Recanalization for Calcified Femoropopliteal Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Hsuan-Li Huang

    2012-01-01

    Full Text Available Endovascular intervention of peripheral chronic total occlusion (CTO is technically challenging and time consuming. Various techniques and devices are used to facilitate lesion crossing and improve the success rate of the procedure. However, these new devices are quite expensive and not readily available. We report 2 cases of peripheral CTO wherein the occlusions were successfully crossed by using stiff end of Terumo glidewire. This sharp recanalization may be a useful technique for the recanalization of calcified peripheral CTOs when conventional techniques fail and new devices are not readily available, but it is accompanied by the risk of distal atheroembolism.

  7. Acute Occlusive Mesenteric Ischemia in Taif Province, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohamed Al Saeed ** Mohamed Abu Shady *Mohamed Hatem *Khalid Alzahrani

    2012-04-01

    Full Text Available Mesenteric ischemia is relatively a rare disorder seen in the emergency department (ED. Due to the effect of hypobaric hypoxia and higher liability for thrombosis encountered in high altitude areas, acute occlusive mesenteric ischemia (AOMI would represent an actual challenge in Taif and related districts. Another risk factor is that about twenty-five percent of Saudis are victims of diabetes due to the changes in lifestyle and diet leading to increasing levels of obesity. Vague nonspecific clinical findings and limitations of diagnostic studies in addition to cultural and social factors, may lead to late presentation making the diagnosis a significant challenge and in turn higher morbidity and mortality are expected. Objectives: In this study, we review type of AOMI, pattern of presentation, laboratory, radiological, Intraoperative findings and results of treatment in 36 patients who were admitted to King Abdul Aziz Specialist Hospital and King Faisal Hospital, Al Taif, Saudi Arabia from January 2009 to January 2012. Methods: 36 patients with final diagnosis of AOMI were included in this retrospective study by means of review of their files and medical records. Results: The disease was more common in men than women (23 male and 13 females. The mean age of patients was 54 years. The mean time of presentation was 2.4 days after occurrence of symptoms. Abdominal pain was the most common symptom of patients followed by nausea, vomiting, constipation and bloody diarrhea. On physical examination; tachycardia was prevalent, Oliguria was seen in approximately 69.4% of patients, 11.1% of patients were in shock status. All patients had abdominal tenderness and 61.1% of patients had marked peritoneal signs (rebound tenderness with guarding or/and rigidity. Twenty one/36 (58.3% patients were diabetics, 17/36 patients (47.2% were hypertensive and 8/36 patients (22.2% with associated cardiac disorders. In laboratory tests, Leukocytosis was present in all

  8. Occlusion Effect of a Long-pulsed 532nm Laser on Veins

    Institute of Scientific and Technical Information of China (English)

    ZHANGLai-ming; YANGGui-long; LIDian-jun; LUQi-peng; GUHua-dong; ZHULin-lin; ZHAOZhen-wu; LIXin; WANGJing-ping; TANGYu-guo; GUOJin

    2005-01-01

    Laser treatment represents an attractive option to other methods of vessel diseases especially varicose veins. A long pulse (30-50ms) 532nm laser was used in our experiments, with the pulse duration matching the thermal relaxation time of the vessels and the green laser matching the absorption spectrum peak of the blood.Laser irradiates nude vein vessels directly or exterior skin to finish operation faster and to acquire the practical data for upper enteron varicose vein treatment in several animal experiments performed in vivo. The 5Jenergy pulse allows us to finely occlude rabbit or dog's vein vessels up to 2 mm in diameter when irradiating them off external skin. Blood vessels are occluded at once, and later biopsy specimens show the immediate and long-term lasting occlusion effect. While vessels are irradiated directly, they are usually irradiated to perforate, detailed causes are still under investigation. Animal experiments showed that the long pulse green laser therapy is a safe and effective solution to the vein's occlusion, which promises such laser with high energy of each pulse and 30-50 ms duration is an ideal candidate for vessel diseases treatment.

  9. Prevalence and impact of a chronic total occlusion in a non-infarct-related artery on long-term mortality in diabetic patients with ST elevation myocardial infarction

    NARCIS (Netherlands)

    B.E.P.M. Claessen; L.P. Hoebers; R.J. van der Schaaf; W.J. Kikkert; A.E. Engstrom; M.M. Vis; J.,Jr Baan; K.T. Koch; M. Meuwissen; N. van Royen; R.J. de Winter; J.G.P. Tijssen; J.J. Piek; J.P.S. Henriques

    2010-01-01

    Background Recently, a chronic total occlusion (CTO) in a non-infarct-related artery (non-IRA) and not multivessel disease (MVD) alone was identified as an independent predictor of mortality after ST elevation myocardial infarction (STEMI). Patients with diabetes mellitus (DM) constitute a patient g

  10. Comparison of efficacy in crossing femoropopliteal artery occlusions with movable core and hydrophilic guidewires

    DEFF Research Database (Denmark)

    Tønnesen, K H; Bülow, J; Holstein, P;

    1994-01-01

    Compare the recanalization rate of femoropopliteal occlusions between movable core wire guide (MG) and hydrophilic guidewire (HG).......Compare the recanalization rate of femoropopliteal occlusions between movable core wire guide (MG) and hydrophilic guidewire (HG)....

  11. Soft versus hard occlusal splint therapy in the management of temporomandibular disorders (TMDs

    Directory of Open Access Journals (Sweden)

    Sameh A Seifeldin

    2015-10-01

    Conclusions: Both forms of occlusal splints (soft and hard improved TMJ symptoms in patients with MPD or ID of the TMJ. However, the soft occlusal splints exhibited superior results after 4 months of use.

  12. Isolated cilioretinal artery occlusion as an initial manifestation of polycythemia vera

    OpenAIRE

    Elasri Fouad; Souhail H; Reda K; Iferkhass S; Idrissi A; Naoumi A; Oubaaz A

    2010-01-01

    Isolated cilioretinal artery occlusion is a rarely reported initial manifestation of polycythemia vera. In this study, we reported a case of a 65-year-old man with polycythemia vera with cilioretinal artery occlusion as an initial manifestation.

  13. Differential diagnosis of small bowel occlusions

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2009-06-01

    Full Text Available Hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome, is a common autosomal dominant syndrome characterized by early age at onset, and microsatellite instability (MSI. Patients with Lynch syndrome have a markedly increased risk of colorectal cancer. We report a case of a 28-year-old male with Lynch syndrome; the case allows to describe clinical manifestations and diagnostic criteria of this syndrome, and to underline the importance of genetics in the diagnosis of this disease.

  14. Ruptured, dissecting posterior inferior cerebellar artery aneurysms: endovascular treatment without parent vessel occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Cellerini, Martino [Careggi Hospital, Interventional Neuroradiology, Florence (Italy); Centro Traumatologico-Ortopedico, Unita di Neuroradiologia, Florence (Italy); Mangiafico, Salvatore [Careggi Hospital, Interventional Neuroradiology, Florence (Italy); Ammannati, Franco; Mennonna, Pasquale [Careggi Hospital, Neurosurgery, Florence (Italy); Ambrosanio, Gennaro; Muto, Mario [Cardarelli Hospital, Neuroradiology, Naples (Italy); Galasso, Luigi [S. Luca Hospital, Neuroradiology, Salerno (Italy)

    2008-04-15

    Treatment of a dissecting aneurysm of the medullary segments of the posterior inferior cerebellar artery (PICA) usually entails trapping of the diseased arterial segment with possible sacrifice of brainstem perforators. The goal of the work was to review our experience with selective coiling of ruptured, dissecting aneurysms of the anterolateral segments of the PICA without parent vessel occlusion. Eleven consecutive patients (9 women, 2 men, mean age 47.2 years) were retrospectively reviewed from a prospectively acquired neuroradiological database. On admission three patients had Hunt and Hess (HH) grade I, three HH grade II, two HH grade III, and one HH grade IV. Outcome was evaluated according to the modified Rankin scale (mRS) score. Follow-up (mean:19.4 months) consisted of magnetic resonance angiography and/or digital subtraction angiography in ten patients. Ten patients had mRS score 0 and one mRS score 2. No treatment failure occurred. The aneurysm was completely occluded in seven patients, a neck residue was present in two, and a loose coil mesh was present in two. Recurrence occurred in three patients, and all were successfully retreated for a total of 13 procedures. Procedure-related complications were all without clinical consequences and included a coil perforation in one procedure and stagnant filling of the parent vessel in six procedures. PICA occlusion did not occur in any patient. Coiling of ruptured, isolated dissecting aneurysms of the PICA without parent vessel occlusion is feasible, relatively safe and effective in preventing early/medium-term rebleeding. A strict angiographic follow-up program is, however, necessary to detect recurrence. (orig.)

  15. Gender influence on occlusal characteristics in the primary dentition

    Directory of Open Access Journals (Sweden)

    Nisha Rani Yadav

    2014-01-01

    Full Text Available Objectives: The objective of this study was to assess and discuss the influence of gender on occlusal characteristics of primary dentition. Materials and Methods: In this study, cluster randomized sampling was done to select 4-6-year-old children from Government primary schools of Farukh Nagar block, Gurgaon, Haryana, India. Children were evaluated clinically for occlusal characteristics of primary dentition such as molar relation, Canine relation, overjet, overbite, openbite, scissors bite, and crossbite. Chi-square test was used to compare the occlusal characteristics of both genders. Results: Flush terminal plane, Class I Canine relation and both primate as well as developmental spaces were found to be prevalent in the study population, in percentages of 62.4%, 67.2%, and 37.6%, respectively. It was observed that females had more spacing, distal step molar relation and increased overjet as compared to males. Males had more Class II Canine relation, crowding, openbite, overbite, and incompetent lips as compared to females. Significant differences were found between males and females w.r.t various occlusal characteristics. Conclusion: Most of the children had gender influence on malocclusion, which indicates the need for early interception or correction of malocclusion traits based on the gender of the child.

  16. Occlusal factors are not related to self-reported bruxism

    NARCIS (Netherlands)

    D. Manfredini; C.M. Visscher; L. Guarda-Nardini; F. Lobbezoo

    2012-01-01

    AIMS: To estimate the contribution of various occlusal features of the natural dentition that may identify self-reported bruxers compared to nonbruxers. METHODS: Two age- and sex-matched groups of self-reported bruxers (n = 67) and self-reported nonbruxers (n = 75) took part in the study. For each p

  17. Example-Based Human Pose Recovery under Predicted Partial Occlusions

    NARCIS (Netherlands)

    Poppe, Ronald; Babuska, Robert; Groen, Frans C A.

    2010-01-01

    For human pose recovery, the presence of occlusions due to objects or other persons in the scene remains a difficult problem to cope with. However, recent advances in the area of human detection allow for simultaneous segmentation of humans and the prediction of occluded regions. In this chapter, we

  18. Segmentally enclosed thrombolysis in percutaneous transluminal angioplasty for femoropopliteal occlusions

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Nielsen, J D;

    1991-01-01

    Segmentally enclosed thrombolysis (SET) was performed immediately following 34 percutaneous transluminal angioplasties (PTAs) for femoropopliteal occlusions. The dilated segment was sealed off with a double balloon catheter, and recombinant tissue plasminogen activator (rt-PA) 1 mg/ml and heparin...

  19. Endovascular treatment for right subclavian artery occlusion: techniques and results

    International Nuclear Information System (INIS)

    Objective: To evaluate the technique and result of endovascular treatment for right subclavian artery stenosis or occlusion. Methods: Seventeen patients [13 males, 4 females; (56 ± 11) years old] with right subclavian artery stenosis or occlusion were treated with endovascular surgery which included recanalization, balloon angioplasty and stenting via femoral or brachial artery route. Cerebral protection devices were used in 6 cases to avoid cerebral embolism. Results: Sixteen of the seventeen patients acquired successful recanalization in 8 cases with subclavian artery stenosis (100% technical success rate) and in other 8 cases with subclavian artery occlusion (88.9% technical success rate). Five cases were treated with balloon angioplasty, and 11 cases were treated with balloon angioplasty combined with stenting. Good patency was seen in the 16 cases immediately after the procedure. The cerebral protection devices prevented all the cases from cerebral embolism and were retrieved successfully. Sixteen cases were followed up from 1 to 66 months [mean (24 ± 18) months]. Restenosis was found in one case 10 months later and was successfully treated with re-PTA. One case with aortoarteritis died of cerebral infarction 18 months later. No symptom recurrence was found in other cases and ultrasound or CTA of followup showed excellent patency. Conclusions: Balloon angioplasty and stenting are safe and effective for the treatment of right subclavian artery occlusion. (authors)

  20. Central retinal artery occlusion: an unusual complication of snakebite

    Directory of Open Access Journals (Sweden)

    A. Bhalla

    2004-01-01

    Full Text Available Snakebites are endemic in some parts of India, being associated with a number of complications. Ocular disturbances are rare, except for injury to the cornea or conjunctiva when the eye is directly exposed to the venom. In this work, we present a case of central retinal artery occlusion caused by snakebite.

  1. Pedestrian Counting with Occlusion Handling Using Stereo Thermal Cameras

    DEFF Research Database (Denmark)

    Kristoffersen, Miklas Strøm; Dueholm, Jacob Velling; Gade, Rikke;

    2016-01-01

    for pedestrian counting based on clustering and tracking of the 3D point clouds. The method is tested on two five-minute video sequences captured at a public event with a moderate density of pedestrians and heavy occlusions. The counting performance is compared to the manually annotated ground truth and shows...

  2. Occlusal wear of provisional implant-supported restorations

    NARCIS (Netherlands)

    Santing, Hendrik J.; Kleverlaan, Cornelis J.; Werner, Arie; Feilzer, Albert J.; Raghoebar, Gerry M.; Meijer, Henny J. A.

    2015-01-01

    BACKGROUND: Implant-supported provisional restorations should be resistant to occlusal wear. PURPOSE: The purpose of this laboratory study was to evaluate three-body wear of three indirect laboratory composite resins, five chair side bis-acryl resin-based materials, and two chair side methacrylate-b

  3. Occlusal wear of provisional implant-supported restorations

    NARCIS (Netherlands)

    H.J. Santing; C.J. Kleverlaan; A. Werner; A.J. Feilzer; G.M. Raghoebar; H.J.A. Meijer

    2015-01-01

    Background Implant-supported provisional restorations should be resistant to occlusal wear. Purpose The purpose of this laboratory study was to evaluate three-body wear of three indirect laboratory composite resins, five chair side bis-acryl resin-based materials, and two chair side methacrylate-bas

  4. Left atrial appendage occlusion for stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Tzikas, Apostolos; Shakir, Samera; Gafoor, Sameer;

    2015-01-01

    Aims: To investigate the safety, feasibility, and efficacy of left atrial appendage occlusion (LAAO) with the AMPLATZER Cardiac Plug (ACP) for stroke prevention in patients with atrial fibrillation (AF). Methods and results: Data from consecutive patients treated in 22 centres were collected...

  5. Inferior Pancreaticoduodenal Artery Aneurysms Associated with Occlusive Lesions of the Celiac Axis: Diagnosis, Treatment Options, Outcomes, and Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Flood, Karen, E-mail: karenrogers@doctors.org.uk; Nicholson, Anthony A. [Leeds Teaching Hospitals, Department of Radiology (United Kingdom)

    2013-06-15

    Purpose. To describe the presentation, treatment, and outcomes for 14 patients with aneurysms of the inferior pancreaticoduodenal arteries associated with occlusive lesions of the celiac axis, and to review the literature for similar cases. Methods, Over a period of 12 years, 14 patients (10 women and 4 men) ranging in age from 26 to 50 (mean 46) years were demonstrated to have aneurysms of the inferior pancreaticoduodenal artery origin associated with stenosis or occlusion of the celiac axis. All patients were treated by a combination of surgery and interventional radiology. Results. Outcome data collected between 3 months and 4 years (mean 2 years) demonstrated that all aneurysms remained excluded, and all 14 patients were well. The 49 case reports in the literature confirm the findings of this cohort. Conclusion. In inferior pancreaticoduodenal artery aneurysm resulting from celiac occlusive disease, endovascular treatment is best achieved by stenting the celiac axis and/or embolizing the aneurysm when necessary.

  6. Risk Factors for Central and Branch Retinal Vein Occlusion: A Meta-Analysis of Published Clinical Data

    Directory of Open Access Journals (Sweden)

    Petr Kolar

    2014-01-01

    Full Text Available Retinal vein occlusion (RVO is a major cause of vision loss. Of the two main types of RVO, branch retinal vein occlusion (BRVO is 4 to 6 times more prevalent than central retinal vein occlusion (CRVO. A basic risk factor for RVO is advancing age. Further risk factors include systemic conditions like hypertension, arteriosclerosis, diabetes mellitus, hyperlipidemia, vascular cerebral stroke, blood hyperviscosity, and thrombophilia. A strong risk factor for RVO is the metabolic syndrome (hypertension, diabetes mellitus, and hyperlipidemia. Individuals with end-organ damage caused by diabetes mellitus and hypertension have greatly increased risk for RVO. Socioeconomic status seems to be a risk factor too. American blacks are more often diagnosed with RVO than non-Hispanic whites. Females are, according to some studies, at lower risk than men. The role of thrombophilic risk factors in RVO is still controversial. Congenital thrombophilic diseases like factor V Leiden mutation, hyperhomocysteinemia and anticardiolipin antibodies increase the risk of RVO. Cigarette smoking also increases the risk of RVO as do systemic inflammatory conditions like vasculitis and Behcet disease. Ophthalmic risk factors for RVO are ocular hypertension and glaucoma, higher ocular perfusion pressure, and changes in the retinal arteries.

  7. Fundus artery occlusion caused by cosmetic facial injections

    Institute of Scientific and Technical Information of China (English)

    Chen Yanyun; Wang Wenying; Li Jipeng; Yu Yajie; Li Lin; Lu Ning

    2014-01-01

    Background With the increasing popularity of cosmetic facial filler injections in recent years,more and more associated complications have been reported.However,the causative surgical procedures and preventative measures have not been studied well up to now.The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections.Methods Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included.Main outcome measures were filler materials,injection sites,best-corrected visual acuity (BCVA),fundus fluorescein angiography,and associated ocular and systemic manifestations.Results Eleven patients had ophthalmic artery occlusion (OAO) and one patient each had central retinal artery occlusion (CRAO) and anterior ischemic optic neuropathy (AION).Injected materials included autologous fat (seven cases),hyaluronic acid (five cases),and bone collagen (one case).Injection sites were the frontal area (five cases),periocular area (two cases),temple area (two cases),and nose area and nasal area (4 cases).Injected autologous fat was associated with worse final BCVA than hyaluronic acid.The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception.Most of the patients with OAO had ocular pain,headache,ptosis,ophthalmoplegia,and no improvement in final BCVA.Conclusions Cosmetic facial injections can cause fundus artery occlusion.Autologous fat injection tends to be associated with painful blindness,ptosis,ophthalmoplegia,and poor visual outcomes.The prognosis is much worse with autologous fat injection than hyaluronic acid injection.

  8. The effect of prolonged monocular occlusion on latent nystagmus in the treatment of amblyopia

    NARCIS (Netherlands)

    H.J. Simonsz (Huib)

    1989-01-01

    textabstractWe recorded eye movements in 5 patients with latent nystagmus (LN) before and after 2 days of occlusion of the better eye. The slow-phase speed of the nystagmus (SPS) was in general, before occlusion, lower when the better eye fixated but, after occlusion, lower when the worse eye fixate

  9. Evaluation of the occlusal contact of crowns fabricated with the bite impression method.

    Science.gov (United States)

    Makino, Sachi; Okada, Daizo; Shin, Chiharu; Ogura, Reiko; Ikeda, Masaomi; Miura, Hiroyuki

    2013-09-30

    In prosthodontic treatment, reconstruction of a proper occlusal contact relationship is very important as well as reconstruction of a proper interproximal relationship and marginal fitness. Unfortunately, occlusal relationships are sometimes lost in the process of occlusal adjustment of crowns. The purpose of this study was to compare the occlusal contacts of single crown fabricated by two different types of impression techniques. Nine subjects, whose molars required treatment with crown restoration, were enrolled in this study. Full cast crowns were fabricated using two types of impression techniques: the conventional impression method (CIM) and the bite impression method (BIM). The occlusal contacts of crowns were precisely evaluated at the following stages: after occlusal adjustment on the articulator (Step 0), before occlusal adjustment in the mouth (Step 1), after occlusal adjustment at the intercuspal position (Step 2), and after occlusal adjustment during lateral and protrusive excursions (Step 3). The number of occlusal contacts of the crowns on the functional cusps fabricated with BIM was significantly greater than that with CIM after occlusal adjustment. For this reason, the crowns fabricated with BIM might have a more functionally desirable occlusal surface compared to the crowns fabricated with CIM.

  10. Digital Evaluation of Functional Occlusion Parameters and their Association with Temporomandibular Disorders

    OpenAIRE

    Haralur, Satheesh B.

    2013-01-01

    Context: Dental researchers are contradictory in their opinion on the role of occlusion in TMD. Occlusal evaluation of both conventional and digital methods in TMD patients will provide the accurate information about the factors accountable for occlusal instability. Identifying the factors responsible will facilitate precise diagnosis and treatment for TMD.

  11. 下肢动脉闭塞性疾病64层CT血管成像中腘动脉小剂量对比剂试验的意义%64-slice CT angiography in lower extremity peripheral arterial occlusive disease: clinical value of test injection at popliteal arteries

    Institute of Scientific and Technical Information of China (English)

    舒政; 邓小飞; 葛琛瑾; 孙凤; 邹银鸽; 孟文斌

    2011-01-01

    Objective To investigate the clinical value of the test injection at popliteal arteries on 64-slice CTA in lower extremity peripheral arterial occlusive disease (PAOD). Methods Twenty-eight patients with PAOD referred for 64-slice CTA were enrolled consecutively in the study. Test injection was performed at bilateral popliteal arteries (the level of knee joints) and the clinic value of the peak value and the time to peak was analyzed. The relationship between the time to peak and the peak value was evaluated with Pearson test. The time to peak was used for programming of the CT angiographic acquisitions with fast scanning mode. The quality of visualization of each arterial segment was determined independently by two radiologists. Results Fifty-four (96%, 54/56) time-attenuation curves were obtained in 28 patients. The wide interindividual variation in the peak value and the time to peak was observed in 52 curves of 26 patients with range of 60-178 HU,21-46 s and an average of (135±28) HU,(31±6) s, respectively. The difference in the peak value and the time to peak between bilateral popliteal arteries was also observed with range of 10-80 HU and an average of (32±18) HU in 19 patients,with range of 1-12 s and an average of (5±3) s in 21 patients. There was negative relationship between the peak value and the time to peak (r=-0.526, P<0.01). The CTA images were of good (598 segments) or medium quality (12 segments) in 99% segments (610/616). Conclusions The test injection at popliteal arteries was useful for 64-slice CTA in the patients with PAOD, as it could accurately specify the delay time of CT angiographic acquisitions.%目的 探讨下肢动脉闭塞性疾病采用64层CT血管成像时,在腘动脉行小剂量对比剂试验的意义.方法 连续选取28例临床怀疑下肢动脉闭塞性疾病患者,应用64层CT在两侧腘动脉(膝关节层面)各设置一ROI进行小剂量对比剂试验,明确显示峰值及达峰时间者认为曲线获取成功.

  12. Brachial access technique for aortoiliac stenting revisited

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We report a modified technique to perform iliac artery stenting through the brachial artery access. A 6F Brite tip sheath (Cordis, Jonhson & Jonhson Medical, Miami Lakes, FL, USA) is inserted into either brachial artery and a standard 4F Judkins Right diagnostic catheter was inserted over a 260 cm 0.038" Terumo Stiff wire (Terumo Corp, Tokyo, Japan) through the sheath. The catheter is navigated down to the aortic bifurcation, and after selecting the common iliac artery ostium, the wire is navigated through the lesion and advanced to the ipsilateral superficial femoral arteries. The catheter should be then moved forward over the wires beyond the lesion and the Terumo guidewire is replaced by two 0.038" 260 cm Supracor wires (Boston Scientific Corporation, San Jose, CA, USA). In order to facilitate advancement of the stent without risk of dislodgement as well as to check the position with low contrast dose injection, a 6 F (or 7F if large stent is selected) 90cm Shuttle Flexor introducer long sheath (Cook Group, Bloomington, IN, USA) should be advanced over the Supracor wire until it reaches the common iliac artery ostium. A road-map technique can be used to check the ostium position in order to properly deploy the selected stent. This technique promises to be safe and effective offering more support than guiding catheter technique; moreover it reduces the stress on the arterial vessel at the subclavian site and enables a stiff balloon or stent catheter to be advanced even through a very elongated and calcified aorta without the risk of stent dislodgement.

  13. Endovascular Aneurysm Repair Treatment of Aortoiliac Aneurysms

    DEFF Research Database (Denmark)

    Taudorf, Mikkel; Grønvall, John; Schroeder, Torben V;

    2016-01-01

    , and a branch iliac device was placed in 25 limbs. Gluteal claudication developed in 38% of limbs treated with IIA exclusion but in none of the limbs treated with branch iliac devices (P fluoroscopy time, and use of iodine contrast material did not differ between the two groups...

  14. Endovascular stents: a review of their use in peripheral arterial disease.

    Science.gov (United States)

    Kudagi, Vinod S; White, Christopher J

    2013-06-01

    Technological advances in the past decade have shifted revascularization strategies from traditional open surgical approaches toward lower-morbidity percutaneous endovascular treatments for patients with lower extremity peripheral arterial disease (PAD). The continuing advances in stent design, more than any other advances, have fueled the growth of catheter-based procedures by improving the safety, durability, and predictability of percutaneous revascularization. Although the 2007 TransAtlantic Inter-Society Consensus (TASC) guidelines recommend endovascular therapy for type A and B aortoiliac and femoropopliteal lesions, recent developments in stent technology and increased experience of interventionists have suggested that a strategy of endovascular therapy first is appropriate in experienced hands for TASC type D lesions. The role of endovascular interventions is also expanding in the treatment of limb-threatening ischemia.

  15. MATHEMATICAL ANALYSIS OF DENTAL ARCH OF CHILDREN IN NORMAL OCCLUSION: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    M. Abu-Hussein DDS, MScD, MSc, DPD

    2012-03-01

    Full Text Available AIM. This paper is an attempt to compare and analyze the various mathematical models for defining the dental arch curvature of children in normal occlusion based upon a review of available literature. Background. While various studies have touched upon ways to cure or prevent dental diseases and upon surgical ways for teeth reconstitution to correct teeth anomalies during childhood, a substantial literature also exists, attempting to mathematically define the dental arch of children in normal occlusion. This paper reviews these dental studies and compares them analytically. Method. The paper compares the different mathematical approaches, highlights the basic assumptions behind each model, underscores the relevancy and applicability of the same, and also lists applicable mathematical formulae. Results. Each model has been found applicable to specific research conditions, as a universal mathematical model for describing the human dental arch still eludes satisfactory definition. The models necessarily need to include the features of the dental arch, such as shape, spacing between teeth and symmetry or asymmetry, but they also need substantial improvement. Conclusions. While the paper shows that the existing models are inadequate in properly defining the human dental arch, it also acknowledges that future research based on modern imaging techniques and computeraided simulation could well succeed in deriving an allinclusive definition for the human dental curve till now eluding the experts.

  16. Retinal vein occlusion and macular edema – critical evaluation of the clinical value of ranibizumab

    Directory of Open Access Journals (Sweden)

    Keane PA

    2011-06-01

    Full Text Available Pearse A Keane1, Srinivas R Sadda21NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2Doheny Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USAAbstract: Retinal vein occlusions (RVOs constitute the second most common cause of retinal vascular disease after diabetic retinopathy, with a prevalence of between 1% and 2% in persons older than 40 years of age. Despite the existence of numerous potential therapeutic options, none is entirely satisfactory, and many patients with RVO suffer irreversible visual loss. Fortunately however, the recent introduction of antivascular endothelial growth factor (VEGF agents, such as ranibizumab (Lucentis®, Genentech, South San Francisco, CA and bevacizumab (Avastin®, Genentech, offers a potentially new treatment approach for clinicians managing this disorder. The results of the BRAVO and CRUISE trials have provided the first definitive evidence for the efficacy and safety of ranibizumab in the treatment of RVO. As a result, ranibizumab has recently been approved by the US Food and Drug Administration for the treatment of RVO-associated macular edema. In this review, we provide a critical evaluation of clinical trial data for the safety and efficacy of ranibizumab, and address unresolved issues in the management of this disorder. Keywords: ranibizumab, retinal vein occlusion, vascular endothelial growth factor, macular edema

  17. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

    Directory of Open Access Journals (Sweden)

    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  18. Functional real-time optoacoustic imaging of middle cerebral artery occlusion in mice.

    Directory of Open Access Journals (Sweden)

    Moritz Kneipp

    Full Text Available BACKGROUND AND PURPOSE: Longitudinal functional imaging studies of stroke are key in identifying the disease progression and possible therapeutic interventions. Here we investigate the applicability of real-time functional optoacoustic imaging for monitoring of stroke progression in the whole brain of living animals. MATERIALS AND METHODS: The middle cerebral artery occlusion (MCAO was used to model stroke in mice, which were imaged preoperatively and the occlusion was kept in place for 60 minutes, after which optoacoustic scans were taken at several time points. RESULTS: Post ischemia an asymmetry of deoxygenated hemoglobin in the brain was observed as a region of hypoxia in the hemisphere affected by the ischemic event. Furthermore, we were able to visualize the penumbra in-vivo as a localized hemodynamically-compromised area adjacent to the region of stroke-induced perfusion deficit. CONCLUSION: The intrinsic sensitivity of the new imaging approach to functional blood parameters, in combination with real time operation and high spatial resolution in deep living tissues, may see it become a valuable and unique tool in the development and monitoring of treatments aimed at suspending the spread of an infarct area.

  19. Experimental Branch Retinal Vein Occlusion Induces Upstream Pericyte Loss and Vascular Destabilization.

    Directory of Open Access Journals (Sweden)

    Elisa Dominguez

    Full Text Available Branch retinal vein occlusion (BRVO leads to extensive vascular remodeling and is important cause of visual impairment. Although the vascular morphological changes following experimental vein occlusion have been described in a variety of models using angiography, the underlying cellular events are ill defined.We here show that laser-induced experimental BRVO in mice leads to a wave of TUNEL-positive endothelial cell (EC apoptosis in the upstream vascular network associated with a transient edema and hemorrhages. Subsequently, we observe an induction of EC proliferation within the dilated vein and capillaries, detected by EdU incorporation, and the edema resolves. However, the pericytes of the upstream capillaries are severely reduced, which was associated with continuing EC apoptosis and proliferation. The vascular remodeling was associated with increased expression of TGFβ, TSP-1, but also FGF2 expression. Exposure of the experimental animals to hypoxia, when pericyte (PC dropout had occurred, led to a dramatic increase in endothelial cell proliferation, confirming the vascular instability induced by the experimental BRVO.Experimental BRVO leads to acute endothelial cells apoptosis and increased permeability. Subsequently the upstream vascular network remains destabilized, characterized by pericyte dropout, un-physiologically high endothelial cells turnover and sensitivity to hypoxia. These early changes might pave the way for capillary loss and subsequent chronic ischemia and edema that characterize the late stage disease.

  20. Lateral occlusion schemes in natural and minimally restored permanent dentition: a systematic review.

    Science.gov (United States)

    Abduo, J; Tennant, M; McGeachie, J

    2013-10-01

    Clinicians commonly encounter the dilemma of which lateral occlusion schemes is most suitable for a specific patient. The aim of this review is to evaluate the prevalence of the lateral occlusion schemes that exist naturally. An electronic search was completed through PubMed (MEDLINE), Google Scholar and Cochrane Library. The search was confined to peer-reviewed studies published in English, up to April 2013. The literature search was supplemented by manual searching through the bibliography lists of the selected studies. The initial search retrieved a total of 575 studies. After applying the selection criteria, only 12 studies were suitable for inclusion. The Critical Appraisal Skills Programme (CASP) tools were utilised to appraise the quality of the studies. The prevalence of canine-guided, group function and balanced occlusions was reported. Overall, there was a clear variability between the studies. The prevalence of the lateral occlusion schemes appears to be influenced by the following factors: (i) the magnitude of excursion, (ii) an individual's age and (iii) the static occlusal relationship. During complete excursion, the canine-guided occlusion tends to be more frequently observed. After partial excursion, the most prevalent lateral occlusion schemes was group function occlusion. With ageing, the prevalence of canine-guided occlusion tends to be reduced and the prevalence of group function occlusion is increased. Dentition that is closer to Class II occlusion exhibits mainly canine-guided occlusion, while for Class III occlusion, group function occlusion is more prevalent. The studies revealed no relationship between the lateral occlusion schemes and TMD development.

  1. Intestinal intussusception and occlusion caused by small bowel polyps in the Peutz-Jeghers syndrome. Management by combined intraoperative enteroscopy and resection through minimal enterostomy: case report

    OpenAIRE

    Gama-Rodrigues Joaquim J.; Silva José Hyppolito da; Aisaka Adilson A.; Jureidini Ricardo; Falci Júnior Renato; Maluf Filho Fauze; Chong A. Kim; Tsai André Wan Wen; Bresciani Cláudio

    2000-01-01

    The Peutz-Jeghers syndrome is a hereditary disease that requires frequent endoscopic and surgical intervention, leading to secondary complications such as short bowel syndrome. CASE REPORT: This paper reports on a 15-year-old male patient with a family history of the disease, who underwent surgery for treatment of an intestinal occlusion due to a small intestine intussusception. DISCUSSION: An intra-operative fiberscopic procedure was included for the detection and treatment of numerous polyp...

  2. An unexpected evolution of symptomatic mild middle cerebral artery (MCA stenosis: asymptomatic occlusion

    Directory of Open Access Journals (Sweden)

    Malferrari Giovanni

    2011-12-01

    Full Text Available Abstract Background The intracranial localization of large artery disease is recognized as the main cause of ischemic stroke in the world, considering all countries, although its global burden is widely underestimated. Indeed it has been reported more frequently in Asians and African-American people, but the finding of intracranial stenosis as a cause of ischemic stroke is relatively common also in Caucasians. The prognosis of patients with stroke due to intracranial steno-occlusion is strictly dependent on the time of recanalization. Moreover, the course of the vessel involvement is highly dynamic in both directions, improvement or worsening, although several data are derived from the atherosclerotic subtype, compared to other causes. Case description We report the clinical, neurosonological and neuroradiological findings of a young woman, who came to our Stroke Unit because of the abrupt onset of aphasia during her work. An urgent neurosonological examination showed a left M1 MCA stenosis, congruent with the presenting symptoms; magnetic resonance imaging confirmed this finding and identified an acute ischemic lesion on the left MCA territory. The past history of the patient was significant only for a hyperinsulinemic condition, treated with metformine, and a mild overweight. At this time a selective cerebral angiography was not performed because of the patient refusal and she was discharged on antiplatelet and lipid-lowering therapy, having failed to identify autoimmune or inflammatory diseases. Within 1 month, she went back to our attention because of the recurrence of aphasia, lasting about ten minutes. Neuroimaging findings were unchanged, but the patient accepted to undergo a selective cerebral angiography, which showed a mild left distal M1 MCA stenosis. During the follow-up the patient did not experienced any recurrence, but a routine neurosonological examination found an unexpected evolution of the known MCA stenosis, i.e. left M1 MCA

  3. Importance of diastolic velocities in the detection of celiac and mesenteric artery disease by duplex ultrasound

    DEFF Research Database (Denmark)

    Perko, M J; Just, S; Schroeder, T V

    1997-01-01

    To assess the predictive value of ultrasound duplex scanning in the detection of superior mesenteric artery (SMA) and celiac artery (CA) occlusive disease.......To assess the predictive value of ultrasound duplex scanning in the detection of superior mesenteric artery (SMA) and celiac artery (CA) occlusive disease....

  4. Sheathotomy in complicated cases of branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Crafoord, S.; Karlsson, N.; Cour, M. la

    2008-01-01

    Purpose: To report the clinical experience and results of using a microsurgical technique to decompress the arteriovenous connection in complicated branch retinal vein occlusion (BRVO) combined with haemorrhage, oedema an ischaemia. Methods: We carried out a retrospective, non-randomized, interve......Purpose: To report the clinical experience and results of using a microsurgical technique to decompress the arteriovenous connection in complicated branch retinal vein occlusion (BRVO) combined with haemorrhage, oedema an ischaemia. Methods: We carried out a retrospective, non......-randomized, interventional case study of the surgical sheathotomy decompression procedure. We enrolled 12 patients (seven women, five men; median age 64 years) with BRVO and decreased visual acuity (VA) caused by haemorrhage, oedema and ischaemia. The mean duration of thrombosis was 7 months (2-15 months). The patients were...

  5. Minor stroke and major vascular occlusion. A case report.

    Science.gov (United States)

    Maestroni, A; Mandelli, C; Zecca, B; Rossi, P; Isalberti, M; Manganaro, D; Guariglia, A; Torgano, G

    2006-07-01

    Occlusion of middle cerebral artery (MCA) is generally associated to severe stroke and poor prognosis; however a few patients with mild to moderate presentation and long-term reversibility of neurological deficits have been reported. A 66-year-old male presented with left-side weakness and dysarthria (NIHSS score 7), which progressively resolved within a few days; ischaemic lesion of the anterior arm of the right internal capsule was found at brain CT obtained 72 h after presentation. Transcranial Colour Doppler showed absence of flow of the right MCA. Cerebral angiography showed occlusion of the right MCA that was retrogradely revascularised by leptomeningeal collaterals. Non-invasive intracranial vascular examinations could identify major intracranial artery lesions in patients who present with mild to moderate stroke symptoms. These patients could be identified and followed to clarify their best treatment and prognosis.

  6. Comparative Analysis of Partial Occlusion Using Face Recognition Techniques

    Directory of Open Access Journals (Sweden)

    N.Nallammal

    2013-04-01

    Full Text Available This paper presents a comparison of partial occlusion using face recognition techniques that gives in which technique produce better result for total success rate. The partial occlusion of face recognition is especially useful for people where part of their face is scarred and defect thus need to be covered. Hence, either top part/eye region or bottom part of face will be recognized respectively. The partial face information are tested with Principle Component Analysis (PCA, Non-negative matrix factorization (NMF, Local NMF (LNMF and Spatially Confined NMF (SFNMF. The comparative results show that the recognition rate of 95.17% with r = 80 by using SFNMF for bottom face region. On the other hand, eye region achieves 95.12% with r = 10 by using LNMF.

  7. Retinal vein occlusion in Saudi Arabia: possible role of dehydration.

    Science.gov (United States)

    Alghadyan, A A

    1993-10-01

    The medical records of 90 patients with a clinical diagnosis of retinal vein occlusion (RVO) who were seen at two referral hospitals in Saudi Arabia were reviewed. Sixty-eight (75.6%) were men. Central RVO was present in 50 patients (55.6%); branch RVO, in 35 patients (38.9%); and hemiretinal occlusion, in five patients (5.6%). Arterial hypertension was present in 43 patients (47.8%); diabetes mellitus, in 28 patients (31%); and preexisting glaucoma, in 26 patients (28.9%). The date of onset of RVO was available in 61 patients. Eighteen attacks (29.5%) had occurred during the month of Ramadan. The Student's t test of paired samples indicated that the incidence of RVO during the month of Ramadan was significantly higher than that of the other months of the Gregorian year. These findings suggest that dehydration may play a role in the pathogenesis of RVO. PMID:8304694

  8. Vascular endothelial growth factor blocking agents in retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Chris Canning

    2008-01-01

    Full Text Available This paper summarises the current status of the use of vascular endothelial growth factor (VEGF blocking agents in retinal vein occlusion. There have been no randomised controlled trials comparing this treatment with the current standard treatment (largely laser so the lower grade evidence of single treatment case series and anecdotal reports are discussed. VEGF blockers are good at reducing macular oedema in the short term, do improve visual acuity in many cases, and do not seem to adversely affect the long term revascularisation that is necessary to overcome the vein occlusion. VEGF blocking agents are not used in isolation in this condition - they will remain an adjunct to systemic and other local treatments. The literature was reviewed in online searches of Embase and Ovid and the papers quoted are a representative sample of a larger body of publications.

  9. 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...... people is a very challenging problem for methods based on pictorials structure as for any other monocular pose estimation method. In this report we present work on a multi-view approach based on pictorial structures that integrate low level information from multiple calibrated cameras to improve the 2D...... pose estimates in each view. The proposed method in shown to work under heavy occlusions but does not improve the pose estimates in the non-occluded cases in it's current form....

  10. A rare case of branch retinal vein occlusion following Sirsasana

    Science.gov (United States)

    Balamurugan, Anugraha; Srikanth, Krishnagopal

    2016-01-01

    Sirsasana is a type of headstand postural yoga in which the body is completely inverted. It is performed with or without wall support. In this position, the body is held upright supported by the forearms, while the crown of the head rests lightly on the floor. This is an advanced pose and should be attempted under the supervision of a qualified yoga instructor. The practice of Sirsasana is postulated to increase blood flow to the brain, improving memory, and other intellectual functions. It is also known to cause causes raised intraocular pressure, decompression retinopathy, glaucomatous visual field defects, central retinal vein occlusion, progression of glaucoma, optic neuropathy, and conjunctival varix thrombosis. We report a case of branch retinal vein occlusion following Sirsasana in a patient with systemic hypertension. PMID:27512326

  11. Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Mason lll JO

    2015-06-01

    Full Text Available John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV rate in eyes with a branch retinal artery occlusion (BRAO or a central retinal artery occlusion (CRAO, and to study factors that may influence the ONV rate secondary to CRAO.Methods: This was a retrospective case series of consecutive patients (286 total eyes: 83 CRAOs and 203 BRAOs who were diagnosed with a retinal artery occlusion from 1998 to 2013 at the Retina Consultants of Alabama and University of Alabama at Birmingham, Birmingham, AL, USA. Generalized estimating equations were used to evaluate the association between hypothesized risk factors and ONV development.Results: Twelve (14.5% of the 83 eyes with a CRAO developed ONV. Eleven of 12 eyes (91.7% had iris neovascularization, ten of 12 eyes (83.3% had neovascular glaucoma, and two of 12 eyes (16.7% had neovascularization of the optic disc. The average time for ONV development secondary to CRAO was 30.7 days, ranging from the date of presentation to 137 days. Only two (<1.0% of the 203 eyes with a BRAO developed iris neovascularization. Diabetes mellitus type 2 was a risk factor for ONV development following a CRAO with an adjusted odds ratio of 5.2 (95% confidence interval: 1.4–19.8 (P=0.02.Conclusion: ONV is an important complication of CRAO and is a less-frequent complication of BRAO. Patients with a CRAO, especially those with diabetes mellitus type 2, should be closely monitored for the first 6 months for ONV. Keywords: neovascularization, neovascular glaucoma, retinal artery occlusion, central

  12. Sarcopenia: An emphasis on occlusion training and dietary protein

    OpenAIRE

    Loenneke, J P; Pujol, T J

    2011-01-01

    Demographics reveal that the world's population aged 60 years and older will triple from 600 million in 2000 to more 2 billion by the year 2050. To remain independent and healthy, an important factor to consider is the maintenance of skeletal muscle, as the elderly seem to become prone to a progressive loss of skeletal muscle with aging, termed sarcopenia. Interventions should focus on resistance training and optimal nutrition. Low intensity occlusion training may provide a mode of resistance...

  13. Occlusal Grinding Pattern during Sleep Bruxism and Temporomandibular Disorder

    OpenAIRE

    Yeni Wijaya; Laura S. Himawan; Roselani W. Odang

    2013-01-01

    Sleep Bruxism is a significant etiology of temporomandibular disorder (TMD) and causes many dental or oral problems such as tooth wear or facet. There is no study analyzing the relationship between sleep bruxism and TMD. Objective: To investigate any relationship between occlusal grinding pattern during sleep bruxism and temporomandibular disorder. Methods: A cross-sectional study involving 30 sleep bruxism patients attended the Faculty Dentistry Universitas Indonesia Teaching Hospital (RSGMP...

  14. Mechanisms of Biliary Plastic Stent Occlusion and Efforts at Prevention

    OpenAIRE

    Kwon, Chang-Il; Lehman, Glen A.

    2016-01-01

    Biliary stenting via endoscopic retrograde cholangiopancreatography has greatly improved the quality of patient care over the last 30 years. Plastic stent occlusion limits the life span of such stents. Attempts to improve plastic stent patency duration have mostly failed. Metal stents (self-expandable metal stents [SEMSs]) have therefore replaced plastic stents, especially for malignant biliary strictures. SEMS are at least 10 times more expensive than plastic stents. In this focused review, ...

  15. The relationship of occlusal disharmonies and symptoms of temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Dodić Slobodan

    2006-01-01

    Full Text Available Introduction: The influence of occlusal condition on the onset of temporomandibular disorder (TMD has been strongly debated for many years and is still the source of controversy. Until 1980s, the occlusal factors such as the presence of uncured malocclusions, discrepancies between intercuspal position (ICP and retruded contact position (RCP greater than two millimeters, occlusal abnormality, particularly mediotrusion and retrusion, and loss of posterior teeth were considered the primary causes of TMD. Objective: The objective of our study was to find correlation of occlusion disharmonies (difference between ICP and RCP and present sings and symptoms of TMD. Method: The study involved 60 subjects between 18 and 26 years of age who were divided in two groups. The study group consisted of 30 subjects between 18 and 26 years of age with sings and symptoms of temporomandibular disorders (TMD. TMD was confirmed according to Helkimo index. An average value of Helkimo index in this group was 1. The control group included 30 subjects between 20 and 25 years of age without TMD sings and symptoms. An average value of Helkimo index in this group was 0. The function analysis of cinematic centers position in RCP and ICP was performed in each subject using the computer pantograph Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany. Results: The results of our study showed that the translation tracing of cinematic points from RCP to ICP was significantly different in TMD subjects and asymptomatic group (p>0.16. In addition, the study revealed that 53.4 % of subjects with sings and symptoms of temporomandibular disorders had marked translation in the lower temporomandibular joint (0.61-1.2 mm what directed to intracapsular disorders. Conclusion: The results of our study suggested significant difference of RCP and ICP between subjects with sings and symptoms of the temporomandibular disorders and subjects without sings and symptoms.

  16. Consequences of retinal image clarity versus occlusion (absent) versus diffusion.

    OpenAIRE

    Jampolsky, A.

    1994-01-01

    A series of clinical questions and stated hypotheses suggested in the pre-1960s regarding the differences between stimuli of occlusion and diffusion are presented (Part I) and are answered and confirmed by a series of experiments and data in animals and humans. A diffusion stimulus is extremely destructive to development of the acuity system in an eye per se (as well as producing myopia), and a unilateral diffusion stimulus is also destructive to development of the binocular system. Real occl...

  17. Immediate Small Side Branch Occlusion after Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Ostovan

    2007-09-01

    Full Text Available Background: Small side branches, albeit less important than their larger counterparts, have not yet received due attention in the literature. Nor has there ever been a comparison between drug-eluting stents and bare metal stents apropos side branch occlusion. The aim of this study was to compare the patency of small (≥0.5 and ≤1.5 mm in diameter side branches with respect to bare metal vs. drug-eluting stents immediately after their deployment.Methods: This prospective bi-center study, conducted between June 2005 and January 2007, enrolled 82 patients treated with ≥1 of two stents (TAXUSTM LiberteTM or LiberteTM. Side branches ≥0.5 and <1.5 mm in diameter arising from the main vessel at the lesion site were evaluated. Results: Thirty-eight patients were treated with 42 LiberteTM stents (58 side branches and forty-four patients with 50 TAXUSTM LiberteTM (102 side branches. The rate of small side branch occlusion was 35.3% (36 in the TAXUSTM LiberteTM group compared to 29.31% (15 in the LiberteTM group (P-value= 0.7. The presence of type 1 side branch morphology (Lefevre classification was the most powerful predictor of small side branch occlusion (P-value=0.03. Conclusion: This study shows that drug-eluting stents are not inferior to bare metal stents as regards small side branch occlusion during coronary stenting

  18. Light transmission and preference of eye patches for occlusion treatment.

    Directory of Open Access Journals (Sweden)

    Hwan Heo

    Full Text Available PURPOSE: To investigate light transmission and preference for six eye patches for occlusion therapy. METHODS: Six patches were examined, including; Ortopad Fun Pack, Ortopad Flesh, Kawamoto A-1, Kawamoto A-2, 3M Opticlude, and Everade Eye Guard. The size and the presence of a light blocking pad of patches were investigated. The amount of light transmitted through the patches was evaluated, using a digital light meter and a model eye, in three different environments; indoors with fluorescent light, outdoors on a sunny day, and strong light from illuminator. After patching the normal eye, the flash visual evoked potential (VEP was measured. Thirty patients with amblyopia or horizontal strabismus, who received occlusion therapy as initial treatment, were included. After using all six patches, patients completed a 7-item questionnaire regarding the patch preference for size, color and shape, adhesive power, pain with removal, skin irritation after removing patch, parent's preference and overall opinion. RESULTS: All patches had a light-blocking pad, except the 3M Nexcare. Ortopad had the strongest light blocking power in the three environments, and the 3M Nexcare had the weakest power. In flash VEP, Ortopad and Kawamoto patches showed flat, but 3M Nexcare and Everade Eye Guard showed normal response. There were significant preferential differences among the patches in all the items of the questionnaire (P<0.05. In comparison between the patches respectively, 3M Nexcare received the lowest satisfaction in pain when removing a patch and skin irritation after removing a patch. Kawamoto A-2 received the lowest score in the overall satisfaction. CONCLUSIONS: We found differences in the light-blocking power and in the preference of the various patches for the occlusion treatment. This is a pilot study regarding only characteristics and preferences of patches. Further clinical studies regarding the relationship between characteristics or preferences of

  19. Incidence and Predictors of Radial Artery Occlusion Associated Transradial Catheterization

    OpenAIRE

    Tuncez, Abdullah; Kaya, Zeynettin; Aras, Dursun; Yıldız, Abdulkadir; Gül, Enes Elvin; Tekinalp, Mehmet; Karakaş, Mehmet Fatih; Kısacık, Halil Lütfü

    2013-01-01

    In this study, we sought to assess the incidence and predictors of radial artery occlusion (RAO), which is a significant complication of transradial cardiac catheterization. We prospectively evaluated the results of 106 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) via the transradial approach (TRA). At the 3rd h of intervention, the radial artery was checked by palpation; color doppler ultrasonography was performed at the 24th h. Fluoroscopy duratio...

  20. Laparoscopic uterine artery occlusion combined with myomectomy for uterine myomas.

    Science.gov (United States)

    Cheng, Zhongping; Yang, Weihong; Dai, Hong; Hu, Liping; Qu, Xiaoyan; Kang, Le

    2008-01-01

    We sought to evaluate the clinical feasibility and mid- to long-term effects of laparoscopic uterine artery occlusion before myomectomy in the treatment of uterine myomas. A total of 566 patients with uterine myoma were treated by laparoscopic uterine artery occlusion before myomectomy from October 2001 through July 2007. Mean blood loss was 88.2 +/- 52.7 mL (95% CI 82.7-93.8). The highest postoperative temperature was 37.8 +/- 0.3 degrees C, and the postoperative morbidity was 5.7% (32/566). Number of days to the return of bowel movement was 1.9 +/- 0.5d and in hospital stay after surgery was 7.7 +/- 2.5d. Complications included 2 instances of subcutaneous emphysema, 1 of vaginal bleeding, and 3 of mild intestinal obstruction. At a median of 26.3 months (range 6-69 months) of follow-up, the rate of myoma recurrence was 3.0% (15/517), uterus volume reduction was 48.9%, and correction of menstruation abnormality was 97.1% (502/517). Laparoscopic uterine artery occlusion before myomectomy can expand myomectomy indications with better results. PMID:18439509

  1. Occlusion-free Blood Flow Animation with Wall Thickness Visualization.

    Science.gov (United States)

    Lawonn, Kai; Glaßer, Sylvia; Vilanova, Anna; Preim, Bernhard; Isenberg, Tobias

    2016-01-01

    We present the first visualization tool that combines pathlines from blood flow and wall thickness information. Our method uses illustrative techniques to provide occlusion-free visualization of the flow. We thus offer medical researchers an effective visual analysis tool for aneurysm treatment risk assessment. Such aneurysms bear a high risk of rupture and significant treatment-related risks. Therefore, to get a fully informed decision it is essential to both investigate the vessel morphology and the hemodynamic data. Ongoing research emphasizes the importance of analyzing the wall thickness in risk assessment. Our combination of blood flow visualization and wall thickness representation is a significant improvement for the exploration and analysis of aneurysms. As all presented information is spatially intertwined, occlusion problems occur. We solve these occlusion problems by dynamic cutaway surfaces. We combine this approach with a glyph-based blood flow representation and a visual mapping of wall thickness onto the vessel surface. We developed a GPU-based implementation of our visualizations which facilitates wall thickness analysis through real-time rendering and flexible interactive data exploration mechanisms. We designed our techniques in collaboration with domain experts, and we provide details about the evaluation of the technique and tool.

  2. Comparative study to evaluate the accuracy of polyether occlusal bite registration material and occlusal registration wax as a guide for occlusal reduction during tooth preparation

    Directory of Open Access Journals (Sweden)

    Niranjan Joshi

    2013-01-01

    Objective: The objective of this study was to compare and evaluate the reliability of the most commonly used occlusal registration wax that with polyether bite registration material as a guide for occlusal reduction required during tooth preparations. Materials and Methods: For the purpose of this study, 25 abutment teeth requiring tooth preparation for fixed prosthesis were selected and tooth preparations carried out. Modeling wax strips of specific dimensions were placed onto the cast of prepared tooth, which was mounted on maximum intercuspation on the articulator and the articulator was closed. The thickness of the wax registration was measured at three zones namely two functional cusps and central fossa. Similar measurements were made using the polyether bite registration material and prosthesis at the same zones. The data was tabulated and was subjected to statistical analysis using anova test and Tukey honestly significant difference test. Results: The differences in thickness between wax record and prosthesis by 0.1346 mm, whereas the difference between polyether and prosthesis was 0.02 mm with a P value of 0.042, which is statistically significant. This means that the wax record was 8.25% larger than the prosthesis while polyether was just 1.27% larger than the prosthesis. Conclusion: The clinical significance of the above analysis is that Ramitec polyether bite registration material is most suitable material when compared with commonly used modeling wax during the tooth preparation.

  3. DISEASES

    DEFF Research Database (Denmark)

    Pletscher-Frankild, Sune; Pallejà, Albert; Tsafou, Kalliopi;

    2015-01-01

    Text mining is a flexible technology that can be applied to numerous different tasks in biology and medicine. We present a system for extracting disease-gene associations from biomedical abstracts. The system consists of a highly efficient dictionary-based tagger for named entity recognition...... of human genes and diseases, which we combine with a scoring scheme that takes into account co-occurrences both within and between sentences. We show that this approach is able to extract half of all manually curated associations with a false positive rate of only 0.16%. Nonetheless, text mining should...... not stand alone, but be combined with other types of evidence. For this reason, we have developed the DISEASES resource, which integrates the results from text mining with manually curated disease-gene associations, cancer mutation data, and genome-wide association studies from existing databases...

  4. Near infrared image processing to quantitate and visualize oxygen saturation during vascular occlusion.

    Science.gov (United States)

    Jalil, B; Salvetti, O; Potì, L; Hartwig, V; Marinelli, M; L'Abbate, A

    2016-04-01

    The assessment of microcirculation spatial heterogeneity on the hand skin is the main objective of this work. Near-infrared spectroscopy based 2D imaging is a non-invasive technique for the assessment of tissue oxygenation. The haemoglobin oxygen saturation images were acquired by a dedicated camera (Kent Imaging) during baseline, ischaemia (brachial artery cuff occlusion) and reperfusion. Acquired images underwent a preliminary restoration process aimed at removing degradations occurring during signal capturing. Then, wavelet transform based multiscale analysis was applied to identify edges by detecting local maxima and minima across successive scales. Segmentation of test areas during different conditions was obtained by thresholding-based region growing approach. The method identifies the differences in microcirculatory control of blood flow in different regions of the hand skin. The obtained results demonstrate the potential use of NIRS images for the clinical evaluation of skin disease and microcirculatory dysfunction. PMID:26725781

  5. Balloon occlusion retrograde transvenous obliteration of gastric varices in two-cirrhotic patients with portal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Borhei, Peyman; Kim, Seung Kwon; Zukerman, Darryl A [Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (United States)

    2014-02-15

    This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt.

  6. Post-traumatic intraarterial thrombolytic treatment for acute occlusion of the extremities artery

    International Nuclear Information System (INIS)

    Objective: To explore the clinical value of intraarterial thrombolytic therapy for acute arterial occlusion of the extremities artery after trauma. Methods: Six cases with acute arterial occlusion of the extremities after trauma underwent intraarterial thrombolytic therapy and the efficiency was analysed. Results: Digital Subtraction Angiograph (DSA)clearly displayed the location, extent and dimensions of the occlusive extremity arteries. All the occlusive arteries were recanalized with successful rate of 100%. 4 cases appeared to have ischemia-reperfusion injury after treatment, outcoming with recovery in one case by musculoaponeuratic splitting, and 3 cases through medication; and simultaneously the pulse of the occlusive arteries returned to normal and the local pains reduced or disapeared afterwards; without serious complications of necrosis, hemorrhage etc. Conclusions: The intraarterial thrombolytic treatment of acute arterial occlusion of the extremities after trauma is safe, effective, minimal invasive and less complication; providing the preparation for further stent placement. (authors)

  7. Computer-aided determination of occlusal contact points for dental 3-D CAD.

    Science.gov (United States)

    Maruyama, Tomoaki; Nakamura, Yasuo; Hayashi, Toyohiko; Kato, Kazumasa

    2006-05-01

    Present dental CAD systems enable us to design functional occlusal tooth surfaces which harmonize with the patient's stomatognathic function. In order to avoid occlusal interferences during tooth excursions, currently available systems usually use the patient's functional occlusal impressions for the design of occlusal contact points. Previous interfere-free design, however, has been done on a trial-and-error basis by using visual inspection. To improve this time-consuming procedure, this paper proposes a computer-aided system for assisting in the determination of the occlusal contact points by visualizing the appropriate regions of the opposing surface. The system can designate such regions from data of the opposing occlusal surfaces and their relative movements can be simulated by using a virtual articulator. Experiments for designing the crown of a lower first molar demonstrated that all contact points selected within the designated regions completely satisfied the required contact or separation during tooth excursions, confirming the effectiveness of our computer-aided procedure.

  8. Basilar artery occlusion: Prognostic signs of severity on computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Poletti, Pierre-Alexandre, E-mail: pierre-alexandre.poletti@hcuge.ch [Service of Radiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes [Service of Neuroradiology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva (Switzerland); Department of Medical Imaging, University of Toronto (Canada); Department of Surgery, University of Toronto (Canada); Lovblad, Karl-Olof [Service of Neuroradiology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva (Switzerland); Canel, Lucie [Service of Radiology, University Hospital of Geneva (Switzerland); Sztajzel, Roman [Service of Neurology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva (Switzerland); Becker, Minerva [Service of Radiology, University Hospital of Geneva (Switzerland); Perneger, Thomas [Division of Clinical Epidemiology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva (Switzerland); Platon, Alexandra [Service of Radiology, University Hospital of Geneva (Switzerland)

    2015-07-15

    Highlights: • The main CT signs associated with basilar artery occlusion were analyzed. • CT sign of acute ischemic lesion is significantly associated with a bad outcome. • The site of the basilar artery occlusion is not associated to the patients’ outcome. - Abstract: Purpose: To determine the computed tomography (CT) signs that are predictive of the clinical outcome of basilar artery occlusion (BAO). Materials and methods: The study population consisted in 37 patients (14 women, 23 men, mean age: 63 years), admitted with onset of neurological deficit, starting 1–72 h prior to admission, who were diagnosed with BAO on the basis of a CT examination with intravenous contrast agent. The following signs were collected on CT scans performed on admission: clot density on noncontrast images, clot length, and clot location, as well as the presence of acute ischemic lesions. The results were compared against the modified Rankin Scale (mRS) score of patients at 3 months, favorable clinical outcome being defined as a mRS score ≤3. Results: The clinical outcome was favorable in 13 (35%) of the 37 patients and unfavorable in 24 (65%). Signs of acute ischemia were visible in 13 of the 24 patients with unfavorable outcome but in none of the 13 patients with favorable outcome (p < 0.001). None of the other CT signs analyzed were significantly correlated with clinical prognosis. Conclusion: Of all the CT signs analyzed, only the presence of signs of acute ischemia on the admission CT of patients with BAO was associated with poor prognosis.

  9. EVALUATION OF THE BRAIN TOLERANCE TO CAROTID ARTERY OCCLUSION

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To establish an objective criterion for assessing brain tolerance to carotid artery occlusion. Methods Endovascular trial balloon occlusion of carotid artery (TBO) in combination with sin- gle-photon emission computed tomography ( SPECT ) , transcranial Doppler ultrasonography (TCD) and carotid artery stump pressure ( SP ) measurement was performed routinely for those patients who might have carotid artery manipulated or permanently occluded. Results Out of the 10 cases, one failed the TBO, though an angiographically adequate collateral circulation was observed. The patient's SP and relative symmetry (rS) of SPECT imaging were 51mmHg and 86 %. The remaining cases showed negative TBOs. After carotid occlusions, their mean velocity of ipsilateral middle cerebral artery decreased ( 16.3 ± 6.9 )% . The mean rS was ( 98.0 ± 2.4)% (92.7%~101.3%). The mean SP was ( 64.5+13.0)mmHg [(72.3±11.3)% of baseline, range 32 ~ 83mmHg ] . For one subject, the ICA was occluded spontaneously in the test. A reversal internal carotid artery ( ICA ) flow was noted in 3 patients with balloon inflated in the common carotid artery ( CCA ). When the CCA was occluded, the system blood pressure and heart rate increased apparently. However, this phe- nomenon did not occur when the ballon was inflated in the ICA. Conclusion With this TBO technique, clinically silent areas of decreased perfusion might be detected. We suggest it be a routine examination prior to carotid manipulations.

  10. Acute multivessel coronary artery occlusion: a case report

    Directory of Open Access Journals (Sweden)

    Gan Feng

    2012-09-01

    Full Text Available Abstract Background In terms of clinical and angiographic findings, multiple simultaneous coronary occlusions in acute myocardial infarction are infrequent, and the mechanism of the occlusions is unclear. Case presentation We herein report a rare case of two simultaneously occluded coronary arteries, one of which subsequently underwent spontaneous lysis. An 88-year-old man had a 3-hour attack of acute crushing retrosternal chest pain. His first electrocardiogram showed ST-segment elevation in the inferior (II, III, and aVF and anterior (V3–V6 leads. His second electrocardiogram in the cardiac care unit showed ST-segment elevation in the inferior leads but ST-segment depression in the anterior leads. Emergency coronary angiography revealed that the right coronary artery was acutely and totally occluded at the midportion and that the proximal and midportion of the left anterior descending coronary artery had an acute thrombus. According to his electrocardiogram and coronary angiography findings, we inferred that the right coronary artery and left anterior descending coronary artery first totally occluded simultaneously, and then the thrombus in the left anterior descending coronary artery spontaneously underwent partial lysis. Therefore, intervention of the right coronary artery was performed followed by injection of glycoprotein IIB-IIIA inhibitor into the left anterior descending coronary artery. He had an uneventful hospital course and was discharged home 10 days later. Conclusion Because patients with multivessel coronary artery occlusion are often in serious condition, abnormal electrocardiographic results must be identified and affected vessel should be opened timely and efficiently to save the myocardium and reduce complications such as congestive heart failure.

  11. Basilar artery occlusion: Prognostic signs of severity on computed tomography

    International Nuclear Information System (INIS)

    Highlights: • The main CT signs associated with basilar artery occlusion were analyzed. • CT sign of acute ischemic lesion is significantly associated with a bad outcome. • The site of the basilar artery occlusion is not associated to the patients’ outcome. - Abstract: Purpose: To determine the computed tomography (CT) signs that are predictive of the clinical outcome of basilar artery occlusion (BAO). Materials and methods: The study population consisted in 37 patients (14 women, 23 men, mean age: 63 years), admitted with onset of neurological deficit, starting 1–72 h prior to admission, who were diagnosed with BAO on the basis of a CT examination with intravenous contrast agent. The following signs were collected on CT scans performed on admission: clot density on noncontrast images, clot length, and clot location, as well as the presence of acute ischemic lesions. The results were compared against the modified Rankin Scale (mRS) score of patients at 3 months, favorable clinical outcome being defined as a mRS score ≤3. Results: The clinical outcome was favorable in 13 (35%) of the 37 patients and unfavorable in 24 (65%). Signs of acute ischemia were visible in 13 of the 24 patients with unfavorable outcome but in none of the 13 patients with favorable outcome (p < 0.001). None of the other CT signs analyzed were significantly correlated with clinical prognosis. Conclusion: Of all the CT signs analyzed, only the presence of signs of acute ischemia on the admission CT of patients with BAO was associated with poor prognosis

  12. Therapeutic ureteral occlusion in advanced pelvic malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kinn, A.C.; Ohlsen, H.; Brehmer-Andersson, E.; Brundin, J.

    1986-01-01

    A technique for ureteral occlusion, combining insertion of nylon plugs with injection of polidocanol, is described. The method was used in 15 patients with vesicovaginal fistulas after operation and irradiation for advanced gynecological malignancy, or with severe malfunction and fibrosis of the bladder after radiotherapy for bladder carcinoma. The urinary leakage ceased in 11 patients, was greatly diminished in 2 and was unchanged in 2. Migration of plugs to the renal pelvis was the most serious complication and may have been the cause of pyelonephritis in 1 case. The technique is recommended for patients with a short life expectancy and uncontrolled, distressing leakage of urine.

  13. Sealing occlusal caries lesions in adults referred for restorative treatment

    DEFF Research Database (Denmark)

    Bakhshandeh, Azam; Qvist, Vibeke; Ekstrand, Kim R

    2012-01-01

    treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made....... Follow-up period was 25-38 months (mean¿=¿33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2-3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners...

  14. Current status of percutaneous coronary intervention of chronic total occlusion

    Institute of Scientific and Technical Information of China (English)

    Jun-bo GE

    2012-01-01

    This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries.Chronic total occlusion is associated with 10%-20% of all PCI procedures.Results show that opening an occluded vessel,especially one supplying a considerable area of myocardium,may be beneficial for a patient's angina relief and heart function.We describe the devices used currently in re-canalization such as new wires,microcatheters (including Tonus and Cosair) and intravascular ultrasound guidance.Different techniques to improve the success rate and reduce complications are discussed in detail.

  15. A New Occlusion Device: Application of the ArtVentive Endoluminal Occlusion System (EOS)—First in Human Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Venbrux, Anthony C., E-mail: avenbrux@mfa.gwu.edu [The George Washington University Medical Center, Division of Vascular and Interventional Radiology (United States); Rudakov, Leon, E-mail: leonrudakov@artventivemedical.com [Artventive Medical Group, Inc. (United States); Plass, Andre, E-mail: andre.plass@usz.ch; Emmert, Maximilian Y., E-mail: maximilian.emmert@usz.ch [University Hospital Zurich, Clinic for Cardiac and Vascular Surgery (Switzerland); Ebner, Adrian, E-mail: adrianebner@fundacor.com.py [Sanatorio Privado Santa Clara, Cath Lab Department (Paraguay)

    2013-05-24

    PurposeThe purpose of this study was to determine the safety and efficacy of a new endoluminal occlusion device, ArtVentive endoluminal occlusion system (EOS), to occlude the spermatic vein in symptomatic males with varicoceles.MethodsThe ArtVentive EOS device has been developed for percutaneous, peripheral occlusion of the peripheral arterial and venous vasculature. The system is comprised of an implantable occlusion device and a delivery catheter. At present, there are two device sizes: (a) size 1 for target vessels ranging between 3.5 and 5.5 mm in diameter, and (b) size 2 for target vessels 5.5–8.5 mm in diameter. The treatment group included six adult males, ages 22–34 years. Nine target vessels were occluded. A total of 20 devices were implanted in six subjects.ResultsThe acute occlusion rate at the end of the procedure was 100 % occurring in nine of nine vessels. The spermatic veins of all patients remained occluded on venography at 30 days follow-up. Pain scores related to varicoceles decreased in five of six patients.ConclusionsAlthough we recognize this study is limited, initial experience indicates that the ArtVentive EOS is a safe and effective new device for occlusion of vessels (varicoceles). The device has potential applications in other clinical conditions requiring occlusion of veins or arteries.

  16. Selectively active markers for solving of the partial occlusion problem in matchmoving and chromakeying workflow

    Science.gov (United States)

    Mazurek, Przemysław

    2013-09-01

    Matchmoving (Match Moving) is the process used for the estimation of camera movements for further integration of acquired video image with computer graphics. The estimation of movements is possible using pattern recognition, 2D and 3D tracking algorithms. The main problem for the workflow is the partial occlusion of markers by the actor, because manual rotoscoping is necessary for fixing of the chroma-keyed footage. In the paper, the partial occlusion problem is solved using the invented, selectively active electronic markers. The sensor network with multiple infrared links detects occlusion state (no-occlusion, partial, full) and switch LED's based markers.

  17. Shape tracking with occlusions via coarse-to-fine region-based sobolev descent

    KAUST Repository

    Yang, Yanchao

    2015-05-01

    We present a method to track the shape of an object from video. The method uses a joint shape and appearance model of the object, which is propagated to match shape and radiance in subsequent frames, determining object shape. Self-occlusions and dis-occlusions of the object from camera and object motion pose difficulties to joint shape and appearance models in tracking. They are unable to 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. Self-occlusions and the warp to propagate the model are coupled, thus we formulate a joint optimization problem. We derive a coarse-to-fine optimization method, advantageous in tracking, that initially perturbs the model by coarse perturbations before transitioning to finer-scale perturbations seamlessly. This coarse-to-fine behavior is automatically induced by gradient descent on a novel infinite-dimensional Riemannian manifold that we introduce. The manifold consists of planar parameterized regions, and the metric that we introduce is a novel Sobolev metric. Experiments on video exhibiting occlusions/dis-occlusions, complex radiance and background show that occlusion/dis-occlusion modeling leads to superior shape accuracy. © 2014 IEEE.

  18. Bilateral Internal Carotid Artery Occlusion Associated with the Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Pria Anand

    2014-03-01

    Full Text Available A 39-year-old woman presented with a right-hemispheric stroke 1 year after she had suffered a left-hemispheric stroke. Her diagnostic workup was notable for bilateral occlusions of the internal carotid arteries at their origins and a positive lupus anticoagulant antibody test. There was no evidence of carotid dissection or another identifiable cause for her carotid occlusions. These findings suggest that the antiphospholipid antibody syndrome may be implicated in the pathological changes that resulted in occlusions of the extracranial internal carotid arteries. Young stroke patients who present with unexplained internal carotid artery occlusions may benefit from testing for the presence of antiphospholipid antibodies.

  19. Immediate hemodynamic changes after revascularization of complete infrarenal aortic occlusion: A classic issue revisited.

    Science.gov (United States)

    Georgakarakos, Efstratios; Argyriou, Christos; Georgiadis, George S; Ioannou, Christos V; Lazarides, Miltos K

    2016-02-01

    Chronic total occlusion of the infrarenal aorta (CTOA) is a rare disease, characterized by severe impairment of limb perfusion. It is advocated that revascularization may improve survival rates, presumably due to improved cardiovascular performance; however no experimental or clinical data exist to identify a clear causative correlation and provide a relevant pathophysiologic background. Therefore we conducted a pilot study based on pulse wave analysis to detect the hemodynamic changes immediately after revascularization, in a group of six consecutive patients with CTOA. All patients were subjected to non-invasive measurements 1 day before surgery and at the end of the 1st postoperative month. Pulse wave analysis was performed noninvasively with a novel validated brachial cuff-based automatic oscillometric device. All patients had markedly preoperative high Augmentation Index (adjusted at heart rate 75 beats/min, AI@75). The AI@75 decreased from 46 ± 6.6 preoperatively to 24 ± 5.7 (p 0.0002). Wave reflection magnitude decreased from 72.3 ± 5.2% to 63 ± 6.7% (p 0.02). Cardiax index increased from 2.8 ± 1.2 to 3.4 ± 1.2l/min × 1/m(2) (p 0.41). Pulse wave velocity remained practically unchanged post-interventionally. These findings show that central aorta hemodynamics can be improved immediately following revascularization procedures in patients with complete occlusion of the entire length of the infrarenal aorta and can constitute the background of improved postoperative life-expectancy. PMID:26826635

  20. Differentiation of acute total occlusion of coronary artery from chronic total occlusion in coronary computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kwag, Hyon Joo [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    To compare the features of coronary computed tomography angiography (CCTA) imaging of the patients with acute total occlusion (ATO) of coronary artery with those of chronic total occlusion (CTO). CCTA of 26 patients with complete interruption of the coronary artery in CCTA and occlusion in conventional coronary angiography, were retrospectively analyzed. Discrimination between the ATO group (n = 11, patients with non ST elevation myocardial infarction or unstable angina) and the CTO group (n = 15, patients with stable angina or nonspecific symptom) was arbitrarily determined by clinical diagnosis. Lesion length, remodeling index (RI), plaque density measured by Hounsfield units (HU), plaque composition, percentage attenuation drop across the lesion, and presence of myocardial thinning were evaluated. Comparisons between the ATO and CTO groups revealed significantly shorter lesion length in the ATO group (0.40 cm vs. 1.87 cm, respectively; p = 0.001), and significantly higher RI (1.56 vs. 1.10, respectively; p = 0.004). Plaque density of the ATO group was lower (37.0 HU vs. 104.7 HU, respectively; p < 0.001) and non calcified plaque was frequently seen in the ATO group (72.7% vs. 26.7%, respectively; p = 0.02). Percentage attenuation drop across the lesion was lower for the ATO group (10.92% vs. 25.44%, respectively; p = 0.005). Myocardial thinning was exclusively observed in the CTO group (seven of 15 patients, p = 0.01). CCTA shows various statistically significant differences between the ATO and CTO groups.

  1. Outflow occlusion for circulatory arrest in dogs "Outfow occlusion" para parada circulatória em cães

    Directory of Open Access Journals (Sweden)

    James N.B.M. de Andrade

    2009-02-01

    Full Text Available The purpose of this study was to evaluate the possibility of producing circulatory arrest by occlusion of the pulmonary trunk as an alternative to the venous inflow occlusion through the left hemithorax. Eight healthy mongrel dogs were divided in two groups. Group I underwent 4 minutes of outflow occlusion and Group II was submitted to 8 minutes of circulatory arrest. Outflow occlusion was performed through left thoracotomy and pericardiotomy by passing a Rumel tourniquet around the pulmonary trunk. Physical examination, electrocardiography, echocardiography, blood gas analyses, hemodynamic, and oxygen transport variables were obtained before and after the procedure. The dogs from Group I did not have any clinical, electrocardiographic, echocardiographic, or hemo-dynamic abnormalities after anesthetic recover. In the Group II, only one dog survived, which had no clinical, electrocardiographic, or echocardiographic abnormalities. In this last dog, just after releasing the occlusion, it was detected increases in the following parameters: heart rate (HR, systolic, diastolic and mean arterial blood pressure (SAP; DAP; MAP, pulmonary artery pressure (PAP, pulmonary wedge pressure (PWP, central venous pressure (CVP, cardiac output (CO, systolic index (SI, cardiac index (CI, left and right ventricular stroke work (LVSW; RVSW, oxygen delivery index (DO2, oxygen consumption index (VO2, and oxygen extraction (O2 ext. Moreover, the oxygen content of arterial and mixed venous blood (CaO2; CvO2, and the arterial and mixed venous partial pressure of oxygen (PaO2; PvO2 were decreased 5 minutes after circulatory arrest. Outflow occlusion is a feasible surgical procedure for period of 4 minutes of circulatory arrest.O objetivo deste estudo foi avaliar a possibilidade de se produzir uma parada circulatória pela oclusão do tronco pulmonar, como alternativa ao "inflow occlusion", pelo hemitórax esquerdo. Oito cães sem raça definida foram divididos em dois

  2. Central retinal artery occlusion resembling Purtscher-like retinopathy

    Directory of Open Access Journals (Sweden)

    Etomi T

    2011-08-01

    Full Text Available Takuji Kurimoto1, Norio Okamoto2, Hidehiro Oku1, Yuko Kanbara1, Tomohiko Etomi1, Masahiro Tonari1, Tsunehiko Ikeda11Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan; 2Okamoto Eye Clinic, Suita, Osaka, JapanAbstract: This paper reports three cases of central retinal artery occlusion (CRAO with Purtscher-like retinopathy and good recovery of visual function. The three cases of CRAO had similar fundus changes, ie, cotton wool patches surrounding the optic disc and whitening of the retina surrounding the fovea with a cherry red spot. Fluorescein angiography showed a delay of arm-to-retina circulation time and a partial defect of choroid circulation. Although the three cases were treated by different regimens of steroid pulse therapy and antiplatelet therapy, visual function recovered well and all disturbances of the retinal and choroid circulations resolved. Although eyes with a CRAO normally have a poor visual prognosis, our three cases responded well to the treatments and recovered good visual function. Thus, cases showing fundus changes similar to our three cases may have a pathogenesis different from that of a complete CRAO.Keywords: central retinal artery occlusion, cotton wool patches, Purtscher retinopathy, steroid therapy

  3. [Diagnosis of occlusal caries lesions using laser fluorescence measurements].

    Science.gov (United States)

    Naphausen, M T P; Riemersma, M; Verdonschot, E H

    2002-01-01

    Recently, a device for detecting occlusal caries lesions (DIAGNOdent) has been introduced. The reproducibility and validity of this laser-fluorescence device were investigated. In the in vivo part of the study, 45 sites at the occlusal surfaces of permanent molar teeth in 13 patients were measured by 2 observers using 2 DIAGNOdent devices, one produced in 1998 and one in 1999. The interobserver reliability between both devices and both observers was established. In the in vitro part of the study, 49 permanent molars were measured by 2 observers using 2 DIAGNOdent devices. In addition, visual inspection was performed. The teeth were sectioned to measure the histological depth and area of the caries lesions. The reproducibility of both DIAGNOdent devices was high, and so was the interobserver reliability. The correlation between DIAGNOdent measurements and the actual depth of the caries lesions was lower than that of visual inspection. The correlation with the enamel part of the lesion exceeded that of the dentine part. It was concluded that the validity of the DIAGNOdent, expressed as the area under the Receiver Operating Characteristic (ROC) curve, was not statistically significantly different from that of visual inspection. Because of the high reproducibility, dental practitioners who wish to use the DIAGNOdent for monitoring caries lesions, this investigation indicates that an old device may be replaced by a new one, provided that the same tip will be used.

  4. Virtual articulator for the analysis of dental occlusion: an update.

    Science.gov (United States)

    Maestre-Ferrín, Laura; Romero-Millán, Javier; Peñarrocha-Oltra, David; Peñarrocha-Diago, María

    2012-01-01

    The future of dental practice is closely linked to the utilization of computer-based technology, specifically virtual reality, which allows the dental surgeon to simulate true life situations in patients. The virtual articulator has been designed for the exhaustive analysis of static and dynamic occlusion, with the purpose of substituting mechanical articulators and avoiding their errors. These tools will help both odontologists and dental prosthetists to provide the best individualized treatment for each patient. The present review analyzes the studies published in the literature on the design, functioning and applications of virtual articulators. A Medline-PubMed search was made of dental journals, with the identification of 137 articles, of which 16 were finally selected. The virtual articulator can simulate the specific masticatory movement of the patient. During mandibular animation, the program calculates the sites where the opposing teeth come into contact. The studies made to assess the reliability of the virtual articulator show good correspondence in visualization of the number and position of the dynamic contacts. The virtual articulator is a precise tool for the full analysis of occlusion in a real patient.

  5. Value of CT angiography in anterior circulation large vessel occlusive stroke: Imaging findings, pearls, and pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Power, Sarah, E-mail: drsarahpower@gmail.com [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); McEvoy, Sinead H., E-mail: sineadmcevoy@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Cunningham, Jane, E-mail: janecunningham0708@gmail.com [Department of Radiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Ti, Joanna P., E-mail: joannapearlyti@gmail.com [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Looby, Seamus, E-mail: seamuslooby@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); O' Hare, Alan, E-mail: alanohare@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Williams, David, E-mail: davidwilliams@rcsi.ie [Department of Geriatrics and Stroke Medicine, Royal College of Surgeons in Ireland (RCSI) and Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Brennan, Paul, E-mail: paulbrennan@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland); Thornton, John, E-mail: johnthornton@beaumont.ie [Department of Neuroradiology, Beaumont Hospital, P.O. Box 1297, Beaumont Rd, Dublin 9 (Ireland)

    2015-07-15

    Highlights: • Site of occlusion determines potential collateralization routes and impacts outcome. • Multifocality of arterial occlusion is common, seen in approximately 20% of cases. • ICA false occlusion sign can be seen in setting of ICA stenosis or carotid T occlusion. • False patency sign: hyperdense thrombus/calcified occlusive plaque misinterpreted as patent vessel. • Additional abnormalities on CTA may infer stroke mechanism or alter decision making. - Abstract: Hyperacute stroke imaging is playing an increasingly important role in determining management decisions in acute stroke patients, particularly patients with large vessel occlusive stroke who may benefit from endovascular intervention. CT angiography (CTA) is an important tool in the work-up of the acute stroke patient. It reliably detects large occlusive thrombi in proximal cerebral arteries and is a quick and highly accurate method in identifying candidates for endovascular stroke treatment. In this article we review the imaging findings on CTA in acute large vessel occlusive stroke using a pictorial case based approach. We retrospectively reviewed CTA studies in 48 patients presenting with acute anterior circulation large vessel occlusive stroke who were brought for intra-arterial acute stroke intervention. We discuss and illustrate patterns of proximal intracranial arterial occlusion, collateralization to the occluded territory, as well as reviewing some important pearls, pitfalls and teaching points in CTA assessment of the acute stroke patient. Performed from the level of the aortic arch CTA also gives valuable information regarding the state of other vessels in the acute stroke patient, identifying additional significant vascular stenoses or occlusions, and as we illustrate, can demonstrate other clinically significant findings which may impact on patient management and outcome.

  6. Comparison of transient arterial occlusion and muscle exercise provocation for assessment of perfusion reserve in skeletal muscle with real-time contrast-enhanced ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Krix, Martin, E-mail: martin.krix@kabelbw.de [German Cancer Research Center, Research Program Imaging and Radiooncology, Department of Radiology, INF 280, D-69120 Heidelberg (Germany); Bracco Imaging Germany, Max-Stromeyer-Str. 116, D-78467 Konstanz (Germany); Krakowski-Roosen, Holger [German Cancer Research Center, Department of Translational Oncology, INF 280, D-69120 Heidelberg (Germany); Armarteifio, Erick [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, INF 110, D-69120 Heidelberg (Germany); Fuerstenberger, Susanne [University Hospital of Heidelberg, Department of Vascular Surgery, INF 110, D-69120 Heidelberg (Germany); Delorme, Stefan [German Cancer Research Center, Research Program Imaging and Radiooncology, Department of Radiology, INF 280, D-69120 Heidelberg (Germany); Kauczor, Hans-Ulrich; Weber, Marc-Andre [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, INF 110, D-69120 Heidelberg (Germany)

    2011-06-15

    Objective: Contrast-enhanced ultrasound (CEUS) is able to quantify muscle perfusion and changes in perfusion due to muscle exercise in real-time. However, reliable measurement of standardized muscle exercise is difficult to perform in clinical examinations. We compared perfusion reserve assessed by CEUS after transient arterial occlusion and exercise to find the most suitable measurement for clinical application. Methods: Contrast pulse sequencing (7 MHz) during continuous IV infusion of SonoVue (4.8 mL/300 s) was used in 8 healthy volunteers to monitor muscle perfusion of the gastrocnemius muscle during transient (1 min) arterial occlusion produced by a thigh cuff of a venous occlusion plethysmograph. Isometric muscle exercise (50% of individual maximum strength for 20 s) was subsequently performed during the same examination, and several CEUS parameters obtained from ultrasound-signal-intensity-time curves and its calculation errors were compared. Results: The mean maximum local blood volume after occlusion was 13.9 [{approx}mL] (range, 4.5-28.8 [{approx}mL]), and similar values were measured after sub-maximum exercise 13.8 [{approx}mL], (range, 4.6-22.2 [{approx}mL]. The areas under the curve during reperfusion vs. recovery were also similar (515.2 {+-} 257.5 compared to 482.2 {+-} 187.5 [{approx}mL s]) with a strong correlation (r = 0.65), as were the times to maximum (15.3 s vs. 15.9 s), with a significantly smaller variation for the occlusion method ({+-}2.1 s vs. {+-}9.0 s, p = 0.03). The mean errors for all calculated CEUS parameters were lower for the occlusion method than for the exercise test. Conclusions: CEUS muscle perfusion measurements can be easily performed after transient arterial occlusion. It delivers data which are comparable to CEUS measurements after muscle exercise but with a higher robustness. This method can be easily applied in clinical examination of patients with e.g. PAOD or diabetic microvessel diseases to assess perfusion reserve.

  7. Comparison of transient arterial occlusion and muscle exercise provocation for assessment of perfusion reserve in skeletal muscle with real-time contrast-enhanced ultrasound

    International Nuclear Information System (INIS)

    Objective: Contrast-enhanced ultrasound (CEUS) is able to quantify muscle perfusion and changes in perfusion due to muscle exercise in real-time. However, reliable measurement of standardized muscle exercise is difficult to perform in clinical examinations. We compared perfusion reserve assessed by CEUS after transient arterial occlusion and exercise to find the most suitable measurement for clinical application. Methods: Contrast pulse sequencing (7 MHz) during continuous IV infusion of SonoVue (4.8 mL/300 s) was used in 8 healthy volunteers to monitor muscle perfusion of the gastrocnemius muscle during transient (1 min) arterial occlusion produced by a thigh cuff of a venous occlusion plethysmograph. Isometric muscle exercise (50% of individual maximum strength for 20 s) was subsequently performed during the same examination, and several CEUS parameters obtained from ultrasound-signal-intensity-time curves and its calculation errors were compared. Results: The mean maximum local blood volume after occlusion was 13.9 [∼mL] (range, 4.5-28.8 [∼mL]), and similar values were measured after sub-maximum exercise 13.8 [∼mL], (range, 4.6-22.2 [∼mL]. The areas under the curve during reperfusion vs. recovery were also similar (515.2 ± 257.5 compared to 482.2 ± 187.5 [∼mL s]) with a strong correlation (r = 0.65), as were the times to maximum (15.3 s vs. 15.9 s), with a significantly smaller variation for the occlusion method (±2.1 s vs. ±9.0 s, p = 0.03). The mean errors for all calculated CEUS parameters were lower for the occlusion method than for the exercise test. Conclusions: CEUS muscle perfusion measurements can be easily performed after transient arterial occlusion. It delivers data which are comparable to CEUS measurements after muscle exercise but with a higher robustness. This method can be easily applied in clinical examination of patients with e.g. PAOD or diabetic microvessel diseases to assess perfusion reserve.

  8. Clinical effect of occlusal-splint removable partial denture%(牙合)垫式可摘局部义齿的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    张涛; 梁虹

    2011-01-01

    目的:观察(牙合)垫式可摘局部义齿对牙齿重度磨耗伴缺牙的患者的修复效果.方法:对25例缺牙伴重度深覆(牙合)患者进行取模型、用蜡(牙合)堤确定颌位关系并升高咬合1mm-2mm,在上颌制作铸造支架式活动义齿,并在余留牙上制作铸造金属(牙合)垫.于治疗后1、2周,1、2、3个月进行定期观察.结果:戴用义齿2周内有3例不愿继续使用义齿,其余的22例均适应了义齿并正常行使咀嚼功能,这其中有4例患者出现过牙周病加重.结论:(牙合)垫式可摘局部义齿能修复缺损的牙列,减小深覆(牙合),加大面下1/3的高度,是修复牙齿重度磨耗伴缺牙的一个可行修复方法.%Objective: To observe the clinical effect of occlusal-splint removable partial denture for patients with severe teeth wear and tooth loss. Method: Twenty-five patients with severe deep overbite occlusal were randomly selected. Impressions were taken and occlusion relationship were fixed with wax, followed by raising occlusion l-2mm. Casting frameworks of removable partial denture in maxillary and casting metal occlusal splint on the remaining teeth were fabricated. The follow-up time points were 1 week, 2 weeks, 1 month, 2 month and 3 months. Result: Three individuals refused to use complete dentures within 2 weeks, while the other 22 were satisfactory in masticatory function, however with 4 cases occurred with aggravating periodontal disease. Conclusion: Occlusal-splint removable partial dentures could repair dentition defect, decrease the degree of deep overbite occlusion, and increase the height of the one-third below. It is a feasible method for repairing severe dental attrition.

  9. Combined Central Retinal Artery and Vein Occlusion Associated with Factor V Leiden Mutation and Treated with Hyperbaric Oxygen

    Directory of Open Access Journals (Sweden)

    José Alberto Lemos

    2015-12-01

    Full Text Available Background: Combined central retinal artery occlusion (CRAO and central retinal vein occlusion (CRVO is an uncommon retinal vascular disease which causes sudden visual acuity loss and is associated with poor prognosis and the development of severe complications. We report a very rare case of combined CRAO and CRVO in a patient with factor V Leiden (FVL mutation (only 3 cases published. To our knowledge, this is the first case of combined CRAO and CRVO treated with hyperbaric oxygen therapy (HBOT. Case and Results: A 49-year-old woman presented with complaints of sudden loss of vision in her left eye (LE, with best corrected visual acuity (BCVA of 1/20. A complete ophthalmic evaluation with fundus angiography showed combined CRAO and CRVO. The patient was urgently treated with HBOT (she completed a total of 9 sessions in 7 days, with marked visual acuity and angiographic improvement (BCVA of 10/10. Forty-five days later, she developed a new LE CRVO, and BCVA decreased to 5/10 and later to Conclusions: Combined CRAO and CRVO in young adults should be investigated thoroughly for embolic sources, thrombophilic disorders and local ocular conditions. This is the first case of this severe disease that was treated with HBOT, and the visual result was very good.

  10. Dynamic computed tomography findings in cerebrovascular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Yutaka; Tomoda, Kaname; Kariya, Mitsumasa; Mori, Shigeru; Mitomo, Masanori.

    1988-01-01

    Dynamic CT was performed with 41 patients with the clinically diagnosed cerebrovascular diseases. A visual evaluation based on the dynamic CT images classified six patterns of brain parenchymal enhancement, especially four patterns of which could only be detected by dynamic CT technique. Dynamic CT was proved of great value in detecting regional cerebral tissue filled by collaterals in retrograde fashion because of the occlusion of main arteries, namely brain tissue perfusion of internal carotid occlusion disease and moyamoya disease was best understood by dynamic CT with adequate resolution.

  11. Treatment of open occlusions with onlay and overlay removable partial dentures.

    Science.gov (United States)

    Farmer, J B; Connelly, M E

    1984-03-01

    The onlay removable partial denture has the primary purposes of restoration of esthetics and function through a conservative modification of the existing dentition. It is particularly applicable to open occlusion situations and in improving an uneven mandibular occlusal plane. Its use should be supplemented with specific instructions in proper cleansing and maintenance of underlying dentition and the prosthesis and with scheduled recall appointments.

  12. Occlusal characteristics during different emergence stages of the permanent dentition in Tanzanian Bantu and finnish children.

    NARCIS (Netherlands)

    Mugonzibwa, E.A.; Eskeli, R.; Kuijpers-Jagtman, A.M.; Laine-Alava, M.T.; Hof, M.A. van 't

    2004-01-01

    Occlusal characteristics and anomalies were studied among 869 (428 boys, 441 girls) Tanzanian Bantu children aged 3.5-16 years and 706 (319 boys, 387 girls) Finnish children aged 5-11 years during different emergence stages of the permanent dentition. Various occlusal variables were registered accor

  13. Successful catheter directed thrombolysis of IVC and renal vein occlusive thrombus.

    LENUS (Irish Health Repository)

    McCarthy, E

    2011-11-01

    Thrombus formation is a recognised complication of IVC filter placement, however IVC and bilateral renal vein occlusion secondary to thrombus is much less common. We present a case of infrahepatic caval and bilateral renal vein occlusion secondary to thrombosis of a suprarenal IVC filter. With progressive clinical deterioration and failure of conservative medical management the patient underwent successful mechanical disruption and catheter directed thrombolysis.

  14. Active cancellation of occlusion: an electronic vent for hearing aids and hearing protectors.

    Science.gov (United States)

    Mejia, Jorge; Dillon, Harvey; Fisher, Michael

    2008-07-01

    The occlusion effect is commonly described as an unnatural and mostly annoying quality of the voice of a person wearing hearing aids or hearing protectors. As a result, it is often reported by hearing aid users as a deterrent to wearing hearing aids. This paper presents an investigation into active occlusion cancellation. Measured transducer responses combined with models of an active feedback scheme are first examined in order to predict the effectiveness of occlusion reduction. The simulations predict 18 dB of occlusion reduction in completely blocked ear canals. Simulations incorporating a 1 mm vent (providing passive occlusion reduction) predict a combined active and passive occlusion reduction of 20 dB. A prototype occlusion canceling system was constructed. Averaged across 12 listeners with normal hearing, it provided 15 dB of occlusion reduction. Ten of the subjects reported a more natural own voice quality and an appreciable increase in comfort with the cancellation active, and 11 out of the 12 preferred the active system over the passive system. PMID:18646971

  15. Isolated cilioretinal artery occlusion as an initial manifestation of polycythemia vera

    Directory of Open Access Journals (Sweden)

    Elasri Fouad

    2010-01-01

    Full Text Available Isolated cilioretinal artery occlusion is a rarely reported initial manifestation of polycythemia vera. In this study, we reported a case of a 65-year-old man with polycythemia vera with cilioretinal artery occlusion as an initial manifestation.

  16. Femoro-popliteal artery occlusions treated by percutaneous transluminal angioplasty and enclosed thrombolysis

    DEFF Research Database (Denmark)

    Tønnesen, K H; Holstein, P; Andersen, E

    1991-01-01

    Removal of fibrin from the site of a newly dilated femoro-popliteal occlusion may be an attractive way of preventing rethrombosis. A double balloon catheter with a dilating tip balloon and an occlusive balloon 10, 15 or 20 cm approximately were introduced percutaneously. Following successful dila...

  17. A part-based probabilistic model for object detection with occlusion.

    Directory of Open Access Journals (Sweden)

    Chunhui Zhang

    Full Text Available The part-based method has been a fast rising framework for object detection. It is attracting more and more attention for its detection precision and partial robustness to the occlusion. However, little research has been focused on the problem of occlusion overlapping of the part regions, which can reduce the performance of the system. This paper proposes a part-based probabilistic model and the corresponding inference algorithm for the problem of the part occlusion. The model is based on the Bayesian theory integrally and aims to be robust to the large occlusion. In the stage of the model construction, all of the parts constitute the vertex set of a fully connected graph, and a binary variable is assigned to each part to indicate its occlusion status. In addition, we introduce a penalty term to regularize the argument space of the objective function. Thus, the part detection is formulated as an optimization problem, which is divided into two alternative procedures: the outer inference and the inner inference. A stochastic tentative method is employed in the outer inference to determine the occlusion status for each part. In the inner inference, the gradient descent algorithm is employed to find the optimal positions of the parts, in term of the current occlusion status. Experiments were carried out on the Caltech database. The results demonstrated that the proposed method achieves a strong robustness to the occlusion.

  18. Occlusion invariant face recognition using mean based weight matrix and support vector machine

    Indian Academy of Sciences (India)

    G Nirmala Priya; R S D Wahida Banu

    2014-04-01

    In this paper, a novel occlusion invariant face recognition algorithm based on Mean based weight matrix (MBWM) technique is proposed. The proposed algorithm is composed of two phases—the occlusion detection phase and the MBWM based face recognition phase. A feature based approach is used to effectively detect partial occlusions for a given input face image. The input face image is first divided into a finite number of disjointed local patches, and features are extracted for each patch, and the occlusion present is detected. 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 rule is applied for the matching. GTAV face database that includes many occluded face images by sunglasses and hand are used for the experiment. The experimental results demonstrate that the proposed local patchbased occlusion detection technique works well and theMBWM based method shows superior performance to other conventional approaches.

  19. Mesenteric vascular occlusion: Comparison of ancillary CT findings between arterial and venous occlusions and independent CT findings suggesting life-threatening events

    International Nuclear Information System (INIS)

    To compare the ancillary CT findings between superior mesenteric artery thromboembolism (SMAT) and superior mesenteric vein thrombosis (SMVT), and to determine the independent CT findings of life-threatening mesenteric occlusion. Our study was approved by the institution review board. We included 43 patients (21 SMAT and 22 SMVT between 1999 and 2008) of their median age of 60.0 years, and retrospectively analyzed their CT scans. Medical records were reviewed for demographics, management, surgical pathology diagnosis, and outcome. We compared CT findings between SMAT and SMVT groups. Multivariate analysis was conducted to determine the independent CT findings of life-threatening mesenteric occlusion. Of 43 patients, 24 had life-threatening mesenteric occlusion. Death related to mesenteric occlusion was 32.6%. A thick bowel wall (p < 0.001), mesenteric edema (p < 0.001), and ascites (p = 0.009) were more frequently associated with SMVT, whereas diminished bowel enhancement (p = 0.003) and paralytic ileus (p = 0.039) were more frequent in SMAT. Diminished bowel enhancement (OR = 20; p = 0.007) and paralytic ileus (OR = 16; p = 0.033) were independent findings suggesting life-threatening mesenteric occlusion. The ancillary CT findings occur with different frequencies in SMAT and SMVT. However, the independent findings indicating life-threatening mesenteric occlusion are diminished bowel wall enhancement and paralytic ileus.

  20. MULTI-TARGET VISUAL TRACKING AND OCCLUSION DETECTION BY COMBINING BHATTACHARYYA COEFFICIENT AND KALMAN FILTER INNOVATION

    Institute of Scientific and Technical Information of China (English)

    Chen Ken; Chul Gyu Jhun

    2013-01-01

    This paper introduces an approach for visual tracking of multi-target with occlusion occurrence.Based on the author's previous work in which the Overlap Coefficient (OC) is used to detect the occlusion,in this paper a method of combining Bhattacharyya Coefficient (BC) and Kalman filter innovation term is proposed as the criteria for jointly detecting the occlusion occurrence.Fragmentation of target is introduced in order to closely monitor the occlusion development.In the course of occlusion,the Kalman predictor is applied to determine the location of the occluded target,and the criterion for checking the re-appearance of the occluded target is also presented.The proposed approach is put to test on a standard video sequence,suggesting the satisfactory performance in multi-target tracking.

  1. Local anesthesia and minilaparotomy: a safe procedure for tubal occlusion in women with severe health problems.

    Science.gov (United States)

    Díaz-Sánchez, V; Bonilla, C; Reyes, A; Valero, A; Domenzáin, M; Pérez-Palacios, G

    1987-08-01

    From 1982 to 1986, 79 women with severe health problems underwent tubal occlusion by minilaparotomy using local anesthesia and intravenous sedation as a permanent method of fertility regulation. All the patients reported herein were classified as "high risk" population for a surgical procedure due to the following medical reasons: cardiovascular (30.2%); diabetes mellitus (25.3%); thyroid disease (18.9%); adrenal dysfunction (11.3%); kidney transplantation (6.3%); severe hypertension (3.7%); and pulmonary problems (3.7%). The procedure morbidity was 3.7% and the mortality 0%. The follow-up rate at 1 year was 86% and no pregnancies or complications of the primary disease due to the surgical procedure have been reported. It was concluded that tubal ligation by minilaparotomy performed by well-trained staff and with back-up hospital services on an out-patient basis is a safe and effective method of family planning in patients considered as a "high risk" population. Post-doctoral research fellows in Reproductive Biology. PMID:3427966

  2. Increasing occlusal vertical dimension--why, when and how.

    Science.gov (United States)

    Bloom, D R; Padayachy, J N

    2006-03-11

    Cosmetic dentistry has evolved with the advent of more robust porcelain materials and ever-stronger bonding agents. This series of three articles aims to provide a practical overview of what is now possible both functionally and cosmetically from the preparation of a small number of teeth, through a whole smile, to full mouth rehabilitation. A complete diagnosis is the starting point to planning any cosmetic or functional changes. Guidance is given on the techniques used but adequate training must be considered essential before embarking upon modification in occlusal schemes or even minor adjustments in smile design. Understanding vertical dimension and how and when it can be changed has always been a challenging prospect for the general dental practitioner. This article aims to discuss the rationale behind changes in vertical dimension and demonstrate how it can be achieved in general practice assuming adequate hands-on postgraduate training has been completed.

  3. Macular edema in branch retinal vein occlusion: types and treatment.

    Science.gov (United States)

    Jalkh, A E; Trempe, C L

    1989-01-01

    In this study of branch retinal vein occlusion, we distinguished between cystoid macular edema caused by increased capillary pressure and noncystoid edema due to hard exudates in the macula caused by chronic leakage from vascular abnormalities in the posterior pole or midperiphery. We performed laser photocoagulation in 51 eyes with cystoid macular edema to achieve focal narrowing of the retinal arterioles perfusing the macular area affected by the cystoid edema; good anatomic and functional results were achieved in 40 of these eyes (78%). In 25 of the five eyes, the treated segment of the retinal arteriole was outside the area of macular edema; results were successful in 19 of these eyes (76%). In 14 eyes with noncystoid exudative macular edema, we performed laser photocoagulation to the vascular abnormalities; good anatomic and functional results were obtained in 12 of these (86%). PMID:2927879

  4. Combined branch retinal vein and artery occlusion in toxoplasmosis.

    Science.gov (United States)

    Aggio, Fabio Bom; Novelli, Fernando José de; Rosa, Evandro Luis; Nobrega, Mário Junqueira

    2016-01-01

    A 22-year-old man complained of low visual acuity and pain in his left eye for five days. His ophthalmological examination revealed 2+ anterior chamber reaction and a white, poorly defined retinal lesion at the proximal portion of the inferotemporal vascular arcade. There were retinal hemorrhages in the inferotemporal region extending to the retinal periphery. In addition, venous dilation, increased tortuosity, and ischemic retinal whitening along the inferotemporal vascular arcade were also observed. A proper systemic work-up was performed, and the patient was diagnosed with ocular toxoplasmosis. He was treated with an anti-toxoplasma medication, and his condition slowly improved. Inferior macular inner and middle retinal atrophy could be observed on optical coherence tomography as a sequela of ischemic injury. To our knowledge, this is the first report of combined retinal branch vein and artery occlusion in toxoplasmosis resulting in a striking and unusual macular appearance. PMID:27463632

  5. Pedestrian Counting with Occlusion Handling Using Stereo Thermal Cameras

    Directory of Open Access Journals (Sweden)

    Miklas S. Kristoffersen

    2016-01-01

    Full Text Available The number of pedestrians walking the streets or gathered in public spaces is a valuable piece of information for shop owners, city governments, event organizers and many others. However, automatic counting that takes place day and night is challenging due to changing lighting conditions and the complexity of scenes with many people occluding one another. To address these challenges, this paper introduces the use of a stereo thermal camera setup for pedestrian counting. We investigate the reconstruction of 3D points in a pedestrian street with two thermal cameras and propose an algorithm for pedestrian counting based on clustering and tracking of the 3D point clouds. The method is tested on two five-minute video sequences captured at a public event with a moderate density of pedestrians and heavy occlusions. The counting performance is compared to the manually annotated ground truth and shows success rates of 95.4% and 99.1% for the two sequences.

  6. Pedestrian Counting with Occlusion Handling Using Stereo Thermal Cameras.

    Science.gov (United States)

    Kristoffersen, Miklas S; Dueholm, Jacob V; Gade, Rikke; Moeslund, Thomas B

    2016-01-01

    The number of pedestrians walking the streets or gathered in public spaces is a valuable piece of information for shop owners, city governments, event organizers and many others. However, automatic counting that takes place day and night is challenging due to changing lighting conditions and the complexity of scenes with many people occluding one another. To address these challenges, this paper introduces the use of a stereo thermal camera setup for pedestrian counting. We investigate the reconstruction of 3D points in a pedestrian street with two thermal cameras and propose an algorithm for pedestrian counting based on clustering and tracking of the 3D point clouds. The method is tested on two five-minute video sequences captured at a public event with a moderate density of pedestrians and heavy occlusions. The counting performance is compared to the manually annotated ground truth and shows success rates of 95.4% and 99.1% for the two sequences. PMID:26742047

  7. Economic aspects of the detection of occlusal dentine caries

    DEFF Research Database (Denmark)

    Norlund, Anders; Axelsson, Susanna; Dahlen, Gunnar;

    2009-01-01

    clinically. A second aim was to analyse the different strategies when the costs of the subsequent restorative care are considered. METHODS: A model analysis was applied owing to the lack of original articles. Sensitivity and specificity were calculated from a systematic review and included in vitro......OBJECTIVE: To evaluate the cost of true-positive occlusal dentine caries detection in permanent molars assessed by: (I) visual-tactile examination, (II) visual-tactile examination combined with bitewing radiographs, and (III) selective radiographic examination of patients with lesions detected...... with decreasing prevalence. The strategy by which radiographs were exposed selectively on the basis of findings from visual-tactile examination resulted in higher initial costs compared with the first and second strategies. When the costs of the subsequent restorative care were added, the selective strategy...

  8. Forms can be recognized from dynamic occlusion alone.

    Science.gov (United States)

    Stappers, P J

    1989-02-01

    Direct and indirect theories of perception differ on whether form perception depends on higher order invariants or on features in the retinal image. The present paper describes a demonstration that an object can be recognized through a higher order pattern (dynamic occlusion) without any of the object's features being displayed. Stimuli consist of computer stimulations of black wireframe objects moving in front of, and occluding, a random layout of point lights on a black background. In this way, no single videoframe of the stimuli displays any of the object's features, and motion of the amodal object in front of the light points is necessary for the form to become visible. The forms can also be recognized when isoluminous colours are used for background and point lights. Finally, it is noted that, if the observer can actively control the motion of the object, e.g., by moving a computer mouse, recognition is enhanced as in Gibson's (1962) experiment on active touch.

  9. Effect of prosthodontic planning on lateral occlusion scheme: a comparison between conventional and digital planning

    Directory of Open Access Journals (Sweden)

    Jaafar ABDUO

    2015-04-01

    Full Text Available Recently, digital wax-up is proposed as a tool to aid prosthodontic planning. However, there are no data about the effect of prosthodontic planning on lateral occlusion scheme. Objective : This study aims to evaluate the impact of conventional and digital prosthodontic planning on lateral occlusion scheme. Material and Methods : Dental models of 10 patients were collected. All models had Angle Class I occlusion and were undergoing prosthodontic treatment that would influence the lateral occlusion scheme. Each set of models had received both conventional wax-up and digital wax-up. In relation to the lateral occlusion scheme, the following variables were evaluated: the prevalence of the different lateral occlusion scheme, number of contacting teeth and percentage of each contacting tooth. Four excursive positions on the working side were included: 0.5, 1.0, 2.0 and 3.0 mm from the maximal intercuspation position. Results : The lateral occlusion scheme of the two wax-up models was subjected to alterations following excursion. There was a tendency for the prevalence of canine-guided occlusion to increase and for the prevalence of group function occlusion to decrease with increasing excursion. The number of contacting teeth was decreasing with the increasing magnitude of excursion. For the 0.5 mm and 1.0 mm positions, the two wax-ups had significantly greater contacts than the pre-treatment models, while at the 2.0 mm and 3.0 mm positions, all the models were similar. For all models, canines were the most commonly contacting teeth, followed by the teeth adjacent to them. No difference was observed between the two wax-ups in relation to the number of contacting teeth. Conclusion : Although the prosthodontic planning had influenced the pattern of the lateral occlusion scheme and contacts, there was no difference between the conventional and digital prosthodontic planning.

  10. Initial clinical experience of CrossBoss catheter for in-stent chronic total occlusion lesions

    Science.gov (United States)

    Zhao, Lei; Li, Long-Bo; Wang, Zhi-Hui; Shi, Yong-Feng; Wu, Jun-Duo; Zhang, Ji-Chang; Liu, Bin

    2016-01-01

    Abstract Background: The CrossBoss coronary chronic total occlusion (CTO) crossing catheter has been demonstrated to have greatly improved the success rate of crossing CTO lesions, but there are no published data on its application for in-stent CTO lesions. Methods: In the current study, we retrospectively reviewed the clinical data of 8 patients with in-stent CTO lesions that were managed with the CrossBoss catheter and herein we report the efficacy and safety of the CrossBoss crossing and re-entry system for this clinically challenging condition. Results: The CrossBoss catheter was used for 8 patients with in-stent CTO lesions, which resulted in success in 6 cases and failure in 2 cases, with a 75% success rate. Of the 6 patients with successful treatment, 5 cases had the occlusive lesions crossed with the CrossBoss catheter through a proximal lumen-to-distal lumen approach, whereas the remaining case had his occlusive lesions penetrated by the CrossBoss catheter and the guidewire. Two cases failed in treatment as the CrossBoss catheter could not cross the occlusive lesions. The 6 cases with successful treatment included 3 cases with occlusive lesions in the left anterior descending artery, 1 case with occlusive lesions in the obtuse marginal branches, and 2 cases with occlusive lesions in the right coronary artery, and the 2 cases with failure in treatment had their occlusive lesions in the right coronary artery. In addition, patients with a higher Japan chronic total occlusion score were found to have a lower success rate of crossing the occlusive lesions. None of the patients developed complications. Conclusion: Our study demonstrates that the CrossBoss catheter has a high success rate and is safe for in-stent CTOs and can be recommended for this rather clinically challenging condition. PMID:27749568

  11. Collateral circulation in ferrets (Mustela putorius) during temporary occlusion of the caudal vena cava.

    Science.gov (United States)

    Calicchio, Kristina W; Bennett, R Avery; Laraio, Leonard C; Weisse, Chick; Zwingenberger, Allison L; Rosenthal, Karen L; Johnston, Matthew S; Campbell, Vicki L; Solomon, Jeffrey A

    2016-05-01

    OBJECTIVE To determine whether extent of collateral circulation would change during temporary occlusion of the caudal vena cava (CVC) in ferrets (Mustela putorius), a pressure change would occur caudal to the occlusion, and differences would exist between the sexes with respect to those changes. ANIMALS 8 adult ferrets (4 castrated males and 4 spayed females). PROCEDURES Ferrets were anesthetized. A balloon occlusion catheter was introduced through a jugular vein, passed into the CVC by use of fluoroscopy, positioned cranial to the right renal vein, and inflated for 20 minutes. Venography was performed 5 and 15 minutes after occlusion. Pressure in the CVC caudal to the occlusion was measured continuously. A CBC, plasma biochemical analysis, and urinalysis were performed immediately after the procedure and 2 or 3 days later. RESULTS All 8 ferrets survived the procedure; no differences were apparent between the sexes. Vessels providing collateral circulation were identified in all ferrets, indicating blood flow to the paravertebral venous plexus. Complications observed prior to occlusion included atrial and ventricular premature contractions. Complications after occlusion included bradycardia, seizures, and extravasation of contrast medium. Mean baseline CVC pressure was 5.4 cm H2O. During occlusion, 6 ferrets had a moderate increase in CVC pressure (mean, 24.3 cm H2O) and 2 ferrets had a marked increase in CVC pressure to > 55.0 cm H2O. CONCLUSIONS AND CLINICAL RELEVANCE Caval occlusion for 20 minutes was performed in healthy ferrets with minimal adverse effects noted within the follow-up period and no apparent differences between sexes. The CVC pressure during occlusion may be prognostic in ferrets undergoing surgical ligation of the CVC, which commonly occurs during adrenal tumor resection. PMID:27111022

  12. [The Bayesian framework of detection of cariesgenic Streptoccocus in dental plaque in children with distal occlusion under orthodontic treatment].

    Science.gov (United States)

    Chesnokov, V A; Chesnokova, M G; Mironov, A Iu; Turchaninov, D V; Kriga, A S

    2013-08-01

    The application of Bayes theorem in medical diagnostic includes such important step as derivation for every symptom and diagnosis data values of finite or a posteriori probability of presence of germ, for instance S. sanguis, in patients receiving orthodontic treatment. This value expresses importance of the given symptoms for detection of germ presence. In the implemented studies the Bayes theorem was applied to evaluate probability of presence of particular germ in particular concentration (degree of semination, CO) under concrete symptom group. The rates were used to calculate probability of presence of cariesgenic streptococcus S. mutans and S. sanguis in prospect patient. The rates were calculated for the group with fixed orthodontic apparatuses. The high degree of risk of development of caries in children under orthodontic treatment is conditioned by a whole complex of existing unfavorable factors present in oral cavity. Hence, a powerful negative potential to develop expressed cariesgenic situation in oral cavity is present. The analysis of medical data of patients with distal occlusion was applied using Bayes theorem from the point of view their diagnostic value. The study established 36 symptoms, factors, risk factors and background diseases common in case of distal occlusion in children. The probability to detect the mentioned characteristics and likelihood ratio under different degree of concentration of cariesgenic Streptococcus mutans and Streptococcus sanguis in dental plaque of children was considered. The establishment of character of likelihood ratio for different qualitative content of streptococcus in case of isolation from biotope of dental plaque permitted to determine the informative characteristics. The Bayesian model can be applied in clinics as a computer program to process incoming information about patients with distal occlusion under active orthodontic treatment. The developed diagnostic algorithm in a fast and simple mode of clinical

  13. René leriche and the development of 20th century surgery

    OpenAIRE

    IONCIOAIA, BOGDAN; BUD, IOAN TEODOR; MURESAN, MIRCEA

    2016-01-01

    René Leriche (1879–1955) was a 20th century French surgeon generally known in medicine for the syndrome that carries his name, namely the Leriche syndrome in the aorto-iliac occlusive disease. This paper is published to mark the commemoration of 60 year since Leriche’s death. Although Dr. Leriche’s legacy resides in the domain of vascular medicine, his research enclosed bone pathology and surgical management of pain. Having his surgical training done under professors Mathieu Jaboulay and Anto...

  14. Vascular endothelial growth factor and hypoxia-inducible factor-1α gene polymorphisms and coronary collateral formation in patients with coronary chronic total occlusions

    Science.gov (United States)

    Amoah, Vincent; Wrigley, Benjamin; Holroyd, Eric; Smallwood, Andrew; Armesilla, Angel L; Nevill, Alan; Cotton, James

    2016-01-01

    Introduction: We evaluated the association between two single nucleotide polymorphisms of the vascular endothelial growth factor gene and one of the hypoxia-inducible factor-1α gene and the degree of coronary collateral formation in patients with a coronary chronic total occlusion. Methods: Totally, 98 patients with symptomatic coronary artery disease and a chronic total occlusion observed during coronary angiography were recruited. Genotyping of two vascular endothelial growth factor promoter single nucleotide polymorphisms (−152G>A and −165C>T) and the C1772T single nucleotide polymorphism of hypoxia-inducible factor-1α were performed using polymerase chain reaction and restriction fragment length polymorphism analysis. The presence and extent of collateral vessel filling was scored by blinded observers using the Rentrop grade. Results: We found no association between the vascular endothelial growth factor −152G>A, −165C>T and hypoxia-inducible factor-1α −1772C>T with the presence and filling of coronary collateral vessels. A history of percutaneous coronary intervention and transient ischaemic attack/cerebrovascular accident were associated with the presence of enhanced collateral vessel formation following binary logistic regression analysis. Conclusion: The study findings suggest that coronary collateral formation is not associated with the tested polymorphic variants of vascular endothelial growth factor and hypoxia-inducible factor-1α in patients with symptomatic coronary artery disease and the presence of a chronic total occlusion.

  15. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    International Nuclear Information System (INIS)

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy

  16. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Murdoch, Dale, E-mail: dale_murdoch@health.qld.gov.au [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia); McAulay, Laura [The Prince Charles Hospital, Brisbane (Australia); Walters, Darren L. [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia)

    2014-11-15

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy.

  17. Evaluate of the Equivalence and Safety of Two Dosage Form of Alprostadil Injection in Patients with Diabetic Lower Extremity Arterial Occlusive Dis-ease by a Clinical Multi-Centre Trial%两种前列地尔注射液治疗糖尿病下肢动脉闭塞症的等效性和安全性比较研究

    Institute of Scientific and Technical Information of China (English)

    张星光; 虞冠锋; 冉兴无; 刘福平; 吕肖锋; 朱旅云; 刘俊江; 吕伯南; 刘超; 刘长建; 王立明

    2015-01-01

    目的:观察2种前列地尔注射液在治疗糖尿病下肢动脉闭塞症(糖尿病足)的等效性和安全性。方法:采用随机双盲、阳性药平行对照、多中心临床研究。试验组使用前列地尔脂微球注射液,对照组使用前列地尔注射液。疗程均为14 d。结果:随机入组235例受试者。对照组入选117人,试验组118人。主要疗效指标中踝肱比值,全分析数据集(full analysis set,FAS)人群组内比较:两组治疗14 d后踝肱比值均较基线时有所提高,且有统计学意义。组间比较:治疗14 d后对照组提高0.09;试验组提高0.10,两组间无统计学意义,符合方案数据集(per-protocol set, PPS)人群结果趋势和FAS一致。两组治疗14 d后静息痛均较基线时有所下降,且有统计学意义,组间比较无统计学差异,PPS人群结果趋势和FAS一致。最大无痛行走距离在两组间无统计学意义,PPS 结果和FAS一致。全部不良事件发生率对照组为19.33%;试验组为17.65%。相关不良事件对照组10.08%;试验组为8.4%;差别无统计学意义。结论:2种前列地尔注射液在治疗慢性下肢动脉闭塞性疾病的过程中,表现出相同的疗效和安全性。%Objective: To compare the equivalence and safety between reference preparation and test preparation of alprostadil injection in patients with chronic lower extremity arterial occlusive disease (LEAOD). Methods: It was a random, blind, multicentre and controlled clinical pharmaceutical trial. All subjects were divided into two groups and each of group. The test and reference preparations of alprostadil injections by different companies were given via the same administration route. Results: Eight hospitals in China and 235 volunteers were involved in the study, and 117 patients received the reference preparation and 118 received the test preparation. The ankle brachial index of both groups increased significantly

  18. Cervical occlusion in women with cervical insufficiency: protocol for a randomised, controlled trial with cerclage, with and without cervical occlusion

    DEFF Research Database (Denmark)

    Secher, Niels Jørgen; MaCormack, CD; Weber, Tom;

    2007-01-01

    Kingdom, Spain, South Africa, Australia and India. This gives both a broad spectrum of diversity global and local. We expect a total of 242 women enrolled per year. POPULATION: Prophylactic study: 1. History of cervical incompetence/insufficiency. (Delivery 15 to cervix...... (secondary to maternal administration of diethyl stilbestrol) or traumatic/surgical damage rendering the vaginal approach difficult (e.g. conisation). 3. Cervical suture applied in previous pregnancy, successful outcome. 4. Previous failed cerclage. Therapeutic study: 5. Secondary cerclage: Short cervix......, without the membranes being exposed to the vagina. 6. Tertiary cerclage: Short cervix, membranes exposed to the vagina. Observational study: Eligible women who refuse to be randomised will participate in an observational study. 7. Repeat/requested cervical occlusion. METHODS: The women will be randomised...

  19. Thromboangiitis obliterans (Buerger disease

    Directory of Open Access Journals (Sweden)

    Jessica Seebald, BS

    2015-10-01

    Full Text Available Thromboangiitis obliterans (Buerger disease is an occlusive, nonatherosclerotic, inflammatory vasculitis that causes ischemia in small and medium vessels. Most commonly, Buerger disease is diagnosed in 40- to 45-year-old men with a heavy smoking history. Our case exemplifies the most common presentation, diagnosis, and treatment in a 53-year-old male smoker who presents with arm pain and dusky cool fingers. A Buerger diagnosis requires exclusion of autoimmune, diabetic, and embolic causes. The only recognized treatment for this disease is smoking cessation.

  20. [Upper extremity arterial diseases].

    Science.gov (United States)

    Becker, F

    2007-02-01

    Compared to lower limb arterial diseases, upper limb arterial diseases look rare, heterogeneous with various etiologies and a rather vague clinical picture, but with a negligible risk of amputation. Almost all types of arterial diseases can be present in the upper limb, but the anatomical and hemodynamic conditions particular to the upper limb often confuse the issue. Thus, atherosclerosis affects mainly the subclavian artery in its proximal segment where the potential of collateral pathway is high making the symptomatic forms not very frequent whereas the prevalence of subclavian artery stenosis or occlusion is relatively high. The clinical examination and the etiologies are discussed according to the clinical, anatomical and hemodynamic context.

  1. Haemodynamic changes in the liver under balloon occlusion of a portal vein branch-evaluation with single-level dynamic computed tomography during hepatic arteriography

    Energy Technology Data Exchange (ETDEWEB)

    Komada, Y. [Department of Radiology/Center for Advanced Medical Technology, Sendagi, Bunkyo-ku, Tokyo (Japan)]. E-mail: brian-komada@msj.biglobe.ne.jp; Murata, S. [Department of Radiology/Center for Advanced Medical Technology, Sendagi, Bunkyo-ku, Tokyo (Japan); Tajima, H. [Department of Radiology/Center for Advanced Medical Technology, Sendagi, Bunkyo-ku, Tokyo (Japan); Kumita, S. [Department of Radiology/Center for Advanced Medical Technology, Sendagi, Bunkyo-ku, Tokyo (Japan); Kanazawa, H. [3rd Department of Internal Medicine, Sendagi, Bunkyo-ku, Tokyo (Japan); Tajiri, T. [1st Department of Surgery, Nippon Medical School, Sendagi, Bunkyo-ku, Tokyo (Japan)

    2007-06-15

    Aim: To assess haemodynamic changes in the liver under temporary occlusion of an intrahepatic portal vein. Materials and methods: Between February 2000 and October 2004, 16 patients with hepatobiliary disease underwent single-level dynamic computed tomography during hepatic arteriography (SLD-CTHA) under temporary balloon occlusion of an intrahepatic portal vein. All patients needed percutaneous transhepatic portography for therapy of their disease. SLD-CTHA was undertaken to clarify the time-attenuation curve influenced by portal vein occlusion, and it was performed continuously over a period of 30 s. The difference in absolute attenuation of the liver parenchyma in segments with occluded and non-occluded portal vein branches was determined by means of the CT number, and the difference in absolute attenuation of the occluded and non-occluded portal veins themselves was also evaluated. Results: SLD-CTHA demonstrated a demarcated hyperattenuation area in the corresponding distribution of the occluded portal vein branch. The attenuation of the liver parenchyma supplied by the occluded portal vein was significantly higher than that in the non-occluded area (p < 0.01). The balloon-occluded portal branch enhancement in 15 of 16 cases (94%) appears due to arterio-portal communications. Failure to evaluate a remaining case for portal branch enhancement was due to absence of a visualized portal branch in the section. Conclusion: Under temporary occlusion of an intrahepatic portal vein, hepatic angiography produced enhancement of the occluded portal branches and their corresponding parenchymal distribution; this finding is considered consistent with the presence of arterio-portal communications.

  2. The diagnosis and treatment of non-occlusive gut ischaemia. Aktueller Stand der Diagnostik und Therapie der nicht-okklusiven Darmischaemie (NOD)

    Energy Technology Data Exchange (ETDEWEB)

    Schindler, G.; Bruch, H.P. (Wuerzburg Univ. (Germany). Abt. fuer Roentgendiagnostik Wuerzburg Univ. (Germany). Chirurgische Universitaetsklinik)

    1991-08-01

    Non-occlusive gut ischaemia is a disease of advanced age. Its causes are reduced cardiac output or shock, facilitated by digitalis, adrenaline, ergotamine and diuretics. The persisting microcirculation and development of gut necrois leads to an increase in certain serum enzymes, such as lactate, LDH and CK-NB. The early application of mesenteric angiography using a DSA technique reveals four grades of under-perfusion. Early and correct diagnosis of the disease should lead to intra-arterial treatment with prostaglandin. In 10 out of 42 cases, conservative therapy led to re-perfusion of the gut. (orig.).

  3. Occlusal enamel complexity in middle miocene to holocene equids (Equidae: Perissodactyla of North America.

    Directory of Open Access Journals (Sweden)

    Nicholas A Famoso

    Full Text Available Four groups of equids, "Anchitheriinae," Merychippine-grade Equinae, Hipparionini, and Equini, coexisted in the middle Miocene, but only the Equini remains after 16 Myr of evolution and extinction. Each group is distinct in its occlusal enamel pattern. These patterns have been compared qualitatively but rarely quantitatively. The processes influencing the evolution of these occlusal patterns have not been thoroughly investigated with respect to phylogeny, tooth position, and climate through geologic time. We investigated Occlusal Enamel Index, a quantitative method for the analysis of the complexity of occlusal patterns. We used analyses of variance and an analysis of co-variance to test whether equid teeth increase resistive cutting area for food processing during mastication, as expressed in occlusal enamel complexity, in response to increased abrasion in their diet. Results suggest that occlusal enamel complexity was influenced by climate, phylogeny, and tooth position through time. Occlusal enamel complexity in middle Miocene to Modern horses increased as the animals experienced increased tooth abrasion and a cooling climate.

  4. A Fast Ambient Occlusion Method for Real-Time Plant Rendering

    Institute of Scientific and Technical Information of China (English)

    Jun Teng; Marc Jaeger; Bao-Gang HU

    2007-01-01

    Global illumination effects are crucial for virtual plant rendering. Whereas real-time global illumination rendering of plants is impractical, ambient occlusion is an efficient alternative approximation. A tree model with millions of triangles is common, and the triangles can be considered as randomly distributed. The existing ambient occlusion methods fail to apply on such a type of object. In this paper, we present a new ambient occlusion method dedicated to real time plant rendering with limited user interaction. This method is a three-step ambient occlusion calculation framework which is suitable for a huge number of geometry objects distributed randomly in space. The complexity of the proposed algorithm is O(n), compared to the conventional methods with complexities of O(n2). Furthermore, parameters in this method can be easily adjusted to achieve flexible ambient occlusion effects. With this ambient occlusion calculation method, we can manipulate plant models with millions of organs, as well as geometry objects with large number of randomly distributed components with affordable time, and with perceptual quality comparable to the previous ambient occlusion methods.

  5. Comparison of NIRS, laser Doppler flowmetry, photoplethysmography, and pulse oximetry during vascular occlusion challenges.

    Science.gov (United States)

    Abay, T Y; Kyriacou, P A

    2016-04-01

    Monitoring changes in blood volume, blood flow, and oxygenation in tissues is of vital importance in fields such as reconstructive surgery and trauma medicine. Near infrared spectroscopy (NIRS), laser Doppler (LDF) flowmetry, photoplethysmography (PPG), and pulse oximetry (PO) contribute to such fields due to their safe and noninvasive nature. However, the techniques have been rarely investigated simultaneously or altogether. The aim of this study was to investigate all the techniques simultaneously on healthy subjects during vascular occlusion challenges. Sensors were attached on the forearm (NIRS and LDF) and fingers (PPG and PO) of 19 healthy volunteers. Different degrees of vascular occlusion were induced by inflating a pressure cuff on the upper arm. The responses of tissue oxygenation index (NIRS), tissue haemoglobin index (NIRS), flux (LDF), perfusion index (PPG), and arterial oxygen saturation (PO) have been recorded and analyzed. Moreover, the optical densities were calculated from slow varying dc PPG, in order to distinguish changes in venous blood volumes. The indexes showed significant changes (p  <  0.05) in almost all occlusions, either venous or over-systolic occlusions. However, differentiation between venous and arterial occlusion by LDF may be challenging and the perfusion index (PI) may not be adequate to indicate venous occlusions. Optical densities may be an additional tool to detect venous occlusions by PPG.

  6. Laparoscopic liver resection under hemihepatic vascular inflow occlusion using the lowering of hilar plate approach

    Institute of Scientific and Technical Information of China (English)

    Ying-Jun Chen; Zuo-Jun Zhen; Huan-Wei Chen; Eric CH Lai; Fei-Wen Deng; Qing-Han Li; Wan Yee Lau

    2014-01-01

    BACKGROUND: With advances in technology, laparoscopic liver resection is widely accepted. Laparoscopic liver resection under hemihepatic vascular inflow occlusion has advantages over the conventional total hepatic inflow occlusion using the Pringle's maneuver, especially in patients with cirrhosis. METHOD: From November 2011 to August 2012, eight consecutive patients underwent laparoscopic liver resection under hemihepatic vascular inflow occlusion using the lowering of hilar plate approach with biliary bougie assistance. RESULTS: The types of liver resection included right hepatectomy (n=1), right posterior sectionectomy (n=1), left hepatectomy and common bile duct exploration (n=1), segment 4b resection (n=1), left lateral sectionectomy (n=2), and wedge resection (n=2). Four patients underwent right and 4 left hemihepatic vascular inflow occlusion. Four patients had cirrhosis. The mean operation time was 176.3 minutes. The mean time taken to achieve hemihepatic vascular inflow occlusion was 24.3 minutes. The mean duration of vascular inflow occlusion was 54.5 minutes. The mean intraoperative blood loss was 361 mL. No patient required blood transfusion. Postoperatively, one patient developed bile leak which healed with conservative treatment. No postoperative liver failure and mortality occurred. The mean hospital stay of the patients was 7 days. CONCLUSION: Our technique of hemihepatic vascular inflow vascular occlusion using the lowering of hilar plate approach was safe, and it improved laparoscopic liver resection by minimizing blood loss during liver parenchymal transection.

  7. Do the physical properties of occlusal-indicating media affect muscle activity [EMG) during use?

    Science.gov (United States)

    Forrester, Stephanie E; Pain, Matthew T G; Presswood, Ron; Toy, Andy

    2009-06-01

    Four occlusal marking media (Parkell film, articulating silk, articulating paper and T-Scan foil) were tested to assess whether they affected neuromuscular function during occlusal marking events. Muscle activity of the anterior temporalis (TA) and superficial masseter (MS) muscles were obtained from surface EMG measurements during a slow closure to occlusion followed immediately by a forceful bite and a maximum clench onto each of the various occlusal indicating media. Muscle activity during the whole period of activation and immediately following onset were investigated. Significant differences in neuromuscular function between the occlusal marking media were observed, particularly between the Parkell film and articulating silk as opposed to the articulating paper and the T-Scan foil. The Parkell film and articulating silk gave neuromuscular function very similar to that of natural dentition occlusal contact, while the articulating paper and T-Scan foil showed similarities to occluding onto cotton rolls as previously reported (1). These results suggest that both the thickness and plasticity of the indicating media affect neuromuscular function during occlusion.

  8. Fast Visual Object Tracking Using Modified kalman and Particle Filtering Algorithms in the Presence of Occlusions

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    G.Mallikarjuna Rao

    2014-09-01

    Full Text Available In the present day real time applications of visual object tracking in surveillance, it has become extremely complex, time consuming and tricky to do the tracking when there are occlusions are present for small duration or for longer time and also when it is done in outdoor environments. In these conditions, the target to be tracked can be lost for few seconds and that should be tracked as soon as possible. As from the literature it is observed that particle filter can be able to track the target robustly in different kinds of background conditions, and it’s robust to partial occlusion. However, this tracking cannot recover from large proportion of occlusion and complete occlusion, to avoid this condition, we proposed two new algorithms (modified kalman and modified particle filter for fast tracking of objects in the presence of occlusions. We considered the complete occlusion of tracking object and the main objective is how fast the system is able to track the object after the occlusion is crossed. From the experimental results, it is observed that the proposed algorithms have shown good improvement in results compared to the traditional methods.

  9. Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

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    N. H. J. Creugers

    2010-01-01

    Full Text Available Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n=25 were compared with subjects with shortened dental arches without extension (n=74 and with subjects who had worn a mandibular extension removable partial denture in the past (n=19. Subjects with complete dentitions (n=72 were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function.

  10. Effect of Toll-Like Receptor 4 on Synovial Injury of Temporomandibular Joint in Rats Caused by Occlusal Interference

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    Jingjing Kong

    2016-01-01

    Full Text Available Synovitis is an important disease that causes intractable pain in TMJ. Some investigations suggested that the increasing expression of IL-1β secreted by synovial lining cells plays an important role in synovial inflammation and cartilage destruction in TMJ. In our previous research, the results demonstrated that TLR4 is involved in the expression of IL-1β in SFs from TMJ with lipopolysaccharide stimulation. However, the inflammatory response that occurred in synovial membrane is not caused by bacterial infection. In the current study, we investigated whether or not TLR4 participates in the inflammatory responses and the expression of IL-1β in synovial membrane of rats induced by occlusal interference. The results showed that obvious inflammation changes were observed in the synovial membranes and the expression of TLR4 and IL-1β was increased at both mRNA and protein levels in the occlusal interference rats. In addition, the inflammation reactions and the increased expression of IL-1β could be restrained by treatment with TAK-242, a blocker of TLR4 signaling. The results prompted us that the activation of TLR4 may be involved in the inflammatory reactions and increased expression of IL-1β in patients with synovitis and participate in the mechanisms of the initiation and development of synovial injury by regulating the expression of inflammatory mediators like IL-1β in synovial membranes.

  11. Review: Interventional radiology in peripheral vascular disease

    International Nuclear Information System (INIS)

    Peripheral vascular diseases (PVD) are referred to as diseases affecting the blood vessels other than the heart and the brain. Interventional endovascular treatment whenever feasible has become the first line of management in the treatment of PVD. Interventions may be aimed at either revascularization or deliberate occlusion of a diseased vessel(s). This article reviews the various peripheral vascular diseases with their appropriate endovascular management

  12. Occlusion culling for computer generated hologram based on ray-wavefront conversion.

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    Wakunami, Koki; Yamashita, Hiroaki; Yamaguchi, Masahiro

    2013-09-23

    We propose a new method for occlusion culling in the computation of a hologram based on the mutual conversion between light-rays and wavefront. Since the occlusion culling is performed with light-ray information, conventional rendering techniques such as ray-tracing or image-based rendering can be employed. On the other hand, the wavefront is derived for the calculation of light propagation, the hologram of 3-D objects can be obtained in high accuracy. In the numerical experiment, we demonstrate that our approach can reproduce a high-resolution image for deep 3-D scene with correct occlusion effect between plural objects.

  13. Life-threatening Cerebral Edema Caused by Acute Occlusion of a Superior Vena Cava Stent

    Energy Technology Data Exchange (ETDEWEB)

    Sofue, Keitaro, E-mail: keitarosofue@yahoo.co.jp; Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp; Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Sugimura, Kazuro, E-mail: sugimura@med.kobe-u.ac.jp [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)

    2013-02-15

    A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required.

  14. Device and method to determine perineal artery occlusion during road bicycling.

    Science.gov (United States)

    Parthiban, Sujeeth; Hotaling, James M; Ohlander, Samuel J; Baftiri, Amit P; Freels, Sally; Niederberger, Craig S

    2014-01-01

    Greater than 60 million American men who ride bicycles are at risk of developing erectile dysfunction. One possible reason is occlusion of the perineal arteries. Researchers relied on indirect methods and stationary models to study this problem. We developed a novel system to quantify occlusion among bicycle riders during a road bike ride. Our verification and validation activities show that this system can be safely used on human subjects to measure perineal artery occlusion. The method described in this paper provides a valuable tool to the researchers to study or to develop new solutions that alleviate this problem. The outcomes of these efforts will help millions of cyclists worldwide. PMID:25570811

  15. Occlusal traits in developmental dyslexia: a preliminary study

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    Perillo L

    2013-08-01

    Full Text Available Letizia Perillo,1 Maria Esposito,2 Mariarosaria Contiello,1 Alessandra Lucchese,3 Annamaria Chiara Santini,2 Marco Carotenuto2 1Department of Orthodontics, Second University of Naples, Naples, 2Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, 3Department of Orthodontics, University of Ferrara, Ferrara, Italy Aim: The objective of the study reported here was to assess the orthodontic features in children affected by developmental dyslexia (DD. Patients and methods: A total of 28 children affected by DD (22 boys, six girls; mean age: 9.78 ± 1.69 years were compared with 51 healthy children (38 boys, 13 girls; mean age 9.41 ± 1.48; range 7–10 years. Reading and writing skills were evaluated along with orthodontic features. Results: The DD and control groups were not significantly different in terms of total intelligence quotient (P = 0.441 and writing skills (P = 0.805 and P = 0.240, respectively, whereas significant differences were observed between the DD group and control group in both word reading (2.018 ± 1.714 vs 0.917 ± 0.563; P = 0.000 and non-word reading (2.537 ± 1.543 vs 0.862 ± 0.244; P = 0.000. Moreover, for many orthodontic features, there was no significant difference between the two groups; only in prevalence of diastemas (57.14%, P = 0.006, midline diastemas (46.42%, P = 0.007, overbite >4 mm (71.42%, P = 0.006 and overjet >4 mm (53.57%, P = 0.001, was there a statistically significant difference. According to univariate logistic regression analysis, the presence of diastemas (odds ratio [OR] 4.33; 95% confidence interval [CI] 1.61–11.65, midline diastemas (OR 4.68; 95% CI 1.61–13.43, an overbite >4 mm (OR 1.75; 95% CI 0.64–4.71, or an overjet >4 mm (OR 2.76; 95% CI 1.06–7.20 seems to play a role in the relationship between occlusal abnormalities and DD in children. Conclusion: Children with DD tend to present with

  16. Neuroprotective effect of minocycline in a rat model of branch retinal vein occlusion.

    Science.gov (United States)

    Sun, Chuan; Li, Xiao-Xin; He, Xiang-Jun; Zhang, Qi; Tao, Yong

    2013-08-01

    Branch retinal vein occlusion (BRVO) is the second most frequent retinal vascular disorder. Currently the first-line therapies for BRVO include anti-VEGF and dexamethasone implant treatment, however, with direct or indirect damage on retinal neurons, it has limited effect in improving patients visual acuity. Therefore, novel treatments with neuroprotective effect for BRVO retina were expected. Minocycline is a semisynthetic, broad spectrum tetracycline antibiotic with high penetration through the blood brain barrier. The neuroprotective effects of minocycline have been shown in various central nervous system (CNS) disease. Since both CNS and retina were composed of neurons and glials, it is reasonable to expect a neuroprotective effect by minocycline for BRVO retina. Therefore, the aim of the present study was to study whether minocycline has neuroprotective effect in branch retinal vein occlusion (BRVO) and the possible underlying molecular basis. We created BRVO in rats using laser photocoagulation. The animals were then randomly divided into 4 groups to evaluate the effect of minocycline: group A: minocycline 45 mg/kg intraperitoneal injection (i.p.), group B: minocycline 90 mg/kg i.p., group C: normal saline i.p., group D: sham injection. Fundus photography and fluorescein angiography (FA) were conducted. The changes in thickness of retinal layers were measured with optical coherence tomography (OCT) in vivo. We found that retinal edema occurred predominantly in the inner retinal layers. Intraperitoneal administration of minocycline significantly ameliorated retinal edema in the early stage of BRVO. We performed Full field Electroretinography (ffERG) to evaluate retinal function and found that the reduction of b wave amplitude decreased in the combined maximal response. The expressional levels of apoptosis related genes (Bax, Bcl-2) and inflammation related genes (IL-1 β, TNF α, MCP-1 and CCR2) were measured by real-time PCR, the results showed that

  17. Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report

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    Noma H

    2013-05-01

    Full Text Available Hidetaka Noma,1 Hiroshi Shimizu,1 Tatsuya Mimura21Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, 2Department of Ophthalmology, Medical Center East, Tokyo Women's Medical University, Tokyo, JapanAbstract: Central retinal vein occlusion (CRVO is frequent in patients with systemic lupus erythematosus (SLE, but the treatment of the macular edema with this disease is extremely difficult. We report a case of cystoid macular edema (CME secondary to unilateral CRVO in a patient with SLE that responded to intravitreous injection of an anti-vascular endothelial growth factor (VEGF agent. A 33-year-old Japanese woman was referred to our department with unilateral impairment of vision. Microperimetry (MP-1 showed a cessation of foveal sensitivity. Fluorescein angiography showed CME without ischaemia of the macular region or peripheral retina (nonischemic CRVO. A diagnosis of CME and unilateral nonischemic CRVO combined with SLE was made and intravitreous anti-VEGF therapy was given. A sample of aqueous humor was harvested at the start of intravitreous injection after obtaining informed consent. Then the levels of VEGF and monocyte chemotactic protein (MCP-1 were measured in the aqueous humor by enzyme-linked immunosorbent assay, revealing that VEGF was 234 pg/mL and MCP-1 was 501 pg/mL. Two weeks later, left eye vision improved to 20/20. Optical coherence tomography (OCT showed considerable amelioration of retinal swelling and CME. MP-1 showed a marked increase of foveal sensitivity. However, she had recurrence of edema 3 months later. After harvesting aqueous humor again, intravitreous injection of an anti-VEGF agent was repeated for CME. The aqueous VEGF and MCP-1 levels were 156 pg/mL and 360 pg/mL, respectively. These findings suggest that inflammation was improved by intravitreous injection of bevacizumab. Intravitreous injection of anti-VEGF agents may be effective for CME due to nonischemic CRVO in SLE patients

  18. 3D face recognition under expressions, occlusions, and pose variations.

    Science.gov (United States)

    Drira, Hassen; Ben Amor, Boulbaba; Srivastava, Anuj; Daoudi, Mohamed; Slama, Rim

    2013-09-01

    We propose a novel geometric framework for analyzing 3D faces, with the specific goals of comparing, matching, and averaging their shapes. Here we represent facial surfaces by radial curves emanating from the nose tips and use elastic shape analysis of these curves to develop a Riemannian framework for analyzing shapes of full facial surfaces. This representation, along with the elastic Riemannian metric, seems natural for measuring facial deformations and is robust to challenges such as large facial expressions (especially those with open mouths), large pose variations, missing parts, and partial occlusions due to glasses, hair, and so on. This framework is shown to be promising from both--empirical and theoretical--perspectives. In terms of the empirical evaluation, our results match or improve upon the state-of-the-art methods on three prominent databases: FRGCv2, GavabDB, and Bosphorus, each posing a different type of challenge. From a theoretical perspective, this framework allows for formal statistical inferences, such as the estimation of missing facial parts using PCA on tangent spaces and computing average shapes. PMID:23868784

  19. Ocelot catheter for the treatment of long SFA occlusion.

    Science.gov (United States)

    Cawich, Ian; Marmagkiolis, Konstantinos; Cilingiroglu, Mehmet

    2014-01-01

    Long saphenous femoral artery (SFA) chronic total occlusions (CTOs) are considered the "Achilles heel" of the lower extremity percutaneous interventions. Antegrade, retrograde, or transcollateral approaches, intraluminal or subintimal techniques with re-entry and specialized CTO devices using microdissection, vibrational energy, and laser have all been tried for the management of such challenging lesions with various success rates. Ocelot is the first CTO crossing device using real-time OCT technology. Its crossing catheter utilizes spiral wedges to corkscrew the CTO cap, while real-time OCT offers direct visualization to facilitate intravascular true-lumen orientation. The recently presented results of the CONNECT-II study demonstrated crossing success of 97% and freedom from major adverse events of 98%. We present one of the most challenging SFA CTOs with ambiguous proximal cap in the ostium of the SFA, heavy calcification and involving almost the entire length of the SFA. The Ocelot catheter assisted to the successful true-lumen recanalization of that complex lesion. PMID:24030969

  20. Percutaneous mechanical thrombectomy for treatment of acute femoropopliteal bypass occlusion

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    Lichtenberg M

    2012-05-01

    Full Text Available Michael Lichtenberg1, Matthias Käunicke1, Birgit Hailer1,21Cardiovascular Clinic, Vascular Center, Katholisches Klinikum Essen, Germany; 2University of Witten/Herdecke, GermanyAbstract: Acute and subacute ischemia of the legs in acute and subacute femoropopliteal bypass occlusion is a dramatic situation that endangers the survival of the limbs, depending on the severity of the ischemia. Different therapy options like percutaneous mechanical thrombectomy procedures, which include rotational thrombectomy, have become available in recent years, in addition to local lysis and surgical thrombectomy. Surgical thrombectomy using the Fogarty catheter technique, in particular, shows an increased incidence of perioperative complications but only small technical success rates in randomized trials. On the other hand, local lysis is associated with increased costs due to resource-consuming measures, such as intensive monitoring and repeat angiographies, in addition to bleeding complications. In the past, further development of the Straub Rotarex® system as an endovascular therapy option has demonstrated good success leading to amputation-free survival in multiple studies. At the same time, a low rate of complications with use has been documented. Most examinations have been conducted in the thigh. To date, there are little investigational data on its use in acutely and subacutely occluded femoropopliteal bypasses. In this paper, the current study-based significance of the Rotarex system for this indication is analyzed based on the existing literature and the authors' own experiences with 22 patients.Keywords: acute limb ischemia, femoropopliteal bypass, local lysis, rotational thrombectomy