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Sample records for cecal vascular ectasia

  1. Radiofrequency ablation for the treatment of gastric antral vascular ectasia

    DEFF Research Database (Denmark)

    Dray, X.; Repici, A.; Gonzalez, P.

    2014-01-01

    Background and study aims: The traditional endoscopic treatment for gastric antral vascular ectasia (GAVE) is argon plasma coagulation, but results are not always positive. Radiofrequency ablation (RFA) is a new endoscopic therapy that may be an attractive option for the treatment of GAVE. The aim...

  2. [Gastric vascular lesions in cirrhosis: gastropathy and antral vascular ectasia].

    Science.gov (United States)

    Casas, Meritxell; Calvet, Xavier; Vergara, Mercedes; Bella, Maria Rosa; Junquera, Félix; Martinez-Bauer, Eva; Campo, Rafael

    2015-02-01

    Portal hypertensive gastropathy (GHP) is a complication of portal hypertension usually associated with liver cirrhosis. The pathogenesis is unclear but the presence of portal hypertension is an essential factor for its development. GHP may be asymptomatic or present as gastrointestinal bleeding or iron deficiency anemia. Endoscopic lesions vary from a mosaic pattern to diffuse red spots; the most common location is the fundus. Treatment is indicated when there is acute or chronic bleeding, as secondary prophylaxis. There is insufficient evidence to recommend primary prophylaxis in patients who have never bled. Drugs that decrease portal pressure, such as non-cardioselective beta-blockers, and/or endoscopic ablative treatments, such as argon-beam coagulation, may be used. The role of transarterial intrahepatic portosystemic shunt) or bypass surgery has been insufficiently analyzed. Antral vascular ectasia (EVA) is a rare entity in liver cirrhosis, whose pathophysiology is still unknown. Clinical presentation is similar to that of GHP and endoscopy usually shows red spots in the antrum. Biopsy is often required to differentiate EVA from GHP. There is no effective medical therapy, so endoscopic ablative therapy and, in severe cases, antrectomy are recommended. Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  3. Clinical Characterization of Gastric Antral Vascular Ectasia: A Potential Manifestation of the Metabolic Syndrome.

    Science.gov (United States)

    Smith, Elliot; Tekola, Bezawit; Patrie, James; Cornella, Scott; Caldwell, Stephen

    2016-12-01

    Gastric antral vascular ectasia is a relatively common endoscopic finding. Past studies have shown an association of gastric antral vascular ectasia with cirrhosis and autoimmune disorders. We aimed to re-examine these associations and to investigate a possible association of gastric antral vascular ectasia with features of the metabolic syndrome. There were 135 patients with a diagnosis of gastric antral vascular ectasia from years 1995-2013 seen at the University of Virginia who were identified from a clinical data repository and age and sex matched to a cohort of patients without gastric antral vascular ectasia undergoing endoscopy within the same time frame as the index cases. The groups were compared for comorbidities including autoimmune disease, cirrhosis, vascular disease, body mass index (BMI), diabetes mellitus, and cirrhosis due to nonalcoholic steatohepatitis. Sixty-four percent of gastric antral vascular ectasia patients were cirrhotic, compared with 14% of controls (P correlation of gastric antral vascular ectasia with features of metabolic syndrome such as diabetes, BMI, vascular disease, and nonalcoholic steatohepatitis cirrhosis. The pathophysiology of gastric antral vascular ectasia remains uncertain, but we speculate that it may be a manifestation of the metabolic syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Radiologic findings of gastric antral vascular ectasia (watermelon stomach): a case report

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    Kim, Joo Chang; Park, Kil Sun; Han, Gi Seok; Cha, Sang Hoon; Kim, Sung Jin; Kim, Dae Young [Chungbuk National Univ. College of Medicine, Cheongjushi (Korea, Republic of)

    1999-01-01

    Gastric antral vascular ectasia (watermelon stomach) is characterized by a prominent longitudinal erythematous fold of gastric antrum. Because it has usually been diagnosed by gastroscopy and biopsy, its radiologic findings have not been well described. We report a case of gastric antral vascular ectasia, and describe its findings, as seen on UGIS, ultrasonography, and computed tomography.

  5. Radiologic findings of gastric antral vascular ectasia (watermelon stomach): a case report

    International Nuclear Information System (INIS)

    Kim, Joo Chang; Park, Kil Sun; Han, Gi Seok; Cha, Sang Hoon; Kim, Sung Jin; Kim, Dae Young

    1999-01-01

    Gastric antral vascular ectasia (watermelon stomach) is characterized by a prominent longitudinal erythematous fold of gastric antrum. Because it has usually been diagnosed by gastroscopy and biopsy, its radiologic findings have not been well described. We report a case of gastric antral vascular ectasia, and describe its findings, as seen on UGIS, ultrasonography, and computed tomography

  6. Gastric Antral Vascular Ectasia in Systemic Sclerosis: Current Concepts

    Directory of Open Access Journals (Sweden)

    Raphael Hernando Parrado

    2015-01-01

    Full Text Available Introduction. Gastric antral vascular ectasia (GAVE is a rare entity with unique endoscopic appearance described as “watermelon stomach.” It has been associated with systemic sclerosis but the pathophysiological changes leading to GAVE have not been explained and still remain uncertain. Methods. Databases Medline, Scopus, Embase, PubMed, and Cochrane were searched for relevant papers. The main search words were “Gastric antral vascular ectasia,” “Watermelon Stomach,” “GAVE,” “Scleroderma,” and “Systemic Sclerosis.” Fifty-four papers were considered for this review. Results. GAVE is a rare entity in the spectrum of manifestations of systemic sclerosis with unknown pathogenesis. Most patients with systemic sclerosis and GAVE present with asymptomatic anemia, iron deficiency anemia, or heavy acute gastrointestinal bleeding. Symptomatic therapy and endoscopic ablation are the first-line of treatment. Surgical approach may be recommended for patients who do not respond to medical or endoscopic therapies. Conclusion. GAVE can be properly diagnosed and treated. Early diagnosis is key in the management of GAVE because it makes symptomatic therapies and endoscopic approaches feasible. A high index of suspicion is critical. Future studies and a critical review of the current findings about GAVE are needed to understand the role of this condition in systemic sclerosis.

  7. Erythropoietin resistance in end-stage renal disease patient with gastric antral vascular ectasia

    Directory of Open Access Journals (Sweden)

    Desiree Ji Re Lee

    2015-09-01

    Full Text Available AbstractWe observed a case of recombinant human erythropoietin resistance caused by Gastric Antral Vascular Ectasia in a 40-year-old female with ESRD on hemodialysis. Some associated factors such as autoimmune disease, hemolysis, heart and liver disease were discarded on physical examination and complementary tests. The diagnosis is based on the clinical history and endoscopic appearance of watermelon stomach. The histologic findings are fibromuscular proliferation and capillary ectasia with microvascular thrombosis of the lamina propria. However, these histologic findings are not necessary to confirm the diagnosis. Gastric Antral Vascular Ectasia is a serious condition and should be considered in ESRD patients on hemodialysis with anemia and resistance to recombinant human erythropoietin because GAVE is potentially curable with specific endoscopic treatment method or through surgical procedure.

  8. Vascular-targeted photodynamic therapy of gastric antral vascular ectasia (GAVE).

    Science.gov (United States)

    Qiu, Haixia; Mao, Yongping; Zeng, Jing; Wang, Ying; Zhang, Jiaying; Huang, Naiyang; Liu, Qingsen; Yang, Yunsheng; Linghu, Enqiang; Gu, Ying

    2017-01-01

    Vascular-targeted photodynamic therapy (V-PDT) has been used for several benign vascular diseases. The aim of this pilot study was to demonstrate the potential benefits of VPDT in the treatment of gastric antral vascular ectasia (GAVE). Data from patients with GAVE (n=5) who underwent endoscopic V-PDT were analyzed retrospectively. Pre- and post-V-PDT clinical and endoscopic features, hemoglobin levels, and transfusion requirement were compared. The five GAVE patients received one to four sessions of V-PDT. The hemoglobin levels of all five patients increased steadily following V-PDT. Within 6-48months of follow-up, gastrointestinal bleeding and melena disappeared in all five patients and none of the patients needed a transfusion. Endoscopy examinations showed that the dilated vessels had disappeared without scar formation. No significant side effects or adverse reactions were reported. This preliminary study indicates the good selectivity, safety, and efficacy of V-PDT in the treatment of patients with GAVE. Larger prospective studies are needed to further confirm the feasibility of using V-PDT to treat patients with GAVE. Copyright © 2016. Published by Elsevier B.V.

  9. Gastric antral vascular ectasia--a cause of refractory anaemia in systemic sclerosis.

    LENUS (Irish Health Repository)

    Busteed, S

    2012-02-03

    Recurrent gastrointestinal haemorrhage is an uncommon manifestation of systemic sclerosis. We report a case of gastrointestinal bleeding due to gastric antral vascular ectasia (GAVE) in a patient with systemic sclerosis. Failure to recognise the condition as a cause of gastrointestinal bleeding may delay the instigation of appropriate treatment. GAVE should be considered in the differential diagnosis of anaemia in patients with autoimmune conditions such as systemic sclerosis and primary biliary cirrhosis.

  10. A Case of Gastric Antral Vascular Ectasia Which Was Aggravated by Acid Reducer

    Directory of Open Access Journals (Sweden)

    Yukiomi Nakade

    2017-02-01

    Full Text Available Gastric antral vascular ectasia (GAVE is known to be characterized by red patches or spots in a diffuse or linear array in the antrum of the stomach. The precise etiology of GAVE remains to be elucidated. Argon plasma laser coagulation (APC has been used to control oozing from GAVE; however, there is no satisfactory long-term effect of APC in the control of oozing from GAVE. An acid reducer is used after APC because even physiological acid exposure might delay post-APC ulcer healing. We describe the case of a patient who had used an acid reducer and experienced repeated gastrointestinal hemorrhage due to GAVE. After ceasing to administer the acid reducer, incidences of hospitalization due to oozing from GAVE stopped. After the administration of the acid reducer was restarted, the patient had tarry stool, and diffuse oozing of blood was seen again. We report a first case of GAVE which was aggravated by acid reducer.

  11. Gastric Antral Vascular Ectasia during the Treatment of Chronic Myelogenous Leukemia with Imatinib Mesylate.

    Science.gov (United States)

    Narukawa, Kensuke; Kakihana, Kazuhiko; Fujiwara, Takashi; Kobayashi, Takeshi; Doki, Noriko; Sakamaki, Hisashi; Ohashi, Kazuteru

    2016-01-01

    This report describes three patients with chronic myelogenous leukemia who developed gastric antral vascular ectasia (GAVE) during treatment with imatinib mesylate (IM). Cessation and/or switching from IM to nilotinib resulted in the alleviation of gastrointestinal (GI) bleeding and ectatic lesions. Furthermore, GI bleeding recurred after the re-administration of IM in one patient. Thus, we consider that the occurrence of GAVE in our patients was induced by IM. Although the precise mechanism of IM-GAVE is not understood, all patients took at least 400 mg/day of IM at the onset of GAVE. Thus, higher doses of IM (≥400 mg/day) may be a risk factor for IM-GAVE.

  12. Gastric antral vascular ectasia and its clinical correlates in patients with early diffuse systemic sclerosis in the SCOT trial.

    Science.gov (United States)

    Hung, Emily W; Mayes, Maureen D; Sharif, Roozbeh; Assassi, Shervin; Machicao, Victor I; Hosing, Chitra; St Clair, E William; Furst, Daniel E; Khanna, Dinesh; Forman, Stephen; Mineishi, Shin; Phillips, Kristine; Seibold, James R; Bredeson, Christopher; Csuka, Mary Ellen; Nash, Richard A; Wener, Mark H; Simms, Robert; Ballen, Karen; Leclercq, Sharon; Storek, Jan; Goldmuntz, Ellen; Welch, Beverly; Keyes-Elstein, Lynette; Castina, Sharon; Crofford, Leslie J; Mcsweeney, Peter; Sullivan, Keith M

    2013-04-01

    To describe the prevalence and clinical correlates of endoscopic gastric antral vascular ectasia (GAVE; "watermelon stomach") in early diffuse systemic sclerosis (SSc). Subjects with early, diffuse SSc and evidence of specific internal organ involvement were considered for the Scleroderma: Cyclophosphamide Or Transplant (SCOT) trial. In the screening procedures, all patients underwent upper gastrointestinal endoscopy. Patients were then categorized into those with or without endoscopic evidence of GAVE. Demographic data, clinical disease characteristics, and autoantibody data were compared using Pearson chi-square or Student t tests. Twenty-three of 103 (22.3%) individuals were found to have GAVE on endoscopy. Although not statistically significant, anti-topoisomerase I (anti-Scl70) was detected less frequently among those with GAVE (18.8% vs 44.7%; p = 0.071). Similarly, anti-RNP antibodies (anti-U1 RNP) showed a trend to a negative association with GAVE (0 vs 18.4%; p = 0.066). There was no association between anti-RNA polymerase III and GAVE. Patients with GAVE had significantly more erythema or vascular ectasias in other parts of the stomach (26.1% vs 5.0%; p = 0.003). Endoscopic GAVE was present on screening in almost one-fourth of these highly selected patients with early and severe diffuse SSc. While anti-Scl70 and anti-U1 RNP trended toward a negative association with GAVE, there was no correlation between anti-RNA Pol III and GAVE. Patients with GAVE had a higher frequency of other gastric vascular ectasias outside the antrum, suggesting that GAVE may represent part of the spectrum of the vasculopathy in SSc.

  13. Dural ectasia

    Directory of Open Access Journals (Sweden)

    Neha Gupta

    2014-01-01

    Full Text Available Dural ectasia is one of the likely causes of incomplete or failed spinal anaesthesia. Its association with diseases like Marfans syndrome, neurofibromatosis, osteogenesis imperfecta, vertebral fracture, postopertative adhesions, trauma etc., is often overlooked as a reason for inadequate spinal anaesthesia. Greater than normal volume of cerebrospinal fluid in the lumber theca in dural ectasia is postulated to restrict the spread of intrathecally injected Local anaesthetic. Here, we report a case of failed spinal anaesthesia but successful epidural anaesthesia in later setting in a patient with dural ectasia.

  14. Gastric antral vascular ectasia and solitary rectal ulcer syndrome - two rare diagnoses as the cause of anemia in a single patient: case report.

    Science.gov (United States)

    Kunovský, Lumír; Dastych, Milan; Kroupa, Radek; Hemmelova, Beata; Muckova, Katarina; Chovancova, Miroslava; Kucerova, Lenka; Dolina, Jiri

    Gastric antral vascular ectasia (GAVE) and solitary rectal ulcer syndrome (SRUS) are both mentioned in the literature as rare causes of iron deficiency anemia and gastrointestinal (GI) bleeding. GAVE accounts for up to 4 % of upper non-variceal GI bleeding; SRUS is a rare benign disorder that presents with rectal bleeding. We present the case of a 75-year-old patient who was admitted to our facility with anemia. In the same patient, we encountered chronic bleeding from GAVE and SRUS. Both diagnoses were treated endoscopically: GAVE by argon plasma coagulation and a subsequent treatment with proton pump inhibitors and SRUS by adrenaline injection and clipping, consecutively treated with mesalazine enemas. The patient was successfully cured, resulting in a stable level of hemoglobin and no recurrent GI bleeding. We report a unique case of chronic GI bleeding caused by two uncommon diagnoses. The co-occurrence of GAVE and SRUS has not been previously described or published.Key words: anemia - endoscopy - gastric antral vascular ectasia (GAVE) - gastrointestinal bleeding - solitary rectal ulcer syndrome (SRUS).

  15. Mammary Duct Ectasia

    Science.gov (United States)

    ... may worry that it's a sign of breast cancer, especially if you develop a hard lump around a milk duct affected by mammary duct ectasia. While it's important to get signs and symptoms checked out promptly, remember that mammary duct ectasia does not increase your risk of breast cancer. By Mayo ... . Mayo Clinic Footer Legal ...

  16. Mammary Duct Ectasia

    Science.gov (United States)

    ... lumps Mammary duct ectasia Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  17. Computed tomographic findings of cerebral arterial ectasia

    International Nuclear Information System (INIS)

    Choi, Woo Suk; Ko, Young Ho; Lim, Jae Hoon

    1987-01-01

    The computed tomographic findings of cerebral arterial ectasia in 8 patients, of which 5 cases were angiographically documented, are reported. The ecstatic arteries, located predominantly in the suprasellar and interpeduncular cisterns, appeared as serpignous, tubular structures on the unenhanced scan. The enhanced CT scan demonstrated dense, sharply defined, homogeneous intraluminal enhancement. Until recently, the diagnosis of cerebral arterial ectasia was usually established by angiography. With introduction of CT it has become possible to noninvasively identify and characterize this vascular disorder and its associated intracranial complications. The vertebrobasilar dolichoectasia may be diagnosed by CT as an extra-axial lesion in the cerebellopontine angle. It enhances in a tubular fashion after intravenous injection of contrast.

  18. Unilateral Post-LASIK Ectasia and Contralateral Spontaneous Ectasia.

    Science.gov (United States)

    Qin, Vincent; Saad, Alain; Gatinel, Damien

    2016-02-01

    To report a case of iatrogenic unilateral post-LASIK corneal ectasia with contralateral spontaneous ectatic evolution. Case report with preoperative and postoperative measurements including uncorrected visual acuity, corrected distance visual acuity, refraction, slit-scanning topographic and pachymetric maps, and differential maps. Six months after unilateral LASIK, the operated eye progressively developed signs of post-LASIK ectasia with increased inferior corneal steepening and corneal thinning and decrease in corrected distance visual acuity. Five years later, the unoperated eye also developed signs of spontaneous ectatic evolution with increased inferior steepening and corneal thinning. LASIK accelerates occurrence of ectasia in ectasia-susceptible and biomechanically fragile eyes. Copyright 2016, SLACK Incorporated.

  19. Corneal ectasia after photorefractive keratectomy.

    Science.gov (United States)

    Leccisotti, Antonio

    2007-06-01

    Corneal ectasia after photorefractive keratectomy (PRK) has only been occasionally reported, and its incidence has not been assessed. In a retrospective, non-comparative case series, incidence of corneal ectasia was evaluated in a personal consecutive 6453-case series of myopic PRK with a minimum follow-up of 18 months. Features and prognosis were evaluated in all patients with ectasia after PRK (in both personal and referred cases). Ectasia was detected in three eyes of two patients (patients 1 and 2) 3 years and 1 year after PRK performed elsewhere. In addition, in the personal PRK series, two eyes of two patients (patients 3 and 4) developed corneal ectasia 5 months after surgery (incidence: 0.03%). Pre-operatively, forme fruste keratoconus was present in patients 1, 3 and 4; keratoconus in the fellow eye in patient 2; pachymetry corneal ectasia in predisposed eyes, even after low myopic ablations. Forme fruste keratoconus and keratoconus in the fellow eye were the main pre-operative findings. Prognosis varies according to severity.

  20. PROSE treatment of corneal ectasia.

    Science.gov (United States)

    Baran, Inna; Bradley, James A; Alipour, Fateme; Rosenthal, Perry; Le, Hong-Gam; Jacobs, Deborah S

    2012-10-01

    Prosthetic replacement of the ocular surface ecosystem (PROSE) uses custom designed and fabricated prosthetic devices in a treatment that restores vision, supports healing, reduces symptoms and improves quality of life in patients with complex corneal disease. We report the success rate for PROSE treatment of corneal ectasia. Records of 59 patients with corneal ectasia seen in consultation over 6 months were reviewed. Candidacy for treatment, topographic indices, change in visual acuity, achievement of satisfactory fit, device wear status and change in visual function at 6 months were recorded. Sixteen eyes were non-candidates because conventional correction was adequate. Trial devices were inserted but not dispensed for 13 eyes. No eyes were excluded for severity of ectasia. In the remaining 89 eyes, satisfactory fit was achieved and a device was dispensed. Twenty-one eyes (15 patients) had undergone penetrating keratoplasty. Device wear at 6 months was documented in 78/89 eyes (88%). NEI VFQ-25 score improved 27.6 points (pcorneal ectasia could be fitted with a PROSE device. PROSE treatment has a high success rate when measured by ability to achieve satisfactory fit, impact on visual acuity and 6 month data on both rate of continued wear and impact on visual function. PROSE treatment is an alternative to penetrating keratoplasty for patients with corneal ectasia who are contact lens intolerant. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  1. Recurrent Ectasia After Penetrating Keratoplasty

    Directory of Open Access Journals (Sweden)

    Ayşe Burcu

    2013-04-01

    Full Text Available Corneal ectasia or recurrent keratoconus after penetrating keratoplasty is rare, and few case reports exist in the literature concerning this condition. Computerized corneal topography is quite useful to identify and manage this disorder. Management consists of several methods ranging from spectacle and contact lens correction to repeated penetrating keratoplasty. Clinical and computerized topography findings of two patients with keratectasia following penetrating keratoplasty are presented in this article. Two healthy 45-year-old and 25-year-old male patients complained of decreased visual acuity following penetrating keratoplasty. Clinical and topographical data were consistent with recurrence of corneal ectasia. After repeated penetrating keratoplasty, best-corrected distance Snellen visual acuity of 0.7 was obtained in the 45-year-old patient. The other patient underwent collagen cross linking, received antiglaucomatous therapy, and his visual acuity reached 0.5. During the follow-up period, ectasia progression did not occur. (Turk J Ophthalmol 2013; 43: 124-8

  2. Apendicitis retro-cecal

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    Augusto Salazar Sánchez

    1948-03-01

    Full Text Available Por definición, se llama apendicitis retro-cecal a la inflamación aguda o crónica del apéndice, cuando está situado en posición retrocecal,sea que acompañe a un ciego móvil y en consecuencia esté provisto de meso, o bien que con ciego fijo se encuentre sin meso y en posición retro-peritoneal, hallándose entonces en íntima relación con algunas formaciones anatómicas como el tejido conjuntivo peri-renal, el nervio génito.crural derecho, el fémoro cutáneo, el obsturador y el uréter derecho. Con la mayor frecuencia y cuando el diagnóstico de apendicitis no se ha comprobado previamente por medio de los rayos X la situación retro-cecal es un hallazgo operatorio, que por no haber sido pre visto puede ocasionar dificultades técnicas más o menos grandes y prolongar, a veces por mucho tiempo el acto quirúrgico. Es importante, conocer la sintomatologíade la apendicitis retrocecal, puesto que es posible confundir esta afección, con otras que están situadas en órganos ajenos al tractus digestivo, como son (Bockus, Duplay, la litiasis renal, la pielitis derecha o los abscesos peri-nefríticos, confusiones éstas que son muy graves porque o bien pueden demorar la intervención quirúrgica, o bien la indican de inmediato cuando está formalmente contraindicada, como ocurre en las dos primeras afecciones mencionadas.

  3. Risk profiles of ectasia after keratorefractive surgery.

    Science.gov (United States)

    Giri, Pushpanjali; Azar, Dimitri T

    2017-07-01

    To identify and evaluate the risk factors of iatrogenic ectasia after refractive surgery. We reviewed recently published papers that identified various risk factors associated with ectasia after LASIK, photorefractive keratectomy, small incision lenticule extraction, and other refractive surgical procedures. We also attempted to evaluate the relative contributions of these factors to the development of ectasia following refractive surgery. Forme fruste keratoconus, genetic predisposition to keratoconus, low residual stromal bed thickness (through high myopia, thin preoperative cornea, or thick LASIK flap), and irregular corneal topography have been identified as risk factors for keratectasia development after refractive surgical procedures. A newly proposed metric, percentage tissue altered, has been reported to be a robust indicator for post LASIK ectasia risk calculation. Several cases of keratectasia have also been reported 6 to 12 months following minimally invasive small incision lenticule extraction procedure. Other risk factors associated with iatrogenic ectasia include eye rubbing, young age, and pregnancy. Ectasia after refractive surgery is a relatively rare complication which can lead to sight-threatening complications if not detected and treated in time. It is important to continue our quest to improve our methods of identifying absolute and relative risk factors of ectasia and their cut-off values following various keratorefractive surgical procedures.

  4. Late onset corneal ectasia after LASIK surgery.

    Science.gov (United States)

    Said, Ashraf; Hamade, Issam H; Tabbara, Khalid F

    2011-07-01

    To report late onset corneal ectasia following myopic LASIK. A retrospective cohort case series. Nineteen patients with late onset corneal ectasia following LASIK procedure were examined at The Eye Center, Riyadh, Saudi Arabia. Patients underwent LASIK for myopia with spherical equivalent ranging from -1.4 to -13.75 diopters. Age and gender, history of systemic or local diseases, and time of onset of corneal ectasia were recorded. Eye examination and corneal topographical analyses were done before and after LASIK surgery. Nineteen patients (29 eyes) with late onset corneal ectasia were identified from 1998 to 2008 in 13 male and six female patients. The mean follow-up period was 108 ± 23 months (range 72-144 months). No patient had pre-operative identifiable risk factors for corneal ectasia and the mean time of onset was 57 ± 24 months (range 24-120 months after LASIK). The pre-operative values included mean central pachymetry 553 ± 25 μm, mean keratometry reading of 42.9 ± 1.5 diopters, average oblique cylinder of 1.4 ± 1.2 diopters, posterior surface elevation of 26 ± 2.1 diopters, corneal flap thickness of 160 μm, mean spherical equivalent of -5.6 ± 3.6 diopters, and calculated residual corneal stromal bed thickness was 288 ± 35 μm. Three (5 eyes) patients developed ectasia after pregnancy. Three (4 eyes) patients developed corneal ectasia following severe adenoviral keratoconjunctivitis and had positive PCR for adenovirus type 8. Corneal ectasia may develop many years after LASIK surgery and symptoms could go undetected for some time. Pregnancy and adenoviral keratoconjunctivitis occurred post-operatively in six patients.

  5. Intrastromal crosslinking in post-LASIK ectasia

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    Bernardo Kaplan Moscovici

    2014-06-01

    Full Text Available Descrevemos um caso de ectasia de córnea precoce após cirurgia de LASIK, detectado no primeiro semestre pós-operatório. Nós optamos tratar este paciente com "crosslinking" embaixo do "flap" , sem desepitelização com bons resultados. A paciente permaneceu sem progressão da ectasia até o momento atual, dois anos após o procedimento.

  6. Percent tissue altered and corneal ectasia.

    Science.gov (United States)

    Santhiago, Marcony R

    2016-07-01

    This article reviews the association of a novel metric, percentage tissue altered (PTA), with the occurrence of ectasia after laser in-situ keratomileusis in eyes with normal corneal topography, and analyses the influence of the variables that comprise it, and its role on eyes with suspicious topography. PTA is derived from [PTA = (FT + AD)/CCT] where FT = flap thickness, AD = ablation depth, and CCT = preoperative central corneal thickness. Our studies revealed that there is a robust relationship between high PTA and ectasia risk in eyes with normal preoperative topography. PTA higher or equal to 40% presented the highest odds ratio and highest predictive capabilities for ectasia risk than each of the variables that comprise it, residual stromal bed or age. Average thicker flaps alone were insufficient to create ectasia unless coupled with greater ablation depths, meaning a high PTA. In eyes with suspicious topography, even low PTA value is sufficient to induce ectasia. This new metric, PTA, should be taken into account when screening patients for refractive surgery. Patients with normal topography or tomography, presenting a PTA higher or equal to 40% should be considered at higher risk for post laser in-situ keratomileusis ectasia.

  7. Risk factors for corneal ectasia after LASIK.

    Science.gov (United States)

    Tabbara, Khalid F; Kotb, Amgad A

    2006-09-01

    To establish a grading system that helps identify high-risk individuals who may experience corneal ectasia after LASIK. Retrospective, comparative, interventional case series. One hundred forty-eight consecutive patients (148 eyes) were included in this study. Thirty-seven patients who underwent LASIK at other refractive centers experienced corneal ectasia in 1 eye after LASIK. One hundred eleven eyes of 111 patients who underwent successful LASIK during the same period were age and gender matched and served as controls. All patients underwent preoperative and postoperative topographic analysis of the cornea. The follow-up period in both groups of patients ranged from 2 to 5 years, with a mean follow-up of 3.6 years. All patients underwent LASIK for myopia (spherical equivalent, -4.00 to -8.00 diopters). Corneal keratometry, oblique cylinder, pachymetry, posterior surface elevation, difference between the inferior and superior corneal diopteric power, and posterior best sphere fit (BSF) over anterior BSF were given a grade of 1 to 3 each. An ectasia grading system was established, and the cumulative risk score was assessed. Patients who had a grade of 7 or less showed no evidence of corneal ectasia, whereas 16 (59%) of 27 patients who had a grade of 8 to 12 had corneal ectasia. Twenty-one (100%) of 21 patients with a grade of more than 12 had corneal ectasia after LASIK (P<0.0001). A risk score may help in the prediction of patients who are at risk of experiencing corneal ectasia after LASIK. A prospective clinical study is needed to assess the validity of these risk factors.

  8. Ectasia risk factors in refractive surgery

    Science.gov (United States)

    Santhiago, Marcony R; Giacomin, Natalia T; Smadja, David; Bechara, Samir J

    2016-01-01

    This review outlines risk factors of post-laser in situ keratomileusis (LASIK) ectasia that can be detected preoperatively and presents a new metric to be considered in the detection of ectasia risk. Relevant factors in refractive surgery screening include the analysis of intrinsic biomechanical properties (information obtained from corneal topography/tomography and patient’s age), as well as the analysis of alterable biomechanical properties (information obtained from the amount of tissue altered by surgery and the remaining load-bearing tissue). Corneal topography patterns of placido disk seem to play a pivotal role as a surrogate of corneal strength, and abnormal corneal topography remains to be the most important identifiable risk factor for ectasia. Information derived from tomography, such as pachymetric and epithelial maps as well as computational strategies, to help in the detection of keratoconus is additional and relevant. High percentage of tissue altered (PTA) is the most robust risk factor for ectasia after LASIK in patients with normal preoperative corneal topography. Compared to specific residual stromal bed (RSB) or central corneal thickness values, percentage of tissue altered likely provides a more individualized measure of biomechanical alteration because it considers the relationship between thickness, tissue altered through ablation and flap creation, and ultimate RSB thickness. Other recognized risk factors include low RSB, thin cornea, and high myopia. Age is also a very important risk factor and still remains as one of the most overlooked ones. A comprehensive screening approach with the Ectasia Risk Score System, which evaluates multiple risk factors simultaneously, is also a helpful tool in the screening strategy. PMID:27143849

  9. Spontaneous cecal perforation secondary to acute fulminant ...

    African Journals Online (AJOL)

    Spontaneous cecal perforation secondary to acute fulminant gastroenteritis: report of a rare case. Duvuru Ram, Vilvapathy S. Karthikeyan, Sarath C. Sistla, Sheik M. Ali, Parnandi Sridhar, Nagarajan Rajkumar ...

  10. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    International Nuclear Information System (INIS)

    Ahn, N.U.; Nallamshetty, L.; Ahn, U.M.; Buchowski, J.M.; Kebaish, K.M.; Sponseller, P.D.; Rose, P.S.; Garrett, E.S.

    2001-01-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P 38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  11. Cecal bascule: an unusual pathology of cecal dilation. Case report and brief review

    OpenAIRE

    Oza, Veeral; Johnson, Andrea; Pfeil, Sheryl

    2013-01-01

    Patients with multiple comorbidities often develop decreased intestinal motility resulting in abdominal distention. A variety of etiologies such as electrolyte abnormalities, medications, and sometimes unusual anatomical pathologies are responsible for this distention. Cecal bascule represents an exceedingly rare anatomical variance that leads to abdominal distention, and mimics a potentially isolated cecal distention. This rare diagnosis, if missed, can lead to severe complications. We prese...

  12. Corneal ectasia after LASIK in a patient with normal scheimpflug evaluation but a high Ectasia Risk Score.

    Science.gov (United States)

    Goncalves, Fauze Abdulmassih; Goncalves, José Marcos Santos

    2013-11-01

    To present a case of ectasia after LASIK that developed in a patient with normal Scheimpflug imaging but a high Ectasia Risk Score System (ERSS) score. Case report. A 24-year-old woman with no preoperative abnormalities on Scheimpflug evaluation but a cumulative ERSS risk of 4 (high risk) in the right eye and 3 (medium risk) in the left eye developed ectasia in both eyes 27 months after LASIK. She underwent ultraviolet-A corneal collagen cross-linking, with no signs of further progression. In this case, the ERSS was effective at predicting ectasia risk despite normal Scheimpflug imaging and only mild asymmetry on Placido topography. Copyright 2013, SLACK Incorporated.

  13. Corneal ectasia after intrastromal presbyopic surgery.

    Science.gov (United States)

    Courjaret, Jean-Christophe; Matonti, Frederic; Savoldelli, Michele; D'Hermies, Francois; Legeais, Jean-Marc; Hoffart, Louis

    2013-12-01

    To report histopathologic findings in a case of bilateral corneal ectasia following intrastromal femtosecond laser presbyopia surgery. Case report. A 56-year-old patient was referred for bilateral corneal ectasia. He was treated for hyperopia using LASIK twice in both eyes. A bilateral femtosecond laser intrastromal presbyopia correction was secondarily performed. The patient complained of progressive loss of distance visual acuity shortly after. Corneal topography showed a bilateral central corneal protrusion. Rigid contact lenses were successfully fitted on the right eye and, because the patient still complained, a deep anterior lamellar keratoplasty was performed in the left eye. Light and electronic microscopy of the corneal button revealed that the inner intrastromal incision crossed the LASIK interface and led to stromal bed dehiscence. This case illustrates that intrastromal refractive surgery should not be recommended in eyes previously treated by lamellar refractive surgery.

  14. Phytase activity in rabbit cecal bacteria

    Czech Academy of Sciences Publication Activity Database

    Marounek, Milan; Břeňová, Natalia; Suchorská, O.; Mrázek, Jakub

    2009-01-01

    Roč. 54, č. 2 (2009), s. 111-114 ISSN 0015-5632 R&D Projects: GA ČR GA523/07/0673 Institutional research plan: CEZ:AV0Z50450515 Keywords : rabbit * cecal bacteria Subject RIV: GH - Livestock Nutrition Impact factor: 0.978, year: 2009

  15. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, N.U. [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Johns Hopkins Outpatient Center, Dept. of Orthopaedic Surgery, Baltimore, MD (United States); Nallamshetty, L.; Ahn, U.M.; Buchowski, J.M.; Kebaish, K.M.; Sponseller, P.D. [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Rose, P.S. [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (United States); Garrett, E.S. [Dept. of Oncology, Division of Biostatistics, Johns Hopkins University School of Medicine, Baltimore (United States)

    2001-06-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P<0.03); scalloping values at the L1 and L5 levels (P<0.05); sagittal diameters of the vertebral canal at L5-S1 (P<0.03); transverse process to width ratios at L2 (P<0.03). Criteria were developed for diagnosis of dural ectasia in Marfan patients. These included presence of one of the following: interpediculate distance at L4 >38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  16. Topographic, Tomographic, and Aberrometric Characteristics of Post-LASIK Ectasia.

    Science.gov (United States)

    Padmanabhan, Prema; Rachapalle Reddi, Sudhir; Sivakumar, Poornima Devi

    2016-11-01

    To report the refractive, topographic, tomographic, and aberrometric characteristics of post-LASIK ectasia; to compare these characteristics with normal post-LASIK controls; and to propose a comprehensive system to grade the severity of post-LASIK ectasia. The refraction, corrected distance visual acuity (CDVA), magnitude, and location of the steepest and thinnest point on the cornea, the highest anterior and posterior surface elevation, the radius of best fit sphere, corneal asphericity, and corneal aberrations were measured in 50 eyes of 29 patients with post-LASIK ectasia. These were compared with corresponding parameters in 50 eyes that did not develop ectasia for more than 1 year after LASIK. A logistic regression analysis was used to create a scoring system to grade the severity. Eyes with post-LASIK ectasia had significantly higher myopia with astigmatism and a lower CDVA than control eyes. Mean topographic toricity was 3.4 ± 1.9D, mean keratometry at the steepest point was 55.32 ± 6.63D, mean highest posterior elevation was 69.72 ± 3 μm, and mean coma was -2.06 ± 1.2 μm. All these parameters were significantly higher than corresponding values in the control group (p ectasia compared to controls. Five parameters, namely, CDVA, spherical equivalent, highest posterior corneal elevation, spherical aberration, and corneal asphericity, were identified as significant predictors of post-LASIK ectasia and used to create a scoring system. Post-LASIK ectasia is characterized by significant changes in refraction, topography, tomography, and aberrometry. The proposed scoring system may be useful in diagnosing, grading, and monitoring post-LASIK ectasia.

  17. Biomechanics of corneal ectasia and biomechanical treatments.

    Science.gov (United States)

    Roberts, Cynthia J; Dupps, William J

    2014-06-01

    Many algorithms exist for the topographic/tomographic detection of corneas at risk for post-refractive surgery ectasia. It is proposed that the reason for the difficulty in finding a universal screening tool based on corneal morphologic features is that curvature, elevation, and pachymetric changes are all secondary signs of keratoconus and post-refractive surgery ectasia and that the primary abnormality is in the biomechanical properties. It is further proposed that the biomechanical modification is focal in nature, rather than a uniform generalized weakening, and that the focal reduction in elastic modulus precipitates a cycle of biomechanical decompensation that is driven by asymmetry in the biomechanical properties. This initiates a repeating cycle of increased strain, stress redistribution, and subsequent focal steepening and thinning. Various interventions are described in terms of how this cycle of biomechanical decompensation is interrupted, such as intrastromal corneal ring segments, which redistribute the corneal stress, and collagen crosslinking, which modifies the basic structural properties. Proprietary or commercial disclosures are listed after the references. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. Corneal ectasia secondary to LASIK after arcuate keratotomy.

    Science.gov (United States)

    Ghanem, Ramon C; Ghanem, Marcielle A; Bogoni, Ayla; Ghanem, Vinícius C

    2013-06-01

    To present a case of corneal ectasia after LASIK in a patient with previous arcuate keratotomy. Case report. The patient underwent arcuate keratotomy in both eyes in 1997 for with-the-rule regular hyperopic astigmatism and uneventful bilateral LASIK for residual astigmatism 5 years later. Visual acuity and refraction remained stable for 5 years, when the patient noticed worsening visual acuity. Corneal topography showed progressive inferior steepening, confirming the diagnosis of ectasia. Corneal high-resolution optical coherence tomography revealed a normal LASIK flap. The patient had no risk factors for corneal ectasia other than previous incisional surgery. This case suggests that isolated arcuate keratotomy can be a significant risk factor for the development of corneal ectasia after LASIK. Copyright 2013, SLACK Incorporated.

  19. Computational Biomechanical Analysis of Asymmetric Ectasia Risk in Unilateral Post-LASIK Ectasia.

    Science.gov (United States)

    Vahdati, Ali; Seven, Ibrahim; Mysore, Naveen; Randleman, J Bradley; Dupps, William J

    2016-12-01

    To develop a computational approach to corneal biomechanical risk analysis in refractive surgery and to investigate its utility in an enigmatic case of unilateral ectasia after bilateral LASIK. Preoperative corneal elevation datasets from both eyes of a patient who developed unilateral post-LASIK ectasia were used to construct geometrically patient-specific, microstructurally motivated finite element models. Models were assessed before and after implementation of case-specific treatment parameters for interocular differences in corneal geometry and strain behavior under physiological loading conditions. Standard clinical predictors of post-LASIK ectasia risk were similar for the affected and contralateral eyes, and no risk factor asymmetry was identified in tomographic screening that included posterior corneal elevation analysis. However, differences in the magnitude and distribution of strain and stress were observed that are consistent with greater predisposition to biomechanical instability in the affected eye. Load testing with simulated intraocular pressure increases provoked opposite trends in curvature change in the preoperative models representing affected and unaffected eyes, with steepening in the ectatic eye and flattening in the clinically stable eye. Patient-specific computational analyses revealed differences in intrinsic biomechanical behaviors that may predispose a cornea to instability after refractive surgery. Strain and stress analyses elucidated differential risk not ascertained with current refractive surgery screening paradigms. This pilot study illustrates a risk analysis approach that implicitly considers the entire corneal three-dimensional geometry and can be performed a priori in a screening setting. [J Refract Surg. 2016;32(12):811-820.]. Copyright 2016, SLACK Incorporated.

  20. Characteristics of corneal ectasia after LASIK for myopia.

    Science.gov (United States)

    Twa, Michael D; Nichols, Jason J; Joslin, Charlotte E; Kollbaum, Pete S; Edrington, Timothy B; Bullimore, Mark A; Mitchell, G Lynn; Cruickshanks, Karen J; Schanzlin, David J

    2004-07-01

    There are numerous reports of corneal ectasia after laser in situ keratomileusis (LASIK) for myopia without a consistent definition of this condition or a definitive etiology. We conducted a retrospective analysis of published case reports to describe common characteristics of this postoperative event and compared them with findings from a group of successful LASIK patients. A MEDLINE search for "LASIK" and "ectasia" yielded 21 relevant articles published before May 2003 (n = 86 eyes, 59 patients). A comparison group (n = 103 eyes, 63 patients) was selected from a clinic-based sample of successful LASIK patients with 12 months of follow-up after treatment. Descriptive statistics are reported as median and interquartile range. Comparisons were performed using the Wilcoxon rank sum, Wilcoxon signed rank, and chi-square tests. Time to diagnosis of ectasia after LASIK was 13 months (6 to 20 months). Residual myopia in the ectasia group was -3.69 D (-6.00 to -2.13 D) and was significantly greater than the comparison group, -0.38 D (-0.75 to 0.00 D), P ectasia had increased corneal toricity 2.87 D (2.00 to 4.9 D) with increased oblique astigmatism 1.3 D (0.23 to 2.89 D) relative to eyes in the comparison group 0.00 D (0.00 to 0.08 D), and a loss of 2 lines (-0.5 to -6 lines) of best spectacle-corrected visual acuity (all P corneal transplantation. Preoperative characteristics of corneal ectasia include worse visual acuity, less corneal thickness, greater residual myopia, and greater corneal toricity than nonectatic eyes. Treatment factors associated with corneal ectasia after LASIK are greater stromal ablation and less residual stromal bed thickness. Postoperative characteristics of corneal ectasia are myopic refractive error with increased astigmatism, worse spectacle-corrected visual acuity, increased corneal toricity with topographic abnormality, and progressive corneal thinning.

  1. [Diagnostic value of confocal microscopy in primary corneal ectasia].

    Science.gov (United States)

    Egorova, G B; Rogova, A Ia; Mitichkina, T S

    2012-01-01

    Diagnostic value of confocal microscopy in subclinical corneal ectasia is analysed. Morphological changes were revealed in 71.2% of cases with subclinical keratoconus. Results of the study let us reveal typical morphological abnormalities in subclinical keratoconus, although these changes are not specific for this condition. The method is also not informative for detecting of early signs of pellucid marginal degeneration. Confocal microscopy may be considered an additional specifying method in diagnostic algorithm of subclinical corneal ectasia.

  2. Corneal Ectasia and Hydrops in Ocular Hypotony: The Corneal Crease.

    Science.gov (United States)

    Farooq, Asim V; Soin, Ketki; Williamson, Samantha; Joslin, Charlotte E; Cortina, Maria S; Tu, Elmer Y

    2015-09-01

    To report the association of chronic ocular hypotony with the development of progressive corneal ectasia and hydrops. Retrospective case series. Three patients with ocular hypotony were referred for corneal evaluation and found to have ectasia and acute corneal hydrops in their hypotonous eye(s). Clinically, the globes were easily deformable with either external digital palpation and/or simple blinking. All 3 patients had a history of chronic iridocyclitis, including one with juvenile idiopathic arthritis. In each case, the area of thinning was narrow and arcuate in configuration, distinctive from other ectatic disorders. Also uncharacteristically, the acute hydrops resolved rapidly within 2 to 3 weeks without surgical intervention. In 1 case, severe thinning with perforation occurred requiring urgent penetrating keratoplasty. This case series demonstrates a unique clinical entity in which corneal ectasia and hydrops developed in the setting of ocular hypotony and easily deformable corneas, in a pattern unlike previously described forms of ectasia. Acute hydrops, even with associated corneal perforation, demonstrated a short and self-limited course. Corneal ectasia and irregular astigmatism should be suspected as a cause of unexplained visual loss in the ever-increasing number of patients with chronic, stable ocular hypotony. Further study is warranted to determine the pathophysiology of corneal ectasia in this setting, which may include mechanical and inflammatory factors.

  3. Ultrasound appearance of chronic mammary duct ectasia

    Energy Technology Data Exchange (ETDEWEB)

    Duchesne, N. [Ottawa Hospital, Dept. of Radiology, Ottawa, Ontario (Canada)]. E-mail: nathalie_duchesne_22@yahoo.ca; Skolnik, S. [Univ. of Toronto, Dept. of Family Medicine, Toronto, Ontario (Canada); Bilmer, S. [Ottawa Hospital, Dept. of Radiology, Ottawa, Ontario (Canada)

    2005-12-15

    Mammary duct ectasia (MDE), also called periductal mastitis, mammary dysplasia, or plasma cell mastitis, is a benign condition of the mammary gland first described by Haagensen in 1951. The etiology of MDE is unknown and its pathogenesis still controversial; the periductal inflammation could be either the cause or the result of dilated damaged ducts. The process is usually bilateral and asymptomatic, with only a small percentage of patients presenting with symptoms that may include long course of tumour formation, usually subareolar breast lumps, nipple discharge, nipple retraction, mastalgia, and mammary abscess or fistulas. Mammographic presentation of MDE is well known; its features include periductal calcification, benign intraductal calcification, and retroareolar duct dilatation. The periductal calcification results from dystrophic calcification and forms calcified rings or very dense, oval, elongated calcifications, each with a central lucency representing the dilated duct. Intraductal calcifications of duct ectasia represent inspissated intraductal material and are typically of uniform high density, often needle-like, and occasionally branching. Occasionally, there are no mammographic findings, and the diagnosis must rely on sonographic features. Appearance of MDE on ultrasonography (US) depends on the stage of the disease and the contents of the dilated ducts. The acute presentation has been demonstrated in the literature more often than has its chronic counterpart. In the former, duct content can vary from anechoic to isoechoic with surrounding fatty tissue. In chronic MDE, episodes of inflammation are longer. This tends to result in secretions that have a more solid, cheesy texture, partly due to cholesterol crystals, foam cells, and inflammatory cells. For both types of MDE, the appearance can mimic high-grade ductal carcinoma in situ (DCIS) on US. In this essay, 2 chronic MDE cases are presented and their US appearance discussed. Our goal is to explore

  4. Non-obstructive cecal dilatation and perforation after cesarean section

    DEFF Research Database (Denmark)

    Sperling, Lene; Schantz, A L; Toftager-Larsen, K

    1990-01-01

    A case of non-obstructive cecal dilatation and perforation after cesarean section is reported, with a review of the literature on the diagnosis and management of this entity. Fifteen cases have been described. Attention is called to this rare complication and to the accompanying pseudo......-obstructive syndrome, the diagnosis of which is important in order to avoid cecal perforation. Non-obstructive cecal dilatation is a life threatening complication to cesarean section, and immediate surgical intervention is important....

  5. Risk Factors in Post-LASIK Corneal Ectasia

    Directory of Open Access Journals (Sweden)

    Mehmet Gurkan Tatar

    2014-01-01

    Full Text Available Purpose. To evaluate the risk factors for post-laser in situ keratomileusis (LASIK ectasia. Materials and Methods. Medical records of 42 eyes of 28 (10 women, 18 men patients who developed corneal ectasia after LASIK were retrospectively reviewed. Topographical features and surgical parameters of those patients were evaluated. Results. The mean age of patients was 34.73±6.50 (23–48 years and the mean interval from LASIK to the diagnosis of post-LASIK ectasia was 36.0±16.92 (12–60 months. The following factors were determined as a risk factors: deep ablation (>75 μm in 10 eyes, FFK (forme fruste keratoconus in 6 eyes, steep cornea (>47 D in 3 eyes, pellucid marginal degeneration (PMD in 2 eyes, thin cornea (<500 μm in 2 eyes, thin and steep cornea in 2 eyes, thin cornea and deep ablation in 5 eyes, FFK and steep cornea in 2 eyes, and FFK, steep cornea, and deep ablation in 1 eye. However no risk factor has been determined in 9 eyes (21.4%. Conclusion. The findings of our study showed that most of the patients who developed post-LASIK ectasia have a risk factor for post-LASIK ectasia. However, the most common risk factor was deep ablation.

  6. Corneal collagen cross-linking: ectasia and beyond.

    Science.gov (United States)

    Suri, Kunal; Hammersmith, Kristin M; Nagra, Parveen K

    2012-07-01

    Corneal collagen cross-linking has recently emerged as a novel approach for management of ectasia. This article reviews the literature published in the past 3 years about the expanding spectrum of cross-linking as a therapeutic modality and its complications. Recent studies have confirmed the beneficial effects of cross-linking in stabilization and to a lesser extent, regression of keratoconus and postrefractive surgery ectasia. Other applications include cross-linking as a combined procedure with intracorneal ring segments, and photorefractive keratectomy for ectasia, corneal edema, and infectious keratitis. Animal studies of chemical cross-linking of sclera as a potential treatment for progressive myopia have also been performed. Various modifications of the technique to increase the safety profile of cross-linking have been reported, including the use of hypoosmolar riboflavin, transepithelial cross-linking, customized epithelial debridement, and higher fluence shorter duration ultraviolet A light exposure. Reported complications include keratitis, corneal haze, endothelial cell loss and failure of treatment. Cross-linking has been shown to be an effective modality for corneal ectasia, the regression being less in patients with postrefractive ectasia than keratoconus. In a few studies, it has been found to be effective in symptomatic improvement of bullous keratopathy, and infectious keratitis but further studies are required. Cross-linking with epithelial debridement is found to be most effective but various modifications are being investigated for an improved, and better safety outcome.

  7. Tumor carcinoide de apéndice cecal Carcinoid tumor of the cecal appendix

    Directory of Open Access Journals (Sweden)

    Gilberto Collazo Mauri

    2012-12-01

    Full Text Available El tumor carcinoide de apéndice cecal es el más frecuente de todos los tumores apendiculares y generalmente no presentan manifestaciones clínicas. El objetivo de este trabajo fue dar a conocer un interesante caso de tumor carcinoide en una paciente de 26 años de edad cuyo cuadro clínico se interpretó como una apendicitis subaguda. Se indicó tratamiento con antibióticoterapia y hospitalización. La evolución fue satisfactoria. Se da el alta a los 10 días, con ausencia de la tumoración abdominal tanto clínica como ecográficamente. A los 3 meses se decide la operación y se realiza apendicectomía cecal, y se recibe como resultado de anatomía patológica argentafinoma del tercio distal del apéndice cecal con infiltración de la mucosa. Se interconsultó con oncología y se realizó seguimiento. La paciente se ha mantenido durante 10 años con evolución satisfactoria, libre de enfermedad. Los exámenes de ultrasonido y tomografía axial computarizada anual informan ausencia de adenopatías regionales y de metástasis hepática.The carcinoid tumors of the cecal appendix are the most frequent of all appendicular tumors, with no clinical manifestations in general. The general objective of this paper was to present an interesting case of carcinoid tumor found in a 26 years-old woman, whose clinical picture was diagnosed as subacute appendicitis. She was hospitalized and treated with antibiotics with good recovery and discharged 10 days later. She had no abdominal tumors confirmed clinically and echographically at that time. Three months later, the patient was operated on and underwent cecal appendicectomy. The pathological anatomy analysis yielded argentaffinoma in the distal third of the cecal appendix with mucosal infiltration. She was referred to the oncology service to be followed up. She has been free from any complication with good recovery for 10 years. The annual ultrasound and the CT scan show that there is neither regional

  8. Role of percent tissue altered on ectasia after LASIK in eyes with suspicious topography.

    Science.gov (United States)

    Santhiago, Marcony R; Smadja, David; Wilson, Steven E; Krueger, Ronald R; Monteiro, Mario L R; Randleman, J Bradley

    2015-04-01

    To investigate the association of the percent tissue altered (PTA) with the occurrence of ectasia after LASIK in eyes with suspicious preoperative corneal topography. This retrospective comparative case-control study compared associations of reported ectasia risk factors in 129 eyes, including 57 eyes with suspicious preoperative Placido-based corneal topography that developed ectasia after LASIK (suspect ectasia group), 32 eyes with suspicious topography that remained stable for at least 3 years after LASIK (suspect control group), and 30 eyes that developed ectasia with bilateral normal topography (normal topography ectasia group). Groups were subdivided based on topographic asymmetry into high- or low-suspect groups. The PTA, preoperative central corneal thickness (CCT), residual stromal bed (RSB), and age (years) were evaluated in univariate and multivariate analyses. Average PTA values for normal topography ectasia (45), low-suspect ectasia (39), high-suspect ectasia (36), low-suspect control (32), and high-suspect control (29) were significantly different from one another in all comparisons (P topography ectasia groups, and CCT was not significantly different between any groups. Stepwise logistic regression revealed the PTA as the most significant independent variable (P topography. Less tissue alteration, or a lower PTA value, was necessary to induce ectasia in eyes with more remarkable signs of topographic abnormality, and PTA provided better discriminative capabilities than RSB for all study populations. Copyright 2015, SLACK Incorporated.

  9. Validation of the Ectasia Risk Score System for Preoperative Laser in Situ Keratomileusis Screening

    Science.gov (United States)

    Randleman, J. Bradley; Trattler, William B.; Stulting, R. Doyle

    2013-01-01

    Purpose To validate the Ectasia Risk Score System for identifying patients at high risk for developing ectasia after laser in situ keratomileusis (LASIK).. Design Retrospective case-control study Methods Fifty eyes that developed ectasia and 50 control eyes with normal postoperative courses after LASIK were analyzed and compared using the previously described Ectasia Risk Score System, which assigns points in a weighted fashion to the following variables: topographic patter, predicted residual stromal bed thickness (RSB), age, preoperative corneal thickness (CT), and manifest refraction spherical equivalent (MRSE). Results In this series 92% of eyes with ectasia were correctly classified as being at high risk for the development of ectasia, while 6% of controls were incorrectly classified as being at high risk for ectasia. (pectasia risk score than by traditional screening parameters relying on abnormal topography or residual stromal bed thickness less than 250 μ (92% vs. 50%, p Ectasia Risk Score System in the population from which it was derived and this independent population of ectasia cases and controls. Conclusion The Ectasia Risk Score System is a valid and effective method for detecting eyes at risk for ectasia after LASIK and represents a significant improvement over previously utilized screening strategies. PMID:18328998

  10. Visual rehabilitation and outcomes for ectasia after corneal refractive surgery.

    Science.gov (United States)

    Woodward, Maria A; Randleman, J Bradley; Russell, Buddy; Lynn, Michael J; Ward, Michael A; Stulting, R Doyle

    2008-03-01

    To analyze the visual outcomes and method of final visual correction in eyes with corneal ectasia after laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Emory University Department of Ophthalmology and Emory Vision, Atlanta, Georgia, USA. This retrospective review comprised 74 eyes of 45 patients with corneal ectasia after LASIK (72 eyes) or PRK (2 eyes). Outcomes included postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), best corrected visual acuity (BCVA), and refraction; method of final visual correction; and time to rigid gas-permeable (RGP) contact lens failure. Corneal ectasia developed a mean of 19.2 months after surgery. Postoperatively, the mean UCVA was 20/400 and the mean BSCVA before ectasia management was 20/108. After ectasia management, the mean BCVA was 20/37 and the final BCVA was 20/40 or better in 78% of eyes. Final visual correction was achieved with RGP lenses in 77% of eyes, spectacles in 9%, collagen crosslinking in 3%, intracorneal ring segments in 1%, and penetrating keratoplasty (PKP) in 8%. Two eyes with intracorneal ring segments required segment explantation and subsequent PKP. One eye that had PKP had a graft-rejection episode; there were no graft failures. Two eyes (3%) did not require a visual device to improve visual acuity. The mean time for successful RGP lens wear was 24.8 months; 80% of cases initially managed with RGP lenses were successful with this form of treatment. The majority of eyes developing postoperative corneal ectasia achieved functional visual acuity with RGP lens wear and did not require further intervention. Penetrating keratoplasty can usually be postponed or avoided by alternative methods of visual rehabilitation; however, PKP, when necessary, can provide good visual outcomes.

  11. Intraparotid ductal ectasia: rare cause of parotid swelling.

    Science.gov (United States)

    Chahed, Houda; Meherzi, Samia; Mediouni, Azza; Ben Amor, Mohamed

    2017-07-27

    A 41-year-old patient was hospitalised for a chronic right parotid mass. A cervical ultrasound revealed a cystic mass of the parotid. Cervical MRI found a ductal ectasia of the parotid and submandibular glands associated with a retention cyst of the right parotid. He had a right total parotidectomy. Histopathological examination of the lesion revealed a multilocular cystic mass with a diffuse glandular ectasia of salivary ducts. The patient had an uneventful postoperative course without any recurrence of symptoms. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Reshaping procedures for the surgical management of corneal ectasia.

    Science.gov (United States)

    Ziaei, Mohammed; Barsam, Allon; Shamie, Neda; Vroman, David; Kim, Terry; Donnenfeld, Eric D; Holland, Edward J; Kanellopoulos, John; Mah, Francis S; Randleman, J Bradley; Daya, Sheraz; Güell, Jose

    2015-04-01

    Corneal ectasia is a progressive, degenerative, and noninflammatory thinning disorder of the cornea. Recently developed corneal reshaping techniques have expanded the treatment armamentarium available to the corneal specialist by offering effective nontransplant options. This review summarizes the current evidence base for corneal collagen crosslinking, topography-guided photorefractive keratectomy, and intrastromal corneal ring segment implantation for the treatment of corneal ectasia by analyzing the data published between the years 2000 and 2014. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Intrastromal corneal ring segment implantation for ectasia after refractive surgery.

    Science.gov (United States)

    Torquetti, Leonardo; Ferrara, Paulo

    2010-06-01

    To evaluate the clinical outcomes of implantation of Ferrara intrastromal corneal ring segments (ICRS) in patients with corneal ectasia after refractive surgery. Private clinic, Belo Horizonte, Brazil. Charts of patients with corneal ectasia after refractive surgery were retrospectively reviewed. The following parameters were studied: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, corneal asphericity, and pachymetry. All patients were evaluated by Scheimpflug scanning-slit tomography (Pentacam). Twenty-five eyes (20 patients) with corneal ectasia (20 after laser in situ keratomileusis, 4 after radial keratotomy, 1 after photorefractive keratectomy) were evaluated. Postoperatively, the mean UDVA increased from 20/185 to 20/66 (P = .005) and the mean CDVA, from 20/125 to 20/40 (P = .008). The mean asphericity decreased from -0.95 preoperatively to -0.23 postoperatively (P = .006). The mean pachymetry at the apex of the cornea increased from 457.7 microm +/- 48.7 (SD) preoperatively to 466.2 +/- 49.8 mum postoperatively (P = .025) and the mean pachymetry at the thinnest point, from 436.3 +/- 46.2 microm to 453.9 +/- 49.3 microm (P = .000). The mean keratometry decreased from 45.41 +/- 5.63 diopters (D) to 42.88 +/- 4.44 D, respectively; the decrease was statistically significant (P = .000). Intrastromal corneal ring segment implantation significantly improved UDVA and CDVA in patients with corneal ectasia. (c) 2010. Published by Elsevier Inc.

  14. Tumores de apéndice cecal

    Directory of Open Access Journals (Sweden)

    Rubén Bembilbre Taboada

    1998-08-01

    Full Text Available Se realizó un estudio descriptivo-retrospectivo de 8 pacientes con tumores de apéndice cecal, en el período comprendido entre el 1 de enero de 1990 y el 1 de enero de 1997, los cuales fueron intervenidos quirúrgicamente en el Hospital Provincial Clinicoquirúrgico Docente "Dr. Gustavo Aldereguía". Se revisaron todos los libros de biopsias del Departamento de Anatomía Patológica correspondientes al período analizado, para obtener aquellos casos con diagnóstico de afección tumoral de apéndice. Se estudiaron las historias clínicas y se recogieron datos de interés como sexo, manifestaciones clínicas, diagnóstico presuntivo, diagnóstico anatomopatológico y tipo de intervención. La afección tumoral de apéndice cecal es infrecuente y constituyó el 0,38% del total de 20057 apéndices examinadas. No se hallaron diferencias respecto al sexo. Hubo un ligero predominio en pacientes con edades de más de 60 años. Los hallazgos clínicos más frecuentes fueron dolor agudo en fosa inguinal derecha y fiebre, con predominio del adenocarcinoma. Los principales resultados se exponen en tablasA retrospective-descriptive study of 8 patients with appendix ceci tumors attending the hospital from January 1st, 1990 to January 1st 1997 was made. These patients were operated at "Dr. Gustavo Aldereguía" clinical surgical teaching hospital in Cienfuegos. All the biopsy records of the analyzed period were checked in the Pathological Anatomy Department so as to collect those cases diagnosed with appendix ceci tumors. Medical records were examined and interesting data were collected as follows: sex, clinical symptoms, presumptive diagnosis, anatomopathological diagnosis and type of surgery. Tumors in appendix ceci are unusual and represented 0.38 % of 20 057 analyzed appendixes. Sex was not a determining factor. The disease was slightly predominant in patients over 60. The most frequent clinical findings were: nagging pain in the right inguinal fosa and

  15. Nonspecific Cecal Ulcer: An Obsolete Jargon

    Directory of Open Access Journals (Sweden)

    Duvuru Ram

    2013-04-01

    Full Text Available Non specific cecal ulcer (NSCU is a rare entity described by Cruveilhier in 1832. NSCU has no specific presenting features and it can mimic a host of conditions like appendicitis, diverticulosis and colonic carcinoma. Earlier, this terminology was used to depict those ulcers where it was not possible to make the exact diagnosis. There are only a few cases where a specific preoperative diagnosis was made. The number of NSCUs being reported recently is less. This is due to the advent of newer diagnostic techniques to identify the etiology of these ulcers. Hence the term NSCU is no longer employed in current literature because a specific diagnosis is attained in most ulcers. Therefore the term NSCU is no longer valid and its use should be largely restricted to those cases where a specific diagnosis is not possible even after exhausting the currently available investigative techniques. This article provides an overview of this outdated term and outlines how to proceed when NSCU is encountered in clinical practice. [J Interdiscipl Histopathol 2013; 1(2.000: 85-88

  16. Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking

    OpenAIRE

    Lam, Kay; Rootman, Dan B.; Lichtinger,, Alejandro; Rootman, David S.

    2013-01-01

    Corneal ectasia is a serious complication of laser in situ keratomileusis (LASIK). We report the case of a 29-year-old man who underwent LASIK in both eyes and in whom corneal ectasia developed in the left eye 3 years after surgery. He was treated sequentially with intraocular pressure–lowering medication, intrastromal corneal ring segment (ICRS) implants, and collagen cross-linking. Vision improved and the ectasia stabilized following treatment. Combined ICRS implantation and collagen cross-...

  17. Corneal ectasia secondary to peripheral endotheliopathy in a patient with classic pars planitis

    OpenAIRE

    Arellanes-Garcia, Lourdes; Preciado-Delgadillo, Maricarmen; Hernandez-Quintela, Everardo; Garza-Leon, Manuel

    2010-01-01

    Purpose To report a case of corneal ectasia secondary to pars planitis corneal endotheliopathy Methods Clinical case description and proposed hypothesis regarding development of corneal ectasia Results Eight-year-old male presented with 360° peripheral corneal endotheliopathy and edema, granulomatous keratic precipitates, and mild iritis OD. A progressive corneal ectasia then developed. Twenty months later, OS presented similarly and anterior chamber inflammatory cells, vitreous snowballs, an...

  18. Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking.

    Science.gov (United States)

    Lam, Kay; Rootman, Dan B; Lichtinger, Alejandro; Rootman, David S

    2013-01-01

    Corneal ectasia is a serious complication of laser in situ keratomileusis (LASIK). We report the case of a 29-year-old man who underwent LASIK in both eyes and in whom corneal ectasia developed in the left eye 3 years after surgery. He was treated sequentially with intraocular pressure-lowering medication, intrastromal corneal ring segment (ICRS) implants, and collagen cross-linking. Vision improved and the ectasia stabilized following treatment. Combined ICRS implantation and collagen cross-linking should be considered early in the management of post-LASIK ectasia.

  19. A modified risk assessment scoring system for post laser in situ keratomileusis ectasia in topographically normal patients

    Directory of Open Access Journals (Sweden)

    Mohammad Miraftab

    2014-01-01

    Conclusion: Our modified ectasia risk scoring system for patients with normal corneal topography can predict post LASIK ectasia risk with acceptable sensitivity and specificity. However, there are still unidentified risk factors for which further studies are required.

  20. A Rare Cause of Acute Abdomen: Idiopathic Isolated Cecal Necrosis

    Directory of Open Access Journals (Sweden)

    Ender Özer

    2015-03-01

    Full Text Available Idiopathic isolated cecal necrosis is a clinical problem characterized by right-sided inferior abdominal pain. It is rarely seen, develops due to decreased blood flow to the colon and, imitates acute appendicitis. Its clinical signs are similar to many illnesses causing sensitivity in the right inferior quadrant and, the diagnosis is generally determined during surgery. An 86-year-old male patient presented with the complaints of abdominal pain, trichiniasis, nausea and vomiting. Surgical intervention was decided when physical examination and laboratory results were taken into consideration. After diagnostic laparoscopy, right hemicolectomy was performed because of cecal necrosis. While the mortality and morbidity rates for ischemic bowel disease are high, prognosis for early diagnosed patients with isolated cecal necrosis is better, provided that timely surgical treatment is decided.

  1. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    International Nuclear Information System (INIS)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F.

    2006-01-01

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought

  2. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F

    2006-11-15

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought.

  3. Dural ectasia as a cause of widening of the internal auditory canals in neurofibromatosis

    International Nuclear Information System (INIS)

    Egelhoff, J.C.; Ball, W.S.; Towbin, R.B.; Cincinnati Univ., OH; Seigel, R.S.; Eckel, C.G.

    1987-01-01

    Patients with neurofibromatosis have an increased incidence of acoustic neuroma, which is often bilateral. We present three patients with neurofibromatosis and enlarged internal auditory canals secondary to dural ectasia, without associated acoustic neuromata. Air CT cisternography and Metrizamide CT cisternography was needed in differentiating dural ectasia from acoustic neuroma in two patients. (orig.)

  4. Coronary and Basilar Artery Ectasia Are Associated: Results From an Autopsy Case-Control Study.

    Science.gov (United States)

    Pico, Fernando; Labreuche, Julien; Hauw, Jean-Jacques; Seilhean, Danielle; Duyckaerts, Charles; Amarenco, Pierre

    2016-01-01

    Intracranial artery dolichoectasia (IADE) and coronary artery ectasia have been associated with stroke and myocardial infarction, respectively. Only rarely have cases of coexisting IADE and coronary artery ectasia been reported. We investigated this association in a large consecutive autopsy series. Sixteen stroke patients with IADE were identified among 381 stroke patients and were matched with 16 stroke patients without IADE. The heart and coronary arteries from all patients were examined after a prespecified protocol. Coronary artery ectasia was observed in 8 of the stroke patients with IADE, and in none of the stroke patients without IADE (P=0.008). The diameters of basilar and right coronary arteries were positively correlated (IADE patients, r=0.51; P=0.003 and coronary artery ectasia patients, P=0.006). This autopsy study examining the association of coronary artery ectasia and IADE in stroke patients suggests a common pathogenesis. © 2015 American Heart Association, Inc.

  5. Dural ectasia and FBN1 mutation screening of 40 patients with Marfan syndrome and related disorders: role of dural ectasia for the diagnosis.

    Science.gov (United States)

    Attanasio, Monica; Pratelli, Elisa; Porciani, Maria Cristina; Evangelisti, Lucia; Torricelli, Elena; Pellicanò, Giannantonio; Abbate, Rosanna; Gensini, Gian Franco; Pepe, Guglielmina

    2013-07-01

    Marfan syndrome is an autosomal dominant disorder of connective tissue caused by mutations in the gene encoding fibrillin-1 (FBN1), a matrix component of microfibrils. Dural ectasia, i.e. enlargement of the neural canal mainly located in the lower lumbar and sacral region, frequently occurs in Marfan patients. The aim of our study was to investigate the role of dural ectasia in raising the diagnosis of Marfan syndrome and its association with FBN1 mutations. We studied 40 unrelated patients suspected for MFS, who underwent magnetic resonance imaging searching for dural ectasia. In all of them FBN1 gene analysis was also performed. Thirty-seven patients resulted affected by Marfan syndrome according to the '96 Ghent criteria; in 30 of them the diagnosis was confirmed when revaluated by the recently revised criteria (2010). Thirty-six patients resulted positive for dural ectasia. The degree of dural ectasia was grade 1 in 19 patients, grade 2 in 11 patients, and grade 3 in 6 patients. In 7 (24%) patients, the presence of dural ectasia allowed to reach a positive score for systemic feature criterion. Twenty-four patients carried an FBN1 mutation, that were represented by 13 missense (54%), and 11 (46%) mutations generating a premature termination codon (PTC, frameshifts and stop codons). No mutation was detected in the remaining 16 (6 patients with MFS and 10 with related disorders according to revised Ghent criteria). The prevalence of severe (grade 2 and grade 3) involvement of dura mater was higher in patients harbouring premature termination codon (PTC) mutations than those carrying missense-mutations (8/11 vs 2/13, P = 0.0111). Our data emphasizes the importance of dural ectasia screening to reach the diagnosis of Marfan syndrome especially when it is uncertain and indicates an association between PTC mutations and severe dural ectasia in Marfan patients. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. Non-obstructive cecal dilatation and perforation after cesarean section

    DEFF Research Database (Denmark)

    Sperling, Lene; Schantz, A L; Toftager-Larsen, K

    1990-01-01

    A case of non-obstructive cecal dilatation and perforation after cesarean section is reported, with a review of the literature on the diagnosis and management of this entity. Fifteen cases have been described. Attention is called to this rare complication and to the accompanying pseudo...

  7. Hydrogen sulfide ameliorates cardiovascular dysfunction induced by cecal ligation and puncture in rats.

    Science.gov (United States)

    Abdelrahman, R S; El-Awady, M S; Nader, M A; Ammar, E M

    2015-10-01

    Hydrogen sulfide (H2S) is an endogenously produced gaseous messenger that participates in regulation of cardiovascular functions. This study evaluates the possible protective effect of H2S in cardiovascular dysfunction induced by cecal ligation and puncture (CLP) in rats. After 24 h of induction of CLP, heart rate (HR), mortality, cardiac and inflammation biomarkers (creatine kinase-MB (CK-MB) isozyme, cardiac troponin I (cTnI), C-reactive protein (CRP), and lactate dehydrogenase (LDH)), in vitro vascular reactivity, histopathological examination, and oxidative biomarkers (malondialdehyde (MDA), reduced glutathione (GSH), and superoxide dismutase (SOD)) were determined. CLP induced elevations in HR, mortality, serum CK-MB, cTnI, CRP, and LDH, in addition to impaired aortic contraction to potassium chloride and phenylephrine and relaxation to acetylcholine without affecting sodium nitroprusside responses. Moreover, CLP increased cardiac and aortic MDA and decreased SOD, without affecting GSH and caused a marked subserosal and interstitial inflammation in endocardium. Sodium hydrosulfide, but not the irreversible inhibitor of H2S synthesis dl-propargyl glycine, protected against CLP-induced changes in HR, mortality, cardiac and inflammatory biomarkers, oxidative stress, and myocardium histopathological changes without affecting vascular dysfunction. Our results confirm that H2S can attenuate CLP-induced cardiac, but not vascular, dysfunction possibly through its anti-inflammatory and antioxidant effects. © The Author(s) 2015.

  8. Bilateral Ectasia After Femtosecond Laser-Assisted Small Incision Lenticule Extraction (SMILE).

    Science.gov (United States)

    Mattila, Jaakko S; Holopainen, Juha M

    2016-07-01

    To describe a case of bilateral ectasia after small incision lenticule extraction (SMILE) in a patient with early keratoconus. Case report. Bilateral SMILE was performed on a patient even though preoperative topographies showed changes indicating early keratoconus. The right eye underwent further photorefractive keratectomy enhancement 18 months later. The patient developed a bilateral corneal ectasia. This case underlines the importance of thorough preoperative assessment for possible keratoconus suspect changes with corneal topography to avoid postoperative ectasia. [J Refract Surg. 2016;32(7):497-500.]. Copyright 2016, SLACK Incorporated.

  9. Acute hydrops with corneal perforation in post-LASIK ectasia.

    Science.gov (United States)

    Gupta, Chirag; Tanaka, Thais Shiota; Elner, Victor M; Soong, H Kaz

    2015-01-01

    To report a case of corneal hydrops with perforation in a patient with ectasia after undergoing laser in situ keratomileusis (LASIK). An observational study with clinical, optical coherence tomographic, and histopathologic findings. A 41-year-old woman had an acute onset of blurry vision, pain, photophobia, tearing, and foreign body sensation in the right eye 10 years after undergoing unilateral LASIK in Jordan. According to her, the surgeon elected not to operate on the left eye because of a "corneal abnormality." On slit-lamp examination, a tear in Descemet membrane with a stromal cleft extending to the overlying LASIK flap interface was noted. The flap was partially dehisced by a diffuse channel of aqueous humor draining from the cleft and streaming out the temporal flap edge. When leakage failed to stop after 2 weeks of treatment with a bandage contact lens, the patient underwent penetrating keratoplasty. Histopathological examination of the host button showed a fluid-filled cleft connecting the flap interface. Slit-lamp examination and corneal topography of the contralateral left eye were consistent with keratoconus. Corneal hydrops with perforation in the setting of post-LASIK ectasia is extremely rare and may be associated with flap dehiscence requiring penetrating keratoplasty.

  10. Unilateral corneal ectasia following small-incision lenticule extraction.

    Science.gov (United States)

    Sachdev, Gitansha; Sachdev, Mahipal S; Sachdev, Ritika; Gupta, Hemlata

    2015-09-01

    We describe a case of unilateral corneal ectasia in a 26-year-old man following small-incision lenticule extraction. The preoperative corneal topography was normal, with a minimum corneal thickness of 511 μm and 513 μm in the right eye and left eye, respectively. Lenticules of 85 μm and 82 μm were fashioned to offer a refractive correction of -3.75 -1.50 × 180 and -3.50 -1.50 × 165 in the right eye and left eye, respectively. Twelve months after small-incision lenticule extraction, the patient presented with early signs of ectasia in the left eye on corneal topography, which had worsened at the 18-month examination. Intrastromal corneal ring segment implantation with corneal collagen crosslinking was performed to arrest further progression and to improve uncorrected distance visual acuity. On the last examination, the corrected distance visual acuity was 20/20(-2). Dr. Mahipal S. Sachdev receives travel grants from Carl Zeiss Meditec AG. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Unique hard scleral lens post-LASIK ectasia fitting.

    Science.gov (United States)

    Mahadevan, Rajeswari; Jagadeesh, Divya; Rajan, Rajni; Arumugam, Amudha Oli

    2014-04-01

    This case report describes an experience with prosthetic replacement of ocular surface ecosystem (PROSE) device in an Indian patient with post-LASIK corneal ectasia. Keratoconus and corneal ectasia (post-LASIK) are characterized by progressive thinning and steepening of the cornea. Common symptoms experienced by patients in such conditions range from mild to severe vision impairments to an array of visual symptoms such as glare and ghosting. Scleral lenses are considered a vision-saving device when all other modalities fail. The patient in this case report had larger palpebral aperture, steeper cornea, and increased toricity of the sclera. Although a larger-diameter device is preferable in steeper corneas, a device with a smaller diameter and a flatter haptic was prescribed because of scleral toricity. There is a need to study scleral profile as well because scleral toricity can produce symptoms in patients even after 6 hours of device wear. After a few days of adaptation, the vault of the PROSE device can change because of haptic alignment on the sclera. This case report gives an overview of how the scleral profile can have an effect on the corneal/contact lens relationship when using a PROSE device.

  12. Interval laparoscopic ileocecectomy in a child with cecal diverticulitis

    Directory of Open Access Journals (Sweden)

    John D. Horton

    2017-02-01

    Cecal diverticulitis is a rare disease process, particularly in children. Patients predictably present with right lower quadrant abdominal pain in a manner similar to appendicitis. Imaging may reveal a phlegmon, perforation, bowel wall thickening, or nonspecific inflammatory changes. These imaging findings may not always indicate a clear diagnosis, especially if the appendix cannot be well visualized. Urgent operation may be ill advisable in this situation as the surgeon may encounter a hostile operative field with dense inflammatory changes resulting in an increased risk of ileostomy creation. We present a case of cecal diverticulitis managed safely with a delayed surgical approach. We feel a delayed surgical approach may provide an alternative option for patients with an uncertain diagnosis or surgeons who wish to avoid a potentially hazardous dissection. A delayed approach may also help to facilitate a minimally invasive approach.

  13. Ectasia following small-incision lenticule extraction (SMILE: a review of the literature

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2017-09-01

    Full Text Available Majid Moshirfar,1,2 Julio C Albarracin,3 Jordan D Desautels,1,4 Orry C Birdsong,1 Steven H Linn,1 Phillip C Hoopes Sr1 1HDR Research Center, Hoopes Vision, Draper, 2John A Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, 3Department of Ophthalmology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, 4Department of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, RI, USA Purpose: Four cases of corneal ectasia after small-incision lenticule extraction (SMILE have been reported. In this review, we provide an overview of the published literature on corneal ectasia after SMILE and risk factors associated with this complication.Methods: Case reports were identified by a search of seven electronic databases for pertinent heading terms between 2011 and July 2017. We identified patient characteristics and surgical details including preoperative topography, central corneal thickness, and anterior keratometry (Km. Residual stromal bed (RSB values not reported were computed using VisuMax ReLEx SMILE software Version 2.10.10. Preoperative ectasia risk was measured using the Randleman Ectasia Risk Score System (ERSS. Percent tissue alteration was calculated for each patient as described by Santhiago et al.Results: Seven eyes of four patients developed corneal ectasia post SMILE. Two patients had abnormal topography in both eyes. One patient had abnormal topography in one eye. Only one patient was noted to have normal topography in both eyes and later developed ectasia in one eye in the absence of any known risk factors. The mean Randleman ectasia risk score was 4±3 (range: 1–8. The mean calculated percent tissue altered (PTA was 38%±6% (range: 30%–47%.Conclusion: A majority of reported ectasia cases occurred in patients with subclinical keratoconus. These conditions may be exacerbated by SMILE and should be

  14. Indications for intrastromal corneal ring segments in ectasia after laser in situ keratomileusis.

    Science.gov (United States)

    Brenner, Luis F; Alió, Jorge L; Vega-Estrada, Alfredo; Baviera, Julio; Beltrán, Jaime; Cobo-Soriano, Rosario

    2012-12-01

    To evaluate clinical results of intrastromal corneal ring segments (ICRS) in a large series of post-laser in situ keratomileusis (LASIK) ectasia and determine which clinical parameters were related to the success of this technique. Vissum Corporation and Clínica Baviera Group, Alicante, Spain. Case series. Intrastromal corneal ring segments were implanted to correct the spherocylindrical error and improve visual acuity. Based on a previously described grading system, the best indications for ICRS implantation to treat post-LASIK ectasia were evaluated. The variables related to favorable outcomes over a 12-month follow-up were determined. Patients who lost 2 or more lines due to post-LASIK ectasia had a mean gain of +2.89 lines of corrected distance visual acuity (CDVA) after ICRS implantation (Pectasia had a mean loss of -2.00 lines of CDVA after the ICRS implantation (Pectasia. The best indications for ICRS were a loss of 2 or more lines of CDVA after ectasia and post-LASIK ectasia grade 4. Patients who do not have vision loss after ectasia and those classified as grade 1 should not be considered candidates for ICRS implantation. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. Multiple Pyogenic Liver Abscesses Caused by Microperforation of an Idiopathic Cecal Ulcer.

    Science.gov (United States)

    Yeom, Dong Han; Sohn, Ki Chang; Chu, Min Su; Jo, Dong Ho; Cho, Eun Young; Kim, Haak Cheoul

    2016-01-25

    Idiopathic cecal ulcer is a rare disease entity of unknown cause diagnosed by ruling out other known causes of cecal ulceration. The most common complication of an idiopathic cecal ulcer is bleeding; perforation, peritonitis, abscess, and stricture formation have been noted. The authors treated a 53-year-old woman who presented with fever and intermittent right upper quadrant abdominal pain. Multiple pyogenic liver abscess and a solitary cecal ulcer were diagnosed by radiologic, endoscopic, and pathologic examination, followed by laparoscopic cecectomy. After extensive study, we concluded that this patient's liver abscesses were a complication of the idiopathic cecal ulcer. Herein, we report a case of multiple pyogenic liver abscess caused by microperforation of idiopathic cecal ulcer.

  16. Effects of feeding potato pulp on cholesterol metabolism and its association with cecal conditions in rats.

    Science.gov (United States)

    Hashimoto, Naoto; Nakamura, Yumi; Noda, Takahiro; Han, Kyu-Ho; Fukushima, Michihiro

    2011-11-01

    To clarify the functional properties of potato pulp (PP), a waste product resulting from extraction of starch from potatoes, we examined the effects of PP on cholesterol metabolism and cecal conditions in rats. Plasma total cholesterol (T-Chol) levels were lower in rats fed a PP-supplemented diet for four weeks than in those fed a control diet. Cecal pH was lowered due to an increase in the levels of cecal total short-chain fatty acids, especially butyrate, in the PP group compared to the control group. Furthermore, animals fed with the PP-supplemented diet showed increased cecal ratios of Lactobacillus and Clostridia and decreased cecal ratios of Bacteroides and Gammaproteobacteria with slightly negative and positive correlations with plasma T-Chol levels, respectively. In conclusion, ingestion of PP for four weeks is likely to improve both cecal conditions and cholesterol metabolism, suggesting that PP has prebiotic effects.

  17. Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral device compared to keratoplasty for the treatment of corneal ectasia.

    Science.gov (United States)

    DeLoss, Karen S; Fatteh, Nadeem H; Hood, Christopher T

    2014-11-01

    To compare the ocular characteristics and visual outcomes of eyes with corneal ectasia that were fitted with the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral device to those that underwent keratoplasty. Retrospective, comparative case series. We reviewed the charts of consecutive patients with corneal ectasia that were evaluated for PROSE or underwent keratoplasty at our institution. Clinical data, topographic indices, and corneal thickness were reviewed, and eyes were stratified according to the Amsler-Krumeich classification for severity of ectasia. Only the more severe eye of each patient was included in the study. We compared visual acuity before and after PROSE fitting or keratoplasty. For PROSE evaluations, achievement of satisfactory fit and continued wear at 1 year of follow-up were recorded. From 2010 to 2012, 36 patients underwent PROSE evaluation for corneal ectasia while 37 patients underwent keratoplasty for the same indication. All eyes were successfully fitted with the PROSE device. Eyes in the keratoplasty group had more severe ectasia than eyes in the PROSE group (P = .038). Visual acuity was achieved more rapidly in the PROSE cohort compared to keratoplasty, and mean visual acuity was significantly better for all eyes (P ectasia (P ectasia achieved 20/25 visual acuity after PROSE than after keratoplasty (P = .003). At 1 year follow-up in the PROSE cohort, Snellen acuity was 20/28 (P = .108 vs keratoplasty), improving to 20/25 with over-refraction (P = .006 vs keratoplasty). Eyes with advanced corneal ectasia can be successfully fitted with the PROSE device, and the visual acuity outcome for stage 4 ectasia was better and more rapid compared to keratoplasty. The acuity remained excellent with 1 year of follow-up. PROSE evaluation should be considered in patients with advanced corneal ectasia before proceeding to keratoplasty, especially if the ectasia is deemed stable. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Marsupialization and distal obliteration of a lumbosacral dural ectasia in a nonsyndromic, adult patient

    Directory of Open Access Journals (Sweden)

    Ha Son Nguyen

    2015-01-01

    Full Text Available Dural ectasia is frequently associated with connective tissue disorders or inflammatory conditions. Presentation in a patient without known risk factors is rare. Moreover, the literature regarding the treatment options for symptomatic dural ectasia is controversial, variable, and limited. A 62-year-old female presents with intractable, postural headaches for years. A lumbar puncture revealed opening pressure 3 cm of water. A computed tomography myelogram of the spine demonstrated erosion of her sacrum due to a large lumbosacral dural ectasia. An initial surgery was attempted to reduce the size of the expansile dura, and reconstruct the dorsal sacrum with a titanium plate (Depuy Synthes, Westchester, PA, USA to prevent recurrence of thecal sac dilatation. Her symptoms initially improved, but shortly thereafter recurred. A second surgery was then undertaken to obliterate the thecal sac distal to the S2 nerve roots. This could not be accomplished through simple ligation of the thecal sac circumferentially as the ventral dura was noted to be incompetent and attempts to develop an extradural tissue plane were unsuccessful. Consequently, an abundance of fibrin glue was injected into the thecal sac distal to S2, and the dural ectasia was marsupialized rostrally, effectively obliterating the distal thecal sac while further reducing the size of the expansile dura. This approach significantly improved her symptoms at 5 months follow-up. Treatment of dural ectasia is not well-defined and has been variable based on the underlying manifestations. We report a rare patient without risk factors who presented with significant lumbosacral dural ectasia. Moreover, we present a novel method to treat postural headaches secondary to dural ectasia, where the thecal sac is obliterated distal to the S2 nerve roots using an abundance of fibrin glue followed by marsupialization of the thecal sac rostally. This method may offer an effective therapy option as it serves to

  19. Prevalence of dural ectasia in Loeys-Dietz syndrome: comparison with Marfan syndrome and normal controls.

    Directory of Open Access Journals (Sweden)

    Atsushi K Kono

    Full Text Available BACKGROUND AND PURPOSE: Dural ectasia is well recognized in Marfan syndrome (MFS as one of the major diagnostic criteria, but the exact prevalence of dural ectasia is still unknown in Loeys-Dietz syndrome (LDS, which is a recently discovered connective tissue disease. In this study, we evaluated the prevalence of dural ectasia in LDS according by using qualitative and quantitative methods and compared our findings with those for with MFS and normal controls. MATERIAL AND METHODS: We retrospectively studied 10 LDS (6 males, 4 females, mean age 36.3 years and 20 MFS cases (12 males, 8 females, mean age 37.1 years and 20 controls (12 males, 8 females, mean age 36.1 years both qualitatively and quantitatively using axial CT images and sagittal multi-planar reconstruction images of the lumbosacral region. For quantitative examination, we adopted two methods: method-1 (anteroposterior dural diameter of S1> L4 and method-2 (ratio of anteroposterior dural diameter/vertebral body diameter>cutoff values. The prevalence of dural ectasia among groups was compared by using Fisher's exact test and the Tukey-Kramer test. RESULTS: In LDS patients, the qualitative method showed 40% of dural ectasia, the quantitative method-1 50%, and the method-2 70%. In MFS patients, the corresponding prevalences were 50%, 75%, and 85%, and in controls, 0%, 0%, and 5%. Both LDS and MFS had a significantly wider dura than controls. CONCLUSIONS: While the prevalence of dural ectasia varied depending on differences in qualitative and quantitative methods, LDS as well as MFS, showed, regardless of method, a higher prevalence of dural ectasia than controls. This finding should help the differentiation of LDS from controls.

  20. Corneal ectasia after myopic laser in situ keratomileusis: a long-term study

    Science.gov (United States)

    Spadea, Leopoldo; Cantera, Emilia; Cortes, Magdalena; Conocchia, Nicole Evangelista; Stewart, Charles WM

    2012-01-01

    Background The purpose of this study was to evaluate the long-term postoperative incidence of and key factors in the genesis of corneal ectasia after myopic laser-assisted in situ keratomileusis (LASIK) in a large number of cases. Methods A retrospective review of one surgeon’s myopic LASIK database was performed. Patients were stratified into two groups based on date of surgery, ie, group 1 (1313 eyes) from 1999 to 2001 and group 2 (2714 eyes) from 2001 to 2003. Visual acuity, refraction, pachymetry, and corneal topography data were available for each patient from examinations performed both before and after the refractive procedures. Results Of the 4027 surgically treated eyes, 23 (0.57%) developed keratectasia during the follow-up period, which was a minimum seven years; nine eyes (0.69%) were from group 1 and 14 eyes (0.51%) were from group 2. The onset of corneal ectasia was at 2.57 ± 1.04 (range 1–4) years and 2.64 ± 1.29 (range 0.5–5) years, respectively, for groups 1 and 2. The most important preoperative risk factors using the Randleman Ectasia Risk Score System were manifest refractive spherical error in group 1 and a thin residual stromal bed in group 2. Each of the cases that developed corneal ectasia had risk factors that were identified. Conclusion Ectasia was an uncommon outcome after an otherwise uncomplicated laser in situ keratomileusis procedure. The variables present in eyes developing postoperative LASIK ectasia can be better understood using the Randleman Ectasia Risk Score System. PMID:23152659

  1. Association between the percent tissue altered and post-laser in situ keratomileusis ectasia in eyes with normal preoperative topography.

    Science.gov (United States)

    Santhiago, Marcony R; Smadja, David; Gomes, Beatriz F; Mello, Glauco R; Monteiro, Mario L R; Wilson, Steven E; Randleman, J Bradley

    2014-07-01

    To investigate the association of a novel metric, percent tissue altered, with the occurrence of ectasia after laser in situ keratomileusis (LASIK) in eyes with normal corneal topography and to compare this metric with other recognized risk factors. Retrospective case-control study. The study included 30 eyes from 16 patients with bilateral normal preoperative Placido-based corneal topography that developed ectasia after LASIK (ectasia group) and 174 eyes from 88 consecutive patients with uncomplicated LASIK and at least 3 years of postoperative follow-up. The following metrics were evaluated: age, preoperative central corneal thickness, residual stromal bed, Ectasia Risk Score System scores, and percent tissue altered, derived from [PTA = (FT + AD)/CCT], where FT = flap thickness, AD = ablation depth, and CCT = preoperative central corneal thickness. In the ectasia group, percent tissue altered ≥40 was the most prevalent factor (97%), followed by age ectasia risk score ≥ 3 (43%) (P ectasia risk score ≥ 4 (8). Stepwise logistic regression revealed percent tissue altered ≥ 40 as the single most significant independent variable (P ectasia in eyes with normal preoperative topography and was a more robust indicator of risk than all other variables in this patient population. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Diagnosis of a cecal tumour with virtual colonoscopy

    International Nuclear Information System (INIS)

    Hermann, J.; Paszkowski, J.; Drews, M.; Karmelita-Katulska, K.; Stajgis, M.

    2011-01-01

    The authors presented a 75-year-old female patient at high risk, suspected of a cecal cancer (CC) due to discomfort in the inguinal fossa, microcytic anemia (although she was postmenopausal), liquid stools and a positive faecal occult blood test. A standard examination of the large intestine was undertaken. Conventional colonoscopy was not completed and the results of barium enema were questionable. Therefore, virtual colonoscopy (VC) was performed, which helped to localize an accurate operation site. As a result, the patient underwent right hemicolectomy. Postoperative histopathological assessment confirmed an advanced cecal cancer. Traditionally, double-contrast barium enema is used to evaluate the colon in patients after incomplete colonoscopy. However, the accuracy of this test is lower in comparison to endoscopy or VC. An incomplete colonoscopy examination may occur in up to 10% of patients. Tortuous course of the colon, diverticulosis, strictures, obstructing mass and fixation of colonic loops due to adhesions after surgery are the most common causes of incomplete examinations. To sum up, VC can be an alternative method of evaluation of the large bowel in patients after an incomplete colonoscopy examination, as follows from the presented case and the available literature. (authors)

  3. [Cecal perforation secondary to surgical drainage. A case report].

    Science.gov (United States)

    Vázquez-Ruiz, José; López-Flor, Vicente; Pérez-Folqués, José Eduardo; Aguado-Pérez, Marta; Fernández-Moreno, José; Mansilla-Molina, Diego

    2015-01-01

    The use of surgical drains in abdominal surgery is still today controversial. While accepting their role in certain circumstances, their systematic use advocated by other schools, is not fully accepted. We present a case of secondary blind drilling drainage tube perineum following an abdominoperineal amputation of the rectum that forced a surgical repair in a neoplastic patient This is a patient who underwent abdomino perineal resection for rectal neoplasia. It was decided to leave a silicone-type drain tube for perineum and in late postoperative he presented cecum perforation due to traumatic introduction thereof into the cecal light, which forced his reoperation and surgical repair. There is a tendency to use less and less drains in abdominal surgery, although there are certain occasions when it becomes inevitable. On the other hand it entails morbidity associated with its use that significantly complicates and delays the recovery of the patient. It is accepted that is not useful to prevent the occurrence of fistulas, although it contributes to its early detection. The cecal perforation due to drain is a rare complication which must always be taken into account, and that perhaps could be avoided by using soft and less rigid drains. Copyright © 2015. Published by Masson Doyma México S.A.

  4. Left-sided cecal diverticulitis associated with midgut malrotation.

    Science.gov (United States)

    Chen, Jia-Hui

    2018-01-01

    Malrotation of the midgut is generally considered as a pediatric pathology with the majority of patients presenting in childhood. The diagnosis is rare in adults, which sometimes leads to delay in diagnosis and treatment. An index of suspicion is therefore required when dealing with patients of any age group with abdominal symptoms. We present a case of a 26-year-old male who presented with left lower abdominal pain with preoperative computed tomography showing suspected left-sided appendicitis associated with midgut malrotation. The duodenum, small bowel, and cecum were abnormally located, with the presence of a thickened and inflamed appendix with fecalith images. The patient underwent an emergency laparotomy, and ruptured cecal diverticulitis with abscess formation was confirmed. We performed a cecectomy, and the patient did not have an uneventful postoperative recovery. A review of the literature is presented to highlight the rarity of midgut malrotation and the controversies surrounding its surgical management in the adult population with ruptured left-sided cecal diverticulitis.

  5. Left-sided cecal diverticulitis associated with midgut malrotation

    Directory of Open Access Journals (Sweden)

    Jia-Hui Chen

    2018-01-01

    Full Text Available Malrotation of the midgut is generally considered as a pediatric pathology with the majority of patients presenting in childhood. The diagnosis is rare in adults, which sometimes leads to delay in diagnosis and treatment. An index of suspicion is therefore required when dealing with patients of any age group with abdominal symptoms. We present a case of a 26-year-old male who presented with left lower abdominal pain with preoperative computed tomography showing suspected left-sided appendicitis associated with midgut malrotation. The duodenum, small bowel, and cecum were abnormally located, with the presence of a thickened and inflamed appendix with fecalith images. The patient underwent an emergency laparotomy, and ruptured cecal diverticulitis with abscess formation was confirmed. We performed a cecectomy, and the patient did not have an uneventful postoperative recovery. A review of the literature is presented to highlight the rarity of midgut malrotation and the controversies surrounding its surgical management in the adult population with ruptured left-sided cecal diverticulitis.

  6. Radiologic analysis of cecal filling defects and local wall displacement

    International Nuclear Information System (INIS)

    Kim, D. I.; Suh, J. S.; Kim, G. E.; Park, C. Y.

    1981-01-01

    It has long been accepted that cecum and ileocecal valve are prime important area in GI roentgenology because of variety and frequency of primary and secondary disease involvement. However, precise preoperative diagnosis is still debatable roentrenologically. It is necessary to use the more descriptive terms and systemic approach for roentgenologic diagnosis in this area. Authors analyzed pathologically verified 54 cases of cecal lesion by double contrast colon examination at Yonsei University Medical College Severance Hospital from January '75 to September '80. Of the distribution of diseases, pericecal abscess (16/54; 29.6%) was most common, and followed by intestinal tuberculosis (9/54; 16.6%), and carcinoma (9/54; 16.6%) etc. The ratio of male and female was 2.18: 1 and peak incidence was above 4th decade. The majority of cases show right lower quadrant pain and palpable mass as clinical manifestation. Of the radiologic findings, abnormality in appendix such as nonfilling or irregular filling of barium suggest pericecal abscess, mucocele and less frequently adenocarcinoma of cecum, and characteristically pericecal abscess show rather smooth displacement of medial wall of cecum, but abrupt transition of lesion is shown in adenocarcinoma. Irritability and shortening of cecum, and fixation and speculation of terminal ileum were frequently found in inflammatory conditions such as pericecal abscess, intestinal tuberculosis and chronic nonspecific inflammation. Cecal lesion associated with involvement of ileocecal value were noted in intestinal tuberculosis, lymphoma and adenocarcinoma

  7. Vascular gastric anomalies as a cause of relapsing bleeding

    Directory of Open Access Journals (Sweden)

    Golubović Gradimir

    2008-01-01

    Full Text Available Background. Although relatively rare, gastric vascular anomalies can be recognized as a source of both chronic and acute blood loss, most often presenting as long term iron deficiency anemia, rarely as severe acute gastrointestinal bleeding. Case report. We present five patients with various gastric vascular anomalies, diagnosed during the year of 2003. in the Clinical Hospital Center Zemun. The diagnosis was based on endoscopic appearances, clinical history and characteristic histological findings. Gastric vascular anomalies presented in our review were: portal hypertensive gastropathy, gastric antral vascular ectasia, angiodysplasia, hereditary hemorrhagic telangiectasia and Dieulafoy lesion. The used treatment modalities included surgery and various endoscopic techniques (schlerotherapy, argon plasma coagulation. Conclusion. Patients presented with chronic iron deficiency anemia or acute and recurrent gastrointestinal hemorrhage should be considered as having one of gastric vascular anomalies.

  8. Pregnancy-triggered iatrogenic (post-laser in situ keratomileusis) corneal ectasia--a case report.

    Science.gov (United States)

    Padmanabhan, Prema; Radhakrishnan, Aiswaryah; Natarajan, Radhika

    2010-05-01

    To report a patient who developed bilateral corneal ectasia, during pregnancy, one and a half years after laser in situ keratomileusis for correction of myopia. Case report with relevant literature review. A 20-year-old woman, with a stable myopic astigmatism underwent laser in situ keratomileusis for the correction of her refractive error. Preoperative clinical examination and topographic automated keratoconus screening did not suggest keratoconus in either eye. The patient had a preoperative corneal thickness of 527 and 525 microm, and a postoperative residual bed thickness of 305 and 282 microm in the right and left eyes, respectively. After being fully satisfied with the outcome of the procedure, she reported 18 months later, in the first trimester of pregnancy, with signs and symptoms of corneal ectasia, which steadily worsened with advancing pregnancy. Pregnancy could prompt hormonal changes, which in turn could affect the biomechanical stability of the cornea, leading to corneal ectasia.

  9. Corneal ectasia after laser in situ keratomileusis after laser thermal keratoplasty.

    Science.gov (United States)

    Nguyen, Myhanh T; Hamilton, David Rex

    2009-02-01

    To report a case of corneal ectasia following hyperopic laser in situ keratomileusis in a patient who had previous laser thermal keratoplasty. Case report. We report a case of a 66-year-old emmetropic man initially presented with complaint of difficulty reading without correction. Laser thermal keratoplasty (LTK) was performed on the non-dominant right eye, resulting in successful monovision. Three years later, the patient presented with decreased unaided near vision caused by hyperopic regression of the LTK. Conventional hyperopic laser in situ keratomileusis (LASIK) was performed, again resulting in successful monovision. More than three years later, the patient returned with worsening near vision. A focal corneal ectasia was noted in the same location as the 6 o'clock LTK leukoma. To our knowledge, this is the first report of ectasia occuring after LASIK following LTK. Consideration should be given to performing photorefractive keratectomy (PRK) instead of LASIK following thermal keratoplasty.

  10. Corneal collagen cross-linking for ectasia after excimer laser refractive surgery: 1-year results.

    Science.gov (United States)

    Vinciguerra, Paolo; Camesasca, Fabrizio I; Albè, Elena; Trazza, Silvia

    2010-07-01

    To evaluate the 1-year results of corneal collagen cross-linking (CXL) in eyes with postoperative excimer laser refractive surgery corneal ectasia. Thirteen eyes of 9 consecutive patients who had undergone excimer laser refractive surgery (photorefractive keratectomy [n = 3], LASIK [n = 10]) with resultant unstable corneal ectasia underwent CXL with photosensitizing riboflavin 0.1% solution and subsequent exposure to ultraviolet radiation. Study eyes underwent complete ophthalmologic examination, endothelial specular microscopy, corneal topography, and aberrometry as well as central pachymetry and Scheimpflug-based topo/tomography preoperatively and at 3-, 6-, and 12-month intervals. Best spectacle-corrected visual acuity (BSCVA) improvement was statistically significant (P corneal thickness at 0 and 2 mm from the thinnest corneal point decreased significantly. One year after surgery, CXL appears to stabilize eyes with ectasia consequent to excimer laser refractive surgery and improve BSCVA.

  11. Long-term outcomes of intrastromal corneal ring segment implantation for post-LASIK ectasia.

    Science.gov (United States)

    Yildirim, Aydin; Cakir, Hanefi; Kara, Necip; Uslu, Hasim

    2014-12-01

    To report the long-term results of intrastromal corneal ring segments (ICRS) for postoperative LASIK ectasia. In this retrospective interventional cases series, 8 eyes of 6 patients who underwent femtosecond laser-assisted ICRS implantation for post-LASIK ectasia were enrolled. Main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent refraction, and average keratometry (Kavg) values were assessed. Mean±SD follow-up was 67±21 months (range, 36-96 months). The mean UDVA, CDVA, spherical equivalent refraction, and Kavg values were significantly improved at all postoperative visits when compared to baseline values. No serious complications were observed during follow-up. Our long-term findings showed that ICRS yielded improvements in visual acuity, refractive status, and keratometric values without any progression in cases with post-LASIK corneal ectasia. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  12. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    International Nuclear Information System (INIS)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine; Hinz, Kerstin; Prokein, Jana; Becker, Hartmut

    2009-01-01

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  13. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine [Hannover Medical School, Institute of Human Genetics, Hannover (Germany); Hinz, Kerstin [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Vivantes Klinikum Neukoelln, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Prokein, Jana [Hannover Medical School, Institute for Biometrics, Hannover (Germany); Becker, Hartmut [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany)

    2009-06-15

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  14. Indwelling cecal catheters for fluid administration in ponies.

    Science.gov (United States)

    Mealey, R H; Carter, G K; Roussel, A J; Ruoff, W W

    1995-01-01

    Two different fluid solutions were infused through percutaneous cecal catheters in 6 healthy ponies to determine the effects on body weight; CBC; packed cell volume (PCV); total plasma protein concentration; plasma fibrinogen concentration; abdominal fluid analysis; concentrations of blood urea nitrogen (BUN), serum creatinine, Ca, total CO2 (TCO2), Na, Cl, K, and P; and fractional clearance (FC) of Na, Cl, K, and P. During intracecal administration of solution 1, FCNa and FCCl were significantly increased, whereas FCK and BUN were significantly decreased. During administration of solution 2, FCNa and serum P were significantly increased, while PCV was significantly decreased. All ponies developed peritonitis during the study. Complications included catheter-related problems, diarrhea, laminitis, and hypocalcemia. We concluded that hydration and electrolyte balance could be maintained by administration of crystalloid solutions intracecally, but that complications were associated with the procedure.

  15. Cecal intubation rates in different eras of endoscopic technological development.

    Science.gov (United States)

    Matyja, Maciej; Pasternak, Artur; Szura, Mirosław; Pędziwiatr, Michał; Major, Piotr; Rembiasz, Kazimierz

    2018-03-01

    Colonoscopy plays a critical role in colorectal cancer (CRC) screening and has been widely regarded as the gold standard. Cecal intubation rate (CIR) is one of the well-defined quality indicators used to assess colonoscopy. To assess the impact of new technologies on the quality of colonoscopy by assessing completion rates. This was a dual-center study at the 2 nd Department of Surgery at Jagiellonian University Medical College and at the Specialist Center "Medicina" in Krakow, Poland. The CIR and cecal intubation time (CIT) in three different eras of technological advancement were determined. The study enrolled 27 463 patients who underwent colonoscopy as part of a national CRC screening program. The patients were divided into three groups: group I - 3408 patients examined between 2000 and 2003 (optical endoscopes); group II - 10 405 patients examined between 2004 and 2008 (standard electronic endoscopes); and group III - 13 650 patients examined between 2009 and 2014 (modern endoscopes). There were statistically significant differences in the CIR between successive eras. The CIR in group I (2000-2003) was 69.75%, in group II (2004-2008) was 92.32%, and in group III (2009-2014) was 95.17%. The mean CIT was significantly reduced in group III. Our study shows that the technological innovation of novel endoscopy devices has a great influence on the effectiveness of the CRC screening program. The new era of endoscopic technological development has the potential to reduce examination-related patient discomfort, obviate the need for sedation and increase diagnostic yields.

  16. Ileostomia continente com preservação da papila íleo-cecal

    OpenAIRE

    FORMIGA,GJS

    2000-01-01

    Seis doentes foram submetidos a ileostomia continente com preservação da papila íleo-cecal, como tempo cirúrgico complementar à proctocolectomia e à colectomia totais, para tratamento de doença inflamatória intestinal e polipose adenomatosa familiar, associada a pólipo degenerado no reto inferior. A técnica utilizada de ileostomia continente preserva a papila íleo-cecal e uma pequena borda circular de parede cecal exteriorizados na parede abdominal. O débito ileal, na primeira semana pós-oper...

  17. Case report of idiopathic cecal perforation presenting as acute appendicitis on ultrasound

    Directory of Open Access Journals (Sweden)

    Calista Harbaugh

    2016-08-01

    Full Text Available Cecal perforation is an uncommon phenomenon in a pediatric population. It has been linked to a number of underlying medical conditions, which may result in focal inflammation or relative ischemia including hematologic malignancy, infection, and inflammatory bowel disease. We present an otherwise healthy 16-year-old male diagnosed with acute uncomplicated appendicitis on ultrasound, who was found to have cecal perforation with normal appendix intraoperatively, ultimately requiring ileocectomy. With this report, we aim to present the numerous pathophysiologic etiologies of cecal perforation, and to promote a comprehensive differential diagnosis despite the clinical and radiologic findings consistent with uncomplicated appendicitis.

  18. PERSONALIZED (LOCAL UV-CROSSLINKING AS A TREATMENT OF KERATOCONUS AND CORNEAL ECTASIA

    Directory of Open Access Journals (Sweden)

    S. I. Anisimov

    2017-01-01

    Full Text Available There is no doubts that problem of keratoconus treatment is high relevant. The number of diagnosed ectasia, including iatrogenic ectasia, increased — in recent years. The amount of post-LASIK and ectasia after RK in late postoperative period multiplies significantly. It is associated not only with inception of new ways of treatment into practice, but also with the upgrade of diagnostic methods and equipment. A new method of local personalized crosslinking (LCXL was integrated into clinical practice using Laplace’s equation, pachymetry and topography maps data, It exceeds usual Dresden protocol on several parameters. This article shows the reaction of patients’ eyes on the treatment and the effectiveness of technique is provided. Materials and methods: topographic indications were evaluated (Orbscan II (B+L of 28 patients (40 eyes aged 18 — 44 with keratoconus stages I-IV (12 eyes — I stage; 16 eyes — II stage; 9 eyes — III stage; 3 eyes — IV stage classified by Abugova T.D., as well as UCVA, BCVA for 12 months after surgery. Normal values were estimated by characteristics of 30 eyes without any refractive errors. Results: LCXL is an effective way of treatment of corneal ectasia; it’s more effective in early stages. This technique has a strong controlled refractive impact and allows to reduce inflammatory after procedure. 

  19. Quantitative assessment of dural ectasia as a marker for Marfan syndrome

    NARCIS (Netherlands)

    Oosterhof, T.; Groenink, M.; Hulsmans, F. J.; Mulder, B. J.; van der Wall, E. E.; Smit, R.; Hennekam, R. C.

    2001-01-01

    PURPOSE: To establish normal values for lumbosacral dural sac dimensions with magnetic resonance (MR) imaging and to use these values to assess the sensitivity and specificity of dural ectasia as a marker for Marfan syndrome. MATERIALS AND METHODS: MR imaging was performed to measure dural sac

  20. Case Study: Contact Lens Fitting in the Presence of Corneal Ectasia ...

    African Journals Online (AJOL)

    Keratoglobus (KG) is a bilateral corneal ectasia characterised by overall protrusion of the cornea associated with diffuse thinning from limbus to limbus. Differen al diagnosis includes pellucid marginal degenera on. (PMD) and keratoconus (KC). KG is rare in comparison to the prevalence of KC and PMD. Refrac ve error.

  1. Surgical Treatment of Corneal Ectasia with Motowa's Trephine and Selective Suturing Technique.

    Science.gov (United States)

    Al-Motowa, Saeed; Al-Harby, Mosa

    2016-01-01

    A 40-year-old male presented with bilateral ectasia, contact lens intolerance, and astigmatism >10 D in both eyes. The patient had end-stage pellucid marginal degeneration that warranted surgical treatment. We present a unique surgical technique to stabilize the cornea, minimize astigmatism, improve vision and corneal status, and avoid penetrating keratoplasty.

  2. [Post-lasik corneal ectasia in patients with significant differences in keratometry readings between both eyes].

    Science.gov (United States)

    Ortega-Usobiaga, J; Llovet-Osuna, F; Djodeyre, M R; Llovet-Rausell, A; Beltran-Sanz, J; Baviera-Sabater, J

    2014-03-01

    A study is made on the incidence of corneal ectasia after laser in situ keratomileusis (LASIK) in patients with large differences in mean keratometry (MK) readings between both eyes (OU). Visual outcomes were also evaluated. The medical records of 164,603 patients (315,259 eyes) who underwent LASIK from January 2003 to December 2011 were reviewed in order to identify patients with a difference in MK of ≥ 1.25 D between OU. The main outcome measures were incidence of ectasia after LASIK, and visual outcome. A total of 35 eyes that met the inclusion criteria were found. Functional and visual results were those expected for myopia studies. After a minimum follow-up of 2 years, no corneal ectasia was found in 3 eyes (2 patients). The possibility of finding a patient with an asymmetry in MK and normal topography is low (0.021%), and it does not seem to be a contraindication of LASIK. Although no corneal ectasia was found in this case series, and as it is a potentially sight-threatening complication, patients with very different MK between OU should be studied carefully before undergoing LASIK. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  3. Recent advances in the treatment of corneal ectasia with intrastromal corneal ring segments.

    Science.gov (United States)

    Poulsen, David M; Kang, Joann J

    2015-07-01

    To review the recent advances and reported outcomes in the use of intrastromal corneal ring segments (ICRS) for the treatment of corneal ectasia. ICRS are a well-tolerated and effective treatment for patients with corneal ectasia, particularly keratoconus, offering long-term improvement in visual, refractive, and keratometric measures. ICRS do not consistently decrease corneal aberrations. Patients with mild-to-moderate keratoconus, known to have less predictable outcomes with ICRS, may be better selected and treated with the use of customized nomograms, accounting for factors such as internal astigmatism. Corneal collagen cross-linking performed after ICRS implantation is an important complementary treatment in preventing the progression of ectasia, whereas subsequent treatment with either photorefractive keratectomy or toric intraocular lens implantation offers a significantly improved visual and refractive result. ICRS are an important component to the treatment of corneal ectasia. Knowledge of outcomes among specific groups of patients should improve treatment planning and nomograms. Combined treatments with ICRS allow for notable improvements in corneal stability and refractive error, in addition to the improvement in irregular astigmatism seen with ICRS.

  4. Corneal topography indices after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results.

    Science.gov (United States)

    Greenstein, Steven A; Fry, Kristen L; Hersh, Peter S

    2011-07-01

    To evaluate changes in corneal topography indices after corneal collagen crosslinking (CXL) in patients with keratoconus and corneal ectasia and analyze associations of these changes with visual acuity. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Corneal collagen crosslinking was performed in eyes with keratoconus or ectasia. Quantitative descriptors of corneal topography were measured with the Pentacam topographer and included 7 indices: index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, minimum radius of curvature, index of height asymmetry, and index of height decentration. Follow-up was 1 year. The study comprised 71 eyes, 49 with keratoconus and 22 with post-LASIK ectasia. In the entire patient cohort, there were significant improvements in the index of surface variance, index of vertical asymmetry, keratoconus index, and minimum radius of curvature at 1 year compared with baseline (all P ectasia subgroups. Improvements in postoperative indices were not correlated with changes in corrected or uncorrected distance visual acuity. There were improvements in 4 of 7 topography indices 1 year after CXL, suggesting an overall improvement in corneal shape. However, no significant correlation was found between the changes in individual topography indices and changes in visual acuity after CXL. Copyright © 2011. Published by Elsevier Inc.

  5. Case Study: Contact Lens Fitting in the Presence of Corneal Ectasia ...

    African Journals Online (AJOL)

    Keratoglobus (KG) is a bilateral corneal ectasia characterised by overall protrusion of the cornea associated with diffuse thinning from limbus to limbus. Differential diagnosis includes pellucid marginal degeneration (PMD) and keratoconus (KC). KG is rare in comparison to the prevalence of KC and PMD. Refractive error ...

  6. Impact of exercise on fecal and cecal metabolome over aging: a longitudinal study in rats.

    Science.gov (United States)

    Deda, Olga; Gika, Helen; Panagoulis, Theodoros; Taitzoglou, Ioannis; Raikos, Nikolaos; Theodoridis, Georgios

    2017-01-01

    Physical exercise can reduce adverse conditions during aging, while both exercise and aging act as metabolism modifiers. The present study investigates rat fecal and cecal metabolome alterations derived from exercise during rats' lifespan. Groups of rats trained life-long or for a specific period of time were under study. The training protocol consisted of swimming, 15-18 min per day, 3-5 days per week, with load of 4-0% of rat's weight. Fecal samples and cecal extracts were analyzed by targeted and untargeted metabolic profiling methods (GC-MS and LC-MS/MS). Effects of exercise and aging on the rats' fecal and cecal metabolome were observed. Fecal and cecal metabolomics are a promising field to investigate exercise biochemistry and age-related alterations.

  7. LaPlace's law revisited: Cecal perforation as an unusual presentation of pancreatic carcinoma

    Directory of Open Access Journals (Sweden)

    Cason Frederick D

    2007-02-01

    Full Text Available Abstract Background Pancreatic cancer is often locally and distally aggressive, but initial presentation as cecal perforation is uncommon. Case presentation We describe a patient presenting with pneumoperitoneum, found at initial exploration to have a cecal perforation believed to be secondary to a large cecal adenoma, after palpation of the remainder of the colon revealed hard stool but no distal obstruction. Postoperatively, however, the patient progressed to large bowel obstruction and upon reexploration, a mass could now be delineated, encompassing the splenic flexure, splenic hilum, and distal pancreas. Histological evaluation determined this was locally invasive pancreatic adenocarcinoma, and therefore the true etiology of the original cecal perforation. Conclusion Any perforation localized to the cecum must be highly suspicious for a distal obstruction, as dictated by the law of LaPlace.

  8. Tratamento cirúrgico para ectasia ânulo-aórtica Surgical treatment for annulo-aortic ectasia

    Directory of Open Access Journals (Sweden)

    Ricardo García-Macedo

    1986-08-01

    Full Text Available Foram estudados 27 pacientes submetidos a implante de tubo de Dacron valvulado (segundo técnica de Bentall-De Bono, entre 1976 e 1985. Todos apresentavam ectasia ânulo-aórtica, que era devida a necrose cística da média em 23 pacientes (85,2%, dissecção crônica de aorta em 3 pacientes (11,1% e aortite luética em 1 paciente (3,7%. A faixa etária foi de 29 a 64 anos (m = 48 anos. Três eram do sexo feminino e 24, do masculino. Foi utilizado tubo de Dacron 28 ou 30 mm em todos. As válvulas utilizadas foram: de dura-máter em 7 pacientes, de aorta heteróloga em 9 e metálica em 11 pacientes. A classe funcional era I-II em 7 pacientes e III-IV em 19 pacientes (NYHA. Houve 1 óbito (3,7% pós-operatório imediato, por sangramento incontrolável e insuficiência renal aguda. As complicações mais freqüentes foram arritmias (13 pacientes, 48% e hemorragia (3 pacientes, 11 %. No pós-operatório tardio faleceram 9 pacientes, pelas seguintes causas: morte súbita (2 pacientes, 7,4%, insuficiência cardíaca aguda (2 pacientes, 7,4%, hemorragia após reoperação (1 paciente, 3,7%, infecção hospitalar (1 paciente, 3,7%, endocardite infecciosa (1 paciente, 3,7% e causa acidental (7,4%. Cinco pacientes (18,5% foram reoperados no pós-operatório tardio, 2 por disfunção de prótese, 2 por endocardite infecciosa sobre tubo de Dacron e 1 por fístula perivalvular. A curva atuarial mostrou uma probabilidade de sobrevida de 83,7% até o 3? ano, 61 % aos 5 anos e 42,7% do 6º ao 9º ano. No fim do período, os 17 pacientes sobreviventes encontram-se em classe funcional I-II (p This is a report of 27 patients presenting annulo-aortic ectasia submitted to surgical correction with a composite valve-tube graft (Bentall-De Bono technique, between 1976 and 1985. Twenty three (85.2% had cystic medial necrosis, 3 (11,1% were chronic aortic disections and 1 (3.7% was luetic aortitis. Age ranged from 29 to 64 years (m = 48. Three were female and 24 male

  9. Indications, visual outcome, and ectasia in clear corneal transplants 20 years old or more.

    Science.gov (United States)

    Felipe, Anthony F; Hammersmith, Kristin M; Nottage, Jennifer M; Rapuano, Christopher J; Nagra, Parveen K; Cohen, Elisabeth J; Laibson, Peter R

    2013-05-01

    To report the indications, visual outcome, and development of ectasia in clear corneal transplants at least 20 years or more after penetrating keratoplasty (PK). A computer search of all post-PK patients in the electronic medical records of the Cornea Service was done. Only patients with clear primary grafts aged 20 years or more were included. Main outcome measures noted were indications for surgery, final visual outcome, and postoperative complications. A subset of patients who developed ectasia clinically was also analyzed. One hundred forty-nine eyes of 109 patients were identified. The most common indication was keratoconus (76.5%). After average follow-up of 27 years, the mean postoperative best-corrected visual acuity was 0.29 ± 0.38 logarithm of the minimum angle of resolution (Snellen equivalent 20/39). Postoperative complications included rejection (29.5%), cataract formation (26.2%), and steroid-induced elevated intraocular pressure (15.4%). Peripheral thinning and ectasia diagnosed by slit lamp were noted in 59 eyes (39.6%), most of which were mild (54.2%), inferiorly located (66.1%), and involved the graft-host junction (81.4%). Most of the grafts that developed ectasia had a preoperative diagnosis of keratoconus (91.5%). Mean postoperative visual acuity of ectatic grafts with rigid gas permeable contact lens and/or glasses was 0.24 ± 0.25 logarithm of the minimum angle of resolution (Snellen equivalent 20/34). PK grafts can remain clear for 20 years or more and have excellent visual outcome. Most of the 20-year-old grafts in our study were in patients with keratoconus. Rejection and graft-host ectasia are problems to be encountered in long-surviving grafts. Ectatic grafts can still attain good vision with properly fitted contact lenses and glasses.

  10. Large particles increase viscosity and yield stress of pig cecal contents without changing basic viscoelastic properties.

    Science.gov (United States)

    Takahashi, Toru; Sakata, Takashi

    2002-05-01

    The viscosity of gut contents should influence digestion and absorption. Earlier investigators measured the viscosity of intestinal contents after the removal of solid particles. However, we previously found that removal of solid particles from pig cecal contents dramatically lowered the viscosity of the contents. Accordingly, we examined the contribution of large solid particles to viscoelastic parameters of gut contents in the present study. We removed large particles from pig cecal contents by filtration through surgical gauze. Then, we reconstructed the cecal contents by returning all, one half or none of the original amount of the large particles to the filtrate. We measured the viscosity, shear stress and shear rate of these reconstructed cecal contents using a tube-flow viscometer. The coefficient of viscosity was larger when the large-particle content was higher (P Bingham plastic nature irrespective of large-particle content. We calculated the yield stress of these fluids assuming that the fluids behave as Bingham plastic. The yield stress of the cecal contents was greater (P Bingham plastic characteristics to pig cecal contents.

  11. A Case of Isolated Coronary Artery Ectasia in the Setting of Chronic Inflamation From human Immunodeficiency Virus Infection.

    Science.gov (United States)

    Heckle, Mark R; Askari, Raza; Morsy, Mohamed; Ibebuogu, Uzoma N

    2016-01-01

    Coronary artery ectasia also known as dilated coronopathy is a relatively rare finding that is most commonly associated with atherosclerosis. Several alternative reasons including congenital malformations and chronic inflammation have been identified as a cause of CAE. In this case, we discuss a 61-year-old male with postoperative chest pain who was found to have localized CAE in the absence of significant atherosclerosis. We also elucidate the recently proposed markers of chronic inflammation that might be associated with coronary artery ectasia.

  12. Corneal ectasia after laser in situ keratomileusis in patients without apparent preoperative risk factors.

    Science.gov (United States)

    Klein, Shawn R; Epstein, Randy J; Randleman, J Bradley; Stulting, R Doyle

    2006-05-01

    To evaluate patients who developed ectasia with no apparent preoperative risk factors. Potential cases of patients who developed ectasia without apparent risk factors were identified by contacting participants in the Kera-Net (n = 580), ASCRS-Net (n = 450), and ISRS/AAO ISRS-Net (n = 525) internet bulletin boards from April to October 2003. Cases were included if ectasia developed after laser in situ keratomileusis in the absence of apparent preoperative risk factors. Reported cases were excluded for the following reasons: (1) calculated residual stromal bed less than 250 microm, (2) preoperative central pachymetry less than 500 microm, (3) any keratometry reading greater than 47.2 diopters (D), (4) a calculated inferior-superior value greater than 1.4, (5) more than 2 retreatments, (6) attempted initial correction greater than -12.00 D, (7) an Orbscan II "posterior float" (if obtained) greater than 50 microm, and (8) surgical/flap complications. A total of 27 eyes of 25 patients were submitted for consideration. Eight eyes (8 patients) met our inclusion criteria. Mean age was 27.7 years (range, 18-41 years). Preoperative manifest refraction spherical equivalent was -4.61 D (range, -2.00 to -8.00 D); steepest keratometric reading was 43.86 D (range, 42.50-46.40 D); keratometric astigmatism was 0.93 D (range, 0.25-1.90 D); and preoperative central pachymetry was 537 microm (range, 505-560 microm). The mean calculated ablation depth was 82.8 microm (range, 21-125.4 microm), and mean calculated residual stromal bed was 299.5 microm (range, 254-373 microm). Mean time to recognition of ectasia onset was 14.2 months (range, 3-27 months) postoperatively. At the time of ectasia diagnosis, the mean manifest refraction spherical equivalent was -1.23 D (range, +0.125 to -3.00) with a mean of 2.72 D (range, 0.75-4.00 D) of astigmatism. Ectasia can occur after an otherwise uncomplicated laser in situ keratomileusis procedure, even in the absence of apparent preoperative risk

  13. Corneal collagen crosslinking for keratoconus or corneal ectasia without epithelial debridement.

    Science.gov (United States)

    Hirji, N; Sykakis, E; Lam, F C; Petrarca, R; Hamada, S; Lake, D

    2015-06-01

    Corneal collagen crosslinking (CXL) is a relatively new technique to reduce the progression of keratoconus. The technique can be performed with or without complete debridement of the corneal epithelium. We describe a novel intermediate technique involving mechanical disruption of the epithelium, and evaluate its safety and efficacy. The case notes of 128 eyes with progressive keratoconus or iatrogenic corneal ectasia who had undergone CXL using the epithelial disruption technique were retrospectively reviewed. Thin corneas were treated with hypotonic riboflavin. All others were treated with an isotonic solution. Note was made of preoperative and postoperative parameters, including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, endothelial cell count, and corneal tomography. Occurrence of procedure-related complications was recorded. Statistical analyses were performed using the paired sample t-test and Wilcoxon signed-rank test, with a level of Pcorneal ectasia, and may be better tolerated by patients than the epithelium-off technique.

  14. Dural ectasia of the optic nerve sheath: is it always benign?

    Directory of Open Access Journals (Sweden)

    Berker Bakbak

    2009-11-01

    Full Text Available Berker Bakbak1, Hava Dönmez2, Tülay Kansu3, Hayyam Kiratli41Hacettepe University Institute of Neurological Sciences and Psychiatry, Neuro-ophthalmology Unit, Ankara, Turkey; 2Diskapi Yildirim Beyazid Education and Research Hospital Neurology Clinic, Ankara, Turkey; 3Hacettepe University Medical Faculty, Department of Neurology, Neuro-Ophthalmology Unit, Ankara, Turkey; 4Hacettepe University Medical Faculty, Department of Ophthalmology, Ocular Oncology Unit, Ankara, TurkeyAbstract: A 36-year-old woman with a 3-month history of progressive visual loss had papilledema, dilatation of the optic nerve sheaths and normal cerebrospinal fluid pressures. She was diagnosed as dural ectasia of the optic nerve sheaths and surgical decompression was performed. In this case report, severe visual loss is described as a serious complication of this rare disease and the importance of early surgical intervention is emphasized.Keywords: optic nerve, dural ectasia, meningocele

  15. Dietary Broccoli Alters Rat Cecal Microbiota to Improve Glucoraphanin Hydrolysis to Bioactive Isothiocyanates.

    Science.gov (United States)

    Liu, Xiaoji; Wang, Yanling; Hoeflinger, Jennifer L; Neme, Bárbara P; Jeffery, Elizabeth H; Miller, Michael J

    2017-03-10

    Broccoli consumption brings many health benefits, including reducing the risk of cancer and inflammatory diseases. The objectives of this study were to identify global alterations in the cecal microbiota composition using 16S rRNA sequencing analysis and glucoraphanin (GRP) hydrolysis to isothiocyanates ex vivo by the cecal microbiota, following different broccoli diets. Rats were randomized to consume AIN93G (control) or different broccoli diets; AIN93G plus cooked broccoli, a GRP-rich powder, raw broccoli, or myrosinase-treated cooked broccoli. Feeding raw or cooked broccoli for four days or longer both changed the cecal microbiota composition and caused a greater production of isothiocyanates ex vivo. A more than two-fold increase in NAD(P)H: quinone oxidoreductase 1 activity of the host colon mucosa after feeding cooked broccoli for seven days confirmed the positive health benefits. Further studies revealed that dietary GRP was specifically responsible for the increased microbial GRP hydrolysis ex vivo, whereas changes in the cecal microbial communities were attributed to other broccoli components. Interestingly, a three-day withdrawal from a raw broccoli diet reversed the increased microbial GRP hydrolysis ex vivo. Findings suggest that enhanced conversion of GRP to bioactive isothiocyanates by the cecal microbiota requires four or more days of broccoli consumption and is reversible.

  16. Angiodysplasia of the colon: A report of two cases and review of ...

    African Journals Online (AJOL)

    There was no anorexia, abdominal swelling, diarrhea, or hematochezia. Abdomino-pelvic ultrasonography showed normal findings. Colonoscopy done, reaching the ileo-cecal valve and caecum, showed an area of dilated tortuous blood vessel (vascular ectasia) in the wall of the descending colon approximately 45 cm ...

  17. Corneal Collagen Crosslinking for Post-LASIK Ectasia: An Australian Study.

    Science.gov (United States)

    Tong, Jessica Y; Viswanathan, Deepa; Hodge, Christopher; Sutton, Gerard; Chan, Colin; Males, John J

    2017-01-01

    Post laser-assisted in situ keratomileusis (LASIK) ectasia is a rare and unpredictable complication after LASIK. Corneal collagen crosslinking (CXL) has emerged as a promising technique to address this complication. Our study evaluates the long-term efficacy of CXL for post-LASIK ectasia in an Australian setting. Retrospective review of post-LASIK ectasia patients referred to and treated at 3 corneal refractive surgery institutions in Sydney, Australia. Eleven patients (14 eyes; mean age, 39.7 ± 12.6 years) underwent epithelium-off CXL with follow-up ranging from 12-78 months. Best spectacle-corrected visual acuity (BSCVA), simulated keratometry, corneal topography indices, and higher-order aberrations (HOAs) [mean ± standard error of the mean (SEM)] were measured with a rotating Scheimpflug camera (Pentacam, Oculus). Comparisons between baseline measurements and postoperative outcomes were performed using paired t test analysis. At last follow-up, BSCVA improved significantly by 0.2 ± 0.06 logMAR (P = 0.01), and 12 of 14 eyes showed no keratometric deterioration. Of the corneal topography indices, index of height asymmetry showed a trend toward a significant improvement (P = 0.05). There was no progression of corneal HOAs. Central corneal thickness was not significantly altered (P = 0.6). No major postoperative complications were observed. In the Australian setting, CXL has proven effective at stabilizing the progression of post-LASIK ectasia, inducing corneal regularity, and improving visual acuity. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  18. Corneal ectasia after myopic laser in situ keratomileusis: a long-term study

    OpenAIRE

    Spadea, Leopoldo; Cantera, Emilia; Cortes, Magdalena; Conocchia, Nicole Evangelista; Stewart, Charles WM

    2012-01-01

    Leopoldo Spadea,1 Emilia Cantera,2 Magdalena Cortes,2 Nicole Evangelista Conocchia,1 Charles WM Stewart11University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L’Aquila, 2Villa Stuart Clinic, Department of Ophthalmic Sciences, Rome, ItalyBackground: The purpose of this study was to evaluate the long-term postoperative incidence of and key factors in the genesis of corneal ectasia after myopic laser-assisted in situ keratomileusis ...

  19. Corneal ectasia after excimer laser keratorefractive surgery: histopathology, ultrastructure, and pathophysiology.

    Science.gov (United States)

    Dawson, Daniel G; Randleman, J Bradley; Grossniklaus, Hans E; O'Brien, Terrence P; Dubovy, Sander R; Schmack, Ingo; Stulting, R Doyle; Edelhauser, Henry F

    2008-12-01

    To evaluate the histopathology and ultrastructure of corneas developing ectasia after LASIK or photorefractive keratectomy (PRK). Retrospective case series. Thirteen specimens from 12 patients undergoing corneal transplantation for progressive ectasia after LASIK (12 specimens) or PRK (1 specimen) were obtained for histopathologic and ultrastructural evaluation. All 13 ectatic corneas were submitted in formalin for light microscopy. Nine specimens were bisected, and the second half was placed in 2.5% glutaraldehyde for transmission electron microscopy (TEM). Corneal histopathology, ultrastructure, and pathophysiology. Light microscopy of the post-LASIK specimens showed corneal epithelial hypoplasia and occasional foci of epithelial hyperplasia, Bowman's layer breaks, a normal stromal thickness of the LASIK flap, a normal thickness of the hypocellular primitive stromal scar, a thinned residual stromal bed (RSB), and larger than normal artifacteous interlamellar clefts in the RSB of the ectatic region. The post-PRK specimen showed similar findings with the addition of a thinned hypercellular fibrotic stromal scar. TEM showed thinning of the collagen lamellae and loss of lamellar number in the RSB of post-LASIK ectasia corneas or throughout the entire corneal stromal bed in the post-PRK ectasia cornea, with the posterior aspect of the corneal stroma being most affected. Histopathologic and ultrastructural studies suggest that interlamellar and interfibrillar biomechanical slippage occurs when the cornea becomes ectatic after LASIK or PRK in the postoperative stress-bearing regions of the corneal stroma. This 2-phase chronic biomechanical failure process is similar to that seen in keratoconus. Composite sciences classify this chronic biomechanical failure process as interfiber fracture. The authors have no proprietary or commercial interest in any materials discussed in this article.

  20. SD-OCT analysis of regional epithelial thickness profiles in keratoconus, postoperative corneal ectasia, and normal eyes.

    Science.gov (United States)

    Rocha, Karolinne Maia; Perez-Straziota, Claudia E; Perez-Straziota, E; Stulting, R Doyle; Randleman, J Bradley

    2013-03-01

    To assess corneal microarchitecture and regional epithelial thickness profile in eyes with keratoconus, postoperative corneal ectasia (ectasia), and normal unoperated eyes (controls) using spectral-domain optical coherence tomography (SD-OCT). Regional corneal epithelial thickness profiles were measured with anterior segment SD-OCT (Optovue RTVue-100, Optovue Inc., Fremont, CA). Epithelial thickness was assessed at 21 points, 0.5 mm apart, across the central 6-mm of the corneal apex in the horizontal and vertical meridians. One hundred twenty eyes were evaluated, including 49 eyes from 29 patients with keratoconus, 32 eyes from 16 patients with ectasia, and 39 eyes from 21 control patients. Average epithelial thickness at the corneal apex was 41.18 ± 6.47 μm (range: 30 to 51 μm) for keratoconus, 46.5 ± 6.72 μm for ectasia (range: 34 to 60 μm), and 50.45 ± 3.92 μm for controls (range: 42 to 55 μm). Apical epithelial thickness was significantly thinner in eyes with keratoconus (P ectasia (P = .0007) than in controls. Epithelial thickness ranges in all other areas varied widely for keratoconus (range: 21 to 101 μm) and ectasia (range: 30 to 82 μm) compared to controls (range: 43 to 64) (P = .0063). SD-OCT demonstrated significant central and regional epithelial thickness profile differences between keratoconus, ectasia, and control eyes, with significant variability and unpredictability in ectatic eyes. This regional irregularity may necessitate direct epithelial thickness measurement for treatments where underlying stromal variations may be clinically relevant, including corneal collagen cross-linking or topography-guided ablations. Copyright 2013, SLACK Incorporated.

  1. Corneal collagen cross-linking for ectasia after LASIK and photorefractive keratectomy: long-term results.

    Science.gov (United States)

    Richoz, Olivier; Mavrakanas, Nikolaos; Pajic, Bojan; Hafezi, Farhad

    2013-07-01

    To report the long-term results of corneal collagen cross-linking (CXL) in ectasia after LASIK and photorefractive keratectomy (PRK). Retrospective, interventional cases series. Twenty-six eyes of 26 patients (18 male, 8 female) with postoperative ectasia after LASIK (23 eyes) and PRK (3 eyes) were included with a mean age of 35 ± 9 years at the time of treatment and a mean follow-up of 25 months (range, 12-62 months). All consecutive patients treated with CXL for progressive ectasia after LASIK or PRK at the Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland between 2004 and 2010 were included. Corrected distance visual acuity (CDVA), maximum keratometry readings (K(max)), minimum radius of curvature (R(min)), and 6 corneal topography indices were assessed in this study. Mean CDVA before CXL was 0.5 logarithm of the minimum angle of resolution (logMAR) units, which improved to a mean of 0.3 logMAR units (PEctasia after LASIK and PRK was arrested by CXL with stabilization or improvement of CDVA and K(max) after a mean follow-up of 25 months. There were improvements in 4 topography indices, suggesting a more regular corneal surface. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  2. Corneal ectasia 6.5 months after small-incision lenticule extraction.

    Science.gov (United States)

    Wang, Yumeng; Cui, Chuanbo; Li, Zhiwei; Tao, Xiangchen; Zhang, Chunxiao; Zhang, Xiao; Mu, Guoying

    2015-05-01

    Our case involves a 19-year-old patient with forme fruste keratoconus. Small-incision lenticule extraction was performed, and 6.5 months after surgery, corneal ectasia was diagnosed. Preoperatively, the minimum central corneal thickness was 546 μm in the right eye and 542 μm in the left eye; the refractive correction was -6.75 -1.00 × 45 and -6.75 -0.75 × 140, respectively; the lenticular thickness was 137 μm and 135 μm, respectively. At 6.5 months, ectasia was diagnosed based on anterior and posterior surface keratometry of 38.4/39.5 diopters (D) and -6.3/-6.8 D, respectively, in the right eye and 38.6/40.8 D and -7.1/-6.6 D, respectively, in the left eye. The keratometry increased gradually and the corneal thickness decreased after surgery, and these trends continued during the 13-month follow-up. This report documents corneal ectasia as a complication of small-incision lenticule extraction and highlights the importance of preoperative evaluation and the need for long-term follow-up. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results.

    Science.gov (United States)

    Greenstein, Steven A; Shah, Vinnie P; Fry, Kristen L; Hersh, Peter S

    2011-04-01

    To determine the changes in corneal thickness over time after corneal collagen crosslinking (CXL) for keratoconus and corneal ectasia. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Corneal thickness at the apex, thinnest point, and pupil center were measured using Scheimpflug imaging (Pentacam) at baseline and 1, 3, 6, and 12 months after CXL. The treatment group was compared with both a sham-procedure control group and a fellow-eye control group. Associations with clinical outcomes (uncorrected and corrected distance visual acuities and maximum keratometry) were analyzed. The study comprised 82 eyes, 54 with keratoconus and 28 with ectasia after laser in situ keratomileusis. The mean preoperative thinnest pachymetry was 440.7 μm ± 52.9 (SD). After CXL, the cornea thinned at 1 month (mean change -23.8 ± 28.7 μm; Pcorneal thickness between 3 months and 6 months (mean +20.5 ± 20.4 μm; Pcorneal thickness was more rapid in ectasia than in keratoconus. There was no association between the degree of corneal thinning at 3 months and clinical outcomes after CXL. After CXL, the cornea thins and then recovers toward baseline thickness. The cause and implications of corneal thickness changes after CXL remain to be elucidated. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Spontaneous Resolution of Acute Corneal Hydrops in a Patient With Post-LASIK Ectasia.

    Science.gov (United States)

    Cooke, Matthew D; Koenig, Steven B

    2015-07-01

    To describe a case of acute corneal hydrops in a patient with corneal ectasia after laser in situ keratomileusis (LASIK). An observational study presenting clinical, slit-lamp, and optical coherence tomographic findings. A 66-year-old man with a history of moderate myopic astigmatism presented with a sudden loss of vision in his left eye 11 years after undergoing LASIK. He underwent a single enhancement in his left eye and was subsequently diagnosed with ectasia 9 years later. Slit-lamp examination demonstrated a small tear in the Descemet membrane with a large fluid-filled cleft separating the LASIK flap and extending to the flap edge. Because no aqueous humor leakage was detected, the patient was managed conservatively with eventual resolution of the fluid-filled cleft and return of 20/30 visual acuity. Acute corneal hydrops is a rare complication of post-LASIK corneal ectasia. In the absence of flap dehiscence and wound leak, such patients may be managed with simple observation.

  5. The hOGG1 Ser326Cys Gene Polymorphism and the Risk of Coronary Ectasia in the Chinese Population

    Directory of Open Access Journals (Sweden)

    Po-Chao Hsu

    2014-01-01

    Full Text Available Oxidative stress (OS is related to vascular inflammation possibly, contributing to the development of coronary ectasia (CE. Base excision repair (BER and nucleotide excision repair are the main DNA repair pathways that can help to remove 8-hydroxydeoxyguanine (8-OHdG, a marker of OS. Human 8-oxoguanine DNA glycosylase 1 (hOGG1 is a key enzyme of the BER pathway and catalyzes the removal of 8-OHdG. The aim of our study was to investigate the association between hOGG1 Ser326Cys gene polymorphism and CE in a Chinese population. Five-hundred forty-seven patients who underwent diagnostic coronary angiography in a tertiary medical center were recruited. The angiographic definition of CE is the diameter of the ectatic segment being more than 1.5 times larger compared with an adjacent healthy reference segment. The gene polymorphisms were analyzed by polymerase chain reaction. The urine 8OHdG concentration was measured using a commercial ELISA kit. The distribution of hOGG1 Ser326Cys genotypes was significantly different between CE and non-CE groups (p = 0.033. The odds ratio of CE development for the Ser to the Cys variant was 1.55 (95% confidence interval (CI, 1.04–2.31, p = 0.033. Both univariate and logistic regression analysis showed a significant association of hOGG1 Ser326Cys polymorphism in the dominant model with CE development (p = 0.009 and 0.011, respectively. Urine 8-OHdG levels were significantly higher in subjects carrying the hOGG1 Ser variant than in those with the Cys/Cys genotype (p < 0.03. In conclusion, our study suggests that the hOGG1 Ser326Cys gene variant might play a role in susceptibility to the development of CE.

  6. Adenocarcinoma primario del apéndice cecal

    Directory of Open Access Journals (Sweden)

    Rolando Galano Urgellés

    1998-08-01

    Full Text Available Se realizó un estudio longitudinal y prospectivo de 5 pacientes operados de cáncer del apéndice cecal, atendidos en una consulta de seguimiento habilitada para pacientes intervenidos de cáncer colorrectal. El análisis destacó que la edad más frecuente se halló por encima de la 5ta. década de la vida, y que hubo predominio del sexo masculino. Se practicó una reintervención durante el seguimiento; como terapéutica se utilizó el 5-fluoracilo; hubo un predominio absoluto del adenocarcinoma como variedad histológica; el diagnóstico de la entidad siempre se confirmó por Anatomía Patológica. La muestra representa el 1,2 % del total de casos de nuestra consulta y el 0,4 % de los pacientes apendicectomizados en nuestro Centro durante el período de estudio. Se recomienda insistir en el pesquisaje masivo de aquellos grupos de riesgo por parte del nivel primario de atención, para detectar precozmente la entidad y, por ende, mejorar los resultados quirúrgicos y de seguimiento posoperatorio, así como aplicar terapéutica de Sieracki en esta entidadA lengthwise and prospective study of 5 patients operated from appendix ceci cancer, who were attended in the follow-up consultation room for patients operated from colo-rectal cancer was performed. The analysis underlined that the most frequent age was over 50 years-old and males were predominant. During the follow-up period, one of the patients was operated again and treated with 5-fluoroacyl; adenocarcinoma prevailed as hystological variant and its diagnosis was always confirmed by the Pathological Anatomy Department. The sample of 5 patients represented 1.2 % of the cases attending our consultation room and 0.4 % of appendectomy-operated patients in our hospital during the studied period. The massive continuos screening of risk groups at the primary care level is recommended so as to early detect adenocarcinoma and thus improve the surgical and posoperative follow-up results and apply the

  7. In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Fanou, Evgenia Maria [University Hospital of North Staffordshire, Stoke-on-Trent (United Kingdom); Reeves, Mike J.; Griffiths, Paul D. [Royal Hallamshire Hospital, University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Howe, David T. [Princess Anne Hospital, Wessex Fetal Medicine Unit, Southampton (United Kingdom); Joy, Harriet [University Hospital of Southampton, Department of Radiology, Southampton (United Kingdom); Morris, Susan [University Hospital of Wales, Radiology Department, Cardiff, Wales (United Kingdom); Russell, Sarah [St. Mary' s Hospital, Radiology Department, Manchester (United Kingdom)

    2013-12-15

    Dural venous sinus ectasia with thrombosis (DVSET) in the fetus is a rare condition that can be diagnosed prenatally with the use of fetal MR imaging, yet with limited indication of long-term clinical significance. To describe and evaluate the diagnostic value of fetal MR imaging in the prenatal diagnosis of dural venous sinus ectasia with thrombosis and its clinical significance. We report a series of nine fetuses with dural venous sinus ectasia with thrombosis. The mothers, located in four feto-maternal centres, were referred for fetal MR imaging due to space occupying lesions identified on second-trimester antenatal ultrasound. In all but one case the dural venous sinus ectasia with thrombosis was in the vicinity of the venous confluence (VC) with various extension in the posterior dural sinuses. Antenatal follow-up imaging was performed in seven cases and showed progression in one, stable appearances in one and regression in five cases. Three pregnancies were terminated. In the remaining six cases there was no reported neurological deficit at up to 44 months of clinical follow-up. This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution. (orig.)

  8. Evaluation of a risk factor scoring system for corneal ectasia after LASIK in eyes with normal topography.

    Science.gov (United States)

    Binder, Perry S; Trattler, William B

    2010-04-01

    To assess a previously published risk score system for predicting postoperative LASIK ectasia in eyes with normal preoperative topography. A retrospective review of one surgeon's LASIK database was performed for eyes with Randleman ectasia risk scores based on patient age corneal thickness -8.00 diopters that had a minimum follow-up of 1 year. RESULTS Of 1702 eyes with myopic errors and normal topographies, 35 (2.0%) eyes had a combined risk score between 5 and 9 points, 92 (5.4%) eyes had a combined risk score of 4 or higher, and 208 (12.2%) eyes had a combined score of 3 or higher. None of these eyes developed ectasia, whereas 3 eyes with preoperative topographic keratoconus with no other risk factors developed ectasia. The current risk score system would have eliminated 5.4% of eyes with 4 or more points from LASIK surgery, and would have also required the surgeon to advise an additional 6.8% of eyes with a score of 3 that they were at "moderate risk" and should "proceed with caution." In eyes with normal preoperative topographies, the scoring system may not accurately predict whether patients are at increased risk for developing postoperative LASIK ectasia.

  9. Effects of dietary fiber on cecal short-chain fatty acid and cecal microbiota of broiler and laying-hen chicks.

    Science.gov (United States)

    Walugembe, M; Hsieh, J C F; Koszewski, N J; Lamont, S J; Persia, M E; Rothschild, M F

    2015-10-01

    This experiment was conducted to evaluate the effects of feeding dietary fiber on cecal short-chain fatty acid (SCFA) concentration and cecal microbiota of broiler and laying-hen chicks. The lower fiber diet was based on corn-soybean meal (SBM) and the higher fiber diet was formulated using corn-SBM-dried distillers grains with solubles (DDGS) and wheat bran to contain 60.0 g/kg of both DDGS and wheat bran from 1 to 12 d and 80.0 g/kg of both DDGS and wheat bran from 13 to 21 d. Diets were formulated to meet or exceed NRC nutrient requirements. Broiler and laying-hen chicks were randomly assigned to the high and low fiber diets with 11 replicates of 8 chicks for each of the 4 treatments. One cecum from 3 chicks was collected from each replicate: one cecum underwent SCFA concentration analysis, one underwent bacterial DNA isolation for terminal restriction fragment length polymorphism (TRFLP), and the third cecum was used for metagenomics analyses. There were interactions between bird line and dietary fiber for acetic acid (P = 0.04) and total SCFA (P = 0.04) concentration. There was higher concentration of acetic acid (P = 0.02) and propionic acid (P effect of dietary fiber on SCFA concentration and modulation of cecal microbiota in broiler and laying-hen chicks. © 2015 Poultry Science Association Inc.

  10. Vascular Cures

    Science.gov (United States)

    ... vascular disease, such as stroke, aneurysm and pulmonary artery disease. Each one has their own unique story about their battle with vascular disease and their road to recovery. SEE PATIENT STORIES Our Supporters Caring ...

  11. New corneal findings in chromosome 10 deletion syndrome: report of two cases of corneal ectasia of varying severity.

    Science.gov (United States)

    Lim, Lik Thai; Rehman, Ajmal; Masoud, Mohammad Tahir; Jaiya, Amrita; Tan, Peng Yi; Scott, J Angus

    2015-01-01

    To describe corneal changes associated with chromosome 10 terminal deletion (chromosome 10, monosomy 10qter) syndrome. Report of two cases of bilateral corneal ectasia with literature review. Corneal pathology has not previously been reported in the limited number of case reports on 10qter syndrome. However, Rodrigues et al.(1) have reported sclerocornea in 10q translocation. Ophthalmic manifestations of 10qter syndrome include strabismus, lid, and facial anomalies. We present two cases of corneal ectasia of varying severity. Possible etiologies include the following: secondary to genetic factors, acquired corneal exposure during sleep, or possible intrinsic immunocompromise exacerbating ocular surface infections. Corneal ectasia with specific histological changes is a feature of various genetic disorders (e.g., Down's, Ehler's Danlos, and Marfan's syndromes). It is unknown whether genetics plays a role in the development of corneal changes in 10qter syndrome. Management of inflammation and visual rehabilitation in these patients poses a therapeutic challenge.

  12. Effects of different dietary protein sources on cecal microflora in rats ...

    African Journals Online (AJOL)

    The aim of this study was to test the effects of balanced diets respectively containing soya protein isolate, zein and casein as the sole protein source on the amount of total bacteria, Lactobacillus, Bifidobacterium and Escherichia in cecal digesta of growing rats. The casein increased the amount of Lactobacillus and ...

  13. Determination of pre-cecal phosphorus digestibility of inorganic phosphates and bone meal products in broilers

    NARCIS (Netherlands)

    Harn, van J.; Spek, J.W.; Vuure, van C.A.; Krimpen, van M.M.

    2017-01-01

    A broiler study was performed to determine the pre-cecal phosphorus (P) digestibility of 5 P sources, 3 from animal (Delfos, Calfos, and porcine bone meal) and 2 of inorganic (monocalcium phosphate [MCP] and dicalcium phosphate [DCP]) origin. Delfos is processed from bones resulting in a

  14. Effect of lactose on oro-cecal transit in lactose digesters and maldigesters

    NARCIS (Netherlands)

    He, T.; Priebe, M. G.; Welling, G. W.; Vonk, R. J.

    2006-01-01

    Background The transit time of the small intestine, in addition to lactase activity, may influence lactose digestion and thus play a role in the occurrence of lactose intolerance. The objectives of this study were to investigate the effect of lactose on the oro-cecal transit time (OCTT) in lactose

  15. Marek’s disease virus induces transient atrophy of cecal tonsils

    Science.gov (United States)

    Marek’s disease (MD) is a lymphoproliferative disease of domestic chickens caused by an immunosupperessive alpha herpesvirus, Marek’s disease virus (MDV). Clinical signs of MD include bursal/thymic atrophy and neurological disorders. The cecal tonsils (CT) are the largest lymphoid aggregates of avia...

  16. Marek’s disease virus induced transient atrophy of cecal tonsils

    Science.gov (United States)

    Although bursal and thymic atrophy associated with Marek’s disease (MD) is well established and characterized, the effect of Marek's disease virus (MDV) infection on lymphoid aggregates within the gut-associated lymphoid tissue (GALT) is not known. The cecal tonsils (CT) are the two largest lympho...

  17. Effects of different dietary protein sources on cecal microflora in rats

    African Journals Online (AJOL)

    User

    2011-05-09

    May 9, 2011 ... The aim of this study was to test the effects of balanced diets respectively containing soya protein isolate, zein and casein as the sole protein source on the amount of total bacteria, Lactobacillus,. Bifidobacterium and Escherichia in cecal digesta of growing rats. The casein increased the amount of.

  18. Cecal ligation and puncture induced sepsis impairs host defense against Enterococcus faecium peritonitis

    NARCIS (Netherlands)

    Leendertse, Masja; Willems, Rob J.; Giebelen, Ida A.; Florquin, Sandrine; van den Pangaart, Petra S.; Bonten, Marc J.; van der Poll, Tom

    2009-01-01

    Multiresistant and vancomycin resistant Enterococcus faecium (VRE) can cause serious infections in hospitalized patients with various co-morbid diseases. We investigated the course of VRE peritonitis after cecal ligation and puncture (CLP)-induced sepsis and compared this to sham operated mice. Mice

  19. Dose-dependent effects of mosapride citrate on duodenal and cecal motility in donkeys (Equus asinus

    Directory of Open Access Journals (Sweden)

    Naglaa A. Gomaa

    2013-12-01

    Full Text Available Prokinetic drugs are used for the management of gastrointestinal motility disorders in horses; however, little is known about their efficacy in donkeys. Therefore, the aim of the present study was to evaluate the effect of different doses of mosapride citrate on duodenal and cecal motility in normal donkeys. Six donkeys (n = 6 were used in a crossover study. Mosapride citrate was administered orally via a nasogastric tube at dose rate of 1, 2 and 3 mg kg−1. Duodenal and cecal motility were evaluated using ultrasonography before administration and at 15, 30, 60, 120 and 180 min post-administration. There was a significant increase of duodenal contractions (p < 0.05 after 30 min of mosapride citrate administration at 3 mg kg−1 with a prolonged (p < 0.05 prokinetic effect at 2 mg kg−1. Cecal contractions were significantly increased (p < 0.05 after 15 min at different doses of mosapride with a prolonged effect at 3 mg kg−1. The results of the present study indicate that mosapride citrate has a dose-dependent prokinetic effect on the duodenal and cecal contractions in healthy donkeys. Further studies need to determine whether mosapride citrate is effective in treatment of intestinal disorders in donkey.

  20. A rare nosological entity: the perforated solitary cecal diverticulum. Research article.

    Science.gov (United States)

    Boselli, Carlo; Burini, Gloria; Covarelli, Piero; Barberini, Francesco; Gemini, Alessandro; Castellani, Elisa; Noya, Giuseppe; Cirocchi, Roberto

    2014-01-01

    To describe three cases of solitary cecal diverticulum, and trying to evaluate the better method of diagnosis and treatment with analysis of the literature. Description of three cases of solitary cecal diverticulum's perforation admitted in the Department of General and Oncologic Surgery, Santa Maria della Misericordia Hospital, Perugia, during the period January 2011 - January 2012. In all patients the clinical presentation was very similar to that of acute appendicitis. Preoperative diagnosis was achieved in one case through abdominal CT scan, other two cases were identified at final pathology. At one year from the treatment all patient are still alive. Cecal diverticulum is a rare condition, often diagnosed either casually or because of inflammatory or perforative complications. The highest incidence is found in Western population. Because of the clinical presentation, very similar to the appendicitis, and the inflammatory reaction involving the colon and its surrounding tissues, the pre- and intra-operative diagnosis are very difficult. The diagnosis is almost always histological. The treatment may vary from simple expectant medical management, carried out with bowel rest, parenteral support and antibiotics as for left-sided diverticulitis, to surgical approach, performed through simple diverticulectomy or by classical right hemicolectomy. Pre-surgical and, also intra-operative, diagnosis of perforated solitary cecal diverticulum is clearly difficult. CT scan represents the gold standard for the differential diagnosis. Right hemicolectomy is an effective and safe approach, allowing accurate control, preventing complications and recurrences, and it represents the optimal management of the disease.

  1. Corneal collagen cross-linking demarcation line depth assessed by Visante OCT After CXL for keratoconus and corneal ectasia.

    Science.gov (United States)

    Yam, Jason C S; Chan, Clement W N; Cheng, Arthur C K

    2012-07-01

    To report the demarcation line depth after corneal collagen cross-linking (CXL) for keratoconus and postoperative LASIK ectasia with Visante (Carl Zeiss Meditec) optical coherence tomography (OCT) and investigate correlations between this depth and preoperative parameters and postoperative visual and keratometry outcomes. Retrospective interventional case series of 40 eyes with keratoconus or postoperative LASIK ectasia treated with riboflavin ultraviolet-A CXL. Ophthalmic evaluation included uncorrected distance visual acuity, corrected distance visual acuity (CDVA), corneal topography (Pentacam, Oculus Optikgeräte GmbH), and postoperative anterior segment OCT. Correlation analyses were performed. Statistical significance was indicated by Pcorneal thickness (r=0.413, P=.008), older age (r=-0.490, P=.001), higher grading of ectasia (for both keratoconus and postoperative LASIK ectasia) (r=-0.332, P=.044), female sex (r=0.343, P=.030), postoperative LASIK ectasia (r=-0.420, P=.007), and longer duration of disease (r=-0.377, P=.023) were correlated with shallower demarcation line depth. Forward stepwise multiple linear regression analysis showed that among all preoperative factors, minimal corneal thickness (standardized β=0.473, P=.003) and age (standardized β=-0.317, P=.036) were significantly associated with demarcation line depth. The CXL demarcation line depth and change in CDVA (r=-0.16, P=.325) and change of the steepest keratometry at 6 months (r=0.084, P=.637) were not correlated. The Visante OCT can be used for assessing CXL demarcation line depth. The demarcation line depth may decrease with the severity of ectasia and age. Copyright 2012, SLACK Incorporated.

  2. Bilateral corneal ectasia after laser in situ keratomileusis in patient with isolated difference in central corneal thickness between eyes.

    Science.gov (United States)

    Saad, Alain; Gatinel, Damien

    2010-06-01

    A patient was treated bilaterally for myopia using laser in situ keratomileusis (LASIK). Preoperatively, there was no known risk factor for ectasia but a 20 microm between-eye difference in central mean corneal thickness was seen on the optical pachymetry map. Two years postoperatively, bilateral ectasia was diagnosed. This case suggests that abstention or surface ablation treatment may be a safer option than LASIK in patients showing central thickness asymmetry between eyes. (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Spectral-Domain OCT Analysis of Regional Epithelial Thickness Profiles in Keratoconus, Postoperative Corneal Ectasia, and Normal Eyes

    Science.gov (United States)

    Rocha, Karolinne Maia; Straziota, Claudia Perez; Stulting, R. Doyle; Randleman, J. Bradley

    2014-01-01

    PURPOSE To assess corneal microarchitecture and regional epithelial thickness profile in eyes with keratoconus, postoperative corneal ectasia, and normal unoperated eyes using spectral-domain optical coherence tomography (SD OCT). METHODS Regional corneal epithelial thickness profiles of eyes with keratoconus (KC) and postoperative corneal ectasia (Ectasia) were measured with anterior segment SC OCT (Optovue RTVue-100, Optovue Inc., Fremont, CA) and compared retrospectively to those of normal eyes (Control). Epithelial thickness was assessed at 21 points, 0.5 mm apart, across the central 6-mm of the corneal apex in the horizontal and vertical meridians. RESULTS One hundred twenty eyes were evaluated, including 49 eyes from 29 patients with KC, 32 eyes from 16 patients with Ectasia, and 39 eyes from 21 control patients. Average epithelial thickness at the corneal apex was 41.18±6.47μm (range 30 to 51 μm) in eyes with KC, 46.5±6.72μm in eyes with ectasia (range 34 to 60 μm), and 50.45±3.92 μm in normal eyes (range 42 to 55 μm). Apical epithelial thickness was significantly thinner in eyes with KC (p ectasia (p=.0007) than it was in controls. Epithelial thickness ranges in all other areas varied widely for KC (SD, range 21 to 101 μm) and ectasia (SD, range 30 to 82 μm) compared to controls (SD, range 43 to 64), p = .0063 CONCLUSION Central epithelial thickness was, on average, significantly thinner in ectatic corneas compared to controls; however, both central and regional epithelial thickness was highly irregular and variable in corneas with keratoconus and postoperative corneal ectasia. These thickness variations may alter preoperative topographic features and measurements in unpredictable ways, especially steepest K values. Regional epithelial thickness cannot be assumed to be uniform in ectatic corneas and therefore may require direct measurement when considering treatments for which underlying stromal thickness is particularly important, such as

  4. Management of post laser in situ keratomileusis ectasia with simultaneous topography guided photorefractive keratectomy and collagen cross-linking.

    Science.gov (United States)

    Kymionis, George D; Portaliou, Dimitra M; Diakonis, Vasilios F; Karavitaki, Alexandra E; Panagopoulou, Sophia I; Jankov Ii, Mirko R; Coskunseven, Efekan

    2011-02-11

    A thirty-nine year old man was referred to our institute due to progressive decreased visual acuity five years after bilateral Laser in situ Keratomileusis (LASIK). Topography revealed signs of post - LASIK ectasia. Patients' left eye was treated with simultaneous Topography Guided Photorefractive Keratectomy (PRK) followed by Corneal Collagen Cross Linking (CXL). Twelve months after the combined procedure both uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) showed significant improvement while topographic findings revealed an improvement of the astigmatic pattern. All higher order aberrations showed a significant decrease twelve months postoperatively. Combined topography guided PRK and corneal cross linking could represent an alternative treatment for post - LASIK ectasia.

  5. Cecal diverticulitis or appendicitis. When should I suspect? A case report

    Directory of Open Access Journals (Sweden)

    Ricardo Pastore

    2012-06-01

    Full Text Available The objective of this article was to report a case of cecal diverticulitis and point out the differential diagnosis of acute appendicitis. The clinical manifestations of these pathological conditions are similar, and the accurate diagnosis of cecal diverticulitis before the surgery is difficult. Therefore, most diagnoses are made during the surgery. Moreover, cecal diverticulum is uncommon in western countries, but it is prevalent in Asian people and their descendants. We report a case of a 55-year-old female patient, whose imaging exams (ultrasonography and computed tomography and blood tests were not enough to diagnose the affection, requiring laparotomy and pathological exams for the final diagnosis. Some studies suggesting the best practice in case of diverticulum of the cecum were revised, as the diagnosis usually occurs during the surgery.O objetivo deste trabalho foi relatar um caso de diverticulite no ceco e chamar a atenção para o diagnóstico diferencial com apendicite aguda. As manifestações clínicas das duas afecções são semelhantes, dificultando o diagnóstico exato de diverticulite cecal, além de ser incomum, em nosso meio, o aparecimento de divertículo em cólon direito, sendo essa entidade mais comum em asiáticos e em seus descendentes. Relata-se atendimento a uma paciente de 55 anos, cujos exames de imagem (ultrassonografia e tomografia computadorizada e de sangue não foram suficientes para o diagnóstico. Houve necessidade de realizar-se laparotomia exploradora e exames anatomopatológicos para a confirmação. Também foram revisados alguns trabalhos que sugerem qual a melhor conduta a ser tomada quando se encontra divertículo cecal no perioperatório, já que, na maioria das vezes, o diagnóstico é feito neste momento.

  6. Intacs with or without same-day corneal collagen cross-linking to treat corneal ectasia.

    Science.gov (United States)

    Legare, Marie Eve; Iovieno, Alfonso; Yeung, Sonia N; Lichtinger, Alejandro; Kim, Peter; Hollands, Simon; Slomovic, Allan R; Rootman, David S

    2013-06-01

    To compare combined intrastromal corneal ring segment implantation with same-day ultraviolet-A/riboflavin corneal collagen cross-linking (ICRS-CXL) versus ICRS implantation alone in patients with corneal ectasia. Retrospective comparative study. Sixty-six eyes from 54 patients with corneal ectasia were included in the study. The groups were composed of 32 eyes from 27 patients and 34 eyes from 27 patients for the ICRS-CXL and ICRS groups, respectively. We reviewed the charts of all patients who underwent these procedures from November 2008 to February 2011 for preoperative and for up to 1 year postoperative uncorrected (UDVA) and best corrected distance visual acuity (BDVA), refraction, topographical analysis (mean and steepest keratometry [K]), as well as root mean-square (RMS) of higher-order aberrations (HOAs). Overall, a significant improvement was seen in both groups for UDVA, BDVA, sphere, cylinder, mean refractive spherical equivalent (MRSE), mean and steepest K, coma, spherical and total HOA at 12 months. Trefoil did not improve, and higher-order astigmatism worsened in the ICRS group (p = 0.0466). There was no statistically significant difference between the 2 groups for visual acuity, sphere, cylinder, coma, trefoil, and spherical HOA. Outcomes were significantly more improved in the ICRS group for MRSE (p = 0.0082), mean K (p = 0.0021), steepest K (p = 0.0152), and total HOAs (p = 0.0208). No complications were observed. ICRS-CXL and ICRS alone were both safe and effective in treating corneal ectasia. The ICRS alone group demonstrated better outcomes of MRSE, mean and steepest K, as well as total HOA. Copyright © 2013 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  7. Corneal collagen crosslinking for ectasia after laser in situ keratomileusis: long-term results.

    Science.gov (United States)

    Yildirim, Aydin; Cakir, Hanefi; Kara, Necip; Uslu, Hasim; Gurler, Bulent; Ozgurhan, Engin Bilge; Colak, Hatice Nur

    2014-10-01

    To report the long-term results of corneal collagen crosslinking (CXL) treatment for post-laser in situ keratomileusis (LASIK) ectasia. Turkiye Hospital Eye Clinic and Fatih University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey. Retrospective case series study. Consecutive patients with ectasia after LASIK were treated with CXL. The main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical and cylindrical refractions, and simulated keratometry (K) values. The study enrolled 20 eyes (14 patients; 7 women) with a mean age of 34.8 years ± 6.0 (SD) (range 25 to 45 years) and mean follow-up of 42 months (range 36 to 60 months). The UDVA and CDVA improved significantly, from 0.78 ± 0.61 logMAR to 0.53 ± 0.36 logMAR (P=.007) and from 0.27 ± 0.23 logMAR to 0.19 ± 0.13 logMAR, respectively (P≤.028). No eye lost 1 or more Snellen lines of UDVA or CDVA. Although the mean spherical refraction was not significantly different at the last visit (P=.074), the mean cylindrical refraction decreased significantly (P=.036). The maximum K value decreased from 46.0 ± 4.4 diopters (D) at baseline to 45.6 ± 3.8 D at the last visit (P=.013). By the last visit, the maximum K value decreased (≥1.0 D) in 5 eyes and remained stable in 15 eyes. No serious complications occurred. Corneal collagen crosslinking yielded long-term stability in cases with post-LASIK corneal ectasia without significant side effects. Improvements in visual acuity, cylindrical refraction, and maximum K values occurred. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Corneal collagen cross-linking to stop corneal ectasia exacerbated by radial keratotomy.

    Science.gov (United States)

    Mazzotta, Cosimo; Baiocchi, Stefano; Denaro, Rosario; Tosi, Gian Marco; Caporossi, Tomaso

    2011-02-01

    To assess the efficacy of riboflavin ultraviolet A (UV-A) corneal collagen cross-linking in the management of keratoconic corneal ectasia exacerbated by radial keratotomy (RK). A patient with progressive corneal ectasia and hyperopic shift, occurring 10 years after RK performed in the left eye, was treated with riboflavin UV-A corneal collagen cross-linking according to the Siena protocol: Pilocarpin 0.1% drop (1 hour before), lidocaine 4% drops 15 minutes before, mechanical scraping of epithelium (9-mm-diameter area), preirradiation stromal soaking for 10 minutes in riboflavin 0.1%-dextrane 20% (Ricrolin; Sooft Italy) applied every 2 minutes, and 30 minutes of total exposure (6 steps of 5 minutes) to solid-state UV-A illuminator (Caporossi, Baiocchi, Mazzotta Vega X linker; CSO Opthalmics, Florence, Italy), energy delivered 3 mW/cm, and irradiated area 9 mm in diameter. After the operation, uncorrected visual acuity and best spectacle-corrected visual acuity improved from 0.2 to 0.6 and from 0.3 to 0.8 Snellen lines, respectively, in a 12-month follow-up. Improved topographical K readings and corneal symmetry index were also recorded starting from the first postoperative month and continuing thereafter. No adverse effects were recorded after treatment. Riboflavin UV-A-induced corneal cross-linking seems to be a promising surgical option in the management of unstable corneal ectasia exacerbated by RK, particularly in eyes with preexisting keratoconus. A large cohort and longer follow-up are needed to determine its long-term efficacy in this clinical setting.

  9. Accelerated Corneal Collagen Cross-linking for Postoperative LASIK Ectasia: Two-Year Outcomes.

    Science.gov (United States)

    Marino, Gustavo K; Torricelli, Andre A M; Giacomin, Natalia; Santhiago, Marcony R; Espindola, Rodrigo; Netto, Marcelo V

    2015-06-01

    To evaluate the effectiveness and safety of accelerated corneal collagen cross-linking for postoperative LASIK ectasia after 2 years. A prospective, single-center case series was performed with patients treated for postoperative LASIK ectasia. All eyes underwent accelerated corneal collagen cross-linking (CCL-Vario Crosslinking; Peschke Meditrade GmbH, Zurich, Switzerland) at 9 mW/cm(2) for 10 minutes. The main outcome measures were changes in uncorrected distance visual acuity, corrected distance visual acuity, central corneal thickness, corneal topography, and endothelial cell density. These parameters were assessed at baseline and at the 6-month and 1- and 2-year follow-up visit. The study enrolled 40 eyes of 24 patients (15 male and 9 female) with a mean age of 33.8 ± 7.5 years (range: 24 to 52 years) that attained at least 2 years of follow-up. The surgical procedure was uneventful in all cases. All eyes stabilized after treatment without any further signs of progression and no statistically significant changes in the mean uncorrected distance visual acuity (P = .649), corrected distance visual acuity (P = .616), mean keratometry (P =.837), steep keratometry (P = .956), ultrasonic pachymetry (P = .135), slit-scanning pachymetry (P = .276), and endothelial cell density (P = .523). In addition, 72.5% of the patients presented stable or gains of Snellen lines over time. Accelerated corneal collagen cross-linking seems to be safe and effective in halting postoperative LASIK ectasia progression after 2 years of follow-up. However, a longer follow-up period with a larger cohort is needed to validate these findings. Copyright 2015, SLACK Incorporated.

  10. Morphology of graft-host junction in cases with postkeratoplasty corneal ectasia.

    Science.gov (United States)

    Jhanji, Vishal; Chan, Elsie; Nambiar, Mithun; Vajpayee, Rasik B

    2013-07-01

    We analyzed the central corneal and graft-host junction (GHJ) thickness profiles in cases with signs of corneal ectasia after penetrating keratoplasty for keratoconus. Anterior segment optical coherence tomography (ASOCT) was performed in cases with clinical or topographic signs of ectasia after complete suture removal. Corneal thickness was measured on the GHJ and at 1 mm on either side of the GHJ. Corneal thickness maps using Scheimpflug imaging were obtained. Eight patients (11 eyes) with an average age of 52.55 ± 10.13 years were included. Mean age of the corneal grafts was 25.83 ± 12.37 years. Mean central corneal thickness was 577.45 ± 78.52 (range, 486-704) μm. Mean thickness 1 mm inside the GHJ, at the GHJ, and 1 mm outside the GHJ was 511.81 ± 66.15 (range, 380-600), 438.18 ± 86.35 (range, 260-550), and 465.45 ± 110.93 (range, 320-690) μm, respectively. Thinning of the graft, GHJ, or the host cornea was seen on ASOCT in all eyes. The central graft thickness was significantly higher compared with the graft thickness at and around the GHJ (P Corneal thinning beyond the GHJ and subsequent ectasia can occur many years after initial keratoplasty in cases with keratoconus. Long-term follow-up of these cases may be desirable after corneal transplantation surgery. ASOCT is a useful tool for monitoring corneal thickness at and around the GHJ.

  11. Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results.

    Science.gov (United States)

    Hersh, Peter S; Greenstein, Steven A; Fry, Kristen L

    2011-01-01

    To evaluate 1-year outcomes of corneal collagen crosslinking (CXL) for treatment of keratoconus and corneal ectasia. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Collagen crosslinking was performed in eyes with keratoconus or ectasia. The treatment group received standard CXL and the sham control group received riboflavin alone. Principal outcomes included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, astigmatism, and topography-derived outcomes of maximum and average keratometry (K) value. The UDVA improved significantly from 0.84 logMAR ± 0.34 (SD) (20/137) to 0.77 ± 0.37 logMAR (20/117) (P = .04) and the CDVA, from 0.35 ± 0.24 logMAR (20/45) to 0.23 ± 0.21 logMAR (20/34) (Pectasia subgroup, respectively. The maximum K value decreased by 2.0 D or more in 22 patients (31.0%) and increased by 2.0 D or more in 3 patients (4.2%). Collagen crosslinking was effective in improving UDVA, CDVA, the maximum K value, and the average K value. Keratoconus patients had more improvement in topographic measurements than patients with ectasia. Both CDVA and maximum K value worsened between baseline and 1 month, followed by improvement between 1, 3, and 6 months and stabilization thereafter. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. An unusual scrotal mass: tubular ductal ectasia within the head of the epididymis

    Energy Technology Data Exchange (ETDEWEB)

    Kletzenbauer, S.P

    2002-11-01

    A patient complained of a right-sided testicular lump, increasing in size over a month, with some associated mild discomfort. There was no history of trauma or infection. The patient had undergone vasectomy 10 years previously. Clinically, the lump was palpable and it was difficult to determine whether it was intra- or extra-testicular. Ultrasound examination revealed a moderate right-sided hydrocele. The palpable mass was a markedly expanded epididymal head with an unusual echo-pattern, consisting of numerous tubular cystic spaces consistent with ductal ectasia.

  13. Effects of corneal cross-linking on ocular response analyzer waveform-derived variables in keratoconus and postrefractive surgery ectasia.

    Science.gov (United States)

    Hallahan, Katie M; Rocha, Karolinne; Roy, Abhijit S; Randleman, J Bradley; Stulting, R Doyle; Dupps, William J

    2014-11-01

    To assess changes in Ocular Response Analyzer (ORA) waveforms after UVA/riboflavin corneal collagen cross-linking (CXL) using investigator-derived and manufacturer-supplied morphometric variables in patients with keratoconus (KC) and postrefractive surgery ectasia. Prospective randomized trial of a standard epithelium-off CXL protocol. Patients with progressive KC (24 eyes of 21 patients) or postrefractive surgery ectasia (27 eyes of 23 patients) were enrolled. Replicate ORA measurements were obtained before and 3 months after CXL. Pretreatment and posttreatment waveform variables were analyzed for differences by paired Student t tests using measurements with the highest waveform scores. Corneal hysteresis, corneal resistance factor, 37-s generation manufacturer-supplied ORA variables, and 15 investigator-derived ORA variables. No variables were significantly different 3 months after CXL in the KC group, and no manufacturer-supplied variables changed significantly in the postrefractive surgery ectasia group. Four custom variables (ApplanationOnsetTime, P1P2avg, Impulse, and Pmax) increased by small but statistically significant margins after CXL in the postrefractive surgery ectasia group. Changes in a small subset of investigator-derived variables suggested an increase in corneal bending resistance after CXL. However, the magnitudes of these changes were low and not commensurate with the degree of clinical improvement or prior computational estimates of corneal stiffening in the same cohort over the same period. Available air-puff-derived measures of the corneal deformation response underestimate the biomechanical changes produced by CXL.

  14. New INTACS SK implantation in patients with post-laser in situ keratomileusis corneal ectasia.

    Science.gov (United States)

    Kymionis, George D; Bouzoukis, Dimitrios I; Portaliou, Dimitra M; Pallikaris, Ioannis G

    2010-02-01

    In this case series, 2 patients with post-laser in situ keratomileusis corneal ectasia were included. Patients were treated with new intrastromal corneal ring segments, INTACS SK (severe keratoconus or steep "K") (Addition Technology, Inc, Des Plaines, IL) implantation. Two segments were inserted without any intraoperative or postoperative complications. Three months after the procedure, uncorrected visual acuity was improved in both patients from counting fingers preoperatively to 20/40 and 20/50, respectively. Best spectacle-corrected visual acuity improved from 20/40 to 20/32 and from 20/50 to 20/40. Manifest refraction improved from -8.75/-5.00 x 125 and -14.25/-6.50 x 33 preoperatively to -5.50/-2.25 x 125 and -8.25/-1.50 x 15 with an improvement in topographic findings. One year postoperatively, uncorrected visual acuity, best spectacle-corrected visual acuity, and topographic findings remained improved. In conclusion, new INTACS SK might be able to improve visual acuity in patients with post-laser in situ keratomileusis corneal ectasia.

  15. Correlation of both corneal surfaces in corneal ectasia after myopic LASIK.

    Science.gov (United States)

    Peinado, Teresa Fernández; Piñero, David P; López, Ignacio Alcaraz; Alio, Jorge L

    2011-04-01

    We report a case of corneal ectasia in a 25-year-old man after myopic laser in situ keratomileusis in which a complete characterization of the corneal structure was performed by means of a Scheimpflug photography-based system. The patient presented in the ectatic eye with a subjective refraction of +0.50 to 6.00 × 100°, which with correction gave a visual acuity of 20/25. With the topographic analysis, corneal shapes from both corneal surfaces at the four different quadrants were found to be complementary, maintaining the meniscus-shaped profile of the cornea. This correlation between the anterior and posterior corneal surfaces was also confirmed with an optical tomography evaluation. Corneal biomechanics was also evaluated by means of the Ocular Response Analyzer (Reichert), which confirmed the biomechanical alteration. In summary, biomechanical changes leading to corneal ectasia in this case affected the global corneal structure, inducing alterations in the shape of both anterior and posterior corneal surfaces.

  16. Evolution in the use of intrastromal corneal ring segments for corneal ectasia.

    Science.gov (United States)

    Park, Jennifer; Gritz, David C

    2013-07-01

    To report the recent advances in the use of intrastromal corneal ring segments (ICRS) for treating patients with corneal ectasia. ICRS improve visual, refractive, and keratometric parameters in patients with keratoconus and postlaser in-situ keratomileusis ectasia. ICRS have been made safer, quicker, and more precise with the use of femtosecond lasers for ring insertion. ICRS produce better visual outcomes in patients with poor preoperative corrected distance visual acuity compared with patients with less preoperative visual impairment. Standard ICRS do not improve vision in patients with stage 3-4 keratoconus (Amsler-Krumeich classification), but newer models of ICRS, such as Intacs SK, appear promising for these patients. ICRS have been successfully combined with treatments such as corneal collagen cross-linking (CXL), penetrating keratoplasty, and photorefractive keratectomy. ICRS variably improve visual acuity. Numerous questions concerning ICRS remain, including the duration of the effects of ICRS and the changes that ICRS induce on a biomechanical level. The optimal method for combined CXL and ICRS placement has not yet been determined. Further well-designed randomized controlled studies with long-term follow-up are needed for clarification.

  17. Apparent Corneal Ectasia After Bilateral Intrastromal Femtosecond Laser Treatment for Presbyopia.

    Science.gov (United States)

    Dukic, Adrijana; Bohac, Maja; Pasalic, Adi; Koncarevic, Mateja; Anticic, Marija; Patel, Sudi

    2016-11-01

    To report a case of apparent corneal ectasia after intrastromal femtosecond laser treatment for presbyopia (INTRACOR). A healthy 56-year-old male with low hyperopia underwent an unremarkable bilateral INTRACOR procedure in March/April 2011. The patient was discharged after follow-up and returned 5 years later. Before discharge, the monocular logarithm of the minimal angle of resolution uncorrected distance visual acuity (UDVA) values were R, 0.0 and L, 0.10. In both eyes near (UNVA) visual acuities were 0.0. There were signs of slight posterior central corneal steepening without loss of corneal stability. Five years postop, monocular UDVA and UNVA values were 0.4 and 0.0, respectively. Ectasia was observed in both eyes, and the centrally placed 5 concentric rings after the INTRACOR procedure were visible under slit-lamp biomicroscopy. There is no clear reason to explain why the patient developed bilateral corneal steepening. It could be that the patient's corneal stromal fibers gradually weakened over this 5-year period.

  18. Corneal Ectasia After LASIK Combined With Prophylactic Corneal Cross-linking.

    Science.gov (United States)

    Taneri, Suphi; Kiessler, Saskia; Rost, Anika; Dick, H Burkhard

    2017-01-01

    To report a case of unilateral corneal ectasia following LASIK surgery combined with prophylactic corneal cross-linking (CXL) in a young patient. Case report. Preoperative topography was unremarkable in both eyes with a minimum corneal thickness of 554 μm in the right eye and 546 μm in the left eye. Preoperative corrected distance visual acuity (CDVA) was 1.0 (20/20 Snellen) in both eyes with a refraction of +1.25 -2.75 × 10 in the right eye and +0.50 -2.00 × 163 in the left eye. LASIK combined with CXL was uneventful. After 12 months, postoperative topography was unremarkable with an uncorrected distance visual acuity (UDVA) of 1.0 in both eyes. Two years after surgery, the patient presented with a loss of vision (UDVA 0.25) and an inferior steepening on topography in the left eye. Standard CXL was performed to arrest further progression. This report illustrates that the currently used prophylactic CXL protocol in combination with LASIK may not be effectively preventing corneal ectasia in every case. [J Refract Surg. 2017;33(1):50-52.]. Copyright 2017, SLACK Incorporated.

  19. Influence of Pasture Rearing on the Cecal Bacterial Microbiota in Broiler Chickens

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    Čermák L.

    2016-09-01

    Full Text Available Differences in quantity of cecal microbiota in broiler chickens from conventional and pasture rearing were investigated by cultivation. Rearing on pasture brings stress reduction and increases comfort and bird welfare, which leads to products with better taste and flavour compared to conventionally produced broiler chickens. A difference in cecal settlement of general anaerobes, coliforms, lactic acid bacteria, and campylobacters and salmonellas in the two different rearing systems was addressed. Whereas numbers of total anaerobes and lactic acid bacteria were not affected, those of coliforms were significantly reduced in pasture rearing. Campylobacters were found only in pasture-reared chickens (in 28% of animals. Salmonellas were not detected in any of the systems.

  20. Diet-dependent modular dynamic interactions of the equine cecal microbiota

    DEFF Research Database (Denmark)

    Kristoffersen, Camilla; Jensen, Rasmus Bovbjerg; Avershina, Ekaterina

    2016-01-01

    Knowledge on dynamic interactions in microbiota is pivotal for understanding the role of bacteria in the gut. We herein present comprehensive dynamic models of the horse cecal microbiota, which include short-chained fatty acids, carbohydrate metabolic networks, and taxonomy. Dynamic models were d...... sugars for the starch-rich diet and monosaccharides for the fiber-rich diet. In conclusion, diet may not only affect the composition of the cecal microbiota, but also dynamic interactions and metabolic cross-feeding....... diet, with Streptococcus spp. and Anaerovibrio spp. showing the largest fluctuations. Shotgun metagenome sequencing revealed that diet differences may be explained by modular switches in metabolic cross-feeding between microbial consortia in which fermentation is linked to sugar alcohols and amino...

  1. INFLUENCE OF DIETARY FIBER IN VITRO MICROBIAL CECAL FERMENTATION IN MEXICAN HAIRLESS AND ASIAN PIG

    Directory of Open Access Journals (Sweden)

    Ignacio Arturo Dominguez Vara

    2010-03-01

    Full Text Available The objective of the present study was to evaluate and compare the in vitro cecal fermentation (by the gas production technique, in hairless Mexican pig and Asian pig, adding cellulose or starch as a substrates (0, 100, 200, 30 and 400 mg/ g DM. 12 pigs were slaughtered ( BW= 104±0.5 kg, six of each genotype, and after that take cecal content of each one, and it was made a pool using two pigs per genotype; after that per substrate (cellulose or starch in each concentration, it were incubated in three flasks per pool with inoculums and it made three incubation series. The experimental design use the effect of genotype, substrate and concentration of the substrate added on the variables of in vitro fermentation. The averages of the data were compared by turkey’s method. In vitro gas production was higher (P

  2. Effect of dietary fiber/starch balance on the cecal proteome of growing rabbits.

    Science.gov (United States)

    Zhu, Yanli; Wang, Chunyang; Wang, Xuepeng; Li, Bing; Li, Fuchang

    2014-05-30

    Dietary fiber/starch imbalance can lead to diarrhea in rabbits. However, the underlying molecular mechanisms are largely unknown, and this is the first study on the proteome profile of the cecal tissue of diarrheic rabbits. In this study, one group of weanling rabbits was fed a high fiber/starch diet (control group), and another group was fed a low fiber/starch diet (diarrhea group). We applied 2-D gel electrophoresis, coupled with histological and biochemical analyses, to study dynamic changes in the proteome of the cecal tissue from healthy and diarrheic growing rabbits. We identified 29 protein spots showing differential abundance between the two groups. We identified the proteins and found that they participated in key biological processes, including absorption, digestion and transport; cell structure and motility; inflammatory response; glucose and energy metabolism; mineral and vitamin metabolism; stress response and cell redox homeostasis. Moreover, the results of our proteomics analysis revealed continuous impairment and compensatory intestinal repair in the rabbits with diarrhea. Therefore, these findings shed light on the main mechanisms and the main proteins involved in intestinal degradation in diarrhea. These findings have important implications for understanding the mechanism of cecal damage and repair in diarrhea in rabbits caused by dietary factors. The different cecal protein expressions were compared between healthy and diarrhea in growing rabbit model fed different fiber/starch diets. Diarrhea caused by feeding high-starch diet induced mucosal injury and inflammation. In this work we identify protein spots by MALDI-TOF MS and classify by biological function. The finding that the expression of all other proteins belonging to seven functional groups was significantly increased in the diarrheic rabbits, except for CMBL, suggests that many intestinal functional proteins may be related to up-regulation, such as cell absorption, digestion, transport

  3. Different antibiotic growth promoters induce specific changes in the cecal microbiota membership of broiler chicken.

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    Marcio C Costa

    Full Text Available Antimicrobials are sometimes given to food animals at low doses in order to promote faster growth. However, the mechanisms by which those drugs improve performance are not fully understood. This study aimed to investigate the impact of zinc bacitracin (55g/ton, enramycin (10g/ton; halquinol® (30g/ton; virginiamycin (16,5g/ton and avilamycin (10g/ton on the cecal microbiota of broiler chicken, compared to a control group. Six hundred and twenty four chicks (Cobb 500 arriving to an experimental unit were randomly assigned into each treatment with four repetitions per treatment. The cecal content of 16 animals per treatment (n = 96 was used for DNA extraction and sequencing of the V4 region of the 16S rRNA gene using Illumina technology. The use of antimicrobials induced significant changes in membership but not in structure of the cecal microbiota compared to the control group, suggesting a greater impact on the less abundant species of bacteria present in that environment. Halquinol was the only drug that did not affect microbial membership. Firmicutes comprised the major bacterial phylum present in the cecum of all groups. There was no statistical difference in relative abundances of the main phyla between treated animals and the control group (all P>0.05. Treatment with enramycin was associated with decreased richness and with lower relative abundance of unclassified Firmicutes, Clostridium XI, unclassified Peptostreptococcaceae (all P<0.001 and greater abundance of Clostridium XIVb (P = 0.004 and Anaerosporobacter spp. (P = 0.015, and treatment with bacitracin with greater relative abundance of Bilophila spp. (P = 0.004. Several bacterial genera were identified as representative of usage of each drug. This study used high throughput sequencing to characterize the impact of several antimicrobials in broiler chicken under controlled conditions and add new insights to the current knowledge on how AGPs affect the cecal microbiota of chicken.

  4. Effect of different levels of copper on growth performance and cecal ecosystem of newly weaned piglets

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    Shao-Feng Mei

    Full Text Available The current study aimed to investigate the effects of different levels of copper sulfate on the growth performance and cecal ecosystem in newly weaned piglets. One hundred piglets weaned at 28±2 d were randomly allocated to 4 treatments with 5 replicates of 5 piglets each. Piglets received for 28 d the base diet with i no addition (control or with copper addition (from copper sulfate at ii 100, iii 175, and iv 250 mg/kg–1. On day 21, twenty piglets were randomly selected (one from each replicate to slaughter and investigate the population and diversity of cecal microorganisms. The results showed that the diets containing 175 and 250 mg/kg–1 copper improved the average daily gain (ADG by 51% and 60% and decreased the feed to gain ratio (F/G by 21% and 16%, respectively. Adding 175 or 250 mg/kg–1 copper improved crude protein, ether extract, calcium and phosphorus digestibility. Viable counts of Enterobacteriaceae and Lactobacilli in cecum tended to be reduced, while the concentrations of cecal volatile fatty acids (VFA were increased in pigs fed diet supplemented as copper level increased. Polymerase chain reaction (PCR results showed that adding 175 or 250 mg/kg–1 copper reduced the lactobacilli in cecum. Denaturing gradient gel electrophoresis (DGGE maps showed that band numbers and intensity of cecal bacterial 16S rDNA decreased as the copper levels increased. The results suggested that the effects of high dietary copper on microflora and their activities and metabolic products might contribute to the intestinal health and result in improved growth performance.

  5. Effect of different levels of copper on growth performance and cecal ecosystem of newly weaned piglets

    Directory of Open Access Journals (Sweden)

    Dai-Wen Chen

    2010-11-01

    Full Text Available The current study aimed to investigate the effects of different levels of copper sulfate on the growth performance and cecal ecosystem in newly weaned piglets. One hundred piglets weaned at 28±2 d were randomly allocated to 4 treatments with 5 replicates of 5 piglets each. Piglets received for 28 d the base diet with i no addition (control or with copper addition (from copper sulfate at ii 100, iii 175, and iv 250 mg/kg-1. On day 21, twenty piglets were randomly selected (one from each replicate to slaughter and investigate the population and diversity of cecal microorganisms. The results showed that the diets containing 175 and 250 mg/kg-1 copper improved the average daily gain (ADG by 51% and 60% and decreased the feed to gain ratio (F/G by 21% and 16%, respectively. Adding 175 or 250 mg/kg-1 copper improved crude protein, ether extract, calcium and phosphorus digestibility. Viable counts of Enterobacteriaceae and Lactobacilli in cecum tended to be reduced, while the concentrations of cecal volatile fatty acids (VFA were increased in pigs fed diet supplemented as copper level increased. Polymerase chain reaction (PCR results showed that adding 175 or 250 mg/kg-1 copper reduced the lactobacilli in cecum. Denaturing gradient gel electrophoresis (DGGE maps showed that band numbers and intensity of cecal bacterial 16S rDNA decreased as the copper levels increased. The results suggested that the effects of high dietary copper on microflora and their activities and metabolic products might contribute to the intestinal health and result in improved growth performance.

  6. Cecal bacterial communities in wild Japanese rock ptarmigans and captive Svalbard rock ptarmigans.

    Science.gov (United States)

    Ushida, Kazunari; Segawa, Takahiro; Tsuchida, Sayaka; Murata, Koichi

    2016-02-01

    Preservation of indigenous gastrointestinal microbiota is deemed to be critical for successful captive breeding of endangered wild animals, yet its biology is poorly understood. Here, we investigated cecal bacterial communities in wild Japanese rock ptarmigans (Lagopus muta japonica) and compared them with those in Svalbard rock ptarmigans (L. m. hyperborea) in captivity. Ultra-deep sequencing of 16S rRNA gene indicated that the community structure of cecal microbiota in wild rock ptarmigans was remarkably different from that in captive Svalbard rock ptarmigans. Fundamental differences between bacterial communities in the two groups of birds were detected at the phylum level. Firmicutes, Actinobacteria, Bacteroidetes and Synergistetes were the major phyla detected in wild Japanese rock ptarmigans, whereas Firmicutes alone occupied more than 80% of abundance in captive Svalbard rock ptarmigans. Furthermore, unclassified genera of Coriobacteriaceae, Synergistaceae, Bacteroidaceae, Actinomycetaceae, Veillonellaceae and Clostridiales were the major taxa detected in wild individuals, whereas in zoo-reared birds, major genera were Ruminococcus, Blautia, Faecalibacterium and Akkermansia. Zoo-reared birds seemed to lack almost all rock ptarmigan-specific bacteria in their intestine, which may explain the relatively high rate of pathogenic infections affecting them. We show evidence that preservation and reconstitution of indigenous cecal microflora are critical for successful ex situ conservation and future re-introduction plan for the Japanese rock ptarmigan.

  7. Changes in cecal microbiota and mucosal gene expression revealed new aspects of epizootic rabbit enteropathy.

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    Christine Bäuerl

    Full Text Available Epizootic Rabbit Enteropathy (ERE is a severe disease of unknown aetiology that mainly affects post-weaning animals. Its incidence can be prevented by antibiotic treatment suggesting that bacterial elements are crucial for the development of the disease. Microbial dynamics and host responses during the disease were studied. Cecal microbiota was characterized in three rabbit groups (ERE-affected, healthy and healthy pretreated with antibiotics, followed by transcriptional analysis of cytokines and mucins in the cecal mucosa and vermix by q-rtPCR. In healthy animals, cecal microbiota with or without antibiotic pretreatment was very similar and dominated by Alistipes and Ruminococcus. Proportions of both genera decreased in ERE rabbits whereas Bacteroides, Akkermansia and Rikenella increased, as well as Clostridium, γ-Proteobacteria and other opportunistic and pathogenic species. The ERE group displayed remarkable dysbiosis and reduced taxonomic diversity. Transcription rate of mucins and inflammatory cytokines was very high in ERE rabbits, except IL-2, and its analysis revealed the existence of two clearly different gene expression patterns corresponding to Inflammatory and (mucin Secretory Profiles. Furthermore, these profiles were associated to different bacterial species, suggesting that they may correspond to different stages of the disease. Other data obtained in this work reinforced the notion that ERE morbidity and mortality is possibly caused by an overgrowth of different pathogens in the gut of animals whose immune defence mechanisms seem not to be adequately responding.

  8. Rate of ectasia and incidence of irregular topography in patients with unidentified preoperative risk factors undergoing femtosecond laser-assisted LASIK

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    Moshirfar M

    2013-12-01

    Full Text Available Majid Moshirfar,1 Jared G Smedley,2 Valliammai Muthappan,1 Allison Jarsted,3 Erik M Ostler1 1John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2College of Human Medicine, Michigan State University, Lansing, MI, USA; 3Department of Ophthalmology, State University of New York Upstate Medical University, Syracuse, NY, USA Purpose: To report the rate of postoperative ectasia after laser-assisted in situ keratomileusis (LASIK with femtosecond laser-assisted flap creation, in a population of patients with no identified preoperative risk factors. Methods: A retrospective case review of 1,992 eyes (1,364 patients treated between March 2007 and January 2009 was conducted, with a follow up of over 4 years. After identifying cases of ectasia, all the patient charts were examined retrospectively for preoperative findings suggestive of forme fruste keratoconus (FFKC. Results: Five eyes of four patients with post-LASIK ectasia were identified. All eyes passed preoperative screening and received bilateral LASIK. One of the five patients developed ectasia in both eyes. Three patients retrospectively revealed preoperative topography suggestive of FFKC, while one patient had no identifiable preoperative risk factors. Upon review of all the charts, a total 69 eyes, including four of the five eyes with ectasia, were retrospectively found to have topographies suggestive of FFKC. Conclusion: We identified four cases of post-LASIK ectasia that had risk factors for FFKC on reexamination of the chart and one case of post-LASIK ectasia with no identifiable preoperative risk factors. The most conservative screening recommendations would not have precluded this patient from LASIK. The rate of purely iatrogenic post-LASIK ectasia at our center was 0.05% (1/1,992, and the total rate of post-LASIK ectasia for our entire study was 0.25% (1/398. The rate of eyes with unrecognized preoperative FFKC that developed post-LASIK ectasia was 5.8% (1/17. Keywords

  9. Determination of pre-cecal phosphorus digestibility of inorganic phosphates and bone meal products in broilers.

    Science.gov (United States)

    van Harn, J; Spek, J W; van Vuure, C A; van Krimpen, M M

    2017-05-01

    A broiler study was performed to determine the pre-cecal phosphorus (P) digestibility of 5 P sources, 3 from animal (Delfos, Calfos, and porcine bone meal) and 2 of inorganic (monocalcium phosphate [MCP] and dicalcium phosphate [DCP]) origin. Delfos is processed from bones resulting in a dicalcium phosphate product, and Calfos is processed from bones in which part of the gelatin is removed but in which the hydroxy-apatite matrix is preserved. During the first 14 d, birds were housed in floor pens bedded with wood shavings and received a commercial starter diet. At d 14, broilers were randomly assigned to pens (0.9 m2, 10 birds/pen) with a slatted floor. From d 14 onwards, one of the 6 experimental diets (a basal diet, and 5 diets containing the P sources) was provided. Test diets were replicated 6 times, and the basal diet 8 times. Electron microscopy images of test products were made in order to verify whether the spatial structure of the test products could be related to the pre-cecal P digestibility of the same products. Diets met or exceeded CVB (2011) requirements for all nutrients except for P and were formulated to contain a calcium to total P ratio of between 1.4 and 1.6 and a minimal amount of phytate P. Diets contained 5 g/kg titanium oxide as a marker to determine digestibility of P. At d 24 all birds were euthanized, after which the content of the terminal part of the ileum was sampled. The P digestibility was calculated by linear regression according to World's Poultry Science Association (WPSA) protocol for determination of pre-cecal P digestibility. Pre-cecal P digestibility of MCP, DCP, Delfos, Calfos, and porcine bone meal was 88.5, 82.4, 94.5, 86.9, and 78.2%, respectively. Based on visual inspection of electron microscopy images of test products, the spatial structure of the test products might be related to P digestibility. It is concluded that processing of bone meal increases the pre-cecal P digestibility in broilers. © The Author 2017

  10. Pitx2 is a critical early regulatory gene in normal cecal development.

    Science.gov (United States)

    Nichol, Peter F; Saijoh, Yukio

    2011-09-01

    The murine cecum is a critical digestive structure. Morphogenesis of the cecum involves several key genes, including Homeobox (Hox) d12. Ectopic expression of Hoxd12 has been shown to result in cecal agenesis and a down-regulation of both Fibroblast growth factor 10 (Fgf10) and the Pituitary homeobox 2 gene (Pitx2). Homozygous null mutation of Fgf10 or its cognate receptor Fgfr2IIIb results in severe cecal defects where there is the initiation of mesodermal budding, but a failure of the endoderm to grow and extend into this structure. We examined the expression of Pitx2 in the cecum and hypothesized that homozygous null mutation of Pitx2 would result in cecal agenesis. IACUC approval was obtained for these studies. Whole mount in situ hybridizations for Pitx2 were performed on wild-type embryos between embryonic d (E)11.0 and E12.5. Pitx2 -/- and Fgfr2IIIb -/- embryos were generated from n/+ heterozygote breedings and harvested at E10.5, E11.5, and E13.5. Genotypes were confirmed by PCR. Morphology of Pitx2 -/- cecae were compared with those of wild-type littermates and Fgfr2IIIb -/- embryos at identical stages. Embryos were fixed overnight and photographed the following day. Pitx2 is expressed in the cecal mesoderm and endoderm as early as E11.0. Expression becomes increasingly more robust by E12.5. Homozygous null mutation of Pitx2 results in agenesis of the cecum. In contrast to Fgfr2IIIb -/- embryos, which demonstrate a persistent mesodermal bud as late as E18.5, no mesodermal bud is present in Pitx2 -/- embryos. Our findings demonstrate that Pitx2 is a critical regulatory gene in cecal morphogenesis and suggest that Pitx2 is required for initiation of mesodermal budding and likely resides upstream of Fgf10-Fgfr2IIIb signaling in the normal development of this structure. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Comparison of fecal and cecal microbiotas reveals qualitative similarities but quantitative differences.

    Science.gov (United States)

    Stanley, Dragana; Geier, Mark S; Chen, Honglei; Hughes, Robert J; Moore, Robert J

    2015-02-27

    The majority of chicken microbiota studies have used the ceca as a sampling site due to the specific role of ceca in chicken productivity, health and wellbeing. However, sampling from ceca and other gastrointestinal tract sections requires the bird to be sacrificed. In contrast, fecal sampling does not require sacrifice and thus allows the same bird to be sampled repeatedly over time. This is a more meaningful and preferred way of sampling as the same animals can be monitored and tracked for temporal studies. The commonly used practice of selecting a subset of birds at each time-point for sacrifice and sampling introduces added variability due to the known animal to animal variation in microbiota. Cecal samples and fecal samples via cloacal swab were collected from 163 birds across 3 replicate trials. DNA was extracted and 16S rRNA gene sequences amplified and pyrosequenced to determine and compare the phylogenetic profile of the microbiota within each sample. The fecal and cecal samples were investigated to determine to what extent the microbiota found in fecal samples represented the microbiota of the ceca. It was found that 88.55% of all operational taxonomic units (OTUs), containing 99.25% of all sequences, were shared between the two sample types, with OTUs unique for each sample type found to be very rare. There was a positive correlation between cecal and fecal abundance in the shared sequences, however the two communities differed significantly in community structure, represented as either alpha or beta diversity. The microbial populations present within the paired ceca of individual birds were also compared and shown to be similar. Fecal sample analysis captures a large percentage of the microbial diversity present in the ceca. However, the qualitative similarities in OTU presence are not a good representation of the proportions of OTUs within the microbiota from each sampling site. The fecal microbiota is qualitatively similar to cecal microbiota but

  12. In vitro effects of some organic acids on swine cecal microflora

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    Andrea Piva

    2010-01-01

    Full Text Available The objective of this study was to evaluate the effects of different organic acids on bacterial growth and ammonia production by swine cecal microflora in an in vitro fermentation system. Formic, acetic, propionic, lactic, butyric, sorbic, fumaric, malic, citric, α-ketoglutaric, and benzoic acids were used at different concentrations (60, 120 and 240 mmol/l to assess if any effect on cecal microflora could be shown. Cecal microbial growth was evaluated using the cumulative gas production technique. Fermentation fluid was analyzed for ammonia concentration. Lactic acid was the only acid that enhanced bacterial fermentation at every concentration tested (+30%, 73%, and 35% gas final volume at 60, 120, and 240mmol/l, respectively; P<0.05. Citric acid strongly increased gas final volume when used at 60 and 120mmol/l (+92% and 52%, respectively; P<0.05 and almost completely inhibited bacterial activity at 240mmol/l (–85% gas final volume; P<0.05. Sorbic acid showed the strongest antibacterial activity and was the only acid that reduced final gas volume when used at 60 mmol/l (–34%; P<0.05. Only sorbic (–34%, 47%, and 67%, fumaric (–57%, 35%, and 26%, citric (–31%, 18%, and 28%, and benzoic (–33%, 29%, and 38% acids reduced ammonia after 24h of fermentation at any given concentration (P<0.05. Other acids, such as formic, acetic, propionic, butyric, and malic acids failed to exert an effective control of ammonia levels in the fermentation liquor. After the first set of fermentations, sorbic, α-ketoglutaric, and benzoic acids were further tested at the final concentration of 7.5, 15, and 30mmol/l. At these lower levels of inclusion, sorbic acid was the only acid that reduced final gas volume at every concentration tested (–31%, 35%, and 39% at 7.5, 15, and 30mmol/l, respectively; P<0.05. Compared with control, ammonia was reduced after 24h of fermentation by all treatments (with an average reduction of 34%, 20%, and 24% for sorbic,

  13. High-throughput sequencing technology to reveal the composition and function of cecal microbiota in Dagu chicken.

    Science.gov (United States)

    Xu, Yunhe; Yang, Huixin; Zhang, Lili; Su, Yuhong; Shi, Donghui; Xiao, Haidi; Tian, Yumin

    2016-11-04

    The chicken gut microbiota is an important and complicated ecosystem for the host. They play an important role in converting food into nutrient and energy. The coding capacity of microbiome vastly surpasses that of the host's genome, encoding biochemical pathways that the host has not developed. An optimal gut microbiota can increase agricultural productivity. This study aims to explore the composition and function of cecal microbiota in Dagu chicken under two feeding modes, free-range (outdoor, OD) and cage (indoor, ID) raising. Cecal samples were collected from 24 chickens across 4 groups (12-w OD, 12-w ID, 18-w OD, and 18-w ID). We performed high-throughput sequencing of the 16S rRNA genes V4 hypervariable regions to characterize the cecal microbiota of Dagu chicken and compare the difference of cecal microbiota between free-range and cage raising chickens. It was found that 34 special operational taxonomic units (OTUs) in OD groups and 4 special OTUs in ID groups. 24 phyla were shared by the 24 samples. Bacteroidetes was the most abundant phylum with the largest proportion, followed by Firmicutes and Proteobacteria. The OD groups showed a higher proportion of Bacteroidetes (>50 %) in cecum, but a lower Firmicutes/Bacteroidetes ratio in both 12-w old (0.42, 0.62) and 18-w old groups (0.37, 0.49) compared with the ID groups. Cecal microbiota in the OD groups have higher abundance of functions involved in amino acids and glycan metabolic pathway. The composition and function of cecal microbiota in Dagu chicken under two feeding modes, free-range and cage raising are different. The cage raising mode showed a lower proportion of Bacteroidetes in cecum, but a higher Firmicutes/Bacteroidetes ratio compared with free-range mode. Cecal microbiota in free-range mode have higher abundance of functions involved in amino acids and glycan metabolic pathway.

  14. Vascular Vertigo

    Directory of Open Access Journals (Sweden)

    Mazyar Hashemilar

    2017-02-01

    Full Text Available Vertigo is a common complaint in neurology and medicine. The most common causes of vertigo are benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, and vascular disorders. Vertigo of vascular origin is usually limited to migraine, transient ischemic attacks, and ischemic or hemorrhagic stroke. Vascular causes lead to various central or peripheral vestibular syndromes with vertigo. This review provides an overview of epidemiology and clinical syndromes of vascular vertigo. Vertigo is an illusion of movement caused by asymmetrical involvement of the vestibular system by various causes. Migraine is the most frequent vascular disorder that causes vertigo in all age groups. Vertigo may occur in up to 25% of patients with migraine. The lifetime prevalence of migrainous vertigo is almost 1%. Cerebrovascular disorders are estimated to account for 3% to 7% of patients with vertigo. Vestibular paroxysmia has been diagnosed in 1.8% to 4% of cases in various dizziness units. Vasculitic disorders are rare in the general population, but vertigo may be seen in almost up to 50% of patients with different vasculitic syndromes. Conclusions: Migraine, cerebrovascular disorders especially involving the vertebrobasilar territory, cardiocirculatory diseases, neurovascular compression of the eighth nerve, and vasculitis are vascular causes of vertigo syndromes.

  15. Stevens-Johnson Syndrome and Corneal Ectasia: Management and a Case for Association.

    Science.gov (United States)

    Saeed, Hajirah N; Kohanim, Sahar; Le, Hong-Gam; Chodosh, James; Jacobs, Deborah S

    2016-09-01

    To report the occurrence of corneal ectasia (ECT) in patients with history of Stevens-Johnson syndrome (SJS), and to make the case for an association between these 2 diagnoses. We also report the impact of prosthetic replacement of the ocular surface ecosystem (PROSE) treatment on visual acuity (VA) in these patients. Retrospective cohort study. A manufacturing database of PROSE patients from 2002 to 2014 at Boston Foundation for Sight (BFS), a single-center clinical practice, was reviewed to identify patients with diagnoses of both SJS and ECT. Nine patients were identified with diagnoses of both SJS and ECT. In each case, review of the medical record revealed that diagnosis of SJS preceded that of ECT. The prevalence of ECT in this population exceeded that in the general population (P corneal microtrauma and matrix metalloproteinases. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  16. Topography-Guided PRK and Crosslinking in Eyes with Keratoconus and Post-LASIK Ectasia.

    Science.gov (United States)

    Müller, T M; Lange, A P

    2017-04-01

    Topography-guided photorefractive keratectomy (TG-PRK) combined with corneal collagen crosslinking (CXL) has been shown to potentially improve vision and stabilize progression in patients with keratoconus (KC). We attempted to reproduce the previously published results using a different laser platform (AMARIS 500E) in patients with KC and post-LASIK ectasia (PLE). All of the 9 included eyes showed improved topography (Kmax, Kmean, RMS HOA, vertical coma, cylinder; p < 0.05) and improved visual acuity (BCVA, UCVA; p < 0.05) after 18 months. Despite some still uncontrollable factors, the combination of TG-PRK and CXL may be a promising option to regularize and stabilize corneas with KC and PLE and improve visual acuity. Georg Thieme Verlag KG Stuttgart · New York.

  17. Grade 4 spondylolisthesis of the L5 vertebra associated with dural ectasia in neurofibromatosis.

    Science.gov (United States)

    Modi, H N; Srinivasalu, S; Suh, S W; Yang, J H

    2009-08-01

    Spondylolisthesis associated with neurofibromatosis is rare, and only 12 cases have been reported so far. However, only one report of grade 4 spondylolisthesis with neurofibromatosis has been reported in the literature. A 15-year-old boy with neurofibromatosis was admitted for back pain and neurological claudication. Radiograph showed grade 4 spondylolisthesis of the L5 vertebra with scalloping of the L4-L5 vertebrae. L4-L5 laminectomy, reduction, L3-S1 posterior instrumentation and fusion were performed. The reduction of the spondylisthesis was done entirely from the posterior approach using pedicle screws. Radiography at four months showed a broken S1 screw with a loss of reduction. The patient was re-operated on, to provide additional stability with pelvic fixation. He was pain-free with a good fusion at the two-year follow-up. Adequate posterior stabilisation with fusion gives good results in grade 4 spondylolisthesis associated with neurofibromatosis and dural ectasia.

  18. Early and medium term results of the sleeve valve-sparing procedure for aortic root ectasia.

    Science.gov (United States)

    Gamba, Amando; Tasca, Giordano; Giannico, Floriana; Lobiati, Elisabetta; Skouse, Douglas; Galanti, Andrea; Martino, Antonello Stefano; Triggiani, Michele

    2015-04-01

    The aim of this retrospective study was to evaluate our experience of using a simplified aortic valve sleeve procedure to treat aortic root ectasia and aneurysms with or without aortic regurgitation. In experienced hands, 2 aortic valve-sparing procedures, ie, Yacoub and David, have yielded excellent long-term results in the treatment of aortic root aneurysms, with or without aortic regurgitation. However, these techniques are demanding and not widely used. Recently, a new and simplified valve-sparing technique, named "sleeve procedure," has been proposed, and has yielded encouraging early results. Ninety consecutive patients with aortic root aneurysms underwent sleeve procedures from October 2006 to October 2012. Follow-up data (clinical 100% complete and echocardiographic 93% complete) were acquired from our outpatient clinic or from the referring cardiologist. The mean age of the patients was 61.5 ± 12.5 years, 79% were male, 16 (18%) had a bicuspid valve, 3 had Marfan syndrome, and 2 had aortic dissection. Over a mean clinical follow-up of 34 ± 19 months, 2 patients died from noncardiac causes and 1 was reoperated on for the recurrence of aortic regurgitation. On follow-up echocardiography after a mean of 18 ± 9 months, aortic regurgitation was absent/negligible, mild or moderate in 62%, 37%, and 1% of patients, respectively, and the diameters of the annulus, Valsalva sinuses, and sinotubular junction were 27.3 + 2.2, 37.0 + 3.4, and 30.6 + 3.1 mm, respectively. Our encouraging early and medium term results suggest that the sleeve procedure is a safe and effective aortic valve-sparing technique for the treatment of aortic root ectasia and aneurysm. However, longer follow-up is needed in order to draw definitive conclusions. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Corneal Tomographic Changes After UV Cross-Linking for Corneal Ectasia (1-Year Results).

    Science.gov (United States)

    Baksoellah, Zainab; Lavy, Itay; Baydoun, Lamis; Hooijmaijers, Hilde C M; van Dijk, Korine; Melles, Gerrit R J

    2017-12-01

    To evaluate changes in maximum keratometry (Kmax), corneal higher-order aberrations (HOAs), and densitometry (backscattered light) up to 1 year after UV cross-linking and their possible relation with changes in the visual outcome. Retrospective cohort study on 18 eyes of 16 patients, who underwent UV cross-linking after the Dresden protocol for progressive keratoconus or ectasia after laser-assisted in situ keratomileusis. Corrected distance visual acuity (CDVA), Scheimpflug-based corneal tomography, mean image brightness (corneal densitometry) from the anterior 120 μm of the midcornea, and posterior 60 μm of the central 6 mm of the cornea, and HOAs were evaluated. Kmax at 1 month (59.7 ± 6.0D) after UV cross-linking resembled preoperative Kmax (59.3 ± 6.4D, P = 0.368), decreased until 3 months postoperatively (58.3 ± 6.3D, P = 0.002), and stabilized thereafter (P > 0.227). All postoperative corneal densitometry values were higher than preoperative values in all measured depths (P corneal HOAs (4.28 ± 1.64 μm and 3.87 ± 1.62 μm, respectively) resembled preoperative values (4.10 ± 1.70 μm and 3.67 ± 1.62 μm, respectively; P > 0.221) and then decreased until 12 months postoperatively (3.86 ± 1.84 μm and 3.40 ± 1.80 μm, respectively; P 0.345 and P > 0.257, respectively). No relations were found between CDVA and the evaluated parameters (P > 0.05). One year after UV cross-linking, the observation of stable CDVA and thinnest point thickness, together with reduced Kmax suggests no ectasia progression within the study period in these cases. Although HOAs showed a trend toward improvement, corneal densitometry remained elevated.

  20. Collagenase-mediated tissue modeling of corneal ectasia and collagen cross-linking treatments.

    Science.gov (United States)

    Hong, Cheng W; Sinha-Roy, Abhijit; Schoenfield, Lynn; McMahon, James T; Dupps, William J

    2012-04-30

    Corneal collagen cross-linking (CXL) is a method for modifying the natural history of keratoconus and other corneal ectatic diseases. The authors evaluated the use of collagenase for generating an experimental model of ectasia to evaluate the topographic effects of CXL interventions. Nine human corneoscleral specimens unsuitable for transplantation were used. After epithelial debridement, mounting, and pressurization on an artificial anterior chamber, a solution of 10 mg/mL collagenase type II with 15% dextran was applied to five corneas for three hours. Three of these corneas subsequently underwent riboflavin/UV-A CXL. Scheimpflug-based tomography was performed before collagenase exposure, after collagenase exposure, and after CXL to evaluate changes in maximum axial curvature of the anterior surface (K(max)) at three IOP levels. Results were compared to four control eyes exposed to dextran alone. A statistically significant increase in K(max) was seen across all IOP levels in the collagenase group compared to the control group (+6.6 ± 1.1 diopters [D] and +0.3 ± 0.8 D, respectively, at physiological IOP). After CXL, K(max) decreased (-7.6 ± 2.0 D at physiological IOP). Anterior corneal aberrations increased after collagenase exposure and decreased after CXL. Light microscopy showed loss of normal stromal collagen architecture and localized edema after collagenase exposure. A method for generating topographic features of corneal ectasia in human tissue is demonstrated. No significant sensitivity of K(max) to IOP was observed. CXL caused regression of steepening and induced aberrations in this model, consistent with clinical trends. The model may be useful for testing modifications to standard CXL techniques.

  1. Characteristics influencing outcomes of corneal collagen crosslinking for keratoconus and ectasia: implications for patient selection.

    Science.gov (United States)

    Greenstein, Steven A; Hersh, Peter S

    2013-08-01

    To determine preoperative patient characteristics that may predict topography and visual acuity outcomes of corneal collagen crosslinking (CXL). Cornea and refractive surgery practice. Cohort study. Crosslinking was performed in eyes with keratoconus or corneal ectasia. Multiple regression and odds ratio analyses were performed to determine independent predictors of changes in topography-derived maximum keratometry (K) and corrected distance visual acuity (CDVA) 1 year postoperatively. Preoperative characteristics included sex, age, uncorrected distance visual acuity (UDVA), CDVA, maximum keratometry (K), corneal thickness, corneal haze, disease group, and cone location. Postoperative improvement in maximum K was defined as flattening of 2.0 diopters (D) or more and worsening as steepening of 1.0 D or more. Improvement in CDVA was defined as a gain of 2 lines or more and worsening as a loss of 1 line or more. The study comprised 104 eyes (66 keratoconus; 38 corneal ectasia). Eyes with a preoperative CDVA of 20/40 or worse were 5.9 times (95% confidence interval [CI], 2.2-6.4) more likely to improve 2 Snellen lines or more. Eyes with a maximum K of 55.0 D or more were 5.4 times (95% CI, 2.1-14.0) more likely to have topographic flattening of 2.0 D or more. No preoperative characteristics significantly predicted worsening of visual acuity or corneal topography. Patients with worse preoperative CDVA and higher K values, particularly with a CDVA of 20/40 or worse or a maximum K of 55.0 D or more, were most likely to have improvement after CXL. No preoperative characteristics were predictive of CXL failure. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Extrusão do anel intra-estromal corneano e vascularização do túnel Extrusion and vascularization of the intrastromal corneal ring tunnel

    Directory of Open Access Journals (Sweden)

    Larissa Casteluber

    2007-12-01

    Full Text Available O objetivo deste trabalho é relatar e discutir os aspectos de um caso clínico em que foi observada a formação de neovascularização no túnel do anel intra-estromal corneano. Trata-se de paciente com ectasia corneana 4 anos após LASIK, comprovada pela paquimetria e topografia, e submetido ao implante de anel intra-estromal corneano. No terceiro ano de acompanhamento após implante do anel intraestromal, com o paciente em uso de lente de contato gelatinosa, verificou-se extrusão de um segmento e neovascularização no túnel. Removeu-se o segmento afetado, realizou-se fotocoagulação vascular, observando-se regressão completa do quadro neovascular.The purpose of this paper is to describe the clinical aspects of one case with deep corneal vascularization after corneal ring implantation to treat corneal ectasia due to LASIK 4 years before. The corneal ectasia diagnostic was performed by corneal pachimetry and topography. Intrastromal corneal ring segment was implanted. On the third year of follow-up, extrusion of one segment was noted and deep corneal neovascularization was found. The segment was removed, laser photocoagulation was applied and complete vascular regression was observed.

  3. Importância da tomografia de córnea para o diagnóstico de ectasia

    Directory of Open Access Journals (Sweden)

    Bruno de Freitas Valbon

    2012-10-01

    Full Text Available OBJETIVO: Utilização da metodologia para interpretação da tomografia de córnea e segmento anterior para a detecção e diagnóstico de ectasia corneana. MÉTODOS: Descrição da interpretação clínica dos índices da tomografia de córnea e segmento anterior (Pentacam High Resolution - Oculus, Wetzlar,Germany; relato de 3 casos, demonstrando a importância da propedêutica no exame complementar, através do Pentacam HR®. CONCLUSÃO: Nossa experiência compatibiliza-se com os relatos de literatura na demonstração do incremento de sensibilidade e especificidade para a detecção precoce de susceptibilidade e diagnóstico de ectasia corneana, utilizando a tomografia de córnea e segmento anterior.

  4. Corneal Collagen Cross-linking for the Treatment of Progressive Corneal Ectasia: 6-Year Prospective Outcome in a French Population.

    Science.gov (United States)

    Poli, Muriel; Lefevre, Amélie; Auxenfans, Céline; Burillon, Carole

    2015-10-01

    To evaluate 6-year results of standardized epithelium-off corneal collagen cross-linking (CXL) for treatment of progressive corneal ectasia. Prospective, consecutive, interventional case series. Thirty-six eyes of 25 consecutive patients with documented progressive primary or iatrogenic corneal ectasia underwent CXL following the Siena protocol. The main outcome measures included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, biomicroscopy and fundus appearance, topography-derived steep and flat keratometry (Kmax, Kmin), central corneal thickness (CCT), intraocular pressure with Goldmann applanation tonometer (GAT-IOP), and endothelial cell density (ECD), recorded at baseline and months 1, 3, 6, 12, 24, 36, and 72. Bilateral macular optical coherence tomography was performed at the endpoint visit. The mean follow-up was 66 ± 6 months (range, 60-78 months). At 6 years, CXL stabilized primary and iatrogenic corneal ectasia in 89% of the patients. In bilateral CXL, the progression of the first eye was highly predictive of the fellow eye's outcome. At the endpoint follow-up, the mean outcome variations were: UDVA: -0.08 ± 0.36 logMAR (P = .2); CDVA: -0.14 ± 0.28 logMAR (P = .004); Kmax: +0.11 ± 1.70 diopters (D) (P = .7); Kmin: -0.25 ± 1.25 D (P = .2); CCT: -16.38 ± 37 μm (P = .01); GAT-IOP: +1.0 ± 2.3 mm Hg (P = .01); ECD: +31 ± 400 cells/mm(2) (P = .6); no cases of macular toxicity or severe adverse events were reported. At 6 years, CXL maintains long-term results in halting the progression of corneal ectasia, with significant improvement in CDVA and long-term stability of keratometry. Further clinical studies with longer follow-up and larger series would be necessary to definitely confirm these results. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. EFFECTS OF CORNEAL CROSSLINKING ON OCULAR RESPONSE ANALYZER WAVEFORM-DERIVED VARIABLES IN KERATOCONUS AND POST-REFRACTIVE SURGERY ECTASIA

    Science.gov (United States)

    Hallahan, Katie M.; Rocha, Karolinne; Sinha Roy, Abhijit; Randleman, J. Bradley; Stulting, R. Doyle; Dupps, William J.

    2014-01-01

    Purpose To assess changes in Ocular Response Analyzer (ORA) waveforms after UVA/riboflavin corneal collagen crosslinking (CXL) using investigator-derived and manufacturer-supplied morphometric variables in keratoconus (KC) and post-refractive surgery ectasia patients. Design Prospective, randomized trial of a standard, epithelium-off CXL protocol Participants Patients with progressive KC (24 eyes of 21 patients) or post-refractive surgery ectasia (27 eyes of 23 patients) were enrolled. Methods Replicate ORA measurements were obtained prior to and 3 months after CXL. Pre-treatment and post-treatment waveform variables were analyzed for differences by paired student’s t-tests using measurements with the highest waveform scores. Main Outcome Measures Corneal Hysteresis, Corneal Resistance Factor, 37 second-generation manufacturer-supplied ORA variables, 15 investigator-derived ORA variables Results No variables were significantly different 3 months after CXL in the KC group, and no manufacturer–supplied variables changed significantly in the post-refractive surgery ectasia group. Four custom variables (ApplanationOnsetTime, P1P2avg, Impulse, and Pmax) increased by small but statistically significant margins after CXL in the post-refractive surgery ectasia group. Conclusions Changes in a small subset of investigator-derived variables suggested an increase in corneal bending resistance after CXL. However, the magnitudes of these changes were low and not commensurate with the degree of clinical improvement or prior computational estimates of corneal stiffening in the same cohort over the same period. Available air-puff derived measures of the corneal deformation response underestimate the biomechanical changes produced by CXL. PMID:25365551

  6. Optic pathway glioma associated with orbital rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia in a child with neurofibromatosis-1

    Energy Technology Data Exchange (ETDEWEB)

    Nikas, Ioannis; Theofanopoulou, Maria; Lampropoulou, Penelope; Hadjigeorgi, Christiana [Aghia Sophia Children' s Hospital, Imaging Department, Athens (Greece); Pourtsidis, Apostolos; Kosmidis, Helen [Children' s Hospital, A. Kyriakou, Department of Oncology, Athens (Greece)

    2006-11-15

    Neurofibromatosis-1 (NF-1) is a multisystem disorder presenting with a variety of clinical and imaging manifestations. Neural and non-neural tumours, and unusual benign miscellaneous conditions, separately or combined, are encountered in variable locations. We present a 21/2-year-old boy with NF-1 who demonstrated coexisting optic pathway glioma with involvement of the chiasm and optic nerve, orbital alveolar rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia. (orig.)

  7. Superior mesenteric vein thrombosis as a complication of cecal diverticulitis: A case report

    Directory of Open Access Journals (Sweden)

    Soniya Pinto

    2016-01-01

    Full Text Available Pylephlebitis is an uncommon complication of uncontrolled intra-abdominal infection that is associated with high morbidity and mortality. We present our experience with a unique case of cecal diverticulitis and septic thrombophlebitis of the superior mesenteric vein that was promptly diagnosed with high-resolution imaging and blood cultures. Antibiotic and anticoagulation therapy was instituted on confirming the diagnosis with magnetic resonance imaging (MRI to control the infection and prevent propagation of the thrombus. Our case report raises awareness about a rare and potentially fatal condition and provides appropriate imaging supplementation to aid in timely diagnosis.

  8. Relative contribution of flap thickness and ablation depth to the percentage of tissue altered in ectasia after laser in situ keratomileusis.

    Science.gov (United States)

    Santhiago, Marcony R; Smajda, David; Wilson, Steven E; Randleman, J Bradley

    2015-11-01

    To evaluate the contribution of flap thickness and ablation depth to the percentage of tissue altered (PTA) (flap thickness plus ablation depth divided by central corneal thickness) in determining the risk for ectasia after laser in situ keratomileusis (LASIK). University of São Paulo, São Paulo, Brazil; Cleveland Clinic, Cleveland, Ohio, and Emory Vision at Emory University, Atlanta, Georgia, USA. Retrospective comparative study. The study included 1 group of eyes with bilateral normal preoperative topography that developed ectasia after LASIK (ectasia group) and 2 control groups of eyes that did not develop ectasia after LASIK, 1 with 40% or more of tissue altered (high-PTA group) and 1 with flaps 120 μm or thicker (thick-flap group). The 29 eyes (16 patients) in the ectasia group had thicker flaps (146 μm) than the 24 eyes (20 patients) in the high-PTA group (118 μm) and derived a higher portion of PTA from flap thickness. The ectasia group had a higher PTA (45%) than the 100 eyes (50 patients) in the thick-flap group (34%) and greater ablation depths (94 μm versus 43 μm) and derived a higher portion of the PTA from ablation depth. Flap thickness had more impact than ablation depth; however, thicker flaps were insufficient to create ectasia unless coupled with greater ablation depths and thus a high PTA. This percentage was a more significant factor than the variables it comprised. Drs. Santhiago and Smadja are consultants to Ziemer Ophthalmic Systems AG. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Clinical characterization of corneal ectasia after myopic laser in situ keratomileusis based on anterior corneal aberrations and internal astigmatism.

    Science.gov (United States)

    Piñero, David P; Alió, Jorge L; Barraquer, Rafael I; Uceda-Montanes, Antonio; Murta, Joaquim

    2011-07-01

    To evaluate and characterize the clinical features of corneal ectasia after myopic laser in situ keratomileusis (LASIK) considering internal astigmatism and corneal aberrations and their correlation with other clinical data. Vissum-Instituto de Oftalmológico de Alicante, Alicante, Spain. Retrospective comparative case series. In this multicenter study, eyes were divided into 2 groups. The study group comprised eyes that had corneal ectasia after myopic LASIK. The control group comprised eyes that had successful LASIK to correct high myopia. The clinical outcomes were analyzed and compared. Internal astigmatism was calculated using vectorial analysis. The study enrolled 91 eyes (48 study group; 40 control group) of 81 patients (age 18 to 67 years). Uncorrected and corrected (CDVA) distance visual acuities and the refractive status were significantly worse in the study group (P ≤ .01). Corneas in the study group had a significantly higher steepest keratometry (K) reading and a more negative central asphericity (P corneal aberrations were also significantly higher in the study group (P corneal aberrations leading to a visual deterioration were present in eyes with corneal ectasia after myopic LASIK. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. U.S. Multicenter Clinical Trial of Corneal Collagen Crosslinking for Treatment of Corneal Ectasia after Refractive Surgery.

    Science.gov (United States)

    Hersh, Peter S; Stulting, R Doyle; Muller, David; Durrie, Daniel S; Rajpal, Rajesh K

    2017-10-01

    To evaluate the safety and efficacy of corneal collagen crosslinking (CXL) for the treatment of corneal ectasia after laser refractive surgery. Prospective, randomized, multicenter, controlled clinical trial. One hundred seventy-nine subjects with corneal ectasia after previous refractive surgery. The treatment group underwent standard CXL, and the sham control group received riboflavin alone without removal of the epithelium. The primary efficacy criterion was the change over 1 year of topography-derived maximum keratometry (K), comparing treatment with control groups. Secondary outcomes evaluated were corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), manifest refraction spherical equivalent, endothelial cell count, and adverse events. In the crosslinking treatment group, the maximum K value decreased by 0.7 diopters (D) from baseline to 1 year, whereas there was continued progression in the control group (1.3 D difference between treatment and control, P Corneal haze was the most frequently reported crosslinking-related adverse finding. Corneal collagen crosslinking was effective in improving the maximum K value, CDVA, and UDVA in eyes with corneal ectasia 1 year after treatment, with an excellent safety profile. CXL is the first approved procedure to diminish progression of this ectatic corneal process. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  11. Scleral lenses in the treatment of post-LASIK ectasia and superficial neovascularization of intrastromal corneal ring segments.

    Science.gov (United States)

    Kramer, Elise G; Boshnick, Edward L

    2015-08-01

    This case report aims to explore the use of scleral lenses for the treatment of ocular and visual complications in an adult patient presenting with post-LASIK (Laser-Assisted in situ Keratomileusis) ectasia in both eyes with cross-linking in the right eye and intrastromal corneal ring segments (ICRS; Intacs, Addition Technology, Fremont, CA) in the left eye. Following a comprehensive eye exam and specific testing for contact lens fitting, scleral lenses were fitted with success in both eyes and dispensed. Due to progressive fibrosis and neovascularization of the inferior ICRS in the left eye, the inferior ICRS was removed and scleral lenses were refit with success. Prescribed scleral lenses helped the patient achieve optimal visual correction (20/20) as well as ocular protection of the cornea. Post-LASIK ectasia is a common finding among contact lens specialists today. When ICRS surgery is involved, the fitting of contact lenses may become more challenging. Scleral lenses offer a unique way of addressing many issues raised in this case report including corneal neovascularization and ectasia. This lens modality may be considered for any other case involving irregular corneal curvature following surgery resulting in reduced visual acuity. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  12. Effects of apples and specific apple components on the cecal environment of conventional rats: Role of apple pectin

    DEFF Research Database (Denmark)

    Licht, Tine Rask; Hansen, Max; Bergström, Anders

    2010-01-01

    Background: Our study was part of the large European project ISAFRUIT aiming to reveal the biological explanations for the epidemiologically well-established health effects of fruits. The objective was to identify effects of apple and apple product consumption on the composition of the cecal...... microbial community in rats, as well as on a number of cecal parameters, which may be influenced by a changed microbiota. Results: Principal Component Analysis (PCA) of cecal microbiota profiles obtained by PCR-DGGE targeting bacterial 16S rRNA genes showed an effect of whole apples in a long-term feeding...... study (14 weeks), while no effects of apple juice, puree or pomace on microbial composition in cecum were observed. Administration of either 0.33 or 3.3% apple pectin in the diet resulted in considerable changes in the DGGE profiles. A 2-fold increase in the activity of beta-glucuronidase was observed...

  13. Effects of nitro compounds and feedstuffs on in vitro methane production in chicken cecal contents and rumen fluid.

    Science.gov (United States)

    Saengkerdsub, Suwat; Kim, Woo-Kyun; Anderson, Robin C; Nisbet, David J; Ricke, Steven C

    2006-04-01

    Short-chain volatile fatty acids (VFA) and methane are the products from a wide variety of microorganisms living in the gastrointestinal tract. The objective of this study was to examine effects of feedstuff and select nitro compounds on VFA and methane production during in vitro incubation of laying hen cecal contents and rumen fluid from cattle and sheep. In the first experiment, one of the three nitro compound was added to incubations containing cecal contents from laying hens supplemented with either alfalfa (AF) or layer feed (LF). Both feed material influenced VFA production and acetic acid was the primary component. Incubations with nitro ethanol and 2-nitropropanol (NP) had significantly (Pmethane production in the incubations although methane was lower (Pmethane production in incubations of both rumen fluids. The results show that NE impedes methane production, especially in incubations of chicken cecal contents.

  14. Cecal intubation time between cap-assisted water exchange and water exchange colonoscopy: a randomized-controlled trial.

    Science.gov (United States)

    Tseng, Chih-Wei; Koo, Malcolm; Hsieh, Yu-Hsi

    2017-11-01

    The water exchange (WE) method can decrease the discomfort of the patients undergoing colonoscopy. It also provides salvage cleansing and improves adenoma detection, but a longer intubation time is required. Cap-assisted colonoscopy leads to a significant reduction in cecal intubation time compared with traditional colonoscopy with air insufflation. The aim of this study was to investigate whether combined cap-assisted colonoscopy and water exchange (CWE) could decrease the cecal intubation time compared with WE. A total of 120 patients undergoing fully sedated colonoscopy at a regional hospital in southern Taiwan were randomized to colonoscopy with either CWE (n=59) or WE (n=61). The primary endpoint was cecal intubation time. The mean cecal intubation time was significantly shorter in CWE (12.0 min) compared with WE (14.8 min) (P=0.004). The volume of infused water during insertion was lower in CWE (840 ml) compared with WE (1044 ml) (P=0.003). The adenoma detection rate was 50.8 and 47.5% for CWE and WE, respectively (P=0.472). The Boston Bowel Preparation Scale scores were comparable in the two groups. Results from the multiple linear regression analysis indicated that WE with a cap, a higher degree of endoscopist's experience, a higher Boston Bowel Preparation Scale score, and a lower volume of water infused during insertion, without abdominal compression, without change of position, and without chronic laxative use, were significantly associated with a shorter cecal intubation time. In comparison with WE, CWE could shorten the cecal intubation time and required lower volume of water infusion during insertion without compromising the cleansing effect of WE.

  15. Vascular dementia

    African Journals Online (AJOL)

    Adele

    2003-12-10

    Dec 10, 2003 ... ischaemic VaD includes multiple lacunes and subcortical arteriosclerotic encephalopathy (Binswanger's disease) and imaging shows multiple deep ... culitis, multiple sclerosis, acute demyelinating encephalomy- ... Table I. The NINDS-AIREN criteria for the diagnosis of Vascular Dementia. 12. Require both ...

  16. VASCULAR SURGERY

    African Journals Online (AJOL)

    2016-06-02

    Jun 2, 2016 ... with the literature from South Africa over the last four decades, and reflects the high rate of interpersonal violence in the country.14,15 As expected, cervical ... via the intact circle of Willis in young patients is the most likely explanation for the lack of strokes. Five patients were referred to the Durban vascular ...

  17. Ultrasound -- Vascular

    Science.gov (United States)

    ... waves from passing into your body. The sonographer (ultrasound technologist) or radiologist then places the transducer on the ... is specialized and is best performed by a technologist and physician with experience in vascular ultrasound imaging. top of page Additional Information and Resources ...

  18. Effect of dried purslane on immunity responses and cecal microflora composition of broiler chickens

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Ghorbani

    2014-10-01

    Full Text Available The aim of the present study was to evaluate the effect of purslane on immune responses and cecal microflora composition of broiler chickens. One hundred forty four day old broiler chicks (Ross 308 were allocated randomly in 3 groups and 4 replicates to receive diets supplemented with 0 (control, 1 and 2 % of dried purslane. At 21 and 35 days of age 1 mL of sheep red blood cell (SRBC injected to 2 broilers of each replicate and blood samples were taken 7 days after each injection. Eight chicks per treatment at the age of 42 d were killed and the number of coliforms, E-Coli and Lactobacillus bacteria populations in ceca were enumerated on appropriate bacteriological media. There were no significant different in primary and secondary antibody titer against SRBC and no different between the treatments for proportional weight of bursa, thymus and spleen. The results of experiment indicated that use of purslane significantly increased Lactobacillus and decreased E-Coli bacteria population. Use of purslane had no effect on coliforms bacteria population. It is concluded that purslane inclusion had a positive significant effect on cecal microflora composition.

  19. Fermentation of carbohydrate in rat ileal excreta is enhanced with cecal inocula compared with fecal inocula.

    Science.gov (United States)

    Monsma, D J; Marlett, J A

    1996-02-01

    The differential fermentative capacities of microflora from two regions of the large bowel and how fermentation was altered by prior exposure of the microflora to the substrate to be fermented were studied using an in vitro fermentation system. Bacterial inocula were prepared from cecal contents and feces from three groups of rats fed purified diets containing 100 g/kg dietary fiber from canned peas or psyllium seed husk, or a nonpurified diet containing 170 g/kg dietary fiber. The substrate for all fermentations was ileal excreta from colectomized rats fed a purified diet containing 100 g/kg dietary fiber from canned peas. Anaerobic fermentations were conducted for 0, 3, 6, 12, 24, 48 and 96 h. Sugars of the unfermented polysaccharides were measured by gas chromatography following acid hydrolysis; disappearance was the measure of fermentation. Independent of inoculum source, > 90% of the starch and arabinose and 75% of the uronic acids, but peas or nonpurified diet. Bacterial efficiency of carbohydrate utilization, the increase in muramic acid/mole carbohydrate fermented, was greatest (P peas. We conclude that using cecal microflora as the inoculum source provides a more accurate index of fermentation during transit through the large bowel and that noncellulosic and storage polysaccharides of the plant cell wall are utilized before cellulose.

  20. Analysis of Resistant Starches in Rat Cecal Contents Using Fourier Transform Infrared Photoacoustic Spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Timothy J. [Ames Laboratory; Ai, Yongfeng [Iowa State University; Jones, Roger W. [Ames Laboratory; Houk, Robert S. [Ames Laboratory; Jane, Jay-lin [Iowa State University; Zhao, Yinsheng [Iowa State University; Birt, Diane F. [Iowa State University; McClelland, John F. [Ames Laboratory

    2013-01-29

    Fourier transform infrared photoacoustic spectroscopy (FTIR-PAS) qualitatively and quantitatively measured resistant starch (RS) in rat cecal contents. Fisher 344 rats were fed diets of 55% (w/w, dry basis) starch for 8 weeks. Cecal contents were collected from sacrificed rats. A corn starch control was compared against three RS diets. The RS diets were high-amylose corn starch (HA7), HA7 chemically modified with octenyl succinic anhydride, and stearic-acid-complexed HA7 starch. To calibrate the FTIR-PAS analysis, samples from each diet were analyzed using an enzymatic assay. A partial least-squares cross-validation plot generated from the enzymatic assay and FTIR-PAS spectral results for starch fit the ideal curve with a R2 of 0.997. A principal component analysis plot of components 1 and 2 showed that spectra from diets clustered significantly from each other. This study clearly showed that FTIR-PAS can accurately quantify starch content and identify the form of starch in complex matrices.

  1. Ability of Arkansas LaKast and LaKast Hybrid Rice Bran to Reduce Salmonella Typhimurium in Chicken Cecal Incubations and Effects on Cecal Microbiota

    Directory of Open Access Journals (Sweden)

    Sun Ae Kim

    2018-02-01

    Full Text Available The objective of the present study was to evaluate the prebiotic ability of Arkansas (AR LaKast rice bran cultivars as a feed supplement to reduce Salmonella Typhimurium and other gut microbiota. An in vitro mixed anaerobic culture system was used to simulate conditions in the chicken ceca. Anaerobic cultures contained feed, cecal contents collected from 2, 4, and 6 weeks of chicken broilers, and with/without AR rice bran (pureline and hybrid. After 24 h pre-incubation, S. Typhimurium was inoculated into the anaerobic cultures and surviving S. Typhimurium were enumerated during anaerobic incubation up to 48 h. Samples were also collected after 0, 6, 12, 24, 48 h incubation for microbiome analysis with an Illumina MiSeq platform to investigate the changes in bacterial composition. Both pure and hybrid LaKast rice exhibited significant inhibitory effects in all experiments using 2, 4, and 6 weeks ceca but greater bactericidal effects by LaKast rice were observed at 6 weeks compared to 2- and 4-week ceca samples. For samples containing 6-week chicken ceca, the pureline and hybrid rice bran resulted in no viable S. Typhimurium and 6.58 log CFU/ml reduction after 48 h, respectively. Adding rice bran also led to changes in the cecal microbiota. LaKast rice bran resulted in more diverse bacterial population than control groups without any rice bran. The lowest abundance of Proteobacteria (at phylum level and Enterobacteriaceae (at family and genus level was exhibited in LaKast pure treated groups followed by LaKast hybrid and control. This may be attributed to a significant reduction of S. Typhimurium of the Enterobacteriaceae family and Proteobacteria phylum. This study suggests the beneficial functionality of LaKast rice brans as biological supplements in feed. The use of rice bran is favorable for both the consumer and the rice industry because of the perception of rice bran as a naturally occurring substance. As an abundant by-product of rice

  2. Vascular neoplasms.

    Science.gov (United States)

    Williams, H B

    1980-07-01

    Vascular neoplasms in the broad sense represent a very common group of tumors or hamartomas that show great variability in gross appearance, microscopic appearance, and clinical course. Generally, neoplasms are composed of one cell type, but vascular neoplasms are collections of endothelial-lined tubes or tubules with connective tissue walls that may contain smooth muscle cells, pericytes, and nerve elements according to the specific tissues of origin. The classification of vascular neoplasms as outlined in this article attempts to delineate each tumor or hamartoma according to its histologic appearance and clinical behavior. The clinical course ranges from completely benign, self-involuting malformations such as the strawberry hemangioma to highly malignant angiosarcomas with their rapid growth and frequent metastases. Defects in the lymphatic system show gradations from simple lymphangiomas through lymphedema and lymphangiectasia, which can probably be explained by faulty embryologic development. Management of these lesions has been discussed, including brief descriptions of most of the currently accepted treatment methods for these frequently encountered clinical problems.

  3. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    International Nuclear Information System (INIS)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F.; Tongerloo, A.J. van; Paepe, A.M. de

    1999-01-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, χ 2 -test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  4. Corneal biomechanics in iatrogenic ectasia and keratoconus: A review of the literature

    Directory of Open Access Journals (Sweden)

    Majid Moshirfar

    2013-01-01

    Full Text Available The Ocular Response Analyzer (ORA (Reichert Ophthalmic Instruments, Buffalo, NY allows direct measurement of corneal biomechanical properties. Since its introduction, many studies have sought to elucidate the clinical applications of corneal hysteresis (CH and corneal resistance factor (CRF. More recently, detailed corneal deformation signal waveform analysis (WA has potentially expanded the diagnostic capabilities of the ORA. In this review, the role of CH, CRF, and WA are examined in keratoconus (KC and iatrogenic ectasia (IE. The PubMed database was searched electronically for peer-reviewed literature in July 2012 and August 2012 without date restrictions. The search strategy included medical subject heading (MeSH and natural language terms to retrieve references on corneal biomechanics, CH, CRF, corneal deformation signal WA, IE, and KC. The evidence suggests that while CH and CRF are poor screening tools when used alone, increased sensitivity and specificity of KC and IE screening result when these parameters are combined with tomography and topography. Recent advances in WA are promising, but little is currently understood about its biomechanical and clinical relevance. Future studies should seek to refine the screening protocols for KC and IE as well as define the clinical applicability of WA parameters.

  5. Toric Intraocular Lens Implantation for Correction of Astigmatism in Cataract Patients with Corneal Ectasia

    Directory of Open Access Journals (Sweden)

    Efstratios A. Parikakis

    2013-11-01

    Full Text Available Our purpose was to examine the long-term efficacy of toric intraocular lens (IOL implantation in cataract patients with high astigmatism due to corneal ectasia, who underwent phacoemulsification cataract surgery. Five eyes of 3 cataract patients with topographically stable keratoconus or pellucid macular degeneration (PMD, in which phacoemulsification with toric IOL implantation was used to correct high astigmatism, are reported. Objective and subjective refraction, visual acuity measurement and corneal topography were performed in all cases before and after cataract surgery. In all cases, there was a significant improvement in visual acuity, as well as refraction, which remained stable over time. Specifically, in subjective refraction, all patients achieved visual acuity from 7/10 to 9/10 with up to -2.50 cyl. Corneal topography also remained stable. Postoperative follow-up was 18-28 months. Cataract surgery with toric IOL implantation seems to be safe and effective in correcting astigmatism and improving visual function in cataract patients with topographically stable keratoconus or PMD.

  6. Shifting "Ectasia": Interface Fluid Collection After Small Incision Lenticule Extraction (SMILE).

    Science.gov (United States)

    Bansal, Aashish K; Murthy, Somasheila I; Maaz, Syed M; Sachdev, Mahipal S

    2016-11-01

    To report the first case and a new diagnostic sign of interface fluid collection following small incision lenticule extraction (SMILE). Case report. A 20-year-old man underwent SMILE for correction of compound myopic astigmatism. Postoperative follow-up examination included vision testing, slit-lamp examination, intraocular pressure measurement, corneal topography, and optical coherence tomography (OCT). The patient presented postoperatively with decreased vision in his right eye. Topography revealed an island of corneal steepening, the location of which kept shifting on successive visits. OCT revealed the presence of fluid pockets in the interface. The condition resolved with topical hypertonic saline and the uncorrected visual acuity recovered to 20/20. The intraocular pressure remained normal throughout. This is the first case report of interface fluid collection after SMILE. The report demonstrates shifting corneal "ectasia" (steepening) as a diagnostic sign of interface fluid collection. The authors recommend a new pathogenesis for this condition and suggest the use of topical hypertonic saline to treat this condition. [J Refract Surg. 2016;32(11):773-775.]. Copyright 2016, SLACK Incorporated.

  7. Influence of a subsequent meal on the oro-cecal transit time of a solid test meal

    NARCIS (Netherlands)

    Priebe, MG; Wachters-Hagedoorn, RE; Landman, K; Heimweg, J; Elzinga, H; Vonk, RJ

    Oro-cecal transit time (OCTT) is determined for clinical diagnostics of intestinal complaints and research purposes. Ingestion of a subsequent meal during the test period shortens the OCTT of a liquid test meal (glucose solution), as previously reported. This study was conducted to determine whether

  8. Characterization of nitrate-reducing and amino acid-using bacteria prominent in nitrotoxin-enriched equine cecal populations

    Science.gov (United States)

    In the present study, populations of equine cecal microbes enriched for enhanced rates of 3-nitro-1-propionic acid (NPA) or nitrate metabolism were diluted and cultured for NPA-metabolizing bacteria on a basal enrichment medium (BEM) or tryptose soy agar (TSA) medium supplemented with either 5 mM NP...

  9. Molecular Properties of Guar Gum and Pectin Modify Cecal Bile Acids, Microbiota, and Plasma Lipopolysaccharide-Binding Protein in Rats.

    Science.gov (United States)

    Ghaffarzadegan, Tannaz; Marungruang, Nittaya; Fåk, Frida; Nyman, Margareta

    2016-01-01

    Bile acids (BAs) act as signaling molecules in various physiological processes, and are related to colonic microbiota composition as well as to different types of dietary fat and fiber. This study investigated whether guar gum and pectin-two fibers with distinct functional characteristics-affect BA profiles, microbiota composition, and gut metabolites in rats. Low- (LM) or high-methoxylated (HM) pectin, and low-, medium-, or high-molecular-weight (MW) guar gum were administered to rats that were fed either low- or high-fat diets. Cecal BAs, short-chain fatty acids (SCFA) and microbiota composition, and plasma lipopolysaccharide-binding protein (LBP) levels were analyzed, by using novel methodologies based on gas chromatography (BAs and SCFAs) and 16S rRNA gene sequencing on the Illumina MiSeq platform. Strong correlations were observed between cecal BA and SCFA levels, microbiota composition, and portal plasma LBP levels in rats on a high-fat diet. Notably, guar gum consumption with medium-MW increased the cecal amounts of cholic-, chenodeoxycholic-, and ursodeoxycholic acids as well as α-, β-, and ω-muricholic acids to a greater extent than other types of guar gum or the fiber-free control diet. In contrast, the amounts of cecal deoxycholic- and hyodeoxycholic acid were reduced with all types of guar gum independent of chain length. Differences in BA composition between pectin groups were less obvious, but cecal levels of α- and ω-muricholic acids were higher in rats fed LM as compared to HM pectin or the control diet. The inflammatory marker LBP was downregulated in rats fed medium-MW guar gum and HM pectin; these two fibers decreased the cecal abundance of Oscillospira and an unclassified genus in Ruminococcaceae, and increased that of an unclassified family in RF32. These results indicate that the molecular properties of guar gum and pectin are important for their ability to modulate cecal BA formation, gut microbiota composition, and high-fat diet induced

  10. B cell activation in the cecal patches during the development of an experimental colitis model.

    Science.gov (United States)

    Watabe, Taro; Nagaishi, Takashi; Tsugawa, Naoya; Kojima, Yudai; Jose, Nisha; Hosoya, Akinori; Onizawa, Michio; Nemoto, Yasuhiro; Oshima, Shigeru; Nakamura, Tetsuya; Karasuyama, Hajime; Adachi, Takahiro; Watanabe, Mamoru

    2018-02-05

    Although previous studies have suggested that appendix seems to be involved in the colitis, the role of this in the pathogenesis remains unclear. In this study, we assessed the importance of appendiceal lymphoid follicles, specifically the cecal patches (CP) in mice, using an experimental colitis model. Treatment with oxazolone resulted in ulcerations particularly at CP with follicular expansion as well as colitis. The colitis was attenuated by either appendectomy or the absence of mature B cells. We therefore established an intravital imaging system accompanied by the fluorescence resonance energy transfer technology to analyze the dynamic immune response of CP B cells. Our observation revealed frequent Ca 2+ signaling in CP B cells during the early phase of colitis development. These findings suggested that the CP B cells may be involved in the pathogenesis of colitis including inflammatory bowel diseases in humans. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Chromogranin A is a sensitive marker of progression or regression in ileo-cecal neuroendocrine tumors

    DEFF Research Database (Denmark)

    Jensen, Kenneth Højsgaard; Hilsted, Linda; Jensen, Claus Verner

    2013-01-01

    Abstract Objective. The correlation between plasma Chromogranin A concentrations and changes in tumor size evaluated by computed tomography (CT) - as a gold standard - was evaluated. Material and methods. One hundred and sixteen patients with CgA-producing ileo-cecal neuroendocrine tumors were...... evaluated by events, which were recorded when a CT was followed by another CT 1 - 12 months later. Change in tumor size was defined as regression, progression, or stable disease using RECIST criteria 1.1. Of 426 events, there were 97 with progression, 279 with stable disease, and 50 with regression. Based...... on the ROC curves a cutoff value of 25% change was selected to discriminate between increased, decreased, or unchanged CgA concentrations in plasma, using a sensitive radioimmunoassay with well-defined epitope specificity. Results. In the 97 events showing tumor progression diagnostic sensitivity...

  12. Vascular ultrasound.

    Science.gov (United States)

    Pilcher, D B; Ricci, M A

    1998-04-01

    Surgeon-interpreted diagnostic ultrasound has become the preferred screening test and often the definitive test for the diagnosis of arterial stenosis, aneurysm, and venous thrombosis. As a modality for surveillance, its noninvasive quality makes it particularly appealing as the test of choice to screen patients for abdominal aortic aneurysms or to perform follow-up examinations on those patients with a carotid endartectomy or in situ bypass grafts. The increasing reliance on intraoperative duplex imaging of vascular procedures demands that the surgeon learn the skills to perform the studies without a technologist or radiologist to interpret the examination.

  13. Comparison and Efficacy of LigaSure and Rubber Band Ligature in Closing the Inflamed Cecal Stump in a Rat Model of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Chun-Chieh Yeh

    2015-01-01

    Full Text Available Safety of either LigaSure or rubber band in closing inflamed appendiceal stump in acute appendicitis has been less investigated. In this study, cecal ligation followed by resecting inflamed cecum was performed to mimic appendectomy in a rat model of acute appendicitis. Rats were sacrificed immediately (Group A and 7 days (Group B after cecal resection, respectively. The cecal stumps were closed by silk ligature (S, 5 mm LigaSure (L, or rubber band (R. Seven days after cecal resection, the LigaSure (BL and silk subgroups (BS had significantly less intra-abdominal adhesion and better laparotomy wound healing than rubber band subgroup (BR. The initial bursting pressure at cecal stump was comparable among the three methods; along with tissue healing process, both BL and BS provided a higher bursting pressure than BR 7 days after appendectomy. BL subgroup had more abundant hydroxyproline deposition than BS and BR subgroup. Furthermore, serum TNF-α in BR group kept persistently increasing along with time after cecal resection. Thus, the finding that LigaSure but not rubber band is safe in sealing off the inflamed cecal stump in rat model of acute appendicitis suggests the possibility of applying LigaSure for appendectomy via single port procedure or natural orifice transluminal endoscopic surgery (NOTES.

  14. Modulations of the chicken cecal microbiome and metagenome in response to anticoccidial and growth promoter treatment.

    Directory of Open Access Journals (Sweden)

    Jessica L Danzeisen

    Full Text Available With increasing pressures to reduce or eliminate the use of antimicrobials for growth promotion purposes in production animals, there is a growing need to better understand the effects elicited by these agents in order to identify alternative approaches that might be used to maintain animal health. Antibiotic usage at subtherapeutic levels is postulated to confer a number of modulations in the microbes within the gut that ultimately result in growth promotion and reduced occurrence of disease. This study examined the effects of the coccidiostat monensin and the growth promoters virginiamycin and tylosin on the broiler chicken cecal microbiome and metagenome. Using a longitudinal design, cecal contents of commercial chickens were extracted and examined using 16S rRNA and total DNA shotgun metagenomic pyrosequencing. A number of genus-level enrichments and depletions were observed in response to monensin alone, or monensin in combination with virginiamycin or tylosin. Of note, monensin effects included depletions of Roseburia, Lactobacillus and Enterococcus, and enrichments in Coprococcus and Anaerofilum. The most notable effect observed in the monensin/virginiamycin and monensin/tylosin treatments, but not in the monensin-alone treatments, was enrichments in Escherichia coli. Analysis of the metagenomic dataset identified enrichments in transport system genes, type I fimbrial genes, and type IV conjugative secretion system genes. No significant differences were observed with regard to antimicrobial resistance gene counts. Overall, this study provides a more comprehensive glimpse of the chicken cecum microbial community, the modulations of this community in response to growth promoters, and targets for future efforts to mimic these effects using alternative approaches.

  15. Modulations of the chicken cecal microbiome and metagenome in response to anticoccidial and growth promoter treatment.

    Science.gov (United States)

    Danzeisen, Jessica L; Kim, Hyeun Bum; Isaacson, Richard E; Tu, Zheng Jin; Johnson, Timothy J

    2011-01-01

    With increasing pressures to reduce or eliminate the use of antimicrobials for growth promotion purposes in production animals, there is a growing need to better understand the effects elicited by these agents in order to identify alternative approaches that might be used to maintain animal health. Antibiotic usage at subtherapeutic levels is postulated to confer a number of modulations in the microbes within the gut that ultimately result in growth promotion and reduced occurrence of disease. This study examined the effects of the coccidiostat monensin and the growth promoters virginiamycin and tylosin on the broiler chicken cecal microbiome and metagenome. Using a longitudinal design, cecal contents of commercial chickens were extracted and examined using 16S rRNA and total DNA shotgun metagenomic pyrosequencing. A number of genus-level enrichments and depletions were observed in response to monensin alone, or monensin in combination with virginiamycin or tylosin. Of note, monensin effects included depletions of Roseburia, Lactobacillus and Enterococcus, and enrichments in Coprococcus and Anaerofilum. The most notable effect observed in the monensin/virginiamycin and monensin/tylosin treatments, but not in the monensin-alone treatments, was enrichments in Escherichia coli. Analysis of the metagenomic dataset identified enrichments in transport system genes, type I fimbrial genes, and type IV conjugative secretion system genes. No significant differences were observed with regard to antimicrobial resistance gene counts. Overall, this study provides a more comprehensive glimpse of the chicken cecum microbial community, the modulations of this community in response to growth promoters, and targets for future efforts to mimic these effects using alternative approaches.

  16. Catecholamines modulate Escherichia coli O157:H7 adherence to murine cecal mucosa.

    Science.gov (United States)

    Chen, Chunsheng; Brown, David R; Xie, Yonghong; Green, Benedict T; Lyte, Mark

    2003-08-01

    Enterohemorrhagic Escherichia coli O157:H7 (EHEC) is an important food-borne pathogen. While the molecular mechanisms governing E. coli O157:H7 pathogenesis have been intensively investigated, the role of host factors has received less attention. In this study, we tested the hypothesis that the enteric catecholamines norepinephrine (NE) and dopamine (DA) modulate interactions of the cecal mucosa with E. coli O157:H7. Full-thickness sheets of murine cecum were mounted in Ussing chambers and short circuit current and tissue electrical conductance were periodically determined to assess active transepithelial ion transport and ionic permeability, respectively. Neurochemicals and stationary-phase E. coli O157:H7 were exposed respectively to the contraluminal and luminal aspects of the mucosa. Epithelial adherence of E. coli O157:H7 was quantified by a bacterial adhesion assay after 90 min of luminal E. coli O157:H7 exposure. DA and NE increased E. coli O157:H7 adherence relative to untreated control tissues at 50% effective concentrations of 3.8 microM and 4.2 microM respectively. Pretreatment of tissues with either the alpha-adrenergic antagonist phentolamine or the beta-adrenergic antagonist propranolol prevented the action of NE. The effect of DA was prevented by the dopamine antagonist haloperidol. The drugs did not impair tissue viability or transepithelial conductance. The present findings suggest that enteric catecholamines modulate E. coli O157:H7 adherence to the cecal epithelium. Conditions associated with elevated catecholamine release, such as stress exposure, may influence host susceptibility to E. coli O157:H7 infection.

  17. Cecal Ligation and Puncture Results in Long-Term Central Nervous System Myeloid Inflammation.

    Directory of Open Access Journals (Sweden)

    Benjamin H Singer

    Full Text Available Survivors of sepsis often experience long-term cognitive and functional decline. Previous studies utilizing lipopolysaccharide injection and cecal ligation and puncture in rodent models of sepsis have demonstrated changes in depressive-like behavior and learning and memory after sepsis, as well as evidence of myeloid inflammation and cytokine expression in the brain, but the long-term course of neuroinflammation after sepsis remains unclear. Here, we utilize cecal ligation and puncture with greater than 80% survival as a model of sepsis. We found that sepsis survivor mice demonstrate deficits in extinction of conditioned fear, but no acquisition of fear conditioning, nearly two months after sepsis. These cognitive changes occur in the absence of neuronal loss or changes in synaptic density in the hippocampus. Sepsis also resulted in infiltration of monocytes and neutrophils into the CNS at least two weeks after sepsis in a CCR2 independent manner. Cellular inflammation is accompanied by long-term expression of pro-inflammatory cytokine and chemokine genes, including TNFα and CCR2 ligands, in whole brain homogenates. Gene expression analysis of microglia revealed that while microglia do express anti-microbial genes and damage-associated molecular pattern molecules of the S100A family of genes at least 2 weeks after sepsis, they do not express the cytokines observed in whole brain homogenates. Our results indicate that in a naturalistic model of infection, sepsis results in long-term neuroinflammation, and that this sustained inflammation is likely due to interactions among multiple cell types, including resident microglia and peripherally derived myeloid cells.

  18. Open door approach by partial sternotomy and sterno-costo-chondroplasty for annuloaortic ectasia with pectus excavatum.

    Science.gov (United States)

    Kawamura, Tomonori; Fukuda, Ikuo; Minakawa, Masahito; Fukui, Kozo

    2011-04-01

    A 32-year-old female patient with Marfan syndrome was admitted for repair of annuloaortic ectasia and severe pectus excavatum. Because the chest cage deformity was severe, concomitant reparative surgery of the chest wall was performed. Partial median sternotomy and left second-fifth rib division was made to obtain good surgical field. The patient underwent valve-sparing aortic root remodeling successfully. After complete neutralization of heparin, additional division of the right ribs was performed and each rib and the sternum was reshaped. Pectus excavatum was completely repaired by this method. We believe this approach is efficacious for intracardiac repair with severe pectus excavatum.

  19. Ultrastructural and three-dimensional study of post-LASIK ectasia cornea.

    Science.gov (United States)

    Akhtar, Saeed; Alkatan, Hind; Kirat, Omar; Almubrad, Turki

    2014-01-01

    Post-laser in situ keratomileusis (LASIK) corneal ectasia is a serious late postoperative complication. Here, we report the ultrastructural features of the post-LASIK cornea of two patients. Two normal corneas (age 24 and 37 years old) and two post-LASIK ectaic corneas from two patients (A and B) were studied. The "patient A" (age 27 years) underwent penetrating keratoplasty and "patient B" (age 31 years) underwent deep-anterior lamellar keratoplasty. The excised corneas were processed for light and electron microscopy. A total of 120 images for three-dimensional (3D) reconstruction were taken by using the software "Recorder" and using a bottom mounted camera "Quemesa" attached to a JOEL 1400 transmission electron microscope. The 3D images were constructed using "Visual Kai" software. In the post-LASIK cornea, the hemidesmosomes, the basement membrane, and Bowman"s layer were abnormal. The stromal lamellae were thin and disorganized. The collagen fibrils (CFs) diameter and interfibrillar spacing had decreased. Aggregated microfibrils were present in the Bowman's layer and all parts of the stroma. A large number of microfilaments were present at the detachment end of the flap and residual stroma. The 3D images showed the presence of collagen microfibrils and proteoglycans (PGs) within the CF of the normal and post-LASIK cornea. The collagen microfibrils and PGs within the CFs had degenerated in the post-LASIK cornea. Collagen microfibrils and PGs within the CFs were degenerated, leading to the degeneration of CFs, followed by the disorganization of lamellae in post-LASIK cornea. The CFs diameter and interfibrillar spacing decreased. Copyright © 2013 Wiley Periodicals, Inc.

  20. In vivo confocal microscopy and tear cytokine analysis in post-LASIK ectasia.

    Science.gov (United States)

    Pahuja, Natasha Kishore; Shetty, Rohit; Deshmukh, Rashmi; Sharma, Anupam; Nuijts, Rudy M M A; Jhanji, Vishal; Sethu, Swaminathan; Ghosh, Arkasubhra

    2017-12-01

    Corneal keratectasia is one of the complications associated with laser in situ keratomileusis (LASIK) that results in vision impairment. The pathogenesis of post-LASIK ectasia (PLE) remains underexplored. We report the tear cytokine profile and in vivo confocal microscopy (IVCM) findings in eyes with PLE. This retrospective study included age-matched 7 (14 eyes) post-LASIK controls (PLCs) and 6 (12 eyes) PLE subjects. Corneal topography was used to categorise the subjects into PLC and PLE groups. Ocular Surface Disease Index (OSDI) scores obtained were based on standard questionnaire and IVCM images were used to determine corneal dendritic cells density (DCD) and sub-basal nerve plexus morphology. Inflammatory cytokines/chemokines in the tears were quantified using flow cytometry based cytometric bead array. Pentacam-based scores, OSDI scores and corneal DCD were significantly (pPLE compared with PLC. Discomfort-related subscale of OSDI score exhibited a positive correlation with total corneal DCD in the PLE cohort. The fold difference of chemokine (C-C motif) ligand/monocyte chemotactic protein-1 (CCL2/MCP1) (3.4±0.6) was found to be significantly (pPLE cohorts and a positive correlation between CCL2/MCP1 levels and total corneal DCD was also observed in the PLE cohort. The current study found a significant difference in the tear film cytokine profile between normal and PLE eyes. Presence of increased corneal dendritic cells and altered tear cytokines suggests an ongoing inflammatory response in PLE. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Coronary collateral circulation in patients of coronary ectasia with significant coronary artery disease.

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    Po-Chao Hsu

    Full Text Available OBJECTIVES: Patients with coronary ectasia (CE usually have coexisting coronary stenosis resulting in myoischemia. Coronary collateral plays an important role in protecting myocardium from ischemia and reducing cardiovascular events. However, limited studies investigate the role of CE in coronary collaterals development. METHODS: We evaluated 1020 consecutive patients undergoing coronary angiography and 552 patients with significant coronary artery disease (SCAD, defined as diameter stenosis more than 70%, were finally analyzed. CE is defined as the ectatic diameter 1.5 times larger than adjacent reference segment. Rentrop collateral score was used to classify patients into poor (grades 0 and 1 or good (grades 2 and 3 collateral group. RESULTS: 73 patients (13.2% had CE lesions which were most located in the right coronary artery (53.4%. Patients with CE had a lower incidence of diabetes (43.8% vs 30.1%, p = 0.03, higher body mass index (25.4±3.5 vs 26.7±4.6, p = 0.027 and poorer coronary collateral (58.2% vs 71.2%, p = 0.040. Patients with poor collateral (n = 331 had a higher incidence of CE (15.7% vs 9.5%, p = 0.040 and fewer diseased vessels numbers (1.96±0.84 vs 2.48±0.69, p<0.001. Multivariate analysis showed diabetes (odd ratio (OR 0.630, p = 0.026, CE (OR = 0.544, p = 0.048, and number of diseased vessels (OR = 2.488, p<0.001 were significant predictors of coronary collaterals development. CONCLUSION: The presence of CE was associated with poorer coronary collateral development in patients with SCAD.

  2. Repeatability and Reproducibility of Corneal Biometric Measurements Using the Visante Omni and a Rabbit Experimental Model of Post-Surgical Corneal Ectasia

    Science.gov (United States)

    Liu, Yu-Chi; Konstantopoulos, Aris; Riau, Andri K.; Bhayani, Raj; Lwin, Nyein C.; Teo, Ericia Pei Wen; Yam, Gary Hin Fai; Mehta, Jodhbir S.

    2015-01-01

    Purpose: To investigate the repeatability and reproducibility of the Visante Omni topography in obtaining topography measurements of rabbit corneas and to develop a post-surgical model of corneal ectasia. Methods: Eight rabbits were used to study the repeatability and reproducibility by assessing the intra- and interobserver bias and limits of agreement. Another nine rabbits underwent different diopters (D) of laser in situ keratosmileusis (LASIK) were used for the development of ectasia model. All eyes were examined with the Visante Omni, and corneal ultrastructure were evaluated with transmission electron microscopy (TEM). Results: There was no significant intra- or interobserver difference for mean steep and flat keratometry (K) values of simulated K, anterior, and posterior elevation measurements. Eyes underwent −5 D LASIK had a significant increase in mean amplitude of astigmatism and posterior surface elevation with time (P for trend corneal ectasia that was gradual in development and simulated the human condition. Translational Relevance: The results provide the foundations for the future evaluation of novel treatment modalities for post-surgical ectasia and keratoconus. PMID:25938004

  3. Same-day intrastromal corneal ring segment and collagen cross-linking for ectasia after laser in situ keratomileusis: long-term results.

    Science.gov (United States)

    Yildirim, Aydin; Uslu, Hasim; Kara, Necip; Cakir, Hanefi; Gurler, Bulent; Colak, Hatice Nur; Ozgurhan, Engin Bilge

    2014-05-01

    To report the long-term results of combined same-day intrastromal corneal ring segment placement and corneal collagen cross-linking (CXL) for postoperative laser in situ keratomileusis (LASIK) ectasia. Retrospective, interventional case series. This retrospective, interventional cases series was performed in Turkiye Hospital Eye Clinic and the Department of Ophthalmology, Fatih University Medical Faculty Hospital, Istanbul, Turkey. Sixteen eyes of 14 patients with postoperative ectasia after LASIK were enrolled. All consecutive patients were treated with femtosecond laser-assisted intrastromal corneal ring segment implantation and followed by same-day corneal collagen cross-linking for ectasia occurring after LASIK. Main outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, spherical and cylindrical refraction, and simulated keratometry values. The mean age ± standard deviation of the 10 women and 4 men was 33.0 ± 6.5 years (range, 23 to 44 years), and the mean follow-up was 43 months (range, 36 to 62 months). The uncorrected distance visual acuity improved significantly from 1.18 ± 0.42 logarithm of the minimal angle of resolution (logMAR) units to 0.44 ± 0.22 logMAR (P corneal ring segment implantation combined with same-day corneal collagen cross-linking was a safe and effective treatment for ectasia occurring after LASIK. It also significantly improved the visual acuity, refraction, and keratometry values. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Prospective study of corneal collagen cross-linking efficacy and tolerance in the treatment of keratoconus and corneal ectasia: 3-year results.

    Science.gov (United States)

    Poli, Muriel; Cornut, Pierre-Loic; Balmitgere, Thomas; Aptel, Florent; Janin, Hélène; Burillon, Carole

    2013-05-01

    To assess the efficacy and tolerance of corneal collagen cross-linking with corneal epithelium debridement in the stabilizing treatment of primary or secondary corneal ectasia. Prospective, comparative, single-center study of patients presenting with progressive primary or secondary corneal ectasia. The control group, comprising the fellow eye of patients with bilateral involvement, was followed up for 6 months and then treated. The parameters examined were the biomicroscopic examination, visual acuity [best spectacle-corrected visual acuity (BSCVA) and uncorrected visual acuity (UCVA)], keratometry of the central 3 mm, intraocular pressure, central pachymetry, endothelial density, and macular profile. Fifty-five eyes of 39 patients were treated; the mean follow-up period was 20.8 ± 6.8 months (range, 12-36 months). The control group comprised 16 eyes. UCVA and BSCVA were significantly improved between 3 and 12 months, reaching their minimum at 6 months, varying from 0.12 UCVA to 0.07 BSCVA (P ectasia confirmed these results. At the end of the study, intraocular pressure, pachymetry, and endothelial density were not significantly modified, and no macular profile modification was observed. This study shows that corneal collagen cross-linking can stabilize progressive corneal ectasia, both primary and secondary, with no induced iatrogenic effects.

  5. Management of corneal ectasia after LASIK with combined, same-day, topography-guided partial transepithelial PRK and collagen cross-linking: the athens protocol.

    Science.gov (United States)

    Kanellopoulos, Anastasios John; Binder, Perry S

    2011-05-01

    To evaluate a series of patients with corneal ectasia after LASIK that underwent the Athens Protocol: combined topography-guided photorefractive keratectomy (PRK) to reduce or eliminate induced myopia and astigmatism followed by sequential, same-day ultraviolet A (UVA) corneal collagen cross-linking (CXL). Thirty-two consecutive corneal ectasia cases underwent transepithelial PRK (WaveLight ALLEGRETTO) immediately followed by CXL (3 mW/cm(2)) for 30 minutes using 0.1% topical riboflavin sodium phosphate. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, keratometry, central ultrasonic pachymetry, corneal tomography (Oculus Pentacam), and endothelial cell counts were analyzed. Mean follow-up was 27 months (range: 6 to 59 months). Twenty-seven of 32 eyes had an improvement in UDVA and CDVA of 20/45 or better (2.25 logMAR) at last follow-up. Four eyes showed some topographic improvement but no improvement in CDVA. One of the treated eyes required a subsequent penetrating keratoplasty. Corneal haze grade 2 was present in 2 eyes. Combined, same-day, topography-guided PRK and CXL appeared to offer tomographic stability, even after long-term follow-up. Only 2 of 32 eyes had corneal ectasia progression after the intervention. Seventeen of 32 eyes appeared to have improvement in UDVA and CDVA with follow-up >1.5 years. This technique may offer an alternative in the management of iatrogenic corneal ectasia. Copyright 2011, SLACK Incorporated.

  6. Two-dimensional echocardiographic and RI angiographic features of aneurysm of the ascending aorta in patients with annuloaortic ectasia

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    Nakamura, K.; Suzuki, S.; Satomi, G. (Tokyo Women' s Medical Coll. (Japan). Heart Inst. and Hospital)

    1981-03-01

    The purpose of this study was to compare the diagnostic value of two-dimensional echocardiography with that of other methods in the detection and localization of aneurysm involving the ascending aorta in patients with annuloaortic ectasia. Two-dimensional echocardiography, RI angiography, CT scan and aortography were performed in 19 patients (12 patients with Marfan's syndrome, 4 with aortitis syndrome and 3 with postoperative perivalvular aneurysm). Eight of 12 patients with Marfan's syndrome had dissection in the ascending aorta which was confirmed at surgery or autopsy. The following observations were obtained. 1) Dissection of the ascending aorta was clearly demonstrated on the two-dimensional echocardiogram in 7 patients by recording the intinal tear and flap, and in these cases the short axis two-dimensional echocardiogram of the ascending aorta was more useful in identifying the site and extent of dissection. 2) In patients with postoperative perivalvular aneurysms, RI angiography proved to be a more useful and sensitive technique in differentiating a leakage into the aneurysm from clots in the aneurysm. 3) CT scanning proved to be an insensitive technique to detect dissection of the ascending aneurysm and to differentiate a leakage from clots in the perivalvular aneurysm. From these observations, we concluded that two-dimensional echocardiography and RI angiography proved to be sensitive techniques in detecting dissection of the ascending aneurysm and evaluating a postoperative aneurysm in patients with annuloaortic ectasia.

  7. Two-dimensional echocardiographic and RI angiographic features of aneurysm of the ascending aorta in patients with annuloaortic ectasia

    International Nuclear Information System (INIS)

    Nakamura, Kenji; Suzuki, Shin; Satomi, Gengi

    1981-01-01

    The purpose of this study was to compare the diagnostic value of two-dimensional echocardiography with that of other methods in the detection and localization of aneurysm involving the ascending aorta in patients with annuloaortic ectasia. Two-dimensional echocardiography, RI angiography, CT scan and aortography were performed in 19 patients (12 patients with Marfan's syndrome, 4 with aortitis syndrome and 3 with postoperative perivalvular aneurysm). Eight of 12 patients with Marfan's syndrome had dissection in the ascending aorta which was confirmed at surgery or autopsy. The following observations were obtained. 1) Dissection of the ascending aorta was clearly demonstrated on the two-dimensional echocardiogram in 7 patients by recording the intinal tear and flap, and in these cases the short axis two-dimensional echocardiogram of the ascending aorta was more useful in identifying the site and extent of dissection. 2) In patients with postoperative perivalvular aneurysms, RI angiography proved to be a more useful and sensitive technique in differentiating a leakage into the aneurysm from clots in the aneurysm. 3) CT scanning proved to be an insensitive technique to detect dissection of the ascending aneurysm and to differentiate a leakage from clots in the perivalvular aneurysm. From these observations, we concluded that two-dimensional echocardiography and RI angiography proved to be sensitive techniques in detecting dissection of the ascending aneurysm and evaluating a postoperative aneurysm in patients with annuloaortic ectasia. (author)

  8. A Large-Scale Computational Analysis of Corneal Structural Response and Ectasia Risk in Myopic Laser Refractive Surgery.

    Science.gov (United States)

    Dupps, William Joseph; Seven, Ibrahim

    2016-08-01

    To investigate biomechanical strain as a structural susceptibility metric for corneal ectasia in a large-scale computational trial. A finite element modeling study was performed using retrospective Scheimpflug tomography data from 40 eyes of 40 patients. LASIK and PRK were simulated with varied myopic ablation profiles and flap thickness parameters across eyes from LASIK candidates, patients disqualified for LASIK, subjects with atypical topography, and keratoconus subjects in 280 simulations. Finite element analysis output was then interrogated to extract several risk and outcome variables. We tested the hypothesis that strain is greater in known at-risk eyes than in normal eyes, evaluated the ability of a candidate strain variable to differentiate eyes that were empirically disqualified as LASIK candidates, and compared the performance of common risk variables as predictors of this novel susceptibility marker across multiple virtual subjects and surgeries. A candidate susceptibility metric that expressed mean strains across the anterior residual stromal bed was significantly higher in eyes with confirmed ectatic predisposition in preoperative and all postoperative cases (P≤.003). The strain metric was effective at differentiating normal and at-risk eyes (area under receiver operating characteristic curve ≥ 0.83, P≤.002), was highly correlated to thickness-based risk metrics (as high as R(2) = 95%, Pectasia risk and provides a novel biomechanical construct for expressing structural risk in refractive surgery. Mechanical strain is an effective marker of known ectasia risk and correlates to predicted refractive error after myopic photoablative surgery.

  9. Ectasia coronaria y lesiones trombóticas como causa de síndrome coronario agudo

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    Paula Awamleh

    2017-03-01

    Full Text Available Se presenta un caso de manejo complicado y decisiones difíciles. Un paciente con antecedente de disección aórtica tipo A y dilatación residual de la aorta descendente de hasta 60 mm es ingresado por un síndrome coronario agudo sin elevación del ST. La coronariografía pone de manifiesto una marcada ectasia coronaria y unos defectos de perfusión de dudoso origen. ¿Trombos o falsas imágenes por flujo muy lentificado? Asumiendo que pudiera tratarse de trombos, el paciente es tratado con anticoagulación repitiéndose la coronariografía al cabo de dos meses. En este segundo estudio se observa la completa desaparición de las imágenes, confirmándose el origen trombótico de las mismas. En este momento se plantea ¿cuál debe ser el tratamiento crónico del paciente? No hay evidencia científica disponible acerca del tratamiento de la ectasia coronaria y se trata de un paciente de alto riesgo por su antecedente de disección aórtica. Finalmente se decide, de forma empírica, mantener la anticoagulación de forma indefinida. Tras dos años y seis meses de seguimiento no ha habido incidencias clínicas.

  10. Fructo-oligosaccharide-Induced Transient Increases in Cecal Immunoglobulin A Concentrations in Rats Are Associated with Mucosal Inflammation in Response to Increased Gut Permeability.

    Science.gov (United States)

    Genda, Tomomi; Sasaki, Yuta; Kondo, Takashi; Hino, Shingo; Nishimura, Naomichi; Tsukahara, Takamitsu; Sonoyama, Kei; Morita, Tatsuya

    2017-10-01

    Background: The mechanism underlying transient increases in immunoglobulin (Ig) A concentrations in the cecal contents of rats fed fructo-oligosaccharide (FOS) is unclear. Objective: This study was designed to test whether increased IgA concentrations represent one aspect of the inflammatory response to increased permeability induced by FOS in the cecum. Methods: Seven-week-old male Wistar rats were fed a fiber-free semipurified diet (FFP) with or without supplemental FOS (60 g/kg diet) for 9 or 58 d [experiment (expt.) 1], 7 d (expt. 2), or 7 or 56 d (expt. 3). In addition to measuring IgA concentrations in cecal content, we assessed gut permeability, inflammatory responses (expt. 1), the number of IgA plasma cells in the cecal lamina propria, polymeric Ig receptor (pIgR) expression in the cecal mucosa (expt. 2), and the condition of the cecal mucus layer (expt. 3). Results: The cecal IgA concentration in the FOS-fed rats was 15-fold higher than that of the rats fed FFP for 9 d ( P d. These effects were not observed in the rats fed FOS for 58 d (expt. 1). Accompanying the higher cecal IgA concentration, pIgR protein and the number of IgA plasma cells in the cecal mucosa were higher in the FOS-fed rats than in the rats fed FFP for 7 d (expt. 2). Destruction of the mucus layer on the epithelial surface, as evidenced by Alcian blue staining in the cecal sections, was evident in the rats fed FOS for 7 d, but the mucus layer appeared normal in the rats fed FOS for 56 d (expt. 3). Conclusions: These findings suggest that transient increases in cecal IgA concentrations induced by FOS in rats are associated with mucosal inflammation in response to increased gut permeability; these are presumably evoked by disruption of the cecal mucus barrier. The observed responses could contribute to the maturation of the gut immune system. © 2017 American Society for Nutrition.

  11. Evaluation of transport and storage techniques for isolation of Campylobacter fetus subsp. jejuni from turkey cecal specimens.

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    Luechtefeld, N W; Wang, W L; Blaser, M J; Reller, L B

    1981-01-01

    Immediate culturing of fecal specimens is not always possible, and appropriate methods for transport and storage of Campylobacter fetus subsp. jejuni specimens have not been fully evaluated. Using nine techniques, we studied the survival of C. fetus subsp. jejuni in cecal specimens from infected turkeys. The organisms survived in specimens held without transport medium for 3 to 15 days (median, 9 days) at 4 degrees C, and 2 to 9 days (median, 4 days) at 25 degrees C. Only 20% of specimens fro...

  12. A comparison of cecal colonization of Salmonella enterica serotype Typhimurium in white leghorn chicks and Salmonella-resistant mice

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    Bogomolnaya Lydia M

    2008-10-01

    Full Text Available Abstract Background Salmonellosis is one of the most important bacterial food borne illnesses worldwide. A major source of infection for humans is consumption of chicken or egg products that have been contaminated with Salmonella enterica serotype Typhimurium, however our knowledge regarding colonization and persistence factors in the chicken is small. Results We compared intestinal and systemic colonization of 1-week-old White Leghorn chicks and Salmonella-resistant CBA/J mice during infection with Salmonella enterica serotype Typhimurium ATCC14028, one of the most commonly studied isolates. We also studied the distribution of wild type serotype Typhimurium ATCC14028 and an isogenic invA mutant during competitive infection in the cecum of 1-week-old White Leghorn chicks and 8-week-old CBA/J mice. We found that although the systemic levels of serotype Typhimurium in both infected animal models are low, infected mice have significant splenomegaly beginning at 15 days post infection. In the intestinal tract itself, the cecal contents are the major site for recovery of serotype Typhimurium in the cecum of 1-week-old chicks and Salmonella-resistant mice. Additionally we show that only a small minority of Salmonellae are intracellular in the cecal epithelium of both infected animal models, and while SPI-1 is important for successful infection in the murine model, it is important for association with the cecal epithelium of 1-week-old chicks. Finally, we show that in chicks infected with serotype Typhimurium at 1 week of age, the level of fecal shedding of this organism does not reflect the level of cecal colonization as it does in murine models. Conclusion In our study, we highlight important differences in systemic and intestinal colonization levels between chick and murine serotype Typhimurium infections, and provide evidence that suggests that the role of SPI-1 may not be the same during colonization of both animal models.

  13. Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB in conjunction to Belin-Ambrósio deviation index (BAD-D

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    Renato Ambrósio Jr

    2014-04-01

    Full Text Available Purpose: To compare the ability to detect preoperative ectasia risk among LASIK candidates using classic ERSS (Ectasia Risk Score System and Pentacam Belin-Ambrósio deviation index (BAD-D, and to test the benefit of a combined approach including BAD-D and clinical data. Methods: A retrospective nonrandomized study involved preoperative LASIK data from 23 post-LASIK ectasia cases and 266 stable-LASIK (follow up > 12 months. Preoperative clinical and Pentacam (Oculus; Wetzlar, Germany data were obtained from all cases. Mann-Whitney's test was performed to assess differences between groups. Stepwise logistic regression was used for combining parameters.The areas under the Receiver Operating Characteristic (ROC curves (AUC were calculated for all parameters and combinations, with pairwise comparisons of AUC (DeLong's method. Results: Statistically significant differences were found for age, residual stromal bed (RSB, central corneal thickness and BAD-D (p0.05. ERSS was 3 or more on 12/23 eyes from the ectasia group (sensitivity = 52.17% and 48/266 eyes from the stable LASIK group (18% false positive. BAD-D had AUC of 0.931 (95% CI: 0.895 to 0.957, with cut-off of 1.29 (sensitivity = 87%; specificity = 92.1%. Formula combining BAD-D, age and RSB provided 100% sensitivity and 94% specificity, with better AUC (0.989; 95% CI: 0.969 to 0.998 than all individual parameters (p>0.001. Conclusion: BAD-D is more accurate than ERSS. Combining clinical data and BAD-D improved ectasia susceptibility screening. Further validation is necessary. Novel combined functions using other topometric and tomographic parameters should be tested to further enhance accuracy.

  14. Effects of mannan oligosaccharide and virginiamycin on the cecal microbial community and intestinal morphology of chickens raised under suboptimal conditions.

    Science.gov (United States)

    Pourabedin, Mohsen; Xu, Zhengxin; Baurhoo, Bushansingh; Chevaux, Eric; Zhao, Xin

    2014-05-01

    There is an increasing movement against use of antibiotic growth promoters in animal feed. Prebiotic supplementation is a potential alternative to enhance the host's natural defense through modulation of gut microbiota. In the present study, the effect of mannan oligosaccharide (MOS) and virginiamycin (VIRG) on cecal microbial ecology and intestinal morphology of broiler chickens raised under suboptimal conditions was evaluated. MOS and VIRG induced different bacterial community structures, as revealed by denaturing gradient gel electrophoresis of 16S rDNA. The antibiotic treatment reduced cecal microbial diversity while the community equitability increased. A higher bacterial diversity was observed in the cecum of MOS-supplemented birds. Quantitative polymerase chain reaction results indicated that MOS changed the cecal microbiota in favor of the Firmicutes population but not the Bacteroidetes population. No difference was observed in total bacterial counts among treatments. MOS promoted the growth of Lactobacillus spp. and Bifidobacterium spp. in the cecum and increased villus height and goblet cell numbers in the ileum and jejunum. These results provide a deeper insight into the microbial ecological changes after supplementation of MOS prebiotic in poultry diets.

  15. Carcinoid tumor of cecal appendix: one-year incidence at the Santa Marcelina Hospital

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    Isaac José Felippe Corrêa Neto

    2014-10-01

    Full Text Available Introduction: Carcinoid tumors are neuroendocrine malignancies that originate in the neuroectodermal cells of the Amine, Peptide Uptake and Decarboxylation system dispersed in the gastrointestinal mucosa and representing about 80–88% of tumors of cecal appendix. These are tumors usually diagnosed at appendectomies, and it is estimated that from each 100 appendectomies yearly performed, at least one case is a neuroendocrine tumor. Objectives: To report the experience of an University Teaching Hospital in health and reference at the east side of São Paulo and great São Paulo in cases of these rare appendicular tumors, with emphasis on the importance of these descriptions, as probably are rare those surgeons in particular who will acquire extensive wisdom in these cases. Method: Retrospective analysis of 237 patients who underwent appendectomy from September 2010 to September 2012 in the Hospital Santa Marcelina-SP. We evaluated data on age, gender, initial clinical presentation and surgical findings of patients undergoing appendectomy with subsequent anatomic and immunopathological diagnosis of carcinoid tumor of cecal appendix. Results: The presence of a carcinoid tumor of the appendix was observed in 5 patients, which corresponds to 2.1% of all appendectomies performed. Regarding gender, 4 patients (80% were female and the average age was 34.2 years, with a range from 17 to 68 years. In all patients the initial hypothesis for surgery indication was acute appendicitis, with an intraoperative finding of necroperforated phase acute appendicitis in 3 patients (60%. Conclusion: The therapeutical conduct after the diagnosis of carcinoid tumors of the appendix must be based on the data provided by pathological and immunohistochemical studies, besides the judicious judgment of the attending physician. Resumo: Introdução: Os tumores carcinoides são neoplasias malignas neuroendócrinas que se originam em células neuroectodérmicas do sistema APUD

  16. Campylobacter inoculation and quantification from broiler cecal samples to compare two plate counting methodologies

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    Anderlise Borsoi

    2015-02-01

    Full Text Available Campylobacteriosis is a zoonosis, a disease transmitted to humans from animals or animal products. The primarily source of Campylobacter infection in human is believed to be the handling and/or consumption of contaminated meat, especially poultry meat. Although in humans such infections are generally self-limiting, complications can arise and may include bacteraemia, Guillain-Barré syndrome, reactive arthritis and abortion. In this study, 32 birds were divided in 2 groups: a control (C group and an inoculated (I group, with 16 birds each. The I group was inoculated orally with 108 CFU/mL of Campylobacter jejuni ATCC 33291, whereas the C group was inoculated with a saline solution. Four chicks per group were euthanized by cervical dislocation at 0, 7, 14 and 21 days post-inoculation (pi. Cecum samples were collected for microbiological analyses. The samples were processed by two plate count methodologies, one developed by the USDA (United States Department of Agriculture in 2011 (B method and the other a serial dilution direct count method (A method. All birds from the C group remained negative until day 21. For the I group, the B method was found to be statistically superior to the A method for counting the recovered cells from the cecal contents at 7, 14 and 21 days pi. The microbiological direct plating counting method is a cost effective and rapid method to determine the level of contamination in broilers to help risk assessment programs at the industry level.

  17. Sepsis induced by cecal ligation and perforation (CLP) alters nucleotidase activities in platelets of rats.

    Science.gov (United States)

    Pereira, Renata S; Bertoncheli, Claudia M; Adefegha, Stephen A; Castilhos, Lívia G; Silveira, Karine L; Rezer, João Felipe P; Doleski, Pedro H; Abdalla, Fátima H; Santos, Karen F; Leal, Claudio A M; Santos, Roberto C V; Casali, Emerson A; Moritz, Cesar E J; Stainki, Daniel R; Leal, Daniela B R

    2017-10-01

    Sepsis is a potentially lethal condition, and it is associated with platelet alterations. The present study sought to investigate the activity of ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase), E-5'-nucleotidase, and ecto-adenosine deaminase (E-ADA) in the platelets of rats that were induced with sepsis. Male Wistar rats were divided into three groups of ten animals each: a negative control group (normal; NC); a group that underwent surgical procedures (sham); and a group that underwent cecal ligation and perforation (CLP). The induction of sepsis was confirmed by bacteremia, and the causative pathogen identified was Escherichia coli. Hematological parameters showed leukocytosis and thrombocytopenia in animals in the septic group. The results also revealed that there were significant (p CLP group compared to the sham and control groups. Conversely, ADP hydrolysis was significantly decreased (p CLP group compared to the sham and control groups. Purine levels were analyzed by high-performance liquid chromatography (HPLC) in serum samples from control, sham, and CLP groups. Increased concentrations of ATP, adenosine, and inosine were found in the CLP group compared to the sham and control groups. Conversely, the concentrations of ADP and AMP in the CPL group were not significantly altered. We suggest that alterations in hematological parameters, nucleotide hydrolysis in platelets, and nucleotide concentrations in serum samples of rats with induced sepsis may be related to thromboembolic events. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Alteration of the rat cecal microbiome during colonization with the helminth Hymenolepis diminuta

    Science.gov (United States)

    McKenney, Erin A; Williamson, Lauren; Yoder, Anne D; Rawls, John F; Bilbo, Staci D; Parker, William

    2015-01-01

    The microbiome is now widely recognized as being important in health and disease, and makes up a substantial subset of the biome within the ecosystem of the vertebrate body. At the same time, multicellular, eukaryotic organisms such as helminths are being recognized as an important component of the biome that shaped the evolution of our genes. The absence of these macroscopic organisms during the early development and life of humans in Western culture probably leads to a wide range of human immunological diseases. However, the interaction between the microbiome and macroscopic components of the biome remains poorly characterized. In this study, the microbiome of the cecum in rats colonized for 2 generations with the small intestinal helminth Hymenolepis diminuta was evaluated. The introduction of this benign helminth, which is of considerable therapeutic interest, led to several changes in the cecal microbiome. Most of the changes were within the Firmicutes phylum, involved about 20% of the total bacteria, and generally entailed a shift from Bacilli to Clostridia species in the presence of the helminth. The results point toward ecological relationships between various components of the biome, with the observed shifts in the microbiome suggesting potential mechanisms by which this helminth might exert therapeutic effects. PMID:25942385

  19. Cecal ameboma in nasopharyngeal carcinoma patient mimicking intra-abdominal malignancy

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    Chih-Wei Hsu

    2016-03-01

    Full Text Available Amebiasis is quite uncommon in developed countries. Its clinical presentation can vary from an asymptomatic carrier state to fulminant colitis and colonic perforation. We presented a 39-year-old female who received combined chemotherapy and radiotherapy for nasopharyngeal carcinoma 1 year prior to admission. Thereafter, she felt acute abdominal pain and diarrhea after traveling to Hainan 3 months ago. A physical examination of the patient revealed diffused peritoneal sign. Abdominal computed tomography showed a cecal tumor and intra-abdominal abscess. A subsequent exploratory laparotomy revealed an infiltrating yellowish tumor about 7 cm over the cecum and massive serous ascites. Pathology reported ambeic colitis with undermined ulcer and abscess formation of the cecum. Ameboma can be found in developed countries, particularly in patients with risk factors and a history of traveling to areas with the developing disease. Colonoscopy with biopsy is recommended for patients with suspected ameboma, and surgical intervention is likely indicated in complicated cases although the surgical mortality rate is high.

  20. Higher-order aberrations after corneal collagen crosslinking for keratoconus and corneal ectasia.

    Science.gov (United States)

    Greenstein, Steven A; Fry, Kristen L; Hersh, Matthew J; Hersh, Peter S

    2012-02-01

    To determine changes in higher-order aberrations (HOAs) after corneal collagen crosslinking (CXL). Cornea and refractive surgery practice. Prospective randomized controlled clinical trial. Corneal and ocular HOAs were measured and analyzed using the Pentacam device and Ladarwave aberrometer, respectively, at baseline and 12 months after CXL. Ninety-six eyes (64 keratoconus, 32 ectasia) of 73 patients had CXL. A fellow-eye control group comprised 42 eyes. The mean preoperative total anterior corneal HOAs, total coma, 3rd-order coma, and vertical coma were 4.68 μm ± 2.33 (SD), 4.40 ± 2.32 μm, 4.36 ± 2.30 μm, and 4.04 ± 2.27 μm, respectively. At 1 year, the mean values decreased significantly to 4.27 ± 2.25 μm, 4.01 ± 2.29 μm, 3.96 ± 2.27 μm, and 3.66 ± 2.22 μm, respectively (all Pcorneal HOAs. The mean preoperative total ocular HOAs, total coma, 3rd-order coma, trefoil, and spherical aberration were 2.80 ± 1.0 μm, 2.60 ± 1.03 μm, 2.57 ± 1.03 μm, 0.98 ± 0.46 μm, and 0.90 ± 0.42 μm, respectively. At 1 year, the mean values decreased significantly to 2.59 ± 1.06 μm, 2.42 ± 1.07 μm, 2.39 ± 1.07 μm, 0.88 ± 0.49 μm, and 0.83 ± 0.38 μm, respectively (all P=.01). After CXL, HOAs were significantly improved compared with the control group. Changes in HOAs were not statistically associated with an improvement in visual acuity or most subjective visual symptoms, however. Corneal and ocular HOAs decreased after CXL, suggesting an improvement in corneal shape. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Early modulation of the cecal microbial activity in the young rabbit with rapidly fermentable fiber: impact on health and growth.

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    Jacquier, V; Combes, S; Oswald, I P; Rogel-Gaillard, C; Gidenne, T

    2014-12-01

    This study aimed at comparing various diets predicted to induce different stimulations of the cecal microbial activity of the young rabbit fed ad libitum from 16 to 70 d of age: i) a diet enriched with rapidly fermentable fiber expected to stimulate the cecal microbial activity (RFF group); ii) a control diet with a standard composition (C group); iii) and the same control diet with tiamulin and apramycin antibiotics, expected to inhibit the microbial activity (C+AB group). A total of 398 rabbits were used from 42 litters and weaned at 28 d of age. An in vivo digestibility trial was performed on 36 rabbits of 42 to 46 d of age housed in individual metabolic cages. The feed intake and growth rates were lower in the RFF group compared with the C+AB group (-15% in ADFI and -11% in ADG, Psoluble fiber (total dietary fiber minus NDF) was greater for the RFF group. The C+AB diet had a positive effect on the postweaning morbidity rate (P<0.05) but did not affect the mortality rate and the health risk index (morbidity and mortality). Conversely, the RFF diet appeared to reduce the mortality rate compared with the C+AB diet, especially before 41 d of age. Concerning the cecal microbial activity, a supply of RFF in the diet increased the cecal VFA concentrations (+28% vs. C+AB and +22% vs. C, P<0.001) and lowered the pH. The VFA pattern was affected at 45 and 60 d, with a dominance of acetate in the RFF group (+4% vs. C+AB and C groups, P<0.001) instead of butyrate in the C+AB and C groups (-3.6% and -5% vs. C+AB and C, respectively, P<0.001). Antibiotics addition (C+AB group) reduced the VFA concentration, but only after weaning (-25% at 45 d of age) without changing the fermentation pattern. In conclusion, early intake of RFF in young rabbits stimulated the cecal microbial activity, and reduced the voluntary feed intake, leading to a reduced G:F ratio.

  2. Evaluation of intrastromal corneal ring segments for treatment of post-LASIK ectasia patients with a mechanical implantation technique

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    Tunc, Zeki; Helvacioglu, Firat; Sencan, Sadik

    2011-01-01

    Aim: To evaluate the clinical outcomes of Keraring segment implantation in patients with post- laser-assisted in situ keratomileusis (LASIK) ectasia, using a mechanical implantation technique. Materials and Methods: Twelve eyes of 10 patients with post-LASIK ectasia were enrolled. Intracorneal ring segments (ICRS) were implanted after dissection of the tunnel using Tunc's specially designed dissector under suction. A complete ophthalmic examination was performed, including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent, keratometric (K) readings, inferosuperior asymmetry index (ISAI), and ultrasound pachymetry. All 3, 6, and 12-month follow-ups were completed, and statistical analysis was performed. Results: The mean preoperative UDVA for all eyes was 1.28 ± 0.59 logMAR. At 12 months, the mean UDVA was 0.36 ± 0.19 logarithm of the Minimum Angle of Resolution (logMAR) (P=0.002), and the mean preoperative CDVA was 0.58 ± 0.3 logMAR, which improved to 0.15 ± 0.12 (P=0.002) at 1 year. There was a significant reduction in cylindrical refractive and spherical equivalent refractive error from –5.29 ± 2.47 diopters (D) and –5.54 ± 5.04 D preoperatively to –1.47 ± 0.71 D and –0.74 ± 1.07 D (P=0.001, P=0.002), respectively, at 1 year. In the same period, the mean K- readings improved from 47.93 ± 4.84 D to 40.87 ± 2.36 D (P=0.002), and the mean ISAI improved from 5.34 ± 3.05 to 2.37 ± 1.68 (P=0.003). No significant changes in mean central corneal thickness were observed postoperatively. There were no major complications during or after surgery. Conclusion: ICRS implantation using a unique mechanical dissection technique is a safe and effective treatment for post-LASIK ectasia. All parameters showed improvement at 1-year follow-up. PMID:22011487

  3. Effect of topographic cone location on outcomes of corneal collagen cross-linking for keratoconus and corneal ectasia.

    Science.gov (United States)

    Greenstein, Steven A; Fry, Kristen L; Hersh, Peter S

    2012-06-01

    To assess the effect of preoperative topographic cone location on 1-year outcomes of corneal collagen cross-linking (CXL). In this prospective, randomized, controlled clinical trial, 99 eyes (66 keratoconus, 33 ectasia) from 76 patients underwent CXL. Cone location was defined by the coordinates of preoperative maximum keratometry (maximum K) using the anterior sagittal curvature topography map (Pentacam, Oculus Optikgeräte GmbH). Patients were divided into three groups: those with a maximum K located within the central 3-mm (central cone group), 3- to 5-mm (paracentral cone group), and outside the 5-mm (peripheral cone group) optical zones. Topography and visual acuity data were obtained preoperatively and at 1 year. In the combined cohort, maximum K and uncorrected and corrected distance visual acuity significantly improved by -1.60±3.40 diopters (D) (Pectasia. Copyright 2012, SLACK Incorporated.

  4. Immunohistological Evaluation of the Healing Response at the Flap Interface in Patients With LASIK Ectasia Requiring Penetrating Keratoplasty

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    Esquenazi, Salomon; Esquenazi, Isi; Grunstein, Lev; He, Juicheng; Bazan, Haydee

    2010-01-01

    PURPOSE To evaluate the healing response at the flap interface in corneas with LASIK ectasia that required penetrating keratoplasty (PK). METHODS Corneas of five patients who developed corneal ectasia after LASIK (range: 2.5 to 5 years postoperative) were collected after corneal transplant surgery. The corneas were bisected and processed for conventional histologic analysis and immunofluorescence. RESULTS Light microscopy showed a hypocellular fibrotic scar at the wound margin compared with the adjacent corneal stroma in all eyes. All corneas had positive staining for alpha-smooth muscle actin (SMA), a myofibroblast marker. In one eye, alpha-SMA cells were located in the fibrotic scar region in the area of the semicircular ring of haze along the margin of the LASIK flap corresponding to an area of epithelial ingrowth. In all other eyes, alpha-SMA positive cells were fewer and mainly located in the superficial stroma under the epithelial wound margin surface. Type III collagen was minimal or absent in the central zone and wound margin of all corneas except for the cornea with epithelial ingrowth present in the hypercellular fibrotic scar region. Chondroitin sulfate was stronger in the periphery of the flap wound coinciding with a higher presence of alpha-SMA–positive cells in that region. Positive staining for matrix metalloproteinase 9 (MMP-9) in the paracentral wound margin scar was seen. CONCLUSIONS A wound-healing process characterized by absence of significant fibrosis and myofibroblasts at the wound edge in the flap interface was noted in all keratectatic eyes. However, changes in the composition of collagen and the presence of MMP-9 at the wound edge several years after LASIK indicates active wound remodeling that may explain the ongoing loss of tissue and tendency of the cornea to bulge. PMID:19714799

  5. Desempenho produtivo e atividade microbiana cecal de coelhos alimentados com dietas contendo diferentes níveis de amido Performance and cecal microbial activity of growing rabbits fed diets with different starch levels

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    Alex Martins Varela de Arruda

    2000-06-01

    Full Text Available Com o objetivo de avaliar a influência do amido dietético sobre o rendimento produtivo e a atividade microbiana cecal de coelhos em crescimento, quatro dietas experimentais foram elaboradas de forma a conter níveis crescentes de amido (23, 28, 33 e 38% de amido total na base da MS, os quais foram fornecidos a 32 coelhos da raça Nova Zelândia Branco, distribuídos em gaiolas de engorda individuais, seguindo um delineamento em blocos casualizados. Houve efeito linear decrescente para consumo e conversão alimentar, em que valores de 108,67 g/d e 3,216, respectivamente, foram obtidos para os animais alimentados com 38% de amido dietético. No entanto, o ganho de peso e o rendimento de carcaça não foram influenciados pelos tratamentos. Por outro lado, os valores de pH, as concentrações totais e as proporções molares dos ácidos graxos voláteis não foram influenciados pelos tratamentos, porém, para o ácido propiônico, houve efeito linear decrescente, sendo a maior proporção molar (12,06% verificada no conteúdo cecal de coelhos alimentados com 23% de amido dietético. O milho-grão apresentou maior influência sobre a atividade microbiana cecal que o amido de milho purificado, porém, sem alterar o desempenho e rendimento de carcaça.With the objective to evaluate the effect of dietary starch on the productive yield and cecal microbial activity for rabbits in the growing, four experimental diets were formulated to contain increasing corn starch levels (23, 28, 33 and 38 % total starch levels in dry matter basis. A total of 32 White New Zealand rabbits were allotted to finishing cages in a completely randomized block design. The results showed a decreasing linear effect for the feed intake and feed:gain ratio, where values of 108.67g/d and 3.216, respectively, were recorded for animals fed 38% dietary starch. However, no difference was observed for the weight gain and carcass yield. Regarding to cecal microbial activity, pH and

  6. The Impact of Lactobacillus casei on the Composition of the Cecal Microbiota and Innate Immune System Is Strain Specific.

    Science.gov (United States)

    Aktas, Busra; De Wolfe, Travis J; Safdar, Nasia; Darien, Benjamin J; Steele, James L

    2016-01-01

    The probiotic function to impact human health is thought to be related to their ability to alter the composition of the gut microbiota and modulate the human innate immune system. The ability to function as a probiotic is believed to be strain specific. Strains of Lactobacillus casei are commonly utilized as probiotics that when consumed alter the composition of the gut microbiota and modulate the host immune response. L. casei strains are known to differ significantly in gene content. The objective of this study was to investigate seven different L. casei strains for their ability to alter the murine gut microbiota and modulate the murine immune system. C57BL/6 mice were fed L. casei strains at a dose of 108 CFU/day/mouse for seven days and sacrificed 3.5h after the last administration. The cecal content and the ileum tissue were collected for microbiota analysis and immune profiling, respectively. While 5 of the L. casei strains altered the gut microbiota in a strain specific manner, two of the strains did not alter the overall cecal microbiota composition. The observed changes cluster into three groups containing between 1 and 2 strains. Two strains that did not affect the gut microbiota composition cluster together with the control in their impact on pattern recognition receptors (PRRs) expression, suggesting that the ability to alter the cecal microbiota correlates with the ability to alter PRR expression. They also cluster together in their impact on the expression of intestinal antimicrobial peptides (AMPs). This result suggests that a relationship exists between the capability of a L. casei strains to alter the composition of the gut microbiota, PRR regulation, and AMP regulation.

  7. Disruption in the cecal microbiota of chickens challenged with Clostridium perfringens and other factors was alleviated by Bacillus licheniformis supplementation.

    Science.gov (United States)

    Lin, Yicen; Xu, Shuai; Zeng, Dong; Ni, Xueqin; Zhou, Mengjia; Zeng, Yan; Wang, Hesong; Zhou, Yi; Zhu, Hui; Pan, Kangcheng; Li, Guangyao

    2017-01-01

    Clostridium perfringens can induce necrotic enteritis of chickens, which causes large economic losses every year. Bacillus licheniformis, a probiotic, can inhibit the growth of pathogenic bacteria such as Clostridium perfringens, thereby improving the health status of chickens. However, from a microbial ecology perspective, the mechanisms by which alterations to the gut microbiota improve health remain unknown. In this study, we used Illumina MiSeq sequencing to investigate the cecal microbiota of a negative control group (NC), a C. perfringens and Eimeria challenge group with fishmeal supplementation (PC), a group supplemented with fishmeal and infected with coccidia (FC), and group PC with B. licheniformis supplementation (BL). We found that the health status of C. perfringens-challenged chickens was compromised, and that B. licheniformis improved the growth of the chickens challenged with pathogens. Microbial diversity analysis and taxonomic profiling of groups NC, PC, and FC revealed a disturbed cecal microflora of the birds with C. perfringens. We also characterized the microbiota of the chickens in the BL group using several methods. Principal coordinate analysis demonstrated that, compared with group PC, the bacterial community structure of group BL was more similar to that of group NC. Linear discriminant analysis with effect size revealed less differentially represented bacterial taxa between groups BL and NC than between groups PC and NC. In addition, groups BL and NC appeared to have similar overrepresented microbial taxa (such as Bacteroides, Helicobacter, Megamonas, and Akkermansia) compared with group PC. Finally, a phylogenetic investigation of communities by reconstruction of unobserved states analysis indicated that large differences existed between group PC and groups NC and BL. In conclusion, pre-treatment with B. licheniformis reduced the disturbance of the cecal microbiome induced by challenge with C. perfringens and other factors in broiler

  8. Collagen vascular disease

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001223.htm Collagen vascular disease To use the sharing features on ... were previously said to have "connective tissue" or "collagen vascular" disease. We now have names for many ...

  9. Vascular Anomalies in Pediatrics.

    Science.gov (United States)

    Foley, Lisa S; Kulungowski, Ann M

    2015-08-01

    A standardized classification system allows improvements in diagnostic accuracy. Multidisciplinary vascular anomaly centers combine medical, surgical, radiologic, and pathologic expertise. This collaborative approach tailors treatment and management of vascular anomalies for affected individuals.

  10. Peripheral Vascular Disease

    Science.gov (United States)

    ... Topics FAQs Peripheral Vascular Disease Peripheral vascular disease (PVD) involves damage to or blockage in the blood ... the organs in and below your stomach area. PVD may also affect the arteries leading to your ...

  11. Correlation between obesity and metabolic syndrome-related factors and cecal intubation time during colonoscopy

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    Kawasato R

    2017-01-01

    Full Text Available Ryo Kawasato,1 Shinichi Hashimoto,1 Tomohiro Shirasawa,1 Atsushi Goto,1 Takeshi Okamoto,1 Jun Nishikawa,2 Isao Sakaida1 1Department of Gastroenterology and Hepatology, 2Department of Laboratory Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan Purpose: To investigate which colonoscopy (CS cases should be presided over by endoscopists in training, using factors including obesity and metabolic syndrome. Patients and methods: Items investigated were sex, age, body mass index (BMI, waist circumference, hypertension, diabetes, hyperlipidemia, history of abdominal surgery (excluding colectomy, colon diverticulosis, prescription of antithrombotic agents, and quality of bowel preparation. Expert physicians were defined as those with at least 9 years of endoscopy experience; all other physicians were defined as being in training. In a retrospective analysis, cases in which a physician in training reached the cecum within 15 minutes without requiring the involvement of the supervising physician were defined as eligible cases over which a physician in training should preside, while other cases were defined as non-eligible. Results: Overall, 813 CS cases were analyzed. Males (P<0.0001, cases started by an expert physician (P<0.0001, cases of no fellow physician involvement (P<0.0001, and cases with good bowel preparation (P<0.0001 had significantly shorter cecal intubation times. Of the 562 cases presided over by a physician in training, 194 were deemed eligible and 368 non-eligible. The eligible cases had a higher proportion of males (P=0.017, younger age (P=0.033, higher BMI (P=0.034, and higher rates of hypertension (P=0.001 and good bowel preparation (P=0.001. In analysis by sex, males demonstrated significantly more eligible cases among younger patients (P=0.009 and those with good bowel preparation (P=0.008, while there were significantly more eligible cases among females with hypertension (P=0.004. Conclusion: It may be

  12. Western diet enhances hepatic inflammation in mice exposed to cecal ligation and puncture

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    Houghton Jeff

    2010-10-01

    Full Text Available Abstract Background Obese patients display an exaggerated morbidity during sepsis. Since consumption of a western-style diet (WD is a major factor for obesity in the United States, the purpose of the present study was to examine the influence of chronic WD consumption on hepatic inflammation in mice made septic via cecal ligation and puncture (CLP. Feeding mice diets high in fat has been shown to enhance evidence of TLR signaling and this pathway also mediates the hepatic response to invading bacteria. Therefore, we hypothesized that the combined effects of sepsis and feeding WD on TRL-4 signaling would exacerbate hepatic inflammation. Male C57BL/6 mice were fed purified control diet (CD or WD that was enriched in butter fat (34.4% of calories for 3 weeks prior to CLP. Intravital microscopy was used to evaluate leukocyte adhesion in the hepatic microcirculation. To demonstrate the direct effect of saturated fatty acid on hepatocytes, C3A human hepatocytes were cultured in medium containing 100 μM palmitic acid (PA. Quantitative real-time PCR was used to assess mRNA expression of tumor necrosis factor-alpha (TNF-α, monocyte chemotactic protein-1 (MCP-1, intercellular adhesion molecule-1 (ICAM-1, toll-like receptor-4 (TLR-4 and interleukin-8 (IL-8. Results Feeding WD increased firm adhesion of leukocytes in the sinusoids and terminal hepatic venules by 8-fold six hours after CLP; the increase in platelet adhesion was similar to the response observed with leukocytes. Adhesion was accompanied by enhanced expression of TNF-α, MCP-1 and ICAM-1. Messenger RNA expression of TLR-4 was also exacerbated in the WD+CLP group. Exposure of C3A cells to PA up-regulated IL-8 and TLR-4 expression. In addition, PA stimulated the static adhesion of U937 monocytes to C3A cells, a phenomenon blocked by inclusion of an anti-TLR-4/MD2 antibody in the culture medium. Conclusions These findings indicate a link between obesity-enhanced susceptibility to sepsis and

  13. Predictors for difficult cecal insertion in colonoscopy: The impact of obesity indices.

    Science.gov (United States)

    Moon, Soo Yun; Kim, Byung Chang; Sohn, Dae Kyung; Han, Kyung Su; Kim, Bun; Hong, Chang Won; Park, Bum Joon; Ryu, Kum Hei; Nam, Ji Hyung

    2017-04-07

    To identify the factors influencing cecal insertion time (CIT) and to evaluate the effect of obesity indices on CIT. We retrospectively reviewed the data for participants who received both colonoscopy and abdominal computed tomography (CT) from February 2008 to May 2008 as part of a comprehensive health screening program. Age, gender, obesity indices [body mass index (BMI), waist-to-hip circumference ratio (WHR), waist circumference (WC), visceral adipose tissue (VAT) volume and subcutaneous adipose tissue (SAT) volume on abdominal CT], history of prior abdominal surgery, constipation, experience of the colonoscopist, quality of bowel preparation, diverticulosis and time required to reach the cecum were analyzed. CIT was categorized as longer than 10 min (prolonged CIT) and shorter than or equal to 10 min, and then the factors that required a CIT longer than 10 min were examined. A total of 1678 participants were enrolled. The mean age was 50.42 ± 9.931 years and 60.3% were men. The mean BMI, WHR, WC, VAT volume and SAT volume were 23.92 ± 2.964 kg/m 2 , 0.90 ± 0.076, 86.95 ± 8.030 cm, 905.29 ± 475.220 cm 3 and 1707.72 ± 576.550 cm 3 , respectively. The number of patients who underwent abdominal surgery was 268 (16.0%). Colonoscopy was performed by an attending physician alone in 61.9% of cases and with the involvement of a fellow in 38.1% of cases. The median CIT was 7 min (range 2-56 min, IQR 5-10 min), and mean CIT was 8.58 ± 5.291 min. Being female, BMI, VAT volume and involvement of fellow were significantly associated with a prolonged CIT in univariable analysis. In multivariable analysis, being female (OR = 1.29, P = 0.047), lower BMI (< 23 kg/m 2 ) (OR = 1.62, P = 0.004) or higher BMI (≥ 25 kg/m 2 ) (OR = 1.80, P < 0.001), low VAT volume (< 500 cm 3 ) (OR = 1.50, P = 0.013) and fellow involvement (OR = 1.73, P < 0.001) were significant predictors of prolonged CIT. In subgroup analyses for gender, lower BMI or higher BMI and fellow involvement were

  14. Cirrose biliar em felinos associada à ectasia do ducto cístico e desvios portossistêmicos extra-hepáticos Biliary cirrhosis in cats associated with cystic duct ectasia and extra-hepatic portosystemic Shunts

    Directory of Open Access Journals (Sweden)

    Marcia Regina da Silva Ilha

    2004-08-01

    Full Text Available Descrevem-se três casos de cirrose biliar em felinos. O quadro clínico manifestado pelos animais afetados consistia em icterícia, vômitos, emagrecimento progressivo, prostração, anorexia e aumento de volume do abdome acompanhado de dor abdominal. Os principais achados macroscópicos incluíam fígado firme e com a superfície natural e de corte irregulares e de aspecto reticulado, ducto cístico acentuadamente distendido (ectasia, desvios portossistêmicos venosos extra-hepáticos ("shunts", efusões cavitárias e carcaças em mau estado corporal. Histologicamente, havia fibrose periportal acentuada, dissecante, associada a infiltrado inflamatório mononuclear, proliferação ductal e retenção biliar. Em um dos casos, a coloração de Brown-Hopps revelou a presença de cocos gram-positivos associada à inflamação no lúmen ductal. A presença de bactérias intralesionais é um achado histológico raramente descrita no complexo colangite/colangio-hepatite felina e não tem sido descrita na cirrose biliar. Ectasia do ducto cístico e formação de desvios portossistêmicos extra-hepáticos são complicações incomuns do estágio terminal dessa síndrome. Cirrose biliar é a forma de apresentação menos comum do complexo colangite/colangio-hepatite felina. O número reduzido de casos dessa condição se deve ao fato de que a maior parte dos animais afetados por esse complexo morrem espontaneamente ou são submetidos à eutanásia antes de a doença progredir para a sua fase terminal. Desconhece-se a prevalência dessa enfermidade nas populações felinas locais das diversas regiões do Brasil.Three cases of biliary cirrhosis in cats are described. Clinical signs included icterus, vomiting, weight loss, depression, anorexia and distension of the abdomen accompanied by abdominal pain. Main gross findings included firm liver with irregular capsular and cut surfaces and enhanced reticular pattern, marked distension of the cystic duct

  15. Salmonella enterica serotype Typhimurium Std fimbriae bind terminal alpha(1,2)fucose residues in the cecal mucosa.

    Science.gov (United States)

    Chessa, Daniela; Winter, Maria G; Jakomin, Marcello; Bäumler, Andreas J

    2009-02-01

    The std operon encodes a fimbrial adhesin of Salmonella enterica serotype Typhimurium that is required for attachment to intestinal epithelial cells and for cecal colonization in the mouse. To study the mechanism by which this virulence factor contributes to colonization we characterized its binding specificity. Std-mediated binding to human colonic epithelial (Caco-2) cells could be abrogated by removing N-linked glycans. Adherence of Std fimbriated S. Typhimurium to Caco-2 cells could be blocked by co-incubation with H type 2 oligosaccharide (Fucalpha1-2Galbeta1-4GlcNAc) or by pretreatment of cells with alpha1-2 fucosidase. In contrast, pretreatment of Caco-2 cells with neuraminidase or co-incubation with the type 2 disaccharide precursor (Galbeta1-4GlcNAc) did not reduce adherence of Std fimbriated S. Typhimurium. Binding of purified Std fimbriae to Fucalpha1-2Galbeta1-4GlcNAc in a solid phase binding assay was competitively inhibited by Ulex europaeus agglutinin-I (UEA-I), a lectin specific for Fucalpha1-2 moieties. Purified Std fimbriae and UEA both bound to a receptor localized in the mucus layer of the murine cecum. These data suggest that the std operon encodes an adhesin that binds an alpha1-2 fucosylated receptor(s) present in the cecal mucosa.

  16. Effect of propolis alcoholic extract on the weight gain, carcass traits and cecal pH of growing rabbits

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    Joseli Alves Ferreira Zanato

    2007-06-01

    Full Text Available The objective of this experiment was to evaluate the effect of different rates of propolis alcoholic extract (PAE on the weight gain, carcass traits and cecal pH of growing rabbits. Forty White New Zealand rabbits were distributed in a completely randomized experimental design consisting of four treatments and ten replicates per treatment. The rabbits were allocated individually in wire cages containing a nipple drinker and a semi-automatic feeder. The treatments were: T1 = control, T2 = 1ml of ethanol, T3 = 0.8ml of PAE, and T4 = 1.5ml of PAE. Commercial feed and water were provided ad libitum to the animals, and the treatment with cereal alcohol and PAE was administered orally using a 2ml syringe. It was concluded that the addition of PAE to the rabbits’ feeding resulted in weight gain, carcass traits and cecal pH similar to those of animals which received the diets with ethanol without any addition, except for the paw weight, that was higher in the rabbits which were given PAE, and for the gastric system, that had a higher weight in the rabbits which received no addition to their diet.

  17. Effect of Dietary Fibers on Cecal Microbiota and Intestinal Tumorigenesis in Azoxymethane Treated A/J Min/+ Mice

    Science.gov (United States)

    Måge, Ingrid; Knutsen, Svein Halvor; Rud, Ida; Hetland, Ragna Bogen; Paulsen, Jan Erik

    2016-01-01

    Foods naturally high in dietary fiber are generally considered to protect against development of colorectal cancer (CRC). However, the intrinsic effect of dietary fiber on intestinal carcinogenesis is unclear. We used azoxymethane (AOM) treated A/J Min/+ mice, which developed a significantly higher tumor load in the colon than in the small intestine, to compare the effects of dietary inulin (IN), cellulose (CE) or brewers spent grain (BSG) on intestinal tumorigenesis and cecal microbiota. Each fiber was tested at two dose levels, 5% and 15% (w/w) content of the AIN-93M diet. The microbiota was investigated by next-generation sequencing of the 16S rRNA gene (V4). We found that mice fed IN had approximately 50% lower colonic tumor load than mice fed CE or BSG (pBSG. The Bacteroidetes/Firmicutes ratio was significantly (p = 0.003) different between the three fiber diets with a higher mean value in IN fed mice compared with BSG and CE. We also found a relation between microbiota and the colonic tumor load, where many of the operational taxonomic units (OTUs) related to low tumor load were significantly enriched in mice fed IN. Among the OTUs related to low tumor load were bacteria affiliated with the Bacteroides genus. These results suggest that type of dietary fiber may play a role in the development of CRC, and that the suppressive effect of IN on colonic tumorigenesis is associated with profound changes in the cecal microbiota profile. PMID:27196124

  18. Diet structure, butyric acid, and fermentable carbohydrates influence growth performance, gut morphology, and cecal fermentation characteristics in broilers.

    Science.gov (United States)

    Qaisrani, S N; van Krimpen, M M; Kwakkel, R P; Verstegen, M W A; Hendriks, W H

    2015-09-01

    An experiment with 288 male (Ross 308) 1-d-old broilers was conducted to test the hypothesis that a coarse diet supplemented with butyric acid (BA) and fermentable carbohydrates (FC) improves performance of broilers with a poorly digestible protein source. The interaction effects of diet structure (fine or coarse), FC supplementation (with or without), and BA supplementation (with or without) in a poorly digestible diet based on rapeseed meal (RSM) were tested in a factorial arrangement of 8 (2×2×2) dietary treatments. The coarseness of the diet affected feed intake (FI) (PFermentable carbohydrate supplementation did not influence growth performance, gut development, or contents of total BCFA and total biogenic amines in the cecal digesta (P>0.05). Supplementation with FC, however, decreased the cecal concentration of spermine by approximately 31% compared with broilers fed diets without FC (P=0.002). In conclusion, feeding a coarse diet supplemented with BA improved performance of broilers fed a diet containing a poorly digestible protein source. The negative effects of a poorly digestible protein source can thus be partly counterbalanced by coarse grinding and BA supplementation in the diet. © The Author 2015. Published by Oxford University Press on behalf of Poultry Science Association.

  19. Evaluation of the effect of trimetazidine on Tc-99m methoxyisobutyl isonitrile gated scintigraphy in patients with coronary artery ectasia

    International Nuclear Information System (INIS)

    Okudan, B.; Ozbek, Feride M.; Yildiz, Mustafa; Dogan, Abdullah; Ozturk, Begum

    2005-01-01

    Coronary artery ectasia (CAE) is the abnormal dilatation of a segment of the coronary artery to a diameter of at least 1.5 times that of normal adjacent segments. Symptoms are variable, and its prognosis and treatment modalities are unclear. The aim of this study is to evaluate the effect of trimetazidine (TMZ) on ischemic left ventricular function by rest-stress Tc-99m methoxyisobutyl isonitrile (Tc-99m MIBI) myocardial scintigraphy in symptomatic patients with CAE. We included patients with ectasia admitted to our Cardiology Department, Turkey, between 2003 and 2004 in this study. All patients underwent coronary angiography and diagnosed with CAE, before and 4 weeks after TMZ administration. Seventeen patients (9 men, 8 women) underwent gated single-proton emission tomographic (SPECT) using Tc-99m MIBI. We performed quantitative global and regional ventricular functional analysis using quantitative gated SPECT software. The global ejection fraction increased from 59.9%+/-8.9% to 62.6%+/-8.3% after therapy (p=0.033). In addition, the end systolic volume and the end diastolic volume decreased after therapy (101.7+/-23.5 ml to 95.1+/-22.9 ml, p=0.002; from 41.1+/-14.3 to 36.4+/-13.6, p=002). In all segments, we observed significant post-therapy increases in relative tracer uptake. Percentage of MIBI uptake was 71.2+/-15.3 at baseline stress and 73.2+/-15 post-TMZ (p=0.001). As global function parameters, the total wall motion normal areas changed significantly (67-74% p=0.01) after therapy, but the total wall thickness did not changed significantly(49-45%, p=0.21). The results of this study demonstrate that TMZ improves myocardial function by rest-stress Tc-99m MIBI gated SPECT during stress-induced ischemia in patients with CAE. Also, the outcomes revealed improvement in functional parameters, and percentage of MIBI uptake post TMZ administration. We can use this procedure to monitor the effect of TMZ in CAE patients. (author)

  20. Epithelium-off versus transepithelial corneal collagen crosslinking for progressive corneal ectasia: a randomised and controlled trial.

    Science.gov (United States)

    Rush, Sloan W; Rush, Ryan B

    2017-04-01

    To compare the outcomes of corneal collagen crosslinking (CXL) for the treatment of progressive corneal ectasia using a standard epithelium-off technique versus a transepithelial technique with enhanced riboflavin solution. One hundred and forty-four eyes with progressive corneal ectasia were prospectively randomised into a transepithelial CXL study arm or an epithelium-off CXL control arm. Follow-up examinations were set at 3, 6, 12 and 24 months. The primary outcome measure was change in the maximum simulated keratometry value (K steep ) after 24 months of follow-up. The secondary outcome measure was change in the best spectacle-corrected visual acuity (BSCVA) after 24 months follow-up. One hundred and thirty-one eyes completed the 24-month follow-up interval. Change in K steep was -1.52±0.66 dioptres (D) for the control group versus -0.54±0.58 D for the study group at 24 months of follow-up (p=0.0320). Change in BSCVA was -0.18±0.09 logMAR for the control group versus -0.14±0.08 logMAR for the study group at 24 months of follow-up (p=0.4978). Two eyes in the control group had minor postoperative complications that did not affect the final visual acuity, and one eye in the control group underwent keratoplasty during the study interval. At 24 months of follow-up, subjects in the epithelium-off CXL group demonstrated a greater improvement in K steep compared with subjects in the transepithelial CXL group, but no statistically significant difference in BSCVA was found between groups. NCT01708538; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Metabolomic Analyses of Brain Tissue in Sepsis Induced by Cecal Ligation Reveal Specific Redox Alterations-Protective Effects of the Oxygen Radical Scavenger Edaravone

    DEFF Research Database (Denmark)

    Hara, Naomi; Chijiiwa, Miyuki; Yara, Miki

    2015-01-01

    at analyzing the preventive effect of the free radical scavenger edaravone on sepsis-induced brain alterations. Sepsis was induced by cecal ligation and puncture (CLP) and the mice were divided into three groups-CLP vehicle (CLPV), CLP and edaravone (MCI-186, 3-methyl-1-phenyl-2-pyrazolin-5-one) (CLPE...

  2. Treatment with 24 h-delayed normo- and hyperbaric oxygenation in severe sepsis induced by cecal ligation and puncture in rats

    DEFF Research Database (Denmark)

    Bærnthsen, Nina Falcon; Hansen, Marco Bo; Wahl, Anna Mygind

    2017-01-01

    uncertain. We investigated the effects of 24 h delayed normobaric oxygen (NBO2) and HBO2treatment on the endogenous production of the inflammatory markers interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-10, and on mortality in rats with cecal ligation and puncture (CLP) induced sepsis. Method...

  3. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    Energy Technology Data Exchange (ETDEWEB)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F. [Dept. of Radiology, Univ. Hospital, Gent (Belgium); Tongerloo, A.J. van; Paepe, A.M. de [Dept. of Medical Genetics, Univ. Hospital, Gent (Belgium)

    1999-11-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, {chi} {sup 2}-test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  4. Removal and Repositioning of Intracorneal Ring Segments: Improving Corneal Topography and Clinical Outcomes in Keratoconus and Ectasia.

    Science.gov (United States)

    Chan, Kahei; Hersh, Peter S

    2017-02-01

    To evaluate the efficacy of removal and relocation of intracorneal ring segments for improving outcomes in treatment of keratoconus and corneal ectasia. This is a retrospective case series conducted at a cornea and refractive surgery subspecialty practice setting. Patients with previous insertion of 2 intracorneal ring segments underwent surgical removal and repositioning of segments because of unsatisfactory visual and topographic outcomes. The principal outcomes included uncorrected and corrected visual acuities, manifest refraction, topography-derived maximum keratometry (Kmax), inferior-superior topography power difference (I - S), and higher-order aberration profile derived from wavefront analysis. Three patients are presented in this case series. Uncorrected visual acuity improved in all eyes by an average of 2.75 lines. Corrected visual acuity improved in 2 eyes and remained unchanged in 1 eye. Refractive astigmatism decreased in all patients by an average of 2.50 D. Kmax decreased by an average of 1.43 D. All patients had improvement in the I - S value with a mean decrease of 5.13 D. Topography-guided repositioning and/or replacement of corneal ring segments can result in improved topographic, optical, and visual outcomes in patients in whom the initial result is suboptimal. In these cases, a single segment repositioned beneath the cone resulted in an improved outcome. Analysis of corneal topography can guide the surgeon in treatment planning and can suggest patients in whom such an effort will be rewarded with better results.

  5. Natural history of corneal haze after collagen crosslinking for keratoconus and corneal ectasia: Scheimpflug and biomicroscopic analysis.

    Science.gov (United States)

    Greenstein, Steven A; Fry, Kristen L; Bhatt, Jalpa; Hersh, Peter S

    2010-12-01

    To determine the natural history of collagen crosslinking (CXL)-associated corneal haze measured by Scheimpflug imagery and slitlamp biomicroscopy in patients with keratoconus or ectasia after laser in situ keratomileusis. Cornea and refractive surgery subpecialty practice, United States. Prospective randomized controlled clinical trial. The treatment group received ultraviolet-A/riboflavin CXL therapy. The control group received riboflavin alone without epithelial debridement. To objectively measure CXL-associated corneal haze, corneal densitometry using Scheimpflug imagery was measured and the changes in haze were analyzed over time. A similar analysis was performed using clinician-determined slitlamp haze. Correlation of CXL-associated corneal haze with postoperative outcomes was analyzed. The mean preoperative corneal densitometry was 14.9 ± 1.93 (SD) (Pentacam Scheimpflug densitometry units). Densitometry peaked at 1 month (mean 23.4 ± 4.40; Pectasia group (16.1 ± 2.41; P = .15). The postoperative course of slitlamp haze was similar to objective densitometry measurements. Increased haze, measured by densitometry, did not correlate with postoperative clinical outcomes. The time course of corneal haze after CXL was objectively quantified; it was greatest at 1 month, plateaued at 3 months, and was significantly decreased between 3 months and 12 months. Changes in haze did not correlate with postoperative clinical outcomes. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Nonlinear optical collagen cross-linking and mechanical stiffening: a possible photodynamic therapeutic approach to treating corneal ectasia

    Science.gov (United States)

    Chai, Dongyul; Juhasz, Tibor; Brown, Donald J.; Jester, James V.

    2013-03-01

    In this study we test the hypothesis that nonlinear optical (NLO) multiphoton photoactivation of riboflavin using a focused femtosecond (FS) laser light can be used to induce cross-linking (CXL) and mechanically stiffen collagen as a potential clinical therapy for the treatment of keratoconus and corneal ectasia. Riboflavin-soaked, compressed collagen hydrogels are cross-linked using a FS laser tuned to 760 nm and set to either 100 mW (NLO CXL I) or 150 mW (NLO CXL II) of laser power. FS pulses are focused into the hydrogel using a 0.75 NA objective lens, and the hydrogel is three-dimensionally scanned. Measurement of hydrogel stiffness by indentation testing show that the calculated elastic modulus (E) values are significantly increased over twofold following NLO CXL I and II compared with baseline values (P0.05). This data suggests that NLO CXL has a comparable effect to conventional UVA CXL in mechanically stiffening collagen and may provide a safe and effective approach to localize CXL at different regions and depths within the cornea.

  7. Intraoperative corneal thickness measurements during corneal collagen cross-linking with isotonic riboflavin solution without dextran in corneal ectasia.

    Science.gov (United States)

    Cınar, Yasin; Cingü, Abdullah Kürşat; Sahin, Alparslan; Türkcü, Fatih Mehmet; Yüksel, Harun; Caca, Ihsan

    2014-03-01

    Abstract Objective: To monitor the changes in corneal thickness during the corneal collagen cross-linking procedure by using isotonic riboflavin solution without dextran in ectatic corneal diseases. The corneal thickness measurements were obtained before epithelial removal, after epithelial removal, following the instillation of isotonic riboflavin solution without dextran for 30 min, and after 10 min of ultraviolet A irradiation. Eleven eyes of eleven patients with progressive keratoconus (n = 10) and iatrogenic corneal ectasia (n = 1) were included in this study. The mean thinnest pachymetric measurements were 391.82 ± 30.34 µm (320-434 µm) after de-epithelialization of the cornea, 435 ± 21.17 µm (402-472 µm) following 30 min instillation of isotonic riboflavin solution without dextran and 431.73 ± 20.64 µm (387-461 µm) following 10 min of ultraviolet A irradiation to the cornea. Performing corneal cross-linking procedure with isotonic riboflavin solution without dextran might not induce corneal thinning but a little swelling throughout the procedure.

  8. Vascularity in thyroid neoplasms

    DEFF Research Database (Denmark)

    Larsen, Karen Kjaer; Andersen, Niels Frost; Melsen, Flemming

    2006-01-01

    The aim of the present study was to evaluate the reliability of four different methods (vascular grading, Chalkley count, microvessel density (MVD) and stereological estimation) for quantifying intratumoral microvascularity in thyroid neoplasms, by comparing the variability within and between...... count should be the preferred method for assessing microvascularity in thyroid neoplasms. The diagnostic evaluation revealed a tendency towards higher degree of vascularity in FA compared to both FC and PC for all methods. No statistically significant association was seen between vascular density...

  9. A Novel Hands-Free Abdominal Compression Device for Colonoscopy Significantly Decreases Cecal Intubation Time: A Prospective Single-Blinded Pilot Study.

    Science.gov (United States)

    Schulman, Allison R; Ryou, Marvin; Chan, Walter W

    2017-06-01

    Colonoscopy outcome is limited by endoscope looping, which leads to patient discomfort, prolonged procedure, and increased sedation requirement. Traditional manual abdominal pressure is imprecise and manually intensive. A hands-free abdominal compression device (ACD) may improve colonoscopy outcome. We aimed to assess the effect of a novel ACD on colonoscopy outcomes compared to manual pressure. This was a prospective single-blinded study of patients undergoing outpatient colonoscopy. The ACD (N-Doe Pillow™) was applied on 50 consecutive patients. Endoscopists were blinded to device usage. Control cases using manual pressure were randomly selected in a 2:1 manner. Primary outcome was cecal intubation time. Secondary outcomes included sedation requirement and complications. Subgroup analyses evaluated ACD effect on endoscopists with different experiences and patients at higher risk of difficult colonoscopy. Fisher's exact and Student's t-tests were performed for univariate analyses. Multivariate analysis was performed using generalized linear regression. Fifty patients undergoing colonoscopy with ACD assistance were compared to 100 matched controls. Mean cecal intubation time was significantly reduced in the ACD group compared to controls (6.38 minutes versus 11.8 minutes, P ACD use was independently associated with reduction in cecal intubation time (β-coeff: -4.11, P = .007). Subgroup analyses revealed a trend toward increased improvement in cecal intubation time among junior endoscopists and obese patients. A novel, hands-free ACD significantly decreased cecal intubation time in this prospective, single-blinded, match-controlled study. A trend toward more improvement was seen among junior faculty, suggesting an application for trainees and/or endoscopists with smaller case volumes.

  10. Ileostomia continente com preservação da papila íleo-cecal Continent ileostomy with preservation of the ileocecal sphincter

    Directory of Open Access Journals (Sweden)

    GJS FORMIGA

    2000-01-01

    Full Text Available Seis doentes foram submetidos a ileostomia continente com preservação da papila íleo-cecal, como tempo cirúrgico complementar à proctocolectomia e à colectomia totais, para tratamento de doença inflamatória intestinal e polipose adenomatosa familiar, associada a pólipo degenerado no reto inferior. A técnica utilizada de ileostomia continente preserva a papila íleo-cecal e uma pequena borda circular de parede cecal exteriorizados na parede abdominal. O débito ileal, na primeira semana pós-operatória, não ultrapassou 430 ml/dia, não houve complicações do procedimento e o aspecto estético ficou excelente. Conclui-se que a ileostomia continente com preservação da papila íleo-cecal, definitiva ou temporária, é um procedimento cirúrgico eficiente, em casos selecionados, quando se deseja manter um controle eficaz do efluente intestinal.The authors report three cases of patients submitted to definitive continent ileostomy and three cases of temporary continent ileostomy. Five of them had inflammatory bowel disease and one had familial adenomatous polyposis associated to lower rectal cancer. It was used the continent ileostomy technique, keeping the ileocecal sphincter and a small border of cecal wall. The ileal flow in the first week of post operative does not overflow 430 ml per day. They conclude that the continent ileostomy is useful procedure in selected cases when we need to keep an efficient control of the intestinal effluent.

  11. Effects of cecal oxytetracycline infusion, and dietary avidin and biotin supplementation on the biotin status of nongravid gilts.

    Science.gov (United States)

    Hamilton, C R; Veum, T L

    2012-11-01

    The objective of this 49-d experiment was to test effects of cecal oxytetracycline (OTC) infusion, and dietary avidin and biotin supplementation on the biotin status of nongravid gilts. Twenty-eight crossbred gilts with an initial age of 160 d and BW of 120 kg were surgically fitted with a T-cannula in the terminal ileum, a cecal fistula, and an indwelling catheter in the anterior vena cava, and allotted to 7 dietary treatments. Treatments with the basal semipurified (SP) diet fed at 1.86 kg/d were: SP-1, negative control; SP-2, positive control with 270 μg of biotin/kg; SP-3, with spray-dried egg albumen (EA, 100 g/d) and OTC (2.56 g/d by cecal infusion); and SP-4, with EA, OTC, and 700 μg of biotin/kg. Treatments with the basal corn-soybean meal (CS) diet fed at 1.80 kg/d were: CS-1, negative control; CS-2, with EA and OTC; and CS-3, with EA, OTC, and 700 μg of biotin/kg. Response criteria were: fecal bacteria counts; plasma concentrations of biotin, glucose, and urea N (PUN); liver pyruvate carboxylase (PC) activity; kidney and epithelial tissue histology; ileal and fecal biotin concentrations; ileal and total tract N and energy utilization; daily gilt observation; and BW gain. Blood samples were collected every 7 d with serial samples collected on d 49. Total urine collections and fecal grab samples were made twice daily from d 44 to 49. Gilts were killed on d 50 and liver, kidney, and skin samples were collected. No gilts had symptoms of biotin deficiency. There were no treatment differences in BW gain, plasma glucose concentrations, liver PC activity, kidney and epithelial tissue histology, or fecal bacteria counts. Ileal and total tract N and energy digestibilities (%) did not differ among treatments within the same protein source, with greater (P ≤ 0.05) values for gilts on the SP treatments than the CS treatments. However, N retained/N absorbed and N retained/N intake (%) were less (P ≤ 0.05) and PUN concentrations were greater (P ≤ 0.05) for SP

  12. Low-Molecular-Weight Chitosan Supplementation Increases the Population of Prevotella in the Cecal Contents of Weanling Pigs

    Directory of Open Access Journals (Sweden)

    Ting Yu

    2017-11-01

    Full Text Available Low-molecular-weight chitosan (LC promoted growth in weaned piglets as an alternative to feed-grade antibiotics. To investigate the influence of LC supplementation on piglets' gut microbiome and compare the differences in community composition between LC and antibiotics with ZnO addition, we assessed the cecal microbial community by 16S rRNA gene sequencing with three treatments consisting of basal diet (CTR group, basal diet with low-molecular-weight chitosan (LC group, and basal diet with antibiotic and ZnO (AZ group. LC decreased pH more than AZ did in the cecum (both compared to CTR. Beta diversity analysis showed that community structure was distinctly different among the CTR, LC, and AZ treatments, indicating that either LC or AZ treatment modulated the piglet microbiota. Bacteroidetes, Firmicutes, and Proteobacteria dominated the community [>98% of operational taxonomic units (OTUs] in piglet cecal contents. Compared to CTR, both LC, and AZ increased the relative abundance of Bacteroidetes while they decreased the count of Firmicutes and AZ decreased the population of Proteobacteria. In CTR the top four abundant genera were Prevotella (~10.4%, Succinivibrio (~6.2%, Lactobacillus (~5.6%, and Anaerovibrio (5.4%. Both LC and AZ increased the relative abundance of Prevotella but decreased the ratio of Lactobacillus when they compared with CTR. Moreover, LC increased the relative abundance of Succinivibrio and Anaerovibrio while AZ decreased them. The microbial function prediction showed LC enriched more pathways in the metabolism of cofactors and vitamins than CTR or AZ did. LC may potentially function as an alternative to feed-grade antibiotics in weaned piglets due to its beneficial regulation of the intestinal microbiome.

  13. Differential responses of cecal microbiota to fishmeal, Eimeria and Clostridium perfringens in a necrotic enteritis challenge model in chickens.

    Directory of Open Access Journals (Sweden)

    Dragana Stanley

    Full Text Available Clostridium perfringens causes enteric diseases in animals and humans. In poultry, avian-specific C. perfringens strains cause necrotic enteritis, an economically significant poultry disease that costs the global industry over $2 billion annually in losses and control measures. With removal of antibiotic growth promoters in some countries this disease appears to be on the rise. In experimental conditions used to study disease pathogenesis and potential control measures, reproduction of the disease relies on the use of predisposing factors such as Eimeria infection and the use of high protein diets, indicating complex mechanisms involved in the onset of necrotic enteritis. The mechanisms by which the predisposing factors contribute to disease progression are not well understood but it has been suggested that they may cause perturbations in the microbiota within the gastrointestinal tract. We inspected changes in cecal microbiota and short chain fatty acids (SCFA induced by Eimeria and fishmeal, in birds challenged or not challenged with C. perfringens. C. perfringens challenge in the absence of predisposing factors did not cause significant changes in either the alpha or beta diversity of the microbiota nor in concentrations of SCFA. Moreover, there was no C. perfringens detected in the cecal microbiota 2 days post-challenge without the presence of predisposing factors. In contrast, both fishmeal and Eimeria caused significant changes in microbiota, seen in both alpha and beta diversity and also enabled C. perfringens to establish itself post challenge. Eimeria had its strongest influence on intestinal microbiota and SCFA when combined with fishmeal. Out of 6 SCFAs measured, including butyric acid, none were significantly influenced by C. perfringens, but their levels were strongly modified following the use of both predisposing factors. There was little overlap in the changes caused following Eimeria and fishmeal treatments, possibly indicating

  14. Effect of Dietary Fibers on Cecal Microbiota and Intestinal Tumorigenesis in Azoxymethane Treated A/J Min/+ Mice.

    Directory of Open Access Journals (Sweden)

    Birgitte Moen

    Full Text Available Foods naturally high in dietary fiber are generally considered to protect against development of colorectal cancer (CRC. However, the intrinsic effect of dietary fiber on intestinal carcinogenesis is unclear. We used azoxymethane (AOM treated A/J Min/+ mice, which developed a significantly higher tumor load in the colon than in the small intestine, to compare the effects of dietary inulin (IN, cellulose (CE or brewers spent grain (BSG on intestinal tumorigenesis and cecal microbiota. Each fiber was tested at two dose levels, 5% and 15% (w/w content of the AIN-93M diet. The microbiota was investigated by next-generation sequencing of the 16S rRNA gene (V4. We found that mice fed IN had approximately 50% lower colonic tumor load than mice fed CE or BSG (p<0.001. Surprisingly, all three types of fiber caused a dose dependent increase of colonic tumor load (p<0.001. The small intestinal tumor load was not affected by the dietary fiber interventions. Mice fed IN had a lower bacterial diversity than mice fed CE or BSG. The Bacteroidetes/Firmicutes ratio was significantly (p = 0.003 different between the three fiber diets with a higher mean value in IN fed mice compared with BSG and CE. We also found a relation between microbiota and the colonic tumor load, where many of the operational taxonomic units (OTUs related to low tumor load were significantly enriched in mice fed IN. Among the OTUs related to low tumor load were bacteria affiliated with the Bacteroides genus. These results suggest that type of dietary fiber may play a role in the development of CRC, and that the suppressive effect of IN on colonic tumorigenesis is associated with profound changes in the cecal microbiota profile.

  15. Quantitative and qualitative evaluation of Campylobacter spp. contamination of turkey cecal contents and carcasses during and following the slaughtering process.

    Science.gov (United States)

    Bily, Lise; Petton, Julie; Lalande, Françoise; Rouxel, Sandra; Denis, Martine; Chemaly, Marianne; Salvat, Gilles; Fravalo, Philippe

    2010-07-01

    The present study aimed to document quantitatively and qualitatively the contamination by thermotolerant Campylobacter spp. of turkey samples during slaughtering. Four Campylobacter-positive turkey flocks were investigated at the slaughterhouse at three different stages: evisceration (cecal content), after carcass rinses but before chilling (neck skin), and after breast meat cut (meat). In each case, the studied flock was slaughtered first thing in the morning any given day of the week. The efficiency of cleaning and disinfecting operations was examined in the facility prior to processing the studied flock. For each flock, 90 samples were collected from cecal contents, neck skins, and meat pieces and checked quantitatively and qualitatively for Campylobacter. Identification of Campylobacter species was determined by PCR, and genetic patterns were determined by pulsed-field gel electrophoresis. Campylobacter contamination levels of ceca range from 2 to more than 7 Log CFU/g, while those of neck skin range from 0.5 to 3.5 Log CFU/g and those of meat range from 0.1 to 1.9 Log CFU/g. These differences in Campylobacter counts were not associated with a modification of Campylobacter species ratio; however, in the Campylobacter jejuni population, four genetic groups identified from the ceca were not recovered during slaughtering operations and two other genetic groups were only detected after chilling at the cutting stage of the breast meat. The present study suggests that the slaughtering process did not affect Campylobacter species populations; however, it might have influenced the strain population. Finally, the Campylobacter populations found on breast meat were similar to those isolated from the digestive tract of the birds.

  16. One-year follow-up of corneal confocal microscopy after corneal cross-linking in patients with post laser in situ keratosmileusis ectasia and keratoconus.

    Science.gov (United States)

    Kymionis, George D; Diakonis, Vasilios F; Kalyvianaki, Maria; Portaliou, Dimitra; Siganos, Charalampos; Kozobolis, Vasilios P; Pallikaris, Aristophanis I

    2009-05-01

    To investigate corneal tissue alterations after corneal collagen cross-linking in patients with post laser in situ keratosmileusis (LASIK) keratectasia and keratoconus. Prospective comparative case series. Five patients (5 eyes) with iatrogenic keratectasia after LASIK and 5 patients (5 eyes) with progressive keratoconus were included. All eyes underwent corneal cross-linking and were assessed by corneal in vivo confocal microscopy. Three normal/healthy and 3 post-LASIK without ectasia corneas were also examined as controls. All corneas revealed normal epithelial thickness before and after surgery. Images of both keratoconic and post-LASIK corneal ectasia eyes revealed similar morphologic alterations. The subepithelial nerve plexus was absent immediately after treatment; regeneration of nerves was evident after the third postoperative month. Keratocytes were absent from the anterior 300 mum of the stroma in the first 3 months while the posterior stromal density of keratocytes was increased. Corneal collagen fibers in the anterior stroma were distributed unevenly in a net-like formation. Full-thickness keratocyte repopulation in the anterior and mid-corneal stroma was detected 6 months after treatment. The corneal endothelium did not undergo any significant changes, since the cell density and hexagonality was not found altered during the follow-up period. Keratocyte nuclei apoptosis in the anterior and intermediate corneal stroma along with collagen alterations were observed during the first 3 postcorneal cross-linking months. Gradual keratocyte repopulation was demonstrated over the following months. Corneal alterations after corneal cross-linking were similar in both keratoconic and post-LASIK corneal ectasia eyes.

  17. Vascular disease: Hemorrhage

    International Nuclear Information System (INIS)

    Norman, D.

    1987-01-01

    An understanding of the role of magnetic resonance (MR) in detection and characterization of vascular lesions is evolving. Improvements in spatial detail suggest great promise in delineation of structural vascular lesions, and insights into the appearance of evolving intraparenchymal hematoma have broadened the applications

  18. Vascular grading of angiogenesis

    DEFF Research Database (Denmark)

    Hansen, S; Grabau, D A; Sørensen, Flemming Brandt

    2000-01-01

    The study aimed to evaluate the prognostic value of angiogenesis by vascular grading of primary breast tumours, and to evaluate the prognostic impact of adding the vascular grade to the Nottingham Prognostic Index (NPI). The investigation included 836 patients. The median follow-up time was 11...... was moderately reproduced (kappa = 0.59). Vascular grade was significantly associated with axillary node involvement, tumour size, malignancy grade, oestrogen receptor status and histological type. In univariate analyses vascular grade significantly predicted recurrence free survival and overall survival for all...... impact for 24% of the patients, who had a shift in prognostic group, as compared to NPI, and implied a better prognostic dissemination. We concluded that the angiogenesis determined by vascular grading has independent prognostic value of clinical relevance for patients with breast cancer....

  19. Could neutrophil/lymphocyte ratio be an indicator of coronary artery disease, coronary artery ectasia and coronary slow flow?

    Science.gov (United States)

    Korkmaz, Hasan; Bilen, Mehmet Nail; Uku, Ökkeş; Kurtoğlu, Ertuğrul

    2016-01-01

    Objective To determine whether neutrophil/lymphocyte ratio (NLR) differed between patients with isolated coronary artery disease (CAD), isolated coronary artery ectasia (CAE), coronary slow flow and normal coronary anatomy. Methods Patients who underwent coronary angiography were consecutively enrolled into one of four groups: CAD, coronary slow flow, CAE and normal coronary anatomy. Results The CAD (n = 40), coronary slow flow (n = 40), and CAE (n = 40) groups had similar NLRs (2.51 ± 0.7, 2.40 ± 0.8, 2.6 ± 0.6, respectively) that were significantly higher than patients with normal coronary anatomy (n = 40; NLR, 1.73 ± 0.7). Receiver operating characteristics demonstrated that with NLR > 2.12, specificity in predicting isolated CAD was 85% and sensitivity was 75%, with NLR > 2.22 specificity in predicting isolated CAE was 86% and sensitivity was 75%. With NLR > 1.92, specificity in predicting coronary slow flow was 89% and sensitivity was 75%. Multivariate logistic regression analyses identified NLR as an independent predictor of isolated CAE (β = −0.499, 95% CI −0.502, −0.178; P <  0.001), CAD (β = −0.426, 95% CI −1.321, −0.408; P <  0.001), and coronary slow flow (β = −0.430, 95% CI −0.811, −0.240; P = 0.001 Table 2). Conclusions NLR was higher in patients with CAD, coronary slow flow and CAE versus normal coronary anatomy. NLR may be an indicator of CAD, CAE and coronary slow flow. PMID:28322100

  20. Effects of the topographical extent of coronary artery ectasia on coronary blood flow in patients with aortic aneurysms.

    Science.gov (United States)

    Ikenaga, Hiroki; Kurisu, Satoshi; Watanabe, Noriaki; Shimonaga, Takashi; Higaki, Tadanao; Iwasaki, Toshitaka; Utsunomiya, Hiroto; Mitsuba, Naoya; Ishibashi, Ken; Dohi, Yoshihiro; Imai, Katsuhiko; Sueda, Taijiro; Kihara, Yasuki

    2015-11-01

    Aortic aneurysms are associated with coronary artery ectasia (CAE). However, the relation between the extent of CAE and coronary blood flow in patients with aortic aneurysms is not fully understood. This study was undertaken to assess the angiographic characteristics and effects of the topographical extent of CAE on coronary blood flow in patients with aortic aneurysms. This study consisted of 93 consecutive patients with aortic aneurysms (AA group) and 79 patients without aortic aneurysms who had angiographically normal coronary arteries as the control group (Control group). Coronary flow velocity was determined using the thrombolysis in myocardial infarction frame count (TFC) and the topographical extent of CAE was assessed. In the AA group, 43 patients (46.2 %) had significant coronary artery stenosis and 37 patients (40.2 %) had diffuse CAE. TFC was significantly higher in the AA group than in the control group in all 3 coronary arteries. Furthermore, mean corrected TFC (CTFC) was significantly higher in the AA group than in the control group (40.1 ± 10.7 vs. 25.8 ± 6.5, p < 0.001). In the AA group, mean CTFC in patients with diffuse CAE was significantly higher than that in patients with segmental CAE (50.2 ± 8.7 vs. 33.6 ± 5.2, p < 0.001). The mean CTFC correlated positively with the topographical extent of CAE. Many patients with aortic aneurysms were accompanied with angiographic coronary artery stenosis and CAE. Furthermore, patients with aortic aneurysms had higher CTFC than those without aortic aneurysms and it was primarily driven by more frequent prevalence of diffuse CAE.

  1. Pediatric vascular access

    International Nuclear Information System (INIS)

    Donaldson, James S.

    2006-01-01

    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  2. Vascular Access in Children

    International Nuclear Information System (INIS)

    Krishnamurthy, Ganesh; Keller, Marc S.

    2011-01-01

    Establishment of stable vascular access is one of the essential and most challenging procedures in a pediatric hospital. Many clinical specialties provide vascular service in a pediatric hospital. At the top of the “expert procedural pyramid” is the pediatric interventional radiologist, who is best suited and trained to deliver this service. Growing awareness regarding the safety and high success rate of vascular access using image guidance has led to increased demand from clinicians to provide around-the-clock vascular access service by pediatric interventional radiologists. Hence, the success of a vascular access program, with the pediatric interventional radiologist as the key provider, is challenging, and a coordinated multidisciplinary team effort is essential for success. However, there are few dedicated pediatric interventional radiologists across the globe, and also only a couple of training programs exist for pediatric interventions. This article gives an overview of the technical aspects of pediatric vascular access and provides useful tips for obtaining vascular access in children safely and successfully using image guidance.

  3. Vascular malformations in pediatrics

    International Nuclear Information System (INIS)

    Reith, W.; Shamdeen, M.G.

    2003-01-01

    Vascular malformations are the cause of nearly all non-traumatic intracranial hemorrhage in children beyond the neonatal stage. Therefore, any child presenting with spontaneous intracranial hemorrhage should be evaluated for child abuse and for vascular malformations. Intracerebral malformations of the cerebral vasculature include vein of Galen malformations, arteriovenous malformation (AVM), cavernomas, dural arteriovenous fistulas, venous anomalies (DVA), and capillary teleangiectasies. Although a few familial vascular malformation have been reported, the majority are sporadic. Clinical symptoms, diagnostic and therapeutic options are discussed. (orig.) [de

  4. A Large-Scale Computational Analysis of Corneal Structural Response and Ectasia Risk in Myopic Laser Refractive Surgery (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Dupps, William Joseph; Seven, Ibrahim

    2016-01-01

    Purpose: To investigate biomechanical strain as a structural susceptibility metric for corneal ectasia in a large-scale computational trial. Methods: A finite element modeling study was performed using retrospective Scheimpflug tomography data from 40 eyes of 40 patients. LASIK and PRK were simulated with varied myopic ablation profiles and flap thickness parameters across eyes from LASIK candidates, patients disqualified for LASIK, subjects with atypical topography, and keratoconus subjects in 280 simulations. Finite element analysis output was then interrogated to extract several risk and outcome variables. We tested the hypothesis that strain is greater in known at-risk eyes than in normal eyes, evaluated the ability of a candidate strain variable to differentiate eyes that were empirically disqualified as LASIK candidates, and compared the performance of common risk variables as predictors of this novel susceptibility marker across multiple virtual subjects and surgeries. Results: A candidate susceptibility metric that expressed mean strains across the anterior residual stromal bed was significantly higher in eyes with confirmed ectatic predisposition in preoperative and all postoperative cases (P≤.003). The strain metric was effective at differentiating normal and at-risk eyes (area under receiver operating characteristic curve ≥ 0.83, P≤.002), was highly correlated to thickness-based risk metrics (as high as R2 = 95%, Pectasia risk and provides a novel biomechanical construct for expressing structural risk in refractive surgery. Mechanical strain is an effective marker of known ectasia risk and correlates to predicted refractive error after myopic photoablative surgery. PMID:27630372

  5. A tomografia de córnea e segmento anterior na propedêutica do exame complementar na avaliação de ectasia

    Directory of Open Access Journals (Sweden)

    Bruno de Freitas Valbon

    2013-02-01

    Full Text Available Descrevemos a importância da tomografia de córnea e segmento anterior na propedêutica do exame complementar na avaliação de ectasia. Esta descrição da interpretação clínica dos índices da tomografia de córnea e segmento anterior (Pentacam - Oculus, Wetzlar, Germany neste relato de caso, demonstra a relevância de uma nova tecnologia na avaliação da córnea e segmento anterior na suspeita de ceratocone. O diagnóstico de ceratocone foi excluído pela análise dos índices tomográficos de ectasia. Detectou-se assimetria entre os lados nasal e temporal por meio da avaliação do mapa de profundidade de câmara anterior. No exame biomicroscópico sob midríase foi constatado subluxação do cristalino, sendo assim devemos estar atentos não somente aos índices tomográficos corneanos na avaliação do exame complementar e sim analisarmos outros dados importantes oferecidos pela tomografia de córnea e segmento anterior.

  6. Congenital Vascular Malformation

    Science.gov (United States)

    ... surgery or less invasive therapy of the enlarged superficial veins can also be helpful. T he V ascular D isease F oundation Established in 1998, t he Vascular Disease Foundation (VDF) develops educational information and initiatives for patients, ...

  7. Uterine Vascular Lesions

    Science.gov (United States)

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

  8. Heart and vascular services

    Science.gov (United States)

    ... maintain body temperature, among other things. CARDIOVASCULAR MEDICINE Cardiovascular medicine refers to the branch of health care that specializes in the treatment of diseases or conditions dealing with the heart and vascular systems. Common ...

  9. Vascular Access Procedures

    Science.gov (United States)

    ... vascular access catheters: A peripherally inserted central catheter (PICC) is a long catheter that extends from an ... central catheter may be larger caliber than a PICC, and is designed to be placed via a ...

  10. Effects of Bacillus amyloliquefaciens as a probiotic strain on growth performance, cecal microflora, and fecal noxious gas emissions of broiler chickens.

    Science.gov (United States)

    Ahmed, Sonia Tabasum; Islam, Manirul; Mun, Hong-Seok; Sim, Hyeon-Ju; Kim, Ye-Jin; Yang, Chul-Ju

    2014-08-01

    This experiment was conducted to investigate the effects of Bacillus amyloliquefaciens probiotic (BAP) as a direct-fed microbial on growth performance, cecal microflora, serum immunoglobulin levels, and fecal noxious gas emissions of broiler chickens. A total of 400 one-day-old broiler chicks (Ross 308) were randomly assigned to 1 of 5 treatment diets formulated to supply 0, 1, 5, 10, and 20 g/kg of BAP and were fed for 35 d. Each treatment had 8 replicate pens with 10 birds per replicate. On completion of the growth trial, fecal samples were collected, and ammonia (NH3) and hydrogen sulfide (H2S) emissions were measured. Increasing concentration of BAP had positive linear effect on the ADG of broilers (P Bacillus content, but exerted negative linear effect on cecal Escherichia coli (P Bacillus amyloliquefaciens could be suggested as a potential feed additive of broiler diets. © Poultry Science Association Inc.

  11. Effect of -based Direct-fed Microbial on Performance, Nutrient Utilization, Intestinal Morphology and Cecal Microflora in Broiler Chickens

    Directory of Open Access Journals (Sweden)

    Xinjian Lei

    2015-02-01

    Full Text Available The present study was conducted to evaluate the effect of the dietary supplementation of Bacillus amyloliquefaciens-based direct-fed microbial (DFM on growth performance, nutrient utilization, intestinal morphology and cecal microflora in broiler chickens. A total of two hundred and eighty eight 1-d-old Arbor Acres male broilers were randomly allocated to one of four experimental treatments in a completely randomized design. Each treatment was fed to eight replicate cages, with nine birds per cage. Dietary treatments were composed of an antibiotic-free basal diet (control, and the basal diet supplemented with either 15 mg/kg of virginiamycin as antibiotic growth promoter (AGP, 30 mg/kg of Bacillus amyloliquefaciens-based DFM (DFM 30 or 60 mg/kg of Bacillus amyloliquefaciens-based DFM (DFM 60. Experimental diets were fed in two phases: starter (d 1 to 21 and finisher (d 22 to 42. Growth performance, nutrient utilization, morphological parameters of the small intestine and cecal microbial populations were measured at the end of the starter (d 21 and finisher (d 42 phases. During the starter phase, DFM and virginiamycin supplementation improved the feed conversion ratio (FCR; p<0.01 compared with the control group. For the finisher phase and the overall experiment (d 1 to 42 broilers fed diets with the DFM had better body weight gain (BWG and FCR than that of control (p<0.05. Supplementation of virginiamycin and DFM significantly increased the total tract apparent digestibility of crude protein (CP, dry matter (DM and gross energy during both starter and finisher phases (p<0.05 compared with the control group. On d 21, villus height, crypt depth and villus height to crypt depth ratio of duodenum, jejunum, and ileum were significantly increased for the birds fed with the DFM diets as compared with the control group (p<0.05. The DFM 30, DFM 60, and AGP groups decreased the Escherichia coli population in cecum at d 21 and d 42 compared with control

  12. Short communication: Inhibitory effects of dietary aflatoxin B1 on cytokines expression and T-cell subsets in the cecal tonsil of broiler chickens

    Directory of Open Access Journals (Sweden)

    Chunyu Liu

    2016-08-01

    Full Text Available Aflatoxin B1 (AFB1 is the most toxic form among the mycotoxins. Cytokines are important mediators of the immune system. T-cell subsets play a crucial role in cell-mediated immunity. The aim of present study was to evaluate the effects of dietary AFB1 on the cytokines expression and T-cell subsets in the cecal tonsil of broiler chickens throughout a 21-day experimental period. One hundred and fifty six one-day-old broiler chickens were randomly divided into control group (0 mg AFB1/kg feed and AFB1 group (0.6 mg pure AFB1/kg feed. At 7, 14 and 21 days of age, the levels of seven cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, IFN-γ and TNF-α mRNA expression as well as the proportions of T-cell subsets (CD3+, CD3+CD4+, CD3+CD8+ by qRT-PCR and flow cytometry methods were assessed in the cecal tonsils. The levels of the seven cytokines mRNA expression and the percentages of T-cell subsets significantly decreased at 14 and 21 days of age in the AFB1 group compared with the control group. However, the CD4+/CD8+ ratio was not significantly changed. These results demonstrate that 0.6 mg/kg AFB1 dietary exposure reduced the levels of cytokines mRNA expression and the percentages of T-cell subsets in the cecal tonsils of broiler chickens, suggesting that the cell-mediated immunity of cecal tonsils might be impaired in broilers.

  13. Short communication: Inhibitory effects of dietary aflatoxin B1 on cytokines expression and T-cell subsets in the cecal tonsil of broiler chickens

    Energy Technology Data Exchange (ETDEWEB)

    Liu, C.; Jiang, M.; Fang, J.; Peng, X.; Cui, H.

    2016-11-01

    Afatoxin B1 (AFB1) is the most toxic form among the mycotoxins. Cytokines are important mediators of the immune system. T-cell subsets play a crucial role in cell-mediated immunity. The aim of present study was to evaluate the effects of dietary AFB1 on the cytokines expression and T-cell subsets in the cecal tonsil of broiler chickens throughout a 21-day experimental period. One hundred and fifty six one-day-old broiler chickens were randomly divided into control group (0 mg AFB1/kg feed) and AFB1 group (0.6 mg pure AFB1/kg feed). At 7, 14 and 21 days of age, the levels of seven cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, IFN-γ and TNF-α) mRNA expression as well as the proportions of T-cell subsets (CD3+, CD3+CD4+, CD3+CD8+) by qRT-PCR and flow cytometry methods were assessed in the cecal tonsils. The levels of the seven cytokines mRNA expression and the percentages of T-cell subsets significantly decreased at 14 and 21 days of age in the AFB1 group compared with the control group. However, the CD4+/CD8+ ratio was not significantly changed. These results demonstrate that 0.6 mg/kg AFB1 dietary exposure reduced the levels of cytokines mRNA expression and the percentages of T-cell subsets in the cecal tonsils of broiler chickens, suggesting that the cell-mediated immunity of cecal tonsils might be impaired in broilers. (Author)

  14. Effects of animal or plant protein diets on cecal fermentation in guinea pigs (Cavia porcellus), rats (Rattus norvegicus) and chicks (Gallus gallus domesticus).

    Science.gov (United States)

    Tsukahara, T; Ushida, K

    2000-10-01

    Monogastric herbivores such as the guinea pig depend on energy supply from enteric fermentation as short-chain fatty acids (SCFA) corresponding to 30-40% of their maintenance energy requirements. They evolved specific digestive system to adapt their indigenous microflora to plant polysaccharides fermentation. No information has been available about the adaptability of microbial fermentation in hindgut of the monogastric herbivorous to an animal protein diet. We investigated if the guinea pig can fully retrieve energy of an animal protein diet by hindgut fermentation compared with a plant protein diet. For comparison, we also studied two omnivores. End products of in vitro cecal fermentation (SCFA, ammonia and gases) were measured to judge how well an animal protein diet could be fermented. The animal protein diet resulted in the less intensive fermentation with increased feed intake and volume of cecal contents than the plant protein diet only in guinea pigs. This may be due to a limited capacity of the hindgut microflora to adapt to the substrate rich in animal protein. We also found that chick cecal contents produced methane at higher emission rate than ruminants.

  15. Antioxidants and vascular health.

    Science.gov (United States)

    Bielli, Alessandra; Scioli, Maria Giovanna; Mazzaglia, Donatella; Doldo, Elena; Orlandi, Augusto

    2015-12-15

    Oxygen free radicals and other reactive oxygen species (ROS) are common products of normal aerobic cellular metabolism, but high levels of ROS lead to oxidative stress and cellular damage. Increased production of ROS favors vascular dysfunction, inducing altered vascular permeability and inflammation, accompanied by the loss of vascular modulatory function, the imbalance between vasorelaxation and vasoconstriction, and the aberrant expression of inflammatory adhesion molecules. Inflammatory stimuli promote oxidative stress generated from the increased activity of mitochondrial nicotinamide adenine dinucleotide phosphate oxidase, particularly of the Nox4 isoform, with the consequent impairment of mitochondrial β-oxidation. Vascular dysfunction due to the increase in Nox4 activity and ROS overproduction leads to the progression of cardiovascular diseases, diabetes, inflammatory bowel disease, and neurological disorders. Considerable research into the development of effective antioxidant therapies using natural derivatives or new synthetic molecules has been conducted. Antioxidants may prevent cellular damage by reducing ROS overproduction or interfering in reactions that involve ROS. Vitamin E and ascorbic acid are well known as natural antioxidants that counteract lipid peroxidative damage by scavenging oxygen-derived free radicals, thus restoring vascular function. Recently, preliminary studies on natural antioxidants such as goji berries, thymus, rosemary, green tea ginseng, and garlic have been conducted for their efficacy in preventing vascular damage. N-acetyl-cysteine and propionyl-L-carnitine are synthetic compounds that regulate ROS production by replacing endogenous antioxidants in both endothelial and smooth muscle cells. In this review, we consider the molecular mechanisms underlying the generation of oxidative stress-induced vascular dysfunction as well as the beneficial effects of antioxidant therapies.

  16. Rat cecal inocula produce different patterns of short-chain fatty acids than fecal inocula in in vitro fermentations.

    Science.gov (United States)

    Monsma, D J; Marlett, J A

    1995-10-01

    The effects of bacterial collection site, bacterial adaption to substrate and duration of fermentation on short-chain fatty acid (SCFA) production were studied using an in vitro fermentation system. Cecal and fecal inocula from rats fed purified diets containing 100 g/kg dietary fiber from canned peas or psyllium seed husk, or a nonpurified diet containing 170 g/kg dietary fiber fermented ileal excreta from colectomized rats fed a purified diet containing 100 g/kg dietary fiber from canned peas. The SCFA concentration, measured by gas chromatography, in anaerobic fermentations of 0, 3, 6, 12, 24, 48, 72 and 96 h, increased (P pea or nonpurified diets produced SCFA at greater (P < 0.05) molar proportions as acetate and less (P < 0.05) as propionate than inocula from rats fed psyllium seed husk at most time points. We conclude that collection site, adaptation of bacteria to the substrate to be fermented and duration of fermentation significantly influence the results of in vitro fermentation studies.

  17. Protective Effects of Huang-Lian-Jie-Du-Tang against Polymicrobial Sepsis Induced by Cecal Ligation and Puncture in Rats

    Directory of Open Access Journals (Sweden)

    Yufen Wei

    2013-01-01

    Full Text Available Huang-Lian-Jie-Du-Tang (HLJDT is a traditional formula that has long been used for treatment of inflammatory diseases in Traditional Chinese Medicine. In this study, we examined its protective effect against sepsis in an experimental septic model induced by cecal ligation and puncture (CLP in rats. The results demonstrated that prophylactic administration of HLJDT protected rats from CLP-induced lethality and ameliorated CLP-induced liver and lung injury. HLJDT treatment suppressed the production of proinflammatory cytokines, including TNF-α, IL-1, IL-6, and IL-17A, indicating HLJDT could limit excessive inflammatory responses in septic condition. In addition, HLJDT facilitated bacterial clearance by increasing phagocytic activities of peritoneal macrophages. Furthermore, HLJDT treatment reversed CLP-induced suppression of IFN-γ expression and blocked CLP-induced increase in IL-4 expression in spleens of rats at 24 h after CLP, indicating that HLJDT could reverse the shift from Th1 to Th2 response and promote Th1/Th2 balance toward Th1 predominance in septic rats. Moreover, HLJDT also inhibited the expression of IL-17A and ROR-γt in spleens of septic rats, indicating HLJDT is able to inhibit Th17 activation in septic condition. In conclusion, the present study demonstrated the protective effects of HLJDT against sepsis and highlighted the potential of HLJDT as a medication for septic patients.

  18. Metagenomic Analysis of Cecal Microbiome Identified Microbiota and Functional Capacities Associated with Feed Efficiency in Landrace Finishing Pigs

    Directory of Open Access Journals (Sweden)

    Zhen Tan

    2017-08-01

    Full Text Available Feed efficiency (FE appears to vary even within closely related pigs, and may be partly affected by the diversity in the composition and function of gut microbes. To investigate the components and functional differences of gut microbiota of low and high FE pigs, high throughput sequencing and de novo metagenomics were performed on pig cecal contents. Pigs were selected in pairs with low and high feed conversion ratio. The microorganisms of individuals with different FE were clustered according to diversity. The genus Prevotella was the most enriched in both groups, and the abundance of species Prevotella sp. CAG:604 was significantly increased in low efficiency individuals compared to that in animals showing high efficiency. In contrast, other differential species, including lactic acid bacteria, were all enriched in the group with good feeding characteristics. Functional analysis based on the Kyoto Encyclopedia of Genes and Genomes databases demonstrated that differential genes for the metabolism of carbohydrates were most abundant in both groups, but pathways of pyruvate-related metabolism were more intense in pigs with higher FE. All these data indicated that the microbial environment was closely related to the growth traits of pigs, and regulating microbial composition could aid developing strategies to improve FE for pigs.

  19. Epinecidin-1 protects mice from LPS-induced endotoxemia and cecal ligation and puncture-induced polymicrobial sepsis.

    Science.gov (United States)

    Su, Bor-Chyuan; Huang, Han-Ning; Lin, Tai-Wen; Hsiao, Chwan-Deng; Chen, Jyh-Yih

    2017-12-01

    The antimicrobial peptide, epinecidin-1 (Epi), was identified from Epinephelus coioides and may have clinical application for treating sepsis. Epi has been shown to ameliorate antibiotic-resistant bacteria-induced sepsis in mice, but further evaluation in mixed-flora models and a description of the protective mechanisms are essential to establish this peptide as a potential therapeutic. Therefore, we first tested the protective effects of Epi against polymicrobial sepsis-induced bactericidal infection, inflammation and lung injury that result from cecal ligation and puncture in mice. Furthermore, since lipopolysaccharide (LPS) is a key inducer of inflammation during bacterial infection and sepsis, we also tested the LPS-antagonizing activity and related mechanisms of Epi-mediated protection in mice with LPS-induced endotoxemia and LPS-treated Raw264.7 mouse macrophage cells. Epi rescued mice from both polymicrobial sepsis and endotoxemia after delayed administration and suppressed both lung and systemic inflammatory responses, while attenuating lung injury and diminishing bacterial load. In vitro studies revealed that Epi suppressed LPS-induced inflammatory cytokine production. Mechanistically, Epi disrupted the interaction between LPS and LPS binding protein, competed with LPS for binding on the cell surface, and inhibited Toll-like receptor 4 endocytosis, resulting in inhibition of LPS-induced reactive oxygen species/p38/Akt/NF-κB signaling and subsequent cytokine production. Overall, our results demonstrate that Epi is a promising therapeutic agent for endotoxemia and polymicrobial sepsis. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Influence of postbiotic RG14 and inulin combination on cecal microbiota, organic acid concentration, and cytokine expression in broiler chickens.

    Science.gov (United States)

    Kareem, K Y; Loh, T C; Foo, H L; Asmara, S A; Akit, H

    2017-04-01

    This study examined the effects of different combinations of inulin and postbiotics RG14 on growth performance, cecal microbiota, volatile fatty acids (VFA), and ileal cytokine expression in broiler chickens. Two-hundred-and sixteen, one-day-old chicks were allocated into 6 treatment groups, namely, a basal diet (negative control, NC), basal diet + neomycin and oxytetracycline (positive control, PC), T1 = basal diet + 0.15% postbiotic RG14 + 1.0% inulin, T2 = basal diet + 0.3% postbiotic RG14 + 1.0% inulin, T3 = basal diet + 0.45% postbiotic RG14 + 1.0% inulin, and T4 = basal diet + 0.6% postbiotic RG14 + 1.0% inulin, and fed for 6 weeks. The results showed that birds fed T1 and T3 diets had higher (P  0.05) among diets. The NC birds had higher (P inulin combinations are potential replacements for antibiotic growth promoters in the poultry industry. © 2016 Poultry Science Association Inc.

  1. Ursolic acid improves survival and attenuates lung injury in septic rats induced by cecal ligation and puncture.

    Science.gov (United States)

    Hu, Zhansheng; Gu, Zhilong; Sun, Meina; Zhang, Ke; Gao, Penghui; Yang, Qinwu; Yuan, Yuan

    2015-04-01

    Sepsis is characterized as a systemic inflammatory response syndrome during infection, which can result in multiple organ dysfunction and death. Ursolic acid (UA), a pentacyclic triterpene acid, has been reported to have potent anti-inflammatory and antioxidant properties. The aim of this study was to detect the possible protective effects of UA on sepsis-evoked acute lung injury. A rat model of sepsis induced by cecal ligation and puncture (CLP) was used. Rats were injected intraperitoneally with UA (10 mg/kg) after CLP, and then the survival was determined twice a day for 4 d. The protective effects of UA on CLP-induced acute lung injury were assayed at 24 h after CLP. The results revealed that UA treatment markedly improved the survival of septic rats, and attenuated CLP-induced lung injury, including reduction of lung wet/dry weight ratio, infiltration of leukocytes and proteins, myeloperoxidase activity, and malondialdehyde content. In addition, UA significantly decreased the serum levels of tumor necrosis factor-α, interleukin-6, and interleukin-1β, inhibited the expression of inducible nitric oxide synthase and cyclooxygenase-2 in the lung, which are involved in the productions of nitric oxide and prostaglandin E2. These findings indicate that UA exerts protective effects on CLP-induced septic rats. UA may be a potential therapeutic agent against sepsis. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Mobilization of immunoglobulin (Ig)-containing plasma cells in Harderian gland, cecal tonsil and trachea of broilers vaccinated with Newcastle Disease Vaccine.

    Science.gov (United States)

    Nasrin, M; Khan, M Z I; Siddiqi, M N H; Masum, M A

    2013-06-01

    Immunohistochemical studies of Harderian gland, cecal tonsil and trachea of various groups of broiler chickens and the response of Baby Chick Ranikhet Disease Vaccines (BCRDV) on the mobilization of Igs-cells during postnatal development of organs was investigated in the Dept. of Anatomy and Histology, Bangladesh Agricultural University, Mymensingh. In this study twelve chickens were grouped into vaccinated broilers (D14 and D28) which had received vaccines first at D3 of age and a booster dose given at D13; and non-vaccinated broilers (D1) which had not been vaccinated. In this study, it was observed that the frequency and distribution of Igs-positive cells were higher at D14 and at D28 rather than D1. Among Igs-positive cells, the IgG-positive cells were significantly higher than IgM and IgA-positive cells in the Harderian gland of D14 and D28 groups of chickens, however, in day-old chickens, the frequency of IgM-positive cells in this gland were greater. In the cecal tonsil, the frequency and distribution of IgG-positive cells were significantly higher than IgA- and IgM-positive cells both at D14 and D28 ages of chicken. On the other hand, in day-old chickens, the frequency and distribution of IgA-positive cells were insignificantly greater, followed by IgM and IgG-positive cells. In the trachea, few immunoglobulin-containing plasma cells were distributed in the subepithelial layer. IgM-positive cells were higher followed by IgG and IgA-positive cells in the trachea in D14 and D28 groups of chickens. In the same organ, IgG-positive plasma cells were greater than IgA and IgM-positive cells at one-day old. When the data for Harderian gland, cecal tonsil and trachea were compared statistically, it was observed that Igs-positive cells were statistically more common in cecal tonsils in day old chickens, and with the advancement of age, Igs-positive cells were found more in the Harderian gland. In conclusion, with the advancement of age in chickens the Harderian gland

  3. Utilização do Anel de Ferrara na estabilização e correção da ectasia corneana pós PRK Use of Ferrara's ring in the stabilization and correction of corneal ectasia after PRK

    Directory of Open Access Journals (Sweden)

    Frederico Bicalho Dias da Silva

    2000-06-01

    Full Text Available Objetivo: Avaliar a ação do anel corneano intra-estromal de Ferrara no tratamento da ectasia corneana pós Excimer Laser. Métodos: O anel de Ferrara, que já vem sendo aplicado no tratamento do ceratocone, alta miopia e astigmatismo irregular, foi utilizado para estabilizar e corrigir a ectasia corneana de dois pacientes submetidos à PRK. Resultados: Após o procedimento cirúrgico, foi observado um aplainamento da córnea central de aproximadamente 6 dioptrias no 1º caso e de 10 dioptrias no 2º, com melhora na acuidade visual. Os resultados vêm se mantendo estáveis até o momento. O tempo de seguimento pós-operatório foi de 3 e 8 meses, respectivamente. Conclusões: Anel de Ferrara obteve sucesso no difícil tratamento desta complicação cirúrgica, permitindo que se retarde ou até mesmo se evite a evolução destes casos para um transplante de córnea com todos os seus riscos, lenta recuperação e dependência da agilidade das filas de doações.Purpose: To evaluate the action of Ferrara's Ring in the treatment of corneal ectasia after Excimer Laser. Methods: Ferrara's Ring, that is already being applied in the treatment of keratoconus, high myopia and irregular astigmatism, has been used to stabilize and to correct the corneal ectasia of 2 patients submitted to PRK. Results: After the surgical procedure, a flattening of the central cornea was observed, with approximately 6 D (first case and 10 D in the second, with visual acuity improvement. The results have remained stable until this moment. The postoperative follow-up was of 3 and 8 months, respectively. Conclusions: Ferrara's ring has obtained success in the difficult treatment of this surgical complication, allowing delay of or even avoiding the evolution of these cases to a corneal transplantation with all its risks, slow recovery and dependence on the agility of the donation lines.

  4. ST-Segment Elevation Myocardial Infarction as a Result of Coronary Artery Ectasia-Related Intracoronary Thrombus in a Patient with Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Ji Woong Roh

    2015-11-01

    Full Text Available Coronary artery ectasia (CAE is a rare condition defined as the dilatation of coronary artery to at least 1.5 times larger than the normal adjacent coronary artery. Clinical manifestations of CAE vary, ranging from asymptomatic to ST-segment elevation myocardial infarction (STEMI. Because of its rarity and clinical diversity, the best treatment strategy and prognosis for CAE remain unclear. We describe a case of STEMI caused by intracoronary thrombus formation within an ectatic area in a patient with liver cirrhosis (LC. The patient was successfully managed by thrombus aspiration only, without balloon angioplasty or stent implantation, and maintained by dual antiplatelet therapy with aspirin and ticagrelor, a potent new P2Y12 inhibitor.

  5. tion of vascular malformations

    African Journals Online (AJOL)

    Imaging is only required in cases where there is diag- nostic uncertainty or where interven- tion is required. Ultrasound (with doppler) will rapidly distinguish solid haemangiomas from vascular malfor- mations. Computed tomography. (CT) and magnetic resonance imag- ing (MRI) will help to assess the depth and extent of ...

  6. Acute kidney injury and inflammatory response of sepsis following cecal ligation and puncture in D-galactose-induced aging rats

    Directory of Open Access Journals (Sweden)

    Liu C

    2017-03-01

    Full Text Available Chao Liu,1,* Jie Hu,1,* Zhi Mao,1,* Hongjun Kang,1 Hui Liu,1 Wanlei Fu,2 Yangfan Lv,2 Feihu Zhou1 1Department of Critical Care Medicine, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China; 2Department of Pathology, Xinqiao Hospital, Third Military Medical University, Chongqing, People’s Republic of China *These authors contributed equally to this work Background: Recently, the D-galactose (D-gal-induced mimetic aging rat model has been widely used in studies of age-associated diseases, which have shown that chronic D-gal exposure induces premature aging similar to natural aging in rats. With the increasing rate of sepsis in the geriatric population, an easy-access animal model for preclinical studies of elderly sepsis is urgently needed. This study investigates whether a sepsis model that is established in D-gal-induced aging rats can serve as a suitable model for preclinical studies of elderly patients with sepsis.Objective: To investigate the acute kidney injury (AKI and inflammatory response of sepsis following cecal ligation and puncture (CLP in D-gal-induced aging rats.Methods: Twelve-week-old male Sprague Dawley rats were divided into low-dose D-gal (L D-gal, 125 mg/kg/d, high-dose D-gal (H D-gal, 500 mg/kg/d, and control groups. After daily subcutaneous injection of D-gal for 6 weeks, the CLP method was used to establish a sepsis model.Results: The mortality was 73.3%, 40%, and 33.3% in the H D-gal, L D-gal, and control groups, respectively. Blood urea nitrogen, creatinine, plasma neutrophil gelatinase-associated lipocalin, interleukin-6, interleukin-10, and tumor necrosis factor-α were markedly increased in the H D-gal group after establishment of the sepsis model (H D-gal vs control, P<0.05 at 12 h and 24 h post-CLP. The rate of severe AKI (RIFLE-F at 24 h post-CLP was 43% for both the control and L D-gal groups and 80% for the H D-gal group.Conclusion: High-dose-D-gal-induced aging rats are

  7. Acupuncture for vascular dementia.

    Science.gov (United States)

    Peng, W N; Zhao, H; Liu, Z S; Wang, S

    2007-04-18

    Dementia is a widespread condition characterized by acquired global impairment of intellect, memory and personality, but with no impairment of consciousness. There is no definitive medical or surgical treatment for vascular dementia. Acupuncture is an ancient Chinese method which has been used for both the prevention and treatment of diseases for over three thousand years. Preliminary searches revealed more than 105 studies of acupuncture for treating vascular dementia. Benefit was reported in up to 70-91% of the treatment group. Body acupuncture and electroacupuncture were the most commonly used techniques. A comparison of electroacupuncture and acupuncture therapy alone suggested that the former was more effective in promoting the recovery of cognitive function. The objective is to assess the efficacy and possible adverse effects of acupuncture therapy for treating vascular dementia. The trials were identified from a search of the Cochrane Dementia and Cognitive Improvement group's Specialized Register on 2 February 2007 which contains records from all major health care databases and many ongoing trials databases. In addition the Allied and Complementary Medicine Database was searched and the web was searched using the search engine Copernic. Randomized controlled trials testing acupuncture therapy in the treatment of vascular dementia were included regardless of language and publication types. The intervention and control group had to receive identical treatment apart from the acupuncture intervention. In view of possible confounding, studies in which acupuncture was combined with other treatments were subjected to subgroup analyses. Titles and abstracts identified from the searches were checked by two reviewers. If it was clear that the study did not refer to a randomized controlled trial in vascular dementia, it was excluded. If it was not clear from the abstract and title, then the full text of study was obtained for an independent assessment by two reviewers

  8. Renal posttransplant's vascular complications

    Directory of Open Access Journals (Sweden)

    Bašić Dragoslav

    2003-01-01

    Full Text Available INTRODUCTION Despite high graft and recipient survival figures worldwide today, a variety of technical complications can threaten the transplant in the postoperative period. Vascular complications are commonly related to technical problems in establishing vascular continuity or to damage that occurs during donor nephrectomy or preservation [13]. AIM The aim of the presenting study is to evaluate counts and rates of vascular complications after renal transplantation and to compare the outcome by donor type. MATERIAL AND METHODS A total of 463 kidneys (319 from living related donor LD and 144 from cadaveric donor - CD were transplanted during the period between June 1975 and December 1998 at the Urology & Nephrology Institute of Clinical Centre of Serbia in Belgrade. Average recipients' age was 33.7 years (15-54 in LD group and 39.8 (19-62 in CD group. Retrospectively, we analyzed medical records of all recipients. Statistical analysis is estimated using Hi-squared test and Fischer's test of exact probability. RESULTS Major vascular complications including vascular anastomosis thrombosis, internal iliac artery stenosis, internal iliac artery rupture obliterant vasculitis and external iliac vein rupture were analyzed. In 25 recipients (5.4% some of major vascular complications were detected. Among these cases, 22 of them were from CD group vs. three from LD group. Relative rate of these complications was higher in CD group vs. LD group (p<0.0001. Among these complications dominant one was vascular anastomosis thrombosis which occurred in 18 recipients (17 from CD vs. one from LD. Of these recipients 16 from CD lost the graft, while the rest of two (one from each group had lethal outcome. DISCUSSION Thrombosis of renal allograft vascular anastomosis site is the most severe complication following renal transplantation. In the literature, renal allograft thrombosis is reported with different incidence rates, from 0.5-4% [14, 15, 16]. Data from the

  9. Cecal ligation and puncture followed by MRSA pneumonia increases mortality in mice and blunts production of local and systemic cytokines

    Science.gov (United States)

    Jung, Enjae; Perrone, Erin E.; Liang, Zhe; Breed, Elise R.; Dominguez, Jessica A.; Clark, Andrew T.; Fox, Amy C.; Dunne, W. Michael; Burd, Eileen M.; Farris, Alton B.; Hotchkiss, Richard S.; Coopersmith, Craig M.

    2011-01-01

    Mortality in the ICU frequently results from the synergistic effect of two temporally-distinct infections. This study examined the pathophysiology of a new model of intraabdominal sepsis followed by methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Mice underwent cecal ligation and puncture (CLP) or sham laparotomy followed three days later by an intratracheal injection of MRSA or saline. Both CLP/saline and sham/MRSA mice had 100% survival while animals with CLP followed by MRSA pneumonia had 67% seven-day survival. Animals subjected to CLP/MRSA had increased bronchoalveolar lavage (BAL) concentrations of MRSA compared to sham/MRSA animals. Animals subjected to sham/MRSA pneumonia had increased BAL levels of IL-6, TNF-α, and G-CSF compared to those given intratracheal saline while CLP/MRSA mice had a blunted local inflammatory response with markedly decreased cytokine levels. Similarly, animals subjected to CLP/saline had increased peritoneal lavage levels of IL-6 and IL-1β compared to those subjected to sham laparotomy while this response was blunted in CLP/MRSA mice. Systemic cytokines were upregulated in both CLP/saline and sham/MRSA mice, and this was blunted by the combination of CLP/MRSA. In contrast, no synergistic effect on pneumonia severity, white blood cell count or lymphocyte apoptosis was identified in CLP/MRSA mice compared to animals with either insult in isolation. These results indicate that a clinically relevant model of CLP followed by MRSA pneumonia causes higher mortality than could have been predicted from studying either infection in isolation, and this was associated with a blunted local (pulmonary and peritoneal) and systemic inflammatory response and decreased ability to clear infection. PMID:21937950

  10. Febrile response induced by cecal ligation and puncture (CLP) in rats: involvement of prostaglandin E2 and cytokines.

    Science.gov (United States)

    Figueiredo, Maria José; Soares, Denis Melo; Soares, Denis de Melo; Martins, Juliano Manvailer; Machado, Renes de Resende; Sorgi, Carlos Arterio; Faccioli, Lucia Helena; Melo, Miriam Cristina Contin de; de Melo, Miriam Cristina Contin; Malvar, David do Carmo; Souza, Glória E P

    2012-05-01

    The purpose of the present study was to better understand the events involved in the febrile response induced by cecal ligation and puncture (CLP), a complex infectious process. To this end, we conducted in vivo experiments in rats examining (1) fever development, (2) bacterial number in the infection focus and in blood, (3) peripheral and hypothalamic synthesis of cytokines, (4) hypothalamic and cerebrospinal fluid (CSF) synthesis of prostaglandin E(2) (PGE(2)), (5) the effect of anti-IL-6 antibody on fever, and (6) the effect of celecoxib on fever and hypothalamic synthesis of PGE(2) after CLP induction. We found that CLP promotes fever and animal death depending on the number of punctures. The peak of CLP-induced fever overlapped with the maximal increase in the number of bacteria in the infectious focus and blood, which occurred at 6 and 12 h. The peak of the febrile response also coincided with increased amounts of interleukin (IL)-1β, IL-6 and IL-10 in the peritoneal exudate and serum; IL-6 in the hypothalamus and PGE(2) in the CSF and predominantly in the hypothalamus. Moreover, intracerebroventricularly injected anti-IL-6 antibody reduced the febrile response while celecoxib reduced the fever and PGE(2) amount in the hypothalamus induced by CLP. Tumor necrosis factor (TNF)-α peaked at 3 h at all sites studied. Conversely, IL-10 concentration decreased in the hypothalamus. These findings show that the peak of CLP-induced fever is accompanied by an increase of bacteria in peritoneal fluid (local infection) and blood; local synthesis of pyrogenic (IL-1β, IL-6) and antipyretic (IL-10) cytokines and central production of IL-6 and PGE(2), suggesting that these last are the central mediators of this response.

  11. 16S rRNA gene sequencing reveals effects of photoperiod on cecal microbiota of broiler roosters

    Directory of Open Access Journals (Sweden)

    Jun Wang

    2018-02-01

    Full Text Available Photoperiod is an important factor in stimulating broiler performance in commercial poultry practice. However, the mechanism by which photoperiod affects the performance of broiler chickens has not been adequately explored. The current study evaluated the effects of three different photoperiod regimes (short day (LD = 8 h light, control (CTR = 12.5 h light, and long day (SD = 16 h light on the cecal microbiota of broiler roosters by sequencing bacterial 16S rRNA genes. At the phylum level, the dominant bacteria were Firmicutes (CTR: 68%, SD: 69%, LD: 67% and Bacteroidetes (CTR: 25%, SD: 26%, and LD: 28%. There was a greater abundance of Proteobacteria (p < 0.01 and Cyanobacteria (p < 0.05 in chickens in the LD group than in those in the CTR group. A significantly greater abundance of Actinobacteria was observed in CTR chickens than in SD and LD chickens (p < 0.01. The abundance of Deferribacteres was significantly higher in LD chickens than in SD chickens (p < 0.01. Fusobacteria and Proteobacteria were more abundant in SD chickens than in CTR and LD chickens. The predicted functional properties indicate that cellular processes may be influenced by photoperiod. Conversely, carbohydrate metabolism was enhanced in CTR chickens as compared to that in SD and LD chickens. The current results indicate that different photoperiod regimes may influence the abundance of specific bacterial populations and then contribute to differences in the functional properties of gut microbiota of broiler roosters.

  12. Nopal feeding reduces adiposity, intestinal inflammation and shifts the cecal microbiota and metabolism in high-fat fed rats.

    Science.gov (United States)

    Moran-Ramos, Sofia; He, Xuan; Chin, Elizabeth L; Tovar, Armando R; Torres, Nimbe; Slupsky, Carolyn M; Raybould, Helen E

    2017-01-01

    Nopal is a cactus plant widely consumed in Mexico that has been used in traditional medicine to aid in the treatment of type-2 diabetes. We previously showed that chronic consumption of dehydrated nopal ameliorated hepatic steatosis in obese (fa/fa) rats; however, description of the effects on other tissues is sparse. The aim of the present study was to investigate the effects of nopal cladode consumption on intestinal physiology, microbial community structure, adipose tissue, and serum biochemistry in diet-induced obese rats. Rats were fed either a normal fat (NF) diet or a HF diet containing 4% of dietary fiber from either nopal or cellulose for 6 weeks. Consumption of nopal counteracted HF-induced adiposity and adipocyte hypertrophy, and induced profound changes in intestinal physiology. Nopal consumption reduced biomarkers of intestinal inflammation (mRNA expression of IL-6) and oxidative stress (ROS), modfied gut microbiota composition, increasing microbial diversity and cecal fermentation (SCFA), and altered the serum metabolome. Interestingly, metabolomic analysis of dehydrated nopal revealed a high choline content, which appeared to generate high levels of serum betaine, that correlated negatively with hepatic triglyceride (TAG) levels. A parallel decrease in some of the taxa associated with the production of trimethylamine, suggest an increase in choline absorption and bioavailability with transformation to betaine. The latter may partially explain the previously observed effect of nopal on the development of hepatic steatosis. In conclusion, this study provides new evidence on the effects of nopal consumption on normal and HF-diet induced changes in the intestine, the liver and systemic metabolism.

  13. Shorter Duration of Post-Operative Antibiotics for Cecal Ligation and Puncture Does Not Increase Inflammation or Mortality.

    Directory of Open Access Journals (Sweden)

    Kendra N Iskander

    Full Text Available Antimicrobial therapy for sepsis has beneficial effects, but prolonged use fosters emergence of resistant microorganisms, increases cost, and secondary infections. We tested whether 3 days versus 5 days of antibiotics in the murine model of cecal ligation and puncture (CLP negatively influences outcomes. Following CLP mice were randomized to receive the antibiotic imipenem-cilastatin (25mg/kg in dextrose 5% in Lactated Ringer's solution every 12 hours for either three or five days. Serial monitoring over 28 days included body weight, temperature, pulse oximetry, and facial vein sampling for hematological analysis and glucose. A separate group of mice were euthanized on post-CLP day 5 to measure cytokines and peritoneal bacterial counts. The first study examined no antimicrobial therapy and demonstrated that antibiotics significantly improved survival compared to fluids only (p = 0.004. We next tested imipenem-cilastatin therapy for 3 days versus 5 days. Body weight, temperature, glucose, and pulse oximetry measurements remained generally consistent between both groups as did the hematological profile. Pro-inflammatory plasma cytokines were comparable between both groups for IL-6, IL-1β, MIP-2 and anti-inflammatory cytokines IL-10, and TNF SRI. At 5 days post-CLP, i.e. 2 days after the termination of antibiotics in the 3 day group, there were no differences in the number of peritoneal bacteria. Importantly, shortening the course of antibiotics by 40% (from 5 days to 3 days did not decrease survival. Our results indicate that reducing the duration of broad-spectrum antibiotics in murine sepsis did not increase inflammation or mortality.

  14. Nopal feeding reduces adiposity, intestinal inflammation and shifts the cecal microbiota and metabolism in high-fat fed rats.

    Directory of Open Access Journals (Sweden)

    Sofia Moran-Ramos

    Full Text Available Nopal is a cactus plant widely consumed in Mexico that has been used in traditional medicine to aid in the treatment of type-2 diabetes. We previously showed that chronic consumption of dehydrated nopal ameliorated hepatic steatosis in obese (fa/fa rats; however, description of the effects on other tissues is sparse. The aim of the present study was to investigate the effects of nopal cladode consumption on intestinal physiology, microbial community structure, adipose tissue, and serum biochemistry in diet-induced obese rats. Rats were fed either a normal fat (NF diet or a HF diet containing 4% of dietary fiber from either nopal or cellulose for 6 weeks. Consumption of nopal counteracted HF-induced adiposity and adipocyte hypertrophy, and induced profound changes in intestinal physiology. Nopal consumption reduced biomarkers of intestinal inflammation (mRNA expression of IL-6 and oxidative stress (ROS, modfied gut microbiota composition, increasing microbial diversity and cecal fermentation (SCFA, and altered the serum metabolome. Interestingly, metabolomic analysis of dehydrated nopal revealed a high choline content, which appeared to generate high levels of serum betaine, that correlated negatively with hepatic triglyceride (TAG levels. A parallel decrease in some of the taxa associated with the production of trimethylamine, suggest an increase in choline absorption and bioavailability with transformation to betaine. The latter may partially explain the previously observed effect of nopal on the development of hepatic steatosis. In conclusion, this study provides new evidence on the effects of nopal consumption on normal and HF-diet induced changes in the intestine, the liver and systemic metabolism.

  15. Water exchange enhanced cecal intubation in potentially difficult colonoscopy. Unsedated patients with prior abdominal or pelvic surgery: a prospective, randomized, controlled trial.

    Science.gov (United States)

    Luo, Hui; Zhang, Linhui; Liu, Xiaodong; Leung, Felix W; Liu, Zhiguo; Wang, Xiangping; Xue, Ling; Wu, Kaichun; Fan, Daiming; Pan, Yanglin; Guo, Xuegang

    2013-05-01

    Colonoscopy is widely used for management of colorectal diseases. A history of abdominal or pelvic surgery is a well-recognized factor associated with difficult colonoscopy. Although water exchange colonoscopy (WEC) was effective in small groups of male U.S. veterans with such a history, its application in other cultural settings is uncertain. To investigate the application of WEC in such patients. Prospective, randomized, controlled, patient-blinded study. Tertiary-care referral center in China. Outpatients with prior abdominal or pelvic surgery undergoing unsedated diagnostic, screening, or surveillance colonoscopy. Patients were randomized to examination by either WEC or conventional air colonoscopy (AC). Cecal intubation rate. A total of 110 patients were randomized to the WEC (n = 55) or AC (n = 55) group. WEC significantly increased the cecal intubation rate (92.7% vs 76.4%; P = .033). The maximum pain scores (± standard deviation) were 2.1 ± 1.8 (WEC) and 4.6 ± 1.7 (AC), respectively (P WEC would be willing to have a repeat unsedated colonoscopy (90.9% vs 72.7%, P = .013). Single center; unblinded but experienced endoscopists. This randomized, controlled trial confirms that the water exchange method significantly enhanced cecal intubation in potentially difficult colonoscopy in unsedated patients with prior abdominal or pelvic surgery. The lower pain scores and higher proportion accepting repeat of the unsedated option suggest that WEC is promising. It may enhances compliance with colonoscopy in specific populations. ( NCT01485133.). Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  16. Major Vascular Neurocognitive Disorder: A Reappraisal to Vascular Dementia

    Directory of Open Access Journals (Sweden)

    Emre Kumral

    2017-03-01

    Full Text Available Major vascular neurocognitive disorder (NCD is the second leading form of dementia after Alzheimer’s disease, accounting for 17-20% of all dementias. Vascular NCD is a progressive disease caused by reduced cerebral blood flow related to multiple large volume or lacunar infarcts that induce a sudden onset and stepwise decline in cognitive abilities. Despite its prevalence and clinical importance, there is still controversy in the terminology of vascular NCD. Only after the release of Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5 (2013 did the American Psychiatric Association define vascular dementia as “major vascular NCD”. This review includes an overview of risk factors, pathophysiology, types, diagnostic and clinical features of major vascular NCD, and current treatment options of vascular NCD regarding to DSM-5 criteria

  17. Efeito protetor da microbiota cecal congelada e liofilizada sobre a infecção experimental de frangos de corte por Salmonella enterica sorovar Enteritidis

    OpenAIRE

    Andreatti Filho R.L.; Crocci A.J.

    2002-01-01

    Estudaram-se os efeitos do tratamento de frangos de corte com microbiota cecal anaeróbia liofilizada (MCL) e congelada (MCC) sobre a infecção do trato digestivo das aves por Salmonella enterica sorovar Enteritidis. Foi usada microbiota intestinal sem prévia identificação bacteriana. A infecção foi persistente, em ordem, no ceco, inglúvio e duodeno. A infecção também foi autolimitante nos grupos tratados e no controle. Não ocorreu diferença entre o grupo-controle positivo e os tratados com MCL...

  18. Efeito da vacina contra coccidiose sobre a colonização de Salmonella enteritidis em frangos de corte tratados com microbiota cecal anaeróbia

    OpenAIRE

    Andreatti Filho,R.L.; Mestrinel Jr.,P.; Sampaio,H.M.; Crocci,A.J.

    1999-01-01

    Avaliou-se o efeito da vacina contra coccidiose sobre a habilidade da microbiota cecal anaeróbia (MCA), administrada por diferentes vias (aves tratadas), em proteger pintos de corte da colonização por Salmonella enteritidis (Se). Utilizaram-se 120 aves assim divididas: grupo A, pulverização de MCA em aves vacinadas contra coccidiose e desafiadas com Se, grupo B, inoculação endoesofágica de MCA em aves vacinadas e desafiadas, grupo C, MCA na água de bebida de aves vacinadas e desafiadas, grupo...

  19. Vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    N.V. Vakhnina

    2014-01-01

    Full Text Available Vascular pathology of the brain is the second most common cause of cognitive impairment after Alzheimer's disease. The article describes the modern concepts of etiology, pathogenetic mechanisms, clinical features and approaches to diagnosis and therapy of vascular cognitive impairment (VCI. Cerebrovascular accident, chronic cerebral circulatory insufficiency and their combination, sometimes in combination with a concomitant neurodegenerative process, are shown to be the major types of brain lesions leading to VCI. The clinical presentation of VCI is characterized by the neuropsychological status dominated by impairment of the executive frontal functions (planning, control, attention in combination with focal neurological symptoms. The diagnosis is based on comparing of the revealed neuropsychological and neurological features with neuroimaging data. Neurometabolic, acetylcholinergic, glutamatergic, and other vasoactive drugs and non-pharmacological methods are widely used to treat VCI. 

  20. Plant Vascular Biology 2010

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Biao

    2014-11-17

    This grant supported the Second International Conference on Plant Vascular Biology (PVB 2010) held July 24-28, 2010 on the campus of Ohio State University, Columbus, Ohio. Biao Ding (Ohio State University; OSU) and David Hannapel (Iowa State University; ISU) served as co-chairs of this conference. Biao Ding served as the local organizer. PVB is defined broadly here to include studies on the biogenesis, structure and function of transport systems in plants, under conditions of normal plant growth and development as well as of plant interactions with pathogens. The transport systems cover broadly the xylem, phloem, plasmodesmata and vascular cell membranes. The PVB concept has emerged in recent years to emphasize the integrative nature of the transport systems and approaches to investigate them.

  1. Vascular Thoracic Outlet Syndrome.

    Science.gov (United States)

    Hussain, Mohamad Anas; Aljabri, Badr; Al-Omran, Mohammed

    2016-01-01

    Two distinct terms are used to describe vascular thoracic outlet syndrome (TOS) depending on which structure is predominantly affected: venous TOS (due to subclavian vein compression) and arterial TOS (due to subclavian artery compression). Although the venous and arterial subtypes of TOS affect only 3% and <1% of all TOS patients respectively, the diagnostic and management approaches to venous and arterial TOS have undergone considerable evolution due to the recent emergence of minimally invasive endovascular techniques such as catheter-directed arterial and venous thrombolysis, and balloon angioplasty. In this review, we discuss the anatomical factors, etiology, pathogenesis and clinical presentation of vascular TOS patients. In addition, we use the most up to date observational evidence available to provide a contemporary approach to the diagnosis and management of venous TOS and arterial TOS patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Engineered vascularized bone grafts

    OpenAIRE

    Tsigkou, Olga; Pomerantseva, Irina; Spencer, Joel A.; Redondo, Patricia A.; Hart, Alison R.; O’Doherty, Elisabeth; Lin, Yunfeng; Friedrich, Claudia C.; Daheron, Laurence; Lin, Charles P.; Sundback, Cathryn A.; Vacanti, Joseph P.; Neville, Craig

    2010-01-01

    Clinical protocols utilize bone marrow to seed synthetic and decellularized allogeneic bone grafts for enhancement of scaffold remodeling and fusion. Marrow-derived cytokines induce host neovascularization at the graft surface, but hypoxic conditions cause cell death at the core. Addition of cellular components that generate an extensive primitive plexus-like vascular network that would perfuse the entire scaffold upon anastomosis could potentially yield significantly higher-quality grafts. W...

  3. Mammary Duct Ectasia

    Science.gov (United States)

    ... Reactive and inflammatory conditions of the breast. In: Breast Pathology. Philadelphia, Pa.: Saunders Elsevier; 2012. https://www.clinicalkey.com. Accessed Feb. 5, 2015. Diagnosis of breast disease. Bloomington, Minn.: Institute for Clinical Systems Improvement ( ...

  4. Pulmonary vascular imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fedullo, P.F.; Shure, D.

    1987-03-01

    A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The characteristics of any ideal technique would include high sensitivity and specificity, safety, simplicity, and sequential applicability. To date, no single technique meets these ideal characteristics. Conventional pulmonary angiography remains the gold standard for the diagnosis of acute thromboembolic disease despite the introduction of newer techniques such as digital subtraction angiography and magnetic resonance imaging. Improved noninvasive lower extremity venous testing methods, particularly impedance plethysmography, and ventilation-perfusion scanning can play significant roles in the noninvasive diagnosis of acute pulmonary emboli when properly applied. Ventilation-perfusion scanning may also be useful as a screening test to differentiate possible primary pulmonary hypertension from chronic thromboembolic pulmonary hypertension. And, finally, angioscopy may be a useful adjunctive technique to detect chronic thromboembolic disease and determine operability. Optimal clinical decision-making, however, will continue to require the proper interpretation of adjunctive information obtained from the less-invasive techniques, applied with an understanding of the natural history of the various forms of pulmonary vascular disease and with a knowledge of the capabilities and shortcomings of the individual techniques.

  5. Vascular lesions following radiation

    International Nuclear Information System (INIS)

    Fajardo, L.F.; Berthrong, M.

    1988-01-01

    The special radiation sensitivity of the vascular system is mainly linked to that of endothelial cells, which are perhaps the most radiation-vulnerable elements of mesenchymal tissues. Within the vascular tree, radiation injures most often capillaries, sinusoids, and small arteries, in that order. Lesions of veins are observed less often, but in certain tissues the veins are regularly damaged (e.g., intestine) or are the most affected structures (i.e., liver). Large arteries do suffer the least; however, when significant damage does occur in an elastic artery (e.g., thrombosis or rupture), it tends to be clinically significant and even fatal. Although not always demonstrable in human tissues, radiation vasculopathy generally is dose and time dependent. Like other radiation-induced lesions, the morphology in the vessels is not specific, but it is characteristic enough to be often recognizable. Vascular injury, especially by therapeutic radiation is not just a morphologic marker. It is a mediator of tissue damage; perhaps the most consistent pathogenetic mechanism in delayed radiation injury

  6. Pulmonary vascular imaging

    International Nuclear Information System (INIS)

    Fedullo, P.F.; Shure, D.

    1987-01-01

    A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The characteristics of any ideal technique would include high sensitivity and specificity, safety, simplicity, and sequential applicability. To date, no single technique meets these ideal characteristics. Conventional pulmonary angiography remains the gold standard for the diagnosis of acute thromboembolic disease despite the introduction of newer techniques such as digital subtraction angiography and magnetic resonance imaging. Improved noninvasive lower extremity venous testing methods, particularly impedance plethysmography, and ventilation-perfusion scanning can play significant roles in the noninvasive diagnosis of acute pulmonary emboli when properly applied. Ventilation-perfusion scanning may also be useful as a screening test to differentiate possible primary pulmonary hypertension from chronic thromboembolic pulmonary hypertension. And, finally, angioscopy may be a useful adjunctive technique to detect chronic thromboembolic disease and determine operability. Optimal clinical decision-making, however, will continue to require the proper interpretation of adjunctive information obtained from the less-invasive techniques, applied with an understanding of the natural history of the various forms of pulmonary vascular disease and with a knowledge of the capabilities and shortcomings of the individual techniques

  7. Hypertonic Saline Solution Drives Neutrophil from Bystander Organ to Infectious Site in Polymicrobial Sepsis: A Cecal Ligation and Puncture Model

    Science.gov (United States)

    Theobaldo, Mariana Cardillo; Llimona, Flavia; Petroni, Ricardo Costa; Rios, Ester Correia Sarmento; Velasco, Irineu Tadeu; Soriano, Francisco Garcia

    2013-01-01

    The effects of hypertonic saline solution (HSS) have been shown in several animal models of ischemia and shock. Literature has shown potential benefits of HSS modulating inflammatory response after sepsis in an animal model. We studied the HSS effects in sepsis through cecal ligation and puncture (CLP) in Balb-C mice. Groups studied: 1- CLP without treatment (CLP-C); 2- CLP treated with normal saline solution NaCl 0.9% – 34 ml/Kg (CLP-S); 3- CLP treated with HSS NaCl 7.5% – 4 ml/Kg (CLP-H); and 4- group (Basal) without no CLP or treatment. Volume infusion was always applied 30 min after CLP. Lung and peritoneal lavage were harvested after 6h and 24h of CLP to analyze cytokines amount, oxide nitric, lipid peroxidation and neutrophil infiltration. Neutrophil infiltration, ICAM-1, CXCR-2, and CXCL-1 in lung were reduced by HSS (CLP-H) compared to CLP-C or CLP-S. Neutrophil in peritoneal lavage was increased in 24h with HSS (CLP-H) compared to CLP and CLP-S. Peritoneal CXCR-2 was increased in CLP-C and CLP-S but presented a lower increase with HSS (CLP-H) after 6 hours. GRK-2 presented difference among the groups at 24 h, showing a profile similar to neutrophil infiltration. Pro-inflammatory cytokines (TNF-α and IL-6) were reduced by HSS treatment; CLP-S increased TNF-α. IL-10 was increased in lung tissue by the HSS treatment. The oxidative stress (TBARS and nitric oxide biochemistry markers) was reduced with HSS. Animal survival was 33.3% in CLP-C group, 46.6% in CLP-S group and 60% in the CLP-H group after the sixth day. The HSS protects the animal against sepsis. Our results suggest that the volume replacement modulate pro and anti-inflammatory mediators of an inflammatory response, but HSS presented a more effective and potent effect. PMID:24069301

  8. Characterisation of the vascular pathology in Sigmodon hispidus (Rodentia: Cricetidae following experimental infection with Angiostrongylus costaricensis (Nematoda: Metastrongylidae

    Directory of Open Access Journals (Sweden)

    Danielle Ingrid Bezerra de Vasconcelos

    Full Text Available BACKGROUND Angiostrongylus costaricensis is a nematode that causes human abdominal angiostrongyliasis, a disease found mainly in Latin American countries and particularly in Brazil and Costa Rica. Its life cycle involves exploitation of both invertebrate and vertebrate hosts. Its natural reservoir is a vertebrate host, the cotton rat Sigmodon hispidus. The adult worms live in the ileo-colic branches of the upper mesenteric artery of S. hispidus, causing periarteritis. However, there is a lack of data on the development of vasculitis in the course of infection. OBJECTIVE To describe the histopathology of vascular lesions in S. hispidus following infection with A. costaricensis. METHODS Twenty-one S. hispidus were euthanised at 30, 50, 90 and 114 days post-infection (dpi, and guts and mesentery (including the cecal artery were collected. Tissues were fixed in Carson’s Millonig formalin, histologically processed for paraffin embedding, sectioned with a rotary microtome, and stained with hematoxylin-eosin, resorcin-fuchsin, Perls, Sirius Red (pH = 10.2, Congo Red, and Azan trichrome for brightfield microscopy analysis. FINDINGS At 30 and 50 dpi, live eggs and larvae were present inside the vasa vasorum of the cecal artery, leading to eosinophil infiltrates throughout the vessel adventitia and promoting centripetal vasculitis with disruption of the elastic layers. Disease severity increased at 90 and 114 dpi, when many worms had died and the intensity of the vascular lesions was greatest, with intimal alterations, thrombus formation, iron accumulation, and atherosclerosis. CONCLUSION In addition to abdominal angiostrongyliasis, our data suggest that this model could be very useful for autoimune vasculitis and atherosclerosis studies.

  9. Effect of dietary protein content on ileal amino acid digestibility, growth performance, and formation of microbial metabolites in ileal and cecal digesta of early-weaned pigs.

    Science.gov (United States)

    Htoo, J K; Araiza, B A; Sauer, W C; Rademacher, M; Zhang, Y; Cervantes, M; Zijlstra, R T

    2007-12-01

    Diarrhea incidence in weaned pigs may be associated with the concentration of intestinal microbial metabolites (ammonia, amines, and VFA) that are influenced by dietary CP content. Three experiments were conducted to determine effects of a low-protein, AA-supplemented diet on ileal AA digestibility, growth performance, diarrhea incidence, and concentration of microbial metabolites in ileal and cecal digesta of pigs weaned at 14 d of age. In Exp. 1, 8 pigs fitted with a simple T-cannula at the distal ileum were assigned in a crossover design to 2 diets containing 24 or 20% CP using wheat, corn, full-fat soybeans, whey powder, fish meal, and blood plasma as the main ingredients. Supplemental AA were added to the diets to meet the AA standards according to the 1998 NRC recommendations. Chromic oxide was used as an indigestible marker. Diets were fed at 2.5 times the ME requirement for maintenance. The reduction of dietary CP decreased (P water. Dietary CP content did not affect growth performance or fecal consistency scores during the 3-wk study, and diarrhea was not observed. The results of these experiments indicate that lowering the dietary CP content combined with supplementation of AA markedly reduced the production of potentially harmful microbial metabolites in cecal digesta of early-weaned pigs without affecting growth performance.

  10. DESEMPENHO, RENDIMENTO DE CARCAÇA E pH CECAL DE COELHOS EM CRESCIMENTO ALIMENTADOS COM DIETAS CONTENDO NÍVEIS DE PROBIÓTICO

    Directory of Open Access Journals (Sweden)

    Daiane Regina Caires

    2006-10-01

    Full Text Available O objetivo deste experimento foi avaliar o desempenho, o rendimento de carcaça e o pH cecal de coelhos em crescimento alimentados com dietas contendo diferentes níveis de probiótico composto por Lactobacillus acidophilus, L. casei, Bifidobacterium bifidum, Streptococcus salivarium, Enterococcus faecium, Bacillus subtillis, B. toyoi e Saccharomyces cerevisiae. Foram utilizados 48 coelhos Nova Zelândia Branco num delineamento inteiramente casualizado com quatro tratamentos e quatro repetições. Os coelhos foram desmamados aos 35 dias e abatidos aos 85 dias de idade. Os níveis de probiótico dietético avaliados foram 0,00%, 0,01%, 0,02% e 0,03%. Não houve efeito significativo (P>0,05 em decorrência da inclusão do probiótico na dieta dos animais sobre o desempenho, rendimento e pH cecal, com vistas a uma melhoria nos índices zootécnicos desses animais. PALAVRAS-CHAVE: Aditivos, bactérias, microrganismos.

  11. Vascular barrier protective effects of baicalin, baicalein and wogonin in vitro and in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Soyoung [College of Pharmacy, CMRI, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 702-701 (Korea, Republic of); Ku, Sae-Kwang [Department of Anatomy and Histology, College of Korean Medicine, Daegu Haany University, Gyeongsan 712-715 (Korea, Republic of); Han, Min-Su [Laboratory for Arthritis and Bone Biology, Fatima Research Institute, Fatima Hospital, Daegu 701-600 (Korea, Republic of); Bae, Jong-Sup, E-mail: baejs@knu.ac.kr [College of Pharmacy, CMRI, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 702-701 (Korea, Republic of)

    2014-11-15

    Inhibition of high mobility group box 1 (HMGB1) protein and restoration of endothelial integrity is emerging as an attractive therapeutic strategy in the management of sepsis. Here, three structurally related polyphenols found in the Chinese herb Huang Qui, baicalin (BCL), baicalein (BCN), and wogonin (WGN), were examined for their effects on lipopolysaccharide (LPS)- or cecal ligation and puncture (CLP)-mediated release of HMGB1 and on modulation of HMGB1-mediated inflammatory responses. According to our data, BCL, BCN, and WGN inhibited the release of HMGB1 and down-regulated HMGB1-dependent inflammatory responses in human endothelial cells. BCL, BCN, and WGN also inhibited HMGB1-mediated hyperpermeability and leukocyte migration in mice. In addition, treatment with BCL, BCN, and WGN reduced CLP-induced release of HMGB1 and sepsis-related mortality and pulmonary injury in mice. These results indicate that BCL, BCN, and WGN could be candidate therapeutic agents for various severe vascular inflammatory diseases owing to their inhibition of the HMGB1 signaling pathway. - Highlights: • HMGB1 is an inflammatory mediator for vascular inflammation. • Baicalin, baicalein and wogonin inhibited HMGB1-induced hyperpermeability in vitro and in vivo. • Baicalin, baicalein and wogonin inhibited HMGB1-mediated inflammatory responses. • Baicalin, baicalein and wogonin suppressed the activation of NF-κB and ERK1/2 and production of TNF-α and IL-6. • Baicalin, baicalein and wogonin prevent CLP-induced septic mortality.

  12. Interventional vascular radiology

    International Nuclear Information System (INIS)

    Yune, H.Y.

    1984-01-01

    The papers published during this past year in the area of interventional vascular radiology presented some useful modifications and further experiences both in the area of thromboembolic therapy and in dilation and thrombolysis, but no new techniques. As an introductory subject, an excellent monograph reviewing the current spectrum of pharmacoangiography was presented in Radiographics. Although the presented material is primarily in diagnostic application of various pharmacologic agents used today to facilitate demonstration of certain diagnostic criteria of various disease processes, both vasodilatory and vasoconstrictive reaction to these agents are widely used in various therapeutic vascular procedures. This monograph should be reviewed by every angiographer whether or not he or she performs interventional procedures, and it would be very convenient to have this table available in the angiography suite. In a related subject, Bookstein and co-workers have written an excellent review concerning pharmacologic manipulations of various blood coagulative parameters during angiography. Understanding the proper method of manipulation of the bloodclotting factors during angiography, and especially during interventional angiography, is extremely important. Particularly, the method of manipulating the coagulation with the use of heparin and protamine and modification of the platelet activity by using aspirin and dipyridamole are succinctly reviewed. The systemic and selective thrombolytic activities of streptokianse are also discussed

  13. Spinal vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Krings, Timo [University Hospital Aachen, Department of Neuroradiology, Aachen (Germany); University Hospital Aachen, Department of Neurosurgery, Aachen (Germany); Mull, Michael; Thron, Armin [University Hospital Aachen, Department of Neuroradiology, Aachen (Germany); Gilsbach, Joachim M. [University Hospital Aachen, Department of Neurosurgery, Aachen (Germany)

    2005-02-01

    Spinal vascular malformations are rare diseases that consist of true inborn cavernomas and arteriovenous malformations (including perimedullary fistulae, glomerular and juvenile AVMs) and presumably acquired dural arteriovenous fistulae. This review article gives an overview of the imaging features both on MRI and angiography, the differential diagnoses, the clinical symptomatology and the potential therapeutic approaches to these diseases. It is concluded that MRI is the diagnostic modality of first choice in suspected spinal vascular malformation and should be complemented by selective spinal angiography. Treatment in symptomatic patients offers an improvement in the prognosis, but should be performed in specialized centers. Patients with spinal cord cavernomas and perimedullary fistulae type I are surgical candidates. Dural arteriovenous fistulae can either be operated upon or can be treated by an endovascular approach, the former being a simple, quick and secure approach to obliterate the fistula, while the latter is technically demanding. In spinal arteriovenous malformations, the endovascular approach is the method of first choice; in selected cases, a combined therapy might be sensible. (orig.)

  14. Vascular Remodeling in Experimental Hypertension

    Directory of Open Access Journals (Sweden)

    Norma R. Risler

    2005-01-01

    Full Text Available The basic hemodynamic abnormality in hypertension is an increased peripheral resistance that is due mainly to a decreased vascular lumen derived from structural changes in the small arteries wall, named (as a whole vascular remodeling. The vascular wall is an active, flexible, and integrated organ made up of cellular (endothelial cells, smooth muscle cells, adventitia cells, and fibroblasts and noncellular (extracellular matrix components, which in a dynamic way change shape or number, or reorganize in response to physiological and pathological stimuli, maintaining the integrity of the vessel wall in physiological conditions or participating in the vascular changes in cardiovascular diseases such as hypertension. Research focused on new signaling pathways and molecules that can participate in the mechanisms of vascular remodeling has provided evidence showing that vascular structure is not only affected by blood pressure, but also by mechanisms that are independent of the increased pressure. This review will provide an overview of the evidence, explaining some of the pathophysiologic mechanisms participating in the development of the vascular remodeling, in experimental models of hypertension, with special reference to the findings in spontaneously hypertensive rats as a model of essential hypertension, and in fructose-fed rats as a model of secondary hypertension, in the context of the metabolic syndrome. The understanding of the mechanisms producing the vascular alterations will allow the development of novel pharmacological tools for vascular protection in hypertensive disease.

  15. Delayed Treatment with Sodium Hydrosulfide Improves Regional Blood Flow and Alleviates Cecal Ligation and Puncture (CLP)-Induced Septic Shock.

    Science.gov (United States)

    Ahmad, Akbar; Druzhyna, Nadiya; Szabo, Csaba

    2016-08-01

    Cecal ligation and puncture (CLP)-induced sepsis is a serious medical condition, caused by a severe systemic infection resulting in a systemic inflammatory response. Recent studies have suggested the therapeutic potential of donors of hydrogen sulfide (H2S), a novel endogenous gasotransmitter and biological mediator in various diseases. The aim of the present study was to assess the effect of H2S supplementation in sepsis, with special reference to its effect on the modulation of regional blood flow. We infused sodium hydrosulfide (NaHS), a compound that produces H2S in aqueous solution (1, 3, or 10 mg/kg/h, for 1 h at each dose level) in control rats or rats 24 h after CLP, and measured blood flow using fluorescent microspheres. In normal control animals, NaHS induced a characteristic redistribution of blood flow, and reduced cardiac, hepatic, and renal blood flow in a dose-dependent fashion. In contrast, in rats subjected to CLP, cardiac, hepatic, and renal blood flow was significantly reduced; infusion of NaHS (1 mg/kg/h and 3 mg/kg/h) significantly increased organ blood flow. In other words, the effect of H2S on regional blood flow is dependent on the status of the animals (i.e., a decrease in blood flow in normal controls, but an increase in blood flow in CLP). We have also evaluated the effect of delayed treatment with NaHS on organ dysfunction and the inflammatory response by treating the animals with NaHS (3 mg/kg) intraperitoneally (i.p.) at 24 h after the start of the CLP procedure; plasma levels of various cytokines and tissue indicators of inflammatory cell infiltration and oxidative stress were measured 6 h later. After 24 h of CLP, glomerular function was significantly impaired, as evidenced by markedly increased (over 4-fold over baseline) blood urea nitrogen and creatinine levels; this increase was also significantly reduced by treatment with NaHS. NaHS also attenuated the CLP-induced increases in malondialdehyde levels (an index of

  16. Temporary vascular shunting in vascular trauma: A 10-year review ...

    African Journals Online (AJOL)

    Five patients with non-viable limbs had the vessel ligated. Conclusions. A TIVS in the damage control setting is both life- and limb-saving. These shunts can be inserted safely in a facility without access to a surgeon with vascular surgery experience if there is uncontrollable bleeding or the delay to definitive vascular surgery ...

  17. Additive Manufacturing of Vascular Grafts and Vascularized Tissue Constructs.

    Science.gov (United States)

    Elomaa, Laura; Yang, Yunzhi Peter

    2017-10-01

    There is a great need for engineered vascular grafts among patients with cardiovascular diseases who are in need of bypass therapy and lack autologous healthy blood vessels. In addition, because of the severe worldwide shortage of organ donors, there is an increasing need for engineered vascularized tissue constructs as an alternative to organ transplants. Additive manufacturing (AM) offers great advantages and flexibility of fabrication of cell-laden, multimaterial, and anatomically shaped vascular grafts and vascularized tissue constructs. Various inkjet-, extrusion-, and photocrosslinking-based AM techniques have been applied to the fabrication of both self-standing vascular grafts and porous, vascularized tissue constructs. This review discusses the state-of-the-art research on the use of AM for vascular applications and the key criteria for biomaterials in the AM of both acellular and cellular constructs. We envision that new smart printing materials that can adapt to their environment and encourage rapid endothelialization and remodeling will be the key factor in the future for the successful AM of personalized and dynamic vascular tissue applications.

  18. Peripheral vascular injuries

    Directory of Open Access Journals (Sweden)

    Celal Yavuz

    2009-01-01

    Full Text Available Aim: To determine etiology and management in patients with peripheral vascular trauma.Materials and Methods: From 2005 to 2006 with a diagnosis of peripheral artery injury, 69 cases admitted to Diyarbakır State Hospital Department of Cardiovascular surgery.Results: These cases have been respectively reviewed. The causes of injuries were; penetrating injuries in 60 cases (87%, blunt trauma in seven cases (10% and gunshot injuries in two cases (3%. In 53 cases (74% upper extremity, in 15 cases (21% lower extremity was involved. As a surgical procedure, in 34 cases (47% end-to-end anastomosis, in 28 cases (39% lateral suture, in five cases (7% venous graft interposition, in five cases (7% ligation was performed.Conclusion: Early intervention, transfusion of fluid and blood, systemic anticoagulation, preoperative and postoperative detailed debridement decreased the morbidity and mortality rates.

  19. Eyes wide shut - unusual two stage repair of pectus excavatum and annuloaortic ectasia in a 37 year old marfan patient: case report

    Directory of Open Access Journals (Sweden)

    Barriuso Clemente

    2011-05-01

    Full Text Available Abstract We report about a 37 year old male patient with a pectus excavatum. The patient was in NYHA functional class III. After performed computed tomography the symptoms were thought to be related to the severity of chest deformation. A Ravitch-procedure had been accomplished in a district hospital in 2009. The crack of a metal bar led to a reevaluation 2010, in which surprisingly the presence of an annuloaortic ectasia (root 73 × 74 mm in direct neighborhood of the formerly implanted metal-bars was diagnosed. Echocardiography revealed a severe aortic valve regurgitation, the left ventricle was massively dilated presenting a reduced ejection fraction of 45%. A marfan syndrome was suspected and the patient underwent a valve sparing aortic root replacement (David procedure in our institution with an uneventful postoperative course. A review of the literature in combination with discussion of our case suggests the application of stronger recommendations towards preoperative cardiovascular assessment in patients with pectus excavatum.

  20. Aortic root reconstruction by aortic valve-sparing operation (David type I reimplantation) in Marfan syndrome accompanied by annuloaortic ectasia and acute type-A aortic dissection.

    Science.gov (United States)

    Inamura, Shunichi; Furuya, Hidekazu; Yagi, Kentarou; Ikeya, Eriko; Yamaguchi, Masaomi; Fujimura, Takabumi; Kanabuchi, Kazuo

    2006-09-20

    To reconstruct the aortic root for aneurysm of the ascending aorta accompanied by aortic regurgitation, annuloaortic ectasia (AAE) and acute type-A dissection with root destruction, the Bentall operation using a prosthetic valve still is the standard procedure today. Valve-sparing procedures have actively been used for aortic root lesions, and have also been attempted in aortic root reconstruction for Marfan syndrome which may have abnormalities in the valve leaflets. We conducted a valve-sparing procedure in a female patient with Marfan syndrome who had AAE accompanied by type-A acute aortic dissection. The patient was a 37-year-old woman complaining of severe pain from the chest to the back. The limbs were long, and funnel breast was observed. Diastolic murmurs were heard. On chest computed tomography, a dissection cavity was present from the ascending aorta to the left common iliac artery, and the root dilated to 55 mm. Grade II aortic regurgitation was observed on ultrasound cardiography. Regarding her family history, her father had died suddenly at 54 years of age. She was diagnosed with type-A acute dissection concurrent with Marfan syndrome and AAE. The structure of the aortic valve was normal, and root reconstruction by a valve-sparing operation and total replacement of the aortic arch was conducted. On postoperative ultrasound cardiography, the aortic regurgitation was within the allowable range, and the shortterm postoperative results were good.

  1. In vivo biomechanical changes after corneal collagen cross-linking for keratoconus and corneal ectasia: 1-year analysis of a randomized, controlled, clinical trial.

    Science.gov (United States)

    Greenstein, Steven A; Fry, Kristen L; Hersh, Peter S

    2012-01-01

    To investigate the in vivo, corneal, biomechanical changes after corneal collagen cross-linking (CXL) using the Ocular Response Analyzer (ORA) in patients with keratoconus and post-laser in situ keratomileusis (LASIK) ectasia. Single-center, prospective, randomized, controlled, clinical trial. After CXL (69 eyes, 46 keratoconus and 23 post-LASIK), corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using the ORA and analyzed in a treatment, sham control, and fellow eye control group at baseline and 1, 3, 6, and 12 months. There were no significant changes in CH (change = 0.05 ± 1.5; P = 0.78) or CRF (change = 0.29 ± 1.4; P = 0.1) at 1 year compared with preoperative values. Changes in CH and CRF were not correlated with changes in clinical outcomes of uncorrected visual acuity, best spectacle-corrected visual acuity, and maximum keratometry. There were no significant changes in CH in the sham or fellow eye control groups (P(sham) = 0.7; P(FE) = 0.3) or CRF (P(sham) = 0.6; P(FE) = 0.72). Despite an increase in CRF at one month, there were no statistically significant changes in CH and CRF measurements 1 year after CXL. Development of other in vivo biomechanical metrics would aid in evaluating the corneal response to CXL.

  2. The vascular secret of Klotho

    DEFF Research Database (Denmark)

    Lewin, Ewa; Olgaard, Klaus

    2015-01-01

    Klotho is an evolutionarily highly conserved protein related to longevity. Increasing evidence of a vascular protecting effect of the Klotho protein has emerged and might be important for future treatments of uremic vascular calcification. It is still disputed whether Klotho is locally expressed ...

  3. Dynamic adaption of vascular morphology

    DEFF Research Database (Denmark)

    Okkels, Fridolin; Jacobsen, Jens Christian Brings

    2012-01-01

    The structure of vascular networks adapts continuously to meet changes in demand of the surrounding tissue. Most of the known vascular adaptation mechanisms are based on local reactions to local stimuli such as pressure and flow, which in turn reflects influence from the surrounding tissue. Here ...

  4. Diagnostic criteria for vascular dementia

    NARCIS (Netherlands)

    Scheltens, P.; Hijdra, A. H.

    1998-01-01

    The term vascular dementia implies the presence of a clinical syndrome (dementia) caused by, or at least assumed to be caused by, a specific disorder (cerebrovascular disease). In this review, the various sets of criteria used to define vascular dementia are outlined. The various sets of criteria

  5. Social media in vascular surgery.

    Science.gov (United States)

    Indes, Jeffrey E; Gates, Lindsay; Mitchell, Erica L; Muhs, Bart E

    2013-04-01

    There has been a tremendous growth in the use of social media to expand the visibility of various specialties in medicine. The purpose of this paper is to describe the latest updates on some current applications of social media in the practice of vascular surgery as well as existing limitations of use. This investigation demonstrates that the use of social networking sites appears to have a positive impact on vascular practice, as is evident through the incorporation of this technology at the Cleveland Clinic and by the Society for Vascular Surgery into their approach to patient care and physician communication. Overall, integration of social networking technology has current and future potential to be used to promote goals, patient awareness, recruitment for clinical trials, and professionalism within the specialty of vascular surgery. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  6. Caffeine's Vascular Mechanisms of Action

    Directory of Open Access Journals (Sweden)

    Darío Echeverri

    2010-01-01

    Full Text Available Caffeine is the most widely consumed stimulating substance in the world. It is found in coffee, tea, soft drinks, chocolate, and many medications. Caffeine is a xanthine with various effects and mechanisms of action in vascular tissue. In endothelial cells, it increases intracellular calcium stimulating the production of nitric oxide through the expression of the endothelial nitric oxide synthase enzyme. Nitric oxide is diffused to the vascular smooth muscle cell to produce vasodilation. In vascular smooth muscle cells its effect is predominantly a competitive inhibition of phosphodiesterase, producing an accumulation of cAMP and vasodilation. In addition, it blocks the adenosine receptors present in the vascular tissue to produce vasoconstriction. In this paper the main mechanisms of action of caffeine on the vascular tissue are described, in which it is shown that caffeine has some cardiovascular properties and effects which could be considered beneficial.

  7. Effects of chromium-enriched bacillus subtilis KT260179 supplementation on chicken growth performance, plasma lipid parameters, tissue chromium levels, cecal bacterial composition and breast meat quality.

    Science.gov (United States)

    Yang, Jiajun; Qian, Kun; Zhang, Wei; Xu, Yayuan; Wu, Yijing

    2016-11-08

    Both chromium (Cr) and probiotic bacillus own the virtues of regulating animal metabolism and meat quality. Purpose of this study was to evaluate the efficiency of supplemental Cr and bacillus in the form of chromium-enriched Bacillus subtilis KT260179 (CEBS) on chicken growth performance, plasma lipid parameters, tissue chromium levels, cecal bacterial composition and breast meat quality. Six hundred of 1-day-old Chinese Huainan Partridge chickens were divided into four groups randomly: Control, inorganic Cr, Bacillus subtilis, and CEBS. The feed duration was 56 days. After 28 days of treatment, broiler feed CEBS or normal B. subtilis had higher body weights than control broiler, and after 56 days, chickens given either CEBS or B. subtilis had greater body weights than control broiler or those given inorganic Cr. Plasma total cholesterol, triglycerides, and low density lipoprotein cholesterol levels declined significantly in the CEBS group compared with the control, whereas plasma high density lipoprotein cholesterol levels increased significantly. The concentration of Cr in blood and breast muscle increased after CEBS and inorganic Cr supplementation. B. subtilis and CEBS supplementation caused a significant increase in the numbers of Lactobacillus and Bifidobacterium in the caecum, while the numbers of Escherichia coli and Salmonella decreased significantly compared to the control. Feed adding CEBS increased the lightness, redness, and yellowness of breast meat, improved the water-holding capacity, decreased the shear force and cooking loss. In all, CEBS supplementation promoted body growth, improved plasma lipid parameters, increased tissue Cr concentrations, altered cecal bacterial composition and improved breast meat quality.

  8. Effects of concentration of corn distillers dried grains with solubles and enzyme supplementation on cecal microbiota and performance in broiler chickens.

    Science.gov (United States)

    Abudabos, Alaeldein M; Al-Atiyat, Raed M; Albatshan, Hamad A; Aljassim, Rafat; Aljumaah, Mashael R; Alkhulaifi, Manal M; Stanley, Dragana M

    2017-09-01

    With the increasing production of ethanol for biofuels, a by-product of corn-based ethanol fermentation, dried distillers grains with solubles (DDGS) is finding its way into the feed of agricultural animals including cattle, pigs, poultry, sheep, goats, aquaculture species and horses. Corn DDGS contains very high levels of non-starch polysaccharides and could be considered a good source of fibre. Despite knowledge of the role of the fibre in modulating intestinal microbiota and consequently influencing health, there is currently little information on the interactions between DDGS and intestinal microbiota. We assessed the changes in the cecal microbiota of broilers feed rations supplemented with DDGS (five concentrations: 0, 6, 12, 18 and 24% w/w) with and without presence of digestive enzymes. DDGS concentration was strongly positively correlated (P = 3.7e -17 , r = 0.74) with feed conversion efficiency (FCR), diminishing broiler performance with higher concentrations. Additionally, DDGS concentrations positively correlated with Richness index (P = 1.5e -3 , r = 0.5), increasing the number of detectable species in the cecum. Among the most affected genera, Faecalibacterium (P = 0.032, r = -0.34) and Streptococcus (P = 7.9e -3 , r = -0.39) were negatively correlated with DDGS, while Turicibacter (P = 2.8e -4 , r = 0.52) was positively correlated with the DDGS concentration. Enzymes showed minimal effect on cecal microbiota.

  9. Impact of feed restriction and housing hygiene conditions on specific and inflammatory immune response, the cecal bacterial community and the survival of young rabbits.

    Science.gov (United States)

    Combes, S; Massip, K; Martin, O; Furbeyre, H; Cauquil, L; Pascal, G; Bouchez, O; Le Floc'h, N; Zemb, O; Oswald, I P; Gidenne, T

    2017-05-01

    Limiting the post-weaning intake of the young rabbit is known to improve its resistance to digestive disorders, whereas a degradation of its housing hygiene is assumed to have a negative impact on its health. This study aims at providing insights into the mechanism of digestive health preservation regarding both host (growth and immune response) and its symbiotic digestive microbiota. A 2×2 factorial design from weaning (day 28) to day 64 was set up: ad libitum intake or restricted intake at 70% of ad libitum, and high v. low hygiene of housing (n=105 per group). At day 36 and day 45, 15 animals/group were subcutaneously immunized with ovalbumin (OVA) to assess their specific immune response. Blood was sampled at 36, 45, 57 and 64 days of age to determine total and anti-OVA immunoglobulin type G (IgG) and haptoglobin levels. The cecal bacterial community was explored (18 per group) by 454 pyrosequencing of genes coding for the 16S ribosomal RNA, whereas cecal pH, NH3 and volatile fatty acid (VFA) concentrations were measured to characterize fermentative activity. A 30% reduction in feed intake reduced the growth by only 17% (Pratio by 15% (Pratio (3.7 v. 2.4; Phighest in animals raised in poor hygiene conditions after 8 days of restriction, but decreased after 19 days of restriction in high hygiene conditions (-2.15%; Presponse in rabbit, but reduced morbidity instead. Our results suggest that the microbiota composition would be a helpful source of biomarkers of digestive health.

  10. Feeding broilers with dry whey powder and whey protein concentrate affected productive performance, ileal digestibility of nutrients and cecal microbiota community.

    Science.gov (United States)

    Pineda-Quiroga, C; Camarinha-Silva, A; Borda-Molina, D; Atxaerandio, R; Ruiz, R; García-Rodríguez, A

    2018-04-01

    Dietary interventions are a common practice in the poultry industry to promote optimal performance and health of animals. Here, we aim at assessing the influence of supplementing broiler diets with dry whey powder (DWP) and whey protein concentrate (WPC) on nutrient coefficient of apparent ileal digestibility (CAID) and productive performance. Cecal microbiota composition was also determined using Illumina amplicon sequencing. Dietary treatments were control diet (no supplementation of DWP or WPC), 60-DWP (60 g/kg of DWP), and 80-WPC (80 g/kg of WPC). One-day-old male broilers were randomly assigned to one of three treatments, and housed in floor pens. In Trial 1, 90 1-day-old chicks were allocated to three pens/treatment, with 10 birds/pen, during 21 days for CAID evaluation. Diet 60-DWP increased Ca CAID (P=0.041), while diet 80-WPC improved Ca and P CAID (PWPC increased their BW, average daily gain (ADG) and feed intake (FI) during the starter (PWPC reduced the feed conversion ratio of chickens during the starter period (PWPC differed from those fed with control diet (R=0.776, P=0.008; and R=0.740, P=0.008, respectively). The abundance of Bacteroides fragilis, Bacteroides spp., Escherichia coli/Shigella flexneri and Megamonas furniformis increased when 60-DWP and 80-WPC diets were offered, while the presence of Helicobacter pullorum decreased. Lactobacillus salivarius consistently increased in chickens with better feed conversion ratio, which were those fed with 60-DWP. The results obtained in the present study indicate that growth of chickens is improved by DWP and WPC supplementation because of a higher mineral digestibility, increased feed intake and modulation of cecal microbiota communities.

  11. Growth Performance, Relative Meat and Organ Weights, Cecal Microflora, and Blood Characteristics in Broiler Chickens Fed Diets Containing Different Nutrient Density with or without Essential Oils

    Directory of Open Access Journals (Sweden)

    Sang-Jin Kim

    2016-04-01

    Full Text Available The present study was conducted to investigate whether dietary essential oils could affect growth performance, relative organ weights, cecal microflora, immune responses and blood profiles of broiler chickens fed on diets containing different nutrient densities. A total of eight hundred-forty 1-d-old male broiler chicks were randomly allotted into twenty-eight pens (7 pens per treatment, 30 chicks per pen. There were four experimental diets containing two different nutrient densities and supplemented with or without essential oils. Experimental period lasted for 35 days. No clear interaction between nutrient density and essential oils on any of growth performance-related parameters was observed. Live body weights were affected (p<0.05 by nutrient density at 21 days and by dietary essential oils at 35 days. Essential oils significantly (p<0.05 increased daily body weight gain and feed conversion ratio during the periods of 22 to 35 and 1 to 35 days, but failed to affect feed intake during the entire experimental period. Daily weight gain at 1 to 21 days and feed intake at 1 to 21 and 1 to 35 days were significantly impaired (p<0.05 by nutrient density. There were significant treatment interactions (p<0.05 on relative weights of bursa of Fabricius and abdominal fat contents. Finally, either essential oil or nutrient density did not influence the relative percentages of breast and leg meats, the population of cecal microflora, blood parameters and antibody titers against Newcastle disease and infectious bronchitis in broiler chickens. It was concluded that dietary essential oils, independent to nutrient density, failed to stimulate feed intake, but increased growth performance in broiler chickens.

  12. Contemporary vascular smartphone medical applications.

    Science.gov (United States)

    Carter, Thomas; O'Neill, Stephen; Johns, Neil; Brady, Richard R W

    2013-08-01

    Use of smartphones and medical mHealth applications (apps) within the clinical environment provides a potential means for delivering elements of vascular care. This article reviews the contemporary availability of apps specifically themed to major vascular diseases and the opportunities and concerns regarding their integration into practice. Smartphone apps relating to major vascular diseases were identified from the app stores for the 6 most popular smartphone platforms, including iPhone, Android, Blackberry, Nokia, Windows, and Samsung. Search terms included peripheral artery (arterial) disease, varicose veins, aortic aneurysm, carotid artery disease, amputation, ulcers, hyperhydrosis, thoracic outlet syndrome, vascular malformation, and lymphatic disorders. Forty-nine vascular-themed apps were identified. Sixteen (33%) were free of charge. Fifteen apps (31%) had customer satisfaction ratings, but only 3 (6%) had greater than 100. Only 13 apps (27%) had documented medical professional involvement in their design or content. The integration of apps into the delivery of care has the potential to benefit vascular health care workers and patients. However, high-quality apps designed by clinicians with vascular expertise are currently lacking and represent an area of concern in the mHealth market. Improvement in the quality and reliability of these apps will require the development of robust regulation. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Vascular disease in cocaine addiction.

    Science.gov (United States)

    Bachi, Keren; Mani, Venkatesh; Jeyachandran, Devi; Fayad, Zahi A; Goldstein, Rita Z; Alia-Klein, Nelly

    2017-07-01

    Cocaine, a powerful vasoconstrictor, induces immune responses including cytokine elevations. Chronic cocaine use is associated with functional brain impairments potentially mediated by vascular pathology. Although the Crack-Cocaine epidemic has declined, its vascular consequences are increasingly becoming evident among individuals with cocaine use disorder of that period, now aging. Paradoxically, during the period when prevention efforts could make a difference, this population receives psychosocial treatment at best. We review major postmortem and in vitro studies documenting cocaine-induced vascular toxicity. PubMed and Academic Search Complete were used with relevant terms. Findings consist of the major mechanisms of cocaine-induced vasoconstriction, endothelial dysfunction, and accelerated atherosclerosis, emphasizing acute, chronic, and secondary effects of cocaine. The etiology underlying cocaine's acute and chronic vascular effects is multifactorial, spanning hypertension, impaired homeostasis and platelet function, thrombosis, thromboembolism, and alterations in blood flow. Early detection of vascular disease in cocaine addiction by multimodality imaging is discussed. Treatment may be similar to indications in patients with traditional risk-factors, with few exceptions such as enhanced supportive care and use of benzodiazepines and phentolamine for sedation, and avoiding β-blockers. Given the vascular toxicity cocaine induces, further compounded by smoking and alcohol comorbidity, and interacting with aging of the crack generation, there is a public health imperative to identify pre-symptomatic markers of vascular impairments in cocaine addiction and employ preventive treatment to reduce silent disease progression. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. [The future of vascular medicine].

    Science.gov (United States)

    Kroeger, K; Luther, B

    2014-10-01

    In the future vascular medicine will still have a great impact on health of people. It should be noted that the aging of the population does not lead to a dramatic increase in patient numbers, but will be associated with a changing spectrum of co-morbidities. In addition, vascular medical research has to include the intensive care special features of vascular patients, the involvement of vascular medicine in a holistic concept of fast-track surgery, a geriatric-oriented intensive monitoring and early geriatric rehabilitation. For the future acceptance of vascular medicine as a separate subject area under delimitation of cardiology and radiology is important. On the other hand, the subject is so complex and will become more complex in future specialisations that mixing of surgery and angiology is desirable, with the aim to preserve the vascular surgical knowledge and skills on par with the medical and interventional measures and further develop them. Only large, interdisciplinary guided vascular centres will be able to provide timely diagnosis and therapy, to deal with the growing multi-morbidity of the patient, to perform complex therapies even in an acute emergency and due to sufficient number of cases to present with well-trained and experienced teams. These requirements are mandatory to decrease patients' mortality step by step. Georg Thieme Verlag KG Stuttgart · New York.

  15. [Aspects of vascular physiology in clinical and vascular surgical practice: basic principles of vascular mechanics].

    Science.gov (United States)

    Nocke, H; Meyer, F; Lessmann, V

    2014-10-01

    To be able to evaluate properly a vascular problem, basic concepts of vascular physiology need to be considered, as they have been taught in physiology for a long time. This article deals with selected definitions and laws of passive vascular mechanics, subdivided into parameters of vascular filling and parameters of vascular flow. PARAMETERS OF VASCULAR FILLING: During vascular filling the transmural pressure distends the vascular wall until it is balanced by the wall tension. The extent of this distension up to the point of balance depends on the elasticity of the wall. Transmural pressure, wall tension and elasticity are defined, and their respective importance is described by clinical examples, e.g. aneurysm and varix. PARAMETERS OF VASCULAR FLOW: The vascular flow can be divided into stationary and pulsating components. Both components are relevant for the bloodstream. Since the blood flow is directed in the circuit, it can be understood in first approximation as stationary ("direct current").The direct current model uses only the average values of the pulsating variables. The great advantage of the direct current model is that it can be described with simple laws, which are not valid without reservation, but often allow a first theoretical approach to a vascular problem: Ohm's law, driving pressure, flow resistance, Hagen-Poiseuille law, wall shear stress, law of continuity, Bernoulli's equation and Reynold's number are described and associated with clinical examples.The heart is a pressure-suction pump and produces a pulsating flow, the pulse. The pulse runs with pulse wave velocity, which is much larger than the blood flow velocity, through the arterial vascular system. During propagation, the pulse has to overcome the wave resistance (impedance). Wherever the wave resistance changes, e.g., at vascular bifurcations and in the periphery, it comes to reflections. The incident (forward) and reflected (backward) waves are superimposed to yield the resulting

  16. Role of preoperative vascular ultrasonography in hemodialysis vascular access operation.

    Science.gov (United States)

    Siribumrungwong, Boonying; Tomtitchong, Prakitpunthu; Kanpirom, Kitti

    2010-12-01

    Preoperative vascular mapping increase rate of successful hemodialysis vascular access operation. Several studies recommend using this procedure routinely. But some studies recommend using this procedure in selected patients. So this study aims to determine the impacts of preoperative vascular mapping in unfavorable-examined patients. 55 patients were studied retrospectively from August 2006 to October 2009. Before April 2008, the operative plans were based on physical examination (group 1). After April 2008, the surgeon did preoperative vascular mapping prior to the operation in unfavorable-examined patients (group 2). The results were compared. There were high maturation rates in favorable-examined patients. In unfavorable-examined patients, preoperative vascular mapping can identified nonpalpable favorable vein which successful maturation of 18.75%. Complementary duplex scan decrease rate of unsuccessful operation significantly (p = 0.037) but does not increase maturation rate. Careful physical examination is important part before operation. Preoperative vascular mapping has benefit only in patients with unfavorable-examined patients. It finds some nonpalpable favorable vein and decrease unsuccessful exploration.

  17. Trauma vascular, visión del cirujano vascular

    Directory of Open Access Journals (Sweden)

    Dr. D. Cristián Salas

    2011-09-01

    Full Text Available El 3% de todas las lesiones en trauma tiene un componente vascular. Con los conflictos armados del siglo pasado se lograron grandes avances en este campo. A partir de la Guerra de Vietnam gracias a las mejoras en el manejo prehospitalario, traslado de pacientes, y avances en técnica quirúrgica se lograron tasas de sobrevida y de amputaciones que se han mantenido estables hasta la fecha. El diagnóstico de lesiones vasculares en extremidades se realiza con el examen físico, sin embargo las lesiones de vasos torácicos y abdominales requieren de imágenes de apoyo, siempre que el paciente se encuentre estabilizado, generalmente tomografía axial computada. La mayoría de las lesiones vasculares son por trauma penetrante, comprometiendo principalmente las extremidades. Con el desarrollo de los procedimientos invasivos vasculares en los últimos años se ha observado un aumento de lesiones vasculares iatrogénicas. Hoy en día muchos pacientes con trauma vascular son manejados por vía endovascular.

  18. Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

    Directory of Open Access Journals (Sweden)

    Marcello Barbosa Barros

    Full Text Available CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

  19. ( Elaeis guineensis Jacq ) vascular wilt

    African Journals Online (AJOL)

    Effet de la jachére sur l'expérimentation de la fusariose vasculaire du palmier à huile ( Elaeis guineensis Jacq ) : Effects of the fallow in the expression of oil-palm ( Elaeis guineensis Jacq ) vascular wilt.

  20. Vascular lesions of the hand

    Energy Technology Data Exchange (ETDEWEB)

    Drape, Jean-Luc [Service de Radiologie B, Hopital Cochin, APHP, Universite Paris, 27 rue du Fbg Saint-Jacques, 75014 Paris (France)]. E-mail: jean-luc.drape@cch.ap-hop-paris.fr; Feydy, Antoine [Service de Radiologie B, Hopital Cochin, APHP, Universite Paris, 27 rue du Fbg Saint-Jacques, 75014 Paris (France); Guerini, Henri [Service de Radiologie B, Hopital Cochin, APHP, Universite Paris, 27 rue du Fbg Saint-Jacques, 75014 Paris (France); Desmarais, Eric [Service de Radiologie B, Hopital Cochin, APHP, Universite Paris, 27 rue du Fbg Saint-Jacques, 75014 Paris (France); Godefroy, Didier [Service de Radiologie B, Hopital Cochin, APHP, Universite Paris, 27 rue du Fbg Saint-Jacques, 75014 Paris (France); Viet, Dominique Le [Institut de la main, Paris (France); Chevrot, Alain [Service de Radiologie B, Hopital Cochin, APHP, Universite Paris, 27 rue du Fbg Saint-Jacques, 75014 Paris (France)

    2005-12-15

    The vascular malformations are not uncommon on the hand and offer diagnostic and therapeutic challenges. Enjolras and Mulliken's classification is exposed. Their depiction and pretreatment assessment may benefit from non-invasive imaging as color-Doppler ultrasound and MRI combined with magnetic resonance angiography (MRA). Some chronic traumatic vascular injuries as the hypothenar hammer syndrome may also take advantage of these imaging modalities.

  1. Hemimegalencephaly, hemihypertrophy and vascular lesions.

    Science.gov (United States)

    Cristaldi, A; Vigevano, F; Antoniazzi, G; di Capua, M; Andreuzzi, A; Morselli, G; Iorio, F; Fariello, G; Trasimeni, G; Gualdi, G F

    1995-02-01

    We report on two children with hemihypertrophy and ipsilateral hemimegalencephaly. Vascular lesions in one were consistent with a diagnosis of the Klippel-Trénaunay-Weber Syndrome. MRI performed in the first days of life and at 1 month of age revealed the presence of the neuronal anomaly. The occurrence of hemimegalencephaly in our patients indicates that hemihypertrophy and vascular dysplasia are pathogenetically related phenomena of a continuous spectrum in which this brain disorder may appear.

  2. Facial vascular malformations in children

    International Nuclear Information System (INIS)

    Brunelle, F.O.; Lallemand, D.; Chaumont, P.; Teillac, D.; Manach, Y.

    1988-01-01

    The authors present their experience with conventional and digital angiography of vascular malformations of the head and neck in children. 22 hemangioendotheliomas, 8 venous angiomas, and 3 arteriovenous fistula were studied. 22 patients were embolised. DSA offers many advantages during the diagnostic as well as during the therapeutic phase of angiography. Embolization appears to have a major role in treatment of such vascular malformations. (orig.)

  3. Heritability of Retinal Vascular Fractals

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Broe, Rebecca; Kessel, Line

    2017-01-01

    Purpose: To determine the genetic contribution to the pattern of retinal vascular branching expressed by its fractal dimension. Methods: This was a cross-sectional study of 50 monozygotic and 49 dizygotic, same-sex twin pairs aged 20 to 46 years. In 50°, disc-centered fundus photographs, the reti...... vasculature may affect the retinal response to potential vascular disease in later life....

  4. Angiogenesis, Cancer, and Vascular Aging

    Directory of Open Access Journals (Sweden)

    Junji Moriya

    2017-10-01

    Full Text Available Several lines of evidence have revealed that the angiogenic response to ischemic injury declines with age, which might account for the increased morbidity and mortality of cardiovascular disease (CVD among the elderly. While impairment of angiogenesis with aging leads to delayed wound healing or exacerbation of atherosclerotic ischemic diseases, it also inhibits the progression of cancer. Age-related changes of angiogenesis have been considered to at least partly result from vascular aging or endothelial cell senescence. There is considerable evidence supporting the hypothesis that vascular cell senescence contributes to the pathogenesis of age-related CVD, suggesting that vascular aging could be an important therapeutic target. Since therapeutic angiogenesis is now regarded as a promising concept for patients with ischemic CVD, it has become even more important to understand the detailed molecular mechanisms underlying impairment of angiogenesis in older patients. To improve the usefulness of therapeutic angiogenesis, approaches are needed that can compensate for impaired angiogenic capacity in the elderly while not promoting the development or progression of malignancy. In this review, we briefly outline the mechanisms of angiogenesis and vascular aging, followed by a description of how vascular aging leads to impairment of angiogenesis. We also examine potential therapeutic approaches that could enhance angiogenesis and/or vascular function in the elderly, as well as discussing the possibility of anti-senescence therapy or reversal of endothelial cell senescence.

  5. Obesity in Indian subjects with Vascular Dementia

    OpenAIRE

    Chandra, Mina; Anand, Kuljeet Singh Anand

    2015-01-01

    ABSTRACT Background: Obesity is considered a public health challenge in South Asia. Obesity is an independent risk factor in vascular dementia. It also contributes to other risk factors of vascular dementia like hypertension, coronary artery disease, dyslipidaemia and diabetes. As the rate of obesity in Indian subjects with vascular dementia is not known, we decided to assess obesity in subjects with vascular dementia. Methods: Subjects with vascular dementia presenting to Mem...

  6. Broilers fed dietary vitamins harbor higher diversity of cecal bacteria and higher ratio of Clostridium, Faecalibacterium, and Lactobacillus than broilers with no dietary vitamins revealed by 16S rRNA gene clone libraries.

    Science.gov (United States)

    Luo, Yu-heng; Peng, Huan-wei; Wright, André-Denis G; Bai, Shi-ping; Ding, Xue-mei; Zeng, Qiu-feng; Li, Hua; Zheng, Ping; Su, Zhuo-wei; Cui, Ren-yong; Zhang, Ke-ying

    2013-09-01

    Research on the interaction between dietary vitamins and intestinal bacteria is poorly understood. To investigate the effect of dietary vitamins on the cecal bacterial communities, 2 bacterial 16S rRNA gene clone libraries were constructed from pooled PCR products obtained from the cecal digesta of 28-d broilers fed diets with vitamins (V) at the NRC level or with no vitamins (NV). The results showed that BW gain and average feed intake of V broilers was significantly higher (P vitamins can increase the ratio of facultative pathogenic bacteria and decrease the diversity of bacteria in the cecum of broilers. Our results provide new leads for further investigations on the interaction between dietary vitamin additives and the gut health of broilers.

  7. Original XPCTM Effect on Salmonella Typhimurium and Cecal Microbiota from Three Different Ages of Broiler Chickens When Incubated in an Anaerobic In Vitro Culture System

    Directory of Open Access Journals (Sweden)

    Si Hong Park

    2017-06-01

    Full Text Available Feed supplements are utilized in the poultry industry as a means for improving growth performance and reducing pathogens. The aim of the present study was to evaluate the effects of Diamond V Original XPCTM (XPC, a fermented product generated from yeast cultures on Salmonella Typhimurium ST 97 along with its potential for modulation of the cecal microbiota by using an anaerobic in vitro mixed culture assay. Cecal slurries obtained from three broiler chickens at each of three sampling ages (14, 28, and 42 days were generated and exposed to a 24 h pre-incubation period with the various treatments: XPC (1% XPC, ceca, and feeds, CO (ceca only, and NC (negative control group consisting of ceca and feeds. The XPC, CO, and NC were each challenged with S. Typhimurium and subsequently plated on selective media at 0, 24, and 48 h. Plating results indicated that the XPC treatment significantly reduced the survival of S. Typhimurium at the 24 h plating time point for both the 28 and 42 days bird sampling ages, while S. Typhimurium reduction in the NC appeared to eventually reach the same population survival level at the 48 h plating time point. For microbiome analysis, Trial 1 revealed that XPC, CO, and NC groups exhibited a similar pattern of taxa summary. However, more Bacteroidetes were observed in the CO group at 24 and 48 h. There were no significant differences (P > 0.05 in alpha diversity among samples based on day, hour and treatment. For beta diversity analysis, a pattern shift was observed when samples clustered according to sampling hour. In Trial 2, both XPC and NC groups exhibited the highest Firmicutes level at 0 h but the Bacteroidetes group became dominant at 6 h. Complexity of alpha diversity was increased in the initial contents from older birds and became less complex after 6 h of incubation. Beta diversity analysis was clustered as a function of treatment NC and XPC groups and by individual hours including 6, 12, 24, and 48 h. Overall

  8. Effect of supplementation of yeast with bacteriocin and culture on growth performance, cecal fermentation, microbiota composition, and blood characteristics in broiler chickens

    Directory of Open Access Journals (Sweden)

    C. Y. Chen

    2017-02-01

    Full Text Available Objective The aim of the present study was to investigate the effect of yeast with bacteriocin and Lactobacillus cultures (mixture of Lactobacillus agilis BCRC 10436 and Lactobacillus reuteri BCRC 17476 supplements, alone or in combination, on broiler chicken performance. Methods A total of 300, 1-d-old healthy broiler chickens were randomly divided into five treatment groups: i basal diet (control, ii basal diet+0.25% yeast (Saccharomyces cerevisiae (YC, iii basal diet+0.25% yeast with bacteriocin (BA, iv basal diet+Lactobacillus cultures (LAB, and v basal diet +0.25% yeast with bacteriocin+Lactobacillus cultures (BA+LAB. Growth performance, cecal microbiota, cecal fermentation products, and blood biochemistry parameters were determined when chickens were 21 and 35 d old. Results The supplementation of YC, BA, and BA+LAB resulted in a significantly better feed conversion rate (FCR than that of the control group during 1 to 21 d (p<0.05. The LAB supplementation had a significant effect on the presence of Lactobacillus in the ceca at 35 d. None of the supplements had an effect on relative numbers of L. agilis and L. reuter at 21 d, but the BA supplementation resulted in the decrease of both Lactobacillus strains at 35 d. The BA+LAB supplementation resulted in higher short chain fatty acid (SCFA in the ceca, but LAB supplementation significantly decreased the SCFA at 35 d (p<0.05. All treatments tended to decrease ammonia concentration in the ceca at 21 d, especially in the LAB treatment group. The BA supplementation alone decreased the triacylglycerol (TG concentration significantly at 21 d (p<0.05, but the synergistic effect of BA and LAB supplementation was required to reduce the TG concentration at 35 d. The YC supplementation tended to increase the plasma cholesterol at 21 d and 35 d. However, the BA supplementation significantly decreased the cholesterol and low density lipoprotein cholesterol level at 35 d. In conclusion, the BA

  9. Diminished responsiveness to dobutamine as an inotrope in mice with cecal ligation and puncture-induced sepsis: attribution to phosphodiesterase 4 upregulation.

    Science.gov (United States)

    Sakai, Mari; Suzuki, Tokiko; Tomita, Kengo; Yamashita, Shigeyuki; Palikhe, Sailesh; Hattori, Kohshi; Yoshimura, Naoki; Matsuda, Naoyuki; Hattori, Yuichi

    2017-06-01

    Dobutamine has been used in septic shock for many years as an only inotrope, but its benefit has been questioned. We weighed the effects of dobutamine and milrinone as inotropes in mice with cecal ligation and puncture (CLP)-induced polymicrobial sepsis. CLP-induced septic mice exhibited significant cardiac inflammation, as indicated by greatly increased mRNAs of proinflammatory cytokines and robust infiltration of inflammatory cells in the ventricular myocardium. Elevations of plasma cardiac troponin-I showed cardiac injury in CLP mice. Noninvasive echocardiographic assessment of cardiac function revealed that despite preserved left ventricular function in the presence of fluid replacement, the dobutamine inotropic response was significantly impaired in CLP mice compared with sham-operated controls. By contrast, milrinone exerted inotropic effects in sham-operated and CLP mice in an equally effective manner. Surface expression levels of β 1 -adrenoceptors and α-subunits of three main G protein families in the myocardium were unaffected by CLP-induced sepsis. Plasma cAMP levels were significantly elevated in both sham-operated and CLP mice in response to milrinone but only in sham-operated controls in response to dobutamine. Of phosphodiesterase (PDE) isoforms, PDE4D, but not PDE3A, both of which are responsible for cardiac cAMP hydrolysis, was significantly upregulated in CLP mouse myocardium. We define a novel mechanism for the impaired responsiveness to dobutamine as an inotrope in sepsis, and understanding the role of PDE4D in modulating cardiac functional responsiveness in sepsis may open the potential of a PDE4D-targeted therapeutic option in septic patients with low cardiac output who have a need for inotropic support. NEW & NOTEWORTHY Advisability of the usefulness of dobutamine in septic shock management is limited. Here, we reveal that the effect of dobutamine as a positive inotrope is impaired in mice with cecal ligation and puncture-induced sepsis

  10. Trauma vascular, visión del cirujano vascular

    OpenAIRE

    Dr. D. Cristián Salas

    2011-01-01

    El 3% de todas las lesiones en trauma tiene un componente vascular. Con los conflictos armados del siglo pasado se lograron grandes avances en este campo. A partir de la Guerra de Vietnam gracias a las mejoras en el manejo prehospitalario, traslado de pacientes, y avances en técnica quirúrgica se lograron tasas de sobrevida y de amputaciones que se han mantenido estables hasta la fecha. El diagnóstico de lesiones vasculares en extremidades se realiza con el examen físico, sin embargo las lesi...

  11. Acidente vascular cerebral e demência vascular no idoso

    OpenAIRE

    Ionel, Cristina

    2015-01-01

    Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra. Em consequência de um fenómeno global de envelhecimento populacional, é expectável um aumento na prevalência de demência. A demência vascular é a segunda causa mais comum de demência, depois da doença de Alzheimer. Trata-se de uma entidade clínica bastante heterogénea, sendo o acidente vascular cerebral (AVC) um dos seus mecanismos subjacentes. No entanto, nem todos os doentes ...

  12. Decreased IgA+ B Cells Population and IgA, IgG, IgM Contents of the Cecal Tonsil Induced by Dietary High Fluorine in Broilers

    Directory of Open Access Journals (Sweden)

    Kangping Wang

    2013-05-01

    Full Text Available Fluoride is an environmental and industrial pollutant that affects various organs in humans and animals. The cecal tonsil is an important component of the mucosal immune system and performs important and unique immune functions. In the present study, we investigated the effects of dietary high fluorine on the quantities of IgA+ B cells in the cecal tonsil by immunohistochemistry, and the immunoglobulin A (IgA, immunoglobulin G (IgG and immunoglobulin M (IgM contents in the cecal tonsil by ELISA. A total of 280 one-day-old avian broilers were divided into four groups and fed on a corn-soybean basal diet as control diet (fluorine 22.6 mg/kg or the same diet supplemented with 400, 800 and 1,200 mg/kg fluorine (high fluorine groups I, II and III in the form of sodium fluoride, respectively, throughout a 42-day experimental period. The results showed that the quantities of IgA+ B cells were lower (p < 0.05 or p < 0.01 and the IgA, IgG, and IgM contents were decreased (p < 0.05 or p < 0.01 in high fluorine groups II and III in comparison with those of control group. It was concluded that dietary fluorine, in the 800–1,200 mg/kg range, could reduce the numbers of the IgA+ B cells and immunoglobulin contents in the cecal tonsil, implying the local mucosal immune function was ultimately impacted in broilers.

  13. Características do líquido peritoneal de eqüinos normais após punção cecal percutânea

    Directory of Open Access Journals (Sweden)

    Valadão Carlos Augusto Araújo

    2004-01-01

    Full Text Available Foram avaliados 10 eqüinos da raça Manga Larga, machos, inteiros clinicamente sadios, submetidos à punção cecal percutânea. Analisou-se a resposta clínica, celular, bioquímica e microbiológica do líquido peritoneal por um período de 24 horas após a punção cecal, nos tempos T0, T6, T12 e T24. Foi observada elevação na freqüência respiratória em T6 e na temperatura retal entre T6 e T12. Decorridas 24 horas da punção cecal, ocorreu aumento na concentração de proteínas totais do líquido peritoneal e na atividade da fosfatase alcalina. Tanto a atividade da ALT quanto os níveis de hemoglobina apresentaram diminuição em T6. Não foram registradas alterações na celularidade do plasma ou do líquido peritoneal e obteve-se resultado negativo para a cultura microbiológica do líquido. Considerando a inexistência de efeitos adversos, além das poucas alterações descritas, conclui-se que a punção cecal percutânea é um procedimento seguro e factível, se praticada criteriosamente.

  14. Imaging after vascular gene therapy

    International Nuclear Information System (INIS)

    Manninen, Hannu I.; Yang, Xiaoming

    2005-01-01

    Targets for cardiovascular gene therapy currently include limiting restenosis after balloon angioplasty and stent placement, inhibiting vein bypass graft intimal hyperplasia/stenosis, therapeutic angiogenesis for cardiac and lower-limb ischemia, and prevention of thrombus formation. While catheter angiography is still standard method to follow-up vascular gene transfer, other modern imaging techniques, especially intravascular ultrasound (IVUS), magnetic resonance (MR), and positron emission tomography (PET) imaging provide complementary information about the therapeutic effect of vascular gene transfer in humans. Although molecular imaging of therapeutic gene expression in the vasculatures is still in its technical development phase, it has already offered basic medical science an extremely useful in vivo evaluation tool for non- or minimally invasive imaging of vascular gene therapy

  15. Fetal origin of vascular aging

    Directory of Open Access Journals (Sweden)

    Shailesh Pitale

    2011-01-01

    Full Text Available Aging is increasingly regarded as an independent risk factor for development of cardiovascular diseases such as atherosclerosis and hypertension and their complications (e.g. MI and Stroke. It is well known that vascular disease evolve over decades with progressive accumulation of cellular and extracellular materials and many inflammatory processes. Metabolic syndrome, obesity and diabetes are conventionally recognized as risk factors for development of coronary vascular disease (CVD. These conditions are known to accelerate ageing process in general and vascular ageing in particular. Adverse events during intrauterine life may programme organ growth and favour disease later in life, popularly known as, ′Barker′s Hypothesis′. The notion of fetal programming implies that during critical periods of prenatal growth, changes in the hormonal and nutritional milieu of the conceptus may alter the full expression of the fetal genome, leading to permanent effects on a range of physiological.

  16. Vascular Gene Expression: A Hypothesis

    Directory of Open Access Journals (Sweden)

    Angélica Concepción eMartínez-Navarro

    2013-07-01

    Full Text Available The phloem is the conduit through which photoassimilates are distributed from autotrophic to heterotrophic tissues and is involved in the distribution of signaling molecules that coordinate plant growth and responses to the environment. Phloem function depends on the coordinate expression of a large array of genes. We have previously identified conserved motifs in upstream regions of the Arabidopsis genes, encoding the homologs of pumpkin phloem sap mRNAs, displaying expression in vascular tissues. This tissue-specific expression in Arabidopsis is predicted by the overrepresentation of GA/CT-rich motifs in gene promoters. In this work we have searched for common motifs in upstream regions of the homologous genes from plants considered to possess a primitive vascular tissue (a lycophyte, as well as from others that lack a true vascular tissue (a bryophyte, and finally from chlorophytes. Both lycophyte and bryophyte display motifs similar to those found in Arabidopsis with a significantly low E-value, while the chlorophytes showed either a different conserved motif or no conserved motif at all. These results suggest that these same genes are expressed coordinately in non- vascular plants; this coordinate expression may have been one of the prerequisites for the development of conducting tissues in plants. We have also analyzed the phylogeny of conserved proteins that may be involved in phloem function and development. The presence of CmPP16, APL, FT and YDA in chlorophytes suggests the recruitment of ancient regulatory networks for the development of the vascular tissue during evolution while OPS is a novel protein specific to vascular plants.

  17. Isoflurane post-treatment improves pulmonary vascular permeability via upregulation of heme oxygenase-1.

    Science.gov (United States)

    Dong, Xiang; Hu, Rong; Sun, Yu; Li, Qifang; Jiang, Hong

    2013-09-01

    Isoflurane (ISO) has been shown to attenuate acute lung injury (ALI). Induction of heme oxygenase-1 (HO-1) and suppression of inducible nitric oxide synthase (iNOS) expression provide cytoprotection in lung and vascular injury. The aim of this study was to investigate the effect of post-treatment with isoflurane on lung vascular permeability and the role of HO-1 in an ALI rat model induced by cecal ligation and puncture (CLP). Male Sprague-Dawley rats were randomly assigned to one of four groups: sham group, sham rats post-treated with vehicle (Sham); CLP group, CLP rats post-treated with vehicle (CLP); ISO group, CLP rats post-treated with isoflurane (ISO); and ZnPP group, CLP rats injected with zinc protoporphyrin IX (ZnPP), a competitive inhibitor of HO-1, 1 hour before the operation, and post-treated with isoflurane (ZnPP). Isoflurane (1.4%) was administered 2 hour after CLP. At 24 hour after CLP, the extent of ALI was evaluated by lung wet/dry ratio, Evans blue dye (EBD) extravasation, lung permeability index (LPI), as well as histological and immunohistochemical examinations. We also determined pulmonary iNOS and HO-1 expression. Compared with the CLP group, the isoflurane post-treatment group showed improved pulmonary microvascular permeability as detected by EBD extravasation, LPI, as well as histological and immunohistochemical examinations. Furthermore, isoflurane decreased iNOS and increased HO-1 expression in lung tissue. Pretreatment with ZnPP prevented the protective effects of isoflurane in rats. These findings indicate that the protective role of isoflurane post-conditioning against CLP-induced lung injury may be associated with its role in upregulating HO-1 in ALI.

  18. Vascular injuries caused by acupuncture.

    Science.gov (United States)

    Bergqvist, D

    2008-08-01

    To systematically review the literature on vascular injuries caused by acupuncture. Systematic literature search in Medline and PubMed. Twentyone cases were identified and the majority developed symptoms in direct connection with the acupuncture treatment. Three patients died, two from pericardial tamponade and one from an aortoduodenal fistula. There were five more tamponades, seven pseudoaneurysms, two with ischaemia, two with venous thrombosis, one with compartment syndrome and one with bleeding. The two patients with ischaemia had remaining sequeleae. Information on follow-up was suboptimal with no information in nine patients. Vascular injuries are rare, bleeding and pseudoaneurysm dominating. Follow-up is insufficient in the hitherto published papers.

  19. Vascular malforma- tions part 1 — normal and abnormal vascular ...

    African Journals Online (AJOL)

    Enrique

    Ang2 with VEGF produces loss of adhesion of endothelial cells allowing their migration to occur. 3. Fibroblast growth factor : (aFGF, bFGF). •. Are potent stimulators of endothelial cell migration, proliferation, sprouting and tube formation. •. Are mainly involved with vascular maintenance and repair. 4. Platelet derived factor ...

  20. Efeito protetor da microbiota cecal congelada e liofilizada sobre a infecção experimental de frangos de corte por Salmonella enterica sorovar Enteritidis

    Directory of Open Access Journals (Sweden)

    Andreatti Filho R.L.

    2002-01-01

    Full Text Available Estudaram-se os efeitos do tratamento de frangos de corte com microbiota cecal anaeróbia liofilizada (MCL e congelada (MCC sobre a infecção do trato digestivo das aves por Salmonella enterica sorovar Enteritidis. Foi usada microbiota intestinal sem prévia identificação bacteriana. A infecção foi persistente, em ordem, no ceco, inglúvio e duodeno. A infecção também foi autolimitante nos grupos tratados e no controle. Não ocorreu diferença entre o grupo-controle positivo e os tratados com MCL ou MCC. Houve redução da colonização do ceco no período de 12 dias após o desafio nos grupos tratados com MCL e MCC, o que não ocorreu no grupo-controle positivo. Não houve variação entre os tratamentos com MCL e MCC quanto às características pesquisadas. A S. Enteritidis reduziu o ganho de peso médio nas aves inoculadas. Os tratamentos com MCL e MCC minimizaram a redução de peso nos grupos infectados.

  1. Pomegranate protects liver against cecal ligation and puncture-induced oxidative stress and inflammation in rats through TLR4/NF-κB pathway inhibition.

    Science.gov (United States)

    Makled, Mirhan N; El-Awady, Mohammed S; Abdelaziz, Rania R; Atwan, Nadia; Guns, Emma T; Gameil, Nariman M; Shehab El-Din, Ahmed B; Ammar, Elsayed M

    2016-04-01

    Acute liver injury secondary to sepsis is a major challenge in intensive care unit. This study was designed to investigate potential protective effects of pomegranate against sepsis-induced acute liver injury in rats and possible underlying mechanisms. Pomegranate was orally given (800mg/kg/day) for two weeks before sepsis induction by cecal ligation and puncture (CLP). Pomegranate improved survival and attenuated liver inflammatory response, likely related to downregulation of mRNA expression of toll like recptor-4, reduced nuclear translocation and DNA binding activity of proinflammatory transcription factor NF-κB subunit p65, decreased mRNA and protein expression of tumor necrosis factor-alpha and reduction in myeloperoxidase activity and mRNA expression. Pomegranate also decreased CLP-induced oxidative stress as reflected by decreased malondialdehyde content, and increased reduced glutathione level and superoxide dismutase activity. These results confirm the antiinflammatory and antioxidant effects of pomegranate in CLP-induced acute liver injury mediated through inhibiting TLR4/NF-κB pathway, lipid peroxidation and neutrophil infiltration. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Artesunate Reduces Serum Lipopolysaccharide in Cecal Ligation/Puncture Mice via Enhanced LPS Internalization by Macrophages through Increased mRNA Expression of Scavenger Receptors

    Directory of Open Access Journals (Sweden)

    Bin Li

    2014-01-01

    Full Text Available Innate immunity is the first line of defense in human beings against pathogen infection; monocytes/macrophages are the primary cells of the innate immune system. Recently, macrophages/monocytes have been discovered to participate in LPS clearance, and the clearance efficiency determines the magnitude of the inflammatory response and subsequent organ injury. Previously, we reported that artesunate (AS protected sepsis mice against heat-killed E. coli challenge. Herein, we further confirmed that AS protected cecal ligation/puncture (CLP sepsis mice. Its protection on sepsis mice was related to not only reduction of pro-inflammatory cytokines and serum LPS levels but also improvement of liver function. Based on the fact that AS did not directly bind and neutralize LPS, we hypothesized that the reduction of serum LPS level might be related to enhancement of LPS internalization and subsequent detoxification. Our results showed that AS increased FITC-LPS internalization by peritoneal macrophage and liver Kupffer cell, but enhancement of LPS internalization by AS was not related to the clathrin-dependent pathway. However, AS induced mRNA expression of important scavenger receptors (SRs; SR-A and MARCO mRNA expression was upregulated, suggesting that AS enhancement of LPS internalization and inhibition of pro-inflammatory cytokines was related to changes in mRNA expression of SRs.

  3. Impact of apoptotic adipose-derived mesenchymal stem cells on attenuating organ damage and reducing mortality in rat sepsis syndrome induced by cecal puncture and ligation.

    Science.gov (United States)

    Chang, Chia-Lo; Leu, Steve; Sung, Hsin-Ching; Zhen, Yen-Yi; Cho, Chung-Lung; Chen, Angela; Tsai, Tzu-Hsien; Chung, Sheng-Ying; Chai, Han-Tan; Sun, Cheuk-Kwan; Yen, Chia-Hung; Yip, Hon-Kan

    2012-12-07

    We tested whether apoptotic adipose-derived mesenchymal stem cells (A-ADMSCs) were superior to healthy (H)-ADMSCs at attenuating organ damage and mortality in sepsis syndrome following cecal ligation and puncture (CLP). Adult male rats were categorized into group 1 (sham control), group 2 (CLP), group 3 [CLP + H-ADMSC administered 0.5, 6, and 18 h after CLP], group 4 [CLP + A-ADMSC administered as per group 3]. Circulating peak TNF-α level, at 6 h, was highest in groups 2 and 3, and higher in group 4 than group 1 (p HO-1, NQO-1) showed an opposite way of Bcl-2; these patterns were reversed for group 4 (all p < 0.001). Mortality was highest in group 3 and higher in group 2 than group 4 than group 1 (all p < 0.001). A-ADMSC therapy protected major organs from damage and improved prognosis in rats with sepsis syndrome.

  4. Sodium bisulfate and a sodium bisulfate/tannin mixture decreases pH when added to an in vitro incubated poultry cecal or fecal contents while reducing Salmonella Typhimurium marker strain survival and altering the microbiome.

    Science.gov (United States)

    Rubinelli, Peter M; Kim, Sun Ae; Park, Si Hong; Roto, Stephanie M; Ricke, Steven C

    2017-08-03

    The objective of the present study was to investigate the ability of animal feed-grade sodium bisulfate (SBS) and a mixture of sodium bisulfate/tannin to inhibit the growth of Salmonella using an anerobic in vitro mixed cecal culture to mimic the conditions within the chicken cecum. An initial inoculum of Salmonella Typhimurium was introduced to an anerobic dilution solution containing 1/3000 diluted cecal bacteria and solids consisting of ground chicken feed and different percentages of solid SBS or SBS/tannin, and surviving organisms were enumerated. Two different experimental designs were employed. In the "unadapted" treatment, the S. Typhimurium was added at the beginning of the culture incubation along with cecal bacteria and chicken feed/SBS or chicken feed/SBS/tannin. In the "adapted" treatment, S. Typhimurium was added after a 24 hour pre-incubation of the cecal bacteria with the chicken feed/SBS or chicken feed/SBS/tannin. Adding SBS resulted in reduction of pH in the cultures which paralleled with the reduction of S. Typhimurium. The SBS alone was found to be inhibitory to S. Typhimurium in the adapted treatment at all concentrations tested (0.25, 0.5, and 0.75%), and the degree of inhibition was concentration-dependent. Salmonella Typhimurium was completely killed in the adapted culture with 0.5% SBS after 24 and 48 h. The SBS/tannin mixture was less inhibitory than SBS alone at the same concentrations in side-by-side comparisons. Testing at a 0.5% SBS concentration, chicken age had little or no effect on log reduction of S. Typhimurium relative to age-matched control cultures without SBS, but age did affect the absolute number of S. Typhimurium surviving, with the greatest decreases occurring at 2 and 4 weeks of age (approx. 10 3 S. Typhimurium surviving) compared to 6 weeks of age (approx. 10 5 Salmonella surviving). Microbiome analysis with an Illumina MiSeq platform was conducted to investigate bacterial compositional changes related to the

  5. Vascular cognitive impairment in dementia.

    Science.gov (United States)

    Etherton-Beer, Christopher D

    2014-10-01

    Vascular risk factors and cerebrovascular disease are common causes of dementia. Shared risk factors for vascular dementia and Alzheimer's disease, as well as frequent coexistence of these pathologies in cognitively impaired older people, suggests convergence of the aetiology, prevention and management of the commonest dementias affecting older people. In light of this understanding, the cognitive impairment associated with cerebrovascular disease is an increasingly important and recognised area of the medicine of older people. Although the incidence of cerebrovascular events is declining in many populations, the overall burden associated with brain vascular disease will continue to increase associated with population ageing. A spectrum of cognitive disorders related to cerebrovascular disease is now recognised. Cerebrovascular disease in older people is associated with specific clinical and imaging findings. Although prevention remains the cornerstone of management, the diagnosis of brain vascular disease is important because of the potential to improve clinical outcomes through clear diagnosis, enhanced control of risk factors, lifestyle interventions and secondary prevention. Specific pharmacological intervention may also be indicated for some patients with cognitive impairment and cerebrovascular disease. However the evidence base to guide intervention remains relatively sparse. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Vascular involvement in tuberous sclerosis.

    Science.gov (United States)

    Salerno, Ann E; Marsenic, Olivera; Meyers, Kevin E C; Kaplan, Bernard S; Hellinger, Jeffrey C

    2010-08-01

    Vascular involvement in tuberous sclerosis (TS) is rare. Central and peripheral aneurysms and large and medium size arterial stenotic-occlusive disease have been reported in patients with TS. We present here three pediatric patients with TS and severe vascular abnormalities, followed by a review of the literature. The three cases include a 14-month-old girl with polycystic kidneys and cerebral tubers who had a large asymptomatic abdominal aortic aneurysm, a 2-year-old boy with multiple features of TS who had hypertension and was found to have mid-aortic syndrome with bilateral renal artery stenosis, and an 18-year-old girl with abdominal pain and TS features who had greater than 70% celiac artery stenosis. In all cases, noninvasive vascular imaging modalities were utilized for either initial diagnosis, surveillance, or both. These cases highlight the collaborative roles of the pediatric nephrologist and cardiovascular imager in the diagnosis and management of the vascular complications in TS patients. Appropriate care can only be made through a high index of suspicion.

  7. Postprandial lipaemia and vascular disease.

    Science.gov (United States)

    Kolovou, Genovefa; Ooi, Teik Chye

    2013-07-01

    In this review we discuss the postprandial pathophysiological mechanisms that promote vascular disease, the evidence for a role of postprandial lipaemia (PPL) in vascular disease and the effect of modifiable and nonmodifiable factors in PPL. PPL refers to the dynamic changes in serum lipids and lipoproteins (mainly in serum triglycerides) that occur after a fat load or a meal. Recent data indicate that postprandial or nonfasting triglyceride levels are better predictors of cardiovascular risk, suggesting that efficiency of postprandial handling of triglyceride-rich lipoproteins plays a role in the causation of vascular disease. The recent finding that postprandial serum triglyceride levels are even better than fasting serum triglyceride levels as predictors of vascular disease indicate that it is better to measure an index of triglyceride-rich lipoproteins (in most cases serum triglyceride levels) in the postprandial period than in the postabsorptive fasting state. Moreover, by the time the postabsorptive state is reached, some of these proatherogenic triglyceride-rich lipoprotein changes may be missed in the measurement.

  8. Peripheral vascular imaging and intervention

    International Nuclear Information System (INIS)

    Kim, D.; Orron, D.E.

    1990-01-01

    This reference addresses the entire clinical approach to the vascular system from the diagnosis of pathology to surgery or interventional radiological management. All diagnostic imaging modalities currently available are included with specific information on how to interpret various results. It features discussions of the latest therapeutic techniques, including laser angioplasty, intravascular stents, and transluminal embolization

  9. Limb vascular function in women

    DEFF Research Database (Denmark)

    Hellsten, Ylva; Gliemann, Lasse

    2018-01-01

    tone and oxidative stress and thereby functions such as oxygen delivery and blood pressure. The acute hormonal fluctuations do not substantially impact health, but their influence should be considered with regard to measurements of vascular function. The chronic hormonal change with menopause strongly...

  10. FOTOPROTECCION EN PLANTAS VASCULARES ANTARTICAS.

    OpenAIRE

    PEREZ TORRES, EDUARDO; PEREZ TORRES, EDUARDO

    2006-01-01

    Colobanthus quitensis y Deschampsia antarctica son las únicas plantas vasculares que han colonizado de manera natural la Antártida Marítima, donde resisten episodios de alta intensidad lumínica y baja temperatura, condiciones que combinadas suelen causar 83p.

  11. Image Quality in Vascular Radiology

    International Nuclear Information System (INIS)

    Vanhavere, F.; Struelens, L.

    2005-01-01

    In vascular radiology, the radiologists use the radiological image to diagnose or treat a specific vascular structure. From literature, we know that related doses are high and that large dose variability exists between different hospitals. The application of the optimization principle is therefore necessary and is obliged by the new legislation. So far, very little fieldwork has been performed and no practical instructions are available to do the necessary work. It's indisputable that obtaining quantitative data is of great interest for optimization purposes. In order to gain insight into these doses and the possible measures for dose reduction, we performed a comparative study in 7 hospitals. Patient doses will be measured and calculated for specific procedures in vascular radiology and evaluated against their most influencing parameters. In view of optimization purposes, a protocol for dose audit will be set-up. From the results and conclusions in this study, experimentally based guidelines will be proposed, in order to improve clinical practice in vascular radiology

  12. Pediatric central nervous system vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Burch, Ezra A. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Orbach, Darren B. [Boston Children' s Hospital, Neurointerventional Radiology, Boston, MA (United States)

    2015-09-15

    Pediatric central nervous system (CNS) vascular anomalies include lesions found only in the pediatric population and also the full gamut of vascular lesions found in adults. Pediatric-specific lesions discussed here include infantile hemangioma, vein of Galen malformation and dural sinus malformation. Some CNS vascular lesions that occur in adults, such as arteriovenous malformation, have somewhat distinct manifestations in children, and those are also discussed. Additionally, children with CNS vascular malformations often have associated broader vascular conditions, e.g., PHACES (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, eye anomalies and sternal anomalies), hereditary hemorrhagic telangiectasia, and capillary malformation-arteriovenous malformation syndrome (related to the RASA1 mutation). The treatment of pediatric CNS vascular malformations has greatly benefited from advances in endovascular therapy, including technical advances in adult interventional neuroradiology. Dramatic advances in therapy are expected to stem from increased understanding of the genetics and vascular biology that underlie pediatric CNS vascular malformations. (orig.)

  13. Pediatric central nervous system vascular malformations

    International Nuclear Information System (INIS)

    Burch, Ezra A.; Orbach, Darren B.

    2015-01-01

    Pediatric central nervous system (CNS) vascular anomalies include lesions found only in the pediatric population and also the full gamut of vascular lesions found in adults. Pediatric-specific lesions discussed here include infantile hemangioma, vein of Galen malformation and dural sinus malformation. Some CNS vascular lesions that occur in adults, such as arteriovenous malformation, have somewhat distinct manifestations in children, and those are also discussed. Additionally, children with CNS vascular malformations often have associated broader vascular conditions, e.g., PHACES (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, eye anomalies and sternal anomalies), hereditary hemorrhagic telangiectasia, and capillary malformation-arteriovenous malformation syndrome (related to the RASA1 mutation). The treatment of pediatric CNS vascular malformations has greatly benefited from advances in endovascular therapy, including technical advances in adult interventional neuroradiology. Dramatic advances in therapy are expected to stem from increased understanding of the genetics and vascular biology that underlie pediatric CNS vascular malformations. (orig.)

  14. ESRD QIP - Vascular Access - Payment Year 2018

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes facility details, performance rates, vascular access topic measure score, and the state and national average measure scores for the vascular...

  15. Vascular smooth muscle function: defining the diabetic vascular phenotype.

    Science.gov (United States)

    Bruno, Rosa Maria; Ghiadoni, Lorenzo

    2013-10-01

    In this issue of Diabetologia, a meta-analysis performed by Montero and co-authors (Diabetologia doi 10.1007/s00125-013-2974-1 ) demonstrates a significant impairment of vascular smooth muscle (VSM) function in type 2 diabetic patients. Endothelial function and VSM function between type 2 diabetic and healthy individuals were associated, especially in the microcirculation, confirming the hypothesis that unresponsiveness of VSM cells to NO may amplify the consequences of reduced NO availability. This study suggests a novel interpretation for endothelial dysfunction in diabetic patients, indicating VSM cells as key players. Causative mechanisms of VSM dysfunction, which seems to be a feature of the vascular phenotype of type 2 diabetes mellitus, are largely unexplored in humans. Future studies should also address the crucial issue of the prognostic significance of VSM dysfunction in diabetic patients, and possibly in other conditions characterised by high cardiovascular risk.

  16. 21 CFR 870.4450 - Vascular clamp.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vascular clamp. 870.4450 Section 870.4450 Food and... CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4450 Vascular clamp. (a) Identification. A vascular clamp is a surgical instrument used to occlude a blood vessel temporarily. (b) Classification. Class II...

  17. Efeito da vacina contra coccidiose sobre a colonização de Salmonella enteritidis em frangos de corte tratados com microbiota cecal anaeróbia

    Directory of Open Access Journals (Sweden)

    Andreatti Filho R.L.

    1999-01-01

    Full Text Available Avaliou-se o efeito da vacina contra coccidiose sobre a habilidade da microbiota cecal anaeróbia (MCA, administrada por diferentes vias (aves tratadas, em proteger pintos de corte da colonização por Salmonella enteritidis (Se. Utilizaram-se 120 aves assim divididas: grupo A, pulverização de MCA em aves vacinadas contra coccidiose e desafiadas com Se, grupo B, inoculação endoesofágica de MCA em aves vacinadas e desafiadas, grupo C, MCA na água de bebida de aves vacinadas e desafiadas, grupo D, aves não tratadas, vacinadas e desafiadas, grupo E, aves não tratadas, não vacinadas e desafiadas e, grupo F, aves não tratadas, não vacinadas e não desafiadas (controle negativo. Utilizaram-se como parâmetros a colonização do trato digestivo por Se e sua presença nas fezes, bem como o peso corporal das aves, avaliados aos dois, sete e 12 dias após o desafio. Nas aves tratadas com MCA, especialmente por meio de pulverização e inoculação endoesofágica, a colonização do ceco por Se e sua presença nas fezes foram menores, mostrando que a ação da MCA contra a colonização de ceco e excreção fecal não foi afetada pelo uso da vacina contra coccidiose em pintos de corte e que a associação MCA/vacina contra coccidiose pode ser utilizada sem que haja comprometimento na eficácia da MCA. Nos grupos que não receberam MCA, vacinados ou não contra coccidiose, houve aumento da colonização cecal, bem como excreção fecal da amostra desafio. O ceco foi o local de maior presença e persistência da Se. O resultado de administração de MCA pela água de bebida não foi tão eficiente, mas somente este tratamento resultou em peso corporal das aves significativamente superior ao das aves do grupo não tratado, não vacinado e desafiado, indicando que a presença de salmonelas paratifóides não interfere na produtividade de frangos de corte. Não se observou diferença no peso das aves dos grupos D (vacinados contra coccidiose e E (n

  18. Cecal ligation and puncture followed by methicillin-resistant Staphylococcus aureus pneumonia increases mortality in mice and blunts production of local and systemic cytokines.

    Science.gov (United States)

    Jung, Enjae; Perrone, Erin E; Liang, Zhe; Breed, Elise R; Dominguez, Jessica A; Clark, Andrew T; Fox, Amy C; Dunne, W Michael; Burd, Eileen M; Farris, Alton B; Hotchkiss, Richard S; Coopersmith, Craig M

    2012-01-01

    Mortality in the intensive care unit frequently results from the synergistic effect of two temporally distinct infections. This study examined the pathophysiology of a new model of intra-abdominal sepsis followed by methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Mice underwent cecal ligation and puncture (CLP) or sham laparotomy followed 3 days later by an intratracheal injection of MRSA or saline. Both CLP/saline and sham/MRSA mice had 100% survival, whereas animals with CLP followed by MRSA pneumonia had 67% 7-day survival. Animals subjected to CLP/MRSA had increased bronchoalveolar lavage concentrations of MRSA compared with sham/MRSA animals. Animals subjected to sham/MRSA pneumonia had increased bronchoalveolar lavage levels of interleukin 6 (IL-6), tumor necrosis factor α, and granulocyte colony-stimulating factor compared with those given intratracheal saline, whereas CLP/MRSA mice had a blunted local inflammatory response with markedly decreased cytokine levels. Similarly, animals subjected to CLP/saline had increased peritoneal lavage levels of IL-6 and IL-1β compared with those subjected to sham laparotomy, whereas this response was blunted in CLP/MRSA mice. Systemic cytokines were upregulated in both CLP/saline and sham/MRSA mice, and this was blunted by the combination of CLP/MRSA. In contrast, no synergistic effect on pneumonia severity, white blood cell count, or lymphocyte apoptosis was identified in CLP/MRSA mice compared with animals with either insult in isolation. These results indicate that a clinically relevant model of CLP followed by MRSA pneumonia causes higher mortality than could have been predicted from studying either infection in isolation, and this was associated with a blunted local (pulmonary and peritoneal) and systemic inflammatory response and decreased ability to clear infection.

  19. Synchronous cecal adenocarcinoma and multiple colonic in situ carcinomas in hamartomatous polyps in a case of isolated Peutz–Jeghers syndrome

    Directory of Open Access Journals (Sweden)

    Yahia Z Gad

    2011-03-01

    Full Text Available Yahia Z Gad1, Doaa H Bakr1, Mohammad G El-Ebeidy21Department of Internal Medicine, 2Department of Surgery, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, EgyptBackground: Peutz–Jeghers syndrome (PJS is a rare autosomal dominant disease characterized by mucocutaneous pigmentation and hamartomatous polyps of the entire gastrointestinal tract. A Peutz–Jeghers polyp (PJP in a patient without pigmentation or a family history of the disease is called an isolated or solitary PJP. Individuals with PJS carry a very high risk of developing gastrointestinal (GI as well as extra-GI malignancies. This case report documents lesion multiplicity and their malignant potential in a young patient with PJS presenting in a serious condition for the first time.Case report: An 18-year-old female Egyptian patient was admitted with hematochezia and remarkable anemia. After appropriate resuscitation and consent, colonoscopic evaluation revealed seven pedunculated colonic polyps at the ascending and the transverse colon, and numerous variable-sized sessile polyps were scattered all over the colon. To establish hemostasis, endoscopic polypectomy for pedunculated polyps and argon plasma photocoagulation for the bleeding sessile polyps were performed. Histopathological examination revealed cecal adenocarcinoma in one specimen and two simultaneous in situ carcinoma at the transverse and the sigmoid colon in the mucosae of the excised histologically proven hamartomatous polyps. Additionally, one focal in situ carcinoma in the resected colon was detected.Conclusions: When considering the family history, serious GI neoplastic lesions may be unmasked in young patients with PJS who present with hematochezia, even in the absence of its characteristic mucocutaneous pigmented lesions. GI endoscopic surveillance programs should be adopted for diagnosed cases of PJS and their families. Genetic prenatal screening for early detection is the best option for

  20. The Effects of Sub-Chronic Treatment with Pioglitazone on the Septic Mice Mortality in the Model of Cecal Ligation and Puncture: Involvement of Nitric Oxide Pathway

    Directory of Open Access Journals (Sweden)

    Hamed Shafaroodi

    2015-10-01

    Full Text Available Sepsis is a systemic inflammatory response syndrome caused by an infection and remains as a major challenge in health care. Many studies have reported that pioglitazone may display anti-inflammatory effects. This study was designed to evaluate the effect of subchronic treatment with pioglitazone on high-grade septic mice survival and nitrergic system involvement. Diffused sepsis was induced by cecal ligation and puncture (CLP surgery in male NMRI mice (20-30 g. Pioglitazone (5,10 and 20 mg/kg was administered by gavage daily for 5 days prior to surgery. Nitric oxide involvement was assessed by sub-chronic administration of a non-selective nitric oxide synthase inhibitor, L-NAME and a selective inducible nitric oxide synthase inhibitor, aminoguanidine. TNF-α  and IL-1β plasma levels were measured by ELISA. Pioglitazone (10 and 20 mg/kg significantly improved survival rate in septic mice. The chronic intraperitoneally co-administration of L-NAME (0.5 mg/kg, daily or aminoguanidine (1 mg/kg, daily with a daily dose of pioglitazone, 5 mg/kg, significantly increased the survival rate. This survival improving effect was accompanied by a significant reduction in pro-inflammatory cytokines TNF-α and IL-1β plasma levels. In conclusion, sub-chronic pioglitazone treatment can improve survival in mouse sepsis model by CLP. Inhibition of nitric oxide release, probably through inducible nitric oxide synthase at least in part is responsible for this effect. Suppression of TNF-α and IL-1β could be another mechanism in pioglitazone-induced survival improving effect in septic mice.

  1. Effect of Triggering Receptor Expressed on Myeloid Cells 1 (TREM-1) Blockade in Rats with Cecal Ligation and Puncture (CLP)-Induced Sepsis.

    Science.gov (United States)

    Shi, Xiaofeng; Zhang, Yue; Wang, Hao; Zeng, Sha

    2017-10-23

    BACKGROUND Blocking of TREM-1 signaling improves survival of mice with sepsis induced by Pseudomonas aeruginosa. However, whether TREM-1 blockade has beneficial effects in polymicrobial sepsis is poorly understood. Here, we aimed to investigate the effect of modulation of the TREM-1 pathway in rats with polymicrobial sepsis induced by cecal ligation and puncture (CLP). MATERIAL AND METHODS Normal Sprague-Dawley (SD) rats with sepsis induced by CLP were allocated randomly to received scramble peptide or LP17 via the jugular vein. Serum level of sTREM-1, IL6, TNF-α, and IL-1β were detected by ELISA assay. The mRNA and protein levels of JAK2 and STAT3 were detected by real-time PCR and Western blot analysis. RESULTS STREM-1 concentration was greatly and progressively increased in rats with CLP-induced sepsis, and the increase was attenuated by TREM-1 inhibitory peptide LP17. More than 60% survival was observed in rats at the experiment endpoint after LP17 treatment. TREM-1 blockade also attenuated the increased level of pro-inflammatory cytokines TNF-α, IL-6, and IL-1β, and thus attenuated systematic and distant inflammatory responses. Furthermore, TREM-1 blockade significantly attenuated the increased levels of pJAK2 and pSTAT3. CONCLUSIONS TREM-1 blockade by the use of an inhibitory peptide LP17 could prolong survival of rats with polymicrobial sepsis and attenuate systematic inflammatory responses through the JAK2/STAT3 signaling pathway. Our results suggest that modulation of TREM-1 by a synthetic peptide might be a potential therapeutic option for polymicrobial sepsis.

  2. Treatment with 24 h–delayed normo- and hyperbaric oxygenation in severe sepsis induced by cecal ligation and puncture in rats

    Directory of Open Access Journals (Sweden)

    Nina Falcon Bærnthsen

    2017-11-01

    Full Text Available Abstract Background Septic shock remains a leading cause of death worldwide. Hyperbaric oxygen treatment (HBO2 has been shown to alter the inflammatory response during sepsis and to reduce mortality. A therapeutic window of HBO2 treatment has been demonstrated experimentally, but optimal timing remains uncertain. We investigated the effects of 24 h delayed normobaric oxygen (NBO2 and HBO2 treatment on the endogenous production of the inflammatory markers interleukin (IL-6, tumor necrosis factor (TNF-α and IL-10, and on mortality in rats with cecal ligation and puncture (CLP induced sepsis. Method Fifty-five male Sprague-Dawley rats underwent CLP and were randomized to the following groups: 1 HBO2 2.5 bar absolute pressure (pabs; 2 NBO2 1.0 bar pabs; 3 Control (no-treatment, and they were individually monitored for 72 h with intermittent blood sampling. Results IL-6, TNF-α, and IL-10 were increased 24 h after the procedure, and IL-6 was significantly higher in non-survivors than in survivors. The level of IL-10 was significantly higher at hour 48 in the HBO2 group compared to control (p = 0.01, but this was not the case at other time points. No other significant differences in cytokine levels were found for any group comparisons. Delayed NBO2 and HBO2 treatment failed to change the mortality in the animals. Conclusion High levels of IL-6 in non-surviving animals with sepsis suggest that IL-6 is a potential biomarker. We found a significantly higher concentration of IL-10 in the HBO2 group at hour 48 vs. control animals. However, 24 h–delayed treatment with HBO2 did not change the levels of pro-inflammatory cytokines and survival, suggesting that earlier intervention may be required to obtain an anti-inflammatory effect.

  3. Vascularized osseous graft for scaphoid

    International Nuclear Information System (INIS)

    Mendez Daza, Carlos Hernan; Mathoulin, Cristophe

    2004-01-01

    The most commonly used technique for treatment of pseudo-arthrosis of the scaphoid is osteo-synthesis with Kirschnet wires and cortical sponge grafts. Results reported by different teams using this procedure show no more than 90% osseous consolidation, especially in cases where vascularisation of the proximal fragment of the scaphoid is compromised. Here we present a series of ten cases of pseudo-arthrosis of the scaphoid, treated using a new surgical technique involving a vascularized osseous graft of the distal radius. Using this procedure we obtained 100% consolidation, with no complications either during the procedure or immediately post-operatively. Patients returned to work in week 15 on average. In 4 cases we observed discomfort in the area of the scar, which was successfully treated using local cortisone injection. The results obtained are very similar to those seen in the literature on the different techniques for vascularized osseous grafts for pseudo-arthrosis of the scaphoid

  4. [Menopause: Hypertension and vascular disease].

    Science.gov (United States)

    Zilberman, J M

    Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Vascular diagnostics for Raynaud's phenomenon

    Directory of Open Access Journals (Sweden)

    Dinsdale G

    2014-10-01

    Full Text Available Graham Dinsdale, Ariane L Herrick Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Abstract: Raynaud's phenomenon (RP is common, and in most patients is primary (idiopathic when due to reversible vasospasm and does not progress to irreversible tissue injury. However, in those patients for whom RP is secondary to an underlying disease (eg, systemic sclerosis or atherosclerosis, progression to digital ulceration or critical ischemia can occur. Therefore, the key question for the clinician is “Why does this patient have RP?” Vascular diagnostics play a key role in answering this. In this review, we firstly discuss the different vascular investigations relevant to clinical practice: nail fold capillaroscopy (including the different methodologies for examining the nail fold capillaries, and the role of capillaroscopy in helping to differentiate between primary and systemic sclerosis-related RP, thermography (available in specialist centers, and evaluation of large vessel disease (for example, due to atherosclerosis. We then discuss research tools, mainly laser Doppler methods, including laser Doppler imaging and laser speckle contrast imaging. These are commercially available as complete imaging systems and are (relatively easy to use. The main current goal in vascular imaging research is to validate these novel state-of-the-art techniques as outcome measures of digital vascular disease, and then apply them in early and later phase studies of new treatment approaches, thus facilitating drug development programs. Keywords: Raynaud's phenomenon, systemic sclerosis, nail fold capillaroscopy, thermography, laser Doppler, angiography

  6. Circadian clock and vascular disease.

    OpenAIRE

    Takeda, Norihiko; Maemura, Koji

    2010-01-01

    Cardiovascular functions, including blood pressure and vascular functions, show diurnal oscillation. Circadian variations have been clearly shown in the occurrence of cardiovascular events such as acute myocardial infarction. Circadian rhythm strongly influences human biology and pathology. The identification and characterization of mammalian clock genes revealed that they are expressed almost everywhere throughout the body in a circadian manner. In contrast to the central clock in the suprac...

  7. Heritability of Retinal Vascular Fractals

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Broe, Rebecca; Kessel, Line

    2017-01-01

    Purpose: To determine the genetic contribution to the pattern of retinal vascular branching expressed by its fractal dimension. Methods: This was a cross-sectional study of 50 monozygotic and 49 dizygotic, same-sex twin pairs aged 20 to 46 years. In 50°, disc-centered fundus photographs, the reti......Purpose: To determine the genetic contribution to the pattern of retinal vascular branching expressed by its fractal dimension. Methods: This was a cross-sectional study of 50 monozygotic and 49 dizygotic, same-sex twin pairs aged 20 to 46 years. In 50°, disc-centered fundus photographs......, the retinal vascular fractal dimension was measured using the box-counting method and compared within monozygotic and dizygotic twin pairs using Pearson correlation coefficients. Falconer's formula and quantitative genetic models were used to determine the genetic component of variation. Results: The mean...... fractal dimension did not differ statistically significantly between monozygotic and dizygotic twin pairs (1.505 vs. 1.495, P = 0.06), supporting that the study population was suitable for quantitative analysis of heritability. The intrapair correlation was markedly higher (0.505, P = 0...

  8. Vascularization regenerative medicine and tissue engineering

    CERN Document Server

    Brey, Eric M

    2014-01-01

    A Complex and Growing Field The study of vascularization in tissue engineering and regenerative medicine (TERM) and its applications is an emerging field that could revolutionize medical approaches for organ and tissue replacement, reconstruction, and regeneration. Designed specifically for researchers in TERM fields, Vascularization: Regenerative Medicine and Tissue Engineering provides a broad overview of vascularization in TERM applications. This text summarizes research in several areas, and includes contributions from leading experts in the field. It defines the difficulties associated with multicellular processes in vascularization and cell-source issues. It presents advanced biomaterial design strategies for control of vascular network formation and in silico models designed to provide insight not possible in experimental systems. It also examines imaging methods that are critical to understanding vascularization in engineered tissues, and addresses vascularization issues within the context of specific...

  9. Vascular Malformations of the Orofacial Region

    Directory of Open Access Journals (Sweden)

    Daya K Jangam

    2010-01-01

    Full Text Available Vascular malformations are the benign lesion of the blood vessels or vascular elements and are considered errors of vascular morphogenesis, displaying abnormal dilatations, and channels but no increased cell turnover. Vascular malformations are always present at birth and enlarge in proportion to the growth of the child- They do not involute and remain throughout the patient′s life. 1 These lesions occur with equal sex predilection and do not favor any races. Vascular lesions of the face are not very common Most of the oral and oropharyngeal lesions tend to occur in the tongue and the floor of the mouth. 2 In most cases, the diagnosis of vascular malformations is based on clinical evaluation Here a case report is presented of 16-year-old male patient with vascular malformation of the orofacial region. The clinical presentation, radiological finding are discussed with emphasis on recent advances for diagnosis of the same.

  10. Ghrelin improves vascular autophagy in rats with vascular calcification.

    Science.gov (United States)

    Xu, Mingming; Liu, Lin; Song, Chenfang; Chen, Wei; Gui, Shuyan

    2017-06-15

    This study aimed to investigate whether ghrelin ameliorated vascular calcification (VC) through improving autophagy. VC model was induced by nicotine plus vitamin D 3 in rats and β-glycerophosphate in vascular smooth muscle cell (VSMC). Calcium deposition was detected by von Kossa staining or alizarin red S staining. ALP activity was also detected. Western blot was used to assess the protein expression. Ghrelin treatment attenuated the elevation of calcium deposition and ALP activity in VC model both in vivo and in vitro. Interesting, the protein levels of autophagy markers, LC3 and beclin1 were significantly upregulated by ghrelin in VC model. An autophagy inhibitor, 3-methyladenine blocks the ameliorative effect of ghrelin on VC. Furthermore, protein expressions of phosphate-AMPK were increased by ghrelin treatment both in calcified aorta and VSMC. The effect of ghrelin on autophagy induction and VC attenuation was prevented by AMPK inhibitor, compound C. Our results suggested that ghrelin improved autophagy through AMPK activation, which was resulted in VC amelioration. These data maybe throw light on prevention and therapy of VC. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. MIGRAINE AND STROKE: VASCULAR COMORBIDITY

    Directory of Open Access Journals (Sweden)

    Donata eGuidetti

    2014-10-01

    Full Text Available Several comorbidities are associated to migraine.Recent meta-analyses have consistently demonstrated a relationship between migraine and stroke, which is well-defined for ischaemic stroke and migraine with aura, even stronger in females on oral contraceptives or smokers. However, there seems to be no clear-cut association between stroke in migraineurs and the common vascular risk factors, at least in the young adult population. Migraineurs also run an increased risk of hemorrhagic stroke, while the association between migraine and cardiovascular disease remains poorly defined.Another aspect is the relationship between migraine and the presence of silent brain lesions. It has been demonstrated that there is an increased frequency of ischaemic lesions in the white matter of migraineurs, especially silent infarcts in the posterior circulation territory in patients with at least 10 attacks per month. Although there is a higher prevalence of patent foramen ovale (PFO in migraineurs, the relationship between migraine and PFO remains controversial and PFO closure is not a recommended procedure to prevent migraine. As an increased frequency of cervical artery dissections has been observed in migrainous patients, it has been hypothesized that migraine may represent a predisposing factor for cervical artery dissection. There still remains the question as to whether migraine should be considered a true vascular disease or if the comorbidity between migraine and cerebrovascular disease may have underlying shared risk factors or pathophysiological mechanisms. Although further studies are required to clarify this issue, current evidence supports a clinical management where MA patients should be screened for other concomitant vascular risk factors and treated accordingly.

  12. Vascular dementia: Facts and controversies

    Directory of Open Access Journals (Sweden)

    Pavlović Aleksandra

    2013-01-01

    Full Text Available Vascular dementia (VaD is the second most frequent dementia after Alzheimer’s disease, and is diagnosed during lifetime in 20% of demented patients. Five­year survival rate in VaD is 39%, while it is estimated to be 75% in healthy persons of the same age. It is therefore important to make correct diagnosis of VaD early in the course of the disease. Risk factors for VaD are identical to stroke risk factors, and there are significant possibilities for the prevention of vascular cognitive decline. Cognitive decline develops acutely or step­by­step within three months after stroke, but more gradual progression of intellectual decline is also possible. Neurological examination can reveal pyramidal and extrapyramidal signs, pseudobulbar palsy, gait disturbance and urinary incontinence. Neuropsychological profile comprises the loss of cognitive set shifting, decline in word fluency, verbal learning difficulties, perseverations, difficulties in complex figure copying, and in patients with cortically located lesions also problems with speech and praxia. The basis of the diagnosis is, besides history, neurological examination and neuropsychological assessment, computed tomography and/ or magnetic resonance brain imaging. Vascular risk factors control is the most important measure in VaD prevention. Modern guidelines for the treatment of cognitive decline in VaD emphasize that donepezil can be useful in the improvement of cognitive status at the level of Class IIa recommendation at the level of evidence A, while memantine may be useful in patients with mixed VaD and Alzheimer’s disease dementia. [Projekat Ministarstva nauke Republike Srbije, br. 175022 i br. 175033

  13. Spinal vascular malformations; Spinale Gefaessmalformationen

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2012-05-15

    Spinal vascular malformations are a group of rare diseases with different clinical presentations ranging from incidental asymptomatic findings to progressive tetraplegia. This article provides an overview about imaging features as well as clinical and therapeutic aspects of spinal arteriovenous malformations, cavernomas and capillary telangiectasia. (orig.) [German] Spinale Gefaessmalformationen sind eine Gruppe seltener Erkrankungen mit unterschiedlichen klinischen Praesentationen, die vom asymptomatischen Zufallsbefund bis zur progredienten Tetraparese reichen. Dieser Artikel gibt einen Ueberblick ueber radiologische Befunde sowie klinische und therapeutische Aspekte von spinalen arteriovenoesen Malformationen, Kavernomen und kapillaeren Teleangiektasien. (orig.)

  14. Vascular comorbidities in multiple sclerosis

    DEFF Research Database (Denmark)

    Thormann, Anja; Magyari, Melinda; Koch-Henriksen, Nils

    2016-01-01

    and randomly matched with controls regarding year of birth, gender, and municipality on January 1st in the year of multiple sclerosis (MS) onset (index date). Individual-level information on comorbidities was obtained from several independent nationwide registries and linked to the study population by unique......To investigate the occurrence of vascular comorbidities before and after the clinical onset of multiple sclerosis. In this combined case–control and cohort study, all Danish born citizens with onset of multiple sclerosis 1980–2005 were identified from the Danish Multiple Sclerosis Registry...

  15. Gene deletion of P-Selectin and ICAM-1 does not inhibit neutrophil infiltration into peritoneal cavity following cecal ligation-puncture

    Directory of Open Access Journals (Sweden)

    Hess Karen

    2004-07-01

    Full Text Available Abstract Background Neutrophil infiltration is one of the critical cellular components of an inflammatory response during peritonitis. The adhesion molecules, P-selectin and intercellular adhesion molecule (ICAM-1, mediate neutrophil-endothelial cell interactions and the subsequent neutrophil transendothelial migration during the inflammatory response. Despite very strong preclinical data, recent clinical trials failed to show a protective effect of anti-adhesion therapy, suggesting that the length of injury might be a critical factor in neutrophil infiltration. Therefore, the objective of this study was to determine the role of P-selectin and ICAM-1 in neutrophil infiltration into the peritoneal cavity during early and late phases of peritonitis. Methods Peritonitis was induced in both male wild-type and P-selectin/ICAM-1 double deficient (P/I null mice by cecal ligation-puncture (CLP. Peripheral blood and peritoneal lavage were collected at 6 and 24 hours after CLP. The total leukocyte and neutrophil contents were determined, and neutrophils were identified with the aid of in situ immunohistochemical staining. Comparisons between groups were made by applying ANOVA and student t-test analysis. Results CLP induced a severe inflammatory response associated with a significant leukopenia in both wild-type and P/I null mice. Additionally, CLP caused a significant neutrophil infiltration into the peritoneal cavity that was detected in both groups of mice. However, neutrophil infiltration in the P/I null mice at 6 hours of CLP was significantly lower than the corresponding wild-type mice, which reached a similar magnitude at 24 hours of CLP. In contrast, in peritonitis induced by intraperitoneal inoculation of 2% glycogen, no significant difference in neutrophil infiltration was observed between the P/I null and wild-type mice at 6 hours of peritonitis. Conclusions The data suggest that alternative adhesion pathway(s independent of P-selectin and ICAM

  16. Vascular adaption to physical inactivity in humans

    OpenAIRE

    Bleeker, M.W.P.

    2006-01-01

    This thesis presents studies on vascular adaptation to physical inactivity and deconditioning. Although it is clear that physical inactivity is an important risk factor for cardiovascular disease, the underlying physiological mechanisms have not yet been elucidated. In contrast to physical inactivity, exercise decreases the risk for cardiovascular disease. This beneficial effect of exercise is partly due to changes in vascular function and structure. However, far less is known about vascular ...

  17. Cryptic vascular malformations involving the brainstem

    Energy Technology Data Exchange (ETDEWEB)

    Yeates, A.; Enzmann, D.

    1983-01-01

    Six patients with angiographically cryptic vascular malformations involving the brainstem were examined with computed tomography (CT). The clinical and CT findings of cryptic vascular malformations of the brainstem are described and distinguished from those of brainstem glioma and multiple sclerosis. Calcification within a brainstem lesion that displays relatively little mass effect and shows little contrast enhancement, particularly when associated with a long history of waxing and waning brainstem symptoms, should suggest a vascular malformation.

  18. Diffuse and vascular hepatic diseases

    International Nuclear Information System (INIS)

    Kreimeyer, S.; Grenacher, L.

    2011-01-01

    In addition to focal liver lesions, diffuse and vascular disorders of the liver represent a wide spectrum of liver diseases which are from the radiological point of view often difficult or nearly impossible to diagnose. Classical diagnostic methods are computed tomography and magnetic resonance imaging in addition to ultrasound. Diffuse parenchymal damage caused by diseases of various etiologies is therefore difficult to evaluate because it often lacks characteristic morphological features. For hepatic steatosis, hemochromatosis/siderosis as an example of a diffuse storage disease and sarcoidosis and candidiasis as infectious/inflammatory diseases, an image-based diagnosis is appropriate in some cases. For most diffuse liver diseases, however only nonspecific changes are visualized. Vascular pathologies of the liver, such as the Budd-Chiari syndrome and portal vein thrombosis, however, can usually be diagnosed very clearly using radiology and there is also a very effective interventional radiological treatment. Chronic diseases very often culminate in liver cirrhosis which is highly associated with an increased risk of liver cancer. (orig.) [de

  19. Microparticles, vascular function, and atherothrombosis.

    Science.gov (United States)

    Rautou, Pierre-Emmanuel; Vion, Anne-Clémence; Amabile, Nicolas; Chironi, Gilles; Simon, Alain; Tedgui, Alain; Boulanger, Chantal M

    2011-08-19

    Membrane-shed submicron microparticles (MPs) are released after cell activation or apoptosis. High levels of MPs circulate in the blood of patients with atherothrombotic diseases, where they could serve as a useful biomarker of vascular injury and a potential predictor of cardiovascular mortality and major adverse cardiovascular events. Atherosclerotic lesions also accumulate large numbers of MPs of leukocyte, smooth muscle cell, endothelial, and erythrocyte origin. A large body of evidence supports the role of MPs at different steps of atherosclerosis development, progression, and complications. Circulating MPs impair the atheroprotective function of the vascular endothelium, at least partly, by decreased nitric oxide synthesis. Plaque MPs favor local inflammation by augmenting the expression of adhesion molecule, such as intercellular adhesion molecule -1 at the surface of endothelial cell, and monocyte recruitment within the lesion. In addition, plaque MPs stimulate angiogenesis, a key event in the transition from stable to unstable lesions. MPs also may promote local cell apoptosis, leading to the release and accumulation of new MPs, and thus creating a vicious circle. Furthermore, highly thrombogenic plaque MPs could increase thrombus formation at the time of rupture, together with circulating MPs released in this context by activated platelets and leukocytes. Finally, MPs also could participate in repairing the consequences of arterial occlusion and tissue ischemia by promoting postischemic neovascularization.

  20. Neuroradiological findings in vascular dementia

    Energy Technology Data Exchange (ETDEWEB)

    Guermazi, Ali; Miaux, Yves; Suhy, Joyce; Pauls, Jon; Lopez, Ria [Synarc, Inc., Department of Radiology Services, San Francisco, CA (United States); Rovira-Canellas, Alex [Hospital General Universitari Vall d' Hebron, Unita de Resonancia Magnetica, Barcelona (Spain); Posner, Holly [Eisai, Inc., Teaneck, NJ (United States)

    2007-01-15

    There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD. The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI. Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies. Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases. (orig.)

  1. Leaf hydraulics II: vascularized tissues.

    Science.gov (United States)

    Rockwell, Fulton E; Holbrook, N Michele; Stroock, Abraham D

    2014-01-07

    Current models of leaf hydration employ an Ohm's law analogy of the leaf as an ideal capacitor, neglecting the resistance to flow between cells, or treat the leaf as a plane sheet with a source of water at fixed potential filling the mid-plane, neglecting the discrete placement of veins as well as their resistance. We develop a model of leaf hydration that considers the average conductance of the vascular network to a representative areole (region bounded by the vascular network), and represent the volume of tissue within the areole as a poroelastic composite of cells and air spaces. Solutions to the 3D flow problem are found by numerical simulation, and these results are then compared to 1D models with exact solutions for a range of leaf geometries, based on a survey of temperate woody plants. We then show that the hydration times given by these solutions are well approximated by a sum of the ideal capacitor and plane sheet times, representing the time for transport through the vasculature and tissue respectively. We then develop scaling factors relating this approximate solution to the 3D model, and examine the dependence of these scaling factors on leaf geometry. Finally, we apply a similar strategy to reduce the dimensions of the steady state problem, in the context of peristomatal transpiration, and consider the relation of transpirational gradients to equilibrium leaf water potential measurements. © 2013 Published by Elsevier Ltd. All rights reserved.

  2. CIRSE Vascular Closure Device Registry

    International Nuclear Information System (INIS)

    Reekers, Jim A.; Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

    2011-01-01

    Purpose: Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods: The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results: Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0–14.5] for antegrade access and 1.8% (95% CI 1.1–2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only 5.9 cm, and two vessel occlusions. Conclusion: The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters.

  3. Proatherogenic pathways leading to vascular calcification

    International Nuclear Information System (INIS)

    Mazzini, Michael J.; Schulze, P. Christian

    2006-01-01

    Cardiovascular disease is the leading cause of morbidity and mortality in the western world and atherosclerosis is the major common underlying disease. The pathogenesis of atherosclerosis involves local vascular injury, inflammation and oxidative stress as well as vascular calcification. Vascular calcification has long been regarded as a degenerative process leading to mineral deposition in the vascular wall characteristic for late stages of atherosclerosis. However, recent studies identified vascular calcification in early stages of atherosclerosis and its occurrence has been linked to clinical events in patients with cardiovascular disease. Its degree correlates with local vascular inflammation and with the overall impact and the progression of atherosclerosis. Over the last decade, diverse and highly regulated molecular signaling cascades controlling vascular calcification have been described. Local and circulating molecules such as osteopontin, osteoprogerin, leptin and matrix Gla protein were identified as critical regulators of vascular calcification. We here review the current knowledge on molecular pathways of vascular calcification and their relevance for the progression of cardiovascular disease

  4. Vascular nursing in Greece: luxury or necessity?

    Science.gov (United States)

    Georgakarakos, Efstratios; Bitza, Christina; Papanas, Nikolaos; Matsagkas, Miltiadis; Lazarides, Miltos K

    2013-09-01

    Although peripheral arterial disease is prevalent in the primary care setting, insufficient vascular education among nurses and physicians coupled with certain economic constraints undermines treatment efficacy. Moreover, the burden of advanced venous pathology such as posthrombotic syndrome, venous ulcers, and lymphedema remains suboptimally treated. This article advocates the development of a vascular nursing specialty as a means to improving vascular care especially nowadays, when health care providers dictate comprehensive and cost-effective nursing practice and patient management. It also presents the first attempt to organize a Vascular Nursing Educational Session in Greece.

  5. Implementation of a vascular access quality programme improves vascular access care

    NARCIS (Netherlands)

    van Loon, M.; van der Mark, W.; Beukers, N.; de Bruin, C.; Blankestijn, P. J.; Huisman, R. M.; Zijlstra, J. J.; van der Sande, F. M.; Tordoir, J. H. M.

    Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres

  6. Vascular anastomosis by Argon Laser

    International Nuclear Information System (INIS)

    Gomes, O.M.; Macruz, R.; Armelin, E.; Brum, J.M.G.; Ribeiro, M.P.; Mnitentog, J.; Verginelli, G.; Pileggi, F.; Zerbini, E.J.

    1982-01-01

    Twenty four mongrel dogs, wheighing 13 to 24 kilograms were studied. After anesthesia, intubation and controlled ventilation, they were submitted to three types of vascular anastomosis: Group I - eight dogs with saphenous vein inter-carotid arteries by-pass: Group II - eight dogs with left mammary artery - left anterior descending coronary artery by-pass; Group III - eight dogs with venovenous anastomosis. In all groups 0.8 to 15 watts of Argon Laser power was applied to a total time of 90 to 300 seconds. The lower power for venovenous anastomosis and the greater for the arterial ones. The mean valves of resistence of the Laser anastomosis to pressure induced rupture was 730 mmHg in the immediate post operative study, and superior to 2.500 mmHg 30 days after. No signs of occlusion was demonstrated at the anastomosis sites by the angiographic and anathomo-patological study performed. (Author) [pt

  7. Vascular access of last resort.

    Science.gov (United States)

    Vachharajani, Tushar J; Agarwal, Anil K; Asif, Arif

    2018-04-01

    Exhausted vasculature is not uncommon in patients receiving long-term hemodialysis treatment. Certain patients exhaust their peripheral veins and do not retain the venous capital necessary for fistula creation. Others suffer from severe peripheral arterial disease and despite the presence of adequate venous capital are not able to receive an arteriovenous access successfully. Most importantly, in the case of occluded central veins, the creation of an arteriovenous access in the arms or thighs would be futile, even if peripheral veins and/or arteries were available. Because renal transplant is not readily available, such patients virtually face death in the absence of dialysis therapy. Hence, it is critically important that vascular access options be available to successfully receive renal replacement therapy. This article describes accesses of last resort and provides information vital to nephrologists for discussion with their patients and to surgeons in choosing an optimal option. Copyright © 2018 International Society of Nephrology. All rights reserved.

  8. Adiposity, adipocytokines & microvesicles in the etiology of vascular disease

    NARCIS (Netherlands)

    Kanhai, D.A.N.I.S.

    2013-01-01

    Vascular disease, in this thesis the terms vascular and cardiovascular are used interchangeably, is the number 1 cause of death worldwide. In 2008, 30% of all mortality had a vascular origin. Vascular mortality rates after a first manifestation of vascular disease are decreasing in Western society,

  9. Mechanics of Vascular Smooth Muscle.

    Science.gov (United States)

    Ratz, Paul H

    2015-12-15

    Vascular smooth muscle (VSM; see Table 1 for a list of abbreviations) is a heterogeneous biomaterial comprised of cells and extracellular matrix. By surrounding tubes of endothelial cells, VSM forms a regulated network, the vasculature, through which oxygenated blood supplies specialized organs, permitting the development of large multicellular organisms. VSM cells, the engine of the vasculature, house a set of regulated nanomotors that permit rapid stress-development, sustained stress-maintenance and vessel constriction. Viscoelastic materials within, surrounding and attached to VSM cells, comprised largely of polymeric proteins with complex mechanical characteristics, assist the engine with countering loads imposed by the heart pump, and with control of relengthening after constriction. The complexity of this smart material can be reduced by classical mechanical studies combined with circuit modeling using spring and dashpot elements. Evaluation of the mechanical characteristics of VSM requires a more complete understanding of the mechanics and regulation of its biochemical parts, and ultimately, an understanding of how these parts work together to form the machinery of the vascular tree. Current molecular studies provide detailed mechanical data about single polymeric molecules, revealing viscoelasticity and plasticity at the protein domain level, the unique biological slip-catch bond, and a regulated two-step actomyosin power stroke. At the tissue level, new insight into acutely dynamic stress-strain behavior reveals smooth muscle to exhibit adaptive plasticity. At its core, physiology aims to describe the complex interactions of molecular systems, clarifying structure-function relationships and regulation of biological machines. The intent of this review is to provide a comprehensive presentation of one biomachine, VSM. Copyright © 2015 John Wiley & Sons, Inc.

  10. FPGA controlled artificial vascular system

    Directory of Open Access Journals (Sweden)

    Laqua D.

    2015-09-01

    Full Text Available Monitoring the oxygen saturation of an unborn child is an invasive procedure, so far. Transabdominal fetal pulse oximetry is a promising method under research, used to estimate the oxygen saturation of a fetus noninvasively. Due to the nature of the method, the fetal information needs to be extracted from a mixed signal. To properly evaluate signal processing algorithms, a phantom modeling fetal and maternal blood circuits and tissue layers is necessary. This paper presents an improved hardware concept for an artificial vascular system, utilizing an FPGA based CompactRIO System from National Instruments. The experimental model to simulate the maternal and fetal blood pressure curve consists of two identical hydraulic circuits. Each of these circuits consists of a pre-pressure system and an artificial vascular system. Pulse curves are generated by proportional valves, separating these two systems. The dilation of the fetal and maternal artificial vessels in tissue substitutes is measured by transmissive and reflective photoplethysmography. The measurement results from the pressure sensors and the transmissive optical sensors are visualized to show the functionality of the pulse generating systems. The trigger frequency for the maternal valve was set to 1 per second, the fetal valve was actuated at 0.7 per second for validation. The reflective curve, capturing pulsations of the fetal and maternal circuit, was obtained with a high power LED (905 nm as light source. The results show that the system generates pulse curves, similar to its physiological equivalent. Further, the acquired reflective optical signal is modulated by the alternating diameter of the tubes of both circuits, allowing for tests of signal processing algorithms.

  11. Experimental studies on glycerol preserved vascular allografts

    NARCIS (Netherlands)

    Fahner, P.J.

    2014-01-01

    Autologous vein is the conduit of choice in patients with critical peripheral arterial disease who need a vascular reconstruction. However, autologous vein could be of inferior quality or used in prior surgery. Vascular allograft transplantation is an attractive alternative to prosthetic grafts in

  12. Vascular permeability alterations induced by arsenic.

    Science.gov (United States)

    Chen, Shih-Chieh; Tsai, Ming-Hsien; Wang, Hsiu-Jen; Yu, Hsin-Su; Chang, Louis W

    2004-01-01

    The impact of arsenic on the integrity of blood vessels in vivo via in situ exposure (local injection) of arsenic was investigated. Vascular permeability changes were evaluated by means of the Evans blue assay and the India ink tracer techniques. Rats were intravenously injected with Evans blue followed by intradermal injections of various doses of sodium arsenite on the back skins of the animals. Evans blue at different time points was extracted and assayed as indices of vascular leakage. Skin at various time point injection sites was sampled for arsenic measurement via graphite furnace atomic absorption spectroscopy. Our time course study with Evans blue technique demonstrated a biphasic pattern of vascular permeability change: an early phase of permeability reduction and a later phase of permeability promotion at all dose levels tested. The India ink tracer technique also demonstrated a time-correlated increase in vascular labelling in the tissues examined, signifying an increase in vascular leakage with time. Moreover, we found that despite an early increase in tissue arsenic content at time of injection, tissue arsenic declined rapidly and returned to near control levels after 30-60 min. Thus, an inverse correlation between tissue arsenic content and the extent of vascular permeability was apparent. This study provides the first demonstration that in situ exposure to arsenic will produce vascular dysfunction (vascular leakage) in vivo.

  13. [Vascular anomalies in the neonatal period].

    Science.gov (United States)

    Bejarano, M; Vicario, F; Soria, A; Parri, F J; Albert, A

    2017-07-20

    Vascular anomalies in the neonatal period are a diagnostic challenge for the lack of evident signs, symptoms and follow-up, and the convenience of restricting aggressive diagnostic tests. The aim of this work is to review the characteristics of neonatal cases presented to our Vascular Anomalies Unit in the last 5 years. All cases of suspected vascular anomaly presented to our unit before 1 month of age between 2010 and 2015 were reviewed, diagnostic tests and treatments carried out with chronology were analyzed. Presumptive diagnosis and final diagnosis (when available) were compared. Fifteen vascular tumors were found, 2 with visceral involvement: 6 infantile hemangiomas (IH), 3 NICH, 4 RICH, 1 tufted hemangioma, 1 unspecified liver vascular tumor, 3 venous malformations (2 equivocal MRI and a hyperkeratotic venous malformation), 4 lymphatic malformations, 3 of them macrocystic, and 2 vascular lesions that were diagnosed of fibrosarcoma and sclerema neonatorum and they were not vascular anomalies. Only 3 patients with macrocystic lymphatic malformations had prenatal diagnosis. Accurate diagnosis of vascular anomalies during the first month of life is difficult, even with MRI. Only in a few cases early treatment is needed, so it is worth taking time to follow-up. Different types of treatment (observation, propranolol, biopsy, laser, embolization, and resection) will depend on the condition to be treated. A continuous observation can avoid unnecessary procedures and risks.

  14. Evaluation of Peripheral Vascular Calcification and Serum ...

    African Journals Online (AJOL)

    Introduction: Vascular calcification is a risk factor for cardiovascular mortality in the general population. It is highly prevalent in end stage renal disease (ESRD) patients. Low magnesium (Mg) levels have been reported to have a strong association with vascular calcification in hemodialysis (HD) patients. The aims of this ...

  15. Management Strategies in Hemodialysis Vascular Access

    NARCIS (Netherlands)

    J. van der Linden (Joke)

    2006-01-01

    textabstractSince the introduction of the AV fistula and the use of interposition graft little improvement has been made in the vascular access field. Still, vascular access related complications, are one of the most important reasons for patient hospitalization, morbidity and even mortality

  16. Vascular hyperreactivity in black Cameroonian hypertensive and ...

    African Journals Online (AJOL)

    Introduction: Vascular hyperreactivity is a risk factor and a factor predicting hypertension (high blood pressure). Unlike other continents where several studies were carried out, it has rarely been studied in black Africa in general and in Cameroon in particular. Methods: Vascular reactivity was measured by the cold test.

  17. Percutaneous Treatment of Peripheral Vascular Malformations

    NARCIS (Netherlands)

    E. van der Linden (Edwin)

    2011-01-01

    textabstractVascular malformations arise from errors in the morphological processes that shape the embryonic vascular system during fetal development. These developmental errors result in abnormal clusters of blood vessels. Although these lesions are present at birth, they might not become visible

  18. Reconstructive vascular surgery below the knee

    DEFF Research Database (Denmark)

    Rasmussen, L B; Jelnes, R; Sager, P

    1986-01-01

    In a series of 38 consecutive patients with advanced peripheral vascular disease (i.e. rest pain) reconstructive vascular surgery was performed with the distal anastomosis below the knee. Ankle/arm pressure index (AAI) was 0.28 (0.11-0.47) preoperatively; accumulated graft patency rate was 0.47 (SD...

  19. Vascular anomalies and retroperitoneal lymphadenectomy (RLA).

    Science.gov (United States)

    Fehér, M; Bedri, I; Böszörményi, G; Villányi, K

    1988-01-01

    In the past 7 years a total of 90 RLAs were performed in patients with testicular tumour and the vascular anomaly of the retroperitoneum was diagnosed in 10 cases. Attention is called to these vascular disorders which render the performance of lymph dissection difficult but can never influence the question of operability.

  20. Vascular dementia | Connor | African Journal of Psychiatry

    African Journals Online (AJOL)

    Vascular dementia (VaD) is a common but heterogeneous condition in which there is a clear temporal relationship between the dementia and vascular disease. It may result from multiple large or small vessel strokes or a single strategic stroke. Subcortical ischaemic VaD includes multiple lacunes and subcortical ...

  1. Apparatus for simulating a vascular interventional procedure

    NARCIS (Netherlands)

    Van den Dobbelsteen, J.J.; Dankelman, J.

    2008-01-01

    The invention relates to an apparatus (1) for simulating a vascular interventional procedure, comprising a wire-like element (7) representing an instrument to be inserted into a vascular tree, which wire-like element can be received in a holder (3), and wherein a sensor (12, 13) is provided for

  2. The Vascular Microenvironment and Systemic Sclerosis

    Directory of Open Access Journals (Sweden)

    Tracy Frech

    2010-01-01

    Full Text Available The role of the vascular microenvironment in the pathogenesis Systemic Sclerosis (SSc is appreciated clinically as Raynaud's syndrome with capillary nail bed change. This manifestation of vasculopathy is used diagnostically in both limited and diffuse cutaneous subsets of SSc, and is thought to precede fibrosis. The degree of subsequent fibrosis may also be determined by the vascular microenvironment. This paper describes why the vascular microenvironment might determine the degree of end-organ damage that occurs in SSc, with a focus on vascular cell senescence, endothelial progenitor cells (EPC including multipotential mesenchymal stem cells (MSC, pericytes, and angiogenic monocytes. An explanation of the role of EPC, pericytes, and angiogenic monocytes is important to an understanding of SSc pathogenesis. An evolving understanding of the vascular microenvironment in SSc may allow directed treatment.

  3. PanVascular medicine. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Lanzer, Peter (ed.) [Health Care Center Bitterfeld (Germany). Division of Cardiovascular Disease

    2015-06-01

    Vascular management and care has become a truly multidisciplinary enterprise as the number of specialists involved in the treatment of patients with vascular diseases has steadily increased. While in the past, treatments were delivered by individual specialists, in the twenty-first century a team approach is without doubt the most effective strategy. In order to promote professional excellence in this dynamic and rapidly evolving field, a shared knowledge base and interdisciplinary standards need to be established. Pan Vascular Medicine, 2nd edition has been designed to offer such an interdisciplinary platform, providing vascular specialists with state-of-the art descriptive and procedural knowledge. Basic science, diagnostics, and therapy are all comprehensively covered. In a series of succinct, clearly written chapters, renowned specialists introduce and comment on the current international guidelines and present up-to-date reviews of all aspects of vascular care.

  4. Bypass materials in vascular surgery

    Directory of Open Access Journals (Sweden)

    Willich, Stephan N.

    2006-03-01

    Full Text Available Introduction: Arteriosclerotic changes can lead to circulatory disturbances in various areas of the human vascular system. In addition to pharmacological therapy and the management of risk factors (e. g. hypertension, diabetes, lipid metabolism disorders, and lifestyle, surgical interventions also play an important role in the treatment of arteriosclerosis. Long-segment arterial occlusions, in particular, can be treated successfully with bypass sur-gery. A number of different materials are available for this type of operation, such as autologous vein or pros-thetic grafts comprised of polytetrafluoroethylene (PTFE or Dacron®. Prosthetic materials are used especially in the treatment of peripheral artery disease, such as in aortoiliac or femoropopliteal bypass surgery. The present report will thus focus on this area in order to examine the effectiveness of different bypass materials. Among the efforts being made to refine the newly introduced DRG system in Germany, analysing the different bypass materials used in vascular surgery is particularly important. Indeed, in its current version the German DRG system does not distinguish between bypass materials in terms of reimbursement rates. Differences in cost structures are thus of especial interest to hospitals in their budget calculations, whereas both private and statutory health insurance funds are primarily interested in long-term results and their costs. Objectives: The goal of this HTA is to compare the different bypass materials used in vascular surgery in terms of their medical efficiency and cost-effectiveness, as well as with regard to their ethical, social and legal implications. In addition, this report aims to point out the areas in which further medical, epidemiological and health economic research is still needed. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information

  5. Vascular narrowing in pulmonary arterial hypertension is heterogeneous: rethinking resistance

    NARCIS (Netherlands)

    Rol, N.; Timmer, E.M.; Faes, T.J.; Noordegraaf, A.V.; Grunberg, K.; Bogaard, H.J.; Westerhof, N.

    2017-01-01

    In idiopathic pulmonary arterial hypertension (PAH), increased pulmonary vascular resistance is associated with structural narrowing of small (resistance) vessels and increased vascular tone. Current information on pulmonary vascular remodeling is mostly limited to averaged increases in wall

  6. Taking care of your vascular access for hemodialysis

    Science.gov (United States)

    ... below as a reminder. What Is a Vascular Access? A vascular access is an opening made in your skin ... access into your body. Know What Type of Vascular Access You Have There are 3 main types of ...

  7. [A new specialty is born: Vascular medicine].

    Science.gov (United States)

    Laroche, J-P

    2016-05-01

    On the 4th of December 2015, the French authorities officially recognized the birth of a specialty in vascular medicine entitled CO-DES cardiology-vascular/vascular Medicine. France is the 7th country to obtain this specialty after Switzerland, Germany, Austria, Czech Republic, Slovakia and Slovenia, six countries in the EEC. It has taken years to achieve a long but exciting experience: we went from hopes to disappointments, sometimes with the blues, but lobbying helping… with sustained confidence. This article tells the story of 30 years of struggle to achieve this vascular medicine specialty. Gaston Bachelard wrote: "Nothing is obvious, nothing is given, all is built." For the construction of vascular medicine, we had to overcome many obstacles, nothing was given to us, everything was conquered. Beware "The specialist is one who knows more and more things about an increasingly restricted field, up to 'knowing everything about nothing"' recalled Ralph Barton Ferry, philosopher; so there is room for modesty and humility but also convictions. The physical examination will remain the basis of our exercise. But let us recall the contributions of all those vascular physicians who practiced in the past, together with those currently active, who built day after day, year after year, a vascular medicine of quality. It is because of the trust of our colleagues and our patients that we can occupy the place that is ours today. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Vascular elastic photoacoustic tomography in humans

    Science.gov (United States)

    Hai, Pengfei; Zhou, Yong; Liang, Jinyang; Li, Chiye; Wang, Lihong V.

    2016-03-01

    Quantification of vascular elasticity can help detect thrombosis and prevent life-threatening conditions such as acute myocardial infarction or stroke. Here, we propose vascular elastic photoacoustic tomography (VE-PAT) to measure vascular elasticity in humans. VE-PAT was developed by incorporating a linear-array-based photoacoustic computed tomography system with a customized compression stage. By measuring the deformation of blood vessels under uniaxial loading, VE-PAT was able to quantify the vascular compliance. We first demonstrated the feasibility of VE-PAT in blood vessel phantoms. In large vessel phantoms, VE-PAT detected a decrease in vascular compliance due to simulated thrombosis, which was validated by a standard compression test. In small blood vessel phantoms embedded 3 mm deep in gelatin, VE-PAT detected elasticity changes at depths that are difficult to image using other elasticity imaging techniques. We then applied VE-PAT to assess vascular compliance in a human subject and detected a decrease in vascular compliance when an occlusion occurred downstream from the measurement point, demonstrating the potential of VE-PAT in clinical applications such as detection of deep venous thrombosis.

  9. Missed Vascular Injuries: Presentation and Outcome

    International Nuclear Information System (INIS)

    Siddique, M. K.; Majeed, S.; Ahmad, N.; Irfan, M.

    2014-01-01

    Objective: To describe the different presentation, diagnostic evaluation, management and outcome of complications of missed vascular injuries. Study Design: A case series. Place and Duration of Study: Combined Military Hospital, Rawalpindi and Combined Military Hospital, Kharian Cantt, from June 2009 to June 2012. Methodology: All the patients with vascular injuries missed at the time of causative trauma who reported during this study period were included. Patients presented with acute vascular injuries and iatrogenic aneurysm at the vascular anastomosis site were excluded. All cases were evaluated with either CT or conventional angiography and managed with various open vascular surgical techniques and their results were assessed. Results: Twenty eight patients with missed vascular injury underwent various vascular repairs. Age of patients ranged from 16 to 78 years (mean = 33.7 A +- 15.4 years). Male to female ratio was 6:1. Twelve (42.8%) patients presented with pseudoaneurysm alone, 10 (35.7%) with traumatic arteriovenous fistulae, 4 (14.3%) with post-traumatic thrombosis and occlusion and 2 (7.1%) with pseudoaneurysm and hemorrhage. Penetrating injuries were the commonest cause in 19 (67.8%). The time interval between injury and presentation in hospital ranged from 2 to 1300 weeks (mean 228 weeks). Lower limb vessels were affected in 20 (71.4%), the upper limb in 5 (17.8%) and neck vessels in 3 (10.7%). Superficial femoral artery was the most frequently involved artery in 9 (32.1%) cases. Interposition reverse autogenous saphenous vein graft was most common type of repair in all types of missed vascular injuries. One (3.5%) patient had amputation after secondary hemorrhage. Conclusion: Low velocity penetrating trauma was the common cause of missed vascular injury. Pseudoaneurysm was the most common presentation. (author)

  10. Dental infection and vascular disease.

    Science.gov (United States)

    Zoellner, Hans

    2011-04-01

    Periodontitis is a chronic inflammatory response to bacterial plaque in which the anchoring bone and soft tissues supporting teeth are destroyed, resulting in tooth mobility and loss. Dental caries involves the spread of infection from the dentine to the vascular dental pulp and periapical bony tissues, before involvement of adjacent soft tissues and spreading sepsis. Several case-controlled, cross-sectional, and cohort studies report correlation between periodontitis and increased cardiovascular, cerebrovascular, and peripheral artery disease, as determined by clinical disease, angiography, ultrasonography, and reduced flow-mediated dilation. Some studies report a similar relationship of atherosclerosis with periapical infection and potentially also with coronal caries, and this review identifies the need to investigate these associations further. Smoking and cadmium exposure are epidemiologically confounding environmental risk factors shared by atherosclerosis and periodontitis. Further complicating epidemiological studies are the risk factors for both atherosclerosis and periodontitis, with which periodontitis appears to have separate positive feedback relationships. These include diabetes, increased plasma lipid levels, hypertension, and white blood cell count. Animal and human intervention studies provide some direct support of a causal role for periodontitis in atherosclerosis, and possible mechanisms include bacterial invasion of arteries, specific atherogenic properties of oral bacteria, the acute phase response, and cytokine polymorphisms. © Thieme Medical Publishers.

  11. Vascular inflammatory cells in hypertension

    Directory of Open Access Journals (Sweden)

    David G. Harrison

    2012-05-01

    Full Text Available Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.

  12. Fascia and Primo Vascular System

    Directory of Open Access Journals (Sweden)

    Chun Yang

    2015-01-01

    Full Text Available The anatomical basis for the concept of acupuncture points/meridians in traditional Chinese medicine (TCM has not been resolved. This paper reviews the fascia research progress and the relationship among acupuncture points/meridians, primo vascular system (PVS, and fascia. Fascia is as a covering, with common origins of layers of the fascial system despite diverse names for individual parts. Fascia assists gliding and fluid flow and holds memory and is highly innervated. Fascia is intimately involved with nourishment of all cells of the body, including those of disease and cancer. The human body’s fascia network may be the physical substrate represented by the meridians of TCM. The PVS is a newly found circulatory system; recent increased interest has led to new research and new discoveries in the anatomical and functional aspects of the PVS. The fasciology theory provides new insights into the physiological effects of acupuncture needling on basic cellular mechanisms including connective tissue mechanotransduction and regeneration. This view represents a theoretical basis and means for applying modern biomedical research to examining TCM principles and therapies, and it favors a holistic approach to diagnosis and treatment.

  13. Comparison of the integrated vascular surgery resident operative experience and the traditional vascular surgery fellowship.

    Science.gov (United States)

    Tanious, Adam; Wooster, Mathew; Jung, Andrew; Nelson, Peter R; Armstrong, Paul A; Shames, Murray L

    2017-07-01

    After almost 10 years since its approval, residents in integrated vascular surgery training programs now outnumber traditional vascular fellows. We examined the Accreditation Council for Graduate Medical Education (ACGME) case log data to assess whether there is a difference in operative experience between the graduating integrated residents and vascular fellows. We analyzed the total clinical experience of vascular surgery trainees during the academic years between 2012 and 2014 for the 30 graduated integrated vascular surgery residents (VSRs) and the 243 graduated vascular surgery fellows (VSFs). Data were compared on the basis of reported categories defined by the ACGME operation reporting system. VSR case totals were calculated by combining "surgeon chief," "surgeon junior," and "secondary procedures" categories. VSF "surgeon fellow" and "secondary procedures" case totals were combined with all vascular cases done in general surgery residency (using averages of general surgery resident ACGME case log data from the same years) to reflect their total vascular experience. The average total vascular experience reported by VSRs was 1446.0 compared with 1421.8 for VSFs (P = .2086). VSRs performed 694.7 major vascular procedures on average compared with 616.3 major cases for VSFs (P = .0106). Highlighted comparisons include the following: open aortic aneurysm cases, VSRs 20.6 and VSFs 22.2 (P = .320); endovascular aortic aneurysm cases, VSRs 80.0 and VSFs 80.6 (P = .945); cerebrovascular cases, VSRs 78.8 and VSFs 85.0 (P = .1132); and peripheral obstructive cases, VSRs 343.6 and VSFs 293.4 (P = .0032). Integrated VSRs and traditional VSFs graduate with comparable overall vascular surgery clinical experience. VSRs reported, on average, a significantly higher number of major vascular procedures during their tenure as trainees as well as a significantly increased number of cases in six of the other ACGME categories. Copyright © 2017 Society for Vascular Surgery

  14. Imaging evaluation of fetal vascular anomalies

    International Nuclear Information System (INIS)

    Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Koch, Bernadette L.; Laor, Tal; Adams, Denise M.; Gupta, Anita; Lim, Foong-Yen

    2015-01-01

    Vascular anomalies can be detected in utero and should be considered in the setting of solid, mixed or cystic lesions in the fetus. Evaluation of the gray-scale and color Doppler US and MRI characteristics can guide diagnosis. We present a case-based pictorial essay to illustrate the prenatal imaging characteristics in 11 pregnancies with vascular malformations (5 lymphatic malformations, 2 Klippel-Trenaunay syndrome, 1 venous-lymphatic malformation, 1 Parkes-Weber syndrome) and vascular tumors (1 congenital hemangioma, 1 kaposiform hemangioendothelioma). Concordance between prenatal and postnatal diagnoses is analyzed, with further discussion regarding potential pitfalls in identification. (orig.)

  15. Imaging evaluation of fetal vascular anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Koch, Bernadette L.; Laor, Tal [MLC 5031 Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Adams, Denise M. [Cincinnati Children' s Hospital Medical Center, Department of Pediatrics and Hemangioma and Vascular Malformation Center, Cincinnati, OH (United States); Gupta, Anita [Cincinnati Children' s Hospital Medical Center, Department of Pathology, Cincinnati, OH (United States); Lim, Foong-Yen [Cincinnati Children' s Hospital Medical Center, Pediatric Surgery and Fetal Center of Cincinnati, Cincinnati, OH (United States)

    2015-08-15

    Vascular anomalies can be detected in utero and should be considered in the setting of solid, mixed or cystic lesions in the fetus. Evaluation of the gray-scale and color Doppler US and MRI characteristics can guide diagnosis. We present a case-based pictorial essay to illustrate the prenatal imaging characteristics in 11 pregnancies with vascular malformations (5 lymphatic malformations, 2 Klippel-Trenaunay syndrome, 1 venous-lymphatic malformation, 1 Parkes-Weber syndrome) and vascular tumors (1 congenital hemangioma, 1 kaposiform hemangioendothelioma). Concordance between prenatal and postnatal diagnoses is analyzed, with further discussion regarding potential pitfalls in identification. (orig.)

  16. Vascular Complications During Catheter Ablation of Cardiac Arrhythmias: A Comparison Between Vascular Ultrasound Guided Access and Conventional Vascular Access.

    Science.gov (United States)

    Sharma, Parikshit S; Padala, Santosh K; Gunda, Sampath; Koneru, Jayanthi N; Ellenbogen, Kenneth A

    2016-10-01

    Vascular access related complications are the most common complications from catheter based EP procedures and have been reported to occur in 1-13% of cases. We prospectively assessed vascular complications in a large series of consecutive patients undergoing catheter based electrophysiologic (EP) procedures with ultrasound (US) guided vascular access versus conventional access. Consecutive patients undergoing catheter ablation procedures at VCU medical center were included. US guided access was obtained in all cases starting June 2015 (US group) while modified Seldinger technique without US guidance (non-US group) was used in cases prior to this date. All vascular complications were recorded for a 30-day period after the procedure. A total of 689 patients underwent 720 procedures. Ablations for ventricular tachyarrhythmias (ventricular tachycardia: VT, premature ventricular contractions: PVCs) accounted for 89 (12%) cases; atrial fibrillation (AF) ablations accounted for 328 procedures (46%) and other catheter based procedures accounted for 42% of cases. A significantly higher incidence of complications was noted in the non-US group compared with the US group (19 [5.3%] vs. 4 [1.1%], respectively, P = 0.002). Major complications were also higher among the non-US group (9 [2.5%] vs. 2 [0.6%], P = 0.03). Increasing age (P = 0.04) and non-US guided vascular access (P = 0.002) were associated with a higher risk of vascular access complications. In a large series of patients undergoing catheter based EP procedures for cardiac arrhythmias, US guided vascular access was associated with a significantly decreased 30-day risk of vascular complications. © 2016 Wiley Periodicals, Inc.

  17. Effect of vascular burden as measured by vascular indexes upon vascular dementia: a matched case-control study

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2012-01-01

    Full Text Available Paul Y Takahashi, Casey R Caldwell, Paul V TargonskiPrimary Care Internal Medicine, Mayo Clinic, Rochester MN, USABackground: Vascular dementia (VaD is a challenging illness that affects the lives of older adults and caregivers. It is unclear how multiple vascular risk factor exposures (polyvascular disease affect VaD.Purpose: To determine the relationship between multiple vascular risk exposures, as counted on an index in cases with VaD, compared with healthy age-/gender-matched controls.Methods: This was a matched case-control study of subjects living in Olmsted County, MN with documented VaD. Controls were selected by gender and age within 3 years from those who did not have dementia. The exposures included a total index (eleven exposure factors added together, along with indexes for cerebrovascular disease (two exposures, cardiovascular disease (four exposures, vascular disease (three exposures, and lifestyle (two exposures. Analysis used matched conditional univariable logistic regression for each index.Results: A total of 1736 potential subjects were identified, and 205 subjects were diagnosed with VaD. There was a significant association of the total score index with an odds ratio of 1.45 (95% confidence interval 1.21–1.74. The cerebrovascular index was also associated with VaD with an odds ratio of 12.18 (95% confidence interval 6.29–23.61. The cardiovascular and vascular indexes were also associated with VaD status. The lifestyle index was not associated with VaD.Conclusion: The cumulative role of multiple vascular risk factors or diseases increased the risk of VaD, as noted by the total vascular index. The lifestyle index did not reveal any significant differences. Further work is required for evaluation of these indexes.Keywords: polyvascular disease, elderly, vascular dementia

  18. RX-207, a Small Molecule Inhibitor of Protein Interaction with Glycosaminoglycans (SMIGs), Reduces Experimentally Induced Inflammation and Increases Survival Rate in Cecal Ligation and Puncture (CLP)-Induced Sepsis.

    Science.gov (United States)

    Juhas, Stefan; Harris, Nicholas; Il'kova, Gabriela; Rehák, Pavol; Zsila, Ferenc; Yurgenzon Kogan, Faina; Lahmy, Orly; Zhuk, Regina; Gregor, Paul; Koppel, Juraj

    2018-02-01

    The fused quinazolinone derivative, RX-207, is chemically and functionally related to small molecule inhibitors of protein binding to glycosaminoglycans (SMIGs). Composed of a planar aromatic amine scaffold, it inhibits protein binding to glycosaminoglycans (GAGs). RX-207 reduced neutrophil migration in thioglycollate-induced peritonitis (37%), inhibited carrageenan-induced paw edema (32%) and cerulein-induced pancreatitis (28%), and increased animal survival in the mouse model of cecal ligation and puncture (CLP)-induced sepsis (60%). The mechanism of RX-207 action, analyzed by UV spectroscopy, confirmed that which was elucidated for chemically related anti-inflammatory SMIGs. RX-207 binding to cell surface GAGs can account for the inhibition of neutrophil recruitment via the micro-vasculature and as a consequence, the reduction of neutrophil mediated tissue damage in the animal models of inflammation and improved survival of mice in CLP-induced sepsis.

  19. Left-colon water exchange preserves the benefits of whole colon water exchange at reduced cecal intubation time conferring significant advantage in diagnostic colonoscopy - a prospective, randomized controlled trial.

    Science.gov (United States)

    Wang, Xiangping; Luo, Hui; Xiang, Yi; Leung, Felix W; Wang, Limei; Zhang, Linhui; Liu, Zhiguo; Wu, Kaichun; Fan, Daiming; Pan, Yanglin; Guo, Xuegang

    2015-07-01

    Whole-colon water exchange (WWE) reduces insertion pain, increases cecal intubation success and adenoma detection rate, but requires longer insertion time, compared to air insufflation (AI) colonoscopy. We hypothesized that water exchange limited to the left colon (LWE) can speed up insertion with equivalent results. This prospective, randomized controlled study (NCT01735266) allocated patients (18-80 years) to WWE, LWE or AI group (1:1:1). The primary outcome was cecal intubation time. Three hundred subjects were randomized to the WWE (n = 100), LWE (n = 100) or AI group (n = 100). Ninety-four to ninety-five per cent of patients underwent diagnostic colonoscopy. Baseline characteristics were balanced. The median insertion time was shorter in LWE group (4.8 min (95%CI: 3.2-6.2)) than those in WWE (7.5 min (95%CI: 6.0-10.3)) and AI (6.4 min (95%CI: 4.2-9.8)) (both p rates in unsedated patients of the two water exchange methods (WWE 99%, LWE 99%) were significantly higher than that (89.8%) in AI group (p = 0.01). The final success rates were comparable among the three groups after sedation was given. Maximum pain scores and number of patients needing abdominal compression between WWE and LWE groups were comparable, both lower than those in AI group (p higher in WWE group. By preserving the benefits of WWE and reducing insertion time, LWE is appropriate for diagnostic colonoscopy, especially in settings with tight scheduling of patients. The higher PDR in the right colon in WWE group deserves to be further investigated.

  20. Generation of human vascularized brain organoids.

    Science.gov (United States)

    Pham, Missy T; Pollock, Kari M; Rose, Melanie D; Cary, Whitney A; Stewart, Heather R; Zhou, Ping; Nolta, Jan A; Waldau, Ben

    2018-03-21

    The aim of this study was to vascularize brain organoids with a patient's own endothelial cells (ECs). Induced pluripotent stem cells (iPSCs) of one UC Davis patient were grown into whole-brain organoids. Simultaneously, iPSCs from the same patient were differentiated into ECs. On day 34, the organoid was re-embedded in Matrigel with 250 000 ECs. Vascularized organoids were grown in vitro for 3-5 weeks or transplanted into immunodeficient mice on day 54, and animals were perfused on day 68. Coating of brain organoids on day 34 with ECs led to robust vascularization of the organoid after 3-5 weeks in vitro and 2 weeks in vivo. Human CD31-positive blood vessels were found inside and in-between rosettes within the center of the organoid after transplantation. Vascularization of brain organoids with a patient's own iPSC-derived ECs is technically feasible.

  1. Extracellular Matrix Molecules Facilitating Vascular Biointegration

    Directory of Open Access Journals (Sweden)

    Martin K.C. Ng

    2012-08-01

    Full Text Available All vascular implants, including stents, heart valves and graft materials exhibit suboptimal biocompatibility that significantly reduces their clinical efficacy. A range of biomolecules in the subendothelial space have been shown to play critical roles in local regulation of thrombosis, endothelial growth and smooth muscle cell proliferation, making these attractive candidates for modulation of vascular device biointegration. However, classically used biomaterial coatings, such as fibronectin and laminin, modulate only one of these components; enhancing endothelial cell attachment, but also activating platelets and triggering thrombosis. This review examines a subset of extracellular matrix molecules that have demonstrated multi-faceted vascular compatibility and accordingly are promising candidates to improve the biointegration of vascular biomaterials.

  2. [Localized purpura revealing vascular prosthetic graft infection].

    Science.gov (United States)

    Boureau, A S; Lescalie, F; Cassagnau, E; Clairand, R; Connault, J

    2013-07-01

    Prosthetic graft infection after vascular reconstruction is a rare but serious complication. We report a case of infection occurring late after implantation of an iliofemoral prosthetic vascular graft. The Staphylococcus aureus infection was revealed by vascular purpura localized on the right leg 7 years after implantation of a vascular prosthesis. This case illustrates an uncommonly late clinical manifestation presenting as an acute infection 7 years after the primary operation. In this situation, the presentation differs from early infection, which generally occurs within the first four postoperative months. Diagnosis and treatment remain a difficult challenge because prosthetic graft infection is a potentially life-threatening complication. Morbidity and mortality rates are high. Here we detail specific aspects of the clinical and radiological presentation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. Vascular training and endovascular practice in Europe

    DEFF Research Database (Denmark)

    Liapis, C.D.; Avgerinos, E.D.; Sillesen, H.

    2009-01-01

    OBJECTIVE: To evaluate the influence of the status of vascular surgery (VS) training paradigms on the actual practice of endovascular therapy among the European countries. METHODS: An email-based survey concerning vascular surgery training models and endovascular practices of different clinical...... specialties was distributed to a VS educator within 14 European countries. European Vascular and Endovascular Monitor (EVEM) data also were processed to correlate endovascular practice with training models. RESULTS: Fourteen questionnaires were gathered. Vascular training in Europe appears in 3 models: 1....... Mono-specialty (independence): 7 countries, 2. Subspecialty: 5 countries, 3. An existing specialty within general surgery: 2 countries. Independent compared to non-independent certification shortens overall training length (5.9 vs 7.9 years, p=0.006), while increasing overall training devoted...

  4. Vascular adaption to physical inactivity in humans

    NARCIS (Netherlands)

    Bleeker, M.W.P.

    2006-01-01

    This thesis presents studies on vascular adaptation to physical inactivity and deconditioning. Although it is clear that physical inactivity is an important risk factor for cardiovascular disease, the underlying physiological mechanisms have not yet been elucidated. In contrast to physical

  5. Vascular adaptation to physical inactivity in humans.

    NARCIS (Netherlands)

    Bleeker, M.W.P.

    2006-01-01

    This thesis presents studies on vascular adaptation to physical inactivity and deconditioning. Although it is clear that physical inactivity is an important risk factor for cardiovascular disease, the underlying physiological mechanisms have not yet been elucidated. In contrast to physical

  6. Lower limb vascular dysfunction in cyclists

    Directory of Open Access Journals (Sweden)

    Thiago Ayala Melo Di Alencar

    2013-06-01

    Full Text Available Sports-related vascular insufficiency affecting the lower limbs is uncommon, and early signs and symptoms can be confused with musculoskeletal injuries. This is also the case among professional cyclists, who are always at the threshold between endurance and excess training. The aim of this review was to analyze the occurrence of vascular disorders in the lower limbs of cyclists and to discuss possible etiologies. Eighty-five texts, including papers and books, published from 1950 to 2012, were used. According to the literature reviewed, some cyclists receive a late diagnosis of vascular dysfunction due to a lack of familiarity of the medical team with this type of dysfunction. Data revealed that a reduced blood flow in the external iliac artery, especially on the left, is much more common than in the femoral and popliteal arteries, and that vascular impairment is responsible for the occurrence of early fatigue and reduced performance in cycling.

  7. Laser-assisted vascular anastomosis

    Science.gov (United States)

    Kao, Race L.; Tsao-Wu, George; Magovern, George J.

    1990-06-01

    The milliwatt CO2 laser and a thermal activated binding compound (20% serum albumin) were used for microvascular anastomoses. Under general anesthesia, the femoral arteries (0.7 to 1.0 mm diameter) of 6 rats were isolated. After the left femoral artery in each rat was clamped and transected, the vessel was held together with 3 equidistant 10-0 Xomed sutures. The cut edges were coated 3 to 4 times with the albumin solution and sealed with the CO2 laser (power density = 120 W/cm2). The binding compound solidified to a translucent tensile substance which supported the anastomosis until self healing and repair were achieved. The right femoral artery was used as sham operated control. Complete hemostasis and patency were observed in every case immediately and at 1, 3, and 6 months following surgery. The binding compound absorbed most of the laser energy thus minimizing thermal injury to the underlying tissue. Mongrel dogs weighing 28 to 33 kg were anesthetized and prepared for sterile surgical procedures. In 5 dogs, the femoral and jugular veins were exposed, transected, and anastomosed using a CO2 laser (Sharplan 1040) with the binding compound. In another 12 dogs, cephalic veins were isolated and used for aortocoronary artery bypass procedures. The Sharplan 1040 CO2 laser and 20% albumin solution were utilized to complete the coronary anastomoses in 6 dogs, and 6 dogs were used as controls by suturing the vessels. Again, hemostasis, patency, and minimal tissue damage were observed immediately and 6 weeks after the procedures. Improved surgical results, reduced operating time, minimized tissue damage, and enhanced anastomotic integrity are the advantages of laser assisted vascular anastomosis with a thermal activated binding compound.

  8. The vascular surgery workforce: a survey of consultant vascular surgeons in the UK, 2014.

    Science.gov (United States)

    Harkin, D W; Beard, J D; Shearman, C P; Wyatt, M G

    2015-04-01

    The purpose of this study was to describe the demographics, training, and practice characteristics of consultant vascular surgeons across the UK to provide an assessment of current, and inform future prediction of workforce needs. A questionnaire was developed using a modified Delphi process to generate questionnaire items. The questionnaire was emailed to all consultant vascular surgeons (n = 450) in the UK who were members of the Vascular Society of Great Britain & Ireland. 352 consultant vascular surgeons from 95 hospital trusts across the UK completed the survey (78% response rate). The mean age was 50.6 years old, the majority (62%) were mid-career, but 24% were above the age of 55. Currently, 92% are men and only 8% women. 93% work full-time, with 60% working >50 hours, and 21% working >60 hours per week. The average team was 5 to 6 (range 2-10) vascular surgeons, with 23% working in a large team of ≥8. 17% still work in small teams of ≤3. Over 90% of consultant vascular surgeons perform the major index vascular surgery procedures (aneurysm repair, carotid endarterectomy, infra-inguinal bypass, amputation). While 84% perform standard endovascular abdominal aortic aneurysm repair (EVAR), <50% perform more complex endovascular aortic therapy. The majority of vascular surgeons "like their job" (85%) and are "satisfied" (69%) with their job. 34% of consultant vascular surgeons indicated they were "extremely likely" to retire within the next 10 years. This study provides the first detailed analysis of the new specialty of vascular surgery as practiced in the UK. There is a need to plan for a significant expansion in the consultant vascular surgeon workforce in the UK over the next 10 years to maintain the status quo. Copyright © 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Evidence for a vascular factor in migraine

    DEFF Research Database (Denmark)

    Asghar, Mohammad S; Hansen, Adam E; Amin, Faisal Mohammad

    2011-01-01

    It has been suggested that migraine is caused by neural dysfunction without involvement of vasodilatation. Because dismissal of vascular mechanisms seemed premature, we examined diameter of extra- and intracranial vessels in migraine without aura patients.......It has been suggested that migraine is caused by neural dysfunction without involvement of vasodilatation. Because dismissal of vascular mechanisms seemed premature, we examined diameter of extra- and intracranial vessels in migraine without aura patients....

  10. Standardized Definitions for Hemodialysis Vascular Access

    OpenAIRE

    Lee, Timmy; Mokrzycki, Michele; Moist, Louise; Maya, Ivan; Vazquez, Miguel; Lok, Charmaine

    2011-01-01

    Vascular access dysfunction is one of the leading causes of morbidity and mortality among end-stage renal disease patients 1,2. Vascular access dysfunction exists in all 3 types of available accesses: arteriovenous fistulas, arteriovenous grafts, and tunneled catheters. In order to improve clinical research and outcomes in hemodialysis access dysfunction, the development of a multidisciplinary network of collaborative investigators with various areas of expertise, and common standards for ter...

  11. Biomimicry, vascular restenosis and coronary stents.

    Science.gov (United States)

    Schwartz, R S; van der Giessen, W J; Holmes, D R

    1998-01-01

    Biomimicry is in its earliest stages and is being considered in the realm of tissue engineering. If arterial implants are to limit neointimal thickening, purely passive structures cannot succeed. Bioactivity must be present, either by pharmacologic intervention or by fabricating a 'living stent' that contains active cellular material. As tissue engineering evolves, useful solutions will emerge from applying this knowledge directly to vascular biologic problems resulting from angioplasty, stenting, and vascular prosthesis research.

  12. Vascular factors and prevention of dementia.

    Science.gov (United States)

    Stephan, Blossom C M; Brayne, Carol

    2008-08-01

    The identification of modifiable risk factors that prevent dementia or slow its progression is a major public health priority. Vascular disease and its risk factors have been linked with cognitive decline and dementia, although the degree of association varies depending on differences in vulnerability related to age, ethnicity, disease co-morbidity and possibly brain reserve. Here we review current dementia prevention strategies linked to vascular modification to identify whether any approach exists that will reduce the population burden of dementia, and whether any exist that show evidence of being cost effective and safe for populations. As yet, there is no compelling evidence that dementia can be prevented through vascular manipulation by pharmacological or non-pharmacological trials. To date, no intervention can be recommended for dementia prevention at the population level including Alzheimer's Disease or Vascular Dementia. Advances in the prevention of dementia will be gained, it is argued, from a more complete understanding of the pathophysiology of disease and its causes, particularly in early life, within and across different populations and age groups. Furthermore, a more complete understanding of the earliest pre-clinical stage of disease is required for effective risk factor modification. Although the current state of knowledge cannot support public health policy for vascular manipulation for dementia prevention at the population level, this does not undermine the importance of vascular manipulation in its own right to promote healthier ageing.

  13. Vascular Adventitia Calcification and Its Underlying Mechanism.

    Directory of Open Access Journals (Sweden)

    Na Li

    Full Text Available Previous research on vascular calcification has mainly focused on the vascular intima and media. However, we show here that vascular calcification may also occur in the adventitia. The purpose of this work is to help elucidate the pathogenic mechanisms underlying vascular calcification. The calcified lesions were examined by Von Kossa staining in ApoE-/- mice which were fed high fat diets (HFD for 48 weeks and human subjects aged 60 years and older that had died of coronary heart disease, heart failure or acute renal failure. Explant cultured fibroblasts and smooth muscle cells (SMCswere obtained from rat adventitia and media, respectively. After calcification induction, cells were collected for Alizarin Red S staining. Calcified lesions were observed in the aorta adventitia and coronary artery adventitia of ApoE-/-mice, as well as in the aorta adventitia of human subjects examined. Explant culture of fibroblasts, the primary cell type comprising the adventitia, was successfully induced for calcification after incubation with TGF-β1 (20 ng/ml + mineralization media for 4 days, and the phenotype conversion vascular adventitia fibroblasts into myofibroblasts was identified. Culture of SMCs, which comprise only a small percentage of all cells in the adventitia, in calcifying medium for 14 days resulted in significant calcification.Vascular calcification can occur in the adventitia. Adventitia calcification may arise from the fibroblasts which were transformed into myofibroblasts or smooth muscle cells.

  14. Stroke injury, cognitive impairment and vascular dementia☆

    Science.gov (United States)

    Kalaria, Raj N.; Akinyemi, Rufus; Ihara, Masafumi

    2016-01-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25–30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood–brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26806700

  15. Vascular vertigo: epidemiology and clinical syndromes.

    Science.gov (United States)

    Karatas, Mehmet

    2011-01-01

    vertigo is a common complaint in medicine. The most common causes of vertigo are benign paroxysmal positional vertigo, vestibular neuritis, Meniere's syndrome, and vascular disorders. Vertigo of vascular origin is usually limited to migraine, transient ischemic attacks, and ischemic or hemorrhagic stroke. Vascular causes lead to various central or peripheral vestibular syndromes with vertigo. This study provides an overview of epidemiology and clinical syndromes of vascular vertigo. vertigo is an illusion of movement caused by asymmetrical involvement of the vestibular system by various causes. Migraine is the most frequent vascular disorder that causes vertigo in all age groups. Vertigo may occur in up to 25% of patients with migraine. The lifetime prevalence of migrainous vertigo is almost 1%. Cerebrovascular disorders are estimated to account for 3% to 7% of patients with vertigo. Vestibular paroxysmia has been diagnosed in 1.8% to 4% of cases in various dizziness units. Vasculitic disorders are rare in the general population, but vertigo may be seen in almost up to 50% of patients with different vasculitic syndromes. migraine, cerebrovascular disorders especially involving the vertebrobasilar territory, cardiocirculatory diseases, neurovascular compression of the eighth nerve, and vasculitis are vascular causes of vertigo syndromes.

  16. Effects of ouabain on vascular reactivity

    Directory of Open Access Journals (Sweden)

    Vassallo D.V.

    1997-04-01

    Full Text Available Ouabain is an endogenous substance occurring in the plasma in the nanomolar range, that has been proposed to increase vascular resistance and induce hypertension. This substance acts on the a-subunit of Na+,K+-ATPase inhibiting the Na+-pump activity. In the vascular smooth muscle this effect leads to intracellular Na+ accumulation that reduces the activity of the Na+/Ca2+ exchanger and to an increased vascular tone. It was also suggested that circulating ouabain, even in the nanomolar range, sensitizes the vascular smooth muscle to vasopressor substances. We tested the latter hypothesis by studying the effects of ouabain in the micromolar and nanomolar range on phenylephrine (PE-evoked pressor responses. The experiments were performed in normotensive and hypertensive rats in vivo, under anesthesia, and in perfused rat tail vascular beds. The results showed that ouabain pretreatment increased the vasopressor responses to PE in vitro and in vivo. This sensitization after ouabain treatment was also observed in hypertensive animals which presented an enhanced vasopressor response to PE in comparison to normotensive animals. It is suggested that ouabain at nanomolar concentrations can sensitize vascular smooth muscle to vasopressor stimuli possibly contributing to increased tone in hypertension

  17. In situ caecal degradation of roughages in horses Degradação cecal in situ de alimentos volumosos em equinos

    Directory of Open Access Journals (Sweden)

    Vinícius Pimentel Silva

    2010-02-01

    Full Text Available The present study was carried out to evaluate the in situ degradation of dry matter (DM, neutral detergent fiber (NDF and crude protein (CP in roughages by the in situ caecal digestion technique in horses. The roughages evaluated were: Lucerne hay (Medicago sativa, peanut (Arachis pintoi cv. Amarillo, desmodio(Desmodium ovalifolium, stylo (Stylosanthes guianensis cv. Mineirão, pigeon pea (Cajanus cajan, lime-yellow pea (Macrotyloma axillare and coastcross hay (Cynodon dactylon cv. coastcross. The assay was conducted in a complete randomized design with seven roughages and three replications. One mare with a cannula fitted in the caecum was used, fed diet consisting of coastcross hay (80% and concentrate (20% at 2.0% BW, four times a day. Nylon 6.5 × 20 cm bags were used with 45 μ/pore, containing 5.2 g DM/bag, inserting 3 or 4 bags in the caecum at the times of 2, 4, 6, 8, 12, 24 and 48 hours incubation. The caecum in situ degradability parameters of nutrients were obtained by Ørskov model. The DM degradability parameters of all the roughages were significant. There was no fit to the model for pigeon pea for CP and NDF and desmodio. Peanut, stylo and lime-yellow pea presented larger potentially degradable DM with values of 53, 46.5 and 40%, respectively, and higher values for the soluble fraction of 20, 21, 28.6%, with high degradability rates of 10.36, 20.26 and 14.8% h-1. Higher NDF degradation rates were observed in these foodstuffs with values of 9.1 and 11.3, 11.2% h-1, high potentially degradable fraction with values of 55, 51.8 and 47.2%, and greater CP degradation at 48 hours with values of 87, 95, and 94.8%. Peanut, stylo and lime-yellow pea presented potential for use in horses diets.Objetivou-se avaliar a degradação da matéria seca (MS, fibra em detergente neutro (FDN e proteína bruta de alimentos volumosos pela técnica da digestão cecal in situ em equinos. Avaliaram-se as forrageiras: feno de alfafa (Medicago sativa

  18. Lung irradiation induces pulmonary vascular remodelling resembling pulmonary arterial hypertension

    NARCIS (Netherlands)

    Ghobadi, G.; Bartelds, B.; van der Veen, S. J.; Dickinson, M. G.; Brandenburg, S.; Berger, R. M. F.; Langendijk, J. A.; Coppes, R. P.; van Luijk, P.

    Background Pulmonary arterial hypertension (PAH) is a commonly fatal pulmonary vascular disease that is often diagnosed late and is characterised by a progressive rise in pulmonary vascular resistance resulting from typical vascular remodelling. Recent data suggest that vascular damage plays an

  19. Patterns of peripheral vascular diseases at Muhimbili National hospital

    African Journals Online (AJOL)

    diseases) and HIV- vasculitis. A total of 97 patients (63%) were surgically treated. Conclusion: Shortage of vascular surgeons and facilities in our. Country needs to be sorted out to save life to these patients with vascular disorders. Key Words: Peripheral Vascular Diseases, and Shortage of Vascular Services in Tanzania.

  20. Assessment of Vascular Injuries and Reconstruction

    Science.gov (United States)

    Baghi, Iraj; Herfatkar, Mohammad Rasool; Shokrgozar, Leila; Poor-Rasuli, Zahra; Aghajani, Fatemeh

    2015-01-01

    Background: Trauma is the third leading cause of death. In this regard, vascular injury plays a leading role in of morbidity and mortality rates. Objectives: The present study aimed to assess the prevalence of vascular injuries and results of vascular reconstruction at a referral hospital in northern Iran. Patients and Methods: A retrospective observational study assessed 88 consecutive patients with vascular injury admitted to Poursina Hospital, Rasht in northern Iran, from October 2007 to October 2009. All study information was collected retrospectively from hospital charts. Results: Most of the affected patients (87/88) were male with a mean age of 29.12 ± 11.20 years. The mechanism of injury in 39.8% was blunt trauma and penetrating trauma in the rest. Of the 53 injured by penetrating trauma (60.2%), the most common cause was stabbing (94.3%). The most common cause of blunt trauma was road traffic accidents (93.1%). The most common mechanism for vascular injuries in upper extremities was penetrating trauma (86.0%) and in lower extremities was blunt trauma (60.0%). Fasciotomy was performed in 16 patients (18.2%) mostly in the lower extremities. Major amputation was required in 10% of the patients. In upper extremities, the most common type of revascularization was end to end anastomosis, followed by inter-position graft. The most common type of reconstruction in the lower extremity was bypass graft. All patients who underwent major amputation were admitted to the center with a delay of more than 6 hours after injury. Conclusions: Major vascular injuries in our center occurred in young men, frequently because of stab wounds. Popliteal injuries mostly caused by motor vehicle accidents was the second most common arterial injury, followed by combined ulnar and radial injuries. Vascular reconstruction in the first hours after trauma may prevent many unnecessary and preventable amputation procedures. PMID:26839869

  1. Congenital vascular malformations in scintigraphic evaluation

    International Nuclear Information System (INIS)

    Pilecki, Stanisław; Gierach, Marcin; Gierach, Joanna; Świętaszczyk, Cyprian; Junik, Roman; Lasek, Władysław

    2014-01-01

    Congenital vascular malformations are tumour-like, non-neoplastic lesions caused by disorders of vascular tissue morphogenesis. They are characterised by a normal cell replacement cycle throughout all growth phases and do not undergo spontaneous involution. Here we present a scintigraphic image of familial congenital vascular malformations in two sisters. A 17-years-old young woman with a history of multiple hospitalisations for foci of vascular anomalies appearing progressively in the upper and lower right limbs, chest wall and spleen. A Parkes Weber syndrome was diagnosed based on the clinical picture. Due to the occurrence of new foci of malformations, a whole-body scintigraphic examination was performed. A 12-years-old girl reported a lump in the right lower limb present for approximately 2 years, which was clinically identified as a vascular lesion in the area of calcaneus and talus. Phleboscintigraphy visualized normal radiomarker outflow from the feet via the deep venous system, also observed in the superficial venous system once the tourniquets were released. In static and whole-body examinations vascular malformations were visualised in the area of the medial cuneiform, navicular and talus bones of the left foot, as well as in the projection of right calcaneus and above the right talocrural joint. People with undiagnosed disorders related to the presence of vascular malformations should undergo periodic follow-up to identify lesions that may be the cause of potentially serious complications and to assess the results of treatment. Presented scintigraphic methods may be used for both diagnosing and monitoring of disease progression

  2. Gene transfer therapy in vascular diseases.

    Science.gov (United States)

    McKay, M J; Gaballa, M A

    2001-01-01

    Somatic gene therapy of vascular diseases is a promising new field in modern medicine. Recent advancements in gene transfer technology have greatly evolved our understanding of the pathophysiologic role of candidate disease genes. With this knowledge, the expression of selective gene products provides the means to test the therapeutic use of gene therapy in a multitude of medical conditions. In addition, with the completion of genome sequencing programs, gene transfer can be used also to study the biologic function of novel genes in vivo. Novel genes are delivered to targeted tissue via several different vehicles. These vectors include adenoviruses, retroviruses, plasmids, plasmid/liposomes, and oligonucleotides. However, each one of these vectors has inherent limitations. Further investigations into developing delivery systems that not only allow for efficient, targeted gene transfer, but also are stable and nonimmunogenic, will optimize the clinical application of gene therapy in vascular diseases. This review further discusses the available mode of gene delivery and examines six major areas in vascular gene therapy, namely prevention of restenosis, thrombosis, hypertension, atherosclerosis, peripheral vascular disease in congestive heart failure, and ischemia. Although we highlight some of the recent advances in the use of gene therapy in treating vascular disease discovered primarily during the past two years, many excellent studies published during that period are not included in this review due to space limitations. The following is a selective review of practical uses of gene transfer therapy in vascular diseases. This review primarily covers work performed in the last 2 years. For earlier work, the reader may refer to several excellent review articles. For instance, Belalcazer et al. (6) reviewed general aspects of somatic gene therapy and the different vehicles used for the delivery of therapeutic genes. Gene therapy in restenosis and stimulation of

  3. Vascular Growth in Health and Disease

    Directory of Open Access Journals (Sweden)

    Anja eBondke Persson

    2011-08-01

    Full Text Available Vascular growth forms the first functional organ system during development, and continues into adult life, wherein it is often associated with disease states. Genetically determined vasculogenesis produces a primary vascular plexus in ontogenesis. Angiogenesis, occuring e.g. in response to metabolic stress within hypoxic tissues, enhances tissue capillarization. Arteriogenesis denotes the adaptive outgrowth of preexistent collateral arteries to bypass arterial stenoses in response to hemodynamic changes. It has been debated whether vasculogenesis occurs in the adult, and whether or not circulating progenitor cells structurally contribute to vessel regeneration. Secondly, the major determinants of vascular growth - genetic predisposition, metabolic factors (hypoxia and hemodynamics - cannot be assigned in a mutually exclusive fashion to vasculogenesis, angiogenesis and arteriogenesis, respectively; rather, mechanisms overlap. Lastly, all three mechanisms of vessel growth seem to contribute to physiological embryogenesis as well as adult adaptive vascularization as occurs in tumors or to circumvent arterial stenosis. Thus, much conceptual and terminological confusion has been created, while therapies targetting neovascularization have yielded promising results in the lab, but failed randomised studies when taken to the bedside. Therefore, this review article aims at providing an exact definition of the mechanisms of vascular growth and their contribution to embryonic development as well as adult adaptive revascularization. We have been looking for potential reasons for why clinical trials have failed, how vitally the application of appropriate methods of measuring and assessment influences study outcomes, and how relevant e.g. results gained in models of vascular occlusive disease may be for antineoplastic startegies, advocating a reverse bedside-to-bench approach, which may hopefully yield successful approaches to therapeutically targetting

  4. Cytoskeleton, cytoskeletal interactions, and vascular endothelial function

    Directory of Open Access Journals (Sweden)

    Wang J

    2012-12-01

    Full Text Available Jingli Wang,1 Michael E Widlansky1,21Department of Medicine, Cardiovascular Medicine Division, 2Department of Pharmacology, Medical College of Wisconsin, Milwaukee, Wisconsin, USAAbstract: Far from being inert, the vascular endothelium is a critical regulator of vascular function. While the endothelium participates in autocrine, paracrine, and endocrine signaling, it also transduces mechanical signals from the cell surface involving key cell structural elements. In this review, we discuss the structure of the vascular endothelium and its relationship to traditional cardiovascular risk factors and clinical cardiovascular events. Further, we review the emerging evidence that cell structural elements, including the glycocalyx, intercellular junctions, and cytoskeleton elements, help the endothelium to communicate with its environment to regulate vascular function, including vessel permeability and signal transduction via nitric oxide bioavailability. Further work is necessary to better delineate the regulatory relationships between known key regulators of vascular function and endothelial cell structural elements.Keywords: endothelium, shear stress, eNOS, cardiovascular risk factors, glycocalyx

  5. Vascular trauma: selected historical reflections from the

    Directory of Open Access Journals (Sweden)

    Rich Norman M

    2011-04-01

    Full Text Available 【Abstract】In the spirit of international exchanges of knowledge with colleagues from all over the world, who are interested in the care and treatment of vascular trauma, we offer selected historical reflections from the western world on vascular trauma. Whereas there are a number of key individuals and a variety of events that are important to us in our writing, we know essentially nothing about what is written by other cultures and, particularly, the Chinese. It is well recognized around the world that Chinese surgeons are among the first to be highly successful in re-plantation of severed extremities, repairing both injured arteries and veins. Also, we recognize that there are contributions in other parts of the world, which are not well known to us collectively. Contributions from the Arabic speaking part of the world come to mind because there is periodic brief reference. We offer our perspective hoping that there will be one or more Chinese surgeons who will offer us the benefit of sharing their perspective on important historical contributions to the managing of vascular trauma outside of the western world, and, particularly, the English speaking literature. Once again, we encourage our colleagues in the Arabic speaking world to provide us with their perspective of the development and management of vascular trauma. Key words: Vascular system injuries; History; Western world; International educational exchange

  6. Effects of PPARγ ligands on vascular tone.

    Science.gov (United States)

    Salomone, Salvatore; Drago, Filippo

    2012-06-01

    Peroxisome Proliferator-Activated Receptor γ (PPARγ), originally described as a transcription factor for genes of carbohydrate and lipid metabolism, has been more recently studied in the context of cardiovascular pathophysiology. Here, we review the available data on PPARγ ligands as modulator of vascular tone. PPARγ ligands include: thiazolidinediones (used in the treatment of type 2 diabetes mellitus), glitazars (bind and activate both PPARγ and PPARα), and other experimental drugs (still in development) that exploit the chemistry of thiazolidinediones as a scaffold for PPARγ-independent pharmacological properties. In this review, we examine both short (mostly from in vitro data)- and long (mostly from in vivo data)-term effects of PPARγ ligands that extend from PPARγ-independent vascular effects to PPARγ-dependent gene expression. Because endothelium is a master regulator of vascular tone, we have attempted to differentiate between endothelium-dependent and endothelium-independent effects of PPARγ ligands. Based on available data, we conclude that PPARγ ligands appear to influence vascular tone in different experimental paradigms, most often in terms of vasodilatation (potentially increasing blood flow to some tissues). These effects on vascular tone, although potentially beneficial, must be weighed against specific cardiovascular warnings that may apply to some drugs, such as rosiglitazone.

  7. Hypoxia and Matrix Manipulation for Vascular Engineering

    Science.gov (United States)

    Abaci, Hasan E.; Hanjaya-Putra, Donny; Gerecht, Sharon

    The great majority of cell types are known to be capable of sensing changes in O2 tension and in the extracellular matrix (ECM), resulting in various responses depending on the cell type and other factors in the microenvironment, such as cell-cell interactions. A growing body of evidence suggests that hypoxia greatly influences the processes of angiogenesis/vasculogenesis through the transcription of several genes, including vascular endothelial growth factor (VEGF), the major regulatory protein of angiogenesis/vasculogenesis. At the same time, the spatial and temporal distribution of ECM components affects ECM properties and growth factor (GF) availability, which, in turn, regulates vascular development. This chapter will discuss how hypoxia and the ECM influence vascular morphogenesis. It seeks a better understanding of vascular development by considering recent research and emerging technologies focused on controlling O2 tension and manipulating ECM properties. The first part of the chapter focuses on the influences of O2 tension and ECM distribution on vascular formation. The second part presents strategies for manipulating the microenvironment using synthetic biomaterials. Control over O2 in three-dimensional (3D) microenvironments is thoroughly highlighted, along with the currently available O2 measurement techniques and mathematical models that are necessary to monitor O2 gradients in 3D microenvironments. Finally, the chapter discusses the state-of-the-art technology in microfluidics and smart biomaterials to provide insight into its future direction.

  8. Nanomedicine approaches in vascular disease: a review.

    Science.gov (United States)

    Gupta, Anirban Sen

    2011-12-01

    Nanomedicine approaches have revolutionized the treatment of cancer and vascular diseases, where the limitations of rapid nonspecific clearance, poor biodistribution and harmful side effects associated with direct systemic drug administration can be overcome by packaging the agents within sterically stabilized, long-circulating nanovehicles that can be further surface-modified with ligands to actively target cellular/molecular components of the disease. With significant advancements in genetics, proteomics, cellular and molecular biology and biomaterials engineering, the nanomedicine strategies have become progressively refined regarding the modulation of surface and bulk chemistry of the nanovehicles, control of drug release kinetics, manipulation of nanoconstruct geometry and integration of multiple functionalities on single nanoplatforms. The current review aims to capture the various nanomedicine approaches directed specifically toward vascular diseases during the past two decades. Analysis of the promises and limitations of these approaches will help identify and optimize vascular nanomedicine systems to enhance their efficacy and clinical translation in the future. Nanomedicine-based approaches have had a major impact on the treatment and diagnosis of malignancies and vascular diseases. This review discusses various nanomedicine approaches directed specifically toward vascular diseases during the past two decades, highlighting their advantages, limitations and offering new perspectives on future applications. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Blood flow restricted exercise and vascular function.

    Science.gov (United States)

    Horiuchi, Masahiro; Okita, Koichi

    2012-01-01

    It is established that regular aerobic training improves vascular function, for example, endothelium-dependent vasodilatation and arterial stiffness or compliance and thereby constitutes a preventative measure against cardiovascular disease. In contrast, high-intensity resistance training impairs vascular function, while the influence of moderate-intensity resistance training on vascular function is still controversial. However, aerobic training is insufficient to inhibit loss in muscular strength with advancing age; thus, resistance training is recommended to prevent sarcopenia. Recently, several lines of study have provided compelling data showing that exercise and training with blood flow restriction (BFR) leads to muscle hypertrophy and strength increase. As such, BFR training might be a novel means of overcoming the contradiction between aerobic and high-intensity resistance training. Although it is not enough evidence to obtain consensus about impact of BFR training on vascular function, available evidences suggested that BFR training did not change coagulation factors and arterial compliance though with inconsistence results in endothelial function. This paper is a review of the literature on the impact of BFR exercise and training on vascular function, such as endothelial function, arterial compliance, or other potential factors in comparison with those of aerobic and resistance training.

  10. Blood Flow Restricted Exercise and Vascular Function

    Directory of Open Access Journals (Sweden)

    Masahiro Horiuchi

    2012-01-01

    Full Text Available It is established that regular aerobic training improves vascular function, for example, endothelium-dependent vasodilatation and arterial stiffness or compliance and thereby constitutes a preventative measure against cardiovascular disease. In contrast, high-intensity resistance training impairs vascular function, while the influence of moderate-intensity resistance training on vascular function is still controversial. However, aerobic training is insufficient to inhibit loss in muscular strength with advancing age; thus, resistance training is recommended to prevent sarcopenia. Recently, several lines of study have provided compelling data showing that exercise and training with blood flow restriction (BFR leads to muscle hypertrophy and strength increase. As such, BFR training might be a novel means of overcoming the contradiction between aerobic and high-intensity resistance training. Although it is not enough evidence to obtain consensus about impact of BFR training on vascular function, available evidences suggested that BFR training did not change coagulation factors and arterial compliance though with inconsistence results in endothelial function. This paper is a review of the literature on the impact of BFR exercise and training on vascular function, such as endothelial function, arterial compliance, or other potential factors in comparison with those of aerobic and resistance training.

  11. Impaired vascular function in sepsis-surviving rats mediated by oxidative stress and Rho-Kinase pathway

    Directory of Open Access Journals (Sweden)

    Priscila de Souza

    2016-12-01

    Full Text Available We investigated long-lasting changes in endothelial and vascular function in adult rat survivors of severe sepsis induced by cecal ligation and puncture (CLP model. For this, male Wistar rats (200–350 g had their cecum punctured once (non-transfixing hole with a 14-gauge needle. Performed in this way, a mortality rate around 30% was achieved in the first 72 h. The survivors, together with age-matched control rats (not subjected to CLP, were maintained in our holding room for 60 days (S60 group and had the descending thoracic aorta processed for functional, histological, biochemical or molecular analyses. Endothelium-intact aortic rings obtained from sepsis-surviving S60 group displayed increased angiotensin II-induced contraction, accompanied by decreased activity of the endogenous superoxide dismutase, augmented reactive oxygen species generation, and increased levels of tyrosine nitration compared with vessels from control group. The superoxide scavengers superoxide dismutase and tempol, and the antioxidant apocynin, were able to avoid this enhanced contractility to angiotensin II in aortic rings from the S60 group. In addition, aortic rings from the S60 group presented reduced sensitivity to Y-27632, a Rho-kinase (ROCK inhibitor. Immunoblot analyses revealed augmented RhoA and ROCK II, and high levels of phosphorylation of myosin phosphatase target subunit 1 in vessels from S60 rats. In conclusion, aortic rings from sepsis-surviving rats display endothelial dysfunction mediated by the increased production of reactive oxygen species, which in turn reduces the bioavailability of nitric oxide and increases the formation of peroxynitrite, and enhances RhoA-ROCK-mediated calcium sensitization, leading to augmented contractile responses to angiotensin II. Notably, this is the first study demonstrating long-term dysfunction in the vasculature of sepsis-surviving rats, which take place or remain beyond the acute septic insult.

  12. Multinephron dynamics on the renal vascular network

    DEFF Research Database (Denmark)

    Marsh, Donald J; Wexler, Anthony S; Brazhe, Alexey

    2012-01-01

    Tubuloglomerular feedback (TGF) and the myogenic mechanism combine in each nephron to regulate blood flow and glomerular filtration rate. Both mechanisms are non-linear, generate self-sustained oscillations, and interact as their signals converge on arteriolar smooth muscle, forming a regulatory...... ensemble. Ensembles may synchronize. Smooth muscle cells in the ensemble depolarize periodically, generating electrical signals that propagate along the vascular network. We developed a mathematical model of a nephron-vascular network, with 16 versions of a single nephron model containing representations...... of both mechanisms in the regulatory ensemble, to examine the effects of network structure on nephron synchronization. Symmetry, as a property of a network, facilitates synchronization. Nephrons received blood from a symmetric electrically conductive vascular tree. Symmetry was created by using identical...

  13. Intraoperative digital angiography: Peripheral vascular applications

    International Nuclear Information System (INIS)

    Bell, K.; Reifsteck, J.E.; Binet, E.F.; Fleisher, H.J.

    1986-01-01

    Intraoperative digital angiography is the procedure of choice for the peripheral vascular surgeon who wishes to evaluate his results before terminating anesthesia. Two operating suites at the John L. McClellan Memorial Veterans Hospital are equipped with permanent ceiling-mounted Philips C-arm fluoroscopes and share an ADAC 4100 digital angiographic system. In the last 18 months, 40 peripheral vascular intraoperative digital angiographic procedures have been performed, in all but two cases using direct arterial puncture. In 65% of cases, the intraoperative study showed no significant abnormality. In 12.5%, minor abnormalities not requiring reoperation were seen. In 22.5% of cases, the intraoperative digital angiogram revealed a significant abnormality requiring immediate operative revision. None of the patients who underwent reoperation experienced postoperative sequelae. Intraoperative digital angiography is useful in identifying complications of peripheral vascular operations

  14. Mitochondria, endothelial cell function, and vascular diseases.

    Science.gov (United States)

    Tang, Xiaoqiang; Luo, Yu-Xuan; Chen, Hou-Zao; Liu, De-Pei

    2014-01-01

    Mitochondria are perhaps the most sophisticated and dynamic responsive sensing systems in eukaryotic cells. The role of mitochondria goes beyond their capacity to create molecular fuel and includes the generation of reactive oxygen species, the regulation of calcium, and the activation of cell death. In endothelial cells, mitochondria have a profound impact on cellular function under both healthy and diseased conditions. In this review, we summarize the basic functions of mitochondria in endothelial cells and discuss the roles of mitochondria in endothelial dysfunction and vascular diseases, including atherosclerosis, diabetic vascular dysfunction, pulmonary artery hypertension, and hypertension. Finally, the potential therapeutic strategies to improve mitochondrial function in endothelial cells and vascular diseases are also discussed, with a focus on mitochondrial-targeted antioxidants and calorie restriction.

  15. Vascular training and endovascular practice in Europe

    DEFF Research Database (Denmark)

    Liapis, C.D.; Avgerinos, E.D.; Sillesen, H.

    2009-01-01

    specialties was distributed to a VS educator within 14 European countries. European Vascular and Endovascular Monitor (EVEM) data also were processed to correlate endovascular practice with training models. RESULTS: Fourteen questionnaires were gathered. Vascular training in Europe appears in 3 models: 1....... Mono-specialty (independence): 7 countries, 2. Subspecialty: 5 countries, 3. An existing specialty within general surgery: 2 countries. Independent compared to non-independent certification shortens overall training length (5.9 vs 7.9 years, p=0.006), while increasing overall training devoted......% respectively. Countries with independent vascular certification, despite their lower average endovascular index (procedures per 100,000 population), reported a higher growth rate of aortic endovascular procedures (VS independent 132% vs VS non-independent 87%), within a four-year period (2003-2007). Peripheral...

  16. Mitochondria, Endothelial Cell Function and Vascular Diseases

    Directory of Open Access Journals (Sweden)

    Xiaoqiang eTang

    2014-05-01

    Full Text Available Mitochondria are perhaps the most sophisticated and dynamic responsive sensing systems in eukaryotic cells. The role of mitochondria goes beyond their capacity to create molecular fuel and includes the generation of reactive oxygen species, the regulation of calcium, and the activation of cell death. In endothelial cells, mitochondria have a profound impact on cellular function under both healthy and diseased conditions. In this review, we summarize the basic functions of mitochondria in endothelial cells and discuss the roles of mitochondria in endothelial dysfunction and vascular diseases, including atherosclerosis, diabetic vascular dysfunction, pulmonary artery hypertension and hypertension. Finally, the potential therapeutic strategies to improve mitochondrial function in endothelial cells and vascular diseases are also discussed, with a focus on mitochondrial-targeted antioxidants and calorie restriction.

  17. Vacuum assisted closure in vascular surgery.

    Science.gov (United States)

    Beno, M; Martin, J; Sager, P

    2011-01-01

    Vacuum assisted closure (VAC-therapy) is a well established method in nearly all surgical disciplines. The aim is to present the efficiency of vacuum assisted closure in the treatment of acute and chronic wounds in patients admitted in the department of vascular surgery. Within the year 2008 there were 59 patients (44 men, 15 women) treated with VAC therapy in our Department of Vascular surgery (Landshut, Germany). VAC was used 22x (37.28 %) in therapy of ulcus cruris (venous, arterial, mixed genesis), 15x (25.42%) in patients with diabetic foot syndrome, 12x (20.33%) in secondary healing wounds and infected wounds, 5x (8.47%) in wounds after several injuries and soft skin tissue infections and 5x (8.47%) in wound infections connected with vascular graft infections after vascular revascularization. VAC therapy seems to be very effective in the management of patients with venous ulcers, especially after a proper surgical treatment (100%), patients with soft skin tissue infections (100%) and secondary healing wounds (100%) especially in combination with MESH-Grafting. In patients with diabetic foot syndrome (80%) and peripheral arterial occlusive disease (72.7%), an evaluation of peripheral blood perfusion and revascularization prior to VAC therapy is often necessary. Although VAC was used 5x in the therapy of infected vascular grafts, successful preservation of infected graft material was observed in only one case (infection of PTFE femoro-popliteal bypass graft). Vacuum assisted closure in vascular surgery proved to be simple and efficient method in therapy of acute and chronic wounds. The efficiency of VAC systems in therapy of infected graft material after revascularization needs further studies (Tab. 3, Ref. 10).

  18. Ultrasound for vascular access in pediatric patients.

    Science.gov (United States)

    Schindler, Ehrenfried; Schears, Gregory J; Hall, Stuart R; Yamamoto, Tomohiro

    2012-10-01

    In pediatric patients vascular access is often more difficult than in adults because of the smaller size of the vessels and the inability of the patient to cooperate without deep sedation or general anesthesia. Therefore Ultrasound has already become an invaluable tool for vascular access, but the full potential of ultrasound has yet to be fully realized. Improvements in image quality and a better understanding of optimal insertion techniques continue to help clinicians safely and efficiently place catheters with fewer complications. The probes used for the vascular access are mainly linear and convex type. Higher- frequency ultrasound provides a vivid image; however, the signals are remarkably attenuated. Therefore, the choice of the probe with appropriate frequency is essential. As blood vessels are relatively easily identified with ultrasound, ultrasound-guided vascular access does not require as sharp images as ultrasound-guided nerve block. For pediatric vascular access, the linear probe with 5-15 MHz, 2-5 cm depth is ideal and adequate for almost all cases. Ultrasound-guided vascular access has two main approaches: 'long-axis' or 'in-plane approach' and 'short-axis' or 'transverse approach'. The long-axis approach visualizes the vessel along the insertion pathway and is commonly used to monitor the entire approach of the needle into the vessel. The short-axis approach is easier to show the positional relationship and depth of target vessels, but it is much harder to follow the needle tip within the tissues. The use of 'real-time' ultrasound has been shown to increase first insertion success, reduce access time, have a higher overall success, and reduce arterial puncture. As the technology continues to improve the use of ultrasound will become as ubiquitous as the lines themselves. © 2012 Blackwell Publishing Ltd.

  19. Prediction of Major Vascular Events after Stroke

    DEFF Research Database (Denmark)

    Ovbiagele, Bruce; Goldstein, Larry B.; Amarenco, Pierre

    2014-01-01

    BACKGROUND: Identifying patients with recent stroke or transient ischemic attack (TIA) at high risk of major vascular events (MVEs; stroke, myocardial infarction, or vascular death) may help optimize the intensity of secondary preventive interventions. We evaluated the relationships between...... were analyzed. Hazard ratios (HRs) from Cox regression models were used to determine the risk of subsequent MVEs based on the FCRS predicting 20% or more 10-year coronary heart disease risk. The novel risk model was derived based on multivariable modeling with backward selection. Model discrimination...

  20. Radiological study of cerebro-vascular accidents

    International Nuclear Information System (INIS)

    Misri, H.T.; Kabawe, Bassam

    1991-01-01

    The role of computerized tomography scanner in studying the cerebro-vascular accidents has been discussed. One hundred fifty patients with cerebro-vascular accidents were studied at Aleppo University Hospital between 1989-1990. Clinical history and physical examination were recorded, as well as, computerized tomography scanning in all cases without using the contrast media mostly. Relationship between the density of the lesion (inforctionor hemorrhage) and the time has been found. This relationship can help in forensic medicine. (author). 29 refs., 5 tabs., 2 figs