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Sample records for balloon-occluded retrograde transvenous

  1. Ileal Varices Treated with Balloon-Occluded Retrograde Transvenous Obliteration.

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    Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun

    2009-04-01

    A 55-year-old man with hepatitis B virus antigen-positive liver cirrhosis was admitted to our hospital with anal bleeding. Colonoscopy revealed blood retention in the entire colon, but no bleeding lesion was found. Computed tomography images showed that vessels in the ileum were connected to the right testicular vein, and we suspected ileal varices to be the most probable cause of bleeding. We immediately performed double balloon enteroscopy, but failed to find any site of bleeding owing to the difficulty of fiberscope insertion with sever adhesion. Using a balloon catheter during retrograde transvenous venography, we found ileal varices communicating with the right testicular vein (efferent vein) with the superior mesenteric vein branch as the afferent vein of these varices. We performed balloon occluded retrograde transvenous obliteration by way of the efferent vein of the varices and have detected no further bleeding in this patient one year after treatment.

  2. Successful Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varix Mainly Draining into the Pericardiophrenic Vein

    International Nuclear Information System (INIS)

    Kageyama, Ken; Nishida, N.; Matsui, H.; Yamamoto, A.; Nakamura, K.; Miki, Y.

    2012-01-01

    Two cases of gastric varices were treated by balloon-occluded retrograde transvenous obliteration via the pericardiophrenic vein at our hospital, and both were successful. One case developed left hydrothorax. Gastric varices did not bled and esophageal varices were not aggravated in both cases for 24–30 months thereafter. These outcomes indicate the feasibility of balloon-occluded retrograde transvenous obliteration via the pericardiophrenic vein.

  3. Balloon occluded retrograde transvenous obliteration of bleeding stomal varices using sodium tetradecyl sulfate foam: A case report

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    Kim, Ji Chang; Yang, Po Sang; Lee, Yeon Soo; Kim, Hyun Jeong; Park, Gun [Dept. of Radiology, The Catholic University of Korea College of Medicine, Daejeon St. Mary' s Hospital, Daejeon (Korea, Republic of)

    2015-05-15

    A small varix is an uncommon complication with a high mortality rate occurring secondary to portal hypertension in patients with a stoma. We describe a case of recurrent stomal varix bleeding successfully managed by balloon occluded retrograde transvenous obliteration using sodium tetradecyl sulfate foam.

  4. Balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding patient

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    Kim, Young Hwan; Seong, Chang Kyu; Kim, Yong Joo; Park, Noh Hyuk [Kyungpook National University School of Medicine, Daegu (Korea, Republic of); Shin, Tae Beom [Dong-A University Medical Center, Pusan (Korea, Republic of); Choi, Jin Soo [Soonchunhyang University College of Medicine, Asan (Korea, Republic of)

    2003-03-01

    To evaluate the technical feasibility and clinical efficacy of balloon-occluded retrograde transvenous obliteration (BRTO) in the treatment of gastric variceal bleeding. Between September 2001 and March 2002, ten patients with gastric variceal bleeding and gastrorenal shunt, underwent BRTO. Three of the ten also had hepatic encephalopathy. To evaluated the gastrorenal shunt and exclude portal vein thrombosis, all patients underwent pre-procedural CT scanning. An occlusion balloon catheter was inserted from the right internal jugular vein and on ballooning was wedged into the left adrenal vein. A sclerosing agent (5% ethanolamine oleate-lipiodol mixture) was injected until the varices were completely filled. In four patients, the collateral veins seen at balloon-occluded adrenal venography were embolized with coils prior to sclerotherapy. Post-procedural follow-up CT (n=3) or endoscopy (n=8) was performed 1-4 weeks later, and both before and after the procedure, hepatic function was also monitored. Treatment was successful in nine cases: the failure involed rupture of the occlusion balloon during inflation, and a transjugular intrahepatic portosystemic shunt was performed. The cessation of bleeding was confirmed endoscopically or clinically; in three patients, follow-up CT showed complete obliteration of the varices. Hepatic function improved in eight patients, but three weeks after the procedure, one expired due to progressive infiltrative hepatoma. The clinical symptoms of the three patients with hepatic encephalopathy showed remarkable improvement. Although more extensive studies and long-term follow up are needed to overcome the limitations of our study, we believe that BRTO is a technically feasible and clinically effective treatment for gastric varices and hepatic encephalopathy.

  5. Efficacy and safety of balloon-occluded retrograde transvenous obliteration with sodium tetradecyl sulfate liquid sclerotherapy

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    Chang, Il Soo; Park, Sang Woo; Kwon, So Young; Cheo, Won Hyeok; Cheon, Young Koog; Shim, Chan Sup; Lee, Tae Yoon; Kim, Jeong Han [Digestive Disease Center, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    To evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sodium tetradecyl sulfate (STS) liquid sclerotherapy of gastric varices. Between February 2012 and August 2014, STS liquid sclerotherapy was performed in 17 consecutive patients (male:female = 8:9; mean age 58.6 years, range 44-86 years) with gastric varices. Retrograde venography was performed after occlusion of the gastrorenal shunt using a balloon catheter and embolization of collateral draining veins using coils or gelfoam pledgets, to evaluate the anatomy of the gastric varices. We prepared 2% liquid STS by mixing 3% STS and contrast media in a ratio of 2:1. A 2% STS solution was injected into the gastric varices until minimal filling of the afferent portal vein branch was observed (mean 19.9 mL, range 6-33 mL). Patients were followed up using computed tomography (CT) or endoscopy. Technical success was achieved in 16 of 17 patients (94.1%). The procedure failed in one patient because the shunt could not be occluded due to the large diameter of gastrorenal shunt. Complete obliteration of gastric varices was observed in 15 of 16 patients (93.8%) with follow-up CT or endoscopy. There was no rebleeding after the procedure. There was no procedure-related mortality. BRTO using STS liquid can be a safe and useful treatment option in patients with gastric varices.

  6. The Incidence of Hepatocellular Carcinoma after Balloon-Occluded Retrograde Transvenous Obliteration

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    Keiji Yokoyama

    2015-01-01

    Full Text Available Balloon-occluded retrograde transvenous obliteration (BRTO is a highly effective therapy for gastric varices with liver cirrhosis. We have investigated the incidence of hepatocellular carcinoma (HCC after BRTO. We enrolled 71 patients with viral hepatitis in which HCC had not appeared with liver imaging findings at the time of BRTO. The overall survival rate after BRTO was 86.8%, 76.1%, and 50.5% at 1, 3, and 5 years. The occurrence rate of HCC after BRTO was 20.9%, 41.1%, and 60.7% at 1, 3, and 5 years, especially showing a higher occurrence of HCC at one year. Meanwhile, the occurrence rate of HCC after treatment which excluded BRTO for esophagogastric varices in patients was 6.3%, 19.2%, and 42.5% at 1, 3, and 5 years. The log-rank test revealed that the occurrence rate of HCC after treatment was significantly higher in the BRTO group compared with that in the non-BRTO group (P=0.0447. The recurrence rate of HCC after BRTO was 35.8% and 80.0% at 1 and 3 years. The present study demonstrated a high incidence of HCC after BRTO in liver cirrhosis patients with viral hepatitis infection. We have suggested the potential for BRTO to accelerate hepatocarcinogenesis.

  7. Balloon-Occluded Retrograde Transvenous Obliteration of a Gastric Vascular Malformation: An Innovative Approach to Treatment of a Rare Condition

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    Hansing, Catherine E., E-mail: catherine.e.hansing.mil@mail.mil [Naval Medical Center Portsmouth, Transitional Year/Graduate Medical Education Department, Medical Corps, United States Navy (United States); Marquardt, Joseph P.; Sutton, Daniel M.; York, John D. [Naval Medical Center Portsmouth, Radiology Department, Medical Corps, United States Navy (United States)

    2017-02-15

    Arteriovenous malformations (AVMs) are a high-flow form of a vascular malformation, which can be found anywhere in the body. While historically treated surgically, a multidisciplinary approach utilizing multiple specialties and treatment modalities is now commonly employed. In order to effectively treat an AVM, the nidus must be targeted and eradicated, which can be done via multiple approaches. We present the case of a 43-year-old male with a gastric wall AVM, which was initially incompletely treated using a percutaneous transarterial approach. The gastric AVM was noted to have dominant drainage through a gastrorenal shunt; therefore, Balloon-occluded Retrograde Transvenous Obliteration (BRTO) was utilized to eradicate the AVM nidus. This case illustrates the utility of Interventional Radiology, specifically BRTO, as another treatment option for challenging AVMs.

  8. Thrombocytopenia in Patients with Gastric Varices and the Effect of Balloon-occluded Retrograde Transvenous Obliteration on the Platelet Count

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    W E Saad

    2014-01-01

    Full Text Available Objectives: Gastric varices primarily occur in cirrhotic patients with portal hypertension and splenomegaly and thus are probably associated with thrombocytopenia. However, the prevalence and severity of thrombocytopenia are unknown in this clinical setting. Moreover, one-third of patients after balloon-occluded retrograde transvenous obliteration (BRTO have aggravated splenomegaly, which potentially may cause worsening thrombocytopenia. The aim of the study is to determine the prevalence and degree of thrombocytopenia in patients with gastric varices associated with gastrorenal shunts undergoing BRTO, to determine the prognostic factors of survival after BRTO (platelet count included, and to assess the effect of BRTO on platelet count over a 1-year period. Materials and Methods: This is a retrospective review of 35 patients who underwent BRTO (March 2008-August 2011. Pre- and post-BRTO platelet counts were noted. Potential predictors of bleeding and survival (age, gender, liver disease etiology, platelet count, model for end stage liver disease [MELD]-score, presence of ascites or hepatocellular carcinoma were analyzed (multivariate analysis. A total of 91% (n = 32/35 of patients had thrombocytopenia (90% of patients in patients undergoing BRTO. However, BRTO (with occlusion of the gastrorenal shunt has little effect on the platelet count. Long-term outcomes of BRTO for bleeding gastric varices using sodium tetradecyl sulfate in the USA are impressive with a 4-year variceal rebleed rate and transplant-free survival rate of 9% and 76%, respectively. Platelet count is not a predictor of higher rebleeding or patient survival after BRTO.

  9. Development of a New Coaxial Balloon Catheter System for Balloon-Occluded Retrograde Transvenous Obliteration (B-RTO)

    International Nuclear Information System (INIS)

    Tanoue, Shuichi; Kiyosue, Hiro; Matsumoto, Shunro; Hori, Yuzo; Okahara, Mika; Kashiwagi, Junji; Mori, Hiromu

    2006-01-01

    Purpose. To develop a new coaxial balloon catheter system and evaluate its clinical feasibility for balloon-occluded retrograde transvenous obliteration (B-RTO). Methods. A coaxial balloon catheter system was constructed with 9 Fr guiding balloon catheter and 5 Fr balloon catheter. A 5 Fr catheter has a high flexibility and can be coaxially inserted into the guiding catheter in advance. The catheter balloons are made of natural rubber and can be inflated to 2 cm (guiding) and 1 cm (5 Fr) maximum diameter. Between July 2003 and April 2005, 8 consecutive patients (6 men, 2 women; age range 33-72 years, mean age 55.5 years) underwent B-RTO using the balloon catheter system. Five percent ethanolamine oleate iopamidol (EOI) was used as sclerosing agent. The procedures, including maneuverability of the catheter, amount of injected sclerosing agent, necessity for coil embolization of collateral draining veins, and initial clinical results, were evaluated retrospectively. The occlusion rate was assessed by postcontrast CT within 2 weeks after B-RTO. Results. The balloon catheter could be advanced into the proximal potion of the gastrorenal shunt beyond the collateral draining vein in all cases. The amount of injected EOI ranged from 3 to 34 ml. Coil embolization of the collateral draining vein was required in 2 cases. Complete obliteration of gastric varices on initial follow-up CT was obtained in 7 cases. The remaining case required re-treatment that resulted in complete obstruction of the varices after the second B-RTO. No procedure-related complications were observed. Conclusion. B-RTO using the new coaxial balloon catheter is feasible. Gastric varices can be treated more simply by using this catheter system

  10. Development of Thrombus in a Systemic Vein after Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices

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    Yoshimatsu, Rika; Yamagami, Takuji; Tanaka, Osamu; Miura, Hiroshi; Nishimura, Tsunehiko [Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto (Japan); Okuda, Kotaro; Hashiba, Mitsuoki [Fukuchiyama City Hospital, Kyoto (Japan)

    2012-06-15

    To retrospectively evaluate the frequency and risk factors for developing thrombus in a systemic vein such as the infrarenal inferior vena cava or the iliac vein, in which a balloon-occluded retrograde transvenous obliteration (B-RTO) catheter was indwelled. Forty-nine patients who underwent B-RTO for gastric varices were included in this study. The B-RTO procedure was performed from the right femoral vein, and the B-RTO catheter was retained overnight in all patients. Pre- and post-procedural CT scans were retrospectively compared in order to evaluate the development of thrombus in the systemic vein in which the catheter was indwelled. Additionally, several variables were analyzed to assess risk factors for thrombus in a systemic vein. In all 49 patients (100%), B-RTO was technically successful, and in 46 patients (94%), complete thrombosis of the gastric varices was achieved. In 6 patients (12%), thrombus developed in the infrarenal inferior vena cava or the right common-external iliac vein. All thrombi lay longitudinally on the right side of the inferior vena cava or the right iliac vein. One of the aforementioned 6 patients required anticoagulation therapy. No symptoms suggestive of pulmonary embolism were observed. Prothrombin time-international normalized ratio and the addition of 5% ethanolamine oleate iopamidol, on the second day, were related to the development of thrombus. Development of a thrombus in a systemic vein such as the inferior vena cava or iliac vein, caused by indwelling of the B-RTO catheter, is relatively frequent. Physicians should be aware of the possibility of pulmonary embolism due to iliocaval thrombosis.

  11. A case of liver cirrhosis due to hepatits C virus infection complicating giant anorectal varices treated with balloon-occluded retrograde transvenous obliteration.

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    Watanabe, Kazuhiro; Imai, Yukinori; Takaya, Hiroaki; Nakazawa, Manabu; Chikayama, Taku; Ando, Satsuki; Mizuno, Yoshie; Sugawara, Kayoko; Nakamura, Yuuka; Saitoh, Eiko; Hamaoka, Kazuhiro; Motoya, Daisuke; Fujimori, Kenji; Inao, Mie; Nakayama, Nobuaki; Nagoshi, Sumiko; Mochida, Satoshi

    2011-02-01

    A 73-year-old man with liver cirrhosis due to hepatitis C virus infection was admitted to our hospital because of massive bleeding from external varices. Colonoscopic examination revealed that giant anorectal varices had developed between the anus and rectal ampulla, and had ruptured at the perianal site. On three-dimensional computed tomography imaging, the feeding and drainage vessels of the varices were identified as the inferior mesenteric vein and right inferior hemorrhoidal vein, respectively. Endoscopic therapies were not employed for the bleeding varices, because the blood flow volume of the feeding vessel was extremely large. Balloon-occluded retrograde transvenous obliteration (B-RTO) was therefore carried out through the drainage vessels. The variceal blood flow disappeared after B-RTO therapy, and the varices decreased in size with thrombus formation verified by colonoscopy. Bleeding from the external varices also ceased. B-RTO therapy may be an effective approach for giant anorectal varices presenting as a complication in liver cirrhosis patients in whom the main drainage vessels can be determined.

  12. Comparison of Coil Embolization and Sclerotherapy of Collateral Veins during Balloon Occluded Retrograde Transvenous Obliteration: Its Long Term Effect for Gastric Varix Treatment

    International Nuclear Information System (INIS)

    An, Eun Jung; Kim, Young Hwan; Kim, Seee Hyung

    2011-01-01

    We compared the long term effect gastric varix treatment between coil embolization and sclerotherapy of collateral veins during balloon occluded retrograde transvenous obliteration (BRTO). Between February 2004 and November 2008 48 patients with gastric varix bleeding successfully treated with BRTO 23 underwent embolization of collateral veins during BRTO were enrolled in this study. In patients, collateral veins were embolized with the use of microcoil (group 1). Agent (5% ethanolamine oleate + lipiodol) was used in the remaining 7 patients (Group 2). Recurrence and rebleeding of gastric varix were evaluated by endoscopy or CT. Gastric varix recurred in 4 patients (17.4%) and rebleeding occurred in 2 (8.7%). Recurrence (57.1%, p 0.001) and rebleeding (28.6%, p = 0.029) of gastric occurred in group 2. CT finding within 6 months in partial or complete thrombosis without lipiodol uptake in gastric varix, gastric varix recurred on follow up CT. Coil embolization of collateral veins during BRTO may promote complete obliteration of gastric varix, provide lower recurrence and rebleeding rates of gastric sclerosing agent on long term follow-up.

  13. Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes

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    Fumio Uchiyama

    2013-01-01

    Full Text Available Our aim was to evaluate the long-term efficacy and safety of percutaneous transhepatic obliteration (PTO alone and combined with balloon-occluded retrograde transvenous obliteration (BRTO for gastroesophageal varices refractory to BRTO alone. Between July 1999 and December 2010, 13 patients with gastroesophageal varices refractory to BRTO were treated with PTO (n = 6 or a combination of PTO and BRTO (n = 7. We retrospectively investigated the rates of survival, recurrence, or worsening of the varices; hepatic function before and after the procedure; and complications. The procedure achieved complete obliteration or significant reduction of the varices in all 13 patients without major complications. During follow-up, the varices had recurred in 2 patients, of which one had hepatocellular carcinoma, and the other died suddenly from variceal rebleeding 7 years after PTO. The remaining 11 patients did not experience worsening of the varices and showed significant improvements in the serum ammonia levels and prothrombin time. The mean follow-up period was 90 months, and the cumulative survival rate at 1, 3, and 5 years was 92.9%, 85.7%, and 85.7%, respectively. Both PTO and combined PTO and BRTO seem as safe and effective procedures for the treatment of gastroesophageal varices refractory to BRTO alone.

  14. Comparison of Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Using Ethanolamine Oleate (EO), BRTO Using Sodium Tetradecyl Sulfate (STS) Foam and Vascular Plug-Assisted Retrograde Transvenous Obliteration (PARTO)

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    Kim, Young Hwan; Kim, Young Hwan; Kim, Chan Sun; Kang, Ung Rae; Kim, See Hyung; Kim, Joo Hwan

    2016-01-01

    PurposeTo compare the clinical outcomes of balloon-occluded retrograde transvenous obliteration (BRTO) using ethanolamine oleate (EO), BRTO using sodium tetradecyl sulfate (STS) foam, and vascular plug-assisted retrograde transvenous obliteration (PARTO).Materials and MethodsFrom April 2004 to February 2015, ninety-five patients underwent retrograde transvenous obliteration for gastric varices were analyzed retrospectively. BRTO with EO was performed in 49 patients, BRTO with STS foam in 25, and PARTO in 21. Among them, we obtained follow-up data in 70 patients. Recurrence of gastric varices was evaluated by follow-up endoscopy or CT. Medical records were reviewed for the clinical efficacy. Statistical analyses were performed by Kaplan–Meier method, Chi-square, Fisher’s, and Kruskal–Wallis tests.ResultsTechnical and clinical success was 94.7 %. As major complications, a hemoglobinuria and a death due to disseminated intravascular coagulation (DIC) were occurred in two patients with BRTO using EO. Recurrence occurred more frequently in PARTO group (P < 0.05). Recurrence occurred in three patients in BRTO using EO group and four patients in PARTO group with 3.2 and 32.8 % of each expected 1-year recurrence rates. There was no recurrence in BRTO using STS group. Abdominal pain occurred more frequently in BRTO using EO than BRTO using STS foam and PARTO (P < 0.05). Procedure time of PARTO was shorter than two conventional BRTOs (P < 0.05).ConclusionsBRTO using STS foam or PARTO is better than BRTO using EO for treatment of gastric varices in terms of complication or procedure time. However, PARTO showed frequent recurrence of gastric varices during the long-term follow-up rather than BRTO.

  15. Comparison of Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Using Ethanolamine Oleate (EO), BRTO Using Sodium Tetradecyl Sulfate (STS) Foam and Vascular Plug-Assisted Retrograde Transvenous Obliteration (PARTO)

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    Kim, Young Hwan; Kim, Young Hwan, E-mail: yhkim68@dsmc.or.kr; Kim, Chan Sun [Keimyung University College of Medicine, Department of Radiology, Dongsan Medical Center (Korea, Republic of); Kang, Ung Rae [Daegu Catholic University Medical Center, Department of Radiology (Korea, Republic of); Kim, See Hyung; Kim, Joo Hwan [Keimyung University College of Medicine, Department of Radiology, Dongsan Medical Center (Korea, Republic of)

    2016-06-15

    PurposeTo compare the clinical outcomes of balloon-occluded retrograde transvenous obliteration (BRTO) using ethanolamine oleate (EO), BRTO using sodium tetradecyl sulfate (STS) foam, and vascular plug-assisted retrograde transvenous obliteration (PARTO).Materials and MethodsFrom April 2004 to February 2015, ninety-five patients underwent retrograde transvenous obliteration for gastric varices were analyzed retrospectively. BRTO with EO was performed in 49 patients, BRTO with STS foam in 25, and PARTO in 21. Among them, we obtained follow-up data in 70 patients. Recurrence of gastric varices was evaluated by follow-up endoscopy or CT. Medical records were reviewed for the clinical efficacy. Statistical analyses were performed by Kaplan–Meier method, Chi-square, Fisher’s, and Kruskal–Wallis tests.ResultsTechnical and clinical success was 94.7 %. As major complications, a hemoglobinuria and a death due to disseminated intravascular coagulation (DIC) were occurred in two patients with BRTO using EO. Recurrence occurred more frequently in PARTO group (P < 0.05). Recurrence occurred in three patients in BRTO using EO group and four patients in PARTO group with 3.2 and 32.8 % of each expected 1-year recurrence rates. There was no recurrence in BRTO using STS group. Abdominal pain occurred more frequently in BRTO using EO than BRTO using STS foam and PARTO (P < 0.05). Procedure time of PARTO was shorter than two conventional BRTOs (P < 0.05).ConclusionsBRTO using STS foam or PARTO is better than BRTO using EO for treatment of gastric varices in terms of complication or procedure time. However, PARTO showed frequent recurrence of gastric varices during the long-term follow-up rather than BRTO.

  16. Clinical outcomes of balloon-occluded retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage in Korean patients with liver cirrhosis: a retrospective multicenter study

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    Se Young Jang

    2012-12-01

    Full Text Available Background/AimsThis study evaluated the clinical outcomes of balloon-occluded retrograde transvenous obliteration (BRTO for the treatment of hemorrhage from gastric varices (GV in Korean patients with liver cirrhosis (LC.MethodsWe retrospectively analyzed data from 183 LC patients who underwent BRTO for GV bleeding in 6 university-based hospitals between January 2001 and December 2010.ResultsOf the 183 enrolled patients, 49 patients had Child-Pugh (CP class A LC, 105 had CP class B, and 30 had CP class C at the time of BRTO. BRTO was successfully performed in 177 patients (96.7%. Procedure-related complications (e.g., pulmonary thromboembolism and renal infarction occurred in eight patients (4.4%. Among 151 patients who underwent follow-up examinations of GV, 79 patients (52.3% achieved eradication of GV, and 110 patients (72.8% exhibited marked shrinkage of the treated GV to grade 0 or I. Meanwhile, new-appearance or aggravation of esophageal varices (EV occurred in 54 out of 136 patients who underwent follow-up endoscopy (41.2%. During the 36.0±29.2 months (mean±SD of follow-up, 39 patients rebled (hemorrhage from GV in 7, EV in 18, nonvariceal origin in 4, and unknown in 10 patients. The estimated 3-year rebleeding-free rate was 74.8%, and multivariate analysis showed that CP class C was associated with rebleeding (odds ratio, 2.404; 95% confidence-interval, 1.013-5.704; P=0.047.ConclusionsBRTO can be performed safely and effectively for the treatment of GV bleeding. However, aggravation of EV or bleeding from EV is not uncommon after BRTO; thus, periodic endoscopy to follow-up of EV with or without prophylactic treatment might be necessary in LC patients undergoing BRTO.

  17. Management of Gastric Varices in the Pediatric Population with Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Utilizing Sodium Tetradecyl Sulfate Foam Sclerosis with or without Partial Splenic Artery Embolization

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    Saad, Wael E. A., E-mail: wspikes@yahoo.com; Anderson, Curtis L., E-mail: dranderson@southfloridavascular.com [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Patel, Rahul S., E-mail: patelr516@gmail.com [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States); Schwaner, Sandra, E-mail: sls5c@virginia.edu [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Caldwell, Stephen, E-mail: shc5c@virginia.edu [University of Virginia Health System, Department of Medicine, Division of Gastroenterology (United States); Pelletier, Shawn, E-mail: sjp7t@virginia.edu; Angle, John, E-mail: jfa2h@virginia.edu; Matsumoto, Alan H., E-mail: ahm4d@virginia.edu [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Fischman, Aaron M., E-mail: aaron.fischman@mountsinai.org [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States)

    2015-02-15

    It is unknown whether spontaneous gastrorenal shunts actually develop in the pediatric population. The minimum age documented in studies from Asia is 32 (range 32–44) years. This study describes three pediatric patients undergoing balloon-occluded retrograde transvenous obliteration (BRTO) for bleeding gastric varices with two of the three patients undergoing combined partial splenic embolization. The first BRTO is a selective-BRTO via a surgical splenorenal shunt (15 years old) and the other two patients underwent conventional-BRTO via a spontaneous gastrorenal shunt (8 and 14 years old). The recurrent significant bleeding that they exhibited before the combined endovascular therapy did not recur for an average of 7.1 (range 1.4–14) months. In the second patient, quantitative digitally subtracted angiography was utilized to evaluate the inline portal venous flow before and after BRTO.

  18. Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

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    Ono, Yasuyuki, E-mail: onoyasy@hirakata.kmu.ac.jp; Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Kono, Yumiko, E-mail: kohnoy@hirakata.kmu.ac.jp; Kan, Naoki, E-mail: kanna@takii.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2015-10-15

    Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.

  19. The clinical results of balloon-occluded retrograde transvenous obliteration in treatment of gastric varices compared with transjugular intrahepatic portosystemic shunt

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    Lee, Nam Kyung; Kim, Chang Won; Jeon, Ung Bae; Kim, Suk; Lee, Jun Woo; Jo, Mong; Heo, Jeong [Pusan National University School of Medicine, Busan (Korea, Republic of)

    2007-03-15

    To compare the clinical results of BRTO in the gastric varices with those of TIPS. From January 2004 to March 2006, eight patients who had been followed up for more than 1 month after BRTO were enrolled in this study. This study compared the clinical efficacy of BRTO with than of TIPS in 13 patients who had undergone TIPS from January 2000 to March 2006. The change in laboratory parameters before and after each procedure and the incidence of rebleeding, encephalopathy, asictes and varices were analyzed after each procedure. In the BRTO group, the level of albumin increased, and the levels of ammonia and the Child-Pugh score decreased. The TIPS group showed no improvement in the liver function. In the BRTO group, the gastric varices were eradicated in 7 patients. Gastric variceal rebleeding and encephalopathy did not occur. However, the esophageal varices worsened in 6 patients. In the TIPS group, rebleeding (n = 4), encephalopathy (n = 7) and a worsening of the gastric (n = 5) or esophageal varices (n = 2) occurred. BRTO improves the metabolic activity of the liver and has a lower incidence of encephalopathy. Hence, BRTO is a good alternative to TIPS in the gastric varices accompanied by a gastrorenal shunt although a treatment for a worsening of the esophageal varices may be needed after BRTO.

  20. Vascular plug-assisted retrograde transvenous obliteration for the management of gastric varices: Comparative effectiveness between gelatin sponge embolization and permanent sclerosant

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    Lee, Ji Hyun; Jo, Jeong Hyun; Park, Jae Hyung; Park, Byeong Ho [Dept. of Radiology, Dong A University Hospital, Dong A University College of Medicine, Busan (Korea, Republic of); Jung, Gyoo Sik [Dept. of Radiology, Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of)

    2016-08-15

    To evaluate the short-term outcome of plug-assisted retrograde transvenous obliteration (PARTO) using vascular plugs and gelatin sponges in comparison with balloon-occluded retrograde transvenous obliteration (BRTO) for the management of gastric varices. From January 2005 to October 2014, 171 patients were referred for management of gastric varices, of which, 52 patients with hemodynamically stable gastric varices (48 recent bleeding; 4 primary prophylaxes) were evaluated. Of these, 38 received BRTO (men/women 23/15; mean age 61.3; Child-Pugh classes A/B/C = 11/25/2) and 14 underwent PARTO (men/women 11/3; mean age 63.4; Child-Pugh classes A/B/C = 9/4/1). The technical success rate, complications, variceal changes, liver function, and exacerbation of ascites/pleural effusion were compared between the 2 groups within 3 months after the procedure. The technical success rates were 92.1% in the BRTO and 100% in the PARTO group. Procedure-related early complications occurred in the BRTO group alone (8%, n = 3). Among patients with technical success, follow-up CT at 1 month was available for 98% (n = 48/49). Complete thrombosis of gastric varices was achieved in 97.1% in the BRTO and 100% in the PARTO group. Worsening of esophageal varices was observed in 24% of the BRTO group alone (n = 8). The albumin level increased significantly in both groups and aspartate aminotransferase/alanine aminotransferase level improved significantly in the PARTO group (p < 0.05). Exacerbation of ascites/pleural effusion was observed in both groups (35.2% vs. 21.4%, both p > 0.05). PARTO appears to be equivalent to BRTO for short-term management of gastric varices.

  1. Retrograde Transvenous Ethanol Embolization of High-flow Peripheral Arteriovenous Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Linden, Edwin van der, E-mail: e.van.der.linden@mchaaglanden.nl [Medical Center Haaglanden, Department of Radiology (Netherlands); Baalen, Jary M. van [Leiden University Medical Center, Department of Surgery (Netherlands); Pattynama, Peter M. T. [Erasmus University Medical Center, Department of Radiology (Netherlands)

    2012-08-15

    Purpose: To report the clinical efficiency and complications in patients treated with retrograde transvenous ethanol embolization of high-flow peripheral arteriovenous malformations (AVMs). Retrograde transvenous ethanol embolization of high-flow AVMs is a technique that can be used to treat AVMs with a dominant outflow vein whenever conventional interventional procedures have proved insufficient. Methods: This is a retrospective study of the clinical effectiveness and complications of retrograde embolization in five patients who had previously undergone multiple arterial embolization procedures without clinical success. Results: Clinical outcomes were good in all patients but were achieved at the cost of serious, although transient, complications in three patients. Conclusion: Retrograde transvenous ethanol embolization is a highly effective therapy for high-flow AVMs. However, because of the high complication rate, it should be reserved as a last resort, to be used after conventional treatment options have failed.

  2. Retrograde Transvenous Ethanol Embolization of High-flow Peripheral Arteriovenous Malformations

    International Nuclear Information System (INIS)

    Linden, Edwin van der; Baalen, Jary M. van; Pattynama, Peter M. T.

    2012-01-01

    Purpose: To report the clinical efficiency and complications in patients treated with retrograde transvenous ethanol embolization of high-flow peripheral arteriovenous malformations (AVMs). Retrograde transvenous ethanol embolization of high-flow AVMs is a technique that can be used to treat AVMs with a dominant outflow vein whenever conventional interventional procedures have proved insufficient. Methods: This is a retrospective study of the clinical effectiveness and complications of retrograde embolization in five patients who had previously undergone multiple arterial embolization procedures without clinical success. Results: Clinical outcomes were good in all patients but were achieved at the cost of serious, although transient, complications in three patients. Conclusion: Retrograde transvenous ethanol embolization is a highly effective therapy for high-flow AVMs. However, because of the high complication rate, it should be reserved as a last resort, to be used after conventional treatment options have failed.

  3. Comparison of transjugular intrahepatic portosystemic shunt with covered stent and ballon-occluded retrograde transvenous obliteration in managing isolated gastric varices

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Kwon; Lee, Kristen A.; Sauk, Steven; Korenblat, Kevin [Washington University St. Louis School of Medicine, St. Louis (United States)

    2017-04-15

    Although a transjugular intrahepatic portosystemic shunt (TIPS) is commonly placed to manage isolated gastric varices, balloon-occluded retrograde transvenous obliteration (BRTO) has also been used. We compare the long-term outcomes from these procedures based on our institutional experience. We conducted a retrospective review of patients with isolated gastric varices who underwent either TIPS with a covered stent or BRTO between January 2000 and July 2013. We identified 52 consecutive patients, 27 who had received TIPS with a covered stent and 25 who had received BRTO. We compared procedural complications, re-bleeding rates, and clinical outcomes between the two groups. There were no significant differences in procedural complications between patients who underwent TIPS (7%) and those who underwent BRTO (12%) (p = 0.57). There were also no statistically significant differences in re-bleeding rates from gastric varices between the two groups (TIPS, 7% [2/27]; BRTO, 8% [2/25]; p = 0.94) or in developing new ascites following either procedure (TIPS, 4%; BRTO, 4%; p = 0.96); significantly more patients who underwent TIPS developed hepatic encephalopathy (22%) than did those who underwent BRTO (0%, p = 0.01). There was no statistically significant difference in mean survival between the two groups (TIPS, 30 months; BRTO, 24 months; p = 0.16); median survival for the patients who received TIPS was 16.6 months, and for those who underwent BRTO, it was 26.6 months. BRTO is an effective method of treating isolated gastric varices with similar outcomes and complication rates to those of TIPS with a covered stent but with a lower rate of hepatic encephalopathy.

  4. The Retrograde Transvenous Push-Through Method: A Novel Treatment of Peripheral Arteriovenous Malformations with Dominant Venous Outflow

    International Nuclear Information System (INIS)

    Wohlgemuth, Walter A.; Müller-Wille, René; Teusch, Veronika I.; Dudeck, Oliver; Cahill, Anne M.; Alomari, Ahmad I.; Uller, Wibke

    2015-01-01

    PurposeTo evaluate the efficacy and safety of a novel retrograde transvenous embolization technique of peripheral arteriovenous malformations (AVMs) using Onyx.Materials and MethodsWe conducted a retrospective analysis of all patients who underwent transvenous retrograde Onyx embolization of peripheral AVMs with dominant venous outflow over a 29-month period. The embolization is aimed at retrograde filling of the nidus after building a solid plug in the dominant venous outflow (push-through). Classification, clinical signs, technical aspects, clinical and technical success rates, and complications were recorded. Short-term outcome was assessed.Results11 Symptomatic patients (8 female; mean age 31.4 years) were treated at our Vascular Anomalies Center with this method between January 2012 and May 2014. The AVMs were located on the upper extremity (n = 3), pelvis (n = 2), buttock (n = 2), and lower extremity (n = 4). Retrograde embolization was successfully carried out after preparatory transarterial-flow reduction in eight cases (73 %) and venous-flow reduction with Amplatzer Vascular Plugs in four cases (36 %). Complete devascularization (n = 10; 91 %) or 95 % devascularization (n = 1; 9 %) led to complete resolution (n = 8; 73 %) or improvement of clinical symptoms (n = 3; 27 %). One minor complication occurred (pain and swelling). During a mean follow-up time of 8 months, one clinically asymptomatic recurrence of AVM was detected.ConclusionInitial results suggest that retrograde transvenous Onyx embolization of peripheral AVMs with dominant venous outflow is a safe and effective novel technique with a low complication rate

  5. The Retrograde Transvenous Push-Through Method: A Novel Treatment of Peripheral Arteriovenous Malformations with Dominant Venous Outflow

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, Walter A., E-mail: walter.wohlgemuth@ukr.de; Müller-Wille, René, E-mail: Rene.Mueller-Wille@ukr.de; Teusch, Veronika I., E-mail: Veronika.Teusch@gmx.de [University Medical Center Regensburg, Department of Radiology (Germany); Dudeck, Oliver, E-mail: Oliver.Dudeck@med.ovgu.de [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Cahill, Anne M., E-mail: Cahill@email.chop.edu [Perelman School of Medicine of the University of Pennsylvania, Division of Interventional Radiology, Department of Radiology, Children’s Hospital of Philadelphia (United States); Alomari, Ahmad I., E-mail: Ahmad.Alomari@childrens.harvard.edu [Boston Children’s Hospital and Harvard Medical School, Division of Vascular and Interventional Radiology (United States); Uller, Wibke, E-mail: Wibke.Uller@ukr.de [University Medical Center Regensburg, Department of Radiology (Germany)

    2015-06-15

    PurposeTo evaluate the efficacy and safety of a novel retrograde transvenous embolization technique of peripheral arteriovenous malformations (AVMs) using Onyx.Materials and MethodsWe conducted a retrospective analysis of all patients who underwent transvenous retrograde Onyx embolization of peripheral AVMs with dominant venous outflow over a 29-month period. The embolization is aimed at retrograde filling of the nidus after building a solid plug in the dominant venous outflow (push-through). Classification, clinical signs, technical aspects, clinical and technical success rates, and complications were recorded. Short-term outcome was assessed.Results11 Symptomatic patients (8 female; mean age 31.4 years) were treated at our Vascular Anomalies Center with this method between January 2012 and May 2014. The AVMs were located on the upper extremity (n = 3), pelvis (n = 2), buttock (n = 2), and lower extremity (n = 4). Retrograde embolization was successfully carried out after preparatory transarterial-flow reduction in eight cases (73 %) and venous-flow reduction with Amplatzer Vascular Plugs in four cases (36 %). Complete devascularization (n = 10; 91 %) or 95 % devascularization (n = 1; 9 %) led to complete resolution (n = 8; 73 %) or improvement of clinical symptoms (n = 3; 27 %). One minor complication occurred (pain and swelling). During a mean follow-up time of 8 months, one clinically asymptomatic recurrence of AVM was detected.ConclusionInitial results suggest that retrograde transvenous Onyx embolization of peripheral AVMs with dominant venous outflow is a safe and effective novel technique with a low complication rate.

  6. Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage

    International Nuclear Information System (INIS)

    Chang, Min Yung; Kim, Man Deuk; Shin, Won Seon; Shin, Min Woo; Kim, Gyoung Min; Won, Jong Yun; Park, Sung Il; Lee, Do Yun; Kim, Tae Hwan

    2016-01-01

    To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. From May 2012 to June 2014, 19 patients (11 men and 8 women, median age; 61, with history of gastric variceal hemorrhage; 17, active bleeding; 2) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Clinical and laboratory data were examined to evaluate primary (technical and clinical success, complications) and secondary (worsening of esophageal varix [EV], change in liver function) end points. Median follow-up duration was 11 months, from 6.5 to 18 months. The Wilcoxon signed-rank test was used to compare laboratory data before and after the procedure. Technical success (complete occlusion of the efferent shunt and complete filling of gastric varix [GV] with a gelfoam slurry) was achieved in 18 of 19 (94.7%) patients. The embolic materials could not reach the GV in 1 patient who had endoscopic glue injection before our procedure. The clinical success rate (no recurrence of gastric variceal bleeding) was the same because the technically failed patient showed recurrent bleeding later. Acute complications included fever (n = 2), fever and hypotension (n = 2; one diagnosed adrenal insufficiency), and transient microscopic hematuria (n = 3). Ten patients underwent follow-up endoscopy; all exhibited GV improvement, except 2 without endoscopic change. Five patients exhibited aggravated EV, and 2 of them had a bleeding event. Laboratory findings were significantly improved after PARTO. PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension

  7. Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Min Yung; Kim, Man Deuk; Shin, Won Seon; Shin, Min Woo; Kim, Gyoung Min; Won, Jong Yun; Park, Sung Il; Lee, Do Yun [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Tae Hwan [Dept. of Radiology, National Health Insurance Serivce Ilsan Hospital, Goyang (Korea, Republic of)

    2016-04-15

    To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. From May 2012 to June 2014, 19 patients (11 men and 8 women, median age; 61, with history of gastric variceal hemorrhage; 17, active bleeding; 2) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Clinical and laboratory data were examined to evaluate primary (technical and clinical success, complications) and secondary (worsening of esophageal varix [EV], change in liver function) end points. Median follow-up duration was 11 months, from 6.5 to 18 months. The Wilcoxon signed-rank test was used to compare laboratory data before and after the procedure. Technical success (complete occlusion of the efferent shunt and complete filling of gastric varix [GV] with a gelfoam slurry) was achieved in 18 of 19 (94.7%) patients. The embolic materials could not reach the GV in 1 patient who had endoscopic glue injection before our procedure. The clinical success rate (no recurrence of gastric variceal bleeding) was the same because the technically failed patient showed recurrent bleeding later. Acute complications included fever (n = 2), fever and hypotension (n = 2; one diagnosed adrenal insufficiency), and transient microscopic hematuria (n = 3). Ten patients underwent follow-up endoscopy; all exhibited GV improvement, except 2 without endoscopic change. Five patients exhibited aggravated EV, and 2 of them had a bleeding event. Laboratory findings were significantly improved after PARTO. PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-15

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

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

    International Nuclear Information System (INIS)

    Borhei, Peyman; Kim, Seung Kwon; Zukerman, Darryl A

    2014-01-01

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

  10. A Retrograde Transvenous Embolization Technique with Balloon-Assisted Arterial Aspiration for a Peripheral Arteriovenous Malformation with a Venous Pouch

    Energy Technology Data Exchange (ETDEWEB)

    Kuhara, Asako, E-mail: kuhara-asako@med.kurume-u.ac.jp; Tanaka, Norimitsu; Koganemaru, Masamichi; Kugiyama, Tomoko [Kurume University School of Medicine, Department of Radiology (Japan); Kiyokawa, Kensuke [Kurume University School of Medicine, Department of Plastic & Reconstructive Surgery and Maxillofacial Surgery (Japan); Abe, Toshi [Kurume University School of Medicine, Department of Radiology (Japan)

    2017-05-15

    Management of arteriovenous malformations (AVMs) is challenging, and there is no consensus regarding either the ideal approach or the treatment timing. Percutaneous embolization is the most frequent approach currently used and is considered the first-line technique for AVMs. There is an ongoing discussion about the best technical approach to embolize AVMs. AVMs associated with a dominant outflow vein (DOV) are rare. Embolization of both the DOV and the nidus is considered more effective. Herein, we report a novel technique of transvenous embolization of a DOV under negative pressure from an arterial balloon catheter in a case of a peripheral AVM. This technique allows the embolization of the DOV and the nidus retrogradely.

  11. Balloon-occluded percutaneous transheptic obliteration of isolated vesical varices causing gross hematuria

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Dong Hoon; Kim, Dong Hyun; Kim, Min Seok; Kim, Chul Sung [Department of Urology, College of Medicine, Chosun University, Gwangju (Korea, Republic of)

    2013-01-15

    Gross hematuria secondary to vesical varices is an unusual presentation. We report such a case recurrent gross hematuria in a male patient who had a history of bladder substitution with ileal segments that had been treated by balloon-occluded percutaneous transhepatic obliteration of vesical varices.

  12. Complications Following Balloon-Occluded Arterial Infusion Chemotherapy for Pelvic Malignancies

    International Nuclear Information System (INIS)

    Sugimoto, Koji; Hirota, Shozo; Imanaka, Kazufumi; Kawabe, Tetsuya; Nakayama, Yoshiharu; Takeuchi, Yasuhito

    1999-01-01

    Purpose: To evaluate the incidence and causes of complications associated with balloon-occluded arterial infusion chemotherapy (BOAI) for pelvic malignancies. Methods: In 34 courses of BOAI in 22 patients with pelvic malignancies, we analyzed the incidence of complications as well as the effect of the dose of the anticancer drugs, the infusion site, and the number of BOAI administrations on these complications. Complications were divided into two categories: cystitis-like symptoms and neurological complications such as pain, numbness, and paresthesia of the lower extremities and the hip. Results: Eleven patients (50%) suffered from complications, seven (31.8%) from neurological complications and four (18.2%) from cystitis-like symptoms. The complications appeared in 14 courses (42.4%) of BOAI, neurological complications in 10 (30.3%) and cystitis-like symptoms in four (12.1%). A high dose of anti-cancer drugs and infusion from the anterior division tended to induce neurological complications more frequently; however, the cystitis-like symptoms were not related to any factors. Conclusion: Our results indicate that a smaller dose of anti-cancer drugs should be infused from the bilateral internal iliac arteries for safer pelvic BOAI

  13. Preoperative balloon occluded arterial infusion chemotherapy for locally invasive bladder cancer. Accurate staging for bladder preservation

    International Nuclear Information System (INIS)

    Hayashi, Norio; Arima, Kiminobu; Kawamura, Juichi; Tochigi, Hiromi

    1999-01-01

    The possibility of bladder preservation by preoperative balloon occluded arterial infusion (BOAI) chemotherapy was studied in 111 patients with locally invasive bladder cancer. BOAI was performed by blocking the blood flow of the internal iliac artery and by performing intra-arterial infusion of adriamycin (50 mg/body) and cisplatin (100 mg/body). Before BOAI the clinical diagnosis was T2 in 36, T3a in 29, T3b in 27, T4 in 11 and after BOAI it was T0 in 1, T1 in 27, T2 in 25, T3a in 20, T3b in 20, and T4 in 10. Down staging was observed on diagnostic images in 46.6%. Thirty patients (27.0%) received transurethral resection of bladder tumor (TUR-Bt) and their bladder could be preserved. The 5-year cancer-specific survival rate was 100% in pT0 (n=9), 97.5% in pT1 (n=47), 79.9% in pT2 (n=21), 80.0% in pT3a (n=6), 39.9% in pT3b (n=18) and 51.9% in pT4 cases (n=9). For the bladder preservation, accurate staging diagnosis is required. Since 1992, endorectal magnetic resonance imaging (MRI) has been used in addition to imaging diagnosis for improving the accuracy of staging diagnosis. The accuracies of staging diagnosis with and without endorectal MRI were 62.5% and 44.0%, respectively. BOAI as a neoadjuvant chemotherapy has the possibility of bladder-preserving therapy in locally invasive bladder cancer. Also, the endorectal MRI can improve the accuracy of staging diagnosis, which is important for the bladder preservation. (author)

  14. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp; Nakamura, Megumi, E-mail: megumi@med.shimane-u.ac.jp; Yoshida, Rika, E-mail: yoshidar@med.shimane-u.ac.jp; Kitagaki, Hajime, E-mail: kitagaki@med.shimane-u.ac.jp [Shimane University Faculty of Medicine, Department of Radiology (Japan)

    2016-03-15

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

  15. Change in Imaging Findings on Angiography-Assisted CT During Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimatsu, Rika [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan); Yamagami, Takuji, E-mail: yamagami@kochi-u.ac.jp [Kochi University, Department of Radiology (Japan); Ishikawa, Masaki; Kajiwara, Kenji [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan); Aikata, Hiroshi; Chayama, Kazuaki [Hiroshima University, Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences (Japan); Awai, Kazuo [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan)

    2016-06-15

    PurposeTo evaluate changes in imaging findings on CT during hepatic arteriography (CTHA) and CT during arterial portography (CTAP) by balloon occlusion of the treated artery and their relationship with iodized oil accumulation in the tumor during balloon-occluded transcatheter arterial chemoembolization (B-TACE).MethodsBoth B-TACE and angiography-assisted CT were performed for 27 hepatocellular carcinomas. Tumor enhancement on selective CTHA with/without balloon occlusion and iodized oil accumulation after B-TACE were evaluated. Tumorous portal perfusion defect size on CTAP was compared with/without balloon occlusion. Factors influencing discrepancies between selective CTHA with/without balloon occlusion and the degree of iodized oil accumulation were investigated.ResultsAmong 27 tumors, tumor enhancement on selective CTHA changed after balloon occlusion in 14 (decreased, 11; increased, 3). In 18 tumors, there was a discrepancy between tumor enhancement on selective CTHA with balloon occlusion and the degree of accumulated iodized oil, which was higher than the tumor enhancement grade in all 18. The tumorous portal perfusion defect on CTAP significantly decreased after balloon occlusion in 18 of 20 tumors (mean decrease from 21.9 to 19.1 mm in diameter; p = 0.0001). No significant factors influenced discrepancies between selective CTHA with/without balloon occlusion. Central area tumor location, poor tumor enhancement on selective CTHA with balloon occlusion, and no decrease in the tumorous portal perfusion defect area on CTAP after balloon occlusion significantly influenced poor iodized oil accumulation in the tumor.ConclusionsTumor enhancement on selective CTHA frequently changed after balloon occlusion, which did not correspond to accumulated iodized oil in most cases.

  16. Plasma Glucose Level Is Predictive of Serum Ammonia Level After Retrograde Occlusion of Portosystemic Shunts.

    Science.gov (United States)

    Ishikawa, Tsuyoshi; Aibe, Yuki; Matsuda, Takashi; Iwamoto, Takuya; Takami, Taro; Sakaida, Isao

    2017-09-01

    The purpose of this study was to evaluate predictors of reduction in ammonia levels by occlusion of portosystemic shunts (PSS) in patients with cirrhosis. Forty-eight patients with cirrhosis (21 women, 27 men; mean age, 67.8 years) with PSS underwent balloon-occluded retrograde transvenous obliteration (BRTO) at one institution between February 2008 and June 2014. The causes of cirrhosis were hepatitis B in one case, hepatitis C in 20 cases, alcohol in 15 cases, nonalcoholic steatohepatitis in eight cases, and other conditions in four cases. The Child-Pugh classes were A in 24 cases, B in 23 cases, and C in one case. The indication for BRTO was gastric varices in 40 cases and hepatic encephalopathy in eight cases. Testing was conducted before and 1 month after the procedure. Statistical analyses were performed to identify predictors of a clinically significant decline in ammonia levels after BRTO. Occlusion of PSS resulted in a clinically significant decrease in ammonia levels accompanied by increased portal venous flow and improved Child-Pugh score. Univariate analyses showed that a reduction in ammonia levels due to BRTO was significantly related to lower plasma glucose levels, higher RBC counts, and higher hemoglobin concentration before the treatment. Furthermore, multivariate logistic regression identified preoperative plasma glucose level as the strongest independent predictor of a significant ammonia reduction in response to BRTO. In addition, although BRTO resulted in significantly declined ammonia levels in patients with normal glucose tolerance before the procedure, ammonia levels were not significantly decreased after shunt occlusion in patients with diabetes mellitus or impaired glucose tolerance before BRTO, according to 75-g oral glucose tolerance test results. Preoperative plasma glucose level is a useful predictor of clinically significant ammonia reduction resulting from occlusion of PSS in patients with cirrhosis. Even if PSS are present, control

  17. Temporal variations in stump pressure and assessment of images obtained from cone-beam computed tomography during balloon-occluded transarterial chemoembolization.

    Science.gov (United States)

    Kakuta, Akihisa; Shibutani, Koichi; Ono, Shuichi; Miura, Hiroyuki; Tsushima, Fumiyasu; Kakehata, Shinya; Basaki, Kiyoshi; Fujita, Hiromasa; Seino, Hiroko; Fujita, Tamaki; Takai, Yoshihiro

    2016-03-01

    Balloon-occluded transcatheter arterial chemoembolization (B-TACE) was used to show the optimized duration of balloon occlusion to start injection of lipiodol in order to maximize lipiodol deposition in the nodule, and to reveal the endpoint of lipiodol injection. Of 29 consecutive patients who underwent balloon-occluded TACE between November 2013 and February 2014, we were able to measure stump pressure for 219 nodules in 27 patients. Tumors were counted, measured and could be visually assessed in 20 of these patients at 26 sites. Tumors with multiple feeders were found in eight patients. Arterial blood pressure was measured before, immediately after and 5 min after balloon occlusion prior to intra-arterial injection, as well as before and after balloon deflation after intra-arterial injection. Images were assessed qualitatively by two radiologists as well as quantitatively by calculating the contrast-to-noise ratio. We found no significant difference in pressure between immediately after and 5 min after balloon occlusion. Mean stump pressure before balloon deflation after intra-arterial injection was 70.4 mmHg. We observed a significant increase in qualitative scores after balloon occlusion (P Japan Society of Hepatology.

  18. Improved transvenous liver biopsy needle

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Matzen, P; Christoffersen, P

    1979-01-01

    A modified type of the standard transvenous cholangiography biopsy needle is described. The modified tranvenous liver biopsy needle caused only minimal artefactual changes of the liver biopsy specimens. The new type of biopsy needle is a modified Menghini needle. The conventional Menghini needle...... should be avoided for transvenous catheter biopsies because of risk of leaving catheter fragments in the liver....

  19. Retrograde signaling

    DEFF Research Database (Denmark)

    Kleine, Tatjana; Leister, Dario Michael

    2016-01-01

    The term retrograde signaling refers to the fact that chloroplasts and mitochondria utilize specific signaling molecules to convey information on their developmental and physiological states to the nucleus and modulate the expression of nuclear genes accordingly. Signals emanating from plastids...... of retrograde signaling has since been extended and revised. Elements of several 'operational' signaling circuits have come to light, including metabolites, signaling cascades in the cytosol and transcription factors. Here, we review recent advances in the identification and characterization of retrograde...

  20. Percutaneous transvenous mitral commissurotomy in juvenile mitral ...

    African Journals Online (AJOL)

    Patients: Forty five consecutive patients aged less than 21 years with severe pure mitral stenosis and suitable mitral valve apparatus (leaflets, chordae and papillary muscles) for successful commissurotomy. Intervention: Percutaneous transvenous mitral commissurotomy under local anaesthesia. Standard left and right ...

  1. Percutaneous transvenous mitral commissurotomy in juvenile mitral ...

    African Journals Online (AJOL)

    Objective: To determine the efficacy and safety of percutaneous transvenous mitral commissurotomy(PTMC), using multi-track double balloon technique in juvenile mitral stenosis. Design: Open non-randomised intervention. Setting: Cardiac catheterisation laboratories of The Mater Hospital, The Nairobi Hospital and ...

  2. Current practice in transvenous lead extraction

    DEFF Research Database (Denmark)

    Bongiorni, Maria Grazia; Blomström-Lundqvist, Carina; Kennergren, Charles

    2012-01-01

    with a compliance rate of 99.9%. Data from the survey show that there seems to be an overall increasing experience of managing various techniques of lead extraction and a widespread involvement of cardiac centres in this treatment. Results and complication rates seem comparable with those of main international......AIM: Current practice with regard to transvenous lead extraction among European implanting centres was analysed by this survey. METHODS AND RESULTS: Among all contacted centres, 164, from 30 countries, declared that they perform transvenous lead extraction and answered 58 questions...... registries. CONCLUSION: This survey gives an interesting snapshot of lead extraction in Europe today and gives some clues for future research and prospective European registries....

  3. Surgical removal of infected transvenous pacemaker leads.

    Science.gov (United States)

    Frame, R; Brodman, R F; Furman, S; Andrews, C A; Gross, J N

    1993-12-01

    Infection, though uncommon, can be the most lethal of all potential complications following transvenous pacemaker implantation. Eradication of infection associated with pacemakers requires complete removal of all hardware, including inactive leads. Since 1972, 5,089 patients have had 8,508 pacemaker generators implanted at Montefiore Medical Center. There were 91 infections (1.06%); four of our patients required surgical removal. Nine additional patients were referred for surgical removal of infected transvenous pacemaker leads from other institutions. Surgical methods for removal included use of cardiopulmonary bypass or inflow occlusion. Surgery may be safely used in unstable or elderly patients and should not be reserved as a last resort. This article reviews our surgical experience removing infected pacemaker leads at Montefiore Medical Center.

  4. Anaesthesia for transvenous transcatheter tricuspid valve-in-valve ...

    African Journals Online (AJOL)

    2011-02-27

    Feb 27, 2011 ... Keywords: transvenous, transcatheter, tricuspid prosthesis, valve-in-valve implantation. Abstract. The authors report and discuss the anaesthetic management of a transvenous transcatheter tricuspid valve replacement. The conduct of anaesthesia, the challenges encountered and the specific risks ...

  5. Transvenous closure of large aortopulmonary collateral

    Directory of Open Access Journals (Sweden)

    Parag W Barwad

    2014-01-01

    Full Text Available Aortopulmonary collaterals (APCs are occluded either preoperatively or at the time of cardiac surgery in patients with pulmonary atresia and ventricular septal defect (PAVSD. If left untreated, APCs are an important cause of deterioration in the early postoperative period. We present here an unusual case with a large residual APC causing refractory low-output state in the early postoperative period. Usual arterial approach failed due to extensive angulation with ostial narrowing. The large residual APC was successfully closed with an Amplatzer duct occluder (ADO device delivered through the transvenous route.

  6. 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

  7. Percutaneous transvenous angioplasty of inferior vena cava by balloon dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kyung Suk; Kim, Jae Kyu; Park, Jin Gyun; Kang, Heung Keun; Chung, Hyon De; Kim, Shin Kon; Chung, Sang Young [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)

    1989-10-15

    3 patients with membranous (2 patients) and segmental (1 patient) obstruction of IVC were successfully treated by percutaneous transvenous angioplasty using balloon catheter. Improvements of clinical and radiological findings could be obtained after procedures. Relatively good patency was obtained in all cases without complications. This procedure can be applied safely to membranous or segmental obstructions of IVC and elsewhere in the venous systems.

  8. Transvenous pacemaker leads in the dog: an experimental study.

    Science.gov (United States)

    Bellenger, C R; Ilkiw, J E; Nicholson, A I; Malik, R; Matthews, R

    1990-09-01

    Tined transvenous pacing leads were inserted into nine healthy large-breed dogs as part of an experimental study evaluating an implantable defibrillator. The pacing leads were used to induce ventricular fibrillation on the day of insertion, two and four weeks after insertion and then monthly. Despite daily running exercise on and off a leash, the tined leads remained firmly anchored to the right ventricular apex for the full experimental period of up to 12 months. Apart from mechanical endocarditis of the tricuspid valve, and partial penetration of the ventricular wall in one dog, problems associated with the pacing leads were not encountered. The use of tined leads and careful technique may minimise the likelihood of transvenous lead displacement.

  9. Retrograde pulmonary arteriography

    International Nuclear Information System (INIS)

    Calcaterra, G.; Lam, J.; Losekoot, T.G.

    1984-01-01

    The authors performed retrograde pulmonary arteriography by means of a pulmonary venous wedge injection in 10 patients with no demonstrable intrapericardial pulmonary arteries by 'conventional' angiographic techniques. In all cases but one, the procedure demonstrated the feasibility of a further operation. No complications were observed. Retrograde pulmonary arteriography is an important additional method for determining the existence of surgically accessible pulmonary arteries when other techniques have failed. (Auth.)

  10. Percutaneous Extraction of Transvenous Permanent Pacemaker/Defibrillator Leads

    Directory of Open Access Journals (Sweden)

    Stylianos Paraskevaidis

    2014-01-01

    Full Text Available Background. Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads. Methods. Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany. Results. Lead extraction was attempted in 59 leads from 36 patients (27 men, mean ± SD age 61±5 years, with permanent pacemaker (n=25, defibrillator (n=8, or cardiac resynchronisation therapy (n=3 with a mean ± SD implant duration of 50±23 months. The indications for lead removal included pocket infection (n=23, endocarditis (n=2, and ventricular (n=10 and atrial lead dysfunction (n=1. Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4±2 minutes/lead for leads implanted 48 months (n=21, P=0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%. Conclusions. In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.

  11. Removal of infected transvenous leads requiring cardiopulmonary bypass or inflow occlusion.

    Science.gov (United States)

    Brodman, R; Frame, R; Andrews, C; Furman, S

    1992-04-01

    Infection, although uncommon, can be the most lethal of all potential complications after transvenous pacemaker implantation. The infection rate at our institution has been 0.56% (42 implants) during the preceding 17 years for 7435 transvenous pacemakers implanted in 4333 patients. Four of the 42 patients required use of cardiopulmonary bypass or inflow occlusion to remove the infected transvenous leads. Seven patients had their pacemakers implanted elsewhere and were transferred to our medical center for treatment. One patient died postoperatively because of persistent sepsis from a retained lead segment. All other patients survived, and none had recurrent infection. We recommend removal of all hardware if there is infection of the pacemaker system. If traction or other methods fail to remove the transvenous portion of the pacemaker system, open methods of removal, although rarely required, are safe and effective and should be used without delay.

  12. Transvenous coronary angiography in humans with synchrotron radiation

    International Nuclear Information System (INIS)

    Thomlinson, W.

    1994-01-01

    The transvenous coronary angiography project at the National Synchrotron Light Source (NSLS) is presently undergoing a significant upgrade to the hardware and software in the synchrotron medical facility. When completed, the project will have reached a level of maturity in the imaging technology which will allow the research team to begin to concentrate on medical research programs. This paper will review the status of the project and imaging technology and will discuss the current upgrades and future advanced technology initiatives. The advantages of using the radiation from a synchrotron, over that from a standard x-ray source, were the motivation for the project. A total of 23 human imaging sessions have been carried out with in the project. The primary goals have been to establish the imaging parameters and protocol necessary to obtain clinically useful images

  13. Transvenous coronary angiography in humans with synchrotron radiation

    Energy Technology Data Exchange (ETDEWEB)

    Thomlinson, W.

    1994-10-01

    The transvenous coronary angiography project at the National Synchrotron Light Source (NSLS) is presently undergoing a significant upgrade to the hardware and software in the synchrotron medical facility. When completed, the project will have reached a level of maturity in the imaging technology which will allow the research team to begin to concentrate on medical research programs. This paper will review the status of the project and imaging technology and will discuss the current upgrades and future advanced technology initiatives. The advantages of using the radiation from a synchrotron, over that from a standard x-ray source, were the motivation for the project. A total of 23 human imaging sessions have been carried out with in the project. The primary goals have been to establish the imaging parameters and protocol necessary to obtain clinically useful images.

  14. Endoscopic retrograde cholanglopancreatography

    International Nuclear Information System (INIS)

    Horii, S.C.; Garra, B.S.; Zeman, R.K.; Krasner, B.H.; Lo, S.C.B.; Davros, W.J.; Silverman, P.M.; Cattau, E.L.; Fleischer, D.E.; Benjamin, S.B.S.B.

    1989-01-01

    As part of the clinical evaluation of image management and communications system (IMACS), the authors undertook a prospective study to compare conventional film versus digitized film viewed on a workstation. Twenty-five each of normal and abnormal endoscopic retrograde cholangiopancreatographic (ERCP) studies were digitized with a 1,684 x 2,048-pixel matrix and evaluated in a single-blind fashion on the workstation. The resulting interpretations were then compared with those resulting from interpretation of film (spot film and 100-mm photospot) images. They report that no significant differences were found in ability to see anatomic detail or pathology. A second study involved performing 10 ERCP studies in a lithotripsy suite equipped with biplane digital fluoroscopy. The digital video displays were comparable in quality to that of film. Progress is being made in using the IMACS for archiving and retrieval of all current ERCP images

  15. Endovascular obliteration of bleeding duodenal varices in patients with liver cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Zamora, Carlos Armando; Sugimoto, Koji; Tsurusaki, Masakatsu; Izaki, Kenta; Fukuda, Tetsuya; Matsumoto, Shinichi; Kawasaki, Ryota; Taniguchi, Takanori; Sugimura, Kazuro [Kobe University School of Medicine, Department of Radiology, Kobe-shi, Hyogo-ken (Japan); Kuwata, Yoichiro [Nishi-Kobe Medical Center, Department of Radiology, Kobe-shi, Hyogo-ken (Japan); Hirota, Shozo [Hyogo Medical College, Department of Radiology, Nishinomiya-shi, Hyogo-ken (Japan)

    2006-01-01

    The purpose of this paper is to describe our experience with endovascular obliteration of duodenal varices in patients with liver cirrhosis and portal hypertension. Balloon-occluded transvenous retrograde and percutaneous transhepatic anterograde embolizations were performed for duodenal varices in five patients with liver cirrhosis, portal hypertension, and decreased liver function. All patients had undergone previous endoscopic treatments that failed to stop bleeding and were poor surgical candidates. Temporary balloon occlusion catheters were used to achieve accumulation of an ethanolamine oleate-iopamidol mixture inside the varices. Elimination of the varices was successful in all patients. Retrograde transvenous obliteration via efferent veins to the inferior vena cava was enough to achieve adequate sclerosant accumulation in three patients. A combined anterograde-retrograde embolization was used in one patient with balloon occlusion of afferent and efferent veins. Transhepatic embolization through the afferent vein was performed in one patient under balloon occlusion of both efferent and afferent veins. There was complete variceal thrombosis and no bleeding was observed at follow-up. No major complications were recorded. Endovascular obliteration of duodenal varices is a feasible and safe alternative procedure for managing patients with portal hypertension and hemorrhage from this source. (orig.)

  16. Long-Term Clinical Outcomes of Subcutaneous Versus Transvenous Implantable Defibrillator Therapy

    NARCIS (Netherlands)

    Brouwer, Tom F.; Yilmaz, Dilek; Lindeboom, Robert; Buiten, Maurits S.; Olde Nordkamp, Louise R. A.; Schalij, Martin J.; Wilde, Arthur A.; van Erven, Lieselot; Knops, Reinoud E.

    2016-01-01

    Transvenous implantable cardioverter-defibrillators (TV-ICDs) improve survival in patients at risk for sudden cardiac death, but complications remain an important drawback. The subcutaneous ICD (S-ICD) was developed to overcome lead-related complications. Comparison of clinical outcomes of both

  17. Transvenous embolization of cavernous sinus dural arteriovenous fistula via angiographic occlusive inferior petrous sinus

    Directory of Open Access Journals (Sweden)

    Chao-Bao Luo

    2015-09-01

    Conclusion: Angiographic occlusive IPS of CSDAVF may be related to true occlusion of IPS or patent IPS with compartment of the IPS-CS. There is no statistically significant difference in procedural times for these two different fistula anatomies. Transvenous embolization via angiographic occlusive IPS is a safe and effective method to manage CSDAVFs.

  18. Securing life through technology acceptance: the first six months after transvenous internal cardioverter defibrillator implantation.

    Science.gov (United States)

    Burke, L J

    1996-01-01

    To understand the experience of living with a transvenous internal cardioverter defibrillator (ICD) during the first 6 months after implantation. A grounded theory approach was used to gain an understanding of the antecedents, conditions, and consequences of the core process. Two midwestern community medical centers and patients' homes within a 250-mile radius from the medical centers. Ten women and 14 men between 22 and 78 years of age, who had undergone a new transvenous ICD implantation within the last week. The core process that described the experience of living with a transvenous ICD during the first 6 months after implantation was the process of "securing life through technology acceptance." This core process was characterized by three major categories: choosing life with technology, integrating technology into life, and living life through technology. Nursing interventions related to individualized assessment, education, and counseling are warranted to facilitate patient and family understanding and to plan for the cyclic process involved in integrating a transvenous ICD into their lives. Directions for further research are provided.

  19. Limited thoracotomy as a second choice alternative to transvenous implant for cardiac resynchronisation therapy delivery.

    Science.gov (United States)

    Puglisi, Andrea; Lunati, Maurizio; Marullo, Antonino G M; Bianchi, Stefano; Feccia, Mariano; Sgreccia, Fabrizio; Vicini, Ilaria; Valsecchi, Sergio; Musumeci, Francesco; Vitali, Ettore

    2004-06-01

    Left ventricular (LV) pacing via transvenous implantation has an overall success rate ranging from 88% to 92%. The aim of this study was to assess whether LV pacing via limited thoracotomy would be feasible and safe when used on a routine basis for those cases in which standard transvenous procedures proved to be ineffective or unsatisfactory. We enrolled 33 patients (8 females, 65+/-10 years) who experienced a transvenous implantation failure. All patients underwent a limited thoracotomy and an epicardial lead was implanted. The procedure time was 51+/-28 min. No surgical or post-operative complications occurred and optimal lateral position was achieved for all patients. In the 12 months follow-up period, 5 patients died from refractory heart failure, the remaining patients did not experience complications. At implant, the mean pacing threshold was 1.3+/-0.7 V, bi-ventricular pacing impedance was 476+/-201 Omega and R-wave amplitude was 15.0+/-6.1 mV. No significant differences were found in any of the electrical parameters between baseline and follow-up. Significant improvement was observed in functional and echocardiographic parameters. Our results suggest that a combined approach to cardiac resynchronisation therapy delivery, including a transvenous attempt followed by a back up thoracotomic procedure, could potentially guarantee the success.

  20. Sensing lead-related complications in patients with transvenous implantable cardioverter-defibrillators.

    Science.gov (United States)

    Lawton, J S; Ellenbogen, K A; Wood, M A; Stambler, B S; Herre, J M; Nath, S; Bernstein, R C; DiMarco, J P; Haines, D E; Szentpetery, S; Baker, L D; Damiano, R J

    1996-09-15

    The widespread use of the redesigned Endotak lead (CPI, St. Paul, Minnesota), which combines transvenous pacing, sensing, and defibrillation on a single transvenous lead in patients receiving transvenous implantable cardioverter-defibrillators (ICDs), has reduced morbidity and shortened length of hospital stay after ICD implantation. We describe the incidence and management of Endotak sensing lead-related failures in a series of 348 consecutive patients from 4 institutions who underwent implantation between 1990 and 1995. We retrospectively reviewed the databases for patients receiving an ICD with an Endotak lead for the incidence of lead-related sensing abnormalities. Ten patients (2.8%) with lead-related sensing abnormalities were detected at a mean of 15 +/- 11 months after ICD implantation. Sensing abnormalities were detected in 6 patients after they received inappropriate shocks. Noise or oversensing was noted in 7 patients from interrogation of the devices' data logs. Eight patients had a new transvenous sensing lead placed, 1 patient had a new Endotak lead placed, and 1 had a chronic pacemaker sensing lead converted to function as a sensing lead. No further sensing problems were noted in 8 of 10 patients during a mean follow-up of 14 +/- 8 months. The site of the sensing lead failure was localized to the subrectus pocket in 5 patients and to the clavicle-first rib area in 3 patients; it was undetermined and presumed to be in the clavicle-first rib area in the other 2 patients. One patient had late failure of the defibrillation lead. We conclude that Endotak sensing lead failure does not require insertion of a new Endotak lead, but can be managed with close follow-up and insertion of a new transvenous sensing lead. Endotak lead fractures are frequently localized to the ICD pocket.

  1. The impact of transvenous lead extraction on tricuspid valve function.

    Science.gov (United States)

    Coffey, James O; Sager, Solomon J; Gangireddy, Sandeep; Levine, Avi; Viles-Gonzalez, Juan F; Fischer, Avi

    2014-01-01

    Few data exist regarding the effect of transvenous lead extraction (TLE) on tricuspid valve function. The objective of this study was to examine the effect of TLE on the development of postprocedure tricuspid regurgitation (TR). To assess the impact of TLE on tricuspid valve function. A single center retrospective analysis of consecutive patients referred for TLE between June 2006 and November 2011. Patients were included only if they underwent transthoracic echocardiography (TTE) before and after lead extraction (N = 124). Patients were assigned a preprocedure and postprocedure TR score on a continuous scale from 0 to 6 (0 = none, 1 = trace, 2 = mild, 3 = mild/moderate, 4 = moderate, 5 = moderate/severe, and 6 = severe). A clinically significant increase in TR was defined as both (1) an increase in TR score of at least two points, and (2) a postprocedure TR score ≥4 (moderate). A total of 124 patients referred for TLE underwent a TTE both before (9 ±16 months) and after lead extraction (4 ± 8 months). A total of 200 leads (1.6 ± 0.8 per patient) were extracted. The mean change in TR score after lead extraction was +0.18 (95% confidence interval [CI] -0.03 to 0.39, P = 0.11). A clinically significant increase in TR occurred in 7/124 (5.6% [CI 2.3-11.3%]) patients. Age ≥75 (+0.45, [CI 0.07-0.84, P = 0.02]), removal of ≥2 leads (+0.40 [CI 0-0.81, P = 0.05]), and powered sheath-assisted extraction (+0.34 [CI 0.05-0.62, P = 0.02]) were significantly associated with an increase in TR score. TLE is rarely associated with the development of clinically significant TR. In our cohort, patient age ≥75 years, pacemaker as opposed to ICD, and removal of ≥2 leads predicted worsening TR. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  2. Endoscopic retrograde cholangiopancreatography and endoscopic ...

    African Journals Online (AJOL)

    An approach to suspected gallstone pancreatitis'based on endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) was adopted in 1976 and was followed in 29 patients. ERCp became the routine method of early biliary tract assessment when gallstone pancreatitis was suspected on ...

  3. Colonic perforation following endoscopic retrograde ...

    African Journals Online (AJOL)

    We highlight a potentially lethal complication of acute severe pancreatitis that may not be suspected in severely ill patients. A 41-year-old woman developed acute severe pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis. When her condition deteriorated ...

  4. Carotid-Cavernous Fistula in Ehlers-Danlos Syndrome by Pure Transvenous Approach

    Science.gov (United States)

    Van Overmeire, O.; De Keukeleire, K.; Van Langenhove, P.; Defreyne, L.

    2006-01-01

    Summary We describe a carotid-cavernous fistula (CCF) in a middle aged woman with Ehlers-Danlos syndrome (EDS) type IV, which manifested with a left-sided ophthalmoplegia. The CCF was diagnosed on magnetic resonance imaging. To prevent potential lethal arterial wall injury, the CCF was treated endovascularly under local anesthesia and exclusively by a transvenous approach. The fistula was successfully closed with Guglielmi Detachable Coils. Notwithstanding these precautionary measures, the patient suffered an intraperitoneal and a small retroperitoneal bleed during the procedure and died suddenly ten days after intervention in hemorrhagic shock. A review of recent literature focussing on the technique of transvenous approach and the catheterization risks of CCF in Ehlers-Danlos syndrome is presented. PMID:20569551

  5. Twenty-Seven Years Experience With Transvenous Pacemaker Implantation in Children Weighing <10 kg.

    Science.gov (United States)

    Konta, Laura; Chubb, Mark Henry; Bostock, Julian; Rogers, Jan; Rosenthal, Eric

    2016-02-01

    Epicardial pacemaker implantation is the favored approach in children weighing 5 kg during long-term follow-up. After a median of 14.3 (range, 13.4-17.6) years of pacing, 7 patients continue with their original lead. Transvenous pacing in infants <10 kg results in encouraging short- and long-term clinical outcomes. Subclavian vein occlusion remains an important complication, occurring predominantly in those weighing <5 kg. © 2016 American Heart Association, Inc.

  6. One-Year Follow-Up of Patients Undergoing Transvenous Extraction of Pacemaker and Defibrillator Leads.

    Directory of Open Access Journals (Sweden)

    Maciej Kempa

    Full Text Available The number of pacemaker and ICD implantations has increased substantially in the recent years. Therefore, complications are also observed in a greater number. In many cases, transvenous extraction of the previously implanted device (pacemaker or ICD is the only solution. One may find in the literature information about the efficacy and safety of that procedure, but data concerning the results of long-term follow up are still limited.The aim of the study was to assess the one-year mortality in the cohort of patients undergoing transvenous lead extraction procedures in our centre.Records of the patients undergoing transvenous lead removal in the Department of Cardiology and Electrotherapy of the Medical University of Gdańsk were analyzed. We collected detailed information about 192 patients that had undergone the procedure from January 2003 until June 2012. Data were collected from medical and surgical records. We analyzed concomitant diseases, indications, and possible complications. Long-term follow-up data were gathered in the follow-up ambulatory records and over-the-phone interviews with patients or families. In several cases, we consulted the database of the Polish National Health Fund.During the early post-operative period 5 patients died, although none of those deaths was associated with the procedure itself. No other major complications were observed. During one-year follow-up other 5 patients died, which gave the overall one-year survival rate of 92.7%. Heart failure, renal failure and an infective indication showed significant association with increased mortality.Results of transvenous lead extraction, a relatively safe procedure, should be assessed over time extending beyond the sole perioperative period. Some complications may be delayed in their nature, and may be observed only during the long-term follow up.

  7. Transvenous Lead Extraction via the Inferior Approach Using a Gooseneck Snare versus Simple Manual Traction.

    Science.gov (United States)

    Jo, Uk; Kim, Jun; Hwang, You-Mi; Lee, Ji-Hyun; Kim, Min-Su; Choi, Hyung-Oh; Lee, Woo-Seok; Kwon, Chang-Hee; Ko, Gi-Young; Yoon, Hyun-Ki; Nam, Gi-Byoung; Choi, Kee-Joon; Kim, You-Ho

    2016-03-01

    The number of patients with cardiac implantable electronic devices needing lead extraction is increasing for various reasons, including infections, vascular obstruction, and lead failure. We report our experience with transvenous extraction of pacemaker and defibrillator leads via the inferior approach of using a gooseneck snare as a first-line therapy and compare extraction using a gooseneck snare with extraction using simple manual traction. The study included 23 consecutive patients (43 leads) who underwent transvenous lead extraction using a gooseneck snare (group A) and 10 consecutive patients (17 leads) who underwent lead extraction using simple manual traction (group B). Patient characteristics, indications, and outcomes were analyzed and compared between the groups. The dwelling time of the leads was longer in group A (median, 121) than in group B (median, 56; p=0.000). No differences were noted in the overall procedural success rate (69.6% vs. 70%), clinical procedural success rate (82.6% vs. 90%), and lead clinical success rate (86% vs. 94.1%) between the groups. The procedural success rates according to lead type were 89.2% and 100% for pacing leads and 66.7% and 83.3% for defibrillator leads in groups A and B, respectively. Major complications were noted in 3 (mortality in 1) patients in group A and 2 patients in group B. Transvenous extraction of pacemaker leads via an inferior approach using a gooseneck snare was both safe and effective. However, stand-alone transvenous extraction of defibrillator leads using the inferior approach was suboptimal.

  8. Retrograde curves of solidus and solubility

    International Nuclear Information System (INIS)

    Vasil'ev, M.V.

    1979-01-01

    The investigation was concerned with the constitutional diagrams of the eutectic type with ''retrograde solidus'' and ''retrograde solubility curve'' which must be considered as diagrams with degenerate monotectic transformation. The solidus and the solubility curves form a retrograde curve with a common retrograde point representing the solubility maximum. The two branches of the Aetrograde curve can be described with the aid of two similar equations. Presented are corresponding equations for the Cd-Zn system and shown is the possibility of predicting the run of the solubility curve

  9. High-Flow Vascular Malformation in the Sigmoid Mesentery Successfully Treated with a Combination of Transarterial and Transvenous Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kamo, Minobu, E-mail: kamomino@luke.ac.jp; Yagihashi, Kunihiro [St. Luke’s International Hospital, Department of Radiology (Japan); Okamoto, Takeshi; Nakamura, Kenji; Fujita, Yoshiyuki [St. Luke’s International Hospital, Department of Gastroenterology (Japan); Kurihara, Yasuyuki [St. Luke’s International Hospital, Department of Radiology (Japan)

    2016-12-15

    Mesenteric high-flow vascular malformation can cause various clinical symptoms and demand specific therapeutic interventions owing to its peculiar hemodynamics. We report a case of high-flow vascular malformation in the sigmoid mesentery which presented with ischemic colitis. The main trunk of the inferior mesenteric vein was occluded. After partially effective transarterial embolization, transvenous embolization was performed using a microballoon catheter advanced to the venous component of the lesion via the marginal vein. Complete occlusion of the lesion was achieved. Combination of transarterial and transvenous embolization may allow us to apply endovascular treatment to a wider variety of high-flow lesions in the area and possibly avoid the bowel resection.

  10. Sonourethrography compared to retrograde urethrography

    International Nuclear Information System (INIS)

    Kim, Jong Chul; Chang, Nam Sik; Park, Cheong Hee; Rhee, Byung Chul; Kong, Jae Chul; Park, Jong Yoon

    1989-01-01

    A total of 15 patients with suspected urethral stricture or fistula underwent conventional retrograde urethrography and following sonourethrography with saline infusion or voiding against Eschmann penile clamp, in Gyeongsang and Chungnam National University Hospital from July, 1989 to June, 1989. The sonographic findings were as diagnostic as the roentgen findings in 12 patients. When the length of the strictures assessed by each imaging modality was compared to measurement at open urothroplasty of 2 patients, sonourethrography was consistently more accurate. Urethroscopy was done in all cases. Sonourethrography using distension technique of the urethra enabled classification of the degree of spongiofibrosis, thus provided the guidance of direct vision internal urethrotomy in 9 patients. In 2 patients, the sonourethrogram identified periurethral tumor and urethral polyp which were not definitely analysed on the retrograde urethrogram. In the patient of posttraumatic postoperative urethrorectal fistula, residual fistuous tract was seen on both examinations. In 1 patient of stricture with severe periurethral scar, urethral stricture recurred after graft. No patient reported significant discomfort during the sonourethrogram. The sonourethrogram provided valuable, dynamic. 3 dimensional information about the luminal and extraluminal anatomy and pathology of the anterior urethra. The new method of sonourethrogram allows for the appropriate decision to be made easier for optimal treatment of urethal stricture, etc, and can be used as a follow up study

  11. Topographic Anterograde and Retrograde Memory for Spatial ...

    African Journals Online (AJOL)

    The Mann Whitney U test and Wilcoxon Rank sum statistics were used for data analysis. The findings showed significant differences between retrograde group: before injection and after injection on time spent to run the maze. Similarly significant difference was seen between the retrograde group (before injection) and ...

  12. Retrograde amnesia in patients with Alzheimer's disease

    NARCIS (Netherlands)

    Meeter, M.; Eijsackers, E; Mulder, J

    2006-01-01

    Patients with mild to moderate Alzheimer's disease and normal controls were tested on two retrograde memory tests, one based on public events, and the other querying autobiographical memory. On both tests, patients showed strong decrements as compared to normal controls, pointing to retrograde

  13. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

    International Nuclear Information System (INIS)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian; Wu Zhongxue

    2010-01-01

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  14. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

    Energy Technology Data Exchange (ETDEWEB)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China)

    2010-08-15

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  15. Retrograde transurethral balloon dilation of the prostate

    International Nuclear Information System (INIS)

    Castaneda, F.; Reddy, P.; Wasserman, N.F.; Lund, G.; Hulbert, J.; Hunter, D.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1986-01-01

    A series of patients with documented benign prostatic hypertrophy evaluated by urodynamic studies, voiding cystourethrography, retrograde urethrography, and MR imaging underwent dilation performed using a retrograde transurethral approach with 25-mm balloon dilators inflated at a pressure of 3-4 atm for 10 minutes. Immediately after the procedure, retrograde and voiding cystourethrography as well as MR imaging were performed. A Foley catheter was left in place for 24 hours. Complete relief of symptoms has occurred in all of the patients during the follow-up period. No significant complications other than transient hematuria resulted from the procedure. Results of the comparison studies and of MR imaging are discussed

  16. Vagal withdrawal during endoscopic retrograde cholangiopancreatography

    DEFF Research Database (Denmark)

    Christensen, M; Rasmussen, Verner; Schulze, S

    2000-01-01

    BACKGROUND: Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) are at risk of developing cardiorespiratory complications, but the mechanism is still unknown. Treatment with metoprolol 2 h before the endoscopy has been shown to decrease the incidence of myocardial ischaemia...

  17. Retrograde prostatic urethroplasty with balloon catheter

    International Nuclear Information System (INIS)

    Castaneda, F.; Reddy, P.; Hulbert, J.; Letourneau, J.G.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1987-01-01

    The authors performed retrograde prostatic urethroplasty in 18 patients using a 25-mm urethroplasty balloon catheter. The procedure was performed on an outpatient basis under local anesthesia. Voiding cystourethrography, retrograde urethrography, rectal US, and MRE imaging were performed before and immediately after the procedure and at 2 weeks and 3, 6, 12, and 18 months. Long-term results at 18 months and possible clinical implications are discussed

  18. First rib and venous anomalies – Anatomical challenges for transvenous implantation of cardiac electronic devices

    Directory of Open Access Journals (Sweden)

    Ernest W. Lau, MD

    2017-07-01

    Full Text Available Atypical anatomy may be encountered unexpectedly and undiagnosed in clinical practice, and this is especially important during the performance of interventional procedures such as transvenous implantation of cardiac electronic devices. The body of the first rib can be absent. If this not noticed, pneumo-/haemothroax may be induced during subclavian vein puncture as the needle may enter the first intercostal space rather than the costo-clavicular angle. The cephalic vein may pursue a supraclavicular course, the axillary vein may drain into an intercostal vein rather than the axillary vein, and the entire length of the axillary-subclavian-brachio-cephalic vein may be absent. Device implanters should be vigilant about the possibility of these anatomical variations, and be equipped with the knowledge and spectrum of alternative techniques needed to deal with them.

  19. Retrogradation enthalpy does not always reflect the retrogradation behavior of gelatinized starch.

    Science.gov (United States)

    Wang, Shujun; Li, Caili; Zhang, Xiu; Copeland, Les; Wang, Shuo

    2016-02-10

    Starch retrogradation is a term used to define the process in which gelatinized starch undergoes a disorder-to-order transition. A thorough understanding of starch retrogradation behavior plays an important role in maintaining the quality of starchy foods during storage. By means of DSC, we have demonstrated for the first time that at low water contents, the enthalpy change of retrograded starch is higher than that of native starch. In terms of FTIR and Raman spectroscopic results, we showed that the molecular order of reheated retrograded starch samples is lower than that of DSC gelatinized starch. These findings have led us to conclude that enthalpy change of retrograded starch at low water contents involves the melting of recrystallized starch during storage and residual starch crystallites after DSC gelatinization, and that the endothermic transition of retrograded starch gels at low water contents does not fully represent the retrogradation behavior of starch. Very low or high water contents do not favor the occurrence of starch retrogradation.

  20. A retrograde object near Jupiter's orbit

    Science.gov (United States)

    Connors, M.; Wiegert, P.

    2018-02-01

    Asteroid 2007 VW266 is among the rare objects with a heliocentric retrograde orbit, and its semimajor axis is within a Hill sphere radius of that of Jupiter. This raised the interesting possibility that it could be in co-orbital retrograde resonance with Jupiter, a second "counter-orbital" object in addition to recently discovered 2015 BZ509. We find instead that the object is in 13/14 retrograde mean motion resonance (also referred to as 13/-14). The object is shown to have entered its present orbit about 1700 years ago, and it will leave it in about 8000 years, both through close approach to Jupiter. Entry and exit states both avoid 1:1 retrograde resonance, but the retrograde nature is preserved. The temporary stable state is due to an elliptic orbit with high inclination keeping nodal passages far from the associated planet. We discuss the motion of this unusual object based on modeling and theory, and its observational prospects.

  1. Transvenous vagus nerve stimulation does not modulate the innate immune response during experimental human endotoxemia: a randomized controlled study

    OpenAIRE

    Kox, M.; Eijk, L.T.G.J. van; Verhaak, T.; Frenzel, T.; Kiers, H.D.; Gerretsen, J.; Hoeven, J.G. van der; Kornet, L.; Scheiner, A.; Pickkers, P.

    2015-01-01

    INTRODUCTION: Vagus nerve stimulation (VNS) exerts beneficial anti-inflammatory effects in various animal models of inflammation, including collagen-induced arthritis, and is implicated in representing a novel therapy for rheumatoid arthritis. However, evidence of anti-inflammatory effects of VNS in humans is very scarce. Transvenous VNS (tVNS) is a newly developed and less invasive method to stimulate the vagus nerve. In the present study, we determined whether tVNS is a feasible and safe pr...

  2. Reconstructive treatment of dural arteriovenous fistulas of the transverse and sigmoid sinus: transvenous angioplasty and stent deployment

    International Nuclear Information System (INIS)

    Liebig, T.; Henkes, H.; Brew, S.; Miloslavski, E.; Kuehne, D.; Kirsch, M.

    2005-01-01

    Various techniques for the endovascular treatment of dural arteriovenous fistulas (dAVFs) of the transverse and sigmoid sinus have recently evolved. Transvenous coil occlusion of the involved segment and transarterial embolization of the feeding arteries with liquid agents are the commonest treatments utilized. However, with respect to venous hypertension as the probable pathogenic cause of this disorder, a nonocclusive or remodeling technique might be preferable. We will present a series involving four patients, treated with transvenous angioplasty and stent deployment as a definitive treatment of dAVFs of the transverse and sigmoid sinus. This method was used as a primary treatment or as an adjunct to previous noncurative transarterial n-butyl cyanoacrylate and particle embolization. In three of the four cases, complete occlusion of the fistula was achieved with confirmation of occlusion seen on follow-up angiographical studies. In one case a negligible and nonsymptomatic remnant of the fistula fed by the tentorial artery was left untreated. From our experience, we conclude that transvenous stent deployment is an alternative to traditional concepts. Additionally, the pathological theory of dAVFs in this region located in venous pouches of the sinus wall is supported by the fact that they can be occluded by mechanical compression during angioplasty and subsequently maintained by a stent. (orig.)

  3. Process for forming retrograde profiles in silicon

    Science.gov (United States)

    Weiner, Kurt H.; Sigmon, Thomas W.

    1996-01-01

    A process for forming retrograde and oscillatory profiles in crystalline and polycrystalline silicon. The process consisting of introducing an n- or p-type dopant into the silicon, or using prior doped silicon, then exposing the silicon to multiple pulses of a high-intensity laser or other appropriate energy source that melts the silicon for short time duration. Depending on the number of laser pulses directed at the silicon, retrograde profiles with peak/surface dopant concentrations which vary from 1-1e4 are produced. The laser treatment can be performed in air or in vacuum, with the silicon at room temperature or heated to a selected temperature.

  4. Brown dwarfs in retrogradely precessing cataclysmic variables?

    Directory of Open Access Journals (Sweden)

    Martin E.L.

    2011-07-01

    Full Text Available We compare Smoothed Particle Hydrodynamic simulations of retrogradely precessing accretion disks that have a white dwarf primary and a main sequence secondary with observational data and with theory on retrograde precession via tidal torques like those by the Moon and the Sun on the Earth [1, 2]. Assuming the primary does not accrete much of the mass lost from the secondary, we identify the theoretical low mass star/brown dwarf boundary. We find no observational candidates in our study that could qualify as brown dwarfs.

  5. Retrograde amnesia after electroconvulsive therapy: a temporary effect?

    NARCIS (Netherlands)

    Meeter, M.; Murre, J.M.J.; Janssen, S.M.J.; Birkenhager, T.; van den Broek, W.W.

    2011-01-01

    Objective: Although electroconvulsive therapy (ECT) is generally considered effective against depression, it remains controversial because of its association with retrograde memory loss. Here, we assessed memory after ECT in circumstances most likely to yield strong retrograde amnesia. Method: A

  6. [Chronic transvenous pacemaker/implantable cardioverter defibrillator leads implantation induced pathological changes].

    Science.gov (United States)

    Li, Yanhui; Dykoski, Richard; Li, Jianming

    2015-05-01

    Widely pacemaker/implantable cardioverter defibrillator (ICD) implantation is also related to an increasing need for transvenous lead extraction. Understanding the location and extent of pathological changes, including adhesions and fibrous tissue formation along the course of chronic pacemaker/ICD leads, are essential for operators performing lead extraction operations in order to reduce the potential life threatening complications. Three parts are included in the research, pathological examination on 83 extracted pacemaker/ICD leads using excimer laser technique from March 2008 to March 2011, autopsy examination of one died patient during lead extraction for lead-related infective endocarditis, and anatomical analysis on pacemaker/ICD leads from 10 patients died of other non-cardiac causes. Extensive encapsulated fibrous tissue around the leads and extensive adhesion/fibrosis along the course of the leads from venous entry site to the lead/myocardial interface could be detected on transvenous pacemaker/ICD leads. Since the tissue at the junction between superior vena cava (SVC) and right atrium (RA) is very thin, free of pericardium, thus, this is a common place for extensive adhesion/fibrosis and myocardial perforation/tear during lead extraction, which accounted for one death during extraction in our cohort. Extensive adhesion and fibrosis were also observed at the tricuspid valve and subvalvular structures. Leads implanted to the right ventricular apex were close to the epicardial surface and prone to perforation through myocardium. It is common to observe thrombus on the leads or at the interface between leads and myocardial tissue, especially at right atrial appendage (RAA) at the site of lead insertion. Extensive adhesions and fibrosis can be commonly seen along the course of pacemaker/ICD leads, and at SVC to RA junction, the tricuspid valve/subvalvular structures, and RA/RV lead interface. The tissue at SVC to RA junction is very thin, making it

  7. Studies of retrograde memory: A long-term view

    OpenAIRE

    Warrington, Elizabeth K.

    1996-01-01

    Studies of retrograde amnesia are reviewed. First, the issues of temporal gradients of retrograde amnesia are discussed. Second, the question of the anatomical substrates of this syndrome are considered. Finally, some evidence for fractionation of different classes of memoranda within the retrograde time period are presented.

  8. Liver parenchumography following endoscopic retrograde cholangiopancreatography (ERCP)

    International Nuclear Information System (INIS)

    Revert, A.; Arana, E.; Pertejo, V.; Berenguer, M.; Masip, M.J.

    1998-01-01

    Focal liver opacification during endoscopic retrograde cholangiography (ERCP) is an uncommon complication caused by excessive pressure during contrast injection. In this situation, ERCP must be interrupted and the position of the cannula checked. We recommend that these images be excluded from the diagnosis of tumor or cystic cavities. 4 refs

  9. Medullary Sponge Kidney on Retrograde Pyelography

    Science.gov (United States)

    Huang, Tsung-Yi; Lin, Jih-Pin

    2014-01-01

    A woman aged 31 had recurrent urinary tract infection with bloody urine. A series image of medullary sponge kidney presented by intravenous urography (IVU) was detected dynamically by retrograde pyelography (RP). Other than ultrasonography and IVU, RP is also a reliable method to detect medullary sponge kidney. PMID:24855603

  10. Kinematics of turnaround and retrograde axonal transport

    International Nuclear Information System (INIS)

    Snyder, R.E.

    1986-01-01

    Rapid axonal transport of a pulse of 35 S-methionine-labelled material was studied in vitro in the sensory neurons of amphibian sciatic nerve using a position-sensitive detector. For 10 nerves studied at 23.0 +/- 0.2 degrees C it was found that a pulse moved in the anterograde direction characterized by front edge, peak, and trailing edge transport rates of (mm/d) 180.8 +/- 2.2 (+/- SEM), 176.6 +/- 2.3, and 153.7 +/- 3.0, respectively. Following its arrival at a distal ligature, a smaller pulse was observed to move in the retrograde direction characterized by front edge and peak transport rates of 158.0 +/- 7.3 and 110.3 +/- 3.5, respectively, indicating that retrograde transport proceeds at a rate of 0.88 +/- 0.04 that of anterograde. The retrograde pulse was observed to disperse at a rate greater than the anterograde. Reversal of radiolabel at the distal ligature began 1.49 +/- 0.15 h following arrival of the first radiolabel. Considerable variation was seen between preparations in the way radiolabel accumulated in the end (ligature) regions of the nerve. Although a retrograde pulse was seen in all preparations, in 7 of 10 preparations there was no evidence of this pulse accumulating within less than 2-3 mm of a proximal ligature; however, accumulation was observed within less than 5 mm in all preparations

  11. Synchronous Retrograde and Micturating Cysto Urethrography A ...

    African Journals Online (AJOL)

    Background: Retrograde Urethrography (RUG) combined with Micturating cystourethrography (MCUG) is imaging method of choice for studying the urethra and its 1-9 abnormalities . Though there are many modern imaging modalities that are also useful but these are not available in most developing countries. Even the ...

  12. Predicting the difficulty of a transvenous lead extraction procedure: Validation of the LED index.

    Science.gov (United States)

    Bontempi, Luca; Vassanelli, Francesca; Cerini, Manuel; Inama, Lorenza; Salghetti, Francesca; Giacopelli, Daniele; Gargaro, Alessio; Raweh, Abdallah; Curnis, Antonio

    2017-07-01

    A lead extraction difficulty (LED) score was proposed to predict the difficult transvenous lead extraction (TLE) procedures, defined by means of the fluoroscopy time. The aim of this study was to validate the estimation model based on the LED index above 10 on an independent data set of TLE cases. Consecutive patients undergoing TLE between January 2014 and January 2016 were included in this analysis. The fluoroscopy time related to the leads removal was dichotomized as above or below its 90th percentile (PCTL). In total, 446 permanent leads were removed during 233 TLE procedures. Complete procedural success was achieved in 232 (99.1%) patients. The LED index resulted >10 in 83(35.6%) procedures. Among these cases, 20 had fluoroscopy time above the 90th PCTL (23.3 minutes) and were classified as true positive. Over the 150 procedures with LED score LED index in predicting complex cases resulted 86.9 (confidence interval [CI] 66.4-97.2)%, 70.0 (CI 63.3-76.1)%, and 98.0 (CI 94.3-99.6)%, respectively. The multivariate logistic regression analysis confirmed a 12% increased risk of high fluoroscopy for each additional point of the LED score (OR 1.12, CI 1.05-1.21, P = 0.001). The validation of the estimation model based on the LED index <10 confirmed its high efficacy in predicting simple TLE procedures. © 2017 Wiley Periodicals, Inc.

  13. Distal femoral fixation: a biomechanical comparison of retrograde nail, retrograde intramedullary nail, and prototype locking retrograde nail.

    Science.gov (United States)

    Heiney, Jake P; Battula, Suneel; O'Connor, Jill A; Ebraheim, Nabil; Schoenfeld, Andrew J; Vrabec, Gregory

    2012-08-01

    Distal femur fractures continue to be a complex surgical problem for which the incidence is increasing. Presently, there is a need for different constructs to address these complex fractures. This study attempts to define the biomechanical properties of several implants. A novel, prototype locking retrograde intramedullary nail and the Russell-Taylor femoral retrograde nail were tested at non-destructive, physiological, axial mode load strength using a young, synthetic bone model for a medial segmental shaft defect in the supracondylar region of the distal femur (medial gap of 10mm, 65mm proximal to the distal joint and parallel to the knee axis). Each specimen was compressively loaded and unloaded to the peak load for 80,000cycles at a 0.5Hz frequency. These were compared to the results from the same lab of the retrograde Trigen intramedullary nail. Motion and peak displacement were measured across the fracture site as a reflection of construct stability. Previous testing demonstrated that Trigen intramedullary nail had significantly less motion across the gap and increased overall stiffness of the construct (Pnails. Locking technology used in a nail biomechanically appears to lead to more micro-motion across the fracture gap and to less stiffness in this construct. Further research needs to be invested into intramedullary, locking technology before introducing it into clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. An unusual experience with endoscopic retrograde cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Mallikarjun Patil

    2013-01-01

    Full Text Available The endoscopic retrograde cholangiopancreatography (ERCP is known for its varied diagnostic and therapeutic utility for a variety of disorders. However it has greater likelihood of procedure related complications among the endoscopic procedures of gastrointestinal tract. The extraluminal hemorrhagic complications following ERCP are potentially life threatening though relatively rare. We present a 50 year patient with choledocholithiasis and cholelithiasis developing rare complication of subcapsular hepatic hematoma, following ERCP due to guide wire injury.

  15. Transvenous Radiofrequency Ablation Therapy in the Treatment of Arrhythmias: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Tayyar Gökdeniz

    2013-03-01

    Full Text Available Introduction: Radiofrequency ablation of tachyarrhythmia is effective in the treatment of tachycardia. In this study, we evaluated the results of radiofrequency catheter ablation of tachyarrhythmia.Patients and Methods: From December 2010 to January 2012, 114 consecutive patients with symptomatic drug-resistant typical slow-fast atrioventricular nodal reentrant tachycardia, 17 patients with atrioventricular reentrant tachycardia (five Wolf Parkinson White syndrome, eight patients with atrial tachycardia, seven patients with atrial flutter, five patients with right ventricular outflow tract tachycardia and three patients with atrial fibrillation underwent an invasive electrophysiology study and radiofrequency ablation. Results: The 154 patients (age: 39.1 ± 17.2 years, body mass index: 24.3 ± 5.2 kg/m2, waist/hip ratio: 0.88 ± 5.2, systolic blood pressure: 128.3 ± 22.4 mmHg, diastolic blood pressure: 75.30 ± 9.0 mmHg, resting heart rate: 76.10 ± 8.2 beat/minute with tachycardia (89 women, 65 men were ablated. Procedure and fluoroscopy times were 57.5 ± 19.0 and 14.4 ± 4.1 minute respectively. The mean follow up period was 10.2 ± 4.3 months. During follow up period three patients with atrioventricular nodal reentrant tachycardia, two patients with atrioventricular reentrant tachycardia, one patient with right ventricular outflow tract tachycardia and one patient with atrial fibrillation had recurrence.Conclusion: The transvenous radiofrequency ablation therapy is a safe and effective approach for the treatment of tachyarrhythmia under experienced hands.

  16. Successful resuscitation of hypermagnesaemic asystolic cardiac arrest with the use of early transvenous cardiac pacemaker: a case report.

    Science.gov (United States)

    Miller, M A; Crystal, C S; Helphenstine, J; Young, S E

    2006-03-01

    A 63 year old woman presented to the emergency department (ED) with 1 week of progressive dyspnoea, constipation, and generalized weakness. She had undergone spinal fustion surgery 10 days previously, and had a history of chronic renal insufficiency. The patient had been using milk of magnesia and magnesium citrate in unknown amounts to alleviate her constipation over this time frame. During her ED stay she became progressively hypotensive and bradycardic, and despite aggressive resuscitative measures she suffered an asystolic arrest 1 hour into her ED course. She was resuscitated with conventional therapy, but her haemodynamic profile did not improve significantly until transvenous cardiac pacing was employed. Her magnesium level was 10.4 mmol/l. Treatment of magnesium overload has focused upon haemodialysis, forced diuresis, and the use of intravenous calcium salts. Case reports have previously documented survival of moderately to severely ill patients when these modalities have been used. Likewise, failure of resuscitation despite use of these methods has been previously noted. To our knowledge, this is the first reported case clearly demonstrating the efficacy of transvenous cardiac pacing to successfully resuscitate a patient upon whom multiple vasopressors, fluids, and calcium previously had no clear effect.

  17. Transvenous Embolization of a Spontaneous Femoral AVF 5 Years After an Incomplete Treatment with Arterial Stent-Grafts

    International Nuclear Information System (INIS)

    Peynircioglu, Bora; Ozkan, Murat; Dogan, Omer Faruk; Cil, Barbaros E.; Dogan, Riza

    2008-01-01

    A 66-year-old man with complex left femoral arterio-venous fistula (AVF) was first diagnosed after a deep venous thrombosis incident approximately 5 years ago. Partial treatment was performed by means of endografts along the superficial femoral artery, which remained patent for 5 years. The patient had been doing well until a couple of months ago when he developed severe venous stasis and ulcers of the left cruris, due to a high-flow nonhealing complex AVF with additional iliac vein occlusion. Therefore; the definitive treatment was performed by a unique endovascular technique combined with surgical venous bypass (femoro-femoral crossover saphenous bypass, the Palma operation). A novel percutaneous transvenous technique for occlusion of a complex high-flow AVF is reported with a review of the literature. The case is unique with spontaneous AVF, transvenous embolization with detachable coils and ONYX, and the hybrid treatment technique as well as the long-term patency of superficial femoral artery stent-grafts

  18. Results of Long-Duration Simulation of Distant Retrograde Orbits

    OpenAIRE

    Gary Turner

    2016-01-01

    Distant Retrograde Orbits in the Earth–Moon system are gaining in popularity as stable “parking” orbits for various conceptual missions. To investigate the stability of potential Distant Retrograde Orbits, simulations were executed, with propagation running over a thirty-year period. Initial conditions for the vehicle state were limited such that the position and velocity vectors were in the Earth–Moon orbital plane, with the velocity oriented such that it would produce retrograde motion abou...

  19. Retrograde amnesia for semantic information in Alzheimer's disease

    OpenAIRE

    Meeter, M.; Kollen, A.; Scheltens, P.

    2005-01-01

    Patients with mild to moderate Alzheimer's disease and normal controls were tested on a retrograde amnesia test with semantic content (Neologism and Vocabulary Test, or NVT), consisting of neologisms to be defined. Patients showed a decrement as compared to normal controls, pointing to retrograde amnesia within semantic memory. No evidence for a gradient within this amnesia was found, although one was present on an autobiographic test of retrograde amnesia that had a wider time scale. Several...

  20. Management of acute gastric varices bleeding

    Directory of Open Access Journals (Sweden)

    Chen-Jung Chang

    2013-10-01

    Full Text Available Gastroesophageal varices bleeding is a major complication in patients with cirrhosis. Gastric varices (GVs occur in approximately 20% of patients with portal hypertension. However, GV bleeding develops in only 25% of patients with GV and requires more transfusion and has higher mortality than esophageal variceal (EV bleeding. The best strategy for managing acute GV bleeding is similar to that of acute EV bleeding, which involves airway protection, hemodynamic stabilization, and intensive care. Blood transfusion should be cautiously administered in order to avoid rebleeding. Vasoactive agents such as terlipressin or somatostatin should be used when GV bleeding is suspected. Routine use of prophylactic antibiotics reduces bacterial infection and lowers rebleeding rates. By administering endoscopic cyanoacrylate injection, the initial hemostasis rate achieved is at least 90% in most cases; the average mortality rate of GV bleeding is approximately 10–30% and the rebleeding rate is between 22% and 37%. Although endoscopic injection of cyanoacrylate is superior to sclerotherapy and band ligation, and has remained the treatment of choice for treating acute GV bleeding, the outcome of this treatment is still unsatisfactory. New treatment options, such as thrombin injection, transjugular intrahepatic portosystemic shunts, or balloon-occluded retrograde transvenous obliteration, have shown promising results for acute GV bleeding. However, randomized controlled trials are needed to compare the efficacy of these therapies with cyanoacrylate.

  1. CT Findings after BRTO in Patients with Gastric Varix Bleeding: Can We Predict Varix Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Joo Hwan; Kim, Young Hwan; An, Eun Jung; Kim, See Hyung; Choi, Jin Soo [Dongsan Medical Center, Keimyung University, College of Medicine, Daegu (Korea, Republic of)

    2011-02-15

    We wanted to retrospectively evaluate the CT findings after balloon occluded retrograde transvenous obliteration (BRTO) to determine whether the CT findings can predict varix recurrence. Of the 48 patients with gastric varix that was bleeding successfully treated with BRTO between February 2004 and November 2008, 35 of them who underwent follow-up endoscopy and CT were enrolled in this study. The morphologic changes of the gastric varix, including gastrorenal shunt and an afferent vein, were evaluated with the use of CT. Gastric varix recurred in 4 patients and rebleeding occurred in 2. In 22 of 25 patients who underwent CT within 6 months, complete thrombosis of the gastric varix filled with lipiodol was noted, and the gastric varix disappeared without recurrence in all the patients during the long term follow up period. In the other 3 patients who only had thrombosis without lipiodol in the gastric varix, the gastric varices recurred (p=0.0001). The existence of lipiodol, as seen on CT within 6 months after BRTO, was useful to predict complete obliteration of gastric varices without recurrence during the long term follow up period

  2. Retrograde pulmonary embolectomy in massive pulmonary embolism.

    Science.gov (United States)

    Zarrabi, Khalil; Yarmohammadi, Hooman; Ostovan, Mohammad Ali

    2005-12-01

    The purpose of this study was introduction and evaluation of efficacy and safety of retrograde thromboembolectomy in acute massive pulmonary emboli. The method is described in a 56-year-old woman with acute massive pulmonary thromboemboli. Postoperative course was uneventful. The described surgical technique is not a panacea and definitely not the whole answer, but is a big part of the solution and may be accompanied with less adverse effects. Additionally, there is a need of being reviewed further in large experimental studies and measurements before it could be used safely as a new technique.

  3. Retrograde pulmonary embolectomy in 11 patients.

    Science.gov (United States)

    Zarrabi, Khalil; Mollazadeh, Reza; Ostovan, Mohammad Ali; Abdi Ardekani, Ali Reza

    2008-04-01

    Eleven consecutive patients who had received diagnosis of massive and submassive pulmonary emboli underwent operations. After performing conventional pulmonary embolectomy, we tried to evacuate the impacted thrombus from the minor branches with the retrograde pulmonary vein perfusion. The combined amount of the removed clot was much more than that removed with the antegrade technique (p = 0.001). Postoperative echocardiography showed a significant decrease in systolic pulmonary artery pressure and right to left ventricle dimensions (p = 0.008 and 0.007, respectively). Although the results should not be excessively interpreted, this technique seems to be effective in removing the distal thrombi.

  4. Retrograde root filling with amalgam and Cavit.

    Science.gov (United States)

    Finne, K; Nord, P G; Persson, G; Lennartsson, B

    1977-04-01

    In a 3-year review of 218 teeth with retrograde root filling with amalgam orCavit, the results obtained with the former proved significantly better than those obtained with the latter. The difference seemed to be due to a better obliteration of the canal by amalgam. The obliterating effect of amalgam probably eliminates the need for revision of incomplete othograde root filling, for example, in cases with a post in the root canal. Irrespective of type of filling materials, the results were less good in cases with marginal bone loss.

  5. Visceral Arterial Aneurysms Complicating Endoscopic Retrograde Cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Vinaya Gaduputi

    2013-01-01

    Full Text Available We report this case of a 74-year-old man with altered anatomy secondary to Billroth-II surgery who underwent endoscopic retrograde cholangiopancreatography (ERCP for choledocholithiasis and subsequently developed severe diffuse abdominal pain with drop in hemoglobin. Patient was found to have hemorrhagic shock requiring aggressive resuscitative measures. Patient was found to have large peripancreatic hematoma secondary to bleeding from gastroduodenal and superior pancreaticoduodenal artery pseudoaneurysms. Gastroduodenal artery aneurysm is the rarest of all the splanchnic artery aneurysms, and to our knowledge this is the only reported case of a gastroduodenal artery pseudoaneurysm complicating ERCP.

  6. Anterograde and Retrograde Amnesia following Bitemporal Infarction

    Directory of Open Access Journals (Sweden)

    A. Schnider

    1994-01-01

    Full Text Available A patient suffered very severe anterograde and retrograde amnesia following infarction of both medial temporal lobes (hippocampus and adjacent cortex and the left inferior temporo-occipital area. The temporal stem and the amygdala were intact; these structures do not appear to be critical for new learning in humans. Extension of the left-sided infarct into the inferior temporo-occipital lobe, an area critically involved in visual processing, appears to be responsible for our patient's loss of remote memories.

  7. Retrograde prostatic urethroplasty with a balloon catheter

    International Nuclear Information System (INIS)

    Castaneda, F.; Reddy, P.; Hulbert, J.; Letourneau, J.G.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1987-01-01

    Twenty-five patients with prostatism and documented BPH who were candidates for transurethral resection of the prostate were dilated for 10 minutes with 25-mm urethroplasty balloons using a retrograde transurethral approach. The procedure was performed under local anesthesia using 2% viscous lidocaine on an outpatient basis. A mild discomfort was experienced by all patients with a moderate urgency sensation. Mild transient hematuria was present in all, which cleared in 4 to 6 hours. Dysuria usually lasted for 72 hours. Significant improvement has been seen in the relief of symptoms in patients without middle-lobe hypertrophy as documented by uroflow studies, voiding cystourethrograms, and retrograde urethrograms. In patients with middle-lobe hypertrophy, moderate improvement in uroflow studies was observed, which correlated well with symptomatic improvement. Rectal US and MR studies have shown no evidence of intraprostatic or periprostatic abnormalities. No complications have been encountered so far. The longest current follow-up is 20 months, with a mean of 10 months

  8. Cerebellar endocannabinoids: retrograde signaling from purkinje cells.

    Science.gov (United States)

    Marcaggi, Païkan

    2015-06-01

    The cerebellar cortex exhibits a strikingly high expression of type 1 cannabinoid receptor (CB1), the cannabinoid binding protein responsible for the psychoactive effects of marijuana. CB1 is primarily found in presynaptic elements in the molecular layer. While the functional importance of cerebellar CB1 is supported by the effect of gene deletion or exogenous cannabinoids on animal behavior, evidence for a role of endocannabinoids in synaptic signaling is provided by in vitro experiments on superfused acute rodent cerebellar slices. These studies have demonstrated that endocannabinoids can be transiently released by Purkinje cells and signal at synapses in a direction opposite to information transfer (retrograde). Here, following a description of the reported expression pattern of the endocannabinoid system in the cerebellum, I review the accumulated in vitro data, which have addressed the mechanism of retrograde endocannabinoid signaling and identified 2-arachidonoylglycerol as the mediator of this signaling. The mechanisms leading to endocannabinoid release, the effects of CB1 activation, and the associated synaptic plasticity mechanisms are discussed and the remaining unknowns are pointed. Notably, it is argued that the spatial specificity of this signaling and the physiological conditions required for its induction need to be determined in order to understand endocannabinoid function in the cerebellar cortex.

  9. Transfer and capture into distant retrograde orbits

    Science.gov (United States)

    Scott, Christopher J.

    This dissertation utilizes theory and techniques derived from the fields of dynamical systems theory, astrodyanamics, celestial mechanics, and fluid mechanics to analyze the phenomenon of satellite capture and interrelated spacecraft transfers in restricted three-body systems. The results extend current knowledge and understanding of capture dynamics in the context of astrodynamics and celestial mechanics. Manifold theory, fast Lyapunov indicator maps, and the classification of space structure facilitate an analysis of the transport of objects from the chaotic reaches of the solar system to the distant retrograde region in the sun-Jupiter system. Apart from past studies this dissertation considers the role of the complex lobe structure encompassing stable regions in the circular restricted three-body problem. These structures are shown to be responsible for the phenomenon of sticky orbits and the transport of objects among stable regions. Since permanent capture can only be achieved through a change in energy, fast Lyapunov indicator maps and other methods which reveal the structure of the conservative system are used to discern capture regions and identify the underpinnings of the dynamics. Fast Lyapunov indicator maps provide an accurate classification of orbits of permanent capture and escape, yet monopolize computational resources. In anticipation of a fully three-dimensional analysis in the dissipative system a new mapping parameter is introduced based on energy degradation and averaged velocity. Although the study specifically addresses the sun-Jupiter system, the qualitative results and devised techniques can be applied throughout the solar system and to capture about extrasolar planets. Extending the analysis beyond the exterior of the stable distant retrograde region fosters the construction of transfer orbits from low-Earth orbit to a stable periodic orbit at the center of the stable distant retrograde region. Key to this analysis is the predictability of

  10. Retrograde superior mesenteric artery stenting for acute mesenteric arterial thrombosis.

    Science.gov (United States)

    Do, Natalie; Wisniewski, Paul; Sarmiento, Jose; Vo, Trung; Aka, Paul K; Hsu, Jeffrey H; Tayyarah, Majid

    2010-08-01

    Retrograde superior mesenteric artery stenting (ROMS) represents a significant development in the treatment of acute mesenteric ischemia. Compared to traditional surgical mesenteric bypass, ROMS is a less invasive technique that avoids many complications associated with emergent mesenteric bypass. This case report illustrates that retrograde superior mesenteric artery (SMA) stenting is an option for the treatment of acute mesenteric ischemia for patients in extremis.

  11. A Healthy Live Birth Following ICSI with Retrograde Ejaculated Sperm

    African Journals Online (AJOL)

    AJRH Managing Editor

    Retrograde ejaculation, sometimes called dry orgasm, refers to the medical condition when semen enters the urinary bladder. (retrograde) instead of emerging through the penis after orgasm (antegrade). In some instances, a very minute quantity of antegrade semen appears in the ejaculate and may or may not be devoid of ...

  12. Retrograde amnesia for semantic information in Alzheimer's disease

    NARCIS (Netherlands)

    Meeter, M.; Kollen, A.; Scheltens, P.

    2005-01-01

    Patients with mild to moderate Alzheimer's disease and normal controls were tested on a retrograde amnesia test with semantic content (Neologism and Vocabulary Test, or NVT), consisting of neologisms to be defined. Patients showed a decrement as compared to normal controls, pointing to retrograde

  13. Retrograde amnesia for semantic information in Alzheimer’s disease

    NARCIS (Netherlands)

    Meeter, M.; Knollen, A.; Scheltens, P.

    2005-01-01

    Patients with mild to moderate Alzheimer's disease and normal controls were tested on a retrograde amnesia test with semantic content (Neologism and Vocabulary Test, or NVT), consisting of neologisms to be defined. Patients showed a decrement as compared to normal controls, pointing to retrograde

  14. Disrupting circadian rhythms in rats induces retrograde amnesia

    NARCIS (Netherlands)

    Fekete, Mátyás; Ree, J.M. van; Niesink, Raymond J.M.; Wied, D. de

    1985-01-01

    Disrupting circadian organization in rats by phase-shifting the illumination cycle or by exposure to a reversed day/night cycle or to continuous light, resulted in retrograde amnesia for passive avoidance behavior. This retrograde amnesia induced by phase-shifting lasted at least 2 days, and

  15. Modeling electric bicycle's lane-changing and retrograde behaviors

    Science.gov (United States)

    Tang, Tie-Qiao; Luo, Xiao-Feng; Zhang, Jian; Chen, Liang

    2018-01-01

    Recently, electric bicycle (EB) has been one important traffic tool due to its own merits. However, EB's motion behaviors (especially at a signalized/non-signalized intersection) are more complex than those of vehicle since it always has lane-changing and retrograde behaviors. In this paper, we propose a model to explore EB's lane-changing and retrograde behaviors on a road with a signalized intersection. The numerical results indicate that the proposed model can qualitatively describe each EB's lane-changing and retrograde behaviors near a signalized intersection, and that lane-changing and retrograde behaviors have prominent impacts on the signalized intersection (i.e., prominent jams and congestions occur). The above results show that EB should be controlled as a vehicle, i.e., lane-changing and retrograde behaviors at a signalized intersection should strictly be prohibited to improve the operational efficiency and traffic safety at the signalized intersection.

  16. Retrograde epidural catheter relieves intractable sacral pain

    Directory of Open Access Journals (Sweden)

    Ruchir Gupta

    2016-01-01

    Full Text Available Pain caused by tumor infiltration of the sacral area remains a major clinical challenge. Patients with poor pain control despite comprehensive medical management may be treated with neuraxial techniques such as continuous epidural or spinal anesthetic. We report a case in which a patient with metastatic breast cancer experienced inadequate pain relief after multiple intravenous pain management regimens as well as intrathecal (IT drug delivery. The concentration of local anesthetics delivered via the IT catheter was limited due to the patient's baseline motor weakness which would be exacerbated with higher concentrations of local anesthetics. Thus, a decision was made to insert an epidural catheter via a retrograde technique to provide the patient with a “band of anesthesia” which would provide profound sensory blockade without concomitant motor weakness. Pain refractory to other modalities of pain control was successfully treated with the epidural technique.

  17. Diagnosis and treatment with endoscopic retrograde cholangiopancreatography

    International Nuclear Information System (INIS)

    Soendenaa, K.; Horn, A.; Viste, A.

    1994-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) was carried out for the first time in 1968. Five years later endoscopic sphincterotomy was performed. Since then both modalities have become established as necessary adjuncts in the diagnosis and treatment of patients with pathology in the bile duct or pancreas. The main indication is common bile duct stone, and as a consequence of this treatment fewer patients are now treated surgically. Patients with malignant bile duct obstruction can be given reasonable palliation of both jaundice and pruritus and therefore improved quality of life. Some reports indicate that endoscopic drainage may be useful for pancreatic stenosis. Complications are few, but vigilance and prompt treatment is necessary to keep morbidity at a minimum. Follow-up after several years shows that sphincterotomy is successful also in the long term. The authors discuss the present diagnostic and therapeutic situation. 31 refs., 2 tabs

  18. Low-tilt monophasic and biphasic waveforms compared with standard biphasic waveforms in the transvenous defibrillation of ventricular fibrillation.

    Science.gov (United States)

    Bennett, Johan R; Darragh, Karen M; Walsh, Simon J; Allen, Desmond J; Scott, Michael; Stevenson, Michael; Adgey, Jennifer A A; Anderson, John M C J; Manoharan, Ganesh

    2014-03-01

    Commercially available implantable defibrillators utilize a high-tilt waveform. Studies in atrial fibrillation and transthoracic defibrillation of ventricular fibrillation (VF) have shown improved defibrillation efficacy using low-tilt (LT) waveforms. We investigated the feasibility, efficacy, and safety of a LT waveform in the transvenous defibrillation of VF and hypothesized that it would be more efficacious than standard tilted biphasic (STB) waveforms. The investigation was performed in four phases in a porcine model: an efficacy study of LT monophasic waveforms (n = 9), an efficacy study of LT biphasic waveforms (n = 9), a comparison study between the most successful LT waveforms and clinically available STB waveforms (n = 15), and a safety study (n = 9). A total of 1,056 shocks were delivered (phase 1: 288, phase 2: 288, phase 3: 480). The LT biphasic 8/4-ms waveform was significantly more likely to successfully defibrillate than the LT monophasic and STB waveforms with an odds ratio of 122.3 (95% confidence interval: 32.5, 460.2, P defibrillation threshold (E50) for the LT 8/4-ms waveform was 12.7 J compared to 43.5 J and 45.5 J for STB waveforms 6/6 ms and 8/4 ms, respectively, and 47.7 J for LT 12-ms waveform. The LT 8/4-ms waveform had no lasting detrimental effect on cardiac function, and any transient hemodynamical or biochemical changes observed were comparable to those observed with STB waveforms. LT waveforms are effective and appear safe in transvenous defibrillation in a porcine model of VF. The LT biphasic 8/4-ms waveform is more efficacious than conventional waveforms. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  19. PRODUCTION OF NEAR-EARTH ASTEROIDS ON RETROGRADE ORBITS

    International Nuclear Information System (INIS)

    Greenstreet, S.; Gladman, B.; Ngo, H.; Granvik, M.; Larson, S.

    2012-01-01

    While computing an improved near-Earth object (NEO) steady-state orbital distribution model, we discovered in the numerical integrations the unexpected production of retrograde orbits for asteroids that had originally exited from the accepted main-belt source regions. Our model indicates that ∼0.1% (a factor of two uncertainty) of the steady-state NEO population (perihelion q < 1.3 AU) is on retrograde orbits. These rare outcomes typically happen when asteroid orbits flip to a retrograde configuration while in the 3:1 mean-motion resonance with Jupiter and then live for ∼0.001 to 100 Myr. The model predicts, given the estimated near-Earth asteroid (NEA) population, that a few retrograde 0.1-1 km NEAs should exist. Currently, there are two known MPC NEOs with asteroidal designations on retrograde orbits which we therefore claim could be escaped asteroids instead of devolatilized comets. This retrograde NEA population may also answer a long-standing question in the meteoritical literature regarding the origin of high-strength, high-velocity meteoroids on retrograde orbits.

  20. The formation of retrograde planetary orbits by close stellar encounters

    Directory of Open Access Journals (Sweden)

    Ford E. B.

    2011-02-01

    Full Text Available We consider the growing number of observations of the RossiterMcLaughlin effect in transiting planets, which seem to suggest that ~30% of transiting planets are in highly inclined or retrograde orbits. We consider the dense cluster environment in which stars are born and investigate whether perturbations from passing stars can drive planetary systems into retrograde configurations. We find that fly-bys can result in significantly more inclination excitation than might naively be expected from impulse approximations, leading to several percent of stellar systems possessing planets in retrograde orbits.

  1. A systematic review of in vivo retrograde obturation materials.

    Science.gov (United States)

    Niederman, R; Theodosopoulou, J N

    2003-09-01

    The aim of this study was to answer the question: For patients requiring apicoectomy (apicectomy/root-end resection) and retrograde (root-end) obturation (filling), which retrograde obturation (root-end filling) material(s) is/are the most effective, as determined by reduction in periapical radiolucency and elimination of signs and symptoms? A MEDLINE and a Cochrane search (two specified searches) were conducted to identify randomised (RCT) and nonrandomised controlled clinical trials (CCT), cohort studies (CS) and case-control studies (CCS), published between 1966 and 2002, October week 4, conducted on humans, and published in English, German and French language, relating to retrograde obturation materials following apicoectomy. The MEDLINE and the Cochrane search identified 324 and 21 published articles, respectively. The Cochrane search identified three additional articles to the MEDLINE-search articles. Fourteen studies met the inclusion criteria: two were RCTs, six were CCTs, none was a CS and six were retrospective CCSs. Nine of the 14 studies compared a new retrograde (root-end)-filling material to amalgam, 4 of the 14 studies compared orthograde root canal fillings to retrograde (root-end) amalgam and the fourteenth study compared variations of a resin composite (Retroplast) when used in combination with the bonding agent Gluma (Bayer AG, Gluma 1 and 2). The two RCTs indicated that glass ionomer cement appeared to be equivalent to amalgam. The six CCTs indicated that orthograde filling with gutta-percha and sealer was more effective than amalgam retrograde (root-end)-filling (one trial). Similarly, retrograde (root-end)-filling with (i) composite and Gluma (Bayer AG, Leverkusen, Germany) as bonding agent (one trial), (ii) reinforced zinc oxide eugenol cement (EBA cement) (Stailine, Staident, Middlesex, England; one trial) and (iii) gold leaf (one trial) appeared to be better than amalgam retrograde (root-end)-filling. Finally, gutta-percha retrograde (root

  2. Using Kinesthetic Activities to Teach Ptolemaic and Copernican Retrograde Motion

    Science.gov (United States)

    Richards, Ted

    2012-06-01

    This paper describes a method for teaching planetary retrograde motion, and the Ptolemaic and Copernican accounts of retrograde motion, by means of a series kinesthetic learning activities (KLAs). In the KLAs described, the students literally walk through the motions of the planets in both systems. A retrospective statistical analysis shows that students who participated in these activities performed better on examination questions pertaining to retrograde motion than students who did not. Potential explanations for this result, including the breaking of classroom routine, the effect of body movement on conceptual memory, and egocentric spatial proprioception, are considered.

  3. A traumatic dural arteriovenous fistula between the inferolateral trunk of the internal carotid artery and the ophthalmic vein: A case of transvenous coil embolization via the facial vein

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Young; Hong, Chang Ki; Suh, Sang Hyun [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Ik [Dept. of of Radiology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2017-05-15

    A 31-year-old man was admitted with exophthalmos. He suffered from progressive exophthalmos, bruit and conjunctival chemosis 7 days after head trauma caused by falling down. Cerebral angiography showed a dural arteriovenous fistula (DAVF) draining into the ophthalmic vein caused by tear in the inferolateral trunk, which is a rare presentation of traumatic DAVF. Selective transvenous coil embolization was performed via the facial vein without neurologic complications.

  4. Endovascular treatment of a cavernous sinus dural arteriovenous fistula by transvenous embolisation through the superior ophthalmic vein via cannulation of a frontal vein

    International Nuclear Information System (INIS)

    Venturi, C.; Bracco, S.; Cerase, A.; Gennari, P.; Lore, F.; Polito, E.; Casasco, A.E.

    2003-01-01

    We describe a new approach for transvenous embolisation of cavernous sinus dural arteriovenous fistulae through the superior ophthalmic vein (SOV), i.e., via percutaneous cannulation of a frontal vein. Modern neurointerventional angiographic materials make it possible to reach the SOV in this way without puncturing it in the orbit or a surgical exposure. Orbital phlebography should still be in the repertoire of interventional neuroradiology units in large centres. (orig.)

  5. Relationship between seasonal weather changes, risk of dehydration, and incidence of severe bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population

    Science.gov (United States)

    Palmisano, Pietro; Accogli, Michele; Zaccaria, Maria; Vergari, Alessandra; De Luca De Masi, Gabriele; Negro, Luca; De Blasi, Sergio

    2014-09-01

    There is little information on any seasonal variations or meteorological factors associated with symptomatic bradyarrhythmias requiring cardiac pacing. The aim of this single-center study was to investigate the seasonal distribution of the incidence of severe, life-threatening bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population. Consecutive patients who underwent urgent temporary transvenous cardiac pacing between 2007 and 2012 were enrolled. The baseline characteristics of the patients and some meteorological parameters, including the calculation the daily heat index (HI), were recorded. During the study period, 79 consecutive patients (mean age 82 ± 8 years, 41 % male) underwent urgent temporary transvenous cardiac pacing, mainly for third-degree atrioventricular block (79 %). The incidence of bradyarrhythmias was significantly higher in summer than in the other seasons ( P 90 °F for >3 h per day for at least 10 days ( P renal function impairment and hyperkalemia (all P < 0.05). This study showed an increased incidence of severe bradyarrhythmias in an elderly population during the hottest months of the year. In these months, in subjects characterized by increased susceptibility to dehydration, the risk of developing bradyarrhythmias was increased significantly.

  6. Prostatic urethra malformation associated with retrograde ejaculation: a case report.

    Science.gov (United States)

    Zhao, Kai; Zhang, Jianzhong; Xu, Aiming; Zhang, Cheng; Wang, Zengjun

    2016-12-21

    Retrograde ejaculation can have anatomical, neurogenic, or pharmacological causes. Among these factors, malformation of the prostatic urethra is an uncommon cause. We describe a 29-year-old Han Chinese man with absence of his verumontanum combined with ejaculatory duct cysts, and no other cause for ejaculatory dysfunction. His verumontanum was replaced by a deep groove adjacent to his bladder neck, which could significantly influence bladder neck contraction. In addition, the large cysts in the ejaculatory duct could obstruct the anterior outlet of his prostatic urethra and prevent seminal fluid flow in an anterograde direction. There are few reports of retrograde ejaculation associated with congenital malformations of the posterior urethra. Malformations associated with bladder neck laxity and increased tone of the prostatic urethral outlet can contribute to retrograde ejaculation. Malformation of the prostatic urethra is an uncommon cause of retrograde ejaculation, and can be difficult to treat.

  7. Pleuropancreatic fistula: endoscopic retrograde cholangiopancreatography and computed tomography

    International Nuclear Information System (INIS)

    McCarthy, S.; Pellegrini, C.A.; Moss, A.A.; Way, L.W.

    1984-01-01

    The complementary use of endoscopic retrograde cholangiopancreatography and computed tomography in the diagnosis and management of pleuropancreatic fistulas is described in relation to four cases in which computed tomography revealedthe thoracic extension of a pancreatic fistula not demonstrable by endoscopic retrograde cholangiopancreatography, although the latter indicated an abnormal pancreatic duct. The complementary use of both techniques may be necessary to define the pathologic anatomy so that the appropriate therapy, particularly the surgical approach, can be decided

  8. Retrograde Melting and Internal Liquid Gettering in Silicon

    Energy Technology Data Exchange (ETDEWEB)

    Hudelson, Steve; Newman, Bonna K.; Bernardis, Sarah; Fenning, David P.; Bertoni, Mariana I.; Marcus, Matthew A.; Fakra, Sirine C.; Lai, Barry; Buonassisi, Tonio

    2011-07-01

    Retrograde melting (melting upon cooling) is observed in silicon doped with 3d transition metals, via synchrotron-based temperature-dependent X-ray microprobe measurements. Liquid metal-silicon droplets formed via retrograde melting act as efficient sinks for metal impurities dissolved within the silicon matrix. Cooling results in decomposition of the homogeneous liquid phase into solid multiple-metal alloy precipitates. These phenomena represent a novel pathway for engineering impurities in semiconductor-based systems.

  9. Retrograde vs. Antegrade Puncture for Infra-Inguinal Angioplasty

    International Nuclear Information System (INIS)

    Nice, C.; Timmons, G.; Bartholemew, P.; Uberoi, R.

    2003-01-01

    This study was done to compare antegrade punctures with a retrograde puncture technique for infrainguinal angioplasty. A group of 100 consecutive patients (71 men, 29 women) were randomized for antegrade puncture or retrograde puncture of the common femoral artery. Following retrograde puncture the guidewire was 'turned' and placed into the superficial femoral artery. The time for gaining access, screening time, radiation dose, patient height, weight and complications were recorded. All patients were reviewed the day after the procedure and within 3 months. Data from 46 patients (34 males and 12 females) in the retrograde group and 44 (28 males and 16 females) in the antegrade group were available for analysis. Mean procedure time,screening time, radiation dose, height and weight were 8.3 minutes(range 3-22), 2.1 minutes (0.3-6.5), 7950 mGy cm -2 (820-71250), 169 cm (149-204) and 79 kg (32-108) for retrograde puncture and 8 min (2-60), 0.7 min (0.0-3.2), 1069 mGycm -2 (0-15400), 169 cm (152-186) and 75 kg (39-125) for antegrade punctures, respectively. An average of 1.2 (1-2) punctures was required for retrograde and 1.75 (1-8) for antegrade. Seven small hematomas occurred with antegrade and three for retrograde puncture.Retrograde puncture is technically easier with a tendency to fewer complications but results in a higher radiation dose. This technique should be used in difficult patients at high risk of haematoma formation

  10. Mismatch analysis of humeral nailing. Antegrade versus retrograde insertion

    International Nuclear Information System (INIS)

    Mahaisavariya, B.; Jiamwatthanachai, P.; Aroonjarattham, P.; Aroonjarattham, K.; Wongcumchang, M.; Sitthiseripratip, K.

    2011-01-01

    Closed humeral nailing is now considered an alternative treatment for humeral-shaft fracture. The nail can be inserted with either the antegrade or retrograde method. We investigated and compared the problem of geometric mismatch of the humeral nail to the humerus between the two methods of insertion. The study was performed using virtual simulation based on computed tomography (CT) data of 76 Thai cadaveric humeri and the commonly used Russell-Taylor humeral nail 8 mm in diameter and 220 mm long. Mismatch of the nail to the intact humerus was analyzed and compared between the antegrade and retrograde nailing approaches. The results showed: the diameter of the medullary canal averaged 7.9-13.8 mm; the minimal reaming diameter to accommodate virtual nail insertion averaged 8.8-14.8 mm for the antegrade and 8.8-29.3 mm for the retrograde approach; the minimal reaming thickness of the inner cortex averaged 0.1-1.5 mm for the antegrade and 0.1-9.9 mm for the retrograde approach; the percentages of cortical bone removed prior to nail insertion were 3.8-107.1% and 3.8-1,287.6% for the antegrade and retrograde approaches, respectively; the eccentricity of the nail-medullary canal center were 0.4-3.4 and 0.4-10.6 mm for the antegrade and retrograde approaches, respectively. Less mismatching occurred with antegrade nailing than with the retrograde approach. Retrograde nailing requires excessive reaming at the distal part of the humerus to accommodate nail insertion. This may create bone weakness and the risk of supracondylar fracture. (author)

  11. Gelation and Retrogradation Mechanism of Wheat Amylose

    Directory of Open Access Journals (Sweden)

    Yukihiro Tamaki

    2011-10-01

    Full Text Available The flow behavior, dynamic viscoelasticity, and optical rotation of aqueous solutions of wheat amylose were measured using a rheogoniometer and a polarimeter. The amylose solutions, at 25 °C, showed shear-thinning behavior at a concentration of 1.2%, but plastic behavior at 1.4 and 1.6%, the yield values of which were estimated to be 0.6 and 1.0 Pa, respectively. The viscosity of the wheat amylose increased a little with increase in temperature up to 10 or 20 °C at 1.2% or 1.4 and 1.6%, which was estimated to be a transition temperature. The elastic modulus increased with increase in concentration, and increased with increasing temperature up to 20, 25 and 30 °C, which was estimated to be a transition temperature, respectively, then decreased gradually but stayed at a large value even at high temperature (80 °C. A very low elastic modulus of the wheat amylose was observed upon addition of urea (4.0 M and in alkaline solution (0.05 M NaOH even at low temperature. The optical rotation of wheat amylose solution increased a little with decreasing temperature down to 25 °C, then increased rapidly with further decrease in the temperature. The mode of gelation mechanism of amylose molecules, which was previously proposed, was confirmed and a retrogradation mechanism of wheat amylose was proposed.

  12. Increased sinusoidal volume and solute extraction during retrograde liver perfusion

    International Nuclear Information System (INIS)

    Bass, N.M.; Manning, J.A.; Weisiger, R.A.

    1989-01-01

    Retrograde isolated liver perfusion has been used to probe acinar functional heterogeneity, but the hemodynamic effects of backward flow have not been characterized. In this study, extraction of a long-chain fatty acid derivative, 12-N-methyl-7-nitrobenzo-2-oxa-1,3-diazol-amino stearate (12-NBDS), was greater during retrograde than during anterograde perfusion of isolated rat liver. To determine whether hemodynamic differences between anterograde and retrograde perfused livers could account for this finding, the hepatic extracellular space was measured for both directions of flow by means of [ 14 C]sucrose washout during perfusion as well as by direct measurement of [ 14 C]sucrose entrapped during perfusion. A three- to fourfold enlargement of the total hepatic extracellular space was found during retrograde perfusion by both approaches. Examination of perfusion-fixed livers by light microscopy and morphometry revealed that marked distension of the sinusoids occurred during retrograde perfusion and that this accounts for the observed increase in the [ 14 C]sucrose space. These findings support the hypothesis that maximum resistance to perfusate flow in the isolated perfused rat liver is located at the presinusoidal level. In addition, increased transit time of perfusate through the liver and greater sinusoidal surface area resulting from sinusoidal distension may account for the higher extraction of 12-NBDS and possibly other compounds by retrograde perfused liver

  13. Transvenous DSA: ECG-controlled cardial effects and venous complications after pre-atrial injection of nonionic contrast media

    International Nuclear Information System (INIS)

    Arlart, I.P.; Sigel, H.

    1986-01-01

    Transvenous DSA is a diagnostic technique for ambulatory examination that is well tolerated by patients, although it is commonly known that bolus injection of contrast medium for examination of the cardiovascular system may affect the cardiovascular hemodynamic process. The prospective study described was intended to reveal in 100 patients the effects on ECG data, as well as clinical symptoms of non-tolerance of contrast medium (nonionic, with high iodine content, Iopamidol 370), applied by central pre-atrial injection. In addition, catheterization-induced complications in the venous system of the arm were studied in 130 patients. Change of heart rate was the most frequent effect observed (increase in 49% of patients pretreated with Buscopan, decrease in 36% of non-pretreated patients). The second next effects were supraventricular and ventricular ES (20%), minor prolongations of PQ and QRS intervals (14%), and ST lowering (3%), without clinical symptons. In one case, an attack of Angina pectoris was observed, another patient developed a cutane allergy. After catheterization of brachial vein, thromboses were observed in 3% of patients, as well as local inflammations in 6%, short attacks of fever in 2.3%. The complications were observed for the most part in cases where re-sterilised catheters had been used. (orig.) [de

  14. Clinical application of transvenous temporary cardiac pacemaker in performing extra-cranial carotid angiography and stent implantation

    International Nuclear Information System (INIS)

    Liu Juan; Yao Guoen; Zhou Huadong; Jiang Xiaojiang; Chen Qiao

    2012-01-01

    Objective: To assess the safety and effectiveness of transvenous temporary cardiac pacemaker in preventing hemodynamic instability occurred during the perioperative period of extra-cranial carotid angiography and stent implantation. Methods: Preoperative install of temporary cardiac pacemaker via left femoral vein was carried out in 41 patients who were at high risk for developing hemodynamic instability, which was followed by extra-cranial carotid angiography and stent implantation. The pacing rhythm of the pacemaker was fixed at 60 beats/min. During and after the procedure the patients were under close observation for the signs of discomfort symptoms as well as the changes in blood pressure and heart rate. The working condition of the pacemaker was also monitored. Results: All the installed pacemakers were technically and hemodynamically effective in producing electrical ventricular responses in all 25 patients who had received balloon dilatation of carotid in advance. Transient pacemaker activation appeared in 25 patients. The longest activation time was one day. During pacemaker activation, one patient developed symptomatic hypotension. The longest duration of hypotension lasted for 4 days. No pacemaker-related or procedure-related complications occurred. Conclusion: Hemodynamic instability is a common complication occurred during perioperative period of extra-cranial carotid angiography and stent implantation. As a prophylactic measure, preoperative placement of temporary cardiac pacemaker can promptly and effectively correct the hemodynamic disorders and prevent perioperative complications such as stroke, etc. Therefore, this technique is worth employing in clinical practice, and it is especially useful for patients with high risks. (authors)

  15. Post-cardiac injury syndrome following transvenous pacemaker insertion: A case report and review of the literature.

    Science.gov (United States)

    Cevik, Cihan; Wilborn, Troy; Corona, Rita; Schanzmeyer, Elizabeth; Nugent, Kenneth

    2009-12-01

    Post-cardiac injury syndrome is an inflammatory process involving the pleura and pericardium secondary to cardiac injury and can develop following transvenous pacemaker insertion. We now report a patient who developed this syndrome following dual-chamber pacemaker insertion with active fixation of the atrial and ventricular leads. The pericardial fluid was bloody and had a neutrophilic predominance. The pericardial biopsy revealed fibrinous pericarditis with a mixed inflammatory cell infiltrate. The pleural effusion was exudative and had a neutrophilic predominance. Nine similar cases were identified in the English literature dating back to 1975. These patients usually present within one month after pacemaker insertion. They have exudative pericardial and pleural effusions. The pericardial effusions can cause tamponade and may require treatment with either catheter drainage or a surgical window. Some of these patients respond well to anti-inflammatory medications, including prednisone. Therefore, early identification of these patients could allow medical treatment and might help avoid the need for a surgical procedure. Cardiologists should remember that this uncommon syndrome can occur after routine endovascular procedures.

  16. Retrograde interference in perceptual learning of a peripheral hyperacuity task.

    Directory of Open Access Journals (Sweden)

    Shao-Chin Hung

    Full Text Available Consolidation, a process that stabilizes memory trace after initial acquisition, has been studied for over a century. A number of studies have shown that a skill or memory must be consolidated after acquisition so that it becomes resistant to interference from new information. Previous research found that training on a peripheral 3-dot hyperacuity task could retrogradely interfere with earlier training on the same task but with a mirrored stimulus configuration. However, a recent study failed to replicate this finding. Here we address the controversy by replicating both patterns of results, however, under different experimental settings. We find that retrograde interference occurs when eye-movements are tightly controlled, using a gaze-contingent display, where the peripheral stimuli were only presented when subjects maintained fixation. On the other hand, no retrograde interference was found in a group of subjects who performed the task without this fixation control. Our results provide a plausible explanation of why divergent results were found for retrograde interference in perceptual learning on the 3-dot hyperacuity task and confirm that retrograde interference can occur in this type of low-level perceptual learning. Furthermore, our results demonstrate the importance of eye-movement controls in studies of perceptual learning in the peripheral visual field.

  17. Mercury Retrograde Effect in Capital Markets: Truth or Illusion?

    Directory of Open Access Journals (Sweden)

    Murgea Aurora

    2016-06-01

    Full Text Available From the most ancient times, the astrological beliefs have played an important role in human history, thinking, world-views, language and other elements of social culture. The practice of relating the movement of celestial bodies to events in financial markets is relatively newer but despite the inconsistency between financial astrology and standard economic or financial theory, it seems to be largely spread among capital market traders. This paper evaluates one of the astrological effects on the capital market, more precisely the Mercury retrograde effect on US capital market. Despite the fact that it is just an optical illusion the astrological tradition says that Mercury retrograde periods are characterized by confusion and miscommunications. The trades could be less effective, the individuals more prone to make mistakes so there is a long-held belief that it is better to avoid set plans during Mercury retrograde, signing contracts, starting new ventures or open new stock market positions. The main findings of this study are lower return’s volatilities in the Mercury retrograde periods, inconsistent with the astrologic theories assumptions but consistent with the idea that trader’s beliefs in Mercury retrograde effect could change the market volatility exactly in the opposite sense than the predicted one.

  18. Results of Long-Duration Simulation of Distant Retrograde Orbits

    Directory of Open Access Journals (Sweden)

    Gary Turner

    2016-11-01

    Full Text Available Distant Retrograde Orbits in the Earth–Moon system are gaining in popularity as stable “parking” orbits for various conceptual missions. To investigate the stability of potential Distant Retrograde Orbits, simulations were executed, with propagation running over a thirty-year period. Initial conditions for the vehicle state were limited such that the position and velocity vectors were in the Earth–Moon orbital plane, with the velocity oriented such that it would produce retrograde motion about Moon. The resulting trajectories were investigated for stability in an environment that included the eccentric motion of Moon, non-spherical gravity of Earth and Moon, gravitational perturbations from Sun, Jupiter, and Venus, and the effects of radiation pressure. The results indicate that stability may be enhanced at certain resonant states within the Earth–Moon system.

  19. Conception following insemination with a freeze-preserved retrograde ejaculate.

    Science.gov (United States)

    Kapetanakis, E; Rao, R; Dmowski, W P; Scommegna, A

    1978-03-01

    Retrograde ejaculation, an infrequent cause of male infertility, may be the sequela of prostate or bladder neck surgery or the result of interruption in the sympathetic innervation to the bladder neck. The diagnosis is established by history and examination of the urine. In infertile couples artificial insemination homologous (AIH) using retrograde ejaculate recovered from the bladder has been successfully accomplished, but conception has occurred only in isolated cases. A literature review of the subject is presented. The technique of semen recovery from the bladder is time-consuming and uncomfortable to the patient, while the quality of the semen recovered is variable and the risk of iatrogenic urinary tract infection is increased. To avoid the above problems, and to have sperm available for AIH at the time of induced ovulation in an anovulatory wife, we were able to freeze-preserve ejaculate recovered from the bladder for future use. A case of conception following AIH with freeze-preserved retrograde ejaculate is presented.

  20. Fluoroscopically guided pyeloureteral interventions using a retrograde perurethral approach

    International Nuclear Information System (INIS)

    Amendola, M.A.; Banner, M.P.; Pollack, H.M.; Gordon, R.L.; Van Arsdalen, K.N.

    1987-01-01

    Employing standard interventional equipment, fluoroscopy, and partially or completely inserted ureteral catheters for access, the authors performed 168 perurethral interventional procedures since 1985. Procedures have included insertion of double (n = 42) or single pigtail stents (n = 47), advancement of retrograde ureteral catheters with or without displacement of a ureteral stone to the renal pelvis (n = 42), urothelial biopsy (n = 30), balloon dilation of ureteral structures (n = 3), ureteral stone extraction (n = 1), and conversion of retrograde to antegrade catheters for balloon dilation of ureteropelvic junction strictures (n = 3). This retrograde approach often obviates the need for antegrade interventional procedures (including percutaneous nephrostomy and ureteral stenting), ureteroscopy, or surgery. Indications, techniques, pitfalls, and complications are illustrated

  1. Choledocholithiasis diagnostics – endoscopic ultrasound or endoscopic retrograde cholangiopancreatography?

    Directory of Open Access Journals (Sweden)

    Jarosław Leszczyszyn

    2014-06-01

    Full Text Available It is estimated that 3.4% of patients qualified for cholecystectomy due to cholelithiasis have a coexisting choledocholithiasis. For decades, endoscopic ascending retrograde cholangiopancreatography has been the golden diagnostic standard in cases of suspected choledocholithiasis. The method is associated with a relatively high rate of complications, including acute pancreatitis, the incidence of which is estimated to range between 0.74% and 1.86%. The mechanism of this ERCP-induced complication is not fully understood, although factors increasing the risk of acute pancreatitis, such as sphincter of Oddi dysfunction, previous acute pancreatitis, narrow bile ducts or difficult catheterization of Vater’s ampulla are known. It has been suggested to discontinue the diagnostic endoscopic retrograde ascending cholangiopancreatography and replace it with endoscopic ultrasonography due to possible and potentially dangerous complications. Endoscopic ultrasonography has sensitivity of 94% and specificity of 95% regardless of gallstone diameter, as opposed to magnetic resonance cholangiography. However, both of these parameters depend on the experience of the performing physician. The use of endoscopic ultrasonography allows to limit the number of performed endoscopic retrograde cholangiopancreatography procedures by more than 2/3. Ascending endoscopic retrograde cholangiopancreatography combined with an endoscopic incision into the Vater’s ampulla followed by a mechanical evacuation of stone deposits from the ducts still remains a golden standard in the treatment of choledocholithiasis. Despite some limitations such as potentially increased treatment costs as well as the necessity of the procedure to be performed by a surgeon experienced in both endoscopic retrograde cholangiopancreatography as well as endoscopic ultrasonography, the diagnostic endoscopic ultrasonography followed by a simultaneous endoscopic retrograde cholangiopancreatography

  2. Dynein is the motor for retrograde axonal transport of organelles

    International Nuclear Information System (INIS)

    Schnapp, B.J.; Reese, T.S.

    1989-01-01

    Vesicular organelles in axons of nerve cells are transported along microtubules either toward their plus ends (fast anterograde transport) or toward their minus ends (retrograde transport). Two microtubule-based motors were previously identified by examining plastic beads induced to move along microtubules by cytosol fractions from the squid giant axon: (i) an anterograde motor, kinesin, and (ii) a retrograde motor, which is characterized here. The retrograde motor, a cytosolic protein previously termed HMW1, was purified from optic lobes and extruded axoplasm by nucleotide-dependent microtubule affinity and release; microtubule gliding was used as the assay of motor activity. The following properties of the retrograde motor suggest that it is cytoplasmic dynein: (i) sedimentation at 20-22 S with a heavy chain of Mr greater than 200,000 that coelectrophoreses with the alpha and beta subunits of axonemal dynein, (ii) cleavage by UV irradiation in the presence of ATP and vanadate, and (iii) a molecular structure resembling two-headed dynein from axonemes. Furthermore, bead movement toward the minus end of microtubules was blocked when axoplasmic supernatants were treated with UV/vanadate. Treatment of axoplasmic supernatant with UV/vanadate also blocks the retrograde movement of purified organelles in vitro without changing the number of anterograde moving organelles, indicating that dynein interacts specifically with a subgroup of organelles programmed to move toward the cell body. However, purified optic lobe dynein, like purified kinesin, does not by itself promote the movement of purified organelles along microtubules, suggesting that additional axoplasmic factors are necessary for retrograde as well as anterograde transport

  3. Biocompatibility of retrograde root filling materials: a review.

    Science.gov (United States)

    Bodrumlu, Emre

    2008-04-01

    The aim of a retrograde filling material is to fill the apical canal space and to obtain a hermetic seal between the periodontium and the root canal system. Several materials have been suggested for root-end filling including: amalgam, gutta-percha, zinc oxide-eugenol cements, glass ionomer cement, gold foil pellets, Cavit, composite resin and mineral trioxide aggregate (MTA). Super-ethoxy benzoic acid and MTA are the most suitable materials and provide better results in apicoectomy procedures than other filling materials. Unfortunately, the ideal material for this purpose has yet to be found. This article is a review of the biocompatibility of retrograde filling materials.

  4. Anterograde and Retrograde Effects of Benzodiazepines on Memory

    Directory of Open Access Journals (Sweden)

    Daniel Beracochea

    2006-01-01

    Full Text Available Benzodiazepines are known as “acquisition-impairing” molecules, and their effects on anterograde memory processes are well described. In contrast, the impact of benzodiazepines on retrograde memory and, more particularly, on retrieval processes, is only marginally studied. This mini-review provides an overlook of the main studies evidencing an effect of benzodiazepines on retrograde memory, both in humans and animals, with special emphasis on retrieval processes. The conditions for the emergence of the benzodiazepine-induced retrieval impairments are also discussed.

  5. A new retrograde transillumination technique for videolaryngoscopic tracheal intubation

    DEFF Research Database (Denmark)

    Biro, P; Fried, E; Schlaepfer, M

    2018-01-01

    This single-centre, prospective trial was designed to assess the efficacy of a new retrograde transillumination device called the 'Infrared Red Intubation System' (IRRIS) to aid videolaryngoscopic tracheal intubation. We included 40 adult patients, who were undergoing elective urological surgery......-10])), credibility (10 (8-10 [5-10])) and ease of use (10 (9-10 [8-10])). Tracheal intubation with the system lasted 26 (16-32 [6-89]) s. No alternative technique of securing the airway was necessary. The lowest SpO2 during intubation was 98 (97-99 [91-100])%. We conclude that this method of retrograde...

  6. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

  7. Transneuronal retrograde dual viral labelling of central autonomic circuitry : possibilities and pitfalls

    NARCIS (Netherlands)

    Ter Horst, GJ

    2000-01-01

    Viral retrograde transneuronal labelling has become an important neuroanatomical tract-tracing tool for characterization of Limbic neuronal networks. Recently, dual viral retrograde transneuronal labelling has been introduced; a method employing differential transgene expression of two genetically

  8. Osteochondral lesion of the tibial plafond treated with a retrograde osteochondral autograft: a report of two cases

    Directory of Open Access Journals (Sweden)

    Kensuke Okamura

    2017-04-01

    Conclusion: Use of the retrograde osteochondral autograft produced satisfactory results including the return to sports. The retrograde osteochondral autograft can be considered recommendable for treating OLTPs.

  9. The loss of episodic memories in retrograde amnesia: single-case and group studies.

    OpenAIRE

    Kopelman, M D; Kapur, N

    2001-01-01

    Retrograde amnesia in neurological disorders is a perplexing and fascinating research topic. The severity of retrograde amnesia is not well correlated with that of anterograde amnesia, and there can be disproportionate impairments of either. Within retrograde amnesia, there are various dissociations which have been claimed-for example, between the more autobiographical (episodic) and more semantic components of memory. However, the associations of different types of retrograde amnesia are als...

  10. Functional Outcomes of the Knee after Retrograde and Antegrade ...

    African Journals Online (AJOL)

    Background: Antegrade intramedullary nailing is currently considered the gold standard for treatment of femur shaft fractures although retrograde technique is gaining acceptance. Although introducing the nail through the knee has potential to damage the intra articular structures, several reports have indicated acceptable ...

  11. Case Report: A Healthy Live Birth Following ICSI with Retrograde ...

    African Journals Online (AJOL)

    Intracytoplasmic sperm injection (ICSI) has been employed to achieve fertilization in some cases of male subfertility e.g. severe oligoasthenoteratozoospermia. Assisted reproductive techniques to aid conception in cases of retrograde ejaculation have been described extensively elsewhere but there is paucity of knowledge ...

  12. Retrograde amnesia after electroconvulsive therapy: a temporary effect?

    Science.gov (United States)

    Meeter, Martijn; Murre, Jaap M J; Janssen, Steve M J; Birkenhager, Tom; van den Broek, W W

    2011-07-01

    Although electroconvulsive therapy (ECT) is generally considered effective against depression, it remains controversial because of its association with retrograde memory loss. Here, we assessed memory after ECT in circumstances most likely to yield strong retrograde amnesia. A cohort of patients undergoing ECT for major depression was tested before and after ECT, and again at 3-months follow-up. Included were 21 patients scheduled to undergo bilateral ECT for severe major depression and 135 controls matched for gender, age, education, and media consumption. Two memory tests were used: a verbal learning test to assess anterograde memory function, and a remote memory test that assessed memory for news during the course of one year. Before ECT the patients' scores were lower than those of controls. They were lower again after treatment, suggesting retrograde amnesia. At follow-up, however, memory for events before treatment had returned to the pre-ECT level. Memory for events in the months after treatment was as good as that of controls. The sample size in this study was not large. Moreover, memory impairment did not correlate with level of depression, which may be due to restriction of range. Our results are consistent with the possibility that ECT as currently practiced does not cause significant lasting retrograde amnesia, but that amnesia is mostly temporary and related to the period of impairment immediately following ECT. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Arfaptin-1 negatively regulates Arl1-mediated retrograde transport.

    Directory of Open Access Journals (Sweden)

    Lien-Hung Huang

    Full Text Available The small GTPase Arf-like protein 1 (Arl1 is well known for its role in intracellular vesicular transport at the trans-Golgi network (TGN. In this study, we used differential affinity chromatography combined with mass spectrometry to identify Arf-interacting protein 1b (arfaptin-1b as an Arl1-interacting protein and characterized a novel function for arfaptin-1 (including the arfaptin-1a and 1b isoforms in Arl1-mediated retrograde transport. Using a Shiga-toxin subunit B (STxB transportation assay, we demonstrated that knockdown of arfaptin-1 accelerated the retrograde transport of STxB from the endosome to the Golgi apparatus, whereas Arl1 knockdown inhibited STxB transport compared with control cells. Arfaptin-1 overexpression, but not an Arl1 binding-defective mutant (arfaptin-1b-F317A, consistently inhibited STxB transport. Exogenous arfaptin-1 expression did not interfere with the localization of the Arl1-interacting proteins golgin-97 and golgin-245 to the TGN and vice versa. Moreover, we found that the N-terminal region of arfaptin-1 was involved in the regulation of retrograde transport. Our results show that arfaptin-1 acts as a negative regulator in Arl1-mediated retrograde transport and suggest that different functional complexes containing Arl1 form in distinct microdomains and are responsible for different functions.

  14. Retrograde pylorogastric intussusception – Case report and review

    Directory of Open Access Journals (Sweden)

    Efrat Avinadav

    2016-07-01

    Full Text Available A case of gastric outlet obstruction in an infant due to retrograde intussusception of the pylorus into the stomach is presented. This anomaly is extremely rare, with almost no reports in the literature. The patient underwent formal Heineke-Mikulicz pyloroplasty with an uneventful recovery and resumed full enteral feeding.

  15. Treatment of lower extremity arterial occlusive through retrograde access

    International Nuclear Information System (INIS)

    Liu Xueqiang; Guo Pingfan; Zhang Jinchi; Cai Fanggang

    2012-01-01

    Objective: To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access. Methods: Twenty-seven cases (male 17, female 10; age range 32-89 years) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans, 7 with diabetic foot and 2 with thromboangiitis obliterans. According to the Fontaine staging, 6 cases were classified as Fontaine Ⅱ, 11 were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ. All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment, but in vain. So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery, peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting. Results: The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms. Hematoma at the puncture site occurred in 3 patients, and paresthesia of toes occurred in 1 after dorsalis pedis arteriotomy. No severe perioperative complication occurred. The average ankle brachial index increased from 0.37 ± 0.11 preoperatively to 0.85 ± 0.12 postoperatively. Conclusions: Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access. (authors)

  16. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    Retrograde jejunal intussusception is a rare disease. A 60‑year‑old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs‑en‑Y. On examination, there was a palpable wax‑like mass on the left‑hand side underneath the umbilicus. Computerized ...

  17. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    2015-11-02

    Nov 2, 2015 ... Retrograde jejunal intussusception is a rare disease. A 60-year-old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs-en-Y. On examination, there was a palpable wax-like mass on the left-hand side underneath the umbilicus.

  18. Rutinemaessig endoskopisk retrograd kolangiopankreatikografi kan ikke anbefales ved galdestenspankreatitis

    DEFF Research Database (Denmark)

    Ainsworth, Alan Patrick; Svendsen, Lars Bo

    2009-01-01

    Danish guidelines recommend that patients with presumed severe gallstone-induced acute pancreatitis (GAP) should receive endoscopic retrograde cholangiopancreatography (ERCP) within 72 hours. The results of a newly performed meta-analysis show that acute ERCP in patients with GAP does not reduce...

  19. Retrograde transport of protein toxins through the Golgi apparatus

    DEFF Research Database (Denmark)

    Sandvig, Kirsten; Skotland, Tore; van Deurs, Bo

    2013-01-01

    at the cell surface, and they are endocytosed both by clathrin-dependent and clathrin-independent mechanisms. Sorting to the Golgi and retrograde transport to the endoplasmic reticulum (ER) are common to these toxins, but the exact mechanisms turn out to be toxin and cell-type dependent. In the ER...

  20. Functional Outcomes of the Knee after Retrograde and Antegrade ...

    African Journals Online (AJOL)

    currently considered the gold standard for treatment of femur shaft fractures although retrograde technique is gaining acceptance. Although introducing the nail through the knee has potential to damage the intra articular structures, several reports have indicated acceptable functional outcome. The results are not known in ...

  1. TRANSIT TIMING VARIATIONS FOR INCLINED AND RETROGRADE EXOPLANETARY SYSTEMS

    International Nuclear Information System (INIS)

    Payne, Matthew J.; Ford, Eric B.; Veras, Dimitri

    2010-01-01

    We perform numerical calculations of the expected transit timing variations (TTVs) induced on a hot-Jupiter by an Earth-mass perturber. Motivated by the recent discoveries of retrograde transiting planets, we concentrate on an investigation of the effect of varying relative planetary inclinations, up to and including completely retrograde systems. We find that planets in low-order (e.g., 2:1) mean-motion resonances (MMRs) retain approximately constant TTV amplitudes for 0 deg. 170 deg. Systems in higher order MMRs (e.g., 5:1) increase in TTV amplitude as inclinations increase toward 45 deg., becoming approximately constant for 45 deg. 135 deg. Planets away from resonance slowly decrease in TTV amplitude as inclinations increase from 0 deg. to 180 deg., whereas planets adjacent to resonances can exhibit a huge range of variability in TTV amplitude as a function of both eccentricity and inclination. For highly retrograde systems (135 deg. < i ≤ 180 deg.), TTV signals will be undetectable across almost the entirety of parameter space, with the exceptions occurring when the perturber has high eccentricity or is very close to an MMR. This high inclination decrease in TTV amplitude (on and away from resonance) is important for the analysis of the known retrograde and multi-planet transiting systems, as inclination effects need to be considered if TTVs are to be used to exclude the presence of any putative planetary companions: absence of evidence is not evidence of absence.

  2. Endoskopisk ultralydvejledt rendezvouskolangiografi ved mislykket endoskopisk retrograd kolangiopankreatikografi

    DEFF Research Database (Denmark)

    Boman, Pia Snedker; Perdawid, Sharafaden Karim; Lykkegaard, John

    2012-01-01

    In this case report we describe an alternative method of cholangiography. Endoscopic retrograde cholangiopancreatography (ERCP) was not successful in a patient with choledocolithiasis. A combined endoscopic ultrasound (EUS) and ERCP procedure was performed and a stent was inserted in the common...

  3. Endoscopic retrograde cholangiopancreatography causes reduced myocardial blood flow

    DEFF Research Database (Denmark)

    Christensen, M; Hendel, H W; Rasmussen, V

    2002-01-01

    BACKGROUND AND STUDY AIMS: Previous studies have shown that up to 50% of healthy patients may develop ST-segment changes during upper gastrointestinal endoscopy. The aim of the study was to evaluate myocardial blood flow in patients during endoscopic retrograde cholangiopancreatography (ERCP...

  4. A rare cause of coffee-ground vomiting: Retrograde jejunogastric ...

    African Journals Online (AJOL)

    Retrograde jejunogastric intussusception is a well-recognised, rare, but potentially fatal long-term complication of gastrojejunostomy or Billroth II reconstruction. Only about 200 cases have been reported in the literature to date. Diagnosis of this condition is difficult in most cases. To avoid mortality, earlydiagnosis and prompt ...

  5. A study of retrograde degeneration of median nerve forearm ...

    African Journals Online (AJOL)

    Mona Mokhtar El Bardawil

    2013-10-22

    Oct 22, 2013 ... A study of retrograde degeneration of median nerve forearm segment in carpal tunnel syndrome of variable severities. Mona Mokhtar El Bardawil, Gihan Abd El Latief Younis,. Marwa Mohammed Hassan, Eman Ramadan Mohammed *. Alexandria University, Department of Physical Medicine, ...

  6. A study of retrograde degeneration of median nerve forearm ...

    African Journals Online (AJOL)

    Introduction: Carpal tunnel syndrome (CTS) is a disorder of the hand which results from compression of the median nerve within its fibro-osseous tunnel at the wrist. The slowing in the forearm motor conduction velocity suggests the presence of retrograde degeneration. Existing studies conflict regarding a correlation ...

  7. Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus

    DEFF Research Database (Denmark)

    Fedder, J; Kaspersen, Maja Døvling; Brandslund, I

    2013-01-01

    Retrograde ejaculation (RE) and erectile dysfunction may be caused by diabetes mellitus (DM), but the prevalence of RE among DM patients is unknown. A prospective, blinded case-control study comparing men with DM with matched controls according to RE and erectile dysfunction was performed. Twenty...

  8. Treatment of functional mitral valve regurgitation with the permanent percutaneous transvenous mitral annuloplasty system: results of the multicenter international Percutaneous Transvenous Mitral Annuloplasty System to Reduce Mitral Valve Regurgitation in Patients with Heart Failure trial.

    Science.gov (United States)

    Machaalany, Jimmy; Bilodeau, Luc; Hoffmann, Rainer; Sack, Stefan; Sievert, Horst; Kautzner, Josef; Hehrlein, Christoph; Serruys, Patrick; Sénéchal, Mario; Douglas, Pamela; Bertrand, Olivier F

    2013-05-01

    PTOLEMY-2 was a prospective multicenter phase I single-arm feasibility trial to evaluate the second-generation permanent percutaneous transvenous mitral annuloplasty (PTMA) device in reducing functional mitral regurgitation (MR). Percutaneous MR reduction has been performed through a direct method of clipping and securing the mitral leaflets together or an indirect approach of reducing mitral annular dimension via the coronary sinus. The PTMA device is the only coronary sinus mitral repair device without a static fixation element. Patients with at least moderate functional MR, New York Heart Association functional class II to IV, and left ventricular ejection fraction of 20% to 50% were enrolled at 14 centers in 5 countries. Device effects on patients were assessed by serial echocardiography, quality of life (QOL), and exercise capacity metrics. A total of 43 patients were recruited, and 30 patients (70%) were implanted with a permanent PTMA device with a mean follow-up of 5.8 ± 3.8 months. The primary safety end point (freedom from death, myocardial infarction, stroke, or emergency surgery) at 30 days was met in 28 patients, whereas 2 patients died of device-related complications. The primary efficacy end point (MR reduction of at least 1.0 grade or reduction of regurgitant orifice area by 0.1 cm(2) or regurgitant volume by 15 mL or regurgitant fraction by 10% compared with baseline) was obtained in 13 patients. No significant changes were noted in MR parameters, ventricular volumes, or QOL. Distance walked on 6 minutes testing at 6-month follow-up increased from 331 ± 167 m to 417 ± 132 m (P = .65). Compared with nonresponders, responders had a higher baseline regurgitant orifice area >0.2 cm(2) (P = .001) and less prior history of myocardial infarction (P = .02), coronary artery bypass surgery (P = .03), and ischemic MR (P = .04). Overall, PTMA had mild impact on MR reduction, left ventricular remodeling, QOL, and exercise capacity. During follow-up, the risk

  9. Retrograde amnesia following carbon monoxide poisoning: a case report.

    Science.gov (United States)

    Acland, Peter R; Heaver, Catriona

    2008-07-01

    Retrograde amnesia is a recognised neurological complication of carbon monoxide poisoning. This article describes the case of a female found dead in her bath where initial post-mortem findings and the surrounding circumstances raised strong suspicions of homicide, especially when there was contradictory evidence from her husband who was the only other person present. He was later diagnosed as having retrograde amnesia between his two visits to the bathroom to attend to his wife which caused him to merge them into one event, thus arousing suspicions of foul play. The discussion explores the current clinical views on non-fatal carbon monoxide poisoning as well as problems of interpretation of information derived from case work.

  10. Retrograde memory in cerebrovascular disease and Alzheimer's disease.

    Science.gov (United States)

    Capruso, Daniel X; Hamsher, Kerry deS

    2012-05-01

    Retrograde memory is frequently tested in the mental status examination of patients with stroke or degenerative dementia. The goal of this experiment was to compare gradients of retrograde memory in patients without neurologic disease (n = 26), patients with cerebrovascular disease (n = 43), and patients with probable Alzheimer's disease (n = 27). Patients were asked to recall and then name photographs of the 6 most recent US presidents. The free recall of patients with both cerebrovascular disease and probable Alzheimer's disease formed an exaggeration of the normal forgetting curve seen in control patients, in that the most recent presidents were most likely to be remembered. For photo naming, control patients showed essentially no forgetting, whereas patients with cerebrovascular disease or Alzheimer's disease had substantial memory loss with no temporal gradient. Alzheimer's disease caused significantly worse retrograde memory loss than did cerebrovascular disease, despite the two groups' equivalence in global intellectual functioning. Consistent with the focal or multifocal nature of cerebrovascular disease, stepwise multiple regression of retrograde memory on neuropsychological testing indicated that producing names by free recall was predicted by aphasic deficits, and that photo naming was predicted by visuoperceptual deficits. In Alzheimer's disease, free recall was predicted primarily by deficits in verbal new learning, consistent with amnesia, whereas photo naming was predicted by loss of general knowledge, consistent with dementia. The results are consistent with the idea that free recall of names from the past is a form of episodic memory, whereas naming of famous faces from the past is a form of semantic memory. Published by Elsevier Inc.

  11. Electrocardiographic Changes in Elderly Patients During Endoscopic Retrograde Cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    NG Kounis

    2003-01-01

    Full Text Available BACKGROUND: Cardiorespiratory complications may occur during gastrointestinal endoscopy, and elderly people seem to be more vulnerable to these complications during endoscopic procedures involving the manipulation of abdominal viscera. OBJECTIVES: To determine the incidence of cardiac arrhythmias, changes in oxygen saturation, heart rate and blood pressure during endoscopic retrograde cholangiopancreatography (ERCP via Holter monitoring in elderly patients older than 70 years of age.

  12. The Retrograde and Retroperitoneal Totally Laparoscopic Hysterectomy for Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    Eugenio Volpi

    2012-01-01

    Full Text Available Introduction. We retrospectively report our experience with the utilization of an original procedure for total laparoscopic hysterectomy based on completely retrograde and retroperitoneal technique for surgical staging and treatment of the endometrial cancer. The surgical, financial, and oncological advantages are here discussed. Methods. The technique used here has been based on a combination of a retroperitoneal approach with a retrograde and lateral dissection of the bladder and retrograde culdotomy with variable resection of parametrium. No disposable instruments and no uterine manipulator were utilized. Results. Intraoperative and postoperative complications were observed in 10% of the cases overall. Operative time length and mean haemoglobin drop value results were 129 min and 125 mL, respectively. Most patients were dismissed on days 3–5 from the hospital. Seventy-eight percent of the patients were alive with no evidence of disease at mean followup of 49 months. Conclusions. Our original laparoscopic technique is based on a retroperitoneal approach in order to rapidly control main uterine vessels coagulation, constantly check the ureter, and eventually decide type and site of lymph nodes removal. This procedure has important cost saving implications and the avoidance of uterine manipulator is of matter in case such as these of uterine malignancy.

  13. Retrograde recanalization of complex SFA lesions indications and techniques.

    Science.gov (United States)

    Fanelli, F; Cannavale, A

    2014-08-01

    Femoro-popliteal segment is often characterized by diffuse and severe steno-obstructive atheroclerotic disease. Most recent guidelines recommended endovascular techniques as a valid and safe treatment in highly symptomatic patients (Rutherford class 4 to 6) with complex femoropopliteal lesions (TASC C and D). Continuous technical development is increasing the efficacy of the endovascular technique with the introduction of new dedicated devices. In most complex situation also retrograde recanalization can be applied. The main indication to this technique is when conventional antegrade recanalisation fails or cannot be apply. The most common retrograde access is through the popliteal artery. However many operators do not like this approach due to the technical issue correlated to the patient position. Recently several reports have been published keeping the patient supine improving patient comfort and operator activity. This tehnique was also affected by several complications at the level of the popliteal puncture site, but those were resolved with the improvement of technique and operator skills. Hence several Authors described different variants of such technique (subintimal techniques, patient in supine position, puncture of the distal superficial femoral artery, tibial/pedal artery access) all obtaining an high rate of success with a low complication rate. In conclusion retrograde recanalization can be considered a safe and effective technique for complex femoral lesions. It is also less expensive than recanalisation devices, less time consuming and can increase the outcome due to the higher percentage of intraluminal recanalization.

  14. A retrograde co-orbital asteroid of Jupiter.

    Science.gov (United States)

    Wiegert, Paul; Connors, Martin; Veillet, Christian

    2017-03-29

    Recent theoretical work in celestial mechanics has revealed that an asteroid may orbit stably in the same region as a planet, despite revolving around the Sun in the sense opposite to that of the planet itself. Asteroid 2015 BZ 509 was discovered in 2015, but with too much uncertainty in its measured orbit to establish whether it was such a retrograde co-orbital body. Here we report observations and analysis that demonstrates that asteroid 2015 BZ 509 is indeed a retrograde co-orbital asteroid of the planet Jupiter. We find that 2015 BZ 509 has long-term stability, having been in its current, resonant state for around a million years. This is long enough to preclude precise calculation of the time or mechanism of its injection to its present state, but it may be a Halley-family comet that entered the resonance through an interaction with Saturn. Retrograde co-orbital asteroids of Jupiter and other planets may be more common than previously expected.

  15. A tripartite complex containing MRCK modulates lamellar actomyosin retrograde flow.

    Science.gov (United States)

    Tan, Ivan; Yong, Jeffery; Dong, Jing Ming; Lim, Louis; Leung, Thomas

    2008-10-03

    Actomyosin retrograde flow underlies the contraction essential for cell motility. Retrograde flow in both lamellipodia and lamella is required for membrane protrusion and for force generation by coupling to cell adhesion. We report that the Rac/Cdc42-binding kinase MRCK and myosin II-related MYO18A linked by the adaptor protein LRAP35a form a functional tripartite complex, which is responsible for the assembly of lamellar actomyosin bundles and of a subnuclear actomyosin network. LRAP35a binds independently to MYO18A and MRCK. This binding leads to MRCK activation and its phosphorylation of MYO18A, independently of ROK and MLCK. The MRCK complex moves in concert with the retrograde flow of actomyosin bundles, with MRCK being able to influence other flow components such as MYO2A. The promotion of persistent protrusive activity and inhibition of cell motility by the respective expression of wild-type and dominant-negative mutant components of the MRCK complex show it to be crucial to cell protrusion and migration.

  16. Osteochondritis Dissecans Involving the Trochlear Groove Treated With Retrograde Drilling

    Science.gov (United States)

    Kaji, Yoshio; Nakamura, Osamu; Yamaguchi, Konosuke; Yamamoto, Tetsuji

    2015-01-01

    Abstract Osteochondritis dissecans (OCD) occurs frequently in the humeral capitellum of the upper extremity, whereas OCD involving the trochlear groove (trochlear groove OCD) is rarely reported. A standard treatment for trochlear groove OCD has therefore not been determined, although several methods have been tried. The case of a 14-year-old male gymnast with bilateral trochlear groove OCD is presented. Retrograde drilling from the lateral condyle of the humerus was applied for the OCD lesion of the left elbow, since it was larger in size than that in the right elbow and was symptomatic. Conversely, since the right lesion was small and asymptomatic, it was managed conservatively. After treatment, consolidation of the OCD lesions was observed in both elbows. However, the time to healing was shorter in the left elbow treated surgically than in the right elbow managed conservatively. In conclusion, retrograde drilling is a very simple and minimally invasive treatment. This case suggests that retrograde drilling for trochlear groove OCD may be a useful procedure that may accelerate the healing process for OCD lesions. PMID:26356703

  17. Clinical features and outcomes of gastric variceal bleeding: retrospective Korean multicenter data

    Directory of Open Access Journals (Sweden)

    Moon Young Kim

    2013-03-01

    Full Text Available Background/AimsWhile gastric variceal bleeding (GVB is not as prevalent as esophageal variceal bleeding, it is reportedly more serious, with high failure rates of the initial hemostasis (>30%, and has a worse prognosis than esophageal variceal bleeding. However, there is limited information regarding hemostasis and the prognosis for GVB. The aim of this study was to determine retrospectively the clinical outcomes of GVB in a multicenter study in Korea.MethodsThe data of 1,308 episodes of GVB (males:females=1062:246, age=55.0±11.0 years, mean±SD were collected from 24 referral hospital centers in South Korea between March 2003 and December 2008. The rates of initial hemostasis failure, rebleeding, and mortality within 5 days and 6 weeks of the index bleed were evaluated.ResultsThe initial hemostasis failed in 6.1% of the patients, and this was associated with the Child-Pugh score [odds ratio (OR=1.619; P<0.001] and the treatment modality: endoscopic variceal ligation, endoscopic variceal obturation, and balloon-occluded retrograde transvenous obliteration vs. endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and balloon tamponade (OR=0.221, P<0.001. Rebleeding developed in 11.5% of the patients, and was significantly associated with Child-Pugh score (OR=1.159, P<0.001 and treatment modality (OR=0.619, P=0.026. The GVB-associated mortality was 10.3%; mortality in these cases was associated with Child-Pugh score (OR=1.795, P<0.001 and the treatment modality for the initial hemostasis (OR=0.467, P=0.001.ConclusionsThe clinical outcome for GVB was better for the present cohort than in previous reports. Initial hemostasis failure, rebleeding, and mortality due to GVB were universally associated with the severity of liver cirrhosis.

  18. Percutaneous Transportal Sclerotherapy with N-Butyl-2-Cyanoacrylate for Gastric Varices: Technique and Clinical Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Hyo Sung; Han, Young Min [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2008-12-15

    This study was deigned to evaluate the technique and clinical efficacy of the use of percutaneous transportal sclerotherapy with N-butyl-2-cyanoacrylate (NBCA) for patients with gastric varices. Seven patients were treated by transportal sclerotherapy with the use of NBCA. For transportal sclerotherapy, portal vein catheterization was performed with a 6-Fr sheath by the transhepatic approach. A 5-Fr catheter was introduced into the afferent gastric vein and a microcatheter was advanced through the 5-Fr catheter into the varices. NBCA was injected through the microcatheter in the varices by use of the continuous single-column injection technique. After the procedure, postcontrast computed tomography (CT) was performed on the next day and then every six months. Gastroendoscopy was performed at one week, three months, and then every six months after the procedure. The technical success rate of the procedure was 88%. In six patients, gastric varices were successfully obliterated with 1-8 mL (mean, 5.4 mL) of a NBCA-Lipiodol mixture injected via a microcatheter. No complications related to the procedure were encountered. As seen on the follow-up endoscopy and CT imaging performed after six months, the presence of gastric varcies was not seen in any of the patients after treatment with the NBCA-Lipiodol mixture and the use of microcoils. Recurrence of gastric varices was not observed during the followup period. Worsening of esophageal varices occurred in four patients after transportal sclerotherapy. The serum albumin level increased, the ammonia level decreased and the prothrombin time increased at six months after the procedure (p < 0.05). Percutaneous transportal sclerotherapy with NBCA is useful to obliterate gastric varices if it is not possible to perform balloon-occluded retrograde transvenous obliteration.

  19. Psychogenic amnesia: syndromes, outcome, and patterns of retrograde amnesia.

    Science.gov (United States)

    Harrison, Neil A; Johnston, Kate; Corno, Federica; Casey, Sarah J; Friedner, Kimberley; Humphreys, Kate; Jaldow, Eli J; Pitkanen, Mervi; Kopelman, Michael D

    2017-09-01

    There are very few case series of patients with acute psychogenic memory loss (also known as dissociative/functional amnesia), and still fewer studies of outcome, or comparisons with neurological memory-disordered patients. Consequently, the literature on psychogenic amnesia is somewhat fragmented and offers little prognostic value for individual patients. In the present study, we reviewed the case records and neuropsychological findings in 53 psychogenic amnesia cases (ratio of 3:1, males:females), in comparison with 21 consecutively recruited neurological memory-disordered patients and 14 healthy control subjects. In particular, we examined the pattern of retrograde amnesia on an assessment of autobiographical memory (the Autobiographical Memory Interview). We found that our patients with psychogenic memory loss fell into four distinct groups, which we categorized as: (i) fugue state; (ii) fugue-to-focal retrograde amnesia; (iii) psychogenic focal retrograde amnesia following a minor neurological episode; and (iv) patients with gaps in their memories. While neurological cases were characterized by relevant neurological symptoms, a history of a past head injury was actually more common in our psychogenic cases (P = 0.012), perhaps reflecting a 'learning episode' predisposing to later psychological amnesia. As anticipated, loss of the sense of personal identity was confined to the psychogenic group. However, clinical depression, family/relationship problems, financial/employment problems, and failure to recognize the family were also statistically more common in that group. The pattern of autobiographical memory loss differed between the psychogenic groups: fugue cases showed a severe and uniform loss of memories for both facts and events across all time periods, whereas the two focal retrograde amnesia groups showed a 'reversed' temporal gradient with relative sparing of recent memories. After 3-6 months, the fugue patients had improved to normal scores for facts

  20. Effects of inulin with different degree of polymerization on gelatinization and retrogradation of wheat starch.

    Science.gov (United States)

    Luo, Denglin; Li, Yun; Xu, Baocheng; Ren, Guangyue; Li, Peiyan; Li, Xuan; Han, Sihai; Liu, Jianxue

    2017-08-15

    The effects of three types of inulin, including FS (DP≤10), FI (DP of 2-60) and FXL (DP≥23), on the gelatinization and retrogradation characteristics of wheat starch were investigated. As the concentration of inulin added into starch increased, the gelatinization temperature increased whereas the breakdown value decreased, and the value of setback first decreased and then increased slightly. The three types of inulin with lower concentrations (inulin showed a significant suppression of starch retrogradation in the addition range of 5-7.5%. They can all inhibit amylose retrogradation, but accelerate amylopectin retrogradation. Inulin with lower DP has stronger effects on the starch retrogradation. Generally, the three types of inulin can all retard the retrogradation performance of wheat starch to some extent in the long-term storage. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Effect of porcine plasma protein hydrolysates on long-term retrogradation of corn starch.

    Science.gov (United States)

    Niu, Haili; Zhang, Mingcheng; Xia, Xiufang; Liu, Qian; Kong, Baohua

    2018-01-15

    The potential effect of porcine plasma protein hydrolysates (PPPH) on the long-term retrogradation of corn starch (CS) was investigated. The differential scanning calorimetry results showed that PPPH significantly reduced the retrogradation enthalpies (ΔHr) of CS (Pstarch. The results demonstrated that the addition of PPPH apparently played a crucial role in retarding the long-term retrogradation of CS. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Retrograde contrast radiography of the distal portions of the intestinal tract in foals

    International Nuclear Information System (INIS)

    Fischer, A.T.; Yarbrough, T.Y.

    1995-01-01

    A technique for retrograde contrast radiography of the distal portions of the intestinal tract of foals was developed and then performed in 25 foals (1 to 30 days old) with colic. Retrograde contrast radiography was shown to be sensitive (100%) and specific (100%) for evaluating obstruction of the small colon or transverse colon. It was slightly less sensitive (86%) and specific (83%) for evaluation of the entire large colon, particularly in older foals. Retrograde contrast radiography provided increased diagnostic capability, compared with that for noncontrast radiography. Retrograde contrast radiography can provide valuable information when evaluating foals with colic and should be part of the diagnostic evaluation

  3. Endoscopic retrograde cholangiopancreatography for suspected choledocholithiasis: testing the current guidelines.

    Science.gov (United States)

    Rubin, Moises Ilan Nevah; Thosani, Nirav C; Tanikella, Rajasekhar; Wolf, David S; Fallon, Michael B; Lukens, Frank J

    2013-09-01

    Current guidelines include an algorithm for predicting choledocholithiasis. Presence of any very strong predictor or both strong predictors confers a high (>50%) probability of choledocholithiasis. Absence of predictors confers low risk (choledocholithiasis. Other combinations have an intermediate risk of choledocholithiasis. Determine accuracy of the proposed algorithm in predicting choledocholithiasis. Retrospective analysis of all endoscopic retrograde cholangiopancreatographies performed for suspected choledocholithiasis in 3 years in a Tertiary care hospital and a community hospital serviced by The University of Texas Health Science Center at Houston Division of Gastroenterology. Application of the guidelines, and comparing results to endoscopic retrograde cholangiopancreatography findings. A total of 1080 endoscopic retrograde cholangiopancreatographies were performed; 521 for choledocholithiasis. Most patients were Hispanic and female. Univariate analysis: presence of any very strong predictor and both strong predictors had an OR for choledocholithiasis of 3.30 and 2.36 respectively. Multivariate analysis: odds of choledocholithiasis with any very strong predictor was 2.87, and both strong predictors 3.24. Choledocholithiasis was present in 71.5%, and 41% of patients with high, and intermediate risk respectively. This study confirms the utility of clinical predictors for the diagnosis of choledocholithiasis. All of the very strong predictors and one of the strong predictors increased the odds of choledocholithiasis. Patients with high risk for choledocholithiasis had a probability of 79% of choledocholithiasis. Sensitivity and specificity of current predictors are too low to obviate the possible need of non-invasive tests to confirm or exclude choledocholithiasis in all risk groups. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. [Retrograde intramedullary nailing for periprosthetic fractures of the distal femur].

    Science.gov (United States)

    Biber, R; Bail, H J

    2014-10-01

    Intramedullary stabilization of periprosthetic distal femoral fractures by interlocking nailing. Closed reduction by retrograde nail can be combined with the use of transmedullary support screws (TMS principle of Stedtfeld). Supracondylar fractures above stable knee arthroplasty (Rorabeck types I and II), femoral shaft fractures ipsilateral of stable hip and/or knee arthroplasty, contraindications for antegrade nailing Closed box design of femoral implant, intercondylar distance of the femoral component smaller than nail diameter, more than 40° flexion deficit of the knee, inability to place two bicortical distal interlocking screws. Relative contraindication: insufficient overlap with proximal implants Supine position and knee flexion of approximately 45°. Fluoroscopy should be possible between the knee and hip. Longitudinal skin incision into the pre-existing scar over the patellar tendon which is then split. The nail entry point is located in the intercondylar groove at the deepest point of Blumensaat's line, often predetermined by the femoral arthroplasty component. Reaming is rarely necessary. Transmedullary support screws may correct axial malalignment during nail insertion. Static interlocking in a direction from lateral to medial by the aiming device. Insertion of locking cap. Retrograde nailing normally allows full weight bearing. Range of motion does not need to be restricted. Out of 101 fractures treated between 2000 and 2013 with a Targon RF nail (Aesculap, Tuttlingen, Germany) 10 were periprosthetic, all were classified as Rorabeck type II and of these 6 fractures were metaphyseal and 4 were diaphyseal. In four cases proximal implants were present. The mean operative time for periprosthetic fracture fixation did not significantly differ from that for normal retrograde femoral nailing. There were no postoperative infections, fixation failures or delayed unions. There was one revision for secondary correction of maltorsion.

  5. Fluoroscopic guidance of retrograde exchange of ureteral stents in women.

    Science.gov (United States)

    Chang, Ruey-Sheng; Liang, Huei-Lung; Huang, Jer-Shyung; Wang, Po-Chin; Chen, Matt Chiung-Yu; Lai, Ping-Hong; Pan, Huay-Ben

    2008-06-01

    The purpose of this study was to review our experience with fluoroscopically guided retrograde exchange of ureteral stents in women. During a 48-month period, 28 women (age range, 38-76 years) were referred to our department for retrograde exchange of a ureteral stent. The causes of urinary obstruction were tumor compression in 26 patients and benign fibrotic stricture in two patients. A large-diameter snare catheter (25-mm single loop or 18- to 35-mm triple loop) or a foreign body retrieval forceps (opening width, 11.3 mm) was used to grasp the bladder end of the stent under fluoroscopic guidance. The technique entailed replacement of a patent or occluded ureteral stent with a 0.035- or 0.018-inch guidewire with or without the aid of advancement of an angiographic sheath. A total of 54 ureteral stents were exchanged with a snare catheter in 42 cases or a forceps in 12 cases. One stent misplaced too far up the ureter was replaced successfully through antegrade percutaneous nephrostomy. Ten occluded stents, including one single-J stent, were managed with a 0.018-inch guidewire in three cases, advancement of an angiographic sheath over the occluded stent into the ureter in five cases, and recannulation of the ureteral orifice with a guidewire in two cases. No complications of massive hemorrhage, ureter perforation, or infection were encountered. With proper selection of a snare or forceps catheter, retrograde exchange of ureteral stents in women can be easily performed under fluoroscopic guidance with high technical success and a low complication rate.

  6. PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY ...

    African Journals Online (AJOL)

    Kateee

    2003-04-04

    Apr 4, 2003 ... G.O. Yonga, MBChB, MMed, Consultant Cardiologist, Hurlingham Heart Clinic, P.O. Box 76555, Nairobi and P. Bonhoeffer, Consultant Cardiologist and Director. Paediatric ... Standard left and right heart catheterisation for mitral valve disease. ... to severe rheumatic fever and also carries poorer prognosis.

  7. Pancreas imaging by computed tomography after endoscopic retrograde pancreatography

    International Nuclear Information System (INIS)

    Frick, M.P.; O'Leary, J.F.; Salomonowitz, E.; Stoltenberg, E.; Hutton, S.; Gedgaudas, E.

    1984-01-01

    A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcimomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone

  8. Utility of retrograde ureterocelogram in management of complex ureterocele.

    Science.gov (United States)

    Arevalo, M K; Prieto, J C; Cost, N; Nuss, G; Brown, B J; Baker, L A

    2017-02-01

    Symptomatic pediatric ureterocele has diverse manifestations, making evidence-based management impractical. Thus, detailed visualization of ureterocele anatomy prior to first surgical incision is invaluable. Retrograde ureterocelogram (RUC) is a simple, underutilized radiologic technique that can be performed during cystoscopy. This study sought to determine whether RUC changes surgical management by more accurately depicting the complex ureteral and ureterocele anatomy, compared with renal ultrasound (US) and voiding cystourethrography (VCUG). Patients who underwent surgical management of ureterocele from 2003 to 2015 were identified; those who received concomitant fluoroscopic RUC were selected for the case series. Data collected included: demographics, pre-operative evaluation, surgical interventions, and outcomes. The RUC images were individually examined, and the anatomic impression compared with previous renal US and VCUG. Novel RUC findings not previously appreciated by the pre-operative evaluation were noted. The RUC was performed by cystoscopically inserting a needle into the ureterocele and injecting contrast retrograde. If indicated, simultaneous PIC (Positioning the Instillation of Contrast) cystography was performed. Of the 43 patients that underwent surgery for suspected ureterocele, 28 underwent cystoscopy + RUC (10 M: 18 F) at a median age of 4.6 months and median follow-up of 37.0 months. All patients had prior US, 25 had prior VCUG, and 20 had prior radionuclide studies. Ureteroceles were either duplex system (n = 21) or single system (n = 7); 17 were ectopic into the bladder neck or urethra; seven were intravesical; and four were pseudoureteroceles. Fourteen patients underwent concomitant transurethral incision of the ureterocele (TUIU); two were deferred for surgery; and 11 received concomitant definitive surgery (e.g., nephrectomy). The RUC illuminated novel aspects of the anatomy in 20 of the 28 patients. No adverse events occurred

  9. Retrograde Intrarenal Surgery for Small Renal Calyx Stones

    Directory of Open Access Journals (Sweden)

    Nevzat Sener

    2014-04-01

    Full Text Available Lower pole kidney stones are one of the most common problems is urology practice. For this group of patients, shock wave lithotripsy (SWL and retrograde intrarenal surgery (RIRS are established treatments with low morbidity and high efficacy. SWL has relatively lower success rates for lower pole stones. On the other hand, RIRS has as high as 100% success rates for lower pole stones. With advances in technology and experience we believe RIRS may be the first treatment option over SWL in the following years.

  10. Modified Technique of Retrograde Intubation in TMJ Ankylosis

    Directory of Open Access Journals (Sweden)

    Shaila Kamat

    2008-01-01

    Full Text Available We are presenting a case report on the anaesthetic management of a case of ankylosis of temporomandibular joint for corrective surgery in a 7 year old child. Anticipated difficult airway in paediatric population has always been a perplexing problem, awake fibreoptic intubation almost impossible due to obvious difficulties with co-operation. Here we are describing a new approach to this problem, in which the patients were kept under GA with spontaneous ventilation while retrograde intubation was done quite comfortably by the conventional method.

  11. The retrograde P-wave theory: explaining ST segment depression in supraventricular tachycardia by retrograde AV node conduction.

    Science.gov (United States)

    Rivera, Santiago; De La Paz Ricapito, Maria; Conde, Diego; Verdu, Mariano Badra; Roux, Jean François; Paredes, Félix Ayala

    2014-09-01

    Pseudo ischemic ST segment changes during supraventricular tachycardia (SVT) are not yet fully understood. Our aim was to determine whether venticulo-atrial (VA) conduction during SVT may be a possible mechanism for ST depression (STd) in SVT. Patients undergoing SVT ablation (2010-2012) were analyzed (n = 72).Typical atrioventricular node reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) were included. Those with STd were compared to those without STd. VA interval length, tachycardia cycle length (TCL), and retrograde P-wave activation during SVT were assessed. Retrograde P waves arriving simultaneously with the ST segment (PWST) during SVT were considered, whenever an atrial electrogram (measured from the high right atrium) was "on time" with the ST segment. Patients with STd during SVT presented longer VA intervals than those without STd (VA 100 ± 37 ms vs VA 69 ± 22 ms; P = 0.006). No differences in TCL were observed (TCL 333 ± 35 ms vs TCL 360 ± 22 ms; P = 0.1). PWST was observed in 38.5% of patients with AVNRT and STd versus 0% in those without STd. The TCL was similar in both groups (355 ± 25 ms vs 334 ± 18 ms; P = 0.1). In patients with AVRT and STd, PWST was present in 81% of cases versus 0% in those without STd. The TCL was also similar (330 ± 29 ms vs 346 ± 17 ms; P = 0.1). STd during SVT is observed at long VA intervals when the retrograde P wave matches the ST segment, without dependence on the TCL. This suggests that STd is not necessarily rate dependent but a result of a fusion between the ST segment and the P wave. ©2014 Wiley Periodicals, Inc.

  12. Mitochondrial retrograde signaling connects respiratory capacity to thermogenic gene expression.

    Science.gov (United States)

    Nam, Minwoo; Akie, Thomas E; Sanosaka, Masato; Craige, Siobhan M; Kant, Shashi; Keaney, John F; Cooper, Marcus P

    2017-05-17

    Mitochondrial respiration plays a crucial role in determining the metabolic state of brown adipose tissue (BAT), due to its direct roles in thermogenesis, as well as through additional mechanisms. Here, we show that respiration-dependent retrograde signaling from mitochondria to nucleus contributes to genetic and metabolic reprogramming of BAT. In mouse BAT, ablation of LRPPRC (LRP130), a potent regulator of mitochondrial transcription and respiratory capacity, triggers down-regulation of thermogenic genes, promoting a storage phenotype in BAT. This retrograde regulation functions by inhibiting the recruitment of PPARγ to the regulatory elements of thermogenic genes. Reducing cytosolic Ca 2+ reverses the attenuation of thermogenic genes in brown adipocytes with impaired respiratory capacity, while induction of cytosolic Ca 2+ is sufficient to attenuate thermogenic gene expression, indicating that cytosolic Ca 2+ mediates mitochondria-nucleus crosstalk. Our findings suggest respiratory capacity governs thermogenic gene expression and BAT function via mitochondria-nucleus communication, which in turn leads to either a thermogenic or storage mode.

  13. Control of synaptic function by endocannabinoid-mediated retrograde signaling

    Science.gov (United States)

    KANO, Masanobu

    2014-01-01

    Since the first reports in 2001, great advances have been made towards the understanding of endocannabinoid-mediated synaptic modulation. Electrophysiological studies have revealed that one of the two major endocannabinoids, 2-arachidonoylglycerol (2-AG), is produced from membrane lipids upon postsynaptic Ca2+ elevation and/or activation of Gq/11-coupled receptors, and released from postsynaptic neurons. The released 2-AG then acts retrogradely onto presynaptic cannabinoid CB1 receptors and induces suppression of neurotransmitter release either transiently or persistently. These forms of 2-AG-mediated retrograde synaptic modulation are functional throughout the brain. The other major endocannabinoid, anandamide, mediates a certain form of endocannabinoid-mediated long-term depression (LTD). Anandamide also functions as an agonist for transient receptor potential vanilloid receptor type 1 (TRPV1) and mediates endocannabinoid-independent and TRPV1-dependent forms of LTD. It has also been demonstrated that the endocannabinoid system itself is plastic, which can be either up- or down-regulated by experimental or environmental conditions. In this review, I will make an overview of the mechanisms underlying endocannabinoid-mediated synaptic modulation. PMID:25169670

  14. Retrograde flow and shear rate acutely impair endothelial function in humans.

    NARCIS (Netherlands)

    Thijssen, D.H.J.; Dawson, E.A.; Tinken, T.M.; Cable, N.T.; Green, D.J.

    2009-01-01

    Changes in arterial shear stress induce functional and structural vasculature adaptations. Recent studies indicate that substantial retrograde flow and shear can occur through human conduit arteries. In animals, retrograde shear is associated with atherogenic effects. The aim of this study was to

  15. Сorrection of retrograde ejaculation in patients with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    D. G. Kurbatov

    2014-11-01

    Full Text Available This article describes a new technique of correction of the retrograde ejaculation in patients with type 1 diabetes mellitus. Currently, treated 12 patients with type 1 diabetes mellitus and retrograde ejaculation as a manifestation of urogenital form of autonomic diabetic neuropathy. The positive effect of the operation was achieved in 11 of 12 treated patients. Registered 2 cases of physiological pregnancy.

  16. Deterioration of cholestasis after endoscopic retrograde cholangiography in advanced primary sclerosing cholangitis

    NARCIS (Netherlands)

    Beuers, U.; Spengler, U.; Sackmann, M.; Paumgartner, G.; Sauerbruch, T.

    1992-01-01

    Complications of endoscopic retrograde cholangiography specific to patients with primary sclerosing cholangitis have not yet been reported. We observed transient rises of serum bilirubin after diagnostic endoscopic retrograde cholangiography in five of 15 patients and persistent rises in three of 15

  17. Inhibition of wheat starch retrogradation by tea derivatives.

    Science.gov (United States)

    Zhang, Haihua; Sun, Binghua; Zhang, Shikang; Zhu, Yuejin; Tian, Yaoqi

    2015-12-10

    The effect of four industrial tea derivatives (tea polyphenols [TPS], tea water-soluble extracts [TSE], tea polysaccharides [TSS], and green tea powder [GTP]), on the retrogradation of wheat starch was investigated using texture profile analysis (TPA), differential scanning calorimetry (DSC), rapid viscosity analysis (RVA), and the α-amylase-iodine method. The addition of the four tea derivatives resulted in decreased hardness and increased cohesiveness of the starch gel as shown by the TPA test. The DSC data demonstrated an increase in the enthalpy change of starch gelatinization and a decrease in the enthalpy change of starch recrystallite dissociation. The RVA results indicated that the peak viscosity, representing the intermolecular forces of wheat starch, was reduced after addition of TPS, TSE, and TSS, respectively, but was increased by GTP. Furthermore, the half crystallization time in the Avrami equation almost doubled after the separate addition of the tea derivatives. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Retrograde versus Prograde Models of Accreting Black Holes

    Directory of Open Access Journals (Sweden)

    David Garofalo

    2013-01-01

    Full Text Available There is a general consensus that magnetic fields, accretion disks, and rotating black holes are instrumental in the generation of the most powerful sources of energy in the known universe. Nonetheless, because magnetized accretion onto rotating black holes involves both the complications of nonlinear magnetohydrodynamics that currently cannot fully be treated numerically, and uncertainties about the origin of magnetic fields that at present are part of the input, the space of possible solutions remains less constrained. Consequently, the literature still bears witness to the proliferation of rather different black hole engine models. But the accumulated wealth of observational data is now sufficient to meaningfully distinguish between them. It is in this light that this critical paper compares the recent retrograde framework with standard “spin paradigm” prograde models.

  19. Endoscopic retrograde cholangiopancreatographic evaluation of patients with obstructive jaundice

    International Nuclear Information System (INIS)

    Khurram, M.; Durrani, A.A.; Butt, A.A.; Ashfaq, S.

    2003-01-01

    Objective: To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice. Results: Of the 226 patients, 117 (51.8%) were males, and 109 (48.2%) females, their mean age being 51.8 plus minus 16.6 years. Common bile and pancreatic ducts were visualized in 81.8% and 68.1% patients respectively. Growth/masses and stones were commonest causes of obstructive jaundice. Choledocholithias was common in males, while biliary channel related growth/masses were common in females (p-value = 0.03). Common bile duct stone clearance rate was 88%, stenting was highly successful in patients with growth and strictures. ERCP related complications were noted in 11 (4.8%) patients. Conclusion: ERCP is an important diagnostic and therapeutic modality for evaluation of patients with obstructive jaundice. Growth/masses and stones are common causes of obstructive jaundice, which can be diagnosed and treated with ERCP. (author)

  20. Retrograde nailing for distal femur fractures in the elderly

    Directory of Open Access Journals (Sweden)

    Giddie Jasdeep

    2015-01-01

    Full Text Available Introduction: We report the results of treating a series of 56 fractures in 54 elderly patients with a distal femur fracture with a retrograde femoral nail. Methods: Fifty-four of the nails were inserted percutaneously with a closed reduction. After surgery all patients were allowed to weight bear as tolerated. Four fractures were supported in a temporary external splint. Results: The mean age of patients was 80.6 years (range 51–103 years, 52/54 (96% were females. There were no cases of nail related complications and no re-operations were required. One patient was lost to follow up. The 30-day mortality was 5/54 (9.3% and the one year mortality was 17/54 (31.5%. Conclusions: Distal femoral nail fixation provides a good method of fixation allowing immediate mobilisation for this group of patients.

  1. Diagnosis of choledocholithiasis and therapeutic results with endoscopic retrograde cholangiopancreatography

    International Nuclear Information System (INIS)

    Ramos Pachon, Carlos; Gonzalez Cansino, Juan; Fernandez Maderos, Irma

    2009-01-01

    A descriptive, prospective study was carried out on 451 patients that were attended for endoscopic retrograde cholangiopancreatography at CIMEQ's Hospital from January 2004-March 2006. The sample was constituted by 353 patients with choledocholithiasis suspicion. The information was search in the reports of ERCP and the variables were analyzed with the objective of evaluating the diagnostic possibilities and the therapy for choledocholithiasis by ERCP. Choledocholithiasis was detected in 1/4 of the patients with indication of ERCP, and was more frequent in patients of the female sex and in patients older than 40 years. The jaundice was the main clinical condition that motivated the ERCP in the patients with choledocholithiasis. The diagnostic effectiveness of the alkaline phosphatase and the ultrasound was not high. The treatment of the choledocholithiasis by means of ERCP showed good results and low morbidity

  2. Retrograde femoral nailing in elderly patients: outcome and functional results.

    Science.gov (United States)

    Neubauer, Thomas; Krawany, Manfred; Leitner, Lukas; Karlbauer, Alois; Wagner, Michael; Plecko, Michael

    2012-06-01

    Functional outcome after retrograde femoral intramedullary nailing was investigated in 35 patients older than 60 years (mean, 86 years) with 36 fractures, comprising 15 (41.7%) shaft and 21 (58.3%) distal fractures; overall, 7 (19.4%) periprosthetic fractures occured. Twenty-two (62.9%) of 35 patients were evaluated at a mean 16.5-month follow-up with the Lyshom-Gillquist score and the SF-8 questionaire. Primary union rate was 97.8%, with no significant differences in duration of surgery, bone healing, mobilization, and weight bearing among different fracture types; periprosthetic fractures revealed a significantly delayed mobilization (P=.03). Complications occured significantly more often among distal femoral fractures (P=.009), including all revision surgeries. The most frequently encountered complication was loosening of distal locking bolts (n=3). Lysholm score results were mainly influenced by age-related entities and revealed fair results in all fractures (mean in the femoral shaft fracture group, 78.1 vs mean in the distal femoral fracture group, 74.9; P=.69), except in the periprosthetic subgroup, which had good results (mean, 84.8; P=.23). This group also had increased physical parameters according to SF-8 score (P=.026). No correlation existed between SF-8 physical parameters and patient age or surgery delay, whereas a negative correlation existed between patient age and SF-8 mental parameters (P=.012). Retrograde femoral intramedullary nailing is commonly used in elderly patients due to reliable bone healing, minimal soft tissue damage, and immediate full weight bearing. It also offers a valid alternative to antegrade nailing in femoral shaft fractures. Copyright 2012, SLACK Incorporated.

  3. Arthroscopic Retrograde Drilling in Juvenile Osteochondritis Dissecans of the Talus.

    Science.gov (United States)

    Masquijo, Julio J; Ferreyra, Andres; Baroni, Eduardo

    2016-09-01

    Juvenile osteochondritis dissecans of the talus is rare, and the literature provides little data to guide treatment. The purpose of the present study was to evaluate our clinical and radiographic results with arthroscopic retrograde drilling in patients who were refractory to conservative care. We retrospectively evaluated all patients with juvenile osteochondritis dissecans of the talus who underwent surgery for the treatment of stable lesions that failed conservative treatment. Medical records were reviewed for symptoms and demographic information. Preoperative and latest postoperative radiographs were used to determine degree of healing. AOFAS Ankle/Hindfoot scale and visual analog scale for pain were used to evaluate clinical outcomes. We identified 6 patients (6 ankles). The mean age was 13 years, and the mean duration of follow-up was 37 months (range, 16 to 69 mo). All of them had progressed toward healing and were asymptomatic, but only 3 out of 6 had a complete radiographic healing at last follow-up. The average AOFAS Ankle/Hindfoot score improved from 69 points (55 to 75, IQR=10) preoperatively to 98 points (90 to 100, IQR=7) (P<0.0027). Visual analog scale improved from 6.2 (4 to 8, IQR=3) to 0.3 (0 to 2, IQR=1) (P<0.002). All patients expressed satisfaction with operative results. Arthroscopic retrograde drilling seems to be effective for symptoms relief, although 50% of the cases have had persistent lesions on radiographs. A longer follow-up is necessary to assess joint function in those cases with partial radiographic healing. Level IV-therapeutic.

  4. Importance of variants in cerebrovascular anatomy for potential retrograde embolization in cryptogenic stroke

    International Nuclear Information System (INIS)

    Markl, Michael; Semaan, Edouard; Carr, James; Collins, Jeremy; Stromberg, LeRoy; Prabhakaran, Shyam

    2017-01-01

    To test the hypothesis that variants in cerebrovascular anatomy will affect the number of patients demonstrating a plausible retrograde embolization mechanism from plaques in the descending aorta (DAo). Thirty-five patients (aged 63 ± 17 years) with cryptogenic stroke underwent 4D flow MRI for the assessment of aortic 3D blood flow and MR angiography for the evaluation of circle of Willis, posterior circulation, and aortic arch architecture. In patients with proven DAo plaque, retrograde embolization was considered a potential mechanism if retrograde flow extended from the DAo to a supra-aortic vessel supplying the cerebral infarct territory. Retrograde embolization with matching cerebral infarct territory was detected in six (17%) patients. Circle of Willis and aortic arch variant anatomy was found in 60% of patients, leading to reclassification of retrograde embolization risk as present in three (9%) additional patients, for a total 26% of cryptogenic stroke patients. 4D flow MRI demonstrated 26% concordance with infarct location on imaging with retrograde diastolic flow into the feeding vessels of the affected cerebral area, identifying a potential etiology for cryptogenic stroke. Our findings further demonstrate the importance of cerebrovascular anatomy when determining concordance of retrograde flow pathways with vascular stroke territory from DAo plaques. (orig.)

  5. The Yeast Retrograde Response as a Model of Intracellular Signaling of Mitochondrial Dysfunction

    Directory of Open Access Journals (Sweden)

    S. Michal eJazwinski

    2012-05-01

    Full Text Available Mitochondrial dysfunction activates intracellular signaling pathways that impact yeast longevity, and the best known of these pathways is the retrograde response. More recently, similar responses have been discerned in other systems, from invertebrates to human cells. However, the identity of the signal transducers is either unknown or apparently diverse, contrasting with the well-established signaling module of the yeast retrograde response. On the other hand, it has become equally clear that several other pathways and processes interact with the retrograde response, embedding it in a network responsive to a variety of cellular states. An examination of this network supports the notion that the master regulator NFkB aggregated a variety of mitochondria-related cellular responses at some point in evolution and has become the retrograde transcription factor. This has significant consequences for how we view some of the deficits associated with aging, such as inflammation. The support for NFkB as the retrograde response transcription factor is not only based on functional analyses. It is bolstered by the fact that NFkB can regulate Myc-Max, which is activated in human cells with dysfunctional mitochondria and impacts cellular metabolism. Myc-Max is homologous to the yeast retrograde response transcription factor Rtg1-Rtg3. Further research will be needed to disentangle the pro-aging from the anti-aging effects of NFkB. Interestingly, this is also a challenge for the complete understanding of the yeast retrograde response.

  6. Importance of variants in cerebrovascular anatomy for potential retrograde embolization in cryptogenic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Markl, Michael [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Northwestern University, Department of Biomedical Engineering, McCormick School of Engineering, Chicago, IL (United States); Semaan, Edouard; Carr, James; Collins, Jeremy [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Stromberg, LeRoy [Northwestern University, Department of Neurology, Feinberg School of Medicine, Chicago, IL (United States); Edward Hospital, Department of Radiology, Naperville, IL (United States); Prabhakaran, Shyam [Northwestern University, Department of Neurology, Feinberg School of Medicine, Chicago, IL (United States)

    2017-10-15

    To test the hypothesis that variants in cerebrovascular anatomy will affect the number of patients demonstrating a plausible retrograde embolization mechanism from plaques in the descending aorta (DAo). Thirty-five patients (aged 63 ± 17 years) with cryptogenic stroke underwent 4D flow MRI for the assessment of aortic 3D blood flow and MR angiography for the evaluation of circle of Willis, posterior circulation, and aortic arch architecture. In patients with proven DAo plaque, retrograde embolization was considered a potential mechanism if retrograde flow extended from the DAo to a supra-aortic vessel supplying the cerebral infarct territory. Retrograde embolization with matching cerebral infarct territory was detected in six (17%) patients. Circle of Willis and aortic arch variant anatomy was found in 60% of patients, leading to reclassification of retrograde embolization risk as present in three (9%) additional patients, for a total 26% of cryptogenic stroke patients. 4D flow MRI demonstrated 26% concordance with infarct location on imaging with retrograde diastolic flow into the feeding vessels of the affected cerebral area, identifying a potential etiology for cryptogenic stroke. Our findings further demonstrate the importance of cerebrovascular anatomy when determining concordance of retrograde flow pathways with vascular stroke territory from DAo plaques. (orig.)

  7. Defibrillation lead placement using a transthoracic transatrial approach in a case without transvenous access due to lack of the right superior vena cava

    Directory of Open Access Journals (Sweden)

    Yosuke Otsuka

    2015-06-01

    Full Text Available A 65-year-old woman with a history of syncope was diagnosed with hypertrophic cardiomyopathy. She had previously undergone mastectomy of the left breast owing to breast cancer. Holter electrocardiogram (ECG and monitor ECG revealed sick sinus syndrome (Type II and non-sustained ventricular tachycardia. Sustained ventricular tachycardia and ventricular fibrillation were induced in an electrophysiological study. Although the patient was eligible for treatment with a dual chamber implantable cardioverter defibrillator (ICD, venography revealed lack of the right superior vena cava (R-SVC. Lead placement from the left subclavian vein would have increased the risk of lymphedema owing to the patient׳s mastectomy history. Consequently, the defibrillation lead was placed in the right ventricle by direct puncture of the right auricle through the tricuspid valve. The atrial lead was sutured to the atrial wall, and the postoperative course was unremarkable. Defibrillation lead placement using a transthoracic transatrial approach can be an alternative method in cases where a transvenous approach for lead placement is not feasible.

  8. Diagnosis of Acute Appendicitis by Endoscopic Retrograde Appendicitis Therapy (ERAT): Combination of Colonoscopy and Endoscopic Retrograde Appendicography.

    Science.gov (United States)

    Li, Yingchao; Mi, Chen; Li, Weizhi; She, Junjun

    2016-11-01

    Acute appendicitis is the most common abdominal emergency, but the diagnosis of appendicitis remains a challenge. Endoscopic retrograde appendicitis therapy (ERAT) is a new and minimally invasive procedure for the diagnosis and treatment of acute appendicitis. To investigate the diagnostic value of ERAT for acute appendicitis by the combination of colonoscopy and endoscopic retrograde appendicography (ERA). Twenty-one patients with the diagnosis of suspected uncomplicated acute appendicitis who underwent ERAT between November 2014 and January 2015 were included in this study. The main outcomes, imaging findings of acute appendicitis including colonoscopic direct-vision imaging and fluoroscopic ERA imaging, were retrospectively reviewed. Secondary outcomes included mean operative time, mean hospital stay, rate of complication, rate of appendectomy during follow-up period, and other clinical data. The diagnosis of acute appendicitis was established in 20 patients by positive ERA (5 patients) or colonoscopy (1 patient) alone or both (14 patients). The main colonoscopic imaging findings included mucosal inflammation (15/20, 75 %), appendicoliths (14/20, 70 %), and maturation (5/20, 25 %). The key points of ERA for diagnosing acute appendicitis included radiographic changes of appendix (17/20, 85 %), intraluminal appendicoliths (14/20, 70 %), and perforation (1/20, 5 %). Mean operative time of ERAT was 49.7 min, and mean hospital stay was 3.3 days. No patient converted to emergency appendectomy. Perforation occurred in one patient after appendicoliths removal was not severe and did not require invasive procedures. During at least 1-year follow-up period, only one patient underwent laparoscopic appendectomy. ERAT is a valuable procedure of choice providing a precise yield of diagnostic information for patients with suspected acute appendicitis by combination of colonoscopy and ERA.

  9. Method of prevention of acute pancreatitis after diagnostic and therapeutic endoscopic retrograde cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Tolstokorov A.S.

    2012-09-01

    Full Text Available Objective of the study: Prevention of acute pancreatitis after diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP. Material and Methods. Analysis of the results of diagnostic and therapeutic ERCP, of the patients treated at Saratov Regional clinical hospital f during the period from 2006 to 2010. Results, lincrease in pancreatic amylase levels in blood above 50 U/l till ERCP is a risk factor for development of acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP. Conclusion. The above-stated follows to the background of increased pancreatic amylase levels in blood, performance of endoscopic retrograde cholangiopancreatography led to the development of acute pancreatitis.

  10. Independent predictors of retrograde failure in CTO-PCI after successful collateral channel crossing.

    Science.gov (United States)

    Suzuki, Yoriyasu; Muto, Makoto; Yamane, Masahisa; Muramatsu, Toshiya; Okamura, Atsunori; Igarashi, Yasumi; Fujita, Tsutomu; Nakamura, Shigeru; Oida, Akitsugu; Tsuchikane, Etsuo

    2017-07-01

    To evaluate factors for predicting retrograde CTO-PCI failure after successful collateral channel crossing. Successful guidewire/catheter collateral channel crossing is important for the retrograde approach in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). A total of 5984 CTO-PCI procedures performed in 45 centers in Japan from 2009 to 2012 were studied. The retrograde approach was used in 1656 CTO-PCIs (27.7%). We investigated these retrograde procedures to evaluate factors for predicting retrograde CTO-PCI failure even after successful collateral channel crossing. Successful guidewire/catheter collateral crossing was achieved in 77.1% (n = 1,276) of 1656 retrograde CTO-PCI procedures. Retrograde procedural success after successful collateral crossing was achieved in 89.4% (n = 1,141). Univariate analysis showed that the predictors for retrograde CTO-PCI failure were in-stent occlusion (OR = 1.9829, 95%CI = 1.1783 - 3.3370 P = 0.0088), calcified lesions (OR = 1.9233, 95%CI = 1.2463 - 2.9679, P = 0.0027), and lesion tortuosity (OR = 1.5244, 95%CI = 1.0618 - 2.1883, P = 0.0216). On multivariate analysis, lesion calcification was an independent predictor of retrograde CTO-PCI failure after successful collateral channel crossing (OR = 1.3472, 95%CI = 1.0614 - 1.7169, P = 0.0141). The success rate of retrograde CTO-PCI following successful guidewire/catheter collateral channel crossing was high in this registry. Lesion calcification was an independent predictor of retrograde CTO-PCI failure after successful collateral channel crossing. Devices and techniques to overcome complex CTO lesion morphology, such as lesion calcification, are required to further improve the retrograde CTO-PCI success rate. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Right retrograde brachial cerebral angiography with simultaneous compression of the left carotid artery

    International Nuclear Information System (INIS)

    Ericson, K.; Mosskin, M.

    1981-01-01

    Right retrograde brachial angiography with simultaneous compression of the left common carotid artery was performed in 12 patients, invariably resulting in filling of the right vertebral and the basilar artery. In all but one patient, the right carotid artery and its branches were also filled. Retrograde filling of the left internal carotid artery occurred in 8 patients. Furthermore, retrograde filling of the intracranial part of the left vertebral artery was obtained in 5 of 12 patients. A complete four-vessel cranial angiography was thus obtained in one third of the patients. The method may be considered as a safe and valuable adjunct to other angiographic techniques. (Auth.)

  12. Ankle fusion with a retrograde locked intramedullary nail

    Directory of Open Access Journals (Sweden)

    WANG Xu

    2012-06-01

    Full Text Available 【Abstract】Objective: To assess the value of ankle fusion with a retrograde locked intramedullary nail in the treatment of sequela of lower extremity compartment syndrome. Methods: Thirty-five cases of equinus deformity follow-ing tibiofibular compartment syndrome treated by means of ankle fusion with a retrograde locked intramedullary nail from January 2001 to December 2010 were retrospectively reviewed. The complications, the time needed for bony fu-sion of the ankle joint assessed by anteroposterior and lateral X-ray photographs as well as patients’ subjective evalua-tion were recorded and analysed. Results: Among the 35 patients, 15 had previously undergone surgical treatment twice on the same limb, 13 had thrice and 7 had to be operated on four times before ankle fusion. An anterior midpoint approach to the ankle joint was adopted in 29 cases, while anterior midpoint ap-proach plus a small incision on the posterior ankle joint was made in 17 cases, whereas lateral approach in 6 cases. Tar-sus joint fusion was performed on 4 cases. The follow-up period ranged 6-124 months, averaged 40.6 months. Bone grafting was not performed in this series. Preoperative tibial shaft fracture occurred in one patient and was healed after conservative treatment. Incision dehiscence located at pre-vious Achilles tendon incision was found in two patients. As a result, one received an intramedullary nail emplace-ment at calcaneoplantar part while the wound at anterosuperior part of the other one was healed by dressing change. Two patients failed to bony union 5 months postoperatively, in which one healed 10 weeks after retrieval of proximal tibial nail and another by iliac grafting. Terminal necrosis of the toe due to blood supply dysfunction was not found in this series. All the patients were satisfied with the ankle joint function postoperatively. The time for bony union on X-rays was 9.8 weeks on average. Except for one patient who demanded removal of

  13. The clinical and radiological observation of endoscopic retrograde cholangiopancreatography

    International Nuclear Information System (INIS)

    Park, Choong Shik; Park, Byoung Lan; Chun, Hyun Woo; Kim, Byung Geun; Park, Hong Bae

    1981-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a new diagnostic method for pancreatic and biliary disease which has been made possible by the development of fiberoptic duodenoscopy. It has been thought that ERCP will serve an important role in the early detection of pancreatic cancer, but in order to detect minor lesions of the pancreas and improve the diagnostic accuracy of resectable pancreatic cancer, Endoscopic Retrograde Parenchymography of the pancreas (ERPP) was developed recently. The authors analyzed 117 cases of ERCP performed at the Kwangju Christian Hospital between January and December 1980, and compared them with the final diagnosis. The results were as follows: 1. One of 117 cases, successful visualization of the duct of concern was achieved in 105 cases. Of these, 25 cases were ERPP. 2. The ratio of males to females was 1.44 : 1. Most patients were in the 4th to 6th decade. 3. The commonest clinical manifestations were upper abdominal pain (77 cases), jaundice (23 cases), indigestion, vomiting and abdominal mass, in order of frequency. 4. Out of 46 cases of suspected pancreatic diseases, the pancreatic duct was visualized in 36 cases, and 24 cases revealed pathognomonic findings. These were diagnosed as 16 cases of pancreatic cancer, 4 cases of chronic pancreatitis, 2 cases of pancreatic pseudocyst and 2 cases of periampullary cancer with pancreas invasion. In pancreatic cancer findings were; encasement, local dilatation, delayed excretion, poor filling, obstruction of pancreatic duct, accompanying C.B.D. obstruction or stenosis and so called double duct sign. The chronic pancreatitis findings included; ductal dilatation (with or without) obstruction, tortuosity with dilated saccular lateral branching, stone formation and the parenchymal filling defect. 5. Out of 71 cases of suspected biliary tract disease, the biliary tract was visualized in 57 cases, and in 31 cases abnormalities were suggested; such as 20 cases of biliary stone, 1 case

  14. Is endoscopic retrograde cholangiopancreatography valuable and safe in children of all ages?

    NARCIS (Netherlands)

    Vegting, I.L.; Tabbers, M.M.; Taminiau, J.A.; Aronson, D.C.; Benninga, M.A.; Rauws, E.A.

    2009-01-01

    OBJECTIVE: To evaluate indications, findings, therapies, safety, and technical success of endoscopic retrograde cholangiopancreatography (ERCP) in children of the Emma Children's Hospital Academic Medical Centre in Amsterdam, the Netherlands. DESIGN: Descriptive. Retrospective analysis by medical

  15. The 'SAFARI' Technique Using Retrograde Access Via Peroneal Artery Access

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Kun Da, E-mail: zkunda@gmail.com [Singapore General Hospital, Interventional Radiology Centre (Singapore); Tan, Seck Guan [Singapore General Hospital, Department of General Surgery (Singapore); Tay, Kiang Hiong [Singapore General Hospital, Interventional Radiology Centre (Singapore)

    2012-08-15

    The 'SAFARI' technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.

  16. Reconsidering the nature and mode of action of metabolite retrograde signals from the chloroplast

    Directory of Open Access Journals (Sweden)

    Gonzalo Martín Estavillo

    2013-01-01

    Full Text Available Plant organelles produce retrograde signals to alter nuclear gene expression in order to coordinate their biogenesis, maintain homeostasis or optimize their performance under adverse conditions. Many signals of different chemical nature have been described in the past decades, including chlorophyll intermediates, reactive oxygen species and adenosine derivatives. While the effects of retrograde signalling on gene expression are well understood, the initiation and transport of the signals and their mode of action have either not been resolved, or are a matter of speculation. Moreover, retrograde signalling should be consider as part of a broader cellular network, instead of as separate pathways, required to adjust to changing physiologically relevant conditions. Here we summarize current plastid retrograde signalling models in plants, with a focus on new signalling pathways, SAL1-PAP, MEcPP and β- cyclocitral, and outline missing links or future areas of research that we believe need to be addressed to have a better understanding of plant intracellular signalling networks.

  17. Vesicourethral fistula after retrograde primary endoscopic realignment in posterior urethral injury.

    Science.gov (United States)

    Arora, Rajat; John, Nirmal Thampi; Kumar, Santosh

    2015-01-01

    A 22-year-old male patient presented with iatrogenic vesicourethral fistula after immediate retrograde endoscopic realignment of urethra after a posterior urethral injury associated with pelvic fracture. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Laparoscopic cholecystectomy is more difficult after a previous endoscopic retrograde cholangiography

    NARCIS (Netherlands)

    Reinders, Jan Siert Kayitsinga; Gouma, Dirk Joan; Heisterkamp, Joos; Tromp, Ellen; van Ramshorst, Bert; Boerma, Djamila

    2013-01-01

    Endoscopic retrograde cholangiography (ERCP) with endoscopic sphincterotomy (ES) followed by a laparoscopic cholecystectomy (LC) is generally accepted as the treatment of choice for patients with choledochocystolithiasis who are eligible for surgery. Previous studies have shown that LC after ES is

  19. Retrograde cystogram for precise localization and irradiation of the urinary bladder of mice

    International Nuclear Information System (INIS)

    Meier, D.

    1988-01-01

    Using a Bangerter cannula contrast medium (Telebrix 30 Meglumine) was instilled for retrograde urography in adult, female mice. Afterwards localization, size and shape of the urinary bladder were examined by computer tomography. (author)

  20. Retrograde cystography US. A new ultrasound technique for the diagnosis and staging of vesicoureteral reflux

    International Nuclear Information System (INIS)

    Farina, R.; Arena, C.; Pennisi, F.; Di Benedetto, V.; Politi, G.; Di Benedetto, A.

    1999-01-01

    The authors investigated the accuracy of a new US (ultrasound) investigation technique, called retrograde cystography US, in the early diagnosis and staging of vesicoureteral reflux. 5 patients, aged 3 months to 10 years, suffering from hydronephrosis and/or pyelonephritis, were examined using retrograde cystography US followed by conventional retrograde cystography. Retrograde cystography US consists in the transcatheter introduction of a contrast agent into the bladder and a subsequent color Doppler examination to show or exclude the presence of reflux. Superpubic scanning of bladder, ureters and pyelocaliceal cavity was performed after echo contrast agent introduction to assess the reflux grade. US was performed with an Esaote AU 590 asynchronous scanner with a 3.5 MHz convex probe. The total agreement of conventional and US findings seems to confirm the importance of the US method for the diagnosis and staging of vesicoureteral reflux [it

  1. Factors that affect the variability in heart rate during endoscopic retrograde cholangiopancreatography

    DEFF Research Database (Denmark)

    Christensen, Merete; Reinert, Rebekka; Rasmussen, Verner

    2002-01-01

    OBJECTIVE: To find out if drugs, position, and endoscopic manipulation during endoscopic retrograde cholangiopancreatography (ERCP) influence the changes in the variability of heart rate. DESIGN: Single-blind randomised trial. SUBJECTS: 10 volunteers given butyscopolamine, glucagon, or saline...

  2. The “SAFARI” Technique Using Retrograde Access Via Peroneal Artery Access

    International Nuclear Information System (INIS)

    Zhuang, Kun Da; Tan, Seck Guan; Tay, Kiang Hiong

    2012-01-01

    The “SAFARI” technique or subintimal arterial flossing with antegrade–retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.

  3. Retrograde Tibiopedal Access as a Bail-Out Procedure for Endovascular Intervention Complications

    Directory of Open Access Journals (Sweden)

    Ahmed Amro

    2016-01-01

    Full Text Available Introduction. Retrograde pedal access has been well described in the literature as a secondary approach for limb salvage in critical limb ischemia (CLI patients. In this manuscript we are presenting a case where retrograde tibiopedal access has been used as a bail-out procedure for the management of superficial femoral artery (SFA intervention complications. Procedure/Technique. After development of a perforation while trying to cross the totally occluded mid SFA using the conventional CFA access, we were able to cross the mid SFA lesion after accessing the posterior tibial artery in a retrograde fashion and delivered a self-expanding stent which created a flap that sealed the perforation without the need for covered stent. Conclusion. Retrograde tibiopedal access is a safe and effective approach for delivery of stents from the distal approach and so can be used as a bail-out technique for SFA perforation.

  4. Retrograde solubility of formamidinium and methylammonium lead halide perovskites enabling rapid single crystal growth

    KAUST Repository

    Saidaminov, Makhsud I.

    2015-10-20

    Here we show the retrograde solubility of various hybrid perovskites through the correct choice of solvent(s) and report their solubility curves. Retrograde solubility enables to develop inverse temperature crystallization of FAPbX3 (FA = HC(NH2)2+, X = Br−/I−). FAPbI3 crystals exhibit a 1.4 eV bandgap – considerably narrower than their polycrystalline counterparts.

  5. Dating of retrograde metamorphism in Western Carpathians by K-Ar analysis of muscovites

    International Nuclear Information System (INIS)

    Cambel, B.; Korikovskij, S.P.; Krasivskaya, I.S.; Arakelyants, M.M.

    1986-01-01

    Using the K-Ar isotope dating method of muscovites it was found that many retrogradely metamorphosed rocks are the results of Variscan retrograde metamorphism and are not pre-Cambrian or Alpine metamorphites (diaphthorites). Samples for dating were taken from the Western Carpathian crystalline formation. The content of radiogenic argon was determined by mass spectrometry using the method of isotope dilution. (M.D.)

  6. Comparison of regional pancreatic tissue fluid pressure and endoscopic retrograde pancreatographic morphology in chronic pancreatitis

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Madsen, P

    1990-01-01

    The relation between pancreatic tissue fluid pressure measured by the needle method and pancreatic duct morphology was studied in 16 patients with chronic pancreatitis. After preoperative endoscopic retrograde pancreatography (ERP) the patients were submitted to a drainage operation. The predrain......The relation between pancreatic tissue fluid pressure measured by the needle method and pancreatic duct morphology was studied in 16 patients with chronic pancreatitis. After preoperative endoscopic retrograde pancreatography (ERP) the patients were submitted to a drainage operation...

  7. Transient global amnesia and functional retrograde amnesia: contrasting examples of episodic memory loss.

    OpenAIRE

    Kritchevsky, M; Zouzounis, J; Squire, L R

    1997-01-01

    We studied 11 patients with transient global amnesia (TGA) and ten patients with functional retrograde amnesia (FRA). Patients with TGA had a uniform clinical picture: a severe, relatively isolated amnesic syndrome that started suddenly, persisted for 4-12 h, and then gradually improved to essentially normal over the next 12-24 h. During the episode, the patients had severe anterograde amnesia for verbal and non-verbal material and retrograde amnesia that typically covered at least two decade...

  8. Profound loss of general knowledge in retrograde amnesia: evidence from an amnesic artist

    OpenAIRE

    Gregory, Emma; McCloskey, Michael; Landau, Barbara

    2014-01-01

    Studies of retrograde amnesia have focused on autobiographical memory, with fewer studies examining how non-autobiographical memory is affected. Those that have done so have focused primarily on memory for famous people and public events—relatively limited aspects of memory that are tied to learning during specific times of life and do not deeply tap into the rich and extensive knowledge structures that are developed over a lifetime. To assess whether retrograde amnesia can also cause impai...

  9. Intraparenchymal hematoma as a late complication of retrograde intrarenal surgery

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    Sedat Yahsi

    Full Text Available ABSTRACT A 34 year-old woman was admitted to our hospital with left flank pain. A non-contrast enhanced computerized tomography (NCCT revealed a 1.5x2cm left proximal ureter stone. Patient was scheduled for ureterorenoscopy (URS and stone removal. She was submitted to retrograde intrarenal surgery (RIRS. At the postoperative 1st day, the patient began to suffer from left flank pain. A NCCT was taken, which revealed a subcapsular hematoma and perirenal fluid. The patient was managed conservatively with intravenous fluid, antibiotic and non-steroidal anti-inflammatory drug therapy and was discharged at the postoperative 6th day. Two weeks after the discharge the patient was admitted to emergency department with severe left flank pain, palpitation and malaise. KUB (kidney-ureter-bladder radiography showed double-J stent (DJS to be repositioned to the proximal ureter. Patient was evaluated with contrast enhanced CT which revealed an 8cm intraparenchymal hematoma/abscess in the middle part of the kidney. A percutaneous drainage catheter was inserted into the collection. The percutaneous drainage catheter and the DJS were removed at the 10th day of second hospitalization. RIRS surgery is an effective and feasible choice for renal stones with high success and acceptable complication rates. However, clinician should be alert to possible complications.

  10. Occupational exposure to staff during endoscopic retrograde cholangiopancreatography in Sudan

    International Nuclear Information System (INIS)

    Sulieman, A.; Elzaki, M.; Khalil, M.

    2011-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) procedure is an invasive technique that requires fluoroscopic and radiographic exposure. The purpose of this study was to determine the occupational dose of ionising radiation at three gastroenterology departments (Fedial, Soba and Ibn seena hospitals) in Khartoum (Sudan). The radiation dose was measured during 55 therapeutic ERCP procedures. Thermoluminescence dosemeters were used. The mean radiation dose for the first operator was 0.27 mGy for the eye lens, 0.21 for the thyroid, 0.32 for the chest, 0.17 for the hand and 0.22 for the leg. The mean radiation dose for the second operator was 0.21 mGy for the hand and 0.20 mGy for the chest, while the mean radiation dose for the nurse was 0.44 mGy for the hand and 0.19 for the chest. The radiation dose received by the staff in these hospitals was found to be higher than most of the values in the literature. The radiation absorbed dose received by the different organs is relatively low. Additional studies need to be conducted for radiation dose optimisation. (authors)

  11. Fluorescence Imaging of Fast Retrograde Axonal Transport in Living Animals

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    Dawid Schellingerhout

    2009-11-01

    Full Text Available Our purpose was to enable an in vivo imaging technology that can assess the anatomy and function of peripheral nerve tissue (neurography. To do this, we designed and tested a fluorescently labeled molecular probe based on the nontoxic C fragment of tetanus toxin (TTc. TTc was purified, labeled, and subjected to immunoassays and cell uptake assays. The compound was then injected into C57BL/6 mice (N = 60 for in vivo imaging and histologic studies. Image analysis and immunohistochemistry were performed. We found that TTc could be labeled with fluorescent moieties without loss of immunoreactivity or biologic potency in cell uptake assays. In vivo fluorescent imaging experiments demonstrated uptake and retrograde transport of the compound along the course of the sciatic nerve and in the spinal cord. Ex vivo imaging and immunohistochemical studies confirmed the presence of TTc in the sciatic nerve and spinal cord, whereas control animals injected with human serum albumin did not exhibit these features. We have demonstrated neurography with a fluorescently labeled molecular imaging contrast agent based on the TTc.

  12. Feedback control of retrograde peristalsis using Neural Gastric Electrical Stimulation.

    Science.gov (United States)

    Aelen, Paul; Aulanier, Anne-Lise; Mintchev, Martin P

    2008-01-01

    Neural Gastric Electrical Stimulation (NGES) is a new method for invoking gastric contractions under microprocessor control. However, optimization of this technique using feedback mechanisms to minimize power consumption and maximize effectiveness has been lacking. The present work proposes a prototype feedback-controlled neural gastric electrical stimulator for the treatment of obesity. Both a force-based and an interelectrode impedance-based feedback neurostimulator were implemented and tested. Four mongrel dogs (2 M, 2 F, weight 14.9 ++/- 2.3kg) underwent subserosal implantation of 2-channel 1-cm bipolar electrode leads in the distal antrum. Two of the dogs were stimulated with a force-based feedback system and the other two animals were stimulated utilizing an interelectrode impedance-based feedback system. Both feedback systems were able to recognize Erythromycin-driven contractions of the stomach and were capable of overriding them with NGES-invoked retrograde contractions. The proposed technique could be helpful for retaining food longer in the stomach, thus inducing early satiety and diminishing food intake.

  13. Our Retrograde Intrarenal Surgery Experience with Horseshoe Kidney

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    Tufan Süelözgen

    2017-09-01

    Full Text Available Objective: To share our experience with retrograde intrarenal surgery (RIRS done in patients with horseshoe kidney anomaly. Materials and Methods: Data from 107 patients who underwent RIRS for kidney stones between 2013 and 2016 in our clinic was retrospectively analyzed and 6 patients with horseshoe kidney anomaly detected on computed tomography (CT were included in the study. Achieving stone-free status or having residual stones of ≤4 mm were considered operational success. Results: The mean age of the patients was 44.5±6.7 years. Four patients were male (66.6% and two were female (33.3%. The mean stone size was 14.5±4.1 (10-22 mm. Three patients had pelvis stones (50% and the rest 3 (50% had lower calyx stones. Two patients (33.3% were found to be stone-free on post-operative non-contrast CT results. Conclusion: RIRS should be performed by experienced surgeons in patients with horseshoe kidney.

  14. Earth-Mars transfers through Moon Distant Retrograde Orbits

    Science.gov (United States)

    Conte, Davide; Di Carlo, Marilena; Ho, Koki; Spencer, David B.; Vasile, Massimiliano

    2018-02-01

    This paper focuses on the trajectory design which is relevant for missions that would exploit the use of asteroid mining in stable cis-lunar orbits to facilitate deep space missions, specifically human Mars exploration. Assuming that a refueling "gas station" is present at a given lunar Distant Retrograde Orbit (DRO), ways of departing from the Earth to Mars via that DRO are analyzed. Thus, the analysis and results presented in this paper add a new cis-lunar departure orbit for Earth-Mars missions. Porkchop plots depicting the required C3 at launch, v∞ at arrival, Time of Flight (TOF), and total Δ V for various DRO departure and Mars arrival dates are created and compared with results obtained for low Δ V Low Earth Orbit (LEO) to Mars trajectories. The results show that propellant-optimal trajectories from LEO to Mars through a DRO have higher overall mission Δ V due to the additional stop at the DRO. However, they have lower Initial Mass in LEO (IMLEO) and thus lower gear ratio as well as lower TOF than direct LEO to Mars transfers. This results in a lower overall spacecraft dry mass that needs to be launched into space from Earth's surface.

  15. Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

    International Nuclear Information System (INIS)

    Saha, Saumitra; Gibson, Matthew; Magee, Timothy R.; Galland, Robert B.; Torrie, E. Peter H.

    2001-01-01

    Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA).Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr post procedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks.Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder.Stenoses (single or multiple) were present in 24 and occlusion in 15.The superficial femoral artery (SFA) was the commonest segment affected(36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found.Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae.Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two.Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occulsions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult

  16. Successful treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique.

    Science.gov (United States)

    Huynh, Thien J; Morton, Ryan P; Levitt, Michael R; Ghodke, Basavaraj V; Wink, Onno; Hallam, Danial K

    2017-08-18

    We report successful transvenous treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture. 2017 BMJ Publishing Group Ltd.

  17. Post-Golgi anterograde transport requires GARP-dependent endosome-to-TGN retrograde transport

    Science.gov (United States)

    Hirata, Tetsuya; Fujita, Morihisa; Nakamura, Shota; Gotoh, Kazuyoshi; Motooka, Daisuke; Murakami, Yoshiko; Maeda, Yusuke; Kinoshita, Taroh

    2015-01-01

    The importance of endosome-to–trans-Golgi network (TGN) retrograde transport in the anterograde transport of proteins is unclear. In this study, genome-wide screening of the factors necessary for efficient anterograde protein transport in human haploid cells identified subunits of the Golgi-associated retrograde protein (GARP) complex, a tethering factor involved in endosome-to-TGN transport. Knockout (KO) of each of the four GARP subunits, VPS51–VPS54, in HEK293 cells caused severely defective anterograde transport of both glycosylphosphatidylinositol (GPI)-anchored and transmembrane proteins from the TGN. Overexpression of VAMP4, v-SNARE, in VPS54-KO cells partially restored not only endosome-to-TGN retrograde transport, but also anterograde transport of both GPI-anchored and transmembrane proteins. Further screening for genes whose overexpression normalized the VPS54-KO phenotype identified TMEM87A, encoding an uncharacterized Golgi-resident membrane protein. Overexpression of TMEM87A or its close homologue TMEM87B in VPS54-KO cells partially restored endosome-to-TGN retrograde transport and anterograde transport. Therefore GARP- and VAMP4-dependent endosome-to-TGN retrograde transport is required for recycling of molecules critical for efficient post-Golgi anterograde transport of cell-surface integral membrane proteins. In addition, TMEM87A and TMEM87B are involved in endosome-to-TGN retrograde transport. PMID:26157166

  18. Retrograde flow and shear rate acutely impair endothelial function in humans.

    Science.gov (United States)

    Thijssen, Dick H J; Dawson, Ellen A; Tinken, Toni M; Cable, N Timothy; Green, Daniel J

    2009-06-01

    Changes in arterial shear stress induce functional and structural vasculature adaptations. Recent studies indicate that substantial retrograde flow and shear can occur through human conduit arteries. In animals, retrograde shear is associated with atherogenic effects. The aim of this study was to examine the impact of incremental levels of retrograde shear on endothelial function in vivo. On 3 separate days, we examined bilateral brachial artery flow-mediated dilation, an index of NO-mediated endothelial function, in healthy men (24+/-3 years) before and after a 30-minute intervention consisting of cuff inflation to 25, 50, or 75 mm Hg. Cuff inflations resulted in "dose"-dependent increases in retrograde shear rate, compared with the noncuffed arm, within subjects (P<0.001). Flow-mediated dilation in the cuffed arm did not change in response to the 25-mm Hg stimulus but decreased significantly after both the 50- and 75-mm Hg interventions (P<0.05). The decrease in flow-mediated dilation after the 75-mm Hg intervention was significantly larger than that observed after a 50-mm Hg intervention (P=0.03). In the noncuffed arm, no changes in shear rate or flow-mediated dilation were observed. These results demonstrate that an increase in retrograde shear rate induces a dose-dependent attenuation of endothelial function in humans. This finding contributes to our understanding regarding the possible detrimental effects of retrograde shear rate in vivo.

  19. Effects of low molecular sugars on the retrogradation of tapioca starch gels during storage.

    Directory of Open Access Journals (Sweden)

    Xiaoyu Zhang

    Full Text Available The effects of low molecular sugars (sucrose, glucose and trehalose on the retrogradation of tapioca starch (TS gels stored at 4°C for different periods were examined with different methods. Decrease in melting enthalpy (ΔHmelt were obtained through differential scanning calorimetry analysis. Analysis of decrease in crystallization rate constant (k and increase in semi-crystallization time (τ1/2 results obtained from retrogradation kinetics indicated that low molecular sugars could retard the retrogradation of TS gels and further revealed trehalose as the best inhibitor among the sugars used in this study. Fourier transform infrared (FTIR analysis indicated that the intensity ratio of 1047 to 1022 cm-1 was increased with the addition of sugars in the order of trehalose > sucrose > glucose. Decrease in hardness parameters and increase in springiness parameters obtained from texture profile analysis (TPA analysis also indicated that low molecular sugars could retard the retrogradation of TS gels. The results of FTIR and TPA showed a consistent sugar effect on starch retrogradation with those of DSC and retrogradation kinetics analysis.

  20. Focal retrograde amnesia: voxel-based morphometry findings in a case without MRI lesions.

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    Bernhard Sehm

    Full Text Available Focal retrograde amnesia (FRA is a rare neurocognitive disorder presenting with an isolated loss of retrograde memory. In the absence of detectable brain lesions, a differentiation of FRA from psychogenic causes is difficult. Here we report a case study of persisting FRA after an epileptic seizure. A thorough neuropsychological assessment confirmed severe retrograde memory deficits while anterograde memory abilities were completely normal. Neurological and psychiatric examination were unremarkable and high-resolution MRI showed no neuroradiologically apparent lesion. However, voxel-based morphometry (VBM-comparing the MRI to an education-, age-and sex-matched control group (n = 20 disclosed distinct gray matter decreases in left temporopolar cortex and a region between right posterior parahippocampal and lingual cortex. Although the results of VBM-based comparisons between a single case and a healthy control group are generally susceptible to differences unrelated to the specific symptoms of the case, we believe that our data suggest a causal role of the cortical areas detected since the retrograde memory deficit is the preeminent neuropsychological difference between patient and controls. This was paralleled by grey matter differences in central nodes of the retrograde memory network. We therefore suggest that these subtle alterations represent structural correlates of the focal retrograde amnesia in our patient. Beyond the implications for the diagnosis and etiology of FRA, our results advocate the use of VBM in conditions that do not show abnormalities in clinical radiological assessment, but show distinct neuropsychological deficits.

  1. Intraoperative cone-beam computed tomography contributes to avoiding hypoglossal nerve palsy during transvenous embolization for dural arteriovenous fistula of the anterior condylar confluence.

    Science.gov (United States)

    Okamura, Akitake; Nakaoka, Mitsuo; Ohbayashi, Naohiko; Yahara, Kaita; Nabika, Shinya

    2016-10-01

    Dural arteriovenous fistula of the anterior condylar confluence (ACC-DAVF) is a rare subtype of DAVFs that occurs around the hypoglossal canal. Transvenous embolization (TVE) with coils has been performed for most ACC-DAVFs with a high clinical cure rate. However, some reports call attention to hypoglossal nerve palsy associated with TVE due to coil mass compression of the hypoglossal nerve caused by coil deviation from the ACC to the anterior condylar vein (ACV). Herein, we report a case of ACC-DAVF in which an intraoperative cone-beam computed tomography (CT) contributed to avoiding hypoglossal nerve palsy. A 74-year-old man presented with left pulse-synchronous tinnitus. An angiography detected left ACC-DAVF mainly supplied by the left ascending pharyngeal artery and mainly drained through the ACV. The two fistulous points were medial side of the ACC and the venous pouch just cranial of the ACC. We performed TVE detecting the fistulous points by contralateral external carotid angiography (ECAG). The diseased venous pouch and ACC were packed with seven coils but a slight remnant of the DAVF was recognized. Because a cone-beam CT revealed that the coil mass was localized in the lateral lower clivus osseous without deviation to the hypoglossal canal, we finished TVE to avoid hypoglossal nerve palsy. Postoperatively, no complication was observed. No recurrence of symptoms or imaging findings were detected during a five-month follow-up period. An intraoperative cone-beam CT contributed to avoiding hypoglossal nerve palsy by estimating the relationship between the coil mass and the hypoglossal canal during TVE of ACC-DAVF. © The Author(s) 2016.

  2. Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography

    Directory of Open Access Journals (Sweden)

    M. P. Mantserov

    2007-01-01

    Full Text Available Hemorrhage from the major duodenal papilla (MDP is a most common complication of endoscopic retrograde cholecystopancreatography (ERCPG with/without papillosphincterotomy (PST.The objective of the present study was to estimate the frequency of this complication and to evaluate the efficiency of methods for its prevention.Subjects and methods: In 1994 to 2005, the N. N. Burdenko Main Military Hospital performed 1373 ERCPGs with/without PST. The patients were divided into 2 groups: 1 326 patients (males, 75.1%; mean age, 58.2±16.1 years who had no drug preventive therapy for postmanipulation complications and PST was performed by the routine procedure; 2 1047 patients (males, 71.9%; mean age, 56.3±14.5 years who had endoscopic (PST being performed, by using atypical or combined procedures and drug (octreotide and protease inhibitors prevention of complications. The incidence of hemorrhage from MDP and a need for endoscopic bleeding arrest were estimated.Results: Just after the manipulation, hemorrhage requiring endoscopic arrest occurred in 24 (7.3% and 43 (4.1% patients in Groups 1 and 2, respectively (p<0.001. Following 24 hours, hemorrhage developed in 6 (13.9% and 3 (3.9% patients (p<0.001, this requiring surgical intervention in 1 (2.3% and 2 (26% patients from Groups 1 and 2, respectively. After 48 hours, hemorrhage recurred in 1 patient in each of the study groups and the signs of unstable hemostasis in esogaso-duodenoscopy (Forrest 2 a,b were detected in 6 (139% and 5 (6.6% patients in Groups 1 and 2, respectively (p<0.05.Conclusion: After ERCPG with PST, hemorrhage occurs in 4.9% of the patients. PST by atypical and combined procedures and the administration of octreotide and protease inhibitors effectively reduce the risk of this complication. 

  3. Endoscopic retrograde cholangiopancreatography in the treatment of intraoperatively demonstrated choledocholithiasis.

    Science.gov (United States)

    Lynn, A P; Chong, G; Thomson, A

    2014-01-01

    The aim of this study was to determine the efficacy and complications of postoperative endoscopic retrograde cholangiopancreatography (ERCP) in confirming and treating choledocholithiasis found at intraoperative cholangiography during laparoscopic cholecystectomy. Patients who had undergone ERCP following a cholecystectomy between 2008 and 2011 with an indication of intraoperative cholangiography findings consistent with choledocholithiasis were identified from a prospectively collected database of a single endoscopist. Deep biliary access rate, confirmation of choledocholithiasis, clearance rate of bile duct stones, delay between cholecystectomy and postoperative ERCP, and the complication rates following the procedure were analysed. The median age of the 41 patients (16 male, 25 female) was 42 years (range: 18-82 years). Sixteen surgeons performed the operations with a median delay of 6 days (range: 1-103 days) between cholecystectomy and postoperative ERCP. Common bile duct access was achieved in 100% of the patients, with ERCP taking a median time of 16 minutes (range: 6-40 minutes). Initial ERCP confirmed the presence of a stone in 30 patients (73%) and successful stone removal occurred in 28 of these 30 patients (93%) during the first ERCP and in the remaining 2 on a subsequent ERCP. Following ERCP, two patients (4.9%) experienced extended hospital stays for four and eight days owing to complications, including one patient (2.4%) with mild acute pancreatitis. This study demonstrates that postoperative ERCP is highly effective in both confirming and treating choledocholithiasis. However, there is a significant risk of short-term complications that must be taken into consideration when deciding management.

  4. Role of endoscopic retrograde cholangiopancreatography before and after laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Sbeih, F.; Aljohani, M.; Altraif, I.; Khan, H.

    1998-01-01

    While the role of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) in the diagnosis and management of choledocholithiasis is well established, this study evaluates the usefulness of ERCP and EST patients with symptomatic cholecystolithiasis and suspected choledocholithiasis before undergoing laparoscopic cholecystectomy (LC), and the role of ERCP-EST in the management of complications resulting from LC. This paper reviews retrospectively our experience from 1992 to 1995. A total of 1221 LCs and 717 ERCPs were performed on 225 patients who underwent LC (230 ERCPs before and 27 after). The age range was 10-85 years (mean 43.5. The study group comprised 148 (66%) females and 77 males (34%). The overall success rate for ERCP was 92% (96% for diagnostic and 88% for therapeutic). Choledocholithiasis was found at preoperative ERCP in 45% cases. Prediction of cholecoledocholithiasis was accurate in 46%, based on abnormal liver chemistry, and 70% when based on a combination of abnormal liver tests and dilated main bile duct (>7 mm) by ultrasound. In 40 cases of acute biliary pancreatitis, choledocholithiasis was found at ERCP in eight cases (20%). In the post LC-group, all eight cases with residual stones and seven of eight cases with bile leaks were successfully treated endoscopically. There were four cases with major duct injuries that required surgical management. The complications related to ERCP-EST included two cases of bleeding post-EST (one was controlled with injection therapy and the second one was managed surgically) and three cases of mild pancreatitis. ERCP and EST are effective and safe in the diagnosis and management of choledocholithiasis and facilitate LC for symptomatic cholelithiasis. The procedures are also valuable in the diagnosis and management of most complications resulting from LC. (author)

  5. Is routine ureteral stenting really necessary after retrograde intrarenal surgery?

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    Ekrem Ozyuvali

    2015-03-01

    Full Text Available Objectives: To investigate the situations in which ureteral double-J stent should be used after retrograde intrarenal surgery (RIRS. Patients and Methods: Patients with no ureteral double-J stent after RIRS constituted Group 1, and those with double- J stent after RIRS constituted Group 2. Patients’ age and gender, renal stone characteristics (location and dimension, stone-free status, VAS score 8 hours after surgery, post-procedural renal colic attacks, length of hospitalization, requirement for re-hospitalization, time to rehospitalization and secondary procedure requirements were analyzed. Results: RIRS was performed on 162 renal units. Double-J stent was used in 121 (74.6% of these after RIRS, but not in the other 41 (25.4%. At radiological monitoring at the first month postoperatively after RIRS, complete stone-free status was determined in 122 (75.3% renal units, while residual stone was present in 40 (24.6%. No significant differences were observed between the groups in terms of duration of fluoroscopy (p = 0.142, operation (p = 0.108 or hospitalization times (p = 0.798. VAS values determined routinely on the evening of surgery were significantly higher in Group 1 than in Group 2 (p = 0.025. Twenty-eight (17.2% presentations were made to the emergency clinic due to renal colic within 1 month after surgery. Double-J catheter was present in 24 (85.7% of these patients. Conclusions: Routine double-J stent insertion after RIRS is not essential since it increases costs, morbidity and operation time.

  6. Uptake of Retrograde Tracers by Intact Optic Nerve Axons: A New Way to Label Retinal Ganglion Cells

    OpenAIRE

    Liang, Yu-Xiang; Yang, Jian; Yuan, Ti-Fei; So, Kwok-Fai

    2015-01-01

    Retrograde labelling of retinal ganglion cells with optic nerve transection often leads to degeneration of ganglion cells in prolonged experiments. Here we report that an intact optic nerve could uptake retrograde tracers applied onto the surface of the nerve, leading to high efficiency labelling of ganglion cells in the retina with long-term survival of cells. This method labelled a similar number of ganglion cells (2289 +/- 174 at 2 days) as the retrograde labeling technique from the superi...

  7. The use of a cutting balloon in contemporary reverse controlled antegrade and retrograde subintimal tracking (reverse CART) technique.

    Science.gov (United States)

    Nakabayashi, Keisuke; Okada, Hisayuki; Oka, Toshiaki

    2017-07-01

    The key concept of reverse controlled antegrade and retrograde tracking (CART) technique is retrograde puncture with a tapered wire to an antegrade balloon (contemporary reverse CART) or new connections between the antegrade and retrograde subintimal space (classical reverse CART). In our case, a 75-year-old man with severe chronic total occlusion of the right coronary artery, reverse CART with conventional balloons could not be accomplished. Externalization wiring was completed by contemporary reverse CART using a cutting balloon as an antegrade balloon to improve the fenestration force of the retrograde guidewire. Thus, the use of a cutting balloon for contemporary reverse CART might be promising.

  8. Retrogradation of Maize Starch after High Hydrostatic Pressure Gelation: Effect of Amylose Content and Depressurization Rate.

    Directory of Open Access Journals (Sweden)

    Zhi Yang

    Full Text Available High hydrostatic pressure (HHP has been employed to gelatinize or physically modify starch dispersions. In this study, waxy maize starch, normal maize starch, and two high amylose content starch were processed by a HHP of the order of 600 MPa, at 25°C for 15min. The effect of HHP processing on the crystallization of maize starches with various amylose content during storage at 4°C was investigated. Crystallization kinetics of HHP treated starch gels were investigated using rheology and FTIR. The effect of crystallization on the mechanical properties of starch gel network were evaluated in terms of dynamic complex modulus (G*. The crystallization induced increase of short-range helices structures were investigated using FTIR. The pressure releasing rate does not affect the starch retrogradation behaviour. The rate and extent of retrogradation depends on the amylose content of amylose starch. The least retrogradation was observed in HHP treated waxy maize starch. The rate of retrogradation is higher for HHP treated high amylose maize starch than that of normal maize starch. A linear relationship between the extent of retrogradation (phase distribution measured by FTIR and G* is proposed.

  9. Retrogradation of Maize Starch after High Hydrostatic Pressure Gelation: Effect of Amylose Content and Depressurization Rate

    Science.gov (United States)

    Yang, Zhi; Swedlund, Peter; Gu, Qinfen; Hemar, Yacine; Chaieb, Sahraoui

    2016-01-01

    High hydrostatic pressure (HHP) has been employed to gelatinize or physically modify starch dispersions. In this study, waxy maize starch, normal maize starch, and two high amylose content starch were processed by a HHP of the order of 600 MPa, at 25°C for 15min. The effect of HHP processing on the crystallization of maize starches with various amylose content during storage at 4°C was investigated. Crystallization kinetics of HHP treated starch gels were investigated using rheology and FTIR. The effect of crystallization on the mechanical properties of starch gel network were evaluated in terms of dynamic complex modulus (G*). The crystallization induced increase of short-range helices structures were investigated using FTIR. The pressure releasing rate does not affect the starch retrogradation behaviour. The rate and extent of retrogradation depends on the amylose content of amylose starch. The least retrogradation was observed in HHP treated waxy maize starch. The rate of retrogradation is higher for HHP treated high amylose maize starch than that of normal maize starch. A linear relationship between the extent of retrogradation (phase distribution) measured by FTIR and G* is proposed. PMID:27219066

  10. Retrogradation of Maize Starch after High Hydrostatic Pressure Gelation: Effect of Amylose Content and Depressurization Rate

    KAUST Repository

    Yang, Zhi

    2016-05-24

    High hydrostatic pressure (HHP) has been employed to gelatinize or physically modify starch dispersions. In this study, waxy maize starch, normal maize starch, and two high amylose content starch were processed by a HHP of the order of 600 MPa, at 25°C for 15min. The effect of HHP processing on the crystallization of maize starches with various amylose content during storage at 4°C was investigated. Crystallization kinetics of HHP treated starch gels were investigated using rheology and FTIR. The effect of crystallization on the mechanical properties of starch gel network were evaluated in terms of dynamic complex modulus (G*). The crystallization induced increase of short-range helices structures were investigated using FTIR. The pressure releasing rate does not affect the starch retrogradation behaviour. The rate and extent of retrogradation depends on the amylose content of amylose starch. The least retrogradation was observed in HHP treated waxy maize starch. The rate of retrogradation is higher for HHP treated high amylose maize starch than that of normal maize starch. A linear relationship between the extent of retrogradation (phase distribution) measured by FTIR and G* is proposed.

  11. On the electrodynamic explanation of the retrograde motion of the electric arc

    International Nuclear Information System (INIS)

    Hong, J.S.; Allen, J.E.

    1992-01-01

    The retrograde motion of the cathode spot in a transverse magnetic field is one of the more intriguing phenomena of the electric arc. Although the phenomenon has been known for nearly ninety years since its discovery by Stark and has stimulated numerous investigations which result in many models giving explanation from different points of view, there is still no theory that can account both qualitatively and quantitatively for all the observations. Most of the explanations of the retrograde motion involve the study of cathode processes to give the preferential formation of new cathode spots along the retrograde direction. One line of explanation, which is rather different from the others, is based on electrodynamics. In this approach the retrograde motion is treated as an electrodynamic event. The present paper develops the theory suggested by Robson and von Engel. A more complete model is proposed and studied in detail by means of electromagnetic field theory. The results obtained not only show that the retrograde motion can be explained by the electrodynamics, but also confirm that the average current density on the cathode spot must be around the order of 10 12 A/m 2 . Recent studies of spot current density have shown values of this order. (author) 22 refs., 4 figs., 1 tab

  12. Profound loss of general knowledge in retrograde amnesia: Evidence from an amnesic artist

    Directory of Open Access Journals (Sweden)

    Emma eGregory

    2014-05-01

    Full Text Available Studies of retrograde amnesia have focused on autobiographical memory, with fewer studies examining how non-autobiographical memory is affected. Those that have done so have focused primarily on memory for famous people and public events—relatively limited aspects of memory that are tied to learning during specific times of life and do not deeply tap into the rich and extensive knowledge structures that are developed over a lifetime. To assess whether retrograde amnesia can also cause impairments to other forms of general world knowledge, we explored losses across a broad range of knowledge domains in a newly-identified amnesic. LSJ is a professional artist, amateur musician and history buff with extensive bilateral medial temporal and left anterior temporal damage. We examined LSJ's knowledge across a range of everyday domains (e.g., sports and domains for which she had premorbid expertise (e.g., famous paintings. Across all domains tested, LSJ showed losses of knowledge at a level of breadth and depth never before documented in retrograde amnesia. These results show that retrograde amnesia can involve broad and deep deficits across a range of general world knowledge domains. Thus, losses that have already been well-documented (famous people and public events may severely underestimate the nature of human knowledge impairment that can occur in retrograde amnesia.

  13. Transport According to GARP: Receiving Retrograde Cargo at the Trans-Golgi Network

    Science.gov (United States)

    Bonifacino, Juan S.; Hierro, Aitor

    2010-01-01

    Tethering factors are large protein complexes that capture transport vesicles and enable their fusion with acceptor organelles at different stages of the endomembrane system. Recent studies have shed new light on the structure and function of a heterotetrameric tethering factor named Golgi-associated retrograde protein (GARP), which promotes fusion of endosome-derived, retrograde transport carriers to the trans-Golgi network (TGN). X-ray crystallography of the Vps53 and Vps54 subunits of GARP has revealed that this complex is structurally related to other tethering factors such as the exocyst, COG and Dsl1, indicating that they all might work by a similar mechanism. Loss of GARP function compromises the growth, fertility and/or viability of the defective organisms, underscoring the essential nature of GARP-mediated retrograde transport. PMID:21183348

  14. ADF/cofilin-mediated actin retrograde flow directs neurite formation in the developing brain.

    Science.gov (United States)

    Flynn, Kevin C; Hellal, Farida; Neukirchen, Dorothee; Jacob, Sonja; Tahirovic, Sabina; Dupraz, Sebastian; Stern, Sina; Garvalov, Boyan K; Gurniak, Christine; Shaw, Alisa E; Meyn, Liane; Wedlich-Söldner, Roland; Bamburg, James R; Small, J Victor; Witke, Walter; Bradke, Frank

    2012-12-20

    Neurites are the characteristic structural element of neurons that will initiate brain connectivity and elaborate information. Early in development, neurons are spherical cells but this symmetry is broken through the initial formation of neurites. This fundamental step is thought to rely on actin and microtubule dynamics. However, it is unclear which aspects of the complex actin behavior control neuritogenesis and which molecular mechanisms are involved. Here, we demonstrate that augmented actin retrograde flow and protrusion dynamics facilitate neurite formation. Our data indicate that a single family of actin regulatory proteins, ADF/Cofilin, provides the required control of actin retrograde flow and dynamics to form neurites. In particular, the F-actin severing activity of ADF/Cofilin organizes space for the protrusion and bundling of microtubules, the backbone of neurites. Our data reveal how ADF/Cofilin organizes the cytoskeleton to drive actin retrograde flow and thus break the spherical shape of neurons. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Pasting, rheological, and retrogradation properties of low-amylose rice starch with date syrup.

    Science.gov (United States)

    Mohamed, Ibrahim O; Babucurr, Jobe

    2017-09-01

    Effects of date syrup on pasting, rheological, and retrogradation properties of low-amylose rice starch were investigated using three levels of date syrup (starch:syrup 1:1, 1:2, or 1:3). Measurements were carried out using HR-2 Discovery Rheometer equipped with a pasting cell and parallel plate geometry. The pasting measurements showed that the peak viscosity of the control is significantly higher than the samples with date syrup (p syrup levels. Addition of date syrup increases the solid-like behavior of the gel in reverse order with increased date syrup levels. Low-amylose starch gel used in this study showed minor changes in elastic modulus (G') during one week cold storage indicting that low-amylose rice starch is resistant to retrogradation. Addition of date syrup slightly resulted in increased retrogradation compared to the control.

  16. Efficient retrograde transport of pseudorabies virus within neurons requires local protein synthesis in axons.

    Science.gov (United States)

    Koyuncu, Orkide O; Perlman, David H; Enquist, Lynn W

    2013-01-16

    After replicating in epithelial cells, alphaherpesviruses such as pseudorabies virus (PRV) invade axons of peripheral nervous system neurons and undergo retrograde transport toward the distant cell bodies. Although several viral proteins engage molecular motors to facilitate transport, the initial steps and neuronal responses to infection are poorly understood. Using compartmented neuron cultures to physically separate axon infection from cell bodies, we found that PRV infection induces local protein synthesis in axons, including proteins involved in cytoskeletal remodeling, intracellular trafficking, signaling, and metabolism. This rapid translation of axonal mRNAs is required for efficient PRV retrograde transport and infection of cell bodies. Furthermore, induction of axonal damage, which also induces local protein synthesis, prior to infection reduces virion trafficking, suggesting that host damage signals and virus particles compete for retrograde transport. Thus, similar to axonal damage, virus infection induces local protein translation in axons, and viruses likely exploit this response for invasion. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. The sealing ability of novel Kryptonite adhesive bone cement as a retrograde filling material

    Directory of Open Access Journals (Sweden)

    İsmail Uzun

    2016-08-01

    Full Text Available Background. This study evaluated the ability of Kryptonite bone cement in sealing retrograde cavities. Methods. The root canals of one hundred extracted human maxillary incisor teeth were instrumented up to master apical file #40 using Mtwo rotary system and obturated with gutta-percha and AH Plus sealer by cold lateral compaction method. The specimens were assigned to one control group and four experimental groups based on the retrograde filling materials (n=20. The specimens were immersed in 0.5% Rhodamine B solution for 48h. Then the specimens were divided longitudinally into two parts and the depth of dye penetration was assessed under ×10 magnification. Data were analyzed using one-way ANOVA and Bonferroni tests. Results. There were statistically significant difference between the experimental groups and the control group (P0.05. Conclusion. Kryptonite cement provided optimal apical seal in a manner similar to MTA, amalgam and IRM when used as a retrograde filling cement.

  18. Preparation of chitosan oligomers COS and their effect on the retrogradation of intermediate amylose rice starch.

    Science.gov (United States)

    Wu, Yue; Lin, Qin Lu; Chen, Zheng Xing; Wu, Wei; Xiao, Hua Xi

    2012-12-01

    Chitosan oligomers (COS) were obtained by enzymatic hydrolysis and H2O2 oxidative treatment, and then separated into different fractions using ultra-filtration membranes. Each COSM fraction prepared using enzymatic hydrolysis retained its structure, especially the reduced end residue (-NH2 group), and had a peak for molecular weight. On the other hand, each COSH fraction prepared by oxidative treatment had partly damaged -NH2 groups and two peaks for molecular weight. These results indicate that the same COS fractions prepared by the two methods differ in their amino groups and in their molecular weights, though they can both pass through the same size ultra-filtration membrane. The effect of COS on the retrogradation of intermediate amylose rice starch (IA-RS) was also investigated. The 5 k COS determined its anti-retrogradation capability. All COSH fractions from oxidative treatment had no effect on the retrogradation.

  19. Retrograde mechanochemical ablation of the small saphenous vein for the treatment of a venous ulcer.

    Science.gov (United States)

    Moore, Hayley M; Lane, Tristan R A; Franklin, Ian J; Davies, Alun H

    2014-10-01

    We present the first case of retrograde ablation of the small saphenous vein to treat active venous ulceration. A 73-year-old gentleman with complicated varicose veins of the left leg and a non-healing venous ulcer despite previous successful endovenous treatment to his left great saphenous vein underwent mechanochemical ablation of his small saphenous vein with the ClariVein® system, under local anaesthetic, using a retrograde cannulation technique. Post-operatively the patient had improved symptomatically and the ulcer size had reduced. This report highlights that patients with small saphenous vein incompetence and active ulceration can be treated successfully with retrograde mechanochemical ablation. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Retrograde cholangiopancreatography in the diagnosis of biliary and pancreatic duct diseases

    International Nuclear Information System (INIS)

    Vasil'ev, Yu.D.; Sedletskaya, T.N.

    1980-01-01

    Results of retrograde cannulation with the aid of flexible fibroduodenoscopes with subsequent introduction of a contrast substance into biliary and pancreatic ducts are presented. The investigation is carried out on 120 patients with different diseases of hepatopancreatoduodenal zone. The standard technique of X-ray examination has been applied permitting to obtain the most exhaustive information. Using retrograde cholangiopancreatography revealed have been choledocholithiasis, deformation of biliary ducts after surgical intervention, pancreatic cyst, tumor of the main pancreatic duct etc. Results of investigation of biliary and pancreatic ducts using retrograde cannulation are reaffirmed with the data of operations on biliary tract in 72 patients. Intraoperational cholangiography has been carried out on 36 of them during operation. An attempt to cannulate big duodenal papilla in 12 patients proved to be ineffective. No complications have been observed during examination

  1. Retrograde ureteroscopic holmium laser endopyelotomy in a selected population of patients with ureteropelvic junction obstruction

    DEFF Research Database (Denmark)

    Stilling, Nicolaj; Jung, Helene; Nørby, Bettina

    2009-01-01

    Objective. Significant controversy remains concerning the best way to treat ureteropelvic junction obstruction (UPJO). This study evaluates subjective and objective outcomes of retrograde holmium laser endopyelotomy in a selected population with UPJO. Material and methods. Forty-seven patients...... with UPJO were referred to retrograde endopyelotomy between April 2004 and March 2007. Patients with a very large pelvis, a high insertion of the ureter, a renal split function below 20% or a long (>2 cm) stenosed ureteropelvic segment, and patients younger than 18 years were not selected for endopyelotomy...... referred to retreatment owing to unchanged symptoms. Conclusion. Retrograde ureteroscopic endopyelotomy is a safe and effective treatment option in patients with primary and secondary UPJO when selected properly....

  2. Charge collection control using retrograde well tested by proton microprobe irradiation

    International Nuclear Information System (INIS)

    Sayama, Hirokazu; Takai, Mikio; Kimura, Hiroshi; Ohno, Yoshikazu; Satoh, Shinichi; Sonoda, Kenichirou; Katani, Norihiko.

    1993-01-01

    Soft error reduction by high-energy ion-implanted layers has been investigated by novel evaluation techniques using high-energy proton microprobes. A retrograde well formed by 160 and 700 keV boron ion implantation could completely suppress soft errors induced by the proton microprobes at 400 keV. The proton-induced current revealed the charge collection efficiency for the retrograde well structure. The collected charge for the retrograde well in the soft-error mapping was proved to be lower than the critical charge of the measured DRAMs(dynamic random-access memories). Complementary use of soft-error mapping and ion-induced-current measurement could clarify well structures immune against soft errors. (author)

  3. Retrograde tracing of fluorescent gold after autogenous nerve transplantation on spinal cord injured in rats

    DEFF Research Database (Denmark)

    Lin, X; Liu, W; Ding, Ming

    2016-01-01

    Objective To investigate the changes of the fluorescent gold retrograde tracing autogenous nerve transplantation on spinal cord injured in rats. Methods The animals were divided into two groups, with modified Allen impact method to establish model of spinal cord injury. After 4 weeks, the transpl......Objective To investigate the changes of the fluorescent gold retrograde tracing autogenous nerve transplantation on spinal cord injured in rats. Methods The animals were divided into two groups, with modified Allen impact method to establish model of spinal cord injury. After 4 weeks......, the transplantation group using autologous sural nerve graft to repair spinal cord injury period and non-transplantation group was only exposed incision without treatment. In the 4, 6 and 8 weeks after operation, the retrograde tracing of FG Fluoro-Gold was performed to discover the recovery of the axial plasma...

  4. On the observed excess of retrograde orbits among long-period comets

    International Nuclear Information System (INIS)

    Fernandez, J.A.

    1981-01-01

    The distribution of orbital inclinations of the observed long-period comets is analysed. An excess of retrograde orbits is found which increases with the perihelion distance, except for the range 1.1 10 3 A U) has the same behaviour as the total sample. It is thus suggested that the excess of retrograde orbits among long-period comets is related to an already existent excess among the incoming new comets (i.e. comets driven into the planetary region by stellar perturbations). Using theoretical considerations and a numerical model it is proposed that an important fraction of the so-called new comets are actually repeating passages through the planetary region. Nearly a half of the new comets with q > 2 A U may be repeating passages. An important consequence of the presence of comets repeating passages among the new ones is the production of an excess of retrograde orbits in the whole sample. (author)

  5. Combined use of intraarterial digital subtraction angiography with conventional retrograde brachial vertebral angiography

    International Nuclear Information System (INIS)

    Yamaguchi, Tatsuo; Ogawa, Toshihide; Inugami, Atsushi; Kawata, Yasushi; Shishido, Fumio; Uemura, Kazuo

    1985-01-01

    For 102 patients who had the examination of conventional bilaterally retrograde brachial vertebral angiography (retrograde VAG), intraarterial digital subtraction angiography (DSA) was successively performed to investigate steno-occlusive lesions of proximal vertebral and subclavian arteries. All the patients had no complication due to the DSA procedure. In 50% of 72 ischemic stroke cases, positive findings were found either in the origin of the vertebral artery or in the subclavian artery. Stenosis of more than 50% of the lumen of the vertebral artery were found in 14% of the cases at the origin of the right one and also in 14% in the left one. Occlusion of the vertebral artery was found in 4% in the left side only. In 30 cases with non-ischemic brain diseases, positive findings were noted in 10%. Intraarterial DSA combined with retrograde VAG was thought to be useful, especially in the examination for ischemic stroke. (author)

  6. Selective retrograde labeling of cholinergic neurons with [3H]choline

    International Nuclear Information System (INIS)

    Bagnoli, P.; Beaudet, A.; Stella, M.; Cuenod, M.

    1981-01-01

    Evidence is presented which is consistent with a specific retrograde labeling of cholinergic neurons following [ 3 H]choline application in their zone of termination. [ 3 H]Choline injection in the rat hippocampus leads to perikaryal retrograde labeling in the ipsilateral medial septal nuclease and nucleus of the diagonal band, thus delineating an established cholinergic pathway, while only diffuse presumably anterograde labeling was observed in the lateral septum, the entorhinal cortex, and the opposite hippocampus. After [ 3 H]choline injection in the pigeon visual Wulst, only the ipsilateral thalamic relay, of all inputs, showed similar perikaryal retrograde labeling, an observation supporting the suggestion that at least some thalamo-Wulst neurons are cholinergic

  7. A dissociation between anterograde and retrograde amnesia after treatment with electroconvulsive therapy: a naturalistic investigation.

    Science.gov (United States)

    O'Connor, Margaret; Lebowitz, Brian K; Ly, Jenny; Panizzon, Matthew S; Elkin-Frankston, Seth; Dey, Sangeeta; Bloomingdale, Kerry; Thall, Mark; Pearlman, Chester

    2008-06-01

    The aim of the present study is to investigate the cumulative effects of a clinically determined course of electroconvulsive therapy (ECT) on anterograde and retrograde amnesia. In this study, mood and memory were examined in the context of a protocol driven by therapeutic response, rather than by preordained research criteria. Twenty-two patients with major depressive disorder and 18 nondepressed controls were taught a series of faces and names before the initiation of ECT, and their retention of this information was examined after the end of treatment. Anterograde (ie, new learning) and retrograde memory (ie, recall of information learned before ECT) were assessed. Eleven ECT patients underwent unilateral (UL) stimulation, and 11 had a combination of UL and bilateral stimulation. Major depressive disorder patients and nondepressed controls participants were matched according to baseline memory abilities. Unilateral and unilateral/bilateral (UB) ECT patients were matched according to baseline depression and memory abilities. Treatment with ECT resulted in a dissociation between anterograde and retrograde memory; after treatment, major depressive disorder patients demonstrated significant retrograde amnesia, whereas there was no change in their anterograde memory. Unilateral and UB ECT patients performed equally well on tasks of anterograde memory. Contrary to our expectation, UB ECT was not associated with greater retrograde memory loss than was UL ECT treatment. However, a trend toward a group difference was present on 1 memory measure. Results of the study suggest that a clinical course of ECT is associated with isolated impairment for information learned before treatment (ie, retrograde memory), whereas there was no effect of ECT on posttreatment learning abilities (ie, anterograde memory).

  8. Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

    Science.gov (United States)

    Wojtasik-Bakalarz, Joanna; Arif, Salech; Chyrchel, Michał; Rakowski, Tomasz; Bartuś, Krzysztof; Dudek, Dariusz

    2017-01-01

    Introduction Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO) of the superficial femoral artery (SFA). Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results The study included 17 patients (7 females, 10 males) who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5%) patients and after a previously failed attempt in 13 (76.5%) patients. The procedure was successful in 15 (88.2%) patients, and unsuccessful in 2 (11.8%) patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy), 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death). The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications. PMID:28344617

  9. Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

    Directory of Open Access Journals (Sweden)

    Joanna Wojtasik-Bakalarz

    2017-03-01

    Full Text Available Introduction : Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO of the superficial femoral artery (SFA. Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim : To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods: We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results: The study included 17 patients (7 females, 10 males who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5% patients and after a previously failed attempt in 13 (76.5% patients. The procedure was successful in 15 (88.2% patients, and unsuccessful in 2 (11.8% patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy, 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death. The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions : The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications.

  10. Retrograde or antegrade double-pigtail stent placement for malignant ureteric obstruction?

    International Nuclear Information System (INIS)

    Uthappa, M.C.; Cowan, N.C.

    2005-01-01

    AIM: To determine the optimum approach for double-pigtail stent placement in malignant ureteric obstruction. PATIENTS AND METHODS: Retrograde stent placement was attempted in a consecutive series of patients presenting with malignant ureteric obstruction. If retrograde stent placement was unsuccessful, percutaneous nephrostomy was performed immediately followed by elective antegrade stent placement. Identical digital C-arm fluoroscopy for image-guidance and conditions for anaesthesia and analgesia were employed for both retrograde and antegrade procedures. Identical 8 Fr (20-26 cm) double-pigtail hydrophilic coated stents were used for each approach. RESULTS: Retrograde placement was attempted in 50 ureters in 30 patients {19 male, 11 female, average age 61.4 yr (range 29-90 yr)} over a 24-month period. The success rate for retrograde ureteric stent placement was 50% (n=25/50). Technical failures were due to failure to identify the ureteric orifice (n=22), failure to cross the stricture (n=1), failure to pass the stent (n=1) and failure to pass a 4 Fr catheter (n=1). Antegrade placement was attempted in 25 ureters with a success rate of 96% (n=24/25). Failure in the one case was due to inability to cross an upper third stricture secondary to pyeloureteritis cystica. CONCLUSION: It is suggested that retrograde route should be the initial approach if imaging shows no involvement of ureteric orifice (UO), when nephrostomy is technically very difficult or in cases of solitary kidney. The antegrade route is preferred if imaging shows tumour occlusion of the UO or if there is a tight stricture very close to the uretero-vesical junction (UVJ) making purchase within the ureter difficult for crossing the stricture

  11. Dimensions of the prostatic and membranous urethra in normal male dogs during maximum distension retrograde urethrocystography

    International Nuclear Information System (INIS)

    Feeney, D.A.; Johnston, G.R.; Osborne, C.A.; Tomlinson, M.J.

    1984-01-01

    Prostatic and membranous urethral diameter was measured in 24 normal mature male Beagle dogs during maximum distension retrograde urethrocystography. This technique involved retrograde urethral distension by infusion with contrast medium until the urinary bladder was distended and the vesicourethral junction remained opened as observed by fluoroscopy. Lateral and ventro-dorsal radiographs were made during subsequent injections of 5–10 ml of contrast medium. The prostatic urethra was consistently greater in diameter than the membranous urethra. However, the numerical ratio between the prostatic urethral diameter and the membranous urethral diameter varied among these dogs by a factor of 2 at the numerical extremes

  12. Radiation-related retrograde hydrogen isotope and K-Ar exchange in clay minerals

    International Nuclear Information System (INIS)

    Halter, C.; Pagel, M.; Sheppard, S.M.F.; Weber, F.; Clauer, N.

    1987-01-01

    Hydrogen and oxygen isotope studies have been widely applied to characterize the origin of fluids during ore-foaming processes. The primary isotope record, however, may be disturbed by retrograde exchange reactions, thus complicating the interpretation of the data. The susceptibility of minerals to retrograde isotope and chemical exchange is variable, reflecting differences in the mechanism and rate of isotope exchange. Results are presented on deuterium depletion, K/Ar ages and H 2 O + content of illites associated with uranium mineralization from the Athabasca basin (Canada). (author)

  13. The Orbital Evolution of 2007 VA85, an Amor-type Asteroid on a Retrograde Orbit.

    Science.gov (United States)

    Kankiewicz, P.; Włodarczyk, I.

    2010-06-01

    Among the known population of asteroids on retrograde orbits (i > 90°) we found an object classified as an Amor-type asteroid. During the analysis of the first results of astrometry, we found some possible Earth-impact solutions for this asteroid. After taking into account the latest observations, we excluded any significant impact solution. However, this asteroid is the first known example of potentially hazardous object on a retrograde orbit. We also investigated the orbital evolution of 2007 VA85 (1 My in the past), obtaining possible scenarios of its dynamical origin.

  14. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy for gingival carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mukai, Y.; Hata, M.; Koike, I.; Inoue, T. [Yokohama City University Graduate School of Medicine, Department of Radiology, Kanazawa-ku, Yokohama, Kanagawa (Japan); Mitsudo, K.; Koizumi, T.; Oguri, S.; Kioi, M.; Tohnai, I. [Yokohama City University Graduate School of Medicine, Department of Oral and Maxillofacial Surgery, Yokohama, Kanagawa (Japan); Omura, M. [Shonankamakura General Hospital, Department of Radiation Oncology, Kamakura, Kanagawa (Japan)

    2014-02-15

    The aim of this study was to review the efficacy and toxicity of radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy in the treatment of gingival carcinoma. In all, 34 patients (21 men and 13 women) with squamous cell carcinoma of the gingiva underwent radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy. Treatment consisted of daily external irradiation and concurrent retrograde superselective intra-arterial infusion with cisplatin and docetaxel. A median total dose of 60 Gy in 30 fractions was delivered to tumors. Of the 34 patients, 29 (85 %) achieved a complete response (CR) and 5 had residual tumors. Of the 29 patients with a CR, 2 had local recurrences and 1 had distant metastasis 1-15 months after treatment. Twenty-six of the 36 patients had survived at a median follow-up time of 36 months (range 12-79 months); 4 died of cancer and 4 died of non-cancer-related causes. At both 3 and 5 years after treatment, the overall survival rates were 79 % and the cause-specific survival rates were 85 %. Osteoradionecrosis of the mandibular bone only developed in 1 patient after treatment. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy was effective and safe in the treatment of gingival carcinoma. This treatment may be a promising curative and organ-preserving treatment option for gingival carcinoma. (orig.) [German] Das Ziel dieser Studie war die Ueberpruefung der Effizienz und Toxizitaet einer Strahlenbehandlung des Gingivakarzinoms mit gleichzeitiger retrograder, superselektiver intraarterieller Chemotherapie. Insgesamt 34 Patienten (21 Maenner und 13 Frauen) mit Zahnfleischplattenzellkarzinom erhielten eine Strahlenbehandlung mit gleichzeitiger retrograder, superselektiver intraarterieller Chemotherapie. Die Behandlung umfasste eine taegliche externe Bestrahlung mit gleichzeitiger retrograder, superselektiver intraarterieller Infusion von Cisplatin und

  15. Outcomes of infrageniculate retrograde versus transfemoral access for endovascular intervention for chronic lower extremity ischemia.

    Science.gov (United States)

    Taha, Ashraf G; Abou Ali, Adham N; Al-Khoury, George; Singh, Michael J; Makaroun, Michel S; Avgerinos, Efthymios D; Chaer, Rabih A

    2018-03-31

    Retrograde infrageniculate access is an alternative treatment strategy for patients who have failed to respond to antegrade endovascular intervention. This study compares the outcomes of infrageniculate retrograde arterial access with the conventional transfemoral access for the endovascular management of chronic lower extremity ischemia. This was a retrospective single-center review of retrograde endovascular intervention (REI) from 2012 to 2016. Indications for intervention, comorbidities, complications, procedural success, limb outcomes, and mortality were analyzed. Technical failure was defined as the inability to complete the procedure because of failed access or unsuccessful recanalization. Infrageniculate access and transfemoral access were obtained with ultrasound or angiographic roadmap guidance. Patency rates were calculated for technically successful interventions. There were 47 patients (85% presenting with critical limb ischemia) who underwent sheathless REI after failed antegrade recanalization of TransAtlantic Inter-Society Consensus class D infrainguinal lesions, whereas 93 patients (83% with critical limb ischemia) underwent standard transfemoral access. There were 16 (34%) femoropopliteal, 14 (30%) tibial, and 17 (36%) multilevel interventions in the retrograde group compared with 41 (41%) femoropopliteal, 20 (20%) tibial, and 39 (39%) multilevel interventions in the transfemoral group. Access sites for the retrograde group included the dorsalis pedis (26%), midcalf peroneal (24%), anterior tibial (22%), posterior tibial (26%), and popliteal (2%) arteries. Overall technical success was achieved in 57% of the retrograde group compared with 78% of the transfemoral group. Mean follow-up was 20 months (range, 1-45 months). There were no significant differences in the primary patency rates between the two groups at 1 year and 2 years. The primary assisted patency rates were significantly better in the transfemoral group at 1 year (66% vs 46%; P

  16. Transesophageal echocardiographic evaluation of an intraoperative retrograde acute aortic dissection: case report

    Directory of Open Access Journals (Sweden)

    Reiter Charles G

    2006-04-01

    Full Text Available Abstract Background We report an intraoperative retrograde dissection of the aorta and its subsequent evaluation by transesophageal echocardiography (TEE. Case presentation A 78 year old woman with an ascending aortic aneurysm without dissection and coronary artery disease was brought to the operating room for aneurysm repair and coronary artery bypass grafting. After initiation of cardiopulmonary bypass through a femoral artery cannula, aortic dissection was noted and subsequently imaged by TEE. Conclusion Retrograde aortic dissection through the femoral artery is life-threatening. Intraoperative TEE can be used to diagnose this uncommon event, and should be considered after initiation of bypass.

  17. Investigation of retinal ganglion cells and axons of normal rats using fluorogold retrograde labeling

    International Nuclear Information System (INIS)

    Yin Xiaolei; Ye Jian; Chen Chunlin

    2006-01-01

    To investigate the retinal ganglion cells (RGCs) by means of fluorogold retrograde labeling, RGCs were labeled by injecting the fluorogold bilaterally into the superficial superior colliculus and lateral genicutate nucleus in six adult SD rats. One and two weeks (3 rats in each group) after injecting the fluorogold, RGCs FG-labeled were observed and the number of them were counted. The results showed that after a week mean density of fluorogold-labeled RGCs was 2210 ± 128/mm 2 , and it was 2164 ± 117/mm 2 after two weeks. Our conclusion is fluorogold retrograde labeling could be very useful in the research of RGCs. (authors)

  18. A novel fluorescent retrograde neural tracer: cholera toxin B conjugated carbon dots

    Science.gov (United States)

    Zhou, Nan; Hao, Zeyu; Zhao, Xiaohuan; Maharjan, Suraj; Zhu, Shoujun; Song, Yubin; Yang, Bai; Lu, Laijin

    2015-09-01

    The retrograde neuroanatomical tracing method is a key technique to study the complex interconnections of the nervous system. Traditional tracers have several drawbacks, including time-consuming immunohistochemical or immunofluorescent staining procedures, rapid fluorescence quenching and low fluorescence intensity. Carbon dots (CDs) have been widely used as a fluorescent bio-probe due to their ultrasmall size, excellent optical properties, chemical stability, biocompatibility and low toxicity. Herein, we develop a novel fluorescent neural tracer: cholera toxin B-carbon dot conjugates (CTB-CDs). It can be taken up and retrogradely transported by neurons in the peripheral nervous system of rats. Our results show that CTB-CDs possess high photoluminescence intensity, good optical stability, a long shelf-life and non-toxicity. Tracing with CTB-CDs is a direct and more economical way of performing retrograde labelling experiments. Therefore, CTB-CDs are reliable fluorescent retrograde tracers.The retrograde neuroanatomical tracing method is a key technique to study the complex interconnections of the nervous system. Traditional tracers have several drawbacks, including time-consuming immunohistochemical or immunofluorescent staining procedures, rapid fluorescence quenching and low fluorescence intensity. Carbon dots (CDs) have been widely used as a fluorescent bio-probe due to their ultrasmall size, excellent optical properties, chemical stability, biocompatibility and low toxicity. Herein, we develop a novel fluorescent neural tracer: cholera toxin B-carbon dot conjugates (CTB-CDs). It can be taken up and retrogradely transported by neurons in the peripheral nervous system of rats. Our results show that CTB-CDs possess high photoluminescence intensity, good optical stability, a long shelf-life and non-toxicity. Tracing with CTB-CDs is a direct and more economical way of performing retrograde labelling experiments. Therefore, CTB-CDs are reliable fluorescent retrograde

  19. Retrograde tracing of zinc-enriched (ZEN) neuronal somata in rat spinal cord

    DEFF Research Database (Denmark)

    Wang, Zhanyou; Danscher, G; Mook Jo, S

    2001-01-01

    The zinc selenide autometallographic (ZnSeAMG) technique for tracing the retrograde axonal transport of zinc ions in zinc-enriched (ZEN) neurons was used to map the distribution of ZEN neuronal somata in rat spinal cord. After a local injection of sodium selenide into the dorsal or ventral horn, Zn...... neurons have relatively short axons or boutons en passage close to the neuronal origin. Ultrastructurally, the retrogradely transported zinc selenide clusters were found in the lysosomes of ZEN somata and proximal dendrites. Electron microscopic studies also revealed two different kinds of ZEN terminals...

  20. MR imaging of the entry, the abdominal communicating orifice, and the retrograde dissection in aortic dissections

    International Nuclear Information System (INIS)

    Yoshida, Y.; Mukohara, N.; Nakamura, K.; Sugimura, K.; Kono, M.

    1986-01-01

    MR imaging (1.5 T) was performed on 41 patients with aortic dissection. Entries were clearly visualized on the MR images as partial defects of the intimal flap in 18 of 21 patients (85.7%). In eight of ten patients, the locations of abdominal communicating orifices corresponded to the lowest signal intensities of the false lumina. Retrograde disections were diagnosed in all six patients from gradual increases in signal intensities of the false lumina toward the heart. MR imaging was very useful in diagnosing entries of the thoracic aorta, abdominal communicating orifices between true and false lumina, and retrograde dissections

  1. Hypotonic duodenography and endoscopic retrograde pancreatography in the diagnosis of pancreatic disease

    International Nuclear Information System (INIS)

    Lukes, P.J.; Rolny, P.; Nilson, A.E.; Gamklou, R.

    1981-01-01

    Hypotonic duodenography and endoscopic retrograde pancreatography were performed in 45 non-icteric patients with suggested pancreatic disease or long-standing upper gastrointestinal symptoms. The accuracy of each method in the diagnosis of pancreatic disease was compared. Hypotonic duodenography revealed pancreatitis in 48 per cent and ERP in 83 per cent of the cases. All 6 pancreatic tumours were detected at ERP and 3 at duodenography. The role of hypotonic duodenography and endoscopic retrograde pancreatography in the diagnosis of pancreatic disease is discussed. (Auth.)

  2. Effects of ciliary neurotrophic factor on retrograde cell reaction after facial nerve crush in young adults rats

    NARCIS (Netherlands)

    Gispen, W.H.; Ulenkate, H.J.L.M.; Jennekens, F.G.I.

    1996-01-01

    Locally applied ciliary neurotrophic factor (CNTF) has a powerful effect on retrograde axonal reaction following facial nerve crush in neonatal rats. We examined whether it also exerts a strong effect on retrograde axonal reaction in young adult rats when administered subcutaneously. The dose was 1

  3. Cervical Retrograde Spinal Cord Stimulation Lead Placement to Treat Failed Back Surgery Syndrome: A Case Report

    NARCIS (Netherlands)

    Helmond, N. van; Kardaszewski, C.N.; Chapman, K.B.

    2017-01-01

    Spinal cord stimulation is an effective treatment modality for refractory neuropathic pain conditions, but the placement of leads can be challenging due to unforeseen anatomical variations. We used a retrograde C7-T1 approach to place a lead at the bottom of T8 in a patient suffering from failed

  4. A Hands-on Exploration of the Retrograde Motion of Mars as Seen from the Earth

    Science.gov (United States)

    Pincelli, M. M.; Otranto, S.

    2013-01-01

    In this paper, we propose a set of activities based on the use of a celestial simulator to gain insights into the retrograde motion of Mars as seen from the Earth. These activities provide a useful link between the heliocentric concepts taught in schools and those tackled in typical introductory physics courses based on classical mechanics for…

  5. The retrogradation kinetics of starches of different botanical origin in the presence of glucose syrup.

    Science.gov (United States)

    Berski, Wiktor; Ziobro, Rafał; Witczak, Mariusz; Gambuś, Halina

    2018-04-09

    The influence of glucose syrup on the retrogradation of cereal starches was investigated. Laboratory isolated starches from wheat (WS) and oats (OS - oat starch and ROS - residual oat starch) were used in this research. ROS was isolated from the flour left after the industrial separation of β-glucans. Gelatinization temperature of oat starches (63.82 °C and 64.01 °C for OS and ROS, respectively) was higher than for WS (62.26 °C), whereas gelatinization enthalpy for oat starches (8.87 J/g and 9.09 J/g for OS and ROS, respectively) was lower than for WS (9.99 J/g). Moreover, retrogradation percentage (%R) was similar for both oat starches (29.76% and 27.72% for OS and ROS, respectively), and was substantially lower than for WS (42.04%). The introduction of glucose syrup into system reduced the extent of the retrogradation. Rate of the process was suppressed for WS and ROS, whereas for OS it was increased. β-Glucan production process had no significant effect on the gelatinization and retrogradation of oat starch. Copyright © 2017. Published by Elsevier B.V.

  6. Retrograde cerebral perfusion and delayed hyperbaric oxygen for massive air embolism during cardiac surgery.

    Science.gov (United States)

    Guy, T Sloane; Kelly, Matthew P; Cason, Brian; Tseng, Elaine

    2009-03-01

    We report a case of massive air embolism from a ventricular vent line during cardiac surgery successfully treated with emergent retrograde cerebral perfusion and delayed hyperbaric oxygen therapy. The etiologies of this rare but potentially devastating complication are discussed along with prevention and treatment options.

  7. Reexposure to the Amnestic Agent Alleviates Cycloheximide-Induced Retrograde Amnesia for Reactivated and Extinction Memories

    Science.gov (United States)

    Briggs, James F.; Olson, Brian P.

    2013-01-01

    We investigated whether reexposure to an amnestic agent would reverse amnesia for extinction of learned fear similar to that of a reactivated memory. When cycloheximide (CHX) was administered immediately after a brief cue-induced memory reactivation (15 sec) and an extended extinction session (12 min) rats showed retrograde amnesia for both…

  8. A comparison of Er, Cr: YSGG laser with ultrasonic preparation on the seal of retrograde cavities

    Science.gov (United States)

    Roghanizad, Nasrin; Kalhori, Katayoun AM; Khalilak, Zohreh; Esmaeili, Maryam Ali; de Fatima Zanirato Lizarelli, Rosane

    2015-01-01

    Background and aim: The aim of this in vitro study was to compare Er, Cr: YSGG laser with ultrasonic preparation on the seal of retrograde cavities. Materials and methods: Twenty-eight maxillary anterior teeth were used in this study. After removing the crowns, the canals were prepared with the step-back technique and filled with guttapercha. Three millimeters below the apex; each root was cut with a fissure diamond bur. The root surfaces were then covered with nail polish and three millimeters deep retrograde class I cavities were prepared, using Er, Cr: YSGG laser (group L=12 roots) or ultrasonic retro-tip (group U=12 roots). Four roots were arranged for negative and positive control groups. Retrograde cavities were then filled with mineral trioxide aggregate (MTA) and teeth were placed in 2% methylene blue dye for 72 hours. The amount of dye penetration in sagittal sections of each tooth was measured with a stereomicroscope. An independent sample t-test was used for statistical analysis. Results: Cavities prepared with the Er, Cr: YSGG laser (1.61 + 0.81) showed significantly less micro-leakage than those prepared with the ultrasound (2.55+ 1.84) (P value =0.02). Conclusions: Under the conditions of this research, the use of Er, Cr: YSGG laser for retrograde cavity preparation causes significantly less apical leakage and may increase the success rate of endodontic surgeries. PMID:25941423

  9. Biliary fascioliasis: Management in a child using endoscopic retrograde cholangio pancreatography

    Directory of Open Access Journals (Sweden)

    Sandesh V Parelkar

    2013-01-01

    Full Text Available A 9-year-old boy presented with right upper abdominal pain and fever. The radiologic investigations revealed multiple cholangitic abscesses with cholangitis and worms in common bile duct. Endoscopic retrograde cholangio pancreatographic (ERCP sphincterotomy, basketing, ballooning and extraction of Fasciola hepatica worms from the common bile duct were done.

  10. Biliary fascioliasis: Management in a child using endoscopic retrograde cholangio pancreatography

    Science.gov (United States)

    Parelkar, Sandesh V.; Oak, Sanjay N.; Maydeo, Amit; Sanghvi, Beejal V.; Joshi, Prashant B.; Chaubal, Nitin; Patil, Rajasekhara T.; Sahoo, Subrat K.; Lal, Patel Jiwan; Sampath, Nandita; Koticha, Avani

    2013-01-01

    A 9-year-old boy presented with right upper abdominal pain and fever. The radiologic investigations revealed multiple cholangitic abscesses with cholangitis and worms in common bile duct. Endoscopic retrograde cholangio pancreatographic (ERCP) sphincterotomy, basketing, ballooning and extraction of Fasciola hepatica worms from the common bile duct were done. PMID:23599579

  11. Retrograde behavior revisited: implications for confined fluid phase equilibria in nanopores.

    Science.gov (United States)

    Tan, Sugata P; Piri, Mohammad

    2017-07-26

    Many fluid mixtures exhibit retrograde behavior, including those that define natural gases. While the behavior is well understood for mixtures in bulk, it is not so in nanosize porous space that dominates shale formations in unconventional reservoirs. The lack of experimental data creates the need for modeling works to make estimates as good as possible due to immediate needs in gas recovery. However, such efforts have been straying without firm guidance from systematic studies over what we have known so far. This article is intended to present the results of such a study that would incite further investigations in this area of research. Revisiting the retrograde behavior in the bulk is appropriate to start with, followed by a short review of what we know about fluids confined in nanosize pores. Based on this information, implications for the behavior of confined mixtures in the retrograde region can be inferred. The implied features that have been supported by experimental evidence are the locations of the confined dew point and bubble point at low temperatures, which are both at pressures lower than their bulk counterparts. Another feature found in this study is completely new, and therefore still open for further investigation. We reveal that the dew-point and bubble-point curves of confined mixtures end at moderate pressures on a multiphase curve, beyond which equilibrium occurs among the bulk and confined phases. The well-known points in the bulk retrograde region, i.e. the critical point and cricondenbar, are consequently absent in confined mixtures.

  12. Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery.

    Science.gov (United States)

    Vadepally, Ashwant Kumar; Sinha, Ramen; Kumar, A V S S Subramanya

    2018-01-01

    Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening. Indications for this technique were mandibular fracture (n = 6), oral submucous fibrosis (OSMF; n = 6), temporomandibular joint (TMJ) ankylosis (n = 4) and internal derangement of TMJ (n = 2). All patients were assessed for preoperative interincisal opening; during intubation through specific parameters and; also postoperative findings were observed. Mean time taken for successful intubation was 5.6 min ± 1.66. One patient had subcutaneous emphysema which was managed conservatively. Postoperatively, four patients had sore throat which resolved in few days. No other complications were encountered. In conclusion, retrograde nasotracheal intubation is an effective and useful technique for airway control in patients with LMO and with only a small risk potential.

  13. Retrograd intrarenal stenkirurgi--en minimalinvasiv metode til behandling af nyresten

    DEFF Research Database (Denmark)

    Jung, Helene U; Osther, Palle J S

    2009-01-01

    Retrograde intrarenal stone surgery (RIRS) is a safe and effective minimally invasive method for the treatment of minor (kidney stones. This modality is the preferred treatment for minor ESWL-resistant kidney stones where resistance is due e.g. to anatomical abnormalities or stones...

  14. Behavioral and Functional Neuroanatomical Correlates of Anterograde Autobiographical Memory in Isolated Retrograde Amnesic Patient M. L.

    Science.gov (United States)

    Levine, Brian; Svoboda, Eva; Turner, Gary R.; Mandic, Marina; Mackey, Allison

    2009-01-01

    Patient M. L. [Levine, B., Black, S. E., Cabeza, R., Sinden, M., Mcintosh, A. R., Toth, J. P., et al. (1998). "Episodic memory and the self in a case of isolated retrograde amnesia." "Brain", "121", 1951-1973], lost memory for events occurring before his severe traumatic brain injury, yet his anterograde (post-injury) learning and memory appeared…

  15. Hydrogen transfer in the formation and destruction of retrograde products in coal conversion

    Energy Technology Data Exchange (ETDEWEB)

    McMillen, D.F.; Malhotra, R. [SRI International, Menlo Park, CA (United States)

    2006-06-01

    The conversion of coals to volatiles or liquids during pyrolysis and liquefaction is notoriously limited by the formation of retrograde products. Analysis of literature data for coals with grafted structures and for polymeric coal models demonstrates that the formation of volatile products from these materials does not correlate primarily with the weakness of the original bonding but correlates with the facility for retrogressive reaction. This analysis suggests further that simple recombination of resonance-stabilized radicals does not tend to yield true retrograde products, except in the case of aryloxy radicals. For pure hydrocarbon structural elements, radical addition to aromatic systems appears to be a key class of retrograde reactions, where the key factor is the kinetics of radical or H-atom loss from a cyclohexadienyl intermediate. We have used a mechanistic numerical model with a detailed set of radical reactions and thermochemically based kinetic parameters operating on a limited set of hydrocarbon structures to delineate important factors in mitigating retrograde processes. This showed that, not only the cleavage of critical bonds in the original coal structures but also the net prevention of retrogression may be due to the H-transfer-induced cleavage of strong bonds.

  16. Self-repair in a Bidirectionally Coupled Astrocyte-Neuron (AN System based on Retrograde Signaling

    Directory of Open Access Journals (Sweden)

    John eWade

    2012-09-01

    Full Text Available In this paper we demonstrate that retrograde signaling via astrocytes may underpin self-repair in the brain. Faults manifest themselves in silent or near silent neurons caused by low transmission probability synapses; the enhancement of the transmission probability of a healthy neighbouring synapse by retrograde signaling can enhance the transmission probability of the faulty synapse (repair. Our model of self-repair is based on recent research showing that retrograde signaling via astrocytes can increase the probability of neurotransmitter release at damaged or low transmission probability synapses. The model demonstrates that astrocytes are capable of bidirectional communication with neurons which leads to modulation of synaptic activity, and that indirect signaling through retrograde messengers such as endocannabinoids leads to modulation of synaptic transmission probability. Although our model operates at the level of cells, it provides a new research direction on brain-like self-repair which can be extended to networks of astrocytes and neurons. It also provides a biologically inspired basis for developing highly adaptive, distributed computing systems that can, at fine levels of granularity, fault detect, diagnose and self-repair autonomously, without the traditional constraint of a central fault detect/repair unit.

  17. Retrograde intrarenal stone surgery for extracorporeal shock-wave lithotripsy-resistant kidney stones

    DEFF Research Database (Denmark)

    Jung, Helene; Nørby, Bettina; Osther, Palle Jörn

    2006-01-01

    OBJECTIVE: The newer flexible ureteroscopes, 150-200-microm holmium YAG laser fibres and superflexible Dormia baskets have made it possible to reach and treat stones in all parts of the kidney. The object of this evaluation was to study the outcome of retrograde intrarenal stone surgery (RIRS...

  18. Atrial activation during atrioventricular nodal reentrant tachycardia: studies on retrograde fast pathway conduction

    NARCIS (Netherlands)

    Katritsis, Demosthenes G.; Ellenbogen, Kenneth A.; Becker, Anton E.

    2006-01-01

    Detailed right and left septal mapping of retrograde atrial activation during typical atrioventricular nodal reentrant tachycardia (AVNRT) has not been undertaken and may provide insight into the complex physiology of AVNRT, especially the anatomic localization of the fast and slow pathways. The

  19. Post–Endoscopic Retrograde Cholangiopancreaticography complications in liver transplanted patients, a single-center experience

    DEFF Research Database (Denmark)

    Ambrus, R B; Svendsen, Lars Bo; Hillingsø, J G

    2015-01-01

    BACKGROUND: Complications in the biliary tract occur in 5%-30% after liver transplantation and the main part of the complications is successfully managed with endoscopic retrograde cholangiopancreaticography (ERCP). The incidence and risk factors for post-ERCP complications in liver transplantation...

  20. Changing strategies of the retrograde approach for chronic total occlusion during the past 7 years

    NARCIS (Netherlands)

    Muramatsu, Toshiya; Tsukahara, Reiko; Ito, Yoshiaki; Ishimori, Hiroshi; Park, Seung-Jung; de Winter, Robert; Shokry, Khaled; Wang, Lefeng; Chen, Jiyan; Wang, Haichang

    2013-01-01

    We reviewed the technical changes and results achieved with the retrograde approach since we introduced it 7 years ago. The subjects were 1,268 patients who were treated for CTO between January 2004 and December 2010. They were investigated with respect to the success rate, the frequency of

  1. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy for gingival carcinoma

    International Nuclear Information System (INIS)

    Mukai, Y.; Hata, M.; Koike, I.; Inoue, T.; Mitsudo, K.; Koizumi, T.; Oguri, S.; Kioi, M.; Tohnai, I.; Omura, M.

    2014-01-01

    The aim of this study was to review the efficacy and toxicity of radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy in the treatment of gingival carcinoma. In all, 34 patients (21 men and 13 women) with squamous cell carcinoma of the gingiva underwent radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy. Treatment consisted of daily external irradiation and concurrent retrograde superselective intra-arterial infusion with cisplatin and docetaxel. A median total dose of 60 Gy in 30 fractions was delivered to tumors. Of the 34 patients, 29 (85 %) achieved a complete response (CR) and 5 had residual tumors. Of the 29 patients with a CR, 2 had local recurrences and 1 had distant metastasis 1-15 months after treatment. Twenty-six of the 36 patients had survived at a median follow-up time of 36 months (range 12-79 months); 4 died of cancer and 4 died of non-cancer-related causes. At both 3 and 5 years after treatment, the overall survival rates were 79 % and the cause-specific survival rates were 85 %. Osteoradionecrosis of the mandibular bone only developed in 1 patient after treatment. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy was effective and safe in the treatment of gingival carcinoma. This treatment may be a promising curative and organ-preserving treatment option for gingival carcinoma. (orig.) [de

  2. Regeneration of unmyelinated and myelinated sensory nerve fibres studied by a retrograde tracer method

    DEFF Research Database (Denmark)

    Lozeron, Pierre; Krarup, Christian; Schmalbruch, Henning

    2004-01-01

    Regeneration of myelinated and unmyelinated sensory nerve fibres after a crush lesion of the rat sciatic nerve was investigated by means of retrograde labelling. The advantage of this method is that the degree of regeneration is estimated on the basis of sensory somata rather than the number...

  3. Closing the medullary canal after retrograde nail removal using a bioabsorbable bone plug: technical tip

    NARCIS (Netherlands)

    Schepers, T.; Vogels, L. M. M.

    2012-01-01

    We describe a simple technique for closure of the intra-articular opening after the removal of a retrograde femur nail. With the use of a gelatine bioabsorbable bone plug the medullary canal is closed, reducing leakage of blood and cancellous bone particles from the bone into the knee joint

  4. Retrograde axoplasmic flow of serotonin in central mono-aminergic neurons

    International Nuclear Information System (INIS)

    Leger, Lucienne; Pujol, J.-F.; Bobillier, Pierre; Jouvet, Michel

    1977-01-01

    Following an injection of 3 H-5 HT in the neostriatum of the Rat, the tracer is transported by axoplasmic retrograde flow to the cell groups containing mono-aminergic neurons which are known or thought to have afferences to this structure: substantia nigra, dopaminergic group A8 and n. raphe dorsalis [fr

  5. Is the 'Trondsen Discriminant Function' useful in patients referred for endoscopic retrograde cholangiopancreatography?

    DEFF Research Database (Denmark)

    Ainsworth, A P; Pless, T; Mortensen, M B

    2003-01-01

    BACKGROUND: Ideally, patients should only be referred to endoscopic retrograde cholangiopancreatography (ERCP) if therapy is indicated. The aim of this study was to evaluate whether or not the 'Trondsen Discriminant Function' (DF) could be used for selecting patients directly for ERCP. METHODS...

  6. The therapeutic effect of crocin on ketamine-induced retrograde amnesia in rats

    Directory of Open Access Journals (Sweden)

    Namdar Yousefvand

    2016-09-01

    Full Text Available Introduction: The glutamatergic system plays an important role in learning and memory. Administration of crocus sativus (Saffron or its constituent, crocin, facilitates the formation of memory. This research investigated the effect of crocin on antagonizing retrograde amnesia induced by ketamine, a glutamatergic receptor antagonist, in rats by shuttle box. Methods: Male Wistar rats were tested to measure their learning behavior in the passive avoidance task. All animals were trained by a 1 mA shock. The drugs were injected immediately after the training was successfully performed. The animals were tested 24h after training to measure Step Through Latency (STL. Results: On the test day, administration of ketamine (12 mg/kg, ip impaired the memory after training. Different doses of crocin (2, 5 or 10 mg/kg, ip were injected 30 min after ketamine, but only 2 mg/kg crocin could improve retrograde amnesia and 5 and 10 mg/kg doses did not have any significant effect on retrograde amnesia. Moreover, administration of crocin (2, 5 or 10 mg/kg, ip after training had no significant impact on passive avoidance memory by itself. Conclusion: Considering the therapeutic effect of post-training administration of crocin on ketamine-induced retrograde amnesia, it can be argued that crocin has an interaction with glutamatergic system in formation of passive avoidance memory in rats.

  7. Retrogradation behavior of corn starch treated with 1,4-α-glucan branching enzyme.

    Science.gov (United States)

    Li, Wenwen; Li, Caiming; Gu, Zhengbiao; Qiu, Yijing; Cheng, Li; Hong, Yan; Li, Zhaofeng

    2016-07-15

    The retrogradation behavior of corn starch treated with 1,4-α-glucan branching enzyme (GBE) was investigated using rheometry, pulsed nuclear magnetic resonance (PNMR), differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy (FTIR). Dynamic time sweep analysis confirmed that the storage modulus (G') of corn starch stored at 4 °C decreased with increasing GBE treatment time. PNMR analysis demonstrated that the transverse relaxation times (T2) of corn starches treated with GBE were higher than that of control during the storage at 4 °C. DSC results demonstrated that the retrogradation enthalpy (ΔHr) of corn starch was reduced by 22.3% after GBE treatment for 10h. Avrami equation analysis showed that GBE treatment reduced the rate of starch retrogradation. FTIR analysis revealed that GBE treatment led to a decrease in hydrogen bonds within the starch. Overall, these results demonstrate that both short- and long-term retrogradation of corn starch were retarded by GBE treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study.

    Science.gov (United States)

    Kerimaa, Pekka; Ojala, Risto; Sinikumpu, Juha-Jaakko; Hyvönen, Pekka; Korhonen, Jussi; Markkanen, Paula; Tervonen, Osmo; Sequeiros, Roberto Blanco

    2014-07-01

    The purpose of this study was to evaluate the feasibility of MRI guidance for percutaneous retrograde drilling in the treatment of osteochondritis dissecans of the talus (OCDT). Four patients, one juvenile and three adults, with one OCDT lesion each and persisting ankle pain after conservative treatment, were treated with MRI-guided retrograde drilling. All lesions were stable and located in the middle or posterior medial third of the talar dome. Pain relief and the ability to return to normal activities were assessed during clinical follow-up. MRI and plain film radiographs were used for imaging follow-up. Technical success was 100% with no complications and with no damage to the overlying cartilage. All patients experienced some clinical benefit, although only one had complete resolution of pain and one had a relapse leading to surgical treatment. Changes in the pathological imaging findings were mostly very slight during the follow-up period. MRI guidance seems accurate, safe and technically feasible for retrograde drilling of OCDT. Larger series are needed to reliably assess its clinical value. • MRI serves as a useful guidance method for numerous mini-invasive applications. • Retrograde drilling is a cartilage-sparing alternative in the treatment of osteochondritis dissecans. • MRI guidance seems feasible for treatment of osteochondritis dissecans of the talus.

  9. Iatrogenic fornix rupture caused during retrograde manipulation of the ureter: a case report

    OpenAIRE

    Bannowsky, Andreas

    2008-01-01

    Iatrogenic fornix rupture caused during retrograde manipulation of the ureter is a rather rare or rarely diagnosed phenomenon. A 22 year-old female patient presented with a fornix rupture following endoscopic ureteral stone extraction under uretero-renoscopy, the rupture having become symptomatic two days later.

  10. The use of technetium-99m hexamethylpropylene amine oxime labelled granulocytes with single-photon emission tomography imaging in the detection and follow-up of recurrence of infective endocarditis complicating transvenous endocardial pacemaker

    International Nuclear Information System (INIS)

    Ramackers, J.M.; Kotzki, P.O.; Couret, I.; Messner-Pellenc, P.; Davy, J.M.; Rossi, M.

    1995-01-01

    In this case report we present a patient with a recurrence of subacute bacterial infectious endocarditis (IE) complicating a transvenous endocardial pacemaker. Technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO) labelled granulocytes were used for diagnosis and follow-up under medical treatment only, since surgical removal of the pacemaker lead was ruled out because of the general condition of the patient. Single-photon emission tomography (SPET) imaging displayed the active lesion previously suspected on echography. At the end of antibiotic therapy, SPET indicated a favourable disease outcome whereas echocardiographic abnormalities remained nearly unchanged. The medical treatment had eradicated the IE, and the patient did well for more than 1 year thereafter. (orig.)

  11. The use of technetium-99m hexamethylpropylene amine oxime labelled granulocytes with single-photon emission tomography imaging in the detection and follow-up of recurrence of infective endocarditis complicating transvenous endocardial pacemaker

    Energy Technology Data Exchange (ETDEWEB)

    Ramackers, J.M. [Department of Nuclear Medicine, CHU E. Herriot, Lyon (France); Kotzki, P.O. [Department of Nuclear Medicine, CHU Lapeyronie et A. de Villeneuve, Montpellier (France); Couret, I. [Department of Nuclear Medicine, CHU Lapeyronie et A. de Villeneuve, Montpellier (France); Messner-Pellenc, P. [Department of Cardiology, CHU Lapeyronie et A. Villeneuve, Montpellier (France); Davy, J.M. [Department of Cardiology, CHU Lapeyronie et A. Villeneuve, Montpellier (France); Rossi, M. [Department of Nuclear Medicine, CHU Lapeyronie et A. de Villeneuve, Montpellier (France)

    1995-11-01

    In this case report we present a patient with a recurrence of subacute bacterial infectious endocarditis (IE) complicating a transvenous endocardial pacemaker. Technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) labelled granulocytes were used for diagnosis and follow-up under medical treatment only, since surgical removal of the pacemaker lead was ruled out because of the general condition of the patient. Single-photon emission tomography (SPET) imaging displayed the active lesion previously suspected on echography. At the end of antibiotic therapy, SPET indicated a favourable disease outcome whereas echocardiographic abnormalities remained nearly unchanged. The medical treatment had eradicated the IE, and the patient did well for more than 1 year thereafter. (orig.)

  12. Retrograde approach for the recanalization of coronary chronic total occlusion: collateral selection and collateral related complication.

    Science.gov (United States)

    Ma, Jian-Ying; Qian, Ju-Ying; Ge, Lei; Fan, Bing; Wang, Qi-Bing; Yan, Yan; Zhang, Feng; Yao, Kang; Huang, Dong; Ge, Jun-Bo

    2013-03-01

    The retrograde approach through collaterals has been applied in the treatment of chronic total occlusion (CTO) lesions during percutaneous recanalization of coronary arteries. This study was to investigate the success rate of recanalization and collateral related complications in patients when using the retrograde approach. Eighty-four cases subjected to retrograde approach identified from July 2005 to July 2012 were included in this study. Patient characteristics, procedural outcomes and in-hospital clinical events were evaluated. Mean age of the patient was (59.6 ± 11.2) years old and 91.7% were men. The target CTO lesions were distributed among the left anterior descending artery in 45 cases (53.5%), left circumflex artery in one case (1.2%), right coronary artery in 34 cases (40.5%), and left main in four cases (4.8%). The overall success rate of recanalization was 79.8%. The septal collateral was three times more frequently used for retrograde access than the epicardial collateral, 68/84 (81%) vs. 16/84 (19%). Successful wire passage through the collateral channel was achieved in 58 (72.6%) patients. The success rate of recanalization was 93.1% (54/58) in patients with and 50% (13/26) in patients without successful retrograde wire passage of the collateral channel (P collaterals was achieved in 49 of 68 septal collaterals (72.1%) and in 9 of 16 epicardial collaterals (56.3%) (P = NS). There was no significant difference between the septal collateral group and the epicardial group in the success rate of recanalization after retrograde wire crossing the collaterals (91.8% vs. 100%, P > 0.05). CART or reverse CART technique was used in 15 patients, and 14 patients (93.3%) were recanalized successfully. Collateral related perforation occurred in three (18.8%) cases with the epicardial collateral as the first choice (compared with the septal collateral group (0), P collaterals. The retrograde approach is an effective technique to recanalize CTO lesions, the septal

  13. Multicentre comparison Of shock efficacy using single-vs. Dual-coil lead systems and Anodal vs. cathodaL polarITY defibrillation in patients undergoing transvenous cardioverter-defibrillator implantation. The MODALITY study.

    Science.gov (United States)

    Baccillieri, Maria Stella; Gasparini, Gianni; Benacchio, Luca; Zorzi, Alessandro; Marras, Elena; Zerbo, Francesca; Tomasi, Luca; Vaccari, Diego; Pastore, Gianni; Bonanno, Carlo; Molon, Giulio; Zanotto, Gabriele; Fusco, Antonio; Carasi, Massimo; Zorzi, Andrea; Calzolari, Vittorio; Ignatiuk, Barbara; Cannas, Sergio; Vaglio, Alessandro; Al Bunni, Muhamad; Pedrini, Antonella; Olivieri, Armando; Rampazzo, Roberta; Minicuci, Nadia; Corrado, Domenico; Verlato, Roberto

    2015-06-01

    An optimal active-can lead configuration during implantable cardioverter defibrillator (ICD) placement is important to obtain an adequate defibrillation safety margin. The purpose of this multicenter study was to evaluate the rate of the first shock success at defibrillation testing according to the type of lead implant (single vs. dual coil) and shock polarity (cathodal and anodal) in a large series of consecutive patients who received transvenous ICDs. This was a multicenter study enrolling 469 consecutive patients. Single- versus dual-coil leads and cathodal versus anodal polarity were evaluated at defibrillation testing. In all cases, the value of the energy for the first shock was set to 20 J less than the maximum energy deliverable from the device. A total of 469 patients underwent defibrillation testing: 158 (34 %) had dual-coil and 311 (66 %) had single-coil lead systems configuration, 254 (54 %) received anodal shock and 215 (46 %) received cathodal shock. In 35 (7.4 %) patients, the shock was unsuccessful. No significant differences in the outcome of defibrillation testing using single- versus dual-coil lead were observed but the multivariate analysis showed an increased risk of shock failure using cathodal shock polarity (OR 2.37, 95 % CI 1.12-5.03). Both single- and dual-coil transvenous ICD lead systems were associated with high rates of successful ICD implantation, and we found no significant differences in ventricular arrhythmias interruption between the two ICD lead systems configuration. Instead, anodal defibrillation was more likely to be successful than cathodal defibrillation.

  14. Control of autophagosome axonal retrograde flux by presynaptic activity unveiled using botulinum neurotoxin type a.

    Science.gov (United States)

    Wang, Tong; Martin, Sally; Papadopulos, Andreas; Harper, Callista B; Mavlyutov, Timur A; Niranjan, Dhevahi; Glass, Nick R; Cooper-White, Justin J; Sibarita, Jean-Baptiste; Choquet, Daniel; Davletov, Bazbek; Meunier, Frédéric A

    2015-04-15

    Botulinum neurotoxin type A (BoNT/A) is a highly potent neurotoxin that elicits flaccid paralysis by enzymatic cleavage of the exocytic machinery component SNAP25 in motor nerve terminals. However, recent evidence suggests that the neurotoxic activity of BoNT/A is not restricted to the periphery, but also reaches the CNS after retrograde axonal transport. Because BoNT/A is internalized in recycling synaptic vesicles, it is unclear which compartment facilitates this transport. Using live-cell confocal and single-molecule imaging of rat hippocampal neurons cultured in microfluidic devices, we show that the activity-dependent uptake of the binding domain of the BoNT/A heavy chain (BoNT/A-Hc) is followed by a delayed increase in retrograde axonal transport of BoNT/A-Hc carriers. Consistent with a role of presynaptic activity in initiating transport of the active toxin, activity-dependent uptake of BoNT/A in the terminal led to a significant increase in SNAP25 cleavage detected in the soma chamber compared with nonstimulated neurons. Surprisingly, most endocytosed BoNT/A-Hc was incorporated into LC3-positive autophagosomes generated in the nerve terminals, which then underwent retrograde transport to the cell soma, where they fused with lysosomes both in vitro and in vivo. Blocking autophagosome formation or acidification with wortmannin or bafilomycin A1, respectively, inhibited the activity-dependent retrograde trafficking of BoNT/A-Hc. Our data demonstrate that both the presynaptic formation of autophagosomes and the initiation of their retrograde trafficking are tightly regulated by presynaptic activity. Copyright © 2015 the authors 0270-6474/15/356179-16$15.00/0.

  15. Highly efficient retrograde gene transfer into motor neurons by a lentiviral vector pseudotyped with fusion glycoprotein.

    Directory of Open Access Journals (Sweden)

    Miyabi Hirano

    Full Text Available The development of gene therapy techniques to introduce transgenes that promote neuronal survival and protection provides effective therapeutic approaches for neurological and neurodegenerative diseases. Intramuscular injection of adenoviral and adeno-associated viral vectors, as well as lentiviral vectors pseudotyped with rabies virus glycoprotein (RV-G, permits gene delivery into motor neurons in animal models for motor neuron diseases. Recently, we developed a vector with highly efficient retrograde gene transfer (HiRet by pseudotyping a human immunodeficiency virus type 1 (HIV-1-based vector with fusion glycoprotein B type (FuG-B or a variant of FuG-B (FuG-B2, in which the cytoplasmic domain of RV-G was replaced by the corresponding part of vesicular stomatitis virus glycoprotein (VSV-G. We have also developed another vector showing neuron-specific retrograde gene transfer (NeuRet with fusion glycoprotein C type, in which the short C-terminal segment of the extracellular domain and transmembrane/cytoplasmic domains of RV-G was substituted with the corresponding regions of VSV-G. These two vectors afford the high efficiency of retrograde gene transfer into different neuronal populations in the brain. Here we investigated the efficiency of the HiRet (with FuG-B2 and NeuRet vectors for retrograde gene transfer into motor neurons in the spinal cord and hindbrain in mice after intramuscular injection and compared it with the efficiency of the RV-G pseudotype of the HIV-1-based vector. The main highlight of our results is that the HiRet vector shows the most efficient retrograde gene transfer into both spinal cord and hindbrain motor neurons, offering its promising use as a gene therapeutic approach for the treatment of motor neuron diseases.

  16. Pre-treatment hemodynamic features involved with long-term survival of cirrhotic patients after embolization of gastric fundal varices

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Hitoshi, E-mail: maru-cib@umin.ac.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan); Okugawa, Hidehiro, E-mail: hideun@yahoo.co.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan); Kobayashi, Satoshi, E-mail: kobakobakopa@yahoo.co.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan); Yoshizumi, Hiroaki, E-mail: yossih04@yahoo.co.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan); Yokosuka, Osamu, E-mail: yokosukao@faculty.chiba-u.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan)

    2010-08-15

    Purpose: To clarify the pre-treatment hemodynamic features involved in the long-term survival of cirrhotic patients with gastric fundal varices (FV) after balloon-occluded retrograde transvenous obliteration (B-RTO). Materials and methods: Eighty-one cirrhotic patients with medium- or large-grade FV treated by B-RTO were enrolled in this retrospective study. Pre-treatment flow volume ratio between gastric vein and portal trunk (GP-R) was obtained by Doppler ultrasound. Results: The cumulative survival rate was 90% at 1 year, 74.8% at 3 years, 57.2% at 5 years, and 45.8% at 7 years without recurrence in a median period of 1148.5 days The survival was poorer in patients with HCC (47% at 3 years, 9.4% at 5 years, p < 0.0001) than without (89.2% at 3 years, 81.9% at 5 years, 67.5% at 7 years), in patients with Child B/C (57.7% at 3 years, 42.1% at 5 years, 28.1% at 7 years, p = 0.0016) than with Child A (91.8% at 3 years, 71.5% at 5 years, 62.1% at 7 years), and in patients with GP-R {>=} 1.0 (58.9% at 3 years, p = 0.0485) than with GP-R < 1.0 (76.3% at 3 years, 62% at 5 years, 49.6% at 7 years). Multivariate analysis identified the presence of HCC (hazard ratio, 12.486; 95% CI, 4.08-38.216; p < 0.0001), Child B/C (hazard ratio, 3.41; 95% CI, 1.594-7.15; p = 0.0051) and GP-R {>=} 1.0 (hazard ratio, 2.701; 95% CI, 1.07-6.15; p = 0.0221) as independent factors for poor prognosis. Conclusion: GP-R {>=} 1.0 on Doppler ultrasound before B-RTO may be a predictive indicator for poor prognosis in cirrhotic patients with FV after B-RTO, in addition to the presence of HCC and severe liver damage.

  17. Conversion rate of laparoscopic cholecystectomy after endoscopic retrograde cholangiography in the treatment of choledocholithiasis - Does the time interval matter?

    NARCIS (Netherlands)

    de Vries, A.; Donkervoort, S. C.; van Geloven, A. A. W.; Pierik, E. G. J. M.

    2005-01-01

    Background: Preceding endoscopic retrograde cholangiography (ERC) in patients with choledochocystolithiasis impedes laparoscopic cholecystectomy (LC) and increases risk of conversion. We studied the influence of time interval between ERC and LC on the course of LC. Methods: All patients treated for

  18. Dynamic blood flow to the retrograde limb of the internal mammary vein in breast reconstruction with free flap.

    Science.gov (United States)

    Sugawara, Jun; Satake, Toshihiko; Muto, Mayu; Kou, Seiko; Yasumura, Kazunori; Maegawa, Jiro

    2015-11-01

    In free flap breast reconstruction, the retrograde limb of the internal mammary vein (IMV) is occasionally used as a second recipient vein. In this study, we evaluated the dynamic blood flow to the retrograde limb of the IMV (retrograde IMV) at the anastomosed site via indocyanine green (ICG) angiography In 40 patients undergoing free flap breast reconstruction, we evaluated the dynamic blood flow as "stain(+)" if a stain by ICG was observed and, "flow(+)" if a smooth blood flow was recognized. Based on the ICG angiography, "stain(+)" was observed in all cases, but "flow(+)" was detected in only 72.5% of the cases. There was no severe complication. This study shows that thrombosis is prone to occur in the second recipient vein in the 27.5% of the cases with no smooth flow, and therefore, the retrograde IMV may not function as a back-up in these cases. © 2015 Wiley Periodicals, Inc.

  19. Osteochondral lesion of lateral tibial plateau with extrusion of lateral meniscus treated with retrograde osteochondral autograft transplantation and arthroscopic centralisation

    Directory of Open Access Journals (Sweden)

    Jae-Sung An

    2017-04-01

    Conclusion: A combination of retrograde osteochondral autograft transplantation and arthroscopic centralisation can be a good option to treat the osteochondral lesion of the tibial plateau caused by extrusion of the meniscus.

  20. Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease

    DEFF Research Database (Denmark)

    Ainsworth, A P; Rafaelsen, S R; Wamberg, P A

    2004-01-01

    BACKGROUND: It is not known whether initial endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) is more cost effective than endoscopic retrograde cholangiopancreatography (ERCP). METHODS: A cost-effectiveness analysis of EUS, MRCP and ERCP was performed on 163...

  1. Irrelevant, Incidental and Core Features in the Retrograde Amnesia Associated with Korsakoff’s Psychosis: A Review

    Directory of Open Access Journals (Sweden)

    P. R. Meudell

    1992-01-01

    Full Text Available A brief review of the literature on retrograde amnesia in Korsakoff's syndrome is presented. Various explanations of the phenomenon are discussed including the notions that it results from the effects of “state-dependency”, that it occurs as a result of a progressive learning problem and that it arises through a failure in contextual processing. None of these hypotheses can satisfactorily account for the length and temporal gradient of alcoholic amnesics retrograde amnesia. Although some evidence points towards the hypothesis that anterograde and retrograde amnesia might result from separate and independent impairments, this view is presently unproven and leaves open what causes the form and duration of Korsakoffs retrograde amnesia.

  2. [Locked retrograde fibula nail for the surgical treatment of unstable ankle fractures].

    Science.gov (United States)

    Förch, S; Franz, U; Mayr, E

    2017-12-01

    Minimally invasive surgical stabilization of ankle fractures allowing postoperative full weight bearing. Unstable ankle fractures type Weber B and C in the geriatric patients or with a critical soft tissue situation. Ankle fractures in young patients and patients with high demands (relative contraindication). Closed reduction, retrograde insertion of the intramedullary nail into the fibula via a small incision, insertion of up to four locking screws using an aiming device and small incisions. Full weight bearing in an ankle joint orthosis. In 34 patients who were treated with a retrograde fibula nail, a 6-month follow-up was possible in 18 patients. Osseous consolidation was achieved without any soft tissue complications or infections in all 18 cases. The patients regained their preoperative level of mobility (Parker Mobility Score 4.2 preoperative vs 4.3 postoperative).

  3. Ascending Aorta Stenting After Off-Pump Aortic Wrapping in Stanford A Retrograde Aortic Dissection.

    Science.gov (United States)

    Verscheure, Dorian; Ramadan, Ramzi; Azmoun, Alexandre; Guihaire, Julien; Angel, Claude; Brenot, Philippe; Deleuze, Philippe

    2017-08-01

    We report 4 cases of off-pump ascending aorta wrapping combined with ascending aorta stenting in retrograde Stanford A acute aortic dissection (SAAD). Since 2008, 18 patients have undergone wrapping of the ascending aorta at our institution. Four patients had a persistent circulating false lumen in the ascending aorta after wrapping, with a threat to the aortic root. We chose an endovascular approach with ascending aorta stenting. Follow-up computed tomography showed a reapplication of the intimal flap in the reinforced aorta. Ascending aorta stenting after aortic wrapping for retrograde SAAD is a safe and efficient technique to prevent proximal progression of the dissection. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Percutaneous reconstruction of the innominate bifurcation using the retrograde 'kissing stents' technique

    International Nuclear Information System (INIS)

    Nagata, Shun-ichi; Kazekawa, Kiyoshi; Matsubara, Shuko; Sugata, Sei

    2006-01-01

    Obstructions of the supraaortic vessels are an important cause of morbidity associated with a variety of symptoms. Percutaneous transluminal angioplasty has evolved as an effective and safe treatment modality for occlusive lesions of the supraaortic vessels. However, the endovascular management of an innominate bifurcation has not previously been reported. A 53-year-old female with a history of systematic hypertension, diabetes mellitus and hypercholesterolemia presented with left hemiparesis and dysarthria. Angiography of the innominate artery showed a stenosis of the innominate bifurcation. The lesion was successfully treated using the retrograde kissing stent technique via a brachial approach and an exposed direct carotid approach. The retrograde kissing stent technique for the treatment of a stenosis of the innominate bifurcation was found to be a safe and effective alternative to conventional surgery. (orig.)

  5. Percutaneous reconstruction of the innominate bifurcation using the retrograde 'kissing stents' technique

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Shun-ichi; Kazekawa, Kiyoshi; Matsubara, Shuko [Fukuoka University Chikushi Hospital, Department of Neurosurgery, Chikushino, Fukuoka (Japan); Sugata, Sei [Bironoki Neurosurgical Hospital, Shibushi, Kagoshima (Japan)

    2006-08-15

    Obstructions of the supraaortic vessels are an important cause of morbidity associated with a variety of symptoms. Percutaneous transluminal angioplasty has evolved as an effective and safe treatment modality for occlusive lesions of the supraaortic vessels. However, the endovascular management of an innominate bifurcation has not previously been reported. A 53-year-old female with a history of systematic hypertension, diabetes mellitus and hypercholesterolemia presented with left hemiparesis and dysarthria. Angiography of the innominate artery showed a stenosis of the innominate bifurcation. The lesion was successfully treated using the retrograde kissing stent technique via a brachial approach and an exposed direct carotid approach. The retrograde kissing stent technique for the treatment of a stenosis of the innominate bifurcation was found to be a safe and effective alternative to conventional surgery. (orig.)

  6. Salvage of a TRAM breast reconstruction flap using the retrograde internal mammary artery system

    Directory of Open Access Journals (Sweden)

    Sameena Hassan

    2014-01-01

    Full Text Available Background: Free tissue transfer provides an optimal means for breast reconstruction in creating an aesthetically natural appearance that is durable over time. The choice of donor vessels vary from surgeon to surgeon, but the internal mammary axis is one of the most popular choices together with the thoracodorsal vessels. Aims and Results: We present the case of a salvaged free transverse rectus abdominis myocutaneous breast reconstruction in which end-to-end antegrade anastomosis to the internal mammary artery (IMA was not possible due to frail vessel walls, but retrograde anastomosis to the IMA and antegrade anastomosis of internal mammary vessel resulted in a perfused and viable flap. Conclusion: We suggest the use of the retrograde internal mammary arterial system for microsurgical anastomosis when the anterograde flow is not adequate, the vessel wall is friable, and when other more common options are not available.

  7. Loss of Renal Function After Retrograde Ureteral Placement of an Allium Stent for Severe Ureteral Stricture.

    Science.gov (United States)

    Salciccia, Stefano; Sciarra, Alessandro; Polese, Milena; Giorgio, Alpi; Maggi, Martina; Gentilucci, Alessandro; Ciccariello, Mauro; D'Eramo, Giuseppe; Shahabadi, Houssain; Lai, Silvia; Ricciuti, Gian Piero

    2018-01-01

    Background: Ureteral strictures are a recurrent chronic condition that leads to severe side effects and poor quality of life. Management of ureteral stricture is a great challenge for urologists and no specific guidelines exist. Retrograde Allium ® ureteral stent (AUS) is a newly developed ureteral stent to treat either bulbar urethral or ureteral stenosis. Case Presentation: We describe a case of a 74-year-old Caucasian adult male presenting with a severe ureteral stricture secondary to an ureteroscopy for stone disease. Treatment with retrograde AUS placement produced a complete loss of renal function after 36 months, probably because of the development of a long achalasic stretch of the ureter. Conclusions: AUS is a new and promising device for the treatment of ureteral stenosis. However, a lack of standardization of the technique recommends a close instrumental follow-up after the procedure to decide the optimal time for stent removal.

  8. Detection of retrograde gas streaming in the SB0 galaxy NGC 4546

    International Nuclear Information System (INIS)

    Galletta, G.

    1987-01-01

    Spectroscopic observations are reported of the almost edge-on SB0 galaxy NGC 4546 which reveal a striking discordance between the derived emission and absorption-line velocities. The gas clouds show velocities that are similar in amplitude but opposite in direction from the stars. This discordance is seen in observations obtained through slits oriented in a wide range of position angles. NGC 4546 is thus, at present, unique as a disk system exhibiting large-scale retrograde motions relative to the stellar component. Orbits elongated both along the bar major axis (prograde, stars) and along the bar intermediate axis (retrograde, gas) are found. The possibility that this material originated from an infall is discussed. 27 references

  9. Retrograde densification in Bi2Sr2CaCu2O8 superconductors

    International Nuclear Information System (INIS)

    Johnson, D.W. Jr.; Rhodes, W.W.

    1989-01-01

    Bi 2 Sr 2 CaCu 2 O 8 was prepared using the mixed oxide-carbonate method and sintered at temperatures ranging from 850 degrees to 911 degrees C. The samples were characterized for density, mechanical strength, phase composition, microstructure, and superconducting transition temperatures. A unique retrograde densification characteristic is demonstrated in the temperature range 850 degrees to 890 degrees C whereby the material first becomes less dense as the sintering temperature is raised, and only in a narrow temperature range from 900 degrees to 905 degrees C does the material densify then with the formation of a liquid phase. This retrograde densification, coupled with a narrow sintering range overlapping the melting temperature, makes this compound a difficult one to process

  10. COPI-mediated retrograde trafficking from the Golgi to the ER regulates EGFR nuclear transport

    International Nuclear Information System (INIS)

    Wang, Ying-Nai; Wang, Hongmei; Yamaguchi, Hirohito; Lee, Hong-Jen; Lee, Heng-Huan; Hung, Mien-Chie

    2010-01-01

    Research highlights: → ARF1 activation is involved in the EGFR transport to the ER and the nucleus. → Assembly of γ-COP coatomer mediates EGFR transport to the ER and the nucleus. → Golgi-to-ER retrograde trafficking regulates nuclear transport of EGFR. -- Abstract: Emerging evidence indicates that cell surface receptors, such as the entire epidermal growth factor receptor (EGFR) family, have been shown to localize in the nucleus. A retrograde route from the Golgi to the endoplasmic reticulum (ER) is postulated to be involved in the EGFR trafficking to the nucleus; however, the molecular mechanism in this proposed model remains unexplored. Here, we demonstrate that membrane-embedded vesicular trafficking is involved in the nuclear transport of EGFR. Confocal immunofluorescence reveals that in response to EGF, a portion of EGFR redistributes to the Golgi and the ER, where its NH 2 -terminus resides within the lumen of Golgi/ER and COOH-terminus is exposed to the cytoplasm. Blockage of the Golgi-to-ER retrograde trafficking by brefeldin A or dominant mutants of the small GTPase ADP-ribosylation factor, which both resulted in the disassembly of the coat protein complex I (COPI) coat to the Golgi, inhibit EGFR transport to the ER and the nucleus. We further find that EGF-dependent nuclear transport of EGFR is regulated by retrograde trafficking from the Golgi to the ER involving an association of EGFR with γ-COP, one of the subunits of the COPI coatomer. Our findings experimentally provide a comprehensive pathway that nuclear transport of EGFR is regulated by COPI-mediated vesicular trafficking from the Golgi to the ER, and may serve as a general mechanism in regulating the nuclear transport of other cell surface receptors.

  11. Ipsilateral proximal femur and shaft fractures treated with hip screws and a reamed retrograde intramedullary nail.

    Science.gov (United States)

    Ostrum, Robert F; Tornetta, Paul; Watson, J Tracy; Christiano, Anthony; Vafek, Emily

    2014-09-01

    Although not common, proximal femoral fractures associated with ipsilateral shaft fractures present a difficult management problem. A variety of surgical options have been employed with varying results. We investigated the use of hip screws and a reamed retrograde intramedullary (IM) nail for the treatment of this combined fracture pattern in terms of postoperative alignment (malunion), nonunion, and complications. Between May 2002 and October 2011, a total of 95 proximal femoral fractures with associated shaft fractures were treated at three participating Level 1 trauma centers; all were treated with hip screw fixation (cannulated screws or sliding hip screws) and retrograde reamed IM nails. The medical records of these patients were reviewed retrospectively for alignment, malunion, nonunion, and complications. Followup was available on 92 of 95 (97%) of the patients treated with hip screws and a retrograde nail. Forty were treated with a sliding hip screw, and 52 were treated with cannulated screws. There were five proximal malunions in this series (5%). The union rate was 98% (90 of 92) for the femoral neck fractures and 91.3% (84 of 92) for the femoral shaft fractures after the initial surgery. There were two nonunions of comminuted femoral neck fractures after cannulated screw fixation. There was no difference in femoral neck union or alignment when comparing cannulated screws to a sliding hip screw. Four open comminuted femoral shaft fractures went on to nonunion and required secondary surgery to obtain union, and one patient developed symptomatic avascular necrosis. The treatment of ipsilateral proximal femoral neck and shaft fractures with hip screw fixation and a reamed retrograde nail demonstrated a high likelihood of union for the femoral neck fractures and a low risk of malunion. Comminution and initial displacement of the proximal femoral fracture may still lead to a small incidence of malunion or nonunion, and open comminuted femoral shaft fractures

  12. Retrograde myotomy: a variation in per oral endoscopic myotomy (POEM) technique.

    Science.gov (United States)

    Ponsky, Jeffrey L; Marks, Jeffrey M; Orenstein, Sean B

    2014-11-01

    Per oral endoscopic myotomy (POEM) has evolved as a novel therapeutic option for the treatment of esophageal motility disorders such as achalasia. The originally described dissection technique involves cutting the inner circular esophageal muscle fibers in an antegrade fashion. We have modified this technique by commencing the muscular division at the most distal aspect of the submucosal tunnel and continuing the dissection in a retrograde fashion. We present our initial series of patients performed using this modified technique. We retrospectively reviewed our prospectively collected database. Peri- and postoperative data were collected and analyzed. POEM procedures were performed in a near-identical manner as previously published. Retrograde myotomy was performed on five patients with a diagnosis of achalasia. Four had a history of prior treatment including balloon dilation, with one of these having a prior surgical myotomy. Retrograde POEM procedures were performed with trace blood loss and without any complications. Mean operative time was 85 min. All patients had normal esophagram studies, and diets were advanced as per protocol. POEM was developed as a minimally invasive method for the treatment of achalasia. Our retrograde dissection modification allows the most critical portion of the case, namely division of the lower esophageal and upper gastric circular muscle fibers, to be performed earlier in the case. This ensures adequate dissection of the primary site of esophageal dysfunction should problems arise during the procedure. The modification is straightforward, without the need for additional training or equipment, and appears to provide a more rapid myotomy with less charring in this small cohort of patients.

  13. Surgical Treatment of Retrograde Peristalsis Following Laparoscopic Roux-en-Y Gastric Bypass

    OpenAIRE

    Sanders, Christina M.; Neff, Marc; Balsama, Louis

    2012-01-01

    Background: Retrograde Roux limb peristalsis following laparoscopic Roux-en-Y gastric bypass is a rare complication that can be difficult to identify. It may present as persistent nausea, vomiting, abdominal pain, or even gastrointestinal bleeding related to an anastomotic ulcer. Upper gastrointestinal (UGI) series is an important diagnostic modality to identify this motility disorder; however, it may not be readily identifiable without specific delayed imaging. The etiology of this phenomeno...

  14. COPI-mediated retrograde trafficking from the Golgi to the ER regulates EGFR nuclear transport

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Ying-Nai; Wang, Hongmei; Yamaguchi, Hirohito [Department of Molecular and Cellular Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030 (United States); Lee, Hong-Jen; Lee, Heng-Huan [Department of Molecular and Cellular Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030 (United States); The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX 77030 (United States); Hung, Mien-Chie, E-mail: mhung@mdanderson.org [Department of Molecular and Cellular Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030 (United States); The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX 77030 (United States); Center for Molecular Medicine and Graduate Institute of Cancer Biology, China Medical University and Hospital, Taichung 404, Taiwan (China); Asia University, Taichung 413, Taiwan (China)

    2010-09-03

    Research highlights: {yields} ARF1 activation is involved in the EGFR transport to the ER and the nucleus. {yields} Assembly of {gamma}-COP coatomer mediates EGFR transport to the ER and the nucleus. {yields} Golgi-to-ER retrograde trafficking regulates nuclear transport of EGFR. -- Abstract: Emerging evidence indicates that cell surface receptors, such as the entire epidermal growth factor receptor (EGFR) family, have been shown to localize in the nucleus. A retrograde route from the Golgi to the endoplasmic reticulum (ER) is postulated to be involved in the EGFR trafficking to the nucleus; however, the molecular mechanism in this proposed model remains unexplored. Here, we demonstrate that membrane-embedded vesicular trafficking is involved in the nuclear transport of EGFR. Confocal immunofluorescence reveals that in response to EGF, a portion of EGFR redistributes to the Golgi and the ER, where its NH{sub 2}-terminus resides within the lumen of Golgi/ER and COOH-terminus is exposed to the cytoplasm. Blockage of the Golgi-to-ER retrograde trafficking by brefeldin A or dominant mutants of the small GTPase ADP-ribosylation factor, which both resulted in the disassembly of the coat protein complex I (COPI) coat to the Golgi, inhibit EGFR transport to the ER and the nucleus. We further find that EGF-dependent nuclear transport of EGFR is regulated by retrograde trafficking from the Golgi to the ER involving an association of EGFR with {gamma}-COP, one of the subunits of the COPI coatomer. Our findings experimentally provide a comprehensive pathway that nuclear transport of EGFR is regulated by COPI-mediated vesicular trafficking from the Golgi to the ER, and may serve as a general mechanism in regulating the nuclear transport of other cell surface receptors.

  15. Loss of Renal Function After Retrograde Ureteral Placement of an Allium Stent for Severe Ureteral Stricture

    OpenAIRE

    Salciccia, Stefano; Sciarra, Alessandro; Polese, Milena; Giorgio, Alpi; Maggi, Martina; Gentilucci, Alessandro; Ciccariello, Mauro; D'Eramo, Giuseppe; Shahabadi, Houssain; Lai, Silvia; Ricciuti, Gian Piero

    2018-01-01

    Abstract Background: Ureteral strictures are a recurrent chronic condition that leads to severe side effects and poor quality of life. Management of ureteral stricture is a great challenge for urologists and no specific guidelines exist. Retrograde Allium® ureteral stent (AUS) is a newly developed ureteral stent to treat either bulbar urethral or ureteral stenosis. Case Presentation: We describe a case of a 74-year-old Caucasian adult male presenting with a severe ureteral stricture secondary...

  16. Retrograde Colonic Stent Implantation Assisted by Percutaneous Colostomy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyoung Gun; Han, Hyun Young; Chun, Tong Jin [Eulji Medical Center, Seoul (Korea, Republic of)

    2009-10-15

    We present a patient with disseminated pancreatic cancer who presented with symptoms of acute obstruction of the sigmoid colon. It was not possible to pass the region of the obstruction with a guide wire under colonoscopy and fluoroscopy. Consequently retrograde implantation of stents was performed successfully with the assistance of a minimally-sized colostomy when compared with a previously described procedure in the literature.

  17. Urethro-venous intravasation during retrograde urethrography (report of 5 cases.

    Directory of Open Access Journals (Sweden)

    Gupta S

    1991-04-01

    Full Text Available Five instances of urethro-venous intravasation during retrograde urethrography are reported. Four cases were of urethral strictures and one case was of urethral hemangioma. All patients had post procedural bleeding while one patient got allergic reactions, another showed chills and rigors. Anatomy of the drainage veins is described. Factors responsible for this complication and its clinical implications are discussed. It is suggested that urethro-venous intravasation should be considered a diagnostic sign of urethral inflammation.

  18. Computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic disease

    International Nuclear Information System (INIS)

    Foley, W.D.; Stewart, E.T.; Lawson, T.L.; Maher, L.; Unger, G.F.; Geenan, J.; Loguidice, J.

    1980-01-01

    A prospective study was performed comparing the sensitivity of computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of pancreatic disease. Forty patients with suspected pancreatic carcinoma, acute recurrent or chronic pancreatitis, and/or jaundice were studied. CT was the most sensitive study in evaluation of pancreatitis. ERCP was most accurate in evaluation of pancreatic malignancy. Ultrasonography was the least sensitive method in detecting pancreatic disease and dilatation of the extrahepatic biliary ducts. (orig.) [de

  19. Routine Use of Surgical Retrograde Transtibial Endovascular Approach for Failed Attempts at Antegrade Recanalization of Chronic Peripheral Artery Total Occlusions

    International Nuclear Information System (INIS)

    Liang, GangZhu; Zhang, FuXian; Luo, XiaoYun; Zhang, ChangMing; Feng, YaPing; Niu, LuYuan; Zhang, Huan; Hu, Lu; Zhao, Hui; Cheng, Long; Zhang, MingYi

    2016-01-01

    PurposeOur aim was to describe the technical aspects and clinical outcomes of an open surgical approach to retrograde transtibial endovascular therapy for recanalization of chronic total occlusions (CTOs) of peripheral arteries because of inability to acquire antegrade intravascular access across the occlusion.Materials and MethodsBetween January 2011 and May 2014, conventional antegrade revascularization failed in 15 limbs of 15 patients (11 males, 4 females) with complex CTOs. The mean age of the patients was 74 years (range 48–83 years). Five patients had severe claudication (Rutherford Category 3), and 10 patients had critical limb-threatening ischemia (Rutherford Categories 4–5). For each of these cases of antegrade failure, an open surgical exposure of the tibial or dorsalis pedis artery was used to allow a safe retrograde transtibial endovascular approach to recanalize the CTO.ResultsSurgical retrograde access from the tibial artery was achieved successfully in 14 of the 15 patients. In the 14 successful retrograde endovascular approaches, surgical retrograde transtibial access was achieved from the dorsalis pedis artery in 8 patients and from the posterior tibial artery in 6. The average time to obtain retrograde access was 5 min (range 2–11 min). No stenosis or occlusion occurred in the tibial or dorsalis pedis arteries used for the retrograde access sites during follow-up.ConclusionsRoutine surgical exposure can be a safe and an effective method for retrograde transtibial access to the more proximal occluded arterial segments in selected patients with CTO.

  20. Routine Use of Surgical Retrograde Transtibial Endovascular Approach for Failed Attempts at Antegrade Recanalization of Chronic Peripheral Artery Total Occlusions

    Energy Technology Data Exchange (ETDEWEB)

    Liang, GangZhu; Zhang, FuXian, E-mail: gangzhuliang@126.com; Luo, XiaoYun; Zhang, ChangMing; Feng, YaPing; Niu, LuYuan; Zhang, Huan; Hu, Lu; Zhao, Hui; Cheng, Long; Zhang, MingYi [Capital Medical University, Department of Vascular Surgery, Beijing Shijitan Hospital (China)

    2016-12-15

    PurposeOur aim was to describe the technical aspects and clinical outcomes of an open surgical approach to retrograde transtibial endovascular therapy for recanalization of chronic total occlusions (CTOs) of peripheral arteries because of inability to acquire antegrade intravascular access across the occlusion.Materials and MethodsBetween January 2011 and May 2014, conventional antegrade revascularization failed in 15 limbs of 15 patients (11 males, 4 females) with complex CTOs. The mean age of the patients was 74 years (range 48–83 years). Five patients had severe claudication (Rutherford Category 3), and 10 patients had critical limb-threatening ischemia (Rutherford Categories 4–5). For each of these cases of antegrade failure, an open surgical exposure of the tibial or dorsalis pedis artery was used to allow a safe retrograde transtibial endovascular approach to recanalize the CTO.ResultsSurgical retrograde access from the tibial artery was achieved successfully in 14 of the 15 patients. In the 14 successful retrograde endovascular approaches, surgical retrograde transtibial access was achieved from the dorsalis pedis artery in 8 patients and from the posterior tibial artery in 6. The average time to obtain retrograde access was 5 min (range 2–11 min). No stenosis or occlusion occurred in the tibial or dorsalis pedis arteries used for the retrograde access sites during follow-up.ConclusionsRoutine surgical exposure can be a safe and an effective method for retrograde transtibial access to the more proximal occluded arterial segments in selected patients with CTO.

  1. Multiple-indicator dilution technique for characterization of normal and retrograde flow in once-through rat liver perfusions

    International Nuclear Information System (INIS)

    St-Pierre, M.V.; Schwab, A.J.; Goresky, C.A.; Lee, W.F.; Pang, K.S.

    1989-01-01

    The technique of normal and retrograde rat liver perfusion has been widely used to probe zonal differences in drug-metabolizing activities. The validity of this approach mandates the same tissue spaces being accessed by substrates during both normal and retrograde perfusions. Using the multiple-indicator dilution technique, we presently examine the extent to which retrograde perfusion alters the spaces accessible to noneliminated references. A bolus dose of 51Cr-labeled red blood cells, 125I-albumin, 14C-sucrose and 3H2O was injected into the portal (normal) or hepatic (retrograde) vein of rat livers perfused at 10 ml per min per liver. The outflow perfusate was serially collected over 220 sec to characterize the transit times and the distribution spaces of the labels. During retrograde perfusion, red blood cells, albumin and sucrose profiles peaked later and lower than during normal perfusion, whereas the water curves were similar. The transit times of red blood cells, albumin and sucrose were longer (p less than 0.005), whereas those for water did not change. Consequently, retrograde flow resulted in significantly larger sinusoidal blood volumes (45%), albumin Disse space (42%) and sucrose Disse space (25%) than during normal flow, whereas the distribution spaces for total and intracellular water remained unaltered. The distension of the vascular tree was confirmed by electron microscopy, by which occasional isolated foci of widened intercellular recesses and spaces of Disse were observed. Cellular ultrastructure was otherwise unchanged, and there was no difference found between normal and retrograde perfusion for bile flow rates, AST release, perfusion pressure, oxygen consumption and metabolic removal of ethanol, a substrate with flow-limited distribution, which equilibrates rapidly with cell water (hepatic extraction ratios were virtually identical: normal vs. retrograde, 0.50 vs. 0.48 at 6 to 7.4 mM input concentration)

  2. Irrelevant, Incidental and Core Features in the Retrograde Amnesia Associated with Korsakoff’s Psychosis: A Review

    OpenAIRE

    Meudell, P. R.

    1992-01-01

    A brief review of the literature on retrograde amnesia in Korsakoff's syndrome is presented. Various explanations of the phenomenon are discussed including the notions that it results from the effects of “state-dependency”, that it occurs as a result of a progressive learning problem and that it arises through a failure in contextual processing. None of these hypotheses can satisfactorily account for the length and temporal gradient of alcoholic amnesics retrograde amnesia. Although some evid...

  3. Innovations in the Endovascular Management of Critical Limb Ischemia: Retrograde Tibiopedal Access and Advanced Percutaneous Techniques.

    Science.gov (United States)

    Mustapha, Jihad A; Diaz-Sandoval, Larry J; Saab, Fadi

    2017-08-01

    Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes. Comparative data is needed to shift the focus from PTA to disruptive treatment modalities that can further improve outcomes. Retrograde pedal access has emerged as an important tool to facilitate successfully percutaneous revascularization and limb salvage in patients with CLI. To efficiently approach the complexity of CLI, new thought processes are needed to change the reigning paradigms. Retrograde tibial-pedal access has shown improvement in the rate of successful revascularizations and is an important tool in the amputation-prevention armamentarium. Additional technologies may further improve success rates. Drug-eluting stents have shown better outcomes than PTA in patients with focal infrapopliteal lesions. Registry data have demonstrated the advantage of several atherectomy devices in the tibial arteries. More recently, bioresorbable vascular scaffolds have been used successfully, and further studies with drug-coated balloons are underway. Interventional operators are now even working in the inframalleolar space to reconstitute the plantar arch. Well-conducted studies are needed to generate high-quality evidence in the field of critical limb ischemia management.

  4. Annexin A1 and A2: roles in retrograde trafficking of Shiga toxin.

    Science.gov (United States)

    Tcatchoff, Lionel; Andersson, Sofia; Utskarpen, Audrun; Klokk, Tove Irene; Skånland, Sigrid S; Pust, Sascha; Gerke, Volker; Sandvig, Kirsten

    2012-01-01

    Annexins constitute a family of calcium and membrane binding proteins. As annexin A1 and A2 have previously been linked to various membrane trafficking events, we initiated this study to investigate the role of these annexins in the uptake and intracellular transport of the bacterial Shiga toxin (Stx) and the plant toxin ricin. Once endocytosed, both toxins are retrogradely transported from endosomes to the Golgi apparatus and the endoplasmic reticulum before being targeted to the cytosol where they inhibit protein synthesis. This study was performed to obtain new information both about toxin transport and the function of annexin A1 and annexin A2. Our data show that depletion of annexin A1 or A2 alters the retrograde transport of Stx but not ricin, without affecting toxin binding or internalization. Knockdown of annexin A1 increases Golgi transport of Stx, whereas knockdown of annexin A2 slightly decreases the same transport step. Interestingly, annexin A1 was found in proximity to cytoplasmic phospholipase A2 (cPLA(2)), and the basal as well as the increased Golgi transport of Stx upon annexin A1 knockdown is dependent on cPLA(2) activity. In conclusion, annexin A1 and A2 have different roles in Stx transport to the trans-Golgi network. The most prominent role is played by annexin A1 which normally works as a negative regulator of retrograde transport from the endosomes to the Golgi network, most likely by complex formation and inhibition of cPLA(2).

  5. Regulation of mitochondria-dynactin interaction and mitochondrial retrograde transport in axons.

    Science.gov (United States)

    Drerup, Catherine M; Herbert, Amy L; Monk, Kelly R; Nechiporuk, Alex V

    2017-04-17

    Mitochondrial transport in axons is critical for neural circuit health and function. While several proteins have been found that modulate bidirectional mitochondrial motility, factors that regulate unidirectional mitochondrial transport have been harder to identify. In a genetic screen, we found a zebrafish strain in which mitochondria fail to attach to the dynein retrograde motor. This strain carries a loss-of-function mutation in actr10 , a member of the dynein-associated complex dynactin. The abnormal axon morphology and mitochondrial retrograde transport defects observed in actr10 mutants are distinct from dynein and dynactin mutant axonal phenotypes. In addition, Actr10 lacking the dynactin binding domain maintains its ability to bind mitochondria, arguing for a role for Actr10 in dynactin-mitochondria interaction. Finally, genetic interaction studies implicated Drp1 as a partner in Actr10-dependent mitochondrial retrograde transport. Together, this work identifies Actr10 as a factor necessary for dynactin-mitochondria interaction, enhancing our understanding of how mitochondria properly localize in axons.

  6. Vesicular stomatitis virus with the rabies virus glycoprotein directs retrograde transsynaptic transport among neurons in vivo

    Directory of Open Access Journals (Sweden)

    Kevin T Beier

    2013-02-01

    Full Text Available Defining the connections among neurons is critical to our understanding of the structure and function of the nervous system. Recombinant viruses engineered to transmit across synapses provide a powerful approach for the dissection of neuronal circuitry in vivo. We recently demonstrated that recombinant vesicular stomatitis virus (VSV can be endowed with anterograde or retrograde synaptic tracing ability by providing the virus with different glycoproteins. Here we extend the characterization of the transmission and gene expression of VSV with the rabies virus glycoprotein (RABV-G, and provide examples of its activity relative to the anterograde tracer form of rVSV. rVSV with RABV-G was found to drive strong expression of transgenes and to spread rapidly from neuron to neuron in only a retrograde manner. Depending upon how the RABV-G was delivered, VSV served as a polysynaptic or monosynaptic tracer, or was able to define projections through axonal uptake and retrograde transport. In animals co-infected with rVSV in its anterograde form, rVSV with RABV-G could be used to begin to characterize the similarities and differences in connections to a given area. rVSV with RABV-G provides a flexible, rapid, and versatile tracing tool that complements the previously described VSV-based anterograde transsynaptic tracer.

  7. Vesicular stomatitis virus with the rabies virus glycoprotein directs retrograde transsynaptic transport among neurons in vivo.

    Science.gov (United States)

    Beier, Kevin T; Saunders, Arpiar B; Oldenburg, Ian A; Sabatini, Bernardo L; Cepko, Constance L

    2013-01-01

    Defining the connections among neurons is critical to our understanding of the structure and function of the nervous system. Recombinant viruses engineered to transmit across synapses provide a powerful approach for the dissection of neuronal circuitry in vivo. We recently demonstrated that recombinant vesicular stomatitis virus (VSV) can be endowed with anterograde or retrograde transsynaptic tracing ability by providing the virus with different glycoproteins. Here we extend the characterization of the transmission and gene expression of recombinant VSV (rVSV) with the rabies virus glycoprotein (RABV-G), and provide examples of its activity relative to the anterograde transsynaptic tracer form of rVSV. rVSV with RABV-G was found to drive strong expression of transgenes and to spread rapidly from neuron to neuron in only a retrograde manner. Depending upon how the RABV-G was delivered, VSV served as a polysynaptic or monosynaptic tracer, or was able to define projections through axonal uptake and retrograde transport. In animals co-infected with rVSV in its anterograde form, rVSV with RABV-G could be used to begin to characterize the similarities and differences in connections to different areas. rVSV with RABV-G provides a flexible, rapid, and versatile tracing tool that complements the previously described VSV-based anterograde transsynaptic tracer.

  8. Retrograde intramedullary fixation of long bone fractures through ipsilateral traumatic amputation sites.

    Science.gov (United States)

    Wagner, Scott C; Chi, Benjamin B; Gordon, Wade T; Potter, Benjamin K

    2015-06-01

    The technique of retrograde intramedullary fixation of fractures through open traumatic amputations has not been previously described. We performed a retrospective case series at a tertiary-care military hospital setting. Ten patients met inclusion criteria. All were male, and all were injured through improvised explosive device. Outcome measures included the incidence of fracture nonunion, osteomyelitis or acute infection, heterotopic ossification (HO), as well as successful prosthesis fitting and ambulation. Average time to fixation after injury and amputation closure was 11.7 and 12.2 days, respectively. Follow-up averaged 20.2 months. The radiographic union rate was 100%, and time to osseous union averaged 7.5 months. One patient had an amputation site infection requiring revision, but none of the nails was removed for infectious reasons. HO occurred in 7 patients, and 2 patients required revision for symptomatic HO. All patients were successfully fitted with prostheses and able to ambulate. To our knowledge, this is the only series in the literature to specifically describe retrograde intramedullary fixation of long bone fractures through the zone of traumatic amputation sites. The infectious risk is relatively low, whereas the union rate (100%) and successful prosthesis fitting are high. For patients with similar injuries, retrograde intramedullary fixation through the zone of amputation is a viable treatment option.

  9. Apicoectomies with the erbium laser: a complementary technique for retrograde endodontic treatment.

    Science.gov (United States)

    Angiero, Francesca; Benedicenti, Stefano; Signore, Antonio; Parker, Steven; Crippa, Rolando

    2011-12-01

    The purpose of this study was to evaluate the efficacy of erbium lasers for retrograde endodontic treatment, in terms of clinical outcome and therapeutic success. Apicoectomy with retrograde filling is a well-established surgical procedure to treat teeth affected by persistent periapical lesions. The apical root end is generally removed with burs, and the adjacent periapical tissue curetted, or alternatively treated with ultrasound or laser. Between 2000 and 2010, 65 apicoectomies were performed on necrotic teeth that presented apical lesions (29 men, 36 women). The lasers used in the study were the erbium:yttrium-aluminum-garnet (Er:YAG) laser, wavelength 2940 nm, and the erbium,chromium-doped:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser, wavelength 2780 nm. Of the 65 teeth in the study, failure only occurred in 9 CASES, MANIFESTING AFTER DIFFERENT TIMES. THE REMAINING PATIENTS, 86.15%, experienced no complications, and their treatment followed a positive course. Laser-assisted surgery increases the range of therapeutic approaches in the sphere of retrograde endodontic treatment. The results of this study show that the erbium laser, used for apicoectomy, results in a high success rate with considerable benefit in terms of clinical outcome and therapeutic success.

  10. MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Kerimaa, Pekka; Ojala, Risto; Markkanen, Paula; Tervonen, Osmo; Blanco Sequeiros, Roberto [Oulu University Hospital, Department of Radiology, Oulu (Finland); Sinikumpu, Juha-Jaakko; Korhonen, Jussi [Oulu University Hospital, Department of Paediatric Surgery, Oulu (Finland); Hyvoenen, Pekka [Oulu University Hospital, Department of Surgery, Oulu (Finland)

    2014-07-15

    The purpose of this study was to evaluate the feasibility of MRI guidance for percutaneous retrograde drilling in the treatment of osteochondritis dissecans of the talus (OCDT). Four patients, one juvenile and three adults, with one OCDT lesion each and persisting ankle pain after conservative treatment, were treated with MRI-guided retrograde drilling. All lesions were stable and located in the middle or posterior medial third of the talar dome. Pain relief and the ability to return to normal activities were assessed during clinical follow-up. MRI and plain film radiographs were used for imaging follow-up. Technical success was 100 % with no complications and with no damage to the overlying cartilage. All patients experienced some clinical benefit, although only one had complete resolution of pain and one had a relapse leading to surgical treatment. Changes in the pathological imaging findings were mostly very slight during the follow-up period. MRI guidance seems accurate, safe and technically feasible for retrograde drilling of OCDT. Larger series are needed to reliably assess its clinical value. (orig.)

  11. Measures of patient radiation exposure during endoscopic retrograde cholangiography: Beyond fluoroscopy time

    Science.gov (United States)

    Kachaamy, Toufic; Harrison, Edwyn; Pannala, Rahul; Pavlicek, William; Crowell, Michael D; Faigel, Douglas O

    2015-01-01

    AIM: To determine whether fluoroscope time is a good predictor of patient radiation exposure during endoscopic retrograde cholangiopancreatography. METHODS: This is a prospective observational study of consecutive patients undergoing endoscopic retrograde cholangiopancreatography in a tertiary care setting. Data related to radiation exposure were collected. The following measures were obtained: Fluoroscopy time (FT), dose area product (DAP) and dose at reference point (DOSERP). Coefficients of determination were calculated to analyze the correlation between FT, DAP and DOSRP. Agreement between FT and DAP/DOSRP was assessed using Bland Altman plots. RESULTS: Four hundred sixty-three data sets were obtained. Fluoroscopy time average was 7.3 min. Fluoroscopy related radiation accounted for 86% of the total DAP while acquisition films related radiation accounted for 14% of the DAP. For any given FT there are wide ranges of DAP and DOSERP and the variability in both increases as fluoroscopy time increases. The coefficient of determination (R2) on the non transformed data for DAP and DOSERP versus FT were respectively 0.416 and 0.554. While fluoroscopy use was the largest contributor to patient radiation exposure during endoscopic retrograde cholangiography (ERCP), there is a wide variability in DAP and DOSERP that is not accounted for by FT. DAP and DOSERP increase in variability as FT increases. This translates into poor accuracy of FT in predicting DAP and DOSERP at higher radiation doses. CONCLUSION: DAP and DOSERP in addition to FT should be adopted as new ERCP quality measures to estimate patient radiation exposure. PMID:25684958

  12. A role for nitric oxide-driven retrograde signaling in the consolidation of a fear memory

    Directory of Open Access Journals (Sweden)

    Kathie A Overeem

    2010-02-01

    Full Text Available In both invertebrate and vertebrate models of synaptic plasticity, signaling via the putative “retrograde messenger” nitric oxide (NO has been hypothesized to serve as a critical link between functional and structural alterations at pre- and postsynaptic sites. However, while in vitro models of synaptic plasticity have consistently implicated NO signaling in linking postsynaptic induction mechanisms with accompanying presynaptic changes, a convincing role of such “retrograde signaling” in mammalian memory formation has remained elusive. Using auditory Pavlovian fear conditioning, we show that synaptic plasticity and NO signaling in the lateral nucleus of the amygdala (LA regulate the expression of the ERK-driven immediate early gene early growth response gene I (EGR-1 in regions of the auditory thalamus that are presynaptic to the LA. Further, antisense knockdown of EGR-1 in the auditory thalamus impairs both fear memory consolidation and the training-induced elevation of two presynaptically localized proteins in the LA. These findings indicate that synaptic plasticity and NO signaling in the LA during auditory fear conditioning promote alterations in ERK-driven gene expression in auditory thalamic neurons that are required for both fear memory consolidation as well as presynaptic correlates of fear memory formation in the LA, and provide general support for a role of NO as a “retrograde signal” in mammalian memory formation.

  13. Measuring retrograde autobiographical amnesia following electroconvulsive therapy: historical perspective and current issues.

    Science.gov (United States)

    Semkovska, Maria; McLoughlin, Declan M

    2013-06-01

    Retrograde amnesia following electroconvulsive therapy (ECT) is a major concern for both patients and clinicians. In contemporary ECT research, retrograde autobiographical amnesia (RAA) is commonly measured with instruments assessing autobiographical memory (AM) consistency over time. However, normal AM recall loses in consistency with the passage of time, and time has a differential effect on stability of personal memories. In addition, experiencing depression is associated with a decreased ability to recall specific AMs, and this difficulty may persist in the euthymic phase of recurrent depression. Despite these scientific facts, relatively few attempts have been made to accurately measure the specific effect of ECT on AM independent of both normal and mood-associated forgetting over time. This major gap in our knowledge prevents us at present from objectively quantifying the nature and extent of RAA associated with ECT. In turn, this hinders our identifying and implementing strategies for prevention or remediation of AM deficits. The present article aims to provide an up-to-date review and historical perspective of this major methodological conundrum for ECT research, highlight current issues in retrograde amnesia assessment following ECT, and propose directions for future studies. In conclusion, we suggest methods to reliably and specifically measure the extent and progression over time of ECT-associated RAA independently from persistent depressive symptoms' contribution and normal loss in AM consistency over time.

  14. Preserved memory in retrograde amnesia: sparing of a recently acquired skill.

    Science.gov (United States)

    Squire, L R; Cohen, N J; Zouzounis, J A

    1984-01-01

    Recent work with amnesic patients has revealed a preserved capacity for acquiring and retaining new skills despite otherwise profound anterograde impairment. In addition to their anterograde impairment, amnesic patients also have retrograde memory loss for some information acquired prior to the amnesic event. The present experiment addresses for the first time the question of whether preservation of memory for skills is also a feature memory impairment. To determine the susceptibility of a recently learned skill to retrograde amnesia, we taught patients to read mirror-reversed words before and during the early part of a prescribed course of electroconvulsive therapy (ECT) and then tested retention of the skill after the course of treatment had been completed. Patients prescribed bilateral or right unilateral ECT and depressed patients not receiving ECT acquired the mirror-reading skill at the same rate and then retained it at the same level. For the patients prescribed ECT, intact learning and retention of the skill occurred despite retrograde amnesia for the previous testing sessions and for the words that they had read previously.

  15. Chemoradiotherapy using retrograde superselective intra-arterial infusion for advanced oral cancer

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Iwai, Toshinori; Mitsunaga, Sachiyo

    2011-01-01

    Concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion demonstrates good local control and overall survival rates due to the advantage of simultaneous infusion of anticancer agent with the synergistic effects of chemotherapy and radiotherapy. This study evaluated the therapeutic results, overall survival and local control rates in patients with advanced oral cancer treated with definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. A total of 688 patients with carcinoma of the head and neck were referred to our institution between January 2001 and December 2006. Among them, 175 patients with carcinoma of the oral cavity underwent definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m 2 , cisplatin, total 125-150 mg/m 2 ) and daily concurrent radiotherapy (total 50-60 Gy) for 5-6 weeks. Four weeks after the completion of all treatments, patients underwent biopsy of the primary lesion and radiological examinations. Complete response (CR) of the primary site was achieved in 160 (91.4%) of the 175 patients. Residual disease at the primary site was seen in 15 patients (8.6%), and 14 patients (8.0%) showed local recurrence during follow-up. Five-year survival and local control rates were 71.6% and 82.2%, respectively. (author)

  16. Temporary Vascular Occlusion by Rapid Reverse Phase Polymer: A Preliminary In Vitro Study of Retrograde Injection

    Directory of Open Access Journals (Sweden)

    Einar Dregelid

    2012-01-01

    Full Text Available During vascular surgical operations, there is a need for a simpler and more reliable method of temporary arterial occlusion than those currently employed, especially of heavily calcified arteries. A thermosensitive polymer, LeGoo (LG (Pluromed, Woburn, MA, has been used successfully for temporary vascular occlusion. It has hitherto been injected by a cannula that has been introduced into the artery to be occluded, here henceforth called the “cannulation method.” Injection into arterial ostia without cannulation, using an injection device that arrests blood flow during the injection, here henceforth called “a retrograde method” may enable temporary hemostasis when ostial stenoses render it impossible to inject LG using the cannulation method. The objective of the present study was to study the feasibility of a retrograde method and to compare it with the cannulation method in an in vitro model, incorporating a narrow orifice to simulate ostial stenosis, using tap water at 37°C instead of blood. The retrograde method of LG injection, using a modified paediatric Foley catheter, turned out to be feasible to produce a durable LG plug more reliably, at higher water pressure and with less deep LG injection than with the cannulation method.

  17. MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

    International Nuclear Information System (INIS)

    Kerimaa, Pekka; Ojala, Risto; Markkanen, Paula; Tervonen, Osmo; Blanco Sequeiros, Roberto; Sinikumpu, Juha-Jaakko; Korhonen, Jussi; Hyvoenen, Pekka

    2014-01-01

    The purpose of this study was to evaluate the feasibility of MRI guidance for percutaneous retrograde drilling in the treatment of osteochondritis dissecans of the talus (OCDT). Four patients, one juvenile and three adults, with one OCDT lesion each and persisting ankle pain after conservative treatment, were treated with MRI-guided retrograde drilling. All lesions were stable and located in the middle or posterior medial third of the talar dome. Pain relief and the ability to return to normal activities were assessed during clinical follow-up. MRI and plain film radiographs were used for imaging follow-up. Technical success was 100 % with no complications and with no damage to the overlying cartilage. All patients experienced some clinical benefit, although only one had complete resolution of pain and one had a relapse leading to surgical treatment. Changes in the pathological imaging findings were mostly very slight during the follow-up period. MRI guidance seems accurate, safe and technically feasible for retrograde drilling of OCDT. Larger series are needed to reliably assess its clinical value. (orig.)

  18. Subintimal Recanalization of Long Superficial Femoral Artery Occlusions Through the Retrograde Popliteal Approach

    International Nuclear Information System (INIS)

    Yilmaz, Saim; Sindel, Timur; Ceken, Kagan; Alimoglu, Emel; Lueleci, Ersin

    2001-01-01

    Purpose: To investigate the value of the retrograde popliteal artery approach for the percutaneous intentional extraluminal recanalization (PIER) of long superficial femoral artery (SFA) occlusions.Methods: During a period of 17 months, PIER through ultrasound-guided retrograde popliteal artery puncture was performed for 39 long SFA occlusions in 37 patients. In six patients, six additional iliac artery stenoses were also treated via the popliteal approach.Results: The procedure was technically successful in 32 (82%) of 39 SFA occlusions; in 29, lesions were treated with balloon angioplasty alone, and in three, stents were also used. Cumulative patency rate was 66% at 6 months, 62% at 1 year, and 59% at 18 months. Additional iliac artery stenoses were successfully treated in the same session. Complications included two minor hematomas and two SFA ruptures, which required no treatment.Conclusion: PIER through retrograde popliteal puncture is a safe and effective method in the treatment of long femoropopliteal occlusions, with a high technical success, low complication rate and a reasonable short-term patency rate. The technique offers an alternative in cases where standard PIER is unsuccessful or contraindicated

  19. The application of wedge type compensation filter for uniform density on the endoscopic retrograde pancreatography

    International Nuclear Information System (INIS)

    Son, Soon Yong; Lee, Hee Jeong; Lee, Won Hong; Cho, Cheong Chan; Ryu, Meung Sun; Jung, Hong Ryang

    2001-01-01

    Over-density of pancreatic duct tail part on the endoscopic retrograde pancreatogram results from patient's position and inserted air during the study. The aim of this paper is to decide the filter angle to obtain an uniform density. Endoscopic retrograde pancratography was performed to 234 patients, and angled wedge filter was used differently. They are 10 deg (47), 20 deg (45), 30 deg (50). We also did not use wedge filter to 42 patients. We decided reliance degree in 95%. The statistical difference was p<0.05. The patients' sex rate was 1.8:1 between 18 and 87 years old(average age 58 years). Their body girth was 18.71 cm on the average. Of total 234 patients, difference of right and left average density was 0.01 by 30 deg wedge filter, -0.08 40 deg wedge filter and 0.27 non-wedge filter. These average values of difference density were very significant statistically, and standard deviation also was close to regular distribution. In conclusion, there is a usefulness of angled wedge filter for increasing diagnostic value of pancreatic duct tail part on the endoscopic retrograde pancreatogram

  20. A modified technique of retrograde intubation dacryocystorhinostomy for proximal canalicular obstruction

    Directory of Open Access Journals (Sweden)

    Nikolaos Trakos

    2009-11-01

    Full Text Available Nikolaos Trakos, Emmanouil Mavrikakis, Kostas G Boboridis, Marselos Ralidis, George Dimitriadis, Ioannis MavrikakisOculoplastic Service, Metropolitan Hospital, Athens, GreecePurpose: To describe a modification of the retrograde intubation dacryocystorhinostomy (DCR in patients with proximal canalicular obstruction.Materials and methods: Interventional case report of a 43-year-old female with a nine-month history of left epiphora following a road traffic accident involving the proximal lower canaliculus. An external DCR approach was performed. Following the creation of a lower canalicular pseudopunctum, the O’Donoghue silicone stent was introduced through the common ostium, out through the pseudopunctum of the lower canaliculus, and returned through the punctum of the normal upper canaliculus down through the common ostium into the nose.Results: The patient experienced complete resolution of symptoms and on her last follow-up, two years later, her lower canaliculus was patent to syringing.Conclusion: This modification of the retrograde intubation DCR is an effective technique which decreases the intraoperative time needed to insert the tubes and minimises further trauma to the newly created punctal area.Keywords: retrograde dacryocystorhinostomy, proximal canalicular obstruction, midcanalicular obstruction, conjuctivodacryocystorhinostomy

  1. NUMERICAL SIMULATIONS OF NATURALLY TILTED, RETROGRADELY PRECESSING, NODAL SUPERHUMPING ACCRETION DISKS

    International Nuclear Information System (INIS)

    Montgomery, M. M.

    2012-01-01

    Accretion disks around black hole, neutron star, and white dwarf systems are thought to sometimes tilt, retrogradely precess, and produce hump-shaped modulations in light curves that have a period shorter than the orbital period. Although artificially rotating numerically simulated accretion disks out of the orbital plane and around the line of nodes generate these short-period superhumps and retrograde precession of the disk, no numerical code to date has been shown to produce a disk tilt naturally. In this work, we report the first naturally tilted disk in non-magnetic cataclysmic variables using three-dimensional smoothed particle hydrodynamics. Our simulations show that after many hundreds of orbital periods, the disk has tilted on its own and this disk tilt is without the aid of radiation sources or magnetic fields. As the system orbits, the accretion stream strikes the bright spot (which is on the rim of the tilted disk) and flows over and under the disk on different flow paths. These different flow paths suggest the lift force as a source to disk tilt. Our results confirm the disk shape, disk structure, and negative superhump period and support the source to disk tilt, source to retrograde precession, and location associated with X-ray and He II emission from the disk as suggested in previous works. Our results identify the fundamental negative superhump frequency as the indicator of disk tilt around the line of nodes.

  2. Osteochondritis Dissecans Involving the Trochlear Groove Treated With Retrograde Drilling: A Case Report.

    Science.gov (United States)

    Kaji, Yoshio; Nakamura, Osamu; Yamaguchi, Konosuke; Yamamoto, Tetsuji

    2015-09-01

    Osteochondritis dissecans (OCD) occurs frequently in the humeral capitellum of the upper extremity, whereas OCD involving the trochlear groove (trochlear groove OCD) is rarely reported. A standard treatment for trochlear groove OCD has therefore not been determined, although several methods have been tried.The case of a 14-year-old male gymnast with bilateral trochlear groove OCD is presented. Retrograde drilling from the lateral condyle of the humerus was applied for the OCD lesion of the left elbow, since it was larger in size than that in the right elbow and was symptomatic. Conversely, since the right lesion was small and asymptomatic, it was managed conservatively.After treatment, consolidation of the OCD lesions was observed in both elbows. However, the time to healing was shorter in the left elbow treated surgically than in the right elbow managed conservatively.In conclusion, retrograde drilling is a very simple and minimally invasive treatment. This case suggests that retrograde drilling for trochlear groove OCD may be a useful procedure that may accelerate the healing process for OCD lesions.

  3. Recanalization of superficial femoral artery by retrograde approach via popliteal artery

    International Nuclear Information System (INIS)

    Kim, Jae Kyu; Kim, Hyung Kil; Yun, Ung; Seo, Jeong Jin; Kang, Heoung Keun

    1995-01-01

    To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all men and range of age were from 53 years to 66 years (mean age: 63 years). Range of lesion length were from 15 cm to 30 cm (mean length: 22.4 cm). Localization of popliteal artery was done with Doppler stethoscope or 'road-map' DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). Retrograde puncture of popliteal artery was done in 15 patients successfully. TEC and PTA was performed in 9 patients, TEC only in 2 patients, and TLA and PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occur in 10 patients except for 1 patient with poor cardiac output in whom it occurred 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. Retrograde approach of superficial femoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method

  4. Mozart, Mozart Rhythm and Retrograde Mozart Effects: Evidences from Behaviours and Neurobiology Bases.

    Science.gov (United States)

    Xing, Yingshou; Xia, Yang; Kendrick, Keith; Liu, Xiuxiu; Wang, Maosen; Wu, Dan; Yang, Hua; Jing, Wei; Guo, Daqing; Yao, Dezhong

    2016-01-21

    The phenomenal finding that listening to Mozart K.448 enhances performance on spatial tasks has motivated a continuous surge in promoting music education over the past two decades. But there have been inconsistent reports in previous studies of the Mozart effect. Here conducted was a systematic study, with Mozart and retrograde Mozart music, Mozart music rhythm and pitch, behaviours and neurobiology tests, rats and humans subjects. We show that while the Mozart K.448 has positive cognitive effects, the retrograde version has a negative effect on rats' performance in the Morris water maze test and on human subjects' performance in the paper folding and cutting test and the pencil-and-paper maze test. Such findings are further confirmed by subsequent immunohistochemical analyses in rats on the neurogenesis and protein levels of BDNF and its receptor, TrkB. Furthermore, when the rhythm and pitch of the normal and retrograde Mozart music are manipulated independently, the learning performance of the rats in the Morris water maze test indicated that rhythm is a crucial element in producing the behavioural effects. These findings suggest that the nature of Mozart effect is the Mozart rhythm effect, and indicate that different music may have quite different to opposite effects. Further study on rhythm effect may provide clues to understand the common basis over animals from rats to humans.

  5. Increased brachial artery retrograde shear rate at exercise onset is abolished during prolonged cycling: role of thermoregulatory vasodilation.

    Science.gov (United States)

    Simmons, Grant H; Padilla, Jaume; Young, Colin N; Wong, Brett J; Lang, James A; Davis, Michael J; Laughlin, M Harold; Fadel, Paul J

    2011-02-01

    Acute leg exercise increases brachial artery retrograde shear rate (SR), while chronic exercise improves vasomotor function. These combined observations are perplexing given the proatherogenic impacts of retrograde shear stress on the vascular endothelium and may be the result of brief protocols used to study acute exercise responses. Therefore, we hypothesized that brachial artery retrograde SR increases initially but subsequently decreases in magnitude during prolonged leg cycling. Additionally, we tested the role of cutaneous vasodilation in the elimination of increased retrograde SR during prolonged exercise. Brachial artery diameter and velocity profiles and forearm skin blood flow and temperature were measured at rest and during 50 min of steady-state, semirecumbent leg cycling (120 W) in 14 males. Exercise decreased forearm vascular conductance (FVC) and increased retrograde SR at 5 min (both P minutes 30 and 40 to blunt cutaneous vasodilation attending exercise, FVC was reduced and the magnitude of retrograde SR was increased from -49.7 ± 13.6 to -78.4 ± 16.5 s(-1) (P cycling subsequently returns toward baseline values due in part to thermoregulatory cutaneous vasodilation during prolonged exercise.

  6. Retrograde flow in the dural sinuses detected by three-dimensional time-of-flight MR angiography

    International Nuclear Information System (INIS)

    Uchino, Akira; Nomiyama, Keita; Takase, Yukinori; Nakazono, Takahiko; Tominaga, Yukiko; Imaizumi, Takeshi; Kudo, Sho

    2007-01-01

    Retrograde flow in the left dural sinuses is sometimes detected by three-dimensional time-of-flight (3D-TOF) magnetic resonance (MR) angiography. The purpose of this study was to evaluate the incidence of this phenomenon and its characteristic features on 3D-TOF MR angiograms. We retrospectively reviewed cranial MR angiography images of 1,078 patients examined at our institution. All images were obtained by the 3D-TOF technique with one of two 1.5-T scanners. Maximum intensity projection (MIP) images in the horizontal rotation view were displayed stereoscopically. We reviewed the source images, inferosuperior MIP images, and horizontal MIP images and identified retrograde flow in the dural sinuses. We found retrograde flow in the dural sinuses of 67 patients on the source images from 3D-TOF MR angiography; the incidence was 6.2%. In 47 of the 67 patients, retrograde flow was identified in the left inferior petrosal sinus, in 13, it was seen in the left sigmoid sinus, and in 6, it was seen in the left inferior petrosal and left sigmoid sinuses. The remaining patient had retrograde flow in the left inferior petrosal and left and right sigmoid sinuses. The mean age of the patients with retrograde flow was slightly greater than that of the patients without this phenomenon (70 years vs 63 years). Retrograde flow in the dural sinuses frequently occurs on the left side in middle-aged and elderly patients during 3D-TOF MR angiography performed with the patient in the supine position. This phenomenon should not be misdiagnosed as a dural arteriovenous fistula. (orig.)

  7. Superficial parotidectomy versus retrograde partial superficial parotidectomy in treating benign salivary gland tumor (pleomorphic adenoma).

    Science.gov (United States)

    Emodi, Omri; El-Naaj, Imad Abu; Gordin, Arye; Akrish, Sharon; Peled, Micha

    2010-09-01

    Of all benign salivary gland tumors of the parotid gland, pleomorphic adenoma (mixed tumor) is the most common. It accounts for 60% to 70% of all benign tumors of the parotid gland. This neoplasm arises in patients in the fourth to sixth decade of life, with a female predominance. The surgical excision of this lesion continues to be the subject of major debate. The goal is to avoid facial disability yet attain complete resection without perforation of the capsule/pseudocapsule. The purpose of our study is to compare 2 surgical techniques performed at the Ear, Nose, and Throat and Maxillofacial Departments, Rambam Medical Center, Haifa, Israel, and determine which is preferable in treating this lesion. We reviewed 48 patients who underwent excision of pleomorphic adenoma of the parotid gland between 1996 and 2005 at Rambam Medical Center: 18 were treated surgically with the classical superficial parotidectomy (SP) technique, using an anterograde approach, and 30 were treated with retrograde partial superficial parotidectomy (PSP). We compared the 2 surgical techniques in terms of surgical time, histopathologic size of the lesion, amount of excised healthy parotid tissue, histologic margin, and the preservation of the capsule/pseudocapsule. We also made clinical records of temporary or definitive injury to the facial nerve, which branches of the facial nerve were temporarily or definitively injured, the occurrence of Frey syndrome, esthetic satisfaction, and the amount of recurrence or infection after surgery. Of the 48 patients, 19 (39.6%) were male and 29 (60.4%) were female, with a mean age (+/- SD) of 43.8 +/- 16.97 years (median, 50 years; range, 12-79 years). We found a significant difference (P = .029) in mean surgical time (+/- SD): 171 +/- 49.7 minutes (median, 165 minutes) when performing the classical SP and 145 +/- 42.7 minutes (median, 130 minutes) when performing the retrograde PSP. Much more healthy parotid tissue was taken out with the classical

  8. A Comparison of the Quality of Life of Patients With an Entirely Subcutaneous Implantable Defibrillator System Versus a Transvenous System (from the EFFORTLESS S-ICD Quality of Life Substudy)

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Mastenbroek, Mirjam H; Carter, Nathan

    2016-01-01

    including baseline QoL. QoL was measured with the Short-Form Health Survey at baseline, 3, and 6 months after implant and compared using multivariable modeling with repeated measures. Patients with an S-ICD (n = 167) versus a TV-ICD system (n = 167) did not differ significantly on physical (p = 0......The first clinical results from the Evaluation of Factors Impacting Clinical Outcome and Cost Effectiveness of the subcutaneous implantable cardioverter defibrillator (EFFORTLESS S-ICD) Registry on the entirely S-ICD system are promising, but the impact of the S-ICD system on patients' quality...... of life (QoL) is not known. We evaluated the QoL of patients with an S-ICD against an unrelated cohort with a transvenous (TV)-ICD system during 6 months of follow-up. Consecutively implanted patients with an S-ICD system were matched with patients with a TV-ICD system on a priori selected variables...

  9. Annexin A1 and A2: roles in retrograde trafficking of Shiga toxin.

    Directory of Open Access Journals (Sweden)

    Lionel Tcatchoff

    Full Text Available Annexins constitute a family of calcium and membrane binding proteins. As annexin A1 and A2 have previously been linked to various membrane trafficking events, we initiated this study to investigate the role of these annexins in the uptake and intracellular transport of the bacterial Shiga toxin (Stx and the plant toxin ricin. Once endocytosed, both toxins are retrogradely transported from endosomes to the Golgi apparatus and the endoplasmic reticulum before being targeted to the cytosol where they inhibit protein synthesis. This study was performed to obtain new information both about toxin transport and the function of annexin A1 and annexin A2. Our data show that depletion of annexin A1 or A2 alters the retrograde transport of Stx but not ricin, without affecting toxin binding or internalization. Knockdown of annexin A1 increases Golgi transport of Stx, whereas knockdown of annexin A2 slightly decreases the same transport step. Interestingly, annexin A1 was found in proximity to cytoplasmic phospholipase A2 (cPLA(2, and the basal as well as the increased Golgi transport of Stx upon annexin A1 knockdown is dependent on cPLA(2 activity. In conclusion, annexin A1 and A2 have different roles in Stx transport to the trans-Golgi network. The most prominent role is played by annexin A1 which normally works as a negative regulator of retrograde transport from the endosomes to the Golgi network, most likely by complex formation and inhibition of cPLA(2.

  10. Impairment of retrograde neuronal transport in oxaliplatin-induced neuropathy demonstrated by molecular imaging.

    Directory of Open Access Journals (Sweden)

    Dawid Schellingerhout

    Full Text Available BACKGROUND AND PURPOSE: The purpose of our study was to utilize a molecular imaging technology based on the retrograde axonal transport mechanism (neurography, to determine if oxaliplatin-induced neurotoxicity affects retrograde axonal transport in an animal model. MATERIALS AND METHODS: Mice (n = 8/group were injected with a cumulative dose of 30 mg/kg oxaliplatin (sufficient to induce neurotoxicity or dextrose control injections. Intramuscular injections of Tetanus Toxin C-fragment (TTc labeled with Alexa 790 fluorescent dye were done (15 ug/20 uL in the left calf muscles, and in vivo fluorescent imaging performed (0-60 min at baseline, and then weekly for 5 weeks, followed by 2-weekly imaging out to 9 weeks. Tissues were harvested for immunohistochemical analysis. RESULTS: With sham treatment, TTc transport causes fluorescent signal intensity over the thoracic spine to increase from 0 to 60 minutes after injection. On average, fluorescence signal increased 722%+/-117% (Mean+/-SD from 0 to 60 minutes. Oxaliplatin treated animals had comparable transport at baseline (787%+/-140%, but transport rapidly decreased through the course of the study, falling to 363%+/-88%, 269%+/-96%, 191%+/-58%, 121%+/-39%, 75%+/-21% with each successive week and stabilizing around 57% (+/-15% at 7 weeks. Statistically significant divergence occurred at approximately 3 weeks (p≤0.05, linear mixed-effects regression model. Quantitative immuno-fluorescence histology with a constant cutoff threshold showed reduced TTc in the spinal cord at 7 weeks for treated animals versus controls (5.2 Arbitrary Units +/-0.52 vs 7.1 AU +/-1.38, p0.56, T-test. CONCLUSION: We show-for the first time to our knowledge-that neurographic in vivo molecular imaging can demonstrate imaging changes in a model of oxaliplatin-induced neuropathy. Impaired retrograde neural transport is suggested to be an important part of the pathophysiology of oxaliplatin-induced neuropathy.

  11. Experimental evaluation of complete endovascular arch reconstruction by in situ retrograde fenestration.

    Science.gov (United States)

    Canaud, Ludovic; Faure, Elsa Madeleine; Branchereau, Pascal; Ozdemir, Baris Ata; Marty-Ané, Charles; Alric, Pierre

    2014-12-01

    The aim of this experimental study was to assess the feasibility of complete endovascular arch reconstruction by in situ retrograde fenestration and to investigate the impact of stent-graft material on stent-graft fenestrations. The experiments were performed using 8 cadaveric human thoracic aortas (aortic arch) using 2 different stent-graft types: woven polyester (Valiant Captivia; Medtronic Vascular, Santa Rosa, CA) and expanded polytetrafluoroethylene (conformable [C]-TAG; W.L. Gore & Associates, Flagstaff, AZ). A benchtop aortic pulsatile flow model was used. Stent-grafts were deployed into the aortic arch, covering the ostia of the supraaortic trunks. A 5-mm 30-degree angioscope was introduced into the ascending aorta to monitor the procedure. Retrograde fenestration and deployment of the balloon expandable stent-graft was performed sequentially for each supraaortic trunk. Subsequent to stent-graft explantation, macroscopic evaluation of each fenestration was performed. All attempts to fenestrate the C-TAG and Valiant stent-grafts and implant the covered stent through the supraaortic trunks were successful. In all cases, branch stents were patent and no endoleak was evident. The Valiant stent-graft was easier to puncture because of the higher radial force of the stent-graft providing better counterpressure; however, stent-graft material had no impact on the quality of fenestrations. Total endovascular repair of the aortic arch through in situ retrograde fenestration of stent-grafts is feasible. The behavior of the 2 types of stent-graft was significantly different while the fenestrations were fashioned, but stent-graft material had no impact on the quality of fenestrations. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Diagnostic and treatment of retrograde ejaculation as a manifestation of urogenital form of autonomic diabetic polyneuropathy

    Directory of Open Access Journals (Sweden)

    Dmitry Gennadyevich Kurbatov

    2015-07-01

    Full Text Available Background. Retrograde ejaculation in patients with type 1 diabetes mellitus is a complication of autonomic neuropathy that causes excretory infertility. It can be partial (reduction of ejaculate or total (absence of ejaculate and occurs in 10%–20% of men with type 1 diabetes mellitus.Aim. The aim of the study was to assess the effectiveness of a new endoscopic method for retrograde ejaculation correction and antegrade ejaculation restoration.Materials and methods. We included 30 patients with type 1 diabetes mellitus who had spermatozoa present in their post-orgasmic urine and ultrasonographic evidence of impaired or absent bladder neck closure. The mean age of participants was 32 (30–35 years, mean duration of diabetes was 17 (12–22 years and mean preoperative glycated haemoglobin level was 7.4% (6.9%–8.0%. All participants had total retrograde ejaculation. We used conventional irrigated urethrocystoscopy under local anaesthesia. During urethroscopy, bladder neck gaping was observed in all cases. Biocompatible material was injected at three points under the mucous layer of the posterior urethra, reaching the closing of the opposite edges of the urethra. A spermiogram was examined 1 week after the operation.Results. Restoration of antegrade ejaculation was achieved for 22 patients (73%, and the effects persisted for a mean of 7 (2–12 months. The spouses of four men became pregnant after surgery. In one case, the pregnancy resulted in a spontaneous abortion at gestational week 8, but the other three cases continued normally.Conclusion.This new method provides a highly effective means of restoring the physiological passage of the ejaculate. The operation is a low-invasive endoscopic procedure that does not disrupt urination, and it is possible to receive ejaculate of sufficient.

  13. NMDA Receptors Contribute to Retrograde Synaptic Transmission from Ganglion Cell Photoreceptors to Dopaminergic Amacrine Cells

    Directory of Open Access Journals (Sweden)

    Lei-Lei Liu

    2017-09-01

    Full Text Available Recently, a line of evidence has demonstrated that the vertebrate retina possesses a novel retrograde signaling pathway. In this pathway, phototransduction is initiated by the photopigment melanopsin, which is expressed in a small population of retinal ganglion cells. These ganglion cell photoreceptors then signal to dopaminergic amacrine cells (DACs through glutamatergic synapses, influencing visual light adaptation. We have previously demonstrated that in Mg2+-containing solution, α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA receptors mediate this glutamatergic transmission. Here, we demonstrate that removing extracellular Mg2+ enhances melanopsin-based DAC light responses at membrane potentials more negative than −40 mV. Melanopsin-based responses in Mg2+-free solution were profoundly suppressed by the selective N-methyl-D-aspartate (NMDA receptor antagonist D-AP5. In addition, application of NMDA to the retina produced excitatory inward currents in DACs. These data strongly suggest that DACs express functional NMDA receptors. We further found that in the presence of Mg2+, D-AP5 reduced the peak amplitude of melanopsin-based DAC responses by ~70% when the cells were held at their resting membrane potential (−50 mV, indicating that NMDA receptors are likely to contribute to retrograde signal transmission to DACs under physiological conditions. Moreover, our data show that melanopsin-based NMDA-receptor-mediated responses in DACs are suppressed by antagonists specific to either the NR2A or NR2B receptor subtype. Immunohistochemical results show that NR2A and NR2B subunits are expressed on DAC somata and processes. These results suggest that DACs express functional NMDA receptors containing both NR2A and NR2B subunits. Collectively, our data reveal that, along with AMPA receptors, NR2A- and NR2B-containing NMDA receptors mediate retrograde signal transmission from ganglion cell photoreceptors to DACs.

  14. Retrograde intrarenal surgery and micro-percutaneous nephrolithotomy for renal lithiasis smaller than 2 CM.

    Science.gov (United States)

    Cepeda, M; Amón, J H; Mainez, J A; de la Cruz, B; Rodríguez, V; Alonso, D; Martínez-Sagarra, J M

    2017-10-01

    Microperc is the upgraded form of percutaneous nephrolithotomy miniaturization. The aim of this study is to compare prospectively microperc and retrograde intrarenal surgery for the treatment of renal stones smaller than 2 cm. A comparative prospective study of both techniques was carried out between January 2014 and June 2015. Thirty-five patients were divided in two groups: Group A, 17 patients treated by retrograde intrarenal surgery and Group B, 18 patients treated by microperc. Stone clearance was assessed using CT scan 3 months after surgery. Both groups were statistically comparable as demographic variables and stone size was similar (16.76 mm Group A vs 15.72 mm Group B). Success rate, hospital stay and JJ stenting were similar for both groups. There was no statistically significant difference regarding post-operatory complications: 17.64% Group A vs 5.56% Group B (p=0,062), all of them Clavien I and II. Surgical time was statistically different (63.82 min Group A vs 103.24 min Group B) as well as hemoglobin drop (0.62 g/dl Group A and 1.89 g/dl Group B). Microperc is an effective and safe procedure for the treatment of renal lithiasis smaller than 2 cm, which makes it a good alternative to retrograde intrarenal surgery for this stone size. However, more prospective studies that include a larger cohort are necessary to confirm our results. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. N-Acetylcysteine Prevents Retrograde Motor Neuron Death after Neonatal Peripheral Nerve Injury.

    Science.gov (United States)

    Catapano, Joseph; Zhang, Jennifer; Scholl, David; Chiang, Cameron; Gordon, Tessa; Borschel, Gregory H

    2017-05-01

    Neuronal death may be an overlooked and unaddressed component of disability following neonatal nerve injuries, such as obstetric brachial plexus injury. N-acetylcysteine and acetyl-L-carnitine improve survival of neurons after adult nerve injury, but it is unknown whether they improve survival after neonatal injury, when neurons are most susceptible to retrograde neuronal death. The authors' objective was to examine whether N-acetylcysteine or acetyl-L-carnitine treatment improves survival of neonatal motor or sensory neurons in a rat model of neonatal nerve injury. Rat pups received either a sciatic nerve crush or transection injury at postnatal day 3 and were then randomized to receive either intraperitoneal vehicle (5% dextrose), N-acetylcysteine (750 mg/kg), or acetyl-L-carnitine (300 mg/kg) once or twice daily. Four weeks after injury, surviving neurons were retrograde-labeled with 4% Fluoro-Gold. The lumbar spinal cord and L4/L5 dorsal root ganglia were then harvested and sectioned to count surviving motor and sensory neurons. Transection and crush injuries resulted in significant motor and sensory neuron loss, with transection injury resulting in significantly less neuron survival. High-dose N-acetylcysteine (750 mg/kg twice daily) significantly increased motor neuron survival after neonatal sciatic nerve crush and transection injury. Neither N-acetylcysteine nor acetyl-L-carnitine treatment improved sensory neuron survival. Proximal neonatal nerve injuries, such as obstetric brachial plexus injury, produce significant retrograde neuronal death after injury. High-dose N-acetylcysteine significantly increases motor neuron survival, which may improve functional outcomes after obstetrical brachial plexus injury.

  16. Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors.

    Science.gov (United States)

    Martin, Donel M; Gálvez, Verònica; Loo, Colleen K

    2015-06-19

    Loss of personal memories experienced prior to receiving electroconvulsive therapy is common and distressing and in some patients can persist for many months following treatment. Improved understanding of the relationships between individual patient factors, electroconvulsive therapy treatment factors, and clinical indicators measured early in the electroconvulsive therapy course may help clinicians minimize these side effects through better management of the electroconvulsive therapy treatment approach. In this study we examined the associations between the above factors for predicting retrograde autobiographical memory changes following electroconvulsive therapy. Seventy-four depressed participants with major depressive disorder were administered electroconvulsive therapy 3 times per week using either a right unilateral or bitemporal electrode placement and brief or ultrabrief pulse width. Verbal fluency and retrograde autobiographical memory (assessed using the Columbia Autobiographical Memory Interview - Short Form) were tested at baseline and after the last electroconvulsive therapy treatment. Time to reorientation was measured immediately following the third and sixth electroconvulsive therapy treatments. Results confirmed the utility of measuring time to reorientation early during the electroconvulsive therapy treatment course as a predictor of greater retrograde amnesia and the importance of assessing baseline cognitive status for identifying patients at greater risk for developing later side effects. With increased number of electroconvulsive therapy treatments, older age was associated with increased time to reorientation. Consistency of verbal fluency performance was moderately correlated with change in Columbia Autobiographical Memory Interview - Short Form scores following right unilateral electroconvulsive therapy. Electroconvulsive therapy treatment techniques associated with lesser cognitive side effects should be particularly considered for

  17. MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Ojala, Risto; Kerimaa, Pekka; Tervonen, Osmo; Blanco-Sequeiros, Roberto [Oulu University Hospital, Department of Radiology, Oulu (Finland); Lakovaara, Martti [Oulu Deaconess Institute, Department of Surgery, Oulu (Finland); Hyvoenen, Pekka; Lehenkari, Petri [Oulu University Hospital, Department of Surgery, Oulu (Finland)

    2011-06-15

    The purpose of this study was to evaluate the feasibility of a new method for osteochondritis dissecans (OCD) treatment. Ten OCD lesions of the knee unresponsive to conservative management were treated with MRI-guided percutaneous retrograde drilling to reduce symptoms and promote ossification of the lesion. All lesions were located in distal femoral condyles. Only stable OCD lesions were included (preprocedural MRI grade I or II). Five lesions were of juvenile type and five lesions were of adult type OCD. All the patients had severe limitation of activity due to the OCD-related pain. By using a 0.23 T open MRI scanner and spinal anesthesia, percutaneous retrograde drilling of the OCD lesions was performed (3 mm cylindrical drill, one to three channels). Optical tracking and MRI imaging were used to guide instruments during the procedure. Mean postprocedural clinical follow-up time was 3 years. Eight patients had a post-procedural follow-up MRI within 1 year. All the OCD lesions were located and drilled using the 0.23 T open MRI scanner without procedural complications. All the patients had pain relief, mean visual analog score (VAS) declined from 6 to 2. Follow-up MRI showed ossification in all lesions. Eight patients could return to normal physical activity with no or minor effect on function (Hughston score 3-4). Treatment failed in two cases where the continuation of symptoms led to arthroscopy and transchondral fixation. MR-guided retrograde OCD lesion drilling is an accurate, feasible, and effective cartilage-sparing techique in OCD management. (orig.)

  18. Branched motifs enable long-range interactions in signaling networks through retrograde propagation.

    Directory of Open Access Journals (Sweden)

    Tharmaraj Jesan

    Full Text Available Branched structures arise in the intra-cellular signaling network when a molecule is involved in multiple enzyme-substrate reaction cascades. Such branched motifs are involved in key biological processes, e.g., immune response activated by T-cell and B-cell receptors. In this paper, we demonstrate long-range communication through retrograde propagation between branches of signaling pathways whose molecules do not directly interact. Our numerical simulations and experiments on a system comprising branches with JNK and p38MAPK as terminal molecules respectively that share a common MAP3K enzyme MEKK3/4 show that perturbing an enzyme in one branch can result in a series of changes in the activity levels of molecules "upstream" to the enzyme that eventually reaches the branch-point and affects other branches. In the absence of any evidence for explicit feedback regulation between the functionally distinct JNK and p38MAPK pathways, the experimentally observed modulation of phosphorylation amplitudes in the two pathways when a terminal kinase is inhibited implies the existence of long-range coordination through retrograde information propagation previously demonstrated in single linear reaction pathways. An important aspect of retrograde propagation in branched pathways that is distinct from previous work on retroactivity focusing exclusively on single chains is that varying the type of perturbation, e.g., between pharmaceutical agent mediated inhibition of phosphorylation or suppression of protein expression, can result in opposing responses in the other branches. This can have potential significance in designing drugs targeting key molecules which regulate multiple pathways implicated in systems-level diseases such as cancer and diabetes.

  19. MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

    International Nuclear Information System (INIS)

    Ojala, Risto; Kerimaa, Pekka; Tervonen, Osmo; Blanco-Sequeiros, Roberto; Lakovaara, Martti; Hyvoenen, Pekka; Lehenkari, Petri

    2011-01-01

    The purpose of this study was to evaluate the feasibility of a new method for osteochondritis dissecans (OCD) treatment. Ten OCD lesions of the knee unresponsive to conservative management were treated with MRI-guided percutaneous retrograde drilling to reduce symptoms and promote ossification of the lesion. All lesions were located in distal femoral condyles. Only stable OCD lesions were included (preprocedural MRI grade I or II). Five lesions were of juvenile type and five lesions were of adult type OCD. All the patients had severe limitation of activity due to the OCD-related pain. By using a 0.23 T open MRI scanner and spinal anesthesia, percutaneous retrograde drilling of the OCD lesions was performed (3 mm cylindrical drill, one to three channels). Optical tracking and MRI imaging were used to guide instruments during the procedure. Mean postprocedural clinical follow-up time was 3 years. Eight patients had a post-procedural follow-up MRI within 1 year. All the OCD lesions were located and drilled using the 0.23 T open MRI scanner without procedural complications. All the patients had pain relief, mean visual analog score (VAS) declined from 6 to 2. Follow-up MRI showed ossification in all lesions. Eight patients could return to normal physical activity with no or minor effect on function (Hughston score 3-4). Treatment failed in two cases where the continuation of symptoms led to arthroscopy and transchondral fixation. MR-guided retrograde OCD lesion drilling is an accurate, feasible, and effective cartilage-sparing techique in OCD management. (orig.)

  20. Effects of kainic acid lesions in lateral geniculate nucleus: activity dependence of retrograde axonal transport of fluorescent dyes.

    Science.gov (United States)

    Woodward, W R; Coull, B M

    1988-06-28

    Kainic acid lesions in the dorsal lateral geniculate nucleus of rats block the retrograde axonal transport of fluorescent dyes in corticogeniculate neurons without affecting the retrograde transport of D-aspartate or the orthograde transport of radiolabelled proteins in these neurons. This blocking of dye transport does not appear to be a consequence of kainic acid-induced damage to axon terminals in the geniculate since retinal ganglion cells are still able to transport dyes retrograde. A more likely explanation for these results is that fluorescent dye transport requires electrical activity in neurons, and elimination of the geniculate afferents to visual cortex reduces impulse traffic in cortical output fibers to a level below that required to support detectable dye transport. This interpretation is supported by the observation that kainic acid lesions also reduce retrograde transport of dyes in cortical neurons which project to the superior colliculus. Electrical stimulation in the subcortical white matter restores the transport of dye compounds in corticogeniculate neurons: evidence consistent with an activity-dependent mechanism of retrograde transport for these substances. These results provide evidence that axon terminals of retinal ganglion cells and corticogeniculate neurons survive in kainate-lesioned geniculates and are capable of normal neuronal function.

  1. Management of Endovascular Aortic Aneurysm Complications via Retrograde Catheterization Through the Distal Stent-Graft Landing Zone.

    Science.gov (United States)

    Zhang, Xicheng; Sun, Yuan; Chen, Zhaolei; Jing, Yuanhu; Xu, Miao

    2017-08-01

    A retrograde technique through the gap between the distal stent landing zone and the iliac artery wall has been applied to treat type II endoleak after endovascular aortic aneurysm repair (EVAR). In this study, we tried to investigate its efficacy in the management of type III endoleak and intraoperative accidental events. We reported 2 complications of EVAR that were difficult to treat with conventional methods. One patient had a sustained type III endoleak after EVAR, and the right renal artery was accidentally sealed by a graft stent in the other patient during the operation. Both complications were managed by the retrograde technique from the distal stent landing zone. In the first case, the endoleak was easily embolized by the retrograde catheterization technique, and in the second case, a stent was implanted in the right renal artery using the retrograde technique to restore blood flow. In some EVAR cases, the technique of retrograde catheterization through the distal stent-graft landing zone is feasible, safe, and easy to perform.

  2. Pancreas imaging by computed tomography after endoscopic retrograde pancreatography. [Dogs; patients

    Energy Technology Data Exchange (ETDEWEB)

    Frick, M.P.; O' Leary, J.F.; Salomonowitz, E.; Stoltenberg, E.; Hutton, S.; Gedgaudas, E.

    1984-01-01

    A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcimomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone.

  3. A fluorescence-based double retrograde tracer strategy for charting central neuronal connections.

    Science.gov (United States)

    Apps, Richard; Ruigrok, Tom J H

    2007-01-01

    Microspheres (beads) tagged with different fluorescent markers can be used for double retrograde axonal tracing of CNS connections. They have several advantages over other double tracer techniques, including ease-of-use, high transport efficiency, distinctive cell labeling and the ability to produce well-defined injection sites. In this protocol we describe the basic procedure for their use, some common problems and how these can be overcome. The protocol, including animal surgery, preparation and delivery of tracer can be completed in approximately 0.5 d. Subsequent histological processing (excluding survival time) can be completed in 0.5-1 d.

  4. Endovascular Treatment of Totally Occluded Superior Mesenteric Artery by Retrograde Crossing via the Villemin Arcade

    Energy Technology Data Exchange (ETDEWEB)

    Ferro, Carlo; Rossi, Umberto G., E-mail: urossi76@hotmail.com; Seitun, Sara; Bovio, Giulio [IRCCS San Martino University Hospital-IST-National Institute for Cancer Research, Department of Radiology and Interventional Radiology (Italy); Fornaro, Rosario [IRCCS San Martino University Hospital-IST-National Institute for Cancer Research, Department of Surgery (Italy)

    2013-06-15

    Chronic mesenteric ischemia (CMI) is a rare disorder that is commonly caused by progressive atherosclerotic stenosis or occlusion of one or more mesenteric arteries. Endovascular treatment for symptomatic CMI represents a viable option, especially in high-operative risk patients. We report a case of acute symptomatic CMI with chronic totally occlusion of the superior mesenteric artery (SMA) associated with significant stenosis of celiac trunk (CT) and inferior mesenteric artery (IMA) that underwent endovascular treatment of all the three mesenteric arteries: stenting of CT and IMA stenosis, and recanalization of the SMA occlusion by retrograde crossing via the Villemin arcade.

  5. The effect of Er, Cr:YSGG laser irradiation on the apical leakage of retrograde cavity

    Science.gov (United States)

    Asnaashari, Mohammad; Fekrazad, Reza; Dehghan Menshadi, Fatemeh; Seifi, Massoud

    2009-01-01

    INTRODUCTION: Controversial results have been reported when organic acids, ultrasonic instruments and laser techniques were used to remove smear layer in endodontic treatments. The aim of this study was to evaluate the effect of removing debris and smear layer by Er,Cr:YSGG laser irradiation on the apical leakage of retrograde cavities. MATERIALS AND METHODS: In this ex vivo study, 24 extracted mandibular single-rooted teeth were selected and instrumented up to K-file size #35. Approximately 3 mm of root apices were dissected perpendicular to the root’s long axis. Retrograde cavities with 3 mm depth were prepared and the teeth were randomly assigned to two groups. In one group, the retrograde cavities were filled with amalgam and in the other group, the dentinal surface of the retrograde cavities were lased with Er,Cr:YSGG laser (2W, 15 seconds, G4 tip). The cavities were filled with amalgam; all tooth surfaces except for dissected outsides were covered with blue wax. Then the teeth were immersed in 2% methylene blue dye for 48 hours. The amount of dye penetration into sagittal sections was measured by stereomicroscope at ×20 magnification by two independent observers who were blinded to the experiment. Data were statistically analyzed using student t-test. RESULTS: This study demonstrated that dye penetration was 0.8 mm (±0.53) in the lased and 0.97 mm (±0.54) in the non-lased group. It showed that, Er,Cr:YSGG laser can remove the debris and smear layer and consequently reduces the amount of dye penetration, although, the difference between the two groups was not statistically significant. CONCLUSION: This study showed that dye penetration was less in lased group because of the better seal of the dissected surface due to the better removal of the debris and smear layer by laser; further investigations are recommended in this field. [Iranian Endodontic Journal 2009;4(4):144-8] PMID:24019836

  6. Endovascular Treatment of Totally Occluded Superior Mesenteric Artery by Retrograde Crossing via the Villemin Arcade

    International Nuclear Information System (INIS)

    Ferro, Carlo; Rossi, Umberto G.; Seitun, Sara; Bovio, Giulio; Fornaro, Rosario

    2013-01-01

    Chronic mesenteric ischemia (CMI) is a rare disorder that is commonly caused by progressive atherosclerotic stenosis or occlusion of one or more mesenteric arteries. Endovascular treatment for symptomatic CMI represents a viable option, especially in high-operative risk patients. We report a case of acute symptomatic CMI with chronic totally occlusion of the superior mesenteric artery (SMA) associated with significant stenosis of celiac trunk (CT) and inferior mesenteric artery (IMA) that underwent endovascular treatment of all the three mesenteric arteries: stenting of CT and IMA stenosis, and recanalization of the SMA occlusion by retrograde crossing via the Villemin arcade.

  7. RETROGRADE DUCTUS VENOSUS ATRIO-WAVE AS A SPECIFIC PREDICTOR OF PERINATAL MORTALITY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    V. Marsoosi

    2005-07-01

    Full Text Available As fetal compensation against hypoxemia progresses, the afterload on the heart and peripheral vascular resistance increases. Eventually, the right heart fails, which is transmitted to the fetal venous system, causing decreased flow during late diastole or atrial contraction and increased resistance in the ductus venosus and inferior vena cava. The ductus has forward flow during atrial contraction, the disappearance of which is always pathologic. This is a report of a case of retrograde ductus venosus atrio-wave in a fetus referred with decreased movement for fetal assessment.

  8. A Class of Selenocentric Retrograde Orbits With Innovative Applications to Human Lunar Operations

    Science.gov (United States)

    Adamo, Daniel R.; Lester, Daniel F.; Thronson, Harley A.; Barbee, Brent

    2014-01-01

    Selenocentric distant retrograde orbits with radii from approx. 12,500 km to approx. 25,000 km are assessed for stability and for suitability as crewed command and control infrastructure locations in support of telerobotic lunar surface operations and interplanetary human transport. Such orbits enable consistent transits to and from Earth at virtually any time if they are coplanar with the Moon's geocentric orbit. They possess multiple attributes and applications distinct from NASA's proposed destination orbit for a redirected asteroid about 70,000 km from the Moon.

  9. Outback catheter-assisted simultaneous antegrade and retrograde access for subintimal recanalization of peripheral arterial occlusion.

    Science.gov (United States)

    Bozlar, Ugur; Shih, Ming-Chen Paul; Harthun, Nancy L; Hagspiel, Klaus D

    2008-01-01

    Subintimal recanalization techniques have been shown to be beneficial in selected patients with severe peripheral vascular disease with tissue loss or rest pain and limited surgical options. In this report, we use an Outback catheter in order to gain access to the subintimal channel from the true lumen during percutaneous intentional extraluminal recanalization using the subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique. To the best of our knowledge, this is the first report where the Outback catheter was used in antegrade fashion in order to gain access to the subintimal space from the true lumen using the SAFARI technique.

  10. Bedside Endoscopic Retrograde Cholangiopancreatography Using Portable X-Ray in Acute Severe Cholangitis

    Directory of Open Access Journals (Sweden)

    Rushikesh Shah

    2018-01-01

    Full Text Available Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation. We present a unique case of life-saving emergent bedside ERCP in a severely ill patient with cholangitis and septic shock, using simple portable X-ray to confirm biliary cannulation.

  11. NEXT GENERATION OF TELESCOPES OR DYNAMICS REQUIRED TO DETERMINE IF EXO-MOONS HAVE PROGRADE OR RETROGRADE ORBITS

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Karen M.; Fujii, Yuka [Earth-Life Science Institute (WPI-ELSI), Tokyo Institute of Technology, Ookayama, Meguro district, Tokyo 152-8551 (Japan)

    2014-08-20

    We survey the methods proposed in the literature for detecting moons of extrasolar planets in terms of their ability to distinguish between prograde and retrograde moon orbits, an important tracer of the moon formation channel. We find that most moon detection methods, in particular, sensitive methods for detecting moons of transiting planets, cannot observationally distinguishing prograde and retrograde moon orbits. The prograde and retrograde cases can only be distinguished where the dynamical evolution of the orbit due to, e.g., three body effects is detectable, where one of the two cases is dynamically unstable, or where new observational facilities, which can implement a technique capable of differentiating the two cases, come online. In particular, directly imaged planets are promising targets because repeated spectral and photometric measurements, which are required to determine moon orbit direction, could also be conducted with the primary interest of characterizing the planet itself.

  12. NEXT GENERATION OF TELESCOPES OR DYNAMICS REQUIRED TO DETERMINE IF EXO-MOONS HAVE PROGRADE OR RETROGRADE ORBITS

    International Nuclear Information System (INIS)

    Lewis, Karen M.; Fujii, Yuka

    2014-01-01

    We survey the methods proposed in the literature for detecting moons of extrasolar planets in terms of their ability to distinguish between prograde and retrograde moon orbits, an important tracer of the moon formation channel. We find that most moon detection methods, in particular, sensitive methods for detecting moons of transiting planets, cannot observationally distinguishing prograde and retrograde moon orbits. The prograde and retrograde cases can only be distinguished where the dynamical evolution of the orbit due to, e.g., three body effects is detectable, where one of the two cases is dynamically unstable, or where new observational facilities, which can implement a technique capable of differentiating the two cases, come online. In particular, directly imaged planets are promising targets because repeated spectral and photometric measurements, which are required to determine moon orbit direction, could also be conducted with the primary interest of characterizing the planet itself

  13. Retrograde placement of double-J ureteral stent with interventional therapy for the treatment of ureteral stricture

    International Nuclear Information System (INIS)

    Kong Jian; Xu Linfeng; Liang Huimin; Zheng Chuansheng; Zheng Jinlong; Feng Gansheng

    2000-01-01

    Objective: To evaluate the retrograde placement of Double-J ureteral stent with interventional therapy for the treatment of ureteral stricture. Methods: Twenty patients with ureteral stricture of various causes were treated with retrograde placing Double-J ureteral stent by interventional therapy. Results: The Double-J stent was successfully performed in all twenty patients. The successful rate of placing stent was 100%. The cure rate was 90% (18/20). The complications such as urinary leakage, wound infection, and bleeding were markedly decreased. The indication, duration of indwelling and complication of the indwelling stent were discussed. Conclusion: Retrograde placing Double-J stent with interventional therapy is simple and less invasive. It is believed to be a safe and effective method for the treatment of ureteral stricture

  14. The retrograde IFT machinery of C. elegans cilia: two IFT dynein complexes?

    Directory of Open Access Journals (Sweden)

    Limin Hao

    Full Text Available We analyzed the relatively poorly understood IFT-dynein (class DYNC2-driven retrograde IFT pathway in C. elegans cilia, which yielded results that are surprising in the context of current models of IFT. Assays of C. elegans dynein gene expression and intraflagellar transport (IFT suggest that conventional IFT-dynein contains essential heavy (CHE-3, light-intermediate (XBX-1, plus three light polypeptide chains that participate in IFT, but no "essential" intermediate chain. IFT assays of XBX-1::YFP suggest that IFT-dynein is transported as cargo to the distal tip of the cilium by kinesin-2 motors, but independent of the IFT-particle/BBSome complexes. Finally, we were surprised to find that the subset of cilia present on the OLQ (outer labial quadrant neurons assemble independently of conventional "CHE-3" IFT-dynein, implying that there is a second IFT-dynein acting in these cilia. We have found a novel gene encoding a dynein heavy chain, DHC-3, and two light chains, in OLQ neurons, which could constitute an IFT-dynein complex in OLQ neuronal cilia. Our results underscore several surprising features of retrograde IFT that require clarification.

  15. Retrograde Instillation of Methylene Blue in the Difficult Diagnosis of BPF

    Directory of Open Access Journals (Sweden)

    F. Ravenna

    2012-01-01

    Full Text Available We report two cases in which we were able to diagnose bronchopleural fistula through retrograde methylene blue instillation during bronchoscopy. In the first case, methylene blue was injected through an abdominal drain, followed by air instillation and detected in the left bronchial tree, demonstrating the presence of a fistula in the lingula’s bronchus. In the second case, methylene blue was injected into a pleural drain, through a breach on a surgical suture and detected in the right bronchial tree, demonstrating the presence of a fistula in the right inferior bronchus. The retrograde instillation of methylene blue, through a drain in the abdomen or the thoracic wall, is a safe, cheap, and practical method that allows the bronchoscopist to identify the presence of a fistula and, more importantly, to identify the exact point on the bronchial tree where a fistula is located. This provides the possibility of sealing the fistula with a variety of devices. It is our opinion that this procedure should be considered a primary method of diagnosis when a bronchopleural fistula is suspected and a drain on the thoracic or abdominal wall is positioned such that effusions are able to drain.

  16. Diclofenac Is Associated With a Reduced Incidence of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis

    DEFF Research Database (Denmark)

    Leerhøy, Bonna; Nordholm-Carstensen, Andreas; Novovic, Srdan

    2014-01-01

    OBJECTIVE: The aim of this study was to assess the clinical effect of diclofenac administered as a single dose for the prevention of postprocedure pancreatitis in a consecutive series of patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Patients with a nat......OBJECTIVE: The aim of this study was to assess the clinical effect of diclofenac administered as a single dose for the prevention of postprocedure pancreatitis in a consecutive series of patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Patients...... with a native papilla Vateri subjected to ERCP during 2010 (control group, n = 218) and 2012 (diclofenac group, n = 182) were included. Patients with a history of chronic pancreatitis or recent acute pancreatitis were excluded. From January 2012, a rectal suppository containing 100 mg of diclofenac...... patients in the diclofenac group (P = 0.002). Moderate to severe pancreatitis occurred in 22 (10.1%) of the 218 patients in the control group versus 8 (4.4%) of the 182 patients in the diclofenac group (P = 0.036). CONCLUSIONS: This controlled cohort study suggests that the implementation of a single dose...

  17. Visualization of cortical projection neurons with retrograde TET-off lentiviral vector.

    Directory of Open Access Journals (Sweden)

    Akiya Watakabe

    Full Text Available We are interested in identifying and characterizing various projection neurons that constitute the neocortical circuit. For this purpose, we developed a novel lentiviral vector that carries the tetracycline transactivator (tTA and the transgene under the TET Responsive Element promoter (TRE on a single backbone. By pseudotyping such a vector with modified rabies G-protein, we were able to express palmitoylated-GFP (palGFP or turboFP635 (RFP in corticothalamic, corticocortical, and corticopontine neurons of mice. The high-level expression of the transgene achieved by the TET-Off system enabled us to observe characteristic elaboration of neuronal processes for each cell type. At higher magnification, we were able to observe fine structures such as boutons and spines as well. We also injected our retrograde TET-Off vector to the marmoset cortex and proved that it can be used to label the long-distance cortical connectivity of millimeter scale. In conclusion, our novel retrograde tracer provides an attractive option to investigate the morphologies of identified cortical projection neurons of various species.

  18. Studies suggest alternatives to amalgam as a retrograde filling material for apicectomy.

    Science.gov (United States)

    Naito, Toru

    2004-01-01

    Sources were Medline and the Cochrane Library. Studies included were in vivo with human subjects, had experimental and control groups, and gave quantitative results in English, German or French. Success and failure rates were derived from randomised controlled trials (RCT), clinical controlled trials (CCT), cohort studies (CS) and case-controlled studies (CCS). Qualitative synthesis of results was performed. Two RCT, six CCT and 14 CCS were identified. The two RCT suggest that glass ionomer may be more effective than amalgam, conversely one CCT showed amalgam to be more effective. CCTs also suggest that EBA (reinforced zinc oxide eugenol) cement, composite with GLUMA (Bayer AG., Leverkusen, Germany) and gold leaf retrograde filling may be more effective than amalgam. A further CCT suggested that gutta-percha used as a retrograde filing is less effective than when used following an orthograde approach. Based on the outcome of two RCT, glass ionomer appears as effective as amalgam. EBA cement, composite with GLUMA and gold leaf and orthograde gutta-percha may also be as effective as amalgam. Evidence is limited, however, and further research is needed.

  19. Selective retrograde transport of D-aspartate in spinal interneurons anc cortical neurons of rats

    International Nuclear Information System (INIS)

    Rustioni, A.; Cuenod, M.

    1982-01-01

    Retrograde labeling of neuronal elements in the brain and spinal cord has been investigated by autoradiographic techniques following injections of D-[ 3 H]aspartate (asp), [ 3 H]γ-aminobutyric acid (GABA) or horseradish peroxidase (HRP) in the medulla and spinal cord of rats. Twenty-four hours after D-[ 3 H]asp injections focused upon the cuneate nucleus, autoradiographic labeling is present over fibers in the pyramidal tract, internal capsule and over layer V pyramids in the forelimb representation of the sensorimotor cortex. After [ 3 H]GABA injections in the same nucleus no labeling attributable to retrograde translocation can be detected in spinal segments, brain stem or cortex. Conversely, injections of 30% HRP in the cuneate nucleus label neurons in several brain stem nuclei, in spinal gray and in layer V of the sensorimotor cortex. D-[ 3 H]Asp injections focused on the dorsal horn at cervical segments label a fraction of perikarya of the substantia gelatinosa and a sparser population of larger neurons in laminae IV to VI for a distance of 3-5 segments above and below the injection point. No brain stem neuronal perikarya appear labeled following spinal injections of D-[ 3 H]asp although autoradiographic grains overlie pyramidal tract fibers on the side contralateral to the injection. (Auth.)

  20. 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.

  1. Human papillomavirus type 16 entry: retrograde cell surface transport along actin-rich protrusions.

    Directory of Open Access Journals (Sweden)

    Mario Schelhaas

    Full Text Available The lateral mobility of individual, incoming human papillomavirus type 16 pseudoviruses (PsV bound to live HeLa cells was studied by single particle tracking using fluorescence video microscopy. The trajectories were computationally analyzed in terms of diffusion rate and mode of motion as described by the moment scaling spectrum. Four distinct modes of mobility were seen: confined movement in small zones (30-60 nm in diameter, confined movement with a slow drift, fast random motion with transient confinement, and linear, directed movement for long distances. The directed movement was most prominent on actin-rich cell protrusions such as filopodia or retraction fibres, where the rate was similar to that measured for actin retrograde flow. It was, moreover, sensitive to perturbants of actin retrograde flow such as cytochalasin D, jasplakinolide, and blebbistatin. We found that transport along actin protrusions significantly enhanced HPV-16 infection in sparse tissue culture, cells suggesting a role for in vivo infection of basal keratinocytes during wound healing.

  2. Properties of retrograded and acetylated starch produced via starch extrusion or starch hydrolysis with pullulanase.

    Science.gov (United States)

    Kapelko, M; Zięba, T; Gryszkin, A; Styczyńska, M; Wilczak, A

    2013-09-12

    The aim of the present study was to determine the impact of serial modifications of starch, including firstly starch extrusion or hydrolysis with pullulanase, followed by retrogradation (through freezing and defrosting of pastes) and acetylation (under industrial conditions), on its susceptibility to amylolysis. The method of production had a significant effect on properties of the resultant preparations, whilst the direction and extent of changes depended on the type of modification applied. In the produced starch esters, the degree of substitution, expressed by the per cent of acetylation, ranged from 3.1 to 4.4 g/100 g. The acetylation had a significant impact on contents of elements determined with the atomic emission spectrometry, as it contributed to an increased Na content and decreased contents of Ca and K. The DSC thermal characteristics enabled concluding that the modifications caused an increase in temperatures and a decrease in heat of transition (or its lack). The acetylation of retrograded starch preparations increased their solubility in water and water absorbability. The modifications were found to exert various effects on the rheological properties of pastes determined based on the Brabender's pasting characteristics and flow curves determined with the use of an oscillatory-rotating viscosimeter. All starch acetates produced were characterized by ca. 40% resistance to amylolysis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Retrograde Endopyelotomy with Cutting Balloon™ for Treatment of Ureteropelvic Junction Obstruction in Infants.

    Science.gov (United States)

    Parente, Alberto; Perez-Egido, Laura; Romero, Rosa Maria; Ortiz, Ruben; Burgos, Laura; Angulo, Jose Maria

    2016-01-01

    The aim of this study is to analyze results of retrograde endopyelotomy with cutting balloon for treatment of ureteropelvic junction obstruction (UPJO) in infants. We routinely treat patients with UPJO under 18 months of age with retrograde high-pressure balloon dilatation of the pelviureteric junction (PUJ). During the procedure, in these cases where narrowing at the PUJ persists, endopyelotomy with cutting balloon is performed. Endopyelotomy is performed over guidewire with 5-mm Cutting Balloon™ under fluoroscopic control. Double-J stents is left in situ for 4 weeks. We retrospectively analyzed the postoperative, clinical, and radiological outcome infants treated with cutting balloon endopyelotomy between 2007 and 2015. Sixteen patients required cutting balloon endopyelotomy to achieve complete resolution of narrowing of the waist observed during high-pressure balloon dilatation of the PUJ. Mean operative time was 35 ± 21 min (mean ± SD) and hospital stay was cutting balloon could be a valid and safe option in minimally invasive management of UPJO in infants.

  4. Adenosine Triphosphate (ATP Is a Candidate Signaling Molecule in the Mitochondria-to-Nucleus Retrograde Response Pathway

    Directory of Open Access Journals (Sweden)

    Zhengchang Liu

    2013-03-01

    Full Text Available Intracellular communication from the mitochondria to the nucleus is achieved via the retrograde response. In budding yeast, the retrograde response, also known as the RTG pathway, is regulated positively by Rtg1, Rtg2, Rtg3 and Grr1 and negatively by Mks1, Lst8 and two 14-3-3 proteins, Bmh1/2. Activation of retrograde signaling leads to activation of Rtg1/3, two basic helix-loop-helix leucine zipper transcription factors. Rtg1/3 activation requires Rtg2, a cytoplasmic protein with an N-terminal adenosine triphosphate (ATP binding domain belonging to the actin/Hsp70/sugar kinase superfamily. The critical regulatory step of the retrograde response is the interaction between Rtg2 and Mks1. Rtg2 binds to and inactivates Mks1, allowing for activation of Rtg1/3 and the RTG pathway. When the pathway is inactive, Mks1 has dissociated from Rtg2 and bound to Bmh1/2, preventing activation of Rtg1/3. What signals association or disassociation of Mks1 and Rtg2 is unknown. Here, we show that ATP at physiological concentrations dissociates Mks1 from Rtg2 in a highly cooperative fashion. We report that ATP-mediated dissociation of Mks1 from Rtg2 is conserved in two other fungal species, K. lactis and K. waltii. Activation of Rtg1/3 upregulates expression of genes encoding enzymes catalyzing the first three reactions of the Krebs cycle, which is coupled to ATP synthesis through oxidative phosphorylation. Therefore, we propose that the retrograde response is an ATP homeostasis pathway coupling ATP production with ATP-mediated repression of the retrograde response by releasing Mks1 from Rtg2.

  5. [Tibio-talo-calcaneal arthrodesis with the retrograde intramedullary nail MEDIN].

    Science.gov (United States)

    Popelka, S; Vavřík, P; Landor, I; Bek, J; Popelka ml, S; Hromádka, R

    2013-01-01

    When the talus and the talocalcaneal joint are both affected, their fusion is the method of treatment. Ankle arthrodesis is carried out using various osteosynthetic materials such as external fixators, screws and plates. One of the options is retrograde nailing. Tibio-talo-calcaneal arthrodesis is frequently indicated in patients with rheumatoid arthritis (RA) in whom both the talus and the subtalar joint are often affected. A retrograde nail for tibio-talo-calcaneal arthrodesis was developed at our department in cooperation with MEDIN Company. This is a titanium double-curved nail, with the distal part bent at 8 degrees ventrally and 10 degrees laterally. It is inserted from the transfibular approach. Sixty-two patients, 35 women and 27 men, were treated at our department from 2005. Since one patient had bilateral surgery, 63 ankles were included. The indications for arthrodesis involved rheumatoid arthritis in 42, post-traumatic arthritis in 10, failed ankle arthrodesis in two and failed total ankle arthroplasty in five ankles; tibial stress fractures close above the ankle in two RA patients, one patient with dermatomyositis and one with lupus erythematodes. The average age at the time of surgery was 64.2 years (range, 30 to 80). The average follow-up was 4.5 years (range, 1 to 9 years), Satisfaction with the treatment outcome and willingness to undergo surgery on the other side were reported by 82% of the patients. The AOFAS score improved from 35 to 74 points. Three (4.8%) patients complained of painful feet due to the fact that exact correction of the calcaneus was not achieved and the heel after arthrodesis remained in a slightly varus position. Of them, two had a failed total ankle arthroplasty. Post-operative complications included early infection managed by antibiotic treatment and early surgical revision with irrigation.in two (3.2%) RA patients, who were undergoing biological therapy. Late infection developed at 2 to 3 years after surgery in three (4

  6. The effects of amylose and starch phosphate on starch gel retrogradation studied by low-field 1H NMR relaxometry

    DEFF Research Database (Denmark)

    Thygesen, Lisbeth Garbrecht; Blennow, A.; Engelsen, S. B.

    2003-01-01

    Low-field Nuclear Magnetic Resonance (23 MHz) was used to study the effects of the degree of phosphorylation, the amylose content and the amylopectin chain length distribution on gel retrogradation for a set of 26 starches, six of which were of crystal polymorph type A, 18 of type B and two of type......) relaxation curves from the two measurements (day 1 and day 7) could be used as a simple, illustrative way of describing the retrogradation. Three different behaviours were identified: One group of samples (mostly potato starches) slowly changed from a soft to a more rigid gel from day 1 to 7. A second group...

  7. Serotonergic projections from the raphe nuclei to the subthalamic nucleus; a retrograde- and anterograde neuronal tracing study

    DEFF Research Database (Denmark)

    Reznitsky, Martin; Plenge, Per; Hay-Schmidt, Anders

    2016-01-01

    the 5-HT1A and 5-HT2A not were present. Retrograde tracer FluoroGold or Choleratoxin subunit B were iontophoretically delivered in the STN and combined with immunohistochemistry for 5-HT in order to map the topographic organization in the dorsal raphe system. The study showed that approximately 320......+/-137 neurons were retrogradely traced from each STN to the DRN, located mainly in the dorsal- and ventrolateral DRN, and of these 108+/-42 or 34% co-localized 5-HT. Additionally anterograde tracer PHA-L was injected in the DRN to confirm projections to STN and accordingly only a sparse number of axon terminals...

  8. Frequency and contributing factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice

    International Nuclear Information System (INIS)

    Zubair, M.; Zaidi, A.R.; Hyder, A.

    2017-01-01

    To evaluate the frequency and contributing factors for acute pancreatitis after endoscopic retrograde cholangio-pancreatography in patients with obstructive jaundice. Study Design: Descriptive case series. Place and Duration of Study: A descriptive case series conducted at department of Gastroenterology, Shaikh Zayed Hospital, Lahore in the period of six months. Material and Methods: Two hundred and thirty patients diagnosed as having obstructive jaundice and undergoing ERCP who fulfilled the inclusion criteria were included in the study from the outpatient and indoor department of Gastroenterology-Hepatology Shaikh Zayed Hospital Lahore. Informed consent was taken. After the selection of the cases, patients were evaluated for the presence or absence of contributing factors like age, gender, cannulation attempts, cannulation time, percutaneous papillotomy, pancreatic duct contrast injection and previous history of post ERCP pancreatitis. Data was analysed by using the statistical software for social sciences (SPSS) version 15. Results: In our study, mean age was 44 +- 14.12 years. Out of 230 patients 42.17% (n=97) were male and 57.83% (n=133) were females. Frequency of acute pancreatitis after ERCP in patients with obstructive jaundice was 4.78% (n=11) while 95.22% (n=219) had no findings of acute pancreatitis after ERCP. Frequency of factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice was recorded which shows that out of 11 cases, 45.45% (n=5) were females, 36.36% (n=4) had previous history of Post ERCP Pancreatitis, 27.27% (n=3) had >5 attempts of cannulation, 36.36% (n=4) had >5 minute time for cannulation, 54.55% (n=6) had pre-cut papillotomy while 63.64% (n=7) had pancreatic duct contrast injection. Conclusion: We concluded that frequency of acute pancreatitis after endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice was found not very high in our practice

  9. Antioxidant drugs to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis: What does evidence suggest?

    Science.gov (United States)

    Fuentes-Orozco, Clotilde; Dávalos-Cobián, Carlos; García-Correa, Jesús; Ambriz-González, Gabriela; Macías-Amezcua, Michel Dassaejv; García-Rentería, Jesús; Rendón-Félix, Jorge; Chávez-Tostado, Mariana; Cuesta-Márquez, Lizbeth Araceli; Alvarez-Villaseñor, Andrea Socorro; Cortés-Flores, Ana Olivia; González-Ojeda, Alejandro

    2015-06-07

    To determine whether or not the use of antioxidant supplementation aids in the prevention of post- endoscopic retrograde cholangiopancreatography pancreatitis. A systematic review of randomized controlled trials (RCTs) was made to evaluate the preventive effect of prophylactic antioxidant supplementation in post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The inclusion criteria included: acute post-endoscopic retrograde cholangiopancreatography pancreatitis in adults; randomized clinical trials with the use of any antioxidant as an intervention compared with placebo, to reduce PEP. The outcome measure was the incidence and severity of PEP. Twelve RCTs involving 3110 patients since 1999 were included. The antioxidants used were selenite, β-carotene, and pentoxifylline (each one in one trial), N-acetylcysteine (NAC) in three trials, and allopurinol in six trials. The group of patients treated with NAC received different doses; either oral or intravenous, and allopurinol-treated patients received five different oral doses in two different administration periods. The results are expressed with raw numbers, proportions, as well as mean and standard deviations. The incidence of pancreatitis between groups was analyzed with Pearson's χ(2) test or Fisher's exact test (F). The main outcome is expressed as relative risks and 95%CI. The incidence of pancreatitis in all antioxidant treatment groups was 8.6%, whereas it was 9.7% in the control group. The antioxidants used were selenite, β-carotene, and pentoxifylline (each one in one trial), NAC in three trials, and allopurinol in six trials. In allopurinol trials, three different dosifications were used; two trials reported a low dosage (of less than 400 mg), two trials reported a moderate dose (600 mg) and the remaining two employed higher doses (more than 900 mg). Supplementation was not associated with a significant reduction in the incidence of PEP [relative risk (RR) = 0.93; 95%CI: 0.82-1.06; P

  10. M1 ipRGCs Influence Visual Function through Retrograde Signaling in the Retina.

    Science.gov (United States)

    Prigge, Cameron L; Yeh, Po-Ting; Liou, Nan-Fu; Lee, Chi-Chan; You, Shih-Feng; Liu, Lei-Lei; McNeill, David S; Chew, Kylie S; Hattar, Samer; Chen, Shih-Kuo; Zhang, Dao-Qi

    2016-07-06

    Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs, with five subtypes named M1-M5) are a unique subclass of RGCs with axons that project directly to many brain nuclei involved in non-image-forming functions such as circadian photoentrainment and the pupillary light reflex. Recent evidence suggests that melanopsin-based signals also influence image-forming visual function, including light adaptation, but the mechanisms involved are unclear. Intriguingly, a small population of M1 ipRGCs have intraretinal axon collaterals that project toward the outer retina. Using genetic mouse models, we provide three lines of evidence showing that these axon collaterals make connections with upstream dopaminergic amacrine cells (DACs): (1) ipRGC signaling to DACs is blocked by tetrodotoxin both in vitro and in vivo, indicating that ipRGC-to-DAC transmission requires voltage-gated Na(+) channels; (2) this transmission is partly dependent on N-type Ca(2+) channels, which are possibly expressed in the axon collateral terminals of ipRGCs; and (3) fluorescence microscopy reveals that ipRGC axon collaterals make putative presynaptic contact with DACs. We further demonstrate that elimination of M1 ipRGCs attenuates light adaptation, as evidenced by an impaired electroretinogram b-wave from cones, whereas a dopamine receptor agonist can potentiate the cone-driven b-wave of retinas lacking M1 ipRGCs. Together, the results strongly suggest that ipRGCs transmit luminance signals retrogradely to the outer retina through the dopaminergic system and in turn influence retinal light adaptation. Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) comprise a third class of retinal photoreceptors that are known to mediate physiological responses such as circadian photoentrainment. However, investigation into whether and how ipRGCs contribute to vision has just begun. Here, we provide convergent anatomical and physiological evidence that

  11. Retrograde Tibial Nailing: a minimally invasive and biomechanically superior alternative to angle-stable plate osteosynthesis in distal tibia fractures

    Science.gov (United States)

    2014-01-01

    Background Currently, antegrade intramedullary nailing and minimally invasive plate osteosynthesis (MIPO) represent the main surgical alternatives in distal tibial fractures. However, neither choice is optimal for all bony and soft tissue injuries. The Retrograde Tibial Nail (RTN) is a small-caliber prototype implant, which is introduced through a 2-cm-long incision at the tip of the medial malleolus with stab incisions sufficient for interlocking. During this project, we investigated the feasibility of retrograde tibial nailing in a cadaver model and conducted biomechanical testing. Methods Anatomical implantations of the RTN were carried out in AO/OTA 43 A1-3 fracture types in three cadaveric lower limbs. Biomechanical testing was conducted in an AO/OTA 43 A3 fracture model for extra-axial compression, torsion, and destructive extra-axial compression. Sixteen composite tibiae were used to compare the RTN against an angle-stable plate osteosynthesis (Medial Distal Tibial Plate, Synthes®). Statistical analysis was performed by Student's t test. Results Retrograde intramedullary nailing is feasible in simple fracture types by closed manual reduction and percutaneous reduction forceps, while in highly comminuted fractures, the use of a large distractor can aid the reduction. Biomechanical testing shows a statistically superior stability (p nail meets the requirements of maximum soft tissue protection by a minimally invasive surgical approach with the ability of secure fracture fixation by multiple locking options. Retrograde tibial nailing with the RTN is a promising concept in the treatment of distal tibia fractures. PMID:24886667

  12. Kinesin-3 and dynein cooperate in long-range retrograde endosome motility along a nonuniform microtubule array

    NARCIS (Netherlands)

    Schuster, M.; Kilaru, S.; Fink, G.; Collemare, J.A.R.; Roger, Y.; Steinberg, G.

    2011-01-01

    The polarity of microtubules (MTs) determines the motors for intracellular motility, with kinesins moving to plus ends and dynein to minus ends. In elongated cells of Ustilago maydis, dynein is thought to move early endosomes (EEs) toward the septum (retrograde), whereas kinesin-3 transports them to

  13. Identification of risk factors for an unfavorable laparoscopic cholecystectomy course after endoscopic retrograde cholangiography in the treatment of choledocholithiasis

    NARCIS (Netherlands)

    Donkervoort, S. C.; van Ruler, O.; Dijksman, L. M.; van Geloven, A. A.; Pierik, E. G.

    2010-01-01

    Laparoscopic cholecystectomy (LC) after an endoscopic retrograde cholangiography (ERC) has higher rates for complications and conversion caused by unpredictable adhesions. The risk factors for an adverse outcome of LC after an ERC were analyzed. Variables from patients treated by LC after ERC for

  14. Periapical surgery using the ultrasound technique and silver amalgam retrograde filling. A study of 71 teeth with 100 canals.

    Science.gov (United States)

    Martí-Bowen, Eva; Peñarrocha-Diago, Miguel; García-Mira, Berta

    2005-04-01

    Periapical surgery using ultrasound allows the treatment of root canals of difficult access, with the sacrifice of little root tissue. As a result, periapical disorders which were condemned to treatment failure in the past can now be dealt with successfully. In 71 teeth presenting 100 root canals treated with ultrasound and subjected to retrograde filling with silver amalgam, the course and short-term success of management was evaluated in relation to lesion size, the magnitude of apical resection, and the size of the retrograde filling cavity. The duration of follow-up was one year, with post-treatment controls after 6 and 12 months. After 6 months, the percentage clinical and radiological success was 92% and 58%, respectively. One year after periapical surgery the corresponding percentages were 95% and 80%. Global success after 6 months was 63%, versus 84.2% after 12 months. No statistically significant relation was observed between treatment success and the size of the periapical lesion, the amount of apex resected, or the size of retrograde filling. Periapical surgery using ultrasound and retrograde filling with silver amalgam affords a high success rate after 12 months.

  15. Structural and functional mapping of Rtg2p determinants involved in retrograde signaling and aging of Saccharomyces cerevisiae.

    Directory of Open Access Journals (Sweden)

    Rafaela Maria Rios-Anjos

    Full Text Available In Saccharomyces cerevisiae mitochondrial dysfunction induces retrograde signaling, a pathway of communication from mitochondria to the nucleus that promotes a metabolic remodeling to ensure sufficient biosynthetic precursors for replication. Rtg2p is a positive modulator of this pathway that is also required for cellular longevity. This protein belongs to the ASKHA superfamily, and contains a putative N-terminal ATP-binding domain, but there is no detailed structural and functional map of the residues in this domain that accounts for their contribution to retrograde signaling and aging. Here we use Decomposition of Residue Correlation Networks and site-directed mutagenesis to identify Rtg2p structural determinants of retrograde signaling and longevity. We found that most of the residues involved in retrograde signaling surround the ATP-binding loops, and that Rtg2p N-terminus is divided in three regions whose mutants have different aging phenotypes. We also identified E137, D158 and S163 as possible residues involved in stabilization of ATP at the active site. The mutants shown here may be used to map other Rtg2p activities that crosstalk to other pathways of the cell related to genomic stability and aging.

  16. Percutaneous retrograde transfemoral closure of mitral paravalvular leak in 3 patients without construction of an arteriovenous wire loop.

    Science.gov (United States)

    Kilic, Teoman; Sahin, Tayfun; Ural, Ertan

    2014-04-01

    Percutaneous closure of paravalvular leaks has emerged as an alternative to repeated surgeries. Different percutaneous techniques and various devices have been used, off-label, for paravalvular leak closure. For mitral leaks, antegrade transseptal, retrograde transfemoral, and retrograde transapical techniques have been developed. In the antegrade transseptal approach, an arteriovenous guidewire loop is often created to advance the delivery sheath. In retrograde transfemoral closure, the wire in the left atrium is usually snared after transseptal puncture, to pull it from the femoral vein. The delivery sheath and closure device will subsequently be deployed from the left atrium. Each of these procedures takes time, is costly, and increases the risk of complications. We present the cases of 3 patients in whom we closed mitral paravalvular leaks by means of a retrograde transfemoral approach, with use of an Amplatzer™ Duct Occluder II device and without the construction of an arteriovenous wire loop. We think that this approach can be very useful in a specific group of patients-reducing costs, fluoroscopy times, and complications related to transseptal puncture and construction of an arteriovenous wire loop. In our institution, this reported technique is routinely used for mitral paravalvular leak closure.

  17. Predictors of Successful Clinical and Laboratory Outcomes in Patients with Primary Sclerosing Cholangitis Undergoing Endoscopic Retrograde Cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    R Enns

    2003-01-01

    Full Text Available Endoscopic retrograde cholangiopancreatography (ERCP in patients with primary sclerosing cholangitis (PSC can be a challenging and sometimes gratifying opportunity for therapeutic intervention. Although there often appears to be initial radiological improvement after ERCP, the benefit as measured by serial estimations of subsequent liver enzymes is questionable. The fluctuating course of the inflammatory process makes the interpretation of serology even more difficult.

  18. Selective Retrograde Venous Revascularization of the Myocardium when PCI or CABG Is Impossible: Investigation in a Porcine Model

    DEFF Research Database (Denmark)

    Møller, Christian H; Nørgaard, Martin A; Gøtze, Jens P

    2008-01-01

    We investigated the possibility of nourishing the myocardium through selective retrograde coronary venous bypass grafting (CVBG) with an off-pump technique and evaluated various methods of monitoring the physiological effects of this procedure. In a porcine model, the left internal mammary artery...

  19. Regeneration of unmyelinated and myelinated sensory nerve fibres studied by a retrograde tracer method

    DEFF Research Database (Denmark)

    Lozeron, Pierre; Krarup, Christian; Schmalbruch, Henning

    2004-01-01

    Regeneration of myelinated and unmyelinated sensory nerve fibres after a crush lesion of the rat sciatic nerve was investigated by means of retrograde labelling. The advantage of this method is that the degree of regeneration is estimated on the basis of sensory somata rather than the number...... of axons. Axonal counts do not reflect the number of regenerated neurons because of axonal branching and because myelinated axons form unmyelinated sprouts. Two days to 10 weeks after crushing, the distal sural or peroneal nerves were cut and exposed to fluoro-dextran. Large and small dorsal root ganglion...... cells that had been labelled, i.e., that had regenerated axons towards or beyond the injection site, were counted in serial sections. Large and small neurons with presumably myelinated and unmyelinated axons, respectively, were classified by immunostaining for neurofilaments. The axonal growth rate...

  20. Retrograde and Direct Powered Aero-Gravity-Assist Trajectories around Mars

    Science.gov (United States)

    Murcia, J. O.; Prado, A. F. B. A.; Gomes, V. M.

    2018-04-01

    A Gravity-Assist maneuver is used to reduce fuel consumption and/or trip times in interplanetary missions. It is based in a close approach of a spacecraft to a celestial body. Missions like Voyager and Ulysses used this concept. The present paper performs a study of a maneuver that combines three effects: the gravity of the planet, the application of an impulsive maneuver when the spacecraft is passing by the periapsis and the effects of the atmosphere of the planet. Direct and retrograde trajectories are considered, with particular attention to the differences due to the higher relative velocity between the spacecraft and the atmosphere, which increases the effects of the atmosphere. The planet Mars is used for the numerical examples.

  1. Analytical investigation of various regimes of retrograde trafficking of neurotropic viruses in axons

    Science.gov (United States)

    Kuznetsov, Andrey V.

    2011-10-01

    A model of retrograde axonal transport of neurotropic viruses is developed. The model accounts for active viral transport by dynein motors as well as for passive transport by diffusion; the destruction of the virus as it propagates toward the neuron soma is modeled utilizing a first-order decay rate process. The effect of a limited time during which the axonal synapse is exposed to the virus is incorporated. An analytical solution is obtained. The obtained solution makes it possible to identify four different regimes of viral transport in the axon that correspond to the following situations: (1) Small viral diffusivity and small rate of viral destruction; (2) Large viral diffusivity and small rate of viral destruction; (3) Small viral diffusivity and large rate of viral destruction; (4) Large viral diffusivity and large rate of viral destruction. Characteristic features of these regimes are discussed.

  2. Effect of gelatinized-retrograded and extruded starches on characteristics of cookies, muffins and noodles.

    Science.gov (United States)

    Sharma, Shagun; Singh, Narpinder; Katyal, Mehak

    2016-05-01

    The effect of substitution of wheat flour with gelatinized-retrograded starch (GRS) and extruded starch (ES) at 10 and 20 % levels on characteristics of cookies, muffins and noodles was evaluated. Cookies made by substitution of flour with GRS or ES were lighter in color, showed higher spread ratio and resistant starch (RS) content. Muffins made by substitution of flour with GRS or ES were lighter in color, showed less height, specific volume and gas cells and higher RS content. Muffins containing GRS were less firm while those made by incorporating ES showed higher firmness than those made without substitution. Noodles made with substitution of flour with GRS or ES showed higher RS content and reduced water uptake, gruel solid loss, hardness and adhesiveness. Cookies and noodles prepared with and without substitution of flour with GRS or ES did not show any significant differences in terms of overall acceptability scores.

  3. The apical leakage of mineral trioxide aggregate as the retrograde filling material with various mixing agents

    Directory of Open Access Journals (Sweden)

    Ema Mulyawati

    2010-06-01

    Full Text Available Background: Mineral trioxide aggregate (MTA is relatively considered as a new material in endodontic. It even has been used as retrograde filling material due to its biocompatibility, antibacterial effect, sealing ability and anti-moist effect. Some materials have been used as mixing agent to achieve an appropiate setting of MTA. Purpose: The aim of this study is to investigate the effect of the mixing agents of MTA towards the apical leakage when they are used together as retrograde filling materials. Method: The samples of this research consist of 30 human extracted upper central incisors. First, the crown of each tooth is sectioned. The root canals are prepared by using the conventional technique and then are obturated with gutta percha. After cutting the root apex, 2 mm from apical, class 1 cavities are prepared by using fissure bur with the depth of 3 mm. The samples then are divided into 3 groups with 10 teeth for each. Group I uses aquabidest as mixing agent of MTA (MTA-aquabidest, group II uses saline (MTA-saline, while group III uses 0.12% chlorhexidine (MTA-chlorhexidine. The apex of each group then is filled with the mixing MTA determined already. Afterwards, clearing method is used to evaluate the apical leakage. The apical leakage actually is determined by measuring the depth of methylene blue penetration with stereomicroscope. The statictical analyses of the linear dye penetration then are performed with analysis of varians ANOVA. Result: The dye penetration for both MTA-aquadest and MTA-saline groups indicates the lowest penetration, and there is even a significant difference compared with MTA-0.12% chlorhexidine group (p<0.005. Conclusion: It can be concluded that aquabidest and saline as mixing agents of MTA produce less apical leakage compared with 0.12% chlorhexidine.Latar belakang: Mineral trioxide aggregate (MTA merupakan bahan yang relatif baru dalam bidang endodontik. Bahan tersebut diindikasikan sebagai bahan pengisi

  4. Comparison of sonourethrography and retrograde urethrography in the evaluation of anterior urethral strictures

    Directory of Open Access Journals (Sweden)

    N. Khan

    2004-06-01

    Full Text Available Radiographic retrograde urethrography (RUG has traditionally been the preferred technique used by urologists to image the anterior urethra. Since originally described by McAninch et aL in 1988, ultrasonic imaging of the urethra has evolved into a powerful and clinically useful tool for the accurate delineation of urethral pathology. However the posterior urethra cannot be assessed reliably using this technique. Sonourethrography has proved to be more accurate than conventional radiographic urethrography in measuring stricture length throughout the anterior urethra. The objective and purpose of this study was to assess the efficacy of sonourethrography in the evaluation of anterior urethral strictures and also to explain its many advantages over traditional imaging technique.

  5. Retrograde amnesia produced by electron beam exposure: causal parameters and duration of memory loss

    International Nuclear Information System (INIS)

    Wheeler, T.G.; Hardy, K.A.

    1985-01-01

    The production of retrograde amnesia (RA) upon electron beam exposure has been investigated. RA production was evaluated using a single-trial avoidance task across a 10 4 dose range for 10-, 1-, and 0.1-μsec pulsed exposures. The dose-response curve obtained at each pulse duration showed significant RA production. The most effective dose range was 0.1-10 rad at a dose rate of 10 6 rad/sec. By employing a 10 rad (10 6 rad/sec) pulse, a memory loss of the events occurring in the previous 4 sec was demonstrated. The conclusion was that the RA effect might be due to sensory activation which provided a novel stimulus that masked previous stimuli

  6. Cateterismo retrógrado em neuro-radiologia Retrograde catheterization in Neuro-radiology

    Directory of Open Access Journals (Sweden)

    Sérgio F. Raupp

    1970-06-01

    Full Text Available The bases and technical cares for the neuro-radiological study of the aorto-cervical and spinal vessels employing the retrograde catheterization according to Seldinger technic and with the Odman-Ledin catheters are reported. The authors recommend type II neuroleptanalgesia as anesthesical sedative and the use of percutaneous punction of the femoral artery or, by choice, of the axilar or humeral artery. For the selective catheterization by femoral via, they make previously an aortography, in order to know the anatomy of the supra-aortic vessels, with control through the image-inten-sifier or fluoroscopy. They employ manual injection for the study of the supra-aortic vessels and a Gidlung injector for the contrast of the ascending aorta. Complications are discussed.

  7. Endoscopic retrograde cholangiopancreatography and stent placement via gastrostomy: technical aspects and clinical application.

    Science.gov (United States)

    Holderman, W H; Etzkorn, K P; Harig, J M; Watkins, J L

    1995-01-01

    Significant advances in the field of enteral nutrition (1), combined with technical advances in percutaneous access, have increased the indications for, and safety of, enteral alimentation (2). A mature gastrostomy stoma not only provides access to the gastrointestinal lumen for nutrition, but in selected cases, provides access for the diagnostic and therapeutic endoscopist. In 1971, Wiendl first reported diagnostic fiberoptic stomal endoscopy (3). This has since been followed by reports of diagnostic endoscopic retrograde cholangiopancreatography (ERCP) (4), and more recently, the first case of therapeutic ERCP by Gray et al. (5). We report here on the second case of therapeutic ERCP in a patient with metastatic squamous-cell carcinoma of the head and neck, with liver metastasis. We discuss the technical aspects, indications, and future of therapeutic stomal endoscopy.

  8. Symptomatic Type B Intramural Aortic Hematoma as a Complication of Retrograde Right Common Iliac Artery Dissection.

    Science.gov (United States)

    Sonetto, Alessia; Gargiulo, Mauro; Gallitto, Enrico; Ancetti, Stefano; Faggioli, Gianluca; Stella, Andrea

    2018-02-16

    To report the endovascular treatment of a spontaneous iliac artery dissection (IAD) involving iliac bifurcation, complicated by a type B intramural aortic hematoma (IMH). A 38-year-old female patient came to our institution referring an acute ascending back pain. The angio computed tomography scan showed the presence of a retrograde right IAD with entry tear at the iliac bifurcation and a concomitant aortic IMH. After hypogastric embolization with a vascular plug, self-expanding stent graft was placed to cover the iliac entry tear. At 12 months, the patient was asymptomatic and the angio computed tomography scan showed the patency of the iliac graft without IMH. Endovascular treatment of spontaneous IAD is a safe and effective option in symptomatic patient complicated with type B IMH. Published by Elsevier Inc.

  9. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography: Can they be successfully combined?

    Science.gov (United States)

    Gornals, Joan B; Esteban, José Miguel; Guarner-Argente, Carlos; Marra-Lopez, Carlos; Repiso, Alejandro; Sendino, Oriol; Loras, Carme

    2016-11-01

    Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) have much in common, including their main indications (biliopancreatic disorders), powerful therapeutic capacities and a steep learning curve. Over the years they have evolved from novel diagnostic procedures to interventional therapeutic techniques, but along different paths (different scopes or devices and endoscopists specializing exclusively in one or the other technique). However, EUS has gradually developed into a therapeutic technique that requires skills in the use of ERCP devices and stents, leading some ERCP specialists to explore the therapeutic potential of EUS. The corresponding literature, which has grown exponentially, includes recent experiments on combining the two techniques, which have gradually come to be used in routine care in a number of centers, with positive technical, clinical and financial outcomes. We review EUS and ERCP as individual or combined procedures for managing biliopancreatic disorders. Copyright © 2016 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  10. Retrograde Rotablator in Limb Salvage: A New Technique Using an Open Approach

    International Nuclear Information System (INIS)

    Tamashiro, Alberto; Villegas, Miguel; Tamashiro, Gustavo; Enterrios, Daniel; Dini, Andres; Balestrini, Aristobulo; Diaz, Jose A.

    2006-01-01

    Conventional vascular surgery and balloon angioplasty have poor results in severe and diffuse atherosclerotic disease of the infrapopliteal arteries. High-speed rotational atherectomy (Auth Rotablator) has not succeeded either, because of poor long-term patency and the non-reflow phenomenon. We report a case of limb salvage with long occlusion of the three infrapopliteal vessels. The anterior tibial artery was treated with retrograde Auth Rotablator atherectomy by an open approach through the pedal artery, resulting in full patency of the anterior tibial artery and healing of the skin lesions. The microparticulate debris from the ablation was drained out through the pedal arteriotomy, avoiding the complications associated with conventional antegrade high-speed rotational atherectomy

  11. Retrograde intrarenal stone surgery for extracorporeal shock-wave lithotripsy-resistant kidney stones

    DEFF Research Database (Denmark)

    Jung, Helene; Nørby, Bettina; Osther, Palle Jörn

    2006-01-01

    OBJECTIVE: The newer flexible ureteroscopes, 150-200-microm holmium YAG laser fibres and superflexible Dormia baskets have made it possible to reach and treat stones in all parts of the kidney. The object of this evaluation was to study the outcome of retrograde intrarenal stone surgery (RIRS......) for extracorporeal shock-wave lithotripsy (ESWL)-resistant kidney stones. MATERIAL AND METHODS: A total of 38 consecutive patients (18 males, 20 females) participated in the study. All patients had undergone ESWL prior to RIRS without success. In all cases the stones could be reached with the endoscope. Calculi...... ranged in size from 3 to 20 mm (mean 9 mm). In 32 cases the stones were fragmented using a holmium YAG laser and in six the stones could be extracted using zero-tip Dormia baskets without fragmentation. Sixteen patients had lower calyceal calculi and eight had an abnormal anatomy of the upper urinary...

  12. Current status of retrograde intrarenal surgery for management of nephrolithiasis in children

    Directory of Open Access Journals (Sweden)

    Yaser El-Hout

    2010-01-01

    Full Text Available Purpose : To review the current status of retrograde intrarenal surgery (RIRS for renal stones in children focusing on its indications, outcomes and success in the management of nephrolithiasis. Materials and Methods : Between 1988 and 2009, a comprehensive PubMed/MEDLINE literature review on RIRS was conducted. Results : The available literature is limited and heterogeneous, skewed by favorable results on ureteral stone outcomes. However, recent case series report outcomes comparable to time-honored modalities: percutaneous nephrolithotomy and shock wave lithotripsy. Concerns about urinary tract damage are not substantiated by the yet available intermediate-term follow-up. Conclusions : RIRS seems to be an effective modality in pediatric nephrolithiasis management. However, long-term outcomes and comparative prospective randomized studies are awaited.

  13. Periorbital Ecchymosis (Raccoon Eye) and Orbital Hematoma following Endoscopic Retrograde Cholangiopancreatography.

    Science.gov (United States)

    Nasiri, Jafar; Zamani, Farhad

    2017-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a conventional technique for diagnosis and treatment of pancratobiliary diseases, which is associated with various complications, including pancreatitis, hemorrhage, cholangitis, perforation, and mortality. In our case, a 69-year-old woman with positive hepatobiliary symptoms underwent ERCP, at the end of which a rare complication (raccoon eye) occurred, which was hypothesized to be due to amyloidosis, but the patient refused to complete the diagnostic procedure and became symptom free after 3 weeks. Racoon eye or periorbital ecchymosis is caused by blood tracking into periorbital tissues, which is frequently observed after head trauma but is also observed in systemic diseases, such as amyloidosis, neuroblastoma, and surgical interventions. To the best of our knowledge, this is the first report of raccoon eye after ERCP; further reports will help to confirm that this complication should also be considered before performing ERCP and that complete diagnostic tests for the predisposing diseases prior to ERCP are necessary.

  14. Retrograde amnesia produced by electron beam exposure: causal parameters and duration of memory loss. [Rats

    Energy Technology Data Exchange (ETDEWEB)

    Wheeler, T.G.; Hardy, K.A.

    1985-01-01

    The production of retrograde amnesia (RA) upon electron beam exposure has been investigated. RA production was evaluated using a single-trial avoidance task across a 10/sup 4/ dose range for 10-, 1-, and 0.1-..mu..sec pulsed exposures. The dose-response curve obtained at each pulse duration showed significant RA production. The most effective dose range was 0.1-10 rad at a dose rate of 10/sup 6/ rad/sec. By employing a 10 rad (10/sup 6/ rad/sec) pulse, a memory loss of the events occurring in the previous 4 sec was demonstrated. The conclusion was that the RA effect might be due to sensory activation which provided a novel stimulus that masked previous stimuli.

  15. Sudden death after endoscopic retrograde cholangiopancreatography (ERCP)--case report and literature review.

    Science.gov (United States)

    Hauser, Goran; Milosevic, Marko; Zelić, Marko; Stimac, Davor

    2014-12-01

    There are only a few cases found in literature regarding air embolism in endoscopic procedures, especially in connection to endoscopic retrograde cholangiopancreatography (ERCP). We are presenting a case of a 56-year-old female patient who suffered from non-Hodgkin lymphoma located in her right groin. She was also diagnosed with choledocholithiasis and underwent ERCP to remove the gallstones. Immediately after the procedure she went into sudden cardiac arrest and subsequently died, despite all of our efforts. We reviewed literature in order to identify possible causes of death because fatal outcome following an uneventful and successful procedure was not expected. It is important to bear in mind all possible complications of ERCP. Our focus during the literature search was on air embolism.

  16. Therapeutic efficacy of endoscopic retrograde cholangiopancreatography among pregnant women with severe acute biliary pancreatitis.

    Science.gov (United States)

    Yang, Jianfeng; Zhang, Xiaofeng; Zhang, Xiao

    2013-05-01

    To explore the feasibility of endoscopic retrograde cholangiopancreatography (ERCP) in pregnant women with severe acute biliary pancreatitis. In total, 24 pregnant patients with severe acute biliary pancreatitis were enrolled in our study between January 2003 and January 2008. Emergency ERCP and endoscopic nasobiliary drainage (ENBD) without fluoroscopy were performed successfully in all 24 patients within 12-72 hours of admission. Once stabilized, 15 patients in late pregnancy underwent a second ERCP with fluoroscopy to remove common bile duct (CBD) stones after pregnancy termination. Nine patients in early or mid-pregnancy continued gestating and underwent endoscopic retrograde biliary drainage (ERBD) with a second ERCP without fluoroscopy, and their stents and CBD stones were removed during a third ERCP with fluoroscopy 1 week after parturition. Among the mothers, all 24 patients were cured, and none of them died. The CBD stones in all 24 patients were completely removed with a two-step ERCP, and no serious post-ERCP complications occurred, although 2 patients had mild hemorrhage in the final ERCP to remove CBD stones. No recurrent pancreatitis or cholangitis occurred in patients who underwent ERBD. Among the infants, all survived without developmental problems or abnormality. Twenty infants were born at term; four infants were born prematurely at 35-37 weeks of gestation without developmental problems or complications. Emergency ERCP and ENBD without fluoroscopy in pregnant women with severe acute biliary pancreatitis are feasible and safe for both mothers and infants. It is also appropriate to remove CBD stones with two-step ERCP in pregnant women according to the stage of pregnancy.

  17. Identification of Two Classes of Somatosensory Neurons That Display Resistance to Retrograde Infection by Rabies Virus

    Science.gov (United States)

    Albisetti, Gioele W.; Ghanem, Alexander; Foster, Edmund

    2017-01-01

    Glycoprotein-deleted rabies virus-mediated monosynaptic tracing has become a standard method for neuronal circuit mapping, and is applied to virtually all parts of the rodent nervous system, including the spinal cord and primary sensory neurons. Here we identified two classes of unmyelinated sensory neurons (nonpeptidergic and C-fiber low-threshold mechanoreceptor neurons) resistant to direct and trans-synaptic infection from the spinal cord with rabies viruses that carry glycoproteins in their envelopes and that are routinely used for infection of CNS neurons (SAD-G and N2C-G). However, the same neurons were susceptible to infection with EnvA-pseudotyped rabies virus in tumor virus A receptor transgenic mice, indicating that resistance to retrograde infection was due to impaired virus adsorption rather than to deficits in subsequent steps of infection. These results demonstrate an important limitation of rabies virus-based retrograde tracing of sensory neurons in adult mice, and may help to better understand the molecular machinery required for rabies virus spread in the nervous system. In this study, mice of both sexes were used. SIGNIFICANCE STATEMENT To understand the neuronal bases of behavior, it is important to identify the underlying neural circuitry. Rabies virus-based monosynaptic tracing has been used to identify neuronal circuits in various parts of the nervous system. This has included connections between peripheral sensory neurons and their spinal targets. These connections form the first synapse in the somatosensory pathway. Here we demonstrate that two classes of unmyelinated sensory neurons, which account for >40% of dorsal root ganglia neurons, display resistance to rabies infection. Our results are therefore critical for interpreting monosynaptic rabies-based tracing in the sensory system. In addition, identification of rabies-resistant neurons might provide a means for future studies addressing rabies pathobiology. PMID:28951448

  18. Optical control of retrogradely infected neurons using drug-regulated "TLoop" lentiviral vectors.

    Science.gov (United States)

    Cetin, Ali; Callaway, Edward M

    2014-05-01

    Many approaches that use viral vectors to deliver transgenes have limited transduction efficiency yet require high levels of transgene expression. In particular, infection via axon terminals is relatively inefficient but is a powerful means of achieving infection of specific neuron types. Combining this with optogenetic approaches requires high gene expression levels that are not typically achieved with nontoxic retrogradely infecting vectors. We generated rabies glycoprotein-pseudotyped lentiviral vectors that use a positive feedback loop composed of a Tet promoter driving both its own tetracycline-dependent transcription activator (tTA) ("TLoop") and channelrhodopsin-2-YFP (ChR2YFP). We show that TLoop vectors strongly express proteins in a drug-controllable manner in neurons that project to injection sites within the mouse brain. After initial infection, the virus travels retrogradely, stably integrates into the host genome, and expresses gene products. The expression is robust and allows optogenetic studies of neurons projecting to the location of virus injection, as demonstrated by fluorescence-targeted intracellular recordings. ChR2YFP expression did not cause observable signs of toxicity and continued for up to 6 mo after infection. Expression can be reversibly blocked by administration of doxycycline, if necessary, for expression of gene products that might be more toxic. Overall, we present a system that will allow researchers to achieve high levels of gene expression even in the face of inefficient viral transduction. The particular vectors that we demonstrate may enhance efforts to gain a precise understanding of the contributions of specific types of projection neurons to brain function. Copyright © 2014 the American Physiological Society.

  19. Inhibition of retrograde transport modulates misfolded protein accumulation and clearance in motoneuron diseases.

    Science.gov (United States)

    Cristofani, Riccardo; Crippa, Valeria; Rusmini, Paola; Cicardi, Maria Elena; Meroni, Marco; Licata, Nausicaa V; Sala, Gessica; Giorgetti, Elisa; Grunseich, Christopher; Galbiati, Mariarita; Piccolella, Margherita; Messi, Elio; Ferrarese, Carlo; Carra, Serena; Poletti, Angelo

    2017-08-03

    Motoneuron diseases, like spinal bulbar muscular atrophy (SBMA) and amyotrophic lateral sclerosis (ALS), are associated with proteins that because of gene mutation or peculiar structures, acquire aberrant (misfolded) conformations toxic to cells. To prevent misfolded protein toxicity, cells activate a protein quality control (PQC) system composed of chaperones and degradative pathways (proteasome and autophagy). Inefficient activation of the PQC system results in misfolded protein accumulation that ultimately leads to neuronal cell death, while efficient macroautophagy/autophagy-mediated degradation of aggregating proteins is beneficial. The latter relies on an active retrograde transport, mediated by dynein and specific chaperones, such as the HSPB8-BAG3-HSPA8 complex. Here, using cellular models expressing aggregate-prone proteins involved in SBMA and ALS, we demonstrate that inhibition of dynein-mediated retrograde transport, which impairs the targeting to autophagy of misfolded species, does not increase their aggregation. Rather, dynein inhibition correlates with a reduced accumulation and an increased clearance of mutant ARpolyQ, SOD1, truncated TARDBP/TDP-43 and expanded polyGP C9ORF72 products. The enhanced misfolded protein clearance is mediated by the proteasome, rather than by autophagy and correlates with the upregulation of the HSPA8 cochaperone BAG1. In line, overexpression of BAG1 increases the proteasome-mediated clearance of these misfolded proteins. Our data suggest that when the misfolded proteins cannot be efficiently transported toward the perinuclear region of the cells, where they are either degraded by autophagy or stored into the aggresome, the cells activate a compensatory mechanism that relies on the induction of BAG1 to target the HSPA8-bound cargo to the proteasome in a dynein-independent manner.

  20. Synthesis of partial stabilized cement–gypsum as new dental retrograde filling material

    International Nuclear Information System (INIS)

    Sadhasivam, S.; Chen, Jung-Chih; Savitha, S.; Hsu, Ming-Xiang; Hsu, Chung-King; Lin, Chun-Pin; Lin, Feng-Huei

    2012-01-01

    The study describes the sol–gel synthesis of a new dental retrograde filling material partial stabilized cement (PSC)–gypsum by adding different weight percentage of gypsum (25% PSC + 75% gypsum, 50% PSC + 50% gypsum and 75% PSC + 25% gypsum) to the PSC. The crystalline phase and hydration products of PSC–gypsum were characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM) analysis. The handling properties such as setting time, viscosity, tensile strength, porosity and pH, were also studied. The XRD and microstructure analysis demonstrated the formation of hydroxyapatite and removal of calcium dihydrate during its immersion in simulated body fluid (SBF) on day 10 for 75% PSC + 25% gypsum. The developed PSC–gypsum not only improved the setting time but also greatly reduced the viscosity, which is very essential for endodontic surgery. The cytotoxic and cell proliferation studies indicated that the synthesized material is highly biocompatible. The increased alkaline pH of the PSC–gypsum also had a remarkable antibacterial activity. - Highlights: ► A new dental retrograde filling material PSC–gypsum was developed. ► PSC–gypsum cement has shown excellent initial and final setting time as 15–35 min. ► It not only improved the setting time but also retain the viscosity, 2 Pa·s. ► High alkaline pH of the cement had a remarkable antibacterial activity. ► Cytotoxicity studies revealed that the synthesized material is highly biocompatible.

  1. Synthesis of partial stabilized cement-gypsum as new dental retrograde filling material

    Energy Technology Data Exchange (ETDEWEB)

    Sadhasivam, S. [Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan (China); Division of Medical Engineering Research, National Health Research Institute, Zhunan, Miaoli County, Taiwan (China); Chen, Jung-Chih [Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan (China); Medical Device Innovation Center, National Cheng Kung University, Tainan,Taiwan (China); Savitha, S. [Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan (China); Hsu, Ming-Xiang; Hsu, Chung-King [Institute of Materials Science and Engineering, National Taipei University of Technology, Taipei, Taiwan (China); Lin, Chun-Pin [School of Dentistry and Graduate Institute of Clinical Dentistry, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan (China); Lin, Feng-Huei, E-mail: double@ntu.edu.tw [Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan (China); Division of Medical Engineering Research, National Health Research Institute, Zhunan, Miaoli County, Taiwan (China)

    2012-10-01

    The study describes the sol-gel synthesis of a new dental retrograde filling material partial stabilized cement (PSC)-gypsum by adding different weight percentage of gypsum (25% PSC + 75% gypsum, 50% PSC + 50% gypsum and 75% PSC + 25% gypsum) to the PSC. The crystalline phase and hydration products of PSC-gypsum were characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM) analysis. The handling properties such as setting time, viscosity, tensile strength, porosity and pH, were also studied. The XRD and microstructure analysis demonstrated the formation of hydroxyapatite and removal of calcium dihydrate during its immersion in simulated body fluid (SBF) on day 10 for 75% PSC + 25% gypsum. The developed PSC-gypsum not only improved the setting time but also greatly reduced the viscosity, which is very essential for endodontic surgery. The cytotoxic and cell proliferation studies indicated that the synthesized material is highly biocompatible. The increased alkaline pH of the PSC-gypsum also had a remarkable antibacterial activity. - Highlights: Black-Right-Pointing-Pointer A new dental retrograde filling material PSC-gypsum was developed. Black-Right-Pointing-Pointer PSC-gypsum cement has shown excellent initial and final setting time as 15-35 min. Black-Right-Pointing-Pointer It not only improved the setting time but also retain the viscosity, 2 Pa{center_dot}s. Black-Right-Pointing-Pointer High alkaline pH of the cement had a remarkable antibacterial activity. Black-Right-Pointing-Pointer Cytotoxicity studies revealed that the synthesized material is highly biocompatible.

  2. The effects of simultaneous antegrade/retrograde cardioplegia on cellular volumes and energy metabolism.

    Science.gov (United States)

    Li, Gang; Tian, Weichen; Wang, Jian; Xiang, Bo; Wang, Lei; Deng, Jixian; Salerno, Tomas A; Deslauriers, Roxanne; Tian, Ganghong

    2008-01-01

    Simultaneous antegrade/retrograde cardioplegia (SARC) has been employed frequently during cardiac surgery to preserve the jeopardized myocardium. However, retrograde perfusion of SARC may interfere with myocardial drainage and disrupt myocardial fluid homeostasis, which may affect the myocardial energy metabolism and contractile function. The study was, therefore, designed to assess the effects of SARC on myocardial fluid homeostasis, cellular volumes, and energy metabolism. Eight isolated pig hearts were subjected to a protocol consisting of a 20-minute control perfusion, 120-minute SARC, and 20-minute reperfusion. The myocardial water content was monitored using near-infrared spectroscopy. Phosphorus-31 magnetic resonance ((31)P MR) spectroscopy was used to monitor the volumes of both intracellular and extracellular compartments and assess myocardial energy metabolism. The near-infrared spectra showed that the 120-min SARC resulted in a 60 +/- 12% increase in the myocardial water content. (31)P MR spectra showed a 36 +/- 4% increase in the intracellular compartment and a 54 +/- 8% increase in the extracellular compartment during SARC relative to their initial volumes measured during control perfusion (100%). However, the myocardial energy metabolites (adenosine triphosphate [ATP] and phosphocreatine [PCr]) remained unchanged during the 120-minute SARC. Moreover, during reperfusion, the hearts showed an almost complete recovery in the left ventricular-developed pressure. A prolonged SARC resulted in water accumulation in both extracellular and intracellular compartments in the normal myocardium. Although its detrimental effect on tissue fluid homeostasis did not jeopardize the myocardial energy metabolism, a prolonged use of SARC should be avoided, particularly in the diseased hearts.

  3. Retrograde Accretion of a Caribbean Fringing Reef Controlled by Hurricanes and Sea-level Rise

    Directory of Open Access Journals (Sweden)

    Paul Blanchon

    2017-10-01

    Full Text Available Predicting the impact of sea-level (SL rise on coral reefs requires reliable models of reef accretion. Most assume that accretion results from vertical growth of coralgal framework, but recent studies show that reefs exposed to hurricanes consist of layers of coral gravel rather than in-place corals. New models are therefore needed to account for hurricane impact on reef accretion over geological timescales. To investigate this geological impact, we report the configuration and development of a 4-km-long fringing reef at Punta Maroma along the northeast Yucatan Peninsula. Satellite-derived bathymetry (SDB shows the crest is set-back a uniform distance of 315 ±15 m from a mid-shelf slope break, and the reef-front decreases 50% in width and depth along its length. A 12-core drill transect constrained by multiple 230Th ages shows the reef is composed of an ~2-m thick layer of coral clasts that has retrograded 100 m over its back-reef during the last 5.5 ka. These findings are consistent with a hurricane-control model of reef development where large waves trip and break over the mid-shelf slope break, triggering rapid energy dissipation and thus limiting how far upslope individual waves can fragment corals and transport clasts. As SL rises and water depth increases, energy dissipation during wave-breaking is reduced, extending the clast-transport limit, thus leading to reef retrogradation. This hurricane model may be applicable to a large sub-set of fringing reefs in the tropical Western-Atlantic necessitating a reappraisal of their accretion rates and response to future SL rise.

  4. Two-step retrograde closed stenting: a novel method for treating canalicular lacerations in Chinese patients.

    Science.gov (United States)

    Bi, Y; Sui, G; Zhou, Q; Heindl, L M; Bock, F; Sun, X; Tang, S; Wang, Z; Cursiefen, C

    2013-11-01

    To evaluate the efficacy of two-step retrograde closed stenting for treating canalicular laceration. methods: Forty-eight consecutive canalicular laceration cases (48 eyes) were randomised and divided into two groups: a one-step group and a two-step group. In the two-step group (23 cases), the first step was performed in the outpatient department and included identifying the medial cut end of the canaliculus and probing under a slit-lamp microscope, followed by a retrograde canalicular stenting assisted by a memory titanium stylet. The second step was canalicular anastomosis, which was performed in the operating room. In the one-step group (25 cases), all of the surgical procedures were performed when preoperative preparations were simultaneously available. The time elapsed from the doctor visit to the treatment was 4.3 ± 2.4 h in the two-step group and 18.8 ± 6.3 h in the one-step group (Ptwo-step group, and 51.4 ± 24.2 min was needed in the one-step group (Ptwo-step group and 5.4 ± 2.2 in the one-step group (Ptwo-step group and nine cases (36%) in the one-step group required other assisted methods to locate the medial cut end (P=0.007). Twenty-one cases (91.3%) in the two-step group and 20 cases (80%) in the one-step group achieved patent lacrimal drainage systems during a 12-month follow-up (P=0.528). The two-step canalicular anastomosis method allows an early search for the medial cut end of the canaliculus and improves the chances of finding it; it is also a quicker, less invasive method for treating canalicular lacerations.

  5. Quantification of retrograde axonal transport in the rat optic nerve by fluorogold spectrometry.

    Directory of Open Access Journals (Sweden)

    Christian van Oterendorp

    Full Text Available PURPOSE: Disturbed axonal transport is an important pathogenic factor in many neurodegenerative diseases, such as glaucoma, an eye disease characterised by progressive atrophy of the optic nerve. Quantification of retrograde axonal transport in the optic nerve usually requires labour intensive histochemical techniques or expensive equipment for in vivo imaging. Here, we report on a robust alternative method using Fluorogold (FG as tracer, which is spectrometrically quantified in retinal tissue lysate. METHODS: To determine parameters reflecting the relative FG content of a sample FG was dissolved in retinal lysates at different concentrations and spectra were obtained. For validation in vivo FG was injected uni- or bilaterally into the superior colliculus (SC of Sprague Dawley rats. The retinal lysate was analysed after 3, 5 and 7 days to determine the time course of FG accumulation in the retina (n = 15. In subsequent experiments axona transport was impaired by optic nerve crush (n = 3, laser-induced ocular hypertension (n = 5 or colchicine treatment to the SC (n = 10. RESULTS: Spectrometry at 370 nm excitation revealed two emission peaks at 430 and 610 nm. We devised a formula to calculate the relative FG content (c(FG, from the emission spectrum. c(FG is proportional to the real FG concentration as it corrects for variations of retinal protein concentration in the lysate. After SC injection, c(FG monotonously increases with time (p = 0.002. Optic nerve axonal damage caused a significant decrease of c(FG (crush p = 0.029; hypertension p = 0.025; colchicine p = 0.006. Lysates are amenable to subsequent protein analysis. CONCLUSIONS: Spectrometrical FG detection in retinal lysates allows for quantitative assessment of retrograde axonal transport using standard laboratory equipment. It is faster than histochemical techniques and may also complement morphological in vivo analyses.

  6. Bilateral Single-Session Retrograde Intrarenal Surgery for the Treatment of Bilateral Renal Stones

    Directory of Open Access Journals (Sweden)

    Gokhan Atis

    2013-06-01

    Full Text Available Purpose The aim of the study was to evaluate the efficacy and safety of bilateral single-session retrograde intrarenal surgery in the treatment of bilateral renal stones. Materials and Methods From December 2008 to February 2012, 42 patients who had undergone bilateral single-session retrograde intrarenal surgery (RIRS and laser lithotripsy were included in the study. The procedures were performed in the lithotomy position on an endoscopy table under general anesthesia, beginning on the side in which the stone size was smaller. Plain abdominal radiography, intravenous urograms (IVU, renal ultrasonography (USG and / or non-contrast tomography (CT scans were conducted for all patients. The success rate was defined as patients who were stone-free or only had residual fragment less than 4 mm. Results A total of 42 patients (28 male, 14 female with a mean age 39.2 ± 14.2 were included in the present study. The mean stone size was 24.09 ± 6.37 mm with a mean operative time of 51.08 ± 15.22 minutes. The stone-free rates (SFR were 92.8% and 97.6% after the first and second procedures, respectively. The average hospital stay was 1.37 ± 0.72 days. In two patients (4.7%, minor complications (Clavien I or II were observed, whereas no major complications (Clavien III-V or blood transfusions were noted in the studied group. Conclusions Bilateral single-session RIRS and laser lithotripsy can be performed safely and effectively with a high success rate and low complication rate in patients with bilateral renal stones.

  7. Retrograde femoral vein catheter insertion. A new approach for challenging hemodialysis vascular access.

    Science.gov (United States)

    Gouda, Zaghloul

    2014-01-01

    Venous catheters provide access for hemodialysis (HD) when patients do not have functioning access device. Obstruction of jugular, femoral or even external iliac vessels further depletes options. Subclavian approach is prohibited. Catheterization of inferior vena cava requires specialized equipment and skills. The purpose is to assess a new lifesaving HD vascular access approach for patients with nonfunctioning access device in the ordinary sites. This entails insertion of a retrograde temporary HD catheter in the superficial femoral vein, directing the catheter distally, toward the foot. We included six end-stage renal disease (ESRD) patients retrospectively who are on regular renal replacement therapy and need urgent HD with nonfunctioning access device in the ordinary sites. Successful insertion of six retrograde femoral vein catheters in the superficial femoral vein. The mean catheter days were 2.5±0.5 days with one patient having 26 catheter days. The mean blood pump speed was 230.0±44.7 mL/min. Urea reduction ratio and Kt/V at 3 hours HD session were 47% and 1.5, respectively, which increased with increasing session duration. The ultrafiltration volume was 2-3 L/session which increased up to 6 L/session in case of using slow low-efficiency dialysis. No major complications were observed during insertion or the postinsertion period except thigh pain in one patient and exit site infection in the case of long duration. This is a newly applied lifesaving HD vascular access approach for selected ESRD patients with no available HD vascular access at the ordinary sites with accepted HD adequacy. It needs more evaluation and more studies.

  8. Anatomy of the coronary sinus and its clinical significance for retrograde cardioplegia.

    Science.gov (United States)

    Liu, Dao-ming; Zhang, Fa-hui; Chen, Long; Zheng, He-ping; Zhong, Shi-zhen

    2003-04-01

    To provide an anatomical basis for selecting optimal retrograde cardioplegia technique therefore to improve the effect of the operation. Fifty formalin-fixed adult human cadaveric hearts were collected in this study, and special attention was given to the observation of the coronary sinus tributary drainage and the anatomical relationship between the orifice of the coronary sinus and the atrioventricular nodal artery. Although the majority of the tributaries drained into the coronary sinus, it was identified in 15 cases that the posterior vein of the left ventricle and in another 2 cases the small cardiac vein (SCV) made their way into the middle cardiac vein (MCV) respectively. In 6 cases MCV solely joined the right atrium, which was joined by SCV only in 1 case. Draining into the coronary sinus as seen in 44 cases, MCV had an opening 3.4+/-1.5 mm away from the orifice of the coronary sinus. In the direction perpendicular to the long axis of the coronary sinus orifice, the anterior and posterior extreme points were 4.9+/-2.5 mm and 9.9+/-4.2 mm respectively, away from the atrioventricular nodal artery, which crossed the long axis of the coronary sinus orifice at an angle of 21.2+/-15.6 degrees. The right atrial wall on both sides of the coronary sinus orifice was of a uniform thickness of 1.1+/-0.2 mm. Direct-vision non-balloon-tipped cannulation conforms better to the anatomical features described above. In purse-string suture, however, sufficient care should be taken of the dangerously thin inferior atrial wall and the close relationship between the coronary sinus orifice and the atrioventricular nodal artery. For better cardioprotective effect of retrograde cardioplegia, non-balloon-tipped cannula under direct vision should be adopted with the assistance of antegrade perfusion and, when necessary, additional transfusion via the exotic MCV opening may be used when the opening appears relatively wide.

  9. Pilot acute study of feedback-controlled retrograde peristalsis invoked by neural gastric electrical stimulation

    International Nuclear Information System (INIS)

    Aelen, P; Jurkov, A; Aulanier, A; Mintchev, M P

    2009-01-01

    Neural gastric electrical stimulation (NGES) is a new method for invoking gastric contractions under microprocessor control. However, optimization of this technique using feedback mechanisms to minimize power consumption and maximize effectiveness has been lacking. The present pilot study proposes a prototype feedback-controlled neural gastric electric stimulator for the treatment of obesity. Both force-based and inter-electrode impedance-based feedback neurostimulators were implemented and tested. Four mongrel dogs (2 M, 2 F, weight 14.9 ± 2.3 kg) underwent subserosal implantation of two-channel, 1 cm, bipolar electrode leads and two force transducers in the distal antrum. Two of the dogs were stimulated with a force feedback system utilizing the force transducers, and the other two animals were stimulated utilizing an inter-electrode impedance-based feedback system utilizing the proximal electrode leads. Both feedback systems were able to recognize erythromycin-driven contractions of the stomach and were capable of overriding them with NGES-invoked retrograde contractions which exceeded the magnitudes of the erythromycin-driven contractions by an average of 100.6 ± 33.5% in all animals. The NGES-invoked contractions blocked the erythromycin-driven contractions past the proximal electrode pair and induced temporary gastroparesis in the vicinity of the distal force transducer despite the continuing erythromycin infusion. The amplitudes of the erythromycin-invoked contractions in the vicinity of the proximal force transducer decreased abruptly by an average of 47.9 ± 6.3% in all four dogs after triggering-invoked retrograde contractions, regardless of the specific feedback-controlled mechanism. The proposed technique could be helpful for retaining food longer in the stomach, thus inducing early satiety and diminishing food intake

  10. Pilot acute study of feedback-controlled retrograde peristalsis invoked by neural gastric electrical stimulation.

    Science.gov (United States)

    Aelen, P; Jurkov, A; Aulanier, A; Mintchev, M P

    2009-03-01

    Neural gastric electrical stimulation (NGES) is a new method for invoking gastric contractions under microprocessor control. However, optimization of this technique using feedback mechanisms to minimize power consumption and maximize effectiveness has been lacking. The present pilot study proposes a prototype feedback-controlled neural gastric electric stimulator for the treatment of obesity. Both force-based and inter-electrode impedance-based feedback neurostimulators were implemented and tested. Four mongrel dogs (2 M, 2 F, weight 14.9 +/- 2.3 kg) underwent subserosal implantation of two-channel, 1 cm, bipolar electrode leads and two force transducers in the distal antrum. Two of the dogs were stimulated with a force feedback system utilizing the force transducers, and the other two animals were stimulated utilizing an inter-electrode impedance-based feedback system utilizing the proximal electrode leads. Both feedback systems were able to recognize erythromycin-driven contractions of the stomach and were capable of overriding them with NGES-invoked retrograde contractions which exceeded the magnitudes of the erythromycin-driven contractions by an average of 100.6 +/- 33.5% in all animals. The NGES-invoked contractions blocked the erythromycin-driven contractions past the proximal electrode pair and induced temporary gastroparesis in the vicinity of the distal force transducer despite the continuing erythromycin infusion. The amplitudes of the erythromycin-invoked contractions in the vicinity of the proximal force transducer decreased abruptly by an average of 47.9 +/- 6.3% in all four dogs after triggering-invoked retrograde contractions, regardless of the specific feedback-controlled mechanism. The proposed technique could be helpful for retaining food longer in the stomach, thus inducing early satiety and diminishing food intake.

  11. A TOCA/CDC-42/PAR/WAVE functional module required for retrograde endocytic recycling

    Science.gov (United States)

    Bai, Zhiyong; Grant, Barth D.

    2015-01-01

    Endosome-to-Golgi transport is required for the function of many key membrane proteins and lipids, including signaling receptors, small-molecule transporters, and adhesion proteins. The retromer complex is well-known for its role in cargo sorting and vesicle budding from early endosomes, in most cases leading to cargo fusion with the trans-Golgi network (TGN). Transport from recycling endosomes to the TGN has also been reported, but much less is understood about the molecules that mediate this transport step. Here we provide evidence that the F-BAR domain proteins TOCA-1 and TOCA-2 (Transducer of Cdc42 dependent actin assembly), the small GTPase CDC-42 (Cell division control protein 42), associated polarity proteins PAR-6 (Partitioning defective 6) and PKC-3/atypical protein kinase C, and the WAVE actin nucleation complex mediate the transport of MIG-14/Wls and TGN-38/TGN38 cargo proteins from the recycling endosome to the TGN in Caenorhabditis elegans. Our results indicate that CDC-42, the TOCA proteins, and the WAVE component WVE-1 are enriched on RME-1–positive recycling endosomes in the intestine, unlike retromer components that act on early endosomes. Furthermore, we find that retrograde cargo TGN-38 is trapped in early endosomes after depletion of SNX-3 (a retromer component) but is mainly trapped in recycling endosomes after depletion of CDC-42, indicating that the CDC-42–associated complex functions after retromer in a distinct organelle. Thus, we identify a group of interacting proteins that mediate retrograde recycling, and link these proteins to a poorly understood trafficking step, recycling endosome-to-Golgi transport. We also provide evidence for the physiological importance of this pathway in WNT signaling. PMID:25775511

  12. Retrograde hot-shot cardioplegia in patients with left ventricular hypertrophy undergoing aortic valve replacement.

    Science.gov (United States)

    Ascione, Raimondo; Suleiman, Saadeh M; Angelini, Gianni D

    2008-02-01

    Intermittent antegrade cold-blood cardioplegia followed by terminal warm-blood cardioplegic reperfusion or hot-shot is reported to reduce myocardial injury in the setting of coronary surgery. The efficacy of this cardioplegic technique in patients with left ventricular hypertrophy secondary to aortic stenosis remains uncertain. Thirty-six patients with left ventricular hypertrophy undergoing aortic valve replacement were prospectively randomized to cold-blood cardioplegia either alone (cold-blood cardioplegia group) or with retrograde hot-shot (hot-shot group). Reperfusion injury was assessed by measuring myocardial levels of adenosine triphosphate and lactate in left and right ventricular biopsies taken 5 minutes after institution of cardiopulmonary bypass and 20 minutes after removal of cross-clamp using high-performance liquid chromatography and enzymatic techniques. Myocardial injury was assessed by serial release of troponin I up to 48 hours postoperatively. Overall clinical outcome was prospectively collected. Baseline and intraoperative characteristics were similar between groups. In the hot-shot group, there were no significant changes in the myocardial concentration of adenosine triphosphate and lactate in both left and right ventricular biopsies after reperfusion. In the cold-blood cardioplegia group, there was a trend to a fall in adenosine triphosphate levels in the left and right ventricular biopsies after reperfusion, but this reached statistical significance only in the right ventricle. Troponin I release was raised in both groups at 4 and 12 hours after surgery (p < 0.05), but did not reach levels of myocardial infarction. The terminal retrograde hot-shot reperfusion does not add any extra benefit to antegrade cold-blood cardioplegia in preventing myocardial injury in patients with left ventricular hypertrophy undergoing aortic valve replacement. Nevertheless, it appears to reduce ischemic stress in the right ventricle. There was no difference in

  13. MICROLEAKAGE ASSOCIATED WITH RETROGRADE FILLING AFTER ROOT END RESECTION (in vitro study

    Directory of Open Access Journals (Sweden)

    Elka Radeva

    2014-09-01

    Full Text Available The purpose of the study is to compare microleakage after root end resection of the two materials (MTA and Biodentine for two different apical cavity preparation using the method of penetration of dye - 0, 2 % Rodamine B. Materials and Methods: Forty-eight extracted single-rooted human teeth were used in this study. The resection was made at 3 mm from the root tip with a high speed diamond bur at an angle of 90 degree to the long axis of the tooth. For the retrofilling, ProRoot MTA and Biodentine were used. The teeth were divided into 5 groups: 1st group (10 teeth – the apical cavity was prepared with stainless steel fissure bur #10 at 3 mm depth in the root canal parallel to the long axis of the tooth and is filled retrograde with MTA. 3rd group (10 teeth - retrofilling with Biodentine. 2 nd group (10 teeth - with a round bur apical cavity was prepared with a concave shape and cavity along the root canal with a depth of 3 mm and retrograde obturation with MTA. 4th group (10 teeth - retrofilling with Biodentine. 5th group (8 teeth - control group - with preparation of the cavity after resection without retrofilling. The outer surface of the root is covered with two layers of varnish, with the exception of the apical 3 mm then immersed in 0.2% Rodamine B for 72 h. The degree of penetration of the dye is measured in millimeters. Results: Relative highest median value of penetration of the dye in mm is in the control group. MTA group has a higher value in mm versus the Biodentine. The apical preparation with a concave shape and cavity along the root canal with a depth of 3 mm after apicoectomy is important to reduce apical microleakage. Conclusion: Different apical cavity preparations in both types of material have led to the microleakage dye, but to varying degrees.

  14. The localization of primary efferent sympathetic neurons innervating the porcine thymus – a retrograde tracing study

    Directory of Open Access Journals (Sweden)

    Paweł Kulik

    2017-01-01

    Full Text Available The autonomic nervous system is a sophisticated and independent structure composed of two antagonistic (opposing divisions (sympathetic and parasympathetic that control many vital functions including: homeostasis maintenance, heart rate, blood circulation, secretion, etc. Thymus is one of the most important primary lymphoid organs playing a role in the developing of a juvenile’s immune system mainly by maturation, development, and migration of T-cells (T lymphocytes. In the last decades, several studies identifying sources of the thymic autonomic supply have been undertaken in humans and several laboratory rodents but not in higher mammals such as the pig. Therefore, in the present work, retrograde tracing technique of Fast Blue and DiI was used to investigate the sources of sympathetic efferent supply to the porcine thymus. After Fast Blue injection into the right lobe of the thymus, the presence of Fast Blue-positive neurons was found in the unilateral cranial cervical ganglion (82.8 ± 3.0% of total Fast Blue-positive neurons as well as in the middle cervical ganglion (17.2 ± 3.0%. Injection of DiI resulted in the presence of retrograde tracer in neurons of the cranial cervical ganglion (80.4 ± 2.3% of total amount of DiI-labelled neurons, the middle cervical ganglion (18.4 ± 1.9%, and the cervicothoracic ganglion (1.2 ± 0.8%. The present report provides the first data describing in details the localization of primary efferent sympathetic neurons innervating the porcine thymus.

  15. Using the Retrograde Internal Mammary System for Stacked Perforator Flap Breast Reconstruction: 71 Breast Reconstructions in 53 Consecutive Patients.

    Science.gov (United States)

    Stalder, Mark W; Lam, Jonathan; Allen, Robert J; Sadeghi, Alireza

    2016-02-01

    Abdominal tissue is the preferred donor source for autologous breast reconstruction, but in select patients with inadequate tissue, additional volume must be recruited to achieve optimal outcomes. Stacked flaps are an effective approach in these cases, but can be limited by the need for adequate recipient vessels. This article reports outcomes for the use of the retrograde internal mammary system for stacked flap breast reconstruction in a large number of consecutive patients. Fifty-three patients underwent stacked autologous tissue breast reconstruction with a total of 142 free flaps. Thirty patients underwent unilateral stacked deep inferior epigastric perforator (DIEP) flap reconstruction, five had unilateral stacked profunda artery perforator flap reconstruction, one had bilateral stacked DIEP/superior gluteal artery perforator flap reconstruction, and 17 underwent bilateral stacked DIEP/profunda artery perforator flap reconstruction. In all cases, the antegrade and retrograde internal mammary vessels were used for anastomoses. In situ manometry studies were also conducted comparing the retrograde internal mammary arteries in 10 patients to the corresponding systemic pressures. There were three total flap losses (97.9 percent flap survival rate), two partial flap losses, four reexplorations for venous congestion, and three patients with operable fat necrosis. The mean weight of the stacked flaps for each reconstructed breast was 622.8 g. The retrograde internal mammary mean arterial pressures were on average 76.6 percent of the systemic mean arterial pressures. The results demonstrate that the retrograde internal mammary system is capable of independently supporting free tissue transfer. These vessels provide for convenient dissection and improved efficiency of these cases, with successful postsurgical outcomes. Therapeutic, IV.

  16. Impact of local hydrothermal treatment during bread baking on soluble amylose, firmness, amylopectin retrogradation and water mobility during bread staling.

    Science.gov (United States)

    Besbes, Emna; Le Bail, Alain; Seetharaman, Koushik

    2016-01-01

    The impact of hydrothermal processing undergone by bread dough during baking on the degree of starch granule disruption, on leaching of soluble amylose, on water mobility, on firmness and on amylopectin retrogradation during staling has been investigated. Two heating rates during baking have been considered (4.67 and 6.31 °C/min) corresponding respectively to baking temperature of 220 and 240 °C. An increase in firmness and in the amount of retrogradated amylopectin accompanied by a decrease in freezable water has been observed during staling. Although a lower heating rate yielded in larger amount of retrogradated amylopectin retrogradation, it resulted in a lower firmness. Additionally, the amount of soluble amylose and the relaxation times of water measured by Nuclear Magnetic Resonance NMR (T20, T21 and T22) decreased during staling. It was demonstrated that the amount of soluble amylose was higher for bread crumb baked at lower heating rate, indicating that an increasing amount of amylose is leached outside the starch granules. This was corresponding to a greater amount of retrograded amylopectin during staling. Moreover, it was found that the degree of gelatinization differs locally in a same bread slice between the top, the centre and the bottom locations in the crumb. This was attributed to the differences in kinetics of heating, the availability of water during baking and the degree of starch granule disruption during baking. Based on first order kinetic model, it was found that staling kinetics were faster for samples baked at higher heating rate.

  17. OPPORTUNITIES OF ENDOSCOPIC RETROGRADE STENTING OF THE BILE DUCTS IN MALIGNANT TUMORS OF THE PANCREATOBILIARY ZONE, COMPLICATED BY OBSTRUCTIVE JAUNDICE

    Directory of Open Access Journals (Sweden)

    S. A. Budzinsky

    2013-01-01

    Full Text Available Purpose. In the last 10 years in the treatment of acute jaundice, developed on a background of malignant tumors of the pancreatobiliary zone (PBZ, more preferred method is endoscopic retrograde biliary drainage.Material and methods. From January 2007 to July 2012 in the clinic of hospital surgery N. 2 PRNMU endoscopic biliary stenting was performed in 441 patients. Of these, 324 (73.5% stenting fell to 234 patients with a tumor of the extrahepatic bile ducts. The diagnostic program included ultrasonography, computed tomography, endoscopic ultrasonography and endoscopic retrograde cholangiopancreaticography.Results. Installing of bilioduodenal stent in 223 patients (95.3% was generated after the pre-endoscopic papillosphincterotomy (EPST. The adequacy of the biliary drainage after produced in the required amount of biliary stent placement was achieved in all patients. In 46 cases, execute the biliary tract prosthesis failed. Complications of endoscopic interventions presented with acute pancreatitis, cholangitis, bleeding from the area of EPST, perforated duodenal wall and migration of the stent were in 19 cases (5?9%. Postoperative mortality was 3?8%. 7 patients (3% died after the endoscopic decompression of the biliary tract. After stenting in all patients with jaundice it was resolved or significantly reduced. In 185 of them (79% was the definitive guide endoscopic treatment because of severity of tumor process. In cases of jaundice reccurence endoscopic stent recanalizing or replacement were performed. In the remaining cases (21% patients after the resolution of jaundice decompressive surgical intervention were done.Conclusion. The method of endoscopic retrograde biliary drainage allows you to prepare patients with obstructive jaundice for surgical intervention, including the radical. The frequency of complications after endoscopic retrograde operations on the major duodenal papilla for acute jaundice blastomatous origin did not differ from

  18. D-[3H]aspartate retrograde labelling of callosal and association neurons of somatosensory areas I and II of cats

    International Nuclear Information System (INIS)

    Barbaresi, P.; Fabri, M.; Conti, F.; Manzoni, T.

    1987-01-01

    Experiments were carried out on cats to ascertain whether corticocortical neurons of somatosensory areas I (SI) and II (SII) could be labelled by retrograde axonal transport of D-[ 3 H]aspartate (D-[ 3 H]Asp). This tritiated enantiomer of the amino acid aspartate is (1) taken up selectively by axon terminals of neurons releasing aspartate and/or glutamate as excitatory neurotransmitter, (2) retrogradely transported and accumulated in perikarya, (3) not metabolized, and (4) visualized by autoradiography. A solution of D-[ 3 H]Asp was injected in eight cats in the trunk and forelimb zones of SI (two cats) or in the forelimb zone of SII (six cats). In order to compare the labelling patterns obtained with D-[ 3 H]Asp with those resulting after injection of a nonselective neuronal tracer, horseradish peroxidase (HRP) was delivered mixed with the radioactive tracer in seven of the eight cats. Furthermore, six additional animals received HRP injections in SI (three cats; trunk and forelimb zones) or SII (three cats; forelimb zone). D-[ 3 H]Asp retrograde labelling of perikarya was absent from the ipsilateral thalamus of all cats injected with the radioactive tracer but a dense terminal plexus of anterogradely labelled corticothalamic fibers from SI and SII was observed, overlapping the distribution area of thalamocortical neurons retrogradely labelled with HRP from the same areas. D-[ 3 H]Asp-labelled neurones were present in ipsilateral SII (SII-SI association neurones) in cats injected in SI. In these animals a bundle of radioactive fibres was observed in the rostral portion of the corpus callosum entering the contralateral hemisphere. There, neurones retrogradely labelled with silver grains were present in SI (SI-SI callosal neurons)

  19. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Yucel Colkesen

    2015-08-01

    Full Text Available Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm] intravenous cannula is described.

  20. Impedance to retrograde and forward flow in chronic mitral regurgitation and the physiology of a double outlet ventricle.

    Science.gov (United States)

    Gaasch, William H; Shah, Sachin P; Labib, Sherif B; Meyer, Theo E

    2017-04-01

    Mitral regurgitation (MR) is generally characterised as exhibiting a 'low impedance leak into the left atrium'. This notion is widely accepted without measured impedance data. The aim of this study was to define the impedance to retrograde and forward blood flow and to examine hydraulic (pressure-volume) and mechanical (stress-shortening) function in chronic severe MR. A mathematical model of a double outlet ventricle was developed and the ratio of retrograde to forward impedance was plotted over a wide range of regurgitant fraction (RF). The model predicts that an impedance ratio >1 indicates that the impedance to retrograde flow exceeds that of forward flow. Left ventricular (LV) systolic pressure/flow rate was used as an index of impedance (mm Hg/mL/s). Data from 10 patients with severe MR were used to assess the clinical applicability of the model. All patients had degenerative valve disease with partial flail leaflet, an RF >50% and an ejection fraction (EF) >0.60. There were seven males and three females, aged 59±10. LV volumes as well as retrograde and forward flow rates were determined with echocardiographic and Doppler techniques. The model indicates that the impedance ratio is >1 when the RF ranges from zero to 57%. Clinical data: end-diastolic volume=184±47 mL; EF=0.63±3%; RF=53±4%. Values for retrograde and forward impedance were 0.77±0.17 and 0.63±0.12 (p=0.003); the impedance ratio was 1.22±0.19. Total impedance to LV emptying was low (0.35±0.06). The ratio of systolic wall stress to EF (580±81 g/cm 2 ) was normal. Data are mean±SD. The model, supported by clinical data, indicates that the impedance to retrograde flow exceeds the impedance to forward flow in chronic severe MR. These findings refute the notion of a low impedance leak into the left atrium. The double outlet of an enlarged ventricle provides a mechanism for low total impedance to ejection in the presence of a normal stress-shortening relation. Published by the BMJ

  1. Prograde and retrograde metamorphic processes in high-pressure subduction zone serpentinites from East Thessaly, Greece

    Science.gov (United States)

    Koutsovitis, Petros

    2016-04-01

    highly comparable with the P-T estimates from the East Thessaly metabasic rocks (˜350 ° C; P≈10-11 kbars)[5], suggesting that the entire metaophiolitic formation underwent blueschist facies metamorphism, comparable with high-pressure metaophiolitic formations appearing in Evia, Attica and the Cyclades. The East Thessaly serpentinites exhibit significantly high PM-normalized Pb, U enrichments and rather high Cs, La, As and Sb concentrations, which are comparable with subduction-related serpentinites, formed after mantle wedge peridotite hydration, and that have interacted with sedimentary derived fluids [2,6,7,8]. These serpentinites were also partly affected by de-serpentinization retrograde metamorphism (estimated at Pcoronas of chlorite along Cr-magnetite crystals, appearance of secondary calcite veins and talc. In the Kalochori-Chasanbali area, intense carbonization processes formed ophicalcite breccias enveloped by imbricated serpentinites[9], whereas talc-rich serpentinites appear in the region of Sklithro. Retrograde metamorphism may have occurred during exhumation, possibly within a serpentinite channel[8]. In addition, their retrograde history can also be indirectly identified through the study of their rodingite intrusions and more specifically through the formation of late-stage vesuvianite-rich dykes at low-moderate temperature conditions (T=250-300 oC) and subsequent derodingitization processes, forming metarodingites. The latter include abundant high-Mg replacive chlorite formed by continuous serpentinization which provided Mg2+ to the infiltrating fluids, causing the partial breakdown of Ca-bearing minerals. References. [1] Pe-Piper & Piper 2002: Borntraeger, Stuttgart, 1-645; [2] Lafay et al 2013: Chem Geol 343, 38-54; [3] Schwartz et al 2013: Lithos 178, 197-210; [4] Guillot, et al 2015: Tectonophysics 646, 1-19; [5] Perraki et al 2002: Geologica Carpathica 53, 164-165; [6] Deschamps, et al 2013: Lithos 178, 96-127; [7] Hattori & Guillot, 2007: G

  2. [Comparison of ablation of left-sided accessory pathway by atrial septal and retrograde arterial approach].

    Science.gov (United States)

    Zhu, J G; Bao, Z Y; Gu, X

    2017-03-07

    Objective: To compare the advantages and disadvantages of radiofrequency ablation of left-sided accessory pathways by via atrial septal approach with retrograde through aortic approach. Methods: A total of 184 patients of left-side accessory pathways were treated in Taizhou People's Hospital and the Subei People's Hospital from March 2012 to August 2015.A total of 103 cases were treated by aortic retrograde approach as through arterial group, 81 cases were treated by punctured atrial septal to left atrial for mapping and ablation as through atrial septal group.Comparison of ablation procedure time, total and pathways of different parts(subgroup) at instant success and relapse rates, safety (serious complications), and statistics other complications in operation and postoperative. Results: Through arterial group and through atrial septal group were no significant difference ( P >0.05) in the ablation procedure time((25±18 ) vs (22±15)min ), instant success(98.1% vs 97.5%) and relapse rates(1.0% vs 1.2%), security(1 vs 0 case). There was no statistical difference in septal part subgroups (all P >0.05) in the ablation procedure time((22±18)vs (25±19)min), instant success(91.7% vs 89.9 %) and relapse rates(0 vs 11.1%); posterior wall subgroup had no statistical difference in the ablation procedure time((18±15)vs (16±12)min), instant success(100% vs 100 %) and relapse rates(0 vs 0)(all P >0.05); side wall subgroup had no statistical difference in the ablation procedure time((29±20)vs (21±18) min), instant success (98.3% vs 98.1%)and relapse rates(1.7% vs 0%)(all P >0.05). Conclusion: Ablation of left-sided accessory pathways by transseptal approach and transaortic approach has no statistical difference in the procedure time, instant success and relapse rates, security.In a particular case, there is a certain complementarity between the two methods.

  3. [Treatment of periprosthetic femoral fractures after total hip arthroplasty with specially constructed retrograde hollow nails].

    Science.gov (United States)

    Szalay, G; Meyer, C; Mika, J; Schnettler, R; Thormann, U

    2014-12-01

    Treatment of periprosthetic fractures by implantation of a specially constructed, retrograde hollow nail which fits over the tip of the prosthesis and becomes locked on it. Periprosthetic femoral fractures with firmly anchored prosthesis shaft after total hip arthroplasty of types B1 and C according to the Vancouver classification. Loosened prosthesis (type B2/B3) and trochanteric fractures (type A). Broken or damaged prosthesis, florid inflammation and soft tissue injuries in the operation field, contracted knee joint, advanced deformation in the knee joint and distal femur, enclosed prosthesis and general contraindications. In a supine position the periprosthetic fracture is exposed via a lateral access. For cemented prostheses the cement is removed around the tip of the prosthesis (at least 2-3 cm) and medullary cavity. Arthrotomy with flexion of the knee joint and marking of the nail entry point. Drill the medullary cavity, retrograde introduction of the nail, visually fit the nail over the tip of the prosthesis and lock the nail with the prosthesis. If necessary use additional spongiosaplasty or also placement of additional cerclages depending on fracture type and size of the defect zone. Lock the nail distally. Use intraoperative radiological imaging to control correct positioning and length of the nail. Close the wound layer by layer with placement of suction drainage devices and dressing. Partial loading for 6 weeks with a subsequent pain-adapted loading gradient until full loading is possible. If selective partial loading is not possible, a decision must be made in individual cases as to whether the intraoperative findings allow immediate full loading. From 2004 to 2011 a total of 25 periprosthetic femoral fractures in 25 patients were treated in 2 locations using specially constructed slotted hollow nails. Within the framework of a retrospective study 20 of these patients (16 female and 4 male; average age 77.2 [72-84] years) were clinically and

  4. Lack of consensus on the role of endoscopic retrograde cholangiography in acute biliary pancreatitis in published meta-analyses and guidelines: a systematic review

    NARCIS (Netherlands)

    Geenen, E.J.M. van; Santvoort, H.C. van; Besselink, M.G.; Peet, D.L. van der; Erpecum, K.J. van; Fockens, P.; Mulder, C.J.; Bruno, M.J.

    2013-01-01

    OBJECTIVES: Several randomized controlled trials studied the role of endoscopic retrograde cholangiopancreaticography (ERCP) and endoscopic sphincterotomy (ES) in acute biliary pancreatitis (ABP). No study assessed whether these trials resulted in international consensus in published meta-analyses

  5. Effect of body weight on fixed dose of diclofenac for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis

    DEFF Research Database (Denmark)

    Leerhøy, Bonna; Nordholm-Carstensen, Andreas; Novovic, Srdjan

    2016-01-01

    OBJECTIVE: The aim of this study was to assess the influence of patient body weight on the clinical effect of 100 mg diclofenac administered as a single dose for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). MATERIALS AND METHODS: All patients subjected...... to endoscopic retrograde cholangiopancreatography (ERCP) from 2009 to 2014 were evaluated for inclusion. In total, 772 patients were included of whom 378 (49%) received diclofenac prophylaxis. RESULTS: In the diclofenac prophylaxis group, body weight was higher in patients with PEP (mean ± SD: 82 ± 18 kg) than...... of 100 mg diclofenac for the prophylaxis of PEP. CONCLUSIONS: High patient body weight was associated with a reduced effect of 100 mg diclofenac for prophylaxis of PEP....

  6. Eiperimental and thermodynamic study od curve of retrograde solidus in InP-Ge quasi-binary system

    International Nuclear Information System (INIS)

    Glazov, V.M.; Pavlova, L.M.; Perederij, L.I.

    1983-01-01

    Germanium solubility in indium phosphide at different temperatures is experimentally investigated, and it is shown that the solidus curve in the portion adjoining InP is of a retrograde character. The method of radioactive tracers has been used to determine the coefficient of germanium distribution between the liquid and solid phases at a melting point of indium phosphide. Concentration dependence of the number of electrons at indium phosphide doping with germanium is investigated, and violation of the ionization equality is shown that is explained by an amphoteric character of o.ermanium behaviour in the InP base solid solution resulting in a self-compensation effect. The retrograde solidus curve in the InP-Ge system is calculated thermodynamically with the use of model representations on the composition of solid and liquid solutions. The ionization degree of doping impurity and self-compensation effect are taken account in calculation. Good agreement of the calculated and experimental data is observed

  7. Thylakoid redox signals are integrated into organellar-gene-expression-dependent retrograde signalling in the prors1-1 mutant

    Directory of Open Access Journals (Sweden)

    Luca eTadini

    2012-12-01

    Full Text Available Perturbations in organellar gene expression (OGE and the thylakoid redox state (TRS activate retrograde signalling pathways that adaptively modify nuclear gene expression (NGE, according to developmental and metabolic needs. The prors1-1 mutation in Arabidopsis down-regulates the expression of the nuclear gene Prolyl-tRNA Synthetase1 (PRORS1 which acts in both plastids and mitochondria, thereby impairing protein synthesis in both organelles and triggering OGE-dependent retrograde signalling. Because the mutation also affects thylakoid electron transport, TRS-dependent signals may likewise have an impact on the changes in NGE observed in this genotype. In this study, we have investigated whether signals related to TRS are actually integrated into the OGE-dependent retrograde signalling pathway. To this end, the chaos mutation (for chlorophyll a/b binding protein harvesting-organelle specific, which shows a partial loss of PSII antennae proteins and thus a reduction in PSII light absorption capability, was introduced into the prors1-1 mutant background. The resulting double mutant displayed a prors1-1-like reduction in plastid translation rate and a chaos-like decrease in PSII antenna size, whereas the hyper-reduction of the thylakoid electron transport chain, caused by the prors1-1 mutation, was alleviated, as determined by monitoring chlorophyll (Chl fluorescence and thylakoid phosphorylation. Interestingly, a substantial fraction of the nucleus-encoded photosynthesis genes down-regulated in the prors1-1 mutant are expressed at nearly wild-type rates in prors1-1 chaos leaves, and this recovery is reflected in the steady-state levels of their protein products in the chloroplast. We therefore conclude that signals related to photosynthetic electron transport and TRS, and indirectly to carbohydrate metabolism and energy balance, are indeed fed into the OGE-dependent retrograde pathway to modulate NGE and adjust the abundance of chloroplast proteins.

  8. Percutaneous Retrograde Recanalization of the Celiac Artery by Way of the Superior Mesenteric Artery for Chronic Mesenteric Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, George, E-mail: joseph59@gmail.com; Chacko, Sujith Thomas [Christian Medical College, Department of Cardiology (India)

    2013-02-15

    A 52-year-old man presented with recurrent postprandial abdominal pain, sitophobia, and progressive weight loss. Chronic mesenteric ischemia (CMI) due to subtotal occlusion of the superior mesenteric artery (SMA) and flush occlusion of the celiac artery (CA) was diagnosed. Retrograde recanalization of the CA by way of a collateral channel from the SMA was performed using contemporary recanalization equipment. The CA and SMA were then stented, resulting in sustained resolution of CMI-related symptoms.

  9. Piecing the Puzzle Together: The Central Role of Reactive Oxygen Species and Redox Hubs in Chloroplast Retrograde Signaling.

    Science.gov (United States)

    Leister, Dario

    2017-12-11

    Reactive oxygen species (ROS) and redox regulation are established components of chloroplast-nucleus retrograde signaling. Recent Advances: In recent years, a complex array of putative retrograde signaling molecules and novel signaling pathways have emerged, including various metabolites, chloroplast translation, mobile transcription factors, calcium, and links to the unfolded protein response. This critical mass of information now permits us to fit individual pieces into a larger picture and outline a few important stimuli and pathways. In this review, we summarize how ROS and redox hubs directly (e.g., via hydrogen peroxide [H 2 O 2 ]) and indirectly (e.g., by triggering the production of signaling metabolites) regulate chloroplast retrograde signaling. Indeed, evidence is accumulating that most of the presumptive signaling metabolites so far identified are produced directly by ROS (such as β-cyclocitral) or indirectly by redox- or ROS-mediated regulation of key enzymes in metabolic pathways, ultimately leading to the accumulation of certain precursors (e.g., methylerythritol cyclodiphosphate and 3'-phosphoadenosine 5'-phosphate) with signal function. Of the ROS generated in the chloroplast, only H 2 O 2 is likely to leave the organelle, and recent results suggest that efficient and specific transfer of information via H 2 O 2 occurs through physical association of chloroplasts with the nucleus. The impact of ROS and redox regulation on chloroplast-nucleus communication is even greater than previously thought, and it can be expected that further instances of control of retrograde signaling by ROS/redox regulation will be revealed in future, perhaps including the basis for the enigmatic GUN response and translation-dependent signals. Antioxid. Redox Signal. 00, 000-000.

  10. The use of retrograde limb of internal mammary vein in autologous breast reconstruction with DIEAP flap: anatomical and clinical study.

    Science.gov (United States)

    Al-Dhamin, Ammar; Bissell, Mary Beth; Prasad, Vani; Morris, Steven F

    2014-03-01

    It has been postulated that the abdominal skin may have either predominantly deep or superficial venous drainage. This may account for complications arising from autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEAP) flap. In this study, we evaluate the use of the retrograde limb of the internal mammary vein (IMV) as a second recipient vein in reconstructions with the DIEAP flap. In Part A, 10 IMVs were harvested from 5 fresh cadavers and the flow of methylene blue through the retrograde limb and the presence of valves were evaluated under a stereoscopic microscope.In Part B, the clinical outcomes of 38 patients who underwent single or bilateral autologous breast reconstruction using the DIEAP flap technique between January 2007 and March 2011 were reviewed. A total of 48 flaps were evaluated: 31 with single vein anastomosis and 17 with 2-vein anastomosis. In Part A, no valves were identified in the IMVs. In all 10 cadaver IMVs, there was free flow of methylene blue in both antegrade (superior) and retrograde (inferior) directions.In Part B, a retrospective analysis of the 2 patient outcomes was performed. Outcomes assessed included total flap loss, partial flap necrosis, fat necrosis, wound infection, wound dehiscence, and hematoma. Results were compared using a 2-tailed Fisher exact test with a critical P value of 0.05. No statistically significant differences between groups were identified. The retrograde limb of the IMV seems to be a safe alternate recipient vein in DIEAP and muscle sparing free TRAM autologous breast reconstruction. This study does not identify a significant reduction in overall fat necrosis or overall complications when using the 2 venous repair techniques versus the simple venous repair technique.

  11. Comparative analysis of uniplanar external fixator and retrograde intramedullary nailing for ankle arthrodesis in diabetic Charcot′s neuroarthropathy

    Directory of Open Access Journals (Sweden)

    Nakul S Shah

    2011-01-01

    Results: All five (100% patients treated by intramedullary nailing achieved radiological union on an average follow-up of 16 weeks. The external fixation group had significantly higher rate of complications with one amputation, four non unions (66.7% and a delayed union which went on to full osseous union. Conclusion: The retrograde intramedullary nailing for tibio-talar arthrodesis in Charcot′s neuroarthropathy yielded significantly better outcomes as compared to the use of uniplanar external fixator.

  12. Understanding about diagnosis of acute small bowel retrograde intussusception in adults by means of 64-slice-spinal CT

    International Nuclear Information System (INIS)

    Jiang Ruizhou; Chen Jincheng

    2009-01-01

    Objective: To have a further study of the value of MSCT in diagnosing acute small bowel retrograde intussusception in adults by means of 64-slice-spinal CT. Methods: A 46-year-old female patient with the history of abdominal operation was found having acute mechanical small bowel obstruction through plain X-ray radiograph. 64-slice MSCT was performed afterwards (plain scan + 3 stage contrast scans). Hence, evidence is provided for operation. Results: Using the technique of MSCT for the patient can promptly approach the diagnosis of jejuno-jejunal intussusception with severe bowel obstruction; no small bowel tumor or other organic lesion found in this case. With the patient who has the history of abdominal operations, MSCT can predict the reason of adhesion causing bowel intussusception, and provide the evidence for operation; whereas MSCT with contrast media offers a further investigation of the blood supply to the bowels through SMA, and observation of blood circulation through the intussuscepting site, which represents venous congestion of intussusception. This case is a retrograde small bowel intussusception and confirmed with operation evidence. A greater amount of gas and fluid is accumulated between the dilated space of middle-distal portion of intussusceptum and intussuscipiens. Nevertheless, less gas at the proximal portion and that can be an important sign for retrograde intussusception. Conclusion: MSCT is a good choice of examination for diagnosis of adult's intussusception. As the literature mentioned the advantages of MSCT for observing the circulation of intussusceptum and whether the diagnosis is antegrade or retrograde intussusception is also essential. (authors)

  13. Massive hemobilia due to hepatic arteriobiliary fistula during endoscopic retrograde cholangiopancretography: An extremely rare guidewir-related complication

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Jeong Gu; Seo, Young Woo; Hwang, Jae Cheol; Weon, Young Cheol; Kang, Byeong Seong; Bang, Sung Jo; Bang, Min Seo [Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

    2015-05-15

    Although endoscopic retrograde cholangiopancreatography (ERCP) is an effective modality for diagnosis and treatment of biliary and pancreatic diseases, the risk for procedure-related complications is high. Hemorrhage is one of major complications of ERCP. Most ERCP-associated bleeding is primarily a complication related to sphincterotomy rather than diagnostic ERCP. We are reporting a case of massive hemobilia due to hepatic arteriobiliary fistula caused by guidewire-associated injury during ERCP, which was successfully treated with transarterial embolization of the hepatic artery.

  14. Diagnostic and therapeutic endoscopic retrograde cholangiopancreaticography after Billroth II gastrectomy--safe provision in a district general hospital.

    OpenAIRE

    Swarnkar, K.; Stamatakis, J. D.; Young, W. T.

    2005-01-01

    INTRODUCTION: Endoscopic retrograde cholangiopancreaticography (ERCP) is available in many district general hospitals in the UK. Most of the published literature on ERCP in cases with Billroth II gastrectomy reflects teaching hospital experience. The aim of this study was to evaluate this procedure in the district general hospital setting, over a 10-year period. PATIENTS AND METHODS: Details of 41 consecutive patients, whom had previously undergone Billroth II gastrectomy and were referred fo...

  15. The Effect of Blocking Screws on Union of Infraisthmal Femur Fractures Stabilized with a Retrograde Intramedullary Nail.

    Science.gov (United States)

    Van Dyke, Bryan; Colley, Ryan; Ottomeyer, Christina; Palmer, Ryan; Pugh, Kevin

    2018-01-05

    To investigate the effect of blocking screws on the union rate and stability of infra-isthmal femur fractures treated with retrograde intramedullary nail (RIMN) insertion. Retrospective cohort study SETTING:: A single level 1 trauma centerPatients/Participants: All patients with an infra-isthmal femur fracture treated with a RIMN from 2005 to 2012. All fractures were treated with a RIMN. Blocking screws (BS) were used at the discretion of the treating surgeon. 1) Radiographic time to union, 2) Initial post-operative sagittal and coronal angulation, and 3) Final sagittal and coronal angulation RESULTS:: Neither the average time to union (BS 21.1 weeks vs. 21.8 weeks), nor union rates (BS 61% vs. 77%) were statistically different between blocking screw and non-blocking screw constructs. No significant alignment differences existed whether BS were used or not. In this study, we were not able to verify our hypothesis. In fact, we did not find any significant advantages when blocking screws were added to a retrograde intramedullary nail construct for distal femur fractures with respect to union time, union rate, or improvements in alignment. Additional studies are needed to determine the actual benefit of blocking screws in the treatment of infra-isthmal femoral shaft fractures treated with retrograde intramedullary nailing.

  16. Methionine restriction activates the retrograde response and confers both stress tolerance and lifespan extension to yeast, mouse and human cells.

    Directory of Open Access Journals (Sweden)

    Jay E Johnson

    Full Text Available A methionine-restricted diet robustly improves healthspan in key model organisms. For example, methionine restriction reduces age-related pathologies and extends lifespan up to 45% in rodents. However, the mechanisms underlying these benefits remain largely unknown. We tested whether the yeast chronological aging assay could model the benefits of methionine restriction, and found that this intervention extends lifespan when enforced by either dietary or genetic approaches, and furthermore, that the observed lifespan extension is due primarily to reduced acid accumulation. In addition, methionine restriction-induced lifespan extension requires the activity of the retrograde response, which regulates nuclear gene expression in response to changes in mitochondrial function. Consistent with an involvement of stress-responsive retrograde signaling, we also found that methionine-restricted yeast are more stress tolerant than control cells. Prompted by these findings in yeast, we tested the effects of genetic methionine restriction on the stress tolerance and replicative lifespans of cultured mouse and human fibroblasts. We found that such methionine-restricted mammalian cells are resistant to numerous cytotoxic stresses, and are substantially longer-lived than control cells. In addition, similar to yeast, the extended lifespan of methionine-restricted mammalian cells is associated with NFκB-mediated retrograde signaling. Overall, our data suggest that improved stress tolerance and extension of replicative lifespan may contribute to the improved healthspan observed in methionine-restricted rodents, and also support the possibility that manipulation of the pathways engaged by methionine restriction may improve healthspan in humans.

  17. Retrograde endovenous laser ablation through saphenopopliteal junctional area for incompetent small saphenous vein; Comparison with antegrade approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Seok; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Chee, Hyun Keun; Hwang, Jin Ho [Konkuk University Hospital, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    To evaluate the safety and efficacy of retrograde endovenous laser ablation (EVLA) and to compare it with the conventional antegrade EVLA for incompetent small saphenous vein (SSV). Small saphenous vein was cannulated via two approaches under ultrasound-guidance. One method involved puncturing the SSV cranially at mid-calf (the antegrade group). If the antegrade puncture into the SSV failed twice, the other approach for puncture was selected that involved puncturing the SSV toward the ankle (the retrograde group). Patients were evaluated in terms of technical and clinical success, closure rates of the SSV, and complications including pain, bruising, or paresthesia at all follow-up visits. The 1470 nm endovenous laser was used in all limbs. Technical success was seen in all limbs in both groups (100%). Closure rate in both groups showed about 95%, without significant difference (p = 0.685). Similar linear endovenous energy density was supplied during the EVLA in both groups (p = 0.876). Three frequent complications including bruising, pain, and paresthesia did not show statistical significance between groups (p = 0.465, 0.823, 1.000, respectively). Major complications were absent in both groups. The EVLA for the incompetent SSV using a retrograde approach is safe and effective and should be considered the alternative method if the antegrade access fails due to vasospasm or small SSV diameter.

  18. Retrograde endovenous laser ablation through saphenopopliteal junctional area for incompetent small saphenous vein; Comparison with antegrade approach

    International Nuclear Information System (INIS)

    Kim, Jun Seok; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Chee, Hyun Keun; Hwang, Jin Ho

    2016-01-01

    To evaluate the safety and efficacy of retrograde endovenous laser ablation (EVLA) and to compare it with the conventional antegrade EVLA for incompetent small saphenous vein (SSV). Small saphenous vein was cannulated via two approaches under ultrasound-guidance. One method involved puncturing the SSV cranially at mid-calf (the antegrade group). If the antegrade puncture into the SSV failed twice, the other approach for puncture was selected that involved puncturing the SSV toward the ankle (the retrograde group). Patients were evaluated in terms of technical and clinical success, closure rates of the SSV, and complications including pain, bruising, or paresthesia at all follow-up visits. The 1470 nm endovenous laser was used in all limbs. Technical success was seen in all limbs in both groups (100%). Closure rate in both groups showed about 95%, without significant difference (p = 0.685). Similar linear endovenous energy density was supplied during the EVLA in both groups (p = 0.876). Three frequent complications including bruising, pain, and paresthesia did not show statistical significance between groups (p = 0.465, 0.823, 1.000, respectively). Major complications were absent in both groups. The EVLA for the incompetent SSV using a retrograde approach is safe and effective and should be considered the alternative method if the antegrade access fails due to vasospasm or small SSV diameter

  19. Transfibular ankle arthrodesis using burring, curettage, multiple drilling, and fixation with two retrograde screws through a single lateral incision.

    Science.gov (United States)

    Lee, H J; Min, W K; Kim, J S; Yoon, S D; Kim, D H

    2016-04-01

    To review the outcome of 23 ankle arthrodeses using burring, curettage, multiple drilling, and fixation with 2 retrograde screws through a single lateral incision. Records of 22 consecutive patients aged 39 to 79 (mean, 62.4) years who underwent 23 ankle arthrodeses for end-stage ankle arthritis were reviewed. Through a single lateral incision, articular cartilage was removed using burring and curettage, and multiple holes were drilled using a Kirschner wire, followed by fixation with 2 retrograde screws. The resected distal fibula was fixed to the distal part of the talus and tibia. The position of the ankle and subtalar joint arthrosis was assessed by 2 orthopaedic specialists. Pre- and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) scores were evaluated. The mean operating time was 122 minutes. The mean follow-up period was 41 months. The mean postoperative ankle alignment was suboptimal: 2.7º varus, 6.7º plantar flexion, and 2.9º internal rotation. The mean AOFAS score improved from 30 to 71 (pfixation with 2 retrograde screws achieved a high union rate and acceptable functional score without serious complications.

  20. Comparison of Clinical Effects of Dexketoprofen and Paracetamol Used for Analgesia in Endoscopic Retrograde Cholangiopancreatography.

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    Akıncı, Nuran; Bakan, Nurten; Karaören, Gülşah; Tomruk, Senay Göksu; Sökmen, Hacı Mehmet; Yanlı, Yonca; Akçay, Mehmet Erdem

    2016-02-01

    This study aimed to compare 50 mg dexketoprofen vs. 1 g paracetamol that were parenterally administered before endoscopic retrograde cholangiopancreatography (ERCP) under sedoanalgesia with comparable anaesthesia depth regarding haemodynamic, pain, narcotic analgesic requirement, recovery and post-procedural cognitive functions. Overall, 80 ASA I-III patients aged 18-75 years who were undergoing scheduled ERCP were randomly assigned into three groups. In all patients, the mini-mental test (MMT) was conducted before the procedure. No drug was administered to controls (Group C; n=26); patients were transferred to ERCP unite 30 min after parenteral dexketoprofen (50 mg) in group D (n=27) and paracetamol (1 g) in group P (n=27). The standard monitoring was applied. After intravenously administering loading doses of midazolam (0.02 mgkg) and propofol (1 mg kg(-1)), propofol infusion was administered at a dose of 2-4 mg kg(-1) h(-1) to maintain a bispectral index value of 50-70. Fentanyl (0.05 μg kg(-1)) was intravenously administered when patients experienced pain. Haemodynamic effects, additional analgesic requirement, adverse effects during procedure, time to reach Aldrete score of 9 and satisfaction of an endoscopist and patient were recorded. MMT was repeated 3 h after completing the procedure. Fentanyl requirement during the procedure was significantly low in group D (pdexketoprofen provided better haemodynamic effect and pain control, thereby decreasing incidence of adverse events by reducing the requirement for narcotic analgesics.

  1. Refinement of canine pancreatitis model: inducing pancreatitis by using endoscopic retrograde cholangiopancreatography.

    Science.gov (United States)

    Ruben, Dawn S; Scorpio, Diana G; Gabrielson, K L; Simon, B W; Buscaglia, Jonathan M

    2009-02-01

    The causes and treatments of pancreatitis have been studied in diverse species, but the canine pancreatitis model has been used most often due to its similarities to the condition in humans. Although pancreatitis in dogs can be induced readily by numerous methods, managing these dogs can be difficult because they often develop severe abdominal pain, vomiting, inappetance, and lethargy. In an effort to study pancreatitis, we performed a pilot study to determine whether an endoscopic pancreatic procedure would be possible in a dog and whether, through various manipulations, a new method of inducing pancreatitis could be developed. The model uses endoscopic retrograde cholangiopancreatography (ERCP), a common procedure in human gastroenterology that has been associated with postprocedural pancreatitis. Although all 8 dogs used in developing the ERCP model had both biochemical and histologic changes consistent with pancreatitis, 7 of the 8 dogs remained free of classic clinical signs of the disease. This method is presented as a refinement of a canine model and presents an alternative method of inducing pancreatitis, with decreased risk of developing associated clinical signs.

  2. Identification of retrograde transport vesicles containing nerve growth factor in vivo

    International Nuclear Information System (INIS)

    Weible, M.W.; Sandow, S.L.; Ozsarac, N.; Hendry, I.A.; Grimes, M.L.

    2002-01-01

    Full text: Survival, differentiation, and development of responsive neurons are regulated by neurotrophins secreted from the target cells that they innervate. These responsive neurons must meet the challenge of transporting the neurotrophins chemical message from the target tissue to the soma; the distance of which may be a few millimetres to many meters. One hypothesis involves the formation of a signalling organelle at the neurite tip and subsequent retrograde axonal transport to the soma. This signalling vesicle is derived from the endocytosis of the neurotrophin-receptor complex. By modifying a method developed to isolate signalling endosomes from PC12 cells, we are able to isolate signalling vesicles from rat and mouse sciatic tissue. Approximately, 4 mole of I 125 -labelled neurotrophin was injected into the rodent foot pad and the sciatic nerve ligated under 88 μ/g ketamine and 16 μ/g rompun (i.p.) anaesthetic. All experiments had the approval of the ANU animal ethics committee. We achieved a recovery of 23% and 34% in the mouse and rat respectively of total transported iodinated neurotrophin accumulating on the distal side of the ligation. The homogenized tissue was characterized via differential centrifugation, blotted, and probed using antibodies to the neurotrophin receptors. Electron microscopy confirmed that the membrane pellet containing the transported neurotrophin from this in vivo preparation contained vesicular structures. Copyright (2002) Australian Neuroscience Society

  3. MR urography versus retrograde pyelography/ureteroscopy for the exclusion of upper urinary tract malignancy

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    Lee, K.S., E-mail: kslee@bidmc.harvard.ed [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Zeikus, E. [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); DeWolf, W.C. [Department of Surgery, Division of Urology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Rofsky, N.M.; Pedrosa, I. [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States)

    2010-03-15

    Aim: To evaluate the diagnostic performance of magnetic resonance urography (MRU) versus retrograde pyelography and/or ureteroscopy (RPU) in the detection of upper urinary tract neoplasms. Materials and methods: This retrospective study included 35 patients with suspected upper urinary tract malignancy who underwent MRU and RPU within 6-months in our institution during the study period (February 2002 to January 2007). MRU and RPU reports were reviewed and results recorded. For each patient, the urinary tract was sub-divided into four regions for analysis: left kidney/renal pelvis, left ureter, right kidney/renal pelvis, and right ureter. MRU and RPU results for each patient were compared to a reference standard and the diagnostic performance of both techniques was compared. Results: A total of 113 regions were analysed on MRU and 90 regions on RPU. Nineteen neoplasms were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for the detection of urinary tract neoplasms were 63, 91, 60, and 92% for MRU, respectively, and 53, 97, 83, and 88% for RPU, respectively. These differences were not statistically significant (p > 0.05). Conclusion: The high negative predictive value of MRU in the present series supports its use as a non-invasive screening examination for excluding the presence of upper urinary tract malignancy.

  4. Cytotoxic effects of cyanoacrylates used as retrograde filling materials: an in vitro analysis

    Directory of Open Access Journals (Sweden)

    Azevedo Cledson Lima de

    2003-01-01

    Full Text Available Cyanoacrylate has been used in medicine and dentistry for many years. It has been used as a postextraction dressing and retrograde filling material in endodontic surgery. The aim of this study was to evaluate the cytotoxic effects of Histoacryl and other two homologue ethyl cyanoacrylates, Super Bonder and Ultrabond, on cultured fibroblasts, using the Trypan blue dye exclusion assay. The cyanoacrylates were applied to round glass coverslips, which were placed in contact with NIH 3T3 cells. After 0, 6, 12 and 24 h (short-term assay; viability and 1, 3, 5 and 7 days (long-term assay; survival, the cells were examined under phase light microscopy and counted. The data were compared by the Kruskal-Wallis test. In the short-term experiments, only the cultures of the Ultrabond group (GIV presented significant smaller percentages of cell viability than the cultures of the other groups (GI: control; GII: Super Bonder; GIII: Histoacryl. Although the cultures of the Super Bonder group (GII presented smaller percentages of cell viability than cultures of the other groups (GI, GIII, GIV at the long-term assay, this group was the only experimental group presenting a continuous and progressive cell growth. Our results have shown an in vitro biocompatibility of Histoacryl and ethyl cyanoacrylate homologues. These cyanoacrylates could therefore be of importance for endodontic purposes.

  5. Bleeding risk in endoscopic retrograde cholangiopancreatography: impact of the use of antithrombotic drugs

    Directory of Open Access Journals (Sweden)

    Fernando Alberca-de-las-Parras

    Full Text Available Aims: To analyze the risk factors for hemorrhage during endoscopic retrograde cholangiopancreatography and the impact of antithrombotic drugs. Material and methods: Data sources: papers indexed in PubMed have been reviewed, as well as those found during the analysis of the bibliography of meta-analysis and reviews. Selection criteria: the references have been firstly evaluated by review of the abstract. After selecting the most significant articles (mainly randomized trials and well-designed case series these have been deeply analyzed. Evaluation of the studies and synthesis: criteria by the Oxford Centre for Evidence-Based Medicine have been used for the analysis of the references and elaboration of evidence levels. Results: Seven hundred and sixty-five references were found, 753 in PubMed and the Cochrane Library. Twelve studies were selected during the analysis of other published articles (systematic reviews, meta-analysis and clinical practice guidelines. After analyzing the title or the abstract, 655 studies were excluded. Finally, 83 high quality trials or descriptive studies have been included in the analysis. Conclusions: Seven conclusions regarding the risk factors for bleeding and the impact of antithrombotic drugs have been defined.

  6. A comparative study between pancreas scintigraphy and endoscopic retrograde pancreatic parenchymography

    International Nuclear Information System (INIS)

    Onishi, Ryuji; Yoshimoto, Shinjiro; Tadokoro, Jiro; Sugimura, Kazuo; Ushio, Keiji.

    1980-01-01

    Fifteen patients with a suspected pancreatic disease were examined by both pancreatic scintigraphy using 75 Se-selenomethionine and endoscopic retrograde pancreatic parenchymography (ERPP). These two diagnostic procedures have different mechanism of parenchymal imaging. In scintigraphy, uptake of 75 Se-selenomethionine depends on metabolic activity of the pancreatic parenchyma while in ERPP visualization of pancreatic tissue depends on patency of the pancreatic duct, permeability of the periductal tissue and cell function of the pancreatic parenchyma. In comparative study, excellent concordance of findings occurred in 11 of 15 cases. An interesting difference of finding occurred in a case of chronic pancreatitis who had marked involvement of pancreatic duct. In this case, scintigraphy visualized entire pancreas though uptake of the radioisotope was diffusely diminished, while ERPP failed to visualize the body and tail. Another interesting finding was difference of image of pancreatic body. In scintigraphy, a relatively cold area is often seen in body of the pancreas in normal subjects and explained as a result of anatomical thinning of the organ by impression of vertebra and major blood vessels. In our series, 5 cases showed such a finding in scintigraphy, while in ERPP 4 of these 5 cases showed no evidence of localized thinning of the organ. A combination of these two imaging procedures of pancreatic parenchyma with different mechanism provides more detailed anatomical and pathophysiological condition of the pancreatic diseases. (author)

  7. Pregnancy is a Risk Factor for Pancreatitis After Endoscopic Retrograde Cholangiopancreatography in a National Cohort Study.

    Science.gov (United States)

    Inamdar, Sumant; Berzin, Tyler M; Sejpal, Divyesh V; Pleskow, Douglas K; Chuttani, Ram; Sawhney, Mandeep S; Trindade, Arvind J

    2016-01-01

    There are limited data on the safety of endoscopic retrograde cholangiopancreatography (ERCP) during pregnancy, only data from observational series (approximately 350 cases) have been published. We aimed to evaluate the safety of ERCP in pregnant women by evaluating a large nationwide database. We performed a retrospective matched-cohort study, collecting data from the National Inpatient Sample from 2008 through 2009. We compared data from pregnant women who underwent ERCP (n = 907) with those from nonpregnant women who underwent ERCP (controls, n = 2721). Complications related to ERCP were measured against the matched controls. Obstetric and fetal complications were measured against the national average of all obstetric admissions. ERCP-associated complications of perforation, infection, and bleeding were infrequent in both cohorts (P > .05). Post-ERCP pancreatitis (PEP) occurred in 12% of pregnant women and in 5% of controls (P Pregnancy is an independent risk factor for PEP; PEP and PEP among pregnant women are each more prevalent in community hospitals than teaching centers. Proper precautions therefore should be considered for pregnant women undergoing ERCP, including transfer to a tertiary care center if appropriate. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  8. Effects of charge-carrying amino acids on the gelatinization and retrogradation properties of potato starch.

    Science.gov (United States)

    Chen, Wenting; Zhou, Hongxian; Yang, Hong; Cui, Min

    2015-01-15

    The objective of this study was to evaluate the effects of charge-carrying amino acids (lysine (Lys), arginine (Arg), aspartic acid (Asp) and glutamic acid (Glu)) on the gelatinization and retrogradation properties of potato starch. Acidic amino acids (Asp and Glu) showed a decreasing trend in swelling power and granule size of potato starch, but increased amylose leaching and gelatinization temperature. Alkaline amino acid (Arg) showed an increasing trend in swelling power and granule size of potato starch, but decreasing amylose leaching and gelatinization temperature. Lys had no effect on the swelling power of potato starch, except at a high content (0.2 mol/kg). Like other two acidic amino acids, Lys also increased gelatinization temperature. Moreover, the addition of alkaline amino acids (Arg) decreased syneresis value of potato starch but acidic amino acids (Asp and Glu) increased it. Compared to Arg, the syneresis of potato starch with Lys was similar to that of its native starch. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Evaluation of the effect of Retrograde Intrarenal Surgery with Myo-Inositol Oxygenase

    Science.gov (United States)

    Mertoglu, Cuma; Bozkurt, Aliseydi; Keskin, Ercüment; Gunay, Murat

    2018-01-01

    Objective: To investigate the effect of retrograde intra-renal surgery (RIRS) on kidneys using the myo-inositol oxygenase (MIOX) enzyme. MIOX is a renal tubular-specific novel marker for the early diagnosis of acute kidney injury. Methods: A total of twenty seven individuals that had undergone RIRS to treat kidney stones were included in the study. Biochemical tests were performed on serum samples collected immediately before RIRS (hour 0) and at the 6th and 24th hours after the surgery. Results: The creatinine value at hour 6 was lower than the baseline (hour 0) value (p = 0.0305). Cystatin C at hour 6 was lower than the value measured at hour 24 (p = 0.0142). Similarly, MIOX was lower at hour 6 compared to hour 24 (p = 0.0214). MIOX/creatinine at hour 6 was lower than the value calculated at hour 24 (p = 0.0348). The basal values of MIOX and creatinine were found to have a positive correlation (correlation coefficient r = 0.5946, p = 0.0035). Conclusions: Similar to the serum creatinine, the serum MIOX level provides information about kidney functions. RIRS was confirmed to be a safe procedure for the treatment of acute kidney injury with no negative effects on the kidneys. PMID:29643901

  10. NEURAL PAIN PATHWAY TRACING OF RABBIT ISCHEMIC HEART BY DOUBLE-RETROGRADE NEUROTRACING

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    Theodorus Dapamede

    2015-01-01

    Full Text Available Background. Myocardial ischaemia occurs due to inadequate supply of oxygen to fulfill the myocardial tissue oxygen demand. This leads to angina pectoris or referred pain, whichhappens because of the inability of the brain to distinguish the visceral afferent inputs from the somatic afferent inputs since they run along a common pathway via the dorsal root ganglia. Aims. This study aims to distinguish specific areas of the rabbit heart that are projected to specific dorsal root ganglia, which then associates to its specific dermatomes. Methods. A double-retrograde neurotracing method was used, with True Blue and Nuclear Yellow as the neurotracers. Rabbits were divided into 3 groups, which the first and second groups were ligated at the left anterior descending artery and at the left circumflex artery, respectively.The third group acted as the control group, without ligation.True blue was injected at ischaemic sites following ligation. Nuclear yellowwas injected at the skin, dermatomes T1-T4. Dorsal root ganglia levels T1-T4 were then examined for both neurotracers at 3 days post injection. Results. There is significant association between the site of ligation to the projection of the neurotracers at specific dorsal root ganglia (p<0.05. The first group showed high tendency to be projected to T2 and the second group showed a high tendency to project to T1. Conclusion. This study shows that the rabbit heart can be specifically projected neuronally to specific dorsal root ganglia, following coronary artery ligation.

  11. Retrograde amnesia in rats with lesions to the hippocampus on a test of spatial memory.

    Science.gov (United States)

    Winocur, Gordon; Moscovitch, Morris; Caruana, Douglas A; Binns, Malcolm A

    2005-01-01

    The present study examined remote spatial memory in a test that spans several months to determine whether remote memories are spared relative to more recent ones, as predicted by models of memory consolidation. At 3, 6 or 12 months of age, groups of rats received forced-choice training as to the location of food reward in a cross maze. At 12.5 months, rats received bilateral neurotoxic lesions to the hippocampus or a control surgical procedure and 2 weeks later their memory for the spatial location was tested. Their performance was compared to that of rats with hippocampal or control lesions with no prior training on several measures of savings. The hippocampal group with no pre-training, as expected, was severely impaired in learning the location of the food reward. Compared to this group, rats with hippocampal lesions that were pre-trained consistently performed better at the shortest training-surgery interval but not at the longer ones. That is, rats with hippocampal lesions exhibited retrograde amnesia at all training-surgery intervals and a forgetting curve that paralleled that of the control groups. The results were interpreted within a framework that distinguishes between relational and associative context, and as providing evidence that the hippocampus is necessary for the retention and retrieval of memories that are bound to relational context, regardless of the age of the memory.

  12. An unusual case of prolonged post-endoscopic retrograde cholangiopancreatography jaundice.

    Science.gov (United States)

    Tziatzios, Georgios; Gkolfakis, Paraskevas; Papanikolaou, Ioannis S; Dimitriadis, George; Triantafyllou, Konstantinos

    2016-04-01

    Despite the effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of choledocholithiasis, various complications have been described. We herein report the first case of prolonged post-ERCP jaundice due to toxicity of the contrast agent Iobitridol (®XENETIX, Guerbet, Roissy CdG Cedex, France) in a patient who underwent ERCP with sphincterectomy and common bile duct stone removal. While clinical improvement and normalization of aminotransferases and cholestatic enzymes after the procedure, an unexplained increase of direct bilirubin was noticed. A second ERCP was performed one week later, excluding possible remaining choledocholithiasis. Nevertheless, serum direct bilirubin increased further up to 15 mg/dL. Other potential causes of direct hyperbilirubinemia were ruled out and patient's liver biopsy was compatible with drug-induced liver toxicity. Additionally, the cause-result time connection between the use of Iobitridol and bilirubin increase indicated the possibility of a toxic effect related to the repeated use of the particular contrast agent. Iobitridol, a contrast agent, can induce prolonged direct hyperbilirubinemia.

  13. Diagnostic accuracy of ultrasound, computed tomography, and endoscopic retrograde choleangiopancreatography in the detection of obstructive jaundice

    International Nuclear Information System (INIS)

    Pasanen, P.A.; Partainen, K.; Pikkarainen, P.; Alhava, E.; Pirinen, A.; Janatuinen, E.

    1991-01-01

    The purpose of this prospective study was to investigate the diagnostic accuracy of ultrasound (US), computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) in the distinction between extrahepatic and intrahepatic causes of jaundice. The limit for the inclusion to the study was defined as a serum bilirubin concentration ≥40μmol/l. Altogether 187 jaundiced patients were studied. The sensitivities of US, CT and ERCP were 63%, 77%, and 87%, respectively. The differences between all these methods were statistically significant. The specificities and positive predictive values were high, reaching 96-99%, but the negative predictive values were low, ranging between 38% and 60%. Choledochal stone disease constituted the main etiology of false-negative studies in all investigations. Imaging procedures have a prominent role in the diagnostic study of the jaundiced patient, but it is obvious that their diagnostic accuracy may vary between institutions because of the variance in local experience and expertise and because of the differences in diseases causing jaundice. 37 refs., 5 tabs

  14. Comparison of ultrasound evaluation of patients of obstructive jaundice with endoscopic retrograde cholangio-pancreatography findings

    International Nuclear Information System (INIS)

    Farrukh, S.Z.U.I.; Siddiqui, A.R.; Haqqi, S.A.; Muhammad, A.J.

    2017-01-01

    Ultrasonography has proven to be quite effective in differentiating hepatocellular from obstructive cause of jaundice in various studies. This study was conducted with the aim to determine the efficacy of ultrasonography and Endoscopic Retrograde Cholangio-Pancreatography (ERCP) in the diagnosis of obstructive reason of jaundice. Methods: In this descriptive case series, 200 patients with >15 years age of either gender with cholestatic liver enzymes were included, i.e., those patients who had an ultrasound prior to ERCP at the department of gastroenterology of Patel Hospital, Karachi. Patients known to have liver disease with cholestatic jaundice had imaging other than ultrasound were excluded. The results of ultrasonography and ERCPs were compared in particularly looking for the cause of obstruction. Results: Out of total 200 patients, mean age was 41.22+-12.46 years with 107 (53.5 percent) females. Ability of ultrasound in correctly diagnosing obstructive reason for stone CBD was found to be 72.5 percent, dilated CBD without reason 41.7 percent, proximal obstruction, 63.15 percent, distal CBD obstruction 60 percent, and sludge 66.7 percent. Overall ability of ultrasound in correctly diagnosing the cause of obstruction was 64.17 percent. Conclusion: Ultrasound is recommended as the initial examination, which provides a guide to choose patients for either a more advanced non-invasive imaging like MRCP or to an invasive procedure like ERCP. (author)

  15. Mitochondria Retrograde Signaling and the UPRmt: Where Are We in Mammals?

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    Thierry Arnould

    2015-08-01

    Full Text Available Mitochondrial unfolded protein response is a form of retrograde signaling that contributes to ensuring the maintenance of quality control of mitochondria, allowing functional integrity of the mitochondrial proteome. When misfolded proteins or unassembled complexes accumulate beyond the folding capacity, it leads to alteration of proteostasis, damages, and organelle/cell dysfunction. Extensively studied for the ER, it was recently reported that this kind of signaling for mitochondrion would also be able to communicate with the nucleus in response to impaired proteostasis. The mitochondrial unfolded protein response (UPRmt is activated in response to different types and levels of stress, especially in conditions where unfolded or misfolded mitochondrial proteins accumulate and aggregate. A specific UPRmt could thus be initiated to boost folding and degradation capacity in response to unfolded and aggregated protein accumulation. Although first described in mammals, the UPRmt was mainly studied in Caenorhabditis elegans, and accumulating evidence suggests that mechanisms triggered in response to a UPRmt might be different in C. elegans and mammals. In this review, we discuss and integrate recent data from the literature to address whether the UPRmt is relevant to mitochondrial homeostasis in mammals and to analyze the putative role of integrated stress response (ISR activation in response to the inhibition of mtDNA expression and/or accumulation of mitochondrial mis/unfolded proteins.

  16. Differentiation between autoimmune pancreatitis and pancreatic carcinoma based on endoscopic retrograde cholangiopancreatography findings

    International Nuclear Information System (INIS)

    Nishino, Takayoshi; Oyama, Hiroyasu; Shiratori, Keiko; Toki, Fumitake

    2010-01-01

    We have reviewed the endoscopic retrograde cholangiopancreatography (ERCP) images of patients with autoimmune pancreatitis (AIP) and pancreatic carcinoma (Pca) in an attempt to identify findings that would facilitate making a differential diagnosis between AIP and Pca. The study cohort consisted of 39 patients diagnosed with AIP and 62 patients diagnosed with Pca. The ERCP findings in the pancreatic duct and biliary tract were compared between the two groups. The ERCP images revealed that AIP patients had a higher prevalence of narrowing of the main pancreatic duct (MPD) for ≥3 cm of its length and a higher prevalence for the presence of side branches in the narrowed portion of the MPD than Pca patients (p 5 cm of its length and the presence of side branches. Among our patient cohort, the ERCP findings in terms of the length of the narrowed portion of the MPD, the presence of side branches, and maximal diameter of the upstream MPD enabled differential diagnosis between AIP and Pca in most of the cases. However, it must be borne in mind that some Pca patients have ERCP findings similar to those of AIP patients. (author)

  17. Retrograde intrarenal surgery (RIRS) in the treatment of calyceal diverticulum with lithiasis.

    Science.gov (United States)

    Palmero, Jose Luis; Miralles, Jaume; Garau, Carmen; Nuño de la Rosa, Ines; Amoros, Araceli; Benedicto, Antonio

    2014-05-01

    To evaluate the result of retrograde intrarenal surgery (RIRS) assisted by flexible ureterorenoscopy (FURS) and Holmium laser in the treatment of lithiasis within calyceal diverticula as a minimally invasive therapeutic option. We retrospectively evaluated 11 cases of symptomatic lithiasis within calyceal diverticula treated between January 2010 and December 2011. We defined treatment success as absence of residual stones and absence/disappearance of symptomatology over the course of follow-up. We describe the RIRS technique and maneuvers for locating the diverticulum, opening the neck, and fragmenting intradiverticular lithiasis. The most frequently experienced symptom was flank pain (72.7%). The size of the lithiasis treated ranged from 7-20 mm. The overall success rate of RIRS was approximately 73% (absence of lithiasis and disappearance of symptoms) with an average follow-up of 13.3 months. Three cases were not solved by RIRS (2 due to unsuccessful location of the neck, 1 due to persistence of lithiasis and symptoms) . Cases of unsuccessful location were treated with laparoscopic surgery. RIRS assisted by FURS and Holmium laser is an effective and minimally invasive procedure for the treatment of lithiasis in the interior of the calyceal diverticulum. This treatment's efficacy improves upon the results from ESWL (extracorporeal shock wave lithotripsy( and equals that of the percutaneous method, exhibiting a lower rate of complications.

  18. Comparison between magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP)

    International Nuclear Information System (INIS)

    Pulpeiro, J. R.; Armesto, V.; Lopez-Roses, L.; Lancho, A.; Gonzalez, A.

    2000-01-01

    To assess the correlation between magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). The authors carried out a prospective study of 71 patients suspected of having biliary diseases. MRCP was performed, followed by ERCP.MRCP was done with a 1.5-T system using hypergradients, abdominal phase array coil and single-shot fast spin-echo (SSFSE) sequences with maximum signal intensity in T2-weighted images. This sequence only provides images of the fluids, similar to those obtained with ERCP. The results of ERCP were employed as a reference standard. Thirty patients were found to have stenosis (19 malignant and 11 benign). 25 had choledocholithiasis and 16 showed no abnormal findings. The correlation was complete in patients with stenosis. MRCP detected 23 cases of choledocholithiasis (ERCP was normal in the remaining two patients, but calculi were discovered on shpincterotomy). MRCP confirmed the normal condition of the bile duct in 12 of the 16 patients free of biliary disease (2 patients in whom ERCP had been normal had been diagnosed as having bile duct dilatation due to choledocholithiasis 24 hours and 10 days earlier, respectively, and two cases of presented ectasia due to fibrosis of the sphincter of Oddi showed good emptying during ERCP). MRCP using SSFSE is highly correlated with ERCP, which should be reserved for cases in which the diagnosis is in doubt or endoscopic management is necessary. (Author) 25 refs

  19. Usefulness of intraductal ultrasonography in icteric patients with highly suspected choledocholithiasis showing normal endoscopic retrograde cholangiopancreatography.

    Science.gov (United States)

    Kim, Dong Choon; Moon, Jong Ho; Choi, Hyun Jong; Chun, A Reum; Lee, Yun Nah; Lee, Min Hee; Lee, Tae Hoon; Cha, Sang Woo; Kim, Sang Gyune; Kim, Young Seok; Cho, Young Deok; Park, Sang-Heum; Lee, Hae Kyung

    2014-08-01

    Choledocholithiasis is one of the causes of jaundice and may require urgent treatment. Endoscopic retrograde cholangiopancreatography (ERCP) has been the primary management strategy for choledocholithiasis. However, small stones can be overlooked during ERCP. The aim of this study was to evaluate the accuracy of intraductal ultrasonography (IDUS) for detecting choledocholithiasis in icteric patients with highly suspected common bile duct (CBD) stones without definite stone diagnosis on ERCP. Ninety-five icteric (bilirubin ≥ 3 mg/dL) patients who underwent ERCP for highly suspected choledocholithiasis without definite filling defects on cholangiography were prospectively enrolled in the present study. We evaluated the bile duct using IDUS for the presence of stones or sludge. Reference standard for choledocholithiasis was endoscopic extraction of stone or sludge. Bile duct stones were detected with IDUS in 31 of 95 patients (32.6%). IDUS findings were confirmed by endoscopic stone extraction in all patients. The mean diameter of CBD stones detected by IDUS was 2.9 mm (range 1-7 mm). IDUS revealed biliary sludge in 24 patients (25.2%) which was confirmed by sludge extraction in 21 patients (87.5%). In dilated CBD, detection rate of bile duct stone/sludge based on IDUS was significantly higher than in non-dilated CBD (p = 0.004). IDUS is useful for the detection of occult CBD stone on ERCP in icteric patients with highly suspected CBD stones.

  20. Non-radiation endoscopic retrograde cholangiopancreatography in the management of choledocholithiasis during pregnancy.

    Science.gov (United States)

    Wu, Wenming; Faigel, Douglas O; Sun, Gang; Yang, Yunsheng

    2014-11-01

    Gallstone diseases are common during pregnancy. In most cases, patients are asymptomatic and do not require any treatment. However, choledocholithiasis, cholangitis, and gallstone pancreatitis may potentially become life-threatening for both mother and fetus and often require urgent intervention. Although endoscopic retrograde cholangiopancreatography (ERCP) has become the standard technique for removing common bile duct stones, it is associated with ionizing radiation that could carry teratogenic risk. Non-radiation ERCP (NR-ERCP) is reported to be effective without incurring this risk. Two techniques have been described to confirm bile duct cannulation: bile aspiration and image guidance. With bile aspiration, biliary cannulation is confirmed by applying suction to the cannula to yield bile, thus confirming an intrabiliary position. Image guidance involves using ultrasound or direct visualization (choledochoscopy) to confirm selective biliary cannulation or duct clearance. Once cannulation is achieved, the stones are removed using standard ERCP techniques and tools. Case series and retrospective studies have reported success rates of up to 90% for NR-ERCP with complication rates similar to standard ERCP. Pregnancy outcomes are not adversely affected by NR-ERCP, but whether the avoidance of radiation carries benefit for the baby is unknown. Prospective comparative trials are lacking. NR-ERCP is technically demanding and should be attempted only by skilled biliary endoscopists in properly equipped and staffed health-care institutions, in a multidisciplinary setting. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.