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Sample records for axillary artery

  1. Adventitial cystic disease of the axillary artery.

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    Elster, Eric A; Hewlett, Stanley; DeRienzo, Damian P; Donovan, Sean; Georgia, Jeff; Yavorski, Chester C

    2002-01-01

    Adventitial cystic disease (ACD) is an extremely rare cause of arterial and venous insufficiency, with only 317 reported cases in the world literature. These lesions have been previously described in the popliteal fossa, external iliac artery, and distal brachial, radial, and ulnar arteries as well as in the proximal saphenous vein at the ankle. We describe here the first reported case of this disease in a proximal vessel, the axillary artery. A 33-year-old man was evaluated for upper extremity arterial insufficiency and was diagnosed with ACD on the basis of physical examination and radiographic findings, which was confirmed by pathological assessment. The patient was treated by excision of the lesion and interposition vein bypass. As this represents the first case of ACD in the proximal vasculature, it demonstrates that these lesions can occur in axial blood vessels.

  2. Axillary artery injury as a complication of proximal humerus fractures.

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    McLaughlin, J A; Light, R; Lustrin, I

    1998-01-01

    Proximal humerus fractures are common injuries and represent approximately 5% of all fractures. These fractures are infrequently associated with neurovascular injuries. Brachial plexus injuries are uncommon, whereas axillary artery injuries are rare. A review of 19 previously reported cases of axillary artery injury after proximal humerus fracture revealed that 84% occurred in patients older than 50 years, 53% were associated with brachial plexus injury, and 21% resulted in upper extremity amputation. This study describes a case of axillary artery injury after proximal humerus fracture and, on the basis of a literature review, offers suggestions for the early diagnosis and effective treatment of this uncommon injury.

  3. Bilateral axillary artery aneurysms after Bentall procedure in Marfan syndrome.

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    Haruki, Takashi; Ito, Hiroshi; Sakata, Kensuke; Kobayashi, Yurio

    2015-11-01

    A man with Marfan syndrome underwent a Bentall procedure for annuloaortic ectasia and severe aortic regurgitation at 43 years of age. Twenty-eight years after the Bentall procedure, he developed bilateral axillary artery aneurysms (length × diameter: right: 80 × 39 mm; left: 103 × 45 mm). Aneurysmectomy and reconstruction of the axillary artery were performed using an artificial vascular graft. Histological examination revealed cystic medial necrosis. The postoperative course was uneventful, but long-term follow-up is necessary.

  4. Anterior shoulder dislocation with axillary artery and nerve injury.

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    Razif, M A Mohamed; Rajasingam, V

    2002-12-01

    We report a rare case of left axillary artery injury associated with anterior dislocation of the left shoulder in a 25 yrs old male as a result of a road traffic accident. The shoulder dislocation was reduced. A left upper limb angiogram showed an obstructed left axillary artery. The obstructed segment was surgically reconstructed with a Dacron graft. Six months post operation in follow up, he was found to have good left shoulder function and no neurovascular deficit. This is an injury that could have been easily missed without a simple clinical examination.

  5. UNILATERAL VARIATION IN THE BRANCHING PATTERN OF RIGHT AXILLARY ARTERY: A CASE REPORT

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    A.K.Manicka Vasuki

    2015-09-01

    Full Text Available Axillary artery and its branches are prone to have variations in their course. Knowledge about such variations are important for Radiologists in imaging techniques, Surgeons,Orthopedicians and Anesthetists in performing surgeries in the axilla and giving regional nerve blocks in the axilla.During dissection of a cadaver in the department of Anatomy, PSG IMS &R, Coimbatore, We observed a variation in the third part of right Axillary artery. From the common trunk, Subscapular artery, Anterior and Posterior circumflex humeral arteries and Profunda brachii artery arose. Third part of Axillary artery continued down as brachial artery. We are highlighting the variation in this study.

  6. Postoperative peri-axillary seroma following axillary artery cannulation for surgical treatment of acute type A aortic dissection

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    Katsanos Konstantinos

    2010-05-01

    Full Text Available Abstract The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic circulatory arrest, thereby minimizing global cerebral ischemia. However, right axillary artery cannulation has been associated with serious complications, including problems with systemic perfusion during cardiopulmonary bypass, problems with postoperative patency of the artery due to stenosis, thrombosis or dissection, and brachial plexus injury. We herein present the case of a 36-year-old Caucasian man with known Marfan syndrome and acute type A aortic dissection, who had direct right axillary artery cannulation for surgery of the ascending aorta. Postoperatively, the patient developed an axillary perigraft seroma. As this complication has, not, to our knowledge, been reported before in cardiothoracic surgery, we describe this unusual complication and discuss conservative and surgical treatment options.

  7. Axillary artery thrombosis with anteroinferior shoulder dislocation:a rare case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Sushil S Rangdal; Shashidhar B Kantharajanna; Daljit Singh; Vikas Bachhal; Nirmal Raj; Vibhu Krishnan; Vijay Goni; Mandeep Singh Dhillon

    2012-01-01

    A very rare and serious complication of shoulder dislocation is a lesion to the axillary artery in the elderly population,whose vascular structures have become less flexible.Axillary artery injury secondary to anteroinferior shoulder dislocation is much rarer,especially in the young people.Proper recognition and treatment of this entity offers a full recovery to the patient.Present report highlights the possibility of axillary artery injury with anteroinferior shoulder dislocation.A few case reports and small case series of this injury have been reviewed.And recommendations for management have been brought up to date,in line with current thinking.

  8. Axillary artery counter-current aortography in the newborn with aortic arch obstruction

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    Lau, K.C.; Lo, R.N.S.; Leung, M.P.

    1989-08-01

    13 newborn infants with aortic coarctation were evaluated by counter-current aortographic technique. The right radial or brachial artery approach (2 cases in each group) did not give successful aortic arch imaging while the right axiallary artery approach resulted in adequate imaging in each of 9 cases investigated. In 2, the axillary artery was transiently weakened but returned to normal within 24 hours. No other complications were encountered. Axillary artery counter-current aortography is a safe and relatively non-invasive procedure which can be used to image the aortic arch in the newborn babies when other non-invasive diagnosis of aortic arch obstruction is tentative. (orig.).

  9. Endovascular repair of traumatic arteriovenous fistula between axillary artery and vein

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    Mo Ansheng

    2014-01-01

    Traumatic arteriovenous fistula between the axillary artery and vein may present a difficult problem in treatment.There are few reports demonstrating the endovascular repair of this challenge.Herein,we present such a case of endovascular repair of traumatic arteriovenous fistula between the axillary artery and vein with false aneurysm formation.The patient was discharged 1 1 days after successful operation.Oral clopidogrel and aspirin were administerted for 18 months.At one year follow-up,the patient was in good condition and showed no evidence of neurological deficit in the left upper limb.

  10. Axillary Versus Femoral Arterial Cannulation During Repair of Type A Aortic Dissection?

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    Stamou, Sotiris C.; Gartner, Derek; Kouchoukos, Nicholas T.; Lobdell, Kevin W.; Khabbaz, Kamal; Murphy, Edward; Hagberg, Robert C.

    2016-01-01

    Background The goal of this study was to compare early postoperative outcomes and actuarial-free survival between patients who underwent repair of acute Type A aortic dissection with axillary or femoral artery cannulation. Methods A total of 305 patients from five academic medical centers underwent acute Type A aortic dissection repair via axillary (n = 107) or femoral (n = 198) artery cannulation between January 2000 and December 2010. Major morbidity, operative mortality, and 5-year actuarial survival were compared between groups. Multivariate logistic regression was used to determine predictors of operative mortality, and Cox regression hazard ratios were calculated to determine predictors of long-term mortality. Results Operative mortality was not influenced by cannulation site (16% for axillary cannulation vs. 19% for femoral cannulation, p = 0.64). In multivariate logistic regression analysis, hemodynamic instability (p 200 min; p = 0.05) emerged as independent predictors of operative mortality. Stroke rates were comparable between the two techniques (14% for axillary and 17% for femoral cannulation, p = 0.52). Five-year actuarial survival was comparable between the groups (55.1% for axillary and 65.7% for femoral cannulation, p = 0.36). In Cox regression analysis, predictors of long-term mortality were: age (p < 0.001), stroke (p < 0.001), prolonged cardiopulmonary bypass time (p = 0.001), hemodynamic instability (p = 0.002), and renal failure (p = 0.001). Conclusions The outcomes of femoral versus axillary arterial cannulation in patients with acute Type A aortic dissection are comparable. The choice of arterial cannulation site should be individualized based on different patient risk profiles. PMID:28097193

  11. [Traumatic lesion of the subclavian and axillary arteries].

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    Giordanengo, F; Boneschi, M; Erba, M; Giuffrida, G F; Miani, S

    1997-05-01

    This study comprises 11 patients with traumatic vascular injuries of the subclavian and axillary vessels treated in the last 13 years at the Institute of General and Cardiovascular Surgery of Milan. Nine patients were male and two were female. In two patients the cause of injury was a penetrating trauma; blunt trauma occurred in nine patients. The majority of injuries were caused by motor vehicle accidents. Two patients suffered complete brachial plexus palsies with complete transection of the median nerve. Seven patients were affected by multiple bone injuries, while major venous injury was present in one case. Diagnosis was established by angiography performed in all stable patients. Vascular repair was performed in 10 patients; 4 patients were treated by primary repair, and 6 patients by interposition grafts. In one case we performed a transluminal percutaneous angioplasty (PTA) during angiographic examination, with a good result. There were no postoperative vascular complications and no patient died.

  12. In situ cephalic vein bypasses from axillary to the brachial artery after catheterization injuries.

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    Hudorovic, Narcis; Lovricevic, Ivo; Ahel, Zaky

    2010-07-01

    The need to bypass to the brachial artery is rare. Over a five-year period, 16 patients had suffered iatrogenic post-catheterization injuries of the upper extremity. We have performed 16 bypasses, in 16 patients, mean age was 65 years (range 47-75), to the brachial artery originating from an artery proximal to the shoulder joint. In all cases, the axillary artery was the donor artery. All bypasses were created by using the cephalic vein with the in situ technique and distal anastomoses were made to a distance-free section of brachial artery. No operative mortality, neurological complications or major upper-extremity amputation was associated with the procedure. Life-long-conduit analysis showed 75% patency in the five-year period. After iatrogenic post-catheterization trauma of arterial system of upper extremity, bypasses from axillary to brachial artery with the cephalic vein with the in situ technique is a safe operation with satisfactory long-term patency.

  13. Axillary artery transection and bilateral pulmonary embolism after anterior shoulder dislocation: case report

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    Leclerc Betty

    2017-01-01

    Full Text Available Introduction: Anterior shoulder dislocation can be associated with vascular and neurological complications. However, axillary artery injury associated with shoulder dislocation is rare and extremely rare without bone fracture. An early diagnosis of these complications allows predicting long-term functional outcomes. Methods: This article reports the case of a 66-year-old patient who presented an anterior shoulder dislocation after a ski fall without any neurological dysfunction or pulse deficit. Results: The first reduction attempts were unsuccessful and during the new attempt, we observed a hematoma. A CT scan showed a disruption of the axillary artery and a bilateral pulmonary embolism. Conclusion: Neurovascular injury must be systematically sought before and after reduction, and a multidisciplinary approach is always necessary.

  14. A coincidental variation of the axillary artery: the brachioradial artery and the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle

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    Marek Konarik

    2014-09-01

    Full Text Available A case of anomalous terminal branching of the axillary artery was encountered and described in a left upper limb of a male cadaver. A series of 214 upper limbs of Caucasian race was dissected. A variant artery, stemming from the very end of the axillary artery followed a superficial course distally. It passed the cubital fossa, ran on the lateral side of the forearm as usual radial artery, crossed ventrally to the palm and terminated in the deep palmar arch. This vessel is a case of the brachioradial artery (incorrectly termed as the “radial artery with high origin”. Moreover, it was associated with another variation, concerning the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle. The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. The superficially located artery brings an elevated danger of heavy bleeding in all unexpected situations, its variant branching can cause problems in radial catheterization procedures and the anomalously coursing other arterial variant poses an elevated danger in surgical procedures concerning the surgical neck of humerus.

  15. Axillary artery injury combined with delayed brachial plexus palsy due to compressive hematoma in a young patient: a case report

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    Yajima Hiroshi

    2008-03-01

    Full Text Available Abstract Introduction Axillary artery injury in the shoulder region following blunt trauma without association with either shoulder dislocation or fracture of the humeral neck has been previously reported. Axillary artery injury might also be accompanied with brachial plexus injury. However, delayed onset of brachial plexus palsy caused by a compressive hematoma associated with axillary injury after blunt trauma in the shoulder region has been rarely reported. In previous reports, this condition only occurred in old patients with sclerotic vessels. We present a case of a young patient who suffered axillary artery injury associated with brachial plexus palsy that occurred tardily due to compressive hematoma after blunt trauma in the shoulder region without association of either shoulder dislocation or humeral neck fracture. Case presentation A 16-year-old male injured his right shoulder in a motorbike accident. On initial physical evaluation, the pulses on the radial and ulnar arteries in the affected arm were palpable. Paralysis developed later from 2 days after the injury. Functions in the right arm became significantly impaired. Angiography showed complete occlusion of the axillary artery. Magnetic resonance imaging demonstrated a mass measuring 4 × 5 cm that was suspected to be a hematoma compressing the brachial plexus in a space between the subscapular muscle and the pectoralis minor muscle. Surgery was performed on the third day after injury. In intraoperative observations, the axillary artery was occluded with thrombus along 5 cm; a subscapular artery was ruptured; the brachial plexus was compressed by the hematoma. After evacuation of the hematoma, neurolysis of the brachial plexus, and revascularization of the axillary artery, the patient had an excellent functional recovery of the affected upper limb, postoperatively. Conclusion Surgeons should be aware that axillary artery injuries may even occur in young people after severe blunt

  16. Serious axillary nerve injury caused by subscapular artery compression resulting from use of backpacks.

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    Haninec, Pavel; Mencl, Libor; Bačinský, Peter; Kaiser, Radek

    2013-12-01

    A palsy of the brachial plexus elements caused by carrying a heavy backpack is a very rare injury usually occurring in soldiers or hikers, and recovery is usually spontaneous. We describe here the case of male civilian presenting with an isolated serious axillary nerve palsy associated with chronic backpack use. During the surgery, a dumbbell-shaped neuroma-in-continuity was found which was caused by direct pressure from the subscapular artery. After resection of the neuroma, a nerve graft from the sural nerve was used to reconstruct the nerve. Reinnervation was successful and the patient was able to abduct his arm to its full range, with full muscle strength, within 24 months.

  17. Impella 5.0 Support in INTERMACS II Cardiogenic Shock Patients Using Right and Left Axillary Artery Access.

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    Schibilsky, David; Lausberg, Henning; Haller, Christoph; Lenglinger, Matthias; Woernle, Barbara; Haeberle, Helene; Rosenberger, Peter; Walker, Tobias; Schlensak, Christian

    2015-08-01

    The catheter-based Impella 5.0 left ventricular assist device (LVAD) is a powerful and less invasive alternative for patients in cardiogenic shock. The use of this device as a primary mechanical circulatory support strategy in INTERMACS II patients should be evaluated. From April 2014 to August 2014, eight Impella 5.0 devices were implanted in seven patients via the axillary artery access (six right and two left). We analyzed the outcome of the four patients in whom the Impella 5.0 device was implanted for the purpose of primary stabilization of cardiogenic shock (INTERMACS II). The remaining three patients had a contraindication for a permanent LVAD and received the device for prolonged weaning from extracorporeal life support (ECLS) system. The implantation of the Impella 5.0 was technically successful in all patients and resulted in the stabilization of the clinical situation. All four patients could be bridged to a long-term device (n = 3) or to cardiac recovery (n = 1). In one patient, 2 days of ECLS support was necessary because of pump thrombosis after 31 days of Impella 5.0 support. One patient with bronchopneumonia had the Impella 5.0 exchanged from the right to the left axillary artery after 22 days of support because of the progressive loss of purge flow and the need for longer bridging to a permanent LVAD. The last patient was supported for giant-cell myocarditis for 22 days and bridged to cardiac recovery. All patients were transferred to the intensive care unit with the Impella device in place. In INTERMACS II situations, the implantation of the Impella 5.0 via the right or left axillary access allowed additional time for decision making. Early patient mobilization, including walking with the Impella device in place, optimized the conditions for either weaning or the implantation of a permanent LVAD. This novel technique of left axillary approach leads to more flexibility in the case of anatomical- or device-related contraindications to right

  18. Use of a Javid™ shunt in the management of axillary artery injury as a complication of fracture of the surgical neck of the humerus: a case report

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    Suttie Stuart A

    2008-08-01

    Full Text Available Abstract Introduction Axillary artery injury is a rare but severe complication of fractures of the surgical neck of the humerus. Case presentation We present a case of axillary artery pseudoaneurysm secondary to such a fracture, in a 82-year-old white woman, presenting 10 weeks after the initial injury, successfully treated with subclavian to brachial reversed vein bypass together with simultaneous open reduction and internal fixation of the fracture. We discuss the use of a Javid™ shunt during combined upper limb revascularisation and open reduction and internal fixation of the fractured humerus. Conclusion This case highlights the usefulness of a Javid™ shunt, over other forms of vascular shunts, in prompt restoration of blood flow to effect limb salvage. It can be considered as a temporary measure whilst awaiting definitive revascularisation which can be performed following fracture fixation.

  19. Midterm Experience of Ipsilateral Axillary-Axillary Arteriovenous Loop Graft as Tertiary Access for Haemodialysis

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    J. P. Hunter

    2014-01-01

    Full Text Available Objectives. To present a series of ipsilateral axillary artery to axillary vein loop arm grafts as an alternative vascular access procedure for haemodialysis in patients with difficult access. Design. Retrospective case series. Methods. Patients who underwent an axillary loop arteriovenous graft from September 2009 to September 2012 were included. Preoperative venous imaging to exclude central venous stenosis and to image arm/axillary veins was performed. A cuffed PTFE graft was anastomosed to the distal axillary artery and axillary vein and looped on the arm. Results. 25 procedures were performed on 22 patients. Median age was 51 years, with 9 males and 13 females. Median number of previous access procedures was 3 (range 0–7. Median followup was 16.4 months (range 1–35. At 3 months and 1 year, the primary and secondary patency rates were 70% and 72% and 36% and 37%, respectively. There were 11 radiological interventions in 6 grafts including 5 angioplasties and 6 thrombectomies. There were 19 surgical procedures in 10 grafts, including thrombectomy, revision, repair for bleeding, and excision. Conclusions. Our series demonstrates that the axillary loop arm graft yields acceptable early patency rates in a complex group of patients but to maintain graft patency required high rates of surgical and radiological intervention, in particular graft thrombectomy.

  20. Damaged axillary nerve (image)

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    Conditions associated with axillary nerve dysfunction include fracture of the humerus (upper arm bone), pressure from casts or splints, and improper use of crutches. Other causes include systemic disorders that cause neuritis (inflammation of ...

  1. Axillary brachial plexus blockade in moyamoya disease?

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    Saban Yalcin

    2011-01-01

    Full Text Available Moyamoya disease is characterized by steno-occlusive changes of the intracranial internal carotid arteries. Cerebral blood flow and metabolism are strictly impaired. The goal in perioperative anaesthetic management is to preserve the stability between oxygen supply and demand in the brain. Peripheral nerve blockade allows excellent neurological status monitoring and maintains haemodynamic stability which is very important in this patient group. Herein, we present an axillary brachial plexus blockade in a moyamoya patient operated for radius fracture.

  2. Bilateral accessory thoracodorsal artery.

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    Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Skandalakis, Panagiotis

    2006-09-01

    The subscapular artery arises from the third part of the axillary artery and gives off the circumflex scapular and the thoracodorsal arteries. Although anatomical variations of the axillary artery are very common, the existence of a unilateral accessory thoracodorsal artery has been described in the literature only once. There are no reports of bilateral accessory thoracodorsal artery, in the literature. In the present study, a bilateral accessory thoracodorsal artery, originating on either side of the third part of the axillary artery, is described in a 68-year-old female cadaver. All the other branches of the axillary artery had a typical origin, course, distribution and termination. This extremely rare anatomical variation apart from the anatomical importance also has clinical significance for surgeons in this area. Especially, during the dissection or mobilization of the latissimus dorsi that is partly used for coverage problems in many regions of the body and also in dynamic cardiomyoplasty, any iatrogenic injury of this accessory artery may result in ischemia and functional loss of the graft.

  3. Axillary breast: Navigating uncharted terrain

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    Medha A Bhave

    2015-01-01

    Full Text Available Introduction: Axillary breast is a common condition that leads to discomfort and cosmetic problems. Liposuction alone and open excision are two techniques used for treatment. Materials and Methods: This study assesses the results of treatment in 24 consecutive patients, operated between 2005 and 2015.All patients had Kajava class IV masses. Three were treated by liposuction alone, while 21 were treated by open axillaplasty with limited liposuction. Results: One patient treated by liposuction alone had to be re-operated for a residual lump, while with axillaplasty, no major complications were observed and the results were uniformly good. Discussion: Certain points of technique emerged as major determinants in obtaining the best results. In brief, these are: a limited skin excision; b placing elliptical incisions within the most lax, apical axillary skin, irrespective of the location of the lump; c raising skin flaps at the level of superficial fascia; dmeticulous dissection and preservation of the nerves, especially the second intercostobrachial; f judicious liposuction for eliminating dog ears and axillary sculpting only; g avoiding drains. Conclusion: Open axillaplasty with limited liposuction is the best way to minimise complications and produce good results.

  4. Axillary and rectal temperature measurements in infants.

    OpenAIRE

    Morley, C J; Hewson, P H; Thornton, A. J.; Cole, T J

    1992-01-01

    Rectal and axillary temperatures were measured during the daytime in 281 infants seen randomly at home and 656 at hospital under 6 months old, using mercury-in-glass thermometers. The normal temperature range derived from the babies at home was 36.7-37.9 degrees C for rectal temperature and 35.6-37.2 degrees C for axillary temperature. Rectal temperature was higher than axillary in 98% of the measurements. The mean (SD) difference between rectal and axillary temperatures was 0.7 (0.5) degrees...

  5. Axillary Brachial Plexus Blockage in Treatment of Upper Extremity Ischemic Disorder in Critically Ill Patient: A Report of Two Cases

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    İlkay Ceylan

    2015-08-01

    Full Text Available Arterial catheterization, vasoactive agents, autonomic dysfunction and septic embolus may cause ischemia at distal ends of upper extremity in critically ill patients. Axillary brachial plexus blockage is highly reliable intervention when appropriate technique is used. Sympathetic blockage occurs after administration of local anesthetic drug and can resolve the circulatory disorder of extremity. We aimed to present two cases with ischemia of upper distal extremity that resolves after axillary brachial plexus blockage.

  6. Axillary Brachial Plexus Blockage in Treatment of Upper Extremity Ischemic Disorder in Critically Ill Patient: A Report of Two Cases

    OpenAIRE

    İlkay Ceylan; Nermin Kelebek Girgin; Mehmet Ali Kopan; Alp Gurbet

    2015-01-01

    Arterial catheterization, vasoactive agents, autonomic dysfunction and septic embolus may cause ischemia at distal ends of upper extremity in critically ill patients. Axillary brachial plexus blockage is highly reliable intervention when appropriate technique is used. Sympathetic blockage occurs after administration of local anesthetic drug and can resolve the circulatory disorder of extremity. We aimed to present two cases with ischemia of upper distal extremity that resolves after axillary ...

  7. [Axillary hyperhidrosis, botulinium A toxin treatment: Review].

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    Clerico, C; Fernandez, J; Camuzard, O; Chignon-Sicard, B; Ihrai, T

    2016-02-01

    Injection of type A botulinum toxin in the armpits is a temporary treatment for axillary hyperhidrosis. This technique described in 1996 by Bushara et al., is known to be efficient and safe. The purpose of this article was to review the data concerning the treatment of axillary hyperhidrosis with botulinum toxin type A, and discuss the other treatment modalities for this socially disabling entity.

  8. Hemodialysis catheter implantation in the axillary vein by ultrasound guidance versus palpation or anatomical reference

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    Restrepo Valencia CA

    2013-10-01

    Full Text Available Cesar A Restrepo Valencia,1 Carlos A Buitrago Villa,1 Jose A Chacon Cardona21Internal Medicine, Nephrology, 2Epidemiology, Caldas University, Manizales, ColombiaBackground: We compared the results of four different methods of hemodialysis catheter insertion in the medial segment of the axillary vein: ultrasound guidance, palpation, anatomical reference, and prior transient catheter.Methods: All patients that required acute or chronic hemodialysis and for whom it was determined impossible or not recommended either to place a catheter in the internal jugular vein (for instance, those patients with a tracheostomy, or to practice arteriovenous fistula or graft; it was then essential to obtain an alternative vascular access. When the procedure of axillary vein catheter insertion was performed in the Renal Care Facility (RCF, ultrasound guidance was used, but in the intensive care unit (ICU, this resource was unavailable, so the palpation or anatomical reference technique was used.Results: Two nephrologists with experience in the technique performed 83 procedures during a period lasting 15 years and 8 months (from January 1997–August 2012: 41 by ultrasound guidance; 19 by anatomical references; 15 by palpation of the contiguous axillary artery; and 8 through a temporary axillary catheter previously placed. The ultrasound-guided patients had fewer punctures than other groups, but the value was not statistically significant. Arterial punctures were infrequent in all techniques. Analyzing all the procedure-related complications, such as hematoma, pneumothorax, brachial-plexus injury, as well as the reasons for catheter removal, no differences were observed among the groups. The functioning time was longer in the ultrasound-guided and previous catheter groups. In 15 years and 8 months of surveillance, no clinical or image evidence for axillary vein stenosis was found.Conclusion: The ultrasound guide makes the procedure of inserting catheters in the

  9. Fibroadenoma in axillary supernumerary breast: case report

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    Délio Marques Conde

    Full Text Available CONTEXT: Supernumerary breast tissue may be affected by the same diseases and alterations that compromise topical breast tissue. Nevertheless, reports of fibroadenoma in supernumerary breast tissue in the axillae are rare. OBJECTIVE: To describe a case of fibroadenoma in an axillary supernumerary breast. DESIGN: Case report. CASE REPORT: A 39-year-old woman was referred to the gynecology and obstetrics outpatient clinic at Hospital Estadual Sumaré, complaining of bilateral axillary masses. The patient reported cosmetic problems and local pain and discomfort. On physical examination, alterations compatible with bilateral axillary accessory breasts, without palpable nodules, were observed. Supplementary examinations (mammography and ultrasonography revealed a 1.1 cm mass in the right axillary breast. The patient underwent resection of the supernumerary breasts and histopathological examination revealed fibroadenoma of the right axillary breast tissue.

  10. An extraordinary case of axillary contracture: trapped healthy skin and its adnexes under contracted scar.

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    Nisanci, Mustafa; Sahin, Ismail; Guzey, Serbulent

    2014-01-01

    Although striking improvements have been achieved in overall management of burn injury, postburn contractures are still an ongoing challenge to burn surgeons. Axillary adduction contracture is one of the most common types of these disabling postburn complications that usually result from suboptimal treatment after acute burns. An unusual and complicated case of axillary contracture in which the unburned, healthy axillary dome skin was trapped as a cystic mass under the scarred area was reconstructed by transfer of a big (17×13-cm) thoracodorsal artery perforator flap after contracture release. The result was satisfactory in terms of function and acceptable cosmetically. The underlying reasons for the inadequate treatment the patient received after surviving a severe electrical injury were discussed.

  11. Axillary node metastasis from primary ovarian carcinoma

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    Trupti S Patel

    2014-01-01

    Full Text Available Metastasization and distinction from mammary carcinoma is of great clinical importance because of different treatment modalities. Here, we discuss a case of stage IIIC ovarian serous carcinoma, presenting with bilateral axillary nodes metastasis after 25 months interval of its initial presentation. Increased serum CA-125 level caused clinical suspicion. Computed tomography scan of abdomen and pelvis showed no residual disease or any abdominal lymphadenopathy. Mammography of both breast were normal. Bilateral axillary nodes were noted. Guided fine needle aspiration cytology (FNAC and biopsy of ovarian carcinoma to axillary node is a rare event. Its recogn done. Cytomorphology revealed poorly differentiated carcinoma, compatible to that of primary ovarian tumor. Thus, metastatic carcinoma to axillary node from ovary was confirmed. This case illustrates a rare metastatic presentation of ovarian carcinoma and unequivocal role of FNAC to provide rapid diagnosis and preferred to be first line diagnostic procedure.

  12. Reversibility of hyperhidrosis post axillary depilatory laser.

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    Helou, Josiane; Habre, Maya; Soutou, Boutros; Maatouk, Ismael; Ibrahim, Tony; Tomb, Roland

    2014-03-01

    Hyperhidrosis and bromhidrosis were lately reported as novel side effects of laser-assisted removal of axillary hair. The goal of our study was to evaluate the reversibility of these two side effects. An observational, single-center cohort study included over a 30-month screening period 30 patients with newly reported hyperhidrosis and/or bromhidrosis related to axillary depilatory laser. After 26 weeks of follow-up, each patient was assessed for spontaneous reversibility. A 12-week duration treatment with topical aluminum chloride was evaluated in patients with persisting hyperhidrosis. Hyperhidrosis was assessed using the Hyperhidrosis Disease Severity Scale (HDSS). Spontaneous reversibility was observed in 20% of patients. In total, 23 out of 30 patients recovered normal axillary transpiration either spontaneously or after treatment. Mean HDSS score was significantly lower in the treated group. It appears that axillary hyperhidrosis and bromhidrosis, secondary to laser depilation, reverse either spontaneously or after using topical antiperspirant.

  13. Ulnar nerve palsy due to axillary crutch.

    Directory of Open Access Journals (Sweden)

    Veerendrakumar M

    2001-01-01

    Full Text Available A young lady with residual polio, using axillary crutch since early childhood, presented with tingling, numbness and weakness in ulnar nerve distribution of five months duration. Ulnar motor conduction study revealed proximal conduction block near the axilla, at the point of pressure by the crutch while walking. Distal ulnar sensory conduction studies were normal but proximal ulnar sensory conduction studies showed absence of Erb′s point potential. These findings suggested the presence of conduction block in sensory fibers as well. Proper use and change of axillary crutch resulted in clinical recovery and resolution of motor and sensory conduction block.

  14. [Ultrasonic guided cannulation of the axillary vein in intensive care patients].

    Science.gov (United States)

    Schregel, W; Höer, H; Radtke, J; Cunitz, G

    1994-10-01

    attempted CV catheters, 43 were placed successfully. In 2 cases the axillary vein could not be encountered by the puncture needle. Guide-wire placement did not succeed in 4 patients. One catheter was malpositioned in the ipsilateral internal jugular vein. Four inadvertent punctures of the axillary artery remained without sequelae after compression. No further puncture-related complications were observed. With high US intensity score the number of puncture attempts necessary for successful vein cannulation was lower. On the other hand, complications and puncture failure seemed to be more frequent in patients with lower US intensity scores. DISCUSSION. CV access via the axillary vein had a satisfying success rate (43/50) and proved to be a safe procedure in our ICU patients despite higher risk factors compared to a healthy population. Although ethical reasons did not allow a randomised comparison with the standard technique, location of the axillary vein by Doppler US is likely to improve cannulation results and reduce complications induced by "blind" needle probing. With a low US intensity score, the rate of successful punctures is lower and complication rates increase. In some patients, e.g., those with extended tumour operations involving the head and neck, CV access via the axillary vein may be of high clinical value.

  15. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01)

    DEFF Research Database (Denmark)

    Galimberti, Viviana; Cole, Bernard F; Zurrida, Stefano;

    2013-01-01

    For patients with breast cancer and metastases in the sentinel nodes, axillary dissection has been standard treatment. However, for patients with limited sentinel-node involvement, axillary dissection might be overtreatment. We designed IBCSG trial 23-01 to determine whether no axillary dissectio...

  16. The use of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery%经右侧腋动脉插管选择性单侧脑灌注在主动脉瘤手术中的应用

    Institute of Scientific and Technical Information of China (English)

    姚昊; 王强; 骆璇; 王喆妍; 陈杨

    2011-01-01

    Objective To summarize the experiences of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery. Methods Methods Retrospectively analyzed 105 cases ( from May 2009 to May 2011 ) of aortic aneurysm surgery with deep hypothermic circulatory arrest ( DHCA ). 78 cases were male and 27 cases were female. The operation procedure included Bentall procedure and semi arch replacement in 6 cases, ascending aorta replacement and semi arch replacement in 5 cases, Bentall procedure and elephant trunk technique in 61 cases, ascending aorta replacement and elephant trunk technique in 33 cases. Combined operations included coronery artery bypass grafting ( 10 cases ), mitral valve replacement or mitral valve repair ( 24 cases ) and tricuspid valve repair ( 11 cases ). Results Average cardiopulmonary bypass time was 81 -374 ( 178. 6 ±41. 5 ) min, average DHCA time was 8 - 36 ( 23.2 ± 10. 1 ) min, average selective cerebral perfusion time was 8 - 46 ( 30. 4 ± 12. 4 ) min, nasopharynx temperature during DHCA was 15. 5 -23. 5 ( 19. 5 ± 1. 7 )℃ , rectal temperature during DHCA was 18.0-25.6 ( 20.6 ± 1. 6 )℃. 89 patients'hearts automaticly reheated and 16 reheated after defibrillation. 5 cases died postoperatively. The complications included mul-tiorgan failure for 3 cases, malignant arrhythmia for 1 case and sudden bleeding for 1 case. Conclusion The use of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery can get effective brain protection and reduce the postoperative nervous system complications with acceptable results.%目的 总结经右侧腋动脉插管选择性脑灌注(SCP)在主动脉瘤手术中应用的经验.方法 回顾性分析我院2009年5月至2011年5月期间采用深低温停循环(DHCA)SCP的手术方式治疗的105例主动脉瘤患者.男78例,女27例.行Bentall+次全弓置换6例,行升主动脉置换+次全弓置换5例,行Bentall+全弓置换+降主

  17. [Case report with multiple variations of blood vessels originating from the fossa axillaris].

    Science.gov (United States)

    Papanchev, V; Krustev, D; Krustev, N

    2003-01-01

    In the course of a dissection of a male's cadaver, fixed in formol carbol solution, we identified the following arterial variations: A) Regio axillaris dextra: a musculi teretis major (9 cm long); a. musculi subscapularis (of insignificant calibre and length); a. thoracica lateralis accessoria prima (10 cm long, with a course along the surface of m. subscapularis); a. thoracica lateralis accessoria secunda (25 cm long, with a course within the conjunctive tissue of the axilla); B) Regio axillaris sinistra: a musculi subcapularis prima et secunda (of insignificant calibre and length); a. musculi teretis major (9 cm long); a. thoracica lateralis accessoria secunda (20 cm long); a. thoracica lateralis accessoria tertia (25 cm long); All three additional arteria had a course along the surface of m. serratis anterior. We called the identified vessels after the name of the muscle blood-supplied by them. Only the vessels ending in m. serratus anterior did we call aa. thoracicae laterales accessoriae.

  18. The Clinical Value of Axillary Ultrasonogra- phy for Detection of Axillary Lymph Node Metastasis in Cases with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sedigheh Tahmasebi

    2014-10-01

    Full Text Available Background: The axillary lymph node stage is one of the single most important determinants in the prognosis of breast cancer patients. The disadvantages of the two previous methods used for evaluating axillary node metastasis, i.e., axillary lymph node dissection and sentinel lymph node biopsy, have directed researchers to investigate new techniques for this purpose. The aim of the current study was to evaluate the clinical usefulness of axillary ultrasonography in detecting axillary metastasis. Methods: This study was conducted during a 12-month period. The breast cancer cases included in this study were all clinically diagnosed as stages I and II, with no prior treatment to the axillary region by surgery and/or chemo-radiotherapy. Excluded from the study group were patients with palpable axillary lymph nodes, those who had major organ failure or concomitant malignancy. All included patients with non-palpable axillary lymph nodes underwent axillary ultrasound examination. An ultrasound- guided core needle biopsy was performed on patients with suspected metastasis. Results: There were 125 female patients with a mean age of 49.6 years included in this study. From these, 16 (12.8% cases had positive axillary sonographic findings. Pathologic evaluation of tissue specimens (taken by ultrasound-guided core needle biopsy in 10 (62.5% out of 16 patients were positive, and in the patient group of 6 (37.5% cases, studies were negative. Axillary ultrasonography had a sensitivity of 35.7%, specificity of 93.8%, positive predictive value of 62.5%, and negative predictive value of 83.5%. Conclusion: The axillary ultrasonogram is a reliable technique in the determination of axillary nodal metastatic involvement in breast cancer patients. By use of this method a significant amount of complications and costs related to the previous techniques can be avoided.

  19. Axillary nerve conduction changes in hemiplegia

    Directory of Open Access Journals (Sweden)

    Ring Haim

    2008-12-01

    Full Text Available Abstract Aim To prove the possibility of axillary nerve conduction changes following shoulder subluxation due to hemiplegia, in order to investigate the usefulness of screening nerve conduction studies in patients with hemiplegia for finding peripheral neuropathy. Methods Forty-four shoulders of twenty-two patients with a first-time stroke having flaccid hemiplegia were tested, 43 ± 12 days after stroke onset. Wasting and weakness of the deltoid were present in the involved side. Motor nerve conduction latency and compound muscle action potential (CMAP amplitude were measured along the axillary nerve, comparing the paralyzed to the sound shoulder. The stimulation was done at the Erb's point whilst the recording needle electrode was inserted into the deltoid muscle 4 cm directly beneath the lateral border of the acromion. Wilcoxon signed rank test was used to compare the motor conduction between the sound and the paralytic shoulder. Mann-Whitney test was used to compare between plegic and sound shoulder in each side. Results Mean motor nerve conduction latency time to the deltoid muscle was 8.49, SD 4.36 ms in the paralyzed shoulder and 5.17, SD 1.35 ms in the sound shoulder (p Mean compound muscle action potential (CMAP amplitude was 2.83, SD 2.50 mV in the paralyzed shoulder and was 7.44, SD 5.47 mV in the sound shoulder (p p p = 0.003, 1-sided for amplitude, and patients with left paralyzed shoulder compared to patients with left sound shoulder (p = 0.011, 1-sided for latency, p = 0.001, 1-sided for amplitude, support the same outcomes. The electro-physiological changes in the axillary nerve may appear during the first six weeks after stroke breakout. Conclusion Continuous traction of the axillary nerve, as in hypotonic shoulder, may affect the electro-physiological properties of the nerve. It most probably results from subluxation of the head of the humerus, causing demyelinization and even axonopathy. Slowing of the conduction velocities of

  20. LANGER’S AXILLARY ARCH AND ITS CLINICAL IMPLICATIONS

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    Jyothi K C

    2014-09-01

    Full Text Available Introduction: The axillary arch muscle of Langer is the most common anatomical variant of axillary musculature which is of clinical and surgical importance. It may lead to neurovascular compression syndrome in the cervicoaxillary region and can be misinterpreted while examining axilla and also impairs movements of shoulder joint. Observation: During routine dissection of axilla for undergraduate teaching, an unusual muscular slip in the left axilla was observed .The muscular slip was extending from lattisimus dorsi muscle to undersurface of pectoralis major muscle, arching over axillary vessels and cords of brachial plexus. Conclusion: The axillary arch may cause obstruction to axillary vessels and nerves and may be involved in thoracic outlet syndrome and shoulder instability. The knowledge of this muscular variant could help to minimize intraoperative complications related to surgeries in or nearby axilla such as mastectomy, breast reconstruction and axillary lymphadenectomy or lymph node biopsy.

  1. [Axillary-femoral by passes. Technic. Complications. Results (92 patients) (author's transl)].

    Science.gov (United States)

    Tricot, J F; Kieffer, E; Maraval, M; Benhamou, A C; Natali, J

    1978-01-01

    Between January 1970 and October 1977, 95 operations of revascularisation of 124 lower limbs were carried out using the axillary artery in 92 patients. 84 patients had very severe ischemia, acute or chronic, which threatened the survival of the limb. In all, direct surgery was too dangerous (77 cases) or impossible owing to local or regional problems (7 cases). The results gave a mortality during the first two months of 13% in which infective complications of the technic accounted for 3.5%. The latter were frequent (12%) but a certain number of them could have been prevented (6%). 55 patients (65%) had a good result at two months (weight-bearing conserved) whilst 20%, i.e. 18 patients were amputated, of which five had a permeable by pass which permitted conservation of the knee. We observed the highest percentage of deaths (3/8 i.e. 37%) in bilateral emergency revascularisations for acute ischemia. We observed a very low percentage of early thrombosis (4%) in axillary bifemoral by pass performed for chronic ischemia. The operation is of great value when no other direct surgical technic is possible and only in these cases. 8 patients underwent an axillary by pass to treat infective complications of aorto-iliac surgery. 4 early deaths showed the severity of this complication (50%). Tactical aspects are discussed briefly.

  2. Axillary reverse mapping in axillary surgery for breast cancer: an update of the current status.

    Science.gov (United States)

    Beek, Martinus A; Gobardhan, Paul D; Schoenmaeckers, Ernst J P; Klompenhouwer, Elisabeth G; Rutten, Harm J T; Voogd, Adri C; Luiten, Ernest J T

    2016-08-01

    Axillary reverse mapping (ARM) is a technique by which the lymphatic drainage of the upper extremity that traverses the axillary region can be differentiated from the lymphatic drainage of the breast during axillary lymph node dissection (ALND). Adding this procedure to ALND may reduce upper extremity lymphedema by preserving upper extremity drainage. This review of the current literature on the ARM procedure discusses the feasibility, safety and relevance of this technique. A PubMed literature search was performed until 12 August 2015. A total of 31 studies were included in this review. The studies indicated that the ARM procedure adequately identifies the upper extremity lymph nodes and lymphatics in the axillary basin using blue dye or fluorescence. Preservation of ARM lymph nodes and corresponding lymphatics was proven to be oncologically safe in clinically node-negative breast cancer patients with metastatic lymph node involvement in the sentinel lymph node (SLN) who are advised to undergo a completion ALND. The ARM procedure is technically feasible with a high visualisation rate using blue dye or fluorescence. ALND combined with ARM can be regarded as a promising surgical refinement in order to reduce the incidence of upper extremity lymphedema in selected groups of patients.

  3. [Acute axillary eczema caused by mercury compounds].

    Science.gov (United States)

    Ippen, H

    1979-01-01

    Not every axillary dermatitis is caused by an allergy against corresponding cosmetics (deodorants or anti-perspirants). This is shown in a 24-year-old man with an acute contact dermatitis in the left axilla. Sensitization probably developed against mercury salts due to the regular use of thermometers which were kept in a disinfecting solution containing phenylmercuric borate. The patient was in two hospitals for a check up before heart surgery and temperature was regularly measured in the left axilla. In both clincis phenylmercuric borate was used for desinfection of the thermometers. The sensitivity was proofed by positive patch tests.

  4. Effect of shaving on axillary stratum corneum.

    Science.gov (United States)

    Marti, V P J; Lee, R S; Moore, A E; Paterson, S E; Watkinson, A; Rawlings, A V

    2003-08-01

    Removal of underarm hair is an intrinsic part of the care regimen for the majority of female consumers, with most using a wet shave with a disposable razor. However, little is known of the impact of shaving on axillary skin, and it is a particularly neglected area of research. To investigate this, we have studied the acute and chronic effects of shaving ultrastructurally, biochemically and functionally. A forearm patch test protocol was devised for antiperspirant (AP) product screening, which involved a pre-shave of the test site with a dry razor just prior to patching. Comparison of the irritation caused by a series of AP products confirmed that shaving leads to increased irritation consistent with enhanced sensitivity. The effect of regular shaving in the axilla was assessed in a 4-week in-use study with shaving either once a week or once a day, both combined with the application of an AP. Expert visual assessment of skin condition showed that more frequent shaving promoted a higher level of visible irritation. However, indirect measurement using corneosurfametry indicated no significant changes to the lipid barrier over the study period irrespective of shaving frequency. Nevertheless, digital images of the axillary skin after dry shaving show distinct opaque lines because of uplifting skin flakes with a corresponding increase in scaliness parameter. Moreover, histamine iontophoresis to assess skin sensitivity demonstrated a significant enhancement of histamine-induced itch and neurogenic flare.

  5. Reduced barrier efficiency in axillary stratum corneum.

    Science.gov (United States)

    Watkinson, A; Lee, R S; Moore, A E; Pudney, P D A; Paterson, S E; Rawlings, A V

    2002-06-01

    The skin of the axilla is cosmetically important with millions of consumers daily applying antiperspirant/deodorant products. Despite this, we know virtually nothing about axillary skin or how antiperspirant (AP) use impacts upon it. To characterize the axillary stratum corneum and determine whether this is a unique skin type, we have looked at stratum corneum composition and function, particularly its barrier properties, and compared it with other body sites. Transepidermal water loss (TEWL) and corneosurfametry (CSM) revealed a reduced barrier function in the axilla. HPTLC analysis of the stratum corneum lipids demonstrated statistically elevated levels of fatty acids, ceramides, and particularly cholesterol in the axilla. Both ceramide and cholesterol did not appear to change with depth, indicating that they were predominantly of stratum corneum origin. On the other hand, at least some of the fatty acid had a sebaceous origin. We hypothesized that the reduced barrier function might be owing to the changes in the crucial ceramide : cholesterol ratio. To address this, we used a combination of attenuated total reflectance-Fourier-transformed infrared spectroscopy (ATR-FTIR) with cyanoacrylate sampling. These results demonstrated more ordered lipid-lamellae phase behaviour in the axilla, suggesting that the elevated cholesterol might form crystal microdomains within the lipid lamellae, allowing an increase in water flux. Since an exaggerated application of antiperspirant had no effect upon the axilla barrier properties, it is concluded that this region of skin physiologically has a reduced barrier function.

  6. The use of pectoralis major flaps during axillary dissection for bulky axillary lymphadenopathy

    Directory of Open Access Journals (Sweden)

    Mohan N

    2013-09-01

    Full Text Available Naomi Mohan, Savtaj Singh Brar, Jason T Rich, Frances Wright, Kevin Higgins Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Abstract: There are a multitude of flaps and advanced techniques employed in reconstructive surgery during axillary dissections. The pectoralis major flap has proven, in our experience, to be favored as it provides excellent access to level three of the axilla and vessel coverage. Keywords: lymphadenopathy, free flap, pectoralis major

  7. Aorta-LITA Bypass Grafting with Saphenous Vein in a Patient Undergoing Coronary Artery Surgery with Subclavian Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Kerim Çağlı

    2011-12-01

    Full Text Available The internal thoracic artery (ITA is the primary graft for coronary artery bypass grafting and can not be used if there is subclavian artery stenosis (SAS. Aorto-axillary, carotid-subclavian bypass and also angioplasty with stenting or other interventional treatments are acceptable procedures for SAS treatment. Aorta-ITA bypass with saphenous vein can be alternative and simple technique for SAS to save Winslow pathway for patients with peripheral artery disease.

  8. Presentation of Axillary Metastases from Occult Breast Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Xin Wang

    2007-01-01

    Axillary presentation from occult breast cancer is uncommon and continues to be a diagnostic and therapeutic challenge to physicians.Once the diagnosis of adenocarcinoma metastatic to an axillary lymph node has been confirmed,a preoperative workup should be done.The current experience is based on several relatively small retrospective reviews and case reports.It is difficult to determine the best management of occult breast cancer.However,treatmenl of axillary Iymph node dissection is recommended for local control and complete staging information.Treatment of breast should be a choice between breast conservation with whole-breast radiotherapy and mastectomy.Adjuvant systemic treatment should be offered.

  9. Florigen is involved in axillary bud development at multiple stages in Arabidopsis

    OpenAIRE

    Niwa, Masaki; Endo, Motomu; Araki, Takashi

    2013-01-01

    The wide variety of plant architectures is largely based on diverse and flexible modes of axillary shoot development. In Arabidopsis, floral transition (flowering) stimulates axillary bud development. The mechanism that links flowering and axillary bud development is, however, largely unknown. We recently showed that FLOWERING LOCUS T (FT) protein, which acts as florigen, promotes the phase transition of axillary meristems, whereas BRANCHED1 (BRC1) antagonizes the florigen action in axillary ...

  10. Micropropagation of Helleborus through axillary budding.

    Science.gov (United States)

    Beruto, Margherita; Viglione, Serena; Bisignano, Alessandro

    2013-01-01

    Helleborus genus, belonging to the Ranunculaceae family, has 20 species of herbaceous perennial flowering plants. The commercial exploitation of this plant is dependent on the selection and propagation of appropriate lines. High propagation rate could be accomplished by using a suitable tissue culture method enabling the rapid introduction of valuable selections in the market. However, in vitro cultivation of Helleborus is still very difficult. Thereby the development of reliable in vitro propagation procedures is crucial for future production systems. Axillary buds cultured on agar-solidified Murashige and Skoog medium supplemented with 1 mg/L benzyladenine, 0.1 mg/L β-naphthoxyacetic acid, and 2 mg/L isopentenyl adenine develop shoots after 16 weeks of culture under 16 h light regime, 50-60 μmol/s/m(2), and 19 ± 1°C. The multiplication rate ranges from 1.4 to 2.1. However, the genotype and the number of subcultures affect the efficiency of the micropropagation process. The rooting of shoots is about 80% in solidified MS medium containing 1 mg/L 1-naphthaleneacetic acid and 3 mg/L indole-3-butyric acid. The described protocol provides information which can contribute to the commercial production of Helleborus plants.

  11. Clinical and Molecular Evidence of ABCC11 Protein Expression in Axillary Apocrine Glands of Patients with Axillary Osmidrosis

    Science.gov (United States)

    Toyoda, Yu; Takada, Tappei; Gomi, Tsuneaki; Nakagawa, Hiroshi; Ishikawa, Toshihisa; Suzuki, Hiroshi

    2017-01-01

    Accumulating evidence suggests that the risk of axillary osmidrosis is governed by a non-synonymous single nucleotide polymorphism (SNP) 538G>A in human ATP-binding cassette C11 (ABCC11) gene. However, little data are available for the expression of ABCC11 protein in human axillary apocrine glands that produce apocrine sweat—a source of odor from the armpits. To determine the effect of the non-synonymous SNP ABCC11 538G>A (G180R) on the ABCC11 in vivo, we generated transiently ABCC11-expressing transgenic mice with adenovirus vector, and examined the protein levels of each ABCC11 in the mice with immunoblotting using an anti-ABCC11 antibody we have generated in the present study. Furthermore, we examined the expression of ABCC11 protein in human axillary apocrine glands extracted from axillary osmidrosis patients carrying each ABCC11 genotype: 538GG, GA, and AA. Analyses of transiently ABCC11-expressing transgenic mice showed that ABCC11 538G>A diminishes the ABCC11 protein levels in vivo. Consistently, ABCC11 protein was detected in the human axillary apocrine glands of the 538GG homozygote or 538GA heterozygote, not in the 538AA homozygote. These findings would contribute to a better understanding of the molecular basis of axillary osmidrosis. PMID:28212277

  12. Post-burn axillary contracture: A therapeutic challenge!

    Directory of Open Access Journals (Sweden)

    Durga Karki

    2014-01-01

    Full Text Available Background: Axillary post-burn scar contracture is a challenging problem to the reconstructive surgeon owing to the wide range of abduction that should be achieved. The aim of this paper was to highlight the various options used in managing axillary contractures in our hospital. Materials and Methods: This is a retrospective hospital-based study of axillary contractures managed at Safdarjung Hospital (a tertiary care hospital from 2009 to 2013.The study consisted of 44 patients from all age group and both sex included in it. Patients with a bilateral axillary contracture were excluded. Axillary contracture was released and resurfaced using split skin graft and/or with different types of flaps including the propeller flap, parascapular flap. All the reconstructed cases were followed-up for a period of 12 months. Assessment was done on the basis of functional and aesthetic outcome. Results: Forty-four patients consisting of 25 males and 19 females presented with axillary contractures that involved 44 axillae. The mean age of the study group was 17.1 years. Injuries involved the anterior axillary fold in 8 (18.18%, posterior fold in ten (22.72%, both folds and axillary fossa in 14 (31.81% and both folds plus part of the chest wall and arm (sparing the axillary fossa in 12 (27.27% axillae. Surgical treatment included split-thickness skin graft in 15 (34.1%, local skin flaps in 4 (9.1%, Z-plasties in 4 (9.1%, parascapular flaps in 3 (6.82%, while propeller flaps in 12 (27.27% and square flap were used in 6 (13.64% patients. The percentage of improvement in abduction had a mean of 156°. The functional and aesthetic results were satisfactory. Conclusion: The choice of surgical procedure for reconstruction of post-burn axillary contractures can be made according to the pattern of scar contracture and the state of the surrounding skin. The choice of a flap should have priority over the skin graft because of the superior functional and aesthetic results

  13. Florigen is involved in axillary bud development at multiple stages in Arabidopsis.

    Science.gov (United States)

    Niwa, Masaki; Endo, Motomu; Araki, Takashi

    2013-11-01

    The wide variety of plant architectures is largely based on diverse and flexible modes of axillary shoot development. In Arabidopsis, floral transition (flowering) stimulates axillary bud development. The mechanism that links flowering and axillary bud development is, however, largely unknown. We recently showed that FLOWERING LOCUS T (FT) protein, which acts as florigen, promotes the phase transition of axillary meristems, whereas BRANCHED1 (BRC1) antagonizes the florigen action in axillary buds. Here, we present evidences for another possible role of florigen in axillary bud development. Ectopic overexpression of FT or another florigen gene TWIN SISTER OF FT (TSF) with LEAFY (LFY) induces ectopic buds at cotyledonary axils, confirming the previous proposal that these genes are involved in formation of axillary buds. Taken together with our previous report that florigen promotes axillary shoot elongation, we propose that florigen regulates axillary bud development at multiple stages to coordinate it with flowering in Arabidopsis.

  14. Fibroadenoma of axillary ectopic breast tissue: A rare clinical entity

    Directory of Open Access Journals (Sweden)

    Sunder Goyal

    2014-01-01

    Full Text Available Supernumerary breast or polymastia is a well-documented anomaly of the breast and commonly presents along the embryonic milk line extending between the axilla and groin. Reported incidence of accessory breast is 0.4-6% in females. During 2 years period, we encountered only two cases out of twenty cases of axillary lumps. We present one case of fibroadenoma in ectopic breast tissue (EBT in axilla. Ectopic breast denotes breast tissue at more than two pectoral regions, which is mostly benign but at times can be malignant. EBT is at a greater risk of malignancy. Fibroadenoma of ectopic axillary breast tissue (EBT is quiet rare, but should always be kept in mind for differential diagnosis of an axillary mass.

  15. Axillary temperature measurement: a less stressful alternative for hospitalised cats?

    Science.gov (United States)

    Girod, M; Vandenheede, M; Farnir, F; Gommeren, K

    2016-02-20

    Rectal temperature measurement (RTM) can promote stress and defensive behaviour in hospitalised cats. The aim of this study was to assess if axillary temperature measurement (ATM) could be a reliable and less stressful alternative for these animals. In this prospective study, paired rectal and axillary temperatures were measured in 42 cats, either by a veterinarian or a student. To assess the impact of these procedures on the cat's stress state, their heart rate was checked and a cat stress score (CSS) was defined and graded from 1 (relaxed) to 5 (terrified). A moderate correlation was found between RTM and ATM (r=0.52; Pcats.

  16. Isolated axillary lymph node metastasis in oesophageal adenocarcinoma.

    Science.gov (United States)

    Toh, Vi Vien; Shirley, Rebecca; Duffy, John; Starley, Ian Francis

    2015-03-01

    Oesophageal adenocarcinoma metastatic to the axilla is a rare occurrence. The authors present a case of a woman who developed an axillary metastasis from a completely excised oesophageal adenocarcinoma with no prior evidence of nodal disease. With aggressive local treatment, including multiple local operations and radiotherapy, she remains alive and disease-free 12 years after her diagnosis following surgical resection of her axillary metastasis with adjuvant radiotherapy. This case report suggests that there are occasions when aggressive local treatment of apparently isolated metastases can result in a cure.

  17. A predictive tool to estimate the risk of axillary metastases in breast cancer patients with negative axillary ultrasound

    DEFF Research Database (Denmark)

    Meretoja, T J; Heikkilä, P S; Mansfield, A S;

    2014-01-01

    risk factors for axillary metastases. Binary logistic regression analysis was conducted to form a predictive model based on the risk factors. The predictive model was first validated internally in a patient series of 566 further patients and then externally in a patient series of 2,463 patients from...... of this study was to evaluate the risk factors for axillary metastases in breast cancer patients with negative preoperative axillary ultrasound. METHODS: A total of 1,395 consecutive patients with invasive breast cancer and SNB formed the original patient series. A univariate analysis was conducted to assess...... of the primary tumor (P predictive model. Internal validation of the model produced an area under the receiver operating characteristics curve (AUC) of 0.731 and external validation an AUC of 0.79. CONCLUSIONS: We present a predictive model to assess the patient-specific probability...

  18. Axillary recurrence rate 5 years after negative sentinel node biopsy for breast cancer

    NARCIS (Netherlands)

    Andersson, Y.; de Boniface, J.; Jonsson, P. -E.; Ingvar, C.; Liljegren, G.; Bergkvist, L.; Frisell, J.

    2012-01-01

    Background: Sentinel lymph node (SLN) biopsy has replaced axillary lymph node dissection (ALND) as the standard axillary staging procedure in breast cancer. Follow-up studies in SLN-negative women treated without ALND report low rates of axillary recurrence, but most studies have short follow-up, an

  19. Axillary Bud Proliferation Approach for Plant Biodiversity Conservation and Restoration

    Directory of Open Access Journals (Sweden)

    F. Ngezahayo

    2014-01-01

    Full Text Available Due to mainly human population pressure and activities, global biodiversity is getting reduced and particularly plant biodiversity is becoming at high risk of extinction. Consequently, many efforts have been deployed to develop conservation methods. Because it does not involve cell dedifferentiation of differentiated cells but rather the development and growth of new shoots from preexisting meristems, the axillary bud proliferation approach is the method offering least risk of genetic instability. Indeed, meristems are more resistant to genetic changes than disorganized tissues. The present review explored through the scientific literature the axillary bud proliferation approach and the possible somaclonal variation that could arise from it. Almost genetic stability or low level of genetic variation is often reported. On the contrary, in a few cases studied to date, DNA methylation alterations often appeared in the progenies, showing epigenetic variations in the regenerated plants from axillary bud culture. Fortunately, epigenetic changes are often temporary and plants may revert to the normal phenotype. Thus, in the absence of genetic variations and the existence of reverting epigenetic changes over time, axillary bud culture can be adopted as an alternative nonconventional way of conserving and restoring of plant biodiversity.

  20. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Aram Baram

    2014-02-01

    Full Text Available Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8% that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4. Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months. A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5% and another patient (2.5% presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353 and 2.5% (p = .552, respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58% compared to palmar type (14, 35.89% or axillary type (7, 17.94%. Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.

  1. Strategies for morbidity control of axillary dissection for breast cancer

    NARCIS (Netherlands)

    J. Bonnema (Jorien)

    1998-01-01

    textabstractBreast cancer accounts for one third of all cancers in females in the Netherlands I and the incidence has been increasing world-wide in the past decades 2.. For the majority of patients, surgery forms the primary treatment of choice 3. Dissection of the axillary lymph nodes has been part

  2. MISSING FLOWERS gene controls axillary meristems initiation in sunflower.

    Science.gov (United States)

    Fambrini, Marco; Cionini, Giuliano; Bertini, Daniele; Michelotti, Vania; Conti, Alessio; Pugliesi, Claudio

    2003-05-01

    The initiation and growth of axillary meristems are fundamental components of plant architecture. Here, we describe the mutant missing flowers (mf) of Helianthus annuus characterized by the lack of axillary shoots. Decapitation experiments and histological analysis indicate that this phenotype is the result of a defect in axillary meristem initiation. In addition to shoot branching, mutation affects floral differentiation. The indeterminate inflorescence of sunflower (capitulum) is formed of a large flat meristem which produces floret primordia in multiple spirals. In wildtype plants a bisecting crease divides each primordium in two distinct bumps that adopt different fate. The peripheral (abaxial) part of the primordium becomes a small leaf-like bract and the adaxial part becomes a flower. In the mf mutant, the formation of flowers at the axil of bracts is precluded. Histological analyses show that in floret primordia of the mutant a clear subdivision in dyads is not established. The primordia progressively bend inside and only large involucral floral bracts are developed. The results suggest that the MISSING FLOWERS gene is essential to provide or perceive an appropriate signal to the initiation of axillary meristems during both vegetative and reproductive phases.

  3. Jugular-axillary vein bypass for salvage of arteriovenous access.

    Science.gov (United States)

    Fulks, K D; Hyde, G L

    1989-01-01

    Stenosis or occlusion of the subclavian vein can cause incapacitating upper extremity swelling and venous hypertension in the patient with an arteriovenous (AV) access. A case of subclavian vein occlusion is reported that was treated with internal jugular-axillary vein bypass. This procedure resulted in salvage of the access and rapid resolution of the associated upper extremity swelling. It was concluded that jugular-axillary vein bypass should be considered in patients who have massive upper extremity edema resulting from a functioning AV access and ipsilateral subclavian vein occlusion. Patients undergoing creation of an AV access who have had previous temporary subclavian catheters or previous early failure of an AV access should have phlebography before surgery.

  4. Isolated Axillary Lymph Node Metastasis from Serous Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Hemant Goyal

    2012-01-01

    Full Text Available A 68-year-old female with past medical history of stage IIIc serous ovarian cancer after cytoreductive surgery and adjuvant chemotherapy came to clinic for regular follow-up visit. Physical examination was completely normal except for an isolated left axillary lymph node enlargement. Patient's abdominal sonogram and CT scan of abdomen and pelvis did not show any other new metastasis. Surgical excisional biopsy of the lymph node was performed and pathology revealed features of metastatic serous ovarian carcinoma.

  5. Axillary lymph nodes and arm lymphatic drainage pathways are spared during routine complete axillary clearance in majority of women undergoing breast cancer surgery.

    Science.gov (United States)

    Szuba, A; Chachaj, Z; Koba-Wszedybylb, M; Hawro, R; Jasinski, R; Tarkowski, R; Szewczyk, K; Bebenek, M; Forgacz, J; Jodkowska, A; Jedrzejuk, D; Janczak, D; Mrozinska, M; Pilch, U; Wozniewski, M

    2011-09-01

    Alterations in axillary lymph nodes (ALNs) after complete axillary lymph node dissection (ALND) in comparison to the preoperative status were evaluated using lymphoscintigraphy performed preoperatively and 1-6 weeks after surgery in 30 women with a new diagnosis of unilateral, invasive breast carcinoma. Analysis of lymphoscintigrams revealed that ALNs after surgery were present in 26 of 30 examined women. In comparison to preoperative status, they were visualized in the same location (12 women), in the same and additionally in different locations (9 women), or only in different locations (4 women). No lymph nodes were visualized in one woman and lymphocoele were in 4 women. Thus, after ALND, a variable number of axillary lymph nodes remain and were visualized on lymphoscintigraphy in the majority of women. The classical ALND, therefore, does not allow complete dissection and removal of axillary nodes with total disruption of axillary lymphatic pathways, accounting in part for the variable incidence and severity of lymphedema after the procedure.

  6. Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer*

    Science.gov (United States)

    Rocha, Rafael Dahmer; Girardi, André Ricardo; Pinto, Renata Reis; de Freitas, Viviane Aguilera Rolim

    2015-01-01

    Objective To propose an algorithm to determine the necessity for ultrasonography-guided fine-needle aspiration (US-FNA) in preoperative axillary lymph node staging of patients with invasive breast cancer. Materials and Methods Prospective study developed at National Cancer Institute. The study sample included 100 female patients with breast cancer referred for axillary staging by US-FNA. Results The overall US-FNA sensitivity was set at 79.4%. The positive predictive value was calculated to be 100%, and the negative predictive value, 69.5%. The US-FNA sensitivity for lymph nodes with normal sonographic features was 0%, while for indeterminate lymph nodes it was 80% and, for suspicious lymph nodes, 90.5%. In the assessment of invasive breast tumors stages T1, T2 and T3, the sensitivity was respectively 69.6%, 83.7% and 100%. US-FNA could avoid sentinel node biopsy in 54% of cases. Conclusion Axillary ultrasonography should be included in the preoperative staging of all patients with invasive breast cancer. The addition of US-FNA in cases of lymph nodes suspicious for malignancy may prevent more than 50% of sentinel lymphadenectomies, significantly shortening the time interval to definitive therapy. PMID:26811550

  7. A Comparison of Tympanic, Oral, and Axillary Temperatures in Women During Labor

    Science.gov (United States)

    1994-06-01

    temperature is the amount of heat present in the skin and tissues under the arm, high in the axillary area (Clemente, 1985; Kozier & Erb, 1989). Axillary...has been considered the "gold standard" of temperature measurement in many clinical areas (Erickson, 1980; Kozier & Erb, 1989; Luckmann & Sorenson...difference as described in many nursing references ( Kozier L Erb, 1989; Lewis & Timby, 1988; Lipsky, 1986). Correlation between oral-axillary

  8. Chyle leak following right axillary lymph node dissection: A case report and review of current literature

    Directory of Open Access Journals (Sweden)

    J.D. Daggett

    2016-01-01

    Full Text Available This report discusses the case of a chyle leak following a right axillary lymph node dissection for breast cancer. This presented as a sudden change in drainage character from a right axillary surgical drain from serous to milky white shortly after restarting a diet. The diagnosis of chyle leak was confirmed by laboratory testing of the fluid and managed with closed suction drainage. Chyle leak is a rare, but increasingly recognized complication following axillary clearance for breast cancer and melanoma.

  9. RADIAL ARTERY ANOMALIES IN THE MACEDONIAN POPULATION DURING TRANSRADIAL ANGIOGRAPHY PROCEDURES

    Directory of Open Access Journals (Sweden)

    Zafirovska Biljana

    2016-07-01

    Full Text Available Objective: To assess the incidence of arterial anomalies of the radial artery in the Macedonian population registered during transradial access (TRA angiography procedures in a large series of patients. Background: Transradial angiography (TRA is now the recommended access for percutaneous coronary intervention, but technically is a more challenging approach for angiography procedures mostly due to the anatomic anomalies on the radial artery, which may influence the success rate of transradial angiographic procedures. Methods: All consecutive 19292 patients from our Center, in the period from March 2011 until December 2014 were examined. Preprocedural radial artery angiography was performed in all patients. Clinical and procedure characteristics, type and incidence of vascular anatomy variants and access site complications were analyzed. Results: Anatomical variants were present in 1625 (8.8% patients. The most frequent was high-bifurcating radial artery origin from the axillary and brachial arteries in 1017(5.5% patients, 227 (1.2% had extreme radial artery tortuosity, 176(0.95% had a full radial loop, 32(0.17% with hypoplastic radial artery and 173(0.9% had tortuous brachial, subclavian and axillary arteries. Radial artery spasm was very common in patients with present radial artery anomalies. Conclusion: Radial artery anomalies are very common in the general population. Knowing the anatomy of the radial artery helps the interventional cardiologist in successfully planning and performing this procedure. Radial artery angiography is strongly encouraged in every patient before the begining of the transradial angiography procedures.

  10. Thoracoscopic sympathectomy for primary palmar and axillary hyperhidrosis

    Institute of Scientific and Technical Information of China (English)

    姚学权

    2004-01-01

    Objective:Open thoracic sympathectomy has been established as a routine treatment for patients with primary hyperhidrosis. Recently, thoracoscopic techniques have allowed surgeons to offer these patients a permanent solution with minimal surgical trauma. Methods:From June 1996 to July 2002, 78 thoracoscopic sympathectomies(TS) were performed. There were 28 males and 50 females with a mean age of 22.4 years (range, 14 to 48 years). The procedures were performed with the patients under general anesthesia using a double- lumen endotracheal tube. In palmar hyperhidrosis the second thoracic sympathetic oanglia are destroyed by electrocautery. In axillary hyperhidrosis the second to fourth oanglion are cut off. Each lung was reinflated on completion of the sympathectomy, and residual pneumothorax aspirated before closure of the incisions. No placement of chest tubes was performed in the operating. Results:All sympathectomies were completed thoracoscopically. The symptoms disappeared completely in all patients immediately after the operation. Their hands were dry and warm when they waked up from anaesthesia. There was no surgical mortality. Median operation time for a bilateral procedure is 28 min. (range, 8 - 90 min). The average hospital stay was 5.5 days. The mean follow- up time was 43.8 months (range, 3 - 73months). Compensatory hyperhidrosis was found in 41.03% (32/78) of patients, but the symptoms were not serve enough to interfere with lifestyle, and were not required further treatment. In all 78 patients had a satisfactory result, without recurrence of palmar or axillary hyperhidrosis. Conclusions: Thoracoscopic sympathectomy is the most effective and minimally invasive treatment for palmar and axillary hyperhydrosis.

  11. Regeneration of Blue Honeysuckle via Dormant Axillary Buds

    Institute of Scientific and Technical Information of China (English)

    QU Guiqin; HUANG Longshuang; HUO Junwei

    2008-01-01

    The optimum medium for dormant axillary buds culture of blue honeysuckle was screened according to the growth rate and elongation rate by inoculating the buds on culture medium with various 6-BA and iron-salt concentration. About 35 days, the stretched stem buds were divided into strong root system after inoculated on 1/2 MS+1.0 mg·L-1 IBA rooting medium. Amount of qualified tissue-cultured young plants could be obtained by the stretched stem buds reproduction.

  12. In vitro mass propagation of Salvia canariensis by axillary shoots

    Directory of Open Access Journals (Sweden)

    Sebastiana Mederos Molina

    2014-01-01

    Full Text Available During the establishment of shoots of Salvia canariensis L., five environmental factor treatments were applied. For each axillary node two shoots grew well when explants were incubated at continued ligth for 15 days followed by 16 hrs photoperiod by 30 days. Shoots multiplication was improved on a modified Murashige and Skoog (MS (1962 medium - MS + 825 mg/l NH4NO3 - supplemented with 10-7 M BA and 10-7 M NAA. The shoots produced well developed root systems within three weeks after transfer to the same culture medium supplemented with 5x 10-7 M NAA.

  13. Rupture of an expander prosthesis mimics axillary cancer recurrence.

    LENUS (Irish Health Repository)

    Ismael, T

    2005-10-01

    Regional silicone gel migration from a ruptured breast implant has been reported at different locations including the upper extremity, chest wall muscles, axilla and back. We report a patient who presented with an axillary mass that mimicked a regional recurrence 5 years after breast cancer reconstruction with a latissimus dorsi musculocutaneous flap and silicon gel expander-prosthesis. Surgical exploration revealed that the mass contained silicone gel around the port of the breast expander that had ruptured. The mass was confluent with an intracapsular silicone leak through a tract along the tube of the expander port.

  14. Modified axillary radiograph of the shoulder: a new position.

    Science.gov (United States)

    Senna, Luís Filipe; Pires E Albuquerque, Rodrigo

    2017-01-01

    Obtaining axillary radiographs of the shoulder in acute trauma is not always feasible. The authors present a new modification of this radiographic view, in order to assess the anatomic relationship between the humeral head and the glenoid cavity. The incidence is performed with the patient sitting on X-ray table, with the affected limb supported thereon. The authors describe the case of a 28-year-old male who suffered an anterior glenohumeral dislocation that was clearly evidenced by this modified radiograph. The concentric relationship between the humeral head and the glenoid cavity was also easily confirmed by obtaining such radiograph after the reduction maneuver.

  15. Rapid on-site evaluation of axillary fine-needle aspiration cytology in breast cancer.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2012-06-01

    Axillary ultrasonography (AUS) and fine-needle aspiration cytology (FNAC) can establish axillary lymph node status before surgery, although this technique is hampered by poor adequacy rates. To achieve consistently high rates of FNAC adequacy, rapid on-site evaluation (ROSE) of FNAC samples was introduced.

  16. A comparative study of thoracoscopic sympathicotomy versus local surgical treatment for axillary hyperhidrosis

    DEFF Research Database (Denmark)

    Heidemann, Erik; Licht, Peter B

    2013-01-01

    Axillary hyperhidrosis affects approximately 1.4% of the population. Medical management is often frustrating, and the response generally transient. Surgical methods include thoracoscopic sympathectomy or sympathicotomy and local axillary surgery such as suction-curettage or en-bloc skin resection...

  17. Axillary block duration and related hemodynamic changes: high versus low dose Adrenaline addition to Lidocaine

    Directory of Open Access Journals (Sweden)

    Shariat Moharari R

    2009-03-01

    Full Text Available "nBackground: Axillary block is used for inducing anesthesia in outpatient hand and forearm surgeries. Few researches have studied hemodynamic and blockade effects of low doses of Epinephrine. The aim of the present study was to compare the duration of analgesia and hemodynamic changes following the injection of high/low epinephrine doses in such surgeries. "nMethods: The present randomized clinical trial study was conducted on healthy individuals (ASA I-II who were candidates for hand and forearm surgeries. The patients were randomly divided into three groups. The first two groups were allocated to receive lidocaine with low (0.6µg/cc and high (5µg/cc doses of epinephrine whereas lidocaine plus normal saline was injected in the third group. The hemodynamic changes (Mean arterial blood pressure and heart rate and the occurance of any side-effects along with the duration of analgesia and motor block were recorded. "nResults: From among the total of 75 patients, 15 cases were excluded due to incomplete blockade or failure needing general anesthesia. The duration of analgesia and the motor block were longer in the high dose epinephrine group, the difference, however, was not statistically significant. Heart rate changes within the groups was significant in the 4th-7th and 10th minutes. Mean arterial blood pressure changes was only significant in the 4th minute, within the groups. "nConclusions: Administering low doses of epinephrine plus lidocaine as a local anesthetic not only provides acceptable analgesia compared to higher doses of the medication, but also is associated with fewer side effects.

  18. Brachiomedian artery (arteria brachiomediana revisited: a comprehensive review

    Directory of Open Access Journals (Sweden)

    David Kachlik

    2016-03-01

    Full Text Available This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis, a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery. Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection.

  19. Factors influencing axillary shoot proliferation and adventitious budding in cedar.

    Science.gov (United States)

    Renau-Morata, Begoña; Ollero, Javier; Arrillaga, Isabel; Segura, Juan

    2005-04-01

    We developed procedures for in vitro cloning of Cedrus atlantica Manetti and C. libani A. Rich explants from juvenile and mature plants. Explant size was one determinant of the frequency of axillary bud break in both species. Shoot tips and nodal explants mainly developed calli, whereas bud sprouting occurred in defoliated microcuttings cultured on a modified Murashige and Skoog medium without growth regulators. Isolation and continuous subculture of sprouted buds on the same medium allowed cloning of microcuttings from C. atlantica and C. libani seedlings and bicentennial C. libani trees, thus providing a desirable alternative for multiplying mature trees that have demonstrated superior characteristics. We also report adventitious bud differentiation from isolated embryos of C. atlantica. Neither auxin treatments nor other methods tested, including infection with Agrobacterium rhizogenes, were effective in inducing root initiation.

  20. Virtual lymph node analysis to evaluate axillary lymph node coverage provided by tangential breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Shin Hyung; Kim, Jae Chul; Lee, Jeong Eun; Park, In Kyu [Dept.of Radiation Oncology, Kyungpook National University Hospital, Daegu(Korea, Republic of)

    2015-03-15

    To investigate the coverage of axillary lymph node with tangential breast irradiation fields by using virtual lymph node (LN) analysis. Forty-eight women who were treated with whole breast irradiation after breast-conserving surgery were analyzed. The axillary and breast volumes were delineated according to the Radiation Therapy Oncology Group (RTOG) contouring atlas. To generate virtual LN contours, preoperative fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans with identifiable LN were fused with the CT scans, and the virtual LN contour were delineated on the CT. The median level I and II axillary volume coverage percentages at the VD95% line were 33.5% (range, 5.3% to 90.4%) and 0.6% (range, 0.0% to 14.6%), respectively. Thirty-one LNs in 18 patients were delineated (26 in level I and 5 in level II). In the level I axilla, 84.6% of virtual LNs were encompassed by the 95% isodose line. In the level II axilla, by contrast, none of the virtual LNs were encompassed by the 95% isodose volumes. There was a substantial discrepancy between the RTOG contouring atlas-based axillary volume analysis and the virtual LN analysis, especially for the level I axillary coverage. The axillary volume coverage was associated with the body mass index (BMI) and breast volume. The tangential breast irradiation did not deliver adequate therapeutic doses to the axillary region, particularly those in the level II axilla. Patients with small breast volumes or lower BMI showed reduced axillary coverage from the tangential breast fields. For axillary LN irradiation, individualized anatomy-based radiation fields for patients would be necessary.

  1. Endosalpingiosis of Axillary Lymph Nodes: A Rare Histopathologic Pitfall with Clinical Relevance for Breast Cancer Staging

    Directory of Open Access Journals (Sweden)

    Laila Nomani

    2016-01-01

    Full Text Available Establishment of accurate axillary lymph node status is of essential importance in determining both prognosis and the potential need for adjuvant therapy in patients with invasive breast cancer. Axillary lymph node heterotopias can in some cases result in overdiagnosis of metastatic disease. Nodal endosalpingiosis is perhaps the least commonly reported type of axially lymph node heterotopia. We herein illustrate a case in which second opinion pathologic interpretation combined with ancillary immunohistochemical studies allowed for a specific diagnosis of axillary nodal müllerian-type inclusions, confirming ypN0 staging and resulting in appropriate disease management and prognostication.

  2. Endosalpingiosis of Axillary Lymph Nodes: A Rare Histopathologic Pitfall with Clinical Relevance for Breast Cancer Staging

    Science.gov (United States)

    Nomani, Laila; Calhoun, Benjamin C.; Biscotti, Charles V.; Grobmyer, Stephen R.; Sturgis, Charles D.

    2016-01-01

    Establishment of accurate axillary lymph node status is of essential importance in determining both prognosis and the potential need for adjuvant therapy in patients with invasive breast cancer. Axillary lymph node heterotopias can in some cases result in overdiagnosis of metastatic disease. Nodal endosalpingiosis is perhaps the least commonly reported type of axially lymph node heterotopia. We herein illustrate a case in which second opinion pathologic interpretation combined with ancillary immunohistochemical studies allowed for a specific diagnosis of axillary nodal müllerian-type inclusions, confirming ypN0 staging and resulting in appropriate disease management and prognostication. PMID:27088025

  3. Report of an unusual combination of arterial, venous and neural variations in a cadaveric upper limb.

    Science.gov (United States)

    Troupis, Theodore G; Michalinos, Adamantios; Manou, Vasiliki; Vlastos, Dimitrios; Johnson, Elizabeth O; Demesticha, Theano; Skandalakis, Panayiotis

    2014-01-01

    In this study an unusual combination of arterial, venous and neural variations discovered during dissection of cervical, axillary and brachial area of a cadaver is described. Variations are thoroughly described and literature is briefly reviewed. Lateral cord of brachial plexus was not formed; Eight Cervical root divided into anterior and posterior division before uniting with First Thoracic root and Upper Trunk was unusually short. Axillary artery gave origin to a superficial brachial artery and then continued as deep brachial artery. Multiple variations in typical axillary artery branches were present including existence of inferior pectoral artery. Cephalic vein was absent. A variety of interventions, from relative simple as central venous catheter placement to most complicated as brachial plexus injury repair demand thorough knowledge of area's regional anatomy. Familiarity with anatomic variations allows more precise and careful interventions. Research on these variations is valuable for anatomists and embryologists but also for clinicians because it may provide useful information for non - typical cases but also helps in raising a high level of suspicion.

  4. The surgical importance of an axillary arch in sentinel node biopsy.

    LENUS (Irish Health Repository)

    Ridgway, P F

    2011-03-01

    When Carl Langer described the aberrant axillary arch in 1846 its relevance in sentinel node biopsy (SNB) surgery could not have been contemplated. The authors define an incidence and elucidate relevance of the arch in SNB of the axilla.

  5. Peripheral communications of intercostobrachial nerve Peripheral communications of the intercostobrachial nerve in relation to the alar thoracic artery.

    Science.gov (United States)

    Rustagi, Shaifaly Madan; Sharma, Mona; Singh, Nidhi; Mehta, Vandana; Suri, Rajesh K; Rath, Gayatri

    2015-01-01

    The intercostobrachial nerve (ICBN) is often encountered during axillary dissection for axillary lymph node dissection (ALND) for diagnostic and therapeutic surgery for mastectomy. The present report is a case observed in the Department of Anatomy at Vardhman Mahavir Medical College, Delhi during routine dissection of the upper extremity of a male cadaver for first year undergraduate medical students. On the right side, the medial cord of brachial plexus gave two medial cutaneous nerves of arm. Both the nerves were seen communicating with the branches of the ICBN. The ICBN and one of its branches were surrounding the termination of an alar thoracic artery. These peripheral neural connections of the ICBN with the branches of the medial cord can be a cause of sensory impairment during axillary procedures done for mastectomy or exploration of long thoracic nerves. The alar thoracic artery found in relation to the ICBN could further be a cause of vascular complications during such procedures.

  6. Peripheral communications of intercostobrachial nerve Peripheral communications of the intercostobrachial nerve in relation to the alar thoracic artery

    Directory of Open Access Journals (Sweden)

    Shaifaly Madan Rustagi

    2015-01-01

    Full Text Available The intercostobrachial nerve (ICBN is often encountered during axillary dissection for axillary lymph node dissection (ALND for diagnostic and therapeutic surgery for mastectomy. The present report is a case observed in the Department of Anatomy at Vardhman Mahavir Medical College, Delhi during routine dissection of the upper extremity of a male cadaver for first year undergraduate medical students. On the right side , the medial cord of brachial plexus gave two medial cutaneous nerves of arm. Both the nerves were seen communicating with the branches of the ICBN. The ICBN and one of its branches were surrounding the termination of an alar thoracic artery. These peripheral neural connections of the ICBN with the branches of the medial cord can be a cause of sensory impairment during axillary procedures done for mastectomy or exploration of long thoracic nerves. The alar thoracic artery found in relation to the ICBN could further be a cause of vascular complications during such procedures.

  7. A comparison of axillary with rectal thermometry in under 5 children

    Directory of Open Access Journals (Sweden)

    B O Edelu

    2011-01-01

    Full Text Available Background: Body temperature measurement is a crucial clinical assessment in the care of an acutely ill child, especially the under fives. Most temperature measurements in our hospital are done from the axilla. Objective: To study the relationship between temperatures taken in the axilla with those taken in the rectum in febrile and afebrile children less than 5 years. Materials and Methods: Rectal and axillary temperatures were taken concurrently in 400 febrile and 400 afebrile children aged less than 5 years using mercury-in-glass thermometers. Result: The rectal temperature measurements ranged from 38.0 to 41.4°C and 36.4 to 37.9°C in the febrile and afebrile groups of children respectively while the axillary temperatures ranged from 36.7 to 41.0°C and 35.9 to 37.5°C in the febrile and afebrile groups of children, respectively. There were significant differences between the temperatures measured at the two sites in all the age groups studied. There was good positive correlation between the rectal and axillary temperatures. A linear relationship between axillary and rectal temperatures was derived using the simple regression analysis. The equation is: rectal temperature = 0.94×axillary temperature+2.92. Conclusion: Although there′s good correlation between axillary and rectal temperatures, significant difference exits between them that cannot be explained by the addition of any single value or any particular equation.

  8. Fibroadenoma of the axillary accessory breast: diagnostic value of dynamic magnetic resonance imaging.

    Science.gov (United States)

    Sawa, Munehisa; Kawai, Nobuyuki; Sato, Morio; Takeuchi, Taizo; Tamaki, Takeshi; Oura, Shoji

    2010-10-01

    Accessory breast is synonymous with polymastia or supernumerary breast tissue. An accessory breast without a nipple or areola is rare. We report a case of fibroadenoma of an accessory breast with no nipple or areola in a 41-year-old woman who presented with a right axillary mass associated with five small nodules in the normally situated breast. Magnetic resonance imaging (MRI) showed the accessory breast surrounding the tumor. We ignored the presence of the component surrounding the mass and made a preoperative diagnosis of an axillary mass of possible metastases from multiple breast cancers or breast cancer of unknown origin associated with multiple breast fibroadenomas. From a retrospective view, based on the histological results, MRI and dynamic MRI demonstrated a tiny component of breast-like tissue surrounding the axillary mass and an enhancement pattern typical of fibroadenoma for the axillary mass. For the later diagnosis of the axillary mass, the interpretation of whether the component of breast tissue surrounding the axillary mass was present is crucial. If the component exists, a tumor that originated from the accessory breast should be foremost in the differential diagnosis. Dynamic MRI appears to contribute to the diagnosis of fibroadenoma of an accessory breast before biopsy or surgical resection.

  9. Axillary versus peripheral blood levels of sialic acid, ferritin, and CEA in patients with breast cancer.

    Science.gov (United States)

    Monti, M; Catania, S; Locatelli, E; Gandini, R; Reggiani, A; Cunietti, E

    1990-12-01

    Serum levels of total sialic acid, carcinoembryonic antigen (CEA), ferritin, lactate dehydrogenase, and creatine phosphokinase were measured both in tumor drainage blood (axillary vein) and in peripheral blood obtained from 121 breast cancer patients during surgery. No significant differences between mean values in peripheral and tumor draining blood, between cancer patients and healthy controls, or between patients with or without axillary lymph node metastases were found for any of the markers. Both ferritin and CEA levels were higher in axillary and peripheral blood from patients with central breast cancer versus other sites but the difference was significant only for CEA (p less than 0.05). CEA levels were significantly higher (p less than 0.01) in patients with greater than 2 cm diameter carcinomas versus T1 stage patients in axillary but not in peripheral blood. When the cephalic vein was clamped before the axillary sample was taken, ferritin showed a significant increase (p less than 0.05). We conclude that measurement of sialic acid, CEA, and ferritin in axillary venous blood in breast cancer patients is not of clinical benefit, although further data are needed to clarify whether other advantages can be derived.

  10. Axillary node metastatic carcinoma without definitive primary: a case report

    Directory of Open Access Journals (Sweden)

    Spencer R. Anderson

    2016-01-01

    Full Text Available Cancer of unknown primary (CUP is the finding of a metastatic cancerous lesion without an established primary source localized within the body. CUP can be of any cancer cell type, however, adenocarcinoma is most often identified by histology. Up to 5% of all malignant diagnoses are classified as CUP. PET is an imaging modality often utilized to distinguish a primary source in the setting of CUP, yet often a primary is never identified. CUP can be further stratified using specific qualifiers as favorable and unfavorable, indicating the potential therapeutic response to treatment regimens. Treatment approach to CUP relies heavily on the cell type identified by histology, the location of the lesion, and the amount of spread within the body. In the typical setting and presentation, per current literature, CUP arises in the 7th decade of life in patients with multiple comorbidities, and often has a poor prognostic value. This case report identifies an atypical presentation of CUP, a 38-year-old Caucasian female with an axillary mobile mass, and no associated systemic symptoms. Biopsy of the node and immunohistochemical staining showed histology consistent with metastatic carcinoma. Mammography, MRI, and PET scan found no evidence of tumor primary or distant metastasis. Further staining confirmed metastatic carcinoma consistent with breast origin, without an established breast primary. As in this case, CUP may present in an atypical manner, warranting a thorough investigation aiming to identify the tumor primary to aid in identification of a proper treatment regimen and approach.

  11. Ex vivo MRI of axillary lymph nodes in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Luciani, Alain [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France)], E-mail: luciani@hmn.ap-hop-paris.fr; Pigneur, Frederic [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Ghozali, Faridah [Department of Pathology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Dao, Thu-Ha [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Cunin, Patrick [Unite de Recherche Clinique, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Meyblum, Evelyne [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); De Baecque-Fontaine, Cecile [Department of Pathology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Alamdari, Ali [Department of Plastic Surgery, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Maison, Patrick [Unite de Recherche Clinique, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Deux, Jean Francois [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Lagrange, Jean Leon [Department of Radiotherapy, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Lantieri, Laurent [Department of Plastic Surgery, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Rahmouni, Alain [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France)

    2009-01-15

    Purpose: To provide a strategy for precise co-localization of lymph nodes on axillary lymph-node dissection (ALND) specimens both on pathology and MR. To identify nodal features suggestive of metastatic involvement on a node-to-node basis. Materials and methods: National Institutional review-board approved this prospective study of 18 patients with breast cancer referred for ALND. Ex vivo T1 and inversion recovery (IR) T2 WI of ALND specimens tightly positioned within scaled plastic cranes was performed immediately after surgery. The correspondence of MR-based or pathologically based nodes location was assessed. The MR size and morphological presentation of metastatic and normal nodes were compared (Student's t-test or Mann-Whitney test). Quantitative variables were compared using Pearson coefficient. Results: 207 nodes were retrieved on pathology and 165 on MR. MR-pathological correlation of nodes location was high regarding MR-identified nodes (r = 0.755). An MR short axis threshold of 4 mm yielded the best predictive value for metastatic nodal involvement (Se = 78.6%; Sp = 62.3%). Irregular contours (Se = 35.7%; Sp = 96.7%), central nodal hyper-intensity on IR T2 WI (Se = 57.1%; Sp = 91.4%), and a cortical thickness above 3 mm (Se = 63.6%; Sp = 83.2%) were significantly associated with metastatic involvement. Conclusion: Ex vivo MR allows node-to-node correlation with pathology. Morphological MR criteria can suggest metastatic involvement.

  12. Characterization of MORE AXILLARY GROWTH genes in Populus.

    Directory of Open Access Journals (Sweden)

    Olaf Czarnecki

    Full Text Available Strigolactones are a new class of plant hormones that play a key role in regulating shoot branching. Studies of branching mutants in Arabidopsis, pea, rice and petunia have identified several key genes involved in strigolactone biosynthesis or signaling pathway. In the model plant Arabidopsis, MORE AXILLARY GROWTH1 (MAX1, MAX2, MAX3 and MAX4 are four founding members of strigolactone pathway genes. However, little is known about the strigolactone pathway genes in the woody perennial plants.Here we report the identification of MAX homologues in the woody model plant Populus trichocarpa. We identified the sequence homologues for each MAX protein in P. trichocarpa. Gene expression analysis revealed that Populus MAX paralogous genes are differentially expressed across various tissues and organs. Furthermore, we showed that Populus MAX genes could complement or partially complement the shoot branching phenotypes of the corresponding Arabidopsis max mutants.This study provides genetic evidence that strigolactone pathway genes are likely conserved in the woody perennial plants and lays a foundation for further characterization of strigolactone pathway and its functions in the woody perennial plants.

  13. Initiation of Begonia erythrophylla L. vitroculture from axillary buds

    Directory of Open Access Journals (Sweden)

    Julieta - Emilia ROMOCEA

    2010-11-01

    Full Text Available In our aim was to establish a short-term in vitro culture of Begonia erythrophylla L., different culture media compositions were tested: complex variants added with growth regulators and simplified modified media with Heller microelements and MS macroelements. Adventitious shoots elongating over 13 mm in length were efficiently obtained from axillary bud segments of the strain of begonia Begonia erythrophylla L. on MS basic mineral medium culture containing different concentration of growth regulators, in order to identify optimal culture conditions, which would facilitate the achievement of a vitroculture, allowing the in vitro culture of this studied species. On complex regeneration variant V1 – mineral basic medium culture MB - MS supplemented with 1 mg/l BA, the rooting process was absent, but according to this carried out research, plantlets were obtained by rooting the elongated shoots on Murashige-Skoog (1962 basic mineral media containing 1 mg/l IBA, respectively a basic mineral medium culture without growth regulators, producing a much better organogenesis, where the phenomenon was greater in rooting process.

  14. [Bilateral axillary nodes. 30-year-old patient, housewife].

    Science.gov (United States)

    Rodak, R; Ramseier, E

    2007-11-14

    A 20-year old patient who had been adequately treated for lymph node tuberculosis 14 years ago presented 1 week after giving birth to a healthy daughter. She complained about painful lumps in both axillae. During pregnancy the patient suffered from hyperemesis gravidarum, lost 6 kg of weight, and had night sweats. During the last three months of her pregnancy she had a deep vein thrombosis in her right lower leg. The clinical examination showed soft axillary lumps up to 3 cm. The lab showed the following pathological findings: blood sedimentation rate 51 mm/h, CRP 44.8 mg/l, LDH 221 U/l and INR 1.3 (indicating insufficient anticoagulation with phenprocoumon). The chest x-ray showed no infiltrate or indications of a past tuberculosis. A fine needle aspiration cytology was performed on an accessible node. Gram stain, Ziehl Neelsen stain, as well as the bacteriological cultures were all negative. An ultrasound examination of the axilla showed a thickened subcutis without a mass. Cytology showed lobular epithelium, consistent wih ductal mamma epithelium without atypical cells. The diagnosis of an accessory mamma tissue in both axillae was made. During the course of the following weeks the glands decreased in size and the patient was free of symptoms.

  15. Contribution of minute axillary lymph nodes to accurate staging for patients with breast cancer

    Institute of Scientific and Technical Information of China (English)

    JIANG Jun; HE Qing-qing; YANG Xin-hua; LIANG Yan; FAN Lin-jun; ZHANG Yi; GUO Mei-qin

    2007-01-01

    Background Axillary lymph node metastasis is a very important metastatic pathway in breast cancer and its accurate detection is important for staging tumour and guiding therapy. However, neither the accuracy of routine detection of lymph node in surgical specimens nor the significance of minute lymph node with metastases in breast cancer is clear. A modified method for conveniently detecting minute lymph node in specimens of axillary dissections in patients with breast cancer was used to analyze their influence on staging breast cancer.Methods Lymph nodes in fresh, unfixed, specimens of axillary dissections from 127 cases of breast cancer were detected routinely. Then the axillary fatty tissues were cut into 1 cm thick pieces, soaked in Carnoy's solution for 6 to 12 hours, taken out and put on a glass plate. Minute lymph nodes were detected by light of bottom lamp and examined by routine pathology.Results Lymph nodes (n= 2483, 19.6±8.0 per case) were found by routine method. A further 879 lymph nodes up to 6 mm (781 < 3 mm, 6.9±5.3 per case, increasing mean to 26.5±9.7) were found from the axillary tissues after soaking in Carnoy's solution. By detection of minute lymph nodes, the stages of lymph node metastasis in 7 cases were changed from pathological node (pN) stage pN0 to pN1 in 4 cases, from pN1 to pN2 in 2 and from pN2 to pN3 in 1.Conclusions The accurate staging of axillary lymph node metastasis can be obtained routinely with number of axillary lymph nodes in most cases of breast cancer. To avoid neglecting minute lymph nodes with metastases, small axillary nodes should be searched carefully in the cases of earlier breast cancer with no swollen axillary nodes. Treatment with Carnoy's solution can expediently detect minute axillary nodes and improve the accurate staging of lymph nodes in breast cancer.

  16. A comparative clinical study of different hair removal procedures and their impact on axillary odor reduction in men

    OpenAIRE

    Lanzalaco, Anthony; Vanoosthuyze, Kristina; Stark, Cynthia; Swaile, David; Rocchetta, Heather; Spruell, Russell

    2015-01-01

    Summary Background Axillary hair can influence the development of underarm odor in men. Objective To compare different hair removal procedures and their impact on the effectiveness of standard soap washing (SW) in reducing male axillary odor. Methods The axillae of healthy Caucasian males (N = 30; 18–48 years of age) were randomized in a noncrossover, split body design. Two of four axillary treatments were evaluated per subject: clipped with scissors; wet shaved with a razor; waxed; and untre...

  17. An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2009-07-01

    Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block.

  18. Toxoplasmosis presenting as a swelling in the axillary tail of the breast and a palpable axillary lymph node mimicking malignancy: a case report

    Directory of Open Access Journals (Sweden)

    Kamel Dia

    2011-08-01

    Full Text Available Abstract Introduction Lymphadenopathy is a common finding in toxoplasmosis. A breast mass due to toxoplasmosis is very rare, and only a few cases have been reported. We present a case of toxoplasmosis that presented as a swelling in the axillary tail of the breast with a palpable axillary lymph node which mimicked breast cancer. Case presentation A 45-year-old otherwise healthy Caucasian woman presented with a lump on the lateral aspect of her left breast. Her mother had breast cancer that was diagnosed at the age of 66 years. During an examination, we discovered that our patient had a discrete, firm lump in the axillary tail of her left breast and an enlarged, palpable lymph node in her left axilla. Her right breast and axilla were normal. The clinical diagnosis was malignancy in the left breast. Ultrasound and mammographic examinations of her breast suggested a pathological process but were not conclusive. She had targeted fine-needle aspiration cytology (FNAC and core biopsy of the lesions. FNAC was indeterminate (C3 but suggested a possibility of toxoplasmosis. The core biopsy was not suggestive of malignancy but showed granulomatous inflammation. She had a wide local excision of the breast lump and an axillary lymph node biopsy. Histopathology and immunohistochemical studies excluded carcinoma or lymphoma but suggested the possibility of intramammary and axillary toxoplasmic lymphadenopathy. The results of Toxoplasma gondii IgM and IgG serology tests were positive, supporting a diagnosis of toxoplasmosis. Conclusions Toxoplasmosis rarely presents as a pseudotumor of the breast. FNAC and histology are valuable tools for a diagnosis of toxoplasmosis, and serology is an important adjunct for confirmation.

  19. Multiple levels paravertebral block versus morphine patient-controlled analgesia for postoperative analgesia following breast cancer surgery with unilateral lumpectomy, and axillary lymph nodes dissection

    Directory of Open Access Journals (Sweden)

    Summayah Fallatah

    2016-01-01

    Full Text Available Background: Postoperative pain after breast cancer surgery is not uncommon. Narcotic based analgesia is commonly used for postoperative pain management. However, the side-effects and complications of systemic narcotics is a significant disadvantage. Different locoregional anesthetic techniques have been tried including, single and multiple levels paravertebral block (PVB, which seems to have a significant reduction in immediate postoperative pain with fewer side-effects. The aim of this study was to compare unilateral multiple level PVB versus morphine patient-controlled analgesia (PCA for pain relief after breast cancer surgery with unilateral lumpectomy and axillary lymph nodes dissection. Materials and Methods: Forty patients scheduled for breast cancer surgery were randomized to receive either preoperative unilateral multiple injections PVB at five thoracic dermatomes (group P, 20 patients or postoperative intravenous PCA with morphine (group M, 20 patients for postoperative pain control. Numerical pain scale, mean arterial pressure, heart rate, Time to first analgesic demand, 24-h morphine consumption side-effects and length of hospital stay were recorded. Results: PVB resulted in a significantly more postoperative analgesia, maintained hemodynamic, more significant reduction in nausea and vomiting, and shorter hospital stay compared with PCA patients. Conclusion: Multiple levels PVB is an effective regional anesthetic technique for postoperative pain management, it provides superior analgesia with less narcotics consumption, and fewer side-effects compared with PCA morphine for patients with breast cancer who undergo unilateral lumpectomy, with axillary lymph nodes dissection.

  20. Micropropagation of Paulownia fortuneii through in vitro axillary shoot proliferation.

    Science.gov (United States)

    Venkateswarlu, B; Mukhopadhyay, J; Sreenivasan, E; Kumar, V M

    2001-06-01

    Primary cultures were established with nodal segments from juvenile shoots of two- year-old Paulownia fortuneii trees from a clonal plantation in Andhra Pradesh. A medium containing half-strength MS salts + RAP (1 mg/L) + sucrose (2%) produced optimum bud break in nodal explants. The same basal medium with reduced hormone level (0.5 mg/L) supported maximum multiplication of secondary cultures of P. fortuneii (1:6 in 6 weeks). Specific treatments were tested to enhance this rate of multiplication. In one approach, five to six week old in vitro grown shoots were ratooned (cutting the main shoot at the bottom leaving one node). The stumps (ratooned basal node) produced 2 to 3 axillary shoots, which grew into 4 to 5 nodes by 3 weeks; thus, providing additional shoots from the same explant. This provided 30% additional shoots in 4 cycles. Secondly, reducing the light intensity to 1200 lux resulted in higher shoot elongation, i.e, formation of 8 nodes in 5 weeks with healthier shoots than the normal intensity of 3000 lux under which only 6 nodes were produced in 6 weeks. In vitro-grown shoots could be successfully rooted ex vitro in vermiculite + cocopeat mixture (1:1 v/v) under 90% humidity, transferred to soil in polybags for hardening in the green house for 2 weeks and shifted to shade net for further hardening. After one month, the plants could be successfully transplanted to field with 95% survival. Micropropagated plants showed an excellent growth in the field attaining a height of 1.5 m and a collar diameter of 2.8 cm in 3 months.

  1. Traumatiske laesioner af a. axillaris og a. brachialis

    DEFF Research Database (Denmark)

    Bitsch, M; Hensler, M K; Schroeder, T V

    1994-01-01

    accidents. Only one case was due to violence. Four patients appeared to be intoxicated with alcohol. Fifteen patients were treated surgically, 12 with vascular reconstruction. One patient was treated conservatively. At the time of discharge all extremities were assessed as having normal arterial supply...

  2. Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients

    Science.gov (United States)

    Tanis, P J; Nieweg, O E; Valdés Olmos, R A; Peterse, J L; Rutgers, E J Th; Hoefnagel, C A; Kroon, B B R

    2002-01-01

    The purpose of this study was to evaluate the occurrence of lymphatic drainage to non-axillary sentinel nodes and to determine the implications of this phenomenon. A total of 549 breast cancer patients underwent lymphoscintigraphy after intratumoural injection of 99mTc-nanocolloid. The sentinel node was intraoperatively identified with the aid of intratumoural administered patent blue dye and a gamma-ray detection probe. Histopathological examination of sentinel nodes included step-sectioning at six levels and immunohistochemical staining. A sentinel node outside level I or II of the axilla was found in 149 patients (27%): internal mammary sentinel nodes in 86 patients, other non-axillary sentinel nodes in 44 and both internal mammary and other non-axillary sentinel nodes in nineteen patients. The intra-operative identification rate was 80%. Internal mammary metastases were found in seventeen patients and metastases in other non-axillary sentinel nodes in ten patients. Staging improved in 13% of patients with non-axillary sentinel lymph nodes and their treatment strategy was changed in 17%. A small proportion of clinically node negative breast cancer patients can be staged more precisely by biopsy of sentinel nodes outside level I and II of the axilla, resulting in additional decision criteria for postoperative regional or systemic therapy. British Journal of Cancer (2002) 87, 705–710. doi:10.1038/sj.bjc.6600359 www.bjcancer.com © 2002 Cancer Research UK PMID:12232750

  3. Percutaneous Intervention in Axillary Loop-Configured Arteriovenous Grafts for Chronic Hemodialysis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Park, Beom Jin; Chung, Hwan Hoon; Sung, Deuk Jae; Park, Sang Joon; Son, Ho Sung; Jo, Sang Kyung; Kim, Yun Hwan; Cho, Sung Bum [College of Medicine, Korea University, Seoul (Korea, Republic of); Kim, Hyoung Rae [Kangwon National University, Chuncheon (Korea, Republic of)

    2010-04-15

    The purpose of this study was to evaluate the fistulographic features of malfunctioning axillary loop-configured arteriovenous grafts and the efficacy of percutaneous interventions in failed axillary loop-configured arteriovenous grafts. Ten patients with axillary loop-configured arteriovenous grafts were referred for evaluation of graft patency or upper arm swelling. Fistulography and percutaneous intervention, including thrombolysis, percutaneous transluminal angioplasty and stent placement, were performed. Statistical analysis of the procedure success rate and the primary and secondary patency rates was done. Four patients had graft related and subclavian venous stenosis, two patients had graft related stenosis and another four patients had subclavian venous stenosis only. Sixteen sessions of interventional procedures were performed in eight patients (average: 2 sessions / patient) until the end of follow-up. An interventional procedure was not done in two patients with central venous stenosis. The overall procedure success rate was 69% (11 of 16 sessions). The post-intervention primary and secondary patency rates were 50% and 63% at three months, 38% and 63% at six months and 25% and 63% at one year, respectively. Dysfunctional axillary loop-configured arteriovenous grafts almost always had subclavian venous and graft-related stenosis. Interventional treatments are helpful to overcome this and these treatments are expected to play a major role in restoring and maintaining the axillary loop-configured arteriovenous loop grafts

  4. Comparison of rectal, tympanic membrane and axillary temperature measurement methods in dogs.

    Science.gov (United States)

    Lamb, V; McBrearty, A R

    2013-11-30

    The aim of this study was to compare axillary and tympanic membrane (TM) temperature measurements to rectal temperature in a large group of clinical canine patients. We also sought to ascertain whether certain factors affected the differences between the measurements and to compare the ease of measurement. Axillary temperatures were easy to obtain but tended to be lower than rectal readings (median difference 0.6°C). In 54.7 per cent of dogs there was a difference of >0.5°C between the two readings. Weight, coat length, body condition score and breed size were significantly associated with the difference between the rectal and axillary temperature. TM temperatures were more similar to rectal temperatures (median difference 0°C) but in 25 per cent of dogs, there was a difference of >0.5°C between rectal and TM readings. TM measurements were less well tolerated than axillary measurements. None of the factors assessed were associated with the difference between the rectal and TM temperature. As a difference of >0.5°C has previously been described as unacceptable for different methods of temperature measurement, neither axillary nor TM temperatures are interchangeable with rectal temperatures for the measurement of body temperature.

  5. Local injection of botulinum toxin A: an alternative therapy for axillary osmidrosis.

    Science.gov (United States)

    Xie, Aiguo; Nie, Lanjun; Tan, Qian

    2014-02-01

    The objective of this study was to investigate the efficacy of local injection of botulinum toxin A for treating axillary osmidrosis. One hundred and fifty patients with axillary osmidrosis were randomly divided to receive botulinum toxin A injection treatment (50 U of botulinum toxin A was injected intracutaneously into 6-20 different sites within each axilla, n = 74) or surgical excision of the apocrine glands (n = 76). The patients were followed up for 1-3 months to analyze the therapeutic effect and complications of the two methods. The curative effect in patients with mild and moderate axillary osmidrosis was not significantly different between the botulinum toxin A injection group and operation group. However, for patients with severe axillary osmidrosis, surgery treatment seemed to be superior to botulinum toxin A treatment (P = 0.005). There was also no significant difference in the modified Dermatology Life Quality Index between the two treatments. Two cases showed complications related to hemorrhage and incision infection in the operation group. In conclusion, local injection of botulinum toxin A is a safe, fast and effective treatment for mild and moderate axillary osmidrosis, but the long-term effect remains to be further investigated.

  6. Acute arterial occlusion - kidney

    Science.gov (United States)

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  7. Novel Axillary Approach for Brachial Plexus in Robotic Surgery: A Cadaveric Experiment

    Directory of Open Access Journals (Sweden)

    Cihangir Tetik

    2014-01-01

    Full Text Available Brachial plexus surgery using the da Vinci surgical robot is a new procedure. Although the supraclavicular approach is a well known described and used procedure for robotic surgery, axillary approach was unknown for brachial plexus surgery. A cadaveric study was planned to evaluate the robotic axillary approach for brachial plexus surgery. Our results showed that robotic surgery is a very useful method and should be used routinely for brachial plexus surgery and particularly for thoracic outlet syndrome. However, we emphasize that new instruments should be designed and further studies are needed to evaluate in vivo results.

  8. Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?

    Science.gov (United States)

    Nitsche, Mirko; Hermann, Robert

    2011-10-01

    At the moment, positive sentinel lymph node dissection (SLND) of the axilla is followed by axillary lymph node dissection (ALND) as standard of care. Recent data proves that omitting ALND after positive SLND in clinically lymph node-negative early stage breast cancer patients is feasible with low recurrence rates. The well known effect of radiotherapy to destroy occult tumor cells highly contributes to these results as a large extent of level I and II lymph nodes are unavoidably included in standard tangential radiation treatment fields. Reviewing the up to date published data on axillary lymph node treatment with radiotherapy, we hypothesize that full dosage coverage of level I and II of the axilla in early stage breast cancer will improve outcome and should be further evaluated.

  9. Tumour location and axillary lymph node involvement in breast cancer: a series of 3472 cases from Sweden

    DEFF Research Database (Denmark)

    Manjer, J; Balldin, G; Garne, J P

    2004-01-01

    AIM: This study investigates the potential relation between breast cancer location and axillary lymph node involvement (ALNI). METHODS: Out of all cases with unilateral first-time diagnosis of invasive breast cancer in Malmö, Sweden, between 1961 and 1991, 3472 underwent axillary dissection. The .......19-2.18), and for central tumours 3.50 (2.32-5.28). CONCLUSIONS: Outer and central breast tumours are associated with a high risk of axillary lymph node involvement. Udgivelsesdato: 2004-Aug......AIM: This study investigates the potential relation between breast cancer location and axillary lymph node involvement (ALNI). METHODS: Out of all cases with unilateral first-time diagnosis of invasive breast cancer in Malmö, Sweden, between 1961 and 1991, 3472 underwent axillary dissection...

  10. Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?

    OpenAIRE

    Nitsche, Mirko; Hermann, Robert

    2011-01-01

    At the moment, positive sentinel lymph node dissection (SLND) of the axilla is followed by axillary lymph node dissection (ALND) as standard of care. Recent data proves that omitting ALND after positive SLND in clinically lymph node-negative early stage breast cancer patients is feasible with low recurrence rates. The well known effect of radiotherapy to destroy occult tumor cells highly contributes to these results as a large extent of level I and II lymph nodes are unavoidably included in s...

  11. Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: Diagnostic accuracy and impact on management

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Ortega, Maria Jose, E-mail: rserranogan@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Alvarez Benito, Marina, E-mail: marinaalvarezbenito@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Fuentes Vahamonde, Elena, E-mail: elena.fuentes.sspa@juntadeandalucia.es [Pathology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Rioja Torres, Pilar, E-mail: priojat@yahoo.es [Clinical Management Unit, Department of General and Digestive Surgery, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Benitez Velasco, Ana, E-mail: abvelazco@yahoo.es [Nuclear Medicine Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Martinez Paredes, Maria, E-mail: mariaparedes@uco.es [Radiology and Physical Medicine Area, University of Cordoba Medical School, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain)

    2011-07-15

    Preoperative diagnosis of axillary metastases in breast cancer patients enables treatment planning. We aimed to evaluate the diagnostic accuracy of axillary ultrasonography and percutaneous biopsy, both alone and in combination, in detecting axillary metastases in patients with breast cancer and to assess the impact of these techniques on the patients' management. Materials and methods: Retrospective study of consecutive patients with suspected breast cancer examined between October 2006 and December 2008. The diagnosis of a primary tumor was histologically confirmed in all patients. All patients underwent axillary ultrasonography and percutaneous core biopsy (14G) of suspicious lymph nodes. We evaluated the morphological characteristics of the lymph nodes by ultrasonography. We calculated the diagnostic accuracy of ultrasonography and of core biopsy, and assessed the impact of these techniques on patients' treatment. Results: We evaluated 675 axillary regions and performed 291 core biopsies of axillary lymph nodes in 662 patients. In 650 patients, breast cancer was histologically confirmed and in 12 patients malignant tumors in other locations were confirmed. The sensitivity and specificity of axillary ultrasonography were 63.2% and 88.7%, respectively. The absence of a fatty hilum within the lymph node was the ultrasonographic finding with the highest positive predictive value for malignancy (93.1%). The sensitivity and specificity of axillary core biopsy were 69.1% and 100%, respectively. Sentinel lymph node biopsy was avoided in 33% of initial candidates and immediate breast reconstruction was undertaken in 35.1% of the patients with mastectomy and negative axillary core biopsy. Conclusions: Ultrasonography and axillary core biopsy enable adequate pretreatment staging in patients with breast cancer and has a positive impact on their management.

  12. A CASE REPORT OF MULTIPLE ARTERIAL ANOMALIES IN A CADAVE R

    Directory of Open Access Journals (Sweden)

    Anbumani

    2015-03-01

    Full Text Available During routine dissection in our department, multiple arterial variations were observed in a cadaver. The following arterial variations are present. They are, superficial brachioulnar artery, which originated at the level of junction of upper and middle th ird of arm. It runs a superficial course anterior to median nerve in the arm and terminates in the formation of superficial palmar arch. The brachial artery terminated as radial and common interosseous artery. Subscapular artery and circumflex humeral arte ry arose as a common trunk from the third part of axillary artery. The circumflex humeral artery later divides into anterior circumflex humeral and posterior circumflex humeral arteries. The right common carotid artery bifurcated into internal carotid arte ry anteromedially and external carotid artery posterolaterally at the level of upper lamin a of th yroid cartilage. A proper knowledge of variations in the arterial pattern is a must for a good treatment outcome, especially in the fields like vascular surge ry, reconstructive surgery, cardiac surgery, angiogram, arterial cannulation, arterio - venous fistula for renal dialysis. etc.

  13. SlARF2a plays a negative role in mediating axillary shoot formation

    Science.gov (United States)

    Xu, Tao; Liu, Xin; Wang, Rong; Dong, Xiufen; Guan, Xiaoxi; Wang, Yanling; Jiang, Yun; Shi, Zihang; Qi, Mingfang; Li, Tianlai

    2016-01-01

    SlARF2a is expressed in most plant organs, including roots, leaves, flowers and fruits. A detailed expression study revealed that SlARF2a is mainly expressed in the leaf nodes and cross-sections of the nodes indicated that SlARF2a expression is restricted to vascular organs. Decapitation or the application of 6-benzylaminopurine (BAP) can initially promote axillary shoots, during which SlARF2a expression is significantly reduced. Down-regulation of SlARF2a expression results in an increased frequency of dicotyledons and significantly increased lateral organ development. Stem anatomy studies have revealed significantly altered cambia and phloem in tomato plants expressing down-regulated levels of ARF2a, which is associated with obvious alterations in auxin distribution. Further analysis has revealed that altered auxin transport may occur via altered pin expression. To identify the interactions of AUX/IAA and TPL with ARF2a, four axillary shoot development repressors that are down-regulated during axillary shoot development, IAA3, IAA9, SlTPL1 and SlTPL6, were tested for their direct interactions with ARF2a. Although none of these repressors are directly involved in ARF2a activity, similar expression patterns of IAA3, IAA9 and ARF2a implied they might work tightly in axillary shoot formation and other developmental processes. PMID:27645097

  14. Effect of axillary blockade on regional cerebral blood flow during static handgrip

    DEFF Research Database (Denmark)

    Friedman, D B; Friberg, L; Mitchell, J H

    1991-01-01

    . Median handgrip force during the control study was 41 (range 24-68) N, which represented 10% of the initial maximal voluntary contraction (MVC) and was 24 (18-36) N after axillary blockade (P less than 0.05), which represented 21% of the new MVC. During static handgrip, the rating of perceived exertion...

  15. Impacts of Choerospondias axillaris Growth on Acidity of Udic Ferrosols in Subtropical China

    Institute of Scientific and Technical Information of China (English)

    LI Qing-Man; WANG Xing-Xiang; BI Shu-Ping

    2005-01-01

    Changes in acidity of Udic Ferrosols, caused by growth of Choerospondias axillaris (Roxb.) Burtt et Hill, in comparison to wild grass, were investigated for pH distribution in the soil profile, exchangeable acidity, and cation status in the soil leachate of a simulated leaching experiment. Soils were sampled in profiles at 5 cm intervals to a depth of 100 cm. In the15-60 cm layer the soils with 10-year old C. axillaris had significantly lower pH (P < 0.05), with the largest difference being 0.41; and in the 25-75 cm soil depths, especially in the 30-55 cm layer, the soils had a significantly higher exchangeable acidity, ranging 1.93 to 3.02 cmolc kg-1. There was also higher aluminum, potassium, and sodium contents in the soil leachate under C. axillaris than with wild grasses. This suggested that the growth of C. axillaris accelerated acidification of Udic Ferrosols and promoted soil clay mineral weathering.

  16. Ultrasound-guided block of the axillary nerve: a volunteer study of a new method

    DEFF Research Database (Denmark)

    Rothe, C; Asghar, S; Andersen, H L;

    2011-01-01

    Interscalene brachial plexus block (IBPB) is the gold standard for perioperative pain management in shoulder surgery. However, a more distal technique would be desirable to avoid the side effects and potential serious complications of IBPB. Therefore, the aim of the present study was to develop a...... and describe a new method to perform an ultrasound-guided specific axillary nerve block....

  17. A clinical assessment tool for ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    Sultan, S F

    2012-05-01

    Competency in anesthesia traditionally has been determined subjectively in practice. Optimal training in procedural skills requires valid and reliable forms of assessment. The objective was to examine a procedure-specific clinical assessment tool for ultrasound-guided axillary brachial plexus block for inter-rater reliability and construct validity in a clinical setting.

  18. Axillary metastasis as first symptom of occult breast cancer: a case report.

    Science.gov (United States)

    Frattaroli, Fabrizio Maria; Carrara, Alessandro; Conte, Anna Maria; Pappalardo, Giuseppe

    2002-01-01

    Axillary lymph node metastasis from an occult breast carcinoma is a rare occurrence. We report this condition in a 59-year-old woman who presented with a swelling in the right axilla. No breast mass was clinically evident. Mammography, ultrasonography and multiple random fine-needle breast biopsies yielded no pathological findings. No extramammary primary lesions were present. Axillary sampling was performed and histological examination revealed the presence of metastatic adenocarcinoma in three of the 12 dissected lymph nodes. Estrogen receptors were positive and immunohistochemistry pointed to a breast origin. All these data were suggestive of occult breast cancer. The patient refused any further treatment but accepted clinical and radiological follow-up. Eight years later mammography revealed in the same breast a 10-mm nodule containing microcalcifications, which was not evident at physical examination. The patient underwent a lumpectomy. Intraoperative histology was positive for breast carcinoma and complete axillary clearance was performed. Histological examination revealed a lobular invasive breast carcinoma and the presence of micrometastasis in one of the 23 removed lymph nodes. The patient was given radiotherapy to the breast and axilla and tamoxifen. At present, one year after the appearance of the primary tumor, she is free of disease. Based on this case report we suggest an eclectic approach in the management of patients with axillary metastasis from occult breast cancer, depending on the clinical, pathological and biological findings.

  19. Bilateral pseudoangiomatous stromal hyperplasia tumors in axillary male gynecomastia: report of a case.

    Science.gov (United States)

    Vega, Roger M; Pechman, David; Ergonul, Burco; Gomez, Carmen; Moller, Mecker G

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign proliferation of breast stromal cells with a complex pattern of interanastomosing spaces lined by myofibroblasts. The exact etiology is still unknown, but a proliferative response of myofibroblasts to hormonal stimuli has been postulated. PASH is a relatively common incidental finding in breast tissue removed for other reasons and rarely manifests as a localized mass. Fewer than 150 cases of tumoral PASH have been reported since it was first described in 1986. Although PASH tends to grow over time, most lesions are cured by surgical excision and the prognosis is excellent. We report an unusual case of bilateral axillary tumoral PASH in a 44-year-old man. Awareness of this disease is important when considering the differential diagnosis of axillary masses. To our knowledge, only one other case of unilateral axillary tumoral PASH in a male patient has been described in English and this is the first case of PASH occurring in male bilateral axillary gynecomastia.

  20. Breast cancer with axillary lymph node involvement; Cancer du sein avec atteinte ganglionnaire axillaire

    Energy Technology Data Exchange (ETDEWEB)

    Belaid, A.; Kanoun, S.; Kallel, A.; Ghorbel, I.; Azoury, F.; Heymann, S.; Marsiglia, H.; Bourgier, C. [Departement de radiotherapie, Unite fonctionnelle de Senologie, institut Gustave-Roussy, 94 - Villejuif (France); Belaid, A.; Ghorbel, I. [Service de radiotherapie Carcinologique, institut Salah-Azaiez, Tunis (Tunisia); Kanoun, S. [Service de radiotherapie, hopital Farhat-Hached, Sousse (Tunisia); Kallel, A. [dUnite de radiotherapie, clinique Ennasr (Tunisia); Pichenot, C.; Verstraet, R. [Departement de physique, institut Gustave-Roussy, 94 - Villejuif (France); Marsiglia, H. [Universite de Florence (Italy)

    2010-07-01

    Breast cancer is the most frequent cancer of women in western countries. There are one million new cases per year in the world which represents 22% of all female cancers, and more than 370.000 deaths due to breast cancer per year (14% of cancer mortality). More than half of breast cancers are associated with axillary nodal involvement. Post-operative radiation therapy (XRT) is a crucial part of locoregional treatment in axillary nodal involvement breast cancer owing to a 15-years risk reduction of locoregional recurrence of 70% and to a 5.4% risk reduction of specific mortality. In 3D-conformal irradiation in such breast cancers, target volumes are chest wall when mastectomy was performed or breast and boost of tumor bed in case of breast conservative surgery, and supra-clavicular and/or axillary and/or internal mammary node areas. The main organs at risk are ipsilateral lung, heart and brachial plexus. The aim of this article is to describe epidemiologic, radio anatomic and prognostic features of axillary nodal involvement breast cancer and to propose guidelines for 3D-conformal treatment planning in locally advanced breast cancers. This review is illustrated by a case report. (authors)

  1. Very superficial ultrasound-assisted lipoplasty for the treatment of axillary osmidrosis.

    Science.gov (United States)

    Park, S

    2000-01-01

    Treatment of axillary osmidrosis has been mainly concerned with surgical excision of glandular tissues and involved major surgical procedures with high morbidities and many complications. Search for a less invasive procedure for axillary osmidrosis resulted in the use of liposuction. However, there have been controversies over the efficacy of this method. The problem was that liposuction could not effectively remove the apocrine gland located in the dermis and dermosubcutaneous junction. A high rate of residual malodor and dissatisfaction were reported. The author used ultrasound-assisted lipoplasty (UAL) in the very superficial plane to remove the apocrine gland located in the dermis and dermosubcutaneous junction. The purpose of this study was to prove the efficacy of the very superficial UAL (VSUAL) for the treatment of axillary osmidrosis. From December 1998 to December 1999, 21 consecutive patients underwent UAL in their axilla for axillary osmidrosis. The follow-up period ranged from 2 to 12 months (mean: 8 months). UAL was performed in the very superficial plane with an amplitude of 40%. The very superficial UAL (VSUAL) was done mainly in a withdrawing manner with the tip of the cannula against the skin. The UAL (VSUAL) was done aggressively until the skin changed slightly erythematous. The results were assessed subjectively and objectively, and classified as excellent, good, fair, and poor. Nineteen patients were graded as excellent and one patient as good. The total satisfaction rate was 95.2%. One patient complained of residual malodor in her left axilla. There were no cases of skin necrosis, hematoma, or seroma. Histology showed partial removal of the subcutaneous layer and deep dermis, and degenerative epithelial changes in the apocrine glands in the residual deep dermis. These microscopic findings meant near-total functional ablation of the apocrine gland in the axilla comparable to "flap-to-graft conversion" or surgical excision of axillary skin. The

  2. Treatment of Axillary Osmidrosis Using a Subcutaneous Pulsed Nd-YAG Laser

    Directory of Open Access Journals (Sweden)

    Daejin Kim

    2012-03-01

    Full Text Available Background Axillary osmidrosis is characterized by an unpleasant odor, profuse sweating, andin some instances, staining of clothes that may socially and psychologically impair affectedindividuals. Various types of surgical procedures have been developed for the treatment ofaxillary osmidrosis. This study was undertaken to evaluate the effectiveness of subcutaneouspulsed neodymium: yttrium-aluminum-garnet (Nd-YAG laser treatment for the treatment ofaxillary osmidrosis.Methods Twenty-nine patients with axillary osmidrosis were included in this study. Patientswere categorized according to the results of an axillary malodor grading system, and asubcutaneous pulsed Nd-YAG laser was applied to all patients. The treatment area for theappropriate distribution of laser energy was determined using the iodine starch test (Minor’stest against a grid pattern composed of 2×2 cm squares. The endpoint of exposure was300 to 500 J for each grid, depending on the preoperative evaluation results. The resultswere evaluated by measurement of axillary malodor both pre- and postoperatively using thegrading system and iodine starch test.Results The average follow-up period was 12.8 months. Nineteen patients had a fair-togoodresult and ten patients had poor results. The postoperative Minor’s test demonstratedthat there were remarkable improvements for patients with mild to moderate symptoms.Complications including superficial second degree burns (n=3 were treated in a conservativemanner. A deep second degree burn (n=1 was treated by a surgical procedure.Conclusions Subcutaneous pulsed Nd-YAG laser has many advantages and is an effectivenoninvasive treatment for mild to moderate axillary osmidrosis.

  3. Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.

    LENUS (Irish Health Repository)

    Solon, Jacqueline G

    2012-02-01

    BACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210\\/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient\\'s preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.

  4. Unilateral axillary arch with two slips entrapping neurovascular bundle in axilla and its innervation by the median nerve

    Directory of Open Access Journals (Sweden)

    Somayaji SN

    2009-10-01

    Full Text Available Axillary arch is an additional muscle bundle of various dimensions extending usually from the latissimus dorsi in the posterior fold of the axilla, to the pectoralis major or other neighboring muscles and bones. In the present case presence of such unusual axillary arch innervated by the median nerve has been reported. During routine dissection of axilla region in one of the upper limbs, the occurrence of axillary arch was observed. The muscle fibers were arising from the belly of latissimus dorsi and were getting inserted to the tendon of coracobrachilais and lateral lip of bicipital groove. As it passed through the axilla it divided into 2 slips, enclosing the axillary vessels and nerves related to them. The fleshy fibers of the axillary arch were innervated by 2 small twigs from the median nerve. Though the occurrence of the axillary arch is very common, axillary arch with 2 slips getting innervated by the median nerve is not been reported so far. Further, a detailed literature review was done and the surgical and clinical importance of the case was discussed.

  5. Impact on regional recurrence and survival of axillary surgery in women with node-negative primary breast cancer

    DEFF Research Database (Denmark)

    Axelsson, C K; Düring, M; Christiansen, P M;

    2009-01-01

    BACKGROUND: This study examined whether axillary lymph node dissection (ALND) with removal of many normal lymph nodes resulted in a reduced rate of axillary recurrence and better survival, as reported in recent studies. METHODS: The follow-up analyses were based on 8657 patients with node-negative...... primary breast cancer treated solely by surgery. Median follow-up was 9 years. RESULTS: The number of lymph nodes removed correlated with a reduction in the rate of subsequent axillary recurrence (from 2.1 to 0.4 per cent; P = 0.037), local recurrence (from 7.4 to 3.8 per cent; P

  6. Coexistence of tuberculous axillary lymphadenitis and giant borderline malignant phyllodes tumor of the breast: A rare case report

    Directory of Open Access Journals (Sweden)

    Sunder Goyal

    2015-04-01

    Full Text Available Cystosarcoma phyllodes are uncommon breast tumors which rarely metastasize to axillary lymph nodes. The tumor is similar to fibroadenoma in structure, but it is different histologically. Although surgery (excision vs. mastectomy is the mainstay of treatment, the need for adjuvant therapies such as radiotherapy for a malignant variety is unclear. Its association with ipsilateral tubercular axillary lymph nodes has not been reported in literature so far. We report a 35-year-old female that presented with a giant borderline malignant phyllodes tumor of the right breast along with ipsilateral tubercular granulomatous axillary lymph nodes. [Arch Clin Exp Surg 2015; 4(2.000: 114-117

  7. The role of ultrasonography and FDG-PET in axillary lymph node staging of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jhii-Hyun; Son, Eun Ju; Kim, Jeong-Ah; Youk, Ji Hyun; Kim, Eun-Kyung; Kwak, Jin Young (Dept. of Radiology, Yonsei Univ. College of Medicine, Research Inst. of Radiological Science, Seoul (Korea)), e-mail: ejsonrd@yuhs.ac; Ryu, Young Hoon (Dept. of Nuclear Medicine, Yonsei Univ. College of Medicine, Research Inst. of Radiological Science, Seoul (Korea)); Jeong, Joon (Dept. of General Surgery, Yonsei Univ. College of Medicine, Research Inst. of Radiological Science, Seoul (Korea))

    2010-10-15

    Background: The presence of axillary lymph node metastasis is the most important prognostic factor and an essential part of staging and prognosis of breast cancer. Purpose: To elucidate the usefulness and accuracy of ultrasonography (United States), fluorodeoxyglucose positron emission tomography (FDG-PET) scan, and combined analysis for axillary lymph node staging in breast cancer. Material and Methods: A total of 250 consecutive breast cancer patients who had undergone US, FDG-PET, and sentinel lymph node biopsy (SLNB) before surgery from January 2005 to December 2006 were included in the study. If an axillary lymph node had a length to width ratio =1.5 or cortical thickening =3 mm or compression of the hilum on US, focal hot uptake (maximal standardized uptake value, SU V{sub max} =2.0) in the ipsilateral axilla on FDG-PET, it was considered to be a metastatic lymph node. In combined analysis of US and FDG-PET, the interpretation was considered positive if at least two of any of the criteria were met. Each imaging finding was compared with a pathologic report regarding the presence of axillary lymph node metastasis, the number of metastatic lymph nodes, and the T stage of the breast mass. Results: Pathologically confirmed axillary lymph node metastasis was noted in 73 cases (29.2%). The mean number of metastatic lymph nodes in pathology was 3.1 +- 3.2, and the size of breast cancer was 2.0 +- 1.04 cm. In the detection of lymph node metastasis, the diagnostic accuracy of US was 78.8% and that of FDG-PET was 76.4%. On combined US and FDG-PET, accuracy was improved (91.6%). The number of metastatic lymph nodes on pathology was correlated with the positivity of US and FDG-PET (P < 0.01). Conclusion: Combined evaluation of US and FDG-PET was a sensitive and accurate method for axillary lymph node staging in breast cancer

  8. Computed tomography image of the mediastinal and axillary lymph nodes in clinically sound Rottweilers

    Directory of Open Access Journals (Sweden)

    Ana Carolina B. Fonseca Pinto

    2013-03-01

    Full Text Available Trough computed tomography (CT, it is possible to evaluate lymph nodes in detail and to detect changes in these structures earlier than with radiographs and ultrasound. Lack of information in the veterinary literature directed the focus of this report to normal aspects of the axillary and mediastinal lymph nodes of adult dogs on CT imaging. A CT scan of 15 normal adult male and female Rottweilers was done. To define them as clinically sound, anamnesis, physical examination, complete blood count, renal and hepatic biochemistry, ECG, and thoracic radiographs were performed. After the intravenous injection of hydrosoluble ionic iodine contrast medium contiguous 10mm in thickness thoracic transverse images were obtained with an axial scanner. In the obtained images mediastinal and axillary lymph nodes were sought and when found measured in their smallest diameter and their attenuation was compared to musculature. Mean and standard deviation of: age, weight, body length and the smallest diameter of the axillary and mediastinal lymph nodes were determined. Mean and standard deviation of parameters: age 3.87±2.03 years, weight 41.13±5.12, and body length 89.61±2.63cm. Axillary lymph nodes were seen in 60% of the animals, mean of the smallest diameter was 3.58mm with a standard deviation of 2.02 and a minimum value of 1mm and a maximum value of 7mm. From 13 observed lymph nodes 61.53% were hypopodense when compared with musculature, and 30.77% were isodense. Mediastinal lymph nodes were identified in 73.33% of the dogs; mean measure of the smallest diameter was 4.71mm with a standard deviation of 2.61mm and a minimum value of 1mm, and a maximum value of 8mm. From 14 observed lymph nodes 85.71% were isodense when compared with musculature and 14.28% were hypodense. The results show that it is possible to visualize axillary and mediastinal lymph nodes in adult clinically sound Rottweilers with CT using a slice thickness and interval of 10mm. The

  9. A 10-year follow-up of treatment outcomes in patients with early stage breast cancer and clinically negative axillary nodes treated with tangential breast irradiation following sentinel lymph node dissection or axillary clearance.

    Science.gov (United States)

    Wernicke, A Gabriella; Goodman, Robert L; Turner, Bruce C; Komarnicky, Lydia T; Curran, Walter J; Christos, Paul J; Khan, Imraan; Vandris, Katherine; Parashar, Bhupesh; Nori, Dattatreyudu; Chao, K S Clifford

    2011-02-01

    We compare long-term outcomes in patients with node negative early stage breast cancer treated with breast radiotherapy (RT) without the axillary RT field after sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND). We hypothesize that though tangential RT was delivered to the breast tissue, it at least partially sterilized occult axillary nodal metastases thus providing low nodal failure rates. Between 1995 and 2001, 265 patients with AJCC stages I-II breast cancer were treated with lumpectomy and either SLND (cohort SLND) or SLND and ALND (cohort ALND). Median follow-up was 9.9 years (range 8.3-15.3 years). RT was administered to the whole breast to the median dose of 48.2 Gy (range 46.0-50.4 Gy) plus boost without axillary RT. Chi-square tests were employed in comparing outcomes of two groups for axillary and supraclavicular failure rates, ipsilateral in-breast tumor recurrence (IBTR), distant metastases (DM), and chronic complications. Progression-free survival (PFS) was compared using log-rank test. There were 136/265 (51%) and 129/265 (49%) patients in the SLND and ALND cohorts, respectively. The median number of axillary lymph nodes assessed was 2 (range 1-5) in cohort SLND and 18 (range 7-36) in cohort ALND (P breast RT and SLND alone, experience low AFR or SFR. Our findings, while awaiting mature long-term data from NSABP B-32, support that in patients with negative axillary nodal status such treatment provides excellent long-term cure rates while avoiding morbidities associated with ALND or addition of axillary RT field.

  10. Is Video-Assited Thoracoscopic Surgery Superior to Limited Axillary Thoracotomy in the Management of Spontaneous Pneumothorax?

    Directory of Open Access Journals (Sweden)

    Meaghen J Hyland

    2001-01-01

    Full Text Available OBJECTIVE: To evaluate bullectomy and pleurectomy in the treatment of spontaneous pneumothorax (PNO using video-assisted thoracoscopic surgery (VATS, and to compare the outcome with that of the same procedure performed using limited axillary thoracotomy (LAT.

  11. Diagnostic accuracy of apparent diffusion coefficient value in differentiating metastatic form benign axillary lymph nodes in cancer breast

    Directory of Open Access Journals (Sweden)

    Ahmed A. Azeem Ismail

    2014-09-01

    Conclusion: Compared with lymph node size or routine magnetic resonance sequences, DWI and ADC are promising techniques for differentiating metastatic and non metastatic axillary lymph nodes in known breast cancer patients.

  12. Sentinel Node Biopsy Alone versus Completion Axillary Node Dissection in Node Positive Breast Cancer: Systematic Review and Meta-Analysis

    OpenAIRE

    Rachna Ram; Jasprit Singh; Eddie McCaig

    2014-01-01

    Introduction. There has been recent interest in validity of completion axillary node dissection after a positive sentinel node. This systematic review aims to ascertain if sentinel lymph node dissection alone was noninferior to axillary lymph node dissection for breast cancer patients who have a positive sentinel node. Method. A systematic review of the electronic databases Embase, MEDLINE, and Cochrane Register of Controlled Trials was carried out. Only randomised trials that had patients wi...

  13. Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.

    LENUS (Irish Health Repository)

    Hayes, Brian D

    2012-02-01

    INTRODUCTION: Fine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes. METHODS: 161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. RESULTS: FNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4). CONCLUSIONS: FNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.

  14. Immunological Effects of Total Flavones from Leaves of Choerospondias axillaris on Mice

    Institute of Scientific and Technical Information of China (English)

    LIU Xin-yuan; YANG Yu-mei; HAN Feng; ZHANG Hao-nan; DU Jian-xi; HAO Xin-min

    2013-01-01

    Objective To investigate the effect of total flavones from the leaves of Choerospondias axillaris (TFLCA) on the immune function of normal mice and to provide the experimental basis for the reasonable application of C.axillaris.Methods The carbon clearance method,cutaneous delayed hypersensitivity rcaction method,serum hemolysin method,and index of immune organs were used to study the effect of TFLCA on the immune function of mice.Results TFLCA could enhance the phagocytic function of mononuclear macrophage and the cutaneous delayed hypersensitivity reaction of mice,and increase the content of hemolysin antibody and the thymus index in mice.Conclusion TFLCA could improve the celiac macrophage activity and specific immunity of mice,and TFLCA,consisting with the total flavones of Choerospondiatis Fructus (TFCF),has the effect on the immune function of mice.So both TFLCA and TFCF have the regulatory effects on the immune function of mice.

  15. Design And Development Of A Mammary And Axillary Region Positron Emission Tomography System (maxpet)

    CERN Document Server

    Doshi, N K

    2000-01-01

    Breast cancer is the second leading cause of cancer death in women. Currently, mammography and physical breast examination, both non-invasive techniques, provide the two most effective methods available for screening potential breast cancer patients. During the management of patients, however, several invasive techniques such as axillary lymph node dissection, core biopsies and lumpectomies, are utilized to determine the stage or malignancy of the disease with significant cost and morbidity associated with them. Positron Emission Tomography (PET), using [F-18] fluorodeoxyglucose (FDG) tracer is a sensitive and non-invasive imaging modality that may be a cost-effective alternative to certain invasive procedures. In this project we have developed a low cost, high performance, dedicated PET camera (maxPET) for mammary and axillary region imaging. The system consists of two 15x15 cm2 planar scintillation detector arrays composed of modular detectors operating in coincidence. The modular detectors are comprised of...

  16. [8-year experience in 40 patients with an axillary-femoral graft].

    Science.gov (United States)

    Bialostozky, L; Rish, L; Legaspi, R; Gutiérrez Bosque, R; Archundia, A; Morales, F; Oropeza, G

    1977-01-01

    The 8 years (1967-1975) experience with axillary-femoral and femoro-femoral grafts in 40 patients is presented; 6 females and 34 males, between 50 and 90 years of age, with arteriosclerosis, all complicated by chronic illnesses. The results have been satisfactory, as the grafts are functioning from 2 months to 80 months (6 years, 8 months), most of them being more than 12 months old. Twenty eight of the 40 patients operated are alive. Four patients (10%) had infection of their grafts. In 6 (15%) the graft closed because of severe progresive distal obstruction. Three patients (7.5%) died in the first 32 post-operative days. In 9 (22.5%) the deaths were not related to surgery. The indications for placement of axillary-femoral and femoro-femoral grafts is established.

  17. Asymptomatic Primary Fallopian Tube Cancer: An Unusual Cause of Axillary Lymphadenopathy

    Directory of Open Access Journals (Sweden)

    N. A. Healy

    2011-01-01

    Full Text Available Primary Fallopian tube malignancy is considered a rare disease and is often mistaken histologically and clinically for ovarian cancer. The etiology is poorly understood, and it typically presents at an advanced disease stage, as symptoms are often absent in the initial period. As a result, primary fallopian tube cancer is generally associated with a poor prognosis. We present the case of a 45-year-old female who presents with a 5-day history of left axillary swelling and a normal breast examination. Mammogram and biopsy of a lesion in the left breast revealed a fibroadenoma but no other abnormalities. Initial sampling of the axillary node was suspicious for a primary breast malignancy, but histology of the excised node refuted this. PET-CT showed an area of high uptake in the right pelvis, and a laparoscopy identified a tumor of the left fallopian tube which was subsequently excised and confirmed as a serous adenocarcinoma.

  18. A rare case of breast carcinoma co-existing with axillary mantle cell lymphoma

    Directory of Open Access Journals (Sweden)

    Scally John

    2003-12-01

    Full Text Available Abstract Background Mantle cell lymphoma (MCL is a rare variety of non-Hodgkin's lymphoma which originates from CD5+ B-cell population in the mantle zones of lymphoid follicles. Coexistence of such tumours in the axillary lymph nodes with invasive breast cancers without prior history of adjuvant chemotherapy or radiotherapy has not been previously reported in literature. Case report We report a rare case of breast cancer co-existing with stage I mantle cell lymphoma of the ipsilateral axillary lymph node detected fortuitously by population screening. Conclusion Though some studies have tried to prove breast carcinomas and lymphomas to share a common molecular or viral link, more research needs to be done to establish whether such a link truly exists.

  19. Sclerotic fibroma (storiform collagenoma)-like stroma in a fibroadenoma of axillary accessory breast tissue.

    Science.gov (United States)

    Val-Bernal, José Fernando; González-Vela, María Carmen; De Grado, Mauricio; Garijo, María Francisca

    2012-08-01

    Accessory breast tissue is a subcutaneous remnant persisting after normal embryological development of the breast. It occurs most frequently in the axilla. Fibroadenomas in axillary breast tissue are rare. We report the case of a 29-year-old female patient who presented a fibroadenoma arising in the accessory breast tissue of the right axillary fossa. The neoplasm showed foci of sclerotic fibroma-like stroma. The patient had no signs of Cowden's syndrome. To the best of our knowledge, a lesion of this kind has not been previously reported. This stromal change suggests an uncommon involutional phase of the fibroadenoma with production of sclerotic and hypocellular collagen. The lesion should be differentiated from extraneural perineuroma, from the changes in fibroadenomas in Cowden's syndrome, from sclerosing lobular hyperplasia (fibroadenomatoid mastopathy) and from pseudoangiomatous stromal hyperplasia.

  20. Assessment of factors affecting in vitro shoot regeneration from axillary bud explant of Camptotheca acuminata

    Institute of Scientific and Technical Information of China (English)

    WANG Hui-Mei; ZU Yuan-Gang; DONG Feng-Li; ZHAO Xiao-Ju

    2005-01-01

    Axillary buds from 3-yr.-old seedlings of Camptotheca acuminata in the greenhouse were cultured on the different basal media with different concentrations of growth regulators for shoot regeneration for studying the effects of different basal media, different concentrations of growth regulators (BA or TDZ), sucrose, agar and pH value on shoot regeneration from axillary bud. The results showed that B5 and WPM media were the optimal basal media and the optimal phyotohormone was BA of 1.0 mg/L or TDZ of 0.1mg/L; The concentrations of sucrose of 30g/L and agar of 6g/L were most suitable for the shoot regeneration; pH value from 5.8 to 6.6 were broadly effective, but the best at pH 5.8.

  1. Convulsion due to levobupivacaine in axillary brachial plexus block: Case report

    Directory of Open Access Journals (Sweden)

    Cevdet Düger

    2013-06-01

    Full Text Available Axillary brachial plexus block is an effective method of anaesthesia for the surgeries performed on the hand, forearm and distal third of the arm. However it has the risk of serious complications such as cardiovascular and central nervous system toxicity. Levobupivacaine is a long acting amide local anaesthetic used for epidural, caudal, spinal, infiltration and peripheral nerve blocks. Levobupivacaine is the S (- isomer of racemic bupivacaine and has a lower risk of cardiovascular, central nervous system toxicity than bupivacaine. However central system toxicity cases due to absorption of the drug into the systemic circulation has been reported. Here, we report a case having no vascular puncture during axillary brachial plexus block performance but developing convulsion due to levobupivacain after the intervention.

  2. Proactive error analysis of ultrasound-guided axillary brachial plexus block performance.

    LENUS (Irish Health Repository)

    O'Sullivan, Owen

    2012-07-13

    Detailed description of the tasks anesthetists undertake during the performance of a complex procedure, such as ultrasound-guided peripheral nerve blockade, allows elements that are vulnerable to human error to be identified. We have applied 3 task analysis tools to one such procedure, namely, ultrasound-guided axillary brachial plexus blockade, with the intention that the results may form a basis to enhance training and performance of the procedure.

  3. Treatment of Combined Injuries of the Axillary and Suprascapular Nerves with Scapulothoracic Dissociation

    OpenAIRE

    Sano, Kazufumi; Ozeki, Satoru

    2015-01-01

    A 20-year-old man suffered the combined axillary and suprascapular nerve palsies associated with scapulothoracic dissociation by motorcycle accident. The dislocated shoulder girdle was reduced and stabilized with osteosynthesis of the fractured clavicle and reattachment of the trapezius avulsed from the scapular spine for removal of continuous traction force to these damaged nerves. Because of no evidence of recovery on manual muscle test and electromyogram, exploration for these nerves was a...

  4. Axillary sentinel node identification in breast cancer patients: degree of radioactivity present at biopsy is critical

    DEFF Research Database (Denmark)

    Nielsen, Kristina R; Oturai, Peter S; Friis, Esbern;

    2011-01-01

    The radioactivity present in the patient (Act(rem) ) at sentinel node (SN) biopsy will depend on injected activity amount as well as on the time interval from tracer injection to biopsy, which both show great variations in the literature. The purpose of this study was to analyse the influence...... of varying Act(rem) levels on the outcome of axillary SN biopsy in patients with breast cancer (BC)....

  5. Surgical treatment of axillary hyperhidrosis with liposuction equipment: risks and benefits.

    Science.gov (United States)

    Bieniek, Andrzej; Białynicki-Birula, Rafał; Baran, Wojciech; Kuniewska, Barbara; Okulewicz-Gojlik, Danuta; Szepietowski, Jacek C

    2005-01-01

    Axillary hyperhidrosis poses a serious problem to the affected patients. So far, the conservative measures employed seem to be disappointing, operations with axillary skin excision, undermining and/or skin reconstruction may cause secondary functional and cosmetic problems, whereas botulinum A toxin injections need to be repeated frequently. The aim of this study was to establish the safety, efficacy, and durability of subdermal (subcorial) suction sweat gland curettage in the treatment of axillary hyperhidrosis. So far, the method seems to be devoid of possible risks and drawbacks. In the last 4.5 years, 15 patients with axillary hyperhidrosis were operated on with the use of liposuction tools. First operations were performed in general anesthesia, then in tumescent anesthesia. The procedure of suction curettage was performed with the use of 3- to 4-mm wide liposuction cannulas. The patients were closely monitored during early stages of the healing process; then they were evaluated at 1 and 3 months, and finally at 1-4 years of the operation, when they were asked to assess the effects of the operation. Four patients had recurrence of the disease within 3 months; three of them were reoperated on, with good result. At 1-4 years of the operation, all our responders (ten of 15 patients) stated that the disease had completely subsided. The following complications were observed during the process of healing: hematomas, transient skin unevenness, and partial skin flap necrosis. In conclusion, subdermal suction curettage seems to be superior to botulinum A toxin injections by the effect durability, and to the surgical methods with skin excision and undermining by the probably lower complication rates.

  6. Incidental detection of filarial worm in metastatic axillary lymph node from ductal carcinoma breast

    Directory of Open Access Journals (Sweden)

    Ranjan Agrawal

    2015-01-01

    Full Text Available Filariasis is a major disease of the tropics. Frequently, lymphatics of the lower limbs, retroperitoneal tissues, spermatic cord, epididymis, and mammary glands are involved. Simultaneous filariasis along with another underlying disease is rare. We present a rare case of filariasis of the axillary lymph node in a modified radical mastectomy specimen, which also showed metastatic deposits of ductal carcinoma breast. The case is presented due to its rarity.

  7. The Axillary Nodal Harvest in Breast Cancer Surgery Is Unchanged by Sentinel Node Biopsy or the Timing of Surgery

    Directory of Open Access Journals (Sweden)

    B. E. Byrne

    2012-01-01

    Full Text Available Introduction. Patients with a positive sentinel lymph node biopsy may undergo delayed completion axillary dissection. Where intraoperative analysis is available, immediate completion axillary dissection can be performed. Alternatively, patients may undergo primary axillary dissection for breast cancer, historically or when preoperative assessment suggests axillary metastases. This study aims to determine if there is a difference in the total number of lymph nodes or the number of metastatic nodes harvested between the 3 possible approaches. Methods. Three consecutive comparable groups of 50 consecutive patients who underwent axillary dissection in each of the above contexts were identified from the Portsmouth Breast Unit Database. Patient demographics, clinicopathological variables, and surgical treatment were recorded. The total pathological nodal count and the number of metastatic nodes were compared between the groups. Results. There were no differences in clinico-pathological features between the three groups for all features studied with the exception of breast surgical procedure (P<0.001. There were no differences in total nodal harvest (P=0.822 or in the number of positive nodes harvested (P=0.157 between the three groups. Conclusion. The three approaches to axillary clearance yield equivalent nodal harvests, suggesting oncological equivalence and robustness of surgical technique.

  8. Negative Expression of Melanoma Cell Adhesion Molecule (MCAM Correlated with Axillary Lymph Node Metastasis in Triple Negative Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sartika Nurwenda

    2016-09-01

    Full Text Available Triple negative breast cancer (TNBC is breast cancer that demonstrate the absence of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2. TNBC has an aggressive behaviour, high frequency of metastasis to the axillary lymph nodes and recurrence, and poor prognosis. Metastasis to the axillary lymph nodes will affect the rate of survival and recurrence in TNBC. Melanoma cell adhession molecule (MCAM is a membrane glycoprotein of the immunoglobulin superfamily, which is involved in the cells binding, which later became known as the marker for the progression and metastasis of melanoma and carcinoma of the prostate. However, MCAM role in mammary carcinoma still controversial. The aim of this study was to assess correlation between MCAM expression with incidence of metastatic to axillary lymph nodes in TNBC. This research was conducted during January 1st 2010–April 31st 2015 at Pathology Anatomy, Faculty of Medicine, Universitas Padjadjaran. This study used a cross-sectional design, using lambda correlation test. MCAM immunohistochemical staining performed on 56 samples of paraffin blocks of TNBC group that did not metastasized and has metastasized to the axillary lymph nodes. A total of 22 of 28 (78.6% of TNBC metastatic to axillary lymph nodes have histoskor MCAM value <4 (negative, whereas 16 of 28 (57.1% of TNBC non-metastatic have histoskor value ≥ 4 (positive. Negative expression of MCAM correlated with TNBC that had metastasized to axillary lymph nodes, although not the only factor that influenced them.

  9. Establishment of a Rapid Plant Regeneration System in Physalis angulata L. through Axillary Meristems

    Directory of Open Access Journals (Sweden)

    Owk ANIEL KUMAR

    2015-12-01

    Full Text Available An optimal plant propagation method of Physalis angulata L., a medicinally important herbaceous plant species has been developed using axillary meristem explants. Shoot bud proliferation was initiated from axillary meristem explants cultured on MS medium supplemented with various concentrations of 0.5-2.5mg/L/(BAP/(Zeatin/(KIN. The maximum in vitro response of shooting frequency of explants (88.1% and shoots per explant (42 was achieved with medium containing 1.0mg/L BAP. Multiple shoot culture was established by repeated subculturing of the shoot buds of axillary meristems on shoot multiplication medium. Among the subculture media BAP in combination with 1.5mg/L (IAA+0.25mg/L(GA3 produced maximum shoots per explant (128±0.29 after two weeks of culture. Effective in vitro shoot elongation and rooting was achieved on 1.0mg/L(GA3 and 1.0mg/L(IBA, respectively. Most of the generated shoots were successfully transferred to soil under field conditions. The survival percentage of the transferred plants on soil was found to be 90 per cent.  This protocol can be used for commercial propagation and for future genetic improvement studies.

  10. Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2014-01-01

    Full Text Available Background: The established methods of nerve location were based on either proper motor response on nerve stimulation (NS or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. Methods : A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60, or ultrasound guidance (group US, n = 60 for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. Results: The median (range number of skin punctures were 2 (2-4 in group US and 3 (2-5 in group NS (P =0.27. Insufficient block was observed in three patient (5% of group US and four patients (6.67% of group NS (P > =0.35. Patient acceptance was similarly good in the two groups. Conclusion: Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine.

  11. Comparison of Axillary and Tympanic Temperature Measurements in Children Diagnosed with Acute Otitis Media

    Directory of Open Access Journals (Sweden)

    Hatice Hilal Doğan

    2016-01-01

    Full Text Available Background. Acute otitis media [AOM] may affect the accuracy of tympanic temperature measurements. We aimed to compare tympanic temperature measurements in patients with AOM against control groups, as well as compare the tympanic temperatures with axillary thermometry. Methods. This is a prospective, observational study. Patients from pediatric outpatient and emergency clinics who were diagnosed as single-sided AOM were included consecutively in the study. Normal ears of patients and children having the same age and gender who were not diagnosed as AOM were also studied as controls. Results. In patients with AOM, infected ears had higher temperatures than normal ears with a mean of 0.48±0.01°C. There was no significant difference between the right and left tympanic temperatures in control group. Compared with axillary temperature, the sensitivity of tympanic temperature in the infected ear was 91.7% and the specificity was 74.8%. Conclusion. Comparisons of axillary and tympanic temperatures in children with AOM during the active infection concluded higher tympanic temperatures in infected ears. We suggest that the higher tympanic temperatures, approximately 0.5°C in our study, in infected ears may aid in diagnosis of patients with fever without a source in pediatric clinics.

  12. Origin and distribution of the axillary nerve in the giant anteater (Myrmecophaga tridactyla

    Directory of Open Access Journals (Sweden)

    Daniela Cristina de Oliveira Silva

    2012-09-01

    Full Text Available The giant anteater (Myrmecophaga tridactyla, a mammal belonging to the order Xenarthra and family Myrmecophagidae, is an endangered species. For this reason, additional knowledge about its anatomy is of interest, especially the forelimb, which plays important roles in feeding and defense. The goal of this study was to learn more about the origin and distribution of the axillary nerve of Myrmecophaga tridactyla by studying two individuals (one male and one female that belong to the Research Laboratory of Wild Animals (UFU. The study material consisted of corpses fixed and preserved in 10% aqueous formalin solution. Dissection of the material followed standard procedures. In both animals, the axillary nerve was found in the ventral branch of the sixth cervical (C6 and seventh (C7 spinal nerve. This nerve showed symmetry in relation to its position in the two specimens and branched into the teres major, teres minor and deltoid muscles. In both specimens the axillary nerve originated in the cranial cutaneous branch of the lower leg.

  13. A Nonpalpable Nodule in Ectopic Axillary Breast Tissue: Consider Phyllodes Tumor

    Science.gov (United States)

    Bautista-Piña, Verónica; Ramírez-Bollas, Julio; Espejo-Fonseca, Ruby; Rodríguez-Cuevas, Sergio

    2016-01-01

    Benign and malignant pathology can develop in ectopic axillary breast tissue, such as fibroadenomas, phyllodes tumors, and breast cancer. We present a rare case of an asymptomatic 43-year-old woman with an axillary nodule which was identified during screening mammography within ectopic axillary breast tissue, initially considered as a suspicious lymph node. Radiologic studies were considered as Breast Imaging-Reporting Data System (BI-RADS) 4. A hyperdense, lobular, and well-circumscribed nodule was identified in mammogram while the nodule by ultrasound (US) was hypoechoic with indistinct microlobular margins, without vascularity by Doppler, and measuring 1.26 × 1 cm. Core-needle biopsy reported a fibroepithelial neoplasm. The patient was submitted to local wide-needle excision located in intraoperative radiography of the surgical specimen and margin evaluation. Final histopathological study reported a 1.8 × 1.2 cm benign phyllodes tumor, with irregular, pushing, and clear wide margins within normal ectopic breast tissue. The patient without surgical complications continued annual screening without recurrence during a follow-up that took place 24 months later. PMID:28105378

  14. Consumption of garlic positively affects hedonic perception of axillary body odour.

    Science.gov (United States)

    Fialová, Jitka; Roberts, S Craig; Havlíček, Jan

    2016-02-01

    Beneficial health properties of garlic, as well as its most common adverse effect - distinctive breath odour - are well-known. In contrast, analogous research on the effect of garlic on axillary odour is currently missing. Here, in three studies varying in the amount and nature of garlic provided (raw garlic in study 1 and 2, garlic capsules in study 3), we tested the effect of garlic consumption on the quality of axillary odour. A balanced within-subject experimental design was used. In total, 42 male odour donors were allocated to either a "garlic" or "non-garlic" condition, after which they wore axillary pads for 12 h to collect body odour. One week later, the conditions were reversed. Odour samples were then judged for their pleasantness, attractiveness, masculinity and intensity by 82 women. We found no significant differences in ratings of any characteristics in study 1. However, the odour of donors after an increased garlic dosage was assessed as significantly more pleasant, attractive and less intense (study 2), and more attractive and less intense in study 3. Our results indicate that garlic consumption may have positive effects on perceived body odour hedonicity, perhaps due to its health effects (e.g., antioxidant properties, antimicrobial activity).

  15. Comparison of Axillary and Tympanic Temperature Measurements in Children Diagnosed with Acute Otitis Media

    Science.gov (United States)

    Doğan, Hatice Hilal; Kırkgöz, Tarık; Bozaykut, Abdulkadir

    2016-01-01

    Background. Acute otitis media [AOM] may affect the accuracy of tympanic temperature measurements. We aimed to compare tympanic temperature measurements in patients with AOM against control groups, as well as compare the tympanic temperatures with axillary thermometry. Methods. This is a prospective, observational study. Patients from pediatric outpatient and emergency clinics who were diagnosed as single-sided AOM were included consecutively in the study. Normal ears of patients and children having the same age and gender who were not diagnosed as AOM were also studied as controls. Results. In patients with AOM, infected ears had higher temperatures than normal ears with a mean of 0.48 ± 0.01°C. There was no significant difference between the right and left tympanic temperatures in control group. Compared with axillary temperature, the sensitivity of tympanic temperature in the infected ear was 91.7% and the specificity was 74.8%. Conclusion. Comparisons of axillary and tympanic temperatures in children with AOM during the active infection concluded higher tympanic temperatures in infected ears. We suggest that the higher tympanic temperatures, approximately 0.5°C in our study, in infected ears may aid in diagnosis of patients with fever without a source in pediatric clinics. PMID:27648079

  16. Extent of metastatic axillary involvement in 1446 cases of breast cancer.

    Science.gov (United States)

    Veronesi, U; Luini, A; Galimberti, V; Marchini, S; Sacchini, V; Rilke, F

    1990-04-01

    One thousand, four hundred and forty-six patients with carcinoma of the breast treated with Halsted mastectomy (167), Patey mastectomy (732), and conservative surgery with axillary dissection, either at the same time (340), or separately (207), were evaluated with regard to the number and distribution of axillary lymph nodes. A total of 29,378 were removed and examined, on average 20.3 per patient. The average number of nodes was 13.5 at the first level, 4.5 at the second and 2.3 at the third. The same number of nodes were removed in patients treated with extensive surgery, such as Halsted mastectomy and limited surgery such as lumpectomy and in independent axillary dissection. In 839 cases metastases were found in the axilla. The average number of involved nodes was 6.4. Out of 839 patients, the first level was the site of metastases in 828, the second level in 364 and the third in 187. When a single lymph node was involved, it was nearly always at the first level. In only 11 cases, were the second and/or third levels invaded without metastases at the first level. Therefore, the percentage of cases with skipping metastases was very low (1.3%). It appears from the present data that the spread of breast cancer to the axilla follows a regular pattern; the first level is invaded first, whilst in most cases, the second and third levels are involved only when the first is substantially affected.

  17. Ultrasound guidance improves the success rate of axillary plexus block: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Qin Qin

    2016-04-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the value of real-time ultrasound (US guidance for axillary brachial plexus block (AXB through the success rate and the onset time. METHODS: The meta-analysis was carried out in the Anesthesiology Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. A literature search of Medline, EMBASE, Cochrane database from the years 2004 to 2014 was performed. The literature searches were carried out using medical subject headings and free-text word: "axilla", "axillary", "brachial plexus", "ultrasonography", "ultrasound", "ultrasonics". Two different reviewers carried out the search and evaluated studies independently. RESULTS: Seven randomized controlled trials, one cohort study and three retrospective studies were included. A total of 2042 patients were identified. 1157 patients underwent AXB using US guidance (US group and the controlled group included 885 patients (246 patients using traditional approach (TRAD and 639 patients using nerve stimulation (NS. Our analysis showed that the success rate was higher in the US group compared to the controlled group (90.64% vs. 82.21%, p < 0.00001. The average time to perform the block and the onset of sensory time were shorter in the US group than the controlled group. CONCLUSION: The present study demonstrated that the real-time ultrasound guidance for axillary brachial plexus block improves the success rate and reduce the mean time to onset of anesthesia and the time of block performance.

  18. Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique

    Science.gov (United States)

    Kumar, Alok; Sharma, DK; Sibi, Maj. E; Datta, Barun; Gogoi, Biraj

    2014-01-01

    Background: The established methods of nerve location were based on either proper motor response on nerve stimulation (NS) or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. Methods: A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60), or ultrasound guidance (group US, n = 60) for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. Results: The median (range) number of skin punctures were 2 (2–4) in group US and 3 (2–5) in group NS (P =0.27). Insufficient block was observed in three patient (5%) of group US and four patients (6.67%) of group NS (P > =0.35). Patient acceptance was similarly good in the two groups. Conclusion: Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine. PMID:25624532

  19. Outcomes of a shoulder treatment flowchart in patients with axillary burns.

    Science.gov (United States)

    Webb, Darren C; Byrne, Martin; Kolmus, Alison; Law, Henrietta Y; Holland, Anne E; Cleland, Heather

    2011-01-01

    The purpose of this study was to evaluate the effects of a structured shoulder treatment flowchart on range of motion (ROM) and function of the upper limb in patients at high and low risk of contracture after an axillary burn injury. Consecutive patients with axillary burns were managed according to a structured pathway based on risk of contracture. Those patients with deep partial- or full-thickness burns to more than one area of the axilla or requiring more than one split skin graft were classified as high risk; these patients underwent a more aggressive approach to splinting and exercise. Measurements of shoulder ROM and functional ability (upper extremity functional index) were made at admission, hospital discharge, and at 12 weeks postdischarge. Twenty patients (19 men) with an average age of 39 years and a median TBSA of 20% were recruited. Median length of stay was 18 days. Ten patients were classified as high risk. Both low-risk and high-risk patients showed good range of movement outcomes at discharge and 12 weeks, with no significant differences between risk groups (abduction at 12 weeks, mean [SD]: 168° [22°] vs 166° [28°], P = .60; flexion at 12 weeks, mean [SD]: 172° [20°] vs 167° [31°], P = .60, respectively). There were no differences in functional outcomes at 12 weeks postdischarge. Use of a shoulder treatment pathway was associated with good shoulder ROM and functional capacity in patients at high and low risk of axillary contracture.

  20. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  1. Non-operative management of arterial liver hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Goerich, J.; Rilinger, N.; Vogel, J.; Sokiranski, R.; Brambs, H.J. [Dept. of Radiology, University of Ulm (Germany); Brado, M. [Dept. of Radiology, Univ. of Heidelberg (Germany); Huppert, P. [Dept. of Radiology, Univ. of Tuebingen (Germany); Siech, M.; Ganzauge, F.; Beger, H.G. [Dept. of Surgery, Univ. of Ulm (Germany)

    1999-02-01

    A retrospective evaluation of embolotherapy in patients with arterial liver hemorrhages was carried out. Twenty-six patients, ranging in age from 10 days to 77 years with active arterial liver hemorrhages, underwent non-surgical embolotherapy. Bleeding was attributed to trauma (n = 21), tumor (n = 3), pancreatitis (n = 1), or unknown cause (n = 1). Twenty-nine embolizations were performed via a transfemoral (n = 26) or biliary (n = 2) approach. One bare Wallstent was placed into the common hepatic artery via to an axillary route to cover a false aneurysm due to pancreatitis. Treatment was controlled in 4 patients by cholangioscopy (n = 2) or by intravascular ultrasound (n = 2). Prior surgery had failed in 3 patients. Intervention controlled the hemorrhage in 24 of 26 (92 %) patients within 24 h. Embolotherapy failed in 1 patient with pancreatic carcinoma and occlusion of the portal vein. In 1 patient with an aneurysm of the hepatic artery treated by Wallstent insertion, total occlusion was not achieved in the following days, as demonstrated by CT and angiography. However, colour Doppler flow examination showed no flow in the aneurysm 6 months later. Complications were one liver abscess, treated successfully by percutaneous drainage for 10 days, and one gallbladder necrosis after superselective embolization of the cystic artery. Embolization is a effective tool with a low complication rate in the treatment of liver artery hemorrhage, even in patients in whom surgery has failed. (orig.) (orig.) With 2 figs., 26 refs.

  2. Clinical significance of the negative lymph node count after the axillary dissection of breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    Yufeng Yao; Jinhai Tang; Jianwei Qin; Jianping Gong

    2012-01-01

    Objective: The purpose of this study was to evaluate the impact of the negative lymph node (LN) count on the survival of the breast cancer patients in early stage after the axillary dissection. Methods: The breast cancer patients with T1–2N0–1M0 stage between January 2001 and December 2005 in Jiangsu Cancer Hospital, who underwent the axillary LNs dissection, were enrolled in this study. We analyzed the data of these patients including information of follow-up and postop-erative pathological results. All patients were divided into two groups according to the axillary LN status and each group was divided into four subgroups according to the negative LN count. Cox regression analysis was performed to screen the patho-logical factor including the negative LN count on the survival and to compare the different negative LN count on the survival. Results: COX proportional hazard regression model showed that the survival of the breast cancer was significantly associ-ated with the negative LN count. In T1–2N0 group, when the negative LN count was 3 or less, 4 to 5, 6 to 9 and 10 or more, the median survival time was (82.6 ± 4.1) months, (101.5 ± 1.3) months, (104.7 ± 1.0) months, and (110.5 ± 0.9) months respectively (P < 0.05). In T1–2N1 group, when the negative LN count was 6 or less, 7 to 8, 9 to 10 and 11 or more, the median survival time was (95.4 ± 1.9) months, (101.8 ± 1.1) months, (104.9 ± 1.0) months, and (106.5 ± 0.9) months respectively (P < 0.05). Conclusion: The negative LN count can reflect the adequacy of the axillary dissection. Increasing negative LN count is independently associated with improved survival in pT1–2N0M0 or pT1–2N1M0 staging breast cancer patients. The negative LN count should be considered for incorporation into staging for breast cancer with the axillary LN dissection.

  3. Coronary artery fistula

    Science.gov (United States)

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the coronary arteries ...

  4. Sentinel Node Biopsy Alone versus Completion Axillary Node Dissection in Node Positive Breast Cancer: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Rachna Ram

    2014-01-01

    Full Text Available Introduction. There has been recent interest in validity of completion axillary node dissection after a positive sentinel node. This systematic review aims to ascertain if sentinel lymph node dissection alone was noninferior to axillary lymph node dissection for breast cancer patients who have a positive sentinel node. Method. A systematic review of the electronic databases Embase, MEDLINE, and Cochrane Register of Controlled Trials was carried out. Only randomised trials that had patients with positive sentinel node as the study sample were included in the meta-analysis using the reported hazard ratios with a fixed effect model. Results. Three randomised controlled trials and five retrospective studies were identified. The pooled effect for overall survival was HR 0.94, 95% CI [0.79, 1.19], and for disease free survival was HR 0.83, 95% CI [0.60, 1.14]. The reported rates for locoregional recurrence were similar in both groups. The surgical morbidity was found to be significantly more in patients who had underwent axillary dissection. Conclusion. Amongst patients with micrometastasis in the sentinel node, no further axillary dissection is necessary. For patients with macrometastasis in the sentinel node, it is reasonable to consider omitting axillary dissection to avoid the morbidity of the procedure.

  5. Sentinel Node Biopsy Alone versus Completion Axillary Node Dissection in Node Positive Breast Cancer: Systematic Review and Meta-Analysis

    Science.gov (United States)

    Singh, Jasprit; McCaig, Eddie

    2014-01-01

    Introduction. There has been recent interest in validity of completion axillary node dissection after a positive sentinel node. This systematic review aims to ascertain if sentinel lymph node dissection alone was noninferior to axillary lymph node dissection for breast cancer patients who have a positive sentinel node. Method. A systematic review of the electronic databases Embase, MEDLINE, and Cochrane Register of Controlled Trials was carried out. Only randomised trials that had patients with positive sentinel node as the study sample were included in the meta-analysis using the reported hazard ratios with a fixed effect model. Results. Three randomised controlled trials and five retrospective studies were identified. The pooled effect for overall survival was HR 0.94, 95% CI [0.79, 1.19], and for disease free survival was HR 0.83, 95% CI [0.60, 1.14]. The reported rates for locoregional recurrence were similar in both groups. The surgical morbidity was found to be significantly more in patients who had underwent axillary dissection. Conclusion. Amongst patients with micrometastasis in the sentinel node, no further axillary dissection is necessary. For patients with macrometastasis in the sentinel node, it is reasonable to consider omitting axillary dissection to avoid the morbidity of the procedure. PMID:25383226

  6. Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries

    Energy Technology Data Exchange (ETDEWEB)

    Goltz, J.P.; Kickuth, R. [Universitaetsklinikum Wuerzburg (Germany). Inst. fuer Roentgendiagnostik; Bastuerk, P.; Hoppe, H.; Triller, J. [Universitaetsspital Bern (Switzerland). Inst. fuer Diagnostische, Interventionelle und Paediatrische Radiologie

    2011-07-15

    Purpose: To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Materials and Methods: Between 03/1998 and 12/2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12/31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Results: Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2/31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Conclusion: Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury. (orig.)

  7. Nerve Stimulator Guided Axillary Block in Painless Reduction of Distal Radius Fractures; a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Hossein Alimohammadi

    2013-12-01

    Full Text Available Introduction: Given the high prevalence of upper extremity fractures and increasing need to perform painless reduction in the emergency departments, the use of analgesic methods with fewer complications and more satisfaction appears to be essential. The aim of this study is comparison the nerve stimulator guided axillary block (NSAB with intravenous sedation in induction of analgesia for painless reduction of distal radius fractures. Methods: In the present randomized clinical trial, 60 patients (18-70 years of age suffered from distal radius fractures, were divided into two equal groups. One group received axillary nerve block by nerve stimulator guidance and the other procedural sedation and analgesia (PSA using midazolam/fentanyl. Onset of analgesia, duration of analgesic effect, total procedure time and pain scores were recorded using visual analogue scale (VAS and the outcomes were compared. Chi-squared and student t test were performed to evaluate differences between two groups. Results: Sixty patients were randomly divided into two groups (83.3% male. The mean age of patients was 31 ±0.7 years. While the onset of analgesia was significantly longer in the NSAB group, the mean total time of procedure was shorter than PSA (p<0.001. The NSAB group needed a shorter post-operative observation time (P<0.001. Both groups experienced equal pain relief before, during and after procedure (p>0.05. Conclusion: It seems that shorter post-operative monitoring time and consequently lesser total time of procedure, make nerve stimulator guided axillary block as an appropriate alternative for procedural sedation and analgesia in painless reduction of distal radius fractures in emergency department. 

  8. The value of level III clearance in patients with axillary and sentinel node positive breast cancer.

    LENUS (Irish Health Repository)

    Dillon, Mary F

    2012-02-01

    BACKGROUND: The value of level III axillary clearance is contentious, with great variance worldwide in the extent and levels of clearance performed. OBJECTIVE: To determine rates of level III positivity in patients undergoing level I-III axillary clearance, and identify which patients are at highest risk of involved level III nodes. METHODS: From a database of 2850 patients derived from symptomatic and population-based screening service, 1179 patients who underwent level I-III clearance between the years 1999-2007 were identified. The pathology, surgical details, and prior sentinel nodes biopsies of patients were recorded. RESULTS: Eleven hundred seventy nine patients had level I-III axillary clearance. Of the patients, 63% (n = 747) were node positive. Of patients with node positive disease, 23% (n = 168) were level II positive and 19% (n = 141) were level III positive. Two hundred fifty patients had positive sentinel node biopsies prior to axillary clearance. Of these, 12% (n = 30) and 9% (n = 22) were level II and level III positive, respectively. On multivariate analysis, factors predictive of level III involvement in patients with node positive disease were tumor size (P < 0.001, OR = 1.36; 95% CI: 1.2-1.5), invasive lobular disease (P < 0.001, OR = 3.6; 95% CI: 1.9-6.95), extranodal extension (P < 0.001, OR = 0.27; 95% CI: 0.18-0.4), and lymphovascular invasion (P = 0.04, OR = 0.58; 95% CI: 0.35-1). Lobular invasive disease (P = 0.049, OR = 4.1; 95% CI: 1-16.8), extranodal spread (P = 0.003, OR = 0.18; 95% CI: 0.06-0.57), and having more than one positive sentinel node (P = 0.009, OR = 4.9; 95% CI: 1.5-16.1) were predictive of level III involvement in patients with sentinel node positive disease. CONCLUSION: Level III clearance has a selective but definite role to play in patients who have node positive breast carcinoma. Pathological characteristics of the primary tumor are of particular use in identifying those who are at various risk of level III nodal

  9. Reconstruction of bilateral axillary post burn contracture in a 3 year old: A case report

    Institute of Scientific and Technical Information of China (English)

    Krishna kumar. A; SUN Bing-wei

    2010-01-01

    A 2 year old male child was admitted with history of accidental pouring by boiling water all over the body resulting in 51% surface area burns involving the posterior and lateral thoracic region, both the upper limbs in the proximal regions near the shoulder, anterior and posterior abdomen and pubic region with second and third degree severe burns. After correcting the dehydration a series of procedures were performed including anti-shock, wound debridement under GA, etc. At 20 days post-burn, after making sure the wound was healthy a partial thickness skin grafting was done. During rehabilitation, bilateral axillary suffered contracture with hypertrophic scar(Fig 1).

  10. Using a Pressure Mapping System to Evaluate Contact Pressure on Hands During Use of Axillary Crutches.

    Science.gov (United States)

    Silva, Danilo C; Medola, Fausto O; Bonfim, Gabriel H C; Paschoarelli, Luis C

    2015-01-01

    The aim of this study was to evaluate different handles used in axillary crutches with a Pressure Mapping System. The Grip Versatek system from Tekscan Inc. was used to measure the levels and the distribution of contact pressure in the hands during a simulated activity of ambulation with crutches. The sample included ten able-bodied subjects: five men and five women. The results show that the different models of handles appear to have influenced the pressure levels measured during the activity. Therefore, the measurement equipment provides parameters that allow the comparison among different designs and assess their contribution to the comprehension of the demands of ergonomic handles.

  11. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1)

    Energy Technology Data Exchange (ETDEWEB)

    Panagiotidis, Emmanouil; Exarhos, Demetrios; Housianakou, Irene; Bournazos, Apostolos; Datseris, Ioannis [General Hospital, PET/CT Unit, Athens (Greece)

    2010-05-15

    To alert the imaging community to potential false positive findings related to current immunization programmes against H1N1 influenza virus. We reviewed 10 patients referred for positron emission tomography/computed tomography (PET/CT) who had undergone recent vaccination. All studies showed{sup 18}F-fluorodeoxyglucose (FDG) uptake in the draining axillary lymph nodes close to the vaccination site, while low-dose CT revealed lymph nodes ranged between 0.5 cm and 1.2 cm at the same site. This potential pitfall in PET/CT should be borne in mind during current vaccination programmes. (orig.)

  12. Persistent mediastinal and axillary lymph node tuberculosis in a renal transplant patient with successful outcome.

    Science.gov (United States)

    Oguz, Y; Yilmaz, M I; Eyileten, T; Caglar, K; Yenicesu, M; Kaya, A; Tasar, M; Saglam, M; Doganci, L; Gulec, B; Oner, K; Oktenli, C; Vural, A

    2006-06-01

    Tuberculosis is an opportunistic infection that carries substantial morbidity and mortality in renal transplant recipients. We report here about a 21 year-old man with a living related renal transplant from his mother who developed persistent extra-pulmonary tuberculosis. The disease showed aggressive invasion to the axillary and mediastinal regions with abscess formations, despite standard antituberculosis treatment. During the course of the disease, immunosuppressive therapy was stopped, and the patient received extraordinary doses of multiple antituberculosis drugs. The patient then showed an uneventful course with good clinical and radiological responses.

  13. Solitary axillary lymph node metastasis without breast involvement from ovarian Cancer: Case report and brief literature review

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ji In; Kim, Soo Jin; Park, Sung Hee; Kim, Hee Sung [Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (Korea, Republic of)

    2014-11-15

    Axillary lymph node metastasis without breast involvement from ovarian cancer is rare. We report a case of a 68-year-old woman proven as ovarian serous papillary carcinoma and metastatic papillary carcinoma of the omentum on surgical diagnostic laparoscopy. In addition, a hypermetabolic lymph node was detected in left axilla and was considered a reactive benign lesion. Mammography and ultrasonography showed no focal lesion in both breasts, but ultrasonography-guided core needle biopsy for the lymph node revealed metastatic serous papillary carcinoma from ovarian origin. Even with a low incidence of axillary lymph node metastasis without breast involvement from ovarian cancer and only marginally elevated standardized uptake value in positron emission tomography, the possibility of metastasis at axillary lymph node in patients with known primary ovarian cancer must be considered.

  14. International multicenter tool to predict the risk of four or more tumor-positive axillary lymph nodes in breast cancer patients with sentinel node macrometastases

    DEFF Research Database (Denmark)

    Meretoja, Tuomo J; Audisio, R A; Heikkilä, P S;

    2013-01-01

    Recently, many centers have omitted routine axillary lymph node dissection (ALND) after metastatic sentinel node biopsy in breast cancer due to a growing body of literature. However, existing guidelines of adjuvant treatment planning are strongly based on axillary nodal stage. In this study, we a...

  15. Effects of axillary blockade on regional cerebral blood flow during dynamic hand contractions

    DEFF Research Database (Denmark)

    Friedman, D B; Friberg, L; Payne, G;

    1992-01-01

    Regional cerebral blood flow (rCBF) was measured at orbitomeatal (OM) plane +5.0 and +9.0 cm in 10 subjects at rest and during dynamic hand contractions before and after axillary blockade. Handgrip strength was significantly reduced, and rating of perceived exertion increased after blockade. During...... hand contractions before blockade, contralateral hemispheric cerebral blood flow (CBF) at OM +9.0 increased from a resting value of 58 (49-75) to 63 (52-82) ml.100 g-1.min-1; contralateral motor sensory rCBF at OM +9 from 58 (50-77) to 71 (64-84); motor sensory rCBF at OM +5 from 67 (54-76) to 77 (64......-87) and 70 (62-84) contralaterally and ipsilaterally, respectively; and supplementary motor area (SM) rCBF from 64 (53-69) to 75 (67-88) ml.100 g-1.min-1. During dynamic hand contractions after axillary blockade, CBF did not increase at OM +5 or in the SM. Furthermore, contralateral motor sensory rCBF at OM...

  16. Does the Addition of Tramadol and Ketamine to Ropivacaine Prolong the Axillary Brachial Plexus Block?

    Directory of Open Access Journals (Sweden)

    Ahmet Can Senel

    2014-01-01

    Full Text Available Background and Objectives. A prospective, randomized, controlled, double-blind clinical trial to assess the effect of tramadol and ketamine, 50 mg, added to ropivacaine in brachial plexus anesthesia. Methods. Thirty-six ASA physical statuses I and II patients, between 18 and 60 years of age, scheduled for forearm and hand surgery under axillary brachial plexus block, were allocated to 3 groups. Group R received 0.375% ropivacaine in 40 mL, group RT received 0.375% ropivacaine in 40 mL with 50 mg tramadol, and group RK received 0.375% ropivacaine in 40 mL with 50 mg ketamine for axillary brachial plexus block. The onset times and the duration of sensory and motor blocks, duration of analgesia, hemodynamic parameters, and adverse events (nausea, vomiting, and feeling uncomfortable were recorded. Results. The onset time of sensorial block was the fastest in ropivacaine + tramadol group. Duration of sensorial and motor block was the shortest in the ropivacaine + tramadol group. Duration of analgesia was significantly longer in ropivacaine + tramadol group. Conclusion. We conclude that when added to brachial plexus analgesia at a dose of 50 mg, tramadol extends the onset and duration time of the block and improves the quality of postoperative analgesia without any side effects.

  17. Treatment of Combined Injuries of the Axillary and Suprascapular Nerves with Scapulothoracic Dissociation.

    Science.gov (United States)

    Sano, Kazufumi; Ozeki, Satoru

    2015-12-01

    A 20-year-old man suffered the combined axillary and suprascapular nerve palsies associated with scapulothoracic dissociation by motorcycle accident. The dislocated shoulder girdle was reduced and stabilized with osteosynthesis of the fractured clavicle and reattachment of the trapezius avulsed from the scapular spine for removal of continuous traction force to these damaged nerves. Because of no evidence of recovery on manual muscle test and electromyogram, exploration for these nerves was administered 6 weeks after injury. Although neurolysis of both nerves revealed neural continuity, excessive tension still existed on the suprascapular nerve. It was thought that previous operation in which the shoulder girdle had been reduced and stabilized as much as possible could not achieve complete anatomical reduction of the scapula. As an additional treatment, medial walls of the suprascapular and spinoglenoid notches were shaven to relax the suprascapular nerve. After a year, complete recovery of both the axillary and suprascapular nerve was identified. Although scapulothoracic dissociation is commonly recognized as massive injury of the shoulder girdle with poor prognosis because of existence of accompanied severe neurovascular injuries, there are more than a few cases in which partial damage on the infraclavicular brachial plexus is only accompanied. In case of them, there is the possibility of lesions in continuity of the nerves in which good prognosis might be expected with surgical intervention including early reduction of the shoulder girdle for removal of excessive tension to the damaged nerve.

  18. Ultrasonografic changes in the axillary vein of patients with lymphedema after mastectomy

    Directory of Open Access Journals (Sweden)

    Gilberto Ferreira de Abreu Junior

    2015-04-01

    Full Text Available OBJECTIVE: To determine the prevalence of sonographic abnormalities (SA in the axillary vein of patients with and without post-mastectomy lymphedema. METHODS: We studied a sample of 80 women, divided into two equal groups, with and without lymphedema, with B mode ultrasound, color and pulsed Doppler. The primary variable, SA, is defined as change in the venous diameter, parietal thickening, intraluminal images, compressibility, parietal collapse at inspiration and feature of the axillary venous flow on the operated side. Secondary variables were: stage of lymphedema, surgical technique, number of radio and chemotherapy sessions, limb volume, weight and age. The differences between the proportions in the groups were determined using the Chi-square test and / or Fisher's test. For continuous variables, we used the Mann-Whitney Test. To estimate the magnitude of the associations, we used the prevalence rate of SA in both groups as a measure of frequency, and as a measure of association, the prevalence ratio (PR obtained as a function of relative risk (RR and estimated by the test Mantel-Haenszel homogeneity test. We adopted the statistical significance level of 5% (p < 0.05. RESULTS: only the criterion "parietal thickening" was strongly associated with the lymphedema group (p = 0.001. The prevalence of SA was 55% in patients with lymphedema and 17.5% in the group without it, with difference in prevalence of 37.5%. CONCLUSION: the prevalence of SA was higher in patients undergoing mastectomy with lymphedema than in those without lymphedema.

  19. Micropropagation of paradise tree (Melia azedarach) by in vitro culture of axillary buds.

    Science.gov (United States)

    Mroginski, Luis A; Rey, Hebe Y

    2013-01-01

    Paradise tree (Melia azedarach L.) is a multipurpose ornamental and timber tree, and its extracts are used to make insecticides and fungicides. Conventional propagation is done by seeds; however, sexual reproduction results in wide genetic variability. Therefore, clonal propagation is desirable to reduce genetic variation. This chapter describes a protocol for in vitro propagation of paradise tree by axillary buds. There are major steps for this protocol. Firstly, shoot induction by in vitro culture of axillary buds, excised from potted plants obtained by rooting of cuttings of 10-15-year-old adult trees. The initiation medium was composed of Murashige and Skoog medium (MS) supplemented with 0.5 mg/L BAP (benzylaminopurine), 0.1 mg/L IBA (indolebutyric acid), and 0.1 mg/L GA(3) (gibberellic acid). Secondly, multiplication of the regenerated shoots on MS medium amended with 0.5 mg/L BAP and 0.1 mg/L GA(3). Thirdly, rooting of the regenerated shoots on MS medium containing 0.1 mg/L IBA. Fully well-developed plants were transferred to pots containing sand, peat moss, and perlite (1:1:1), and maintained initially in the greenhouse or plastic tunnels.

  20. Prognostic Significance of Axillary Lymph Node Micrometastases and Microvessel Count in Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    RuiHui; FengyunZhao

    2004-01-01

    OBJECTIVE To investigate the influence of axillary lymph node micrometastases and the microvessel count on the prognosis of patients with breast cancer. METHODS Forty-eight patients with breast cancer, who had no tumor cells in their regional lymph nodes based on conventional histopathologic examination, were re-examined with immunohistochemical LSAB techniques. H&E, anti-EMA, CK 19 and FVlII factor staining was used to identify tumor cells in both lymph nodes and tumor tissues and to count the microvessels. A total of 882 lymph nodes were examined. RESULTS Immunostaining-positive tumor cells were found in 9.0 %(79/882) of the dissected lymph nodes. The positive rates were not significantly different between a surviving group and a deceased group (P>0.05). The microvessel count was significantly higher in group that had died (P<0.001). CONCLUSION The lymph node micrometastases did not show any correlation with patients'survival, but the microvessel density had a negative correlation with the survival period in breast cancer patients who had negative axillary lymph nodes.

  1. Axillary lymph node dissection for breast cancer utilizing Harmonic Focus®

    Directory of Open Access Journals (Sweden)

    Moldrem Amy

    2011-08-01

    Full Text Available Abstract Background For patients with axillary lymph node metastases from breast cancer, performance of a complete axillary lymph node dissection (ALND is the standard approach. Due to the rich lymphatic network in the axilla, it is necessary to carefully dissect and identify all lymphatic channels. Traditionally, these lymphatics are sealed with titanium clips or individually sutured. Recently, the Harmonic Focus®, a hand-held ultrasonic dissector, allows lymphatics to be sealed without the utilization of clips or ties. We hypothesize that ALND performed with the Harmonic Focus® will decrease operative time and reduce post-operative complications. Methods Retrospective review identified all patients who underwent ALND at a teaching hospital between January of 2005 and December of 2009. Patient demographics, presenting pathology, treatment course, operative time, days to drain removal, and surgical complications were recorded. Comparisons were made to a selected control group of patients who underwent similar surgical procedures along with an ALND performed utilizing hemostatic clips and electrocautery. A total of 41 patients were included in this study. Results Operative time was not improved with the use of ultrasonic dissection, however, there was a decrease in the total number of days that closed suction drainage was required, although this was not statistically significant. Complication rates were similar between the two groups. Conclusion In this case-matched retrospective review, there were fewer required days of closed suction drainage when ALND was performed with ultrasonic dissection versus clips and electrocautery.

  2. Minimum effective concentration of bupivacaine for axillary brachial plexus block guided by ultrasound

    Directory of Open Access Journals (Sweden)

    Alexandre Takeda

    2015-06-01

    Full Text Available INTRODUCTION: The use of ultrasound in regional anesthesia allows reducing the dose of local anesthetic used for peripheral nerve block. The present study was performed to determine the minimum effective concentration (MEC90 of bupivacaine for axillary brachial plexus block. METHODS: Patients undergoing hand surgery were recruited. To estimate the MEC90, a sequential up-down biased coin method of allocation was used. The bupivacaine dose was 5 mL for each nerve (radial, ulnar, median, and musculocutaneous. The initial concentration was 0.35%. This concentration was changed by 0.05% depending on the previous block; a blockade failure resulted in increased concentration for the next patient; in case of success, the next patient could receive or reduction (0.1 probability or the same concentration (0.9 probability. Surgical anesthesia was defined as driving force ≤2 according to the modified Bromage scale, lack of thermal sensitivity and response to pinprick. Postoperative analgesia was assessed in the recovery room with numeric pain scale and the amount of drugs used within 4 h after the blockade. RESULTS: MEC90 was 0.241% [R 2: 0.978, confidence interval: 0.20-0.34%]. No patient, with successful block, reported pain after 4 h. CONCLUSION: This study demonstrated that ultrasound guided axillary brachial plexus block can be performed with the use of low concentration of local anesthetics, increasing the safety of the procedure. Further studies should be conducted to assess blockade duration at low concentrations.

  3. Distribution of apocrine sweat glands in axillary region of patients with axillary osmidrosis%腋臭患者腋区顶泌汗腺的分布特点

    Institute of Scientific and Technical Information of China (English)

    邢卫斌; 刘文芳; 赵子申; 彭军; 李兴文; 马玉枝; 王娜

    2014-01-01

    目的 检测腋臭患者腋区顶泌汗腺在深度、广度的分布,探讨其范围内的分布差异性.方法 2010年9-12月间的15例腋臭患者,行直视下顶泌汗腺剪除术,切取切口处宽约2 mm的全层皮肤,深度达腋浅筋膜浅层,用于判明顶泌汗腺分布的深度.留取腋中心(点1)、距腋中心1 cm(点2)、距腋毛边缘内1cm(点3)、腋毛边缘(点4)、距腋毛边缘外1 cm(点5)共5个标记点对应的皮下暗红色粗大的颗粒状组织,用于判明顶泌汗腺的分布范围及分布规律.结果 顶泌汗腺分泌部主要分布于真皮网状层和皮下脂肪浅层,表皮层、真皮乳头层及腋浅筋膜浅层均无顶泌汗腺分布.顶泌汗腺广度分布与腋毛范围基本一致,腋中心部可见大量顶泌汗腺组织,腋毛边缘处仍有少量顶泌汗腺分布,腋毛边缘外1.0 cm处已无顶泌汗腺分布.5个点顶泌汗腺面积占整块组织面积的百分比平均值分别为74.1%、46.6%、25.3%、2.1%和0,相邻两点进行t检验,点1、2之间f=29.78,P< 0.01;点2、3之间t=9.76,P< 0.01;点3、4之间t=20.83,P< 0.01;点4、5之间t=1.96,P> 0.05.结论 手术治疗腋臭时,清除范围深度达真皮网状层和浅层脂肪层,广度到腋毛范围即可,没有必要过度扩大清除范围.%Objective To determine the distribution profile of apocrine sweat glands in axillary region of patients with axillary osmidrosis,and to compare their distribution at different sites.Methods Fifteen patients with axillary osmidrosis were enrolled in this study from September to December 2010.All the patients underwent surgical removal of apocrine sweat glands under direct vision.Full-thickness skin tissue measuring 2 mm in width was excised down to the axillary superficial fascia at the incisional surgical sites from five patients.Five points,which were at the center of axillary region (point 1),1 cm away from the center of axillary region (point 2),1 cm inside the edge of axillary

  4. Peripheral arterial line (image)

    Science.gov (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of ...

  5. Abscisic acid signaling is controlled by a BRANCHED1/HD-ZIP i cascade in Arabidopsis axillary buds

    NARCIS (Netherlands)

    Gonzalez-Grandio, Eduardo; Pajoro, Alice; Franco-Zorrilla, Jose M.; Tarancon, Carlos; Immink, Richard G.H.; Cubas, Pilar

    2017-01-01

    Shoot-branching patterns determine key aspects of plant life and are important targets for crop breeding. However, we are still largely ignorant of the genetic networks controlling locally themost important decision during branch development: whether the axillary bud, or branch primordium, grows out

  6. Observation of the Primo Vessel Approaching the Axillary Lymph Node with the Fluorescent Dye, DiI

    Directory of Open Access Journals (Sweden)

    Su Youn Park

    2014-01-01

    Full Text Available The primo vascular system (PVS floating in lymph fluid has mostly been observed in large caliber ducts around the caudal vena cava and the thoracic duct of rabbits, rats, and mice. But the PVS has not been traced up to the lymph nodes. It has not been established whether the PVS leaves the lymph vessel through the lymph vessel wall or it enters the lymph nodes. Therefore, observing the PVS entering a lymph node, for example, the axillary node, is desirable. In the current work, we traced the PVS approaching up to the surface of axillary node of a rat. The method used for this study was based upon a method that was recently developed to detect the PVS in the lymph duct from the inguinal to the axillary nodes in the skin of a rat by injecting Alcian blue into the inguinal node. However, the Alcian blue blurred near the lymph nodes and tracing the PVS up to the lymph nodes has not been possible. The current method clearly showed the PVS approaching the axillary node.

  7. Four Hypotheses to Explain Axillary Budbreak after Removal of Flower Shoots in a Cut-rose Crop

    NARCIS (Netherlands)

    Wubs-Timmermans, A.M.; Heuvelink, E.; Marcelis, L.F.M.; Okello, R.C.; Buck-Sorlin, G.H.; Vos, J.

    2013-01-01

    When flower-bearing shoots in cut-rose (Rosa ×hybrida) are harvested (removed), a varying number of repressed axillary buds on the shoot remainder start to grow into new shoots (budbreak). Besides removing within-shoot correlative inhibition, it is hypothesized that shoot removal leads to 1) increas

  8. Epistatic natural allelic variation reveals a function of AGAMOUS-LIKE6 in axillary bud formation in Arabidopsis

    NARCIS (Netherlands)

    Huang, X.; Effgen, S.; Meyer, R.C.; Theres, K.; Koornneef, M.

    2012-01-01

    In the Arabidopsis Multiparent Recombinant Inbred Line mapping population, a limited number of plants were detected that lacked axillary buds in most of the axils of the cauline (stem) leaves, but formed such buds in almost all rosette axils. Genetic analysis showed that polymorphisms in at least th

  9. The efficacy of a microwave device for treating axillary hyperhidrosis and osmidrosis in Asians: a preliminary study.

    Science.gov (United States)

    Lee, Sang-Jun; Chang, Ka-Yeun; Suh, Dong-Hye; Song, Kye-Yong; Ryu, Hwa Jung

    2013-10-01

    A microwave-based device has been developed to treat axillary hyperhidrosis by selectively heating the interface between the skin and underlying fat in the axilla. This study was conducted to evaluate the efficacy and safety of microwave-based devices for axillary hyperhidrosis and osmidrosis in Asians. Eleven patients (8 females and 3 males, age range 20-52 years, mean age 37.6 years) with axillary hyperhidrosis or osmidrosis were enrolled, treated with the microwave-based device, and followed up for 7 months. Procedure efficacy, patient satisfaction, and treatment safety were assessed. The clinical records were reviewed and the patients were interviewed individually at follow-up visits or via telephone. Evaluation of sweating showed at least a 2-point drop or greater in hyperhidrosis disease severity scale (HDSS) in 83.3% subjects (10/12 axillae) as measured at the 7-month follow-up. Of 16 axillae with osmidrosis, 93.8% (15/16 axillae) showed good to excellent results. Histologic findings also showed destruction of eccrine and apocrine glands that were replaced with fibrosis. Regarding safety, altered sensation of arms developed in one case that resolved after 3 months. This novel microwave-based treatment appears to be effective and well tolerated for the treatment of axillary hyperhidrosis and osmidrosis in Asians.

  10. Deodorant effects of a sage extract stick: Antibacterial activity and sensory evaluation of axillary deodorancy

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Shahtalebi

    2013-01-01

    Full Text Available Background: Deodorant products prevent the growth and activity of the degrading apocrine gland bacteria living in the armpit. Common antibacterial agents in the market like triclosan and aluminum salts, in spite of their suitable antibacterial effects, increase the risk of Alzheimer′s disease, breast and prostate cancers or induce contact dermatitis. Therefore, plant extracts possessing antibacterial effects are of interest. The aim of the present study was to verify the in vitro antimicrobial effects of different sage extracts against two major bacteria responsible for axillary odor, and to evaluate the deodorant effect of a silicon-based stick containing sage extracts in different densities in humans. Materials and Methods: Different fractions of methanolic extract of Salvia officinalis (sage were evaluated on a culture of armpit skin surface of volunteers through agar microdilution antimicrobial assay. Then, randomized, double-blind placebo-controlled clinical trial with the best antibacterial fraction was conducted on 45 female healthy volunteers. Participants were treated with a single dose in four groups, each containing 15 individuals: Group 1 (200 μg/mL, 2 (400 μg/mL, 3 (600 μg/mL of dichloromethane sage extract, and placebo (without extract. A standard sensory evaluation method for the evaluation of deodorant efficacy was used before, and two hours, four hours, and eight hours after single application of a deodorant or placebo (ASTM method E 1207-87 Standard Practice for the Sensory Evaluation of Axillary Deodorancy. Results: The data were analyzed with two factors relating to densities and time. In 45 participants with a mean [± standard deviation (SD] age of 61.5±11.8 years, statistically significant within-group differences were observed before and two, four, and eight hours after deodorant treatment for groups 1, 2, and 3. Groups 1, 2, and 3 had a significantly smaller odor score than placebo after two, four, and eight hours

  11. Optimized Axillary Vein Technique versus Subclavian Vein Technique in Cardiovascular Implantable Electronic Device Implantation: A Randomized Controlled Study

    Institute of Scientific and Technical Information of China (English)

    Peng Liu; Yi-Feng Zhou; Peng Yang; Yan-Sha Gao; Gui-Ru Zhao; Shi-Yan Ren; Xian-Lun Li

    2016-01-01

    Background:The conventional venous access for cardiovascular implantable electronic device (CIED) is the subclavian vein,which is often accompanied by high complication rate.The aim of this study was to assess the efficacy and safety of optimized axillary vein technique.Methods:A total of 247 patients undergoing CIED implantation were included and assigned to the axillary vein group or the subclavian vein group randomly.Success rate of puncture and complications in the perioperative period and follow-ups were recorded.Results:The overall success rate (95.7% vs.96.0%) and one-time success rate (68.4% vs.66.1%) of punctures were similar between the two groups.In the subclavian vein group,pneumothorax occurred in three patients.The subclavian gaps of three patients were too tight to allow operation of the electrode lead.In contrast,there were no puncture-associated complications in the axillary vein group.In the patient follow-ups,two patients in the subclavian vein group had subclavian crush syndrome and both of them received lead replacement.The incidence of complications during the perioperative period and follow-ups of the axillary vein group and the subclavian vein group was 1.6% (2/125) and 8.2% (10/122),respectively (x2=5.813,P =0.016).Conclusion:Optimized axillary vein technique may be superior to the conventional subclavian vein technique for CIED lead placement.

  12. FDG PET evaluation of early axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Rousseau, Caroline [Comprehensive Cancer Center Rene Gauducheau, IRCNA, Nuclear Medicine Department, Saint Herblain (France); Nantes University, INSERM UMR 892, Cancer Research Center CRCNA, Nantes (France); Centre Rene Gauducheau, Service de Medecine Nucleaire, Saint Herblain Cedex (France); Devillers, Anne [Eugene Marquis Cancer Center, Nuclear Medicine Department, Rennes (France); Campone, Mario [Comprehensive Cancer Center Rene Gauducheau, Medical Oncology Department, Saint Herblain (France); Campion, Loic [Comprehensive Cancer Center Rene Gauducheau, Statistic Department, Saint Herblain (France); Ferrer, Ludovic [Comprehensive Cancer Center Rene Gauducheau, Medical Physics Department, Saint Herblain (France); Sagan, Christine [University Hospital, Pathology Department, Nantes (France); Ricaud, Myriam [Comprehensive Cancer Center Rene Gauducheau, Radiology Department, Saint Herblain (France); Bridji, Boumediene [Comprehensive Cancer Center Rene Gauducheau, IRCNA, Nuclear Medicine Department, Saint Herblain (France); Kraeber-Bodere, Francoise [Comprehensive Cancer Center Rene Gauducheau, IRCNA, Nuclear Medicine Department, Saint Herblain (France); Nantes University, INSERM UMR 892, Cancer Research Center CRCNA, Nantes (France)

    2011-06-15

    Regional axillary lymph node status has remained the single most independent variable to predict prognosis both in terms of disease recurrence and survival. This study aimed to prospectively assess sequential [{sup 18}F]fluorodeoxyglucose (FDG) positron emission tomography (PET) findings as early predictors of axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients. Images were acquired with a PET/CT scanner in 52 patients after administration of FDG (5 MBq/kg) at baseline and after the first, second, third and sixth course of chemotherapy before surgery. Clinical examination and ultrasound (US) were used to assess the size of axillary nodes. Decrease in the standardized uptake value (SUV) with PET corrected or not for partial volume effects was compared to the pathological response. The sensitivity, specificity and accuracy of axillary node staging was higher with PET (75, 87 and 80%) than with US (50, 83 and 65%), and even more so when PET images were corrected for partial volume effects (86, 83 and 84%). While FDG uptake did not vary much in non-responders, as confirmed by histopathological analysis, it markedly decreased to baseline levels in responders (p < 10{sup -5}). Fifty per cent of baseline SUV was considered the best cutoff value to distinguish responders from non-responders. The sensitivity, specificity, negative predictive value and accuracy of FDG PET after one course of chemotherapy were, respectively, 96, 75, 95 and 84%. The pathological status of regional axillary lymph nodes in stage II and III breast cancer patients could be accurately predicted after one course of neoadjuvant chemotherapy based on FDG PET images. (orig.)

  13. Successful closure of feline axillary wounds by reconstruction of the elbow skin fold.

    Science.gov (United States)

    Brinkley, C H

    2007-02-01

    This report describes the successful closure of five chronic feline axillary wounds. The aetiology was known to be forelimb entrapment in a neck collar in three cases and was suspected in the others. Each cat underwent a single surgical procedure during which the wound was debrided, the normal structure of the elbow skin fold was restored and the remaining skin defect was closed primarily. None of the cats had undergone any previous reconstruction attempts. No postoperative complications were observed and the wounds healed uneventfully. Cats have well-developed elbow skin folds, allowing a wide range of limb motion to occur. Having a forelimb trapped in a neck collar not only creates a wound in the axilla but also disrupts the normal anatomy of the skin fold. This report demonstrates that restoring the elbow skin fold before closing the wound may improve the chances of a successful reconstruction at the first surgical intervention.

  14. A mechanistic breast cancer survival modelling through the axillary lymph node chain.

    Science.gov (United States)

    Cobre, Juliana; Castro Perdoná, Gleici S; Peria, Fernanda M; Louzada, Francisco

    2013-04-30

    In this paper, we proposed a mechanistic breast cancer survival model based on the axillary lymph node chain structure, considering lymph nodes as a potential dissemination arrangement. We assume a naive breast cancer treatment protocol consisting of exposing patients first to a chemotherapy treatment on r intervals at k-cycles separated by equal time intervals, and then they proceed to surgery. Our model, different from former ones, accommodates a quantity of contaminated lymph nodes, which is observed during surgery. We assume a generalised negative binomial survival distribution for the unknown number of contaminated lymph nodes after surgery, which, during an unknown period, may potentially propagate the disease. Estimation is based on a maximum likelihood approach. A simulation study assesses the coverage probability of asymptotic confidence intervals when small or moderate samples are considered. A Brazilian breast cancer data illustrate the applicability of our modelling.

  15. Staging of women with breast cancer after introduction of sentinel node guided axillary dissection

    DEFF Research Database (Denmark)

    Tvedskov, Tove Filtenborg

    2012-01-01

    Today, sentinel lymph node dissection (SLND) has replaced axillary lymph node dissection (ALND) as standard procedure for staging of the axilla in the treatment of breast cancer. SLND can accurately stage the axilla by removing on average only two lymph nodes. Only in case of metastatic spread...... to sentinel nodes an ALND is offered. Removing fewer nodes has made more extensive histopathological examinations of the lymph nodes possible and as a consequence more metastases are found. This has resulted in stage migration. Based on data from the nationwide Danish Breast Cancer Cooperative Group (DBCG.......8%, when estimated using today´s criteria for risk-allocation, because nodal status is now less important in risk-allocation. In general, only 15-20% of patients with micrometastases and 10-15% of patients with isolated tumor cells (ITC) in sentinel node have further metastatic spread to non-sentinel nodes...

  16. Primo Vascular System in the Lymph Vessel from the Inguinal to the Axillary Nodes

    Directory of Open Access Journals (Sweden)

    Seung Hwan Lee

    2013-01-01

    Full Text Available The primo vascular system (PVS in a lymph system was observed mostly in large caliber ducts around the caudal vena cava of rabbits, rats, and mice. This required a severe surgery with laparectomy and massive removal of fat tissues in the abdomen to expose the lymph vessel. In the current brief report, we presented a new method to evade these shortcomings by observing the PVS in a less large caliber duct in the skin, that is, the lymph vessel from the inguinal to the axillary nodes. The Alcian blue injection into the inguinal node revealed the desired primo vessel in the target lymph vessel. This opened a new perspective for the investigation of the lymphatic PVS without severe damage to subject animals and for monitoring of the PVS in a long period of time.

  17. AGROBACTERIUM MEDIATED TRANSFORMATION OF PIGEONPEA (CAJANUS CAJAN L MILLLSP VAR LRG-41 FROM AXILLARY BUD

    Directory of Open Access Journals (Sweden)

    T. Raghavendra

    2014-02-01

    Full Text Available A reliable method of plant regeneration has been achieved from Axillary buds. Shoots appeared from explants when cultured on Murashige and skoog (MS medium supplemented with BAP (Benzyl amino purine, Napthalene acetic acid (NAA and Kinetin at various combinations. Elongated shoots were rooted with 70.6% rooting frequency in MS medium with indole buteric acid (IBA at 1.0mg/l. The rooted plantlets were established well in soilrite mixture medium with 91% success and days taken for acclimatization were 12.8 days. This protocol was used in Agrobacterium mediated transformation. The transformation was carried out using the Agrobacterium strain LBA4404 containing the binary vector pCAMBIA2301 harboring npt II as selectable marker and GUS as reporter gene.

  18. AGROBACTERIUM MEDIATED TRANSFORMATION OF PIGEONPEA (CAJANUS CAJAN L MILLLSP VAR LRG-41 FROM AXILLARY BUD

    Directory of Open Access Journals (Sweden)

    T. Raghavendra

    2014-03-01

    Full Text Available A reliable method of plant regeneration has been achieved from Axillary buds. Shoots appeared from explants when cultured on Murashige and skoog (MS medium supplemented with BAP (Benzyl amino purine, Napthalene acetic acid (NAA and Kinetin at various combinations. Elongated shoots were rooted with 70.6% rooting frequency in MS medium with indole buteric acid (IBA at 1.0mg/l. The rooted plantlets were established well in soilrite mixture medium with 91% success and days taken for acclimatization were 12.8 days. This protocol was used in Agrobacterium mediated transformation. The transformation was carried out using the Agrobacterium strain LBA4404 containing the binary vector pCAMBIA2301 harboring npt II as selectable marker and GUS as reporter gene.

  19. Is it necessary to do axillary dissection in old women with breast cancer?A meta-analysis of randomized clinical trials

    Institute of Scientific and Technical Information of China (English)

    Chong Le; Tian Jin-hui; Gu Jing; Yang Ke-hu

    2012-01-01

    Objective To assess the effectiveness and safety of axillary dissection in old women with breast cancer.Methods All randomized controlled trials on axillary dissection in old woman were retrieved in the Cochrane Library, PubMed, EMBASE and Chinese Biomedical Literature Database. Meta-analyses were completed using RevMan 5.1.Results Three eligible randomized controlled trials (RCTs) including 5337 patients were involved. There were weak evidences in favor of axillary dissection in old woman. The meta-analysis showed that the overall survival (OS) in 1, 3, 5 and 7 years and the disease-free survival (DFS) in 1, 3 and 5 years were not statistically different between axillary dissection patients and non-axillary dissection patients. However there was a statistical difference in 7-year DFS.Conclusions Axillary dissection does not show a survival benefit in the old women with breast cancer. Therefore it is not well-founded to do axillary dissection in old women with breast cancer.

  20. Comparison of intraoperative frozen section analysis of sentinel node with preoperative positron emission tomography in the diagnosis of axillary lymph node status in breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Jung-Hyun; Nam, Seok-Jin; Lee, Hae-Kyung; Kim, Byung-Tae [Sungkyunkwan Univ., Seoul (Korea, Republic of); Lee, Tae-Seung; Jung, Sung-Hoo

    2001-01-01

    Although axillary lymph node status is an important prognostic factor and axillary dissection is regarded as the gold standard for staging, it requires radical surgery which is accompanied by considerable postoperative problems such as lymphedema. This study was carried out to evaluate the diagnostic accuracy of preoperative positron emission tomography (PET) and intraoperative frozen biopsy of sentinel lymphadenectomy (SLND) in detecting axillary lymph node metastasis. We studied 18 patients who had preoperative PET and SLND for breast cancer in the Department of Surgery at Samsung Medical Center. They all had preoperative PET with a radiolabeled glucose analogue ([{sup 18}F]FDG) to visualize primary tumors and metastatic nodes. Isosulphan blue dye was used for intraoperative SLND. Frozen and permanent biopsies were then compared after full axillary dissection. In 18 cases, six had positive metastatic nodes in the permanent biopsy of full axillary dissection but were negative in three cases by preoperative PET. There was one false negative result by frozen biopsy of SLND which was later shown to be positive by permanent biopsy. The sensitivity and specificity of SLND and PET for detecting axillary node metastasis were 83, 100% and 50, 100%, respectively. Although both methods are good for axillary nodal status, the intraoperative frozen biopsy result of SLND was superior to preoperative PET in our preliminary study. (author)

  1. Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

    Directory of Open Access Journals (Sweden)

    Chiofalo Maria

    2012-02-01

    Full Text Available Abstract Background Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Case presentation Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with "signet ring cells" and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Discussion and Conclusion Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. "Signet ring cell" is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare "signet ring cells" carcinomas so far described.

  2. The control of axillary meristem fate in the maize ramosa pathway.

    Science.gov (United States)

    Gallavotti, Andrea; Long, Jeff A; Stanfield, Sharon; Yang, Xiang; Jackson, David; Vollbrecht, Erik; Schmidt, Robert J

    2010-09-01

    Plant axillary meristems are composed of highly organized, self-renewing stem cells that produce indeterminate branches or terminate in differentiated structures, such as the flowers. These opposite fates, dictated by both genetic and environmental factors, determine interspecific differences in the architecture of plants. The Cys(2)-His(2) zinc-finger transcription factor RAMOSA1 (RA1) regulates the fate of most axillary meristems during the early development of maize inflorescences, the tassel and the ear, and has been implicated in the evolution of grass architecture. Mutations in RA1 or any other known members of the ramosa pathway, RAMOSA2 and RAMOSA3, generate highly branched inflorescences. Here, we report a genetic screen for the enhancement of maize inflorescence branching and the discovery of a new regulator of meristem fate: the RAMOSA1 ENHANCER LOCUS2 (REL2) gene. rel2 mutants dramatically increase the formation of long branches in ears of both ra1 and ra2 mutants. REL2 encodes a transcriptional co-repressor similar to the TOPLESS protein of Arabidopsis, which is known to maintain apical-basal polarity during embryogenesis. REL2 is capable of rescuing the embryonic defects of the Arabidopsis topless-1 mutant, suggesting that REL2 also functions as a transcriptional co-repressor throughout development. We show by genetic and molecular analyses that REL2 physically interacts with RA1, indicating that the REL2/RA1 transcriptional repressor complex antagonizes the formation of indeterminate branches during maize inflorescence development. Our results reveal a novel mechanism for the control of meristem fate and the architecture of plants.

  3. Arterial embolization for iatrogenic life-threatening bleeding from subcutaneous hypervascular tumor in prone position

    Institute of Scientific and Technical Information of China (English)

    Seiji Morita; Tomoatsu Tsuji; Toru Sawamoto; Hiromichi Aoki; Naoya Miura; Hiroyuki Otsuka; Sadaki Inokuchi

    2010-01-01

    Performing angiography in the prone position is a difficult technique; however it is useful in some emergency situation. We experienced a 60 years old male who was performed lipoma excision on his back in his family doctor's clinic. Since massive arterial bleeding could not be controlled with manual astriction, he transferred to our hospital in prone position with hemodynamic instability. Operating field was not kept because of massive bleeding; there-fore surgical treatment was impossible. We planed emer-gency arterial embolization (AE) in prone position. Hence we chose the left radial artery for vascular access. The left subclavicle arteriography showed many major and minor feeding arteries from left subclavicular and axillary arteries and a massive extravasation of the contrast medium. Three major feeding arteries were performed AE with gelatin sponge and steel coils. After AE, massive bleeding was controlled.He could discharge from our hospital on the 5th hospital day without any complication. Arterial embolization for lifethreatening bleeding from subcutaneous hypervascular tumor in the prone position is first report to our knowledge,and it is extremely rare. However we thought that this tech-nique is useful for patients who could not turn in the supine position, e.g. massive bleeding during renal biopsy and penetrating trauma from back.

  4. Intraspecific and Interspecific Competition in Polyspora axillaris Community in Maluan Mountain of Shenzhen%深圳马峦山大头茶(Polyspora axillaris)群落种内与种间竞争研究

    Institute of Scientific and Technical Information of China (English)

    张锦新; 廖国新; 徐晓晖

    2013-01-01

    The intraspecific and interspecific competition intensity in Polyspora axillaris in Maluan Mountain of Shenzhen City were quantitatively analyzed using Hegyi single tree competition index model. The results showed that the intraspecific competition intensity in P. axillaris was decreased gradually with the increase of forest tree diameter class, and the interspecific competition in P. axillaris was more intensive than that in associated tree species. The order of the intraspecific and interspecific competition intensity in P. axillaris was: P. axillaris > Toxicodendron verniciflua >Litsea rotundifolia var. oblongtfolia >Schima superba >Microcos paniculata >Sapium sebiferum>Litsea cubeba>Sapium discolor. There was significantly negative correlation between the competition intensity and the individual size of objective tree, and the relationship of the competition intensity between the competitive tree and the objective tree and the individual size of objective tree obeyed power function rule. When the diameter at breast height of P. axillaris reached 15 cm, the competition intensity inconspicuously changed into stable situation.%采用Hegyi的单木竞争指数模型对马峦山的大头茶群落种内、种间的竞争强度进行定量分析.结果表明,大头茶种内竞争强度随着植株径级的增大而具减小趋势,种内竞争显著大于种间竞争,对象木种内、种间竞争强度的顺序为:大头茶>漆树>豺皮樟>荷木>布渣叶>乌桕>山苍子>山乌桕.竞争木对对象木的竞争强度与对象木的个体大小服从幂函数关系,竞争强度和对象木个体的大小呈极显著的负相关关系,当大头茶胸径达到15 cm后,竞争强度趋于稳定.

  5. Comparison of the diagnostic value of FDG-PET/CT and axillary ultrasound for the detection of lymph node metastases in breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Riegger, Carolin; Heusner, Till A. [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)], E-mail: Heusner@med.uni-duesseldorf.de; Koeninger, Angela; Kimmig, Rainer [Univ Duisburg-Essen, Medical Faculty, Department of Gynecology and Obstetrics, Essen (Germany); Hartung, Verena; Bockisch, Andreas [Univ Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Otterbach, Friedrich [Univ Duisburg-Essen, Institute of Pathology and Neuropathology, Essen (Germany); Forsting, Michael [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Antoch, Gerald [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany)

    2012-12-15

    Background. FDG-PET/CT is increasingly being used for breast cancer staging. Its diagnostic accuracy in comparison to ultrasound as the standard non-invasive imaging modality for the evaluation of axillary lymph nodes has yet not been evaluated. Purpose. To retrospectively compare the diagnostic value of full-dose, intravenously contrast-enhanced FDG-PET/CT and ultrasound for the detection of lymph node metastases in breast cancer patients. Material and Methods. Ninety patients (one patient with a bilateral carcinoma) (89 women, one man; mean age, 55.5 {+-} 16.6 years) suffering from primary breast cancer underwent whole-body FDG-PET/CT and axillary ultrasound. The ipsilateral axillary fossa (n = 91) was evaluated for metastatic spread. The sensitivity, specificity, the positive predictive value (PPV), negative predictive value (NPV), and accuracy of both methods were calculated. The sensitivity and accuracy were statistically compared using the McNemar Test (P <0.05). Analyses were made on a patient basis. The number of patients with extra-axillary locoregional lymph node metastases exclusively detected by FDG-PET/CT was evaluated. For axillary lymph node metastases histopathology served as the reference standard. Results. The sensitivity, specificity, PPV, NPV, and accuracy of FDG-PET/CT for the detection of axillary lymph node metastases were 54%, 89%, 77%, 74%, and 75%, respectively. For ultrasound it was 38%, 78%, 54%, 65%, and 62%, respectively. FDG-PET/CT was significantly more accurate than ultrasound for the detection of axillary lymph node metastases (P = 0.019). There was no statistically significant difference between the sensitivity of both modalities (P = 0.0578). FDG-PET/CT detected extra-axillary locoregional lymph node metastases in seven patients (8%) that had not been detected by another imaging modality. Conclusion. Though more accurate compared to ultrasound for evaluating the axillary lymph node status FDG-PET/CT is only as sensitive as

  6. Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction

    Directory of Open Access Journals (Sweden)

    Russo James K

    2011-12-01

    Full Text Available Abstract Background To define the dosimetric coverage of level I/II axillary volumes and the lung volume irradiated in postmastectomy radiotherapy (PMRT following tissue expander placement. Methods and Materials Twenty-three patients were identified who had undergone postmastectomy radiotherapy with tangent only fields. All patients had pre-radiation tissue expander placement and expansion. Thirteen patients had bilateral expander reconstruction. The level I/II axillary volumes were contoured using the RTOG contouring atlas. The patient-specific variables of expander volume, superior-to-inferior location of expander, distance between expanders, expander angle and axillary volume were analyzed to determine their relationship to the axillary volume and lung volume dose. Results The mean coverage of the level I/II axillary volume by the 95% isodose line (VD95% was 23.9% (range 0.3 - 65.4%. The mean Ipsilateral Lung VD50% was 8.8% (2.2-20.9. Ipsilateral and contralateral expander volume correlated to Axillary VD95% in patients with bilateral reconstruction (p = 0.01 and 0.006, respectively but not those with ipsilateral only reconstruction (p = 0.60. Ipsilateral Lung VD50% correlated with angle of the expander from midline (p = 0.05. Conclusions In patients undergoing PMRT with tissue expanders, incidental doses delivered by tangents to the axilla, as defined by the RTOG contouring atlas, do not provide adequate coverage. The posterior-superior region of level I and II is the region most commonly underdosed. Axillary volume coverage increased with increasing expander volumes in patients with bilateral reconstruction. Lung dose increased with increasing expander angle from midline. This information should be considered both when placing expanders and when designing PMRT tangent only treatment plans by contouring and targeting the axilla volume when axillary treatment is indicated.

  7. Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction

    Science.gov (United States)

    2011-01-01

    Background To define the dosimetric coverage of level I/II axillary volumes and the lung volume irradiated in postmastectomy radiotherapy (PMRT) following tissue expander placement. Methods and Materials Twenty-three patients were identified who had undergone postmastectomy radiotherapy with tangent only fields. All patients had pre-radiation tissue expander placement and expansion. Thirteen patients had bilateral expander reconstruction. The level I/II axillary volumes were contoured using the RTOG contouring atlas. The patient-specific variables of expander volume, superior-to-inferior location of expander, distance between expanders, expander angle and axillary volume were analyzed to determine their relationship to the axillary volume and lung volume dose. Results The mean coverage of the level I/II axillary volume by the 95% isodose line (VD95%) was 23.9% (range 0.3 - 65.4%). The mean Ipsilateral Lung VD50% was 8.8% (2.2-20.9). Ipsilateral and contralateral expander volume correlated to Axillary VD95% in patients with bilateral reconstruction (p = 0.01 and 0.006, respectively) but not those with ipsilateral only reconstruction (p = 0.60). Ipsilateral Lung VD50% correlated with angle of the expander from midline (p = 0.05). Conclusions In patients undergoing PMRT with tissue expanders, incidental doses delivered by tangents to the axilla, as defined by the RTOG contouring atlas, do not provide adequate coverage. The posterior-superior region of level I and II is the region most commonly underdosed. Axillary volume coverage increased with increasing expander volumes in patients with bilateral reconstruction. Lung dose increased with increasing expander angle from midline. This information should be considered both when placing expanders and when designing PMRT tangent only treatment plans by contouring and targeting the axilla volume when axillary treatment is indicated. PMID:22204504

  8. Tumescent suction curettage vs. curettage only for treatment of axillary hyperhidrosis evaluated by subjective and new objective methods.

    Science.gov (United States)

    Tronstad, Christian; Helsing, Per; Tønseth, Kim Alexander; Grimnes, Sverre; Krogstad, Anne Lene

    2014-03-01

    The main purpose of this study was to compare the effect of the 2 minimally invasive surgical techniques for treating axillary hyperhidrosis: superficial tumescent suction curettage and curettage only. A total of 22 patients diagnosed with axillary hyperhidrosis received one type of treatment at each side, randomized. Examinations were performed pre-operatively and at 3, 6 and 12 months following treatment. Sweating was measured by gravimetry and a new skin conductance method. Subjective rating of sweating was assessed by a visual analogue scale. Skin conductance was recorded during a stress-test including acoustic, mental and physical stressors. Five patients withdrew or did not meet for any follow-up examination, giving 17 subjects in total for data analysis. Significant reduction in sweating after surgery lasting at least 12 months was found based on skin conductance, gravimetry and visual analogue scale scoring. Comparison between types of treatment revealed a significantly better effect of tumescent suction curettage than curettage only.

  9. Quantum dots in axillary lymph node mapping: Biodistribution study in healthy mice

    Directory of Open Access Journals (Sweden)

    Guillemin François

    2008-04-01

    Full Text Available Abstract Background Breast cancer is the first cause of cancer death among women and its incidence doubled in the last two decades. Several approaches for the treatment of these cancers have been developed. The axillary lymph node dissection (ALND leads to numerous morbidity complications and is now advantageously replaced by the dissection and the biopsy of the sentinel lymph node. Although this approach has strong advantages, it has its own limitations which are manipulation of radioactive products and possible anaphylactic reactions to the dye. As recently proposed, these limitations could in principle be by-passed if semiconductor nanoparticles (quantum dots or QDs were used as fluorescent contrast agents for the in vivo imaging of SLN. QDs are fluorescent nanoparticles with unique optical properties like strong resistance to photobleaching, size dependent emission wavelength, large molar extinction coefficient, and good quantum yield. Methods CdSe/ZnS core/shell QDs emitting around 655 nm were used in our studies. 20 μL of 1 μM (20 pmol QDs solution were injected subcutaneously in the anterior paw of healthy nude mice and the axillary lymph node (ALN was identified visually after injection of a blue dye. In vivo fluorescence spectroscopy was performed on ALN before the mice were sacrificed at 5, 15, 30, 60 min and 24 h after QDs injection. ALN and all other organs were removed, cryosectioned and observed in fluorescence microscopy. The organs were then chemically made soluble to extract QDs. Plasmatic, urinary and fecal fluorescence levels were measured. Results QDs were detected in ALN as soon as 5 min and up to 24 h after the injection. The maximum amount of QDs in the ALN was detected 60 min after the injection and corresponds to 2.42% of the injected dose. Most of the injected QDs remained at the injection site. No QDs were detected in other tissues, plasma, urine and feces. Conclusion Effective and rapid (few minutes detection of

  10. Infrared micro-spectral imaging: distinction of tissue types in axillary lymph node histology

    Directory of Open Access Journals (Sweden)

    Stone Nicholas

    2008-08-01

    Full Text Available Abstract Background Histopathologic evaluation of surgical specimens is a well established technique for disease identification, and has remained relatively unchanged since its clinical introduction. Although it is essential for clinical investigation, histopathologic identification of tissues remains a time consuming and subjective technique, with unsatisfactory levels of inter- and intra-observer discrepancy. A novel approach for histological recognition is to use Fourier Transform Infrared (FT-IR micro-spectroscopy. This non-destructive optical technique can provide a rapid measurement of sample biochemistry and identify variations that occur between healthy and diseased tissues. The advantage of this method is that it is objective and provides reproducible diagnosis, independent of fatigue, experience and inter-observer variability. Methods We report a method for analysing excised lymph nodes that is based on spectral pathology. In spectral pathology, an unstained (fixed or snap frozen tissue section is interrogated by a beam of infrared light that samples pixels of 25 μm × 25 μm in size. This beam is rastered over the sample, and up to 100,000 complete infrared spectra are acquired for a given tissue sample. These spectra are subsequently analysed by a diagnostic computer algorithm that is trained by correlating spectral and histopathological features. Results We illustrate the ability of infrared micro-spectral imaging, coupled with completely unsupervised methods of multivariate statistical analysis, to accurately reproduce the histological architecture of axillary lymph nodes. By correlating spectral and histopathological features, a diagnostic algorithm was trained that allowed both accurate and rapid classification of benign and malignant tissues composed within different lymph nodes. This approach was successfully applied to both deparaffinised and frozen tissues and indicates that both intra-operative and more conventional

  11. Breast MRI in clinically and mammographically occult breast cancer presenting with an axillary metastasis: a systematic review

    OpenAIRE

    Bresser, J; De Vos, B.; van der Ent, F.; Hulsewé, K.

    2010-01-01

    Abstract Background Axillary metastatic lymphadenopathy with no primary tumour identified in the breast on physical examination, mammography or ultrasound is referred to as occult breast cancer. The goal of this systematic review is to give an overview of the value and additional considerations of using breast MRI in occult breast cancer. Methods The databases of Pubmed, Embase, CINAHL and the Cochrane library were searched for studies addressing th...

  12. 彰武松腋芽诱导研究%Axillary Bud Induction in Pinus densiflora var. zhangwuensis

    Institute of Scientific and Technical Information of China (English)

    范岳霞; 袁文华; 孔冬梅

    2013-01-01

      为了探讨彰武松组培快繁的可行性,以彰武松封顶芽为外植体进行培养,研究灭菌方法、培养基成分以及植物生长调节物质等对其腋芽诱导的影响。结果表明:外植体用70%的乙醇处理30 s 后用0.1%的 HgCl2灭菌5 min,在添加 BA 2~5 mg/L 和蔗糖30 g/L 的 WPM 培养基上,腋芽诱导率达50%~70%,NAA对腋芽诱导无促进作用。通过在添加和不添加植物生长调节物质(PGR)的WPM培养基中交替继代培养可以实现芽丛伸长与增殖。%In order to explore the feasibility of propagating Pinus densiflora var. zhangwuensis by tissue culture, the dormant shoot buds of the species were used as explants to investigate the influence of sterilization methods, medium composition and plant growth regulators on axillary bud induction. The results showed that:the most effective sterilization treatment was rinsing the explants in 70% ethanol for 30 s following with 0.1%HgCl2 for 5 min. The optimal medium for axillary bud induction was WPM containing 2-5 mg/L BA and 30 g/L sucrose (shoot induction 50%-70% ). NAA didn’t promote axillary bud induction. The new axillary shoots alternately subcultured in WPM with and without PGR elongated and proliferated well.

  13. A moat around castle walls. The role of axillary and facial hair in lymph node protection from mutagenic factors.

    Science.gov (United States)

    Komarova, Svetlana V

    2006-01-01

    Axillary hair is a highly conserved phenotypical feature in humans, and as such deserves at least consideration of its functional significance. Protection from environmental factors is one of the main functions attributed to hair in furred vertebrates, but is believed to be inapplicable to humans. I considered the hypothesis that the phenotypic preservation of axillary hair is due to its unrecognized role in the organism protection. Two immediate questions arise--what exactly is being protected and what it is protected from. A large group of axillary lymph nodes represents a major difference between underarms and the adjacent areas of the trunk. The consideration of potential factors from which hair can offer protection identifies sunlight as the most likely candidate. Intense sweat production underarms may represent an independent defense mechanism, specifically protecting lymph nodes from overheating. Moreover, the pattern of facial hair growth in males strikingly overlaps with the distribution of superficial lymph nodes, suggesting potential role for facial hair in protection of lymph nodes, and possibly thymus and thyroid. The idea of lymph node protection from environmental mutagenic factors, such as UV radiation and heat, appears particularly important in light of wide association of lymph nodes with cancers. The position of contemporary fashion towards body hair is aggressively negative, including the social pressure for removal of axillary and bikini line hair for women, facial hair for men in many professional occupations, and even body hair for men. If this hypothesis is proven to be true, the implications will be significant for immunology (by providing new insights in lymph node physiology), health sciences (depilation is painful and therefore easily modifiable habit if proven to increase disease risk), as well as art, social fashion and economy.

  14. Horizontal right axillary minithoracotomy: aesthetic and effective option for atrial and ventricular septal defect repair in infants and toddlers

    OpenAIRE

    Luciana da Fonseca da Silva; José Pedro da Silva; Turquetto,Aida L R; Sonia Meiken Franchi; Cascudo,Cybelle M; Rodrigo Moreira Castro; Walter José Gomes; Christian Schreiber

    2014-01-01

    Introduction:Congenital heart defects treatment shows progressive reduction in morbidity and mortality, however, the scar, resulting from ventricular (VSD) and atrial septal defect (ASD) repair, may cause discomfort. Right axillary minithoracotomy approach, by avoiding the breast growth region, is an option for correction of these defects that may provide better aesthetic results at low cost. Since October 2011, we have been using this technique for repairing VSD and ASD defects as well as as...

  15. Correlation of primary tumor size and axillary nodal status with tumor suppressor gene p53 in breast carcinoma

    Directory of Open Access Journals (Sweden)

    Topić Brano

    2002-01-01

    Full Text Available Correlation of standard path morphological prognostic parameters, primary tumor size and axillary nodal status with new prognostic factor in breast carcinoma: tumor suppressor gene p53 was analyzed. The studied sample included 65 women who underwent surgery for breast carcinoma at the Surgical Clinic of Clinical Center Banja Luka, from January 1st 1997 till January 1st 1999. Statistical data analysis was performed and correlation of prognostic factors was determined. The majority of authors in this field agree that the primary tumor size and axillary nodal status are the two most important prognostic factors. These factors are the best predictors of prognosis and survival of women who had the tumor and were operated on. Tumor markers were immunohistochemically determined in the last ten years and, according to the majority of authors, are still considered the additional or relative prognostic factors in breast carcinoma. Their prognostic value and significance increase almost daily. Most frequently determined tumor markers are bcl-2, pS2, Ki-67 and p53. There was a positive, directly proportional relationship between primary tumor size and tumor suppressor gene p53, but there was no positive correlation between the axillary nodal status and tumor suppressor gene p53. Significance of determination of new tumor markers as the prognostic factors was emphasized. These markers represent a powerful tool in the early detection and prevention of breast carcinoma.

  16. Using quantitative image analysis to classify axillary lymph nodes on breast MRI: A new application for the Z 0011 Era

    Energy Technology Data Exchange (ETDEWEB)

    Schacht, David V., E-mail: dschacht@radiology.bsd.uchicago.edu; Drukker, Karen, E-mail: kdrukker@uchicago.edu; Pak, Iris, E-mail: irisgpak@gmail.com; Abe, Hiroyuki, E-mail: habe@radiology.bsd.uchicago.edu; Giger, Maryellen L., E-mail: m-giger@uchicago.edu

    2015-03-15

    Highlights: •Quantitative image analysis showed promise in evaluating axillary lymph nodes. •13 of 28 features performed better than guessing at metastatic status. •When all features were used in together, a considerably higher AUC was obtained. -- Abstract: Purpose: To assess the performance of computer extracted feature analysis of dynamic contrast enhanced (DCE) magnetic resonance images (MRI) of axillary lymph nodes. To determine which quantitative features best predict nodal metastasis. Methods: This institutional board-approved HIPAA compliant study, in which informed patient consent was waived, collected enhanced T1 images of the axilla from patients with breast cancer. Lesion segmentation and feature analysis were performed on 192 nodes using a laboratory-developed quantitative image analysis (QIA) workstation. The importance of 28 features were assessed. Classification used the features as input to a neural net classifier in a leave-one-case-out cross-validation and evaluated with receiver operating characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) values for features in the task of distinguishing between positive and negative nodes ranged from just over 0.50 to 0.70. Five features yielded AUCs greater than 0.65: two morphological and three textural features. In cross-validation, the neural net classifier obtained an AUC of 0.88 (SE 0.03) for the task of distinguishing between positive and negative nodes. Conclusion: QIA of DCE MRI demonstrated promising performance in discriminating between positive and negative axillary nodes.

  17. Establishment of a Rapid Plant Regeneration System in Physalis angulata L. through Axillary Meristems

    Directory of Open Access Journals (Sweden)

    Owk ANIEL KUMAR

    2015-12-01

    Full Text Available An optimal plant propagation method of Physalis angulata L., a medicinally important herbaceous plant species has been developed using axillary meristem explants. Shoot bud proliferation was initiated from axillary meristem explants cultured on MS medium supplemented with various concentrations of 0.5-2.5mg/L/(BAP/(Zeatin/(KIN. The maximum in vitro response of shooting frequency of explants (88.1% and shoots per explant (42 was achieved with medium containing 1.0mg/L BAP. Multiple shoot culture was established by repeated subculturing of the shoot buds of axillary meristems on shoot multiplication medium. Among the subculture media BAP in combination with 1.5mg/L (IAA+0.25mg/L(GA3 produced maximum shoots per explant (128±0.29 after two weeks of culture. Effective in vitro shoot elongation and rooting was achieved on 1.0mg/L(GA3 and 1.0mg/L(IBA, respectively. Most of the generated shoots were successfully transferred to soil under field conditions. The survival percentage of the transferred plants on soil was found to be 90 per cent.  This protocol can be used for commercial propagation and for future genetic improvement studies.

  18. False-positive axillary lymph node on F-18 FDG PET/CT due to moxibustion therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Shin Young; Lee, Sang Woo; Ahn, Byeong Cheol; Lee, Jae Tae [Kyungpook National University Hospital, Daegu (Korea, Republic of); Seo, Ji Hyoung [Inje University Haeundae Paik Hospital, Busan (Korea, Republic of)

    2010-12-15

    A 30-year-old female was diagnosed with papillary thyroid cancer and underwent total thyroidectomy and high-dose radioiodine ablation. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for recurrence detection of thyroid carcinoma was performed at 3 years after total thyroidectomy. Moxibustion is a traditional Chinese medicine therapy using moxa or the mugwort herb. Moxibustion is the burning of a small, thimble-sized, smoldering plug of dried leaves such as moxa or mugwort on the skin at an acupuncture point. Acupuncture and moxibustion induce hyperemia and a local inflammatory reaction. Complications associated with moxibustion such as skin bums or infection of the site have been reported previously. False-positive FDG uptake in PET may result from inflammation, infection, and variations in physiological uptake. In the present case, the hypermetabolic axillary lymph node disappeared without any treatment. Well-known of false-positive FDG uptake in axillary lymph noes such as arthritis of the upper extremity, extravasation of injected FDG, and vaccination were not found. Thus, left axillary lymph node uptake was

  19. Botulinum toxin type A and B improve quality of life in patients with axillary and palmar hyperhidrosis.

    Science.gov (United States)

    Rosell, Karolina; Hymnelius, Kristina; Swartling, Carl

    2013-05-01

    Hyperhidrosis is a common disorder that may have a severe impact on quality of life. The aim of this study was to investigate the clinical effect of two novel botulinum toxins, Xeomin®, a type A botulinum toxin, and Neuro-bloc®, a type B botulinum toxin, in the treatment of axillary and palmar hyperhidrosis. A total of 84 patients, 58 with axillary and 26 with palmar hyperhidrosis, were included in this open study. Axillae were injected with 107 ± 22 U Xeomin® and palms were injected with 213 ± 19 U Xeomin® and 264 ± 60 U Neurobloc® over the thenar eminences to avoid muscle weakness. At follow-up 3 weeks post-treatment, all patients treated for axillary hyperhidrosis reported satisfaction in self-ranking, evaporation decreased > 40%, and Dermatology Life Quality Index (DLQI) score improved from 12.0 to 1.7 (p 50% and DLQI score improved from 10.3 to 1.2 (p hyperhidrosis and in combination with Neurobloc® on palmar hyperhidrosis. Neurobloc® may be an option for use in the treatment of palmar hyperhidrosis in order to minimize muscular side-effects.

  20. BRANCHED1 interacts with FLOWERING LOCUS T to repress the floral transition of the axillary meristems in Arabidopsis.

    Science.gov (United States)

    Niwa, Masaki; Daimon, Yasufumi; Kurotani, Ken-ichi; Higo, Asuka; Pruneda-Paz, José L; Breton, Ghislain; Mitsuda, Nobutaka; Kay, Steve A; Ohme-Takagi, Masaru; Endo, Motomu; Araki, Takashi

    2013-04-01

    Plant architecture shows a large degree of developmental plasticity. Some of the key determinants are the timing of the floral transition induced by a systemic flowering signal (florigen) and the branching pattern regulated by key factors such as BRANCHED1 (BRC1). Here, we report that BRC1 interacts with the florigen proteins FLOWERING LOCUS T (FT) and TWIN SISTER OF FT (TSF) but not with TERMINAL FLOWER1, a floral repressor. FT protein induced in leaves moves into the subtended bud, suggesting that FT protein also plays a role in promotion of the floral transition in the axillary meristem (AM). The brc1-2 mutant shows an earlier floral transition in the axillary shoots compared with the wild type, suggesting that BRC1 plays a role in delaying the floral transition of the AMs. Genetic and gene expression analyses suggest that BRC1 interferes with florigen (FT and TSF) function in the AMs. Consistent with this, BRC1 ectopically expressed in the shoot apical meristem delays the floral transition in the main shoot. These results taken together suggest that BRC1 protein interacts with FT and TSF proteins and modulates florigen activity in the axillary buds to prevent premature floral transition of the AMs.

  1. Mesenteric artery ischemia

    Science.gov (United States)

    ... medlineplus.gov/ency/article/001156.htm Mesenteric artery ischemia To use the sharing features on this page, please enable JavaScript. Mesenteric artery ischemia occurs when there is a narrowing or blockage ...

  2. Axillary bud and pericycle involved in the thickening process of the rhizophore nodes in Smilax species

    Directory of Open Access Journals (Sweden)

    B Appezzato-da-Glória

    Full Text Available AbstractThe species of the genus Smilax, popularly known as sarsaparilla, are widely used in folk medicine due to the antirheumatic properties of its underground structures. Smilax fluminensis and S. syphilitica occur in forested areas and form thickened stems called rhizophores from which adventitious roots grow. To provide information for more accurate identification of the commercialised product and for elucidating the process of stem thickening, a morphology and anatomy study of the underground organs of the two species was conducted. The adventitious roots differ in colour and diameter depending on the stage of development. They are white and have a larger diameter in the early stages of development, but as they grow, the adventitious roots become brown and have a smaller diameter due to the disintegration of the epidermis and virtually the entire cortex. In brown roots, the covering function is then performed by the lignified endodermis and the remaining walls of the cells from the last parenchyma cortical layer. These results are similar to those found in studies of other Smilax and suggest that the anatomy of the roots can be useful for identifying fraud in commercialised materials. The thickening process of the nodal regions of the rhizophores in both species involves the activity of axillary buds and pericyclic layers.

  3. Axillary bud and pericycle involved in the thickening process of the rhizophore nodes in Smilax species.

    Science.gov (United States)

    Appezzato-da-Glória, B; Silva, J M; Soares, M K M; Soares, A N; Martins, A R

    2015-08-01

    The species of the genus Smilax, popularly known as sarsaparilla, are widely used in folk medicine due to the antirheumatic properties of its underground structures. Smilax fluminensis and S. syphilitica occur in forested areas and form thickened stems called rhizophores from which adventitious roots grow. To provide information for more accurate identification of the commercialised product and for elucidating the process of stem thickening, a morphology and anatomy study of the underground organs of the two species was conducted. The adventitious roots differ in colour and diameter depending on the stage of development. They are white and have a larger diameter in the early stages of development, but as they grow, the adventitious roots become brown and have a smaller diameter due to the disintegration of the epidermis and virtually the entire cortex. In brown roots, the covering function is then performed by the lignified endodermis and the remaining walls of the cells from the last parenchyma cortical layer. These results are similar to those found in studies of other Smilax and suggest that the anatomy of the roots can be useful for identifying fraud in commercialised materials. The thickening process of the nodal regions of the rhizophores in both species involves the activity of axillary buds and pericyclic layers.

  4. Radical Surgical Excision and Use of Lateral Thoracic Flap for Intractable Axillary Hidradenitis Suppurativa

    Directory of Open Access Journals (Sweden)

    Wan-Lin Teo

    2012-11-01

    Full Text Available Current treatments for hidradenitis suppurativa (HS include prolonged courses of antibiotics,retinoids, immunosuppressants, and biologics. Severe cases that are resistant to prolongedmedical treatment pose a therapeutic challenge. We propose radical excision and lateral thoracicflap reconstruction as a treatment option for such cases. In our experience with two patients,good aesthetic and functional outcomes were achieved, with a high level of patient satisfaction.The availability of suitable flap coverage allows for wide resection of all of the hair-bearing skin,leading to a low incidence of residual disease and subsequent recurrence. Following excisionof the affected tissue, the ideal reconstructive method in the axilla provides suitable coveragewithout unacceptable donor site morbidity and also avoids axillary contractures. A long lateralthoracic flap with delay has excellent coverage with minimal donor tissue sacrifice. With asuitable flap coverage option, the management paradigm of intractable HS should shift fromprolonged medical treatment to allow decisive radical excision, which will improve the qualityof life for patients.

  5. Correlation between bacterial population and axillary and plantar bromidrosis: study of 30 patients.

    Science.gov (United States)

    Guillet, G; Zampetti, A; Aballain-Colloc, M L

    2000-01-01

    Although studies on the chemistry of odors are expanding to identify the chemical structures of odorous substances, there are no universal standards as yet to measure odor and intensity of bromidrosis. Clinical evaluation can be made on a subjective scoring from 0 to 3 prior to prescription of an antiseptic soap. In order to appreciate the correlation between the intensity of bromidrosis (BI) and bacterial activity, a study was carried out with both clinical and bacterial assessment in thirty patients with axillary or plantar BI. Odor intensity was evaluated by two physicians using a score from 0 to 3 (i.e. absent, minor, moderate, major), meanwhile bacterial composition and density were assessed before and after 10 days of hygiene using an antiseptic detergent (trichlocarbanilide) provided on the first visit. Baseline count of diphtheroids/cm2 was 35.104 and baseline micrococci average was 32.104/cm2. At the end of the study, the reduction of odor intensity was observed in 20 patients (67%) without any change in sweat production. The clinical improvement correlated with a reduction of both micrococci (70%) or diphtheroids (73%) as compared with initial data. In patients presenting persistant bromidrosis, the bacterial count/cm2 did not significantly decrease and remained above 104 diphtheroids/cm2. Thus, this study suggests that body odor may be at least indirectly correlated to microbia counts with a bacteria threshold of BI ranging around and above 104.

  6. Elbow moment and forces at the hands during swing-through axillary crutch gait.

    Science.gov (United States)

    Reisman, M; Burdett, R G; Simon, S R; Norkin, C

    1985-05-01

    We investigated swing-through axillary crutch gait (nonweight bearing on the left lower extremity) to determine the effects of gait speed, crutch length, and handle position on the forces exerted at the hands and on the moments exerted about the elbow joints. Ten healthy subjects, skilled in swing-through crutch gait, walked at three speeds using fitted crutches, at a fixed speed with four different crutch lengths, and at a fixed speed with four different handle positions. We collected ground reaction forces that exerted simultaneously on the right crutch and motion data with a force plate and three high-speed movie cameras. A biomechanical model was developed to calculate the forces exerted at the right hand and the moments exerted about the right elbow joint. Changing gait speed from slow to the normal gait of the subject showed statistically significant effects (p less than .05) on the forces at the hand. When we changed crutch heights for the subjects, we found no significant effects on the forces at the subjects' hands. Changing handle position significantly affected the moment at the elbow. Increasing the elbow-flexion angle above 30 degrees by raising the crutch handle 1 to 2 in resulted in a 100 percent increase in elbow-extension moment. We found a correlation of .82 between actual average elbow-flexion angle and elbow-extension moment. Changing gait speed or crutch length did not affect elbow moment.

  7. Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis

    Science.gov (United States)

    Kong, Benjamin Y.; Chou, Shaun; Wakade, Deepal; Carlino, Matteo S.; Fernandez-Penas, Pablo

    2017-01-01

    There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event. PMID:28182109

  8. An efficient regeneration and rapid micropropagation protocol for Almond using dormant axillary buds as explants.

    Science.gov (United States)

    Choudhary, Ravish; Chaudhury, Rekha; Malik, Surendra Kumar; Sharma, Kailash Chandra

    2015-07-01

    An efficient in vitro protocol was standardized for Almond (Prunus dulcis) propagation using dormant axillary buds as explants. Explants were cultured on Murashige and Skoog (MS) and woody plant medium (WPM) supplemented with different concentration/combination(s) of phytohormones. MS basal medium showed lowest shoot induction and took longest duration for shoot initiation. Multiple shoots were induced in MS medium supplemented with the combination of BAP (0.5 mgL(-1)). Cultures showed poor response for rooting in all combinations of plant growth regulators (PGRs) and took 90 days for initiation. Rooting was higher in half strength of MS than in full-strength. The highest root induction (33.33%) was recorded in half MS medium supplemented with 0.1 mgL(-1) IBA (indole-3-butyric acid) followed by full strength of MS medium (20%) supplemented with IBA (0.1 mgL(-1)). α-Naphthalene acetic acid (NAA) was less effective for rooting than IBA. The highest root induction (25%) was found in half strength of MS medium supplemented with 0.1 mgL(-1) NAA followed by full strength of MS medium (20%). The protocol developed would be of use in mass propagation of almond and also support in vitro conservation.

  9. Axillary Metaplastic Breast Carcinoma with Ipsilateral Pectoral Invasive Ductal Carcinoma: An Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Lei Zhang

    2014-01-01

    Full Text Available We report a case of axillary metaplastic breast carcinoma (MBC with triple negative (ER−/PR−/Her2− phenotype, concurrent with multifocal invasive ductal carcinoma (IDC of ipsilateral pectoral breast (ER+/PR+/Her2− in a 60-year-old woman. The two tumors demonstrate different morphology, immunophenotype, and opposite response to neoadjuvant chemotherapy of paclitaxol, adriamycin, and cyclophosphamide. Methylation analysis of human androgen receptor (HUMARA on X-chromosome identified monoclonal pattern of X-chromosome inactivation in MBC and mosaic pattern in the IDC. Stem cell origin of MBC is suggested in this case. Clinicopathological features, imaging findings, biological markers, chemoradiation management, and prognosis of MBC are reviewed in comparison to invasive ductal carcinoma. Our case and literature review suggest that traditional chemotherapy applicable to IDC is less effective towards MBC. However, new chemotherapy protocols targeting stem cell and multimodality management of MBC are promising. Recognition of unusual presentation of MBC will help tailor therapy towards tumor with worse prognosis.

  10. Upper limb arterial thromboembolism

    DEFF Research Database (Denmark)

    Andersen, L V; Lip, Gregory Y.H.; Lindholt, J S;

    2013-01-01

    The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF).......The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF)....

  11. [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.

  12. Impact of axillary nodal metastases on lymphatic mapping and sentinel lymph node identification rate in patients with early stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pelosi, Ettore [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Universita Torino, Dottorato di Ricerca Radioimmunolocalizzazione dei Tumori Umani, Turin (Italy); Ala, Ada; Bussone, Riccardo [Ospedale S. Giovanni Battista, Reparto di Chirurgia Oncologica 10, Turin (Italy); Bello, Marilena; Douroukas, Anastasios; Varetto, Teresio [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Migliaretti, Giuseppe [Universita di Torino, Dipartimento di Sanita Pubblica e Microbiologia, Turin (Italy); Berardengo, Ester [Ospedale S. Giovanni Battista, Servizio di Anatomia Patologica 4, Turin (Italy); Bisi, Gianni [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Universita di Torino, Dipartimento di Medicina Interna, SCDU Medicina Nucleare 2, Turin (Italy)

    2005-08-01

    The aim of this study was to define the impact of the presence of axillary nodal metastases on lymphatic mapping and sentinel lymph node (SLN) identification rate in patients with early breast cancer. Two hundred and forty-six lymphatic mapping procedures were performed with both labelled nanocolloid and blue dye, followed by SLN biopsy and/or complete axillary dissection. The following parameters were recorded: patient's age, tumour laterality and location, tumour size, tumour histology, tumour stage, tumour grade, lymphovascular invasion, radiotracer injection site (subdermal-peritumoural/peri-areolar), SLN visualisation at lymphoscintigraphy, SLN metastases (presence/absence, size) and other axillary metastases (presence/absence, number). Discriminant analysis was used to analyse the data. SLNs were identified by labelled nanocolloid alone in 94.7% of tumours, by blue dye alone in 93.5% and by the combined technique in 99.2%. Discriminant analysis showed the gamma probe SLN identification rate to be significantly limited by the presence of axillary nodal metastases. In particular, the size of SLN metastases and the number of other axillary metastases were the most important variables in reducing the gamma probe SLN identification rate (p=0.004 and p=0.002, respectively). On the other hand, high tumour grade was the only parameter limiting the blue dye SLN identification rate. The accuracy of lymphatic mapping with labelled nanocolloid is limited by the presence of axillary nodal metastases, and particularly by the degree of SLN tumoural invasion and the presence and number of other axillary nodal metastases. Neither of these elements seems to interfere with the blue dye identification rate. The combination of the two tracers maximises the SLN identification rate. (orig.)

  13. Transradial artery coronary angioplasty.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J; de Melker, E

    1995-01-01

    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. 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.

  15. Efficient Axillary Shoot Proliferation and in Vitro Rooting of Apple cv. ‘Topaz’

    Directory of Open Access Journals (Sweden)

    Snjezana KERESA

    2012-05-01

    Full Text Available ‘Topaz’ is a modern Czech apple cultivar well accepted by consumers and scab-resistant, providing reasons for the significant spreadof cv. ‘Topaz’ in European orchards, especially in the organic fruit production industry. Growing the apple trees on their own rootsprovides some advantages in comparison with grafted trees. Micropropagation is the method of choice for plantlet production for thispurpose as well as for the establishment of healthy mother stock trees as a source of scions. The efficiency of axillary shoot proliferationwas examined on four media differing in plant growth regulators and their concentrations, and from three explant types: intact ordecapitated and defoliated microshoots placed vertically and one-nodal segments placed horizontally. All media consisted of Quoirin andLepoivre (QL macroelements and Murashige and Skoog (MS microelements. Furthermore, rooting efficiency on six different media/treatments was analyzed. Media with 1 mg/L 6-benzylaminopurine (BA or BA (0.5 mg/L + 1.5 mg/L kinetin (Kin produced similarnumber of microshoots per inoculated one (2.5 and 2.4, respectively. Medium with 1 mg/L thidiazuron (TDZ produced significantlyhigher number of shoots (3.6 but they were fasciated. Three different explant types also produced similar numbers of microshoots.High rooting efficiency (68.7%, a high number of roots per shoot (6.6 and the best quality of shoots were obtained in rooting mediumcontaining 2 mg/L of indole-3-butyric acid (IBA. An efficient method of shoot proliferation was established, and, since rooting was themost critical step, an efficient procedure for rooting apple cv. ‘Topaz’ was established.

  16. Ki-67 expression in axillary lymph node metastases in breast cancer is prognostically significant.

    Science.gov (United States)

    Tawfik, Kareem; Kimler, Bruce F; Davis, Marilyn K; Fan, Fang; Tawfik, Ossama

    2013-01-01

    Several studies have documented the prognostic significance of cell proliferation in breast cancer and its positive relationship with tumor grade, size, mitotic activity, hormonal and Her-2 status, and tumor progression. The Ki-67 antigen provides an accurate measure of the growth fraction of a tumor. Ki-67 expression in 103 primary breast carcinomas and their corresponding axillary lymph node metastases was correlated with age, tumor grade, size, estrogen receptor (ER), progesterone receptor (PgR), p53, epidermal growth factor receptor (EGFR), Bcl-2, Her-2 status, and patients' overall survival. Median Ki-67 expression in primary and metastatic tumors was 20% and 15%, respectively. Although there was no difference in overall survival (P = .65, log-rank test) between primary tumors with less than or at least 10% Ki-67 expression, there was significantly better overall survival when Ki-67 expression in lymph nodes was less than 10% (P = .040). For patients whose primary tumors exhibited Ki-67 expression less than 10%, most of their metastatic lesions had a similar low Ki-67; these patients had a favorable outcome. A small subgroup was noted to have a nodal Ki-67 of 10% or more and worse survival (P = .047). For patients whose primary tumors had a Ki-67 of 10% or more, most of their metastatic lesions had similar high Ki-67 values; however, a group of 12 patients had lymph node Ki-67 less than 10% and had a better overall survival (P = .092). Our results showed that measurement of Ki-67 in lymph node is superior to its evaluation in primary tumors. Identification of subgroups of patients in whom Ki-67 expression in lymph nodes differs from expression in primary tumor may assist in the selection of therapeutic options.

  17. Expression and significance of NKCC1 in axillary sweat glands of palmar hyperhidrosis patients with axillary hyperhidrosis%NKCC1在手汗症伴腋窝多汗患者腋窝汗腺中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    陈幼平; 涂远荣; 陈剑锋; 邱明链; 李旭; 林敏; 赵冬峰; 罗荣刚

    2010-01-01

    目的 观察手汗症伴腋窝多汗患者(腋窝多汗组)、手汗症无腋窝多汗患者(单纯型手汗症组)及非手汗症患者(对照组)的腋窝汗腺数目及Na+K+Cl-联合转运子1(NKCC1)的表达,探讨其与手汗症发病的关系.方法 27例腋窝多汗组,11例单纯型手汗症组,8例对照组,取各组患者腋窝皮肤作常规苏木素.伊红(HE)染色,计数汗腺数目,并检测NKCC1在3组患者腋窝皮肤汗腺中的表达和分布.结果 3组汗腺计数差异均无统计学意义(HC=2.528,P>0.05).腋窝多汗组与单纯型手汗症组、对照组NKCC1的吸光度差异有统计学意义(F=5.158,P0.05).结论 伴有腋窝多汗的手汗症患者腋汗增多与NKCC1蛋白表达增强有关,而与腋窝汗腺数目无关.%Objective To examine the number of axillary sweat glands and the expression of Na+ K+ Cl+ cotransporter isoform1(NKCC1) in axillary sweat glands of palmar hyperhidrosis patients with axillary hyperhidrosis, palmar hyperhidrosis patients and non-hyperhidrosis patients, to investigate its relationship with the pathogenesis of palmar hyperhidrosis. Methods Axillary glands were gained in 27 cases of palmar hyperhidrosis with axillary hyperhidrosis, 11 cases of palmar hyperhidrosis and 8 cases of non-hyperhidrosis as control group. The number of axillary sweat glands was calculated by using HE staining and the expression of NKCC1 was detected respectively. Results The number of axillary sweat glands in three groups had no significant difference in statistics (HC=2.528 ,P>0.05). There was significant difference in the expression of NKCC1 between palamar hyperhidrosis patients with axillary hyperhidrosis and palmar hyperhidrosis patients (F=5.158,P0.05). Conclusion The increase of NKCC1 expression has the relationship with axillary hyperhidrosis of palmar hyperhidrosis patients with axillary hyperhidrosis, but has no relationship with the number of axillary sweat glands.

  18. Minimally Invasive Surgery for Axillary Osmidrosis Using a Combination of Subcutaneous Tissue Removal and a 1,444-nm Nd:YAG Laser.

    Science.gov (United States)

    Lee, Sang Geun; Ryu, Hwa Jung; Kim, Il-Hwan

    2014-12-01

    Many treatment modalities have been developed for axillary osmidrosis. It is well known that the surgical treatment has the best results. However, there is a high possibility of side effects. The 1,444-nm lipolysis laser has been recently introduced to remove the apocrine glands. So far, subdermal coagulation treatment with a 1,444-nm Nd:YAG laser may be the least invasive and most effective therapy for axillary osmidrosis. However, according to our previous experience, the recurrence rate was 20%~30%. This emphasizes the need for combination of surgical method and non-surgical method and we combined subcutaneous tissue removal and photothermocoagulation with a 1,444-nm Nd:YAG laser. Three patients for bilateral axillary osmidrosis were enrolled. After an incision of about one-third the length of the widest transverse diameter, the apocrine glands were separated from the skin. And then apocrine glands within the marked area were destroyed by irradiation with a 1,444-nm Nd:YAG laser thereafter. All patients exhibited no relapse of axillary osmidrosis and were satisfied with the treatment results. A combination of subcutaneous tissue removal and Interstitial laser photothermocoagulation with a 1,444-nm Nd:YAG laser could be an effective treatment for mild to moderate axillary osmidrosis.

  19. Reoperations for occluded arterial bypasses in the lower limbs

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background We reviewed the outcomes of reoperations for 29 patients (30 limbs) who had undergone occluded arterial bypass in the lower limbs from May 1996 to September 2005. Methods The 30 lower limbs of the 29 patients with arteriosclerotic obstruction received 44 reoperations, including thrombectomy alone (group T, 27) and inflow or outflow reconstruction plus thrombectomy (group C, 17). Among the 17 operations in group C, 17.6% (3/17) were inflow reconstructions involving the axillary-femoral (1), aorta-iliac (1) and aorta-femoral (1) arteries, and 76.4% (13/17) outflow reconstructions involving the femoral-popliteal bypass-tibial (8), femoral-tibial (1), femoral-popliteal bypass-popliteal arteries below the knee (2), and the femoral-popliteal bypass-tibial-peroneal trunk (2). One patient (1 limb) underwent both inflow and outflow reconstructions with an iliac arterial stent and a graft-popliteal anastomosis patch. Polytetrafluoroethylene (PTFE) grafts were used in the inflow or outflow reconstructions abve the knee. Autovenous grafts or autovenously combined PTFE grafts were used in the outflow reconstructions below the knee. Results The percentages of Fontaine stage III and IV before primary operation and reoperation were 60% (18/30) and 86.7% (26/30), respectively (P0.05). Among 42 reoperations, 19 failed within 1 month in groups T (16) and C (3) (P0.05). The rate of limb salvage was 64.29% (18/28). Conclusions The percentages of Fontaine stage III and IV before reoperation may be much higher than those before primary operation. Thrombectomy plus inflow/outflow reconstruction creates patency better than thrombectomy alone for re-occluded bypass.

  20. STUDY OF DISTRIBUTION OF SUBSCAPULAR ARTERY BRANCHES IN MALES AND FEMALES

    Directory of Open Access Journals (Sweden)

    Sreenivasulu

    2015-07-01

    Full Text Available INTRODUCTI ON: the subscapular arterial tree may be used as a source of microvascular grafts to replace damaged or diseased portions of arteries, particularly in the hand and forearm. The use of muscle patches, myocutaneous, osteomuscular and even muscle fascia in reconstructive surgery of the head, neck and limbs is becoming increasingly frequent. The muscles of the scapular and axillary regions, mainly the serratus anterior and the latissimus dorsi, are among those most commonly used in reparative surgery. The current importance of knowledge of blood supply to the muscles of the scapular region and the controversies that persist in the literature were the reasons for our study of the subscapular artery focusing on new objectives which has not yet been dealt with thoroughly in the existing literature. AIMS AND OBJECTIVES : The motive for this research was the use of the muscles of the scapular region in transposition, transplantation and reparative surgery and the need for more detailed knowledge of the blood supply to these muscles. The development of reparative surgery has demanded more detailed anatomical knowledge of the blood supply and innervation of muscles in general and of those with more significant surgical application in particular. Anatomy textbooks do not describe these structures with the necessary depth, either because they were designed at a time when this type of surgery was only in its early stages, or because descriptions of the structures mentioned above were not their main objective. It is our sincere hope that this study proves useful for surgeons specializing in reparative surgery. MATERIALS AND METHODS : We have studied the axillary artery and its branches in 30 cadavers, of both sexes, aged 26 to 70 years, through routine dissection on the axillary regions on both sides. RESULTS : Our research showed collateral branches to the following muscles: serratus anterior (54% in males, 30 % in females, teres major (26% in

  1. Local administration of liposomal adriamycin inhibited proliferation of metastatic cells in axillary lymph nodes in rabbit breast cancer model

    Institute of Scientific and Technical Information of China (English)

    Li Xiaojun; Qin Hong; Yao Jia; Wang Jiansheng; Xian Yinsheng; Zhang Yunfeng; Ren Hong

    2009-01-01

    Objective: To assess the inhibitory effects of liposomal adriamycin (LADR) locally injected into mammary glands of VX2 tumor-bearing rabbits on proliferation of lymph nodal metastatic cells. Methods: Twenty-one VX2 tumor-bearing rabbits were randomly and equally divided into 3 groups. Rabbits were randomized to receive sham treatment (Group I), subcutaneous LADR around tumor (Group II) and intravenous free adriamycin (Group III), respectively. Breast tumor and axillary lymph nodes were harvested after 3 repeated treatment. Nodal sizes of both pre- and post-treatment were measured. Proliferating cell nuclear antigen (PCNA) mRNA in both tumor and lymph nodes were determined by RT-PCR. Results: The mean size of axillary lymph nodes in Group I, II and III increased by 3.70%, 1.55% and 2.89%, respectively, with significant difference between Group III and I (P=0.004) and between Group II and III (P=0.002). Relative expression values of PCNA mRNA in breast tumors of Group I, II and III were 0.486, 0.513 and 0.396, respectively. For Group III, PCNA mRNA was significantly less expressed than that in Group I (P=0.023) and II (P=0.005). Relative expression values of PCNA mRNA in axillary lymph nodes of Group I, II and III were 0.541, 0.329 and 0.450, respectively. Compared with Group I, Group III showed a markedly decreased expression of PCNA (P=0.021). The least level of PCNA mRNA was found in Group II, with a significant difference from that in Group HI (P=0.004). Conclusion: Local injection of LADR was an effective therapeutic regimen for lymphatic metastases from breast cancer, regardless of its little effect on primary tumor.

  2. Accumulation of FDG in axillary sweat glands in hyperhidrosis: a pitfall in whole-body PET examination

    Energy Technology Data Exchange (ETDEWEB)

    Jacobsson, H. [Department of Radiology, Karolinska Hospital, Stockholm (Sweden); Celsing, F. [Department of Haematology and Infectious Diseases, Karolinska Hospital, Stockholm (Sweden); Ingvar, M. [Department of Cognitive Neurophysiology, Karolinska Hospital, Stockholm (Sweden); Stone-Elander, S. [Department of Cognitive Neurophysiology, Karolinska Hospital, Stockholm (Sweden)]|[Karolinska Pharmacy, Stockholm (Sweden); Larsson, S.A. [Department of Hospital Physics, Karolinska Hospital, Stockholm (Sweden)

    1998-03-27

    A diabetic male with severe autonomic neuropathy and recently discovered Hodgkin`s disease demonstrated bilateral uptake of [2-{sup 18}F]-2-fluoro-2-deoxy-d-glucose (FDG) in the axillary sweat glands during profuse sweating caused by hypoglycaemia at positron emission tomography examination. It is not yet clear whether the sweating interfered with the distribution of the radiopharmaceutical. Regardless of the cause or mechanism for the uptake, the finding is clinically relevant. A bilateral symmetrical accumulation of FDG in the axillae of a tumour patient does not necessarily indicate malignant involvement of the lymph nodes. (orig.) With 1 fig., 9 refs.

  3. Bilateral axillary masses mimicking as accessory breast with multiple fibroadenoma and bilateral gigantomastia in HIV-positive patient.

    Science.gov (United States)

    Singh, Saumya; Mishra, Anand K; Tewari, S; Kumar, Sanjeev

    2013-06-24

    Accessory breast is a rare entity that can present as asymptomatic masses or can cause symptoms like heaviness, pain, restriction of arm movement and limitation in daily pursuits with allied apprehension and anxiety for the patient. We present a case of bilateral axillary masses mimicking as accessory breast with multiple fibroadenoma in a 28 years, nulliparous, Indian woman who is HIV positive, which proves to be a diagnostic dilemma. Excisional biopsy was diagnostic. The rarity of such cases imposes challenges on the management in terms of diagnosis, prognosis and therapeutic options.

  4. Imagens ultra-sonográficas do plexo braquial na região axilar Imágenes ultra-sonográficas del plexo braquial en la región axilar Ultrasound images of the brachial plexus in the axillary region

    Directory of Open Access Journals (Sweden)

    Diogo Brüggemann da Conceição

    2007-12-01

    permite la identificación de las estructuras del plexo braquial ¹. Ese estudio buscó describir el posicionamiento de los nervios del plexo braquial con relación a la arteria axilar. MÉTODO: Fueron estudiados 30 voluntarios de los dos sexos, en posición supina con abducción a 90° y rotación externa del hombro y flexión del codo a 90°. Utilizando transductor digital de 5 cm y 5-10 MHz, fueron identificados los nervios mediano, ulnar y radial, y las respectivas posiciones en relación a la arteria fueron marcadas en una carta gráfica seccional de 8 sectores, enumerados en orden creciente a partir de la hora 12 (medial, cuyo centro representaba la arteria axilar. RESULTADOS: El nervio mediano se ubicó predominante en el sector 8 (55% y en el sector 1 (28% (mediales; el nervio radial se ubicó predominantemente en los sectores 4 (59% y 5 (34% (laterales y el nervio ulnar en los sectores 2 y 3 (inferiores en un 69% y un 24% de los casos, respectivamente. Hubo una considerable variación de la localización de los nervios con relación a los aspectos superior e inferior de la arteria. CONCLUSIÓN: La inspección en tiempo real, por ultrasonido, de las estructuras neuro vasculares del plexo braquial en la axila mostró que los nervios mediano, ulnar y radial pueden presentar diferentes relaciones con la arteria axilar.BACKGROUND AND OBJECTIVES: The axillary artery is the anatomical reference, in the surface, for axillary brachial plexus block. Anatomic studies suggest variability in the location of the structures in the brachial plexus in relation to the axillary artery. These variations can hinder blocks by neurostimulation. The ultrasound allows the identification of the structures within the brachial plexus¹. The objective of this report was to describe the position of the nerves in the brachial plexus in relation to the axillary artery. METHODS: Thirty volunteers of both genders were studied. They were in the supine position with 90° abduction and external

  5. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

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

  6. Popliteal artery entrapment syndrome.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2010-01-01

    Popliteal artery entrapment syndrome is a rare abnormality of the anatomical relationship between the popliteal artery and adjacent muscles or fibrous bands in the popliteal fossa. The following is a case report of a 19 year old female, in whom popliteal artery entrapment syndrome was diagnosed, and successfully treated surgically. A review of literature is also presented and provides details on how PAES is classified, diagnosed both clinically and radiologically, and treated surgically.

  7. Arterial waveform analysis.

    Science.gov (United States)

    Esper, Stephen A; Pinsky, Michael R

    2014-12-01

    The bedside measurement of continuous arterial pressure values from waveform analysis has been routinely available via indwelling arterial catheterization for >50 years. Invasive blood pressure monitoring has been utilized in critically ill patients, in both the operating room and critical care units, to facilitate rapid diagnoses of cardiovascular insufficiency and monitor response to treatments aimed at correcting abnormalities before the consequences of either hypo- or hypertension are seen. Minimally invasive techniques to estimate cardiac output (CO) have gained increased appeal. This has led to the increased interest in arterial waveform analysis to provide this important information, as it is measured continuously in many operating rooms and intensive care units. Arterial waveform analysis also allows for the calculation of many so-called derived parameters intrinsically created by this pulse pressure profile. These include estimates of left ventricular stroke volume (SV), CO, vascular resistance, and during positive-pressure breathing, SV variation, and pulse pressure variation. This article focuses on the principles of arterial waveform analysis and their determinants, components of the arterial system, and arterial pulse contour. It will also address the advantage of measuring real-time CO by the arterial waveform and the benefits to measuring SV variation. Arterial waveform analysis has gained a large interest in the overall assessment and management of the critically ill and those at a risk of hemodynamic deterioration.

  8. Resistance to freezing in liquid nitrogen of carnation (Dianthus caryophyllus L. var Eolo) apical and axillary shoot tips excised from different aged in vitro plantlets.

    Science.gov (United States)

    Dereuddre, J; Fabre, J; Bassaglia, C

    1988-05-01

    The ability of shoot tips from carnation (Dianthus caryophyllus L., var. Eolo) cultured in vitro to develop resistance to freezing in liquid nitrogen depends on the physiological state of the cell material and the pretreatment conditions. Regrowth rates close to 100% have been obtained with apical shoot tips isolated from 2 month-old stems, precultured on medium supplemented with sucrose (0.75M) and treated with dimethylsulfoxide (5% or more). Resistance of axillary shoot tips decreased progressively as a funtion of their distance from the apical shoot tip. During the development of the stem from axillary buds (obtained by cutting), progressive increases in the regrowth rate of frozen apices were noted, from 30% before cutting (axillary buds) to 98% after 3 weeks of culture.

  9. Fístula axilo-cava para hemodiálise: relato de caso Axillary arteriovenous fistula for hemodialysis: case report

    Directory of Open Access Journals (Sweden)

    Yosio Nagato

    2009-12-01

    Full Text Available Na confecção de fístula arteriovenosa (FAV para hemodiálise, condutos venosos autógenos demonstram performance superior quando comparados com material protético em relação à perviedade primária ou secundária. A prótese de politetrafluoroetileno (PTFE é reservada para casos de falência de material autógeno e é geralmente utilizada em fístulas em membros superiores. Descrevemos o caso de uma paciente de 52 anos que, após falência de acessos para hemodiálise e impossibilidade de realização de diálise peritoneal em razão de peritonite bacteriana, foi submetida à confecção de FAV entre a artéria axilar direita e a veia cava inferior com prótese de PTFE de 6 mm. O acesso foi utilizado para hemodiálise 1 mês após sua criação e permanece pérvio após 24 meses. Até o momento, não houve complicações infecciosas, sinais de insuficiência cardíaca ou síndrome de roubo em membro superior direito.With regards to the creation of an arteriovenous fistula (AV fistula for hemodialysis, autogenous venous grafts clearly show high performance when compared with prosthetic material in terms of primary or secondary patency. Polytetrafluoroethylene (PTFE grafts for the reconstruction of AV fistulae must be restricted to cases of failure of the autogenous material, which is generally used in upper limb fistulae. We describe a case of a 52-year-old patient, who, after access failure for hemodialysis and the impossibility of performing peritoneal dialysis due to bacterial peritonitis, underwent the reconstruction of an AV fistula between the right axillary artery and the cava vein using a 6-mm PTFE prosthesis. One month after surgery, this AV fistula started to be used for hemodialysis. The AV fistula remains patent 24 months after its creation. No infectious complications, cardiac insufficiency symptoms, or steal syndromes of right upper limb were detected.

  10. Study of Axillary Reverse Mapping and Lymph Node Metastasis during an Axillary Dissection%乳腺癌腋窝清扫术中上肢淋巴结定位及转移规律的研究

    Institute of Scientific and Technical Information of China (English)

    贾实; 李建一; 张文海; 张扬; 费翔

    2012-01-01

    目的 在乳腺癌腋窝清扫术中利用上肢淋巴结反转定位(ARM)技术对引流上肢的淋巴管及淋巴结进行定位,分析其转移可能性及对上肢淋巴水肿的影响.方法 选取乳腺癌改良根治术20例.美兰法进行术前定位.术中行淋巴结清扫,蓝染淋巴结单独分组,行免疫组化方法病理检测.结果 在20例患者中术中发现16例患者存在蓝染淋巴管及淋巴结,4例未发现蓝染的淋巴管或淋巴结.术中发现蓝染的上肢淋巴结均位于腋静脉下方,肋间臂神经上方这一区域内;在施行上肢淋巴结清除的患者中,术后短期内上肢水肿的发生率高于表进行上肢淋巴结清扫的患者;上肢淋巴结可能出现转移.结论 利用美兰法能够对腋窝处的上肢淋巴结进行定位;上肢淋巴结在腋窝的位置相对固定;肿瘤如仅在Level 1水平淋巴结发生转移,上肢淋巴结可能不会受累.%Objective In breast cancer axillary lymph node dissection,reverse positioning aim (ARM) technology is used for the upper limb lymphatic drainage and lymph nodes, This paper aimed to analyze the possibility of transfer and its impact on upper extremity lym-phedema. Methods Twenty patients undergoing modified radical mastectomy were chosen whose axillary lymph nodes could be palpable or be found by breast ultrasound and enhanced CT examinations. All the patients did not receive preopeian've neoadjuvant chemotherapy and neoadjuvant endocrine therapy. Methylene blue method was employed for preoperan've localization. During operation,lymph node dissection was performed. Blue-stained lymph nodes weie grouped and examined using the immunohistoeheimeal method. Results (X the 20 patients, 16 had blue-stained lymphatic vessels and lymph nodes,4 did not show blue-stained lymphatic vessels or lymph nodes. Blue-stained lymph nodes were found to have been located in the region below the axillary vein and over the Intercostal brachial nerves. The

  11. The value of T2* in differentiating metastatic from benign axillary lymph nodes in patients with breast cancer--a preliminary in vivo study.

    Directory of Open Access Journals (Sweden)

    Chuanming Li

    Full Text Available BACKGROUND: Accurate detection and determination of axillary lymph node metastasis are crucial for the clinical management of patients with breast cancer. Noninvasive imaging methods including ultrasound (US, computed tomography (CT, or conventional magnetic resonance imaging (MRI are not yet accurate enough. The purpose of this study was to investigate the value of in vivo T2* in differentiating metastatic from benign axillary lymph nodes in patients with breast cancer. METHODOLOGY/PRINCIPAL FINDINGS: In this institutional review board approved study, 35 women with breast cancer underwent multi-echo T2* weighted imaging (T2*WI of the axillary area on a 3.0 T clinical magnetic resonance (MR imaging system. T2* values of pathologically proven benign and metastatic axillary lymph nodes were calculated and compared. Receiver operating characteristics (ROC analysis was conducted to evaluate the diagnostic ability. The areas under the ROC curve (AUCs and the confidence intervals (CIs were assessed. In total, 56 metastatic and 65 benign axillary lymph nodes were identified in this study. For metastatic lymph nodes, the average T2* value (55.96±11.87 ms was significantly longer than that of the benign lymph nodes (26.00±5.51 ms, P<0.05. The AUC of T2* in differentiating benign from metastatic lymph nodes was 0.993. The cut-off value of 37.5 milliseconds (ms gave a sensitivity of 94.6%, a specificity of 98.5%, a positive predictive value of 98.17 and a negative predictive value 95.54. CONCLUSIONS: In vivo T2* can differentiate benign from metastatic axillary lymph nodes in patients with breast cancer. The high sensitivity and specificity as well as the easiness suggest its high potential for use in clinical practice.

  12. Anomalous origin of right coronary artery from pulmonary artery

    Directory of Open Access Journals (Sweden)

    Rajat Gupta

    2012-01-01

    Full Text Available Anomalous origin of coronary artery from the pulmonary artery is a rare anomaly that most frequently involves the left coronary artery and very rarely the right coronary artery. These lesions can be missed on echocardiography unless carefully looked for. We describe a case of isolated anomalous origin of right coronary artery from pulmonary artery diagnosed on echocardiography and confirmed by computed tomography (CT angiography.

  13. A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E.; Rietman, Johan S.; Vries, de Jakob; Baas, Peter C.; Geertzen, Jan H.B.; Hoekstra, Harald J.

    2010-01-01

    Background: Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and ALN

  14. Occult breast primary malignancy presenting as isolated axillary lymph node metastasis - early detection of primary site by 18F-FDG PET/CT.

    Science.gov (United States)

    Soundararajan, Ramya; Naswa, Niraj; Karunanithi, Sellam; Walia, Ritika; Kumar, Rakesh; Bal, Chandrasekhar

    2016-01-01

    Breast cancer patients rarely present with isolated axillary lymph node metastasis without any clinical or radiological evidence of primary tumor. Identification of the primary site of tumor helps in planning appropriate patient management which has definite impact on patient's survival. We present here a case of 30-year-old female who presented with isolated right axillary lymph node metastasis with no evidence of primary tumor clinically. Conventional imaging modalities were negative for primary site. She underwent whole body 18F-Flurodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and it contributed significantly in early detection of occult primary tumor in right breast.

  15. The detection of axillary lymph node metastases from breast cancer by radiolabelled monoclonal antibodies: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Tjandra, J.J. (Melbourne Univ., Parkville (Australia) Royal Melbourne Hospital, Parkville (Australia)); Sacks, N.P.M.; Thompson, C.H. (Melbourne Univ., Parkville (Australia)) (and others)

    1989-02-01

    Two murine monoclonal antibodies that react with human breast cancer (3E1.2 and RCC-1) were labelled with {sup 131}iodine, and the radiolabelled antibody was injected into 40 patients, 36 of whom had breast cancer and the remaining four of whom had fibroadenoma (the normal, contralateral axilla was used as a control). Immunoscintigraphy had an overall sensitivity of 33% (23% with {sup 131}I-3E1.2 and 5% with {sup 131}I-RCC-1) for the detection of lymph node metastases and a specificity of 63% (67% with {sup 131}I-3E1.2 and 60% with {sup 131}I-RCC-1) with problems of non-specific uptake by presumably normal lymph nodes. The results of immunoscintigraphy obtained with {sup 131}I-RCC-1 (IgG) were superior to {sup 131}I-3E1.2 (IgM) although the accuracy of immunoscintigraphy using {sup 131}I-RCC-1 (56%) was not much better than preoperative clinical assessment (50%). However, there were cases when immunoscintigraphy using radiolabelled antibody (IgM or IgG) detected axillary lymph node metastases not suspected by clinical examination. Thus it appears that while immunoscintigraphy may be a useful adjunct to preoperative clinical assessment and is simple and safe, a major improvement in its accuracy is needed before it can replace axillary dissection and histological examination in the accurate staging of axilla in breast cancer. (author).

  16. Sentinel lymph node detection after trans axillary augmentation mammoplasty: a prospective controlled study utilizing lymphoscintigraphy in 43 breasts

    Energy Technology Data Exchange (ETDEWEB)

    Sado, Heitor Naoki; Timi, Jorge Rufino Ribas; Matias, Jorge Eduardo Fouto [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Program of Post-Graduation in Surgical Practice]. E-mail: heitor@cermen.com.br; Graf, Ruth Maria [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital de Clinicas; Urban, Cicero Andrade [UnicenP, Curitiba, PR (Brazil); Yamada, Airton Seiji [CERMEN - Centro de Radioimunoensaio e Medicina Nuclear de Curitiba, PR (Brazil); Woellner, Luiz Carlos [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital de Clinicas. Unit of Nuclear Medicine; Ferreira, Eduardo de Castro [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital de Clinicas

    2008-09-15

    Objective: to evaluate the potential influence of trans axillary augmentation mammoplasty on future detection of sentinel lymph node. Materials and methods: prospective controlled study where 22 patients were selected and divided into two groups (post-mammoplasty and control) corresponding to 43 breasts (22 in the post-mammoplasty group and 21 in the control group) evaluated by lymphoscintigraphy immediately after periareolar {sup 99m}Tc-phytate injections. In the statistical analysis, p values < 0.05 were considered as significant. Results: all the breasts in the post-mammoplasty group presented lymphatic drainage to the axillary chain, with no difference as compared with the control group (p 0.488). The average number of hot lymph nodes was 1.27 {+-} 0.46 in the post-mammoplasty group, and 1.33 {+-} 0.58 in the control group (p = 0.895). The mean time required to visualize the first lymph node was 3.14 {+-} 4.42 minutes in the post mammoplasty group, and 5.48 {+-} 5.06 minutes in the control group (p 0.136). Conclusion: transaxillary augmentation mammoplasty did not affect the future detection of sentinel lymph node. (author)

  17. THE PROGNOSIS SIGNIFICANCE OF CATHEPSIN-D EXPRESSION IN THE DIFFERENT LOCATIONS IN AXILLARY NODES NEGATIVE CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: The aim of this study was to investigate Cathepsin-D (Cath-D) expression in different location and its relationship with prognosis in the axillary lymph nodes negative (ANN) breast cancer patients. Methods: Cath-D expression in 192 cases of breast carcinoma were examined by immunohistochemistry. Depending on different parts of expression, three evaluating methods were used, compared and analysed. Results: The positive rate of Cath-D expression in ANN breast cancer with poor prognosis group and axillary nodes positive (ANP) group were significantly higher than that in ANN breast cancer with good prognosis group (x2=23.20, P0.05). Cath-D expression in stromal cells had no statistical difference among the three groups (x2=1.56, P>0.05). When the Cath-D expression in cancer and stromal cells were counted into the positive rate, it was near the same (u1=0.47, u2=1.41, P>0.05). Conclusion: These results suggest that Cath-D expression is one of the powerful prognostic markers in ANN breast cancer. It's a reliable, practical, and convenient method to observe and evaluate Cath-D expression in cancer cells.

  18. Male axillary extracts contain pheromones that affect pulsatile secretion of luteinizing hormone and mood in women recipients.

    Science.gov (United States)

    Preti, George; Wysocki, Charles J; Barnhart, Kurt T; Sondheimer, Steven J; Leyden, James J

    2003-06-01

    Human underarm secretions, when applied to women recipients, alter the length and timing of the menstrual cycle. These effects are thought to arise from exposure to primer pheromones that are produced in the underarm. Pheromones can affect endocrine (primer) or behavioral (releaser) responses, provide information (signaler), or perhaps even modify emotion or mood (modulator). In this study, we extracted underarm secretions from pads worn by men and placed the extract under the nose of women volunteers while monitoring serum LH and emotion/mood. Pulses of LH are excellent indicators of the release of GnRH from the brain's hypothalamus. In women, the positive influence of GnRH on LH affects the length and timing of the menstrual cycle, which, in turn, affects fertility. Here we show that extracts of male axillary secretions have a direct effect upon LH-pulsing and mood of women. In our subjects, the putative male pheromone(s) advanced the onset of the next peak of LH after its application, reduced tension, and increased relaxation. These results demonstrate that male axillary secretions contain one or more constituents that act as primer and modulator pheromones.

  19. Outcome of Trans-Axillary Approach for Surgical Decompression of Thoracic Outlet: A Retrospective Study in a Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Mohd Riyaz Lattoo

    2014-05-01

    Full Text Available Objective: The aim of this study was to evaluate the trans-axillary surgical approach in patients with thoracic outlet syndrome. Methods: This retrospective study is comprised of data acquired from January 1998 until Oct 2008. Case histories of all the patients were reviewed from the Medical Records Department of Sher-i-Kashmir Institute. Relevant information and follow-up of the patients was carried out by examining the relevant clinical notes available by telephone interviews and personal contact whenever possible. All data was compiled and analyzed statistically. Results: There were a total of 139 patients. The female: male ratio was about 6:1. Pain was the most common presenting symptom followed by weakness and parasthesia. Nerve conduction velocity was abnormal in 111 patients. Twenty-eight patients had abnormal Doppler study of subclavian vessels. Preoperative symptoms persisted in 13 patients. Overall, 126 patients showed improvement in symptoms and no recurrence or persistence of symptoms on follow-up examination. Conclusion: Trans-axillary approach provides a good exposure and cosmesis in patients with thoracic outlet syndrome. It should be considered as the gold standard in the management of thoracic outlet syndrome.

  20. Arterial hypoxaemia in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, Jens; Christensen, E

    1998-01-01

    BACKGROUND: Although low arterial oxygen tension (Po2) has been claimed to occur in one to two thirds of patients with cirrhosis, hypoxaemia appears to be rare in clinical practice. AIMS: To assess the frequency of arterial hypoxaemia in cirrhosis in relation to clinical and haemodynamic......%, 96%, 96%, and 93% (NS). So2 was below the lower limit of 92% in 0%, 9%, 7%, and 24% (p arterial carbon dioxide tension, a low systemic vascular...... resistance, and a low indocyanine green clearance (p arterial hypoxaemia in cirrhosis is about 22% in patients without encephalopathy, but it varies from 10-40% depending on the degree of hepatic dysfunction. Arterial hypoxaemia in patients with cirrhosis of differing...

  1. Artery by Neuropeptides

    Directory of Open Access Journals (Sweden)

    Esmeralda Sofia Costa Delgado

    2012-01-01

    Methods. Isolated rabbit eyes (n=12 were perfused in situ with tyrode through the external ophthalmic artery. Effects of intra-arterial injections of NPY 200 μg/ml (Group A; n=6 and VIP 200 μg/ml (Group B; n=6 on the recorded pressure were obtained. For statistical analysis, Student's paired t-test and Fast Fourier Transform were used. Results. Spontaneous oscillations were observed before any drug administration in the 12 rabbit models. NPY produced an increase in total vascular resistance and a higher frequency and amplitude of oscillations, while VIP evoked the opposite effects. Conclusions. This study provides evidence of vasomotion in basal conditions in rabbit external ophthalmic artery. Concerning drug effects, NPY increased arterial resistance and enhanced vasomotion while VIP produced opposite effects which demonstrates their profound influence in arterial vasomotion.

  2. [Transposition of Great Artery].

    Science.gov (United States)

    Konuma, Takeshi; Shimpo, Hideto

    2015-07-01

    Transposition of the great artery is one of common congenital cardiac disease resulting cyanosis. Death occurs easily in untreated patients with transposition and intact ventricular septal defect (VSD) in infancy at a few days of age when posterior descending coronary artery (PDA) closed. Since there are 2 parallel circulations, flow from pulmonary to systemic circulation is necessary for systemic oxygenation, and Balloon atrial septostomy or prostaglandin infusion should be performed especially if patient do not have VSD. Although the advent of fetal echocardiography, it is difficult to diagnose the transposition of the great arteries (TGA) as abnormality of great vessels is relatively undistinguishable. The diagnosis of transposition is in itself an indication for surgery, and arterial switch procedure is performed in the case the left ventricle pressure remains more than 2/3 of systemic pressure. Preoperative diagnosis is important as associated anomalies and coronary artery branching patterns are important to decide the operative indication and timing of surgery.

  3. Expression and significance of AQP5 in axillary sweat glands of palmar hyperhidrosis patients with axillary hyperhidrosis%水通道蛋白5在手汗症伴腋窝多汗患者腋窝汗腺中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    赵冬峰; 涂远荣; 陈剑锋; 邱明链; 李旭; 林敏

    2010-01-01

    Objective To examine the expression of aquaporin (AQP) in axillary sweat glands of palmar hyperhidrosis patients with axillary hyperhidrosis and investigate its relationship with the pathogene-sis of palmar hyperhidrosis patients with axillary hyperhidrosis. Methods Axillary sweat glands were obtained in 34 cases of hyperhidrosis and 8 cases of non-hyperhidrosis as control group. The number of axillary sweat glands was calculated by using HE staining and the expression of aquaporins (AQP1, AQP3, AQP5) was detected by using immunochemical method respectively. The comparison was made between hyperhidrosis group and control group. Results The number of axillary sweat glands in two groups had no significant difference in statistics (Z=- 1.506, P>0. 05 ). Both groups had the expression of AQP5, and AQP1, AQP3 were undetectable; The AQP5 expression of axillary sweat glands in hyperhidmsis cases was significantly increased as compared with that in control group (Z=- 3. 523, P0.05);两组腋窝汗腺中均无AQP1、AQP3表达,AQP5在两组均有表达且在实验组中表达显著增强(Z=-3.523,P<0.05).结论 AQP1、AQP3不参与人体腋窝汗腺分泌;AQP5可能是参与人体腋窝汗腺分泌的主要水通道蛋白之一,其表达增强很可能是手汗症伴腋窝多汗患者的发病机制之一.

  4. Axillary budbreak in a cut rose crop as influenced by light intensity and red:far-red ratio at bud level

    NARCIS (Netherlands)

    Wubs-Timmermans, A.M.; Heuvelink, E.; Marcelis, L.F.M.; Buck-Sorlin, G.H.; Vos, J.

    2014-01-01

    When flower-bearing shoots in cut rose (Rosa ·hybrida) are harvested, a varying number of repressed axillary buds on the shoot remainder start to grow into new shoots (budbreak). Earlier experiments indicated that light reaching the bud affected the number of budbreaks. In all these studies, whole p

  5. Comparison of molecular analysis and histopathology for axillary lymph node staging in primary breast cancer: results of the B-CLOSER-I study.

    Science.gov (United States)

    Vegué, Laia Bernet; Rojo, Federico; Hardisson, David; Iturriagagoitia, Alicia Córdoba; Panadés, Maria José; Velasco, Ana; Bonet, Eugeni López; Muñoz, Rafael Cano; Polo, Luis

    2012-06-01

    In breast cancer, the number of lymph node metastases is the strongest predictor of outcome. However, histopathology may underestimate the frequency of metastasis. Here we compare automated molecular detection of cytokeratin 19 mRNA by one-step nucleic acid amplification (OSNA) with histopathology of single tissue sections for the staging of axillary lymph nodes in patients with breast cancer. Axillary lymph nodes were collected from 55 patients with primary breast cancer and sentinel lymph node (SLN) metastases. The central 1-mm portion of each node was processed for hematoxylin-eosin staining, and the remaining tissue was analyzed by OSNA. According to OSNA, histopathology misclassified 41.8% of patients as negative for axillary node metastasis (P=0.007). Of the individual nodes considered negative by histopathology, 4.5% contained micrometastases and 2.5% contained macrometastases according to OSNA. Furthermore, 80% of micrometastases identified by histopathology were reclassified as macrometastases by OSNA. Histopathology failed to identify 81.1% of nodes shown to contain metastasis by OSNA. However, OSNA yielded no false-negative results. On the basis of OSNA results, 3 patients were reclassified to a higher pathologic stage. The number of SLN and non-SLN metastases was unrelated according to OSNA (P=0.891). These results show that, compared with molecular detection, histopathology of single tissue sections significantly underestimates the frequency of axillary node metastases. We discuss the implications of these findings in light of current recommendations on the staging of breast cancer.

  6. The value of completion axillary treatment in sentinel node positive breast cancer patients undergoing a mastectomy : A Dutch randomized controlled multicentre trial (BOOG 2013-07)

    NARCIS (Netherlands)

    Roozendaal, L.M.; de Wilt, J.H.; van Dalen, T.; van der Hage, J.A.; Strobbe, L.J.; Boersma, L.J.; Linn, S.C.; Lobbes, M.B.; Poortmans, P.M.P.; Tjan-Heijnen, V. C. G.; van de Vijver, K.K.; Westenberg, A.G.; Kessels, A.G.; Smidt, M.L.; de Vries, J.

    2015-01-01

    BACKGROUND: Trials failed to demonstrate additional value of completion axillary lymph node dissection in case of limited sentinel lymph node metastases in breast cancer patients undergoing breast conserving therapy. It has been suggested that the low regional recurrence rates in these trials might

  7. Ultrasound-guided diffuse optical tomography (DOT) of invasive breast carcinoma: Does tumour total haemoglobin concentration contribute to the prediction of axillary lymph node status?

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Qingli, E-mail: qinglizhu@gmail.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Xiao, Mengsu, E-mail: xiaomengsu_2000@sina.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); You, Shanshan, E-mail: shanshan_0531@sina.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Zhang, Jing, E-mail: zhang.jing1029@163.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Jiang, Yuxin, E-mail: yuxinjiangxh@yahoo.com.cn [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Lai, Xingjian, E-mail: lxjpumch@yahoo.com.cn [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Dai, Qing, E-mail: qingdai_2000@yahoo.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China)

    2012-11-15

    Objectives: To prospectively study the ultrasound-guided near-infrared diffuse optical tomography (DOT) findings of the total haemoglobin concentration (THC) detected in invasive breast carcinomas and its contribution to the prediction of axillary lymph node (LN) status. Methods: A total of 195 invasive breast carcinomas were prospectively studied with DOT before surgery. Lumpectomy or mastectomy with full axillary nodal dissection was performed. Tumour size and THC level were correlated with LN status by a logistic regression analysis. Results: One hundred twenty-four patients (63.59%) was LN(-) and 71 (36.41%) was LN(+). The average THC was significantly higher in the LN(+) group than in the LN(-) group (252.94 {+-} 69.19 {mu}mol/L versus 203.86 {+-} 83.13 {mu}mol/L, P = 0.01). A multivariate analysis showed an independent relationship between the probability of axillary metastasis, elevated THC level (P = 0.01), and tumour size (P = 0.001). The odds ratio with THC {>=} 140 {mu}mol/L was 13.651 (1.781-104.560), whereas that of tumour size with a 1 cm increment was only 1.777 (1.283-2.246). Conclusions: The THC level and the tumour size are independent and preoperative predictors of axillary nodal status; these variables may improve the diagnosis of patients with lymph node metastasis.

  8. Coronary artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Koischwitz, D.; Harder, T.; Schuppan, U.; Thurn, P.

    1982-04-01

    Seven saccular coronary artery aneurysms have been demonstrated in the course of 1452 selective coronary artery angiograms. In six patients they were arterio-sclerotic; in one patient the aneurysm must have been congenital or of mycotic-embolic origin. The differential diagnosis between true aneurysms and other causes of vascular dilatation is discussed. Coronary artery aneurysms have a poor prognosis because of the possibility of rupture with resultant cardiac tamponade, or the development of thrombo-embolic myocardial infarction. These aneurysms can only be diagnosed by means of coronary angiography and require appropriate treatment.

  9. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  10. Renal arteries (image)

    Science.gov (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  11. Coronary Artery Bypass Surgery

    Science.gov (United States)

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  12. Carotid Artery Disease

    Science.gov (United States)

    ... make them more vulnerable to damage. Tobacco use. Nicotine can irritate the inner lining of your arteries. ... your physical and mental capabilities such as strength, memory and speech. After that, your doctor may recommend: ...

  13. Pulmonary Arterial Hypertension

    Science.gov (United States)

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  14. Induction of callus from axillary buds of taro (Colocasia esculenta var. esculenta, Araceae) and subsequent plantlet regeneration.

    Science.gov (United States)

    Yam, T W; Young, J L; Fan, K P; Arditti, J

    1990-12-01

    Axillary buds of taro (Colocasia esculenta var. esculenta, Araceae) cultured on half strength Murashige-Skoog medium (HMS) containing taro extract (HMSTE) and 2, 4, 5-trichlorophenoxyacetic acid produce a compact, hard, slow growing callus which is not very active morphogenetically and produces only a few plantlets. When cultured on HMSTE plus 5 mg 1(-1) each of naphthaleneacetic acid and benzyl adenine (HMSNB) the buds produce a fast growing, friable and morphogenetically active callus. Meristematic regions form on the friable callus after 30 days on HMSNB. If transferred to HMSTE at this point the callus gives rise to plantlets. Addition of taro extract to the media is required for the culture of buds, induction of callus and plantlet regeneration.

  15. Expression of the Apoptosis Inhibitor Survivin and its correlation with Thymidine Kinase and Axillary Lymph Node Metastasis in Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Jian-Ping WU; Yun-Feng ZHOU; Zhi-Guo LUO; Ming-Sheng ZHANG

    2005-01-01

    @@ 1 Introduction Many molecular factors have been demonstrated to interfere with cellular proliferation and programmed cell death. One of these factors is a recently discovered member of the "inhibitor of apoptosis protein(IAP)" called survivin. Survivin is abundantly expressed in most solid and hematologic malignancies, but undetectable in normal adult tissues. Interference with survivin function induces pleiotropic cell-division defects and apoptosis. Cytosolic thymidine kinase (TK) is a marker for proliferating cells and TK is one of several key enzymes involved in DNAmetabolism that phosphorylates thymidine to thymidine mono-phosphate. This study was aimed to detect the expression of suvivin and TK in breast cancer, and to explore a possible relationship between survivin expression and axillary lymph node metastasis.

  16. Cyclosporine-A therapy-induced multiple bilateral breast and accessory axillary breast fibroadenomas: a case report

    Directory of Open Access Journals (Sweden)

    Darwish Ahmed

    2010-08-01

    Full Text Available Abstract Introduction Breast adenoma is common. However, in the setting of post-transplantation immune suppression it may be expressed differently. Case presentation A 35-year-old Sudanese woman, with a history of renal transplantation two and half years prior to presentation, was on a single immune suppression therapy in the form of cyclosporine-A since the transplantation. During a regular follow-up visit, she was noticed to have gingival hypertrophy and bilateral breast and axillary swellings. She underwent successful surgical resection of the bilateral fibroadenomas. Conclusions Cyclosporine-A therapy post renal transplantation is associated with an increased incidence of benign breast changes as fibroadenoma. Regular follow-up and appropriate selection of immunosuppressant therapy are essential in the post transplantation management of these patients.

  17. Necrotizing granulomatous inflammation in an ipsilateral axillary lymph node in a patient with invasive ductal carcinoma of the breast.

    Science.gov (United States)

    Yang, Limin; Park, Jeong Mi; Askeland, Ryan W; Fajardo, Laurie L

    2012-01-01

    A patient presented with flu-like symptoms and a warm, tender area in the left axilla after working with an ancient piece of Cyprus wood. Antibiotics prescribed failed to improve symptoms. Followup physical examination and subsequent ultrasound found suspicious left-breast mass and an enlarged lymph node in the left axilla. Biopsy and lumpectomy of the left-breast mass revealed invasive ductal carcinoma. Biopsy and excision of the enlarged lymph node in the left axilla revealed necrotizing granulomatous inflammation without evidence of metastatic breast carcinoma. To our knowledge, this is the first case report to show the coexistence of breast cancer with necrotizing granulomatous inflammation in the ipsilateral axillary lymph node, likely due to exposure to ancient wood.

  18. Heritability of cilioretinal arteries

    DEFF Research Database (Denmark)

    Taarnhøj, Nina Charlotte; Munch, Inger C; Kyvik, Kirsten O;

    2005-01-01

    PURPOSE: To determine whether the presence of one or more cilioretinal arteries, a distinct element of the pattern of fundus vessels, is genetically programmed, influenced by environmental factors, or the result of random mechanisms of vascular development. METHODS: The fundi of 112 pairs...... environmental factors. CONCLUSIONS: The presence or absence of one or more cilioretinal arteries in healthy persons is markedly influenced by genetic factors....

  19. Effects of postmastectomy radiotherapy on prognosis in different tumor stages of breast cancer patients with positive axillary lymph nodes

    Institute of Scientific and Technical Information of China (English)

    Miao-Miao Jia; Zhi-Jie Liang; Qin Chen; Ying Zheng; Ling-Mei Li; Xu-Chen Cao

    2014-01-01

    Objective: To explore the effects of postmastectomy radiotherapy (PMRT) on the locoregional failure-free survival (LRFFS) and overall survival (OS) of breast cancer patients under different tumor stages and with one to three positive axillary lymph nodes (ALNs). Methods: We conducted a retrospective review of 527 patients with one to three positive lymph nodes who underwent modiifed radical or partial mastectomy and axillary dissection from January 2000 to December 2002. hTe patients were divided into the T1-T2 N1 and T3-T4 N1 groups. hTe effects of PMRT on the LRFFS and OS of these two patient groups were analyzed using SPSS 19.0, Pearson’s χ2-test, Kaplan-Meier method, and Cox proportional hazard model. Results: For T1-T2 N1 patients, no statistical signiifcance was observed in the effects of PMRT on LRFFS [hazard ratio (HR)=0.726; 95% conifdence interval (CI): 0.233-2.265;P=0.582] and OS (HR=0.914; 95% CI: 0.478-1.745;P=0.784) of the general patients. Extracapsular extension (ECE) and high histological grade were the risk factors for LRFFS and OS with statistical significance in multivariate analysis. Stratification analysis showed that PMRT statistically improved the clinical outcomes in high-risk patients [ECE (+), LRFFS:P=0.026, OS:P=0.007; histological grade III, LRFFS:P Conclusion: PMRT could reduce ECE (+), histological grade III-related LRR, and total mortality of T1-T2 N1 patients. T3-T4 N1 patients with ER/PR (-) could beneift from PMRT by improving LRFFS and OS. However, PMRT could only reduce LRR but failed to improve OS for T3-T4 N1 patients with ER/PR (+) who received endocrine therapy.

  20. Arterial supply in the human pectoralis minor muscle.

    Science.gov (United States)

    Moriya, A; Takafuji, T; Sato, Y

    1993-03-01

    In the following, we report our findings obtained as a result of injecting an acrylic pigment in the arteries supplying the pectoralis minor muscle in 50 lateral chests of 26 Japanese adults (15 males and 11 females). In the pectoralis minor muscle, the muscular bundle near the terminal is supplied by A. processus coracoideris (Pc, Sato-Takafuji, '85) or A. coracobrachialis (Cb, Sato, '80) of A. axillaris (Ax), while its middle upper and lower peripherals are supplied by A. thoracoacromialis (Ta) and A. partis abdominalis (Pab, Sato, '76), respectively. Further, the upper and lower peripherals at its origin are supplied by A. thoracica suprema (Ts) and A. thoracica lateralis (Tl), respectively. Pc, Cb, Pab and Ts may occasionally be absent. Arteries supplying this muscle are classified according to their origins and routes of distribution, as follows. Type I-a: Pc or Cb, Ta, Pab, Ts and Tl are present, 32%; Type II-a: Ts is absent from Type I-a, 14%; Type III-a: Pb and Pc are absent from Type I-a, 20%; Type IV-a: Cb, Pc and Ts are absent from Type I-a, 10%. Type b is Type a without Pab. The rates of appearance of Type I-b, II-b, III-b and IV-b were all 6%. The ratios of distribution in area a were as follows, in order of decreasing ratio: 37.6% for Pab (37 cases), 32.4% for Tl (49 cases), 30.2% for Ta (49 cases), 10.8% for Ts (32 cases), 7% for Cb (9 cases), and 6.37% for Pc. In the pectoralis minor muscle, the major supplying arteries are Pab, Tl and Ta, and where Pab was absent, this was compensated for by a branch of Ta. The total number of supplying arteries in this muscle was two to five, with the majority, or 36%, having four arteries. As for sex differences in the incidence of each type, Type I-a appeared more often in males (40%) than in females (20%). The rates according to the ribs of origin were 46%, 36%, 16%, and 2% for types 2.3.4.5, 3.4.5, 2.3.4, and 2.3.4.5.6, respectively. It was interesting that all Type II and Type IV cases without Ts corresponded

  1. Coronary anomaly: the single coronary artery

    Institute of Scientific and Technical Information of China (English)

    QIN Xu-guang; XIONG Wei-guo; LU Chun-peng; GONG Cheng-jie; SHANG Li-hua

    2010-01-01

    @@ Single coronary artery (SCA), defined as an artery that arises from the arterial trunk and nourishes the entire myocardium, is rare. We report two cases of SCA, one is the right coronary artery (RCA) originating from the middle of left descending artery (LAD), and the other is the left main coronary artery (LMCA) arising from the proximal right coronary artery.

  2. Coronary Artery and Pulmonary Artery Fistula Originated from Significant Stenosis in the Left Anterior Descending Artery

    Directory of Open Access Journals (Sweden)

    Alper Sami Kunt

    2013-01-01

    Full Text Available Coronary artery fistula (CAF is defined as a rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA. CAF is often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, the pathophysiology, the diagnostic modalities, and the treatment options.

  3. Diagnostic accuracy of dual-time-point 18F-FDG PET/CT for the detection of axillary lymph node metastases in breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Steffen; Forsting, Michael [Dept. of Diagnostic and Interventional Radiology and Neuroradiology, Univ. Hospital Essen, Univ. at Duisburg-Essen, Essen (Germany)], e-mail: steffen.hahn@uk-essen.de; Hecktor, Jennifer; Kimmig, Rainer [Dept. of Gynecology and Obstetrics, Univ. Hospital Essen, Univ. at Duisburg-Essen, Essen (Germany); Grabellus, Florian [Institute of Pathology and Neuropathology, Univ. Hospital Essen, Univ. at Duisburg-Essen, Essen (Germany); Hartung, Verena; Poeppel, Thorsten [Dept. of Nuclear Medicine, Univ. Hospital Essen, Univ. at Duisburg-Essen, Essen (Germany); Antoch, Gerald; Heusner, Till A. [Univ. of Dusseldorf, Medical Faculty, Dept. of Diagnostic and Interventional Radiology, Dusseldorf (Germany)

    2012-06-15

    Background: The diagnostic accuracy of FDG-PET/CT for the detection of axillary lymph node metastases in breast cancer patients acquired 60 min after FDG administration is reported to be only moderate, especially due to low sensitivity. Purpose: To test whether a delayed scan 90 min after FDG administration could enhance the diagnostic accuracy of FDG-PET/CT for the detection of axillary lymph node metastases. Material and Methods: Thirty-eight women suffering from primary breast cancer (mean age 52 years; range 25-78 years; standard deviation 14 years) underwent a pre-therapeutic dual-time-point FDG-PET/CT scan. The maximum standardized uptake value (SUVmax) of axillary lymph nodes was measured at two different time points (time point T1: 60 min after FDG injection, time point T2: 90 min after FDG injection). SUVmax of axillary lymph nodes at T1 and T2 were assessed for statistical significance using a paired Wilcoxon-Test (P < 0.05). At T1 a qualitative analysis of the FDG-PET/CT scan was performed to define physiologic and metastatic lymph nodes. At T2 an increase of the SUVmax of at least 3.75% over time was rated as indicating malignancy. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the accuracy of FDG-PET/CT for the detection of axillary lymph node metastases was calculated at time points T1 and T2. Statistically significant differences were determined using Fisher's exact test (P < 0.05). Histopathology served as the standard of reference. A compartment based analysis was done. Results: Axillary lymph nodes had a mean SUVmax of 1.6 (range 0.6-10.8; SD 1.9) at T1 and a mean SUVmax of 1.8 (range 0.5-17.9; SD 3.5) at T2. This difference was statistically significant (P = 0.047). The sensitivity, specificity, PPV, NPV, and accuracy of FDG-PET/CT for the detection of axillary lymph node metastases was 81%, 100%, 100%, 88%, and 92% at T1, and 88%, 50%, 56%, 85%, and 66% at T2, respectively. This

  4. Tangential vs. defined radiotherapy in early breast cancer treatment without axillary lymph node dissection. A comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Nitsche, Mirko [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Universitaet Kiel, Klinik fuer Strahlentherapie, Karl-Lennert-Krebscentrum, Kiel (Germany); Temme, Nils; Foerster, Manuela; Reible, Michael [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Hermann, Robert Michael [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Medizinische Hochschule Hannover, Abteilung Strahlentherapie und Spezielle Onkologie, Hannover (Germany)

    2014-08-15

    Recent studies have demonstrated low regional recurrence rates in early-stage breast cancer omitting axillary lymph node dissection (ALND) in patients who have positive nodes in sentinel lymph node dissection (SLND). This finding has triggered an active discussion about the effect of radiotherapy within this approach. The purpose of this study was to analyze the dose distribution in the axilla in standard tangential radiotherapy (SRT) for breast cancer and the effects on normal tissue exposure when anatomic level I-III axillary lymph node areas are included in the tangential radiotherapy field configuration. We prospectively analyzed the dosimetric treatment plans from 51 consecutive women with early-stage breast cancer undergoing radiotherapy. We compared and analyzed the SRT and the defined radiotherapy (DRT) methods for each patient. The clinical target volume (CTV) of SRT included the breast tissue without specific contouring of lymph node areas, whereas the CTV of DRT included the level I-III lymph node areas. We evaluated the dose given in SRT covering the axillary lymph node areas of level I-III as contoured in DRT. The mean V{sub D95} {sub %} of the entire level I-III lymph node area in SRT was 50.28 % (range, 37.31-63.24 %), V{sub D45} {sub Gy} was 70.1 % (54.8-85.4 %), and V{sub D40} {sub Gy} was 83.5 % (72.3-94.8 %). A significant difference was observed between lung dose and heart toxicity in SRT vs. DRT. The V{sub 20} {sub Gy} and V{sub 30} {sub Gy} of the right and the left lung in DRT were significantly higher in DRT than in SRT (p < 0.001). The mean heart dose in SRT was significantly lower (3.93 vs. 4.72 Gy, p = 0.005). We demonstrated a relevant dose exposure of the axilla in SRT that should substantially reduce local recurrences. Furthermore, we demonstrated a significant increase in lung and heart exposure when including the axillary lymph nodes regions in the tangential radiotherapy field set-up. (orig.) [German] Aktuelle Studien zeigen

  5. Left Coronary Artery-Pulmonary Artery Fistula in Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Orhan Veli Doğan

    2012-08-01

    Full Text Available Coroner artery fistula which is rare and congenital or acquired arise from whole coroner artery drainage all of cardiac chamber and great artery. Although coroner artery fistula is uncommon, it can cause significant mortality and morbidity rates. The article is presented which coroner artery disease and coroner-pulmonary artery fistula was accomplishment committed. Sixty three year-old male patient admitted to the hospital with chest pain. Non-ST myocardial infarction was diagnosed in the examinations. After coroner angiography, it was found coronary artery disease in addition between LAD proximal portion and main pulmonary artery fistula. Fistula repair and coronary bypass were performed successfully under cardiopulmonary bypass. Without hemodynamic problem in intensive care and service follow-up, the patient was discharged from the hospital in the seventh postoperative day. We think that surgical treatment of coronary fistulas in patients with coronary artery lesion is done at the earliest time would enable improvement in mortality and morbidity rates.

  6. Arterial hypertension and cancer.

    Science.gov (United States)

    Milan, Alberto; Puglisi, Elisabetta; Ferrari, Laura; Bruno, Giulia; Losano, Isabel; Veglio, Franco

    2014-05-15

    Arterial hypertension and cancer are two of the most important causes of mortality in the world; correlations between these two clinical entities are complex and various. Cancer therapy using old (e.g., mitotic spindle poisons) as well as new (e.g., monoclonal antibody) drugs may cause arterial hypertension through different mechanisms; sometimes the increase of blood pressure levels may be responsible for chemotherapy withdrawal. Among newer cancer therapies, drugs interacting with the VEGF (vascular endothelial growth factors) pathways are the most frequently involved in hypertension development. However, many retrospective studies have suggested a relationship between antihypertensive treatment and risk of cancer, raising vast public concern. The purposes of this brief review have then been to analyse the role of chemotherapy in the pathogenesis of hypertension, to summarize the general rules of arterial hypertension management in this field and finally to evaluate the effects of antihypertensive therapy on cancer disease.

  7. Idiopathic pulmonary artery aneurysm.

    Science.gov (United States)

    Kotwica, Tomasz; Szumarska, Joanna; Staniszewska-Marszalek, Edyta; Mazurek, Walentyna; Kosmala, Wojciech

    2009-05-01

    Pulmonary artery aneurysm (PAA) is an uncommon lesion, which may be associated with different etiologies including congenital cardiovascular diseases, systemic vasculitis, connective tissue diseases, infections, and trauma. Idiopathic PAA is sporadically diagnosed by exclusion of concomitant major pathology. We report a case of a 56-year-old female with an idiopathic pulmonary artery dilatation identified fortuitously by echocardiography and confirmed by contrast-enhanced computed tomography. Neither significant pulmonary valve dysfunction nor pulmonary hypertension and other cardiac abnormalities which might contribute to the PAA development were found. Here, we describe echocardiographic and computed tomography findings and review the literature on PAA management.

  8. Long-term results of endovascular therapy for proximal subclavian arterial obstructive lesions

    Institute of Scientific and Technical Information of China (English)

    WANG Ke-qin; LIAO Chuan-jun; ZHANG Yang; WANG Zhong-gao; YANG Bao-zhong; YUAN Chao; ZHANG Wang-de; YUAN Biao; XING Tong; SONG Sheng-han; LI Tan

    2010-01-01

    Background Endovascular therapy is a treatment option for localized occlusion of the subclavian artery. In this report the long-term experience with 59 patients is presented.Methods Between June 1998 and September 2008, we used endovascular therapy to treat 61 subclavian arterial obstructive lesions in 59 patients (46 males and 13 females, 34-82 years of age with a mean age (61.9±11.0) years). Twenty patients (34%) had clinical symptoms due to vertebrobasilar insufficiency, 26 (44%) had disabling arm ischemia, and 13 (22%) had both symptoms. We performed all procedures under local anesthesia. The approaches were from the femoral artery (n=47), brachial artery (n=\\, involving bilateral subclavian disease) or both (n=11). Sixty stents were implanted. All patients were followed-up at 1,3, 6, and 12 months post-procedure, and annually thereafter. Results We achieved technical success in 58 (95.1%) arteries, all of which were stented. There were three technical failures; two were due to the inability to cross over an occlusion, necessitating the switch to an axillo-axillary bypass, and the third was due to shock after digital subtraction angiography and prior to stenting. Arterial stenosis pre- and post-stenting was (83.6±10.8)% and (2.5±12.5)% (P <0.01). Clinical success was achieved in 55 of the 59 patients (93.4%). Of the four clinical failures, three were technical and the remaining patient had a stent thrombosis. Systolic blood pressure difference between the two brachial arteries was (44.7±18.5) vs. (2.2±3.9) mmHg (P <0.01). Primary patency was 98% at 12 months, 93% at 24 months, and 82% at 5 years. Five patients were lost to follow-up by 12 months post-stenting. Significant recurrent obstruction developed in five patients with resumption of clinical symptoms. The overall survival rate was 98.2% at 12 months, 89.5% at 24 months, and 84.5% at 5 years.Conclusions Endovascular therapy for proximal subclavian arterial obstructive lesions is effective and

  9. Left Anterior Descending Artery-Pulmonary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Turan Ege

    2011-12-01

    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  10. Pulmonary arterial hypertension in children after neonatal arterial switch operation

    NARCIS (Netherlands)

    Zijlstra, Willemijn Mh; Elmasry, Ola; Pepplinkhuizen, Shari; Ivy, D Dunbar; Bonnet, Damien; Lévy, Marilyne; Gavilan, Jose Luis; Torrent-Vernetta, Alba; Mendoza, Alberto; Del Cerro, Maria Jesus; Moledina, Shahin; Berger, Rolf M. F.

    2017-01-01

    OBJECTIVES: Paediatric pulmonary arterial hypertension (PAH) after neonatal arterial switch operation (ASO) for transposition of the great arteries (TGA) is a clinically recognised entity with an estimated incidence of 0.6%-1.0%. Nevertheless, a clinical characterisation is lacking. We present an in

  11. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre

    2011-09-10

    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  12. Buprenorphine for postoperative analgesia: Axillary brachial plexus block versus intramuscular administration in a placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Deepali Thakur

    2015-01-01

    Full Text Available Background and Aims: Peripheral administration of opioids has been suggested for prolongation of regional analgesia. This prospective, randomized, double-blind placebo-controlled study was undertaken to compare the effect of regional (axillary brachial plexus block [ABPB] versus intramuscular (IM buprenorphine (2 μg/kg in adults. Material and Methods: Seventy-five adults undergoing upper limb surgery received ABPB with local anaesthetic (15 ml 0.5% bupivacaine, 15 ml 2% lignocaine with adrenaline 1:200,000, 9 ml normal saline [NS]. In addition, regional group RB (n = 25 received buprenorphine 2 μg/kg in ABPB and 1 ml NS IM. Systemic Group SB (n = 25 received 1 ml NS in ABPB and buprenorphine 2 μg/kg IM. Group C (n = 25 received 1 ml NS in ABPB and IM. Onset, duration of sensory and motor block, hemodynamic parameters, sedation score, pain scores using visual analog scale, duration of postoperative analgesia, rescue analgesic (RA requirement, adverse events, and patient satisfaction were noted. Results: Demographics, onset and duration of sensory, motor block were similar. RB group had longest duration of analgesia (20.61 ± 1.33 h compared to SB (10.91 ± 0.90 h and control group (5.86 ± 0.57 h (P < 0.05 RB vs. SB/C and SB vs. C. RA requirement was highest in the control group and least in RB group (P = 0.000 RB vs. SB/C and SB vs. C. SB group had a maximum number of side effects (P = 0.041, SB vs. RB/C. Patient satisfaction was highest with group RB (P < 0.05 RB vs. SB/C, and P = 0.06 SB vs. C. Conclusion: Buprenorphine 2 μg/kg in axillary plexus block provides significantly prolonged analgesia with less RA requirement and greater patient satisfaction compared to IM administration. This is highly suggestive of action on peripheral opioid receptors.

  13. Pulmonary artery sling: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Gil Hyun; Lee, Sun Wha; Cha, Sung Ho [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1993-09-15

    Aberrant left-sided pulmonary artery(pulmonary artery sling) is an uncommon anomaly,which may cause significant respiratory abnormality. We report a case of pulmonary artery sling which is combined with persistent left superior vena cava and dextrocardia. This case were identified by esophagogram and CT and confirmed by MRI and angiography. We consider that MRI is a valuable new method for the diagnosis of aberrant left-sided pulmonary artery.

  14. Positive versus negative sentinel nodes in early breast cancer patients: axillary or loco-regional relapse and survival. A study spanning 2000-2012.

    Science.gov (United States)

    García Fernández, A; Chabrera, C; García Font, M; Fraile, M; Lain, J M; Barco, I; González, C; Gónzalez, S; Reñe, A; Veloso, E; Cassadó, J; Pessarrodona, A; Giménez, N

    2013-10-01

    Sentinel Node Biopsy (SNB) is a minimally invasive alternative to elective axillary lymph node dissection (ALND) for nodal staging in early breast cancer. The present study was conducted to evaluate prognostic implications of a negative sentinel node (SN) versus a positive SN (followed by completion ALND) in a closely followed-up sample of early breast cancer patients. We studied 889 consecutive breast cancer patients operated for 908 primaries. Patients received adjuvant therapy with chemotherapy, hormone therapy and eventually trastuzumab. Radiation therapy was based on tangential radiation fields that usually included axillary level I. Median follow-up was 47 months. Axillary recurrence was seen in 1.2% (2/162) of positive SN patients, and 0.8% (5/625) of negative SN patients (p = n.s.). There was an overall 3.2% loco-regional failure rate (29/908). Incidence of distant recurrence was 3.3% (23/693) for negative SN patients, and 4.6% (9/196) for positive SN patients (p = n.s.). Overall mortality rate was 4% (8/198) for positive SN patients, while the corresponding specific mortality rate was 2.5% (5/198). For patients with negative SNs, overall mortality was 4.9% (34/693), and the specific mortality was 1.4% (19/693) (p = n.s.). We did not find significant differences in axillary/loco-regional relapse, distant metastases, disease-free interval or mortality between SN negative and SN positive patients, with a follow-up over 4 years.

  15. A型肉毒毒素注射治疗腋臭疗效探讨%Effect of Botulinum Toxin type A injection on axillary bromidrosis

    Institute of Scientific and Technical Information of China (English)

    茅付勇

    2015-01-01

    Objective To investigate the clinical value of Botulinum Toxin A on axillary bromidrosis by minimally invasive injection. Methods Using minimally invasive Botulinum Toxin A injection method in the 60 cases of axillary bromidrosis (all of them are bilateral axillary), and then observing the curative effect. Results Of all the 60 patients 58 cases were followed up from March 2011 to June 2014,on average one year and a half,in order to observe the effect and complications and therapeutic effect of them,and the follow- up rate was 96.7% .The curative effect is satisfied. Conclusion Minimally invasive Botulinum Toxin A injection,as a non-operation therapy for axillary bromidrosis,is a method which is simple to operation,easy to master,region without scar,and the curative effect is satisfactory.%目的:探讨微创A型肉毒毒素注射法治疗腋臭的应用价值。方法:采用微创A型肉毒毒素注射法治疗腋臭60例(均为双侧腋窝)观察治疗效果。结果:60例患者中,随访58例,随访率为96.7%。随访时间2011年3月-2014年6月,平均1.5年,疗效满意。结论:微创A型肉毒毒素注射法治疗腋臭操作简单、易于掌握、创区无瘢痕,且疗效满意。

  16. Is there a requirement for axillary lymph node dissection following identification of micro-metastasis or isolated tumour cells at sentinel node biopsy for breast cancer?

    LENUS (Irish Health Repository)

    Joyce, D P

    2012-02-29

    INTRODUCTION: Recent decades have seen a significant shift towards conservative management of the axilla. Increasingly, immunohistochemical analysis of sentinel nodes leads to the detection of small tumour deposits, the significance of which remains uncertain. The aims of this study are to examine patients whose sentinel lymph nodes are positive for macro-metastasis, micro-metastasis or isolated tumour cells (ITCs) and to determine the rate of further nodal disease after axillary lymph node dissection (ALND). METHODS: A retrospective analysis of all patients undergoing a sentinel lymph node biopsy (SLNB) between January 2007 and December 2010 in a tertiary referral breast unit was performed. Patients who underwent an axillary lymph node dissection for macro-metastasis, micro-metastasis or ITCs were identified. Demographics, histological data and the rate of further axillary disease were examined. RESULTS: In total, 664 breast cancer patients attended the symptomatic breast unit during the study period, 360 of whom underwent a SLNB. Seventy patients had a SLNB positive for macro-metastasis. All of these patients underwent ALND. A positive SLNB with either micro-metastasis or ITCs was identified in 58 patients. Only 41 of the 58 patients went on to have an ALND, due primarily to variations in surgeons\\' preferences. Nineteen patients with micro-metastasis underwent an ALND. Four patients had further axillary disease (21%). Twenty-two patients had ITCs identified, of whom only one had further disease (4.5%). No statistically significant difference was found between the two groups in terms of tumour size, grade, lymphovascular invasion or oestrogen receptor status. CONCLUSION: ALND should be considered in patients with micro-metastasis at SLNB. It should rarely be employed in the setting of SLNB positive for ITCs.

  17. Spontaneously Migrated Tip of an Implantable Port Catheter into the Axillary Vein in a Patient with Severe Cough and the Subsequent Intervention to Reposition It

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Kyung Sik; Yoo, Kweon; Cha, In Ho; Seo, Tae Seok [Korea University Guro Hospital, Seoul (Korea, Republic of)

    2008-07-15

    Migration of an implantable port catheter tip is one of the well-known complications of this procedure, but the etiology of this problem is not clear. We describe here a case of migration of the tip of a port catheter from the right atrium to the right axillary vein in a patient with severe cough. Coughing was suggested for this case as the cause of the catheter tip migration. We corrected the position of the catheter tip via transfemoral snaring

  18. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    2014-01-01

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  19. Popliteal artery entrapment syndrome

    DEFF Research Database (Denmark)

    Altintas, Ümit; Helgstrand, Ulf Johan Vilhelm; Hansen, Marc A;

    2013-01-01

    The purpose of this study was to report our experience with popliteal artery entrapment syndrome (PAES) with special emphasis on the applicability of duplex ultrasound scanning (DUS) when diagnosing PAES. In addition to examining the correlation between DUS and intraoperative findings...

  20. Arterial Emboli Complicating Cisplatin Therapy

    OpenAIRE

    Tait, Campbell D.; Rankin, Elaine M

    2012-01-01

    We report three cases of arterial emboli in patients with lung cancer treated with cisplatin chemotherapy. All three patients were managed without surgical intervention but subsequent oncological treatment was complicated by the sequelae of arterial emboli. We discuss the issues surrounding these patients and the importance of identifying patients at risk of arterial embolic phenomena with cisplatin treatment.

  1. [Correlation of size of the primary tumor and axillary node status with the p53 tumor suppressor gene in carcinoma of the breast].

    Science.gov (United States)

    Topić, Brano; Stanković, N; Savjak, D; Grbić, S

    2002-01-01

    Correlation of standard pathomorphological prognostic parameters, primary tumor size and axillary nodal status with new prognostic factor in breast carcinoma: tumor suppressor gene p53 was analyzed. The studied sample included 65 women who underwent surgery for breast carcinoma at the Surgical Clinic of Clinical Center Banja Luka, from January 1st 1997 till January 1st 1999. Statistical data analysis was performed and correlation of prognostic factors was determined. The majority of authors in this field agree that the primary tumor size and axillary nodal status are the two most important prognostic factors. These factors are the best predictors of prognosis and survival of women who had the tumor and were operated on. Tumor markers were immunohistochemically determined in the last ten years and, according to the majority of authors, are still considered the additional or relative prognostic factors in breast carcinoma. Their prognostic value and significance increase almost daily. Most frequently determined tumor markers are bcl-2, pS2, Ki-67 and p53. There was a positive, directly proportional relationship between primary tumor size and tumor suppressor gene p53, but there was no positive correlation between the axillary nodal status and tumor suppressor gene p53. Significance of determination of new tumor markers as the prognostic factors was emphasized. These markers represent a powerful tool in the early detection and prevention of breast carcinoma.

  2. Temporary left ventricular assist device through an axillary access is a promising approach to improve outcomes in refractory cardiogenic shock patients.

    Science.gov (United States)

    Doersch, Karen M; Tong, Carl W; Gongora, Enrique; Konda, Subbareddy; Sareyyupoglu, Basar

    2015-01-01

    Cardiogenic shock (CS) causes significant morbidity and mortality and such patients can deteriorate rapidly. Temporary left ventricular assist devices (LVADs) are a promising approach to manage these patients. The following is a case series in which patients stabilized with a temporary LVAD for CS improvement were analyzed retrospectively. Between June 2011 and January 2014, 15 patients received temporary devices through an axillary approach (mean age: 53 ± 15, 93% male). Mean survival time was 317.8 ± 359.5 days (range: 6-936 days). During support there were no major bleeding events, infectious complications at the axillary access site, upper extremity edema, or emboli. The most of the patients recovered from CS (93%) were mobilized (67%) and were extubated (73%) while on temporary device support. Median times to extubation, intensive care unit discharge, and discontinuation of inotropic medications were: 1.63, 18, and 15 days, respectively. Four patients recovered to no device support and five received a long-term LVAD, all of whom remain alive. Therefore, implantation of a temporary LVAD through an axillary approach is a promising therapy for improving outcomes in patients needing mechanical circulatory support as a bridge to recovery or a definitive LVAD.

  3. Changes In Men’s Salivary Testosterone And Cortisol Levels, And In Sexual Desire After Smelling Female Axillary And Vulvar Scents

    Directory of Open Access Journals (Sweden)

    Ricardo eMondragón-Ceballos

    2013-10-01

    Full Text Available Several studies have shown that a woman’s vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60 and 75 min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant.

  4. Cytological and Pathological Correlation of FNAC in Assessing Breast Lumps and Axillary Lymph Node Swellings in a Public Sector Hospital in India

    Directory of Open Access Journals (Sweden)

    Vasu Reddy Challa

    2013-01-01

    Full Text Available Background. Breast lumps have varied pathology, and there are different techniques to prove the diagnosis. The aim of the present study is to analyze the role of fine needle aspiration cytology (FNAC of the breast lesions at our center. Methods. We had retrospectively analysed 854 patients who underwent FNAC for primary breast lumps and 190 patients who underwent FNAC for an axillary lymph node in the year 2010. Results. Of 854 patients, histological correlation was available in 723 patients. The analysis was done for 812 patients as medical records were not available for 42 patients. FNAC was false negative in seven cases; 2 cases of phyllodes were reported as fibroadenoma, and 5 cases of carcinoma were diagnosed as atypical hyperplasia. The sensitivity, specificity, and false negative value of FNAC in diagnosing breast lumps were 99% (715/723, 100%, and 1%, respectively. Of 190 patients for whom FNAC was performed for axilla, 170 had proven to have axillary lymph node metastases, and the rest had reactive hyperplasia or inflammatory cells. Conclusions. FNAC is rapid, accurate, outpatient based, and less complicated procedure and helps in diagnosis of breast cancer, benign diseases, and axillary involvement in experienced hands with less chance of false results.

  5. MicroRNA393 is involved in nitrogen-promoted rice tillering through regulation of auxin signal transduction in axillary buds

    Science.gov (United States)

    Li, Xiang; Xia, Kuaifei; Liang, Zhen; Chen, Kunling; Gao, Caixia; Zhang, Mingyong

    2016-08-01

    Rice tillering has an important influence on grain yield, and is promoted by nitrogen (N) fertilizer. Several genes controlling rice tillering, which are regulated by poor N supply, have been identified. However, the molecular mechanism associated with the regulation of tillering based on N supply is poorly understood. Here, we report that rice microRNA393 (OsmiR393) is involved in N-mediated tillering by decreasing auxin signal sensitivity in axillary buds. Expression analysis showed that N fertilizer causes up-regulation of OsmiR393, but down-regulation of two target genes (OsAFB2 and OsTB1). In situ expression analysis showed that OsmiR393 is highly expressed in the lateral axillary meristem. OsmiR393 overexpression mimicked N-mediated tillering in wild type Zhonghua 11 (ZH11). Mutation of OsMIR393 in ZH11 repressed N-promoted tillering, which simulated the effects of limited N, and this could not be restored by supplying N fertilizer. Western blot analysis showed that OsIAA6 was accumulated in both OsmiR393-overexpressing lines and N-treated wild type rice, but was reduced in the OsMIR393 mutant. Therefore, we deduced that N-induced OsmiR393 accumulation reduces the expression of OsTIR1 and OsAFB2, which alleviates sensitivity to auxin in the axillary buds and stabilizes OsIAA6, thereby promoting rice tillering.

  6. Biomonitorization of cadmium, chromium, manganese, nickel and lead in whole blood, urine, axillary hair and saliva in an occupationally exposed population.

    Science.gov (United States)

    Gil, Fernando; Hernández, Antonio F; Márquez, Claudia; Femia, Pedro; Olmedo, Pablo; López-Guarnido, Olga; Pla, Antonio

    2011-02-15

    Heavy metal contamination from occupational origin is a cause for concern because of its potential accumulation in the environment and in living organisms leading to long term toxic effects. This study was aimed to assess Cd, Cr, Mn, Ni and Pb levels in whole blood, urine, axillary hair and saliva from 178 individuals with occupational exposure to heavy metals. Levels of metal compounds were determined by atomic absorption spectrometry. We collected information on occupation, lifestyle habits and food intake by questionnaire. Multiple linear regression analyses for metal ion concentration in whole blood, urine, axillary hair and saliva were adjusted for age, gender, smoking and alcohol consumption, lifetime workplace exposure, residence area and food habits. Overall, blood and urine median concentrations found for the five metals analyzed do not exceed biological exposure indexes, so that they are very similar to a non-occupationally exposed population. Toxicokinetic differences may account for the lack of correlations found for metal levels in hair and saliva with those in blood or urine. For those heavy metals showing higher median levels in blood with respect to hair (Cd, Mn and Pb) indicating lesser hair incorporation from blood, the lifetime working experience was inversely correlated with their hair levels. The longer the lifetime working experience in industrial environments, the higher the Mn and Ni concentration in saliva. Axillary hair and saliva may be used as additional and/or alternative samples to blood or urine for biomonitoring hair Mn, and saliva Ni in subjects with occupational exposure.

  7. Cerebral Arterial Fenestrations

    Science.gov (United States)

    Cooke, Daniel L; Stout, Charles E; Kim, Warren T; Kansagra, Akash P; Yu, John Paul; Gu, Amy; Jewell, Nicholas P; Hetts, Steven W; Higashida, Randall T; Dowd, Christopher F; Halbach, Van V

    2014-01-01

    Summary Arterial fenestrations are an anatomic variant with indeterminate significance. Given the controversy surrounding fenestrations we sought their prevalence within our practice along with their association with other cerebrovascular anomalies. We retrospectively reviewed 10,927 patients undergoing digital subtraction angiography between 1992 and 2011. Dictated reports were searched for the terms “fenestration” or “fenestrated” with images reviewed for relevance, yielding 228 unique cases. A Medline database search from February 1964 to January 2013 generated 304 citations, 127 cases of which were selected for analysis. Cerebral arterial fenestrations were identified in 228 patients (2.1%). At least one aneurysm was noted in 60.5% of patients, with an aneurysm arising from the fenestration in 19.6% of patients. Aneurysmal subarachnoid hemorrhage or non-aneurysmal subarachnoid hemorrhage were present in 60.1% and 15.8%, respectively. For the subset of patients with an aneurysm arising directly from a fenestration relative to those patients with an aneurysm not immediately associated with a fenestration, the prevalence of aneurysmal subarachnoid hemorrhage was 66.7% vs. 58.6% (p = 0.58). Fenestrations were more often within the posterior circulation (73.2%) than the anterior circulation (24.6%), though there was no difference in the prevalence of aneurysms within these groups (61.1% vs. 60.7%, p = 1.0). Cerebral arterial fenestrations are an anatomic variant more often manifesting at the anterior communicating arterial complex and basilar artery and with no definite pathological relationship with aneurysms. PMID:24976087

  8. Post-mastectomy radiotherapy for one to three axillary node positive early breast cancer: To radiate or not to radiate?

    Directory of Open Access Journals (Sweden)

    Sayan Paul

    2013-01-01

    Full Text Available Post-mastectomy radiotherapy (PMRT in early breast cancer has long been a matter of debate among oncologists. The American Society of Clinical Oncology (ASCO and the American Society for Therapeutic Radiology and Oncology (ASTRO recommend the use of PMRT for patients, whose primary tumor is larger than 5 cm and/or patients who have four or more involved axillary lymph nodes (ALNs. Recently, few trials have been published showing the positive impact of PMRT on overall survival (OS even in patients having 1-3 positive ALNs with T1-T2 primary disease or early breast cancer (EBC. So, it has become a matter of controversy whether to radiate or not to radiate? We have made an extensive search in the internet in Pubmed and other sites of medical publication mentioning our topic of discussion and reviewed the relevant articles. We nearly got 3,220 articles. After reviewing the available publications in the internet, we blended the elixir with our experience and tried to find an answer of our question. In conclusion, PMRT significantly and substantially improved loco-regional control and overall survival in patients with 1-3 positive nodes as in patients with 4 or more positive nodes, and nearly the same number of patients is needed to treat to avoid a loco-regional recurrence and/or death in both groups. We should reconsider the current guidelines for the indication for PMRT.

  9. Clinicopathologic features of sentinel node metastases predictive of positive axillary clearance in grade 1 invasive breast carcinoma.

    LENUS (Irish Health Repository)

    Hayes, B

    2012-02-01

    BACKGROUND: Sentinel node (SN) biopsy is widely used to stage breast carcinoma and, when positive, typically leads to axillary clearance (AC). AIMS: This study assesses clinicopathologic features of grade 1 breast carcinoma SNs with the aim of identifying a group of patients, who are likely to have a negative AC and can, therefore, safely be spared further surgery. RESULTS: Two hundred and forty-seven patients with grade 1 invasive carcinoma were identified, of whom 29 had a positive SN. Four patients (13.8%) had a positive AC. Positive AC occurred in 3 of 6 (50%) patients whose SN showed extranodal extension (EE), but in only 1 of 23 (4.3%) patients without EE. All patients were staged as pN1(sn) following SN biopsy: only one, who had a 5.27 mm metastasis with EE, was pN2 following AC. CONCLUSIONS: Extranodal extension is a significant predictor of a positive AC in this group. In its absence, AC did not alter the post-SN biopsy pN stage.

  10. Recovery of the endangered Chatham petrel (Pterodroma axillaris: A review of conservation management techniques from 1990 to 2010

    Directory of Open Access Journals (Sweden)

    Helen Gummer

    2015-01-01

    Full Text Available Conservation of gadfly petrels, some of the most threatened seabirds, is frequently dependent on long-term research and management. We review 20 years of a program preventing the extinction of the Chatham petrel (Pterodroma axillaris, a New Zealand endemic once declining due to intense burrow competition from another native seabird. Breeding success in the early 1990s was unsustainably low (10–30%. Recovery measures started in 1992 when Chatham petrel burrows were converted and artificial entrances blockaded to exclude broad-billed prions (Pachyptila vittata. Pair and burrow fidelity were enhanced, though prions still posed a threat during Chatham petrel chick-rearing. Breeding success improved when prions were culled, however a less intensive and contentious solution was to introduce burrow flaps in 2001 which reduced interference from prospecting prions. Subsequently, breeding success increased to a mean 80% per annum. Finding burrows, primarily using radio-telemetry, increased those under management from eight in 1990 to 217 in 2010 when spotlight surveys indicated 72% of juvenile birds had fledged from managed burrows. Chick translocations to two other islands and increasing population size (from 200–400 birds in 1990 to an estimated 1400 birds by 2010 has improved the species IUCN status from Critically Endangered in 1990 to Endangered in 2013.

  11. 广枣的化学成分%Chemical constituents from Choerospondias axillaris(Roxb.)Burtt et Hill

    Institute of Scientific and Technical Information of China (English)

    申旭霁; 格日力; 王金辉

    2009-01-01

    目的:对未经炮制的广枣(Choerospondias axillaris(Roxb.)Burtt et Hill)干燥成熟果实的体积分数为70%乙醇提取物进行化学成分研究.方法:利用多种色谱方法进行成分分离,根据物理化学性质和渡谱学手段对化合物进行结构鉴定.结果:分离得到8个化合物,分别鉴定为3.3'-二甲氧基鞣花酸(3,3'-di-O-methylellagic acid,1)、鞣花酸(ellagic acid,2)、槲皮素(quercetin,3)、丁香醛(syringaldehyde,4)、香草酸(vanillic acid,5)、柠檬酸(citric acid,6)、原儿荼酸(protocatechuic acid,7)、没食子酸(gallic acid,8).结论:化舍物4、5为首次从南酸枣属植物中分离得到.

  12. Quality of life in patients with primary axillary hyperhidrosis before and after treatment with fractionated microneedle radiofrequency

    Directory of Open Access Journals (Sweden)

    Bahareh Abtahi-Naeini

    2015-01-01

    Full Text Available Background: Primary axillary hyperhidrosis (PAH is a common condition with a great impact on the patient′s quality of life (QOL. It is associated with serious social, emotional, and occupational distress. The aim of this study was to investigate the QOL in patients with PAH before and after treatment with fractionated microneedle radiofrequency (FMR. Materials and Methods: We evaluated 25 patients with severe PAH. Each patient had three sessions of FMR treatment using a novel applicator at 3-week intervals. The study was based on Dermatology Life Quality Index (DLQI Questionnaires. Patients were evaluated at baseline and 3 months after the last session. Results: Our patients included 32% males and 68% females. The mean ± standard deviation (SD age of subjects was 30.2 ± 6.27 years. The mean ± SD of the DLQI before and after treatment was 12.96 ± 5.93, and 4.29 ± 2.21, respectively. There was a statistically significant difference between the before and after intervention (P < 0.001. No major, permanent adverse effects were shown. Conclusion: Treatment with FMR can improve the DLQI of patients with PAH.

  13. In vitro micropropagation of Desmodium gangeticum (L.) DC (Fam-Fabaceae): a medicinal legume through axillary bud multiplication.

    Science.gov (United States)

    Puhan, Puspashree; Rath, Shiba Prasad

    2012-05-15

    Medicinal plants possess unlimited and untapped wealth of chemical compounds with high drug potential which make these plants useful as sources of biomedicines. The rising demand for herbal medicines in the organized manufacturing sector has ruthlessly exploited the wild growing plant population those have bulk use. So for high rate multiplication of different medicinal plants, it is necessary to standardize the protocol for high regeneration. The efficiency of any regeneration is primarily depends on factors like type of explants used, composition of the medium and type of genotype. Here, we have developed a regeneration protocol of Desmodium gangeticum (L.) DC (Salparni, Fam- Fabaceae) a medicinal plant through axillary bud multiplication. Nodal explants from Desmodium gangeticum plants were cultured on Murashige and Skoog's basal medium with Kn or BA at different concentrations. 0.5 mg L(-1) BA in the medium, showed shoot multiplication. Regenerated shoots measuring 3 cm or more were excised and planted on semi solid basal medium supplemented with varying concentrations of either IAA or IBA for induction of rooting. IBA treatment at 1.0 mg L(-1) was the best eliciting 100% rooting response. The in vitro propagation protocol standardized can be highly useful in raising quality planting materials of Desmodium gangeticum for commercial plantation programmes and germplasm conservation.

  14. The value of preoperative ultrasound guided fine-needle aspiration cytology of radiologically suspicious axillary lymph nodes in breast cancer

    Directory of Open Access Journals (Sweden)

    Torill Sauer

    2014-01-01

    Full Text Available Background: Preoperative ultrasound (US and eventually US-guided fine-needle aspiration cytology (FNAC of suspicious axillary lymph nodes (ALN is a standard procedure in the work-up of suspicious breast lesions. Preoperative US FNAC may prevent sentinel node biopsy (SNB procedure in 24-30% of patients with early stage breast carcinoma. The aim of this study was to evaluate the institutional results of this preoperative diagnostic procedure. Materials and Methods: A total of 182 cases of preoperative FNAC of suspicious ALN where retrieved from the pathology files. The results were compared with the final histology and staging. False negative (FN FNAC cases were reviewed and possibly missed metastatic cases (2 were immunostained with the epithelial marker AE1/AE3. Results: There were no false positives, whereas 16 cases were FN. In all but one case the FN′s represented sampling error. Half of the 16 FN cases in this series were macrometastases. Discussion: About 83% of the preoperatively aspirated cases were N+, indicating that a radiologically suspicious ALN has a very high risk of being metastatic. Preoperative US guided FNAC from radiologically suspicious ALN is highly efficient in detecting metastases. Depending on national guidelines, a preoperative, positive ALN FNAC might help to stratify the patients as to SNB and/or ALN dissection.

  15. Contouring Guidelines for the Axillary Lymph Nodes for the Delivery of Radiation Therapy in Breast Cancer: Evaluation of the RTOG Breast Cancer Atlas

    Energy Technology Data Exchange (ETDEWEB)

    Gentile, Michelle S. [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois (United States); Usman, Asad A.; Neuschler, Erin I. [Department of Radiology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois (United States); Sathiaseelan, Vythialinga; Hayes, John P. [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois (United States); Small, William, E-mail: WMSMALL@lumc.edu [Department of Radiation Oncology, Loyola University, Chicago, Illinois (United States)

    2015-10-01

    Purpose: The purpose of this study was to identify the axillary lymph nodes on pretreatment diagnostic computed tomography (CT) of the chest to determine their position relative to the anatomic axillary borders as defined by the Radiation Therapy Oncology Group (RTOG) breast cancer atlas for radiation therapy planning. Methods and Materials: Pretreatment diagnostic CT chest scans available for 30 breast cancer patients with clinically involved lymph nodes were fused with simulation CT. Contouring of axillary levels I, II, and III according to the RTOG guidelines was performed. Measurements were made from the area of distal tumor to the anatomic borders in 6 dimensions for each level. Results: Of the 30 patients, 100%, 93%, and 37% had clinical involvement of levels I, II, and III, respectively. The mean number of lymph nodes dissected was 13.6. The mean size of the largest lymph node was 2.4 cm. Extracapsular extension was seen in 23% of patients. In 97% of patients, an aspect of the involved lymph node lay outside of the anatomic border of a level. In 80% and 83% of patients, tumor extension was seen outside the cranial (1.78 ± 1.0 cm; range, 0.28-3.58 cm) and anterior (1.27 ± 0.92 cm; range, 0.24-3.58 cm) borders of level I, respectively. In 80% of patients, tumor extension was seen outside the caudal border of level II (1.36 ± 1.0 cm, range, 0.27-3.86 cm), and 0% to 33% of patients had tumor extension outside the remaining borders of all levels. Conclusions: To cover 95% of lymph nodes at the cranial and anterior borders of level I, an additional clinical target volume margin of 3.78 cm and 3.11 cm, respectively, is necessary. The RTOG guidelines may be insufficient for coverage of axillary disease in patients with clinical nodal involvement who are undergoing neoadjuvant chemotherapy, incomplete axillary dissection, or treatment with intensity modulated radiation therapy. In patients with pretreatment diagnostic CT chest scans, fusion with

  16. Topical niacinamide 4% and desonide 0.05% for treatment of axillary hyperpigmentation: a randomized, double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Castanedo-Cazares JP

    2013-01-01

    Full Text Available Juan Pablo Castanedo-Cazares,1 Gabryela Lárraga-Piñones,1 Adriana Ehnis-Pérez,1 Cornelia Fuentes-Ahumada,1 Cuauhtemoc Oros-Ovalle,2 Bruce R Smoller,3 Bertha Torres-Álvarez11Department of Dermatology, 2Department of Pathology, Hospital Central Dr Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, México; 3Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AK, USABackground: Axillary hyperpigmentation is a frequent cause of cosmetic consultations in dark-skinned women from tropical areas, including Latin America. Currently, there is no widely accepted treatment for the disorder, but it is usually treated with bleaching agents because it is considered a variant of inflammatory hyperpigmentation. The purpose of this study was to assess the efficacy of niacinamide 4% and desonide 0.05% emulsions compared with placebo in the treatment of axillary hyperpigmentation.Methods: Twenty-four women aged 19–27 years with hyperpigmented axillae (phototype III–V were randomly assigned to receive the study treatments in the axillary region. Improvement was assessed at baseline, then clinically and by colorimetry 9 weeks later. Quantitative evaluation including melanin, inflammatory infiltrates, NKI/Beteb, CD1a, CD68, and collagen type IV content was performed by histochemistry and immunohistochemistry, assisted by computerized morphometric analysis.Results: Both niacinamide and desonide induced significant colorimetric improvement compared with placebo; however, desonide showed a better depigmenting effect than niacinamide. A good to excellent response was achieved in 24% of cases for niacinamide, 30% for desonide, and 6% for placebo. We observed a marked disruption of the basal membrane in axillary hyperpigmentation and an inflammatory infiltrate that improved after treatment. Decreased pigmentation in the desonide-treated axillae was associated with recovery of disruption at the basal membrane

  17. Caliber-Persistent Artery

    Directory of Open Access Journals (Sweden)

    Sabrina Araújo Pinho Costa

    2015-01-01

    Full Text Available Caliber-persistent artery (CPLA of the lip is a common vascular anomaly in which a main arterial branch extends to the surface of the mucous tissue with no reduction in its diameter. It usually manifests as pulsatile papule, is easily misdiagnosed, and is observed more frequently among older people, suggesting that its development may involve a degenerative process associated with aging; CPLA is also characterized by the loss of tone of the adjacent supporting connective tissue. Although the diagnosis is clinical, high-resolution Doppler ultrasound is a useful noninvasive tool for evaluating the lesion. This report describes the case of a 58-year-old male patient who complained of a lesion of the lower lip with bleeding and recurrent ulceration. The patient was successfully treated in our hospital after a diagnosis of CPLA and is currently undergoing a clinical outpatient follow-up with no complaints.

  18. Renal Artery Stent Outcomes

    Science.gov (United States)

    Murphy, Timothy P.; Cooper, Christopher J.; Matsumoto, Alan H.; Cutlip, Donald E.; Pencina, Karol M.; Jamerson, Kenneth; Tuttle, Katherine R.; Shapiro, Joseph I.; D’Agostino, Ralph; Massaro, Joseph; Henrich, William; Dworkin, Lance D.

    2016-01-01

    BACKGROUND Multiple randomized clinical trials comparing renal artery stent placement plus medical therapy with medical therapy alone have not shown any benefit of stent placement. However, debate continues whether patients with extreme pressure gradients, stenosis severity, or baseline blood pressure benefit from stent revascularization. OBJECTIVES The study sought to test the hypothesis that pressure gradients, stenosis severity, and/or baseline blood pressure affects outcomes after renal artery stent placement. METHODS Using data from 947 patients with a history of hypertension or chronic kidney disease from the largest randomized trial of renal artery stent placement, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) study, we performed exploratory analyses to determine if subsets of patients experienced better outcomes after stent placement than the overall cohort. We examined baseline stenosis severity, systolic blood pressure, and translesion pressure gradient (peak systolic and mean) and performed interaction tests and Cox proportional hazards analyses for the occurrence of the primary endpoint through all follow-up, to examine the effect of these variables on outcomes by treatment group. RESULTS There were no statistically significant differences in outcomes based on the examined variables nor were there any consistent nonsignificant trends. CONCLUSIONS Based on data from the CORAL randomized trial, there is no evidence of a significant treatment effect of the renal artery stent procedure compared with medical therapy alone based on stenosis severity, level of systolic blood pressure elevation, or according to the magnitude of the transstenotic pressure gradient. (Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions [CORAL]; NCT00081731) PMID:26653621

  19. Case Report: Coronary arterial spasm in single right coronary artery

    Institute of Scientific and Technical Information of China (English)

    En-zhi JIA; Qi-jun SHAN; Zhi-jian YANG; Tie-bing ZHU; Lian-sheng WANG; Ke-jiang CAO; Wen-zhu MA

    2009-01-01

    We presented a case of anomalous single-coronary artery detected incidentally during routine coronary angiography. A 32-year-old male Chinese patient presented with recurrent pre-syncope and six episodes of syncope. Coronary angiography and coronary-computed tomography (CT)-angiography performed by a dual-source computed tomography (DSCT) revealed that the patient had a single large right coronary artery. A moderately large branch originated from the proximal part of the single right coronary artery and extended to the left, passing the anterior to the pulmonary artery, and divided into the anterior descending artery branch and circumflex branch at the base of the left auricular appendage. The episodes of the syncope were suspected to be caused by coronary arterial spasm, so this patient was on a regimen of 30 mg of diltiazem every 6 h and had no recurrence of syncope during follow-up.

  20. 负压抽吸联合腋横皮纹小切口皮下修剪法治疗腋臭临床研究%Clinical research of negative pressure suction plus the excision of the axillary subcutaneous tissue via a small transverse incision for the treatment of axillary hyperhidrosis

    Institute of Scientific and Technical Information of China (English)

    朱麟; 郑万方; 杨华

    2011-01-01

    Objective To observe the clinical efficacy of negative pressure suction plus the excision of the axillary subcutaneous tissue via a small transverse incision for the treatment of axillary hyperhidrosis. Methods 35 patients with axillary hyperhidrosis were treated by negative pressure suction plus the excision of the axillary subcutaneous tissue via a small transverse incision. All patients were followed up for one year. Results Of 35 patients, 33 had good results,2 had fair results, no patient had poor results. The procedure achieved a 100% total effective rate, and 94.29% total curative rate. None of the patients had relapse during one year plus follow-up. Conclusions The combined surgical procedure of negative pressure suction plus the excision of the axillary subcutaneous tissue via a small transverse incision is effective for the treatment of axillary hyperhidrosis with the following features: micro -invasive.faster patient rehabitation.causing no apparent scarring.and fewer complications as well as high curative rate. Thus the procedure is sufficient to be recommended for wide clinical use.%目的:观察采用负压抽吸联合腋横皮纹小切口皮下修剪法治疗腋臭的临床效果与并发症的预防.方法:采用负压抽吸联合腋横皮纹小切口皮下修剪的手术方案治疗腋臭患者35例,并随访1年.结果:治愈33例,有效2例,无效0例,总有效率为100%,治愈率为94.29%,所有病例经随访1年以上无复发.结论:负压抽吸联合腋横皮纹小切口皮下修剪法治疗腋臭创伤较少、恢复较快、无明显瘢痕、治愈率高,并发症较少,值得临床推广应用.

  1. Massive cerebral arterial air embolism following arterial catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Yang, C.W. [Northwestem University Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Yang, B.P. [Northwestern University Feinberg School of Medicine, Department of Neurological Surgery, Chicago, IL (United States)

    2005-12-01

    Microscopic cerebral arterial air embolism (CAAE) has been described in many patients undergoing cardiac surgery as well as other invasive diagnostic and therapeutic procedures. However, massive CAAE is rare. We report a 42-year-old woman who initially presented with thalamic and basal ganglia hemorrhages. Shortly after a radial arterial catheter was inserted, the patient suffered a generalized seizure and CT demonstrated intra-arterial air in bilateral cerebral hemispheres. (orig.)

  2. Arterial stiffness as a risk factor for coronary artery disease.

    Science.gov (United States)

    Liao, Josh; Farmer, John

    2014-02-01

    Hypertension is a major modifiable risk factor, and clinical trials have demonstrated that successful reduction of elevated blood pressure to target levels translates into decreased risk for the development of coronary artery disease, stroke, heart failure, and renal failure. The arterial system had previously been regarded as a passive conduit for the transportation of arterial blood to peripheral tissues. The physiologic role the arterial system was greatly expanded by the recognition of the central role of the endothelial function in a variety of physiologic processes. The role of arterial function and structure in cardiovascular physiology was expanded with the development of a variety of parameters that evaluate arterial stiffness. Markers of arterial stiffness have been correlated with cardiovascular outcomes, and have been classified as an emerging risk factor that provides prognostic information beyond standard stratification strategies involving hypertension, diabetes, obesity, dyslipidemia and smoking. Multiple epidemiologic studies have correlated markers of arterial stiffness such as pulse-wave velocity, augmentation index and pulse pressure with risk for the development of fatal and nonfatal cardiovascular events. Additionally, measurements of arterial stiffness had clarified the results of clinical trials that demonstrated differing impacts on clinical outcomes, despite similar reductions in blood pressure, as measured by brachial and sphygmomanometry.

  3. 腋窝乳房外Paget病1例%A Case of Extramammary Paget' s Disease on the Axillary

    Institute of Scientific and Technical Information of China (English)

    单滢; 王飞

    2013-01-01

    A 83-year-old male, complaining of itch, had been suffered with erythema on the axillary fossa for 6 years, repeatedly misdiagnosed as eczema and received the Symptomatic treatment, but the symptom did not get better. He felt a little pain and much itch on the erythema with the skin disunion 3 years ago. The extent of the erythema got bigger recently and he received resection at last. Histological examnation showed; Epidermis hyperkeratosis,single or a nest of Paget cells in the epidermis and part of eecrine ductal epithelium,multiple lymphocytic infiltration in the superficial layer of dermis; AB staining( + ) ,PAS staining( — ). Immunohis-tochemistry showed: CK7 ,CK8/18 ,CEA and Ki67 ( + ) ,S100 and HMB45 ( - ). Diagnosis: extramammary Paget' s disease.%患者男,83岁.左侧腋窝红斑伴瘙痒6年.多次按湿疹治疗,无效;3年前始皮损伴轻度疼痛,瘙痒明显,反复破溃不能愈合.近日来皮损增大明显,予手术切除.切除物组织病理示:表皮轻度角化过度,表皮全层可见单个或成巢的Paget细胞,真皮浅层较多淋巴细胞浸润;AB染色(+),PAS染色(-);免疫组化示:CK7,CK8/18,CEA和Ki67均(+):S100和HM B45均(-).诊断:乳房外Paget病.

  4. Coverage of Axillary Lymph Nodes with Tangential Breast Irradiation in Korea: A Multi-Institutional Comparison Study

    Directory of Open Access Journals (Sweden)

    Jinhong Jung

    2016-01-01

    Full Text Available Introduction. To evaluate the dose distribution and coverage of axilla using only tangential field for whole breast radiotherapy (RT at three institutions in Korea. Methods. We used computed tomography (CT images of nine consecutive 1-2 sentinel lymph node-positive patients who underwent breast conserving surgery and whole breast RT without axillary lymph node (ALN dissection for clinical T1-2N0 breast cancer. The CT data were transferred to three radiation oncologists in 3 institutions and each radiation oncologist created treatment plans for all nine patients; a total of 27 treatment plans were analyzed. Results. The mean doses delivered to levels I and II were 31.9 Gy (9.9–47.9 Gy and 22.3 Gy (3.4–47.7 Gy. Ninety-five percent of levels I and II received a mean dose of 11.8 Gy (0.4–43.0 Gy and 3.0 Gy (0.3–40.0 Gy. The percent volumes of levels I and II covered by 95% of the prescribed dose were only 29.0% (0.2–74.1% and 11.5% (0.0–70.1%. The dose distribution and coverage of axilla were significantly different between three institutions (p=0.001. Conclusion. There were discrepancies in ALN coverage between three institutions. A standardization of whole breast RT technique through further research with a nationwide scale is needed.

  5. Clinical axillary recurrence after sentinel node biopsy in breast cancer: a follow-up study of 220 patients

    Energy Technology Data Exchange (ETDEWEB)

    Sanjuan, A. [University of Barcelona, Department of Gynecology and Obstetrics, Breast Pathology Unit (Spain); Hospital Clinic Provincial, Barcelona (Spain); Vidal-Sicart, S.; Pons, F. [University of Barcelona, Department of Nuclear Medicine, Hospital Clinic (Spain); Zanon, G.; Pahisa, J.; Vanrell, J.A. [University of Barcelona, Department of Gynecology and Obstetrics, Breast Pathology Unit (Spain); Velasco, M.; Santamaria, G. [University of Barcelona, Department of Radiology, Breast Pathology Unit, Hospital Clinic (Spain); Fernandez, P.L. [University of Barcelona, Department of Pathology, Breast Pathology Unit, Hospital Clinic (Spain); Farrus, B. [University of Barcelona, Department of Radiation Oncology, Breast Pathology Unit, Hospital Clinic (Spain); Munoz, M.; Albanell, J. [University of Barcelona, Department of Medical Oncology, Breast Pathology Unit, Hospital Clinic (Spain)

    2005-08-01

    The aim of this study was to evaluate the frequency of false-negative (FN) sentinel node procedures in patients with breast cancer and the subsequent clinical outcome in such patients. A total of 325 breast cancer patients underwent sentinel lymph node biopsy at our institution between June 1998 and May 2004. A 2-day protocol was used to localise the sentinel node with the injection of{sup 99m}Tc-nanocolloid. There were two phases in the study: the learning phase (105 patients) and the application phase (220 patients). In the learning phase, a complete lymphadenectomy was always performed. In the application phase, sentinel nodes were studied intraoperatively and lymphadenectomy was performed when considered warranted by the pathological intraoperative results. The median follow-up duration in the 220 patients studied during the application phase was 21.2 months (range 4-45 months). In this phase a total of 427 sentinel nodes were obtained (range 1-5 per patient, median 1.99), with 66 positive sentinel nodes in 56 patients (26%). The lymphadenectomies performed were also positive in 25% of cases (14 patients). We observed a total of two false-negative sentinel lymph node results (3.45%). One of them was found during the surgical excision of non-sentinel nodes, and the other presented as an axillary recurrence 17 months postoperatively (1.72% clinical false-negative rate). The latter patient died 1 year after the first recurrence. After a median follow-up of 21.2 months we observed only one clinical recurrence among 220 patients. Our results indicate that adequate local control is achieved by application of the sentinel node protocol. (orig.)

  6. Arterial responses during migraine headache

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Nielsen, T H; Olesen, J

    1990-01-01

    The superficial temporal artery has been thought to be the main focus of pain during migraine attacks, but its diameter has never been measured directly. The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed...... that the lumen was wider on the painful than on the non-painful side during a migraine attack. The diameters of both radial arteries and the temporal artery on the non-painful side were smaller during than between attacks. The generalised vasoconstriction was not shared by the temporal artery on the affected...... side, which suggests a local vasodilatory response. The findings suggest that cephalic arteries may play a role in migraine pathogenesis....

  7. True aneurysm of brachial artery.

    Science.gov (United States)

    Hudorović, Narcis; Lovričević, Ivo; Franjić, Dario Bjorn; Brkić, Petar; Tomas, Davor

    2010-10-01

    True upper extremity peripheral artery aneurysms are a rarely encountered arterial disorder. Following computer-tomography angiographic (CT-a) imaging examination, true saccular aneurysm, originating from the left brachial artery was diagnosed in the 77-year-old female without history of trauma. The aneurysm was resected by surgical intervention, and primary repair of the brachial artery was performed by interposition of a part of great saphenous vein harvested from the left groin and creation of two end-to-end anastomoses between interposition graft and previously resected part of brachial artery. No complication was observed during the follow-up. Surgical intervention for upper extremity aneurysms should be initiated without delay. Factors combined with minimal morbidity associated with repair suggest that surgical repair should be performed routinely for true upper extremity arterial aneurysms.

  8. Age, hypertension and arterial function.

    Science.gov (United States)

    McEniery, Carmel M; Wilkinson, Ian B; Avolio, Albert P

    2007-07-01

    1. Ageing exerts a marked effect on the cardiovascular system and, in particular, the large arteries. Using a variety of techniques to assess arterial stiffness, many cross-sectional studies have demonstrated a significant relationship between age and aortic stiffness, although the age-related changes observed in peripheral arteries appear to be less marked. 2. The relationship between arterial stiffness and hypertension is more complex. The distending, or mean arterial, pressure is an important confounder of measurements of arterial stiffness and, therefore, must be taken into consideration when assessing arterial stiffness in hypertensive subjects or investigating the effect of antihypertensive agents. Current methods for correcting for differences in distending pressure involve pharmacological manipulation, statistical correction or mathematical manipulation of stiffness indices. 3. Many studies have provided evidence that both peripheral (muscular) and central (elastic) arteries are stiffer in subjects with mixed (systolic/diastolic) hypertension compared with normotensive subjects. However, it is unclear to what extent differences in mean arterial pressure explain the observed differences in hypertensive subjects. In contrast, isolated systolic hypertension is associated with increased aortic, but not peripheral artery, stiffness, although the underlying mechanisms are somewhat unclear. 4. Traditional antihypertensive agents appear to reduce arterial stiffness, but mostly via an indirect effect of lowering mean pressure. Therefore, therapies that target the large arteries to reduce stiffness directly are urgently required. Agents such as nitric oxide donors and phosphodiesterase inhibitors may be useful in reducing stiffness via functional mechanisms. In addition, inhibitors or breakers of advanced glycation end-product cross-links between proteins, such as collagen and elastin, hold substantial promise.

  9. The right hepatic artery syndrome

    Institute of Scientific and Technical Information of China (English)

    Kazumi Miyashita; Katsuya Shiraki; Takeshi Ito; Hiroki Taoka; Takeshi Nakano

    2005-01-01

    Various benign and malignant conditions could cause biliary obstruction. Compression of extrahepatic bile duct (EBD) by right hepatic artery was reported as a right hepatic artery syndrome but all cases were compressed EBD from stomach side. Our case compressed from dorsum was not yet reported, so it was thought to be a very rare case. We present here the first case of bile duct obstruction due to the compression of EBD from dorsum by right hepatic artery.

  10. Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT in combination with ultrasonography for axillary staging in primary breast cancer

    Directory of Open Access Journals (Sweden)

    Tamura Katsumi

    2008-06-01

    Full Text Available Abstract Background Accurate evaluation of axillary lymph node (ALN involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT and axillary ultrasonography (AUS for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB and preoperative systemic chemotherapy (PSC. Methods One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND. Using 18F-FDG PET/CT, we studied both a visual assessment of 18F-FDG uptake and standardized uptake value (SUV for axillary staging. Results In a visual assessment of 18F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12 in 18F-FDG PET uptake only, 80% (4 of 5 in AUS positive only, and 100% (28 of 28 in dual positive. By the combination of AUS and 18F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03. Conclusion The diagnostic accuracy of 18F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their

  11. Countercurrent aortography via radial artery

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Hyung Kuk; Lee, Young Chun; Lee, Seung Chul; Jeon, Seok Chol; Joo, Kyung Bin; Lee, Seung Ro; Kim, Soon Yong [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1987-06-15

    Countercurrent aortography via radial artery was performed for detection of aortic arch anomalies in 4 infants with congenital heart disease. Author's cases of aortic arch anomalies were 3 cases of PDA, 1 case of coarctation of aorta, and 1 case of occlusion of anastomosis site on subclavian artery B-T shunt. And aberrant origin of the right SCA, interrupted aortic arch, hypoplastic aorta, anomalous origin of the right pulmonary artery from the ascending aorta can be demonstrated by this method. Countercurrent aortography affords an safe and simple method for detection of aortic arch anomalies without retrograde arterial catheterization, especially in small infants or premature babies.

  12. Arterial Abnormalities Leading to Tinnitus.

    Science.gov (United States)

    Miller, Timothy R; Serulle, Yafell; Gandhi, Dheeraj

    2016-05-01

    Tinnitus is a common symptom that usually originates in the middle ear. Vascular causes of pulsatile tinnitus are categorized by the location of the source of the noise within the cerebral-cervical vasculature: arterial, arteriovenous, and venous. Arterial stenosis secondary to atherosclerotic disease or dissection, arterial anatomic variants at the skull base, and vascular skull base tumors are some of the more common causes of arterial and arteriovenous pulsatile tinnitus. Noninvasive imaging is indicated to evaluate for possible causes of pulsatile tinnitus, and should be followed by catheter angiography if there is a strong clinical suspicion for a dural arteriovenous fistula.

  13. Pulmonary arterial hypertension in pregnancy.

    Science.gov (United States)

    Običan, Sarah G; Cleary, Kirsten L

    2014-08-01

    Pulmonary hypertension is a medical condition characterized by elevated pulmonary arterial pressure and secondary right heart failure. Pulmonary arterial hypertension is a subset of pulmonary hypertension, which is characterized by an underlying disorder of the pulmonary arterial vasculature. Pulmonary hypertension can also occur secondarily to structural cardiac disease, autoimmune disorders, and toxic exposures. Although pregnancies affected by pulmonary hypertension and pulmonary arterial hypertension are rare, the pathophysiology exacerbated by pregnancy confers both high maternal and fetal mortality and morbidity. In light of new treatment modalities and the use of a multidisciplinary approach to care, maternal outcomes may be improving.

  14. Linfadenectomia Axilar Conservadora no Câncer de Mama Estádio Clínico I Conservative Axillary Dissection in Stage I Breast Cancer

    Directory of Open Access Journals (Sweden)

    Luiz Antonio Guimarães Brondi

    2000-01-01

    Full Text Available Objetivo: determinar a eficácia da linfadenectomia axilar conservadora (esvaziamento dos níveis I e II no tratamento cirúrgico do câncer da mama estádio I. Métodos: foram avaliados os resultados de 142 cirurgias realizadas em pacientes portadoras de câncer mamário estádio I (T1NO entre janeiro/93 e dezembro/98. Removidos os linfonodos axilares presentes nos níveis I e II com preservação dos músculos peitorais, os mesmos foram dissecados pelo próprio autor (LAGB, sendo posteriormente examinados histopatologicamente com a realização de apenas 1 corte por linfonodo. A quadrantectomia foi realizada em 138 casos e a mastectomia modificada segundo Patey em 4 casos. Houve predomínio dos casos T1c (130 casos. Resultados: foram removidos 3.282 linfonodos (2.456 presentes no nível I e 826 no nível II com um número médio de 23,1 linfonodos por axila. Desse total, apenas 68 estavam comprometidos (2,1%. Skip metastasis estava presente em apenas um caso (0,7%. Foram observados 35 casos de falso-negativos clínicos (24,6%, estando o nível I comprometido em 34 casos (97,1% e o nível II em apenas 2 casos (5,7%. A axila estava negativa nos 107 casos restantes (75,4%. Conclusão: a dissecção axilar dos níveis I e II é suficiente para tratar a axila no estádio I do câncer de mama. Se linfonodos suspeitos são identificados durante a cirurgia, os gânglios do nível III e o grupo interpeitoral de Rotter deverão ser retirados.Purpose: to evaluate the efficacy of conservative axillary dissection (levels I and II in the surgical treatment of stage I breast cancer. Methods: the results of 142 mastectomies performed from January/93 to December/98 in patients with clinical stage I breast cancer (T1NO were evaluated. Removing the axillary lymph nodes present at levels I and II, with the preservation of the pectoralis muscles, the axillary lymph nodes were dissected by the author (LAGB, and subsequently one section of each lymph node was

  15. [Measurement of arterial pressure].

    Science.gov (United States)

    Rorive, G

    1998-03-01

    The casual determination of blood pressure remains the basis of the diagnosis of arterial hypertension and the criteria for usefulness of drug therapy. The reference values usually in use concern determinations by the doctor in very well defined conditions, rest, size of the bladder, etc.... The poor reproductibility of the determinations made by the doctor in casual conditions has produced a large interest for new approaches: autodetermination by the patient at home, and ambulatory blood pressure determinations using automatic devices. These new approaches have their own reference values, specific indications and limitations.

  16. A single dose of preoperative gabapentin for pain reduction and requirement of morphine after total mastectomy and axillary dissection: Randomized placebo-controlled double-blind trial

    Directory of Open Access Journals (Sweden)

    Grover V

    2009-01-01

    Full Text Available Background : Gabapentin has been recently found to be useful for reducing acute postoperative pain when administered preoperatively. Although various dose regimens have been tried in different surgical settings, the minimum effective dose is not established. Aims : We aimed to evaluate the analgesic efficacy of single low dose gabapentin in patients undergoing total mastectomy and axillary dissection. Settings and Design : Prospective randomized placebo-controlled double-blind trial in a tertiary care teaching hospital. Materials and Methods : Fifty women scheduled for total mastectomy and axillary dissection were randomized to receive either gabapentin 600 mg or placebo orally 1 h preoperatively. The intraoperative and postoperative management was standardized. Postoperative pain was assessed at rest and on movement for 12 h using the numerical rating scale (NRS. Morphine was administered if NRS exceeded 30. Primary outcome measure was total morphine consumption. Statistical Analysis : The morphine consumption was compared using independent t test while pain and sedation scores were analyzed using Mann-Whitney U test. Results : Forty-six patients completed the trial. The postoperative morphine consumption was significantly less (5.8 ± 4.2 vs. 11.0 ± 3.4 mg; P 〈 0.001 and the median [IQR] time to first analgesic was significantly longer (90 [37.5-120] vs. 0 [0-90] min; P 〈 0.001 in the gabapentin group than in the placebo group. The incidence of side effects was similar in the two groups. Conclusions : A single low dose of 600 mg gabapentin administered 1 h prior to surgery produced effective and significant postoperative analgesia after total mastectomy and axillary dissection without significant side effects.

  17. Using Tc-99m MIBI scintimammography to differentiate nodular lesions in breast and detect axillary lymph node metastases from breast cancer

    Institute of Scientific and Technical Information of China (English)

    王景; 吴华; 周健; 胡健

    2003-01-01

    Objective To test the clinical value of using Tc-99m MIBI scintimammography (Tc-99m MIBI SMM) to differentiate nodular lesions in breasts and detect axillary lymph node metastases of breast cancer. Methods The subjects consisted of sixty female patients exhibiting unilateral palpable breast mass. The early and delay static acquisitions were undertaken in all subjects at 10 and 90 min after injection with Tc-99m MIBI. The acquisition included three positions: anterior supine, left lateral prone and right lateral prone. A special device for SMM which was developed by our laboratory was used. The ratio of [(T-B)/(NT-B)] was calculated as radioactivity of mass to that of opposite corresponding tissue, and [(T-B)/(NT-B)]≥1.21 was used as the cut-off for semi-quantitative discrimination of malignancy from benignity in semi-quantitative analysis. The final diagnosis was obtained from histology examination in all subjects. Results Using Tc-99m MIBI SMM to differentiate between nodular lesions in breasts, the diagnostic sensitivity and specificity were 92.9% and 90.6% respectively, the positive predictive value 89.7%, the negative predictive value 93.5%, and the accuracy 91.7%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained with Tc-99m MIBI SMM for detecting axillary lymph node metastases were 83.3%, 86.1%, 80%, 88.6% and 85% respectively. Conclusions It is suggested that Tc-99m MIBI SMM may be not only valuable in differentiating malignant lesions from benign nodular masses of breast, but also helpful in detecting axillary lymph node metastases of breast cancer.

  18. Feasibility of FDG PET/CT to monitor the response of axillary lymph node metastases to neoadjuvant chemotherapy in breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Straver, Marieke E.; Rutgers, Emiel J.T.; Peeters, Marie-Jeanne T.F.D.V. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Aukema, Tjeerd S.; Olmos, Renato A.V.; Vogel, Wouter V. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Gilhuijs, Kenneth G.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); Schot, Margaret E. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Medical Oncology, Amsterdam (Netherlands)

    2010-06-15

    The aim of this study was to assess the accuracy of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to visualize lymph node metastases before the start of neoadjuvant chemotherapy and to determine how often the visualization is sufficiently prominent to allow monitoring of the axillary response. Thirty-eight patients with invasive breast cancer of >3 cm and/or lymph node metastasis underwent FDG PET/CT before neoadjuvant chemotherapy. The results of the FDG PET/CT were compared with those from ultrasonography with fine-needle aspiration (FNA) cytology or sentinel node biopsy. Patients suitable for response monitoring of the axilla were defined as having either a maximum standardized uptake value (SUV{sub max}){>=}2.5 or a tumour to background ratio {>=}5 in the most intense lymph node. The sensitivity and specificity of FDG PET/CT in detecting axillary involvement were 97 and 100%, respectively. No difference existed between the SUV{sub max} of the primary tumour and that from the related most intense lymph node metastasis. Moreover, the mean tumour to background ratio was 90% higher in the lymph nodes compared to the primary tumour (p=0.006). Ninety-three per cent of the patients had sufficient uptake in the lymph nodes to qualify for subsequent response monitoring of the axilla. A considerable distinction in metabolic activity was observed between the different subtypes of breast cancer. The mean SUV{sub max} in lymph node metastases of oestrogen receptor (ER)-positive, triple-negative and human epidermal growth factor receptor 2 (HER2)-positive tumours was 6.6, 11.6 and 6.6, respectively. The high accuracy in visualizing lymph node metastases and the sufficiently high SUV{sub max} and tumour to background ratio at baseline suggest that it is feasible to monitor the axillary response with FDG PET/CT, especially in triple-negative tumours. (orig.)

  19. Reference values for local arterial stiffness. Part B : femoral artery

    NARCIS (Netherlands)

    Bossuyt, Jelle; Engelen, Lian; Ferreira, Isabel; Stehouwer, Coen D; Boutouyrie, Pierre; Laurent, Stéphane; Segers, Patrick; Reesink, Koen; Van Bortel, Luc M

    2015-01-01

    OBJECTIVE: Carotid-femoral pulse wave velocity (PWV) is considered the gold standard measure of arterial stiffness, representing mainly aortic stiffness. As compared with the elastic carotid and aorta, the more muscular femoral artery may be differently associated with cardiovascular risk factors (C

  20. Dual anterior descending coronary artery associated with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Siqueira Luciane da L. V.

    2003-01-01

    Full Text Available The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation.

  1. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)

    2014-10-18

    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  2. A ¤Terminal Flower-1¤-like gene from perennial ryegrass involved in floral transition and axillary meristem identity

    DEFF Research Database (Denmark)

    Jensen, C.S.; Salchert, K.; Nielsen, K.K.

    2001-01-01

    . To investigate the regulation of meristem identity and the control of floral transition in perennial ryegrass (Lolium perenne) we isolated a ryegrass TERMINAL FLOWER1-like gene, LpTFL1, and characterized it for its function in ryegrass flower development. Perennial ryegrass requires a cold treatment of at least...... spikelets. Arabidopsis plants overexpressing LpTFL1 were significantly delayed in flowering and exhibited dramatic changes in architecture such as extensive lateral branching, increased growth of all vegetative organs, and a highly increased trichome production. Furthermore, overexpression of LpTFL1...... and a controller of axillary meristem identity in ryegrass....

  3. Brief reports: a clinical evaluation of block characteristics using one milliliter 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian

    2010-09-01

    We report onset and duration of ultrasound-guided axillary brachial plexus block using 1 mL of 2% lidocaine with 1:200,000 epinephrine per nerve (total local anesthetic volume 4 mL). Block performance time, block onset time, duration of surgery, and block duration were measured. Seventeen consecutive patients were recruited. The mean (SD) block performance and onset times were 271 (67.9) seconds and 9.7 (3.7) minutes, respectively. Block duration was 160.8 (30.7) minutes. All operations were performed using regional anesthesia alone. The duration of anesthesia obtained is sufficient for most ambulatory hand surgery.

  4. Effects of local anti-inflammatory drugs on seroma formation after mastectomy and axillary lymph node dissection in the rat model

    Directory of Open Access Journals (Sweden)

    Kadir Serkan Turel

    2014-09-01

    Results: The seroma amount showed significant increase (p<0.05 in group 1 when compared to group 2 and 3. However no significant differences were observed between group 2 and group 3. The postoperative infection rate was 40 percent in group 2. Conclusions: It was concluded that methylprednisolone sodium succinate and meloxicam were effective on the seroma formed after radical mastectomy and axillary dissection. However, due to the high risk of wound infection of methylprednisolone sodium succinate, this should not been preferred. [Natl J Med Res 2014; 4(3.000: 228-231

  5. Genetics Home Reference: pulmonary arterial hypertension

    Science.gov (United States)

    ... Home Health Conditions pulmonary arterial hypertension pulmonary arterial hypertension Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Pulmonary arterial hypertension is a progressive disorder characterized by abnormally high ...

  6. Isolated superior mesenteric artery dissection

    Directory of Open Access Journals (Sweden)

    Lalitha Palle

    2010-01-01

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

  7. Epigenetics and Peripheral Artery Disease.

    Science.gov (United States)

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

    2016-04-01

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

  8. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance a

  9. Conservation of an important montane bamboo Thamnocalamus falconeri, Hook.f. ex Munro through axillary bud proliferation

    Institute of Scientific and Technical Information of China (English)

    Meena Bakshi; Chandrakant Tiwari; Sajad Razvi

    2015-01-01

    Thamnocalamus falconeri, Hook.f. ex Munro., an important bamboo species belonging to the family Po-aceae, locally known as Ringal, occurs in the hills of Ut-tarakhand, India. This species has been traditionally exploited by local communities to support their livelihoods. Increasing needs of the hill villages impose unsustainable pressure on natural stands of Ringal in the Uttarakhand hills and forests have been degraded. The long history of excessive cutting of Ringal from natural forests and the lack of replanting threaten villager livelihoods. Replanting is required to conserve the species. We propose a protocol for generation of planting material through axillary bud proliferation for multiplication and conservation of this species. We collected offsets/rhizomes from a natural stand of T. falconeri in the Chopta Mandal areas (Chamoli dis-trict, India). These were planted at sites of varied elevation and fresh single nodal segments were collected from them as explants. Different sterilization treatments were assessed to combat contamination. Among these, treatment of 0.1%HgCl2 followed by 5% NaOCl, proved best. Among two cytokinin treatments, viz. BAP and Kinetin, singly or in combination, BAP alone (5 mg L-1) proved superior and resulted in 100% bud break. BAP-supplemented MS media yielded maximum vigorous shoot formation (90%) and maximum number of shoots (8.9). Subculturing of shoots on the same medium with similar BAP treatment (5 mg L-1 BAP) enabled continuous production of healthy shoots at similar frequency. Maximum rooting (100%) was recorded on half-strength MS medium supplemented with 5 mg L-1 IBA. Micropropagated plants were hard-ened and acclimatized in soil mixture (2:1:1) and then transplanted to field sites (Magra, Uttarakhand, 1,834 m). Eight to ten months after field transplantation we recorded 100% survival of transplanted material. This microprop-agation protocol could be used successfully for raising a stock of genetically homogenous plant

  10. Arterial Stiffness: Recommendations and Standardization

    Science.gov (United States)

    Townsend, Raymond R.

    2017-01-01

    The use of arterial stiffness measurements in longitudinal cohorts of normal populations, hypertensive patients, diabetic patients, healthy elderly, and patients on hemodialysis have confirmed the value of this important measure of arterial health, and established its complementary role to measures of blood pressure. Its contribution to understanding cardiovascular and mortality risk beyond blood pressure measurements has moved measures of arterial stiffness into the ranks of factors such as elevated cholesterol, diabetes, and left ventricular hypertrophy in considering cardiovascular risk. The recent international collaboration's publication of reference ranges for normal people and those with hypertension, along with the American Heart Association's recent scientific statement on standardizing arterial stiffness measurements are important aspects to consider in future studies employing these valuable methods, particularly as interventions that not only lower blood pressure but improve arterial function are tested in the clinical arena. PMID:28275588

  11. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most......Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release...

  12. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...... likely includes the combination of vasodilatation and vasoconstriction in parallel. Arterial compliance; Central vascular filling; Chyperdynamic circulation; Kidney function, Nitric oxide; Blood pressure regulation; Renin–angiotensin–aldosterone system; Sympathetic nervous system; Vasodilatation...

  13. Obesity and arterial compliance alterations.

    Science.gov (United States)

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

    2010-03-01

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

  14. Fatal dissection of the pulmonary artery in pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    B. Degano

    2009-09-01

    Full Text Available A 41-yr-old patient with chronic stable idiopathic pulmonary arterial hypertension (PAH presented with sudden chest pain and unusual dyspnoea during physical exertion. The patient had been diagnosed with PAH at the age of 12 yrs and was in New York Heart Association functional class I/II. The patient was being treated with an anticoagulant regimen, low-dose diuretics and continuous intravenous epoprostenol therapy. A computed tomography scan showed ancient massive thrombi in dilated central pulmonary arteries, which were not haemodynamically significant (perfusion lung scans did not demonstrate segmental or larger defects, and extensive dissection of the right pulmonary artery starting from the intermediate branch. Due to the extensiveness of the dissection, the patient was immediately considered for heart–lung transplantation, but died 72 h after the onset of symptoms. Permission for post mortem examination was denied. Pulmonary artery dissection should be suspected in PAH patients presenting with chest pain and worsening dyspnoea. In the current case, the factors possibly associated with increased risk for dissection may include dilatation of the pulmonary artery, local inflammation favoured by in situ thrombosis, and acute increase of pulmonary pressure secondary to physical exertion. Extensive pulmonary artery dissection is a life-threatening complication of PAH, and urgent heart/lung transplantation might be the treatment of choice in eligible patients. In addition, better identification of the risk factors for pulmonary artery dissection may help in considering transplantation for selected patients at risk.

  15. [The lymphotropic marking and biopsy of sentinel lymph nodes in T1 tumors--a new approach to the staging of axillary lymphatic metastasis in breast cancer].

    Science.gov (United States)

    Deliĭski, T; Baĭchev, G; Popovska, S; Penkova, R

    1997-01-01

    It is the purpose of the study to assay the possibility of demonstrating axillary lymph status through marking and biopsy of sentinel lymph nodes. Preoperative lymphotropic marking of sentinel lymph nodes is performed in 48 female patients presenting mammary gland carcinoma, measuring up to two centimeters. Drimaren 0.5 ml (in 18 cases), Mitoxantrone (17 cases) or Patent Blue (13 cases) each are perineoplastically injected in two points. Intraoperatively, in 34 patients blue stained lymph nodes (from Patent Blue and Mitoxantrone mainly) are identified, and compared with the results of axillary dissection. Metastases in sentinel nodes are documented in seven instances. In the remainder (30) which are histologically negative, lymph node metastasis II level is discovered in one case (false negative = 3.3 per cent). As shown by the initial observations perioperative marking of lymph nodes with Patent Blue and Mitoxantrone contribute to demonstrate sentinel nodes, and by biopsy study of the latter it is possible to judge about the pattern of lymph metastasizing of mammary gland carcinoma.

  16. Clinical and Histological Prognostic Factors in Axillary Node-Negative BreastCancer: Univariate and Multivariate Analysis with Relation to 5-Year Recurrence.

    Science.gov (United States)

    Khanna; Tokuda; Shibuya; Tanaka; Sekine; Tajima; Osamura; Mitomi

    1995-04-30

    In the recent years several studies have shown that about 30% of cases with axillary node-nagative breast cancer suffer relapse of the disease. Our attempt was made to evaluate the most significant prognostic factors to predict this high risk group which may be benefited from adjuvant treatment. For this purpose, we selected 9 patients out of 80 cases of node-negative breast cancer who had been followed up at least for 5 years and had the recurrence of the disease. For comparison, 16 patients from the same group who did not have relapse were selected on a random basis. Histology, receptor status, AgNOR, DNA flow cytometry and various immunohistochemical parameters were compared between the groups with recurrence and that without recurrence. On univariate analysis, tumor size, immunohistochemical expressions of PCNA, MIB-1, c-erbB-2 and S-phase fraction were significantly different between the above two groups. By multivariate analysis, immunohistochemical c-erbB-2 expression (more than 50% of cancer cells) was an independent parameter. As a summary from our studies, c-erbB-2 immunohistochemical staining on paraffin sections might be the best independent prognostic factor in axillary node-negative breast cancers.

  17. [Grafting of carotid arteries].

    Science.gov (United States)

    Belov, Iu V; Stepanenko, A B; Gens, A P; Bazylev, V V; Seleznev, M N; Savichev, D D

    2005-01-01

    Over 5-years, 167 reconstructive surgeries for stenosis of internal carotid arteries (ICA) were performed in 124 patients. Mean age of the patients was 63.5 years. One hundred and twenty-nine carotid endarterectomies (CEAE) in 86 patients and 38 reconstructive operations of ICA in 38 patients were performed. There were no lethal outcomes in short- and long-term postoperative period. In short-term period after prosthesis of ICA restenosis was revealed in 3% patients, after eversion CEAE in 3% patients the embolism was seen, after standard CEAE restenosis were diagnosed in 8% patients and thrombosis -- in 3%. In long-term period after grafting of ICA the strokes were seen in 3%, stenosis -- in 6% patients, after eversion endarterectomy -- in 0 and 3% patients, and after standard CEAE -- in 3 and 24% patients, respectively. It is concluded that grafting of ICA is adequate surgical method of reconstruction and stroke prevention in specific variants of carotid atherosclerosis.

  18. Spontaneous Coronary Artery Dissection.

    Science.gov (United States)

    Tweet, Marysia S; Gulati, Rajiv; Hayes, Sharonne N

    2016-07-01

    Spontaneous coronary artery dissection is an important etiology of nonatherosclerotic acute coronary syndrome, myocardial infarction, and sudden death. Innovations in the catheterization laboratory including optical coherence tomography and intravascular ultrasound have enhanced the ability to visualize intimal disruption and intramural hematoma associated with SCAD. Formerly considered "rare," these technological advances and heightened awareness suggest that SCAD is more prevalent than prior estimates. SCAD is associated with female sex, young age, extreme emotional stress, or extreme exertion, pregnancy, and fibromuscular dysplasia. The clinical characteristics and management strategies of SCAD patients are different than for atherosclerotic heart disease and deserve specific consideration. This review will highlight recent discoveries about SCAD as well as describe current efforts to elucidate remaining gaps in knowledge.

  19. Middle meningeal artery arising from the basilar artery.

    Science.gov (United States)

    Salem, Mohamed M; Fusco, Matthew R; Dolati, Parviz; Reddy, Arra S; Gross, Bradley A; Ogilvy, Christopher S; Thomas, Ajith J

    2014-12-01

    Various anomalies for the origin of the middle meningeal artery (MMA) have been described in the literature. However, origin of the MMA from the basilar trunk is an extremely rare variant. We report on a 54-year-old female who presented with frequent headaches; magnetic resonance imaging showed a right parietal meningioma. The abnormal origin of the middle meningeal artery from the basilar artery was diagnosed by angiography performed for preoperative embolization of the tumor. We report on the case with a review of the embryologic basis, possible explanations for this aberrant origin, and its clinical implications.

  20. Total Arterial Revascularization with Internal Mammary Artery or Radial Artery Graft Configuration

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    To investigate the clinical use of π graft in total arterial revascularization and its outcomes, a retrospective analysis of 23 patients out of 1000 patients undergoing total arterial coronary bypass surgery with a π graft between September 1994 and December 2004 was performed. In the selected patients for the management of triple vessel disease with middle diagonal/intermediate ramus disease such that a skip with the left internal mammary artery (LIMA) or radial artery (RA),the main stem of π graft, to the left anterior descending coronary artery (LAD) will not work and the right internal mammary artery (RIMA) or right gastroepiploic artery (RGEA) cannot pick up the diagonal/intermediate ramus, hence the LAD and diagonal/intermediate ramus were grafted with a mini Y graft using the distal segment of LIMA, RIMA, RA or RGEA, together with the bilateral internal mammary artery (BIMA) or LIMA-RA T graft to compose π graft. Twenty-three patients (18 males, 5 females) underwent the π graft procedure. There were no deaths or episodes of myocardial infarction, stroke, and deep sternal wound infection. One patient required reopening for controlling bleeding. Until the end of 2004, during a mean follow-up of 81.0 ±28.4 months, no angina needing re-intervention or operative therapy or coronary related death occurred. In conclusion, in patients with specific coronary artery anatomy/stenosis, the BIMA (sometimes LIMA with RA or RGEA) π graft can be successfully performed for total arterial revascularization with good midterm outcomes.

  1. Cerebellar arteries originating from the internal carotid artery: angiographic evaluation and embryologic explanations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Han, Moon Hee; Yu, In Gyu; Chang, Ki Hyun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Eui Jong [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Dae Ho [Soonchunhyang Univ. College of Medicine, Asan(Korea, Republic of)

    1997-06-01

    To find and describe the cerebellar arteries arising from the internal carotid artery, explain them embryologically, and evaluate their clinical implication. To determine the point in the internal carotid artery from which the cereballar artery arose anomalously, consecutive angiographic studies performed in the last three years were reviewed. The distribution of such anomalous cerebellar arteries, the point in the internal carotid artery from which the anomalous vessels originated, and associated findings were analyzed. Five anomalous origins of cerebellar arteries arising arising directly from the internal carotid artery were found in five patients. Three anterior inferior cerebellar arteries (AICA) and one common trunk of an AICA and a posterior inferior cerebellar artery (PICA) were found to originate from the internal carotid artery at a point close to the origin of the primitive trigeminal artery. A PICA arose from an artery presenting a course similar to the proatlantal intersegmental artery. Intracranial aneurysms in two patients, Moyamoya disease in one, and facial arteriovenous malformation in one. In our series, AICAs supplied from the arteries considered to be persistent trigeminal artery variants were the most common type. A correlation between type of anomalous cerebellar artery and type of carotid-vertebrobasilar anastomosis may exist. Cerebellar arteries originating anomalously from the internal carotid artery seem to occur as a result of the persistence of carotid-vertebrobasilar anastomoses associated with incomplete fusion of the longitudinal neural arteries. An understanding of these anomalous cerebellar arteries may help prevent accidents during therapeutic embolization and surgical treatment, as well as misinterpretation.

  2. Embolisation of the splenic artery

    Energy Technology Data Exchange (ETDEWEB)

    Essler, G.; Duex, A.

    1982-09-01

    In bleeding of oesophageal varices with resistance to common treatment embolisation of the splenic artery causes depression of the portal hypertension by forty per cent. Thrombosis of the splenic or portal vein as in splenectomies are not to be expected. The splenic vein remains open for later spleno-renal anastomosis. By occlusion of the splenic artery we were successful in stopping oesophageal bleeding. In a patient with dominant hypersplenism in portal hypertension the severity of the syndrome decreased after embolisation of the splenic artery. Thrombocytes, leukocytes and gammaglobulin increased.

  3. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  4. Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis

    Directory of Open Access Journals (Sweden)

    Nodari Franco

    2011-08-01

    Full Text Available Abstract Background The ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, but in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility. Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine. From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral, with minimal residual flow to the right and no signal on the humeral and radial left artery. Results Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery. Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with

  5. Idiopathic arterial calcification in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Maya [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa); Red Cross Children' s Hospital, School of Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town (South Africa); Andronikou, Savvas; Solomon, Rustum; Sinclair, Paul; McCulloch, Mignon [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa)

    2004-08-01

    Idiopathic arterial calcification in infancy is usually fatal with death in early life and diagnosis at post mortem. This report describes a unique, late presentation with hypertension and cardiac failure in a child aged 33 months, found to have widespread arterial calcification at radiological imaging. The calcium-phosphate axis was normal and there was no other demonstrable cause for calcification. Additionally, the histological features of arterial calcification at renal biopsy paralleled the findings in infants with this disorder. The late presentation in this case is unusual and has not been previously reported. Ultrasound and CT are sensitive for calcification, and the disease should be suspected in children presenting with cardiac or respiratory manifestations and features of arterial calcification, where no metabolic cause is established. (orig.)

  6. Peripheral Artery Disease and Diabetes

    Science.gov (United States)

    ... Venous Thromboembolism Aortic Aneurysm More Peripheral Artery Disease & Diabetes Updated:Jan 26,2016 People with diabetes are ... life. This content was last reviewed January 2016. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  7. Robotics and coronary artery surgery.

    Science.gov (United States)

    Magee, Mitchell J; Mack, Michael J

    2002-11-01

    Significant progress in cardiac surgery, and specifically the surgical management of coronary artery disease, has been due in large part to enabling technology. Robotic systems have been recently developed and refined for use in cardiac surgery to facilitate, among other procedures, a totally endoscopic approach to coronary artery bypass surgery. These systems enhance precision through endoscopic approaches by specifically addressing the inherent limitations of conventional endoscopic coronary microsurgical instrumentation via computerized, digital interface, telemanipulation technology. With a combined experience of 125 patients, several groups have independently demonstrated the clinical feasibility of totally endoscopic coronary artery bypass with two commercially available robotic telemanipulation systems. Additional enabling technology is needed to overcome the challenges currently limiting development and widespread application of totally endoscopic off-pump multivessel coronary artery bypass surgery.

  8. Update in pulmonary arterial hypertension.

    Science.gov (United States)

    Mejía Chew, C R; Alcolea Batres, S; Ríos Blanco, J J

    2016-11-01

    Pulmonary arterial hypertension is a rare and progressive disease that mainly affects the pulmonary arterioles (precapillary), regardless of the triggering aetiology. The prevalence of pulmonary hypertension and pulmonary arterial hypertension in Spain is estimated at 19.2 and 16 cases per million inhabitants, respectively. The diagnosis of pulmonary arterial hypertension is based on haemodynamic criteria (mean pulmonary artery pressure ≥25mmHg, pulmonary capillary wedge pressure ≤15mmHg and pulmonary vascular resistance >3 Wood units) and therefore requires the implementation of right cardiac catheterisation. Sequential therapy with a single drug has been used in clinical practice. However, recent European guidelines recommend combined initial therapy in some situations. This review conducts a critical update of our knowledge of this disease according to the latest guidelines and recommendations.

  9. Heart transplantation and arterial elasticity

    Directory of Open Access Journals (Sweden)

    Colvin-Adams M

    2013-12-01

    Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a

  10. Liver cirrhosis and arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    Jens H Henriksen; Soren Moller

    2006-01-01

    Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system,sympathetic nervous system, release of vasopressin),and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin, calcitonin generelated peptide, nitric oxide, and other vasodilators,and is most pronounced in the splanchnic area.This constitutes an effective (although relative)counterbalance to increased arterial blood pressure.This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most likely includes the combination of vasodilatation and vasoconstriction in parallel.

  11. 腋-腋动脉人工血管旁路联合腔内修复术治疗复杂型Stanford B型主动脉夹层%Axillary-axillary bypass grafting and endovascular repair therapy for complicated Stanford type B aortic dissection

    Institute of Scientific and Technical Information of China (English)

    陈浩; 曹建军; 刘伟; 王宏宇; 张光青; 郑建设

    2015-01-01

    Objective To summarize the present experience on axillary-axillary bypass grafting and endovas-cular repair therapy for complicated Stanford type B aortic dissection. Methods From Feb. 2011 to Dec. 2014, 16 pa-tients with complicated Stanford type B aortic dissection were all treated with axillary-axillary bypass grafting under general anesthesia and then endovascular repair. Results All 16 patients were successfully operated. The crevasses were perfectly closed. No endoleak was found. And the patency rate after reconstruction was 100%. No ertebrobasilar insufficiency or left upper limb ischemia was found in patients. Three patients were found with upper limbs anaesthe-sia which recovered 1~3 months after the surgery, and one patient was found with left pneumothorax. Of 14 patients who were followed up for 1~30 months, with an average of (18.0 ± 3.6) months), one died 45 days after the surgery. The aortic CTA at 3 months and 12 months after surgery both showed good graft patency, no stent displacement and no endoleak. However, distal aneurysm was found in one patient. Conclusion Axillary-axillary bypass grafting com-bined with endovascular repair is a safe and effective treatment for complicated Stanford type B aortic dissection. It can help reduce the risk of surgery, a brain complications, and also shorten the recovery time.%目的 总结腋-腋动脉人工血管旁路联合腔内修复术治疗复杂型Stanford B型主动脉夹层的经验.方法 2011年2月至2014年12月,16例复杂型Stanford B型主动脉夹层患者于手术室全麻下行腋-腋动脉人工血管旁路术,转介入手术室经股动脉切口行主动脉腔内修复术治疗.结果 所有患者均手术成功,术毕造影均提示破口封闭良好,无内漏,旁路血管通畅.术后无椎基底供血不足及左上肢缺血症状;3例患者术后上肢麻木感,术后1~3个月均消失;左侧气胸1例.随访14例,失访2例,随访时间1~30个月,平均(18.0±3.6)个月,术后45 d猝死1

  12. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

    Directory of Open Access Journals (Sweden)

    Su T

    2011-08-01

    Full Text Available Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited.Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD, compliance (BAC, and resistance (BAR. Fasting blood levels of glucose, lipids, lipoprotein (a, high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured.Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity.Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than

  13. Linfonodo sentinela intramamário comprometido e axila livre: esvaziamento axilar ou conduta conservadora? Intramammary lymph node sentinel metastasis without metastasis in axilla: axillary lymph node dissection or conservative surgery?

    Directory of Open Access Journals (Sweden)

    René Aloisio da Costa Vieira

    2012-01-01

    Full Text Available A pesquisa do linfonodo sentinela constitui tratamento padrão para pacientes portadoras de câncer de mama e axila clinicamente negativa. A presença do linfonodo sentinela (LS extra-axilar e intramamário (IM ocorre em até 2,6% dos casos, e na presença do LS IM metastático, a positividade axilar pode alcançar até 81%. Na associação do LS IM metastático ao LS axilar não metastático, não há conduta padronizada, visto um limitado número de casos descritos. Adicionamos dois casos à literatura, observando, em um deles, a presença de doença metastática axilar na linfadenectomia complementar. A utilização de nomograma demonstrou que o risco de doença metastática axilar era inferior a 10%, e a adição destes casos à literatura mostrou que, nesta situação, a taxa de doença metastática axilar é de 6,25%. Discutimos os prós e contras da linfadenectomia axilar complementar nesta situação.The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM sentinel lymph node (SLN occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.

  14. Linfonodo sentinela intramamário comprometido e axila livre: esvaziamento axilar ou conduta conservadora? Intramammary lymph node sentinel metastasis without metastasis in axilla: axillary lymph node dissection or conservative surgery?

    Directory of Open Access Journals (Sweden)

    René Aloisio da Costa Vieira

    2012-10-01

    Full Text Available A pesquisa do linfonodo sentinela constitui tratamento padrão para pacientes portadoras de câncer de mama e axila clinicamente negativa. A presença do linfonodo sentinela (LS extra-axilar e intramamário (IM ocorre em até 2,6% dos casos, e na presença do LS IM metastático, a positividade axilar pode alcançar até 81%. Na associação do LS IM metastático ao LS axilar não metastático, não há conduta padronizada, visto um limitado número de casos descritos. Adicionamos dois casos à literatura, observando, em um deles, a presença de doença metastática axilar na linfadenectomia complementar. A utilização de nomograma demonstrou que o risco de doença metastática axilar era inferior a 10%, e a adição destes casos à literatura mostrou que, nesta situação, a taxa de doença metastática axilar é de 6,25%. Discutimos os prós e contras da linfadenectomia axilar complementar nesta situação.The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM sentinel lymph node (SLN occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.

  15. Recurrent ischemia resulting from left internal mammary artery-to-pulmonary artery fistula.

    Science.gov (United States)

    Madu, E C; Hanumanthu, S K; Kim, C; Prudoff, A

    2001-03-01

    This report describes a case series of recurrent ischemia after coronary artery bypass grafting resulting from left internal mammary artery-to-pulmonary artery fistula. An angiographic demonstration of this fistula is presented.

  16. Evaluating the Effects of Aluminum-Containing and Non-Aluminum Containing Deodorants on Axillary Skin Toxicity During Radiation Therapy for Breast Cancer: A 3-Armed Randomized Controlled Trial

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Lucy, E-mail: Lucy.lewis@curtin.edu.au [Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); School of Nursing and Midwifery Curtin University, Perth (Australia); Carson, Sharron [Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); Bydder, Sean [Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); School of Surgery, The University of Western Australia, Crawley, Western Australia (Australia); Athifa, Mariyam [School of Nursing and Midwifery Curtin University, Perth (Australia); Williams, Anne M. [School of Nursing and Midwifery Curtin University, Perth (Australia); School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia (Australia); Bremner, Alexandra [School of Population Health, The University of Western Australia, Crawley, Western Australia (Australia)

    2014-11-15

    Purpose: Deodorant use during radiation therapy for breast cancer has been controversial as there are concerns deodorant use may exacerbate axillary skin toxicity. The present study prospectively determined the use of both aluminum-containing and non aluminum containing deodorants on axillary skin toxicity during conventionally fractionated postoperative radiation therapy for breast cancer. Methods and Materials: This 3-arm randomized controlled study was conducted at a single center, tertiary cancer hospital between March 2011 and April 2013. Participants were randomized to 1 of 2 experimental groups (aluminum-containing deodorant and soap or non–aluminum containing deodorant and soap) or a control group (soap). A total of 333 participants were randomized. Generalized estimating equations were used to estimate and compare the odds of experiencing high levels of sweating and skin toxicity in each of the deodorant groups to the odds in the control group. The study evaluated a range of endpoints including objective measurements of axilla sweating, skin toxicity, pain, itch and burning. Quality of life was assessed with a validated questionnaire. Results: Radiation characteristics were similar across all groups. Patients in the deodorant groups did not report significantly different ratings for axillary pain, itch, or burning compared with the control group. Patients in the aluminum-containing deodorant group experienced significantly less sweating than the control; the odds of their sweating being barely tolerable and frequently or always interfering with their daily activities was decreased by 85% (odds ratio, 0.15; 95% confidence interval, 0.03-0.91). Conclusions: We found no evidence that the use of either aluminum-containing or non–aluminum containing deodorant adversely effects axillary skin reaction during conventionally fractionated radiation therapy for breast cancer. Our analysis also suggests patients in the aluminum-containing deodorant arm had

  17. Effect of Axillary Dissection on Prognosis in Patients With Early Breast Cancer%腋窝清扫手术对早期老年乳腺癌患者预后的影响分析

    Institute of Scientific and Technical Information of China (English)

    熊念忠

    2015-01-01

    Objective Study of elderly patients with early breast cancer axillary dissection in prognosis. Methods 80 cases of elderly breast cancer patients were randomly divided into control and treatment groups of patients treated with axillary lymph node dissection, the control group without axillary lymph node dissection, compared two groups of patients were followed up for 3 years and quality of life of. Results The results of three years of follow-up the case and control groups treated group was small and the quality of life is also very similar scores. Conclusion Axillary dissection surgery or not is not obvious impact on the prognosis of patients, clinical treatment can choose whether axillary dissection according to the speciifc circumstances of the patient.%目的:研究早期老年乳腺癌患者进行腋窝清扫手术的预后效果。方法将老年乳腺癌患者80例随机分成对照组和治疗组,对治疗组患者进行腋窝淋巴结清扫手术,对照组不进行腋窝淋巴结清扫手术,对比两组患者术后的3年的随访情况和生活质量。结果治疗组的3年随访情况与对照组差异不大,且生活质量的各项评分也很相近。结论腋窝清扫手术进行与否对患者预后影响并不明显,临床治疗时可根据患者的具体情况选择是否进行腋窝清扫手术。

  18. A Palpable Painless Axillary Mass as the Clinical Manifestation of Castleman’s Disease in a Patient with Hepatitis C Disease

    Directory of Open Access Journals (Sweden)

    Athanasia K. Papazafiropoulou

    2016-01-01

    Full Text Available Introduction. Castleman’s disease (CD is a rare lymphoproliferative disorder. CD is divided into two clinical subtypes: the most common unicentric and the less usual multicentric subtype. The majority of unicentric CD affects the mediastinum, while neck, abdomen, and axilla are less common locations. Case Presentation. Herein, we describe a rare case of unicentric CD in the right axilla in a 36-year-old white male with a medical history of hepatitis C virus infection admitted to our hospital due to palpation of a painless mass in the right axilla. Complete excision of the lesion was performed and, one year after the diagnosis, patient was free of the disease. Conclusions. Although infrequent, it is important to include CD in the differential diagnosis when evaluating axillary lymphadenopathy particularly in young patients with a low-grade inflammation process and chronic disease even in the absence of an abnormal blood picture or organomegaly.

  19. Progress on Clinical Diagnosis and Treatment of Axillary Hyperhidrosis%腋部多汗症的临床诊断与治疗进展

    Institute of Scientific and Technical Information of China (English)

    谢爱国; 谭谦

    2008-01-01

    腋部多汗症(axillary hyperhidrosis)是临床常见病,多见于青少年,虽对健康不产生严重危害,但对患者的社会交往和日常生活产生较大影响.目前对于该病的治疗方法较多,疗效各异.A型肉毒毒素局部注射治疗腋部多汗症临床操作简捷,起效快,不影响日常生活,是一种安全、有效的治疗方法.本文对A型肉毒毒素局部注射治疗腋部多汗症的研究进展作一综述.

  20. Anatomic study of intercostal to axillary nerve transfer%肋间神经移位腋神经的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    楚彬; 胡韶楠; 陈亮; 宋捷

    2012-01-01

    Objective To provide the anatomical basis for intercostal to axillary nerve transfer to restore shoulder abduction.Methods Thirty sides of thoracic walls of human cadaver specimens were used.The intercostal nerves Ⅲ to Ⅵ were dissected to measure the lengths of the intercostal nerves from the midaxillary line to the midclavicular line.Meanwhile the distances from the relevant intercostal space to the quadrilateral foramen (with 45° of shoulder abduction and 90° of shoulder abduction) through the subcutaneous tunnel were also measured.Results The differences between the length of the intercostal nerve Ⅲ to Ⅵ and the distance from the relevant intercostal space to the quadrilateral foramen were (3.89 ± 0.85) cm,(4.14 ± 1.15) cm,(2.99 ±1.33) cm and (0.25± 1.49) cm with 45° of shoulder abduction,and (2.54 ±0.87) cm,(2.37 ± 1.51) cm,(1.04 ± 1.74) cm and (-1.59 ± 1.95) cm with 90° of shoulder abduction.Conclusion It is feasible to perform direct coaptation between the axillary nerve and the intercostal nerves Ⅲ to Ⅴ at the quadrilateral foreman without nerve graft.To achieve tension-free coaptation of intercostal nerve Ⅵ and the axillary nerve at 90° of shoulder abduction,extra-length of the intercostal nerve Ⅵ or axillary nerve should be obtained.%目的 为利用肋间神经移位腋神经恢复肩外展功能提供解剖学依据.方法对30侧成人尸体标本中第三至第六肋间神经自腋中线至锁骨中线的长度和相应肋间神经自腋中线起点处穿过皮下隧道至四边孔腋神经缝合口处的距离(在肩外展45°和90°两种情况下)进行比较.结果 在肩外展45°时第三肋间至第六肋间自腋中线到锁骨中线的选取长度与相应肋间自腋中线自皮下隧道至四边孔距离差值分别为(3.89±0.85) cm、(4.14± 1.15)cm、(2.99± 1.33) cm和(0.25±1.49)cm.在肩外展90°时,差值分别为(2.54±0.87) cm、(2.37± 1.51)cm、(1.04± 1.74) cm和(-1.59± 1.95)cm.结论 第三、第

  1. Capsaicin- resistant arterial baroreceptors

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    Andresen Michael C

    2006-05-01

    Full Text Available Abstract Background Aortic baroreceptors (BRs comprise a class of cranial afferents arising from major arteries closest to the heart whose axons form the aortic depressor nerve. BRs are mechanoreceptors that are largely devoted to cardiovascular autonomic reflexes. Such cranial afferents have either lightly myelinated (A-type or non-myelinated (C-type axons and share remarkable cellular similarities to spinal primary afferent neurons. Our goal was to test whether vanilloid receptor (TRPV1 agonists, capsaicin (CAP and resiniferatoxin (RTX, altered the pressure-discharge properties of peripheral aortic BRs. Results Periaxonal application of 1 μM CAP decreased the amplitude of the C-wave in the compound action potential conducting at 0.50 but completely inhibited discharge of an irregularly discharging BR (C-type. CAP at high concentrations (10–100 μM depressed BR sensitivity in regularly discharging BRs, an effect attributed to non-specific actions. RTX (≤ 10 μM did not affect the discharge properties of regularly discharging BRs (n = 7, p > 0.18. A CAP-sensitive BR had significantly lower discharge regularity expressed as the coefficient of variation than the CAP-resistant fibers (p Conclusion We conclude that functional TRPV1 channels are present in C-type but not A-type (A-δ myelinated aortic arch BRs. CAP has nonspecific inhibitory actions that are unlikely to be related to TRV1 binding since such effects were absent with the highly specific TRPV1 agonist RTX. Thus, CAP must be used with caution at very high concentrations.

  2. 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.

  3. The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies.

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    Chao Han

    Full Text Available The axillary reverse mapping (ARM technique has recently been developed to prevent lymphedema by preserving the arm lymphatic drainage during sentinel lymph node biopsy (SLNB or axillary lymph node dissection (ALND procedures. The objective of this systematic review and meta-analysis was to evaluate the feasibility and oncological safety of ARM.We searched Medline, Embase, Web of science, Scopus, and the Cochrane Library for relevant prospective studies. The identification rate of ARM nodes, the crossover rate of SLN-ARM nodes, the proportion of metastatic ARM nodes, and the incidence of complications were pooled into meta-analyses by the random-effects model.A total of 24 prospective studies were included into meta-analyses, of which 11 studies reported ARM during SLNB, and 18 studies reported ARM during SLNB. The overall identification rate of ARM nodes was 38.2% (95% CI 32.9%-43.8% during SLNB and 82.8% (78.0%-86.6% during ALND, respectively. The crossover rate of SLN-ARM nodes was 19.6% (95% CI 14.4%-26.1%. The metastatic rate of ARM nodes was 16.9% (95% CI 14.2%-20.1%. The pooled incidence of lymphedema was 4.1% (95% CI 2.9-5.9% for patients undergoing ARM procedure.The ARM procedure was feasible during ALND. Nevertheless, it was restricted by low identification rate of ARM nodes during SLNB. ARM was beneficial for preventing lymphedema. However, this technique should be performed with caution given the possibility of crossover SLN-ARM nodes and metastatic ARM nodes. ARM appeared to be unsuitable for patients with clinically positive breast cancer due to oncological safety concern.

  4. Axillary lymph node characterization in breast cancer patients using magnetic resonance mammography: A prospective comparative study with FDG PET-CT and healthy women

    Energy Technology Data Exchange (ETDEWEB)

    Krammer, J., E-mail: Julia.Krammer@medma.uni-heidelberg.de; Wasser, K.; Schnitzer, A.; Henzler, T.; Schoenberg, S.O.; Kaiser, C.G.

    2013-12-01

    Objective: The aim of this study was to evaluate the capability of dynamic contrast enhanced MR-mammography (MRM) for the interpretation of axillary lymph nodes (LNs) in patients with breast cancer. Material and methods: 25 patients with breast cancer preoperatively underwent both FDG positron emission computed tomography (PET-CT) and dynamic contrast enhanced MRM. The maximum signal increase (SI{sub max}) and curve shape (types I–III) of contrast enhanced LNs ≥0.5 cm (short-axis) were analyzed in MRM and correlated to the maximum standard uptake value (SUV{sub max}) of FDG PET-CT. 29 healthy women with MRM served as control group. Enhancement kinetics of all malignant LNs were compared to LN findings of the healthy control group. Results: Overall 33 contrast enhanced LNs on preoperative MRM had a corresponding FDG uptake on PET-CT. 30 of the PET positive LNs were classified as surely malignant (mean SUV{sub max} 7.3 (±5.4)). The mean SI{sub max} of these LNs was not significantly different to the control group (222% vs 197%), but malignant LNs had a significantly higher rate of type III curves with rapid washout (93% vs 66%, p = 0.008). Conclusion: The maximum signal increase is not capable of differentiating malignant from benign axillary LNs. However, since malignant LNs showed a higher frequency of rapid washout curves (type III curves) on corresponding MRM future studies should concentrate on the analysis of this parameter. In clinical routine the curve shape still should be taken with care as there is a high overlap with benign LNs.

  5. Non-invasive imaging modalities for preoperative axillary lymph node staging in patients with breast cancer; Nichtinvasive bildgebende Verfahren zum praeoperativen axillaeren Lymphknotenstaging beim Mammakarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Wasser, K.; Schnitzer, A.; Schoenberg, S.O. [Universitaetsmedizin Mannheim, Institut fuer Klinische Radiologie und Nuklearmedizin, Mannheim (Germany); Brade, J. [Universitaetsmedizin Mannheim, Institut fuer Medizinische Statistik, Mannheim (Germany)

    2010-11-15

    In the last decade sentinel lymph node biopsy has become a well-established method for axillary lymph node staging in patients with breast cancer. Using preoperative imaging modalities it can be tested whether patients are suitable for sentinel node biopsy or if they should directly undergo an axillary dissection. The imaging modalities used must be mainly characterized by a high positive predictive value (PPV). For this question B-mode ultrasound is the best evaluated method and provides clear morphological signs for a high PPV (>90%) but the sensitivity barely exceeds 50%. It has not yet been proven whether other modalities such as duplex sonography, magnetic resonance imaging, computed tomography (CT) or scintigraphy might achieve a higher sensitivity while still maintaining a high PPV. There is only some evidence that positron emission tomography (PET) might achieve a higher sensitivity. This should be confirmed by further studies because PET or PET/CT will play an increasing role for an initial whole body staging in patients with breast cancer in the near future. (orig.) [German] Die Waechterlymphknotenbiopsie hat sich in den letzten 10 Jahren fuer das axillaere Lymphknotenstaging des Mammakarzinoms fest etabliert. Durch praeoperative bildgebende Verfahren kann getestet werden, ob sich Patientinnen fuer eine Waechterlymphknotenbiopsie eignen oder direkt einer axillaeren Dissektion unterzogen werden sollten. Diese bildgebenden Verfahren muessen sich in erster Linie durch einen hohen positiven Vorhersagewert (PVW) auszeichnen. Die B-Bild-Sonographie ist diesbezueglich bisher am besten evaluiert. Sie liefert eindeutige morphologische Kriterien fuer einen hohen PVW (>90%). Die Sensitivitaet liegt dabei allerdings kaum ueber 50%. Bisher ist nicht erwiesen, dass andere Verfahren wie die Duplexsonographie, die MRT, die CT oder Szintigraphie eine bessere Sensitivitaet bei hohem PVW liefern. Lediglich fuer die Positronenemissionstomographie (PET) bestehen Hinweise

  6. Ultrasound elastography as an adjuvant to conventional ultrasound in the preoperative assessment of axillary lymph nodes in suspected breast cancer: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, K., E-mail: kathryn.taylor@addenbrookes.nhs.uk [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); O' Keeffe, S.; Britton, P.D.; Wallis, M.G. [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Treece, G.M.; Housden, J. [Department of Engineering, University of Cambridge, Cambridge (United Kingdom); Parashar, D.; Bond, S. [Cambridge Cancer Trials Centre, Department of Oncology, University of Cambridge, Addenbrookes Hospital, Cambridge (United Kingdom); Cambridge Hub in Trials Methodology Research, MRC Biostatics Unit, University Forvie Site, Cambridge (United Kingdom); Sinnatamby, R. [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom)

    2011-11-15

    Aims: To compare the performance of ultrasound elastography with conventional ultrasound in the assessment of axillary lymph nodes in suspected breast cancer and whether ultrasound elastography as an adjunct to conventional ultrasound can increase the sensitivity of conventional ultrasound used alone. Materials and methods: Fifty symptomatic women with a sonographic suspicion for breast cancer underwent ultrasound elastography of the ipsilateral axilla concurrent with conventional ultrasound being performed as part of triple assessment. Elastograms were visually scored, strain measurements calculated and node area and perimeter measurements taken. Theoretical biopsy cut points were selected. The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were calculated and receiver operating characteristic (ROC) analysis was performed and compared for elastograms and conventional ultrasound images with surgical histology as the reference standard. Results: The mean age of the women was 57 years. Twenty-nine out of 50 of the nodes were histologically negative on surgical histology and 21 were positive. The sensitivity, specificity, PPV, and NPV for conventional ultrasound were 76, 78, 70, and 81%, respectively; 90, 86, 83, and 93%, respectively, for visual ultrasound elastography; and for strain scoring, 100, 48, 58 and 100%, respectively. There was no significant difference between any of the node measurements Conclusions: Initial experience with ultrasound elastography of axillary lymph nodes, showed that it is more sensitive than conventional ultrasound in detecting abnormal nodes in the axilla in cases of suspected breast cancer. The specificity remained acceptable and ultrasound elastography used as an adjunct to conventional ultrasound has the potential to improve the performance of conventional ultrasound alone.

  7. A case report: accessory right renal artery

    Directory of Open Access Journals (Sweden)

    Patasi B

    2009-10-01

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

  8. Livergraftvascularvariantwith 3 extra-hepatic arteries

    Institute of Scientific and Technical Information of China (English)

    Paulo N Martins

    2010-01-01

     Vascular anatomy of the liver is varied, and the"standard"anatomy is seen in 55%-80%of cases. It is very important that extrahepatic arteries are identiifed precisely at the time of graft procurement to avoid injuries that might compromise the liver function. In the present case the liver donor had the vascular anatomy of Michels type Ⅶ, e.g. a hepatic artery originating from the celiac trunk and going to the left lobe, an accessory left hepatic artery coming from the left gastric artery, and a replaced right hepatic artery coming from the superior mesenteric artery. This pattern of vascular supply is uncommon, representing less than 5%of cases. The replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery, and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.

  9. Bronchial artery embolization in hemoptysis

    Institute of Scientific and Technical Information of China (English)

    DAI Hong-xiu; YANG Ding-cai; LIU Wei-hong; TANG He-qing; LIU Ke-yong; ZHAO Xiao-hua; TAN Yi-qing; WANG Jun

    2005-01-01

    Massive hemoptysis is one of the most dreaded of all respiratory emergencies and can have a variety of underlying causes. It is mostly caused by bleeding from bronchial circulation. Bronchial artery embolization is now considered to be the treatment of choice for acute massive hemoptysis. Bronchial artery embolization (BAE) is a safe and effective nonsurgical treatment for patients with massive hemoptysis. However, nonbronchial systemic arteries can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. So knowledge of the bronchial artery anatomy, together with an understanding of the pathophysiologic features of massive hemoptysis, are essential for planning and performing BAE in affected patients. In addition, interventional radiologists should be familiar with the techniques, results, efficacy, safety and possible complications of BAE and with the characteristics of the various embolic agents. Bronchial arterial catheterisation in human via a percutaneous approach has been practiced for 32 years (1973) in the world and 20 years (1986) in China, initially for direct chemotherapy treatment for bronchial malignancies and then for the embolization of patients with massive haemoptysis. A review of clinical experience to evaluate technique,embolic materials,outcome and complications of BAE is presented.

  10. Arterial calcification: A new perspective?

    Science.gov (United States)

    Nicoll, R; Henein, M

    2017-02-01

    Arterial calcification is commonly seen in atherosclerosis, chronic kidney disease (CKD) and diabetes and has long been considered a natural progression of atherosclerosis. Yet it is a systemic condition, occurring in a wide and diverse range of disease states and no medical treatment for cardiovascular disease has yet found a way to regress it; on the contrary, lipid-lowering therapy may worsen its progression. Although numerous studies have found associations between calcification and biomarkers, none has yet found a unifying mechanism that explains the calcification found in atherosclerosis, CKD or diabetes and many of the biomarkers are equally associated with atheroma development and cardiovascular events. Furthermore, both presence and absence of coronary artery calcification appear predictive of plaque rupture and cardiovascular events, indicating that the association is not causal. This suggests that we are no further forward in understanding the true nature of arterial calcification or its pathogenesis, other than noting that it is 'multifactorial'. This is because most researchers view arterial calcification as a progressive pathological condition which must be treated. Instead, we hypothesise that calcification develops as an immune response to endothelial injury, such as shear stress or oxidative stress in diabetics, and is consequently part of the body's natural defences. This would explain why it has been found to be protective of plaque rupture and why it is unresponsive to lipid-lowering agents. We propose that instead of attempting to treat arterial calcification, we should instead be attempting to prevent or treat all causes of endothelial injury.

  11. THE PROGNOSIS SIGNIFICANCE OF CATHEPSIN-D EXPRESSION IN THE DIFFERENT LOCATIONS IN AXILLARY NODES NEGATIVE CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    NIU; Yun

    2001-01-01

    [1]Garcia M, Platet N, Liaudet Estradiol, et al. Biological and clinical significance of cathepsin D in breast cancer metastasis [J]. Stem Cells 1996; 14:642.[2]Johnson MD, Torri JA, Lippman ME, et al. The role of cathepsin D in the invasiveness of human breast cancer cells [J]. Cancer Res 1993; 53: 873.[3]Duffy MJ. Proteases as prognostic markers in cancer [J]. Clin Cancer Res 1996; 2:613.[4]Westley BR, May FE. Cathepsin D and breast cancer [J]. Eur J Cancer 1996; 32A:7.[5]Riley LB, Lange MK, Browne RJ, et al. Analysis of cathepsin D in human breast cancer: usefulness of the processed 31 kDa active form of the enzyme as a prognostic indicator in node-negative and node-positive patients [J]. Breast Cancer Res Treat 2000; 60:173.[6]Fu XL. Histopathologic diagnosis. Chinese Common Malignant Tumor Diagnosis and Treatment Rule. Breast Carcinoma Volume [M]. 2nd ed. Beijing: Beijing Medical University and Chinese Xiehe Medical University Union Publisher, 1999; 23.[7]Yang SQ. Health Statistics [M]. 3rd ed. Beijing: People Health Publisher, 1998; 131.[8]Bittl A, Nap M, Jager W, et al. Immuno-histochemical detection of P-glycoprotein on frozen and paraffin-embedded tissue sections of normal and malignant tissues [J]. Anticancer Res 1995; 15:1007.[9]Isola J, Weitz S, Visakorpi T, et al. Cathepsin D expression detected by immunohistochemistry has independent prognostic value in axillary node-negative breast cancer [J]. J Clin Oncol 1993; 11:36.[10]Castiglioni T, Merino MJ, Elsner B, et al. Immunohistochemical analysis of cathepsins D, B, and L in human breast cancer [J]. Hum Pathol 1994; 25:857.[11]Montcourrier P, Mangeat PH, Valembois C, et al. Characterization of very acidic phagosomes in breast cancer cells and their association with invasion [J]. J Cell Sci 1994; 107:238l.[12]Foekens JA, Look MP, Bolt de Vries J, et al. Cathepsin-D in primary breast cancer: prognostic evaluation involving 2810 patients [J]. Br J Cancer 1999

  12. First jejunal artery, an alternative graft for right hepatic artery reconstruction.

    Science.gov (United States)

    Aryal, Bibek; Komokata, Teruo; Kadono, Jun; Motodaka, Hiroyuki; Ueno, Tetsuya; Furoi, Akira; Imoto, Yutaka

    2015-04-01

    Common bile duct cancer invading right hepatic artery is sometimes diagnosed intraoperatively. Excision and safe reconstruction of the artery with suitable graft is essential. Arterial reconstruction with autologous saphenous vein graft is the preferred method practiced routinely. However the right hepatic artery reconstruction has also been carried out with several other vessels like gastroduodenal artery, right gastroepiploic artery or the splenic artery. We report a case of 63-year-old man presenting with history of progressive jaundice, pruritus and impaired appetite. Following various imaging modalities including computed tomography, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, intraductal ultrasound extrahepatic bile duct cancer was diagnosed; however, none of those detected vessel invasion. Intraoperatively, right hepatic artery invasion was revealed. Right hepatic artery was resected and reconstructed with a graft harvested from the first jejunal artery (JA). Postoperative outcome was satisfactory with a long-term graft patency. First JA can be a reliable graft option for right hepatic artery reconstruction.

  13. Hypothenar hammer syndrome: Distal ulnar artery reconstruction with autologous inferior epigastric artery.

    Science.gov (United States)

    Smith, Hadley E; Dirks, Marco; Patterson, Robert B

    2004-12-01

    Digital artery embolization and ulnar artery thrombosis are consequences of repetitive trauma and can lead to digit loss and debility from ischemia and cold intolerance. We postulate that an arterial autograft is a theoretically superior conduit to traditional saphenous vein, and report reconstruction with inferior epigastric artery. Three adult male smokers, ages 39 to 49 years, had severe digital ischemia and cold-induced vasospasm. Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch, distal digital artery embolization, and normal proximal vasculature. All reconstructions were performed from the distal most patent ulnar artery at the wrist to the superficial palmar arch (1 patient) or sequentially to the involved common digital arteries (2 patients), with inferior epigastric artery. Handling characteristics and size match between the arterial autografts and bypassed arteries was excellent. Patency has been confirmed with duplex scanning at follow-up of 8 to 24 months, with resolution of cold intolerance and successful digital preservation.

  14. Spontaneous internal carotid artery dissection.

    Science.gov (United States)

    Khimenko, L P; Esham, H R; Ahmed, W

    2000-10-01

    Once considered uncommon, spontaneous dissection of the carotid artery is an increasingly recognized cause of stroke, headache, cranial nerve palsy, or ophthalmologic events, especially in young adults. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced physicians of all specialties. We report a case of spontaneous internal carotid artery dissection in a 38-year-old woman with a cortical stroke and visual disturbances as initial symptoms. The diagnosis was confirmed by magnetic resonance imaging/angiography and by angiography. Prompt anticoagulation was instituted, and the patient had complete resolution of symptoms. Cervicocephalic arterial dissection should be included in the differential diagnosis of the causes of cerebrovascular events.

  15. PERSISTENT MEDIAN ARTERY IN THE CARPAL TUNNEL

    Directory of Open Access Journals (Sweden)

    Raviprasanna.K.H

    2014-09-01

    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  16. Spontaneous isolated celiac artery dissection

    Directory of Open Access Journals (Sweden)

    Tuba Cimilli Ozturk

    2011-01-01

    Full Text Available Dyspepsia with mild, stabbing epigastric discomfort without history of trauma is a very common symptom that emergency physicians see in their daily practice. Vascular emergencies, mostly the aortic dissection and aneurysm, are always described in the differential diagnosis with persistent symptoms. Isolated celiac artery dissection occurring spontaneously is a very rare diagnosis. The involvement of branch vessels is generally observed and patients show various clinical signs and symptoms according to the involved branch vessel. Here we are presenting a case with spontaneous isolated celiac artery dissection, without any branch vessel involvement or visceral damage, detected by computed tomography scans taken on admission.

  17. Transcatheter intraarterial fibrinolysis for arterial occlusions%经导管血管内溶栓治疗急慢性动脉闭塞性疾患

    Institute of Scientific and Technical Information of China (English)

    印建国; 宋锦文; 杨艳; 贾雄; 郑曙光; 张亚琴; 杨炳飞

    2001-01-01

    目的:探讨经导管血管内溶栓治疗的疗效、价值和 方法。方法:6例患者经健侧股动脉穿刺置管,其中1例腹 主 动脉肾动脉平面以下广泛栓塞者,采用肱动脉置管。首先造影明确血栓部位与范围,用导丝或/与导管开辟血栓性“隧道”,充分抽吸血栓物与变性坏死血液后,采用微量泵注入国产 尿激酶50 万U加生理盐水50 ml/3~4 h。结果:腹主动 脉广泛血栓1例,股浅动脉和动脉各2例,外伤性腋动脉1例。除后者外溶通率达100%,平 均溶通时间21.4 h。结论:经导管血管内溶栓治疗,疗效 可靠,方便快捷,是治疗闭塞性血管疾患的首选方法。%Objective:To evaluate the curative effect,value and method of intravascular thrombolysis in the treatment of acute and chro nic arterial thrombotic lesions.Methods:The catheter izations were laid up through the femoral artery on the healthy side in 6 cases .1 case of diffuse thrombosis of the abdominal aorta below the orifice of renal artery,the catheterization through the humeral artery.The arteriography was empl oyed to denote the site and extent of thrombi firstly,then use the guidewire an d /or catheter to create a“tunnel”in the thrombi,and aspirate the blood clots and bloody materials thoroughly and inject urokinase (500 000 units in 50 ml sa line)slowly with micropump in 3-4 h.Results:1 case of diffuse abdominal aortic thrombosis,2 cases of thrombosis of femoral artery and 2 cases of thrombosis of popliteal artery(totally 5 cases)recanalized in 21.4 h (Average).Only 1 case of traumatic thrombosis of axillary artery failed becaus e of severe arterial trauma. Conclusion:Intravascula r thrombolysis might be a good method to treat arterial occlusive disease.

  18. Effect of different-dose botulinum toxin A intradermal injection on axillary hyperhidrosis%不同剂量A型肉毒毒素皮内注射治疗腋部多汗症效果观察

    Institute of Scientific and Technical Information of China (English)

    高扬; 杨亚东; 王元元; 杨洋; 鲁元刚

    2013-01-01

    目的 评估不同剂量A型肉毒毒素治疗腋部多汗症的时效.方法 腋部多汗症患者86例,患者左右侧腋窝自身对照:左侧为小剂量A型肉毒毒素注射组,皮内注射生理盐水稀释的A型肉毒毒素50U;右侧为大剂量A型肉毒毒素注射组,皮内注射生理盐水稀释的A型肉毒毒素200U;随访3~29个月,观察两组并发症,并建立两组等级资料,行x2检验,评价患者两侧腋窝维持疗效的时间差异.结果 两组疗效进行对比,大剂量与小剂量的A型肉毒毒素的疗效维持时间的差异有统计学意义(P<0.05).结论 大剂量A型肉毒毒素能够显著延长腋部多汗症疗效时间.%Objective To evaluate the long-term effectiveness of different-dose of botulinum toxin A (BTXA) therapy on axillary hyperhidrosis.Methods Total 86 patients with axillary hyperhidrosis were self-controlled.One group of left axillary was injected with a low-dose of BTXA,50U.Another group of right axillary was injected with a high-dose of BTXA.A total dose of 200 U of BTXA was used per axilla.Patients were followed-up for 29 months.To investigate the effect of two methods,we analyzed two ranked data by rank sum test and x2 test to judge the disparities of the therapeutic effect.Results The results showed that the relapse-free interval of two groups with axillary hyperhidrosis was significant difference through the statistical analysis (P < 0.05).Conclusions High-dose of BTXA treatment is capable of prolonging the antihidrotic effect on axillary hyperhidrosis.

  19. Three new families with arterial tortuosity syndrome.

    NARCIS (Netherlands)

    Wessels, M.W.; Catsman-Berrevoets, C.E.; Mancini, G.M.; Breuning, M.H.; Hoogeboom, J.J.; Stroink, H.; Frohn-Mulder, I.M.; Coucke, P.J.; Paepe, A.D.; Niermeijer, M.F.; Willems, P.J.

    2004-01-01

    Arterial tortuosity syndrome (ATS) is a rare condition with autosomal recessive inheritance characterized by connective tissue abnormalities. The most specific clinical findings are cardiovascular anomalies including tortuosity, lengthening, aneurysm, and stenosis formation of major arteries. Also v

  20. Could Peripheral Arterial Disease Be Your Problem?

    Science.gov (United States)

    ... exercise and yoga classes and has returned to teaching. Fast Facts Peripheral arterial disease (P.A.D.) occurs when a fatty material called plaque (pronounced plak) builds up on the inside walls of the arteries that carry blood from ...

  1. Transposition of the Greater Arteries (TGA)

    Science.gov (United States)

    ... Atrioventricular Canal Defect Transposition of the Great Arteries Coarctation of the Aorta Truncus Arteriosus Single Ventricle Defects ... Atrioventricular Canal Defect Transposition of the Great Arteries Coarctation of the Aorta Truncus Arteriosus Single Ventricle Defects ...

  2. The effect of sumatriptan on cephalic arteries

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Asghar, Mohammad Sohail; Ravneberg, Julie W;

    2013-01-01

    AIM: To explore a possible differential effect of sumatriptan on extracerebral versus cerebral arteries, we examined the superficial temporal (STA), middle meningeal (MMA), extracranial internal carotid (ICAextra), intracranial internal carotid (ICAintra), middle cerebral (MCA) and basilar arteries...

  3. Middle cerebral artery blood velocity during rowing

    DEFF Research Database (Denmark)

    Secher, Niels Henry; Pott, F; Knudsen, L.;

    1997-01-01

    original,arterial blood pressure,central venous pressure,cerebral blood flow, exercise, transcranial Doppler......original,arterial blood pressure,central venous pressure,cerebral blood flow, exercise, transcranial Doppler...

  4. Bilateral Internal Thoracic Artery Configuration for Coronary Artery Bypass Surgery

    Science.gov (United States)

    Boodhwani, Munir; Hanet, Claude; de Kerchove, Laurent; Navarra, Emiliano; Astarci, Parla; Noirhomme, Philippe; El Khoury, Gebrine

    2016-01-01

    Background— Bilateral internal thoracic arteries (BITA) have demonstrated superior patency and improved survival in patients undergoing coronary artery bypass grafting. However, the optimal configuration for BITA utilization and its effect on long-term outcome remains uncertain. Methods and Results— We randomly assigned 304 patients undergoing coronary artery bypass grafting using BITA to either in situ or Y grafting configurations. The primary end point was 3-year angiographic patency. Secondary end points included major adverse cardiac and cerebrovascular events (ie, death from any cause, stroke, myocardial infarction, or repeat revascularization) at 7 years. More coronary targets were able to be revascularized using internal thoracic arteries in patients randomized to Y grafting versus in situ group (3.2±0.8 versus 2.4±0.5 arteries/patient; P<0.01). The primary end point did not show significant differences in graft patency between groups. Secondary end points occurred more frequently in the in situ group (P=0.03), with 7-year rates of 34±10% in the in situ and 25±12% in the Y grafting groups, driven largely by a higher incidence of repeat revascularization in the in situ group (14±4.5% versus 7.4±3.2% at 7 years; P=0.009). There were no significant differences in hospital mortality or morbidity or in late survival, myocardial infarction, or stroke between groups. Conclusions— Three-year systematic angiographic follow-up revealed no significant difference in graft patency between the 2 BITA configurations. However, compared with in situ configuration, the use of BITA in a Y grafting configuration results in lower rates of major adverse cardiovascular and cerebrovascular events at 7 years. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01666366. PMID:27406988

  5. An unreported type of coronary artery naomaly in congenitally corrected transposition of great arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Min Kyu; Jeong, Yeon Joo; Lee, Gee Won; Lee, Nam Kyung; Choi, Jung Hyun; Lee, Ji Won [Medical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of)

    2016-07-15

    Coronary artery variations are associated anomalies in 45% of congenitally corrected transposition of the great arteries (ccTGA) cases, and it is important to detect any coronary artery anomalies before cardiac surgery. We report a case of a 51-year-old woman with ccTGA and an unreported type of coronary artery anomaly.

  6. 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

  7. Correlation of invasive central arterial pressure with peripheral arterial pressure and coronary sclerosis

    Institute of Scientific and Technical Information of China (English)

    吴琪

    2013-01-01

    Objective To study the consistency among non-invasive and invasive brachial artery pressure,radial artery pressure and invasive central arterial pressure,and to explore the correlation between the severe degree of coronary artery disease and invasive central aortic pressure.

  8. Hypogastric artery autograft treating hemorrhage with infection of external iliac artery secondary to renal transplantation

    Institute of Scientific and Technical Information of China (English)

    WANG Ze-hou; YI Shan-hong; YAO Zhi-yong; SUN Bin; HONG Quan; ZHANG Zhi-chao

    2008-01-01

    @@ Massive hemorrhage from infected anastomosed site between the graft artery and the external iliac artery is one of the most serious complications of renal transplantation. Clinically, it is a rare but fatal occasion. We reported here one case of hemorrhage with infection in the iliac artery anastomosed site treated successfully with hypogastric artery autograft interposition in March 2003.

  9. Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Sawada, A.; Takase, Y.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan); Koizumi, T. [Department of Neurosurgery, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan)

    2002-07-01

    The authors present a case of moyamoya disease associated with a persistent trigeminal artery from which the anterior inferior cerebellar artery arose. We reviewed previously reported cases of moyamoya disease associated with persistent carotid-basilar arterial anastomosis and investigated the embryology of this rare arterial variation. (orig.)

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

    Science.gov (United States)

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

    2008-05-01

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

  11. Pregnancy after uterine arterial embolization

    Directory of Open Access Journals (Sweden)

    Cláudio E. Bonduki

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter. Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2, and 87.5% were successful live births (n = 14. The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54. One of the pregnancies resulted in twins. The newborn weights (n = 14 ranged from 2.260 to 3.605 kg (mean, 3.072 kg. One (7.1% was considered to have a low birth weight (2.260 kg. There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%], one case of premature rupture of the membranes (PRM (6.3%, and one case of preeclampsia (6.3%. All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  12. Capsaicin and arterial hypertensive crisis.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; La Rosa, Felice Carmelo; La Rocca, Roberto

    2010-10-08

    Chili peppers are rich in capsaicin. The potent vasodilator calcitonin gene-related peptide (CGRP) is stored in a population of C-fiber afferents that are sensitive to capsaicin. CGRP and peptides released from cardiac C fibers have a beneficial effect in myocardial ischemia and reperfusion. It has been reported that capsaicin pretreatment can deplete cardiac C-fiber peptide stores. Furthermore, it has also been reported that capsaicin-treated pigs have significantly increased mean arterial blood pressure compared with controls, and that the decrease in CGRP synthesis and release contributes to the elevated blood pressure. A case has also been reported of an arterial hypertensive crisis in a patient with a large ingestion of peppers and chili peppers the day before. We present a case of an arterial hypertensive crisis in a 19-year-old Italian man with an abundant ingestion of peppers and of chili peppers the preceding day. This case describes an unusual pattern of arterial hypertensive crisis due to capsaicin.

  13. Management of pulmonary arterial hypertension.

    LENUS (Irish Health Repository)

    Judge, Eoin P

    2013-02-01

    Pulmonary arterial hypertension (PAH) is a complex disease with a high mortality. Management of this disease is underpinned by supportive and general therapies delivered by multidisciplinary teams in specialist centres. In recent years, a number of PAH-specific therapies have improved patient outcomes. This article will discuss the management of PAH in the context of relevant recently published studies in this area.

  14. Diagnosis and treatment of renal artery stenosis.

    NARCIS (Netherlands)

    Plouin, P.F.; Bax, L.

    2010-01-01

    A reduction in the diameter of the renal arteries can lead to hypertension, renal dysfunction and/or pulmonary edema. About 90% of patients with renal artery stenosis have atherosclerosis, and 10% have fibromuscular dysplasia. Atherosclerotic renal artery stenosis is a common condition that typicall

  15. Peripheral Arterial Disease (P.A.D.)

    Science.gov (United States)

    ... page please turn Javascript on. Peripheral Artery Disease (P.A.D.) What is P.A.D.? Arteries Clogged With Plaque Peripheral arterial ... Escape (Esc) button on your keyboard.) Why Is P.A.D. Dangerous? Click for more information Blocked ...

  16. Fenestration of the anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Ito, J.; Washiyama, K.; Hong, K.C.; Ibuchi, Y.

    1981-08-01

    Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed.

  17. Anomalous external carotid artery-internal carotid artery anastomosis in two patients with proximal internal carotid arterial remnants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Hun [Dept. of Neurology, Stroke Center, Myongji Hospital, Goyang (Korea, Republic of); Cho, Young Dae; Kang, Hyun Seung; Kim, Jeong Eun; Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jung, Seung Chai [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Ahn, Jun Hyong [Dept. of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)

    2015-08-15

    Two angiographic instances of anomalous external carotid artery (ECA) and internal carotid artery (ICA) anastomosis are described, each occurring at the C2-3 level and bearing remnants of proximal ICA. The ICA remnant of one patient (identifiable immediately upon bifurcation of the common carotid artery) was hypoplastic, and that of the other patient was an occluded arterial stump. These features are not typical of non-bifurcating ICA. The occipital artery originated from an anomalous connection in one instance and from the main trunk of the ECA (just past the ECA-ICA connection) in the other.

  18. Revascularization using satellite vein after radial artery harvested for coronary artery bypass grafting.

    Science.gov (United States)

    Gon, Shigeyoshi; Yoshida, Shigehiko; Sanae, Tsutomu; Takahashi, Tamami; Inada, Eiichi

    2006-06-01

    The radial artery has been increasingly used for coronary artery bypass grafting and has excellent long-term patency rates. Hand claudication is one of the adverse effects after radial artery harvest. We reconstructed a radial artery using the satellite vein to prevent hand claudication. Pulsating blood flow at 35 cm/sec was evaluated using color Doppler echocardiography three months after surgery. This method makes it possible to use a radial artery in patients with a positive Allen test.

  19. Endovascular rescue from arterial rupture and thrombosis during middle cerebral artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, J.Y.; Chung, Y.S. [Department of Neurosurgery, College of Medicine, Pundang CHA Hospital, 351 Yatap-ding, Pundang-gu, 463-712, Sungnam (Korea); Lee, B.H. [Department of Interventional Neuroradiology, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea); Kim, O.J. [Department of Emergency Medicine, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea)

    2003-08-01

    Intravascular stents are being used with increasing frequency in interventional neuroradiology. Iatrogenic arterial rupture is an uncommon but serious complication. We present a case of arterial rupture and subarachnoid haemorrhage during middle cerebral artery stenting, treated by emergency additional, overlapping stenting and balloon tamponade of the dissected vessel. Thrombotic occlusion of the artery was managed by intra-arterial abciximab. Normal vessel patency was re-established within 20 min and the patient recovered with no neurological deficit. (orig.)

  20. Iatrogenic subclavian artery pseudoaneurysm close to the origin of the vertebral artery: an endovascular strategy

    Institute of Scientific and Technical Information of China (English)

    XU Gao-feng; Dae Chul Suh

    2006-01-01

    Subclavian artery pseudoaneurysm that induced from central venous catheterization through the internal jugular vein is relatively uncommon. However, the management of subclavian artery pseudoaneurysm remains a challenge because of their non-compressibility of deep locality and relationship to important surrounding anatomy, such as the origin of vertebral artery. In this paper, the authors report a patient with larger iatrogenic subclavian arterial pseudoaneurysm near the origin of vertebral artery, that was treated successfully by endovascular covered stent and coils.

  1. Analysis on correlation between the characteristic of breast cancer MRI and axillary lymph node metastasis%乳腺癌MRI的特征性表现与腋窝淋巴结转移的相关性分析

    Institute of Scientific and Technical Information of China (English)

    谢龙龙; 刘晟; 王维; 刘文; 简练; 彭和香

    2015-01-01

    Objective: To explore the relationship between the characteristic of breast cancer MRI and axillary lymph node metastasis, thus offering therapeutic schedule and prognosis in treating breast cancer.Materials and Methods:Forty-four cases of breast cancer were conifrmed by pathology and preoperative MR scan, twenty-six cases of these patients were conifrmed with ipsilateral axillary lymph node metastasis. Two experts read MRI image, and analyze the relationship between the ratio of different masses' short axis over long axis, dynamic enhanced MR features and the axillary lymph node metastasis of breast cancer.Results:(1) MR morphology analysis shows that the ratio of breast lumps' short axis over long axis has a negaive correlation with axillary lymphnode matastasis (t=5.892,P<0.05). (2) Edge reinforcement tumors' early intensive rate of breast cancer has positive correlation with axillary lymph node metastasis (t=3.966,P<0.01).Conclusion:The larger the ratio of breast lumps' short axis over long axis is, the smaller the possibility of axillary lymph node metastasis will be, the bigger edge reinforcement tumors' early intensive rate is, the greater the possibility of lymph node metastasis will be, and associated with poor prognosis. Therefore, axillary lymph node metastasis of breast cancer has good correlation with MR characteristic. MR examination can judge prognosis of breast cancer and axillary lymph node properties, then provide reference for effective treatment.%目的:探讨乳腺癌MRI的特征性表现与腋窝淋巴结转移的相关性,为乳腺癌淋巴结阳性患者治疗方案的选择及预后评估提供理论依据。材料与方法44例经病理证实为乳腺癌且均术前行MR扫描,其中26例患者证实有同侧腋窝淋巴结转移。由2名有经验的影像科医师阅读MRI,分析不同肿块的短径与长径之比、动态增强的特征与乳腺癌腋窝淋巴结转移的相关性。结果(1)MR形态学分析乳腺肿块短径

  2. SU-E-T-596: Axillary Nodes Radiotherapy Boost Field Dosimetric Impact Study: Oblique Field and Field Optimization in 3D Conventional Breast Cancer Radiation Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Su, M [Mount Sinai School of Medicine, Elmhurst, NY (United States); Sura, S

    2014-06-01

    Purpose: To evaluate dosimetric impact of two axillary nodes (AX) boost techniques: (1) posterior-oblique optimized field boost (POB), (2) traditional posterior-anterior boost (PAB) with field optimization (O-PAB), for a postmastectomy breast patient with positive axillary lymph nodes. Methods: Five patients, 3 left and 2 right chest walls, were included in this study. All patients were simulated in 5mm CT slice thickness. Supraclavicular (SC) and level I/II/III AX were contoured based on the RTOG atlas guideline. Five treatment plans, (1) tangential chest wall, (2) oblique SC including AX, (3) PAB, O-PAB and POB, were created for each patient. Three plan sums (PS) were generated by sum one of (3) plan with plan (1) and (2). The field optimization was done through PS dose distribution, which included a field adjustment, a fractional dose, a calculation location and a gantry angle selection for POB. A dosimetric impact was evaluated by comparing a SC and AX coverage, a PS maximum dose, an irradiated area percentage volume received dose over 105% prescription dose (V105), an ipsi-laterial mean lung dose (MLD), an ipsi-laterial mean humeral head dose (MHHD), a mean heart dose (MHD) (for left case only) and their DVH amount these three technique. Results: O-PAB, POB and PAB dosimetric results showed that there was no significant different on SC and AX coverage (p>0.43) and MHD (p>0.16). The benefit of sparing lung irradiation from PAB to O-PAB to POB was significant (p<0.004). PAB showed a highest PS maximum dose (p<0.005), V105 (p<0.023) and MLD (compared with OPAB, p=0.055). MHHD showed very sensitive to the patient arm positioning and anatomy. O-PAB convinced a lower MHHD than PAB (p=0.03). Conclusion: 3D CT contouring plays main role in accuracy radiotherapy. Dosimetric advantage of POB and O-PAB was observed for a better normal tissue irradiation sparing.

  3. Molecular cloning, phylogenetic analysis, and expression patterns of LATERAL SUPPRESSOR-LIKE and REGULATOR OF AXILLARY MERISTEM FORMATION-LIKE genes in sunflower (Helianthus annuus L.).

    Science.gov (United States)

    Fambrini, Marco; Salvini, Mariangela; Pugliesi, Claudio

    2016-12-29

    The wild sunflower (Helianthus annuus) plants develop a highly branched form with numerous small flowering heads. The origin of a no branched sunflower, producing a single large head, has been a key event in the domestication process of this species. The interaction between hormonal factors and several genes organizes the initiation and outgrowth of axillary meristems (AMs). From sunflower, we have isolated two genes putatively involved in this process, LATERAL SUPPRESSOR (LS)-LIKE (Ha-LSL) and REGULATOR OF AXILLARY MERISTEM FORMATION (ROX)-LIKE (Ha-ROXL), encoding for a GRAS and a bHLH transcription factor (TF), respectively. Typical amino acid residues and phylogenetic analyses suggest that Ha-LSL and Ha-ROXL are the orthologs of the branching regulator LS and ROX/LAX1, involved in the growth habit of both dicot and monocot species. qRT-PCR analyses revealed a high accumulation of Ha-LSL transcripts in roots, vegetative shoots, and inflorescence shoots. By contrast, in internodal stems and young leaves, a lower amount of Ha-LSL transcripts was observed. A comparison of transcription patterns between Ha-LSL and Ha-ROXL revealed some analogies but also remarkable differences; in fact, the gene Ha-ROXL displayed a low expression level in all organs analyzed. In situ hybridization (ISH) analysis showed that Ha-ROXL transcription was strongly restricted to a small domain within the boundary zone separating the shoot apical meristem (SAM) and the leaf primordia and in restricted regions of the inflorescence meristem, beforehand the separation of floral bracts from disc flower primordia. These results suggested that Ha-ROXL may be involved to establish a cell niche for the initiation of AMs as well as flower primordia. The accumulation of Ha-LSL transcripts was not restricted to the boundary zones in vegetative and inflorescence shoots, but the mRNA activity was expanded in other cellular domains of primary shoot apical meristem as well as AMs. In addition, Ha

  4. Determination of arterial wall shear stress

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The arteries can remodel their structure and function to adapt themselves to the mechanical environment. In various factors that lead to vascular remodeling, the shear stress on the arterial wall induced by the blood flow is of great importance. However, there are many technique difficulties in measuring the wall shear stress directly at present. In this paper, through analyzing the pulsatile blood flow in arteries, a method has been proposed that can determine the wall shear stress quantitatively by measuring the velocity on the arterial axis, and that provides a necessary means to discuss the influence of arterial wall shear stress on vascular remodeling.

  5. Trans-axillary retro-mammary gland route approach of video-assisted breast surgery can perform breast conserving surgery for cancers even in inner side of the breast

    Institute of Scientific and Technical Information of China (English)

    Koji Yamashita; Kazuo Shimizu

    2008-01-01

    Background The endoscopic surgery for inner-side cancer of the breast is usually performed by periareolar approach,but it often makes deformation or malposition of nipple and areola. The trans-axillary approach is favorable without making any injuries on breast skin. Furthermore, we devised a new approach of retro-mammary route without subcutaneous exfoliation, from axillary skin incision, to preserve skin touch sensation.Methods We have performed video-assisted breast surgery (VABS) on 200 patients since December 2001. The newly devised trans-axillary retromammary-route approach (TARM) was performed on 12 patients of early breast cancer. After endoscopic sentinel lymph node biopsy, we lengthened the axillary skin incision to 2.5 cm, and dissected retromammary tissue from superficial pectoral fascia onto major pectoral muscle below the tumor. The working space was made by lifting traction sutures through the gland. We cut the gland vertically at free margin 2 cm apart from the tumor edge, and dissect skin flap over the tumor. The breast reconstruction was done by filling absorbable fiber cotton.Results Traction sutures made it easier to cut the mammary gland vertically. We did not experience any skin damages like bum. All surgical margins were negative. The operation time was needed longer but the blood loss was not different.The postoperative esthetic results were good. The sensory disturbance was minimal. All patients were satisfied with this operation.Conclusion This newly devised TARM approach need no injury on whole breast, and can become a single standard method for breast conserving surgery wherever the cancer situated.

  6. Pulmonary Artery Intimal Sarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Joseph P. Kriz

    2016-04-01

    Full Text Available Pulmonary artery intimal sarcomas are rare and lethal malignant tumors that typically affect larger vessels: the aorta, inferior vena cava, and pulmonary arteries. Since symptoms and imaging of pulmonary arterial intimal sarcomas mimic pulmonary thromboembolism, the differential diagnosis of a patient presenting with chest pain, dyspnea, and filling defect within the pulmonary arteries should include intimal sarcoma. Often right ventricular failure is observed due to pulmonary hypertension caused by the obstructive effect of the tumor and concomitant chronic thromboembolism. We report the case of a 72-year-old African-American male with arterial intimal sarcoma of the left and right pulmonary artery with extension through the right artery into the bronchus and right lung.

  7. Location of foot arteries using infrared images

    Science.gov (United States)

    Villasenor-Mora, Carlos; González-Vega, Arturo; Martín Osmany Falcón, Antonio; Benítez Ferro, Jesús Francisco Guillemo; Córdova Fraga, Teodoro

    2014-11-01

    In this work are presented the results of localization of foot arteries, in a young group of participants by using infrared thermal images, these are the dorsal, posterior tibial and anterior tibial arteries. No inclusion criteria were considered, that causes that no strong statistical data about the influence of the age in the arterial localization. It was achieved to solve the confusion when veins present a heat distribution similar to the artery and in the position of this. it contributes to enhance the rate of location of arteries. In general it is possible to say that the use of infrared thermal images is a good technique to find the foot arteries and can be applied in its characterization in a future. The procedure proposed is a non-invasive technique, and in certain fashion does not requires specialized personnel to achieve locate the arteries. It is portable, safe, and relatively economical.

  8. Arterial endothelial function measurement method and apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Maltz, Jonathan S; Budinger, Thomas F

    2014-03-04

    A "relaxoscope" (100) detects the degree of arterial endothelial function. Impairment of arterial endothelial function is an early event in atherosclerosis and correlates with the major risk factors for cardiovascular disease. An artery (115), such as the brachial artery (BA) is measured for diameter before and after several minutes of either vasoconstriction or vasorelaxation. The change in arterial diameter is a measure of flow-mediated vasomodification (FMVM). The relaxoscope induces an artificial pulse (128) at a superficial radial artery (115) via a linear actuator (120). An ultrasonic Doppler stethoscope (130) detects this pulse 10-20 cm proximal to the point of pulse induction (125). The delay between pulse application and detection provides the pulse transit time (PTT). By measuring PTT before (160) and after arterial diameter change (170), FMVM may be measured based on the changes in PTT caused by changes in vessel caliber, smooth muscle tone and wall thickness.

  9. Physiologic assessment of coronary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, N.C.; Beauvais, J. (Creighton Univ., Omaha, NE (USA))

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  10. New Technologies in Coronary Artery Surgery

    Directory of Open Access Journals (Sweden)

    David Taggart

    2013-07-01

    Full Text Available Coronary artery disease remains the leading cause of death in developed countries. Major recent studies such as SYNTAX and FREEDOM have confirmed that coronary artery bypass grafting (CABG remains the gold standard treatment in terms of survival and freedom from myocardial infarction and the need for repeat revascularization. The current review explores the use of new technologies and future directions in coronary artery surgery, through 1 stressing the importance of multiple arterial conduits and especially the use of bilateral mammary artery; 2 discussing the advantages and disadvantages of off-pump coronary artery bypass; 3 presenting additional techniques, e.g. minimally invasive direct coronary artery bypass grafting, hybrid, and robotic-assisted CABG; and, finally, 4 debating a novel external stenting technique for saphenous vein grafts.

  11. Variant origin of right testicular artery – a rare case

    Directory of Open Access Journals (Sweden)

    Salve VM

    2010-02-01

    Full Text Available Testicular arterial anatomy is important for testicular and renal surgeries. It may vary at the origin and arise from renal artery, suprarenal artery or lumbar artery. During routine dissection of 52-year-old male cadaver; the right testicular artery arising from right aberrant renal artery was found. Anatomical variation of testicular arteries is reported to be 4.7%. Presence of aberrant renal artery is seen in 13–16% of cases only. The origin of right testicular artery from right aberrant renal artery is very rare. Thus knowledge of this type of variation is very important in avoiding complications during operative surgeries.

  12. Evaluation of renal artery stenosis using color Doppler sonography in young patients with multiple renal arteries

    Institute of Scientific and Technical Information of China (English)

    QIN Wei; ZHANG Xin; YANG Min; ZHONG Xu-hui; ZHAO Ming-hui

    2011-01-01

    Background Some individuals have multiple renal arteries. Severe stenosis in one of the arteries may cause refractory hypertension. The detection of stenosis within one of the multiple renal arteries usually required invasive procedures, such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA). This study reported the application of color Doppler sonography (CDS) in the detection of severe stenosis in one of the multiple arteries.Methods Patients with multiple renal arteries and one of the arteries with severe stenosis were retrospectively studied. Peak systolic velocities (PSV) of renal arteries and the intrarenal CDS patterns were collected and compared. The diagnosis was confirmed by digital subtraction angiography (DSA).Results Four children with multiple renal arteries and one of the arteries with stenosis were investigated. They were admitted due to refractory hypertension. CDS screening identified two renal arteries in one kidney of each patient with one of the two renal arteries having stenosis >70%. The PSV of the stenosed arteries were much higher, and the intrarenal CDS patterns supplied by the stenosed arteries changed into T-P patterns.Conclusion Non-invasive CDS technology may be a useful method to identify severe stenosis in one of multiple renal arteries in young patients.

  13. Immune Mechanisms in Arterial Hypertension.

    Science.gov (United States)

    Wenzel, Ulrich; Turner, Jan Eric; Krebs, Christian; Kurts, Christian; Harrison, David G; Ehmke, Heimo

    2016-03-01

    Traditionally, arterial hypertension and subsequent end-organ damage have been attributed to hemodynamic factors, but increasing evidence indicates that inflammation also contributes to the deleterious consequences of this disease. The immune system has evolved to prevent invasion of foreign organisms and to promote tissue healing after injury. However, this beneficial activity comes at a cost of collateral damage when the immune system overreacts to internal injury, such as prehypertension. Renal inflammation results in injury and impaired urinary sodium excretion, and vascular inflammation leads to endothelial dysfunction, increased vascular resistance, and arterial remodeling and stiffening. Notably, modulation of the immune response can reduce the severity of BP elevation and hypertensive end-organ damage in several animal models. Indeed, recent studies have improved our understanding of how the immune response affects the pathogenesis of arterial hypertension, but the remarkable advances in basic immunology made during the last few years still await translation to the field of hypertension. This review briefly summarizes recent advances in immunity and hypertension as well as hypertensive end-organ damage.

  14. Arterial calcification: friend or foe?

    Science.gov (United States)

    Nicoll, Rachel; Henein, Michael Y

    2013-07-31

    There is a significant relationship between the presence, extent and progression of coronary artery calcification (CAC) and cardiovascular (CV) events and mortality in both CV and renal patients and CAC scoring can provide improved predictive ability over risk factor scoring alone. There is also a close relationship between CAC presence and atherosclerotic plaque burden, with angiography studies showing very high sensitivity but poor specificity of CAC score for predicting obstructive disease. Nevertheless, there are objections to CAC screening because of uncertainties and lack of studies showing improved outcome. Furthermore, histopathology studies indicate that heavily calcified plaque is unlikely to result in a CV event, while the vulnerable plaque tends to be uncalcified or 'mixed', suggesting that calcification may be protective. This scenario highlights a number of paradoxes, which may indicate that the association between CAC and CV events is spurious, following from the adoption of CAC as a surrogate for high plaque burden, which itself is a surrogate for the presence of vulnerable plaque. Since studies indicate that arterial calcification is a complex, organised and regulated process similar to bone formation, there is no particular reason why it should be a reliable indicator of either the plaque burden or the risk of a future CV event. We suggest that it is time to divorce arterial calcification from atherosclerosis and to view it as a distinct pathology in its own right, albeit one which frequently coexists with atherosclerosis and is related to it for reasons which are not yet fully understood.

  15. Impedance matching at arterial bifurcations.

    Science.gov (United States)

    Brown, N

    1993-01-01

    Reflections of pulse waves will occur in arterial bifurcations unless the impedance is matched continuously through changing geometric and elastic properties. A theoretical model is presented which minimizes pulse wave reflection through bifurcations. The model accounts for the observed linear changes in area within the bifurcation, generalizes the theory to asymmetrical bifurcations, characterizes changes in elastic properties from parent to daughter arteries, and assesses the effect of branch angle on the mechanical properties of daughter vessels. In contradistinction to previous models, reflections cannot be minimized without changes in elastic properties through bifurcations. The theoretical model predicts that in bifurcations with area ratios (beta) less than 1.0 Young's moduli of daughter vessels may be less than that in the parent vessel if the Womersley parameter alpha in the parent vessel is less than 5. Larger area ratios in bifurcations are accompanied by greater increases in Young's moduli of branches. For an idealized symmetric aortic bifurcation (alpha = 10) with branching angles theta = 30 degrees (opening angle 60 degrees) Young's modulus of common iliac arteries relative to that of the distal abdominal aorta has an increase of 1.05, 1.68 and 2.25 for area ratio of 0.8, 1.0 and 1.15, respectively. These predictions are consistent with the observed increases in Young's moduli of peripheral vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Inflammation in coronary artery diseases

    Institute of Scientific and Technical Information of China (English)

    LI Jian-jun

    2011-01-01

    The concept that atherosclerosis is an inflammation has been increasingly recognized,and subsequently resulted in great interest in revealing the inflammatory nature of the atherosclerotic process.More recently,a large body of evidence has supported the idea that inflammatory mechanisms play a pivotal role throughout all phases of atherogenesis,from endothelial dysfunction and the formation of fatty streaks to plaque destabilization and the acute coronary events due to vulnerable plaque rupture.Indeed,although triggers and pathways of inflammation are probably multiple and vary in different clinical entities of atherosclerotic disorders,an imbalance between anti-inflammatory mechanisms and pro-inflammatory factors will result in an atherosclerotic progression.Vascular endothelial dysfunction and lipoprotein retention into the arterial intima have been reported as the earliest events in atherogenesis with which inflammation is linked.Inflammatory has also been extended to the disorders of coronary microvasculature,and associated with special subsets of coronary artery disease such as silent myocardial ischemia,myocardial ischemia-reperfusion,cardiac syndrome X,variant angina,coronary artery ectasia,coronary calcification and in-stent restenosis.Inflammatory biomarkers,originally studied to better understand the pathophysiology of atherosclerosis,have generated increasing interest among researches and clinicians.The identification of inflammatory biomarkers and cellular/molecular pathways in atherosclerotic disease represent important goals in cardiovascular disease research,in particular with respect of the development of therapeutic strategies to prevent or reverse atherosclerotic diseases.

  17. 腋下小切口在小儿脓胸手术中的临床应用%Clinical application of axillary small incision in pediatric pyothorax surgery

    Institute of Scientific and Technical Information of China (English)

    苏乃伟; 李新宁; 石群峰; 蒋琦培

    2012-01-01

    目的 探讨腋下小切口治疗小儿脓胸的临床应用价值.方法 回顾性分析我院2003年6月~2011年6月腋下小切口(24例)及后外侧切口(26例)手术治疗小儿脓胸患者的临床资料,并对治疗效果、手术情况及手术并发症等进行比较.结果 两组手术方式、手术时间及疗效差异无统计学意义(P > 0.05).两组术中出血量、术后引流量、胸管引流时间、止痛药的使用、肩部活动障碍、切口感染、切口长度及术后住院时间相比差异有统计学意义(P < 0.05).结论 腋下小切口治疗小儿脓胸疗效可靠,较传统切口手术胸壁损伤轻、出血少、术后并发症少、功能恢复好、切口隐蔽而美观,值得进一步推广应用.%Objective To investigate the clinical value of axillary small incision in the pediatric pyothorax surgery. Methods Clinical data of pediatric pyothorax undergoing surgical operation with axillary small incision (24 cases) and traditional posterolateral incision (26 cases) from June 2003 to June 2011 were retrospectively analyzed. The treatment effect, operation situation and complications were compared with each other. Results Two groups of patients were equally effective in curative effect, surgery way and operation time (P > 0.05). It was found that the intraoperative blood lose, drainage volume, drainage tube retention, the use of painkillers, shoulder activities obstacles, incision infection, incision length and postoperative hospital stay were significantly lower in axillary incision group than those of traditional posterolateral incision group (P < 0.05). Conclusion It is reliable that axillary small incision in pediatric pyothorax surgery compared with the traditional posterolateral incision, the axillary incision show benefits of less chest wall damage, less bleeding and postoperative complications, and faster functional recovery, incision concealed and beautiful, which can be used as worth further application.

  18. 右腋下小切口在小儿心内直视手术中的应用研究%Application of the right axillary incision in pediatric heart surgery

    Institute of Scientific and Technical Information of China (English)

    陈仁伟; 罗金文; 曾德斌; 阳广贤; 王敬华

    2014-01-01

    Objetive To compare the clinical data of open heart surgery using the right axillary incision with using median sternotomy incision,to explore the clinical effect of right axillary incision surgery for congeni-tal heart disease. Methods We have performed 102 cases of open heart surgery in the right axillary incision, and in median sternotomy incision respectively.They have similar primary diagnosis at the same period,were retrospectively analyzed since December 2012 to December 2013. Results The aortic clamping time,cardiop-ulmonary bypass time and operation time,the difference was not statistically significant (P>0.05).Mechanical ventilation time,24 h after drainage and postoperative hospital stay compared with right axillary incision superior median sternotomy,the difference was statistically significant (P<0.01).Conclusion The right axillary inci-sion can accomplished congenital heart heart surgery safely and effectively,rapid postoperative recovery,and good incision appearance.%目的:比较小儿右腋下小切口与胸骨正中切口行心内直视手术的临床资料,探讨右腋下小切口先心病手术的临床效果。方法我们自2012年12月至2013年12月实施右腋下小切口小儿心内直视手术102例,与同期胸骨正中切口手术主要诊断类似患儿102例比较,进行回顾性分析。结果两组主动脉阻断时间、体外循环时间及手术时间比较,差异无统计学意义(P>0.05)。呼吸机辅助通气时间、术后24 h引流量以及术后住院时间比较,右腋下小切口优于胸骨正中切口,差异有统计学意义(P<0.01)。结论采用右腋下小切口能安全有效地完成先心病心内直视手术,治疗效果好,术后恢复快,切口美观。

  19. [Bilateral coronary artery-pulmonary artery fistulas in a case with unstable angina pectoris].

    Science.gov (United States)

    Kepez, Alper; Kaya, Ergün Bariş; Aytemir, Kudret; Oto, Ali

    2008-03-01

    Bilateral coronary artery fistulas originating from both right and left coronary arteries are rare congenital abnormalities. A 58-year-old man presented with chest pain unrelated to exertion. Coronary angiography showed a fistula originating from the level of the first diagonal branch of the left anterior descending (LAD) coronary artery and a 95% stenosis just distal to the fistula. Right coronary angiography showed another fistula originating from the ostium of the right coronary artery. Both fistulas drained into the pulmonary artery. Coronary bypass surgery was performed for the LAD lesion using the left internal mammary artery graft, during which both fistulas were ligated. No complications were encountered postoperatively.

  20. A Rare Case of Triple Coronary Artery Fistulae Originating from Left Main and Right Coronary Arteries

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Elbey

    2012-10-01

    Full Text Available ABSTRACTDual coronary artery fistulae (CAF involving both right and left coronary trees are uncommon; accounting for only 5% of all CAFs. A 48-year-old male patient was admitted to our institution for evaluation of chest pain. The coronary angiography revealed fistulae from left main coronary artery (LMCA and right coronary artery (RCA to the pulmonary artery. We concluded that angina pectoris was caused by a steal phenomenon and the patient was recommended surgical intervention. To our knowledge, this is the first paper reporting three fistulae associated with multiple aneurysms originating from proximal coronary arteries, which were connected to the pulmonary artery.

  1. Superficial Ulnar Artery Associated with Anomalous Origin of the Common Interosseous and Ulnar Recurrent Arteries

    Science.gov (United States)

    Pamidi, Narendra; Nayak, Satheesha B; Jetti, Raghu; Thangarajan, Rajesh

    2016-01-01

    Occurrence of vascular variations in the upper limb is not uncommon and is well described in the medical literature. However, occurrence of superficial ulnar artery associated with unusual origin of the common interosseous and ulnar recurrent arteries is seldom reported in the literature. In the present case, we report the anomalous origin of common trunk of common interosseous, anterior and posterior ulnar recurrent arteries from the radial artery, in a male cadaver. Further, ulnar artery had presented superficial course. Knowledge of anomalous arterial pattern in the cubital fossa reported here is clinically important during the angiographic procedures and plastic surgeries. PMID:27437201

  2. Hereditary and environmental influences on arterial function.

    Science.gov (United States)

    Hayward, C S; Benetos, A

    2007-07-01

    1. With the ageing population and increasing heart failure, arterial function has been shown to contribute to cardiovascular risk because of its adverse effects on ventriculovascular coupling. Population studies have confirmed independent prognostic information of arterial stiffening on cardiovascular survival. 2. The term 'arterial function' encompasses a range of phenotypes, including measures of arterial structure/remodelling, measures of arterial wall mechanics, surrogate measures of stiffness and of wave reflection. There exists significant interaction between these measures and none is truly independent of the others. Added to this complexity is the recognition that, although arterial function has a strong genetic component, quantification requires a range of techniques from twin to family and population studies. 3. The contribution of heritability is often derived from statistical models with input from genomic scanning and candidate gene studies. Studies to date confirm a significant heritable component for the majority of phenotypes examined. However, it has also been recognized that the factors involved in blood pressure maintenance are likely to be separate to those in arterial structural degeneration with ageing. Candidate genes for arterial function go beyond those of the sympathetic and renin-angiotensin systems and include genes involved in signalling pathways and extracellular matrix modulation. 4. The present review examines the evidence for heritability of the major arterial function phenotypes with environmental and ageing modulation. A brief overview of the impact of atherosclerotic risk factors on arterial function is included.

  3. Assessment of conduit artery vasomotion using photoplethysmography

    Science.gov (United States)

    Kanders, Karlis; Grabovskis, Andris; Marcinkevics, Zbignevs; Aivars, Juris Imants

    2013-11-01

    Vasomotion is a spontaneous oscillation of vascular tone. The phenomenon has been observed in small arterioles and capillaries as well as in the large conduit arteries. The layer of smooth muscle cells that surrounds a blood vessel can spontaneously and periodically change its tension and thereby the arterial wall stiffness also changes. As the understanding of the phenomenon is still rather obscure, researchers would benefit from a low-cost and reliable investigation technique such as photoplethysmography (PPG). PPG is an optical blood pulsation measurement technique that can offer substantial information about the arterial stiffness. The aims of this pilot study were to evaluate the usefulness of the PPG technique in the research of vasomotion and to investigate vasomotion in the relatively large conduit arteries. Continuous 15 minute long measurements of posterior tibial artery wall stiffness were taken. Artery diameter, electrocardiogram, blood pressure and respiration were also simultaneously registered. Fast Fourier Transform power spectra were calculated to identify unique stiffness oscillations that did not correspond to fluctuations in the systemic parameters and thus would indicate vasomotion. We concluded that photoplethysmography is a convenient method for the research of the vasomotion in large arteries. Local stiffness parameter b/a is more accurate to use and easier to measure than the pulse wave velocity which describes stiffness of a segment of an artery. Conduit arteries might exhibit a low amplitude high frequency vasomotion ( 9 to 27 cycles per minute). Low frequency vasomotion is problematic to distinguish from the passive oscillations imposed by the arterial pressure.

  4. Intracranial cerebral artery stenosis with associated coronary artery and extracranial carotid artery stenosis in Turkish patients

    Energy Technology Data Exchange (ETDEWEB)

    Alkan, Ozlem [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey)], E-mail: yalinozlem@hotmail.com; Kizilkilic, Osman; Yildirim, Tulin [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey); Atalay, Hakan [Department of Cardiovascular Surgery, Baskent University, Faculty of Medicine, Ankara (Turkey)

    2009-09-15

    Purpose: Although it has been demonstrated that there is a high prevalence of extracranial carotid artery stenosis (ECAS) in patients with severe coronary artery disease, intracranial cerebral artery stenosis (ICAS) is rarely mentioned. We evaluated the prevalence of ICAS in patients with ECAS having elective coronary artery bypass grafting (CABG) surgery to determine the relations between ICAS, ECAS and atherosclerotic risk factors. Methods: We retrospectively reviewed the digital subtraction angiography findings of 183 patients with ECAS {>=} 50% preparing for CABG surgery. The analyses focused on the intracranial or extracranial location and degree of the stenosis. The degree of extracranial stenoses were categorized as normal, <50%, 50-69%, 70-89%, and 90-99% stenosis and occluded. The degree of intracranial stenosis was classified as normal or {<=}25%, 25-49%, and {>=}50% stenosis and occluded. Traditional atherosclerotic risk factors were recorded. Results: ECAS < 70% in 42 patients and ECAS {>=} 70% in 141 patients. ICAS was found in 51 patients and ICAS {>=} 50% in 30 patients. Regarding risk factors, we found hypertension in 135 patients, diabetes mellitus in 91 patients, hyperlipidemia in 84 patients, and smoking in 81 patients. No risk factor was significant predictors of intracranial atherosclerosis. The severity of ICAS was not significantly associated with that of the ECAS. Conclusions: We found ICAS in 27.8% of the patients with ECAS > 50% on digital subtraction angiography preparing for CABG. Therefore a complete evaluation of the neck vessels with magnetic resonance or catheter angiography seems to be indicated as well as intracranial circulation for the risk assessment of CABG.

  5. Right Gastroepiploic Artery as an Alternative for Arterial Reconstruction in Living Donor Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Klaus Steinbrück

    2014-01-01

    Full Text Available Background. An adequate blood flow is directly related to graft survival in living donor liver transplantation. However, in some cases, unfavorable conditions prevent the use of the hepatic artery for arterial reconstruction. Herein, we report a case in which the recipient right gastroepiploic artery was used as an option for arterial reconstruction in adult-to-adult living donor liver transplantation. Case Report. A 62-year-old woman, with cirrhosis due to hepatitis B associated with hepatocellular carcinoma, was submitted to living donor liver transplantation. During surgery, thrombosis of the hepatic artery with intimal dissection until the celiac trunk was observed, which precluded its use in arterial reconstruction. We decided to use the right gastroepiploic artery for arterial revascularization of the liver graft. Despite the discrepancy in size between donor hepatic artery and recipient right gastroepiploic artery, anastomosis was performed successfully. Conclusions. The use of the right gastroepiploic artery as an alternative for arterial revascularization of the liver graft in living donor liver transplantation should always be considered when the hepatic artery of the recipient cannot be used. For performing this type of procedure, familiarity with microsurgical techniques by the surgical team is necessary.

  6. Anatomy of the Ophthalmic Artery: Embryological Consideration

    Science.gov (United States)

    TOMA, Naoki

    2016-01-01

    There are considerable variations in the anatomy of the human ophthalmic artery (OphA), such as anomalous origins of the OphA and anastomoses between the OphA and the adjacent arteries. These anatomical variations seem to attribute to complex embryology of the OphA. In human embryos and fetuses, primitive dorsal and ventral ophthalmic arteries (PDOphA and PVOphA) form the ocular branches, and the supraorbital division of the stapedial artery forms the orbital branches of the OphA, and then numerous anastomoses between the internal carotid artery (ICA) and the external carotid artery (ECA) systems emerge in connection with the OphA. These developmental processes can produce anatomical variations of the OphA, and we should notice these variations for neurosurgical and neurointerventional procedures. PMID:27298261

  7. Permanent Cortical Blindness After Bronchial Artery Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Doorn, Colette S. van, E-mail: cvandoorn@gmail.com; De Boo, Diederick W., E-mail: d.w.deboo@amc.uva.nl [Academic Medical Centre, Department of Radiology (Netherlands); Weersink, Els J. M., E-mail: e.j.m.weersink@amc.uva.nl [Academic Medical Centre, Department of Pulmonology (Netherlands); Delden, Otto M. van, E-mail: o.m.vandelden@amc.uva.nl; Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl; Lienden, Krijn P. van, E-mail: k.p.vanlienden@amc.uva.nl [Academic Medical Centre, Department of Radiology (Netherlands)

    2013-12-15

    A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.

  8. Permanent cortical blindness after bronchial artery embolization.

    Science.gov (United States)

    van Doorn, Colette S; De Boo, Diederick W; Weersink, Els J M; van Delden, Otto M; Reekers, Jim A; van Lienden, Krijn P

    2013-12-01

    A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.

  9. Segmented Coronary Artery Aneurysms and Kawasaki Disease

    Directory of Open Access Journals (Sweden)

    Hamid Reza Ghaemi

    2011-05-01

    Full Text Available Kawasaki disease (KD is an acute vasculitis syndrome of unknown etiology. It occurs in infants and young children,affecting mainly small and medium-sized arteries, particularly the coronary arteries. Generalized microvasculitis occurs in the first 10 days, and the inflammation persists in the walls of medium and small arteries, especially the coronary arteries, and changes to coronary artery aneurysms.We report the case of a 10-month-old girl referred to our center three months after the onset of disease due to the aneurysmsof the coronary arteries. During the acute phase of her illness, she received 2 gr/kg intravenous gamma globulin; and afterher referral to us, the patient was treated by antiaggregant doses of acetylsalicylic acid (ASA (5 mg/kg and Warfarin (1 mg/daily. At three months’ follow-up, the aneurysms still persisted in the echocardiogram.

  10. Transarterial embolization of acute intercostal artery bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Ik; Park, Auh Whan; Lee, Seon Joo [Inje University College of Medicine, Busan (Korea, Republic of); Ko, Gi Young; Yoon, Hyun Ki [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yoon, Chang Jin [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Shin, Tae Beom [Donga University College of Medicine, Busan (Korea, Republic of); Kim, Young Hwan [Kyimyung University School of Medicine, Daegu (Korea, Republic of)

    2005-09-15

    To report our experiences of transarterial embolization for acute intercostal artery bleeding. A retrospectively analysis of the causes, clinical manifestations, angiographic findings and transarterial embolization technique in 8 patients with acute intercostal artery bleeding, with a review of the anatomical basis. The causes of intercostal artery bleeding were iatrogenic and traumatic in 88 and 12% of cases, respectively. Active bleeding from the collateral intercostal or posterior intercostal arteries was angiographically demonstrated in 75 and 25% of cases, respectively. Transarterial embolization successfully achieved hemostasis in all cases. However, two patient with hypovolemic shock expired due to a massive hemothorax, despite successful transarterial embolization. Intercostal access should be performed through the middle of the intercostal space to avoid injury to the collateral intercostal artery. Transarterial embolization is an effective method for the control of intercostal artery bleeding.

  11. Aberrant overian artery originating from the Ilolumbar artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Eun; Lee, Jae Myeong [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2016-05-15

    Here, we report a case of a 30-year-old woman who presented with primary postpartum hemorrhage due to uterine atony. She received uterine artery embolization (UAE). During left internal iliac arteriography, an aberrant left ovarian artery originating from the left iliolumbar artery was visualized. The aberrant left ovarian artery was connected to the left uterine artery via prominent collateral vessels. It supplied a significant amount of blood to the fundus of the uterus. Bilateral hypertrophied uterine arteries were embolized very carefully so that the embolic material did not reflux into the aberrant left ovarian artery. After the procedure, her vaginal bleeding was successfully controlled. Accurate understanding of anatomical variations of the ovarian artery is essential to avoid failure in controlling postpartum hemorrhage with UAE.

  12. Coronary Artery Bypass Grafting (CABG) Dengan Menggunakan Vena Saphenous, Arteri Mammaria Interna

    OpenAIRE

    Lita Feriyawati

    2006-01-01

    Coronary Artery Bypass Grafting (CABG) merupakan salahsatu penanganan intervensi dari Penyakit Jantung Koroner (PJK), dengan cara membuat saluran baru melewati bagian Arteri Coronaria yang mengalami penyempitan atau penyumbatan, oleh Lita Feriyawati 06001193

  13. 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.

  14. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  15. Carotid artery stenting in patients with coexistent carotid and coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    LUO Jian-fang; HUANG Wen-hui; WANG Shuo; DAI Cheng-bo; LI Guang; CHEN Ji-yan; ZHOU Ying-ling; WANG Li-juan

    2007-01-01

    @@ Atherosclerotic disease, as a systemic process, affects all arteries to varying degrees. In particular,coexistent carotid and coronary artery diseases are common; Management of such patients has been a point of continuing controversy.

  16. Arterial hypertension in cirrhosis: arterial compliance, volume distribution, and central haemodynamics

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Fuglsang, S; Bendtsen, F;

    2006-01-01

    were 130 normotensive cirrhotic patients, 19 controls with normal arterial blood pressure and without liver disease, and 16 patients with essential arterial hypertension. All groups underwent haemodynamic investigation with determination of cardiac output (CO), plasma volume (PV), central blood volume...

  17. Multiple coarctation of the pulmonary artery

    Energy Technology Data Exchange (ETDEWEB)

    Dicle, Oguz; Yilmaz, Erkan E-mail: eyilmaz@kordon.deu.edu.tr

    2000-12-01

    Pulmonary artery coarctation is a rare congenital anomaly characterized by single or multiple stenoses of the pulmonary arteries and their branches. There are only a few reports describing the radiological film of this entity. In this paper we report the case of a 68 year-old woman who presented with dyspnea. The scintigraphic, examination of the lungs gave the misleading impression of pulmonary embolism, and only angiography and magnetic resonance imaging established the correct diagnosis of multiple coarctations of the pulmonary artery.

  18. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  19. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K;

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation. T....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  20. [Prosthesis interposition in the case of subclavian artery transposition].

    Science.gov (United States)

    György, G; Acosta Alvarez, P

    1993-01-01

    When we can't realize the reimplantation because of technical difficulties, special cases are presented during transposition from the subclavian artery to the primitive carotid artery. In these cases, between primitive carotid artery and the subclavian artery and also the vertebral artery, Gore-tex's tubes were implanted with favourable results.

  1. Hemoptysis and pulmonary artery agenesis: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Lopez-Majano, V.; Sobti, P.

    1985-08-01

    The combination of a pulmonary scintigram using radioactively labeled albumin macroaggregates (MAA) and a study of the circulation in the bronchial artery was performed in one patient. This noninvasive methodology showed that there was increased circulation to the vascular territory of the lung in which the pulmonary artery was missing. This could have resulted from abnormal communications between the bronchial artery and the pulmonary vessels or an increased blood supply to the right lung from bronchial arteries arising from the aorta. The absence of pulmonary circulation in the right lung was proved by the absence of radioactivity in the right lung after an intravenous injection of labeled albumin MAA.

  2. Dual (type IV left anterior descending artery

    Directory of Open Access Journals (Sweden)

    Ozdil Baskan

    2013-11-01

    Full Text Available Congenital coronary artery anomalies are uncommon. Dual left anterior descending coronary artery (LAD is defined as the presence of two LADs within the anterior interventricular sulcus (AIVS, and is classified into four types. Type IV is a rarely reported subtype and differs from the others, with a long LAD originating from the right coronary artery (RCA. Dual LAD is a benign coronary artery anomaly, but should be recognised especially before interventional procedures. With the increasing use of multidedector computed tomography (MDCT, it is essential for radiologists to be aware of this entity and the cross-sectional findings.

  3. Continuous blood gas monitoring in femoral arteries

    Science.gov (United States)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart

    1995-05-01

    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  4. TRAS principles blight arterial bypass and plasty.

    Directory of Open Access Journals (Sweden)

    Kothari M

    1997-04-01

    Full Text Available A new concept--Tissue Requisitions (Principle I/Relinquishes (Principle II Arterial Supply--of TRAS principles is introduced to help appreciate the failures/successes of modern medicine′s attempts at restoring arterial flow in luminally compromised coronary/carotid fields, an invasive branch rightly called vascular ReRheology, which comprises diagnosing/treating arterial blocks. The technical wizardry of arterial reconstruction (bypass or lumen--restoration (plasty has to reckon with the TRAS principles all the time.

  5. Transcatheter Arterial Embolization of Cystic Artery Pseudoaneurysm in Acalculous Cholecystitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyung Ook; Lee, Young Hwan [Dept. of Radiology, Daegu Catholic University College of Medicine, Daegu (Korea, Republic of); Kim, Young Hwan [Dept. of Diagnostic Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-04-15

    A pseudoaneurysm of the cystic artery is a rare complication of cholecystitis, and is manifested by hemobilia or hematemesis. An early diagnosis is required for the successful treatment by cholecystectomy and ligation of the cystic artery. Herein, we report a case of a pseudoaneurysm of the cystic artery diagnosed by color Doppler ultrasonography and CT, and successfully treated by transcatheter arterial embolization with N-butyl cyanoacrylate in a high-risk surgical patient.

  6. Atypical presentation of popliteal artery entrapment syndrome: involvement of the anterior tibial artery.

    Science.gov (United States)

    Bou, Steven; Day, Carly

    2014-11-01

    Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain. We report the case of an 18-year-old female volleyball player with bilateral exertional lower extremity pain who had been previously diagnosed with tendinitis and periostitis. Diagnostic studies showed entrapment of the left popliteal artery and the left anterior tibial artery. To our knowledge, there has only been 1 previous report of anterior tibial artery involvement in PAES.

  7. Electronic database of arterial aneurysms

    Directory of Open Access Journals (Sweden)

    Fabiano Luiz Erzinger

    2014-12-01

    Full Text Available Background:The creation of an electronic database facilitates the storage of information, as well as streamlines the exchange of data, making easier the exchange of knowledge for future research.Objective:To construct an electronic database containing comprehensive and up-to-date clinical and surgical data on the most common arterial aneurysms, to help advance scientific research.Methods:The most important specialist textbooks and articles found in journals and on internet databases were reviewed in order to define the basic structure of the protocol. Data were computerized using the SINPE© system for integrated electronic protocols and tested in a pilot study.Results:The data entered onto the system was first used to create a Master protocol, organized into a structure of top-level directories covering a large proportion of the content on vascular diseases as follows: patient history; physical examination; supplementary tests and examinations; diagnosis; treatment; and clinical course. By selecting items from the Master protocol, Specific protocols were then created for the 22 arterial sites most often involved by aneurysms. The program provides a method for collection of data on patients including clinical characteristics (patient history and physical examination, supplementary tests and examinations, treatments received and follow-up care after treatment. Any information of interest on these patients that is contained in the protocol can then be used to query the database and select data for studies.Conclusions:It proved possible to construct a database of clinical and surgical data on the arterial aneurysms of greatest interest and, by adapting the data to specific software, the database was integrated into the SINPE© system, thereby providing a standardized method for collection of data on these patients and tools for retrieving this information in an organized manner for use in scientific studies.

  8. Arterial Windkessels in marine mammals.

    Science.gov (United States)

    Shadwick, R E; Gosline, J M

    1995-01-01

    In marine mammals, the aortic arch is enlarged relative to the descending aorta to varying degrees in different species. The ratio of maximal diameter of the arch to that of the thoracic aorta is about 2.3 in the harbour seal (Phoca vitulina), 3.6 in the Weddell seal (Leptonychotes weddelli) and 3.2 in the fin whale (Balaenoptera physalus), compared with only 1.4 in the dog. This anatomical specialisation probably provides increased volume capacitance in the arterial circulation as an adaptation to diving bradycardia. Data on the morphometric and mechanical properties of aortic tissues from seals and fin whale are compared. In the harbour seal, more than 80% of the volume change in the entire thoracic aorta that results from a pressure pulse occurs in the bulbous arch, and this is more than 90% in the Weddell seal and fin whale. The enhanced capacitance of the arch in the harbour seal is primarily due to its larger diameter, as the relative wall thickness and elasticity of the arch and thoracic aorta are the same. A similar situation appears to exist in the larger Weddell seal, although extrapolation of the pressure-volume curves suggests that the arch might be somewhat less stiff than the thoracic aorta. In addition to being greatly expanded, the aortic arch of the fin whale is also much more distensible than the relatively thin-walled and much stiffer descending aorta. At the estimated mean blood pressure, the elastic modulus of this vessel is 12 MPa, or 30 times that of the aortic arch. The major haemodynamic consequence of this type of arterial modification is that the aortic arch acts as a Windkessel, i.e. the capacitance of the aorta is increased significantly close to the heart, leading to a reduced characteristic impedance and probably reduced pulsatility in the descending aorta. In the extreme case of the whale, the arterial capacitance is shifted entirely to the arch, and the impedance change at the entrance to the thoracic aorta is so high that this

  9. Electroencephalograms in basilar artery migraine.

    Science.gov (United States)

    Parain, D; Samson-Dollfus, D

    1984-11-01

    Nine cases of 'basilar artery migraine' (BAM) have been recorded. In 8 cases, excess of beta activity was observed during the attacks and disappeared in less than 3 days. The inter-ictal EEGs were normal. Drug ingestion was excluded each time. These EEG patterns are different from those which have been reported in the literature, i.e., transitory posterior abnormal slow waves. However, case no.1 is in agreement with the literature. The expression 'BAM' probably covers different syndromes which are further discussed.

  10. 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.

  11. Arterial elastance and heart-arterial coupling in aortic regurgitation are determined by aortic leak severity

    NARCIS (Netherlands)

    Segers, P; Morimont, P; Kolh, P; Stergiopulos, N; Westerhof, N; Verdonck, P

    2002-01-01

    Background In aortic valve regurgitation (AR), aortic leak severity modulates left ventricle (LV) arterial system interaction. The aim of this study was to assess (1) how arterial elastance (E-a), calculated as the ratio of LV end-systolic pressure and stroke volume, relates to arterial properties a

  12. Study on the screening program and risk factors of carotid artery stenosis with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李庆祥

    2013-01-01

    Objective The purpose of this research project was to evaluate the relationship and risk factors between coronary artery disease and carotid artery stenosis (CAS) ,screened by duplex ultra-sonography.Methods 1339 patients with coronary artery disease were enrolled into this

  13. Vertebral artery stenosis in the Basilar Artery International Cooperation Study (BASICS): prevalence and outcome

    NARCIS (Netherlands)

    Compter, A.; Hoeven, E.J. van der; Worp, H.B. van der; Vos, J.A.; Weimar, C.; Rueckert, C.M.; Kappelle, L.J.; Algra, A.; Schonewille, W.J.; Leeuw, F.E. de

    2015-01-01

    We assessed the prevalence of vertebral artery (VA) stenosis or occlusion and its influence on outcome in patients with acute basilar artery occlusion (BAO). We studied 141 patients with acute BAO enrolled in the Basilar Artery International Cooperation Study (BASICS) registry of whom baseline CT an

  14. Vertebral artery stenosis in the Basilar Artery International Cooperation Study (BASICS) : prevalence and outcome

    NARCIS (Netherlands)

    Compter, Annette; van der Hoeven, Erik J R J; van der Worp, H. Bart; Vos, Jan Albert; Weimar, Christian; Rueckert, Christina M.; Kappelle, L. Jaap; Algra, Ale; Schonewille, Wouter J.; Vergouwen, MD

    2015-01-01

    We assessed the prevalence of vertebral artery (VA) stenosis or occlusion and its influence on outcome in patients with acute basilar artery occlusion (BAO). We studied 141 patients with acute BAO enrolled in the Basilar Artery International Cooperation Study (BASICS) registry of whom baseline CT an

  15. Carotid artery stenting by non-femoral arterial approach in patients with difficult anatomy

    Directory of Open Access Journals (Sweden)

    R V Narayana

    2013-01-01

    Full Text Available Background: Carotid endarterectomy (CEA and carotid artery stenting (CAS are safe, effective, and standard methods to treat significant carotid artery stenosis. CAS is generally performed through femoral arterial access. We had six patients with significant carotid artery stenosis, who had difficult anatomy prohibiting a trans-femoral CAS. Those patients were given an option for CEA. However, they refused for surgical intervention. Aim: We investigated the feasibility of performing CAS from a non-femoral arterial approach in patients with difficult anatomies like severe aortic/aorto-iliac disease, tortuous aortic arch, and tortuous carotid artery origin. Materials and Methods: Six patients with difficult anatomy presented to us with either transient ischemic attack or stroke with high-grade carotid artery stenosis. Out of the six patients, three had aorto-iliac disease, one had high-grade coarctation of aorta, two had tortuous aortic arch and or tortuous carotid artery origin. All these patients were treated with CAS though non-femoral arterial route. Results: CAS could be done successfully in all these six patients; four of them were done through trans-brachial arterial route and two were done through a direct carotid artery puncture. There were no new neurological deficits seen in any of the patient post-procedure. Conclusion: CAS can be done safely through non-femoral arterial approach in patients with difficult anatomy.

  16. 乳腺癌腋窝淋巴结转移的多因素分析%Multiple factors analysis of axillary lymph node metastasis of breast cancer

    Institute of Scientific and Technical Information of China (English)

    刘敏; 刘德权; 杨延林

    2014-01-01

    To study the relation between metastasis of breast cancer and age,nationality,age of menar-che,the first child - bearing age,pausimenia,the age of menopause,the course of disease,numbers of pregnancies,the site of the tumor,tumor size(ultrasonic,mammography,MRI),time of nursing,pathological type,ER,PR,the expres-sion of C - erbB - 2 gene. Methods:Make retrospective analysis for 365 cases of breast cancer patients who have been proved by pathology. Results:There were 228 metastases cases(64% )in 365 cases and 128(36% )cases haven't transfered. There were relationships(P ﹤ 0. 05)between axillary lymph node metastasis and the first child - bearing age,numbers of pregnancies,time of nursing,the course of disease,tumor size(ultrasonic,mammograph,MRI meas-ured value),the site of the tumor,pathological type,P values were 0. 007,0. 005,0. 006,0. 022,(0. 001,0. 000, 0. 020),0. 009,0. 000. Conclusion:Multiple factors influence axillary lymph node metastasis.%目的:研究乳腺癌腋窝淋巴结转移与年龄、民族、初潮年龄、第一胎生育年龄、绝经、绝经年龄、病程、哺乳时间、妊娠次数、肿瘤部位、肿瘤大小(B 超、钼靶、MRI 分别测值)、病理分型、雌激素受体(ER)、孕激素受体(PR)、C - erbB -2基因表达之间的关系及规律,为乳腺癌手术中腋窝淋巴结清扫术的指征提供理论依据。方法:回顾性分析356例乳腺癌患者的临床资料。结果:腋窝淋巴结转移228例(64%),无转移128例(36%);腋窝淋巴结转移与第一胎生育年龄、妊娠次数、哺乳时间、病程、肿瘤大小(B 超、钼靶、MRI)、肿瘤部位、病理类型相关(P ﹤0.05),P 值分别为0.007、0.005、0.006、0.022、(0.001、0.000、0.020)、0.009、0.000。结论:腋窝淋巴结的转移受多种因素影响。

  17. Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Su Jeong [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of); Hallym University Medical Center, Department of Radiology, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of)

    2016-11-15

    To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease. A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group. The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039). Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group. (orig.)

  18. Postmastectomy irradiation in breast in breast cancer patients with T1-2 and 1-3 positive axillary lymph nodes: Is there a role for radiation therapy?

    Directory of Open Access Journals (Sweden)

    Sezer Atakan

    2011-03-01

    Full Text Available Abstract Background We aimed to evaluate retrospectively the correlation of loco-regional relapse (LRR rate, distant metastasis (DM rate, disease free survival (DFS and overall survival (OS in a group of breast cancer (BC patients who are at intermediate risk for LRR (T1-2 tumor and 1-3 positive axillary nodes treated with or without postmastectomy radiotherapy (PMRT following modified radical mastectomy (MRM. Methods Ninety patients, with T1-T2 tumor, and 1-3 positive nodes who had undergone MRM received adjuvant systemic therapy with (n = 66 or without (n = 24 PMRT. Patient-related characteristics (age, menopausal status, pathological stage/tumor size, tumor location, histology, estrogen/progesterone receptor status, histological grade, nuclear grade, extracapsular extension, lymphatic, vascular and perineural invasion and ratio of involved nodes/dissected nodes and treatment-related factors (PMRT, chemotherapy and hormonal therapy were evaluated in terms of LRR and DM rate. The 5-year Kaplan-Meier DFS and OS rates were analysed. Results Differences between RT and no-RT groups were statistically significant for all comparisons in favor of RT group except OS: LRR rate (3%vs 17%, p = 0.038, DM rate (12% vs 42%, p = 0.004, 5 year DFS (82.4% vs 52.4%, p = 0.034, 5 year OS (90,2% vs 61,9%, p = 0.087. In multivariate analysis DM and lymphatic invasion were independent poor prognostic factors for OS. Conclusion PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval.

  19. Lymph Drainage Studied by Lymphoscintigraphy in the Arms after Sentinel Node Biopsy Compared with Axillary Lymph Node Dissection Following Conservative Breast Cancer Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Celebioglu, F.; Perbeck, L.; Frisell, J.; Groendal, E.; Svensson, L.; Danielsson, R. [Dept. of Molecular Medicine and Surgery, Karolinska Inst., Karolinska Univ Hospital Solna, Stockholm (Sweden)

    2007-07-15

    Purpose: To investigate lymphatic drainage as measured by lymphoscintigraphy in the arms of patients undergoing either sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND). Material and Methods: From January 2001 to December 2002, 30 patients with unilateral invasive breast carcinoma underwent breast-conserving surgery with SNB and 30 patients with ALND. All patients received radiotherapy to the breast. Lymphoscintigraphy was performed, and skin circulation, skin temperature, and arm volume were measured 2-3 years after radiotherapy. Results: None of the 30 patients who underwent SNB showed any clinical manifestation of lymphedema. Of the 30 patients undergoing ALND, six (20%) had clinical lymphedema, with an arm volume that was >10% larger on the operated than on the non-operated side (P<0.01). Scintigraphically, visual analysis revealed lymphatic dysfunction in three patients, manifested as forearm dermal back flow. Two of these patients also had an increased arm volume. Quantitative analysis showed no differences between the groups, apart from a smaller amount of isotope in the axilla in the ALND group. There was no difference in skin circulation or skin temperature. Conclusion: Our study shows that lymph drainage in the operated arm compared with the non-operated arm was less affected by SNB than by ALND, and that morbidity associated with SNB was lower than with ALND. However, the results do not confirm our hypothesis that lymphoscintigraphy can reveal differences in lymph circulation that are not evident clinically in the form of manifest lymphedema. The most sensitive clinical method of assessing lymph drainage seems to be measurement of arm volume.

  20. Optimized Volumetric Modulated Arc Therapy Versus 3D-CRT for Early Stage Mediastinal Hodgkin Lymphoma Without Axillary Involvement: A Comparison of Second Cancers and Heart Disease Risk

    Energy Technology Data Exchange (ETDEWEB)

    Filippi, Andrea Riccardo, E-mail: andreariccardo.filippi@unito.it [Department of Oncology, Radiation Oncology, University of Torino, Torino (Italy); Ragona, Riccardo; Piva, Cristina; Scafa, Davide; Fiandra, Christian [Department of Oncology, Radiation Oncology, University of Torino, Torino (Italy); Fusella, Marco; Giglioli, Francesca Romana [Medical Physics, AOU Città della Salute e della Scienza Hospital, Torino (Italy); Lohr, Frank [Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim (Germany); Ricardi, Umberto [Department of Oncology, Radiation Oncology, University of Torino, Torino (Italy)

    2015-05-01

    Purpose: The purpose of this study was to evaluate the risks of second cancers and cardiovascular diseases associated with an optimized volumetric modulated arc therapy (VMAT) planning solution in a selected cohort of stage I/II Hodgkin lymphoma (HL) patients treated with either involved-node or involved-site radiation therapy in comparison with 3-dimensional conformal radiation therapy (3D-CRT). Methods and Materials: Thirty-eight patients (13 males and 25 females) were included. Disease extent was mediastinum alone (n=8, 21.1%); mediastinum plus unilateral neck (n=19, 50%); mediastinum plus bilateral neck (n=11, 29.9%). Prescription dose was 30 Gy in 2-Gy fractions. Only 5 patients had mediastinal bulky disease at diagnosis (13.1%). Anteroposterior 3D-CRT was compared with a multiarc optimized VMAT solution. Lung, breast, and thyroid cancer risks were estimated by calculating a lifetime attributable risk (LAR), with a LAR ratio (LAR{sub VMAT}-to-LAR{sub 3D-CRT}) as a comparative measure. Cardiac toxicity risks were estimated by calculating absolute excess risk (AER). Results: The LAR ratio favored 3D-CRT for lung cancer induction risk in mediastinal alone (P=.004) and mediastinal plus unilateral neck (P=.02) presentations. LAR ratio for breast cancer was lower for VMAT in mediastinal plus bilateral neck presentations (P=.02), without differences for other sites. For thyroid cancer, no significant differences were observed, regardless of anatomical presentation. A significantly lower AER of cardiac (P=.038) and valvular diseases (P<.0001) was observed for VMAT regardless of disease extent. Conclusions: In a cohort of patients with favorable characteristics in terms of disease extent at diagnosis (large prevalence of nonbulky presentations without axillary involvement), optimized VMAT reduced heart disease risk with comparable risks of thyroid and breast cancer, with an increase in lung cancer induction probability. The results are however strongly influenced by

  1. A GRAS-like gene of sunflower (Helianthus annuus L.) alters the gibberellin content and axillary meristem outgrowth in transgenic Arabidopsis plants.

    Science.gov (United States)

    Fambrini, M; Mariotti, L; Parlanti, S; Salvini, M; Pugliesi, C

    2015-11-01

    The GRAS proteins belong to a plant transcriptional regulator family that function in the regulation of plant growth and development. Despite their important roles, in sunflower only one GRAS gene (HaDella1) with the DELLA domain has been reported. Here, we provide a functional characterisation of a GRAS-like gene from Helianthus annuus (Ha-GRASL) lacking the DELLA motif. The Ha-GRASL gene contains an intronless open reading frame of 1,743 bp encoding 580 amino acids. Conserved motifs in the GRAS domain are detected, including VHIID, PFYRE, SAW and two LHR motifs. Within the VHII motif, the P-H-N-D-Q-L residues are entirely maintained. Phylogenetic analysis reveals that Ha-GRASL belongs to the SCARECROW LIKE4/7 (SCL4/7) subfamily of the GRAS consensus tree. Accumulation of Ha-GRASL mRNA at the adaxial boundaries from P6/P7 leaf primordia suggests a role of Ha-GRASL in the initiation of median and basal axillary meristems (AMs) of sunflower. When Ha-GRASL is over-expressed in Arabidopsis wild-type plants, the number of lateral bolts increases differently from untransformed plants. However, Ha-GRASL slightly affects the lateral suppressor (las-4-) mutation. Therefore, we hypothesise that Ha-GRASL and LAS are not functionally equivalent. The over-expression of Ha-GRASL reduces metabolic flow of gibberellins (GAs) in Arabidopsis and this modification could be relevant in AM development. Phylogenetic analysis includes LAS and SCL4/7 in the same major clade, suggesting a more recent separation of these genes with respect to other GRAS members. We propose that some features of their ancestor, as well as AM initiation and outgrowth, are partially retained in both LAS and SCL4/7.

  2. Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique

    Directory of Open Access Journals (Sweden)

    Amit Mishra

    2016-02-01

    Full Text Available Abstract Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation. Methods: This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years. Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text. Results: The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3. Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34±815.26 days (range 369 - 2730. Conclusion: Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons' armamentarium.

  3. Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique

    Science.gov (United States)

    Mishra, Amit; Jain, Anil; Hinduja, Manish; Wadhawa, Vivek; Patel, Ramesh; Vaidhya, Nikunj; Rodricks, Dayesh; Patel, Hardik

    2016-01-01

    Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation. Methods: This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years). Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text. Results: The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3). Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34±815.26 days (range 369 - 2730). Conclusion: Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons' armamentarium. PMID:27074270

  4. Genetic determinants of arterial stiffness: Results from the Rotterdam Study

    NARCIS (Netherlands)

    M.P.S. Sie (Mark)

    2007-01-01

    textabstractArterial stiffness increases with age. It is also associated with various diseases, such as diabetes mellitus and hypertension. Recently, arterial stiffness has also been found to independently predict cardiovascular disease. The pathogenesis of arterial stiffness, however, has n

  5. Surgical Management of Intramyocardial Left Anterior Descending Artery.

    Science.gov (United States)

    De Salvatore, Sergio; Segreto, Antonio; Chiusaroli, Alessandro; Congiu, Stefano; Bizzarri, Federico

    2015-11-01

    An intramyocardial left anterior descending artery can be found in up to 30% of patients undergoing coronary artery bypass graft procedures. We review the various techniques available to identify an intramyocardial left anterior descending artery.

  6. Research progress of axillary management approach for 1-2 sentinel lymph node positive early stage breast cancer patients%前哨淋巴结1~2个阳性早期乳腺癌患者腋窝淋巴结管理办法研究进展

    Institute of Scientific and Technical Information of China (English)

    张丽; 俞晓立; 郭小毛

    2016-01-01

    前哨淋巴结活检术是临床腋窝阴性乳腺癌患者的标准治疗方法。前哨淋巴结阴性患者可省略腋窝清扫手术,而前哨淋巴结1~2个阳性患者腋窝最佳治疗手段却存在争议。本文总结了前哨淋巴结1~2个阳性的早期乳腺癌患者腋窝管理模式的最新进展。%Sentinel lymph node biopsy has been the standard axillary intervention for breast cancer patients with clinical negative axillary lymph nodes.Complete axillary dissection could be omitted for patients with negative sentinel lymph nodes.While, the optimal axillary intervention for patients with 1-2 positive sentinel lymph nodes remained controversial.This review introduced the latest research results of the axillary management for early stage breast cancer patients with 1-2 positive sentinel lymph nodes.

  7. 800nm半导体激光脱腋毛的临床疗效和安全性分析%Efifcacy and Safety on Axillary air Removal Effect of 800 nm Diode Laser

    Institute of Scientific and Technical Information of China (English)

    刘淼箐; 李慧琼; 崔诗悦

    2016-01-01

    目的:评价800 nm半导体激光脱腋毛的临床疗效及安全性。方法采用800 nm半导体激光脱毛仪对400例患者800处腋窝部行脱毛治疗,波长800 nm,光斑直径9 mm×9mm,能量密度是15到30J/cm,脉冲宽度30-100 ms,治疗间隔6~8周,分别于治疗3次、6次后评价疗效。结果400例患者经3-6次连续治疗后均达到理想的脱毛效果,治疗后腋窝部毛发数量明显减少,再生的毛发较之前浅淡且细小。其中3次治疗后累计脱毛治愈率为10.75%,6次治疗后累计治愈率达100.0%。部分患者治疗过程中出现红斑、瘙痒、多汗症、臭汗症等并发症,经积极处理后均消退,长期随访无并发症遗留。结论800 nm半导体激光用于腋窝部脱毛效果确切,安全性高,患者满意度高,不良反应小。%[ABSTRACT] ObjectiveTo evaluate the efficacy and safety of 800 nm vacuum diode laser axillary hair removal system. MethodsA total of 400 patients (800 sites) were treated with 800 nm vacuum diode laser to perform axillary hair removal. The parameters were set as below: wave length 800nm, energy density:15-30 J /cm2,spot size: 9mm×8mm,and pulse duration: 30-100 ms.The interval time was 6 to 8 weeks. The efifcacy was evaluated after third times and sixth times treatment.Result In total,400 patients had satisfactory effects after 3 to 6 continuous treatments. The axillary hair was reduced obviously and the regenerated hair was ifne and pale.Three times after treatment, 10.75% patients had more than 95% axillary hair reduction. After six times treatment, all the patients had more than 95% hair reduction. A part of patients occurred erythema, pruritus, hyperhidrosis, bromidrosis, folliculitis, and all of them were recovered in one to three month. No complication were found after long-term follow-up time.Conclusion 800 nm diode laser vacuum axillary hair removal system is a relatively safe,efifcient and high satisfaction for axillary hair

  8. The application of simplified axillary lymph nodes dissection on the treatment of early breast cancer%简化腋窝淋巴结清扫术在早期乳腺癌治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    黄炜; 王亚兵; 殷照才; 刘三保; 陈洁; 陈晓林

    2015-01-01

    目的:探讨简化腋窝淋巴结清扫术( axillary lymph node dissection, ALND)在乳腺癌手术中的应用及效果。方法分析2009年1月至2013年6月间行前哨淋巴结活检( sentinel lymph node bi-opsy,SLNB)327例乳腺癌患者的临床资料,行亚甲蓝染色法 SLNB后根据前哨淋巴结( sentinel lymph node, SLN)冰冻病理结果,对 SLN阳性者行规范的 ALND, SLN阴性则行简化的 ALND (只清扫 LevelⅠ),比较两组在手术时间、术后住院时间、腋窝引流时间及术后并发症的差异。结果327例患者中,314例成功进行了SLNB,119例SLN阳性者行标准的ALND,195例SLN阴性者行简化的ALND,11例SLN阴性患者出现LevelⅠ组织淋巴结转移;简化组手术时间、术后住院时间、腋窝引流时间明显缩短,术后腋窝积液、肌力减退、活动受限、疼痛、麻木、肿胀等并发症明显减少。术后随访3~60个月,患者无腋窝淋巴结复发及远处转移。结论蓝染法SLNB是乳腺癌患者腋窝淋巴结转移状态的重要检测技术,对SLN阴性行简化的ALND,可节省医疗资源、减少术后并发症。%Objective To explore the application and effect of simplified axillary lymph node dissection ( ALND) in the operation of breast cancer . Methods Through the analysis of 327 cases of breast cancer pa-tients with clinical data in our department from Jan. 2009 to Jun. 2013 receiving sentinel lymph node biopsy (SLNB), according to the sentinel lymph node (SLN) frozen pathological results which were used methylene blue staining of SLNB , the patients who were SLN positive did the standard ALND, and the SLN negative pa-tients did the simplified ALND ( only clean up Level I) , Differences on operative time, postoperative hospitali-zation time, axillary drainage time and postoperative complications were compared between the two groups. Re-sults Among 327 cases, 314 cases successfully carried out SLNB, ALND in 119 cases with SLN positive and 195 cases of ALND

  9. Coronary Artery Disease - Coronary Heart Disease

    Science.gov (United States)

    ... result of coronary artery disease, or CAD, said Edward A. Fisher, M.D., Ph.D., M.P. ... Problems and Disease • High Blood Pressure (HBP) • Metabolic Syndrome • Pericarditis • Peripheral Artery Disease (PAD) • Stroke • Vascular Health • ...

  10. Medical treatment in carotid artery intervention

    NARCIS (Netherlands)

    Kolkert, J. L.; Meerwaldt, R.; Lefrandt, Johan; Geelkerken, R. H.; Zeebregts, C. J.

    2011-01-01

    Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical the

  11. Totally thrombosed giant anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    V R Roopesh Kumar

    2015-01-01

    Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

  12. Goldenhar Syndrome Associated with Extensive Arterial Malformations

    Directory of Open Access Journals (Sweden)

    Renee Frances Modica

    2015-01-01

    Full Text Available Goldenhar Syndrome is characterized by craniofacial, ocular and vertebral defects secondary to abnormal development of the 1st and 2nd branchial arches and vertebrae. Other findings include cardiac and vascular abnormalities. Though these associations are known, the specific anomalies are not well defined. We present a 7-month-old infant with intermittent respiratory distress that did not improve with respiratory interventions. Echocardiogram suggested a double aortic arch. Cardiac CT angiogram confirmed a right arch and aberrant, stenotic left subclavian artery, dilation of the main pulmonary artery, and agenesis of the left thyroid lobe. Repeat echocardiograms were concerning for severely dilated coronary arteries. Given dilation, a rheumatologic workup ensued, only identifying few weakly positive autoantibodies. Further imaging demonstrated narrowing of the aorta below the renal arteries and extending into the common iliac arteries and proximal femoral arteries. Given a physical exam devoid of rheumatologic findings, only weakly positive autoantibodies, normal inflammatory markers, and presence of the coronary artery dilation, the peripheral artery narrowings were not thought to be vasculitic. This case illustrates the need to identify definitive anomalies related to Goldenhar Syndrome. Although this infant’s presentation is rare, recognition of specific vascular findings will help differentiate Goldenhar Syndrome from other disease processes.

  13. [Internal carotid artery dissection after Heimlich maneuver].

    Science.gov (United States)

    Rakotoharinandrasana, H; Petit, E; Dumas, P; Vandermarcq, P; Gil, R; Neau, J-Ph

    2003-01-01

    We report a case of cervical artery dissection following a Heimlich maneuver. Cervical artery dissections are at the present time well known and are sometimes associated with trivial traumas. However, to our knowledge, this complication of such maneuver was never reported in the literature. Pathophysiological mechanisms are discussed.

  14. Multimodality imaging of coronary artery bypass grafts

    NARCIS (Netherlands)

    Salm, Liesbeth Pauline

    2006-01-01

    This thesis describes multiple imaging modalities to examine coronary artery bypass grafts, and the research which was performed to further develop noninvasive imaging techniques to detect stenoses in native coronary arteries and bypass grafts in patients who experienced recurrent chest pain after c

  15. Renal infarction resulting from traumatic renal artery dissection.

    Science.gov (United States)

    Kang, Kyung Pyo; Lee, Sik; Kim, Won; Jin, Gong Yong; Na, Ki Ryang; Yun, Il Yong; Park, Sung Kwang

    2008-06-01

    Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.

  16. Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Kachel, R.; Basche, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Radiologische Klinik); Heerklotz, I.; Grossmann, K. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Innere Medizin); Endler, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Neurologie und Psychiatrie)

    1991-06-01

    We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symtoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment. (orig.).

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

    Institute of Scientific and Technical Information of China (English)

    HUANG Yuan; LIU Chao; LIN Jin-ling

    2013-01-01

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

  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. Arterial stiffness: pathophysiology and clinical impact.

    Science.gov (United States)

    London, Gérard M; Marchais, Sylvain J; Guerin, Alain P; Pannier, Bruno

    2004-01-01

    The ill effects of hypertension are usually attributed to a reduction in the caliber or the number of arterioles, resulting in an increase in total peripheral resistance (TPR). This definition does not take into account the fact that BP is a cyclic phenomenon with systolic and diastolic BP being the limits of these oscillations. The appropriate term to define the arterial factor(s) opposing LV ejection is aortic input impedance which depends on TPR, arterial distensibility (D), and wave reflections (WR). D defines the capacitive properties of arterial stiffness, whose role is to dampen pressure and flow oscillations and to transform pulsatile flow and pressure in arteries into a steady flow and pressure in peripheral tissues. Stiffness is the reciprocal value of D. These parameters are BP dependent, and arteries become stiffer at high pressure. In to D which provides information about the elasticity> of artery as a hollow structure, the elastic incremental modulus (Einc) characterizes the properties of the arterial wall biomaterials, independently of vessel geometry. As an alternative, arterial D can be evaluated by measuring the pulse wave velocity (PWV) which increases with the stiffening of arteries. Arterial stiffening increases left ventricular (LV) afterload and alters the coronary perfusion. With increased PWV, the WR impacts on the aorta during systole, increasing systolic pressures and myocardial oxygen consumption, and decreasing diastolic BP and coronary flow. The arterial stiffness is altered primarily in association with increased collagen content and alterations of extracellular matrix (arteriosclerosis) as classically observed during aging or in arterial hypertension. The arterial stiffening estimated by changes in aortic PWV and intensity of WR are independent predictors of survival in end stage renal disease (ESRD) and general population. Improvement of arterial stiffening could be obtained by antihypertensive treatmen as observed with the calcium

  20. Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

    Directory of Open Access Journals (Sweden)

    Venkat Gangadharan MD

    2017-01-01

    Full Text Available A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery. Right and left heart catheterizations demonstrated moderate pulmonary hypertension with a slight step-up in oxygen saturation between the right ventricle and main pulmonary artery. Coronary angiography showed a large tortuous right coronary artery with collaterals to the left anterior descending artery that drained into the main pulmonary artery. She was referred for surgery. This case demonstrates a rare coronary artery anomaly in an adult where survival is dependent on collateral circulation.