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Sample records for carotid body tumor

  1. Efficacy of Surgical Therapy for Carotid Body Tumors

    Institute of Scientific and Technical Information of China (English)

    Li-shan Lian; Chang-wei Liu; Heng Guan; Yue-hong Zheng; Xing-ming Chen; Yong-jun Li

    2011-01-01

    Objective To evaluate the efficacy of surgical therapy for carotid body tumors.Methods A retrospective analysis was conducted,covering the diagnosis,surgical procedure,post-operative complications,and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May,2011.Results Surgical excision was successfully performed in 111 cases with 117 tumors.In all those cases,50 underwent simple tumor resection,42 underwent resection of tumors and ligation of the external carotid arteries,7 underwent co-resection of tumors and common carotid arteries,internal carotid arteries,as well as external arteries without vascular reconstruction,and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved.After operation,3 cases developed cerebral infarction,30 cases showed cranial nerve palsy,including 15 cases of hypoglossal nerve damage,10 cases of vagus paralysis,and 5 cases of Horner's syndrome.Conclusion It is essential to make a proper surgical strategy,which can reduce postoperative complications.

  2. Diagnosis and surgical treatment of the carotid body tumors.

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    Matticari, S; Credi, G; Pratesi, C; Bertini, D

    1995-06-01

    Resection of carotid body tumors can be difficult to perform because of its site, vascularity, arterial adherence and local cranial nerve involvement. Advances in vascular surgical technique have reduced the risks of perioperative complications such as carotid injury, stroke and death. From January 1980 to May 1994 20 patients (22 carotid body tumors) were examined. All patients except one were evaluated with a preoperative angiography. No preoperative embolization was performed. Thirteen patients underwent ultrasonography, nine a CT scan of the neck, 5 magnetic resonance scanning and two magnetic resonance angiography. One old patient refused operation. The authors report their experience on 21 carotid body tumor resections (14 Shamblin group I and 7 group II paragangliomas). Surgical technique is based on subadventitial resection (18 excisions) and 3 resections were performed from the medial surface of the carotid bifurcation which had been partially absorbed into the mass. In the last 15 operations intraoperative Somatosensorial Evoked Potential (SEP) monitoring has been used. Only two patient required arterial repair because intimal dissection and another patient needed vagus nerve section. The ligation of external carotid artery and internal carotid resection with graft replacement were never necessary in these patients. No early or late deaths occurred and no recurrences were detected at follow-up.

  3. Carotid body tumors: radioguided surgical approach

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    Gossetti Bruno

    2009-12-01

    Full Text Available Abstract Background Carotid body tumours (CBTs are very rare lesions which should be treated as soon as possible even when benign since small tumour size permits easier removal and lower incidence of perioperative complications and recurrence. Malignant forms are rare and they can be identified by lymph node invasion and metastases in distant locations. The need of reliable and effective diagnostic modalities for both primary CBTs and its metastases or recurrence is evident. The present study reviews our experience and attempt to define the role of colour coded ultrasound (CCU and Somatostatin receptor scintigraphy (SRS with Indium-111-DTPA-pentetretide (Octreoscan® using both planar and single photon emission tomography (SPECT technique in the diagnosis and follow-up of these uncommon lesions within a multidisciplinary approach. Methods From 1997 to 2008, 12 patients suffering from 16 CBTs (4 bilateral were investigated by CCU and SRS-SPECT before and after surgery. All tumours were grouped according to Shamblin's classification in order to assess the technical difficulties and morbidity of surgical resection on the ground of their size and relationship with the carotid arteries. Intraoperative radiocaptation by Octreoscan® was also carried out in all cases to evaluate the radicality of surgery. All perioperative scans were evaluated by the same nuclear medicine physician. Results Preoperatively CCU showed CBTs (four were not palpable with a sensitivity of 100%. Radioisotope imaging identified the CBTs as chemodectomas in 15 cases while no radioisotopic uptake was detected in 1 vagus nerve neurinoma. No evidence of metastasis or multicentricity were seen by total body radioisotopic scans. Combined data from CCU and SRS-SPECT allowed to determine tumour size in order to select 7 larger tumours which were submitted to selective preoperative embolization. Intraoperatively Octreoscan demonstrated microscopic tumour leftovers promptly removed in 1

  4. Diagnosis of carotid body tumor by digital subtraction angiography

    Institute of Scientific and Technical Information of China (English)

    戚跃勇; 邹利光; 孙清荣; 徐健; 周政; 谭颖徽

    2004-01-01

    Objective: To make a further understanding of the features of the carotid body tumor (CBT) by digital subtraction angiography (DSA) so as to explore the clinical value of DSA diagnosis and interventional therapy for CBT. Methods: DSA data from 12 cases of CBT were analyzed retrospectively. A consensus interpretation of the DSA appearances in all of the patients was reached after dynamic observation by 2 experienced radiologists in a double-blind manner. Results: Definite diagnosis in all cases could be made by DSA. The DSA features of the CBT included bigger bifurcation angles of the internal and external carotid arteries, displacement of internal and external carotid arteries, CBT supplied by external carotid arteries in most cases and the significant increase of tumor blood vessels in bifurcation. Invasion of internal or external carotid arteries was found in 6 cases. Smaller stained area of the tumor and significantly reduced intraoperative bleeding were found after embolization of the supplying arteria in 2 cases. Conclusion: DSA is the effective method for the diagnosis and preoperative assessment of CBT. Preoperative embolization of CBT may contribute to the reduced intraoperative bleeding.

  5. [Surgical treatment of tumors of the carotid body with reconstruction of the internal carotid artery].

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    Reparaz, L; Magallón, P; Riera, L; Capilla, M T; Merino, M J; Martínez, I; Hernández, A; Sáez, L; Alamo, O; Jiménez Cossío, J A

    1990-01-01

    The experience about treatment in infiltrating tumors of Carotid Corpus, III Degree (Shamblin), is presented. Different methods of carotid reconstruction, and biologic and evolutive characteristics are emphasized, discussing preoperatory study and surgical technics.

  6. Carotid body tumor imitator: An interesting case of Castleman′s disease

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    Hakeem J Shakir

    2015-01-01

    Conclusions: We present a unique case of a tumor initially and incorrectly diagnosed as a carotid body tumor. However, after comprehensive treatment with endovascular and surgical modalities and subsequent pathologic examination, the diagnosis of this rare entity was made.

  7. Management of three carotid body tumors and review of the topic

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    Torres-Morientes LM

    2014-05-01

    Full Text Available Introduction and objective: Carotid paragangliomas are rare tumors arising from the carotid body paraganglia. They grow slowly and only big tumours come to cause neurological symptoms. The diagnosis is made by clinical and radiological findings, and curative treatment is radical surgery. Supported by clinical reports we review the ethiology, clinical presentation and treatments options, along with possible complications. Case reports: We present three cases of carotid paragangliomas. The first case is a 61yo man referred from another center after the incidental finding of a left carotid paraganglioma on a radiological test. The second case is a 57yo patient with a long lasting right lateral neck tumor. In both cases the lesions were resected with the pathological diagnosis of carotid glomus. The third case is a 80yo patient with a large left carotid paraganglioma in whom observation was decided. Discussion: Carotid paragangliomas are a rare benign disease originated in the carotid body. They are included in the cervico-facial paragangliomas. The most frequent presentation is a painless slow-growing mass. The treatment of choice is a radical surgery after embolization. Conclusions: Carotid paragangliomas should be included in the differential diagnosis of cervical tumors; imaging assessment is essential. Preoperative embolization to decrease the potential for intraoperative bleeding is imperative in the surgical management of paragangliomas.

  8. A simple technique to achieve bloodless excision of carotid body tumors.

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    Spinelli, Francesco; Massara, Mafalda; La Spada, Michele; Stilo, Francesco; Barillà, David; De Caridi, Giovanni

    2014-05-01

    We describe a technique for Shamblin II-III carotid body tumor (CBT) resection to reduce bleeding and neurologic complications during surgery. The technique was based on the fact that CBTs are supplied almost exclusively from the external carotid artery. Therefore, we carefully isolated the origin of the external carotid artery and its distal branches outside the tumor and temporarily clamped all of these vessels after heparin administration. This allowed a safe and bloodless resection as the tumor was dissected from the internal carotid artery in the usual subadventitial plane. The internal carotid artery was never clamped, and respect of peripheral nerves was warranted in the clean and bloodless field. From 2007 to 2010, we treated 11 patients with a CBT: six had a Shamblin II and five had a Shamblin III lesion. Neither perioperative neurologic events nor recurrences occurred after a mean follow-up of 42 months.

  9. Surgical treatment of carotid body tumor: case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Tao Luo; Chao Zhang; Ya-Chan Ning; Yong-Quan Gu; Jian-Xin Li; Zhong-Gao Wang

    2013-01-01

    Carotid body tumors (CBT) are rare chemical receptor tumors. We report nine cases of CBT who were diagnosed at our center during 2004 to 2008 with a literature review. Of these nine patients, eight underwent complete resection, one received palliative resection due to the malignant nature of the tumor, and the other one refused surgery. No perioperative mortality and stroke occurred. During a mean follow up of 2.2 years, no deaths related to CBT occurred. Surgical treatment for CBT is relatively safe. The surgeon should be careful to maintain the integrity of carotid artery, and prevent cerebral ischemia and cranial nerve injuries in order to improve outcome.

  10. Iatrogenic central retinal artery occlusion after carotid body tumor embolization and excision

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    Rangel, Carlos M.

    2017-03-01

    Full Text Available Objective: To report a case of iatrogenic central retinal artery occlusion after embolization and surgical resection of carotid body paraganglioma.Methods: Case report Results: One adult female patient presented with persistent unilateral visual loss after embolization with Embosphere and Contour microparticles of carotid body tumor. Fluorescein angiography revealed intraluminal microspheres in the central retinal artery ramifications. OCT revealed intraretinal spherical, hyporeflective particles with posterior shadowing. Conclusions: Central retinal artery occlusion should be assessed as a possible complication after surgical repair of head and neck paragangliomas.

  11. ANALYSIS OF EFFECT AND COMPLICATION ON SURGICAL TREATMENT OF CAROTID BODY TUMORS IN 46 CASES

    Institute of Scientific and Technical Information of China (English)

    郑月宏; 刘暴; 李拥军; 刘昌伟; 管珩

    2003-01-01

    Objective. To describe the effects of surgical treatment and complications in 46 patients with carotid body tumor (CBT). Method. Retrospective study on surgical treatment and complications was carried out in 46 cases of CBT which were surgically treated with different kind of procedures. Result. All procedures performed successfully except that the CBT was not excised in 4 cases. No operative mortality was observed. There were 2 postoperative hemiplegia, 4 hypoglossal nerve impairment,2 glossopharyngeal nerve impairment, 1 vagus nerve impairment, and 1 accessory nerve impairment. One patient presented postoperative cranial nerve impairment in glossopharyngeal, vagus and hypoglossal nerves. Two patients developed local recurrence during the long-term follow-up. Conclusion. Complete surgical excision was possible in each patient if the diagnosis had been correctly made through selective preoperative angiography, vessel ultrasound Doppler and other examinations.Reasonable surgical procedure and Matas training were necessary to the successful surgical treatment and thus decrease the complicative incidence rate of carotid chemodectomas.

  12. Giant malignant carotid body tumor in a 40 years old woman: a case report from Gondar University Hospital.

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    Amsalu, Ashenafi; Anderson, Bernard; Tesfaye, Wegahta

    2013-10-01

    The Carotid Body Tumor (CBT) should be considered in the differential diagnosis of any patient with an anterior lateral neck mass (mass in the region of carotid artery bifurcation) even though it is a rare neoplasm. Physical findings that support the diagnosis include pulsation without expansile palpation and the ability to move the mass from side to side but not vertically. The diagnosis is supported further by radiological procedures that may include US, CT, MRI and arteriography. Once the diagnosis is made, surgery is the principal treatment and the only curative modality but has inherent risks for hemorrhage and stroke for which the patient should be informed. Radiation therapy has been shown to be an alternative to surgery in certain patients and an adjunct to surgery in others. The internal carotid artery may need to be resected in order to remove the tumor. The surgeon needs to be prepared to employ intraoperative stump pressure manometry, to use intravascular shunts and be familiar with the several diagnostic and reconstructive vascular techniques relevant to this area, any of which may be needed to ensure adequate cerebral perfusion thereby reducing the risk of stroke and death that may attend simple ligation of the internal carotid artery. Regional anesthesia has proven benefit in carotid endarterectomy surgery. This technique may have a role in CBT surgery. In this paper we present an encounter with a giant malignant carotid body tumor and a brief review of CBTs in the English literature.

  13. Color Doppler Ultrasound in Diagnosis and Assessment of Carotid Body Tumors: Comparison with Computed Tomography Angiography.

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    Jin, Zhan-Qiang; He, Wen; Wu, Dong-Fang; Lin, Mei-Ying; Jiang, Hua-Tang

    2016-09-01

    A carotid body tumor (CBT) is a rare, non-chromaffin paraganglioma, and its diagnosis mainly depends on imaging modalities. The aim of this study was to investigate the ability of color Doppler ultrasound (CDU) in the diagnosis and assessment of CBT based on computed tomography (CT). We retrospectively reviewed the CDU and CT features of 49 consecutive CBTs and 23 schwannomas from 67 patients and compared these findings with surgical resection specimens. The mean size of CBT lesions on ultrasound scans and CT angiography (CTA) was 3.24 cm ± 0.82 cm (range, 1.6-5.2 cm) and 3.84 cm ± 1.08 cm (range, 1.8-6.8 cm), respectively, which had statistically significant difference (t = 9.815, p = 0.000). The vascularity of CBT lesions was richer than that of schwannoma lesions (p CDU in identifying Shamblin type I CBT lesions, while CTA technique was superior for CDU, identifying Shamblin type II and III CBT lesions. Accuracy, specificity and sensitivity of CDU in diagnosing CBTs were 87.5% (63 of 72), 82.6% (19 of 23) and 89.8% (44 of 49), respectively. Both accuracy and sensitivity of CTA in diagnosing CBTs were 100%. CDU can be useful for assessment of Shamblin's type and intra-lesional blood flow of CBTs before its metastases, while CT imaging can reveal the relationship between lesions and adjacent arteries, as well as the involvement of the skull base. CDU combined with CT imaging can be used as an optimal detection modality for the assessment and management of CBT.

  14. 颈动脉体瘤的影像学诊断%Imaging diagnosis of carotid body tumor

    Institute of Scientific and Technical Information of China (English)

    孙明霞

    2016-01-01

    目的:探讨分析颈动脉体瘤的影像学特征。方法收集2009年至2016年经上级医院手术病理证实的5例颈动脉体瘤的影像学资料,其中4例在我院行CT检查,后将原始图像上传至工作站进行MPR、VR等后处理;1例行MR检查。通过查阅文献资料,回顾性分析颈动脉体瘤的CT、MR影像特征及CT后处理技术在颈动脉体瘤中的应用价值。结果5例颈动脉体瘤,均为单侧,男2例,女3例,年龄28~45岁,5例均位于颈总动脉分叉处,使颈内外动脉分叉角增大;4例行CT检查,病变边缘光滑,椭圆形;增强扫描明显强化,以动脉期显著,与邻近动脉密度几近相似,2例病变表面见增粗迂曲的血管影;1例行MR检查,病变较大,边界清晰,边缘见分叶, T1WI病变内见"椒盐"征,增强T1WI显示病变明显强化。结论颈动脉体瘤CT及MR具有特征性表现,CT后处理技术及MR多方位扫描可以清晰显示病变部位及病变与邻近血管的位置关系,从而指导临床手术。%Objective To analyze the Imaging features of carotid body tumor. Methods 5 cases of carotid body tumor imaging data by pathology were collected, 4 cases of CT examination and Volume Rendering(VR) and multi planar reconstruction(MPR), 1case of MR examination. the imaging features and CT post-processing technique in the application value of carotid body tumor were analyzed retrospectively. Results 5 cases was all single, 2 cases were male, 3 cases were female,age 28 to 45 years old, 5 cases were all located at the bifurcation of the carotid artery, usually caused the internal and external carotid arteries shifted,and the angle between the two arteries became enlarged; 4 cases of CT examination,defined margin and marked enhancement, significantly to arterial phase, and the adjacent arteries density was almost similar, 2 cases of lesions in surface showed circuitous vessels. 1case of MR examination, lesions was bigger, well

  15. 颈动脉体瘤与SDH基因突变的研究进展%Research advances in SDH gene mutation in carotid body tumor

    Institute of Scientific and Technical Information of China (English)

    袁荣涛; 郑家伟; 李宁毅

    2009-01-01

    颈动脉体瘤(carotid body tumor,CBT)又称副神经节瘤,其存在线粒体SDH基因的突变,包括SDHD、SDHC及SDHB基因的突变.SDH基因突变多发生于家族性CBT中,散发性CBT中少见.对CBT与SDH基因突变的研究,将为CBT的发病机制、基因诊断、遗传咨询和治疗提供新的思路.%Carotid body tumor (CBT), also referred to as paraganglioma, has mitoehondrial suecinate dehydrogenase (SDH) gene mutation, including SDHD, SDHC and SDHB gene mutation. SDH gene mutation mainly occurred in familial CBT patients, seldom in sporadic cases. Researches in the relationship between CBT and SDH gene would provide a new approach for tumor genesis, gene diagnosis, genetic consulting and therapy of CBT.

  16. The use of dual source CT in diagnosis of carotid body tumors%双源CT在颈动脉体瘤诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    曹罡; 郭婷; 周长圣; 张森林; 孟昭业; 杨震; 董震; 徐金科; 毛钊

    2011-01-01

    Objective To evaluate the value of dual source CT in diagnosis and treatment of carotid body tumors.Methods Between Sep, 2007 and April 2010, a total of 5 patients who were planed to be diagnosed as carotid body underwent dual source CT.The relationship of the tumour and the near vessels, and the character of the tumor were identified by analysis of clinical signs and imaging results.The risk factors and feasibility of operations were evaluated before done.The tumors were resected.Results The clear edge mass of soft tissue was shown in all 5 patients in dual source CT images at the bifurcation of the common carotid artery.The minors presented obviously enhanced high-density after contrast media administration.The tumors have plenty blood supply.4 patients with small tumor in only one side show especially “cup-sign”.One female patient with bilateral tumors didn't have“ cup-sign” and significant narrow blood vessel, however the tumors were much bigger.5 patients were all diagnosed by dual source CT.The tumonrs were resected and reserved common carotid artery and internal carotid artery.Couclusion Dual source CT is convenience, non-trauma.Its information can be composited.It can offer overall image information of the blood vessel disease such as CBT, which is very important for diagnosis, typing, evaluation the risk of the operation of CBT.So, dual source CT can be the first choice in the diagnosis of carotid body tumor.%目的 评价双源CT(dual source CT,DSCT)在颈动脉体瘤(carotid body tumor,CBT)诊断、治疗中的价值.方法 2007年9月至2010年4月对临床拟诊CBT的5例行颈部双源CT检查,根据临床体征及影像学检查确定肿瘤的性质及其与颈总、颈内、颈外动脉的关系,评估手术的风险及可行性.结果 5例DSCT检查结果均显示颈总动脉分叉处界线清晰的软组织实性肿块.增强扫描后病灶均呈明显强化,瘤体血供丰富.4例单侧瘤体较小CBT呈现典型的"高脚杯"征.1例双

  17. Myocardial hypertrophy induces carotid body hyperplasia.

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    Sivridis, Efthimios; Pavlidis, Pavlos; Fiska, Aliki; Pitsiava, Dimitra; Giatromanolaki, Alexandra

    2011-01-01

    The carotid bodies tend to enlarge after long-standing cardiopulmonary disease. Our objective was to investigate whether cardiac hypertrophy is associated with carotid body hyperplasia. Fifteen autopsy cases with combined left and right ventricular hypertrophy were examined and compared with two control groups (16 cases). The study involved a meticulous dissection of carotid bifurcations, thin serial sections, and morphometric analysis of carotid body volume and cell types (progenitor, dark, light, and sustentacular). There was a significant increase in sustentacular cells in all individuals with cardiac hypertrophy, which was not drug-induced, and accompanied by a similar increase in carotid body volume. Dark or light cell accumulation was detected focally and only in three instances. It appears that the generalized sustentacular cell hyperplasia is the result of long-standing hypoxia, while a superimposed focal prominence of dark or light cells may be proliferative or metaplastic in nature and attributed to short-term hypoxia.

  18. Embolização intra-arterial pré-operatória de tumor do corpo carotídeo Preoperative intraarterial embolization of carotid body tumor

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    Gaudêncio Espinosa

    2006-09-01

    Full Text Available Os autores relatam um caso de tumor de corpo carotídeo (paraganglioma em um paciente de 74 anos de idade, submetido a embolização intra-arterial com micropartículas esféricas, de polivinil acetato, com casca de polivinil álcool (PVAc + PVA, previamente à ressecção do tumor. O estudo angiográfico demonstrou massa altamente vascularizada na bifurcação carotídea esquerda, sendo a embolização pré-operatória utilizada no intuito de diminuir a vascularização e reduzir a perda sangüínea, aumentando a segurança do tratamento cirúrgico. O estudo histopatológico confirmou a presença de trombose e isquemia tecidual.The authors report a case of carotid body tumor (paraganglioma in a 74-year-old male patient, submitted to intraarterial embolization with spherical core/shield polyvinyl acetate and polyvinyl alcohol (PVAc + PVA microparticles prior to surgical excision. Angiography has demonstrated a highly vascularized mass in the left carotid bifurcation, and preoperative embolization was used in order to decrease vascularity, reduce blood loss and improve safety of surgical treatment. Microscopic study confirmed presence of thrombosis and tissue ischemia.

  19. Surgical treatment of carotid body tumor: a report of 36 cases%颈动脉体瘤36例手术治疗体会

    Institute of Scientific and Technical Information of China (English)

    黄德亮; 马玥莹; 刘良发; 赵辉; 王嘉陵; 武文明; 刘明波; 赵建东

    2013-01-01

    目的 总结颈动脉体瘤患者手术经验,提高患者生活质量.方法 对2004年6月至2012年6月的36例颈动脉体瘤患者的病历资料进行分析,其中男13例,女23例;年龄9~61岁,中位数42岁;肿瘤所在位置为右侧14例,左侧19例,双侧3例(其中2例为兄妹);经颈部B超、CT、MRI和DSA检查,手术的基本术式是颌下、颈侧及胸锁乳突肌上段前缘切口.结果 36例(38侧,1例双侧病变者左侧未行手术)中29侧颈动脉体瘤完全切除,其中6侧肿瘤质地坚硬并包裹颈内动脉者在宫藤夹夹闭颈总动脉后行肿瘤和颈动脉切除;9侧质地坚硬肿瘤残留.术中出血80 ml以内17侧,100~550ml 18侧,800 ml、1000 ml和1500 ml各1侧;15侧血管栓塞中位出血量200 ml,23侧血管未栓塞中位出血量60 ml.术后神经功能障碍共10例(26.3%),含8例术前神经损伤术后神经麻痹无改善或加重者,新增术后神经损伤2例.1例恶性颈动脉体瘤术后2年随访时仍带瘤生存,其余病例经10个月至6年随访除9例失访者外均存活,肿瘤未增大.结论 颈动脉体瘤首选手术切除,其质地较软者一般可完整分离切除肿瘤、保留颈内动脉,而质地坚硬且包裹颈内动脉手术时血管破裂可能性极大,术前应行DSA,确认脑血管交通支存在时,结扎颈外动脉后,置宫藤夹逐渐夹闭颈总动脉,待建立良好代偿后行肿瘤及颈动脉切除,可避免颅内并发症.%Objective To study surgical methods and techniques to reduce complications in carotid body tumors (CBT).Methods A total of 36 patients with CBT treated by the same surgeon between 2004and 2012 was reviewed.Clinical presentation,imaging,surgery techniques,postoperative complications and outcomes as well as follow-up evaluations were analyzed.Results Of 36 patients,13 males and 23 females,with a median age of 42 years (range 9-61 years).Nineteen patients had a CBT on the left side,14 on the right side and 3 on both sides.All patients (36

  20. Tumor del cuerpo carotídeo: Presentación de un caso por ecografía y resonancia magnética Carotid body tumor: A case presentation with ultrasonography and magnetic resonance imaging

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    Marcelo Cabrini

    2009-09-01

    Full Text Available El tumor de cuerpo carotídeo, que se origina en los quimiorreceptores de dicha estructura, representa hasta el 50% de los paragangliomas de cabeza y cuello. En forma frecuente, constituye un hallazgo incidental (asintomático, aunque en algunos casos los pacientes pueden consultar por una masa indolora, ronquera, paresia lingual y/o disfagia. Sus características imagenológicas permiten una aproximación diagnóstica no invasiva con altos índices de sensibilidad y especificidad, por lo que su conocimiento facilita la conducta clínico-terapéutica. Se presenta un caso clínico que resulta particularmente elocuente para la práctica diaria, ya que la paciente tiene antecedentes quirúrgicos por patología tiroidea maligna, hecho que precisa una aproximación diagnóstica estricta para su correcto seguimiento.The carotid body tumor, which arises from its chief cells (glomus type 1, is the most common paraganglioma of the head and neck (up to 50%. This tumor is in most cases clinically silent and is detected incidentally at imaging study during evaluation of patients with unrelated symptoms such as painless, slowly growing lateral neck mass, dysphagia, sleep apnea, and paresia or atrophy of the tongue. According to its appearance, precise non-invasive imaging techniques may allow the radiologist to reach the correct diagnosis and treatment. The following case report is particularly useful for daily practice; the patient has surgical history of tiroid neoplasm which requires a thorough diagnosis, in order to determine an accurate follow-up.

  1. Respiratory neuroplasticity following carotid body denervation Central and peripheral adaptations

    Institute of Scientific and Technical Information of China (English)

    Matthew R. Hodges; Hubert V. Forster

    2012-01-01

    Historically, the role of the carotid bodies in ventilatory control has been understated, but the current view suggests that the carotid bodies (1) provide a tonic, facilitory input to the respiratory network, (2) serve as the major site of peripheral O2 chemoreception and minor contributor to CO2/H+ chemoreception, and (3) are required for ventilatory adaptation to high altitude. Each of these roles has been demonstrated in studies of ventilation in mammals after carotid body denervation. Following carotid body denervation, many of the compromised ventilatory "functions" show a time-dependent recovery plasticity that varies in the degree of recovery and time required for recovery. Respiratory plasticity following carotid body denervation is also dependent on species, with contributions from peripheral and central sites/mechanisms driving the respiratory plasticity. The purpose of this review is to provide a summary of the data pointing to peripheral and central mechanisms of plasticity following carotid body denervation. We speculate that after carotid body denervation there are altered excitatory and/or inhibitory neuromodulator mechanisms that contribute to the initial respiratory depression and the subsequent respiratory plasticity, and further suggest that the continued exploration of central effects of carotid body denervation might provide useful information regarding the capacity of the respiratory network for plasticity following neurologic injury in humans.

  2. Solitary fibrous tumor surrounding the carotid sheath.

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    Gómez-Oliveira, Guillermo; Alvarez-Flores, Modesto; Arribas-García, Ignacio; Martínez-Gimeno, Carlos

    2010-03-01

    Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms that are mostly found arising from the pleura. Although SFTs recently have been reported in other regions, they are rare in the head and neck and have often been misdiagnosed due to their rarity. SFTs are benign in most cases. Clinically, SFTs usually manifest as well-circumscribed, slow-growing, smooth and painless masses. Symptoms are often minimal, although they may include sore throat, difficulty in swallowing, change of voice or trismus. CT-Scan and MRI are the most sensitive imaging procedures used. The treatment of choice is complete surgical excision of the lesion. Because recurrences have been noted up to 30 years after surgery, long-term follow up is mandatory. In this article, we present a case of a Solitary Fibrous Tumor arising in the parapharyngeal space in a 20-year-old man, involving the carotid sheath, treated by surgical excision with no recurrence after 1 year. The clinical presentation, surgical management and pathological findings are described.

  3. Simultaneous adrenal pheochromocytoma and carotid body paraganglioma in a woman

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    Han, Eun Ji; Lee, Sang Hoon; Song, In Uk; Chung, Yong An; Maeng, Lee So [The Catholic Univ. of Korea, Incheon (Korea, Republic of)

    2012-03-15

    Simultaneous occurrence of carotid body tumor and pheochromocytoma is rare. Most pheochromocytomas have grown on adrenal medulla, but some of the pheochromocytoma patients have multifocal paragangliomas arising from extraaderenal tissues. Pheochromocytomas and paragangliomas occur as sporadic tumors or they can be associated with several hereditary syndromes such as (1) multiple endocrine neoplasia type 2 (MEN 2), (2) Von Hippel Lindau disease (VHL) and (3) neurofibromatosis type 1 as an unusual genetic cause of pheochromocytomas. Genetic testing is recommended for patients with an apparently sporadic pheochromocytoma under the age of 20 years with a family history or features suggestive of hereditary pheochromocytoma or for patients with sympathetic paragangliomas. For individuals who do not meet these criteria, genetic testing is optional. Discovery of pheochromocytoma or paraganglioma in a patient should lead to a careful search to rule out multifocal lesions and/or hereditary syndromes. The diagnosis of pheochromocytoma and paraganglioma is made by biochemical testing, and imaging is done to localize the tumor for surgical planning. F 18 FDG PET has proved to be an effective tool in the localization of pheochromocytomas and paragangliomas.

  4. Gasotransmitter regulation of ion channels: a key step in O2 sensing by the carotid body.

    Science.gov (United States)

    Prabhakar, Nanduri R; Peers, Chris

    2014-01-01

    Carotid bodies detect hypoxia in arterial blood, translating this stimulus into physiological responses via the CNS. It is long established that ion channels are critical to this process. More recent evidence indicates that gasotransmitters exert powerful influences on O2 sensing by the carotid body. Here, we review current understanding of hypoxia-dependent production of gasotransmitters, how they regulate ion channels in the carotid body, and how this impacts carotid body function.

  5. Sympathetic innervation of the carotid bifurcation in the rabbit and cat: blood vessels, carotid body and carotid sinus. A fluorescence and electron microscopic study.

    Science.gov (United States)

    Knoche, H; Kienecker, E W

    1977-10-21

    Two postganglionic branches of the superior cervical ganglion enter the area of the carotid bifurcation in the rabbit and the cat. The common and external carotid arteries receive a rich adrenergic nerve supply, which can be demonstrated by fluorophores of biogenic amines appearing after formaldehyde treatment. The internal carotid artery is only sparsely innervated; however, it shows a dense sympathetic supply at the site of pressor receptors. Following removal of the superior cervical ganglion, a total loss of fluorescent adrenergic nerves occurs and degeneration of nerve endings possessing dense core vesicles is conspicuous. These nerve terminals are situated mainly subendothelially in the carotid body sinusoids; they only rarely terminate on type I cells.

  6. The histology of the carotid bodies in highlanders from Ladakh

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    Khan, Q.; Heath, D.; Smith, P.; Norboo, T.

    1988-12-01

    A histological study was made of the carotid bodies in a boy and three adult male highlanders born and residing between altitudes of 3300 m to 4200 m in Ladakh. The carotid bodies were enlarged in two of the men, and in all four subjects showed increased numbers and enlargement of the dark variants of the chief cells of the glomic tissue. In these dark cells the cytoplasm was voluminous, formed streamers and contained many intracytoplasmic vesicles of which some had mused to form larger vesicles that appeared to have discharged from the cell surface. Immunohistochemical studies showed that these cells contained considerable amounts of the peptide met-enkephalin. It is thus considered that prominence of dark cells containing this peptide is characteristic of sustained exposure of the carotid bodies to hypobaric hypoxia. In the middle-aged highlander there was a prominence of sustentacular cells which encroached upon the cores of chief cells and this may be associated with the characteristic loss of hypoxic ventilatory response in the highlander.

  7. Cerebral foreign body reaction after carotid aneurysm stenting

    DEFF Research Database (Denmark)

    Lorentzen, Anastasia Orlova; Nome, Terje; Bakke, Søren Jacob

    2016-01-01

    Flow diverter stents are new important tools in the treatment of large, giant, or wide-necked aneurysms. Their delivery and positioning may be difficult due to vessel tortuosity. Common adverse events include intracranial hemorrhage and ischemic stroke, which usually occurs within the same day......, or the next few days after the procedure. We present a case where we encountered an unusual intracerebral complication several months after endovascular treatment of a large left internal carotid artery aneurysm, and where brain biopsy revealed foreign body reaction to hydrophilic polymer fragments distally...

  8. Synchronous malignant vagal paraganglioma with contralateral carotid body paraganglioma treated by radiation therapy

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    Devlina Chakarvarty

    2010-06-01

    Full Text Available Paragangliomas are rare tumors and very few cases of malignant vagal paraganglioma with synchronous carotid body paraganglioma have been reported. We report a case of a 20-year old male who presented with slow growing bilateral neck masses of eight years duration. He had symptoms of dysphagia to solids, occasional mouth breathing and hoarseness of voice. Fine needle aspiration cytology (FNAC performed where he lived showed a sinus histiocytosis and he was administered anti-tubercular treatment for six months without any improvement in his symptoms. His physical examination revealed pulsatile, soft to firm, non-tender swellings over the anterolateral neck confined to the upper-mid jugulo-diagastric region on both sides. Direct laryngoscopy examination revealed a bulge on the posterior pharyngeal wall and another over the right lateral pharyngeal wall. Magnetic resonance imaging (MRI, 99mTc-labeled octreotide scan and angiography diagnosed the swellings as carotid body paraganglioma, stage III on the right side with left-sided vagal malignant paraganglioma. Surgery was ruled out as a high morbidity with additional risk to life was expected due to the highly vascular nature of the tumor. The patient was treated with radiation therapy by image guided radiation to a dose of 5040cGy in 28 fractions. At a follow-up at 16 months, the tumors have regressed bilaterally and the patient can take solids with ease.

  9. Carotid body, insulin and metabolic diseases: unravelling the links

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    Silvia V Conde

    2014-10-01

    Full Text Available The carotid bodies (CB are peripheral chemoreceptors that sense changes in arterial blood O2, CO2 and pH levels. Hypoxia, hypercapnia and acidosis activate the CB, which respond by increasing the action potential frequency in their sensory nerve, the carotid sinus nerve (CSN. CSN activity is integrated in the brain stem to induce a panoply of cardiorespiratory reflexes aimed, primarily, to normalize the altered blood gases, via hyperventilation, and to regulate blood pressure and cardiac performance, via sympathetic nervous system (SNS activation. Besides its role in the cardiorespiratory control the CB has been proposed as a metabolic sensor implicated in the control of energy homeostasis and, more recently, in the regulation of whole body insulin sensitivity. Hypercaloric diets cause CB overactivation in rats, which seems to be at the origin of the development of insulin resistance and hypertension, core features of metabolic syndrome and type 2 diabetes. Consistent with this notion, CB sensory denervation prevents metabolic and hemodynamic alterations in hypercaloric feed animal. Obstructive sleep apnoea (OSA is another chronic disorder characterized by increased CB activity and intimately related with several metabolic and cardiovascular abnormalities. In this manuscript we review in a concise manner the putative pathways linking CB chemoreceptors deregulation with the pathogenesis of insulin resistance and arterial hypertension. Also, the link between chronic intermittent hypoxia (CIH and insulin resistance is discussed. Then, a final section is devoted to debate strategies to reduce CB activity and its use for prevention and therapeutics of metabolic diseases with an emphasis on new exciting research in the modulation of bioelectronic signals, likely to be central in the future.

  10. Role of carotid body for neuronal protection in experimental subarachnoid haemorrhage

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    Mehmet Dumlu Aydın

    2013-01-01

    Full Text Available Objective: Carotid bodies are known as main arterialchemoregulatory units. Despite well known that carotidbodies have an important role in cerebral circulation andblood pH regulation, their roles has not been investigatedin subarachnoid haemorrhage. We investigated whetherthere is neuroprotective effect of neuron density of carotidbodies on the brain in subarachnoid haemorrhage.Methods: Twenty hybrid rabbits were studied. Four ofthem were used as reference group (n=4 and the remainingwas obliged to subarachnoid haemorrhage by injectingautologous blood into their cisterna magna (n=16and sacrificed after one month. All carotid bodies andbrains examined histopathologically using by stereologicmethods. The relationship between the neuronal densityof carotid body and degenerated neuron density of thehippocampus were compared statistically.Results: Five rabbits with subarachnoid haemorrhagedead during the follow-up time (n=5. The average neuronaldensity of carotid body was 4500±500 cells/mm3and of hippocampus 170.000±17.000 cell/mm3 in normalrabbit family. The degenerated neuron density ofthe hippocampus was 20.000±3.000 cells/mm3 in rabbitswith have high neuron density of carotid body and was65.000±8.000 cells/mm3 in rabbits with low neuron densityof carotid body. The differences between the neuronaldensity of carotid body and the degenerated neuron numbersof the hippocampus were significant.Conclusion: The neuron density of carotid body mayplay an important role on the protection of brain in subarachnoidhaemorrhage.Key words: Subarachnoid haemorrhage, carotid body,hippocampus, neurodegeneration, cerebral ischemia

  11. Ultrastructure of the carotid body of the goat.

    Science.gov (United States)

    Abdel-Magied, E M; Taha, A A

    1995-09-01

    The carotid body of the goat was found to be a small oval or rounded parenchymatous organ. It was characterized by its profound vascularity. Delicate septa divided the parenchyma into small feebly defined lobules. Electron microscopy revealed that the parenchyma comprised type I cells, type II cells, nerve endings, axons and fenestrated dilated capillaries. Type I cells were characterized with electron dense-cored vesicles. They showed variations in size and concentration of the dense-cored vesicles and number of mitochondria. The possibility that these variations are reflections of different stages of activity is discussed. Type II cells were less numerous than type I cells, relatively small and devoid of dense-cored vesicles. They usually surrounded small groups of type I cells and associated nerve endings and axons. Presumptive afferent nerve endings characterized with many clear vesicles, occasional large granular vesicles and varying numbers of slender mitochondria, lay apposed to type I cells. Nerve endings of this kind showed afferent and efferent synaptic junctions with type I cells. Presumptive sympathetic efferent endings were occasionally seen within the lobules but never lay apposed to type I cells or afferent nerve ending.

  12. Carotid body oxygen sensing and adaptation to hypoxia.

    Science.gov (United States)

    López-Barneo, José; Macías, David; Platero-Luengo, Aida; Ortega-Sáenz, Patricia; Pardal, Ricardo

    2016-01-01

    The carotid body (CB) is the principal arterial chemoreceptor that mediates the hyperventilatory response to hypoxia. Our understanding of CB function and its role in disease mechanisms has progressed considerably in the last decades, particularly in recent years. The sensory elements of the CB are the neuron-like glomus cells, which contain numerous transmitters and form synapses with afferent sensory fibers. The activation of glomus cells under hypoxia mainly depends on the modulation of O2-sensitive K(+) channels which leads to cell depolarization and the opening of Ca(2+) channels. This model of sensory transduction operates in all mammalian species studied thus far, including man. However, the molecular mechanisms underlying the modulation of ion channel function by changes in the O2 level are as yet unknown. The CB plays a fundamental role in acclimatization to sustained hypoxia. Mice with CB atrophy or patients who have undergone CB resection due to surgical treatments show a marked intolerance to even mild hypoxia. CB growth under hypoxia is supported by the existence of a resident population of neural crest-derived stem cells of glia-like phenotype. These stem cells are not highly affected by exposure to low O2 tension; however, there are abundant synapse-like contacts between the glomus cells and stem cells (chemoproliferative synapses), which may be needed to trigger progenitor cell proliferation and differentiation under hypoxia. CB hypo- or hyper-activation may also contribute to the pathogenesis of several prevalent human diseases.

  13. Reference gene validation for qPCR in rat carotid body during postnatal development

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    Carroll John L

    2011-10-01

    Full Text Available Abstract Background The carotid bodies are the main arterial oxygen chemoreceptors in mammals. Afferent neural output from the carotid bodies to brainstem respiratory and cardiovascular nuclei provides tonic input and mediates important protective responses to acute and chronic hypoxia. It is widely accepted that the selection of reference genes for mRNA normalization in quantitative real-time PCR must be validated for a given tissue and set of conditions. This is particularly important for studies in carotid body during early postnatal maturation as the arterial oxygen tension undergoes major changes from fetal to postnatal life, which may affect reference gene expression. In order to determine the most stable and suitable reference genes for the study of rat carotid body during development, six commonly used reference genes, β-actin, RPII (RNA polymerase II, PPIA (peptidyl-proyl-isomerase A, TBP (TATA-box binding protein, GAPDH, and 18s rRNA, were evaluated in two age groups (P0-1 and P14-16 under three environmental oxygen conditions (normoxia, chronic hypoxia and chronic hyperoxia using the three most commonly used software programs, geNorm, NormFinder and BestKeeper. Findings The three programs produced similar results but the reference gene rankings were not identical between programs or experimental conditions. Overall, 18s rRNA was the least stable reference gene for carotid body and, when hyperoxia and/or hypoxia conditions were included, actin was similarly unstable. Conclusions Reference or housekeeping gene expression for qPCR studies of carotid body during postnatal development may vary with developmental stage and environmental conditions. Selection of the best reference gene or combination of reference genes for carotid body development studies should take environmental conditions into account. Two commonly used reference genes, 18s rRNA and actin, may be unsuitable for studies of carotid body maturation, especially if the study

  14. Neonatal Maternal Separation Augments Carotid Body Response to Hypoxia in Adult Males but Not Female Rats

    Science.gov (United States)

    Soliz, Jorge; Tam, Rose; Kinkead, Richard

    2016-01-01

    Perinatal exposure to adverse experiences disrupts brain development, including the brainstem network that regulates breathing. At adulthood, rats previously subjected to stress (in the form of neonatal maternal separation; NMS) display features reported in patients suffering from sleep disordered breathing, including an increased hypoxic ventilatory response and hypertension. This effect is also sex-specific (males only). Based on these observations, we hypothesized that NMS augments the carotid body's O2-chemosensitivity. Using an isolated and perfused ex vivo carotid body preparation from adult rats we compared carotid sinus nerve (CSN) responses to hypoxia and hypercapnia in carotid bodies harvested from adult rats that either experienced control conditions (no experimental manipulation) or were subjected to NMS (3 h/day from postnatal days 3 to 12). In males, the CSN response to hypoxia measured in preparations from NMS males was 1.5 fold higher than controls. In control rats, the female's response was similar to that of males; however, the increase in CSN activity measured in NMS females was 3.0 times lower than controls. The CSN response to hypercapnia was not influenced by stress or sex. We conclude that NMS is sufficient to have persistent and sex-specific effects on the carotid body's response to hypoxia. Because NMS also has sex-specific effects on the neuroendocrine response to stress, we propose that carotid body function is influenced by stress hormones. This, in turn, leads to a predisposition toward cardio-respiratory disorders. PMID:27729873

  15. The carotid body of the spontaneous insulin-dependent diabetic rat

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    Clarke J.A.

    1999-01-01

    Full Text Available The carotid bodies from adult spontaneous insulin-dependent diabetic rats (strain BB/S were perfusion-fixed at normal arterial blood pressure with 3% phosphate-buffered glutaraldehyde and compared with the organs from control rats (strain BB/Sc prepared in the same way. Serial 5-µm sections were cut, stained, and using an interactive image analysis system, were analysed to determine the volumes of the carotid body and its vascular and extravascular compartments. There was no evidence of systemic arterial disease in the carotid stem arteries in either group of animals, and the microvasculature of the organs appeared normal by light microscopy. The volume of the carotid body was unchanged 3 months after the onset of diabetes but was increased at 6 months. The total vascular volume of the organ was unchanged, but the volume of the small vessels (5-12 µm was increased. In the control group the small vessels comprised 5% of the total volume of the carotid body, or about 44% of the vascular compartment. The percentage of small vessels increased at 3 months in the diabetic group, but had returned to normal at 6 months. The extravascular volume followed the same pattern as the total carotid body volume and so did not change appreciably when expressed as a percentage of the total volume of the organ. The increase in size of the carotid body in diabetic rats is due, therefore, to an augmented extravascular volume. In one diabetic specimen the carotid sinus nerve showed signs of diabetic neuropathy, axonal swelling and intramyelinic oedema. The clinical implications of these results are discussed.

  16. Revisiting cAMP signaling in the carotid body

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    Ana Rita eNunes

    2014-10-01

    Full Text Available Chronic carotid body (CB activation is now recognized as being essential in the development of hypertension and promoting insulin resistance; thus, it is imperative to characterize the chemotransduction mechanisms of this organ in order to modulate its activity and improve patient outcomes. For several years, and although controversial, cyclic adenosine monophosphate (cAMP was considered an important player in initiating the activation of the CB. However, its relevance was partially displaced in the 90s by the emerging role of the mitochondria and molecules such as AMP-activated protein kinase (AMPK and O2-sensitive K+ channels. Neurotransmitters/neuromodulators binding to metabotropic receptors are essential to chemotransmission in the CB, and cAMP is central to this process. cAMP also contributes to raise intracellular Ca2+ levels, and is intimately related to the cellular energetic status (AMP/ATP ratio. Furthermore, cAMP signaling is a target of multiple current pharmacological agents used in clinical practice. This review provides an outline on 1 the classical view of the cAMP-signaling pathway in the CB that originally supported its role in the O2/CO2 sensing mechanism, 2 present recent evidence on CB cAMP neuromodulation and 3 discuss how CB activity is affected by current clinical therapies that modify cAMP-signaling, namely dopaminergic drugs, caffeine (modulation of A2A/A2B receptors and roflumilast (PDE4 inhibitors. cAMP is key to any process that involves metabotropic receptors and the intracellular pathways involved in CB disease states are likely to involve this classical second messenger. Research examining the potential modification of cAMP levels and/or interactions with molecules associated with CB hyperactivity is currently in its beginning and this review will open doors for future explorations.

  17. Chronic hyperoxia alters the expression of neurotrophic factors in the carotid body of neonatal rats.

    Science.gov (United States)

    Dmitrieff, Elizabeth F; Wilson, Julia T; Dunmire, Kyle B; Bavis, Ryan W

    2011-02-15

    Chronic exposure to hyperoxia alters the postnatal development and innervation of the rat carotid body. We hypothesized that this plasticity is related to changes in the expression of neurotrophic factors or related proteins. Rats were reared in 60% O(2) from 24 to 36h prior to birth until studied at 3d of age (P3). Protein levels for brain-derived neurotrophic factor (BDNF) were significantly reduced (-70%) in the P3 carotid body, while protein levels for its receptor, tyrosine kinase B, and for glial cell line-derived neurotrophic factor (GDNF) were unchanged. Transcript levels in the carotid body were downregulated for the GDNF receptor Ret (-34%) and the neuropeptide Vgf (-67%), upregulated for Cbln1 (+205%), and unchanged for Fgf2; protein levels were not quantified for these genes. Immunohistochemical analysis revealed that Vgf and Cbln1 proteins are expressed within the carotid body glomus cells. These data suggest that BDNF, and perhaps other neurotrophic factors, contribute to abnormal carotid body function following perinatal hyperoxia.

  18. Evidence for a carotid body homolog in the lizard Tupinambis merianae.

    Science.gov (United States)

    Reichert, Michelle N; Brink, Deidre L; Milsom, William K

    2015-01-15

    The homolog to the mammalian carotid body has not yet been identified in lizards. Observational studies and evolutionary history provide indirect evidence for the existence of a chemoreceptor population at the first major bifurcation of the common carotid artery in lizards, but a chemoreceptive role for this area has not yet been definitively demonstrated. We explored this possibility by measuring changes in cardiorespiratory variables in response to focal arterial injections of the hypoxia mimic sodium cyanide (NaCN) into the carotid artery of 12 unanesthetized specimens of Tupinambis merianae. These injections elicited increases in heart rate (f(H); 101±35% increase) and respiratory rate (f(R); 620±119% increase), but not mean arterial blood pressure (MAP). These responses were eliminated by vagal denervation. Similar responses were elicited by injections of the neurotransmitters acetylcholine (ACh) and serotonin (5-HT) but not norepinephrine. Heart rate and respiratory rate increases in response to NaCN could be blocked or reduced by antagonists to ACh (atropine) and/or 5-HT (methysergide). Finally, using immunohistochemistry, we demonstrate the presence of putative chemoreceptive cells immunopositive for the cholinergic cell marker vesicular ACh transporter (VAChT) and 5-HT on internal lattice-like structures at the carotid bifurcation. These results provide evidence in lizards for the existence of dispersed chemoreceptor cells at the first carotid bifurcation in the central cardiovascular area that have similar properties to known carotid body homologs, adding to the picture of chemoreceptor evolution in vertebrates.

  19. Inherent variations in CO-H2S-mediated carotid body O2 sensing mediate hypertension and pulmonary edema.

    Science.gov (United States)

    Peng, Ying-Jie; Makarenko, Vladislav V; Nanduri, Jayasri; Vasavda, Chirag; Raghuraman, Gayatri; Yuan, Guoxiang; Gadalla, Moataz M; Kumar, Ganesh K; Snyder, Solomon H; Prabhakar, Nanduri R

    2014-01-21

    Oxygen (O2) sensing by the carotid body and its chemosensory reflex is critical for homeostatic regulation of breathing and blood pressure. Humans and animals exhibit substantial interindividual variation in this chemosensory reflex response, with profound effects on cardiorespiratory functions. However, the underlying mechanisms are not known. Here, we report that inherent variations in carotid body O2 sensing by carbon monoxide (CO)-sensitive hydrogen sulfide (H2S) signaling contribute to reflex variation in three genetically distinct rat strains. Compared with Sprague-Dawley (SD) rats, Brown-Norway (BN) rats exhibit impaired carotid body O2 sensing and develop pulmonary edema as a consequence of poor ventilatory adaptation to hypobaric hypoxia. Spontaneous Hypertensive (SH) rat carotid bodies display inherent hypersensitivity to hypoxia and develop hypertension. BN rat carotid bodies have naturally higher CO and lower H2S levels than SD rat, whereas SH carotid bodies have reduced CO and greater H2S generation. Higher CO levels in BN rats were associated with higher substrate affinity of the enzyme heme oxygenase 2, whereas SH rats present lower substrate affinity and, thus, reduced CO generation. Reducing CO levels in BN rat carotid bodies increased H2S generation, restoring O2 sensing and preventing hypoxia-induced pulmonary edema. Increasing CO levels in SH carotid bodies reduced H2S generation, preventing hypersensitivity to hypoxia and controlling hypertension in SH rats.

  20. Towards the sensory nature of the carotid body: Hering, De Castro and Heymans

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    Fernando De Castro

    2009-12-01

    Full Text Available The carotid body or glomus caroticum is a chemosensory organ bilaterally located between the external and internal carotid arteries. Although known by anatomists since the report included by Von Haller and Taube in the mid XVIIIth century, its detailed study started the first quarter of the XXth. The Austro-German physiologist Heinrich E. Hering studied the cardio-respiratory reflexes searched for the anatomical basis of this reflex in the carotid sinus, while the Ghent School leaded by the physio-pharmacologists Jean-François Heymans and his son Corneille focussed in the cardio-aortic reflexogenic region. In 1925, Fernando De Castro, one of the youngest and more brilliant disciples of Santiago Ramón y Cajal at the Laboratorio de Investigaciones Biológicas (Madrid, Spain, profited from some original novelties in histological procedures to study the fine structure and innervation of the carotid body. De Castro unravelled them in a series of scientific papers published between 1926 and 1929, which became the basis to consider the carotid body as a sensory receptor (or chemoreceptor to detect the chemical changes in the composition of the blood. Indeed, this was the first description of arterial chemoreceptors. Impressed by the novelty and implications of the work of De Castro, Corneille Heymans invited the Spanish neurologist to visit Ghent on two occasions (1929 and 1932, where both performed experiences together. Shortly after, Heymans visited De Castro at the Instituto Cajal (Madrid. From 1932-33, Corneille Heymans focused all his attention on the carotid body his physiological demonstration of De Castro’s hypothesis regarding chemoreceptors was awarded with the Nobel Prize in Physiology or Medicine in 1938, just when Spain was immersed in its catastrophic Civil War.

  1. Anaesthetic challenges in carotid body tumour resection: a case report and review of literature

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    Anuradha Malliwal

    2015-12-01

    Full Text Available Carotid body tumour (CBT is an extremely rare, non-chromaffin paraganglioma arising from chemoreceptor cells at the carotid bifurcation. Reported incidence is 1-2 per 100,000. Surgical excision of the tumour, the definitive treatment, poses several anaesthetic challenges and a high incidence of perioperative morbidity and mortality (20-40%. Very few cases have been reported so far. We report the anaesthetic management of a case of CBT excision with a review of recent literature on the same. [Int J Res Med Sci 2015; 3(12.000: 3897-3900

  2. Hydrogen sulfide activates the carotid body chemoreceptors in cat, rabbit and rat ex vivo preparations.

    Science.gov (United States)

    Jiao, Yingfu; Li, Qian; Sun, Biying; Zhang, Guohua; Rong, Weifang

    2015-03-01

    We and others previously reported experimental evidence suggesting an important role for hydrogen sulfide (H2S) in oxygen sensing in murine carotid body chemoreceptors. More recent data implicated abnormal H2S-mediated chemoreceptor signaling in pathological conditions such as chronic heart failure and hypertension. However, the idea of H2S as a mediator of oxygen-sensing in chemoreceptors has been challenged. In particular, it was shown that exogenous H2S inhibited the release of neurotransmitters (ACh and ATP) from the cat carotid body, raising the possibility that there exists significant species difference in H2S-mediated signaling in chemoreceptors. This study was designed specifically to determine the effect of H2S on chemoreceptors in different species. We conducted multiunit extracellular recordings of the sinus nerve in the ex vivo carotid body preparation taken from the rat, the cat and the rabbit. As observed in the mouse carotid body, H2S donors (NaHS or Na2S) evoked qualitatively similar excitatory responses of the afferent sinus nerves of the species studied here. The excitatory effects of the H2S donors were concentration-dependent and reversible. The sinus nerve responses to H2S donors were prevented by blockade of the transmission between type I cells and the afferent terminals, as was the response to hypoxia. These results demonstrate that exogenous H2S exerts qualitatively similar excitatory effects on chemoreceptor afferents of different species. The role of endogenous H2S-mediated signaling in carotid body function in different species awaits further investigation.

  3. Opportunity choice of surgical resection of carotid body tumor after transcathter superselective embolization of feeding artery: A color Doppler ultrasonic observation%颈动脉体瘤超选择性动脉栓塞治疗后外科切除术的时机选择:彩色多普勒超声观察

    Institute of Scientific and Technical Information of China (English)

    叶有强; 梁建深; 郭辉; 林志东; 王思阳

    2012-01-01

    Objective To investigate the opportunity choice of surgical resection of carotid body tumor (CBT) after transcathter superselective embolization of feeding artery with color Doppler ultrasound observation (CDU). Methods Tran-stheter embolization of tumor feeding artery was performed on 22 CBT patients before surgical operation. CDU was used to measure the peak systolic velocity (PSV) and resistance index (RI) of blood flow of feeding artery before and 1,2,4 days after embolization, respectively. Statistical analysis of these data was performed. Results One and 2 days after embolization, PSV and RI of tumor feeding artery were lower than those before embolization (both P0. 05). Conclusion CDU is valuable for the judgment of involvement aera, feeding artery and collateral pathways of CBT, as well as for the opportunity choice of surgical resection. Surgical resection of CBT may be safely performed within 2 days after transtheter superselective arterial embolization of feeding artery.%目的 利用彩色多普勒超声(CDU)观察经导管超选择性动脉栓塞治疗颈动脉体瘤(CBT)后的外科切除时机.方法 对22例外科切除术前CBT患者行经导管超选择性肿瘤供血动脉栓塞.于栓塞术前、术后1、2、4天分别采用CDU检测肿瘤供血动脉的峰值血流速度(PSV)和阻力指数(RI),并进行统计学分析.结果 栓塞术后1、2天,CBT供血动脉的PSV、RI均低于术前(P均<0.01),而栓塞术后4天PSV、RI与术前比较差异无统计学意义(P均>0.05).结论 CDU对判断CBT侵犯范围、供血血管、侧支循环状况及选择手术时机均具有临床应用价值.栓塞术后2天内可能为安全切除CBT的手术时机.

  4. Morphological changes of carotid bodies in acute respiratory distress syndrome: a morphometric study in humans

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    Vinhaes E.N.G.

    2002-01-01

    Full Text Available Carotid bodies are chemoreceptors sensitive to a fall of partial oxygen pressure in blood (hypoxia. The morphological alterations of these organs in patients with chronic obstructive pulmonary disease (COPD and in people living at high altitude are well known. However, it is not known whether the histological profile of human carotid bodies is changed in acute clinical conditions such as acute respiratory distress syndrome (ARDS. The objective of the present study was to perform a quantitative analysis of the histology of carotid bodies collected from patients who died of ARDS. A morphometric study of carotid bodies collected during routine autopsies was carried out on three groups: patients that died of non-respiratory diseases (controls, N = 8, patients that presented COPD and died of its complications or associated diseases (N = 7, and patients that died of ARDS (N = 7. Morphometric measurements of the volume fraction of clusters of chief cells were performed in five fields on each slide at 40X magnification. The numerical proportion of the four main histological cell types (light, dark, progenitor and sustentacular cells was determined analyzing 10 fields on each slide at 400X magnification. The proportion of dark cells was 0.22 in ARDS patients, 0.12 in controls (P<0.001, and 0.08 in the COPD group. The proportion of light cells was 0.33 (ARDS, 0.44 (controls (P<0.001, and 0.36 (COPD. These findings suggest that chronic and acute hypoxia have different effects on the histology of glomic tissue.

  5. [Carotid body paraganglioma in a teenager. Case report].

    Science.gov (United States)

    López-Vázquez, María Elisa; Llamas-Macías, Francisco Javier; Nuño-Escobar, César; González-Ojeda, Alejandro; Fuentes-Orozco, Clotilde; Macías-Amezcua, Michel Dassaejv

    2014-01-01

    Antecedentes: los paragangliomas de cabeza y cuello son tumores neuroendocrinos de baja incidencia (0.6%), en su mayor parte benignos, en cuyo origen se han involucrado múltiples factores. Los seres humanos y otras especies que viven a grandes alturas (por arriba de 2000 metros sobre el nivel del mar) son propensos a sufrir hipoxia crónica relativa, hiperplasia del cuerpo carotídeo y, eventualmente, paragangliomas. Este padecimiento aparece en la quinta década de la vida y en la tercera, en caso de presentación familiar. Caso clínico: se comunica el caso de una adolescente de 16 años de edad que un año antes tuvo faringitis aguda con tumor localizado en la cara lateral izquierda del cuello, de crecimiento gradual, sin ningún síntoma. El ultrasonido Doppler dúplex de cuello mostró una lesión nodular sólida sobre el trayecto de la bifurcación carotídea izquierda. Fue intervenida quirúrgicamente mediante cervicotomía lateral izquierda, en la cual se encontró una tumoración de aproximadamente 4 × 3 × 3 cm, sumamente vascularizada, que afectaba la carótida común desde su tercio medio, la carótida interna hasta la base del cráneo y la carótida externa hasta el tercio superior, con íntima relación con la tráquea, el esófago y la columna cervical. La tumoración se resecó en su totalidad, el estudio histopatológico corroboró los paragangliomas. Conclusiones: la edad de presentación es poco común, por lo que se considera relevante y de interés clínico comunicar este caso, toda vez que debe considerarse como posibilidad diagnóstica.

  6. Hemodynamic and ventilatory response to different levels of hypoxia and hypercapnia in carotid body-denervated rats

    Directory of Open Access Journals (Sweden)

    João Paulo J. Sabino

    2013-01-01

    Full Text Available OBJECTIVE: Chemoreceptors play an important role in the autonomic modulation of circulatory and ventilatory responses to changes in arterial O2 and/or CO2. However, studies evaluating hemodynamic responses to hypoxia and hypercapnia in rats have shown inconsistent results. Our aim was to evaluate hemodynamic and respiratory responses to different levels of hypoxia and hypercapnia in conscious intact or carotid body-denervated rats. METHODS: Male Wistar rats were submitted to bilateral ligature of carotid body arteries (or sham-operation and received catheters into the left femoral artery and vein. After two days, each animal was placed into a plethysmographic chamber and, after baseline measurements of respiratory parameters and arterial pressure, each animal was subjected to three levels of hypoxia (15, 10 and 6% O2 and hypercapnia (10% CO2. RESULTS: The results indicated that 15% O2 decreased the mean arterial pressure and increased the heart rate (HR in both intact (n = 8 and carotid body-denervated (n = 7 rats. In contrast, 10% O2did not change the mean arterial pressure but still increased the HR in intact rats, and it decreased the mean arterial pressure and increased the heart rate in carotid body-denervated rats. Furthermore, 6% O2 increased the mean arterial pressure and decreased the HR in intact rats, but it decreased the mean arterial pressure and did not change the HR in carotid body-denervated rats. The 3 levels of hypoxia increased pulmonary ventilation in both groups, with attenuated responses in carotid body-denervated rats. Hypercapnia with 10% CO2 increased the mean arterial pressure and decreased HR similarly in both groups. Hypercapnia also increased pulmonary ventilation in both groups to the same extent. CONCLUSION: This study demonstrates that the hemodynamic and ventilatory responses varied according to the level of hypoxia. Nevertheless, the hemodynamic and ventilatory responses to hypercapnia did not depend on the

  7. Effects of angiotensin II on leptin and downstream leptin signaling in the carotid body during acute intermittent hypoxia.

    Science.gov (United States)

    Moreau, J M; Messenger, S A; Ciriello, J

    2015-12-03

    Angiotensin II (ANG II) is known to promote leptin production and secretion. Although ANG II type 1 receptors (AT1Rs) and leptin are expressed within the carotid body, it is not known whether AT1R and leptin are co-expressed in the same glomus cells nor if these peptides are affected within the carotid body by intermittent hypoxia (IH). This study was done to investigate whether ANG II modulated leptin signaling in the carotid body during IH. Rats were treated with captopril (Capt) or the AT1R blocker losartan (Los) in the drinking water for 3days prior to being exposed to IH (8h) or normoxia (8h). IH induced increases in plasma ANG II and leptin compared to normoxic controls. Capt treatment abolished the plasma leptin changes to IH, whereas Los treatment had no effect on the IH induced increase in plasma leptin. Additionally, carotid body glomus cells containing both leptin and the long form of the leptin receptor (OB-Rb) were found to co-express AT1R protein, and IH increased the expression of only AT1R protein within the carotid body in both Capt- and non-Capt-treated animals. On the other hand, Los treatment did not modify AT1R protein expression to IH. Additionally, Capt and Los treatment eliminated the elevated carotid body leptin protein expression, and the changes in phosphorylated signal transducer and activator of transcription three protein, the short form of the leptin receptor (OB-R100), suppressor of cytokine signaling 3, and phosphorylated extracellular-signal-regulated kinase 1/2 protein expression induced by IH. However, Capt elevated the expression of OB-Rb protein, whereas Los abolished the changes in OB-Rb protein to IH. These findings, taken together with the previous observation that ANG II modifies carotid body chemosensitivity, suggest that the increased circulating levels of ANG II and leptin induced by IH act at the carotid body to alter leptin signaling within the carotid body which in turn may influence chemoreceptor function.

  8. Radical resection of a Shamblin type III carotid body tumour without cerebro-neurological deficit: Improved technique with preoperative embolization and carotid stenting.

    Science.gov (United States)

    Ong, H S; Fan, X D; Ji, T

    2014-12-01

    The surgical resection of a large unfavourable Shamblin type III carotid body tumour (CBT) can be very challenging technically, with many potential significant complications. Preoperative embolization aids in shrinking the lesion, reducing intraoperative blood loss, and improving visualization of the surgical field. Preoperative internal carotid artery (ICA) stenting aids in reinforcing the arterial wall, thereby providing a better dissection plane. A woman presented to our institution with a large right-sided CBT. Failure of the preoperative temporary balloon occlusion (TBO) test emphasized the importance of intraoperative preservation of the ipsilateral ICA. A combination of both preoperative embolization and carotid stenting allowed a less hazardous radical resection of the CBT. An almost bloodless surgical field permitted meticulous dissection, hence reducing the risk of intraoperative vascular and nerve injury. Embolization and carotid stenting prior to surgical resection should be considered in cases with bilateral CBT or a skull base orientated high CBT, and for those with intracranial extension and patients who have failed the TBO test.

  9. GabaB receptors activation in the NTS blocks the glycemic responses induced by carotid body receptor stimulation.

    Science.gov (United States)

    Lemus, Mónica; Montero, Sergio; Cadenas, José Luis; Lara, José Jesús; Tejeda-Chávez, Héctor Rafael; Alvarez-Buylla, Ramón; de Alvarez-Buylla, Elena Roces

    2008-08-18

    The carotid body receptors participate in glucose regulation sensing glucose levels in blood entering the cephalic circulation. The carotid body receptors information, is initially processed within the nucleus tractus solitarius (NTS) and elicits changes in circulating glucose and brain glucose uptake. Previous work has shown that gamma-aminobutyric acid (GABA) in NTS modulates respiratory reflexes, but the role of GABA within NTS in glucose regulation remains unknown. Here we show that GABA(B) receptor agonist (baclofen) or antagonists (phaclofen and CGP55845A) locally injected into NTS modified arterial glucose levels and brain glucose retention. Control injections outside NTS did not elicit these responses. In contrast, GABA(A) agonist and antagonist (muscimol or bicuculline) produced no significant changes in blood glucose levels. When these GABAergic drugs were applied before carotid body receptors stimulation, again, only GABA(B) agonist or antagonist significantly affected glycemic responses; baclofen microinjection significantly reduced the hyperglycemic response and brain glucose retention observed after carotid body receptors stimulation, while phaclofen produced the opposite effect, increasing significantly hyperglycemia and brain glucose retention. These results indicate that activation of GABA(B), but not GABA(A), receptors in the NTS modulates the glycemic responses after anoxic stimulation of the carotid body receptors, and suggest the presence of a tonic inhibitory mechanism in the NTS to avoid hyperglycemia.

  10. Cervical sympathetic chain schwannoma masquerading as a carotid body tumour with a postoperative complication of first-bite syndrome.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2012-01-31

    Carotid body tumours (CBT) are the most common tumours at the carotid bifurcation. Widening of the bifurcation is usually demonstrated on conventional angiography. This sign may also be produced by a schwannoma of the cervical sympathetic plexus. A 45-year-old patient presented with a neck mass. Investigations included contrast-enhanced CT, MRI and magnetic resonance arteriography with contrast enhancement. Radiologically, the mass was considered to be a CBT due to vascular enhancement and splaying of the internal and external carotid arteries. Intraoperatively, it was determined to be a cervical sympathetic chain schwannoma (CSCS). The patient had a postoperative complication of first-bite syndrome (FBS).Although rare, CSCS should be considered in the differential diagnosis for tumours at the carotid bifurcation. Damage to the sympathetic innervation to the parotid gland can result in severe postoperative pain characterised by FBS and should be considered in all patients undergoing surgery involving the parapharyngeal space.

  11. CaV3.2 T-type Ca²⁺ channels in H₂S-mediated hypoxic response of the carotid body.

    Science.gov (United States)

    Makarenko, Vladislav V; Peng, Ying-Jie; Yuan, Guoxiang; Fox, Aaron P; Kumar, Ganesh K; Nanduri, Jayasri; Prabhakar, Nanduri R

    2015-01-15

    Arterial blood O2 levels are detected by specialized sensory organs called carotid bodies. Voltage-gated Ca(2+) channels (VGCCs) are important for carotid body O2 sensing. Given that T-type VGCCs contribute to nociceptive sensation, we hypothesized that they participate in carotid body O2 sensing. The rat carotid body expresses high levels of mRNA encoding the α1H-subunit, and α1H protein is localized to glomus cells, the primary O2-sensing cells in the chemoreceptor tissue, suggesting that CaV3.2 is the major T-type VGCC isoform expressed in the carotid body. Mibefradil and TTA-A2, selective blockers of the T-type VGCC, markedly attenuated elevation of hypoxia-evoked intracellular Ca(2+) concentration, secretion of catecholamines from glomus cells, and sensory excitation of the rat carotid body. Similar results were obtained in the carotid body and glomus cells from CaV3.2 knockout (Cacna1h(-/-)) mice. Since cystathionine-γ-lyase (CSE)-derived H2S is a critical mediator of the carotid body response to hypoxia, the role of T-type VGCCs in H2S-mediated O2 sensing was examined. Like hypoxia, NaHS, a H2S donor, increased intracellular Ca(2+) concentration and augmented carotid body sensory nerve activity in wild-type mice, and these effects were markedly attenuated in Cacna1h(-/-) mice. In wild-type mice, TTA-A2 markedly attenuated glomus cell and carotid body sensory nerve responses to hypoxia, and these effects were absent in CSE knockout mice. These results demonstrate that CaV3.2 T-type VGCCs contribute to the H2S-mediated carotid body response to hypoxia.

  12. CaV3.2 T-type Ca2+ channels in H2S-mediated hypoxic response of the carotid body

    Science.gov (United States)

    Makarenko, Vladislav V.; Peng, Ying-Jie; Yuan, Guoxiang; Fox, Aaron P.; Kumar, Ganesh K.; Nanduri, Jayasri

    2014-01-01

    Arterial blood O2 levels are detected by specialized sensory organs called carotid bodies. Voltage-gated Ca2+ channels (VGCCs) are important for carotid body O2 sensing. Given that T-type VGCCs contribute to nociceptive sensation, we hypothesized that they participate in carotid body O2 sensing. The rat carotid body expresses high levels of mRNA encoding the α1H-subunit, and α1H protein is localized to glomus cells, the primary O2-sensing cells in the chemoreceptor tissue, suggesting that CaV3.2 is the major T-type VGCC isoform expressed in the carotid body. Mibefradil and TTA-A2, selective blockers of the T-type VGCC, markedly attenuated elevation of hypoxia-evoked intracellular Ca2+ concentration, secretion of catecholamines from glomus cells, and sensory excitation of the rat carotid body. Similar results were obtained in the carotid body and glomus cells from CaV3.2 knockout (Cacna1h−/−) mice. Since cystathionine-γ-lyase (CSE)-derived H2S is a critical mediator of the carotid body response to hypoxia, the role of T-type VGCCs in H2S-mediated O2 sensing was examined. Like hypoxia, NaHS, a H2S donor, increased intracellular Ca2+ concentration and augmented carotid body sensory nerve activity in wild-type mice, and these effects were markedly attenuated in Cacna1h−/− mice. In wild-type mice, TTA-A2 markedly attenuated glomus cell and carotid body sensory nerve responses to hypoxia, and these effects were absent in CSE knockout mice. These results demonstrate that CaV3.2 T-type VGCCs contribute to the H2S-mediated carotid body response to hypoxia. PMID:25377087

  13. Experimental Study on Heterograft of Glomus Ccl ls of Carotid Body for Hemioarkinsonian Rats

    Institute of Scientific and Technical Information of China (English)

    曹学兵; 孙圣刚; 童萼塘

    2002-01-01

    Summary: To observe the effects of heterograft of glomus cells of carotid body on hemiparkinsonian rat models, rats with unilateral 6-hydroxydopamine (6-OHDA)-induced lesions of the right dopamin ergic neurons of substantia nigra received intrastriatal glomus cells heterograft. Apomorphine-induced rotation was monitored for 30 rmin at various time points after grafting. The striata were cut and ex-amined for dopamine content by HPLC and for immunohistochemical staining of tyrosine hydroxylase positive neurons (TH+ ) at the end of the experiments. The results showed that apomorphine-induced rotational behavior was significantly reduced for 12 weeks and the dopamine contents were signifi cantly elevated after grafting (P<0.01), and TH+ cells survived better. The present study demon strates that intrastriatal heterograft of glomus cells within carotid body in rats with 6-OHDA-elicited lesions could reduce apomorphine-induced rotational behavior and elevate the dopamine contents and numbers of TH+ cell surviving within striatum, and can serve as a new and effective alternative for Parkinson disease.

  14. Interpositional carotid artery bypass strategies in the surgical management of aneurysms and tumors of the skull base.

    Science.gov (United States)

    Liu, James K; Couldwell, William T

    2003-03-15

    Cerebral revascularization is an important component in the surgical management of complex skull base tumors and aneurysms. Patients who harbor complex aneurysms that cannot be clipped directly and in whom parent vessel occlusion cannot be tolerated may require cerebrovascular bypass surgery. In cases in which skull base tumors encase the carotid artery (CA) and a resection is desired, a cerebrovascular bypass may be necessary in planned CA occlusion or sacrifice. In this review the authors discuss options for performing high-flow anterograde interposition CA bypass for lesions of the skull base. The authors review three important bypass techniques involving saphenous vein grafts: the cervical-to-petrous internal carotid artery (ICA), petrous-to-supraclinoid ICA, and cervical-to-supraclinoid ICA bypass. These revascularization techniques are important tools in the surgical treatment of complex aneurysms and tumors of the skull base and cavernous sinus.

  15. The von Hippel-Lindau Chuvash mutation in mice causes carotid-body hyperplasia and enhanced ventilatory sensitivity to hypoxia.

    Science.gov (United States)

    Slingo, Mary E; Turner, Philip J; Christian, Helen C; Buckler, Keith J; Robbins, Peter A

    2014-04-01

    The hypoxia-inducible factor (HIF) family of transcription factors coordinates diverse cellular and systemic responses to hypoxia. Chuvash polycythemia (CP) is an autosomal recessive disorder in humans in which there is impaired oxygen-dependent degradation of HIF, resulting in long-term systemic elevation of HIF levels at normal oxygen tensions. CP patients demonstrate the characteristic features of ventilatory acclimatization to hypoxia, namely, an elevated baseline ventilation and enhanced acute hypoxic ventilatory response (AHVR). We investigated the ventilatory and carotid-body phenotype of a mouse model of CP, using whole-body plethysmography, immunohistochemistry, and electron microscopy. In keeping with studies in humans, CP mice had elevated ventilation in euoxia and a significantly exaggerated AHVR when exposed to 10% oxygen, with or without the addition of 3% carbon dioxide. Carotid-body immunohistochemistry demonstrated marked hyperplasia of the oxygen-sensing type I cells, and the cells themselves appeared enlarged with more prominent nuclei. This hypertrophy was confirmed by electron microscopy, which also revealed that the type I cells contained an increased number of mitochondria, enlarged dense-cored vesicles, and markedly expanded rough endoplasmic reticulum. The morphological and ultrastructural changes seen in the CP mouse carotid body are strikingly similar to those observed in animals exposed to chronic hypoxia. Our study demonstrates that the HIF pathway plays a major role, not only in regulating both euoxic ventilatory control and the sensitivity of the response to hypoxia, but also in determining the morphology of the carotid body.

  16. Molecular tumor-diagnostics in body fluids

    NARCIS (Netherlands)

    Kok, Jacques Benno de

    2000-01-01

    Tumor-derived nucleic acids are frequently present in body fluids (e.g. urine, blood, sputum, stool, bile, and cerebrospinal fluid) that had contact with malignant or premalignant tissues. Detection of this mutant DNA or quantification of aberrant gene expression may offer new noninvasive methods fo

  17. Volatile Anaesthetic Depression of the Carotid Body Chemoreflex-Mediated Ventilatory Response to Hypoxia: Directions for Future Research

    Directory of Open Access Journals (Sweden)

    J. J. Pandit

    2014-01-01

    Full Text Available In assessing whether volatile anaesthetics directly depress the carotid body response to hypoxia it is necessary to combine in meta-analysis studies of when it is “functionally isolated” (e.g., recordings are made from its afferent nerve. Key articles were retrieved (full papers in English and subjected to quantitative analysis to yield an aggregate estimate of effect. Results from articles that did not use such methodology were assessed separately from this quantitative approach, to see what could be learned also from a nonquantitative overview. Just 7 articles met the inclusion criteria for hypoxia and just 6 articles for hypercapnia. Within these articles, the anaesthetic (mean dose 0.75, standard deviation (SD 0.40 minimum alveolar concentration, MAC statistically significantly depressed carotid body hypoxic response by 24% (P=0.041, but a similar dose (mean 0.81 (0.42 MAC did not affect the hypercapnic response. The articles not included in the quantitative analysis (31 articles, assessed qualitatively, also indicated that anaesthetics depress carotid body function. This conclusion helps direct future research on the anaesthetic effects on putative cellular/molecular processes that underlie the transduction of hypoxia in the carotid body.

  18. Chemotransduction in the Carotid Body: K+ Current Modulated by Po2 in Type I Chemoreceptor Cells

    Science.gov (United States)

    Lopez-Barneo, Jose; Lopez-Lopez, Jose R.; Urena, Juan; Gonzalez, Constancio

    1988-07-01

    The ionic currents of carotid body type I cells and their possible involvement in the detection of oxygen tension (Po2) in arterial blood are unknown. The electrical properties of these cells were studied with the whole-cell patch clamp technique, and the hypothesis that ionic conductances can be altered by changes in Po2 was tested. The results show that type I cells have voltage-dependent sodium, calcium, and potassium channels. Sodium and calcium currents were unaffected by a decrease in Po2 from 150 to 10 millimeters of mercury, whereas, with the same experimental protocol, potassium currents were reversibly reduced by 25 to 50 percent. The effect of hypoxia was independent of internal adenosine triphosphate and calcium. Thus, ionic conductances, and particularly the O2-sensitive potassium current, play a key role in the transduction mechanism of arterial chemoreceptors.

  19. The Carotid Body Does Not Mediate the Acute Ventilatory Effects of Leptin.

    Science.gov (United States)

    Olea, E; Ribeiro, M J; Gallego-Martin, T; Yubero, S; Rigual, R; Masa, J F; Obeso, A; Conde, S V; Gonzalez, C

    2015-01-01

    Leptin is a hormone produced mostly in adipose tissue and playing a key role in the control of feeding and energy expenditure aiming to maintain a balance between food intake and metabolic activity. In recent years, it has been described that leptin might also contributes to control ventilation as the administration of the hormone reverses the hypoxia and hypercapnia commonly encountered in ob/ob mice which show absence of the functional hormone. In addition, it has been shown that the carotid body (CB) of the rat expresses leptin as well as the functional leptin-B receptor. Therefore, the possibility exists that the ventilatory effects of leptin are mediated by the CB chemoreceptors. In the experiments described below we confirm the stimulatory effect of leptin on ventilation, finding additionally that the CB does not mediate the instant to instant control of ventilation.

  20. Endogenous H2S is required for hypoxic sensing by carotid body glomus cells.

    Science.gov (United States)

    Makarenko, Vladislav V; Nanduri, Jayasri; Raghuraman, Gayatri; Fox, Aaron P; Gadalla, Moataz M; Kumar, Ganesh K; Snyder, Solomon H; Prabhakar, Nanduri R

    2012-11-01

    H(2)S generated by the enzyme cystathionine-γ-lyase (CSE) has been implicated in O(2) sensing by the carotid body. The objectives of the present study were to determine whether glomus cells, the primary site of hypoxic sensing in the carotid body, generate H(2)S in an O(2)-sensitive manner and whether endogenous H(2)S is required for O(2) sensing by glomus cells. Experiments were performed on glomus cells harvested from anesthetized adult rats as well as age and sex-matched CSE(+/+) and CSE(-/-) mice. Physiological levels of hypoxia (Po(2) ∼30 mmHg) increased H(2)S levels in glomus cells, and dl-propargylglycine (PAG), a CSE inhibitor, prevented this response in a dose-dependent manner. Catecholamine (CA) secretion from glomus cells was monitored by carbon-fiber amperometry. Hypoxia increased CA secretion from rat and mouse glomus cells, and this response was markedly attenuated by PAG and in cells from CSE(-/-) mice. CA secretion evoked by 40 mM KCl, however, was unaffected by PAG or CSE deletion. Exogenous application of a H(2)S donor (50 μM NaHS) increased cytosolic Ca(2+) concentration ([Ca(2+)](i)) in glomus cells, with a time course and magnitude that are similar to that produced by hypoxia. [Ca(2+)](i) responses to NaHS and hypoxia were markedly attenuated in the presence of Ca(2+)-free medium or cadmium chloride, a pan voltage-gated Ca(2+) channel blocker, or nifedipine, an L-type Ca(2+) channel inhibitor, suggesting that both hypoxia and H(2)S share common Ca(2+)-activating mechanisms. These results demonstrate that H(2)S generated by CSE is a physiologic mediator of the glomus cell's response to hypoxia.

  1. Influence of age, body mass index, and blood pressure on the carotid intima-media thickness in normotensive and hypertensive patients.

    Science.gov (United States)

    Honzikova, Natasa; Labrova, Ruzena; Fiser, Bohumil; Maderova, Eva; Novakova, Zuzana; Zavodna, Eva; Semrad, Borivoj

    2006-10-01

    We investigated whether body mass index and blood pressure have an additive influence on the carotid intima-media thickness (IMT). In 27 patients treated for hypertension (47.2+/-8.7 years) and 23 normotensive subjects (44.1+/-8.1 years), 24-h recording of blood pressure was performed. The carotid IMT was determined by ultrasonography and baroreflex sensitivity by a spectral method from 5-min recordings of blood pressure. Significant differences between hypertensive and normotensive subjects were observed for carotid IMT (0.60+/-0.08 vs. 0.51+/-0.07 mm; pmass index (pinfluenced by either age or body mass index. Baroreflex sensitivity decreased with age (pinfluence of age and body mass index on the development of carotid IMT is essential only in normotensive subjects. In hypertensive subjects the influence of blood pressure predominates, as documented by a comparison of the carotid IMT between hypertensive and normotensive subjects.

  2. Oxygen sensing by the carotid body: mechanisms and role in adaptation to hypoxia.

    Science.gov (United States)

    López-Barneo, José; González-Rodríguez, Patricia; Gao, Lin; Fernández-Agüera, M Carmen; Pardal, Ricardo; Ortega-Sáenz, Patricia

    2016-04-15

    Oxygen (O2) is fundamental for cell and whole-body homeostasis. Our understanding of the adaptive processes that take place in response to a lack of O2(hypoxia) has progressed significantly in recent years. The carotid body (CB) is the main arterial chemoreceptor that mediates the acute cardiorespiratory reflexes (hyperventilation and sympathetic activation) triggered by hypoxia. The CB is composed of clusters of cells (glomeruli) in close contact with blood vessels and nerve fibers. Glomus cells, the O2-sensitive elements in the CB, are neuron-like cells that contain O2-sensitive K(+)channels, which are inhibited by hypoxia. This leads to cell depolarization, Ca(2+)entry, and the release of transmitters to activate sensory fibers terminating at the respiratory center. The mechanism whereby O2modulates K(+)channels has remained elusive, although several appealing hypotheses have been postulated. Recent data suggest that mitochondria complex I signaling to membrane K(+)channels plays a fundamental role in acute O2sensing. CB activation during exposure to low Po2is also necessary for acclimatization to chronic hypoxia. CB growth during sustained hypoxia depends on the activation of a resident population of stem cells, which are also activated by transmitters released from the O2-sensitive glomus cells. These advances should foster further studies on the role of CB dysfunction in the pathogenesis of highly prevalent human diseases.

  3. Effects on the rabbit carotid body of stimulation by almitrine, natural high altitude, and experimental normobaric hypoxia.

    Science.gov (United States)

    Smith, P; Heath, D; Fitch, R; Hurst, G; Moore, D; Weitzenblum, E

    1986-06-01

    Rabbits were given intraperitoneal injections of almitrine in ascending doses for 5 weeks. They were compared with a control group and with a group of rabbits which had been exposed from birth to the natural hypobaric hypoxia found at Cerro de Pasco (433 m) in the Peruvian Andes. A further group of animals was placed in an experimental normobaric chamber for either 3 or 6 months to subject them to the same degree of hypoxia as that occurring in Cerro. The carotid bodies of the rabbits in all these groups were processed for light and electron microscopy, and examined both qualitatively and quantitatively. The carotid bodies in the group given almitrine showed no changes in their size or in the population of their glomic cells when compared with controls. In contrast, the carotid bodies of Peruvian rabbits were greatly enlarged with a disproportionate increase in the population of the light variant of chief cell. Rabbits from the hypoxic chamber also had enlarged carotid bodies but those killed after 3 months showed an increase in the dark variant of chief cell, whereas after 6 months this cell was reduced in number. There was also intense cytoplasmic vacuolation. Election microscopy confirmed these changes and revealed that dark cells had larger, more pleomorphic granules than the light variant. Vacuolation of the granules in light cells was most pronounced in Peruvian rabbits, but was uncommon in animals exposed to hypoxia for 3 months. We suggest that the dark cell responds to the early stages of hypoxia but later matures into the light variant of chief cell.

  4. A importância da embolização pré-operatória no tratamento do tumor do corpo carotídeo: relato de caso e revisão da literatura The importance of preoperative embolization for the treatment of the carotid body tumor: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Luciana Marins Cavalcanti

    2008-06-01

    Full Text Available Os tumores do corpo carotídeo são neoplasias raras, que se originam dos pequenos órgãos quimio e barorreceptores localizados na adventícia da bifurcação da artéria carótida comum. Constituem-se uma doença de grande interesse para o cirurgião vascular, na medida em que crescem aderidos à adventícia dos vasos que compõem essa bifurcação. Por isso, sua cirurgia requer não só o conhecimento anatômico da região, mas também perfeito reconhecimento das técnicas de reconstrução vascular. Representam um problema especial quanto a seu manejo, devido à sua rica vascularização e intimidade com estruturas nobres da região cervical, como nervos e grandes vasos. Neste caso, apresentamos um homem com um tumor de corpo carotídeo aderido à carótida direita, diagnosticado por punção biópsia e tratado em dois tempos, sendo o primeiro por tratamento endovascular, realizando embolização percutânea do tumor, e, no segundo, a ressecção cirúrgica do mesmo, o que evidencia o tratamento combinado, segundo atual literatura.

  5. Intermittent Hypoxia-Induced Carotid Body Chemosensory Potentiation and Hypertension Are Critically Dependent on Peroxynitrite Formation

    Directory of Open Access Journals (Sweden)

    Esteban A. Moya

    2016-01-01

    Full Text Available Oxidative stress is involved in the development of carotid body (CB chemosensory potentiation and systemic hypertension induced by chronic intermittent hypoxia (CIH, the main feature of obstructive sleep apnea. We tested whether peroxynitrite (ONOO−, a highly reactive nitrogen species, is involved in the enhanced CB oxygen chemosensitivity and the hypertension during CIH. Accordingly, we studied effects of Ebselen, an ONOO− scavenger, on 3-nitrotyrosine immunoreactivity (3-NT-ir in the CB, the CB chemosensory discharge, and arterial blood pressure (BP in rats exposed to CIH. Male Sprague-Dawley rats were exposed to CIH (5% O2, 12 times/h, 8 h/day for 7 days. Ebselen (10 mg/kg/day was administrated using osmotic minipumps and BP measured with radiotelemetry. Compared to the sham animals, CIH-treated rats showed increased 3-NT-ir within the CB, enhanced CB chemosensory responses to hypoxia, increased BP response to acute hypoxia, and hypertension. Rats treated with Ebselen and exposed to CIH displayed a significant reduction in 3-NT-ir levels (60.8 ± 14.9 versus 22.9 ± 4.2 a.u., reduced CB chemosensory response to 5% O2 (266.5 ± 13.4 versus 168.6 ± 16.8 Hz, and decreased mean BP (116.9 ± 13.2 versus 82.1 ± 5.1 mmHg. Our results suggest that CIH-induced CB chemosensory potentiation and hypertension are critically dependent on ONOO− formation.

  6. Lipopolysaccharide exposure during the early postnatal period adversely affects the structure and function of the developing rat carotid body.

    Science.gov (United States)

    Master, Zankhana R; Porzionato, Andrea; Kesavan, Kalpashri; Mason, Ariel; Chavez-Valdez, Raul; Shirahata, Machiko; Gauda, Estelle B

    2016-09-01

    The carotid body (CB) substantially influences breathing in premature infants by affecting the frequency of apnea and periodic breathing. In adult animals, inflammation alters the structure and chemosensitivity of the CB, yet it is not known if this pertains to neonates. We hypothesized that early postnatal inflammation leads to morphological and functional changes in the developing rat CB, which persists for 1 wk after the initial provoking insult. To test our hypothesis, we exposed rat pups at postnatal day 2 (P2) to lipopolysaccharide (LPS; 100 μg/kg) or saline (SAL) intraperitoneally. At P9-10 (1 wk after treatment), LPS-exposed animals had significantly more spontaneous intermittent hypoxic (IH) events, attenuated ventilatory responses to changes in oxygen tension (measured by whole body plethysmography), and attenuated hypoxic chemosensitivity of the carotid sinus nerve (measured in vitro), compared with SAL-exposed controls. These functional changes were associated with the following: 1) increased inflammatory cytokine mRNA levels; 2) decreased volume of supportive type II cells; and 3) elevated dopamine levels (a major inhibitory neuromodulator) within the CB. These findings suggest that early postnatal inflammation in newborn rats adversely affects the structure and function of the CB and is associated with increased frequency of intermittent desaturations, similar to the phenomenon observed in premature infants. Furthermore, this is the first newborn model of spontaneous intermittent desaturations that may be used to understand the mechanisms contributing to IH events in newborns.

  7. Lower body positive pressure application with an antigravity suit in acute carotid occlusion.

    Science.gov (United States)

    Berthet, Karine; Lukaszewicz, Anne Claire; Bousser, Marie-Germaine; Payen, Didier

    2010-04-01

    The challenge in acute stroke is still to reperfuse as early as possible the ischemic territory. Since fibrinolytic therapies have a limited window with potential risk of bleeding, having a nonpharmacologic mean to recruit vessels in area surrounding necrosis might be useful. We propose here to use antigravity suit inflated at "venous" pressure levels to shift blood towards thoracic and brain territories. We report two cases of spectacular clinical recovery after acute carotid occlusion.

  8. Lower Body Positive Pressure Application with an Antigravity Suit in Acute Carotid Occlusion

    Directory of Open Access Journals (Sweden)

    Karine Berthet

    2010-01-01

    Full Text Available The challenge in acute stroke is still to reperfuse as early as possible the ischemic territory. Since fibrinolytic therapies have a limited window with potential risk of bleeding, having a nonpharmacologic mean to recruit vessels in area surrounding necrosis might be useful. We propose here to use antigravity suit inflated at “venous” pressure levels to shift blood towards thoracic and brain territories. We report two cases of spectacular clinical recovery after acute carotid occlusion.

  9. A Short-Term Fasting in Neonates Induces Breathing Instability and Epigenetic Modification in the Carotid Body.

    Science.gov (United States)

    Shirahata, Machiko; Tang, Wan-Yee; Kostuk, Eric W

    2015-01-01

    The respiratory control system is not fully developed in newborn, and data suggest that adequate nutrition is important for the development of the respiratory control system. Infants need to be fed every 2-4 h to maintain appropriate energy levels, but a skip of feeding can occur due to social economical reasons or mild sickness of infants. Here, we asked questions if a short-term fasting (1) alters carotid body (CB) chemoreceptor activity and integrated function of the respiratory control system; (2) causes epigenetic modification within the respiratory control system. Mouse pups (fasting time was longer. The hypoxic response of the carotid sinus nerve activity appeared to be depressed after fasting. Moreover, fasting increased global 5mC and 5-hmC content in DNA isolated from the CB but not DNA in the superior cervical ganglion (SCG). Methylation specific PCR (MSPCR) revealed that fasting increased methylation of leptin and socs3 genes. The results suggest fasting inhibits CB activity leading to hypoventilation, and low glucose does not compensate the low CB activity. Epigenetic effect on CB function/activity may be related to the prolonged effect of fasting on ventilation.

  10. Paraganglioma of the carotid body: Report of 26 patients and review of the literature

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    Zainine Rim

    2015-03-01

    Results: The present study included 6 men and 20 women. Bilateral involvement of the carotid glomus was noted in 2 cases and tympano-jugular location was associated in 2 other cases. Ultrasound of the neck, computed tomography (CT and magnetic resonance (MR tomography were performed in 13, 17 and 10 cases, respectively. 2 patients have had preoperative embolization and 22 patients, in total, were operated. External radiation was an exclusive therapeutic option in 2 patients and adjuvant to incomplete surgery in one patient. Only one case of malignant paraganglioma was noted that evolution was, in fact, rapidly fatal.

  11. Carotid Ultrasound

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Carotid Ultrasound Also known as carotid duplex. Carotid ultrasound is a painless imaging test that uses high- ... of your carotid arteries. This test uses an ultrasound machine, which includes a computer, a screen, and ...

  12. In the carotid body, galanin is a signal for neurogenesis in young, and for neurodegeneration in the old and in drug-addicted subjects

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    Andrea eMazzatenta

    2014-10-01

    Full Text Available The carotid body is a highly specialized chemoreceptive structure for the detection of and reaction to hypoxia, through induction of an increase in hypoxia inducible factor. As tissue hypoxia increases with ageing and can have dramatic effects in respiratory depression induced by drug addiction, we investigated the carotid body in young and old healthy subjects in comparison with drug-addicted subjects, including the expression of the neurotransmitter galanin. Galanin expression was recently reported for neuronal-like cells of the human carotid body, and it is implicated in several functions in neurons. In particular, this includes the regulation of differentiation of neural stem cells, and participation in the development and plasticity of the nervous system. Using immunohistochemistry detection, we demonstrate that galanin expression in the human carotid body in healthy older subjects and drug-addicted subjects is significantly reduced in comparison with healthy young subjects. This demonstrates not only the effects of normal ageing and senescence, but also in the drug-addicted subjects, this is due to a disorganization of the chemo-sensory region. With both ageing and drug addiction, this results in a physiological reduction in neuronal-like cells, coupled with interlobular and intralobular increases in connective tissue fibers. Consequently, in both ageing and drug addiction, this reduction of neuronal-like cells and the regeneration suggest that the carotid body is losing its sensory capabilities, with the transmission of chemoreceptive signals dramatically and vitally reduced. The level of galanin expression thus provides a signal for neurogenesis in young subjects, and for neurodegeneration in older and drug-addicted subjects.

  13. In the carotid body, galanin is a signal for neurogenesis in young, and for neurodegeneration in the old and in drug-addicted subjects

    Science.gov (United States)

    Mazzatenta, Andrea; Marconi, Guya D.; Zara, Susi; Cataldi, Amelia; Porzionato, Andrea; Di Giulio, Camillo

    2014-01-01

    The carotid body is a highly specialized chemoreceptive structure for the detection of and reaction to hypoxia, through induction of an increase in hypoxia inducible factor. As tissue hypoxia increases with aging and can have dramatic effects in respiratory depression induced by drug addiction, we investigated the carotid body in young and old healthy subjects in comparison with drug-addicted subjects, including the expression of the neurotransmitter galanin. Galanin expression was recently reported for neuronal-like cells of the human carotid body, and it is implicated in several functions in neurons. In particular, this includes the regulation of differentiation of neural stem cells, and participation in the development and plasticity of the nervous system. Using immunohistochemistry detection, we demonstrate that galanin expression in the human carotid body in healthy older subjects and drug-addicted subjects is significantly reduced in comparison with healthy young subjects. This demonstrates not only the effects of normal aging and senescence, but also in the drug-addicted subjects, this appears to be due to a disorganization of the chemo-sensory region. With both aging and drug addiction, this results in a physiological reduction in neuronal-like cells, coupled with interlobular and intralobular increases in connective tissue fibers. Consequently, in both aging and drug addiction, this reduction of neuronal-like cells and the regeneration suggest that the carotid body is losing its sensory capabilities, with the transmission of chemoreceptive signals dramatically and vitally reduced. The level of galanin expression would thus provide a signal for neurogenesis in young subjects, and for neurodegeneration in older and drug-addicted subjects. PMID:25400591

  14. Tetrodotoxin as a Tool to Elucidate Sensory Transduction Mechanisms: The Case for the Arterial Chemoreceptors of the Carotid Body

    Directory of Open Access Journals (Sweden)

    Constancio Gonzalez

    2011-12-01

    Full Text Available Carotid bodies (CBs are secondary sensory receptors in which the sensing elements, chemoreceptor cells, are activated by decreases in arterial PO2 (hypoxic hypoxia. Upon activation, chemoreceptor cells (also known as Type I and glomus cells increase their rate of release of neurotransmitters that drive the sensory activity in the carotid sinus nerve (CSN which ends in the brain stem where reflex responses are coordinated. When challenged with hypoxic hypoxia, the physiopathologically most relevant stimulus to the CBs, they are activated and initiate ventilatory and cardiocirculatory reflexes. Reflex increase in minute volume ventilation promotes CO2 removal from alveoli and a decrease in alveolar PCO2 ensues. Reduced alveolar PCO2 makes possible alveolar and arterial PO2 to increase minimizing the intensity of hypoxia. The ventilatory effect, in conjunction the cardiocirculatory components of the CB chemoreflex, tend to maintain an adequate supply of oxygen to the tissues. The CB has been the focus of attention since the discovery of its nature as a sensory organ by de Castro (1928 and the discovery of its function as the origin of ventilatory reflexes by Heymans group (1930. A great deal of effort has been focused on the study of the mechanisms involved in O2 detection. This review is devoted to this topic, mechanisms of oxygen sensing. Starting from a summary of the main theories evolving through the years, we will emphasize the nature and significance of the findings obtained with veratridine and tetrodotoxin (TTX in the genesis of current models of O2-sensing.

  15. Lower fractional anisotropy at the anterior body of the normal-appearing corpus callosum in multiple sclerosis versus symptomatic carotid occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Lou, Xin; Ma, Lin; Cai, Youquan [PLA General Hospital, Department of Radiology, Beijing (China); Jiang, Weijian; Ma, Ning [Capital University of Medical Sciences, Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing (China); Huang, Dehui [PLA General Hospital, Department of Neurology, Beijing (China); Wong, Edward Hochung [Prince of Wales Hospital, Division of Neurology, Department of Medicine and Therapeutics, Hong Kong (China)

    2009-09-15

    Not uncommonly, differentiating multiple sclerosis (MS) from ischemic cerebral vascular disease is difficult based on conventional magnetic resonance imaging (MRI). We aim to determine whether preferential occult injury in the normal-appearing corpus callosum (NACC) is more severe in patients with MS than symptomatic carotid occlusion by comparing fractional anisotropy (FA) from diffusion tensor imaging (DTI). Eighteen patients (eight men, ten women; mean age, 38.6 years) with MS and 32 patients (24 men, eight women; mean age, 64.0 years) with symptomatic unilateral internal carotid occlusion were included. DTI (1.5 T) were performed at corpus callosum which were normal-appearing on fluid-attenuated inversion recovery MRI. Mean FA was obtained from the genu, anterior body, posterior body, and splenium of NACC. Independent-sample t test statistical analysis was performed. The FA values in various regions of NACC were lower in the MS patients than symptomatic carotid occlusion patients, which was statistically different at the anterior body (0.67{+-}0.12 vs 0.74{+-}0.06, P=0.009), but not at genu, posterior body, and splenium (0.63{+-}0.09 vs 0.67{+-}0.07, P=0.13; 0.68{+-}0.09 vs 0.73{+-}0.05, P=0.07; 0.72{+-}0.09 vs 0.76{+-}0.05, P=0.13). MS patients have lower FA in the anterior body of NACC compared to patients with symptomatic carotid occlusion. It suggests that DTI has potential ability to differentiate these two conditions due to the more severe preferential occult injury at the anterior body of NACC in MS. (orig.)

  16. 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 ...

  17. Changes in carotid body and nTS neuronal excitability following neonatal sustained and chronic intermittent hypoxia exposure.

    Science.gov (United States)

    Mayer, C A; Wilson, C G; MacFarlane, P M

    2015-01-01

    We investigated whether pre-treatment with neonatal sustained hypoxia (SH) prior to chronic intermittent hypoxia (SH+CIH) would modify in vitro carotid body (CB) chemoreceptor activity and the excitability of neurons in the caudal nucleus of the solitary tract (nTS). Sustained hypoxia followed by CIH exposure simulates an oxygen paradigm experienced by extremely premature infants who developed persistent apnea. Rat pups were treated with 5 days of SH (11% O2) from postnatal age 1 (P1) followed by 10 days of subsequent chronic intermittent hypoxia (CIH, 5% O2/5 min, 8 h/day, between P6 and P15) as described previously (Mayer et al., Respir. Physiol. Neurobiol. 187(2): 167-75, 2013). At the end of SH+CIH exposure (P16), basal firing frequency was enhanced, and the hypoxic sensory response of single unit CB chemoafferents was attenuated. Further, basal firing frequency and the amplitude of evoked excitatory post-synaptic currents (ESPC's) of nTS neurons was augmented compared to age-matched rats raised in normoxia. These effects were unique to SH+CIH exposure as neither SH or CIH alone elicited any comparable effect on chemoafferent activity or nTS function. These data indicated that pre-treatment with neonatal SH prior to CIH exposure uniquely modified mechanisms of peripheral (CB) and central (nTS) neural function in a way that would be expected to disturb the ventilatory response to acute hypoxia.

  18. Apleural loose body mimicking a pleural tumor: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoo Kyung; Shim, Sung Shine; Chun, Eun Mi; Won, Tae Hee; Park, Sang Hui [Ewha Womans University, Seoul (Korea, Republic of)

    2015-10-15

    We present a rare case of a pleural loose body, thought to be a pedunculated pleural tumor, found incidentally in a 58-year-old female. Computed tomography showed a non-enhancing mass, which migrated along the mediastinum and paravertebral area. Thoracoscopic surgery revealed a 4 cm, soap-like mass that was found to be a fibrin body consisting of hyalinized collagen histopathologically. Mobility and the lack of contrast enhancement of a pleural mass are important clues to diagnosing this benign condition.

  19. Regulation of hypoxia-inducible factor-α isoforms and redox state by carotid body neural activity in rats.

    Science.gov (United States)

    Peng, Ying-Jie; Yuan, Guoxiang; Khan, Shakil; Nanduri, Jayasri; Makarenko, Vladislav V; Reddy, Vaddi Damodara; Vasavda, Chirag; Kumar, Ganesh K; Semenza, Gregg L; Prabhakar, Nanduri R

    2014-09-01

    Previous studies reported that chronic intermittent hypoxia (CIH) results in an imbalanced expression of hypoxia-inducible factor-α (HIF-α) isoforms and oxidative stress in rodents, which may be due either to the direct effect of CIH or indirectly via hitherto uncharacterized mechanism(s). As neural activity is a potent regulator of gene transcription, we hypothesized that carotid body (CB) neural activity contributes to CIH-induced HIF-α isoform expression and oxidative stress in the chemoreflex pathway. Experiments were performed on adult rats exposed to CIH for 10 days. Rats exposed to CIH exhibited: increased HIF-1α and decreased HIF-2α expression; increased NADPH oxidase 2 and decreased superoxide dismutase 2 expression; and oxidative stress in the nucleus tractus solitarius and rostral ventrolateral medulla as well as in the adrenal medulla (AM), a major end organ of the sympathetic nervous system. Selective ablation of the CB abolished these effects. In the AM, sympathetic activation by the CB chemoreflex mediates CIH-induced HIF-α isoform imbalance via muscarinic acetylcholine receptor-mediated Ca(2+) influx, and the resultant activation of mammalian target of rapamycin pathway and calpain proteases. Rats exposed to CIH presented with hypertension, elevated sympathetic activity and increased circulating catecholamines. Selective ablation of either the CB (afferent pathway) or sympathetic innervation to the AM (efferent pathway) abolished these effects. These observations uncover CB neural activity-dependent regulation of HIF-α isoforms and the redox state by CIH in the central and peripheral nervous systems associated with the chemoreflex.

  20. Endoscopic endonasal approach for the treatment of a large clival giant cell tumor complicated by an intraoperative internal carotid artery rupture

    Directory of Open Access Journals (Sweden)

    Iacoangeli M

    2013-01-01

    Full Text Available Maurizio Iacoangeli,1 Alessandro Di Rienzo,1 Massimo Re,2 Lorenzo Alvaro,1 Niccolò Nocchi,1 Maurizio Gladi,1 Maurizio De Nicola,3 Massimo Scerrati11Department of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy; 2Department of Ear, Nose, and Throat Surgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy; 3Department of Radiology, Interventional Radiology Section, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, ItalyAbstract: Giant cell tumors (GCTs are primary bone neoplasms that rarely involve the skull base. These lesions are usually locally aggressive and require complete removal, including the surrounding apparently healthy bone, to provide the best chance of cure. GCTs, as well as other lesions located in the clivus, can nowadays be treated by a minimally invasive fully endoscopic extended endonasal approach. This approach ensures a more direct route to the craniovertebral junction than other possible approaches (transfacial, extended lateral, and posterolateral approaches. The case reported is a clival GCT operated on by an extended endonasal approach that provides another contribution on how to address one of the most feared complications attributed to this approach: a massive bleed due to an internal carotid artery injury.Keywords: clival giant cell tumor, endoscopic endonasal approach, internal carotid artery injury, minimally invasive surgery

  1. Detection of Unknown Primary Tumors Using Whole Body FDG PET

    Institute of Scientific and Technical Information of China (English)

    ZHAOJun; LINXiangtong; GUANYihui; ZUOChuantao; HUAFengchun; SHENGXiaofang; WANGYang

    2003-01-01

    Objective: To assess the usefulness of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in locating occult primary lesions. Methods: 50 patients with varying hetero-geneous metastases of unknown primary origin were referred for FDG PET. The locations of the known metastatic tumor manifestations were distributed as follows: cervical lymph nodes metastases (n=18),skeletal metastases (n=15), cerebral metastases (n=12), others (n=5). All patients underwent whole body 18F-FDG PET imaging. The images were interpreted by visual inspection and semi-quantitative analysis(standardized uptake value, SUV). The patients had undergone conventional imaging within 2 weeks of FDG PET. Surgical, clinical and histopathologic findings were used to assess the performance of FDG PET.Results: FDG PET was able to detect the location of the primary tumor in 32/50 patients (64%). The primary tumors were proved by histopathologic results, and located in the lungs (n=17), the nasopharynx(n=9), the breast (n=2), the ovary (n=l), the colon(n=l), the prostate(n=l),the thyroid (n=l). FDG PET were proved false positive in 2 patients (4%), and the suspicious primary tumors were in uterus and colon respectively. During the clinical follow-up of 2 to 26 months, the primary tumor was found in only 2 patients ( prostate cancer, gastric cancer). Conclusion: PET imaging allows identification of the primary site and metastatic lesions(including bone and soft tissue metastases) at a single examination.Whole body lSF-FDG PET allows effective localization of the unknown primary site of origin and can contribute substantially to patient care.

  2. Schwannoma of the vagus nerve masquerading as a carotid body tumor.

    Science.gov (United States)

    Schupp, Daniela J; Mukherjee, Dipankar; Sharma, Gopesh K

    2009-01-01

    A 45-year-old male presented with increasing hoarseness and swelling of his right neck over 5 months. He was noted to have right vocal cord paralysis and hemiatrophy of his tongue. He was found to have a schwannoma of the vagus nerve with compression of the right hypoglossal nerve. One month after his surgery, the patient's tongue mobility was improving, he was not aspirating, his voice was better and his right vocal cord remained abducted. A discussion of this case is followed by a review of the literature surrounding this rare disease and this unique presentation.

  3. CaV3.2 T-type Ca2+ channels mediate the augmented calcium influx in carotid body glomus cells by chronic intermittent hypoxia.

    Science.gov (United States)

    Makarenko, Vladislav V; Ahmmed, Gias U; Peng, Ying-Jie; Khan, Shakil A; Nanduri, Jayasri; Kumar, Ganesh K; Fox, Aaron P; Prabhakar, Nanduri R

    2016-01-01

    Chronic intermittent hypoxia (CIH) is a hallmark manifestation of sleep apnea. A heightened carotid body activity and the resulting chemosensory reflex mediate increased sympathetic nerve activity by CIH. However, the mechanisms underlying heightened carotid body activity by CIH are not known. An elevation of intracellular calcium ion concentration ([Ca(2+)]i) in glomus cells, the primary oxygen-sensing cells, is an essential step for carotid body activation by hypoxia. In the present study, we examined the effects of CIH on the glomus cell [Ca(2+)]i response to hypoxia and assessed the underlying mechanisms. Glomus cells were harvested from adult rats or wild-type mice treated with 10 days of either room air (control) or CIH (alternating cycles of 15 s of hypoxia and 5 min of room air; 9 episodes/h; 8 h/day). CIH-treated glomus cells exhibited an enhanced [Ca(2+)]i response to hypoxia, and this effect was absent in the presence of 2-(4-cyclopropylphenyl)-N-((1R)-1-[5-[(2,2,2-trifluoroethyl)oxo]-pyridin-2-yl]ethyl)acetamide (TTA-A2), a specific inhibitor of T-type Ca(2+) channels, and in voltage-gated calcium channel, type 3.2 (CaV3.2), null glomus cells. CaV3.2 knockout mice exhibited an absence of CIH-induced hypersensitivity of the carotid body. CIH increased reactive oxygen species (ROS) levels in glomus cells. A ROS scavenger prevented the exaggerated TTA-A2-sensitive [Ca(2+)]i response to hypoxia. CIH had no effect on CaV3.2 mRNA levels. CIH augmented Ca(2+) currents and increased CaV3.2 protein in plasma membrane fractions of human embryonic kidney-293 cells stably expressing CaV3.2, and either a ROS scavenger or brefeldin-A, an inhibitor of protein trafficking, prevented these effects. These findings suggest that CIH leads to an augmented Ca(2+) influx via ROS-dependent facilitation of CaV3.2 protein trafficking to the plasma membrane.

  4. Endoscopic endonasal approach for the treatment of a large clival giant cell tumor complicated by an intraoperative internal carotid artery rupture.

    Science.gov (United States)

    Iacoangeli, Maurizio; Di Rienzo, Alessandro; Re, Massimo; Alvaro, Lorenzo; Nocchi, Niccolò; Gladi, Maurizio; De Nicola, Maurizio; Scerrati, Massimo

    2013-01-01

    Giant cell tumors (GCTs) are primary bone neoplasms that rarely involve the skull base. These lesions are usually locally aggressive and require complete removal, including the surrounding apparently healthy bone, to provide the best chance of cure. GCTs, as well as other lesions located in the clivus, can nowadays be treated by a minimally invasive fully endoscopic extended endonasal approach. This approach ensures a more direct route to the craniovertebral junction than other possible approaches (transfacial, extended lateral, and posterolateral approaches). The case reported is a clival GCT operated on by an extended endonasal approach that provides another contribution on how to address one of the most feared complications attributed to this approach: a massive bleed due to an internal carotid artery injury.

  5. Carotid Ultrasound Imaging

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Carotid Carotid ultrasound uses sound waves to produce ... limitations of Carotid Ultrasound Imaging? What is Carotid Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  6. Tumor segmentation of whole-body magnetic resonance imaging in neurofibromatosis type 1 patients: tumor burden correlates

    Energy Technology Data Exchange (ETDEWEB)

    Heffler, Michael A.; Xi, Yin; Chhabra, Avneesh [University of Texas Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Le, Lu Q. [University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, TX (United States)

    2017-01-15

    Segmentation of whole-body MRI (WBMRI) to assess the feasibility, quantitate the total tumor volume (tumor burden) in patients with neurofibromatosis type 1 (NF1) and examine associations with demographic, disease-related and anthropomorphic features. A consecutive series of patients with NF1 underwent WBMRI and were reviewed for tumors. Tumors were segmented using a semiautomated software-based tool. Tumors were classified as superficial or deep and discrete or plexiform. Segmentation times were recorded. Segmentation yielded the quantity and tumor burden of superficial, internal and plexiform tumors. Correlations between segmentation data and demographic, disease-related and anthropomorphic features were examined. Fifteen patients were evaluated (42.3 ± 13.6 years, 10 female, 5 male). Segmentation times were a median of 30 min and yielded 2,328 tumors (1,582 superficial, 746 internal and 23 plexiform). One tumor was malignant. Tumor counts ranged from 14 to 397. Tumor burden ranged from 6.95 cm3 to 571 cm3. Individual tumor volume ranged from 0.0120 cm3 to 298 cm3. Significant correlation was found between the total volume of superficial tumors and height (ρ = 0.5966, p < 0.02). Male patients had higher overall tumor burdens (p < 0.05) and higher superficial tumor burden (p < 0.03). Patients with negative family history had more tumors (p < 0.05). Segmentation of WBMRI in patients with NF1 is feasible and elucidates meaningful relationships among disease phenotype, anthropomorphic and demographic features. (orig.)

  7. Correlation between Carotid Artery Intima-Media Thickness and Luminal Diameter with Body Mass Index and Other Cardiovascular Risk Factors in Adults

    Directory of Open Access Journals (Sweden)

    Sameeah A. Rashid

    2015-08-01

    Full Text Available Objectives: This study aimed to examine the correlation between carotid artery intima-media thickness (IMT and luminal diameter (LD with body mass index (BMI and other cardiovascular risk factors. Methods: This observational cross-sectional study took place between June 2013 and March 2014 in the Radiology Department of Rizgary Teaching Hospital in Erbil, Iraq. Non-randomly selected subjects ≥20 years old (n = 140 were divided into BMI groups and evaluated for the following cardiovascular risk factors: gender, age, hypertension (HTN, diabetes (DM, smoking, alcohol consumption, blood pressure, serum total cholesterol and triglyceride (TG levels. IMT and LD of the extracranial carotid arteries were measured by B-mode ultrasonography. Results: The mean IMT was 0.8 ± 0.3 mm, ranging from a total mean of 0.7 mm in the normal BMI group to 1.0 mm in the extremely obese group. A significant correlation was found between IMT and BMI (P = 0.04, but not between BMI and LD (P = 0.3. No significant difference in mean IMT or LD was seen between genders. Significant correlations were found between IMT and age, HTN, DM, high serum cholesterol and TG levels (P <0.001. An increase of one BMI unit caused a 0.009 mm increase in IMT and an increase of one year in age caused a 0.011 mm increase in IMT. Conclusion: Age, obesity, HTN, DM, high serum cholesterol and TG levels were found to have an impact on carotid IMT, which is a strong marker for the early development of atherosclerosis.

  8. Tasting Arterial Blood: What do the Carotid Chemoreceptors Sense?

    Directory of Open Access Journals (Sweden)

    Nanduri R. Prabakhar

    2015-01-01

    Full Text Available The carotid bodies are sensory organs that detect the chemical composition of the arterial blood. The carotid body sensory activity increases in response to arterial hypoxemia and the ensuing chemoreflex regulates vital homeostatic functions. Recent studies suggest that the carotid bodies might also sense arterial blood glucose and circulating insulin levels. This review focuses on how the carotid bodies sense O2, glucose and insulin and some potential implications of these sensory functions on physiological regulation and in pathophysiological conditions. Emerging evidence suggests that carbon monoxide (CO-regulated hydrogen sulfide (H2S, stemming from hypoxia, depolarizes type I cells by inhibiting certain K+ channels, facilitates voltage-gated Ca2+ influx leading to sensory excitation of the carotid body. Elevated CO and decreased H2S renders the carotid bodies insensitive to hypoxia resulting in attenuated ventilatory adaptations to high altitude hypoxia, whereas reduced CO and high H2S result in hypersensitivity of the carotid bodies to hypoxia and hypertension. Acute hypoglycemia augments the carotid body responses to hypoxia but that a prolonged lack of glucose in the carotid bodies can lead to a failure to sense hypoxia. Emerging evidence also indicates that carotid bodies might sense insulin directly independent of its effect on glucose, linking the carotid bodies to the pathophysiological consequences of the metabolic syndrome. How glucose and insulin interact with the CO-H2S signalling is an area of ongoing study.KEY WORDS: Glomus cells, K+ channels, Carbon monoxide, hydrogen sulfide, hypoglycemia, diabetes.

  9. Microsurgical anatomy of the human carotid body (glomus caroticum): Features of its detailed topography, syntopy and morphology.

    Science.gov (United States)

    Schulz, Sissy-Amelie; Wöhler, Aliona; Beutner, Dirk; Angelov, Doychin N

    2016-03-01

    The human glomus caroticum (GC) is not readily accessible during ordinary anatomical teaching courses because of insufficient time and difficulties encountered in the preparation. Accordingly, most anatomical descriptions of its location, relationship to neighboring structures, size and shape are supported only by drawings, but not by photographs. The aim of this study is to present the GC with all associated roots and branches. Following microscope-assisted dissection and precise photo-documentation, a detailed analysis of location, syntopy and morphology was performed. We carried out this study on 46 bifurcations of the common carotid artery (CCA) into the external (ECA) and internal (ICA) carotid arteries and identified the GC in 40 (91%) of them. We found significant variations regarding the location of the GC and its syntopy: GC was associated with CCA (42%), ECA (28%) and ICA (30%) lying on the medial or lateral surface (82% or 13%, respectively) or exactly in the middle (5%) of the bifurcation. The short and long diameter of its oval form varied from 1.0 × 2.0 to 5.0 × 5.0mm. Connections with the sympathetic trunk (100%), glossopharyngeal (93%), vagus (79%) and hypoglossal nerve (90%) could be established in 29 cadavers. We conclude that precise knowledge of this enormous variety might be very helpful not only to students in medicine and dentistry during anatomical dissection courses, but also to surgeons working in this field.

  10. PRELIMINARY STUDY OF FEASIBILITY OF WHOLE BODY DIFFUSION WEIGHTED IMAGING IN DIAGNOSIS OF METASTASIS OF TUMOR

    Institute of Scientific and Technical Information of China (English)

    Tian-he Yang; Jian-zhong Lin; Xin Wang; Jian-hua Lu; Zhong Chen

    2008-01-01

    Objective To evaluate the feasibility of whole body diffusion weighted imaging (DWI) in the diagnosis of metastatic tumor.Methods Fifty-six patients (40 males and 16 females, age ranging from 29 to 84 years with a mean age of 57 years) with a variety of primary tumors were investigated by whole body DWI combined with computed tomography (CT) and/or conventional magnetic resonance imaging (MRI) scans. Twelve patients underwent positron emission tomography. The final diagnosis was made on the basis of CT or high resolution CT result for lung lesion and MRI or CT result for skull, abdomen and other parts. All tumors were classified into four groups by their diameter: below 1.0 cm, 1.0-1.9 cm, 2.0-2.9 cm, and above 3.0 cm. The sensitivity and specificity of whole body DWI in the detection of metastatic tumor were analyzed.Results The sensitivities of whole body DWI for screening metastasis oftlie four groups were 38%, 75%, 97%, and 100%, respectively. Whole body DWI showed the highest sensitivity and specificity for detecting metastasis of the skeletal system. It was difficult to find metastatic tumor whose diameter was below 1.0 cm, or lymph nodes located in the pelvis with diameter below 2.0 cm. Conclusions Whole body DWI is a promising method in the diagnosis ofmetastastic tumors. With the perfection of scanning parameter, whole body DWI should be a new effective whole body technique for tumor detection.

  11. Glomus tumor of the gastric body:helical CT findings

    Institute of Scientific and Technical Information of China (English)

    HU Xiao-yun; HU Chun-hong; FANG Xiang-ming; ZHANG Tong-hua

    2007-01-01

    @@ Glomus tumors, also known as glomangiomas, are rare and originate in the neuromyoarterial glomus, a normal arteriovenous shunt which is abundantly supplied with nerve fibers and fulfills a temperature-regulating function. The classic location of glomus tumor is the subungual region, but the tumor can occur elsewhere in the skin, soft tissues, nerves, stomach, nasal cavity, and trachea.1 In the gastrointestinal (GI) tract the tumor occurs more often in the stomach than other parts, and typically occurs as a solitary submucosal nodule in the antrum.2 We reported a case of glomus tumor originating from the greater curvature of stomach which was studied with contrast-enhanced helical computed tomography (CT) and described the characteristic helical CT findings of the rare lesion.

  12. Paraganglioma de cuerpo carotídeo: reporte de un caso clínico con correlación familiar Carotid body paraganglioma: clinical case report with family correlation

    Directory of Open Access Journals (Sweden)

    José Martín Toranzo Fernández

    2011-06-01

    Full Text Available Los paragangliomas de cabeza y cuello son neoplasias infrecuentes que se originan de un tejido paraganglionar del grupo braquiomérco que está ligado al desarrollo de los arcos branquiales. No son cromafines, ya que no secretan catecolaminas¹. De estos paragangliomas, el que se presenta con más frecuencia es el del cuerpo carotídeo, que se origina a partir de los paraganglios localizados en la adventicia de la bifurcación del cuerpo carotídeo².The head and neck paragangliomas are infrequent neoplases that originate from a paraganglionar tissue of the brachiomeric group that are linked to the development of the branchial arches; they are not cromafins since they do not secrete catecholamines¹. The most frequent one appears in the carotid body that originates from the paraganglions located in the adventitia of the carotid body's bifurcation².

  13. The CamKKβ Inhibitor STO609 Causes Artefacts in Calcium Imaging and Selectively Inhibits BKCa in Mouse Carotid Body Type I Cells.

    Science.gov (United States)

    Jurcsisn, Jennifer G; Pye, Richard L; Ali, Jon; Barr, Barbara L; Wyatt, Christopher N

    2015-01-01

    It has previously been reported that AMP-activated protein kinase (AMPK) may be critical for hypoxic chemotransduction in carotid body type I cells. This study sought to determine the importance of the regulatory upstream kinase of AMPK, CamKKβ, in the acute response to hypoxia in isolated mouse type I cells.Initial data indicated several previously unreported artefacts associated with using the CamKKβ inhibitor STO609 and Ca(2+) imaging techniques. Most importantly Fura-2 and X-Rhod1 imaging revealed that STO609 quenched emission fluorescence even in the absence of intracellular Ca(2+) ([Ca(2+)](I)). Furthermore, STO609 (100 μM) rapidly inhibited outward macroscopic currents and this inhibition was abolished in the presence of the selective BK(Ca) inhibitor paxilline.Taken together these data suggest that ST0609 should be used with caution during Ca(2+) imaging studies as it can directly interact with Ca(2+) binding dyes. The rapid inhibitory effect of STO609 on BK(Ca) was unexpected as the majority of studies using this compound required an incubation of approximately 10 min to inhibit the kinase. Furthermore, as AMPK activation inhibits BK(Ca), inhibiting AMPK's upstream kinases would, if anything, be predicted to have the opposite effect on BK(Ca). Future work will determine if the inhibition of BK(Ca) is via CamKKβ or via an off target action of STO609 on the channel itself.

  14. Whole-body MR imaging in tumor staging

    Energy Technology Data Exchange (ETDEWEB)

    Eustace, S. [Cappagh National Orthopaedic and Mater Misericordiae Hospitals, Dublin (Ireland)

    2003-11-01

    Recent refinements allow widespread use of turboSTIR MRI as a whole-body imaging tool and, in particular, as a powerful oncologic screening tool. Whole-body MRI screening can play a primary role in assessing skeletal metastases, as well as metastatic breast and lung carcinoma. (orig.)

  15. Foreign body granuloma mimicking recurrent intracranial tumor: a very rare clinical entity.

    Directory of Open Access Journals (Sweden)

    Askin Esen Hasturk

    2013-11-01

    Full Text Available Gelatin sponge, oxidized cellulose and microfibrillar collagen are used to achieve hemostasis during neurosurgical procedures. Hemostatic agents may produce clinically symptomatic, radiologically apparent mass lesions. The differential diagnosis should include the foreign body along with recurrent tumor. We present a case of intracranial hemostatic agents found in a 56-year-old male patient seven years after undergoing a craniotomy for a left posterior parietal convexity meningioma. Preoperative magnetic resonance imaging (MRI suggested the presence of a recurrent tumor. We emphasize that although it is rare, a granuloma due to a foreign body reaction can result in a false image of tumor recurrence.

  16. Managing Vascular Tumors-Open Approaches.

    Science.gov (United States)

    Schmalbach, Cecelia E; Gourin, Christine

    2016-06-01

    The most common vascular tumors encountered by the otolaryngologist are rare chromaffin cell tumors termed paragangliomas. Within the head and neck region, they commonly arise from the carotid body, vagus nerve (glomus vagale), and jugular vein (glomus jugulare). Other vascular head and neck tumors include sinonasal malignancies, because of proximity to or involvement of the pterygoid plexus as well as the rich vascularity of the sinonasal mucosa; juvenile nasopharyngeal angiofibroma, a vascular tumor of male adolescents; unusual vascular tumors such as hemangiopericytoma; and metastatic renal cell cancer, which has a proclivity for an unusually rich blood supply.

  17. [Mesectodermal leiomyoma. Unusual tumor of the ciliary body].

    Science.gov (United States)

    Rentería-Ruiz, Nancy Paulina; de Wit-Carter, Guillermo; Villaseñor-Diez, Jaime; Flores-Estrada, José Javier; Rodríguez-Reyes, Abelardo Antonio

    2014-01-01

    Antecedentes: el leiomioma mesoectodérmico es un tumor benigno excepcional que se origina en el músculo liso del cuerpo ciliar y deriva de la cresta neural. Caso clínico: se comunica el caso de una mujer de 35 años, con disminución de la agudeza visual y visión borrosa de 2 meses de evolución en el ojo derecho. El diagnóstico presuncional clínico e imagenológico fue: adenoma del epitelio no pigmentado del cuerpo ciliar, por lo que se resecó quirúrgicamente. Microscópicamente, el tumor estaba formado por células de núcleos redondos de escaso citoplasma sin atipia ni mitosis, dispuestas en una matriz fibrilar. Los inmunomarcadores para vimentina, actina músculo específica, actina de músculo liso y calponina fueron todos positivos en el citoplasma de las células neoplásicas, excepto de los inmunomarcadores para la proteína ácida gliofibrilar y la proteína S-100 que resultaron negativos en la misma población celular. Conclusiones: el leiomioma mesoectodérmico del cuerpo ciliar es un tumor benigno de músculo liso extremadamente raro en esta localización. Hasta el momento, sólo hay 25 casos informados en la bibliografía médica y su principal diagnóstico diferencial es melanoma uveal, motivo por el que algunos ojos se enuclearon. Los estudios de ultrabiomicroscopia y ecografía modos A y B son útiles en la evaluación; sin embargo, es obligado el estudio microscópico con tinciones de rutina, y el uso de marcadores inmunohistoquímicos, como los utilizados en este caso para establecer la naturaleza del músculo liso de esta neoplasia y descartar algunas otras, como el melanoma.

  18. Tumor parameter estimation considering the body geometry by thermography.

    Science.gov (United States)

    Hossain, Shazzat; Mohammadi, Farah A

    2016-09-01

    Implementation of non-invasive, non-contact, radiation-free thermal diagnostic tools requires an accurate correlation between surface temperature and interior physiology derived from living bio-heat phenomena. Such associations in the chest, forearm, and natural and deformed breasts have been investigated using finite element analysis (FEA), where the geometry and heterogeneity of an organ are accounted for by creating anatomically-accurate FEA models. The quantitative links are involved in the proposed evolutionary methodology for forecasting unknown Physio-thermo-biological parameters, including the depth, size and metabolic rate of the underlying nodule. A Custom Genetic Algorithm (GA) is tailored to parameterize a tumor by minimizing a fitness function. The study has employed the finite element method to develop simulated data sets and gradient matrix. Furthermore, simulated thermograms are obtained by enveloping the data sets with ±10% random noise.

  19. Combining Percutaneous Pedicular and Extrapedicular Access for Tumor Ablation in a Thoracic Vertebral Body

    Science.gov (United States)

    Cianfoni, Alessandro; Massari, Francesco; Ewing, Stacey; Persenaire, Maarten; Rumboldt, Zoran; Bonaldi, Giuseppe

    2014-01-01

    Summary We present a percutaneous modified technique to access large thoracic vertebral body lytic lesions, to increase the volume of tumor accessible to ablation, prior to cement augmentation. Tumor ablation and cavity creation-assisted percutaneous vertebroplasty was considered a palliative measure for structural stabilization in plasmocytoma involvement of the entire T8 vertebral body. Given the extent of osteolysis bilateral combined transpedicular and extrapedicular access to the vertebral body was undertaken to maximize the volume of cavity creation within the tumor. The combined transpedicular and extrapedicular access was feasible, uncomplicated, and successful in reaching all the quadrants of the anterior two thirds of the vertebral body. Slow, fluoroscopically monitored injection of high-viscosity cement resulted in a successful, desired cement distribution into the anterior two thirds of the vertebral body, spanning superior to inferior endplates, providing structural stability, in the absence of venous or epidural leakage. The technical modification described in this case yielded positive results while overcoming some of the limitations of the existing coblation device. This approach may offer an option for cement augmentation of extensive vertebral body lytic lesions, at increased risk for tumor displacement and extra-vertebral cement leakage. PMID:25363263

  20. Exosome levels in human body fluids: A tumor marker by themselves?

    Science.gov (United States)

    Cappello, Francesco; Logozzi, Mariantonia; Campanella, Claudia; Bavisotto, Celeste Caruso; Marcilla, Antonio; Properzi, Francesca; Fais, Stefano

    2017-01-01

    Despite considerable research efforts, the finding of reliable tumor biomarkers remains challenging and unresolved. In recent years a novel diagnostic biomedical tool with high potential has been identified in extracellular nanovesicles or exosomes. They are released by the majority of the cells and contain detailed molecular information on the cell of origin including tumor hallmarks. Exosomes can be isolated from easy accessible body fluids, and most importantly, they can provide several biomarkers, with different levels of specificity. Recent clinical evidence shows that the levels of exosomes released into body fluids may themselves represent a predictive/diagnostic of tumors, discriminating cancer patients from healthy subjects. The aim of this review is to highlight these latest challenging findings to provide novel and groundbreaking ideas for successful tumor early diagnosis and follow-up.

  1. DIAGNOSTIC VALUE OF WHOLE BODY DIFFUSION WEIGHTED IMAGING FOR SCREENING PRIMARY TUMORS OF PATIENTS WITH METASTASES

    Institute of Scientific and Technical Information of China (English)

    Tai-fu Gu; Xin-lan Xiao; Fei Sun; Jian-hua Yin; Hai Zhao

    2008-01-01

    Objective To evaluate the values of whole body diffusion weighted imaging (DWI) in screening primary unknown tumor in patients with metastases.Methods Totally, 34 patients with metastases of primary unknown tumors were scanned with whole body DWI, and conventional magnetic resonance (MR) imaging was performed if suspected lesions were detected. All the metastases including 27 cases of osseous metastases, 2 brain metastases, 2 liver metastases, 1 pulmonary multiple metastasis, 1 neck metastasis and 1 malignant ascites, were diagnosed by computed tomography, single photon emission computed tomography, or MR imaging. For the proven primary tumors diagnosed by biopsy or pathology of surgical specimens, apparent diffusion coefficient (ADC) values of the primary and metastatic lesions were measured respectively. The sensitivity and specificity of this technique for screening primary tumors were evaluated. Results We found 24 cases with suspected primary lesions, in which 23 lesions were proved to be primary tumors, and 1 was proved to be benign lesion. And no definite primary lesion was found in 10 cases on whole body DWI, but in which 1 case was diagnosed with primary tumor by biopsy later, and the other 9 cases remained unknown within follow-up of over half a year. The difference was not significant in ADC values between primary and metastatic lesions (P>0.05). The sensitivity and specificity of whole body DWI for searching primary tumors was 95.8% and 90.0%, respectively. Conclusion Combined with conventional MR scanning, whole body DWI can help to search primary lesions of patients with metastases.

  2. Surgical treatment of carotid body tumor%颈动脉体瘤的外科治疗

    Institute of Scientific and Technical Information of China (English)

    汪忠镐; 潘松龄

    2002-01-01

    目的探讨颈动脉体瘤(CBT)的外科治疗方法.方法回顾性分析78例CBT的临床资料.结果 78例共88个肿瘤(双侧CBT10例)中切除83个.手术方式:CBT剥除28例侧;CBT与颈外动脉同时切除12例侧;CBT剥离式切除和颈内动脉部分切除、颈内动脉间置吻合3例侧,颈内动脉对端吻合1例侧,颈外动脉与颈内动脉吻合1例侧;CBT与颈总动脉整块切除颈动脉重建30例侧;CBT切除与颈总动脉结扎8例侧.手术死亡率为3.8%(3/78).65例术后随访1~21年,64例仍存活,1例于术后7年死于肺转移.随访期间,1例术后2年局部复发,行再次切除已8年无复发;1例家族性病例左侧病变切除后10年出现右侧病变.结论颈动脉体瘤可双侧发病,可有家族性,可恶变和可有内分泌相关的特性.对于较小的瘤体术中常可用分离法加以切除;涉及颈外动脉时可将其与瘤体同时切除;涉及颈内动脉而瘤体难以完全自颈内动脉剥脱时,可切除部分颈内动脉,行对端吻合,人工血管间置移植或以颈外动脉与之吻合.瘤体过大或粘连严重时,对端吻合可在瘤体横断面的颈内动脉上进行.

  3. Effects of the removal of extracellular Ca2+ on [Ca2+]i responses to FCCP and acetate in carotid body glomus cells of adult rabbits.

    Science.gov (United States)

    Sato, M

    1997-09-12

    The effects of the removal of extracellular Ca2+ on the responses of cytosolic concentrations of Ca2+ ([Ca2+]i) to acidic stimuli, a protonophore carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP) and an organic acid acetate, were examined in clusters of cultured carotid body glomus cells of adult rabbits using fura-2 microfluorometry. Application of FCCP (1 microM) induced an increase in [Ca2+]i (mean +/- S.E.M., 108 +/- 14%). After withdrawal of the protonophore the increased [Ca2+]i returned slowly to a resting level. The [Ca2+]i response was attenuated by an inorganic Ca2+ channel antagonist Ni2+ (2 mM) by 81 +/- 4%, and by an L-type voltage-gated Ca2+ channel antagonist D600 (10 microM) by 53 +/- 13%. The removal of extracellular Ca2+ eliminated the [Ca2+]i response in 71% of the tested cells (n = 17), and depressed it by 68 +/- 6% in the rest. Recovery following stimulation with FCCP in the absence of Ca2+ reversibly produced a rapid and large rise in [Ca2+]i, referred to as a [Ca2+]i rise after Ca2+-free/FCCP. The magnitude of a [Ca2+]i rise after Ca2+-free/FCCP (285 +/- 28%, P < 0.05) was larger than that of an increase in [Ca2+]i induced by FCCP in the presence of Ca2+ and had a correlation with the intensity of the suppression of the [Ca2+]i response by Ca2+ removal. A [Ca2+]i rise after Ca2+-free/FCCP was inhibited mostly by D600. Similarly, recovery following exposure to acetate in the absence of Ca2+ caused a rise in [Ca2+]i, referred to as a [Ca2+]i rise after Ca2+-free/acetate which was sensitive to D600. The magnitude of the [Ca2+]i rise was larger than that of a change in [Ca2+]i caused by acetate in the presence of Ca2+. These results suggest that FCCP-induced increase in [Ca2+]i was, in most cells, due to Ca2+ influx via L-type voltage-gated Ca2+ channels and, in some cells, due to both Ca2+ influx and Ca2+ release from internal Ca2+ pool. The removal of extracellular Ca2+ might modify [Ca2+]i responses to acidic stimuli, causing [Ca2+]i

  4. Carotid angiography

    Directory of Open Access Journals (Sweden)

    Arne Torkildsen

    1950-03-01

    Full Text Available After a brief review of the history of cerebral angiography, some of the most important points concerning the percutaneous angiographic technique have been described. The value of the angiographic examination in cases of cerebral gliomas has been studied, based upon a consecutive series of 127 verified cases of hemispherical gliomas. Of 31 cases of frontal glioma, 28 could be diagnosed by the angiographic method; of 33 cases of parietal glioma, the angiograms revealed the neoplasm in 27 instances; of 39 cases of temporal glioma, the tumor could be localized in 38 cases; of 13 cases of occipital glioma, the angiographic localization of the tumor was successfull in 9 instances; of 11. cases of glioma infiltrating the corpus callosum and (or the basal ganglia, the angiographic examination was successful in only 3 cases. The angiographic examination in cases of cerebral glioma, in my experience, yields a more satisfactory result as to the localization than does the pneumography. The only exception concerns the gliomas growing in the thalamus or in the basal ganglia. These are more easily localized by means of ventriculography. As to the differential diagnosis of the gliomas, tumor vessels could, be seen both in astrocytomas and in glioblastomas. Most cases of astrocytomas were however devoid of specific tumor vessels. When present they could not be definitely distinguished from those seen in glioblastomas, but the abnormal findings were far less numerous and definitely less pronounced in astrocytomas than in glioblastomas. In most cases the astrocytomas were characterized only by displacement of blood vessels of normal appearance, while the glioblastomas frequently-presented both displacement of normal appearing blood vessels and new formed blood vessels within the neoplasm itself. The pathological blood vessels in the tumor were frequently abnormal both regarding their topographical appearance and their type. Frequent findings were arterio

  5. A Novel Rabbit Carotid Body and Common Carotid Artery Model in Vivo for the Simulation of Various Intermittent and Continuous Hypoxia Modes%不同间歇低氧与持续低氧模式家兔在体颈动脉体和颈总动脉模型的建立

    Institute of Scientific and Technical Information of China (English)

    冯靖; 崔林阳; 陈宝元; 郭美南; 曹洁; 孙蓓

    2009-01-01

    Objective To develope a novel rabbit carotid body and carotid common artery model in vivo for the simulation of various intermittent hypoxia (IH) intensities, IH durations, IH reoxygenation (ROX) durations and continuous hypoxia (CH) modes.Methods Forty-five adult New Zealand rabbits (2.5~3.0 kg) were anesthetized while spontaneous breathing kept intact.The tissue surrounding the fight earetid common artery and carotid sinus nerve (CSN) were cleared and "single" chemoreceptor bundle of the CSN was revealed.Then suction electrodes were placed and CSN afferent activity was monitored and recorded carefully.The fight common carotid artery was exposed, cannulated to distal part and its proximal part was ligated.Preparations were challenged by changing the PO2 of the gas mixture equilibrating the perfusate.Alternatively perfusion (2 mL/min) of equilibrated porfusate bubbled with normoxia or hypoxia gas mixtures formed IH/ROX cycles in carotid common artery,simulating the pattern of hypoxic episodes seen in obstructive sleep apnea syndrome (OSAS), or with continuously perfusing hypoxia perfusate to form CH modes.All the perfusing procedures were regulated by a customized computer-controlled set and monitored using O2 gas analyzer.After the systematic exposures, carotid body, carotid common artery part distal to cannula,and carotid bifurcation were harvested as samples.Results The frequencies and average amplitudes of CSN chemoreceptor bundles afferent activities with normoxia peffusion were (0.17±0.03) impulse/s and (46.2±4.4) μV, and with hypoxia perfusion were (0.6±0.09) impulse/s and (87.4±6.6) μV, respectively.PO2 was (139±1.5) nun Hg in normoxia perfusate and (35.2±1.3) mm Hg in hypoxia perfusate.Conclusion This new carotid body and carotid common artery model is a valuable tool to study neurological and biochemical changes in various IH and CH modes.%目的 探讨建立不同间歇低氧(IH)程度、IH时间和再氧合(ROX)时间以及持续低氧(CH)模

  6. Carotid artery stenting will replace carotid endarterectomy.

    Science.gov (United States)

    McCormick, Daniel J; Vlad, Tudor; Fasseas, Panayotis

    2007-09-01

    Stroke is the third leading cause of death in the United States. Carotid artery stenosis represents one of the most common etiologies of stroke. The current treatment modalities available for the treatment of carotid artery stenosis are carotid endarterectomy (CEA) and carotid artery stenting (CAS). Several clinical trials comparing CEA with medical management showed superiority of the surgical arm; however, the applicability of these results to the general population is limited by the fact that the patients and surgeons enrolled in these trials were carefully selected, and the optimal medical therapy used does not meet the current treatment standards. Carotid artery stenting has emerged as a treatment alternative to CEA, as shown in randomized trials comparing the 2 treatment modalities. Recent data from large-volume CAS registries indicate that percutaneous treatment of carotid artery stenosis compares favorably to CEA. Furthermore, the CAS trial designs make these results more applicable to the community standards. These data suggest that CAS will become the treatment of choice in patients with carotid artery stenosis.

  7. Enhanced responses to tumor immunization following total body irradiation are time-dependent.

    Directory of Open Access Journals (Sweden)

    Adi Diab

    Full Text Available The development of successful cancer vaccines is contingent on the ability to induce effective and persistent anti-tumor immunity against self-antigens that do not typically elicit immune responses. In this study, we examine the effects of a non-myeloablative dose of total body irradiation on the ability of tumor-naïve mice to respond to DNA vaccines against melanoma. We demonstrate that irradiation followed by lymphocyte infusion results in a dramatic increase in responsiveness to tumor vaccination, with augmentation of T cell responses to tumor antigens and tumor eradication. In irradiated mice, infused CD8(+ T cells expand in an environment that is relatively depleted in regulatory T cells, and this correlates with improved CD8(+ T cell functionality. We also observe an increase in the frequency of dendritic cells displaying an activated phenotype within lymphoid organs in the first 24 hours after irradiation. Intriguingly, both the relative decrease in regulatory T cells and increase in activated dendritic cells correspond with a brief window of augmented responsiveness to immunization. After this 24 hour window, the numbers of dendritic cells decline, as does the ability of mice to respond to immunizations. When immunizations are initiated within the period of augmented dendritic cell activation, mice develop anti-tumor responses that show increased durability as well as magnitude, and this approach leads to improved survival in experiments with mice bearing established tumors as well as in a spontaneous melanoma model. We conclude that irradiation can produce potent immune adjuvant effects independent of its ability to induce tumor ablation, and that the timing of immunization and lymphocyte infusion in the irradiated host are crucial for generating optimal anti-tumor immunity. Clinical strategies using these approaches must therefore optimize such parameters, as the correct timing of infusion and vaccination may mean the difference

  8. A gamma-ray therapeutic system applied to treatment of body tumors

    Institute of Scientific and Technical Information of China (English)

    HUANG Yu; DUAN Zheng-Cheng; ZHU Guo-Li; GONG Shi-Hua; LI Xiao-Ping

    2004-01-01

    In order to treat malignant tumors in human body, a stereotactic gamma-ray whole-body therapeutic system has been developed. This system is a typical large mechatronics treatment machine. In this paper, its main working principles and characteristics are introduced. This system comprises a special gallows frame with an open vertical structure, a changeable collimator device by which the size of convergence center can be chosen, and a 3D treatment couch. A computer brings the couch to target position automatically. Therefore precise and dynamic rotary converging therapy for tumors located anywhere in the body has been realized. The system's performance has been proved in practice, which includes good curative effect, reliable automation, and safe and secure operation.

  9. Tumorer

    DEFF Research Database (Denmark)

    Prause, J.U.; Heegaard, S.

    2005-01-01

    oftalmologi, øjenlågstumorer, conjunctivale tumorer, malignt melanom, retinoblastom, orbitale tumorer......oftalmologi, øjenlågstumorer, conjunctivale tumorer, malignt melanom, retinoblastom, orbitale tumorer...

  10. Carotid Stump Syndrome

    Directory of Open Access Journals (Sweden)

    Lara Toufic Dakhoul MD

    2014-08-01

    Full Text Available Objectives. To highlight the case of a patient with multiple transient ischemic attacks and visual disturbances diagnosed with carotid stump syndrome and managed with endovascular approach. Case Presentation. We present the case of a carotid stump syndrome in an elderly patient found to have moderate left internal carotid artery stenosis in response to an advertisement for carotid screening. After a medical therapeutic approach and a close follow-up, transient ischemic attacks recurred. Computed tomographic angiography showed an occlusion of the left internal carotid artery and the presence of moderate stenosis in the right internal carotid artery, which was treated by endovascular stenting and balloon insertion. One month later, the patient presented with visual disturbances due to the left carotid stump and severe stenosis of the left external carotid artery that was reapproached by endovascular stenting. Conclusion. Considerations should be given to the carotid stump syndrome as a source of emboli for ischemic strokes, and vascular assessment could be used to detect and treat this syndrome.

  11. Meningioma: The role of a foreign body and irradiation in tumor formation

    Energy Technology Data Exchange (ETDEWEB)

    Saleh, J.; Silberstein, H.J.; Salner, A.L.; Uphoff, D.F. (Hartford Hospital, CT (USA))

    1991-07-01

    A case of meningioma is reported. At the age of 18 years, the patient had undergone insertion of a Torkildsen shunt through a posteroparietal burr hole for obstructive hydrocephalus secondary to a tumor of the pineal region, of which no biopsy had been made. After the hydrocephalus was relieved, he underwent irradiation of the tumor. Thirty years later, he was treated for an intracranial meningioma wrapped around the shunt. The tumor followed the shunt in all of its intracranial course. Microscopy disclosed pieces of the shunt tube within the meningioma. The role of a foreign body and irradiation in the induction of meningiomas is discussed, and a comprehensive review of the literature is presented. 47 references.

  12. Stereotactic Body Radiotherapy for Small Lung Tumors in the University of Tokyo Hospital

    Directory of Open Access Journals (Sweden)

    Hideomi Yamashita

    2014-01-01

    Full Text Available Our work on stereotactic body radiation therapy (SBRT for primary and metastatic lung tumors will be described. The eligibility criteria for SBRT, our previous SBRT method, the definition of target volume, heterogeneity correction, the position adjustment using four-dimensional cone-beam computed tomography (4D CBCT immediately before SBRT, volumetric modulated arc therapy (VMAT method for SBRT, verifying of tumor position within internal target volume (ITV using in-treatment 4D-CBCT during VMAT-SBRT, shortening of treatment time using flattening-filter-free (FFF techniques, delivery of 4D dose calculation for lung-VMAT patients using in-treatment CBCT and LINAC log data with agility multileaf collimator, and SBRT method for centrally located lung tumors in our institution will be shown. In our institution, these efforts have been made with the goal of raising the local control rate and decreasing adverse effects after SBRT.

  13. Persistent carotid-vertebrobasilar anastomosis: radiologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Il; Kim, Dong Ik; Jun, Pyoung; Yoon, Pyeong Ho; Hwang, Geum Ju; Cheon, Young Jik; Lim, Joon Seok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-11-01

    To evaluate the radiologic findings of carotid-vertebrobasilar anastomosis and associated anomalies. Thirteen pateints with fourteen cases of carotid-vertebrobasilar anastomosis collected from January 1992 to December 1997 were reviewed. Clinical diagnosis refered for cerebral angiography were cerebral infarction (n=3D3), intracranial hemorrhage (n=3D2), subarachnoid hemorrhage (n=3D1), brain tumor (n=3D3), arteriovenous malformation (n=3D3) and trigeminal neuralgia (n=3D1). Cerebral angiograms and clinical symptoms were retrospectively analyzed. The fourteen carotid-vertebrobasilar anastomsis consisted of eleven cases of persistent trigeminal artery and three cases of type I proatantal intersegmental artery. Persistent trigeminal arteries were associated with anterior communicating artery aneurysm(n=3D1), posterior fossa arteriovenous malformation(n=3D2) and persistent trigeminal artery variant(n=3D5). Type I proatantal intersegmental arteries were associated with hypoplastic vertebral arteries(n=3D2): only proximal segment in one, and proximal and distal segments in one case. Only one patient had clinical symptom related to the carotid-vertebrobasilar anastomosis which was trigeminal neuralgia. Knowledge of the anatomical and radiologic findings of carotid-vertebrobasilar anastomosis and associated anomalies will aid in the accurate diagnosis of neurovascular disease and prevent possible complications during surgical and interventional procedures.=20.

  14. Interfraction variation in lung tumor position with abdominal compression during stereotactic body radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mampuya, Wambaka Ange; Nakamura, Mitsuhiro; Matsuo, Yukinori; Ueki, Nami; Iizuka, Yusuke; Monzen, Hajime; Mizowaki, Takashi; Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto 606-8507 (Japan); Fujimoto, Takahiro; Yano, Shinsuke [Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507 (Japan)

    2013-09-15

    Purpose: To assess the effect of abdominal compression on the interfraction variation in tumor position in lung stereotactic body radiotherapy (SBRT) using cone-beam computed tomography (CBCT) in a larger series of patients with large tumor motion amplitude.Methods: Thirty patients with lung tumor motion exceeding 8 mm who underwent SBRT were included in this study. After translational and rotational initial setup error was corrected based on bone anatomy, CBCT images were acquired for each fraction. The residual interfraction variation was defined as the difference between the centroid position of the visualized target in three dimensions derived from CBCT scans and those derived from averaged intensity projection images. The authors compared the magnitude of the interfraction variation in tumor position between patients treated with [n= 16 (76 fractions)] and without [n= 14 (76 fractions)] abdominal compression.Results: The mean ± standard deviation (SD) of the motion amplitude in the longitudinal direction before abdominal compression was 19.9 ± 7.3 (range, 10–40) mm and was significantly (p < 0.01) reduced to 12.4 ± 5.8 (range, 5–30) mm with compression. The greatest variance of the interfraction variation with abdominal compression was observed in the longitudinal direction, with a mean ± SD of 0.79 ± 3.05 mm, compared to −0.60 ± 2.10 mm without abdominal compression. The absolute values of the 95th percentile of the interfraction variation for one side in each direction were 3.97/6.21 mm (posterior/anterior), 4.16/3.76 mm (caudal/cranial), and 2.90/2.32 mm (right/left) without abdominal compression, and 2.14/5.03 mm (posterior/anterior), 3.93/9.23 mm (caudal/cranial), and 2.37/5.45 mm (right/left) with abdominal compression. An absolute interfraction variation greater than 5 mm was observed in six (9.2%) fractions without and 13 (17.1%) fractions with abdominal compression.Conclusions: Abdominal compression was effective for reducing the amplitude

  15. Cyberknife Stereotactic Body Radiation Therapy for Nonresectable Tumors of the Liver: Preliminary Results

    Directory of Open Access Journals (Sweden)

    K. Goyal

    2010-01-01

    Full Text Available Purpose. Stereotactic body radiation therapy (SBRT has emerged as a treatment option for local tumor control of primary and secondary malignancies of the liver. We report on our updated experience with SBRT in patients with non-resectable tumors of the liver. Methods. Our first 17 consecutive patients (mean age 58.1 years receiving SBRT for HCC (=6, IHC (=3, and LM (=8 are presented. Mean radiation dose was 34Gy delivered over 1–3 fractions. Results. Treated patients had a mean decrease in maximum pretreatment tumor diameter from 6.9±4.6 cm to 5.0±2.1 cm at three months after treatment (<.05. The mean total tumor volume reduction was 44% at six months (<.05. 82% of all patients (14/17 achieved local control with a median follow-up of 8 months. 100% of patients with HCC (=6 achieved local control. Patients with surgically placed fiducial markers had no complications related to marker placement. Conclusion. Our preliminary results showed that SBRT is a safe and effective local treatment modality in selected patients with liver malignancies with minimal adverse events. Further studies are needed to define its role in the management of these malignancies.

  16. Targeted microbubbles for imaging tumor angiogenesis: assessment of whole-body biodistribution with dynamic micro-PET in mice

    DEFF Research Database (Denmark)

    Willmann, Jürgen K; Cheng, Zhen; Davis, Corrine;

    2008-01-01

    To evaluate in vivo whole-body biodistribution of microbubbles (MBs) targeted to tumor angiogenesis-related vascular endothelial growth factor (VEGF) receptor 2 (VEGFR2) by using dynamic micro-positron emission tomography (PET) in living mice....

  17. Fatty Acid Synthase Polymorphisms, Tumor Expression, Body Mass Index, Prostate Cancer Risk, and Survival

    Science.gov (United States)

    Nguyen, Paul L.; Ma, Jing; Chavarro, Jorge E.; Freedman, Matthew L.; Lis, Rosina; Fedele, Giuseppe; Fiore, Christopher; Qiu, Weiliang; Fiorentino, Michelangelo; Finn, Stephen; Penney, Kathryn L.; Eisenstein, Anna; Schumacher, Fredrick R.; Mucci, Lorelei A.; Stampfer, Meir J.; Giovannucci, Edward; Loda, Massimo

    2010-01-01

    Purpose Fatty acid synthase (FASN) regulates de novo lipogenesis, body weight, and tumor growth. We examined whether common germline single nucleotide polymorphisms (SNPs) in the FASN gene affect prostate cancer (PCa) risk or PCa-specific mortality and whether these effects vary by body mass index (BMI). Methods In a prospective nested case-control study of 1,331 white patients with PCa and 1,267 age-matched controls, we examined associations of five common SNPs within FASN (and 5 kb upstream/downstream, R2 > 0.8) with PCa incidence and, among patients, PCa-specific death and tested for an interaction with BMI. Survival analyses were repeated for tumor FASN expression (n = 909). Results Four of the five SNPs were associated with lethal PCa. SNP rs1127678 was significantly related to higher BMI and interacted with BMI for both PCa risk (Pinteraction = .004) and PCa mortality (Pinteraction = .056). Among overweight men (BMI ≥ 25 kg/m2), but not leaner men, the homozygous variant allele carried a relative risk of advanced PCa of 2.49 (95% CI, 1.00 to 6.23) compared with lean men with the wild type. Overweight patients carrying the variant allele had a 2.04 (95% CI, 1.31 to 3.17) times higher risk of PCa mortality. Similarly, overweight patients with elevated tumor FASN expression had a 2.73 (95% CI, 1.05 to 7.08) times higher risk of lethal PCa (Pinteraction = .02). Conclusion FASN germline polymorphisms were significantly associated with risk of lethal PCa. Significant interactions of BMI with FASN polymorphisms and FASN tumor expression suggest FASN as a potential link between obesity and poor PCa outcome and raise the possibility that FASN inhibition could reduce PCa-specific mortality, particularly in overweight men. PMID:20679621

  18. Dose estimation for internal organs during boron neutron capture therapy for body-trunk tumors.

    Science.gov (United States)

    Sakurai, Y; Tanaka, H; Suzuki, M; Masunaga, S; Kinashi, Y; Kondo, N; Ono, K; Maruhashi, A

    2014-06-01

    Radiation doses during boron neutron capture therapy for body-trunk tumors were estimated for various internal organs, using data from patients treated at Kyoto University Research Reactor Institute. Dose-volume histograms were constructed for tissues of the lung, liver, kidney, pancreas, and bowel. For pleural mesothelioma, the target total dose to the normal lung tissues on the diseased side is 5Gy-Eq in average for the whole lung. It was confirmed that the dose to the liver should be carefully considered in cases of right lung disease.

  19. Asymmetric Cancer Hallmarks in Breast Tumors on Different Sides of the Body

    Science.gov (United States)

    Campoy, Emanuel M.; Laurito, Sergio R.; Branham, María T.; Urrutia, Guillermo; Mathison, Angela; Gago, Francisco; Orozco, Javier; Urrutia, Raul; Mayorga, Luis S.; Roqué, María

    2016-01-01

    During the last decades it has been established that breast cancer arises through the accumulation of genetic and epigenetic alterations in different cancer related genes. These alterations confer the tumor oncogenic abilities, which can be resumed as cancer hallmarks (CH). The purpose of this study was to establish the methylation profile of CpG sites located in cancer genes in breast tumors so as to infer their potential impact on 6 CH: i.e. sustained proliferative signaling, evasion of growth suppressors, resistance to cell death, induction of angiogenesis, genome instability and invasion and metastasis. For 51 breast carcinomas, MS-MLPA derived-methylation profiles of 81 CpG sites were converted into 6 CH profiles. CH profiles distribution was tested by different statistical methods and correlated with clinical-pathological data. Unsupervised Hierarchical Cluster Analysis revealed that CH profiles segregate in two main groups (bootstrapping 90–100%), which correlate with breast laterality (p = 0.05). For validating these observations, gene expression data was obtained by RealTime-PCR in a different cohort of 25 tumors and converted into CH profiles. This analyses confirmed the same clustering and a tendency of association with breast laterality (p = 0.15). In silico analyses on gene expression data from TCGA Breast dataset from left and right breast tumors showed that they differed significantly when data was previously converted into CH profiles (p = 0.033). We show here for the first time, that breast carcinomas arising on different sides of the body present differential cancer traits inferred from methylation and expression profiles. Our results indicate that by converting methylation or expression profiles in terms of Cancer Hallmarks, it would allow to uncover veiled associations with clinical features. These results contribute with a new finding to the better understanding of breast tumor behavior, and can moreover serve as proof of principle for other

  20. Staged bilateral carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Engell, Hans Christian

    1986-01-01

    In a series of 56 staged bilateral carotid endarterectomies, new neurologic symptoms developed in 5% and 20% following the first and second procedure, respectively. All complications were transient or minor. The incidence of postendarterectomy hypertension was significantly higher following...

  1. DHA effect on chemotherapy-induced body weight loss: an exploratory study in a rodent model of mammary tumors.

    Science.gov (United States)

    Hajjaji, Nawale; Couet, Charles; Besson, Pierre; Bougnoux, Philippe

    2012-01-01

    Body weight loss during the course of cancer disease has been associated with poor prognosis. Beside cancer-associated cachexia, weight loss can also result from chemotherapy. This work explored whether a model of mammary tumors in female Sprague Dawley rats could be appropriate to study the effect of doxorubicin on body weight, described weight change in this model, and assessed the effect of DHA on weight during chemotherapy. After tumor induction, rats were randomly assigned to a control or a DHA-enriched diet, and treated with doxorubicin or placebo twice a week for 2.5 wk (n = 6 in each group). Body weight, food intake, and tumor growth were monitored. Neither the induction of tumors nor their initial development impaired body weight gain. No reduction in food intake was observed. Tumor growth was similar between groups from day 1 to day 11. Although doxorubicin induced body weight loss from day 4 compared to placebo (Pweight loss in rats fed the DHA-enriched diet (P = 0.02), indicating that DHA had a protective effect. These results indicate that doxorubicin can induce body weight loss in this model and that a DHA-enriched diet can prevent this effect.

  2. Comparison between Carotid Stenting and Carotid Endarterectomy in Early Outcome

    OpenAIRE

    Kovačić, Slavica; Kovačević, Miljenko; Strenja-Linić, Ines; Budiselić, Berislav; Knežević, Siniša

    2011-01-01

    Carotid artery stenting (CAS) is a widely used method in prevention of stroke for carotid artery stenosis as an alternative to surgical treatment. Initial studies reveal higher morbidity and mortality rates for CAS than acceptable standards for carotid endarterectomy (CEA). The aim of this study was to compare results in a series of CAS with concurrent risk-matched group of CEA patients. The study included two groups of 50 patients with internal carotid artery stenosis. We compare...

  3. Obesity and carotid artery remodeling

    DEFF Research Database (Denmark)

    Kozakova, M; Palombo, C; Morizzo, C

    2015-01-01

    BACKGROUND/OBJECTIVE: The present study tested the hypothesis that obesity-related changes in carotid intima-media thickness (IMT) might represent not only preclinical atherosclerosis but an adaptive remodeling meant to preserve circumferential wall stress (CWS) in altered hemodynamic conditions...... and CCA LD (266 healthy subjects with wide range of body weight (24-159 kg)); (B) longitudinal associations between CCA LD and 3-year IMT progression rate (ΔIMT; 571 healthy non-obese subjects without increased cardiovascular (CV) risk); (C) the impact of obesity on CCA geometry and CWS (88 obese subjects...... without CV complications and 88 non-obese subjects matched for gender and age). RESULTS: CCA LD was independently associated with SV that was determined by body size. In the longitudinal study, baseline LD was an independent determinant of ΔIMT, and ΔIMT of subjects in the highest LD quartile...

  4. 4π Noncoplanar Stereotactic Body Radiation Therapy for Head-and-Neck Cancer: Potential to Improve Tumor Control and Late Toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Rwigema, Jean-Claude M.; Nguyen, Dan [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States); Heron, Dwight E. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Chen, Allen M.; Lee, Percy; Wang, Pin-Chieh [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States); Vargo, John A. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Low, Daniel A. [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States); Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Tenn, Stephen; Steinberg, Michael L.; Kupelian, Patrick [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States); Sheng, Ke, E-mail: ksheng@mednet.ucla.edu [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States)

    2015-02-01

    Purpose: To evaluate the potential benefit of 4π radiation therapy in recurrent, locally advanced, or metastatic head-and-neck cancer treated with stereotactic body radiation therapy (SBRT). Methods and Materials: Twenty-seven patients with 29 tumors who were treated using SBRT were included. In recurrent disease (n=26), SBRT was delivered with a median 44 Gy (range, 35-44 Gy) in 5 fractions. Three patients with sinonasal mucosal melanoma, metastatic breast cancer, and primary undifferentiated carcinoma received 35 Gy, 22.5 Gy, and 40 Gy in 5 fractions, respectively. Novel 4π treatment plans were created for each patient to meet the objective that 95% of the planning target volume was covered by 100% of the prescription dose. Doses to organs at risk (OARs) and 50% dose spillage volumes were compared against the delivered clinical SBRT plans. Local control (LC), late toxicity, tumor control probability (TCP), and normal tissue complication probability were determined. Results: Using 4π plans, mean/maximum doses to all OARs were reduced by 22% to 89%/10% to 86%. With 4π plans, the 50% dose spillage volume was decreased by 33%. Planning target volume prescription dose escalation by 10 Gy and 20 Gy were achieved while keeping doses to OARs significantly improved or unchanged from clinical plans, except for the carotid artery maximum dose at 20-Gy escalation. At a median follow-up of 10 months (range, 1-41 months), crude LC was 52%. The 2-year LC of 39.2% approximated the predicted mean TCP of 42.2%, which increased to 45.9% with 4π plans. For 10-Gy and 20-Gy dose escalation, 4π plans increased TCP from 80.1% and 88.1% to 85.5% and 91.4%, respectively. The 7.4% rate of grade ≥3 late toxicity was comparable to the predicted 5.6% mean normal tissue complication probability for OARs, which was significantly reduced by 4π planning at the prescribed and escalated doses. Conclusions: 4π plans may allow dose escalation with significant and consistent

  5. Carotid endarterectomies for relieving severe or moderate carotid stenosis

    Institute of Scientific and Technical Information of China (English)

    L(U) Zhi-qian 吕志前; XIAO Ming-di 萧明第; Montagna Pietro; Farhat Fadi; Olivier Jegaden

    2004-01-01

    @@ Carotid artery stenosis is one of the major causes of ischemic strokes.1 To prevent or reduce the occurrences of ischemic strokes, carotid endarterectomies (CEAs) were performed on 48 patients with carotid artery stenosis from November 2000 to June 2003. Results from this study were analyzed and presented here.

  6. Carotid Artery Management in Head and Neck Surgery

    Directory of Open Access Journals (Sweden)

    Murat Haluk Özkul

    2014-06-01

    Full Text Available Prevention and management of intraoperative and postoperative bleeding are of a great importance in performing successful head and neck surgery. Since the carotid artery is the major source of cerebral vascular supply, the management of carotid artery diseases including replacement, when needed, necessitates special knowledge and skill as well as experience. Delayed postoperative hemorrhage usually comes from carotid artery due to increasing frequency of radiotherapy treatment of head and neck cancers nowadays. This is the most catastrophic complication of the head and neck surgery. Carotid resection can be planned as part of surgical treatment or salvage. Carotid resection is performed mostly to salvage patients when radiotherapy and chemotherapy are ineffective and less for carotid invasion caused by either direct extension of a malign tumor originating from the nasopharynx and oropharynx or extracapsular invasion of advanced jugular node metastasis. The purpose of this presentation was to enlighten the readers about carotid artery problems and management emphasizing the importance of preoperative evaluation. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 71-4

  7. Influence of Body Mass Index on Tumor Pathology and Survival in Uterine Cancer

    DEFF Research Database (Denmark)

    Kristensen, Anne Bjerrum; Hare-Bruun, Helle; Høgdall, Claus Kim;

    2016-01-01

    for uterine cancer or atypical endometrial hyperplasia (International Classification of Diseases-10 codes D070, DC549) 2005 to 2012 (n = 6003). MAIN OUTCOME MEASURES: Impact of BMI on type I and II endometrial cancer survival. MATERIALS AND METHODS: Danish Gynecological Cancer Database data on women with type......OBJECTIVE: To evaluate the influence of body mass index (BMI) on endometrial tumor pathology, stage and complication rate and to identify individual prognostic factors, such as BMI, in types I and II endometrial cancer. DESIGN: Register study included all Danish women who underwent surgery...... I and II endometrial cancer were retrieved. Kaplan-Meier plot was used to illustrate differences in survival in relation to BMI. Log-rank test was used to demonstrate difference between the curves. Cox regression hazard model was used to estimate hazard ratios (HR) of the effect of BMI on overall...

  8. 一种永生化的大鼠颈动脉血管球细胞系的生化特性%The neurochemical properties of an immortalized glomus cell line from the carotid body of rat

    Institute of Scientific and Technical Information of China (English)

    周光斗

    2006-01-01

    目的 神经干细胞在帕金森病的治疗中有十分巨大的潜在价值,然而,神经干细胞含有多种神经细胞成分,目前选择性分离纯化其中的多巴胺能神经元尚不完全成熟.在这里我们报告一种来自颈动脉体的克隆细胞系.方法 我们用逆转录病毒转导SV40 T抗原和Cre/lox P到大鼠颈动脉血管球细胞使其永生化,然后这些原癌基因被腺病毒转导的Cre重组酶切除.结果 克隆的血管球细胞表达高水平的酪氨酸羟化酶免疫反应性物质并且选择性地释放多巴胺.这些克隆细胞几乎不表达多巴胺转运体(DAT)而且抵抗多巴胺和MPTP介导的神经毒性.结论 克隆的血管球细胞可能为帕金森病的治疗提供一种新的方法.%Objective Embryonic stem cells (ES) are potentially useful for treatment of Parkinson's disease. However, ES cells contain a mixed population of neurons, and selective enrichment of dopaminergic components remains difficult. Here, we report that a dopaminergic clonal cell line developed from carotid body. Methods Glomus cells of the rat carotid body were conditionally immortalized by retroviral transfer of the SV40 T antigen and Cre/lox P elements. The oncogene was subsequently removed adenoviral delivery of the Cre recombinase. Results Cloned glomus cells expressed high levels of tyrosine hydroxylase immunoreactivity and selectively released dopamine in culture. Remarkably, they expressed little dopamine transporter DAT, and were resistant to dopamine- and MPTP-mediated neurotoxicity. Conclusion Immortalized glomus cell line might provide an alternative way to the treatment of Parkinson's disease.

  9. [Grafting of carotid arteries].

    Science.gov (United States)

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

    2005-01-01

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

  10. Whole-body (99m)Tc-octreotide scintigraphy with SPECT/CT to detect occult tumor inducing paraneoplastic osteomalacia.

    Science.gov (United States)

    Rodrigues, Napoleão Ramalho; Calich, Ana Luisa; Etchebehere, Mauricio; Ichiki, Wilson Andre; Pereira, Fabio Payao; Amstalden, Elaine Maria Ingrid; de Sa Etchebehere, Elba Cristina

    2015-01-01

    A 32-year-old woman presented with progressive myalgia, bone pain, fatigue, insufficiency hip fractures, high urine phosphate, and low serum phosphate and vitamin D levels. These findings were suggestive of oncogenic osteomalacia. A whole-body Tc-octreotide scintigraphy with SPECT/CT showed uptake on a sclerotic intramedullary lesion in the left medial tibia plateau. MRI depicted a solid lesion. The lesion was surgically removed; the patient became asymptomatic, and follow-up laboratory results normalized. Histopathologic examination revealed a vascular hemangiopericytoma-like tumor, positive for somatostatin receptor (SSR-2). Whole-body Tc-octreotide scintigraphy with SPECT/CT may detect occult oncogenic osteomalacia tumors.

  11. Fatty liver, carotid disease and gallstones: A study of age-related associations

    Institute of Scientific and Technical Information of China (English)

    Amedeo Lonardo; Paola Loria; Silvia Lombardini; Federica Scaglioni; Stefano Ballestri; Anna Maria Verrone; Marco Bertolotti; Lucia Carulli; Dorval Ganazzi; Nicola Carulli

    2006-01-01

    AIM: To evaluate carotid intima-media thickening (IMT)and plaques, gallstone disease (GD) and fatty liver (FL)as a function of age.METHODS: In 449 subjects, FL and carotid disease were assessed ultrasonographically. In a subgroup of 65/449 patients with non-alcoholic fatty liver disease (NAFLD), carotid disease, GD and associated factors were determined.RESULTS: FL of unspecified etiology was more common in younger and GD in older individuals. FL subjects had an increased prevalence of IMT and a decreased prevalence of plaques and manifested carotid disease earlier. Plaques were more common in subjects with GD.Age was an independent predictor of carotid disease outcome and FL was a protective factor for plaques. In NAFLD, there was an inverse correlation between body weight and age and the latter independently predicted carotid findings.CONCLUSION: Cardiovascular risk in patients with FL and NAFLD needs to be assessed as a function of age and body weight.

  12. 一氧化碳和硫化氢在颈动脉体缺氧反应中的调节作用%Hypoxia responses led by carotid body is regulated by carbon monoxide and hydrogen sulfide

    Institute of Scientific and Technical Information of China (English)

    黄跃宇; 夏建华; 石学银

    2008-01-01

    传统认为一氧化碳和硫化氢为有毒气体,但近年的研究表明在颈动脉体感受低氧的过程中,这两种气体起重要的调节作用.一氧化碳通过增加内向钾离子电流抑制窦神经;硫化氢供体硫氢化钠则呈剂量依赖性兴奋窦神经.并且一氧化碳供体能完全逆转硫化氢对窦神经的兴奋作用.因而,一氧化碳和硫化氢共同调节颈动脉体对低氧状态反应的信号转导.%Carbon monoxide and hydrogen sulfide, both of which are well known toxic agents, are now demonstrated as critical gaseous mediators in carotid body when it responds to hypoxia. While carbon monoxide reduces sinus nerve impulses by decreasing inward potassium ion flux, sodium hydrosulfide, a donor of hydrogen sulfide, exerts an opposite effect in a dose - dependent manner.However, the exciting effect of hydrogen sulfide will be reversed completely after the donor of carbon monoxide is subjected. In this way, carbon monoxide and hydrogen sulfide intermingle into the regulation to the hypoxic information transduetion.

  13. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study) : an interim analysis of a randomised controlled trial

    NARCIS (Netherlands)

    Ederle, Joerg; Dobson, Joanna; Featherstone, Roland L.; Bonati, Leo H.; van der Worp, H. Bart; de Borst, Gert J.; Lo, T. Hauw; Gaines, Peter; Dorman, Paul J.; Macdonald, Sumaira; Lyrer, Philippe A.; Hendriks, Johanna M.; McCollum, Charles; Nederkoorn, Paul J.; Brown, Martin M.; Algra, A.; Bamford, J.; Beard, J.; Bland, M.; Bradbury, A. W.; Brown, M. M.; Clifton, A.; Gaines, P.; Hacke, W.; Halliday, A.; Malik, I.; Mas, J. L.; McGuire, A. J.; Sidhu, P.; Venables, G.; Bradbury, A.; Brown, M. M.; Clifton, A.; Gaines, P.; Collins, R.; Molynewc, A.; Naylor, R.; Warlow, C.; Ferro, J. M.; Thomas, D.; Bonati, L. H.; Coward, L.; Dobson, J.; Ederle, J.; Featherstone, R. F.; Tindall, H.; McCabe, D. J. H.; Wallis, A.; Brooks, M.; Chambers, B.; Chan, A.; Chu, P.; Clark, D.; Dewey, H.; Donnan, G.; Fell, G.; Hoare, M.; Molan, M.; Roberts, A.; Roberts, N.; Beiles, B.; Bladin, C.; Clifford, C.; Fell, G.; Grigg, M.; New, G.; Bell, R.; Bower, S.; Chong, W.; Holt, M.; Saunder, A.; Than, P. G.; Gett, S.; Leggett, D.; McGahan, T.; Quinn, J.; Ray, M.; Wong, A.; Woodruff, P.; Foreman, R.; Schultz, D.; Scroop, R.; Stanley, B.; Allard, B.; Atkinson, N.; Cambell, W.; Davies, S.; Field, P.; Milne, P.; Mitchell, P.; Tress, B.; Yan, B.; Beasley, A.; Dunbabin, D.; Stary, D.; Walker, S.; Cras, P.; d'Archambeau, O.; Hendriks, J. M. H.; Van Schil, P.; Bosiers, M.; Deloose, K.; van Buggenhout, E.; De Letter, J.; Devos, V.; Ghekiere, J.; Vanhooren, G.; Astarci, P.; Hammer, F.; Lacroix, V.; Peeters, A.; Verhelst, R.; DeJaegher, L.; Peeters, A.; Verbist, J.; Blair, J-F; Caron, J. L.; Daneault, N.; Giroux, M-F; Guilbert, F.; Lanthier, S.; Lebrun, L-H; Oliva, V.; Raymond, J.; Roy, D.; Soulez, G.; Weill, A.; Hill, M.; Hu, W.; Hudion, M.; Morrish, W.; Sutherland, G.; Wong, J.; Alback, A.; Harno, H.; Ijas, P.; Kaste, M.; Lepantalo, M.; Mustanoja, S.; Paananen, T.; Porras, M.; Putaala, J.; Railo, M.; Sairanen, T.; Soinne, L.; Vehmas, A.; Vikatmaa, P.; Goertler, M.; Halloul, Z.; Skalej, M.; Brennan, P.; Kelly, C.; Leahy, A.; Moroney, J.; Thornton, J.; Koelemay, M. J. W.; Nederkoorn, P. J.; Reekers, J. A. A.; Roos, Y. B. W. E. M.; Hendriks, J. M.; Koudstaal, P. J.; Pattynama, P. M. T.; van der Lugt, A.; van Dijk, L. C.; van Sambeek, M. R. H. M.; van Urk, H.; Verhagen, H. J. M.; Bruininckx, C. M. A.; de Bruijn, S. F.; Keunen, R.; Knippenberg, B.; Mosch, A.; Treurniet, F.; van Dijk, L.; van Overhagen, H.; Wever, J.; de Beer, F. C.; van den Berg, J. S. P.; van Hasselt, B. A. A. M.; Zeilstra, D. J.; Boiten, J.; van Otterloo, J. C. A. de Mol; de Vries, A. C.; Nieholt, G. J. Lycklama A.; van der Kallen, B. F. W.; Blankensteijn, J. D.; De Leeuw, F. E.; Kool, L. J. Schultze; van der Vliet, J. A.; de Borst, G. J.; de Kort, G. A. P.; Kapelle, L. J.; Lo, T. H.; Mali, W. P. Th M.; Moll, F.; van der Worp, H. Bart; Verhagen, H.; Barber, P. A.; Bourchier, R.; Hill, A.; Holden, A.; Stewart, J.; Bakke, S. J.; Krohg-Sorensen, K.; Skjelland, M.; Tennoe, B.; Bialek, P.; Biejat, Z.; Czepiel, W.; Czlonkowska, A.; Dowzenko, A.; Jedrzejewska, J.; Kobayashi, A.; Lelek, M.; Polanski, J.; Kirbis, J.; Milosevic, Z.; Zvan, B.; Blasco, J.; Chamorro, A.; Macho, J.; Obach, V.; Riambau, V.; San Roman, L.; Branera, J.; Canovas, D.; Estela, Jordi; Gimenez Gaibar, A.; Perendreu, J.; Bjorses, K.; Gottsater, A.; Ivancev, K.; Maetzsch, T.; Sonesson, B.; Berg, B.; Delle, M.; Formgren, J.; Gillgren, P.; Kall, T-B; Konrad, P.; Nyman, N.; Takolander, R.; Andersson, T.; Malmstedt, J.; Soderman, M.; Wahlgren, C.; Wahlgren, N.; Binaghi, S.; Hirt, L.; Michel, P.; Ruchat, P.; Bonati, L. H.; Engelter, S. T.; Fluri, F.; Guerke, L.; Jacob, A. L.; Kirsch, E.; Lyrer, P. A.; Radue, E-W; Stierli, P.; Wasner, M.; Wetzel, S.; Bonvin, C.; Kalangos, A.; Lovblad, K.; Murith, N.; Ruefenacht, D.; Sztajzel, R.; Higgins, N.; Kirkpatrick, P. J.; Martin, P.; Adam, D.; Bell, J.; Bradbury, A. W.; Crowe, P.; Gannon, M.; Henderson, M. J.; Sandler, D.; Shinton, R. A.; Scriven, J. M.; Wilmink, T.; D'Souza, S.; Egun, A.; Guta, R.; Punekar, S.; Seriki, D. M.; Thomson, G.; Brennan, A.; Enevoldson, T. P.; Gilling-Smith, G.; Gould, D. A.; Harris, P. L.; McWilliams, R. G.; Nasser, H-C; White, R.; Prakash, K. G.; Serracino-Inglott, F.; Subramanian, G.; Symth, J. V.; Walker, M. G.; Clarke, M.; Davis, M.; Dixit, S. A.; Dolman, P.; Dyker, A.; Ford, G.; Golkar, A.; Jackson, R.; Jayakrishnan, V.; Lambert, D.; Lees, T.; Louw, S.; Macdonald, S.; Mendelow, A. D.; Rodgers, H.; Rose, J.; Stansby, G.; Wyatt, M.; Baker, T.; Baldwin, N.; Jones, L.; Mitchell, D.; Munro, E.; Thornton, M.; Baker, D.; Davis, N.; Hamilton, G.; McCabe, D.; Platts, A.; Tibballs, J.; Beard, J.; Cleveland, T.; Dodd, D.; Gaines, P.; Lonsdale, R.; Nair, R.; Nassef, A.; Nawaz, S.; Venables, G.; Belli, A.; Clifton, A.; Cloud, G.; Halliday, A.; Markus, H.; McFarland, R.; Morgan, R.; Pereira, A.; Thompson, A.; Chataway, J.; Cheshire, N.; Gibbs, R.; Hammady, M.; Jenkins, M.; Malik, I.; Wolfe, J.; Adiseshiah, M.; Bishop, C.; Brew, S.; Brookes, J.; Brown, M. M.; Jaeger, R.; Kitchen, N.; Ashleigh, R.; Butterfield, S.; Gamble, G. E.; McCollum, C.; Nasim, A.; O'Neill, P.; Wong, J.; Edwards, R. D.; Lees, K. R.; MacKay, A. J.; Moss, J.; Rogers, P.

    2010-01-01

    Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid

  14. Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden: a cross sectional study using whole body magnetic resonance angiography.

    Directory of Open Access Journals (Sweden)

    Jonathan R Weir-McCall

    Full Text Available Common carotid intima media thickness (CIMT and ankle brachial pressure index (ABPI are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA.50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR. The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated.The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045, however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01 with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012, which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45, while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005.ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is

  15. SU-E-J-182: Reproducibility of Tumor Motion Probability Distribution Function in Stereotactic Body Radiation Therapy of Lung Using Real-Time Tumor-Tracking Radiotherapy System

    Energy Technology Data Exchange (ETDEWEB)

    Shiinoki, T; Hanazawa, H; Park, S; Takahashi, T; Shibuya, K [Yamaguchi University, Ube, Yamaguchi (Japan); Kawamura, S; Uehara, T; Yuasa, Y; Koike, M [Yamaguchi University Hospital, Ube, Yamaguchi (Japan)

    2015-06-15

    Purpose: We aim to achieve new four-dimensional radiotherapy (4DRT) using the next generation real-time tumor-tracking (RTRT) system and flattening-filter-free techniques. To achieve new 4DRT, it is necessary to understand the respiratory motion of tumor. The purposes of this study were: 1.To develop the respiratory motion analysis tool using log files. 2.To evaluate the reproducibility of tumor motion probability distribution function (PDF) during stereotactic body RT (SBRT) of lung tumor. Methods: Seven patients having fiducial markers closely implanted to the lung tumor were enrolled in this study. The positions of fiducial markers were measured using the RTRT system (Mitsubishi Electronics Co., JP) and recorded as two types of log files during the course of SBRT. For each patients, tumor motion range and tumor motion PDFs in left-right (LR), anterior-posterior (AP) and superior-inferior (SI) directions were calculated using log files of all beams per fraction (PDFn). Fractional PDF reproducibility (Rn) was calculated as Kullback-Leibler (KL) divergence between PDF1 and PDFn of tumor motion. The mean of Rn (Rm) was calculated for each patient and correlated to the patient’s mean tumor motion range (Am). The change of Rm during the course of SBRT was also evluated. These analyses were performed using in-house developed software. Results: The Rm were 0.19 (0.07–0.30), 0.14 (0.07–0.32) and 0.16 (0.09–0.28) in LR, AP and SI directions, respectively. The Am were 5.11 mm (2.58–9.99 mm), 7.81 mm (2.87–15.57 mm) and 11.26 mm (3.80–21.27 mm) in LR, AP and SI directions, respectively. The PDF reproducibility decreased as the tumor motion range increased in AP and SI direction. That decreased slightly through the course of RT in SI direction. Conclusion: We developed the respiratory motion analysis tool for 4DRT using log files and quantified the range and reproducibility of respiratory motion for lung tumors.

  16. Adenosarcoma of the uterine body initially presenting as an interstitial small tumor of the uterus: a case report.

    Science.gov (United States)

    Miyata, H; Tsuji, N; Jimi, T; Butsuhara, Y; Terakawa, K; Nagano, T

    2014-01-01

    Adenosarcoma of the uterine body is a rare mixed tumor in which a benign epithelial component is mixed with a malignant stromal element. It has been considered that this tumor originates from the endometrium and its most common finding of imaging is a polypoid tumor occupying the uterine cavity. The authors herein present a case of 37-year-old female with a complaint of abnormal vaginal bleeding. At the first visit, transvaginal ultrasound and magnetic resonance imaging (MRI) showed a round mass with a diameter of one cm in the uterine wall. No malignant pathological finding was detected. The patient visited the authors again one year later, because of continuous bleeding. At that time, they found a polypoid tumor in the uterine cavity, which turned out to be adenosarcoma with sarcomatous overgrowth. The round mass in the uterus detected at first time seems to have been incipience of adenosarcoma. Prodromal sign of adenosarcoma has not been reported previously.

  17. Feasibility Study of Automated Framework for Estimating Lung Tumor Locations for Target-Based Patient Positioning in Stereotactic Body Radiotherapy

    Directory of Open Access Journals (Sweden)

    Satoshi Yoshidome

    2015-01-01

    Full Text Available Objective. To investigate the feasibility of an automated framework for estimating the lung tumor locations for tumor-based patient positioning with megavolt-cone-beam computed tomography (MV-CBCT during stereotactic body radiotherapy (SBRT. Methods. A lung screening phantom and ten lung cancer cases with solid lung tumors, who were treated with SBRT, were employed to this study. The locations of tumors in MV-CBCT images were estimated using a tumor-template matching technique between a tumor template and the MV-CBCT. Tumor templates were produced by cropping the gross tumor volume (GTV regions, which were enhanced by a Sobel filter or a blob structure enhancement (BSE filter. Reference tumor locations (grand truth were determined based on a consensus between a radiation oncologist and a medical physicist. Results. According to the results of the phantom study, the average Euclidean distances of the location errors in the original, Sobel-filtered, and BSE-filtered images were 2.0 ± 4.1 mm, 12.8 ± 9.4 mm, and 0.4 ± 0.5 mm, respectively. For clinical cases, these were 3.4 ± 7.1 mm, 7.2 ± 11.6 mm, and 1.6 ± 1.2 mm, respectively. Conclusion. The feasibility study suggests that our proposed framework based on the BSE filter may be a useful tool for tumor-based patient positioning in SBRT.

  18. Carotid revascularization: risks and benefits

    Directory of Open Access Journals (Sweden)

    O'Brien M

    2014-07-01

    Full Text Available Marlene O'Brien, Ankur Chandra Department of Surgery, Division of Vascular Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA Abstract: Despite a decline during the recent decades in stroke-related death, the incidence of stroke has remained unchanged or slightly increased, and extracranial carotid artery stenosis is implicated in 20%–30% of all strokes. Medical therapy and risk factor modification are first-line therapies for all patients with carotid occlusive disease. Evidence for the treatment of patients with symptomatic carotid stenosis greater than 70% with either carotid artery stenting (CAS or carotid endarterectomy (CEA is compelling, and several trials have demonstrated a benefit to carotid revascularization in the symptomatic patient population. Asymptomatic carotid stenosis is more controversial, with the largest trials only demonstrating a 1% per year risk stroke reduction with CEA. Although there are sufficient data to advocate for aggressive medical therapy as the primary mode of treatment for asymptomatic carotid stenosis, there are also data to suggest that certain patient populations will benefit from a stroke risk reduction with carotid revascularization. In the United States, consensus and practice guidelines dictate that CEA is reasonable in patients with high-grade asymptomatic stenosis, a reasonable life expectancy, and perioperative risk of less than 3%. Regarding CAS versus CEA, the best-available evidence demonstrates no difference between the two procedures in early perioperative stroke, myocardial infarction, or death, and no difference in 4-year ipsilateral stroke risk. However, because of the higher perioperative risks of stroke in patients undergoing CAS, particularly in symptomatic, female, or elderly patients, it is difficult to recommend CAS over CEA except in populations with prohibitive cardiac risk, previous carotid surgery, or prior neck radiation. Current treatment

  19. Tumor

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008479 Preliminary study of MR elastography in brain tumors. XU Lei(徐磊), et al.Neurosci Imaging Center, Beijing Tiantan Hosp, Capital Med Univ, Beijing 100050.Chin J Radiol 2008;42(6):605-608. Objective To investigate the potential values of magnetic resonance elastography (MRE) for evaluating the brain tumor consistency in vivo. Methods Fourteen patients with known solid brain tumor (5 male, 9 female; age range: 16-63 years)

  20. Stereotactic body radiotherapy for stage I lung cancer and small lung metastasis: evaluation of an immobilization system for suppression of respiratory tumor movement and preliminary results

    OpenAIRE

    Ayakawa Shiho; Oda Kyota; Ikeya-Hashizume Chisa; Tomita Natsuo; Shibamoto Yuta; Baba Fumiya; Ogino Hiroyuki; Sugie Chikao

    2009-01-01

    Abstract Background In stereotactic body radiotherapy (SBRT) for lung tumors, reducing tumor movement is necessary. In this study, we evaluated changes in tumor movement and percutaneous oxygen saturation (SpO2) levels, and preliminary clinical results of SBRT using the BodyFIX immobilization system. Methods Between 2004 and 2006, 53 consecutive patients were treated for 55 lesions; 42 were stage I non-small cell lung cancer (NSCLC), 10 were metastatic lung cancers, and 3 were local recurrenc...

  1. Whole-body imaging of HER2/neu-overexpressing tumors using scFv-antibody conjugated quantum dots

    Science.gov (United States)

    Balalaeva, Irina V.; Zdobnova, Tatiana A.; Brilkina, Anna A.; Krutova, Irina M.; Stremovskiy, Oleg A.; Lebedenko, Elena N.; Vodeneev, Vladimir V.; Turchin, Ilya V.; Deyev, Sergey M.

    2010-02-01

    Semiconductor quantum dots (QDs) are widely used in different fields of bioscience and biotechnology due to their unique optical properties. QDs can be used as fluorescent markers for optical detection and monitoring of deeply located tumors in vivo after specific labeling achieved by conjugating of QDs with targeting molecules. In this work the possibilities of intravital tumor labeling with QDs and subsequent in vivo tumor imaging were estimated. The experiments were run on immunodeficient nu/nu mice bearing human breast carcinoma SKBR-3, overexpressing surface protein HER2/neu. We used quantum dots Qdot 705 ITK (Invitrogen, USA) linked to anti-HER2/neu 4D5 scFv antibody. Antibody scFv fragments as a targeting agent for directed delivery of fluorophores possess significant advantages over full-size antibodies due to their small size, lower cross-reactivity and immunogenicity. QDs were bound to 4D5 scFv by barnase-barstar system (bn-bst) analogous to the streptavidin-biotidin system. Whole-body images were obtained using diffuse fluorescence tomography (DFT) setup with low-frequency modulation and transilluminative configuration of scanning, created at the Institute of Applied Physics of RAS, Russia). DFT-results were confirmed ex vivo by confocal microscopy. We report the results of in vivo whole-body tumor imaging with QDs complexes as contrasting agents. Intravital images of QDs-labeled tumors were obtained using specific tumor cells targeting and fluorescence transilluminative imaging method, while "passive" QD-labeling failed to mark effectively the tumor.

  2. Influence of nuclear interactions in body tissues on tumor dose in carbon-ion radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Inaniwa, T., E-mail: taku@nirs.go.jp; Kanematsu, N. [Medical Physics Research Program, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage-ku, Chiba 263-8555 (Japan); Tsuji, H.; Kamada, T. [Hospital, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan)

    2015-12-15

    Purpose: In carbon-ion radiotherapy treatment planning, the planar integrated dose (PID) measured in water is applied to the patient dose calculation with density scaling using the stopping power ratio. Since body tissues are chemically different from water, this dose calculation can be subject to errors, particularly due to differences in inelastic nuclear interactions. In recent studies, the authors proposed and validated a PID correction method for these errors. In the present study, the authors used this correction method to assess the influence of these nuclear interactions in body tissues on tumor dose in various clinical cases. Methods: Using 10–20 cases each of prostate, head and neck (HN), bone and soft tissue (BS), lung, liver, pancreas, and uterine neoplasms, the authors first used treatment plans for carbon-ion radiotherapy without nuclear interaction correction to derive uncorrected dose distributions. The authors then compared these distributions with recalculated distributions using the nuclear interaction correction (corrected dose distributions). Results: Median (25%/75% quartiles) differences between the target mean uncorrected doses and corrected doses were 0.2% (0.1%/0.2%), 0.0% (0.0%/0.0%), −0.3% (−0.4%/−0.2%), −0.1% (−0.2%/−0.1%), −0.1% (−0.2%/0.0%), −0.4% (−0.5%/−0.1%), and −0.3% (−0.4%/0.0%) for the prostate, HN, BS, lung, liver, pancreas, and uterine cases, respectively. The largest difference of −1.6% in target mean and −2.5% at maximum were observed in a uterine case. Conclusions: For most clinical cases, dose calculation errors due to the water nonequivalence of the tissues in nuclear interactions would be marginal compared to intrinsic uncertainties in treatment planning, patient setup, beam delivery, and clinical response. In some extreme cases, however, these errors can be substantial. Accordingly, this correction method should be routinely applied to treatment planning in clinical practice.

  3. {sup 18}F-FDG-PET/CT of orofacial tumors, a value of whole-body imaging approach

    Energy Technology Data Exchange (ETDEWEB)

    Ferda, Jiri [Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Department of Radiology, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic)], E-mail: ferda@fnplzen.cz; Ferdova, Eva [Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Department of Radiology, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Zahlava, Jan [Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Walter, Jiri [Department of Stomatosurgery, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Mukensnabl, Petr; Daum, Ondrej [sikls Institute of Pathological Anatomy, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic); Kreuzberg, Boris [Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzen (Czech Republic)

    2010-02-15

    Aim: Staging of head and neck tumors is one of the most difficult tasks in imaging techniques, due to the very complicated head and neck anatomy and serious problems with the differentiation of reactive enlarged lymph nodes and lymph nodes involved with metastases. The aim of the study was to evaluate the validity of the whole-body approach in the assessment of head and neck malignancies using {sup 18}F-FDG-PET/CT. Materials and methods: The analysis of a group of 1750 consecutive whole-body procedures in all indications of {sup 18}F-FDG-PET/CT was made according to: the presence of orofacial tumors; their histology; findings concerning the spread outside head and neck region; and findings concerning the primary staging or restaging. The examinations of head and neck tumors were performed after intravenous application of the {sup 18}F-FDG and its accumulation for one hour. Drinking and speaking is restricted during this accumulation to prevent artificial muscle {sup 18}F-FDG uptake and to minimize false positive findings. In our hospital, high resolution PET is followed by the sub-millimeter isotropic acquisition of CT data after intravenous application of an iodinated contrast material. The acquisitions of head and neck region and trunk are performed separately to obtain optimal resolution in both regions. Results: 105 examinations of the orofacial tumors were performed on 87 patients in a group of 1750 consecutive PET/CT examinations. The ratio between primary staging and restaging was 3:7. The most frequent indications were carcinomas of the tongue (19 examinations) and carcinomas of the salivary glands (19 examinations). The metastatic spread of the tumor outside the region of the head and neck was noted in 12 cases. Conclusion: Our findings of distant metastases confirmed the importance of the use of whole-body PET/CT in this indication.

  4. Effect of antidepressants on body weight, ethology and tumor growth of human pancreatic carcinoma xenografts in nude mice

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To investigate the effects of mirtazapine and fluoxetine, representatives of the noradrenergic and specific serotonergic antidepressant (NaSSA) and se- lective serotonin reuptake inhibitor (SSRI) antidepres- sant respectively, on body weight, ingestive behavior, locomotor activity and tumor growth of human pancre- atic carcinoma xenografts in nude mice. METHODS: A subcutaneous xenograft model of hu- man pancreatic cancer cell line SW1990 was estab- lished in nude mice. The tumor-bearing mice were ran- domly divided into mirtazapine group [10 mg/(kg'd)], (an equivalent normal saline solution) (7 mice in each group). Doses of all drugs were administered orally, once a day for 42 d. Tumor volume and body weight were measured biweekly. Food intake was recorded once a week. Locomotor activity was detected weekly using an open field test (OFT). RESULTS: Compared to the fluoxetine, mirtazapine significantly increased food intake from d 14 to 42 and attenuated the rate of weight loss from d 28 to 42 (t = 4.38, P = 10.89, P < 0.01). These effects disappeared in the mirtazapine and fluoxetine groups during 2-6 wk. The grooming activity was higher in the mirtazapine group than in the fluoxetine group (10.1 ± 2.1 vs 7.1 ± 1.9 ) (t = 2.40, P < 0.05) in the second week. There was no significant difference in tumor vol- ume and tumor weight of the three groups. CONCLUSION: Mirtazapine and fluoxetine have no effect on the growth of pancreatic tumor. However, mirtazapine can significantly increase food intake and improve nutrition compared with fluoxetine in a pan- creatic cancer mouse model.

  5. Complications of the Carotid Endarterectomy

    Directory of Open Access Journals (Sweden)

    Hafize Yaliniz

    2003-06-01

    Full Text Available Postoperative complications of the carotid endarterectomy; hypertention and hypotention, cervical hematoma, wound infection, and false aneurysm, cranial nerve dysfonctions, carotid thrombosis, recurrent stenosis and operative strok are discused. [Archives Medical Review Journal 2003; 12(3.000: 166-176

  6. [Carotid duplex ultrasonography for neurosurgeons].

    Science.gov (United States)

    Sadahiro, Hirokazu; Ishihara, Hideyuki; Oka, Fumiaki; Suzuki, Michiyasu

    2011-12-01

    Carotid duplex ultrasonography (CDU) is one of the most well-known imaging methods for arteriosclerosis and ischemic stroke. For neurosurgeons, it is very important for the details of carotid plaque to be thoroughly investigated by CDU. Symptomatic carotid plaque is very fragile and easily changes morphologically, and so requires frequent CDU examination. Furthermore, after carotid endarterectomy (CEA) and carotid artery stenting (CAS), restenosis is evaluated with CDU. CDU facilitates not only morphological imaging in the B mode, but also allows a flow study with color Doppler and duplex imaging. So, CDU can help assess the presence of proximal and intracranial artery lesions in spite of only having a cervical view, and the patency of the extracranial artery to intracranial artery bypass is revealed with CDU, which shows a rich velocity and low pulsatility index (PI) in duplex imaging. For the examiner, it is necessary to ponder on what duplex imaging means in examinations, and to summarize all imaging finding.

  7. DSA在颈动脉体瘤术前诊断中的价值%Diagnostic value of DSA in preoperative carotid body tumor

    Institute of Scientific and Technical Information of China (English)

    任勇军; 杨林; 翟昭华; 缪南东; 邓进

    2010-01-01

    目的 回顾性分析颈动脉体瘤(CBT)的数字减影血管造影(DSA)表现,探讨DSA在CBT术前诊断中的价值.方法 收集并分析11例(12个)CBT患者的临床资料和DSA表现.结果 11例CBT临床均表现为颈部无痛性肿块,肿块呈椭圆形、圆形,质较硬,实性,边界清楚,无压痛,其中颈部闻及血管杂音2例;肿物可前后推动而不能上下移动.DSA显示所有患侧颈动脉分叉夹角增大,颈内外动脉移位;所有CBT肿瘤血供丰富,肿瘤染色明显,瘤体与血管的关系清晰,主要供血动脉起源于颈外动脉.DSA显示瘤体位于颈总动脉分叉内3个,9个瘤体呈偏心性生长并包绕颈内动脉或颈总动脉分叉.瘤体直径3.0~9.0 cm,平均约(4.5±1.5)cm.DSA显示右侧6例,左侧4例,双侧1例.肿瘤定性、定位以及与邻近血管的关系与外科手术、病理检查结果相符.结论 大多数CBT临床表现不典型,易于误诊,但具有特殊的DSA表现.DSA能清晰显示瘤体与颈部血管关系,为外科手术或栓塞治疗提供了可靠的依据.DSA诊断CBT准确率100%.

  8. 颈动脉体瘤的MRA诊断与外科治疗%MRA diagnosis and surgical treatment of carotid body tumor

    Institute of Scientific and Technical Information of China (English)

    马中; 边杰芳; 袁时芳; 李晓军; 王廷; 常英娟; 贺洪德

    2007-01-01

    目的 探讨颈动脉体瘤(CBT)的影像学诊断方法和外科疗效.方法 回顾性分析24例经磁共振血管造影(MRA)确诊的CBT患者的临床资料,总结MRA的临床诊断价值以及手术方式的选择和疗效.结果 MRA清楚显示位于颈总动脉分叉处的实质性肿块及其与周围动脉的关系,24例CBT均为Shamblin Ⅰ型和Ⅱ型;CBT单纯剥离18例,CBT联合颈外动脉切除3例,CBT联合颈内动脉切除颈外动脉转流2例,CBT联合颈内动脉切除自体静脉移植1例.全部患者术后无偏瘫及严重颅神经并发症.经1~8年随访,24例患者均无复发.结论 MRA是临床诊断CBT的重要手段,可疑CBT患者术前应常规行MRA检查.外科手术是治疗CBT的最有效方法,最大限度地保留或重建颈内动脉是手术成败的关键.

  9. 颈动脉体瘤的诊断及治疗%The diagnosis and treatment of carotid body tumor (A report of 19 cases)

    Institute of Scientific and Technical Information of China (English)

    余昌俊; 宋海屏; 叶雨生

    2002-01-01

    目的: 探讨颈动脉体瘤(CBT)的生物学特征、诊断与手术治疗方式.方法: 回顾我院1997年7月至2001年12月收治的19例CBT诊治经验.结果:本组病例均根据其典型的临床表现即颈侧部肿块且伴有传导性搏动, 结合彩超、CT或血管造影确诊.17例接受手术, CBT剥离式切除8例; CBT与颈外动脉同时切除4例;CBT与颈内动脉部分切除,颈内动脉对端吻合2例, 颈外动脉与颈内动脉对端吻合2例,CBT与颈动脉分叉切除,自体大隐静脉间置移植1例.本组无围手术期死亡.结论: 根据临床表现,结合影像学检查CBT诊断并不困难.CBT剥离术是理想安全的手术方式, 必要时行颈动脉重建, 需预防脑缺血和颅神经损伤.

  10. Nerve Sheath Tumors in Neurofibromatosis Type 1: Assessment of Whole-Body Metabolic Tumor Burden Using F-18-FDG PET/CT.

    Directory of Open Access Journals (Sweden)

    Johannes Salamon

    Full Text Available To determine the metabolically active whole-body tumor volume (WB-MTV on F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT in individuals with neurofibromatosis type 1 (NF1 using a three-dimensional (3D segmentation and computerized volumetry technique, and to compare PET WB-MTV between patients with benign and malignant peripheral nerve sheath tumors (PNSTs.Thirty-six NF1 patients (18 patients with malignant PNSTs and 18 age- and sex-matched controls with benign PNSTs were examined by F-18-FDG PET/CT. WB-MTV, whole-body total lesion glycolysis (WB-TLG and a set of semi-quantitative imaging-based parameters were analyzed both on a per-patient and a per-lesion basis.On a per-lesion basis, malignant PNSTs demonstrated both a significantly higher MTV and TLG than benign PNSTs (p < 0.0001. On a per-patient basis, WB-MTV and WB-TLG were significantly higher in patients with malignant PNSTs compared to patients with benign PNSTs (p < 0.001. ROC analysis showed that MTV and TLG could be used to differentiate between benign and malignant tumors.WB-MTV and WB-TLG may identify malignant change and may have the potential to provide a basis for investigating molecular biomarkers that correlate with metabolically active disease manifestations. Further evaluation will determine the potential clinical impact of these PET-based parameters in NF1.

  11. TUMORS INVADING PARAPHARYNGEAL SPACE: REFINED IMAGING DIAGNOSIS

    Institute of Scientific and Technical Information of China (English)

    Zhuang Qixin; Cheng Yingsheng; Yang Shixun; Shang kezhong; Yan Xinhua

    1998-01-01

    Objective: To investigate imaging findings of tumors invading parapharyngeal space. Methods: Magnetic resonance imaging (MRI) computerized tomography (CT), magnetic resonance angiography (MRA)and digital subtruation angiography (DSA) findings of 19patients with tumors infiltrating parapharyngeal space by surgery and pathology were analysed, including four branchial cleft cysts, three jugular glomus tumors, four carotid body tumors, three neurilemomas and five carcinomas of nasopharynx involving parapharyngeal space. Fifteen patients underwent MRI scanning nine patients had CT scanning, three patients MRA and five patients DSA. Results: MRI provided clinically useful informations about the size, shape, extent and site of the parapharyngeal space tumors, and also their effects on adjacent structures. The main MRI features of paraganglioma presented as many low signal tortuous and creeping vessels in the tumor. The main CT features of jugular glomus tumor revealed as jugular foramen enlargement with bone destruction. Tumor vessels were clearly displayed by MRA and DSA. Conclusion: MRI was superior to CT in the diagnosis of tumors invading parapharyngeal space. The location and nature of the lesions could be diagnosed accurately by MRI combined with CT or DSA.

  12. Accurate tumor localization and tracking in radiation therapy using wireless body sensor networks.

    Science.gov (United States)

    Pourhomayoun, Mohammad; Jin, Zhanpeng; Fowler, Mark

    2014-07-01

    Radiation therapy is an effective method to combat cancerous tumors by killing the malignant cells or controlling their growth. Knowing the exact position of the tumor is a very critical prerequisite in radiation therapy. Since the position of the tumor changes during the process of radiation therapy due to the patient׳s movements and respiration, a real-time tumor tracking method is highly desirable in order to deliver a sufficient dose of radiation to the tumor region without damaging the surrounding healthy tissues. In this paper, we develop a novel tumor positioning method based on spatial sparsity. We estimate the position by processing the received signals from only one implantable RF transmitter. The proposed method uses less number of sensors compared to common magnetic transponder based approaches. The performance of the proposed method is evaluated in two different cases: (1) when the tissue configuration is perfectly determined (acquired beforehand by MRI or CT) and (2) when there are some uncertainties about the tissue boundaries. The results demonstrate the high accuracy and performance of the proposed method, even when the tissue boundaries are imperfectly known.

  13. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial.

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2010-03-20

    Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy.

  14. Carotid Disease Management: Surgery, Stenting, or Medication.

    Science.gov (United States)

    Khandelwal, Priyank; Chaturvedi, Seemant

    2015-09-01

    Internal carotid artery stenosis accounts for about 7-10 % of ischemic strokes. Conventional risk factors such as aging, hypertension, diabetes mellitus, and smoking increase the risk for carotid atherosclerosis. All patients with carotid stenosis should receive aggressive medical therapy. Carotid revascularization with either endarterectomy or stenting can benefit select patients with severe stenosis. New clinical trials will examine the contemporary role of carotid revascularization relative to optimal medical therapy.

  15. Effect of rosuvastatin on inflammatory factors and carotid atherosclerotic plaque in patients with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    YAN Jun

    2013-10-01

    Full Text Available Carotid atherosclerosis is closely related with ischemic stroke occurrence, development and recurrence. This study aims to make an evaluation of the effects of rosuvastatin on inflammatory factors, serum lipid and carotid atherosclerotic plaque in patients with acute ischemic stroke. In this study, 98 patients with acute ischemic stroke and carotid atherosclerosis were given oral administration of rosuvastatin calcium (10 mg once every night, and the course of treatment was 6 months. After treatment, the changes of serum high-sensitivity C-reactive protein (hs-CRP, tumor necrosis factor-alpha (TNF-α and blood lipid were measured, as well as carotid atherosclerotic intima-media thickness (IMT and the calculation of carotid atherosclerotic plaque score. According to the examination results, after 6 months' treatment with rosuvastatin, serum hs-CRP, TNF-α, total cholesterol (TC, triglyceride (TG and low-density lipoprotein cholestrol (LDL-C decreased significantly (P < 0.01, for all, while high-density lipoprotein cholestrol (HDL-C increased significantly (P < 0.01; the total number of plaque reduced, while the number of stable plaque increased (P < 0.05; carotid artery IMT and carotid artery plaque score decreased significantly (P < 0.05. There were significant differences between before and after treatment. The results of this study show that rosuvastatin plays a role in anti-inflammation and alleviates the degree of carotid atherosclerotic plaque.

  16. Utilizing the micron sized non-thermal atmospheric pressure plasma inside the animal body for the tumor treatment application.

    Science.gov (United States)

    Mirpour, Shahriar; Piroozmand, Somayeh; Soleimani, Neda; Jalali Faharani, Neda; Ghomi, Hamidreza; Fotovat Eskandari, Hoda; Sharifi, Ali Mohammad; Mirpour, Sahar; Eftekhari, Mohammad; Nikkhah, Maryam

    2016-07-07

    This study aimed to evaluate the effects of micron sized non-thermal atmospheric pressure plasma inside the animal body on breast cancer tumor. The μ-plasma jet consists of micron sized hollow tube in which pure helium gas is ionized by high voltage (4 kV) and high frequency (6 kHz). The efficiency of the plasma treatment in killing cancer cells was first investigated by cell viability measurements of treated 4T1 cells using flow cytometry and cell cycle analysis. For exploration of the in vivo effects of the plasma treatment, the BALB/c mice inoculated by 4T1 cell lines were exposed subcutaneously to plasma for 3 minutes. In addition, H&E staining, TUNEL and Western blotting assays were performed in order to observed the effects of the non-thermal plasma on the tumor cells. The results showed that the efficiency of the plasma in suppression of the tumor growth is comparable to that of a typical chemotherapy drug. Moreover, the results indicated that the plasma induces apoptosis in the tumor tissue and increases the ratio of the apoptotic to anti-apoptotic protein expression. We believe that these findings presented herein may extend our knowledge of the mechanisms by which the plasma exerts its promising anti-cancer effects.

  17. [Carotid endarterectomy under local anesthesia].

    Science.gov (United States)

    Kuz'min, A L; Belov, Iu V

    2001-01-01

    Results of carotid endarterectomy (CEAE) in 193 patients with different degree of cerebrovascular insufficiency were analyzed. All the patients were men with carotid atherosclerosis (age from 39 to 68 years, mean age 53.6 +/- 0.4). A total of 253 CEAEs were performed under local anesthesia (60 patients underwent consecutive bilateral operations). In early postoperative period 3 patients died, one of them--of ischemic stroke due to thrombosis of internal carotid artery on the side of the operation. Non-fatal stroke was in 1 patient. There were no intraoperative cerebral complications. This testifies to reliability of cerebral circulation control through direct contact with patient.

  18. The Short-Term Effect of Ketogenic Diet on Carotid Intima-Media Thickness and Elastic Properties of the Carotid Artery and the Aorta in Epileptic Children.

    Science.gov (United States)

    Doksöz, Önder; Güzel, Orkide; Yılmaz, Ünsal; İşgüder, Rana; Çeleğen, Kübra; Meşe, Timur; Uysal, Utku

    2015-10-01

    The aim of this prospective study is to investigate the effect of a 6-month-long ketogenic diet on carotid intima-media thickness, carotid artery, and aortic vascular functions. Thirty-eight drug-resistant epileptic patients who were being treated with ketogenic diet were enrolled. Fasting total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, total cholesterol, and glucose concentrations were measured and echocardiography was performed in all patients before the beginning of ketogenic diet and at the sixth month of treatment. The body weight, height, body mass index, serum levels of triglyceride, total cholesterol, and low-density lipoprotein increased significantly at month 6 when compared to baseline values (P ketogenic diet has no effect on carotid intima-media thickness and elastic properties of the carotid artery and the aorta.

  19. Associations between bicycling and carotid arterial stiffness in adolescents

    DEFF Research Database (Denmark)

    Ried-Larsen, M; Grøntved, A; Østergaard, Lars;

    2015-01-01

    The aim of the study was to investigate the associations between bicycling and carotid arterial stiffness, independent of objectively measured moderate-and-vigorous physical activity. This cross-sectional study included 375 adolescents (age 15.7 ± 0.4 years) from the Danish site of the European...... Youth Heart Study. Total frequency of bicycle usage was assessed by self-report, and carotid arterial stiffness was assessed using B-mode ultrasound. After adjusting for pubertal status, body height, and objectively measured physical activity and other personal lifestyle and demographic factors, boys...... modulus [standard beta -0.48 (95% CI -0.91 to -0.06)]. Similar trends were observed when investigating the association between commuter bicycling and carotid arterial stiffness. These associations were not observed in girls. Our observations suggest that increasing bicycling in adolescence may...

  20. Intracerebral haemorrhage after carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Boesen, J

    1987-01-01

    Among 662 consecutive carotid endarterectomies eight cases of postoperative ipsilateral intracerebral haemorrhage were identified, occurring into brain areas which, preoperatively were without infarction. As blood pressures across the stenosis were routinely measured during surgery, the internal...

  1. Carotid cavernous fistula: Ophthalmological implications

    Directory of Open Access Journals (Sweden)

    Chaudhry Imtiaz

    2009-01-01

    Full Text Available Carotid cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. A CCF can be due to a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus, or a communication between the cavernous sinus, and one or more meningeal branches of the internal carotid artery, external carotid artery or both. These fistulas may be divided into spontaneous or traumatic in relation to cause and direct or dural in relation to angiographic findings. The dural fistulas usually have low rates of arterial blood flow and may be difficult to diagnose without angiography. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Patients with CCF may have predisposing causes, which need to be elicited. Radiological features may be helpful in confirming the diagnosis and determining possible intervention. Patients with any associated visual impairment or ocular conditions, such as glaucoma, need to be identified and treated. Based on patient′s signs and symptoms, timely intervention is mandatory to prevent morbidity or mortality. The conventional treatments include carotid ligation and embolization, with minimal significant morbidity or mortality. Ophthalmologist may be the first physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome.

  2. An analysis of tumor control probability of stereotactic body radiation therapy for lung cancer with a regrowth model

    Science.gov (United States)

    Tai, An; Liu, Feng; Gore, Elizabeth; Li, X. Allen

    2016-05-01

    We report a modeling study of tumor response after stereotactic body radiation therapy (SBRT) for early-stage non-small-cell lung carcinoma using published clinical data with a regrowth model. A linear-quadratic inspired regrowth model was proposed to analyze the tumor control probability (TCP) based on a series of published data of SBRT, in which a tumor is controlled for an individual patient if number of tumor cells is smaller than a critical value K cr. The regrowth model contains radiobiological parameters such as α, α/β the potential doubling time T p. This model also takes into account the heterogeneity of tumors and tumor regrowth after radiation treatment. The model was first used to fit TCP data from a single institution. The extracted fitting parameters were then used to predict the TCP data from another institution with a similar dose fractionation scheme. Finally, the model was used to fit the pooled TCP data selected from 48 publications available in the literature at the time when this manuscript was written. Excellent agreement between model predictions and single-institution data was found and the extracted radiobiological parameters were α  =  0.010  ±  0.001 Gy-1, α /β  =  21.5  ±  1.0 Gy and T p  =  133.4  ±  7.6 d. These parameters were α  =  0.072  ±  0.006 Gy-1, α/β  =  15.9  ±  1.0 Gy and T p  =  85.6  ±  24.7 d when extracted from multi-institution data. This study shows that TCP saturates at a BED of around 120 Gy. A few new dose-fractionation schemes were proposed based on the extracted model parameters from multi-institution data. It is found that the regrowth model with an α/β around 16 Gy can be used to predict the dose response of lung tumors treated with SBRT. The extracted radiobiological parameters may be useful for comparing clinical outcome data of various SBRT trials and for designing new treatment regimens.

  3. Effectiveness of stereotactic body radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombosis.

    Directory of Open Access Journals (Sweden)

    Mian Xi

    Full Text Available BACKGROUND: To report the feasibility, efficacy, and toxicity of stereotactic body radiotherapy (SBRT for the treatment of portal vein tumor thrombosis (PVTT and/or inferior vena cava tumor thrombosis (IVCTT in patients with advanced hepatocellular carcinoma (HCC. MATERIALS AND METHODS: Forty-one patients treated with SBRT using volumetric modulated arc therapy (VMAT for HCC with PVTT/IVCTT between July 2010 and May 2012 were analyzed. Of these, 33 had PVTT and 8 had IVCTT. SBRT was designed to target the tumor thrombosis and deliver a median total dose of 36 Gy (range, 30-48 Gy in six fractions during two weeks. RESULTS: The median follow-up was 10.0 months. At the time of analysis, 15 (36.6% achieved complete response, 16 (39.0% achieved partial response, 7 (17.1% patients were stable, and three (7.3% patients showed progressive disease. No treatment-related Grade 4/5 toxicity was seen within three months after SBRT. One patient had Grade 3 elevation of bilirubin. The one-year overall survival rate was 50.3%, with a median survival of 13.0 months. The only independent predictive factor associated with better survival was response to radiotherapy. CONCLUSIONS: VMAT-based SBRT is a safe and effective treatment option for PVTT/IVCTT in HCC. Prospective randomized controlled trials are warranted to validate the role of SBRT in these patients.

  4. Investigation of Peri-implant Status and Risk Variables for Implant Failure in Body of Maxilla after Oral Tumor Surgery

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The aim of this study was to assess the peri-implant parameters and evaluate the clinical status with the survival of dental implants in body of maxilla after treatments of oral tumor. A follow-up examination included 27 patients who underwent the ablative tumor and (or) reconstructive surgery during a 5-year period. The follow-up protocol included clinical examination, radiological evaluation, and an interview using a standardized questionnaire. The reasons related to implant failure were studied by comparing the amount of failure with the value of marginal bone resorption, probing pocket depth, and plaque index using statistical t-test. The relationship between smoking and implant failure was analyzed statistically by chi-square test. The results showed among the 112 implants observed after implant loading, 29 have failed with the failure rate being 22.14 %. There was no significant correlation between the peri-implant status and the implant failure (P>0.05), however, the association of smoking and implant failure was statistically tested (P<0.05). It was suggested that the association of peri-implant status and implant failure in the maxilla after tumor surgery can't be statistically tested, however smoking was still a mainly significant factor.

  5. Stereotactic body radiotherapy for liver tumors. Principles and practical guidelines of the DEGRO Working Group on Stereotactic Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sterzing, Florian [Deutsches Krebsforschungszentrum (DKFZ), Klinische Kooperationseinheit Strahlentherapie, Heidelberg (Germany); Radiologische Universitaetsklinik, Abteilung fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany); Brunner, Thomas B. [Universitaetsklinikum Freiburg, Klinik fuer Strahlenheilkunde, Radiologische Klinik, Freiburg (Germany); Ernst, Iris; Greve, Burkhard [Universitaetsklinikum Muenster, Klinik fuer Strahlentherapie - Radioonkologie, Muenster (Germany); Baus, Wolfgang W. [Universitaetsklinikum Koeln, Klinik und Poliklinik fuer Strahlentherapie, Koeln (Germany); Herfarth, Klaus [Radiologische Universitaetsklinik, Abteilung fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany); Guckenberger, Matthias [UniversitaetsSpital Zuerich, Klinik fuer Radio-Onkologie, Zuerich (Switzerland)

    2014-10-15

    This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a practical guideline for safe and effective stereotactic body radiotherapy (SBRT) of liver tumors. The literature on the clinical evidence of SBRT for both primary liver tumors and liver metastases was reviewed and analyzed focusing on both physical requirements and special biological characteristics. Recommendations were developed for patient selection, imaging, planning, treatment delivery, motion management, dose reporting, and follow-up. Radiation dose constraints to critical organs at risk are provided. SBRT is a well-established treatment option for primary and secondary liver tumors associated with low morbidity. (orig.) [German] Die Arbeitsgruppe Stereotaxie der Deutschen Gesellschaft fuer Radioonkologie (DEGRO) legt hier eine Empfehlung zur sicheren und effektiven Durchfuehrung der SBRT von Lebertumoren vor. Eine Literaturrecherche zur Untersuchung der Evidenz der SBRT sowohl fuer primaere Lebertumore als auch fuer Lebermetastasen wurde durchgefuehrt. Auf dieser Basis werden Empfehlungen fuer technisch-physikalische Voraussetzungen wie auch fuer die taegliche Praxis der Leber-SBRT gegeben. Weiterhin werden radiobiologische Besonderheiten dieses Verfahrens dargestellt. Praktische Vorgaben werden fuer Patientenselektion, Bildgebung, Planung, Applikation, Bewegungsmanagement, Dosisdokumentation und Follow-up gegeben. Dosisempfehlungen fuer die kritischen Risikoorgane werden dargestellt. Die SBRT stellt eine etablierte Behandlungsmethode fuer primaere und sekundaere Lebertumore dar und ist mit niedriger Morbiditaet assoziiert. (orig.)

  6. Adoptive transfer of Mammaglobin-A epitope specific CD8 T cells combined with a single low dose of total body irradiation eradicates breast tumors.

    Science.gov (United States)

    Lerret, Nadine M; Rogozinska, Magdalena; Jaramillo, Andrés; Marzo, Amanda L

    2012-01-01

    Adoptive T cell therapy has proven to be beneficial in a number of tumor systems by targeting the relevant tumor antigen. The tumor antigen targeted in our model is Mammaglobin-A, expressed by approximately 80% of human breast tumors. Here we evaluated the use of adoptively transferred Mammaglobin-A specific CD8 T cells in combination with low dose irradiation to induce breast tumor rejection and prevent relapse. We show Mammaglobin-A specific CD8 T cells generated by DNA vaccination with all epitopes (Mammaglobin-A2.1, A2.2, A2.4 and A2.6) and full-length DNA in vivo resulted in heterogeneous T cell populations consisting of both effector and central memory CD8 T cell subsets. Adoptive transfer of spleen cells from all Mammaglobin-A2 immunized mice into tumor-bearing SCID/beige mice induced tumor regression but this anti-tumor response was not sustained long-term. Additionally, we demonstrate that only the adoptive transfer of Mammaglobin-A2 specific CD8 T cells in combination with a single low dose of irradiation prevents tumors from recurring. More importantly we show that this single dose of irradiation results in the down regulation of the macrophage scavenger receptor 1 on dendritic cells within the tumor and reduces lipid uptake by tumor resident dendritic cells potentially enabling the dendritic cells to present tumor antigen more efficiently and aid in tumor clearance. These data reveal the potential for adoptive transfer combined with a single low dose of total body irradiation as a suitable therapy for the treatment of established breast tumors and the prevention of tumor recurrence.

  7. Very low-dose adult whole-body tumor imaging with F-18 FDG PET/CT

    Science.gov (United States)

    Krol, Andrzej; Naveed, Muhammad; McGrath, Mary; Lisi, Michele; Lavalley, Cathy; Feiglin, David

    2015-03-01

    The aim of this study was to evaluate if effective radiation dose due to PET component in adult whole-body tumor imaging with time-of-flight F-18 FDG PET/CT could be significantly reduced. We retrospectively analyzed data for 10 patients with the body mass index ranging from 25 to 50. We simulated F-18 FDG dose reduction to 25% of the ACR recommended dose via reconstruction of simulated shorter acquisition time per bed position scans from the acquired list data. F-18 FDG whole-body scans were reconstructed using time-of-flight OSEM algorithm and advanced system modeling. Two groups of images were obtained: group A with a standard dose of F-18 FDG and standard reconstruction parameters and group B with simulated 25% dose and modified reconstruction parameters, respectively. Three nuclear medicine physicians blinded to the simulated activity independently reviewed the images and compared diagnostic quality of images. Based on the input from the physicians, we selected optimal modified reconstruction parameters for group B. In so obtained images, all the lesions observed in the group A were visible in the group B. The tumor SUV values were different in the group A, as compared to group B, respectively. However, no significant differences were reported in the final interpretation of the images from A and B groups. In conclusion, for a small number of patients, we have demonstrated that F-18 FDG dose reduction to 25% of the ACR recommended dose, accompanied by appropriate modification of the reconstruction parameters provided adequate diagnostic quality of PET images acquired on time-of-flight PET/CT.

  8. Anatomy of the carotid sinus nerve and surgical implications in carotid sinus syndrome

    NARCIS (Netherlands)

    Toorop, Raechel J.; Scheltinga, Marc R.; Moll, Frans L.; Bleys, Ronald L.

    2009-01-01

    Background: The carotid sinus syndrome (CSS) is characterized by syncope and hypotension due to a hypersensitive carotid sinus located in the carotid bifurcation. Some patients ultimately require surgical sinus denervation, possibly by transection of its afferent nerve (carotid sinus nerve [CSN]). T

  9. Case Report: A Non-Surgical, Non-Pharmacologic, Mind-Body Intervention for Ovarian Tumor

    Directory of Open Access Journals (Sweden)

    Laurie Nadel

    2015-10-01

    Full Text Available A 60-year old female patient designed an experimental protocol of distant prayer, Reiki, and guided imagery to successfully treat an ovarian tumor measuring 2.5 centimeters. Background: On October 8, 2008, multiplanar imaging using T1-T2 weighted technique/MRI of patient’s lumbar spine reported “a suspected cyst within the right ovary measuring 2.5 centimeters” [1]. Patient: The patient is a psychologist who is also a Reiki master. Her decision to experiment with prayer, Reiki and guided imagery was due to the size of the tumor which was smaller than the 3 cm. required for surgical intervention. Setting: The patient’s home office was the setting for the experiment. Intervention: Due to a medical crisis in the patient’s family, she was delayed in scheduling an office visit with an obstetrician/gynecologist to follow up the findings in the MRI report of 10/8/08. On 10/10/08, she sent an email request to five Reiki masters to request distant Reiki be transmitted to the “suspected cyst.” The Reiki masters emailed their students, asking that they transmit Reiki to the patient’s right ovary.

  10. Cardiovascular magnetic resonance in carotid atherosclerotic disease

    Directory of Open Access Journals (Sweden)

    Chen Huijun

    2009-12-01

    Full Text Available Abstract Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR of the carotid vessel wall is one promising modality in the evaluation of patients with carotid atherosclerotic disease. Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis. Although carotid vessel wall CMR has not been widely used to screen for carotid atherosclerotic disease, many trials support its potential for this indication. This review summarizes the current state of knowledge regarding carotid vessel wall CMR and its potential clinical application for management of carotid atherosclerotic disease.

  11. Stereotactic body radiotherapy for stage I lung cancer and small lung metastasis: evaluation of an immobilization system for suppression of respiratory tumor movement and preliminary results

    Directory of Open Access Journals (Sweden)

    Ayakawa Shiho

    2009-05-01

    Full Text Available Abstract Background In stereotactic body radiotherapy (SBRT for lung tumors, reducing tumor movement is necessary. In this study, we evaluated changes in tumor movement and percutaneous oxygen saturation (SpO2 levels, and preliminary clinical results of SBRT using the BodyFIX immobilization system. Methods Between 2004 and 2006, 53 consecutive patients were treated for 55 lesions; 42 were stage I non-small cell lung cancer (NSCLC, 10 were metastatic lung cancers, and 3 were local recurrences of NSCLC. Tumor movement was measured with fluoroscopy under breath holding, free breathing on a couch, and free breathing in the BodyFIX system. SpO2 levels were measured with a finger pulseoximeter under each condition. The delivered dose was 44, 48 or 52 Gy, depending on tumor diameter, in 4 fractions over 10 or 11 days. Results By using the BodyFIX system, respiratory tumor movements were significantly reduced compared with the free-breathing condition in both craniocaudal and lateral directions, although the amplitude of reduction in the craniocaudal direction was 3 mm or more in only 27% of the patients. The average SpO2 did not decrease by using the system. At 3 years, the local control rate was 80% for all lesions. Overall survival was 76%, cause-specific survival was 92%, and local progression-free survival was 76% at 3 years in primary NSCLC patients. Grade 2 radiation pneumonitis developed in 7 patients. Conclusion Respiratory tumor movement was modestly suppressed by the BodyFIX system, while the SpO2 level did not decrease. It was considered a simple and effective method for SBRT of lung tumors. Preliminary results were encouraging.

  12. Tolerance of the carotid-sheath contents to brachytherapy: an experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Werber, J.L.; Sood, B.; Alfieri, A.; McCormick, S.A.; Vikram, B. (Department of Otolaryngology--Head and Neck Surgery, New York Medical College, Beth Israel (USA))

    1991-06-01

    Tumor invasion of the carotid artery is a potential indication for brachytherapy, which delivers a high dose of irradiation to residual tumor while limiting the dose to adjacent healthy tissues. The tolerance of carotid-sheath contents to varying doses of brachytherapy, however, has not been clearly established. In order to evaluate brachytherapy effects on carotid-sheath contents, after-loading catheters were implanted bilaterally in 3 groups of 6 rabbits each (18 rabbits). Iridium 192 brachytherapy doses of either 5000 cGy (rad), 9000 cGy, or 13,000 cGy were delivered unilaterally, with the contralateral neck serving as a nonirradiated control in each animal. There were no carotid ruptures and wound healing was normal. Two animals from each group were killed at 6, 20, and 48 weeks. Even at the highest dose (13,000 cGy), nerve conduction studies performed on the vagus nerve prior to sacrifice revealed no increased latency, histologic changes were minimal, and carotid arteries were patent. These observations suggest that the carotid-sheath contents in healthy rabbits could tolerate high doses (up to 13,000 cGy) of low-dose-rate interstitial brachytherapy without complications.

  13. FGFR inhibitors: Effects on cancer cells, tumor microenvironment and whole-body homeostasis (Review).

    Science.gov (United States)

    Katoh, Masaru

    2016-07-01

    Fibroblast growth factor (FGF)2, FGF4, FGF7 and FGF20 are representative paracrine FGFs binding to heparan-sulfate proteoglycan and fibroblast growth factor receptors (FGFRs), whereas FGF19, FGF21 and FGF23 are endocrine FGFs binding to Klotho and FGFRs. FGFR1 is relatively frequently amplified and overexpressed in breast and lung cancer, and FGFR2 in gastric cancer. BCR-FGFR1, CNTRL-FGFR1, CUX1-FGFR1, FGFR1OP-FGFR1, MYO18A-FGFR1 and ZMYM2-FGFR1 fusions in myeloproliferative neoplasms are non-receptor-type FGFR kinases, whereas FGFR1-TACC1, FGFR2-AFF3, FGFR2-BICC1, FGFR2-PPHLN1, FGFR3-BAIAP2L1 and FGFR3-TACC3 fusions in solid tumors are transmembrane-type FGFRs with C-terminal alterations. AZD4547, BGJ398 (infigratinib), Debio-1347 and dovitinib are FGFR1/2/3 inhibitors; BLU9931 is a selective FGFR4 inhibitor; FIIN-2, JNJ-42756493, LY2874455 and ponatinib are pan-FGFR inhibitors. AZD4547, dovitinib and ponatinib are multi-kinase inhibitors targeting FGFRs, colony stimulating factor 1 receptor (CSF1R), vascular endothelial growth factor (VEGF)R2, and others. The tumor microenvironment consists of cancer cells and stromal/immune cells, such as cancer-associated fibroblasts (CAFs), endothelial cells, M2-type tumor-associating macrophages (M2-TAMs), myeloid-derived suppressor cells (MDSCs) and regulatory T cells. FGFR inhibitors elicit antitumor effects directly on cancer cells, as well as indirectly through the blockade of paracrine signaling. The dual inhibition of FGF and CSF1 or VEGF signaling is expected to enhance the antitumor effects through the targeting of immune evasion and angiogenesis in the tumor microenvironment. Combination therapy using tyrosine kinase inhibitors (FGFR or CSF1R inhibitors) and immune checkpoint blockers (anti-PD-1 or anti-CTLA-4 monoclonal antibodies) may be a promising choice for cancer patients. The inhibition of FGF19-FGFR4 signaling is associated with a risk of liver toxicity, whereas the activation of FGF23-FGFR4 signaling

  14. Local Control and Toxicity in a Large Cohort of Central Lung Tumors Treated With Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Modh, Ankit; Rimner, Andreas [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Williams, Eric [Department of Medical Physics Memorial Sloan Kettering Cancer Center, New York, New York (United States); Foster, Amanda; Shah, Mihir [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Shi, Weiji; Zhang, Zhigang [Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Gelblum, Daphna Y. [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Rosenzweig, Kenneth E. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, New York (United States); Yorke, Ellen D.; Jackson, Andrew [Department of Medical Physics Memorial Sloan Kettering Cancer Center, New York, New York (United States); Wu, Abraham J., E-mail: wua@mskcc.org [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

    2014-12-01

    Purpose: Stereotactic body radiation therapy (SBRT) in central lung tumors has been associated with higher rates of severe toxicity. We sought to evaluate toxicity and local control in a large cohort and to identify predictive dosimetric parameters. Methods and Materials: We identified patients who received SBRT for central tumors according to either of 2 definitions. Local failure (LF) was estimated using a competing risks model, and multivariate analysis (MVA) was used to assess factors associated with LF. We reviewed patient toxicity and applied Cox proportional hazard analysis and log-rank tests to assess whether dose-volume metrics of normal structures correlated with pulmonary toxicity. Results: One hundred twenty-five patients received SBRT for non-small cell lung cancer (n=103) or metastatic lesions (n=22), using intensity modulated radiation therapy. The most common dose was 45 Gy in 5 fractions. Median follow-up was 17.4 months. Incidence of toxicity ≥ grade 3 was 8.0%, including 5.6% pulmonary toxicity. Sixteen patients (12.8%) experienced esophageal toxicity ≥ grade 2, including 50% of patients in whom PTV overlapped the esophagus. There were 2 treatment-related deaths. Among patients receiving biologically effective dose (BED) ≥80 Gy (n=108), 2-year LF was 21%. On MVA, gross tumor volume (GTV) was significantly associated with LF. None of the studied dose-volume metrics of the lungs, heart, proximal bronchial tree (PBT), or 2 cm expansion of the PBT (“no-fly-zone” [NFZ]) correlated with pulmonary toxicity ≥grade 2. There were no differences in pulmonary toxicity between central tumors located inside the NFZ and those outside the NFZ but with planning target volume (PTV) intersecting the mediastinum. Conclusions: Using moderate doses, SBRT for central lung tumors achieves acceptable local control with low rates of severe toxicity. Dosimetric analysis showed no significant correlation between dose to the lungs, heart, or NFZ and

  15. Carotid artery stenting : a 2009 update

    NARCIS (Netherlands)

    Zeebregts, Clark J.; Meerwaldt, Robbert; Geelkerken, Robert H.

    2009-01-01

    Purpose of review Carotid endarterectomy (CEA) is is still considered the gold standard in the treatment of patients with significant carotid stenosis and has proven its value over the past decades. Endovascular techniques have evolved, and carotid artery stenting (CAS) is challenging CEA to become

  16. Spontaneous Resolution of Direct Carotid Cavernous Fistula

    NARCIS (Netherlands)

    Ishaq, Mazhar; Arain, Muhammad Aamir; Ahmed, Saadullah; Niazi, Muhammad Khizar; Khan, Muhammad Dawood; Iqbal, Zamir

    2010-01-01

    Proptosis due to carotid cavernous fistula is rare sequelae of head injury. We report a case of post-traumatic, direct high flow carotid cavernous fistula that resolved spontaneously 06 weeks after carotid angiography. It however, resulted in loss of vision due to delay in early treatment. In the ca

  17. A treatment-planning comparison of three beam arrangement strategies for stereotactic body radiation therapy for centrally located lung tumors using volumetric-modulated arc therapy

    OpenAIRE

    Ishii, Kentaro; Okada, Wataru; Ogino, Ryo; Kubo, Kazuki; Kishimoto, Shun; Nakahara, Ryuta; Kawamorita, Ryu; Ishii, Yoshie; Tada, Takuhito; Nakajima, Toshifumi

    2016-01-01

    The purpose of this study was to determine appropriate beam arrangement for volumetric-modulated arc therapy (VMAT)-based stereotactic body radiation therapy (SBRT) in the treatment of patients with centrally located lung tumors. Fifteen consecutive patients with centrally located lung tumors treated at our institution were enrolled. For each patient, three VMAT plans were generated using two coplanar partial arcs (CP VMAT), two non-coplanar partial arcs (NCP VMAT), and one coplanar full arc ...

  18. Effective detection of the tumors causing osteomalacia using [Tc-99m]-HYNIC-octreotide (99mTc-HYNIC-TOC) whole body scan

    Energy Technology Data Exchange (ETDEWEB)

    Jing, Hongli, E-mail: annsmile1976@sina.com [Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730 (China); Li, Fang, E-mail: lifang@pumch.cn [Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730 (China); Zhuang, Hongming, E-mail: zhuang@email.chop.edu [Department of Radiology, The Children' s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 34th and Civic Ctr Blvd, Philadelphia, PA 19104 (United States); Wang, Zhenghua, E-mail: ccq1214@yahoo.com.cn [Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730 (China); Tian, Jian, E-mail: tianjian4809@hotmail.com [Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730 (China); Xing, Xiaoping, E-mail: xingxp@126.com [Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730 (China); Jin, Jin, E-mail: jinjin9010@126.com [Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730 (China); Zhong, Dingrong, E-mail: ZhongDR@pumch.cn [Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730 (China); Zhang, Jingjing, E-mail: zhangjingjingtag@163.com [Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730 (China)

    2013-11-01

    Purpose: Tumor-induced osteomalacia (TIO) is an endocrine disorder caused by tumors producing excessive fibroblast growth factor-23 (FGF-23). The causative tumors are generally small, slow-growing benign mesenchymal tumors. The only cure of the disease depends on resection of the tumors, which are extremely difficult to localize due to their small sizes and rare locations. Since these tumors are known to express somatostatin receptors, this research was undertaken to evaluate efficacy of [Tc-99m]-HYNIC-octreotide (99mTc-HYNIC-TOC) whole body imaging in this clinical setting Methods: Images of 99mTc-HYNIC-TOC scans and clinical chart from 183 patients with hypophosphatemia and clinically suspected TIO were retrospectively reviewed. The scan findings were compared to the results of histopathological examinations and clinical follow-ups. Results: Among 183 patients, 72 were confirmed to have TIO while 103 patients were found to have other causes of hypophosphatemia. The possibility of TIO could not be either diagnosed or excluded in the remaining 8 patients. For analytical purposes, these 8 patients who could neither be diagnosed nor excluded as having TIO were regarded as having the disease, bringing the total of TIO patients to 80. The 99mTc-HYNIC-TOC scan identified 69 tumors in 80 patients with TIO, which rendered a sensitivity of 86.3% (69/80). 99mTc-HYNIC-TOC scintigraphy excluded 102 patients without TIO with a specificity of 99.1% (102/103). The overall accuracy of 99mTc-HYNIC-TOC whole body scan in the localization of tumors responsible for osteomalacia is 93.4% (171/183). Conclusions: Whole body 99mTc-HYNIC-TOC imaging is effective in the localization of occult tumors causing TIO.

  19. Computerized method for estimation of the location of a lung tumor on EPID cine images without implanted markers in stereotactic body radiotherapy.

    Science.gov (United States)

    Arimura, H; Egashira, Y; Shioyama, Y; Nakamura, K; Yoshidome, S; Anai, S; Nomoto, S; Honda, H; Toyofuku, F; Higashida, Y; Onizuka, Y; Terashima, H

    2009-02-07

    The purpose of this study was to develop a computerized method for estimation of the location of a lung tumor in cine images on an electronic portal imaging device (EPID) without implanted markers during stereotactic body radiotherapy (SBRT). Each tumor region was segmented in the first EPID cine image, i.e., reference portal image, based on a multiple-gray level thresholding technique and a region growing technique, and then the image including the tumor region was cropped as a 'tumor template' image. The tumor location was determined as the position in which the tumor template image took the maximum cross-correlation value within each consecutive portal image, which was acquired in cine mode on the EPID in treatment. EPID images with 512 x 384 pixels (pixel size: 0.56 mm) were acquired at a sampling rate of 0.5 frame s(-1) by using energies of 4, 6 or 10 MV on linear accelerators. We applied our proposed method to EPID cine images (226 frames) of 12 clinical cases (ages: 51-83, mean: 72) with a non-small cell lung cancer. As a result, the average location error between tumor points obtained by our method and the manual method was 1.47 +/- 0.60 mm. This preliminary study suggests that our method based on the tumor template matching technique might be feasible for tracking the location of a lung tumor without implanted markers in SBRT.

  20. Computerized method for estimation of the location of a lung tumor on EPID cine images without implanted markers in stereotactic body radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Arimura, H; Toyofuku, F; Higashida, Y; Onizuka, Y; Terashima, H [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Egashira, Y [Department of Health Sciences, School of Medicine, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Shioyama, Y; Nomoto, S; Honda, H [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Nakamura, K [Department of Radiology, Faculty of Medicine, Fukuoka University, 8-19-1, Nanakuma, Jyonan-ku, Fukuoka 814-0180 (Japan); Yoshidome, S; Anai, S [Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka 812-8582 (Japan)], E-mail: arimura@shs.kyushu-u.ac.jp

    2009-02-07

    The purpose of this study was to develop a computerized method for estimation of the location of a lung tumor in cine images on an electronic portal imaging device (EPID) without implanted markers during stereotactic body radiotherapy (SBRT). Each tumor region was segmented in the first EPID cine image, i.e., reference portal image, based on a multiple-gray level thresholding technique and a region growing technique, and then the image including the tumor region was cropped as a 'tumor template' image. The tumor location was determined as the position in which the tumor template image took the maximum cross-correlation value within each consecutive portal image, which was acquired in cine mode on the EPID in treatment. EPID images with 512 x 384 pixels (pixel size: 0.56 mm) were acquired at a sampling rate of 0.5 frame s{sup -1} by using energies of 4, 6 or 10 MV on linear accelerators. We applied our proposed method to EPID cine images (226 frames) of 12 clinical cases (ages: 51-83, mean: 72) with a non-small cell lung cancer. As a result, the average location error between tumor points obtained by our method and the manual method was 1.47 {+-} 0.60 mm. This preliminary study suggests that our method based on the tumor template matching technique might be feasible for tracking the location of a lung tumor without implanted markers in SBRT.

  1. Carotid cavernous fistula after elective carotid endarterectomy: Case report

    Directory of Open Access Journals (Sweden)

    Andres Asser

    2014-12-01

    This is a case to illustrate a rare complication of carotid artery surgery. The patient had atherosclerotic vessel damage of ICA visible on earlier CT scans. This combined with abrupt increase of transmural pressure due to the revascularization procedure could possibly lead to arterial wall rupture and fistula formation.

  2. [Glomus tumors of the temporal bone: a report of 6 cases].

    Science.gov (United States)

    Arruda, W O; Teive, H A; Torres, L F; Ramina, R; Parolim, M K; Maniglia, J J; Barrionuevo, C E

    1989-03-01

    The authors review the clinical, radiological and pathological features of 6 cases of glomus tumors of the temporal bone. Out of the 6 patients, 5 were female; age was distributed between 22 and 76 years (mean 48 years). The main clinical features were hypoacusia, tinnitus and otoscopic findings suggestive of the diagnosis. In one case was noted the concomitant presence of a neurinoma of the VIII cranial nerve with a ipsilateral glomus tumor, and in another case there was a concomitancy of carotid body tumor with temporal glomus jugularis tumor. Metastases were not observed in any case. Tumoral lesions were successfully ressected employing microsurgical techniques and a multidisciplinary staff involving neurosurgeons, head and neck surgeons and otolaryngologists. Radioteraphy was not employed, neither pre-operative embolization. Some aspects related to the nosology, embriology, pathophysiology, diagnosis and treatment of this interesting type of neoplasms are discussed.

  3. Tumor glucose metabolism imaged in vivo in small animals with whole-body photoacoustic computed tomography

    Science.gov (United States)

    Chatni, Muhammad Rameez; Xia, Jun; Sohn, Rebecca; Maslov, Konstantin; Guo, Zijian; Zhang, Yu; Wang, Kun; Xia, Younan; Anastasio, Mark; Arbeit, Jeffrey; Wang, Lihong V.

    2012-07-01

    With the increasing use of small animals for human disease studies, small-animal whole-body molecular imaging plays an important role in biomedical research. Currently, none of the existing imaging modalities can provide both anatomical and glucose molecular information, leading to higher costs of building dual-modality systems. Even with image co-registration, the spatial resolution of the molecular imaging modality is not improved. Utilizing a ring-shaped confocal photoacoustic computed tomography system, we demonstrate, for the first time, that both anatomy and glucose uptake can be imaged in a single modality. Anatomy was imaged with the endogenous hemoglobin contrast, and glucose metabolism was imaged with a near-infrared dye-labeled 2-deoxyglucose.

  4. A STUDY OF ANATOMICAL VARIATIONS OF THE COMMON CAROTID ARTERIES: A CADAVERIC STUDY

    Directory of Open Access Journals (Sweden)

    Vatsala A R

    2014-03-01

    Full Text Available Background: Anatomical variations of carotid arterial system which are not infrequently encountered have a great impact on the surgical approaches of the neck. Although the described individual variations of the carotid arteries are well-known in the literature, the combination of anomalies reported in this study has not been, to the best of our knowledge, previously described. The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck. Methods:The present study was undertaken on 80 common carotid arteries (40 left, 40 right of both sexes from embalmed adult human cadavers. The specimens were studied by detailed dissection method. Results: In the present study,fiftyone (63.8% bifurcations of common carotid arteries were high among which the most common levels of bifurcation was at the level of C 3 vertebral body (37.5%. The origin of the right common carotid artery was high and low in 10% and 2.6% of vessels respectively. Conclusion: The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck.

  5. The Impact of Tumor Size on Outcomes After Stereotactic Body Radiation Therapy for Medically Inoperable Early-Stage Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Allibhai, Zishan [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto (Canada); Taremi, Mojgan [Department of Radiation Oncology, Stronach Regional Cancer Centre, Newmarket (Canada); Bezjak, Andrea; Brade, Anthony; Hope, Andrew J.; Sun, Alexander [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto (Canada); Cho, B.C. John, E-mail: john.cho@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto (Canada)

    2013-12-01

    Purpose: Stereotactic body radiation therapy for medically inoperable early-stage non-small cell lung cancer (NSCLC) offers excellent control rates. Most published series deal mainly with small (usually <4 cm), peripheral, solitary tumors. Larger tumors are associated with poorer outcomes (ie, lower control rates, higher toxicity) when treated with conventional RT. It is unclear whether SBRT is sufficiently potent to control these larger tumors. We therefore evaluated and examined the influence of tumor size on treatment outcomes after SBRT. Methods and Materials: Between October 2004 and October 2010, 185 medically inoperable patients with early (T1-T2N0M0) NSCLC were treated on a prospective research ethics board-approved single-institution protocol. Prescription doses were risk-adapted based on tumor size and location. Follow-up included prospective assessment of toxicity (as per Common Terminology Criteria for Adverse Events, version 3.0) and serial computed tomography scans. Patterns of failure, toxicity, and survival outcomes were calculated using Kaplan-Meier method, and the significance of tumor size (diameter, volume) with respect to patient, treatment, and tumor factors was tested. Results: Median follow-up was 15.2 months. Tumor size was not associated with local failure but was associated with regional failure (P=.011) and distant failure (P=.021). Poorer overall survival (P=.001), disease-free survival (P=.001), and cause-specific survival (P=.005) were also significantly associated with tumor size (with tumor volume more significant than diameter). Gross tumor volume and planning target volume were significantly associated with grade 2 or worse radiation pneumonitis. However, overall rates of grade ≥3 pneumonitis were low and not significantly affected by tumor or target size. Conclusions: Currently employed stereotactic body radiation therapy dose regimens can provide safe effective local therapy even for larger solitary NSCLC tumors (up to 5.7 cm

  6. Recent concepts in the management of extracranial carotid stenosis: Carotid endarterectomy versus carotid artery stenting

    Directory of Open Access Journals (Sweden)

    Jeyaraj D Pandian

    2011-01-01

    Full Text Available Carotid stenosis is seen in 10% of patients with ischemic stroke, and carotid endarterectomy (CEA and carotid artery stenting (CAS are the two invasive treatments options available. Pooled analysis of the three largest randomized trials of CEA involving more than 3000 symptomatic patients estimated 30-day stroke and death rate at 7.1% after CEA. Some subgroups among the symptomatic patients appeared to have more benefit from CEA. These include patients aged 75 years or more, patients with ulcerated plaques, and patients with recent transient ischemic attacks within 2 weeks of randomization. Selection of asymptomatic patients for carotid revascularization should be guided by an assessment of comorbid conditions, life expectancy, and other individual factors, and should include a thorough discussion of the risks and benefits of the procedure with an understanding of patient preferences. The recent trials comparing CEA with CAS has not established its superiority over CEA. The carotid revascularization endarterectomy versus stenting (CREST study showed that CAS is still associated with a higher periprocedural risk of stroke or death than CEA. In patients over 70 years of age, CEA is clearly superior to CAS. The increased risk of nonfatal myocardial infarction in the CREST group subjected to CEA clearly suggests that patients being considered for CEA or CAS require a careful preliminary cardiac evaluation. CAS can be justified for patients whose medical comorbidities or cervical anatomy make them questionable candidates for CEA. The benefit of revascularization by either method versus modern aggressive medical therapy has not been established for patients with asymptomatic carotid stenosis.

  7. Fractionated half body irradiation for palliation of multiple symptomatic bone metastases from solid tumors

    Energy Technology Data Exchange (ETDEWEB)

    Sekiguchi, Kenji; Hayashi, Shinya; Sunagawa, Yoshimitsu; Sougawa, Mitsuharu; Nakazawa, Masanori; Yamashita, Takashi (Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital)

    1992-06-01

    This was a phase I-II nonrandomized study that explored the toxicity and response of fractionated half-body irradiation (F-HBI) in patients with multiple symptomatic osseous metastases. The patients had no premedication and received 10 Gy in 5 fractions with a dose rate of 15 cGy/min. At the Cancer Institute Hospital, 9 patients were treated by this technique (1 upper and lower F-HBI, 6 upper F-HBI, 2 lower F-HBI). All patients were female and had adenocarcinomas (8 breast and 1 lung). Adverse effects were myelosuppression, vomiting and partial alopecia. But hematologic toxicity was treated with blood transfusion or G-CSF. All toxicity was transient, and no pneumonitis nor radiation-related deaths occurred. When given as palliation, F-HBI was found to relieve pain in 80% of the patients. In 10% of the patients the pain relief was complete. The mean time to achieve pain relief in responders after F-HBI was 9 days. The pain relief was long-lasting and continued without need of reirradiation for 40% of the remaining patient's life. This treatment modality appears to be well tolerated and effective in patients with multiple symptomatic osseous metastases. The optimal indications, dose and fractionation for F-HBI should be further explored in randomized trials. (author).

  8. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial

    OpenAIRE

    Ederle, J; Dobson, J.; Featherstone, RL; Bonati, LH; van der Worp, HB; de Borst, GJ; lo, TH; Gaines, P.; Dorman, PJ; Macdonald, S; Lyrer, PA; Hendriks, JM; McCollum, C; Nederkoorn, PJ; Brown, MM

    2010-01-01

    Summary Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were ra...

  9. Selection of treatment for patients with carotid artery disease: medication, carotid endarterectomy, or carotid artery stenting.

    Science.gov (United States)

    Bosiers, Marc; Peeters, Patrick; Deloose, Koen; Verbist, Jürgen; Sprouse, Richard L

    2005-01-01

    Patients presenting with atherosclerosis of the extracranial carotid arteries may be offered carotid endarterectomy (CEA), carotid artery stenting (CAS), or medical therapy to reduce their risk of stroke. In many cases, the choice between treatment modalities remains controversial. An algorithm based on patients' neurologic symptoms, comorbidities, limiting factors for CAS and CEA, and personal preferences was developed to determine the optimal treatment in each case. This algorithm was then employed to determine therapy in 308 consecutive patients presenting to a single institution during one calendar year. Ninety-five (30.8%) patients presented with an asymptomatic carotid stenosis of more than 80% and 213 (69.2%) with a symptomatic stenosis of more than 50%. According to our algorithm, 59 (62.1%) of the 95 asymptomatic patients received CAS, 20 (21.1%) received CEA, and 16 (16.8%) received medical therapy. All symptomatic patients underwent intervention; 153 (71.8%) were treated with CAS and 60 (28.2%) with CEA. Combined 30-day stroke and death rates after CAS were 1.7% in asymptomatic patients and 2.6% in symptomatic patients. After CEA, these rates were 0% and 3.3%, respectively. Careful selection of treatment modality according to predetermined criteria can result in improved outcomes.

  10. Carotid artery grafting for restenosis after carotid endarterectomy.

    Science.gov (United States)

    Pokrovskiĭ, A V; Kuntsevich, G I; Beloiartsev, D F; Burtseva, E A; Fedorov, E E

    2007-01-01

    The paper analyzes outcomes of 12 internal carotid artery (ICA) graftings for repeat stenosis after carotid endarterectomy (CEA) in 11 patients. In 6 cases restenosis occurred after eversion CEA, in 5 - after conventional patch CEA, and in 1 case - after ICA patch angioplasty for post-CEA restenosis. Critical restenosis >75% in reconstruction area was an indication for surgical intervention. There was 1 case of graft thrombosis in early postoperative period with hemispherical stroke and lethal outcome. Eight patients were examined in late postoperative period. Mean follow-up was 34?+/-?8.44 months (from 16 to 48 months). No cerebrovascular disturbances in operated ICA feeding area were detected. In 6 patients graft patency was good, while 2 smoking patients with diabetes mellitus and hyperlipidemia demonstrated repeat restenosis of proximal anastomosis >70%.

  11. Acute internal carotid artery occlusion after carotid endarterectomy

    Directory of Open Access Journals (Sweden)

    Masatoshi Yunoki

    2016-09-01

    Full Text Available We report two cases of acute carotid artery (CA occlusion following carotid endarterectomy (CEA. Case 1: a 58-year-old man was admitted with transient right-sided hemiparesis. Magnetic resonance imaging (MRI and MR angiography (MRA revealed cerebral infarction in the left cerebral hemisphere and left CA stenosis. Ten days after admission, he underwent CEA. 24 h after surgery, he developed right hemiplegia. MRI and MRA demonstrated a slightly enlarged infarction and left internal carotid artery (ICA occlusion. Emergency reoperation was performed and complete recanalization achieved. The patient made a clinically significant recovery. Case 2: a 65 year-old man underwent a right-sided CEA for an asymptomatic 80% CA stenosis. 48 h after surgery, his family noticed he was slightly disorientated. MRI and MRA revealed multiple infarctions and right ICA occlusion. He was treated with antiplatelet therapy without reoperation because sufficient cross-flow from the left ICA through the anterior communicating artery was demonstrated by angiography, and his neurological symptoms were mild. His symptoms gradually alleviated and he was discharged 14 days after surgery. With ICA occlusion after CEA, immediate re-operation is mandatory with severe neurological symptoms, whereas individualized judgement is needed when the symptoms are mild.

  12. Free radical erythrocyte damage in tumoral disease assessed by He-Ne laser and optical microscope through "Heinz Bodies" method.

    Science.gov (United States)

    Broccio, M; Della Rovere, F; Granata, A; Wanderlingh, U; Zirilli, A; Tanzariello, A; Pirrone, G; Broccio, G

    1998-01-01

    Results obtained from blood sample readings by optical microscopy and He-Ne laser (lambda = 630.1 mW), have confirmed the reduction in Heinz Bodies (HB) formation time and the Transmittance Reduction Degree (TRD), in malignancies. The results of spectrometric readings in colorectum polyposis, (TRD = 0.07) and fibrocystic mastopathy (TRD = 0.08) gave results overlapping with controls (TRD = 0.08). In neoplasias, the early HB formation in erythrocytes observed by optical microscope corresponded to TRD increase = 0.17 (P < 0.01). TRD increase was statistically significant (P < 0.01), as well as the reduction in the time of HB appearance (< 0.01). The relationship between optical and laser readings was exponential in tumors, while it was linear in controls, in polyposis and mastopathies. The values of the correlation coefficients obtained by both methods were significant (P < 0.01) for all the studied groups. Moreover, these research data further support the existence, even in the earlier stages of the disease, of the labile state of the red cell membrane due to strong lipid peroxidation by FRs.

  13. Carotid endarterectomy in patients with occlusion of the contralateral carotid artery. Perioperative risk and late results

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T; Rasmussen, L;

    1987-01-01

    Recent reports on the outcome of carotid endarterectomy in patients with contralateral occlusion have been conflicting. Therefore, we reviewed 51 cases identified, among 675 consecutive carotid endarterectomies. A perioperative mortality of 2% and a permanent morbidity rate of 16% was observed....... Compared with a complication rate of about 5% previously reported from this institution, this clearly indicates contralateral carotid occlusion as a major risk factor in carotid surgery. Though not statistically significant, patients with severely reduced cerebral perfusion pressure (CPP) had suffered more...

  14. Carotid baroreceptor reflexes in humans during orthostatic stress.

    Science.gov (United States)

    Cooper, V L; Hainsworth, R

    2001-09-01

    Orthostatic stress, including standing, head-up tilting and lower body suction, results in increases in peripheral vascular resistance but little or no change in mean arterial pressure. This study was undertaken to determine whether the sensitivity of the carotid baroreceptor reflex was enhanced during conditions of decreased venous return. We studied eight healthy subjects and determined responses of pulse interval (ECG) and forearm vascular resistance (mean finger blood pressure divided by Doppler estimate of brachial artery blood velocity) to graded increases and decreases in carotid transmural pressure, effected by a neck suction/pressure device. Responses were determined with and without the application of lower body negative pressure (LBNP) at -40 mmHg. Stimulus-response curves were determined as the responses to graded neck pressure changes and the differential of this provided estimates of reflex sensitivity. Changes in carotid transmural pressure caused graded changes in R-R interval and vascular resistance. The cardiac responses were unaffected by LBNP. Vascular resistance responses, however, were significantly enhanced during LBNP and the peak gain of the reflex was increased from 1.2 +/- 0.3 (mean +/- S.E.M.) to 2.2 +/- 0.3 units (P < 0.05). The increased baroreflex gain may contribute to maintenance of blood pressure during orthostatic stress and limit the pressure decreases during prolonged periods of such stress.

  15. Spontaneous internal carotid artery dissection.

    Science.gov (United States)

    Khimenko, L P; Esham, H R; Ahmed, W

    2000-10-01

    Once considered uncommon, spontaneous dissection of the carotid artery is an increasingly recognized cause of stroke, headache, cranial nerve palsy, or ophthalmologic events, especially in young adults. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced physicians of all specialties. We report a case of spontaneous internal carotid artery dissection in a 38-year-old woman with a cortical stroke and visual disturbances as initial symptoms. The diagnosis was confirmed by magnetic resonance imaging/angiography and by angiography. Prompt anticoagulation was instituted, and the patient had complete resolution of symptoms. Cervicocephalic arterial dissection should be included in the differential diagnosis of the causes of cerebrovascular events.

  16. Carotid endarterectomy: current consensus and controversies.

    Science.gov (United States)

    Meerwaldt, Robbert; Hermus, Linda; Reijnen, Michel M P J; Zeebregts, Clark J

    2010-10-01

    Stroke is the third most common cause of mortality, and carotid artery stenosis causes 8% to 29% of all ischemic strokes. Best medical treatment forms the basis of carotid stenosis treatment, and carotid endarterectomy (CEA) has an additional beneficial effect in high-grade stenosis. Carotid angioplasty and stenting (CAS) has challenged CEA as a primary carotid intervention. At present, CEA remains the gold standard, but in the future, CAS techniques will evolve and might become beneficial for subgroups of patients with carotid stenosis. This chapter briefly describes the history of carotid interventions and current consensus and controversies in CEA. In the last two years, several meta-analyses were published on a variety of aspects of best medical treatment, CEA, and CAS. It is still a matter of debate as to whether asymptomatic patients with carotid stenosis should undergo a carotid intervention. Especially because medical treatment has dramatically evolved since the early carotid trials. On the other hand, it is clear that carotid interventions in symptomatic patients with a high-grade stenosis should be performed as early as possible after the initial neurological event in order to achieve optimal stroke risk reduction. In CEA, the use of patching is advocated above primary closure, while the role of selective patching is still unclear. No differences in stroke and mortality rates are observed for routine versus selective shunting, for conventional versus eversion CEA, or for local versus general anesthesia. It is anticipated that in the future, there will be several interesting developments in carotid interventions such as plaque morphology analysis, acute interventions during stroke in progress, and further evolvement of CAS techniques.

  17. Does carotid intima-media thickness have relationship with polycystic ovary syndrome?

    Directory of Open Access Journals (Sweden)

    Zahra Allameh

    2013-01-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is a common reproductive endocrine disorder associated with cardiovascular disease (CVD risk factors and metabolic disturbances and a genetically heterogeneous disease. Intima-media thickness (IMT is an indicator of atherosclerosis. This study aimed to determine the relation between IMT and PCOS in women. Methods: This cross-sectional study was performed on 44 PCOS patients and 44 healthy women. Data collection included lipid profiles, blood pressure, waist circumference, body mass index (BMI, and common and internal IMT of carotid artery which were measured in studied subjects. IMT was measured by a radiologist using a linear 12 MHz ultrasound probe (LOGIC S6, GE in carotid setting. Results: IMT of common carotid artery (56.8 ΁ 7.6 in cases versus 49.8 ΁ 7.3 in controls, internal carotid artery (56.9 ΁ 6.03 in cases versus 49.6 ΁ 6.9 in controls, and both common and internal carotid artery (56.6 ΁ 6.7 in cases versus 49.7 ΁ 6.9 in controls were significantly higher in PCOS patients than healthy women (P < 0.001. Conclusions: In summary, results demonstrated that carotid artery thickness as a risk for premature atherosclerosis in patients with PCOS is higher than healthy subjects. And hence care and monitoring of PCOS women with these risk factors sounds to be important and necessary.

  18. Carotid thromboses in the early postoperative period after carotid endarterectomy.

    Science.gov (United States)

    Pokrovskiĭ, A V; Kuntsevich, G I; Beloiartsev, D F; Timina, I E; Kolosov, R V

    2005-01-01

    The paper analyzes 10 cases of internal carotid artery (ICA) thrombosis, which occurred after 635 carotid endarterectomies (CEA), carried out from January 1997 to July 2004. CEA procedures included 346 (54.5%) open CEAs with PTFE patch angioplasty and 289 (45.5%) eversion CEAs. Patients with thromboses in the reconstructed area (n=10) had the profiles of comorbidities and cerebrovascular insufficiency grade similar to the total CEA group (p>0.1). Differences concerned the higher rate of atrial fibrillation cases (10%), diabetes mellitus (30%) and contralateral ICA occlusions (20%) in the group of thromboses (p>0.1). Among these 10 patients, 5 underwent eversion CEA (1.44% of the total eversion CEA group) and 5 - open CEA with patch angioplasty (1.73%). In 8 patients thromboses manifested as local neurological symptoms in the area supplied by the operated carotid artery. One patient demonstrated the progression of general cerebral symptomatology, while in the tenth patient thrombosis was accompanied with cerebral coma. Urgent ultrasonography in 7 patients failed to detect a blood flow in ICA, that proved the diagnosis of ICA thrombosis; in 3 patients ultrasonography showed a mural thrombosis. Nine patients underwent reoperation in emergency, while for the tenth patient an intervention was contraindicated due to the thrombosis of middle cerebral artery, unstable clinical state (cerebral coma) and progression of neurological symptomatology. PTFE arterial graft was implantedin 7 reoperated patients with ICA thrombosis, thrombectomy from ICA was carried out in 1 patient and in another one patient a thrombectomy from reconstructed segment with PTFE patch angioplasty of the arteriotomy defect was fulfilled. In 3 reoperated patients a complete resolution of neurological symptoms was evident 24 hours after intervention, in 2 patients neurological symptomatology regressed over 2-4 weeks. In another 3 reoperated patients local neurological symptoms persisted; 1 patient

  19. Indirect Tumor Cell Death After High-Dose Hypofractionated Irradiation: Implications for Stereotactic Body Radiation Therapy and Stereotactic Radiation Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Song, Chang W., E-mail: songx001@umn.edu [Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota (United States); Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Lee, Yoon-Jin [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Griffin, Robert J. [Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas (United States); Park, Inhwan [Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota (United States); Koonce, Nathan A. [Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas (United States); Hui, Susanta [Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota (United States); Kim, Mi-Sook [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Dusenbery, Kathryn E. [Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota (United States); Sperduto, Paul W. [Minneapolis Radiation Oncology and Gamma Knife Center, University of Minnesota, Minneapolis, Minnesota (United States); Cho, L. Chinsoo [Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota (United States)

    2015-09-01

    Purpose: The purpose of this study was to reveal the biological mechanisms underlying stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS). Methods and Materials: FSaII fibrosarcomas grown subcutaneously in the hind limbs of C3H mice were irradiated with 10 to 30 Gy of X rays in a single fraction, and the clonogenic cell survival was determined with in vivo–in vitro excision assay immediately or 2 to 5 days after irradiation. The effects of radiation on the intratumor microenvironment were studied using immunohistochemical methods. Results: After cells were irradiated with 15 or 20 Gy, cell survival in FSaII tumors declined for 2 to 3 days and began to recover thereafter in some but not all tumors. After irradiation with 30 Gy, cell survival declined continuously for 5 days. Cell survival in some tumors 5 days after 20 to 30 Gy irradiation was 2 to 3 logs less than that immediately after irradiation. Irradiation with 20 Gy markedly reduced blood perfusion, upregulated HIF-1α, and increased carbonic anhydrase-9 expression, indicating that irradiation increased tumor hypoxia. In addition, expression of VEGF also increased in the tumor tissue after 20 Gy irradiation, probably due to the increase in HIF-1α activity. Conclusions: Irradiation of FSaII tumors with 15 to 30 Gy in a single dose caused dose-dependent secondary cell death, most likely by causing vascular damage accompanied by deterioration of intratumor microenvironment. Such indirect tumor cell death may play a crucial role in the control of human tumors with SBRT and SRS.

  20. Ischemic stroke risk reduction following cardiac surgery by carotid compression

    Science.gov (United States)

    Isingoma, Paul

    Every year over 500,000 cardiovascular procedures requiring cardiopulmonary bypass (CPB) are performed in the United States. CPB is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. During CPB, an aortic cross-clamp is used to clamp the aorta and separate the systemic circulation from the outflow of the heart. Unfortunately, these procedures have been found to cause most cerebral emboli, which produce clinical, subclinical and silent neurologic injuries. Many clinical neurologic injuries occur in the postoperative period, with over 20% of the clinical strokes occurring during this period. In this study, we focus on visualizing the flow distribution in the aortic arch, the effect of carotid compression and the influence of compression time and MAP during CPB on reducing cerebral emboli. Experiments are performed with an aortic arch model in a mock cardiovascular system. Fluorescent particles are used to simulate emboli that are released into circulation immediately after carotid compression. The LVAD is used as the pump to produce flow in the system by gradually adjusting the speed to maintain desired clinical conditions. Aortic and proximal branches MAP of 65.0 +/- 5.0 mmHg (normal MAP) or 95.0 +/- 5.0 mmHg (high MAP), aortic flow of 4.0 +/- 0.5 L/min, and all branches flow (left and right carotids, and subclavian arteries) of 10% of the aortic flow. Flow distribution of particles is visualized using LaVision's DaVis imaging software and analyzed using imagej's particle analysis tool to track, count, and record particle properties from the aortic arch. Carotid compression for 10-20 seconds reduces the number of particles entering the carotid arteries by over 73% at normal MAP, and by over 85% at high MAP. A higher MAP resulted in fewer particles entering the branching vessels both at baseline and during occlusion conditions. A compression duration of

  1. Medical treatment in carotid artery intervention

    NARCIS (Netherlands)

    Kolkert, J. L.; Meerwaldt, R.; Lefrandt, Johan; Geelkerken, R. H.; Zeebregts, C. J.

    2011-01-01

    Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical the

  2. Neuroendocrine Tumor: Statistics

    Science.gov (United States)

    ... Tumor > Neuroendocrine Tumor: Statistics Request Permissions Neuroendocrine Tumor: Statistics Approved by the Cancer.Net Editorial Board , 11/ ... the body. It is important to remember that statistics on how many people survive this type of ...

  3. Immune augmentation and Dalton's Lymphoma tumor inhibition by glucans/glycans isolated from the mycelia and fruit body of Pleurotus ostreatus.

    Science.gov (United States)

    Devi, K Sanjana P; Behera, Birendra; Mishra, Debasish; Maiti, Tapas K

    2015-03-01

    With the increase in cancer progression, alternatives in the medicinal field with minimal side effects need to be ascertained. In this context, for the first time novel glucans/glycans isolated from the mycelia and fruit body of Pleurotus ostreatus have been compared for their exquisite property as immunoceuticals. Glucans from both the sources displayed immunological functions which include lymphocyte proliferation, macrophage activation (nitric oxide production, ROS generation, phagocytosis, TNF-α production) as well as macrophage and NK cell mediated cytotoxicity. In vivo studies with Dalton's Lymphoma mice tumor model further enumerated the immune enhancing and tumor regression potential of the two glucan molecules. Highest tumor inhibition of about 75% and 71.4% were observed at 20mg/kg of mycelia and fruit body glucan/glycan treatments. A concomitant increase in the survival period of glucan treated tumor bearing mice was found to be primarily associated with immune boosting and apoptosis of cancerous cells. Both the glucan molecules exhibited similar degree of immune response at the systemic level with only subtle amount of differences in two dimensional in vitro cultures. Efficacy of glucans/glycans as immunomodulators may thereby provide decisive leads in strengthening the immune system along with other therapies.

  4. SU-E-J-31: Monitor Interfractional Variation of Tumor Respiratory Motion Using 4D KV Conebeam Computed Tomography for Stereotactic Body Radiation Therapy of Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tai, A; Prior, P; Gore, E; Johnstone, C; Li, X [Medical College of Wisconsin, Milwaukee, WI (United States)

    2015-06-15

    Purpose: 4DCT has been widely used to generate internal tumor volume (ITV) for a lung tumor for treatment planning. However, lung tumors may show different respiratory motion on the treatment day. The purpose of this study is to evaluate 4D KV conebeam computed tomography (CBCT) for monitoring tumor interfractional motion variation between simulation and each fraction of stereotactic body radiation therapy (SBRT) for lung cancer. Methods: 4D KV CBCT was acquired with the Elekta XVI system. The accuracy of 4D KV CBCT for image-guided radiation therapy (IGRT) was tested with a dynamic thorax motion phantom (CIRS, Virginia) with a linear amplitude of 2 cm. In addition, an adult anthropomorphic phantom (Alderson, Rando) with optically stimulated luminescence (OSL) dosimeters embedded at the center and periphery of a slab of solid water was used to measure the dose of 4D KV CBCT and to compare it with the dose with 3D KV CBCT. The image registration was performed by aligning\\ each phase images of 4D KV CBCT to the planning images and the final couch shifts were calculated as a mean of all these individual shifts along each direction.A workflow was established based on these quality assurance tests for lung cancer patients. Results: 4D KV CBCT does not increase imaging dose in comparison to 3D KV CBCT. Acquisition of 4D KV CBCT is 4 minutes as compared to 2 minutes for 3D KV CBCT. Most of patients showed a small daily variation of tumor respiratory motion about 2 mm. However, some patients may have more than 5 mm variations of tumor respiratory motion. Conclusion: The radiation dose does not increase with 4D KV CBCT. 4D KV CBCT is a useful tool for monitoring interfractional variations of tumor respiratory motion before SBRT of lung cancer patients.

  5. Comparison of pencil beam–based homogeneous vs inhomogeneous target dose planning for stereotactic body radiotherapy of peripheral lung tumors through Monte Carlo–based recalculation

    Energy Technology Data Exchange (ETDEWEB)

    Ohtakara, Kazuhiro, E-mail: ohtakara@murakami.asahi-u.ac.jp [Department of Radiation Oncology, Murakami Memorial Hospital, Asahi University, Gifu (Japan); Hoshi, Hiroaki [Department of Radiology, Gifu University Graduate School of Medicine, Gifu (Japan)

    2015-10-01

    This study was conducted to ascertain whether homogeneous target dose planning is suitable for stereotactic body radiotherapy (SBRT) of peripheral lung cancer under appropriate breath-holding. For 20 peripheral lung tumors, paired dynamic conformal arc plans were generated by only adjusting the leaf margin to the planning target volume (PTV) edge for fulfilling the conditions such that the prescription isodose surface (IDS) encompassing exactly 95% of the PTV (PTV D{sub 95}) corresponds to 95% and 80% IDS, normalized to 100% at the PTV isocenter under a pencil beam (PB) algorithm with radiologic path length correction. These plans were recalculated using the x-ray voxel Monte Carlo (XVMC) algorithm under otherwise identical conditions, and then compared. Lesions abutting the parietal pleura or not were defined as edge or island tumors, respectively, and the influences of the target volume and its location relative to the chest wall on the target dose were examined. The median (range) leaf margin required for the 95% and 80% plans was 3.9 mm (1.3 to 5.0) and −1.2 mm (−1.8 to 0.1), respectively. Notably, the latter was significantly correlated negatively with PTV. In the 80% plans, the PTV D{sub 95} was slightly higher under XVMC, whereas the PTV D{sub 98} was significantly lower, irrespective of the dose calculation algorithm used. Other PTV and all gross tumor volume doses were significantly higher, while the lung doses outside the PTV were slightly lower. The target doses increased as a function of PTV and were significantly lower for island tumors than for edge tumors. In conclusion, inhomogeneous target dose planning using smaller leaf margin for a larger tumor volume was deemed suitable in ensuring more sufficient target dose while slightly reducing lung dose. In addition, more inhomogeneous target dose planning using <80% IDS (e.g., 70%) for PTV covering would be preferable for island tumors.

  6. Prognostic impact of average iodine density assessed by dual-energy spectral imaging for predicting lung tumor recurrence after stereotactic body radiotherapy.

    Science.gov (United States)

    Aoki, Masahiko; Hirose, Katsumi; Sato, Mariko; Akimoto, Hiroyoshi; Kawaguchi, Hideo; Hatayama, Yoshiomi; Fujioka, Ichitaro; Tanaka, Mitsuki; Ono, Shuichi; Takai, Yoshihiro

    2016-07-01

    The purpose of this study was to investigate the prognostic significance of average iodine density as assessed by dual-energy computed tomography (DE-CT) for lung tumors treated with stereotactic body radiotherapy (SBRT). From March 2011 to August 2014, 93 medically inoperable patients with 74 primary lung cancers and 19 lung metastases underwent DE-CT prior to SBRT of a total dose of 45-60 Gy in 5-10 fractions. Of these 93 patients, nine patients had two lung tumors. Thus, 102 lung tumors were included in this study. DE-CT was performed for pretreatment evaluation. Regions of interest were set for the entire tumor, and average iodine density was obtained using a dedicated imaging software and evaluated with regard to local control. The median follow-up period was 23.4 months (range, 1.5-54.5 months). The median value of the average iodine density was 1.86 mg/cm(3) (range, 0.40-9.27 mg/cm(3)). Two-year local control rates for the high and low average iodine density groups divided by the median value of the average iodine density were 96.9% and 75.7% (P = 0.006), respectively. Tumors with lower average iodine density showed a worse prognosis, possibly reflecting a hypoxic cell population in the tumor. The average iodine density exhibited a significant impact on local control. Our preliminary results indicate that iodine density evaluated using dual-energy spectral CT may be a useful, noninvasive and quantitative assessment of radio-resistance caused by presumably hypoxic cell populations in tumors.

  7. The Current Role of Carotid Duplex Ultrasonography in the Management of Carotid Atherosclerosis: Foundations and Advances

    Directory of Open Access Journals (Sweden)

    Kelly R. Byrnes

    2012-01-01

    Full Text Available The management of atherosclerotic carotid occlusive disease for stroke prevention has entered a time of dramatic change. Improvements in medical management have begun to challenge traditional interventional approaches to asymptomatic carotid stenosis. Simultaneously, carotid artery stenting (CAS has emerged as an alternative to carotid endarterectomy (CE. Finally, multiple factors beyond degree of stenosis and symptom status now mitigate clinical decision making. These factors include brain perfusion, plaque morphology, and patency of intracranial collaterals (circle of Willis. With all of these changes, it seems prudent to review the role of carotid duplex ultrasonography in the management of atherosclerotic carotid occlusive disease for stroke prevention. Carotid duplex ultrasonography (CDU for initial and serial imaging of the carotid bifurcation remains an essential component in the management of carotid bifurcation disease. However, correlative axial imaging modalities (computer tomographic angiography (CTA and contrast-enhanced magnetic resonance angiography (CE-MRA increasingly aid in the assessment of individual stroke risk and are important in treatment decisions. The purpose of this paper is twofold: (1 to discuss foundations and advances in CDU and (2 to evaluate the current role of CDU, in light of other imaging modalities, in the clinical management of carotid atherosclerosis.

  8. Pituitary Tumors

    Science.gov (United States)

    ... impairment, and behavioral changes. Tumors can also either produce excessive amounts of hormone or limit how much hormone is produced. The hormones most commonly affected include: growth hormone (regulates body height and structure), prolactin (controls ...

  9. Anomalous external carotid artery-internal carotid artery anastomosis in two patients with proximal internal carotid arterial remnants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Hun [Dept. of Neurology, Stroke Center, Myongji Hospital, Goyang (Korea, Republic of); Cho, Young Dae; Kang, Hyun Seung; Kim, Jeong Eun; Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jung, Seung Chai [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Ahn, Jun Hyong [Dept. of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)

    2015-08-15

    Two angiographic instances of anomalous external carotid artery (ECA) and internal carotid artery (ICA) anastomosis are described, each occurring at the C2-3 level and bearing remnants of proximal ICA. The ICA remnant of one patient (identifiable immediately upon bifurcation of the common carotid artery) was hypoplastic, and that of the other patient was an occluded arterial stump. These features are not typical of non-bifurcating ICA. The occipital artery originated from an anomalous connection in one instance and from the main trunk of the ECA (just past the ECA-ICA connection) in the other.

  10. Apopotic gene Bax expression in carotid plaque

    Institute of Scientific and Technical Information of China (English)

    Bao-Zhong MEN; Ding-Biao ZHOU; Huai-Yin SHI; Xiao-Ming ZHANG

    2006-01-01

    The expression of BAX in carotid atherosclerosis and its regulation is far from defined. Objectives To investigate BAX expression in stable/fibrous and instable/vulnerable carotid plaque and its clinical significance. Methods 25 cases of carotid plaque specimens obtained from endarterectomy were divided into two groups, stable/fibrous 14 cases, vulnerable/instable 11 cases; aortic artery and its branches from hepatic transplantation donors 6 case as control. The expression of proapoptotic BAX was detected by immunohistochemistry(IHC), in situ hybridization(ISH) and in situ TdT dUTP nick end labeling (TUNEL). Results 5 cases of BAX ( + ) were detected by ICH and ISH, 4 case of TUNEL ( + ) were detected by TUNEL in stable/fibrous carotid plaque , while 10 cases were BAX ( + )by IHC(P < 0.05) , 11case by ISH and 9 case by TUNEL were detected in instable/vulnerable carotid plaque ( P < 0.01 ), respectively. The intensity of BAX ( + ) cells by IHC and ISH was 8.63 ± 2.62 and 10.32 ± 3.12 in fibrous plaques, whereas 122 ± 21.64and 152 ± 23.35 in vulnerable plaques, respectively. No expression of BAX was found in controlled group. Conclusion The higher expression of Bax in vulnerable carotid plaque may be one mechanisms in molecular pathogenesis of carotid atherosclerosis which affect plaque stability and be the cause of higher incidence of stroke than fibrous carotid plaques, the regulation of BAX expression in different stage of atherosclerosis may provide targets in gene therapy for carotid atherosclerosis.

  11. [The effect of carotid endarterectomy on cognitive disturbances in patients with atherosclerotic stenosis of carotid arteries].

    Science.gov (United States)

    Iakhno, N N; Fedorova, T S; Damulin, I V; Shcherbiuk, A N; Vinogradov, O A; Lavrent'ev, A V

    2011-01-01

    Clinical and neuropsychological features of non-dementia cognitive disturbances were studied in 102 patients with atherosclerotic carotid stenosis. Cognitive disturbances were assessed after the carotid endarterectomy (CEAE). Mild cognitive impairment was found in 37 (36,3%) of patients, moderate cognitive impairment was diagnosed in 36 (35,3%)patients. Moderate cognitive impairment was found more often in patients with symptomatic carotid stenosis with structural brain changes confirmed by neuroimaging data and with instable atherosclerotic plaques with the predomination of hypodensity component. It allows to suggest that both the reduction of perfusion and arterio-arterial microemboli may cause cognitive dysfunction in patients with atherosclerotic carotid stenosis. The data on the positive effect of CEAE on cognitive functions have been obtained. The positive changes were more distinct in patients with asymptomatic course of carotid stenosis. However CEAE may have a negative effect on cognitive functions in patients with moderate cognitive impairment of dysmnestic character and symptomatic carotid stenosis.

  12. Serum Levels of Anticyclic Citrullinated Peptide Antibodies, Interleukin-6, Tumor Necrosis Factor-α, and C-Reactive Protein Are Associated with Increased Carotid Intima-Media Thickness: A Cross-Sectional Analysis of a Cohort of Rheumatoid Arthritis Patients without Cardiovascular Risk Factors

    Directory of Open Access Journals (Sweden)

    Mónica Vázquez-Del Mercado

    2015-01-01

    Full Text Available The main cause of death in rheumatoid arthritis (RA is cardiovascular events. We evaluated the relationship of anticyclic citrullinated peptide (anti-CCP antibody levels with increased carotid intima-media thickness (cIMT in RA patients. Methods. Forty-five anti-CCP positive and 37 anti-CCP negative RA patients, and 62 healthy controls (HC were studied. All groups were assessed for atherogenic index of plasma (AIP and cIMT. Anti-CCP, C-reactive protein (CRP, and levels of tumor necrosis factor alpha (TNFα and interleukin-6 (IL-6 were measured by enzyme-linked immunosorbent assay (ELISA. Results. The anti-CCP positive RA patients showed increased cIMT compared to HC and anti-CCP negative (P<0.001. Anti-CCP positive versus anti-CCP negative RA patients, had increased AIP, TNFα and IL-6 (P<0.01, and lower levels of high density lipoprotein cholesterol (HDL-c (P=0.02. The cIMT correlated with levels of anti-CCP (r=0.513, P=0.001, CRP (r=0.799, P<0.001, TNFα (r=0.642, P=0.001, and IL-6 (r=0.751, P<0.001. In multiple regression analysis, cIMT was associated with CRP (P<0.001 and anti-CCP levels (P=0.03. Conclusions. Levels of anti-CCP and CRP are associated with increased cIMT and cardiovascular risk supporting a clinical role of the measurement of cIMT in RA in predicting and preventing cardiovascular events.

  13. Serum Levels of Anticyclic Citrullinated Peptide Antibodies, Interleukin-6, Tumor Necrosis Factor-α, and C-Reactive Protein Are Associated with Increased Carotid Intima-Media Thickness: A Cross-Sectional Analysis of a Cohort of Rheumatoid Arthritis Patients without Cardiovascular Risk Factors

    Science.gov (United States)

    Vázquez-Del Mercado, Mónica; Nuñez-Atahualpa, Lourdes; Figueroa-Sánchez, Mauricio; Gómez-Bañuelos, Eduardo; Rocha-Muñoz, Alberto Daniel; Martín-Márquez, Beatriz Teresita; Martínez-García, Erika Aurora; Macias-Reyes, Héctor; Gamez-Nava, Jorge Ivan; Navarro-Hernandez, Rosa Elena; Nuñez-Atahualpa, María Alejandra; Andrade-Garduño, Javier

    2015-01-01

    The main cause of death in rheumatoid arthritis (RA) is cardiovascular events. We evaluated the relationship of anticyclic citrullinated peptide (anti-CCP) antibody levels with increased carotid intima-media thickness (cIMT) in RA patients. Methods. Forty-five anti-CCP positive and 37 anti-CCP negative RA patients, and 62 healthy controls (HC) were studied. All groups were assessed for atherogenic index of plasma (AIP) and cIMT. Anti-CCP, C-reactive protein (CRP), and levels of tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA). Results. The anti-CCP positive RA patients showed increased cIMT compared to HC and anti-CCP negative (P < 0.001). Anti-CCP positive versus anti-CCP negative RA patients, had increased AIP, TNFα and IL-6 (P < 0.01), and lower levels of high density lipoprotein cholesterol (HDL-c) (P = 0.02). The cIMT correlated with levels of anti-CCP (r = 0.513, P = 0.001), CRP (r = 0.799, P < 0.001), TNFα (r = 0.642, P = 0.001), and IL-6 (r = 0.751, P < 0.001). In multiple regression analysis, cIMT was associated with CRP (P < 0.001) and anti-CCP levels (P = 0.03). Conclusions. Levels of anti-CCP and CRP are associated with increased cIMT and cardiovascular risk supporting a clinical role of the measurement of cIMT in RA in predicting and preventing cardiovascular events. PMID:25821796

  14. SU-E-J-179: Assessment of Tumor Volume Change and Movement During Stereotactic Body Radiotherapy (SBRT) for Lung Cancer: Is Adaptive Radiation Therapy (ART) Necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Lee, C; Lee, C [Asan Medical Center, Seoul (Korea, Republic of)

    2015-06-15

    Purpose: Delineation of gross tumor volumes (GTVs) is important for stereotactic body radiotherapy (SBRT). However, tumor volume changes during treatment response. Here, we have investigated tumor volume changes and movement during SBRT for lung cancer, as a means of examining the need for adaptive radiation therapy (ART). Methods: Fifteen tumors in 15 patients with lung cancer were treated with SBRT (total dose: 60 Gy in 4 fractions). GTVs were obtained from cone-beam computed tomography scans (CBCT1–4) taken before each of the 4 fractions was administered. GTVs were delineated and measured by radiation oncologists using a treatment planning system. Variance in the tumor position was assessed between the planning CT and the CBCT images. To investigate the dosimetric effects of tumor volume changes, planning CT and CBCT4 treatment plans were compared using the conformity index (CI), homogeneity index (HI), and Paddick’s index (PCI). Results: The GTV on CBCT1 was employed as a baseline for comparisons. GTV had decreased by a mean of 20.4% (range: 0.7% to 47.2%) on CBCT4. Most patients had smaller GTVs on CBCT4 than on CBCT1. The interfractional shifts of the tumor position between the planning CT and CBCT1–4 were as follows: right-left, −0.4 to 1.3 mm; anterior-posterior, −0.8 to 0.5 mm; and superiorinferior, −0.9 to 1.1 mm. Indices for plans from the planning CT and CBCT4 were as follows: CI = 0.94±0.02 and 1.11±0.03; HI= 1.1±0.02 and 1.10±0.03; and PCI = 1.35±0.16 and 1.11±0.02, respectively. Conclusion: CI, HI, and PCI did not differ between the planning CT and CBCTs. However, daily CBCT revealed a significant decrease in the GTV during lung SBRT. Furthermore, there was an obvious interfractional shift in tumor position. Using ART could potentially lead to a reduced GTV margin and improved regional tumor control for lung cancer patients with significantly decreased GTV.

  15. Carotid sheath abscess caused by a tooth decay infection on the opposite side.

    Science.gov (United States)

    Tuncturk, F Ruya; Uzun, Lokman; Kalcioglu, M Tayyar; Egilmez, Oguz Kadir; Timurlenk, Emine; Erguven, Muferet

    2015-01-01

    Deep neck infections are mortal diseases that need emergency treatment. It can occur at any age but usually in pediatric ages. In this report, a left cervical carotid space abscess of a pediatric patient was discussed. It was interesting that the only origin of the left carotid sheath abscess was right inferior first molar tooth decay. Right neck spaces were all clean. Patient had no immunosupression and also there were no congenital masses such as branchial cleft cysts, foreign bodies, or masses suspicious for malignancies in cervical ultrasound and MRI. We discussed this rare condition under the light of the literature.

  16. General principles of carotid Doppler ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Whal [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2014-03-15

    Carotid Doppler ultrasonography is a popular tool for evaluating atherosclerosis of the carotid artery. Its two-dimensional gray scale can be used for measuring the intima-media thickness, which is very good biomarker for atherosclerosis and can aid in plaque characterization. The plaque morphology is related to the risk of stroke. The ulceration of plaque is also known as one of the strong predictors of future embolic event risk. Color Doppler ultrasonography and pulse Doppler ultrasonography have been used for detecting carotid artery stenosis. Doppler ultrasonography has unique physical properties. The operator should be familiar with the physics and other parameters of Doppler ultrasonography to perform optimal Doppler ultrasonography studies.

  17. Hypofractionated stereotactic body radiotherapy for primary and metastatic liver tumors using the novalis image-guided system: preliminary results regarding efficacy and toxicity.

    Science.gov (United States)

    Iwata, Hiromitsu; Shibamoto, Yuta; Hashizume, Chisa; Mori, Yoshimasa; Kobayashi, Tatsuya; Hayashi, Naoki; Kosaki, Katsura; Ishikawa, Tetsuya; Kuzuya, Teiji; Utsunomiya, Setsuo

    2010-12-01

    www.tcrt.org The purpose of this study was to evaluate the efficacy and toxicity of stereotactic body radiotherapy (SBRT) for primary and metastatic liver tumors using the Novalis image-guided radiotherapy system. After preliminarily treating liver tumors using the Novalis system from July 2006, we started a protocol-based study in February 2008. Eighteen patients (6 with primary hepatocellular carcinoma and 12 with metastatic liver tumor) were treated with 55 or 50 Gy, depending upon their planned dose distribution and liver function, delivered in 10 fractions over 2 weeks. Four non-coplanar and three coplanar static beams were used. Patient age ranged from 54 to 84 years (median: 72 years). The Child-Pugh classification was Grade A in 17 patients and Grade B in 1. Tumor diameter ranged from 12 to 35 mm (median: 23 mm). Toxicities were evaluated according to the Common Terminology Criteria of Adverse Events version 4.0, and radiation-induced liver disease (RILD) was defined by Lawrence's criterion. The median follow-up period was 14.5 months. For all patients, the 1-year overall survival and local control rates were 94% and 86%, respectively. A Grade 1 liver enzyme change was observed in 5 patients, but no RILD or chronic liver dysfunction was observed. SBRT using the Novalis image-guided system is safe and effective for treating primary and metastatic liver tumors. Further investigation of SBRT for liver tumors is warranted. In view of the acceptable toxicity observed with this protocol, we have moved to a new protocol to shorten the overall treatment time and escalate the dose.

  18. Glomus jugulare tumor with intra- and extracranial extension. A case report with MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Morisako, Toshitaka; Goya, Tomokazu; Wakisaka, Shinichiro; Kinoshita, Kazuo

    1987-11-01

    A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C/sub 2/. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension

  19. Reference values of one-point carotid stiffness parameters determined by carotid echo-tracking and brachial pulse pressure in a large population of healthy subjects.

    Science.gov (United States)

    Vriz, Olga; Aboyans, Victor; Minisini, Rosalba; Magne, Julien; Bertin, Nicole; Pirisi, Mario; Bossone, Eduardo

    2017-03-02

    Arterial stiffness can predict cardiovascular events, and the aim of this study was to produce age- and sex-specific reference values for echo-tracking carotid stiffness in healthy subjects. A total of 900 subjects (500 males, mean age 45.8±19 years) were enrolled. Common carotid artery stiffness and compliance, using a high-definition echo-tracking ultrasound system, were evaluated. To compare stiffness parameters across the different age groups, individual scores were transformed into T-scores, indicating how many standard deviation (s.d.) units an individual's score was above or below the mean that was observed in the group including same-sex individuals aged 36 to 44 years. Carotid stiffness was similar among genders, except compliance, which was lower in women (Pgroups. Stiffness parameters increased significantly with age, but the opposite occurred for compliance. The T-score was found to increase significantly across all age groups, with a steeper increase in stiffness around the age of 60 years in women. For each T-score s.d., the corresponding carotid absolute values for arterial stiffness and compliance were obtained. In a multivariate model, carotid stiffness parameters were constantly and independently associated with age, mean arterial pressure, pulse pressure, heart rate and body mass index. Our study provides a normogram of carotid arterial stiffness and compliance indices obtained with the echo-tracking method in a large population of healthy subjects stratified by gender and age that can be used in clinical practice.Hypertension Research advance online publication, 2 March 2017; doi:10.1038/hr.2017.24.

  20. Carotid angioplasty with stenting for chronic internal carotid artery occlusion: technical note

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Nozomu; Tanasawa, Toshihiko; Okada, Takeshi; Endo, Otone; Yamamoto, Naohito [Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Department of Neurosurgery, Aichi (Japan); Miyachi, Shigeru; Hattori, Kenichi [Nagoya University Graduate School of Medicine, Department of Neurosurgery, Nagoya (Japan)

    2006-11-15

    Carotid angioplasty with stenting (CAS) is becoming accepted as an effective and reliable treatment option for severe carotid artery stenosis. However, it is rarely applied for carotid occlusion, especially in its chronic stage. We report our experience of CAS for chronic internal carotid artery occlusion representing compromised cerebral blood flow using various protection methods. A 77-year-old woman, who was already diagnosed with severe left internal carotid artery stenosis, suddenly had right hemiparesis and aphasia. At that time, she was treated conservatively because her neurological status was quite good, in spite of left carotid artery occlusion. Her symptoms improved in the short term, except slight aphasia, but deteriorated again 18 days from the onset, and magnetic resonance imaging (MRI) showed new ischemic lesions. CAS was then performed for the occluded carotid artery on the 23rd day from the first onset. Using the proximal protection technique, the occluded lesion was crossed carefully with a microguidewire. Stents were also placed successfully with the distal protection technique. The occluded carotid artery was completely recanalized without any unfavorable events or neurological deterioration. In this patient, CAS was successfully to treat chronic carotid artery occlusion. These procedures and techniques are reviewed and discussed. (orig.)

  1. Interventional procedure based on nanorobots propelled and steered by flagellated magnetotactic bacteria for direct targeting of tumors in the human body.

    Science.gov (United States)

    Martel, Sylvain; Felfoul, Ouajdi; Mohammadi, Mahmood; Mathieu, Jean-Baptiste

    2008-01-01

    Flagellated bacteria used as bio-actuators may prove to be efficient propulsion mechanisms for future hybrid medical nanorobots when operating in the microvasculature. Here, we briefly describe a medical interventional procedure where flagellated bacteria and more specifically MC-1 Magnetotactic Bacteria (MTB) can be used to propel and steer micro-devices and nanorobots under computer control to reach remote locations in the human body. In particular, we show through experimental results the potential of using MTB-tagged robots to deliver therapeutic agents to tumors even the ones located in deep regions of the human body. We also show that such bacterial nanorobots can be tracked inside the human body for enhanced targeting under computer guidance using MRI as imaging modality. MTB can not only be guided and controlled directly towards a specific target, but we also show experimentally that these flagellated bacterial nanorobots can be propelled and steered in vivo deeply through the interstitial region of a tumor. The targeting efficacy is increased when combined with larger ferromagnetic micro-carriers being propelled by magnetic gradients generated by a MRI platform to carry and release nanorobots propelled by a single flagellated bacterium near the arteriocapillar entry. Based on the experimental data obtained and the experience gathered during several experiments conducted in vivo with this new approach, a general medical interventional procedure is briefly described here in a biomedical engineering context.

  2. Defective cerebrovascular autoregulation after carotid endarterectomy

    DEFF Research Database (Denmark)

    Jørgensen, L G; Schroeder, T V

    1993-01-01

    that ipsilateral middle cerebral artery mean flow velocity was pressure dependent. This substantiates the hypothesis of defective autoregulation in the ipsilateral hemisphere after carotid endarterectomy, and in turn demonstrates an immediate cessation of symptoms with reduction of arterial pressure even...

  3. Ophthalmic masquerades of the atherosclerotic carotids

    Directory of Open Access Journals (Sweden)

    Anupriya Arthur

    2014-01-01

    Full Text Available Patients with carotid atherosclerosis can present with ophthalmic symptoms. These symptoms and signs can be due to retinal emboli, hypoperfusion of the retina and choroid, opening up of collateral channels, or chronic hypoperfusion of the globe (ocular ischemic syndrome. These pathological mechanisms can produce many interesting signs and a careful history can bring out important past symptoms pointing toward the carotid as the source of the patient′s presenting symptom. Such patients are at high risk for an ischemic stroke, especially in the subsequent few days following their first acute symptom. It is important for clinicians to be familiar with these ophthalmic symptoms and signs caused by carotid atherosclerosis for making an early diagnosis and to take appropriate measures to prevent a stroke. This review elaborates the clinical features, importance, and implications of various ophthalmic symptoms and signs resulting from atherosclerotic carotid artery disease.

  4. Carotid canal dehiscence in the human skull

    Energy Technology Data Exchange (ETDEWEB)

    Pastor Vazquez, J.F.; Gil Verona, J.A. [Department of Anatomy, Faculty of Medicine, University of Valladolid, Ramon y Cajal, 7, E-47005 Valladolid (Spain); Garcia Porrero, M. [Department of Radiology, Faculty of Medicine, University of Valladolid (Spain)

    1999-06-01

    Abnormalities of the floor of the carotid canal have been studied in 538 skulls. These abnormalities range from a fissure to total absence of the floor. This variation may be caused by abnormalities of the internal carotid artery or deficiencies in ossification of the skull base. CT suggests that these changes should be taken into account by surgeons working on the skull base. (orig.) With 4 figs., 8 refs.

  5. Ketone bodies metabolism during ischemic and reperfusion brain injuries following bilateral occlusion of common carotid arteries in rats Metabolismo dos corpos cetônicos durante as lesões de isquemia e reperfusão cerebrais após oclusão bilateral das artérias carótidas comuns em ratos

    Directory of Open Access Journals (Sweden)

    Mário Henrique Girão Faria

    2007-04-01

    Full Text Available PURPOSE: To evaluate the in vivo alterations on ketone bodies metabolism after cerebral ischemia/reperfusion through an experimental model of brain ischemia induced by simple occlusion of common carotid arteries (CCAs in Wistar rats. METHODS: Forty-eight male Wistar rats were randomly distributed on two groups (S - Sham; T - Test and further redistributed into four times sets of study. After bilateral occlusion of CCAs for 30min, the animals of group T were allowed reperfusion for 0, 5, 10 and 15min. Samples of cerebral tissue and systemic arterial blood were collected and the metabolites acetoacetate (ACT and beta-hydroxybutyrate (BHB were determined. RESULTS: Cerebral ACT and BHB levels increased significantly in Group T after 30min of carotid occlusion (time 0. The highest brain ketone bodies (ACT+BHB concentration was verified at 5min of reperfusion, decreasing after 10min of recirculation. Systemic ketone bodies levels increased similarly between test and sham groups. Group S demonstrated a significant increase in cerebral and systemic ACT and BHB concentrations mainly after 40-45min of study. CONCLUSIONS: The partial transient acute global brain ischemia induced by the bilateral carotid occlusion in Wistar rats triggered ketogenesis probably due to a central stimulation of catecholamine secretion. There was an increased cerebral uptake of ketone bodies following brain ischemia, reaffirming these metabolites as alternative energy substrates under conditions of cerebral metabolic stress as well as its potential role on neuroprotection. The greatest changes in ketone bodies metabolism were verified at initial minutes of recirculation as a result of the reperfusion injury phenomenon.OBJETIVO: Avaliar as alterações in vivo no metabolismo dos corpos cetônicos após isquemia/reperfusão cerebral através de um modelo experimental de isquemia cerebral induzido pela simples oclusão das artérias carótidas comuns (CCAs em ratos Wistar. M

  6. MR and CT diagnosis of carotid pseudoaneurysm in children following surgical resection of craniopharyngioma.

    Science.gov (United States)

    Lakhanpal, S K; Glasier, C M; James, C A; Angtuaco, E J

    1995-01-01

    We report the cases of two children who underwent CT, MR, MRA and angiography in the diagnosis of postoperative aneurysmal dilatation of the supraclinoid carotid arteries following surgical resection of craniopharyngioma. Craniopharyngiomas are relatively common lesions, accounting for 6-7% of brain tumors in children. They are histologically benign, causing symptoms by their growth within the sella and suprasellar cistern with compression of adjacent structures, especially the pituitary gland, hypothalamus and optic nerves, chiasm, and tracts. Complete surgical resection, particularly of large tumors, is complicated by the fact that the lesions are usually found within the circle of Willis, with displacement and adherence to the adventitia of these vessels [1, 2]. Recent reports in the neurosurgical literature have described aneurysmal dilatation of the supraclinoid internal carotid arteries following aggressive surgical resection of craniopharyngioma [3, 4].

  7. Endovascular treatment of traumatic carotid cavernous fistula with trapping technique

    Directory of Open Access Journals (Sweden)

    Benny Young

    2013-08-01

    Full Text Available Conventional endovascular treatment for carotid cavernous fistula (CCF involves a direct delivery of either coils, detachable balloon or both to the fistula with end point of CCF resolution and carotid artery preservation. But in few cases with severe laceration of carotid artery, the feasible endovascular technique applicable is by blocking the filling of fistula from cerebral circulation. This method known as trapping technique which implicates carotid artery occlusion, was performed in our present case with good result. (Med J Indones. 2013;22:178-82. doi: 10.13181/mji.v22i3.588Keywords: Carotid cavernous fistula (CCF, carotid occlusion, trapping technique

  8. Severe orthostatic hypotension due to unilateral carotid artery dissection

    Directory of Open Access Journals (Sweden)

    Nobuyuki Ishii

    2014-06-01

    Full Text Available A 46-year-old woman was admitted to our hospital with mild right-sided hemiparesis and orthostatic hypotension. Magnetic resonance angiography of the neck showed stenosis of the left distal carotid sinus surrounded by intraluminal hyperintensities on both T1-weighted and T2-weighted images, representing a periluminal hematoma secondary to carotid artery dissection. The dissection hyperextended the carotid artery wall and stimulated baroreceptors in the carotid sinus. The stimulated baroreceptors induced carotid sinus hypersensitivity, which may have been related to her orthostatic hypotension. Post-stroke orthostatic hypotension should prompt consideration of carotid artery dissection.

  9. Clinical Results of Carotid Denervation by Adventitial Stripping in Carotid Sinus Syndrome

    NARCIS (Netherlands)

    Toorop, R. J.; Scheltinga, M. R.; Huige, M. C.; Moll, F. L.

    2010-01-01

    Aims: Older patients with spells of syncope may suffer from a carotid sinus syndrome (CSS). Patients with invalidating CSS routinely receive pacemaker treatment. This study evaluated the safety and early outcome of a surgical technique termed carotid denervation by adventitial stripping for CSS trea

  10. Metastatic tumor to the iris and ciliary body as an initial sign of lung cancer: a case report

    Institute of Scientific and Technical Information of China (English)

    SUI Rui-fang; ZHAO Jia-liang; ZHANG Shun-hua; FENG Rui-e; CHENG Gang-wei; MA Jian-min; MAO Jin

    2005-01-01

    @@ The most common sites of lung cancer metastases are pleura, bone, brain, pericardium and liver.1 Tumor metastasis to the eye is a rare complication of lung cancer. Metastatic cancer to the ocular region most often involves the uveal tract, however, most uveal metastases occur in the posterior uvea, and iris metastases are relatively rare. We describe a patient with adenocarcinoma of the lung metastatic to the iris as the first clinical sign without symptoms of lung cancer.

  11. Coping and quality of life in patients with skin tumors in the follow-up stage: The mediating role of body image and psychological morbidity.

    Science.gov (United States)

    Pereira, M Graça; Baia, Vânia; Machado, José C

    2016-01-01

    This study examined the relationships between coping style, body image, psychological morbidity, and quality of life. A total of 58 patients who were diagnosed with skin tumors, had been submitted to surgery, and were in the follow-up phase answered the following instruments: dermatology life quality index (DLQI), hospital anxiety and depression scales (HADS), body image scale (BIS), and the mini mental adjustment to cancer scale (Mini-MAC). The results showed that patients with a higher use of the coping styles of helplessness/hopelessness, anxious preoccupation, and cognitive avoidance reported a worse quality of life. Body image mediated the relationship between the coping styles of anxious preoccupation, helplessness/hopelessness, and quality of life. Psychological morbidity mediated the relationship between helplessness/hopelessness and quality of life. Therefore, even in the follow-up phase, it is important that health professionals are aware of the patient's emotional distress and body image to identify those at a higher risk of having a poorer quality of life.

  12. Ventilatory chaos is impaired in carotid atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Laurence Mangin

    Full Text Available Ventilatory chaos is strongly linked to the activity of central pattern generators, alone or influenced by respiratory or cardiovascular afferents. We hypothesized that carotid atherosclerosis should alter ventilatory chaos through baroreflex and autonomic nervous system dysfunctions. Chaotic dynamics of inspiratory flow was prospectively evaluated in 75 subjects undergoing carotid ultrasonography: 27 with severe carotid stenosis (>70%, 23 with moderate stenosis (<70%, and 25 controls. Chaos was characterized by the noise titration method, the correlation dimension and the largest Lyapunov exponent. Baroreflex sensitivity was estimated in the frequency domain. In the control group, 92% of the time series exhibit nonlinear deterministic chaos with positive noise limit, whereas only 68% had a positive noise limit value in the stenoses groups. Ventilatory chaos was impaired in the groups with carotid stenoses, with significant parallel decrease in the noise limit value, correlation dimension and largest Lyapunov exponent, as compared to controls. In multiple regression models, the percentage of carotid stenosis was the best in predicting the correlation dimension (p<0.001, adjusted R(2: 0.35 and largest Lyapunov exponent (p<0.001, adjusted R(2: 0.6. Baroreflex sensitivity also predicted the correlation dimension values (p = 0.05, and the LLE (p = 0.08. Plaque removal after carotid surgery reversed the loss of ventilatory complexity. To conclude, ventilatory chaos is impaired in carotid atherosclerosis. These findings depend on the severity of the stenosis, its localization, plaque surface and morphology features, and is independently associated with baroreflex sensitivity reduction. These findings should help to understand the determinants of ventilatory complexity and breathing control in pathological conditions.

  13. Ultrasonic Measurement of Carotid Intima–Media Thickness in a Group of Iranian with No Cardiovascular Risk Factors

    Directory of Open Access Journals (Sweden)

    M. Pourafkari

    2006-06-01

    Full Text Available Background/Objective: To obtaining reference values for intima–media thickness (IMT of the carotid arteries in the Iranian subjects without any known atherosclerosis risk factors. Patients and Methods: A total of 400 subjects (146 male and 254 female, mean age 36.3±14 years in men and 35.9±12 years in women, with normal body mass index and no history or evidence of cardiovascular or peripheral vascular disease, hypertension, diabetes, thyroid diseases or smoking were examined. IMT was measured on a longitudinal ultrasound image of the carotid artery. Mean thickness was evaluated for the right common carotid (RCCA, right internal carotid (RICA, left common carotid (LCCA and left internal carotid (LICA. Results: The mean value of carotid IMT was 0.38±0.11 in women and 0.41±0.13 in men. For different age groups, the lowest mean thickness was 0.305±0.045, seen in the RCCA among 20–29-year-old cases, and the highest was 0.645±0.125, seen in the LICA of cases over 60. The mean thickness was higher in men than in women, in all four locations (all p values< 0.02 Linear regression models for prediction of IMT by age, were separately done in different groups of anatomical location and gender, and all models’ R2 were higher than 0.5. Conclusion: Mean IMT in RCCA, RICA, LCCA and LICA in both genders and different age dec-ades was lower than many reports, which may be due to ethnic factors or different inclusion criteria. Reference values of carotid IMT increase significantly with age and IMT is higher in men than in women.

  14. 中青年男性体脂分布与颈动脉内膜中层厚度的相关研究%The study of relationship between body fat distribution and carotid intima-media thickness in young and middle-aged men

    Institute of Scientific and Technical Information of China (English)

    马春朋; 刘兰祥; 杨蕾; 刘晓丽; 王锐; 尹福在; 陆强

    2013-01-01

    Objective To evaluate the relationship between fat distribution and carotid intima-media thickness (CIMT) in young and middle-aged men.Methods Five hundred and one men aged 20-50 years who took physical examination in the first hospital of qinhuangdao were selected.The abdominal obesity group included 299 cases with waist circumference ≥90 cm,and the normol waist circumference group included 202 cases with waist circumference <90 cm.Height,weight and waist circumference were measured and body mass index was calculated.Fasting insulin (FINS) and fasting plasma glucose (FPG) were detected,and homeostasis model assay insulin resistance index (HOMA-IR) was calculated.Total body fat mass (BF),body muscle mass (BM),truncal fat mass (TrF),upper limb fat mass (UF),limb fat mass (LF) were measured by dual energy X-ray absorptiometry (DEXA).BF%(=BF/W) and TrF/BF were calculated.CIMT was detected with color ultrasound.Results (1) The abdominal obesity group showed increased levels of BF%,TrF/BF,BF,BM,TrF,UF,LF,body mass index,waist circumference,CIMT and HOMA-IR,compared with normol waist circumference group (all P <0.05).(2) In Pearson correlation analysis,CIMT had positive correlation with BF%,TrF/BF,BF,BM,TrF,UF,LF,body mass index and waist circumference (R=0.443,0.481,0.429,0.377,0.472,0.376,0.304,all P <0.05).(3)In Pearson correlation analysis,HOMA-IR had positive correlation with BF%,TrF/BF,BF,BM,TrF,UF,LF,body mass index,waist circumference(R =0.510,0.441,0.576,0.502,0.528,0.526,0.577,0.384,0.639,all P<0.05).HOMA-IR had positive correlation with CIMT (R =0.416,P <0.05).(4)In multiple regression analyses,TrF/BF and body mass index were the independent risk factors of CIMT.Conclusion Fat distribution was closely related with CIMT and insulin resistance in young and middle-aged men.To prevent carotid atherosclerosis and cardiovascular diseases,exercise should be recommended and abdominal obesity should be avoided.%目的 探讨中青年男性体

  15. Tumor control probability and the utility of 4D vs 3D dose calculations for stereotactic body radiotherapy for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Valdes, Gilmer, E-mail: gilmer.valdes@uphs.upenn.edu [Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA (United States); Robinson, Clifford [Department of Radiation Oncology, Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO (United States); Lee, Percy [Department of Radiation Oncology, David Geffen School of Medicine, UCLA, Los Angeles, CA (United States); Morel, Delphine [Department of Biomedical Engineering, AIX Marseille 2 University, Marseille (France); Department of Medical Physics, Joseph Fourier University, Grenoble (France); Low, Daniel; Iwamoto, Keisuke S.; Lamb, James M. [Department of Radiation Oncology, David Geffen School of Medicine, UCLA, Los Angeles, CA (United States)

    2015-04-01

    Four-dimensional (4D) dose calculations for lung cancer radiotherapy have been technically feasible for a number of years but have not become standard clinical practice. The purpose of this study was to determine if clinically significant differences in tumor control probability (TCP) exist between 3D and 4D dose calculations so as to inform the decision whether 4D dose calculations should be used routinely for treatment planning. Radiotherapy plans for Stage I-II lung cancer were created for 8 patients. Clinically acceptable treatment plans were created with dose calculated on the end-exhale 4D computed tomography (CT) phase using a Monte Carlo algorithm. Dose was then projected onto the remaining 9 phases of 4D-CT using the Monte Carlo algorithm and accumulated onto the end-exhale phase using commercially available deformable registration software. The resulting dose-volume histograms (DVH) of the gross tumor volume (GTV), planning tumor volume (PTV), and PTV{sub setup} were compared according to target coverage and dose. The PTV{sub setup} was defined as a volume including the GTV and a margin for setup uncertainties but not for respiratory motion. TCPs resulting from these DVHs were estimated using a wide range of alphas, betas, and tumor cell densities. Differences of up to 5 Gy were observed between 3D and 4D calculations for a PTV with highly irregular shape. When the TCP was calculated using the resulting DVHs for fractionation schedules typically used in stereotactic body radiation therapy (SBRT), the TCP differed at most by 5% between 4D and 3D cases, and in most cases, it was by less than 1%. We conclude that 4D dose calculations are not necessary for most cases treated with SBRT, but they might be valuable for irregularly shaped target volumes. If 4D calculations are used, 4D DVHs should be evaluated on volumes that include margin for setup uncertainty but not respiratory motion.

  16. Disability, body image and sports/physical activity in adult survivors of childhood CNS tumors: population-based outcomes from a cohort study.

    Science.gov (United States)

    Boman, Krister K; Hörnquist, Lina; De Graaff, Lisanne; Rickardsson, Jenny; Lannering, Birgitta; Gustafsson, Göran

    2013-03-01

    Childhood CNS tumor survivors risk health and functional impairments that threaten normal psychological development and self-perception. This study investigated the extent to which health and functional ability predict adult survivors' body image (BI) and self-confidence regarding sports and physical activity. The study cohort covered 708 eligible ≥ 18 year old CNS tumor survivors, and data from 528 (75 %) were analyzed. Disability was estimated using the Health Utilities Index™ Mark2/3, a multidimensional self-report instrument. Physical self-confidence in terms of BI and sports/physical activity-related self-confidence (SPAS) were assessed using the BI and the Sports/Athletics modules of a standardized self-report assessment scale. In adjusted regression models, global health and functional status (GHFS) predicted BI (B = 0.94, 95 % CI 0.69-1.19) and SPAS (B = 0.79, 95 % CI 0.55-1.04). Emotion and pain, and to a lesser degree cognition, speech and vision disability, were associated with poorer BI and SPAS. Gender, sub-diagnosis, and time since diagnosis influenced the relationship between health status and physical self-confidence outcomes. Females had poorer GHFS, BI and SPAS than males. Decreased health and functional ability following childhood CNS cancer intrudes on physical self-confidence, with females being at heightened risk for both disability and negative self-confidence. Identified disability and gender-related risk calls for a follow-up plan that integrates treatment of psychological sequelae in lifetime monitoring of childhood CNS tumor survivors to restore and protect self-image and self-confidence, essential mental health correlates. An expanded plan should recognize the need for such services, optimizing life-long quality of survival for CNS tumor survivors.

  17. Association of circulating omentin-1 level with arterial stiffness and carotid plaque in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Yoo Hye

    2011-11-01

    Full Text Available Abstract Background Adipokines contribute directly to the atherosclerotic process, connecting metabolic disorders such as obesity and diabetes to cardiovascular disease. Omentin-1 is a recently discovered novel adipokine, so data about the relationship of this adipokine to vascular health in type 2 diabetes is limited. Methods We enrolled 60 people with type 2 diabetes, with or without carotid plaque, and 30 participants with normal glucose tolerance. We measured serum omentin-1, high-sensitivity C-reactive protein (hsCRP levels, and the homeostasis model assessment of insulin resistance (HOMA-IR, as well as other cardiovascular risk factors. Vascular health was assessed by brachial ankle pulse wave velocity (baPWV and carotid intima-media thickness (IMT. Results Serum omentin-1 levels were significantly decreased in type 2 diabetes patients compared to normal glucose controls and was further reduced in type 2 diabetes patients with carotid plaque compared to those without carotid plaque. Multiple stepwise regression analysis showed that age, systolic blood pressure, history of use of statins, angiotensin receptor blockers or angiotensin-converting enzyme inhibitors, and serum omentin-1 level were independent factors determining baPWV in people with type 2 diabetes (r2 = 0.637. Furthermore, in multivariate logistic regression analysis, circulating omentin-1 level was an independent decisive factor for the presence of carotid plaque in type 2 diabetes patients, even after adjusting for age, gender, body mass index, systolic blood pressure, fasting blood glucose, low density lipoprotein cholesterol, and history of smoking and medication (odds ratio, 0.621; 95% confidence interval, 0.420-0.919; P = 0.017. Conclusions Circulating omentin-1 level was independently correlated with arterial stiffness and carotid plaque in type 2 diabetes, even after adjusting for other cardiovascular risk factors and detailed medication history.

  18. Image guided respiratory gated hypofractionated Stereotactic Body Radiation Therapy (H-SBRT) for liver and lung tumors: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Wurm, R.E.; Gum, F.; Erbel, S. [Charite Campus Mitte, Berlin (Germany). Dept. of Radiation Oncology

    2006-09-15

    To evaluate our initial experience with image guided respiratory gated H-SBRT for liver and lung tumors. The system combines a stereoscopic x-ray imaging system (ExacTrac{sup R} X-Ray 6D) with a dedicated conformal stereotactic radiosurgery and radiotherapy linear accelerator (Novalis) and ExacTrac{sup R} Adaptive Gating for dynamic adaptive treatment. Moving targets are located and tracked by x-ray imaging of implanted fiducial markers defined in the treatment planning computed tomography (CT). The marker position is compared with the position in verification stereoscopic x-ray images, using fully automated marker detection software. The required shift for a correct, gated set-up is calculated and automatically applied. We present our acceptance testing and initial experience in patients with liver and lung tumors. For treatment planning CT and Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) as well as magnetic resonance imaging (MRI) taken at free breathing and expiration breath hold with internal and external fiducials present were used. Patients were treated with 8-11 consecutive fractions to a dose of 74.8-79.2 Gy. Phantom tests demonstrated targeting accuracy with a moving target to within {+-}1 mm. Inter- and intrafractional patient set-up displacements, as corrected by the gated set-up and not detectable by a conventional set-up, were up to 30 mm. Verification imaging to determine target location during treatment showed an average marker position deviation from the expected position of up to 4 mm on real patients. This initial evaluation shows the accuracy of the system and feasibility of image guided real-time respiratory gated H-SBRT for liver and lung tumors.

  19. [Ischaemic lesions of cerebral after carotid stenting].

    Science.gov (United States)

    Medvedev, R B; Tanashian, M M; Kuntsevich, G I; Lagoda, O V; Skrylev, S I; Krotenkova, M V; Koshcheev, A Iu; Suslin, A S; Gemdzhian, É G

    2015-01-01

    Carotid angioplasty with stenting is a reliable method of primary and secondary prevention of ischaemic stroke in patients with stenosing lesions of the internal carotid artery. However, carrying out such operations is sometimes associated with risk for the development of intraoperative impairments of cerebral circulation due to arterioarterial embolism in cerebral arteries, as well as vasospasm. Presented herein are the results of following up a total of 64 patients with pronounced atherosclerotic lesions of internal carotid arteries (>70%) - "symptomatic" and "asymptomatic", undergoing carotid stenting. Acute foci of ischaemia in the brain after stenting according to the findings of diffusion-weighted magnetic resonance tomography were revealed in 40% of cases, and in only 6% of patients they manifested themselves by symptoms of acute cerebral circulatory impairment. We revealed a direct correlation between the number, size of infarctions in the brain, and the appearance of neurological symptomatology. Intraoperative monitoring of blood flow in the middle cerebral artery during stenting makes it possible to predict the appearance of acute foci of cerebral ischaemia, to specify the genesis of perioperative stroke, as well as to evaluate clinical significance of vasospasm and material microembolism. The obtained findings should concentrate neurologists' attention on active postoperative follow up of patients subjected to carotid angioplasty with stenting in order to perform adequate personified neuroprotective correction, including preventive one.

  20. MIGRAINE, CAROTID STIFFNESS AND GENETIC POLYMORPHISM.

    Science.gov (United States)

    Kes, Vanja Basić; Jurasić, Miljenka-Jelena; Zavoreo, Iris; Corić, Lejla; Rotim, Kresimir

    2015-12-01

    Recently migraine has been associated with increased arterial stiffness, procoagulant state, increased incidence of cerebral white matter lesions (WML) and stroke. Our aim was to compare the characteristics of migraineurs to headache free controls regarding their functional carotid ultrasound parameters. Sixty patients (45 women) with migraine (mean age 40.42 ± 10.61 years) were compared with 45 controls (30 women) with no prior history of repeating headache (mean age 38.94 ± 5.46 years) using E-tracking software on Alpha 10 ultrasound platform. Student's t-test was used on statistical analysis with alpha < 0.05. All tested carotid vascular parameters were worse in patients with migraine including increased intima-media thickness, greater carotid diameter and carotid diameter change, as well as several arterial stiffness indices. Additionally, patients with migraine had greater incidence of homozygous mutations for procoagulant genes (MTHFR (C677T), PAI-1 and ACE I/D) than expected. Computed tomography and magnetic resonance imaging of the brain showed WML in 11 patients, four of them migraine with aura patients. Since we established increased carotid stiffness and higher frequency of procoagulant gene mutations in migraineurs, we propose prospective ultrasound monitoring in such patients, especially those with detected WML, in order to timely commence more active and specific preventive stroke management strategies.

  1. A Rare Diabetic Autonomic Neuropathy: Carotid Sinus Hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ahmet Kaya

    2016-03-01

    Full Text Available Carotid sinus hypersensitivity is a common cause of fainting and falls in the elderly, and can be diagnosed by carotid sinus massage. We present a 67-year-old diabetic man who was admitted with hyperglycemia. During thyroid examination, clouding of consciousness occurred with unilateral palpation. Asystole was documented for 4.8 seconds and suspected for 7 seconds upon carotid sinus massage. A cardioverter defibrillator was implanted. Carotid sinus hypersensitivity should be kept in mind when examining diabetic patients.

  2. Volumetric response classification in metastatic solid tumors on MSCT: Initial results in a whole-body setting

    Energy Technology Data Exchange (ETDEWEB)

    Wulff, A.M., E-mail: a.wulff@rad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Fabel, M. [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Freitag-Wolf, S., E-mail: freitag@medinfo.uni-kiel.de [Institut für Medizinische Informatik und Statistik, Brunswiker Str. 10, 24105 Kiel (Germany); Tepper, M., E-mail: m.tepper@rad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Knabe, H.M., E-mail: h.knabe@rad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Schäfer, J.P., E-mail: jp.schaefer@rad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Jansen, O., E-mail: o.jansen@neurorad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Bolte, H., E-mail: hendrik.bolte@ukmuenster.de [Klinik für Nuklearmedizin, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster (Germany)

    2013-10-01

    Purpose: To examine technical parameters of measurement accuracy and differences in tumor response classification using RECIST 1.1 and volumetric assessment in three common metastasis types (lung nodules, liver lesions, lymph node metastasis) simultaneously. Materials and methods: 56 consecutive patients (32 female) aged 41–82 years with a wide range of metastatic solid tumors were examined with MSCT for baseline and follow up. Images were evaluated by three experienced radiologists using manual measurements and semi-automatic lesion segmentation. Institutional ethics review was obtained and all patients gave written informed consent. Data analysis comprised interobserver variability operationalized as coefficient of variation and categorical response classification according to RECIST 1.1 for both manual and volumetric measures. Continuous data were assessed for statistical significance with Wilcoxon signed-rank test and categorical data with Fleiss kappa. Results: Interobserver variability was 6.3% (IQR 4.6%) for manual and 4.1% (IQR 4.4%) for volumetrically obtained sum of relevant diameters (p < 0.05, corrected). 4–8 patients’ response to therapy was classified differently across observers by using volumetry compared to standard manual measurements. Fleiss kappa revealed no significant difference in categorical agreement of response classification between manual (0.7558) and volumetric (0.7623) measurements. Conclusion: Under standard RECIST thresholds there was no advantage of volumetric compared to manual response evaluation. However volumetric assessment yielded significantly lower interobserver variability. This may allow narrower thresholds for volumetric response classification in the future.

  3. Stereotactic Body Radiation Therapy for Non-Small Cell Lung Cancer Tumors Greater Than 5 cm: Safety and Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Woody, Neil M., E-mail: woodyn@ccf.org; Stephans, Kevin L.; Marwaha, Gaurav; Djemil, Toufik; Videtic, Gregory M.M.

    2015-06-01

    Purpose: The purpose of this study was to determine outcomes of patients with node-negative medically inoperable non-small cell lung cancer (NSCLC) whose primary tumors exceeded 5 cm and were treated with stereotactic body radiation therapy (SBRT). Methods and Materials: We surveyed our institutional prospective lung SBRT registry to identify treated patients with tumors >5 cm. Treatment outcomes for local control (LC), locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) were assessed by Kaplan-Meier estimates. Toxicities were graded according to Common Terminology Criteria for Adverse Events version 4. Mean pretreatment pulmonary function test values were compared to mean posttreatment values. Results: From December 2003 to July 2014, 40 patients met study criteria. Median follow-up was 10.8 months (range: 0.4-70.3 months). Median age was 76 years (range: 56-90 years), median body mass index was 24.3 (range: 17.7-37.2), median Karnofsky performance score was 80 (range: 60-90), and median Charlson comorbidity index score was 2 (range: 0-5). Median forced expiratory volume in 1 second (FEV1) was 1.41 L (range: 0.47-3.67 L), and median diffusion capacity (DLCO) was 47% of predicted (range: 29%-80%). All patients were staged by fluorodeoxyglucose-positron emission tomography/computed tomography staging, and 47.5% underwent mediastinal staging by endobronchial ultrasonography. Median tumor size was 5.6 cm (range: 5.1-10 cm), median SBRT dose was 50 Gy (range: 30-60 Gy) in 5 fractions (range: 3-10 fractions). Eighteen-month LC, LRC, DFS, and OS rates were 91.2%, 64.4%, 34.6%, and 59.7%, respectively. Distant failure was the predominant pattern of failure (32.5%). Three patients (7.5%) experienced grade 3 or higher toxicity. Mean posttreatment FEV1 was not significantly reduced (P=.51), but a statistically significant absolute 6.5% (P=.03) reduction in DLCO was observed. Conclusions: Lung SBRT for medically inoperable node

  4. Endarterectomy or carotid artery stenting : the quest continues part two

    NARCIS (Netherlands)

    Kolkert, Joe L.; Meerwaldt, Robbert; Geelkerken, Robert H.; Zeebregts, Clark J.

    2015-01-01

    BACKGROUND: Although randomized trials on carotid artery stenting (CAS) could not establish its equivalence to carotid endarterectomy (CEA) in patients with symptomatic carotid disease, CAS is rapidly evolving. Data on long-term outcome after CAS from randomized trials have now become available and

  5. Agenesis of internal carotid artery associated with congenital anterior hypopituitarism

    Energy Technology Data Exchange (ETDEWEB)

    Moon, W.-J. [Department of Diagnostic Radiology, Samsung Medical Center, Seoul (Korea); Institute of Neuroradiology, University of Frankfurt (Germany); Porto, L.; Lanfermann, H.; Zanella, F.E. [Institute of Neuroradiology, University of Frankfurt (Germany); Weis, R. [Department of Pediatric Neurology, University of Frankfurt (Germany)

    2002-02-01

    We report a rare case of unilateral agenesis of the internal carotid artery in association with congenital anterior hypopituitarism. The collateral circulation is supplied by a transsellar intercavernous anastomotic vessel connecting the internal carotid arteries. These abnormalities are well depicted on MRI and MRA. The agenesis of the internal carotid artery may explain the pathogenesis of some of congenital anterior hypopituitarism. (orig.)

  6. Pituitary Tumors: Condition Information

    Science.gov (United States)

    ... and metabolism. Thyroid-stimulating hormone is involved in growth, body temperature, and heart rate. Nonfunctioning pituitary tumors (also called nonsecretory tumors) do not produce hormones. They can press on or damage the pituitary ...

  7. Primary gastric cancer presenting with a metastatic embolus in the common carotid artery: a case report

    Directory of Open Access Journals (Sweden)

    Zhang Ying

    2012-10-01

    Full Text Available Abstract Although about 30% of gastric cancers have distant metastasis at the time of initial diagnosis, metastatic tumor embolus in the main blood vessels is not common, especially in the main artery. The report presents, for the first time, an extremely rare clinical case of a metastatic embolus in the common carotid artery (CCA from primary gastric cancer. Metastatic embolus from the primary tumor should be considered when patients present with gastric cancer accompanied by intravascular emboli. The patient should be actively examined further so as to allow early detection and treatment.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  9. Carotid Artery Stenting 2013: Thumbs up

    Science.gov (United States)

    Wagdi, Philipp

    2013-01-01

    It has been customary for interventional cardiologists involved in carotid artery stenting, to underline non-inferiority of the percutaneous technique versus surgical carotid endarterectomy. To that end, all cause morbidity and mortality figures of both methods are compared. Surgery has, in most large randomized studies, had an edge over stenting in terms of cerebrovascular adverse events. This may have partly been due to occasional indiscriminate indication for stenting in lesions and/or vessels with unfavourable characteristics (severe target vessel tortuosity and calcification, Type III aortic arch, and so on). On one hand, the author pleads for improvement of the excellent results of endarterectomy, by subjecting all patients planned for surgery to a thorough preoperative cardiological work up, including generous invasive investigation, thus reducing the incidence of perioperative myocardial infarction, heart failure and cardiac death. On the other hand, we are convinced that the results of carotid stenting should then be compared to best practice surgery. The rate of neurological adverse event rate after carotid endarterectomy at our institution lies under 0.7% at 30 days postoperatively. Specifically, the goal should be that carotid stenting underbids surgical endarterectomy, also and mainly, in terms of cerebral and cerebrovascular adverse events. Cardiac morbidity and mortality as well as laryngeal nerve palsy should no more be the main arguments for the percutaneous approach. This should easily be possible if patient selection for carotid revascularisation would be approached according to morphological criteria, in analogy with the “Syntax”-score used to optimise revascularisation strategies in coronary artery disease.

  10. Percutaneous catheter dilatation of carotid stenoses

    Energy Technology Data Exchange (ETDEWEB)

    Mathias, K.; Mittermayer, C.; Ensinger, H.; Neff, W.

    1980-09-01

    Thirty-one carotid artery stenoses were produced in thirty dogs by three different techniques. Twenty-three of these could be cured by transfemoral percutaneous catheter dilatation. High grade tight stenoses may present resistance which cannot be overcome by the catheter. Histological examination of the dilated vessels showed circumscribed changes in the vessel wall, with destruction of elastic membranes. From our experience of catheter dilatation of pelvic and lower limb arteries and of renal arteries, we consider it feasible to use this technique in selected patients with carotid stenosis.

  11. Percutaneous cervical carotid artery access with stenting of the left internal carotid artery in an elderly patient

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for symptoms of progressive weakness with disorientation and dysphasia. Carotid Duplex ultrasonography was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery by velocities of 608/240 cm/sec. The patient refused surgical endarterectomy and thus he was referred for carotid artery stenting. Using the femoral artery approach and multiple catheter techniques, access to the common carotid artery could not be accomplished safely. The procedure was aborted and he was therefore brought back to the catheterization laboratory the following day for direct carotid access. Carotid artery stenting was accomplished by using of a 6F sheath percutaneously in the left common carotid, cerebral protection device (CPD) and a Nitinol stent. The patient was discharged the following day without complications. At 14 months follow-up the patient is functional and independent without recurrence of symptoms. Carotid artery stenting via direct access can be accomplished in patients when the femoral artery approach is anatomically prohibitive. In this case of advanced age and the patient's refusal for surgery, direct carotid access was his only option.

  12. 恶性颈动脉体瘤合并闭经和泌乳一例%A case of malignant tumor of carotid body complicated with amenorrhea and galactorrhea

    Institute of Scientific and Technical Information of China (English)

    高继东; 贾乃镛; 高芬; 李积德; 马立公; 鲍海华

    2001-01-01

    @@  患者女,36岁,右下颌肿物5年余伴低热1年。于1998年11月2日入院。5年前发现右下颌蚕豆大小的无痛肿块,3年前出现停经、溢乳。根据血清催乳素(PRL)水平及头颅MRI检查诊断泌乳—闭经症。口服溴隐亭治疗,月经恢复,催乳素降至正常水平,以后每日服溴隐亭2.5 mg维持治疗。2年前感右下颌肿物逐渐增大,行手术治疗,发现肿物呈椭圆形包绕颈内外动脉分叉部,因与颈动脉粘连紧密未能剥离。术后诊断:颈动脉体瘤。经CT检查示右侧颈内外动脉分叉处,45 mm×48 mm圆形低密度影,边界清,病灶将右侧颈内静脉向外推压,增强后病灶明显增强,同血管密度。1年来出现午后低热、盗汗、消瘦症状。X线片发现双肺结节样肿块数个、类园形(直径1~2 cm),密度均匀,边界清。CT检查诊断为肺转移瘤。肺组织活检免疫组化分析:神经原特异性烯醇化酶(neuron-specific enolase,NSE),嗜铬粒素(CgA)。既住无糖尿病及风湿病史,结婚10年,G1P1,月经14,(3-5)/(28-31),1998年5月7日。父母体健,家族中无遗传病史。体检:体温37.5℃,脉搏90次/分,呼吸20次/分,血压120/60 mm Hg(1 mm Hg=0.133 kPa),发育正常,精神差。右下颌角前下方可触及一约3 cm×5 cm大小的肿块,中等硬度、边界清、无触痛、活动度欠佳。甲状腺(-)、气管居中,双肺呼吸音略粗糙,心(-),肝脾未触及。神经系统病理反射(-)。住院期间实验室检查:血沉130~168 mm/h,血清总蛋白61~67 g/L、白蛋白20~31 g/L、球蛋白36~41 g/L。自身抗体:抗核抗体(ANA)+、抗核糖核酸蛋白抗体(32kd、29kd)+、A-SSB(47kd)+、A-SSA(52kd)±、抗核糖体蛋白抗体(38kd)+、口服葡萄糖耐量试验血糖水平:0h 12.9 mmol/L、0.5h 20.9 mmol/L、1h 24.6 mmol/L、2h 23.3 mmol/L。免疫反应性胰岛素:0h 5 mU/L、0.5h 20 mU/L、1h 26 mU/L、2h 10 mU/L。血清甲状腺激素:T3 0~0.3 nmol/L(正常值0.8~2.94 nmol/L)、T4 50~72 nmol/L(正常值43~183 nmol/L)、FT3 0.05~0.9 pmol/L(正常值3.18~9.22 pmol/L)、FT4 4.68~17.00 pmol/L(正常值8.6~25.6 pmol/L)、促甲状腺激素(TSH)0 mU/L(正常值0~8 mU/L)、皮质醇157~224 μg/L(正常值50~250 μg/L)、促生长素(GH)1.0~1.2 μg/L(正常值<5 μg/L)、促性腺激素FSH 0.0~1.5 IU/L(正常值3~30 IU/L)、LH 0 IU/L(正常值3~16.8 IU/L),催乳素29 μg/L(正常值2~25 μg/L)。住院半年,终因病情恶化未能救治。

  13. 恶性实体瘤全身伽玛刀适形放疗643例报告%Clinical study of gamma ray whole body therapeutic system for malignant tumors(report of 643 cases)

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective: To evaluate the feasibility of the whole body gamma knife in the treatment of malignant solid tumors.Methods: 643 patients diagnosed by pathology or cytology were treated with the whole body gamma knife.They received a total dose from 40-60 Gy/2-3 w, 3-10 Gy/fraction, 5 fractions/week.Results: The rates of response, complete remission, partial remission, no remission, and tumor progression were 94.6%, 39.2%, 55.4%, 5.1% and 0.3%, respectively.Conclusion: Whole body γ-radiation system(γ-knife)was an effective method in treatment of patients with malignant tumor.

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

    Directory of Open Access Journals (Sweden)

    Ding-biao ZHOU

    2014-01-01

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

  15. Carotid artery stenting in patients with coexistent carotid and coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    LUO Jian-fang; HUANG Wen-hui; WANG Shuo; DAI Cheng-bo; LI Guang; CHEN Ji-yan; ZHOU Ying-ling; WANG Li-juan

    2007-01-01

    @@ Atherosclerotic disease, as a systemic process, affects all arteries to varying degrees. In particular,coexistent carotid and coronary artery diseases are common; Management of such patients has been a point of continuing controversy.

  16. MR coil sensitivity inhomogeneity correction for plaque characterization in carotid arteries

    Science.gov (United States)

    Salvado, Olivier; Hillenbrand, Claudia; Suri, Jasjit; Wilson, David L.

    2004-05-01

    We are involved in a comprehensive program to characterize atherosclerotic disease using multiple MR images having different contrast mechanisms (T1W, T2W, PDW, magnetization transfer, etc.) of human carotid and animal model arteries. We use specially designed intravascular and surface array coils that give high signal-to-noise but suffer from sensitivity inhomogeneity. With carotid surface coils, challenges include: (1) a steep bias field with an 80% change; (2) presence of nearby muscular structures lacking high frequency information to distinguish bias from anatomical features; (3) many confounding zero-valued voxels subject to fat suppression, blood flow cancellation, or air, which are not subject to coil sensitivity; and (4) substantial noise. Bias was corrected using a modification of the adaptive fuzzy c-mean method reported by Pham et al. (IEEE TMI, 18:738-752), whereby a bias field modeled as a mechanical membrane was iteratively improved until cluster means no longer changed. Because our images were noisy, we added a noise reduction filtering step between iterations and used about 5 classes. In a digital phantom having a bias field measured from our MR system, variations across an area comparable to a carotid artery were reduced from 50% to <5% with processing. Human carotid images were qualitatively improved and large regions of skeletal muscle were relatively flat. Other commonly applied techniques failed to segment the images or introduced strong edge artifacts. Current evaluations include comparisons to bias as measured by a body coil in human MR images.

  17. Hyperuricemia and carotid artery dilatation among young adults without metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Eswar Krishnan

    2012-10-01

    Full Text Available It is not known if hyperuricemia is associated with early vascular changes signifying arteriosclerosis. We performed a cross sectional study of 163 young adults without metabolic syndrome in Allegheny County, PA, USA. Doppler ultrasound was used to measure two metrics of early arteriosclerosis: carotid artery dimensions and aortic pulse wave velocity. Individuals in the highest quartiles of serum uric acid (>6.2 mg/dL for men and >4.6 for women were more likely to be of younger age, and to possess greater measures of adiposity and an adverse cardiovascular risk profile. Higher serum uric acid concentration was associated with larger luminal and adventitial diameters as well as changes in diameters between the phases of the cardiac cycle (P<0.001 but not with carotid intima media thickness, pulse wave velocity, or pressure strain modulus. In multivariable linear regression models where the effects of age, ethnicity, serum creatinine, systolic blood pressure, current alcohol use, body mass index and smoking status were accounted for, the highest quartile of serum uric acid was associated with greater luminal and adventitial diameters and change in luminal diameter between the phases of cardiac cycle (P<0.05, but not with pulse wave velocity, pressure strain modulus or carotid intima media thickness. We can conclude that hyperuricemia is associated with larger carotid artery diameters signifying an early adaptive response to vascular stress. This has implications on the observed link between hyperuricemia and hypertension.

  18. Serum carotenoids reduce progression of early atherosclerosis in the carotid artery wall among Eastern Finnish men.

    Directory of Open Access Journals (Sweden)

    Jouni Karppi

    Full Text Available BACKGROUND: Several previous epidemiologic studies have shown that high blood levels of carotenoids may be protective against early atherosclerosis, but results have been inconsistent. We assessed the association between atherosclerotic progression, measured by intima-media thickness of the common carotid artery wall, and serum levels of carotenoids. METHODS: We studied the effect of carotenoids on progression of early atherosclerosis in a population-based study. The association between concentrations of serum carotenoids, and intima-media thickness of the common carotid artery wall was explored in 840 middle-aged men (aged 46-65 years from Eastern Finland. Ultrasonography of the common carotid arteries were performed at baseline and 7-year follow-up. Serum levels of carotenoids were analyzed at baseline. Changes in mean and maximum intima media thickness of carotid artery wall were related to baseline serum carotenoid levels in covariance analyses adjusted for covariates. RESULTS: In a covariance analysis with adjustment for age, ultrasound sonographer, maximum intima media thickness, examination year, body mass index, systolic blood pressure, smoking, physical activity, serum LDL cholesterol, family history of coronary heart disease, antihypertensive medication and serum high sensitivity C-reactive protein, 7-year change in maximum intima media thickness was inversely associated with lycopene (p = 0.005, α-carotene (p = 0.002 and β-carotene (p = 0.019, respectively. CONCLUSIONS: The present study shows that high serum concentrations of carotenoids may be protective against early atherosclerosis.

  19. Stenosis of calcified carotid artery detected on Panoramic Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, So Yang; Oh, Won Mann; Yoon, Suk Ja; Yoon, Woong; Lee, Jae Seo; Kang, Byung Cheol [School of Dentistry, Chonnam National University, Seoul (Korea, Republic of); Palomo, Juan M. [Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland (United States)

    2009-09-15

    This study aimed to investigate the luminal stenosis of the internal carotid artery with calcification detected on panoramic radiographs. This study used fifty carotid arteries of 36 dental patients whose panoramic radiograph and computed tomography angiography (CTA) revealed the presence of carotid artery calcification. A neuroradiologist interpreted CTA to determine the degree of stenosis of the internal carotid arteries. The degree of stenosis was stratified in four stages; normal (no stenosis), mild stenosis (1-49%), moderate stenosis (50-69%) and severe stenosis (70-99%). Among the fifty carotid arteries with calcification detected on both panoramic radiography and CTA, 20 carotid arteries (40%) were normal, 29 carotid arteries (18%) had mild stenosis, 1 carotid artery (2%) had moderate stenosis, and there was none with severe stenosis. Sixty percent of the carotid arteries with calcification detected on both panoramic radiography and CTA had internal luminal stenosis, and two percent had moderate stenosis. When carotid atheroma is detected on panoramic radiograph, it is possible that the dental patient has luminal stenosis of the internal carotid artery.

  20. Endovascular Management of Long-Segmental Petrocavernous Internal Carotid Artery (Carotid S) Occlusion

    OpenAIRE

    Park, Soonchan; Park, Eun Suk; Kwak, Jae Hyuk; Lee, Dong-geun; Suh, Dae Chul; Kwon, Sun U.; Lee, Deok Hee

    2015-01-01

    Background and Purpose Long-segmental thrombotic occlusion of the distal internal carotid artery (ICA) sparing the cervical segment proximally and the supraclinoid segment distally, which could be termed ’Carotid S occlusion’, has an unusual clinical presentation. However, endovascular management of this lesion is challenging. The purpose of our study is to report our endovascular treatment clinical experience of the disease. Methods From March 2008 to June 2013, we could identify 14 patients...

  1. Stroke prevention-surgical and interventional approaches to carotid stenosis

    Directory of Open Access Journals (Sweden)

    Kumar Rajamani

    2013-01-01

    Full Text Available Extra cranial carotid artery stenosis is an important cause of stroke, which often needs treatment with carotid revascularization. To prevent stroke recurrence, carotid endarterectomy (CEA has been well-established for several decades for symptomatic high and moderate grade stenosis. Carotid stenting is a less invasive alternative to CEA and several recent trials have compared the efficacy of the 2 procedures in patients with carotid stenosis. Carotid artery stenting has emerged as a potential mode of therapy for high surgical risk patients with symptomatic high-grade stenosis. This review focuses on the current data available that will enable the clinician to decide optimal treatment strategies for patients with carotid stenosis.

  2. Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography.

    Science.gov (United States)

    Omoto, Shusaku; Hasegawa, Yuki; Sakai, Kenichiro; Matsuno, Hiromasa; Arai, Ayumi; Terasawa, Yuka; Mitsumura, Hidetaka; Iguchi, Yasuyuki

    2016-10-01

    Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy.

  3. Haemodynamic evaluation of carotid artery disease

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T

    1989-01-01

    evaluating therapeutic modalities or natural history of carotid artery disease should therefore include a test capable of assessing cerebral haemodynamics. However, most studies, invasive as well as non-invasive, have focused on the ability of the test to diagnose the ICA lesions itself, rather than...

  4. Management of Extracranial Carotid Artery Aneurysm

    NARCIS (Netherlands)

    Welleweerd, J. C.; den Ruijter, H. M.; Nelissen, B. G. L.; Bots, M. L.; Kappelle, L. J.; Rinkel, G. J. E.; Moll, F. L.; de Borst, G. J.

    2015-01-01

    Introduction: Aneurysms of the extracranial carotid artery (ECAA) are rare. Several treatments have been developed over the last 20 years, yet the preferred method to treat ECAA remains unknown. This paper is a review of all available literature on the risk of complications and long-term outcome aft

  5. Lesion load in unprotected carotid artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Papanagiotou, P.; Roth, C.; Karp, K.; Krick, C.; Schieber, H.; Mueller, M.; Reith, W. [University of the Saarland, Department for Diagnostic and Interventional Neuroradiology, Homburg (Germany); Fassbender, K.; Haass, A. [University of the Saarland, Division of Neurology, Homburg (Germany)

    2009-05-15

    The purpose of the study was to determine the incidence of new ischemic lesions found on diffusion-weighted MR imaging (DWI) in nonselected patients after unprotected carotid artery stent placement. We retrospectively reviewed a nonrandomized cohort of 197 patients presenting with carotid occlusive disease who underwent unprotected carotid artery stent placement between 2003 and 2006. Mean degree of stenosis was 86.94% {+-} 9.72. In all patients, DWI was obtained before and 24 h after stent placement. New lesions were evaluated according to size and location. In 59 of 197 patients (29.9%), new ischemic lesions were found on DWI in the vessel dependent area. In 23 of 197 patients (11.7%), new ischemic lesions were found in the vessel independent area. Combined stroke/death rate was 3.63%. In our series of unprotected carotid angioplasty with stent, we found new DWI lesions in 34% of the patients. Further studies should now show in how far protection devices can reduce these lesions. (orig.)

  6. Can an alternative backround-corrected [18F] fluorodeoxyglucose (FDG standard uptake value (SUV be used for monitoring tumor local control following lung cancer stereotactic body radiosurgery?

    Directory of Open Access Journals (Sweden)

    Charles Shang

    2014-08-01

    assessing local tumor control after lung SBRT......................................................Cite this article as: Shang CY, Kasper ME, Kathriarachchi V, Benda RK, Kleinman JH, Cole J, Williams TR. Can an alternative backround-corrected [18F] fluorodeoxyglucose (FDG standard uptake value (SUV be used for monitoring tumor local control following lung cancer stereotactic body radiosurgery? Int J Cancer Ther Oncol 2014; 2(4:020317.DOI: 10.14319/ijcto.0203.17

  7. Carotid angioplasty and stenting in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Kadkhodayan, Yasha [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Cross, DeWitte T.; Moran, Christopher J. [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Derdeyn, Colin P. [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurology, St. Louis, MO (United States)

    2007-11-15

    To investigate the technical success rate as well as the procedural and mid-term complication rates of carotid angioplasty and stenting in elderly patients, a group excluded from large randomized endarterectomy trials given their perceived high surgical risk. Of 200 consecutive carotid angioplasty and/or stenting procedures performed between March 1996 and March 2005, 21 procedures were performed without cerebral protection devices in 20 patients over the age of 79 years (mean age: 83 years, 12 men, eight women). These patients' medical records were retrospectively reviewed for vascular imaging reports and available clinical follow-up. Procedural and mid-term complication rates were calculated and compared to a previously published cohort of 133 consecutive patients {<=}79 years of age who also underwent endovascular treatment at our institution. Carotid stenosis was reduced from a mean of 82% to no significant stenosis in all procedures. The procedural stroke rate was zero of 21 procedures. The procedural transient ischemic attack rate (TIA) was one of 21 procedures (4.8%). Mean follow-up was 24.6 months (range: 1.0-79.5 months) with at least a 30-day follow-up for 20 of the 21 procedures (95.2%). There were no new strokes. There was one recurrent ipsilateral TIA at 1.9 months. In five cases with follow-up carotid ultrasonography, no hemodynamically significant restenosis had occurred. There were three myocardial infarctions (MI) occurring at 0.5, 2.1, and 15.2 months, of which the last MI was fatal. The composite 30-day stroke and death rate was zero of 21 procedures (95% confidence interval: 0-14%). No significant difference was found in the 30-day rate of stroke, TIA, MI, or death between the elderly and younger patients. Carotid angioplasty and stenting in elderly patients can be performed successfully with acceptable procedural and mid-term complication rates comparable to younger patients. (orig.)

  8. Automated carotid artery intima layer regional segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Meiburger, Kristen M; Molinari, Filippo [Biolab, Department of Electronics, Politecnico di Torino, Torino (Italy); Acharya, U Rajendra [Department of ECE, Ngee Ann Polytechnic (Singapore); Saba, Luca [Department of Radiology, A.O.U. di Cagliari, Cagliari (Italy); Rodrigues, Paulo [Department of Computer Science, Centro Universitario da FEI, Sao Paulo (Brazil); Liboni, William [Neurology Division, Gradenigo Hospital, Torino (Italy); Nicolaides, Andrew [Vascular Screening and Diagnostic Centre, London (United Kingdom); Suri, Jasjit S, E-mail: filippo.molinari@polito.it [Fellow AIMBE, CTO, Global Biomedical Technologies Inc., CA (United States)

    2011-07-07

    Evaluation of the carotid artery wall is essential for the assessment of a patient's cardiovascular risk or for the diagnosis of cardiovascular pathologies. This paper presents a new, completely user-independent algorithm called carotid artery intima layer regional segmentation (CAILRS, a class of AtheroEdge(TM) systems), which automatically segments the intima layer of the far wall of the carotid ultrasound artery based on mean shift classification applied to the far wall. Further, the system extracts the lumen-intima and media-adventitia borders in the far wall of the carotid artery. Our new system is characterized and validated by comparing CAILRS borders with the manual tracings carried out by experts. The new technique is also benchmarked with a semi-automatic technique based on a first-order absolute moment edge operator (FOAM) and compared to our previous edge-based automated methods such as CALEX (Molinari et al 2010 J. Ultrasound Med. 29 399-418, 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CULEX (Delsanto et al 2007 IEEE Trans. Instrum. Meas. 56 1265-74, Molinari et al 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CALSFOAM (Molinari et al Int. Angiol. (at press)), and CAUDLES-EF (Molinari et al J. Digit. Imaging (at press)). Our multi-institutional database consisted of 300 longitudinal B-mode carotid images. In comparison to semi-automated FOAM, CAILRS showed the IMT bias of -0.035 {+-} 0.186 mm while FOAM showed -0.016 {+-} 0.258 mm. Our IMT was slightly underestimated with respect to the ground truth IMT, but showed uniform behavior over the entire database. CAILRS outperformed all the four previous automated methods. The system's figure of merit was 95.6%, which was lower than that of the semi-automated method (98%), but higher than that of the other automated techniques.

  9. CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS

    Directory of Open Access Journals (Sweden)

    N. V. Pizova

    2014-01-01

    Full Text Available Objective: to determine the incidence of atherosclerotic lesions in the carotid and vertebral arteries of young patients from Doppler ultrasound data and to compare the quantitatively assessed traditional risk factors of coronary heart disease (CHD with severe extracranial artery atherosclerotic lesion.Subjects and methods. Doppler ultrasound was carried out evaluating structural changes in the aortic arch branches in 1563 railway transport workers less than 45 years of age. A separate sample consisted of 68 young people with carotid atherosclerotic changes, in whom traditional risk factors for CHD were studied, so were in a control group of individuals without atherosclerotic changes (n = 38.Results. Among the examinees, carotid atherosclerotic lesion was detected in 112 (7.1 % cases, the increase in the rate of atherosclerotic plaques in patients aged 35–45 years being 9.08 %; that in the rate of local intima-media thickness in those aged 31–40 years being 5.1 %. Smoking (particularly that along with hypercholesterolemia and a family history of cardiovascular diseases, obesity (along with low activity, and emotional overstrain were defined as important risk factors in the young patients. Moreover, factor analysis has shown that smoking,hypertension, and early cardiovascular pathology in the next of kin makes the greatest contribution to the development of carotid atherosclerotic lesion.Conclusion. Among the patients less than 45 years of age, carotid and vertebral artery atherosclerotic changes were found in 112 (7.1 % cases, which were more pronounced in male patients. Smoking, particularly along with hypercholesterolemia and genetic predisposition to cardiovascular diseases, was a risk factor that had the highest impact on the degree of atherosclerotic lesion in the aortic arch branches of the young patients.

  10. Volumetric-Modulated Arc Therapy for Stereotactic Body Radiotherapy of Lung Tumors: A Comparison With Intensity-Modulated Radiotherapy Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Holt, Andrea; Vliet-Vroegindeweij, Corine van; Mans, Anton; Belderbos, Jose S. [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Damen, Eugene M.F., E-mail: e.damen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

    2011-12-01

    Purpose: To demonstrate the potential of volumetric-modulated arc therapy (VMAT) compared with intensity-modulated radiotherapy (IMRT) techniques with a limited number of segments for stereotactic body radiotherapy (SBRT) for early-stage lung cancer. Methods and Materials: For a random selection of 27 patients eligible for SBRT, coplanar and noncoplanar IMRT and coplanar VMAT (using SmartArc) treatment plans were generated in Pinnacle{sup 3} and compared. In addition, film measurements were performed using an anthropomorphic phantom to evaluate the skin dose for the different treatment techniques. Results: Using VMAT, the delivery times could be reduced to an average of 6.6 min compared with 23.7 min with noncoplanar IMRT. The mean dose to the healthy lung was 4.1 Gy for VMAT and noncoplanar IMRT and 4.2 Gy for coplanar IMRT. The volume of healthy lung receiving >5 Gy and >20 Gy was 18.0% and 5.4% for VMAT, 18.5% and 5.0% for noncoplanar IMRT, and 19.4% and 5.7% for coplanar IMRT, respectively. The dose conformity at 100% and 50% of the prescribed dose of 54 Gy was 1.13 and 5.17 for VMAT, 1.11 and 4.80 for noncoplanar IMRT and 1.12 and 5.31 for coplanar IMRT, respectively. The measured skin doses were comparable for VMAT and noncoplanar IMRT and slightly greater for coplanar IMRT. Conclusions: Coplanar VMAT for SBRT for early-stage lung cancer achieved plan quality and skin dose levels comparable to those using noncoplanar IMRT and slightly better than those with coplanar IMRT. In addition, the delivery time could be reduced by {<=}70% with VMAT.

  11. Carotid subclinical atherosclerosis is associated with disease activity but not vitamin D in Korean systemic lupus erythematosus.

    Science.gov (United States)

    Jung, J-Y; Koh, B-R; Bae, C-B; Kim, H-A; Suh, C-H

    2014-12-01

    Atherosclerosis develops early in systemic lupus erythematosus (SLE) patients and is an important cause of mortality. Vitamin D deficiency is found to be associated with cardiovascular disease and autoimmunity. We evaluated the extent of carotid subclinical atherosclerosis and analyzed its correlation with vitamin D in SLE. One hundred and two female patients with SLE and 52 normal controls (NCs) were recruited. The mean carotid intima-media thickness (IMT) of SLE patients was 0.41 ± 0.08 mm, which was higher than that of NCs (0.32 ± 0.08 mm, p = 0.012). In addition, carotid plaques were more frequent and the plaque index was higher in SLE patients than in NCs (0.68 ± 1.39 vs. 0.26 ± 0.87, p = 0.026). Carotid IMT was correlated with age, body mass index, SLE disease activity index, and aspirin use in SLE patients. The plaque index was correlated with renal involvement. Vitamin 25(OH)D3 level was not correlated with carotid IMT, plaque index or disease activity markers. In SLE, the risk of cardiovascular disease is higher than that in NCs, which may be derived from systemic inflammation. It may be not suitable to assess vitamin D as a marker of disease activity or subclinical atherosclerosis in SLE patients.

  12. 低剂量辐射对荷S180肉瘤小鼠肿瘤的抑制作用及信号传导影响%The effect of low-dose total body irradiation on tumor-inhibition and signal transduction in tumor tissues of mice bearing S180 sarcoma

    Institute of Scientific and Technical Information of China (English)

    Hongsheng Yu; Weihua Sun; Ning Liu

    2011-01-01

    Objective: By studying the influence of low-dose total body irradiation to proliferating cell nuclear antigens (PCNA), epidermal growth factor receptor (EGFR), erythropoietin (EPO) and vascular endothelial growth factor receptor (VEGFR) of tumor tissues in mice bearing S180 sarcoma, to further explore the mechanism of low doses radiation. Methods: S180 sarcoma cells were implanted subcutaneously into 58 male Kunming mice. Randomly these mice were divided into sham-irradiation (S) group and low-dose radiation (LDR) group. 12 days after implantation, the mice in LDR group were once delivered 75 mGy total-body 60Co γ-ray irradiation, while the mice in S group were left without irradiation. Then the mice in LDR group were executed at 6 h (LDR-6h group), 12 h (LDR-12 h group), 24 h (LDR-24 h group), 48 h (LDR-48 h group) and 72 h (LDR-72h group) after irradiation. Tumor tissues were weighed and histological observed. Immunohistochemical stain-ing was used to detect the expression of PCNA, VEGF, EPO and VEGFR of tumor tissues. Results: Though there was no significant difference between LDR group and S group in tumor weight, after irradiation the expression of PCNA and EPO of tumor tissues in LDR group decreased with time. LDR-24h, LDR-48h and LDR-72h groups were all statistically significantly different from S group. The expression of EGFR and VEGFR also decreased, and LDR-24h group was the lowest (P < 0.05). Conclusion: Seventy-two h after low-dose total body irradiation, there was no significant change in tumor size of mice bear-ing S180 sarcoma. Low-dose total body radiation decreased the expression of PCNA inhibiting tumor growth; reduced the expression of EGFR in tumor tissue impacting the signal transduction of tumor cells. The study also indicated that low-dose total body irradiation, within a certain period of time, can decrease the expression of hypoxia factor EPO and VEGFR, which may improve the situation of tumor hypoxia and radiosensitivity of tumor itself.

  13. A meta-analysis of carotid endarterectomy versus stenting in the treatment of symptomatic carotid stenosis

    Institute of Scientific and Technical Information of China (English)

    WANG Liang; LIU Xiao-zhi; LIU Zhen-lin; LAN Feng-ming; SHI Wan-chao; LIU Jun; ZHANG Jian-ning

    2013-01-01

    Background Carotid stenosis is one of the common reasons for patients with ischemic stroke,and the two invasive options carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the most popular treatments.But the relative efficacy and safety of the methods are not clear.Methods About 521 articles related to CAS and CEA for carotid stenosis published in 1995-2011 were retrieved from MEDLINE,Cochrane Library (CL),and China National Knowledge Infrastructure (CNKI) China Journal Full-Test database.Of them,eight articles were chosen.Meta-analysis was used to assess the relative risks.Results The eight studies included 3873 patients with symptomatic carotid artery stenosis,including 1941 cases in the carotid stent angioplasty group,and 1932 cases in the carotid endarterectomy group.Fixed effect model analysis showed that within 30 days of incidence of all types of strokes,surgery was significantly highly preferred in CAS patients (CAS group) than the CEA patients (CEA group),and the difference was statistically significant (relative ratio (RR)=1.80,95% confidence interval (CI):1.380-2.401,P <0.0001).But the incidence of death in the two groups is not showed and is not statistically significant after 30 days (RR=1.52,95% CI:0.82-2.82,P=0.18).The rate of cranial nerve injury in the CAS group is lower than the CEA group (RR=0.14,95% CI:0.05-0.43,P=0.0005).The incidence of CAS patients with myocardial infarction is lower than the CEA group after 30 days,but statistically meaningless (RR=0.22,95% CI:0.05-1.02,P=0.05).The stroke or death in CAS patients were higher than the CEA group after 1 year of treatment (RR=2.58,95% CI:1.03-6.48,P=0.04).Conclusions Compared to CAS,carotid endarterectomy is still the preferred treatment methodology of symptomatic carotid artery stenosis.Future meta-analyses should then be performed in long-term follow-up to support this treatment recommendation.

  14. CT angiography helps to differentiate acute from chronic carotid occlusion: the ''carotid ring sign''

    Energy Technology Data Exchange (ETDEWEB)

    Michel, Patrik; Ntaios, George [Centre Hospitalier Universitaire Vaudois and University of Lausanne, Neurology Service, Lausanne (Switzerland); Delgado, Montserrat G. [Hospital Universitario Central de Asturias, Oviedo (Spain); Bezerra, Daniel C. [Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD (United States); Meuli, Reto; Binaghi, Stefano [Centre Hospitalier Universitaire Vaudois and University of Lausanne, Department of Radiology, Lausanne (Switzerland)

    2012-02-15

    Currently, there is no reliable method to differentiate acute from chronic carotid occlusion. We propose a novel CTA-based method to differentiate acute from chronic carotid occlusions that could potentially aid clinical management of patients. We examined 72 patients with 89 spontaneously occluded extracranial internal carotids with CT angiography (CTA). All occlusions were confirmed by another imaging modality and classified as acute (imaging <1 week of presumed occlusion) orchronic (imaging >4 weeks), based on circumstantial clinical and radiological evidence. A neuroradiologist and a neurologist blinded to clinical information determined the site of occlusion on axial sections of CTA. They also looked for (a) hypodensity in the carotid artery (thrombus), (b) contrast within the carotid wall (vasa vasorum), (c) the site of the occluded carotid, and (d) the ''carotid ring sign'' (defined as presence of a and/or b). Of 89 occluded carotids, 24 were excluded because of insufficient circumstantial evidence to determine timing of occlusion, 4 because of insufficient image quality, and 3 because of subacute timing of occlusion. Among the remaining 45 acute and 13 chronic occlusions, inter-rater agreement (kappa) for the site of proximal occlusion was 0.88, 0.45 for distal occlusion, 0.78 for luminal hypodensity, 0.82 for wall contrast, and 0.90 for carotid ring sign. The carotid ring sign had 88.9% sensitivity, 69.2% specificity, and 84.5% accuracy to diagnose acute occlusion. The carotid ring sign helps to differentiate acute from chronic carotid occlusion. If further confirmed, this information may be helpful in studying ischemic symptoms and selecting treatment strategies in patients with carotid occlusions. (orig.)

  15. Fusiform dilatation of the internal carotid artery in childhood-onset craniopharyngioma : multicenter study on incidence and long-term outcome

    NARCIS (Netherlands)

    Hoffmann, Anika; Warmuth-Metz, Monika; Lohle, Kristin; Reichel, Julia; Daubenbuchel, Anna M. M.; Sterkenburg, Anthe S.; Mueller, Hermann L.

    2016-01-01

    Fusiform dilatations of the internal carotid artery (FDCA) represent a vascular complication following surgery for suprasellar tumors in children. Incidence rate and long-term prognosis of FDCA in terms of survival rates, vascular complications, and quality of survival are unknown for patients with

  16. Effects of body-resistance strengthening and tumor suppressing granules on immune adhesion function of red blood cells and expression of metastasis protein CD44 in tumor cells of patients with esophageal carcinoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To investigate the effects of Fuzheng Yiliu granules (body-resistance strengthening and tumor-suppressing granules) in patients with esophageal carcinoma.METHODS: We compared the immune adherent properties of red blood cells (RBCs), the expression of metastasis protein CD44, and the metastasis inhibition factor nm23, in esophageal carcinoma tumor cells of patients before and after radiotherapy in the presence and absence of orally administered Fuzheng Yiliu granules. Sixty-three hospitalized patients with esophageal carcinoma were treated with standard radiotherapy and randomly divided into treatment group (n = 30) treated with both radiotherapy and Fuzheng Yiliu granules and control group (n = 33) given radiotherapy only. Blood samples and tumor tissue were obtained before and after 21 d of treatment. The rosette rates for complement receptor type 3b (C3bRR)and immune complex receptor (ICRR) on RBCs were measured by erythrocyte immunological methods.Expression of CD44 and nm23 in tumor tissue sections was determined by immunohistochemical staining with monoclonal antibodies CD44v6 ad nm23H-1, respectively.RESULTS: The positivity of RBC-C3bRR before and after 21 d of treatment increased from 7.78% ± 1.59% to 10.03% ± 2.01% in the double treatment group,while it changed only slightly from 7.18% ± 1.29% to 7.46% ± 1.12% in the radiotherapy group. The positive rate for RBC-ICRR decreased from 37.68% ± 2.51% to 22.55% ± 1.65% after the double treatment, and from 37.28% ± 2.41% to 24.69% ± 1.91% in radiotherapy group at the same time points. The difference in erythrocyte immune adherent function between the two groups was significant (P < 0.01, t-test). The CD44+-cases were reduced from 21 (70.00%) to 12 (40.00%) after treatment with Fuzheng Yiliu granules, whereas the CD44+-cases (69.70%) in the radiotherapy group remained unchanged. The difference between the treatment (40.00%) and control (69.70%) groups was significant (P < 0.05). Although the nm23

  17. The G-308A variant of the Tumor Necrosis Factor-α (TNF-α gene is not associated with obesity, insulin resistance and body fat distribution

    Directory of Open Access Journals (Sweden)

    Vecci Elio

    2001-09-01

    Full Text Available Abstract Background Tumor Necrosis Factor-α (TNF-α has been implicated in the pathogenesis of insulin resistance and obesity. The increased expression of TNF-α in adipose tissue has been shown to induce insulin resistance, and a polymorphism at position -308 in the promoter region ofTNF-α has been shown to increase transcription of the gene in adipocytes. Aim of this study is to investigate the role of the G-308A TNFα variant in obesity and to study the possible influence of this mutation on body fat distribution and on measures of obesity (including Fat Free Mass, Fat Mass, basal metabolic rate, insulin resistance (measured as HOMAIR, and lipid abnormalities. The G-308A TNFα polymorphism has been studied in 115 patients with obesity (mean BMI 33.9 ± 0.5 and in 79 normal lean subjects (mean BMI 24.3 ± 0.3. Methods The G-308A variant, detected by PCR amplification and Nco-1 digestion, determines the loss of a restriction site resulting in a single band of 107 bp [the (A allele]. Results The (A allele frequencies of the G-308A TNFα polymorphism were 13.1% in the obese group and 14.6% in the lean subjects, with no significant difference between the two groups. Furthermore, no association was found with BMI classes, body fat distribution, HOMAIR, and metabolic abnormalities. Conclusions Our study did not detect any significant association of the G-308A TNFα polymorphism with obesity or with its clinical and metabolic abnormalities in this population. Our data suggests that, in our population, the G-308A TNFα polymorphism is unlikely to play a major role in the pathogenesis of these conditions.

  18. Estimation of Stiffness Parameter on the Common Carotid Artery

    Science.gov (United States)

    Koya, Yoshiharu; Mizoshiri, Isao; Matsui, Kiyoaki; Nakamura, Takashi

    The arteriosclerosis is on the increase with an aging or change of our living environment. For that reason, diagnosis of the common carotid artery using echocardiogram is doing to take precautions carebropathy. Up to the present, several methods to measure stiffness parameter of the carotid artery have been proposed. However, they have analyzed at the only one point of common carotid artery. In this paper, we propose the method of analysis extended over a wide area of common carotid artery. In order to measure stiffness parameter of common carotid artery from echocardiogram, it is required to detect two border curves which are boundaries between vessel wall and blood. The method is composed of two steps. The first step is the detection of border curves, and the second step is the calculation of stiffness parameter using diameter of common carotid artery. Experimental results show the validity of the proposed method.

  19. Advanced Asymptomatic Carotid Disease and Cognitive Impairment: An Understated Link?

    Directory of Open Access Journals (Sweden)

    Irena Martinić-Popović

    2012-01-01

    Full Text Available Advanced carotid disease is known to be associated with symptomatic cerebrovascular diseases, such as stroke or transient ischemic attack (TIA, as well as with poststroke cognitive impairment. However, cognitive decline often occurs in patients with advanced carotid stenosis without clinically evident stroke or TIA, so it is also suspected to be an independent risk factor for dementia. Neurosonological methods enable simple and noninvasive assessment of carotid stenosis in patients at risk of advanced atherosclerosis. Cognitive status in patients diagnosed with advanced carotid stenosis is routinely not taken into consideration, although if cognitive impairment is present, such patients should probably be called symptomatic. In this paper, we discuss results of some most important studies that investigated cognitive status of patients with asymptomatic advanced carotid disease and possible mechanisms involved in the causal relationship between asymptomatic advanced carotid disease and cognitive decline.

  20. An internal carotid artery aneurysm presenting with dysarthria.

    Science.gov (United States)

    Davey, P T; Rychlik, I; O'Donnell, M; Baker, R; Rennie, I

    2013-10-01

    A 72-year-old woman presented to her general practitioner with a 4-week history of right neck swelling. Clinical examination elicited a pulsatile mass consistent with a carotid artery aneurysm. Five days later the patient noticed her tongue movements had become awkward with associated dysarthria. Computed tomography confirmed a 4cm internal carotid artery aneurysm arising just distally to the carotid bifurcation. She proceeded to transfemoral diagnostic carotid angiography. Balloon occlusion of the right internal carotid artery origin was performed for a ten-minute period without any neurological deficit. The decision was taken to proceed to surgical ligation of the origin of the internal carotid artery. Her symptoms of dysarthria have resolved.

  1. The association of carotid cavernous fistula with Graves′ ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Ozlem Celik

    2013-01-01

    Full Text Available Graves′ ophthalmopathy (GO is one of the frequent manifestations of the disorder which is an inflammatory process due to fibroblast infiltration, fibroblast proliferation and accumulation of glycosaminoglycans. Eye irritation, dryness, excessive tearing, visual blurring, diplopia, pain, visual loss, retroorbital discomfort are the symptoms and they can mimic carotid cavernous fistulas. Carotid cavernous fistulas are abnormal communications between the carotid arterial system and the cavernous sinus. The clinical manifestations of GO can mimic the signs of carotid cavernous fistulas. Carotid cavernous fistulas should be considered in the differential diagnosis of the GO patients especially who are not responding to the standard treatment and when there is a unilateral or asymmetric eye involvement. Here we report the second case report with concurrent occurrence of GO and carotid cavernous fistula in the literature.

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  7. File list: His.CDV.10.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  8. File list: Unc.CDV.20.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  9. File list: Unc.CDV.10.AllAg.Carotid_Arteries [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  10. High Resolution Contrast-enhanced MRA in the Evaluation of Rabbit Carotid Artery

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Introduction:Accurate lumen definition of carotid artery is crucial for determining patient treatment, because a 70% or greater stenosis of a carotid artery will benefit from carotid endarterectomy to reduce the incidence of stroke[1].

  11. Review of stents for the carotid artery.

    Science.gov (United States)

    Bosiers, M; Deloose, K; Verbist, J; Peeters, P

    2006-04-01

    The individual characteristics of a stent may make it an attractive choice in some circumstances, but render it a less desirable option in others. The applicability depends primarily on the arterial anatomy and the specific details of the lesion being treated. A careful assessment by the interventionalist is required to select the proper type of stent that is of appropriate size. Certainly, personal preferences and familiarity with a specific device may legitimately influence the decision to choose one stent over another. Finally, stent design can play a role in the selection procedure. Although carotid stents are often functionally equivalent in the clinical setting and have been used successfully to treat a wide variety of lesions, a basic knowledge of stent geometry can contribute to make up your mind in certain carotid cases.

  12. Oxygen transfer in human carotid artery bifurcation

    Institute of Scientific and Technical Information of China (English)

    Z.G.Zhang; Y.B.Fan; X.Y.Deng

    2007-01-01

    Arterial bifurcations are places where blood flow may be disturbed and slow recirculation flow may occur.To reveal the correlation between local oxygen transfer and atherogenesis, a finite element method was employed to simulate the blood flow and the oxygen transfer in the human carotid artery bifurcation. Under steady-state flow conditions, the numerical simulation demonstrated a variation in local oxygen transfer at the bifurcation, showing that the convective condition in the disturbed flow region may produce uneven local oxygen transfer at the blood/wall interface.The disturbed blood flow with formation of slow eddies in the carotid sinus resulted in a depression in oxygen supply to the arterial wall at the entry of the sinus, which in turn may lead to an atherogenic response of the arterial wall, and contribute to the development of atherosclerotic stenosis there.

  13. Pre-clinical atherosclerosis evaluated by carotid artery intima-media thickness and the risk factors in children

    Institute of Scientific and Technical Information of China (English)

    YANG Xiao-zheng; LIU Ying; MI Jie; TANG Chao-shu; DU Jun-bao

    2007-01-01

    Background Atherosclerosis as a cardiovascular disease was found to begin even in the fetal period. However,information about risk factors of pre-clinical atherosclerosis in childhood has been limited. Hence, this study was aimed to find out the risk factors of atherosclerosis by measuring the carotid artery intima-media thickness in children. High resolution B-mode ultrasound used to examine the carotid artery intima-media thickness was demonstrated to be useful in finding the early carotid structural changes.Methods The study included 79 children who were divided into two groups according to their ages: group Ⅰ consisted of 42 children with ages from 5 to 9 years and group Ⅱ consisted of 37 children with ages from 10 to 18 years, Among them,23 had a positive family history for risk, such as hypertension, obesity or dyslipidemia. Blood samples were collected and total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein were assayed. The carotid artery intima-media thickness was measured by ultrasound. Comparisons were done between the two groups using Student's t tests and Chi-square analysis. Body mass index, blood pressure, levels of lipids, family history and the carotid artery intima-media thickness were calculated by conditional logistic regression analysis.Results Compared with the children without a positive family history, the incidence of the increased carotid artery intima-media thickness was significantly high (x2=4.364, P<0.05). There were no statistically significant differences between left and right carotid arteries in carotid artery intima-media thickness (P>0.05). In this study, diastolic blood pressure and the atherosclerosis index were suggested to be the risk factors to the thickened carotid artery intima-media thickness. In group I the diastolic blood pressure's odds radio was 1.187 (P=0.035) and the atherosclerosis index odds radio was 37.165 (P=0.001); in group Ⅱ the diastolic blood pressure's odds

  14. Carotid artery access for transcatheter aortic valve replacement.

    Science.gov (United States)

    Guyton, Robert A; Block, Peter C; Thourani, Vinod H; Lerakis, Stamatios; Babaliaros, Vasilis

    2013-10-01

    We report three patients who had successful transcatheter aortic valve replacement (TAVR) via carotid artery access. None were candidates for thoracotomy (including minimal access incisions) and had no other vascular access sites that would accommodate the transcatheter valve sheath. Antegrade carotid perfusion and retrograde insertion of the delivery sheath maintained cerebral blood flow without sequelae. Carotid access for TAVR is an option for unusual patients without other access.

  15. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  16. Surgical preparation of a permanent carotid transposition in sheep

    OpenAIRE

    Gouvêa, Liana Villela de; Novais, Ernane de Paiva Ferreira; Leite, Ceci Ribeiro; Ximenes, Fábio Henrique Bezerra; de Almeida, Ricardo Miyasaka; Molás, Renato Bizinoto; Palermo, João Gabriel Cesar; Silva, Carlos Eduardo Vasconcelos da; Borges,José Renato Junqueira; Lima, Eduardo Maurício Mendes de; Godoy, Roberta Ferro de

    2011-01-01

    In large animal research, when frequent sampling of arterial blood is needed, the carotid artery transposition is the most used technique. The objective of this paper is to describe a new technique for carotid artery transposition in sheep and evaluate its effectiveness using the echo-Doppler ultrasound. The animals enrolled in this study had their carotid surgically elevated to the subcutaneous level, by suturing underneath muscles sternocephalic and brachiocephalic. None of the ...

  17. A big floating thrombus in the common carotid artery.

    Science.gov (United States)

    La Spada, Michele; Stilo, Francesco; Barillà, David; Spinelli, Francesco

    2011-11-01

    The management of the free-floating thrombus (FFT) is difficult, and it is unclear whether surgical or medical treatment is superior. The common carotid artery is rarely involved. An 80-year-old woman presented with right hand weakness and syncope. Ultrasound showed the presence of FFT in the left common carotid artery. A carotid endarterectomy with Dacron patch angioplasty was immediately performed without complications. In the presence of symptoms, the interventional management of FFT is advised.

  18. Cerebral haemodynamics during carotid cross-clamping.

    Science.gov (United States)

    Pistolese, G R; Ippoliti, A; Appolloni, A; Ronchey, S; Faraglia, V

    1993-03-01

    Carotid artery cross-clamping ischaemia during carotid endarterectomy (CEA) causes 5-30% of perioperative neurological deficits. This study was performed to identify possible clinical situations at higher risk for carotid cross-clamping ischaemia. 606 consecutive patients underwent CEA and were retrospectively studied; they were grouped according to risk factors, presence of associated vascular diseases, clinical pattern, angiographic and CT scan findings. Stump pressure measurement was provided in all patients, perioperative monitoring during CEA was performed by electroencephalogram (EEG) in 469 (77%) and somatosensorial evoked potentials (SEP) in 137 (23%). Local anaesthesia was used in 88 (14.5%) patients. Ischaemic changes during carotid cross-clamping were registered in 118 patients (19.5%). The incidence of cross-clamping ischaemia was then related to different factors; it affected 5.6% of asymptomatics, 25.4% of patients with fixed stroke and 38.5% of those with stenosis and contralateral occlusion. Angiographic and clinical correlation showed that patients with more severe lesions are mostly affected by clamping ischaemia (up to 55% in those with stroke and stenosis with contralateral occlusion). Age, hypertension and diabetes do not significantly affect incidence of ischaemic changes. Positive CT scan increased this risk; statistical relevance was found in regard to patients with unilateral or bilateral stenosis and in those with transient ischaemic attacks. A higher risk can be expected for subjects with more severe clinical and instrumental findings, even if no patients can be considered completely at risk or risk free. Perioperative monitoring is always mandatory and is of great importance in detecting ischaemic changes and preventing cerebral damage using a temporary intraluminal shunt.

  19. [Carotid chemodectoma: a clinical case report and review of the literature].

    Science.gov (United States)

    Rossi, P; Russo, F; Paganelli, C; Forlini, A; Danza, F; Gentileschi, P

    1994-01-01

    Carotid chemodectoma (CC) is a very rare neoplasia. It originates from Type 1 main cells of the carotid body and affects both sexes almost in the same proportion (mostly in the fourth and fifth decades). It can be on a familiar basis (5-10%) and in these cases it is more frequently multicentric, being sporadically found in association with other paragangliomas. CC is a slow-growing neoplasia, locally aggressive and it can give metastases to regional lymph nodes and surrounding anatomical structures. Once surgically removed, it can reoccur in a small percentage of patients. Early diagnosis is of the utmost importance and surgeon's skill is fundamental as well as awareness of the real nature of the disease. Surgical treatment of CC is difficult and demanding, for the close relation of CC to the neighbouring neurovascular structures. The authors report a case of CC radically operated on. Clinical parameters are analysed as well, and Literature is reviewed.

  20. Hyperperfusion syndrome after carotid stent angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Politi, M.; Reith, W.; Krick, C.; Karp, K.; Zimmer, A.; Struffert, T.; Kuehn, A.L.; Papanagiotou, P. [University of the Saarland, Department for Interventional and Diagnostic Neuroradiology, Homburg (Germany); Roth, C.; Haass, A. [University of the Saarland, Clinic for Neurology, Homburg (Germany)

    2009-03-15

    This study assesses the incidence and causes of hyperperfusion syndrome occurring after carotid artery stenting (CAS). We retrospectively reviewed the clinical database of 417 consecutive patients who were treated with CAS in our department to identify patients who developed hyperperfusion syndrome and/or intracranial hemorrhage. Magnetic resonance imaging (MRI) including fluid-attenuated inversion recovery and diffusion-weighted imaging was performed before and after CAS in 269 cases. A Spearman's rho nonparametric correlation was performed to determine whether there was a correlation between the occurrence/development of hyperperfusion syndrome and the patient's age, degree of stenosis on the stented and contralateral side, risk factors such as diabetes, smoking, hypertension, adiposity, gender and fluoroscopy time, and mean area of postprocedural lesions as well as preexisting lesions. Significance was established at p < 0.05. Of the 417 carotid arteries stented and where MRI was also completed, we found hyperperfusion syndrome in 2.4% (ten cases). Patients who had preexisting brain lesions (previous or acute stroke) were at a higher risk of developing hyperperfusion syndrome (p = 0.022; Spearman's rho test). We could not validate any correlation with the other patient characteristics. Extensive microvascular disease may be a predictor of hyperperfusion syndrome after carotid stent placement. We believe that further studies are warranted to predict more accurately which patients are at greater risk of developing this often fatal complication. (orig.)

  1. [Eversion carotid endarterectomy: advantages and disadvantages].

    Science.gov (United States)

    Kazanchian, P O; Popov, V A; Rudakova, T V; Gaponova, E N

    1998-01-01

    A comparative analysis of results of 70 operations fulfilled by the method of classical with autovein plasty of the internal carotid artery (ICA) and of 103 operations by the method of eversion carotid endarterectomy (CEAE) was made. The time of compression of the carotid artery during the eversion CEAE proved to be considerably less (22.5 +/- 6.5) min, than when using the "classical" method (32.5 +/- 5.3) min. In the nearest postoperative period no neurological complications of embologenic genesis or those associated with acute thrombosis of ICA after the eversion CEAE were noted while after the "classical" method they developed in 3 patients and 2 of them died. After the eversion CEAE 1 patients died of myocardial infarction. In remote periods after the "classical" CEAE the restenosis and reocclusions appeared in 6 patients, while after the eversion method--in 3 patients. CEAE fulfilled by the eversion technique is an effective operation reducing the amount of postoperative neurological complications as well as of late restenosis and reocclusions. It can be used without the applying of the internal bypass.

  2. [Morbidity and mortality of carotid endarterectomy].

    Science.gov (United States)

    Rodríguez Pérez, A; Cabrera Morán, V; Abad Vázquez, C; Muñoz Falcón, L; Hernández Ruiz, A; Hermida Anllo, M; Cárdenes Romero, I

    1993-01-01

    In order to investigate the peroperative complications in carotid surgery, a cohort of 64 patients operated of carotid endarterectomy (EC) were evaluated. A total 78 EC were performed, 56 unilateral (EC-U) and 11 bilateral (EC-B). All the cases were managed in a similar manner regarding surgical technique, monitoring, anesthetic management and pre and postoperative care. A temporary shunt was inserted in 6 cases. The hospital mortality has been 0. We registered the following postoperative complications: arterial hypertension in 23.1 of EC-U and 18.2% of EC-B, cervical hematoma in 5.3% (EC-U) and 13.6% (EC-B), TIA in 5.3% (EC-U) and 4.5% (EC-B), stroke 1.7% (EC-U) and 4.5% (EC-B), vocal cord injury in 3.5% of EC-U and chest pain with angina in 1.7% of EC-U. A review of the mortality and morbidity in carotid surgery is done.

  3. Carotid Endarterectomy for Symptomatic Complete Occlusion of the Internal Carotid Artery

    Directory of Open Access Journals (Sweden)

    Cho,Yong-Pil

    2011-08-01

    Full Text Available We described 9 consecutive patients who underwent operative carotid artery exploration with attempted carotid endarterectomy (CEA for symptomatic internal carotid artery (ICA occlusion. Indications for this surgery based on vascular imaging included segmental occlusion of the proximal ICA and also extensive occlusion of the distal ICA in selected patients in whom color-flow duplex ultrasound showed a poorly echogenic or anechoic thrombus with a flow void, suggestive of an acute thrombus. CEA was performed successfully to restore blood flow in all 9 patients:CEA in 5 and CEA with Fogarty thrombectomy in 4. Postoperative magnetic resonance (MR angiography confirmed that revascularization had been successful in all 9 patients, and MR imaging displayed improved perfusion in 4 patients. Despite the lack of a generalized efficacy of surgical revascularization for symptomatic ICA occlusion, our study demonstrated that preoperative vascular imaging allows the selection of patients who may benefit from CEA.

  4. Bilateral hypoplasia of the internal carotid arteries with basilar aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, F.; Tortora, F.; Elefante, A. [Universita di Napoli Federico II, Dipartimento di Scienze Neurologiche, Cattedra di Neuroradiologia, 80131, Napoli (Italy); Maiuri, F. [Universita di Napoli Federico II, Department of Neurological Sciences, Neurosurgery Service, Napoli (Italy)

    2004-10-01

    We report a rare case of bilateral hypoplasia of the internal carotid arteries with an associated aneurysm of the basilar tip, studied by CT angiography, MR angiography and digital angiography. The patient became symptomatic with an episode of loss of consciousness, likely due to reduced blood perfusion. The other 20 reported cases of bilateral carotid hypoplasia (only four of which with an associated aneurysm) are reviewed. The findings of noninvasive procedures (including narrowing of the carotid canals on CT) may lead to a correct diagnosis before angiography is performed; they may also help to differentiate angiographic narrowing of the hypoplastic internal carotids from the string sign often observed in some acquired conditions. (orig.)

  5. The Dolichoarteriopathia of Common Carotid Artery Narrowing the Airway

    Directory of Open Access Journals (Sweden)

    Erkan Eski

    2013-01-01

    Full Text Available Tortuousity of the common carotid artery is rarely seen in otorinolaryngologic  practice. In this report, a case of tortuous common carotid artery narrowing the airway and indenting the epiglottis is presented. In endoscopic examination, pulsating bulge at the level of right lateral farengeal wall, pyriform sinus and larynx was found in a 73 year-old female. Computerized tomographic scan showed tortuous  right common carotid artery bulging the submucosal area of the oropharynx and pyriform sinus. Awareness of the tortuous common carotid artery before any  laryngologic surgical intervention is very important to prevent serious complications.

  6. Surgical techniques and curative effect of carotid endarterectomy for carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Min HAN

    2014-02-01

    Full Text Available Objective To investigate the surgical techniques of carotid endarterectomy (CEA for treating carotid artery stenosis, in order to improve the surgical efficacy and reduce intraoperative adverse events and complications after operation. Methods Retrospective analysis was carried out on surgical data of 53 cases who were performed CEA from October 2010 to October 2013 in Department of Neurosurgery in Tianjin Huanhu Hospital. There were 39 males and 14 females, aged from 40 to 78 years old and mean age (60.34 ± 8.92 years old; the course of disease was from 2 d to 4 years. Twenty-six cases were diagnosed as right carotid stenosis, 15 cases left carotid stenosis and 12 cases double-sided carotid stenosis. Among all of those cases, 35 cases were diagnosed as moderate stenosis (30%-69%, 16 cases severe stenosis (70%-99% , and 2 cases complete occlusion. Results Among 53 patients, 50 patients underwent CEA; 2 cases underwent CEA and aneurysm clipping; one case underwent stent removal surgery and CEA because restenosis was found after carotid artery stenting (CAS. Postoperative neck CTA and fMRI showed good morphology of carotid artery, fluent blood flow and improved cerebral perfusion after operation. All of those patients were followed up for 3 to 24 months. One case died of myocardial infarction; 2 cases appeared skin numbness on the operating side of the neck, and the symptom disappeared 3 months later; one case appeared hoarseness after operation; 3 cases experienced mild transient ischemic attack (TIA and the symptom disappeared 2 months later. No case of stroke was found. Conclusions CEA is a safe and effective surgical approach to treat carotid stenosis. Correct and reasonable choices of the surgical indications and skilled surgical technique are the key to ensure the success of operation and to improve efficacy of the therapy. doi:10.3969/j.issn.1672-6731.2014.02.006Video: http://www.cjcnn.org/index.php/cjcnn/pages/view/v14n2a6

  7. William Hunter Harridge Lecture. Carotid endarterectomy versus stenting for stroke prevention: what we have and will learn from Carotid Revascularization Endarterectomy versus Stenting Trial.

    Science.gov (United States)

    Weaver, Fred A

    2014-07-01

    The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) has major implications for the future of carotid revascularization and stroke prevention. The purpose of The William Hinter Harridge Lecture was to discuss the history of carotid revascularization before CREST, to delineate the emergence of carotid artery stenting as an alternative to carotid endarterectomy, analyze the key findings in CREST, and describe the next phase of investigation, CREST-2.

  8. More Accurate Definition of Clinical Target Volume Based on the Measurement of Microscopic Extensions of the Primary Tumor Toward the Uterus Body in International Federation of Gynecology and Obstetrics Ib-IIa Squamous Cell Carcinoma of the Cervix

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Wen-Jia [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Wu, Xiao [Department of Pathology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Xue, Ren-Liang; Lin, Xiang-Ying [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Kidd, Elizabeth A. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Yan, Shu-Mei [Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province (China); Zhang, Yao-Hong [Department of Radiation Oncology, Chaozhou Hospital of Chaozhou City, Guangdong Province (China); Zhai, Tian-Tian; Lu, Jia-Yang; Wu, Li-Li; Zhang, Hao [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Huang, Hai-Hua [Department of Pathology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Chen, Zhi-Jian; Li, De-Rui [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Xie, Liang-Xi, E-mail: xieliangxi1@qq.com [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China)

    2015-01-01

    Purpose: To more accurately define clinical target volume for cervical cancer radiation treatment planning by evaluating tumor microscopic extension toward the uterus body (METU) in International Federation of Gynecology and Obstetrics stage Ib-IIa squamous cell carcinoma of the cervix (SCCC). Patients and Methods: In this multicenter study, surgical resection specimens from 318 cases of stage Ib-IIa SCCC that underwent radical hysterectomy were included. Patients who had undergone preoperative chemotherapy, radiation, or both were excluded from this study. Microscopic extension of primary tumor toward the uterus body was measured. The association between other pathologic factors and METU was analyzed. Results: Microscopic extension toward the uterus body was not common, with only 12.3% of patients (39 of 318) demonstrating METU. The mean (±SD) distance of METU was 0.32 ± 1.079 mm (range, 0-10 mm). Lymphovascular space invasion was associated with METU distance and occurrence rate. A margin of 5 mm added to gross tumor would adequately cover 99.4% and 99% of the METU in the whole group and in patients with lymphovascular space invasion, respectively. Conclusion: According to our analysis of 318 SCCC specimens for METU, using a 5-mm gross tumor volume to clinical target volume margin in the direction of the uterus should be adequate for International Federation of Gynecology and Obstetrics stage Ib-IIa SCCC. Considering the discrepancy between imaging and pathologic methods in determining gross tumor volume extent, we recommend a safer 10-mm margin in the uterine direction as the standard for clinical practice when using MRI for contouring tumor volume.

  9. Serum calcium level is related to both intima-media thickness and carotid atherosclerosis: a neglect risk factor in obese/overweight subjects

    Directory of Open Access Journals (Sweden)

    Montalcini Tiziana

    2012-06-01

    Full Text Available Abstract Background Experimental studies suggested that high serum calcium may be important in the pathogenesis of vascular diseases. Since calcium seems to affect specifically the cerebrovascular district, aim of this study was to determine the relation between serum calcium levels, within normal range, and subclinical atherosclerosis in the carotid arteries, in a population of obese/overweight subjects. Methods In our retrospective study we included 472 subjects (59% female with body mass index equal to or more than 25 kg/m2. They underwent a physical examination, a biochemical assessment (including calcium evaluation and a B-mode ultrasonography of the extracranial carotid arteries to detect carotid atherosclerosis presence and to measure intima-media thickness. Results Mean age of the population was 50 ±12 years. Prevalence of the Carotid atherosclerosis was 40%. Mean carotid intima-media thickness was 0,66 ± 0,18 mm. The univariate and multivariate analysis showed an association between calcium and carotid intima-media thickness (p = 0,035. We divided the population in serum calcium tertiles. We found an higher carotid atherosclerosis prevalence in the III tertile in comparison to that of the I tertile (p = 0,039. Conclusions In this study we found a positive relation between serum calcium levels, within normal range, and subclinical atherosclerosis in the carotid arteries, in a population of obese/overweight subjects. It is important to consider the impact of the serum calcium levels in the overall risk assessment of patients, at least in obese subjects.

  10. Baseline Metabolic Tumor Volume and Total Lesion Glycolysis Are Associated With Survival Outcomes in Patients With Locally Advanced Pancreatic Cancer Receiving Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dholakia, Avani S. [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Chaudhry, Muhammad; Leal, Jeffrey P. [Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Chang, Daniel T. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Raman, Siva P. [Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Hacker-Prietz, Amy [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Su, Zheng; Pai, Jonathan [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Oteiza, Katharine E.; Griffith, Mary E. [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Wahl, Richard L. [Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Tryggestad, Erik [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Pawlik, Timothy [Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Laheru, Daniel A. [Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Wolfgang, Christopher L. [Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Koong, Albert C. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); and others

    2014-07-01

    Purpose: Although previous studies have demonstrated the prognostic value of positron emission tomography (PET) parameters in other malignancies, the role of PET in pancreatic cancer has yet to be well established. We analyzed the prognostic utility of PET for patients with locally advanced pancreatic cancer (LAPC) undergoing fractionated stereotactic body radiation therapy (SBRT). Materials and Methods: Thirty-two patients with LAPC in a prospective clinical trial received up to 3 doses of gemcitabine, followed by 33 Gy in 5 fractions of 6.6 Gy, using SBRT. All patients received a baseline PET scan prior to SBRT (pre-SBRT PET). Metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum and peak standardized uptake values (SUV{sub max} and SUV{sub peak}) on pre-SBRT PET scans were calculated using custom-designed software. Disease was measured at a threshold based on the liver SUV, using the equation Liver{sub mean} + [2 × Liver{sub sd}]. Median values of PET parameters were used as cutoffs when assessing their prognostic potential through Cox regression analyses. Results: Of the 32 patients, the majority were male (n=19, 59%), 65 years or older (n=21, 66%), and had tumors located in the pancreatic head (n=27, 84%). Twenty-seven patients (84%) received induction gemcitabine prior to SBRT. Median overall survival for the entire cohort was 18.8 months (95% confidence interval [CI], 15.7-22.0). An MTV of 26.8 cm{sup 3} or greater (hazard ratio [HR] 4.46, 95% CI 1.64-5.88, P<.003) and TLG of 70.9 or greater (HR 3.08, 95% CI 1.18-8.02, P<.021) on pre-SBRT PET scan were associated with inferior overall survival on univariate analysis. Both pre-SBRT MTV (HR 5.13, 95% CI 1.19-22.21, P=.029) and TLG (HR 3.34, 95% CI 1.07-10.48, P=.038) remained independently associated with overall survival in separate multivariate analyses. Conclusions: Pre-SBRT MTV and TLG are potential predictive factors for overall survival in patients with LAPC and may assist in

  11. Uterine primitive neuroectodermal tumor.

    Science.gov (United States)

    Aminimoghaddam, Soheila; Seifirad, Soroush; Abbasi Dezfouli, Golbahar; Abbasi, Neda; Zare Mehrjardi, Ali; Razavi, Seyed Mohsen; Mahmoudzadeh, Fatemeh

    2015-04-01

    Primitive neuroectodermal tumors are fairly rare in uterus. A case of uterine body primitive neuroectodermal tumor in a 32-year-old Iranian woman is presented. The patient was admitted with abdominal pain and fever and underwent emergency exploratory surgery with total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. Posterior wall of the uterus was necrotic and ruptured and a huge tumor disrupted the uterine body. The tumor was strongly positive for CD99, NSE, and chromogranin; No reaction was seen for CD10, CD45 and myogenin. To the best of our knowledge, this is the first report of an uterine body primitive neuroectodermal tumor and the second report of uterine primitive neuroectodermal tumor from Iran.

  12. Carotid intima media thickness and arterial stiffness in children with acute rheumatic fever.

    Science.gov (United States)

    Çiftel, Murat; Yılmaz, Osman; Kardelen, Fırat; Kocabaş, Abdullah

    2014-01-01

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) constitute important public health problems in developing countries. Inflammation is present both in the early and late stages of the diseases. Chronic inflammation is known to be associated with atherosclerosis. We hypothesize that subclinical atherosclerosis and arterial stiffness may increase due to the ongoing inflammation as well as the increased pulse pressure and left-ventricular systolic dysfunction in RHD. The purpose of the present study was to investigate carotid intima media thickness (CIMT) and carotid artery stiffness in patients with ARF. Forty patients in follow-up due to ARF in the age group of 7-16 years (disease duration 1-10 years) and 36 volunteered subjects with similar body mass index were included in the study. The subjects included in the present study were compared regarding M-mode echocardiographic parameters and CIMT as well as carotid arterial strain (CAS), carotid artery distensibility (CAD), beta stiffness index (βSI), and pressure-strain elasticity modulus (Ep) as carotid artery stiffness parameters. CIMT (0.52 ± 0.08 and 0.48 ± 0.07 mm, p = 0.01), βSI (5.29 ± 2.98 and 3.02 ± 1.30, p < 0.001), and Ep (426.53 ± 210.50 and 254.44 ± 104.69 p < 0.001) were increased, whereas CAS (0.11 ± 0.01 and 0.19 ± 0.09, p < 0.001) and CAD (10.27 ± 4.69 and 17.76 ± 14.41, p < 0.001) were decreased in patients with ARF compared with the control group. There was a positive correlation between pulse pressure and βSI (r = 0.25, p = 0.02) and Ep (r = 0.28, p = 0.01) in addition to a correlation between left atrial dilatation and CIMT (r = 0.55 p < 0.001) in patients with ARF. CIMT and carotid artery stiffness were increased in patients with ARF. Patients with ARF may have an increased risk of subclinical atherosclerosis and cardiovascular events.

  13. Variation of adverse drug reaction profile of platinum-based chemotherapy with body mass index in patients with solid tumors: An observational study

    Directory of Open Access Journals (Sweden)

    Dattatreyo Chatterjee

    2014-01-01

    Full Text Available Objectives: Toxicity of cancer chemotherapy may be affected by nutritional status of patients which is reflected in the body mass index (BMI. We sought to assess whether the adverse drug reaction (ADR profile of platinum-based chemotherapy varies with BMI status. Materials and Methods: Adult patients of either sex, suffering from a solid tumor (lung, head and neck, ovary, gall bladder, stomach, colon and started on platinum-based chemotherapy as initial treatment were included. BMI at chemotherapy commencement was obtained from medical records. Events were recorded and graded as per Eastern Co-operative Oncology Group Common Toxicity Criteria-patients′ complaints; clinically evident signs and laboratory reports were considered. Frequencies of individual adverse events were compared between low BMI (<18.5 kg/m 2 and satisfactory BMI groups. Similar comparisons were done for events with grades 2 or 3 severities. Results: A total of 50 patients were observed over a 3-month period of whom 17 (34% belonged to the low BMI group. Nausea, vomiting, diarrhea, stomatitis, anemia, alopecia, tinnitus and paresthesia were the commonly observed ADRs. The frequencies of anemia (P = 0.152 and vomiting (P = 0.140 and severity of grades of nausea (P = 0.066, anemia (P = 0.120 and paresthesia (P = 0.128 showed a higher trend in the low BMI group though differences were not statistically significant. The frequencies of tinnitus (P = 0.021 and paresthesia overall (P = 0.036 were significantly higher in the low BMI group. Conclusion: ADR profile of primary platinum-based chemotherapy appears to be partly influenced by BMI. This suggests the importance of maintaining adequate nutrition in patients and the need for greater vigilance in those with low BMI.

  14. SU-E-T-355: A Comparative Study of Robotic and Linac-Based Stereotactitc Body Radiation Therapy for Lumbar Spinal Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Bossart, E; Monterroso, M; Couto, M; Ly, B; Mihaylov, I [UniversityMiami, Miami, FL (United States)

    2014-06-01

    Purpose: Dosimetrically compare CyberKnife (CK) and linac-based (LB) stereotactic body radiotherapy (SBRT) plans for lumbar spine. Methods: Ten patient plans with lumbar spine tumors treated with CK were selected and retrospectively optimized using three techniques: CK, volumetric modulated arc (VMAT, three arcs), and 9-field-intensity modulated radiotherapy (IMRT). For the LB plans, the target volume was expanded by 1mm to accommodate additional uncertainty in patient positioning. All plans were optimized to a prescription dose of 27Gy in 3 fractions covering 90% of the PTV. If the dose constraints to the cauda equina (cauda) were not met, the prescription dose was lowered to 24Gy. Parameters evaluated included Paddick Conformity-Index (CI) and Gradient-Index (GI). A two-tailed paired t-test was used to establish statistically significant differences in cauda doses. Results: Target volumes for LB plans were on average 38% larger. In terms of the indices, the closer the index values to unity the steeper the dose falloff and the higher the dose conformity to the target. The results showed that LB plans were in general statistically superior to CK plans. The IMRT plan showed the best average gradient index of 2.995, with VMAT and CK GI values of 3.699 and 5.476, respectively. Similarly, the same trend occurs with the average CI results: 0.821, 0.814, and 0.758, corresponding to IMRT, VMAT, and CK. Notably, in one CK plan the target dose was reduced to 24Gy to meet cauda constraints. Additionally, there was a statistically significant dose difference for the cauda between the CK and LB plans. Conclusion: This study demonstrates that LB plans for lumbar spine SBRT can be as effective or even better than CK plans. Despite the expansion of the target volume, the LB plans did not demonstrate dosimetric inferiority. The LB plans Resultin 2-to-3 fold decrease of treatment time.

  15. Carotid baroreceptor-muscle sympathetic relation in humans.

    Science.gov (United States)

    Rea, R F; Eckberg, D L

    1987-12-01

    The purpose of this study was to define the relation between carotid distending pressure and muscle sympathetic activity in humans. Carotid baroreceptors of nine healthy subjects were compressed or stretched for 5 s with graded neck pressure or suction (+40 to -65 mmHg), and muscle sympathetic nerve activity was recorded. The results delineate several features of human baroreflex function. First, the carotid-muscle sympathetic relation is well described by an inverse sigmoid function. Second, a linear relation exists between carotid distending pressure and sympathetic outflow over a range of approximately 25 mmHg. Third, sympathetic responses to changes of carotid pressures are asymmetric; increases of sympathetic activity during carotid compression are much greater than reductions of sympathetic activity during carotid stretch. Fourth, at rest, normal subjects operate near the threshold level for sympathetic excitation. Thus the carotid-muscle sympathetic baroreflex is poised to oppose reductions more effectively than elevations of arterial pressure, and the range of pressures over which the reflex is active is wider than thought hitherto.

  16. PERFORMING TRANSCATHETER AORTIC VALVE IMPLANTATION IN PATIENTS WITH CAROTID STENOSIS

    Directory of Open Access Journals (Sweden)

    Veselin Valkov

    2016-07-01

    Full Text Available The management of carotid artery disease in patients with severe aortic stenosis referred for transcatheter aortic valve implantation is challenging. By reviewing the very limited amount of literature we will try to answer the question should we perform carotid revascularization before or after the TAVI procedure.

  17. Carotid endarterectomy after intravenous thrombolysis for acute cerebral ischaemic attack

    DEFF Research Database (Denmark)

    Rathenborg, Lisbet Knudsen; Jensen, L P; Baekgaard, N;

    2013-01-01

    Intravenous thrombolysis (IVT) has proven effective in the treatment of acute cerebral ischaemic attack in selected cases. In the presence of a carotid artery stenosis, such patients may be candidates for carotid endarterectomy (CEA). Few studies have been made on the safety of CEA performed afte...

  18. Surgical interventions and studies of the carotid sinus

    NARCIS (Netherlands)

    Toorop, R.J.

    2012-01-01

    Background: The carotid baroreflex buffers acute changes in blood pressure and is triggered by baroreceptors in the carotid sinus. Baroreceptor firing results in an increased parasympathetic tone and a decreased sympathetic tone leading to reduced heart rate and blood pressure. Under normal conditio

  19. Posture-dependent chronotropic effect of carotid sinus massage

    DEFF Research Database (Denmark)

    Møller, M; Oxhøj, H; Mickley, H

    1987-01-01

    The hypertensive carotid sinus can be divided into cardioinhibitory (chronotropic) and vasodepressor components; the former can be evaluated by carotid sinus massage performed in the supine position. We present the case of a patient in whom the abnormal cardioinhibitory response could only...

  20. Spontaneous carotid artery dissection causing a juvenile cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S.; Huebsch, P.; Schindler, E.

    1988-11-01

    The case of a 19-year-old patient is presented who was admitted with aphasia and hemiparesis due to basal ganglia infarction as a result of spontaneous dissection of the internal carotid artery. The difficulties in diagnosing this disease with CT and MRI in the acute stage are demonstrated. Angiography is still imperative in order to ascertain that a carotid dissection has occurred.

  1. Carotid plaque, intima-media thickness, and incident aortic stenosis

    DEFF Research Database (Denmark)

    Martinsson, Andreas; Östling, Gerd; Persson, Margaretha

    2014-01-01

    OBJECTIVE: Aortic stenosis (AS) shares risk factors with atherosclerotic vascular disease. Carotid intima-media thickness (IMT) and plaque may reflect the cumulative damage from exposure to different atherosclerotic risk factors. We examined the relationship of carotid IMT and plaque with incident...

  2. Carotid plaque burden as a measure of subclinical atherosclerosis

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram

    2012-01-01

    The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease....

  3. Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children.

    Science.gov (United States)

    Iannuzzi, Arcangelo; Licenziati, Maria Rosaria; Vacca, Maria; De Marco, Donata; Cinquegrana, Giorgio; Laccetti, Marco; Bresciani, Alessandro; Covetti, Giuseppe; Iannuzzo, Gabriella; Rubba, Paolo; Parillo, Mario

    2009-11-01

    Childhood obesity is associated with an increased carotid intima-media thickness (IMT) and stiffness. Increased carotid wall thickening and rigidity are considered markers of subclinical atherosclerosis. The aim of the present study was to test the effect of two hypocaloric diets of varying glycemic index on weight loss and markers of subclinical atherosclerosis in obese children. Seventy consecutive obese children attending the Outpatient Weight Clinic of the Department of Pediatrics were invited to participate in an intensive dietary protocol. Twenty-six accepted and were randomly assigned to two different groups: the first group followed a hypocaloric low-glycemic index diet and the second a hypocaloric high-glycemic index diet. Anthropometric measures and biochemical tests were performed in all children. Quantitative B-mode ultrasound scans were used to measure intima-media thickness (IMT) and diameters of the common carotid artery. Considering both groups together, at 6 months, body mass index decreased from 28.3 +/- 3.1 to 25.8 +/- 3.3 kg/m(2), systolic blood pressure from 119 +/- 12 to 110 +/- 11 mmHg (Pglycemic index diet. These results justify the advice to obese children to follow a low-glycemic index diet in order to improve their cardiometabolic profile.

  4. Relation between visceral fat and carotid intimal media thickness in Mexican postmenopausal women: a preliminary report

    Directory of Open Access Journals (Sweden)

    Sebastián Carranza-Lira

    2016-07-01

    Full Text Available Aim of the study: To investigate the relationship between visceral fat and carotid IMT (intima media thickness in Mexican postmenopausal women. Material and methods: In 71 postmenopausal women divided in two groups: group 1, IMT > 1 mm and group 2, IMT ≤ 1 mm, blood pressure, body mass index (BMI, waist hip ratio (WHR, visceral and subcutaneous fats and carotid IMT were analyzed. Descriptive statistics were used and the comparison among those with abnormal and normal IMT was carried out using Mann-Whitney U test; also Spearman’s correlation analysis was done. Results When comparing group 1 (n = 9, 12.7% with group 2 (n = 62, 87.3%, it was found that the subcutaneous fat, visceral fat and systolic blood pressure were significantly greater in group 1 (p < 0.018, p < 0.001 and p < 0.006, respectively, and also in this group there was a correlation between BMI and subcutaneous fat ( = 0.686, p < 0.041 and between visceral fat and the systolic blood pressure (= 0.712, p < 0.031. In group 2, there was a correlation between IMT and diastolic blood pressure (= 0.251, p < 0.049. Conclusion : Subcutaneous and visceral fat have an unfavorable effect in the carotid IMT and in blood pressure.

  5. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae

    Science.gov (United States)

    Kobkitsuksakul, Chai; Jiarakongmun, Pakorn; Chanthanaphak, Ekachat; Singhara Na Ayudya, Sirintara (Pongpech)

    2016-01-01

    PURPOSE The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages. METHODS We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded. RESULTS Of those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction. CONCLUSION Arteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow. PMID:27767958

  6. [Primitive neuroectodermal tumor of the vagus nerve].

    Science.gov (United States)

    Pegbessou, E; Diom, E S; Ndiaye, M; Dieng, P A; Nao, E E M; Thiam, A; Diouf, M S; Boube, D; Ndiaye, C; Kossinda, F; Tall, A; Diallo, B K; Ndiaye, I C; Diouf, R; Diop, E M

    2013-12-01

    Primitive neuroectodermal tumors are a rare type of malignant neuroectodermal tumor that is very aggressive. Cervicofacial location is rare, even exceptional. We report a case of a 4-month-old male infant, referred from the pediatric clinic for severe supralaryngeal dyspnea, a firm mass under the left mandibular angle, mobile and extended to the parotid area, painful, with a curve of the left side wall of the oropharynx. Cervical computed tomodensitometry showed a well-limited mass in the carotid area, enhanced by the contrast product. A vascularized mass, which had developed at the expense of the vagus nerve, was removed surgically. Histology found a primitive neuroectodermal tumor.

  7. Dynamics of collateral circulation in progressive asymptomatic carotid disease.

    Science.gov (United States)

    Moll, F L; Eikelboom, B C; Vermeulen, F E; van Lier, H J; Schulte, B P

    1986-03-01

    Inadequacy of collateral arterial flow is the major risk factor for hemispheric infarction in association with spontaneous occlusion of the ipsilateral carotid artery. This prospective study was designed to measure the adaptation of collateral cerebral circulation through the circle of Willis in patients in whom a unilateral carotid stenosis of hemodynamic consequence develops asymptomatically. The collateral cerebral potential is assessed by ocular pneumoplethysmography (OPG) during proximal common carotid artery compression, measuring the collateral ophthalmic artery pressure (COAP). During an average follow-up of almost 3 years (maximum more than 7 years), 45 patients showed asymptomatic development of a unilateral hemodynamically significant carotid stenosis according to OPG evidence. In these patients the mean index COAP/brachial artery pressure did not change on the side of stenosis progression (p greater than 0.05). The developed carotid stenosis had only reduced collateral circulation to the contralateral hemisphere. The risk of inadequate collateral cerebral circulation remained during progression of asymptomatic extracranial arterial obstructive disease.

  8. Mathematical model of carotid artery for stent placement

    Science.gov (United States)

    Rahman, Tengku Husna Tengku Abdul; Din, Ummul Khair Salma; Ahmad, Rokiah @ Rozita

    2016-11-01

    The carotid artery stenting is one of the methods used to reduce the effect of artherosclerosis which caused by the thickening of the artery wall. In most of the studies, the measure of wall elasticity, shear stress and the blood pressure through the blood flow were considered. The aim of this study is to determine the position to place the stent inside the carotid artery. A mathematical model is reconstructed to determine the suitable location of the stent in the carotid artery. Throughout the study, differences in fluid flow between a normal carotid artery wall and stenosed carotid artery wall are investigated. Since the existence of the stenosis provides a resistance in the flow, it is important to identify the right position to place the stent. The stent will be placed in the position where stenosis exists to ease the blood to flow normally. Later after the stent placement, the blood flow normally through the blood vessel.

  9. Effective surgical treatment of the carotid sinus sindrome.

    Science.gov (United States)

    TOOROP, R J; SCHELTINGA, M R M; BENDER, M H M; CHARBON, J A; HUIGE, M C; MOLL, F L; BRUIJNINCKX, C M A

    2009-10-01

    Elderly patients frequently suffer from dizziness and syncope; however, an underlying disease may not always be identified. Three patients aged 69, 71 and 56, respectively, experienced spells of dizziness and syncope. Massage of the carotid sinus demonstrated the presence of a carotid sinus syndrome (CSS), an abnormal baroreflex response of the carotid sinus that leads to asystole and extreme hypotension. Conventional treatment is generally by insertion of a pacemaker. These patients, however, were referred to the vascular surgery department of our hospital for removal of adventitial layers of proximal portions of the internal carotid artery. Recovery was uneventful; all three are now free of symptoms. CSS should be considered in the differential diagnosis of dizziness and syncope. Surgical denervation of the carotid artery is a valid treatment option, especially in the vasodepressive or mixed type of CSS.

  10. Increased carotid intima media thickness is associated with prolactin levels in subjects with untreated prolactinoma: a pilot study.

    Science.gov (United States)

    Jiang, Xiao-Bing; Li, Cui-Ling; He, Dong-Sheng; Mao, Zhi-Gang; Liu, Dong-Hong; Fan, Xiang; Hu, Bin; Zhu, Yong-Hong; Wang, Hai-Jun

    2014-06-01

    Hyperprolactinemia is associated with endothelial dysfunction and atherogenic risk factors, but carotid intima media thickness (IMT) has not been studied in hyperprolactinemic patients. To determine whether untreated hyperprolactinemia contributes to increased carotid IMT. Thirty-one prolactinoma patients and 60 healthy controls were respectively studied. Participants underwent hormone evaluation. Anthropometric parameters (body mass index and blood pressure), inflammatory markers (high-sensitivity C-reactive protein and fibrinogen), serum glucose, insulin, lipid and apolipoprotein profiles were also determined. Endothelial function measured as the flow-mediated dilation (FMD) of a brachial artery and carotid IMT were evaluated using high-resolution ultrasonography. Multivariate linear regression analysis was applied to identify independent determinants of FMD and carotid IMT. Triglycerides, homeostasis model assessment of insulin resistance, apolipoprotein (apo)B/apoA-I ratio, high-sensitivity C-reactive protein (hsCRP) and fibrinogen were significantly higher, while apoA-I was significantly lower in patients with prolactinomas than in the controls. Meanwhile, decreased FMD and increased carotid IMT were observed in hyperprolactinemic group. Serum prolactin was positively correlated with triglycerides, apoB/apoA-I ratio, hypogonadal, hsCRP and fibrinogen (P < 0.05), but inversely associated with apoA-I and HDL-C (P ≤ 0.001). Moreover, prolactin was found negatively correlated with FMD (r = -0.576, P < 0.0001), and positively correlated with mean carotid IMT (r = 0.652, P < 0.0001). Multivariate regression analysis revealed that prolactin determined, independent of traditional risk factors, FMD (B = -0.589, 95% confidence interval (CI) -2.525 to -0.804, P = 0.001) and mean carotid IMT (B = 0.527, 95% CI 0.027-0.069, P < 0.0001). Hyperprolactinemia may be involved in the preclinical increase in carotid IMT, directly or by promoting atherogenic factors, including

  11. Management of a chronic carotid artery pseudoaneurysm.

    Science.gov (United States)

    Baker, Aaron C; Arko, Frank R; Zarins, Christopher K; Lee, Eugene S

    2010-01-01

    An 82-year-old female with a history of right carotid endarterectomy with patch closure 12 years prior presents with a pulsatile right neck mass with skin erosion and bleeding. The patient had been previously evaluated but refused the surgical intervention because a median sternotomy was recommended to obtain adequate proximal control. Her aneurysm was successfully repaired using a combination of open and endovascular method. The repair was performed through a right-hand side anterior sternocleidomastoid neck incision, and proximal vascular control was obtained with an 8.5-mm balloon positioned under fluoroscopic guidance via a femoral puncture.

  12. Carotid Stent Fracture from Stylocarotid Syndrome

    Science.gov (United States)

    Hooker, Jeffrey D; Joyner, David A; Farley, Edward P; Khan, Majid

    2016-01-01

    Eagle syndrome is a rare condition resulting from elongation of the temporal styloid process or calcification of its associated stylohyoid ligaments. Although usually presenting with pain or odynophagia, Eagle syndrome has been reported to cause a multitude of neurologic symptoms or vascular complications, some of which can be life-threatening. We present a case in which an endovascularly placed internal carotid artery stent in close proximity to a calcified stylohyoid ligament resulted in stent fracture with subsequent stent and vessel occlusion. We review and discuss the presentation, diagnosis, etiology, complications and treatment options of the syndrome.

  13. Pulse Wave Velocity in the Carotid Artery

    DEFF Research Database (Denmark)

    Sørensen, Gertrud Laura; Jensen, Julie Brinck; Udesen, Jesper;

    2008-01-01

    The pulse wave velocity (PWV) in the carotid artery (CA) has been estimated based on ultrasound data collected by the experimental scanner RASMUS at DTU. Data is collected from one test subject using a frame rate (FR) of 4000 Hz. The influence of FRs is also investigated. The PWV is calculated from...... distension wave forms (DWF) estimated using cross-correlation. The obtained velocities give results in the area between 3-4 m/s, and the deviations between estimated PWV from two beats of a pulse are around 10%. The results indicate that the method presented is applicable for detecting the local PWV...

  14. Association between the Gensini Score and Carotid Artery Stenosis

    Science.gov (United States)

    Fidan, Serdar; Tabakçı, Mehmet Mustafa; Toprak, Cuneyt; Alizade, Elnur; Acar, Emrah; Bayam, Emrah; Tellice, Muhammet; Naser, Abdurrahman; Kargın, Ramazan

    2016-01-01

    Background and Objectives The aim of this study was to evaluate the association between the extent of coronary artery disease assessed by the Gensini score and/or the SYNTAX score and the significant carotid stenosis in patients undergoing coronary artery bypass grafting (CABG). Subjects and Methods A total of 225 patients who had carotid doppler ultrasonography prior to CABG were included retrospectively. Significant coronary artery disease was assumed as a lumen diameter stenosis of ≥50% in any of the major epicardial coronary arteries. The severity of carotid stenosis was determined by B-mode and duplex ultrasonography. Clinically significant carotid stenosis was defined as peak systolic velocity greater than 125 cm/s. Results The mean value of SYNTAX score and Gensini score was highest in patients allocated to significant carotid stenosis (22.98±7.32, p<0.001 and 77.40±32.35, p<0.001, respectively). The other risk factors for significant carotid stenosis were found to be male gender (p=0.029), carotid bruit (p<0.001), diabetes (p=0.021), left main disease (p=0.002), 3-vessel disease (p=0.008), chronic total coronary occlusion (p=0.001), and coronary artery calcification (p=0.001) in univariate analysis. However, only the Gensini score (odds ratio[OR]=1.030, p=0.004), carotid bruit (OR=0.068, p<0.001), and male gender (OR=0.190, p=0.003) were the independent predictors. The Gensini score cut off value predicting significant carotid stenosis was 50.5 with 77% sensitivity (p<0.001). Conclusion The Gensini score may be used to identify patients at high risk for significant carotid stenosis prior to CABG. PMID:27721854

  15. Experiences with carotid endarterectomy at Sree Chitra Tirunal Institute

    Directory of Open Access Journals (Sweden)

    Unnikrishnan Madathipat

    2008-01-01

    Full Text Available Background: Atherosclerotic carotid artery disease poses a grave threat to cerebral circulation, leading to a stroke with its devastating sequelae, if left untreated. Carotid endarterectomy has a proven track record with compelling evidence in stroke prevention. Objectives: aTo confirm that carotid endarterectomy (CEA is safe and effective in preventing stroke at both short and long term. b to demonstrate long term patency of internal carotid artery when arteriotomy repair is performed using autologous saphenous vein patch. Materials and Methods: During ten years, from September 1997 to February 2008, thirty nine patients who underwent consecutive carotid endarterectomy at our institute, form the basis of this report. Their age ranged from thirty to seventy eight years, with a mean age of 56. There were four women in this cohort. Thirty seven patients were symptomatic with> 70% stenosis and two were asymptomatic with> 80% stenosis, incidentally detected. Imaging included Duplex scan and MRA for carotid territory and brain, and non-invasive cardiac assessment. Co-morbidities included smoking, hypertension, diabetes, and coronary artery disease. Carotid Endarterectomy was performed under general anaesthesia, using carotid shunt and vein patch arteriotomy repair. Results: All the patients made satisfactory recovery, without major adverse cerebral events in this series. Morbidities included Transient Ischemic Attack (TIA in two, needing only medications in one, and carotid stenting in the other. Minor morbidities included neck hematoma in two and transient hypoglossal paresis in three patients. Yearly follow-up included duplex scan assessment for all the patients. Two patients died of contralateral stroke, two of myocardial events and two were lost to follow up. Thirty three patients are well and free of the disease during the follow up of three to 120 months. Conclusion: Carotid endarterectomy provided near total freedom from adverse cerebral

  16. Estimated carotid-femoral pulse wave velocity has similar predictive value as measured carotid-femoral pulse wave velocity

    DEFF Research Database (Denmark)

    Greve, Sara V; Blicher, Marie K; Kruger, Ruan;

    2016-01-01

    BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) adds significantly to traditional cardiovascular risk prediction, but is not widely available. Therefore, it would be helpful if cfPWV could be replaced by an estimated carotid-femoral pulse wave velocity (ePWV) using age and mean blood pres...

  17. Congenital bilateral absence of the common carotid artery and internal carotid artery: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    YUE Xuan-ye; XI Gang-ming; ZHANG Ying-chun; ZHOU Shao-hua; YE Fei

    2006-01-01

    Absence of the common carotid artery(CCA) and/or internal carotid artery (ICA) is a kind of rare congenital anomaly. This paper reports one patient with bilateral absence of the CCA and ICA who suffered from cerebral infarction. And the relative literatures of the possible cause and collateral circulation were reviewed.

  18. Do carotid MR surface coils affect PET quantification in PET/MR imaging?

    Energy Technology Data Exchange (ETDEWEB)

    Willemink, Martin J; Eldib, Mootaz [Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (United States); Leiner, Tim [Department of Radiology, University Medical Center Utrecht, Utrecht (Netherlands); Fayad, Zahi A; Mani, Venkatesh [Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (United States)

    2015-05-18

    To evaluate the effect of surface coils for carotid MR imaging on PET quantification in a clinical simultaneous whole-body PET/MR scanner. A cylindrical phantom was filled with a homogeneous 2L water-FDG mixture at a starting dose of 301.2MBq. Clinical PET/MR and PET/CT systems were used to acquire PET-data without a coil (reference standard) and with two carotid MRI coils (Siemens Special Purpose 8-Channel and Machnet 4-Channel Phased Array). PET-signal attenuation was evaluated with Osirix using 51 (PET/MR) and 37 (PET/CT) circular ROIs. Mean and maximum standardized uptake values (SUVs) were quantified for each ROI. Furthermore, SUVs of PET/MR and PET/CT were compared. For validation, a patient was scanned with an injected dose of 407.7MBq on both a PET/CT and a PET/MR system without a coil and with both coils. PET/MR underestimations were -2.2% (Siemens) and -7.8% (Machnet) for SUVmean, and -1.2% (Siemens) and -3.3% (Machnet) for SUVmax, respectively. For PET/CT, underestimations were -1.3% (Siemens) and -1.4% (Machnet) for SUVmean and -0.5% (both Siemens and Machnet) for SUVmax, respectively using no coil data as reference. Except for PET/CT SUVmax values all differences were significant. SUVs differed significantly between PET/MR and PET/CT with SUVmean values of 0.51-0.55 for PET/MR and 0.68-0.69 for PET/CT, respectively. The patient examination showed that median SUVmean values measured in the carotid arteries decreased from 0.97 without a coil to 0.96 (Siemens) and 0.88 (Machnet). Carotid surface coils do affect attenuation correction in both PET/MR and PET/CT imaging. Furthermore, SUVs differed significantly between PET/MR and PET/CT.

  19. Cushing syndrome due to adrenal tumor

    Science.gov (United States)

    Adrenal tumor - Cushing syndrome ... Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the ... or cancerous (malignant). Noncancerous tumors that can cause ... Adrenal adenomas Micronodular hyperplasia Cancerous tumors that ...

  20. EVALUATION OF CAROTID ARTERY STENOSIS IN STROKE/TRANSIENT ISCHAEMIC ATTACK

    OpenAIRE

    Nambakam Tanuja; Naveen Kumar; Girish P.

    2015-01-01

    BACKGROUND : Stroke remains the second leading cause of death worldwide, after ischaemic heart disease. Patients with carotid artery stenosis are at higher risk of development of stroke. Carotid atherosclerosis occurs in patients with atheros clerotic risk factors like diabetes mellitus, hypertension, smoking and hyperlipidemia. Carotid artery stenosis can be assessed by means of noninvasive high - resolution B - mode ultrasonography of the carotid arteries. ...

  1. Quantitative analysis of anatomical relationship between cavernous segment internal carotid artery and pituitary macroadenoma

    Science.gov (United States)

    Lin, Bon-Jour; Chung, Tzu-Tsao; Lin, Meng-Chi; Lin, Chin; Hueng, Dueng-Yuan; Chen, Yuan-Hao; Hsia, Chung-Ching; Ju, Da-Tong; Ma, Hsin-I; Liu, Ming-Ying; Tang, Chi-Tun

    2016-01-01

    Abstract Cavernous segment internal carotid artery (CSICA) injury during endoscopic transsphenoidal surgery for pituitary tumor is rare but fatal. The aim of this study is to investigate anatomical relationship between pituitary macroadenoma and corresponding CSICA using quantitative means with a sense to improve safety of surgery. In this retrospective study, a total of 98 patients with nonfunctioning pituitary macroadenomas undergoing endoscopic transsphenoidal surgeries were enrolled from 2005 to 2014. Intercarotid distances between bilateral CSICAs were measured in the 4 coronal levels, namely optic strut, convexity of carotid prominence, median sella turcica, and dorsum sellae. Parasellar extension was graded and recorded by Knosp–Steiner classification. Our findings indicated a linear relationship between size of pituitary macroadenoma and intercarotid distance over CSICA. The correlation was absent in pituitary macroadenoma with Knosp–Steiner grade 4 parasellar extension. Bigger pituitary macroadenoma makes more lateral deviation of CSICA. While facing larger tumor, sufficient bony graft is indicated for increasing surgical field, working area and operative safety. PMID:27741111

  2. Medical treatment in carotid artery intervention.

    Science.gov (United States)

    Kolkert, J L; Meerwaldt, R; Lefrandt, J D; Geelkerken, R H; Zeebregts, C J

    2011-12-01

    Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical therapy has evolved tremendously. Next to aspirin, antiplatelet regimens acting on a different level in the modulation of platelet aggregation have made their entry. Moreover, statin therapy has been introduced. These changes among others in secondary stroke prevention, along with better understanding in life-style adjustments and perioperative medical management, have led to a decrease in stroke recurrence. Secondary prevention is therefore now the most important pillar of medical therapy. It consists of antiplatelet therapy, statins and blood pressure lowering agents in all patients. Small adjustments are recommended for those patients referred for invasive treatment. Moreover, long-term medical treatment is imperative. In this article, we summarize current evidence in literature regarding medical management in patients with previous stroke or TIA.

  3. Successful treatment of common carotid artery transection

    Institute of Scientific and Technical Information of China (English)

    刘健; 肖颖彬; 钟前进; 郝嘉

    2004-01-01

    @@ A case that a patient presented a life-threatening carotid artery hemorrhage after a work-related accident was reported. This case demonstrates the importance of prompt intervention and surgery assisted by cardiopulmonary bypass(CPB). A 22-year-old man was admitted to our hospital with left carotid hemorrhage and progressive dyspnea eight minutes after being injured at work by infra-flying sheet metal. Upon arrival, he was semi-conscious and anemic,whose blood pressure could not be measured. Clinically,he presented poor peripheral perfusion with pale, cool extremities, and oliguria. Under tight digital compression of the left cervical incision of 2 - 5 cm long, endotracheal intubation was performed and a central venous catheter was placed. The severe arterial bleeding could not be controlled even applying dopamine at dose of 10 - 15 μg· kg- 1 · min- 1and 1 200 ml of blood transfusion and 1 000 ml of Gelofusine. The patient was immediately transferred to the operation room of the cardiovascular surgery unit.

  4. Cognitive changes after carotid artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Politi, M.; Struffert, T.; Krick, C.; Backens, M. [University of the Saarland, Department for Diagnostic and Interventional Neuroradiology, Homburg (Germany); Supprian, T.; Falkai, P.; Reith, W. [University of the Saarland, Clinic for Psychiatry and Psychotherapy, Homburg (Germany)

    2006-05-15

    We aimed to test changes in cognitive performance after carotid artery stenting (CAS). Ten patients were neuropsychologically tested at least 24 h before and 48 h after CAS. To diminish thromboembolic events, we used a proximal protection device. The following neuropsychological tests were selected: The Mini Mental State Examination (MMSE), symbol digit test and subtests of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery (verbal fluency, constructional practice, word list memory and delayed recall). Affective state was determined by the Beck Depression Score (BDS). No patient suffered from depression (BDS <1) or dementia (MMSE 29.9{+-}1.5). Nine of the ten patients (P=0.12) showed increased speed in the Number Connection Test (NCT) (corresponding to trail making test). Most patients showed better or similar results concerning delayed recall (P=0.31). No change was observed in the symbol digit test, word list memory, verbal fluency or constructional practice. Better results concerning NCT and delayed recall after carotid stenting might be due to improved brain perfusion. After CAS, cognitive and memory performance seem to improve. Further studies with different time intervals and more refined testing, as well as perfusion-weighted imaging, are needed. (orig.)

  5. Endovascular management of carotid-cavernous fistulas

    Institute of Scientific and Technical Information of China (English)

    GAO Bu-lang; LI Ming-hua; LI Yong-dong; FANG Chun; WANG Jue; DU Zhuo-ying

    2007-01-01

    Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas (CCF) and their complications such as pseudoaneurysms. Methods: Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coil embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stent management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% (4/22). A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% (8/22). Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.

  6. Indium-111 platelet scintigraphy in carotid disease

    Energy Technology Data Exchange (ETDEWEB)

    Branchereau, A.; Bernard, P.J.; Ciosi, G.; Bazan, M.; de Laforte, C.; Elias, A.; Bouvier, J.L.

    1988-07-01

    Forty-five patients (35 men, 10 women) undergoing carotid surgery had Indium-111 platelet scintigraphy as part of their preoperative work-up. Imaging was performed within three hours after injection of the Indium-111. A second series of views was obtained 24 hours later and repeated at 24 hour intervals for two days. Of 54 scintigrams, 22 were positive and 32 negative. Positive results were defined as a twofold or more increase in local activity on a visualized carotid after 24 hours. The sensitivity of the method was 41%, intraoperatively, and the specificity, 100%. The low sensitivity places this method behind sonography and duplex-scanning for screening patients for surgery. We believe that indications for platelet scintigraphy are limited to: 1. Repeated transient ischemic attacks in the same territory with minimal lesions on arteriography and non-homogeneous plaque on duplex scan; 2. Symptomatic patients being treated medically as a possible argument for surgery; 3. Determining therapeutic policy for patients having experienced a transient ischemic attack with a coexisting intracardiac thrombus.

  7. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  8. Effect of rimonabant on carotid intima-media thickness (CIMT) progression in patients with abdominal obesity and metabolic syndrome: the AUDITOR Trial

    NARCIS (Netherlands)

    O'Leary, D.H.; Reuwer, A.Q.; Nissen, S.E.; Després, J.P.; Deanfield, J.E.; Brown, M.W.; Zhou, R.; Zabbatino, S.M.; Job, B.; Kastelein, J.J.P.; Visseren, F.L.J.

    2011-01-01

    OBJECTIVE: The aim of this trial was to determine whether obese patients benefit from treatment with rimonabant in terms of progression of carotid atherosclerosis. Rimonabant, a selective cannabinoid-1 receptor blocker, reduces body weight and improves cardiometabolic risk factors in patients who ar

  9. Support Vector Machine-Based Prediction of Local Tumor Control After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Klement, Rainer J., E-mail: rainer_klement@gmx.de [Department of Radiation Oncology, University of Würzburg (Germany); Department of Radiotherapy and Radiation Oncology, Leopoldina Hospital, Schweinfurt (Germany); Allgäuer, Michael [Department of Radiotherapy, Barmherzige Brüder Regensburg, Regensburg (Germany); Appold, Steffen [Department of Radiation Oncology, Technische Universität Dresden (Germany); Dieckmann, Karin [Department of Radiotherapy, Medical University of Vienna (Austria); Ernst, Iris [Department of Radiotherapy, University Hospital Münster (Germany); Ganswindt, Ute [Department of Radiation Oncology, Ludwigs-Maximilians-University Munich, München (Germany); Holy, Richard [Department of Radiation Oncology, RWTH Aachen University, Aachen (Germany); Nestle, Ursula [Department of Radiation Oncology, University Hospital Freiburg, Freiburg i Br (Germany); Nevinny-Stickel, Meinhard [Department of Therapeutic Radiology and Oncology, Innsbruck Medical University (Austria); Semrau, Sabine [Department of Radiation Oncology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen (Germany); Sterzing, Florian [Department of Radiation Oncology, University Hospital Heidelberg (Germany); Wittig, Andrea [Department of Radiotherapy and Radiation Oncology, Philipps-University Marburg (Germany); Andratschke, Nicolaus [Department of Radiation Oncology, Technische Universität München (Germany); Guckenberger, Matthias [Department of Radiation Oncology, University of Würzburg (Germany)

    2014-03-01

    Background: Several prognostic factors for local tumor control probability (TCP) after stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC) have been described, but no attempts have been undertaken to explore whether a nonlinear combination of potential factors might synergistically improve the prediction of local control. Methods and Materials: We investigated a support vector machine (SVM) for predicting TCP in a cohort of 399 patients treated at 13 German and Austrian institutions. Among 7 potential input features for the SVM we selected those most important on the basis of forward feature selection, thereby evaluating classifier performance by using 10-fold cross-validation and computing the area under the ROC curve (AUC). The final SVM classifier was built by repeating the feature selection 10 times with different splitting of the data for cross-validation and finally choosing only those features that were selected at least 5 out of 10 times. It was compared with a multivariate logistic model that was built by forward feature selection. Results: Local failure occurred in 12% of patients. Biologically effective dose (BED) at the isocenter (BED{sub ISO}) was the strongest predictor of TCP in the logistic model and also the most frequently selected input feature for the SVM. A bivariate logistic function of BED{sub ISO} and the pulmonary function indicator forced expiratory volume in 1 second (FEV1) yielded the best description of the data but resulted in a significantly smaller AUC than the final SVM classifier with the input features BED{sub ISO}, age, baseline Karnofsky index, and FEV1 (0.696 ± 0.040 vs 0.789 ± 0.001, P<.03). The final SVM resulted in sensitivity and specificity of 67.0% ± 0.5% and 78.7% ± 0.3%, respectively. Conclusions: These results confirm that machine learning techniques like SVMs can be successfully applied to predict treatment outcome after SBRT. Improvements over traditional TCP

  10. Carotid lesions in outpatients with nonalcoholic fatty liver disease

    Institute of Scientific and Technical Information of China (English)

    Stefano Ramilli; Stefano Pretolani; Antonio Muscari; Barbara Pacelli; Vincenzo Arienti

    2009-01-01

    AIM: To ascertain whether carotid lesions are more prevalent in outpatients with incidental findings of nonalcoholic fatty liver disease (NAFLD) at abdominal ultrasound (US). METHODS: One hundred and fifty-four consecutive outpatients (age range 24-90 years, both sexes) referred by general practitioners for abdominal US, and drinking less than 20 g alcohol/day, underwent carotid US for an assessment of carotid intima-media thickness (c-IMT) and carotid plaque prevalence. Hepatic steatosis, visceral fat thickness and subcutaneous fat thickness were also assessed at ultrasonography. RESULTS: Higher c-IMT values were found in the presence of NAFLD (90 patients), even after adjustment for indices of general and abdominal obesity and for the principal cardiovascular risk factors (0.84 ± 0.10 mm vs 0.71 ± 0.10 mm, P < 0.001). The prevalence of carotid plaques was 57.8% in the patients with NAFLD vs 37.5% in the patients without this condition ( P = 0.02). The adjusted relative risk of having carotid plaques for paients with NAFLD was 1.85 (95% CI: 1.33-2.57, P < 0.001). CONCLUSION: An incidental finding of hepatic steatosis may suggest the presence of silent carotid atherosclerotic lesions.

  11. Carotid artery stenting: Rationale, technique, and current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, Hasan, E-mail: hasan.yilmaz@hcuge.c [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes; Narata, Ana-Paula [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland); Sztajzel, Roman [Department of Neurology, University Hospital of Geneva (Switzerland); Lovblad, Karl-Olof [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland)

    2010-07-15

    Carotid stenosis is a major risk factor for stroke. With the aging of the general population and the availability of non-invasive vascular imaging studies, the diagnosis of a carotid plaque is commonly made in medical practice. Asymptomatic and symptomatic carotid stenoses need to be considered separately because their natural history is different. Two large randomized controlled trials (RCTs) showed the effectiveness of carotid endarterectomy (CEA) in preventing ipsilateral ischemic events in patients with symptomatic severe stenosis. The benefit of surgery is much less for moderate stenosis and harmful in patients with stenosis less than 50%. Surgery has a marginal benefit in patients with asymptomatic stenosis. Improvements in medical treatment must be taken into consideration when interpreting the results of these previous trials which compared surgery against medical treatment available at the time the trials were conducted. Carotid artery stenting (CAS) might avoid the risks associated with surgery, including cranial nerve palsy, myocardial infarction, or pulmonary embolism. Therefore and additionally to well-established indications of CAS, this endovascular approach might be a valid alternative particularly in patients at high surgical risk. However, trials of endovascular treatment of carotid stenosis have failed to provide enough evidence to justify routine CAS as an alternative to CEA in patients suitable for surgery. More data from ongoing randomized trials of CEA versus CAS will be soon available. These results will help determining the role of CAS in the management of patients with carotid artery stenosis.

  12. [Simultaneous carotid and vertebral revascularization in the aged].

    Science.gov (United States)

    Illuminati, G; Caliò, F G; Bertagni, A; Piermattei, A; Vietri, F; Martinelli, V

    1997-09-01

    Five patients of a mean age of 76, have been submitted to combined vertebral and carotid artery revascularization for a severe vertebro-basilar insufficiency. Vertebral artery revascularization consisted of a transposition to the common carotid artery in one case and of a carotid-distal vertebral artery saphenous bypass graft. The associated carotid artery revascularization consisted of a carotid endarterectomy with patch in 4 cases and without patch in one case. There were no postoperative mortality and no postoperative stroke. Postoperative morbidity included a transitory revascularization syndrome, a myocardial ischemia and a Horner's syndrome. Complete relief of vertebrobasilar symptoms was obtained in 4 patients whereas in one patient only a mild positional vertigo persisted. All vascular reconstructions have been assessed with postoperative arteriography and duplex-scan every six months. At 11 months mean follow-up, all revascularizations are patent. Combined carotid and vertebral artery surgery is effective in well selected cases, and it does not enhance the risk of the two operations performed separately. It also eliminate the possibility of failure of isolated carotid revascularization for vertebrobasilar symptoms.

  13. [Is there a role for asymptomatic carotid artery stenosis screening?].

    Science.gov (United States)

    Heldenberg, Eitan; Bass, Arie

    2014-08-01

    Screening for asymptomatic carotid artery stenosis (CAS) is highly controversial Many surgeons routinely screen their patients for carotid disease prior to major operations, yet the benefit of such practice was never demonstrated. The treatment of symptomatic patients has not changed much during the last twenty years, since the publication of the North American Symptomatic Carotid Endarterectomy Trial (NASCET). However, in contrast, the Asymptomatic Carotid Atherosclerosis Study (ACAS) and the Asymptomatic Carotid Surgery Trial (ACST) failed to get the same acceptance among the multidisciplinary group treating CAS.The prevalence of asymptomatic 60-99% carotid artery stenosis among the general population is about 1%. Neither ACAS nor ACST showed that stenosis severity was associated with increasing stroke risk. The 'realpolitik' is that mass interventions in asymptomatic patients will probably only ever prevent about 1% of all strokes. This is even truer regarding patients scheduLed for major operation, in which the incidence of stroke is less than 1%. Moreover the current evidence in the literature suggests that the best medicaL treatment (BMT) results in 0.5% strokes per year, better than resuLts which can be offered by surgery. According to the current evidence, it seems that asymptomatic carotid artery screening should be discontinued, since it is a major waste of resources.

  14. Parental history of premature myocardial infarction is a stronger predictor of increased carotid intima-media thickness than parental history of hypertension.

    Science.gov (United States)

    Barra, S; Gaeta, G; Cuomo, V; Guarini, P; Cuomo, S; Capozzi, G; Tudisca, G; Madrid, A; Trevisan, M

    2011-06-01

    An increased carotid intima-media thickness (IMT) is detectable in young subjects with parental history of premature myocardial infarction (PHPMI) or hypertension (PHH). In this study we evaluated if PHPMI and PHH exert a different influence on carotid IMT and if their conjunction produces additive effects. High-resolution B-mode ultrasonographic evaluation of common carotid artery IMT was acquired from 48 subjects without PHPMI and PHH (22 males, 26 females; mean age 22.1±4.9 years; controls), 24 age- (±1 year) and sex-matched subjects with PHH without PHPMI (PHH-positive/PHPMI-negative subjects), 24 age- and sex-matched subjects with PHPMI without PHH (PHH-negative/PHPMI-positive subjects) and 24 age- and sex-matched subjects with both PHPMI and PHH (PHH/PHPMI-positive subjects). Lipid profile, resting blood pressure, smoking behaviour and body mass index (BMI) were also assessed. Carotid IMT was smaller in controls (0.41±0.07mm) compared to PHH-positive/PHPMI-negative subjects (0.47±0.10, p=0.023), to PHH-negative/PHPMI-positive subjects (0.54±0.11, p<0.001) and to PHH/PHPMI-positive subjects (0.52±0.10mm, p<0.001). Carotid IMT was greater in PHH-negative/PHPMI-positive (p=0.006) and in PHH/PHPMI-positive (p=0.031) than in PHH-positive/PHPMI-negative subjects. No difference in carotid IMT was evident between PHH-negative/PHPMI-positive and PHH/PHPMI-positive subjects (p=0.549). In the comparison among subjects using multiple regression analysis, only PHPMI, age and BMI were independently associated with carotid IMT. In healthy young subjects with PHPMI and/or PHH, carotid IMT is increased. PHPMI is a stronger predictor of increased carotid IMT than PHH. PHH in conjunction with PHPMI does not add any further detrimental effect on carotid IMT.

  15. Permanent catheterization of the carotid artery induces kidney infection and inflammation in the rat

    DEFF Research Database (Denmark)

    Fonseca, Uno Nicolas Kjærup; Nielsen, Sanne Gram; Hau, Jann

    2010-01-01

    Catheterization of the carotid artery and the jugular vein is one of the most commonly applied techniques used to gain intravascular access in pharmacology studies on rodents. We catheterized 10 rats by conventional clean techniques, 10 rats by aseptic techniques and 10 rats by conventional clean...... techniques using a heparin-coated catheter rather than an ordinary non-coated polyvinyl chloride catheter. In all groups, approximately 80% of the rats developed kidney infection and 10-30% of the rats were septicaemic. Clinical chemistry did not indicate severe kidney damage, but serum haptoglobin and body...

  16. Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Karp Kjell

    2011-07-01

    Full Text Available Abstract Background Directed ultrasonic screening for carotid stenosis is cost-effective in populations with > 5% prevalence of the diagnosis. Occasionally, calcifications in the area of the carotid arteries are incidentally detected on odontological panoramic radiographs. We aimed to determine if directed screening for carotid stenosis with ultrasound is indicated in individuals with such calcifications. Methods This was a cross-sectional study. Carotid ultrasound examinations were performed on consecutive persons, with findings of calcifications in the area of the carotid arteries on panoramic radiography that were otherwise eligible for asymptomatic carotid endarterectomy. Results Calcification in the area of the carotid arteries was seen in 176 of 1182 persons undergoing panoramic radiography. Of these, 117 fulfilled the inclusion criterion and were examined with carotid ultrasound. Eight persons (6.8%; 95% CI 2.2-11.5% had a carotid stenosis - not significant over the 5% pre-specified threshold (p = 0.232, Binomial test. However, there was a significant sex difference (p = 0.008, as all stenoses were found in men. Among men, 12.5% (95%CI 4.2-20.8% had carotid stenosis - significantly over the 5% pre-specified threshold (p = 0.014, Binomial test. Conclusions The incidental finding of calcification in the area of the carotid arteries on panoramic radiographs should be followed up with carotid screening in men that are otherwise eligible for asymptomatic carotid endarterectomy. Trial Registration The study was registered at http://www.clinicaltrials.gov; NCT00514644

  17. Angiographic features of unilateral nonbifurcating cervical carotid artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    En, Na Lae [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Seung Koo [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-08-15

    Nonbifurcating cervical carotid artery is a rare anomaly of the common carotid artery (CCA), in which the branches of the external carotid artery (ECA) arise directly from the CCA or proximal internal carotid artery without bifurcation, and therefore there is no proximal main trunk of the ECA. We report a unilateral nonbifurcating cervical carotid artery of a 67-year-old woman, incidentally found during cerebral aneurismal treatment.

  18. Simultaneous Endovascular Treatment of Tandem Internal Carotid Lesions: Case Report and Review of Literature.

    Science.gov (United States)

    Cvetic, Vladimir; Dragas, Marko; Colic, Momcilo; Vukasinovic, Ivan; Radmili, Oliver; Ilic, Nikola; Koncar, Igor; Bascarevic, Vladimir; Ristanovic, Natasa; Davidovic, Lazar

    2016-07-01

    The incidence of concomitant extracranial carotid artery stenosis and ipsilateral intracranial carotid aneurysm has been reported to vary between 2.8% and 5%. These complex lesions may present a challenge for treatment decision-making. This case report describes an asymptomatic male patient with severe carotid bifurcation stenosis, coupled with an unruptured supraclinoid internal carotid aneurysm. Both lesions were treated simultaneously. Patient underwent carotid stenting followed by aneurysm coiling in the same setting without any complication.

  19. Hydrocortisone supresses inflammatory activity of metalloproteinase - 8 in carotid plaque

    Directory of Open Access Journals (Sweden)

    Sthefano Atique Gabriel

    2015-09-01

    Full Text Available AbstractObjective:Matrix metalloproteinases are inflammatory biomarkers involved in carotid plaque instability. Our objective was to analyze the inflammatory activity of plasma and carotid plaque MMP-8 and MMP-9 after intravenous administration of hydrocortisone.Methods:The study included 22 patients with stenosis ≥ 70% in the carotid artery (11 symptomatic and 11 asymptomatic who underwent carotid endarterectomy. The patients were divided into two groups: Control Group - hydrocortisone was not administered, and Group 1 - 500 mg intravenous hydrocortisone was administered during anesthetic induction. Plasma levels of MMP-8 and MMP-9 were measured preoperatively (24 hours before carotid endarterectomy and at 1 hour, 6 hours and 24 hours after carotid endarterectomy. In carotid plaque, tissue levels of MMP-8 and MMP-9 were measured.Results:Group 1 showed increased serum levels of MMP- 8 (994.28 pg/ml and 408.54 pg/ml, respectively; P=0.045 and MMP-9 (106,656.34 and 42,807.69 respectively; P=0.014 at 1 hour after carotid endarterectomy compared to the control group. Symptomatic patients in Group 1 exhibited lower tissue concentration of MMP-8 in comparison to the control group (143.89 pg/ml and 1317.36 respectively; P=0.003. There was a correlation between preoperative MMP-9 levels and tissue concentrations of MMP-8 (P=0.042 and MMP-9 (P=0.019 between symptomatic patients in the control group.Conclusion:Hydrocortisone reduces the concentration of MMP- 8 in carotid plaque, especially in symptomatic patients. There was an association between systemic and tissue inflammation.

  20. Risk Factors for the Progression of Intima-Media Thickness of Carotid Arteries: A 2-Year Follow-Up Study in Patients with Newly Diagnosed Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Sang Ouk Chin

    2013-10-01

    Full Text Available BackgroundIntima-media thickness (IMT of the carotid arteries is known to have a positive correlation with the risk of cardiovascular disease. This study was designed to identify risk factors affecting the progression of carotid IMT in patients with type 2 diabetes mellitus (T2DM.MethodsPatients with newly diagnosed T2DM with carotid IMT measurements were enrolled, and their clinical data and carotid IMT results at baseline and 2 years later were compared.ResultsOf the 171 patients, 67.2% of males and 50.8% of females had abnormal baseline IMT of the left common carotid artery. At baseline, systolic blood pressure, body mass index and smoking in male participants, and fasting plasma glucose and glycated hemoglobin levels in females were significantly higher in patients with abnormal IMT than in those with normal IMT. Low density lipoprotein cholesterol (LDL-C levels in males and high density lipoprotein cholesterol (HDL-C levels in females at the 2-year follow-up were significantly different between the nonprogression and the progression groups. Reduction of the United Kingdom Prospective Diabetes Study (UKPDS 10-year coronary heart disease (CHD risk score after 2 years was generally higher in the nonprogression group than the progression group.ConclusionLDL-C levels in males and HDL-C levels in females at the 2-year follow-up were significantly different between participants with and without progression of carotid IMT. Furthermore, a reduction in the UKPDS 10-year CHD risk score appeared to delay the advancement of atherosclerosis. Therefore, the importance of establishing the therapeutic goal of lipid profiles should be emphasized to prevent the progression of carotid IMT in newly diagnosed T2DM patients.

  1. Increased YKL-40 expression in patients with carotid atherosclerosis

    DEFF Research Database (Denmark)

    Michelsen, Annika E; Rathcke, Camilla N; Skjelland, Mona

    2010-01-01

    atherosclerosis and 20 healthy controls. Carotid expression of YKL-40 was examined by real time RT-PCR in 57 of the patients. Regulation and effect of YKL-40 were examined in THP-1 monocytes. RESULTS: Our main findings were: (1) serum YKL-40 levels were significantly elevated in patients with carotid...... atherosclerosis, with particularly high levels in those with symptomatic disease; (2) patients with recent ischemic symptoms (within 2 months) had higher YKL-40 mRNA levels in carotid plaque than other patients; (3) in vitro, the beta-adrenergic receptor agonist isoproterenol, toll-like receptor (TLR) 2 and TLR4...

  2. Increased YKL-40 expression in patients with carotid atherosclerosis

    DEFF Research Database (Denmark)

    Michelsen, Axel Gottlieb; Rathcke, C.N.; Skjelland, M.

    2010-01-01

    atherosclerosis and 20 healthy controls. Carotid expression of YKL-40 was examined by real time RT-PCR in 57 of the patients. Regulation and effect of YKL-40 were examined in THP-1 monocytes. Results: Our main findings were: (1) serum YKL-40 levels were significantly elevated in patients with carotid...... atherosclerosis, with particularly high levels in those with symptomatic disease; (2) patients with recent ischemic symptoms (within 2 months) had higher YKL-40 mRNA levels in carotid plaque than other patients; (3) in vitro, the beta-adrenergic receptor agonist isoproterenol, toll-like receptor (TLR) 2 and TLR4...

  3. Atypically localized glomus tumors

    Directory of Open Access Journals (Sweden)

    Meric Ugurlar

    2016-12-01

    Conclusion: When a painful mass is found in the body, glomus tumors should be kept in mind. The consideration of symptoms, including pain, temperature sensitivity, point tenderness, and discoloration, common characteristics of glomus tumors, may aid diagnosis. [Hand Microsurg 2016; 5(3.000: 112-117

  4. Carotid stenting through the right brachial approach for left internal carotid artery stenosis and bovine aortic arch configuration

    Energy Technology Data Exchange (ETDEWEB)

    Montorsi, Piero; Galli, Stefano; Ravagnani, Paolo; Ghulam Ali, Sarah; Trabattoni, Daniela; Fabbiocchi, Franco; Lualdi, Alessandro; Ballerini, Giovanni; Andreini, Daniele; Pontone, Gianluca; Annoni, Andrea; Bartorelli, Antonio L. [Institute of Cardiology University of Milan, Centro Cardiologico Monzino, IRCCS, Milan (Italy)

    2009-08-15

    Unfavorable complex anatomy or congenital anomalies of supra-aortic vessel take-off may increase carotid artery stenting (CAS) procedural difficulties and complications through the femoral route. We assessed the feasibility, safety, and efficacy of CAS through the right brachial approach in patients in whom left internal carotid artery stenosis and bovine aortic arch configuration were identified with computed tomography (CT) angiography. Bovine configuration of the aortic arch and left carotid artery stenosis were easily identified by CT angiography and successfully treated through the right brachial approach technique. (orig.)

  5. Cardiac Iodine-123-Meta-Iodo-Benzylguanidine Uptake in Carotid Sinus Hypersensitivity.

    Directory of Open Access Journals (Sweden)

    Maw Pin Tan

    Full Text Available Carotid sinus syndrome is the association of carotid sinus hypersensitivity with syncope, unexplained falls and drop attacks in generally older people. We evaluated cardiac sympathetic innervation in this disorder in individuals with carotid sinus syndrome, asymptomatic carotid sinus hypersensitivity and controls without carotid sinus hypersensitivity.Consecutive patients diagnosed with carotid sinus syndrome at a specialist falls and syncope unit were recruited. Asymptomatic carotid sinus hypersensitivity and non-carotid sinus hypersensitivity control participants recruited from a community-dwelling cohort. Cardiac sympathetic innervation was determined using Iodine-123-metaiodobenzylguanidine (123-I-MIBG scanning. Heart to mediastinal uptake ratio (H:M were determined for early and late uptake on planar scintigraphy at 20 minutes and 3 hours following intravenous injection of 123-I-MIBG.Forty-two subjects: carotid sinus syndrome (n = 21, asymptomatic carotid sinus hypersensitivity (n = 12 and no carotid sinus hypersensitivity (n = 9 were included. Compared to the non- carotid sinus hypersensitivity control group, the carotid sinus syndrome group had significantly higher early H:M (estimated mean difference, B = 0.40; 95% confidence interval, CI = 0.13 to 0.67, p = 0.005 and late H:M (B = 0.32; 95%CI = 0.03 to 0.62, p = 0.032. There was, however, no significant difference in early H:M (p = 0.326 or late H:M (p = 0.351 between the asymptomatic carotid sinus hypersensitivity group and non- carotid sinus hypersensitivity controls.Cardiac sympathetic neuronal activity is increased relative to age-matched controls in individuals with carotid sinus syndrome but not those with asymptomatic carotid sinus hypersensitivity. Blood pressure and heart rate measurements alone may therefore represent an over simplification in the assessment for carotid sinus syndrome and the relative increase in cardiac sympathetic innervation provides additional clues to

  6. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  7. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  8. Impending Carotid Blowout Stabilization Using an LT-D Tube

    Directory of Open Access Journals (Sweden)

    G. Desuter

    2014-01-01

    Full Text Available Adequate stabilization of a patient presenting with a carotid blowout is one of the most challenging issues an on-call ENT surgeon can be confronted with. Reducing the bleeding and securing the airway are essential before more definitive management. We present the case of a 72-year-old patient with head and neck cancer who arrived at the emergency room with a carotid blowout and who was successfully stabilized using a King LT-D ventilation tube.

  9. Gene expression and 18FDG uptake in atherosclerotic carotid plaques

    DEFF Research Database (Denmark)

    Pedersen, Sune Folke; Græbe, Martin; Hag, Anne Mette Fisker;

    2010-01-01

    ) and an additional ipsilateral internal carotid artery stenosis of greater than 60% were recruited. FDG uptake in the carotids was determined by PET/computed tomography and expressed as mean and maximal standardized uptake values (SUVmean and SUVmax). The atherosclerotic plaques were subsequently recovered...... as SUVmax (R=0.30, Puptake. We suggest that FDG uptake is a composite indicator of macrophage load, overall inflammatory activity and collagenolytic plaque...

  10. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis.......The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  11. Isolated supraclinoid occlusive disease of the internal carotid artery.

    Science.gov (United States)

    Lagrèze, H L; Hartmann, A; Ries, F; Wappenschmidt, J; Hanisch, E

    1987-01-01

    Isolated supraclinoid occlusive disease of the internal carotid artery is a rare cause of cerebral ischemia. The authors of the only review of this subject concluded that it is caused predominantly by factors other than atherosclerosis. We examined 6 patients with isolated supraclinoid occlusive lesions. Five of them had one or more risk factors for atherosclerosis. Thus, the isolated stenosis of that part of the internal carotid artery does not seem to represent a particular pathologic entity.

  12. Stent-graft repair of carotid endarterectomy-related pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    Manuela Carnini; Gabriele Piffaretti; Chiara Lomazzi

    2013-01-01

    Objective: Carotid endarterectomy-related pseudoaneurysms are rare lesions challenging to be treated with conventional open surgery. Endovascular stent-graft has been rarely adopted with encouraging results. We present a case of a huge carotid pseudoaneurysm treated with a stent-graft and managed with a stent-graft and reviewed the available literature on the management and results of this technique for these challenging lesions.

  13. Dissection of a non-bifurcating cervical carotid artery.

    Science.gov (United States)

    Nas, Omer Fatih; Karakullukcuoglu, Zeynel; Hakyemez, Bahattin; Erdogan, Cuneyt

    2016-06-01

    A non-bifurcating cervical carotid artery is a rare anomaly in the population. Radiologic diagnosis of pathologies seen together with this anomaly can be challenging. Despite not being diagnostic all the time, digital subtraction angiography is accepted as the gold standard method for the diagnosis of dissection. We present a case of a non-bifurcating cervical carotid artery and concomitant dissection, which presented to the hospital with trauma and ischemic findings.

  14. Computed Tomography-Based Anatomic Assessment Overestimates Local Tumor Recurrence in Patients With Mass-like Consolidation After Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dunlap, Neal E. [Department of Radiation Oncology, University of Louisville, Louisville, KY (United States); Yang Wensha [Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA (United States); McIntosh, Alyson [Department of Radiation Oncology, John and Dorothy Morgan Cancer Center, Lehigh Valley Hospital, Allentown, PA (United States); Sheng, Ke [Department of Radiation Oncology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA (United States); Benedict, Stanley H.; Read, Paul W. [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States); Larner, James M., E-mail: jml2p@virginia.edu [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States)

    2012-12-01

    Purpose: To investigate pulmonary radiologic changes after lung stereotactic body radiotherapy (SBRT), to distinguish between mass-like fibrosis and tumor recurrence. Methods and Materials: Eighty consecutive patients treated with 3- to 5-fraction SBRT for early-stage peripheral non-small cell lung cancer with a minimum follow-up of 12 months were reviewed. The mean biologic equivalent dose received was 150 Gy (range, 78-180 Gy). Patients were followed with serial CT imaging every 3 months. The CT appearance of consolidation was defined as diffuse or mass-like. Progressive disease on CT was defined according to Response Evaluation Criteria in Solid Tumors 1.1. Positron emission tomography (PET) CT was used as an adjunct test. Tumor recurrence was defined as a standardized uptake value equal to or greater than the pretreatment value. Biopsy was used to further assess consolidation in select patients. Results: Median follow-up was 24 months (range, 12.0-36.0 months). Abnormal mass-like consolidation was identified in 44 patients (55%), whereas diffuse consolidation was identified in 12 patients (15%), at a median time from end of treatment of 10.3 months and 11.5 months, respectively. Tumor recurrence was found in 35 of 44 patients with mass-like consolidation using CT alone. Combined with PET, 10 of the 44 patients had tumor recurrence. Tumor size (hazard ratio 1.12, P=.05) and time to consolidation (hazard ratio 0.622, P=.03) were predictors for tumor recurrence. Three consecutive increases in volume and increasing volume at 12 months after treatment in mass-like consolidation were highly specific for tumor recurrence (100% and 80%, respectively). Patients with diffuse consolidation were more likely to develop grade {>=}2 pneumonitis (odds ratio 26.5, P=.02) than those with mass-like consolidation (odds ratio 0.42, P=.07). Conclusion: Incorporating the kinetics of mass-like consolidation and PET to the current criteria for evaluating posttreatment response will

  15. Carotid endovascular interventions: patient selection, devices, techniques and tips.

    Science.gov (United States)

    Bosiers, M; Deloose, K; Peeters, P

    2010-02-01

    The optimal treatment of patients with asymptomatic or symptomatic carotid artery disease (CAD) has been a long-lasting debate. The choice between carotid endarterectomy (CEA), carotid artery stenting (CAS) and/or optimal medical therapy to treat patients with CAD, depends on their risk profile. Recent data from EVA-3S, SPACE randomized trials failed to demonstrate non-inferiority for CAS over CEA. However, other publications suggest that with growing experience and the development of dedicated CAS technology, CAS can be performed safely and efficiently. The success of carotid stenting does not solely depend on the operator's skills and experience, but also on the adequate selection of carotid stents and cerebral protection devices. Currently, CAS practitioners are confronted with a large number of dedicated CAS devices (stents and embolic protection devices). This wide array of products makes individual treatment strategies difficult to generalise as no single device possesses all of the optimal features to treat all types of carotid plaques and patients. This article reviews the principles of patient selection and device selection in contemporary CAS practice.

  16. The role of carotid artery stenting for recent cerebral ischemia.

    Science.gov (United States)

    Bosiers, M; Callaert, J; Deloose, K; Verbist, J; Keirse, K; Peeters, P

    2010-06-01

    Patients with cerebral ischemia as a result of acute cervical internal carotid artery occlusion are generally considered to have a poor prognosis. Despite maximal medical treatment, a better treatment for patients with acute ischemic stroke who present with serious neurologic symptoms on admission or continue to deteriorate neurologically due to a total occlusion, a dissection or a high-grade stenosis of the internal carotid artery is required. An effective intervention to improve their neurologic symptoms and clinical outcome has not yet been established and represents a challenging and complex problem. Treatment of acute symptomatic occlusion of the cervical internal carotid artery includes intravenous administration of thrombolytic agent, carotid endarterectomy and an interventional approach (intra-arterial administration of thrombolytic agent, transluminal angioplasty with or without stenting). The endovascular interventional approach is becoming a part of the stroke therapy armamentarium for intracranial occlusion. It may also now be considered in select patients with acute internal carotid artery occlusion. Stenting and angioplasty for acute internal carotid artery occlusion appears to be feasible, safe and may be associated with early neurological improvement. The encouraging preliminary results await confirmation from prospective, randomized studies.

  17. Occlusion of Internal Carotid Artery in Kimura's Disease

    Directory of Open Access Journals (Sweden)

    Tomonori Tamaki

    2010-01-01

    Full Text Available We describe a unique case of Kimura's disease in which cerebral infarction was caused by occlusion of the right internal carotid artery. A 25-year-old man with Kimura's disease was admitted to our hospital because of left hemiparesis. Computed tomography and magnetic resonance imaging of the head showed infarction in the right frontal and temporal lobes. Cerebral angiography demonstrated right internal carotid artery occlusion affecting the C1 segment, with moyamoya-like collateral vessels arising from the right opthalamic artery. Kimura's disease is a chronic disease characterized by the clinical triad of slowly enlarging subcutaneous masses with lymphoid hyperplasia in the head and neck. It often occurs in young Asian men. In our patient, the pathogenesis of internal carotid artery occlusion was unknown. There have only been a few case reports in which occlusion of the internal carotid artery was associated with autoimmune disease, and no previous cases of internal carotid occlusion associated with Kimura's disease have been reported. We suspected that occlusion of this patient's internal carotid artery may be caused by the autoimmune mechanism that underlies Kimura's disease.

  18. Metastasis and circulating tumor cells

    NARCIS (Netherlands)

    Dalum, van G.; Holland, L.; Terstappen, L.W.M.M.

    2012-01-01

    Cancer is a prominent cause of death worldwide. In most cases, it is not the primary tumor which causes death, but the metastases. Metastatic tumors are spread over the entire human body and are more difficult to remove or treat than the primary tumor. In a patient with metastatic disease, circulati

  19. Transarterial detachable coil embolization combined with ipsilateral intermittent carotid oppression for traumatic carotid-cavernous fistula with small fistula

    Institute of Scientific and Technical Information of China (English)

    Qing Huang; Hongbing Zhang; Gang Wang; Jun Yang; Yanlong Hu; Jianxin Liu

    2015-01-01

    One case of traumatic carotid-cavernous fistula (TCCF) with small fistula treated by transarterial detachable coil embolization was reported.The intermittent ipsilateral carotid compression was used to identify the final blocking of the residual fistula.The follow-up digital subtraction angiography showed that the TCCF was cured finally, From this case, we conclude that this method may be an effective way to treat TCCF with small fistula.

  20. Wall stress of the cervical carotid artery in patients with carotid dissection: a case-control study.

    Science.gov (United States)

    Callaghan, Fraser M; Luechinger, Roger; Kurtcuoglu, Vartan; Sarikaya, Hakan; Poulikakos, Dimos; Baumgartner, Ralf W

    2011-04-01

    Spontaneous internal carotid artery (ICA) dissection (sICAD) results from an intimal tear located around the distal carotid sinus. The mechanisms causing the tear are unknown. This case-control study tested the hypotheses that head movements increase the wall stress in the cervical ICA and that the stress increase is greater in patients with sICAD than in controls. Five patients with unilateral, recanalized, left sICAD and five matched controls were investigated before and after maximal head rotation to the left and neck hyperextension after 45° head rotation to the left. The anatomy of the extracranial carotid arteries was assessed by magnetic resonance imaging and used to create finite element models of the right ICA. Wall stress increased after head movements. Increases above the 80th and 90th percentile were located at the intimal side of the artery wall from 7.4 mm below to 10 mm above the cranial edge of the carotid sinus, i.e., at the same location as histologically confirmed tears in patients with sICAD. Wall stress increase did not differ between patients and controls. The present findings suggest that wall stress increases at the intimal side of the artery wall surrounding the distal edge of the carotid bulb after head movements may be important for the development of carotid dissection. The lack of wall stress difference between the two groups indicates that the carotid arteries of patients with carotid dissection have either distinct functional or anatomical properties or endured unusually heavy wall stresses to initiate dissection.

  1. Calcifying epithelial odontogenic tumor (Pindborg tumor)

    Science.gov (United States)

    Singh, Neeraj; Sahai, Sharad; Singh, Sourav; Singh, Smita

    2011-01-01

    The calcifying epithelial odontogenic tumor (CEOT) is a rare entity and represents less than 1% of all odontogenic tumors. Dr. J J Pindborg (1958) first described four cases of this unusual lesion; subsequently Shafer et al coined the term Pindborg tumor. This lesion is a locally aggressive benign odontogenic neoplasm arising from epithelial tissue. It occurs most commonly in 4th-5th-6th decade of life and bears no gender predilection. A case of CEOT in a 50-year-old male arising in the left body region is described. PMID:22639521

  2. Contrast-enhanced ultrasound imaging of the vasa vasorum of carotid artery plaque

    Institute of Scientific and Technical Information of China (English)

    Ze-Zhou; Song; Yan-Ming; Zhang

    2015-01-01

    The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.

  3. Double-blind comparison of safety and efficacy of iomeprol and iopamidol in carotid digital subtraction angiography.

    Science.gov (United States)

    Beltramello, A; Piovan, E; Rosta, L

    1994-05-01

    Iomeprol is a nonionic monomer which provides injectable formulations with the lowest osmolalities and the lowest viscosities among the currently available low-osmolar radiographic contrast agents of the same category. These favourable physico-chemical characteristics, together with high water solubility and low molecular toxicity, make this agent particularly suitable for carotid angiography, a procedure in which contrast-induced blood-brain barrier damage is maximal. This single-centre, randomised, double-blind, parallel-group study aimed at comparing the safety, tolerance and efficacy of 200 mgI/ml solutions of iomeprol and iopamidol in 100 consenting adult inpatients undergoing carotid intra-arterial digital subtraction angiography (IA-DSA). Both agents appeared to be safe and well tolerated. Only minor and transient adverse events occurred throughout the study. Electroencephalographic and neurological examinations performed pre- and post-contrast showed no abnormality induced by the test compounds. Vessel opacification was good or excellent in the vast majority of technically adequate examinations. Information provided by the angiographic examination was useful for subsequent patient management in almost all cases. It is concluded that iomeprol-200 and iopamidol-200 are safe and effective contrast media when used for carotid IA-DSA, an examination which proves useful not only for the diagnosis of vascular lesions, but also to best direct the management of patients scheduled for surgery of intracranial tumors.

  4. Case Report: En Bloc Resection of Pancoast Tumor with Adjuvant Aortic Endograft and Chemoradiation

    Science.gov (United States)

    Lu, Tony; Fischer, Uwe M.; Marco, Rex A.; Naoum, Joseph J.; Reardon, Michael J.; Lumsden, Alan B.; Blackmon, Shanda H.; Davies, Mark G.

    2015-01-01

    “Pancoast” tumors frequently require a multidisciplinary approach to therapy and are still associated with high morbidity and mortality. Due to their sensitive anatomic location, complex resections and chemoradiation regimens are typically required for treatment. Those with signs of aortic invasion pose an even greater challenge, given the added risks of cardiopulmonary bypass for aortic resection and interposition. Placement of an aortic endograft can facilitate resection if the tumor is in close proximity to or is invading the aorta. Prophylactic endografting to prevent radiation-associated aortic rupture has also been described. This case describes a 60-year-old female who presented with a stage IIIa left upper lobe undifferentiated non-small-cell carcinoma encasing the subclavian artery with thoracic aorta and bony invasion. Following carotid-subclavian bypass with Dacron, en bloc resection of the affected lung, ribs, and vertebral bodies was performed. The aorta was prophylactically reinforced with a Gore TAG thoracic endograft prior to adjuvant chemoradiation. The patient remains disease-free at more than 5 years follow-up after completing her treatment course. Endovascular stenting with subsequent chemoradiation may prove to be a viable alternative to palliation or open operative management and prevention of aortic injury during tumor resection and/or adjuvant therapy in select patients with aortic involvement. PMID:26306134

  5. Association of thrombomodulin Ala455Val dimorphism and inflammatory cytokines with carotid atherosclerosis in the Chinese Han population

    Directory of Open Access Journals (Sweden)

    Qian G

    2012-11-01

    more common among patients with carotid atherosclerosis than in controls (P < 0.05. The frequency of the C allele was 45.5% in patients and 36.2% in controls. The thrombomodulin Ala455 genotypes C/C and C/T were significantly more common than the T/T genotype in patients with carotid atherosclerosis in the Chinese Han population. In addition, higher baseline levels of tumor necrosis factor alpha (55.45 ± 11.58 pg/mL versus 52.70 ± 10.74 pg/mL; P < 0.05, interleukin-6 (31.53 ± 10.51 pg/mL versus 27.73 ± 8.37 pg/mL; P < 0.01, and C-reactive protein (6.65 ± 2.01 mg/L versus 4.06 ± 1.03 mg/L; P < 0.01 were observed in patients with carotid atherosclerosis than in controls. Interestingly, compared with baseline inflammatory cytokine levels in those with the Val/Val genotype, higher baseline tumor necrosis factor alpha, interleukin-6, and C-reactive protein levels were observed for the Ala/Ala genotype in both patients with carotid atherosclerosis and healthy controls.Conclusion: Our results support a significant association between thrombomodulin Ala455Val dimorphism, inflammatory cytokines, and carotid atherosclerosis in the Chinese Han population.Keywords: thrombomodulin, carotid atherosclerosis, dimorphism, inflammatory cytokines, association study

  6. Apolipoprotein E gene polymorphisms as risk factors for carotid atherosclerosis

    Directory of Open Access Journals (Sweden)

    Zurnić Irena

    2014-01-01

    Full Text Available Background/Aim. Atherosclerosis is still the leading cause of death in Western world. Development of atherosclerotic plaque involves accumulation of inflammatory cells, lipids, smooth muscle cells and extracellular matrix proteins in the intima of the vascular wall. Apolipoprotein E participates in the transport of exogenous cholesterol, endogenouly synthesized lipids and triglycerides in the organism. Apolipoprotein E gene has been identified as one of the candidate genes for atherosclerosis. Previous studies in different populations have clearly implicated apolipoprotein E genetic variation (ε polymorphisms as a major modulator of low density lipoprotein cholesterol levels. Data considering apolipoprotein E polymorphisms in relation to carotid atherosclerosis gave results that are not in full compliance. The aim of present study was to investigate the apolipoprotein E polymorphisms in association with carotid plaque presence, apolipoprotein E and lipid serum levels in patients with carotid atherosclerosis from Serbia. Methods. The study group enrolled 495 participants: 285 controls and 210 consecutive patients with carotid atherosclerosis who underwent carotid endarterectomy. Genotyping of apolipoprotein E polymorphisms were done using polymerase chain reaction and restriction fragment length polymorphism methods. Results. Patients had significantly decreased frequency of the ε2 allele compared to controls. Patients who carry at least one ε2 allele had a significantly higher level of serum apolipoprotein E and significantly lower low density lipoprotein cholesterol levels compared to those who do not carry this allele. Conclusion. Our results suggest protective effect of apolipoprotein E ε2 allele on susceptibility for carotid plaque presence as well as low density lipoprotein cholesterol lowering effect in Serbian patients with carotid atherosclerosis. Further research of multiple gene and environmental factors that contribute to the

  7. Capsaicin facilitates carotid sinus baroreceptor activity in anesthetized rats

    Institute of Scientific and Technical Information of China (English)

    HaoZHANG; Yi-xianLIU; Yu-mingWU; Ze-minWANG; Rui-rongHE

    2004-01-01

    AIM: To study the effect of capsaicin on carotid sinus baroreceptor activity (CBA). METHODS: The functional curve of carotid baroreceptor (FCCB) was constructed and the functional parameters of carotid sinus baroreceptor were measured by recording sinus nerve afferent discharge in anesthetized rats with perfused isolated carotid sinus. RESULTS: Low-concentration of capsaicin (0.2μmol/L) had no significant effect on CBA, while perfusion of the isolated carotid sinus with middle-concentration of capsaicin (1μmol/L) could shift FCCB to the left and upward,with peak slope (PS) increased from (2.47%±0.14%)/mmHg to (2.88%±0.10%)/mmHg (P<0.05) and peak integral value of carotid sinus nerve discharge (PIV) enhanced from 211%±5% to 238%±6% (P<0.01). The threshold pressure (TP) and saturation pressure (SP) were significantly decreased from 68.0±1.1 to 62.7±1.0mmHg (P<0.01) and from 171.0±1.6 to 165.0±0.6 mmHg (P<0.01). By perfusing with high-concentration of capsaicin (5μmol/L), FCCB was shifted to the left and upward further and the changes of the functional parameters such as PS, TP, and SP were concentration-dependent. Pretreatment with ruthenium red (100μmol/L), an antagonist of vanilloid receptor subtype 1 (VR1), blocked the effect of capsaicin on CBA. Preperfusion with glibenclamide(20μmol/L), a KATP channel blocker, could eliminate the effect of capsaicin on CBA. CONCLUSION: Capsaicin exerts a facilitatory role on the isolated carotid baroreceptor in a concentration-dependent manner. The facilitatory action of capsaicin may be attributed to the opening of KATP channels mediated by VR1.

  8. Capsaicin facilitates carotid sinus baroreceptor activity in anesthetized rats

    Institute of Scientific and Technical Information of China (English)

    Hao ZHANG; Yi-xian LIU; Yu-ming WU; Ze-min WANG; Rui-rong HE

    2004-01-01

    AIM: To study the effect of capsaicin on carotid sinus baroreceptor activity (CBA). METHODS: The functional curve of carotid baroreceptor (FCCB) was constructed and the functional parameters of carotid sinus baroreceptor were measured by recording sinus nerve afferent discharge in anesthetized rats with perfused isolated carotid sinus.RESULTS: Low-concentration of capsaicin (0.2 μmol/L) had no significant effect on CBA, while perfusion of the isolated carotid sinus with middle-concentration of capsaicin (1 μmol/L) could shift FCCB to the left and upward,with peak slope (PS) increased from (2.47 %±0.14 %)/mmHg to (2.88 %±0.10 %)/mmHg (P<0.05) and peak integral value of carotid sinus nerve discharge (PIV) enhanced from 211%±5 % to 238 %±6 % (P<0.01). The threshold pressure (TP) and saturation pressure (SP) were significantly decreased from 68.0±1.1 to 62.7±1.0mmHg (P<0.01) and from 171.0±1.6 to 165.0±0.6 mmHg (P<0.01). By perfusing with high-concentration of capsaicin (5 μmol/L), FCCB was shifted to the left and upward further and the changes of the functional parameters such as PS, TP, and SP were concentration-dependent. Pretreatment with ruthenium red (100 μmol/L), an antagonist of vanilloid receptor subtype 1 (VR1), blocked the effect of capsaicin on CBA. Preperfusion with glibenclamide(20 μmol/L), a KATp channel blocker, could eliminate the effect of capsaicin on CBA. CONCLUSION: Capsaicin exerts a facilitatory role on the isolated carotid baroreceptor in a concentration-dependent manner. The facilitatory action of capsaicin may be attributed to the opening of KATP channels mediated by VR1.

  9. LPS-induced c-Fos activation in NTS neurons and plasmatic cortisol increases in septic rats are suppressed by bilateral carotid chemodenervation.

    Science.gov (United States)

    Reyes, Edison-Pablo; Abarzúa, Sebastián; Martin, Aldo; Rodríguez, Jorge; Cortés, Paula P; Fernández, Ricardo

    2012-01-01

    Lipopolysaccharide (LPS) administered I.P. increases significantly the activation of c-Fos in neurons of the nucleus of the solitary tract (NTS), which in turn activates hypothalamus-pituitary-adrenal axis. The vagus nerve appears to play a role in conveying cytokines signals to the central nervous system (CNS), since -in rodent models of sepsis- bilateral vagotomy abolishes increases in plasmatic glucocorticoid levels, but does not suppress c-Fos NTS activation. Considering that NTS also receives sensory inputs from carotid body chemoreceptors, we evaluated c-Fos activation and plasmatic cortisol levels 90 min after I.P. administration of 15 mg/kg LPS. Experiments were performed in male Sprague-Dawley rats, in control conditions and after bilateral carotid neurotomy (BCN). LPS administration significantly increases the number of c-Fos positive NTS neurons and plasmatic cortisol levels in animals with intact carotid/sinus nerves. When LPS was injected after BCN, the number of c-Fos positive NTS neurons, and plasmatic cortisol levels were not significantly modified. Our data suggest that carotid body chemoreceptors might mediate CNS activation during sepsis.

  10. Carotid artery occlusion by rhinoorbitocerebral mucormycosis.

    Science.gov (United States)

    Al-Otaibi, Faisal; Albloushi, Monirah; Alhindi, Hindi; Timms, Michael S

    2012-01-01

    Mucormycosis is the third most common invasive fungal infection that particularly occurs in immunocompromised patients. Intracranial and extracranial arteriovenous vasculopathy is a complication that makes this disease more complex and difficult to treat. We describe a 23-year-old female, who presented to her local hospital with acute blindness and diabetic ketoacidosis-induced coma requiring intensive care treatment. She was found to have lesions in the nasal sinuses, orbit, and frontal base. The left carotid artery was occluded from its origin in the neck to the supraclinoid segment and left cavernous sinus involvement. No cerebral infarction was noted. Biopsies obtained by endonasal debridement confirmed mucormycosis. In addition to antimicrobial therapy, she underwent several multidisciplinary approaches to treat her disease. Multiple endonasal, and cranial procedures were done including bilateral orbital exenteration. After prolonged treatment on the intensive care unit she made a remarkable recovery to the point where she was communicating verbally and had normal limb movements and later discharged home. She remained alive and well for two months, but later succumbed to a recurrence of her disease. In conclusion, mucormycosis-induced vasculopathy is a complex problem, which merits aggressive treatment of this invasive disease. It is normally regarded as an indicator of grave prognosis.

  11. Carotid Artery Occlusion by Rhinoorbitocerebral Mucormycosis

    Directory of Open Access Journals (Sweden)

    Faisal Al-Otaibi

    2012-01-01

    Full Text Available Mucormycosis is the third most common invasive fungal infection that particularly occurs in immunocompromised patients. Intracranial and extracranial arteriovenous vasculopathy is a complication that makes this disease more complex and difficult to treat. We describe a 23-year-old female, who presented to her local hospital with acute blindness and diabetic ketoacidosis-induced coma requiring intensive care treatment. She was found to have lesions in the nasal sinuses, orbit, and frontal base. The left carotid artery was occluded from its origin in the neck to the supraclinoid segment and left cavernous sinus involvement. No cerebral infarction was noted. Biopsies obtained by endonasal debridement confirmed mucormycosis. In addition to antimicrobial therapy, she underwent several multidisciplinary approaches to treat her disease. Multiple endonasal, and cranial procedures were done including bilateral orbital exenteration. After prolonged treatment on the intensive care unit she made a remarkable recovery to the point where she was communicating verbally and had normal limb movements and later discharged home. She remained alive and well for two months, but later succumbed to a recurrence of her disease. In conclusion, mucormycosis-induced vasculopathy is a complex problem, which merits aggressive treatment of this invasive disease. It is normally regarded as an indicator of grave prognosis.

  12. High-Dose Chemotherapy With or Without Total-Body Irradiation Followed by Autologous Stem Cell Transplant in Treating Patients With Hematologic Cancer or Solid Tumors

    Science.gov (United States)

    2016-11-07

    Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor (PNET); Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Plasma Cell Neoplasm; Primary Systemic Amyloidosis; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2

  13. Hemiparesis in carotid cavernous fistulas (CCFs):a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    王慧晓; 白如林; 黄承光; 卢亦成; 张光霁

    2004-01-01

    @@ Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous anastamoses between the carotid artery and the cavernous sinus. These fistulas may be classified by cause (spontaneous or traumatic), flow velocity (high or low ), or pathogenesis (direct or indirect).

  14. Carotid artery stenting: which stent for which lesion?

    Science.gov (United States)

    Bosiers, Marc; Deloose, Koen; Verbist, Jürgen; Peeters, Patrick

    2005-01-01

    The different geometries and working principles of carotid stents (nitinol or cobalt chromium, open- or closed-cell configuration) provide each product with unique functional properties. The individual characteristics of each device may make it an attractive choice in one circumstance but render it less desirable in other situations. In approximately 75% of all procedures, all types of stents will achieve similar outcomes, making adequate device selection unnecessary. For the remaining quarter, careful preoperative screening is mandatory. In addition to eventual access issues, the choice of the optimal carotid stent depends mainly on arterial anatomy and lesion morphology. When treating a tortuous anatomy, stents with a flexible and comformable open-cell configuration are preferred. In arteries with a significant mismatch between common carotid artery and internal carotid artery diameter, cobalt chromium (Elgiloy) or tapered nitinol stents are selected. Lesions with suspected high emboligenicity are best covered with stents with a closed-cell configuration, whereas highly calcified lesions need treatment with nitinol stents. Thorough knowledge of the characteristics, advantages and disadvantages, and working principles of the different available stents is mandatory to optimally select the materials to be used for patients eligible for carotid revascularization.

  15. [Injuries of the intracranial part of the carotid artery].

    Science.gov (United States)

    Sulla, I; Kafka, J; Mach, P; Výrostko, J; Kat'uch, V

    2000-07-01

    The objective of the submitted work was to draw attention to different types of injuries of the intracranial portion of the carotid artery and some problems associated with its solution. The investigated group comprised 7 subjects (2 women, 5 men) aged 19 to 76 years who attended between Jan. 1, 1995 and Feb. 29 2000 the Neurosurgical Clinic in Kosice with sequelae of injuries of the intracranial carotid artery. Two patients developed a pseudoaneurysm. In one case it was manifested by subarachnoid haemorrhage on the 24th day after a crash, in one instance by diplopia six weeks after a retrobulbar injection. Injury of the intracavernous portion of the artery was manifested in one instance by profuse epistaxis on the 17th day after a fall from a bicycle, four times by the development of a carotid-cavernous fistula several days to 3 years after the head injury. In the diagnosis classical as well as MR and digital subtraction angiography were used. In the patient with epistaxis classical carotid angiography was 3 times negative. The results are comparable with data in the literature. In three patients the problem was resolved by ligature of the common carotid artery on the neck. In another three it was necessary to use extra-intracranial trapping. One patient will be subjected to endovascular surgery. Two patients died (a 76-year-old woman from bronchopneumonia, a 19-year-old man from meningitis, despite a liquor fistula treated correctly by a patch).

  16. Increased LDL susceptibility to oxidation accelerates future carotid artery atherosclerosis

    Directory of Open Access Journals (Sweden)

    Aoki Toshinari

    2012-01-01

    Full Text Available Abstract Background We analyzed the causal relationship between LDL susceptibility to oxidation and the development of new carotid artery atherosclerosis over a period of 5 years. We previously described the determinants related to a risk of cardiovascular changes determined in a Japanese population participating in the Niigata Study, which is an ongoing epidemiological investigation of the prevention of cardiovascular diseases. Methods We selected 394 individuals (169 males and 225 females who underwent a second carotid artery ultrasonographic examination in 2001 - 2002 for the present study. The susceptibility of LDL to oxidation was determined as the photometric absorbance and electrophoretic mobility of samples that had been collected in 1996 - 1997. The measurements were compared with ultrasonographic findings obtained in 2001 - 2002. Results The multivariate-adjusted model showed that age (odds ratio (OR, 1.034; 95% confidence interval (95%CI, 1.010 - 1.059, HbA1c (OR, 1.477; 95%CI, 0.980 - 2.225, and photometric O/N (OR, 2.012; 95%CI, 1.000 - 4.051 were significant variables that could independently predict the risk of new carotid artery atherosclerosis. Conclusion The susceptibility of LDL to oxidation was a significant parameter that could predict new carotid artery atherosclerosis over a 5-year period, and higher susceptibility was associated with a higher incidence of new carotid artery atherosclerosis.

  17. Capsaicin facilitates carotid sinus baroreflex in anesthetized rats.

    Science.gov (United States)

    Zhang, Hao; Liu, Yi-Xian; Wu, Yu-Ming; Wang, Sheng; He, Rui-Rong

    2004-04-25

    The effects of capsaicin (CAP) on the carotid sinus baroreflex were studied in 30 anaesthetized rats with perfused isolated carotid sinus. The results are as follows. (1) By perfusing the isolated carotid sinus with CAP (1 micromol/L), the functional curve of the baroreflex was shifted to the left and downward, with a peak slope (PS) increasing from 0.34+/-0.01 to 0.42+/-0.01 (PPS and RD induced by capsaicin were dose-dependent. (2) By pretreatment with ruthenium red (RR, 100 micromol/L), an antagonist of vanilloid receptor subtype 1 (VR(1)), the above effects of CAP on carotid baroreflex were abolished. (3) The CAP-induced change in the baroreflex was also eliminated by pretreatment with glibenclamide (20 microm ol/L), a K(ATP) channel blocker. On the basis of the results, it is concluded that CAP facilitates the carotid baroreflex, an effect of which may be resulted from the opening of K(ATP) channels mediated by VR(1).

  18. Electrical carotid sinus stimulation in treatment resistant arterial hypertension.

    Science.gov (United States)

    Jordan, Jens; Heusser, Karsten; Brinkmann, Julia; Tank, Jens

    2012-12-24

    Treatment resistant arterial hypertension is commonly defined as blood pressure that remains above goal in spite of the concurrent use of three antihypertensive agents of different classes. The sympathetic nervous system promotes arterial hypertension and cardiovascular as well as renal damage, thus, providing a logical treatment target in these patients. Recent physiological studies suggest that baroreflex mechanisms contribute to long-term control of sympathetic activity and blood pressure providing an impetus for the development of electrical carotid sinus stimulators. The concept behind electrical stimulation of baroreceptors or baroreflex afferent nerves is that the stimulus is sensed by the brain as blood pressure increase. Then, baroreflex efferent structures are adjusted to counteract the perceived blood pressure increase. Electrical stimulators directly activating afferent baroreflex nerves were developed years earlier but failed for technical reasons. Recently, a novel implantable device was developed that produces an electrical field stimulation of the carotid sinus wall. Carefully conducted experiments in dogs provided important insight in mechanisms mediating the depressor response to electrical carotid sinus stimulation. Moreover, these studies showed that the treatment success may depend on the underlying pathophysiology of the hypertension. Clinical studies suggest that electrical carotid sinus stimulation attenuates sympathetic activation of vasculature, heart, and kidney while augmenting cardiac vagal regulation, thus lowering blood pressure. Yet, not all patients respond to treatment. Additional clinical trials are required. Patients equipped with an electrical carotid sinus stimulator provide a unique opportunity gaining insight in human baroreflex physiology.

  19. Feature selection applied to ultrasound carotid images segmentation.

    Science.gov (United States)

    Rosati, Samanta; Molinari, Filippo; Balestra, Gabriella

    2011-01-01

    The automated tracing of the carotid layers on ultrasound images is complicated by noise, different morphology and pathology of the carotid artery. In this study we benchmarked four methods for feature selection on a set of variables extracted from ultrasound carotid images. The main goal was to select those parameters containing the highest amount of information useful to classify the pixels in the carotid regions they belong to. Six different classes of pixels were identified: lumen, lumen-intima interface, intima-media complex, media-adventitia interface, adventitia and adventitia far boundary. The performances of QuickReduct Algorithm (QRA), Entropy-Based Algorithm (EBR), Improved QuickReduct Algorithm (IQRA) and Genetic Algorithm (GA) were compared using Artificial Neural Networks (ANNs). All methods returned subsets with a high dependency degree, even if the average classification accuracy was about 50%. Among all classes, the best results were obtained for the lumen. Overall, the four methods for feature selection assessed in this study return comparable results. Despite the need for accuracy improvement, this study could be useful to build a pre-classifier stage for the optimization of segmentation performance in ultrasound automated carotid segmentation.

  20. Anatomical and functional characteristics of carotid sinus stimulation in humans

    Science.gov (United States)

    Querry, R. G.; Smith, S. A.; Stromstad, M.; Ide, K.; Secher, N. H.; Raven, P. B.

    2001-01-01

    Transmission characteristics of pneumatic pressure to the carotid sinus were evaluated in 19 subjects at rest and during exercise. Either a percutaneous fluid-filled (n = 12) or balloon-tipped catheter (n = 7) was placed at the carotid bifurcation to record internal transmission of external neck pressure/neck suction (NP/NS). Sustained, 5-s pulses, and rapid ramping pulse protocols (+40 to -80 Torr) were recorded. Transmission of pressure stimuli was less with the fluid-filled catheter compared with that of the balloon-tipped catheter (65% vs. 82% negative pressure, 83% vs. 89% positive pressure; P Anatomical location of the carotid sinus averaged 3.2 cm (left) and 3.6 cm (right) from the gonion of the mandible with a range of 0-7.5 cm. Transmission was not altered by exercise or Valsalva maneuver, but did vary depending on the position of the carotid sinus locus beneath the sealed chamber. These data indicate that transmission of external NP/NS was higher than previously recorded in humans, and anatomical variation of carotid sinus location and equipment design can affect transmission results.

  1. Indium-111-labeled platelet scintigraphy in carotid atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Minar, E.; Ehringer, H.; Dudczak, R.; Schoefl, R.J.; Jung, M.; Koppensteiner, R.; Ahmadi, R.; Kretschmer, G.

    1989-01-01

    We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index.

  2. Correlation of restenosis after rabbit carotid endarterectomy and inflammatory cytokines

    Institute of Scientific and Technical Information of China (English)

    Jun-Jun Liang; Wei Xue; Li-Zhi Lou; Cheng Liu; Zhao-Fen Wang; Qing-Guo Li; Shao-Hua Huang

    2014-01-01

    Objective:To establish rabbit model of restenosis after carotid endarterectomy surgery, and to study tissue inflammatory cytokines(TNF-α,IL-6) involved in restenosis.Methods:A total of32 rabbits were randomly divided into two groups: model group and control group.The right common carotid artery in rabbits was damaged by carotid endar terectomy in model group.The tissues were harvested at different time points respectively, the pathological changes of the vascular wall after operation were observed at different time points.The changes of expression of tissue vascular wall inflammatory cytokines(TNF-α,IL-6) at different time points after the surgery was observed byRT-PCR, and the changes of serum inflammatory cytokines(TNF-α, IL -6) were detected byELISA.Results:The new intima appeared after7 daysof the injury and reached the peak on28 d which is uneven and significantly thicker than the control group (P<0.01).The tissue inflammatory cytokines(TNF-α,IL-6) were significantly increased after the rabbit common carotid artery injury, which was significant difference compared with normal control group(P<0.05).Conclusions:The tissue inflammatory factors significantly increase after the rabbit carotid artery injury, which suggests the mutual concurrent effects of inflammatory cytokines can result in the proliferation of vascular restenosis.

  3. The Accuracy of Noninvasive Imaging Techniques in Diagnosis of Carotid Plaque Morphology

    Directory of Open Access Journals (Sweden)

    Detelina Valchkova Lukanova

    2015-03-01

    CONCLUSION: The ultrasound has high accuracy for diagnostics of carotid plaque morphology, magnetic resonance imaging has high potential for tissue differentiation and multidetector computed tomography determines precisely degree of stenosis and presence of ulceration and calcifications. The three noninvasive imaging modalities are complementary for optimal evaluation of the morphology of carotid plaque. This will help to determine the risk of stroke and to decide on the best treatment – carotid endarterectomy or carotid stenting.

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  7. Baroreflex Sensitivity And Autonomic Nervous System Function In Carotid Sinus Hypersensitivity

    DEFF Research Database (Denmark)

    Brinth, Louise Schouborg; Pors, Kirsten; Theibel, Ann Cathrine

    2015-01-01

    Syncope in the elderly may be caused by an apparent hypersensitivity in the high pressure baroreflex control of heart rate and blood pressure - carotid sinus hypersensitivity. Previous studies have found ambiguous results regarding the baroreceptor sensitivity in patients with carotid sinus hyper...... sensitivity may not follow the same neuronal pathways as those responding to the crude external pressures applied during carotid sinus massage...

  8. Prevalence of significant carotid artery stenosis in patients with transient ischaemic attack

    DEFF Research Database (Denmark)

    Rappeport, Yael; Simonsen, Lene; Christiansen, Hanne Hjertmann;

    2002-01-01

    Carotid artery stenosis is one of the risk factors for transient ischaemic attack (TIA) and stroke. The purpose of this study was to investigate the prevalence of carotid artery stenosis and the prevalence of candidates for carotid endarterectomy in a hospital-based cohort of TIA patients under 71...

  9. Asymptomatic carotid stenosis: What we can learn from the next generation of randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Mark N Rubin

    2014-04-01

    Full Text Available Stroke remains an exceedingly incident and prevalent public health burden across the globe, with an estimated 16 million new strokes per annum and prevalence over 60 million, and extracranial internal carotid artery atherosclerotic disease is an important risk factor for stroke. Randomized trials of surgical treatment were conducted (North American Symptomatic Carotid Endarterectomy Trial, European Carotid Surgery Trial and demonstrated efficacy of carotid endarterectomy for secondary prevention of stroke in patients with cerebrovascular events (e.g. ipsilateral stroke, transient ischemic attack, and/or amaurosis fugax attributable to a diseased artery with 50–99% stenosis. Therapeutic clarity, however, proved elusive with asymptomatic carotid artery disease. Asymptomatic Carotid Atherosclerosis Study (ACAS, Asymptomatic Carotid Surgery Trial, and Veterans Affairs Cooperative Study (VACS suggested only modest benefit from surgical intervention for primary stroke prevention and the best medical therapy at the time of these trials is not comparable to modern medical therapy. ACT-1, Asymptomatic Carotid Surgery Trial-2, Stent-Protected Angioplasty in asymptomatic Carotid artery stenosis versus Endarterectomy Trial-2, European Carotid Surgery Trial-2, Carotid Revascularization Endarterectomy Versus Stenting Trial-2 are trials that are recent, ongoing, or in development that include diverse populations across Europe and North America, complementary trial designs, and a collaborative spirit that should provide clinicians with evidence that informs best clinical practice for asymptomatic carotid artery disease.

  10. Effects of comprehensive rehabilitation training in combination with multi-mode analgesia on body function recovery after tumor-type knee replacement

    Science.gov (United States)

    Zhang, Junjuan; Wang, Yahan; Yang, Guangyu; Liu, Jing; Wang, Junjie

    2016-01-01

    Objective: To discuss the significance of comprehensive rehabilitation training combined with multimodal analgesia (MMA) for the early knee function recovery of patients with knee bone tumor who underwent prosthesis replacement operation. Methods: Sixty patients with knee bone tumor who underwent prosthesis replacement operation were selected and randomly divided into two groups according to rehabilitation training and postoperative analgesic methods, namely, observation group and control group, 30 cases in each group. The control group was treated with symptomatic treatment (drugs were given based on pain before and after surgery) and continuous passive motion (CPM) functional training, while the observation group was treated with comprehensive rehabilitation training combined with MMA. The compliance of patients in the two groups was compared and the first-time off-bed activity time was recorded. Recovery conditions of wounds were observed, and recovery conditions of limb functions after operations were evaluated. Results: The compliance of patients in the observation group was significantly higher than that in the control group, and the difference was statistically significant (Pknee (HSS) score and evaluation result of range of motion (ROM) of knees of the observation group were both better than those of the control group in different periods after operation, and the differences were statistically significant (Prehabilitation training combined with MMA can improve the compliance of patients and help patients off bed earlier, and remarkably promote the early recovery of knee functions; hence it deserves to be promoted clinically. PMID:27882029

  11. Border Detection of Common Carotid Artery Using Hough Transform

    Science.gov (United States)

    Koya, Yoshiharu; Nagahara, Yoshihiro

    The arteriosclerosis is on the increase with an aging or change of our living environment. For that reason, diagnosis of the common carotid artery using echocardiogram is doing to take precautions carebropathy. The arteriosclerosis of the common carotid artery is diagnosed using Intima-Media Thickness (IMT) which is obtained from echocardiogram. In order to measure IMT from echocardiogram, it is required to detect a border which is a boundary between vessel tissue layers. The method of border detection requires reproducibility and high accuracy. The conventional methods to detect the border curve depend on differential value of brightness on the common carotid artery. Therefore, we can't extract a good candidate point by influence of a noise. In this paper, we propose the high-accuracy detection method by Hough Transform. About high-accuracy, it realized by attaching importance to high reliable candidate point of border.

  12. Thrombectomy assisted by carotid stenting in acute ischemic stroke management

    DEFF Research Database (Denmark)

    Steglich-Arnholm, Henrik; Holtmannspötter, Markus; Kondziella, Daniel;

    2015-01-01

    -term outcome (mRS ≤ 2). Harms included complications during and following EVT. Mean age was 64.3 years (standard deviation ±12.5), 40 (85%) patients received IVT initially. Median NIHSS was 16 (inter-quartile range 14-19). Mean time from stroke onset to recanalization was 311 min (standard deviation ±78......Extracranial carotid artery occlusion or high-grade stenosis with concomitant intracranial embolism causes severe ischemic stroke and shows poor response rates to intravenous thrombolysis (IVT). Endovascular therapy (EVT) utilizing thrombectomy assisted by carotid stenting was long considered risky......-center analysis of 47 consecutive stroke patients with carotid occlusion or high-grade stenosis and concomitant intracranial embolus treated between September 2011 and December 2014. Benefits included early improvement of stroke severity (NIHSS ≥ 10) or complete remission within 72 h and favorable long...

  13. Risk Analysis on Uric Acid Resulting in Carotid Atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    肖敏; 李河; 郭兰; 石美铃; 麦劲壮

    2004-01-01

    Objectives To explore the risk of uric acid (UA) resulting in carotid atherosclerosis. Methods With a cross sectional study, 643 subjects (aged 41-83 yrs, male 552 and female 91)were surveyed in 1999 in Guangdong Province, China.The main research variables were uric acid (UA), occurrence and the size of carotid artery plaque. Results There was no statistical significance between the UA means of plaque occurrence and no-occurrence groups (t=0.60, df=242, P=0.5495). It seemed UA was not a possible risk factor of carotid atherosclerosis (OR=1.060, P=-0.8448>0.05, n=244) based on the logistic regression analysis. Conclusions Our results are not consistent with serum UA being an independent risk factor for atherosclerosis and coronary heart disease (CHD). It is necessary to do more research to learn the risk degree of UA during the progress of atherosclerosis/CHD.

  14. Effect of cabergoline on insulin sensitivity, inflammation, and carotid intima media thickness in patients with prolactinoma.

    Science.gov (United States)

    Inancli, Serap Soytac; Usluogullari, Alper; Ustu, Yusuf; Caner, Sedat; Tam, Abbas Ali; Ersoy, Reyhan; Cakir, Bekir

    2013-08-01

    The aim of this study was to evaluate the effect of Cabergoline on insulin sensitivity, inflammatory markers, and carotid intima media thickness in prolactinoma patients. Twenty-one female, newly diagnosed patients with prolactinoma were included in the study. None of the patients were treated previously. Cabergoline was given as treatment, starting with 0.5 mg/day and tapered necessarily. Blood samples were taken for prolactin, highly sensitive C-reactive protein, homocysteine, total cholesterol, low density lipoprotein (LDL) cholesterol, fasting glucose, insulin, and HOMA (homeostasis model assessment of insulin resistance) score was calculated, prior to and 6 months after starting treatment. The body mass index (BMI) was measured and carotid intima media thickness (CIMT) was evaluated for each patient prior to and 6 months after the treatment. The prolactin levels and LDL decreased significantly after cabergoline treatment. Insulin sensitivity improved independently from the decrease in prolactin levels and BMI. The significant decrease in homocysteine and hs-CRP was not related with the decrease in prolactin levels. The significant decrease in CIMT was independent from the decrease in prolactin levels, HOMA score, and BMI. Our data suggest that cabergoline treatment causes an improvement in insulin sensitivity and inflammatory markers and causes a decrease in CIMT independent from the decrease in prolactin, LDL cholesterol, and BMI. We conclude that short term cabergoline treatment can improve endothelial function independently from the changes in metabolic disturbances and inflammatory markers.

  15. Cyclophosphamide Enhances Human Tumor Growth in Nude Rat Xenografted Tumor Models

    Directory of Open Access Journals (Sweden)

    Yingjen Jeffrey Wu

    2009-02-01

    Full Text Available The effect of the immunomodulatory chemotherapeutic agent cyclophosphamide (CTX on tumor growth was investigated in primary and metastatic intracerebral and subcutaneous rat xenograft models. Nude rats were treated with CTX (100 mg/kg, intraperitoneally 24 hours before human ovarian carcinoma (SKOV3, small cell lung carcinoma (LX-1 SCLC, and glioma (UW28, U87MG, and U251 tumor cells were inoculated subcutaneously, intraperitoneally, or in the right cerebral hemisphere or were infused into the right internal carotid artery. Tumor development was monitored and recorded. Potential mechanisms were further investigated. Only animals that received both CTX and Matrigel showed consistent growth of subcutaneous tumors. Cyclophosphamide pretreatment increased the percentage (83.3% vs 0% of animals showing intraperitoneal tumors. In intracerebral implantation tumor models, CTX pretreatment increased the tumor volume and the percentage of animals showing tumors. Cyclophosphamide increased lung carcinoma bone and facial metastases after intra-arterial injection, and 20% of animals showed brain metastases. Cyclophosphamide transiently decreased nude rat white blood cell counts and glutathione concentration, whereas serum vascular endothelial growth factor was significantly elevated. Cyclophosphamide also increased CD31 reactivity, a marker of vascular endothelium, and macrophage (CD68-positive infiltration into glioma cell-inoculated rat brains. Cyclophosphamide may enhance primary and metastatic tumor growth through multiple mechanisms, including immune modulation, decreased response to oxidative stress, increased tumor vascularization, and increased macrophage infiltration. These findings may be clinically relevant because chemotherapy may predispose human cancer subjects to tumor growth in the brain or other tissues.

  16. Rare complex aneurysm of special type in the superior segment of clinoid process of internal carotid artery%瘤颈处理困难的床突上段动脉瘤三例报告

    Institute of Scientific and Technical Information of China (English)

    刘峥; 尚明超; 李琦; 王如密; 王守森; 林航; 张小军; 郑兆聪; 魏梁锋; 杨少春; 荆俊杰

    2009-01-01

    目的 探讨罕见颈内动脉床突上段特殊类刑复杂动脉瘤某些特征,临床特点及治疗方法.方法 通过3例十分罕见颈内动脉床突上段动脉瘤的治疗经过,总结手术中所遇见的瘤颈撕裂,载瘤动脉壁薄、撕裂,血栓形成,无法夹闭等特殊情况,并且与术前的影像学资料进行对比研究,寻找这些动脉瘤的特征.结果 发现这种特殊动脉瘤,载瘤动脉局部不规则钙化、增粗畸形,甚至载瘤动脉壁菲薄;动脉瘤发生部位不规则,瘤颈及瘤体壁非薄,显微镜下见瘤体壁薄旱紫红色,手术时轻微分离瘤颈或夹闭时容易撕裂,或载瘤动脉壁撕裂,无法修补止血;2例术中由丁载瘤动脉钙化而坚硬,其近端不能予以临时阻断控制;瘤颈内有部分血栓侵犯,导致瘤夹闭合不全,调整瘤夹易撕裂瘤颈.结论 手术需谨慎,术中有可能无法夹闭或载瘤动脉壁破裂,术前造影具有明显特征,手术方法 以颅内外血管吻合+孤立为妥.%Objective To discuss the features, clinical characteristics and therapies of rare aneurysm of special type in the superior segment of clinoid process of internal carotid artery. Method From clinical courses of treatment of 3 patients with extremely rare aneurysms in the superior segment of clinoid process of internal eardotid artery, we summarized special clinical characteristics including torn aneurysm neck, thin or tom tumor-loading artery wail, thrombosis, and clipping failure, etc. , encountered during the surgery, and compared them with pro-surgical imaging data, to investigate features of this type of aneurysms. Results Of such special neurysms, it was found that the tumor-loading artery was irregularly calcified, thickened and deformed, or even the tumor-loading artery wall was extremely thin. Such neurysms occurred in irregular sites, with quite thin tumor neck and tumor body wall. Under a microscope,the tumor body wall was carmine. It was readily torn in slight

  17. A Specialized device designed for eversion carotid endarterectomy.

    Science.gov (United States)

    Lavrent'ev, A V; Vinogradov, O A; Shcherbiuk, A N

    2011-01-01

    Carotid endarterectomy (CEAE) is currently considered to be one of the most efficient methods of treatment for chronic cerebrovascular insufficiency and prevention of recurrent acute impairments of cerebral blood supply. Methodically, the manipulation concerned is in the majority of cases carried out by one of two most commonly employed techniques, i. e., classical CEAE from the longitudinal arteriotomy with plasty with a synthetic patch, and the so-called eversion CEAE implying removal of an atherosclerotic plaque (ASP) by means of eversion of the internal carotid artery (ICA). Many Russian and foreign authors point out indisputable advantages of eversion CEAE, consisting in a shorter duration of ICA clamping, no need to use synthetic materials, preservation of the anatomical geometry of the bifurcation of the common carotid artery (CCA), a lower incidence rate of restenoses in the remote period. Along with it, eversion CEAE also possesses certain disadvantages consisting in namely complicated revision of the distal intima of the ICA (the zone wherein the ASP is tapering), the necessity of traction by the ASP, which may might lead to its premature detachment, impossibility of ICA eversion distal to the endarterectomy zone and repeat eversion of the already endarterectomised portion of the ICA. Hence, eversion carotid endarterectomy still remains the area of skilled and experienced vascular surgeons, thus giving prerequisites for further levelling its technical disadvantages shortcomings, which was the objective of the present study. The authors describe herein a new specially designed surgical device intended to facilitate the operation of eversion carotid endarterectomy, as well as the technique of application thereof. Based on a comparative example comprising a total of eighty-six eversion carotid endarterectomic procedures performed both with and without the new device, we demonstrated efficiency of using the proposed technique.

  18. Ultrasound Common Carotid Artery Segmentation Based on Active Shape Model

    Directory of Open Access Journals (Sweden)

    Xin Yang

    2013-01-01

    Full Text Available Carotid atherosclerosis is a major reason of stroke, a leading cause of death and disability. In this paper, a segmentation method based on Active Shape Model (ASM is developed and evaluated to outline common carotid artery (CCA for carotid atherosclerosis computer-aided evaluation and diagnosis. The proposed method is used to segment both media-adventitia-boundary (MAB and lumen-intima-boundary (LIB on transverse views slices from three-dimensional ultrasound (3D US images. The data set consists of sixty-eight, 17 × 2 × 2, 3D US volume data acquired from the left and right carotid arteries of seventeen patients (eight treated with 80 mg atorvastatin and nine with placebo, who had carotid stenosis of 60% or more, at baseline and after three months of treatment. Manually outlined boundaries by expert are adopted as the ground truth for evaluation. For the MAB and LIB segmentations, respectively, the algorithm yielded Dice Similarity Coefficient (DSC of 94.4% ± 3.2% and 92.8% ± 3.3%, mean absolute distances (MAD of 0.26 ± 0.18 mm and 0.33 ± 0.21 mm, and maximum absolute distances (MAXD of 0.75 ± 0.46 mm and 0.84 ± 0.39 mm. It took 4.3 ± 0.5 mins to segment single 3D US images, while it took 11.7 ± 1.2 mins for manual segmentation. The method would promote the translation of carotid 3D US to clinical care for the monitoring of the atherosclerotic disease progression and regression.

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

    Directory of Open Access Journals (Sweden)

    Su T

    2011-08-01

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

  20. Case of radiation induced aneurysm of extracranial carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Tashiro, Takashi; Ikota, Toshio; Yamashita, Kousuke; Kodama, Takao

    1988-08-01

    An unusual case of post-irradiation aneurysm of extracranial internal carotid artery is presented. A 70-year-old man, complaining of left cervical throbbing mass with focal pain, was admitted on February 8, 1985. It was noted, from his past history, that he had had surgery of the removal of cervical lymphnodes and that unknown dosage of irradiation had been added to the cervical region 30 years before. Left carotid angiography (on admission) demonstrated a giant aneurysm in the cervical portion of internal carotid artery. Right carotid angiography with compression of left carotid artery revealed good cross filling through anterior communicating artery. Computed tomography with contrast media showed a ring like enhanced mass, which was thought to suggest that a large part of the aneurysm was filled with intraluminal thrombosis. During 30 days of evaluation, the aneurysm grew larger and his cervical pain became untolerable. Operation, the resection of the aneurysm and the reconstruction (of circulation) with vein graft, was challenged on March 12. It was so difficult with meticulous work that the ligation of left common carotid artery was performed after all. Seven days after the operation, he suffered from the gastrointestinal bleeding, which was enough to lead him to hypovolemic shock. Thereafter, right hemiparesis and aphasia were brought about. Two months later, he died of pneumonia. On histological examination, it was demonstrated that the aneurysm communicated with the necrotic tissue and that the normal structure of the blood vessel was not observed in the aneurysmal wall and consisted of the collagenous fiber and granulated tissue. The aneurysm was interpreted as a false one.

  1. 肿瘤患者机体组成及肌肉减少症的调查%Observational research on body composition and sarcopenia in patients with tumor

    Institute of Scientific and Technical Information of China (English)

    吴焱; 凌轶群; 丁慧萍; 钱泳; 汪琼

    2016-01-01

    Objective:To observe body composition and the occurrence of sarcopenia in tumor patients so as to provide evidence for the early monitoring of their nutritional status .Methods:Bioelectrical impedance analysis(BIA) was adopted to analyze the body composition and appendicular skeletal muscle mass index (ASMI) was used to observe the occurrence of sarcopenia to explore the relationship between BMI and sarcopenia in 224 patients with tumor .The body composition of 224 cases of tumor patients was analyzed by bioelectrical impedance analysis(BIA) .The occurrence of sarcopenia was observed with appendicular skeletal mass index (ASMI) ,and the relationship between body mass index (BMI) and sarcopenia was also explored .Results:In 224 tumor patients ,13 .4% (30/224) were underweight ,60 .7% (136/224) were normal weight and 25 .9% (58/224) were overweight or obese .The incidence of sarcopenia was 58 .04% (130/224) ,and 77 .7% (101/130) of the patients with sarcopenia were normal ,overweight or obese .Conclusions:The change of the muscle and its function in cancer patients is as noteworthy as weight loss .Body composition of cancer patients should be timely monitored in order to optimize nutritional risk screening , establish individualized nutritional support , and develop the treatment plan with best tolerance .%目的:观察肿瘤患者的机体组成和肌肉减少症(sarcopenia)的发生情况,为尽早监测肿瘤患者的营养状况提供依据。方法:采用生物电阻抗法(bioelectrical impedance analysis ,BIA )分析224例肿瘤患者的机体组成,利用四肢骨骼肌指数(appendicular skeletal mass index ,ASMI)观察肌肉减少症的发生情况,并探究肿瘤患者体质指数(BMI)与肌肉减少症的关系。结果:224例肿瘤患者中13.4%(30/224)为消瘦,60.7%(136/224)为正常体质量,25.9%(58/224)为超重或肥胖。肌肉减少症发生率为58.04%(130/224) ,77.7

  2. [A case of epidermoid tumor inside the Meckel's cave].

    Science.gov (United States)

    Ohta, H; Ottomo, M; Nakamura, T; Yokota, A

    1997-10-01

    An epidermoid tumor inside the Meckel's cave is rare. The symptoms caused by this tumor include trigeminal neuralgia, facial hypesthesia and paresis of the 3rd, 4th and 6th nerves. A case of epidermoid tumor inside Meckel's cave was presented. A 54-year-old female who had complained of 3rd nerve palsy with right facial hypesthesia since 3 years before was referred to our clinic. Magnetic resonance imaging (MRI) showed the tumor at Meckel's cave. The tumor removal was performed using the orbito-zygomatic approach. To avoid injury of the internal carotid artery and nerves inside the cavernous sinus, removal of the tumor inside the capsule was carried out leaving the capsule. Postoperatively, the tumor removal was confirmed by MRI and improvement of the 3rd and the 5th nerve palsy was obtained three months after surgery. This case suggests that the capsule of the tumor inside the Meckel's cave should be allowed to remain to avoid injury of the adjacent 4th, 5th and 6th nerves and of the internal carotid artery.

  3. Tissue Characterization on Common Carotid Artery using AR Model

    Science.gov (United States)

    Koya, Yoshiharu; Mizoshiri, Isao

    This study uses one image with a echocardiography and detects arteriosclerosis on the common carotid artery by tissue characterization. The conventional methods are measurement of thickness on the vessel wall or stiffness on the common carotid artery. However, they need frames of several beats and great calculation times. But, we detect the arteriosclerosis with only one image. Our method estimate the grade of arteriosclerosis by AR model parameters fitted to the texture on the lumen-intima wall. Experimental results show the validity of the proposed method.

  4. Statins and their use in preventing carotid disease

    DEFF Research Database (Denmark)

    Sillesen, H.

    2009-01-01

    Carotid disease may be evaluated by surrogate outcomes, such as intima-media thickness and carotid plaque features, and by clinical end points. Statins stop progression or may induce regression of intima-media thickness, and statins may also stop plaque growth or even induce reduction of plaque...... volume. Areas rich in lipids within plaques may be reduced in size and/or in number of inflammatory cells. Ultrasound reflectivity may be reduced by statin treatment, indicating less lipid/inflammatory content. Finally, statins appear to reduce the risk of all cardiovascular events (eg, stroke...

  5. The evidence for medicine versus surgery for carotid stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Ederle, Joerg [Stroke Research Group, UCL Institute of Neurology, London (United Kingdom); Brown, Martin M. [Stroke Research Group, UCL Institute of Neurology, London (United Kingdom)]. E-mail: m.brown@ion.ucl.ac.uk

    2006-10-15

    Atherosclerotic stenosis of the internal carotid artery is an important cause of stroke. Several large randomised trials have compared best medical management with carotid endarterectomy and provide a strong evidence base for advising and selecting patients for carotid surgery. Best medical management of carotid stenosis includes lowering of blood pressure, treatment with statins and antiplatelet therapy in symptomatic patients. Combined analysis of the symptomatic carotid surgery trials, together with observational data, has shown that patients with recently symptomatic severe carotid stenosis have a very high risk of recurrent stroke in the first few days and weeks after symptoms. Carotid endarterectomy has a risk of causing stroke or death at the time of surgery in symptomatic patients of around 5-7%, but in patients with recently symptomatic stenosis of more than 70%, the benefits of endarterectomy outweigh the risks. In patients with moderate stenosis of between 50 and 69%, the benefits may justify surgery in patients with very recent symptoms, and in patients older than 75 years within a few months of symptoms. Patients with less than 50% stenosis do not benefit from surgery. In asymptomatic patients, or those whose symptoms occurred more than 6 months ago, the benefits of surgery are considerably less. Patients with asymptomatic stenosis treated medically only have a small risk of future stroke when treated medically of about 2% per annum. If carotid endarterectomy can be performed safely with a perioperative stroke and death rate of no more than 3%, then the randomised trials showed a significant benefit of surgery over 5 years follow-up, with an overall reduction in the risk of stroke from about 11% over 5 years down to 6%. However, of 100 patients operated, only 5 will benefit from avoiding a stroke over 5 years. The majority of neurologists have concluded that this does not justify a policy of routine screening and endarterectomy for asymptomatic

  6. A suggested training programme for carotid artery stenting (CAS)

    Energy Technology Data Exchange (ETDEWEB)

    Gaines, Peter [Sheffield Vascular Institute, Northern General Hospital, Sheffield S5 7AU (United Kingdom)]. E-mail: P.A.gaines@Sheffield.ac.uk; Nicholson, Tony [Leeds Teaching Hospitals NHS Trust, Great George St., Leeds LS13EX (United Kingdom)]. E-mail: tonynick@tonynick.karoo.co.uk

    2006-10-15

    Carotid artery stenting as an alternative to traditional carotid endartrectomy is becoming increasingly important in the treatment of transient ischemic attack and stroke. Physicians from several different medical disciplines are interested in treating appropriate patients by this method. Patients are entitled to know what training and experience the surgeon or clinician has before giving consent. This should involve endovascular experience in all systems and experience and knowledge of cerebral angiography and intervention. A multidisciplinary approach and reporting of adverse events is vital for patient safety.

  7. Tomographic cerebral blood flow measurement during carotid surgery

    DEFF Research Database (Denmark)

    Rathenborg, Lisbet Knudsen; Vorstrup, Sidsel; Olsen, K S

    1994-01-01

    OBJECTIVES: The aim of the study was to depict regional cerebral blood flow (rCBF) during carotid cross clamping using 99mTechnetium-hexamethylpropylene amine oxime (TcHMPAO). This tracer rapidly passes the blood-brain barrier and is retained for hours in the brain tissue. Injecting TcHMPAO during...... RESULTS: We found a significant correlation between stump pressure and enhancement of side-to-side asymmetry in rCBF due to carotid cross clamping. Pronounced variations were seen in which regions were deprived of perfusion during clamping. CONCLUSION: TcHMPAO allows tomographic assessment of CBF during...

  8. Heuber Maneuver in Evaluation of Direct Carotid-Cavernous Fistula

    Science.gov (United States)

    Rajagopal, Rengarajan; Mehta, Neeraj; Saran, Sonal; Khera, Pushpinder S.

    2016-01-01

    Summary Carotid-cavernous fistulas are abnormal communications between the carotid system and the cavernous sinus. Elevated venous pressure produces congestion in the orbit with resultant transudation of fluid and increased intraocular pressure, thereby leading to secondary glaucoma which may result in visual loss. Immediate treatment is hence, warranted in these cases. The planning of endovascular management is dependent on many parameters, the most important of which are the size and location of the fistula. Since these are high-flow fistulas, assessment requires certain manoeuvers. Heuber manoeuver is one of the manoeuvers used to demonstrate the size of the fistula.

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

    Directory of Open Access Journals (Sweden)

    Pria Anand

    2014-03-01

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

  10. Bilateral internal carotid artery occlusion associated with the antiphospholipid antibody syndrome.

    Science.gov (United States)

    Anand, Pria; Mann, Sharan K; Fischbein, Nancy J; Lansberg, Maarten G

    2014-01-01

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

  11. Early complement activation follows eversion carotid endarterectomy and correlates with the time of clamping of the carotid artery

    DEFF Research Database (Denmark)

    Széplaki, Gábor; Hirschberg, Kristóf; Gombos, Tímea

    2008-01-01

    -inhibitor, C4d, C3a and SC5b-9 and concentrations of C-reactive protein (CRP) were measured in samples serially taken from 16 patients with eversion CEA and 10 with carotid artery stenting (CAS) in the first 24h post-surgery/intervention. MBL2 genotypes were also determined. RESULTS: In patients with CEA...... an intense increase in C3a levels were observed immediately after surgery (psurgery, compared with the baseline values and with CAS patients. Peak C3a levels correlated with the time of carotid...

  12. Asymptomatic carotid lesions after endarterectomy of contralateral carotid artery. Five-year follow-up study and prognosis

    DEFF Research Database (Denmark)

    Schroeder, T; Helgstrand, U J; Egeblad, M R

    1987-01-01

    patients developed symptoms referable to the territory of the previously asymptomatic ICA (five strokes and eight transient ischemic attacks). Using life-table analysis, the annual stroke rate was estimated to be 1% and 2.2% considering the previously asymptomatic and symptomatic ICA, respectively......Of 185 patients who consecutively underwent carotid endarterectomy five years ago, 135 had a patent asymptomatic contralateral internal carotid artery (ICA). During follow-up (median, 59 months), 36 patients developed new neurologic symptoms (18 strokes and 18 transient ischemic attacks). Thirteen...

  13. Wavelet-based neural network analysis of internal carotid arterial Doppler signals.

    Science.gov (United States)

    Ubeyli, Elif Derya; Güler, Inan

    2006-06-01

    In this study, internal carotid arterial Doppler signals recorded from 130 subjects, where 45 of them suffered from internal carotid artery stenosis, 44 of them suffered from internal carotid artery occlusion and the rest of them were healthy subjects, were classified using wavelet-based neural network. Wavelet-based neural network model, employing the multilayer perceptron, was used for analysis of the internal carotid arterial Doppler signals. Multi-layer perceptron neural network (MLPNN) trained with the Levenberg-Marquardt algorithm was used to detect stenosis and occlusion in internal carotid arteries. In order to determine the MLPNN inputs, spectral analysis of the internal carotid arterial Doppler signals was performed using wavelet transform (WT). The MLPNN was trained, cross validated, and tested with training, cross validation, and testing sets, respectively. All these data sets were obtained from internal carotid arteries of healthy subjects, subjects suffering from internal carotid artery stenosis and occlusion. The correct classification rate was 96% for healthy subjects, 96.15% for subjects having internal carotid artery stenosis and 96.30% for subjects having internal carotid artery occlusion. The classification results showed that the MLPNN trained with the Levenberg-Marquardt algorithm was effective to detect internal carotid artery stenosis and occlusion.

  14. Surgical Treatment in Uveal Tumors

    Directory of Open Access Journals (Sweden)

    Kaan Gündüz

    2014-09-01

    Full Text Available Surgical treatment in uveal tumors can be done via iridectomy, partial lamellar sclerouvectomy (PLSU and endoresection. Iridectomy is done in iris tumors without angle and ciliary body involvement. PLSU is performed in tumors with ciliary body and choroidal involvement. For this operation, a partial thickness scleral flap is dissected, the intraocular tumor is excised, and the flap is sutured back in position. PLSU surgery is done in iridociliary and ciliary body tumors with less than 3 clock hours of iris and ciliary body involvement and in choroidal tumors with a base diameter less than 15 mm. However, it can be employed in any size tumor for biopsy purposes. Potential complications of PLSU surgery include vitreous hemorrhage, cataract, retinal detachment, and endophthalmitis. Endoresection is a technique whereby the intraocular tumor is excised using vitrectomy techniques. The rationale for performing endoresection is based on the fact that irradiated uveal melanomas may be associated with exudation and neovascular glaucoma and removing the dead tumor tissue may contribute to better visual outcome. There are some centers where endoresection is done without prior radiotherapy. Allegedly, avoidance of radiation retinopathy and papillopathy are the main advantages of using endoresection without prior radiotherapy. (Turk J Ophthalmol 2014; 44: Supplement 29-34

  15. Insulin sensitivity and carotid intima-media thickness

    DEFF Research Database (Denmark)

    Kozakova, Michaela; Natali, Andrea; Dekker, Jacqueline;

    2013-01-01

    Despite a wealth of experimental data in animal models, the independent association of insulin resistance with early carotid atherosclerosis in man has not been demonstrated. APPROACH AND RESULTS: We studied a European cohort of 525 men and 655 women (mean age, 44±8 years) free of conditions know...

  16. Eight to ten years follow-up after carotid endarterectomy

    DEFF Research Database (Denmark)

    Knudsen Rathenborg, Lisbet; Sillesen, H; Schroeder, T

    1990-01-01

    Follow-up information was obtained on 185 patients who consecutively underwent carotid endarterectomy eight to ten years previously. Doppler ultrasound examination was performed in 59 patients who were still alive and living within 100 miles of the hospital. Using lifetable analysis, the annual...

  17. Serum 25-Hydroxyvitamin D Concentration in Subclinical Carotid Atherosclerosis

    NARCIS (Netherlands)

    Deleskog, Anna; Piksasova, Olga; Silveira, Angela; Gertow, Karl; Baldassarre, Damiano; Veglia, Fabrizio; Sennblad, Bengt; Strawbridge, Rona J.; Larsson, Malin; Leander, Karin; Gigante, Bruna; Kauhanen, Jussi; Rauramaa, Rainer; Smit, Andries J.; Mannarino, Elmo; Giral, Philippe; Gustafsson, Sven; Ostenson, Claes-Goran; Humphries, Steve E.; Tremoli, Elena; de Faire, Ulf; Ohrvik, John; Hamsten, Anders

    2013-01-01

    Objective Vitamin D deficiency has been implicated in cardiovascular disease and is associated with multiple cardiovascular risk factors. We investigated the serum 25-hydroxyvitamin D (25(OH)D) concentration in relation to latitude, baseline carotid intima-media thickness (IMT), and IMT progression,

  18. [Revascularization of the carotid and vertebral arteries in the elderly].

    Science.gov (United States)

    Illuminati, G; Bezzi, M; D'Urso, A; Giacobbi, D; Ceccanei, G; Vietri, F

    2004-01-01

    From January 1994 to July 2004, 323 patients underwent 348 revascularization of carotid bifurcation for atherosclerotic stenoses. Eighty eight patients (group A) were 75 year-old or older, whereas 235 (group B) were younger than 75 years. Postoperative mortality/neurologic morbidity rate was 1% in group A, and 1.4% in group B. At 5 years, patency and freedom from symptoms/stroke were, respectively, 91% and 92% in group A, and 89% and 91% in group B. None of these differences was statistically significant. In the same time period, 26 internal carotid arteries were revascularized in 24 patients, 75 or more aged, for a symptomatic kinking. Postoperative mortality/morbidity rate was absent, whereas, at 5 years, patency and freedom from symptoms/stroke were, respectively, 88% and 92%. Twelve vertebral arteries were revascularized in 12 patients, 75 or more aged, for invalidating symptoms of vertebrobasilar insufficiency. Postoperative mortality/neurologic morbidity rate was absent. In one case postoperative recurrence of symptoms occurred, despite a patent revascularization. Patency and freedom from symptoms/stroke were 84% and 75%, at 5 years. Revascularization of carotid and vertebral arteries in the elderly can be accomplished with good results, superposable to those of standard revascularization of carotid bifurcation in a younger patients' population.

  19. Reproducibility of Two 3-D Ultrasound Carotid Plaque Quantification Methods

    DEFF Research Database (Denmark)

    Graebe, Martin; Entrekin, Robert; Collet-Billon, Antoine;

    2014-01-01

    -sectional, 2-D freehand sweep and a mechanical 3-D ultrasound investigation of 62 carotid artery plaques is reported with intra-class correlation coefficients (with 95% confidence intervals). Inter-observer agreement was 0.60 (0.29-0.77) for the freehand method and 0.89 (0.83-0.93) for the mechanical 3-D...

  20. PET/SPECT imaging : From carotid vulnerability to brain viability

    NARCIS (Netherlands)

    Meerwaldt, Robbert; Slart, Riemer H. J. A.; van Dam, Gooitzen M.; Luijckx, Gert-Jan; Tio, Rene A.; Zeebregts, Clark J.

    2010-01-01

    Background: Current key issues in ischemic stroke are related to carotid plaque vulnerability, brain viability, and timing of intervention. The treatment of ischemic stroke has evolved into urgent active interventions, as 'time is brain'. Functional imaging such as positron emission tomography (PET)

  1. Transcranial Doppler for detection of cerebral ischaemia during carotid endarterectomy

    DEFF Research Database (Denmark)

    Jørgensen, L G; Schroeder, T V

    1992-01-01

    We evaluated transcranial Doppler sonography (TCD) for the detection of cerebral ischaemia during carotid endarterectomy in 30 male and 14 female patients with ipsilateral focal cerebro-vascular symptoms. Surgery was performed during halothane-nitrous oxide anaesthesia with moderate hypocapnia...

  2. Three-dimensional carotid ultrasound plaque texture predicts vascular events

    DEFF Research Database (Denmark)

    van Engelen, Arna; Wannarong, Thapat; Parraga, Grace;

    2014-01-01

    carotid plaque volume and 376 measures of plaque texture. Patients were followed up to 5 years (median [range], 3.12 [0.77-4.66]) for myocardial infarction, transient ischemic attack, and stroke. Sparse Cox regression was used to select the most predictive plaque texture measurements in independent...

  3. A Parallel Lattice Boltzmann Model of a Carotid Artery

    Science.gov (United States)

    Boyd, J.; Ryan, S. J.; Buick, J. M.

    2008-11-01

    A parallel implementation of the lattice Boltzmann model is considered for a three dimensional model of the carotid artery. The computational method and its parallel implementation are described. The performance of the parallel implementation on a Beowulf cluster is presented, as are preliminary hemodynamic results.

  4. Cone pathway function in relation to asymmetric carotid artery stenosis

    DEFF Research Database (Denmark)

    Kofoed, Peter Kristian; Munch, Inger Christine; Holfort, Stig K;

    2013-01-01

    in the same patient. Results:  Ophthalmic systolic pressure was 95.8 ± 13.1 mmHg on the side with the highest degree of carotid artery stenosis (mean 94.0%) and 111.7 ± 10.3 mmHg in the fellow eyes on the side with the lesser degree of stenosis (mean 33.9%). Summed mfERG implicit times (N1 and P1) were 3......Purpose:  To examine retinal function in relation to retinal perfusion pressure in patients with carotid artery stenosis. Methods:  Thirteen patients with carotid artery stenosis without clinical eye disease underwent assessment of ophthalmic artery systolic blood pressure (OSP) by ocular...... pneumoplethysmography, carotid artery obstructive disease by ultrasonography, intraocular pressure by applanation tonometry, retinal perfusion by fluorescein angiography and retinal function by multifocal electroretinography (mfERG). Data analysis compared the eye on the most stenotic side with the fellow eye...

  5. Heterogeneous cerebral vasoreactivity dynamics in patients with carotid stenosis.

    Directory of Open Access Journals (Sweden)

    Ting-Yu Chang

    Full Text Available Cerebral vasoreactivity (CVR can be assessed by functional MRI (fMRI using hypercapnia challenges. In normal subjects, studies have shown temporal variability of CVR blood oxygenation level-dependent responses among different brain regions. In the current study, we analyzed the variability of BOLD CVR dynamics by fMRI with a breath-holding task in 17 subjects with unilateral carotid stenosis before they received carotid stenting. Great heterogeneity of CVR dynamics was observed when comparing BOLD responses between ipsilateral and contralateral hemispheres in each patient, especially in middle cerebral artery (MCA territories. While some subjects (n=12 had similar CVR responses between either hemisphere, the others (n=5 had a poorly correlated pattern of BOLD changes between ipsilateral and contralateral hemispheres. In the latter group, defined as impaired CVR, post-stenting perfusion tended to be more significantly increased. Our data provides the first observation of divergent temporal BOLD responses during breath holding in patients with carotid stenosis. The development of collateral circulation and the derangement of cerebral hemodynamics can be detected through this novel analysis of the different patterns of BOLD changes. The results also help in prediction of robust increase of perfusion or hyperperfusion after carotid stenting.

  6. Acute Carotid Artery Stent Thrombosis Due to Dual Antiplatelet Resistance

    Energy Technology Data Exchange (ETDEWEB)

    Köklü, Erkan, E-mail: drerkankoklu@gmail.com; Arslan, Şakir; Yüksel, İsa Öner; Bayar, Nermin [Antalya Education and Research Hospital, Clinic of Cardiology (Turkey); Koç, Pınar [Antalya Education and Research Hospital, Clinic of Radiology (Turkey)

    2015-08-15

    Carotid artery stenting (CAS) is a revascularization modality that is an alternative to carotid endarterectomy. The efficacy of CAS in primary and secondary prevention from ischemic stroke has been demonstrated in various trials. Acute thrombosis of CAS is a rare complication that can lead to dramatic and catastrophic consequences. We discuss a case of acute CAS thrombosis in a patient who had previously undergone successful CAS. CAS was performed in a 73-year-old man who had had dysarthria lasting 2 weeks with 95 % stenosis in his left internal carotid artery. An acute cerebrovascular event resulting in right-sided hemiplegia developed 24 h after the procedure. Computed tomographic carotid angiography revealed complete occlusion of the stent with thrombus. The cause of stent thrombosis was thought to be antiaggregant resistance to both acetylsalicylic acid and clopidogrel. The most important cause of acute CAS thrombosis is inadequate or ineffective antiaggregant therapy. Evaluating patients who are candidates for CAS for acetylsalicylic acid and clopidogrel resistance may preclude this complication.

  7. 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.)

  8. Radioiodine Therapy Does Not Change the Atherosclerotic Burden of the Carotid Arteries

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Andersen, Ulrik Bjørn; Sørensen, Christian Hjort

    2016-01-01

    of cerebrovascular events has been reported after radioiodine therapy. This study aimed to examine whether atherosclerosis develops early or late after radioiodine therapy of benign thyroid disease. METHOD: Patients treated for benign thyroid disorders (nontoxic goiter, adenoma, and hyperthyroidism) were examined...... with ultrasound for the main outcome, carotid intima media thickness (CIMT), and for plaque presence (plaque presence only in late damage). Signs of early damage from radioiodine were studied in 39 radioiodine-treated patients, who were examined before treatment and at 1, 3, 6, and 12 months after treatment. Late...... were adjusted for age, sex, cholesterol, smoking status, known atherosclerotic disease, and body mass index. RESULTS: No changes in CIMT were found in the patients followed prospectively for one year after treatment with radioactive iodine for benign thyroid disease (p = 0.58). In the study on late...

  9. Improvement in Cerebral and Ocular Hemodynamics Early after Carotid Endarterectomy in Patients of Severe Carotid Artery Stenosis with or without Contralateral Carotid Occlusion

    Directory of Open Access Journals (Sweden)

    Jian Wang

    2016-01-01

    Full Text Available Purpose. To investigate the alternation in cerebral and ocular blood flow velocity (BFV in patients of carotid stenosis (CS with or without contralateral carotid occlusion (CO early after carotid endarterectomy (CEA. Patients and Methods. Nineteen patients underwent CEA for ≥50% CS. Fourteen patients had the unilateral CS, and five patients had the ipsilateral CS and the contralateral CO. Transcranial Doppler (TCD and Color Doppler Imaging (CDI were performed before and early after CEA. Results. In patients with unilateral CS, significant improvements in BFV were observed in anterior cerebral artery (ACA and middle cerebral artery (MCA on the ipsilateral side after CEA. In patients of ipsilateral CS and contralateral CO, significant improvements in BFV were observed in the ACA and MCA not only on the ipsilateral side but also on the contralateral side postoperatively. The ipsilateral ophthalmic artery (OA retrograde flows in two patients were recovered to anterograde direction following CEA. The BFV in short posterior ciliary artery (SPCA of the ipsilateral side significantly increased postoperatively irrespective of the presence of contralateral CO. Conclusions. CEA improved cerebral anterior circulation hemodynamics especially in patients of unilateral CS and contralateral CO, normalized the OA reverse flow, and increased the blood perfusion of SPCA.

  10. 对颈动脉鞘解剖的再认识及其意义%Recognition of the anatomy of carotid sheath

    Institute of Scientific and Technical Information of China (English)

    聂政; 单建林; 姜恒

    2015-01-01

    carotid sheath. The junction fascia between middle layer of the cervical fascia and superficial layer of prevertebral fascia and carotid sheath was thick and tight. Conclusion Carotid sheath was closely associated with every layer of cervical fascia. Middle layer of the cervical fascia and superficial layer of prevertebral fascia forms the main body of carotid sheath.

  11. Optical detection of structural changes in human carotid atherosclerotic plaque

    Science.gov (United States)

    Korol, R. M.; Canham, P. B.; Finlay, H. M.; Hammond, R. R.; Quantz, M.; Ferguson, G. G.; Liu, L. Y.; Lucas, A. R.

    2005-08-01

    Background: Arterial bifurcations are commonly the sites of developing atherosclerotic plaque that lead to arterial occlusions and plaque rupture (myocardial infarctions and strokes). Laser induced fluorescence (LIF) spectroscopy provides an effective nondestructive method supplying spectral information on extracellular matrix (ECM) protein composition, specifically collagen and elastin. Purpose: To investigate regional differences in the ECM proteins -- collagen I, III and elastin in unstable plaque by analyzing data from laser-induced fluorescence spectroscopy of human carotid endarterectomy specimens. Methods: Gels of ECM protein extracts (elastin, collagen types I & III) were measured as reference spectra and internal thoracic artery segments (extra tissue from bypass surgery) were used as tissue controls. Arterial segments and the endarterectomy specimens (n=21) were cut into 5mm cross-sectional rings. Ten fluorescence spectra per sampling area were then recorded at 5 sites per ring with argon laser excitation (357nm) with a penetration depth of 200 μm. Spectra were normalized to maximum intensity and analyzed using multiple regression analysis. Tissue rings were fixed in formalin (within 3 hours of surgery), sectioned and stained with H&E or Movat's Pentachrome for histological analysis. Spectroscopy data were correlated with immunohistology (staining for elastin, collagen types I, III and IV). Results: Quantitative fluorescence for the thoracic arteries revealed a dominant elastin component on the luminal side -- confirmed with immunohistology and known artery structure. Carotid endarterectomy specimens by comparison had a significant decrease in elastin signature and increased collagen type I and III. Arterial spectra were markedly different between the thoracic and carotid specimens. There was also a significant elevation (pcollagen type I distal to the bifurcation compared to proximal tissue in the carotid specimens. Conclusion: Fluorescence spectroscopy

  12. Cerebral hemodynamic changes and electroencephalography during carotid endarterectomy

    Energy Technology Data Exchange (ETDEWEB)

    Algotsson, L.; Messeter, K.; Rehncrona, S.; Skeidsvoll, H.; Ryding, E. (University Hospital, Lund (Sweden))

    1990-05-01

    Some patients undergoing endarterectomy for occlusive carotid artery disease run a risk of brain ischemia during cross-clamping of the artery. The present study of 15 patients was undertaken to evaluate changes in cerebral blood flow (CBF), as measured with an intravenous (IV) tracer (133Xenon) technique, and to relate CBF changes to changes in the electroencephalogram (EEG). CBF was measured before and after induction of anesthesia, during cross-clamping of the carotid artery, after release of the clamps, and at 24 hours after the operation. All the patients were anesthetized with methohexitone, fentanyl, and nitrous oxide and oxygen. EEG was continuously recorded during the operation. Carotid artery shunts were not used. In 8 patients, cross-clamping of the carotid artery did not influence the EEG. In this group of patients, induction of anesthesia caused a 38% decrease in CBF, which presumably reflects the normal reaction to the anesthetic agent given. There were no further changes in CBF during cross-clamping. In 7 patients, the EEG showed signs of deterioration during the intraoperative vascular occlusion. In these patients, anesthesia did not cause any CBF change, whereas cross-clamping the artery induced a 33% decrease in CBF. In individual patients, the severity of EEG changes correlated with the decrease in CBF. The absence of a change in CBF by anesthesia and a decrease due to cross-clamping of the carotid artery may be explained by the presence of a more advanced cerebrovascular disease and an insufficiency to maintain CBF during cross-clamping.

  13. Tumor ablations in IMRI

    Institute of Scientific and Technical Information of China (English)

    Roberto Blanco Sequeiros

    2002-01-01

    @@ IntroductionMagnetic resonance imaging based guidance control and monitoring of minimally invasive intervention has developed from a hypothetical concept to a practical possibility. Magnetic-resonance-guided interstitial therapy in principle is defined as a treatment technique for ablating deepseated tumors in the human body.

  14. Anterior Reconstruction of C2–C3 Bodies in a 6-Year-Old Patient with a Huge Osteoblastoma: A Novel Technique

    Science.gov (United States)

    Haghnegahdar, Ali; Sedighi, Mahsa

    2015-01-01

    Study Design Case report. Objective We report the youngest child diagnosed with upper cervical osteoblastoma and the first case operated on with our novel surgical approach. Methods Our patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of a C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. Posterior fixation of C1–C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Ten days later, a total resection of the residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath). Reconstruction of C1–C3 was performed with C1 anterior sublaminar wiring and an expandable titanium cage. Results Successful reconstruction of C2–C3 vertebral bodies was achieved. At 2-year follow-up, the child was symptom-free. Imaging studies revealed no recurrence of tumor or instability. Conclusion A novel technique for reconstruction of C2–C3 vertebral bodies is demonstrated for the youngest case (a 6-year-old boy) of osteoblastoma in the literature. We recommend this approach for cervical spine reconstruction in patients who have an intact C1 arc and resected lower bodies. PMID:26835212

  15. Anterior Reconstruction of C2-C3 Bodies in a 6-Year-Old Patient with a Huge Osteoblastoma: A Novel Technique.

    Science.gov (United States)

    Haghnegahdar, Ali; Sedighi, Mahsa

    2016-02-01

    Study Design Case report. Objective We report the youngest child diagnosed with upper cervical osteoblastoma and the first case operated on with our novel surgical approach. Methods Our patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of a C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. Posterior fixation of C1-C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Ten days later, a total resection of the residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath). Reconstruction of C1-C3 was performed with C1 anterior sublaminar wiring and an expandable titanium cage. Results Successful reconstruction of C2-C3 vertebral bodies was achieved. At 2-year follow-up, the child was symptom-free. Imaging studies revealed no recurrence of tumor or instability. Conclusion A novel technique for reconstruction of C2-C3 vertebral bodies is demonstrated for the youngest case (a 6-year-old boy) of osteoblastoma in the literature. We recommend this approach for cervical spine reconstruction in patients who have an intact C1 arc and resected lower bodies.

  16. Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries’ Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration

    Directory of Open Access Journals (Sweden)

    Victoria García-Espinosa

    2016-01-01

    Full Text Available Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries’ stiffness. Methods. 221 subjects (4–15 years, 92 females were assigned to normal weight (NW, n=137 or obesity (OB, n=84 groups, considering their body mass index z-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus, BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children.

  17. Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries' Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration

    Science.gov (United States)

    García-Espinosa, Victoria; Curcio, Santiago; Castro, Juan Manuel; Arana, Maite; Giachetto, Gustavo; Chiesa, Pedro; Zócalo, Yanina

    2016-01-01

    Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries' stiffness. Methods. 221 subjects (4–15 years, 92 females) were assigned to normal weight (NW, n = 137) or obesity (OB, n = 84) groups, considering their body mass index z-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP) levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus), BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial) stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children. PMID:27066273

  18. Can carotid angiography be performed by vascular surgeons? A critical evaluation of indications, technique, and results.

    Science.gov (United States)

    Sullivan, Timothy M; Patel, Ajay; Langan, Eugene M; Gray, Bruce H; Mackrell, Peter J; Taylor, Spence M; Carsten, Christopher G; Cull, David L; Snyder, Bruce A; Miskulin, Joseph; Youkey, Jerry

    2004-11-01

    The purpose of this report is to examine the contemporary indications for diagnostic carotid arteriography and evaluate its utility and safety when performed by vascular surgeons. The records of all patients having selective carotid arteriography from September 2000 through March 2002 at our institution were reviewed. One hundred sixty-four consecutive patients had selective arteriography of the extracranial carotid arteries for the following indications: hemispheric symptoms with stenosis 80% by duplex) internal carotid stenosis (9.8%), ipsilateral internal carotid artery occlusion (7.1%), bilateral high-grade internal carotid artery stenoses (7.1%), vertebral-basilar ischemia (7.0%), contralateral internal carotid occlusion (5.4%), duplex ultrasound from a nonaccredited vascular laboratory (3.3%), and evaluation of nonatherosclerotic carotid disease (3.3%). There were no transient ischemic attacks, strokes, or deaths related to the index procedure. Selective angiography of the extracranial carotid arteries remains an important adjunct in the evaluation of patients with carotid disease. This procedure can be performed safely by vascular surgeons.

  19. Prevalence of carotid and pulp calcifications: a correlation using digital panoramic radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Clark, Stephen J. [School of Dentistry, University of Louisville, Department of Periodontics, Endodontics and Dental Hygiene, Louisville, KY (United States); Scheetz, James P.; Khan, Zafrulla [University of Louisville, Department of Diagnostic Sciences, Prosthodontics and Restorative Dentistry, School of Dentistry, Louisville, KY (United States); Farman, Allan G. [School of Dentistry, University of Louisville, Department of Periodontics, Endodontics and Dental Hygiene, Louisville, KY (United States); Horsley, Scott H.; Beckstrom, Brice

    2009-03-15

    To compare the prevalence of pulp calcification with that of carotid calcification using digital panoramic dental radiographs. Digital panoramic radiographs of patients at a dental oncology clinic were included if (1) the carotid artery bifurcation region was visible bilaterally and (2) the patient had non-restored or minimally restored molars and/or canines. An endodontist evaluated the images for pulpal calcifications in the selected teeth. An oral and maxillofacial radiologist independently evaluated the same images for calcifications in the carotid bifurcation region. Odds-ratio and Pearson {chi}{sup 2} were used for data analysis. Presence of pulpal calcification was also evaluated as a screening test for the presence of carotid calcification. A total of 247 panoramic radiographs were evaluated. 32% (n=80) had pulpal calcifications and 25% (n=61) had carotid calcifications with 12% (n=29) having both carotid and pulp calcifications. A significantly higher prevalence of both pulp and carotid calcification was found in subjects older than age 60 years compared to younger age groups. Accuracy of pulpal calcification in screening for carotid calcification was 66.4%. Both pulp and carotid calcifications were more prevalent in older individuals. The presence of pulp calcification was not a strong predictor for the presence of carotid calcification. (orig.)

  20. Association of carotid atherosclerotic plaque features with acute ischemic stroke: A magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Huilin [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Zhao, Xihai [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084 (China); Liu, Xiaosheng; Cao, Ye [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Hippe, Daniel S.; Sun, Jie [Department of Radiology, University of Washington, Seattle, WA 98109 (United States); Li, Feiyu [Department of Radiology, Peking University First Hospital, Beijing 100034 (China); Xu, Jianrong, E-mail: renjixjr@yahoo.com.cn [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Yuan, Chun [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084 (China); Department of Radiology, University of Washington, Seattle, WA 98109 (United States)

    2013-09-15

    Background and purpose: It remains unclear whether direct vessel wall imaging can identify carotid high-risk lesions in symptomatic subjects and whether carotid plaque characteristics are more effective indicators for cerebral infarct severity than stenosis. This study sought to determine the associations of carotid plaque characteristics by MR imaging with stenosis and acute cerebral infarct (ACI) sizes on diffusion weighted imaging (DWI). Materials and methods: One hundred and fourteen symptomatic patients underwent carotid and brain MRI. ACI volume was determined from symptomatic internal carotid artery territory on DWI images. Ipsilateral carotid plaque morphological and compositional characteristics, and stenosis were also determined. The relationships between carotid plaque characteristics, stenosis and ACIs size were then evaluated. Results: In carotid arteries with 30–49% stenosis, 86.7% and 26.7% were found to have lipid-rich necrotic core (LRNC) and intraplaque hemorrhage, respectively. Furthermore, 45.8% of carotid arteries with 0–29% stenosis developed LRNCs. Carotid morphological measurements, such as % wall volume, and the LRNC size were significantly associated with ipsilateral ACIs volume before and after adjustment for significant demographic factors (age and LDL) or stenosis in patients with carotid plaque (all p < 0.05). Conclusions: A substantial number of high-risk plaques characterized by vessel wall imaging exist in carotid arteries with lower grade stenosis. In addition, carotid plaque characteristics, particularly the % wall volume and LRNC size, are independently associated with cerebral infarction as measured by DWI lesions. Our findings indicate that characterizing atherosclerotic plaque by MR vessel wall imaging might be useful for stratification of plaque risk and infarction severity.

  1. Reductions in carotid chemoreceptor activity with low-dose dopamine improves baroreflex control of heart rate during hypoxia in humans.

    Science.gov (United States)

    Mozer, Michael T; Holbein, Walter W; Joyner, Michael J; Curry, Timothy B; Limberg, Jacqueline K

    2016-07-01

    The purpose of the present investigation was to examine the contribution of the carotid body chemoreceptors to changes in baroreflex control of heart rate with exposure to hypoxia. We hypothesized spontaneous cardiac baroreflex sensitivity (scBRS) would be reduced with hypoxia and this effect would be blunted when carotid chemoreceptor activity was reduced with low-dose dopamine. Fifteen healthy adults (11 M/4 F) completed two visits randomized to intravenous dopamine or placebo (saline). On each visit, subjects were exposed to 5-min normoxia (~99% SpO2), followed by 5-min hypoxia (~84% SpO2). Blood pressure (intra-arterial catheter) and heart rate (ECG) were measured continuously and scBRS was assessed by spectrum and sequence methodologies. scBRS was reduced with hypoxia (P dopamine (P dopamine (P dopamine did not attenuate the decrease in baroreflex sensitivity to falling pressures (scBRS "down-down"; P > 0.05). Present findings are consistent with a reduction in scBRS with systemic hypoxia. Furthermore, we show this effect is partially mediated by the carotid body chemoreceptors, given the fall in scBRS is attenuated when activity of the chemoreceptors is reduced with low-dose dopamine. However, the improvement in scBRS with dopamine appears to be specific to rising blood pressures. These results may have important implications for impairments in baroreflex function common in disease states of acute and/or chronic hypoxemia, as well as the experimental use of dopamine to assess such changes.

  2. Effects of decline in renal function with age on the outcome of asymptomatic carotid plaque in healthy adults:a 5-year follow-up study

    Institute of Scientific and Technical Information of China (English)

    JIANG Shi-min; SUN Xue-feng; GU Hong-xia; CHEN Yun-shuang; XI Chun-sheng; QIAO Xi; CHEN Xiang-mei

    2012-01-01

    Background It has been long suggested that abnormal clinical factors in the body,such as dyslipidemia and diabetes.can affect the presence of atherosclerosis.However,few studies on the effect of factors within the normal range,such as the loss of renal function with age,on the prevalence of atherosclerosis are few know in healthy individuals.The aim of this study was to investigate risk factors affecting the presence of asymptomatic carotid plaques in a middle-aged and elderly healthy population.Methods In this regard,we prospectively evaluated 245 healthy individuals (98 males and 147 females) at baseline and after 5 years.Changes in the presence of carotid plaque between 2003 and 2008 were categorized into four groups,i.e.subjects without plaque at entry (n=165):Group 1 (without plaque on two occasions,n=129) and Group 2 (with nascent plaque at follow-up,n=36); subjects with plaque at entry (n=80); Group 3 (with plaque regression at follow-up,n=29) and Group 4 (with plaque on two occasions,n=51).Results Univariate analysis showed that the positive rate of carotid plaques in males was higher than that in females at the baseline,and that a significantly inverse correlation existed between the prevalence rate of plaque and aging.Logistic regression analysis of cross-sectional research showed that independent risk factors for the prevalence of atherosclerosis were male gender,lower estimated glomerular filtration rate (eGFR) and higher low-density lipoprotein cholesterol (LDL-C) at the baseline,and older age and lower eGFR were involved in the presence of carotid plaques at follow-up point.However,logistic regression analysis of the longitudinal data showed that older age,decreased eGFR and increased systolic blood pressure (SBP) independently predicted the presence of carotid plaques after 5 years in subjects without plaque at entry.In addition,in subjects with plaque at entry,age,changes in eGFR and the baseline levels of serum albumin (ALB) and serum total

  3. 颈动脉硬化的发生率及其影响因素的分析%Analysis of prevalence and risk factors of carotid atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    成丽岚; 肖丽敏; 马恩红; 王建栋; 倪素娜

    2011-01-01

    Objective It is to explore the prevalence and risk factors of carotid atherosclerosis. Methods The height, body mass, waist, blood pressure, blood lipids, blood sugar, blood uric acid were determined and carotid artery ultrasound was detected in 2 807 officials examined in our medical department. Results The incidence of obesity, center obesity, hyperuricemia, high blood pressure, hyperlipemia, glycometabolism abnormality, and metabolism syndrome in carotid atherosclerosis group were higher than that of the ones without carotid atherosclerosis, and the results of waistline, blood sugar and blood uric acid were higher in the former group than that in the latter group. With age increasing, the rate of carotid atheroscleros was increased. Conclusion The carotid atherosclerosis is closely related to metabolic targets, we should pay attention to carotid artery ultrasound, it will guide clinical work to the extent.%目的 探讨颈动脉粥样硬化的发生率及其影响因素.方法 对2807例进行体检的公务员进行身高、体质量、腰围、血压、血脂、血糖及血尿酸等指标的测定及颈动脉超声检查.结果 颈动脉硬化组合并肥胖、中心性肥胖、高尿酸血症、高血压、高血脂症、糖代谢异常及代谢综合征发生率均明显高于颈动脉正常组;腰围、血糖、血尿酸的检测结果均高于颈动脉正常组;而且随年龄增加,颈动脉硬化的发生率增加.结论 颈动脉硬化与各代谢指标密切相关,颈动脉超声检查在一定程度上可指导临床工作.

  4. Impact on the carotid intima-medial thickness and safety of rosuvastatin in Chinese patients with carotid atherosclerosis:a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    冯雪茹

    2014-01-01

    Objective To evaluate the efficacy and safety of rosuvastatin in Chinese patients with carotid atherosclerosis.Methods A systematic search of Pubmed,EMBase,CENTRAL,CBMdisc,CNKI and WANFANG databases up the January 2013 was performed to identify studies comparing rosuvastatin with a placebo or other statins on carotid intima-medial thickness(IMT)with a minimum

  5. Glomus tumor of penis- A rare case

    Directory of Open Access Journals (Sweden)

    Madhuri S. Kate

    2013-01-01

    Full Text Available Glomus tumors are rare, painful, and benign soft tissue tumors of the skin arising from the glomus body, an arteriovenous thermoregulatory structure. This lesion is usually found on the extremities. Glomus tumor involving the external genital organs including penis is extremely rare. Until now, only few cases have been reported in the available literature. A 22 year old male patient presented with a painful nodule over the penis. The pathologic diagnosis was glomus tumor of the glans penis. We report herewith a case of glomus tumor of penis diagnosed on histopathologic examination. Glomus tumor, being a benign neoplasm, complete extirpation of the glomus tumor is the treatment of choice.

  6. Hypothalamic tumor

    Science.gov (United States)

    Complications of brain surgery may include: Bleeding Brain damage Death (rarely) Infection Seizures can result from the tumor or from any surgical procedure on the brain. Hydrocephalus can occur with some tumors and ...

  7. Wilms Tumor

    Science.gov (United States)

    ... Wilms tumor is 1 pound at diagnosis. Some children also may have nausea, stomach pain, high blood pressure (hypertension), blood in the urine, loss of appetite, or fever. Even though Wilms tumors often are ...

  8. Successful surgical repair of impending rupture of a pseudoaneurysm of the brachiocephalic artery with prior reconstruction of the carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Miyahara, Ken; Maeda, Masanobu; Sakai, Yoshimasa; Sakurai, Hajime; Murayama, Hiroomi; Hasegawa, Hiroki [Social Insurance Chukyo Hospital, Nagoya (Japan)

    2003-01-01

    We report the successful repair of impending rupture of a pseudoaneurysm of the brachiocephalic artery (BCA) in a 70-year-old man. He had undergone a mediastinal tumor resection through a median sternotomy in 1995. Pathological examination revealed non-Hodgkin's lymphoma. Two years later, he underwent radiation therapy of 65 Gray for metastasis to the supraclavicular lymph nodes. On January 18, 2000, plastic surgeons planned to perform a pectoralis major musculocutaneous flap to repair a radiation skin ulcer. During the operation, the BCA was lacerated, possibly in an area of radiation tissue damage. We performed a prosthetic graft (10-mm Gelseal) replacement of the BCA. The right subclavian artery had to be ligated. Postoperative digital subtraction angiography (DSA) showed excellent reconstruction of the artery. Magnetic resonance angiography of the brain showed a deficit in the anterior communicating artery and stenosis of the posterior communicating artery, which indicated that the reconstruction procedure was reasonable. Seven months later, on August 18, 2000, the patient was transferred to our hospital because of swelling of the right neck and oozing from the previous cutaneous wound. CT scan and DSA demonstrated the presence of a pseudoaneurysm of the proximal anastomosis site, which required emergency surgery. Before this third sternotomy, a saphenous vein graft was interposed between both external carotid arteries. Removal of the prosthetic graft and resection of the pseudoaneurysm were performed under mild hypothermia and cardiopulmonary bypass with left common carotid arterial perfusion. Then, the wound was closed completely using a left pectoralis major musculocutaneous flap. The postoperative course was uneventful and DSA showed good patency of the graft and intracranial arteries. The patient was discharged without neurological complications. We conclude that prior reconstruction of the carotid artery is a safe and effective procedure for patients

  9. Determination of bilateral symmetry of carotid artery structure and function in children and adolescents

    Directory of Open Access Journals (Sweden)

    Uithoven KE

    2017-01-01

    Full Text Available Katelyn E Uithoven,1 Justin R Ryder,2 Roland Z Brown,3 Kyle D Rudser,3 Nicholas G Evanoff,1 Donald R Dengel,1,2 Aaron S Kelly2,4 1School of Kinesiology, University of Minnesota, 2Department of Pediatrics, University of Minnesota Medical School, 3Division of Biostatistics, School of Public Health, University of Minnesota, 4Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA Abstract: The carotid artery represents an ideal location for noninvasive assessment of subclinical atherosclerosis in youth. Examination of arterial structure and function is generally conducted in the left common carotid. However, if the left common carotid is inaccessible or provides a poor acoustic window, it is unknown if the right common carotid can provide comparable values. The symmetry of carotid arteries in youth with high-resolution ultrasound was compared. Participants (N=230 [121 females], 13.8±2.9 years old were assessed for carotid intima media thickness (cIMT, carotid lumen diameter (cLD, carotid incremental elastic modulus (cIEM, carotid diameter compliance (cDC, carotid cross-sectional compliance (cCSC, carotid diameter distensibility (cDD, and carotid cross-sectional distensibility (cCSD. No significant differences (P>0.05 all were found for cIMT (0.49±0.09 vs 0.49±0.08 mm, cIEM (1095±382 vs 1116±346 mmHg, cDC (0.01±0.0 vs 0.01±0.0 mm/mmHg, cCSC (0.01±0.001/mmHg vs 0.01±0.001/mmHg, cDD (14.0%±3.16% vs 13.7%±3.18%, and cCSD (30.1%±7.37% vs 29.4%±7.36%. Significant differences were found for cLD (6.06±0.62 mm vs 6.33±0.64 mm, P<0.001. The majority of measures for arterial structure and function are comparable between the left and right common carotid arteries. There were differences present for cLD; however, these discrepancies are likely due to anatomical differences between the left and right common carotid arteries. Therefore, if the left common carotid is unable to be assessed properly, the right common

  10. Urogenital tumors

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1994-03-01

    An overview is provided for veterinary care of urogenital tumors in companion animals, especially the dog. Neoplasms discussed include tumors of the kidney, urinary bladder, prostate, testis, ovary, vagina, vulva and the canine transmissible venereal tumor. Topics addressed include description, diagnosis and treatment.

  11. Brain Tumors

    Science.gov (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are ...

  12. [Comparative characteristics of the open and endovascular methods of treatment for carotid artery stenoses].

    Science.gov (United States)

    Krotovskiĭ, G S; Uchkin, I G; Shugushev, Z Kh; Zudin, A M; Kagdasarian, A G

    2010-01-01

    The article is dedicated to the problem concerning treatment for stenoses of the extracranial portions of carotid arteries. From March 2004 to November 2009 at the Department of Vascular Surgery No 2 of the N. A. Semashko Central Clinical Hospital No 2 we treated a total of 364 patients presenting with stenotic lesions of the extracranial portion of the carotid arteries. Of these, 176 patients underwent revascularization of the carotid basin: 120 patients endured open carotid endarterectomy (CEAE), 56 patients sustained carotid angioplasty and stenting (CAS), with a total of 128 CEAE and 67 CAS interventions performed. The following conclusion was made: with high skill of surgeons and broad experience in carrying out revascularization of the carotid basin, the CEAE and CAS procedures possess comparable efficacy and safety with CEAE possessing reliable advantage in terms of the parameters of the patient's quality of life.

  13. Reflex influence of carotid baroreceptor inactivation on respiratory resistance in humans

    Directory of Open Access Journals (Sweden)

    Klawe JJ

    2009-12-01

    Full Text Available Abstract Our previous study demonstrated that selective carotid baroreceptors activation decreases airway resistance. The aim of the present study was to evaluate the effect of carotid baroreceptor inactivation on the reflex change of respiratory resistance. Twenty healthy men aged between 20 and 25 were included in the study. Selective inactivation of carotid baroreceptors was induced by generating a positive pressure of 40 mmHg for 5 s in two capsules placed bilaterally on the neck over the bifurcation of the carotid arteries. The oscillatory method (Siregnost FD5, Siemens was used to measure continuously respiratory resistance. Inactivation of carotid baroreceptors produced a short increase in respiratory resistance by 0.39 ± 0.01(SE mbar/l/s, i.e., 21.7% above the resting level. We conclude that in humans, carotid baroreceptors might have a background contribution to bronchodilator tone. This observation seems to be important for clinical situations of impairment of baroreflex function.

  14. Mutations of mitochondrial genome in patients with carotid atherosclerosis

    Directory of Open Access Journals (Sweden)

    Margarita A Sazonova

    2015-03-01

    Full Text Available With aim of detection the spectrum of mitochondrial DNA mutations in patients with carotid atherosclerosis from Moscow Region, we used a Roche 454 high-throughput sequencing of the whole mitochondrial genome. We have found that the presence of a number of homoplasmic mitochondrial DNA mutations in genes of 16S ribosomal RNA, subunits 2, 4 and 5 NADH dehydrogenase, subunits 1 and 2 cytochrome C oxidase, subunit 6 ATP-synthase, tRNA- Leu 2 and cytochrome B differed between conventionally healthy participants of the study and patients with carotid atherosclerosis. We also found heteroplasmic mutations, including insertions one or several nucleotides, that occurred more frequently in mitochondrial DNA of conventionally healthy participants of the study or patients with atherosclerotic lesions.

  15. Compliant Wall Simulation of a Healthy Carotid Bifurcation

    Science.gov (United States)

    Williamson, Shobha; Rayz, Vitaliy; Saloner, David; Berger, Stanley

    2003-11-01

    Cardiovascular disease is a major cause of mortality in the industrialized world. Together with the genetic causes of this disease, fluid-structure interaction (FSI) in the arterial system plays a role in the development of arteriosclerosis. In an effort to further understand this disease, an FSI model of the carotid artery is in progress. To construct this model, we begin with compliant arterial wall deformation considered under transient global blood pressure. Vessel walls are composed of collagen fibers, elastin, smooth muscle, and water. Due to its complexity and variation among humans, it is difficult to create an accurate mechanical description of this material. Hence, we begin by way of isotropic properties with the future intent of anisotropic modeling. Using these parameters, a pulsatile 3D model of wall movement for a healthy carotid artery is presented. Supported under a National Science Foundation Graduate Research Fellowship, NIH Grant HL61823, and PBD, Inc.

  16. Outcome of carotid endarterectomy for acute neurological deficit.

    Science.gov (United States)

    Mussa, Firas F; Aaronson, Nicole; Lamparello, Patrick J; Maldonado, Thomas S; Cayne, Neal S; Adelman, Mark A; Riles, Thomas S; Rockman, Caron B

    2009-01-01

    We reviewed our experience with urgent carotid intervention in the setting of acute neurological deficits. Between June 1992 and August 2008, a total of 3145 carotid endarterectomies (CEA) were performed. Twenty-seven patients (<1.0%) were categorized as urgent. The mean age was 74.1 years (range 56-93 years) with 16 (60%) men, and 11 (40%) women, Symptoms included extremity weakness or paralysis (n=13), amaurosis fugax (n=6), speech difficulty (n=2), and syncope, (n=3). Three patients exhibited a combination of these symptoms. Three open thrombectomy were performed. Regional anesthesia was used in 13 patients (52%). Seventeen patients (67%), required shunt placement. At 30-days, 2 patient (7%) suffered a stroke, and 1 (4%) died. Urgent CEA can be performed safely. A stroke rate of 7% is acceptable in those who may otherwise suffer a dismal outcome without intervention.

  17. Cognitive Deficits in Symptomatic and Asymptomatic Carotid Endarterectomy Surgical Candidates

    Science.gov (United States)

    Jackson, Daren C.; Sandoval-Garcia, Carolina; Rocque, Brandon G.; Wilbrand, Stephanie M.; Mitchell, Carol C.; Hermann, Bruce P.; Dempsey, Robert J.

    2016-01-01

    The role played by vessel disease in stroke-related cognition dysfunction is unclear. We assessed the impact of significant atherosclerotic disease on cognition—even in patients asymptomatic for stroke. We hypothesized that patients would perform poorly relative to controls, but that symptomatic/asymptomatic status (history of stroke/transient ischemic attack) would have no effect. Fifty-two carotid endarterectomy candidates with >60% carotid stenosis and 17 controls underwent a 60-min neuropsychological test protocol. Symptomatic and asymptomatic patients showed deficits in executive function, delayed verbal recall, and general knowledge. Patients symptomatic for stroke also performed worse on tests of language and motor/visuomotor ability. Symptomatic and asymptomatic patients differed in working memory and language task performance. Although all patients showed deficits in executive function and memory, only symptomatic patients showed additional deficits in language and motor function. Cognitive abnormalities in patients viewed as “asymptomatic” for stroke underscore the need for early identification and treatment. PMID:26663810

  18. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniela dos; Monsignore, Lucas Moretti; Nakiri, Guilherme Seizem; Cruz, Antonio Augusto Velasco e; Colli, Benedicto Oscar; Abud, Daniel Giansante, E-mail: danisantos2404@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-07-15

    Arteriovenous fistulae of the cavernous sinus are rare and difficult to diagnose. They are classified into dural cavernous sinus fistulae or direct carotid-cavernous fistulae. Despite the similarity of symptoms between both types, a precise diagnosis is essential since the treatment is specific for each type of fistula. Imaging findings are remarkably similar in both dural cavernous sinus fistulae and carotid-cavernous fistulae, but it is possible to differentiate one type from the other. Amongst the available imaging methods (Doppler ultrasonography, computed tomography, magnetic resonance imaging and digital subtraction angiography), angiography is considered the gold standard for the diagnosis and classification of cavernous sinus arteriovenous fistulae. The present essay is aimed at didactically presenting the classification and imaging findings of cavernous sinus arteriovenous fistulae. (author)

  19. Aberrant internal carotid artery in the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Keun Tak; Kang, Hyun Koo [Dept. of Radiology, Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2014-10-15

    The knowledge about the aberrant internal carotid artery (ICA) in the middle ear is essential for clinicians, because a misdiagnosis of the aberrant ICA could have serious consequences such as excessive aural bleeding during a middle ear surgery. A 38-year-old woman presented with tinnitus and hearing difficulties of the left ear that had started 5 years ago. During otoscopy, an anteroinferior bluish mass was seen in the tympanic space. Computed tomography and magnetic resonance imaging demonstrated a left-side aberrant ICA with bony dehiscence of the carotid canal in the middle ear and a reduced diameter of the tympanic ICA. Herein we report a case of an aberrant ICA in the middle ear. We also review the literature regarding this important vascular anomaly of the temporal bone which may lead to disastrous surgical complications.

  20. Carotid artery disease and low cerebral perfusion pressure

    DEFF Research Database (Denmark)

    Schroeder, T; Utzon, N P; Aabech, J

    1990-01-01

    Direct internal carotid artery blood pressure measurements in patients undergoing carotid endarterectomy identified 49 patients, among 239 consecutive cases (21%), who had a reduction in perfusion pressure of 20% or more. The clinical history, objective findings and angiographic data were compared...... with those of a control group of a further 49 patients selected from the remaining patients operated on over the same period. The two groups were compared for short- and long-term outcome of surgery. We were unable to delineate a symptomatic neurological profile that identified patients with low perfusion...... pressures. Surgery in patients with low perfusion pressures seemed to be associated with an increased complication rate (12% versus 4%), although this was not statistically significant. Definite postoperative improvements in persisting neurological deficits were observed only in one patient. Long...