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Sample records for axillary vein

  1. A novel technique of axillary vein puncture involving peripherally inserted central venous catheters for a small basilic vein.

    Science.gov (United States)

    Saijo, Fumito; Odaka, Yoshinobu; Mutoh, Mitsuhisa; Katayose, Yu; Tokumura, Hiromi

    2018-03-01

    Peripherally inserted central venous catheters are some of the most useful devices for vascular access used globally. Peripherally inserted central venous catheters have a low rate of fatal mechanical complications when compared to non-tunnel central venous catheters. However, as peripherally inserted central venous catheter access requires a smaller vein, there is a high risk of thrombosis. The axillary vein (confluence of the basilic and brachial veins) can serve as an access for cannulation. Moreover, as this vein is larger than the basilic or brachial vein, it might be a superior option for preventing thrombosis. The risk of catheter-related bloodstream infection should be considered when the puncture site is at the axillary fossa. The aim of this study was to present our new protocol involving peripherally inserted central venous catheters (non-tunneled/tunneled) and a tunneling technique and assess its feasibility and safety for improving cannulation and preventing thrombosis and infection. The study included 20 patients. The axillary vein in the upper arm was used for peripherally inserted central venous catheters in patients with a small-diameter basilic vein (venous catheter. The observed catheter duration was 645 days (median ± standard deviation, 26 ± 22.22 days). Catheterization was successful in all cases, however, two accidental dislodgements were identified. No fatal or serious complications were observed after catheterization. Our new protocol for axillary peripherally inserted central venous catheters/tunneled axillary peripherally inserted central venous catheters use for a small-diameter basilic vein is safe and feasible.

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

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

    1994-10-01

    Cannulation of the axillary vein is claimed to be an effective and relatively safe access to the central venous (CV) system [2, 4, 5, 8]. However, anatomical landmarks recommended for venous location (Muskulus pectoralis minor, processus coracoideus) are probably hard to identify in the majority of intensive care (ICU) patients. This investigation evaluated unidirectional 8 MHz Doppler ultrasound (US) in locating the axillary vein. Success rates and complications of this CV access in ICU patients is analysed. METHODS. The experimental design was approved by the local ethical committee (RUB). In 50 patients from our ICU cannulation of the axillary vein was attempted; all were in need of a CV line. Other CV puncture sites (except for the subclavian vein) were associated with contraindications. Patients were placed in a 15 degrees Trendelenburg position (15 exceptions); the arm was abducted to 45 degrees [5, 8]. The course of the axillary vein was located by Doppler US and marked on the skin with a felt pen. Prior to puncture, US intensity was judged by a score ranging from 0 to 4. After skin desinfection, sterile draping, and local anaesthesia, puncture of the axillary vein was attempted. The puncture kit LeaderCath 11,515 (Vygon, Aachen, FRG) was used. When venous blood could be aspirated, the Seldinger guidewire was inserted and the definite catheter placed. The experimental design allowed up to ten punctures, slightly modified in angle and direction of the needle, if puncture of the axillary vein or guide-wire placement failed. The cannulation attempt was classified as unsuccessful in the following cases: malposition, axillary vein not encountered by the puncture needle, guide-wire placement unsuccessful, or if identification and cannulation of the vein lasted more than 20 min. The puncture attempts were evaluated in respect to success rate, time, relation of US intensity to puncture attempts and CV pressure, complications, and malposition. RESULTS. Of the 50

  3. 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

  4. Muscular Variations During Axillary Dissection: A Clinical Study in ...

    African Journals Online (AJOL)

    muscle and the coracoid process, without interruption by any type of tendinous fibres. The axillary arch muscle crossed anteriorly over the axillary vein [Figure 1]. The mastectomy along with axillary dissection was completed uneventfully. There was left sided absence of pectoralis major and minor muscles in a 45 years old ...

  5. 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.

  6. Axillary bud development in chrysanthemum

    NARCIS (Netherlands)

    Ruiter, de H.A.

    1996-01-01


    Each chrysanthemum cutting originates from an axillary bud. For an improvement of the cultivation of cuttings or more specific their quality, it is necessary that the development of an axillary bud can be controlled as good as possible. Axillary bud development can be distinguished into

  7. Upper extremity deep vein thrombosis after elbow trauma: a case ...

    African Journals Online (AJOL)

    ... K antagonists was conducted and evaluation by Doppler ultrasonography realized 18 months after trauma showed recanalization of basilica and humeral veins and thrombosis of axillary and subclavian veins. Management of occupational activity was prescribed including eviction of heavy loads handling and repetitive ...

  8. Axillary bud development in rose

    NARCIS (Netherlands)

    Marcelis - van Acker, C.A.M.

    1994-01-01

    Axillary buds form the basis of flower production of a rose crop. Within a rose crop there exists an undesired large variation in shoot number and size, which affects flower yield. Part of this variation may be traced back to early variation in axillary buds. The aim of the research

  9. Topical glycopyrrolate reduces axillary hyperhidrosis.

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    Baker, D M

    2016-12-01

    Oral anti-cholinergic medications reduce generalized hyperhidrosis, but the effectiveness of topical anticholinergic solutions on axillary hyperhidrosis is unclear. This study determines the initial effectiveness of 1% and 2% topical glycopyrrolate spray and compares this with Botulinum toxin type A injections for the management of axillary hyperhidrosis. In a non-randomized, consecutive patient, prospective questionnaire, treatment comparison study, 40 patients with axillary hyperhidrosis were allocated to one of four study groups (10 patients to each group): (a) 1% glycopyrrolate spray, (b) 2% glycopyrrolate spray, (c) subcutaneous Botulinum toxin type A injections, (d) no treatment. Clinical outcomes were measured by comparing a prospectively administered questionnaire, completed both pre-treatment and 6 weeks after starting treatment. Forty healthy volunteers without axillary hyperhidrosis completed the same questionnaire. The three treatment groups showed a significant (P hyperhidrosis scores following treatment. The degree of improvement was less for the 1% glycopyrrolate group when compared with the Botulinum toxin type A group (P hyperhidrosis to a level similar to those without hyperhidrosis. Patients in both, the 2% glycopyrrolate and Botulinum toxin type A groups reported a significant improvement in axillary hyperhidrosis symptoms. These included reduction in psychologically precipitating factors (e.g. public speaking) and axillary hyperhidrosis-specific physical effects (e.g. limitation of clothing choice). Topical glycopyrrolate spray could provide a further treatment modality to manage axillary hyperhidrosis. © 2016 European Academy of Dermatology and Venereology.

  10. Radial to axillary nerve transfer.

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    Vanaclocha, Vicente; Herrera, Juan Manuel; Rivera-Paz, Marlon; Martínez-Gómez, Deborah; Vanaclocha, Leyre

    2018-01-01

    Axillary nerve injury is common after brachial plexus injuries, particularly with shoulder luxation. Nerve grafting is the traditional procedure for postganglionic injuries. Nerve transfer is emerging as a viable option particularly in late referrals. At the proximal arm the radial and axillary nerves lie close by. Sacrificing one of the triceps muscle nerve branches induces little negative consequences. Transferring the long head of the triceps nerve branch is a good option to recover axillary nerve function. The surgical technique is presented in a video, stressing the steps to achieve a successful result. The video can be found here: https://youtu.be/WbVbpMuPxIE .

  11. Axillary hyperhidrosis: a focused review.

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    Sammons, Jason E; Khachemoune, Amor

    2017-11-01

    Axillary hyperhidrosis is characterized by an increased amount of sweat production, localized to the armpits, to compensate for environmental conditions and to control thermoregulation. It affects about 3.12% of the US population. It has a significant effect on one's psychological and physical health, as well as one's occupational life. The objective of this paper is to review the epidemiology, clinical presentation, pathophysiology, histology, genetics, and management and treatment of axillary hyperhidrosis.

  12. Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report

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    Salvador Loris

    2008-02-01

    Full Text Available Abstract With the proliferation of minimally invasive cardiac surgery a number of alternative inflow sites for coronary artery bypass grafting have been utilized, especially in higher risk patients. The use of axillary-coronary artery bypass is a safe and effective alternative especially in the case of patients requiring redo coronary revascularization. However, the length and convoluted course of the axillary-coronary vein graft makes is susceptible to twisting, trauma and neointimal hyperplasia. We therefore report a case of an axillary-coronary artery bypass in a high risk patient in which a Dacron conduit was used to externally support and protect the vein graft to the left anterior descending artery. Surgical technique and considerations are presented and discussed.

  13. 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.

  14. Varicose veins

    Science.gov (United States)

    ... varicose veins, and taking birth control pills or hormone replacement can increase your risk) Being born with defective valves Obesity Pregnancy History of blood clots in your legs Standing or ...

  15. Partial axillary dissection in early breast cancer

    African Journals Online (AJOL)

    Tarek Abdel Halim El-Fayoumi

    ORIGINAL ARTICLE. Partial axillary dissection in early breast cancer. Tarek Abdel Halim El-Fayoumi *. Department of General Surgery, Faculty of Medicine, Alexandria University, Egypt. Received 16 October 2012; accepted 7 January 2013. Available online 7 March 2013. KEYWORDS. Breast cancer;. Axillary lymph nodes.

  16. 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.

  17. Prevention of vascular access hand ischemia using the axillary artery as inflow.

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    Jennings, William; Brown, Robert; Blebea, John; Taubman, Kevin; Messiner, Ryan

    2013-11-01

    Avoiding dialysis access-associated ischemic steal syndrome (DASS) in patients with upper extremity peripheral vascular occlusive disease while creating a functional hemodialysis vascular access may be challenging. We constructed an autogenous access with primary proximalization of the arterial inflow to prevent hand ischemia in patients at high risk for this complication. Patients requiring hemodialysis access with physical findings suggesting a high risk of access-related hand ischemia (absent radial, ulnar, and brachial palpable pulses associated with small calcified vessels by ultrasound examination) underwent a primary arteriovenous fistula transposition procedure utilizing the axillary artery for inflow. The arteriovenous fistula was either a reversed flow basilic vein transposition supplemented by valvulotomy (n = 22); a translocated reversed basilic vein (n = 4); a cephalic vein harvested into the forearm and placed in a loop configuration for axillary artery inflow (n = 3); or a translocated reversed saphenous vein (n = 1). Thirty patients with a mean age of 60 years (range, 31-83 years) underwent successful primary axillary artery inflow procedures during a 3-year period. Of these, 23 (77%) were female and 25 (83%) were diabetic. Twenty-one (70%) had previous vascular access procedures and 10 (33%) were obese. No patient developed postoperative ischemia. Three individuals died 2, 14, and 19 months following surgery, none related to vascular access. Three accesses failed after 1, 5, and 7 months and could not be salvaged. Life-table primary, primary assisted, and cumulative patency rates were 57%, 78%, and 87% respectively at 1 year with a mean follow-up of 7 months (range, 1-25 months). Cephalic vein outflow was associated with fewer access failures, fewer interventions postoperatively, and lower rates of arm swelling (P vascular access utilizing axillary artery inflow is a good option for patients with severe peripheral vascular disease. It offers a high

  18. Deep Vein Thrombosis

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    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein ... the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem ...

  19. Varicose vein stripping

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    ... stripping; Venous reflux - vein stripping; Venous ulcer - veins Patient Instructions Surgical wound care - open Varicose veins - what to ask your doctor Images Circulatory system References American Family Physician. Management of varicose veins. www.aafp.org/afp/2008/ ...

  20. Efficacy of ultrasound-guided axillary/subclavian venous approaches for pacemaker and defibrillator lead implantation: a randomized study.

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    Liccardo, Mattia; Nocerino, Pasquale; Gaia, Salzano; Ciardiello, Carmine

    2018-03-01

    Subclavian access is a reliable technique for lead insertion in pacemaker and defibrillator (ICD) implantation, but it is often accompanied by complications. The aim of this study was to compare the efficacy of the ultrasound-guided axillary approach to the subclavian method. This randomized comparative study was performed on 174 patients: as a first attempt, 116 patients underwent the ultrasound-guided axillary access and 58 patients underwent the subclavian approach. A total of 364 leads were placed. Operators were trained in ultrasound-guided vein access technique. Axillary access was successful in 69% of patients (32/46), in the training phase and, as a first attempt, in 91.4% of patients (106/116), in the randomized phase. When axillary approach failed, we performed the following: subclavian access in 5.2% of patients (6/116), cephalic approach in 2.6% of patients (3/116), surgical method in 0.9% of patients (1/116). The subclavian technique was effective, as a first attempt, in 55 patients (94.8%). When the subclavian access failed, the ultrasound axillary approach successfully performed in all three cases. During a mean follow-up of 18 ± 6 months, the number of lead complications was similar in the subclavian group compared to the axillary group (p = 0.664). As first attempt, ultrasound-guided axillary method showed similarly high-success rate than subclavian approach and well performed when the first attempt in subclavian group failed. Axillary access can be considered a safe and effective alternative technique to the conventional subclavian method for device implantation.

  1. 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.

  2. 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.

  3. Fibroadenoma in the bilateral accessory axillary breast.

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    Gentile, P; Izzo, V; Cervelli, V

    2010-10-01

    The authors treated a case of bilateral accessory axillary breast tissue. Excision with histologic examination confirmed the diagnosis of fibroadenoma. Treatment left the woman with incision scars (3.5 cm) in the axillary pyramid, a location often not seen during a patient's normal movements. Thus, despite a minor aesthetic incision, gives the advantage of complete histologic analysis was gained. Liposuction treatment was used in this case. The scar results were good.

  4. Axillary nerve neurotization by a triceps motor branch: comparison between axillary and posterior arm approaches.

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    Jácome, Daniel Tôrres; Alencar, Fernando Henrique Uchôa de; Lemos, Marcos Vinícius Vieira de; Kobig, Rudolf Nunes; Rocha, João Francisco Recalde

    2018-01-01

    This study is aimed at comparing the functional outcome of axillary nerve neurotization by a triceps motor branch through the axillary approach and posterior arm approach. The study included 27 patients with post-traumatic brachial plexus injury treated with axillary nerve neurotization by a triceps motor branch for functional recovery of shoulder abduction and external rotation. The patients were retrospectively evaluated and two groups were identified, one with 13 patients undergoing axillary nerve neurotization by an axillary approach and the second with 14 patients using the posterior arm approach. Patients underwent assessment of muscle strength using the scale recommended by the British Medical Research Council, preoperatively and 18 months postoperatively, with useful function recovery considered as grade M3 or greater. In the axillary approach group, 76.9% of patients achieved useful abduction function recovery and 69.2% achieved useful external rotation function recovery. In the group with posterior arm approach, 71.4% of patients achieved useful abduction function recovery and 50% achieved useful external rotation function recovery. The difference between the two groups was not statistically significant ( p  = 1.000 for the British Medical Research Council abduction scale and p  = 0.440 for external rotation). According to the British Medical Research Council grading, axillary nerve neurotization with a triceps motor branch using axillary approach or posterior arm approach shows no statistical differences.

  5. Topographic pattern of the brachial plexus at the axillary fossa through real-time ultrasonography in Koreans.

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    Han, Jin Hye; Kim, Youn Jin; Kim, Jong Hak; Kim, Dong Yeon; Lee, Guie Yong; Kim, Chi Hyo

    2014-11-01

    The ability to explore the anatomy has improved our appreciation of the brachial anatomy and the quality of regional anesthesia. Using real-time ultrasonography, we investigated the cross-sectional anatomy of the brachial plexus and of vessels at the axillary fossa in Koreans. One hundred and thirty-one patients scheduled to undergo surgery in the region below the elbow were enrolled after giving their informed written consent. Using the 5-12 MHz linear probe of an ultrasound system, we examined cross-sectional images of the brachial plexus in the supine position with the arm abducted by 90°, the shoulder externally rotated, and the forearm flexed by 90° at the axillary fossa. The results of the nerve positions were expressed on a 12-section pie chart and the numbers of arteries and veins were reported. Applying gentle pressure to prevent vein collapse, the positions of the nerves changed easily and showed a clockwise order around the axillary artery (AA). The most frequent positions were observed in the 10-11 section (79.2%) for the median, 1-2 section (79.3%) for the ulnar, 3-5 section (78.4%) for the radial, and 8-9 section (86.9%) for the musculocutaneous nerve. We also noted anatomical variations consisting of double arteries (9.2%) and multiple axillary veins (87%). Using real-time ultrasonography, we found that the anatomical pattern of the major nerves in Koreans was about 80% of the frequent position of individual nerves, 90.8% of the single AA, and 87% of multiple veins around the AA.

  6. Results of surgery without axillary dissection for breast cancer

    International Nuclear Information System (INIS)

    Higaki, Kenji; Okamura, Shinsuke; Morita Katsuyuki

    2000-01-01

    We believe that routine axillary dissection for relatively early breast cancer should be reconsidered in view of the low incidence of lymph node metastasis and its effects on postoperative quality of life. We have performed bioptic lumpectomy to examine histological type, invasive tumor size, histological infiltration, and lymphatic invasion and have avoided axillary dissection in cases with a low risk of lymph node metastasis. In 126 cases of T0, T1a, or T2a breast cancers less than 3 cm in diameter in which axillary dissection was not performed, axillary recurrence was observed in 2 cases. Both patients underwent salvage procedures and are alive without disease. Furthermore, axillary recurrence was not observed in 23 cases treated with tangent irradiation and breast-preserving surgery. These findings suggest that axillary recurrence is possible in cases with previous indications for avoiding axillary dissection and that breast irradiation may prevent axillary recurrence. (author)

  7. Axillary arthrotomography of the glenoid labrum

    International Nuclear Information System (INIS)

    Kleinman, P.K.; Kanzaria, P.K.; Goss, T.P.; Pappas, A.M.

    1984-01-01

    In a study of 67 shoulders evaluated by axillary arthrotomography, tears of the glenoid labrum were accurately detected in all 26 surgically confirmed cases. One false-positive case was identified in the five patients without labral tears; there were no false-negative cases. Only 40% of the patients had clinical evidence of subluxation or dislocation. Axillary arthrotomography provides important information about the integrity of the labrum that may be helpful in planning surgery for patients without clinical subluxation or dislocation but with pain, clicking, or vague shoulder discomfort secondary to labral pathology (functional instability)

  8. Brachial plexus injury with emphasis on axillary nerve paralysis after thoracoscopic sympathicotomy for axillary hyperhidrosis.

    Science.gov (United States)

    Chon, Soon-Ho; Suk Choi, Matthew Seung

    2006-12-01

    Thoracic sympathicotomy for the treatment of axillary hyperhidrosis with the use of 2 mm thoracoscope and instruments is a simple and safe procedure. Nerve paralysis of any type after thoracic sympathicotomy is an extremely rare event. We report a 44-year-old woman who developed brachial plexus injury of her left arm after thoracoscopic sympathicotomy for axillary hyperhidrosis. The lesion involved the whole arm. All nerves of the brachial plexus except the axillary nerve recovered quickly. An axillary nerve type lesion was observed for 7 weeks, until the patient fully recovered all functions of her arm. The mechanism is believed not to be caused by the procedure itself, but by dorsal overextension of the abducted arm during the operation.

  9. [Axillary pathologic response after neoadjuvant chemotherapy in locally advanced breast cancer with axillary involvement].

    Science.gov (United States)

    Jiménez-Ballvé, A; Serrano-Palacio, A; García-Sáenz, J A; Ortega Candil, A; Salsidua-Arroyo, O; Román-Santamaría, J M; Pelayo Alarcón, A; Fuentes Ferrer, M E; Carreras-Delgado, J L

    2015-01-01

    To compare axillary involvement (N+) at initial staging in locally advanced breast cancer (LABC) with axillary lymphadenectomy histologic results after neoadjuvant chemotherapy treatment (NeoChemo). Retrospective study between November 2011 and September 2013 of LABC cases treated with neoadjuvant chemotherapy based on docetaxel (associated with trastuzumab in HER2 positive cases and carboplatin/adriamycin in HER2 negative cases). Those clinically or radiologically suspected cases of axillary involvement were histologically confirmed. When there was no suspicion of axillary involvement, sentinel lymph node radioguided biopsy (SLNRB) was performed using intradermal injection of (99m)Tc-nanocolloid albumin prior to neoadjuvant treatment. Axillary lymphadenectomy after NeoChemo was undertaken in all cases with positive axilla. Final pathologic response was classified as complete (pCR) when there was no evidence of tumoral disease and as non-pathologic complete response (no pCR) in the opposite case. A total of 346 patients treated with docetaxel were reviewed, identifying 105 LABC. Axillary involvement at initial staging was detected in 70 (67%) before starting NeoChemo. From these 70, 73% (n=51) were N+ (fine needle biopsy and/or biopsy) and the remaining 19 (27%) were occult N+ detected by SLNRB. Axillary lymphadenectomy detected pCR in 56% (39/70), increasing up to 84% pCR when initial N+ status was reached using SNLB. On the other hand, when N+ was detected using fine needle biopsy/lymph biopsy, pCR was only 45%. More than 50% of women affected by locally advanced breast cancer with tumoral axillary involvement at initial diagnosis present free metastatic axilla after therapeutic neoadjuvant chemotherapy effect. This increases up to almost 90% in case of occult metastatic axilla detected with sentinel node biopsy prior starting neoadjuvant chemotherapy. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  10. CASE REPORT Unilateral axillary adenopathy with unremarkable ...

    African Journals Online (AJOL)

    of bursitis. As a local inflammatory cause for the unilateral axillary adenopathy was presumed, no biopsy was performed. Follow-up ultrasound was arranged for 4 weeks later. Diagnosis. After discussion with the patient's family physician, she attended for consultation the same day. A clinical diagnosis of elbow bursitis was.

  11. Breast cancer with axillary lymph node involvement

    International Nuclear Information System (INIS)

    Belaid, A.; Kanoun, S.; Kallel, A.; Ghorbel, I.; Azoury, F.; Heymann, S.; Marsiglia, H.; Bourgier, C.; Belaid, A.; Ghorbel, I.; Kanoun, S.; Kallel, A.; Pichenot, C.; Verstraet, R.; Marsiglia, H.

    2010-01-01

    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)

  12. Radiofrequency Thermotherapy for Treating Axillary Hyperhidrosis.

    Science.gov (United States)

    Schick, Christoph H; Grallath, Tanja; Schick, Kerstin S; Hashmonai, Moshe

    2016-05-01

    Thermotherapy has been established between conservative and surgical options as a minimally invasive method for the treatment of axillary hyperhidrosis. The objective of this study was to present radiofrequency thermotherapy (RFTT) as a safe and effective new treatment method. Thirty adult patients with pronounced axillary hyperhidrosis were treated with RFTT with noninsulated microneedles 3 times at intervals of 6 weeks. Subjective improvement was rated using the Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI). Satisfaction and estimated reduction of sweating were monitored. Objective measurements were made using gravimetry. Adverse effects were recorded in follow-up. At the 6-month follow-up, improvement in sweating was seen in 27 patients. The HDSS dropped from 3.4 to 2.1, the DLQI improved significantly from 16 to 7. The gravimetric measurements of sweat were reduced from 221 to 33 mg/min. The average reduction of sweating was reported to be 72%. Adverse effects were generally mild and improved rapidly. Radiofrequency thermotherapy was shown to be an effective and minimally invasive treatment option for axillary hyperhidrosis. Patients described their sweating as normal. The method clearly has the potential to normalize axillary sweating.

  13. Axillary nerve injury associated with sports.

    Science.gov (United States)

    Lee, Sangkook; Saetia, Kriangsak; Saha, Suparna; Kline, David G; Kim, Daniel H

    2011-11-01

    The aim of this retrospective study was to present and investigate axillary nerve injuries associated with sports. This study retrospectively reviewed 26 axillary nerve injuries associated with sports between the years 1985 and 2010. Preoperative status of the axillary nerve was evaluated by using the Louisiana State University Health Science Center (LSUHSC) grading system published by the senior authors. Intraoperative nerve action potential recordings were performed to check nerve conduction and assess the possibility of resection. Neurolysis, suture, and nerve grafts were used for the surgical repair of the injured nerves. In 9 patients with partial loss of function and 3 with complete loss, neurolysis based on nerve action potential recordings was the primary treatment. Two patients with complete loss of function were treated with resection and suturing and 12 with resection and nerve grafting. The minimum follow-up period was 16 months (mean 20 months). The injuries were associated with the following sports: skiing (12 cases), football (5), rugby (2), baseball (2), ice hockey (2), soccer (1), weightlifting (1), and wrestling (1). Functional recovery was excellent. Neurolysis was performed in 9 cases, resulting in an average functional recovery of LSUHSC Grade 4.2. Recovery with graft repairs averaged LSUHSC Grade 3 or better in 11 of 12 cases Surgical repair can restore useful deltoid function in patients with sports-associated axillary nerve injuries, even in cases of severe stretch-contusion injury.

  14. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Hakan Demirci

    2016-01-01

    Full Text Available Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low molecular weight heparin achieves recanalization in more than half of acute cases.

  15. Anterior deltopectoral approach for axillary nerve neurotisation.

    Science.gov (United States)

    Jerome, J Terrence Jose

    2012-04-01

    To report outcome of axillary nerve neurotisation for brachial plexus injury through the anterior deltopectoral approach. Nine men aged 20 to 52 (mean, 27.8) years with brachial plexus injury underwent axillary nerve neurotisation through the anterior deltopectoral approach. Three of the patients had complete avulsion of C5-T1 nerve roots. The remaining 6 patients had brachial plexus injury of C5-C6 nerve roots, with associated subluxation of the glenohumeral joint, atrophy of the supraspinatus, deltoid and elbow flexors. They had no active shoulder abduction, external rotation, and elbow flexion. The pectoralis major and minor were cut and/or retracted to expose the underlying infraclavicular plexus. The axillary nerve was identified with respect to the available donor nerves (long head of triceps branch, thoracodorsal nerve, and medial pectoral nerve). In addition to the axillary nerve neurotisation, each patient had a spinal accessory nerve transferred to the suprascapular nerve for better shoulder animation. Patients were followed up for 24 to 30 (mean, 26) months. In the 3 patients with C5-T1 nerve root injuries, the mean active abduction and external rotation were 63 and 20 degrees, respectively, whereas the mean abduction strength was M3 (motion against gravity). In the 6 patients with C5-C6 nerve root injuries, the mean active abduction and external rotation were 133 and 65 degrees, respectively, whereas the strength of the deltoids and triceps was M5 (normal) in all. In 4 patients with the pectoralis major cut and repaired, the muscle regained normal strength. The anterior deltopectoral approach enabled easy access to all available donor nerves for axillary nerve neurotisation and achieved good outcomes.

  16. [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.

  17. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Ronny Cohen

    2015-01-01

    Full Text Available Portal vein thrombosis (PVT is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community.

  18. Axillary lymph node treatment in breast cancer: an update.

    Science.gov (United States)

    Williams, Patrick A; Suggs, Jeanann; Mangana, Sophy H

    2014-05-01

    Sentinel lymph node biopsy (SLNbx) is the standard of care for staging of breast cancer. Patients with a negative sentinel lymph node biopsy (SLNbx) do not undergo axillary lymph node dissection (ALND) or regional nodal irradiation (RNI). However, if a patient has a positive sentinel lymph node biopsy (SLNbx), then axillary lymph nodal dissection (ALND) is the standard treatment. Recent studies, notably the Z-0011 and MA-20 trials, have demonstrated that omission of axillary lymph nodal dissection (ALND) did not decrease overall survival. MA-20 demonstrated that inclusion of regional nodal irradiation (RNI) in addition to axillary lymph nodal dissection (ALND) did increase survival when compared to axillary lymph nodal dissection (ALND) without regional nodal irradiation (RNI). Ongoing studies are randomizing patients to axillary lymph nodal dissection (ALND) or regional nodal irradiation (RNI) after a positive sentinel lymph node biopsy (SLNbx).

  19. What Is Deep Vein Thrombosis?

    Science.gov (United States)

    ... To Health Topics / Deep Vein Thrombosis Deep Vein Thrombosis Leer en español What Is Deep vein thrombosis ( ... life-threatening problems if not treated. Deep Vein Thrombosis Only about half of the people who have ...

  20. 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

  1. Nerve Transfers for Treatment of Isolated Axillary Nerve Injuries.

    Science.gov (United States)

    Wheelock, Margie; Clark, Tod A; Giuffre, Jennifer L

    2015-01-01

    The most common neurological defect in traumatic anterior glenohumeral dislocation is isolated axillary nerve palsy. Most recover spontaneously; however, some have persistent axillary neuropathy. An intact rotator cuff may compensate for an isolated axillary nerve injury; however, given the high rate of rotator cuff pathology with advancing age, patients with an axillary nerve injury are at risk for complete shoulder disability. To review reconstruction of the axillary nerve to alleviate shoulder pain, augment shoulder stability, abduction and external rotation to alleviate sole reliance on the rotator cuff to move and stabilize the shoulder. A retrospective review of 10 patients with an isolated axillary nerve injury and an intact rotator cuff who underwent a triceps nerve branch to axillary nerve transfer was performed. Patient demographics, surgical technique, deltoid strength, donor-site morbidity, complications and time to surgery were evaluated. Ten male patients, mean age 38.3 years (range 18 to 66 years), underwent a triceps to axillary nerve transfer for isolated axillary nerve injury 7.4 months (range five to 12 months) post-traumatic shoulder dislocation. Deltoid function was British Medical Research Council grade 0/5 in all patients preoperatively and ≥3/5 deltoid strength in eight patients at final follow-up (14.8 months [range 12 to 25 months]). There were no complications and no donor-site morbidity. A triceps to axillary nerve transfer for isolated axillary neuropathy following traumatic shoulder dislocation improved shoulder pain, stability and deltoid strength, and potentially preserves shoulder function with advancing age by alleviating sole reliance on the rotator cuff for shoulder abduction and external rotation.

  2. Comparison of rectal and axillary temperatures in dogs and cats.

    Science.gov (United States)

    Goic, Joana B; Reineke, Erica L; Drobatz, Kenneth J

    2014-05-15

    To compare rectal versus axillary temperatures in dogs and cats. Prospective observational study. 94 dogs and 31 cats. Paired axillary and rectal temperatures were measured in random order with a standardized method. Animal signalment, initial complaint, blood pressure, blood lactate concentration, and variables associated with vascular perfusion and coat were evaluated for associations with axillary and rectal temperatures. Axillary temperature was positively correlated with rectal temperature (ρ = 0.75 in both species). Median axillary temperature (38.4°C [101.1°F] in dogs, and 38.4°C [101.2°F] in cats) was significantly different from median rectal temperature in dogs (38.9°C [102.0°F]) but not in cats (38.6°C [101.5°F]). Median rectal-axillary gradient (difference) was 0.4°C (0.7°F; range, -1.3° to 2.3°C [-2.4° to 4.1°F]) in dogs and 0.17°C (0.3°F; range -1.1° to 1.6°C [-1.9° to 3°F]) in cats. Sensitivity and specificity for detection of hyperthermia with axillary temperature were 57% and 100%, respectively, in dogs and 33% and 100%, respectively, in cats; sensitivity and specificity for detection of hypothermia were 86% and 87%, respectively, in dogs and 80% and 96%, respectively, in cats. Body weight (ρ = 0.514) and body condition score (ρ = 0.431) were correlated with rectal-axillary gradient in cats. Although axillary and rectal temperatures were correlated in dogs and cats, a large gradient was present between rectal temperature and axillary temperature, suggesting that axillary temperature should not be used as a substitute for rectal temperature.

  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. Axillary apocrine carcinoma skin: report of a case | Issara | Pan ...

    African Journals Online (AJOL)

    ... and axillary MRI had objectified mass axillary measuring 171mm. Pathological examination with immunostaining was in favor of apocrine carcinoma. The cutaneous apocrine carcinomas are well-known in the mammary glands, but it is difficult to morphologically distinguish between breast cancer and apocrine carcinoma.

  5. In vitro PROLIFERATION ABILITY OF AXILLARY BUDS IN Musa spp

    African Journals Online (AJOL)

    AISA

    As axillary buds have shown mass propagation abilities in Big Ebanga, this explant is tested ... tested. To verify the efficiency of this protocol and then assure its wide adoption, axillary buds have been excised from suckers of various cultivars belonging to other genomic ... various data were processed with the software.

  6. Axillary nerve conduction changes in hemiplegia.

    Science.gov (United States)

    Tsur, Atzmon; Ring, Haim

    2008-12-17

    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. 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. 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 atrophy in the same limb. The usefulness of routine screening nerve conduction studies in the shoulder of hemiplegic patients seems to be advocated.

  7. Bilateral meandering pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

    2015-06-15

    Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

  8. Focus on Varicose Veins

    Science.gov (United States)

    ... stagnate (pool) in the legs, leading to high blood pressure in the leg veins. This may result in further enlargement of the ... you can help delay the development of varicose veins or keep them from progressing. Some ... pressure under control. • To temporarily relieve symptoms, lie down ...

  9. Axillary staging for breast cancer during pregnancy

    DEFF Research Database (Denmark)

    Han, S N; Amant, F; Cardonick, E H

    2018-01-01

    BACKGROUND: Safety of sentinel lymph node (SLN) biopsy for breast cancer during pregnancy is insufficiently explored. We investigated efficacy and local recurrence rate in a large series of pregnant patients. PATIENTS AND METHODS: Women diagnosed with breast cancer who underwent SLN biopsy during...... pregnancy were identified from the International Network on Cancer, Infertility and Pregnancy, the German Breast Group, and the Cancer and Pregnancy Registry. Chart review was performed to record technique and outcome of SLN biopsy, locoregional and distant recurrence, and survival. RESULTS: We identified...... were alive and free of disease. Eleven patients experienced a locoregional relapse, including 1 isolated ipsilateral axillary recurrence (0.7%). Eleven (7.6%) patients developed distant metastases, of whom 9 (6.2%) died of breast cancer. No neonatal adverse events related to SLN procedure during...

  10. Axillary Silicone Granulomas in Patients With Melanoma.

    Science.gov (United States)

    Fernández Canedo, M I; Blázquez Sánchez, N; Valdés Solís, P; de Troya Martín, M

    2016-05-01

    Subcutaneous lesions may be detected during follow-up of patients with melanoma. The main entities that should be contemplated in the differential diagnosis in such cases are in-transit and regional lymph node metastases. We describe 2 cases of women with breast implants who developed palpable subcutaneous lesions in the axillary region during follow-up of melanoma. In both cases, the ultrasound study showed diffuse hyperechoic signals forming the characteristic snowstorm sign in the subcutaneous tissue. Ultrasound proved to be a key diagnostic tool for ruling out melanoma-related disease, such as in-transit metastases and regional lymph node metastases. Copyright © 2015 Elsevier España, S.L.U. y AEDV. All rights reserved.

  11. Proximal humerus fracture associated with delayed axillary nerve injury

    Directory of Open Access Journals (Sweden)

    Patpiya Sirasaporn

    2016-01-01

    Full Text Available Axillary nerve injury is the most common complication in humerus fracture. The symptoms that are caused by affecting axillary nerve vary according to the structures involved such as sensory disturbance and weakness of muscles, e.g., three parts of deltoid and teres muscles in an affected limb. The severity of injury is classified in demyelinating and axonal lesions, which usually occurs at the onset of fracture. The author reports a case of humerus fracture with delayed axonal lesion of axillary nerve result from inadvertent traction.

  12. Transposition of cephalic vein to rescue hemodialysis access arteriovenous fistula and treat symptomatic central venous obstruction

    Directory of Open Access Journals (Sweden)

    Felipe Jose Skupien

    2014-03-01

    Full Text Available It is known that stenosis or central venous obstruction affects 20 to 50% of patients who undergo placement of catheters in central veins. For patients who are given hemodialysis via upper limbs, this problem causes debilitating symptoms and increases the risk of loss of hemodialysis access. We report an atypical case of treatment of a dialysis patient with multiple comorbidities, severe swelling and pain in the right upper limb (RUL, few alternative sites for hemodialysis vascular access, a functioning brachiobasilic fistula in the RUL and severe venous hypertension in the same limb, secondary to central vein occlusion of the internal jugular vein and right brachiocephalic trunk. The alternative surgical treatment chosen was to transpose the RUL cephalic vein, forming a venous necklace at the anterior cervical region, bypassing the site of venous occlusion. In order to achieve this, we dissected the cephalic vein in the right arm to its junction with the axillary vein, devalved the cephalic vein and anastomosed it to the contralateral external jugular vein, providing venous drainage to the RUL, alleviating symptoms of venous hypertension and preserving function of the brachiobasilic fistula.

  13. 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

    BACKGROUND: Sentinel node biopsy (SNB) is the "gold standard" in axillary staging in clinically node-negative breast cancer patients. However, axillary treatment is undergoing a paradigm shift and studies are being conducted on whether SNB may be omitted in low-risk patients. The purpose of this ......BACKGROUND: Sentinel node biopsy (SNB) is the "gold standard" in axillary staging in clinically node-negative breast cancer patients. However, axillary treatment is undergoing a paradigm shift and studies are being conducted on whether SNB may be omitted in low-risk patients. The purpose...... 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...... four other centers. All statistical tests were two-sided. RESULTS: A total of 426 of the 1,395 (30.5 %) patients in the original patient series had axillary lymph node metastases. Histological size (P

  14. Axillary web syndrome following secondary breast-conserving surgery: a case report

    OpenAIRE

    Wei, Panmei; Zhu, Liling; Chen, Kai; Jia, Weijuan; Hu, Yue; Su, Fengxi

    2013-01-01

    Background Axillary web syndrome is a cause of significant morbidity in the early postoperative period after axillary surgery. Case presentation A patient developed axillary web syndrome after secondary breast surgery and recovered in 3 weeks through physical therapy and using Aescuven Forte. Discussion The pathogenesis of axillary web syndrome is not clear. It is reported that axillary surgery is the main cause. The presented case indicates that tissue injury might be an important cause of a...

  15. Ultrasound-guided block of the axillary nerve

    DEFF Research Database (Denmark)

    Rothe, C; Lund, J; Jenstrup, M T

    2012-01-01

    performed using a newly developed in-plane ultrasound-guided technique. In one patient undergoing arthroscopic shoulder surgery, we used the axillary nerve block as the only analgesic combined with propofol sedation and spontaneous breathing. Chronic shoulder pain was eliminated after the axillary nerve...... block in two patients. The pain score after arthroscopic shoulder surgery in these two patients remained low until termination of the nerve block. In a fourth patient, severe post-operative pain after osteosynthesis of a displaced proximal humerus fracture was almost eliminated after performing...... an axillary nerve block. These findings warrant larger clinical trials that investigate the pain-mediating role of the axillary nerve in the perioperative setting....

  16. Energy expenditure during ambulation with ortho crutches and axillary crutches.

    Science.gov (United States)

    Hinton, C A; Cullen, K E

    1982-06-01

    Thirteen normal male college students were studied during unassisted ambulation and nonweight-bearing ambulation with Ortho crutches and axillary crutches to determine energy expenditure. Subjects walked at self-selected velocities. Energy expenditure was determined by analyzing expired air collected by a calorimeter. Heart rate was monitored by telemetry. During the first 2.5 minutes of walking, heart rate and energy expenditure were significantly greater for ambulation with axillary crutches than with Ortho crutches. After 11.5 minutes of walking, no difference in energy cost was found between crutch types; however, heart rate increased significantly (p less than .01) during ambulation with axillary crutches. Differences in energy cost and heart rate were attributed to increased upper extremity work performed when using axillary crutches. We concluded that during nonweight-bearing ambulation for short periods of time or over a short distance, the Ortho crutch is less taxing in terms of energy cost and heart rate demands.

  17. Axillary web syndrome following sentinel node biopsy for breast cancer.

    Science.gov (United States)

    Nieves Maldonado, S M; Pubul Núñez, V; Argibay Vázquez, S; Macías Cortiñas, M; Ruibal Morell, Á

    2016-01-01

    A 49 year-old woman diagnosed with infiltrating lobular breast carcinoma, underwent a right mastectomy and sentinel node biopsy (SLNB). The resected sentinel lymph nodes were negative for malignancy, with an axillary lymphadenectomy not being performed. In the early post-operative period, the patient reported an axillary skin tension sensation, associated with a painful palpable cord. These are typical manifestations of axillary web syndrome (AWS), a poorly known axillary surgery complication, from both invasive and conservative interventions. By presenting this case we want to focus the attention on a pathological condition, for which its incidence may be underestimated by not including it in SLNB studies. It is important for nuclear medicine physicians to be aware of AWS as a more common complication than infection, seroma, or lymphoedema, and to discuss this possible event with the patient who is consenting to the procedure. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  18. Nerve Transfers for Treatment of Isolated Axillary Nerve Injuries

    OpenAIRE

    Wheelock, Margie; Clark, Tod A; Giuffre, Jennifer L

    2015-01-01

    Almost one-half of all dislocations involve the shoulder and may also involve the axillary nerves, which may influence functional recovery and result in persistent shoulder neuropathy. Although individuals with intact rotator cuffs may be able to compensate for axillary nerve dysfunction, the injury may become problematic in later years, especially given the increasing incidence of rotator cuff tears in aging populations, thus placing increased importance on the immediate success of acute man...

  19. Surgical Algorithm and Results of Isolated Traumatic Axillary Nerve Injuries.

    Science.gov (United States)

    Chen, Wayne A; Schippert, David W; Daws, Snow B; Koman, L Andrew; Li, Zhongyu

    2016-03-01

    Axillary nerve injuries are common and typically occur during high-energy, traumatic events. The purpose of this study is to propose a treatment algorithm for acute isolated axillary nerve injuries and report the outcomes of surgically treated patients. A retrospective review identified 14 patients surgically treated for an isolated axillary nerve injury. Axillary nerve neurolysis was performed for all patients, and a triceps branch of the radial nerve was transferred to the axillary nerve in patients without evidence of deltoid function following intraoperative axillary nerve stimulation. Four patients were treated with neurolysis alone and 10 patients received a transfer. Pre- and postoperative deltoid strength, shoulder abduction, and the Disabilities of the Arm, Shoulder, and Hand (DASH) outcome score were evaluated. At most recent follow-up, both the neurolysis and nerve transfer groups had significant improvement in deltoid strength, with 86% achieving M4 or greater. Shoulder abduction improved from a mean of 63 to 127 degrees. This difference was significant in the nerve transfer group and when all patients were analyzed together. DASH scores significantly improved from a mean of 47 to 34 when all patients were analyzed together. No patients experienced a decrease in elbow extension strength following nerve transfer. In patients with preserved triceps strength, a triceps branch of the radial nerve can be coapted directly to the axillary nerve in the absence of deltoid contraction following electrical stimulation. Functional improvements were seen in patients treated with neurolysis alone and in combination with nerve transfer, supporting the use of intraoperative axillary nerve stimulation to guide treatment. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Proximal humerus fracture associated with delayed axillary nerve injury

    OpenAIRE

    Patpiya Sirasaporn

    2016-01-01

    Axillary nerve injury is the most common complication in humerus fracture. The symptoms that are caused by affecting axillary nerve vary according to the structures involved such as sensory disturbance and weakness of muscles, e.g., three parts of deltoid and teres muscles in an affected limb. The severity of injury is classified in demyelinating and axonal lesions, which usually occurs at the onset of fracture. The author reports a case of humerus fracture with delayed axonal lesion of axill...

  1. The role of axillary dissection in mammographically detected carcinoma.

    Science.gov (United States)

    Pandelidis, S M; Peters, K L; Walusimbi, M S; Casady, R L; Laux, S V; Cavanaugh, S H; Bauer, T L

    1997-04-01

    Axillary dissection remains a standard component of the treatment of invasive carcinoma of the breast. The presence of metastases to the regional lymph nodes guides adjuvant therapy and aids in determining prognosis. Mammography results in the discovery of small and often node-negative carcinomas of the breast. This 15-year, retrospective analysis investigated whether certain patients with small tumors could be spared the morbidity of axillary dissection. Medical records showed that from January 1980 to May 1995, 4,543 needle localization biopsies were done at York Hospital because of abnormalities detected on mammograms. Of these, 703 (15.5 percent) proved to be carcinoma. Of the carcinomas, 68 percent were infiltrating ductal carcinoma, 26 percent were ductal carcinoma in situ, and 5.4 percent were infiltrating lobular carcinoma. Axillary dissection was done on 588 patients, and 88.1 percent of the patients had no metastases to axillary lymph nodes. No axillary metastases were present in 109 patients with ductal carcinoma in situ who underwent axillary lymph node dissection or in 21 patients with microscopic invasive tumors. Only two of 54 patients with a T1a tumor (tumor [T], 0.5 to 1 to 2 cm) were given adjuvant chemotherapy or hormonal therapy. Patients with ductal carcinoma in situ and microscopic invasive tumors do not require node dissections. Possibly patients with T1a tumors and patients with well-differentiated, estrogen-receptor positive, progesterone-receptor positive, T1b tumors can also be spared axillary node dissection. By following this approach on occasion, patients with positive nodes might not undergo axillary lymph node dissection, but they may still be offered adjuvant therapy.

  2. Congenital pulmonary vein stenosis.

    Science.gov (United States)

    Manzar, Shabih

    2007-06-01

    A case of a newborn infant is described who presented with severe cyanosis at birth with rapid deterioration. The infant died at six hours of life. The diagnosis was determined at autopsy as congenital pulmonary vein stenosis.

  3. The blind pushing technique for peripherally inserted central catheter placement through brachial vein puncture.

    Science.gov (United States)

    Lee, Jae Myeong; Cho, Young Kwon; Kim, Han Myun; Song, Myung Gyu; Song, Soon-Young; Yeon, Jae Woo; Yoon, Dae Young; Lee, Sam Yeol

    2018-03-01

    The objective of this study was to conduct a prospective clinical trial evaluating the technical feasibility and short-term clinical outcome of the blind pushing technique for placement of pretrimmed peripherally inserted central catheters (PICCs) through brachial vein access. Patients requiring PICC placement at any of the three participating institutions were prospectively enrolled between January and December 2016. The review boards of all participating institutions approved this study, and informed consent was obtained from all patients. PICC placement was performed using the blind pushing technique and primary brachial vein access. The following data were collected from unified case report forms: access vein, obstacles during PICC advancement, procedure time, and postprocedural complications. During the 12-month study period, 1380 PICCs were placed in 1043 patients. Of these, 1092 PICCs placed in 837 patients were enrolled, with 834 PICCs (76%) and 258 PICCs (34%) placed through brachial vein and nonbrachial vein access, respectively. In both arms, obstacles were most commonly noted in the subclavian veins (n = 220) and axillary veins (n = 94). Successful puncture of the access vein was achieved at first try in 1028 PICCs (94%). The technical success rate was 99%, with 1055 PICCs (97%) placed within 120 seconds of procedure time and 1088 PICCs (99%) having the tip located at the ideal position. Follow-up Doppler ultrasound detected catheter-associated upper extremity deep venous thrombosis (UEDVT) for 18 PICCs in 16 patients and late symptomatic UEDVT for 16 PICCs in 16 patients (3.1%). Catheter-associated UEDVT was noted for 28 PICCs (82%) and 6 PICCs (18%) placed through brachial vein and nonbrachial vein access, respectively. The incidence of obstacles and the procedure time (<120 seconds) differed significantly between brachial vein and nonbrachial vein access (P = .001). There was no statistically significant difference between brachial vein and

  4. Mesenteric vein thrombosis: CT identification

    Energy Technology Data Exchange (ETDEWEB)

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-07-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis.

  5. Mesenteric vein thrombosis: CT identification

    International Nuclear Information System (INIS)

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-01-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis

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

    Directory of Open Access Journals (Sweden)

    Yu Toyoda

    2017-02-01

    Full Text Available 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.

  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. Acquired Jugular Vein Aneurysm

    Science.gov (United States)

    Hopsu, Erkki; Tarkkanen, Jussi; Vento, Seija I.; Pitkäranta, Anne

    2009-01-01

    Venous malformations of the jugular veins are rare findings. Aneurysms and phlebectasias are the lesions most often reported. We report on an adult patient with an abruptly appearing large tumorous mass on the left side of the neck identified as a jugular vein aneurysm. Upon clinical examination with ultrasound, a lateral neck cyst was primarily suspected. Surgery revealed a saccular aneurysm in intimate connection with the internal jugular vein. Histology showed an organized hematoma inside the aneurysmal sac, which had a focally thinned muscular layer. The terminology and the treatment guidelines of venous dilatation lesions are discussed. For phlebectasias, conservative treatment is usually recommended, whereas for saccular aneurysms, surgical resection is the treatment of choice. While an exact classification based on etiology and pathophysiology is not possible, a more uniform taxonomy would clarify the guidelines for different therapeutic modalities for venous dilatation lesions. PMID:20107571

  9. Iatrogenic axillary neuropathy after intramuscular injection of the deltoid muscle.

    Science.gov (United States)

    Davidson, Loren T; Carter, Gregory T; Kilmer, David D; Han, Jay J

    2007-06-01

    A previously healthy 26-yr-old male presented for an electrodiagnostic evaluation with complaints of significant right deltoid muscle atrophy and shoulder abduction weakness after receiving an intramuscular (IM) deltoid injection of an antiemetic 4 wk earlier. Electrodiagnostic evaluation confirmed an acute axillary neuropathy. We hypothesize that direct mechanical trauma to the anterior branch of the axillary nerve resulted in axillary mononeuropathy with axonal loss, although chemically induced nerve injury cannot be excluded. Injections in and about the shoulder complex are performed routinely for the purposes of vaccination, IM medication administration, deltoid trigger-point injections, and intra-articular and bursal steroid injections. Although such injections are considered routine office procedures, there is increased risk of neurovascular injury if they are performed incorrectly. The purpose of this brief report is to make practitioners aware of the potential for axillary neuropathy with such procedures, to review the salient anatomy, and to propose a potential guideline for clinical practice to minimize iatrogenic axillary neuropathy.

  10. The Effect of Ethnicity on Human Axillary Odorant Production.

    Science.gov (United States)

    Prokop-Prigge, Katharine A; Greene, Kathryn; Varallo, Lauren; Wysocki, Charles J; Preti, George

    2016-01-01

    Previous findings from our laboratory highlighted marked ethnic differences in volatile organic compounds (VOCs) from cerumen among individuals of Caucasian, East Asian, and African-American descent, based, in part, on genetic differences in a gene that codes for a transport protein, which is a member of the ATP-binding cassette transporter, sub-family C, member 11 (ABCC11). In the current work, we hypothesized that axillary odorants produced by East Asians would differ markedly from those obtained from individuals of European or African descent based on the pattern of ethnic diversity that exists in ABCC11. Using gas chromatography/mass spectrometry (GC/MS) we examined differences in axillary odorant VOCs among 30 individuals of African-American, Caucasian, and East Asian descent with respect to their ABCC11 genotype. While no qualitative differences in the type of axillary odorants were observed across ethnic groups, we found that characteristic axillary odorants varied quantitatively with respect to ethnic origin. We propose that ABCC11 is not solely responsible for predicting the relative amounts of volatiles found in axillary secretions and that other biochemical pathways must be involved.

  11. Anatomical information for intercostobrachial nerve preservation in axillary lymph node dissection for breast cancer.

    Science.gov (United States)

    Zhu, J J; Liu, X F; Zhang, P L; Yang, J Z; Wang, J; Qin, Y; Zhang, G L; Ren, D Q; Cui, C L; Guo, X G

    2014-01-24

    This study aimed to provide additional anatomical information for axillary lymph node dissection (ALND) through in vivo anatomy studies of intercostobrachial nerve (ICBN) preservation in order to provide theoretical and practical experience for clinicians. A total of 156 patients with breast cancer underwent ALND at the Department of Gynecology of Baotou Tumor Hospital between June 2009 and March 2010. The origin, destination, main source, length, branch type, and direction of ICBN in axilla were observed, as well as its relationship with adjacent major blood vessels and nerves within the axilla. There were 120 cases of single trunk, 23 cases of double trunks, 9 cases of multiple trunks, and 4 cases without trunks in 156 patients with ICBN preservation. The transverse diameter at the origin of the ICBN was 1.89 ± 0.44 mm with a length of 94.45 ± 12.08 mm; the distances were 77.19 ± 21.04 mm, 29.34 ± 6.73 mm, 90.04 ± 13.13 mm, and 28.63 ± 13.01 mm from origin to the inferior margin at the midpoint of the clavicle, inferior margin of the axillary vein, the bottom of axilla, and branch point, respectively. The identification, dissection, and preservation of ICBN was simple and easy in a modified radical mastectomy for breast cancer and breast-conserving surgery, which only took 10-20 min, but effectively reduced the incidence of post-mastectomy pain syndrome and significantly improved the quality of life for patients after surgery.

  12. Influence of arm position on ultrasound visibility of the axillary brachial plexus

    NARCIS (Netherlands)

    Frkovic, Vedran; Ward, Catherine; Preckel, Benedikt; Lirk, Phillip; Hollmann, Markus W.; Stevens, Markus F.; Wegener, Jessica T.

    2015-01-01

    BACKGROUND Contemporary axillary brachial plexus block is performed by separate injections targeting radial, median, ulnar and musculocutaneous nerve. These nerves are arranged around the axillary artery, making ultrasound visualisation sometimes challenging. In particular, the radial nerve can be

  13. Radial to Axillary Nerve Transfers: A Combined Case Series.

    Science.gov (United States)

    Desai, Mihir J; Daly, Charles A; Seiler, John G; Wray, Walter H; Ruch, David S; Leversedge, Fraser J

    2016-12-01

    Loss of active shoulder abduction after brachial plexus or isolated axillary nerve injury is associated with a severe functional deficit. The purpose of this 2-center study was to retrospectively evaluate restoration of shoulder abduction after transfer of a radial nerve branch to the axillary nerve for patients after brachial plexus or axillary nerve injury. Patients who underwent transfer of a radial nerve branch to the anterior branch of the axillary nerve between 2004 and 2014 were reviewed. A total of 27 patients with an average follow-up of 22 months were included. Outcome measures included pre- and postoperative shoulder abduction and triceps strength and active and passive shoulder range of motion. Shoulder abduction strength increased after surgery in 89% of patients. Average preoperative shoulder abduction was 12° compared with 114° after surgery. Twenty-two of 27 patients (81.5%) achieved at least M3 strength, with 17 of 27 patients (62.9%) achieving M4 strength. No differences were observed when subgroup analysis was performed for isolated nerve transfer versus multiple nerve transfer, mechanism of injury, injury level, branch of radial nerve transferred, or time from injury to surgery. A negative correlation was found comparing increasing age and both shoulder abduction strength and active shoulder abduction. No patients lost triceps strength after surgery. There were 4 patients who achieved no significant gain in shoulder abduction or deltoid strength and were deemed failures. No postoperative complications occurred. Transfer of a branch of the radial nerve to the anterior branch of the axillary nerve was successful in improving shoulder abduction strength and active shoulder motion in the majority of the patients with brachial plexus or isolated axillary nerve injury. Therapeutic IV. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  14. Mapping the axillary nerve within the deltoid muscle.

    Science.gov (United States)

    Loukas, Marios; Grabska, Joanna; Tubbs, R Shane; Apaydin, Nihal; Jordan, Robert

    2009-01-01

    Reports place the frequency of axillary nerve injury at 6% for all brachial plexus injuries, emphasizing the importance of an accurate anatomic description of this nerve within the deltoid in order to reduce iatrogenic injury. The aim of the present study was to explore the anatomic variations of the axillary nerve within the deltoid muscle. Fifty human cadavers were dissected, resulting in 100 nerve specimens. The anterior and posterior branches of the axillary nerve were identified and their length measured from their point of origin (split from the axillary nerve) to their termination in the deltoid muscle. In 65% of cases, the axillary nerve split into two branches (anterior and posterior) within the quadrangular space, and in the remaining 35% split within the deltoid muscle. The posterior branch of the deltoid muscle irrespectively of origin gave off a branch to the teres minor and the superior lateral brachial cutaneous nerve in 100% of cases. The branch to the posterior part of the deltoid muscle was present in 90% of cases, and the branch to the middle part of the deltoid was present in 38% of cases. The anterior branch of the deltoid muscle provided a branch to the joint capsule, a branch to the anterior part of the deltoid muscle and the middle part of the deltoid in 100% of cases. In 18% of the cases, the anterior branch of the axillary nerve provided a branch to the posterior part of the deltoid muscle. The middle part of the deltoid muscle received dual innervation in 38% of cases and the posterior part of the deltoid muscle in 8% of the cases.

  15. Potential axillary nerve stretching during RSA implantation: an anatomical study.

    Science.gov (United States)

    Marion, Blandine; Leclère, Franck Marie; Casoli, Vincent; Paganini, Federico; Unglaub, Frank; Spies, Christian; Valenti, Philippe

    2014-09-01

    Clinical and subclinical neurological injury after reverse shoulder arthroplasty (RSA) may jeopardize functional outcomes due to the risk of irreversible damage to the axillary nerve. We proposed a simple anatomical study in order to assess the macroscopic effects on the axillary nerve when lowering the humerus as performed during RSA implantation. We also measured the effect on the axillary nerve of a lateralization of the humerus. Between 2011 and 2012, cadaveric dissections of 16 shoulder specimens from nine fresh human cadavers were performed in order to assess the effects on the axillary nerve after the lowering and lateralization of the humerus. We assessed the extent of stretching of the axillary nerve in four positions in the sagittal plane [lowering of the humerus: great tuberosity in contact with the acromion (position 1), in contact with the upper (position 2), middle (position 3) and lower rim of the glenoid (position 4)] and three positions in the frontal plane [lateralization of the humerus: humerus in contact with the glenoid (position 1), humerus lateralized 1 cm (position 2) and 2 cm (position 3)]. When the humerus was lowered, clear macroscopical changes appeared below the middle of the glenoid (the highest level of tension). As regards the lateralization of the humerus, macroscopic study and measurements confirm the absence of stretching of the nerve in those positions. Lowering of the humerus below the equator of the glenoid changes the course and tension of the axillary nerve and may lead to stretching and irreversible damage, compromising the function of the deltoid. Improvements in the design of the implants and modification of the positioning of the glenosphere to avoid notching and to increase mobility must take into account the anatomical changes induced by the prosthesis and its impact on the brachial plexus. Level of Evidence and study type Level IV.

  16. The vein collar

    DEFF Research Database (Denmark)

    Lundgren, F; Schroeder, Torben Veith

    2012-01-01

    Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect on...

  17. Portal vein thrombosis.

    Science.gov (United States)

    Chawla, Yogesh K; Bodh, Vijay

    2015-03-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion.

  18. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts

    2012-04-05

    This podcast discusses the risk for deep vein thrombosis in long-distance travelers and ways to minimize that risk.  Created: 4/5/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/5/2012.

  19. Portal Vein Thrombosis

    Science.gov (United States)

    Chawla, Yogesh K.; Bodh, Vijay

    2015-01-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  20. The vein collar

    DEFF Research Database (Denmark)

    Lundgren, F; Schroeder, Torben Veith

    2012-01-01

    Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect...

  1. What Are Varicose Veins?

    Science.gov (United States)

    ... Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve ...

  2. Deep Vein Thrombosis

    African Journals Online (AJOL)

    OWNER

    ABSTRACT. BACKGROUND: Deep vein thrombosis (DVT) is a cause of preventable morbidity and mortality in hospitalized surgical patients. The occurrence of the disease is related to presence of risk factors, which are related primarily to trauma, venous stasis and hyper-coagulability. DVT seems not to be taken seriously ...

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

    Science.gov (United States)

    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. © The Author(s) 2014.

  4. Axillary hyperhidrosis treated with alcoholic solution of aluminium chloride hexahydrate.

    Science.gov (United States)

    Scholes, K T; Crow, K D; Ellis, J P; Harman, R R; Saihan, E M

    1978-01-01

    Sixty-five patients with axillary hyperhidrosis took part in a trial of treatment with a solution of 20% aluminium chloride hexahydrate in absolute alcohol, applied topically each night for a week and then whenever the patient thought it necessary. Excellent control of sweating was achieved in 64 patients, and occlusion of the area was found to be unnecessary. No troublesome side effects were reported. The results of this study indicate that 20% aluminium chloride hexahydrate in absolute alcohol is the treatment of first choice for patients with axillary hyperhidrosis. PMID:667571

  5. Effect of temperature on development and growth potential of axillary buds in roses

    NARCIS (Netherlands)

    Marcelis-van Acker, C.A.M.

    1995-01-01

    The effect of temperature during axillary bud formation on axillary bud development and subsequent shoot growth was investigated. Growth potential of the axillary buds was studied either in situ, by pruning the parent shoot above the bud, or in isolation, by grafting the bud or by culturing the bud

  6. Collateral veins in left renal vein stenosis demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.; Talle, K.

    1983-01-01

    Twelve patients with left renal vein stenosis from tumor compression were studied with CT. All had distended collateral veins in the perirenal space which either formed a radiating or a cobweb pattern or appeared as marked longitudinal veins. Inferior phrenic vein branches were seen in seven patients and were considerably enlarged in two. Other major veins possibly taking part in collateral circulation could not be recognized due to obliteration of fat planes. The renal fascia was thickened in eleven patients, probably due to edema. A close study of the perirenal space with CT may give valuable information about collateral development. (orig.)

  7. [Axillary hyperhidrosis--efficacy and tolerability of an aluminium chloride antiperspirant. Prospective evaluation on 20 patients with idiopathic axillary hyperhidrosis].

    Science.gov (United States)

    Streker, M; Reuther, T; Verst, S; Kerscher, M

    2010-02-01

    The purpose of this study was to evaluate the efficacy and tolerability of aluminium chloride gel for treatment of axillary hyperhidrosis. A total of 20 patients aged 22-38 (mean age: 26.9+/-4.3) with idiopathic axillary hyperhidrosis were included and treated with an antiperspirant (Sweat-off, Sweat-off GmbH, Hügelsheim). Study duration was 42 days. Treatment efficacy was evaluated clinically, as well as by starch-iodine test, gravimetric analysis and evaluation of the skin surface pH. After treatment there was a significant clinical improvement accompanied by significant qualitative and quantitative reduction of sweat as well as a significant reduction of skin surface pH. Except for slight skin irritation in 6 patients, there were no other side effects. Patient satisfaction improved markedly during the study. Treatment of axillary hyperhidrosis with aluminium chloride is an effective, safe and inexpensive treatment modality.

  8. Deep Cerebral Vein Thrombosis: A Clinical Masquerader

    OpenAIRE

    Kumar, Prabhat; Sasmal, Gargi; Mahto, Subodh Kumar; Gupta, Shreya; Gupta, Harish

    2017-01-01

    Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosis of internal cerebral vein, vein of Galen and basal vein of Rosenthal. Only 10% cases of CVT are because of thrombosis of deep cerebral vein. The diagnosis of DCVT is often missed because of its heterogenous presentation. Herein, we present a case of DCVT which was initially ...

  9. Axillary treatment for patients with early breast cancer and lymph node metastasis: systematic review protocol

    Directory of Open Access Journals (Sweden)

    Goyal Amit

    2013-01-01

    Full Text Available Abstract Background For patients with early breast cancer and lymph node metastasis, axillary treatment is widely recommended. This is either surgical removal of the axillary lymph nodes, or axillary radiotherapy. The rationale for axillary treatment is that it will reduce the risk of recurrence in the axilla, and may improve survival. However, both treatments are associated with adverse effects, such as lymphedema, pain and sensory loss, and are costly to the health services and to patients. With improvements in adjuvant therapy, routine axillary treatment may no longer offer any overall advantage. Objectives To assess the short and long term benefits and adverse effects of routine axillary treatment (axillary lymph node clearance or axillary radiotherapy for patients with lymph node positive early-stage breast cancer. Methods/Design Criteria for potentially eligibility for the study will be that the participants are men and women with early breast cancer and lymph nodes with metastasis. The study compares either axillary treatment with no axillary treatment, or axillary node clearance with axillary radiotherapy, and the study is a randomized trial. Primary outcomes are axillary recurrence, disease-free and overall survival. Secondary outcomes include breast or chest wall recurrence, distant metastasis, time to axillary recurrence, axillary recurrence-free survival, arm morbidity, quality of life and health economic costs. The search strategy will include the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and WHO International Clinical Trials Registry Platform (ICTRP search portal. Two independent reviewers will assess studies for inclusion in the review, assess study quality and extract data. Characteristics of included studies will be described. Meta-analysis will be conducted using ReVman software. Comment This review addresses an important clinical question, and results will inform clinical practice and health care policy.

  10. Accessory hepatic vein: MR imaging

    International Nuclear Information System (INIS)

    Lee, Chang Hee; Rho, Tack Soo; Cha, Sang Hoon; Park, Cheol Min; Cha, In Ho

    1995-01-01

    To evaluate the MR appearance of the accessory hepatic veins. The study included 87 consecutive patients for whom abdominal MR images were obtained. The subjects who had liver lesion or hepatic vascular abnormalities were excluded. Couinaud classified accessory hepatic veins into inferior and middle right hepatic veins. Our major interests were evaluation of the incidence, morphology, and location of the accessory hepatic vein. Inferior right hepatic vein was demonstrated in 43 out of 87 patients (49%). The morphology was linear in 35 patients (80.5%), and V-shaped in 8 patients (19.5%). In 40 patients (93%), the inferior right hepatic vein was located in the posteroinferior aspect of the right lobe. Middle right hepatic vein was demonstrated in 7 out of 87 patients (8%). All were single linear in morphology, combined with the inferior right hepatic vein, and located between the right hepatic vein and inferior right hepatic vein. The accessory hepatic vein was demonstrated in 49% among the Korean adult population, and was located in posteroinferior portion of the liver, in 93%

  11. High Ki67 predicts unfavourable outcomes in early breast cancer patients with a clinically clear axilla who do not receive axillary dissection or axillary radiotherapy.

    Science.gov (United States)

    Zurrida, S; Bagnardi, V; Curigliano, G; Mastropasqua, M G; Orecchia, R; Disalvatore, D; Greco, M; Cataliotti, L; D'Aiuto, G; Talakhadze, N; Goldhirsch, A; Viale, G

    2013-10-01

    Axillary dissection is increasingly forgone in early breast cancer patients with a clinically negative axilla. The GRISO 053 randomised trial recruited 435 patients of age over 45 years, tumour ≤1.4 cm and clinically negative axilla, to assess the importance of axillary radiotherapy versus no axillary radiotherapy in patients not given axillary dissection. In the present study on a subgroup GRISO cases our aim was to assess the prognostic importance of tumour biological factors after more than 10 years of follow-up. We retrospectively assessed biological factors in a subgroup of 285 GRISO cases (145 given axillary radiotherapy; 140 not given axillary radiotherapy) with complete biologic, therapeutic and follow-up information, using multivariable Cox proportional hazards regression modelling. Only 10-year cumulative incidence of distant metastasis was lower in the axillary radiotherapy (1%) than no axillary radiotherapy arm (7%) (p=0.037). Irrespective of study arm, hormone receptor positivity had significantly favourable effects on 10-year disease-free survival (DFS) and overall survival. human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes were associated with lower 10-year DFS (60% and 76%, respectively) than luminal A (96%) and B (91%) (p=0.001). Ten-year DFS for high (≥14%) Ki67 cancers was lower than for low Ki67 cancers (p=0.027); however, this effect was mainly confined to the no axillary radiotherapy arm. For patients with clinically node-negative small breast cancer not given axillary dissection, 10-year DFS is worsened by HER2 positivity, triple-negative phenotype and high Ki67. Axillary radiotherapy counteracts the negative prognostic effect of high Ki67 in patients not receiving axillary dissection. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Partial axillary dissection in early breast cancer | El-Fayoumi ...

    African Journals Online (AJOL)

    ... of later clinical involvement of the axilla and at establishing a sound basis for adjuvant treatment planning axillary dissection is an important operative procedure. ... Methods: Eighteen patients underwent modified radical mastectomy, while the other two patients who were fulfilling the criteria for conservative breast surgery ...

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

    DEFF Research Database (Denmark)

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

    1994-01-01

    During af six year period 16 patients were treated for an axillary or brachial artery trauma. The vascular injury was caused by fracture in nine cases, contusion in four and penetrating injury in three. Concomitant nerve or tendon lesion occurred in five cases. Five of the 16 events were industri...

  14. Use Of Continuous Axillary Brachial Plexus Block Facilitates ...

    African Journals Online (AJOL)

    Objective: To report the successful use of continuous axillary brachial plexus block in the assessment of muscle functions during tendon repair. Methods: A prospective observational study carried out at Obafemi Awolowo University Teaching Hospital, Ile-Ife between November 2006 and December 2007. The study included ...

  15. Endovascular treatment of a spontaneous aneurysm in the axillary artery.

    Science.gov (United States)

    Park, Sung Kyun; Hwang, Jeong Kye; Park, Sun Cheol; Kim, Sang Dong

    2015-01-01

    Spontaneous aneurysm in the axillary artery is extremely rare. The standard treatment for axillary artery aneurysm has been surgical repair, but endovascular management of select aneurysms using stent grafts has become more prevalent with the development of endoluminal technology. We report the case of a 36-year old man with a spontaneous aneurysm in the axillary artery. He experienced a tingling sensation and intermittent pain in the left upper extremity and had no history of trauma to the axilla. We performed endovascular treatment [placement of a Viabahn stent graft (W.L. Gore & Associates, Flagstaff, AZ, USA)] for a spontaneous aneurysm in the axillary artery. Following the procedure, his symptoms disappeared completely. After 6, 12 and 24 months, we carried out computed tomography angiography; all scans showed no complications. Now, the patient has no symptoms related to aneurysm in the axilla. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  16. Clinical Evaluation of a Microwave Device for Treating Axillary Hyperhidrosis

    Science.gov (United States)

    Hong, H Chih-Ho; Lupin, Mark; O'Shaughnessy, Kathryn F

    2012-01-01

    Background A third-generation microwave-based device has been developed to treat axillary hyperhidrosis by selectively heating the interface between the skin and underlying fat where the sweat glands reside. Materials and Methods Thirty-one (31) adults with primary axillary hyperhidrosis were enrolled. All subjects had one to three procedure sessions over a 6-month period to treat both axillae fully. Efficacy was assessed using the Hyperhidrosis Disease Severity Scale (HDSS), gravimetric weight of sweat, and the Dermatologic Life Quality Index (DLQI), a dermatology-specific quality-of-life scale. Subject safety was assessed at each visit. Subjects were followed for 12 months after all procedure sessions were complete. Results At the 12-month follow-up visit, 90.3% had HDSS scores of 1 or 2, 90.3% had at least a 50% reduction in axillary sweat from baseline, and 85.2% had a reduction of at least 5 points on the DLQI. All subjects experienced transient effects in the treatment area such as swelling, discomfort, and numbness. The most common adverse event (12 subjects) was the presence of altered sensation in the skin of the arm that resolved in all subjects. Conclusion The device tested provided efficacious and durable treatment for axillary hyperhidrosis. PMID:22452511

  17. Interposition vein cuffs.

    Science.gov (United States)

    Harris, P; Da Silva, T; How, T

    1996-01-01

    A vein cuff interposed at the distal anastomosis between a prosthetic vascular graft and a recipient infrageniculate artery improves the chances of continued patency of the graft, at least in the short and medium term. The mode of effect appears to be suppression or modification of anastomotic myointimal hyperplasia (MIH). In the event of graft failure the recipient artery and run-off vessels remain free from MIH and their patency is preserved thereby improving the prospects for further vascular reconstruction and limb salvage. The mechanisms by which interposition vein cuffs might modulate MIH are reviewed. Experimental evidence is described to show that the geometry of a cuffed anastomosis promotes a characteristic haemodynamic flow structure with a stable vortex. It is suggested that this vortex exerts greater shear stress upon the wall of the artery than the normal laminar flow observed in conventional anastomoses. High shear stress is known to inhibit MIH.

  18. Effective axillary malodour reduction by polyquaternium-16-containing deodorants.

    Science.gov (United States)

    Traupe, B; Fölster, H; Max, H; Schulz, J

    2017-04-01

    Worldwide, individuals apply deodorants to combat malodour formation originating from the axillary vault. Considering the globally increasing demand for efficacious, safe deodorants, we investigated the antimicrobial effectiveness of a polymeric quaternary ammonium compound (PQ-16) as a new active in a roll-on formulation against microbial growth and axillary malodour. We utilized an in vivo microbiological assessment to determine antimicrobial effects of the PQ-16-containing deodorant formulation (DEO1) (i) in comparison with a commercially available deodorant roll-on claiming a 24-h protection against body odour (DEO2) and (ii) in comparison with a roll-on containing the same formulation as DEO1 but comprising aluminium chlorohydrate instead of PQ-16 (DEO3) 1, 4, 8, 24 and 48 h after treatment. Also, the axillary malodour intensity 24 and 48 h after application of deodorants was investigated in a controlled in vivo study performed by a trained sniffer panel using direct sniffing. Treatment with DEO1 in comparison with application of DEO2 significantly reduced the log 10 bacterial count at all points in time. After 24 and 48 h, sniffers rated malodour production in the DEO1-treated axillae significantly lower than in the DEO2-treated armpits. Application of DEO1 in comparison with DEO3 decreased the log 10 bacterial count after 1, 4, 8 and 24 h (significant for 4 and 8 h). After 48 h, the log 10 bacterial count showed similar values for both DEO1 and DEO3. The sniffer panel reported no significant differences between axillary malodour in DEO1-treated compared to DEO3-treated armpits after 24 and 48 h. We identified polyquaternium-16 (PQ-16, copolymers of 1-vinyl-2-pyrrolidone and 1-vinyl-3-methylimidazolium chloride) as a highly effective deodorant active. Results showed that a newly developed PQ-16-containing deodorant roll-on formulation (i) significantly reduced axillary malodour 24 and 48 h after treatment, (ii) significantly decreased the amount of axillary

  19. Pulmonary vein stenosis and the pathophysiology of "upstream" pulmonary veins.

    Science.gov (United States)

    Kato, Hideyuki; Fu, Yaqin Yana; Zhu, Jiaquan; Wang, Lixing; Aafaqi, Shabana; Rahkonen, Otto; Slorach, Cameron; Traister, Alexandra; Leung, Chung Ho; Chiasson, David; Mertens, Luc; Benson, Lee; Weisel, Richard D; Hinz, Boris; Maynes, Jason T; Coles, John G; Caldarone, Christopher A

    2014-07-01

    Surgical and catheter-based interventions on pulmonary veins are associated with pulmonary vein stenosis (PVS), which can progress diffusely through the "upstream" pulmonary veins. The mechanism has been rarely studied. We used a porcine model of PVS to assess disease progression with emphasis on the potential role of endothelial-mesenchymal transition (EndMT). Neonatal piglets underwent bilateral pulmonary vein banding (banded, n = 6) or sham operations (sham, n = 6). Additional piglets underwent identical banding and stent implantation in a single-banded pulmonary vein 3 weeks postbanding (stented, n = 6). At 7 weeks postbanding, hemodynamics and upstream PV pathology were assessed. Banded piglets developed pulmonary hypertension. The upstream pulmonary veins exhibited intimal thickening associated with features of EndMT, including increased transforming growth factor (TGF)-β1 and Smad expression, loss of endothelial and gain of mesenchymal marker expression, and coexpression of endothelial and mesenchymal markers in banded pulmonary vein intimal cells. These immunopathologic changes and a prominent myofibroblast phenotype in the remodeled pulmonary veins were consistently identified in specimens from patients with PVS, in vitro TGF-β1-stimulated cells isolated from piglet and human pulmonary veins, and human umbilical vein endothelial cells. After stent implantation, decompression of a pulmonary vein was associated with reappearance of endothelial marker expression, suggesting the potential for plasticity in the observed pathologic changes, followed by rapid in-stent restenosis. Neonatal pulmonary vein banding in piglets recapitulates critical aspects of clinical PVS and highlights a pathologic profile consistent with EndMT, supporting the rationale for evaluating therapeutic strategies designed to exploit reversibility of upstream pulmonary vein pathology. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All

  20. Relationship between axillary nerve and percutaneously inserted proximal humeral locking plate: a cadaver study.

    Science.gov (United States)

    Esenyel, Cem Zeki; Dedeoğlu, Semih; Imren, Yunus; Kahraman, Sinan; Çakar, Murat; Öztürk, Kahraman

    2014-01-01

    The aim of this study was to investigate the relationship between the axillary nerve and the percutaneously inserted proximal humeral locking plate and to evaluate the risk of axillary nerve injury during percutaneous plate insertion. The study included 50 shoulders of 25 fresh frozen cadavers. A 5 cm incision was made from the anterolateral border of the acromion to the arm and a 5-hole 3.5-mm proximal humeral plate was inserted. The axillary nerve was then dissected. Plate holes which crossed the axillary nerve were noted. The distance between the axillary nerve and the lateral edge of the acromion and the length of the arm were measured and their relations evaluated with a correlation test. The average arm length was 319 mm. The average distance between the axillary nerve and the lateral edge of the acromion was 60 mm. There was a significant correlation between the arm length and acromion-axillary nerve distance (paxillary nerve lesions. In 1 case, the distal end of the plate was inserted in the deltoid muscle. No constant relationship between the plate holes and the axillary nerve was detected. There is a risk of axillary nerve injury during percutaneous plate insertion. It must be ensured that the plate is inserted under the deltoid fascia during the surgery. The axillary nerve must be visible during application of the screws due to the impossibility of knowing which holes cross the axillary nerve.

  1. Avulsive axillary artery injury in reverse total shoulder arthroplasty.

    Science.gov (United States)

    Wingert, Nathaniel C; Beck, John D; Harter, G Dean

    2014-01-01

    In addition to neurologic injuries such as peripheral nerve palsy, axillary vessel injury should be recognized as a possible complication of reverse total shoulder arthroplasty. Limb lengthening associated with Grammont-type reverse total shoulder arthroplasty places tension across the brachial plexus and axillary vessels and may contribute to observed injuries. The Grammont-type reverse total shoulder arthroplasty prosthesis reverses the shoulder ball and socket, shifts the shoulder center of rotation distal and medial, and lengthens the arm. This alteration of native anatomy converts shearing to compressive glenohumeral joint forces while augmenting and tensioning the deltoid lever arm. Joint stability is enhanced; shoulder elevation is enabled in the rotator cuff–deficient shoulder. Arm lengthening associated with reverse total shoulder arthroplasty places a longitudinal strain on the brachial plexus and axillary vessels. Peripheral nerve palsies and other neurologic complications of reverse total shoulder arthroplasty have been documented. The authors describe a patient with rotator cuff tear arthropathy and a history of radioulnar synostosis who underwent reverse total shoulder arthroplasty complicated by intraoperative injury to the axillary artery and postoperative radial, ulnar, and musculocutaneous nerve palsies. Following a seemingly unremarkable placement of reverse shoulder components, brisk arterial bleeding was encountered while approximating the incised subscapularis tendon in preparation for wound closure. Further exploration revealed an avulsive-type injury of the axillary artery. After an unsuccessful attempt at primary repair, a synthetic arterial bypass graft was placed. Reperfusion of the right upper extremity was achieved and has been maintained to date. Postoperative clinical examination and electromyographic studies confirmed ongoing radial, ulnar, and musculocutaneous neuropathies.

  2. Advances in development of transgenic resistance to beet necrotic yellow vein virus (BNYVV) in sugar beet

    OpenAIRE

    Nagl Nevena; Atanasov Ivan; Rusanov Krasimir; Paunović Svetlana; Kovačev Lazar; Atanasov Atanas

    2005-01-01

    Fragments of viral cDNA containing the coat protein gene of beet necrotic yellow vein virus were cloned in plant transformation vector pCAMBIA3301M with the bar gene as selectable marker. Vector pC3301MCPL carrying coat protein gene with leader sequence, and pC3301MCPS with coat protein gene, were used in Agrobacterium - mediated transformation of sugar beet. The transformation method used was based on the fact that sugar beet develops axillary shoots in in vitro conditions, when placed on me...

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Vein grafting in fingertip replantations.

    Science.gov (United States)

    Yan, Hede; Jackson, William D; Songcharoen, Somjade; Akdemir, Ovunc; Li, Zhijie; Chen, Xinglong; Jiang, Liangfu; Gao, Weiyang

    2009-01-01

    In this retrospective study, the survival rates of fingertip replantation with and without vein grafting were evaluated along with their postoperative functional and cosmetic results. One hundred twenty-one-fingertip amputations were performed in 103 patients between September 2002 and July 2007. Thirty-four amputated fingertips were replanted without vein grafting, while 87 amputated fingertips were replanted with vein grafting for arterial and/or venous repairs. The overall survival rates of the replantations with and without vein grafting were 90% (78/87) and 85% (29/34), respectively. The survival rates were 88% (36/41) with venous repair, 93% (25/27) with arterial repair, and 89% (17/19) with both. Nineteen patients without vein grafting and 48 patients with vein grafting had a follow-up period of more than one year. Good cosmetic and functional outcomes were observed in both groups of patients. The results show that vein grafting is a reliable technique in fingertip replantations, showing no significant difference (P > 0.05) in survival between those with and without vein grafting. Furthermore, no significant difference (P > 0.05) in survival was found between cases with vein grafts for arterial and/or venous repairs. In fingertip replantations with vein grafting, favorable functional and esthetic results can be achieved without sacrificing replantation survival. (c) 2009 Wiley-Liss, Inc.

  5. AXILLARY ARTERY- A STUDY ON BRANCHING PATTERN AND VARIATIONS

    Directory of Open Access Journals (Sweden)

    Maheswary Thampi S

    2017-05-01

    Full Text Available BACKGROUND Study of variations in the branching pattern of axillary artery is of considerable importance. There may be variations in the origin of branches, additional branches or 2 or more from common trunk or the artery may arise separately. The anomalous branching pattern can be correlated to the developmental defects of vasculature during embryonic life. The axillary artery is a part of axis artery of upper limb. Morphological variations of axillary artery of upper limb is very important for vascular surgeons, cardiologists, anaesthetists, radiologists and orthopaedic surgeons. Present study is aimed at finding out the branching pattern of axillary artery, clinical significance and to correlate its embryological basis. MATERIALS AND METHODS The present study was conducted on 20 formalin fixed cadavers (40 limbs, which were allotted to the undergraduate, postgraduate students and BDS students of Government Medical College, Kottayam. Cadavers were numbered 1-20 and the axillary artery and its branches were dissected on both sides following the classical incision and dissection procedure taking care to preserve all branches. The artery was studied under the following headings- 1. Origin of all branches; 2. Course and variation. RESULTS In the present study, it was observed that the branching pattern of axillary artery showed variations in 80% of cases. 8 upper limbs showed normal pattern of distribution (20%. The branches revealed different levels of origin and distribution from the normal pattern. The most common variations observed in the origin of subscapular artery and anterior and posterior circumflex humeral arteries together constitute 40%. The remaining 40% of variations were observed in superior thoracic (17.5%, thoracoacromial (12.5% and lateral thoracic (10%. These observations in the arterial variations highlights the awareness during regional surgeries and other interventional procedures. CONCLUSION Variations observed in this

  6. Outcome of axillary nerve injuries treated with nerve grafts.

    Science.gov (United States)

    Okazaki, M; Al-Shawi, A; Gschwind, C R; Warwick, D J; Tonkin, M A

    2011-09-01

    This study evaluates the outcome of axillary nerve injuries treated with nerve grafting. Thirty-six patients were retrospectively reviewed after a mean of 53 months (minimum 12 months). The mean interval from injury to surgery was 6.5 months. Recovery of deltoid function was assessed by the power of both abduction and retropulsion, the deltoid bulk and extension lag. The deltoid bulk was almost symmetrical in nine of 34 cases, good in 22 and wasted in three. Grade M4 or M5* was achieved in 30 of 35 for abduction and in 32 of 35 for retropulsion. There was an extension lag in four patients. Deltoid bulk continued to improve with a longer follow-up following surgery. Nerve grafting to the axillary nerve is a reliable method of regaining deltoid function when the lesion is distal to its origin from the posterior cord.

  7. Microbiological and biochemical origins of human axillary odour.

    Science.gov (United States)

    James, A Gordon; Austin, Corrine J; Cox, Diana S; Taylor, David; Calvert, Ralph

    2013-03-01

    The generation of malodour on various sites of the human body is caused by the microbial biotransformation of odourless natural secretions into volatile odorous molecules. On the skin surface, distinctive odours emanate, in particular, from the underarm (axilla), where a large and permanent population of microorganisms thrives on secretions from the eccrine, apocrine and sebaceous glands. Traditional culture-based microbiological studies inform us that this resident microbiota consists mainly of Gram-positive bacteria of the genera Staphylococcus, Micrococcus, Corynebacterium and Propionibacterium. Among the molecular classes that have been implicated in axillary malodour are short- and medium-chain volatile fatty acids, 16-androstene steroids and, most recently, thioalcohols. Most of the available evidence suggests that members of the Corynebacterium genus are the primary causal agents of axillary odour, with the key malodour substrates believed to originate from the apocrine gland. In this article, we examine, in detail, the microbiology and biochemistry of malodour formation on axillary skin, focussing on precursor-product relationships, odour-forming enzymes and metabolic pathways and causal organisms. As well as reviewing the literature, some relevant new data are presented and considered alongside that already available in the public domain to reach an informed view on the current state-of-the-art, as well as future perspectives. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  8. Pathological axillary lymph nodes detected at mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Lim, E. T.; O' Doherty, A.; Hill, A. D.; Quinn, C. M. E-mail: c.quinn@st-vincents.ie

    2004-01-01

    AIM: To investigate the significance of abnormal axillary lymph nodes detected at mammographic screening in the absence of a concomitant breast lesion. METHODS: Twenty-three thousand, seven hundred and seven women were screened at the Merrion Unit as part of the Irish National Breast Screening Programme ('BreastCheck') in the period June 2000 to July 2002. Nine women (0.4 per 1000 women screened) were found to have an abnormal axillary lymph node(s) in the absence of a mammographic breast lesion and were recalled for assessment. The radiological criteria for recall included: size greater than or equal to 15 mm, round or irregular shape, increased node density and absence of hilar lucency. Each woman underwent further mammographic views, ultrasound examination of axilla and breast, clinical examination and lymph node biopsy either by 14 G needle core biopsy (NCB) or open excision. RESULTS: The final pathological diagnoses in the nine patients were oestrogen receptor (OR) positive metastatic breast carcinoma (two patients), metastatic malignant melanoma (one patient), malignant lymphoma (two patients), caseating granulomatous lymphadenitis suggestive of tuberculosis (one patient), and other benign conditions (three patients). CONCLUSION: Abnormal axillary lymph nodes, in the absence of an accompanying breast lesion, are rarely identified on screening mammogram, but may harbour significant pathology and their presence on screening mammogram merits further investigation including biopsy.

  9. Sentinel node detection in pre-operative axillary staging

    International Nuclear Information System (INIS)

    Trifiro, Giuseppe; Travaini, Laura Lavinia; Paganelli, Giovanni; Viale, Giuseppe; Gentilini, Oreste

    2004-01-01

    The concept of sentinel lymph node biopsy in breast cancer surgery is based on the fact that the tumour drains in a logical way via the lymphatic system, from the first to upper levels. Since axillary node dissection does not improve the prognosis of patients with breast cancer, sentinel lymph node biopsy might replace complete axillary dissection for staging of the axilla in clinically N0 patients. Sentinel lymph node biopsy would represent a significant advantage as a minimally invasive procedure, considering that about 70% of patients are found to be free from metastatic disease, yet axillary node dissection can lead to significant morbidity. Subdermal or peritumoural injection of small aliquots (and very low activity) of radiotracer is preferred to intratumoural administration, and 99m Tc-labelled colloids with most of the particles in the 100-200 nm size range would be ideal for radioguided sentinel node biopsy in breast cancer. The success rate of radioguidance in localising the sentinel lymph node in breast cancer surgery is about 97% in institutions where a high number of procedures are performed, and the success rate of lymphoscintigraphy in sentinel node detection is about 100%. The sentinel lymph node should be processed for intraoperative frozen section examination in its entirety, based on conventional histopathology and, when necessary, immune staining with anti-cytokeratin antibody. Nowadays, lymphoscintigraphy is a useful procedure in patients with different clinical evidence of breast cancer. (orig.)

  10. Leiomyosarcoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Lemos Gustavo C.

    2003-01-01

    Full Text Available Leiomyosarcoma of the renal vein is a rare tumor of complex diagnosis. We presented a case of renal vein leiomyosarcoma detected in a routine study. The primary treatment was complete surgical removal of the mass. In cases where surgical removal is not possible the prognosis is poor, with high rates of local recurrence and distant spread.

  11. How I do it: Simple and effortless approach to identify thoracodorsal nerve on axillary clearance procedure

    OpenAIRE

    Zin, T; Maw, M; Oo, SM; Pai, DR; Paijan, RB; Kyi, M

    2012-01-01

    Breast cancer surgery frequently involves an axillary clearance procedure for nodal metastases. Injury to the thoracodorsal nerve is one of the complications related to the axillary dissection. The thoracodorsal nerve innervates the latissimus dorsi muscle which facilitates in certain movements of the arm. Moreover, it can be used as a nerve graft in long thoracic nerve injury whether in trauma or surgery. Understanding the anatomy structures and good surgical technique in the axillary cleara...

  12. Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II).

    Science.gov (United States)

    García Novoa, Alejandra; Acea Nebril, Benigno; Díaz, Inma; Builes Ramírez, Sergio; Varela, Cristina; Cereijo, Carmen; Mosquera Oses, Joaquín; López Calviño, Beatriz; Seoane Pillado, María Teresa

    2016-01-01

    Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Vein type uranium deposits

    International Nuclear Information System (INIS)

    1986-01-01

    Veins are tabular- or sheet-like masses of minerals occupying or following a fracture or a set of fractures in the enclosing rock. They have been formed later than the country rock and fractures, either by filling of the open spaces or by partial or complete replacement of the adjoining rock or most commonly by both of these processes combined. This volume begins with the occurrences and deposits known from old shield areas and the sedimentary belts surrounding them. They are followed by papers describing the European deposits mostly of Variscan age, and by similar deposits known from China being of Jurassic age. The volume is completed by two papers which do not fit exactly in the given scheme. A separate abstract was prepared for each of the 25 papers in this report

  14. How I do it: Simple and effortless approach to identify thoracodorsal nerve on axillary clearance procedure.

    Science.gov (United States)

    Zin, T; Maw, M; Oo, Sm; Pai, Dr; Paijan, Rb; Kyi, M

    2012-01-01

    Breast cancer surgery frequently involves an axillary clearance procedure for nodal metastases. Injury to the thoracodorsal nerve is one of the complications related to the axillary dissection. The thoracodorsal nerve innervates the latissimus dorsi muscle which facilitates in certain movements of the arm. Moreover, it can be used as a nerve graft in long thoracic nerve injury whether in trauma or surgery. Understanding the anatomy structures and good surgical technique in the axillary clearance procedure can identify and prevent such an injury to the thoracodorsal nerve. Here, we demonstrate a simple and effortless technique for identification of the thoracodorsal nerve during axillary surgery.

  15. Deep Cerebral Vein Thrombosis: A Clinical Masquerader.

    Science.gov (United States)

    Kumar, Prabhat; Sasmal, Gargi; Mahto, Subodh Kumar; Gupta, Shreya; Gupta, Harish

    2017-04-01

    Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosis of internal cerebral vein, vein of Galen and basal vein of Rosenthal. Only 10% cases of CVT are because of thrombosis of deep cerebral vein. The diagnosis of DCVT is often missed because of its heterogenous presentation. Herein, we present a case of DCVT which was initially treated as meningoencephalitis. A timely advised brain imaging helped in making the diagnosis and patient recovered completely after institution of anticoagulation.

  16. Superficial vein thrombosis and deep vein thrombosis – a comparison

    OpenAIRE

    Krasiński, Zbigniew; Aniukiewicz, Krzysztof; Krasińska, Aleksandra; Krasińska, Beata; Gabriel, Marcin

    2017-01-01

    Although superficial vein thrombosis is commonly considered a rather minor condition, a number of studies indicate that its consequences can be much more severe. Since the introduction of Doppler ultrasonography to common diagnosis of venous diseases, the approach to threats associated with superficial vein thrombosis has changed, mainly in the context of venous thromboembolism. Superficial thrombosis in varicose veins must be differentiated from that occurring in patients without...

  17. Varicose Vein Treatment (Endovenous Ablation of Varicose Veins)

    Science.gov (United States)

    ... surgery. Most of the veins treated are effectively invisible even to ultrasound 12 months after the procedure. ... understanding of the possible charges you will incur. Web page review process: This Web page is reviewed ...

  18. Vein matching using artificial neural network in vein authentication systems

    Science.gov (United States)

    Noori Hoshyar, Azadeh; Sulaiman, Riza

    2011-10-01

    Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.

  19. Axillary artery thrombus and infective endocarditis in lupus

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2011-01-01

    Full Text Available Systemic lupus erythematosus is a chronic systemic autoimmune disease, often associated with severe infection. A female patient was referred for surgical treatment of infective endocarditis after being treated for systemic lupus erythematosus and lupus nephritis. She developed symptoms of left axillary artery occlusion before heart operation. Bulky fungal hyphae were noted on pathological examination of the surgically removed thrombi. The patient had an uncomplicated recovery after receiving high doses of antibiotics and subsequent mitral valve replacement. Either infective endocarditis or fungal thrombi may be secondary to systemic lupus erythematosus and impaired renal function.

  20. 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.

  1. 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.

  2. A Vein Map Biometric System

    Directory of Open Access Journals (Sweden)

    Felix Fuentes

    2013-08-01

    Full Text Available There is increasing demand world-wide, from government agencies and the private sector for cutting-edge biometric security technology that is difficult to breach but userfriendly at the same time. Some of the older tools, such as fingerprint, retina and iris scanning, and facial recognition software have all been found to have flaws and often viewed negatively because of many cultural and hygienic issues associated with them. Comparatively, mapping veins as a human barcode, a new technology, has many advantages over older technologies. Specifically, reproducing a three-dimensional model of a human vein system is impossible to replicate. Vein map technology is distinctive because of its state-of-the-art sensors are only able to recognize vein patterns if hemoglobin is actively flowing through the person

  3. [Management of superficial vein thrombosis].

    Science.gov (United States)

    Frappé, Paul; Bertoletti, Laurent; Moulin, Nathalie; Décousus, Hervé

    2015-02-01

    Recent epidemiological studies have highlighted the potential severity of superficial vein thrombosis of the lower limbs (SVT). Diagnosis is based on clinical and Doppler ultrasonography evaluation, and define its therapeutic management. If SVT is associated with objectively confirmed deep vein thrombosis or pulmonary embolism, curative anticoagulation is indicated. If SVT is isolated and measured over 5 cm long, prophylactic dosage of fondaparinux may be provided for 45 days.

  4. 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.

  5. Development and growth potential of axillary buds in roses as affected by bud age.

    NARCIS (Netherlands)

    Marcelis-van Acker, C.A.M.

    1994-01-01

    The effect of axillary bud age on the development and potential for growth of the bud into a shoot was studied in roses. Age of the buds occupying a similar position on the plant varied from 'subtending leaf just unfolded' up to 1 year later. With increasing age of the axillary bud its dry mass,

  6. Ontogeny of axillary buds and shoots in roses: Leaf initiation and pith development.

    NARCIS (Netherlands)

    Marcelis-van Acker, C.A.M.

    1994-01-01

    The ontogeny of an axillary bud (in the middle region of a shoot) from initiation up to flowering of the subsequent shoot was studied. The first secondary buds appeared in the axillary bud (primary bud) when the leaf subtending the primary bud unfolded. By that time, the primary bud contained seven

  7. Breast-axillary complex in HIV/AIDS patients | Eni | Nigerian Journal ...

    African Journals Online (AJOL)

    The patient on HAART had a hard breast-axillary mass complex. Biopsy (FNAB) revealed inflammatory cells and no malignancy in all three cases. HIV screening was positive in all cases. One of the patients had excision of breast-axillary mass complex, and the histology showed features of chronic inflammation, with no ...

  8. Acute traumatic anterior glenohumeral dislocation complicated by axillary nerve damage: a case report

    OpenAIRE

    Kazemi, Mohsen

    1998-01-01

    An elite soccer player presented with a classic acute anterior dislocation of the glenohumeral joint complicated by axillary nerve damage. The incidence, mechanism of injury, clinical presentation, conservative treatment and rehabilitation of the anterior glenohumeral joint dislocation and associated axillary nerve damage are discussed in this paper.

  9. Surgical anatomy of the axillary nerve branches to the deltoid muscle.

    Science.gov (United States)

    Leechavengvongs, Somsak; Teerawutthichaikit, Tanawit; Witoonchart, Kiat; Uerpairojkit, Chairoj; Malungpaishrope, Kanchai; Suppauksorn, Sunikom; Chareonwat, Boonsong

    2015-01-01

    Variations in the innervation of the posterior deltoid muscle by the anterior branch of the axillary nerve have been reported. The objective of this study is to clarify the anatomy of the axillary nerve branches to the deltoid muscle. One hundred and twenty-nine arms (68 right and 61 left) from 88 embalmed cadavers (83 male and 46 female) were included in the study. The anterior and posterior branches of the axillary nerve were identified and their lengths were measured from the point of emergence from the axillary nerve to their terminations in the deltoid muscle. In all cases, the axillary nerves split into two branches (anterior and posterior) within the quadrangular space and none split within the deltoid muscle. In all specimens, the anterior and middle parts of the deltoid muscle received their nerve supplies from the anterior branch of the axillary nerve. The posterior part of the deltoid muscle was supplied only by the anterior branch of the axillary nerve in 2.3% of the specimens, from the posterior branch in 8.5%, and from both branches in 89.1%. There were two sub-branches of the anterior branch in 4.7% of the specimens. The anterior branch of the axillary nerve supplied not only the anterior and middle parts of the deltoid muscle but also the posterior part in most cases (91.5%). © 2014 Wiley Periodicals, Inc.

  10. Axillary Nerve Reconstruction: Anterior-Posterior Exposure With Sural Nerve Cable Graft Pull-Through Technique.

    Science.gov (United States)

    Baltzer, Heather L; Spinner, Robert J; Bishop, Allen T; Shin, Alexander Y

    2015-12-01

    Deltoid paralysis after axillary nerve injury results in limitations in shoulder function and stability. In the setting of an isolated axillary nerve injury with no clinical or electromyographic evidence of recovery that is within 6 to 9 months postinjury, the authors' preferred technique to reinnervate the deltoid is to reconstruct the axillary nerve with sural nerve grafting. Intraoperative neuromuscular electrophysiology is critical to determine the continuity of the axillary nerve before proceeding with reconstruction. The majority of the time, both an anterior and posterior incision and dissection of the axillary nerve is required to adequately delineate the zone of injury. This also ensures that both proximally and distally, uninjured axillary nerve is present before graft inset and also facilitates the ability to perform a meticulous microsurgical inset of the nerve graft posteriorly. The nerve graft must be pulled through from posterior to anterior to span the zone of injury and reconstruct the axillary nerve. Careful infraclavicular brachial plexus dissection is necessary to prevent further injury to components of the brachial plexus in the setting of a scarred bed. Patients will require postoperative therapy to prevent limitations in shoulder range of motion secondary to postoperative stiffness. This paper presents a detailed surgical technique for axillary nerve reconstruction by an anterior-posterior approach with a pull-through technique of a sural nerve cable graft.

  11. Mammographic characterization of breast cancer associated with axillary lymph node metastasis

    Directory of Open Access Journals (Sweden)

    Patcharee Hongsmatip

    2012-08-01

    Full Text Available Objective: To describe mammographic characterization of breast cancer associated with axillary lymph node metastasis at King Chulalongkorn Memorial Hospital. Methods: The data were collected retrospectively from female patients with breast cancers who underwent breast surgery and axillary node dissection at King Chulalongkorn Memorial Hospital during January 1, 2004 and July 31, 2011. One hundred and ninety histopathologically proven cases of invasive ductal carcinoma (IDC were randomly recruited; consisted of ninety-five patients with axillary lymph node metastasis and the rest of patients without axillary lymph node metastasis. All patients were reviewed their mammograms with additional ultrasounds and correlation between each mammographic characteristic and ipsilateral node involvement was analyzed, using P-value (P, Odd ratio (OR and 95% confidence interval (CI. Results: Mammographic characterization associated with the highest risk of axillary node metastasis was malignant pattern of ipsilateral axillary node (P < 0.001; OR = 44.53; 95% CI = 13.10 - 151.37 with following by intermediate pattern of ipsilateral axillary node (P = 0.002; OR=5.18; 95% CI = 1.79 - 15.04. The other characteristics in descending orders for associated with axillary node involvement are upper outer quadrant tumors associated risk of ipsilateral axillary node involvement (P = 0.02; OR = 3.36; 95% CI = 1.23 - 9.14 and size of breast cancer by additional ultrasound (P = 0.04; OR = 1.48; 95% CI = 1.02-2.17. There was no association between risk of axillary node involvement and the rest of mammographic findings, including microcalcification of the tumor, vascularity of the tumor and size of axillary node. Conclusions: The highest predictive risk of axillary node metastasis in breast cancer was malignant axillary node pattern. The moderate risk was intermediate axillary node pattern and the lower risks were the tumor located in upper outer quadrant and increased tumor

  12. Locating difficult veins for venepuncture and cannulation.

    Science.gov (United States)

    Shaw, Sally Jane

    2017-02-15

    Vein location and assessment are essential to improve the success rates for vascular access. However, problems remain with first attempt success rates for peripheral cannulation and locating difficult veins. Practitioners may not be aware of developments in technology and aids to assist in the location and assessment of veins to achieve vascular access. This article provides an overview of two vein location aids that can be used to locate difficult veins: the IV-eye vein imager and the Vacuderm tourniquet. It discusses the patient factors that can increase the difficulty of vein assessment and location, and emphasises the importance of vessel health and preservation, and vein palpation. Practitioners should be experienced and skilled in the assessment of veins, and they are encouraged to revisit how they locate and assess veins.

  13. Axillary Artery Injury Associated with Proximal Humerus Fracture: A Report of 6 Cases

    Directory of Open Access Journals (Sweden)

    Rinne M. Peters

    2017-01-01

    Full Text Available Proximal humerus fractures are common, but associated injury of the axillary artery is uncommon. The majority of published blunt traumatic axillary artery injuries are associated with anterior glenohumeral dislocation; a few are associated with isolated proximal humerus fractures or fracture-dislocation. Experience within our institution demonstrates that axillary artery injury is often unrecognized on initial presentation owing to palpable peripheral pulses and the absence of ischemia and places the hand at risk of necrosis and amputation if there is prolonged ischemia and the forearm at risk of compartment syndrome after revascularization. Accurate physical examination in combination with a low threshold for Doppler examination or angiography can establish the diagnosis of axillary artery injury. We present 6 cases of axillary artery injury associated with proximal humerus fractures in order to highlight the potential for this vascular injury in the setting of a proximal humerus fracture.

  14. Traumatic Pseudoaneurysm of Axillary Artery Combined with Brachial Plexus Injury

    Science.gov (United States)

    Chen, Lin; Peng, Feng; Wang, Tao; Chen, Desong; Yang, Jianyun

    2014-01-01

    Traumatic pseudoaneurysm of the axillary artery combined with brachial plexus injury is extremely rare. The factors that influence the symptoms and functional recovery related to this condition are unclear. Nine patients who had sustained this trauma were surgically treated at our unit between June 1999 and November 2010. The cause of trauma, symptoms, signs and examinations of neurological and vascular deficits, and the surgical findings of the involved nerves and vessels were recorded in detail. The functional recovery of vessels and nerves, as well as the extent of pain, were evaluated, respectively. The average length of patient follow-up was 4.5 years (range, 24 months to 11.3 years). After vessel repair, whether by endovascular or operative treatment, the distending, constant, and pulsating pain was relieved in all patients. Furthermore, examination of the radial artery pulse on the repaired side appeared normal at last follow-up. All patients showed satisfactory sensory recovery, with motor recovery rated as good in five patients and fair in four patients. The symptom characteristics varied with the location of the damage to the axillary artery. Ultrasound examination and computed tomography angiography are useful to evaluate vascular injury and provide valuable information for operative planning. Surgical exploration is an effective therapy with results related to the nerve injury condition of the brachial plexus. PMID:25412426

  15. Traumatic pseudoaneurysm of axillary artery combined with brachial plexus injury.

    Directory of Open Access Journals (Sweden)

    Lin Chen

    Full Text Available Traumatic pseudoaneurysm of the axillary artery combined with brachial plexus injury is extremely rare. The factors that influence the symptoms and functional recovery related to this condition are unclear. Nine patients who had sustained this trauma were surgically treated at our unit between June 1999 and November 2010. The cause of trauma, symptoms, signs and examinations of neurological and vascular deficits, and the surgical findings of the involved nerves and vessels were recorded in detail. The functional recovery of vessels and nerves, as well as the extent of pain, were evaluated, respectively. The average length of patient follow-up was 4.5 years (range, 24 months to 11.3 years. After vessel repair, whether by endovascular or operative treatment, the distending, constant, and pulsating pain was relieved in all patients. Furthermore, examination of the radial artery pulse on the repaired side appeared normal at last follow-up. All patients showed satisfactory sensory recovery, with motor recovery rated as good in five patients and fair in four patients. The symptom characteristics varied with the location of the damage to the axillary artery. Ultrasound examination and computed tomography angiography are useful to evaluate vascular injury and provide valuable information for operative planning. Surgical exploration is an effective therapy with results related to the nerve injury condition of the brachial plexus.

  16. Deodorants and antiperspirants affect the axillary bacterial community.

    Science.gov (United States)

    Callewaert, Chris; Hutapea, Prawira; Van de Wiele, Tom; Boon, Nico

    2014-10-01

    The use of underarm cosmetics is common practice in the Western society to obtain better body odor and/or to prevent excessive sweating. A survey indicated that 95 % of the young adult Belgians generally use an underarm deodorant or antiperspirant. The effect of deodorants and antiperspirants on the axillary bacterial community was examined on nine healthy subjects, who were restrained from using deodorant/antiperspirant for 1 month. Denaturing gradient gel electrophoresis was used to investigate the individual microbial dynamics. The microbial profiles were unique for every person. A stable bacterial community was seen when underarm cosmetics were applied on a daily basis and when no underarm cosmetics were applied. A distinct community difference was seen when the habits were changed from daily use to no use of deodorant/antiperspirant and vice versa. The richness was higher when deodorants and antiperspirants were applied. Especially when antiperspirants were applied, the microbiome showed an increase in diversity. Antiperspirant usage led toward an increase of Actinobacteria, which is an unfavorable situation with respect to body odor development. These initial results show that axillary cosmetics modify the microbial community and can stimulate odor-producing bacteria.

  17. Lymphedema following axillary lymph node dissection for breast cancer.

    Science.gov (United States)

    Sakorafas, George H; Peros, George; Cataliotti, Luigi; Vlastos, George

    2006-11-01

    Lymphedema is a relatively common, potentially serious and unpleased complication after axillary lymph node dissection (ALND) for breast cancer. It may be associated with functional, esthetic, and psychological problems, thereby affecting the quality-of-life (QOL) of breast cancer survivors. Objective measurements (preferentially by measuring arm volumes or arm circumferences at predetermined sites) are required to identify lymphedema, but also subjective assessment can help to determine the clinical significance of any volume/circumference differences. Lymphedema per se predisposes to the development of other secondary complications, such as infections of the upper limb, psychological sequelae, development of malignant tumors, alterations of the QOL, etc. The risk of lymphedema is associated with the extent of ALND and the addition of axillary radiation therapy. Treatment involves the application of therapeutic measures of the so-called decongestive lymphatic therapy. Prevention is of key importance to avoid lymphedema formation. The application of the sentinel lymph node biopsy in the management of breast cancer has been associated with a reduced incidence of lymphedema formation.

  18. Effects of shoulder position on axillary nerve positions during the split lateral deltoid approach.

    Science.gov (United States)

    Cheung, Sunny; Fitzpatrick, Michael; Lee, Thay Q

    2009-01-01

    The axillary nerve may be injured during percutaneous fixation of proximal humerus fractures. This study investigated the kinematic behavior of the superior and inferior borders of the axillary nerve under varying shoulder positions. This information may reduce iatrogenic neurologic injury during fracture reduction and hardware placement. The lateral deltoid approach was performed on 7 fresh frozen shoulders. The inferior and superior borders of the axillary nerve were tagged. Screws were placed in the anterior, middle, and posterior acromion as landmarks. Three-dimensional distances of the inferior and superior border of the nerve were measured to the mid-acromion while the shoulder was placed in combinations of forward flexion, vertical abduction, and humeral rotation. The distances were compared by repeated measures ANOVA statistical analysis. The distance from the mid-acromion to the superior border of the axillary nerve was 66.6 mm (+/-5.7), and to the inferior axillary nerve was 75.7 mm (+/-5.8) with the shoulder in neutral position. Vertical abduction to 60 degrees significantly moved the superior and inferior borders of the axillary nerve to a distance of 53.9 (+/-7.7) and 61.6 mm (+/-8.1), respectively (P axillary nerve (P > 0.5). The longest distance from the mid-acromion to the inferior border of the axillary nerve was 86 mm with the arm forward flexed. The main determinant of axillary nerve position with respect to the acromion is vertical abduction. Axillary nerve position is essentially unaffected by varying degrees of humeral rotation and forward flexion. Vertical glenohumeral abduction to 60 degrees is required to move the nerve significantly closer to the acromion.

  19. Commercialization of vein contrast enhancement

    Science.gov (United States)

    Lovhoiden, Gunnar; Deshmukh, Harshal; Vrancken, Carlos; Zhang, Yong; Zeman, Herbert D.; Weinberg, Devin

    2003-07-01

    An ongoing clinical study of an experimental infrared (IR) device, the Vein Contrast Enhancer (VCE) that visualizes surface veins for medical access, indicates that a commercial device with the performance of the existing VCE would have significant clinical utility for even a very skilled phlebotomist. A proof-of-principle prototype VCE device has now been designed and constructed that captures IR images of surface veins with a commercial CCD camera, transfers the images to a PC for real-time software image processing to enhance the vein contrast, and projects the enhanced images back onto the skin with a modified commercial LCD projector. The camera and projector are mounted on precision slides allowing for precise mechanical alignment of the two optical axes and for measuring the effects of axes misalignment. Precision alignment of the captured and projected images over the entire field-of-view is accomplished electronically by software adjustments of the translation, scaling, and rotation of the enhanced images before they are projected back onto the skin. This proof-of-principle prototype will be clinically tested and the experience gained will lead to the development of a commercial device, OnTarget!, that is compact, easy to use, and will visualize accessible veins in almost all subjects needing venipuncture.

  20. Portal vein and mesenteric vein gas: CT features

    International Nuclear Information System (INIS)

    Schmutz, G.; Fournier, L.; Le Pennec, V.; Provost, N.; Hue, S.; Phi, I.N.

    2001-01-01

    Portal vein and mesenteric vein gas are unusual conditions with a complex and nuclear pathogenesis. Mesenteric ischemia frequently causes such pathological conditions but a variety of other causes are known: inflammatory bowel disease, bowel distension, traumatic and iatrogenic injury, intra-abdominal sepsis, and idiopathic conditions. This pathologic entity is favored by intestinal wall alterations, bowel distension and sepsis. The prognosis is frequently fatal, especially when associated with extended bowel necrosis although in the majority of the cases, outcome is favorable without surgery. (author)

  1. Vortex veins: anatomic investigations on human eyes.

    Science.gov (United States)

    Kutoglu, Tunc; Yalcin, Bulent; Kocabiyik, Necdet; Ozan, Hasan

    2005-05-01

    The aim of this study was to determine number of ocular vortex veins, their scleral coordinates, and their relationship with nearby extraocular muscles. Sixty intact cadaver orbits having no history of eye or orbital disorders during life were carefully dissected under stereomicroscopic magnification to expose vortex veins and their exit sites from the eyeball. The number of vortex veins per eye varied from four to eight. Eyes having four (35%) or five (30%) vortex veins were observed most frequently. Three eyes (5%) had eight vortex veins. Although the incidence of the vortex veins was variable, there was at least one vein in each quadrant of the sclera. Knowledge of the approximate location of the vortex vein exit sites is very important for surgeons because damage to these veins during eye surgery could produce potential complications, especially choroidal detachment. Copyright 2005 Wiley-Liss, Inc.

  2. [Axillary local anesthetic spread after the thoracic interfacial ultrasound block - a cadaveric and radiological evaluation].

    Science.gov (United States)

    Torre, Patricia Alfaro de la; Jones, Jerry Wayne; Álvarez, Servando López; Garcia, Paula Diéguez; Miguel, Francisco Javier Garcia de; Rubio, Eva Maria Monzon; Boeris, Federico Carol; Sacramento, Monir Kabiri; Duany, Osmany; Pérez, Mario Fajardo; Gordon, Borja de la Quintana

    Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter-fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper-intense signals in the axillary region. These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  3. Axillary local anesthetic spread after the thoracic interfacial ultrasound block - a cadaveric and radiological evaluation

    Directory of Open Access Journals (Sweden)

    Patricia Alfaro de la Torre

    Full Text Available Abstract Background Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. Methods After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Results Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter-fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper-intense signals in the axillary region. Conclusions These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block.

  4. Outcomes Following Closed Axillary Nerve Injury: A Case Report and Review of the Literature.

    Science.gov (United States)

    Galvin, Joseph W; Eichinger, Josef K

    2016-03-01

    We report a case of a 43-year-old male who sustained an axillary nerve injury secondary to a glenohumeral joint dislocation at a young age, and who has served over 20 years in the military with near normal shoulder function. In addition, we review the literature for the natural history of axillary nerve injury. A 43-year-old male sustained a left anterior glenohumeral dislocation in a motor vehicle accident as an 18-year-old. Following prompt manual reduction and subsequent physical therapy, the patient developed a permanent axillary nerve palsy. Despite the development of complete atrophy of his deltoid musculature and persistent sensory loss in the axillary nerve distribution, he experienced restoration of function with minimal to no deficit. Ultimately, he enlisted in the military 4 years after the injury and has served 22 years, which includes combat deployments with normal shoulder function and absence of pain. Axillary nerve injury is a relatively common injury after anterior glenohumeral joint dislocation. There is little known about the long-term outcome of patient's with permanent axillary nerve injury. This case suggests that it is possible for a young athletic individual to function at a high level of activity after permanent loss of axillary nerve function. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  5. Injury to the axillary nerve after reverse shoulder arthroplasty: an anatomical study.

    Science.gov (United States)

    Lädermann, A; Stimec, B V; Denard, P J; Cunningham, G; Collin, P; Fasel, J H D

    2014-02-01

    Subclinical neurological lesions after reverse shoulder arthroplasty are frequent, mainly those involving the axillary nerve. One of the major reported risk factors is postoperative lengthening of the arm. The purpose of this study was to evaluate the anatomical relationship between the axillary nerve and prosthetic components after reverse shoulder arthroplasty. The study hypothesis was that inferior overhang of the glenosphere relative to glenoid could put this nerve at risk. Eleven fresh frozen shoulder specimens were dissected after having undergone reverse shoulder arthroplasty using a classic deltopectoral approach. The mean distance from the inferior border of the glenoid to the inferior edge of the glenosphere was 6.0±4.3mm (range, 1.0 to 16.2mm). The axillary nerve was never closer than 15mm to the glenosphere. The main anterior branch of the axillary nerve was in close contact with the posterior metaphysis or humeral prosthetic implant. The mean distance between the nerve and the humeral implants was 5.2±2.1mm (range, 2.0 to 8.1mm). The proximity of the axillary nerve to the posterior metaphysis or humeral implants may be a risk factor for axillary nerve injury after reverse shoulder arthroplasty. This study quantifies the proximity of the axillary nerve to the implant after reverse shoulder arthroplasty. Basic science study, cadaver study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. Characterization of Staphylococcus and Corynebacterium clusters in the human axillary region.

    Directory of Open Access Journals (Sweden)

    Chris Callewaert

    Full Text Available The skin microbial community is regarded as essential for human health and well-being, but likewise plays an important role in the formation of body odor in, for instance, the axillae. Few molecular-based research was done on the axillary microbiome. This study typified the axillary microbiome of a group of 53 healthy subjects. A profound view was obtained of the interpersonal, intrapersonal and temporal diversity of the human axillary microbiota. Denaturing gradient gel electrophoresis (DGGE and next generation sequencing on 16S rRNA gene region were combined and used as extent to each other. Two important clusters were characterized, where Staphylococcus and Corynebacterium species were the abundant species. Females predominantly clustered within the Staphylococcus cluster (87%, n = 17, whereas males clustered more in the Corynebacterium cluster (39%, n = 36. The axillary microbiota was unique to each individual. Left-right asymmetry occurred in about half of the human population. For the first time, an elaborate study was performed on the dynamics of the axillary microbiome. A relatively stable axillary microbiome was noticed, although a few subjects evolved towards another stable community. The deodorant usage had a proportional linear influence on the species diversity of the axillary microbiome.

  7. Comparing axillary and mediastinal lymphadenopathy on CT in children with suspected pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Theron, Salomine; Andronikou, Savvas

    2005-01-01

    Radiographic demonstration of mediastinal lymphadenopathy is important for the diagnosis of pulmonary tuberculosis (PTB). Plain radiographs are unreliable for this and CT, which is relatively more expensive and carries a high radiation burden, remains the gold standard. No studies correlating the presence of axillary with mediastinal lymphadenopathy have been reported. Such a correlation would allow for clinical or ultrasound diagnosis of PTB via the axilla. To correlate the presence of axillary lymphadenopathy with mediastinal lymphadenopathy in children with suspected PTB. CT scans were performed and reviewed in 100 children (prospectively recruited) with suspected PTB. The axilla and mediastinum were reviewed separately by covering the non-relevant sections on the CT scans prior to reading. Only nodes greater than 1 cm were regarded as pathological. Mediastinal lymphadenopathy was present in 46% of children; 70% had lymphadenopathy in either axilla. Bilateral axillary lymphadenopathy was identified in 47%. Axillary lymphadenopathy showed a sensitivity of 74% and a specificity of 33% for the presence of mediastinal adenopathy. Bilateral axillary adenopathy had a sensitivity of 50% and a specificity of 56%. Axillary lymphadenopathy has a moderate sensitivity and low specificity for the presence of mediastinal and hilar lymphadenopathy in children with suspected PTB. Further research should be aimed at correlating ultrasound-detected axillary lymphadenopathy with FNA results in children. (orig.)

  8. The relationship of proximal locking screws to the axillary nerve during antegrade humeral nail insertion of four commercially available implants.

    Science.gov (United States)

    Prince, Edward J; Breien, Kristoffer M; Fehringer, Edward V; Mormino, Matthew A

    2004-10-01

    The purpose of this study was to determine the proximity of proximal interlocking mechanisms in 4 current antegrade humeral nails to the axillary nerve and its branches. Cadaveric study. Anatomy laboratory. Anatomic relationships. Four humeral nail designs (labeled SS, SL, SZ, and SN) were each inserted in successive antegrade fashion in 10 cadaveric upper extremity specimens. Three variables were measured: from acromion to the axillary nerve, from acromion to entry sites of proximal locking devices, and from locking devices to axillary nerves and their branches. In nail SS, the proximally directed oblique locking screw came into contact with the ascending branch of the axillary nerve in 6 of 10 specimens. Mean distance from spiral blades in nails SS and SL were 26 mm to the axillary nerve and 16 mm to its ascending branch. Interlocking screws for nails SZ, SN, and SL did not violate the axillary nerve or its branches in any specimen. Mean distance from lateral acromion to the axillary nerve measured 58.7 mm. Nail SS's oblique locking screw may injure the ascending branch of the axillary nerve. Three of the 4 nails tested did not endanger the axillary nerve. However, when transverse proximal locking screws are inserted from a lateral-to-medial direction, they may endanger an arborized axillary nerve. Blunt dissection should be performed with a visible path to bone before instrumentation to reduce the risk of axillary nerve injury. Copyright 2004 Lippincott Williams & Wilkins

  9. Management of superficial vein thrombosis.

    Science.gov (United States)

    Cosmi, B

    2015-07-01

    Superficial vein thrombosis (SVT) is less well studied than deep vein thrombosis (DVT), because it has been considered to be a minor, self-limiting disease that is easily diagnosed on clinical grounds and that requires only symptomatic relief. The most frequently involved sites of the superficial vein system are the lower limbs, especially the saphenous veins, mostly in relation to varicosities. Lower-limb SVT shares the same risk factors as DVT; it can propagate into the deep veins, and have a complicated course with pulmonary embolism. Clinical diagnosis may not be accurate, and ultrasonography is currently indicated for both confirmation and evaluation of SVT extension. Treatment aims are symptom relief and prevention of venous thromboembolism (VTE) in relation to the thrombotic burden. SVT of the long saphenous vein within 3 cm of the saphenofemoral junction (SFJ) is considered to be equivalent to a DVT, and thus deserving of therapeutic anticoagulation. Less severe forms of lower-limb SVT not involving the SFJ have been included in randomized clinical trials of surgery, compression hosiery, non-steroidal anti-inflammatory drugs, unfractionated heparin, and low molecular weight heparins, with inconclusive results. The largest randomized clinical trial available, on 3004 patients with lower-limb SVT not involving the SFJ, showed that fondaparinux 2.5 mg once daily for 6 weeks is more effective than placebo in reducing the risk of the composite of death from any cause and symptomatic VTE (0.9% versus 5.9%). Further studies are needed to define the optimal management strategies for SVT of the lower limbs and other sites, such as the upper limbs. © 2015 International Society on Thrombosis and Haemostasis.

  10. Initial axillary surgery: results from the BreastSurgANZ Quality Audit.

    Science.gov (United States)

    Chong, Chilton; Walters, David; de Silva, Primali; Taylor, Corey; Spillane, Andrew; Kollias, James; Pyke, Chris; Campbell, Ian; Maddern, Guy

    2015-10-01

    The aim of this study was to establish the preference and reasons for initial axillary surgery performed on women with invasive breast cancer in Australia and New Zealand using data from the Breast Surgeon's Society of Australia and New Zealand Quality Audit (BQA) according to whether sentinel lymph node (SLN) biopsy, axillary lymph node dissection (ALND) or no axillary surgery was used. Patient data from 1999 to 2011 were categorized according to primary tumour size (≤3 cm or >3 cm) and analysed by year of diagnosis, type of initial axillary surgery and frequency of second axillary surgery following SLN biopsy. Patient age at diagnosis, health insurance status, surgeon caseload and hospital location were also examined as factors affecting the likelihood of performing different types of axillary surgery. Seventy thousand six hundred and eighty-eight episodes of early breast cancer with axillary surgery data were reported to the BQA in the study period. The proportion of patients undergoing SLN biopsy as the first operation increased over this period in both tumour size groups with a concomitant decline in the use of ALND as the first operation over the same interval. Elderly women (>70 years old) were four times less likely to undergo axillary surgery for their initial management when compared with women aged 41-70 years old (P < 0.001). Factors favouring ALND as the initial surgery over SLN biopsy included larger tumour size, elderly age, uninsured status and having surgery in a regional centre. From 1999 to 2011, SLN biopsy as the initial axillary surgery has been widely adopted by surgeons reporting to the BQA. Future evaluation of the BQA data in the following 3-5 years will be performed to monitor this progression. © 2013 Royal Australasian College of Surgeons.

  11. Treatment of axillary hyperhidrosis: combination of the starch-iodine test with the tumescent liposuction technique.

    Science.gov (United States)

    Swinehart, J M

    2000-04-01

    To evaluate and permanently improve axillary hyperhidrosis. Excessive sweating of the axillae is a common problem for which patients frequently seek dermatologic advice and therapy. Many treatments, including aluminum chloride, topical and systemic anticholinergic agents, tranquilizers, iontophoresis, direct surgical excision, botulinum toxin injection, and thoracic sympathectomy, have been employed to control this problem. All have drawbacks of one sort or another. The starch-iodine technique for delineation of preoperative and postoperative axillary sweating is described in detail. A method of sweat gland removal utilizing tumescent liposuction is discussed. The combination of the starch-iodine technique and tumescent liposuction is safe and effective for therapy of axillary hyperhidrosis.

  12. Low incidence of complications after cephalic vein cutdown for pacemaker lead implantation in children weighing less than 10 kilograms: A single-center experience with long-term follow-up.

    Science.gov (United States)

    Kircanski, Bratislav; Vasic, Dragan; Savic, Dragutin; Stojanov, Petar

    2015-08-01

    Only a few studies on the cephalic vein cutdown technique for pacemaker lead implantation in children weighing ≤10 kg have been reported even though the procedure is widely accepted in adults. The purpose of this study was to prove that cephalic vein cutdown for pacemaker lead implantation is a reliable technique with a low incidence of complications in children weighing ≤10 kg. The study included 44 children weighing ≤10 kg with an endocardial pacemaker. Cephalic, subclavian, and axillary vein diameters were measured by ultrasound before implantation. The measured diameters were used to select either an endocardial or epicardial surgical technique. Regular 6-month follow-up visits included pacemaker interrogation and clinical and ultrasound examinations. Two dual-chamber and 42 single-chamber pacemakers were implanted. Mean weight at implantation was 6.24 kg (range 2.25-10.40 kg), and mean age was 11.4 months (range 1 day-47 months). In 40 children (90.1%), the ventricular leads were implanted using the cephalic vein cutdown technique, and implantation was accomplished via the prepared right external jugular vein in 4 of the children (9.9%). The atrial leads were implanted using axillary vein puncture and external jugular vein preparations. Mean follow-up was 8.9 years (range 0-20.9 years). Only 1 pacemaker-related complication was detected (a lead fracture near the connector that was successfully resolved using a lead repair kit). The cephalic vein cutdown technique is feasible and reliable in children weighing ≤10 kg, which justifies the application of additional surgical effort in the treatment of these small patients. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  13. Preoperative ultrasound mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi, Niels; Schroeder, T

    1997-01-01

    A prospective series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. Sixteen (17%) bypass procedures thrombosed within the first week postoperatively. A naturally occurring optimal vein diameter was discove...

  14. Phlebectasia of Internal Jugular Vein

    African Journals Online (AJOL)

    Internal jugular phlebectasia (IJP) is a congenital fusiform dilatation of the internal jugular vein that appears as a soft, compressible mass in the neck during straining or is triggered by the Valsalva maneuver. The possible differential diagnosis for the swelling could include a laryngocele, branchial cyst, cystic hygroma, ...

  15. Renal arcuate veins: new microangiogrphic observations

    International Nuclear Information System (INIS)

    Clark, R.L.; Klein, S.

    1983-01-01

    Standard references state that arcuate veins at the corticomedullary junction form continuous arcades. Because some preliminary anatomic observations seemed to disagree with this traditional teaching, the arcuate veins were systematically studied in normal human kidneys. Microangiographic studies indicate that, unlike the occasional anastomoses that exist between proximal interlobar and segmental veins, arcuate venous communications in human are extremely rare. Arcuate veins, like the corresponding arteries, should be considered end vessels

  16. Is axillary sonographic staging less accurate in invasive lobular breast cancer than in ductal breast cancer?

    Science.gov (United States)

    Sankaye, Prashant; Chhatani, Sharmila; Porter, Gareth; Steel, Jim; Doyle, Sarah

    2014-10-01

    The purpose of this study was to determine whether axillary sonography is less accurate in invasive lobular breast cancer than in ductal breast cancer. Patients with invasive breast cancer were retrospectively identified from histologic records from 2010 to 2012. Staging axillary sonograms from 96 patients with primary breast cancer in each of 2 subgroups, invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC), were reviewed. Preoperative sonographically guided 14-gauge core biopsy was performed on morphologically abnormal lymph nodes. Thirty-one of 96 patients (32%) in each subgroup were node positive on final postoperative histopathologic analysis. Axillary staging sensitivity was 17 of 31 patients (54%) in the IDC subgroup and 15 of 31(48%) in the ILC subgroup. Further analysis of the data showed no statistically significant differences between these subgroups. We found that there was no statistically significant difference in the accuracy of axillary sonographic staging between ILC and IDC. © 2014 by the American Institute of Ultrasound in Medicine.

  17. 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.

  18. Preoperative mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Sillesen, H; Nielsen, Tina G

    1995-01-01

    A consecutive series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. A naturally occurring optimal vein diameter was discovered. It was significantly correlated with higher postoperative ankle-brachial pres......-brachial pressure index (ABI) and lesser early postoperative thrombosis. A significant linear regression was found between the pre and postoperative vein diameter....

  19. Advances in development of transgenic resistance to beet necrotic yellow vein virus (BNYVV in sugar beet

    Directory of Open Access Journals (Sweden)

    Nagl Nevena

    2005-01-01

    Full Text Available Fragments of viral cDNA containing the coat protein gene of beet necrotic yellow vein virus were cloned in plant transformation vector pCAMBIA3301M with the bar gene as selectable marker. Vector pC3301MCPL carrying coat protein gene with leader sequence, and pC3301MCPS with coat protein gene, were used in Agrobacterium - mediated transformation of sugar beet. The transformation method used was based on the fact that sugar beet develops axillary shoots in in vitro conditions, when placed on media with citokinins. Since this ability is not genotype or ploidy dependant it is widely used for sugar beet vegetative multiplication. Sterile seedlings, with removed cotyledons and lower half of hypocotyl, were used as starting material. After transformation ex-plants were put on micropropagation medium with cephotaxime and phosphinotricyn (ppt, where axillary shoots started to develop. Since concentration of ppt was not selective enough, after two subcultivations it was increased twofold. Only one sample, transformed with pC3301MCPS preserved morphogenetic potential for micropropagatio, and it was tested for presence of COS fragment and bar gene bz PCR with soecific primers.

  20. 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....... Many case series with retrospective follow-up are available in the literature, but no comparative studies between surgical techniques have been published....

  1. Axillary lymph node tuberculosis masquerading as inflammatory breast carcinoma in an immune-compromised patient.

    Science.gov (United States)

    Chikkannaiah, Panduranga; Vani, B R; Benachinmardi, Kirtilaxmi; Murthy, V Srinivasa

    2016-02-01

    While tuberculosis is still the leading opportunistic infection among human immunodeficiency virus-seropositive patients, extra-pulmonary tuberculosis is more common than pulmonary tuberculosis, with lymph nodes being a common site. Axillary lymph node pathology such as tuberculosis and lymphoma rarely mimics inflammatory breast carcinoma by producing lymphatic obstruction. We report a case of axillary lymph node tuberculosis in a 40-year-old immune-compromised woman, clinically presenting as inflammatory breast carcinoma. © The Author(s) 2015.

  2. Tuberculosis and metastatic carcinoma coexistence in axillary lymph node: A case report

    Directory of Open Access Journals (Sweden)

    K Chandramohan

    2003-04-01

    Full Text Available Abstract Background Coexistence of cancer and tuberculosis in axillary lymph nodes is rare. Only seven cases have been reported in the literature. Case Report We report here a case of infiltrating ductal carcinoma breast metastasizing to the axillary lymph node along with tubercular granuloma in the same lymph node without primary mammary or pulmonary tuberculosis. Conclusion Primary tuberculosis coexisting with carcinoma is of rare occurrence. A possibility should always be borne in mind especially in patients from endemic areas.

  3. MIPO of proximal humerus fractures through an anterolateral acromial approach. Is the axillary nerve at risk?

    Science.gov (United States)

    Knežević, Josip; Mihalj, Mario; Čukelj, Fabijan; Ivanišević, Arsen

    2017-11-01

    It is known that shoulder surgery may cause iatrogenic injury to the axillary nerve as a serious complication, but there is little evidence to indicate whether the axillary nerve is at risk of injury during an anterolateral acromial approach for minimally-invasive plate osteosynthesis (MIPO) of proximal humerus fractures. We hypothesised that this surgical method is safe for the axillary nerve and would preserve it from iatrogenic injury. We conducted a prospective follow-up cohort study on 49 consecutive patients with proximal humerus fractures who were managed with MIPO through an anterolateral approach. All patients underwent standardised electroneurographic testing, with assessment of amplitudes of evoked compound muscle action potentials (CMAP) and distal motor latencies (DML) of the axillary nerves, pre- and post-operatively. Six weeks after injury, all patients underwent needle electromyographic (EMG) testing of anterior, middle, posterior deltoid, teres minor and paraspinal muscles for detecting abnormal muscle activity as a sign of acute denervation. After six months of physical rehabilitation, patients with axillary nerve injury underwent control electroneurographic testing to check the recovery of neurographic features (CMAP, DML). All nerve measurements were compared to reference values, and between right and left side. Five patients had a mild-to-moderate traumatic axillary nerve injury before surgery. There were no significant differences between amplitudes of CMAP (p = 0.575) and DML (p = 0.857) pre- and post-surgical procedure. These results confirmed safety of this surgical method in the preservation of axillary nerve from iatrogenic injury, but the course of the axillary nerve must be kept in mind. © 2017 Elsevier Ltd. All rights reserved.

  4. Collateral veins in inferior caval vein occlusion demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.

    1983-01-01

    CT-scans of 12 patients with tumour-induced occlusion of the inferior vena cava were studied with regard to collateral veins. A comparison was performed with findings at phlebography in 10 patients and at autopsy in 2. The site and appearance of the main collateral pathway are presented. A close study of vascular structures renders useful information on collateral circulation in occlusion of the inferior vena cava. (orig.)

  5. Tumescent suction curettage in the treatment of axillary hyperhidrosis: experience in 63 patients.

    Science.gov (United States)

    Boni, Roland

    2006-01-01

    Axillary hyperhidrosis is a common and most distressing problem, which can be addressed by a variety of treatment modalities. To assess the value of tumescent suction curettage in the treatment of axillary hyperhidrosis. 63 patients (39 female, 25 male; mean age 30.3 +/- 7.6 years) with axillary hyperhidrosis were enrolled in the study. All patients were treated in an outpatient setting with tumescent suction curettage of the axillary cavity, using two entry sites. The results were evaluated with the iodine-starch test after 4 weeks and after 6 months. Two years after the procedure, patient satisfaction was evaluated as 'satisfied', 'partially satisfied' or 'dissatisfied'. None of the patients had early postoperative complications of infection or seroma. All patients had a marked reduction of hyperhidrosis after 4 weeks, confirmed by the iodine-starch test. After 6 months, 15 patients had high sweat rates and asked for repeat surgery. Two years after the procedure, 49 patients were satisfied, 11 patients were partially satisfied and 3 patients were dissatisfied. Tumescent suction curettage is a safe and effective treatment of axillary hyperhidrosis resulting in a high level of patient satisfaction. Some patients will need repeat surgery. Suction curettage, however, should not be used as the first line of treatment in axillary hyperhidrosis.

  6. Injury of the axillary nerve subsequent to recurrence of shoulder dislocation. Clinical and electromyographic study.

    Science.gov (United States)

    Gumina, S; Bertino, A; Di Giorgio, G; Postacchini, F

    2005-01-01

    Injuries of the axillary nerve subsequent to recurrence of glenohumeral dislocation have received only minimal attention. It is the purpose of this study to define the prevalence and the progression in time of injury of the axillary nerve in patients with recurrence of anterior shoulder dislocation. For two years we observed a total of 185 patients who had had primary shoulder dislocation. Excluded from the study were patients who had fractures associated with metabolic disorders that favored neurologic deficit. During the period of study, 98 patients contacted us again after recurrence of the dislocation: there were 89 patients aged over 60 years and 9 aged below 60 years. All of the patients were evaluated clinically and submitted to EMG in order to verify the condition of the axillary nerve. Four patients (4%) had neuroapraxia of the axillary nerve. One of these also had neuroapraxia of the radial nerve. Of the four patients, one was a male aged 34 years; the others were all aged over 60 years. In all of the cases, function of the axillary nerve completely recovered after a mean period of 4 months (3-5.3 months) after recurrence. Injury of the axillary nerve can occur at the time of the first recurrence of the injury. However, prevalence is significantly lower than that observed after primary dislocation. The occurrence of this injury should be taken into consideration, particularly in elderly patients, in order to avoid erroneous clinical diagnosis and massive rupture of the cuff subsequent to recurrence of the dislocation.

  7. Axillary nerve neurotization with the anterior deltopectoral approach in brachial plexus injuries.

    Science.gov (United States)

    Jerome, J Terrence Jose; Rajmohan, Bennet

    2012-09-01

    Combined neurotization of both axillary and suprascapular nerves in shoulder reanimation has been widely accepted in brachial plexus injuries, and the functional outcome is much superior to single nerve transfer. This study describes the surgical anatomy for axillary nerve relative to the available donor nerves and emphasize the salient technical aspects of anterior deltopectoral approach in brachial plexus injuries. Fifteen patients with brachial plexus injury who had axillary nerve neurotizations were evaluated. Five patients had complete avulsion, 9 patients had C5, six patients had brachial plexus injury pattern, and one patient had combined axillary and suprascapular nerve injury. The long head of triceps branch was the donor in C5,6 injuries; nerve to brachialis in combined nerve injury and intercostals for C5-T1 avulsion injuries. All these donors were identified through the anterior approach, and the nerve transfer was done. The recovery of deltoid was found excellent (M5) in C5,6 brachial plexus injuries with an average of 134.4° abduction at follow up of average 34.6 months. The shoulder recovery was good with 130° abduction in a case of combined axillary and suprascapular nerve injury. The deltoid recovery was good (M3) in C5-T1 avulsion injuries patients with an average of 64° shoulder abduction at follow up of 35 months. We believe that anterior approach is simple and easy for all axillary nerve transfers in brachial plexus injuries. Copyright © 2012 Wiley Periodicals, Inc.

  8. [Comparison of body temperatures in children measured using 3 different thermometers: tympanic, skin and digital axillary].

    Science.gov (United States)

    Padilla-Raygoza, Nicolás; Ruiz-Paloalto, M Laura; Díaz-Guerrero, Rosalina; Olvera-Villanueva, Georgina; Maldonado, Angélica; Raygoza-Mendoza, María Del Pilar

    2014-01-01

    To compare body temperature measurements using tympanic, skin and digital axillary thermometers. Hospitalized or outpatient children from the General Hospital Celaya, ISSSTE Hospital Clinic and General Hospital No. 4 IMSS, and the pediatric private service in Celaya, Guanajuato, from 1 day of life until 16 years old, were recruited over a one month period, after their parents signed the consent form. The order of each institution was selected by simple randomization. Body temperatures were measured in triplicate using tympanic, skin and digital axillary thermometers. The sample consisted of 554 children. The Pearson r between the tympanic and digital axillary thermometers was 0.57 to 0.65, with a positive linear relationship (P<.05); between the skin and the digital axillary thermometers, it was between 0.47 and 0.52 with a positive linearrelationship (P<.05). The intra-observer Kappa for the tympanic thermometer was 0.86, and for the inter-observer was 0.77; for the skin thermometer it was 0.82 and 0.67, respectively, and for the digital axillary thermometer it was 0.86 for intra-observer reliability and 0.78 for inter -observer reliability. Tympanic and axillary thermometers showed better precision in measuring the body temperature in children than skin thermometers. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  9. 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.

  10. Recurrence of superficial vein thrombosis in patients with varicose veins.

    Science.gov (United States)

    Karathanos, Christos; Spanos, Konstantinos; Saleptsis, Vassileios; Tsezou, Aspasia; Kyriakou, Despina; Giannoukas, Athanasios D

    2016-08-01

    To investigate which factors other than history of superficial vein thrombosis (SVT) are associated with recurrent spontaneous SVT episodes in patients with varicose veins (VVs). Patients with a history of spontaneous SVT and VVs were followed up for a mean period of 55 months. Demographics, comorbidities, and thrombophilia screening test were analyzed. Patients were grouped according to the clinical-etiology-anatomy-pathophysiology classification. A multiple logistic regression analysis with the forward likelihood ratio method was undertaken. Thirteen patients out of 97 had a recurrence SVT episode during the follow-up period. All those patients were identified to have a thrombophilia defect. Protein C and S, antithrombin, and plasminogen deficiencies were more frequently present in patients without recurrence. Gene mutations were present in 38% in the nonrecurrence group and 77% in the recurrence group. After logistic regression analysis, patients with dislipidemia and mutation in prothrombin G20210A (FII) had an increased risk for recurrence by 5.4-fold and 4.6-fold, respectively. No deep vein thrombosis or pulmonary embolism occurred. Dislipidemia and gene mutations of F II are associated with SVT recurrence in patients with VVs. A selection of patients may benefit from anticoagulation in the short term and from VVs intervention in the long term. © The Author(s) 2015.

  11. Unusual termination of the right testicular vein | Woldeyes | Anatomy ...

    African Journals Online (AJOL)

    The testicular veins are formed by the veins emerging from the testis and epididymis forming the pampiniform venous plexus. The right testicular vein drains into inferior vena cava and the left testicular vein to the left renal vein. Testicular veins display a great variability with regard to their number, course and sites of ...

  12. Blood sampling from adrenal gland vein

    International Nuclear Information System (INIS)

    Sun Yong; Ni Caifang

    2009-01-01

    Adrenal gland vein sampling is an interventional method to get the blood samples from the adrenal gland vein. The blood is obtained via a catheter which is selectively inserted in the adrenal gland vein. This technique is mainly used to be diagnostic for primary hyperaldosteronism. A full knowledge of the anatomy and variations of the adrenal gland vein, serious preoperative preparation and skilled catheterization manipulation are necessary for obtaining sufficient blood sample and for reducing the occurrence of complications. Providing the physicians with definite diagnostic evidence and being technically feasible, adrenal gland vein sampling should become one of the routine examinations for clarifying the cause of primary hyperaldosteronism. (authors)

  13. Varicose veins show enhanced chemokine expression.

    Science.gov (United States)

    Solá, L del Rio; Aceves, M; Dueñas, A I; González-Fajardo, J A; Vaquero, C; Crespo, M Sanchez; García-Rodríguez, C

    2009-11-01

    Leucocyte infiltration in the wall of varicose veins has been reported previously. This study was designed to investigate the expression of pro-inflammatory cytokines and chemokines in control and in patients with varicose veins and to test the effect of treating varicose vein patients with acetylsalicylic acid (ASA) on cytokine expression prior to removal of varices. Sections of vein were removed during operation from both patient groups, and ribonuclease protection assays (RPAs) were performed to assess the expression of chemokines. Group I included non-varicose saphenous veins from healthy patients undergoing amputation for trauma. Varicose veins were obtained from patients with primary varicose undergoing surgical treatment who received no drug (group II) or treatment with 300 mg day(-1) of ASA for 15 days before surgery (group III). Non-varicose veins constitutively expressed low levels of monocyte-chemoattractant protein (MCP-1) and interleukin (IL)-8 mRNA. Varicose veins had a distinct chemokine expression pattern, since significant up-regulation of MCP-1 and IL-8 and a marked expression of IP-10, RANTES, MIP-1alpha and MIP-1beta mRNA were detected. Removal of the endothelium did not alter this pattern. Varicose veins obtained from patients treated with ASA showed a consistent decrease in chemokine expression, although it did not reach statistical significance. Varicose veins showed increased expression of several chemokines compared to control veins. A non-significant reduction of activation was observed following treatment with ASA for 15 days.

  14. Intravascular lipoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Z Doyle

    2015-06-01

    Full Text Available Lipomas are benign neoplasms composed of adipocytes encased in a fibrous capsule. Intravascular lipomas are rare and almost always incidental findings. In the published literature, the majority are described within the inferior vena cava (IVC and less frequently reported in the superior vena cava, brachiocephalic vein, subclavian vein, internal jugular vein, external iliac vein and common femoral vein. We present the case of a 59-year-old male who presented with a symptomatic ureteral calculus and was found to have an intravascular lipoma of the right renal vein with extension into the IVC. To our knowledge, this is the first ever report of an intravascular lipoma in the renal vein. We discuss the imaging characteristics of intravascular lipomas and the differential diagnosis that should be considered.

  15. Deep vein thrombosis in pregnancy.

    Science.gov (United States)

    Colman-Brochu, Stephanie

    2004-01-01

    This article provides a review of the incidence, pathophysiology, and treatment of deep vein thrombosis (DVT) in pregnancy, a rare but serious complication of pregnancy. The incidence of DVT in pregnancy varies widely, but it is a leading cause of maternal morbidity in both the United States and the United Kingdom. Risk factors during pregnancy include prolonged bed rest or immobility, pelvic or leg trauma, and obesity. Additional risk factors are preeclampsia, Cesarean section, instrument-assisted delivery, hemorrhage, multiparity, varicose veins, a previous history of a thromboembolic event, and hereditary or acquired thrombophilias such as Factor V Leiden. Heparin is the anticoagulant of choice to treat active thromboembolic disease or to administer for thromboprophylaxis, but low molecular-weight heparin is being used with increasing frequency in the pregnant woman. Perinatal nurses should be aware of the symptoms, diagnostic tools, and treatment options available to manage active thrombosis during pregnancy and in the intrapartum and postpartum periods.

  16. A Vein Map Biometric System

    OpenAIRE

    Felix Fuentes; Dulal C. Kar

    2013-01-01

    There is increasing demand world-wide, from government agencies and the private sector for cutting-edge biometric security technology that is difficult to breach but userfriendly at the same time. Some of the older tools, such as fingerprint, retina and iris scanning, and facial recognition software have all been found to have flaws and often viewed negatively because of many cultural and hygienic issues associated with them. Comparatively, mapping veins as a human barcode, a new technology, ...

  17. [Long head of the triceps brachii in axillary nerve injury: anatomy and clinical aspects].

    Science.gov (United States)

    Rezzouk, J; Durandeau, A; Vital, J M; Fabre, T

    2002-10-01

    Earlier work has demonstrated possible paralysis of the long head of the triceps brachii (LTB) after surgical repair of traumatic injury to the axillary nerve. Anatomy textbooks describe the motor branch of the LTB arising from the radial nerve within the body of the triceps. We studied the position of the motor branch for the LTB to determine its exact origin. Three groups were studied: Group I included 9 traumatic injuries of the axillary nerve associated with clinical involvement of the LTB; Group II included 20 secondary posterior trunks dissected from cadaver specimens; Group III included 15 dissections of the infraclavicular plexus with complete dissection of the secondary posterior trunk. The position of the axillary nerve injury was retrieved from the operative reports for Group I. The precise origin of the motor branch for the LTB was identified for Group II. Neurostimulation was used to identify the origin of the motor branch for the LTB in Group III. For Group I: injury to the axillary nerve was situated 10 mm (mean) from the bifurcation of the secondary posterior trunk in 6 cases and at the bifurcation in 3. Type IV injury was identified in 4 cases and type V in 5. For Group II: the motor branch for the LTB arose 6 mm (mean) from the bifurcation of the secondary posterior branch in 13 cases, at the bifurcation in 5, and 10 mm proximally in 2, but never from the radial nerve. For Group III: the motor branch for the LTB arose 4.5 mm (mean) from the bifurcation of the secondary posterior trunk in 11 cases, at the bifurcation in 4, and never from the radial nerve. Observed injuries to the axillary nerve with an associated paralysis of the long head of the triceps brachii were located proximally and were severe. Our dissections always located the motor branch of the LTB arising from the axillary nerve or the secondary posterior branch. We thus deducted that associated LTB paralysis is a sign of poor prognosis. In patients with axillary nerve injury it is a

  18. Vein-type uranium deposits

    International Nuclear Information System (INIS)

    Rich, R.A.; Holland, H.D.; Petersen, U.

    1975-01-01

    A critical review is presented of published data bearing on the mineralogy, paragenesis, geochemistry, and origin of veiw-type uranium deposits. Its aim is to serve as a starting point for new research and as a basis for the development of new exploration strategies. During the formation of both vein and sandstone types of deposits uranium seems to have been dissolved by and transported in rather oxidized solutions, and deposited where these solutions encountered reducing agents such as carbon, sulfides, ferrous minerals and hydrocarbons. Granitic rocks abnormally enriched in uranium have apparently been the most common source for uranium in vein-type deposits. Oxidizing solutions have been derived either from the surface or from depth. Surface solutions saturated with atmospheric oxygen have frequently passed through red bed or clean sandstone conduits on their way to and from uranium source rocks. Deep solutions of non-surface origin have apparently become sufficiently oxidizing by passage through and equilibration with red beds. The common association of clean sandstones or red beds with uranium-rich granites in the vicinity of vein-type uranium deposits is probably not fortuitous, and areas where these rock types are found together are considered particularly favorable targets for uranium exploration

  19. Added value of dedicated axillary hybrid 18F-FDG PET/MRI for improved axillary nodal staging in clinically node-positive breast cancer patients. A feasibility study

    International Nuclear Information System (INIS)

    Nijnatten, Thiemo J.A. van; Goorts, B.; Voeoe, S.; Wildberger, J.E.; Boer, M. de; Kooreman, L.F.S.; Heuts, E.M.; Mottaghy, F.M.; Lobbes, M.B.I.; Smidt, M.L.

    2018-01-01

    To investigate the feasibility and potential added value of dedicated axillary 18F-FDG hybrid PET/MRI, compared to standard imaging modalities (i.e. ultrasound [US], MRI and PET/CT), for axillary nodal staging in clinically node-positive breast cancer. Twelve patients with clinically node-positive breast cancer underwent axillary US and dedicated axillary hybrid 18F-FDG PET/MRI. Nine of the 12 patients also underwent whole-body PET/CT. Maximum standardized uptake values (SUVmax) were measured for the primary breast tumor and the most FDG-avid axillary lymph node. A positive axillary lymph node on dedicated axillary hybrid PET/MRI was defined as a moderate to very intense FDG-avid lymph node. The diagnostic performance of dedicated axillary hybrid PET/MRI was calculated by comparing quantitative and its qualitative measurements to results of axillary US, MRI and PET/CT. The number of suspicious axillary lymph nodes was subdivided as follows: N0 (0 nodes), N1 (1-3 nodes), N2 (4-9 nodes) and N3 (≥ 10 nodes). According to dedicated axillary hybrid PET/MRI findings, seven patients were diagnosed with N1, four with N2 and one with N3. With regard to mean SUVmax, there was no significant difference in the primary tumor (9.0 [±5.0] vs. 8.6 [±5.7], p = 0.678) or the most FDG-avid axillary lymph node (7.8 [±5.3] vs. 7.7 [±4.3], p = 0.767) between dedicated axillary PET/MRI and PET/CT. Compared to standard imaging modalities, dedicated axillary hybrid PET/MRI resulted in changes in nodal status as follows: 40% compared to US, 75% compared to T2-weighted MRI, 40% compared to contrast-enhanced MRI, and 22% compared to PET/CT. Adding dedicated axillary 18F-FDG hybrid PET/MRI to diagnostic work-up may improve the diagnostic performance of axillary nodal staging in clinically node-positive breast cancer patients. (orig.)

  20. 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.

  1. Isolated axillary lymph node tuberculosis in ultrasonography. A case report.

    Science.gov (United States)

    Ścieszka, Joanna; Urbańska-Krawiec, Dagmara; Kajor, Maciej; Stefański, Leszek

    2012-09-01

    We present a rare case of isolated axillary lymph node tuberculosis. A 66-year-old patient was admitted in order to perform the diagnostics of a painless tumor of the left armpit. Blood biochemistry tests and chest X-ray did not show any abnormalities. In the ultrasound examination a solid structure of the dimensions of 1.8×1 cm of irregular outline with adjacent hypoechogenic lymph nodes was visualized. The diagnosis of tuberculosis was based on histopathologic examination of the excised tumor. In the latter years an increase in extrapulmonary type of tuberculosis has been observed. Extrapulmonary tuberculosis may appear in practically each organ, nevertheless it affects pleura most often. Lymph node tuberculosis is the second, when it comes to the prevalence rate, type of extrapulmonary tuberculosis. In the majority of cases of lymph node tuberculosis it affects superficial lymph nodes. In the ultrasound examination a packet of pathological, enlarged and hypoechogenic lymph nodes is stated. In 1/3 of cases the central part of the nodes is hyperechogenic which indicates its caseation necrosis. Lymph nodes have a tendency to be matted and they have blurred outline. We observed this type of lymph node image in the presented patient. This image may be a diagnostic hint. Nevertheless, in the differentiation diagnostics one should take many other disease entities into consideration, inter alia: sarcoidosis, lymphomas, fungal infections, neoplastic metastases; the latter ones have an image most similar to tuberculosis lymph nodes. Tuberculosis ought to be considered in differential diagnosis of atypical masses.

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

    International Nuclear Information System (INIS)

    Luciani, Alain; Pigneur, Frederic; Ghozali, Faridah; Dao, Thu-Ha; Cunin, Patrick; Meyblum, Evelyne; De Baecque-Fontaine, Cecile; Alamdari, Ali; Maison, Patrick; Deux, Jean Francois; Lagrange, Jean Leon; Lantieri, Laurent; Rahmouni, Alain

    2009-01-01

    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

  3. 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.

  4. Deep venous drainage in great cerebral vein (vein of Galen) absence and malformations

    International Nuclear Information System (INIS)

    Lasjaunias, P.; Garcia-Monaco, R.; Rodesch, G.; Terbrugge, K.

    1991-01-01

    We report two types of venous patterns associated with great cerebral vein (vein of Galen) absence or unavailability. Developmental venous anomalies or vein of Galen arteriovenous malformations (VGAM) serve as an illustrative material. A diencephalic pattern that collects the thalamo-striate veins into the tentorial sinus is recognized in most VGAM. A telencephalic arrangement connecting the striate veins with the rostral afferents to the basal vein is less frequent. Both patterns reproduce embryonic stages preceeding the development of the great cerebral vein, thus confirming Raybaud's hypothesis that in VGAM the pouch is not the vein of Galen but the medial vein of the prosencephalon. The prognostic value of each pattern can then be appreciated and the therapeutic strategies rationalized; some unexplained complications of the venous approach for non-selected VGAM can thus be avoided. (orig.)

  5. Factors associated with involvement of four or more axillary nodes for sentinel lymph node-positive patients

    International Nuclear Information System (INIS)

    Katz, Angela; Niemierko, Andrzej; Gage, Irene; Evans, Sheila; Shaffer, Margaret; Smith, Frederick P.; Taghian, Alphonse; Magnant, Colette

    2006-01-01

    Purpose: Sentinel lymph node-positive (SLN+) patients who are unlikely to have 4 or more involved axillary nodes might be treated with less extensive regional nodal radiation. The purpose of this study was to define possible predictors of having 4 or more involved axillary nodes. Methods and Materials: The records of 224 patients with breast cancer and 1 to 3 involved SLNs, who underwent completion axillary dissection without neoadjuvant chemotherapy or hormonal therapy were reviewed. Factors associated with the presence of 4 or more involved axillary nodes (SLNs plus non-SLNs) were evaluated by Pearson chi-square test of association and by simple and multiple logistic-regression analysis. Results: Of 224 patients, 42 had involvement of 4 or more axillary nodes. On univariate analysis, the presence of 4 or more involved axillary nodes was positively associated with increased tumor size, lobular histology, lymphovascular space invasion (LVSI), increased number of involved SLNs, decreased number of uninvolved SLNs, and increased size of SLN metastasis. On multivariate analysis, the presence of 4 or more involved axillary nodes was associated with LVSI, increased number of involved SLNs, increased size of SLN metastasis, and lobular histology. Conclusions: Patients with 1 or more involved SLN, LVSI, or SLN macrometastasis should be treated to the supraclavicular fossa/axillary apex if they do not undergo completion axillary dissection. Other SLN+ patients might be adequately treated with less extensive radiation fields

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

    Science.gov (United States)

    Kim, Daejin; Kim, Junhyung; Yeo, Hyeonjung; Kwon, Hyukjun; Son, Daegu; Han, Kihwan

    2012-03-01

    Axillary osmidrosis is characterized by an unpleasant odor, profuse sweating, and in some instances, staining of clothes that may socially and psychologically impair affected individuals. Various types of surgical procedures have been developed for the treatment of axillary osmidrosis. This study was undertaken to evaluate the effectiveness of subcutaneous pulsed neodymium: yttrium-aluminum-garnet (Nd-YAG) laser treatment for the treatment of axillary osmidrosis. Twenty-nine patients with axillary osmidrosis were included in this study. Patients were categorized according to the results of an axillary malodor grading system, and a subcutaneous pulsed Nd-YAG laser was applied to all patients. The treatment area for the appropriate distribution of laser energy was determined using the iodine starch test (Minor's test) against a grid pattern composed of 2×2 cm squares. The endpoint of exposure was 300 to 500 J for each grid, depending on the preoperative evaluation results. The results were evaluated by measurement of axillary malodor both pre- and postoperatively using the grading system and iodine starch test. The average follow-up period was 12.8 months. Nineteen patients had a fair-to-good result and ten patients had poor results. The postoperative Minor's test demonstrated that there were remarkable improvements for patients with mild to moderate symptoms. Complications including superficial second degree burns (n=3) were treated in a conservative manner. A deep second degree burn (n=1) was treated by a surgical procedure. Subcutaneous pulsed Nd-YAG laser has many advantages and is an effective noninvasive treatment for mild to moderate axillary osmidrosis.

  7. Proximity of the axillary nerve during bicortical drilling for biceps tenodesis.

    Science.gov (United States)

    Lancaster, Sarah; Smith, Geoff; Ogunleye, Oluwafunto; Packham, Iain

    2016-06-01

    Pathology of the biceps tendon can contribute to significant shoulder pain and dysfunction for which biceps tenodesis may be indicated. A variety of techniques tenodesing the biceps tendon have been described. Recently, tenodesis using a uni- or bicortical button has been advocated. This cadaveric study investigates the proximity of the axillary nerve to the position of bicortical drill passages during biceps tenodesis. Twelve cadaveric shoulder specimens were used. The axillary nerve was marked during a preparatory dissection using wire. Drills were passed through the humerus at the proximal and distal ends of the bicipital groove, and at the superior insertion point of pectoralis major (PM). These were left in situ. The distances between these drills and the axillary nerves were measured using computed tomography imaging. The drill bits placed at the superior insertion of PM were in closest proximity to the axillary nerve (3D distance mean 10.7 mm, 95 % confidence interval 7.2-14.2 mm). A drill placed at the distal end of the bicipital groove was a mean distance of 18.2 mm from the nerve. This study highlights the need for caution when drilling the posterior humeral cortex during biceps tenodesis, particularly during drilling at the superior insertion of PM as this is the location that poses the highest risk to the axillary nerve. To our knowledge, this is the first cadaveric study to radiologically assess the proximity of the axillary nerve to the positions of biceps tenodesis. Surgeons should therefore be cautious when performing bicortical drilling for biceps tenodesis, and a supero-lateral drill trajectory would pose a smaller risk to the axillary nerve.

  8. Transfer of pectoral nerves to suprascapular and axillary nerves: an anatomic feasibility study.

    Science.gov (United States)

    David, Sylvain; Balaguer, Thierry; Baque, Patrick; Lebreton, Elisabeth

    2010-01-01

    We conducted an anatomic study to provide detailed information on the pectoral nerves and anatomic data on the transfer of the pectoral nerves to the axillary nerve. Moreover, we experimentally determined the feasibility of transferring the pectoral nerves to the suprascapular nerve in upper brachial plexus injury. We dissected 26 brachial plexus from 15 fresh cadavers. The origin, location, course, and branching of the pectoral nerves were recorded. The length and the diameter of the pectoral nerves were measured. The diameter of the suprascapular and axillary nerves was recorded. In all dissections, we assessed the feasibility of directly transferring the pectoral nerves to the suprascapular and axillary nerves. We found 3 constant branches of pectoral nerves arising from 3 distinct origins in 20 cases, and 3 constant branches arising from 2 distinct origins in 6 cases. The C7 sent nerve fibers to all 3 branches. The average length and diameter of the superior, middle, and inferior branches of the pectoral nerves were 65 mm, 110 mm, and 105 mm, and 2.0 mm, 2.3 mm, ad 2.4 mm, respectively. The average diameter of the suprascapular and axillary were 2.8 mm and 3.6 mm, respectively. The superior branch reached the suprascapular and axillary nerves in 17 and 8 cases. The middle and inferior branches reached the suprascapular and axillary nerve in all dissections. With an adequate length, diameter, and nerve composition, the middle and inferior branches of the pectoral nerves are suitable donor nerves to the axillary nerve and a potential source of reinnervation of the suprascapular nerve in upper brachial plexus injury. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  9. The correlation between acromion-axillary nerve distance and upper arm length; a cadaveric study.

    Science.gov (United States)

    Samart, Supawat; Apivatgaroon, Adinun; Lakchayapakorn, Kajorn; Chemchujit, Bancha

    2014-08-01

    Deltoid splitting is one of common and useful approaches in proximal humerus surgery. The disadvantage of this approach is high risk of axillary nerve injury. Nowadays, there is no consensus in the proper mean of the individual's axillary nerve location. The present study aim to determine the correlation between the axillary nerve and the upper arm length that may create equations to calculate the nerve location. Seventy shoulders were measured the distance from lateral acromial edge to axillary nerve and compared with upper arm length in three positions of the shoulder (adduction 30°, abduction 45° and 90°). The authors used distance of lateral acromial edge to lateral epicondyle and tip ofgreater tuberosity to lateral epicondyle as the upper arm length. The average distance ofshoulder adduction 30°, abduction 45° and90° were 57.9, 57.1 and 52.9 mm, respectively. All of three positions showed linear correlation to upper arm length from both of reference sites. From acromion edge reference, where "Y" is axillary nerve distance in mm and "x" is upper arm length in cm, the relation were Y= 2.3x-10, Y= 2x-2 and Y= 2x-7with the accuracy rate were 88.57%, 85.71% and 81.43%, respectively. From greater tuberosity reference, the relations were Y = 2.54x-14, Y = 2x and Y = 2.3x-12 with the accuracy rates 87.14%, 80% and 84.29%, respectively. There is linear correlation between distance from the lateral acromial edge to axillary nerve and the upper arm length. The authors can predict the danger zone in the location of the anterior upper branch of the axillary nerve. However, further clinical study may helpful to prove the equations. Level ofevidence: Basic science anatomy study.

  10. 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 BackgroundAxillary osmidrosis is characterized by an unpleasant odor, profuse sweating, and in some instances, staining of clothes that may socially and psychologically impair affected individuals. Various types of surgical procedures have been developed for the treatment of axillary osmidrosis. This study was undertaken to evaluate the effectiveness of subcutaneous pulsed neodymium: yttrium-aluminum-garnet (Nd-YAG laser treatment for the treatment of axillary osmidrosis.MethodsTwenty-nine patients with axillary osmidrosis were included in this study. Patients were categorized according to the results of an axillary malodor grading system, and a subcutaneous pulsed Nd-YAG laser was applied to all patients. The treatment area for the appropriate distribution of laser energy was determined using the iodine starch test (Minor's test against a grid pattern composed of 2×2 cm squares. The endpoint of exposure was 300 to 500 J for each grid, depending on the preoperative evaluation results. The results were evaluated by measurement of axillary malodor both pre- and postoperatively using the grading system and iodine starch test.ResultsThe average follow-up period was 12.8 months. Nineteen patients had a fair-to-good result and ten patients had poor results. The postoperative Minor's test demonstrated that there were remarkable improvements for patients with mild to moderate symptoms. Complications including superficial second degree burns (n=3 were treated in a conservative manner. A deep second degree burn (n=1 was treated by a surgical procedure.ConclusionsSubcutaneous pulsed Nd-YAG laser has many advantages and is an effective noninvasive treatment for mild to moderate axillary osmidrosis.

  11. Twist buckling of veins under torsional loading.

    Science.gov (United States)

    Garcia, Justin R; Sanyal, Arnav; Fatemifar, Fatemeh; Mottahedi, Mohammad; Han, Hai-Chao

    2017-06-14

    Veins are often subjected to torsion and twisted veins can hinder and disrupt normal blood flow but their mechanical behavior under torsion is poorly understood. The objective of this study was to investigate the twist deformation and buckling behavior of veins under torsion. Twist buckling tests were performed on porcine internal jugular veins (IJVs) and human great saphenous veins (GSVs) at various axial stretch ratio and lumen pressure conditions to determine their critical buckling torques and critical buckling twist angles. The mechanical behavior under torsion was characterized using a two-fiber strain energy density function and the buckling behavior was then simulated using finite element analysis. Our results demonstrated that twist buckling occurred in all veins under excessive torque characterized by a sudden kink formation. The critical buckling torque increased significantly with increasing lumen pressure for both porcine IJV and human GSV. But lumen pressure and axial stretch had little effect on the critical twist angle. The human GSVs are stiffer than the porcine IJVs. Finite element simulations captured the buckling behavior for individual veins under simultaneous extension, inflation, and torsion with strong correlation between predicted critical buckling torques and experimental data (R 2 =0.96). We conclude that veins can buckle under torsion loading and the lumen pressure significantly affects the critical buckling torque. These results improve our understanding of vein twist behavior and help identify key factors associated in the formation of twisted veins. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Evaluation of apoptosis in varicose vein disease complicated by superficial vein thrombosis.

    Science.gov (United States)

    Filis, Konstantinos; Kavantzas, Nikolaos; Dalainas, Ilias; Galyfos, George; Karanikola, Evridiki; Toutouzas, Konstantinos; Tsioufis, Constantinos; Sigala, Fragiska

    2014-07-01

    The factors contributing to superficial vein thrombosis (SVT) in patients with varicose vein disease are unclear. Differences in vein wall apoptotic activity could be associated with the pathogenesis of SVT. The aim of the study is to address the role of the programmed cell death in the vein wall by comparing varicose veins with history of SVT to uncomplicated varicose veins. Vein segments from the proximal part of the great saphenous vein (GSV), the distal part of the vein and from a varicose tributary, from 16 patients with varicose vein disease and one episode of SVT, were evaluated for the immunohistochemical expression of pro-apoptotic (Bax, p53, Caspase 3, BCL-6, BCL-xs), anti-apoptotic (BCL-xl and BCL-2) and proliferation (Ki-67) markers. The results of this study were compared to the results from the evaluation of 19 patients suffering from uncomplicated varicose vein disease and 10 healthy GSVs as controls. Overall, there was increased apoptosis in the distal part of GSV compared to the proximal part documented by increased expression of Bax (p veins and patients with a history of SVT showed significant differences among the three different anatomic locations. In the proximal GSV, only BCL-xs was higher in patients with SVT (p = 0.029). In the tributaries, Bax, BCL-xl and Ki-67 were higher in patients with SVT (p thrombosis group compared to uncomplicated veins (p vein wall in SVT shows increased pro-apoptotic activity compared to uncomplicated disease and normal veins. Whether increased vein wall cell apoptosis is a causative factor for SVT in varicose veins disease or a repairing mechanism of the thrombosis itself needs further research.

  13. Compression syndrome of the left renal vein

    Energy Technology Data Exchange (ETDEWEB)

    Justich, E.

    1982-04-01

    Severe compression of the left renal vein produces a pressure gradient between it and the inferior vena cava and results in changes in haemodynamics. The cause of the narrowing is usually the aorta, less commonly the superior mesenteric artery. Compression of the left renal vein may be responsible for a number of abnormalities such as primary varicoceles, primary varices of the ovarian, renal, pelvic and ureteric veins on the left, the more frequent occurrence of unilateral renal vein thrombosis on the left and the development of renovascular hypertension. One hundred and twenty-three selective phlebograms of the left renal vein and CT examinations of this structure in a further 87 patients acting as a control group were carried out. The significance of compression of the left renal vein as an aetiological factor in the development of the above mentioned abnormalities is discussed.

  14. Gold Veins near Great Falls, Maryland

    Science.gov (United States)

    Reed, John Calvin; Reed, John C.

    1969-01-01

    Small deposits of native gold are present along an anastomosing system of quartz veins and shear zones just east of Great Falls, Montgomery County, Md. The deposits were discovered in 1861 and were worked sporadically until 1951, yielding more than 5,000 ounces of gold. The vein system and the principal veins within it strike a few degrees west of north, at an appreciable angle to foliation and fold axial planes in enclosing rocks of the Wissahickon Formation of late Precambrian (?) age. The veins cut granitic rocks of Devonian or pre-Devonian age and may be as young as Triassic. Further development of the deposits is unlikely under present economic conditions because of their generally low gold content and because much of the vein system lies on park property, but study of the Great Falls vein system may be useful in the search for similar deposits elsewhere in the Appalachian Piedmont.

  15. [Isolated traumatic injuries of the axillary nerve. Radial nerve transfer in four cases and literatura review].

    Science.gov (United States)

    Domínguez-Páez, Miguel; Socolovsky, Mariano; Di Masi, Gilda; Arráez-Sánchez, Miguel Ángel

    2012-11-01

    To analyze the results of an initial series of four cases of traumatic injuries of the axillary nerve, treated by a nerve transfer from the triceps long branch of the radial nerve. An extensive analysis of the literature has also been made. Four patients aged between 21 and 42 years old presenting an isolated traumatic palsy of the axillary nerve were operated between January 2007 and June 2010. All cases were treated by nerve transfer six to eight months after the trauma. The results of these cases are analyzed, the same as the axillary nerve injuries series presented in the literature from 1982. One year after the surgery, all patients improved their abduction a mean of 70° (range 30 to 120°), showing a M4 in the British Medical Council Scale. No patient complained of triceps weakness after the procedure. These results are similar to those published employing primary grafting for the axillary nerve. Isolated injuries of the axillary nerve should be treated with surgery when spontaneous recovery is not verified 6 months after the trauma. Primary repair with grafts is the most popular surgical technique, with a rate of success of approximately 90%. The preliminary results of a nerve transfer employing the long triceps branch are similar, and a definite comparison of both techniques with a bigger number of cases should be done in the future. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  16. Potential bud bank responses to apical meristem damage and environmental variables: matching or complementing axillary meristems?

    Directory of Open Access Journals (Sweden)

    Jitka Klimešová

    Full Text Available Soil nutrients, dormant axillary meristem availability, and competition can influence plant tolerance to damage. However, the role of potential bud banks (adventitious meristems initiated only after injury is not known. Examining Central European field populations of 22 species of short-lived monocarpic herbs exposed to various sources of damage, we hypothesized that: (1 with increasing injury severity, the number of axillary branches would decrease, due to axillary meristem limitation, whereas the number of adventitious shoots (typically induced by severe injury would increase; (2 favorable environmental conditions would allow intact plants to branch more, resulting in stronger axillary meristem limitation than in unfavorable conditions; and (3 consequently, adventitious sprouting would be better enabled in favorable than unfavorable conditions. We found strong support for the first hypothesis, only limited support for the second, and none for the third. Our results imply that whereas soil nutrients and competition marginally influence plant tolerance to damage, potential bud banks enable plants to overcome meristem limitation from severe damage, and therefore better tolerate it. All the significant effects were found in intraspecific comparisons, whereas interspecific differences were not found. Monocarpic plants with potential bud banks therefore represent a distinct strategy occupying a narrow environmental niche. The disturbance regime typical for this niche remains to be examined, as do the costs associated with the banks of adventitious and axillary reserve meristems.

  17. Axillary nerve palsy after retrograde humeral nailing: clinical confirmation of an anatomical fear.

    Science.gov (United States)

    Lögters, Tim Tobias; Wild, Michael; Windolf, Joachim; Linhart, Wolfgang

    2008-12-01

    Locked antegrade or retrograde nailing of humeral shaft and proximal humerus fractures is a well established treatment option. Anatomic-morphological studies revealed a potential high risk of axillary nerve injury within proximal interlocking screw insertion. However, clinical experiences do not seem to confirm this, as there is a lack of interlocking screw insertion associated axillary lesions in literature. We report about a 69-year-old man with a humeral shaft fracture (AO-type 12-A3) stabilized by a retrograde implanted interlocking nail. Proximal interlocking screw insertion was performed in a posterior-to-anterior direction. The fracture healed uneventfully. In a follow-up examination 2 years later, an atrophy and paralysis of the deltoid muscle were visible. Electrophysiological evaluation confirmed an isolated axillary nerve injury. Nevertheless, the patient showed good functional recovery with almost free range of motion. Even for clinical practise proximal interlocking screw insertion is associated with a substantial risk of axillary nerve injury. Particularly for posterior-to-anterior screw insertion anatomic conditions should be considered. In spite of axillary nerve lesion, recovery of almost full shoulder function is possible by compensating the loss of deltoid function by rotator cuff muscles.

  18. Triceps motor branch transfer for isolated axillary nerve injury: Outcomes in 9 patients.

    Science.gov (United States)

    Yang, X; Xu, B; Tong, J-S; Zhang, C-G; Dong, Z; Liu, J-B

    2017-12-01

    Triceps motor branch transfer has been used for more than ten years to restore deltoid function after axillary nerve injury. However, there have been few reports of the outcome of this procedure in isolated axillary nerve injury. Triceps motor branch transfer could be an effective method to restore deltoid function for patients with isolated axillary nerve injury. Nine patients who underwent triceps motor branch transfer for treatment of isolated axillary nerve injury were followed up for at least 22 months. Shoulder abduction was assessed for all patients. The DASH outcome questionnaire was completed by every patient. Electrophysiological study was performed on 7 patients. All patients regained≥90° (mean, 137°) shoulder abduction. Mean DASH score decreased from 35.2 before surgery to 13.1 at the last follow-up. There was no noticeable weakness of elbow extension in any patient. Triceps motor branch transfer provided good results and may be a feasible alternative to nerve grafting for the treatment of complete isolated axillary nerve injury. IV, retrospective cohort study. Copyright © 2017. Published by Elsevier Masson SAS.

  19. Proximity of Axillary Nerve During Cortical Button Repair of Pectoralis Major Tendon Rupture.

    Science.gov (United States)

    Lancaster, Sarah T; Smith, Geoff C; Ogunleye, Oluwafunto E; Clark, Damian A; Packham, Iain N

    2014-01-01

    Rupture of the pectoralis major (PM) tendon is a rare but severe injury. Several techniques have been described for PM fixation, including a transosseus technique, placing cortical buttons at the superior, middle and inferior PM tendon insertion points. The present cadaveric study investigates the proximity of the posterior branch of the axillary nerve to the drill positions for transosseus PM tendon repair. Twelve cadaveric shoulders were used. The axillary nerve was marked during a preparatory dissection. Drills were passed through the humerus at the superior, middle and inferior insertions of the PM tendon and the drill bits were left in situ. The distance between these and each axillary nerve was measured using computed tomography. The superior drill position was in closest proximity to the axillary nerve (three-dimensional distance range 0-18.01 mm, mean 10.74 mm, 95% confidence interval 7.24 mm to 14.24 mm). The middle PM insertion point was also very close to the nerve. Caution should be used when performing bicortical drilling of the humerus, especially when drilling at the superior border of the PM insertion. We describe 'safe' and 'danger' zones for the positioning of cortical buttons through the humerus reflecting the risk posed to the axillary nerve.

  20. Long-nerve grafts and nerve transfers demonstrate comparable outcomes for axillary nerve injuries.

    Science.gov (United States)

    Wolfe, Scott W; Johnsen, Parker H; Lee, Steve K; Feinberg, Joseph H

    2014-07-01

    To compare the functional and EMG outcomes of long-nerve grafts to nerve transfers for complete axillary nerve palsy. Over a 10-year period at a single institution, 14 patients with axillary nerve palsy were treated with long-nerve grafts and 24 patients were treated with triceps-to-axillary nerve transfers by the same surgeon (S.W.W.). Data were collected prospectively at regular intervals, beginning before surgery and continuing up to 11 years after surgery. Prior to intervention, all patients demonstrated EMG evidence of complete denervation of the deltoid. Deltoid recovery (Medical Research Council [MRC] grade), shoulder abduction (°), improvement in shoulder abduction (°), and EMG evidence of deltoid reinnervation were compared between cohorts. There were no significant differences between the long-nerve graft cohort and the nerve transfer cohort with respect to postoperative range of motion, deltoid recovery, improvement in shoulder abduction, or EMG evidence of deltoid reinnervation. These data demonstrate that outcomes of long-nerve grafts for axillary nerve palsy are comparable with those of modern nerve transfers and question a widely held belief that long-nerve grafts do poorly. When healthy donor roots or trunks are available, long-nerve grafts should not be overlooked as an effective intervention for the treatment of axillary nerve injuries in adults with brachial plexus injuries. Therapeutic III. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Congenital Agenesis of the Portal Vein: Case

    International Nuclear Information System (INIS)

    Puerta R, Andres F; Vargas B, Maria C; Gomez, Eduardo

    2011-01-01

    Portal vein agenesis is an uncommon anomaly in which the venous drainage from the intestine and spleen bypasses the liver and drains into the systemic veins through shunts. We report a case of a newborn with a prenatal diagnosis of congenital absence of the portal vein, as well as a medical literature review about the main radiological features of this condition and the different associated venous shunts.

  2. A complicated case of deep vein thrombosis

    OpenAIRE

    Cerutti, Elena; Colagrande, Paola; Provera, Edoardo; Giusti, Massimo

    2011-01-01

    We report a case of a patient with deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) associated to portal vein thrombosis (PVT), complicated by hospital-acquired pneumonia (HAP). The pathogenesis of DVT is multifactorial; among risk factors we can list: transitory situations (surgical interventions, infectious diseases with fever, traumas), acquired conditions (neoplasms, antiphospholipid syndrome) or genetically determined situations (thrombophilia). PVT of the sovrahepatic vein...

  3. Mesenteric vein thrombosis following laparoscopic appendectomy

    OpenAIRE

    Jamie Harris; Brian Blackwood; Srikumar Pillai; Bill Chiu

    2014-01-01

    Mesenteric vein thrombosis is an uncommon complication following laparoscopic surgery. A review of the literature has shown that there is a higher incidence of thrombosis following laparoscopic bariatric procedures, including the gastric sleeve procedure and roux-en-y gastric bypass surgery. Additionally, pylephlebitis, thrombosis of portal or mesenteric veins, has been described following perforated appendicitis. However no report has described mesenteric vein thrombosis following laparoscop...

  4. Interposition vein cuff in infrainguinal prosthetic bypasses.

    Science.gov (United States)

    D'Andrea, V; Biancari, F; Catania, A; Di Matteo, F M; Sorrenti, S; Spyrou, M; Dibra, A; Foti, N; Ortensi, A

    1999-01-01

    The Authors describe the interposition vein cuff technique as an adjuvant method to infrainguinal prosthetic bypass grafts. The haemodynamic, mechanical and humoral factors thought to be involved in the beneficial effects of the vein cuff are herein discussed. The results of the main series suggest the use of this method particularly in patients without any available autologous vein conduit requiring a below-knee popliteal or crural reconstruction.

  5. Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) - Blood Clot Forming in a Vein

    Science.gov (United States)

    ... Recommend on Facebook Tweet Share Compartir Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) are often underdiagnosed and serious, but preventable medical conditions. Deep vein thrombosis (DVT) is a medical condition that occurs when ...

  6. Cephalic Vein Transposition versus Vein Grafts for Venous Outflow in Free-flap Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Edward I. Chang, MD

    2014-05-01

    Conclusions: The CVT is a reliable alternate venous outflow that can be used as a primary recipient vein or as a salvage option following venous thrombosis. Surgeons should consider a CVT when primary recipient veins are compromised or unavailable.

  7. Right portal vein embolization by laparoscopic catheterization of the inferior mesenteric vein

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Martins Cury

    2013-12-01

    Full Text Available Right portal vein embolization is often performed to prevent liver insufficiency after major hepatic resection. The procedure usually involves direct puncture of the portal vein, which requires hepatic hilum manipulation, and may be associated with liver injury, pneumothorax, and hemoperitoneum. This report describes a technique of laparoscopic insertion of a sheath into the inferior mesenteric vein followed by right portal vein embolization.

  8. Clinically silent deep vein thrombosis in patients with superficial thrombophlebitis and varicose veins at legs.

    Science.gov (United States)

    Jerkic, Zoran; Karic, Alen; Karic, Amela

    2009-01-01

    Although superficial thrombophlebitis is a common disorder until recently it was considered as benign disorder. Also it is associated with varicose vein at legs and it was treated effectively with conservative methods, walking and non-steroid anti-inflammatory drugs. Aims of our investigation were: determine frequency of clinically silent deep vein thrombosis at legs in patient with and without superficial thrombophlebitis, determine correlation between superficial thrombophlebitis and deep vein thrombosis regardless of localization of superficial thrombophlebitis in superficial veins of legs and determine adequacy and safety vein phlebography in early diagnosis clinically silent deep vein thrombosis in patients with superficial thrombophlebitis. Using flebography in prospective study was evaluated incidence of clinically silent deep vein thrombosis in 92 patients with varicose veins at legs. By phlebograpy in patients with varicose veins at legs and superficial thrombophlebitis at legs and without clinical signs of DVT at legs of the 49 patients we detected DVT in 12 patients (24, 48%), in three male and nine female. We detected localization of DVT in ilijacofemoral junction in 4,08% patients, although localization of DVT in femoropopliteal region was observed in 6, 12% patients and localization in crural region was in 14.28% patients. Localization of DVT at legs was detected in iliac vein in 16.66% patients, in femoral vein in 25% patients, popliteal vein 8.33% patients, anterior tibial vein 16.66%, posterior tibial vein in 25% and crural veins 8.33% patients. Also we deduced significant difference between two group of patients (chi2 = 10, 76). Such result proves thesis that in most patients with superficial thrombophlebitis and varicose veins is possibility of developing of DVT.

  9. Superficial vein thrombosis and deep vein thrombosis – a comparison

    Directory of Open Access Journals (Sweden)

    Zbigniew Krasiński

    2017-09-01

    Full Text Available Although superficial vein thrombosis is commonly considered a rather minor condition, a number of studies indicate that its consequences can be much more severe. Since the introduction of Doppler ultrasonography to common diagnosis of venous diseases, the approach to threats associated with superficial vein thrombosis has changed, mainly in the context of venous thromboembolism. Superficial thrombosis in varicose veins must be differentiated from that occurring in patients without varicosities. In the former case, superficial vein thrombosis is usually caused by haemodynamic disorders (slower flow, while in the latter, it is caused by thrombophilia or inflammation, but it can also be a prodromal sign of cancer. Ultrasonography enables one to distinguish deep vein thrombosis caused by superficial vein thrombosis progression (by extension through perforator veins or the great/small saphenous vein ostium into the deep venous system from deep vein thrombosis occurring at a certain distance from the site of superficial vein thrombosis. The authors emphasise that due to the possibility of concomitant deep vein thrombosis or pulmonary embolism, our attitude to the diagnostic process, potential complications and treatment of superficial vein thrombosis should be changed.

  10. Quantifying the number of lymph nodes identified in one-stage versus two-stage axillary dissection in breast cancer

    DEFF Research Database (Denmark)

    Damgaard, Olaf E; Jensen, Maj-Britt; Kroman, Niels

    2013-01-01

    To establish whether a different number of lymph nodes is identified in a delayed versus an immediate axillary lymph node dissection (ALND) in breast cancer patients.......To establish whether a different number of lymph nodes is identified in a delayed versus an immediate axillary lymph node dissection (ALND) in breast cancer patients....

  11. Is the Axillary Nerve at Risk During a Deltoid-Splitting Approach for Proximal Humerus Fractures?

    Science.gov (United States)

    Traver, Jessica L; Guzman, Miguel A; Cannada, Lisa K; Kaar, Scott G

    2016-05-01

    The strain placed across the axillary nerve during the deltoid-splitting approach could correlate with microtrauma and place the patient at risk of a neuropraxia or more permanent injury. The purposes of this study were to evaluate the change in length and strain exhibited by the axillary nerve during the deltoid-splitting approach and to determine the presence of any microscopic structural damage. The axillary nerve was identified through a lateral deltoid-splitting approach in 10 fresh-frozen cadaver specimens. Two suture tags were placed near the lateral margins of the incision. The initial distance between the 2 tags was measured and the distance at each retractor click of a Kölbel retractor until full expansion (6 clicks). The retractor was then released for a 1-minute break at 30, 60, 90, and 120 minutes. The strain at each interval was calculated as change in length divided by the initial distance. The section of nerve in the field of exposure was excised for histologic analysis. The location of the axillary nerve was 6.32 cm (range, 5.20-7.6 cm) from the anterolateral aspect of the acromion. The mean final increase in length was 8.42 mm (range, 6.43-12.26 mm). The strain increased to a final mean of 51% (range, 28%-99%). Histologic analysis confirmed disruption of the myelin sheaths and axonal retraction. This study demonstrated a progressive, irreversible increase in axillary nerve length and strain, resulting in microscopic damage to the neuronal structure during a deltoid-splitting approach. Prolonged soft tissue retraction can place the axillary nerve at substantial risk for injury.

  12. [Verneuil's disease. The diffuse inguino-perineo-gluteal and bilateral axillary form].

    Science.gov (United States)

    Tropet, Y; Balmat, P; Mantion, G; Agache, P; Vichard, P

    1989-01-01

    The authors report a case of suppurative hidradenitis of unusual severity affecting the axillary, inguinal, perianal, genital and sacral areas. The surgical treatment consisted initially of large excision of the axillary areas. A musculo-cutaneous latissimus dorsi island flap was then used to cover the defect. 45 days later, a complete excision, in only one operative session, of the inguinal, perianal, genital and sacral area was performed, associate durth colostomy. A mesh graft was performed 15 days after the excision. This procedure allowed an early scar.

  13. 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.

  14. Surgical treatment of axillary hyperhidrosis by suction-curettage of sweat glands*

    Science.gov (United States)

    de Rezende, Rebeca Maffra; Luz, Flávio Barbosa

    2014-01-01

    Suction curettage is a dermatologic surgery technique for the treatment of axillary hyperhidrosis, which is becoming more popular. Objective: The purpose of this study is to describe the current technique of removal of axillary sweat glands, and evaluate its efficacy and safety. Conclusion: Suction-curettage of sweat glands is a minimally invasive surgical technique that is easy to perform, safe, has high rates of success and relatively few side-effects. It is generally well tolerated by patients and requires shorter time away from daily activities, when compared with other surgical modalities. PMID:25387499

  15. Durability of the Viabahn stent graft after axillary artery pseudoaneurysm exclusion

    Directory of Open Access Journals (Sweden)

    Aaron Y. Chen, BS

    2017-06-01

    Full Text Available Pseudoaneurysm formation caused by iatrogenic arterial injury during a regional anesthetic block is a rare complication. We report a case of a 56-year-old male patient who developed an axillary artery pseudoaneurysm caused by brachial plexus block performed for an upper extremity dialysis access operation. Successful repair of this pseudoaneurysm was achieved with endovascular stent graft exclusion. The repaired axillary artery with the stent graft remained patent after 10 years of follow-up. The successful long-term patency of this treatment and a strategy to potentially avoid this complication are discussed.

  16. Intercostobrachial nerve injury from axillary dissection resulting in necrotizing fasciitis after a burn injury.

    Science.gov (United States)

    Brooks, Peter; Malic, Claudia; Austen, Orla

    2008-01-01

    We present here the successful management of a 50-year-old female patient who developed necrotizing fasciitis after a burn injury to her left arm. The burn injury was sustained in a minimally lymphoedematous arm, in an area of post surgical paresthesia caused by division of the intercostobrachial nerve. This is a common consequence of axillary lymph node dissection. We discuss the diagnosis, management strategies, and the available literature. We conclude that division of the intercostobrachial nerve increases the risk of morbidity significantly and support the view that its preservation at the time of axillary surgery is preferable.

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

    International Nuclear Information System (INIS)

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

    1989-01-01

    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.)

  18. Editorial Commentary: Shoulder Anatomy, Finding the Axillary Nerve: Measure Twice, Cut Once.

    Science.gov (United States)

    Nottage, Wesley M

    2018-03-01

    Most descriptions of shoulder anatomy note that the axillary nerve lies approximately 5 cm below the anterolateral corner of the acromion, and the nerve has been reported to range from 2 to 7 cm from the acromial edge, depending on the patient and measuring technique. The safe trans-deltoid operable area has been described as up to 4 cm below the acromion. A useful clinical guide I use is that the inferior extent of the subacromial bursa ends above the axillary nerve. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. A new technique for complete portal vein and superior mesenteric vein thrombosis in a liver transplant recipient.

    Science.gov (United States)

    Song, Sanghyun; Kwon, Choon Hyuck David; Shin, Milljae; Kim, Tae-Seok; Lee, Sanghoon; Moon, Hyung Hwan; Park, Jae Berm; Kim, Sung Joo; Joh, Jae-Won; Lee, Suk-Koo

    2014-02-01

    We describe a deceased-donor liver transplant recipient with grade 3 complete portal vein and superior mesenteric vein thromboses, which was successfully managed with an extensive thrombectomy through the venotomy site of superior mesenteric vein. In this case report, we suggest our method as an option for grade 3 portal vein thromboses, and discuss other options available for recipients with portal vein thromboses.

  20. Prevention of axillary nerve injury in anterior shoulder reconstructions: use of a subscapularis muscle-splitting technique and a review of the literature.

    Science.gov (United States)

    McFarland, Edward G; Caicedo, Juan Carlos; Kim, Tae Kyun; Banchasuek, Prachan

    2002-01-01

    Previous authors have suggested that the axillary nerve should be explored or palpated during all anterior shoulder stabilization procedures. The goal of this study was to document the axillary nerve injury rate in a cohort of patients who had undergone anterior shoulder stabilization without axillary nerve dissection. Use of a subscapularis muscle-splitting approach by using a retractor along the scapular neck does not result in significant risk of injury to the axillary nerve, and exploration of the axillary nerve is not necessary using this approach. Prospective cohort study. One hundred and twenty-eight anterior stabilizations were performed with a subscapularis muscle-splitting approach that has been previously described. In all cases a retractor was placed along the inferior scapular neck to protect the axillary nerve. The axillary nerve was not exposed or palpated in any case. All patients were evaluated on the 1st postoperative day and again within 10 days for symptoms of axillary nerve palsy, including sensory loss and return of muscle function. One patient (0.8%) had paresthesia in an axillary nerve distribution; recovery occurred without the need for electromyography or other interventions. There were no clinically detected cases of axillary nerve motor dysfunction. Routine exposure of the axillary nerve is not necessary during anterior stabilization procedures using a subscapularis muscle-splitting approach if proper precautions are taken to protect the nerve. Other techniques of anterior stabilization may require exposure of the axillary nerve.

  1. Interventional treatment of iliac vein compression syndrome

    International Nuclear Information System (INIS)

    Li Xiaoqiang; Zhou Weiming; Nie Zhonglin; Yu Chaowen

    2002-01-01

    Objective: To explore the clinical significance of interventional treatment of iliac vein compression syndrome (IVCS). Methods: Percutaneous transluminal angioplasty (PTA) was performed in 40 cases. Thirty-three cases underwent endovascular stent implantation and 27 cases underwent second-stage left saphenous vein ligation and stripping and the valves of left femoral veins narrowing. Thirty-one cases were followed-up postoperatively and the duration was 6-66 months (mean 28 months). Results: The dilation of iliac veins was successful in 36 cases and there were god efficacy in all patients when they discharged from hospital. Followed-up during post-operation, all the limbs ulcers were cured and varicose veins disappeared. The skin pigmentation disappeared in 17 of 19 cases and markedly relieved in 2 cases. Left lower limb swelling disappeared in 15 of 17 cases and relieved in 2 cases. Conclusion: There is good efficacy in the interventional treatment of left iliac vein lesions, but second-stage procedures should be performed in secondary lesions of saphenous veins and valves of femoral veins

  2. 'Closed' in Situ Vein Infrainguinal Bypass

    NARCIS (Netherlands)

    L.C. van Dijk (Lukas)

    1996-01-01

    textabstractThe autologous greater saphenous vein is considered to be the best bypass material for below knee femoropopliteal and femorocnual arterial reconstructions . . The history of the greater saphenous vein arterial bypass in humans started in 1949, with its first introduction by Kunlin. Upto

  3. Geology and geochemistry of giant quartz veins

    Indian Academy of Sciences (India)

    They show imprints of strong brittle to ductile–brittle deformation, and in places are associated with base metal and gold incidences, and pyrophyllite-diaspore mineralization. The geochemistry of giant quartz veins were studied. Apart from presenting new data on the geology and geochemistry of these veins, an attempt has ...

  4. Preoperative mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Sillesen, H; Nielsen, Tina G

    1996-01-01

    A series of 124 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. 33 (27%) bypass procedures thrombosed within the first year. A naturally occurring optimal vein diameter was discovered: 5.0-6.5 mm at mid-thigh lev...

  5. PORTAL VEIN THROMBOSIS-ULTRASOUND IMAGING

    Directory of Open Access Journals (Sweden)

    Trajkovska Meri

    2016-07-01

    Full Text Available Portal venous system, apart from the main portal vein, includes its tributaries: superior and inferior mesenteric vein, as well as splenic vein, so the term portal venous thrombosis encompasses a broad spectrum of pathological conditions. Usually, one or more causative factors can be recognized, either local endothelial/ flow disturbances, or systemic inherited /acquired conditions. Portal vein thrombosis can be associated with benign or malignant disorders. Weather we are speaking about acute or chronic thrombosis, the clinical presentation is different. Acute thrombosis can be presented in a wide range, from mild abdominal discomfort to a state of intestinal ischemia and life-threatening infarction. Chronic thrombosis is usually recognized when variceal bleeding or other symptoms of portal hypertension express. Fast and accurate diagnosis sometimes is a life-saving procedure, especially in acute vascular alterations. Recently, due to the improvement of imaging procedures the number of patients with diagnosed portal vein thrombosis is increasingly growing. With a negative predictive value of 98% color Doppler ultrasound is considered as imaging modality of choice in detecting portal vein thrombosis. Based on large studies it is presumed that overall risk of getting portal vein thrombosis during lifetime is 1% in general population, but much bigger 5%-15% in cirrhotic patients. Existence of specific ultrasound criteria, if fulfilled, has ensured that diagnosis of portal vein thrombosis is fast and non-invasive. Procedure is convenient for the patient and healthcare providers, and above all, allows prompt treatment preventing further deterioration.

  6. Preoperative mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Sillesen, H; Nielsen, Tina G

    1995-01-01

    A consecutive series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. A naturally occurring optimal vein diameter was discovered. It was significantly correlated with higher postoperative ankle-brachial pres...

  7. Deep vein thrombosis and pulmonary embolism

    NARCIS (Netherlands)

    Di Nisio, Marcello; van Es, Nick; Büller, Harry R.

    2016-01-01

    Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer

  8. Effectiveness of the extended surgical approach to visualize the axillary nerve in the blind zone in an arthroscopic axillary nerve injury model.

    Science.gov (United States)

    Maldonado, Andrés A; Spinner, Robert J; Bishop, Allen T; Shin, Alexander Y; Elhassan, Bassem T

    2016-12-01

    The aims of this study were to create a model of axillary nerve (AN) injury during an arthroscopic capsular plication to analyze the site for potential nerve injury and to determine the AN length that can be visualized through standard and extended anterior, axillary, and posterior approaches. Six arthroscopic inferior capsular plications were performed in 3 human adult frozen cadavers. A nonabsorbable suture was used to plicate the inferior capsule aiming at capturing the AN (at a location closest to the joint capsule). We then attempted to explore the AN through 3 different surgical approaches (each approach was performed in 2 shoulders): a standard and an extended anterior, axillary, and posterior approach. Surgical clips were used to mark the AN length that was visualized through each approach. The AN injury was located in a range from 5.4 to 7.8 cm from its origin from the posterior cord. This location corresponds with the previously described AN injury zone B (blind) and zone C (circumflex). Compared to the standard approaches, the extended anterior, axillary, and posterior approaches improved the visualization of the AN by 3.6, 1.5, and 2.8 cm, respectively. None of these approaches independently was sufficient to expose the entire course of the AN. The blind zone is a potential location for AN injury after inferior capsular plication. On the basis of this study, a combination of a standard and an extended surgical approach may lead to better exposure of most of the AN length. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. A Comparison of Outcomes of Triceps Motor Branch-to-Axillary Nerve Transfer or Sural Nerve Interpositional Grafting for Isolated Axillary Nerve Injury.

    Science.gov (United States)

    Baltzer, Heather L; Kircher, Michelle F; Spinner, Robert J; Bishop, Allen T; Shin, Alexander Y

    2016-08-01

    Deltoid paralysis following isolated axillary nerve injury can be managed with triceps motor branch transfer or interpositional grafting. No consensus exists on the treatment that results in superior deltoid function. The purpose of this study was to review the authors' experience with axillary nerve injury management and compare functional outcomes following these two treatment options. Twenty-nine adult isolated axillary nerve injury patients that had either interpositional nerve grafting or triceps motor branch transfer with greater than 1 year of follow-up between 2002 and 2013 were reviewed for demographic and clinical factors and functional outcomes of deltoid reinnervation, including clinical examination (shoulder abduction and forward flexion graded by the Medical Research Council system) and electromyographic recovery. Disabilities of the Arm, Shoulder, and Hand scale grades were also compared. Twenty-one patients had a triceps motor transfer and eight had interpositional nerve grafting. At a mean follow-up of 22 months, Medical Research Council scores were greater in the grafting group compared with the nerve transfer group (4.3 versus 3.0), and more graft patients achieved useful deltoid function (Medical Research Council score ≥3) recovery (100 percent versus 62 percent); however, both groups had similar improvement in self-reported disability: change in Disabilities of the Arm, Shoulder, and Hand score of 11 following nerve transfer versus 15 following nerve graft. Although the question of nerve transfer versus grafting for restoration of axillary nerve function is controversial, this study demonstrates that grafting can result in good objective functional outcomes, particularly during an earlier time course after injury. This question requires further investigation in a larger, prospective patient population. Therapeutic, III.

  10. Assessment and management of patients with varicose veins.

    Science.gov (United States)

    Allen, Louise

    Varicose veins are enlarged superficial veins found in the legs. This article explores the anatomy and physiology of the venous system to assist nurses to assess, manage and treat patients with varicose veins.

  11. The veining phenomenon in unalloyed plutonium

    International Nuclear Information System (INIS)

    White, J.S.

    1976-01-01

    An investigation has been made of the veining phenomenon in unalloyed plutonium. The surface markings, or veins, which are sometimes seen on α-phase plutonium samples, arise as a result of the β→α transformation. As far as is known, this veining is unrivalled in its scale and form as compared with the solid state surface transformation effects shown by any other metal. The phenomenon has been explained by the application of the Le Chatelier principle to the phase change. In this instance, the large (10%) volume contraction associated with the β→α reaction and the anisotropy of the nonoclinic α-phase structure, account for the fact that the veins are so prominent in plutonium. On the basis of the proposed model, the veins can only form at temperatures where the transformation mechanism is non-martensitic. (Auth.)

  12. Ultrasound assessment of great saphenous vein insufficiency

    Directory of Open Access Journals (Sweden)

    Chander RK

    2015-06-01

    Full Text Available Rajiv K Chander,1 Thomas S Monahan1,2 1Section of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, 2Department of Surgery, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA Abstract: Duplex ultrasonography is the ideal modality to assess great saphenous vein insufficiency. Duplex ultrasonography incorporates both gray scale images to delineate anatomy and color-Doppler imaging that visualizes the flow of blood in a structure. Assessment of great saphenous vein requires definition of the anatomy, augmentation of flow, evaluation for both superficial and deep vein thrombosis, and determining the presence of reflux. Currently, evolution in the treatment of reflux also relies on ultrasound for the treatment of the disease. Understanding the utilization of the ultrasound for the diagnosis and treatment of greater saphenous vein reflux is important for practitioners treating reflux disease. Keywords: duplex ultrasonography, small saphenous vein 

  13. Cavernous transformation of the portal vein

    International Nuclear Information System (INIS)

    Lehotska, V.; Dostalova, K.; Durkovsky, A.; Samal, V.

    1995-01-01

    In this contribution, the authors give an account of a rare case of a cavernous transformation of the portal vein that may have originated secondarily in a proliferative hematogenous disease with a polyglobulia and thrombosis in the periferal blood count as well as development of portal hypertension of a prehepatal type. The state of hyper-coagulation in a myeloproliferative disease may have lead to a chronic thrombosis of the portal vein with a subsequent malformation of the portal vein in terms of a cavernous transformation of the portal vein. The case is an interesting one because of the discrepancy between the gravity of the thrombotic complication and slightness of the symptoms in the clinical picture. The authors point out the importance of ultrasonography and computed tomography examination following the intravenous application of a water solution of a contrast medium in a morphologic diagnosing of a rare complication of a chronic thrombotic clot of the portal vein - the cavernous transformation. (authors)

  14. Retinal vein occlusion: current treatment.

    Science.gov (United States)

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

    2011-01-01

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

  15. 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.

  16. 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...

  17. What do you think of an unusual axillary mass? | Benzzi | Pan ...

    African Journals Online (AJOL)

    Skin apocrine carcinoma is a rare malgnancy of epidermal adnexa, most frequent in axillary seat, where apocrine sweat gland are abundant, the neoplasm can arise ... Standard treatment is surgical excision with margins of 2 to 3cm for local tumor, for apocrine adenocarcinoma regional lymph node dissection if nodes were ...

  18. 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...... and describe a new method to perform an ultrasound-guided specific axillary nerve block....

  19. Right Axillary Artery Cannulation for Surgical Management of the Hostile Ascending Aorta

    Science.gov (United States)

    Kokotsakis, John; Lazopoulos, George; Milonakis, Michael; Athanasiadis, George; Romana, Konstantina; Skouteli, Elian; Bastounis, Elias

    2005-01-01

    Extensive aortic disease, such as atherosclerosis with aneurysms or dissections that involve the ascending aorta, can complicate the choice of a cannulation site for cardiopulmonary bypass. To date, the standard peripheral arterial cannulation site has been the common femoral artery; however, this approach carries the risk of atheroembolism due to retrograde aortic perfusion, or it is undesirable because of severe iliofemoral disease. Arterial perfusion through the axillary artery provides sufficient antegrade aortic flow, is more likely to perfuse the true lumen in the event of dissection, and is associated with fewer atheroembolic complications. From September 2000 through March 2004, 27 patients underwent right axillary artery cannulation for acute ascending aortic dissection (n = 16), ascending aortic aneurysm (n = 9), or coronary artery bypass grafting (n = 2). Direct artery cannulation was performed in the first 4 patients, and the last 23 patients were cannulated through a longitudinal arteriotomy via an 8-mm woven Dacron graft. Seventeen patients underwent hypothermic circulatory arrest and antegrade cerebral perfusion. Two patients died intraoperatively: one due to low cardiac output and one due to diffuse bleeding. One patient suffered mild right-arm paresthesia postoperatively, but recovered completely. Axillary artery cannulation was successful in all patients; it provided sufficient arterial flow, and there were no intraoperative problems with perfusion. In the presence of extensive aortic or iliofemoral disease, arterial perfusion through the axillary artery is a safe and effective means of providing sufficient arterial inflow during cardiopulmonary bypass. In this regard, it is an excellent alternative to standard femoral artery cannulation. PMID:16107111

  20. Potential Bud Bank Responses to Apical Meristem Damage and Environmental Variables: Matching or Complementing Axillary Meristems?

    Czech Academy of Sciences Publication Activity Database

    Klimešová, Jitka; Malíková, Lenka; Rosenthal, J.; Šmilauer, P.

    2014-01-01

    Roč. 9, č. 2 (2014), e88093 E-ISSN 1932-6203 R&D Projects: GA ČR GPP504/12/P540; GA ČR GA526/09/0963 Institutional support: RVO:67985939 Keywords : bud bank * axillary meristem * disturbance Subject RIV: EH - Ecology, Behaviour Impact factor: 3.234, year: 2014

  1. Case Report: Variant Origin of an Arterial Trunk from Axillary Artery ...

    African Journals Online (AJOL)

    Background: Axillary artery is known to show different variations mostly in its branching pattern. Similarly, the origin of profunda brachii is often encountered with abnormality. Therefore, when the vascular variations in the upper limb persist, mostly it is confined to its branching pattern followed by its variant origin. But, among ...

  2. Secondary node analysis as an indicator for axillary lymphadenectomy in breast cancer patients.

    Science.gov (United States)

    Cremades, Manel; Torres, Mireia; Solà, Montse; Navinés, Jordi; Pascual, Icíar; Mariscal, Antonio; Caballero, Albert; Castellà, Eva; Luna, Miguel Ángel; Julián, Joan Francesc

    2017-11-01

    Currently, there is no agreement regarding if it would be necessary to perform an axillary lymph node dissection (ALND) in patients who have macrometastases in the sentinel lymph node (SLN). We studied the utility of the secondary node analysis (SN), defined as the following node after the SLN in an anatomical and lymphatic pathway, as a sign of malignant axillary involvement. An observational, retrospective and multicentre study was designed to assess the utility of the SN as a sign of axillary involvement. Among 2273 patients with breast cancer, a valid sample of 283 was obtained representing those who had the SN studied. Main endpoints of our study were: the SLN, the SN and the ALND histological pattern. Sensitivity, specificity and precision of the test were also calculated. SN test, in cases with positive SLN, has a sensitivity of 61.1%, a specificity of 78.7%, a positive predictive value of 45.8% and a negative predictive value of 87.3% with a precision of 74.7%. The study of the SN together with the technique of the SLN allows a more precise staging of the axillary involvement, in patients with breast cancer, than just the SLN technique. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Arteries and Veins of the Cerebellum.

    Science.gov (United States)

    Delion, Matthieu; Dinomais, Mickael; Mercier, Philippe

    2017-12-01

    Surgery of the posterior fossa represents a technical challenge because of the proximity of the vessels of the cerebellum. If the arterial vascularization of the cerebellum is well known, the main arterial variations and the whole venous vascularization are probably under recognized. We describe the vascular organization and the main variations through photographs of colored latex perfused brains, obtained with a surgical microscope. The arterial vascularization of the cerebellum is based on three arteries which all originate from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior and inferior cerebellar artery (AICA), and the posterior and inferior cerebellar artery (PICA). The main arterial variations involve essentially the origin of these vessels. Concerning the SCA, its origin depends on the embryology. The AICA can arise from a common trunk AICA-PICA. It can be sometimes doubled and rarely absent. The PICA also can arise from a common trunk AICA-PICA and sometimes from the extradural segment of the vertebral artery. Concerning the venous organization, we distinguish the superficial and deep veins. The superficial veins drain the cerebellar cortex and transit on the surface of the cerebellum. The deep veins refer to the veins transiting in the fissures between the cerebellum and the brainstem. All these veins terminate as bridging veins that we can divide in three groups: a superior group emptying into the great vein, a posterior group emptying into the transtentorial sinus, and a lateral group ending into the superior petrosal sinus. The surgical implications are discussed.

  4. Portal vein gas in emergency surgery

    Directory of Open Access Journals (Sweden)

    Mahmood Hind

    2008-07-01

    Full Text Available Abstract Background Portal vein gas is an ominous radiological sign, which indicates a serious gastrointestinal problem in the majority of patients. Many causes have been identified and the most important was bowel ischemia and mesenteric vascular accident. The presentation of patients is varied and the diagnosis of the underlying problem depends mainly on the radiological findings and clinical signs. The aim of this article is to show the clinical importance of portal vein gas and its management in emergency surgery. Methods A computerised search was made of the Medline for publications discussing portal vein gas through March 2008. Sixty articles were identified and selected for this review because of their relevance. These articles cover a period from 1975–2008. Results Two hundreds and seventy-five patients with gas in the portal venous system were reported. The commonest cause for portal vein gas was bowel ischemia and mesenteric vascular pathology (61.44%. This was followed by inflammation of the gastrointestinal tract (16.26%, obstruction and dilatation (9.03%, sepsis (6.6%, iatrogenic injury and trauma (3.01% and cancer (1.8%. Idiopathic portal vein gas was also reported (1.8%. Conclusion Portal vein gas is a diagnostic sign, which indicates a serious intra-abdominal pathology requiring emergency surgery in the majority of patients. Portal vein gas due to simple and benign cause can be treated conservatively. Correlation between clinical and diagnostic findings is important to set the management plan.

  5. On dynamics of uranium vein mineralization

    International Nuclear Information System (INIS)

    Petrosyan, R.V.

    1981-01-01

    The formation of urnaium vein deposits and the essence of consanguinity of the mineralization and wall metasomatites are considered. The formation of uranium mineralization is analysed from the positions of Korzhinsky D. S. : the formation of metasomatite aureole and associated vein ores take place as a result of the development of one solution flow while the formation of mineral vein associations occurs on the background of contineous filtration of the solution during metasomato is due to a repeated (pulse) half-opening of fractures and their filling with a part of filtrating solution. The analysis of the available information on the example of two different uranium manifestations permits to reveal certain relations both in the character of wall rock alterations and between the metasomatosis and the formation of ore minerals in veins. The conclusion is made that spatial-time correlations of vein formations with wall metasomatites attest that the pulse formation of ores in veinlets occurs on the background and in interrelation with a consecutive precipitation of components in the aureole volume. The analysis of element migration dynamics in wall aureole carried out from the positions of the Korzhinsky hypothesis of the advance wave of acid components that takes into account the interaction of continuous and pulse mechanisms of solution movement permits to avoid contradictions when interpreting the processes of wall rock alterations and vein ore-forming, and permits to make a common scheme of vein ore-genesis [ru

  6. Superficial vein thrombosis in non-varicose veins of the lower limbs and thrombophilia.

    Science.gov (United States)

    Lucchi, Gabriella; Bilancini, Salvino; Tucci, Sandro; Lucchi, Massimo

    2017-01-01

    Objectives Superficial vein thrombosis in non-varicose veins of the lower limbs is rather frequent and may be underestimated. This study aims to evaluate the prevalence of inherited or acquired thrombophilia in a sample of outpatients with the disease. Method An observational study was conducted on 73 consecutive superficial vein thrombosis patients tested for inherited or acquired thrombophilia. Results Sixty of 73 patients with superficial vein thrombosis completed the testing protocol, while 13 dropped out; 46 of 60 patients were found to have a thrombophilia (76.6%). The types detected were: factor V Leiden (31/60, i.e. 51.6%), prothrombin mutation (2/60, i.e. 3.3%), MTHFR mutation (23/60, i.e. 38.3%), antiphospholipid antibodies (5/60, i.e. 8.3%), protein C deficit (1/60, i.e. 1.6%), protein S deficit (1/60, i.e. 1.6%), and antithrombin deficit (0/60, i.e. 0%). Conclusions Among patients with superficial vein thrombosis in non-varicose veins, testing demonstrated a high prevalence of thrombophilia. The most common form proved to be factor V Leiden. As thrombophilia was found to be a major cause of superficial vein thrombosis in non-varicose veins, the authors recommend that patients with superficial vein thrombosis in non-varicose veins be investigated for thrombophilia.

  7. Losartan ameliorates "upstream" pulmonary vein vasculopathy in a piglet model of pulmonary vein stenosis.

    Science.gov (United States)

    Zhu, Jiaquan; Ide, Haruki; Fu, Yaqin Yana; Teichert, Anouk-Martine; Kato, Hideyuki; Weisel, Richard D; Maynes, Jason T; Coles, John G; Caldarone, Christopher A

    2014-12-01

    Pulmonary vein stenosis (PVS) is a relentless disease with a poor prognosis. Although surgical repair can effectively treat "downstream" (near left atrial junction) PVS, residual "upstream" (deep in lung parenchyma) PVS commonly dictates long-term survival. Our initial studies revealed an association between PVS and transforming growth factor-β signaling, which led us to investigate the effect of losartan on upstream pulmonary vein vasculopathy in a piglet model of PVS. Neonatal Yorkshire piglets underwent sham surgical banding (sham, n = 6), staged bilateral pulmonary vein banding of all pulmonary veins except the right middle pulmonary vein (banded, n = 6), and staged pulmonary vein banding with losartan treatment (losartan, 1 mg/kg/d, n = 7). After 7 weeks, the hemodynamic data were obtained and the piglets killed. Pulmonary vein banding (compared with sham) was associated with continuous turbulent flow in banded pulmonary veins, pulmonary hypertension (pulmonary artery/systemic blood pressure ratio 0.51 ± 0.06 vs 0.23 ± 0.02, P < .001), and diffuse pulmonary vein intimal hyperplasia in the upstream pulmonary veins (P < .001). Losartan administration decreased the pulmonary artery/systemic blood pressure ratios compared with those in the banded piglets (0.36 ± 0.08 vs 0.51 ± 0.06, P = .007) but it remained greater than those in the sham group (P = .001). Losartan was also associated with diminished pulmonary vein intimal hyperplasia compared with that in the banded piglets (P < .001) but still remained more than that in the sham group (P = .035). Pulmonary vein banding reduced vascular endothelial-cadherin expression, indicative of diminished endothelial integrity, which was restored with losartan. Losartan treatment improved PVS-associated pulmonary hypertension and intimal hyperplasia and might be a beneficial prophylactic therapy for patients at high risk of developing PVS after pulmonary vein surgery. Copyright © 2014 The American Association for

  8. Nomogram for prediction of level 2 axillary lymph node metastasis in proven level 1 node-positive breast cancer patients.

    Science.gov (United States)

    Jiang, Yanlin; Xu, Hong; Zhang, Hao; Ou, Xunyan; Xu, Zhen; Ai, Liping; Sun, Lisha; Liu, Caigang

    2017-09-22

    The current management of the axilla in level 1 node-positive breast cancer patients is axillary lymph node dissection regardless of the status of the level 2 axillary lymph nodes. The goal of this study was to develop a nomogram predicting the probability of level 2 axillary lymph node metastasis (L-2-ALNM) in patients with level 1 axillary node-positive breast cancer. We reviewed the records of 974 patients with pathology-confirmed level 1 node-positive breast cancer between 2010 and 2014 at the Liaoning Cancer Hospital and Institute. The patients were randomized 1:1 and divided into a modeling group and a validation group. Clinical and pathological features of the patients were assessed with uni- and multivariate logistic regression. A nomogram based on independent predictors for the L-2-ALNM identified by multivariate logistic regression was constructed. Independent predictors of L-2-ALNM by the multivariate logistic regression analysis included tumor size, Ki-67 status, histological grade, and number of positive level 1 axillary lymph nodes. The areas under the receiver operating characteristic curve of the modeling set and the validation set were 0.828 and 0.816, respectively. The false-negative rates of the L-2-ALNM nomogram were 1.82% and 7.41% for the predicted probability cut-off points of level 1 axillary lymph node metastasis. Patients with a low probability of L-2-ALNM could be spared level 2 axillary lymph node dissection, thereby reducing postoperative morbidity.

  9. Temporal artery and axillary thermometry comparison with rectal thermometry in children presenting to the ED.

    Science.gov (United States)

    Forrest, Adam J; Juliano, Michael L; Conley, Sean P; Cronyn, Patrick D; McGlynn, Andrea; Auten, Jonathan D

    2017-12-01

    Accurate temperature readings, often obtained rectally, are an important part of the initial evaluation of pediatric patients in the Emergency Department. Temporal artery thermometry (TAT) is one way to noninvasively measure temperature. We sought to compare the accuracy of axillary and temporal artery temperatures compared to rectal. This prospective study included children age 0-36months presenting to the Emergency Department of a large military treatment facility. Rectal, axillary, and temporal artery temperatures were obtained. Test characteristics (sensitivity, specificity, NPV, PPV) were reported. The effect of cutoff values 99.9°F, 100.4°F, and 102.2°F on test characteristics were also evaluated. The sensitivities of axillary and temporal artery thermometry to detect rectal fever is 11.5% and 61.5% respectively. Cutoff values did not significantly alter test characteristics. In this study, temporal artery thermometry was 0.2°C lower than rectal temperature, axillary measurement was 0.9°C below the reference standard. Mean temperature difference in the febrile group between TAT and rectal thermometry was >0.5°C compared with a mean temperature difference 0.05°C in afebrile patients. The findings of our study do not support using axillary thermometry to screen pediatric patients for fever in the emergency department. TAT cannot be recommended as a rectal thermometry replacement where height and duration of fever are used in pediatric disease prediction models. TAT may have a role in screening for fever in the appropriate pediatric patient population like primary orthopedic or trauma presentations where the balance between device precision, data capture and patient comfort may favor use of TAT. Published by Elsevier Inc.

  10. Nerve transfer from triceps medial head and anconeus to deltoid for axillary nerve palsy.

    Science.gov (United States)

    Bertelli, Jayme Augusto; Ghizoni, Marcos Flávio

    2014-05-01

    To report our results with reconstruction of the axillary nerve by transferring the branch to the triceps lower medial head and anconeus to the anterior division of the axillary nerve. This study included 9 patients with isolated injury of the axillary nerve. Their average age ± SD was 35 ± 9 years, and the mean interval ± SD between injury and surgery was 6.6 ± 2.6 months. Through a posterior arm approach, the radial nerve branch to the lower triceps medial head and anconeus was transferred to the anterior division of the axillary nerve. We observed patients for a mean of 34 ± 7 months. At final evaluation, we measured range of shoulder motion, shoulder abduction and elbow extension strength, and abduction endurance. Patients were assessed via the deltoid extension lag test and abduction-in-internal-rotation test. All patients recovered deltoid function and maintained full active elbow extension. Seven of 9 patients recovered from lagging abduction in internal rotation. Abduction strength improved from approximately 40% that of the normal side at 90° of abduction preoperatively to 60% of normal strength postoperatively. There was improved endurance in abduction from approximately 25% to 65% that of the normal side, which was sufficient to eliminate all reports of shoulder pain or fatigability. Transfer of the radial nerve branch for the lower triceps medial head and anconeus to the anterior division of the axillary nerve proved to be an effective method of deltoid reinnervation. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  11. Abduction in internal rotation: a test for the diagnosis of axillary nerve palsy.

    Science.gov (United States)

    Bertelli, Jayme Augusto; Ghizoni, Marcos Flávio

    2011-12-01

    To describe and validate the use of a test of abduction in internal rotation for the assessment of axillary nerve injury. A total of 14 male patients with a mean age of 29 years (SD ± 6 y), with axillary nerve lesions lasting an average of 6 months, participated. We measured their shoulder range of motion. In the upright position, with the trunk bending forward, we asked our patients to actively extend the shoulder (swallowtail test), and then we extended the shoulders and asked each patient to hold them in that position (deltoid extension lag test). For the abduction in internal rotation test, we asked patients to abduct the shoulder in internal rotation. If full abduction compared with the normal contralateral side was not possible, the examiner passively held the affected limb in maximal abduction and internal rotation. The patient was instructed to maintain the position when the examiner released the limb. In each test, any lag compared with the normal side accounted for deltoid palsy. All patients exhibited abduction beyond horizontal and full external rotation. The swallowtail test and the deltoid extension lag test identified the axillary nerve lesion in 10 of 14 patients. The abduction in internal rotation test recognized the axillary nerve injury in all 14. The average difference in the range of abduction in internal rotation between the normal and affected side was 37° (abduction lag). Compensatory abduction in axillary nerve palsy has been attributed to the action of the supraspinatus, biceps, coracobrachialis, and pectoralis major. During abduction in internal rotation, compensatory abduction is impaired, clearly indicating deltoid muscle dysfunction. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  12. Axon Counts Yield Multiple Options for Triceps Fascicular Nerve to Axillary Nerve Transfer.

    Science.gov (United States)

    Khair, M Michael; Schreiber, Joseph J; Rosenblatt, Lauren; Byun, David J; Lee, Steve K; Wolfe, Scott W

    2016-11-01

    To evaluate the relative axonal match between potential donor and recipient nerves, so that maximal reinnervation potential may be reached with the least chance of donor site morbidity. In 10 fresh-frozen cadaveric specimens, the main trunk and anterior, posterior, sensory and teres minor branches of the axillary nerve were identified, as were the radial nerve branches to the long, medial, and lateral heads of the triceps. The swing distances of the triceps fascicular nerve branches and the axillary nerve branches relative to the inferior border of the teres major muscle were recorded. Histomorphological analysis and axon counts were performed on sections of each branch. The median number of axons in the main axillary trunk was 7,887, with 4,052, 1,242, and 1,161 axons in the anterior, posterior, and teres minor branches, respectively. All specimens had a single long head triceps branch (median, 2,302 axons), a range of 1 to 3 branches to the medial head of the triceps (composite axon count, 2,198 axons), and 1 to 3 branches to the lateral head of the triceps (composite average, 1,462 axons). The medial and lateral head branches had sufficient swing distance to reach the anterior branch of the axillary nerve in all 10 specimens, with only 4 specimens having adequate long head branch swing distances. It is anatomically feasible to transfer multiple branches of the radial nerve supplying the medial, lateral, and sometimes, long head of the triceps to all branches of the axillary nerve in an attempt to reinnervate the deltoid and teres minor muscles. Understanding the axon counts of the different possible transfer combinations will improve operative flexibility and enable peripheral nerve surgeons to reinnervate for both abduction and external rotation with the highest donor/recipient axon count ratios. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. 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.

  14. Axillary lymph nodes siliconoma in a woman with intracapsular implant rupture

    International Nuclear Information System (INIS)

    Plachkov, I.; Cvetankov, K.; Hadjidekov, G.

    2013-01-01

    Full text: Introduction: Siliconoma, or silicone granuloma is the migration of silicon particles in the axillary lymph nodes, muscle and other non- ruptured or intact silicone implant. The latter is a relatively rare finding, and usually occurs in patients with extracapsular rupture of silicone prosthesis and has a typical ultrasound image. We present a case of a young woman with bilateral silicone prostheses placed 5 years ago, where in the right axilla are enlarged, structurally altered lymph nodes in the clinical and ultrasonography studies. Subsequent magnetic resonance examination shows intracapsular rupture ipsilateral silicone prosthesis and migration of silicon particles in the axillary lymph nodes. What you will learn: In this case we present twenty-three year old woman who reported pain and ‘swelling’ in the right axilla. The patient is with bilateral silicone prosthesis, she is not febrile and not reported other illness. After physical examination enlarged and tender lymph nodes in the right axilla was found. Several structurally altered and enlarged lymph nodes were visualized by ultrasound. These lymph nodes are hypoechogenic with obliterated fatty hilus. Due to the suspicion of silicone ‘extravasation’ in axillary lymph nodes, a magnetic resonance study of both mammary glands was performed. The images show intracapsular rupture of the right prosthesis without reliable data on silicone gel outside the fibrous capsule. Discussion: Siliconoma is a complication after plastic surgery of the breast and can affect both the axillary lymph nodes, and other lymphatic chains and also muscle and lung. Most frequently it occurs at damage of the extracapsular silicone prostheses. More rarely siliconoma occurs in siliconoma intracapsular damage, as in the presented case or in a silicone gel microbleed. Conclusion: The presence of siliconoma in axillary lymph nodes is relatively rare complication in plastic surgery of the breast. Methods of imaging diagnostic

  15. Effectiveness of OK-432 (Sapylin) to reduce seroma formation after axillary lymphadenectomy for breast cancer.

    Science.gov (United States)

    Yang, Yinlong; Gao, Erli; Liu, Xinying; Ye, Zhiqiang; Chen, Yizuo; Li, Quan; Qu, Jinmiao; Dai, Xuanxuan; Wang, Ouchen; Pan, Yifei; Zhang, Xiaohua

    2013-05-01

    The occurrence of seroma formation after axillary lymphadenectomy for breast cancer cannot be ignored. Various approaches have been used in an effort to reduce it, but these results are still controversial. We aimed to describe a new method of application of OK-432 (Sapylin, heat-treated Su strain of Streptococcus) to reduce seroma formation after axillary lymphadenectomy for breast cancer and to verify the safety and efficacy of it as a beneficial supplement for conventional surgery. A prospective, randomized analysis of consecutive quadrantectomy or mastectomy plus axillary lymphadenectomy using or not using OK-432 was designed. From July 2010 to November 2011, a total of 111 patients were enrolled in this prospective, randomized study and completed the follow-up. OK-432 applied to the axillary fossa plus placement of closed suction drainage was used in 54 patients (the experimental group); placement of closed suction drainage was used in 57 patients (the control group). There were no statistical significance between the two groups in terms of age, body mass index, treatment received, tumor size, number of removed lymph nodes, and lymph node status. Postoperative drainage magnitude and duration were significantly reduced in the experimental group (P = 0.008 and 0.003, respectively). One week after hospital discharge, fewer patients developed a palpable seroma in the experimental group: 10 in the experimental group versus 28 in the control group (P = 0.001). Fewer seromas needed aspiration (mean 1 [range 0-3] in the experimental group vs. mean 4 [range 1-5] in the control group; P OK-432 is a feasible and safe option for axillary lymphadenectomy for breast cancer. The use of it does not always prevent seroma formation, but it can reduce drainage magnitude and duration, as well as decrease the incidence of seroma after the removal of drainage. It may be increasingly conducted in day surgery clinics.

  16. Predicting axillary lymph node metastasis from kinetic statistics of DCE-MRI breast images

    Science.gov (United States)

    Ashraf, Ahmed B.; Lin, Lilie; Gavenonis, Sara C.; Mies, Carolyn; Xanthopoulos, Eric; Kontos, Despina

    2012-03-01

    The presence of axillary lymph node metastases is the most important prognostic factor in breast cancer and can influence the selection of adjuvant therapy, both chemotherapy and radiotherapy. In this work we present a set of kinetic statistics derived from DCE-MRI for predicting axillary node status. Breast DCE-MRI images from 69 women with known nodal status were analyzed retrospectively under HIPAA and IRB approval. Axillary lymph nodes were positive in 12 patients while 57 patients had no axillary lymph node involvement. Kinetic curves for each pixel were computed and a pixel-wise map of time-to-peak (TTP) was obtained. Pixels were first partitioned according to the similarity of their kinetic behavior, based on TTP values. For every kinetic curve, the following pixel-wise features were computed: peak enhancement (PE), wash-in-slope (WIS), wash-out-slope (WOS). Partition-wise statistics for every feature map were calculated, resulting in a total of 21 kinetic statistic features. ANOVA analysis was done to select features that differ significantly between node positive and node negative women. Using the computed kinetic statistic features a leave-one-out SVM classifier was learned that performs with AUC=0.77 under the ROC curve, outperforming the conventional kinetic measures, including maximum peak enhancement (MPE) and signal enhancement ratio (SER), (AUCs of 0.61 and 0.57 respectively). These findings suggest that our DCE-MRI kinetic statistic features can be used to improve the prediction of axillary node status in breast cancer patients. Such features could ultimately be used as imaging biomarkers to guide personalized treatment choices for women diagnosed with breast cancer.

  17. 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.

  18. Mesenteric vein thrombosis following laparoscopic appendectomy

    Directory of Open Access Journals (Sweden)

    Jamie Harris

    2014-11-01

    Full Text Available Mesenteric vein thrombosis is an uncommon complication following laparoscopic surgery. A review of the literature has shown that there is a higher incidence of thrombosis following laparoscopic bariatric procedures, including the gastric sleeve procedure and roux-en-y gastric bypass surgery. Additionally, pylephlebitis, thrombosis of portal or mesenteric veins, has been described following perforated appendicitis. However no report has described mesenteric vein thrombosis following laparoscopy for nonperforated appendicitis in the pediatric population. The cause of this thrombosis is hypothesized to be secondary to venous stasis secondary to insufflation during laparoscopy.

  19. Alterações venosas e linfáticas em mulheres com linfedema após linfadenectomia axilar no tratamento do câncer de mama Venous and lymphatic alterations in women with lymphedema after axillary lymphadenectomy in breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Sarah Patrizia Araújo Valinote

    2013-04-01

    Full Text Available OBJETIVO: Avaliar as alterações do sistema venoso axilo-subclávio e do sistema linfático em mulheres com linfedema após linfadenectomia axilar para o tratamento do câncer de mama. MÉTODOS: Trata-se de um estudo de série de casos, envolvendo 11 mulheres com linfedema unilateral de membro superior após linfadenectomia axilar para o tratamento do câncer de mama. O estudo foi realizado em hospital universitário do Brasil Central no período compreendido entre os meses de março de 2010 e março de 2011. Avaliou-se a presença de alterações venosas nas veias subclávia e axilar, por meio do exame de ultrassonografia com dopplervelocimetria, e de alterações linfáticas, pela linfocintilografia, em ambos os membros superiores. O teste Exato de Fisher foi utilizado na comparação entre os membros. RESULTADOS: No membro superior com linfedema, detectou-se diferença significativa na veia subclávia, em relação ao membro contralateral, quanto ao volume do fluxo (pPURPOSE: To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment. METHODS: This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fisher's exact test was used for the comparison between limbs. RESULTS: Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001, 54.6% of the women had increased flow. In the axillary vein, 45.4% had

  20. 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

  1. Progression of Thrombus in Portal Vein, Superior Mesenteric Vein, and Splenic Vein Even on Anticoagulation in a Patient with Ascending Colonic Malignancy with Liver Metastasis: Portal Vein Thrombosis versus Portal Vein Tumor Thrombosis.

    Science.gov (United States)

    Sule, Ashish; Borja, Annamarie; Chin, Tay Jam

    2016-12-01

    Portal vein thrombosis (PVT) in a setting of liver metastasis is not easy to treat as it may be portal vein tumor thrombus (PVTT). A 77-year-old male patient was diagnosed as ascending colon carcinoma, underwent right hemicolectomy in 1991 with a recurrence in July 2009. In August 2009, he underwent computed tomography (CT) scan of the abdomen which showed evidence of superior mesenteric vein thrombosis with no liver metastasis. He was started with anticoagulation and decision was to treat long term. He was admitted with mesenteric artery ischemic symptoms in February 2012 on anticoagulation. CT scan abdomen and pelvis in February 2012 showed tumor thrombus involving the superior mesenteric vein, portal vein, and splenic vein with hepatic metastasis. His tumor marker chorioembryonic antigen was 34 µg/L. He was continued on anticoagulation. A repeat CT scan abdomen after 2 years (in January 2014) showed, increase in size of hepatic metastasis, extensive thrombus involving the superior mesenteric vein, portal vein, and splenic vein with collaterals. Mesentery was congested due to extensive superior mesenteric vein thrombus. He finally succumbed in June 2014. It is very important to differentiate PVT from PVTT as the prognosis is different. PVTT progresses despite of long-term anticoagulation with poor prognosis.

  2. Aneurysm of the vein of Galen

    International Nuclear Information System (INIS)

    Leff, S.L.; Kronfeld, G.; Leonidas, J.C.

    1989-01-01

    We report a case of a vein of Galen aneurysm in a neonate in which MR imaging provided essentially all pertinent diagnostic information prior to surgery. MR findings correlated well with selective cerebral angiography. (orig./MG)

  3. [Retinal vein occlusion in a young patient].

    Science.gov (United States)

    Zemba, Mihail; Ochinciuc, Uliana; Sarbu, Laura; Avram, Corina; Camburu, Raluca; Stamate, Alina

    2013-01-01

    We present a case report of a 27 years old pacient with central retinal vein occlussion and macular edema. The pacient has a significant reduction of the macular aedema with complete recovery of vision after the treatment.

  4. Hepatic vein obstruction (Budd-Chiari)

    Science.gov (United States)

    ... of cells in the bone marrow (myeloproliferative disorders) Cancers Chronic inflammatory or autoimmune diseases Infections Inherited (hereditary) or acquired problems with blood clotting Oral contraceptives Pregnancy Hepatic vein blockage is the most common ...

  5. A current approach to superficial vein thrombosis.

    Science.gov (United States)

    Ellis, Martin H; Fajer, Simone

    2013-02-01

    Superficial vein thrombosis (SVT) is an entity commonly encountered in practice. While the clinical diagnosis is reasonably straightforward, care must be taken to exclude concurrent thrombosis of the deep veins, and the possibility of the presence of occult systemic illness such as malignancy should be considered. Recent studies of the epidemiology of SVT demonstrate a high incidence of concurrent deep vein thrombosis emphasizing the need for surveying the deep veins using compression ultrasonography. Treatment decisions are may now be based upon the results of randomized clinical trials and should include a period of anticoagulation using fondaparinux or a low molecular weight heparin. The appropriate doses and duration of therapy are not fully established, and the cost-effectiveness of these drugs for the treatment of SVT needs further evaluation. © 2012 John Wiley & Sons A/S.

  6. CT in thrombosed dilated posterior epidural vein

    Energy Technology Data Exchange (ETDEWEB)

    Bammatter, S.; Schnyder, P.; Preux, J. de

    1987-05-01

    The authors report a case of thrombosis of the distal end of an enlarged right posterior epidural vein. The patient had a markedly narrow lumbar canal due to L5 spondylolisthesis. The dilated vein and the thrombosis were displayed by computed tomography but remained unrecognized until surgery. Pathogenesis of this condition is discussed. A review of the English, French and German literature revealed no prior radiological reports of a similar condition.

  7. Varicose Vein And Ecchymosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Ertan Yetkin

    2017-08-01

    Full Text Available Assessment of varicose vein and chronic venous insufficiency and making a differential diagnosis in patients suffering from a variety of sign and symptoms is sometimes a big challenge in daily clinical practice. Here, we present a female patient with varicose vein symptoms and ecchymosis on her lower extremities. Several irregular shaped ecchymotic lesions on both extremities in different stage of healing with deep purple have been treated by using micronized purified flavonoid fraction.

  8. Varicose Vein And Ecchymosis: A Case Report

    OpenAIRE

    Ertan Yetkin; Selçuk Öztürk; Mehmet ILeri

    2017-01-01

    Assessment of varicose vein and chronic venous insufficiency and making a differential diagnosis in patients suffering from a variety of sign and symptoms is sometimes a big challenge in daily clinical practice. Here, we present a female patient with varicose vein symptoms and ecchymosis on her lower extremities. Several irregular shaped ecchymotic lesions on both extremities in different stage of healing with deep purple have been treated by using micronized purified flavonoid fraction.

  9. Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

    Directory of Open Access Journals (Sweden)

    G Raghavendra Prasad

    2013-01-01

    Full Text Available Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric - inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up.

  10. Efficacy of varicose vein surgery with preservation of the great safenous vein

    Directory of Open Access Journals (Sweden)

    Bernardo Cunha Senra Barros

    Full Text Available OBJECTIVE: To evaluate the efficacy of surgical treatment of varicose veins with preservation of the great saphenous vein. METHODS: We conducted a prospective study of 15 female patients between 25 and 55 years of age with clinical, etiologic, anatomic and pathophysiologic (CEAP classification 2, 3 and 4. The patients underwent surgical treatment of primary varicose veins with great saphenous vein (GSV preservation. Doppler ultrasonography exams were carried out in the first and third months postoperatively. The form of clinical severity of venous disease, Venous Clinical Severity Score (VCSS was completed before and after surgery. We excluded patients with history of deep vein thrombosis, smoking or postoperatively use of elastic stockings or phlebotonics. RESULTS: All patients had improved VCSS (p <0.001 and reduction in the diameter of the great saphenous vein (p <0.001. There was a relationship between VCSS and the GSV caliber, as well as with preoperative CEAP. There was improvement in CEAP class in nine patients when compared with the preoperative period (p <0.001. CONCLUSION: The varicose vein surgery with preservation of the great saphenous vein had beneficial effects to the GSV itself, with decreasing caliber, and to the symptoms when the vein had maximum caliber of 7.5 mm, correlating directly with the CEAP. The decrease in GSV caliber, even without complete abolition of reflux, leads to clinical improvement by decreasing the reflux volume.

  11. Individual Pulmonary Vein Atresia in Adults: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyoung Nam; Kim, Young Tong; Cho, Sung Sik [Cheonan Hospital, SoonchunhyangUniversity College of Medicine, Cheonan (Korea, Republic of)

    2011-06-15

    We present two cases of individual pulmonary vein atresia without vestige of an involved pulmonary vein. On CT, we noted the absence or interruption of normal pulmonary venous structures, and the presence of abnormal vascular structures that represented collaterals for the involved lung parenchyma. On angiography, the artertic pulmonary vein was found to drain into the other ipsilateral pulmonary veins through the collaterals.

  12. Transvenous liver biopsy via the femoral vein

    International Nuclear Information System (INIS)

    Khosa, F.; McNulty, J.G.; Hickey, N.; O'Brien, P.; Tobin, A.; Noonan, N.; Ryan, B.; Keeling, P.W.N.; Kelleher, D.P.; McDonald, G.S.A.

    2003-01-01

    AIM: To study the safety, effectiveness and diagnostic value of transvenous forceps biopsy of the liver in 54 patients with coagulopathy, gross ascites or morbid obesity and suspected liver disease in whom percutaneous liver biopsy was contraindicated. MATERIAL AND METHODS: Forceps biopsy of the liver via the femoral vein was attempted in 54 adult patients with advanced liver disease of unknown aetiology who had coagulation disorders (41 cases), gross ascites (11 cases) or morbid obesity (two cases). In each patient two to six biopsies (average four) were taken using a radial jaw forceps inserted via the right or left femoral vein. RESULTS: The procedure was successful in 53 cases. Hepatic vein catheterization failed in one patient. Adequate liver tissue for diagnosis was obtained in 84% of cases. One patient developed delayed haemorrhage at 12 h from a capsular leak that was undetected during the biopsy procedure. This patient required blood transfusions and laparotomy to control bleeding. There were no deaths in the 53 patients studied. Transient minor chest and shoulder pain was encountered during sheath insertion into a hepatic vein in 23 patients. Three patients developed a femoral vein haematoma, which resolved with conservative treatment. CONCLUSION: Transvenous liver biopsy via the femoral vein is another safe, effective, simple alternative technique of biopsy when the percutaneous route is contraindicated

  13. Veins improve fracture toughness of insect wings.

    Directory of Open Access Journals (Sweden)

    Jan-Henning Dirks

    Full Text Available During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect's flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material's resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m. However, the cross veins increase the wing's toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm. This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically 'optimal' solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial 'venous' wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species.

  14. Veins Improve Fracture Toughness of Insect Wings

    Science.gov (United States)

    Dirks, Jan-Henning; Taylor, David

    2012-01-01

    During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect’s flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material’s resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m). However, the cross veins increase the wing’s toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm). This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically ‘optimal’ solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial ‘venous’ wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species. PMID:22927966

  15. 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

  16. Hypermetabolic axillary mass on 18F FDG PET/CT: breast cancer arising from accessory breast tissue

    International Nuclear Information System (INIS)

    Park, Ji Sun; Lee, Ah Young; Bae, Sang Gyun; Lee, Seok Mo

    2010-01-01

    Differential diagnosis among several causes of axillary malignant mass is important. The most common cause of palpable malignant axillary mass is metastatic lymphadenopathy. Although carcinoma arising from ectopic breast tissue is rare, the diagnosis should be kept in mind when evaluation malignant axillary mass. In this report we present a case with carcinoma arising from ectopic breast tissue. 18 F FDG PET/CT was performed for the purpose of localizing primary breast cancer lesion and systemic evaluation. PET/CT showed hypermetabolic lesions only in the right axilla. There is no evidence of malignancy in both breasts. When nuclear physicians encounter a hypermetabolic axillary mass indicating malignant lesion without evidence of primary breast malignant lesion, carcinoma arising from ectopic breast tissue should be included in the differential diagnosis

  17. Review of the surgical anatomy of the axillary nerve and the anatomic basis of its iatrogenic and traumatic injury.

    Science.gov (United States)

    Apaydin, Nihal; Tubbs, R Shane; Loukas, Marios; Duparc, Fabrice

    2010-03-01

    The axillary nerve is invariably reported to be one of the most commonly injured nerves during surgical procedures of the shoulder, and the importance of protecting it cannot be overemphasized. Many researchers have tried to identify safe regions, but the results vary among published studies. The axillary nerve may also be injured during acute trauma to the shoulder or by chronic repeated trauma as has been described in the quadrilateral space syndrome. The nerve injury may occur together with shoulder dislocation and rotator cuff tear, thus comprising the so-called "unhappy triad" of the shoulder joint. Simple attention to potential variations in the origin and course of the axillary nerve and its relationship to the shoulder capsule and having a precise knowledge of "safe zones" during operations can enhance clinical outcomes. The objective of this review, therefore, is to discuss the surgical anatomy of the axillary nerve and further emphasize the clinical importance of the its injury following shoulder trauma.

  18. The CT appearance of the superior intercostal veins

    International Nuclear Information System (INIS)

    Lund, G.

    1982-01-01

    The CT appearance of the superior intercostal veins is described. The veins are more frequently seen on the right side. The right superior intercostal vein should not be misinterpreted as a paraspinal mass when it is large or bulges into the contour of the right lung. A case of stenosis of the left brachiocephalic vein is shown, where the left superior intercostal vein serves as a collateral. (orig.)

  19. Induced chorioretinal venous anastomosis in experimental retinal branch vein occlusion.

    OpenAIRE

    McAllister, I L; Yu, D Y; Vijayasekaran, S; Barry, C; Constable, I

    1992-01-01

    Iatrogenic retinal vein to choroidal vein anastomoses were created using laser photocoagulation in six of seven dog eyes in which a partial branch retinal vein occlusion had previously been created photochemically. A similar attempt to create an anastomosis was made in six control eyes in which no branch vein occlusion was present. In the eyes in which a branch retinal vein had been created, a venous chorioretinal anastomosis appeared to be present by 3 to 6 weeks. In three control eyes simil...

  20. Gonadal vein tumor thrombosis due to renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Hamidreza Haghighatkhah

    2015-01-01

    Full Text Available Renal cell carcinoma (RCC had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC

  1. Repair of Multiple Subclavian and Axillary Artery Aneurysms in a 58-Year-Old Man with Marfan Syndrome

    OpenAIRE

    Dolapoglu, Ahmet; de la Cruz, Kim I.; Preventza, Ourania; Coselli, Joseph S.

    2016-01-01

    Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were succe...

  2. 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.

  3. Axillary nerve injury in young adults-An overlooked diagnosis? Early results of nerve reconstruction and nerve transfers.

    OpenAIRE

    Dahlin, Lars; Cöster, Marcus; Björkman, Anders; Backman, Clas

    2012-01-01

    An injury to the axillary nerve from a shoulder trauma can easily be overlooked. Spontaneous functional recovery may occur, but occasionally reconstructive surgery is required. The time frame for nerve reconstruction procedures is from a neurobiological view crucial for a good functional outcome. This study presents a group of operatively and non-operatively treated young adults with axillary nerve injuries caused by motorcycle accidents, where the diagnosis was set late. Ten young men (media...

  4. Corrosion cast study of the canine hepatic veins.

    Science.gov (United States)

    Uršič, M; Vrecl, M; Fazarinc, G

    2014-11-01

    This study presents a detailed description of the distribution, diameters and drainage patterns of hepatic veins on the basis of the corrosion cast analysis in 18 dogs. We classified the hepatic veins in three main groups: the right hepatic veins of the caudate process and right lateral liver lobe, the middle hepatic veins of the right medial and quadrate lobes and the left hepatic veins of both left liver lobes and the papillary process. The corrosion cast study showed that the number of the veins in the Nomina Anatomica Veterinaria and most anatomical textbooks is underestimated. The number of various-sized hepatic veins of the right liver division ranged from 3 to 5 and included 1 to 4 veins from the caudate process and 2 to 4 veins from the right lateral liver lobe. Generally, in all corrosion casts, one middle-sized vein from the right part of the right medial lobe, which emptied separately in the caudal vena cava, was established. The other vein was a large-sized vein from the remainder of the central division, which frequently joined the common left hepatic vein from the left liver lobes. The common left hepatic vein was the largest of all the aforementioned hepatic veins.

  5. Diagnosis and treatment of superficial vein thrombosis.

    Science.gov (United States)

    Bauersachs, R M

    2013-08-01

    Superficial vein thrombosis (SVT) is a common disease, characterized by an inflammatory-thrombotic process in a superficial vein. Typical clinical findings are pain and a warm, tender, reddish cord along the vein. Until recently, no reliable epidemiological data were available. The incidence is estimated to be higher than that of deep-vein thrombosis (DVT) (1/1000). SVT shares many risk factors with DVT, but affects twice as many women than men and frequently occurs in varicose veins. Clinically, SVT extension is commonly underestimated, and patients may have asymptomatic DVT. Therefore, ultrasound assessment and exclusion of DVT is essential. Risk factors for concomitant DVT are recent hospitalization, immobilization, autoimmune disorders, age > 75 years, prior VTE, cancer and SVT in non-varicose veins. Even though most patients with isolated SVT (without concomitant DVT or PE) are commonly treated with anticoagulation for a median of 15 days, about 8% experience symptomatic thromboembolic complications within three months. Risk factors for occurrence of complications are male gender, history of VTE, cancer, SVT in a non-varicose vein or SVT involving the sapheno-femoral junction (SFJ). As evidence supporting treatment of isolated SVT was sparse and of poor quality, the large, randomized, double-blind, placebo-controlled CALISTO trial was initiated assessing the effect of fondaparinux on symptomatic outcomes in isolated SVT. This study showed that, compared with placebo, 2.5 mg fondaparinux given for 45 days reduced the risk of symptomatic thromboembolic complications by 85% without increasing bleeding. Based on CALISTO and other observational studies, evidence-based recommendations can be made for the majority of SVT patients. Further studies can now be performed in higher risk patients to address unresolved issues.

  6. 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.

  7. Portal vein embolization induces more liver regeneration than portal vein ligation in a standardized rabbit model

    NARCIS (Netherlands)

    van den Esschert, Jacomina W.; van Lienden, Krijn P.; de Graaf, Wilmar; Maas, Martinus A. W.; Roelofs, Joris J. T. H.; Heger, Michal; van Gulik, Thomas M.

    2011-01-01

    Background. Portal vein ligation (PVL) and portal vein embolization (PVE) are used to induce hypertrophy of the future remnant liver before major liver resection. The aim of our study was to compare the hypertrophy response of the liver after PVL versus PVE in a rabbit model. Methods. Twenty rabbits

  8. 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. Copyright © 2012 John Wiley & Sons A/S.

  9. Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Selami Ilgaz Kayılıoğlu

    2014-01-01

    Full Text Available Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

  10. Comparison of Temporal Artery Thermometry with Axillary and Rectal Thermometry in Full Term Neonates.

    Science.gov (United States)

    Goswami, Ekta; Batra, Prerna; Khurana, Ritika; Dewan, Pooja

    2017-03-01

    To assess the efficacy of temporal artery thermometer in febrile and hypothermic neonates in comparison to axillary thermometer. It was a cross sectional observational study. Study participants included 210 neonates admitted in neonatal intensive care unit of a tertiary care teaching hospital, divided into three groups of 70 each, namely normothermic, febrile and hypothermic. Temperatures were measured using temporal artery, axillary and rectal thermometers in each patient. Mean rectal temperature was found to be comparable to mean temporal artery temperature in normothermic babies. Temporal artery thermometer had a better sensitivity to diagnose fever, than hypothermia. Also, temporal artery temperature showed a good correlation with rectal temperature in normothermic and febrile group and not in hypothermic neonates. Temporal artery thermometer can accurately detect temperature in febrile and normothermic fullterm neonates but not in hypothermic neonates. Further studies are required before advocating temporal artery thermometry as a replacement of rectal thermometry among this group of population.

  11. Comparison of rectal, axillary, tympanic, and temporal artery thermometry in the pediatric emergency room.

    Science.gov (United States)

    Batra, Prerna; Goyal, Sudhanshu

    2013-01-01

    Accurate measurement of temperature in the emergency room is important for diagnosis as well as investigating a patient. Various noninvasive methods thermometry are available today, but there is no consensus on the most accurate method of thermometry. The present study was conducted to compare different methods of temperature measurement available in the emergency room, that is, rectal, axillary, and temporal artery and tympanic membrane. This was a cross-sectional observational study Fifty febrile and 50 afebrile children aged 2 to 12 years attending the pediatric emergency room of a tertiary care hospital were included. Temperatures were measured using rectal, axillary, tympanic (right and left), and temporal artery thermometers and were compared. All the temperatures correlated well with rectal temperature, with temporal artery temperature showing the best correlation (correlation coefficients, 0.99 in the febrile and 0.91 in the afebrile group). Temporal artery thermometry has the potential to replace rectal thermometry in a busy emergency room setting.

  12. [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.

  13. 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.

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

    OpenAIRE

    T. Raghavendra; P. Sudhakar

    2014-01-01

    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 acclimati...

  15. 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.

  16. Laparoscopic Cholecystectomy: Incidental Carcinoma of the Gallbladder with Abdominal Wall and Axillary Node Metastasis

    Directory of Open Access Journals (Sweden)

    Richard C. Johnson

    1997-01-01

    Full Text Available A case report is presented of intra-mural gallbladder carcinoma discovered incidentally after laparoscopic cholecystectomy who subsequently developed abdominal wall recurrence at the epigastric exit port, and axillary lymph node metastases. Possible preventative steps for tumour dissemination and a management plan if incidental carcinoma is diagnosed is discussed. The use of a non-porous retrieval bag, early recognition of the carcinoma and excision of the exit wound are advocated.

  17. Primary mucinous eccrine carcinoma of axillary skin: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Rajashree Pradhan

    2017-01-01

    Full Text Available Primary mucinous eccrine carcinoma is a rare low-grade malignancy of sweat gland. Axilla is an uncommon site of this tumor. Primary mucinous carcinoma mimics metastatic mucinous carcinoma from breast, gastrointestinal tract, lung, and ovary. Histopathology with immunohistochemistry and other ancillary investigations are necessary to confirm the diagnosis and to exclude metastatic mucinous carcinoma. We present a rare case of primary mucinous carcinoma of axillary skin in an elderly male patient, diagnosed by histopathology and immunohistochemistry.

  18. Tuberculosis axillary lymph node coexistent breast cancer in adjuvant treatment: case report

    OpenAIRE

    Bromberg, Silvio Eduardo; do Amaral, Paulo Gustavo Ten?rio

    2015-01-01

    Coexistence of breast cancer and tuberculosis is rare. In most cases, involvement by tuberculosis occurs in axillary lymph nodes. We report a case of a 43-years-old patient who had undergone adenomastectomy and left sentinel lymph node biopsy due to a triple negative ductal carcinoma. At the end of adjuvant treatment, the patient had an atypical lymph node in the left axilla. Lymph node was excised, and after laboratory analysis, the diagnosis was ganglion tuberculosis. The patient underwent ...

  19. The role of sonography in patients with breast cancer presenting as an axillary mass

    International Nuclear Information System (INIS)

    Park, Sun Young; Kim, Eun Kyung; Oh, Ki Keun; Lee, Kyong Sik; Park, Byeong Woo

    2002-01-01

    To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographically guided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography

  20. Anatomical Relationship of the Axillary Nerve to the Pectoralis Major Tendon Insertion.

    Science.gov (United States)

    Shiu, Brian; Jazini, Ehsan; Robertson, Astor; Henn, R Frank; Hasan, S Ashfaq

    2017-05-01

    Axillary nerve injury is a risk of the deltopectoral approach to the proximal humerus. The anterior motor branch is potentially vulnerable during subdeltoid dissection. Insertion of the pectoralis major tendon is an easily identifiable landmark on the humerus. This anatomical study explored whether the superior aspect of the pectoralis major tendon is a useful landmark for localizing the anterior motor branch of the axillary nerve as it travels under the lateral and anterior deltoid muscle. A total of 30 fresh-frozen human bilateral cadaveric upper extremities were examined. A deltopectoral approach was used to expose the pectoralis major tendon insertion and the anterior motor branch of the nerve under the deltoid muscle. The distance between the nerve as it crossed the posterolateral humerus and superior border of the pectoralis major tendon was measured. The axillary nerve was a mean 3.2 mm (range, 0-8 mm) distal to the superior border of the pectoralis major tendon insertion. No significant differences were observed in this anatomical relationship with the shoulder in abduction or external rotation. The nerve was not proximal to the superior border of the pectoralis major tendon in any specimen. The superior border of the pectoralis major tendon insertion represents a reliable landmark for the anterior motor branch of the axillary nerve as it travels under the deltoid muscle. The nerve is located at the level of the proximal centimeter of the pectoralis major tendon. Appreciation of this relationship may decrease risk of injury to the nerve when using a deltopectoral approach. [Orthopedics. 2017; 40(3):e460-e464.]. Copyright 2017, SLACK Incorporated.

  1. Radial to axillary nerve neurotization for brachial plexus injury in children: a combined case series.

    Science.gov (United States)

    Zuckerman, Scott L; Eli, Ilyas M; Shah, Manish N; Bradley, Nadine; Stutz, Christopher M; Park, Tae Sung; Wellons, John C

    2014-11-01

    Axillary nerve palsy, isolated or as part of a more complex brachial plexus injury, can have profound effects on upper-extremity function. Radial to axillary nerve neurotization is a useful technique for regaining shoulder abduction with little compromise of other neurological function. A combined experience of this procedure used in children is reviewed. A retrospective review of the authors' experience across 3 tertiary care centers with brachial plexus and peripheral nerve injury in children (younger than 18 years) revealed 7 cases involving patients with axillary nerve injury as part of an overall brachial plexus injury with persistent shoulder abduction deficits. Two surgical approaches to the region were used. Four infants (ages 0.6, 0.8, 0.8, and 0.6 years) and 3 older children (ages 8, 15, and 17 years) underwent surgical intervention. No patient had significant shoulder abduction past 15° preoperatively. In 3 cases, additional neurotization was performed in conjunction with the procedure of interest. Two surgical approaches were used: posterior and transaxillary. All patients displayed improvement in shoulder abduction. All were able to activate their deltoid muscle to raise their arm against gravity and 4 of 7 were able to abduct against resistance. The median duration of follow-up was 15 months (range 8 months to 5.9 years). Radial to axillary nerve neurotization improved shoulder abduction in this series of patients treated at 3 institutions. While rarely used in children, this neurotization procedure is an excellent option to restore deltoid function in children with brachial plexus injury due to birth or accidental trauma.

  2. [Proximal interlocking of humeral intramedullary nails and risk of axillary nerve injury].

    Science.gov (United States)

    Blum, J; Rommens, P M

    2002-01-01

    Possible injuries to the axillary nerve are criticised in antegrade and retrograde endomedullary nailing of the humeral shaft during proximal interlocking. Clinical experience seems not to support the theory of a high risk of nerve injury. The real risk although remains unknown under anatomical-morphological aspects. Eight complete human cadaveric shoulder-arm regions with original soft-tissue coverage had been used. Four times the unreamed humeral nail (UHN) had been inserted retrograde, and four times antegrade, distributed in each pair. Antegrade interlocking was performed after skin incision and spreading of soft tissues through the aiming devices. This involved one oblique bolt from lateral to medial. Retrograde proximal interlocking was performed under image intensifier. This involved triple interlocking, once dorso-ventrally and twice latero-medially. The incision paths have been marked. After preparation of the nerve stem in the lateral axillary portal the different branches have been searched and exposed. The spatial relations of bolts and nerve branches have been measured and the insertion path of the bolts has been revised, finally lesions of nerve structures have been documented. We found the latero-medially inserted bolt heads of the retrograde approach and the oblique bolt head of the antegrade approach being placed in a safe distance from the medio-dorsally positioned stem of the axillary nerve. On the other hand the dorsoventrally inserted bolt head (retrograde approach) showed in most cases a very tight relation to the nerve stem. Exploring the axillary nerve and its branches showed in no case a direct nerve lesion. We suggest to perform only a sharp cutaneous incision and then to prepare the muscle only by careful spreading until touching bone, with tissue retraction during drilling. In retrograde nailing the dorso-ventral bolt should only be used in extreme proximal fractures.

  3. Nerve Transfer versus Interpositional Nerve Graft Reconstruction for Posttraumatic, Isolated Axillary Nerve Injuries: A Systematic Review.

    Science.gov (United States)

    Koshy, John C; Agrawal, Nikhil A; Seruya, Mitchel

    2017-11-01

    The purpose of this study was to compare functional outcomes between nerve grafting and nerve transfer procedures in the setting of isolated, posttraumatic axillary nerve injuries. A systematic review was performed using the PubMed, Scopus, and Cochrane databases to identify all cases of isolated, posttraumatic axillary nerve injuries in patients aged 18 years or older. Patients who underwent axillary nerve reconstruction were included and categorized by technique: graft or transfer. Demographics were recorded, including age, time to operation, and presence of concomitant injuries. Functional outcomes were evaluated, including British Medical Research Council strength and range of motion for shoulder abduction. Ten retrospective studies met criteria, for a total of 66 patients (20 nerve grafts and 46 nerve transfers). Median time from injury to operation was equivalent across the nerve graft and nerve transfer groups (8.0 months versus 7.0 months; p = 0.41). Postoperative follow-up was 24.0 months for nerve grafting versus 18.5 months for nerve transfer (p = 0.13). Clinically useful shoulder abduction, defined as British Medical Research Council grade M3 or greater, was obtained in 100 percent of nerve graft patients versus 87 percent of nerve transfer patients (p = 0.09). Grade M4 or better strength was obtained in 85 percent of nerve graft patients and 73.9 percent of nerve transfer patients (p = 0.32). Significant differences in functional outcomes between nerve graft and transfer procedures for posttraumatic axillary nerve injuries are not apparent at this time. Prospective outcomes studies are needed to better elucidate whether functional differences do exist. Therapeutic, IV.

  4. The role of sonography in patients with breast cancer presenting as an axillary mass

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sun Young; Kim, Eun Kyung; Oh, Ki Keun; Lee, Kyong Sik; Park, Byeong Woo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2002-09-01

    To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographically guided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography.

  5. Is daily shaving of axillary and pubic hair a feature of suicide in the Muslim community?

    Science.gov (United States)

    Demirci, Serafettin; Dogan, Kamil Hakan; Erkol, Zerrin; Deniz, Idris

    2008-12-01

    In the Islamic context, "fitrah" refers to humanity's innate disposition toward virtue and the ability to differentiate between right and wrong. A common quote regarding fitrah, from the Prophet is "The fitrah consists of 5 things: circumcision, trimming the moustache, cutting the nails, plucking the armpit hairs, and shaving the pubic hairs."In this study, our aim was to determine the status of axillary and pubic shaving in medicolegal death cases that took place in the Konya Province of Turkey and to evaluate the relationship with the origin of suicide. Of 2850 medicolegal death cases, 206 (7.2%) were of suicidal origin. It was observed that the average age in the cases of suicidal origin was 36.76 +/- 17.72 years, and 146 of 206 cases (70.9%) were men. As a method of suicide, hanging was the chosen method in 100 cases (48.5%), whereas firearm injuries occurred in 54 cases (26.2%), and intoxication was involved in 37 cases (18.0%). Daily axillary and pubic shaving was observed in 26 of 2644 (1.0%) death cases that occurred with nonsuicidal reasons, but in 65 of 206 were (31.6%) suicidal cases. Because suicidal notes were present in 25 (12.1%) of all of the suicidal cases, the ratio of daily axillary and pubic shaving was significantly higher than that of the suicidal notes.In investigating the cases of suicidal origin for medicolegal purposes, evidence showing that this action was committed by the victim, the presence of a suicide note at the death scene and, a history of a previous suicidal attempt, it was thought that the presence of daily axillary and pubic shaving on external examination of the victim's body, when of Muslim faith, could also be considered a feature of suicide.

  6. Estudo anatômico da veia braquial comum como via de drenagem colateral do membro superior Anatomic study of the common brachial vein as a collateral drainage channel of the upper limb

    Directory of Open Access Journals (Sweden)

    Carlos Adriano Silva dos Santos

    2011-03-01

    % (22/30 of the cadavers dissected. The common brachial vein drained into the axillary vein in 82% (18/22 and into the basilic vein in the proximal segment of the upper limb in 18% of the cadavers (04/22. CONCLUSION: The common brachial vein is frequently present, and, in most cases, it drains into the axillary vein.

  7. Animal Model of Acute Deep Vein Thrombosis

    International Nuclear Information System (INIS)

    Roy, Sumit; Laerum, Frode; Brosstad, Frank; Kvernebo, Knut; Sakariassen, Kjell S.

    1998-01-01

    Purpose: To develop an animal model of acute deep vein thrombosis (DVT). Methods: In part I of the study nine juvenile domestic pigs were used. Each external iliac vein was transluminally occluded with a balloon catheter. Thrombin was infused through a microcatheter in one leg according to one of the following protocols: (1) intraarterial (IA): 1250 U at 25 U/min in the common femoral artery (n= 3); (2) intravenous (IV): 5000 U in the popliteal vein at 500 U/min (n= 3), or at 100 U/min (n= 3). Saline was administered in the opposite leg. After the animals were killed, the mass of thrombus in the iliofemoral veins was measured. The pudendoepiploic (PEV), profunda femoris (PF), and popliteal veins (PV) were examined. Thrombosis in the tributaries of the superficial femoral vein (SFVt) was graded according to a three-point scale (0, +, ++). In part II of the study IV administration was further investigated in nine pigs using the following three regimens with 1000 U at 25 U/min serving as the control: (1) 1000 U at 100 U/min, (2) 250 U at 25 U/min, (3) 250 U at 6.25 U/min. Results: All animals survived. In part I median thrombus mass in the test limbs was 1.40 g as compared with 0.25 g in the controls (p= 0.01). PEV, PFV and PV were thrombosed in all limbs infused with thrombin. IV infusion was more effective in inducing thrombosis in both the parent veins (mass 1.32-1.78 g) and SVFt (++ in 4 of 6 legs), as compared with IA infusion (mass 0.0-1.16 g; SFVt ++ in 1 of 3 legs). In part II thrombus mass in axial veins ranged from 1.23 to 2.86 g, and showed no relationship with the dose of thrombin or the rate of infusion. Tributary thrombosis was less extensive with 250 U at 25 U/min than with the other regimens. Conclusion: Slow distal intravenous thrombin infusion in the hind legs of pigs combined with proximal venous occlusion induces thrombosis in the leg veins that closely resembles clinical DVT in distribution

  8. Comparison of the effect of diode laser versus intense pulsed light in axillary hair removal.

    Science.gov (United States)

    Ormiga, Patricia; Ishida, Cleide Eiko; Boechat, Alvaro; Ramos-E-Silva, Marcia

    2014-10-01

    Devices such as diode laser and intense pulsed light (IPL) are in constant development aiming at permanent hair removal, but there are few comparative studies between these technologies. The objective was to comparatively assess axillary hair removal performed by diode laser and IPL and to obtain parameters of referred pain and evolution response for each method. A comparative prospective, double-blind, and randomized study of axillary hair removal performed by the diode laser and IPL was conducted in 21 females. Six sessions were held with application of the diode laser in one axilla and the IPL in the other, with intervals of 30 days and follow-up of 6 months after the last session. Clinical photographs and digital dermoscopy for hair counts in predefined and fixed fields of the treated areas were performed before, 2 weeks after the sixth session, and 6 months after the end of treatment. A questionnaire to assess the pain was applied. The number of hair shafts was significantly reduced with the diode laser and IPL. The diode laser was more effective, although more painful than the IPL. No serious, adverse, or permanent effects were observed with both technologies. Both diode laser and the IPL are effective, safe, and able to produce lasting results in axillary hair removal.

  9. CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS

    Directory of Open Access Journals (Sweden)

    Lona Jalini

    2016-01-01

    Full Text Available Background: Axillary lymph node status is the most important breast cancer prognostic factor. Preoperative axillary ultrasound examination (PAUS is used to triage patients for sentinel lymph node biopsy (SLNB or axillary lymph node dissection (ALND. We assessed the detection rate of lymph node metastases by PAUS in a screening unit and evaluated associations between clinicopathological factors and PAUS positivity. Patients and Methods: This was a single-centre retrospective analysis of data extracted from a hospital breast cancer database and clinical records. Clinical, radiological, and pathological and prognostic indices were compared between PAUS-positive and PAUS-negative patients subsequently found to have lymph node metastases on histopathological analysis. Results: Two hundred and two patients were eligible for analysis. 50.5% of lymph node-positive patients were correctly identified as PAUS positive. Patients with PAUS-positive lymph nodes had less favorable disease characteristics, namely clinically palpable lymph nodes, higher Nottingham prognostic (NPI index, high lymph node burden according to the European Society of Medical Oncology (ESMO group classification, and larger, grade 3 tumors with lymphovascular invasion and extranodal spread. Moreover, PAUS-positive patients had more macrometastases and lymph node involvement than PAUS-negative patients. Conclusion: PAUS-positive patients and PAUS-negative (SLNB-positive patients have different clinicopathological characteristics. The presence of LVI, extranodal spread, grade 3 histology, or large tumors with poor prognostic indices in PAUS-negative patients should be regarded with caution and perhaps prompt second-look ultrasound examination.

  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. 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). Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. In vitro establishment of axillary buds of Colocasia esculenta Schott clone `INIVIT MC-2001'

    Directory of Open Access Journals (Sweden)

    Diosdada Gálvez Guerra

    2013-04-01

    Full Text Available The new Colocacia esculenta Schott clone `INIVIT MC-2001', obtained by the INIVIT breeding program, presented high percentages of losses in the in vitro establishment phase, mainly by microbial contamination. The aim of this study was to establish axillary buds of taro clone `INIVIT MC-2001' with low percentages of microbial contamination and explants mortality. For disinfection, six treatments were studied using different concentrations and times of immersion in sodium hypochlorite (NaClO and ozonized water. Furthermore, the influence of the concentration of 6-BAP (0.1, 0.3, 0.5 and 1.0 mg l-1 of 6-BAP in the culture medium was determined. With the use of 3.0% sodium hypochlorite for the disinfection of taro corms for 25 minutes we were able to reduce the percentage of microbial contamination and gain efficiency in the establishment of the apices of axillary buds of 85.38%. By employing the culture medium consisting of MS salts and vitamins, with 0.5 mg l-1 6-BAP at 29 days of culture, the explants were achieved the morphology characteristics for transferring to the multiplication phase. Keywords: axillary buds, Colocasia, ozone.

  13. 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.

  14. Axillary hyperhidrosis: A review of the extent of the problem and treatment modalities.

    Science.gov (United States)

    Singh, Sanjay; Davis, Harriet; Wilson, Paul

    2015-10-01

    The purpose of this review is to summarize the extent of the problem of axillary hyperhidrosis and treatment modalities available. The benefits and disadvantages of various treatments are reflected on with the hope of providing a starting point to investigate new ways of treating hyperhidrosis. A literature search was conducted using various databases and search criteria. Current treatments include aluminium chloride antiperspirants, iontophoresis, botox injections and endoscopic thoracic sympathectomy. Botox therapy is usually the most effective treatment, without surgery or unpleasant side effects. However it has to be administered by a skilled clinician and involves around 20 injections to treat axillary hyperhidrosis. Other ways of giving Botox are being developed, the most promising one being the use of microneedles which are able to penetrate the skin and deliver drugs to the target area of the dermis without causing pain. In comparison to the temporary effects of microneedles, laser and microwave therapies are also assessed as they offer the hope of permanent relief from hyperhidrosis. There is a considerable dearth in the literature on the management of axillary hyperhidrosis. Further study in larger populations with longer follow up times is critical to access the long term effects of treatment. Microneedles could be the future treatment of choice with the potential to deliver drugs in a safe and pain free way. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  15. Triceps motor branch transfer for isolated traumatic pediatric axillary nerve injuries.

    Science.gov (United States)

    Chim, Harvey; Kircher, Michelle F; Spinner, Robert J; Bishop, Allen T; Shin, Alexander Y

    2015-01-01

    Transfer of the triceps motor branch has been used for treatment of isolated axillary nerve palsy in the adult population. However, there are no published data on the effectiveness of this procedure in the pediatric population with traumatic injuries. The authors reviewed demographics and outcomes in their series of pediatric patients who underwent this procedure. Six patients ranging in age from 10 to 17 years underwent triceps motor branch transfer for the treatment of isolated axillary nerve injuries between 4 and 8 months after the inciting injury. Deltoid muscle strength was evaluated using the modified British Medical Research Council (MRC) grading system. Shoulder abduction at last follow-up was measured. The mean duration of follow-up was 38 months. The average postoperative MRC grading of deltoid muscle strength was 3.6 ± 1.3. The median MRC grade was 4. One patient who did not achieve an MRC grade of 3 suffered multiple injuries from high-velocity trauma. Unlike in the adult population, age, body mass index of the patient, and delay from injury to surgery were not significant factors affecting the outcome of the procedure. In the pediatric population with traumatic injuries, isolated axillary nerve injury treated with triceps motor branch transfer can result in good outcomes.

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

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    Eva Ruvalcaba-Limón

    2016-01-01

    Full Text Available 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.

  17. A new approach for sclera vein recognition

    Science.gov (United States)

    Thomas, N. L.; Du, Yingzi; Zhou, Zhi

    2010-04-01

    The vein structure in the sclera is stable over time, unique to each person, and well suited for human identification. A few researchers have performed sclera vein pattern recognition and reported promising initial results. Sclera recognition poses several challenges: the vein structure moves and deforms with the movement of the eye; images of sclera patterns are often defocused and/or saturated; and, most importantly, the vein structure in the sclera is multi-layered and has complex non-linear deformation. In this paper, we proposed a new method for sclera recognition: First, we developed a color-based sclera region estimation scheme for sclera segmentation. Second, we designed a Gabor wavelet-based sclera pattern enhancement method, and an adaptive thresholding method to emphasize and binarize the sclera vein patterns. Third, we proposed a line descriptor-based feature extraction, registration, and matching method that is illumination-, scale-, orientation-, and deformation-invariant, and can mitigate the multi-layered deformation effects exhibited in the sclera and tolerate segmentation error. It is empirically verified using the UBIRIS database that the proposed method can perform accurate sclera recognition.

  18. Management of reticular veins and telangiectases.

    Science.gov (United States)

    Smith, Philip Coleridge

    2015-11-01

    To review the literature related to the management of reticular varices and telangiectases of the lower limbs to provide guidance on the treatment of these veins. Very few randomised clinical trials are available in this field. A European Guideline has been published on the treatment of reticular varices and telangiectases, which is largely based on the opinion of experts. Older accounts written by individual phlebologists contain extensive advice from their own practice, which is valuable in identifying effective methods of sclerotherapy. All accounts indicate that a history should be taken combined with a clinical and ultrasound examination to establish the full extent of the venous disease. Sclerotherapy is commenced by injecting the larger veins first of all, usually the reticular varices. Later in the same session or in subsequent sessions, telangiectases can be treated by direct injection. Following treatment, the application of class 2 compression stockings for a period of up to three weeks is beneficial but not used universally by all phlebologists. Further sessions can follow at intervals of 2-8 weeks in which small residual veins are treated. Resistant veins can be managed by ultrasound-guided injection of underlying perforating veins and varices. Other treatments including RF diathermy and laser ablation of telangiectases have very limited efficacy in this condition. Sclerotherapy, when used with the correct technique, is the most effective method for the management of reticular varices and telangiectases. © The Author(s) 2015.

  19. Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux.

    Science.gov (United States)

    Holdstock, J M; Dos Santos, S J; Harrison, C C; Price, B A; Whiteley, M S

    2015-03-01

    To determine the prevalence of haemorrhoids in women with pelvic vein reflux, identify which pelvic veins are associated with haemorrhoids and assess if extent of pelvic vein reflux influences the prevalence of haemorrhoids. Females presenting with leg varicose veins undergo duplex ultrasonography to assess all sources of venous reflux. Those with significant reflux arising from the pelvis are offered transvaginal duplex ultrasound (TVS) to evaluate reflux in the ovarian veins and internal Iliac veins and associated pelvic varices in the adnexa, vulvar/labial veins and haemorrhoids. Patterns and severity of reflux were evaluated. Between January 2010 and December 2012, 419 female patients with leg or vulvar varicose vein patterns arising from the pelvis underwent TVS. Haemorrhoids were identified on TVS via direct tributaries from the internal Iliac veins in 152/419 patients (36.3%) and absent in 267/419 (63.7%). The prevalence of the condition increased with the number of pelvic trunks involved. There is a strong association between haemorrhoids and internal Iliac vein reflux. Untreated reflux may be a cause of subsequent symptomatic haemorrhoids. Treatment with methods proven to work in conditions caused by pelvic vein incompetence, such as pelvic vein embolisation and foam sclerotherapy, could be considered. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Arm lymphoscintigraphy after axillary lymph node dissection or sentinel lymph node biopsy in breast cancer

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    Sarri AJ

    2017-03-01

    Full Text Available Almir José Sarri,1 Rogério Dias,2 Carla Elaine Laurienzo,1 Mônica Carboni Pereira Gonçalves,3 Daniel Spadoto Dias,2 Sonia Marta Moriguchi4 1Department of Physical Therapy, Barretos Cancer Hospital, Barretos, 2Department of Obstetrics, Gynaecology and Mastology, Botucatu Medical School, São Paulo State University – UNESP, Botucatu, 3Department of Nuclear Medicine, Barretos Cancer Hospital, Barretos, 4Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, São Paulo State University – UNESP, Botucatu, São Paulo, Brazil Purpose: Compare the lymphatic flow in the arm after breast cancer surgery and axillary lymph node dissection (ALND versus sentinel lymph node biopsy (SLNB using lymphoscintigraphy (LS.Patients and methods: A cross-sectional study with 39 women >18 years who underwent surgical treatment for unilateral breast cancer and manipulation of the axillary lymph node chain through either ALND or SLNB, with subsequent comparison of the lymphatic flow of the arm by LS. The variables analyzed were the area reached by the lymphatic flow in the upper limb and the sites and number of lymph nodes identified in the ALND or SLNB groups visualized in the three phases of LS acquisition (immediate dynamic and static images, delayed scan images. For all analyses, the level of significance was set at 5%.Results: There was a significant difference between the ALND and SLNB groups, with predominant visualization of lymphatic flow and/or lymph nodes in the arm and axilla (P=0.01 and extra-axillary lymph nodes (P<0.01 in the ALND group. There was no significant difference in the total number of lymph nodes identified between the two groups. However, there was a significant difference in the distribution of lymph nodes in these groups. The cubital lymph node was more often visualized in the immediate dynamic images in the ALND group (P=0.004, while the axillary lymph nodes were more often identified in the delayed scan

  1. A comparison of axillary and tympanic membrane to rectal temperatures in children

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    Tania Paramita

    2017-02-01

    Full Text Available Background Core body temperature measurement is not commonly done in pediatric populations because it is invasive and difficult to perform. Therefore, axillary and tympanic membrane temperature measurements are preferable, but their accuracy is still debatable. Objective To compare the accuracy of axillary and tympanic temperatures to rectal temperature in children with fever, and to measure the cut-off point for fever based on each temperature measurement method. Methods A diagnostic study was conducted among feverish children aged 6 months to 5 years who were consecutively selected from the Pediatric Outpatient Clinic, Pediatric Emergency Unit, and the inpatient ward in the Department of Child Health, Cipto Mangunkusumo Hospital (CMH, from December 2014 to January 2015. Subjects underwent three measurements within a two minute span, namely, the axillary, tympanic membrane, and rectal temperature measurements. The values obtained from the examination were analyzed with appropriate statistical tests. Results The cut-off for fever on axilla was 37.4oC and on tympanic membrane was  37.4oC, with sensitivity 96% (95%CI 0.88 to 0.98 and 93% (95%CI 0.84 to 0.97, respectively; specificity 50% (95%CI 0.47 to 0.84 and 50% (95%CI 0.31 to 0.69, respectively; positive predictive value/PPV 90% (95%CI 0.81 to 0.95 and 85% (95%CI 0.75 to 0.91, respectively; and negative predictive value/NPV 83% (95%CI 0.61 to 0.94 and 69% (95%CI 0.44 to 0.86, respectively. The optimal cut-off of tympanic membrane and axilla temperature was 37.8oC (AUC 0.903 and 0.903, respectively. Conclusion Axillary temperature measurement is as good as tympanic membrane temperature measurement and can be used in daily clinical practice or at home. By increasing the optimum fever cut-off point for axillary and tympanic membrane temperature to 37.8oC, we find sensitivity 81% and 88%, specificity 86% and 73%, PPV 95% and 91%, and NPV 95% and 91%, respectively.

  2. The risk of suprascapular and axillary nerve injury in reverse total shoulder arthroplasty: An anatomic study.

    Science.gov (United States)

    Leschinger, Tim; Hackl, Michael; Buess, Eduard; Lappen, Sebastian; Scaal, Martin; Müller, Lars Peter; Wegmann, Kilian

    2017-10-01

    Implantation of a reverse total shoulder arthroplasty (rTSA) places the axillary and suprascapular nerves at risk. The aim of this anatomic study was to digitally analyse the location of these nerves in relation to bony landmarks in order to predict their path and thereby help to reduce the risk of neurological complications during the procedure. A total of 22 human cadaveric shoulder specimens were used in this study. The axillary and suprascapular nerves were dissected, and radiopaque threads were sutured onto the nerves without mobilizing the nerves from their native paths. Then, 3D X-ray scans of the specimens were performed, and the distance of the nerves to bony landmarks at the humerus and the glenoid were measured. The distance of the inferior glenoid rim to the axillary nerve averaged 13.6mm (5.8-27.0mm, ±5.1mm). In the anteroposterior direction, the distance between the axillary nerve and the humeral metaphysis averaged 8.1mm (0.6-21.3mm, ±6.5mm). The distance of the glenoid centre to the suprascapular nerve passing point under the transverse scapular ligament measured 28.4mm (18.9-35.1mm, ±3.8mm) in the mediolateral direction and 10.8mm (-4.8 to 25.3mm, ±6.1mm) in the anteroposterior direction. The distance to the spinoglenoid notch was 16.6mm (11.1-24.9mm, ±3.4mm) in the mediolateral direction and -11.8mm posterior (-19.3 to -4.7mm, ±4.7mm) in the anteroposterior direction. Implantation of rTSA components endangers the axillary nerve because of its proximity to the humeral metaphysis and the inferior glenoid rim. Posterior and superior drilling and extraosseous screw placement during glenoid baseplate implantation in rTSA place the suprascapular nerve at risk, with safe zones to the nerve passing the spinoglenoid notch of 11mm and to the suprascapular notch of 19mm. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. A modified deltoid splitting approach with axillary nerve bundle mobilization for proximal humeral fracture fixation.

    Science.gov (United States)

    Shin, Young Ho; Lee, Young Ho; Choi, Ho Sung; Kim, Min Bom; Pyo, Sung Hee; Baek, Goo Hyun

    2017-11-01

    The deltopectoral and the deltoid splitting approach are commonly used for the treatment of proximal humeral fractures. While the deltopectoral approach requires massive soft tissue devascularization, the deltoid splitting approach needs an additional skipped incision to avoid axillary nerve injury. The purpose of this study was to describe a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization in the treatment of proximal humeral fractures and to assess its radiologic and clinical outcomes. Twenty-two consecutive patients with proximal humeral fractures were treated with minimally invasive plate osteosynthesis by using a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization. The patients were divided into two groups: 10 patients of Neer type 2 or 3 fractures vs. 12 patients of Neer type 4 fractures. The mean age of the study population was 63.5 years (range: 30-80 years). Six patients had valgus impacted fractures, and nine had fractures with medial comminution. Fracture union was achieved in all cases. The mean time to union was 8.6 weeks (range: 6-12 weeks). Major complications, such as avascular necrosis of the humeral head and varus collapse at the fracture site, were not observed. No patients had clinically detectable sensory deficits in the axillary nerve distribution or paralysis of the anterior deltoid muscle. The mean neck-shaft angle at the final follow-up was 136.9° (range, 115°-159°). The mean visual analog score for patient satisfaction was 9.1 (range, 6-10), and the mean Neer scores were 93.5 (range, 84-100). There were no significant differences between the two groups with respect to radiologic and clinical outcomes except Neer scores: 95.8 (range: 86-100) in Neer type 2 or 3 fractures and 91.7 (range: 84-99) in Neer type 4 fractures. The use of a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization in the treatment of proximal humeral

  4. Contemporary management of subclavian and axillary artery injuries-A Western Trauma Association multicenter review.

    Science.gov (United States)

    Waller, Christine J; Cogbill, Thomas H; Kallies, Kara J; Ramirez, Luis D; Cardenas, Justin M; Todd, S Rob; Chapman, Kayla J; Beckman, Marshall A; Sperry, Jason L; Anto, Vincent P; Eriksson, Evert A; Leon, Stuart M; Anand, Rahul J; Pearlstein, Maura; Capano-Wehrle, Lisa; Cothren Burlew, Clay; Fox, Charles J; Cullinane, Daniel C; Roberts, Jennifer C; Harrison, Paul B; Berg, Gina M; Haan, James M; Lightwine, Kelly

    2017-12-01

    Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. A multicenter, retrospective review of patients with subclavian or axillary artery injuries from January 1, 2004, to December 31, 2014, was completed at 11 participating Western Trauma Association institutions. Statistical analysis included χ, t-tests, and Cochran-Armitage trend tests. A p value less than 0.05 was significant. Two hundred twenty-three patients were included; mean age was 36 years, 84% were men. An increase in computed tomography angiography and decrease in conventional angiography was observed over time (p = 0.018). There were 120 subclavian and 119 axillary artery injuries. Procedure type was associated with injury grade (p < 0.001). Open operations were performed in 135 (61%) patients, including 93% of greater than 50% circumference lacerations and 83% of vessel transections. Endovascular repairs were performed in 38 (17%) patients; most frequently for pseudoaneurysms. Fourteen (6%) patients underwent a hybrid procedure. Use of endovascular versus open procedures did not increase over the duration of the study (p = 0.248). In-hospital mortality rate was 10%. Graft or stent thrombosis occurred in 7% and graft or stent infection occurred in 3% of patients. Mean follow-up was 1.6 ± 2.4 years (n = 150). Limb salvage was achieved in 216 (97%) patients. The management of subclavian and axillary artery injuries still requires a wide variety of open exposures and procedures, especially for the control of active hemorrhage from more than 50% vessel lacerations and transections. Endovascular repairs were used most often for

  5. Superficial vein thrombosis with hemorrhagic cerebral infarction

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    Yu-wei CONG

    2016-01-01

    Full Text Available Background Cerebral superficial vein thrombosis was rare and often misdiagnosed or missed for its various etiological factors, and complicated and nonspecific clinical manifestations. This paper reported one case of superficial vein thrombosis in right fronto-parietal lobe with hemorrhagic infarction. The anatomy of superficial vein, pathophysiological points, diagnosis and treatment of superficial vein thrombosis were reviewed to help to reduce missed diagnosis or misdiagnosis. Methods and Results A 18-year-old male patient had suffered from progressive headache for 4 years and weakness of left limbs for 2 d. Head MRI showed circular space-occupying lesion in right fronto-parietal lobe. Magnetic resonance venography (MRV examination showed the front two-thirds of the superior sagittal sinus was not clear. The lesions were removed and decompressive craniectomy was conducted, showing the brain tissue was pale, partly yellow or dark red, and superficial venous engorgement. Histological observation showed pial superficial vein thrombosis and subpial encephalomalacia, and multifocal hemorrhage of cerebral cortex and local parenchymal hemorrhage. A large number of "grid cells" and vascular "cuff" phenomenan were visible in surrounding tissue, and the parenchymal blood vessel proliferation was obvious. Left hand activity of the patient was obviously limited after the operation. Conclusions Clinical diagnosis of superficial vein thrombosis with hemorrhagic infarction is difficult, and brain imaging and serological examination can provide certain help. Much attention should be paid to the multidisciplinary diagnosis and treatment to reduce misdiagnosis or missed diagnosis, and gather clinical experience. DOI: 10.3969/j.issn.1672-6731.2016.01.007

  6. Postpartum Ovarian Vein Thrombophlebitis with Staphylococcal Bacteremia

    Science.gov (United States)

    Parino, Eduardo; Mulinaris, Eric; Saccomano, Edgardo; Gallo, Juan Cruz; Kohan, Gabriel

    2015-01-01

    A 34-year-old female patient presented with fever and right flank pain ten days after uncomplicated vaginal delivery. CT examination revealed right ovarian vein thrombosis and methicillin-resistant Staphylococcus aureus (MRSA) was isolated from blood cultures. No other source of bacteremia was found. Antibiotic therapy and anticoagulation with enoxaparin were instituted. Fourteen days after admission, she was discharged in good condition. Although a very uncommon complication after spontaneous vaginal delivery, septic ovarian vein thrombophlebitis should be suspected in cases of persistent puerperal fever when other diagnostic possibilities have been excluded. PMID:26221549

  7. Deep vein thrombosis: a clinical review

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    Kesieme EB

    2011-04-01

    Full Text Available Emeka Kesieme1, Chinenye Kesieme2, Nze Jebbin3, Eshiobo Irekpita1, Andrew Dongo11Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 2Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 3Department of Surgery, University of Port Harcourt Teaching Hospital, Port-Harcourt, NigeriaBackground: Deep vein thrombosis (DVT is the formation of blood clots (thrombi in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.Aim: To present an update on the causes and management of DVT.Methods: A review of publications obtained from Medline search, medical libraries, and Google.Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome.Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran and selective

  8. Surgical treatment of central retinal vein occlusion.

    Science.gov (United States)

    Berker, Nilufer; Batman, Cosar

    2008-05-01

    The treatment of central retinal vein occlusion (CRVO) is still a subject of debate. Medical therapy efforts, as well as retinal laser photocoagulation, have mostly dealt with management of the sequelae of CRVO, and have shown limited success in improving visual acuity. The unsatisfactory results of such therapeutic efforts led to the development of new treatment strategies focused on the surgical treatment of the occluded retinal vein. The purpose of this review is to summarize the outcomes of commonly reported surgical treatment strategies and to review different opinions on the various surgical approaches to the treatment of CRVO.

  9. Superior mesenteric vein thrombosis complicating appendicular masses

    International Nuclear Information System (INIS)

    Echitibi, Salma S.; Bashir, Masoud O.; Ahmad, Misba U.

    2003-01-01

    Mesenteric vein thrombosis (MVT) is rare. Its diagnosis is usually difficult and delayed. We report two patients who developed MVT as a complication of an appendicular mass. One of them had appendectomy and developed fever 10 days postoperatively. The other was treated conservatively. An abdominal computerized tomography(CT) scan with intravenous contrast was helpful in diagnosing superior MVT in both patients, which were not suspected. Intravenous contrast should be used when performing CT of an appendicular mass. Special interest should be directed at studying the superior mesenteric vein. Early diagnosis of our patients helped to start early medical treatment with anticoagulation. (author)

  10. [Idiopathic thrombosis of the renal vein].

    Science.gov (United States)

    Ignjatović, I; Ilić, M; Marković, N; Stamenić, T

    1995-01-01

    Renal vein thrombosis (TVR) is not a common disease especially when is not associated with renal parenchymal nephropathy. TVR has no characteristic symptoms, so it is often late recognised. The main procedures for diagnosis of TVR are: echotomography, CT and phlebography. All these procedures, although very informative, have certain limits in the clinical use. Therapy of TVR trombolytic, anticoagulant or surgical: thrombectomy or nephrectomy. In cases where the underlying parenchymal disease exists, aggresive therapeutic approach is not recommended, but in acute idiopathic TVR immediate recanalisation of the renal vein is the most effective.

  11. Image Quality Enhancement Using the Direction and Thickness of Vein Lines for Finger-Vein Recognition

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    Young Ho Park

    2012-10-01

    Full Text Available On the basis of the increased emphasis placed on the protection of privacy, biometric recognition systems using physical or behavioural characteristics such as fingerprints, facial characteristics, iris and finger-vein patterns or the voice have been introduced in applications including door access control, personal certification, Internet banking and ATM machines. Among these, finger-vein recognition is advantageous in that it involves the use of inexpensive and small devices that are difficult to counterfeit. In general, finger-vein recognition systems capture images by using near infrared (NIR illumination in conjunction with a camera. However, such systems can face operational difficulties, since the scattering of light from the skin can make capturing a clear image difficult. To solve this problem, we proposed new image quality enhancement method that measures the direction and thickness of vein lines. This effort represents novel research in four respects. First, since vein lines are detected in input images based on eight directional profiles of a grey image instead of binarized images, the detection error owing to the non-uniform illumination of the finger area can be reduced. Second, our method adaptively determines a Gabor filter for the optimal direction and width on the basis of the estimated direction and thickness of a detected vein line. Third, by applying this optimized Gabor filter, a clear vein image can be obtained. Finally, the further processing of the morphological operation is applied in the Gabor filtered image and the resulting image is combined with the original one, through which finger-vein image of a higher quality is obtained. Experimental results from application of our proposed image enhancement method show that the equal error rate (EER of finger-vein recognition decreases to approximately 0.4% in the case of a local binary pattern-based recognition and to approximately 0.3% in the case of a wavelet transform

  12. Comparison of only T3 and T3-T4 sympathectomy for axillary hyperhidrosis regarding treatment effect and compensatory sweating.

    Science.gov (United States)

    Yuncu, Gökhan; Turk, Figen; Ozturk, Gökhan; Atinkaya, Cansel

    2013-08-01

    Patients diagnosed with axillary hyperhidrosis can face psychosocial issues that can ultimately hinder their quality of life both privately and socially. The routine treatment for axillary hyperhidrosis is T3-T4 sympathectomy, but compensatory sweating is a serious side effect that is commonly seen with this approach. This study was designed to evaluate whether a T3 sympathectomy was effective for the treatment of axillary hyperhidrosis and whether this treatment led to less compensatory sweating than T3-T4 sympathectomies among our 60-patient population. One hundred and twenty endoscopic thoracic sympathectomies were performed on 60 patients who had axillary hyperhidrosis. The sympathectomies were accomplished by means of a single-lumen endotracheal tube and a single port. The axillary hyperhidrosis patients were randomly divided into two groups with 17 patients in Group 1 undergoing T3-T4 sympathectomies and 43 in Group 2 undergoing only T3 sympathectomies. We analysed the data associated with the resolution of axillary hyperhidrosis, the degree of patient satisfaction with the surgical outcome and the quality of life in parallel with compensatory sweating after the procedure as reported by the patient and confirmed by the examiner. Moreover, the results were compared statistically. No statistically significant difference was observed between the groups based on age (P=0.56), gender (P=0.81), duration of the surgery (P=0.35) or postoperative satisfaction levels (P=0.45). However, the incidence and degree of compensatory sweating were lower in the T3 group than the T3-T4 group at the 1-year follow-up (P=0.008). T3 sympathectomy was as effective as T3-T4 sympathectomy for the treatment of axillary hyperhidrosis based on the patients' reported postoperative satisfaction, and the T3 group demonstrated lower compensatory sweating at the 1-year follow-up.

  13. Role of Tulipa gesneriana TEOSINTE BRANCHED1 (TgTB1) in the control of axillary bud outgrowth in bulbs.

    Science.gov (United States)

    Moreno-Pachon, Natalia M; Mutimawurugo, Marie-Chantal; Heynen, Eveline; Sergeeva, Lidiya; Benders, Anne; Blilou, Ikram; Hilhorst, Henk W M; Immink, Richard G H

    2017-12-07

    Tulip vegetative reproduction. Tulips reproduce asexually by the outgrowth of their axillary meristems located in the axil of each bulb scale. The number of axillary meristems in one bulb is low, and not all of them grow out during the yearly growth cycle of the bulb. Since the degree of axillary bud outgrowth in tulip determines the success of their vegetative propagation, this study aimed at understanding the mechanism controlling the differential axillary bud activity. We used a combined physiological and "bottom-up" molecular approach to shed light on this process and found that first two inner located buds do not seem to experience dormancy during the growth cycle, while mid-located buds enter dormancy by the end of the growing season. Dormancy was assessed by weight increase and TgTB1 expression levels, a conserved TCP transcription factor and well-known master integrator of environmental and endogenous signals influencing axillary meristem outgrowth in plants. We showed that TgTB1 expression in tulip bulbs can be modulated by sucrose, cytokinin and strigolactone, just as it has been reported for other species. However, the limited growth of mid-located buds, even when their TgTB1 expression is downregulated, points at other factors, probably physical, inhibiting their growth. We conclude that the time of axillary bud initiation determines the degree of dormancy and the sink strength of the bud. Thus, development, apical dominance, sink strength, hormonal cross-talk, expression of TgTB1 and other possibly physical but unidentified players, all converge to determine the growth capacity of tulip axillary buds.

  14. An unusual case: right proximal ureteral compression by the ovarian vein and distal ureteral compression by the external iliac vein

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    Halil Ibrahim Serin

    2015-12-01

    Full Text Available A 32-years old woman presented to the emergency room of Bozok University Research Hospital with right renal colic. Multidetector computed tomography (MDCT showed compression of the proximal ureter by the right ovarian vein and compression of the right distal ureter by the right external iliac vein. To the best of our knowledge, right proximal ureteral compression by the ovarian vein together with distal ureteral compression by the external iliac vein have not been reported in the literature. Ovarian vein and external iliac vein compression should be considered in patients presenting to the emergency room with renal colic or low back pain and a dilated collecting system.

  15. Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up

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    Elferink Marloes AG

    2007-10-01

    Full Text Available Abstract Background The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven. Methods Before the introduction of the sentinel node biopsy, we conducted a study in which 180 women of 50 years and older with T1/T2 cN0 breast cancer were treated with breast conserving therapy. Instead of an axillary lymph node dissection regional radiotherapy was given in combination with tamoxifen (RT-group. The study group was compared with 341 patients, with the same patient and tumour characteristics, treated with an axillary lymph node dissection (S-group. Results The treatment groups were comparable, except for age. The RT-group was significantly older than the S-group. The median follow up was 7.2 years. The regional relapse rates were low and equal in both treatment groups, 1.1% in RT-group versus 1.5% in S-group at 5 years. The overall survival was similar; the disease free survival was significant better in the RT-group. Conclusion Regional recurrence rates after regional radiotherapy are very low and equal to an axillary lymphnode dissection.

  16. Incidental retroaortic left innominate vein in adult patient

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    Alexandre Semionov, MD, PhD

    2017-09-01

    Full Text Available Retro-aortic left innominate vein is a rare vascular abnormality, usually associated with congenital heart disease. Here we report a case of isolated retro-aortic left innominate vein in an adult female.

  17. Varicose Veins: Role of Mechanotransduction of Venous Hypertension

    Science.gov (United States)

    Atta, Hussein M.

    2012-01-01

    Varicose veins affect approximately one-third of the adult population and result in significant psychological, physical, and financial burden. Nevertheless, the molecular pathogenesis of varicose vein formation remains unidentified. Venous hypertension exerted on veins of the lower extremity is considered the principal factor in varicose vein formation. The role of mechanotransduction of the high venous pressure in the pathogenesis of varicose vein formation has not been adequately investigated despite a good progress in understanding the mechanomolecular mechanisms involved in transduction of high blood pressure in the arterial wall. Understanding the nature of the mechanical forces, the mechanosensors and mechanotransducers in the vein wall, and the downstream signaling pathways will provide new molecular targets for the prevention and treatment of varicose veins. This paper summarized the current understanding of mechano-molecular pathways involved in transduction of hemodynamic forces induced by blood pressure and tries to relate this information to setting of venous hypertension in varicose veins. PMID:22489273

  18. Venous Thromboembolic Events After Cerebral Vein Thrombosis

    NARCIS (Netherlands)

    Miranda, Bruno; Ferro, José M.; Canhão, Patrícia; Stam, Jan; Bousser, Marie-Germaine; Barinagarrementeria, Fernando; Scoditti, Umberto

    2010-01-01

    Background and Purpose-After cerebral vein and dural sinus thrombosis (CVT), there is an increased risk of further venous thromboembolic events (VTEs). Time to a second cerebral or systemic venous thrombotic event and risk factors for recurrence have not been investigated in large prospective

  19. Portal vein thrombosis following laparoscopic gastric plication

    Science.gov (United States)

    Rikabi, S; Chang, A; Durkin, N; Ramar, S

    2017-01-01

    Portal vein thrombosis (PVT) following laparoscopic surgery including Roux-en-Y bypass, sleeve gastrectomy and Nissen’s fundoplication is a rare but recognised complication. Laparoscopic gastric plication in a new procedure that is popular in some parts of the world. We report a case of a patient suffering PVT as a complication of this surgery. PMID:27652795

  20. Portal vein thrombosis complicating appendicitis | Ayantunde | West ...

    African Journals Online (AJOL)

    Appendicitis is still the most common acute surgical abdomen all over the world and its complications may be grave. We report an adult case of acute appendicitis complicated by Portal Vein Thrombosis (PVT) and ascending portomesenteric phlebitis treated successfully with antibiotics and anticoagulation with no residual ...

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

    African Journals Online (AJOL)

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

  2. Internal Jugular Vein Cannulation; Anatomical Surface Markings ...

    African Journals Online (AJOL)

    She had undergone numerous central venous cannulations and unsuccessful peripheral vein cut-downs in the past. On two separate occasions she had central venous catheters (CVCs) inserted in theatre using the surface landmark technique and ultrasound-guided technique. This paper describes these procedures and ...

  3. Endovascular vein harvest: systemic carbon dioxide absorption.

    Science.gov (United States)

    Maslow, Andrew M; Schwartz, Carl S; Bert, Arthur; Hurlburt, Peter; Gough, Jeffrey; Stearns, Gary; Singh, Arun K

    2006-06-01

    Endovascular vein harvest (EDVH) requires CO(2) insufflation to expand the subcutaneous space, allowing visualization and dissection of the saphenous vein. The purpose of this study was to assess the extent of CO(2) absorption during EDVH. Prospective observational study. Single tertiary care hospital. Sixty patients (30 EDVH and 30 open-vein harvest) undergoing isolated coronary artery bypass graft surgery. Hemodynamic, procedural, and laboratory data were collected prior to (baseline), during, and at it the conclusion (final) of vein harvesting. Data were also collected during cardiopulmonary bypass (CPB). Data were compared by using t tests, analysis of variance, and correlation statistics when needed. There were significant increases in arterial CO(2) (PaCO(2), 35%) and decreases in pH (1.35%) during EDVH. These were associated with increases in heart rate, mean blood pressure, and cardiac output. Within the EDVH group, greater elevations (>10 mmHg) in PaCO2 were more likely during difficult harvest procedures, and these patients exhibited greater increase in heart rate. Elevated CO(2) persisted during CPB, requiring higher systemic gas flows and greater use of phenylephrine to maintain desired hemodynamics. EDVH was associated with systemic absorption of CO(2). Greater absorption was more likely in difficult procedures and was associated with greater hemodynamic changes requiring medical therapy.

  4. Preduodenal portal vein: A potential laparoscopic cholecystectomy ...

    African Journals Online (AJOL)

    Variations of biliary anatomy are well described. Those of most relevance to the operative surgeon are the variations of the extrahepatic ducts and their relationships to the right hepatic artery and its branches. We describe another even rarer congenital anomaly of a preduodenal portal vein. Its embryological derivation and ...

  5. Portal vein thrombosis following laparoscopic gastric plication

    OpenAIRE

    Som, R; Rikabi, S; Chang, A; Durkin, N; Ramar, S

    2017-01-01

    Portal vein thrombosis (PVT) following laparoscopic surgery including Roux-en-Y bypass, sleeve gastrectomy and Nissen’s fundoplication is a rare but recognised complication. Laparoscopic gastric plication in a new procedure that is popular in some parts of the world. We report a case of a patient suffering PVT as a complication of this surgery.

  6. Portal vein thrombosis in patients with cirrhosis

    DEFF Research Database (Denmark)

    von Köckritz, Leona; De Gottardi, Andrea; Trebicka, Jonel

    2017-01-01

    Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty...

  7. Puzzles in practice: splenic vein thrombosis.

    Science.gov (United States)

    McIntyre, Brittany; Marsh, Melanie; Walden, Jeffrey

    2016-06-01

    This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis. Our patient had prominent collateral vasculature, suggesting that his splenic vein thrombosis was chronic in nature and likely the cause of his ongoing abdominal pain. Splenic vein thrombosis is an uncommon cause of abdominal pain, but one that should be included in the treating physician's differential diagnoses when abdominal pain is ongoing despite medical therapy. Although he had no evidence of initial findings on radiography, our patient was eventually diagnosed with biopsy-proven pancreatic cancer. Our case report demonstrates how patients presenting with persistent or worsening abdominal pain despite the use of proton pump inhibitors or other acid reducing agents and potential 'red flag' findings such as decreased appetite and weight loss should be worked up for other potential sources of abdominal pathology.

  8. Preoperative axillary imaging with percutaneous lymph node biopsy is valuable in the contemporary management of patients with breast cancer.

    Science.gov (United States)

    Hieken, Tina J; Trull, Brent C; Boughey, Judy C; Jones, Katie N; Reynolds, Carol A; Shah, Sejal S; Glazebrook, Katrina N

    2013-10-01

    ACOSOG Z11 and other studies showing little benefit to axillary dissection (ALND) for early-stage breast cancers with limited nodal disease have led to questioning the value of preoperative axillary imaging ± ultrasound-guided needle biopsy (USNB). Data are lacking on the value of this approach in identifying cases that fall outside Z11 guidelines. We studied 988 consecutive patients with invasive breast cancers who underwent operation including axillary surgery in 2010-2011. Preoperative axillary ultrasonography (AUS) was performed in 92% and breast/axillary magnetic resonance imaging (MRI) in 51%; 82 (33.5%) of 245 patients with suspicious lymph nodes (LN) were USNB-positive. Regarding nodal status, AUS, MRI, and USNB had negative and positive predictive values of 78%, 76%, 70% and 54%, 58%, 100%, respectively. AUS/MRI visualization of one versus multiple abnormal LNs visualized predicted >2LN+ on final pathology (13.5%/15.1% % vs 30.8%/32.6%, P 2LN+, P = .001. In our contemporary series, preoperative AUS±USNB streamlined surgical care for 29% of node-positive patients. Two-thirds of T1/T2 USNB-LN+ patients with multiple AUS-suspicious LNs had >2LN+, suggesting they should undergo ALND without SLNB. AUS±USNB helps identify node-positive breast cancer patients who fall outside Z11 guidelines. Copyright © 2013 Mosby, Inc. All rights reserved.

  9. Treatment of focal axillary hyperhidrosis using a long-pulsed Nd:YAG 1064 nm laser at hair reduction settings.

    Science.gov (United States)

    Letada, Philip R; Landers, John T; Uebelhoer, Nathan S; Shumaker, Peter R

    2012-01-01

    Axillary hyperhidrosis is a rather common idiopathic disorder of the eccrine sweat glands, which can interfere with daily activities and cause significant social distress. The effects of 1064 nm laser hair reduction on sweat production in a pilot study in patients with focal axillary hyperhidrosis are described. In a prospective, case-controlled, randomized pilot study, one axilla from six different subjects with axillary hyperhidrosis was treated with monthly laser hair reduction sessions using the 1064 nm Nd:YAG laser at typical settings. The contralateral axilla acted as a control. Subjects were asked to subjectively classify improvement of axillary sweating using a Global Assessment Questionnaire (GAQ) weekly after each treatment. Qualitative evaluation of sweating was also performed using a modified starch iodine test monthly after each treatment. In addition, prior to the first treatment and at one month following the final treatment, a punch biopsy was performed on the treatment axilla to assess for histologic changes to the eccrine gland and surrounding structures. Statistically significant improvements in subjective ratings of sweating using the GAQ compared to baseline were observed. Objective improvements in sweating with modified starch iodine testing comparing treated versus non-treated axillae were also seen for at least nine months in selected subjects. No significant differences in pre- and post-treatment biopsies were noted on routine histology. Laser hair reduction using the 1064 nm Nd:YAG at laser hair removal settings provides subjective and objective improvements in patients with focal axillary hyperhidrosis.

  10. Staging primary breast cancer. Are there tumour pathological features that correlate with a false-negative axillary ultrasound?

    International Nuclear Information System (INIS)

    Johnson, S.; Brown, S.; Porter, G.; Steel, J.; Paisley, K.; Watkins, R.; Holgate, C.

    2011-01-01

    Aim: To investigate whether the histopathological characteristics of primary breast cancer tumours could predict the likelihood of false-negative axillary ultrasound. Materials and methods: Screening and symptomatic patients were identified from pathology records and imaging and pathology records reviewed. True and false-negative axillary staging ultrasound groups were compared statistically in terms of tumour size, pathological type and grade, lymphovascular invasion, and oestrogen receptor (ER) status. Results: Of 155 women with normal ultrasounds, 45 (29%) were node positive at axillary surgery. Breast tumour size was significantly different with the average size smaller in the true-negative group: 21 versus 30 mm (p < 0.02). The histological type varied significantly between the groups, with more lobular carcinomas in the false-negative group [6/110 (5%) versus 6/45 (13%), p < 0.001]. The false-negative group was also more likely to show lymphovascular invasion in the breast [6/110 (5%) versus 14/45 (31%), p < 0.001]. There was no significant difference in tumour grade or ER status. Conclusion: The present study has found significant differences in tumour characteristics between women with true-negative and false-negative axillary staging ultrasound in terms of size, primary tumour histological type and presence of lymphovascular invasion. In particular, axillary ultrasound in primary lobular carcinoma may be less accurate and a negative result is more likely to be spurious than with primary ductal carcinomas.

  11. Sustained Benefit Lasting One Year from T4 Instead of T3-T4 Sympathectomy for Isolated Axillary Hyperhidrosis

    Science.gov (United States)

    Munia, Marco Antonio S.; Wolosker, Nelson; Kaufmann, Paulo; de Campos, José Ribas Milanes; Puech-Leão, Pedro

    2008-01-01

    INTRODUCTION Level T4 video-assisted thoracoscopic sympathectomy proved superior to T3-T4 treatment for controlling axillary hyperhidrosis at the initial and six-month follow-ups of these patients. OBJECTIVE To compare the results of two levels of sympathectomy (T3-T4 vs. T4) for treating axillary sudoresis over one year of follow-up. METHODS Sixty-four patients with axillary hyperhidrosis were randomized to denervation of T3-T4 or T4 alone and followed prospectively. All patients were examined preoperatively and were followed postoperatively for one year. Axillary hyperhidrosis treatment was evaluated, along with the presence, location, and severity of compensatory hyperhidrosis and self-reported quality of life. RESULTS According to patient reports after one year, all cases of axillary hyperhidrosis were successfully treated by surgery. There were no instances of treatment failure. After six months, compensatory hyperhidrosis was present in 27 patients of the T3-T4 group (87.1%) and in 16 patients of the T4 group (48.5%). After one year, all T3-T4 patients experienced some degree of compensatory hyperhidrosis, compared to only 14 patients in the T4 group (42.4%). In addition, compensatory hyperhidrosis was less severe in the T4 patients (p hyperhidrosis, but the T4 group showed milder compensatory hyperhidrosis and greater patient satisfaction at the one-year follow-up. PMID:19060999

  12. Isolated thrombosis of the external jugular vein.

    Science.gov (United States)

    Colomina, M J; Godet, C; Bagó, J; Pellisé, F; Puig, O; Villanueva, C

    2000-08-01

    Thrombosis of the external jugular vein (EJV) is an infrequent clinical condition that has been associated with central venous catheterization, head and neck infections, intravenous drug abuse, and compression at the affected site. The authors report a case of thrombotic obstruction of the EJV in the late postoperative period after laparoscopic anterior lumbar interbody fusion. A 40-year-old morbidly obese woman with a depressive syndrome was diagnosed with L5-S1 discopathy and was submitted to laparoscopic anterior isthmic fusion. The operation lasted approximately 6 hours, during which the patient remained in a supine decubitus and Trendelenburg position. The left radial artery, peripheral veins, and right internal jugular vein were canalized. The internal jugular vein catheter was electively withdrawn 24 hours after the intervention. The postoperative period was satisfactory, and the patient was started on prophylaxis with low-molecular-weight heparin. She sat up and began walking at 24 hours and was discharged to her home 4 days after the procedure. Eight days after discharge she returned, experiencing right cervical pain. Palpation revealed a painful induration and erythematous area under the anterior edge of the sternocleidomastoid muscle. Results of otoscopy and laryngoscopy were normal. Cervical echo-Doppler disclosed an image consistent with EJV thrombosis. The most frequent causes of jugular vein thrombosis are mentioned above. A higher incidence has been described after upper abdomen and pelvic surgery; other contributing factors are age, obesity, and associated illness. There are few references in the literature to position-induced EJV thrombosis in the late postoperative period. The authors' patient presented signs and symptoms of EJV thrombosis (probably because of various factors), which was confirmed by echo-Doppler study and treated with 10 days of calcic heparin.

  13. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Young-Kyun Kim

    2016-07-01

    Full Text Available Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review.

  14. 21 CFR 880.6970 - Liquid crystal vein locator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters). (b...

  15. Variant Anatomy of the External Jugular Vein | Olabu | Anatomy ...

    African Journals Online (AJOL)

    Variant communications noted included facial vein, internal jugular, and a presence of a large anastomotic vein connecting it to the anterior jugular. It was duplicated in 2.2% cases and terminated into internal jugular vein in 7.7% of cases. The most common variations were in origin, course, communications and termination.

  16. Prevalence of Isolated Asymptomatic Deep Vein Thrombosis in Varicose Vein Patients with Superficial Thrombophlebitis: A Single Center Experience in Japan.

    Science.gov (United States)

    Shirasugi, Nozomu; Horiguchi, Sadaaki; Shirato, Hiroyuki; Kawakami, Toshimitsu; Ono, Hisako; Yabuki, Shiho; Jojima, Kumiko; Niimi, Masanori

    2016-01-01

    Prevalence of asymptomatic deep vein thrombosis (DVT) in patients with primary varicose veins remains unclear. Here, we conducted a retrospective study to clarify the incidence of asymptomatic DVT in patients with varicose veins, especially focusing on those with superficial thrombophlebitis (STP). Among 431 patients with primary varicose veins with saphenous vein incompetence, 20 (4.64%) had asymptomatic DVT. The presence of STP was a significant risk factor for asymptomatic DVT as 10 of the 24 (41.7%) patients with STP had asymptomatic DVT, and all cases having calf muscle vein thrombosis. In contrast, of the patients with primary varicose veins without STP only 2.46% had asymptomatic DVT. In patients with primary varicose veins with STP, significant risk factors for DVT were being over C3 on the clinical, etiological, anatomical, and pathophysiological (CEAP) classification. (This article is a translation of Jpn J Phlebol 2014; 25: 13-19.).

  17. Endovascular Radiofrequency Ablation for Varicose Veins

    Science.gov (United States)

    2011-01-01

    Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost–effectiveness of endovascular radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. Background The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition Varicose veins (VV) are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad

  18. 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. 

  19. Factors affecting outcome of triceps motor branch transfer for isolated axillary nerve injury.

    Science.gov (United States)

    Lee, Joo-Yup; Kircher, Michelle F; Spinner, Robert J; Bishop, Allen T; Shin, Alexander Y

    2012-11-01

    Triceps motor branch transfer has been used in upper brachial plexus injury and is potentially effective for isolated axillary nerve injury in lieu of sural nerve grafting. We evaluated the functional outcome of this procedure and determined factors that influenced the outcome. A retrospective chart review was performed of 21 patients (mean age, 38 y; range, 16-79 y) who underwent triceps motor branch transfer for the treatment of isolated axillary nerve injury. Deltoid muscle strength was evaluated using the modified British Medical Research Council grading at the last follow-up (mean, 21 mo; range, 12-41 mo). The following variables were analyzed to determine whether they affected the outcome of the nerve transfer: the age and sex of the patient, delay from injury to surgery, body mass index (BMI), severity of trauma, and presence of rotator cuff lesions. The Spearman correlation coefficient and multiple linear regression were performed for statistical analysis. The average Medical Research Council grade of deltoid muscle strength was 3.5 ± 1.1. Deltoid muscle strength correlated with the age of the patient, delay from injury to surgery, and BMI of the patient. Five patients failed to achieve more than M3 grade. Among them, 4 patients were older than 50 years and 1 was treated 14 months after injury. In the multiple linear regression model, the delay from injury to surgery, age of the patient, and BMI of the patient were the important factors, in that order, that affected the outcome of this procedure. Isolated axillary nerve injury can be treated successfully with triceps motor branch transfer. However, outstanding outcomes are not universal, with one fourth failing to achieve M3 strength. The outcome of this procedure is affected by the delay from injury to surgery and the age and BMI of the patient. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. Axillary staging for breast cancer during pregnancy: feasibility and safety of sentinel lymph node biopsy.

    Science.gov (United States)

    Han, S N; Amant, F; Cardonick, E H; Loibl, S; Peccatori, F A; Gheysens, O; Sangalli, C A; Nekljudova, V; Steffensen, K Dahl; Mhallem Gziri, M; Schröder, C P; Lok, C A R; Verest, A; Neven, P; Smeets, A; Pruneri, G; Cremonesi, M; Gentilini, O

    2017-12-12

    Safety of sentinel lymph node (SLN) biopsy for breast cancer during pregnancy is insufficiently explored. We investigated efficacy and local recurrence rate in a large series of pregnant patients. Women diagnosed with breast cancer who underwent SLN biopsy during pregnancy were identified from the International Network on Cancer, Infertility and Pregnancy, the German Breast Group, and the Cancer and Pregnancy Registry. Chart review was performed to record technique and outcome of SLN biopsy, locoregional and distant recurrence, and survival. We identified 145 women with clinically N0 disease who underwent SLN during pregnancy. The SLN detection techniques were as follows: 99m Tc-labeled albumin nanocolloid only (n = 96; 66.2%), blue dye only (n = 14; 9.7%), combined technique (n = 15; 10.3%), or unknown (n = 20; 13.8%). Mapping was unsuccessful in one patient (0.7%) and she underwent an axillary lymph node dissection (ALND). Mean number of SLNs was 3.2 (interquartile range 1-3; missing n = 15). Positive SLNs were found in 43 (29.7%) patients and 34 subsequently underwent ALND. After a median follow-up of 48 months (range 1-177), 123 (84.8%) patients were alive and free of disease. Eleven patients experienced a locoregional relapse, including 1 isolated ipsilateral axillary recurrence (0.7%). Eleven (7.6%) patients developed distant metastases, of whom 9 (6.2%) died of breast cancer. No neonatal adverse events related to SLN procedure during pregnancy were reported. SLN biopsy during pregnancy has a comparably low axillary recurrence rate as in nonpregnant women. Therefore, this method can be considered during pregnancy instead of standard ALND for early-stage, clinically node-negative breast cancer.

  1. Comparison of ultrasound and ultrasound plus nerve stimulator guidance axillary plexus block

    International Nuclear Information System (INIS)

    Demirelli, G.; Baskan, S.; Karabeyoglu, I.; Aytac, I.; Omek, D.H.; Erdogmus, A.; Baydar, M.

    2017-01-01

    To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. Methods: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery. Participants were separated into 2 groups. In Group 1, the nerve roots required for the surgical site were located one by one and local anaesthetic was applied separately to each nerve for the block. In Group 2, the vascular nerve bundle was located under ultrasound guidance and a total block was achieved by administering all the local anaesthetic within the nerve sheath. In the operating room, standard monitorisation was applied. Following preparation of the skin, the axillary region nerve roots and branches and vascular structures were observed by examination with a high-frequency ultrasound probe. In both groups, a 22-gauge, 5cm block needle was entered to the axillary region with visualisation of the whole needle on ultrasound and 20ml local anaesthetic of 0.5% bupivacaine was injected. SPSS 19 was used for data analysis. Results: Of the 60 participants, there were 30(50%) in each group. The mean age was 39.1+-15 years in the group 1 which was the ultrasound nerve stimulation group, and 41.5+-14.3 years in group 2. The duration of the procedure was longer in group I than in group 2 (p<0.05). Patient satisfaction values during the procedure were higher in group 2(p<0.05). In the ulnar sensory examination, the values of the patients in group 1 were higher at 10, 15, 20 and 25 minutes (p<0.05). In the median, radial and ulnar motor examination, the values of the patients in group 1were higher at 15 and 20 minutes (p<0.05). Conclusion: Brachial plexus blockade via axillary approach guided by ultrasound offered

  2. 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.)

  3. Isolated axillary lymph node tuberculosis in ultrasonography. A case report

    OpenAIRE

    Joanna Ścieszka; Dagmara Urbańska‑Krawiec; Maciej Kajor; Leszek Stefański

    2012-01-01

    We present a rare case of isolated axillary lymph node tuberculosis. A 66‑year‑old patient was admitted in order to perform the diagnostics of a painless tumor of the left armpit. Blood biochemistry tests and chest X‑ray did not show any abnormalities. In the ultrasound examination a solid structure of the dimensions of 1.8×1 cm of irregular outline with adjacent hypoechogenic lymph nodes was visualized. The di‑ agnosis of tuberculosis was based on histopathologic examination o...

  4. Tuberculosis axillary lymph node coexistent breast cancer in adjuvant treatment: case report.

    Science.gov (United States)

    Bromberg, Silvio Eduardo; Amaral, Paulo Gustavo Tenório do

    2015-01-01

    Coexistence of breast cancer and tuberculosis is rare. In most cases, involvement by tuberculosis occurs in axillary lymph nodes. We report a case of a 43-years-old patient who had undergone adenomastectomy and left sentinel lymph node biopsy due to a triple negative ductal carcinoma. At the end of adjuvant treatment, the patient had an atypical lymph node in the left axilla. Lymph node was excised, and after laboratory analysis, the diagnosis was ganglion tuberculosis. The patient underwent treatment for primary tuberculosis. The development of these two pathologies can lead to problems in diagnosis and treatment. An accurate diagnosis is important to avoid unnecessary surgical procedures.

  5. A Case Report of Coronary-Subclavian Steal Syndrome Treated with Carotid to Axillary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Wissam Al-Jundi

    2009-01-01

    Full Text Available Coronary-subclavian steal syndrome results from atherosclerotic disease of the proximal subclavian artery causing reversal of flow in an internal mammary artery used as conduit for coronary artery bypass. This rare complication of cardiac revascularisation leads to recurrence of myocardial ischaemia. When feasible, subclavian angioplasty and/or stent placement can provide acceptable result for these patients. Vascular reconstruction through carotid to subclavian artery bypass has been the standard procedure of choice. Other interventions in literature include axilloaxillary bypass and subclavian carotid transposition. This case report describes the use of carotid axillary artery bypass for the treatment of coronary-subclavian steal syndrome.

  6. Anatomy of Axillary Nerve and Its Clinical Importance: A Cadaveric Study

    Science.gov (United States)

    Kuppasad, Saniya

    2015-01-01

    Introduction: Axillary nerve is one of the terminal branches of posterior cord of brachial plexus, which is most commonly injured during numerous orthopaedic surgeries, during shoulder dislocation & rotator cuff tear. All these possible iatrogenic injuries are because of lack of awareness of anatomical variations of the nerve. Therefore, it is very much necessary to explore its possible variations and guide the surgeons to enhance the better clinical outcome by reducing the risk and complications. Materials and Methods: Twenty five cadavers (20 Males & 05 Females) making 50 specimens including both right and left sides were dissected as per standard dissection methods to find the origin, course, branches, distribution & exact location of the nerve beneath the deltoid muscle from important landmarks like: posterolateral aspect of acromion process, anteromedial aspect of tip of coracoid process, midpoint of deltoid muscle insertion (deltoid tuberosity of humerus) and from the midpoint of vertical length of deltoid muscle. The measurements were recorded and tabulated. Statistical Analysis: The measurements were entered in Microsoft excel and mean, proportion, standard deviation were calculated by using SPSS 16th version. Results: The axillary nerve was found to take origin from the posterior cord of brachial plexus (100%) dividing into anterior & posterior branches in Quadrangular space (88%) and supply deltoid muscle mainly. It also gave branches to teres minor muscle, shoulder joint capsule & superolateral brachial cutaneous nerve (100%). This study concluded that the mean distance of axillary nerve from the – anteromedial aspect of tip of coracoid process, posterolateral aspect of acromion process, midpoint of deltoid insertion & from the midpoint of vertical length of deltoid muscle measured to be (in cm) as 3.56±0.51, 7.4±0.99, 6.7±0.47 & 2.45±0.48 respectively. The mean vertical distance of entering point of axillary nerve from the anterior upper, mid

  7. 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

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

    International Nuclear Information System (INIS)

    Panagiotidis, Emmanouil; Exarhos, Demetrios; Housianakou, Irene; Bournazos, Apostolos; Datseris, Ioannis

    2010-01-01

    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 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.)

  9. Axillary lymph node metastases in adenoid cystic carcinoma of the breast. A rare finding.

    Science.gov (United States)

    Spiliopoulos, D; Mitsopoulos, G; Kaptanis, S; Halkias, C

    2015-01-01

    Adenoid cystic carcinoma (ACC) of the breast is a rare malignant salivary-type neoplasm that has a good prognosis and represents less than 1% of all breast cancers. It is a triple negative carcinoma that presents as a painful mass. The mean age at the time of diagnosis is 50-60 years old. The solid variant of this type of tumour with basaloid features and presence of nodal metastases is very rare and considered to have a more aggressive clinical course. We present a case with presence of axillary lymph node metastases that was successfully treated with no evidence of recurrence one year after the diagnosis and review the literature.

  10. Tattoo pigment in axillary lymph node mimicking calcification of breast cancer

    Science.gov (United States)

    Matsika, Admire; Srinivasan, Bhuvana; Gray, Janet Meryl; Galbraith, Christine Ruth

    2013-01-01

    A tattoo is defined as the intentional or accidental deposit of pigment into the skin. The phenomenon of skin tattooing is on the rise worldwide and complications of tattooing are increasingly being recognised in diagnostic and clinical medicine. We describe a case of calcification-like changes on mammography resembling that of breast malignancy as a result of tattoo pigment deposition in an axillary lymph node. Recognition of such changes in routine breast screening is crucial to avoid further unnecessary invasive investigations and surgery in such patients. PMID:23929611

  11. Treatment results of adjuvant radiotherapy and chemotherapy in breast cancer patients with positive axillary nodes

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hyun Soo [College of Medicine, Pochon CHA Univ, Sungnam (Korea, Republic of); Suh, Chang Ok [College of Medicine, Yonsei Univ, Seoul (Korea, Republic of)

    2000-12-01

    Between January 1983 and December 1988, 218 female patients with known breast cancer and positive axillary nodes were treated with adjuvant radiotherapy and chemotherapy following radical mastectomy. Treatment results were retrospectively analysed at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University of College of Medicine. The patients were classified into 3 groups; group 1 included 80 patients treated with adjuvant chemotherapy alone; in group 2, 52 patients treated with radiotherapy alone; and in group 3, 86 patients treated with combined chemo-radiotherapy. The mean age was 44 years and ranged from 27 to 70. The median follow-up time was 51 months. Seven-year relapse free and overall survival rates were 56% and 67%; in group 1, 50% and 56%; in group 2, 51% and 65%; and in group 3, 62% and 75% respectively. This difference was not statistically significant(p<0.05). The loco-regional failure rates were 13% and distant failure rates were 33%. There was less risk of loco-regional failure in group 2 and 3 which included radiotherapy (.0<0.05). But there was no significant y difference in the rates of distant failure(p>0.05). By univariate analysis, the only significant prognostic factor affecting relapse-free survival was the percentage of positive axillary nodes; and the overall survival significantly correlated with the primary tumor size, the number or percentage of positive axillary nodes, and stage. But in multivariate analysis, the only significant prognostic factor was treatment modality. By univariate analysis of prognostic factors affecting the rates of overall failure and distant failure, the significant prognostic factors was the percentage of positive axillary nodes; and the risk of the loco-regional failure significantly correlated with the treatment modality. In conclusion, these results suggest a potential for decreasing the risk of loco-regional failure with the addition of postoperative radiotherapy to chemotherapy in the

  12. Para-axillary subcutaneous endoscopic approach in torticollis: tips and tricks in the surgical technique.

    Science.gov (United States)

    Tokar, Baran; Karacay, Safak; Arda, Surhan; Alici, Umut

    2015-04-01

    An obvious scar on the neck may appear following the open surgery for congenital muscular torticollis (CMT). The cosmetic result may displease the patient and the family. In this study, we describe a minimally invasive technique, para-axillary subcutaneous endoscopic approach (PASEA) in CMT. A total of 11 children (seven girls and four boys with the age range between 1 and 15 years) were operated for torticollis by PASEA. All patients had facial asymmetry and head and neck postural abnormality. Following an incision at the ipsilateral para-axillary region, a subcutaneous cavernous working space is formed toward sternocleidomastoid (SCM) muscle. The muscle and fascia are cut by cautery under endoscopic vision. The patients had postoperative 2nd-week and 3rd-month visits. The incision scar, inspection, and palpation findings of the region, head posture, and shoulder position of the affected side were considered in evaluation of the cosmetic outcome. Preoperative and postoperative range of motion of the head and neck were compared for functional outcome. We preferred single incision surgery in our last two patients; the rest had double para-axillary incision for port insertion. Incomplete transection of the muscle was not observed. There was no serious complication. Postoperatively, head posture and shoulder elevation were corrected significantly. Range of motion of the head was improved. Postoperatively, all the patients had rotation capacity with more than 30 degrees. The range of postoperative flexion and extension movements was between 45 and 60 degrees. The open surgery techniques of CMT causes visible lifelong incision scar on the neck. PASEA leaves a cosmetically hidden scar in the axillary region. A single incision surgery is also possible. A well-formed cavernous working space is needed. External manual palpation, delicate dissection, and cutting of SCM muscle with cautery are the important components of the procedure. Surgeons having experience in pediatric

  13. Perivenous support reduces early changes in human vein grafts : Studies in whole blood perfused human vein segments

    NARCIS (Netherlands)

    Stooker, W; Niessen, HWM; Baidoshvili, A; Wildevuur, WR; Van Hinsbergh, VWH; Fritz, J; Wildevuur, CRH; Eijsman, L

    Background: Patency of vein grafts in coronary artery bypass grafting procedures is generally less favorable than those of selected arterial grafts. However, vein grafts still are needed in cardiac operations. It would be desirable to find measures to improve the patency of vein grafts next to

  14. ClariVein® - Early results from a large single-centre series of mechanochemical endovenous ablation for varicose veins.

    Science.gov (United States)

    Tang, T Y; Kam, J W; Gaunt, M E

    2017-02-01

    Objectives This study assessed the effectiveness and patient experience of the ClariVein® endovenous occlusion catheter for varicose veins from a large single-centre series in the UK. Methods A total of 300 patients (371 legs) underwent ClariVein® treatment for their varicose veins; 184 for great saphenous vein (GSV) incompetence, 62 bilateral GSV, 23 short saphenous vein (SSV), 6 bilateral SSV and 25 combined unilateral great saphenous vein and SSV. Patients were reviewed at an interval of two months post procedure and underwent Duplex ultrasound assessment. Postoperative complications were recorded along with patient satisfaction. Results All 393 procedures were completed successfully under local anaesthetic. Complete occlusion of the treated vein was initially achieved in all the patients, but at eight weeks' follow-up, there was only partial obliteration in 13/393 (3.3%) veins. These were all successfully treated with ultrasound-guided foam sclerotherapy. Procedures were well tolerated with a mean pain score of 0.8 (0-10). No significant complications were reported. Conclusions ClariVein® can be used to ablate long and short saphenous varicose veins on a walk-in-walk-out basis. Bilateral procedures can be successfully performed, and these are well tolerated as can multiple veins in the same leg. Early results are promising but further evaluation and longer term follow-up are required.

  15. [No need to spare the arm after axillary dissection: the prohibition on interventions such as venepuncture is obsolete].

    Science.gov (United States)

    van der Linden, Ragna L A; van Bebber, Ignas P T; Bosscha, Koop; Bessems, Maud

    2015-01-01

    Annually, around 11,500 patients are treated surgically for breast cancer. In the past, 5-25% of these underwent an axillary dissection. This procedure can entail complications such as lymphoedema. Known risk factors are obesity and infections or wounds in the arm concerned. There is a traditional assumption that interventions on this arm, such as venepuncture, infusion or measurement of blood pressure, may induce lymphoedema. This assumption has been queried in recent years. Based on our analysis of the current literature, we believe that the above-mentioned interventions after non-complicated axillary dissection do not increase the risk of lymphoedema or other complications. We recommend changing the policy that prohibits interventions such as venepuncture after axillary dissection.

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

    International Nuclear Information System (INIS)

    Choi, Ji In; Kim, Soo Jin; Park, Sung Hee; Kim, Hee Sung

    2014-01-01

    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.

  17. {sup 18F} FDG PET/CT Findings in a Breast Cancer Patient with Concomitant Tuberculous Axillary Lymphadenitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Jeju National Univ. Hospital, Jeju (Korea, Republic of); Lee, Sang Mi [Soonchunhyang Univ. Cheonan Hospital, Cheonan (Korea, Republic of); Choi, Jae Hyuck [Jeju National Univ. School of Medicine, Jeju (Korea, Republic of)

    2011-06-15

    Although {sup 18F} fluorodeoxyglucose ({sup 18F} FDG) positron emission tomography (PET) is a sensitive modality for detecting a malignant lesion, increased {sup 18F} FDG uptake is also seen in infected or inflammatory processes. Here, we report the case of a a breast cancer patient with concomitant tuberculous axillary lymphadenitis that showed increased {sup 18F} FDG uptake. A 39 year old woman underwent preoperative {sup 18F} FDG PET/computed tomography (CT) as a part of the work up for right breast cancer. {sup 18F} FDG PET/CT images showed a malignant lesion in the right breast with moderate {sup 18F} FDG uptake, and multiple enlarged right axillary lymph nodes with intense {sup 18F} FDG uptake. Subsequently, the patient underwent right mastectomy and right axillary lymph node dissection. Histopathological examination confirmed breast cancer and tuberculous lymphadenitis, and the patient was treated concomitantly with anti tuberculous therapy.

  18. 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.

  19. Axillary artery injury after an anterior shoulder fracture dislocation and “periosteal sleeve avulsion of the rotator cuff” (SARC. Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ash Chehata

    2017-04-01

    Full Text Available We present the rare complication of an axillary artery injury associated with an anterior dislocation of the humerus and what we believe to be the first reported periosteal sleeve avulsion of the entire rotator cuff (SARC. We review the literature and discuss the cause of this unusual injury pattern. Keywords: Axillary artery, Shoulder fracture dislocation, Periosteal sleeve avulsion, SARC

  20. Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for stage I or II breast carcinoma

    NARCIS (Netherlands)

    Rietman, J.S.; Dijkstra, P.U.; Geertzen, J.H.; Baas, P.; de Vries, J; Dolsma, W.; Groothoff, J.W.; Eisma, W.H.; Hoekstra, H.J.

    2003-01-01

    BACKGROUND. The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment-related upper-limb morbidity. In the current prospective study, short-term upper-limb morbidity was assessed after SLNB

  1. Biometric Authentication Using Infrared Imaging of Hand Vein Patterns

    Science.gov (United States)

    Bhattacharyya, Debnath; Shrotri, A.; Rethrekar, S. C.; Patil, M. H.; Alisherov, Farkhod A.; Kim, Tai-Hoon

    Hand vein patterns are unique and universal. Vein pattern is used as biometric feature in recent years. But, it is not very much popular biometric system as compared to other systems like fingerprint, iris etc, because of the higher cost. For conventional algorithm, it is necessary to use high quality images, which demand high-priced collection devices. There are two approaches for vein authentication, these are hand dorsa and hand ventral. Currently we are working on hand dorsa vein patterns. Here we are putting forward the new approach for low cost hand dorsa vein pattern acquisition using low cost device and proposing a algorithm to extract features from these low quality images.

  2. Arthroscopic perspective of the axillary nerve in relation to the glenoid and arm position: a cadaveric study.

    Science.gov (United States)

    Yoo, Jae Chul; Kim, Jae Hoon; Ahn, Jin Hwan; Lee, Seok Hyun

    2007-12-01

    The purposes of this study were to examine the morphologic features of the axillary nerve and its relation to the glenoid under an arthroscopic setup, and to determine the changes in nerve position according to different arm positions. Twenty-three fresh-frozen fore-quarter cadaveric shoulder specimens were used for evaluations in an arthroscopic setup with the lateral decubitus position. The main trunk of the axillary nerve with or without some of its branches was exposed after careful arthroscopic dissection. Morphologic features and the course of the axillary nerve from the anterior and posterior portals were documented. The closest distances from the glenoid rim were measured with a probe by use of a distance range system. The changes in nerve position were determined in 4 different arm positions. At the end of arthroscopic examination, the nerves were marked and verified by open dissections. The axillary nerve appeared in the joint near the inferior edge of the subscapularis muscle. With reference to the inferior glenoid rim horizontally, the nerve had a mean running angle of 23 degrees (range, 14 degrees to 41 degrees; SD, 8 degrees ). The closest points from the glenoid were between the 5:30- and 6:00-o'clock position (right) or 6:00- and 6:30-o'clock position (left). The closest distance range varied from 10 to 25 mm in the neutral arm position. The abduction-neutral position resulted in the greatest distance between the inferior glenoid and the nerve. The abduction-neutral rotation position was the optimal position for minimizing axillary nerve injuries, because it resulted in the greatest distance between the inferior glenoid and the nerve. Knowledge of the anatomy of the axillary nerve aids the shoulder surgeon in avoiding nerve injury during arthroscopic procedures. Abduction-neutral rotation may be more helpful for arthroscopic surgeons performing procedures in the anteroinferior glenoid with the nerve being farther away from the working field.

  3. Axillary nerve injury in young adults--an overlooked diagnosis? Early results of nerve reconstruction and nerve transfers.

    Science.gov (United States)

    Dahlin, Lars B; Cöster, Marcus; Björkman, Anders; Backman, Clas

    2012-09-01

    An injury to the axillary nerve from a shoulder trauma can easily be overlooked. Spontaneous functional recovery may occur, but occasionally reconstructive surgery is required. The time frame for nerve reconstruction procedures is from a neurobiological view crucial for a good functional outcome. This study presents a group of operatively and non-operatively treated young adults with axillary nerve injuries caused by motorcycle accidents, where the diagnosis was set late. Ten young men (median age at trauma 13 years, range 9-24) with an axillary nerve injury were diagnosed by examination of shoulder function and electromyography (EMG). The patients had either a nerve reconstruction procedure or were treated conservatively and their recovery was monitored. The axillary nerve was explored and reconstructed at a median of 8 months (range 1-22 months) after trauma in 8/10 patients. Two patients were treated non-operatively. In 4/8 cases, a reconstruction with sural nerve graft was performed and in 1/8 case only exploration of the nerve was made (minor neuroma). In 3/8 cases a radial nerve branch transfer to the axillary nerve was chosen as the procedure. The shoulder was mobilised after 3 weeks with physiotherapy and the patients were monitored regularly. Functional recovery was observed in 9/10 cases (median follow up 11 months, range 7-64) with EMG signs of reinnervation in seven patients. Axillary nerve function should not be overlooked in young patients with a minor shoulder trauma. Nerve reconstruction can successfully recreate function.

  4. Human axillary skin condition is improved following incorporation of glycerol into the stratum corneum from an antiperspirant formulation.

    Science.gov (United States)

    Evans, Richard L; Turner, Graham A; Bates, Susan; Robinson, Teresa; Arnold, David; Marriott, Robert E; Pudney, Paul D A; Bonnist, Eleanor Y M; Green, Darren

    2017-11-01

    The study objectives were to demonstrate that glycerol, when topically applied from a roll-on antiperspirant formulation, can be delivered directly to human skin ex vivo and the axillary stratum corneum (SC) in vivo, and to assess whether it improves the quality of the axillary skin barrier. Ex vivo human skin absorption of glycerol was measured following application of a roll-on antiperspirant formulation containing 4% 13 C 3 -glycerol. Skin distribution of 13 C 3 -glycerol over 24 h was assessed using gas chromatography-mass spectrometry. In vivo axillary SC penetration was measured by confocal Raman spectroscopy and multivariate curve-resolution software 1 h after topical application of a roll-on antiperspirant formulation containing 8% deuterated glycerol (d 5 -glycerol). A clinical study was conducted to determine the efficacy of a roll-on antiperspirant formulation containing 4% glycerol in reducing shaving-induced visual irritation and in increasing axillary-skin hydration. Ex vivo skin absorption studies indicated that the formulation delivered 13 C 3 -glycerol into the SC at all timepoints over the 24-h period. In vivo Raman measurements (1 h after application) demonstrated that d 5 -glycerol was detectable to a depth of at least 10 μm in the axillary SC. Application of 4% glycerol from a roll-on antiperspirant formulation to the axilla was associated with significantly less visible irritation and greater skin hydration than observed with the control (glycerol-free) product. These studies demonstrate that glycerol, incorporated in a roll-on antiperspirant formulation, is delivered directly and rapidly to all depths of the axillary SC, and results in improvements in visible irritation and hydration in the axilla.

  5. Injury to the axillary and suprascapular nerves in rotator cuff arthropathy and after reverse shoulder arthroplasty: a prospective electromyographic analysis.

    Science.gov (United States)

    Lopiz, Yaiza; Rodriguez-González, Alberto; Martín-Albarrán, Susana; Marcelo, Hector; García-Fernández, Carlos; Marco, Fernando

    2018-02-20

    Neurologic pre- and postoperative injuries to the axillary and/or suprascapular nerve (SSN) have a higher incidence than expected and may lead to significantly decreased functional outcomes and increased risk of reverse shoulder arthroplasty (RSA) failure. Patients who underwent a RSA for rotator cuff tear arthropathy (RCTA) were included from December 2014 to December 2015. This study focused on the clinical (Constant score), radiographic, and pre- and postoperative electromyographic evaluations at 3 and 6 months. Twenty patients met the inclusion criteria. One was lost to follow-up. Preoperatively, 15 patients showed changes on electromyography (9 SSN and 15 axillary nerve lesions); all of them were chronic and disuse injuries. The mean preoperative relative Constant score (rCS) of all included patients was 39 ± 9 (range, 19-64). At 3 months postsurgery, the prevalence of acute injuries for both nerves was 31.5%. At 6 months postsurgery, 2 axillary nerve injuries and 6 SSN injuries remain unchanged, and the rest improved or normalized. The mean postsurgery rCS of the entire cohort at 6-month follow-up was 78 ± 6.5. Mean postoperative rCS for acute postoperative nerve injury was 71 ± 3 for the axillary nerve and 64 ± 5 for SSN. Axillary and SSN injuries in RCTA have a much higher incidence than expected. Most of these axillary lesions are transient, with an almost complete recovery seen on electromyography at 6 months and with scarce functional impact. However, SSN lesions appear to behave differently, with poor functional results and having a lower potential for a complete recovery. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. Internal vein texture and vein evolution of the epithermal Shila-Paula district, southern Peru

    Science.gov (United States)

    Chauvet, Alain; Bailly, Laurent; André, Anne-Sylvie; Monié, Patrick; Cassard, Daniel; Tajada, Fernando Llosa; Vargas, Juan Rosas; Tuduri, Johann

    2006-07-01

    The epithermal Shila-Paula Au-Ag district is characterized by numerous veins hosted in Tertiary volcanic rocks of the Western Cordillera (southern Peru). Field studies of the ore bodies reveal a systematic association of a main E-W vein with secondary N55-60°W veins—two directions that are also reflected by the orientation of fluid-inclusion planes in quartz crystals of the host rock. In areas where this pattern is not recognized, such as the Apacheta sector, vein emplacement seems to have been guided by regional N40°E and N40°W fractures. Two main vein-filling stages are identified. stage 1 is a quartz-adularia-pyrite-galena-sphalerite-chalcopyrite-electrum-Mn silicate-carbonate assemblage that fills the main E-W veins. stage 2, which contains most of the precious-metal mineralization, is divided into pre-bonanza and bonanza substages. The pre-bonanza substage consists of a quartz-adularia-carbonate assemblage that is observed within the secondary N45-60°W veins, in veinlets that cut the stage 1 assemblage, and in final open-space fillings. The two latter structures are finally filled by the bonanza substage characterized by a Fe-poor sphalerite-chalcopyrite-pyrite-galena-tennantite-tetrahedrite-polybasite-pearceite-electrum assemblage. The ore in the main veins is systematically brecciated, whereas the ore in the secondary veins and geodes is characteristic of open-space crystallization. Microthermometric measurements on sphalerite from both stages and on quartz and calcite from stage 2 indicate a salinity range of 0 to 15.5 wt% NaCl equivalent and homogenization temperatures bracketed between 200 and 330°C. Secondary CO2-, N2- and H2S-bearing fluid inclusions are also identified. The age of vein emplacement, based on 40Ar/39Ar ages obtained on adularia of different veins, is estimated at around 11 Ma, with some overlap between adularia of stage 1 (11.4±0.4 Ma) and of stage 2 (10.8±0.3 Ma). A three-phase tectonic model has been constructed to explain the

  7. Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy – Case report

    Directory of Open Access Journals (Sweden)

    Jianlin Tang

    2014-12-01

    Conclusion: The lessons we learned are (1 Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2 Synthetic graft is an alternative for internal jugular vein graft. (3 Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4 It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival.

  8. Augmented reality based real-time subcutaneous vein imaging system.

    Science.gov (United States)

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-07-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed.

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

    Directory of Open Access Journals (Sweden)

    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

  10. Qualitative and Quantitative Anatomy of the Proximal Humerus Muscle Attachments and the Axillary Nerve: A Cadaveric Study.

    Science.gov (United States)

    Moatshe, Gilbert; Marchetti, Daniel Cole; Chahla, Jorge; Ferrari, Márcio B; Sanchez, George; Lebus, George F; Brady, Alex W; Frank, Rachel M; LaPrade, Robert F; Provencher, Matthew T

    2018-03-01

    To provide a quantitative and qualitative anatomic analysis of the pectoralis major, teres major, and latissimus dorsi on the humerus, as well as the deltoid tendinous attachments on the proximal humerus and acromion, and to quantitatively characterize the humeral course of the axillary nerve. Ten nonpaired, fresh-frozen human cadaveric shoulders were analyzed. A portable coordinate-measuring device quantified the location of bony landmarks and tendon attachment areas. The tendon footprints were recorded by tracing their outlines and center points. The footprint areas of the tendons, the distances between the footprint areas and pertinent osseous and soft-tissue landmarks, and the distance between where the axillary nerve courses across the humerus relative to the acromion and greater tuberosity were measured. Of the 10 specimens, 9 (90%) had 5 distinct tendinous bands attaching the deltoid to the acromion; 1 specimen had 4 bands. The distances between the center of the deltoid footprint on the humerus and the centers of the pectoralis major, latissimus dorsi, and teres major tendon footprints on the humerus were 43.5 mm, 58.5 mm, and 49.4 mm, respectively. The shortest distances from the perimeter of the pectoralis major to the latissimus dorsi and teres major tendon footprints were 3.9 mm and 9.5 mm, respectively. The distance from the superior aspect of the greater tuberosity to the axillary nerve on the humeral shaft was 50.3 mm (95% confidence interval, 47.0-53.5 mm). The distance from the lateral acromion to the axillary nerve was 69.3 mm (95% confidence interval, 64.1-74.5 mm). The deltoid muscle had 4 to 5 tendinous insertions on the acromion, and the axillary nerve was 50.3 mm from the tip of the greater tuberosity. The distance between the lower border of the pectoralis major and the axillary nerve was 9.4 mm. Knowledge of the quantitative anatomy of the tendons of the proximal humerus and axillary nerve can aid in identifying structures of

  11. 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...... metastases (from 15.0 to 10.3 per cent; P treatment has decreased significantly during the past decade. The findings...... leave the concept of the sentinel node biopsy intact, as a highly specific procedure compared to ALND....

  12. Absent right superior caval vein in situs solitus

    DEFF Research Database (Denmark)

    Lytzen, Rebekka; Sundberg, Karin; Vejlstrup, Niels

    2015-01-01

    Introduction In up to 0.07% of the general population, the right anterior cardinal vein obliterates and the left remains open, creating an absent right superior caval vein and a persistent left superior caval vein. Absent right superior caval vein is associated with additional congenital heart...... disease in about half the patients. We wished to study the consequences of absent right superior caval vein as an incidental finding on prenatal ultrasonic malformation screening. Material and methods This is a retrospective case series study of all foetuses diagnosed with absent right superior caval vein...... at the national referral hospital, Rigshospitalet, Denmark, from 2009 to 2012. RESULTS: In total, five cases of absent right superior caval vein were reviewed. No significant associated cardiac, extra-cardiac, or genetic anomalies were found. Postnatal echocardiographies confirmed the diagnosis and there were...

  13. Lower extremity dep vein thrombosis in children

    International Nuclear Information System (INIS)

    Perlmutt, L.; Fellows, K.E.; Harvard Medical School, Boston, MA

    1983-01-01

    Of 113 leg venograms performed in patients of all ages between 1969 and 1982, 68 were in children 16 years old or less. The patients were all studied on a tilt table (method of Rabinov and Paulin) in a head-up, 40-50 0 incline without tourniquets, supporting their weight on the unaffected leg. Among the 68 venograms, 12 (18%) were positive for deep vein thrombosis. The clinical settings for thrombosis in children were post-catheterization (two patients), post surgery (two), tumor/tumor therapy (three), drug abuse (one), and idiopathic (three). There were no long-term clinical sequelae in five patients. Pulmonary infarction occurred in three, and three patients required either long-term anticoagulation or IVC clipping. Clinical diagnosis is no more accurate for the diagnosis of deep vein thrombosis in children than it is in adults. Venography is the best method for making an accurate diagnosis and directing subsequent therapy.(orig.)

  14. Deep Vein Thrombosis after Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Vivek Singh Guleria

    2015-01-01

    Full Text Available Deep vein thrombosis (DVT is a rare but potentially serious complication of coronary angiography (CAG, incidence being just 0.05%. Only a few clinical cases of DVT after diagnostic transfemoral catheterization have been reported. Here, we describe the case of a 54-year-old woman who developed significant DVT after CAG without venous thromboembolism (VTE and, which was treated with anticoagulants.

  15. Brucellosis associated with deep vein thrombosis.

    Science.gov (United States)

    Tolaj, Ilir; Mehmeti, Murat; Ramadani, Hamdi; Tolaj, Jasmina; Dedushi, Kreshnike; Fejza, Hajrullah

    2014-11-19

    Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg.

  16. Brucellosis associated with deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Ilir Tolaj

    2014-11-01

    Full Text Available Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg.

  17. Angiographic investigation of the male gonadal vein

    International Nuclear Information System (INIS)

    Vajda, J.; Boehm, K.; Horvath, L.; Molnar, Z.

    1980-01-01

    Retrograde angiography of the gonadal vein was carried out in 110 cases. Because of valve-insufficience the left vena spermatica interna filled spontaneously from the vena renalis in the majority (88%) of the cases. In the cases of well functioning valves superselective angiography was carried out. The examination is advised in cases of the following syndromes: varicokele, abdominal tumours, determination of the place of non-palpable testes, Klinefelter syndrome. (L.E.)

  18. Superior mesenteric vein thrombosis: a case report

    International Nuclear Information System (INIS)

    Costa Praxedes, Marcia da; Malheiros, Noemia Reis; Machado, Dianne Melo; Carvalho, Ana Alice Vidal de; Marchiori, Edson; Universidade Federal, Rio de Janeiro, RJ; Santos, Alair Augusto S.M.

    1995-01-01

    A case of superior mesenteric mesenteric vein thrombosis diagnosed by computed tomography in 29 year-old man with abdominal pain, without any predisposing pathologic disorders is reported. This patient had a chronic evolution, had not resulting in mesenteric infarction. He was treated conservatively with anticoagulant therapy and recanalization of the involved vessels was demonstrated by another computed tomography. The patient is asymptomatic now. (author). 8 refs., 3 figs

  19. Deep vein thrombosis: diagnosis, treatment, and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, W.P.; Youngswick, F.D.

    Deep vein thrombosis (DVT) is a dangerous complication that may present after elective foot surgery. Because of the frequency with which DVT occurs in the elderly patient, as well as in the podiatric surgical population, the podiatrist should be acquainted with this entity. A review of the diagnosis, treatment, prevention, and the role of podiatry in the management of DVT is discussed in this paper.

  20. Sclerotherapy and foam sclerotherapy for varicose veins.

    Science.gov (United States)

    Coleridge Smith, P

    2009-12-01

    To review published evidence concerning treatment of varicose veins using ultrasound-guided foam sclerotherapy (UGFS) to assess the safety and efficacy of this treatment. Medical literature databases including MedLine, Embase and DH-DATA were searched for recent literature concerning UGFS. Papers describing the early results and later outcome have been assessed and their main findings were included in this summary. Few randomized studies have been published in this field and much of the available data come from clinical series reported by individual clinicians. It is clear that foam sclerotherapy is far more effective than liquid sclerotherapy and that ultrasound imaging allows the treatment to be delivered accurately to affected veins. There is evidence that 3% polidocanol foam is no more effective than 1% polidocanol foam. The optimum ratio of gas to liquid is 4:1, although a range of ratios is reported in the published work. There is a wide variation in the volume used as well as the method by which it is injected. The use of carbon dioxide foam reduces the systemic complications, particularly visual disturbance, as compared with air foams. Very few serious adverse events have been reported in the literature despite the widespread use of this method. Rates of recanalization of saphenous trunks following UGFS are similar to those observed after endovenous laser and endovenous RF ablation of veins, as well as the residual incompetence after surgical treatment. UGFS is a safe and effective method of treating varicose veins. The relative advantages or disadvantages of this treatment in the longer term have yet to be published.

  1. Comparison of onabotulinumtoxinA and rimabotulinumtoxinB for the treatment of axillary hyperhidrosis.

    Science.gov (United States)

    An, Jee Soo; Hyun Won, Chong; Si Han, Ji; Park, Hyun Sun; Seo, Kyle K

    2015-08-01

    Recently, rimabotulinumtoxinB has been increasingly used as an off-label treatment of primary axillary hyperhidrosis (PAH). However, the optimal conversion ratios for onabotulinumtoxinA and rimabotulinumtoxinB remain to be determined. To compare effectiveness, satisfaction level, and safety of rimabotulinumtoxinB with onabotulinumtoxinA at a conversion ratio of 1:30 for the treatment of PAH. Adults with PAH were enrolled in this bilaterally paired single-subject study. Each patient was randomly treated with 1,500 U rimabotulinumtoxinB on 1 axilla and 50 U onabotulinumtoxinA contralaterally. Hyperhidrosis Disease Severity Scale was assessed before and after treatment up to 20 weeks. A 10-cm visual analog scale representing improvement of hidrotic symptom and starch-iodine test were also used to assess therapeutic efficacy. Twenty-four patients completed the study. Both groups showed comparable and efficacious anhidrotic effects through 20 weeks for any variable. There were no significant differences in terms of the onset of action or mean duration of action between the 2 groups. Overall satisfaction with the treatment was equally high in both groups. Both toxins showed comparable anhidrotic effect for the treatment of axillary hyperhidrosis at a conversion ratio of 1:30.

  2. [Axillary ectopic breast tissue fibroadenoma: report of three cases and review of the literature].

    Science.gov (United States)

    Ortiz-Mendoza, Carlos Manuel

    2012-02-01

    Ninety-five percent of women have mammary tissue at the axilla. However, the fibroadenoma seldom occur in this area and there are only isolated case reports of this tumor. This paper presents a series of three cases of this rare entity. Three women came to our hospital by axillary lumps. The patients had a median age of 36 +/- 9-years-old with an average time of evolution of 34 +/- 53 months. One patient had the history of a breast phyllodes tumor previously excised, and two were nulliparous. In two cases, neither ultrasound nor mammogram gave useful information for its diagnosis. Mammary glands of all cases were normal. The tumors were firm and movable, similar to a lymphadenopathy, and one was evident. The mean tumor size was 28 +/- 18 mm; all were oval and with white appearance. Histological diagnosis for all cases was fibroadenoma. Our findings match with literature reports. The axillary fibroadenomas may occur in women aged 30 to 50-years-old, mimicking a lymphadenopathy. Finally, the ultrasound and the mammography are not useful tools for its diagnosis.

  3. BRANCHED1 promotes axillary bud dormancy in response to shade in Arabidopsis.

    Science.gov (United States)

    González-Grandío, Eduardo; Poza-Carrión, César; Sorzano, Carlos Oscar S; Cubas, Pilar

    2013-03-01

    Plants interpret a decrease in the red to far-red light ratio (R:FR) as a sign of impending shading by neighboring vegetation. This triggers a set of developmental responses known as shade avoidance syndrome. One of these responses is reduced branching through suppression of axillary bud outgrowth. The Arabidopsis thaliana gene BRANCHED1 (BRC1), expressed in axillary buds, is required for branch suppression in response to shade. Unlike wild-type plants, brc1 mutants develop several branches after a shade treatment. BRC1 transcription is positively regulated 4 h after exposure to low R:FR. Consistently, BRC1 is negatively regulated by phytochrome B. Transcriptional profiling of wild-type and brc1 buds of plants treated with simulated shade has revealed groups of genes whose mRNA levels are dependent on BRC1, among them a set of upregulated abscisic acid response genes and two networks of cell cycle- and ribosome-related downregulated genes. The downregulated genes have promoters enriched in TEOSINTE BRANCHED1, CYCLOIDEA, and PCF (TCP) binding sites, suggesting that they could be transcriptionally regulated by TCP factors. Some of these genes respond to BRC1 in seedlings and buds, supporting their close relationship with BRC1 activity. This response may allow the rapid adaptation of plants to fluctuations in the ratio of R:FR light.

  4. Axillary apocrine adenocarcinoma in a young male suspected initially on fine-needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Ranjan Agrawal

    2015-01-01

    Full Text Available Primary apocrine sweat gland adenocarcinomas are a rare entity, with only a few case reports so far. Many of these carcinomas are slow-growing with a high recurrence rate. A distinct cytological diagnosis can be made, and metastatic adenocarcinomas are always considered as a differential diagnosis on cytology. Our case was a 35-year-old male who presented with a discharging axillary sinus and swelling for the past 1 year. A clinical suspicion of tuberculous sinus was raised that however, remained unsupported by laboratory investigations. There was quite a high suspicion of apocrine adenocarcinoma on cytological examination that was confirmed by histopathology and immunohistochemistry. The patient was successfully treated with total excision and a wide margin. We report this case in view of its rarity and its occurrence in a 35-year-old young male, and emphasize that an initial cytological suspicion should be raised for primary apocrine adenocarcinoma in case of an axillary tumor, especially keeping in consideration the poor prognosis of the same and chances of early metastasis.

  5. Axillary silicone lymphadenopathy presenting with a lump and altered sensation in the breast: a case report

    Directory of Open Access Journals (Sweden)

    Adams Simon T

    2009-03-01

    Full Text Available Abstract Introduction Silicone lymphadenopathy is a rare but recognised complication of procedures involving the use of silicone. It has a poorly understood mechanism but is thought to occur following the transportation of silicone particles from silicone-containing prostheses to lymph nodes by macrophages. Case presentation We report of a case involving a 35-year-old woman who presented to the breast clinic with a breast lump and altered sensation below her left nipple 5 years after bilateral cosmetic breast augmentations. A small lump was detected inferior to the nipple but clinical examination and initial ultrasound investigation showed both implants to be intact. However, mammography and magnetic resonance imaging of both breasts revealed both intracapsular and extracapsular rupture of the left breast prosthesis. The patient went on to develop a flu-like illness and tender lumps in the left axilla and right mastoid regions. An excision biopsy of the left axillary lesion and replacement of the ruptured implant was performed. Subsequent histological analysis showed that the axillary lump was a lymph node containing large amounts of silicone. Conclusion The exclusion of malignancy remains the priority when dealing with lumps in the breast or axilla. Silicone lymphadenopathy should however be considered as a differential diagnosis in patients in whom silicone prostheses are present.

  6. 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.

  7. Ultrasound imaging of the axillary nerve and its role in the diagnosis of traumatic impairment.

    Science.gov (United States)

    Gruber, H; Peer, S; Gruber, L; Loescher, W; Bauer, T; Loizides, A

    2014-08-01

    The axillary nerve (AN) is frequently injured during shoulder trauma and imaging is required to define the site and extent of nerve injury. However, the AN has a rather complex course through several soft tissue compartments of the shoulder and axilla. Therefore, imaging of the nerve with MRI and sonography is troublesome. Thus detection and sonographic assessment bases on thorough knowledge of local topography. This investigation aimed at defining reliable anatomical landmarks for AN-sonography in 5 volunteers and later validating the proposed sonographic examination protocol in 10 unselected patients. With strict adherence to the proposed examination algorithm, sonography of the AN was feasible in all volunteers and patients. Furthermore, sonographic findings correlated nicely with the golden standard "surgical exploration" concerning severity and topography of neural impairment. Based on our study results we propose our algorithm for AN-sonography as the first-line imaging tool for the assessment of axillary nerve trauma. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Effect of patient positioning in axillary nerve safety during arthroscopic inferior glenohumeral ligament plication.

    Science.gov (United States)

    Cuéllar, Adrián; Cuéllar, Ricardo; Heredia, Jorge Díaz; Cuéllar, Asier; Ruiz-Ibán, Miguel Angel

    2017-10-01

    To evaluate the risk of injuring the axillary nerve during an inferior glenohumeral ligament (IGHL) plication and finding out whether shoulder position (either beach chair position or lateral decubitus position) has any effect in this risk. The axillary nerve (AN) was identified through a 3-cm posterior incision in 12 cadaveric shoulders. Under arthroscopic visualization, a curved indirect suture-passing device was placed through the posterior and anterior bands of the IGHL. The distances between the device and the AN were measured with the shoulder specimen placed at simulated lateral decubitus position and beach chair position. There were no cases of nerve injury nor the suture-passing device came closer than 10 mm to the nerve. There was an increase in the injury risk to the AN when inserting the device at the posterior band of the IGHL in the beach chair position [median 13 mm (range 10-21 mm)] compared to the risk in the lateral decubitus position [22.5 mm (20-26 mm), significant differences, p nerve to the IGHL and to highlight that the risk of nerve injury during capsular plication might be reduced in the lateral decubitus position.

  9. Usefulness of dynamic MR mammography for diagnosis of axillary lymph node status in breast cancer patient

    Energy Technology Data Exchange (ETDEWEB)

    Enya, Mayumi; Goto, Hiroo; Nandate, Yuka; Kiryu, Takuji; Kanematsu, Masayuki; Hoshi, Hiroaki [Gifu Univ. (Japan). School of Medicine

    2000-11-01

    A retrospective study was performed to evaluate whether dynamic MR imaging is useful for the diagnosis of axillary lymph node metastases from breast cancer. Thirty-five patients with breast cancer were scanned and 147 lymph nodes were detected and compared with pathological nodal status. The parameters were the long axis dimension, the short axis dimension, the long-to-short axis (L/S) ratio, the shape, the contrast enhancement ratio (CER), the CER of lymph node-to-primary tumor (L/P) ratio. All parameters had significant differences between metastatic and normal nodes and there was a positive correlation between the CER of primary breast tumors and metastatic nodes. Multivariate analysis identified three parameters: the shape, the CER (1st phase), the L/P ratio (1st phase). ROC analysis revealed the shape and CER are superior in diagnostic performance to L/P ratio. If the shape and CER (1st phase) 60% and above are employed as criteria, the sensitivity, the specificity, the accuracy and the positive and negative predictive value were 86.0%, 78.4%, 81.0%, 67.2% and 91.6%, respectively. This method gives us useful information about the evaluation of axillary lymph node status preoperatively. (author)

  10. A complicated case of deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Elena Cerutti

    2011-03-01

    Full Text Available We report a case of a patient with deep vein thrombosis (DVT and pulmonary thromboembolism (PTE associated to portal vein thrombosis (PVT, complicated by hospital-acquired pneumonia (HAP. The pathogenesis of DVT is multifactorial; among risk factors we can list: transitory situations (surgical interventions, infectious diseases with fever, traumas, acquired conditions (neoplasms, antiphospholipid syndrome or genetically determined situations (thrombophilia. PVT of the sovrahepatic veins is responsible for 5-10% of portal hypertension cases in adults and can be associated to local or systemic infections. PVT is present in 10% of patients with cirrhosis and often associated to cancers. It can also complicate a surgery abdominal intervention. HAP is defined as pneumonia that appears for the first time within 48 h of hospital admission. In Internal Medicine Departments the incidence is 7-10 cases/1.000 of hospital admissions, with an important impact in terms of both mortality and morbility. An early diagnosis, together with a correct identification of microbiologic agents in cause, allows a suitable antibiotic therapy with consequent improvement of clinical prognosis and a meaningful reduction of mortality. Main risk factors are: age, hospital and department. An important variable to be considered is the onset of pneumonia. The later is the onset of HAP (5 or more days from the admission to hospital, the more often is associated to multidrug resistant (MRD microorganisms, poorly responsive to antibiotic.

  11. Compressed sensing approach for wrist vein biometrics.

    Science.gov (United States)

    Lantsov, Aleksey; Ryabko, Maxim; Shchekin, Aleksey

    2017-10-13

    The work describes features of the compressed sensing (CS) approach utilized for development of a wearable system for wrist vein recognition with single-pixel detection; we consider this system useful for biometrics authentication purposes. The CS approach implies use of a spatial light modulation (SLM) which, in our case, can be performed differently-with a liquid crystal display or diffusely scattering medium. We show that compressed sensing combined with above-mentioned means of SLM allows us to avoid using an optical system-a limiting factor for wearable devices. The trade-off between the 2 different SLM approaches regarding issues of practical implementation of CS approach for wrist vein recognition purposes is discussed. A possible solution of a misalignment problem-a typical issue for imaging systems based upon 2D arrays of photodiodes-is also proposed. Proposed design of the wearable device for wrist vein recognition is based upon single-pixel detection. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Comparison between mechanical properties of human saphenous vein and umbilical vein

    Directory of Open Access Journals (Sweden)

    Hamedani Borhan

    2012-08-01

    Full Text Available Abstract Background As a main cause of mortality in developed countries, Coronary Artery Disease (CAD is known as silent killer with a considerable cost to be dedicated for its treatment. Coronary Artery Bypass Graft (CABG is a common remedy for CAD for which different blood vessels are used as a detour. There is a lack of knowledge about mechanical properties of human blood vessels used for CABG, and while these properties have a great impact on long-term patency of a CABG. Thus, studying these properties, especially those of human umbilical veins which have not been considered yet, looks utterly necessary. Methods Umbilical vein, as well as human Saphenous vein, are respectively obtained after cesarean and CABG. First, histological tests were performed to investigate different fiber contents of the samples. Having prepared samples carefully, force-displacement results of samples were rendered to real stress–strain measurements and then a fourth-order polynomial was used to prove the non-linear behavior of these two vessels. Results Results were analyzed in two directions, i.e. circumferentially and longitudinally, which then were compared with each other. The comparison between stiffness and elasticity of these veins showed that Saphenous vein’s stiffness is much higher than that of umbilical vein and also, it is less stretchable. Furthermore, for both vessels, longitudinal stiffness was higher than that of circumferential and in stark contrast, stretch ratio in circumferential direction came much higher than longitudinal orientation. Conclusion Blood pressure is very high in the region of aorta, so there should be a stiff blood vessel in this area and previous investigations showed that stiffer vessels would have a better influence on the flow of bypass. To this end, the current study has made an attempt to compare these two blood vessels’ stiffness, finding that Saphenous vein is stiffer than umbilical vein which is somehow as stiff as

  13. Association between superficial vein thrombosis and deep vein thrombosis of the lower extremities.

    Science.gov (United States)

    Binder, Barbara; Lackner, Helmut Karl; Salmhofer, Wolfgang; Kroemer, Susanne; Custovic, Jasmina; Hofmann-Wellenhof, Rainer

    2009-07-01

    To evaluate the occurrence of deep vein thrombosis (DVT) in patients with superficial vein thrombosis (SVT). A prospective study in patients with sonographically proven SVT. Outpatient department of the Department of Dermatology, Medical University of Graz. Patients Forty-six consecutive patients with superficial vein thrombosis were enrolled. Intervention Every patient underwent color-coded duplex sonography of both lower extremities at the beginning of the study. Important risk factors (eg, history of thromboembolic events, recent immobilization, active malignant disease, and the use of oral contraceptives) were investigated. In 24% of our patients, a concomitant, mostly asymptomatic DVT was found. In 73% of these patients, the DVT occurred in the affected leg, in 9% in the contralateral leg, and in 18% in both legs. The calf muscle veins were most commonly involved. In all patients with DVT, the SVT was located on the lower leg and the D-dimer findings were positive. Superficial vein thrombosis is not a life-threatening disease, but the risk of concomitant DVT cannot be ignored. Color-coded duplex sonography should be performed in patients with SVT to rule out DVT.

  14. A manikin-based evaluation of a teaching modality for ultrasound-guided infraclavicular longitudinal in-plane axillary vein cannulation in comparison with ultrasound-guided internal jugular vein cannulation: A pilot study

    Directory of Open Access Journals (Sweden)

    Sanjib Adhikary

    2017-01-01

    Conclusion: A teaching model for US-guided infraclavicular longitudinal in-plane AXV cannulation can be established using a phantom model. A focused educational program would result in an appreciable change in preference in embracing US-based cannulation techniques among residents.

  15. Quantification of deep medullary veins at 7 T brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kuijf, Hugo J.; Viergever, Max A.; Vincken, Koen L. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Bouvy, Willem H.; Razoux Schultz, Tom B.; Biessels, Geert Jan [University Medical Center Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht (Netherlands); Zwanenburg, Jaco J.M. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)

    2016-10-15

    Deep medullary veins support the venous drainage of the brain and may display abnormalities in the context of different cerebrovascular diseases. We present and evaluate a method to automatically detect and quantify deep medullary veins at 7 T. Five participants were scanned twice, to assess the robustness and reproducibility of manual and automated vein detection. Additionally, the method was evaluated on 24 participants to demonstrate its application. Deep medullary veins were assessed within an automatically created region-of-interest around the lateral ventricles, defined such that all veins must intersect it. A combination of vesselness, tubular tracking, and hysteresis thresholding located individual veins, which were quantified by counting and computing (3-D) density maps. Visual assessment was time-consuming (2 h/scan), with an intra-/inter-observer agreement on absolute vein count of ICC = 0.76 and 0.60, respectively. The automated vein detection showed excellent inter-scan reproducibility before (ICC = 0.79) and after (ICC = 0.88) visually censoring false positives. It had a positive predictive value of 71.6 %. Imaging at 7 T allows visualization and quantification of deep medullary veins. The presented method offers fast and reliable automated assessment of deep medullary veins. (orig.)

  16. A vein display system based on three-dimensional reconstruction

    Science.gov (United States)

    Wang, Danting; Zhou, Ya; Hu, Xiaoming; Wu, Zhaoguo; Dai, Xiaobin

    2014-10-01

    Venipuncture is the most common way of all invasive medical procedures. A vein display system can make vein access easier by capturing the vein information and projecting a visible vein image onto the skin, which is correctly aligned with the subject's vein. The existing systems achieve correct alignment by the design of coaxial structure. Such a structure causes complex optical and mechanical design and big physical dimensions inevitably. In this paper, we design a stereovision- based vein display system, which consists of a pair of cameras, a DLP projector and a near-infrared light source. We recover the three-dimensional venous structure from image pair acquired from two near-infrared cameras. Then the vein image from the viewpoint of projector is generated from the three-dimensional venous structure and projected exactly onto skin by the DLP projector. Since the stereo cameras get the depth information of vessels, the system can make sure the alignment of projected veins and the real veins without a coaxial structure. The experiment results prove that we propose a feasible solution for a portable and low-cost vein display device.

  17. Computed tomographic evaluation of the portal vein in the hepatomas

    International Nuclear Information System (INIS)

    Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam

    1986-01-01

    Computed tomography and pornographic findings of 63 patients with hepatoma, undergone hepatic angiography and superior mesenteric pornography for evaluation of tumor and thrombosis of portal vein and determination of indication of transcatheter arterial embolization for palliative treatment of hepatoma from April, 85 to June, 86 in Hanyang university hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis was detected during photography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the liver showed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liver revealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2. Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence of portal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal vein thrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did not reveal contrast enhancement. 4. CT revealed well the evidence of obstructions in the cases of portal vein thrombosis and the findings were well-corresponded to the findings of the superior mesenteric photography. 5. Five of the cases of the portal vein thrombosis were missed in the CT and the causes were considered as due to partial volume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases with occlusion of main portal vein showed cavernous transformation and they were noted as multiple small enhanced vascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a useful modality to detect the changes of the portal veins in the patients of the hepatoma.

  18. Computed tomographic evaluation of the portal vein in the hepatomas

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1986-10-15

    Computed tomography and pornographic findings of 63 patients with hepatoma, undergone hepatic angiography and superior mesenteric pornography for evaluation of tumor and thrombosis of portal vein and determination of indication of transcatheter arterial embolization for palliative treatment of hepatoma from April, 85 to June, 86 in Hanyang university hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis was detected during photography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the liver showed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liver revealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2. Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence of portal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal vein thrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did not reveal contrast enhancement. 4. CT revealed well the evidence of obstructions in the cases of portal vein thrombosis and the findings were well-corresponded to the findings of the superior mesenteric photography. 5. Five of the cases of the portal vein thrombosis were missed in the CT and the causes were considered as due to partial volume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases with occlusion of main portal vein showed cavernous transformation and they were noted as multiple small enhanced vascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a useful modality to detect the changes of the portal veins in the patients of the hepatoma.

  19. Five-year follow-up of treatment outcomes in patients with early-stage breast cancer and clinically negative axillary nodes treated with no lymph node dissection or axillary clearance

    Directory of Open Access Journals (Sweden)

    Yamamoto D

    2012-08-01

    Full Text Available Daigo Yamamoto,1 Kanji Tanaka,2 Yu T subota,1 Noriko Sueoka,1 Tetsuji Shoji,3 Kayoko Kuwana,1 A-Hon Kwon11Department of Surgery, Kansai Medical University, Hirakata, 2Ribon-Rose Tanaka Kanji Breast Clinic, 3Shoji Clinic, Osaka, JapanBackground: Sentinel lymph node biopsy has steadily replaced axillary lymph node dissection (ALND for staging clinically node-negative breast cancer. However, ALND remains standard management of the axilla when a tumor-positive sentinel lymph node is identified.Methods: We identified 460 patients with breast cancer (clinically T1/T2N0M0 from the database for 1999–2004. Patient age ranged from 26 to 81 (median 50 years. Patients who underwent mastectomy or breast-conserving surgery with or without ALND were compared for regional recurrence, disease-free survival, and overall survival.Results: Patients with ALND (n = 308 were compared with the no ALND group (n = 152. Five-year overall survival and disease-free survival were not significantly different between the two groups, while there was a significant difference between them for regional recurrence. Of the 152 patients who did not undergo axillary dissection, four developed ipsilateral axillary disease, most of whom were rescued by delayed axillary dissection. Further, the criterion for identifying lymphedema was used, ie, a 2 cm circumferential change at any measured location. As a result, the incidence of lymphedema in the ALND group was 12.7%, while it was not seen in the non ALND group.Conclusion: There is a possibility that ALND may be omitted for cT1/T2N0M0 breast cancer through a combination of hormone therapy and adjuvant chemotherapy.Keywords: breast cancer, axillary lymph node dissection

  20. Disc edge veins of Kraupa: rare exit anomalies of the retinal vein.

    OpenAIRE

    Barroso, L; Hoyt, W F; Narahara, M

    1992-01-01

    Disc edge veins of Kraupa are anomalies of the retinal venous system in which blood flows from the retina through a single venous trunk at or near the edge of the disc instead of at its centre. We report two examples of patients with these anomalies and illustrate the appearance of the anomalies with fundus photographs and a fluorescein angiogram. In one patient the retinal vein exited the eye through the sclera at the margin of the optic disc; in the other it disappeared into the disc tissue...

  1. Mesenteric vein thrombosis after percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma

    Energy Technology Data Exchange (ETDEWEB)

    Luska, G.; Langer, H.E.; Le Blanc, S.

    1984-07-01

    The authors report on a fatal mesenteric vein thrombosis following an uncomplicated percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma. Several hours after the procedure the patient developed an acute abdomen. An emergency laparotomy revealed a haemorrhagic infarct of the ileum. The resected specimen showed an acute phlebitis with fresh thrombus. The cause of the phlebothrombosis was thought to be intimal damage from high osmolar contrast medium. There was no evidence of damage due to the catheder, either on the phlebogram or pathologically. 1 fig.

  2. Mesenteric vein thrombosis after percitaneous transhepatic portal vein catheterisation for the localisation of an insulinoma

    International Nuclear Information System (INIS)

    Luska, G.; Langer, H.E.; Le Blanc, S.; Medizinische Hochschule Hannover

    1984-01-01

    The authors report on a fatal mesenteric vein thrombosis following an uncomplicated percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma. Several hours after the procedure the patient developed an acute abdomen. An emergency laparotomy revealed a haemorrhagic infarct of the ileum. The resected specimen showed an acute phlebitis with fresh thrombus. The cause of the phlebothrombosis was thought to be intimal damage from high osmolar contrast medium. There was no evidence of damage due to the catheder, either on the phlebogram or pathologically. (orig.) [de

  3. Portal vein and mesenteric vein gas: CT features; Aeroportie ety aeromesenterie: donnees TDM

    Energy Technology Data Exchange (ETDEWEB)

    Schmutz, G.; Fournier, L.; Le Pennec, V.; Provost, N.; Hue, S.; Phi, I.N. [Centre Hospitalier Universitaire, 14 - Caen (France)

    2001-04-01

    Portal vein and mesenteric vein gas are unusual conditions with a complex and nuclear pathogenesis. Mesenteric ischemia frequently causes such pathological conditions but a variety of other causes are known: inflammatory bowel disease, bowel distension, traumatic and iatrogenic injury, intra-abdominal sepsis, and idiopathic conditions. This pathologic entity is favored by intestinal wall alterations, bowel distension and sepsis. The prognosis is frequently fatal, especially when associated with extended bowel necrosis although in the majority of the cases, outcome is favorable without surgery. (author)

  4. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study.

    NARCIS (Netherlands)

    Beurskens, C.H.G.; Uden, C. van; Strobbe, L.J.; Oostendorp, R.A.B.; Wobbes, Th.

    2007-01-01

    BACKGROUND: Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physiotherapy has been clinically observed to improve treatment of these patients. However, it is not a standard treatment regime. The purpose of this study is to

  5. Procedural pain of an ultrasound-guided brachial plexus block: a comparison of axillary and infraclavicular approaches

    DEFF Research Database (Denmark)

    Frederiksen, Benedikte Skøtt; Koscielniak-Nielsen, Z J; Jacobsen, R B

    2010-01-01

    Ultrasound (US)-guided infraclavicular (IC) and axillary (AX) blocks have similar effectiveness. Therefore, limiting procedural pain may help to choose a standard approach. The primary aims of this randomized study were to assess patient's pain during the block and to recognize its cause....

  6. [Surgical treatment of suppurative axillary hidradenitis: value of a musculocutaneous island flap of the latissimus dorsi. Apropos of 3 cases].

    Science.gov (United States)

    Blanc, D; Tropet, Y; Balmat, P

    1990-01-01

    We report our experience of the surgical management of severe, extensive, medically intractable axillary Hidradenitis suppurativa in three male patients. Under general anaesthesia, all patients underwent large, deep and full excision of the disease prone areas, i. e. zones of apocrine sweat gland distribution and not only of the skin involved at the time of surgery, for the best possible prevention of recurrence. The operation was bilateral in two patients and unilateral in one. In all cases closure was achieved using the latissimus dorsi flap technique. In the two patients with bilateral lesions surgery was carried out in two steps at about two months' interval. At present, after a follow-up of about two years, none of the patients have relapsed and their shoulder mobility is perfectly preserved with a normal abduction allowed by the total absence of axillary scar contracture. The latissimus dorsi flap technique consists of transplanting into the recipient's axillary defect the pedicellated lateral margin of the latissimus dorsi muscle with (2 patients) or without (1 patient) a cover of attached skin palette vascularized by the underlying muscle tissue. Mainly used hitherto for reconstructive mammary surgery, this technique perfectly fits axillary diseases, such as Hidradenitis suppurativa, which can only be cured by creating wide surgical skin defects. It is particularly reliable: covering of the defect is easy and the immediate muscle interposition effectively protects the otherwise widely exposed neurovascular pedicle. The need for a skin palette cover associated with the latissimus dorsi flap is discussed.

  7. 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

  8. Coexistence of metastatic breast carcinoma and primary tuberculosis in axillary lymph nodes: a report of a rare case.

    Science.gov (United States)

    Pujani, Mukta; Khan, Sabina; Hassan, Mohd Jaseem; Jetley, Sujata; Raina, Prabhat Kumar

    2015-01-01

    Concomitant breast cancer metastasis and tubercular lymphadenitis in axillary lymph node is an extremely rare occurrence. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma and the number of axillary nodes showing metastases alters the stage. As tuberculosis also produces nodal enlargement, this can mimic or complicate the staging of malignant disease. Dual pathology in an organ can lead to difficulties in interpretation and inappropriate treatment of tuberculosis as well as carcinoma breast. Moreover, fine needle aspiration cytology (FNAC) from such cases may be misleading if only one of the diseases is picked up. Therefore, the need for multiple attempts at FNAC should be stressed upon for all palpable lumps. We report a case of infiltrating duct carcinoma breast in a 45-year-old female where tuberculosis was discovered in axillary lymph nodes in addition to metastases. As the present case led to incidental discovery of tuberculosis with tumor metastasis, it reinforces the possibility of a coexistent lesion in the pathologists' mind, especially in regions endemic for tuberculosis.

  9. The number of histologically examined axillary lymph nodes can improve the prediction of individual prognosis of primary breast cancer patients

    NARCIS (Netherlands)

    Schaapveld, M; Otter, R; E De Vries, E G; A Van der Graaf, W T; Vries, de Jakob; B Willemse, P H

    2004-01-01

    558 Background: A minimal number of histologically examined nodes has been associated with improved survival in both node-negative and node-positive patients. Following a retrospective audit of quality of axillary staging, the prognostic effect of variation in the number of histologically examined

  10. 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)

  11. 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.

  12. Axillary Artery Injury Associated with Proximal Humeral Fractures: Review of Long-Term Vascular, Orthopedic, and Neurologic Outcomes.

    Science.gov (United States)

    Ng, Andrew Jin-Hean; Arora, Varun; Tang, Howard Ho-Fung; Treseder, Thomas; Jain, Arvind; Wagner, Timothy

    2016-05-01

    Fracture and dislocation of the proximal humerus is common. It is associated with a number of vascular, neurologic, and orthopedic complications; these include brachial plexopathy and avascular necrosis (AVN) of the humeral head. These complications are rare but can potentially cause severe disability to patients; however, they remain poorly described in the literature. To describe vascular, orthopedic, and neurologic outcomes after axillary artery repair, in patients with proximal humeral fractures or dislocations. We conducted a retrospective review of patients admitted to 2 tertiary trauma centers in Victoria, Australia, with fracture or dislocation of the proximal humerus and associated axillary artery injury. Patients were selected according to guidelines for trauma call or alert and the presence of high-risk mechanism of injury. Data on vascular, orthopedic, and neurologic complications were collected. Twenty-one patients were identified. Injury to the first part of the axillary artery was noted in 11 patients (52%). Brachial plexus exploration was performed in 17 patients (81%). Four patients (19%) underwent nerve repair. Long-term neurologic recovery was universally poor. Major orthopedic complications included AVN of the humeral head, delayed union, and the need for prosthesis or arthrodesis. Eleven patients (52%) received upper limb fasciotomy. Five patients (24%) underwent delayed secondary upper limb amputation. There was an unusually high rate of injuries to the first part of the axillary artery. Close clinical observation is recommended for such patients. AVN of the humeral head and brachial plexopathy remain significant and debilitating complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Effect of axillary lymph node dissection on prevalence and intensity of chronic and phantom pain after breast cancer surgery.

    NARCIS (Netherlands)

    Steegers, M.A.H.; Wolters, B.; Evers, A.W.; Strobbe, L.; Wilder-Smith, O.H.G.

    2008-01-01

    Chronic pain after breast cancer surgery is a major problem and is expected to increase in the coming years because of an increased prevalence of breast cancer coupled with better survival. Axillary lymph node dissection (ALND) in patients with breast cancer is associated with nerve damage. The

  14. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients.

    Science.gov (United States)

    Rodríguez, Pedro M; Freixinet, Jorge L; Hussein, Mohamed; Valencia, Jose M; Gil, Rita M; Herrero, Jorge; Caballero-Hidalgo, Araceli

    2008-09-01

    Thoracic sympathectomy (TS) is the treatment of choice for severe primary hyperhidrosis. However, complications, side effects and satisfaction have not been well defined. To analyze the complications, side effects, satisfaction degree and quality of life of patients after TS for primary upper limb hyperhidrosis. One-year follow-up after 406 consecutive TS for primary upper limb hyperhidrosis. Bilateral TS was completed in all patients. Complications arose in 23 cases (5.6%), with pneumothorax being the most frequent. The success rate after discharge, 6 and 12 months was respectively, 100%, 98.1% and 96.5% for palmo-axillary hyperhidrosis; 100%, 99.3% and 97.8% for isolated palmar hyperhidrosis and 100%, 85.7% and 71.4% for isolated axillary hyperhidrosis. No persistence of hyperhidrosis was observed. Global recurrence was 3.7% (28.5% axillary hyperhidrosis group). Compensatory sweating (CS) appeared in 55% and was not related to the extension of the TS. Being female was a predisposing factor of CS (p<0.004). Excessive dryness appeared at 9% and was associated with extensive TS (P<0.001). Plantar hyperhidrosis improved at 33.6%, worsened at 10% and remained stable during the follow-up. Satisfaction degree decreased with the passage of time and was associated with recurrence. Quality of life was excellent at discharge, 6 and 12 month in 100%, 100% and 97%, respectively. Pneumothorax is the most frequent complication of TS. CS is the main and undesirable side effect, appears with the passage of time, and is not related to the extension of TS. Being female is the only predictor factor of suffering CS. Plantar hyperhidrosis improves initially, although tends to reappear. Excessive dryness appears in extensive TS and does not improve over time. Postoperative satisfaction degree is high but decreases over time owing to the appearance of recurrence. Effectiveness and the absence of CS determine an excellent quality of life. Six percent of the patients regret the surgery

  15. Design and development of a dedicated mammary and axillary region positron emission tomography system

    Science.gov (United States)

    Doshi, Niraj Kumar

    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 a 9x9 array of 3x3x20 mm3 lutetiurn oxyorthosilicate (LSO) detector elements, read out by a 5x5 array of position- sensitive photomultiplier tubes. The average measured intrinsic spatial resolution of a detector module is 2.26 mm with a sensitivity of up to 40% for a central point source. The measured coincidence timing resolution for two modules is 2.4 ns. The average energy resolution measured across the entire two detector plates is 21.6%. The coincidence timing resolution for the entire system is 8.1 ns. A line bar phantom was imaged and images were reconstructed using the focal plane tomography algorithm. A 4 mm projection image resolution was measured based on profiles taken through the line bar phantom images. The goal of the maxPET system will be to aid in breast cancer patient management by assisting in imaging women with dense, fibro-glandular breasts, detecting axillary lymph node metastases without surgery, monitoring chemotherapy effectiveness and

  16. 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

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

    Science.gov (United States)

    Shahtalebi, Mohammad Ali; Ghanadian, Mustafa; Farzan, Ali; Shiri, Niloufar; Shokri, Dariush; Fatemi, Syed Ali

    2013-10-01

    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. 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). 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 (P sage extract sticks (P sage extract of 200, 400, or 600

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

    International Nuclear Information System (INIS)

    Chiofalo, Maria Grazia; Losito, Nunzia Simona; Fulciniti, Franco; Setola, Sergio Venanzio; Tommaselli, Antonio; Marone, Ugo; Di Cecilia, Maria Luisa; Pezzullo, Luciano

    2012-01-01

    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. 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. 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

  19. The compression syndrome of the left renal vein

    International Nuclear Information System (INIS)

    Justich, E.

    1982-01-01

    Severe compression of the left renal vein produces a pressure gradient between it and the inferior vena cava and results in changes in haemodynamics. The cause of the narrowing is usually the aorta, less commonly the superior mesenteric artery. Compression of the left renal vein may be responsible for a number of abnormalities such as primary varicoceles, primary varices of the ovarian, renal, pelvic and ureteric veins on the left, the more frequent occurrence of unilateral renal vein thrombosis on the left and the development of renovascular hypertension. One hundred and twenty-three selective phlebograms of the left renal vein and CT examinations of this structure in a further 87 patients acting as a control group were carried out. The significance of compression of the left renal vein as an aetiological factor in the development of the above mentioned abnormalities is discussed. (orig.) [de

  20. A superior mesenteric vein thrombosis associated with in vitro fertilization.

    Science.gov (United States)

    Dorais, Jessie; Jones, Kirtly; Hammoud, Ahmad; Gibson, Mark; Johnstone, Erica; Peterson, C Matthew

    2011-02-01

    To describe a case of superior mesenteric vein thrombosis associated with IVF. Case report. University teaching hospital. A 33-year-old female developed progressive abdominal pain several days after ET in her first IVF cycle. A computed tomography scan 12 days after ET showed a superior mesenteric vein thrombosis. Therapeutic anticoagulation. Resolution of the superior mesenteric vein thrombosis with therapeutic anticoagulation. Early diagnosis and treatment of a superior mesenteric vein thrombosis associated with IVF led to a favorable outcome. Endocrine alterations consequent to controlled ovarian hyperstimulation for IVF place patients at risk for thromboembolic events. Thromboembolic events may occur during an IVF cycle in the absence of overt ovarian hyperstimulation, an inherited thrombophilia, or pregnancy. Early diagnosis and treatment of superior mesenteric vein thrombosis can lead to a favorable outcome. Treatment guidelines for superior mesenteric vein thrombosis in setting of IVF are discussed. Published by Elsevier Inc.

  1. Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient

    Directory of Open Access Journals (Sweden)

    Marian Simka

    2012-01-01

    Full Text Available We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed totally collapsed middle part of the treated vein with no outflow detected. Still, the vein widened and the flow was restored when the patient’s mouth opened. Thus, the abnormality was likely to be caused by muscular compression. Surgical exploration confirmed that an atypical omohyoid muscle was squeezing the vein. Consequently, pathological muscle was transected. Sonographic control three weeks after surgical procedure revealed a decompressed vein with fully restored venous outflow. Although such a muscular compression can be successfully managed surgically, future research has to establish its clinical relevance.

  2. The sensitivity of pre-operative axillary staging in breast cancer: comparison of invasive lobular and ductal carcinoma.

    Science.gov (United States)

    Topps, A; Clay, V; Absar, M; Howe, M; Lim, Y; Johnson, R; Bundred, N

    2014-07-01

    Axillary ultrasound (AUS) with fine-needle aspiration (FNA) biopsy of abnormal lymph nodes is important for pre-operative staging and planning the surgical management of the axilla. Invasive lobular carcinoma (ILC) metastases are thought to be difficult to detect because the cells are small and on cytology resemble lymphocytes. To investigate this we directly compared the sensitivity of pre-operative axillary staging between ILC and invasive ductal carcinoma (IDC). Consecutive patients that presented in a single breast unit with pure IDC between April 2005 and December 2006 and pure ILC between January 2008 and December 2012 were retrospectively identified from pathology records. Pre-operative axillary ultrasound and FNA biopsy results were compared with post-operative histopathology from the sentinel node biopsy (SNB) or axillary lymph node dissection (ALND). A total of 275 and 142 axillae were identified in the IDC and ILC groups respectively. In the node positive patients there was no significant difference in the sensitivity of AUS (IDC vs. ILC; 58.7% vs. 52.8%). However, there was a significant difference in the sensitivity of ultrasound-guided FNA biopsy of abnormal nodes (IDC vs. ILC; 98.4% vs. 53.6%; p < 0.001). AUS has comparative sensitivities between IDC and ILC populations. In contrast, FNA biopsy of abnormal axillary nodes is clearly less sensitive in the ILC group. In these patients, who have abnormal AUS, we suggest that a core biopsy is required to improve the pre-operative staging and prevent unnecessary surgical procedures. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Biomechanical contributions of posterior deltoid and teres minor in the context of axillary nerve injury: a computational study.

    Science.gov (United States)

    Crouch, Dustin L; Plate, Johannes F; Li, Zhongyu; Saul, Katherine R

    2013-02-01

    To determine whether transfer to only the anterior branch of the axillary nerve will restore useful function after axillary nerve injury with persistent posterior deltoid and teres minor paralysis. We used a computational musculoskeletal model of the upper limb to determine the relative contributions of posterior deltoid and teres minor to maximum joint moment generated during a simulated static strength assessment and to joint moments during 3 submaximal shoulder movements. Movement simulations were performed with and without simulated posterior deltoid and teres minor paralysis to identify muscles that may compensate for their paralysis. In the unimpaired limb model, teres minor and posterior deltoid accounted for 16% and 14% of the total isometric shoulder extension and external rotation joint moments, respectively. During the 3 movement simulations, posterior deltoid produced as much as 20% of the mean shoulder extension moment, whereas teres minor accounted for less than 5% of the mean joint moment in all directions of movement. When we paralyzed posterior deltoid and teres minor, the mean extension moments generated by the supraspinatus, long head of triceps, latissimus dorsi, and middle deltoid increased to compensate. Compensatory muscles were not fully activated during movement simulations when posterior deltoid and teres minor were paralyzed. Reconstruction of the anterior branch of the axillary nerve only is an appropriate technique for restoring shoulder abduction strength after isolated axillary nerve injury. When shoulder extension strength is compromised by extensive neuromuscular shoulder injury, reconstruction of both the anterior and posterior branches of the axillary nerve should be considered. By quantifying the biomechanical role of muscles during submaximal movement, in addition to quantifying muscle contributions to maximal shoulder strength, we can inform preoperative planning and permit more accurate predictions of functional outcomes

  4. Endovascular Treatment of Deep Vein Thrombosis.

    Science.gov (United States)

    Javier, Julian J

    2014-10-01

    Venous thromboembolism (VTE) is associated with substantial morbidity and mortality. Conventional treatment with anticoagulation therapy may undertreat the condition. Patients with VTE are at risk for recurrence with increasing time passage. Endovascular approaches exist for treating VTE, including deep vein thrombosis, but it is unclear which patients are appropriate candidates for endovascular versus medical approaches. Many new endovascular technologies are in development, and new oral anticoagulants are also on the market. Clinicians must be mindful of these new products and use them appropriately to better manage VTE. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Central Retinal Vein Occlusion Revealing Coelic Disease

    Directory of Open Access Journals (Sweden)

    Hana ZOUBEIDI

    2016-11-01

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

  6. [How to do: central vein catheterization].

    Science.gov (United States)

    Allgäuer, Sebastian

    2016-03-01

    The cannulation of a central vein is a standard acces to the vascular system of critically ill patients. It can be used for administration of medication and parenteral nutrition, haemodynamic monitoring as well as hemodialsis via Shaldon catheter.The technique of implantation of a central venous catheter is described step by step in this article. Moreover, advantages and disadvantages of the different techniques and puncture sites as well as indications and contraindications are critically discussed regarding the most recent literature. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Deep vein thrombosis chemoprophylaxis in plastic surgery.

    Science.gov (United States)

    Gold, Alan

    2013-07-01

    The practice of plastic surgery is a unique mixture of art and science, and both must be carefully balanced to provide the best possible care for patients. To do that, clinicians should be practicing evidence-based medicine. This article discusses the prevalence and risks associated with deep vein thrombosis and the reasons and options for its possible chemoprophylaxis. Until evidence-based medicine best-practice recommendations can be developed, it would be prudent for clinicians to empirically select and consistently apply a risk stratification system and prophylaxis regimen of their choice for the benefit of their patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Unilateral pulmonary vein atresia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, So Hwa; Kim, Ki Jun [Dept. of Radiology, Incheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Incheon (Korea, Republic of)

    2014-01-15

    Unilateral pulmonary vein atresia is a rare congenital anomaly. Its symptoms begin to manifest in childhood and a broad spectrum of clinical severity has been described, ranging from asymptomatic, recurrent pulmonary infection, severe hemoptysis, to death. Only a few adult cases with this condition, with no or mild symptoms, have been reported. Pulmonary angiography has been typically used for definite diagnosis. However, pulmonary angiography may be replaced with the current developing multidetector CT. This report presents an adult case with mild symptoms, diagnosed by multidetector CT.

  9. Vein mechanism simulation study for deep vein thrombosis early diagnosis using cfd

    Science.gov (United States)

    Ibrahim, Nabilah; Aziz, Nur Shazilah Abd; Manap, Abreeza Noorlina Abd

    2017-04-01

    Using a Computational Fluid Dynamics (CFD) technique, this work focus on the analysis of pressure, velocity, and vorticity of blood flow along the popliteal vein. Since the study of early stage of Deep Vein Thrombosis (DVT) becomes essential to prevent the pulmonary embolism (PE), those three parameters are analysed to assess the effect of different opening between two valves of a normal popliteal vein. When only one valve is simulated, the result of pressure shows that the highest and lowest velocities are 15.45 cm/s and 0.73 cm/s, respectively. From the visualization of observed data, however, the different size of orifice between the first and second valves influencing the velocity and vorticity of the blood flow. The rotational motion of blood particle at the same region increases the probability of blood accumulating which is associated with the development of thrombus. Thus, a series of experiment has been conducted by changing the size of valve orifice for the first and second valves along the vein distribution. The result of the CFD simulation shows a significant variation in blood flow in terms of velocity and vorticity.

  10. Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis.

    Science.gov (United States)

    Gradman, Wayne S

    2015-04-01

    The possible benefits of endovenous saphenous ablation (EVSA) as initial treatment in patients presenting with isolated superficial-vein thrombosis (SVT) and saphenous vein reflux include: (1) definitive treatment of the underlying pathology and (2) elimination of the saphenous vein as a path for pulmonary emboli, which (3) may eliminate the need for anticoagulation. In a ten-year review of 115 limbs presenting with acute isolated SVT, 72 limbs (71 patients) with saphenous reflux were given a choice of two treatments following an explanation of the risks and benefits of each. Group I limbs (n = 41) were treated with office EVSA using radiofrequency or laser with or without thrombophlebectomy if performed within 45 days of diagnosis. Post-treatment anticoagulants were not given. Group II limbs (n = 31) were treated with compression hose and repeat Duplex within one week, with added anticoagulants if SVT extended into the thigh. In group I, mean interval from diagnosis to treatment was 13.7 days. One calf deep vein thrombosis was noted. In group II no complications were noted. In late follow-up of group II patients, 12/29 underwent EVSA more than 45 days after initial presentation. The safety and efficacy of EVSA and thrombophlebectomy appear indistinguishable from conservative measures and may be offered as initial treatment to patients presenting with SVT and saphenous reflux. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. Treatment of superficial vein thrombosis to prevent deep vein thrombosis and pulmonary embolism: a systematic review

    NARCIS (Netherlands)

    Wichers, Iris M.; Di Nisio, Marcello; Büller, Harry R.; Middeldorp, Saskia

    2005-01-01

    The aim of this systematic review was to summarize the evidence from randomized controlled trials (RCT) concerning the efficacy and safety of medical or surgical treatments of superficial vein thrombosis (SVT) for the prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE). A

  12. Reduced risk of axillary lymphatic spread in triple-negative breast cancer

    DEFF Research Database (Denmark)

    Holm-Rasmussen, Emil Villiam; Jensen, Maj-Britt; Balslev, Eva

    2015-01-01

    We examined the association between the hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status of women with primary breast cancer and the risk of axillary lymph node (ALN) involvement at the time of diagnosis. Information on 20,009 women diagnosed with primary breast...... cancer between 2008 and 2012 was retrieved from the Danish Breast Cancer Cooperative Group database. The associations between clinical and pathological variables and ALN involvement at the time of diagnosis were evaluated in univariate and multivariate regression analyses, as well as the significance...... of tumor subtypes in ALN involvement. The risk of ALN metastases at the time of diagnosis was significantly reduced in HR-negative patients compared to HR-positive patients [adjusted odds ratio (OR) 0.69; 95 % CI 0.63-0.76; P = 0.0009]. A HER2-positive status was associated with an increased risk of ALN...

  13. Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

    Science.gov (United States)

    Ellsworth, Rachel E; Toro, Allyson L; Blackburn, Heather L; Decewicz, Alisha; Deyarmin, Brenda; Mamula, Kimberly A; Costantino, Nicholas S; Hooke, Jeffrey A; Shriver, Craig D; Ellsworth, Darrell L

    2015-01-01

    Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN) metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome (P = 0.009). In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance. PMID:26279627

  14. Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

    Directory of Open Access Journals (Sweden)

    Rachel E. Ellsworth

    2015-01-01

    Full Text Available Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome ( P = 0.009. In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance.

  15. 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.

  16. Axillary nerve palsy following blunt trauma to the shoulder region: a clinical and electrophysiological review.

    Science.gov (United States)

    Berry, H; Bril, V

    1982-01-01

    Although the commonest type of axillary nerve palsy occurs following shoulder dislocation on humeral fracture, another form is seen after blunt trauma to the shoulder region without associated fracture or dislocation. The former usually goes on to a full recovery whereas a failure to recover is common in the latter group. In our review of 13 patients with palsy after blunt shoulder trauma, seven patients showed minimal or no recovery of deltoid muscle function and six patients went on to complete or near complete recovery. Serial electromyographic examinations usually revealed the lesion to be in continuity although eventual clinical recovery was not satisfactory in a number of these patients. The mechanism of the palsy appeared to involve a stretch injury and this was confirmed at operation in two patients. Glenohumeral fixation was a troublesome complication which limited recovery of function in four patients. Further details of the type of trauma, clinical and electromyographic examination, assessment and management are discussed. Images PMID:7175526

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

    Science.gov (United States)

    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. Georg Thieme Verlag KG Stuttgart · New York.

  18. Locoregional failure of postmastectomy patients with 1-3 positive axillary lymph nodes without adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Cheng, Jason C.-H.; Chen, C.-M.; Liu, M.-C.; Tsou, M.-H.; Yang, P.-S.; Jian, J. J.-M.; Cheng, S.H.; Tsai, S.Y.; Leu, S.-Y.; Huang, A.T.

    2002-01-01

    Purpose: To analyze the incidence and risk factors for locoregional recurrence (LRR) in patients with breast cancer who had T1 or T2 primary tumor and 1-3 histologically involved axillary lymph nodes treated with modified radical mastectomy without adjuvant radiotherapy (RT). Methods and Materials: Between April 1991 and December 1998, 125 patients with invasive breast cancer were treated with modified radical mastectomy and were found to have 1-3 positive axillary nodes. The median number of nodes examined was 17 (range 7-33). Of the 125 patients, 110, who had no adjuvant RT and had a minimum follow-up of 25 months, were included in this study. Sixty-nine patients received adjuvant chemotherapy and 84 received adjuvant hormonal therapy with tamoxifen. Patient-related characteristics (age, menopausal status, medial/lateral quadrant of tumor location, T stage, tumor size, estrogen/progesterone receptor protein status, nuclear grade, extracapsular extension, lymphovascular invasion, and number of involved axillary nodes) and treatment-related factors (chemotherapy and hormonal therapy) were analyzed for their impact on LRR. The median follow-up was 54 months. Results: Of 110 patients without RT, 17 had LRR during follow-up. The 4-year LRR rate was 16.1% (95% confidence interval [CI] 9.1-23.1%). All but one LRR were isolated LRR without preceding or simultaneous distant metastasis. According to univariate analysis, age <40 years (p=0.006), T2 classification (p=0.04), tumor size ≥3 cm (p=0.002), negative estrogen receptor protein status (p=0.02), presence of lymphovascular invasion (p=0.02), and no tamoxifen therapy (p=0.0006) were associated with a significantly higher rate of LRR. Tumor size (p=0.006) was the only risk factor for LRR with statistical significance in the multivariate analysis. On the basis of the 4 patient-related factors (age <40 years, tumor ≥3 cm, negative estrogen receptor protein, and lymphovascular invasion), the high-risk group (with 3 or 4

  19. Allergic axillary dermatitis due to hydrogenated castor oil in a deodorant.

    Science.gov (United States)

    Taghipour, Kathy; Tatnall, Frances; Orton, David

    2008-03-01

    We present a case of axillary dermatitis caused by hydrogenated castor oil (HCO) in a commercially available deodorant. Patch testing with constituents obtained from the manufacturer showed allergic reaction to HCO 'as is', whereas there was no reaction to HCO 30% in pet. Testing 10 controls with HCO 'as is' did not cause irritant contact dermatitis. Allergic contact dermatitis to non-HCO in cosmetics has been described previously but sensitization to HCO seems to be rare. Most common allergens identified in deodorants are fragrances, and this case illustrates that HCO is another possible allergen found in this group of personal care products. It is important that it is tested 'as is' to avoid false-negative results.

  20. 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......) database we have estimated the magnitude and therapeutic consequences of this stage migration in Denmark by comparing the distribution of lymph node metastases in breast cancer patients operated in 1993-1996 and 2005-2008; before and after introducing SLND. The proportion of patients having macrometastases...

  1. Intercostobrachial nerve handling and pain after axillary lymph node dissection for breast cancer

    DEFF Research Database (Denmark)

    Andersen, Kenneth Geving; Aasvang, E K; Kroman, N

    2014-01-01

    BACKGROUND: Moderate to severe pain in the first week after axillary lymph node dissection (ALND) for breast cancer is experienced by approximately 50% of the patients. Damage to the intercostobrachial nerve (ICBN) has been proposed as a risk factor for the development of persistent pain following......%) partially preserved and 49 (37%) sectioned. At 1 week after surgery, 104 patients (78%) reported pain, whereas 35 (26%) reported moderate to severe pain. There was no difference between the ICBN groups in pain scores or sensory disturbances measured pre-operatively compared to 1 week post...... breast cancer surgery but with limited information on acute post-operative pain. The aim of the present study was to examine the influence of ICBN handling on pain during the first week after ALND. METHODS: The study was part of a larger prospective cohort study on persistent pain after breast cancer...

  2. Case Report and Dosimetric Analysis of an Axillary Recurrence After Partial Breast Irradiation with Mammosite Catheter

    International Nuclear Information System (INIS)

    Shah, Anand P.; Dickler, Adam; Kirk, Michael C.; Chen, Sea S.; Strauss, Jonathan B.; Coon, Alan B.; Turian, Julius V.; Siziopikou, Kalliopi; Dowlat, Kambiz; Griem, Katherine L.

    2008-01-01

    Partial breast irradiation (PBI) was designed in part to decrease overall treatment times associated with whole breast radiation therapy (WBRT). WBRT treats the entire breast and usually portions of the axilla. The goal of PBI is to treat a smaller volume of breast tissue in less time, focusing the dose around the lumpectomy cavity. The following is a case of a 64-year-old woman with early-stage breast cancer treated with PBI who failed regionally in the ipsilateral axilla. With our dosimetric analysis, we found that the entire area of this axillary failure would have likely received at least 45 Gy if WBRT had been used, enough to sterilize microscopic disease. With PBI, this area received a mean dose of only 2.8 Gy, which raises the possibility that this regional failure may have been prevented had WBRT been used instead of PBI

  3. 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.......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....../3 of patients with ITC in sentinel node for an ALND. In patients with micrometastases in sentinel node the risk of NSN metastases was significantly associated with increasing tumor size, lymphovascular invasion, negative hormone receptor status, location of tumor in the upper lateral quadrant of the breast...

  4. Axillary nerve palsy consequent to a guided manual stretch of the upper extremities: a case report.

    Science.gov (United States)

    Heckmann, Josef G

    2014-05-01

    Reflexive breathing therapy and complementary manual therapy aim to improve breathing by mobilizing the chest, reducing the muscle tone of the breath supporting muscles, and improving secretion and chest wall compliance. We describe an uncommon case of axillary nerve (AN) palsy in association with a treatment session of reflexive breathing therapy combined with manual therapy. After a therapist's guided intensive movement of crossed arms in front of the body, upward, as high as possible, a sudden ache in the left shoulder that radiated to the lateral upper arm occurred along with loss of elevation and abduction of the shoulder. An electrophysiological examination demonstrated a diminished and delayed compound muscle action potential that indicated AN injury. Following conservative treatment, the nerve dysfunction resolved completely. Stretching of the nerve may have resulted in tearing some nerve fibers and is discussed as a possible pathophysiological mechanism.

  5. [Portal perfusion with right gastroepiploic vein flow in liver transplant].

    Science.gov (United States)

    Mendoza-Sánchez, Federico; Javier-Haro, Francisco; Mendoza-Medina, Diego Federico; González-Ojeda, Alejandro; Cortés-Lares, José Antonio; Fuentes-Orozco, Clotilde

    Liver transplantation in patients with liver cirrhosis, portal vein thrombosis, and cavernous transformation of the portal vein, is a complex procedure with high possibility of liver graft dysfunction. It is performed in 2-19% of all liver transplants, and has a significantly high mortality rate in the post-operative period. Other procedures to maintain portal perfusion have been described, however there are no reports of liver graft perfusion using right gastroepiploic vein. A 20 year-old female diagnosed with cryptogenic cirrhosis, with a Child-Pugh score of 7 points (class "B"), and MELD score of 14 points, with thrombosis and cavernous transformation of the portal vein, severe portal hypertension, splenomegaly, a history of upper gastrointestinal bleeding due to oesophageal varices, and left renal agenesis. The preoperative evaluation for liver transplantation was completed, and the right gastroepiploic vein of 1-cm diameter was observed draining to the infrahepatic inferior vena cava and right suprarenal vein. An orthotopic liver transplantation was performed from a non-living donor (deceased on January 30, 2005) using the Piggy-Back technique. Portal vein perfusion was maintained using the right gastroepiploic vein, and the outcome was satisfactory. The patient was discharged 13 days after surgery. Liver transplantation was performed satisfactorily, obtaining an acceptable outcome. In this case, the portal perfusion had adequate blood flow through the right gastroepiploic vein. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  6. Characterization of a porcine model of chronic superficial varicose veins.

    Science.gov (United States)

    Jones, Gregory T; Grant, Mark W; Thomson, Ian A; Hill, B Geraldine; van Rij, André M

    2009-06-01

    Previous animal models of venous disease, while inducing venous hypertension and valvular insufficiency, do not produce superficial varicose veins. In this study, we aimed to develop and characterize a pig-based model of superficial varicose veins. Right femoral arteriovenous fistulae (AVF) were surgically fashioned in young adult pigs. Animals were examined at postoperative times up to 15 weeks to determine the development of varicose veins and measurement of both blood pressure and flow velocities within the superficial thigh veins. Histology and vascular corrosion casts were used to characterize the resulting structural venous alterations. Porcine pathophysiological features were compared with those of human primary superficial varicose veins. Gross superficial varicosities developed over the ipsilateral medial thigh region after an initial lag period of 1-2 weeks. Veins demonstrated retrograde filling with valvular incompetence, and a moderate, non-pulsatile, venous hypertension, which was altered by changes in posture and Valsalva. Venous blood flow velocities were elevated to 15-30 cm/s in varicose veins. Structurally, pig varicose veins were enlarged, tortuous, had valvular degeneration, and regions of focal medial atrophy with or without overlying intimal thickening. The superficial varicose veins, which developed within this model, have a pathophysiology that is consistent with that observed in humans. The porcine femoral AVF model is proposed as a suitable experimental model to evaluate the pathobiology of superficial venous disease. It may also be suitable for the evaluation of treatment interventions including drug therapy.

  7. Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1.

    Science.gov (United States)

    Al-Yasi, A R; Carroll, M J; Ellison, D; Granowska, M; Mather, S J; Wells, C A; Carpenter, R; Britton, K E

    2002-03-18

    In early breast cancer axillary nodes are usually impalpable and over 50% of such patients may have an axillary clearance when no nodes are involved. This work identifies axillary node status by imaging with a Tc-99m radiolabelled anti-Polymorphic Epithelial Mucin, humanised monoclonal antibody (human milk fat globule 1), prior to surgery in 30 patients. Change detection analysis of image data with probability mapping is undertaken. A specificity of 93% and positive predictive value of 92% (both 100% if a second cancer in the axilla with negative nodes is considered) were found. A strategy for combining negative imaging with the sentinel node procedure is presented. Copyright 2002 Cancer Research UK

  8. Ultrasonographic measurement of the axillary recess thickness in an asymptomatic shoulder

    Directory of Open Access Journals (Sweden)

    Gi-Young Park

    2017-04-01

    Full Text Available Purpose The purpose of this study was to measure the axillary recess (AR thickness in an asymptomatic shoulder by using ultrasonography (US and to analyze the factors affecting it. Methods We recruited 141 patients (52 males; 89 females; age, 57.7±9.9 years with unilateral shoulder pain and performed US on the unaffected shoulder. Two physiatrists measured the AR thickness of the unaffected shoulder independently. All patients were examined in an upright sitting position with 90° shoulder abduction. The ultrasonographic transducer was placed longitudinally on the mid-axillary line and along the long axis of the humeral shaft. The factors affecting the AR thickness values were analyzed, and intra-class correlation coefficients were used for assessing the reproducibility of each measurement. Results The intrarater reliability values for the two physiatrists were 0.98 and 0.96, respectively. The inter-rater reliability of the mean AR thickness measurements was 0.91. The mean AR thickness in all subjects, males, and females was 2.8±0.6 mm, 3.1±0.6 mm, and 2.6±0.5 mm (P<0.01, respectively. No difference between the left and the right sides (males, P=0.086; females, P=0.535 or between the dominant and the non-dominant sides (males, P=0.173; female, P=0.244 was found. The AR thickness correlated positively with the height (r=0.313, P<0.01 and the weight (r=0.319, P<0.01. However, it did not correlate with the body mass index (r=0.152, P=0.077 or the age (r=-0.056, P=0.515. Conclusion US measurements of the AR thickness in asymptomatic shoulders demonstrated excellent intrarater and inter-rater reliabilities. The AR thickness showed anatomical variation with sex, height, and weight.

  9. Ultrasonographic measurement of the axillary recess thickness in an asymptomatic shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Park, Gi Young; Lee, Jin Hoon; Kwon, Dae Gil [Dept. of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu (Korea, Republic of)

    2017-04-15

    The purpose of this study was to measure the axillary recess (AR) thickness in an asymptomatic shoulder by using ultrasonography (US) and to analyze the factors affecting it. We recruited 141 patients (52 males; 89 females; age, 57.7±9.9 years) with unilateral shoulder pain and performed US on the unaffected shoulder. Two physiatrists measured the AR thickness of the unaffected shoulder independently. All patients were examined in an upright sitting position with 90° shoulder abduction. The ultrasonographic transducer was placed longitudinally on the mid-axillary line and along the long axis of the humeral shaft. The factors affecting the AR thickness values were analyzed, and intra-class correlation coefficients were used for assessing the reproducibility of each measurement. The intrarater reliability values for the two physiatrists were 0.98 and 0.96, respectively. The inter-rater reliability of the mean AR thickness measurements was 0.91. The mean AR thickness in all subjects, males, and females was 2.8±0.6 mm, 3.1±0.6 mm, and 2.6±0.5 mm (P<0.01), respectively. No difference between the left and the right sides (males, P=0.086; females, P=0.535) or between the dominant and the non-dominant sides (males, P=0.173; female, P=0.244) was found. The AR thickness correlated positively with the height (r=0.313, P<0.01) and the weight (r=0.319, P<0.01). However, it did not correlate with the body mass index (r=0.152, P=0.077) or the age (r=-0.056, P=0.515). US measurements of the AR thickness in asymptomatic shoulders demonstrated excellent intrarater and inter-rater reliabilities. The AR thickness showed anatomical variation with sex, height, and weight.

  10. CT-Guided, Ethanol Sympatholysis for Primary Axillary-Palmar Hyperhidrosis.

    Science.gov (United States)

    Tsitskari, Maria; Friehs, Gerhard; Zerris, Vassilis; Georgiades, Christos

    2016-12-01

    Primary hyperhidrosis is an excessive sweating due to an overactive sympathetic system. Our objective was to test the feasibility and provide early data on the safety/efficacy of CT-guided sympatholysis, for primary hyperhidrosis. Nine consecutive patients with axillary-palmar hyperhidrosis were treated between 2013 and 2015. CT-guided sympathetic block was performed in the outpatients at T-2, T-3, and T-4, bilaterally using alcohol under local anesthesia. Immediate postprocedure CT was obtained to assess the complications as per Common Terminology Criteria for Adverse Events, version 4. Technical success and clinical success were recorded. Primary and secondary efficacy were assessed by phone and clinical visits; mean follow-up was 12 months (6-26 months). Descriptive statistics was used to report the outcomes. One procedure was aborted due to eyelid ptosis after lidocaine injection. All other eight patients (5:3, F:M) (median age 32) had immediate cessation of sweating. Two major complications (pneumothorax, one requiring a chest tube) occurred. Two patients recurred with unilateral and one with bilateral symptoms. One of the unilateral recurrence and the bilateral recurrence patients was retreated successfully. Median follow-up was 1 year. No cases of Horner's or compensatory hyperhidrosis were observed. CT-guided EtOH sympatholysis for axillary/palmar primary hyperhidrosis is feasible. Technical failure rate was 11 %. Primary and secondary efficacy are 75 and 94 %, respectively, to a median follow-up of 1 year. Risk profile appears favorable. Despite a small sample size, results confirm feasibility and encourage a larger study.

  11. Winged scapula incidence and upper limb morbidity after surgery for breast cancer with axillary dissection.

    Science.gov (United States)

    Rizzi, Samantha Karlla Lopes de Almeida; Haddad, Cinira Assad Simão; Giron, Patricia Santolia; Pinheiro, Thaís Lúcia; Nazário, Afonso Celso Pinto; Facina, Gil

    2016-06-01

    The aim of this study was to determine the incidence of winged scapula after breast cancer surgery, its impact on shoulder morbidity and difference in incidence according to surgery type. Patients with breast cancer and surgical indication for axillary dissection were included. A total of 112 patients were surveyed with one physical evaluation before the surgery and others 15, 30, 90, and 180 days after. Winged scapula was assessed with test proposed by Hoppenfeld. Shoulder range of motion (ROM) was assessed with goniometer for flexion, extension, adduction, abduction, internal rotation, and external rotation. A verbal scale from 0 to 10 was used to assess pain. Winged scapula incidence was 8.0 % 15 days after surgery. Two patients recovered from winged scapula 90 days after surgery and four more 180 days after surgery, while three patients still had winged scapula at this time. The incidence after 15 days from surgery was 20.9 and 22.6 % among patients submitted to sentinel node biopsy or axillary lymphadenectomy (AL), respectively (p < 0.01). There was no statistical difference of incidence according to breast surgery type. Operated side shoulder flexion, adduction, and abduction ROM changes were statistically different in patients with or without winged scapula. The mean reduction was higher in patients with winged scapula. Both groups showed the same pattern over time in pain. Winged scapula incidence was 8.0 % and was higher in AL, and prevalence decreased during 6 months after surgery. Patients who developed winged scapula had more shoulder flexion, adduction, and abduction limitation.

  12. Trapezius tendon transfer according to Saha after neglected complete axillary nerve injury.

    Science.gov (United States)

    Selim, Naser M

    2012-08-01

    Traumatic axillary nerve injury represents less than 1% of all nerve injuries.It is often subclinical because it is masked by the pain due to a shoulder fracture or dislocation, so that treatment is neglected for a long period. When nerve repair and physiotherapy are unsuccessful, trapezius tendon transfer may be considered. Between March 2008 and May 2009, 10 patients with neglected deltoid paralysis were treated by trapezius tendon transfer at Mansoura University hospital and in a private hospital. All patients were males. Their mean age was 27.8 years (range: 17-35). The mean follow-up period was 30 months (range: 24 to 36 months). The operations were performed according to the method described by Saha in 1967, involving transfer of the lateral extremity of the clavicle, the acromioclavicular joint and the acromion, with the insertion of the trapezius, to the proximal humerus. The authors retrospectively assessed the results according to the 5 items (a-e) of the Rowe and Zarins score: all 10 patients had (a) improved shoulder function with (e) a more stable shoulder. The mean active abduction (b) was 76 degrees (range: 50-100 degrees) and the mean active flexion (c) 78 degrees (range: 45-110 degrees). However, most authors report lower values: from 34 to 76 degrees of abduction, and from 30 to 78 degrees of flexion. Arthrodesis results in 59 to 71.43 degrees of abduction. The abduction power (d) was improved: it reached grade 3 in 7 cases and grade 4 in 3 cases. In this study, trapezius tendon transfer provided satisfactory functional improvement for paralysis of shoulder abduction after neglected complete axillary nerve injury, with improvement in shoulder stability, power and range of motion.

  13. Long thoracic nerve injury in breast cancer patients treated with axillary lymph node dissection.

    Science.gov (United States)

    Belmonte, Roser; Monleon, Sandra; Bofill, Neus; Alvarado, Martha Ligia; Espadaler, Josep; Royo, Inmaculada

    2015-01-01

    The objectives of this study were to electromyographically (EMG) describe and analyze factors associated with long thoracic nerve injuries in breast cancer patients after axillary lymph node dissection. This was a prospective longitudinal observational study. Two hundred sixty-four women with primary invasive breast cancer were included between 2008 and 2011. All of them were treated by axillary lymph node dissection. Patients were evaluated at 1, 6, and 12 months following surgery. The presence of winged scapula was systematically tested at each follow-up and an EMG performed whenever it was observed. Affected and unaffected groups were compared for demographic, tumour, and treatment variables. Student t test, Mann-Whitney U test, chi-squared or Fisher test were computed as appropriate. Among the 36 (13.6%) winged scapula observed, the EMG confirmed long thoracic nerve injury in 30 (11.3%) of them, 27 were partial axonotmesis and three were severe axonotmesis. At 12 months, the EMG showed that injury persisted in six (2.27%) patients. Patients with long thoracic nerve injury had a lower body mass index than unaffected patients (26.2 vs. 28.2, p = 0.045). Age, tumour stage, type of breast surgery, nodes excised, surgical complications, previous chemotherapy and previous hormonotherapy were not factors associated with winged scapula. A lower body mass index was the only factor associated to long thoracic nerve injury. In most of the patients, the EMG showed partial axonotmesis. At 12 months, 2.27% of studied patients remained with an unsolved long thoracic nerve injury.

  14. The Study of Relationship Between Aggresive Ductal Breast Carcinoma and Axillary Lymph Node Involvement

    Directory of Open Access Journals (Sweden)

    G Irvanloo

    2001-06-01

    Full Text Available Breast cancer is a major cause of mortality in women due to malignant diseases and is the most prevalent type of cancer in western countries. According to investigations which has been done in Iran so far, the prevalence of disease in our country is also very high, therefore complete attention to clinical and pathological findings of this disease would be extremely essential. In this study, the direct relationship between axillary lymph node involvement and the aggressiveness of invasive ductal carcinoma has been brought into consideration. This study is a case series of 90 patients which all of them have had radical mastectomy because of breast cancer and all their samples has been referred to the center of pathology of Imam hospital. Based on modified Bloom-Richardson grading, all the samples have been graded. The study of all lymph node samples related to above cases has also been conducted along with the main study. The most frequent ages of disease was 31 to 40 and left breast had most involvement. From all cases, 12.2% were in grade I with 27.2% lymph node involvement, 66.7% grade II with 73.4% lymph node involvement and 21.1% in grade III with 100% lymph node involvement (P=0.00008. Based on statistical analysis we concluded that the axillary lymph node involvement in breast cancer is strongly associated with the aggressiveness of invasive ductal carcinoma. This important point should not be neglected in planning for treatment of this kind of disease.

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

    Science.gov (United States)

    Takeda, Alexandre; Ferraro, Leonardo Henrique Cunha; Rezende, André Hosoi; Sadatsune, Eduardo Jun; Falcão, Luiz Fernando dos Reis; Tardelli, Maria Angela

    2015-01-01

    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. 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 4h after the blockade. MEC90 was 0.241% [R(2): 0.978, confidence interval: 0.20-0.34%]. No patient, with successful block, reported pain after 4h. 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. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  16. [Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block].

    Science.gov (United States)

    Ferraro, Leonardo H C; Takeda, Alexandre; Barreto, Cleber N; Faria, Bernadete; Assunção, Nilson A

    The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. 30 patients were randomized. In the 0.25% Group, 0.25% bupivacaine (10mL) was injected per nerve. In the 0.5% Group, 0.5% bupivacaine (5mL) was injected per nerve. Peripheral blood samples were collected during the first 2hours after the blockade. For sample analyses, high performance liquid chromatography mass spectrometry was used. Plasma peak occurred 45minutes after the blockade, with no difference between groups at the assessed time-points. Plasma peak was 933.97 ± 328.03 ng.mL -1 (mean ± SD) in 0.25% Group and 1022.79 ± 253.81 ng.mL -1 in 0.5% Group (p = 0.414). Latency was lower in 0.5% Group than in 0.25% Group (10.67 ± 3.71 × 17.33min ± 5.30, respectively, p = 0.004). No patient had pain within the first 4hours after the blockade. For axillary brachial plexus block, there was no difference in bupivacaine plasma peak despite the use of different concentrations with the same local anesthetic mass. The concentration inversely influenced latency. Copyright © 2017. Publicado por Elsevier Editora Ltda.

  17. Can deep vein thrombosis be predicted after varicose vein operation in women in rural areas?

    Directory of Open Access Journals (Sweden)

    Marcin Warot

    2014-09-01

    Full Text Available [b]Introduction[/b]. Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels. One of the most common aspects of this disease is the occurrence of varicose veins. There are many ways of prevention and treatment of varicose veins, but in Poland the leading one is still surgery. As in every medical procedure there is the possibility of some complications. One of them is deep vein thrombosis (DVT. The diagnosis of DVT can be difficult, especially when access to a specialist is limited, such as in case of rural patients. [b]The aim of the study.[/b] The aim of the study was estimation of the influence of LMWH primary prophylaxis on the formation of postoperative DVT, as well as sensitivity and specificity of clinical examination and D-dimer value in diagnosis of postoperative DVT in women. [b]Materials and methods[/b]. The study was conducted in a group of 93 women operated on in the Department of General, Vascular Surgery and Angiology at the Karol Marcinkowski University of Medical Sciences in Poznań, Poland. The patients had undergone a varicose vein operation and were randomly divided into two groups: A – 48 women receiving LMWH during two days of the perioperative period, B – 45 women receiving LMWH during seven days of the perioperative period. [b]Results[/b]. There was no significant difference in the postoperative DVT complications in both groups. The value of D-dimer > 0.987 mcg/ml and swelling > 1.5 cm of shin (in comparison to the preoperative period plays a significant role in diagnosis of DVT. [b]Conclusions[/b]. The extended primary prophylaxis with LMWH does not affect the amount or quality of thrombotic complications after varicose vein operation. If the DVT occurs, the evaluation of the D – dimer and careful clinical examination can be a useful method for its diagnosis.

  18. Suitability of Varicose Veins for Endovenous Treatments

    International Nuclear Information System (INIS)

    Goode, S. D.; Kuhan, G.; Altaf, N.; Simpson, R.; Beech, A.; Richards, T.; MacSweeney, S. T.; Braithwaite, B. D.

    2009-01-01

    The aim of the study was to assess the suitability of radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and foam sclerotherapy (FS) for patients with symptomatic varicose veins (VVs). The study comprised 403 consecutive patients with symptomatic VVs. Data on 577 legs from 403 consecutive patients with symptomatic VVs were collected for the year 2006. Median patient age was 55 years (interquartile range 45-66), and 62% patients were women. A set of criteria based on duplex ultrasonography was used to select patients for each procedure. Great saphenous vein (GSV) reflux was present in 77% (446 of 577) of legs. Overall, 328 (73%) of the legs were suitable for at least one of the endovenous options. Of the 114 legs with recurrent GSV reflux disease, 83 (73%) were suitable to receive endovenous therapy. Patients with increasing age were less likely to be suitable for endovenous therapy (P = 0.03). Seventy-three percent of patients with VVs caused by GSV incompetence are suitable for endovenous therapy.

  19. Further evidence of Mirafiori lettuce big-vein virus but not of Lettuce big-vein associated virus with big-vein disease in lettuce.

    Science.gov (United States)

    Sasaya, Takahide; Fujii, Hiroya; Ishikawa, Koichi; Koganezawa, Hiroki

    2008-04-01

    Mirafiori lettuce big-vein virus (MLBVV) and Lettuce big-vein associated virus (LBVaV) are found in association with big-vein disease of lettuce. Discrimination between the two viruses is critical for elucidating the etiology of big-vein disease. Using specific antibodies to MLBVV and LBVaV for western blotting and exploiting differences between MLBVV and LBVaV in host reaction of cucumber and temperature dependence in lettuce, we separated the two viruses by transfering each virus from doubly infected lettuce plants to cucumber or lettuce plants. A virus-free fungal isolate was allowed to acquire the two viruses individually or together. To confirm the separation, zoospores from MLBVV-, LBVaV-, and dually infected lettuce plants were used for serial inoculations of lettuce seedlings 12 successive times. Lettuce seedlings were infected at each transfer either with MLBVV alone, LBVaV alone, or both viruses together, depending on the virus carried by the vector. Lettuce seedlings infected with MLBVV alone developed the big-vein symptoms, while those infected with LBVaV alone developed no symptoms. In field surveys, MLBVV was consistently detected in lettuce plants from big-vein-affected fields, whereas LBVaV was detected in lettuce plants not only from big-vein-affected fields but also from big-vein-free fields. LBVaV occurred widely at high rates in winter-spring lettuce-growing regions irrespective of the presence of MLBVV and, hence, of the presence of the big-vein disease.

  20. Frequency of superficial and deep vein thrombosis in patients with variations of superficial veins of lower extremities.

    Science.gov (United States)

    Lovic, Svetlana; Delic, Jasmin; Ljuca, Farid; Mujanovic, Emir; Custendil-Delic, Sunita; Zabic, Aida; Suljkanovic-Mahmutovic, Ahida

    2012-01-01

    Anatomical variations of veins often play a crucial role in formation of thrombotic changes in superficial and deep veins of lower extremities. THE AIM of this study was to determine the frequency of the dominant type of the lower extremity superficial veins, and to determine the eventual influence of such variations to the formation of superficial and deep vein thrombosis (DVT). The sample used in this study consisted of 180 patients subjected to ascedent contrast phlebography of lower extremities. The total sample was divided into following groups: patients with and without variations of the lower extremity superficial veins. Dominant type of the superficial veins (without variation) consisted of 97 patients (53.89%), while the rest of 83 patients showed some kind of anatomical variation (46.11%). The most frequent variation was the duplicated form ofv. saphena magna in 53.85%, while this procentage in women was 57.89%. Most frequent variations of duplicated v. saphena magna were: simple duplicated form, closed loop form, branching form and combined form. Topographical variation of saphenopopliteal junction besides fossa poplitea in the group of men showed procentage of 53.85%, while in the group of women that value accounted 63.16%. The percentage of varicose veins was more frequent in men and women without variations, but deep vein DVT showed higher frequency in patients with anatomical variations of superficial veins of lower extremities.

  1. Change in Auxin and Cytokinin Levels Coincides with Altered Expression of Branching Genes during Axillary Bud Outgrowth in Chrysanthemum.

    Science.gov (United States)

    Dierck, Robrecht; De Keyser, Ellen; De Riek, Jan; Dhooghe, Emmy; Van Huylenbroeck, Johan; Prinsen, Els; Van Der Straeten, Dominique

    2016-01-01

    In the production and breeding of Chrysanthemum sp., shoot branching is an important quality aspect as the outgrowth of axillary buds determines the final plant shape. Bud outgrowth is mainly controlled by apical dominance and the crosstalk between the plant hormones auxin, cytokinin and strigolactone. In this work the hormonal and genetic regulation of axillary bud outgrowth was studied in two differently branching cut flower Chrysanthemum morifolium (Ramat) genotypes. C17 is a split-type which forms an inflorescence meristem after a certain vegetative period, while C18 remains vegetative under long day conditions. Plant growth of both genotypes was monitored during 5 subsequent weeks starting one week before flower initiation occurred in C17. Axillary bud outgrowth was measured weekly and samples of shoot apex, stem and axillary buds were taken during the first two weeks. We combined auxin and cytokinin measurements by UPLC-MS/MS with RT-qPCR expression analysis of genes involved in shoot branching regulation pathways in chrysanthemum. These included bud development genes (CmBRC1, CmDRM1, CmSTM, CmLsL), auxin pathway genes (CmPIN1, CmTIR3, CmTIR1, CmAXR1, CmAXR6, CmAXR2, CmIAA16, CmIAA12), cytokinin pathway genes (CmIPT3, CmHK3, CmRR1) and strigolactone genes (CmMAX1 and CmMAX2). Genotype C17 showed a release from apical dominance after floral transition coinciding with decreased auxin and increased cytokinin levels in the subapical axillary buds. As opposed to C17, C18 maintained strong apical dominance with vegetative growth throughout the experiment. Here high auxin levels and decreasing cytokinin levels in axillary buds and stem were measured. A differential expression of several branching genes accompanied the different hormonal change and bud outgrowth in C17 and C18. This was clear for the strigolactone biosynthesis gene CmMAX1, the transcription factor CmBRC1 and the dormancy associated gene CmDRM1, that all showed a decreased expression in C17 at floral

  2. Change in Auxin and Cytokinin Levels Coincides with Altered Expression of Branching Genes during Axillary Bud Outgrowth in Chrysanthemum.

    Directory of Open Access Journals (Sweden)

    Robrecht Dierck

    Full Text Available In the production and breeding of Chrysanthemum sp., shoot branching is an important quality aspect as the outgrowth of axillary buds determines the final plant shape. Bud outgrowth is mainly controlled by apical dominance and the crosstalk between the plant hormones auxin, cytokinin and strigolactone. In this work the hormonal and genetic regulation of axillary bud outgrowth was studied in two differently branching cut flower Chrysanthemum morifolium (Ramat genotypes. C17 is a split-type which forms an inflorescence meristem after a certain vegetative period, while C18 remains vegetative under long day conditions. Plant growth of both genotypes was monitored during 5 subsequent weeks starting one week before flower initiation occurred in C17. Axillary bud outgrowth was measured weekly and samples of shoot apex, stem and axillary buds were taken during the first two weeks. We combined auxin and cytokinin measurements by UPLC-MS/MS with RT-qPCR expression analysis of genes involved in shoot branching regulation pathways in chrysanthemum. These included bud development genes (CmBRC1, CmDRM1, CmSTM, CmLsL, auxin pathway genes (CmPIN1, CmTIR3, CmTIR1, CmAXR1, CmAXR6, CmAXR2, CmIAA16, CmIAA12, cytokinin pathway genes (CmIPT3, CmHK3, CmRR1 and strigolactone genes (CmMAX1 and CmMAX2. Genotype C17 showed a release from apical dominance after floral transition coinciding with decreased auxin and increased cytokinin levels in the subapical axillary buds. As opposed to C17, C18 maintained strong apical dominance with vegetative growth throughout the experiment. Here high auxin levels and decreasing cytokinin levels in axillary buds and stem were measured. A differential expression of several branching genes accompanied the different hormonal change and bud outgrowth in C17 and C18. This was clear for the strigolactone biosynthesis gene CmMAX1, the transcription factor CmBRC1 and the dormancy associated gene CmDRM1, that all showed a decreased expression in

  3. Characterization of microRNAs of Beta macrocarpa and their responses to Beet necrotic yellow vein virus infection.

    Science.gov (United States)

    Liu, Jun-Ying; Fan, Hui-Yan; Wang, Ying; Zhang, Yong-Liang; Li, Da-Wei; Yu, Jia-Lin; Han, Cheng-Gui

    2017-01-01

    Plant microRNAs (miRNAs) are a class of non-coding RNAs that play important roles in plant development, defense, and symptom development. Here, 547 known miRNAs representing 129 miRNA families, and 282 potential novel miRNAs were identified in Beta macrocarpa using small RNA deep sequencing. A phylogenetic analysis was performed, and 8 Beta lineage-specific miRNAs were identified. Through a differential expression analysis, miRNAs associated with Beet necrotic yellow vein virus (BNYVV) infection were identified and confirmed using a microarray analysis and stem-loop RT-qPCR. In total, 103 known miRNAs representing 38 miRNA families, and 45 potential novel miRNAs were differentially regulated, with at least a two-fold change, in BNYVV-infected plants compared with that of the mock-inoculated control. Targets of these differentially expressed miRNAs were also predicted by degradome sequencing. These differentially expressed miRNAs were involved in hormone biosynthesis and signal transduction pathways, and enhanced axillary bud development and plant defenses. This work is the first to describe miRNAs of the plant genus Beta and may offer a reference for miRNA research in other species in the genus. It provides valuable information on the pathogenicity mechanisms of BNYVV.

  4. A case report and epidemiological investigation of axillary lymph node abscess caused by Corynebacterium ulcerans in an HIV-1-positive patient.

    Science.gov (United States)

    Yoshimura, Y; Tachikawa, N; Komiya, T; Yamamoto, A

    2014-07-01

    A human immunodeficiency virus-1 (HIV-1)-positive male undergoing antiretroviral therapy was diagnosed with an axillary lymph node abscess caused by Corynebacterium ulcerans, and an environmental survey revealed that the patient's cat as the source of infection.

  5. Concurrent Rotator Cuff Tear and Axillary Nerve Palsy Associated with Anterior Dislocation of the Shoulder and Large Glenoid Rim Fracture: A “Terrible Tetrad”

    Directory of Open Access Journals (Sweden)

    Fumiaki Takase

    2014-01-01

    Full Text Available We present a case of concurrent rotator cuff tear and axillary nerve palsy resulting from anterior dislocation of the shoulder and a large glenoid rim fracture—a “terrible tetrad.” A 61-year-old woman fell on her right shoulder. Radiographs showed anterior dislocation of the shoulder with a glenoid rim fracture, and an MRI two months after injury revealed a rotator cuff tear. Upon referral to our hospital, physical and electrophysiological examinations revealed axillary nerve palsy. The axillary nerve palsy was incomplete and recovering, and displacement of the glenoid rim fracture was minimal and already united; therefore, we surgically repaired only the rotator cuff tear three months after injury. The patient recovered satisfactorily following the operation. In patients whose axillary nerve palsy is recovering, surgeons should consider operating on rotator cuff tears in an attempt to prevent rotator cuff degeneration.

  6. Portal vein thrombosis after splenectomy for beta-thalassemia major

    International Nuclear Information System (INIS)

    Al-Hawsawi, Zakaria M.; Tarawah, Ahmed M.; Hassan, Ruhul Amin A.; Haouimi, Ammar S.

    2004-01-01

    Portal vein thrombosis is a recognized complication after splenectomy for beta-thalassemia major due to the chronic hypercoagulable state which has been recognized to exist in childhood thalassemia and contribute to thromboembolic events. We reporting one patient with beta-thalassemia major developed portal vein thrombosis following splenectomy. (author)

  7. Ovarian vein thrombosis | Jenayah | Pan African Medical Journal

    African Journals Online (AJOL)

    Diagnosis can be made with confidence using ultrasound, computed tomography or magnetic resonance imaging. Treatment of ovarian vein thrombosis is particularly important in the postpartum patients, with anticoagulation therapy being the current recommendation. Key words: Ovarian vein thrombosis, postpartum, ...

  8. Pressure-diameter relationship in the human greater saphenous vein

    NARCIS (Netherlands)

    Stooker, W; Gok, M; Sipkema, P; Niessen, HWM; Baidoshvili, A; Westerhof, N; Jansen, EK; Wildevuur, CRH; Eijsman, L

    2003-01-01

    Background. Compliance of artificial and autologous vascular grafts is related to future patency. We investigated whether differences in compliance exist between saphenous vein grafts derived from the upper or lower leg, which might indicate upper or lower leg saphenous vein preference in coronary

  9. Cerebral Vein Thrombosis Post Cabg Precipitated by Malposition of ...

    African Journals Online (AJOL)

    CASE DETAILS: In this case report, we described the clinical and radiological findings of a patient who developed cerebral vein thrombosis post coronary artery bypass grafting secondary undiagnosed protein C and S deficiency which was precipitated by malposition of subclavian central catheter into internal jugular vein.

  10. Mean Normal Portal Vein Diameter Using Sonography among ...

    African Journals Online (AJOL)

    BACKGROUND: Mean portal vein diameter is considered as the best indicator for portal hypertension. However, the cutoff point differs from study to study (above 10-15 mm) despite the existence of normal mean portal vein diameter between 10-15 mm in different settings.This implies the existence of limited evidence on ...

  11. A case of the vein of Galen malformation

    International Nuclear Information System (INIS)

    Eun, Tchoong Kie; Cha, Seong Sook; Han, Sang Suk; Chung, Duck Hwan

    1986-01-01

    The vein of Galen malformation is a rare midline intracranial arteriovenous malformation. The majority of the malformations were seen in neonate, infancy and childhood, and the clinical symptoms and prognosis depended on age of presentation. The authors report a case of the vein of Galen malformation in 17 month-old female with hydrocephalus, which is confirmed by computed tomography and digital subtraction angiography.

  12. Portal Vein Stenting for Portal Biliopathy with Jaundice

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Dongho, E-mail: mesentery@naver.com; Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center (Korea, Republic of); Lim, Seong Joo [Konyang University, Department of Radiology, College of Medicine, Konyang University Hospital (Korea, Republic of); Hwang, Jin Ho [Hallym University Sacred Heart Hospital, Department of Radiology (Korea, Republic of); Sinn, Dong Hyun [Sungkyunkwan University School of Medicine, Department of Medicine, Samsung Medical Center (Korea, Republic of)

    2016-04-15

    Portal biliopathy refers to obstruction of the bile duct by dilated peri- or para-ductal collateral channels following the main portal vein occlusion from various causes. Surgical shunt operation or endoscopic treatment has been reported. Herein, we report a case of portal biliopathy that was successfully treated by interventional portal vein recanalization.

  13. The Short Saphenous Vein: A Viable Alternative Conduit for ...

    African Journals Online (AJOL)

    This novel position allowed for two members of the surgical team to operate at the same time, thus ... along the ultrasound-marked vein positions similar to when harvesting the LSV. Once the veins were harvested and ... occlusion compared to LSV grafts utilized in the same procedure,[8] it was brought back to prominence ...

  14. Antenatal Deep Vein Thrombosis with an Underlying Thrombophilia ...

    African Journals Online (AJOL)

    Antenatal Deep Vein Thrombosis with an Underlying Thrombophilia. Emmanuel K Srofenyoh, Ali Samba, Enyonam Y Kwawukume. Abstract. Deep vein thrombosis (DVT) can cause severe morbidity in the puerperium and, less commonly, during pregnancy. A woman who developed DVT as a result of thrombophilia was ...

  15. Foam treatment for varicose veins; efficacy and safety | Kotb ...

    African Journals Online (AJOL)

    Introduction: Lower extremity varicose vein is a common disease. Sclerotherapy can be used to treat truncal varices of the superficial venous system. This involves injecting a sclerosant intraluminally in order to cause fibrosis and eventual obliteration of the vein. Objective: To demonstrate the efficacy and safety of foam ...

  16. The fifth pulmonary vein | Kinfemichael | Anatomy Journal of Africa

    African Journals Online (AJOL)

    A cadaver in Myungsung Medical College (MMC) had a 3rd pulmonary vein originating from the middle lobe of the right lung. Such anatomical variations are very rare. People with this variation have a total of five pulmonary veins entering left atrium. It has clinical implications especially for thoracic surgeons and radiologists ...

  17. Central Retinal Vein Occlusion AssociatedWith Sildenafil (Viagra ...

    African Journals Online (AJOL)

    His left fundus showed marked, diffuse disc edema, extensive retinal hemorrhages in all quadrants, engorged retinal veins and cotton wool spots on the macula. His intraocular pressures were 27mmHg right eye and 25mmHg left eye. Results Fundus fluoresceine angiography confirmed left ischemic central retinal vein ...

  18. Thrombolysis for acute upper extremity deep vein thrombosis

    DEFF Research Database (Denmark)

    Feinberg, Joshua; Nielsen, Emil Eik; Jakobsen, Janus C

    2017-01-01

    BACKGROUND: About 5% to 10% of all deep vein thromboses occur in the upper extremities. Serious complications of upper extremity deep vein thrombosis, such as post-thrombotic syndrome and pulmonary embolism, may in theory be avoided using thrombolysis. No systematic review has assessed the effect...

  19. Early Diagnosis of Posttraumatic Deep Vein Thrombosis - A Review ...

    African Journals Online (AJOL)

    OBJECTIVE: The importance of early diagnosis and treatment of deep vein thrombosis in patients with fractures of long bones. INTRODUCTION: Associated injury to deep-veins in limb fractures presents a serious pathology. It results not only to localized venous occlusion but also to death from pulmonary embolism.

  20. A study of images of Projective Angles of pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Wang Jue [Beijing Anzhen Hospital, Beijing (China); Zhaoqi, Zhang [Beijing Anzhen Hospital, Beijing (China)], E-mail: zhaoqi5000@vip.sohu.com; Yu Wei; Miao Cuilian; Yan Zixu; Zhao Yike [Beijing Anzhen Hospital, Beijing (China)

    2009-09-15

    Aims: In images of magnetic resonance and computed tomography (CT) there are visible angles between pulmonary veins and the coronary, transversal or sagittal section of body. In this study these angles are measured and defined as Projective Angles of pulmonary veins. Several possible influential factors and characters of distribution are studied and analyzed for a better understanding of this imaging anatomic character of pulmonary veins. And it could be the anatomic base of adjusting correctly the angle of the central X-ray of the angiography of pulmonary veins undergoing the catheter ablation of atrial fibrillation (AF). Method: Images of contrast enhanced magnetic resonance angiography (CEMRA) and contrast enhanced computer tomography (CECT) of the left atrium and pulmonary veins of 137 health objects and patients with atrial fibrillation (AF) are processed with the technique of post-processing, and Projective Angles to the coronary and transversal sections are measured and analyzed statistically. Result: Project Angles of pulmonary veins are one of real and steady imaging anatomic characteristics of pulmonary veins. The statistical distribution of variables is relatively concentrated, with a fairly good representation of average value. It is possible to improve the angle of the central X-ray according to the average value in the selective angiography of pulmonary veins undergoing the catheter ablation of AF.