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Sample records for brachial artery median

  1. Median nerve's loop in the arm penetrated by a superficial brachial artery: case report and neurosurgical considerations

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    George K. Paraskevas

    2015-08-01

    Full Text Available Median nerve is commonly formed by the union of the lateral and medial cord of the brachial plexus, which embrace the third part of the axillary artery. Formation of a median nerve's loop is a very rare condition. We present a cadaveric case, in which the right median nerve was found at the upper arm forming a fusiform neural loop penetrated by a superficial brachial artery, which continued over the forearm as the radial artery. The literature concerning nerve loops and traversing arteries is discussed, as well as the relevant embryology. We consider that such nerve loops constitute vulnerable sites of the nerve trunk since it is compressed by the pulsation of the abnormal traversing artery. Moreover, neurosurgeons should keep in mind that in case of existing arterial variation, variation of the associated neural structures may co-exist. [Int J Res Med Sci 2015; 3(8.000: 2123-2125

  2. True aneurysm of brachial artery.

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

    2010-10-01

    True upper extremity peripheral artery aneurysms are a rarely encountered arterial disorder. Following computer-tomography angiographic (CT-a) imaging examination, true saccular aneurysm, originating from the left brachial artery was diagnosed in the 77-year-old female without history of trauma. The aneurysm was resected by surgical intervention, and primary repair of the brachial artery was performed by interposition of a part of great saphenous vein harvested from the left groin and creation of two end-to-end anastomoses between interposition graft and previously resected part of brachial artery. No complication was observed during the follow-up. Surgical intervention for upper extremity aneurysms should be initiated without delay. Factors combined with minimal morbidity associated with repair suggest that surgical repair should be performed routinely for true upper extremity arterial aneurysms. PMID:20865459

  3. PERSISTENT MEDIAN ARTERY IN THE CARPAL TUNNEL

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    Raviprasanna.K.H

    2014-09-01

    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  4. Does retraction of the sternum during median sternotomy result in brachial plexus injuries?

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    Healey, Scott; O'Neill, Bridie; Bilal, Haris; Waterworth, Paul

    2013-07-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'does retraction of the sternum during median sternotomy result in brachial plexus injuries or peripheral neuropathies?' Altogether 58 papers were found using the reported search, of which 12 represented the best evidence to answer the question. The authors, date, journal and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. Caudal placement of the retractor or relieving the pressure superiorly by removing the upper blades of a retractor (P = 0.02) and use of a caudally placed symmetrical retractor has been shown to reduce neuropathy. Positioning of the patient with 'hands up' positioning showed significant reduction in the incidence of brachial plexus injuries. Furthermore, how wide the retractor is opened and use of an asymmetrical retractor for internal mammary artery (IMA) harvesting are also important factors in quantifying risk of postoperative neuropathy. Wider sternal retraction and longer bypass time did increase the risk of developing postoperative neuropathy. Three asymmetrical retractors were looked at that demonstrates the Delacroix-Chevalier to be the safest (P retractor and using a caudally placed retractor.

  5. PERSISTENT MEDIAN ARTERY ASSOCIATED WITH SUPERFICIA L RADIAL ARTERY AT THE WRIST- A CASE REPORT

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    Jayasabarinathan

    2013-02-01

    Full Text Available ABSTRACT: Vascular variations are usually the result of deve lopmental anomaly during the formation of blood vessels in any respective part of the body. In this case a rare unilateral variation was found on the left upper limb during rou tine dissection in the Department of Anatomy. Brachial artery divided into radial artery and a common trunk. The common trunk in turn divided into ulnar, median and common inteross eous artery. The median artery was palmar type, had two proper palmar digital branches in t he palm. The radial artery had normal course in the forearm till the junction between upper two third and lower one third where it turned dorsally and reached the anatomical snuff bo x and ran superficial to the abductor pollicis longus, extensor carpi radialis brevis and extensor carpi radialis longus along the cephalic vein medially and superficial branch of radial nerve late rally. The median artery, arose from the common trunk, had pierced the median nerve about 4cm from its origin then ran along the median nerve in the forearm thereby reached the palm where it gave off two common palmar digital branches but did not anastomose with the ul nar artery hence formed incomplete superficial palmar arch. But on the right side no suc h variations found. These vascular variations have been studied in detail and their cl inical implications and embryological significance are emphasized.

  6. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

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    Su T

    2011-08-01

    Full Text Available Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited.Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD, compliance (BAC, and resistance (BAR. Fasting blood levels of glucose, lipids, lipoprotein (a, high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured.Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity.Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than

  7. Reconstruction of brachial pressure from finger arterial pressure during orthostasis

    DEFF Research Database (Denmark)

    Bogert, Lysander W J; Harms, Mark P M; Pott, Frank;

    2004-01-01

    In patients with recurrent syncope, monitoring of intra-arterial pressure during orthostatic stress testing is recommended because of the potentially sudden and rapid development of hypotension. Replacing brachial arterial pressure (BAP) by the non-invasively obtained finger arterial pressure (Fin...

  8. DOES BRACHIAL ARTERY FMD PROVIDE A BIOASSAY FOR NITRIC OXIDE?

    OpenAIRE

    Wray, D. Walter; Witman, Melissa A. H.; Ives, Stephen J.; McDaniel, John; Trinity, Joel D.; Conklin, Jamie D.; Supiano, Mark A.; Richardson, Russell S.

    2013-01-01

    This study sought to better define the role of nitric oxide (NO) in brachial artery flow-mediated vasodilation (FMD) in young, healthy humans. Brachial artery blood velocity and diameter were determined (ultrasound Doppler) in eight volunteers (26 ± 1 yrs) before and after 5-min forearm circulatory occlusion with and without intra-arterial infusion of the endothelial nitric oxide synthase (eNOS) inhibitor L-NMMA (0.48 mg/dl/min). Control (CON) and L-NMMA trials were performed with the occlusi...

  9. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults The ... Recommendation | 1 Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults Potential ...

  10. An anatomical study of double brachial arteries – a case report

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    Krstonosic B

    2010-02-01

    Full Text Available Superficial brachial artery is one of the major variations of the arterial pattern in the upper limb. During routine anatomical dissection in our department, we observed a case of unilateral double brachial artery in a formalin-fixed female cadaver.Left axillary artery entered into the anterior region of the arm, where it branched into two brachial arteries – the superficial brachial artery (SBA, which was longer, tortuous and with a smaller caliber, and the brachial artery (BA, which was placed deep and medially. In the cubital fossa, covered with an aponeurosis of the biceps brachii muscle, both brachial arteries were connected with an anastomotic vessel. Under this anastomotic branch, in the forearm, SBA continued as the radial artery, whereas BA continued as the ulnar artery.Variations of the arterial pattern in the upper limb are undoubtedly of interest to the anatomists as well as to the clinicians.

  11. RELATIONS OF ENDOTHELIAL FUNCTION AND BLOOD FLOW IN BRACHIAL ARTERY AND CORONARY ARTERY

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    孙寅光; 沈卫峰; 施仲伟; 张大东

    2003-01-01

    Objective To determine the relations between endothelium dependent vasodilator function and blood flow in the brachial and coronary arteries in patients with suspected coronary artery disease.MethodsTwenty eight patients with suspected coronary artery disease underwent brachial artery endothelial function test by using high resolution B mode ultrasound before coronary angiography (CAG) and coronary flow reserve (CFR) test by using intracoronary Doppler technique. The correlation of coronary artery dilatation induced by an increase in blood flow after intracoronary adenosine infusion and brachial artery flow mediated dilatation (FMD) following reactive hyperemia was evaluated. The relation between the change of brachial artery blood flow and CFR was also studied.ResultsThere was a positive correlation between brachial FMD and percent change of coronary diameter after adenosine infusion (12.50%±9.35% vs 11.38%±7.55%, r=0.425,P=0.02). There was also a weak negative relation between brachial flow change following reactive hyperemia and CFR (r=0.397, P=0.04).ConclusionThere is a correlation between the coronary endothelial function and the CFR by ultrasonic determination of brachial flow changes following reactive hyperemia.

  12. Delayed presentation of a traumatic brachial artery pseudoaneurysm.

    LENUS (Irish Health Repository)

    Forde, James C

    2009-09-01

    Delayed presentation of a brachial artery pseudoaneurysm following penetrating trauma is infrequently reported. We report the case of a 23-year-old male who presented three months following a penetrating trauma to his antecubital fossa with a sudden exacerbation of swelling and tenderness of his elbow. Doppler ultrasound and computed tomography arteriography confirmed the presence of a large pseudoaneurysm. Surgical reconstruction was performed using the long saphenous vein as an interposition vein graft, restoring normal arterial circulation.

  13. Occult rib fractures and brachial plexus injury following median sternotomy for open-heart operations.

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    Baisden, C E; Greenwald, L V; Symbas, P N

    1984-09-01

    The incidence and the sites of rib fractures during open-heart operations through a median sternotomy incision were studied in 36 consecutive patients divided into two groups. In Group 1 (24 patients), a conventional Ankeney retractor was used to expose the heart, and in Group 2 (12 patients), a similar retractor was used but with its uppermost pair of blades removed. Thorough physical examinations and preoperative and postoperative chest roentgenograms were obtained, and postoperative bone scans were done in all patients. No rib fractures were detected on the routine chest roentgenograms in patients in either group. Bone scans, however, showed 44 rib fractures (15 of the first rib, 13 of the second rib, 4 of the third rib, 6 of the fourth rib, 3 of the fifth rib, and 3 of the sixth rib) in 16 patients in Group 1. Six patients in Group 2 had 9 rib fractures (2 of the first rib, 4 of the second rib, and 1 each of the third, fifth, and sixth ribs). None of the patients in Group 2 had brachial plexus injury and neither of the first rib fractures in this group were located posteriorly, whereas 3 patients in Group 1 had both brachial plexus injury and posterior first rib fractures.

  14. Differences in brachial and femoral artery responses to prolonged sitting

    OpenAIRE

    Thosar, Saurabh S.; Bielko, Sylvanna L.; Wiggins, Chad C.; Wallace, Janet P

    2014-01-01

    Introduction It is unknown if there are limb differences in vascular function during prolonged sitting. Purpose This study was designed to test whether the effects of prolonged sitting on brachial artery (BA) and the superficial femoral artery (SFA) are similar. Methods Twelve men (24.2 ± 4 yrs.) participated in a 3 hr prolonged sitting trial (SIT). SFA and BA flow mediated dilation (FMD) and respective flow patterns were measured at baseline, 1 hr, 2 hr and 3 hr. Results By a one-way ANOVA t...

  15. Brachial artery injury following opened elbow dislocation associated with accessory brachial artery: two rare entities in a 17-year –old girl: case report

    OpenAIRE

    Hajji, Rita; Zrihni, Youssef; Naouli, Hamza; Bouarhroum, Abdellatif

    2015-01-01

    Elbow dislocations are the most frequently encountered after shoulder dislocations. In their vast majority, these injuries carry a good prognosis. Although, concomitant arterial injury is rare and make them more serious. In this paper, we report a case of a 17 year old woman with opened elbow dislocation with arterial injury associated to an artery variation: "accessory brachial artery"

  16. Iatogenic pseudoaneurysm of the brachial artery in a child

    International Nuclear Information System (INIS)

    Arterial aneurysms are rarely encountered in children. When they are, the existence of an underlying disease or a history of previous infection or trauma should be suspected since the majority them are acquired. Pseudo aneurysms or false aneurysms are a consequence of the rupture of the arterial wall after accidental injury or a iatrogenic lesion. We present a case of a pseudoaneurysm of the brachial artery secondary to repeated attempts at venipuncture in a 3-month-old infant. We show the plain radiography and duplex Doppler color Doppler ultrasound findings which, in the clinical context of the patient, were sufficient for diagnosis, making it unnecessary to perform arteriography prior to surgical treatment. (Author) 9 refs

  17. Relationship of sonographic wall components of the brachial artery to hypertension and coronary atherosclerosis

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    Frick, Matthias; Alber, Hannes F; Rinner, Alexander; Suessenbacher, Alois; Ulmer, Hanno; Schwarzacher, Severin P; Pachinger, Otmar; Weidinger, Franz

    2005-01-01

    Abstract The aim of this study was to determine whether sonographically assessed intimal (echodense, ED) or medial (echolucent, EL) thickening of the brachial artery is associated with coronary artery disease (CAD) and/or arterial hypertension (HT). In 201 patients the ED and EL wall components, as well as the total wall thickness of the brachial artery, were measured with high-resolution ultrasound (13 MHz). According to the presence or absence of CAD and HT, the patients were div...

  18. Morphological Assessment of Cadaveric Radial, Brachial and Subclavian Arteries: A Neurointerventional Approach

    Science.gov (United States)

    Yilmaz, Ali; Ozkul, Ayca; Shin, Dong Seong; Im, Soo-Bin; Yoon, Seok-Mann

    2015-01-01

    Objective The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. Methods Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured. Results The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was 13.41±2.19 mm, and the RSP was 26.85±2.47 mm from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as 44.23±5.47 mm, whereas the distance between the ME and the MN was 42.23±4.77 mm. The average VAO-ScA angle was 70.94±6.12°, and the length between the ScA junction (SCJ) and the VAO was 60.30±8.48 mm. Conclusion This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients. PMID:26819682

  19. Difference in carotid artery elasticity in subjects with different brachial artery kinetic of vasodilatation.

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    Tripolino, C; Gnasso, A; Carallo, C; Scavelli, F B; Irace, C

    2016-08-01

    Increased carotid stiffness and impaired brachial artery flow-mediated dilatation (FMD) associate with cardiovascular events. We have previously reported three FMD patterns based on the time of maximal dilatation. The aim of the present study was to verify whether different FMD patterns associate with carotid artery stiffness. In all, 133 subjects were enrolled. All participants underwent complete clinical examination, blood sampling and ultrasound study. FMD was used as a measure of endothelial function. Based on the maximal brachial artery FMD, subjects were divided into Early dilators (peak FMD at 50 s), Late dilators (peak FMD over 50 s) and No dilators. Echo-Doppler evaluation of carotid arteries was performed in order to calculate elastic indexes (strain, β-stiffness index and distensibility). In all, 64 subjects were classified as Early FMD, 36 as Late FMD and 33 as No dilators. Age, gender and cardiovascular risk factors were comparable among three groups. Early FMD had higher values of strain compared with both Late and no Dilators (PFMD and No Dilators were detected. Our results demonstrate that common carotid artery elasticity indexes significantly differ among Early, Late and No dilators. Subjects with delayed or absent brachial artery dilatation have stiffer common carotid arteries compared with subjects with early dilatation. In conclusion, our research suggests that the assessment of the kinetics of FMD in a clinical setting might represent a useful screening tool to improve the cardiovascular risk stratification. PMID:26467820

  20. Amlodipine induces a flow and pressure-independent vasoactive effect on the brachial artery in hypertension.

    OpenAIRE

    Megnien, J L; Levenson, J.; Del-Pino, M; Simon, A

    1995-01-01

    1. The objectives of this study were to study the flow-dependent arterial reactivity and pressure-independent arterial compliance of the calcium antagonist amlodipine in hypertensive men. 2. Twenty-one hypertensive patients were randomized to receive 2 months treatment with placebo (n = 10) or 5-10 mg amlodipine (n = 11) once a day. Non-invasive measurement of brachial artery mean blood pressure, diameter and flow (pulsed Doppler) and compliance (arterial mechanography and logarithmic elastic...

  1. Acute Brachial Artery Thrombosis in a Neonate Caused by a Peripheral Venous Catheter

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    Simon Berzel

    2014-01-01

    Full Text Available This case describes the diagnostic testing and management of an acute thrombosis of the brachial artery in a female neonate. On day seven of life, clinical signs of acutely decreased peripheral perfusion indicated an occlusion of the brachial artery, which was confirmed by high-resolution Doppler ultrasound. Imaging also showed early stages of collateralization so that surgical treatment options could be avoided. Unfractionated heparin was used initially and then replaced by low-molecular-weight heparin while coagulation parameters were monitored closely. Within several days, brachial artery perfusion was completely restored. Acetylsalicylic acid was given for additional six weeks to minimize the risk of recurring thrombosis. If inadequately fixated in a high-risk location, a peripheral venous catheter can damage adjacent structures and thus ultimately cause arterial complications.

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

    Science.gov (United States)

    Hudorovic, Narcis; Lovricevic, Ivo; Ahel, Zaky

    2010-07-01

    The need to bypass to the brachial artery is rare. Over a five-year period, 16 patients had suffered iatrogenic post-catheterization injuries of the upper extremity. We have performed 16 bypasses, in 16 patients, mean age was 65 years (range 47-75), to the brachial artery originating from an artery proximal to the shoulder joint. In all cases, the axillary artery was the donor artery. All bypasses were created by using the cephalic vein with the in situ technique and distal anastomoses were made to a distance-free section of brachial artery. No operative mortality, neurological complications or major upper-extremity amputation was associated with the procedure. Life-long-conduit analysis showed 75% patency in the five-year period. After iatrogenic post-catheterization trauma of arterial system of upper extremity, bypasses from axillary to brachial artery with the cephalic vein with the in situ technique is a safe operation with satisfactory long-term patency. PMID:20395248

  3. Formation of median nerve without the medial root of medial cord and associated variations of the brachial plexus

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    Bhanu SP

    2010-02-01

    Full Text Available The anatomical variations in the formation, course and termination of brachial plexus are well documented and have clinical significance to surgeons, neurologists and anatomists. The present case report describes the unusual origin of median nerve, arising directly from the lateral cord without the union of lateral and medial roots of brachial plexus. A communicating branch existed between the ulnar nerve and anterior division of middle trunk. The lateral pectoral nerve was arising from anterior divisions of upper and middle trunks as two separate branches instead from lateral cord. The branches then joined together to form the lateral pectoral nerve. The medial cord instead of its five terminal branches, had only three branches, the ulnar nerve, medial pectoral nerve and a single trunk for the medial cutaneous nerve of arm and forearm which got separated at the middle of the arm. The variations of the lateral cord and its branches make it a complicated clinical and surgical approach which is discussed with the developmental background.

  4. A persisting median artery in a patient with symbrachydactyly and carpal tunnel syndrome.

    Science.gov (United States)

    Tollan, C J; Sivarajan, V

    2008-07-01

    A persisting median artery associated with carpal tunnel syndrome in a patient with symbrachydactyly has not been previously described in the literature. It is unclear whether there may be a developmental association between persistence of a median artery and Symbrachydactyly.

  5. Iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus:A rare injury

    Institute of Scientific and Technical Information of China (English)

    Kumar Vishal; R.H.H.Arjun; Aggarwal Sameer; John Rakesh; Kishan Rama

    2015-01-01

    Complications following supracondylar fracture of humerus are well-known.Pre-and post-operative complications have been documented in the literature.Neurovascular injury due to fracture fragments following this type of fracture is described,Iatrogenic brachial artery during surgical treatment of this fracture is unknown to the literature.So we report a rare case of iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus and try to create awareness to the surgeons that such injuries can occur with improper operative techniques.

  6. A case of elbow hyperextension leading to complete brachial artery rupture

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    David Huw G

    2007-03-01

    Full Text Available Abstract Background To our knowledge there are no cases in the literature of traumatic vascular injury of the brachial artery by elbow hyperextension without elbow dislocation based on either clinical or radiological evidence. Case presentation We present the first case of complete brachial artery rupture resulting from a hyperextension injury to an elbow, without dislocation. The history, early assessment and operative treatment with figures are presented. Conclusion We advocate prompt clinical assessment by orthopaedic and vascular teams and early surgical exploration and repair.

  7. Five Roots Pattern of Median Nerve Formation

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    Konstantinos Natsis

    2016-04-01

    Full Text Available An unusual combination of median nerve’s variations has been encountered in a male cadaver during routine educational dissection. In particular, the median nerve was formed by five roots; three roots originated from the lateral cord of the brachial plexus joined individually the median nerve’s medial root. The latter (fourth root was united with the lateral (fifth root of the median nerve forming the median nerve distally in the upper arm and not the axilla as usually. In addition, the median nerve was situated medial to the brachial artery. We review comprehensively the relevant variants, their embryologic development and their potential clinical applications.

  8. Reactivity to low‐flow as a potential determinant for brachial artery flow‐mediated vasodilatation

    OpenAIRE

    Aizawa, Kunihiko; Elyas, Salim; Adingupu, Damilola D.; Casanova, Francesco; Gooding, Kim M.; Strain, W. David; Shore, Angela C.; Gates, Phillip E.

    2016-01-01

    Abstract Previous studies have reported a vasoconstrictor response in the radial artery during a cuff‐induced low‐flow condition, but a similar low‐flow condition in the brachial artery results in nonuniform reactivity. This variable reactivity to low‐flow influences the subsequent flow‐mediated dilatation (FMD) response following cuff‐release. However, it is uncertain whether reactivity to low‐flow is important in data interpretation in clinical populations and older adults. This study aimed...

  9. [Transradial percutaneous approach for cardiac catheterization in patients with previous brachial artery cutdown].

    Science.gov (United States)

    Magariños, Eduardo; Solioz, Germán; Cermesoni, Gabriel; Koretzky, Martín; Carnevalini, Mariana; González, Daniel

    2013-01-01

    The percutaneous punction of the radial artery for catheterization procedures has gained acceptance lately. This was a consequence of achieving results similar to the femoral approach, with the benefits of a lower rate of complications and increased comfort for the patients post procedure. Recently it has gained an additional impulse with the better prognosis obtained in acute coronary syndromes. In this trial we have evaluated if the feasibility, results and advantages related with the use of the radial artery percutaneous approach to perform catheterization procedures, continues when used in patients who have had a previous brachial artery cutdown. Out of a total of 1356 percutaneous radial accesses, 53 were in patients with previous brachial artery cutdown. Through this access 71 catheterization procedures were performed, achieving access success in 96.2% (51/53) of the punctions. Once the access success was obtained, 93.6% (44/47) of the diagnostic procedures and 100% (24/24) of the therapeutics procedures were successful. During hospitalization, in this group of patients, no major adverse cardiac events occurred and there was a 1.4% (1/71) rate of minor events. At seven days follow up, no new complications were recorded. Although this is a small group, we believe that it is enough to show that percutaneous punctions of the radial artery to perform catheterization procedures, in patients with previous brachial artery cutdown, are feasible, allowing high access and procedure success rates, with a low frequency of complications.

  10. Stenting of Variant Left Carotid Artery Using Brachial Artery Approach in a Patient with Unusual Type of Bovine Aortic Arch

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    Emre Gürel

    2016-01-01

    Full Text Available Bovine aortic arch is the most frequently encountered variation in human aortic arch branching. A 63-year-old Asian male presented with symptomatic severe stenosis of left carotid artery originating from the brachiocephalic trunk. Selective engagement to the left carotid artery was unsuccessful using transfemoral approach. We reported on a successful left carotid artery stenting case using right brachial artery approach in a bovine aortic arch. This paper is worthy of reporting in terms of guiding physicians for interventional procedures in these types of challenging cases.

  11. latrogenic brachial artery injury during anterolateral plating of humeral shaft fracture

    Institute of Scientific and Technical Information of China (English)

    Vishal Kumar; Prateek Behera; Sameer Aggarwal; Umesh Kumar Meena

    2013-01-01

    There are several well defined indications for surgical management of humeral shaft fractures.Operative procedures on the humerus are associated with their own complications.Iatrogenic brachial artery injury as a complication of humeral shaft plating has not been reported previously.We report a case of a 48 years old femalewho received operation at a district hospital and was referred to us when the surgeon could not palpate the pulse.CT angiogram showed that there was segmental non-opacification of the brachial artery.There was distal reformation and the thrombosis was decided to be managed conservatively.We believe that the arterial injury was a result ofimproper surgical technique and the segmental block might be due to improper use of plate holding forceps.This case report makes us aware of a rare complication of operative management of humeral shaft fractures and that basic principles of surgery must be always followed to prevent such injuries.

  12. Brachial Artery Responses to Ambient Pollution, Temperature, and Humidity in People with Type 2 Diabetes: A Repeated-Measures Study

    OpenAIRE

    Zanobetti, Antonella; Luttmann-Gibson, Heike; Horton, Edward S.; Cohen, Allison; Coull, Brent A.; Hoffmann, Barbara; Schwartz, Joel D; Mittleman, Murray A.; Li, Yongsheng; Stone, Peter H.; de Souza, Celine; Lamparello, Brooke; Koutrakis, Petros; Gold, Diane R.

    2014-01-01

    Background: Extreme weather and air pollution are associated with increased cardiovascular risk in people with diabetes. Objectives: In a population with diabetes, we conducted a novel assessment of vascular brachial artery responses both to ambient pollution and to weather (temperature and water vapor pressure, a measure of humidity). Methods: Sixty-four 49- to 85-year-old Boston residents with type 2 diabetes completed up to five study visits (279 repeated measures). Brachial artery diamete...

  13. Correlation of Arterial Stiffness and Bone Mineral Density by Measuring Brachial-Ankle Pulse Wave Velocity in Healthy Korean Women

    OpenAIRE

    Kim, Nam-Lee; Suh, Heuy-Sun

    2015-01-01

    Background An association between arterial stiffness and osteoporosis has previously been reported. Therefore, we investigated the relationship between arterial stiffness, measured by brachial-ankle pulse wave velocity, and bone mineral density in a sample of healthy women undergoing routine medical checkup. Methods We retrospectively reviewed the medical charts of 135 women who had visited the Health Promotion Center (between May 2009 and December 2012). Brachial-ankle pulse wave velocity wa...

  14. Measuring FMD in the brachial artery: how important is QRS gating?

    OpenAIRE

    Kizhakekuttu, Tinoy J.; Gutterman, David D.; Phillips, Shane A.; Jurva, Jason W.; Arthur, Emily I. L.; Das, Emon; Widlansky, Michael E.

    2010-01-01

    Recommendations for the measurement of brachial flow-mediated dilation (FMD) typically suggest images be obtained at identical times in the cardiac cycle, usually end diastole (QRS complex onset). This recommendation presumes that inter-individual differences in arterial compliance are minimized. However, published evidence is conflicting. Furthermore, ECG gating is not available on many ultrasound systems; it requires an expensive software upgrade or increased image processing time. We teste...

  15. Brachial artery injury due to closed posterior elbow dislocation: case report☆

    Science.gov (United States)

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; do Val Sella, Guilherme; Checchia, Caio Santos; Checchia, Sergio Luiz

    2016-01-01

    An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided. This consists of joint reduction and immobilization, along with urgent surgical restoration of arterial flow. Here, a case (novel to the Brazilian literature) of an association between these injuries (and the treatment implemented) in a 27-year-old male patient is reported. These injuries were sustained through physical assault. PMID:27069896

  16. Brachial artery injury due to closed posterior elbow dislocation: case report☆

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2016-04-01

    Full Text Available An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided. This consists of joint reduction and immobilization, along with urgent surgical restoration of arterial flow. Here, a case (novel to the Brazilian literature of an association between these injuries (and the treatment implemented in a 27-year-old male patient is reported. These injuries were sustained through physical assault.

  17. Ankle Brachial Index: simple non-invasive estimation of peripheral artery disease

    Science.gov (United States)

    Pieniak, Marcin; Cieślicki, Krzysztof; Żyliński, Marek; Górski, Piotr; Murgrabia, Agnieszka; Cybulski, Gerard

    2014-11-01

    According to international guidelines, patients with Peripheral Artery Disease (PAD) are burdened with high cardiovascular risk. One of the simplest, non-invasive methods for PAD detection is the ankle-brachial index (ABI) measurement. The ABI is calculated as the ratio of systolic blood pressure at the ankle (pressure in the posterior tibial artery or the dorsal artery) to the systolic pressure in the arm (in the brachial artery) when the body is in a horizontal position. The physiological value of the ABI is assumed to be between 1 and 1.3; however, these limits vary from study to study. A value less than 0.9 indicates PAD. Some authors propose also measuring the ABI on both sides of the body to highlight possible differences in blood pressure between the opposite arterial segments. The aim of this study was to perform a meta-analysis of the ABI diagnostic criteria used in different publications. Additionally, ABI measurements were performed on 19 healthy patients in age ranged from 20 to 63 years. The results showed a slight dependence between age and the differences between the values obtained from left and right sides of the body.

  18. Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Cary, Theodore W.; Sultan, Laith R.; Sehgal, Chandra M., E-mail: sehgalc@uphs.upenn.edu [Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Reamer, Courtney B.; Mohler, Emile R. [Department of Medicine, Division of Cardiovascular Medicine, Section of Vascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States)

    2014-02-15

    Purpose: To use feed-forward active contours (snakes) to track and measure brachial artery vasomotion on ultrasound images recorded in both transverse and longitudinal views; and to compare the algorithm's performance in each view. Methods: Longitudinal and transverse view ultrasound image sequences of 45 brachial arteries were segmented by feed-forward active contour (FFAC). The segmented regions were used to measure vasomotion artery diameter, cross-sectional area, and distention both as peak-to-peak diameter and as area. ECG waveforms were also simultaneously extracted frame-by-frame by thresholding a running finite-difference image between consecutive images. The arterial and ECG waveforms were compared as they traced each phase of the cardiac cycle. Results: FFAC successfully segmented arteries in longitudinal and transverse views in all 45 cases. The automated analysis took significantly less time than manual tracing, but produced superior, well-behaved arterial waveforms. Automated arterial measurements also had lower interobserver variability as measured by correlation, difference in mean values, and coefficient of variation. Although FFAC successfully segmented both the longitudinal and transverse images, transverse measurements were less variable. The cross-sectional area computed from the longitudinal images was 27% lower than the area measured from transverse images, possibly due to the compression of the artery along the image depth by transducer pressure. Conclusions: FFAC is a robust and sensitive vasomotion segmentation algorithm in both transverse and longitudinal views. Transverse imaging may offer advantages over longitudinal imaging: transverse measurements are more consistent, possibly because the method is less sensitive to variations in transducer pressure during imaging.

  19. Short- and long-term influence of diet and simvastatin on brachial artery endothelial function

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Petersen, Knud Erik;

    2006-01-01

    as well as short- and long-term effect of simvastatin on EDD in patients with hypercholesterolemia and ischemic heart disease. METHODS: In 43 male patients with hypercholesterolemia and ischemic heart disease, EDD of the brachial artery was measured at baseline, after 3 months on a lipid-lowering diet......BACKGROUND: Endothelium-dependent dilation (EDD) has often been studied in patients with hypercholesterolemia without overt coronary atherosclerosis where an improvement after statin treatment has been documented within few weeks. The aim of the study was to assess the short-term effect of diet...

  20. Nerve transfer for treatment of brachial plexus injury:comparison study between the transfer of partial median and ulnar nerves and that of phrenic and spinal accessary nerves

    Institute of Scientific and Technical Information of China (English)

    侯之启; 徐中和

    2002-01-01

    Objective:To compare the effect of using partial median and ulnar nerves for treatment of C5-6 orC5-7 avulsion of the brachial plexus with that of using phrenic and spinal accessary nerves.Methods:The patients were divided into 2groups randomly according to different surgical procedures.Twelve cases were involved in the first group.The phrenic nerve was transferred to the musculocutaneous nerve or through a sural nerve graft,and the spinal accessary nerve was to the suprascapular nerve.Eleven cases were classified into the second group.A part of the fascicles of median nerve was transferred to be coapted with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to the axillary nerve.The cases were followed up from 1to 3years and the clinical outcome was compared between the two groups.

  1. Nerve transfer for treatment of brachial plexus injury: comparison study between the transfer of partial median and ulnar nerves and that of phrenic and spinal accessary nerves

    Institute of Scientific and Technical Information of China (English)

    侯之启; 徐中和

    2002-01-01

    Objective: To compare the effect of using partial median and ulnar nerves for treatment of C5-6 or C5-7 avulsion of the brachial plexus with that of using phrenic and spinal accessary nerves.Methods: The patients were divided into 2 groups randomly according to different surgical procedures. Twelve cases were involved in the first group. The phrenic nerve was transferred to the musculocutaneous nerve or through a sural nerve graft, and the spinal accessary nerve was to the suprascapular nerve. Eleven cases were classified into the second group. A part of the fascicles of median nerve was transferred to be coapted with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to the axillary nerve. The cases were followed up from 1 to 3 years and the clinical outcome was compared between the two groups. Results: There were 2 cases (16.6%) who got the recovery of M4 strength of biceps muscle in the first group but 7 cases (63.6%) in the second group, and the difference was statistically significant (P<0.025). However, it was not statistically different in the recovery of shoulder function between the two groups. Conclusions: Partial median and ulnar nerve transfer, phrenic and spinal accessary nerve transfer were all effective for the reconstruction of elbow or shoulder function in brachial plexus injury, but the neurotization using a part of median nerve could obtain more powerful biceps muscle strength than that of phrenic nerve transfer procedure.

  2. Exercise intensity modulates brachial artery retrograde blood flow and shear rate during leg cycling in hypoxia.

    Science.gov (United States)

    Iwamoto, Erika; Katayama, Keisho; Ishida, Koji

    2015-06-01

    The purpose of this study was to elucidate the effect of exercise intensity on retrograde blood flow and shear rate (SR) in an inactive limb during exercise under normoxic and hypoxic conditions. The subjects performed two maximal exercise tests on a semi-recumbent cycle ergometer to estimate peak oxygen uptake (V˙O2peak) while breathing normoxic (inspired oxygen fraction [FIO2 = 0.21]) and hypoxic (FIO2 = 0.12 or 0.13) gas mixtures. Subjects then performed four exercise bouts at the same relative intensities (30 and 60% V˙O2peak) for 30 min under normoxic or hypoxic conditions. Brachial artery diameter and blood velocity were simultaneously recorded, using Doppler ultrasonography. Retrograde SR was enhanced with increasing exercise intensity under both conditions at 10 min of exercise. Thereafter, retrograde blood flow and SR in normoxia returned to pre-exercise levels, with no significant differences between the two exercise intensities. In contrast, retrograde blood flow and SR in hypoxia remained significantly elevated above baseline and was significantly greater at 60% than at 30% V˙O2peak. We conclude that differences in exercise intensity affect brachial artery retrograde blood flow and SR during prolonged exercise under hypoxic conditions. PMID:26038470

  3. Prediction of preeclampsia by means of Doppler flowmetry of uterine artery and flow-mediated dilation of brachial artery

    Directory of Open Access Journals (Sweden)

    Aline Costa Calixto

    2014-02-01

    Full Text Available Objective To evaluate the association of Doppler of uterine artery and flow-mediated dilation of brachial artery (FMD in the assessment of placental perfusion and endothelial function to predict preeclampsia. Materials and Methods A total of 91 patients considered as at risk for developing preeclampsia were recruited at the prenatal unit of the authors' institution. All the patients underwent FMD and Doppler of uterine arteries between their 24th and 28th gestational weeks. Calculations of sensitivity and specificity for both isolated and associated methods were performed. Results Nineteen out of the 91 patients developed preeclampsia, while the rest remained normotensive. Doppler flowmetry of uterine arteries with presence of bilateral protodiastolic notch had sensitivity of 63.1% and specificity of 87.5% for the prediction of preeclampsia. Considering a cutoff value of 6.5%, FMD showed sensitivity of 84.2% and specificity of 73.6%. In a parallel analysis, as the two methods were associated, sensitivity was 94.2% and specificity, 64.4%. Conclusion The association of Doppler study of uterine arteries and FMD has proved to be an interesting clinical strategy for the prediction of preeclampsia, which may represent a positive impact on prenatal care of patients considered as at high-risk for developing such a condition.

  4. Impact of volunteer-related and methodology-related factors on the reproducibility of brachial artery flow-mediated vasodilation

    NARCIS (Netherlands)

    Mil, van Anke C.C.M.; Greyling, Arno; Zock, Peter L.; Geleijnse, Marianne; Hopman, Maria T.; Mensink, Ronald P.; Reesink, Koen D.; Green, Daniel J.; Ghiadoni, Lorenzo; Thijssen, Dick H.

    2016-01-01

    Objectives: Brachial artery flow-mediated dilation (FMD) is a popular technique to examine endothelial function in humans. Identifying volunteer and methodological factors related to variation in FMD is important to improve measurement accuracy and applicability. Methods: Volunteer-related and me

  5. Oxidized low-density lipoprotein and ankle-brachial pressure index in patients with clinically evident peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Ruben Miguel Ayzin Rosoky

    2010-01-01

    Full Text Available OBJECTIVES: To investigate whether oxidized low-density lipoprotein is a suitable predictor of peripheral arterial disease severity. The role of oxidized low-density lipoprotein in the pathogenesis of atherosclerosis has already been investigated. Its relevance as a predictor of the appearance and worsening of coronary arterial disease is also well known. However, the same is not true regarding peripheral arterial disease. METHOD: Eighty-five consecutive patients with an ankle-brachial pressure index (ABPI < 0.9 and the presence of either intermittent claudication or critical lower leg ischemia were included. The plasma level of IgG autoantibodies against oxidized low-density lipoprotein was evaluated through an enzyme-linked immunosorbent assay. The results were categorized into quartiles according to the ankle-brachial pressure index (a marker of peripheral arterial disease severity, and significant differences were investigated with the Kruskal-Wallis test. RESULTS: There was no significant difference between the quartiles for this population (p = 0.33. No correlation was found between the ankle-brachial pressure index and oxidized low-density lipoprotein levels in subjects with clinically evident peripheral arterial disease with a wide range of clinical manifestations. CONCLUSIONS: Oxidized low-density lipoprotein is not a good predictor of peripheral arterial disease severity.

  6. A correlation study between ankle brachial pressure index and the severity of coronary artery disease.

    Science.gov (United States)

    Benyakorn, Thoetphum; Kuanprasert, Sarun; Rerkasem, Kittipan

    2012-06-01

    Previous studies have shown that there was a correlation between low ankle brachial pressure index (ABPI) and the presence of the coronary artery disease (CAD). However, few studies have investigated the correlation between ABPI and the severity of CAD by using a scoring system. The authors aimed to investigate this correlation by using ABPI and CAD diagnosed by coronary angiography (CAG). A total of 213 consecutive patients awaiting CAG in Maharaj Nakorn Chiang Mai Hospital from July 2009 to November 2009 were enrolled in this study. The ABPI was measured before CAG. The severity of CAD was graded on CAG by using SYNTAX scores. The authors found a significantly negative correlation between ABPI and SYNTAX scores (correlation coefficient = -.172, P = .01). The authors concluded that ABPI appeared to correlate negatively with the severity of CAD in the Thai population. PMID:22561522

  7. Comparing Two Ovulation Induction Methods by Brachial Artery Ultrasonography in Infertile Women with Polycystic Ovary Syndrome

    Directory of Open Access Journals (Sweden)

    B Ghorbani Yekta

    2012-07-01

    Full Text Available Background: Endothelial dysfunction can influence fertility rate in women with polycystic ovary syndrome (PCOS as flow mediated dilatation (FMD is impaired in patients with the disease. The aim of this study was to compare two methods of ovulation induction by letrozole or letrozole plus human menopausal gonadotropins (HMGs in infertile women with PCOS who were resistant to clomiphene citrate based on brachial artery ultrasound findings.Methods: In this double -blind randomized clinical trial, 59 infertile women who had the inclusion criteria for PCOS were evaluated in the Infertility Clinic of Shariati Hospital in Tehran, Iran in 2010-2011. The patients were assigned to two letrozole and letrozole plus HMG groups and were evaluated for FMD in the brachial artery by transvaginal ultrasonography. Later, the values were recorded and analyzed statistically.Results: In the letrozole group, infertility treatment was successful in 15 (57.7% but it failed in 11 (42.3% patients. In letrozole plus HMG group, the treatment was successful in 18 (54.5% while it failed in 15 (45.5% patients. The mean FMD values in the groups with successful and unsuccessful treatment results were 19.42±10% and 18.57±7.2%, respectively, but the difference was not statistically significant (P=0.712. Moreover, the average endometrial thickness in groups with successful and unsuccessful treatment results were 8.4±1.3 mm and 9.8±3.9 mm, respectively but the difference was not significant either (P=0.06.Conclusion: In infertile women with polycystic ovary syndrome that are resistant to clomiphene, letrozole or letrozole combined with gonadotropin can be equally effective for ovulation induction.

  8. Changes of Blood Flow Volume in the Superior Mesenteric Artery and Brachial Artery with Abdominal Thermal Stimulation

    Directory of Open Access Journals (Sweden)

    Shin Takayama

    2011-01-01

    Full Text Available In traditional Chinese medicine, moxibustion is a local thermal therapy that is used for several conditions. Quantifying the effects of moxibustion therapy has been difficult because the treatment temperature depends on the physician's experience, and the temperature distribution in the target area is not uniform. This prospective observational study aims to quantify the effect of local thermal stimulation to the abdomen. We developed a heat transfer control device (HTCD for local thermal stimulation. Twenty-four healthy subjects were enrolled and they underwent abdominal thermal stimulation to the para-umbilical region with the device for 20 min. Blood flow volume in the superior mesenteric artery (SMA and brachial artery (BA, the heart rate and the blood pressure were measured at rest, 15 min after starting thermal stimulation and 10, 20, 30 and 40 min after completing thermal stimulation. Blood flow parameters were measured by high-resolution ultrasound. In the SMA, blood flow volume was significantly increased during thermal stimulation (, as well as at 10 min ( and 20 min ( after stimulation. In the BA, blood flow volume decreased at 40 min after stimulation (. In conclusion we could quantify the effect of local thermal stimulation with an HTCD and high-resolution ultrasound. Thermal stimulation of the para-umbilical region increased blood flow in the SMA 20 min after stimulation in healthy subjects.

  9. Successful Retrieval of a Coronary Stent Dislodged in the Brachial Artery by Means of Improvised Snare and Guiding Catheter

    OpenAIRE

    Deftereos, Spyridon; Raisakis, Konstantinos; Giannopoulos, Georgios; Kossyvakis, Charalampos; Pappas, Loukas; Kaoukis, Andreas

    2011-01-01

    This is a case report regarding the retrieval, by means of an improvised snare and guiding catheter, of a stent dislodged in the brachial artery during a transradial coronary intervention. A full-length guiding catheter could not be used to approach the lost stent, which was a mere 30 to 35 cm away from the sheath insertion site at the radial artery, and a commercial snare was not available at the time. Thus, we had to improvise a shortened guiding catheter and a snare, which was formed by fo...

  10. Stroke volume obtained by electrical interrogation of the brachial artery: transbrachial electrical bioimpedance velocimetry

    International Nuclear Information System (INIS)

    The goal of this study is to measure left ventricular stroke volume (SV) from the brachial artery (BA) using electrical bioimpedance. Doppler-derived SV was used for comparison. Twenty-nine healthy adults were recruited for study. Doppler echocardiographic-derived SV was obtained from the product of distal left ventricular outflow tract cross-sectional area and systolic velocity integral. SV from the BA was obtained by transbrachial electrical bioimpedance velocimetry (TBEV). Application of a current field across the left brachium was effected by injection of a constant magnitude, high frequency, low amperage, alternating current. Therein, a static voltage (U0) and pulsatile voltage change (ΔU(t)) were measured and converted to their corresponding impedances, Z0 and ΔZ(t). TBEV-derived SV was obtained by multiplying a square root value of the normalized, acceleration-based, peak first time derivative of ΔZ(t) by a volume conductor and systolic flow time. Inter-method agreement was determined by the Bland–Altman method. To assess the contribution of blood resistivity variations to ΔZ(t), BA diameters were measured at end-diastole and peak systolic expansion. Results indicate that since the BA demonstrates parabolic, laminar flow, with minimal diameter changes, blood resistivity variations are likely responsible for the derived impedance changes. Bland–Altman analysis shows that SV is obtainable by TBEV from healthy humans at rest. (paper)

  11. PREVALENCE OF PERIPHERAL ARTERIAL DISEASE IN TYPE - 2 DIABETES MELLITUS AND ITS CORRELATION WITH CORONARY ARTERY DISEASE USING ANKLE - BRACHIAL INDEX

    Directory of Open Access Journals (Sweden)

    Basawaraj

    2015-02-01

    Full Text Available OBJECTIVES: Peripheral vascular disease is one of the macrovascular complications of diabetes mellitus. The purpose of this study was to examine the peripheral arterial disease (PAD complicating type 2 diabetes, in particular the influence of PAD on the risk of coronary artery disease. METHODS: Randomly selected T2DM pat ients admitted to Basaweshwara Teaching and General Hospital were included. In addition to a detailed history and physical examination, anthropometric parameters like body mass index was measured. Relevant laboratory investigations were performed. Modified Rose questionnaire was used to diagnose coronary artery disease (CAD. Colour Doppler examination of the arteries of the lower limbs was performed. A cut off of 7% were significant predictors of PAD. Older age, higher HbA1c levels microalbuminuria and deranged lipid profile were found to be significant predictors of CAD. CONCLUSION: We found evidence of PAD in 16% of type 2 dia betics using ankle brachial index. The prevalence of CAD was higher in patients with PAD. So there is definite and strong correlation between PAD and CAD. Thus the early diagnosis of PAD should alert the clinician to a high probability of underlying CAD. KEYWORDS: D i abetes mellitus; Coronary artery disease; Peripheral artery disease; Ankle - brachial index.

  12. Ankle-brachial index as indicator of chronic arterial insufficiency of the lower extremities and renal artery stenosis CT/DS angiography

    International Nuclear Information System (INIS)

    Full text: The aim is to validate the measurements of ankle -brachial index (ABI), as part of routine examination algorithm in conducting CTA/DSA of the extremities in patients suffering from PAD. Correlations between ABI values and renal artery stenosis. The present study includes 200 patients (138 men and 62 women, aged between 60 and 75 years). 130 of them were examined by a computer- tomography angiography - 95 men and 32 women. 70 patients were examined by digital subtraction angiography - 50 men and 20 women. Measurements of ankle-brachial index (ABI) were performed on all patients by measuring the systolic blood pressure on both brachial arteries and determine the peak pressure in both aa. dorsalis pedis. Statistical data processing. There are no patients in the study with ABI values above 0.7 that have established renal artery stenosis. All patients with severe atherosclerotic changes have values of the ABI below 0.7, and those with the most severe changes below 0.5. This fully corresponds to global data showing that values below 0.9 ABI show mild engagement, below 0.7 average, and below 0.5 severe involvement. According to the results of this survey sensitivity of ABI for renal arteries below 0.7 equals 100% and its specificity = 67.5%. For values of ABI below 0.5: Sensitivity =100%; Specificity = 83.85%. By determining ABI values both symptomatic and asymptomatic form of a PAD can be diagnosed. the method is fast, non-invasive, inexpensive and applicable everywhere. No special preparation of the patient is needed. The method can be used not only to assess the degree of commitment of the vessels of the lower limbs, but also as an indicator for the state of renal arteries in those patients

  13. Association of particulate air pollution and secondhand smoke on endothelium-dependent brachial artery dilation in healthy children

    Directory of Open Access Journals (Sweden)

    Mohammad Hashemi

    2012-01-01

    Full Text Available Background: This study aimed to determine the association of particulate matters with endothelial function, measured by flow mediated dilation (FMD of brachial artery, in children with or without exposure to secondhand smoke. Methods: This cross-sectional study was conducted from January to March 2011 in Isfahan, which is the second large and air-polluted city in Iran. The areas of the city with lowest and highest air pollution were determined, and in each area, 25 prepubescent boys with or without exposure to daily tobacco smoke in home were selected, i.e. 100 children were studied in total. Results: FMD was significantly smaller in those living in high-polluted area and those exposed to secondhand smoke. Multiple linear regression analysis, adjusted for age and body mass index, showed that both passive smoking status and living area in terms of particulate air pollution were effective determinants of the brachial artery diameter. The standardized coefficient of passive smoking status was –0.36 (SD = 0.09, P < 0.0001 showing negative association with percent increase in FMD. Likewise, the percent increase in brachial artery diameter was lower in passive smoker children. Similar relationship was documented for PM 10 concentration with a regression coefficient of –0.32 (SD = 0.04, P < 0.0001. Without considering passive smoking variable, PM 10 concentration has significant independent effect on FMD level. Conclusion: Our findings provide evidence on the association of environmental factors on endothelial dysfunction from early life. Studying such associations among healthy children may help identify the underlying mechanisms. The clinical implications of environmental factors on early stages of atherosclerosis should be confirmed in longitudinal studies.

  14. Comparison of Different Edge Detections and Noise Reduction on Ultrasound Images of Carotid and Brachial Arteries Using a Speckle Reducing Anisotropic Diffusion Filter

    OpenAIRE

    Rafati, Mehravar; Arabfard, Masoud; Rafati-Rahimzadeh, Mehrdad

    2014-01-01

    Background: Common carotid artery (CCA) ultrasound with measurement of intima-media thickness (IMT) is a safe and noninvasive technique for assessing subclinical atherosclerosis and determining cardiovascular risks. Moreover, the pattern of wall thickening in the brachial artery (BA) is rather diffuse compared to the carotid artery and may be a more sensitive indicator of long-term systemic exposure to risk factors. Therefore noninvasive evaluation of mechanical parameters changes of both art...

  15. Complex anatomic variation in the brachial region.

    Science.gov (United States)

    Troupis, Th; Michalinos, A; Protogerou, V; Mazarakis, A; Skandalakis, P

    2015-01-01

    Authors describe a case of a complex anatomic variation discovered during dissection of the humeral region. On the right side, brachial artery followed a superficial course. Musculocutaneous nerve did not pierce coracobrachialis muscle but instead passed below the muscle before continuing in the forearm. On the left side, a communication between musculocutaneous and median nerve was dissected. Those variations are analytically presented with a brief review on their anatomic and clinical implications. Considerations on their embryological origin are attempted.

  16. Feed-forward active contour analysis for improved brachial artery reactivity testing.

    Science.gov (United States)

    Pugliese, Daniel N; Sehgal, Chandra M; Sultan, Laith R; Reamer, Courtney B; Mohler, Emile R

    2016-08-01

    The object of this study was to utilize a novel feed-forward active contour (FFAC) algorithm to find a reproducible technique for analysis of brachial artery reactivity. Flow-mediated dilation (FMD) is an important marker of vascular endothelial function but has not been adopted for widespread clinical use given its technical limitations, including inter-observer variability and differences in technique across clinical sites. We developed a novel FFAC algorithm with the goal of validating a more reliable standard. Forty-six healthy volunteers underwent FMD measurement according to the standard technique. Ultrasound videos lasting 5-10 seconds each were obtained pre-cuff inflation and at minutes 1 through 5 post-cuff deflation in longitudinal and transverse views. Automated segmentation using the FFAC algorithm with initial boundary definition from three different observers was used to analyze the images to measure diameter/cross-sectional area over the cardiac cycle. The %FMD was calculated for average, minimum, and maximum diameters/areas. Using the FFAC algorithm, the population-specific coefficient of variation (CV) at end-diastole was 3.24% for transverse compared to 9.96% for longitudinal measurements; the subject-specific CV was 15.03% compared to 57.41%, respectively. For longitudinal measurements made via the conventional method, the population-specific CV was 4.77% and subject-specific CV was 117.79%. The intraclass correlation coefficient (ICC) for transverse measurements was 0.97 (95% CI: 0.95-0.98) compared to 0.90 (95% CI: 0.84-0.94) for longitudinal measurements with FFAC and 0.72 (95% CI: 0.51-0.84) for conventional measurements. In conclusion, transverse views using the novel FFAC method provide less inter-observer variability than traditional longitudinal views. Improved reproducibility may allow adoption of FMD testing in a clinical setting. The FFAC algorithm is a robust technique that should be evaluated further for its ability to replace the

  17. Feed-forward active contour analysis for improved brachial artery reactivity testing.

    Science.gov (United States)

    Pugliese, Daniel N; Sehgal, Chandra M; Sultan, Laith R; Reamer, Courtney B; Mohler, Emile R

    2016-08-01

    The object of this study was to utilize a novel feed-forward active contour (FFAC) algorithm to find a reproducible technique for analysis of brachial artery reactivity. Flow-mediated dilation (FMD) is an important marker of vascular endothelial function but has not been adopted for widespread clinical use given its technical limitations, including inter-observer variability and differences in technique across clinical sites. We developed a novel FFAC algorithm with the goal of validating a more reliable standard. Forty-six healthy volunteers underwent FMD measurement according to the standard technique. Ultrasound videos lasting 5-10 seconds each were obtained pre-cuff inflation and at minutes 1 through 5 post-cuff deflation in longitudinal and transverse views. Automated segmentation using the FFAC algorithm with initial boundary definition from three different observers was used to analyze the images to measure diameter/cross-sectional area over the cardiac cycle. The %FMD was calculated for average, minimum, and maximum diameters/areas. Using the FFAC algorithm, the population-specific coefficient of variation (CV) at end-diastole was 3.24% for transverse compared to 9.96% for longitudinal measurements; the subject-specific CV was 15.03% compared to 57.41%, respectively. For longitudinal measurements made via the conventional method, the population-specific CV was 4.77% and subject-specific CV was 117.79%. The intraclass correlation coefficient (ICC) for transverse measurements was 0.97 (95% CI: 0.95-0.98) compared to 0.90 (95% CI: 0.84-0.94) for longitudinal measurements with FFAC and 0.72 (95% CI: 0.51-0.84) for conventional measurements. In conclusion, transverse views using the novel FFAC method provide less inter-observer variability than traditional longitudinal views. Improved reproducibility may allow adoption of FMD testing in a clinical setting. The FFAC algorithm is a robust technique that should be evaluated further for its ability to replace the

  18. A young man with intimomedial mucoid degeneration of the brachial artery.

    Science.gov (United States)

    Raber, Menno H; Meerwaldt, Robbert; van Det, Rob J

    2011-03-01

    Intimomedial mucoid degeneration is a rare disorder and has been described as a distinctly different entity from Erdheim's cystic medial necrosis. Most studies show a strong predominance in African American females with hypertension. In our case report, we describe the presence of a large brachial aneurysm in a young white male with intimomedial mucoid degeneration.

  19. Median effective concentration of ropivacaine for ultrasound-guided brachial plexus block%超声引导下罗哌卡因臂丛神经阻滞的半数有效浓度

    Institute of Scientific and Technical Information of China (English)

    顾晨桃; 王爱忠; 单宇; 江伟

    2011-01-01

    Objective To determine the median effective concentration (EC50) of ropivacaine for ultrasound-guided brachial plexus block.Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes, aged 19-72 yr, weighing 45-83 kg, scheduled for upper extremity surgery under brachial plexus block guided by ultrasound, were enrolled in this study. Brachial plexus block was performed under the guidance of ultrasound. After successful location, ropivacaine 30 ml was injected. EC50 of ropivacaine was determined by up-and-down sequential method. The initial concentration was 0.50% . Each time the concentration increased/decreased by 0.05% . EC50 of ropivacaine required for ultrasound-guided brachial plexus block and 95% confidence interval were calculated using Probit analysis.Results The EC50 of ropivacaine resulting in complete block of the brachial plexus nerve was 0.436%(95% confidence interval 0.393%-0.477% ). Conclusion The EC50 of ropivacaine is 0.436% for ultrasoundguided brachial plexus block.%目的 超声引导下罗哌卡因臂丛神经阻滞的半数有效浓度.方法 择期上肢手术患者50例,年龄19~72岁,体重45~83 ks,身高150~181 cm,ASA分级Ⅰ或Ⅱ级.超声引导下行臂丛神经阻滞,定位成功后注入罗哌卡因30 ml,初始浓度0.50%,浓度变化梯度为O.05%,阻滞有效则下一例采用低一级浓度,阻滞无效,则下一例采用高一级浓度.采用Prebit法计算超声引导下罗哌卡因臂丛神经阻滞的半数有效浓度及其95%可信区间.结果 超声引导下罗哌卡因臂丛神经阻滞的半数有效浓度为0.436%,95%可信区间为0.393%~0.477%.结论 超声引导下罗哌卡因臂丛神经阻滞的半数有效浓度为0.436%.

  20. [Case of cerebellar and spinal cord infarction presenting with acute brachial diplegia due to right vertebral artery occlusion].

    Science.gov (United States)

    Fujii, Takayuki; Santa, Yo; Akutagawa, Noriko; Nagano, Sukehisa; Yoshimura, Takeo

    2012-01-01

    A 73-year-old man was admitted for evaluation of sudden onset of dizziness, bilateral shoulder pain, and brachial diplegia. Neurological examination revealed severe bilateral weakness of the triceps brachii, wrist flexor, and wrist extensor muscles. There was no paresis of the lower limbs. His gait was ataxic. Pinprick and temperature sensations were diminished at the bilateral C6-C8 dermatomes. Vibration and position senses were intact. An MRI of the head revealed a right cerebellar infarction and occlusion of the right vertebral artery. An MRI of the cervical spine on T₂ weighted imaging (T₂WI) showed cord compression at the C3/4-C5/6 level secondary to spondylotic degeneration without any intramedullary signal changes of the cord. On the following day, however, high-signal lesions on T₂WI appeared in the C5-C6 spinal cord, suggesting cord infarction. Unilateral vertebral artery occlusion does not usually result in cervical cord infarction because of anastomosis of arteries. Because of the long-term mechanical compression in our case, it was likely that cervical cord ischemia was present before the onset of symptoms. On the basis of chronic cord compression, our case suggests that occlusion of a unilateral vertebral artery could cause cervical cord infarction.

  1. [Brachial artery endothelial function in teenagers with obesity depending on severity of clinical, trophological and metabolic disorders].

    Science.gov (United States)

    Maskova, G S; Chernaia, N L; Nagornova, E Iu; Fomina, O V; Byteva, T A

    2014-01-01

    We carried out complex examination of 68 adolescents aged 11-17 years with primary obesity which in addition to assessment of clinical-anamnestic, laboratory data and functional parameters of cardiovascular system included registration of reaction of brachial artery endothelium to reactive hyperemia. Vascular endothelial dysfunction (VED) was found in 66% of obese teenagers. Obesity in adolescents with VED was characterized by aggravated course with higher fat mass index (36.8 +/- 4.39%) and prevalence of hypothalamic (42%) and metabolic (8.8%) syndromes. Stable arterial hypertension (AH) found in 37% of examined adolescents was 1.5 times more often registered in those with VED. We distinguished 4 groups of adolescents with various degree of risk of development of cardiovascular disorders: with stable AH and VED (group I), with stable AH and normal function of vascular endothelium (group II), with normal or labile arterial pressure with VED (group III), with normal or labile arterial pressure with normal function of vascular endothelium. It is expedient to supplement examination of obese adolescents with assessment of the state of vascular endothelium aiming at determination of degree of risk of development of atherosclerosis and/or stable AH.

  2. Sex-specific effects of habitual aerobic exercise on brachial artery flow-mediated dilation in middle-aged and older adults.

    Science.gov (United States)

    Pierce, Gary L; Eskurza, Iratxe; Walker, Ashley E; Fay, Tara N; Seals, Douglas R

    2011-01-01

    Brachial artery FMD (flow-mediated dilation) is impaired with aging and is associated with an increased risk of CVD (cardiovascular disease). In the present study, we determined whether regular aerobic exercise improves brachial artery FMD in MA/O (middle-aged/older) men and post-menopausal women. In sedentary MA/O adults (age, 55-79 years) without CVD, 8 weeks of brisk walking (6 days/week for approx. 50 min/day; randomized controlled design) increased treadmill time approx. 20% in both MA/O men (n=11) and post-menopausal women (n=15) (P50% in the MA/O men (from 4.6±0.6 to 7.1±0.6%; Ppost-menopausal women (5.1±0.8 compared with 5.4±0.7%; P=0.50). No changes occurred in the non-exercising controls. In a separate cross-sectional study (n=167), brachial artery FMD was approx. 50% greater in endurance-exercise-trained (6.4±0.4%; n=45) compared with sedentary (4.3±0.3%; n=60) MA/O men (Ppost-menopausal women (P=0.70). Brachial artery lumen diameter, peak hyperaemic shear rate and endothelium-independent dilation did not differ with exercise intervention or in the endurance exercise compared with sedentary groups. In conclusion, regular aerobic exercise is consistently associated with enhanced brachial artery FMD in MA/O men, but not in post-menopausal women. Some post-menopausal women without CVD may be less responsive to habitual aerobic exercise than MA/O men.

  3. Risk factors and ankle brachial indexes in cerebral infarction combined with peripheral arterial disease

    Institute of Scientific and Technical Information of China (English)

    Huihua Liu; Jun Wang

    2006-01-01

    BACKGROUND: Ankle brachial index(ABI)is widely involved in researches and clinical application of peripheral vascular injury of patients with diabetes (DM);however ,the application in cerebral infarction(CI)is rare.OBJECTIVE: To investigate the possible risk factor of cerebral infarction plus peripheral arterial disease(PAD),compare metabolic characteristics of patients who having CI plus PAD or only having CI,and understand the significance of ABI on screening and diagnosing CI plus PAD of lower limb.DESIGN: Contrast observation based on CI patients.SETTING: Deparment of Neurology,Nanxishan Hospital of Guangxi Zhang Autonomous Region.PARTICIPANTS:A total of 124 CI patients were selected from Department of Neurology.Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2005 to April 2006,including 72 males and 52 females aged from 45 to 88 years.All patients met the diagnostic criteria of cerebrovascular disease established by National Academic Conference of Cerebrovascular Diseases in 1995 and determined as cerebral infarction with MRI or CT examination.All patients provided informed consent.There were 46 cases(37.2%)with CI plus PAD and 78 cases(62.8%)only with CI.METHODS: Blood pressure of bilateral ankles and upper extremities was measured at plain clinostatism with DINAMAP blood pressure monitor(GE Company).The ratio between average systolic pressure of lateral ankle and average systolic pressure of both upper extremities was regarded as ABI.The normal ABI was equal to or more than 0.9.If ABI<0.9 occurred at one side,patients were diagnosed as PAD.On the second morning after hospitalization,blood was collected to measure fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG2h),glycosylated hemoglobin(HbAlc),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).Among them,blood glucose.lipid and other biochemical markers were measured with enzyme chemistry assay

  4. Change in Elasticity Caused by Flow-Mediated Dilation Measured Only for Intima-Media Region of Brachial Artery

    Science.gov (United States)

    Sugimoto, Masataka; Hasegawa, Hideyuki; Kanai, Hiroshi

    2005-08-01

    Endothelial dysfunction is considered to be an initial step of arteriosclerosis [R. Ross: N. Engl. J. Med. 340 (2004) 115]. For the assessment of the endothelium function, brachial artery flow-mediated dilation (FMD) caused by increased blood flow has been evaluated with ultrasonic diagnostic equipment. In the case of conventional methods, the change in artery diameter caused by FMD is measured [M. Hashimoto et al.: Circulation 92 (1995) 3431]. Although the arterial wall has a layered structure (intima, media, and adventitia), such a structure is not taken into account in conventional methods because the change in diameter depends on the characteristic of the entire wall. However, smooth muscle present only in the media contributes to FMD, whereas the collagen-rich hard adventitia does not contribute. In this study, we measure the change in elasticity of only the intima-media region including smooth muscle using the phased tracking method [H. Kanai et al.: IEEE Trans. Ultrason. Ferroelectr. Freq. Control 43 (1996) 791]. From the change in elasticity, FMD measured only for the intima-media region by our proposed method was found to be more sensitive than that measured for the entire wall by the conventional method.

  5. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease.

    Science.gov (United States)

    Je, Hyung Gon; Kim, Bo Hyun; Cho, Kyoung Im; Jang, Jae Sik; Park, Yong Hyun; Spertus, John

    2015-01-01

    Improvement in quality of life (QoL) is a primary treatment goal for patients with peripheral arterial disease (PAD). The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ) and ankle-brachial index (ABI), and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p's PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

  6. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hyung Gon Je

    2015-05-01

    Full Text Available Improvement in quality of life (QoL is a primary treatment goal for patients with peripheral arterial disease (PAD. The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ and ankle-brachial index (ABI, and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p < 0.001. PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p’s < 0.001. As expected the ABI of treated limbs showed significant improvement post-revascularization (p < 0.001. ABI after revascularization correlated with patient-reported changes in the physical function and QoL domains of the PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI < 0.15. Interestingly, poor responders reported improvement in symptoms on the PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

  7. Evaluation of Asymptomatic Peripheral Arterial Disease by Ankle-brachial Index in Patients with Concomitant Coronary Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hosein Vakili

    2012-12-01

    Full Text Available Background: Peripheral arterial disease is associated with adverse cardiovascular outcomes. As such, it is found that screening for peripheral arterial disease (PAD improves risk assessment. Thus, intensive risk factor modification and medical treatment in these patients are necessary. Objectives: The purpose of this study was to determine the prevalence of asymptomatic peripheral arterial disease in patients with concomitant coronary arterial disease. Methods: Asymptomatic peripheral arterial disease was investigated in 400 patients (60% males, 40% females, aged 59.7± 11.3 with a documented coronary arterial disease. Results: Among patients with documented CAD, 12% had asymptomatic PAD with the ABI ratio of less than 0.9. Conclusions: It is advisable to screen for PAD not only as a disease but also as a risk assessment method for atherosclerosis.

  8. Axillary artery pseudoaneurysm resulting in brachial plexus injury in a patient taking new oral anticoagulants.

    Science.gov (United States)

    Monem, Mohammed; Iskandarani, Mohamad Khalid; Gokaraju, Kishan

    2016-01-01

    We discuss the case of an independent 80-year-old Caucasian woman, being treated with new oral anticoagulants for a previous deep vein thrombosis, who had fallen on her right shoulder. She made a delayed presentation to the emergency department with a wrist drop in her right dominant hand. She had right arm bruising with good distal pulses but had a global neurological deficit in the hand. Plain radiographs of the shoulder, humerus, elbow, forearm and wrist demonstrated no fractures. MRI showed a significant right axillary lesion distorting the surrounding soft tissues, including the brachial plexus, and CT with contrast confirmed this to be a large axillary pseudoaneurysm. This was treated with an endovascular stent resulting in slightly improved motor function, but the significant residual deficit required subsequent rehabilitation to improve right upper limb function. PMID:27535738

  9. Hemodynamic Changes in the Brachial Artery Induced by Acupuncture Stimulation on the Lower Limbs: A Single-Blind Randomized Controlled Trial

    OpenAIRE

    Masashi Watanabe; Shin Takayama; Atsushi Hirano; Takashi Seki; Nobuo Yaegashi

    2012-01-01

    Acupuncture is commonly performed at acupoints. No comparisons of quantitative physiological alterations in the brachial artery (BA) induced by the stimulation of different acupoints in the lower limbs have been performed in humans. Therefore, we investigated changes in blood flow volume (BFV) in the BA as an indicator of the physiological effects induced by stimulation at 3 points. Seventy-five healthy participants aged 33 ± 9 years (mean ± SD) were enrolled and randomly assigned to 3 groups...

  10. Brachial artery flow mediated dilatation and carotid intima media thickness measured by high resolution B-mode ultrasound in patients with rheumatoid arthritis

    OpenAIRE

    Mohamed A. Amin; Alsiagy A. Salama; Ashraf M. Elaggan; Salwa E. Elsayed

    2015-01-01

    Objectives: Firstly to assess the prevalence of subclinical atherosclerosis and endothelial dysfunction by high resolution ultrasound measurements of carotid intima media thickness (CIMT) and brachial artery flow mediated dilatation percentage (FMD%) in patients with rheumatoid arthritis (RA), secondly to analyze the correlation of CIMT and FMD% with different clinical and laboratory parameters, third aim was to analyze the relationship between CIMT and FMD%. Patients and methods: The pros...

  11. Association of the Cardioankle Vascular Index and Ankle-Brachial Index with Carotid Artery Intima Media Thickness in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Tomohito Gohda

    2013-01-01

    Full Text Available The objectives of the present study are (1 to compare the cardioankle vascular index (CAVI, ankle-brachial index (ABI, and carotid artery intima-media thickness (CA-IMT between HD patients with and without type 2 diabetes (T2D or prevalence of cardiovascular (CV disease and (2 also to evaluate the relationship of these indices with CA-IMT in these patients according to ABI levels. This study consisted of 132 HD patients with T2D and the same number of patients without T2D. The patients with diabetes or prevalence of CV disease had significantly higher CA-IMT and lower ABI values than those without diabetes or prevalence of CV disease, respectively. Although diabetic patients had higher CAVI than those without diabetes, CAVI did not differ between patients with or without prevalence of CV disease. In univariate analysis, CA-IMT was more strongly correlated with ABI than CAVI. However, the opposite was true in patients with an ABI value of more than 0.95. Both indices were significantly correlated with CA-IMT although ABI was a powerful determinant than CAVI. It appears that both indices are associated with CA-IMT in HD patients, especially with an ABI value of more than 0.95.

  12. Effect of black tea consumption on brachial artery flow-mediated dilation and ischaemia-reperfusion in humans.

    Science.gov (United States)

    Schreuder, Tim H A; Eijsvogels, Thijs M H; Greyling, Arno; Draijer, Richard; Hopman, Maria T E; Thijssen, Dick H J

    2014-02-01

    Tea consumption is associated with reduced cardiovascular risk. Previous studies found that tea flavonoids work through direct effects on the vasculature, leading to dose-dependent improvements in endothelial function. Cardioprotective effects of regular tea consumption may relate to the prevention of endothelial ischaemia-reperfusion (IR) injury. Therefore, we examined the effect of black tea consumption on endothelial function and the ability of tea to prevent IR injury. In a randomized, crossover study, 20 healthy subjects underwent 7 days of tea consumption (3 cups per day) or abstinence from tea. We examined brachial artery (BA) endothelial function via flow-mediated dilation (FMD), using high resolution echo-Doppler, before and 90 min after tea or hot water consumption. Subsequently, we followed a 20-min ischaemia and 20-min reperfusion protocol of the BA after which we measured FMD to examine the potential of tea consumption to protect against IR injury. Tea consumption resulted in an immediate increase in FMD% (pre-consumption: 5.8 ± 2.5; post-consumption: 7.2 ± 3.2; p tea consumption (p tea ingestion improves BA FMD. However, the impact of the IR protocol on FMD was not influenced by tea consumption. Therefore, the cardioprotective association of tea ingestion relates to a direct effect of tea on the endothelium in humans in vivo.

  13. A control systems approach to quantify wall shear stress normalization by flow-mediated dilation in the brachial artery.

    Directory of Open Access Journals (Sweden)

    Frank C G van Bussel

    Full Text Available Flow-mediated dilation is aimed at normalization of local wall shear stress under varying blood flow conditions. Blood flow velocity and vessel diameter are continuous and opposing influences that modulate wall shear stress. We derived an index FMDv to quantify wall shear stress normalization performance by flow-mediated dilation in the brachial artery. In 22 fasting presumed healthy men, we first assessed intra- and inter-session reproducibilities of two indices pFMDv and mFMDv, which consider the relative peak and relative mean hyperemic change in flow velocity, respectively. Second, utilizing oral glucose loading, we evaluated the tracking performance of both FMDv indices, in comparison with existing indices [i.e., the relative peak diameter increase (%FMD, the peak to baseline diameter ratio (Dpeak/Dbase, and the relative peak diameter increase normalized to the full area under the curve of blood flow velocity with hyperemia (FMD/shearAUC or with area integrated to peak hyperemia (FMD/shearAUC_peak]. Inter-session and intra-session reproducibilities for pFMDv, mFMDv and %FMD were comparable (intra-class correlation coefficients within 0.521-0.677 range. Both pFMDv and mFMDv showed more clearly a reduction after glucose loading (reduction of ~45%, p≤0.001 than the other indices (% given are relative reductions: %FMD (~11%, p≥0.074; Dpeak/Dbase (~11%, p≥0.074; FMD/shearAUC_peak (~20%, p≥0.016 and FMD/shearAUC (~38%, p≤0.038. Further analysis indicated that wall shear stress normalization under normal (fasting conditions is already far from ideal (FMDv << 1, which (therefore does not materially change with glucose loading. Our approach might be useful in intervention studies to detect intrinsic changes in shear stress normalization performance in conduit arteries.

  14. Impact of handgrip exercise intensity on brachial artery flow-mediated dilation.

    NARCIS (Netherlands)

    Atkinson, C.L.; Carter, H.H.; Dawson, E.A.; Naylor, L.H.; Thijssen, D.H.J.; Green, D.J.

    2015-01-01

    PURPOSE: Previous studies that have examined the impact of exercise intensity on conduit artery endothelial function have involved large muscle group exercise which induces local and systemic effects. The aim of this study was to examine flow-mediated dilation (FMD) before and after incremental inte

  15. What Is the Clinical Utility of the Ankle-Brachial Index in Patients With Diabetic Foot Ulcers and Radiographic Arterial Calcification?

    Science.gov (United States)

    Álvaro-Afonso, Francisco Javier; Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan

    2015-12-01

    The purpose of this study was to analyze the influence of radiographic arterial calcification (RAC) on the clinical interpretation of ankle-brachial index (ABI) values in patients with diabetic foot ulcers. We analyzed a retrospective clinical database of 60 patients with diabetic foot ulcers from the Diabetic Foot Unit (Complutense University, Madrid, Spain) between January 2012 and March 2014. For each patient, anteroposterior XR-plains were evaluated, and the ABI and toe-brachial index (TBI) were assessed by an experienced clinician. To analyze the correlation among quantitative variables, we applied the Pearson correlation coefficient. Fifty percent (n = 9/18) of our patients with a normal ABI and RAC had a TBI diabetic foot ulcers, or RAC.

  16. Measurement of brachial artery endothelial function using a standard blood pressure cuff

    OpenAIRE

    Maltz, Jonathan S.; Tison, Geoffrey H; Alley, Hugh F.; Budinger, Thomas F; Owens, Christopher D.; Olgin, Jeffrey

    2015-01-01

    The integrity of endothelial function in major arteries (EFMA) is a powerful independent predictor of heart attack and stroke. Existing ultrasound-based non-invasive assessment methods are technically challenging and suitable only for laboratory settings. EFMA, like blood pressure (BP), is both acutely and chronically affected by factors such as lifestyle and medication. Consequently, lab-based measurements cannot fully gauge the effects of medical interventions on EFMA. EFMA and BP have, arg...

  17. Characterization of endothelial function in the brachial artery via affine registration of ultrasonographic image sequences

    Science.gov (United States)

    Lamata, Pablo; Laclaustra, Martin; Frangi, Alejandro F.

    2003-05-01

    The assessment and characterization of the endothelial function is a current research topic as it may play an important role in the diagnosis of cardiovascular diseases. Flow mediated dilatation may be used to investigate endothelial function, and B-mode ultrasonography is a cheap and non-invasive way to assess the vasodilation response. Computerized analysis techniques are very desirable to give higher accuracy and objectivity to the measurements. A new method is presented that solves some limitations of existing methods, which in general depend on accurate edge detection of the arterial wall. This method is based on a global image analysis strategy. The arterial vasodilation between two frames is modeled by a superposition of a rigid motion model and a stretching perpendicular to the artery. Both transformation models are recovered using an image registration algorithm based on normalized mutual information and a multi-resolution search framework. Temporal continuity of in the variation of the registration parameters is enforced with a Kalman filter, since the dilation process is known to be a gradual and continuous physiological phenomenon. The proposed method presents a negligible bias when compared with manual assessment. It also eliminates artifacts introduced by patient and probe motion, thus improving the accuracy of the measurements. Finally, it is also robust to typical problems of ultrasound, like speckle noise and poor image quality.

  18. Measurement of brachial artery endothelial function using a standard blood pressure cuff.

    Science.gov (United States)

    Maltz, Jonathan S; Tison, Geoffrey H; Alley, Hugh F; Budinger, Thomas F; Owens, Christopher D; Olgin, Jeffrey

    2015-11-01

    The integrity of endothelial function in major arteries (EFMA) is a powerful independent predictor of heart attack and stroke. Existing ultrasound-based non-invasive assessment methods are technically challenging and suitable only for laboratory settings. EFMA, like blood pressure (BP), is both acutely and chronically affected by factors such as lifestyle and medication. Consequently, laboratory-based measurements cannot fully gauge the effects of medical interventions on EFMA. EFMA and BP have, arguably, comparable (but complementary) value in the assessment of cardiovascular health. Widespread deployment of EFMA assessment is thus a desirable clinical goal. To this end, we propose a device based on modifying the measurement protocol of a standard electronic sphygmomanometer. The protocol involves inflating the cuff to sub-diastolic levels to enable recording of the pulse waveform before and after vasodilatory stimulus. The mechanical unloading of the arterial wall provided by the cuff amplifies the distension that occurs with each pulse, which is measured as a pressure variation in the cuff. We show that the height of the rising edge of each pulse is proportional to the change in lumen area between diastole and systole. This allows the effect of vasodilatory stimuli on the artery to be measured with high sensitivity. We compare the proposed cuff flow-mediated dilation (cFMD) method to ultrasound flow-mediated dilation (uFMD). We find significant correlation (r = 0.55, p = 0.003, N = 27) between cFMD- and uFMD-based metrics obtained when the release of a 5 min cuff occlusion is employed to induce endothelial stimulus via reactive hyperemia. cFMD is approximately proportional to the square of uFMD, representing a typical increase in sensitivity to vasodilation of 300-600%. This study illustrates the potential for an individual to conveniently measure his/her EFMA by using a low-cost reprogrammed home sphygmomanometer. PMID:26393958

  19. Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work?

    Directory of Open Access Journals (Sweden)

    Zinat Nadia-Hatmi

    2015-10-01

    Full Text Available Background: Given the lack of consistency in the literature regarding the reliability of the ankle-brachial index (ABI as a valid screening tool and an independent risk indicator of cardiovascular events and mortality, we compared it with angiography as a reference standard test.Methods: This case-control study, conducted between 2010 and 2011 in Tehran Heart Center, recruited 362 angiographically confirmed cases of coronary artery disease (CAD and 337 controls. A standard protocol was used to measure the ABI and different CAD risk factors.Results: A low ABI had specificity of 99.7%, positive predictive value of 95.8%, negative predictive value of 49.8%, sensitivity of 64%, likelihood ratio of 24.07, and odds ratio (OR of 22.79 (95%CI: 3.06-69.76. The role of the associated risk factors was evaluated with OR (95%CI, with the variables including gender 3.15 (2.30-4.30, cigarette smoking 2.72 (1.86-3.99, family history 1.72 (1.17-2.51, diabetes 1.66 (1.15-2.4, and dyslipidemia 1.38 (1.02-1.88. In a multivariate model, the following variables remained statistically significantly correlated with CAD [OR (95%CI]: ABI 13.86 (1.78-17.62; gender 3.69 (2.43- 5.58; family history of CAD 2.18 (1.41-3.37; smoking 1.69 (1.08-2.64; age 1.04 (1.02-1.06.Conclusions: A low ABI had specificity of 99.7%; however, because of its low sensitivity (64%, we should consider CAD risk factors associated with a low ABI in order to use it as a first-line screening test.

  20. Ankle-brachial pressure index estimated by laser Doppler in patients suffering from peripheral arterial obstructive disease.

    Science.gov (United States)

    Ludyga, Tomasz; Kuczmik, Waclaw B; Kazibudzki, Marek; Nowakowski, Przemyslaw; Orawczyk, Tomasz; Glanowski, Michal; Kucharzewski, Marcin; Ziaja, Damion; Szaniewski, Krzysztof; Ziaja, Krzysztof

    2007-07-01

    Ankle-brachial index (ABI) measurements are widely used for evaluating the functional state of circulation in the lower limbs. However, there is some evidence that the value of ABI does not accurately reflect the degree of walking impairment in symptomatic patients with peripheral arterial obstructive disease (PAOD). We investigated the diagnostic value of ABI estimated by means of laser Doppler flowmetry (IT) for evaluating limb ischemia. We wanted to know whether laser Doppler could be more sensitive than the Doppler method in predicting walking capacity in patients with stable intermittent claudication. We analyzed a group of 30 patients with intermittent claudication (Fontain II, II/III) who were admitted for reconstructive treatment. There were 21 men and 9 women, aged 46-74 (mean 61) years. All patients underwent the treadmill test, and pain-free walking distances were measured. In each patient, we measured ABI using the two different methods: Doppler ultrasound device (ABI-Doppler) and laser Doppler (ABI-laser Doppler). The claudication distances were 25-200 m (mean 73 +/- 50.2 m). ABI-Doppler was 0.2-0.7 (0.582 +/- 0.195). ABI-laser Doppler measurements were 0.581 (+/-0.218). A correlation was found between ABI-Doppler and claudication distance (r = 0.46, P = 0.009). Also, ABI-laser Doppler values significantly correlated with claudication distances (r = 0.536, P = 0.002). The ABI evaluated by laser Doppler correlated well with claudication distances in patients with PAOD. Comparison of Doppler and laser Doppler measurements used for determining ABI showed that both methods have similar predictive power for walking capacity; however, higher correlation was observed between claudication distances and ABI measured by laser Doppler flowmetry. ABI-laser Doppler measurements are easier, are quicker, and seem to be better suited for noncompliant patients. Further investigation should be undertaken to determine whether laser Doppler is superior to the Doppler

  1. Brachial plexopathy

    OpenAIRE

    Khadilkar, Satish V; Snehaldatta S Khade

    2013-01-01

    Brachial plexus injury can occur as a result of trauma, inflammation or malignancies, and associated complications. The current topic is concerned with various forms of brachial plexopathy, its clinical features, pathophysiology, imaging findings, and management. Idiopathic brachial neuritis (IBN), often preceded with antecedent events such as infection, commonly present with abruptonset painful asymmetric upper limb weakness with associated wasting around the shoulder girdle and arm muscles....

  2. Brachial plexus

    Science.gov (United States)

    The brachial plexus is a group of nerves that run from the lower neck through the upper shoulder area. These ... Damage to the brachial plexus nerves can cause muscle and sensation problems that are often associated with pain in the same area. Symptoms may ...

  3. Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral Infected aneurysm of brachial artery after mitral valve infective endocarditis

    Directory of Open Access Journals (Sweden)

    Heraldo Guedis Lobo Filho

    2011-03-01

    Full Text Available Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva mitral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa.We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis.

  4. Endothelial dysfunction and brachial intima-media thickness: long term cardiovascular risk with claudication related to peripheral arterial disease: a prospective analysis.

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    Franz Hafner

    Full Text Available OBJECTIVE: Endothelial dysfunction plays a key role in the development, progression, and clinical manifestation of atherosclerosis, and in symptomatic peripheral arterial disease, endothelial dysfunction and enlarged intima-media thickness might be associated with increased cardiovascular risk. Flow-mediated dilatation and serologic parameters are used to evaluate individual endothelial function. Brachial intima-media thickness, a less recognized parameter of cardiovascular risk, is independently associated with coronary artery disease. The aim of this study was to evaluate the prognostic value of ultrasound and serologic parameters of endothelial function in relation to cardiovascular mortality in peripheral arterial disease. DESIGN: monocentric, prospective cohort study. METHODS: Flow mediated dilatation and brachial intima-media thickness were assessed in 184 (124 male patients with peripheral arterial disease (Rutherford stages 2-3. Serologic parameters of endothelial function included asymmetric dimethylarginine (ADMA, symmetric dimethylarginine (SDMA, and L-homoarginine. Cardiovascular events were recorded during a follow-up of 99.1±11.1 months. Subjects who died of noncardiovascular causes were excluded from further analysis. RESULTS: Eighty-two patients (44.6% died during follow-up after a mean duration of 49.7±28.3 months. There were 49 cardiovascular deaths (59.8% and 33 other deaths (40.2%. Flow mediated dilatation was associated with cardiovascular death [1.17% (0.0, 4.3 vs. 4.1% (1.2, 6.4, p<0.001]. Intima-media thickness was greater in patients who succumbed to cardiovascular disease [0.37 mm (0.30, 0.41] than in survivors [0.21 mm (0.15, 0.38, p<0.001]. Brachial intima-media thickness above 0.345 mm was most predictive of cardiovascular death, with sensitivity and specificity values of 0.714 and 0.657, respectively (p<0.001. Furthermore, ADMA levels above 0.745 µmol/l and SDMA levels above 0.825 µmol/l were significantly

  5. Brachial plexopathy

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    Satish V Khadilkar

    2013-01-01

    Full Text Available Brachial plexus injury can occur as a result of trauma, inflammation or malignancies, and associated complications. The current topic is concerned with various forms of brachial plexopathy, its clinical features, pathophysiology, imaging findings, and management. Idiopathic brachial neuritis (IBN, often preceded with antecedent events such as infection, commonly present with abruptonset painful asymmetric upper limb weakness with associated wasting around the shoulder girdle and arm muscles. Idiopathic hypertrophic brachial neuritis, a rare condition, is usually painless to begin with, unlike IBN. Hereditary neuralgic amyotrophy is an autosomal-dominant disorder characterized by repeated episodes of paralysis and sensory disturbances in an affected limb, which is preceded by severe pain. While the frequency of the episodes tends to decrease with age, affected individuals suffer from residual deficits. Neurogenic thoracic outlet syndrome affects the lower trunk of the brachial plexus. It is diagnosed on the basis of electrophysiology and is amenable to surgical intervention. Cancer-related brachial plexopathy may occur secondary to metastatic infiltration or radiation therapy. Traumatic brachial plexus injury is commonly encountered in neurology, orthopedic, and plastic surgery set-ups. Trauma may be a direct blow or traction or stretch injury. The prognosis depends on the extent and site of injury as well as the surgical expertise.

  6. Brachial plexopathy.

    Science.gov (United States)

    Khadilkar, Satish V; Khade, Snehaldatta S

    2013-01-01

    Brachial plexus injury can occur as a result of trauma, inflammation or malignancies, and associated complications. The current topic is concerned with various forms of brachial plexopathy, its clinical features, pathophysiology, imaging findings, and management. Idiopathic brachial neuritis (IBN), often preceded with antecedent events such as infection, commonly present with abruptonset painful asymmetric upper limb weakness with associated wasting around the shoulder girdle and arm muscles. Idiopathic hypertrophic brachial neuritis, a rare condition, is usually painless to begin with, unlike IBN. Hereditary neuralgic amyotrophy is an autosomal-dominant disorder characterized by repeated episodes of paralysis and sensory disturbances in an affected limb, which is preceded by severe pain. While the frequency of the episodes tends to decrease with age, affected individuals suffer from residual deficits. Neurogenic thoracic outlet syndrome affects the lower trunk of the brachial plexus. It is diagnosed on the basis of electrophysiology and is amenable to surgical intervention. Cancer-related brachial plexopathy may occur secondary to metastatic infiltration or radiation therapy. Traumatic brachial plexus injury is commonly encountered in neurology, orthopedic, and plastic surgery set-ups. Trauma may be a direct blow or traction or stretch injury. The prognosis depends on the extent and site of injury as well as the surgical expertise. PMID:23661957

  7. Brachial plexopathy

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis

    2015-01-01

    Background Work-related upper limb disorders constitute a diagnostic challenge. However, patterns of neurological abnormalities that reflect brachial plexus dysfunction are frequent in limbs with pain, weakness and/or numbness/tingling. There is limited evidence about the association between...... occupational physical exposures and brachial plexopathy. Methods 80 patients with brachial plexopathy according to defined criteria and 65 controls of similar age and sex without upper limb complaints were recruited by general practitioners. Patients and controls completed a questionnaire on physical....... The identified psychosocial relations were limited to measures reflecting physical exposures. Conclusions While the identified risk indicators have previously been associated to upper limb symptoms as well as to diagnosed disorders other than brachial plexopathy, this study indicates an association between...

  8. Serum sP-Selectin Level and Brachial Artery Flow Mediated Dilation as Predictors of No Reflow in Patients with ST Segment Elevation Myocardial Infarction Undergoing Primary PCI

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    Ayman Saleh, Hany Awadallah, Hamdy Soliman , Eman Hasan , *Mohamed Omar

    2016-07-01

    Full Text Available Background: no reflow phenomenon is associated with major adverse cardiac events, prediction of no reflow using laboratory and noninvasive imaging techniques can help in early prevention and management of this phenomenon. Objectives: to investigate the predictive value of serum sP-selectin and endothelial dysfunction assessed by using brachial artery flow mediated dilation (FMD in patients with STEMI undergoing primary PCI to address patients with high incidence of no reflow. Methods: the prognostic performance, clinical and angiographic correlates of sP-selectin and FMD was assessed in 96 patients admitted in National Heart Institute and Ain Shams University Hospitals by STEMI and underwent primary PCI as a reperfusion strategy. Each patient was subjected to (history taking, clinical examination, laboratory investigations including withdrawal of serum samples for detection of sP-selectin levels, echocardio-graphy, assessment of endothelial dysfunction by measuring the FMD, assessment of the angiographic results using TIMI flow grade and myocardial blush grade. Follow up of the patients during hospital stay and after one month for the incidence of MACE. Results: a significant correlation between patients with high serum sP-selectin and TIMI flow ≤ II was found (P=0.038 and between the serum levels of the sP-selectin and the MBG score (P=0.009, also a significant correlation between the FMD and the MBG score among the study cases (P=0.029 as well as a significant correlation between the FMD and the serum P-selectin level among study cases (P=0.016. There were no statistical significance between TIMI flow grade and brachial artery FMD (P=0.075. Also no significant correlation was found between the patients' serum levels of sP-selectin, brachial artery FMD and the incidence of MACE during the hospital stay or during one month of follow up after discharge (P=0.127 and P=0.693, respectively. Conclusions: serum sP-selectin level in patients with

  9. Clinical significance of inter-arm pressure difference and ankle-brachial pressure index in patients with suspected coronary artery disease

    International Nuclear Information System (INIS)

    Although measuring blood pressure at the bilateral brachia is common in medical practice, its clinical significance in patients with suspected coronary artery disease (CAD) has not been fully clarified. The method of this study was to define the significance of inter-arm systolic blood pressure difference in patients with suspected CAD, and to assess the relationship between inter-arm pressure difference and CAD, simultaneous brachial and ankle blood pressure measurements and stress myocardial single-photon emission computed tomography (SPECT) were performed in 386 consecutive patients with suspected CAD, excluding those with previous myocardial infarction or coronary revascularization. Subclavian artery stenosis, defined as ≥15 mmHg inter-arm systolic blood pressure difference, was found in 27 patients (7%). Age (65±12 vs 65±11 years), male sex (21/27 vs 244/359), prevalence of hypertension (63% vs 56%), hypercholesterolemia (63% vs 62%), diabetes mellitus (33% vs 38%), cigarette smoking (44% vs 41%) and family history of CAD (15% vs 12%) were similar between patients with subclavian artery stenosis and those without. The incidence of decreased ankle-brachial pressure index (ABI) was higher (37% vs 12%, p=0.001), and percentage ischemic myocardium as assessed by SPECT was greater (9.0±8.5% vs 5.6±6.6%, p=0.05) in patients with subclavian artery stenosis than in those without. Furthermore, significant correlations were observed between inter-arm pressure difference and percentage ischemic myocardium (r=0.13; p=0.01), and ABI (r=-0.26, p<0.0001). Among 386 patients, 283 underwent coronary angiography, and 63% of those who had inter-arm blood pressure difference had CAD. Furthermore, 83% of those CAD patients had multi-vessel CAD, which is regarded as a high-risk subset for subsequent cardiac events. Inter-arm pressure difference is often found in patients with suspected CAD, and is associated with significant CAD and peripheral artery disease. Thus, inter

  10. Genome-wide association of echocardiographic dimensions, brachial artery endothelial function and treadmill exercise responses in the Framingham Heart Study

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    Newton-Cheh Christopher

    2007-09-01

    Full Text Available Abstract Background Echocardiographic left ventricular (LV measurements, exercise responses to standardized treadmill test (ETT and brachial artery (BA vascular function are heritable traits that are associated with cardiovascular disease risk. We conducted a genome-wide association study (GWAS in the community-based Framingham Heart Study. Methods We estimated multivariable-adjusted residuals for quantitative echocardiography, ETT and BA function traits. Echocardiography residuals were averaged across 4 examinations and included LV mass, diastolic and systolic dimensions, wall thickness, fractional shortening, left atrial and aortic root size. ETT measures (single exam included systolic blood pressure and heart rate responses during exercise stage 2, and at 3 minutes post-exercise. BA measures (single exam included vessel diameter, flow-mediated dilation (FMD, and baseline and hyperemic flow responses. Generalized estimating equations (GEE, family-based association tests (FBAT and variance-components linkage were used to relate multivariable-adjusted trait residuals to 70,987 SNPs (Human 100K GeneChip, Affymetrix restricted to autosomal SNPs with minor allele frequency ≥0.10, genotype call rate ≥0.80, and Hardy-Weinberg equilibrium p ≥ 0.001. Results We summarize results from 17 traits in up to 1238 related middle-aged to elderly men and women. Results of all association and linkage analyses are web-posted at http://ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?id=phs000007. We confirmed modest-to-strong heritabilities (estimates 0.30–0.52 for several Echo, ETT and BA function traits. Overall, p -5 in either GEE or FBAT models were observed for 21 SNPs (nine for echocardiography, eleven for ETT and one for BA function. The top SNPs associated were (GEE results: LV diastolic dimension, rs1379659 (SLIT2, p = 1.17*10-7; LV systolic dimension, rs10504543 (KCNB2, p = 5.18*10-6; LV mass, rs10498091 (p = 5.68*10-6; Left atrial size, rs

  11. Subclavian artery angioplasty in elderly patients with coronary-subclavian steal syndrome: preliminary comparison between a modified brachial technique and the standard femoral approach

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Background and Objective Elderly patients who have been submitted to coronary bypass grafting with the left internal mammary artery (LIMA) may develop a coronary-subclavian steal syndrome because of a left subclavian artery (LSA) stenosis. Usually stenting of LSA is performed by the standard femoral route with guiding catheter technique, but this technique can be particularly difficult in elderly patients who often have iliac-femoral kinking and aortic tortuosity. We compared a new "ad hoc" brachial artery approach technique with the standard guiding catheter technique through the femoral access. Methods Between January 2005 and September 2006, four patients underwent LSA stenting using the left brachial artery access obtained with a 6F or 7F 45-cm-long valved anti-kinking sheath as the Super Arrow Flex sheath (Arrow International, PA, USA). The sheath was positioned just before the LIMA graft ostium and a 0.035 inch 260-cm-long Storq guidewire (Cordis Inc., Johnson & Johnson, Warren, NJ) was advanced across the lesion to the descending aorta. A balloon-expandable Genesis (Cordis Inc., Johnson & Johnson, Warren, NJ) endovascular stent was easily deployed, and the correct position was checked by direct contrast injection through the long sheath. This small group of patients has been compared to a group of 5 age-matched patients with coronary steal syndrome in whom the procedure has been performed with standard technique including femoral approach and guide catheter. Results The procedure was successful in all patients; vertebral and LIMA ostia remained patent in all cases. In the control group, cannulation of the subclavian artery was difficult in two cases, while one patient developed a groin hematoma. Mean pretreatment gradient was 32 mm Hg with a range of 25 to 40 mm Hg (34 mmHg, range 26-43, in the control group, P=0.87) and fell to 2 mm Hg with a range of 0 to 4 mm Hg (3.1 mmHg, range 0 to 5, P=0.89) posttreatment. Mean contrast dose was 60±16 ml (138±26 ml

  12. Prolonged low flow reduces reactive hyperemia and augments low flow mediated constriction in the brachial artery independent of the menstrual cycle.

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    Mark Rakobowchuk

    Full Text Available Non-invasive forearm ischemia-reperfusion injury and low flow induced vascular dysfunction models provide methods to evaluate vascular function. The role of oestrogen, an endogenous anti-oxidant on recovery from ischemia-reperfusion injury has not been evaluated nor has the impact of prolonged low flow on vascular function been established. Eight healthy women (33±10 yr attended the lab during the follicular, ovulatory and mid-luteal phases of their menstrual cycles. After 30 minutes of rest, brachial artery vascular function was assessed by ultrasound measurements of diameter changes during 5 minutes of forearm ischemia and 3 minutes after. Subsequently, a 20-minute forearm ischemia period was completed. Further, vascular function assessments were completed 15, 30 and 45 minutes into recovery. Flow-mediated dilation, low-flow-mediated constriction, and reactive hyperaemia proximal to the area of ischemia were determined. Flow-mediated dilation was reduced at 15 minutes of recovery but recovered at 30 and 45 minutes (PRE: 7.1±1.0%, POST15∶4.5±0.6%, POST30∶5. 5±0.7% POST45∶5.9±0.4%, p<0.01. Conversely, low-flow mediated constriction increased (PRE: -1.3±0.4%, POST15: -3.3±0.6%, POST30: -2.5±0.5% POST45: -1.5±0.12%, p<0.01. Reactive hyperaemia was reduced throughout recovery (p<0.05. Data were unaffected by menstrual phase. Prolonged low flow altered vascular function and may relate as much to increased vasoconstriction as with decreased vasodilation. Reductions in anterograde shear and greater retrograde shear likely modulate the brachial artery response, but the reduced total shear also plays an important role. The data suggest substantial alterations in vascular function proximal to areas of ischemia with potential clinical implications following reperfusion.

  13. Relationship between resistant hypertension and arterial stiffness assessed by brachial-ankle pulse wave velocity in the older patient

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    Chung CM

    2014-09-01

    Full Text Available Chang-Min Chung,1,2 Hui-Wen Cheng,2 Jung-Jung Chang,2 Yu-Sheng Lin,2 Ju-Feng Hsiao,2 Shih-Tai Chang,1 Jen-Te Hsu2,31School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, 2Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, 3Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, TaiwanBackground: Resistant hypertension (RH is a common clinical condition associated with increased cardiovascular mortality and morbidity in older patients. Several factors and conditions interfering with blood pressure (BP control, such as excess sodium intake, obesity, diabetes, older age, kidney disease, and certain identifiable causes of hypertension are common in patients resistant to antihypertensive treatment. Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV, is increasingly recognized as an important prognostic index and potential therapeutic target in hypertensive patients. The aim of this study was to determine whether there is an association between RH and arterial stiffness. Methods: This study included 1,620 patients aged ≥65 years who were referred or self-referred to the outpatient hypertension unit located at a single cardiovascular center. They were separated into normotensive, controlled BP, and resistant hypertension groups. Home BP, blood laboratory parameters, echocardiographic studies and baPWV all were measured. Results: The likelihood of diabetes mellitus was significantly greater in the RH group than in the group with controlled BP (odds ratio 2.114, 95% confidence interval [CI] 1.194–3.744, P=0.010. Systolic BP was correlated in the RH group significantly more than in the group with controlled BP (odds ratio 1.032, 95% CI 1.012–1.053, P=0.001. baPWV (odds ratio 1.084, 95% CI 1.016–1.156, P=0.015 was significantly correlated with the presence of RH. The other factors were negatively correlated with the existence of RH.Conclusion: In

  14. Management of carotid Dacron patch infection: a case report using median sternotomy for proximal common carotid artery control and in situ polytetrafluoroethylene grafting.

    Science.gov (United States)

    Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Ceccanei, Gianluca; Pacilè, Maria Antonietta

    2009-01-01

    We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained through a median sternotomy, because the patient was markedly obese with minimal thyromental distance, and the treatment consisting of in situ polytetrafluoroethylene bypass grafting, due to the absence of a suitable autogenous saphenous vein. Median sternotomy is rarely required in case of reintervention for septic false aneurysms and hematomas following carotid endarterectomy but should be considered whenever difficult control of the common carotid artery, when entering the previous cervicotomy, is anticipated. In situ polytetrafluoroethylene grafting can be considered if autogenous vein material is lacking. PMID:19875014

  15. Severe upper extremity polyneuropathy due to inferior brachial plexus compression as a result of left subclavian artery pseudoaneurism

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    George Kosmadakis

    2012-01-01

    Full Text Available In the present report, we describe the case of a 76-year-old hemodialysis patient who was admitted with clinical features of neurological thoracic exit syndrome due to subclavian artery pseudoaneurism following the insertion of a dual lumen vascular internal jugular catheter (vascath with excellent outcome after endo-arterial stent placement.

  16. 缺血性卒中患者踝臂指数与颅内动脉狭窄数量的关系%Relationship between Ankle Brachial Index and Number of Intracerebral Artery Stenosis in Patients with Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    李轶; 孙海欣; 董可辉; 王拥军

    2011-01-01

    目的 探讨缺血性脑卒中患者踝臂指数(ABI)与颅内动脉狭窄支数的相关性.方法 测量314例行脑血管造影的缺血性卒中患者的ABI值,并收集其相关临床资料.结果 ABI异常、年龄与缺血性卒中患者颅内动脉狭窄数量有关.ABI值与患者具备的危险因素(高血压、糖尿病、冠心病及缺血性卒中史)数量之间存在负相关性,两者之间存在线性趋势(x2=36.35,P<0.001).ABI值与狭窄血管数量之间存在负相关性,两者之间存在线性趋势.结论 缺血性脑卒中患者ABI值与颅内动脉狭窄数量具有相关性.%Objective To investigate the relationship of ankle brachial index and the number of intracranial artery stenosis. Methods Ankle brachial index were measured in 314 patients with ischemic cerebrovascular disease received cerebral angiograpathy. Their data including general information and medical history were collected. Results Abnormality of ankle brachial index and age were associated with the number of intracranial artery stenosis in patients with ischemic stroke. Ankle brachial index was negative correlation with the number of risk factors( hyperten-tion/diabetes/coronary heart disease/ischemic stroke history) (r, = -0. 292,P <0. 001). Linear trend analysis showed linear trend between them(x2 =36. 35 ,P<0.001). Ankle brachial index was negative correlation with the number of intracranial artery stenosis(r, = -0. 161 ,P = 0.004). Trend analysis showed linear trend between them(x2 = 6. 53,P = 0. 01). Conclusion Ankle brachial index was associated with the number of intracerebral artery stenosis.

  17. Combination of pulse volume recording (PVR) parameters and ankle-brachial index (ABI) improves diagnostic accuracy for peripheral arterial disease compared with ABI alone.

    Science.gov (United States)

    Hashimoto, Tomoko; Ichihashi, Shigeo; Iwakoshi, Shinichi; Kichikawa, Kimihiko

    2016-06-01

    The ankle-brachial index (ABI) measurement is widely used as a screening tool to detect peripheral arterial disease (PAD). With the advent of the oscillometric ABI device incorporating a system for the measurement of pulse volume recording (PVR), not only ABI but also other parameters, such as the percentage of mean arterial pressure (%MAP) and the upstroke time (UT), can be obtained automatically. The purpose of the present study was to compare the diagnostic accuracy for PAD with ABI alone with that of a combination of ABI, %MAP and UT. This study included 108 consecutive patients on whom 216 limb measurements were performed. The sensitivity, specificity and positive and negative predictive values of ABI, %MAP, UT and their combination were evaluated and compared with CT angiography that was used as a gold standard for the detection of PAD. The diagnostic accuracy as well as the optimal cutoff values of %MAP and UT were evaluated using receiver operating characteristic (ROC) curve analysis. The combination of ABI, %MAP and UT achieved higher sensitivity, negative predictive value and accuracy than ABI alone, particularly for mild stenosis. The areas under the ROC curve for the detection of 50% stenosis with UT and %MAP were 0.798 and 0.916, respectively. The optimal UT and %MAP values to detect ≧50% stenosis artery were 183 ms and 45%, respectively. The combination of ABI, %MAP and UT contributed to the improvement of the diagnostic accuracy for PAD. Consideration of the values of %MAP and UT in addition to ABI may have a significant impact on the detection of early PAD lesions.

  18. Hemodynamic Changes in the Brachial Artery Induced by Acupuncture Stimulation on the Lower Limbs: A Single-Blind Randomized Controlled Trial

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    Masashi Watanabe

    2012-01-01

    Full Text Available Acupuncture is commonly performed at acupoints. No comparisons of quantitative physiological alterations in the brachial artery (BA induced by the stimulation of different acupoints in the lower limbs have been performed in humans. Therefore, we investigated changes in blood flow volume (BFV in the BA as an indicator of the physiological effects induced by stimulation at 3 points. Seventy-five healthy participants aged 33 ± 9 years (mean ± SD were enrolled and randomly assigned to 3 groups; they received stimulation at 3 different points located on the lower limbs: ST36, LR3, and a non-acupoint. Stimulation was performed bilaterally with manual rotation of the needles. Using ultrasonography, BFV was measured continuously from rest to 180 seconds after stimulation. LR3 stimulation significantly increased BFV compared to that before needle insertion. Meanwhile, stimulation at ST36 and the non-acupoint significantly decreased BFV compared to that before needle insertion. Stimulation at LR3 elicited a significant increase in BFV compared to that at ST36 and the non-acupoint. The results suggest that the stimulation of different points on the lower limbs causes distinct physiological effects on BFV in the BA.

  19. Hemodynamic changes in the brachial artery induced by acupuncture stimulation on the lower limbs: a single-blind randomized controlled trial.

    Science.gov (United States)

    Watanabe, Masashi; Takayama, Shin; Hirano, Atsushi; Seki, Takashi; Yaegashi, Nobuo

    2012-01-01

    Acupuncture is commonly performed at acupoints. No comparisons of quantitative physiological alterations in the brachial artery (BA) induced by the stimulation of different acupoints in the lower limbs have been performed in humans. Therefore, we investigated changes in blood flow volume (BFV) in the BA as an indicator of the physiological effects induced by stimulation at 3 points. Seventy-five healthy participants aged 33 ± 9 years (mean ± SD) were enrolled and randomly assigned to 3 groups; they received stimulation at 3 different points located on the lower limbs: ST36, LR3, and a non-acupoint. Stimulation was performed bilaterally with manual rotation of the needles. Using ultrasonography, BFV was measured continuously from rest to 180 seconds after stimulation. LR3 stimulation significantly increased BFV compared to that before needle insertion. Meanwhile, stimulation at ST36 and the non-acupoint significantly decreased BFV compared to that before needle insertion. Stimulation at LR3 elicited a significant increase in BFV compared to that at ST36 and the non-acupoint. The results suggest that the stimulation of different points on the lower limbs causes distinct physiological effects on BFV in the BA. PMID:23304231

  20. Brachial Plexus Anatomy: Normal and Variant

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    Steven L. Orebaugh

    2009-01-01

    Full Text Available Effective brachial plexus blockade requires a thorough understanding of the anatomy of the plexus, as well as an appreciation of anatomic variations that may occur. This review summarizes relevant anatomy of the plexus, along with variations and anomalies that may affect nerve blocks conducted at these levels. The Medline, Cochrane Library, and PubMed electronic databases were searched in order to compile reports related to the anatomy of the brachial plexus using the following free terms: "brachial plexus", "median nerve", "ulnar nerve", "radial nerve", "axillary nerve", and "musculocutanous nerve". Each of these was then paired with the MESH terms "anatomy", "nerve block", "anomaly", "variation", and "ultrasound". Resulting articles were hand searched for additional relevant literature. A total of 68 searches were conducted, with a total of 377 possible articles for inclusion. Of these, 57 were found to provide substantive information for this review. The normal anatomy of the brachial plexus is briefly reviewed, with an emphasis on those features revealed by use of imaging technologies. Anomalies of the anatomy that might affect the conduct of the various brachial plexus blocks are noted. Brachial plexus blockade has been effectively utilized as a component of anesthesia for upper extremity surgery for a century. Over that period, our understanding of anatomy and its variations has improved significantly. The ability to explore anatomy at the bedside, with real-time ultrasonography, has improved our appreciation of brachial plexus anatomy as well.

  1. 肱动脉内皮功能对老年冠心病患者的预测价值%The value of endothelial function of brachial artery in predicting coronary artery disease in elderly patients

    Institute of Scientific and Technical Information of China (English)

    刘东红; 刘艳秋; 林红; 姚凤娟; 杨震; 胡承恒

    2011-01-01

    目的 探讨肱动脉内皮功能对老年冠心病患者的预测价值.方法 测定98例冠心病患者及37例对照者肱动脉内皮依赖血管舒张功能(FMD)及非内皮依赖血管舒张功能(NMD),根据冠脉造影结果将患者分为冠脉病变<50%,50%~75%,>75%病变组和冠脉病变0、1、2、3支病变组,以比较老年冠心病患者冠脉病变程度、范围与肱动脉FMD及NMD的相关性,进一步探讨肱动脉内皮功能对老年冠心病患者的预测价值.结果 冠心病组肱动脉FMD及NMD均较对照组显著降低;FMD及NMD减低均与冠状动脉病变相关(r=-0.54,-0.52,均P<0.01),都与冠状动脉病变程度及范围呈弱相关性(P<0.01);FMD、NMD均可作为评估冠状动脉病变的独立因素(OR值分别为0.81、0.82),FMD和NMD对诊断冠心病有意义(P<0.05).结论 血管内皮功能对老年冠心病患者有一定的预测价值.%Objective To evaluate the value of endothelial function of brachial artery in predicting coronary artery disease in elderly patients. Methods Flow-mediated vasodilation (FMD)and nitroglycerin mediated dilation (NMD) were measured by high-frequency ultrasound in 98 patients with coronary artery disease and 37 controls. All the subjects were diagnosed by coronary arteriography. They were divided into coronary artery blockages < 50% subgroup, 50%-75%subgroup, >75% subgroup or coronary blockages in 0, 1, 2, 3 branch (es) subgroups. The correlations between FMD or NMD and the pathological extent or branches of coronary artery were studied and the predictive value of FMD and NMD were analyzed with ROC curve. Results In coronary artery disease group, FMD and NMD were significantly decreased as compared with the control group. They were closely related with coronary artery disease (r= -0. 54, -0. 52, P<0.01), and were weakly correlated with severity and range of coronary arterial lesion (P<0. 01).With ROC curve analysis, FMD and NMD could be used to predict coronary

  2. Avulsão do plexo braquial em cães - 2: biópsia fascicular e histologia dos nervos radial, mediano, ulnar e musculocutâneo Brachial plexus avulsion in dogs - 2: fascicular biopsy and histology of the radial, median, ulnar and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available O objetivo deste trabalho foi demonstrar os aspectos clínicos e neurológicos relevantes para o diagnóstico da avulsão do plexo braquial em cães, relacionando estes achados com os resultados da histologia dos nervos radiais, medianos, ulnar e músculo cutânea. A biópsia fascicular destes nervos foi realizada após abordagem cirúrgica às faces lateral e medial do braço afetado. Todos os fascículos submetidos ao exame histológico apresentaram alterações como tumefação axonal, degeneração walleriana e infiltrado inflamatório em graus variados, havendo principalmente nos nervos radial, mediano e ulnar a proliferação de colagem endoneural. A associação destes resultados com as alterações neurológicas e da eletroneuroestimulação (relatados na parte 1 e 3 deste trabalho respectivamente sugeriu envolvimento quase que total das raízes do plexo braquial em todos os casos.The main purposes of this work were the neurological evaluation of dogs with brachial plexus avulsion and correlation of these findings with the results of histology of the radial, median, and ulnar and muscle cutaneous nerves. Fascicular nerve biopsy was performed after surgical approach of medial and lateral aspect of the arm. Ali the submitted fascicles presented histologic alterations compatible with wallerian degeneration, axonal swelling, and inflammatory infiltrate ranging from mild to pronounced, with endoneural collagen proliferation mainly in radial, median and ulnar nerves. The association of these results with neurological and electroneurostimulation exams (respectively described in part 1 and 3 of this work suggested in all cases an almost total involvement of brachial plexus roots.

  3. Doença arterial obstrutiva periférica e índice tornozelo-braço em pacientes submetidos à angiografia coronariana Peripheral arterial occlusive disease and ankle-brachial index in patients who had coronary angiography

    Directory of Open Access Journals (Sweden)

    Sthefano Atique Gabriel

    2007-03-01

    Full Text Available OBJETIVO: Avaliar a prevalência de doença arterial obstrutiva periférica (DAOP em coronariopatas. Avaliar a relação entre Índice Tornozelo-Braço (ITB e doença coronariana, e sua correlação com fatores de risco cardiovascular. MÉTODO: ITB investigado com ultra-sonografia Doppler. Características clínicas pesquisadas: idade, sexo, diabetes mellitus, hipertensão arterial sistêmica, etilismo, tabagismo e obesidade. População: 113 pacientes submetidos à angiografia coronariana. Primeira análise: 2 grupos - ausência e presença de coronariopatia. Segunda análise: 3 grupos - Grupo 1 - ausência de lesão coronariana; Grupo 2 - estenose 70%. Terceira análise: 2 grupos - ausência e presença de DAOP. RESULTADOS: 90,76% dos coronariopatas apresentaram DAOP. Houve diferença significante quanto à faixa etária (pOBJECTIVE: To evaluate the prevalence of peripheral arterial disease (PAD in patients with coronary arterial disease. To evaluate the relation between ankle-brachial index (ABI and coronary arterial disease, and its correlation with cardiovascular risk factors. METHOD: ABI investigated with Doppler ultrasonic device. Clinical characteristics researched: age, gender, diabetes, hypertension, alcoholism, smoking and obesity. Population: 113 patients who had coronary angiography. First analyses: 2 groups - absence and presence of coronary arterial disease. Second analyses: 3 groups - Group 1 - absence of coronary lesion; Group 2 - stenosis 70%. Third analyses: 2 groups - absence and presence of PAD. RESULTS: 90.76% of patients with coronary arterial disease presented PAD. There were significant difference including age (p<0.001, hypertension (p<0.001. smoking (p<0.001, body mass index (BMI (p<0.001, systolic blood pressure (SBP (p<0.001, diastolic blood pressure (DBP (p<0.001 and pulse pressure (PP (p<0.001 and ABI (p<0.001 between patients with and without coronary lesion. There were significant difference including age (p<0

  4. Brachial plexus (image)

    Science.gov (United States)

    The brachial plexus is a group of nerves that originate from the neck region and branch off to give rise ... movement in the upper limb. Injuries to the brachial plexus are common and can be debilitating. If the ...

  5. [THE EFFECTIVENESS OF THE CORRECTION OF ENDOTHELIAL DYSFUNCTION AND REMODELING OF THE BRACHIAL ARTERY WITH CONCENTRIC AND ECCENTRIC LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH UNSTABLE ANGINA WITH COMORBID HYPERTENSION].

    Science.gov (United States)

    Denesiuk, E V

    2015-01-01

    The study involved patients with unstable angina (UA), comorbid hypertension (AH), myocardial infarction in 55.5% of cases. Systolic blood pressure was (163.2 ± 1.5) mm Hg. Art., diastolic blood pressure--(101.10 ± 0.67) mm Hg. Art., pulse pressure--(61.1 ± 17.0) mm Hg. Art. Examined patients underwent clinical studies, ECG in 12 conventional leads, echocardiography in M and B modes, Doppler ultrasonography of the brachial artery. To correct the detected change using standard combined therapy: perindopril 5-10 mg/day, bisoprolol--5-10 mg/day, atorvastatin--20 mg/day, acetylsalicylic acid--75-100 mg/day. Monitoring the treatment was carried out at 3; 6 and 12 months. Standard one-year comprehensive treatment of patients with UA with comorbid AH resulted in significant improvement of effective endothelial dysfunction in concentric and eccentric left ventricular hypertrophy in 3; 6 and 12 months, however, regression of hypertrophy brachial artery advancing much less mainly in concentric left ventricular hypertrophy. PMID:27089719

  6. [Measurement ofthe ankle-brachial pressure index (ABPI)].

    Science.gov (United States)

    Kulisić, Sandra Marinović

    2012-10-01

    Measurement of the ankle-brachial pressure index, also known as ankle-brachial index or ankle-arm index is a ratio of the ankle blood pressure and brachial blood pressure. It is easy to perform and allows for diagnosis and further definition of the severity of peripheral arterial disease with sensitivity 90% and specificity 98%. The test is not appropriate for mild arterial changes as in case of comorbidity. Its further objectives are to identify patients at an higher risk of cardiovascular events. PMID:23193828

  7. Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Fabiane Noronha Bergonse

    2006-03-01

    Full Text Available FUNDAMENTOS: As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS: Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS: Foram estudados 40 doentes portadores de úlcera venosa crônica, com o intuito de se avaliar a presença de doença arterial periférica pela medida do índice tornozelo/braço por doppler-ultra-som. RESULTADOS: O índice tornozelo/braço mostrou-se alterado (menor que 1 em 9/22 (40,9% doentes com úlcera venosa crônica e hipertensão arterial concomitante, e apenas em 1/13 (7,7% doentes de úlcera venosa crônica sem hipertensão arterial. CONCLUSÕES: Doentes de úlcera venosa crônica e hipertensão arterial concomitantes devem ser submetidos rotineiramente à medida do índice tornozelo/braço para detecção de possível insuficiência arterial periférica associada.BACKGROUND: Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES: Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS: Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS: The resting ankle/brachial pressure index was abnormal (lower than 1 in 9/22 (40.9% patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7% patients with chronic venous ulcers and no hypertension. CONCLUSIONS: Patients with concomitant chronic venous

  8. Assessing the perceived quality of brachial artery Flow Mediated Dilation studies for inclusion in meta-analyses and systematic reviews: Description of data employed in the development of a scoring ;tool based on currently accepted guidelines.

    Science.gov (United States)

    Greyling, Arno; van Mil, Anke C C M; Zock, Peter L; Green, Daniel J; Ghiadoni, Lorenzo; Thijssen, Dick H

    2016-09-01

    Brachial artery Flow Mediated Dilation (FMD) is widely used as a non-invasive measure of endothelial function. Adherence to expert consensus guidelines on FMD measurement has been found to be of vital importance to obtain reproducible data. This article lists the literature data which was considered in the development of a tool to aid in the objective judgement of the extent to which published studies adhered to expert guidelines for FMD measurement. Application of this tool in a systematic review of FMD studies (http://dx.doi.org/10.1016/j.atherosclerosis.2016.03.011) (Greyling et al., 2016 [1]) indicated that adherence to expert consensus guidelines is strongly correlated to the reproducibility of FMD data. PMID:27284565

  9. Assessing the perceived quality of brachial artery Flow Mediated Dilation studies for inclusion in meta-analyses and systematic reviews: Description of data employed in the development of a scoring ;tool based on currently accepted guidelines

    Directory of Open Access Journals (Sweden)

    Arno Greyling

    2016-09-01

    Full Text Available Brachial artery Flow Mediated Dilation (FMD is widely used as a non-invasive measure of endothelial function. Adherence to expert consensus guidelines on FMD measurement has been found to be of vital importance to obtain reproducible data. This article lists the literature data which was considered in the development of a tool to aid in the objective judgement of the extent to which published studies adhered to expert guidelines for FMD measurement. Application of this tool in a systematic review of FMD studies (http://dx.doi.org/10.1016/j.atherosclerosis.2016.03.011 (Greyling et al., 2016 [1] indicated that adherence to expert consensus guidelines is strongly correlated to the reproducibility of FMD data.

  10. Brachial plexus variations during the fetal period.

    Science.gov (United States)

    Woźniak, Jowita; Kędzia, Alicja; Dudek, Krzysztof

    2012-12-01

    The brachial plexus is an important nervous system structure. It can be injured during the perinatal period and by postnatal damage. The goal of this study was to assess human fetal brachial plexus variability. A total of 220 brachial plexuses were surgically prepared from 110 human fetuses aged 14-32 weeks of fetal life (50 females and 60 males) ranging in CRL from 80 to 233 mm. The study incorporated the following methods: dissectional and anthropological, digital image acquisition, digital image processing using Image J and GIMP software, and statistical methods (Statistica 9.0). Symmetry and sexual dimorphism were examined. Anomalies of the brachial plexuses were observed in 117 (53.18 %) cases. No sexual dimorphism was found. It was observed that cord variations occurred more often on the left side. Division variants (33.64 %) occurred most often, but also cords (18.18 %) as well as root nerves and terminal ramifications (15.90 %) were found. Trunk anomalies were rare and occurred in only 5.45 % of plexuses. Three height types of median nerve roots in combination with the nerve were distinguished. In one-third of cases, median nerve root connections were found below the axillary fossa and even half in the proximal part of the humerus. In conclusion, the brachial plexus was characterized for anatomical structural variability. Most often division and cord variations were observed. Anomalies occurred regardless of sex or body side except for cord variants. Brachial plexus variation recognition is significant from the neurosurgical and traumatological point of view. PMID:22945314

  11. 瑞芬太尼抑制患儿臂丛神经阻滞穿刺诱发体动反应的半数有效血浆靶浓度%Median effective target plasma concentration of remifentainil inhibiting body movement evoked by puncture during brachial plexus block in pediatric patients

    Institute of Scientific and Technical Information of China (English)

    朱志鹏; 沈颖彦; 吴军民; 肖旺频

    2013-01-01

    目的 确定瑞芬太尼抑制患儿臂丛神经阻滞穿刺诱发体动反应的半数有效血浆靶浓度(Cp50).方法 择期前臂或手外科手术患儿,年龄5~12岁,性别不限,发育正常,麻醉前30 min口服咪达唑仑0.2 mg/kg.瑞芬太尼初始血浆靶浓度5.0 ng/ml,采用序贯法确定其血浆靶浓度,穿刺诱发体动反应时下一例上调1级浓度,否则下调1级浓度,相邻浓度比值1.2.血浆靶浓度和效应室浓度达到平衡时,行臂丛神经阻滞穿刺.体动反应判断标准:穿刺诱发的肢体或/和头颈部的运动反应.计算其Cp50及95%可信区间.结果 瑞芬太尼抑制臂丛神经阻滞穿刺诱发体动反应的Cp50为3.9ng/ml,其95%可信区间为3.6~ 4.2 ng/ml.结论 瑞芬太尼抑制患儿臂丛神经阻滞穿刺诱发体动反应的Cp50为3.9 ng/ml.%Objective To determine the median effective target plasma concentration (Cp50) of remifentainil inhibiting body movement evoked by puncture during brachial plexus block in pediatric patients.Methods Pediatric patients of both sexes,aged 5-12 yr,who grown normally,scheduled for elective forearm or hand surgery,were enrolled in this study.Children were premedicated with oral midazolam 0.2 mg/kg at 30 min before anesthesia.The initial target Cp of remifentainil was 5.0 ng/ml.The target Cp was determined by up-and-down sequential method.Each time Cp increased/decreased by 20% in the next patient depending on the response of the previous patient to puncture.The ratio between the two successive concentrations was 1.2.The puncture was performed after the target effect-site and plasma concentrations were balanced.Body movement was defined as puncture-induced movement of truncus,limbs and/or head and neck.The Cp50 and 95 % confidence interval of remifentainil were calculated by Dixon method.Results Cp50 of remifentainil inhibiting body movement evoked by puncture during brachial plexus block was 3.9 ng/ml,and 95 % confidence interval was 3.6-4.2 ng

  12. 小颗粒明胶海绵栓塞犬髂内动脉及骶正中动脉后并发症的研究%COMPLICATION AFTER SELECTIVE ARTERIAL EMBOLIZATION IN INTERNAL ILIAC ARTERY AND MEDIAN SACRAL ARTERY WITH GELFOAM PARTICLE IN DOGS

    Institute of Scientific and Technical Information of China (English)

    李叶天; 尹宗生; 王伟; 秦坤鹏; 王亚光

    2011-01-01

    Objective To observe the complication after embol izing the bilateral internal iliac arteries and the median sacral artery of dogs by different combinations and embolization levels with gelfoam particle, and to provide a reference for safety application of gelfoam in clinic.Methods Sixteen common grade adult healthy dogs (weighing 10-13 kg, 14 males and 2 females) were randomly divided into 5 groups.Under the monitoring of digital subtraction angiography (DSA), the embolization was performed with gelfoam particle (diameter, 50-150 μm) in bilateral internal iliac arteries and the main branch of the median sacral artery (group A, n=3), in bilateral internal iliac arteries and the first branch of the median sacral artery (group B, n=3), in the main branch of bilateral internal iliac arteries (group C, n=3), in the unilateral internal iliac artery and the main branch of the median sacral artery (group D, n=4), and in the main branch of unilateral internal iliac artery (group E, n=3).Under the DSA,the anatomic relationships of the abdominal aorta, bilateral external iliac arteries, bilateral internal iliac arteries, and median sacral artery were observed before embolization.The survival dogs were observed and the specimens of bladder, rectum, sciatic nerve, and gluteal muscles were harvested for the general and histological observations at 3 days after embolization.Results In dogs, there was no common iliac artery; bilateral external iliac arteries originated from the abdominal aorta and the starting of the median sacral artery had variation.Seven dogs (3 in group A, 3 in group C, and 1 in group D) died within 2 days after embolization, and the others survived to the end of the experiment.In the dead dogs of groups A, C, and D, the darkening and necrosis of the rectum were observed; the bladder presented lamellar obfuscation and focal hemorrhage and edema; and the median urinary volume in bladder was 270.6 mL.In survival dogs, no obvious change was observed in the

  13. MRI of brachial plexopathies

    Energy Technology Data Exchange (ETDEWEB)

    Sureka, J. [Department of Radiology, Christian Medical College, Vellore (India)], E-mail: drjyoticmch@rediffmail.com; Cherian, R.A.; Alexander, M.; Thomas, B.P. [Department of Radiology, Christian Medical College, Vellore (India)

    2009-02-15

    Magnetic resonance imaging (MRI) has become the primary imaging technique in the evaluation of brachial plexus pathology, and plays an important role in the identification, localization, and characterization of the cause. Improvements in MRI technique have helped in detecting changes in the signal intensity of nerves, subtle enhancement, and in detecting perineural pathology, thereby refining the differential diagnosis. The present review of the visualization of brachial plexus abnormalities using MRI is based on a review of 26 cases. The causes include trauma and a spectrum of non-traumatic causes, such as acute idiopathic/viral plexitis, metastases, immune-mediated plexitis, and mass lesions compressing the brachial plexus.

  14. Stable Angina Pectoris : Evaluation of Ultrasonography in Detetion of Carotid Atherosclerosis and Flow-Mediated Dilation of Brachial Artery%超声检查颈动脉粥样硬化情况和肱动脉FMD对稳定性心绞痛的价值

    Institute of Scientific and Technical Information of China (English)

    田敏; 韩晓云; 王丽丽; 王小艳

    2011-01-01

    Objective: To explore the value of brachial artery FMD and common carotid arterial IMT in patients with stable angina evaluated by ultrasonography. Methods: We divided 65 patients with stable angina into mild stenosis, moderate stenosis and severe stenosis group. In all of cases, the IMT of common carotid artery and the FMD in the brachial artery were measured by ultrasouography. And their relationship were analyzed. Results: Califf risk score and As integral were obviously increased, aggravating with coronary artery stenosis, and there were positive correlation (P<0.05). Common carotid arterial IMT was obviously increased and brachial artery FMD was obviously reduced, aggravating with coronary artery stenosis. The two were negative correlation(P<0.05). Conclusion: It can control the clinical risk in SAP patients by noninvasive ultrasouography monitoring of brachial artery FMD and common carotid arterial IMT.%目的:探讨无创超声检查颈动脉粥样硬化情况和肱动脉FMD对SAP的价值.方法:将选取的65例SAP患者分为轻度狭窄组、中度狭窄组和重度狭窄组,超声检测所有病例的肱动脉FMD和颈总动脉IMT,并作Califf危险评分和As积分,分析观察指标间的关系.结果:Califf危险评分和As积分都随着冠脉狭窄程度的加深而增大,且二者呈正相关(P<0.05);颈总动脉IMT随着狭窄程度的加深而增大,肱动脉FMD则随着狭窄程度的加深而降低,二者呈负相关(P<0.05).结论:无创监测颈总动脉IMT和肱动脉FMD,可指导SAP临床风险的控制.

  15. Avulsão do plexo braquial em cães - 3: eletroneuroestimulação dos nervos radial, mediano, ulnar e musculocutâneo Brachial plexus avulsion in dogs - 3: electroneurostimulation of radial, median, ulnar and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available O objetivo deste trabalho foi relacionar os aspectos clínicos, neurológicos e histopatológicos (descritos nas partes l e 2 deste trabalho com os resultados obtidos após estimulação elétrica dos nervos radiai, mediano, ulnar e musculocutâneo. Realizou-se a estimulação elétrica destes nervos durante o ato cirúrgico no qual foram coletados os fascículos para histopatolo gia. Os nervos radial, mediano e ulnar de todos os cães submetidos à eletroneuroestimulação apresentaram evidências de degenera- ção. enquanto que o nervo musculocutâneo apresentava função próxima do normal em 25% dos casos. A associação dos resultados do exame neurológico, da histologia e da eletroneuroestimulação sugeriu envolvimento quase que total das raízes do plexo braquial, enfatizando a necessidade de continuidade de pesquisas na área, visando principalmente a recuperação das raízes nervosas envolvidas.The purpose ofthis work was to relate lhe clinicai, neurological and histopathotogical aspects (as described in the sections I and 2 ofthis work with the obtained results after the electric stimulation of radial, median, ulnar and musculocutaneous nerrves. The electric stimulation of these nerves was realized during the cirurgic act, when the fascicle were obtained for the histopathologic examination. The radial, median and ulnar nerves of ali dogs submitted to electroneurostimulation presented evidences of degeneration, while the musculocutaneous nerve present almost normal functions in 25% of the cases. The interpretation ofthe results obtained from neurologic, histologic and electroneurostimulation examination suggested the almost total involvement of brachial plexus in ali cases. This work emphasized the need for further research in this área with lhe main purpose of recuperating the involved roots.

  16. Surface‐enhanced Raman spectral biomarkers correlate with Ankle Brachial Index and characterize leg muscle biochemical composition of patients with peripheral arterial disease

    OpenAIRE

    Cluff, Kim; Kelly, Abby M.; Koutakis, Panagiotis; He, Xiang N.; Huang, Xi; Lu, Yong Feng; Pipinos, Iraklis I; Casale, George P.; Subbiah, Jeyamkondan

    2014-01-01

    Abstract Peripheral arterial disease (PAD) is characterized by atherosclerotic blockages of the arteries supplying the lower extremities, which cause a progressive accumulation of ischemic injury to the skeletal muscles of the lower limbs. This injury includes altered metabolic processes, damaged organelles, and compromised bioenergetics in the affected muscles. The objective of this study was to explore the association of Raman spectral signatures of muscle biochemistry with the severity of ...

  17. Transcutaneous oximetry but not arterial toe blood pressure or ankle-brachial index is related to macular thickness in patients with chronic diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Per Katzman

    2013-04-01

    Full Text Available Objectives: Diabetes related vascular complications of the lower extremity could be classified as micro- and macrovascular. Ankle-brachial index (ABI and toe blood pressure (TBP measurements evaluate macro-circulation, whereas transcutaneous oximetry (TcPO2 is considered to be a composite measure of vascular function, thereby also reflecting microcirculation. Microvascular disease in the eye involves abnormal capillary permeability and possibly thereby increased macular thickness. The aim of the present clinical study was to evaluate if microvascular disease in the eye was related to measures of foot ischemia in patients with diabetes mellitus. Methods: Twenty consecutive patients with diabetes and chronic full-thickness foot ulcers were included. Peripheral ischemia was diagnosed using TcPO2, TBP and ABI. Macular thickness was measured with optical coherence tomography technique. Results: Based on TcPO2, TBP and ABI measurements 14, 13 and 13 patients, respectively, were classified as ischemic. Patients with ischemic TcPO2 levels at the dorsum of the foot had significantly higher macular thicknesses. This was not the case in patients with ischemic TBP or ABI levels. Conclusion: TcPO2, unlike TBP and ABI, seems to be a clinically relevant measure of peripheral microvascular disease in patients with diabetes mellitus and may, if low, indicate an increased risk of macular edema. [J Exp Integr Med 2013; 3(2.000: 81-85

  18. Brachial plexopathy after chemoradiotherapy for head and neck squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Platteaux, Nele; Dirix, Piet; Nuyts, Sandra [Dept. of Radiation Oncology, Leuvens Kankerinstituut (LKI), Univ. Hospitals Leuven, Campus Gasthuisberg (Belgium); Hermans, Robert [Dept. of Radiology, Leuvens Kankerinstituut (LKI), Univ. Hospitals Leuven, Campus Gasthuisberg (Belgium)

    2010-09-15

    Purpose: To evaluate late brachial plexopathy after primary chemoradiotherapy for locally advanced head and neck squamous cell carcinoma. Patients and Methods: Consecutive 43 disease-free patients were evaluated by a specifically developed 26-item questionnaire. Retrospectively, the brachial plexus was delineated and the dose-volume histograms were calculated. Results: After a median follow-up of 24 months, no radiation-induced brachial plexopathy was reported in these 43 patients. Conclusion: No radiation-induced brachial plexopathy was seen in the patient group, although 72.1% of the brachial plexuses received doses > 60 Gy. These findings should prompt further prospective studies and also stress the importance of trying to keep the doses to the brachial plexus as low as possible while covering the target volumes well. (orig.)

  19. Peripheral Arterial Disease in Older People with Intellectual Disability in The Netherlands Using the Ankle-Brachial Index: Results of the HA-ID Study

    Science.gov (United States)

    de Winter, C. F.; Bastiaanse, L. P.; Kranendonk, S. E.; Hilgenkamp, T. I. M.; Evenhuis, H. M.; Echteld, M. A.

    2013-01-01

    Older people with an intellectual disability (ID) have been shown to have similar to increased cardiovascular risks as compared to the general population. Peripheral arterial disease (PAD), atherosclerosis distal from the aortic bifurcation, is associated with increased cardiovascular morbidity and mortality. The prevalence of PAD has not been…

  20. Brachial access technique for aortoiliac stenting revisited

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

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

  1. Genetic determinants of the ankle-brachial index

    DEFF Research Database (Denmark)

    Wassel, Christina L; Lamina, Claudia; Nambi, Vijay;

    2012-01-01

    Candidate gene association studies for peripheral artery disease (PAD), including subclinical disease assessed with the ankle-brachial index (ABI), have been limited by the modest number of genes examined. We conducted a two stage meta-analysis of ∼50,000 SNPs across ∼2100 candidate genes to iden...

  2. Proximity of arteries to the anterior ulna with changing flexion.

    Science.gov (United States)

    Enad, Jerome G; Douglas, Thomas J; Ruland, Robert T

    2015-04-01

    During surgery for elbow fracture, wires and screws crossing the elbow from posterior to anterior place the brachial and ulnar arteries at risk for inadvertent penetration. The authors' goal was to define the sagittal proximity of the brachial and ulnar arteries to the proximal ulna throughout an arc of elbow motion using dynamic fluoroscopy. The brachial artery was injected with barium in 10 fresh-frozen cadaveric elbows. Sagittal fluoroscopic images were obtained at elbow flexion angles of 0°, 30°, 60°, 90°, and 120°. Two measurements were obtained at each flexion angle: (1) the distance between the coronoid tip and the brachial artery and (2) the distance between the coronoid base and the ulnar artery. One-way analysis of variance was used to compare mean distances for each flexion angle within each measurement group. A coronal image identified the mediolateral course of the brachial artery. The distance from the coronoid tip to the brachial artery significantly increased with increasing flexion from 0° to 60° (P120° (P<.002). The brachial artery traversed lateral to the coronoid in 9 of 10 specimens. The brachial and ulnar arteries are located further from the coronoid with increasing elbow flexion to at least 60°, and the brachial artery is typically located lateral to the coronoid in the coronal plane. These measurements can be used as surgical guides to reduce the risk of arterial injury during olecranon fracture surgery. PMID:25901616

  3. Comparative on comparison between central aortic pressure and brachial artery pressure of hypertension pa-tients in elderly%老年高血压患者中心动脉压与肱动脉压的对比分析

    Institute of Scientific and Technical Information of China (English)

    冬兰; 周冬翠; 尹秋生; 毕磊

    2015-01-01

    Objective To compare the difference between central aortic pressure and brachial artery pressure in elderly patients with hypertension.Methods One hundred and fifty-two elderly patients with hypertension were enrolled this study.The central aortic pressure of each patient was measured by Sphygmo Cor(Australia),respective-ly,and compared with brachial artery pressure.Results The brachial artery systolic pressure and pulse pressure were higher than central aortic systolic pressure and pulse pressure[(134.34 ±16.38)mm Hg vs.(116.21 ±14.71)mm Hg,(61.16 ±14.74)mm Hg vs.(37.55 ±7.92)mm Hg]and the difference was significant (P <0.01).But the brachial artery diastolic pressure was lower than central aortic diastolic pressure,the difference was significantly statis-tically (P <0.01).Compared with hypertension patients of grade-Ⅰ,systolic pressure and pulse pressure of brachial artery,augmentation pressure and augmentation index of central aortic were significantly higher in hypertension pa-tients of grade-Ⅲ (P <0.05).Conclusion There is significant difference between central aortic pressure and bra-chial artery pressure,it is necessary to measure the central aortic pressure for diagnosis and treatment of hypertension in elderly patients.%目的:对老年高血压患者的中心动脉压(CAP)和肱动脉血压进行对比分析,观察 CAP 与肱动脉压的差异。方法采用动脉脉搏波分析仪测量152例老年高血压患者的 CAP,并与肱动脉血压进行比较分析。结果老年高血压患者的肱动脉收缩压(SBP)、脉压(PP)显著高于中心动脉的收缩压(cSBP)、脉压(cPP)[(134.34±16.38)mm Hg 比(116.21±14.71)mm Hg;(61.16±14.74)mm Hg 比(37.55±7.92) mm Hg],而肱动脉舒张压(DBP)则显著低于中心动脉的舒张压(cDBP)[(73.03±9.66)mm Hg 比(79.34± 11.23)mm Hg],差异均有统计学意义(P <0.01)。与Ⅰ级高血压患者相

  4. Structure of the brachial plexus root and adjacent regions displayed by ultrasound imaging

    Institute of Scientific and Technical Information of China (English)

    Zhengyi Li; Xun Xia; Xiaoming Rong; Yamei Tang; Dachuan Xu

    2012-01-01

    Brachial plexuses of 110 healthy volunteers were examined using high resolution color Doppler ultrasound. Ultrasonic characteristics and anatomic variation in the intervertebral foramen, interscalene, supraclavicular and infraclavicular, as well as the axillary brachial plexus were investigated. Results confirmed that the normal brachial plexus on cross section exhibited round or elliptic hypoechoic texture. Longitudinal section imaging showed many parallel linear hypo-moderate echoes, with hypo-echo. The transverse processes of the seventh cervical vertebra, the scalene space, the subclavian artery and the deep cervical artery are important markers in an examination. The display rates for the interscalene, and supraclavicular and axillary brachial plexuses were 100% each, while that for the infraclavicular brachial plexus was 97%. The region where the normal brachial plexus root traversed the intervertebral foramen exhibited a regular hypo-echo. The display rate for the C5-7 nerve roots was 100%, while those for C8 and T1 were 83% and 68%, respectively. A total of 20 of the 110 subjects underwent cervical CT scan. High-frequency ultrasound can clearly display the outline of the transverse processes of the vertebrae, which were consistent with CT results. These results indicate that high-frequency ultrasound provides a new method for observing the morphology of the brachial plexus. The C7 vertebra is a marker for identifying the position of brachial plexus nerve roots.

  5. Idiopathic Brachial Neuritis

    OpenAIRE

    Gonzalez-Alegre, Pedro; Recober, Ana; Kelkar, Praful

    2002-01-01

    Idiopathic brachial neuritis is a well defined clinical condition that most commonly affects young adults, seen usually by primary care physicians, neurologists or orthopaedic surgeons. Its onset is characterized by acute, aching shoulder pain lasting a few days to weeks, followed by progressive shoulder girdle and upper extremity weakness and atrophy, with a slow but progressive recovery of motor function over 6 to 18 months. Its early recognition can help avoid unnecessary and potentially h...

  6. 踝肱指数与趾肱指数在下肢动脉疾病诊断中的临床价值%Diagnostic value of ankle-brachial index and toe-brachial index in arterial disease of lower extremity

    Institute of Scientific and Technical Information of China (English)

    李岚; 刘道燕; 祝之明; 赵志钢; 闫振成; 倪银星; 孙芳; 孙靖; 徐兴森; 于浩; 李英莎

    2012-01-01

    Objective To investigate the clinical application and its influencing factors of ankle-brachial index (ABl) and toe-brachial index (TBI) in the diagnosis of arterial disease of lower extremity. Methods ABI and TBI were measured in 800 limbs of 402 patients with diabetes and/or hypertension hospitalized from July 2010 to February 2011 The patients were divided into narrow group (ABI<0.9), normal group (0.9≤ABI<1.3), and calcification group (ABI≤ 1.3) according to the value of ABI, and also into narrow group (TBI<0.7) and normal group (TBI≥ 0.7) according to the value of TBL The correlation of ABI with TBI was analyzed, and the differences in age, obesity parameters, biochemical indicators and other factors were compared between the groups. Influence of high-sensitivity C-reactive protein (hs-CRP) on ABI and TBI was further analyzed. Results Only when ABI<0.9, ABI and TBI have significant correlation (r=0.826, p<0.0l). When the group comparison based on ABI values, it was shown that the age and hs-CRP were significantly higher in the narrow group than in the normal group and calcification group (P<0.0l). The comparison between groups based on TBI values indicated that the age, systolic blood pressure and hs-CRP in the narrow group were significantly higher than those in the normal group (P<0.01 or P<0.05), ABI and TBI in the normal hs-CRP group were significantly higher than those in high hs-CRP group (P<0.05). Conclusion Hs-CRP may play an important role in the development and progression in peripheral arterial atherosclerosis. Therefore, ABI and TBI measurements in combination with hs-CRP level can improve early diagnosis of arterial disease of lower extremity%目的 探讨踝肱指数(ABI)、趾肱指数(TBI)在下肢动脉疾病诊断中的应用价值及其影响因素.方法 对2010年7月-2011年2月收治的402例糖尿病和(或)高血压患者的800条下肢行ABI和TBI检查,根据ABI结果分为狭窄组(ABI<0.9),正常组(0.9≤ABI< 1.3)

  7. Reversible brachial plexopathy following primary radiation therapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Salner, A.L.; Botnick, L.E.; Herzog, A.G.; Goldstein, M.A.; Harris, J.R.; Levene, M.B.; Hellman, S.

    Reversible brachial plexopathy has occurred in very low incidence in patients with breast carcinoma treated definitively with radiation therapy. Of 565 patients treated between January 1968 and December 1979 with moderate doses of supervoltage radiation therapy (average axillary dose of 5000 rad in 5 weeks), eight patients (1.4%) developed the characteristic symptoms at a median time of 4.5 months after radiation therapy. This syndrome consists of paresthesias in all patients, with weakness and pain less commonly seen. The symptom complex differs from other previously described brachial plexus syndromes, including paralytic brachial neuritis, radiation-induced injury, and carcinoma. A possible relationship to adjuvant chemotherapy exists, though the etiology is not well-understood. The cases described demonstrate temporal clustering. Resolution is always seen.

  8. Nerve transfer helps repair brachial plexus injury by increasing cerebral cortical plasticity

    Institute of Scientific and Technical Information of China (English)

    Guixin Sun; Zuopei Wu; Xinhong Wang; Xiaoxiao Tan; Yudong Gu

    2014-01-01

    In the treatment of brachial plexus injury, nerves that are functionally less important are trans-ferred onto the distal ends of damaged crucial nerves to help recover neuromuscular function in the target region. For example, intercostal nerves are transferred onto axillary nerves, and accessory nerves are transferred onto suprascapular nerves, the phrenic nerve is transferred onto the musculocutaneous nerves, and the contralateral C7 nerve is transferred onto the median or radial nerves. Nerve transfer has become a major method for reconstructing the brachial plexus after avulsion injury. Many experiments have shown that nerve transfers for treatment of brachi-al plexus injury can help reconstruct cerebral cortical function and increase cortical plasticity. In this review article, we summarize the recent progress in the use of diverse nerve transfer methods for the repair of brachial plexus injury, and we discuss the impact of nerve transfer on cerebral cortical plasticity after brachial plexus injury.

  9. Relationship of levels of Vitamin D with flow-mediated dilatation of brachial artery in patients of myocardial infarction and healthy control: A case–control study

    Science.gov (United States)

    Malik, Sarthak; Giri, Subhash; Madhu, S. V.; Rathi, Vinita; Banerjee, B. D.; Gupta, Nikhil

    2016-01-01

    Background: Cardiovascular diseases (CVD) remain the leading cause of death worldwide. Vitamin D deficiency has been linked to increased risk of adverse CV events. Vitamin D deficiency may be responsible for endothelial dysfunction which in turn affects the onset and progression of coronary artery disease and its risk factors, directly or indirectly through various mechanisms. Materials and Methods: It was case–control study. A total of 50 cases of acute myocardial infarction (AMI) (aged 40–60 years), admitted to medicine emergency/CCU, were taken as per ACC/AHA 2007 guidelines. An equal number of age- and sex-matched controls were also taken. Risk factors of AMI, flow-mediated dilatation (FMD), and 25(OH)D levels were studied in all cases and controls. Correlation was also studied between FMD and 25(OH)D. Results: The mean values of FMD were 18.86 ± 5.39% and 10.35 ± 4.90% in controls and cases, respectively (P GTN) was also studied and was found to be 26.175 ± 4.25% and 18.80 ± 5.72% in controls and cases, respectively (P GTN and 25(OH)D levels (r = 0.743, P < 0.01). Conclusion: In this study, it was found that FMD was markedly impaired in patients of AMI when compared to controls. It was also found that majority of the study population was Vitamin D deficient; however, the deficiency was more severe in patients of AMI. We also found out that FMD was positively correlated (r = 0.841) to the deficiency state of Vitamin D in all the study subjects. PMID:27730081

  10. Relationship of levels of Vitamin D with flow-mediated dilatation of brachial artery in patients of myocardial infarction and healthy control: A case-control study

    Directory of Open Access Journals (Sweden)

    Sarthak Malik

    2016-01-01

    Full Text Available Background: Cardiovascular diseases (CVD remain the leading cause of death worldwide. Vitamin D deficiency has been linked to increased risk of adverse CV events. Vitamin D deficiency may be responsible for endothelial dysfunction which in turn affects the onset and progression of coronary artery disease and its risk factors, directly or indirectly through various mechanisms. Materials and Methods: It was case-control study. A total of 50 cases of acute myocardial infarction (AMI (aged 40-60 years, admitted to medicine emergency/CCU, were taken as per ACC/AHA 2007 guidelines. An equal number of age- and sex-matched controls were also taken. Risk factors of AMI, flow-mediated dilatation (FMD, and 25(OHD levels were studied in all cases and controls. Correlation was also studied between FMD and 25(OHD. Results: The mean values of FMD were 18.86 ± 5.39% and 10.35 ± 4.90% in controls and cases, respectively (P < 0.05. The endothelial dilatation after glyceryl trinitrate (GTN was also studied and was found to be 26.175 ± 4.25% and 18.80 ± 5.72% in controls and cases, respectively (P < 0.05. The mean levels of 25(OHD in controls and cases were 25.45 ± 12.17 and 14.53 ± 8.28 ng/ml, respectively. In this study, 56% of subjects were Vitamin D deficient, 25% were Vitamin D insufficient, and only 19% had Vitamin D in normal range. A positive correlation coefficient was found between FMD and 25(OH Vitamin D levels (r = 0.841, P < 0.01. In this study, a positive correlation coefficient was also found between endothelial dilatation after GTN and 25(OHD levels (r = 0.743, P < 0.01. Conclusion: In this study, it was found that FMD was markedly impaired in patients of AMI when compared to controls. It was also found that majority of the study population was Vitamin D deficient; however, the deficiency was more severe in patients of AMI. We also found out that FMD was positively correlated (r = 0.841 to the deficiency state of Vitamin D in all the study

  11. Management of Brachial Plexus Injuries

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-02-01

    Full Text Available The results of early neurosurgical treatment of 58 infants with various types of brachial plexus birth injury have been compared with non-surgical intervention in 91 patients followed by a multidisciplinary team at the Brachial Plexus Program, Miami Children’s Hospital, FL.

  12. The Ultrasonographic Findings of Bifid Median Nerve

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Jin; Park, Noh Hyuck; Joh, Joon Hee [Myoungji Hospital, Gwandong University College of Medicine, Gangneung (Korea, Republic of); Lee, Sung Moon [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2009-09-15

    We wanted to evaluate the ultrasonographic findings of bifid median nerve and its clinical significance. We retrospectively reviewed five cases (three men and two women, mean age: 54 years) of incidentally found bifid median nerve from 264 cases of clinically suspected carpal-tunnel syndrome that were seen at our hospital during last 6 years. Doppler sonography was performed in all five cases and MR angiography was done in one case for detecting a persistent median artery. The difference ({Delta}CSA) between the sum of the cross-sectional areas of the bifid median nerve at the pisiform level (CSA2) and the cross-sectional area proximal to the bifurcation(CSA1) was calculated. The incidence of a bifid median nerve was 1.9%. All the patients presented with a tingling sensation on a hand and two patients had nocturnal pain. All the cases showed bifurcation of the nerve bundle proximal to the carpal tunnel. The margins appeared relatively smooth and each bundle showed a characteristic fascicular pattern. A persistent median artery was noted between the bundles in four cases. {Delta}CSA was more than 2 mm 2 in four cases. Bifid median nerve with a persistent median artery is a relatively rare normal variance and these are very important findings before performing surgical intervention to avoid potential nerve injury and massive bleeding. We highly suggest that radiologists should understand the anatomical characteristics of this anomaly and make efforts to detect it

  13. Adult traumatic brachial plexus injury

    Energy Technology Data Exchange (ETDEWEB)

    Rankine, J.J. E-mail: james.rankine@leedsth.nhs.uk

    2004-09-01

    Injury to the brachial plexus in the adult is usually a closed injury and the result of considerable traction to the shoulder. Brachial plexus injury in the adult is an increasingly common clinical problem. Recent advances in neurosurgical techniques have improved the outlook for patients with brachial plexus injuries. The choice of surgical procedure depends on the level of the injury and the radiologist has an important role in guiding the surgeon to the site of injury. This article will describe the anatomy and pathophysiology of traction brachial plexus injury in the adult. The neurosurgical options available will be described with emphasis on the information that the surgeon wants from imaging studies of the brachial plexus. The relative merits of MRI and CT myelography are discussed.

  14. Dose Constraints to Prevent Radiation-Induced Brachial Plexopathy in Patients Treated for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Amini, Arya [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); University of California Irvine School of Medicine, Irvine, California (United States); Yang Jinzhong; Williamson, Ryan [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); McBurney, Michelle L. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Erasmus, Jeremy [Department of Diagnostic Imaging, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K.; Karhade, Mandar; Komaki, Ritsuko; Liao, Zhongxing; Gomez, Daniel; Cox, James [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Dong, Lei [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Welsh, James, E-mail: jwelsh@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2012-03-01

    Purpose: As the recommended radiation dose for non-small-cell lung cancer (NSCLC) increases, meeting dose constraints for critical structures like the brachial plexus becomes increasingly challenging, particularly for tumors in the superior sulcus. In this retrospective analysis, we compared dose-volume histogram information with the incidence of plexopathy to establish the maximum dose tolerated by the brachial plexus. Methods and Materials: We identified 90 patients with NSCLC treated with definitive chemoradiation from March 2007 through September 2010, who had received >55 Gy to the brachial plexus. We used a multiatlas segmentation method combined with deformable image registration to delineate the brachial plexus on the original planning CT scans and scored plexopathy according to Common Terminology Criteria for Adverse Events version 4.03. Results: Median radiation dose to the brachial plexus was 70 Gy (range, 56-87.5 Gy; 1.5-2.5 Gy/fraction). At a median follow-up time of 14.0 months, 14 patients (16%) had brachial plexopathy (8 patients [9%] had Grade 1, and 6 patients [7%] had Grade {>=}2); median time to symptom onset was 6.5 months (range, 1.4-37.4 months). On multivariate analysis, receipt of a median brachial plexus dose of >69 Gy (odds ratio [OR] 10.091; 95% confidence interval [CI], 1.512-67.331; p = 0.005), a maximum dose of >75 Gy to 2 cm{sup 3} of the brachial plexus (OR, 4.909; 95% CI, 0.966-24.952; p = 0.038), and the presence of plexopathy before irradiation (OR, 4.722; 95% CI, 1.267-17.606; p = 0.021) were independent predictors of brachial plexopathy. Conclusions: For lung cancers near the apical region, brachial plexopathy is a major concern for high-dose radiation therapy. We developed a computer-assisted image segmentation method that allows us to rapidly and consistently contour the brachial plexus and establish the dose limits to minimize the risk of brachial plexopathy. Our results could be used as a guideline in future prospective

  15. Avulsion of the brachial plexus in a great horned owl (Bubo virginaus)

    Science.gov (United States)

    Moore, M.P.; Stauber, E.; Thomas, N.J.

    1989-01-01

    Avulsion of the brachial plexus was documented in a Great Horned Owl (Bubo virginianus). A fractured scapula was also present. Cause of these injuries was not known but was thought to be due to trauma. Differentiation of musculoskeletal injury from peripheral nerve damage can be difficult in raptors. Use of electromyography and motor nerve conduction velocity was helpful in demonstrating peripheral nerve involvement. A brachial plexus avulsion was suspected on the basis of clinical signs, presence of electromyographic abnormalities in all muscles supplied by the nerves of the brachial plexus and absence of median-ulnar motor nerve conduction velocities.

  16. Dose Constraints to Prevent Radiation-Induced Brachial Plexopathy in Patients Treated for Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: As the recommended radiation dose for non-small-cell lung cancer (NSCLC) increases, meeting dose constraints for critical structures like the brachial plexus becomes increasingly challenging, particularly for tumors in the superior sulcus. In this retrospective analysis, we compared dose-volume histogram information with the incidence of plexopathy to establish the maximum dose tolerated by the brachial plexus. Methods and Materials: We identified 90 patients with NSCLC treated with definitive chemoradiation from March 2007 through September 2010, who had received >55 Gy to the brachial plexus. We used a multiatlas segmentation method combined with deformable image registration to delineate the brachial plexus on the original planning CT scans and scored plexopathy according to Common Terminology Criteria for Adverse Events version 4.03. Results: Median radiation dose to the brachial plexus was 70 Gy (range, 56–87.5 Gy; 1.5–2.5 Gy/fraction). At a median follow-up time of 14.0 months, 14 patients (16%) had brachial plexopathy (8 patients [9%] had Grade 1, and 6 patients [7%] had Grade ≥2); median time to symptom onset was 6.5 months (range, 1.4–37.4 months). On multivariate analysis, receipt of a median brachial plexus dose of >69 Gy (odds ratio [OR] 10.091; 95% confidence interval [CI], 1.512–67.331; p = 0.005), a maximum dose of >75 Gy to 2 cm3 of the brachial plexus (OR, 4.909; 95% CI, 0.966–24.952; p = 0.038), and the presence of plexopathy before irradiation (OR, 4.722; 95% CI, 1.267–17.606; p = 0.021) were independent predictors of brachial plexopathy. Conclusions: For lung cancers near the apical region, brachial plexopathy is a major concern for high-dose radiation therapy. We developed a computer-assisted image segmentation method that allows us to rapidly and consistently contour the brachial plexus and establish the dose limits to minimize the risk of brachial plexopathy. Our results could be used as a guideline in future

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

    Directory of Open Access Journals (Sweden)

    Anbumani

    2015-03-01

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

  18. Subclavicular angiography with brachial-axillary artery externally and temporally occluded in interventional treatment of hemoptysis%肱-腋动脉体外临时阻断后行锁骨下动脉造影对判断咯血来源血管的价值

    Institute of Scientific and Technical Information of China (English)

    伍筱梅; 梁荣光; 赖清; 钱元新; 陈志远; 李平

    2011-01-01

    Objective To evaluate subclavicular angiography with brachial-axillary artery externally and temporally occluded in depicting hemoptysis-related ectopic arteries originating from shoulder, neck and chest wall in the interventional treatment of hemoptysis. Methods A retrospective analysis of the medical records and angiograms of 103 patients who underwent transarterial procedures for hemoptysis was carried out. The arteries originating from the subclavicular arteries supplying the shoulder, the neck and the chest wall, ectopic bronchial arteries (EBA) as well as non bronchial systemic arteries (NBSA), were depicted by subclavicular angiography with brachial-axillary artery externally and temporally occluded. The number and distribution of the responsible aberrant arteries were investigated. Results Of the hemoptysis-related arteries(n=372) depicted and embolized in the studies, 51.9% was normally-originated bronchial arteries(n=193),6.7% was ectopic bronchial arteries (n=25),41.4% was NBSA(n=154).Both anomalous and NBSA arising from subclavicular-axillary area(n=80) were accounted for 21.5% (80/372) of all aberrant arteries, and 44.7%(80/179) of all anomalous and NBSA (n=25+154=179).Of those arising from subclavicular-axillary arteries,56.3%(45/80) were found to be originated from the internal thoracic artery (n=45),98.2%(112/114)of responsible internal thoracic arteries and their distal branches were well depicted by subclavicular angiography with brachial-axillary artery externally and temporally occluded. Conclusion Subclavicular-axillary artery is a very important vessel where EBA and NBSA originate. Subclavicular angiography with brachial-axillary artery externally and temporally occluded could help to determine the abnormal arteries in the region quickly. The method should be taken as a routine procedure for interventional treatment of hemoptysis.%目的 探讨肱-腋动脉体外临时阻断后行锁骨下动脉造影对显示肩颈-胸壁区咯血来源血

  19. Brachial Artery Injury Accompanying Closed Elbow Dislocations

    Directory of Open Access Journals (Sweden)

    Patrick Harnarayan

    2015-01-01

    Conclusion: A high index of suspicion should be maintained in order to make the diagnosis early. Exploration with excision of the injured segment and reverse vein interposition grafting is the treatment of choice in these cases.

  20. MRI of the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Es, H.W. van [Dept. of Radiology, St. Antonius Ziekenhuis, Nieuwegein (Netherlands)

    2001-02-01

    Magnetic resonance imaging is the imaging method of first choice for evaluating the anatomy and pathology of the brachial plexus. This review discusses the used imaging techniques, the normal anatomy, and a variety of pathologies that can involve the brachial plexus. The pathology includes primary and secondary tumors (the most frequent secondary tumors being superior sulcus tumor and metastatic breast carcinoma), radiation plexopathy, trauma, thoracic outlet syndrome, neuralgic amyotrophy, chronic inflammatory demyelinating polyneuropathy (CIDP), and multifocal motor neuropathy (MMN). (orig.)

  1. Functional Median Polish

    KAUST Repository

    Sun, Ying

    2012-08-03

    This article proposes functional median polish, an extension of univariate median polish, for one-way and two-way functional analysis of variance (ANOVA). The functional median polish estimates the functional grand effect and functional main factor effects based on functional medians in an additive functional ANOVA model assuming no interaction among factors. A functional rank test is used to assess whether the functional main factor effects are significant. The robustness of the functional median polish is demonstrated by comparing its performance with the traditional functional ANOVA fitted by means under different outlier models in simulation studies. The functional median polish is illustrated on various applications in climate science, including one-way and two-way ANOVA when functional data are either curves or images. Specifically, Canadian temperature data, U. S. precipitation observations and outputs of global and regional climate models are considered, which can facilitate the research on the close link between local climate and the occurrence or severity of some diseases and other threats to human health. © 2012 International Biometric Society.

  2. Relationship between upper and lower limb conduit artery vasodilator function in humans

    OpenAIRE

    Thijssen, Dick H. J.; Rowley, Nicola; Padilla, Jaume; Simmons, Grant H; Laughlin, M. Harold; Whyte, Greg; Cable, N Timothy; Green, Daniel J

    2011-01-01

    Brachial artery flow-mediated dilation (FMD) is a strong predictor of future cardiovascular disease and is believed to represent a “barometer” of systemic endothelial health. Although a recent study [Padilla et al. Exp Biol Med (Maywood) 235: 1287–1291, 2010] in pigs confirmed a strong correlation between brachial and femoral artery endothelial function, it is unclear to what extent brachial artery FMD represents a systemic index of endothelial function in humans. We conducted a retrospective...

  3. Morphological description of the brachial plexus in ocelot (Leopardus pardalis

    Directory of Open Access Journals (Sweden)

    Kylma Lorena Saldanha Chagas

    2014-06-01

    Full Text Available The brachial plexus is formed by the ventral roots of the spinal nerves, which unite to form the nerve trunks. It is usually formed by contributions of the last three cervical nerves and the first two thoracic nerves. Due to the scarcity of information on neuroanatomy, this study aimed to determine the macroscopic morphology of the brachial plexus of the ocelot (Leopardus pardalis. In this work, we used two ocelot specimens from the area of the Paragominas Bauxite Mine, PA, Brazil/Empresa Terra LTDA, with permission from SEMA – BP Nos. 455/2009 and 522/2009. The animals were donated to the Research Laboratory of Animal Morphology (LaPMA, Federal Rural University of Amazonia (UFRA, after they were accidentally run over. They were fixed by intramuscular injection of 10% formaldehyde. After fixation, the animals were dissected, allowing visualization of the thoracic nerves, as well as the identification of the ventral rami of the cervical and thoracic spinal nerves forming the brachial plexus. The brachial plexus was found to be formed by four trunks, which originated the ventral branches of cervical spinal nerves C6, C7 and C8 and the first thoracic (T1. These trunks gave rise to the suprascapular, subscapular, musculocutaneous, axillary, radial, median, ulnar, thoracodorsal and lateral thoracic nerves.

  4. Sosiaalisen median merkitys verkkokauppatoiminnassa

    OpenAIRE

    Nieminen, Kira

    2014-01-01

    Opinnäytetyön aiheena on sosiaalisen median merkitys verkkokauppatoiminnassa. Tavoitteenani on selventää yritysten tarvetta sosiaalisen median palveluihin ja miten sitä voidaan hyödyntää yrityksen toiminnassa. Opinnäytetyön alussa käydään läpi sosiaalinen media terminä ja sen lisäksi mainitaan yritysten yleisimmin käyttämät sosiaalisen median palvelut sekä käydään läpi markkinointiviestinnän käsitettä digitaalisessa mediassa. Työssä pohjustetaan yritysten mediasuunnitteluprosessia ja sen vaih...

  5. Sosiaalisen median vallankumous

    OpenAIRE

    Suomijoki, Riku

    2012-01-01

    Tässä opinnäytetyössä selvitettiin, miten ihmiset toimivat sosiaalisessa mediassa ja käyttävät hyväkseen sen tuomia mahdollisuuksia sekä miten netin käyttäjät osallistuvat erilaisiin verkkopalvelutoimintoihin ja sosiaalisen median käyttöön. Opinnäytetyössä pohdittiin, miten digiaikana kasvanut sukupolvi mahdollisesti erottuu vanhemmista sukupolvista käyttäytymisellään ja minkälaisia arvoja sosiaalisen median mukana kasvaneet nuoret edustavat. Lisäksi tarkasteltiin, onko ihmisen yksityisyy...

  6. Value of brachial artery FMD and sCD40L in predicting acute coronary syndrome%超声检查肱动脉FMD和sCD40L对急性冠状动脉综合征的预测价值

    Institute of Scientific and Technical Information of China (English)

    赵娟; 张小勇; 邓彩妹; 沈锡林; 潘伟

    2014-01-01

    目的:探讨超声检查肱动脉血流介导性舒张( FMD )和血清可溶性细胞分化抗原40配体(sCD40L)对急性冠状动脉综合征(ACS)的预测价值。方法随机入选39名健康志愿者、39例稳定性心绞痛患者(SA组)和79例急性冠状动脉综合征(ACS)患者。 ACS患者包括不稳定性心绞痛患者49例(UA组),急性心肌梗死患者30例(AMI组)。用超声检查肱动脉FMD,并用ELISA法检测血清sCD40L的含量。研究ACS患者肱动脉FMD和血清sCD40L的变化。用Pearson相关性分析ACS患者肱动脉FMD与血清sCD40L水平的关系。结果肱动脉 FMD 正常对照组(9.52±2.54)%, SA 组(5.35±1.24)%, UA 组(3.32±1.41)%,AMI组(3.26±1.32)%,ACS患者肱动脉FMD下调(P<0.05)。血清sCD40L正常对照组(1.21±0.31)ng/ml,SA组(4.12±0.98)ng/ml,UA组(12.86±2.67)ng/ml,AMI组(13.95±2.83)ng/ml,ACS患者血清sCD40L升高(P<0.05)。 ACS患者肱动脉FMD与血清sCD40L水平呈负相关,r=-0.708,P=0.000。结论超声发现肱动脉FMD下调,血清sCD40L升高,对ACS有预测价值。%Objective To investigate the predictive value of ACS by brachial artery FMD and sCD 40L. Methods Thirty-nine healthy volunteers(control group), 39 patients with stable angina pectoris(SA group) and 79 patients with acute coronary syndrome (ACS),including 49 patients with unstable angina pectoris (UA group) and 30 patients with acute myocardial infarction (AMI group), were radomly selected.The patients with ACS were detected the brachial artery FMD by ultrasonic testing and the serum sCD 40L by ELISA.Relation of brachial artery FMD and serum sCD40L of ACS patients were analyzed by using Pearson correlation analysis .Results Compared with control group and SA goup , the brachial artery FMD decreased in UA group and AMI group ( 9.52 ±2.54 )%( control group) vs (5.35 ±1.24)%(SA group) vs (3.32 ±1.41)% (UA group) vs (3

  7. Towards optimal range medians

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Gfeller, Beat; Jørgensen, Allan Grønlund;

    2011-01-01

    We consider the following problem: Given an unsorted array of n elements, and a sequence of intervals in the array, compute the median in each of the subarrays defined by the intervals. We describe a simple algorithm which needs O(nlog k + klog n) time to answer k such median queries. This improves...... where the time per query is reduced to O(log n / log log n). We also give efficient dynamic variants of both data structures, achieving O(log2 n) query time using O(nlog n) space in the comparison model and O((log n/loglog n)2) query time using O(nlog n/log log n) space in the RAM model, and show...... that in the cell-probe model, any data structure which supports updates in O(logO(1)n) time must have Ω(log n/loglog n) query time. Our approach naturally generalizes to higher-dimensional range median problems, where element positions and query ranges are multidimensional - it reduces a range median query...

  8. Correlation of invasive central arterial pressure with peripheral arterial pressure and coronary sclerosis

    Institute of Scientific and Technical Information of China (English)

    吴琪

    2013-01-01

    Objective To study the consistency among non-invasive and invasive brachial artery pressure,radial artery pressure and invasive central arterial pressure,and to explore the correlation between the severe degree of coronary artery disease and invasive central aortic pressure.

  9. MRI of the Brachial Plexus

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Mostafavi

    2010-05-01

    Full Text Available Evaluation of the brachial plexus is a clinical chal-lenge. Physical examination has traditionally been a mainstay in evaluating and localizing pathology involving the brachial plexus. Physical examination is especially difficult in patients with scarring and fibrosis secondary to surgery or irradiation. Electrophysiologic studies may be used to detect abnormalities in nerve conduction, but are poor for localizing a lesion. "nMRI has become increasingly important in the evaluation of brachial plexus pathology, as the technology and resolution has improved. Correlation of imaging results with electrophysiologic findings increases the overall specificity and sensitivity. CT has increased sensitivity for depicting extrinsic masses that com-press the nerves; however, it offers poor soft tissue contrast to directly evaluate the nerves."nWith the advent of MRI, nerves that compose the brachial plexus can now be directly evaluated. Intrinsic and extrinsic pathology may be evaluated. Exact anatomic components of the brachial plexus, such as the roots, trunks, divisions, and cords may be identified. MRI has the additional benefit of multiplanar imaging and increased soft tissue contrast. The tissue resolution of MRI is constantly improving with new pulse sequences and coil designs."nWith radiography and CT, changes in the shape or position of the brachial plexus were used to assess the pathology. With MRI, the nerve can be directly visualized and evaluated for pathology. MRI sequences such as fat-saturated T2-weighted spin-echo, short-tau inversion recovery (STIR, and gadolinium-enhanced T1-weighted spin-echo sequences help in depicting subtle changes in the signal intensity of the nerves or enhancement and aid in refining the differential diagnosis. In addition, maximum intensity projections can make localization and visualization of the pathology most understandable for referring clinicians and surgeons.

  10. Hyperbolicity in Median Graphs

    Indian Academy of Sciences (India)

    José M Sigarreta

    2013-11-01

    If is a geodesic metric space and $x_1,x_2,x_3\\in X$, a geodesic triangle $T=\\{x_1,x_2,x_3\\}$ is the union of the three geodesics $[x_1 x_2],[x_2 x_3]$ and $[x_3 x_1]$ in . The space is -hyperbolic (in the Gromov sense) if any side of is contained in a -neighborhood of the union of the two other sides, for every geodesic triangle in . If is hyperbolic, we denote by () the sharp hyperbolicity constant of , i.e.,$(X)=\\inf\\{≥ 0: X \\quad\\text{is}\\quad -\\text{hyperbolic}\\}$. In this paper we study the hyperbolicity of median graphs and we also obtain some results about general hyperbolic graphs. In particular, we prove that a median graph is hyperbolic if and only if its bigons are thin.

  11. 高龄冠状动脉旁路移植术患者的中期疗效分析%Analysis of median-term therapeutic effect of coronary artery bypass grafting in the elderly patients

    Institute of Scientific and Technical Information of China (English)

    徐根兴; 郑家豪; 朱洪生; 薛松; 申达甫; 黄日太; 刘沙; 胡振雷; 连锋; 谢波; 叶清

    2009-01-01

    Objective To summarize the clinical experiences and early-to median effect of coronary artery bypass grafting(CABG)in patients aged 70 years or above.Methods From Dec.2006 to Dec.2007,86 patients aged 70 or above underwent CABG,of whom 71 cases underwent off-pump coronary artery bypass grafting(OPCAB),15 cases had CABG with cardiopulmonary bypass(CPB).5 cases underwent mitral valve replacement,3 underwent aortic valve replacement besides CABG,and one case underwent removal of ventricular aneurysm.Their clinical data were retrospectively analyzed.Results There was one case who died of enterobrosis after operation.The average ICU stay time was(77.4±49.6)h,the average postoperative stay time was 15 d,and the average drainage was 530 ml.22 postoperative complications were found.76 cases were followed up for 10-22 months.Follow up effect was better showing cardiac classification I-II and no angina pectoris,myocardial infarction and late death.Conclusion Patients with coronary heart disease in good condition will have not remarkable improvement in mortality as compared with ordinary patients but attention should be paid to their preoperative pulmonary function and angina pectoffs.OPCABG would have encouraging result in reducing the rate of postoperative complications and hospital death,which should be recommended as the first choice for the elderly patients.%目的 总结70岁以上高龄冠心病患者行冠状动脉搭桥术的早、中期结果和经验教训,以期提高手术治疗效果.方法 回顾性分析我院2006年12月至2007年12月86例70岁以上冠心病患者进行冠状动脉旁路移植术(CABG)的临床资料,其中行不停搏CABG 71例,体外循环下CABG 15例,同时行二尖瓣置换5例、主动脉瓣置换3例和室壁瘤切除1例.结果 1例术后死亡,死亡原因为术后肠穿孔.平均术后气管插管时间8 h,ICU停留时间(77.4±49.6)h,术后住院时间15 d,术后引流量平均530 ml.共有22例次术后

  12. Role of nitric oxide of the median preoptic nucleus (MnPO in the alterations of salivary flow, arterial pressure and heart rate induced by injection of pilocarpine into the MnPO and intraperitoneally

    Directory of Open Access Journals (Sweden)

    Wilson A. Saad

    2003-07-01

    Full Text Available We investigated the effect of L-NAME, a nitric oxide (NO inhibitor and sodium nitroprusside (SNP, an NO-donating agent, on pilocarpine-induced alterations in salivary flow, mean arterial blood pressure (MAP and heart rate (HR in rats. Male Holtzman rats (250-300 g were implanted with a stainless steel cannula directly into the median preoptic nucleus (MnPO. Pilocarpine (10, 20, 40, 80, 160 µg injected into the MnPO induced an increase in salivary secretion (P<0.01. Pilocarpine (1, 2, 4, 8, 16 mg/kg ip also increased salivary secretion (P<0.01. Injection of L-NAME (40 µg into the MnPO prior to pilocarpine (10, 20, 40, 80, 160 µg injected into the MnPO or ip (1, 2, 4, 8, 16 mg/kg increased salivary secretion (P<0.01. SNP (30 µg injected into the MnPO or ip prior to pilocarpine attenuated salivary secretion (P<0.01. Pilocarpine (40 µg injection into the MnPO increased MAP and decreased HR (P<0.01. Pilocarpine (4 mg/kg body weight ip produced a decrease in MAP and an increase in HR (P<0.01. Injection of L-NAME (40 µg into the MnPO prior to pilocarpine potentiated the increase in MAP and reduced HR (P<0.01. SNP (30 µg injected into the MnPO prior to pilocarpine attenuated (100% the effect of pilocarpine on MAP, with no effect on HR. Administration of L-NAME (40 µg into the MnPO potentiated the effect of pilocarpine injected ip. SNP (30 µg injected into the MnPO attenuated the effect of ip pilocarpine on MAP and HR. The present study suggests that in the rat MnPO 1 NO is important for the effects of pilocarpine on salivary flow, and 2 pilocarpine interferes with blood pressure and HR (side effects of pilocarpine, that is attenuated by NO.

  13. Brachial plexopathy from stereotactic body radiotherapy in early-stage NSCLC: Dose-limiting toxicity in apical tumor sites

    International Nuclear Information System (INIS)

    Background and purpose: We report frequency of brachial plexopathy in early-stage non-small cell lung cancer treated with stereotactic body radiotherapy. Materials and methods: 276 T1-T2, N0 or peripheral T3, N0 lesions were treated in 253 patients with stereotactic radiotherapy at Indiana University and Richard L. Roudebush VAMC from 1998 to 2007. Thirty-seven lesions in 36 patients were identified as apical lesions, defined as epicenter of lesion superior to aortic arch. Brachial plexus toxicity was scored for these apical lesions according to CTCAE v. 3.0 for ipsilateral shoulder/arm neuropathic pain, motor weakness, or sensory alteration. Results: The 37 apical lesions (19 Stage IA, 16 IB, and 2 IIB) were treated with stereotactic body radiotherapy to a median total dose of 57 Gy (30-72). The associated brachial plexus of 7/37 apical lesions developed grade 2-4 plexopathy (4 pts - grade 2, 2 pts - grade 3, 1 pt - grade 4). Five patients had ipsilateral shoulder/arm neuropathic pain alone, one had pain and upper extremity weakness, and one had pain progressing to numbness of the upper extremity and paralysis of hand and wrist. The median of the maximum brachial plexus doses of patients developing brachial plexopathy was 30 Gy (18-82). Two-year Kaplan-Meier risk of brachial plexopathy for maximum brachial plexus dose >26 Gy was 46% vs 8% for doses ≤26 Gy (p = 0.04 for likelihood ratio test). Conclusions: Stereotactic body radiotherapy for apical lesions carries a risk of brachial plexopathy. Brachial plexus maximum dose should be kept <26 Gy in 3 or 4 fractions.

  14. The reliability of toe systolic pressure and the toe brachial index in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Perrin Byron M

    2010-12-01

    Full Text Available Abstract Background The Ankle Brachial Index is a useful clinical test for establishing blood supply to the foot. However, there are limitations to this method when conducted on people with diabetes. As an alternative to the Ankle Brachial Index, measuring Toe Systolic Pressures and the Toe Brachial Index have been recommended to assess the arterial blood supply to the foot. This study aimed to determine the intra and inter-rater reliability of the measurement of Toe Systolic Pressure and the Toe Brachial Index in patients with diabetes using a manual measurement system. Methods This was a repeated measures, reliability study. Three raters measured Toe Systolic Pressure and the Toe Brachial Index in thirty participants with diabetes. Measurement sessions occurred on two occasions, one week apart, using a manual photoplethysmography unit (Hadeco Smartdop 45 and a standardised measurement protocol. Results The mean intra-class correlation for intra-rater reliability for toe systolic pressures was 0.87 (95% LOA: -25.97 to 26.06 mmHg and the mean intra-class correlation for Toe Brachial Indices was 0.75 (95% LOA: -0.22 to 0.28. The intra-class correlation for inter-rater reliability was 0.88 for toe systolic pressures (95% LOA: -22.91 to 29.17.mmHg and 0.77 for Toe Brachial Indices (95% LOA: -0.21 to 0.22. Conclusion Despite the reasonable intra-class correlation results, the range of error (95% LOA was broad. This raises questions regarding the reliability of using a manual sphygmomanometer and PPG for the Toe Systolic Pressure and Toe Brachial Indice.

  15. Aging Index using Photoplethysmography for a Healthcare Device: Comparison with Brachial-Ankle Pulse Wave Velocity

    OpenAIRE

    Hong, Kyung Soon; Park, Kyu Tae; Ahn, Jae Mok

    2015-01-01

    Objectives Recent studies have emphasized the potential information embedded in peripheral fingertip photoplethysmogram (PPG) signals for the assessment of arterial wall stiffening during aging. For the discrimination of arterial stiffness with age, the brachial-ankle pulse wave velocity (baPWV) has been widely used in clinical applications. The second derivative of the PPG (acceleration photoplethysmogram [APG]) has been reported to correlate with the presence of atherosclerotic disorders. I...

  16. Sonoanatomy of the median, ulnar and radial nerves

    Energy Technology Data Exchange (ETDEWEB)

    Loewy, J. [Humber River Regional Hospital, Dept. of Radiology, Toronto, Ontario (Canada)

    2002-02-01

    There are 5 nerve roots emerging from the brachial plexus. Three of these are readily seen ultrasonographically and can be followed throughout most of their course. The purpose of this article is twofold - to demonstrate the sonoanatomy of the median, ulnar and radial nerves and to provide background material for understanding the pathologic conditions or abnormalities that may be encountered. Only the most common pathways will be described here; the reader is encouraged to consult anatomy texts for the multitude of variations that can occur. Before delving into the anatomy, the normal ultrasonographic (US) appearance of a nerve will be presented. (author)

  17. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

    Range selection is the problem of preprocessing an input array A of n unique integers, such that given a query (i; j; k), one can report the k'th smallest integer in the subarray A[i];A[i+1]; : : : ;A[j]. In this paper we consider static data structures in the word-RAM for range selection...... selection problem. In the former, data structures must support prex selection queries under the assumption that k for some value n given at construction time, while in the latter, data structures must support range selection queries where k is xed beforehand for all queries. We prove cell probe lower bounds...... for range selection, prex selection and range median, stating that any data structure that uses S words of space needs (log n= log(Sw=n)) time to answer a query. In particular, any data structure that uses n logO(1) n space needs (log n= log log n) time to answer a query, and any data structure...

  18. Functional reconstruction following brachial plexus root avulsion

    Institute of Scientific and Technical Information of China (English)

    Guixin Sun; Cunyi Fan; Yudong Gu

    2007-01-01

    OBJECTIVE: To sum up the treatment of brachial plexus root avulsion and the progress in functional reconstruction and rehabilitation following brachial plexus root avulsion.DATA SOURCES: A search of Medline was performed to select functional reconstruction and rehabilitation following brachial plexus injury-related English articles published between January 1990 and July 2006, with key words of "brachial plexus injury, reconstruction and rehabilitation". Meanwhile, a computer-based search of CBM was carried out to select the similar Chinese articles published between January 1998 and July 2006,with key words of "brachial plexus injury, reconstruction and rehabilitation".STUDY SELECTION: The materials were checked primarily, and the literatures of functional reconstruction and rehabilitation of brachial plexus injury were selected and the full texts were retrieved.Inclusive criteria: ① Functional reconstruction following brachial plexus injury. ② Rehabilitation method of brachial plexus injury. Exclusive criteria: Reviews, repetitive study, and Meta analytical papers.DATA EXTRACTION: Forty-six literatures about functional reconstruction following brachial plexus injury were collected, and 36 of them met the inclusive criteria.DATA SYNTHESIS: Brachial plexus injury causes the complete or incomplete palsy of muscle of upper extremity. The treatment of brachial plexus is to displace not very important nerves to the distal end of very important nerve, called nerve transfer, which is an important method to treat brachial plexus injury.Postoperative rehabilitations consist of sensory training and motor functional training. It is very important to keep the initiativeness of exercise. Besides recovering peripheral nerve continuity by operation, combined treatment and accelerating neural regeneration, active motors of cerebral cortex is also the important factor to reconstruct peripheral nerve function.CONCLUSION: Consciously and actively strengthening functional

  19. 心踝血管指数、踝臂指数与颈动脉超声检查在体检中的相关性分析%Relationship between cardio-ankle vascular index,ankle brachial index and carotid artery ultrasonography in physical examination

    Institute of Scientific and Technical Information of China (English)

    徐宁; 田利源; 卢丽琨; 高镇北

    2014-01-01

    目的:研究心踝血管指数(CAVI)、踝臂指数(ABI)与颈动脉超声检查结果的相关性及这些指标在体检筛查动脉硬化上的应用。方法对481例体检人员进行CAVI、ABI、颈动脉超声检查,对结果的相关性进行统计学分析。结果相对于ABI,CAVI与颈动脉内中膜厚度(IMT)相关度更高(r=0.437,P=0.001),超声检出颈动脉斑块与未检出斑块的人群CAVI、ABI均有显著性差异(P<0.05);CAVI正常与异常人群比较, ABI无显著性差异,而IMT、颈动脉斑块阳性率均有显著性差异。结论 CAVI和ABI与颈动脉超声检查结果均有相关性,针对不同性别、年龄、身高、体重给出CAVI的正常值范围对于早期诊断动脉硬化更为敏感,但各个指标之间不能相互替代,需要进行综合判断。%Objective To investigate the relationship between cardio-ankle vascular index(CAVI),ankle brachial index (ABI) and carotid ultrasonic examination results and their application in physical examination for screening arteriosclerosis. Methods Cardio ankle vascular index,ankle brachial index were measured and carotid artery ultrasonography was checked in 481 people. Correlation of the results was statistically analyzed. Results Compared with ABI,CAVI was more relevant to the carotid artery intima-media thickness(IMT), r=0.437,P=0.001. CAVI and ABI had significant differences between carotid artery plaque and no plaque group tested by ultrasound (P<0.05). There was no significant difference in ABI between normal CAVI group compared with the abnormal group,while IMT and the positive rate of carotid artery plaque were significantly different(P<0.05). Conclusion CAVI and ABI are relevant with the result of carotid artery ultrasound test. CAVI normal ranges given according to different gender,age,height,weight are more sensitive for early diagnosis of arteriosclerosis. But all the indexes can not replace each other. The results should be

  20. Comparison of noninvasive central arterial pressure and brachial arterialpressure in elderly hypertensive patients and its nursing measures%老年高血压患者无创中心动脉压与肱动脉压的比较及护理

    Institute of Scientific and Technical Information of China (English)

    张英; 吴金凤; 高春红

    2015-01-01

    目的:比较老年高血压患者无创中心动脉压与肱动脉血压的差异,探讨有效控制患者血压的护理方法。方法通过欧姆龙 HEM9000AI 系统对老年科住院的老年高血压患者692例进行无创中心动脉收缩压(cSBP)和肱动脉收缩压(SBP)的测量,比较患者的 cSBP 与 SBP,根据比较结果,对患者在病情观察、药物应用、健康教育等方面给以针对性的护理干预。结果总体老年高血压患者的 cSBP 与其 SBP 比较无明显差异(P >0.05),但≥80岁的高血压患者的 cSBP 高于其 SBP (P <0.05),老年女性高血压患者的 cSBP 也高于其 SBP(P <0.05)。差异分析发现,53.6%患者的 cSBP 比 SBP 高,39.9%患者的 cSBP 比 SBP 低,只有6.5%老年患者的 cSBP 与 SBP 相等。通过针对性的治疗和护理干预,患者的中心动脉压能得到有效控制。结论给予个体化的治疗和护理干预,能有效控制老年高血压患者的血压,可以达到预防和控制老年高血压患者心脑血管疾病的发生和发展的目的。%Objective To compare the differences of non-invasive central arterial pressure and brachial arterial pressure in elderly hypertensive patients and to explore effective nursing meth-ods.Methods Noninvasive central arterial systolic blood pressure (cSBP)and brachial arterial systolic blood pressure (SBP)of 692 elderly hypertensive patients in the hospital were measured by Omron HEM9000AI system and cSBP and SBP were compared.According to the results,patients were given corresponding nursing intervention in disease observation,drug application and health education.Results Overall cSBP and SBP in elderly hypertensive patients showed no significant difference (P >0.05),but cSBP level was higher than SBP in more than 80-year-old hyperten-sive patients (P <0.05).The cSBP level was higher than their SBP in female elderly hypertensive patients (P <0.05),Differences showed

  1. A novel technique of ultrasound-guided brachial plexus block in calves.

    Science.gov (United States)

    Iwamoto, Jiro; Yamagishi, Norio; Sasaki, Kouya; Kim, Danil; Devkota, Bhuminand; Furuhama, Kazuhisa

    2012-12-01

    An interventional ultrasound technique to increase the safety of surgical treatment of the calf forelimb was tested. First, the brachial plexus was evaluated using ultrasonography and then 2% lidocaine was injected under ultrasound guidance. Ultrasonically, the brachial plexus appeared as multiple hypoechoic areas surrounded by a hyperechoic rim or a hyperechoic structure characterised by multiple discontinuous lines. It was located between the omotransverse muscle and axillary artery and vein. The sensitive effect in the forelimb was seen mainly in the area supplied by the musculocutaneous nerve, indicating successful blockage in the nerve plexus. Out of the eight forelimbs, the motor effect was observed in seven forelimbs. These results suggest the clinical feasibility of ultrasound-guided brachial plexus block in bovine medicine, although further studies are needed to examine various approaches, including the sites of needle insertion and the appropriate volume and dosage of anaesthetic. PMID:22682007

  2. Clinical applications of transcutaneous oxygen pressure combined with ankle-brachial index in Type 2 diabetics with peripheral arterial disease%经皮氧分压联合踝臂指数在2型糖尿病合并下肢动脉病变中的临床应用

    Institute of Scientific and Technical Information of China (English)

    李梦娟; 李素梅; 汝燕; 王芳; 王菊梅; 荆春艳; 王东; 董林; 任安

    2011-01-01

    目的:比较经皮氧分压(transcutaneous oxygen pressure,TcPO2)与踝臂指数(ankle--brachial index,ABI)在2型糖尿病(Type 2 diabetes mellitus,T2DM)合并下肢动脉病变(peripheral arterial disease,PAD)中的应用价值,探讨TcPO2与ABI在PAD诊断及治疗中的意义.方法:368例T2DM患者(男性188例,女性180例),采用多通道经皮氧分压检测仪测定足背TcPO2.依据TcPO2水平分为无受损组、轻度受损组、重度受损组.同时,采用彩色双功能超声诊断仪测定踝动脉压/肱动脉压比值即ABI,依据ABI水平分为无病变组(ABI≥0.9)和PAD组(ABI <0.9).结果:PAD组与无病变组相比,年龄增大,病程延长,合并冠心痛者增多,空腹血糖、餐后2h血糖、糖化血红蛋白、尿肌酐均升高,TcPO2减低(p<0.05).相关分析显示:年龄、病程、空腹血糖、三酰甘油、糖化血红蛋白Alc、体质量指数与TcPO2水平呈负相关(P<0.05),高密度脂蛋白、ABI与TcPO2水平呈正相关(P<0.05);TcPO2与ABI检测结果的符合率为93.9%,敏感度为90.2%,特异度约为95.2%.结论:随着年龄、病程的延长以及尿白蛋白肌酐比值的增加,糖尿病患者PAD程度越严重,PAD程度随着ABI和TcPO2减低而加重;TcPO2联合ABI对早期诊断糖尿病PAD具有较高的临床价值.%Objective To compare the clinical application in diagnosis and therapy for Type 2 diabetes patients with perpheral arterial diease ( PAD) between transcutaneous oxygen pressure ( TcPO2 ) determination and ankle-brachial index (ABI). Methods A total of 368 Type 2 diabetics (188 males and 180 females) were recruited into the study. TcPO2 of the acrotarsium was detected by multiple-channel transcutaneous tissue oxygen tension survey meter. According to die TcPO2 level, diese patients were divided into a non-injury group, a mild injury group, and a severe injury group. Moreover,the ankle artery pressure and brachial artery pressure were determined by Doppler color ultrasonography

  3. Avaliação da função endotelial em pacientes com esclerose sistêmica limitada por meio do eco Doppler da artéria braquial Evaluation of endothelial function in patients with limited systemic sclerosis by use of brachial artery Doppler ultrasound

    Directory of Open Access Journals (Sweden)

    Tatiana Melo Fernandes

    2012-08-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi comparar a resposta dilatadora dependente e independente do endotélio em pacientes portadores de esclerose sistêmica limitada (ESL com aquela de indivíduos sadios de mesmo gênero, idade e cor. MÉTODOS: Vinte mulheres adultas, não obesas, não tabagistas, não diabéticas, não dislipidêmicas, não hipertensas, que preencheram os critérios para esclerose sistêmica (ES segundo o American College of Rheumatology, foram submetidas ao exame de Doppler de artéria braquial do membro superior direito. Foi analisada a resposta dilatadora, dependente do endotélio, após isquemia induzida com esfigmomanômetro por cinco minutos no braço direito, e a resposta dilatadora, independente do endotélio, após administração de 300 mcg de nitroglicerina (NTG sublingual. Esses resultados foram comparados com a resposta obtida em indivíduos sadios. RESULTADOS: O diâmetro longitudinal da artéria braquial (DAB foi significativamente menor na fase basal 1 nos pacientes com ESL (3,57 ± 0,52 mm e 3,93 ± 0,39 mm, respectivamente no grupo paciente (P e grupo-controle (C, P = 0,005. Não foi encontrada diferença estatisticamente significativa entre a velocidade das hemácias (VH após isquemia/hiperemia reativa (HR e após NTG (110,2 ± 43,86 cm/s vs. 102,0 ± 25,89 cm/s e 63,80 ± 17,69 cm/s vs. 65,4 ± 12,90 cm/s nos grupos P e C, após HR e NTG, respectivamente. Também não foi encontrada diferença significativa entre o DAB após HR e após NTG (3,77 ± 0,59 mm vs. 4,14 ± 0,49 mm e 4,44 ± 0,64 mm vs. 4,70 ± 0,58 mm nos grupos P e C, após HR e NTG, respectivamente. CONCLUSÃO: Embora o grupo de pacientes com ESL tenha apresentado menor DAB basal, a resposta dilatadora dependente e independente do endotélio se manteve preservada em ambos os grupos.OBJECTIVES: The aim of this study was to compare the brachial artery endothelium-dependent and endothelium-independent dilating responses in patients with limited

  4. Neuromuscular hamartoma arising in the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Lai, P.H.; Chen, C.; Yeh, L.R.; Pan, H.B. [Department of Radiology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaohsiung (Taiwan); Ho, J.T.; Hsu, S.S. [Department of Neurosurgery, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaosiung (Taiwan); Lin, S.L. [Department of Pathology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaohsiung (Taiwan)

    2004-03-01

    We report a case brachial plexus neuromuscular hamartoma (choristoma) in a 28-year-old man who complained of numbness of the left hand and forearm for several years. MRI revealed a circumscribed, rounded mass in the left brachial plexus. The patient is well 2 years after surgery, with no neurological deficit. (orig.)

  5. MR imaging of the brachial plexus

    NARCIS (Netherlands)

    Es, Hendrik Wouter van

    2001-01-01

    In this retrospective study we describe the MR imaging findings in 230 consecutive patients with suspected pathology in or near the brachial plexus. These patients were studied from 1991 through to 1996. Chapter 2 describes the anatomy and the MR imaging techniques. As the anatomy of the brachial pl

  6. Brachial neuritis following a corticosteroid injection.

    Science.gov (United States)

    Robinson, Matthew; Fulcher, Mark

    2014-01-01

    This report presents a case of brachial neuritis following a subacromial corticosteroid injection. The patient developed an anterior interosseous neuropathy shortly after the injection, with no other trigger being identified. This neuropathy has unfortunately not shown any sign of recovery at 2 years. The authors propose that corticosteroid injection be added to the list of possible triggering events of brachial neuritis and highlight the frequent use of oral corticosteroids in its treatment. (1) The injection of local anaesthetic and corticosteroid should be considered as a potential trigger for brachial neuritis. (2) Brachial neuritis should be considered in the differential diagnosis for patients presenting with severe arm pain and weakness. (3) The nerves originating from the upper trunk of the brachial plexus are most commonly affected. (4) The anterior interosseous nerve is involved in one-third of cases. PMID:24596414

  7. OCT/PS-OCT imaging of brachial plexus neurovascular structures

    Science.gov (United States)

    Raphael, David T.; Zhang, Jun; Zhang, Yaoping; Chen, Zhongping; Miller, Carol; Zhou, Li

    2004-07-01

    Introduction: Optical coherence tomography (OCT) allows high-resolution imaging (less than 10 microns) of tissue structures. A pilot study with OCT and polarization-sensitive OCT (PS-OCT) was undertaken to image ex-vivo neurovascular structures (vessels, nerves) of the canine brachial plexus. Methods: OCT is an interferometry-based optical analog of B-mode ultrasound, which can image through non-transparent biological tissues. With approval of the USC Animal Care and Use Committee, segments of the supra- and infraclavicular brachial plexus were excised from euthanized adult dogs, and the ex-vivo specimens were placed in cold pH-buffered physiologic solution. An OCT beam, in micrometer translational steps, scanned the fixed-position bisected specimens in transverse and longitudinal views. Two-dimensional images were obtained from identified arteries and nerves, with specific sections of interest stained with hematoxylin-eosin for later imaging through a surgical microscope. Results: with the beam scan direction transverse to arteries, the resulting OCT images showed an identifiable arterial lumen and arterial wall tissue layers. By comparison, transverse beam OCT images of nerves revealed a multitude of smaller nerve bundles contained within larger circular-shaped fascicles. PS-OCT imaging was helpful in showing the characteristic birefringence exhibited by arrayed neural structures. Discussion: High-resolution OCT imaging may be useful in the optical identification of neurovascular structures during attempted regional nerve blockade. If incorporated into a needle-shaped catheter endoscope, such a technology could prevent intraneural and intravascular injections immediately prior to local anesthetic injection. The major limitation of OCT is that it can form a coherent image of tissue structures only to a depth of 1.5 - 2 mm.

  8. [Ankle-brachial pressure index as a predictor of future cardiovascular outcomes].

    Science.gov (United States)

    Topalusić, Iva; Valpotić, Ina; Marković, Asja Stipić

    2012-10-01

    Peripheral arterial occlusive disease is very common in the general population and it is mostly of atherosclerotic origin. About 50%-75% of patients are asymptomatic. Many studies have shown the ankle-brachial pressure index (ABPI) to be a simple and reliable test with high sensitivity (90%) and specificity (98%) in the diagnosis of hemodynamically relevant stenosis of an arterial segment and also in detection of asymptomatic patients. The values of ABPI ABPI > 1.40 is associated with arterial calcification and wall stiffening. This test is highly specific (92.7%) in predicting future cardiovascular and cerebrovascular risk and could provide a tool for more focused prevention strategies. PMID:23814974

  9. Diagnosis value of ankle brachial index and cardio-ankle vascular index on coronary artery disease%踝臂指数及心踝血管指数对冠状动脉病变的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王玉; 陈明

    2013-01-01

    目的 评价踝臂指数(ankle brachial index,ABI)与心踝血管指数(cardio-ankle vascular index,CAVI)对冠状动脉病变的诊断价值.方法 选择2012年6月至2012年11月在重庆医科大学附属第一医院心血管内科住院,因拟诊为冠状动脉粥样硬化性心脏病(冠心病)而行冠状动脉造影的127例患者,根据冠状动脉造影结果,88例冠状动脉狭窄患者列入冠状动脉病变组(D组):根据狭窄程度,将患者分为轻度病变亚组(A组,31例),中重度病变亚组(B组,57例);依累及血管支数,分为单支病变亚组(22例),双支病变亚组(26例),三支病变亚组(40例).对照组为39例冠状动脉造影阴性患者.入选患者接受ABI及CAVI检测,比较分析各组间ABI及CAVI.结果 对照组、A组、B组3组比较,ABI依次降低,且对照组、A组、B组两两比较差异有统计学意义(P<0.05).CAVI在对照组、A组、B组3组数值依次增高,但两两比较差异无统计学意义(P>0.05);但D组与对照组比较CAVI明显升高,且差异有统计学意义(P<0.05).对照组、单支病变组、双支病变组、三支病变组4组ABI值依次降低,对照组与各病变组ABI值差异有统计学意义(P<0.05),但各病变组之间两两比较差异无统计学意义(P>0.05).在各组中随病变范围增大,CAVI数值并未依次增高,且各病变组两两比较差异无统计学意义(P>0.05).结论 ABI值能很好地反映病变狭窄程度,ABI数值越低,冠状动脉狭窄程度越重,但无法反映病变范围;CAVI既不能反映冠心病的病变程度,也无法反映病变范围.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  11. Neonatal brachial plexus palsy: a permanent challenge

    Directory of Open Access Journals (Sweden)

    Carlos Otto Heise

    2015-09-01

    Full Text Available Neonatal brachial plexus palsy (NBPP has an incidence of 1.5 cases per 1000 live births and it has not declined despite recent advances in obstetrics. Most patients will recover spontaneously, but some will remain severely handicapped. Rehabilitation is important in most cases and brachial plexus surgery can improve the functional outcome of selected patients. This review highlights the current management of infants with NBPP, including conservative and operative approaches.

  12. Lateral progression of brachial plexus avulsion injury

    Institute of Scientific and Technical Information of China (English)

    GU Yudong

    2007-01-01

    @@ All reports on brachial plexus injury which were presented on the 9th International Hand Surgery Meeting (2004),the 5th Asia-Pacific Area Hand Surgery Meeting (2005),the 10th Europe Hand Surgery Meeting (2005) and 49th Japan Hand Surgery Meeting (2006),were collected and reviewed.We also went through our own research on brachial plexus injury,and a cumulative review of all these reports and researches was made.

  13. Brachial neuritis following a corticosteroid injection

    OpenAIRE

    Robinson, Matthew; Fulcher, Mark

    2014-01-01

    This report presents a case of brachial neuritis following a subacromial corticosteroid injection. The patient developed an anterior interosseous neuropathy shortly after the injection, with no other trigger being identified. This neuropathy has unfortunately not shown any sign of recovery at 2 years. The authors propose that corticosteroid injection be added to the list of possible triggering events of brachial neuritis and highlight the frequent use of oral corticosteroids in its treatment....

  14. Acute brachial neuritis following influenza vaccination

    OpenAIRE

    Shaikh, Maliha Farhana; Baqai, Tanya Jane; Tahir, Hasan

    2012-01-01

    Brachial neuritis following vaccination is an uncommon but clinically important presentation of severe shoulder and arm pain associated with globally reduced range of movement. It may be confused with the more common diagnoses of rotator cuff pathology, adhesive capsulitis (frozen shoulder), shoulder arthritis or cervical spondylosis. We present a case of acute brachial neuritis, which posed a clinical diagnostic challenge to emergency, acute medical and rheumatology clinicians.

  15. Dissecção robótica da artéria torácica interna direita por esternotomia mediana Robotic dissection of the right internal thoracic artery through median sternotomy

    Directory of Open Access Journals (Sweden)

    Fabio Biscegli Jatene

    2010-06-01

    Full Text Available A utilização de sistemas robóticos em cirurgia cardíaca visa à diminuição do trauma operatório. A revascularização do miocárdio totalmente endoscópica, assistida por robô DaVinci (Intuitive Surgical, Sunnyvale, Califórnia é factível e seu aprendizado deve ser realizado em etapas. O primeiro passo é o preparo da artéria torácica interna esquerda, já por via totalmente endoscópica. O caso apresentado propõe a dissecção da artéria torácica interna direita por esternotomia completa. Propõe um novo passo rumo ao procedimento completamente endoscópico, visando à diminuição de lesões decorrentes da curva de aprendizado.The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma.The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma. The totally endoscopic myocardial revascularization, assisted by the DaVinci robot (Intuitive Surgical, Sunnyvale, California is feasible and the learning process must be carried out in steps. The first step is the preparation of the left internal thoracic artery, through the totally endoscopic approach. The case presented here proposes the dissection of the right internal thoracic artery through complete sternotomy. It proposes a new step directed at the totally endoscopic procedure, aiming at decreasing the injuries caused by the learning curve.

  16. Association of Ankle-Brachial Index and Aortic Arch Calcification with Overall and Cardiovascular Mortality in Hemodialysis

    Science.gov (United States)

    Chen, Szu-Chia; Lee, Mei-Yueh; Huang, Jiun-Chi; Shih, Ming-Chen Paul; Chang, Jer-Ming; Chen, Hung-Chun

    2016-01-01

    Peripheral artery occlusive disease and vascular calcification are highly prevalent in hemodialysis (HD) patients, however the association of the combination of ankle-brachial index (ABI) and aortic arch calcification (AoAC) with clinical outcomes in patients undergoing HD is unknown. In this study, we investigated whether the combination of ABI and AoAC is independently associated with overall and cardiovascular mortality in HD patients. The median follow-up period was 5.7 years. Calcification of the aortic arch was assessed by chest X-ray. Forty-seven patients died including 24 due to cardiovascular causes during the follow-up period. The study patients were stratified into four groups according to an ABI 4 or ≤4 according to receiver operating characteristic curve. Those with an ABI  4 (vs. ABI ≥ 0.95 and AoAC score ≤ 4) were associated with overall (hazard ratio [HR], 4.913; 95% confidence interval [CI], 1.932 to 12.497; p = 0.001) and cardiovascular (HR, 3.531; 95% CI, 1.070 to 11.652; p = 0.038) mortality in multivariable analysis. The combination of a low ABI and increased AoAC was associated with increased overall and cardiovascular mortality in patients undergoing HD. PMID:27608939

  17. Ankle-Brachial Index Is a Powerful Predictor of Renal Outcome and Cardiovascular Events in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Fu-An Chen

    2012-01-01

    Full Text Available Ankle-brachial index (ABI is an accurate tool to diagnose peripheral arterial disease. The aim of this study was to evaluate whether ABI is also a good predictor of renal outcome and cardiovascular events in patients with chronic kidney disease (CKD. We enrolled 436 patients with stage 3–5 CKD who had not been undergoing dialysis. Patients were stratified into two groups according to the ABI value with a cut point of 0.9. The composite renal outcome, including doubling of serum creatinine level and commencement of dialysis, and the incidence of cardiovascular events were compared between the two groups. After a median follow-up period of 13 months, the lower ABI group had a poorer composite renal outcome (OR=2.719, P=0.015 and a higher incidence of cardiovascular events (OR=3.260, P=0.001. Our findings illustrated that ABI is a powerful predictor of cardiovascular events and renal outcome in patients with CKD.

  18. 血管回声跟踪技术评价抗氧化剂干预吸烟对肱动脉弹性的影响%Echo-tracking technique in evaluation on effects of antioxidant to smoking-induced brachial arterial wall stiffness in healthy volunteers

    Institute of Scientific and Technical Information of China (English)

    薛莉; 罗春英; 王谦谦; 李学奇; 申宝忠

    2011-01-01

    Objective To investigate whether the oral administration of vitamin C (Vit C ) can prevent the smoking-induced acceleration arterial stiff'ness in short -term smoking healthy volunteers with echo -tracking (ET ) technique . Methods Sixty healthy smokers were enrolled and divided into treatment group (oral administrating Vit C ) and control group (oral administrating placebo ) . ET technique was used to measure the parameters of elasticity of brachial artery including stiffness (β) , pressure strain elastic modulus (Ep) , arterial compliance (AC ) . The hlood pressure and heart rate before and after smoking in healthy volunteers were also measured . Results In treatment group , β , Ep of brachial artery increased and AC decreased immediately after smoking than those before smoking ( P< 0. 05 ) . The level of β, Ep and AC measured at 5 min after smoking had no difference with those measured before smoking . In control group , β , Ep increased significantly and AC decreased significantly at O , 5 , 10 min after smoking than those before smoking ( P< 0. 05 ) . The level of β, Ep and AC measured at 15 min after smoking had no difference with those measured before smoking . The level ofβ , Ep in treatment group were lower than those in control group at 0 , 5 . 10 min after smoking ( P<0. 05 ) , w hile AC measured at 0 , 5 min after smoking were higher than those in control group ( P< 0. 05 ) . The changes of blood pressure and heart rate had no difference between the two groups (all P>0. 05 ) . Conclusion Smoking may lead to acute transient increase in blood pressure , heart rate and elasticity of branchial artery . Single-dose oral administrating Vit C may ameliorate the smoking-induced aaleleration arterial stiffness in healthy volunteers , but has no intervention effect on blood pressure and heart rate .%目的 应用血管回声跟踪(ET)技术探讨单剂口服维生素C(Vit C)拮抗吸烟对短期吸烟者肱动脉弹性的影响.方法 60名健康

  19. Sosiaalisen median merkitys maisemasuunnittelutoimiston markkinoinnissa

    OpenAIRE

    Holmstén, Salla

    2013-01-01

    Sosiaalisen median merkitys on kasvanut nopeasti viime vuosien aikana ja nykyään myös moni yritys on lähtenyt hyödyntämään sen palveluita. Tässä opinnäytetyössä käsitellään sosiaalisen median merkitystä maisemasuunnittelutoimistoille tänä päivänä. Työn tavoitteena on selvittää, millainen merkitys sosiaalisen median palveluilla on yritysten markkinoinnissa yleisesti. Käytetäänkö sosiaalisen median palveluita, entä miksi jätetään käyttämättä? Onko käytöstä koettu olevan hyötyä, entä haittaa? Ta...

  20. Central hemodynamics in risk assessment strategies: additive value over and above brachial blood pressure.

    Science.gov (United States)

    Yannoutsos, Alexandra; Rinaldi, Elisa R; Zhang, Yi; Protogerou, Athanassios D; Safar, Michel E; Blacher, Jacques

    2015-01-01

    Although the clinical relevance of brachial blood pressure (BP) measurement for cardiovascular (CV) risk stratification is nowadays widely accepted, this approach can nevertheless present several limitations. Pulse pressure (PP) amplification accounts for the notable increase in PP from central to peripheral arterial sites. Target organs are more greatly exposed to central hemodynamic changes than peripheral organs. The pathophysiological significance of local BP pulsatility, which has a role in the pathogenesis of target organ damage in both the macro- and the microcirculation, may therefore not be accurately captured by brachial BP as traditionally evaluated with cuff measurements. The predictive value of central systolic BP and PP over brachial BP for major clinical outcomes has been demonstrated in the general population, in elderly adults and in patients at high CV risk, irrespective of the invasive or non-invasive methods used to assess central BP. Aortic stiffness, timing and intensity of wave reflections, and cardiac performance appear as major factors influencing central PP. Great emphasis has been placed on the role of aortic stiffness, disturbed arterial wave reflections and their intercorrelation in the pathophysiological mechanisms of CV diseases as well as on their capacity to predict target organ damage and clinical events. Comorbidities and age-related changes, together with gender-related specificities of arterial and cardiac parameters, are known to affect the predictive ability of central hemodynamics on individual CV risk. PMID:25341861

  1. Superficial Ulnar Artery: A Case Report of its Unusual Course

    OpenAIRE

    QUADROS, Lydia Shobha; BHAT, Nandini; D'SOUZA, Antony Sylvan

    2015-01-01

    After arising from the brachial artery in the cubital fossa the ulnar artery usually passes deep into the superficial flexor muscles of the forearm. In the lower two-thirds, it typically follows a sub-fascial course. In the present case, during a routine undergraduate course dissection of a cadaver, it was found that the ulnar artery arose normally as a terminal branch of the brachial artery in the cubital fossa, followed a sub-fascial course by lying superficial to the flexor muscles then co...

  2. Predictive value of ankle brachial index combined with serum high sensitivity C-reactive protein for extent of coronary artery disease%踝臂指数联合超敏C反应蛋白对冠状动脉病变的判定价值

    Institute of Scientific and Technical Information of China (English)

    张宁; 牛楠; 曲鹏; 王红艳

    2012-01-01

    目的:探讨踝臂指数(ABI)联合超敏C反应蛋白(hs-CRP)对冠状动脉病变的判定价值.方法:选择2010-09-12期间住院并行冠状动脉造影的120例患者,收集行冠状动脉造影前ABI及hs-CRP的数值,根据冠状动脉病变狭窄程度(Gensini积分评价)及病变血管数量进行分组.结果:以ABI<0.9及hs-CRP>3 mg/L为截断值,二者联合检测判定冠状动脉严重狭窄及多支病变的敏感度分别为85%和92%,特异度分别为69%和61%,与单用ABI或hs-CRP的方法比较,其敏感度均显著提高(均P<0.05),特异度有所下降.结论:ABI、hs-CRP的水平变化与冠状动脉的病变程度密切相关,对于冠状动脉严重狭窄及3支病变的判定,二者联合检测具有更高的实用价值.%Objective: To investigate whether the combination of ankle brachial index (ABI) and serum high sensitivity C-reactive protein (hs-CRP) could improve their diagnosis value for extent of coronary artery disease (CAD) in patients. Method: The study population consisted of 120 patients scheduled to undergo elective cardiac catheterization for suspected CAD (from September 2010 to December). Collected data included ABI and hs-CRP before underwent coronary angiography. According to the degree of coronary stenosis (estimated by Gensini score) and the number of coronary artery stenosis, all subjects were divided into different groups. Result: With ABI 3 mg/L as the cutoff value, combined the 2 methods to predict serious stenosis and multi-vessel CAD, the sensitivity was respectively 85%, 92%, and the specificity was respectively 69%, 61%. Compared with using ABI or hs-CRP alone, the sensitivity of the 2 joint detection for predicting CAD increased significantly (P<0. 05); the specificity decreased, but the difference was not statistically significant. Conclusion: ABI and hs-CRP are closely related to the extent of coronary artery disease, and the combination of ABI and hs-CRP may have higher practical value for

  3. Ankle brachial pressure index of normal, healthy, younger adults.

    Science.gov (United States)

    Niblo, Jane; Coull, Alison

    Doppler ultrasound and ankle brachial pressure index (ABPI) calculations are used in the assessment of lower limb vascularity, specifically to determine arterial deficiency. ABPI is important as it is used as an indicator when deciding management options for the treatment of leg ulceration. This study aimed to investigate the range of ABPI measurement, using Doppler ultrasound and sphygmomanometry in 36 young healthy adults aged 18-55 years. The findings show a mean ABPI in the left leg of 1.19 and a mean ABPI of 1.17 in the right leg which, while within the normal range, are consistently in the upper range and significantly higher than the acknowledged 'normal' midpoint of 1.0. It would appear that younger people will have ABPIs within the upper aspect of the normal range and well above the established norm of 1.0. PMID:24151719

  4. Resting Doppler ankle brachial pressure index measurement: a literature review.

    Science.gov (United States)

    Sihlangu, Dorcus; Bliss, Julie

    2012-07-01

    Peripheral vascular disease (PVD) is under-diagnosed in primary and acute settings. The use of Doppler ankle brachial pressure index (ABPI) is effective in diagnosing PVD , aid in determining aetiology of leg ulcers and is cost efficient in reducing the effects of atherosclerosis and cardiovascular events. The aim of this literature review was to review practitioners' experience in using Doppler ABPI, different skills used to measure ABPI and to examine practitioners' confidence in ABPI. The findings identified variation in method for Doppler measurement: including position of the artery, arm measurement, resting period and type of equipment for measuring blood pressure, variations in practitioners' training and experience have demonstrated variability in ABPI results. Although limited in number, the studies have demonstrated knowledge gap, and the need for training among health professionals. PMID:22875182

  5. Non-Local Euclidean Medians.

    Science.gov (United States)

    Chaudhury, Kunal N; Singer, Amit

    2012-11-01

    In this letter, we note that the denoising performance of Non-Local Means (NLM) can be improved at large noise levels by replacing the mean by the Euclidean median. We call this new denoising algorithm the Non-Local Euclidean Medians (NLEM). At the heart of NLEM is the observation that the median is more robust to outliers than the mean. In particular, we provide a simple geometric insight that explains why NLEM performs better than NLM in the vicinity of edges, particularly at large noise levels. NLEM can be efficiently implemented using iteratively reweighted least squares, and its computational complexity is comparable to that of NLM. We provide some preliminary results to study the proposed algorithm and to compare it with NLM.

  6. Obstetrical brachial plexus palsy (OBPP) outcome with conservative management

    NARCIS (Netherlands)

    Eng, GD; Binder, H; Getson, P; ODonnell, R

    1996-01-01

    Resurgence of neurosurgical intervention oi obstetrical brachial plexus palsy prompted our review of 186 patients evaluated between 1981 and 1993, correlating clinical examination, electrodiagnosis, and functional outcome with conservative management. Eighty-eight percent had upper brachial plexus p

  7. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

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

  8. Radiation-induced brachial plexopathy: MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wouter van Es, H. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Engelen, A.M. [Department of Radiation Therapy, University Hospital Utrecht, Utrecht (Netherlands); Witkamp, T.D. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Ramos, L.M.P. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Feldberg, M.A.M. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    1997-05-01

    Objective. To describe the MR imaging appearance of radiation-induced brachial plexopathy. Design. MR imaging was performed in two patients with the clinical diagnosis of radiation-induced brachial plexopathy and in one with surgically proven radiation fibrosis of the brachial plexus. Patients. Three patients who had had radiation therapy to the axilla and supraclavicular region (two with breast carcinoma and one with Hodgkin`s lymphoma) presented with symptoms in the arm and hand. To exclude metastases or tumor recurrence MR imaging was performed. Results and conclusion. In one patient, fibrosis showing low signal intensity was found, while in two patients high signal intensity fibrosis surrounding the brachial plexus was found on the T2-weighted images. In one case gadolinium enhancement of the fibrosis was seen 21 years after radiation therapy. It is concluded that radiation-induced brachial plexopathy can have different MR imaging appearances. We found that radiation fibrosis can have both low or high signal intensities on T2-weighted images, and that fibrosis can enhance even 21 years after radiation therapy. (orig.). With 3 figs.

  9. Role of dexamethasone in brachial plexus block

    International Nuclear Information System (INIS)

    To evaluate the effect of dexamethasone added to (lignocaine) on the onset and duration of axillary brachial plexus block. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital Rawalpindi, from September 2009 to March 2010. Patients and Methods: A total of 100 patients, who were scheduled for elective hand and forearm surgery under axillary brachial plexus block, were randomly allocated to group A in which patients received 40 ml 1.5% lidocaine with 2 ml of isotonic saline (0.9%) and group B in which patients received 40 ml 1.5% lidocaine with 2 ml of dexamethasone (8 mg). Nerve stimulator with insulated needle for multiple stimulations technique was used to locate the brachial plexus nerves. After the injection onset of action and duration of sensory blockade of brachial plexus were recorded at 5 minutes and 15 minutes interval. Results: Group A showed the onset of action of 21.64 ± 2.30 min and in group B it was 15.42 ± 1.44 min (p< 0.001). Duration of nerve block was 115.08 ± 10.92 min in group A and 265.42 ± 16.56 min in group B (p < 0.001). Conclusion: The addition of dexamethasone to 1.5% lignocaine solution in axillary brachial plexus block prolongs the duration of sensory blockade significantly. (author)

  10. Ultrasound study of brachial plexus%臂丛神经的超声解剖学研究

    Institute of Scientific and Technical Information of China (English)

    曹文; 郭瑞军; 周亚静; 张淼; 于泽兴; 梁晓宁

    2008-01-01

    Objective To explore the anatomic character of brachial plexus nerve by ultrasonography,and provide a basis for ultrasound-guided brachial plexus block.Methods Twenty-four healthy volunteers were chosen for high-frequency sonography examination,the features of brachial plexus distributions were studied in the axilla location and the interscalene location.Results Brachial plexus of all the 24 cases were detected.At the axilla level,main braches of brachial plexus nerves were very close to the axillary artery.At the interscalene level,the brachial plexus was consistently found between the scalenus anterior and medius muscles in the interscalene groove.Conclusions Using high-frequency sonography,the main braches of brachial plexus can be observed clearly.%目的 应用超声研究臂丛神经解剖学特点,为超声引导臂丛神经阻滞提供解剖学依据.方法 应用高频超声研究24例健康人臂丛神经在腋路和肌间沟的解剖分布特点.结果 24例健康人臂丛神经完全显示.臂丛神经在腋路主要沿腋动脉走行;在肌间沟水平,臂丛神经分布于前、中斜角肌组成的肌间沟内.结论 超声能清晰显示臂丛神经各个主要分支.

  11. Brachial Plexopathy in Apical Non-Small Cell Lung Cancer Treated With Definitive Radiation: Dosimetric Analysis and Clinical Implications

    Energy Technology Data Exchange (ETDEWEB)

    Eblan, Michael J.; Corradetti, Michael N.; Lukens, J. Nicholas; Xanthopoulos, Eric [Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Mitra, Nandita [Department of Biostatistics and Epidemiology, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Christodouleas, John P.; Grover, Surbhi; Fernandes, Annemarie T. [Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Langer, Corey J.; Evans, Tracey L.; Stevenson, James [Department of Medical Oncology, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Rengan, Ramesh [Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Apisarnthanarax, Smith, E-mail: apisarns@uphs.upenn.edu [Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States)

    2013-01-01

    Purpose: Data are limited on the clinical significance of brachial plexopathy in patients with apical non-small cell lung cancers (NSCLC) treated with definitive radiation therapy. We report the rates of radiation-induced brachial plexopathy (RIBP) and tumor-related brachial plexopathy (TRBP) and associated dosimetric parameters in apical NSCLC patients. Methods and Materials: Charts of NSCLC patients with primary upper lobe or superiorly located nodal disease who received {>=}50 Gy of definitive conventionally fractionated radiation or chemoradiation were retrospectively reviewed for evidence of brachial plexopathy and categorized as RIBP, TRBP, or trauma-related. Dosimetric data were gathered on ipsilateral brachial plexuses (IBP) contoured according to Radiation Therapy Oncology Group atlas guidelines. Results: Eighty patients were identified with a median follow-up and survival time of 17.2 and 17.7 months, respectively. The median prescribed dose was 66.6 Gy (range, 50.4-84.0), and 71% of patients received concurrent chemotherapy. RIBP occurred in 5 patients with an estimated 3-year rate of 12% when accounting for competing risk of death. Seven patients developed TRBP (estimated 3-year rate of 13%), comprising 24% of patients who developed locoregional failures. Grade 3 brachial plexopathy was more common in patients who experienced TRBP than RIBP (57% vs 20%). No patient who received {<=}78 Gy to the IBP developed RIBP. On multivariable competing risk analysis, IBP V76 receiving {>=}1 cc, and primary tumor failure had the highest hazard ratios for developing RIBP and TRBP, respectively. Conclusions: RIBP is a relatively uncommon complication in patients with apical NSCLC tumors receiving definitive doses of radiation, while patients who develop primary tumor failures are at high risk for developing morbid TRBP. These findings suggest that the importance of primary tumor control with adequate doses of radiation outweigh the risk of RIBP in this population of

  12. 阿托伐他汀改善冠心病患者血管内皮功能的临床研究%The Effects of Atorvastatin on Brachial Artery Endothelial Function in Patients with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    罗俊; 张湘; 王赛华; 马珏; 严俊峰; 苏芬; 宋玮

    2011-01-01

    Objective: To study the effects of atorvastatin cholesterol-lowering therapy on vascular endothelial function in patients with coronary heart disease( CHD). Methoeds: A total of 78 patients took atorvastatin daily for 8 weeks. Vascular endothelial function in form of flow-mediated dilatation was assessed in the brachium artery by high-resolution ultrasound technique and the levels of total cholesterol (TC), triglyceride (TG),low-density lipoprotein cholesterol (LDL-C), oxidatively modified low-density lipoprotein(ox-LDL), high-density lipoprotein cholesterol (HDL-C) and nitric oxide (NO) were assayed before and after 8 weeks treatment Results: After 8 weeks atorvastatin treatment, vascular endothelial function were obviously improved and the levels of HDL-C and NO were markedly increased compared with that before treatment (P < 0. 01), while TC, TG, LDL-C and ox-LDL were markedly decreased (P < 0. 01). Conchision:The cholesterol-lowering therapy with atorvastatin could improve vascular endothelial function of CHD patients with high serum cholesterol.%目的:观察短期阿托伐他汀治疗对高胆固醇血症的冠心病患者血管内皮功能的影响.方法:78例高胆固醇血症患者每日口服阿托伐他汀共8周,服药前后测量患者血清的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和氧化低密度脂蛋白(ox-LDL)以及NO值,并用彩色多普勒超声测定反应性充血时肱动脉内径的变化.结果:高胆固醇血症患者经阿托伐他汀8周治疗后,血清的TC、TG、LDL-C和ox-LDL明显下降,血清的HDL-C以及NO值明显增加,反应性充血时肱动脉内径扩张程度明显增加,这些与治疗前相比有明显差异.结论:阿托伐他汀治疗能使高胆固醇血症的冠心病患者血脂改变,NO值增加,血管内皮功能改善.

  13. Description of the brachial plexus of the short-eared dog (Atelocynus microtis Sclater, 1882: case report

    Directory of Open Access Journals (Sweden)

    Luane Lopes Pinheiro

    2013-09-01

    Full Text Available The short-eared dog (Atelocynus microtis is one of the rarest species of South American canids. Aiming to describe the morphology of this animal and enhance the study of comparative neuroanatomy, we studied the anatomical makeup of the brachial plexus of a female specimen from Paragominas (PA. The specimen was donated, after natural death, to the Institute of Animal Health and Production (ISPA at the Universidade Federal Rural da Amazônia (UFRA. The animal was fixed in 10% formalin and later dissected bilaterally to reveal the origin of the brachial plexus. In A. microtis, the brachial plexus is derived from the ventral rami of the last three cervical spinal nerves and the first thoracic spinal nerve (C6-T1. The brachial plexus derivatives with their respective origins were: suprascapular n. (C6 and C7, subscapular n. (C6, musculocutaneous n. (C6 and C7, axillary n. (C6 and C7, radial n. (C7 and C8, median n. (C7, C8 and T1, ulnar n. (C8 and T1, thoracodorsal n. (C8 and T1, cranial pectoral nn. (C7, C8 and T1 and caudal pectoral nn. (C8 and T1. The brachial plexus of A. microtis resembled what has been described for the domestic dog, in relation to the origin of the initial and final segment, but showed differences in the composition of some nerves.

  14. Brachial plexus variation involving the formation and branches of the cords

    Directory of Open Access Journals (Sweden)

    Fabian-Taylor FM

    2010-11-01

    Full Text Available This case report is aimed at reporting a rare variation of brachial plexus involving the cords and its branches in the right upper limb. The musculocutaneous nerve was missing. The whole medial cord continued as a medial root of median nerve. The lateral cord gave off the lateral root of median nerve and an additional root joined with posterior cord to form a short common trunk. The short common trunk divided into two roots: one joined the median nerve; and the second one continued down as ulnar nerve. Median nerve supplied biceps brachii and brachialis muscles. The coracobrachialis muscle was supplied by radial nerve. The cutaneous innervation to the upper limb was derived from radial and ulnar nerves.

  15. Research on flow-mediated dilatation of brachial artery and risk factors of cerebral infarction%肱动脉内皮依赖性舒张功能与脑梗死危险因素高血压、糖尿病及高脂血症的相关研究

    Institute of Scientific and Technical Information of China (English)

    陈洪汉; 黎红华; 向慧娟; 武强; 杨梅; 徐志鹏

    2012-01-01

    目的 探讨肱动脉内皮依赖性舒张功能(FMD)与脑梗死危险因素中高血压、糖尿病及高脂血症的相关性.方法 选取急性脑梗死患者40例,健康对照组11例,将急性脑梗死患者中单一危险因素者归列为单危险因素脑梗死组,2~3个危险因素者归列为多危险因素脑梗死组,均行肱动脉内皮功能检测.组间比较采用t检验.将FMD作为因变量,高血压、糖尿病及高脂血症作为自变量行多元线性回归分析.结果 脑梗死组FMD较对照组显著降低,多危险因素脑梗死组FMD较单危险因素脑梗死组显著降低.高血压和糖尿病与FMD存在线性回归关系.结论 高血压、糖尿病及高脂血症等脑梗死危险因素越多,FMD降低越显著,其中以高血压病与FMD的改变关系最密切,其次为糖尿病.%Objective To explore the relevance of the risk factors for cerebral infarction and flow-mediated dilatation. Methods Selected 40 patients with acute cerebral infarction, and divided the patients with acute cerebral infarction into multiple risk factors group who had a single risk factor and single risk factors group who had 2-3 risk factors. Selected 11 healthy people as control group. All patients underwent brachial artery endothelial function testing. Groups were compared using independent samples t test. And using multiple linear regression analysis, that regarded FMD as the dependent variable, and hypertension, diabetes, hyperlipidemia as independent variables. Results FMD of cerebral infarction group was significantly lower than the control group. FMD of multiple risk factors group were significantly higher than single risk factors group. Hypertension and diabetes were related to vWF and sEPCR linear regression. Conclusion The more risk factors for cerebral infarction, FMD decreases significantly more. And hypertension is the most closely with the change of FMD , followed by diabetes.

  16. Clinical Application of Brachial Artery Wave Intensity in Evaluating the Left Ventricular Systolic Function of Patients with Complex Congenital Heart Disease%肱动脉波强度对复杂先天性心脏病患者左心收缩功能评估的临床应用

    Institute of Scientific and Technical Information of China (English)

    丁云川; 陈剑; 尹帆; 王庆慧; 苏璇; 罗庆祎

    2013-01-01

    目的 探讨外周动脉瞬时波强度在左心室几何形态异常或大动脉连接异常的复杂先天性心脏病心功能评估方面的临床应用价值.方法 应用以回声跟踪技术为基础的波强度(wave intensity,WI)技术对27例单心室患儿和30例健康受检者的肱动脉进行检查,测量其瞬时波强度曲线,并自动获得W1峰(瞬时加速度波强)等参数,进行对比分析;并对右室双出口18例(其中室间隔缺损靠近主动脉的12例),完全性大动脉转位6例,矫正型大动脉转位8例共32例大动脉连接关系异常的患者进行W1的测量评估.结果 单心室等复杂先天性心脏病患儿W1峰较对照组显著减低(P<0.01),W1与心室Max (dP/dt)呈显著正相关(r=0.874,P<0.01).大动脉连接关系异常的受检者W1均较健康对照组减低,差异有统计学意义(P<0.05),右室双出口中室间隔缺损靠近主动脉的患者W1峰值较右室双出口中主动脉远离室间隔的患者稍高.结论 WI可作为评价心室收缩功能的新方法,对于由于左心室几何形态异常及大动脉连接异常的复杂先天性心脏病患者左心室功能,WI技术也能对其进行较为准确的评估;能够在心脏病外科手术治疗术前、术中及术后提供真实准确的评价.%Objective To explore clinical value of peripheral artery instantaneous wave intensity in the assessment of abnormal left ventricular geometry or arterial connection abnormal heart function of complex congenital heart disease. Methods We used wave intensity (WI, wave intensity) hased on echo tracking technology to check the brachial artery of 27 children with single ventricle and 30 healthy subjects, and measured the instantaneous wave intensity curve, automatically obtain parameters such as WI peak (instantaneous acceleration wave) , and analyzed these parameters. We also measured and evaluated the WI of 18 cases of double outlet right ventricle (in which 12 cases of ventricular septal

  17. Analysis of Arterial Mechanics During Head-Down-Tilt Bed Rest

    Science.gov (United States)

    Elliott, Morgan B.; Martin, David S.; Westby, Christian M.; Stenger, Michael B.; Platts, Steven H.

    2014-01-01

    Carotid, brachial, and tibial arteries reacted differently to HDTBR. Previous studies have not analyzed the mechanical properties of the human brachial or anterior tibial arteries. After slight variations during bed-rest, arterial mechanical properties and IMT returned to pre-bed rest values, with the exception of tibial stiffness and PSE, which continued to be reduced post-bed rest while the DC remained elevated. The tibial artery remodeling was probably due to decreased pressure and volume. Resulting implications for longer duration spaceflight are unclear. Arterial health may be affected by microgravity, as shown by increased thoracic aorta stiffness in other ground based simulations (Aubert).

  18. 踝臂指数对老年高血压合并下肢动脉病变患者发生心脑血管病风险的预测价值%Assessment of peripheral arterial disease in elderly hypertensive patients and risk prediction of cardio-cerebral vascular disease by ankle-brachial index

    Institute of Scientific and Technical Information of China (English)

    沈丹; 曹萍; 王桦; 刘珍丽

    2012-01-01

    目的 探讨踝臂指数(ABI)对老年高血压合并下肢动脉病变(PAD)患者发生心脑血管病变风险的预测价值.方法 回顾性分析老年高血压病患者285例,按照ABI值分为高血压合并PAD组(PAD组,55例)和高血压未合并PAD组(非PAD组,230例),比较2组间臂踝脉搏波传导速度(baPWV)及各种心脑血管病危险因素的差异.结果 与非PAD组比较,PAD组收缩压(SBP)、脉压(PP)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)[Lp(a)]、血尿酸(UA)、C反应蛋白(CRP)、糖化血红蛋白(HbA1c)以及baPWV值均明显增加(P<0.05,或P<0.01);且发生冠心病、脑梗死的风险分别增高3.17倍(95%CI 1.29~7.76)和5.57倍(95%CI 2.15~14.44);相关分析显示,ABI与年龄(r=-0.273,P=0.025)、PP(r=-0.230,P=0.034)、Lp(a)(r=-0.361,P=0.002)、UA(r=-0.210,P=0.046)、CRP(r=-0.311,P=0.030)、HbA1c(r=-0.272,P=0.017)、baPWV(r=-0.291,P=0.018)均呈负相关.Logistic回归分析提示,年龄、SBP、PP及Lp(a)是PAD的独立危险因素.结论 ABI可评估老年高血压患者下肢动脉病变的严重程度,并预测其心脑血管疾病的发生风险.%Objective To investigate whether the ankle-brachial index ( ABI ) can assess peripheral arterial disease ( PAD ) in elderly hypertensive patients and predict the risk of cardio-cerebral vascular diseases. Methods The data of 285 elderly hypertensive patients was retrospectively reviewed and analyzed. They were diagnosed as hypertension with PAD ( n = 55 ) or without PAD ( none-PAD, n = 230 ) according to ABI criteria. Brachial-ankle pulse wave velocity ( baPWV ) and various cardiovascular risk factors were compared between the two groups. Results The prevalence of PAD in elderly hypertensive patients was 19. 3% . Compared with patients without PAD, the levels of systolic blood pressure ( SBP ), pulse pressure ( PP ), low density lipoprotein-cholesterol ( LDL-C ), lipoprotein (a)[Lp(a)], uric acid ( UA ), C-reactive protein ( CRP ), HbAl c and ba

  19. Variação do diâmetro da artéria braquial em crianças obesas: presente e futuro Variación del diámetro de la arteria braquial en niños obesos: presente y futuro Variation of the brachial artery diameter in obese children: present and future

    Directory of Open Access Journals (Sweden)

    Karla Cristina M. Costa

    2012-09-01

    como predictor de riesgo para enfermedades cardiovasculares, tales como aterosclerosis y enfermedad cardíaca coronariana, puesto que la lesión endotelial es un importante evento en la fisiopatología de tales enfermedades. CONCLUSIONES: La dilatación de la arteria braquial mediada por flujo se muestra importante como herramienta diagnóstica y pronóstica en la evaluación de la función endotelial de niños y adolescentes con exceso de peso, por ser un método no invasivo, con buena aplicabilidad respecto al costo, a la inclusión y al beneficio.OBJECTIVE: Literature review on the use of the variation measure of the brachial artery diameter by high-resolution ultrasound (flow-mediated dilation as a predictor of cardiovascular disease risk in children and adolescents. DATA SOURCE: Survey of studies indexed in Medline/Pubmed, which were published between 2002 and 2011 using the following keywords in various combinations:"endothelium," "child", "ultrasonography" and "obesity", as well as classic texts on the subject. We found 54 publications and 32 were included in this review. SYNTHESIS OF DATA: The study of endothelial dysfunction has been used as a predictor of risk for cardiovascular diseases such as atherosclerosis and coronary heart disease, since endothelial injury is an important event in the physiopathology of these diseases. CONCLUSIONS: The flow-mediated dilation of the brachial artery seems to be important as a diagnostic and prognostic tool to assess endothelial function in children and adolescents who are overweight, because it is a noninvasive method with good profile regarding cost, safety, and benefits.

  20. Low Median Nerve Transfers (Opponensplasty).

    Science.gov (United States)

    Chadderdon, Robert Christopher; Gaston, R Glenn

    2016-08-01

    Opposition is the placement of the thumb opposite the fingers into a position from which it can work. This motion requires thumb palmar abduction, flexion, and pronation, which are provided by the abductor pollicis brevis, flexor pollicis brevis (FPB), and opponens pollicis. In the setting of a median nerve palsy, this function is typically lost, although anatomic variations and the dual innervation of the FPB may prevent complete loss at times. There are multiple well described and accepted tendon transfers to restore opposition, none of which have been proven to be superior to the others. PMID:27387078

  1. Sosiaalisen median opas pienille hotelleille

    OpenAIRE

    Lohtander, Annukka

    2014-01-01

    Tämä työ on produktityyppinen opinnäytetyö, joka koostuu tietoperustasta ja tuotoksesta. Tuotos on sosiaalisen median opas pienille suomalaisille hotelleille. Sosiaalisesta mediasta on tullut osa lähes jokaisen yrityksen toimintaa. Majoitusalalla tärkeimpiä alustoja ovat Facebook, TripAdvisor, Twitter, Foursquare, keskustelufoorumit, blogit sekä kuva- ja videopalvelut. Osassa näistä alustoista on syytä olla mukana niin sisällön tuottajana kuin sen seuraajana ja reagoijanakin. Osa...

  2. Magnetic resonance imaging in brachial plexus injury.

    Science.gov (United States)

    Caranci, F; Briganti, F; La Porta, M; Antinolfi, G; Cesarano, E; Fonio, P; Brunese, L; Coppolino, F

    2013-08-01

    Brachial plexus injury represents the most severe nerve injury of the extremities. While obstetric brachial plexus injury has showed a reduction in the number of cases due to the improvements in obstetric care, brachial plexus injury in the adult is an increasingly common clinical problem. The therapeutic measures depend on the pathologic condition and the location of the injury: Preganglionic avulsions are usually not amenable to surgical repair; function of some denervated muscles can be restored with nerve transfers from intercostals or accessory nerves and contralateral C7 transfer. Postganglionic avulsions are repaired with excision of the damaged segment and nerve autograft between nerve ends or followed up conservatively. Magnetic resonance imaging is the modality of choice for depicting the anatomy and pathology of the brachial plexus: It demonstrates the location of the nerve damage (crucial for optimal treatment planning), depicts the nerve continuity (with or without neuroma formation), or may show a completely disrupted/avulsed nerve, thereby aiding in nerve-injury grading for preoperative planning. Computed tomography myelography has the advantage of a higher spatial resolution in demonstration of nerve roots compared with MR myelography; however, it is invasive and shows some difficulties in the depiction of some pseudomeningoceles with little or no communication with the dural sac. PMID:23949940

  3. [Percutaneous brachial access: a few simple considerations].

    Science.gov (United States)

    Marcy, P Y; Ianessi, A; Ben Taarit, I

    2009-01-01

    This letter is with regards to the recently published article by Vidal et al. in the Journal Français de Radiologie Médicale. A clarification of US and venographic techniques of brachial venous catheterization and related complications are presented. The main indications for PICC line and subcutaneous port placement are described.

  4. Superficial Ulnar Artery: A Case Report of its Unusual Course.

    Science.gov (United States)

    Quadros, Lydia Shobha; Bhat, Nandini; D'Souza, Antony Sylvan

    2015-01-01

    After arising from the brachial artery in the cubital fossa the ulnar artery usually passes deep into the superficial flexor muscles of the forearm. In the lower two-thirds, it typically follows a sub-fascial course. In the present case, during a routine undergraduate course dissection of a cadaver, it was found that the ulnar artery arose normally as a terminal branch of the brachial artery in the cubital fossa, followed a sub-fascial course by lying superficial to the flexor muscles then completed the superficial palmar arch in hand. This artery gave only minute muscular branches in the forearm. Moreover, the main branches that usually arise from the ulnar artery were given off by the radial artery. This type of variation is of importance for both the clinicians and surgeons due to its vulnerability to injuries and of academic interest for anatomists. PMID:26715898

  5. Association Between Chromosome 9p21 Variants and the Ankle-Brachial Index Identified by a Meta-Analysis of 21 Genome-Wide Association Studies

    NARCIS (Netherlands)

    Murabito, Joanne M.; White, Charles C.; Kavousi, Maryam; Sun, Yan V.; Feitosa, Mary F.; Nambi, Vijay; Lamina, Claudia; Schillert, Arne; Coassin, Stefan; Bis, Joshua C.; Broer, Linda; Crawford, Dana C.; Franceschini, Nora; Frikke-Schmidt, Ruth; Haun, Margot; Holewijn, Suzanne; Huffman, Jennifer E.; Hwang, Shih-Jen; Kiechl, Stefan; Kollerits, Barbara; Montasser, May E.; Nolte, Ilja M.; Rudock, Megan E.; Senft, Andrea; Teumer, Alexander; van der Harst, Pim; Vitart, Veronique; Waite, Lindsay L.; Wood, Andrew R.; Wassel, Christina L.; Absher, Devin M.; Allison, Matthew A.; Amin, Najaf; Arnold, Alice; Asselbergs, Folkert W.; Aulchenko, Yurii; Bandinelli, Stefania; Barbalic, Maja; Boban, Mladen; Brown-Gentry, Kristin; Couper, David J.; Criqui, Michael H.; Dehghan, Abbas; den Heijer, Martin; Dieplinger, Benjamin; Ding, Jingzhong; Doerr, Marcus; Espinola-Klein, Christine; Felix, Stephan B.; Ferrucci, Luigi; Folsom, Aaron R.; Fraedrich, Gustav; Gibson, Quince; Goodloe, Robert; Gunjaca, Grgo; Haltmayer, Meinhard; Heiss, Gerardo; Hofman, Albert; Kieback, Arne; Kiemeney, Lambertus A.; Kolcic, Ivana; Kullo, Iftikhar J.; Kritchevsky, Stephen B.; Lackner, Karl J.; Li, Xiaohui; Lieb, Wolfgang; Lohman, Kurt; Meisinger, Christa; Melzer, David; Mohler, Emile R.; Mudnic, Ivana; Mueller, Thomas; Navis, Gerjan; Oberhollenzer, Friedrich; Olin, Jeffrey W.; O'Connell, Jeff; O'Donnell, Christopher J.; Palmas, Walter; Penninx, Brenda W.; Petersmann, Astrid; Polasek, Ozren; Psaty, Bruce M.; Rantner, Barbara; Rice, Ken; Rivadeneira, Fernando; Rotter, Jerome I.; Seldenrijk, Adrie; Stadler, Marietta; Summerer, Monika; Tanaka, Toshiko; Tybjaerg-Hansen, Anne; Uitterlinden, Andre G.; van Gilst, Wiek H.; Vermeulen, Sita H.; Wild, Sarah H.; Wild, Philipp S.; Willeit, Johann; Zeller, Tanja; Zemunik, Tatijana; Zgaga, Lina; Assimes, Themistocles L.; Blankenberg, Stefan; Campbell, Harry; Boerwinkle, Eric; Cooke, John P.; de Graaf, Jacqueline; Herrington, David; Kardia, Sharon L. R.; Mitchell, Braxton D.; Murray, Anna; Muenzel, Thomas; Newman, Anne B.; Oostra, Ben A.; Rudan, Igor; Shuldiner, Alan R.; Snieder, Harold; van Duijn, Cornelia M.; Voelker, Uwe; Wright, Alan F.; Wichmann, H. -Erich; Wilson, James F.; Witteman, Jacqueline C. M.; Liu, Yongmei; Hayward, Caroline; Borecki, Ingrid B.; Ziegler, Andreas; North, Kari E.; Cupples, L. Adrienne; Kronenberg, Florian; Dorr, M.; Munzel, T.; Volker, U.

    2012-01-01

    Background-Genetic determinants of peripheral arterial disease (PAD) remain largely unknown. To identify genetic variants associated with the ankle-brachial index (ABI), a noninvasive measure of PAD, we conducted a meta-analysis of genome-wide association study data from 21 population-based cohorts.

  6. Dose–Volume Modeling of Brachial Plexus-Associated Neuropathy After Radiation Therapy for Head-and-Neck Cancer: Findings From a Prospective Screening Protocol

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Allen M., E-mail: amchen@mednet.ucla.edu [Department of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California (United States); Wang, Pin-Chieh [Department of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California (United States); Daly, Megan E.; Cui, Jing; Hall, William H. [Department of Radiation Oncology, University of California, Davis, Comprehensive Cancer Center, Sacramento, California (United States); Vijayakumar, Srinivasan [Department of Radiation Oncology, University of Mississippi School of Medicine, Jackson, Mississippi (United States); Phillips, Theodore L. [Department of Radiation Oncology, University of California, Davis, Comprehensive Cancer Center, Sacramento, California (United States); Farwell, D. Gregory [Department of Otolaryngology–Head and Neck Surgery, University of California, Davis, Comprehensive Cancer Center, Sacramento, California (United States); Purdy, James A. [Department of Radiation Oncology, University of California, Davis, Comprehensive Cancer Center, Sacramento, California (United States)

    2014-03-15

    Purpose: Data from a prospective screening protocol administered for patients previously irradiated for head-and-neck cancer was analyzed to identify dosimetric predictors of brachial plexus-associated neuropathy. Methods and Materials: Three hundred fifty-two patients who had previously completed radiation therapy for squamous cell carcinoma of the head and neck were prospectively screened from August 2007 to April 2013 using a standardized self-administered instrument for symptoms of neuropathy thought to be related to brachial plexus injury. All patients were disease-free at the time of screening. The median time from radiation therapy was 40 months (range, 6-111 months). A total of 177 patients (50%) underwent neck dissection. Two hundred twenty-one patients (63%) received concurrent chemotherapy. Results: Fifty-one patients (14%) reported brachial plexus-related neuropathic symptoms with the most common being ipsilateral pain (50%), numbness/tingling (40%), and motor weakness and/or muscle atrophy (25%). The 3- and 5-year estimates of freedom from brachial plexus-associated neuropathy were 86% and 81%, respectively. Clinical/pathological N3 disease (P<.001) and maximum radiation dose to the ipsilateral brachial plexus (P=.01) were significantly associated with neuropathic symptoms. Cox regression analysis revealed significant dose–volume effects for brachial plexus-associated neuropathy. The volume of the ipsilateral brachial plexus receiving >70 Gy (V70) predicted for symptoms, with the incidence increasing with V70 >10% (P<.001). A correlation was also observed for the volume receiving >74 Gy (V74) among patients treated without neck dissection, with a cutoff of 4% predictive of symptoms (P=.038). Conclusions: Dose–volume guidelines were developed for radiation planning that may limit brachial plexus-related neuropathies.

  7. [Dextrocardia in situs inversus totalis with obstructive coronary disease. Its treatment by coronary angioplasty by the brachial approach].

    Science.gov (United States)

    da Silva, M J; Arie, S; Garcia, D P; Bellotti, G; Pileggi, F

    1992-10-01

    Dextrocardia in "situs inversus totalis" with obstructive coronary disease is a rare clinical situation, with few cases treated by coronary angioplasty using the femoral approach being reported. In this report we describe the case of a 61-year-old male patient who underwent successful dilatation of two arteries by the brachial approach. We discuss technical aspects related to the procedure, which may be easily performed when proper equipment is available.

  8. Atypical leg symptoms: does routine measurement of the ankle brachial pressure index (ABPI) in primary care benefit patients?

    OpenAIRE

    Oesterling, Christine; Kalia, Amun; Chetcuti, Thomas; Walker, Steven

    2015-01-01

    Abstract Background : Managing patients with atypical leg symptoms in primary care can be problematic. Determining the ankle brachial pressure index (ABPI) may be readily performed to help diagnose peripheral arterial disease, but is often omitted where signs and symptoms are unclear. Question : Does routine measurement of ABPI in patients with atypical leg symptoms aid management increase satisfaction and safely reduce hospital referral? Methodology : Patients with atypical leg symptoms but ...

  9. The Relationship among Pulse Wave Velocity, Ankle-Brachial Pressure Index and Heart Rate Variability in Adult Males

    OpenAIRE

    Ahn, Jeong-Hwan; Kong, Mihee

    2011-01-01

    Background Pulse wave velocity (PWV) and ankle-brachial pressure index (ABI) are non-invasive tools to measure atherosclerosis and arterial stiffness. Heart rate variability (HRV) has proven to be a non-invasive powerful tool in the investigation of the autonomic cardiovascular control. Therefore, the purpose of this study was to determine the relationship among PWV, ABI, and HRV parameters in adult males. Methods The study was carried out with 117 males who visited a health care center from ...

  10. Brachial Plexus-Associated Neuropathy After High-Dose Radiation Therapy for Head-and-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California, Davis School of Medicine, Sacramento, California (United States); Hall, William H. [Department of Radiation Oncology, University of California, Davis School of Medicine, Sacramento, California (United States); Li, Judy; Beckett, Laurel [Department of Biostatistics, University of California, Davis School of Medicine, Sacramento, California (United States); Farwell, D. Gregory [Department of Otolaryngology-Head and Neck Surgery, University of California, Davis School of Medicine, Sacramento, California (United States); Lau, Derick H. [Department of Medical Oncology, University of California, Davis School of Medicine, Sacramento, California (United States); Purdy, James A. [Department of Radiation Oncology, University of California, Davis School of Medicine, Sacramento, California (United States)

    2012-09-01

    Purpose: To identify clinical and treatment-related predictors of brachial plexus-associated neuropathies after radiation therapy for head-and-neck cancer. Methods and Materials: Three hundred thirty patients who had previously completed radiation therapy for head-and-neck cancer were prospectively screened using a standardized instrument for symptoms of neuropathy thought to be related to brachial plexus injury. All patients were disease-free at the time of screening. The median time from completion of radiation therapy was 56 months (range, 6-135 months). One-hundred fifty-five patients (47%) were treated by definitive radiation therapy, and 175 (53%) were treated postoperatively. Radiation doses ranged from 50 to 74 Gy (median, 66 Gy). Intensity-modulated radiation therapy was used in 62% of cases, and 133 patients (40%) received concurrent chemotherapy. Results: Forty patients (12%) reported neuropathic symptoms, with the most common being ipsilateral pain (50%), numbness/tingling (40%), motor weakness, and/or muscle atrophy (25%). When patients with <5 years of follow-up were excluded, the rate of positive symptoms increased to 22%. On univariate analysis, the following factors were significantly associated with brachial plexus symptoms: prior neck dissection (p = 0.01), concurrent chemotherapy (p = 0.01), and radiation maximum dose (p < 0.001). Cox regression analysis confirmed that both neck dissection (p < 0.001) and radiation maximum dose (p < 0.001) were independently predictive of symptoms. Conclusion: The incidence of brachial plexus-associated neuropathies after radiation therapy for head-and-neck cancer may be underreported. In view of the dose-response relationship identified, limiting radiation dose to the brachial plexus should be considered when possible.

  11. Sonographic evaluation of brachial plexus pathology

    Energy Technology Data Exchange (ETDEWEB)

    Graif, Moshe; Blank, Anat; Weiss, Judith; Kessler, Ada [Department of Radiology, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv (Israel); Martinoli, Carlo; Derchi, Lorenzo E. [Department of Radiology, University of Genoa, Genoa (Italy); Rochkind, Shimon [Department of Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv (Israel); Trejo, Leonor [Department of Pathology, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv (Israel)

    2004-02-01

    Pre-operative US examinations of the brachial plexus were performed with the purpose of exploring the potential of this technique in recognizing lesions in the region and defining their sonographic morphology, site, extent, and relations to adjacent anatomic structures, and comparing them to the surgical findings to obtain maximal confirmation. Twenty-eight patients with clinical, electro-conductive, and imaging findings suggestive of brachial plexus pathology were included in this study. There were four main etiology groups: post-traumatic brachial plexopathies; primary tumors (benign and malignant); secondary tumors; and post irradiation injuries. Twenty-one of the 28 patients underwent surgery. Advanced imaging (mostly MRI) served as an alternative gold standard for confirmation of the findings in the non-surgically treated group of patients. The US examinations were performed with conventional US units operating at 5- to 10-MHz frequencies. The nerves were initially localized at the level of the vertebral foramina and then were followed longitudinally and axially down to the axillary region. Abnormal US findings were detected in 20 of 28 patients. Disruption of nerve continuity and focal scar tissue masses were the principal findings in the post-traumatic cases. Focal masses within a nerve or adjacent to it and diffuse thickening of the nerve were the findings in primary and secondary tumors. Post-irradiation changes presented as nerve thickening. Color Doppler was useful in detecting internal vascularization within masses and relation of a mass to adjacent vessels. The eight sonographically negative cases consisted either of traumatic neuromas smaller than 12 mm in size and located in relatively small branches of posterior location or due to fibrotic changes of diffuse nature. Sonography succeeded in depicting a spectrum of lesions of traumatic, neoplastic, and inflammatory nature in the brachial plexus. It provided useful information regarding the lesion site

  12. MR neurography in traumatic brachial plexopathy

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyaya, Vaishali, E-mail: vshali77@yahoo.co.in [Department of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India); Upadhyaya, Divya N. [Department of Plastic Surgery, King George Medical University, Shah Meena Road, Chowk, Lucknow 226 003 (India); Kumar, Adarsh [Department of Plastic Surgery, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India); Gujral, Ratni B. [Department of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India)

    2015-05-15

    Highlights: • MR neurography is the imaging modality of choice in patients who have sustained brachial plexus injury. It is helpful in determining the level and extent of injury. • The authors have used a Visual Per-operative Scoring system to assess the usefulness of MR neurography in delineating the level and type of the lesion. • The imaging findings were classified based on the level of injury—root, trunk or cord. These findings were correlated with those seen on surgical exploration. A good correlation was found in the majority (65%) of patients and average correlation (30%) in others. - Abstract: Objectives: Imaging of the brachial plexus has come a long way and has progressed from plain radiography to CT and CT myelography to MRI. Evolution of MR imaging sequences has enabled good visualization of the small components of the plexus. The purpose of our study was to correlate the results of MR neurography (MRN) in patients with traumatic brachial plexopathy with their operative findings. We wanted to determine the usefulness of MRN and how it influenced surgical planning and outcome. Methods: Twenty patients with features of traumatic brachial plexopathy who were referred to the MRI section of the Department of Radiology between September 2012 and January 2014 and subsequently underwent exploration were included in the study. MR neurography and operative findings were recorded at three levels of the brachial plexus—roots, trunks and cords. Results: Findings at the level of roots and trunks were noted in 14 patients each and at the level of the cords in 16 patients. 10 patients had involvement at all levels. Axillary nerve involvement as a solitary finding was noted in two patients. These patients were subsequently operated and their studies were assigned a score based on the feedback from the operating surgeons. The MRN study was scored as three (good), two (average) or one (poor) depending on whether the MR findings correlated with operative

  13. The superficial ulnar artery: development and clinical significance Artéria ulnar superficial: desenvolvimento e relevância clínica

    Directory of Open Access Journals (Sweden)

    Srinivasulu Reddy

    2007-09-01

    Full Text Available The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.As principais artérias do membro superior apresentam uma ampla variação, que é relativamente importante a cirurgiões ortopédicos e plásticos, radiologistas e anatomistas.Apresentamosumcaso de artéria ulnar superficial encontrada durante dissecção de rotina de membro superior direito de um cadáver masculino de 50 anos de idade.Aartéria ulnar superficial originava-se da artéria braquial, cruzava o nervo mediano anteriormente e percorria lateralmente esse nervo e a artéria braquial. A artéria ulnar superficial no braço deu origem a um ramo muscular estreito do músculo bíceps braquial. Ao nível do cotovelo, a artéria percorria superficialmente a aponeurose bicipital, onde era cruzada pela veia cubital mediana. Percorria, então, em sentido descendente e medialmente superficial aos músculos flexores do antebraço, e então descendia para

  14. Role of Metals and Aspects of Socioeconomic Status (SES) in Peripheral Arterial Disease in the US Population

    Science.gov (United States)

    Atherosclerosis and atherothrombosis are serious pathological changes and are responsible for various disease conditions such as peripheral arterial disease (PAD). The prevalence of PAD, commonly assessed by Ankle–Brachial Index (ABI), is over 10% in the US population over...

  15. Median arcuate ligament syndrome: a nonvascular, vascular diagnosis.

    Science.gov (United States)

    Skeik, Nedaa; Cooper, Leslie T; Duncan, Audra A; Jabr, Fadi I

    2011-07-01

    Median arcuate ligament syndrome (MALS) is often diagnosed when idiopathic, episodic abdominal pain is associated with dynamic compression of the proximal celiac artery by fibers of the median arcuate ligament. The character of the abdominal pain is often postprandial and associated with gradual weight loss from poor food intake, suggestive of chronic mesenteric ischemia. However, the pathognomonic imaging feature of dynamic, ostial celiac artery compression with expiration does not consistently predict clinical improvement from revascularization. Proposed but unproven pathophysiological mechanisms include neurogenic pain from compression of the splanchnic nerve plexus and intermittent ischemia from compression of the celiac artery. Alterations in blood flow and ganglion compression are both associated with delayed gastric emptying, another physiological correlate of the clinical syndrome. Published reports describe a variable response to revascularization and nerve plexus resection suggest a need for translational research to better characterize this poorly understood clinical entity. We illustrate the current gaps in our knowledge of MALS with the case of a 51-year-old woman with a 4-year history of chronic abdominal pain who responded to a combination of ganglion resection and celiac artery reconstruction. PMID:21536596

  16. Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population

    OpenAIRE

    Zhou, Fang; Zhang, Haifeng; Yao, Wenming; Mei, Hongbin; Xu, Dongjie; Sheng, Yanhui; Yang, Rong; Kong, Xiangqing; Wang, Liansheng; Zou, Jiangang; Yang, Zhijian; Li, Xinli

    2014-01-01

    Abstract The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity (baPWV), and the presence of the metabolic syndrome (MS) in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in our study population was 21.7%, 17.2% and 25.6% for the general population, males and females, respectively. With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density l...

  17. Malignant brachial plexopathy: A pictorial essay of MRI findings

    International Nuclear Information System (INIS)

    For imaging, the brachial plexus is a technically and anatomically challenging region of the peripheral nervous system. MRI has a central role in the identification and accurate characterization of malignant lesions arising here, as also in defining their extent and the status of the adjacent structures. The purpose of this pictorial essay is to describe the MRI features of primary and secondary malignant brachial plexopathies and radiation-induced brachial nerve damage

  18. A comparison of two approaches to brachial plexus anaesthesia

    OpenAIRE

    Rajib Hazarika; Tejwant Rajkhowa; Mridu Paban Nath; Samit Parua

    2016-01-01

    Background: A prospective, double blind study was performed to compare the clinical effect of vertical infraclavicular and supraclavicular brachial plexus block using a nerve stimulation technique for upper limb surgery. Methods: Eighty patients undergoing upper limb surgery under infraclavicular or supraclavicular brachial plexus block were enrolled into this study. The infraclavicular brachial plexus block was performed using the vertical technique (group I; N=40). The supraclavicular b...

  19. Measurement of brachial artery velocity variation and inferior vena cava variability to estimate fluid responsiveness%肱动脉峰流速变异度和下腔静脉呼吸变异度 对容量反应性的评估作用

    Institute of Scientific and Technical Information of China (English)

    朱炜华; 万林骏; 万晓红; 王刚; 苏美仙; 廖庚进; 黄青青

    2016-01-01

    feasibility of brachial artery peak velocity variation (ΔVpeakbrach) and inferior vena cava variability (VIVC) as indicators of fluid responsiveness in critically ill patients. Methods A single-center prospective observation was conducted. The patients on mechanical ventilation with spontaneously breathing admitted to Department of Critical Care Medicine of the Second Affiliated Hospital of Kunming Medical University from June 2013 to August 2015 were enrolled. The patients were diagnosed as severe sepsis or sepsis shock. The peak velocity in brachial artery and diameter of the inferior vena cava at the end of inspiration and expiration was measured by bedside portable ultrasonic machine, and then ΔVpeakbrach and VIVC were calculated. The hemodynamic parameters were collected at baseline and after volume expansion (VE). The stroke volume (SV) was measured by pulse-indicated continuous cardiac output (PiCCO). Patients were classified as responders or non-responders according to the variation of SV (ΔSV) increased ≥ 15% or not after VE. Receiver operating characteristic curve (ROC) was plotted to evaluate the sensitivity and specificity of ΔVpeakbrach and VIVC in predicting volume responsiveness. Results Among 58 patients after VE, 32 patients were defined as responders and the rest 26 were defined as non-responders.There were no differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, dose of vasoactive agent, ventilator parameters and infection site. Compared with baseline hemodynamic parameters, heart rate (HR) was decreased (bpm: 95±18 vs. 103±21), and systolic blood pressure (SBP) was increased [mmHg (1 mmHg = 0.133 kPa): 92±8 vs. 80±7] after VE in responders; central venous pressure (CVP) was increased after VE in non-responders (mmHg: 11±4 vs. 8±3, all P < 0.05). The ΔVpeakbrach [(15.4±4.3)% vs. (11.2±3.5)%] and VIVC [(18.6±4.1)% vs. (14.3±3.6)%] in responders were significantly increased as compared with those

  20. Brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis

    Institute of Scientific and Technical Information of China (English)

    QIAN Bang-ping; QIU Yong; WANG Bin; YU Yang; ZHU Ze-zhang

    2007-01-01

    Objective: To explore the clinical features and treatment results of brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis.Methods: A total of 300 cases of severe scoliosis received halo traction before posterior correction in our department from July 1997 to November 2004. Among them, 7 cases were complicated with brachial plexus palsy.The average Cobb angle was 110° (range, 90°-135°).Diagnoses were made as idiopathic scoliosis in 1 case,congenital scoliosis in 3 cases, and neuromuscular scoliosis in 3 cases. Additionally, diastematomyelia and tethered cord syndrome were found in 3 cases and thoracolumbar kyphosis in 2 cases. Weight of traction was immediately reduced when the patient developed any abnormal neurological symptoms in the upper extremity, and rehabilitation training was undertaken. Simultaneously,neurotrophic pharmacotherapy was applied, and the neurological function restoration of the upper limbs and the recovery time were documented.Results: Traction was used for an average of 3.5 weeks (range, 2-6 weeks) before spinal fusion for these 7 patients. The average traction weight was 8 kg, which was 19% on average (range, 13%-26%) of the average body weight (40.2 kg). These 7 patients had long and thin body configuration with a mean height of 175 cm. The duration between symptoms of brachial plexus paralysis and the diagnosis was 1-3 hours. All of these 7 patients presented various degrees of numbness in the ulnar side of the hand and forearm. Median nerve paresis was found in 3 cases and ulnar nerve paresis in 4 cases. Complete recovery of the neurological function had been achieved by the end of three months.Conclusions: The clinical features of brachial plexus palsy caused by halo traction include median nerve paresis,ulnar nerve paralysis, and numbness in the ulnar side of the hand and forearm, which may be due to the injury of the inferior part of the brachial plexus, i.e. , damage of Cs and

  1. MRI of the brachial plexus: A pictorial review

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    Es, Hendrik W. van [Department of Radiology, St. Antonius Hospital, Nieuwegein, Koekoekslaan 1, 3435 CM Nieuwegein (Netherlands)], E-mail: h.es@antoniusziekenhuis.nl; Bollen, Thomas L.; Heesewijk, Hans P.M. van [Department of Radiology, St. Antonius Hospital, Nieuwegein, Koekoekslaan 1, 3435 CM Nieuwegein (Netherlands)

    2010-05-15

    Magnetic resonance imaging (MRI) of the brachial plexus is the imaging modality of first choice for depicting anatomy and pathology of the brachial plexus. The anatomy of the roots, trunks, divisions and cords is very well depicted due to the inherent contrast differences between the nerves and the surrounding fat. In this pictorial review the technique and the anatomy will be discussed. The following pathology will be addressed: neurogenic tumors of the brachial plexus and sympathetic chain, superior sulcus tumors, other tumors in the vicinity of the brachial plexus, the differentiation between radiation and metastatic plexopathy, trauma, neurogenic thoracic outlet syndrome and immune-mediated neuropathies.

  2. Nerve transfer in brachial plexus traction injuries

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    Samardžić Miroslav M.

    2003-01-01

    Full Text Available Background. The aim of this study was to analyze the results of nerve transfer to the musculocutaneous and axillary nerves, using some technical modalities such as intercostal, spinal accessory or intraplexal transfer, and on the basis of the results to try to clarify the most common controversies concerning these operations. Methods. The study included 82 patients with brachial plexus traction injuries, who were operated on using various techniques of nerve transfer. The follow-up period was at least two years. The analysis of biceps and deltoid muscles recovery was performed according to the type of the donor nerve. Results. The corresponding rates of recovery for the musculocutaneous and axillary nerves were 46.7% and 68.1% in intercostal nerve transfer, 71.4% and 75% in accessory nerve transfer, 93.1% and 88.8% in nerve transfer of the brachial plexus collateral branches, and 55.5% and 60% in classical intraplexal nerve transfer, respectively. Comparative statistical analysis demonstrated significantly better final outcome and quality of recovery in regional nerve transfers in comparison to the other methods. Conclusion. Our findings suggest that nerve transfer of collateral branches, where possible, (such as in cases with upper or extended upper brachial plexus palsy might be a method of choice, offering better results and quality of recovery.

  3. Use of adjunctive palmaris longus abductorplasty (Camitz) tendon transfer in pediatric median nerve injury.

    Science.gov (United States)

    Baluch, Narges; Borschel, Gregory H

    2013-05-01

    A number of tendon transfers have been described for opponensplasty. Transfer of the palmaris longus (PL) tendon with a palmar fascial extension was initially described by Camitz. This technique has mostly been combined with carpal tunnel release in patients with long standing median neuropathy with atrophy of the thenar muscles. However, the Camitz transfer has not been previously described in the setting of pediatric median nerve injury. We report 4 cases of Camitz transfer in pediatric patients with median nerve injuries. Four children (all female; age range 3-15 yrs) underwent PL tendon transfer following median nerve injury. The causes of injury included trauma, iatrogenic injury, and neuritis of the brachial plexus. The Camitz procedure was performed at the time of median nerve decompression and/or reconstruction. All patients had excellent early return of function. Transfer of the palmaris longus tendon reliably restores palmar abduction, with minimal to no additional morbidity, in carefully selected pediatric patients with median nerve injury undergoing release of the carpal tunnel. PMID:22981385

  4. A giant plexiform schwannoma of the brachial plexus: case report

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    Kohyama Sho

    2011-11-01

    Full Text Available Abstract We report the case of a patient who noticed muscle weakness in his left arm 5 years earlier. On examination, a biloculate mass was observed in the left supraclavicular area, and Tinel's sign caused paresthesia in his left arm. Magnetic resonance imaging showed a continuous, multinodular, plexiform tumor from the left C5 to C7 nerve root along the course of the brachial plexus to the left brachia. Tumor excision was attempted. The median and musculocutaneous nerves were extremely enlarged by the tumor, which was approximately 40 cm in length, and showed no response to electric stimulation. We resected a part of the musculocutaneous nerve for biopsy and performed latissimus dorsi muscle transposition in order to repair elbow flexion. Morphologically, the tumor consisted of typical Antoni A areas, and immunohistochemistry revealed a Schwann cell origin of the tumor cells moreover, there was no sign of axon differentiation in the tumor. Therefore, the final diagnosis of plexiform Schwannoma was confirmed.

  5. Progressive Brachial Plexus Palsy after Osteosynthesis of an Inveterate Clavicular Fracture

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    Marco Rosati

    2013-07-01

    Full Text Available Introduction: The thoracic outlet syndrome (TOS is a rare complication of clavicular fracture, occurring in 0.5-9% of cases . In the literature from 1965 – 2010, 425 cases of TOS complicating a claviclular fracture were described. However, only 5 were observed ​​after a surgical procedure of reduction and fixation. The causes of this complication were due to the presence of an exuberant callus, to technical surgery errors or to vascular lesions. In this paper we describe a case of brachial plexus plasy after osteosynthesis of clavicle fracture. Case Report: A 48 year old female, presented to us with inveterate middle third clavicle fracture of 2 months duration. She was an alcoholic, smoker with an history of opiate abuse and was HCV positive. At two month the fracture was displaced with no signs of union and open rigid fixation with plate was done. The immediate postoperative patient had signs of neurologic injury. Five days after surgery showed paralysis of the ulnar nerve, at 10 days paralysis of the median nerve, radial and ulnar paresthesias in the territory of the C5-C6-C7-C8 roots. She was treated with rest, steroids and neurotrophic drugs. One month after surgery the patient had signs of complete denervation around the brachial plexus. Implant removal was done and in a month ulnar and median nerve functions recovered. At three months post implant removal the neurological picture returned to normal. Conclusion: We can say that TOS can be seen as arising secondary to an “iatrogenic compartment syndrome” justified by the particular anatomy of the space cost joint. The appropriateness of the intervention for removal of fixation devices is demonstrated by the fact that the patient has returned to her daily activities in the absence of symptoms and good functional recovery in about three months, despite fracture nonunion. Keywords: Brachial plexus palsy, clavicle fractures, outlet thoracic syndrome.

  6. A comparison of two approaches to brachial plexus anaesthesia

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    Rajib Hazarika

    2016-05-01

    Conclusions: Supraclavicular brachial plexus block may be easier to perform than infraclavicular brachial plexus block. The infraclavicular approach may be preferred to the supraclavicular approach when considering the complications. [Int J Res Med Sci 2016; 4(5.000: 1335-1338

  7. Arterial endothelial function measurement method and apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Maltz, Jonathan S; Budinger, Thomas F

    2014-03-04

    A "relaxoscope" (100) detects the degree of arterial endothelial function. Impairment of arterial endothelial function is an early event in atherosclerosis and correlates with the major risk factors for cardiovascular disease. An artery (115), such as the brachial artery (BA) is measured for diameter before and after several minutes of either vasoconstriction or vasorelaxation. The change in arterial diameter is a measure of flow-mediated vasomodification (FMVM). The relaxoscope induces an artificial pulse (128) at a superficial radial artery (115) via a linear actuator (120). An ultrasonic Doppler stethoscope (130) detects this pulse 10-20 cm proximal to the point of pulse induction (125). The delay between pulse application and detection provides the pulse transit time (PTT). By measuring PTT before (160) and after arterial diameter change (170), FMVM may be measured based on the changes in PTT caused by changes in vessel caliber, smooth muscle tone and wall thickness.

  8. Unusual and Unique Variant Branches of Lateral Cord of Brachial Plexus and its Clinical Implications- A Cadaveric Study

    Science.gov (United States)

    Padur, Ashwini Aithal; Shanthakumar, Swamy Ravindra; Shetty, Surekha Devadas; Prabhu, Gayathri Sharath; Patil, Jyothsna

    2016-01-01

    Introduction Adequate knowledge on variant morphology of brachial plexus and its branches are important in clinical applications pertaining to trauma and surgical procedures of the upper extremity. Aim Current study was aimed to report variations of the branches of the lateral cord of brachial plexus in the axilla and their possible clinical complications. Materials and Methods Total number of 82 upper limbs from 41 formalin embalmed cadavers was dissected. Careful observation was made to note the formation and branching pattern of lateral cord. Meticulous inspection for absence of branches, presence of additional or variant branches and presence of abnormal communications between its branches or with branches of other cords was carried out. Results In the present study, we noted varied branching pattern of lateral cord in 6 out of 82 limbs (7%). In one of the limb, the median nerve was formed by three roots; two from lateral cord and one from medial cord. Two limbs had absence of lateral pectoral nerve supplemented by medial pectoral nerves. One of which had an atypical ansa pectoralis. In 2 upper limbs, musculocutaneous nerve was absent and in both cases it was supplemented by median nerve. In one of the limb, coracobrachialis had dual nerve supply by musculocutaneous nerve and by an additional branch from the lateral cord. Conclusion Variations of brachial plexus and its branches could pose both intraoperative and postoperative complications which eventually affect the normal sensory and motor functions of the upper limb. PMID:27190783

  9. Peripheral arterial stenosis and coronary artery disease coincidence

    Directory of Open Access Journals (Sweden)

    Reza Ghasemi

    2014-12-01

    Full Text Available Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of coronary heart disease and stroke. In some countries, coronary artery disease (CAD is the cause of nearly half (48% of the deaths and, loss of productivity life. Peripheral arterial disease (PAD is defined as atherosclerosis in peripheral arteries instead of coronary arteries. CAD and PAD have same risk factors and underlying pathophysiological processes. Therefore, patient with CAD should be considered for PAD. Ankle brachial index (ABI, duplex sonography, and some other non-invasive techniques are recommended for PAD diagnosis in patients with the history of CAD. Pharmacotherapy, endovascular interventions, and surgical management could be chosen according to the patient’s situation. Cardiologists and general practitioners should consider PAD in a patient with CAD or DM as a strong correlated disease.      

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

    Science.gov (United States)

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

    2014-01-01

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

  11. Non-invasive model-based estimation of aortic pulse pressure using suprasystolic brachial pressure waveforms.

    Science.gov (United States)

    Lowe, A; Harrison, W; El-Aklouk, E; Ruygrok, P; Al-Jumaily, A M

    2009-09-18

    Elevated central arterial (aortic) blood pressure is related to increased risk of cardiovascular disease. Methods of non-invasively estimating this pressure would therefore be helpful in clinical practice. To achieve this goal, a physics-based model is derived to correlate the arterial pressure under a suprasystolic upper-arm cuff to the aortic pressure. The model assumptions are particularly applicable to the measurement method and result in a time-domain relation with two parameters, namely, the wave propagation transit time and the reflection coefficient at the cuff. Central pressures estimated by the model were derived from completely automatic, non-invasive measurement of brachial blood pressure and suprasystolic waveform and were compared to simultaneous invasive catheter measurements in 16 subjects. Systolic blood pressure agreement, mean (standard deviation) of difference was -1 (7)mmHg. Diastolic blood pressure agreement was 4 (4)mmHg. Correlation between estimated and actual central waveforms was greater than 90%. Individualization of model parameters did not significantly improve systolic and diastolic pressure agreement, but increased waveform correlation. Further research is necessary to confirm that more accurate brachial pressure measurement improves central pressure estimation. PMID:19665136

  12. Effect of dexamethasone added to lidocaine in supraclavicular brachial plexus block: A prospective, randomised, double-blind study

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    Prashant A Biradar

    2013-01-01

    Full Text Available Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomised, double-blind study to evaluate the effect of dexamethasone added to lidocaine on the onset and duration of supraclavicular brachial plexus block as this is the most common type of brachial block performed in our institute. Methods: Sixty American Society of Anaesthesiologist′s physical status I and II patients undergoing elective hand, forearm and elbow surgery under brachial plexus block were randomly allocated to receive either 1.5% lidocaine (7 mg/kg with adrenaline (1:200,000 and 2 ml of normal saline (group C, n=30 or 1.5% lidocaine (7 mg/kg with adrenaline (1:200,000 and 2 ml of dexamethasone (8 mg (group D, n=30. The block was performed using a nerve stimulator. Onset and duration of sensory and motor blockade were assessed. The sensory and motor blockade of radial, median, ulnar and musculocutaneous nerves were evaluated and recorded at 5, 10, 20, 120 min, and at every 30 min thereafter. Results: Two patients were excluded from the study because of block failure. The onset of sensory and motor blockade (13.4±2.8 vs. 16.0±2.3 min and 16.0±2.7 vs. 18.7±2.8 min, respectively were significantly more rapid in the dexamethasone group than in the control group ( P=0.001. The duration of sensory and motor blockade (326±58.6 vs. 159±20.1 and 290.6±52.7 vs. 135.5±20.3 min, respectively were significantly longer in the dexamethasone group than in the control group ( P=0.001. Conclusion: Addition of dexamethasone to 1.5% lidocaine with adrenaline in supraclavicular brachial plexus block speeds the onset and prolongs the duration of sensory and motor blockade.

  13. A comparison between brachial and echocardiographic systolic time intervals.

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    Ho-Ming Su

    Full Text Available Systolic time interval (STI is an established noninvasive technique for the assessment of cardiac function. Brachial STIs can be automatically determined by an ankle-brachial index (ABI-form device. The aims of this study are to evaluate whether the STIs measured from ABI-form device can represent those measured from echocardiography and to compare the diagnostic values of brachial and echocardiographic STIs in the prediction of left ventricular ejection fraction (LVEF <50%. A total of 849 patients were included in the study. Brachial pre-ejection period (bPEP and brachial ejection time (bET were measured using an ABI-form device and pre-ejection period (PEP and ejection time (ET were measured from echocardiography. Agreement was assessed by correlation coefficient and Bland-Altman plot. Brachial STIs had a significant correlation with echocardiographic STIs (r = 0.644, P<0.001 for bPEP and PEP; r  = 0.850, P<0.001 for bET and ET; r = 0.708, P<0.001 for bPEP/bET and PEP/ET. The disagreement between brachial and echocardiographic STIs (brachial STIs minus echocardiographic STIs was 28.55 ms for bPEP and PEP, -4.15 ms for bET and ET and -0.11 for bPEP/bET and PEP/ET. The areas under the curve for bPEP/bET and PEP/ET in the prediction of LVEF <50% were 0.771 and 0.765, respectively. Brachial STIs were good alternatives to STIs obtained from echocardiography and also helpful in prediction of LVEF <50%. Brachial STIs automatically obtained from an ABI-form device may be helpful for evaluation of left ventricular systolic dysfunction.

  14. Idiopathic brachial plexus neuritis after laparoscopic treatment of endometriosis: a complication that may mimic position-related brachial plexus injury.

    Science.gov (United States)

    Minas, Vasileios; Aust, Thomas

    2013-01-01

    We report the case of a 37-year-old woman who developed idiopathic brachial plexus neuritis, also referred to as Parsonage-Turner syndrome, after laparoscopic excision of endometriosis. The differential diagnosis between this non-position-related neuritis and brachial plexus injury is discussed. The aim of this report was to raise awareness on this distressing postoperative complication. PMID:24183278

  15. Transcutaneous measurement of the arterial input function in positron emission tomography

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) provides a powerful tool in medical research. Biochemical function can be both precisely localized and quantitatively measured. To achieve reliable quantitation it is necessary to know the time course of activity concentration in the arterial blood during the measurement. In this study the arterial blood curve from the brachial artery is compared to the activity measured in the internal carotid artery with a new transcutaneous detector

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

    Science.gov (United States)

    Liao, Josh; Farmer, John

    2014-02-01

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

  17. 脉压增大的高血压患者脉搏波传导速度、颈动脉内膜中层厚度和踝臂指数的检测现状%Examination status of pulse wave velocity, carotid artery intima-media thickness and ankle-brachial index in hypertensive patients with increased pulse pressure

    Institute of Scientific and Technical Information of China (English)

    隋辉; 马丽媛; 刘明波; 王文

    2014-01-01

    目的:了解脉压增大(脉压≥50 mmHg,1mmHg=0.133kPa)的高血压患者脉搏波传导速度(PWV)、颈动脉内膜中层厚度(IMT)和踝臂指数的检测现状。方法2011年4月至2012年9月,选取中国北部、南部和西部的96个大、中、小城市的709家医院进行的大型横断面调查。入选脉压增大(脉压≥50 mmHg)的高血压患者36259例。根据患者的血压水平、危险因素数量、靶器官损害和心血管疾患分为低危、中危、高危和很高危。根据脉压分为50~60 mmHg,60~70 mmHg和≥70 mmHg三层。询问病史(心血管病、脑血管病、肾脏病和糖尿病史)、吸烟史;记录PWV、IMT和踝臂指数的检查情况。现场测量血压、身高、体重、腰围。结果患者IMT、PWV和踝臂指数的检查率分别为20.7%、8.8%和7.8%,即未做IMT、PWV和踝臂指数检查的患者分别为79.3%、91.2%和92.2%。进一步分析,在检查的患者中, IMT(≥0.9 mm和粥样斑块)、PWV(>12 ms)和踝臂指数(≤0.9)异常的检出率分别为65.7%、40.9%和47.4%。IMT、PWV和踝臂指数异常的检出率在高危患者中分别为86.8%、68.5%和22.9%,在很高危患者中分别为66.1%、40.2%和48.2%。脉压50~60 mmHg,60~70 mmHg和≥70 mmHg组的IMT异常的检出率分别是39.3%,66.6%和80.7%;PWV异常的检出率分别是24.6%,43.0%和59.0%。结论我国城市中,脉压增大(≥50 mmHg)的高血压患者血管病变相关项目的检测率低。%Objective To get to know the examination status of pulse wave velocity (PWV), carotid artery intima-media thickness (CA-IMT) and ankle-brachial index (ABI) in hypertensive patients with increased pulse pressure (≥50 mmHg).Methods A large-scale cross-sectional survey was carried out in 709 hospitals in 96 large, medium and small cities in North, South and West China from Apr. 2011 to Sept. 2012. The patients (n=36259) were chosen and divided into low risk group, mid

  18. Imaging tumours of the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Saifuddin, Asif [Department of Radiology, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, HA7 4LP, Stanmore (United Kingdom)

    2003-07-01

    Tumours of the brachial plexus are rare lesions and may be classified as benign or malignant. Within each of these groups, they are further subdivided into those that are neurogenic in origin (schwannoma, neurofibroma and malignant peripheral nerve sheath tumour) and those that are non-neurogenic. Careful pre-operative diagnosis and staging is essential to the successful management of these lesions. Benign neurogenic tumours are well characterized with pre-operative MRI, appearing as well-defined, oval soft-tissue masses, which are typically isointense on T1-weighted images and show the ''target sign'' on T2-weighted images. Differentiation between schwannoma and neurofibroma can often be made by assessing the relationship of the lesion to the nerve of origin. Many benign non-neurogenic tumours, such as lipoma and fibromatosis, are also well characterized by MRI. This article reviews the imaging features of brachial plexus tumours, with particular emphasis on the value of MRI in differential diagnosis. (orig.)

  19. Role of ultrasound-guided continuous brachial plexus block in the management of neonatal ischemia in upper limb

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    Vrushali C Ponde

    2012-01-01

    Full Text Available Neonatal upper limb ischemia due to accidental arterial damage remains a major concern, which can lead to devastating complications if untreated. The primary objective of this case report is to emphasize the role of continuous infraclavicular brachial plexus block, the issues related with block performance in an ischemic hand, and the importance of ultrasound guidance in this particular case scenario. A 1.1 kg infant suffered from distal forearm ischemia due to accidental arterial damage, which was treated with brachial plexus block. An ultrasound-guided single shot block with 0.5 mL/kg of 0.25% bupivacaine was followed by ultrasound-guided catheter placement in the target area. A continuous infusion of 0.03% of bupivacaine at the rate of 0.5 mL/kg/hr (approx. 0.15 mg/kg/h of bupivacaine was administered for 36 h. This treatment resulted in reversal of ischemia. Permanent ischemic damage was eventually confined to the tips of 4 fingers. We conclude that ultrasound-guided continuous infraclavicular block has a therapeutic role to play in the treatment of hand ischemia due to arterial damage and subsequent arterial spasm in neonates with added benefits.

  20. PREVALENCE OF PERIPHERAL VASCULAR DISEASE IN CHRONIC ALCOHOLICS AS MEASURED BY ANKLE TO BRACHIAL INDEX

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    Raj Bahadur

    2015-08-01

    Full Text Available The ankle - brachial pressure index (ABI, which is the ratio of ankle to brachial systolic blood pressure, is the golden standard for the diagnosis of peripheral arterial disease (PAD and is a highly specific method for the assessment of vascular risk in otherwise asymptomatic patients . ABI value of individual with daily alcohol level >60g/d was significantly lower consumption of less than 60g/d had an inverse association with peripheral atherosclerosis whereas consumption of 60 g/d or more had a positive association. Studies have shown the sensitivity of ABPI is 90% with a corresponding 98% specificity for detecting hemodynamically significant (Serious stenosis >50% in major leg arteries, defined by angiogram. AIMS AND OBJECTIVES : To determine the prevalence of peripheral vascular disease in chronic alcoholics using ankle to brachial index and to compare the values of ankle brachial index in chronic alcoholics with age and sex matched healthy controls. MATERIALS AND METHODS : In the present study, 50 cases consuming more than 60gm of absolute alcohol per day for more than 12 months attending out p atient department and admitted were enrolled. 50 age and sex matched healthy controls who have never consumed alcohol (never drinkers were also enrolled . After taking detailed history using Doppler ultrasound blood flow detector mean systolic pressure in upper limb and lower limb was calculated and then the mean ABI was calculated. This value was then compared with variables like LDL levels, Triglycerides levels, age, clinical symptoms of PVD, alcohol consumption amount and duration. RESULTS: It was observed that mean ABI was significantly lower (<0.9 in 11(22% cases and majority of them were between age group of 41 - 50 years. Of these only 7(14% showed clinical symptoms of PVD. The prevalence of PVD was 66% in those who consumed 61 - 70 grams alcohol per day for around 6 - 10 years. Results were found to be statistically significant. CONCLUSION

  1. Advanced median method for timing jitter compensation

    Institute of Scientific and Technical Information of China (English)

    Wang Chen; Zhu Jiangmiao; Jan Verspecht; Liu Mingliang; Li Yang

    2008-01-01

    Timing jitter is one of the main factors that influence on the accuracy of time domain precision measurement. Timing jitter compensation is one of the problems people concern. Because of the flaws of median method, PDF deconvolution method and synthetic method, we put forward a new method for timing jitter compensation, which is called advanced median method. The theory of the advanced median method based on probability and statistics is analyzed, and the process of the advanced median method is summarized in this paper. Simulation and experiment show that compared with other methods, the new method could compensate timing jitter effectively.

  2. Association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    顾玥

    2014-01-01

    Objective To investigate the association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis(CAPD)patients.Methods Ninety-four stable CAPD patients from a single center were enrolled in this cross-sectional study.Ultrasound evaluation was conducted on brachial artery to estimate endothelial-dependent

  3. Exercise and arterial adaptation in humans: uncoupling localized and systemic effects

    NARCIS (Netherlands)

    Rowley, N.J.; Dawson, E.A.; Birk, G.K.; Cable, N.T.; George, K.; Whyte, G.; Thijssen, D.H.J.; Green, D.J.

    2011-01-01

    Previous studies have established effects of exercise training on arterial wall thickness, remodeling, and function in humans, but the extent to which these changes are locally or systemically mediated is unclear. We examined the brachial arteries of the dominant (D) and nondominant (ND) upper limbs

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

    Directory of Open Access Journals (Sweden)

    A.K.Manicka Vasuki

    2015-09-01

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

  5. Obstetrical brachial plexus injuries: a MRI diagnostic approach

    International Nuclear Information System (INIS)

    Purpose: To demonstrate the utility of Magnetic Resonance (MR) imaging in the evaluation of the obstetric injuries of the brachial plexus. Material and methods: 23 patients with semiology of brachial plexus palsy have been evaluated with high field MR. Patients were evaluated with a brain coil in axial, oblique coronal and sagittal planes with T1, T2 and STIR sequences. Results: In four patients (17%) the study was normal. In 19 patients (83%) we got pathological findings (pseudomeningoceles, neuromas, tumour and arachnoid cyst). Conclusion: The MR is a non-invasive method that permits to determinate the site and range of the brachial plexus damage, allowing to plan therapy. (author)

  6. LOCAL MEDIAN ESTIMATION OF VARIANCE FUNCTION

    Institute of Scientific and Technical Information of China (English)

    杨瑛

    2004-01-01

    This paper considers local median estimation in fixed design regression problems. The proposed method is employed to estimate the median function and the variance function of a heteroscedastic regression model. Strong convergence rates of the proposed estimators are obtained. Simulation results are given to show the performance of the proposed methods.

  7. Índice tornozelo-braço em pacientes hemodialíticos Ankle-brachial index in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Mariane Torres Uchôa

    2012-12-01

    . The ankle-brachial index was calculated for each artery of the lower limb. It was considered normal ankle-brachial index from 0.9 to 1.3. RESULTS: We diagnosed peripheral arterial disease and poorly compressible arteries in 26.9 and 30.8% of hemodialysis patients and in 33 and 22.7% of the Control Group. In hemodialysis patients, we found abnormal ankle-brachial index in 75% of symptomatic patients (p=0.005, in 67.3% of men and 31% of women (p<0.005, in 78.6% of the elderly, 34.8% of young adults (p<0.01, and 76.9% of diabetics (p<0.005 versus nondiabetic. These patients had a higher prevalence of severe peripheral arterial disease than the Control Group. CONCLUSIONS: Abnormal ankle-brachial index was very prevalent in the groups studied; however, hemodialysis patients had more severe changes, when compared to the Control Group. Diabetes mellitus, male gender, and advanced age were important risk factors for abnormal ankle-brachial index in hemodialysis patients. The ankle-brachial index was a good method of screening for the studied changes; therefore, we suggest the routine use in the management of hemodialysis patients.

  8. Association Between Chromosome 9p21 Variants and the Ankle-Brachial Index Identified by a Meta-Analysis of 21 Genome-Wide Association Studies

    DEFF Research Database (Denmark)

    Murabito, Joanne M; White, Charles C; Kavousi, Maryam;

    2012-01-01

    BACKGROUND: -Genetic determinants of peripheral arterial disease (PAD) remain largely unknown. To identify genetic variants associated with the ankle-brachial index (ABI), a noninvasive measure of PAD, we conducted a meta-analysis of genome-wide association study data from 21 population-based coh......BACKGROUND: -Genetic determinants of peripheral arterial disease (PAD) remain largely unknown. To identify genetic variants associated with the ankle-brachial index (ABI), a noninvasive measure of PAD, we conducted a meta-analysis of genome-wide association study data from 21 population...... additive genetic models. Study-specific data were combined using fixed-effects inverse variance weighted meta-analyses. There were a total of 41,692 participants of European ancestry (~60% women, mean ABI 1.02 to 1.19), including 3,409 participants with PAD and with GWAS data available. In the discovery...

  9. Electrodiagnosis in traumatic brachial plexus injury

    Directory of Open Access Journals (Sweden)

    K A Mansukhani

    2013-01-01

    Full Text Available Electrodiagnosis (EDX is a useful test to accurately localize the site, determine the extent, identify the predominant pathophysiology, and objectively quantify the severity of brachial plexopathies. It can also be used to examine muscles not easily assessed clinically and recognize minimal defects. Post-operatively and on follow up studies, it is important for early detection of re-innervation. It can be used intra-operatively to assess conduction across a neuroma, which would help the surgeon to decide further course of action. Localization of the site of the lesion can be very challenging as there may be multiple sites of involvement and hence the electroneuromyographic evaluation must be adequate. The unaffected limb also needs to be examined for comparison. The final impression must be co-related with the type and severity of injury.

  10. Electrodiagnosis in traumatic brachial plexus injury.

    Science.gov (United States)

    Mansukhani, K A

    2013-01-01

    Electrodiagnosis (EDX) is a useful test to accurately localize the site, determine the extent, identify the predominant pathophysiology, and objectively quantify the severity of brachial plexopathies. It can also be used to examine muscles not easily assessed clinically and recognize minimal defects. Post-operatively and on follow up studies, it is important for early detection of re-innervation. It can be used intra-operatively to assess conduction across a neuroma, which would help the surgeon to decide further course of action. Localization of the site of the lesion can be very challenging as there may be multiple sites of involvement and hence the electroneuromyographic evaluation must be adequate. The unaffected limb also needs to be examined for comparison. The final impression must be co-related with the type and severity of injury.

  11. Birth brachial plexus palsy: a race against time.

    Science.gov (United States)

    Patra, Sambeet; Narayana Kurup, Jayakrishnan K; Acharya, Ashwath M; Bhat, Anil K

    2016-01-01

    A 5-year-old child presented to us with weakness of the left upper limb since birth. With the given history of obstetric trauma and limb examination, a diagnosis of birth brachial plexus palsy was made. Brachial plexus exploration along with microsurgery was performed at the same time which included extrinsic neurolysis of the roots and trunks and nerve transfer for better shoulder external rotation and elbow flexion. Both the movements were severely restricted previously due to co-contractures with the shoulder internal rotators and triceps. The problem of birth brachial plexus palsy is proving to be a global health burden both in developed countries and in developing countries such as India. The lack of awareness among the general public and primary healthcare providers and inadequate orthopaedic and neurosurgeons trained to treat the condition have worsened the prognosis. This case lays stress on the delayed complications in birth brachial palsy and its effective management. PMID:27402656

  12. Median Approximations for Genomes Modeled as Matrices.

    Science.gov (United States)

    Zanetti, Joao Paulo Pereira; Biller, Priscila; Meidanis, Joao

    2016-04-01

    The genome median problem is an important problem in phylogenetic reconstruction under rearrangement models. It can be stated as follows: Given three genomes, find a fourth that minimizes the sum of the pairwise rearrangement distances between it and the three input genomes. In this paper, we model genomes as matrices and study the matrix median problem using the rank distance. It is known that, for any metric distance, at least one of the corners is a [Formula: see text]-approximation of the median. Our results allow us to compute up to three additional matrix median candidates, all of them with approximation ratios at least as good as the best corner, when the input matrices come from genomes. We also show a class of instances where our candidates are optimal. From the application point of view, it is usually more interesting to locate medians farther from the corners, and therefore, these new candidates are potentially more useful. In addition to the approximation algorithm, we suggest a heuristic to get a genome from an arbitrary square matrix. This is useful to translate the results of our median approximation algorithm back to genomes, and it has good results in our tests. To assess the relevance of our approach in the biological context, we ran simulated evolution tests and compared our solutions to those of an exact DCJ median solver. The results show that our method is capable of producing very good candidates. PMID:27072561

  13. Pulse Waves in the Lower Extremities as a Diagnostic Tool of Peripheral Arterial Disease and Predictor of Mortality in Elderly Chinese.

    Science.gov (United States)

    Sheng, Chang-Sheng; Li, Yan; Huang, Qi-Fang; Kang, Yuan-Yuan; Li, Fei-Ka; Wang, Ji-Guang

    2016-03-01

    Patients with peripheral arterial disease may have elongated upstroke time in pulse waves in the lower extremities. We investigated upstroke time as a diagnostic tool of peripheral arterial disease and predictor of mortality in an elderly (≥60 years) Chinese population. We recorded pulse waves at the left and right ankles by pneumoplethysmography and calculated the percentage of upstroke time per cardiac cycle. Diagnostic accuracy was compared with the conventional ankle-brachial index method (n=4055) and computed tomographic angiography (34 lower extremities in 17 subjects). Upstroke time per cardiac cycle at baseline (mean±SD, 16.4%±3.1%) was significantly (Pperipheral arterial disease (upstroke time per cardiac cycle, ≥21.7%) in comparison with computed tomographic angiography. During 5.9 years (median) of follow-up, all-cause and cardiovascular deaths occurred in 366 and 183 subjects, respectively. In adjusted Cox regression analyses, an upstroke time per cardiac cycle ≥21.7% (n=219; 5.4%) significantly (Pperipheral arterial disease and predictor of mortality in the elderly.

  14. Clinical and radiologic review of uncommon cause of profound iron deficiency anemia: Median arcuate ligament syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Gunduz, Yasemin; Asil, Kiyasrttin; Aksoy, Yakup Ersel; Ayhan, Lacin Tatli [Dept. of Radiology, Sakarya University Medical Faculty, Sakarya (Turkmenistan)

    2014-08-15

    Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

  15. Acute Effect of Whole-Body Periodic Acceleration on Brachial Flow-Mediated Vasodilatation Assessed by a Novel Semi-Automatic Vessel Chasing UNEXEF18G System

    OpenAIRE

    Takase, Bonpei; Hattori, Hidemi; Tanaka, Yoshihiro; Uehata, Akimi; Nagata, Masayoshi; Ishihara, Masayuki; Fujita, Masatoshi

    2013-01-01

    Background Repeated application of whole-body periodic acceleration (WBPA) upregulates endothelial nitric oxide synthase and improves brachial artery endothelial function (BAEF) as assessed by measurement of flow-mediated vasodilatation (FMD). However, the acute effect of a single application of WBPA on BAEF has not been fully characterized. In addition, although a novel semi-automatic vessel chasing system (UNEXEF18G) has now been developed in Japan, the direct comparison of UNEXEF18G with a...

  16. Interscalene brachial plexus blocks in the management of shoulder dislocations.

    OpenAIRE

    Underhill, T J; Wan, A; Morrice, M

    1989-01-01

    Interscalene brachial plexus block is a simple and effective alternative to intravenous benzodiazepines or general anaesthesia for manipulation of the dislocated shoulder. Thirty interscalene brachial plexus blocks were performed on 29 patients with dislocations of the shoulder to provide regional anaesthesia for reduction. Pain was abolished by 14 out of the 30 blocks performed, improved by 13 and unchanged by three. Muscle relaxation (MRC grade 3 or less) occurred in 21 patients. In 26 case...

  17. Brachial plexus variations in its formation and main branches

    OpenAIRE

    Valéria Paula Sassoli Fazan; André de Souza Amadeu; Adilson L. Caleffi; Omar Andrade Rodrigues Filho

    2003-01-01

    PURPOSE: The brachial plexus has a complex anatomical structure since its origin in the neck throughout its course in the axillary region. It also has close relationship to important anatomic structures what makes it an easy target of a sort of variations and provides its clinical and surgical importance. The aims of the present study were to describe the brachial plexus anatomical variations in origin and respective branches, and to correlate these variations with sex, color of the subjects ...

  18. Morphological description of the brachial plexus in ocelot (Leopardus pardalis)

    OpenAIRE

    Kylma Lorena Saldanha Chagas; Lara Cochete Moura Fé; Luiza Correa Pereira; Érika Branco; Ana Rita de Lima

    2014-01-01

    The brachial plexus is formed by the ventral roots of the spinal nerves, which unite to form the nerve trunks. It is usually formed by contributions of the last three cervical nerves and the first two thoracic nerves. Due to the scarcity of information on neuroanatomy, this study aimed to determine the macroscopic morphology of the brachial plexus of the ocelot (Leopardus pardalis). In this work, we used two ocelot specimens from the area of the Paragominas Bauxite Mine, P...

  19. Diagnosis and operative treatment of radiation-induced brachial plexopathy

    Institute of Scientific and Technical Information of China (English)

    路来金; 宫旭; 刘志刚; 王东生; 张志新

    2002-01-01

    Objective: To explore the diagnosis and operative treatment of radiation-induced brachial plexopathy. Methods: Nine cases of radiation-induced brachial plexopathy were divided into two groups, 4 cases undergoing neurolysis of brachial plexus as Group A and 5 cases undergoing transfer of myocutaneous flaps after neurolysis as Group B. In Group B, 4 cases were treated with latissimus dorsi myocutaneous flaps (about 20 cm×20 cm) and 1 case with pectoralis major myocutaneous flap (about 8 cm×6 cm). Results: All the 9 cases of radiation-induced brachial plexopathy were followed up for a period of 2 to 5 years, with an average of 2.3 years. As far as pain relief and function recovery were concerned, the results of Group B were better than those of Group A.Conclusions: Based on the results of Group B in the series, we suggest that the procedure of covering the wounds with transferred myocutaneous flaps after neurolysis of the brachial plexus should be performed to those advanced patients. The procedure may improve the blood supply of the fibrotic brachial plexus by reestablishing a good nerve bed.

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

    Directory of Open Access Journals (Sweden)

    Alexandre Takeda

    2015-06-01

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

  1. Ankle-Brachial Index: Nurses Strategy To Cardiovascular Disease Risk Factors Identification

    Directory of Open Access Journals (Sweden)

    Daniela Luisa Maggi

    2014-04-01

    Full Text Available Elevated risk of fatal and non-fatal cardiovascular events is associated with high prevalence of peripheral arterial disease, with assessment through the ankle-brachial index (ABI. This study aimed to demonstrate that the ABI and the Edinburgh Claudication Questionnaire are tools to be used by nurses in prevention and/or treatment of CVD (cardiovascular disease. A cross-sectional study was carried out with patients from a cardiovascular clinic. The Edinburgh Claudication Questionnaire was applied and the ABI was measured with the formula (ABI= Blood Pressure Ankle/Blood Pressure Brachial. A total of 115 patients were included, most were females (57.4%, aged 60.6 ± 12.5 years. The most prevalent risk factors were hypertension (64.3%, physical inactivity (48.7% and family history (58.3%. The study showed that abnormal ABI was frequently found and 42.6% of the patients with abnormal ABI showed intermittent claudication. The method to evaluate the ABI associated to the Edinburg Claudication Questionnaire, can be easily used by nurses in the clinical evaluation of asymptomatic and symptomatic CVD patients.

  2. Median topographic maps for biomedical data sets

    CERN Document Server

    Hammer, Barbara; Rossi, Fabrice; 10.1007/978-3-642-01805-3_6

    2009-01-01

    Median clustering extends popular neural data analysis methods such as the self-organizing map or neural gas to general data structures given by a dissimilarity matrix only. This offers flexible and robust global data inspection methods which are particularly suited for a variety of data as occurs in biomedical domains. In this chapter, we give an overview about median clustering and its properties and extensions, with a particular focus on efficient implementations adapted to large scale data analysis.

  3. Interrater and intrarater reliability of photoplethysmography for measuring toe blood pressure and toe-brachial index in people with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Scanlon Christopher

    2012-06-01

    Full Text Available Abstract Background A reliable tool to measure arterial flow to the feet in people with diabetes is required given that they are particularly prone to peripheral arterial disease. Traditionally, the ankle brachial index (ABI has been used to measure arterial circulation, but its application is limited due to calcification of larger arteries. More recently, toe pressure and the toe brachial index (TBI has been suggested as superior to ABI measurements because they assess smaller digital arteries less prone to arterial calcification. However, reliability studies for the clinical use of photoplethysmography (PPG in people with diabetes are lacking. Methods Sixty people with diabetes mellitus (35 males and 25 females, mean age 59.6 yrs consented to take part in the study. The majority (92% had type 2 diabetes and 8% had type 1 diabetes. Forty-three percent were diagnosed as having peripheral neuropathy when tested using a biothesiometer and 15% were current smokers (10 – 40/day. A podiatrist and a diabetes educator measured toe and brachial blood pressure independently and in a random order using PPG. These measurements were repeated again seven days later, and subsequently analysed with intraclass correlation coefficients (ICC, 95% confidence intervals (CI and standard error of measurement (SEM. Results The intrarater reliability of measuring toe pressures was excellent (ICC3,1 =0.78-0.79, SEM 8 mmHg and interrater reliability was also excellent (ICC2,2 = 0.93, SEM 4 mmHg. The intrarater reliability for measuring brachial pressures was generally poor (ICC3,1 = 0.40 – 0.42, SEM 19 mmHg and interrater reliability was fair-good (ICC2,2. 0.65, SEM 14 mmHg. The TBI intrarater reliability was fair-good (ICC3,1 = 0.51-0.72, SEM 0.08, whilst the interrater reliability of TBI was excellent (ICC2,2 = 0.85, SEM 0.07. Conclusions Based on these results, interrater and intrarater reliability of PPG is excellent for measuring toe

  4. [Popliteal artery entrampment: report of one case].

    Science.gov (United States)

    Parra, Juan; Corvalán, Felipe; Ibáñez, Fernando; Bianchi, Víctor; Bastías, Waldo; Salas, Cristian; Cam, Alfredo; Lamarca, Andrés

    2006-02-01

    Popliteal artery entrampment is a rare condition, occurring in young subjects, that causes ischemia of the extremity. The anatomical background is the compression or occlussion of the popliteal artery caused by forced plantar or dorsal flexion. We report a 32 year-old sportsman who presented with gangrene of the right first toe and a history of three months of progressive claudication. The Ankle-Brachial index and pulse volume curve registries showed a severe ischemia below the knee. Angiography showed a medial deviation of the popliteal artery associated to stenosis and aneurysm formation. A CT scan of the contralateral artery was normal. The patient was operated using a posterior approach, performing a reverse saphenous vein bypass graft and excising the popliteal artery. The postoperative period was uneventful. PMID:16554929

  5. Advanced radiological work-up as an adjunct to decision in early reconstructive surgery in brachial plexus injuries

    Directory of Open Access Journals (Sweden)

    Björkman Anders

    2010-07-01

    Full Text Available Abstract Background As neurophysiologic tests may not reveal the extent of brachial plexus injury at the early stage, the role of early radiological work-up has become increasingly important. The aim of the study was to evaluate the concordance between the radiological and clinical findings with the intraoperative findings in adult patients with brachial plexus injuries. Methods Seven consecutive male patients (median age 33; range 15-61 with brachial plexus injuries, caused by motor cycle accidents in 5/7 patients, who underwent extensive radiological work-up with magnetic resonance imaging (MRI, computed tomography myelography (CT-M or both were included in this retrospective study. A total of 34 spinal nerve roots were evaluated by neuroradiologists at two different occasions. The degree of agreement between the radiological findings of every individual nerve root and the intraoperative findings was estimated by calculation of kappa coefficient (К-value. Using the operative findings as a gold standard, the accuracy, sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of the clinical findings and the radiological findings were estimated. Results The diagnostic accuracy of radiological findings was 88% compared with 65% for the clinical findings. The concordance between the radiological findings and the intraoperative findings was substantial (К = 0.76 compared with only fair (К = 0.34 for the clinical findings. There were two false positive and two false negative radiological findings (sensitivity and PPV of 0.90; specificity and NPV of 0.87. Conclusions The advanced optimized radiological work-up used showed high reliability and substantial agreement with the intraoperative findings in adult patients with brachial plexus injury.

  6. Arterial distensibility in adolescents: the influence of adiposity, the metabolic syndrome, and classic risk factors.

    OpenAIRE

    Whincup, P H; Gilg, J A; Donald, A E; Katterhorn, M.; Oliver, C.; Cook, D.G.; Deanfield, J E

    2005-01-01

    BACKGROUND: Atherosclerosis develops from childhood, but the determinants of this preclinical stage remain uncertain. We examined the relations of classic coronary risk factors, adiposity and its associated metabolic disturbances, to arterial distensibility (a marker of early arterial disease) in 13- to 15-year-olds, some of whom had previously been studied at ages 9 to 11 years. METHODS AND RESULTS: Brachial artery distensibility was measured by a noninvasive ultrasound technique in 471 Brit...

  7. Association between peripheral arterial disease and creactive protein in the japanese-brazilian population

    Directory of Open Access Journals (Sweden)

    Luciana Garofolo

    2014-06-01

    Full Text Available OBJECTIVE: To evaluate the relationship between peripheral arterial disease and elevated levels of C-reactive protein in the Japanese-Brazilian population of high cardiovascular risk. METHODS: We conducted a cross-sectional study derived from a population-based study on the prevalence of diabetes and associated diseases in the Japanese-Brazilian population. One thousand, three hundred and thirty individuals aged e" 30 underwent clinical and laboratory examination, including measurement of ultrasensitive C-reactive protein. The diagnosis of peripheral arterial disease was performed by calculating the ankle-brachial index. We considered with peripheral arterial disease patients who had ankle-brachial index d" 0.9. After applying the exclusion criteria, 1,038 subjects completed the study. RESULTS: The mean age of the population was 56.8 years; 46% were male. The prevalence of peripheral arterial disease was 21%, with no difference between genders. Data analysis showed no association between peripheral arterial disease and ultrasensitive C-reactive protein. Patients with ankle-brachial index d" 0.70 showed higher values of ultrasensitive C-reactive protein and worse cardiometabolic profile. We found a positive independent association of peripheral arterial disease with hypertension and smoking. CONCLUSION: The association between low levels of ankle-brachial index and elevated levels of ultrasensitive C-reactive protein may suggest a relationship of gravity, aiding in the mapping of high-risk patients.

  8. Relationship Between Earlobe Crease and Brachial-ankle Pulse Wave Velocity in Non-hypertensive, Non-diabetic Adults in Korea

    OpenAIRE

    Choi, Sang In; Kang, Hee Cheol; Kim, Choon Ok; Lee, Seung Beom; Hwang, Won Ju; Kang, Dae Ryong

    2009-01-01

    OBJECTIVES Several studies have found a significant association between the presence of earlobe crease (ELC) and cardiovascular disease (CVD). Brachial-ankle Pulse Wave Velocity (baPWV) is a non-invasive and useful measure of arterial stiffness predicting cardiovascular events and mortality. However, few studies have reported the relationship between ELC and baPWV as a new measure of arterial stiffness. The purpose of this study was to determine whether ELC is related to baPWV in non-diabetic...

  9. MRI DIAGNOSIS OF TWO CASES OF FIBROLIPOMATOUS HAMARTOMA OF THE MEDIAN NERVE WITH HISTOPATHOLOGICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Mary Hazarika

    2015-08-01

    Full Text Available Fibrolipomatous hamartoma is an uncommon congenital disorder, which is characterized by disproportionate hyperplasia of adipose tissue infiltrating along the perineurium, the epineurium and the affected nerve trajectory. 1 The median nerve and its branches are most commonly affected, followed by the radial nerve, ulnar nerve, nerves at the dorsal aspect of the foot, brachial plexus and cranial nerves. 1,2 Magnetic resonance imaging demonstrated a typical fibrolipomatous hamartoma with high signal intensity o f fat on both T1 - weighted and T2 - weighted images, characteristic coaxial cable appearance on axial images, and spaghetti appearance on sagittal images in two of our cases. Fibrolipomatous hamartoma (FLH of nerve is a rare tumor - like condition in which mat ure fat infiltrates the neural sheath, with the majority of the lesions occurring in the median nerve. 3 W e present two cases of Fibrolipomatous hamartoma of median nerve at the wrist with an unusual proximal extension to the forearm in one case.

  10. Cadaveric Study of Anatomic Far Distal Musculocutaneous and Median Nerve Communication.

    Science.gov (United States)

    Hussain, Namath S

    2016-01-01

    One of the more commonly reported variations in musculocutaneous and median nerves is a communication between the two. Such communications have been noted in the literature for well over a century, and numerous studies have attempted to quantify their rate of incidence and classify their different patterns. Most communications occur close to the brachial plexus in the proximal arm; communications distal to the musculocutaneous nerve perforation of the coracobrachialis have been reported with less frequency, and several rare and unique communication patterns have been reported as case studies. This paper describes a case of a communicating branch between the musculocutaneous and median nerves, distal to the origin of the brachialis muscle. This communication was found during a routine educational dissection and is closer to the level of the elbow than previously documented communications that are distal to the musculocutaneous perforation of the coracobrachialis. Identification and documentation of the variety of musculocutaneous and median nerve communications is relevant to clinical diagnosis of peripheral nerve pathologies, as well as for planning surgical approaches and procedures. PMID:27433406

  11. Cadaveric Study of Anatomic Far Distal Musculocutaneous and Median Nerve Communication.

    Science.gov (United States)

    Hussain, Namath S

    2016-06-02

    One of the more commonly reported variations in musculocutaneous and median nerves is a communication between the two. Such communications have been noted in the literature for well over a century, and numerous studies have attempted to quantify their rate of incidence and classify their different patterns. Most communications occur close to the brachial plexus in the proximal arm; communications distal to the musculocutaneous nerve perforation of the coracobrachialis have been reported with less frequency, and several rare and unique communication patterns have been reported as case studies. This paper describes a case of a communicating branch between the musculocutaneous and median nerves, distal to the origin of the brachialis muscle. This communication was found during a routine educational dissection and is closer to the level of the elbow than previously documented communications that are distal to the musculocutaneous perforation of the coracobrachialis. Identification and documentation of the variety of musculocutaneous and median nerve communications is relevant to clinical diagnosis of peripheral nerve pathologies, as well as for planning surgical approaches and procedures.

  12. Monitoring Median Queries over Moving Objects

    Institute of Scientific and Technical Information of China (English)

    XU Hu; LU Yan-sheng; LI Zhi-cheng

    2010-01-01

    The k-median problem has attracted a number of researchers. However, few of them have considered both the dynamic environment and the issue of accuracy. In this paper, a new type of query is studied, called continuous median monitoring (CMM) query. It considers the k-median problem under dynamic environment with an accuracy guarantee. A continuous group nearest neighbor based (CGB) algorithm and an average distance medoid (ADM) algorithm are proposed to solve the CMM problem. ADM is a hill climbing schemed algorithm and achieves a rapid converging speed by checking only qualified candidates. Experiments show that ADM is more efficient than CGB and outperforms the classical PAM (partitioning around medoids) and CLARANS (clustering large applications based on randomized search) algorithms with various parameter settings.

  13. Switching non-local vector median filter

    Science.gov (United States)

    Matsuoka, Jyohei; Koga, Takanori; Suetake, Noriaki; Uchino, Eiji

    2016-04-01

    This paper describes a novel image filtering method that removes random-valued impulse noise superimposed on a natural color image. In impulse noise removal, it is essential to employ a switching-type filtering method, as used in the well-known switching median filter, to preserve the detail of an original image with good quality. In color image filtering, it is generally preferable to deal with the red (R), green (G), and blue (B) components of each pixel of a color image as elements of a vectorized signal, as in the well-known vector median filter, rather than as component-wise signals to prevent a color shift after filtering. By taking these fundamentals into consideration, we propose a switching-type vector median filter with non-local processing that mainly consists of a noise detector and a noise removal filter. Concretely, we propose a noise detector that proactively detects noise-corrupted pixels by focusing attention on the isolation tendencies of pixels of interest not in an input image but in difference images between RGB components. Furthermore, as the noise removal filter, we propose an extended version of the non-local median filter, we proposed previously for grayscale image processing, named the non-local vector median filter, which is designed for color image processing. The proposed method realizes a superior balance between the preservation of detail and impulse noise removal by proactive noise detection and non-local switching vector median filtering, respectively. The effectiveness and validity of the proposed method are verified in a series of experiments using natural color images.

  14. Sosiaalisen median toimintasuunnitelma, case Guild Travel Ltd

    OpenAIRE

    Vanhanen, Anni

    2014-01-01

    Tämän työn tarkoituksena on luoda käyttökelpoinen sosiaalisen median markkinointi-suunnitelma lontoolaiselle matkatoimistolle, joka myy matkoja Suomeen. Työn toimek-siantaja on Guild Travel Ltd. Työ toteutettiin vuoden 2014 keväällä. Työssä esitellään toimeksiantaja matkailualan toimijana ja perehdytään markkinoinnin teoriaan. Käsittelyssä ovat useat eri markkinoinnin teoriat, kuten SOSTAC, SMART ja marketing mix. Näitä malleja hyödyntäen luodaan yrityksen sosiaalisen median toimin-tasuun...

  15. ANKLE-BRACHIAL INDEX AND LDL-RECEPTOR GENE IN ASYMPTOMATIC SEVERE HYPERCHOLESTEROLEMIA

    Directory of Open Access Journals (Sweden)

    L. Vladimirova-Kitova

    2011-08-01

    Full Text Available The issue with the different levels of ankle-brachial index, as screening for LDL-receptor defective gene in newly detected asymptomatic severe hypercholesterolemia is less studied, but quite interesting. There have not been any studies on ankle-brachial index in patients with severe hypercholesterolemia in Bulgaria. Aim: To examine the difference between patients with severe hypercholesterolemia, who are carriers and non-carriers of LDL-R defective gene, with respect to their structural (ankle-brachial index characteristics of arterial wall. Methods and materials: 60 patients with documented severe hypercholesterolemia >7.5 mmol/l satisfying the Simon-Broom criteria for clinically established and probable Familial Hypercholesterolemia were studied. All of the patients had a negative stress echocardiography and not known coronary artery disease. The laboratory used was the Clinical Laboratory at the Medical University Plovdiv. The total cholesterol and triglycerides were measured with enzyme-colorimetry and cholesterol in high density lipoprotein and cholesterol in low density lipoprotein with direct automatic analyses. Apolipoproteins were calculated by immunoturbodimetric method. The biochemical analyzer Konelab 60i was used in all the measurements. Results: According to whether there were or were not molecular defects, patients were assigned to two groups: carriers (11 patients, 18 % and non-carriers (49 patients, 82 %.There was a statistically significant difference (p 0.05. We found no statistically significant difference between non-carriers and carriers with respect to body mass index (25.30 ± 0.40 vs 24.63 ± 0.45, respectively, t = 0.50; p > 0.05. There was not a statistically significant difference in levels of total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol between carries (p>0.05. The cholesterol x years. score was significantly higher in the carries (440.36 ± 0.25 mmol-y/L, than in the non-carries (390.30 ± 0

  16. Electroacupuncture stimulation of the brachial plexus trunk on the healthy side promotes brain-derived neurotrophic factor mRNA expression in the ischemic cerebral cortex of a rat model of cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Zongjun Guo; Lumin Wang

    2012-01-01

    A rat model of cerebral ischemia/reperfusion was established by suture occlusion of the left middle cerebral artery. In situ hybridization results showed that the number of brain-derived neurotrophic factor mRNA-positive cells in the ischemic rat cerebral cortex increased after cerebral ischemia/ reperfusion injury. Low frequency continuous wave electroacupuncture (frequency 2-6 Hz, current intensity 2 mA) stimulation of the brachial plexus trunk on the healthy (right) side increased the number of brain-derived neurotrophic factor mRNA-positive cells in the ischemic cerebral cortex 14 days after cerebral ischemia/reperfusion injury. At the same time, electroacupuncture stimulation of the healthy brachial plexus truck significantly decreased neurological function scores and alleviated neurological function deficits. These findings suggest that electroacupuncture stimulation of the brachial plexus trunk on the healthy (right) side can greatly increase brain-derived neurotrophic factor mRNA expression and improve neurological function.

  17. Carotid artery stenting by non-femoral arterial approach in patients with difficult anatomy

    Directory of Open Access Journals (Sweden)

    R V Narayana

    2013-01-01

    Full Text Available Background: Carotid endarterectomy (CEA and carotid artery stenting (CAS are safe, effective, and standard methods to treat significant carotid artery stenosis. CAS is generally performed through femoral arterial access. We had six patients with significant carotid artery stenosis, who had difficult anatomy prohibiting a trans-femoral CAS. Those patients were given an option for CEA. However, they refused for surgical intervention. Aim: We investigated the feasibility of performing CAS from a non-femoral arterial approach in patients with difficult anatomies like severe aortic/aorto-iliac disease, tortuous aortic arch, and tortuous carotid artery origin. Materials and Methods: Six patients with difficult anatomy presented to us with either transient ischemic attack or stroke with high-grade carotid artery stenosis. Out of the six patients, three had aorto-iliac disease, one had high-grade coarctation of aorta, two had tortuous aortic arch and or tortuous carotid artery origin. All these patients were treated with CAS though non-femoral arterial route. Results: CAS could be done successfully in all these six patients; four of them were done through trans-brachial arterial route and two were done through a direct carotid artery puncture. There were no new neurological deficits seen in any of the patient post-procedure. Conclusion: CAS can be done safely through non-femoral arterial approach in patients with difficult anatomy.

  18. New approaches in imaging of the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Vargas, M.I. [Department of Neuroradiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland)], E-mail: maria.i.vargas@hcuge.ch; Viallon, M. [Department of Radiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland); Nguyen, D. [Department of Neuroradiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland); Beaulieu, J.Y. [Unit of Hand Surgery, Geneva University Hospital and University of Geneva, Geneva (Switzerland); Delavelle, J. [Department of Neuroradiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland); Becker, M. [Unit of Head and Neck Radiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland)

    2010-05-15

    Imaging plays an essential role for the detection and analysis of pathologic conditions of the brachial plexus. Currently, several new techniques are used in addition to conventional 2D MR sequences to study the brachial plexus: the 3D STIR SPACE sequence, 3D heavily T2w MR myelography sequences (balanced SSFP = CISS 3D, True FISP 3D, bFFE and FIESTA), and the diffusion-weighted (DW) neurography sequence with fiber tracking reconstruction (tractography). The 3D STIR sequence offers complete anatomical coverage of the brachial plexus and the ability to slice through the volume helps to analyze fiber course modification and structure alteration. It allows precise assessment of distortion, compression and interruption of postganglionic nerve fibers thanks to the capability of performing maximum intensity projections (MIP) and multiplanar reconstructions (MPRs). The CISS 3D, b-SSFP sequences allow good visualization of nerve roots within the spinal canal and may be used for MR myelography in traumatic plexus injuries. The DW neurography sequence with tractography is still a work in progress, able to demonstrate nerves tracts, their structure alteration or deformation due to pathologic processes surrounding or located along the postganglionic brachial plexus. It may become a precious tool for the understanding of the underlying molecular pathophysiologic mechanisms in diseases affecting the brachial plexus and may play a role for surgical planning procedures in the near future.

  19. Idiopathic brachial neuritis in a child: A case report and review of the literature

    OpenAIRE

    Shikha Jain; Girish Chandra Bhatt; Nirendra Rai; Bhavna Dhingra Bhan

    2014-01-01

    Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2³-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association wit...

  20. Diffusion-weighted MR neurography for the assessment of brachial plexopathy in oncological practice

    NARCIS (Netherlands)

    Andreou, Adrian; Sohaib, Aslam; Collins, David J.; Takahara, Taro; Kwee, Thomas C.; Leach, Martin O.; MacVicar, David A.; Koh, Dow-Mu

    2015-01-01

    Background: To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial plexopathy. Methods: 40 oncological patients with symptoms of brachial plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. T

  1. Electroacupuncture attenuates neuropathic pain after brachial plexus injury

    Institute of Scientific and Technical Information of China (English)

    Shenyu Zhang; Hailiang Tang; Junming Zhou; Yudong Gu

    2014-01-01

    Electroacupuncture has traditionally been used to treat pain, but its effect on pain following brachial plexus injury is still unknown. In this study, rat models of an avulsion injury to the left brachial plexus root (associated with upper-limb chronic neuropathic pain) were given electroacu-puncture stimulation at bilateralQuchi(LI11),Hegu(LI04),Zusanli(ST36) andYanglingquan (GB34). After electroacupuncture therapy, chronic neuropathic pain in the rats’ upper limbs was signiifcantly attenuated. Immunolfuorescence staining showed that the expression of β-endorphins in the arcuate nucleus was signiifcantly increased after therapy. Thus, experimental ifndings indi-cate that electroacupuncture can attenuate neuropathic pain after brachial plexus injury through upregulatingβ-endorphin expression.

  2. Prognostic value of thumb pain sensation in birth brachial plexopathy

    Directory of Open Access Journals (Sweden)

    Carlos O. Heise

    2012-08-01

    Full Text Available OBJECTIVE: To evaluate the prognostic value of absent thumb pain sensation in newborns and young infants with birth brachial plexopathy. METHODS: We evaluated 131 patients with birth brachial plexopathy with less than two months of age. Pain sensation was evoked by thumb nail bed compression to evaluate sensory fibers of the upper trunk (C6. The patients were followed-up monthly. Patients with less than antigravity elbow flexion at six months of age were considered to have a poor outcome. RESULTS: Thirty patients had absent thumb pain sensation, from which 26 showed a poor outcome. Sensitivity of the test was 65% and specificity was 96%. CONCLUSION: Evaluation of thumb pain sensation should be included in the clinical assessment of infants with birth brachial plexopathy.

  3. Permanent upper trunk plexopathy after interscalene brachial plexus block.

    Science.gov (United States)

    Avellanet, Merce; Sala-Blanch, Xavier; Rodrigo, Lidia; Gonzalez-Viejo, Miguel A

    2016-02-01

    Interscalene brachial plexus block (IBPB) has been widely used in shoulder surgical procedures. The incidence of postoperative neural injury has been estimated to be as high as 3 %. We report a long-term neurologic deficit after a nerve stimulator assisted brachial plexus block. A 55 year-old male, with right shoulder impingement syndrome was scheduled for elective surgery. The patient was given an oral dose of 10 mg of diazepam prior to the nerve stimulator assisted brachial plexus block. The patient immediately complained, as soon as the needle was placed in the interscalene area, of a sharp pain in his right arm and he was sedated further. Twenty-four hours later, the patient complained of severe shoulder and arm pain that required an increased dose of analgesics. Severe peri-scapular atrophy developed over the following days. Electromyography studies revealed an upper trunk plexus injury with severe denervation of the supraspinatus, infraspinatus and deltoid muscles together with a moderate denervation of the biceps brachii muscle. Chest X-rays showed a diaphragmatic palsy which was not present post operatively. Pulmonary function tests were also affected. Phrenic nerve paralysis was still present 18 months after the block as was dysfunction of the brachial plexus resulting in an inability to perform flexion, abduction and external rotation of the right shoulder. Severe brachial plexopathy was probably due to a local anesthetic having been administrated through the perineurium and into the nerve fascicles. Severe brachial plexopathy is an uncommon but catastrophic complication of IBPB. We propose a clinical algorithm using ultrasound guidance during nerve blocks as a safer technique of regional anesthesia. PMID:25744163

  4. Subintimal angioplasty for below-the-ankle arterial occlusion in diabetic patients with chronic critical limb ischemia

    International Nuclear Information System (INIS)

    Objective: To assess the feasibility and efficacy of subintimal angioplasty (SA) for the treatment of below-the-arterial occlusion in diabetic patients with chronic critical limb ischemia (CLI). Methods: SA was adopted for 57 diseased lower limbs in 37 diabetic patients with chronic CLI and occlusive disease of the dorsalis pedis artery (DPA) and/or planter artery (PA), who were not suitable candidates for intraluminal angioplasty or bypass surgery. Of the total 57 diseased lower limbs, tissue loss was seen in 31 (54.4%) and pain was reported in 51 (89.5%). SA was carried out to create continuous arterial flow to the foot for limb salvage. Both before and after the procedure the clinical symptoms, DPA or PA pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the healing of the wound, the salvage of the diseased limb and the re-stenosis occurrence of the target vessels were evaluated. Kaplan-Meier curves were constructed to evaluate limb salvage, survival rate and freedom from amputation. Results: A total of 66 below-the-ankle arterial lesions were detected in 57 affected limbs. Of the 66 lesions, SA was successfully performed in 55 (83.3%). Before SA the median pulse volume scores and ABIs were 0.33±0.54 and 0.31±0.19 respectively, which became 2.04±1.05 and 0.80±0.14 respectively after SA, the differences in both median pulse volume scores and ABI were statistically significant (P<0.01 for both). One patient (2.7%) died within 30 days after the procedure. Mild complications, such as bleeding, thrombosis or angiospasm etc. occurred in five patents (13.5%). Twelve months after SA. Kaplan-Meier analysis showed that the limb salvage rate was 94.6%, the freedom from amputation was 89.2% and the survival rate was 97.3%. Conclusion: SA of the dorsalis pedis artery and/or planter artery is an effective technique for lower limb salvage in diabetic

  5. Pediatric Stinger Syndrome: Acute Brachial Plexopathy After Minor Trauma.

    Science.gov (United States)

    Quong, Whitney L; Hynes, Sally L; Arneja, Jugpal S

    2015-11-01

    The "stinger" or "burner" is a form of transient brachial plexopathy termed for its characteristic knife-like pain extending from the neck to the fingertips. Muscle weakness and paresthesia are oftentimes associated symptoms and are similarly temporary. Commonly observed in athletes of contact sports, the stinger results from high force trauma causing either traction/direct compression to the brachial plexus or extension/compression of the cervical nerve roots. We describe a pediatric case of a stinger in a 14-year-old boy, which was caused by a relatively low force trauma accident. Our management strategy and recommendations are discussed. PMID:26893985

  6. Electrodiagnosis of brachial plexopathies and proximal upper extremity neuropathies.

    Science.gov (United States)

    Simmons, Zachary

    2013-02-01

    This article describes the normal anatomy of the brachial plexus and its major terminal branches, as well as the major causes and clinical presentations of lesions of these structures. An approach to electrodiagnosis of brachial plexopathies and proximal upper extremity neuropathies is provided, with an emphasis on those nerve conduction studies and portions of the needle examination, which permit localization of lesions to specific trunks, cords, and terminal branches. The importance of specific sensory nerve conduction studies for differentiating plexopathies from radiculopathies and mononeuropathies is emphasized.

  7. The median forehead flap reviewed: a histologic study on vascular anatomy.

    Science.gov (United States)

    Skaria, A M

    2015-05-01

    Local skin flaps can be divided into two types: random flaps and axial flaps. An axial flap is defined as a flap containing a named artery in its pedicle. For the paramedian forehead flap (PMFF) a lot of surgeons insist on the point that the pedicle must contain the supratrochlear artery. To demonstrate that median forehead flaps (MFF) need not contain a named artery, we selected first 8 patients with a PMFF and further 12 patients who had undergone reconstructive surgery using a MFF. After division, we analysed the pedicle of the flap histologically and measured the diameter of the arteries or arterioles and compared them to anatomical descriptions of the frontal arteries. In none of the 12 cases could we find a functional artery of approximately 1 mm in diameter that could correspond to the supratrochlear artery. The MFF is an axial flap but not in accordance with the current definition of this term. In contrast to published literature, we show that only in a part of cases a named artery was present in the pedicle. Despite this fact, the MFF is a secure flap for full thickness defect repair on the nose. PMID:24756613

  8. Median sternotomy closure: review and update research

    Institute of Scientific and Technical Information of China (English)

    Hua Kun; Yang Xiubin

    2009-01-01

    Cardiac surgery is a very common operation nowadays all over the world. Median stemotomy is a routine procedure required for cardiac access during open heart surgery. The complications of this procedure after the cardiac surgery range from 0.7% to 1.5% of all cases, and bear a high mortality rate if they occur. Every individual surgeon must pay great attention on every detail during the sternal closure. This article shows the details as to conventional information and updated progress on median sternotomy closure. The update contents involve in biomechanics, number of wires twists, biomaterial and so on.According to our experience, we recommend four peristernal single/double steel wires for sternal closure as our optimal choice.

  9. Intraneural Venous Malformations of the Median Nerve

    Science.gov (United States)

    González Rodríguez, Alba; Midón Míguez, José

    2016-01-01

    Venous malformations arising from the peripheral nerve are a rare type of vascular malformation. We present the first case of an intraneural venous malformation of the median nerve to be reported in a child and review the previous two cases of median nerve compression due to a venous malformation that have been reported. These cases presented with painless masses in the volar aspect of the wrist or with symptoms suggestive of carpal tunnel syndrome. Clinical suspicion should lead to the use of Doppler ultrasonography as the first-line diagnostic tool. Magnetic resonance imaging and histopathology can confirm the diagnosis, as phleboliths are pathognomonic of venous malformations. Surgical treatment appears to be the only modality capable of successfully controlling the growth of an intraneural malformation. Sclerotherapy and radiotherapy have never been used to treat this type of malformation.

  10. Isolated median sensory neuropathy after acupuncture.

    Science.gov (United States)

    Lee, Chang Ho; Hyun, Jung Keun; Lee, Seong Jae

    2008-12-01

    A 47-year-old left-handed man presented with pain and numbness in his left thumb and index finger after acupuncture treatment on an acupoint in his left wrist. A technique of herbal acupuncture, involving the use of a needle coated with apricot seed extract, was used. Median nerve conduction study showed an absence of sensory nerve action potential in the left index finger, whereas the results were normal in all other fingers. The radial and ulnar nerves in the left thumb and ring finger, respectively, showed no abnormality. Infrared thermography of the left index finger showed severe hypothermia. The patient was diagnosed as having an isolated injury to the sensory nerve fibers of the median nerve innervating the index finger. This is the first case report of complications from an herbal acupuncture treatment, and it highlights the possibility of focal peripheral nerve injury caused by acupuncture. PMID:19061751

  11. 臂丛神经MRI扫描方案探讨%MRI scan protocols of brachial plexus.

    Institute of Scientific and Technical Information of China (English)

    宋海岩; 雷益; 林帆; 夏军; 侯严振

    2011-01-01

    Objective To analyze the appearance of normal brachial plexus employing different MRI sequences, and determine the best MRI scan protocol for brachial plexus. Methods A total of 18 healthy volunteers were examined with routine and DWIBS sequences. The manifestations of normal brachial plexus in these sequences were observed. Results The signal intensity of brachial plexus was isointense on T1WI and T2WI, lightly hyperintense on TIPM images, and significantly hyperintense on DWIBS. On the wansverse sections, the nerve roots appeared as linear structure exiting from the imervertebral foramen and passing through the scalene gap, and then surrounding flow void of the subclavian artery. On coronal images, the roots appeared as linear structures exiting from C5~T1 intervertebral foramen and collecting to infraclavicular and axillary fossa. Conclusion By the combination of routine and DWIBS sequences, the brachial plexus can be manifested comprehensively and distinctly.%目的 探讨臂丛神经图像常规扫描方案以及各个序列臂丛神经的不同表现.方法 对18例健康志愿者分别行常规及弥散加权背景抑制神经成像(Diffusion weighted whole body imaging with background body signal suppression,DWIBS)扫描,观察各序列中臂丛神经的表现.结果 常规T1WI、T2WI臂丛神经呈等信号,横轴位反转恢复(TIRM)序列呈稍高信号,DWIBS呈明显高信号.横断面上,显示神经根自椎间孔处穿出,行于斜角肌间隙,后与锁骨下动脉及腋动脉伴行;冠状面上,显示为由C5~T1神经孔旁起始的条索状结构.结论 联合常规及DWIBS序列,可全面、清晰地显示臂丛神经.

  12. Traumatic injuries of brachial plexus: present methods of surgical treatment Part II. Treatment policy for brachial plexus injuries

    Directory of Open Access Journals (Sweden)

    M. L. Novikov

    2013-01-01

    Full Text Available The task of this paper is to familiarize practicing neurologists, neurosurgeons, traumatologists, and orthopedists with the current principles of diagnosis and treatment of different brachial plexus (BP injuries. Part I describes the anatomy of BP in detail, considers the main mechanisms of its injuries, and gives their current classification (Nervno-Myshechnye Bolezni (Neuromuscular Diseases 2012;4:19–27.Part II presents the author's approach to treatment of brachial plexus injuries according to the type of lesion and period of denervation: nonoperative methods; rehabilitation; preoperative management; indications for surgical treatment. The tactics and techniques of primary brachial plexus reconstructions are discussed in detail.

  13. COLOUR IMAGE STEGANOGRAPHY USING MEDIAN MAINTENANCE

    Directory of Open Access Journals (Sweden)

    S. Arivazhagan

    2011-08-01

    Full Text Available Steganographic algorithms in the recent past have been producing stego images with perceptual invisibility, better secrecy and certain robustness against attacks like cropping, filtering etc. Recovering a good quality secret from a good quality stego image may not always be possible. The method proposed in this paper works in transform domain and attempts to extract the secret almost as same as the embedded one maintaining minimal changes to the cover image by using techniques like median maintenance, offset and quantization.

  14. Portfolio optimization using median-variance approach

    Science.gov (United States)

    Wan Mohd, Wan Rosanisah; Mohamad, Daud; Mohamed, Zulkifli

    2013-04-01

    Optimization models have been applied in many decision-making problems particularly in portfolio selection. Since the introduction of Markowitz's theory of portfolio selection, various approaches based on mathematical programming have been introduced such as mean-variance, mean-absolute deviation, mean-variance-skewness and conditional value-at-risk (CVaR) mainly to maximize return and minimize risk. However most of the approaches assume that the distribution of data is normal and this is not generally true. As an alternative, in this paper, we employ the median-variance approach to improve the portfolio optimization. This approach has successfully catered both types of normal and non-normal distribution of data. With this actual representation, we analyze and compare the rate of return and risk between the mean-variance and the median-variance based portfolio which consist of 30 stocks from Bursa Malaysia. The results in this study show that the median-variance approach is capable to produce a lower risk for each return earning as compared to the mean-variance approach.

  15. A CASE REPORT ON HIGH ORIGIN OF RADIAL ARTERY

    Directory of Open Access Journals (Sweden)

    Vaishali Bondage

    2014-09-01

    Full Text Available Background: The use of radial artery (RA as an access to heart and for other procedures and surgeries make it significant. The context and purpose: The RA is a common access port for coronary angiography (CAG, percutaneous coronary intervention (PCI, and coronary artery bypass graft Surgery (CABG, RA cannulation, along with others. Results: In this case report, we want to present a case of unilateral high origin of RA arising as branch of brachial artery in the proximal 1/3rd of arm. Conclusions, brief summary and potential implications: Misdiagnosis, complications during medical procedures and increased possibility of injury are the most common dangers of having a superficial RA.

  16. Diagnostic value of combined magnetic resonance imaging examination of brachial plexus and electrophysiological studies in multifocal motor neuropathy

    Directory of Open Access Journals (Sweden)

    Basta Ivana

    2014-01-01

    Full Text Available Background/Aim. Multifocal motor neuropathy (MMN is an immune-mediated disorder characterized by slowly progressive asymetrical weakness of limbs without sensory loss. The objective of this study was to investigate the involvement of brachial plexus using combined cervical magnetic stimulation and magnetic resonance imaging (MRI of plexus brachialis in patients with MMN. We payed special attention to the nerve roots forming nerves inervating weak muscles, but without detectable conduction block (CB using conventional nerve conduction studies. Methods. Nine patients with proven MMN were included in the study. In all of them MRI of the cervical spine and brachial plexus was performed using a Siemens Avanto 1.5 T unit, applying T1 and turbo spinecho T1 sequence, axial turbo spin-echo T2 sequence and a coronal fat-saturated turbo spin-echo T2 sequence. Results. In all the patients severe asymmetric distal weakness of muscles inervated by radial, ulnar, median and peroneal nerves was observed and the most striking presentation was bilateral wrist and finger drop. Three of them had additional proximal weakness of muscles inervated by axillar and femoral nerves. The majority of the patients had slightly increased cerebrospinal fluid (CSF protein content. Six of the patients had positive serum polyclonal IgM anti-GM1 antibodies. Electromyoneurography (EMG showed neurogenic changes, the most severe in distal muscles inervated by radial nerves. All the patients had persistent partial CBs outside the usual sites of nerve compression in radial, ulnar, median and peroneal nerves. In three of the patients cervical magnetic stimulation suggested proximal CBs between cervical root emergence and Erb’s point (prolonged motor root conduction time. In all the patients T2-weighted MRI revealed increased signal intensity in at least one cervical root, truncus or fasciculus of brachial plexus. Conclusion. We found clinical correlation between muscle weakness

  17. Characterizing the continuously acquired cardiovascular time series during hemodialysis, using median hybrid filter preprocessing noise reduction.

    Science.gov (United States)

    Wilson, Scott; Bowyer, Andrea; Harrap, Stephen B

    2015-01-01

    The clinical characterization of cardiovascular dynamics during hemodialysis (HD) has important pathophysiological implications in terms of diagnostic, cardiovascular risk assessment, and treatment efficacy perspectives. Currently the diagnosis of significant intradialytic systolic blood pressure (SBP) changes among HD patients is imprecise and opportunistic, reliant upon the presence of hypotensive symptoms in conjunction with coincident but isolated noninvasive brachial cuff blood pressure (NIBP) readings. Considering hemodynamic variables as a time series makes a continuous recording approach more desirable than intermittent measures; however, in the clinical environment, the data signal is susceptible to corruption due to both impulsive and Gaussian-type noise. Signal preprocessing is an attractive solution to this problem. Prospectively collected continuous noninvasive SBP data over the short-break intradialytic period in ten patients was preprocessed using a novel median hybrid filter (MHF) algorithm and compared with 50 time-coincident pairs of intradialytic NIBP measures from routine HD practice. The median hybrid preprocessing technique for continuously acquired cardiovascular data yielded a dynamic regression without significant noise and artifact, suitable for high-level profiling of time-dependent SBP behavior. Signal accuracy is highly comparable with standard NIBP measurement, with the added clinical benefit of dynamic real-time hemodynamic information.

  18. Rheumatoid Arthritis and the Ankle-Brachial Pressure Index: Any Association?

    Directory of Open Access Journals (Sweden)

    Asso Fraidoon

    2014-02-01

    Full Text Available Purpose: Several studies tried to assess the influence of rheumatoid arthritis (RA on peripheral arteries and found an association with later development of intimal thickness and atherosclerosis. We tried to uncover the prevalence of subclinical peripheral vascular disease (PVD in rheumatoid arthritis patients. Materials and Methods: This case control-study had involved sixty patients who were diagnosed with rheumatoid. Forty age, gender, and body mass index-matched healthy individuals were selected as the control group. All participants were non-smokers, non-hypertensive, and non-diabetics and had a normal lipid profile. The presence of peripheral arterial disease was evaluated by measuring the ankle-brachial pressure index (ABPI at the level of each artery of the lower limbs. An index of ≤0.9 was considered abnormal and a possible reflection of an underlying PVD. Results: Twenty three (38% out of the 60 RA patients demonstrated one or more abnormal arteries while only 3 (7.5% out of the 40 control individuals had abnormal results (p-value <0.001. A statistically significant association was noted between abnormal ABPI and RA disease severity as indicated by C-reactive protein (P-value <0.003, ESR (P-value <0.002, and positive serum rheumatoid factor (P-value <0.01. However, age, gender, and disease duration showed no link with abnormal ABPI. Conclusion: A higher prevalence of abnormal ABPI, and hence a possible higher incidence of subclinical atherosclerosis, was found in patients with RA. Further analytic studies are required to assess the relationship of RA with PVD.

  19. EXERCISE-INDUCED ARTERIAL ADAPTATIONS IN ELITE JUDO ATHLETES

    Directory of Open Access Journals (Sweden)

    Panagiotis Karagounis

    2009-09-01

    Full Text Available The purpose of this study was to examine exercise-induced arterial adaptations in elite Judo male and female athletes. 27 male Judo athletes (age 24.06 ± 2 years, 11 female Judoka (age 24.27 ± 1 years, 27 sedentary healthy men (age 24.01 ± 2 years and 11 women (age 24.21 ± 1 years participated in the current study. The examined vessels included brachial, radial, ulnar, popliteal, anterior and posterior tibial arteries. The experimental parameters were recorded with the use of Duplex ultrasound at rest. Diastolic diameter and blood mean flow velocity of the examined arteries in Judo athletes were found to be both significantly increased (p < 0.05 compared to the findings of the control groups. In male Judo athletes the brachial (p < 0.001, radial (p < 0.001, and anterior tibial artery (p < 0.001 presented the highest difference on the diastolic diameter, compared with the control male group. In female Judo athletes, ulnar (p < 0.001, radial (p < 0.001, and brachial (p < 0.001 arteries illustrated the highest diastolic diameter. The highest blood mean flow velocity was recorded in ulnar (p < 0.001 and popliteal arteries (p < 0.001 of the Judo athletes groups. Recording differences between the two genders, male participants presented larger arteries than females. Conclusively, Judo has been found to be a highly demanding physical sport, involving upper and lower limbs leading to significant arterial adaptations. Obtaining vascular parameters provide a useful tool to the medical team, not only in the direction of enhancement of the efficacy of physical training, but in unknown so far parameters that may influence athletic performance of both male and female elite Judokas

  20. Axillary Brachial Plexus Blockade for the Reflex Sympathetic Dystrophy Syndrome.

    Science.gov (United States)

    Ribbers, G. M.; Geurts, A. C. H.; Rijken, R. A. J.; Kerkkamp, H. E. M.

    1997-01-01

    Reflex sympathetic dystrophy syndrome (RSD) is a neurogenic pain syndrome characterized by pain, vasomotor and dystrophic changes, and often motor impairments. This study evaluated the effectiveness of brachial plexus blockade with local anaesthetic drugs as a treatment for this condition. Three patients responded well; three did not. (DB)

  1. Ultrasound of the cervical roots and brachial plexus in neonates

    NARCIS (Netherlands)

    Pillen, S.; Semmekrot, B.; Meulstee, J.; Verrips, A.; Alfen, N. van

    2015-01-01

    INTRODUCTION: In this exploratory study we investigated whether ultrasound can visualize the neonatal cervical roots and brachial plexus. METHODS: In 12 healthy neonates <2 days old, the neck region was studied unilaterally with ultrasound using a small-footprint 15-7-MHz transducer. RESULTS: The

  2. Treatment for idiopathic and hereditary neuralgic amyotrophy (brachial neuritis) (Review)

    NARCIS (Netherlands)

    Alfen, N. van; Engelen, B.G.M. van; Hughes, R.A.

    2009-01-01

    BACKGROUND: Neuralgic amyotrophy (also know as Parsonage-Turner syndrome or brachial plexus neuritis) is a distinct peripheral nervous system disorder characterised by episodes (attacks) of extreme neuropathic pain and rapid multifocal weakness and atrophy in the upper limbs. Neuralgic amyotrophy ha

  3. Brachial plexus neuropathy - A long-term outcome study

    NARCIS (Netherlands)

    Geertzen, JHB; Groothoff, JW; Nicolai, JP; Rietman, JS

    2000-01-01

    This retrospective study assessed the long-term outcome of brachial plexus neuropathy in 16 patients. The mean follow up was 8 years. Nine patients complained of persistent pain and muscle weakness, four had continuing problems with various activities of daily living and 11 had trouble with some hou

  4. Solitary median maxillary central incisor (SMMCI) syndrome

    OpenAIRE

    Hall Roger K

    2006-01-01

    Abstract Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th–38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; i...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  6. Entrapment of the Martin-Gruber branch of median nerve in the forearm

    Directory of Open Access Journals (Sweden)

    Anu Vinod Ranade

    2016-07-01

    Full Text Available We report a rare case of a dual neuro-vascular variation, which was observed in the right extremity of male cadaver. About an inch inferior to the elbow joint, three branches arose from the median nerve. These were the anterior interosseous branch, a Martin-Gruber branch (MGB and a muscular branch. The MGB coursed infero-medially to join with the ulnar nerve by running posterior to the ulnar artery. It was surprising to observe that the MGB passed between the ulnar artery and its venae comitantes. There was an acute angulation of the MGB here, suggesting entrapment at this site.

  7. Entrapment of the Martin-Gruber branch of median nerve in the forearm

    OpenAIRE

    Anu Vinod Ranade; Bukkambudhi Virupakshamurthy Murlimanju; Rajalakshmi Rai; Mohamed Ahmed Eladl

    2016-01-01

    We report a rare case of a dual neuro-vascular variation, which was observed in the right extremity of male cadaver. About an inch inferior to the elbow joint, three branches arose from the median nerve. These were the anterior interosseous branch, a Martin-Gruber branch (MGB) and a muscular branch. The MGB coursed infero-medially to join with the ulnar nerve by running posterior to the ulnar artery. It was surprising to observe that the MGB passed between the ulnar artery and its venae comit...

  8. Relationship between upper and lower limb conduit artery vasodilator function in humans

    NARCIS (Netherlands)

    Thijssen, D.H.J.; Rowley, N.; Padilla, J.; Simmons, G.H.; Laughlin, M.H.; Whyte, G.; Cable, N.T.; Green, D.J.

    2011-01-01

    Brachial artery flow-mediated dilation (FMD) is a strong predictor of future cardiovascular disease and is believed to represent a "barometer" of systemic endothelial health. Although a recent study [Padilla et al. Exp Biol Med (Maywood) 235: 1287-1291, 2010] in pigs confirmed a strong correlation b

  9. Ultra Low-Power Analog Median Filters

    Directory of Open Access Journals (Sweden)

    A. Diaz-Sanchez

    2013-09-01

    Full Text Available The design and implementation of three analog median filter topologies, whose transistors operate in the deep weak-inversion region, is described. The first topology is a differential pairs array, in which drain currents are driven into two nodes in a differential fashion, while the second topology is based on a wide range OTA, which is used to maximize the dynamic range. Finally, the third topology uses three range-extended OTAs. The proposed weak-inversion filters were designed and fabricated in ON Semiconductor 0.5 micrometer technology through MOSIS. Experimental results of three-input fabricated prototypes for all three topologies are show, where power consumptions of 90nW in the first case, and 270nW in the other two cases can be noticed. A dual power supply +/-1.5 Volts were used.

  10. Sosiaalisen median paikallismarkkinointisuunitelma : case: Lahden Kellokeskus Oy

    OpenAIRE

    Hiukka, Piia

    2015-01-01

    Tämä opinnäytetyö käsittelee markkinointiviestinnän tehokkuutta ja siihen liittyviä ilmiöitä sosiaalisessa mediassa. Työn tavoitteena oli löytää vaikuttavimmat sisällöt, joiden avulla case-yritys Lahden Kellokeskus voi parantaa paikallista näkyvyyttään Facebookissa. Opinnäytetyössä ei puututtu erilaisten sosiaalisen median kanavien teknisiin ominaisuuksiin tai niiden hyödyntämiseen, vaan tavoittena oli löytää tehokkaimmat markkinointiviestinnän sisällöt, joita voidaan julkaista sähköisesti. ...

  11. Association of Arterial Stiffness and Osteoporosis in Healthy Men Undergoing Screening Medical Examination

    OpenAIRE

    Kim, Nam Lee; Jang, Ha Min; Kim, Sul Ki; Ko, Ki Dong; Hwang, In Cheol; Suh, Heuy Sun

    2014-01-01

    Background Association of arterial stiffness and osteoporosis has been previously reported in women. However, this association is still controversial for men. Therefore, we investigated correlation of arterial stiffness and osteoporosis by measuring brachial-ankle (ba) pulse wave velocity (PWV) and bone mineral density (BMD). Methods We reviewed medical charts of 239 people (women: 128, men: 111) who visited the Health Promotion Center, retrospectively. ba-PWV was measured by automatic wave a...

  12. Arterial stiffness is inversely associated with a better running record in a full course marathon race

    OpenAIRE

    Jung, Su-Jeen; Park, Jae-Hyoung; Lee, Sewon

    2014-01-01

    [Purpose] Arterial stiffness is an independent predictor of cardiovascular risk and may contribute to reduced running capacity in humans. This study investigated the relationship between course record and arterial stiffness in marathoners who participated in the Seoul International Marathon in 2012. [Methods] A total of 30 amateur marathoners (Males n = 28, Females n = 2, mean age = 51.6 ± 8.3 years) were assessed before and after the marathon race. Brachial-ankle pulse wave velocity (ba-PWV)...

  13. Midterm Outcome of Femoral Artery Stenting and Factors Affecting Patency

    OpenAIRE

    Yu, Jae Seoung; Park, Keun-Myoung; Jeon, Yong Sun; Cho, Soon Gu; Hong, Kee Chun; Shin, Woo Young; Choe, Yun-Mee; Shin, Seok-Hwan; Kim, Kyung Rae

    2015-01-01

    Purpose: The purpose of this study was to evaluate the early and midterm results of superficial femoral artery (SFA) stenting with self-expanding nitinol stents and to identify the factors affecting patency. Materials and Methods: SFA stenting was performed in 165 limbs of 117 patients from January 2009 to December 2013. Patients were followed-up for the first occurrence of occlusion or stenosis based on computed tomography and duplex scan results and a decrease in ankle brachial index of >15...

  14. Arterial Stiffening and Clinical Outcomes in Dialysis Patients

    OpenAIRE

    Kato, Akihiko

    2015-01-01

    Cardiovascular disease (CVD) is an important cause of morbidity and mortality in dialysis patients. Brachial-ankle pulse wave velocity (baPWV) is more efficient to handily assess arteriosclerosis than aortic PWV. The cardio-ankle vascular index (CAVI) is also a novel blood pressure-independent arterial stiffness parameter. In dialysis patients, both baPWV and CAVI are increased compared to general subjects. Several studies have demonstrated that increased baPWV is associated with carotid athe...

  15. Arterial stiffness, renal function and renal blood flow in patients with coronary artery disease, arterial hypertension and type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Elena Vasilievna Oskola

    2014-07-01

    Full Text Available AimTo investigate the relationship between changes in indicators of arterial stiffness of various types of vessels, hemodynamic pulsatility, renal function and renal blood flow in patients with coronary artery disease (CAD and arterial hypertension in the presence or absence of type 2 diabetes mellitus (T2DM.Materials and MethodsThe study included 96 patients with CAD and arterial hypertension; among them, 54 subjects had T2DM and 42 did not. Сarbohydrate and lipid metabolism, renal function, stiffness of various types of arteries, parameters of hemodynamic pulsatility and renal blood flow were investigated.ResultsArterial stiffness of various types of vessels was increased in the T2DM group: carotid–femoral pulse wave velocity as a marker of aortic stiffness (a vessel of the elastic type was increased by 16% (p <0.001, index β of the common carotid artery (a vessel of the muscular elastic type was increased by 7.6% (p <0.05 and index β of the brachial artery (a vessel of the muscular type was increased by 22% (p <0.05. The level of microalbuminuria was 5-fold higher (p <0.05 and the renal resistive index was 12.5% higher (p <0.05 in the diabetics group. Significant correlations were found between aortic stiffness, parameters of hemodynamic pulsatility (pulse pressure, measured at the brachial artery, the central pulse pressure, augmentation index and renal function and renal blood flow in patients in both groups.ConclusionThe results may indicate the general pathogenetic mechanisms and the relationship between the development of increased aortic stiffness and renal dysfunction in patients with CAD, arterial hypertension and T2DM.

  16. Unusual Origin of a Double Upper Subscapular Nerve from the Suprascapular Nerve and the Posterior Division of the Upper Trunk of the Brachial Plexus: A Case Report.

    Science.gov (United States)

    Paraskevas, George; Koutsouflianiotis, Konstantinos; Iliou, Kalliopi; Bitsis, Theodosios; Kitsoulis, Panagiotis

    2016-06-01

    A double upper subscapular nerve on the right side was detected in a male cadaver, with the proximal one arising from the suprascapular nerve and the distal one from the posterior division of the upper trunk of the brachial plexus. Both of them penetrated and supplied the uppermost portion of the right subscapularis muscle. That anatomic variation was associated with a median nerve formed by two lateral roots. The origin and pattern of the upper subscapular nerve displays high variability, however the presented combination of the variable origin of a double upper subscapular nerve has rarely been described in the literature. The knowledge of such an anatomic variation is essential for the surgeon operating in the region especially in instances of brachial plexus' repair after any traumatic injury. Moreover, the awareness of the precise origin and topography of these nerves is important for the physician attempting to block these nerves or utilizing these nerves as grafts for neurotization of adjacent damaged nerves of the brachial plexus. PMID:27504272

  17. Transplantation of human amniotic epithelial cells repairs brachial plexus injury:pathological and biomechanical analyses

    Institute of Scientific and Technical Information of China (English)

    Qi Yang; Min Luo; Peng Li; Hai Jin

    2014-01-01

    A brachial plexus injury model was established in rabbits by stretching the C6 nerve root. Imme-diately after the stretching, a suspension of human amniotic epithelial cells was injected into the injured brachial plexus. The results of tensile mechanical testing of the brachial plexus showed that the tensile elastic limit strain, elastic limit stress, maximum stress, and maximum strain of the injured brachial plexuses were signiifcantly increased at 24 weeks after the injection. The treat-ment clearly improved the pathological morphology of the injured brachial plexus nerve, as seen by hematoxylin eosin staining, and the functions of the rabbit forepaw were restored. These data indicate that the injection of human amniotic epithelial cells contributed to the repair of brachial plexus injury, and that this technique may transform into current clinical treatment strategies.

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

    International Nuclear Information System (INIS)

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

  19. Gestational pulmonary arterial hypertension

    OpenAIRE

    Moll, Matthew; Payne, Julie G.; Tukey, Melissa H.; Farber, Harrison W.

    2015-01-01

    Pulmonary arterial hypertension (PAH) is a progressive disease marked by the irreversible pulmonary vascular changes of vasoconstriction, thrombosis, and proliferation of smooth muscle and endothelial cells. The untreated clinical course is characterized by progressive dyspnea and a median survival of less than 3 years. Many of these patients are of child-bearing age; however, pregnancy leads to physiologic changes that are particularly poorly tolerated in PAH, conferring a 30%–56% mortality....

  20. Technical note: the humeral canal approach to the brachial plexus.

    LENUS (Irish Health Repository)

    Frizelle, H P

    2012-02-03

    Many variations to the axillary approach to the brachial plexus have been described. However, the success rate varies depending on the approach used and on the definition of success. Recent work describes a new approach to regional anaesthesia of the upper limb at the humeral\\/brachial canal using selective stimulation of the major nerves. This report outlines initial experience with this block, describing the technique and results in 50 patients undergoing hand and forearm surgery. All patients were assessed for completeness of motor and sensory block. The overall success rate was 90 percent. Motor block was present in 80 percent of patients. Completion of the block was necessary in 5 patients. Two patients required general anaesthesia. The preponderance of ulnar deficiencies agrees with previously published data on this technique. No complications were described. Initial experience confirms the high success rate described using the Dupre technique. This technically straightforward approach with minimal complications can be recommended for regional anaesthesia of the upper limb.

  1. A comparison of infraclavicular and supraclavicular approaches to the brachial plexus using neurostimulation

    OpenAIRE

    Yang, Chun Woo; Kwon, Hee Uk; Cho, Choon-Kyu; Jung, Sung Mee; Kang, Po-Soon; Park, Eun-Su; Heo, Youn Moo; Shinn, Helen Ki

    2010-01-01

    Background A prospective, double blind study was performed to compare the clinical effect of vertical infraclavicular and supraclavicular brachial plexus block using a nerve stimulator for upper limb surgery. Methods One hundred patients receiving upper limb surgery under infraclavicular or supraclavicular brachial plexus block were enrolled in this study. The infraclavicular brachial plexus block was performed using the vertical technique with 30 ml of 0.5% ropivacaine. The supraclavicular b...

  2. Relationships between the Brook Street Terrane and Median Tectonic Zone (Median Batholith) : evidence from Jurassic conglomerates

    International Nuclear Information System (INIS)

    U-Pb zircon ages of 237-180 Ma and c. 280 Ma of seven granitoid clasts from the Rainy River Conglomerate which lies within the eastern Median Tectonic Zone (Median Batholith) in Nelson, and the Barretts Formation of the Brook Street Terrane in Southland, constrain the depositional ages of both units to be no older than c. 180-200 Ma (Early Jurassic). The minimum age of the Rainy River Conglomerate is constrained by the 147 +2 -1 Ma (Latest Jurassic) emplacement age of the One Mile Gabbronorite (new name: previously western Buller Diorite). The ages and chemistry of five of the granitoid clasts are broadly compatible with derivation from rocks that are now represented by Triassic plutons of the Median Tectonic Zone (Median Batholith), although ages as young as 180 Ma are slightly outside the range of the latter as currently exposed in New Zealand. The age (273-290 Ma, 237 +/- 3 Ma) and chemistry of the other two clasts (one each from Rainy River Conglomerate and Barretts Formation) suggest derivation from the Brook Street Terrane. Similarity in stratigraphic age, depositional characteristics, granitoid clast ages and composition between Rainy River Conglomerate and Barretts Formation suggests that they are broadly correlative and collectively overlapped a combined Brook Street Terrane - Median Batholith (MTZ) before the Late Jurassic (147 +2 -1 Ma). Sedimentary overlap may also have continued across to Middle Jurassic conglomeratic strata in the Murihiku Terrane to the east of the Brook Street Terrane. A U-Pb zircon age of 261 +/- 2 Ma is reported for Pourakino Trondhjemite of the Brook Street Terrane. (author). 56 refs., 10 figs., 4 tabs

  3. Ankle Brachial Pressure Index (ABPI): An update for practitioners

    OpenAIRE

    Al-Qaisi, Mo

    2009-01-01

    Mo Al-Qaisi1, David M Nott1, David H King2, Sam Kaddoura11Imperial College, London, UK; 2Broomfield Hospital, Chelmsford, Essex, UKAbstract: Peripheral vascular disease affects some 12%–14% of the general population, and the majority of people with the disease are asymptomatic. The Ankle Brachial Pressure Index (ABPI) test is widely used by a diverse range of practitioners (in the community and hospital setting) in order to screen asymptomatic patients, diagnose patients with clinic...

  4. Oscillometric blood pressure measurement: a simple method in screening for peripheral arterial disease

    DEFF Research Database (Denmark)

    Mehlsen, Jesper; Wiinberg, Niels; Bruce, Christopher

    2008-01-01

    Blood pressure at the ankle level is a reliable indicator of peripheral arterial disease (PAD) and the ankle brachial index (ABI) is a useful non-invasive screening tool for the early detection of atherosclerosis. In the first part of the study, systolic blood pressures obtained by oscillometry...... of PAD was sufficiently high in subjects over the age of 60 years to warrant screening. The ankle brachial index based on measurements with an oscillometric device was shown reliable in the exclusion of PAD, thereby fulfilling an important criterion for the use in screening....

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

    Directory of Open Access Journals (Sweden)

    Cihangir Tetik

    2014-01-01

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

  6. Idiopathic brachial neuritis in a child: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Shikha Jain

    2014-01-01

    Full Text Available Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2³-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association with antibiotic therapy in this case could be incidental, indeed it is intriguing and requires further studies.

  7. Post-operative brachial plexus neuropraxia: A less recognised complication of combined plastic and laparoscopic surgeries

    Directory of Open Access Journals (Sweden)

    Jimmy Thomas

    2014-01-01

    Full Text Available This presentation is to increase awareness of the potential for brachial plexus injury during prolonged combined plastic surgery procedures. A case of brachial plexus neuropraxia in a 26-year-old obese patient following a prolonged combined plastic surgery procedure was encountered. Nerve palsy due to faulty positioning on the operating table is commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus has been a recently reported phenomenon due to the increasing number of laparoscopic and robotic procedures. Brachial plexus injury needs to be recognised as a potential complication of prolonged combined plastic surgery. Preventive measures are discussed.

  8. Idiopathic brachial neuritis in a child: A case report and review of the literature.

    Science.gov (United States)

    Jain, Shikha; Bhatt, Girish Chandra; Rai, Nirendra; Bhan, Bhavna Dhingra

    2014-01-01

    Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2½-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association with antibiotic therapy in this case could be incidental, indeed it is intriguing and requires further studies. PMID:25624937

  9. Continuous shoulder analgesia via an indwelling axillary brachial plexus catheter.

    Science.gov (United States)

    Reuben, S S; Steinberg, R B

    2000-09-01

    Continuous interscalene brachial plexus blockade can provide anesthesia and analgesia in the shoulder region. Difficulty accessing the interscalene space and premature displacement of interscalene catheters may preclude their use in certain situations. We present two case reports in which a catheter was advanced from the axilla along the brachial plexus sheath to the interscalene space to provide continuous cervicobrachial plexus analgesia. In the first case report, previous neck surgery made the anatomic landmarks for performing an interscalene block very difficult. An epidural catheter was advanced from the axillary brachial plexus sheath to the interscalene space under fluoroscopic guidance. This technique provided both intraoperative analgesia for shoulder surgery as well as 24-hour postoperative analgesia by an infusion of 0.125% bupivacaine. In the second case report, a catheter was inserted in a similar fashion from the axillary to the interscalene space to provide 14 days of continuous analgesia in the management of complex regional pain syndrome. We have found that this technique allows us to secure the catheter more easily than with the traditional interscalene approach and thus prevents premature dislodgment. This approach may be a suitable alternative when either an interscalene or an infraclavicular catheter may not be inserted. PMID:11090734

  10. Neurolysis and myocutaneous flap for radiation induced brachial plexus neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Hirachi, Kazuhiko; Minami, Akio; Kato, Hiroyuki; Nishio, Yasuhiko [Hokkaido Univ., Sapporo (Japan). School of Medicine; Ohnishi, Nobuki

    1998-11-01

    Surgical treatment for radiation induced brachial plexus neuropathy is difficult. We followed 9 patients of radiation induced brachial plexus neuropathy who were surgically treated with neurolysis and myocutaneous flap coverage. Their ages ranged from 29 to 72 years old. Their diagnoses were breast cancer in 6 patients, lingual cancer in 1, thyroid cancer in 1 and malignant lymphoma in 1. Total dose of radiation ranged from 44 to 240 Gy. Interval from radiation therapy to our surgery ranged from 1 to 18 years (mean 6.7 years). Chief complaints were dysesthesia in 9 patients, motor weakness in 7 patients and dullach in scar formation of radiated skin in 7 patients. Preoperative neural functions were slight palsy in 1, moderate palsy in 5 and complete palsy in 3. In surgical treatment, neurolysis of the brachial plexus was done and it was covered by latissimus dorsi myocutaneous flap. We evaluated about dysesthesia and motor recovery after treatment for neuropathy. Follow up periods ranged from 1 to 11 years (average in 5 years). Dysesthesia improved in 6 patients and got worse in 3 patients. Motor weakness recovered in only 2 patients and got worse in 7 patients. From our results, intolerable dysesthesia which was first complaint of these patients improved. But motor function had not recovered. Our treatment was thought to be effective for extraneural factor like an compression neuropathy by scar formation and poor vascularity. But it was not effective for intraneural damage by radiation therapy. (author)

  11. Solitary median maxillary central incisor (SMMCI) syndrome.

    Science.gov (United States)

    Hall, Roger K

    2006-01-01

    Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th-38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis) is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18-22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated. PMID:16722608

  12. Solitary median maxillary central incisor (SMMCI syndrome

    Directory of Open Access Journals (Sweden)

    Hall Roger K

    2006-04-01

    Full Text Available Abstract Solitary median maxillary central incisor syndrome (SMMCI is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s operating in utero about the 35th–38th day(s from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated.

  13. Correspondence in relation to the case report "Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note." published in May issue of Journal of Brachial Plexus and Peripheral Nerve Injury

    OpenAIRE

    Bhakta Pradipta

    2008-01-01

    Abstract Comment on 'Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note' Bhagat H, Agarwal A, Sharma MS Journal of Brachial Plexus and Peripheral Nerve Injury 2008, 3:14 (22 May 2008)

  14. Impact of menaquinone-4 supplementation on coronary artery calcification and arterial stiffness: an open label single arm study

    OpenAIRE

    Ikari, Yuji; Torii, Sho; Shioi, Atsushi; Okano, Toshio

    2016-01-01

    Background Dietary intake of vitamin K has been reported to reduce coronary artery calcification (CAC) and cardiovascular events. However, it is unknown whether supplemental menaquinone (MK)-4 can reduce CAC or arterial stiffness. To study the effect of MK-4 supplementation on CAC and brachial ankle pulse wave velocity (baPWV). Methods This study is a single arm design to take 45 mg/day MK-4 daily as a therapeutic drug for 1 year. Primary endpoint was CAC score determined using 64-slice multi...

  15. Epicardial ultrasound in coronary artery bypass surgery

    OpenAIRE

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the surgeon may face several intraoperative difficulties: 1. Localization of the target coronary artery for bypass grafting. 2. Selection of the optimal anastomotic site on the target coronary artery. 3. Asses...

  16. Effect of beta-1-blocker, nebivolol, on central aortic pressure and arterial stiffness in patients with essential hypertension

    Directory of Open Access Journals (Sweden)

    Radhika Soanker

    2012-01-01

    Conclusion: Nebivolol 5 mg demonstrated antihypertensive efficacy in patients with essential hypertension by reducing not only peripheral brachial pressures, but also significantly reducing central aortic pressures, augmentation index, and carotid femoral pulse wave velocity, which is the marker of arterial stiffness.

  17. Arterial Wall Properties and Womersley Flow in Fabry Disease

    Directory of Open Access Journals (Sweden)

    Dimitriadis Emilios

    2002-01-01

    Full Text Available Abstract Background Fabry disease is an X-linked recessive lysosomal storage disease resulting in the cellular accumulation of globotriaosylceramide particularly globotriaosylceramide. The disease is characterized by a dilated vasculopathy with arterial ectasia in muscular arteries and arterioles. Previous venous plethysomographic studies suggest enhanced endothelium-dependent vasodilation in Fabry disease indicating a functional abnormality of resistance vessels. Methods We examined the mechanical properties of the radial artery in Fabry disease, a typical fibro-muscular artery. Eight control subjects and seven patients with Fabry disease had a right brachial arterial line placed allowing real time recording of intra-arterial blood pressure. Real time B-mode ultrasound recordings of the right radial artery were obtained simultaneously allowing calculation of the vessel wall internal and external diameter, the incremental Young's modulus and arterial wall thickness. By simultaneously measurement of the distal index finger-pulse oximetry the pulse wave speed was calculated. From the wave speed and the internal radial artery diameter the volume flow was calculated by Womersley analysis following truncation of the late diastolic phase. Results No significant difference was found between Fabry patients and controls for internal or external arterial diameters, the incremental Young's modulus, the arterial wall thickness, the pulse wave speed and the basal radial artery blood flow. Further, no significant difference was found for the radial artery blood flow in response to intra-arterial acetylcholine or sodium nitroprusside. Both drugs however, elevated the mean arterial flow. Conclusions The current study suggests that no structural or mechanical abnormality exists in the vessel wall of fibro-muscular arteries in Fabry disease. This may indicate that a functional abnormality downstream to the conductance vessels is the dominant feature in

  18. Training to measure ankle-brachial index at the undergraduate level: can it be successful?

    Science.gov (United States)

    Georgakarakos, Efstratios; Papadaki, Evaggelia; Vamvakerou, Vasileia; Lytras, Dimitrios; Tsiokani, Afroditi; Tsolakaki, Olympia; Chlimpou, Dimitra; Papanas, Nikolaos

    2013-06-01

    We examined the effectiveness of teaching ankle-brachial index (ABI) measurement to medical students. ABI was estimated in 28 lower limbs by an experienced vascular surgeon. After a 2-week training course, 5 fourth-year students repeated the estimations and their results were compared with that of the trainer's. There was no difference in ABI values between trainees and trainer for subjects with mild-to-moderate peripheral arterial disease (PAD; 0.77 ± 0.22 vs 0.77 ± 0.19, respectively, P = .95). In the 4 normal limbs, ABI was 1.37 ± 0.12 and 1.16 ± 0.11, as measured by the trainer and the trainees, respectively (P < .00001). In subjects with severe PAD, trainees tended to overestimate ABI (P = .0002) in the beginning of the educational process, but this was no longer the case at a later stage of the training with no difference in ABI values between the 2 examiner groups (P = .09). In conclusion, training of medical students in ABI measurement can be helpful toward accurate estimation of PAD and merits further practice. PMID:23667100

  19. 超声引导喙突处锁骨下臂丛神经阻滞与逆行锁骨下臂丛神经阻滞的比较%Comparison of the anesthetic effects between ultrasound-guided infraclavicular brachial plexus block via coracoid approach and ultrasound-guided retrograde infraclavicular brachial plexus block

    Institute of Scientific and Technical Information of China (English)

    张媛; 斯妍娜; 程浩; 鲍红光; 韩流

    2012-01-01

    目的 比较超声引导喙突处锁骨下臂丛神经阻滞与逆行锁骨下臂丛神经阻滞的临床麻醉效果.方法 拟行前臂或手部手术患者60例,随机分为两组,分别行超声引导下喙突处锁骨下臂丛神经阻滞(观察组)和超声引导逆行锁骨下臂丛神经阻滞(对照组),每组30例.记录麻醉成功率、麻醉操作时间、持续时间及并发症发生例数、各臂丛神经的起效时间.结果 对照组尺神经、前臂内侧皮神经起效时间较观察组短(P<0.05).对照组有5例Homer's综合征,1例误入血管.结论 超声引导喙突处锁骨下臂丛神经阻滞和逆行锁骨下臂丛神经阻滞均是可行有效的区域麻醉方法.%Objective To compare the anesthetic effects between ultrasound-guided infraclavicular brachial plexus block via ooracoid approach and ultrasound-guided retrograde infraclavicular hrachial plexus block. Methods Sixty patient:, scheduled for forearm or kind surgery were equally randomized into two groups; infraclavicular brachial plexus block via coraeoid approach group (observation group) and retrograde infraclavicular brachial plexus block group (control group). The anesthesia success rale, performance time, duration time, the block onset time of brachial plexus, and the incidence of complication were recorded. Results There was no statistical significance in respect of the anesthesia success rate, performance time, and duration time. Compared wilh observation group, the block onset time of ulnar nerve and median antebrachial cutaneous nerve was shorter and the incidence of complication was higher in control group(P<0. 03). Concha-ion Infraclavicular hrachial plexus block via coraeoid approach and retrograde infraclavicular brachial plexus block by ultrasound-guided are feasible technique in regional anaesthesia, hut the block onset was slower and the incidence of complication was higher in ultrasound-guided retrograde infraclauicnar brachial plexus block.

  20. The Heterogeneous P-Median Problem for Categorization Based Clustering

    Science.gov (United States)

    Blanchard, Simon J.; Aloise, Daniel; DeSarbo, Wayne S.

    2012-01-01

    The p-median offers an alternative to centroid-based clustering algorithms for identifying unobserved categories. However, existing p-median formulations typically require data aggregation into a single proximity matrix, resulting in masked respondent heterogeneity. A proposed three-way formulation of the p-median problem explicitly considers…

  1. EMG MEDIAN POWER FREQUENCY IN AN EXHAUSTING EXERCISE

    NARCIS (Netherlands)

    AMENT, W; BONGA, GJJ; HOF, AL; VERKERKE, GJ

    1993-01-01

    EMG median power frequency of the calf muscles was investigated during an exhausting treadmill exercise. This exercise was an uphill run, the average endurance time was 1.5 min. Median power frequency of the calf muscles declined by more than 10% during this exercise. In addition EMG median power fr

  2. Association of Aortic Compliance and Brachial Endothelial Function with Cerebral Small Vessel Disease in Type 2 Diabetes Mellitus Patients: Assessment with High-Resolution MRI.

    Science.gov (United States)

    Shan, Yan; Lin, Jiang; Xu, Pengju; Zeng, Mengsu; Lin, Huandong; Yan, Hongmei

    2016-01-01

    Objective. To assess the possible association of aortic compliance and brachial endothelial function with cerebral small vessel disease in type 2 diabetes mellitus (DM2) patients by using 3.0 T high-resolution magnetic resonance imaging. Methods. Sixty-two clinically confirmed DM2 patients (25 women and 37 men; mean age: 56.8 ± 7.5 years) were prospectively enrolled for noninvasive MR examinations of the aorta, brachial artery, and brain. Aortic arch pulse wave velocity (PWV), flow-mediated dilation (FMD) of brachial artery, lacunar brain infarcts, and periventricular and deep white matter hyperintensities (WMHs) were assessed. Pearson and Spearman correlation analysis were performed to analyze the association between PWV and FMD with clinical data and biochemical test results. Univariable logistic regression analyses were used to analyze the association between PWV and FMD with cerebral small vessel disease. Multiple logistic regression analyses were used to find out the independent predictive factors of cerebral small vessel disease. Results. Mean PWV was 6.73 ± 2.00 m/s and FMD was 16.67 ± 9.11%. After adjustment for compounding factors, PWV was found significantly associated with lacunar brain infarcts (OR = 2.00; 95% CI: 1.14-3.2; P < 0.05) and FMD was significantly associated with periventricular WMHs (OR = 0.82; 95% CI: 0.71-0.95; P < 0.05). Conclusions. Quantitative evaluation of aortic compliance and endothelial function by using high-resolution MRI may be potentially useful to stratify DM2 patients with risk of cerebral small vessel disease. PMID:27525261

  3. Association of Aortic Compliance and Brachial Endothelial Function with Cerebral Small Vessel Disease in Type 2 Diabetes Mellitus Patients: Assessment with High-Resolution MRI

    Science.gov (United States)

    Shan, Yan; Zeng, Mengsu; Lin, Huandong; Yan, Hongmei

    2016-01-01

    Objective. To assess the possible association of aortic compliance and brachial endothelial function with cerebral small vessel disease in type 2 diabetes mellitus (DM2) patients by using 3.0 T high-resolution magnetic resonance imaging. Methods. Sixty-two clinically confirmed DM2 patients (25 women and 37 men; mean age: 56.8 ± 7.5 years) were prospectively enrolled for noninvasive MR examinations of the aorta, brachial artery, and brain. Aortic arch pulse wave velocity (PWV), flow-mediated dilation (FMD) of brachial artery, lacunar brain infarcts, and periventricular and deep white matter hyperintensities (WMHs) were assessed. Pearson and Spearman correlation analysis were performed to analyze the association between PWV and FMD with clinical data and biochemical test results. Univariable logistic regression analyses were used to analyze the association between PWV and FMD with cerebral small vessel disease. Multiple logistic regression analyses were used to find out the independent predictive factors of cerebral small vessel disease. Results. Mean PWV was 6.73 ± 2.00 m/s and FMD was 16.67 ± 9.11%. After adjustment for compounding factors, PWV was found significantly associated with lacunar brain infarcts (OR = 2.00; 95% CI: 1.14–3.2; P < 0.05) and FMD was significantly associated with periventricular WMHs (OR = 0.82; 95% CI: 0.71–0.95; P < 0.05). Conclusions. Quantitative evaluation of aortic compliance and endothelial function by using high-resolution MRI may be potentially useful to stratify DM2 patients with risk of cerebral small vessel disease. PMID:27525261

  4. [Intra-arterial thrombolysis of a basilar vascular accident during coronary angiography].

    Science.gov (United States)

    Battikh, K; Rihani, R; Lemahieu, J M; Mokahal, M; Houchaymi, Z; Cornaert, P; Dutoit, A

    2001-09-01

    The authors report the case of a 67 year old man with a previous history of aortobifemoral arterial graft who had unstable angina after carotid endarterectomy. Coronary angiography by the right brachial artery was complicated by a cerebrovascular accident with a reactive coma, convulsions and respiratory problems. Selective angiography of the right vertebral artery showed an image of occlusive thrombosis of the basilar artery. In view of the clinical state and angiographic appearances, the authors decided on immediate intra-arterial thrombolysis with Urokinase which dissolved the clot and reestablished flow in the basilar artery, the cerebellar and posterior cerebral arteries. The outcome was favourable with immediate and good recovery of consciousness and hospital discharge on the sixth day without neurological or radiological sequellae. Cerebrovascular accident is a rare and potentially serious complication of left heart catheterisation which requires immediate cerebral angiography to determine the mechanism and propose an appropriate therapeutic approach. PMID:11603067

  5. 3 T MR tomography of the brachial plexus: Structural and microstructural evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Mallouhi, Ammar, E-mail: Ammar.Mallouhi@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Marik, Wolfgang, E-mail: Wolfgang.Marik@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Prayer, Daniela, E-mail: Daniela.Prayer@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kainberger, Franz, E-mail: Franz.Kainberger@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Bodner, Gerd, E-mail: Gerd.Bodner@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kasprian, Gregor, E-mail: Gregor.Kasprian@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2012-09-15

    Magnetic resonance (MR) neurography comprises an evolving group of techniques with the potential to allow optimal noninvasive evaluation of many abnormalities of the brachial plexus. MR neurography is clinically useful in the evaluation of suspected brachial plexus traumatic injuries, intrinsic and extrinsic tumors, and post-radiogenic inflammation, and can be particularly beneficial in pediatric patients with obstetric trauma to the brachial plexus. The most common MR neurographic techniques for displaying the brachial plexus can be divided into two categories: structural MR neurography; and microstructural MR neurography. Structural MR neurography uses mainly the STIR sequence to image the nerves of the brachial plexus, can be performed in 2D or 3D mode, and the 2D sequence can be repeated in different planes. Microstructural MR neurography depends on the diffusion tensor imaging that provides quantitative information about the degree and direction of water diffusion within the nerves of the brachial plexus, as well as on tractography to visualize the white matter tracts and to characterize their integrity. The successful evaluation of the brachial plexus requires the implementation of appropriate techniques and familiarity with the pathologies that might involve the brachial plexus.

  6. Penile erectile dysfunction after brachial plexus root avulsion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Guo Fu; Xuejia Li; Liqiang Gu; Bengang Qin; Li Jiang; Xijun Huang; Qinsen Lu; Dechun Zhang; Xiaolin Liu; Jiakai Zhu; Jianwen Zheng

    2014-01-01

    Our previous studies have demonstrated that some male patients suffering from brachial plexus injury, particularly brachial plexus root avulsion, show erectile dysfunction to varying degrees. However, the underlying mechanism remains poorly understood. In this study, we evaluated the erectile function after establishing brachial plexus root avulsion models with or without spinal cord injury in rats. After these models were established, we administered apomorphine (via a sub-cutaneous injection in the neck) to observe changes in erectile function. Rats subjected to simple brachial plexus root avulsion or those subjected to brachial plexus root avulsion combined with spinal cord injury had signiifcantly fewer erections than those subjected to the sham operation. Expression of neuronal nitric oxide synthase did not change in brachial plexus root avulsion rats. However, neuronal nitric oxide synthase expression was signiifcantly decreased in brachial plexus root avulsion + spinal cord injury rats. These ifndings suggest that a decrease in neuronal nitric oxide synthase expression in the penis may play a role in erectile dysfunction caused by the combi-nation of brachial plexus root avulsion and spinal cord injury.

  7. Brachial Plexus Root Injection in a Human Cadaver Model Injectate Distribution and Effects on the Neuraxis

    NARCIS (Netherlands)

    Orebaugh, Steven L.; Mukalel, Jessen J.; Krediet, Annalot C.; Weimer, Jonathan; Filip, Patrick; McFadden, Kathryn; Bigeleisen, Paul E.

    2012-01-01

    Background: The potential for injection into the brachial plexus root at cervical levels must be considered during interscalene block or chronic pain interventions in the neck, but this phenomenon has not been well studied. In this investigation, we performed injections into the brachial plexus root

  8. Correlation Between Ultrasound Imaging, Cross-Sectional Anatomy, and Histology of the Brachial Plexus A Review

    NARCIS (Netherlands)

    van Geffen, Geert J.; Moayeri, Nizar; Bruhn, Joergen; Scheffer, Gert J.; Chan, Vincent W.; Groen, Gerbrand J.

    2009-01-01

    The anatomy of the brachial plexus is complex. To facilitate the understanding of the ultrasound appearance of the brachial plexus, we present a review of important anatomic considerations. A detailed correlation of reconstructed, cross-sectional gross anatomy and histology with ultrasound sonoanato

  9. Correlation between ultrasound imaging, cross-sectional anatomy, and histology of the brachial plexus: a review.

    NARCIS (Netherlands)

    Geffen, G.J. van; Moayeri, N.; Bruhn, J.; Scheffer, G.J.; Chan, V.W.; Groen, G.J.

    2009-01-01

    The anatomy of the brachial plexus is complex. To facilitate the understanding of the ultrasound appearance of the brachial plexus, we present a review of important anatomic considerations. A detailed correlation of reconstructed, cross-sectional gross anatomy and histology with ultrasound sonoanato

  10. Correlation between ultrasound imaging, cross-sectional anatomy, and histology of the brachial plexus: a review.

    Science.gov (United States)

    van Geffen, Geert J; Moayeri, Nizar; Bruhn, Jörgen; Scheffer, Gert J; Chan, Vincent W; Groen, Gerbrand J

    2009-01-01

    The anatomy of the brachial plexus is complex. To facilitate the understanding of the ultrasound appearance of the brachial plexus, we present a review of important anatomic considerations. A detailed correlation of reconstructed, cross-sectional gross anatomy and histology with ultrasound sonoanatomy is provided.

  11. 3 T MR tomography of the brachial plexus: Structural and microstructural evaluation

    International Nuclear Information System (INIS)

    Magnetic resonance (MR) neurography comprises an evolving group of techniques with the potential to allow optimal noninvasive evaluation of many abnormalities of the brachial plexus. MR neurography is clinically useful in the evaluation of suspected brachial plexus traumatic injuries, intrinsic and extrinsic tumors, and post-radiogenic inflammation, and can be particularly beneficial in pediatric patients with obstetric trauma to the brachial plexus. The most common MR neurographic techniques for displaying the brachial plexus can be divided into two categories: structural MR neurography; and microstructural MR neurography. Structural MR neurography uses mainly the STIR sequence to image the nerves of the brachial plexus, can be performed in 2D or 3D mode, and the 2D sequence can be repeated in different planes. Microstructural MR neurography depends on the diffusion tensor imaging that provides quantitative information about the degree and direction of water diffusion within the nerves of the brachial plexus, as well as on tractography to visualize the white matter tracts and to characterize their integrity. The successful evaluation of the brachial plexus requires the implementation of appropriate techniques and familiarity with the pathologies that might involve the brachial plexus

  12. 3T MR tomography of the brachial plexus: structural and microstructural evaluation.

    Science.gov (United States)

    Mallouhi, Ammar; Marik, Wolfgang; Prayer, Daniela; Kainberger, Franz; Bodner, Gerd; Kasprian, Gregor

    2012-09-01

    Magnetic resonance (MR) neurography comprises an evolving group of techniques with the potential to allow optimal noninvasive evaluation of many abnormalities of the brachial plexus. MR neurography is clinically useful in the evaluation of suspected brachial plexus traumatic injuries, intrinsic and extrinsic tumors, and post-radiogenic inflammation, and can be particularly beneficial in pediatric patients with obstetric trauma to the brachial plexus. The most common MR neurographic techniques for displaying the brachial plexus can be divided into two categories: structural MR neurography; and microstructural MR neurography. Structural MR neurography uses mainly the STIR sequence to image the nerves of the brachial plexus, can be performed in 2D or 3D mode, and the 2D sequence can be repeated in different planes. Microstructural MR neurography depends on the diffusion tensor imaging that provides quantitative information about the degree and direction of water diffusion within the nerves of the brachial plexus, as well as on tractography to visualize the white matter tracts and to characterize their integrity. The successful evaluation of the brachial plexus requires the implementation of appropriate techniques and familiarity with the pathologies that might involve the brachial plexus. PMID:21763092

  13. Vibration sensation as an indicator of surgical anesthesia following brachial plexus block

    Directory of Open Access Journals (Sweden)

    Seema Jindal

    2016-01-01

    Conclusions: Vibration sense serves as a reliable indicator for the onset of surgical anesthesia following brachial plexus block. Vibration sense testing with 128 Hz Rydel–Seiffer tuning fork along with motor power assessment should be used as an objective tool to assess the onset of surgical anesthesia following brachial plexus block.

  14. Measurement of blood pressure, ankle blood pressure and calculation of ankle brachial index in general practice

    DEFF Research Database (Denmark)

    Nexøe, Jørgen; Damsbo, Bent; Lund, Jens Otto;

    2012-01-01

    BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values......BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values...

  15. Endothelial dysfunction, carotid artery plaque burden, and conventional exercise-induced myocardial ischemia as predictors of coronary artery disease prognosis

    Directory of Open Access Journals (Sweden)

    Ishihara Masayuki

    2008-12-01

    Full Text Available Abstract Background While both flow-mediated vasodilation (FMD in the brachial artery (BA, which measures endothelium-dependent vasodilatation, and intima-media thickness (IMT in the carotid artery are correlated with the prognosis of coronary artery disease (CAD, it is not clear which modality is a better predictor of CAD. Furthermore, it has not been fully determined whether either of these modalities is superior to conventional ST-segment depression on exercise stress electrocardiogram (ECG as a predictor. Thus, the goal of the present study was to compare the predictive value of FMD, IMT, and stress ECG for CAD prognosis. Methods and Results A total of 103 consecutive patients (62 ± 9 years old, 79 men with clinically suspected CAD had FMD and nitroglycerin-induced dilation (NTG-D in the BA, carotid artery IMT measurement using high-resolution ultrasound, and exercise treadmill testing. The 73 CAD patients and 30 normal coronary patients were followed for 50 ± 15 months. Fifteen patients had coronary events during this period (1 cardiac death, 2 non-fatal myocardial infarctions, 3 acute heart failures, and 9 unstable anginas. On Kaplan-Meier analysis, only FMD and stress ECG were significant predictors for cardiac events. Conclusion Brachial endothelial function as reflected by FMD and conventional exercise stress testing has comparable prognostic value, whereas carotid artery plaque burden appears to be less powerful for predicting future cardiac events.

  16. Association of polymorphisms in NOS3 with the ankle-brachial index in hypertensive adults.

    Science.gov (United States)

    Kullo, Iftikhar J; Greene, M Todd; Boerwinkle, Eric; Chu, Jian; Turner, Stephen T; Kardia, Sharon L R

    2008-02-01

    We investigated the association of 14 polymorphisms in the endothelial nitric oxide synthase gene (NOS3) with ankle brachial index (ABI) in non-Hispanic white hypertensives belonging to hypertensive sibships. Subjects (n=659, mean age 61+/-9 years, 54% women) underwent measurement of ABI using a standard protocol, and the lowest of 4 ABI values was used in the analyses. Non-synonymous SNPs with a minor allele frequency >0.02 and tag SNPs selected based on a measure of linkage disequilibrium (r(2)) were genotyped. We reduced the chance of false positives by testing for replication, randomly selecting 1 hypertensive sib from each sibship to create Subset 1 (n=330) and Subset 2 (n=329). Multivariable linear regression models were used to assess the associations of single NOS3 polymorphisms and haplotypes with ABI after adjustment for covariates (age, sex, body mass index, smoking, total cholesterol, HDL cholesterol, and diabetes). Two specific SNPs in significant LD with each other (rs891512 and rs1808593) were significantly associated with ABI in both subsets. Based on a sliding window approach with a window size of 2, estimated haplotypes from 2 SNP pairs (rs2070744-rs3918226 and rs1808593-rs7830) were also significantly associated with ABI in both subsets. In conclusion, specific NOS3 SNPs and haplotypes were associated with inter-individual variation in ABI, a non-invasive marker of peripheral arterial disease, in replicate subsets of hypertensive subjects. These findings motivate further investigation of the role of NOS3 variants in determining susceptibility to peripheral arterial disease.

  17. Clinical research of comprehensive rehabilitation in treating brachial plexus injury patients

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jun-ming; GU Yu-dong; XU Xiao-jun; ZHANG Shen-yu; ZHAO Xin

    2012-01-01

    Background Brachial plexus injury is one of the difficult medical problems in the world.The aim of this study was to observe the clinical therapeutic effect of comprehensive rehabilitation in treating dysfunction after brachial plexus injury.Methods Forty-three cases of dysfunction after brachial plexus injury were divided into two groups randomly.The treatment group,which totaled 21 patients (including 14 cases of total brachial plexus injury and seven cases of branch brachial plexus injury),was treated with comprehensive rehabilitation including transcutaneous electrical nerve stimulation,mid-frequency electrotherapy,Tuina therapy,and occupational therapy.The control group,which totaled 22patients (including 16 cases of total brachial plexus injury and six cases of branch brachial plexus injury),was treated with home-based electrical nerve stimulation and occupational therapy.Each course was of 30 days duration and the patients received four courses totally.After four courses,the rehabilitation effect was evaluated according to the brachial plexus function evaluation standard and electromyogram (EMG) assessment.Results In the treatment group,there was significant difference in the scores of brachial plexus function pre- and post-treatment (P <0.01 ) in both "total" and "branch" injury.The scores of two "total injury" groups had statistical differences (P <0.01),while the scores of two "branch injury" groups had statistical differences (P<0.05) after four courses.EMG suggested that the.appearance of regeneration potentials of the recipient nerves in the treatment group was earlier than the control group and had significant differences (P <0.05).Conclusion Comprehensive rehabilitation was more effective in treating dysfunction after brachial plexus injury thannonintegrated rehabilitation.

  18. Brachial versus central blood pressure and vascular stiffness

    DEFF Research Database (Denmark)

    Rasmussen, Susanne; Hansen, Tine; Frimodt-Møller, Marie

    2009-01-01

    Central blood pressure (BP) estimates the true load imposed on the left ventricle to a higher degree than does brachial BP. Increased aortic pulse wave velocity (aPWV) and central BP are risk markers for cardiovascular disease. Both can be measured by simple and noninvasive methods. Guidelines...... recommend measurements of aPWV for diagnosis and treatment of hypertension. However, the availability of the method is limited. Intervention studies showing a reduction of aPWV and indices of central BP are independently associated with fewer cardiovascular events are required as normal reference values...

  19. Brachial versus central blood pressure and vascular stiffness

    DEFF Research Database (Denmark)

    Rasmussen, Susanne; Hansen, Tine; Frimodt-Møller, Marie

    2010-01-01

    Central blood pressure (BP) estimates the true load imposed on the left ventricle to a higher degree than does brachial BP. Increased aortic pulse wave velocity (aPWV) and central BP are risk markers for cardiovascular disease. Both can be measured by simple and noninvasive methods. Guidelines...... recommend measurements of aPWV for diagnosis and treatment of hypertension. However, the availability of the method is limited. Intervention studies showing a reduction of aPWV and indices of central BP are independently associated with fewer cardiovascular events are required as normal reference values...

  20. Obesity in children with brachial plexus birth palsy.

    Science.gov (United States)

    Singh, Avreeta K; Mills, Janith; Bauer, Andrea S; Ezaki, Marybeth

    2015-11-01

    Fetal macrosomia is associated with a 14-fold increased risk of brachial plexus birth palsy (BPBP), and is a predictor of childhood obesity. The purpose of this study was to identify the relationships between BPBP, fetal macrosomia, and childhood obesity. We retrospectively reviewed 214 children with BPBP. The average age was 8 years and 53% had a Narakas 1 grade BPBP. Overall, 49% of children were normal weight, 22% overweight, and 29% obese. Of the children with a history of fetal macrosomia, 41% were obese; a statistically significant difference. Overall quality of life scores, however, were not correlated with obesity.

  1. Arterial Ageing

    OpenAIRE

    Lee, Seung-Jun; Park, Sung-Ha

    2013-01-01

    Arterial ageing is characterized by age associated degeneration and sclerosis of the media layer of the large arteries. However, besides ageing, clinical conditions, which enhance oxidative stress and inflammation act to accelerate the degree of arterial ageing. In this review, we summarized the pathophysiology and contributing factors that accelerate arterial ageing. Among them, we focused on hypertension, the renin-angiotensin-aldosterone system and vascular inflammation which are modifiabl...

  2. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-18

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

  3. The localization of brachial plexus nerve roots and ultrasonographic characteristics in healthy adults%高频超声对正常成人臂丛神经根和椎间孔的定位及其图像特征

    Institute of Scientific and Technical Information of China (English)

    冯桦; 周晓东; 陈定章; 丛锐; 张党谋

    2011-01-01

    Objective To explore localization markers of normal brachial plexus intervertebral foramen and nerve root by high-resolution ultrasonography. Methods The brachial plexus intervertebral foramen and nerve root of corpse were localized by the metal probe under the guidance of high-resolution ultrasonography. The normal brachial plexus nerve root and cervicothoracic specimen of body ultrasound images were compared and the normal ultrasonographic imagings of brachial plexus were observed. Results The root of parapophysisi and vertebral artery were detected to be valuable anatomy landmarks for mapping of intervertebral foramen. The detection ratios of different normal brachial plexus were 100% ( 100/100 ) for C5-C8 and 34% ( 34/100 ) for T1 and lower trunk. Conclusion High-resolution ultrasonography provides brachial plexus intervertebral foramen and nerve root ultrasound images with high quality, which shows great potential in improving noninvasive diagnostic rate of brachial plexus lesions and localization of anesthesia.%目的 探讨应用高频超声对正常成人臂丛神经根和椎间孔定位的准确性及影响因素.方法 在高频超声引导下使用金属探针对成人尸体颈胸段双侧臂丛神经椎间孔及神经根行穿刺定位,并与正常成人臂丛神经声像图对照分析.结果 声像图显示,颈椎椎体横突根部和椎动脉是辨认和定位椎间孔及其内神经根发出水平的重要解剖标志.50例受检者中,所有受检者均可观察到C5~C8水平的神经根,显示率为100%(100/100),T1和下干显示率为34%(34/100).结论 高频超声可准确区分和定位臂丛神经各个神经根及椎间孔位置,可为臂丛神经损伤及局部麻醉的定位诊断提供可靠的影像学依据和参考.

  4. Comparison between absorbable and nonabsorbable sutures in arterial anastomoses in growing dogs.

    Science.gov (United States)

    Gersak, B

    1991-01-01

    Five dogs, 10 weeks old, underwent operation using ketamin-HCl anesthesia and end-to-end anastomoses of the femoral and brachial arteries were made using polyfilament nonabsorbable material (Ethibond), monofilament nonabsorbable material (Prolene), polyfilament absorbable material (Vicryl) and monofilament absorbable material (PDS). The arterial diameter using a micrometer and blood flow using an electromagnetic flow meter were determined. After six months another operation was performed and diameter and blood flow were measured again. No statistically significant differences were found between the different materials used with respect to growth related increases either in arterial diameter or blood flow.

  5. Retrograde transdorsal-to-plantar or transplantar-to-dorsal intraluminal re-entry treatment following unsuccessful subintimal angioplasty for below-the-ankle arterial occlusion

    International Nuclear Information System (INIS)

    Objective: To assess the technical feasibility and efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) intraluminal re-entry procedure following unsuccessful subintimal angioplasty for the treatment of arterial occlusion below the ankle. Methods: TDP or TPD retrograde intraluminal re-entry angioplasty was carried out in 8 diseased limbs of 8 diabetic patients (5 males and 3 females, aged 62∼81 years with a mean age of 75±8 years), who were accompanied with chronic below-the-ankle arterial occlusive disease, after the standard transtibial subintimal angioplasty had failed. Both before and after the procedure the clinical symptoms, dorsal or plantar arterial pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the degree of pain relief, the healing of the wound, the salvage of the diseased limb and the restenosis occurrence of the target vessels were evaluated. Results: Of the total 8 patients, TDP or TPD retrograde intraluminal re-entry angioplasty was successfully performed in 5(62.5%). After the treatment the foot pain was markedly relieved, the median pulse volume scores and ankle-brachial indexes were increased from 0.60±0.55 and 0.32±0.20 before the procedure to 2.40±0.55 and 0.75±0.12 after the procedure, respectively (P<0.01 for both). At the end of the follow-up lasting for twelve months, the visual analogue scale was apparently improved, the scores decreased from preoperative 7.40±1.14 to 2.20±1.48 (P=0.002). Of two cases with intractable skin ulcer, the skin lesion was completely healed in one and was significantly decreased in size in another. No amputation surgery was needed in all successfully treated patients. Magnetic resonance angiography revealed that one target vessel developed re-stenosis. Conclusion: TDP and TDP retrograde intraluminal re-entry techniques are clinically feasible and effective for the

  6. Ankle Brachial Pressure Index (ABPI: An update for practitioners

    Directory of Open Access Journals (Sweden)

    Mo Al-Qaisi

    2009-09-01

    Full Text Available Mo Al-Qaisi1, David M Nott1, David H King2, Sam Kaddoura11Imperial College, London, UK; 2Broomfield Hospital, Chelmsford, Essex, UKAbstract: Peripheral vascular disease affects some 12%–14% of the general population, and the majority of people with the disease are asymptomatic. The Ankle Brachial Pressure Index (ABPI test is widely used by a diverse range of practitioners (in the community and hospital setting in order to screen asymptomatic patients, diagnose patients with clinical symptoms, and to monitor patients who have had radiological or surgical intervention. This paper explains the theoretical basis of the ABPI test, as well as the relevance of the common modifications of the test. It explores the background to the quoted normal ranges for the ABPI test. It reviews the large body of literature that has developed on the association between ABPI and cardiovascular risk, as well as ABPI as a predictor for cardiovascular morbidity and mortality, highlighting the evidence that can inform practice. The review looks critically at the limitations of the ABPI test, providing practitioners with an evidence-based update on the importance and challenges of standardizing ABPI methodology. This paper highlights the influence of the key technical aspects of the ABPI test that all practitioners need to consider in order to be able to make more reliable and informed management decisions based on ABPI findings.Keywords: ankle, brachial, pressure, index, ABPI, update

  7. Brachial plexus surgery: our concept of the last twelve years.

    Science.gov (United States)

    Berger, A; Becker, M H

    1994-01-01

    In patients with brachial plexus injuries restoration of complete function is seldom seen. The diagnosis is a clinical one; investigations such as MRI or myelography are not sufficiently reliable to base surgical indications on them. Surgery has to be performed within the first six months after the trauma. The surgical procedure firstly includes an exact intraoperative definition of the extent of the lesion. Depending on the type of the lesion, microsurgical neurolysis, nerve grafting, or reneurotization is performed. When regeneration is complete, secondary operations may follow if necessary as part of our integrated concept. The spectrum of secondary operations in our patients includes arthrodesis, tenodesis, tendon transfers, muscle transfers, and free neurovascular tissue transfer. In selected cases with extensive lesions a bifunctional latissimus dorsi transfer allows restoration of minimal grip with simultaneous elbow flexion. Our concept includes a series of hierarchical steps: 1. Diagnosis and indication 2. Nerve repair 3. Intensive physiotherapy, control in intervals 4. Secondary operations--if necessary 5. Intensive physiotherapy 6. Ergotherapy, orthosis In the last 12 years 362 patients with brachial plexus lesions have been operated on in our clinic. In these patients we performed 104 neurolyses, 126 nerve grafting procedures, 87 reneurotizations, and 191 secondary operations in 96 patients. Only the combination of nerve repair with both conventional and newer methods of tendon and muscle transfers can restore the maximum function for the individual situation. PMID:7700136

  8. Our experience on brachial plexus blockade in upper extremity surgery

    Directory of Open Access Journals (Sweden)

    Ömer Uslukaya

    2012-03-01

    Full Text Available Objective: Peripheral nerve blocks are usually used either alone or along with general anesthesia for postoperative analgesia. We also aimed to present the results and experiences.Materials and methods: This retrospective study was conducted to scan the files of patients who underwent orthopedic upper extremity surgery with peripheral nerve block between September 2009 and October 2010. After ethics committee approval was obtained, 114 patients who were ASA physical status I-III, aged 18-70, performed upper extremity surgery in the Orthopedics and Traumatology Clinic were included to study. Patients’ demographic data, clinical diagnoses, premedication status, peripheral block type, local anesthetic dose, stimuplex needle types, hemodynamic parameters at the during surgery, the first postoperative analgesic requirements, complications and patient satisfaction were recorded.Results: Demographic data were similar to each other. Brachial plexus block was commonly performed for the forearm surgery. Infraclavicular block was performed the most frequently to patients. As the classical methods in the supine position were preferred in 98.2% of patients, Stimuplex A needle (B. Braun, Melsungen AG, Germany have been used for blockage in 80.7% of patients. Also, in 54.4% of patients, 30 ml of local anesthetic solution composed of bupivacaine + prilocaine was used for blockade. Blocks applied to patients had provided adequate anesthesia.Conclusion: Since the brachial plexus blockade guided peripheral nerve stimulator for upper extremity surgery provide adequate depth of anesthesia and analgesia, it may be a good alternative to general anesthesia because of unwanted side effects

  9. USE OF DEXMEDETOMIDINE ALONG WITH BUPIVACAINE FOR BRACHIAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Rachana Gandhi

    2012-02-01

    Full Text Available Introduction: Supraclavicular brachial plexus block provides safe, effective, low cost anaesthesia with good postoperative analgesia. This study was conducted to compare the postoperative analgesic efficacy and safety of dexmedetomidine for brachial plexus blockade along with bupivacaine. Methodology: This prospective double blind study was conducted on 70 patients of age 18 to 60 years posted for various upper limb surgeries and randomly allocated into two equal groups of 35 each. Control group-C received injection bupivacaine (0.25% 38 milliliter plus 2 milliliter normal saline, dexmedetomidine group-D received injection bupivacaine (0.25% 38 milliliter plus dexmedetomidine 30 microgram (2 milliliter. Assessment of motor and sensory blockade, pulse, systolic blood pressure, respiration and side effects were noted every 5 minutes for first 30 minute and every 10 minute till end of surgery. Duration of analgesia and incidence of various complications following the procedure were observed. Results: It was observed that in control group onset of motor and sensory blockade was faster. Where as, dexmedetomidine group have better hemodynamic stability and greater postoperative analgesia. Only two cases of bradycardia and two cases of hypotension were noticed in dexmedetomidine group-D. [National J of Med Res 2012; 2(1.000: 67-69

  10. Prevalencia de calcificación arterial y factores de riesgo cardiovascular asociados: Estudio multicéntrico poblacional ARTPER Prevalence of arterial calcification and related risk factors: The multicenter population-based ARTPER study

    Directory of Open Access Journals (Sweden)

    María Teresa Alzamora

    2012-02-01

    Full Text Available Objetivos: Estudiar la prevalencia de calcificación arterial (índice tobillo-brazo >1,4 y de factores de riesgo cardiovascular asociados en población general >49 años de edad. Métodos: Estudio transversal, 3786 sujetos seleccionados aleatoriamente en 28 centros. Para el cálculo de la prevalencia se usó toda la muestra, excluyendo los sujetos con arteriopatía periférica (índice tobillo-brazo Objective: To determine the prevalence of arterial calcification (ankle-brachial index >1.4 and its related factors among the general population aged >49 years. Methods: We performed a cross-sectional study of 3,786 people randomly selected from 28 centers. To assess the factors associated with arterial calcification using a multivariate logistic model, the whole sample was used to compute prevalence, excluding persons with peripheral arterial disease (ankle-brachial index <0.9. Results: Arterial calcification was found in 235 persons (prevalen 6.2%; 95% CI: 5.6-7.0, and was twice as frequent in men as in women. Patients with arterial calcification were older, had more previous cardiovascular events, diabetes and obesity, and were less able to perform physical activity than persons with a healthy ankle-brachial index. Conclusions: We recommend measurement of the ankle-brachial index in primary care centers to detect arterial calcification among men, persons with diabetes, overweight, obesity or difficulty in performing physical activity, and in those with left ventricular hypertrophy.

  11. A prospective randomized longitudinal study involving 6 months of endurance or resistance exercise. Conduit artery adaptation in humans.

    Science.gov (United States)

    Spence, Angela L; Carter, Howard H; Naylor, Louise H; Green, Daniel J

    2013-03-01

    Abstract  This randomized trial evaluated the impact of different exercise training modalities on the function and size of conduit arteries in healthy volunteers. Young (27 ± 5 years) healthy male subjects were randomized to undertake 6 months of either endurance training (ET; n = 10) or resistance training (RT; n = 13). High-resolution ultrasound was used to determine brachial, femoral and carotid artery diameter and wall thickness (IMT) and femoral and brachial flow-mediated dilatation (FMD) and glyceryl trinitrate (GTN)-mediated dilatation. Improvements in peak oxygen uptake occurred with ET (from 3.6 ± 0.7 to 3.8 ± 0.6 l min(-1), P = 0.024) but not RT. Upper body muscular strength increased following RT (from 57.8 ± 17.7 to 69.0 ± 19.5 kg, P lean body mass (ET, 1.4 ± 1.8 kg and RT, 2.3 ± 1.3 kg, P < 0.05). Resistance training increased brachial artery resting diameter (from 3.8 ± 0.5 to 4.1 ± 0.4 mm, P < 0.05), peak FMD diameter (+0.2 ± 0.2 mm, P < 0.05) and GTN-mediated diameter (+0.3 ± 0.3 mm, P < 0.01), as well as brachial FMD (from 5.1 ± 2.2 to 7.0 ± 3.9%, P < 0.05). No improvements in any brachial parameters were observed following ET. Conversely, ET increased femoral artery resting diameter (from 6.2 ± 0.7 to 6.4 ± 0.6 mm, P < 0.05), peak FMD diameter (+0.4 ± 0.4 mm, P < 0.05) and GTN-induced diameter (+0.3 ± 0.3 mm, P < 0.05), as well as femoral FMD-to-GTN ratio (from 0.6 ± 0.3 to 1.1 ± 0.8, P < 0.05). Resistance training did not induce changes in femoral artery parameters. Carotid artery IMT decreased in response to both forms of training. These findings indicate that 6 months of supervised exercise training induced changes in brachial and femoral artery size and function and decreased carotid artery IMT. These impacts of both RT and ET would be expected to translate to decreased cardiovascular risk. PMID:23247114

  12. Intraoperative radial nerve injury during coronary artery surgery – report of two cases

    Directory of Open Access Journals (Sweden)

    Tsivgoulis Georgios

    2006-12-01

    Full Text Available Abstract Background Peripheral nerve injury and brachial plexopathy are known, though rare complications of coronary artery surgery. The ulnar nerve is most frequently affected, whereas radial nerve lesions are much less common accounting for only 3% of such intraoperative injuries. Case presentations Two 52- and 50-year-old men underwent coronary artery surgery. On the first postoperative day they both complained of wrist drop on the left. Neurological examination revealed a paresis of the wrist and finger extensor muscles (0/5, and the brachioradialis (4/5 with hypoaesthesia on the radial aspect of the dorsum of the left hand. Both biceps and triceps reflexes were normoactive, whereas the brachioradialis reflex was diminished on the left. Muscles innervated from the median and ulnar nerve, as well as all muscles above the elbow were unaffected. Electrophysiological studies were performed 3 weeks later, when muscle power of the affected muscles had already begun to improve. Nerve conduction studies and needle electromyography revealed a partial conduction block of the radial nerve along the spiral groove, motor axonal loss distal to the site of the lesion and moderate impairment in recruitment with fibrillation potentials in radial innervated muscles below the elbow and normal findings in triceps and deltoid. Electrophysiology data pointed towards a radial nerve injury in the spiral groove. We assume external compression as the causative factor. The only apparatus attached to the patients' left upper arm was the sternal retractor, used for dissection of the internal mammary artery. Both patients were overweight and lying on the operating table for a considerable time might have caused the compression of their left upper arm on the self retractor's supporting column which was fixed to the table rail 5 cm above the left elbow joint, in the site where the radial nerve is directly apposed to the humerus. Conclusion Although very uncommon, external

  13. Association between non-alcoholic fatty liver disease and arterial stiffness in the non-obese, non-hypertensive, and non-diabetic young and middle-aged Chinese population

    OpenAIRE

    Yu, Xin-Yan; Zhao, Yi; Song, Xiao-xiao; Song, Zhen-ya

    2014-01-01

    Background and objective: Non-alcoholic fatty liver disease (NAFLD) is associated with arterial stiffness in the general population. Age, obesity, hypertension, and diabetics are risk factors for arterial stiffness. In this study, we aimed to investigate the association between NAFLD and arterial stiffness as measured by brachial-ankle pulse wave velocity (baPWV) in the non-obese, non-hypertensive, and non-diabetic young and middle-aged Chinese population. Methods: A cross-sectional study wit...

  14. POSSIBLE ENTRAPMENT OF THE ULNAR ARTERY BY THE THIRD HEAD OF PRONATOR TERES MUSCLE. EL POSIBLE ATRAPAMIENTO DE LA ARTERIA ULNAR POR EL TERCER FASCÍCULO DEL MÚSCULO PRONADOR TERES

    OpenAIRE

    Satheesha Nayak B; Ashwini Aithal; Srinivasa Rao Sirasanagandla; Naveen Kumar

    2012-01-01

    Knowledge of variations at and in the surroundings of cubital fossa is useful for the orthopedic surgeons, plastic surgeons and medical practitioners in general. During routine dissection, we observed arterial and muscular variations in and around the cubital fossa. The brachial artery terminated 2 inches above the base of the cubital fossa. The radial and ulnar arteries entered the cubital fossa by passing in front of the tendons of brachialis and biceps brachii respectively. The ulnar arter...

  15. Arterial damages in acute elbow dislocations: which diagnostic tests are required?

    Science.gov (United States)

    Lutter, Christoph; Pfefferkorn, Ronny; Schoeffl, Volker

    2016-07-19

    Blunt vessel injuries of peripheral arteries caused by a direct trauma are rare. Studies have described the frequency of arterial ruptures following closed elbow dislocations in 0.3-1.7% of all cases. However, arterial damage does not always necessarily appear as a complete rupture of the vessel with a loss of peripheral circulation and ischaemic symptoms; a relatively strong periarticular system of collaterals can maintain circulation. Furthermore, the traumatic dislocation can also cause intimal tears, arterial dissections and aneurysms or thrombosis. In all cases of vessel injury, including total disruption, a peripheral pulse might still be palpable. 3 weeks after an acute elbow dislocation, we have diagnosed a patient with a long-segment stenosis of the brachial artery and a thrombosis of the radial artery. Therefore, the close anatomic proximity to the neurovascular structures should always be considered in cases of elbow dislocations, even if peripheral pulses are traceable.

  16. Association of Brachial-Ankle Pulse Wave Velocity and Cardiomegaly With Aortic Arch Calcification in Patients on Hemodialysis.

    Science.gov (United States)

    Shin, Ming-Chen Paul; Lee, Mei-Yueh; Huang, Jiun-Chi; Tsai, Yi-Chun; Chen, Jui-Hsin; Chen, Szu-Chia; Chang, Jer-Ming; Chen, Hung-Chun

    2016-05-01

    Aortic arch calcification (AoAC) is associated with cardiovascular and all-cause mortality in end-stage renal disease population. AoAC can be simply estimated with an AoAC score using plain chest radiography. The objective of this study is to evaluate the association of AoAC with brachial-ankle pulse wave velocity (baPWV) and cardiomegaly in patients who have undergoing hemodialysis (HD).We retrospectively determined AoAC and cardiothoracic ratio (CTR) by chest x-ray in 220 HD patients who underwent the measurement of baPWV. The values of baPWV were measured by an ankle-brachial index-form device. Multiple stepwise logistic regression analysis was used to identify the factors associated with AoAC score >4.Compared patients with AoAC score ≦4, patients with AoAC score >4 had older age, higher prevalence of diabetes and cerebrovascular disease, lower diastolic blood pressure, higher baPWV, higher CTR, higher prevalence of CTR ≧50%, lower total cholesterol, and lower creatinine level. After the multivariate stepwise logistic analysis, old age, cerebrovascular disease, high baPWV (per 100 cm/s, odds ratio [OR] 1.065, 95% confidence interval [CI] 1.003-1.129, P = 0.038), CTR (per 1%, OR 1.116, 95% CI 1.046-1.191, P = 0.001), and low total cholesterol level were independently associated with AoAC score >4.Our study demonstrated AoAC severity was associated with high baPWV and high CTR in patients with HD. Therefore, we suggest that evaluating AoAC on plain chest radiography may be a simple and inexpensive method for detecting arterial stiffness in HD patients. PMID:27175684

  17. Schwannoma of the brachial plexus: cross-sectional imaging diagnosis using CT, sonography, and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rettenbacher, Thomas; Soegner, Peter; Springer, Peter; Nedden, Dieter zur [Department of Radiology II, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Fiegl, Michael [Department of Internal Medicine, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Hussl, Heribert [Department of Plastic and Reconstructive Surgery, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria)

    2003-08-01

    Primary brachial plexus tumors are rare, usually benign, and in general have a good prognosis after surgical excision. We present a case of a schwannoma in which sonography enabled the correct diagnosis of a probably benign brachial plexus tumor. Key to the diagnosis was the demonstration of a smooth-bordered, longish, and well-defined nodule along a brachial plexus nerve root. Cross-sectional imaging modalities that provide a high degree of soft tissue contrast and spatial resolution, such as sonography and MR imaging, were suitable methods to establish the correct preoperative diagnosis. Findings at CT, sonography, MR imaging, and surgery are discussed. (orig.)

  18. The product of resting heart rate times blood pressure is associated with high brachial-ankle pulse wave velocity.

    Directory of Open Access Journals (Sweden)

    Anxin Wang

    Full Text Available OBJECTIVE: To investigate potential associations between resting heart rate, blood pressure and the product of both, and the brachial-ankle pulse wave velocity (baPWV as a maker of arterial stiffness. METHODS: The community-based "Asymptomatic Polyvascular Abnormalities in Community (APAC Study" examined asymptomatic polyvascular abnormalities in a general Chinese population and included participants with an age of 40+ years without history of stroke and coronary heart disease. Arterial stiffness was defined as baPWV≥1400 cm/s. We measured and calculated the product of resting heart rate and systolic blood pressure (RHR-SBP and the product of resting heart rate and mean arterial pressure (RHR-MAP. RESULTS: The study included 5153 participants with a mean age of 55.1 ± 11.8 years. Mean baPWV was 1586 ± 400 cm/s. Significant (P<0.0001 linear relationships were found between higher baPWV and higher resting heart rate or higher arterial blood pressure, with the highest baPWV observed in individuals from the highest quartiles of resting heart rate and blood pressure. After adjusting for confounding parameters such as age, sex, educational level, body mass index, fasting blood concentrations of glucose, blood lipids and high-sensitive C-reactive protein, smoking status and alcohol consumption, prevalence of arterial stiffness increased significantly (P<0.0001 with increasing RHR-SBP quartile (Odds Ratio (OR: 2.72;95%Confidence interval (CI:1.46,5.08 and increasing RHR-MAP (OR:2.10;95%CI:1.18,3.72. Similar results were obtained in multivariate linear regression analyses with baPWV as continuous variable. CONCLUSIONS: Higher baPWV as a marker of arterial stiffness was associated with a higher product of RHR-SBP and RHR-MAP in multivariate analysis. In addition to other vascular risk factors, higher resting heart rate in combination with higher blood pressure are risk factors for arterial stiffness.

  19. Accidental Coverage of Both Renal Arteries during Infrarenal Aortic Stent-Graft Implantation: Cause and Treatment

    Directory of Open Access Journals (Sweden)

    Umberto Marcello Bracale

    2014-01-01

    Full Text Available The purpose of this paper is to report a salvage maneuver for accidental coverage of both renal arteries during endovascular aneurysm repair (EVAR of an infrarenal abdominal aortic aneurysm (AAA. A 72-year-old female with a 6 cm infrarenal abdominal aortic aneurysm was treated by endovascular means with a standard bifurcated graft. Upon completing an angiogram, both renal arteries were found to be accidentally occluded. Through a left percutaneous brachial approach, the right renal artery was catheterized and a chimney stent was deployed; however this was not possible for the left renal artery. A retroperitoneal surgical approach was therefore carried out with a retrograde chimney stent implanted to restore blood flow. After three months, both renal arteries were patent and renal function was not different from the baseline. Both endovascular with percutaneous access via the brachial artery and open retroperitoneal approaches with retrograde catheterization are feasible rescue techniques to recanalize the accidentally occluded renal arteries during EVAR.

  20. A theoretical analysis of the median LMF adaptive algorithm

    DEFF Research Database (Denmark)

    Bysted, Tommy Kristensen; Rusu, C.

    1999-01-01

    the speed of convergence, no analytical studies have yet been made to prove this. In order to enhance the usability, this paper presents a convergence and steady-state analysis of the median LMF adaptive algorithm. As expected this proves that the median LMF has a slower convergence and a lower steady...

  1. Head rotation and sound image localization in the median plane

    Institute of Scientific and Technical Information of China (English)

    RAO Dan; XIE Bosun

    2005-01-01

    The effect of head rotation on median plane sound source (or image) localization is studied. It is suggested that, at low frequency, the change of interaural time difference (ITD) caused by head rotation supplies information for determining sound source direction in the median plane. Based on the suggestion, the summed sound image localization equations for multiple loudspeakers arranged in the median plane are derived. Especially, for a pair of loudspeakers arranged front-back symmetrically in the median plane, the localization equations are similar to that of stereophonic sound in horizontal plane. A sound image localization experiment was carried out to prove the theoretical analysis. The results of this paper are not only available to virtual spatial auditory, but also supply a quantitative validation of the hypothesis that head rotation is a cue for sound source localization in the median plane at low frequency.

  2. Adaptive Threshold Median Filter for Multiple-Impulse Noise

    Institute of Scientific and Technical Information of China (English)

    JIANG Bo; HUANG Wei

    2007-01-01

    Attenuating the noises plays an essential role in the image processing. Almost all the traditional median filters concern the removal of impulse noise having a single layer, whose noise gray level value is constant. In this paper, a new adaptive median filter is proposed to handle those images corrupted not only by single layer noise. The adaptive threshold median filter(ATMF) has been developed by combining the adaptive median filter (AMF) and two dynamic thresholds. Because of the dynamic threshold being used, the ATMF is able to balance the removal of the multiple-impulse noise and the quality of image. Comparison of the proposed method with traditional median filters is provided. Some visual examples are given to demonstrate the performance of the proposed Filter.

  3. Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: a systematic review.

    Science.gov (United States)

    Brownrigg, J R W; Hinchliffe, R J; Apelqvist, J; Boyko, E J; Fitridge, R; Mills, J L; Reekers, J; Shearman, C P; Zierler, R E; Schaper, N C

    2016-01-01

    Non-invasive tests for the detection of peripheral artery disease (PAD) among individuals with diabetes mellitus are important to estimate the risk of amputation, ulceration, wound healing and the presence of cardiovascular disease, yet there are no consensus recommendations to support a particular diagnostic modality over another and to evaluate the performance of index non-invasive diagnostic tests against reference standard imaging techniques (magnetic resonance angiography, computed tomography angiography, digital subtraction angiography and colour duplex ultrasound) for the detection of PAD among patients with diabetes. Two reviewers independently screened potential studies for inclusion and extracted study data. Eligible studies evaluated an index test for PAD against a reference test. An assessment of methodological quality was performed using the quality assessment for diagnostic accuracy studies instrument. Of the 6629 studies identified, ten met the criteria for inclusion. In these studies, the patients had a median age of 60-74 years and a median duration of diabetes of 9-24 years. Two studies reported exclusively on patients with symptomatic (ulcerated/infected) feet, two on patients with asymptomatic (intact) feet only, and the remaining six on patients both with and without foot ulceration. Ankle brachial index (ABI) was the most widely assessed index test. Overall, the positive likelihood ratio and negative likelihood ratio (NLR) of an ABI threshold saturation of peripheral blood and Doppler wave form analyses had NLRs of 0.2 and wave form analysis may be superior to ABI for diagnosing PAD in patients with neuropathy with and without foot ulcers. There were insufficient data to support the adoption of one particular diagnostic modality over another and no comparisons existed with clinical examination. The quality of studies evaluating diagnostic techniques for the detection of PAD in individuals with diabetes is poor. Improved compliance with

  4. Direct anastomosis of contralateral C7 nerve root transfer with affected-side inferior trunk for repair of brachial plexus avulsion injury

    Institute of Scientific and Technical Information of China (English)

    Houjun Yan; Changqing Hu; Yingli Jia; Chunjie Cui; Xuefeng Li; Jingyang Zhang

    2006-01-01

    AIM:To observe the effect of direct anastomosis of contralateral C7 nerve root transferred through prespinal route with affected-side inferior trunk for repair of brachial plexus avulsion injury,and investigate its feasibility. METHODS:Two male patients.with the age of 24 and 41 years respectively,were retrieved.When admitted to the hospital,they were diagnosed as brachial plexus avulsion injury.They subjected the operation in the 252 Hospital of Chinese PLA in March 2006 and May 2006 respectively.The proximal end of contralateral C7 nerve root was dissociated to nerve root pore and the distal end was dissociated to anterior and posterior divisions of middle trunk.The injured C7 nerve root was widely dissociated to inferior trunk,medial cord,ulnar nerve and medial head of median nerve.When elbow and shoulder joints were in flexion,the injured C7 nerve root was directly anastomosed with contralateral C7 nerve root in the gap between affected-side cervical vagina vasorum and esophagus with no tensions. RESULTS:Durling 3 to 5 hours of operation,little hemorrhage was found,nerves were not used for connection.Dyspnea,hoarse voice and other complications did not appear,either.In the postoperative 7th to 8th months.electremyogram examination showed that the growth velocity of anastomosed nerve was normal.CONCLUSION:Direct anastomosis of contralateral C7 nerve root transferred through prespinal route with affected-side inferior trunk can be used for repair of brachial plexus avulsion injury with satisfying therapeutic effects.

  5. Axillary artery aneurysm in tuberous sclerosis: cross-sectional imaging findings

    International Nuclear Information System (INIS)

    A 10-month-old boy with a known diagnosis of tuberous sclerosis presented with axillary and brachial masses. Cross-sectional imaging with computed tomography, magnetic resonance, and ultrasound demonstrated unsuspected aneurysms of the axillary and brachial arteries. The results of these studies significantly changed the preoperative planning for this patient, who was scheduled for a biopsy of a presumed soft-tissue tumor. To our knowledge, this is the first description of the cross-sectional imaging findings in the extremity peripheral vascular manifestation of tuberous sclerosis; it has only been previously described on angiography in one case. The rare association of peripheral arterial aneurysms with tuberous sclerosis is important to recognize not only for clinical diagnosis but also for appropriate surgical treatment and genetic counseling. (orig.)

  6. The reliability of the ankle-brachial index in the Atherosclerosis Risk in Communities (ARIC study and the NHLBI Family Heart Study (FHS

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    Catellier Diane J

    2006-02-01

    Full Text Available Abstract Background A low ankle-brachial index (ABI is associated with increased risk of coronary heart disease, stroke, and death. Regression model parameter estimates may be biased due to measurement error when the ABI is included as a predictor in regression models, but may be corrected if the reliability coefficient, R, is known. The R for the ABI computed from DINAMAP™ readings of the ankle and brachial SBP is not known. Methods A total of 119 participants in both the Atherosclerosis Risk in Communities (ARIC study and the NHLBI Family Heart Study (FHS had repeat ABIs taken within 1 year, using a common protocol, automated oscillometric blood pressure measurement devices, and technician pool. Results The estimated reliability coefficient for the ankle systolic blood pressure (SBP was 0.68 (95% CI: 0.57, 0.77 and for the brachial SBP was 0.74 (95% CI: 0.62, 0.83. The reliability for the ABI based on single ankle and arm SBPs was 0.61 (95% CI: 0.50, 0.70 and the reliability of the ABI computed as the ratio of the average of two ankle SBPs to two arm SBPs was estimated from simulated data as 0.70. Conclusion These reliability estimates may be used to obtain unbiased parameter estimates if the ABI is included in regression models. Our results suggest the need for repeated measures of the ABI in clinical practice, preferably within visits and also over time, before diagnosing peripheral artery disease and before making therapeutic decisions.

  7. Ankle-Brachial Index and cardiovascular events in atrial fibrillation. The ARAPACIS Study.

    Science.gov (United States)

    Violi, Francesco; Davì, Giovanni; Proietti, Marco; Pastori, Daniele; Hiatt, William R; Corazza, Gino Roberto; Perticone, Francesco; Pignatelli, Pasquale; Farcomeni, Alessio; Vestri, Anna Rita; Lip, Gregory Y H; Basili, Stefania

    2016-04-01

    Atrial fibrillation (AF) patients are at high risk for thrombotic and vascular events related to their cardiac arrhythmia and underlying systemic atherosclerosis. Ankle-Brachial Index (ABI) is a non-invasive tool in evaluating systemic atherosclerosis, useful in predicting cardiovascular events in general population; no data are available in AF patients. ARAPACIS is a prospective multicentre observational study performed by the Italian Society of Internal Medicine, analysing association between low ABI (≤ 0.90) and vascular events in NVAF out- or in-patients, enrolled in 136 Italian centres. A total of 2,027 non-valvular AF (NVAF) patients aged > 18 years from both sexes followed for a median time of 34.7 (interquartile range: 22.0-36.0) months, yielding a total of 4,614 patient-years of observation. Mean age was 73 ± 10 years old with 55 % male patients. A total of 176 patients (8.7 %) experienced a vascular event, with a cumulative incidence of 3.81 %/patient-year. ABI≤ 0.90 was more prevalent in patients with a vascular event compared with patients free of vascular events (32.2 vs 20.2 %, p5.083; p=0.001). This latter association was also confirmed after excluding patients with previous MI (HR: 2.901, 95 % CI: 1.408-5.990, p=0.004). No association was observed between low ABI and stroke/transient ischaemic attack (p=0.91). In conclusion, low ABI is useful to predict MI and vascular death in NVAF patients and may independently facilitate cardiovascular risk assessment in NVAF patients.

  8. Relationships between Brachial-Ankle Pulse Wave Velocity and Peripheral Neuropathy in Type 2 Diabetes

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    Byung Kil Ha

    2012-12-01

    Full Text Available BackgroundBrachial-ankle pulse wave velocity (baPWV is known to be a good surrogate marker of clinical atherosclerosis. Atherosclerosis is a major predictor for developing neuropathy. The goal of this study was to determine the relationship between baPWV and diabetic peripheral neuropathy (DPN in patients with type 2 diabetes.MethodsA retrospective cross-sectional study was conducted involving 692 patients with type 2 diabetes. The correlation between increased baPWV and DPN, neurological symptoms, and neurological assessment was analyzed. DPN was examined using the total symptom score (TSS, ankle reflexes, the vibration test, and the 10-g monofilament test. DPN was defined as TSS ≥2 and an abnormal neurological assessment. Data were expressed as means±standard deviation for normally distributed data and as median (interquartile range for non-normally distributed data. Independent t-tests or chi-square tests were used to make comparisons between groups, and a multiple logistic regression test was used to evaluate independent predictors of DPN. The Mantel-Haenszel chi-square test was used to adjust for age.ResultsPatients with DPN had higher baPWV and systolic blood pressure, and were more likely to be older and female, when compared to the control group. According to univariate analysis of risk factors for DPN, the odds ratio of the baPWV ≥1,600 cm/sec was 1.611 (95% confidence interval [CI], 1.072 to 2.422; P=0.021 and the odds ratio in female was 1.816 (95% CI, 1.195 to 2.760; P=0.005.ConclusionIncreased baPWV was significantly correlated with peripheral neuropathy in patients with type 2 diabetes.

  9. Effectiveness of surgical banding for high flow in brachial artery-based hemodialysis vascular access

    NARCIS (Netherlands)

    Vaes, R.H.; Wouda, R.; Loon, M.; Hoek, F. van; Tordoir, J.H.; Scheltinga, M.R.

    2015-01-01

    OBJECTIVE: Autogenous arteriovenous hemodialysis (HD) access may develop high flow (>2 L/min) over time. Reducing flow volume of a high-flow access (HFA) using a surgical banding technique has been reported to be successful in the short-term. The aim of this study was to evaluate the efficacy of

  10. Epithelioid hemangioma of brachial artery: report of a case and review of the literature

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    Ragazzi Moira

    2015-01-01

    Full Text Available Epithelioid hemangioma (EH is an uncommon benign vascular lesion, also known as angioblastic lymphoid (or angiolymphoid hyperplasia with eosinophilia, characterized by an unclear etiopathogenesis.

  11. Interscalenic approach to the cervico-brachial plexus.

    Science.gov (United States)

    Evenepoel, M C; Blomme, A

    1981-12-01

    The concept of a closed peri-neurovascular space surrounding the cervicobrachial plexus, introduced by A. Winnie, allows the blockade of the cervical and brachial plexuses by means of a single puncture technique. The single puncture has positive advantages: 1. The rapidity of the blockade; 2. The simplicity of the blockade; 3. Comfort for the patient. The landmarks are easy to make. As with epidural blockade, the injection level and the volume of local anesthetic determine the quality and extent of the block. The traditional indication is surgery of the shoulder and of the supraclavicular area. A new indication seems to be the implantation of a cardiac pacemaker. Complications often quoted in literature are Horner syndrome-a minor complication-and blockade of the ascending branches of the recurrent laryngeal nerve and of the phrenic nerve. The risk of a pneumothorax is almost nil. PMID:7324853

  12. Brachial plexus injury in adults: Diagnosis and surgical treatment strategies

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    Mukund R Thatte

    2013-01-01

    Full Text Available Adult post traumatic Brachial plexus injury is unfortunately a rather common injury in young adults. In India the most common scenario is of a young man injured in a motorcycle accident. Exact incidence figures are not available but of the injuries presenting to us about 90% invole the above combination This article reviews peer-reviewed publications including clinical papers, review articles and Meta analysis of the subject. In addition, the authors′ experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Results have been discussed and analysed to get an idea of factors influencing final recovery. It appears that time from injury and number of roots involved are most crucial.

  13. Temporal pattern of pulse wave velocity during brachial hyperemia reactivity

    Science.gov (United States)

    Graf, S.; Valero, M. J.; Craiem, D.; Torrado, J.; Farro, I.; Zócalo, Y.; Valls, G.; Bía, D.; Armentano, R. L.

    2011-09-01

    Endothelial function can be assessed non-invasively with ultrasound, analyzing the change of brachial diameter in response to transient forearm ischemia. We propose a new technique based in the same principle, but analyzing a continuous recording of carotid-radial pulse wave velocity (PWV) instead of diameter. PWV was measured on 10 healthy subjects of 22±2 years before and after 5 minutes forearm occlusion. After 59 ± 31 seconds of cuff release PWV decreased 21 ± 9% compared to baseline, reestablishing the same after 533 ± 65 seconds. There were no significant changes observed in blood pressure. When repeating the study one hour later in 5 subjects, we obtained a coefficient of repeatability of 4.8%. In conclusion, through analysis of beat to beat carotid-radial PWV it was possible to characterize the temporal profiles and analyze the acute changes in response to a reactive hyperemia. The results show that the technique has a high sensitivity and repeatability.

  14. Misdiagnosis of Brachial Plexus Schwannoma as Cervical Radiculopathy

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    Mahnaz Khajepour

    2013-01-01

    Full Text Available Schwannomas are relatively rare but benign nerve sheath tumors deriving from Schwann cells with low tendency of transformation to malignancy. Extracranial shwannomas usually present insidiously and thus are often diagnosed incorrectly or after lengthy delays. We present the case of a 51 years old female patient with chronic cervical pain radiating in left upper limb who was treated as cervical radiculopathy for 5 years. By aggrevation of pain and paresthesia, imaging and electrodiagnostic study revealed schwannoma of brachial plexus. In case of radiating pain and paresthesia in upper limb (such as this case symptoms can be misleading for cervical radiculopathy but careful examination especialy in persistence of symptoms with negative imaging results for radiculopathies are important and electrodiagnostic study can be helpful.

  15. Brachial plexus variations in its formation and main branches

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    Valéria Paula Sassoli Fazan

    2003-01-01

    Full Text Available PURPOSE: The brachial plexus has a complex anatomical structure since its origin in the neck throughout its course in the axillary region. It also has close relationship to important anatomic structures what makes it an easy target of a sort of variations and provides its clinical and surgical importance. The aims of the present study were to describe the brachial plexus anatomical variations in origin and respective branches, and to correlate these variations with sex, color of the subjects and side of the body. METHODS: Twenty-seven adult cadavers separated into sex and color had their brachial plexuses evaluated on the right and left sides. RESULTS: Our results are extensive and describe a large number of variations, including some that have not been reported in the literature. Our results showed that the phrenic nerve had a complete origin from the plexus in 20% of the cases. In this way, a lesion of the brachial plexus roots could result in diaphragm palsy. It is not usual that the long thoracic nerve pierces the scalenus medius muscle but it occurred in 63% of our cases. Another observation was that the posterior cord was formed by the posterior divisions of the superior and middle trunks in 9%. In these cases, the axillary and the radial nerves may not receive fibers from C7 and C8, as usually described. CONCLUSION: Finally, the plexuses studied did not show that sex, color or side of the body had much if any influence upon the presence of variations.OBJETIVOS: O plexo braquial apresenta uma estrutura anatômica complexa, desde sua origem, no pescoço, até sua ramificação terminal, na região axilar. Ele também apresenta relações importantes com outras estruturas anatômicas locais, o que o torna vulnerável ao aparecimento de uma série de variações anatômicas, marcando sua importância clínica e cirúrgica. Os objetivos desse estudo foram de descrever as variações anatômicas do plexo braquial, desde sua origem até seus

  16. Determinants of Brachial-Ankle Pulse Wave Velocity in Chinese Patients with Rheumatoid Arthritis

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    Ping Li

    2013-01-01

    Full Text Available Objective. To investigate the relationship between Brachial-ankle pulse wave velocity (baPWV, and its associated risk factors in Chinese patients with RA. Methods. 138 Chinese RA patients and 150 healthy subjects were included. baPWV of all the participants was measured. RA related factors were determined, as well as traditional cardiovascular risk factors. Results. baPWV was significant higher in RA group (1705.44 ± 429.20 cm/s compared to the healthy control group (1386.23 ± 411.09 cm/s (P<0.001. Compared with low baPWV group, high baPWV group patients were significantly older (P = 0.008 and taller (P = 0.033. Serum cholesterol (P = 0.035, triglycerides (P = 0.004, and LDL level (P = 0.006 were significantly higher in high baPWV group patients compared with low baPWV group patients. The baPWV of RA patients was positively correlated with age (r = 0.439, P<0.001, and serum cholesterol level (r = 0.231, P = 0.035, serum triglycerides level (r = 0.293, P<0.001, serum LDL level (r = 0.323, P = 0.003. Meanwhile, baPWV negatively correlated with the height of RA patients (r = −0.253, P = 0.043. Multivariate regression analysis showed that baPWV of RA group was independently associated with age and serum triglycerides level. Conclusions. The old age and high level of serum triglycerides may be the major determinants of arterial stiffness in Chinese RA patients.

  17. Assessment of central haemomodynamics from a brachial cuff in a community setting

    Directory of Open Access Journals (Sweden)

    Nunan David

    2012-06-01

    Full Text Available Abstract Background Large artery stiffening and wave reflections are independent predictors of adverse events. To date, their assessment has been limited to specialised techniques and settings. A new, more practical method allowing assessment of central blood pressure from waveforms recorded using a conventional automated oscillometric monitor has recently been validated in laboratory settings. However, the feasibility of this method in a community based setting has not been assessed. Methods One-off peripheral and central haemodynamic (systolic and diastolic blood pressure (BP and pulse pressure and wave reflection parameters (augmentation pressure (AP and index, AIx were obtained from 1,903 volunteers in an Austrian community setting using a transfer-function like method (ARCSolver algorithm and from waveforms recorded with a regular oscillometric cuff. We assessed these parameters for known differences and associations according to gender and age deciles from 80 years in the whole population and a subset with a systolic BP  Results We obtained 1,793 measures of peripheral and central BP, PP and augmentation parameters. Age and gender associations with central haemodynamic and augmentation parameters reflected those previously established from reference standard non-invasive techniques under specialised settings. Findings were the same for patients with a systolic BP below 140 mmHg (i.e. normotensive. Lower values for AIx in the current study are possibly due to differences in sampling rates, detection frequency and/or averaging procedures and to lower numbers of volunteers in younger age groups. Conclusion A novel transfer-function like algorithm, using brachial cuff-based waveform recordings, provides robust and feasible estimates of central systolic pressure and augmentation in community-based settings.

  18. Alcohol consumption and ankle-to-brachial index: results from the Cardiovascular Risk Survey.

    Directory of Open Access Journals (Sweden)

    Xiang Xie

    Full Text Available BACKGROUND AND METHODOLOGY: A low ankle-to-brachial index (ABI is a strong correlate of cardiovascular disease and subsequent mortality. The relationship between ABI and alcohol consumption remains unclear. Data are from the Cardiovascular Risk Survey (CRS, a multiple-ethnic, community-based, cross-sectional study of 14,618 Chinese people (5757 Hans, 4767 Uygurs, and 4094 Kazakhs aged 35 years and over at baseline from Oct. 2007 to March 2010. The relationship between alcohol intake and ABI was determined by use of analysis of covariance and multivariable regressions. PRINCIPAL FINDINGS: In men, alcohol consumption was significantly associated with ABI (P60.0 g/d [OR = 3.857, (95% CI: 2.555-5.824; OR = 2.797, (95% CI: 1.106-3.129; OR = 2.878, (95% CI: 1.215-4.018; respectively] and was significantly lower in men who consumed 20.1-40.0 g/d [OR= 0.330, (95% CI: 0.181-0.599; OR = 0.484, (95% CI: 0.065-0.894; OR = 0.478, (95% CI: 0.243-1.534; respectively] and 40.1-60.0 g/d [OR= 0.306, (95% CI: 0.096-0.969; OR = 0.267, (95% CI: 0.087-0.886; OR = 0.203, (95% CI: 0.113-0.754; respectively] compared with never drinking, respectively (all P0.05 in women. Similarly, PAD was not correlated with alcohol intake in women (all P>0.05. CONCLUSIONS/SIGNIFICANCE: Our results indicated that in Chinese men, alcohol consumption was associated with peripheral artery disease, and consumption of less than 60 g/d had an inverse association with peripheral atherosclerosis whereas consumption of 60 g/d or more had a positive association.

  19. Can we early diagnose metabolic syndrome using brachial-ankle pulse wave velocity in community population?

    Institute of Scientific and Technical Information of China (English)

    Li Xin; Zheng Liang; Wu Juanli; Ma Yunsheng; Masanori Munakata; Oleski Jessica; Zhang Lijuan

    2014-01-01

    Background The prevalence of metabolic syndrome (MetS) increased recently and there was still not a screening index to predict MetS.The aim of this study was to estimate whether brachial-ankle pulse wave velocity (baPVVV),a novel marker for systemic arterial stiffness,could predict MetS in Chinese community population.Methods A total of 2 191 participants were recruited and underwent medical examination including 1 455 men and 756 women from June 2011 to January 2012.MetS was diagnosed according to the criteria of the International Diabetes Federation (IDF).Multiple Logistic regressions were conducted to explore the risk factors of MetS.Receiver operating characteristic (ROC) curve was performed to estimate the ideal diagnostic cutoff point of baPWV to predict MetS.Results The mean age was (45.35±8.27) years old.In multiple Logistic regression analysis,the gender,baPWV and smoking status were risk factors to MetS after adjusting age,gender,baPWV,walk time and sleeping time.The prevalence of MetS was 17.48% in 30-year age population in Shanghai.There were significant differences (X2=96.46,P <0.05) between male and female participants on MetS prevalence.According to the ROC analyses,the ideal cutoff point of baPWV was 1 358.50 cm/s (AUC=60.20%) to predict MetS among male group and 1 350.00 cm/s (AUC=70.90%) among female group.Conclusion BaPWV may be considered as a screening marker to predict MetS in community Chinese population and the diagnostic value of 1 350.00 cm/s was more significant for the female group.

  20. Radiation-induced brachial plexus neuropathy in breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, N.K.; Pfeiffer, P.; Mondrup, K.; Rose, C. (Odense Univ. Hospital (Denmark). Dept. of Neurology Odense Univ. Hospital (Denmark). Dept. of Clinical Neurophysiology Odense Univ. Hospital (Denmark). Dept. of Oncology R)

    1990-01-01

    The incidence and latency period of radiation-induced brachial plexopathy (RBP) were assessed in 79 breast cancer patients by a neurological follow-up examination at least 60 months (range 67-130 months) after the primary treatment. All patients were treated primarily with simple mastectomy, axillary nodal sampling and radiotherapy (RT). Postoperatively, pre- and postmenopausal patients were randomly allocated chemotherapy for antiestrogen treatment. All patients were recurrence-free at time of examination. Clinically, 35% (25-47%) of the patients had RBP; 19% (11-29%) had definite RBP, i.e. were physically disabled, and 16% (9-26%) had probable RBP. Fifty percent (31-69%) had affection of the entire plexus, 18% (7-35%) of the upper trunk only, and 4% (1-18%) of the lower trunk. In 28% (14-48%) of cases assessment of a definite level was not possible. RBP was more common after radiotherapy and chemotherapy (42%) than after radiotherapy alone (26%) but the difference was not statistically significant (p = 0.10). The incidence of definite RBP was significantly higher in the younger age group (p = 0.02). This could be due to more extensive axillary surgery but also to the fact that chemotherapy was given to most premenopausal patients. In most patients with RBP the symptoms began during or immediately after radiotherapy, and were thus without significant latency. Chemotherapy might enhance the radiation-induced effect on nerve tissue, thus diminishing the latency period. Lymphedema was present in 22% (14-32%), especially in the older patients, and not associated with the development of RBP. In conclusion, the damaging effect of RT on peripheral nerve tissue was documented. Since no successful treatment is available, restricted use of RT to the brachial plexus is warranted, especially when administered concomitantly with cytotoxic therapy. (orig.).

  1. Morphometric Atlas Selection for Automatic Brachial Plexus Segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Van de Velde, Joris, E-mail: joris.vandevelde@ugent.be [Department of Anatomy, Ghent University, Ghent (Belgium); Department of Radiotherapy, Ghent University, Ghent (Belgium); Wouters, Johan [Department of Anatomy, Ghent University, Ghent (Belgium); Vercauteren, Tom; De Gersem, Werner; Duprez, Fréderic; De Neve, Wilfried [Department of Radiotherapy, Ghent University, Ghent (Belgium); Van Hoof, Tom [Department of Anatomy, Ghent University, Ghent (Belgium)

    2015-07-01

    Purpose: The purpose of this study was to determine the effects of atlas selection based on different morphometric parameters, on the accuracy of automatic brachial plexus (BP) segmentation for radiation therapy planning. The segmentation accuracy was measured by comparing all of the generated automatic segmentations with anatomically validated gold standard atlases developed using cadavers. Methods and Materials: Twelve cadaver computed tomography (CT) atlases (3 males, 9 females; mean age: 73 years) were included in the study. One atlas was selected to serve as a patient, and the other 11 atlases were registered separately onto this “patient” using deformable image registration. This procedure was repeated for every atlas as a patient. Next, the Dice and Jaccard similarity indices and inclusion index were calculated for every registered BP with the original gold standard BP. In parallel, differences in several morphometric parameters that may influence the BP segmentation accuracy were measured for the different atlases. Specific brachial plexus-related CT-visible bony points were used to define the morphometric parameters. Subsequently, correlations between the similarity indices and morphometric parameters were calculated. Results: A clear negative correlation between difference in protraction-retraction distance and the similarity indices was observed (mean Pearson correlation coefficient = −0.546). All of the other investigated Pearson correlation coefficients were weak. Conclusions: Differences in the shoulder protraction-retraction position between the atlas and the patient during planning CT influence the BP autosegmentation accuracy. A greater difference in the protraction-retraction distance between the atlas and the patient reduces the accuracy of the BP automatic segmentation result.

  2. Upright MRI of glenohumeral dysplasia following obstetric brachial plexus injury.

    Science.gov (United States)

    Nath, Rahul K; Paizi, Melia; Melcher, Sonya E; Farina, Kim L

    2007-11-01

    The purpose of this study was to evaluate the role of upright magnetic resonance imaging (MRI) shoulder scanning in the diagnosis of glenohumeral deformity following obstetric brachial plexus injury (OBPI). Eighty-nine children (ages 0.4 to 17.9 years) with OBPI who have medial rotation contracture and reduced passive and active lateral rotation of the shoulder were evaluated via upright MRI of the affected glenohumeral joint. Qualitative impressions of glenoid form were recorded, and quantitative measurements were made of glenoid version and posterior subluxation. Glenoid version of the affected shoulder averaged -16.8 +/- 11.0 degrees (range, -55 degrees to 1 degrees ), and percentage of the humeral head anterior to the glenoid fossa (PHHA) averaged 32.6 +/- 16.5% (range, -17.8% to 52.4%). The glenoid form was normal in 43 children, convex in 19 children and biconcave in 27 children. Standard MRI protocols were used to obtain bilateral images from 14 of these patients. Among the patients with bilateral MR images, glenoid version and PHHA were significantly different between the involved and uninvolved shoulders (P<.000). Glenoid version in the involved shoulder averaged -19.0 +/- 13.1 degrees (range, -52 degrees to -3 degrees ), and PHHA averaged 29.7 +/- 18.4% (range, -16.2% to 48.7%). In the uninvolved shoulder, the average glenoid version and PHHA were -5.2 +/- 3.7 degrees (range, -12 degrees to -1 degrees ) and 47.7 +/- 3.0% (range, 43% to 54%), respectively. The relative beneficial aspects of upright MRI include lack of need for sedation, low claustrophobic potential and, most important, natural, gravity-influenced position, enabling the surgeon to visualize the true preoperative picture of the shoulder. It is an effective tool for demonstrating glenohumeral abnormalities resulting from brachial plexus injury worthy of surgical exploration. PMID:17448618

  3. Does conduit artery diameter vary according to the anthropometric characteristics of children or men?

    Science.gov (United States)

    Hopkins, N D; Green, D J; Tinken, T M; Sutton, L; McWhannell, N; Thijssen, D H J; Cable, N T; Stratton, G; George, K

    2009-12-01

    Arterial measurements are commonly undertaken to assess acute and chronic adaptations to exercise. Despite the widespread adoption of scaling practices in cardiac research, the relevance of scaling for body size and/or composition has not been addressed for arterial measures. We therefore investigated the relationships between brachial artery diameter and body composition in 129 children aged 9 to 10 yr (75 girls and 54 boys), and 50 men aged 16-49 yr. Body composition variables (total, lean, and fat mass in the whole body, arm, and forearm) were assessed by dual-energy X-ray absorptiometry, and brachial artery diameter was measured using high-resolution ultrasound. Bivariate correlations were performed, and arterial diameter was then scaled using simple ratios (y/x) and allometric approaches after log-log least squares linear regression and production of allometric exponents (b) and construction of power function ratios (y/xb). Size independence was checked via bivariate correlations (x:y/x; x:y/xb). As a result, significant correlations existed between brachial artery diameter and measures of body mass and lean mass in both cohorts (r=0.21-0.48, P0.05). In conclusion, when between- or within-group comparisons are performed under circumstances where it is important to control for differences in body size or composition, allometric scaling of artery diameter should be adopted rather than ratio scaling. Our data also suggest that scaling for lean or total mass may be more appropriate than scaling for indexes of fat mass.

  4. Does conduit artery diameter vary according to the anthropometric characteristics of children or men?

    Science.gov (United States)

    Hopkins, N D; Green, D J; Tinken, T M; Sutton, L; McWhannell, N; Thijssen, D H J; Cable, N T; Stratton, G; George, K

    2009-12-01

    Arterial measurements are commonly undertaken to assess acute and chronic adaptations to exercise. Despite the widespread adoption of scaling practices in cardiac research, the relevance of scaling for body size and/or composition has not been addressed for arterial measures. We therefore investigated the relationships between brachial artery diameter and body composition in 129 children aged 9 to 10 yr (75 girls and 54 boys), and 50 men aged 16-49 yr. Body composition variables (total, lean, and fat mass in the whole body, arm, and forearm) were assessed by dual-energy X-ray absorptiometry, and brachial artery diameter was measured using high-resolution ultrasound. Bivariate correlations were performed, and arterial diameter was then scaled using simple ratios (y/x) and allometric approaches after log-log least squares linear regression and production of allometric exponents (b) and construction of power function ratios (y/xb). Size independence was checked via bivariate correlations (x:y/x; x:y/xb). As a result, significant correlations existed between brachial artery diameter and measures of body mass and lean mass in both cohorts (r=0.21-0.48, P0.05). In conclusion, when between- or within-group comparisons are performed under circumstances where it is important to control for differences in body size or composition, allometric scaling of artery diameter should be adopted rather than ratio scaling. Our data also suggest that scaling for lean or total mass may be more appropriate than scaling for indexes of fat mass. PMID:19837946

  5. Restoration and protection of brachial plexus injur y:hot topics in the last decade

    Institute of Scientific and Technical Information of China (English)

    Kaizhi Zhang; Zheng Lv; Jun Liu; He Zhu; Rui Li

    2014-01-01

    Brachial plexus injury is frequently induced by injuries, accidents or birth trauma. Upper limb function may be partially or totally lost after injury, or left permanently disabled. With the de-velopment of various medical technologies, different types of interventions are used, but their effectiveness is wide ranging. Many repair methods have phasic characteristics, i.e., repairs are done in different phases. This study explored research progress and hot topic methods for pro-tection after brachial plexus injury, by analyzing 1,797 articles concerning the repair of brachial plexus injuries, published between 2004 and 2013 and indexed by the Science Citation Index database. Results revealed that there are many methods used to repair brachial plexus injury, and their effects are varied. Intervention methods include nerve transfer surgery, electrical stimula-tion, cell transplantation, neurotrophic factor therapy and drug treatment. Therapeutic methods in this ifeld change according to the hot topic of research.

  6. MRI of the brachial plexus and its region: anatomy and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Wouter van Es, H. [Dept. of Radiology, University Hospital, Utrecht (Netherlands); Witkamp, T.D. [Dept. of Radiology, University Hospital, Utrecht (Netherlands); Feldberg, M.A.M. [Dept. of Radiology, University Hospital, Utrecht (Netherlands)

    1995-08-01

    Magnetic resonance imaging (MRI) of the brachial plexus and its region has become the imaging modality of choice, due to its multiplanar capabilities and inherent contrast differences between the brachial plexus, related vessels, and surrounding fat. A total of 41 patients with clinically suspected brachial plexus pathology or tumors in its region were studied. A normal anatomy was found in 12 patients. Pathologic entities included: traumatic nerve-root avulsion (n = 2), hematoma (n = 1), postoperative changes after scalenotomy (n = 2), primary tumor of the brachial plexus (n = 2), primary (n = 8) and metastatic (n = 1) tumors in the superior sulcus, primary (n = 5) and metastatic (n = 4) tumors in the axillary, supra- or infraclavicular region, and changes after nodal dissection and radiation therapy for breast carcinoma (n = 5; 1 patient also had had a prior scalenotomy). There was a positive correlation with surgery in 11 patients, and a negative correlation in 1 patient. (orig.)

  7. Neonatal brachial plexus injury: comparison of incidence and antecedents between 2 decades.

    LENUS (Irish Health Repository)

    Walsh, Jennifer M

    2011-04-01

    We sought to compare the incidence and antecedents of neonatal brachial plexus injury (BPI) in 2 different 5-year epochs a decade apart following the introduction of specific staff training in the management of shoulder dystocia.

  8. Brachial Plexus Neuritis Associated With Streptococcus agalactiae Infection: A Case Report.

    Science.gov (United States)

    Seo, Yu Jung; Lee, Yu Jin; Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

    2014-08-01

    Brachial plexus neuritis is reportedly caused by various factors; however, it has not been described in association with Streptococcus agalactiae. This is a case report of a patient diagnosed with brachial plexus neuritis associated with pyogenic arthritis of the shoulder. A 57-year-old man visited the hospital complaining of sudden weakness and painful swelling of the left arm. The diagnosis was pyogenic arthritis of the left shoulder, and the patient was treated with open irrigation and debridement accompanied by intravenous antibiotic therapy. S. agalactiae was isolated from a wound culture, and an electrodiagnostic study showed brachial plexopathy involving the left upper and middle trunk. Nine weeks after onset, muscle strength improved in most of the affected muscles, and an electrodiagnostic study showed signs of reinnervation. In conclusion, S. agalactiae infection can lead to various complications including brachial plexus neuritis. PMID:25229037

  9. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  10. The Role of Systemic Arterial Stiffness in Open-Angle Glaucoma with Diabetes Mellitus

    OpenAIRE

    Seong Hee Shim; Chan Yun Kim; Joon Mo Kim; Da Yeong Kim; Yang Jae Kim; Jeong Hun Bae; Ki Chul Sung

    2015-01-01

    Purpose. To investigate the role of systemic arterial stiffness in glaucoma patients with diabetes mellitus (DM). Design. Retrospective, cross-sectional study. Participants. DM subjects who underwent brachial-ankle pulse wave velocity (baPWV) were recruited. Methods. Glaucoma patients (n = 75) and age-matched control subjects (n = 92) were enrolled. Systemic examination including BaPWV and detailed eye examination were performed. The glaucoma group was divided into subgroups of normal tension...

  11. Potentialities Of Tendomyoplasty In Rehabilitation Of Patients With Rough Injuries Of Brachial Plexus Trunks

    Directory of Open Access Journals (Sweden)

    G.A.Korshunova

    2009-09-01

    Full Text Available To improve functional results after surgical treatment of consequences of brachial plexus trunks rough injuries rehabilitation results of 111 patients with consequences of brachial plexus trunks rough injuries were studied. Thanks to the adequate tendomyoplasty rehabilitation of shoulder abduction, forearm flexion and of hand grasping is obtained in 85% of patients. The suggested method of treatment may be recommended for wide usage in practical health care

  12. Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note

    OpenAIRE

    Agarwal Anil; Bhagat Hemant; Sharma Manish S

    2008-01-01

    Abstract Background To determine whether monitoring end- tidal Carbon Dioxide (capnography) can be used to reliably identify the phrenic nerve during the supraclavicular exploration for brachial plexus injury. Methods Three consecutive patients with traction pan-brachial plexus injuries scheduled for neurotization were evaluated under an anesthetic protocol to allow intraoperative electrophysiology. Muscle relaxants were avoided, anaesthesia was induced with propofol and fentanyl and the airw...

  13. Axillary brachial plexus block--an underused technique in the accident and emergency department.

    OpenAIRE

    MacKay, C A; Bowden, D F

    1997-01-01

    OBJECTIVE: To compare axillary brachial plexus block and Bier's block as methods of providing upper limb anaesthesia. METHODS: Axillary brachial plexus or Bier's blocks were performed on all patients requiring upper limb anaesthesia in a three month period. For Bier's block, a single cuff tourniquet and 3 mg/kg 0.5% prilocaine were used. For axillary plexus block, 40 ml 1% lignocaine with adrenaline (1:200,000) were used, given by perivascular or transarterial technique. Prospective analysis ...

  14. Brachial Plexus Neuritis Associated With Streptococcus agalactiae Infection: A Case Report

    OpenAIRE

    Seo, Yu Jung; Lee, Yu Jin; Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

    2014-01-01

    Brachial plexus neuritis is reportedly caused by various factors; however, it has not been described in association with Streptococcus agalactiae. This is a case report of a patient diagnosed with brachial plexus neuritis associated with pyogenic arthritis of the shoulder. A 57-year-old man visited the hospital complaining of sudden weakness and painful swelling of the left arm. The diagnosis was pyogenic arthritis of the left shoulder, and the patient was treated with open irrigation and deb...

  15. Anterior spinal artery syndrome of the cervical hemicord.

    Science.gov (United States)

    Baumgartner, R W; Waespe, W

    1992-01-01

    Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery. PMID:1315578

  16. Significance of magnetic resonance imaging in differential diagnosis of nontraumatic brachial plexopathy

    Directory of Open Access Journals (Sweden)

    Perić Stojan

    2011-01-01

    Full Text Available Background/Aim. Nontraumatic brachial plexopathies may be caused by primary or secondary tumors, radiation or inflammation. The aim of this study was to present the significance of MRI in revealing the cause of nontraumatic brachial plexopathy. Methods. A two-year retrospective study included 22 patients with nontraumatic brachial plexopathy. In all the patients typical clinical findings were confirmed by upper limb neurophysiological studies. In all of them MRI of brachial plexus was performed by 1.5 T scanner in T1 and T1 FS sequence with and without contrast, as well as in T2 and T2 FS sequences. Results. Seven (32% patients had brachial plexopathy with signs of inflammatory process, 5 (23% patients had secondary tumors, in 4 (18% patients multifocal motor neuropathy was established and in the same number (18% of the patients postradiation fibrosis was found. Two patients (9% had primary neurogenic tumors. Conclusion. According to the results of this study MRI is a method which may determine localization and cause of brachial plexopathy. MRI can detect focal nerve lesions when other methods fail to find them. Thus, MRI has a direct impact on further diagnostic and therapeutical procedures.

  17. The prevalence of peripheral arterial disease in diabetic subjects in south-west Nigeria

    Directory of Open Access Journals (Sweden)

    Bolaji O. Oyelade

    2012-02-01

    Full Text Available Background: Peripheral arterial disease (PAD is rarely sought for and generally underdiagnosed even in diabetics in developing countries like Nigeria. PAD is easily detected and diagnosed by the ankle-brachial index, a simple and reliable test. Objectives: To determine the prevalence of PAD in diabetic subjects aged 50–89 years and the value of ankle-brachial index measurement in the detection of PAD.Method: A cross-sectional descriptive study of 219 diabetic subjects aged 50–89 years was carried out. The participants were administered a pre-tested questionnaire and measurement of ankle-brachial index (ABI was done. The ankle-brachial index < 0.90 was considered equivalent to peripheral arterial disease.Results: The overall prevalence of PAD was 52.5%. The prevalence of symptomatic PAD was 28.7% whilst that of asymptomatic PAD was 71.3%. There were a number of associations with PAD which included, age (p < 0.05, sex (p < 0.05, and marital status (p < 0.05. The use of the ankle-brachial index in the detection of PAD was clearly more reliable than the clinical methods like history of intermittent claudication and absence or presence of pedal pulses.Conclusion: The prevalence of PAD is relatively high in diabetic subjects in the southwestern region of Nigeria. Notable is the fact that a higher proportion was asymptomatic. Also the use of ABI is of great value in the detection of PAD as evidenced by a clearly more objective assessment of PAD compared to both intermittent claudication and absent pedal pulses.

  18. An exact solver for the DCJ median problem.

    Science.gov (United States)

    Zhang, Meng; Arndt, William; Tang, Jijun

    2009-01-01

    The "double-cut-and-join" (DCJ) model of genome rearrangement proposed by Yancopoulos et al. uses the single DCJ operation to account for all genome rearrangement events. Given three signed permutations, the DCJ median problem is to find a fourth permutation that minimizes the sum of the pairwise DCJ distances between it and the three others. In this paper, we present a branch-and-bound method that provides accurate solution to the multichromosomal DCJ median problems. We conduct extensive simulations and the results show that the DCJ median solver performs better than other median solvers for most of the test cases. These experiments also suggest that DCJ model is more suitable for real datasets where both reversals and transpositions occur.

  19. Median Analysis on the TNCs Financial Characteristics of China

    Directory of Open Access Journals (Sweden)

    LU Diqian

    2012-04-01

    Full Text Available The purpose of this empirical study is to study the basic characteristics of Chinese TNCs in the background of economic globalization. Based on the theory of modern TNCs, with data of Chinese listed companies financial statements in 2009, we constructed quantitative analysis system by using more steady statistics which included median, Median Average Difference (MAD, median average difference of dispersion coefficient and median regression model fitted by two-stage least absolute derivation. Then empirical study was carried out on financial characteristics of Chinese TNCs. The results show that Chinese TNCs have advantages relative to other types of companies, ultra big company size is Chinese TNCs' essential requirements, fast capital expansion is Chinese TNCs salient feature and concept of financial management lag is Chinese TNCs' major defect and so on.

  20. A rare variant of the ulnar artery with important clinical implications: a case report

    Directory of Open Access Journals (Sweden)

    Casal Diogo

    2012-11-01

    Full Text Available Abstract Background Variations in the major arteries of the upper limb are estimated to be present in up to one fifth of people, and may have significant clinical implications. Case presentation During routine cadaveric dissection of a 69-year-old fresh female cadaver, a superficial brachioulnar artery with an aberrant path was found bilaterally. The superficial brachioulnar artery originated at midarm level from the brachial artery, pierced the brachial fascia immediately proximal to the elbow, crossed superficial to the muscles that originated from the medial epicondyle, and ran over the pronator teres muscle in a doubling of the antebrachial fascia. It then dipped into the forearm fascia, in the gap between the flexor carpi radialis and the palmaris longus. Subsequently, it ran deep to the palmaris longus muscle belly, and superficially to the flexor digitorum superficialis muscle, reaching the gap between the latter and the flexor carpi ulnaris muscle, where it assumed is usual position lateral to the ulnar nerve. Conclusion As far as the authors could determine, this variant of the superficial brachioulnar artery has only been described twice before in the literature. The existence of such a variant is of particular clinical significance, as these arteries are more susceptible to trauma, and can be easily confused with superficial veins during medical and surgical procedures, potentially leading to iatrogenic distal limb ischemia.

  1. An approximate algorithm for median graph computation using graph embedding

    OpenAIRE

    Ferrer Sumsi, Miquel; Valveny, Ernest; Serratosa Casanelles, Francesc; Riesen, Kaspar; Bunke, Horst

    2008-01-01

    Graphs are powerful data structures that have many attractive properties for object representation. However, some basic operations are difficult to define and implement, for instance, how to obtain a representative of a set of graphs. The median graph has been defined for that purpose, but existing algorithms are computationally complex and have a very limited applicability. In this paper we propose a new approach for the computation of the median graph based on graph embedding in vector spac...

  2. Testing the gravity p-median model empirically

    Directory of Open Access Journals (Sweden)

    Kenneth Carling

    2015-12-01

    Full Text Available Regarding the location of a facility, the presumption in the widely used p-median model is that the customer opts for the shortest route to the nearest facility. However, this assumption is problematic on free markets since the customer is presumed to gravitate to a facility by the distance to and the attractiveness of it. The recently introduced gravity p-median model offers an extension to the p-median model that account for this. The model is therefore potentially interesting, although it has not yet been implemented and tested empirically. In this paper, we have implemented the model in an empirical problem of locating vehicle inspections, locksmiths, and retail stores of vehicle spare-parts for the purpose of investigating its superiority to the p-median model. We found, however, the gravity p-median model to be of limited use for the problem of locating facilities as it either gives solutions similar to the p-median model, or it gives unstable solutions due to a non-concave objective function.

  3. Treatment of lower extremity arterial occlusive through retrograde access

    International Nuclear Information System (INIS)

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

  4. Carpal tunnel syndrome: an unusual presentation of brachial hypertrophy.

    OpenAIRE

    Shenoy, K T; Saha, P. K.; Ravindran, M

    1980-01-01

    A patient with carpal tunnel syndrome in association with congenital hypertrophy of right upper limb is described. The median nerve also showed hypertrophy. The symptoms were relieved by decompression of the carpal tunnel.

  5. Impact of blood pressure perturbations on arterial stiffness.

    Science.gov (United States)

    Lim, Jisok; Pearman, Miriam E; Park, Wonil; Alkatan, Mohammed; Machin, Daniel R; Tanaka, Hirofumi

    2015-12-15

    Although the associations between chronic levels of arterial stiffness and blood pressure (BP) have been fairly well studied, it is not clear whether and how much arterial stiffness is influenced by acute perturbations in BP. The primary aim of this study was to determine magnitudes of BP dependence of various measures of arterial stiffness during acute BP perturbation maneuvers. Fifty apparently healthy subjects, including 25 young (20-40 yr) and 25 older adults (60-80 yr), were studied. A variety of BP perturbations, including head-up tilt, head-down tilt, mental stress, isometric handgrip exercise, and cold pressor test, were used to encompass BP changes induced by physical, mental, and/or mechanical stimuli. When each index of arterial stiffness was plotted with mean BP, all arterial stiffness indices, including cardio-ankle vascular index or CAVI (r = 0.50), carotid-femoral pulse wave velocity or cfPWV (r = 0.51), brachial-ankle pulse wave velocity or baPWV (r = 0.61), arterial compliance (r = -0.42), elastic modulus (r = 0.52), arterial distensibility (r = -0.32), β-stiffness index (r = 0.19), and Young's modulus (r = 0.35) were related to mean BP (all P modulus were significantly associated with changes in mean BP in the pooled conditions, while changes in arterial compliance, arterial distensibility, β-stiffness index, and Young's modulus were not. In conclusion, this study demonstrated that BP changes in response to various forms of pressor stimuli were associated with the corresponding changes in arterial stiffness indices and that the strengths of associations with BP varied widely depending on what arterial stiffness indices were examined.

  6. 25-Hydroxyvitamin D status, arterial stiffness and the renin-angiotensin system in healthy humans.

    Science.gov (United States)

    Abdi-Ali, Ahmed; Nicholl, David D M; Hemmelgarn, Brenda R; MacRae, Jennifer M; Sola, Darlene Y; Ahmed, Sofia B

    2014-01-01

    Vitamin D deficiency is associated with increased arterial stiffness. We sought to clarify the influence of vitamin D in modulating angiotensin II-dependent arterial stiffness. Thirty-six healthy subjects (33 ± 2 years, 67% female, mean 25-hydroxyvitamin D 69 ± 4 nmol/L) were studied in high salt balance. Arterial stiffness, expressed as brachial pulse wave velocity (bPWV) and aortic augmentation index (AIx), was measured by tonometry at baseline and in response to angiotensin II infusion (3 ng/kg/min × 30 min then 6 ng/kg/min × 30 min). The primary outcome was change in bPWV after an angiotensin II challenge. Results were analyzed according to plasma 25-hydroxyvitamin D status: deficient (nmol/L) and sufficient (≥ 50 nmol/L). There were no differences in baseline arterial stiffness between vitamin D deficient (25-hydroxyvitamin D 40 ± 2 nmol/L) and sufficient (25-hydroxyvitamin D 80 ± 4 nmol/L) groups. Compared with sufficient vitamin D status, vitamin D deficiency was associated with a decreased arterial response to angiotensin II challenge (Δbrachial pulse wave velocity: 0.48 ± 0.44 m/s versus 1.95 ± 0.22 m/s, p=0.004; Δaortic augmentation index: 9.4 ± 3.4% versus 14.2 ± 2.7%, p=0.3), which persisted for brachial pulse wave velocity response after adjustment for covariates (p=0.03). Vitamin D deficiency is associated with increased arterial stiffness in healthy humans, possibly through an angiotensin II-dependent mechanism. PMID:24164282

  7. Ultrasonic Measurement of Change in Elasticity due to Endothelium Dependent Relaxation Response by Accurate Detection of Artery-Wall Boundary

    Science.gov (United States)

    Kaneko, Takuya; Hasegawa, Hideyuki; Kanai, Hiroshi

    2007-07-01

    Ross hypothesized that an endothelial dysfunction is considered to be an initial step in atherosclerosis. Endothelial cells, which release nitric oxide (NO) in response to shear stress from blood flow, have a function of relaxing smooth muscle in the media of the arterial wall. For the assessment of the endothelial function, there is a conventional method in which the change in the diameter of the brachial artery caused by flow-mediated dilation (FMD) is measured with ultrasound. However, despite the fact that the collagen-rich hard adventitia does not respond to NO, the conventional method measures the change in diameter depending on the mechanical property of the entire wall including the adventitia. Therefore, we developed a method of measuring the change in the thickness and the elasticity of the brachial artery during a cardiac cycle using the phased tracking method for the evaluation of the mechanical property of only the intima-media region. In this study, the initial positions of echoes from the lumen-intima and media-adventitia boundaries are determined using complex template matching to accurately estimate the minute change in the thickness and the elasticity of the brachial and radial arteries. The ambiguity in the determination of such boundaries was eliminated using complex template matching, and the change in elasticity measured by the proposed method was larger than the change in inner diameter obtained by the conventional method.

  8. Repair of brachial plexus lower trunk injury by transferring brachialis muscle branch of musculocutaneous nerve:anatomic feasibility and clinical trials

    Institute of Scientific and Technical Information of China (English)

    ZHENG Xian-you; HOU Chun-lin; GU Yu-dong; SHI Qi-lin; GUAN Shi-bing

    2008-01-01

    Background There are few effective methods for treating injuries to the lower trunk of brachial plexus,and the curative effect is usually poor.The purpose of this study was to provide anatomic references for transferring the brachialis muscle branch of musculocutaneous nerve(BMBMCN)for selective neurotization of finger flexion in brachiaI plexus lower trunk injury,and to evaluate its clinical curative effects.Methods Microanatomy and measurement were done on 50 limbs from 25 adult human cadavers to obserye the origin,branch,type of the BMBMCN and median nerve,as well as their adjacent structures.Internal topographic features of the fascicular groups of the median nerve at the level of the BMBMCN were observed.In addition,the technique of BMBMCN transfer for selective neurotization of finger flexion of the median nerve was designed and tested in 6 fresh adult human cadavers.Acetylcholinesterase(AchE)staining of the BMBMCN and median nerve was done to observe the features of the nerve fibers.This technique was clinically tried to restore digital flexion in 6 cases of adult brachial plexus lower trunk injury.These cases were followed up for 3,6,9 and 12 months postoperatively.Recovery of function,grip strength,nerve electrophysiology and muscle power of the affected limbs were observed and measured.Results The brachialis muscle was totally innervated by the musculocutaneous nerve(MCN).Based on the Hunter's line,the Ievel of the origin of the BMBMCN was(13.18±2.77)cm.AchE histochemical staining indicated that the BMBMCN were totally made up of medullated nerve fibers.At the level of the BMBMCN,the median nerve consistently collected into three fascicular groups as shown by microanatomy in combination with AchE stain.The posterior fascicular group was mainly composed of anterior Interosseous nerves and branches to the palmaris longus.The technique was tested in six fresh cadavers successfully,except that stoma split occurred in one case.Five of the six cases recovered

  9. Brachial Plexus Block for Cancer-Related Pain: A Case Series.

    Science.gov (United States)

    Zinboonyahgoon, Nantthasorn; Vlassakov, Kamen; Abrecht, Christ R; Srinivasan, Suresh; Narang, Sanjeet

    2015-01-01

    Neoplastic brachial plexopathy (NBP) is caused by a cancerous infiltration into the brachial plexus, presenting often as severe pain in the affected upper extremity. Such pain can be resistant to medical treatment. Invasive interventions such as brachial plexus neurolysis with phenol or cordotomy may result in severe complications including permanent neurological damage and death. Continuous brachial plexus and paravertebral block with local anesthetic have been reported to successfully control pain from NBP, but these techniques are logistically challenging and frequently have catheter-related complications. We report a series of patients who received single-shot brachial plexus blocks with a mixture of local anesthetic and corticosteroid (bupivacaine 0.25% with methyl-prednisolone 20-120 mg) for the treatment of refractory cancer-related pain in the brachial plexus territory, mostly from NBP. Theoretically, such blocks could provide immediate analgesia from the local anesthetic and a longer-lasting analgesia from the slow-release steroids. Responders reported a sustained decrease in their pain (lasting from 2 weeks to 10 months), a significant decrease in their opioid and non-opioid (ketamine, gabapentin) consumption, overall satisfaction with the block, and unchanged or improved function of their limb. The ideal candidate for this procedure is a patient who has pain that is predominantly neuropathic from a lesion within the brachial plexus and with anatomy amenable to ultrasound-guided nerve block. Our case series suggests that, in the appropriately selected patient, this technique can safely and effectively alleviate pain from NBP. The procedure is simple, spares limb function, and can be diagnostic, predicting response to more complex procedures. To the best of our knowledge, this is the first report using this technique for NBP.

  10. Body height and arterial pressure in seated and supine young males during +2 G centrifugation

    DEFF Research Database (Denmark)

    Arvedsen, Sine K.; Eiken, Ola; Kölegård, Roger;

    2015-01-01

    by the use of a human centrifuge would increase mean arterial pressure (MAP) more in tall than in short males in the seated position. In short (162-171cm, n=8) and tall (194-203cm, n=10) healthy males (18-41yr), brachial arterial pressure, heart rate (HR) and cardiac output were measured during +2G...... centrifugation, while they were seated upright with the legs kept horizontal (+2Gz). In a separate experiment, the same measurements were done with the subjects supine (+2Gx). During +2Gz MAP increased in the short (22±2 mmHg, P 

  11. Sosiaalinen media markkinoinnin kanavana : suunnitelma Lycka Reklamin sosiaalisen median aktivoimiseen

    OpenAIRE

    Tuomenoksa, Michaela

    2016-01-01

    Tämä opinnäytetyö käsittelee sosiaalista mediaa yrityksen näkökulmasta. Miten yritys voi hyödyntää sosiaalista mediaa toiminnassaan ja markkinoinnissa? Mitä eroa on sosiaalisen median kanavissa ja mitä kanavat mahdollistavat? Pohdin myös, minkälainen sisältö on kiinnostavaa ja mitä asioita pitää ottaa huomioon sosiaalisen median viestinnässä. Opinnäytetyössäni pureudun myös yksinomaisesti Lycka Reklamin sosiaalisen median käyttöön – mitkä kanavat ovat hyödyll...

  12. Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome.

    Science.gov (United States)

    Wakerley, Benjamin R; Yuki, Nobuhiro

    2014-03-01

    The pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré syndrome is defined by rapidly progressive oropharyngeal and cervicobrachial weakness associated with areflexia in the upper limbs. Serial nerve conduction studies suggest that PCB represents a localised subtype of Guillain-Barré syndrome characterised by axonal rather than demyelinating neuropathy. Many neurologists are unfamiliar with PCB, which is often misdiagnosed as brainstem stroke, myasthenia gravis or botulism. The presence of additional ophthalmoplegia and ataxia indicates overlap with Fisher syndrome. Half of patients with PCB carry IgG anti-GT1a antibodies which often cross-react with GQ1b, whereas most patients with Fisher syndrome carry IgG anti-GQ1b antibodies which always cross-react with GT1a. Significant overlap between the clinical and serological profiles of these patients supports the view that PCB and Fisher syndrome form a continuous spectrum. In this review, we highlight the clinical features of PCB and outline new diagnostic criteria. PMID:23804237

  13. Somesoppa : Sosiaalisen median kehittämissuunnitelma ravintola Rustikille

    OpenAIRE

    Hartikainen, Lotta

    2016-01-01

    Tämän opinnäytetyön tarkoituksena oli tehdä Ravintola Rustikille sosiaalisen median kehittämissuunnitelma. Kehittämissuunnitelmaa varten ideoita ja kehittämiskohtia kerättiin kolmen eri keinon avulla. Ensimmäiseksi tehtiin vertaileva kirjoituspöytätutkimus neljän muun ravintolan toiminnasta sosiaalisessa mediassa ja etsittiin muiden toiminnasta vinkkejä Rustikia varten. Seuraavaksi tehtiin kartoitus Rustikin toiminnasta sosiaalisessa mediassa. Rustikin käyttämät sosiaalisen median alustat ova...

  14. Morphological and Median Adaptive Filters Based on LCBP Rank Filter

    Directory of Open Access Journals (Sweden)

    D. Prokin

    2013-11-01

    Full Text Available The presented median and morphological (min and max filters based on low complexity bit-pipeline (LCBP rank filter provide reduced complexity of required processing hardware, due to similar pipeline stages and the complete absence of sorting networks in comparison with other solutions. FPGA realization of bit-pipeline median and morphological filter and adaptive bit-pipeline rank filter according to this paper provides significantly higher maximum operating frequency and much smaller used chip resources in comparison with state-of-the-art sorting methods.

  15. Myofibroma in the Palm Presenting with Median Nerve Compression Symptoms

    Directory of Open Access Journals (Sweden)

    Heidi Sarkozy, PA-C, BS

    2014-08-01

    Full Text Available Summary: A myofibroma is a benign proliferation of myofibroblasts in the connective tissue. Solitary myofibromas are a rare finding especially in an adult. We report a case of a 23-year-old man presenting with an enlarging mass over his right palm. The patient is an active weight lifter. He reported numbness and tingling in the median nerve distribution. Nerve conduction studies and magnetic resonance imaging scans suggested a tumor involving or compressing the median nerve. The final diagnosis of myofibroma was made only after the histopathological diagnosis.

  16. FASCICULAR NEURORRHAPHY FOR NEUROMA IN CONTINUITY OF MEDIAN NERVE

    Directory of Open Access Journals (Sweden)

    Manikumar

    2015-10-01

    Full Text Available It is not common for an orthopaedic surgeon to anastomose or repair a peripheral nerve lesion. Fascicular neurorrhaphy has variable out come with median nerve repairs. The recovery by neuropathy as evidenced by NCVS does not correlate with the clinical out come. We treated a post traumatic median nerve neuroma in continuity of right hand proximal to wrist with sensory hyperaesthesisa. It was treated with excision of neuroma internal neurolysis and fascicular neurorrhaphy along with, carpal tunnel release whi ch gave him good relief from pain in the immediate post - operative period.

  17. Sosiaalisen median käyttö matkan eri vaiheissa

    OpenAIRE

    Nuottimäki, Iina

    2015-01-01

    Tämä opinnäytetyö on tehty toimeksiantona suomalaiselle matkailumedialle Rantapallo Oy:lle. Opinnäytetyö kartoitti matkaprosessin eri vaiheissa käytettyjä sosiaalisen median kanavia sekä niiden käyttötarkoitusta. Vastaajilta kysyttiin myös, kuinka paljon sosiaalisesta mediasta hankittu tieto vaikuttaa heidän ostopäätöksiinsä ja mitä matkailutiedon lähteitä sekä sosiaalisen median kanavia he pitävät luotettavimpina lähteinä matkan suunnittelussa. Tutkimukseen sisältyi yhteensä 11 suosittua sos...

  18. Diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury

    Energy Technology Data Exchange (ETDEWEB)

    Medina, L.S. [Miami Children' s Hospital, Division of Neuroradiology, Department of Radiology, Brain Institute, Health Outcomes, Policy, and Economics (HOPE) Center, Miami, FL (United States); Miami Children' s Hospital, Department of Radiology, Miami, FL (United States); Yaylali, Ilker [Miami Children' s Hospital, Brachial Plexus and Peripheral Nerve Surgery Program, Miami, FL (United States); Zurakowski, David [Harvard Medical School, Boston Children' s Hospital, Boston, MA (United States); Ruiz, Jennifer; Altman, Nolan R. [Miami Children' s Hospital, Division of Neuroradiology, Department of Radiology, Brain Institute, Health Outcomes, Policy, and Economics (HOPE) Center, Miami, FL (United States); Grossman, John A.I. [Miami Children' s Hospital, Brachial Plexus and Peripheral Nerve Surgery Program, Miami, FL (United States); New York University, Hospital for Joint Disease, New York, NY (United States)

    2006-12-15

    Detailed evaluation of a brachial plexus birth injury is important for treatment planning. To determine the diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury. Included in the study were 31 children with perinatal brachial plexus injury who underwent surgical intervention. All patients had cervical and brachial plexus MRI. The standard of reference was the combination of intraoperative (1) surgical evaluation and (2) electrophysiological studies (motor evoked potentials, MEP, and somatosensory evoked potentials, SSEP), and (3) the evaluation of histopathological neuronal loss. MRI findings of cord lesion, pseudomeningocele, and post-traumatic neuroma were correlated with the standard of reference. Diagnostic performance characteristics including sensitivity and specificity were determined. From June 2001 to March 2004, 31 children (mean age 7.3 months, standard deviation 1.6 months, range 4.8-12.1 months; 19 male, 12 female) with a brachial plexus birth injury who underwent surgical intervention were enrolled. Sensitivity and specificity of an MRI finding of post-traumatic neuroma were 97% (30/31) and 100% (31/31), respectively, using the contralateral normal brachial plexus as the control. However, MRI could not determine the exact anatomic area (i.e. trunk or division) of the post-traumatic brachial plexus neuroma injury. Sensitivity and specificity for an MRI finding of pseudomeningocele in determining exiting nerve injury were 50% and 100%, respectively, using MEP, and 44% and 80%, respectively, using SSEP as the standard of reference. MRI in infants could not image well the exiting nerve roots to determine consistently the presence or absence of definite avulsion. In children younger than 18 months with brachial plexus injury, the MRI finding of pseudomeningocele has a low sensitivity and a high specificity for nerve root avulsion. MRI and MR myelography cannot image well the exiting nerve roots to determine

  19. Correspondence in relation to the case report "Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note." published in May issue of Journal of Brachial Plexus and Peripheral Nerve Injury

    Directory of Open Access Journals (Sweden)

    Bhakta Pradipta

    2008-10-01

    Full Text Available Abstract Comment on 'Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note' Bhagat H, Agarwal A, Sharma MS Journal of Brachial Plexus and Peripheral Nerve Injury 2008, 3:14 (22 May 2008

  20. Standard versus a novel technique for restoring neurological function following brachial plexus injuries

    Institute of Scientific and Technical Information of China (English)

    Damien Kuffler

    2011-01-01

    The brachial plexus, a complex network of peripheral nerves, involves the motor, sensory, and sympathetic nerve supply to the upper extremity, and is formed by the union of the ventral primary rami of the spinal nerves. Brachial plexus trauma, damage to the complex of nerves, has a high incidence from delivery throughout life, leading to loss of all innervation of the arm and hand, their paralysis, and frequently results in excruciating neuropathic pain. The most frequent brachial plexus repair techniques use autologous sensory nerve grafts to bridge the nerve gaps. However, these do not induce reliable neurological recovery or reduce neuropathic pain, thus permanent neurological loss and neuropathic pain frequently occur. The present study evaluated the current best brachial plexus repair techniques and another involving a collagen tube filled with autologous platelet-rich fibrin that clinically induces extensive neurological recovery and a reduction/elimination of neuropathic pain, which are not possible by sural nerve grafts, even across long nerve gaps that are repaired years post trauma, and in older patients. This novel technique is proposed for use in restoring brachial plexus neurological function and in reducing/eliminating neuropathic pain.

  1. MR imaging of brachial plexopathy in breast cancer patients without palpable recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Lingawi, S.S. (Department of Radiology, St. Paul' s Hospital, Vancouver, BC (Canada) Vancouver General Hospital, University of British Columbia, Vancouver, BC (Canada) Radiology Department, Vancouver General Hospital, BC (Canada)); Bilbey, J.H. (Department of Radiology, St. Paul' s Hospital, Vancouver, BC (Canada)); Munk, P.L.; Marchinkow, L.O. (Vancouver General Hospital, University of British Columbia, Vancouver, BC (Canada)); Poon, P.Y. (Department of Diagnostic Imaging, British Columbia Cancer Agency, Vancouver, BC (Canada)); Allan, B.M. (Department of Neurology, Vancouver Hospital, Vancouver, BC (Canada)); Olivotto, I.A. (Division of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC (Canada))

    1999-06-01

    Objective. To investigate the role of MR imaging in detecting brachial plexus (BP) abnormalities in breast cancer patients with plexopathy but without palpable masses.Design. MR imaging of the BP was performed on 26 breast cancer patients with brachial plexopathy without palpable regional masses, using 0.5 T and 1.5 T imaging systems. Findings were correlated with the clinical diagnoses.Patients. Twenty-six patients with brachial plexopathy and history of breast cancer were enrolled in the study. All patients presented with plexopathy symptoms. Fourteen patients were positive and 12 patients were indeterminate for BP metastasis according to clinical criteria.Results and conclusion. MR imaging demonstrated masses involving the BP representing metastases in two patients. Nine patients had other regional abnormalities with a normal brachial plexus. It is concluded that MR imaging is useful in the assessment and direction of therapy of brachial plexopathy in breast cancer patients by detecting both metastases to the BP as well as other abnormalities, unrelated to the BP, which may explain the patient's symptoms. (orig.) With 4 figs., 1 tab., 18 refs.

  2. Phrenic nerve transfer to the musculocutaneous nerve for the repair of brachial plexus injury: electrophysiological characteristics

    Directory of Open Access Journals (Sweden)

    Ying Liu

    2015-01-01

    Full Text Available Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we performed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduction function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regenerated potentials first appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering ′excellent′ and ′good′ muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The functional recovery of a transplanted nerve can be dynamically observed after the surgery.

  3. A case of relapsing-remitting facial palsy and ipsilateral brachial plexopathy caused by HSV-1.

    Science.gov (United States)

    Alstadhaug, Karl B; Kvarenes, Hanne W; Prytz, Jan; Vedeler, Christian

    2016-05-01

    The etiologies of Bell's palsy and brachial neuritis remain uncertain, and the conditions rarely co-occur or reoccur. Here we present a woman in her twenties who had several relapsing-remitting episodes with left-sided facial palsy and brachial neuropathy. The episodes always started with painful left-sided oral blisters. Repeat PCRs HSV-1 DNA from oral vesicular lesions were positive. Extensive screening did not reveal any other underlying cause. Findings on MRI T2-weighted brachial plexus STIR images, using a 3.0-Tesla scanner during an episode, were compatible with brachial plexus neuritis. Except a mannose-binding lectin deficiency, a congenital complement deficiency that is frequently found in the general Caucasian population, no other immunodeficiency was demonstrated in our patient. In vitro resistance to acyclovir was tested negative, but despite prophylactic treatment with the drug in high doses, relapses recurred. To our knowledge, this is the first ever reported documentation of relapsing-remitting facial and brachial plexus neuritis caused by HSV-1. PMID:26991053

  4. Carotid artery surgery

    Science.gov (United States)

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

  5. Epicardial ultrasound in coronary artery bypass surgery

    NARCIS (Netherlands)

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the surgeo

  6. Arterial Stiffening and Clinical Outcomes in Dialysis Patients.

    Science.gov (United States)

    Kato, Akihiko

    2015-09-01

    Cardiovascular disease (CVD) is an important cause of morbidity and mortality in dialysis patients. Brachial-ankle pulse wave velocity (baPWV) is more efficient to handily assess arteriosclerosis than aortic PWV. The cardio-ankle vascular index (CAVI) is also a novel blood pressure-independent arterial stiffness parameter. In dialysis patients, both baPWV and CAVI are increased compared to general subjects. Several studies have demonstrated that increased baPWV is associated with carotid atherosclerosis and diastolic left ventricular dysfunction in hemodialysis (HD) patients. In addition, higher baPWV is related to all-cause and cardiovascular (CV) mortality. CAVI is similarly associated with CVD. However, baPWV is superior to CAVI as a predictor of CV outcomes in HD patients. Besides these outcomes, a close relationship exists between sarcopenia, abdominal visceral obesity and arterial stiffening. Reduction of thigh muscle mass is inversely correlated with baPWV and CAVI in males. Abdominal fatness is also associated with increased arterial stiffness in females. These observations provide further evidence of higher risk of CV events in HD patients with sarcopenic obesity. In addition, arterial stiffness is associated with cerebral small vessel disease and decreased cognitive function in the elderly. However, it is unknown whether arterial stiffness may be useful as an early indicator of cognitive decline in dialysis patients. Because dialysis patients are at risk of developing dementia, more studies are needed to elucidate the causal link between arterial stiffness and cognitive impairment. PMID:26587457

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

    International Nuclear Information System (INIS)

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

  8. Addition of a third field significantly increases dose to the brachial plexus for patients undergoing tangential whole-breast therapy after lumpectomy

    Energy Technology Data Exchange (ETDEWEB)

    Stanic, Sinisa; Mathai, Mathew; Mayadev, Jyoti S.; Do, Ly V.; Purdy, James A. [Department of Radiation Oncology, University of California, Davis, Sacramento, CA (United States); Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California, Davis, Sacramento, CA (United States)

    2012-07-01

    Our goal was to evaluate brachial plexus (BP) dose with and without the use of supraclavicular (SCL) irradiation in patients undergoing breast-conserving therapy with whole-breast radiation therapy (RT) after lumpectomy. Using the standardized Radiation Therapy Oncology Group (RTOG)-endorsed guidelines delineation, we contoured the BP for 10 postlumpectomy breast cancer patients. The radiation dose to the whole breast was 50.4 Gy using tangential fields in 1.8-Gy fractions, followed by a conedown to the operative bed using electrons (10 Gy). The prescription dose to the SCL field was 50.4 Gy, delivered to 3-cm depth. The mean BP volume was 14.5 {+-} 1.5 cm{sup 3}. With tangential fields alone, the median mean dose to the BP was 0.57 Gy, the median maximum dose was 1.93 Gy, and the irradiated volume of the BP receiving 40, 45, and 50 Gy was 0%. When the third (SCL field) was added, the dose to the BP was significantly increased (P = .01): the median mean dose to the BP was 40.60 Gy, and the median maximum dose was 52.22 Gy. With 3-field RT, the median irradiated volume of the BP receiving 40, 45, and 50 Gy was 83.5%, 68.5%, and 24.6%, respectively. The addition of the SCL field significantly increases dose to the BP. The possibility of increasing the risk of BP morbidity should be considered in the context of clinical decision making.

  9. Management of sternal osteomyelitis and mediastinal infection following median sternotomy

    Institute of Scientific and Technical Information of China (English)

    GAO Ju; WANG Wen-zhang; WANG You-li; LU Shu-qiang; CAI Ai-bing; YANG Zhi-fu; HAN Zhi-yi; LI Jiu-jiang; WEN Yu-ming; GENG Feng-yong

    2010-01-01

    Background Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.Methods Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.Results No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.Conclusions Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged stermal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.

  10. Mean, Median and Mode from a Decision Perspective

    Science.gov (United States)

    Holt, Melinda Miller; Scariano, Stephen M.

    2009-01-01

    The classroom activity described here allows mathematically mature students to explore the role of mean, median and mode in a decision-making environment. While students discover the importance of choosing a measure of central tendency, their understanding of probability distributions, maximization, and prediction is reinforced through active…

  11. A novel image inpainting technique based on median diffusion

    Indian Academy of Sciences (India)

    Rajkumar L Biradar; Vinayadatt V Kohir

    2013-08-01

    Image inpainting is the technique of filling-in the missing regions and removing unwanted objects from an image by diffusing the pixel information from the neighbourhood pixels. Image inpainting techniques are in use over a long time for various applications like removal of scratches, restoring damaged/missing portions or removal of objects from the images, etc. In this study, we present a simple, yet unexplored (digital) image inpainting technique using median filter, one of the most popular nonlinear (order statistics) filters. The median is maximum likelihood estimate of location for the Laplacian distribution. Hence, the proposed algorithm diffuses median value of pixels from the exterior area into the inner area to be inpainted. The median filter preserves the edge which is an important property needed to inpaint edges. This technique is stable. Experimental results show remarkable improvements and works for homogeneous as well as heterogeneous background. PSNR (quantitative assessment) is used to compare inpainting results.

  12. Brain malformation in single median maxillary central incisor

    DEFF Research Database (Denmark)

    Kjaer, I; Wagner, Aa; Thomsen, L L;

    2009-01-01

    Clinical and radiographic examinations and MR scan of a 12-year-old girl with SMMCI (single median maxillary central incisor) showed impaired growth and a midline defect involving the central incisor, cranium and the midline structures in the brain, falx cerebri and pituitary gland. She had a...

  13. Estimation of Transition Probabilities Using Median Absolute Deviations

    OpenAIRE

    Kim, C. S.; Schaible, Glenn D.

    1988-01-01

    The probability-constrained minimum absolute deviations (MAD) estimator appears to be superior to the probability-constrained quadratic programming estimator in estimating transition probabilities with limited aggregate time series data Futhermore, one can reduce the number of columns in the probability-constrained MAD simplex tableau by adopting the median property

  14. Hand Function in Children with an Upper Brachial Plexus Birth Injury: Results of the Nine-Hole Peg Test

    Science.gov (United States)

    Immerman, Igor; Alfonso, Daniel T.; Ramos, Lorna E.; Grossman, Leslie A.; Alfonso, Israel; Ditaranto, Patricia; Grossman, John A. I.

    2012-01-01

    Aim: The aim of this study was to evaluate hand function in children with Erb upper brachial plexus palsy. Method: Hand function was evaluated in 25 children (eight males; 17 females) with a diagnosed upper (C5/C6) brachial plexus birth injury. Of these children, 22 had undergone primary nerve reconstruction and 13 of the 25 had undergone…

  15. Response to comments on "Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note"

    Directory of Open Access Journals (Sweden)

    Agarwa Anil

    2008-10-01

    Full Text Available Abstract Response to comments on 'Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note' Bhagat H, Agarwal A, Sharma MS Journal of Brachial Plexus and Peripheral Nerve Injury 2008, 3:14 (22 May 2008

  16. Response to comments on "Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note"

    OpenAIRE

    Agarwa Anil; Bhagat Hemant; Sharma Manish S

    2008-01-01

    Abstract Response to comments on 'Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note' Bhagat H, Agarwal A, Sharma MS Journal of Brachial Plexus and Peripheral Nerve Injury 2008, 3:14 (22 May 2008)

  17. Constraint-Induced Movement Therapy for Children with Obstetric Brachial Plexus Palsy: Two Single-Case Series

    Science.gov (United States)

    Buesch, Francisca Eugster

    2010-01-01

    The objective of this pilot study was to investigate the feasibility of constraint-induced movement therapy (CIMT) in children with obstetric brachial plexus palsy and receive preliminary information about functional improvements. Two patients (age 12 years) with obstetric brachial plexus palsy were included for a 126-h home-based CIMT…

  18. PERIPHERAL ARTERIAL DISEASE IN THE LEG

    Directory of Open Access Journals (Sweden)

    Nair P

    2014-09-01

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

  19. Reversal of phantom pain and hand-to-face remapping after brachial plexus avulsion.

    Science.gov (United States)

    Tsao, Jack W; Finn, Sacha B; Miller, Matthew E

    2016-06-01

    Following left brachial plexus avulsion, a 20-year-old man had phantom limb pain and remapping of sensation from his paralyzed hand onto his face. Mirror therapy (15 min daily, 5 days/week) led immediately to good movement of the phantom limb with decreased pain. Within 2 weeks following nerve graft surgery, remapping of hand sensation onto the face disappeared along with resolution of phantom limb pain. Mirror therapy coupled with nerve grafting may relieve phantom limb pain due to brachial plexus avulsion and reverse hand-to-face remapping, suggesting that both peripheral and central mechanisms mediate development of phantom limb pain and cortical reorganization/neuroplasticity after brachial plexus avulsion. PMID:27547774

  20. Neurolymphomatosis of Brachial Plexus in Patients with Non-Hodgkin's Lymphoma

    Directory of Open Access Journals (Sweden)

    Yong Jun Choi

    2013-01-01

    Full Text Available Neurolymphomatosis (NL is a rare clinical disease where neoplastic cells invade the cranial nerves and peripheral nerve roots, plexus, or other nerves in patients with hematologic malignancy. Most NL cases are caused by B-cell non-Hodgkin’s lymphoma (NHL. Diagnosis can be made by imaging with positron emission tomography (PET and magnetic resonance imaging (MRI. We experienced two cases of NL involving the brachial plexus in patients with NHL. One patient, who had NHL with central nervous system (CNS involvement, experienced complete remission after 8 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy but relapsed into NL of the brachial plexus 5 months later. The other patient, who suffered from primary central nervous system lymphoma (PCNSL, had been undergoing chemoradiotherapy but progressed to NL of the brachial plexus.

  1. Brachial plexus surgery: the role of the surgical technique for improvement of the functional outcome

    Directory of Open Access Journals (Sweden)

    Leandro Pretto Flores

    2011-08-01

    Full Text Available OBJECTIVE: The study aims to demonstrate the techniques employed in surgery of the brachial plexus that are associated to evidence-based improvement of the functional outcome of these patients. METHOD: A retrospective study of one hundred cases of traumatic brachial plexus injuries. Comparison between the postoperative outcomes associated to some different surgical techniques was demonstrated. RESULTS: The technique of proximal nerve roots grafting was associated to good results in about 70% of the cases. Significantly better outcomes were associated to the Oberlin's procedure and the Sansak's procedure, while the improvement of outcomes associated to phrenic to musculocutaneous nerve and the accessory to suprascapular nerve transfer did not reach statistical significance. Reinnervation of the hand was observed in less than 30% of the cases. CONCLUSION: Brachial plexus surgery renders satisfactory results for reinnervation of the proximal musculature of the upper limb, however the same good outcomes are not usually associated to the reinnervation of the hand.

  2. The importance of the preoperative clinical parameters and the intraoperative electrophysiological monitoring in brachial plexus surgery

    Directory of Open Access Journals (Sweden)

    Leandro Pretto Flores

    2011-08-01

    Full Text Available OBJECTIVE: The study aims to demonstrate the impact of some preoperative clinical parameters on the functional outcome of patients sustaining brachial plexus injuries, and to trace some commentaries about the use of intraoperative monitoring techniques. METHOD: A retrospective study one hundred cases of brachial plexus surgery. The analysis regarding postoperative outcomes was performed by comparing the average of the final result of the surgery for each studied cohort. RESULTS: Direct electrical stimulation was used in all patients, EMG in 59%, SEPs in 37% and evoked NAPs in 19% of the cases. Patients in whom the motor function of the hand was totally or partially preserved before surgery, and those in whom surgery was delayed less than 6 months demonstrated significant (p<0.05 better outcomes. CONCLUSION: The preoperative parameters associated to favorable outcomes in reconstruction of the brachial plexus are a good post-traumatic status of the hand and a short interval between injury and surgery.

  3. Perceptions of the ankle brachial index amongst podiatrists registered in Western Australia

    Directory of Open Access Journals (Sweden)

    Chen Pamela Y

    2012-07-01

    Full Text Available Abstract Background The ankle brachial index (ABI is an objective diagnostic tool that is widely used for the diagnosis of peripheral arterial disease. Despite its usefulness, it is evident within the literature that many practitioners forgo using this screening tool due to limiting factors such as time. There is also no recommended technique for ABI measurement. The purpose of this study is to investigate the perceptions of the use of ABI clinically among Western Australian podiatrists. Methods This study was a cross sectional survey which evaluated the perceptions of the ABI amongst registered podiatrists in Western Australia. The study sample was obtained from the register of podiatrists listed with the Podiatrists Registration Board of Western Australia. Podiatrists were contacted by telephone and invited to participate in a telephone questionnaire. Chi-square tests were performed to determine if there was a statistically significant relationship between use of the ABI and podiatrists’ profile which included: sector of employment; geographical location; and length of time in practice. Results There is a statistically significant relationship (p=0.004 between podiatrists’ profile and the use of ABI, with higher usage in the tertiary hospital setting than in private practice. Length of time spent in practice had no significant impact on ABI usage (p=0.098. Time constraints and lack of equipment were key limiting factors to performing the ABI, and no preferred technique was indicated. Conclusion Western Australian podiatrists agree that the ABI is a useful tool for lower limb vascular assessment, however, various factors influence uptake in the clinical setting. This study suggests that a podiatrists’ profile has a significant influence on the use of the ABI, which may be attributed to different patient types across the various settings. The influence of time spent in practice on ABI usage may be attributed to differences in clinical

  4. Carotid Artery Screening

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should consider ... about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find disease ...

  5. Diffusion weighted MR imaging of brachial plexus diseases

    International Nuclear Information System (INIS)

    Diffusion weighted image (DWI) can specifically give running of nerve fibers as they have diffusion anisotropic property and DW whole body imaging with background body signal suppression (DWIBS) procedure, which being capable of imaging cervical and lumber nerve roots, is thus suggested to be useful for diagnosis of diseases related to brachial plexus (BP). The purpose of the present study is to confirm the usefulness of DWIBS by comparison of its images of the normal and sick plexuses. Subjects are 5 normal healthy males (27-36 y), 29 patients (19 M/10 F, 7-73 y) with BP diseases (10 cases of external injury, 6 of obstetric palsy, 2 of paralysis by dysfunctional position, 6 by Schwannoma, 2 by metastasis of breast cancer and 3 by radiation) and, to see the diagnostic specificity, 9 patients (M 7/F 2, 15-64 y) with severely reduced hand force by nervous causes other than BP ones. MRI with Philips Gyroscan INTERA 1.5T machine is conducted for DWIBS by DWI with single shot EPI (echo planar imaging) with the coil of either sensitivity encoding (SENSE) Cardiac, Flex-M or -S. Images are reconstructed 3D by a radiological technician possessing no information concerning patient's conditions, with Philips software Soap-bubble tool on the workstation, and are then evaluated by a radiologist and an orthopedist separately. It is found that BP disorders by injury, obstetric palsy and tumors, of which diagnosis has been difficult hitherto, can be imaged either negatively or positively depending on their history. In radiation paralysis, only 1/3 cases give a reduced signal intensity in the whole BP. DWIBS will be a new diagnostic mean for systemic peripheral nerve diseases as well as BP ones. (T.T.)

  6. Arterial Stiffness, Central Pulsatile Hemodynamic Load, and Orthostatic Hypotension.

    Science.gov (United States)

    Liu, Kai; Wang, Si; Wan, Shixi; Zhou, Yufei; Pan, Pei; Wen, Bo; Zhang, Xin; Liao, Hang; Shi, Di; Shi, Rufeng; Chen, Xiaoping; Jangala, Tulasiram

    2016-07-01

    The association between central pulsatile hemodynamic load, arterial stiffness, and orthostatic hypotension (OH) is unclear. The authors recruited 1099 participants from the community. Questionnaire, physical examination, and laboratory tests were performed. To assess the correlation between central pulsatile hemodynamic load, arterial stiffness, and OH, multiple logistic regression analysis was performed, and the discriminatory power was assessed by the area under the receiver operating curve. The prevalence of OH in this population was 5.6%. After adjusting for potential confounders, brachial-ankle pulse wave velocity (BaPWV) was significantly and positively correlated with OH in both the hypertension and nonhypertension groups (all Ppower than CSBP in both subgroups. BaPWV appears to be a better indicator of OH than CSBP in routine clinical practice. PMID:26543017

  7. Algorithm for treatment of children of first months of life with brachial plexus birth palsy

    Directory of Open Access Journals (Sweden)

    Ирина Александровна Крюкова

    2016-03-01

    Full Text Available Aim. We present the algorithm for treatment designed specially for medical doctors who are involved in treatment process of children with brachial plexus birth palsy during first few months of their life.Materials and methods. We analyzed domestic and foreign literature which highlights the problem of brachial plexus birth palsy.Results. Key-moments of diagnostic and treatment of these patients were discovered. Based-upon them algorithm was developed.Conclusion. Integration of developed algorithm in clinical practice is essential for understanding the etiology, pathogenesis, natural history, differential diagnostic and prior treatment by medical doctors of different specialties to improve the quantity of medical service.

  8. Obstetric Brachial Plexus Palsy in the Context of Early Physical Rehabilitation

    Directory of Open Access Journals (Sweden)

    Vivian Lucía Yanes Sierra

    2014-08-01

    Full Text Available Cuban health system currently promotes prenatal testing and monitoring of pregnancy; nevertheless obstetric brachial plexus palsy remains an unfortunate consequence of a difficult delivery and is one of the most common birth trauma. Traditionally, its treatment has been conservative, based on multidisciplinary monitoring and consultations with various specialists to deal with the consequences. After conducting an extensive literature review, we discussed in this paper the etiology, anatomy, pathophysiology, types of injuries, prognosis and outcome, consequences, assessment tools, existing treatments and series of exercises for obstetric brachial plexus palsy.

  9. Anatomical basis for nerve block of the brachial plexus via superomedial to midpoint of the clavicle%锁骨中点内上方阻滞臂丛神经的解剖学

    Institute of Scientific and Technical Information of China (English)

    董西安; 李光宗; 郭荣奎; 刘宝梅; 孙静; 鞠晓华; 张志玉

    2011-01-01

    Objective: To provide the morphological basis for blocking the brachial plexus via superomedial to midpoint of the clavicle. Methods:Length of the brachial plexus, diameter of the junction of three cords of the brachial plexus above the first rib were measured on sixteen fixed cadavers, in order to identify the optimal point, direction, angle and depth of needling on account that the subclavian artery was prevented. Results: The length of the brachial plexus was 108. 09 mm±12. 49 mm. The diameter of the junction of three cords of the brachial plexus above the first rib was 16. 40 mm±2. 10 mm. The distance of needling pathway was 25. 45 mm± 0. 42 mm. The optimal angle that could protect the subclavian artery was 12. 85°±0. 59°. Conclusion: The needle can be inserted at the point that 10 mm inwards and 23 mm upwards to the midpoint of the clavicle, and run inferolaterally (meaning at 140° that identify as the angle between the vertical line through the needling point and the needling pathway) toward superior border of the midpoint of the clavicle. The angle is 12. 85° to protect the subclavian artery. This approach is effective to complete block the brachial plexus without complications such as pneumothorax and hemothorax.%目的:为临床麻醉工作者提供锁骨中点上方阻滞人路方法.方法:在经10%甲醛溶液固定的60侧头颈、上肢标本及锁骨中点矢状切断面标本上测量臂丛的长度、第1肋上面臂丛神经3束汇合处的直径,确定臂丛阻滞进针点、进针方向、进针角度、进针深度、确定锁骨下动脉的保护角度.结果:臂丛神经的长度为108.09mm±12.49 mm;第1肋上面臂丛神经3束汇合处的直径为16.40 mm±2.10 mm;进针路径(即进针点至锁骨中点上缘)距离为25.45mm±0.42 mm;保护锁骨下动脉的夹角为12.85°±0.59°.结论:锁骨中点向内10 mm向上23 mm处即为进针点,以140°(即进针点的垂线与进针路径呈的夹角)斜向外下至

  10. Solitary median maxillary central incisor: a report of 2 cases.

    Science.gov (United States)

    Sekerci, Ahmet Ercan; Uçar, Faruk Izzet; Gümüş, Hüsniye; Aydınbelge, Mustafa; Sisman, Yildiray

    2012-01-01

    A single median maxillary central incisor (SMMCI) is a rare dental anomaly that may occur alone or be associated with growth deficiency or other systemic abnormalities. The best known association is with holoprosencephaly (HPE). HPE is a complex brain malformation that affects both the forebrain and the face. Early diagnosis of SMMCI is important, since it may be a sign of other severe congenital or developmental abnormalities. Therefore, systematic follow-up and close monitoring of the growth and development of SMMCI patients is crucial. The purpose of this paper was to report the cases of 2 children, each with a single median maxillary central incisor, and describe important symptoms of this syndrome that have not yet been reported. PMID:22583889

  11. The median recoil direction as a WIMP directional detection signal

    CERN Document Server

    Green, Anne M

    2010-01-01

    Direct detection experiments have reached the sensitivity required to detect dark matter WIMPs. Demonstrating that a putative signal is due to WIMPs, and not backgrounds, is a major challenge however. The direction dependence of the WIMP scattering rate provides a potential WIMP `smoking gun'. If the WIMP distribution is predominantly smooth, the Galactic recoil distribution is peaked in the direction opposite to the direction of Solar motion. Previous studies have found that, for an ideal detector, of order 10 WIMP events would be sufficient to reject isotropy, and rule out an isotropic background. We examine how the median recoil direction could be used to confirm the WIMP origin of an anisotropic recoil signal. Specifically we determine the number of events required to reject the null hypothesis that the median direction is random (corresponding to an isotropic Galactic recoil distribution) at 95% confidence. We find that for zero background 31 events are required, a factor of roughly 2 more than are requi...

  12. Lapset median käyttäjinä

    OpenAIRE

    Jalonen, Taru; Suomela, Sonja

    2010-01-01

    Laurea-ammattikorkeakoulu Tiivistelmä Hyvinkää Sosiaali-, terveys- ja liikunta-ala Hoitotyön koulutusohjelma Terveydenhoitaja AMK Sairaanhoitaja AMK Taru Jalonen, Sonja Suomela Lapset median käyttäjinä Vuosi ‎2010‎ Sivumäärä ‎63‎ Tämän opinnäytetyön tarkoituksena oli selvittää lasten tottumuksia ja kokemuksia mediasta sekä ‎niiden herättämiä tunteita. Lisäksi selvitimme lasten käyttämiä mediaympäristöjä sekä median ‎näkymistä lasten leikeissä. Tämä työ on os...

  13. Intraneural hemangioma of the median nerve: A case report

    Directory of Open Access Journals (Sweden)

    Sevinç Teoman

    2008-02-01

    Full Text Available Abstract Hemangiomas of the median nerve are very rare and, so far, only ten cases of intraneural hemangioma of this nerve have been reported in the literature. We present a case of 14-year-old girl who had a soft tissue mass in the region of the left wrist with signs and symptoms of carpal tunnel syndrome. Total removal of the mass was achieved using microsurgical epineural and interfasicular dissection. The symptoms were relieved completely, after this procedure, without any neurologic deficit. On follow-up two years later, no recurrence was observed. Whenever a child or young adult patient presents with CTS the possibility of a hemangioma involving the median nerve should be kept in mind in the differential diagnosis.

  14. Peripheral artery disease in korean patients undergoing percutaneous coronary intervention: prevalence and association with coronary artery disease severity.

    Science.gov (United States)

    Kim, Eun Kyoung; Song, Pil Sang; Yang, Jeong Hoon; Song, Young Bin; Hahn, Joo-Yong; Choi, Jin-Ho; Gwon, Hyeon-Cheol; Lee, Sang Hoon; Hong, Kyung Pyo; Park, Jeong Euy; Kim, Duk-kyung; Choi, Seung-Hyuk

    2013-01-01

    Peripheral artery disease (PAD) is an important marker for the risk stratification of patients with coronary artery disease (CAD). We investigated the prevalence of PAD in patients undergoing percutaneous coronary intervention (PCI) with CAD and the relationship between ankle-brachial pressure index (ABPI) and CAD severity. A total of 711 patients undergoing PCI for CAD from August 2009 to August 2011 were enrolled. PAD diagnosis was made using the ABPI. The prevalence of PAD was 12.8%. In PAD patients, mean values of right and left ABPI were 0.71 ± 0.15 and 0.73 ± 0.15. Patients with PAD had a higher prevalence of left main coronary disease (14.3% vs 5.8%, P = 0.003), more frequently had multivessel lesions (74.9% vs 52.1%, P ABPI-based PAD screening should be implemented in all patients undergoing PCI with CAD, especially in severe cases. PMID:23341717

  15. The median Genocchi numbers, Q-analogues and continued fractions

    OpenAIRE

    Feigin, Evgeny

    2011-01-01

    The goal of this paper is twofold. First, we review the recently developed geometric approach to the combinatorics of the median Genocchi numbers. The Genocchi numbers appear in this context as Euler characteristics of the degenerate flag varieties. Second, we prove that the generating function of the Poincar\\' e polynomials of the degenerate flag varieties can be written as a simple continued fraction. As an application we prove that the Poincar\\' e polynomials coincide with the $q$-version ...

  16. Quadratic Assignment of Hubs in p-Hub Median Problem

    DEFF Research Database (Denmark)

    Gelareh, Shahin

    We introduce Generalized p-Hub Median Problem (GpHMP) that seeks to locate p hub nodes and install p distinct hub facilities/operators on the hubs while discount factor resulted by consolidation of flow on the hub links depends on the facilities/operators that are installed/operating on both hub ......-points. The mathematical model is presented and numerical results on the instances of CAB and AP data sets are reported....

  17. Educational system, income inequality and growth: the median voter's decision

    Directory of Open Access Journals (Sweden)

    Joilson Dias

    2005-03-01

    Full Text Available I analyze a long run educational policy as a mechanism to close the income gap among low, median and high-income families. If the choice is made endogenous by the use of the median voter theorem, the results are as follow: i public education system guarantees income convergence, however the income growth rate of the median voter is smaller; ii the combination public and private (hybrid educational system allows faster income growth rate, but income inequality is almost the natural outcome. The ending result is that the combination public and private system will prevail, since the income growth rate of the median voter is higher in this system. This might explain the persistence and differences of income inequality among the economies.O objetivo deste artigo é analisar a utilização da política educacional no longo prazo como mecanismo para a redução da desigualdade de renda entre famílias de renda baixa, mediana e alta. Se a decisão sobre a política for endogeneizada, de acordo com o teorema do eleitor mediano, os resultados são os seguintes: i o sistema educacional público para todos, apesar de garantir convergência de renda, produz uma menor taxa de crescimento da renda do eleitor mediano; ii a combinação público-privado (sistema educacional híbrido permite uma maior taxa de crescimento da renda do eleitor mediano, no entanto a desigualdade de renda é inerente a este sistema. Como resultado final, o eleitor mediano irá escolher o sistema público-privado, pois o crescimento da sua renda é maior, o que pode explicar a persistência e as diferenças na desigualdade de renda das economias.

  18. Association of arterial stiffness and electrocardiography-determined left ventricular hypertrophy with left ventricular diastolic dysfunction.

    Directory of Open Access Journals (Sweden)

    Po-Chao Hsu

    Full Text Available OBJECTIVES: Increased arterial stiffness is associated with left ventricular diastolic dysfunction (LVDD, but this association may be influenced by left ventricular (LV performance. Left ventricular hypertrophy (LVH is not only a significant determinant of LV performance, but is also correlated with LVDD. This study is designed to compare LV diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV and electrocardiography (ECG-determined LVH and to assess whether increased baPWV and ECG-determined LVH are independently associated with LVDD. METHODS: This cross-sectional study enrolled 270 patients and classified them into four groups according to the median value of baPWV and with/without ECG-determined LVH. The baPWV was measured using an ABI-form device. ECG-determined LVH was defined by Sokolow-Lyon criterion. LVDD was defined as impaired relaxation, pseudonormal, and restrictive mitral inflow patterns. Groups 1, 2, 3, and 4 were patients with lower baPWV and without ECG-determined LVH, lower baPWV but with ECG-determined LVH, higher baPWV but without ECG-determined LVH, and higher baPWV and with ECG-determined LVH respectively. RESULTS: Early diastolic mitral velocity (Ea was gradually decreased from group 1 to group 4 (p≦0.027. Patients in group 4 had the highest prevalence of LVDD (all p<0.001. After multivariate analysis, both baPWV and ECG-determined LVH were independent determinants of Ea (β = -0.02, P<0.001; β = -1.77, P<0.001 respectively and LVDD (odds ratio = 1.02, P = 0.011 and odds ratio = 3.53, P = 0.013 respectively. CONCLUSION: Our study showed the group with higher baPWV and ECG-determined LVH had the lowest Ea and highest prevalence of LVDD. In addition, both baPWV and ECG-determined LVH were independently associated with Ea and LVDD. Hence, assessment of arterial stiffness by baPWV and LVH by ECG may be useful in identifying the high risk group of LVDD.

  19. Median Robust Extended Local Binary Pattern for Texture Classification.

    Science.gov (United States)

    Liu, Li; Lao, Songyang; Fieguth, Paul W; Guo, Yulan; Wang, Xiaogang; Pietikäinen, Matti

    2016-03-01

    Local binary patterns (LBP) are considered among the most computationally efficient high-performance texture features. However, the LBP method is very sensitive to image noise and is unable to capture macrostructure information. To best address these disadvantages, in this paper, we introduce a novel descriptor for texture classification, the median robust extended LBP (MRELBP). Different from the traditional LBP and many LBP variants, MRELBP compares regional image medians rather than raw image intensities. A multiscale LBP type descriptor is computed by efficiently comparing image medians over a novel sampling scheme, which can capture both microstructure and macrostructure texture information. A comprehensive evaluation on benchmark data sets reveals MRELBP's high performance-robust to gray scale variations, rotation changes and noise-but at a low computational cost. MRELBP produces the best classification scores of 99.82%, 99.38%, and 99.77% on three popular Outex test suites. More importantly, MRELBP is shown to be highly robust to image noise, including Gaussian noise, Gaussian blur, salt-and-pepper noise, and random pixel corruption. PMID:26829791

  20. Male median raphe cysts: serial retrospective analysis and histopathological classification

    Directory of Open Access Journals (Sweden)

    Shao I-Hung

    2012-09-01

    Full Text Available Abstract Background To review the clinical and pathological characteristics of median raphe cysts and to classify the lesions according to pathogenesis and histopathological findings. Methods The medical records of patients who were diagnosed with median raphe cysts between 2001 and 2010 were reviewed to document the clinical presentation and pathological findings of the cysts. Results Most patients were asymptomatic; however, 9 patients had inflammatory or infectious cysts that were tender or painful. Four patients who had cysts on the parameatus and distal prepuce had difficulty voiding. Hematuria and hematospermia were noted in 2 cases. Thirty-one cysts were lined with an urothelium-like epithelium, and a squamous epithelium lining was found in 3 cases. In 2 cases, a well-formed mucinous glandular structure was observed. The other 20 cysts consisted of mixed epithelia. After excision of the cysts under local or general anesthesia, an urethral fistula developed as a complication in only 1 case. Conclusions Median raphe cysts are benign lesions formed due to tissue trapping during the development of urethral folds. The cysts can be defined into 4 types based on pathological findings: urethral, epidermoid, glandular, and mixed. The associated symptoms and signs should be taken into consideration when determining the treatment for the cysts. Virtual slides The virtual slide(s for this article can be found here: http//http://www.diagnosticpathology.diagnomx.eu/vs/7727074877500751

  1. Regional block anesthesia in a patient with factor V Leiden mutation and axillary artery occlusion

    Science.gov (United States)

    Erkalp, Kerem; Comlekci, Mevlut; Inan, Bekir; Basaranoglu, Gokcen; Ozdemir, Haluk; Saidoglu, Leyla

    2011-01-01

    Anesthetic management of patients with coagulation disorders presents safety and technical challenges. This case describes a 58-year-old woman with factor V Leiden mutation who required distal saphenous vein harvest and axillo-brachial bypass to treat axillary artery occlusion. The patient underwent surgery with satisfactory anesthesia using infraclavicular brachial plexus block, thoracic paravertebral block, and unilateral subarachnoid block. These three regional anesthetic interventions were performed in lieu of general anesthesia to minimize risks of thrombotic events, pain, and to decrease recovery time. Despite higher failure rates of regional anesthesia, longer time required for procedures, and added discomforts during surgery, the benefits may outweigh risks for selected high-risk patients, including those with factor V Leiden mutations. PMID:22915885

  2. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola.

    Science.gov (United States)

    Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91-52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ (2) = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69-3.21) and 1.42 (95% CI: 0.64-3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966

  3. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola

    Directory of Open Access Journals (Sweden)

    Feliciano Chanana Paquissi

    2016-01-01

    Full Text Available Background. Peripheral arterial disease (PAD is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91 years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91–52.17%. Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years (χ2=3.917, P≤0.05. The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69–3.21 and 1.42 (95% CI: 0.64–3.17, respectively. Hypertension was also high in the group (66.95%. Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors.

  4. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola

    Science.gov (United States)

    Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91–52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ2 = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69–3.21) and 1.42 (95% CI: 0.64–3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966

  5. Celiac artery stenosis/occlusion treated by interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-08-15

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

  6. Celiac artery stenosis/occlusion treated by interventional radiology

    International Nuclear Information System (INIS)

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

  7. [Subclavian artery stenting using gadolinium contrast medium in a case with iodine allergy].

    Science.gov (United States)

    Miyamoto, Michiyuki; Asano, Takeshi; Osanai, Toshiya; Endo, Shogo; Nakayama, Naoki; Kuroda, Satoshi; Houkin, Kiyohiro

    2012-05-01

    The authors reported a subclavian artery stenting (SAS) using gadolinium contrast medium. The patient was a 65-year-old female who presented dizziness and right upper extremity pain with movement. Digital subtraction angiography revealed right subclavian artery occlusion with subclavian steal phenomenon. We tried to treat this lesion using SAS. However, iodinated contrast medium caused the allergy in this patient and the treatment was discontinued. Therefore, SAS was performed with gadolinium contrast medium. Using gadolinium contrast medium, it is possible to confirm large arteries like innominate artery and subclavian artery. The stenting procedure was performed without complication. The usage of gadolinium contrast medium has the limit and some strategies are important to reduce the usage of gadolinium contrast medium in SAS. First, PercuSurge GuardWire® was placed in the right internal carotid artery to confirm the anatomy, to decide working angle, and to treat the common carotid artery in case of dissection. Second, a "U" shaped guide wire was placed in the distal end from the brachial artery. Guide wire from femoral side was able to pass the lesion at midpoint of the "U" shaped one. SAS using gadolinium contrast medium may be an alternative treatment if a patient with subclavian artery stenosis or occlusion is allergic to iodinated contrast medium.

  8. Non-invasive assessment of arterial stiffness using oscillometric blood pressure measurement

    Directory of Open Access Journals (Sweden)

    Komine Hidehiko

    2012-02-01

    Full Text Available Abstract Background Arterial stiffness is a major contributor to cardiovascular diseases. Because current methods of measuring arterial stiffness are technically demanding, the purpose of this study was to develop a simple method of evaluating arterial stiffness using oscillometric blood pressure measurement. Methods Blood pressure was conventionally measured in the left upper arm of 173 individuals using an inflatable cuff. Using the time series of occlusive cuff pressure and the amplitudes of pulse oscillations, we calculated local slopes of the curve between the decreasing cuff pressure and corresponding arterial volume. Whole pressure-volume curve was derived from numerical integration of the local slopes. The curve was fitted using an equation and we identified a numerical coefficient of the equation as an index of arterial stiffness (Arterial Pressure-volume Index, API. We also measured brachial-ankle (baPWV PWV and carotid-femoral (cfPWV PWV using a vascular testing device and compared the values with API. Furthermore, we assessed carotid arterial compliance using ultrasound images to compare with API. Results The slope of the calculated pressure-volume curve was steeper for compliant (low baPWV or cfPWV than stiff (high baPWV or cfPWV arteries. API was related to baPWV (r = -0.53, P r = -0.49, P r = 0.32, P Conclusions These results suggest that our method can simply and simultaneously evaluate arterial stiffness and blood pressure based on oscillometric measurements of blood pressure.

  9. Social Security: a financial appraisal for the median voter.

    Science.gov (United States)

    Galasso, V

    Several explanations have been proposed for why voters continue to support unfunded social security systems. Browning (1975) suggests that the extremely large unfunded pension systems of most democracies depend on the existence of a voting majority composed of middle-aged and older people who fail to fully internalize the cost of financing the system. In fact, when voting, economically rational workers consider only their current and future contributions to the system and their expected pension benefits--not their past contributions, which they regard as sunk costs. If, for a majority of voters, the expected continuation return from social security exceeds the return from alternative assets, an unfunded social security system is politically sustainable. This article explores the validity of Browning's proposition by quantifying the returns that U.S. voters in presidential elections from 1964 to 1996 have obtained, or expect to obtain, from Social Security. Did "investments" in Social Security outperform alternative forms of investment, such as mutual funds or pension funds, for a majority of the voters? What can be expected for the future? The U.S. Social Security system redistributes income within age cohorts on the basis of sex, income, and marital status. To account for some of these features, the median voter is represented by a family unit whose members--a husband who accounts for 70 percent of household earnings and a wife who accounts for 30 percent--make joint economic and voting decisions. Thus, retirement and survival benefits paid out to the spouse of an insured worker can be included in the calculation of Social Security returns. Interval estimates of voters' family incomes from the U.S. Census Bureau were used to obtain the median voter's household earnings. The median voter's age is derived from the ages of those who voted in presidential elections, not from the ages of the entire electorate. The median voter's contributions to Social Security are the

  10. Arterial stiffness of lifelong Japanese female pearl divers.

    Science.gov (United States)

    Tanaka, Hirofumi; Tomoto, Tsubasa; Kosaki, Keisei; Sugawara, Jun

    2016-05-15

    Japanese female pearl divers called Ama specialize in free diving in the cold sea for collecting foods and pearls in oysters. Exercising in the water combined with marked bradycardia and pressor responses provides a circulatory challenge to properly buffer or cushion elevated cardiac pulsations. Because Ama perform repeated free dives throughout their lives, it is possible that they may have adapted similar arterial structure and function to those seen in diving mammals. We compared arterial stiffness of lifelong Japanese pearl divers with age-matched physically inactive adults living in the same fishing villages. A total of 115 Japanese female pearl divers were studied. Additionally, 50 physically inactive adults as well as 33 physically active adults (participating in community fitness programs) living in the same coastal villages were also studied. There were no differences in age (∼65 yr), body mass index, and brachial blood pressure between the groups. Measures of arterial stiffness, cardio-ankle vascular index and β-stiffness index were lower (P < 0.05) in pearl divers and physically active adults than in their physically inactive peers. Augmentation pressure and augmentation index adjusted for the heart rate of 75 beats/min were lower (P < 0.05) in pearl divers than in other groups. These results indicate that lifelong Japanese pearl divers demonstrate reduced arterial stiffness and arterial wave reflection compared with age-matched physically inactive peers living in the same fishing villages. PMID:26984889

  11. REGIONAL ANESTHESIA CONTINUOUS BRACHIAL PLEXUS BLOCK WITH ULTRASONOGRAPHY GUIDANCE

    Directory of Open Access Journals (Sweden)

    T. G. A. Senapathi

    2015-03-01

    Full Text Available Background: Regional anesthesia has an anti-inflammatory effect that blockade the C-fiber hence reduced cytokine production and blocked the activity of the sympathetic nerve fibers. Postoperative pain caused primarily by tissue inflammation and activity of the C-fibers in the manner of reduced the production of cytokines, regional anesthesia may limit the inflammatory response after surgery and severity of postoperative pain. Methods: This study is a clinical experimental study with randomized pre and post test control group design. A total of 24 samples were recruited in this study divided into two groups each consisting of 12 samples. The first group was given regional anesthesia method of continuous brachial plexus block with ultrasound guidance and the second group with general anesthesia method. T-test or Mann-Whitney continued multivariate linear regression analysis was performed to analyze the differences in treatment and not because of differences in the initial values with significance level of p<0.05. Results: This study reports that the mean decreased levels of IL-6 postoperatively in 1stgroup is 29.8 lower than in 2ndgroup and it is statistically significant p< 0.05. There was an increase of IL-10 mean levels from preoperative to postoperatively with significance level of p<0.05 in both groups. Declined in the mean levels of PAF postoperatively in 1st group 1.3 lower than 2nd group and it was statistically significant p<0.05. The declined of  postoperative VAS in 1st group is 3.1 lower than 2nd group and it is statistically significant p< 0.05, and it also contained the pure effect of PAF levels against value of VAS that any increased 1ng/ml levels of PAF then an increase in the value of 0.18 cm VAS and this was statistically significant p<0.05. Selection of this anesthesia technique in orthopedic antebrachii surgery provides better inflammatory response and improved clinical outcomes.

  12. Human amniotic epithelial cell transplantation for the repair of injured brachial plexus nerve: evaluation of nerve viscoelastic properties

    Directory of Open Access Journals (Sweden)

    Hua Jin

    2015-01-01

    Full Text Available The transplantation of embryonic stem cells can effectively improve the creeping strength of nerves near an injury site in animals. Amniotic epithelial cells have similar biological properties as embryonic stem cells; therefore, we hypothesized that transplantation of amniotic epithelial cells can repair peripheral nerve injury and recover the creeping strength of the brachial plexus nerve. In the present study, a brachial plexus injury model was established in rabbits using the C 6 root avulsion method. A suspension of human amniotic epithelial cells was repeatedly injected over an area 4.0 mm lateral to the cephal and caudal ends of the C 6 brachial plexus injury site (1 × 10 6 cells/mL, 3 μL/injection, 25 injections immediately after the injury. The results showed that the decrease in stress and increase in strain at 7,200 seconds in the injured rabbit C 6 brachial plexus nerve were mitigated by the cell transplantation, restoring the viscoelastic stress relaxation and creep properties of the brachial plexus nerve. The forepaw functions were also significantly improved at 26 weeks after injury. These data indicate that transplantation of human amniotic epithelial cells can effectively restore the mechanical properties of the brachial plexus nerve after injury in rabbits and that viscoelasticity may be an important index for the evaluation of brachial plexus injury in animals.

  13. Human amniotic epithelial cell transplantation for the repair of injured brachial plexus nerve:evaluation of nerve viscoelastic properties

    Institute of Scientific and Technical Information of China (English)

    Hua Jin; Qi Yang; Feng Ji; Ya-jie Zhang; Yan Zhao; Min Luo

    2015-01-01

    The transplantation of embryonic stem cells can effectively improve the creeping strength of nerves near an injury site in animals. Amniotic epithelial cells have similar biological properties as em-bryonic stem cells; therefore, we hypothesized that transplantation of amniotic epithelial cells can repair peripheral nerve injury and recover the creeping strength of the brachial plexus nerve. In the present study, a brachial plexus injury model was established in rabbits using the C6root avulsion method. A suspension of human amniotic epithelial cells was repeatedly injected over an area 4.0 mm lateral to the cephal and caudal ends of the C6 brachial plexus injury site (1 × 106 cells/mL, 3μL/injection, 25 injections) immediately after the injury. The results showed that the decrease in stress and increase in strain at 7,200 seconds in the injured rabbit C6 brachial plexus nerve were mitigated by the cell transplantation, restoring the viscoelastic stress relaxation and creep properties of the brachial plexus nerve. The forepaw functions were also signiifcantly improved at 26 weeks after injury. These data indicate that transplantation of human amniotic epithelial cells can effec-tively restore the mechanical properties of the brachial plexus nerve after injury in rabbits and that viscoelasticity may be an important index for the evaluation of brachial plexus injury in animals.

  14. A Novel Approach to Brachial Plexus Catheter Management: A Brachial Plexus Test Dose for Phrenic Nerve Paralysis and Patient-Controlled, Demand-Only Dosing for a Patient With Extreme Obesity.

    Science.gov (United States)

    Meier, Adam W; Lin, Shin-E; Hanson, Neil A; Auyong, David B

    2016-09-15

    A 53-year-old woman with extreme obesity (body mass index = 82 kg/m) presented for an open reduction and internal fixation of the proximal humerus. This report describes the novel management of her continuous brachial plexus catheter in the setting of her comorbidities. Phrenic nerve paralysis from brachial plexus blocks can cause clinically significant dyspnea in obese patients. Brachial plexus catheters can be used effectively for these patients with some modification to routine management. We detail our use of a short-acting chloroprocaine test dose for phrenic paralysis and demand-only dosing to provide effective analgesia while avoiding respiratory complications associated with these blocks. PMID:27464944

  15. Contralateral brachial plexus palsy and Horner syndrome following vestibular schwannoma resection: A complication of patient positioning

    Directory of Open Access Journals (Sweden)

    Matthew R. Fusco, MD

    2014-09-01

    Conclusions: We present the first known cases of submandibular gland inflammation and hemorrhage resulting in brachial plexopathy and Horner syndrome opposite the site of tumor resection. This case underscores the importance of adequate and safe patient positioning in skull based neurosurgical procedures.

  16. Ipsilateral Brachial Plexus Block and Hemidiaphragmatic Paresis as Adverse Effect of a High Thoracic Paravertebral Block

    NARCIS (Netherlands)

    Renes, Steven H.; van Geffen, Geert J.; Snoeren, Miranda M.; Gielen, Matthieu J.; Groen, Gerbrand J.

    2011-01-01

    Background: Thoracic paravertebral block is regularly used for unilateral chest and abdominal surgery and is associated with a low complication rate. Case Reports: We describe 2 patients with an ipsilateral brachial plexus block with Horner syndrome after a high continuous thoracic paravertebral blo

  17. Changes in Spinal Cord Architecture after Brachial Plexus Injury in the Newborn

    Science.gov (United States)

    Korak, Klaus J.; Tam, Siu Lin; Gordon, Tessa; Frey, Manfred; Aszmann, Oskar C.

    2004-01-01

    Obstetric brachial plexus palsy is a devastating birth injury. While many children recover spontaneously, 20-25% are left with a permanent impairment of the affected limb. So far, concepts of pathology and recovery have focused on the injury of the peripheral nerve. Proximal nerve injury at birth, however, leads to massive injury-induced…

  18. A Case of Scapulothoracic Dissociation with Brachial Plexus Injury: Magnetic Resonance Imaging Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, G.K.; Suh, K.J.; Choi, J.A.; Oh, O.Y. [Dept. of Radiology, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea)

    2007-11-15

    Scapulothoracic dissociation is defined as violent lateral or rotational displacement of the shoulder girdle from its thoracic attachments with severe neurovascular injury. We describe the radiographic and associated magnetic resonance (MR) imaging findings of a case of scapulothoracic dissociation with brachial plexus injury in a 17-year-old man, and include a review of the relevant literature.

  19. Brachial plexus injury after transfer of free latissimus dorsi musculocutaneous flap

    Institute of Scientific and Technical Information of China (English)

    周友清; 陈亮; 胡韶楠; 顾玉东

    2002-01-01

    @@ Free latissimus dorsi muscle transfer is widely used for functional reconstruction of flexion of elbow and fingers after brachial plexus injury at later stage, as well as for soft tissue coverage because of its large size and long and reliable pedicle with adequate vessel diameter.

  20. Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block

    DEFF Research Database (Denmark)

    Asghar, Semera; Bjerregaard, Lars S; Lundstrøm, Lars H;

    2014-01-01

    BACKGROUND: Increases in skin temperature may be used as an early predictor of the success of interscalene brachial plexus block (IBPB), but we lack detailed information on the thermographic response. OBJECTIVE: To investigate and characterise the thermographic response after IBPBs. DESIGN...