WorldWideScience

Sample records for circumferential pulmonary vein

  1. Initial experience with circumferential pulmonary vein ablation guided by fusion of magnetic resonance imaging with three-dimensional electroanatomic mapping

    Institute of Scientific and Technical Information of China (English)

    TANG Kai; MA Jian; MA Fu-sheng; JlA Yu-he; ZHANG Shu

    2006-01-01

    @@ Catheter ablation for the treatment of atrial fibrillation (AF) has been a focal target of electrophysiological study in recent years. Up to date,circumferential pulmonary vein ablation (CPVA)guided by three-dimensional (3-D) electroanatomic mapping (Carto, USA) has been one of the most favourable procedures for the treatment of AF.

  2. Radiofrequency Ablation Mapping with Circumferential Catheter for Paroxys-mal Atrial Fibrillation Originating From the Pulmonary Veins

    Institute of Scientific and Technical Information of China (English)

    刘震; 吴书林; 杨平珍; 方咸宏; 李海杰; 陈泗林; 詹贤章; 薛玉梅

    2002-01-01

    Objectives To assessed thefeasibility and effectiveness of electrophysiologicalmapping of pulmonary veins with a circumferential 10-electrode catheter and radiofrequency catheter abla-tion therapy for patients with paroxysmal atrial fibril-lation. Background Standard mapping and ablationof focal sources of atrial fibrillation are associated withvery long procedure times and low efficacy. Mappingand ablation pulmonary veins guide with a circularcatheter could overcome these limitations. Methods16 patients [male 11, female 5, mean age (51 +14.5) years] with paroxysmal atrial fibrillation refrac-tory to antiarrhythmic drugs were included in thisgroup. A circumferential 10-electrode catheter wasused to pulmonary vein mapping during sinus rhythm orCSd pacing to determine the origin of atrial prematurecontractions. When the ablative target pulmonary veinwas found, the pulmonary vein potentials' distributionand activation were assessment pulmonary veins' ostialablation was performed at the segments showing earliestactivation of pulnonary vein potentials. The end pointwas designed: 1 ) elimination of pulmonary vein po-tential; 2) pulmonary vein potential dissociation fromatrial waves; 3) atrial ectopic beats disappear. ResultsA total of 36 pulmonary veins were ablated, in-cluding 16 left superior, 12 right superior, 7 left in-ferior and 1 right inferior. 1 pulmonary vein in 2 pa-tients was ablated, 2 pulmonary veins in 8 patientswere ablated, 3 pulmonary veins were ablated in 5patients and 4 pulmonary veins were ablated in 1 pa-tient. Procedure duration and fluoroscopy time respec-tively were 186.7 _+ 63.8 min and 51.5 + 15.0 min.During the follow-up 1- 12 months, 11 patients(68.7 % ) were free of AF without any antiarrhythmicdrugs, 2 of them were reablation, effective in 3/16(18.7%) and unsuccessful in 2/16 (12.6%) . 2cases recurred with atrial premature, 1 was treated withamiodarone and the other was repeat electrophysiologi-cal mapping and ablation, 5 cases with

  3. Effect of anxiety and depression on the recurrence of persistent atrial fibrillation after circumferential pulmonary vein ablation

    Institute of Scientific and Technical Information of China (English)

    YU Sheng-bo; HU Wei; ZHAO Qing-yan; QIN Mu; HUANG He; CUI Hong-ying; HUANG Cong-xin

    2012-01-01

    Background The effects of anxiety and depression on the recurrence of persistent atrial fibrillation (AF) after circumferential pulmonary vein ablation (CPVA) are not clear.Whether CPVA can alleviate the anxiety and depression symptoms of persistent AF patients is unknown.Methods One hundred and sixty-four patients with persistent AF,of which 43 treated with CPVA (CPVA group) and 103 treated with anti-arrhythmics drugs (medicine group),were enrolled.The Zung Self-Rating Anxiety Scale (SAS),and Zung Self-Rating Depression Scale (SDS) were assessed before and 12 months after treatment in all patients.Results The scores of SAS (40.33±7.90 vs.49.76±9.52,P <0.01) and SDS (42.33±8.73 vs.48.17±8.77,P <0.01)decreased 12 months after CPVA.Over 12 months follow-up,AF relapsed in 17 patients in CPVA group.Compared with the data in the recurrent group (17 patients),the scores of SAS and SDS were significantly lower in the non-recurrent group (26 patients) at baseline.The results of multivariate Logistic regression analysis showed normal scores of SAS and SDS were the independent risk factors of AF recurrence after CPVA.Conclusions Anxiety and depression increase the recurrence risk of persistent AF after CPVA.CPVA can ameliorate the anxiety and depression symptoms in patients with persistent AF.

  4. Initial experience with circumferential pulmonary vein isolation guided by Overlay Ref and CartoMerge in the treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    TANG Kai; ZHAO Dong-dong; ZHANG Jing-ying; CHEN Yan-qing; XU Ya-wei

    2010-01-01

    Background CartoMerge has been widely used in guiding circumferential pulmonary vein isolation (CPVI) for the treatment of paroxysmal atrial fibrillation (PAF).However, the procedure of landmarks selection varies among operators according to their experience.Techniques have to be established to standardize this procedure.We propose that Overlay Ref could facilitate this procedure.This paper aimed to report our initial experience with CPVI guided by Overlay Ref and CartoMerge for the treatment of PAF.Methods Fifty-nine patients with PAF were enrolled in this study.Using Overlay Ref technique, a reference image (inverted) was faded into the live fluoroscopic image.Landmarks of CartoMerge were selected from anatomic points of the top of superior pulmonary veins (PVs) and the bottom of inferior PVs guided by Overlay Ref image.Overlay Ref images were also used to guide the ablation procedure combining with CartoMerge.Results All patients were successfully mapped by CartoMerge guided by Overlay Ref.The distance between the mapping points and the CT surfaces was (1.42±0.67) mm for the patients as a whole.This led to a successful rate of 96%for isolation of pulmonary veins.Duration of ablation procedure was (92±17) minutes.And the total duration of procedure was (139±32) minutes.CartoMerge could also be performed just with 3 paries to 4 paries selected landmarks guided by Overlay Ref without a full anatomic model constructed by Carto.Then, the total duration of procedure could be shortened to (115±38) minutes.Conclusions Overlay Ref technique can facilitate the catheter ablation of PAF and can help to standardize the procedure of landmarks selection.

  5. A randomized prospective comparison of CartoMerge and CartoXP to guide circumferential pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    TANG Kai; MA Jian; ZHANG Shu; ZHANG Jing-ying; WEI Yi-dong; CHEN Yan-qing; YU Xue-jing; XU Ya-wei

    2008-01-01

    Background CartoXP and CartoMerge have been used to treat atrial fibrillation(AF)for several years.Our randomized prospective study compared clinical outcomes of these two versions of three dimensional electroanatomic mapping system in guiding catheter ablation for paroxysmal atrial fibrillation (PAF).Methods Eighty-one patients with symptomatic,drug refractory PAF were randomly assigned to CartoMerge group (n=42,mean age(54.5±13.1)years,history of AF=3.2 years)or CartoXP group(n=39,mean age(59.8±15.6)years,history of AF=2.9 years).All patients underwent 64-slice computed tomography(MSCT)1 to 3 days prior to ablation procedure.Using CartoMergeTM Image Integration Module,3D anatomical images of the left atrium(LA)and pulmonary veins(PVs)derived from MSCT of CartoMerge group were established and merged with the electroanatomical map.The integrated images were used to guide the procedure of circumferential pulmonary vein isolation (CPVI).In the other group,CPVI was guided just by CartoXP.The endpoint of CPVI in both groups was abolition or dissociation of pulmonary vein potentials(PVPs).Results Mapping points to establish the electroanatomical model of the LA/PVs were 48.7±13.4 in CartoMerge group and 62.5±15.7 in CartoXP group(P<0.001).Mean distance between mapping points and the MSCT surfaces in CartoMerge group was(1.59±0.33)mm.Accomplishment of abolition or dissociation of PVPs was achieved 95.2% in CartoMerge group and 92.3% in CartoXP group.Durations of procedure and exposure to X-ray were(156±25)minutes,(179±21)minutes(P<0.001) and(19.6±7.5)minutes,(28.5±12.8)minutes(P<0.001),respectively.After a follow-up with duration of(11.9±3.1)months vs (12.4±3.6)months post the first ablation procedure,patients free of AF were 33(78.6%)in CartoMerge group and 29(74.4%) in CartoXP group(P>0.50).No patient suffered pulmonary vein stenosis,alrioesophageal fistula,stroke or death.Conclusion Compared to CartoXP,CartoMerge shortened the catheter ablation

  6. Circumferential lesion formation around the pulmonary veins in the left atrium with focused ultrasound using a 2D-array endoesophageal device: a numerical study

    Energy Technology Data Exchange (ETDEWEB)

    Pichardo, Samuel; Hynynen, Kullervo [Imaging Research-Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room C713, Toronto, ON M4N 3M5 (Canada)

    2007-08-21

    Atrial fibrillation (AF) is the most frequently sustained cardiac arrhythmia affecting humans. The electrical isolation by ablation of the pulmonary veins (PVs) in the left atrium (LA) of the heart has been proven as an effective cure of AF. The ablation consists mainly in the formation of a localized circumferential thermal coagulation of the cardiac tissue surrounding the PVs. In the present numerical study, the feasibility of producing the required circumferential lesion with an endoesophageal ultrasound probe is investigated. The probe operates at 1 MHz and consists of a 2D array with enough elements (114 x 20) to steer the acoustic field electronically in a volume comparable to the LA. Realistic anatomical conditions of the thorax were considered from the segmentation of histological images of the thorax. The cardiac muscle and the blood-filled cavities in the heart were identified and considered in the sound propagation and thermal models. The influence of different conditions of the thermal sinking in the LA chamber was also studied. The circumferential ablation of the PVs was achieved by the sum of individual lesions induced with the proposed device. Different scenarios of lesion formation were considered where ultrasound exposures (1, 2, 5 and 10 s) were combined with maximal peak temperatures (60, 70 and 80 {sup 0}C). The results of this numerical study allowed identifying the limits and best conditions for controlled lesion formation in the LA using the proposed device. A controlled situation for the lesion formation surrounding the PVs was obtained when the targets were located within a distance from the device in the range of 26 {+-} 7 mm. When combined with a maximal temperature of 70 {sup 0}C and an exposure time between 5 and 10 s, this distance ensured preservation of the esophageal structures, controlled lesion formation and delivery of an acoustic intensity at the transducer surface that is compatible with existing materials. With a peak

  7. Electroanatomical systems to guided circumferential pulmonary veins ablation for atrial fibrillation: initial experience from comparison between the Ensite/NavX and CARTO system

    Institute of Scientific and Technical Information of China (English)

    LIU Xu; WANG Xin-hua; GU Jia-ning; ZHOU Li; QIU Jian-hua

    2005-01-01

    Background The circumferential pulmonary vein ablation (CPVA) has been proved effective for atrial fibrillation (AF) treatment and is becoming more widely accepted and practiced. This study aims to evaluate the characteristics of the CARTO and the Ensite/NavX system and draw a comparison between them on the aspects of procedural parameters and clinical effectiveness.Methods Seventy-five cases with paroxysmal or chronic symptomatic AF were randomly assigned to CPVA procedure guided by the Ensite/NavX system (group Ⅰ, n=40) and by the CARTO system (group Ⅱ, n=35). After successful transseptal procedure, the geometry of left atrium was created under the guidance of the two systems. Radiofrequency energy was applied to circumferentially ablate tissues out of pulmonary veins' (PVs') ostia. In cases with chronic AF, linear ablation was applied to modify the substrate of left atrium (LA). The endpoint of the procedure was complete PVs isolation. Results Seventy-five cases underwent the procedure successfully. The total procedure and fluoroscopic durations in group Ⅱ were significantly shorter than in group Ⅰ [(150±23) min and (18±17) min versus (170±34) min and (25±16) min, P=0.03 and 0.04, respectively]. There was no significant difference in the fluoroscopic and procedure durations for geometry creation between group Ⅰ and group Ⅱ [(8±4) min and (16±11) min versus (5±4) min and (14±8) min, respectively]. The fluoroscopic durations for CPVA were (15±5) min in group Ⅰ versus (10±6) min in group Ⅱ (P=0.05), and the CPVA procedural durations were significantly shorter in group Ⅱ than in group Ⅰ [(18±11) min versus (25±10) min, P=0.04]. AF was terminated by radio frequency delivery in 14 cases (35%) in group Ⅰ versus 5 cases (14%) in group Ⅱ (P=0.035). After CPVA complete PV isolation was attained in 26 cases (65%) in group Ⅰ versus 11 cases (31%) in group Ⅱ (P=0.004). During a mean follow-up of 7 months, 32 (80%) cases in group

  8. Varicosity of the pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Leicher-Dueber, A.; Lindner, P.; Schild, H.; Plewe, G.

    1986-04-01

    Varicosity of the pulmonary veins is a rare anomaly of the pulmonary vascular system. The varices do not usually change in size over years, do not cause symptoms and need no therapy. However, raised left atrial pressure can cause increase in the diameter of pulmonary vein varices. A case of lung vein varicosity in the right middle and upper lobe associated with coarctation of the aorta and an anomalous upper-middle lobe vein was observed over a period of 10 years. Increase in left atrial pressure (aortic and relative mitral regurgitation) led to enlargement of the pulmonary veins.

  9. Meandering right pulmonary vein associated with severe and progressive "idiopathic-like" pulmonary hypertensive vascular disease.

    Science.gov (United States)

    Cuenca, Sofia; Bret, Montserrat; del Cerro, Maria Jesus

    2016-03-01

    Congenital anomalies of the pulmonary veins are rare. Meandering right pulmonary vein, considered a part of the Scimitar syndrome spectrum, is often an incidental finding during chest imaging. We present the case of a 4-year-old girl diagnosed with meandering pulmonary vein, who developed pulmonary hypertensive disease with an aggressive course, in spite of absence of hypoxia or elevated pulmonary wedge pressure.

  10. Measurement of the circumferential mechanical properties of the umbilical vein: experimental and numerical analyses.

    Science.gov (United States)

    Karimi, Alireza; Navidbakhsh, Mahdi; Rezaee, Taraneh; Hassani, Kamran

    2015-01-01

    Coronary artery disease is responsible for almost 30% of all deaths worldwide. The saphenous vein and umbilical vein (UV) are the most common veins using for treatment as a coronary artery bypass graft (CABG). The mechanical properties of UV belonging to its long-term patency for CABG are very important. However, there is a lack of knowledge on the linear elastic and nonlinear hyperelastic mechanical properties of the UV. In this study, three stress definitions (second Piola-Kichhoff stress, engineering stress and true stress) and four strain definitions (Almansi-Hamel strain, Green-St Venant strain, engineering strain and true strain) are used to determine the elastic modulus, maximum stress and strain of eight human UVs under circumferential loading. The nonlinear mechanical behaviour of the UV is computationally investigated using Mooney-Rivlin hyperelastic model. A numerical finite element analysis is also carried out to simulate the constitutive modelling versus its numerical results. The results show that the Almansi-Hamel strain definition overestimates the elastic modulus while Green-St Venant strain definition underestimates the elastic modulus at different stress definitions. The true stress-true strain definition, which gives more accurate measurements of the tissue's response using the instantaneous values, reveals the Young's modulus and maximum stress of 2.18 and 6.01 MPa, respectively. The Mooney-Rivlin material model is well represented by the nonlinear mechanical behaviour of the UV. The findings of this study could have implications not only for understanding the extension and rupture mechanism of UV but also for interventions and surgeries, including balloon angioplasty, bypass and stenting.

  11. Pulmonary vein stenosis: Etiology, diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Pablo Pazos-López; Cristina García-Rodríguez; Alba Guitián-González; Emilio Paredes-Galán; María ángel; De La Guarda álvarez-Moure; Marta Rodríguez-álvarez; José Antonio Baz-Alonso; Elvis Teijeira-Fernández; Francisco Eugenio Calvo-Iglesias; Andrés í?iguez-Romo

    2016-01-01

    Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.

  12. Recurrence of pulmonary vein conduction and atrial fibrillation after pulmonary vein isolation for atrial fibrillation: a randomized trial of the ostial versus the extraostial ablation strategy

    DEFF Research Database (Denmark)

    Nilsson, Brian; Chen, Xu; Pehrson, Steen;

    2006-01-01

    BACKGROUND: Both segmental ostial and circumferential extraostial pulmonary vein (PV) isolation have been proven effective in the treatment of atrial fibrillation (AF). However, the recurrence of AF and PV conduction after the 2 ablation strategies has never been compared in a randomized study....... METHODS: A total of 100 consecutive patients (age 56 +/- 10; 71 men) with symptomatic AF (paroxysmal, 51; persistent, 49) were randomized to segmental ostial (n = 54) or circumferential extraostial (n = 46) PV isolation. A circular catheter positioned at the ostium of each target PV guided the ostial PV...... who underwent ostial PV isolation (P strategies was mainly seen in patients known with persistent AF (52% and 15%, respectively; P = .02) as opposed to patients with paroxysmal AF (65% and 46%, respectively; P = .26). CONCLUSIONS: Overall...

  13. 应用重叠参考图像透视技术易化环肺静脉电隔离术操作治疗阵发性心房颤动%Circumferential pulmonary vein isolation guided by overlay ref for the treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    唐恺; 肖彬; 赵冬冬; 张敬莹; 陈艳清; 徐亚伟

    2012-01-01

    目的 探讨重叠参考图像透视技术(Overlay Ref)对环肺静脉电隔离术治疗阵发性心房颤动(房颤)的影响.方法 入选194例阵发性房颤患者,随机分为Overlay Ref组(97例)及对照组(97例).Overlay Ref组使用Overlay Ref技术(将参考图像以反白的形式叠加于透视屏上)辅助环肺静脉电隔离术的操作.对照组常规方法完成环肺静脉电隔离术.比较两组的总消融手术时间、消融时间、X线曝光量、肺静脉隔离率及随访1年的成功率.结果 两组患者的基线临床特征差异无统计学意义.所有患者均接受了环肺静脉电隔离术.Overlay Ref组的消融时间〔(89±13) min对(102±22) min,P<0.01〕和总消融术时间[ (139±22) min对(162±31) min,P<0.01]均明显比对照组短.Oveday Ref组的X线曝光量[( 13531±283) mGy对(13123±369)mGy]稍大,但差异无统计学意义(P>0.05).两组的环肺静脉电隔离率(97.9%对96.9%,P=NS)及随访1年的成功率(84.5%对81.4%,P>0.05)差异也无统计学意义.结论 Overlay Ref技术可以易化环肺静脉电隔离术的操作,缩短房颤导管消融术的学习曲线.%Objective Circumferential pulmonary vein isolation (CPVI) is still not a easy task to an inexperienced operator for the treatment of paroxysmal atrial fibrillation(PAF).We hypothesized that Overlay Ref technique could facilitate the procedure of CPVI.This study was to report the results of CPVI guided by Overlay Ref for the treatment of PAF.Methods One hundred and ninety-four patents suffered PAF were enrolled into this study,and randomly assigned to Overlay Ref group ( n =97 ) and control group ( n =97 ).CPVI procedure was guided by inverted and faded overlay reference imaging in the Overlay Ref group and conventional approach in the control group.The total procedure time,duration of ablation,successful rate of isolation of pulmonary veins(PVs),radiation dose as well as results of follow up in 12 months were recorded.Results All

  14. A Tight Spot After Pulmonary Vein Catheter Ablation

    NARCIS (Netherlands)

    Amir, Rabia; Yeh, Lu; Montealegre-Gallegos, Mario; Saraf, Rabya; Matyal, Robina; Mahmood, Feroze

    2016-01-01

    A 52-YEAR-OLD woman with a history of embolic stroke due to paroxysmal atrial fibrillation was referred to the authors’ institution for epicardial surgical pulmonary vein isolation with left atrial appendage resection. The patient had 2 previous failed pulmonary vein catheter ablations. Dense fibrou

  15. [Treatment of pulmonary vein stenosis secondary to radiofrequency ablation].

    Science.gov (United States)

    Ferrero Guadagnoli, Adolfo; Contreras, Alejandro E; Leonardi, Carlos R; Ballarino, Miguel A; Atea, Leonardo; Peirone, Alejandro R

    2014-01-01

    Isolation of the pulmonary veins by applying radiofrequency is an effective treatment for atrial fibrillation. One of the potential complications with higher clinical compromise utilizing this invasive technique is the occurrence of stenosis of one or more pulmonary veins. This complication can be treated by angioplasty with or without stent implantation, with an adequate clinical improvement, but with a high rate of restenosis.

  16. A study of images of Projective Angles of pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Wang Jue [Beijing Anzhen Hospital, Beijing (China); Zhaoqi, Zhang [Beijing Anzhen Hospital, Beijing (China)], E-mail: zhaoqi5000@vip.sohu.com; Yu Wei; Miao Cuilian; Yan Zixu; Zhao Yike [Beijing Anzhen Hospital, Beijing (China)

    2009-09-15

    Aims: In images of magnetic resonance and computed tomography (CT) there are visible angles between pulmonary veins and the coronary, transversal or sagittal section of body. In this study these angles are measured and defined as Projective Angles of pulmonary veins. Several possible influential factors and characters of distribution are studied and analyzed for a better understanding of this imaging anatomic character of pulmonary veins. And it could be the anatomic base of adjusting correctly the angle of the central X-ray of the angiography of pulmonary veins undergoing the catheter ablation of atrial fibrillation (AF). Method: Images of contrast enhanced magnetic resonance angiography (CEMRA) and contrast enhanced computer tomography (CECT) of the left atrium and pulmonary veins of 137 health objects and patients with atrial fibrillation (AF) are processed with the technique of post-processing, and Projective Angles to the coronary and transversal sections are measured and analyzed statistically. Result: Project Angles of pulmonary veins are one of real and steady imaging anatomic characteristics of pulmonary veins. The statistical distribution of variables is relatively concentrated, with a fairly good representation of average value. It is possible to improve the angle of the central X-ray according to the average value in the selective angiography of pulmonary veins undergoing the catheter ablation of AF.

  17. Computer-assisted diagnostic tool to quantify the pulmonary veins in sickle cell associated pulmonary hypertension

    Science.gov (United States)

    Jajamovich, Guido H.; Pamulapati, Vivek; Alam, Shoaib; Mehari, Alem; Kato, Gregory J.; Wood, Bradford J.; Linguraru, Marius George

    2012-03-01

    Pulmonary hypertension is a common cause of death among patients with sickle cell disease. This study investigates the use of pulmonary vein analysis to assist the diagnosis of pulmonary hypertension non-invasively with CT-Angiography images. The characterization of the pulmonary veins from CT presents two main challenges. Firstly, the number of pulmonary veins is unknown a priori and secondly, the contrast material is degraded when reaching the pulmonary veins, making the edges of these vessels to appear faint. Each image is first denoised and a fast marching approach is used to segment the left atrium and pulmonary veins. Afterward, a geodesic active contour is employed to isolate the left atrium. A thinning technique is then used to extract the skeleton of the atrium and the veins. The locations of the pulmonary veins ostia are determined by the intersection of the skeleton and the contour of the atrium. The diameters of the pulmonary veins are measured in each vein at fixed distances from the corresponding ostium, and for each distance, the sum of the diameters of all the veins is computed. These indicators are shown to be significantly larger in sickle-cell patients with pulmonary hypertension as compared to controls (p-values < 0.01).

  18. Unilateral pulmonary vein atresia: A rare case of hemoptysis

    Directory of Open Access Journals (Sweden)

    Cindy S. DeMastes-Crabtree

    2015-01-01

    Full Text Available We present a rare case of hemoptysis secondary to isolated unilateral pulmonary vein atresia. Isolated pulmonary vein atresia is a rare condition in which patients typically acquire a diagnosis in infancy and early childhood [Mataciunas et al.; Pourmoghadam et al.]. Our patient presented during puberty with several previous episodes of hemoptysis prior to her admission and diagnosis. The initial diagnosis was suspected in our patient from chest computerized tomography (CT, and confirmed with cardiac catheterization and pulmonary angiography. Treatment aim is to preserve lung function and minimize irreversible pulmonary remodeling [Pourmoghadam et al.; Harrison et al.]. Conservative monitoring can be considered with milder or asymptomatic cases, while others may require preoperative collateral artery banding, surgical anastomosis between the pulmonary vein (PV & left atrium (LA and even pneumonectomy [Pourmoghadam et al.].

  19. Nitroprusside modulates pulmonary vein arrhythmogenic activity

    Directory of Open Access Journals (Sweden)

    Chen Yao-Chang

    2010-03-01

    Full Text Available Abstract Background Pulmonary veins (PVs are the most important sources of ectopic beats with the initiation of paroxysmal atrial fibrillation, or the foci of ectopic atrial tachycardia and focal atrial fibrillation. Elimination of nitric oxide (NO enhances cardiac triggered activity, and NO can decrease PV arrhythmogensis through mechano-electrical feedback. However, it is not clear whether NO may have direct electrophysiological effects on PV cardiomyocytes. This study is aimed to study the effects of nitroprusside (NO donor, on the ionic currents and arrhythmogenic activity of single cardiomyocytes from the PVs. Methods Single PV cardiomyocytes were isolated from the canine PVs. The action potential and ionic currents were investigated in isolated single canine PV cardiomyocytes before and after sodium nitroprusside (80 μM, using the whole-cell patch clamp technique. Results Nitroprusside decreased PV cardiomyocytes spontaneous beating rates from 1.7 ± 0.3 Hz to 0.5 ± 0.4 Hz in 9 cells (P Conclusion Nitroprusside regulates the electrical activity of PV cardiomyocytes, which suggests that NO may play a role in PV arrhythmogenesis.

  20. Levoatriocardinal vein with normal intracardiac anatomy and pulmonary venous return

    Directory of Open Access Journals (Sweden)

    Ender Odemis

    2011-01-01

    Full Text Available Levoatriocardinal vein (LACV is characterized by an abnormal connection between pulmonary and systemic venous return. This extremely rare cardiac malformation is usually associated with left-sided obstructive lesions including mitral atresia, hypoplastic left-heart syndrome, and abnormal pulmonary venous connection. Patients may have low systemic cardiac output and pulmonary venous obstruction symptoms. In this manuscript, we report a case with LACV and normal pulmonary venous return with absence of any intracardiac pathology. LACV was demonstrated with echocardiography, angiography, and computed tomography. Surgical correction was made successfully.

  1. Pathogenetics of alveolar capillary dysplasia with misalignment of pulmonary veins

    NARCIS (Netherlands)

    Szafranski, P.; Gambin, T.; Dharmadhikari, A.V.; Akdemir, K.C.; Jhangiani, S.N.; Schuette, J.; Godiwala, N.; Yatsenko, S.A.; Sebastian, J.; Madan-Khetarpal, S.; Surti, U.; Abellar, R.G.; Bateman, D.A.; Wilson, A.L.; Markham, M.H.; Slamon, J.; Santos-Simarro, F.; Palomares, M.; Nevado, J.; Lapunzina, P.; Chung, B.H.; Wong, W.L.; Chu, Y.W.; Mok, G.T.; Kerem, E.; Reiter, J.; Ambalavanan, N.; Anderson, S.A.; Kelly, D.R.; Shieh, J.; Rosenthal, T.C.; Scheible, K.; Steiner, L.; Iqbal, M.A.; McKinnon, M.L.; Hamilton, S.J.; Schlade-Bartusiak, K.; English, D.; Hendson, G.; Roeder, E.R.; DeNapoli, T.S.; Littlejohn, R.O.; Wolff, D.J.; Wagner, C.L.; Yeung, A.; Francis, D.; Fiorino, E.K.; Edelman, M.; Fox, J.; Hayes, D.A.; Janssens, S.; Baere, E. De; Menten, B.; Loccufier, A.; Vanwalleghem, L.; Moerman, P.; Sznajer, Y.; Lay, A.S.; Kussmann, J.L.; Chawla, J.; Payton, D.J.; Phillips, G.E.; Brosens, E.; Tibboel, D.; Klein, A.; Maystadt, I.; Fisher, R.; Sebire, N.; Male, A.; Chopra, M.; Pinner, J.; Malcolm, G.; Peters, G.; Arbuckle, S.; Lees, M.; Mead, Z.; Quarrell, O.; Sayers, R.; Owens, M.; Shaw-Smith, C.; Lioy, J.; McKay, E.; Leeuw, N. de; Feenstra, I.; Spruijt, L.; Elmslie, F.; Thiruchelvam, T.; Bacino, C.A.; Langston, C.; Lupski, J.R.; Sen, P.; Popek, E.; Stankiewicz, P.

    2016-01-01

    Alveolar capillary dysplasia with misalignment of pulmonary veins (ACDMPV) is a lethal lung developmental disorder caused by heterozygous point mutations or genomic deletion copy-number variants (CNVs) of FOXF1 or its upstream enhancer involving fetal lung-expressed long noncoding RNA genes LINC0108

  2. Radiofrequency ablation of an atypical left atrial flutter after pulmonary vein isolation

    Directory of Open Access Journals (Sweden)

    Bockeria L.A.

    2014-12-01

    Full Text Available In paroxysmal atrial fibrillation usually pulmonary veins isolation is enough, while in persistent and long-standing persistent forms ablation lines in the left atrium are needed. After that post ablational macroreentry tachycardia and focal atrial tachycardia, resistant to antiarrhythmic therapy, occur. Left atrial macroreentry tachycardia are localized perimitrally, around pulmonary veins and septally. There are also roof and posterior wall-associated macroreentry tachycardia. Considering relevance of postablation arrhythmias, we present our case report. A patient had paroxysmal atrial fibrillation. Pulmonary vein isolation was performed. After patient’s radiofrequency pulmonary vein isolation, three-dimensional map of left atrium was made using CARTO XP navigation system. Macroreentry tachycardia around left inferior pulmonary vein was revealed.There were fragmented potentials between left superior and left inferior pulmonary veins. An ablation lineconnecting inferior and superior pulmonary veins was made. After the completion of ablation line sinus rhythmwas restored.

  3. The Role of Pulmonary Veins in Cancer Progression from a Computed Tomography Viewpoint

    Science.gov (United States)

    Chang, Hung; Liao, Tzu-Yao; Wen, Ming-Sheng; Yu, Chih-Teng

    2016-01-01

    Background. We studied the role of pulmonary veins in cancer progression using computed tomography (CT) scans. Methods. We obtained data from 260 patients with pulmonary vein obstruction syndrome (PVOS). We used CT scans to investigate pulmonary lesions in relation to pulmonary veins. We divided the lesions into central and peripheral lesions by their anatomical location: in the lung parenchymal tissue or pulmonary vein; in the superior or inferior pulmonary vein; and by unilateral or bilateral presence in the lungs. Results. Of the 260 PVOS patients, 226 (87%) had central lesions, 231 (89%) had peripheral lesions, and 190 (75%) had mixed central and peripheral lesions. Among the 226 central lesions, 93% had lesions within the superior pulmonary vein, either bilaterally or unilaterally. Among the 231 peripheral lesions, 65% involved bilateral lungs, 70% involved lesions within the inferior pulmonary veins, and 23% had obvious metastatic extensions into the left atrium. All patients exhibited nodules within their pulmonary veins. The predeath status included respiratory failure (40%) and loss of consciousness (60%). Conclusion. CT scans play an important role in following tumor progression within pulmonary veins. Besides respiratory distress, PVOS cancer cells entering centrally can result in cardiac and cerebral events and loss of consciousness or can metastasize peripherally from the pulmonary veins to the lungs.

  4. [NHG guideline 'Deep-vein thrombosis and pulmonary embolus'].

    Science.gov (United States)

    de Jong, Jip; Lucassen, Wim A M; Geersing, Geert-Jan; Burgers, Jako S; Wiersma, Tjerk

    2015-01-01

    The revised Dutch College of General Practitioners (Nederlands Huisartsen Genootschap [NHG]) guideline 'Deep-vein thrombosis and pulmonary embolus' includes recommendations for the treatment of patients with deep-vein thrombosis (DVT) and thrombophlebitis, and for the exclusion of pulmonary embolism (PE). The general practitioner (GP) can exclude the presence of DVT or PE in some patients by using a decision rule and a D-dimer test. When using D-dimer test as a point-of-care test, meticulous care is essential during the test procedure and storage of blood. The GP can treat many patients with DVT; the NHG guideline does not advise use of direct oral anticoagulants. In the case of an isolated DVT in the calf, treatment with anticoagulants or ultrasound follow-up can be chosen in consultation with the patient or on the basis of regional agreements. In the case of patients with superficial thrombophlebitis, a wait-and-see approach is usually sufficient.

  5. Refractory Pulmonary Edema Caused by Late Pulmonary Vein Thrombosis After Lung Transplantation: A Rare Adverse Event.

    Science.gov (United States)

    Denton, Eve J; Rischin, Adam; McGiffin, David; Williams, Trevor J; Paraskeva, Miranda A; Westall, Glen P; Snell, Greg

    2016-09-01

    After lung transplantation, pulmonary vein thrombosis is a rare, potentially life-threatening adverse event arising at the pulmonary venous anastomosis that typically occurs early and presents as graft failure and hemodynamic compromise with an associated mortality of up to 40%. The incidence, presentation, outcomes, and treatment of late pulmonary vein thrombosis remain poorly defined. Management options include anticoagulant agents for asymptomatic clots, and thrombolytic agents or surgical thrombectomy for hemodynamically significant clots. We present a rare case highlighting a delayed presentation of pulmonary vein thrombosis occurring longer than 2 weeks after lung transplantation and manifesting clinically as graft failure secondary to refractory pulmonary edema. The patient was treated successfully with surgical thrombectomy and remains well. We recommend a high index of suspicion of pulmonary vein thrombosis when graft failure after lung transplantation occurs and is not responsive to conventional therapy, and consideration of investigation with transesophageal echocardiography or computed tomography with venous phase contrast in such patients even more than 2 weeks after lung transplantation.

  6. Thoracic exploration for the diagnosis of multiple pulmonary vein varices: case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xun; HAN Hong-li; SHI Zhen-liang

    2007-01-01

    @@ Pulmonary vein varix, congenital or acquired dilation of the pulmonary vein, is a rare vascular abnormality.This disease often presents as a pulmonary mass on chest roentgenography, and pulmonary angiography, computed tomography (CT), or magnetic resonance imaging (MRI)is considered necessary for diagnosis.1 The diagnosis of the disease by thoracic exploration is rare because the present case was diagnosed as a pulmonary arteriovenous fistula before operation.

  7. Atresia of the bilateral pulmonary veins: a rare and dismal anomaly identified on cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Park, Sang-Hyub; Koo, Hyun Jung; Cho, Young Hoon; Lee, Eunsol [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

    2014-08-15

    Imaging findings of bilateral pulmonary vein atresia have not been described. To describe cardiac CT findings and clinical outcomes of bilateral pulmonary vein atresia. Three newborns with bilateral pulmonary vein atresia were encountered at our institution during a period of 8 years. We evaluated prenatal echocardiographic findings, clinical presentations, postnatal echocardiographic findings, chest radiographic findings, cardiac CT findings and clinical outcomes. All newborns presented immediately after birth with severe cyanosis, respiratory distress and acidosis that were unresponsive to medical management. Prenatal and postnatal echocardiographic studies and chest radiography were misleading, inconclusive or nonspecific in making the diagnosis in these children; however cardiac CT clearly demonstrated atresia of the bilateral pulmonary veins with multiple small mediastinal collateral veins and pulmonary edema. Surgical treatments were not feasible for this anomaly. Their clinical outcomes were universally dismal and all infants died within 3 days. Cardiac CT provides an accurate diagnosis of bilateral pulmonary vein atresia and leads to prompt treatment decision in these children. (orig.)

  8. VARIATION IN THE OPENINGS (OSTIA OF LEFT PULMONARY VEINS INTO THE LEFT ATRIUM: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sesi

    2015-03-01

    Full Text Available During early embryonic development, absorption of pulmonary venous network by the left primitive atrial chamber results in opening of four pulmonary veins which drain independently into its chamber. The extent of absorption and hence, the number of pulmon ary veins which open into the left atrium, may vary. Here we report a variation in the opening of the Left upper (superior pulmonary vein into the Left atrium. A total of six openings observed

  9. Varicose vein trauma: a risk for pulmonary embolism.

    Science.gov (United States)

    Joy, Parijat S; Marak, Creticus P; Ponea, Anna M; Guddati, Achuta K

    2014-10-01

    Pulmonary embolism (PE) is a deceptive condition which is often incorrectly diagnosed leading to high morbidity and mortality. We present a case where symptoms were localised to different areas of the body starting with post-traumatic pain over lower extremity varicosities that migrated sequentially over a month to the knee, hip, back, abdomen and chest finally presenting as syncope. Despite a low pre-test clinical probability, a very high index of suspicion led to a timely diagnosis of a massive bilateral PE that eventually caused a troponin leak. The aetiology is highly suspicious of a thrombus which originated in the veins of the leg due to trauma over varicose veins.The case described here exemplifies the importance of considering trauma to varicosities as a risk factor for embolism when the clinical picture is concerning but other signs and symptoms of PE are not apparent.

  10. The Hunter pulmonary angiography catheter for a brachiocephalic vein approach.

    Science.gov (United States)

    Rosen, Galia; Kowalik, Karen J; Ganguli, Suverano; Hunter, David W

    2006-01-01

    The purpose of this work was to describe our experience in performing pulmonary angiography using the Hunter pulmonary catheter, manufactured by Cook, Inc., which is a modified 6F pigtail catheter with a "C-shaped" curve, designed for a brachiocephalic vein approach. One hundred twenty-three patients underwent pulmonary angiograms using the Hunter catheter between August 1997 and January 2002. Operator comments were gathered in 86 (70%) of the cases. The operator was, if possible, the most junior resident on the service. Thirty-nine operators participated in the survey. Efficacy, safety, and ease of use of the catheter were determined by operators' comments and ECG observations during the procedure. Corroborating clinical data were gathered from medical records. In 68 (79%) of the procedures that were commented upon, the operator described insertion into the pulmonary artery (PA) as easy; only 2 (2%) indicated difficulty in accessing the PA. In 41 (63%) of the bilateral angiograms that were commented upon, the operator described accessing the left PA from the right PA as easy; only 6 (9%) rated it as difficult and all were with an older technique in which the catheter was withdrawn to the pulmonary bifurcation without a wire or with only the soft tip of the wire in the pigtail and then rotated to the left main pulmonary artery. Thirty-one of the 41 patients who demonstrated premature ventricular contractions (PVCs) had a previous history of heart disease. Nineteen of the 39 patients who did not have PVCs had a history of heart disease (p = 0.018). The maneuverability and shape of the Hunter catheter make pulmonary angiography an easy procedure, even for operators with minimal experience and limited technical proficiency. PVCs demonstrated a statistically significant correlation with a positive patient history for cardiac disease, rather than being a universal risk.

  11. Total anomalous connection of pulmonary veins to the portal vein. Value of multislice angiotomography. Report on three cases

    Directory of Open Access Journals (Sweden)

    Sara Alejandra Solórzano-Morales

    2014-07-01

    15 and 26% if all its varieties. Multislice angiotomography allows us to view the blood vessels and adjacent organs under consideration and obtain high-definition anatomic information. In the patients in this study, total anomalous connection of pulmonary veins to the portal vein was viewed with three-dimensional volumetric tomographic reconstructions and their correlation with ultrasonography studies.

  12. OCT imaging of myocardium extending to pulmonary vein

    Science.gov (United States)

    Li, Zhifang; Dickfeld, Timm; Tang, Qinggong; Wang, Bohan; Chen, Yu

    2016-02-01

    In this study, we propose to use optical coherence tomography to enable a direct visualization of myocardium extending into the pulmonary vein (PV). The results showed that there are obvious differences in the morphology of myocardium and fibrous tissue in the transition region of myocardial sleeve, which is in agreement with the histological analysis. In addition, the myocardial area in transition point has three layers in the depth of 1 mm, and the depth-resolved myocardial fiber show different orientation in the different layers. This characteristic was applied for segmentation of the structures of myocardium extending into PV.

  13. Normal and abnormal development of pulmonary veins : State of the art and correlation with clinical entities

    NARCIS (Netherlands)

    Douglas, Yvonne L.; Jongbloed, Monique R. M.; DeRuiter, Marco C.; Gittenberger-de Groot, Adriana C.

    2011-01-01

    Interest for the pulmonary veins has increased in the past decade after the potential arrhythmogenicity of the myocardial sleeve surrounding these structures has been recognized. Furthermore, there are several clinical entities, such as anomalous connection pattern and pulmonary vein stenosis, that

  14. Achieving Bidirectional Long Delays In Pulmonary Vein Antral Lines Prior To Bidirectional Block In Patients With Paroxysmal Atrial Fibrillation (The Bi-Bi Technique For Atrial Fibrillation Ablation).

    Science.gov (United States)

    Mina Md Facc Fhrs, Adel F; L Warnecke Pa-C, Nicholas

    2016-01-01

    Background: Pulmonary Vein Antral isolation (PVAI) is currently the standard of care for both paroxysmal and persistent atrial fibrillation ablation. Reconnection to the pulmonary vein is the most common cause of recurrence of atrial fibrillation. Achieving the endpoint of bidirectional block (BDB) for cavotricuspid isthmus dependant flutter has improved our outcomes for atrial flutter ablation. With this we tried to achieve long delays in the pulmonary veins antral lines prior to complete isolation comparable to those delays found in patient with bidirectional block of atrial flutter lines. Study Objective:The objective of this paper was to evaluate feasibility and efficacy of achieving Bidirectional long delays in pulmonary vein antral lines prior to Bidirectional Block in patient with paroxysmal atrial fibrillation. Method: A retrospective analysis was performed on patients who had paroxysmal atrial fibrillation procedures at Unity Point Methodist from January 2015 to January 2016. 20 consecutive patients with paroxysmal atrial fibrillation who had AF ablation using the Bi-Bi technique were evaluated. Result: Mean age was 63, number of antiarrhythmic used prior to ablation was 1.4, mean left atrial size was 38 mm. Mean chads score was 1.3. Mean EF was 53%. Long delays in the left antral circumferential lines were achieved with mean delay of 142 milliseconds +/-100. Also long delays in the right antral circumferential lines were achieved with mean delay of 150 milliseconds +/-80. 95 % (19/20) of patients were free of any atrial arrhythmias and were off antiarrhythmic medications for AF post procedure. There was only one transient complication in one patient who developed a moderate pericardial effusion that was successfully drained with no hemodynamic changes. The only patient who had recurrence was found to have asymptomatic AF with burden on his device paroxysmal atrial fibrillation is feasible and highly effective technique in this small cohort of patients

  15. Idiopathic Pulmonary Vein Thrombus Extending into Left Atrium: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Muhammad Asim Rana

    2016-01-01

    Full Text Available Pulmonary vein thrombosis (PVT is rather an uncommon condition which presents nonspecifically and is usually associated with lung malignancy and major pulmonary surgery. Rarely could no cause be found. It causes increased pulmonary venous pressure leading to pulmonary arterial vasoconstriction and subsequent pulmonary arterial hypertension and subsequently can cause cor pulmonale if not addressed in timely fashion. Other associated complications like peripheral embolization and stroke have also been reported. This case emphasizes the importance of maintaining high index of clinical suspicion especially when CT pulmonary angiogram is negative for pulmonary embolism.

  16. Treatment of atrial fibrillation with radiofrequency ablation and simultaneous multipolar mapping of the pulmonary veins

    Directory of Open Access Journals (Sweden)

    Rocha Neto Almino C.

    2001-01-01

    Full Text Available OBJECTIVE: To demonstrate the feasibility and safety of simultaneous catheterization and mapping of the 4 pulmonary veins for ablation of atrial fibrillation. METHODS: Ten patients, 8 with paroxysmal atrial fibrillation and 2 with persistent atrial fibrillation, refractory to at least 2 antiarrhythmic drugs and without structural cardiopathy, were consecutively studied. Through the transseptal insertion of 2 long sheaths, 4 pulmonary veins were simultaneously catheterized with octapolar microcatheters. After identification of arrhythmogenic foci radiofrequency was applied under angiographic or ultrasonographic control. RESULTS: During 17 procedures, 40 pulmonary veins were mapped, 16 of which had local ectopic activity, related or not with the triggering of atrial fibrillation paroxysms. At the end of each procedure, suppression of arrhythmias was obtained in 8 patients, and elimination of pulmonary vein potentials was accomplished in 4. During the clinical follow-up of 9.6±3 months, 7 patients remained in sinus rhythm, 5 of whom were using antiarrhythmic drugs that had previously been ineffective. None of the patients had pulmonary hypertension or evidence of stenosis in the pulmonary veins. CONCLUSION: Selective and simultaneous catheterization of the 4 pulmonary veins with microcatheters for simultaneous recording of their electrical activity is a feasible and safe procedure that may help ablation of atrial fibrillation.

  17. Renal infarction in a patient with pulmonary vein thrombosis after left upper lobectomy.

    Science.gov (United States)

    Manabe, Shun; Oshima, Yasuko; Nakano, Marie; Fujii, Teruhiro; Maehara, Takamitsu; Nitta, Kosaku; Hatano, Michiyasu

    2014-05-01

    A 43-year-old male experienced renal infarction (RI) following left upper lobectomy for lung cancer. The patient complained of acute-onset severe left flank pain on the 14th postoperative day. A contrast-enhanced computed tomography (CT) of the abdomen revealed RI by a large wedge-shaped defect in the left kidney. A chest CT scan located the thrombus in the stump (a blind-ended vessel) of the left superior pulmonary vein. Therefore, thromboembolic RI caused by pulmonary vein thrombosis was suspected. Anticoagulation therapy was initiated with heparin and warfarin to treat RI and to prevent further embolic episodes. Two months later, pulmonary vein thrombosis had resolved without the appearance of additional peripheral infarction. This case emphasizes the need to consider thrombus in the stump of the pulmonary vein as a cause of RI.

  18. Are pulmonary embolism and deep-vein thrombosis always one disease?

    NARCIS (Netherlands)

    Langevelde, Kirsten van

    2012-01-01

    Pulmonary embolism is traditionally, since autopsy studies by Virchow in the mid 1800s, thought to originate from embolization of a deep-vein thrombosis, resulting in two clinical manifestations of one disease: venous thrombosis. The incidence of deep-vein thrombosis in the population is twice as hi

  19. Idiopathic pulmonary vein thrombosis extending to left atrium:a case report with a literature review

    Institute of Scientific and Technical Information of China (English)

    WU Jun-ping; WU Qi; YANG Yang; DU Zhong-zhen; SUN Hong-fen

    2012-01-01

    Pulmonary vein thrombosis is a rare disease and is usually represented as a complication of atrial fibrillation,pulmonary tumors,and Iobectomy.Although it is a potentially life threatening condition,the venous disease is easy to misdiagnose because of the non-specific symptoms.In this article,we present a 30-year-old patient who suffered from pulmonary vein thrombosis without any causes.He was diagnosed with other pulmonary disorders till the thrombus within the pulmonary vein extended into the left atrium.Left atrium mass resection and a left lower Iobectomy were undertaken with relative urgency.The postoperative course was uneventful.The patient received a long course of oral anticoagulant therapy.

  20. Unusual presentation of renal vein thrombosis with pulmonary artery embolism.

    Science.gov (United States)

    Mzayen, Khaled; Al-Said, Jafar; Nayak-Rao, Shobhana; Catacutan, Maria Teresa; Kamel, Olfat

    2013-05-01

    A young 23-year-old male patient presented with a two-day history of right flank pain. He had no history of any significant illnesses in the past. His investigations showed nephrotic range proteinuria with hypoalbuminemia. The patient developed cough and shortness of breath after having a left kidney biopsy. He did not respond to regular respiratory tract infection treatment. The kidney biopsy revealed membranoproliferative glomerulonephritis. Further investigations for the cough showed thromboembolism of the posterior and lateral basal segments of the right lower lobe. Moreover he was found to have thrombosis of the right upper pole renal vein. The patient was started on full anticoagulation along with three days pulse steroid, followed by 1 mg/kg oral steroid. Clinical improvement was noticed within 48 h. After eight weeks the proteinuria decreased from 8.5 gm/day to 1.1 gm/day. The kidney function was normal with eGFR 145 mL/min through the course of the disease. This case represent one of the unusual presentation of nephrotic syndrome with pulmonary and renal vascular thromboembolic events. The response to the combination of anticoagulation and steroid was remarkable.

  1. Unusual presentation of renal vein thrombosis with pulmonary artery embolism

    Directory of Open Access Journals (Sweden)

    Khaled Mzayen

    2013-01-01

    Full Text Available A young 23-year-old male patient presented with a two-day history of right flank pain. He had no history of any significant illnesses in the past. His investgations showed nephrotic range proteinuria with hypoalbuminemia. The patient developed cough and shortness of breath after having a left kidney biopsy. He did not respond to regular respiratory tract infection treat-ment. The kidney biopsy revealed membranoproliferative glomerulonephritis. Further investigations for the cough showed thromboembolism of the posterior and lateral basal segments of the right lower lobe. Moreover he was found to have thrombosis of the right upper pole renal vein. The patient was started on full anticoagulation along with three days pulse steroid, followed by 1 mg/kg oral steroid. Clinical improvement was noticed within 48 h. After eight weeks the proteinuria decreased from 8.5 gm/day to 1.1 gm/day. The kidney function was normal with eGFR 145 mL/min through the course of the disease. This case represent one of the unusual presentation of nephrotic syndrome with pulmonary and renal vascular thromboembolic events. The response to the combination of anticoagulation and steroid was remarkable.

  2. Epicardial isolation of pulmonary veins with ethanol in open chest dogs

    Institute of Scientific and Technical Information of China (English)

    YIN Xian-dong; DONG Jian-zeng; MA Chang-sheng; NING Man; SANG Cai-hua; MIAO Cheng-long; LIANG Cui; TANG Ri-bo; LONG De-yong; YU Rong-hui; LIU Xing-peng

    2011-01-01

    Background Radiofrequency (RF) ablation has become a widely accepted treatment for atrial fibrillation (AF). This study aimed to identify the efficacy and safety of pulmonary vein (PV) ablation with ethanol and to explore an alternative energy source for catheter ablation of AF.Methods Twelve open-chest mongrel dogs were randomized into ethanol ablation group and control group. Both the injections and electrophysiological mapping procedures were performed epicardialy. In ethanol ablation group (n=6),injections were performed to circumferentially ablate the root of each PV (0.2 ml each site, 3 mm apart) with 95% ethanol using an 1 ml injector. In control group (n=-6), saline was injected other than ethanol. PV isolation was confirmed with a circular catheter immediately after the procedure and at follow up of 30 days. PV isolation was defined as the absence of PV potentials at each electrode of the circular catheter positioned at the PV side of the lesions, as well as complete conduction block into left atrium (LA) during PV pacing.Results PV electrical isolation with complete bidirectional conduction block was achieved with ethanol immediately and at 30 days in 95% of PVs, while saline injection caused only transient conduction changes between LA and PVs. In ethanol group, histologic analysis showed transmural lesions at 30 days. And there was no evidence of PV stenosis or thrombus formation. Mean LA diameter was not significantly different between baseline and 30 days.Conclusion Ethanol is a safe energy source to effectively isolate PV in canine model and may be promising in endocardial ablation procedure of AF patients in the future.

  3. Hemodynamic Change in Pulmonary Vein Stenosis after Radiofrequency Ablation: Assessment with Magnetic Resonance Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Doyoung; Jung, Jung Im; Oh, Yong Seog; Youn, Ho Joong [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2012-11-15

    We present a case of pulmonary vein (PV) stenosis after radio-frequency (RF) ablation, in which a hemodynamic change in the pulmonary artery was similar to that of congenital PV atresia on time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA). A 48-year-old man underwent RF ablation due to atrial fibrillation. The patient subsequently complained of hemoptysis, dyspnea on exertion, and right chest pain. Right PV stenosis after catheter ablation was diagnosed through chest computed tomography and lung perfusion scan. Pulmonary TR-MRA revealed the pulmonary artery via systemic arterial collaterals and draining systemic collateral veins. On a velocity-encoded cine image, the flow direction of the right pulmonary artery was reversed in the diastolic phase and the left pulmonary artery demonstrated continuous forward flow throughout the cardiac cycle. These hemodynamic changes were similar to those seen in congenital unilateral PV atresia.

  4. Transesophageal Echocardiographically-Confirmed Pulmonary Vein Thrombosis in Association with Posterior Circulation Infarction.

    LENUS (Irish Health Repository)

    Kinsella, Justin A

    2010-01-01

    Pulmonary venous thromboembolism has only been identified as a cause of stroke with pulmonary arteriovenous malformations\\/fistulae, pulmonary neoplasia, transplantation or lobectomy, and following percutaneous radiofrequency ablation of pulmonary vein ostia in patients with atrial fibrillation. A 59-year-old man presented with a posterior circulation ischemic stroke. \\'Unheralded\\' pulmonary vein thrombosis was identified on transesophageal echocardiography as the likely etiology. He had no further cerebrovascular events after intensifying antithrombotic therapy. Twenty-eight months after initial presentation, he was diagnosed with metastatic pancreatic adenocarcinoma and died 3 months later. This report illustrates the importance of doing transesophageal echocardiography in presumed \\'cardioembolic\\' stroke, and that potential \\'pulmonary venous thromboembolic\\' stroke may occur in patients without traditional risk factors for venous thromboembolism. Consideration should be given to screening such patients for occult malignancy.

  5. Usefulness of helical computed tomography in diagnosing pulmonary vein stenosis in infants.

    Directory of Open Access Journals (Sweden)

    Ohtsuki,Shinnichi

    2005-06-01

    Full Text Available

    We investigated the usefulness of helical computed tomography(CTin the morphological diagnosis of pulmonary vein stenosis, particularly that in infants and small children. In total, 20 helical CT examinations were performed in 10 post-operative cases of Total Anomalous Pulmonary Venous Drainage(TAPVD, 3 cases of single right ventricle, and 1 case of single left ventricle. In all cases, distinct morphological imaging was possible. Pulmonary vein stenosis could be categorized into three types: (1stenosis from the anastomosis of the common pulmonary vein (CPV-the left atrium (LA to the peripheral pulmonary vein; (2 stenosis only at the anastomosis of CPV-LA; and (3 stenosis due to compression by nearby organs. Coronal views by multiplanar reconstruction (MPR provided morphological information along the up-down direction of the body axis. Morphological diagnosis of pulmonary vein stenosis is important in deciding prognosis and therapeutic regimens, and helical CT was considered useful for such diagnosis in our 14 young patients.

  6. Specific echocardiographic findings useful for the diagnosis of common pulmonary vein atresia

    Directory of Open Access Journals (Sweden)

    Hiroyuki Nagasawa

    2015-12-01

    Full Text Available In this paper, we report a case of common pulmonary vein atresia, which is a very rare disease characterized by cyanosis, heart failure and pulmonary hypertension. Reverse flow in the pulmonary artery at end-diastole as well as in the isthmus of the aorta from early systole to end-diastole detected by echocardiography were found to be specific features useful in diagnosing the disease.

  7. Pulmonary vein isolation in the treatment of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Kumar S

    2016-05-01

    Full Text Available Saurabh Kumar, Gregory F Michaud Cardiac Arrhythmia Service, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA Abstract: Atrial fibrillation (AF is the commonest arrhythmia in humans and is associated with marked reduction in quality of life and an elevated thromboembolic risk. Paroxysmal, persistent, and permanent forms of AF have been recognized. Whilst antiarrhythmic drugs are considered as first-line therapy, the role of catheter ablation is increasing due to its superior efficacy in terms of quality of life and reduction in AF burden. The central paradigm for catheter ablation of AF is that triggers for AF are located near and within the pulmonary veins (PVs, and electrical isolation of the PVs from the left atrium forms the cornerstone of most catheter ablation strategies. Whilst paroxysmal form is generally trigger dependent, persistent and permanent forms are associated with variable interaction between triggers and "substrate" comprised of atrial and PV electrical and structural remodeling. Nevertheless, isolation of the PVs still forms a critical component of catheter ablation strategies, regardless of AF type. Procedural efficacy, however, is limited by PV conduction recovery. This is likely due to deficiencies in ablation tools or limitations of intraprocedural assessment of lesion efficacy. Careful attention to surrogates of tissue heating, such as impedance decrease and electrogram morphology changes, along with advances in catheter technology like contact force catheters may improve rates of durable PV isolation and single-procedural success. This review discusses the mechanism of paroxysmal AF with particular focus on the role of the PVs in AF initiation and PV isolation in the management of AF. Keywords: contact force, lesion transmurality, radiofrequency catheter ablation, paroxysmal atrial fibrillation, electrophysiology, AF

  8. Pathogenetics of alveolar capillary dysplasia with misalignment of pulmonary veins.

    Science.gov (United States)

    Szafranski, Przemyslaw; Gambin, Tomasz; Dharmadhikari, Avinash V; Akdemir, Kadir Caner; Jhangiani, Shalini N; Schuette, Jennifer; Godiwala, Nihal; Yatsenko, Svetlana A; Sebastian, Jessica; Madan-Khetarpal, Suneeta; Surti, Urvashi; Abellar, Rosanna G; Bateman, David A; Wilson, Ashley L; Markham, Melinda H; Slamon, Jill; Santos-Simarro, Fernando; Palomares, María; Nevado, Julián; Lapunzina, Pablo; Chung, Brian Hon-Yin; Wong, Wai-Lap; Chu, Yoyo Wing Yiu; Mok, Gary Tsz Kin; Kerem, Eitan; Reiter, Joel; Ambalavanan, Namasivayam; Anderson, Scott A; Kelly, David R; Shieh, Joseph; Rosenthal, Taryn C; Scheible, Kristin; Steiner, Laurie; Iqbal, M Anwar; McKinnon, Margaret L; Hamilton, Sara Jane; Schlade-Bartusiak, Kamilla; English, Dawn; Hendson, Glenda; Roeder, Elizabeth R; DeNapoli, Thomas S; Littlejohn, Rebecca Okashah; Wolff, Daynna J; Wagner, Carol L; Yeung, Alison; Francis, David; Fiorino, Elizabeth K; Edelman, Morris; Fox, Joyce; Hayes, Denise A; Janssens, Sandra; De Baere, Elfride; Menten, Björn; Loccufier, Anne; Vanwalleghem, Lieve; Moerman, Philippe; Sznajer, Yves; Lay, Amy S; Kussmann, Jennifer L; Chawla, Jasneek; Payton, Diane J; Phillips, Gael E; Brosens, Erwin; Tibboel, Dick; de Klein, Annelies; Maystadt, Isabelle; Fisher, Richard; Sebire, Neil; Male, Alison; Chopra, Maya; Pinner, Jason; Malcolm, Girvan; Peters, Gregory; Arbuckle, Susan; Lees, Melissa; Mead, Zoe; Quarrell, Oliver; Sayers, Richard; Owens, Martina; Shaw-Smith, Charles; Lioy, Janet; McKay, Eileen; de Leeuw, Nicole; Feenstra, Ilse; Spruijt, Liesbeth; Elmslie, Frances; Thiruchelvam, Timothy; Bacino, Carlos A; Langston, Claire; Lupski, James R; Sen, Partha; Popek, Edwina; Stankiewicz, Paweł

    2016-05-01

    Alveolar capillary dysplasia with misalignment of pulmonary veins (ACDMPV) is a lethal lung developmental disorder caused by heterozygous point mutations or genomic deletion copy-number variants (CNVs) of FOXF1 or its upstream enhancer involving fetal lung-expressed long noncoding RNA genes LINC01081 and LINC01082. Using custom-designed array comparative genomic hybridization, Sanger sequencing, whole exome sequencing (WES), and bioinformatic analyses, we studied 22 new unrelated families (20 postnatal and two prenatal) with clinically diagnosed ACDMPV. We describe novel deletion CNVs at the FOXF1 locus in 13 unrelated ACDMPV patients. Together with the previously reported cases, all 31 genomic deletions in 16q24.1, pathogenic for ACDMPV, for which parental origin was determined, arose de novo with 30 of them occurring on the maternally inherited chromosome 16, strongly implicating genomic imprinting of the FOXF1 locus in human lungs. Surprisingly, we have also identified four ACDMPV families with the pathogenic variants in the FOXF1 locus that arose on paternal chromosome 16. Interestingly, a combination of the severe cardiac defects, including hypoplastic left heart, and single umbilical artery were observed only in children with deletion CNVs involving FOXF1 and its upstream enhancer. Our data demonstrate that genomic imprinting at 16q24.1 plays an important role in variable ACDMPV manifestation likely through long-range regulation of FOXF1 expression, and may be also responsible for key phenotypic features of maternal uniparental disomy 16. Moreover, in one family, WES revealed a de novo missense variant in ESRP1, potentially implicating FGF signaling in the etiology of ACDMPV.

  9. Maintenance of atrial fibrillation by pulmonary vein tachycardia with ostial conduction block: evidence of an interpulmonary vein electrical connection.

    Science.gov (United States)

    Matsuo, Seiichiro; Jaïs, Pierre; Wright, Matthew; Lim, Kang-Teng; Knecht, Sébastien; Haïssaguerre, Michel

    2008-10-01

    We report a case of a 56-year-old man with paroxysmal atrial fibrillation who underwent segmental, ostial pulmonary vein (PV) isolation while in arrhythmia. During isolation of the left superior PV (LSPV), organized electrical activity was seen within the vein, suggestive of a PV tachycardia with a cycle length of 90 ms. Simultaneously, organized electrical activity with a cycle length of 180 ms was seen in the left inferior PV (LIPV), suggestive of 2:1 conduction between the LSPV and the LIPV. Isolation of the LIPV resulted in conversion to sinus rhythm, while confirming isolation of the LSPV by the presence of ongoing PV tachycardia in this vein. This case demonstrates a direct electrical connection between the ipsilateral left PVs, leading to maintenance of atrial fibrillation.

  10. The developing pulmonary veins and left atrium: implications for ablation strategy for atrial fibrillation.

    Science.gov (United States)

    Sherif, Hisham M F

    2013-11-01

    The majority of cases of atrial fibrillation (AF) are the result of triggers originating in the area of the pulmonary veins. The reason for the predilection for that area remains unclear. We sought to examine the different mechanisms responsible for this observation through an extensive search of the medical literature, examining the development of the pulmonary veins, genetics of AF and left to -right cardiac chamber differentiation. Results confirm that the LAA is anatomically and embryologically different from other areas of the atrial walls and develops under distinct genetic and transcriptional pathways. Findings support an ablation strategy whose primary focus should be the creation of a 'box' lesion set, plus additional lines to prevent propagation to the left atrial appendage, the isthmus of the left atrium and the right atrium are likely to be more effective than simple pulmonary vein isolation.

  11. Effects of pulmonary veins ligation style for the patients' stress and cardiac on lung cancer

    Directory of Open Access Journals (Sweden)

    Yang SHENTU

    2008-10-01

    Full Text Available Background and objective It is needed to explore the effects of operation on stress statue, myocardial damage and arrhythmia to lung cancer. This study would compare the effects of two ligation styles of pulmonary vein on lung cancer patients' stress and cardiac postoperative. Methods 54 cases were divided into two groups randomly:the pulmonary vein trunk-ligation group (trunk group, 27 cases and the pulmonary vein branch-ligation group (branch group, 27 cases. The blood concentrations of hydrocortisone (HC, blood glucose (BG and cardial troponin-I (cTnI were determined at different time point. The surgical data, the quantum of pain and ECG also recorded. Results ① There were no significance difference of the operation time, blood loss during operation and drainage volume in first day after operation between two groups. ② There're no differences of the quantum of pain between two groups. ③ The HC of the two groups' ascend obviously on the end of operation and descend during postoperative. ④ The BG of the two groups' rise on the 1st day obviously, maintain high level on the 2nd day, descend on the 3rd day but still higher than that of preoperation.⑤ The BG and HC show a direct positive correlation postoperative. ⑥ The cTnIs of the trunk group ascend immediatelyafter operation, but there's no statistically significance between two groups. ⑦ The arrhythmia incidence is higher in the trunk group, but the arrhythmia incidences classified by the date after operation of the two groups' show no distinction. Conclusion ① The effects of two pulmonary vein ligation styles on postoperative stress show no significance differences.② The style of pulmonary vein trunk-ligation has a more obvious tendency to do harm to heart than that of branch-ligation. ③ The style of pulmonary vein branch-ligation may reduce the arrhythmia incidence after operation.

  12. Pulmonary Embolism following Endovenous Laser Ablation (EVLA of the Great Saphenous Vein

    Directory of Open Access Journals (Sweden)

    Nnamdi Nwaejike

    2008-08-01

    Full Text Available

    A 70yr old lady presented to accident and emergency with sudden onset pleuritic chest pain. A pulmonary embolus (PE was diagnosed by CTPA. Ten days earlier she had bilateral EVLA for recurrent long saphenous vein disease. Confounding risk factors for pulmonary embolism included bilateral ligation and stripping of the long saphenous vein a year earlier, malignancy, EVLA and phlebitic tributary varices. EVLA has been shown to be an effective treatment for superficial venous insufficiency with low morbidity and high patient satisfaction. The investigation of confounding risk factors and possible causes should not compromise the initial treatment of PE.

  13. Pulmonary vein dilatation in a case of total pulmonary vein occlusion: Contemporary approach using a combination of 3D-mapping system and image integration.

    Science.gov (United States)

    Hilbert, Sebastian; Sommer, Philipp; Bollmann, Andreas

    2016-12-01

    Pulmonary vein stenosis (PVS) is a known complication of PV isolation procedures for atrial fibrillation. In this report a case of recurring PV occlusion after repeated percutaneous procedures has been described. Focus is on a novel interventional technique employing a three-dimensional mapping system which enables targeting total occlusion of PVs and on the use of a drug eluting balloon. A focused review of the current literature regarding ongoing limitations of PV stenosis treatment has been provided. © 2015 Wiley Periodicals, Inc.

  14. Ganglionated plexi stimulation induces pulmonary vein triggers and promotes atrial arrhythmogenecity: In silico modeling study

    Science.gov (United States)

    Hwang, Minki; Lim, Byounghyun; Song, Jun-Seop; Yu, Hee Tae; Ryu, Ah-Jin; Lee, Young-Seon; Joung, Boyoung; Shim, Eun Bo; Pak, Hui-Nam

    2017-01-01

    Background The role of the autonomic nervous system (ANS) on atrial fibrillation (AF) is difficult to demonstrate in the intact human left atrium (LA) due to technical limitations of the current electrophysiological mapping technique. We examined the effects of the ANS on the initiation and maintenance of AF by employing a realistic in silico human left atrium (LA) model integrated with a model of ganglionated plexi (GPs). Methods We incorporated the morphology of the GP and parasympathetic nerves in a three-dimensional (3D) realistic LA model. For the model of ionic currents, we used a human atrial model. GPs were stimulated by increasing the IK[ACh], and sympathetic nerve stimulation was conducted through a homogeneous increase in the ICa-L. ANS-induced wave-dynamics changes were evaluated in a model that integrated a patient’s LA geometry, and we repeated simulation studies using LA geometries from 10 different patients. Results The two-dimensional model of pulmonary vein (PV) cells exhibited late phase 3 early afterdepolarization-like activity under 0.05μM acetylcholine (ACh) stimulation. In the 3D simulation model, PV tachycardia was induced, which degenerated to AF via GP (0.05μM ACh) and sympathetic (7.0×ICa-L) stimulations. Under sustained AF, local reentries were observed at the LA-PV junction. We also observed that GP stimulation reduced the complex fractionated atrial electrogram (CFAE)-cycle length (CL, p<0.01) and the life span of phase singularities (p<0.01). GP stimulation also increased the overlap area of the GP and CFAE areas (CFAE-CL≤120ms, p<0.01). When 3 patterns of virtual ablations were applied to the 3D AF models, circumferential PV isolation including the GP was the most effective in terminating AF. Conclusion Cardiac ANS stimulations demonstrated triggered activity, automaticity, and local reentries at the LA-PV junction, as well as co-localized GP and CFAE areas in the 3D in silico GP model of the LA. PMID:28245283

  15. A novel multiscale topo-morphometric approach for separating arteries and veins via pulmonary CT imaging

    Science.gov (United States)

    Saha, Punam K.; Gao, Zhiyun; Alford, Sara; Sonka, Milan; Hoffman, Eric

    2009-02-01

    Distinguishing arterial and venous trees in pulmonary multiple-detector X-ray computed tomography (MDCT) images (contrast-enhanced or unenhanced) is a critical first step in the quantification of vascular geometry for purposes of determining, for instance, pulmonary hypertension, using vascular dimensions as a comparator for assessment of airway size, detection of pulmonary emboli and more. Here, a novel method is reported for separating arteries and veins in MDCT pulmonary images. Arteries and veins are modeled as two iso-intensity objects closely entwined with each other at different locations at various scales. The method starts with two sets of seeds -- one for arteries and another for veins. Initialized with seeds, arteries and veins grow iteratively while maintaining their spatial separation and eventually forming two disjoint objects at convergence. The method combines fuzzy distance transform, a morphologic feature, with a topologic connectivity property to iteratively separate finer and finer details starting at a large scale and progressing towards smaller scales. The method has been validated in mathematically generated tubular objects with different levels of fuzziness, scale and noise. Also, it has been successfully applied to clinical CT pulmonary data. The accuracy of the method has been quantitatively evaluated by comparing its results with manual outlining. For arteries, the method has yielded correctness of 81.7% at the cost of 6.7% false positives and 11.6% false negatives. Our method is very promising for automated separation of arteries and veins in MDCT pulmonary images even when there is no mark of intensity variation at conjoining locations.

  16. Regular atrial tachycardias developing after cryoballoon pulmonary vein isolation: Incidence, characteristics, and predictors

    NARCIS (Netherlands)

    E. Mikhaylov (Evgeny); R. Bhagwandien (Rohit); P. Janse (Petter); D.A.M.J. Theuns (Dominic); T. Szili-Torok (Tamas)

    2013-01-01

    textabstractAimsCryoballoon ablation (CBA) is a well-used technique when performing pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (AF). Our aim is to describe incidence, characteristics, and clinical predictors for developing atrial tachycardias (ATs) after cryoballoo

  17. Atrioesophageal fistula complicating cryoballoon pulmonary vein isolation for paroxysmal atrial fibrillation.

    Science.gov (United States)

    Kawasaki, Raymond; Gauri, Andre; Elmouchi, Darryl; Duggal, Manoj; Bhan, Adarsh

    2014-07-01

    Although atrioesophageal fistula (AEF) formation is a well known, albeit rare, catastrophic complication of atrial fibrillation radiofrequency ablation procedures, there are less data regarding this complication using the cryoballoon technique. We report on 3 cases of AEF as a complication of cryoballoon pulmonary vein isolation at 3 different institutions with 2 different generations of cryoballoons.

  18. Unilateral pulmonary veins atresia: evaluation by computed tomography; Atresia unilateral das veias pulmonares: avaliacao por tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Eifer, Diego Andre; Arsego, Felipe Veras, E-mail: felipesoarestorres@gmail.com [Hospital de Clinicas de Porto Alegre (HCPA), RS (Brazil). Serv. de Radiologia; Torres, Felipe Soares [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Escola de Medicina

    2013-11-15

    Unilateral pulmonary vein atresia is a rare congenital condition. In addition to cardiac malformations or pulmonary hypertension, patients may present with recurrent pulmonary infections or hemoptysis in childhood or adolescence. The authors report a case where the typical findings of such condition were observed at computed tomography in an adult patient. (author)

  19. Effect of K201, a novel antiarrhythmic drug on calcium handling and arrhythmogenic activity of pulmonary vein cardiomyocytes

    Science.gov (United States)

    Chen, Y-J; Chen, Y-C; Wongcharoen, W; Lin, C-I; Chen, S-A

    2007-01-01

    Background and purpose: Pulmonary veins are the most important focus for the generation of atrial fibrillation. Abnormal calcium homeostasis with ryanodine receptor dysfunction may underlie the arrhythmogenic activity in pulmonary veins. The preferential ryanodine receptor stabilizer (K201) possesses antiarrhythmic effects through calcium regulation. The purpose of this study was to investigate the effects of K201 on the arrhythmogenic activity and calcium regulation of pulmonary vein cardiomyocytes. Experimental approach: The ionic currents and intracellular calcium were studied in isolated single cardiomyocytes from rabbit pulmonary vein before and after the administration of K201, by the whole-cell patch clamp and indo-1 fluorimetric ratio techniques. Key results: K201 (0.1, 0.3, 1 μM) reduced the firing rates in pulmonary vein cardiomyocytes, decreased the amplitudes of the delayed afterdepolarizations and prolonged the action potential duration. K201 decreased the L-type calcium currents, Na+/Ca2+ exchanger currents, transient inward currents and calcium transients. K201 (1 μM, but not 0.1 μM or 0.3 μM) also reduced the sarcoplasmic reticulum calcium content. Moreover, both the pretreatment and administration of K201 (0.3 μM) decreased the isoprenaline (10 nM)-induced arrhythmogenesis in pulmonary veins. Conclusions and implications: K201 reduced the arrhythmogenic activity of pulmonary vein cardiomyocytes and attenuated the arrhythmogenicity induced by isoprenaline. These findings may reveal the anti-arrhythmic potential of K201. PMID:17994112

  20. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective: to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods: The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF). The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃. The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132±68 min for our patients. The average fluoroscopy time was 33±17 min. With a mean follow-up of 16±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion: Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  1. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective : to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods : The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF) . The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃ . The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132± 68 min for our patients. The average fluoroscopy time was 33 ±17 min. With a mean follow-up of 16 ±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion : Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  2. Impact of the origin of sinus node artery on recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhi-jun; CHEN Ke; TANG Ri-bo; gANG Cai-hua; Edmundo Patricio Lopes Lao; YAN Qian; HE Xiao-nan

    2013-01-01

    Background Major atrial coronary arteries,including the sinus node artery (SNA),were commonly found in the areas involved in atrial fibrillation (AF) ablation and could cause difficulties in achieving linear block at the left atrial (LA) roof.The SNA is a major atrial coronary artery of the atrial coronary circulation.This study aimed to determine impact of the origin of SNA on recurrence of AF after pulmonary vein isolation (PVI) in patients with paroxysmal AF.Methods Seventy-eight patients underwent coronary angiography for suspected coronary heart disease,followed by catheter ablation for paroxysmal AF.According to the origin of SNA from angiographic findings,they were divided into right SNA group (SNA originating from the right coronary artery) and left SNA group (SNA originating from the left circumflex artery).Guided by an electroanatomic mapping system,circumferential pulmonary vein ablation (CPVA) was performed in both groups and PVI was the procedural endpoint.All patients were followed up at 1,3,6,9 and 12 months post-ablation.Recurrence was defined as any episode of atrial tachyarrhythmias (ATAs),including AF,atrial flutter or atrial tachycardia,that lasted longer than 30 seconds after a blanking period of 3 months.Results The SNA originated from the right coronary artery in 34 patients (43.6%) and the left circumflex artery in 44 patients (56.4%).Freedom from AF and antiarrhythmic drugs (AADs) at 1 year was 67.9 % (53/78) for all patients.After 1 year follow-up,79.4% (27/34) in right SNA group and 59.1% (26/44) in left SNA group (P=0.042) were in sinus rhythm.On multivariate analysis,left atrium size (HR=1.451,95%CI:1.240-1.697,P <0.001) and a left SNA (HR=6.22,95%CI:2.01-19.25,P=0.002)were the independent predictors of AF recurrence.Conclusions The left SNA is more frequent in the patients with paroxysmal AF.After one year follow-up,the presence of a left SNA was identified as an independent predictor of AF recurrence after CPVA in

  3. Pulmonary vein flow pattern in children with bidirectional cavopulmonary connection or Fontan circuit

    Energy Technology Data Exchange (ETDEWEB)

    Shariat, Masoud; Yoo, Shi-Joon [Hospital for Sick Children, Department of Radiology, Toronto (Canada); Grosse-Wortmann, Lars; Windram, Jonathan [Hospital for Sick Children, Department of Cardiology, Toronto (Canada)

    2012-02-15

    Typical flow velocity profiles in the extraparenchymal pulmonary veins (PVs) demonstrate two major antegrade flow waves: a biphasic systolic wave (S), with S1 and S2 peaks and a monophasic early diastolic wave (D). Flow reversal during atrial systole (A) is common. There is agreement that the forward diastolic PV flow wave is caused by left ventricular relaxation with opening of the mitral valve. The origin of the PV systolic wave, however, remains a topic of debate. Some studies have suggested that the S wave is created by the relaxation of the left atrium and descent of the mitral valve plane. These studies have concluded that forces generated by the right ventricle (RV) have no effect on the S wave. Others suggest that the forward propagation of the right ventricular systolic pressure pulse is the major contributor to the S wave. To determine whether any part of the systolic wave of PV flow is dependent on forces created by the right ventricle. We assessed PV flow pattern, as obtained by cardiac MRI in 12 cases (39 pulmonary veins) with RV-independent pulmonary circulation (bidirectional cavopulmonary connection or Fontan circulation). Phase-contrast imaging of the PVs was performed on a 1.5-T MR scanner with velocity encoding set at 120 cm/s. We compared these flow patterns with those of a control group of ten children (15 pulmonary veins) who had RV-dependent pulmonary circulation and underwent CMR for other indications. In all PVs of children with RV-independent pulmonary circulation the flow curves showed a single systolic peak in early systole (S1) with the S2 peak consistently absent. PV flow pattern in the control group consistently showed distinct early and late systolic peaks. This study supports the concept that S2 is caused by forward propagation of the right ventricular systolic pressure pulse. It also demonstrates that the S1 is independent of the right ventricle. (orig.)

  4. Case Series: Fetal Pulmonary Vein A-Wave Reversal: An Early Marker of Left-Sided Cardiac Anomalies?

    Directory of Open Access Journals (Sweden)

    Aldo L. Schenone

    2015-04-01

    Full Text Available Background - Improvements in congenital heart disease (CHD screening are needed based on the lack of sensitivity of current screening methods and the understanding that the early detection of certain CHDs may improve outcomes. Fetal venous circulation has caught medical attention, and two studies demonstrated that it is feasible to register pulmonary vein flow velocity waveforms (FVWs during early gestation. Meanwhile, the latter study proposed pulmonary vein A-wave reversal as a marker of cardiac anomaly. Methods - We report a series of six consecutive fetuses with confirmed cardiac anomalies that underwent first-trimester screening, including pulmonary vein FVWs, at our center during 2013. CHD was confirmed by late pregnancy echocardiography, and in three cases fetal autopsies were performed. Result/Discussion - The ductus venosus (DV and nuchal translucency (NT predicted 50% of CHD cases, whereas the combination of markers identified 66.6% of CHD cases. When adding pulmonary vein assessment, the rate of detection rose to 83.3%. Total five of six cases of CHD had reversal of pulmonary vein A-wave during early pregnancy. The sixth case with CHD and nonreversal of A-wave was described as right ventricle hypoplasia with type 1 tricuspid atresia and persistent ductus arteriosus. Conclusion This is the first series reporting pulmonary vein end-diastolic reversal as a CHD screening add-on during early pregnancy. The addition of pulmonary vein FVW assessment to the current CHD screening bundle could increase the rate detection of cardiac anomalies. This pilot study suggests that pulmonary vein end-diastolic flow reversal favors detection of left-sided CHD over the right-sided ones.

  5. Bilateral chylothorax in a patient with chronic central vein thrombosis and chronic thromboembolic pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Avdhesh Bansal

    2015-01-01

    Full Text Available The chylothorax is not a common presentation, and bilateral chylothorax in patients with chronically high central venous pressure secondary to venous thrombosis is a rare in incidence. We reported a case of bilateral chylothorax in a patient of chronic deep vein thrombosis (DVT in central veins with chronic thromboembolic pulmonary hypertension who presented with 2 weeks history of increased breathlessness, bilateral chest discomfort and weakness. Work-up with chest X-ray and ultrasonography-chest showed gross left sided and mild right sided pleural effusion, thoracocentesis was consistent with chylothorax. Contrast enhanced computed tomography-chest showed multiple collateral formation of left side subclavian vein, venous Doppler showed old DVT in right and left subclavian veins and two-dimensional echocardiogram showed finding of severe pulmonary hypertension. After 24 h of fasting and conservative management, pleural drain became clear and decreased in the amount. Patient′s video assisted thoracoscopic surgery was done, and thoracic duct was ligated and cut down at diaphragmatic level and bilateral talc pleurodesis done. Patient improved clinically and radiologically.

  6. Cystic lung changes in a thin section CT in an asymptomatic young adult with unilateral pulmonary vein atresia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Choul; Yi, Jeong Geun; Park, Jeong Hee [Konkuk Univ. Medical Center, Seoul (Korea, Republic of)

    2012-07-15

    Unilateral pulmonary vein atresia is a rare anomaly, usually associated with symptoms of recurrent hemoptysis and pneumonia in early childhood. Only one report of an asymptomatic adult patient can be found in the literature. We present the case of an asymptomatic patient with unilateral right pulmonary vein atresia in a 20 year old man. Chest radiograph and multidetector computed tomography showed not only pulmonary vein atresia, pulmonary artery hypoplasia, but also cystic lung changes on thin section CT, along with septal and bronchovascular bundle thickening, and ground-glass opacity. Unilateral pulmonary vein atresia could be another disease which can show cystic lung changes on thin section chest CT.

  7. The role of the second heart field in pulmonary vein development : new insights in the origin of clinical abnormalities

    NARCIS (Netherlands)

    Douglas, Yvonne Louise

    2010-01-01

    In this thesis we describe normal and abnormal pulmonary vein development in human and mouse hearts, and focus on the histo(patho)logy of the pulmonary venous and left atrial dorsal wall, in order to elucidate the role of the posterior heart field in the formation and differentiation of the pulmonar

  8. Achieving Bidirectional Long Delays In Pulmonary Vein Antral Lines Prior To Bidirectional Block In Patients With Paroxysmal Atrial Fibrillation (The Bi-Bi Technique For Atrial Fibrillation Ablation)

    OpenAIRE

    Mina MD FACC, FHRS, Adel F; L Warnecke, PA-C, Nicholas

    2016-01-01

    Background: Pulmonary Vein Antral isolation (PVAI) is currently the standard of care for both paroxysmal and persistent atrial fibrillation ablation. Reconnection to the pulmonary vein is the most common cause of recurrence of atrial fibrillation. Achieving the endpoint of bidirectional block (BDB) for cavotricuspid isthmus dependant flutter has improved our outcomes for atrial flutter ablation. With this we tried to achieve long delays in the pulmonary veins antral lines prior to complete is...

  9. Rare case of coronary to pulmonary vein fistula with coronary steal phenomenon

    Institute of Scientific and Technical Information of China (English)

    Emad; A; Barsoum; Faisal; B; Saiful; Deepak; Asti; Rewais; Morcus; Georges; Khoueiry; James; Lafferty; Donald; A; McCord

    2014-01-01

    Coronary artery fistulas are abnormal connections between coronary artery territories and cardiac chambers or major vessels,most of them are congenital.Patients with coronary artery fistula can be asymptomatic or present with different symptoms like angina.Cardiac computed tomography(CT)is one of the best modalities for diagnosis.We present an elderly patient that presented with angina symptoms,non invasive stress test was positive for ischemic heart disease,coronary angiogram could not reveal any obstructive lesions,but an abnormal branch of the left descending coronary artery(LAD),cardiac CT showed fistula that connect left anterior descending coronary artery to left superior pulmonary vein.Our case is extremely rare as most of the reported cases were fistulas between LAD and pulmonary artery,but in our case the fistula between LAD and left superior pulmonary vein.In addition,our patients’symptoms resolved with anti-ischemic medical treatment without any surgical intervention.

  10. Acute fatal pulmonary vein occlusion after catheter ablation of atrial fibrillation

    DEFF Research Database (Denmark)

    Nilsson, Brian; Chen, Xu; Pehrson, Steen

    2004-01-01

    . The patient was first diagnosed as having pneumonia but five days later transesophageal echocardiography and pulmonal angiography revealed total occlusion of the left superior and inferior PVs. When we received the patient he underwent open-heart surgery, which showed thrombi in the orifices of the left sided...... PVs protruding into the left atrium. In each of the left sided PVs severe stenosis was seen in the bifurcation area. Thrombus material was removed followed by placement of two stents in each of the left sided pulmonary veins at the first bifurcations. However, the patient died 14 days after...

  11. The incidence of deep vein thrombosis and pulmonary embolism with the elective use of external fixators

    OpenAIRE

    Roberts, David J. S.; Panagiotidou, Anna; Sewell, Matthew; Calder, Peter; Goodier, David

    2015-01-01

    Little evidence exists about the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) with the use of external fixators. We investigated this in a cohort of 207 consecutive patients undergoing 258 elective frame applications by case note review. Case notes were obtained for 84 % of the sample population. The type of surgery, demographic data, thromboembolic risk factors and the incidence of DVT/PE were recorded. One patient experienced DVT (0.39 %) and one a PE (0.39 %). Both w...

  12. Down Syndrome with Complete Atrioventricular Septal Defect, Hypertrophic Cardiomyopathy, and Pulmonary Vein Stenosis.

    Science.gov (United States)

    Mahadevaiah, Guruprasad; Gupta, Manoj; Ashwath, Ravi

    2015-10-01

    The prevalence of congenital heart disease in infants with Down syndrome is 40%, compared with 0.3% in children who have normal chromosomes. Atrioventricular and ventricular septal defects are often associated with chromosomal aberrations, such as in trisomy 21, whereas hypertrophic cardiomyopathy is chiefly thought to be secondary to specific gene mutations. We found only one reported case of congenital hypertrophic cardiomyopathy and atrioventricular septal defect in an infant with Down syndrome. Here, we report atrioventricular septal defect, hypertrophic cardiomyopathy, and pulmonary vein stenosis in a neonate with Down syndrome-an apparently unique combination. In addition, we discuss the relevant medical literature.

  13. Deep vein thrombosis and pulmonary embolus associated with a ruptured popliteal aneurysm – a cautionary note

    Directory of Open Access Journals (Sweden)

    Lewis Mike H

    2007-12-01

    Full Text Available Abstract Popliteal artery aneurysms representing 80% of peripheral artery aneurysms rarely rupture (a reported incidence of 0.1–2.8 % and second commonest in frequency after aorto-iliac aneurysms. They usually present with pain, swelling, occlusion or distal embolisation and can cause diagnostic difficulties. We report a 78 year old man who was previously admitted to hospital with a pulmonary embolus secondary to deep venous thrombosis. He was heparinized then warfarinised and was readmitted with a ruptured popliteal aneurysm leading to a large pseudo aneurysm formation. The pulmonary embolus had been due to popliteal vein thrombosis and propagation of the clot. A thorough review of literature identified only one previously reported case of ruptured popliteal artery aneurysm and subsequent large pseudo aneurysm formation. We feel it is important to exclude a popliteal aneurysm in a patient with DVT. This may be more common than the published literature suggests.

  14. A three-pulmonary vein isolation approach to treat paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Lexin WANG; Jing ZHOU

    2004-01-01

    Objective To investigate the safety and efficacy of a 3-pulmonary vein (PV) isolation approach in treating paroxysmal atrial fibrillation (AF). Methods Radiofrequency catheter ablation was used to eliminate PV potential in 11 patterns with frequent paroxysmal AF refractory to anti-arrhythmic agents. During sinus rhythm, PV potential was mapped in the left and right superior PVs and left inferior PV. The procedural success was defined as the elimination of PV potential in the 3 PVs. Restults PV potential was identified and abolished in a total of 24 PVs, mostly in the left and right superior PV. There was no pulmonary stenosis or other complications during or after the procedures. AF recurred in one patient after an average of 12 ± 3 month follow-up. Conclusions PV potemials were present mostly in the left or right superior PV. The 3-PVs isolation approach is safe and effective in preventing drug-resistant paroxysmal AF.

  15. Development of the pulmonary vein and the systemic venous sinus: an interactive 3D overview.

    Directory of Open Access Journals (Sweden)

    Gert van den Berg

    Full Text Available Knowledge of the normal formation of the heart is crucial for the understanding of cardiac pathologies and congenital malformations. The understanding of early cardiac development, however, is complicated because it is inseparably associated with other developmental processes such as embryonic folding, formation of the coelomic cavity, and vascular development. Because of this, it is necessary to integrate morphological and experimental analyses. Morphological insights, however, are limited by the difficulty in communication of complex 3D-processes. Most controversies, in consequence, result from differences in interpretation, rather than observation. An example of such a continuing debate is the development of the pulmonary vein and the systemic venous sinus, or "sinus venosus". To facilitate understanding, we present a 3D study of the developing venous pole in the chicken embryo, showing our results in a novel interactive fashion, which permits the reader to form an independent opinion. We clarify how the pulmonary vein separates from a greater vascular plexus within the splanchnic mesoderm. The systemic venous sinus, in contrast, develops at the junction between the splanchnic and somatic mesoderm. We discuss our model with respect to normal formation of the heart, congenital cardiac malformations, and the phylogeny of the venous tributaries.

  16. Left ventricular hypertrophy are associated with increased ostial pulmonary vein diameter

    Directory of Open Access Journals (Sweden)

    Yoga Yuniadi

    2006-09-01

    Full Text Available Atrial fibrillation (AF, which is called as a global epidemic disease, frequently found in hypertensive patients with left ventricular hypertrophy (LVH. Pulmonary vein (PV, which is known to have an important role in AF initiation and maintenance, increases in its diameter during AF. We sought to investigate PVs diameter changes in LVH with sinus rhythm. Of 70 hypertensive patients with sinus rhythm, 42 subjects demonstrated LVH. The mean ostial diameter of patient with and without LVH, assessed by doing spiral multisliced CT scan in the axial plane, were as follow: right superior (RSPV of 19.6±2.78 vs 17.8±1.93 (p = 0.003, right inferior (RIPV of 18.4±3.12 vs 16.0±2.19 (p < 0.001, left superior (LSPV of 18.1±2.62 vs 16.0±2.16 (p < 0.001, and left inferior (LIPV of 15.9±1.93 vs 15.4±1.85 mm (p = 0.284, respectively. Even during sinus rhythm, LVH causes PV dilation. This result might give an explanation of frequent AF prevalence in hypertensive patients. (Med J Indones 2006; 15:173-6 Keywords: Pulmonary veins, Left ventricular hypertrophy

  17. Late Gadolinium Enhancement Cardiac Magnetic Resonance Imaging Post-robotic Radiosurgical Pulmonary Vein Isolation (RRPVI): First Case in the World

    Science.gov (United States)

    Azpiri, Jose; De La Peña, Cuauhtémoc; Cardona, Carlos; Hinojosa, Miguel; Zamarripa, Rafael; Assad, Jose

    2016-01-01

    Pulmonary vein isolation using robotic radiosurgery system CyberKnife is a new non-invasive treatment of atrial fibrillation, currently in clinical phase. Robotic radiosurgical pulmonary vein isolation (RRPVI) uses stereotactic, non-invasive (painless) pinpoint radiation energy delivery to a small, precise area to accomplish ablation. The purpose of this report is to describe the finding of an increase in the enhancement of the left atrium demonstrated with the use of cardiac magnetic resonance imaging using late gadolinium enhancement (LGE-CMR) as a result of RRPVI in the first case in the world in humans using CyberKnife as a treatment for paroxysmal atrial fibrillation (PAF). PMID:27660737

  18. Recurrence of alveolar capillary dysplasia with misalignment of pulmonary veins in two consecutive siblings

    Directory of Open Access Journals (Sweden)

    Gabriel Nuncio Benevides

    2015-03-01

    Full Text Available Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV is a rare, developmental lung disorder, which has been increasingly reported. This entity usually presents as neonatal persistent pulmonary hypertension that is unresponsive to treatment, and is known to be uniformly fatal. Recent discoveries in the genetic field, and intensive treatments, may change the natural course of this disease, permitting easier diagnosis and giving new hope for the dismal prognosis. The authors present two cases of siblings, with two years of difference, from different fathers - one of them was a first-degree and the other a second-degree cousin of the mother. Both patients were full-term babies born apparently without malformations and were sent to the nursery. Both siblings near 35 hours of age presented severe respiratory failure due to pulmonary hypertension. The outcome was fatal in both cases and at autopsy ACD/MPV was diagnosed. The authors call attention to this entity in the differential diagnosis of acute respiratory distress in early life.

  19. Pulmonary vein isolation during cryoballoon ablation using the novel Achieve inner lumen mapping catheter: a feasibility study.

    NARCIS (Netherlands)

    Chierchia, G.B.; Asmundis, C. de; Namdar, M.; Westra, S.W.; Kuniss, M.; Sarkozy, A.; Bayrak, F.; Ricciardi, D.; Casado-Arroyo, R.; Rodriguez Manero, M.; Rao, J.Y.; Smeets, J.; Brugada, P.

    2012-01-01

    AIMS: Cryoballoon (CB) ablation has proven very effective in achieving pulmonary vein isolation (PVI). The Achieve catheter (AC) is a novel inner lumen catheter designed to be used in conjunction with the CB, which serves the double purpose of a guidewire and a mapping catheter. We aimed to evaluate

  20. Surgical vs. transcatheter pulmonary vein isolation as first invasive treatment in patients with atrial fibrillation : a matched group comparison

    NARCIS (Netherlands)

    De Maat, Gijs E.; Van Gelder, Isabelle C.; Rienstra, Michiel; Quast, Anne-Floor B. E.; Tan, Eng S.; Wiesfeld, Ans C. P.; Pozzoli, Alberto; Mariani, Massimo A.

    2014-01-01

    AIMS: Pulmonary vein isolation (PVI) can be considered for treatment of symptomatic atrial fibrillation (AF). Nowadays, in addition to transcatheter ablation, thoracoscopic surgical PVI is available. The aim of this study is to compare clinical outcome of surgical with transcatheter PVI as first inv

  1. Paradoxical embolism, deep vein thrombosis, pulmonary embolism in a patient with patent foramen ovale: a case report

    Directory of Open Access Journals (Sweden)

    Guo Shan

    2007-09-01

    Full Text Available Abstract Introduction Coexistence of pulmonary embolism and systemic arterial embolism suggest the diagnosis of paradoxical embolism which suggests the presence of intracardiac defects such as patent foramen ovale (PFO. Case presentation A 42 year old man was found to have a paradoxical embolism in the systemic arterial circulation, in the setting of pulmonary embolism and deep vein thrombosis (DVT in the lower extremities. Conclusion Paradoxical embolism and intracardiac shunt should be immediately considered in a patient with pulmonary embolism and systemic arterial embolism. Diagnostic modalities included arteriogram and saline contrast echocardiography. Closure of intracardiac shunt is needed for patients who are at risk for recurrent embolic events.

  2. Bilateral Morgagni hernia: operative discovery of appendix lying on superior pulmonary vein.

    Science.gov (United States)

    Lammy, S; Stewart, M; Carnochan, F M; Walker, W S

    2013-08-01

    A patient presented having an acute abdomen on a background of a twelve-month history of worsening asthma. Computed tomography showed giant bilateral intrathoracic hernias extending to both thoracic apices. Our case was unusual as the defect was bilateral and left-sided. Surgical repair revealed each hernia sac measuring >20 cm and to contain the entirety of the small bowel and colon (including retroperitoneal bowel). The appendix was discovered adjacent to right superior pulmonary vein. Both sacs were excised and the defects dissected and transfixed in a single stage operation. In the post-operative stage, he developed a 6.3 cm fluid collection anterior to the right atrium and a left-sided pleural effusion. Morgagni hernias can escape detection and be attributed to other diagnoses courtesy of false localising signs on clinical examination and symptoms in the history.

  3. Geometric analysis on the unidirectionality of the pulmonary veins for atrial reentry

    CERN Document Server

    Chun, Sehun

    2013-01-01

    It is widely believed that the pulmonary veins (PVs) of the atrium play the central role in the generation of atrial reentry leading to atrial fibrillation, but its mechanism has not been analytically explained. In order to improve the current clinical procedures for atrial reentry by understanding its mechanism, geometrical analysis is proposed on the conditions of conduction failure at the PVs and is validated by various computational modeling. To achieve this, a new analytic approach is proposed by adapting the geometric relative acceleration analysis from spacetime physics on the hypothesis that a large relative acceleration can translate to a dramatic increase in the curvature of the wavefront and subsequently to conduction failure. This analytic method is applied to a simplified model of the PV to reveal the strong dependency of the propagational direction and the magnitude of anisotropy for conduction failure. The unidirectionality of the PVs follows directly and is validated by computational tests in ...

  4. Nerves projecting from the intrinsic cardiac ganglia of the pulmonary veins modulate sinoatrial node pacemaker function

    Science.gov (United States)

    Zarzoso, Manuel; Rysevaite, Kristina; Milstein, Michelle L.; Calvo, Conrado J.; Kean, Adam C.; Atienza, Felipe; Pauza, Dainius H.; Jalife, José; Noujaim, Sami F.

    2013-01-01

    Aims Pulmonary vein ganglia (PVG) are targets for atrial fibrillation ablation. However, the functional relevance of PVG to the normal heart rhythm remains unclear. Our aim was to investigate whether PVG can modulate sinoatrial node (SAN) function. Methods and results Forty-nine C57BL and seven Connexin40+/EGFP mice were studied. We used tyrosine-hydroxylase (TH) and choline-acetyltransferase immunofluorescence labelling to characterize adrenergic and cholinergic neural elements. PVG projected postganglionic nerves to the SAN, which entered the SAN as an extensive, mesh-like neural network. PVG neurones were adrenergic, cholinergic, and biphenotypic. Histochemical characterization of two human embryonic hearts showed similarities between mouse and human neuroanatomy: direct neural communications between PVG and SAN. In Langendorff perfused mouse hearts, PVG were stimulated using 200–2000 ms trains of pulses (300 μs, 400 µA, 200 Hz). PVG stimulation caused an initial heart rate (HR) slowing (36 ± 9%) followed by acceleration. PVG stimulation in the presence of propranolol caused HR slowing (43 ± 13%) that was sustained over 20 beats. PVG stimulation with atropine progressively increased HR. Time-course effects were enhanced with 1000 and 2000 ms trains (P < 0.05 vs. 200 ms). In optical mapping, PVG stimulation shifted the origin of SAN discharges. In five paroxysmal AF patients undergoing pulmonary vein ablation, application of radiofrequency energy to the PVG area during sinus rhythm produced a decrease in HR similar to that observed in isolated mouse hearts. Conclusion PVG have functional and anatomical biphenotypic characteristics. They can have significant effects on the electrophysiological control of the SAN. PMID:23559611

  5. Deep venous thrombosis and pulmonary embolism caused by an intravascular synovial sarcoma of the common femoral vein.

    Science.gov (United States)

    Schoneveld, J M; Debing, E; Verfaillie, G; Geers, C; Van den Brande, P

    2012-11-01

    Malignant tumors arising in deep veins of the lower extremities are very uncommon. To our best knowledge, this is the seventh case of a primary venous intravascular synovial sarcoma (SS) reported in literature. A 32-year-old woman was admitted with a second episode of deep venous thrombosis of the right lower limb and pulmonary embolism. Physical and radiological examinations showed besides the thrombosis a tumor arising from the right common femoral vein involving the bifurcation of the common femoral artery. At surgery, en block resection of the tumor including the deep femoral vein and arterial bifurcation was done with an arterial reconstruction using a synthetic graft. Histopathological examination revealed an intravascular SS of the common femoral vein. The mainstay of curative therapy is complete surgical resection of all tumor manifestations with negative histological margins.

  6. Impact of right upper pulmonary vein isolation on atrial vagal innervation and vulnerability to atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    LIU Yuan; ZHANG Shu-long; DONG Ying-xue; ZHAO Hong-wei; GAO Lian-jun; YIN Xiao-meng; LI Shi-jun; LIN Zhi-hu; YANG Yan-zong

    2006-01-01

    Background Based on the hypothesis that pulmonary vein isolation could result in the damage of the epicardial fat pads, this study aimed to investigated the impact of right upper pulmonary vein (RUPV) isolation on vagal innervation to atria.Methods Bilateral cervical sympathovagal trunks were decentralized in 6 dogs. Metoprolol was given to block sympathetic effects. Multipolar catheters were placed into the right atrium (RA) and coronary sinus (CS). RUPV isolation was performed via transseptal procedure. Atrial effective refractory period (ERP), vulnerability window (VW) of atrial fibrillation (AF), and sinus rhythm cycle length (SCL) were measured at RA and distal coronary sinus (CSd) at baseline and vagal stimulation before and after RUPV isolation. Serial sections of underlying tissues before and after ablation were stained with haematoxylin and eosin.Results SCL decreased significantly during vagal stimulation before RUPV isolation (197 ± 21 vs 13 ±32 beats per minute, P<0.001), but remained unchanged after RUPV isolation (162±29 vs 140±39 beats per minute,P>0.05). ERP increased significantly before RUPV isolation compared with that during vagal stimulation [(85.00±24.29) ms vs (21.67±9.83) ms at RA, P<0.001; (90.00± 15.49) ms vs (33.33±25.03) ms at CSd P<0.005],but ERP at baseline hardly changed after RUPV isolation compared with that during vagal stimulation [(103.33 ±22.50) vs (95.00± 16.43) ms at RA, P = 0.09; (98.33±24.83) vs (75.00±29.50) ms at CSd, P=0.009]. The ERP shortening during vagal stimulation after RUPV isolation decreased significantly [(63.33 ± 22.51) ms vs (8.33 ±9.83) ms at RA, P<0.005; (56.67±20.66) ms vs (23.33± 13.66) ms at CSd, P<0.05]. AF was rarely induced at baseline before and after RUPV isolation (VW close to 0), while VW of AF to vagal stimulation significantly decreased after RUPV isolation [(40.00± 10.95) vs 0 ms at RA, P<0.001; (45.00±32.09) vs (15.00±23.45) ms at CS, P <0.05]. The

  7. Isolamento das veias pulmonares em pacientes com fibrilação atrial permanente secundária a valvopatia mitral Isolation of the pulmonary veins in patients with permanent atrial fibrillation secondary to mitral valve disease

    Directory of Open Access Journals (Sweden)

    Gustavo G. Lima

    2004-04-01

    Full Text Available OBJETIVO: Analisar a eficácia do isolamento cirúrgico das veias pulmonares para restabelecer ritmo sinusal em pacientes com fibrilação atrial secundária à doença mitral. MÉTODOS: 33 pacientes com indicação de correção cirúrgica da valva mitral e com fibrilação atrial permanente, foram submetidos ao isolamento cirúrgico das veias pulmonares, sendo 67% mulheres. Média de idade de 56,3±10 anos, classe funcional NYHA pré-operatória de 3,2±0,6, tamanho de átrio esquerdo de 5,5± 0,9 cm, fração de ejeção de 61,3±13%. A técnica cirúrgica consistiu de incisão circunferencial ao redor das 4 veias pulmonares, excisão do apêndice atrial esquerdo e de incisão perpendicular desde a borda inferior da incisão, isolando as veias pulmonares, até o ânulo da valva mitral. Arritmias precoces foram tratadas, agressivamente, com cardioversão. RESULTADOS: O seguimento médio foi de 23,9±17 meses e ocorreram 3 óbitos no pós-operatório. Dez pacientes necessitaram de cardioversão elétrica no pós-operatório; 87% apresentavam ritmo sinusal na última consulta e 33% estavam em uso de amiodarona. CONCLUSÃO: Isolamento das veias pulmonares associado à cirurgia da valva mitral é uma técnica efetiva e segura na manutenção de ritmo sinusal em pacientes com fribilação atrial permanente.OBJECTIVE: To assess the efficacy of surgical isolation of the pulmonary veins for re-establishing sinus rhythm in patients with atrial fibrillation secondary to mitral valve disease. METHODS: Thirty-three (67% were women patients with permanent atrial fibrillation and indication for surgical correction of the mitral valve underwent surgical isolation of the pulmonary veins. Their mean age was 56.3±10 years, preoperative NYHA functional class was 3.2±0.6, left atrial size was 5.5±0.9 cm, and ejection fraction was 61.3±13%. The surgical technique consisted of a circumferential incision surrounding the 4 pulmonary veins, excision of the left

  8. Biophysical and molecular comparison of sodium current in cells isolated from canine atria and pulmonary vein.

    Science.gov (United States)

    Barajas-Martinez, Hector; Goodrow, Robert J; Hu, Dan; Patel, Payal; Desai, Mayurika; Panama, Brian K; Treat, Jacqueline A; Aistrup, Gary L; Cordeiro, Jonathan M

    2017-02-27

    The collar of the pulmonary vein (PV) is the focal point for the initiation of atrial arrhythmias, but the mechanisms underlying how PV cells differ from neighboring left atrial tissue are unclear. We examined the biophysical and molecular properties of INa in cells isolated from the canine pulmonary sleeve and compared the properties to left atrial tissue. PV and left atrial myocytes were isolated and patch clamp techniques were used to record INa. Action potential recordings from either tissue type were made using high-resistance electrodes. mRNA was determined using quantitative RT-PCR and proteins were determined by Western blot. Analysis of the action potential characteristics showed that PV tissue had a lower Vmax compared with left atrial tissue. Fast INa showed that current density was slightly lower in PV cells compared with LA cells (-96 ± 18.7 pA/pF vs. -120 ± 6.7 pA/pF, respectively, p < 0.05). The recovery from inactivation of INa in PV cells was slightly slower but no marked difference in steady-state inactivation was noted. Analysis of late INa during a 225-ms pulse showed that late INa was significantly smaller in PV cells compared to LA cells at all measured time points into the pulse. These results suggest PV cells have lower density of both peak and late INa. Molecular analysis of Nav1.5 and the four beta subunits showed lower levels of Nav1.5 as well as Navβ1 subunits, confirming the biophysical findings. These data show that a lower density of INa may lead to depression of excitability and predispose the PV collar to re-entrant circuits under pathophysiological conditions.

  9. A Case of Antiphospholipid Syndrome Refractory to Secondary Anticoagulating Prophylaxis after Deep Vein Thrombosis-Pulmonary Embolism

    OpenAIRE

    Gu, Kang Mo; Shin,Jong Wook; Park, In Won

    2014-01-01

    Antiphospholipid syndrome (APS) is an acquired systemic autoimmune disorder characterized by a combination of clinical criteria, including vascular thrombosis or pregnancy morbidity and elevated antiphospholipid antibody titers. It is one of the causes of deep vein thrombosis and pulmonary embolism that can be critical due to the mortality risk. Overall recurrence of thromboembolism is very low with adequate anticoagulation prophylaxis. The most effective treatment to prevent recurrent thromb...

  10. [Thrombectomy and plication of veins as a method of preventing pulmonary artery thromboembolism at a multidisciplinary surgical hospital].

    Science.gov (United States)

    Galkin, S V; Pashin, N V; Dedyukhin, I G; Aleksandrov, A G; Lebedeva, M V

    2016-01-01

    The authors assessed efficacy and safety of the operation of plication of deep veins of lower extremities, pelvic veins, and the inferior vena cava as a method of preventing fatal pulmonary artery thromboembolism. A total of 48 patients were operated on. Of these, 23 patients belonged to traumatological-and-orthopaedical cohort, 3 to general surgical cohort, 4 to gynaecological, and 18 to vascular cohort (isolated deep vein thrombosis). The length of the floating head of the thrombus varied from 2 to 10 cm. The presence of a floating thrombus in traumatological, surgical and gynaecological patients, regardless of the length of the floating part was an absolute indication for thrombectomy and venous plication. Vascular patients were operated on in accordance with the National Guidelines (with the length of the thrombus floating portion of not less than 4 cm). In all cases, surgical management envisaged direct and indirect thrombectomy. Plication was always performed above the level of venotomy. It was shown that thrombectomy combined with plication of major veins is a reliable and safe method of prophylaxis, being in some cases the only possible method of preventing fatal pulmonary artery thromboembolism. The operation of plication makes it possible not to cancel a scheduled surgical intervention in patients with a detected floating thrombus of major veins. The operation of thrombectomy and plication above the level of the floating head of the thrombus may be considered an operation of choice in the conditions where there is no possibility to use endovascular methods of treatment (implantation of a cava filter, endovascular catheter thrombectomy), as well as in pregnant women. Restoration of the venous lumen occurs at safe terms spontaneously, not requiring repeat surgical intervention. Simultaneous plication of the vein does not complicate the course of the postoperative period of the main surgical intervention. Thrombectomy and plication do not lead to the

  11. Anticoagulant Treatment of Deep Vein Thrombosis and Pulmonary Embolism: The Present State of the Art.

    Science.gov (United States)

    Thaler, Johannes; Pabinger, Ingrid; Ay, Cihan

    2015-01-01

    Venous thromboembolism (VTE), a disease entity comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a frequent and potentially life-threatening event. To date different agents are available for the effective treatment of acute VTE and the prevention of recurrence. For several years, the standard of care was the subcutaneous application of a low molecular weight heparin (LMWH) or fondaparinux, followed by a vitamin K antagonist (VKA). The so-called direct oral anticoagulants (DOAC) were introduced rather recently in clinical practice for the treatment of VTE. DOAC seem to have a favorable risk-benefit profile compared to VKA. Moreover, DOAC significantly simplify VTE treatment because they are administered in fixed doses and no routine monitoring is needed. Patients with objectively diagnosed DVT or PE should receive therapeutic anticoagulation for a minimum of 3 months. Whether a patient ought to receive extended treatment needs to be evaluated on an individual basis, depending mainly on risk factors determined by characteristics of the thrombotic event and patient-related factors. In specific patient groups (e.g., pregnant women, cancer patients, and elderly patients), treatment of VTE is more challenging than that in the general population and additional issues need to be considered in those patients. The aim of this review is to give an overview of the currently available treatment modalities of acute VTE and secondary prophylaxis. In particular, specific aspects regarding the initiation of VTE treatment, duration of anticoagulation, and specific patient groups will be discussed.

  12. Treatment of deep vein thrombosis and pulmonary embolism: The present state of the art

    Directory of Open Access Journals (Sweden)

    Johannes eThaler

    2015-07-01

    Full Text Available AbstractVenous thromboembolism (VTE, a disease entity comprising deep vein thrombosis (DVT and pulmonary embolism (PE, is a frequent and potentially life-threatening event. To date different agents are available for the effective treatment of acute VTE and the prevention of recurrence. For several years the standard of care was the subcutaneous application of a low molecular weight heparin (LMWH or fondaparinux, followed by a vitamin K antagonist (VKA. The so-called direct oral anticoagulants (DOACs were introduced rather recently in clinical practice for the treatment of VTE. DOACs seem to have a favourable risk-benefit profile compared to VKAs. Moreover, DOACs significantly simplify VTE treatment, because they are administered in fixed doses and no routine monitoring is needed.Patients with objectively diagnosed DVT or PE should receive therapeutic anticoagulation for a minimum of 3 months. Whether a patient ought to receive extended treatment needs to be evaluated on an individual basis, depending mainly on risk factors determined by characteristics of the thrombotic event and patient-related factors. In specific patients groups (e.g. pregnant women, cancer patients and elderly patients treatment of VTE is more challenging than in the general population and additional issues need to be considered in those patients.The aim of this review is to give an overview of the currently available treatment modalities of acute VTE and secondary prophylaxis. In particular, specific aspects regarding the initiation of VTE treatment, duration of anticoagulation and specific patient groups will be discussed.

  13. Ectopic activity induced by elevated atrial pressure in rabbit pulmonary vein in vitro

    Institute of Scientific and Technical Information of China (English)

    LIU Jie; HUANG Cong-xin; BAO Ming-wei; WANG Teng

    2005-01-01

    @@ Atrial fibrillation (AF) is a common tachyarrhythmia and may cause serious complications, such as stroke. When atrial pressure was elevated, the effect refraction period (ERP) was shortened and the conductivity in atria was slowed and the heterogeneity of different parts of atria was increased. These changes facilitate the occurrence and maintenance of AF. Recent researches demonstrated that pulmonary veins (PVs) are important sources of ectopic beats in the initiation of paroxysmal AF. In patients with drug-resistant chronic AF and structural heart disease, after electrical cardioversion, the PVs are also the dominant trigger in reinitiating AF.1 Yamane et al2 reported that, AF patients were often with dilated PVs if the AF was initiated by focal activity in PVs. Atrial myocardial fibers wrap around the PVs entering the left atrium to form PV myocardial sleeves (PVMSs), and this structure is the origin of focal activity. Little is known about the effects of elevated atrial pressure on PV electrophysiology. In the present study, we found that, spontaneous activity in PVMSs could be induced by elevated atrial pressure and it could affect the atrial rhythm.

  14. MR evaluation of pulmonary vein diameter reduction after radiofrequency catheter ablation of atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Anselme, Frederic; Savoure, Arnaud; Mabru, Mikael; Cribier, Alain [Rouen University Hospital, Department of Cardiology, Rouen (France); Gahide, Gerald [Rouen University Hospital, Department of Radiology and Laboratoire QuantIF, Rouen (France); Gerbaud, Edouard [Rouen University Hospital, Department of Cardiology, Rouen (France); Rouen University Hospital, Department of Radiology and Laboratoire QuantIF, Rouen (France); Dacher, Jean-Nicolas [Rouen University Hospital, Department of Radiology and Laboratoire QuantIF, Rouen (France); University Hospital, Department of Radiology, Rouen, Cedex (France)

    2006-11-15

    Fifty consecutive patients aged 52{+-}12 years suffering from drug refractory atrial fibrillation (AF) underwent baseline and post-ablation MR angiography (MRA) at a mean follow-up of 4{+-}3.5 months. Pulmonary vein (PV) disconnection was performed with a maximum energy delivery of 30 W. MRA allowed a two-plane measurement of each PV ostium. After ablation, no significant stenosis was observed, and only 1/194 (0.5%) and 3/194 (2%) PVs had a diameter reduction of 31-40% in the coronal and axial planes, respectively. There was a significant overall post-procedural PV narrowing of 4.9% in the coronal plane and 6.5% in the axial plane (P=ns between both planes). MRA is an efficient technique that can be used in pre- and postoperative evaluation of AF patients. Using a maximal power delivery limited to 30 W, no significant PV stenosis was observed at mid-term follow-up. Late PV anatomical assessment is needed to confirm these results on long-term follow-up. (orig.)

  15. Optimization of imaging before pulmonary vein isolation by radiofrequency ablation: breath-held ungated versus ECG/breath-gated MRA

    Energy Technology Data Exchange (ETDEWEB)

    Allgayer, C.; Haller, S.; Bremerich, J. [University Hospital Basel, Department of Radiology, Basel (Switzerland); Zellweger, M.J.; Sticherling, C.; Buser, P.T. [University Hospital Basel, Department of Cardiology, Basel (Switzerland); Weber, O. [University Hospital Basel, Department of Medical Physics, Basel (Switzerland)

    2008-12-15

    Isolation of the pulmonary veins has emerged as a new therapy for atrial fibrillation. Pre-procedural magnetic resonance (MR) imaging enhances safety and efficacy; moreover, it reduces radiation exposure of the patients and interventional team. The purpose of this study was to optimize the MR protocol with respect to image quality and acquisition time. In 31 patients (23-73 years), the anatomy of the pulmonary veins, left atrium and oesophagus was assessed on a 1.5-Tesla scanner with four different sequences: (1) ungated two-dimensional true fast imaging with steady precession (2D-TrueFISP), (2) ECG/breath-gated 3D-TrueFISP, (3) ungated breath-held contrast-enhanced three-dimensional turbo fast low-angle shot (CE-3D-tFLASH), and (4) ECG/breath-gated CE-3D-TrueFISP. Image quality was scored from 1 (structure not visible) to 5 (excellent visibility), and the acquisition time was monitored. The pulmonary veins and left atrium were best visualized with CE-3D-tFLASH (scores 4.50 {+-} 0.52 and 4.59 {+-} 0.43) and ECG/breath-gated CE-3D-TrueFISP (4.47 {+-} 0.49 and 4.63 {+-} 0.39). Conspicuity of the oesophagus was optimal with CE-3D-TrueFISP and 2D-TrueFISP (4.59 {+-} 0.35 and 4.19 {+-} 0.46) but poor with CE-3D-tFLASH (1.03 {+-} 0.13) (p < 0.05). Acquisition times were shorter for 2D-TrueFISP (44 {+-} 1 s) and CE-3D-tFLASH (345 {+-} 113 s) compared with ECG/breath-gated 3D-TrueFISP (634 {+-} 197 s) and ECG/breath-gated CE-3D-TrueFISP (636 {+-} 230 s) (p < 0.05). In conclusion, an MR imaging protocol comprising CE-3D-tFLASH and 2D-TrueFISP allows assessment of the pulmonary veins, left atrium and oesophagus in less than 7 min and can be recommended for pre-procedural imaging before electric isolation of pulmonary veins. (orig.)

  16. Successful thoracoscopic lobectomy for lung cancer in a patient with anatomic variation of the left inferior pulmonary vein

    Directory of Open Access Journals (Sweden)

    Nakano,Hideharu

    2007-04-01

    Full Text Available We present a case of primary lung cancer with a rare distribution pattern of left inferior pulmonary vein (PV, encountered in the thoracoscopic left lower lobectomy. Thoracoscopic observation revealed 2 trunks of inferior PV (ventral and dorsal branch at the stem level. The ventral trunk consisted of a branch of vein (V(5 from the lingular segment and venous ramifications (V(8a, V(9 and V(10a from the basal segment. On the other hand, a branch of vein (V(6 from the superior segment in the lower lobe and other veins (V(8b and V(10b + c from the basal segment emptied together into the dorsal trunk. We successfully carried out a thoracoscopic left lower lobectomy without excision of the aberrant vein (V(5. Retrospective review of the preoperative chest CT demonstrates the double trunk inferior PV and the aberrant lingular branch emptying with V(8a into the ventral trunk. Knowledge of the branching variations of PV from preoperative evaluations leads to appropriate thoracoscopic procedures for lung cancer.

  17. CLINICAL APPLICATION OF 99mTc MAA PULMONARY SCINTISCAN IN DEEP VEIN THROMBOSIS AND RHEUMATIC HEART DISEASE

    Institute of Scientific and Technical Information of China (English)

    陈万春; 曾昭瑞; 金立仁; 包玉倩

    1992-01-01

    We studied 21 cases of pulmonary thromboembolism (PTE) in 67 consecutive cases of deep vein thrombosis (DVT) of the lower limbs and 4 cases in 9 selective cases of rheumatic heart disease (RHD). The incidence of PTE in DVT could be inferred as being 31.3%. PTE were diagnosed by 99mTc MAA lung scintiscans. In the DVT cases, lung scintiscan were done right after venography of the legs. Six cases underwent pulmonary angiography, ⅠDSA. As PTE in the DVT cases were all subclinical, only oligemia andvascular "pruning" were noted. Injection of urokinase into the pulmonary artery concerned through a catheter after which intravenous infusion was continued for 10-14 days, only 3 PTE resolved, probably representing early cases.

  18. An Independent Risk of Gout on the Development of Deep Vein Thrombosis and Pulmonary Embolism

    Science.gov (United States)

    Huang, Chien-Chung; Huang, Po-Hao; Chen, Jiunn-Horng; Lan, Joung-Liang; Tsay, Gregory J.; Lin, Hsiao-Yi; Tseng, Chun-Hung; Lin, Cheng-Li; Hsu, Chung-Yi

    2015-01-01

    Abstract Previous studies indicated that gout is a risk factor of cardiovascular diseases. This study aimed to determine if patients with gout have an increased risk of deep vein thrombosis (DVT) or pulmonary embolism (PE). We used the Longitudinal Health Insurance Database, a subset of the national insurance claim dataset, which enrolled 1 million Taiwanese to identify 57,981 patients with gout and 115,961 reference subjects matched by sex, age, and entry date of diagnosis. The risk of DVT and PE was analyzed using the Cox proportional hazards model. In this Taiwanese dataset observed from 2000 to 2010, we found the incidence of DVT was 5.26 per 104 person-years in the gout cohort, which was twofold higher than the incidence of 2.63 per 104 person-years in the reference cohort. After adjusting for age, sex, and 9 comorbidities, the hazard ratio (HR) of developing DVT was 1.66 (95% confidence interval [CI] = 1.37–2.01). Among patients with gout, the youngest age group had the highest increase in the risk of developing DVT (HR [95% CI] = 2.04 [1.24–3.37] for ages 20 to 49 years, 1.80 [1.28–2.51] for ages 50 to 64 years, and 1.45 [1.11–1.91] for ages ≥65 years). The incidence of PE was about one-fifth that of DVT in gout patients, but the effect of gout on the risk was similar (HR [95% CI] = 1.53 [1.01–2.29]). Our analysis confirmed that gout increased the risk of DVT and PE. Further exploration is needed in the future. PMID:26705202

  19. Impact of pulmonary vein isolation on atrial vagal activity and atrial electrical remodeling

    Institute of Scientific and Technical Information of China (English)

    Yingxue Dong; Shulong Zhang; Lianjun Gao; Hongwei Zhao; Donghui Yang; Yunlong Xia; Yanzong Yang

    2008-01-01

    Objective Mechanisms of pulmonary vein isolation (PVI) for atrial fibrillation remain controversy.This study aimed to investigate the impact of PVI on vagal modulation to atria.Methods Eighteen adult mongrel dogs under general anesthesia were randomly divided into two groups.Bilateral cervical sympathovagal trunks were decentralized and sympathetic effects was blocked by metoprolol administration.Atrial electrical remodeling (AER) was established by rapid right atrial pacing at the rate of 600 bpm for 30 minutes.PVI was performed in group A.Atrial effective refractory period (ERP),vulnerability window (VW) of atrial fibrillation,and sinus rhythm cycle length (SCL) were measured at baseline and during vagal stimulation before and after atrial rapid pacing with and without PVI at fight atrial appendage (RAA),left atrial appendage (LAA),distal coronary sinus (CSd) and proximal coronary sinus (CSp).Results (1) Effects of PVI on vagal modulation:Shortening of SCL during vagal stimulation decreased significantly after PVI compared with that before PVI in group A (P<0.001).Shortening of ERP during vagal stimulation decreaseed significantly after PVI compared with that before PVI (P<0.05).VW of atrial fibrillation during vagal stimulation decreased significantly after PVI compared with that before PVI (P<0.05).(2) Effects of PVI on AER:shortening of ERP before and after atrial rapid pacing increased significantly at baseline and vagal stimulation in group B compared with that in group A (P<0.05).VW during vagal stimulation increased significantly after atrial rapid pacing in group B (P<0.05).Conclusion PVI attenuates the vagal modulation to the atria,thereby decreases the susceptibility to atrial fibrillation mediated by vagal activity.PVI releases AER,which maybe contributes to the vagal denervation.Our study indicates that PVI not only can eradicate triggered foci but also modify substrates for AF.(J Geriatr Cardiol 2008;5:28-32)

  20. Estenosis de venas pulmonares post ablación por radiofrecuencia Pulmonary vein stenosis after radio frequency ablation

    Directory of Open Access Journals (Sweden)

    Marcelo Guzzi

    2011-06-01

    Full Text Available Es importante estar atento ante la aparición de síntomas respiratorios luego de la realización de un procedimiento de ablación por radiofrecuencia en el tratamiento de la fibrilación auricular, pues la estenosis de venas pulmonares (EVP tiene una incidencia de entre 1 y 3% y puede aparecer hasta en los dos años posteriores al procedimiento1. Presentamos el caso de un paciente de 41 años de sexo masculino, que ingresó por un cuadro de hemoptisis y toracodinia de tres semanas de evolución, con antecedente de ablación por radiofrecuencia 6 meses antes de la admisión. La angiotomografía no evidenció tromboembolismo pulmonar (TEP y la angiorresonancia detectó hipoperfusión deI lóbulo superior del pulmón izquierdo (LSI. Debido a los antecedentes de ablación se solicitó angiotomografía de venas pulmonares, que evidenció estenosis de la vena del LSI. Se realizó estudio hemodinámico con dilatación y colocación de stent.Physicians should be alert to the occurrence of respiratory symptoms after radio frequency ablation for the treatment of atrial fibrillation. Pulmonary veins stenosis could appear with an incidence of between 1and 3% during the two years following the procedure. We present the case of a 41year-old-male patient admitted with a three weeks old hemoptysis and thoracodinia and a prior history of a radiofrecuency ablation procedure performed six months earlier. The angiotomography was not compatible with the diagnosis of pulmonary embolism and the angio-MRI detected hypoperfusion of the left upper pulmonary lobe. Consequently pulmonary veins angiotomography was requested, showing upper pulmonary lobe vein stenosis. An hemodynamic study with vein expansion and stent placement was successfully performed.

  1. Sudden Death by Pulmonary Thromboembolism due to a Large Uterine Leiomyoma with a Parasitic Vein to the Mesentery

    Directory of Open Access Journals (Sweden)

    Varsha Podduturi

    2014-01-01

    Full Text Available The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow’s triad: hypercoagulability, stasis, and damage to the vascular endothelium. Deep vein thrombosis (DVT may lead to pulmonary thromboembolism (PE, and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported. We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE. The association of large pelvic masses with venous thrombosis has clinical implications, since prophylactic surgery could be life-saving.

  2. Two cases of delayed cardiac tamponade due to pericarditis after pulmonary vein (PV) isolation for atrial fibrillation.

    Science.gov (United States)

    Torihashi, Sadayoshi; Shiraishi, Hirokazu; Hamaoka, Tetsuro; Imai, Mikimasa; Kuroyanagi, Akira; Nakanishi, Naohiko; Nakamura, Takeshi; Yamano, Tetsuhiro; Matsumuro, Akiyoshi; Shirayama, Takeshi

    2015-01-01

    Catheter ablation is an established treatment for atrial fibrillation (AF). The incidence of major complications related to the procedure is reported to be 4.5%, and delayed cardiac tamponade (DCT) is a rare, although recently recognized, complication. However, the mechanisms underlying the development of DCT remain unclear. We herein report the cases of two men, both 49 years of age, who developed cardiac tamponade requiring pericardiocentesis a few weeks after undergoing pulmonary vein isolation for persistent AF. Physicians should explain to the patient the potential for DCT as a complication prior to performing catheter ablation and provide careful follow-up for at least a few weeks after the session.

  3. Whole heart cine MR imaging of pulmonary veins in patients with congenital heart disease. Comparison with Spin Echo MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mitsui, Hideaki [Yamagata City Hospital Saiseikan (Japan); Saito, Haruo; Ishibashi, Tadashi; Takahashi, Shoki; Zuguchi, Masayuki; Yamada, Shogo

    2002-01-01

    We evaluated the accuracy of Whole Heart Cine (WHC) magnetic resonance (MR) imaging in the depiction of pulmonary veins (PVs) in patients with congenital heart disease (CHD) compared to that of spin echo (SE) MR imaging. Among our 35 patients, 4 patients had anomalous PV return. Detectability of four PVs on each MR examination images were evaluated. MR imaging is an effective modality for the clarification of PVs, and WHC MR imaging is more useful in delineating PV anomalies than SE MR imaging. (author)

  4. Imaging in congenital pulmonary vein anomalies: the role of computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Dyer, Kevin Todd; McQuiston, Andrew Douglas [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Hlavacek, Anthony Marcus; Pietris, Nicholas Peter [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology Department of Pediatrics, Charleston, SC (United States); Meinel, Felix Gabriel [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Ludwig-Maximilians-University Hospital, Institute for Clinical Radiology, Munich (Germany); De Cecco, Carlo Nicola [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Rome ' ' Sapienza' ' - Polo Pontino, Department of Radiological Sciences Oncology and Pathology, Latina (Italy); Schoepf, Uwe Joseph [Medical University of South Carolina, Division of Cardiology Department of Medicine, Charleston, SC (United States); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology Department of Pediatrics, Charleston, SC (United States)

    2014-09-15

    Pulmonary venous anomalies comprise a wide spectrum of anatomical variations and their clinical presentations may vary from the relatively benign single partial anomalous pulmonary venous connection (PAPVC) to the critical obstructed total anomalous pulmonary venous connection (TAPVC). We briefly review the common anomalies encountered, while highlighting the utility that computed tomographic angiography (CTA) provides for this spectrum of extracardiac vascular malformations and connections. CTA has established itself as an invaluable imaging modality in these patients. A detailed knowledge of the CTA imaging findings in pulmonary venous anomalies is crucial to guide clinical decision-making in these patients. (orig.)

  5. Topographic anatomy of the fetal inferior vena cava, coronary sinus, and pulmonary veins: Variations in Chiari's network.

    Science.gov (United States)

    Naito, Michiko; Yu, Hee Chul; Kim, Ji Hyun; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

    2015-07-01

    To understand anomalies in Chiari's network better, we assessed the topographical anatomy of the fetal inferior vena cava (IVC), coronary sinus, and atria. We examined sagittal serial paraffin sections of 15 human fetuses of crown-rump length 24-36 mm, corresponding to a gestational age of 8 weeks. Although their outflow tract morphologies were similar, these 15 specimens could be classified into two groups. In eight specimens, the left common cardinal vein reached the body wall, whereas in the other seven the vein was obliterated near the left pulmonary vein. Irrespective of the group in which the specimen was included, the anteroposterior arrangement of the coronary sinus, the sinus septum (septum), and the right sinus valve (right valve) could be classified into three types: the right valve-septum-coronary sinus arrangement in seven specimens; the right valve-coronary sinus-septum arrangement in five; and the coronary sinus-right valve-septum arrangement in three. Depending on differences in topographical anatomy, the sinus septum separated the coronary sinus opening from either the right or the left atrium. Likewise, the coronary sinus opening was either adjacent to or distant from the IVC terminal. Rather than the counter-side position of the right valve being at the IVC terminal, the left sinus valve protruded leftward, forming an incomplete interatrial septum. Fetal variations seemed to be closely connected with individual variations and a high frequency of Chiari's network anomalies in adults.

  6. Different risk of deep vein thrombosis and pulmonary embolism in carriers with factor V Leiden compared with non-carriers, but not in other thrombophilic defects. Results from a large retrospective family cohort study

    NARCIS (Netherlands)

    Makelburg, Anja B. U.; Veeger, Nic J. G. M.; Middeldorp, Saskia; Hamulyak, Karly; Prins, Martin H.; Buller, Harry R.; Lijfering, Willem M.

    2010-01-01

    The term factor V Leiden (FVL) paradox is used to describe the different risk of deep vein thrombosis and pulmonary embolism that has been found in carriers of FVL. In a thrombophilic family-cohort, we estimated differences in absolute risks of deep vein thrombosis and pulmonary embolism for various

  7. Venous velocity of the right femoral vein decreases in the right lateral decubitus position compared to the supine position: a cause of postoperative pulmonary embolism?

    Directory of Open Access Journals (Sweden)

    Sato,Shizou

    2007-04-01

    Full Text Available The right lateral decubitus position is a risk factor for postoperative pulmonary embolism. We examined postural changes of femoral vein velocity in order to elucidate the mechanism. Thirty patients scheduled for general thoracic surgery were enrolled in this study. The common femoral veins on both sides were examined by color-duplex ultrasound for venous caliber and velocity when the patients were in the right lateral, left lateral, and supine positions. The maximum diameters of the right femoral vein in the right lateral decubitus position and the left femoral vein in the left decubitus position were significantly larger than those in the other positions. The venous velocity of the right femoral vein in the right lateral decubitus position was significantly smaller than that in the supine position, while the velocity of the left femoral vein in the left lateral decubitus position was not significantly decreased. We speculate that the decreased venous velocity of the right femoral vein in the right lateral decubitus position could result in a deep venous thromboembolism in the right leg, making this position a possible risk factor for postoperative pulmonary embolism.

  8. A patient who experienced thyroid storm complicated by rhabdomyolysis, deep vein thrombosis, and a silent pulmonary embolism: a case report

    Science.gov (United States)

    2013-01-01

    Background Thyroid storm is a serious condition of thyrotoxicosis. Hyperthyroidism often presents with thrombotic events, especially at cerebral sites; however, the possible association between a lower extremity deep vein thrombosis (LEDVT) and thyroid storm has not been previously reported. We encountered a patient who developed thyroid storm, associated with rhabdomyolysis, followed by LEDVT and a small silent pulmonary embolism (PE). The case is discussed with references to the pertinent literature. Case presentation A 50-year-old woman with no past medical history was referred to our hospital because of severe diarrhea, muscle weakness in her lower limbs (manual muscle testing: MMT 3), and disturbances of consciousness. She was diagnosed as having Graves’ disease based on the presence of struma, exophthalmos, and hyperthyroidism with TSH receptor antibody positivity; we further determined that the patient was experiencing thyroid storm based on the results of the Burch-Wartofsky scoring system and a Japanese diagnostic criteria. Treatment with steroids, iodine potassium, methimazole, and propranolol was initiated. Severe watery diarrhea continued, and the laboratory data revealed hypokalemia (2.0 meq/L). On day 14, a blood analysis showed a sudden elevation in her creatinine kinase (CK) level, leading to a diagnosis of rhabdomyolysis. Thereafter, the muscle weakness in her lower limbs advanced to a degree of MMT 1. Seven days after the diagnosis of rhabdomyolysis, pitting edema began to appear in bilateral lower extremities. Contrast-enhanced CT scans revealed a LEDVT involving the left common iliac vein, bilateral femoral veins, and left popliteal vein. Furthermore, a small PE was identified. Hyperthyroidism often presents with thrombotic events, especially at cerebral sites, but few reports of PE or LEDVT have been made. Conclusion This case suggests that the occurrence of thyroid storm may be associated with a risk of LEDVT and/or PE. We suggest that DVT

  9. Pulmonary embolus

    Science.gov (United States)

    ... Blood clot - lung; Embolus; Tumor embolus; Embolism - pulmonary; DVT-pulmonary embolism; Thrombosis - pulmonary embolism ... area). This type of clot is called a deep vein thrombosis (DVT) . The blood clot breaks off and travels ...

  10. Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: A randomized, placebo-controlled, double-blind trial.

    NARCIS (Netherlands)

    Heijer, M. den; Willems, H.P.J.; Blom, H.J.; Gerrits, W.B.J.; Cattaneo, M.; Eichinger, S.; Rosendaal, F.R.; Bos, G.M.

    2007-01-01

    The Vitamins and Thrombosis (VITRO) study investigated the effect of homocysteine lowering by daily supplementation of B vitamins on the risk reduction of deep vein thrombosis (DVT) and pulmonary embolism (PE). Patients between 20 to 80 years old with a first objectively confirmed proximal DVT or PE

  11. Early recurrence of atrial fibrillation as a predictor for 1-year efficacy after successful phased RF pulmonary vein isolation: evaluation of complaints and multiple Holter recordings

    NARCIS (Netherlands)

    Mulder, A.A.W.; Wijffels, M.C.; Wever, E.F.; Boersma, L.V.

    2013-01-01

    BACKGROUND: Early arrhythmia recurrences after pulmonary vein isolation (PVI) for atrial fibrillation (AF) are accepted as part of the blanking period. Their relevance for long-term efficacy is not well-known. We evaluated patients, who came to hospital with a documented recurrence of AF, or had a r

  12. Five-year efficacy of pulmonary vein antrum isolation as a primary ablation strategy for atrial fibrillation : a single-centre cohort study

    NARCIS (Netherlands)

    Teunissen, Cas; Kassenberg, W; van der Heijden, Jeroen F; Hassink, RJ; van Driel, Vincent J H M; Zuithoff, NPA; Doevendans, Pieter A; Loh, KP

    2016-01-01

    AIMS: Pulmonary vein antrum isolation (PVAI) is the cornerstone of atrial fibrillation (AF) ablation. There is an ongoing discussion on whether and when to add substrate modification to PVAI. This study evaluates (1) long-term efficacy of PVAI as a primary ablation strategy in all patients independe

  13. Feasibility and outcome of epicardial pulmonary vein isolation for lone atrial fibrillation using minimal invasive surgery and high intensity focused ultrasound

    NARCIS (Netherlands)

    Klinkenberg, Theo J.; Ahmed, Sheba; Ten Hagen, Anita; Wiesfeld, Ans C. P.; Tan, Eng S.; Zijlstra, Felix; Van Gelder, Isabelle C.

    2009-01-01

    Transvenous pulmonary vein isolation (PVI) is the cornerstone of non-pharmacological rhythm control therapy in symptomatic atrial fibrillation (AF). Success and complications rates are, however, still not optimal. New techniques and energy sources are therefore being developed. Fifteen patients with

  14. Verification of pulmonary vein isolation during single transseptal cryoballoon ablation: a comparison between the classical circular mapping catheter and the inner lumen mapping catheter

    NARCIS (Netherlands)

    Chierchia, G.B.; Namdar, M.; Sarkozy, A.; Sorgente, A.; Asmundis, C. de; Casado-Arroyo, R.; Capulzini, L.; Bayrak, F.; Rodriguez-Manero, M.; Ricciardi, D.; Rao, J.Y.; Overeinder, I.; Paparella, G.; Brugada, P.

    2012-01-01

    AIMS: Cryoballoon ablation has proven very effective in achieving pulmonary vein isolation (PVI). The novel Achieve inner lumen mapping catheter designed to be used in conjunction with the cryoballoon, serves as both a guidewire and a mapping catheter. To our knowledge, this is the first study compa

  15. Multi-level tree analysis of pulmonary artery/vein trees in non-contrast CT images

    Science.gov (United States)

    Gao, Zhiyun; Grout, Randall W.; Hoffman, Eric A.; Saha, Punam K.

    2012-02-01

    Diseases like pulmonary embolism and pulmonary hypertension are associated with vascular dystrophy. Identifying such pulmonary artery/vein (A/V) tree dystrophy in terms of quantitative measures via CT imaging significantly facilitates early detection of disease or a treatment monitoring process. A tree structure, consisting of nodes and connected arcs, linked to the volumetric representation allows multi-level geometric and volumetric analysis of A/V trees. Here, a new theory and method is presented to generate multi-level A/V tree representation of volumetric data and to compute quantitative measures of A/V tree geometry and topology at various tree hierarchies. The new method is primarily designed on arc skeleton computation followed by a tree construction based topologic and geometric analysis of the skeleton. The method starts with a volumetric A/V representation as input and generates its topologic and multi-level volumetric tree representations long with different multi-level morphometric measures. A new recursive merging and pruning algorithms are introduced to detect bad junctions and noisy branches often associated with digital geometric and topologic analysis. Also, a new notion of shortest axial path is introduced to improve the skeletal arc joining two junctions. The accuracy of the multi-level tree analysis algorithm has been evaluated using computer generated phantoms and pulmonary CT images of a pig vessel cast phantom while the reproducibility of method is evaluated using multi-user A/V separation of in vivo contrast-enhanced CT images of a pig lung at different respiratory volumes.

  16. A Sleeve Gastrectomy Complicated by Mesenteric Vein Thrombosis, Abdominal Compartment Syndrome and Pulmonary Emboli: Case Report

    Directory of Open Access Journals (Sweden)

    Erika Leung

    2015-09-01

    Full Text Available Background: Obesity is a growing problem all over the world, including the United States. Single-incision laparoscopic sleeve gastrectomy is a surgery performed for patients who want to lose weight. The number of deaths resulting from thromboembolic complications from bariatric surgeries continues to be of major concern. Case Description: A 38-year-old female was admitted for single incision sleeve gastrectomy and was discharged home three days later. Subsequently she began to have abdominal pain, nausea and vomiting. A CT scan revealed superior mesenteric vein thrombosis with small bowel ischemia, splenic infarction and main and right portal vein branch thrombosis. An exploratory laparotomy demonstrated necrotic bowel due to abdominal compartment syndrome, and an area of small bowel was resected due to internal hernia. Surgical management of the patient during her second hospital stay included a decompressive laparotomy, internal hernia reduction, a small bowel resection. Discussion: Superior mesenteric vein thrombosis can be a life-threatening complication and present with non-specific presentations; thus, it is imperative that it is identified and managed promptly as these cases carry significant morbidity and mortality. Obese patients who undergo bariatric surgery frequently have other co-morbidities; many of which can complicate a case further. Mesenteric vein thromboses are normally treated with unfractionated or low-molecular-weight heparin.

  17. Imaging of pulmonary vein anatomy using low-dose prospective ECG-triggered dual-source computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Blanke, Philipp; Baumann, Tobias; Langer, Mathias; Pache, Gregor [University Hospital Freiburg, Department of Diagnostic Radiology, Freiburg (Germany)

    2010-08-15

    To prospectively investigate the feasibility, image quality and radiation dose estimates for computed tomography angiography (CTA) of the pulmonary veins and left atrium using prospective electrocardiography (ECG)-triggered sequential dual-source (DS) data acquisition at end-systole in patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation. Thirty-five patients (mean age 66.2 {+-} 12.6 years) with paroxysmal atrial fibrillation underwent prospective ECG-triggered sequential DS-CTA with tube current (250 mAs/rotation) centred 250 ms past the R-peak. Tube voltage was adjusted to the BMI (<25 kg/m{sup 2}: 100 kV, >25 kg/m{sup 2}: 120 kV). Presence of motion or stair-step artefacts was assessed. Effective radiation dose was calculated from the dose-length product. All data sets could be integrated into the electroanatomical mapping system. Twenty-two patients (63%) were in sinus rhythm (mean heart rate 69.2 {+-} 11.1 bpm, variability 1.0 {+-} 1.7 bpm) and 13 (37%) showed an ECG pattern of atrial fibrillation (mean heart rate 84.8 {+-} 16.6 bpm, variability 17.9 {+-} 7.5 bpm). Minor step artefacts were observed in three patients (23%) with atrial fibrillation. Mean estimated effective dose was 1.1 {+-} 0.3 and 3.0 {+-} 0.5 mSv for 100 and 120 kV respectively. Imaging of pulmonary vein anatomy is feasible using prospective ECG-triggered sequential data acquisition at end-systole regardless of heart rate or rhythm at the benefit of low radiation dose. (orig.)

  18. Why can pulmonary vein stenoses created by radiofrequency catheter ablation worsen during and after follow-up ? A potential explanation

    Directory of Open Access Journals (Sweden)

    Dorsaz Pierre-André

    2008-05-01

    Full Text Available Abstract Background Radiofrequency catheter ablation of excitation foci inside pulmonary veins (PV generates stenoses that can become quite severe during or after the follow-up period. Since severe PV stenoses have most often disastrous consequences, it would be important to know the underlying mechanism of this temporal evolution. The present study proposes a potential explanation based on mechanical considerations. Methods we have used a mathematical-physical model to examine the cyclic increase in axial wall stress induced in the proximal (= upstream, non-stenosed segment of a stenosed pulmonary vein during the forward flow phases. In a representative example, the value of this increase at peak flow was calculated for diameter stenoses (DS ranging from 1 to 99%. Results The increase becomes appreciable at a DS of roughly 30% and rise then strongly with further increasing DS value. At high DS values (e.g. > 90% the increase is approximately twice the value of the axial stress present in the PV during the zero-flow phase. Conclusion Since abnormal wall stresses are known to induce damages and abnormal biological processes (e.g., endothelium tears, elastic membrane fragmentations, matrix secretion, myofibroblast generation, etc in the vessel wall, it seems plausible that the supplementary axial stress experienced cyclically by the stenotic and the proximal segments of the PV is responsible for the often observed progressive reduction of the vessel lumen after healing of the ablation injury. In the light of this model, the only potentially effective therapy in these cases would be to reduce the DS as strongly as possible. This implies most probably stenting or surgery.

  19. Effect of ivaradine on hyperpolarization activated cation current in canine pulmonary vein sleeve cardiomyocytes with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Yang Li; Yan Huang; Zongbin Li; Hao Wang; Jianguo Song; Yuqi Liu; Lei Gao; Shiwen Wang

    2008-01-01

    Objective To study the effect of ivabradine on hyperpolarization activated cation current in canine pulmonary vein(PY) sleeve cardiomyocytes with atrial fibrillation.Methods Dissociation of PVs yielded single cardiomyocytes from a Landengorff column without or with pacemaker activity from long-term rapidly atrial pacing (RAP) canines.If current was measured with the whole-cell patch-clamp technique.Results Compared with the control group,the rapidly atrial pacing canine PV cardiomyocytes had spontaneous diastolic depolarization and had larger If densities.Ivabradine (Iva,1 μM),a selective inhibitor of the If current,markedly reduced If currents in the RAP from -2.66±0.4 pA/pF to -1.58±0.1 pA/pF at the test potential of-120 mV (P<0.01,n=12).Inhibition effect of Iva of If current showed concentration-dependent range from 0.1 to 10.0μM,with IC50 of 2.2 μ M ( 1.8-2.9 μM,95% CL).Furthermore,V1/ of steady-state activated curve was shifted from -84.3±4.9 mV to -106.9±3.4 mV and k value of steady-state activated curve was changed from 12.1+2.6 mV to 9.9±3.4 mV by the application of.1.0 μM Iva ( P<0.01,n=12).Conclusions Our study revealed that Ivarbadine may significantly decrease If of rapidly atrial pacing pulmonary vein sleeve ceUs with atrial fibdllation.(J Geriatr Cardiol 2008;5:39-42)

  20. Sixteen-row multislice computed tomography in the assessment of pulmonary veins prior to ablative treatment: validation vs conventional pulmonary venography and study of reproducibility

    Energy Technology Data Exchange (ETDEWEB)

    Maksimovic, R.; Cademartiri, F.; Pattynama, P.M.T. [Erasmus Medical Center, Rotterdam (Netherlands). Dept. of Radiology; Scholten, M; Jordaens, L.J. [Erasmus Medical Center, Rotterdam (Netherlands). Dept. of Cardiology

    2004-03-01

    The aim of this study was to validate multislice computed tomography (MSCT) venography measurements of pulmonary vein (PV) diameters vs conventional pulmonary venography (CPV), and to assess the reproducibility of MSCT data. The study included 21 consecutive patients with atrial fibrillation who were planned for cryothermal ablation of PVs. One day before ablation, all patients underwent CPV and contrast-enhanced non-gated MSCT venography. The MSCT was repeated 3 months after ablation. The CPV images of the treated PVs (n=40) were analyzed and compared with the results of MSCT measurements. Reproducibility of MSCT venography-based data was assessed by interobserver (n=84 PVs) and interexamination (n=44 PVs) variability. Pre-treatment PV diameters on MSCT and CPV showed good correlation (r=0.87, p<0.01; 18.9{+-}2.3 mm, 188.5{+-}2.4 mm, respectively). Interobserver agreement and interexamination reproducibility were good (r=0.91, r=0.82, respectively, p<0.01), with narrow limits of agreement (Bland and Altman method). The MSCT venography allows accurate and reproducible assessment of PVs. It can be used both in non-invasive planning of treatment for ablative therapy and in the follow-up of patients.

  1. Rare Anomalous Origin of Superior Left Pulmonary Artery from Left Subclavian Vein

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Tian-shi, E-mail: TerrenceLv@126.com; Wang, Chao, E-mail: wangchaoxs@163.com; Song, Li, E-mail: song9981@163.com; Lv, Yong-xing, E-mail: lyongxing@msn.com; Zou, Ying-hua, E-mail: yinghzou@139.com [Peking University First Hospital, Department of Interventional Radiology and Vascular Surgery (China)

    2013-10-15

    We report for the first time an extremely rare anomalous origin of the superior left pulmonary artery in a 60 year-old man. Although it was occult in clinical indications, such a malformation still ought to be considered, especially during endovascular procedures.

  2. Lung Infarction due to Pulmonary Vein Stenosis after Ablation Therapy for Atrial Fibrillation Misdiagnosed as Organizing Pneumonia: Sequential Changes on CT in Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Mi Ri; Lee, Ho Yun; Cho, Jong Ho; Um, Sang Won [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-08-15

    Pulmonary vein (PV) stenosis is a complication of ablation therapy for arrhythmias. We report two cases with chronic lung parenchymal abnormalities showing no improvement and waxing and waning features, which were initially diagnosed as nonspecific pneumonias, and finally confirmed as PV stenosis. When a patient presents for nonspecific respiratory symptoms without evidence of infection after ablation therapy and image findings show chronic and repetitive parenchymal abnormalities confined in localized portion, the possibility of PV stenosis should be considered.

  3. Five-year efficacy of pulmonary vein antrum isolation as a primary ablation strategy for atrial fibrillation : a single-centre cohort study

    OpenAIRE

    Teunissen, Cas; Kassenberg, W; van der Heijden, Jeroen F.; Hassink, RJ; van Driel, Vincent J H M; Zuithoff, NPA; Pieter A Doevendans; Loh, KP

    2016-01-01

    AIMS: Pulmonary vein antrum isolation (PVAI) is the cornerstone of atrial fibrillation (AF) ablation. There is an ongoing discussion on whether and when to add substrate modification to PVAI. This study evaluates (1) long-term efficacy of PVAI as a primary ablation strategy in all patients independently from AF type and (2) predictors of arrhythmia recurrence. METHODS AND RESULTS: A total of 509 consecutive patients (mean age 57 years, 38.9% non-paroxysmal AF) with AF underwent PVAI. In redo ...

  4. Cerebral air embolism as a complication of computed tomography-guided marking of the lung: depiction of air inflow route from a pulmonary vein to the left atrium.

    Science.gov (United States)

    Higashino, Takanori; Noma, Satoshi; Nishimoto, Yuko; Endo, Junki; Taguchi, Yoshio; Shindo, Toru

    2011-02-01

    Air embolism in the arterial system is a very rare but potentially fatal complication of percutaneous transthoracic needle biopsy or marking. We report a case of a patient with interstitial pneumonia associated with Sjögren syndrome, who presented with systemic arterial air embolism as a complication of computed tomography-guided marking of the lung. The air inflow route was depicted clearly on computed tomography from the peripheral pulmonary vein that crossed the needle pathway to the left atrium.

  5. Fusion of Delayed-enhancement MR Imaging and Contrast-enhanced MR Angiography to Visualize Radiofrequency Ablation Scar on the Pulmonary Vein.

    Science.gov (United States)

    Shigenaga, Yutaka; Kiuchi, Kunihiko; Ikeuchi, Kazushi; Ikeda, Takayuki; Okajima, Katsunori; Yasaka, Yoshinori; Kawai, Hiroya

    2015-01-01

    Delayed-enhancement magnetic resonance imaging (DE-MRI) is reported to detect the radiofrequency (RF) ablation scar of pulmonary vein isolation. However, the precise localization of RF scar is difficult to recognize due to the poor anatomical information of the 3-dimensionally reconstructed DE-MRI. We report 2 cases in which fusion of DE-MRI and contrast-enhanced MR angiography facilitated the identification of RF scar, and we detail our fusion method.

  6. Effects of new antiarrhythmic agent SS-68 on excitation conduction, electrical activity in Purkinje fibers and pulmonary veins: Assessment of safety and side effects risk.

    Science.gov (United States)

    Bogus, Saida K; Kuzmin, Vladislav S; Abramochkin, Denis V; Suzdalev, Konstantin F; Galenko-Yaroshevsky, Pavel A

    2017-03-02

    The compound SS-68 has been selected among numerous new derivatives of indole and demonstrated antiarrhythmic effects in animal models. The present study concerns several aspects of SS-68 safety and efficacy as a potential antiarrhythmic drug. The first estimation of atrioventricular conduction in mammalian heart under SS-68 has been carried out; effects of SS-68 in Purkinje fibers and myocardium of pulmonary veins have been investigated. The drug weakly affects cardiac atrioventricular conduction: only high concentrations of SS-68 (≥10 μmol/L) significantly decrease this parameter. Also, the drug weakly affects Purkinje fibers automaticity, but effectively alters action potential waveform in Purkinje fibers in a concentration-dependent manner. SS-68 (0.1-100 μmol/L) failed to induce any early or delayed afterdepolarizations in Purkinje fibers both in basal conditions and under provocation of proarrhythmic activity by norepinephrine (NE). Moreover, 10 μmol/L SS-68 suppressed NE-induced extra-beats and rapid firing in Purkinje fibers. In pulmonary veins only high concentrations of SS-68 significantly increased action potential duration, while lower concentrations (0.1-1 μmol/L) were ineffective. Also, 0.1-100 μmol/L SS-68 was unable to elicit arrhythmogenic alternations of action potential waveform in pulmonary veins. In conclusion, SS-68 has no proarrhythmic effects, such as afterdepolarizations or abnormal automaticity in used experimental models.

  7. Magnetic resonance angiography virtual endoscopy in the assessment of pulmonary veins before radiofrequency ablation procedures for atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Cirillo, S.; Tosetti, Irene; Giuseppe, M.De; Longo, M.; Regge, D. [Institute for Cancer Research and Treatment (IRCC), Unit of Radiology, Candiolo (Torino) (Italy); Bonamini, R. [University of Torino, Department of Cardiology, Torino (Italy); Gaita, F.; Bianchi, F.; Vivalda, L. [Ospedale Mauriziano Umberto I, Department of Cardiology, Torino (Italy)

    2004-11-01

    Magnetic resonance angiography (MRA) is a safe and non-invasive imaging method that can readily depict the pulmonary veins (PV), whose imaging has acquired momentum with the advent of new techniques for radiofrequency ablation of atrial fibrillation (AF). We evaluated whether virtual endoscopy from 3D MRA images (MRA-VE) is feasible in studying the morphology of PV. Fifty patients with AF underwent pre-ablative MRA (1.5 T). Images were acquired with axial T-2 weighted and 3D-SPGR sequences after intravenous administration of Gd-DTPA and automatic triggering. Postprocessing was performed by an experienced radiologist with maximum intensity projection (MIP) and virtual endoscopy software (Navigator, GEMS). The venoatrial junction was visualized with MRA-VE in 49 of 50 patients (98.0%). Twenty-seven patients (55.1%) had two ostia on both sides, 13 patients (26.5%) had two ostia on the right and a single common ostium on the left, 5 patients (10.2%) had accessory PV and 4 patients (8.2%) had both an accessory right PV and a single common ostium on the left. Flythrough navigation showed the number and spatial disposition of second-order PV branches in 48 out of 49 patients (98.0%). MRA-VE is an excellent tool for at-a-glance visualization of ostia morphology, navigation of second-generation PV branches and easy endoluminal assessment of left atrial structures in pre-ablative imaging. (orig.)

  8. The study in pulmonary vein anatomy and the variation by DSCT%DSCT在肺静脉解剖及变异中的应用研究

    Institute of Scientific and Technical Information of China (English)

    赵昕; 时季成; 吕京光

    2013-01-01

    目的 利用DSCT对肺静脉正常解剖及变异类型、变异率进行研究,指导房颤导管消融手术的准确定位.方法 选择300例通过DSCT冠状动脉成像序列进行肺静脉成像,其中男性210例,女性90例,年龄14~81岁,平均年龄54.8岁,对肺静脉的数量、位置、分型和变异进行分析.结果 300例样本中,双侧均为标准型肺静脉者共144例,肺静脉总变异率为52%,左侧、右侧肺静脉变异分别为123例、102例,其变异率分别为41%、34%,其中右侧肺静脉变异以独立肺静脉较为常见,占60%,左侧肺静脉变异以肺静脉共同口较为常见,占96%;此外,本样本中肺静脉开口数目为2个、3个、4个、5个和6个的分别有19例、72例、196例、36例和4例.结论 肺静脉解剖存在较大变异,DSCT增强扫描可准确显示肺静脉解剖及其变异和类型,对指导房颤射频消融及心胸外科手术均具有重要意义.%Objective To study pulmonary vein anatomy and variation types and variation rate by the dual-source CT (DSCT) for guiding catheter ablation of atrial fibrillation( Af). Methods A total of 300 Patients (210 males, 90 females, aged 14 to 81 years old, with an average age of 54. 8 years) was undergone the pulmonary vein imaging by the DSCT coronary angiography imaging sequence. The number and position and classification and variation of the pulmonary vein (PV) were analyzed by multi-angle analysis of observation. Results Of 300 cases, 144 cases were found in both sides of normal pulmonary veins, with the variation rate of 52%. Among these cases, 123 cases had anatomic variation in the left PV, with the variation of 41 % , and the additional PV was common relatively, accounting for 60% , and 102 cases had anatomic variation in the right PV, with the variation rate of 34%, and the common vein opening PV was common relatively, accounting for 96%. In addition, according to the number of pulmonary vein opening, there were five types

  9. A RARE CASE OF EXTENSIVE THROMBOSIS OF INFERIOR VENA CAVA, PORTAL VEIN, SPLENIC VEIN AND SUPERIOR MESENTRIC VEIN

    Directory of Open Access Journals (Sweden)

    Giridhar

    2015-03-01

    Full Text Available While the most common presentation of venous thromboembolic disease is deep vein thrombosis (DVT or pulmonary thromboembolism, rarer manifestations are thrombosis of jugular vein, cerebral sinus and inferior vena cava. Here we are presenting a rare case of inferior vena caval thrombosis with multiple thrombus in portal vein, splenic vein and superior mesenteric vein

  10. Impact of ECG gating in contrast-enhanced MR angiography for the assessment of the pulmonary veins and the left atrium anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Katoh, M.; Buecker, A.; Muehlenbruch, G.; Guenther, R.W.; Spuentrup, E. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum RWTH Aachen (Germany); Schauerte, P. [Medizinische Klinik 1, Universitaetsklinikum RWTH Aachen (Germany)

    2006-02-15

    Purpose: Implementation of ECG gating in contrast-enhanced MR angiography (ceMRA) for improved visualization of the pulmonary veins, the left atrium, and the thoracic vessels. Materials and Methods: CeMRA was performed on twelve patients with a history of recurrent atrial fibrillation for the purpose of an intra-individual comparison with and without ECG gating on a 1.5 Tesla MR system (Gyroscan Intera, Philips Medical Systems, Best, NL). Objective image quality parameters such as the signal-to-noise ratio (SNR) of the blood and the contrast-to-noise ratio (CNR) between the blood and myocardium or lung parenchyma were analyzed. The contour sharpness of the pulmonary veins, left atrium, ascending aorta, and pulmonary trunk was also measured. In addition, the artifact level was subjectively assessed by two observers blinded with respect to the sequence parameters. Statistically significant differences (p<0.05) between the procedures were analyzed using the Wilcoxon test and Pearson Chi-square test. Results: The use of ECG gating in ceMRA significantly reduced artifacts caused by cardiac motion and vessel pulsation. This in turn lead to a significant increase in the contour sharpness of the left atrium and the thoracic vessels. In addition, higher SNR and CNR were found using ECG-gated ceMRA compared to standard ceMRA. Conclusion: The use of ECG gating in ceMRA results in artifact-free and sharper delineation of the structures of the heart and thoracic vessels. (orig.)

  11. Imaging of pulmonary vein anatomy and progress of multislice Computed tomography%多层螺旋CT肺静脉解剖成像及进展

    Institute of Scientific and Technical Information of China (English)

    赵昕

    2012-01-01

    肺静脉的解剖结构存在着一定的共性,但是也常发生变异.随着医疗技术的不断发展和对肺静脉相关疾病的逐渐认识,充分了解肺静脉的正常解剖关系及变异显得越发重要.因此,对MSCT技术在肺静脉成像中的应用现状、优缺点和进展作一综述患者.%The anatomical structure of pumonary vein exists certain common characters, but it also exists variations. As the development of the medical technology and the recognize of the related disease of pumonary vein, fully understanding of the normal anatomy and variation of pulmonary vein is becoming more and more important. So. the present situation of application, advantage, disadvantage and the progress for the usage of MSCT in the image of pumonary vein are reviewed.

  12. Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation

    Science.gov (United States)

    Collins, Jeremy D.; Pereles, F. S.; Bello, David; Betts, Timothy; Zachariah, Anish; Kaliney, Ryan; Song, Gina K.; Shors, Stephanie M.; Carr, James C.; Finn, John P.

    2003-05-01

    Pulmonary MRA generates high-resolution images of the pulmonary veins (PV) and left atrium (LA), permitting characterization of complex PV anatomy, which is useful in electrophysiologic PV catheter ablation, a proven technique for the treatment of paroxysmal atrial fibrillation (PAF). The purpose of this study was to determine if pre-ablative pulmonary MRA with intra-ablative viewing facilitates ablation by reducing fluoroscopy time. We studied the morphology of the LA and PV at 1.5T (Magnetom Sonata, Siemens Medical Solutions, Erlangen Germany) with breath-held gadolinium-enhanced 3D MRA in 7 patients with PAF undergoing PV ablation. Data was volume rendered (VR) on a stereoscopic workstation. PV ostial diameter and cross-sectional area measurements were obtained on multi-planar reformatted (MPR) images. VR datasets were converted into digital movies and were viewed on a laptop computer adjacent to real-time fluoroscopic images. Fluoroscopy times for patients undergoing pre-ablative MPA mapping were compared with a cohort of 22 consecutive patients diagnosed with PAF who underwent catheter ablation without pre-ablative MRA planning. Mean PV ablation fluoroscopic time with MRA planning versus fluoroscopic imaging alone were 84+/-20 minutes and 114+/-20 minutes respectively. Pre-ablative MRA planning resulted in a significant mean fluoroscopy time savings of 26% (p<0.05). In patients with PAF undergoing PV ablation, analysis of MRA datasets depicting PV anatomy confirms that there is great variability in anatomy between veins. Pre-ablative 3D PV mapping by MRA greatly facilitates fluoroscopic identification of individual veins and significantly reduces fluoroscopic radiation time.

  13. Long-term results of a minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Shuai Zheng

    Full Text Available BACKGROUND: Ganglionated plexi (GP ablation has been become an adjunct to pulmonary vein isolation (PVI. This study describes the long-term results of minimally invasive surgical PVI, ablation of GPs, and exclusion of the left atrial appendage for atrial fibrillation (AF. METHODS: Long-term follow-up of 55 months was performed in 139 consecutive patients (age 58.3±20.8 years with symptomatic, drug-refractory lone AF who underwent minimally invasive surgical PVI, GPs ablation, and exclusion of the left atrial appendage. Success was defined as freedom from AF, atrial flutter, or atrial tachycardia off antiarrhythmic drugs. RESULTS: AF was paroxysmal in 77.7%, persistent in 12.2% and long-standing persistent in 10.1%. Single-procedure success rate was 71.7%, 59.4% and 46.6% at 12, 24 and 60 months respectively. Single-procedure success rate was 72.9%, 62.6% and 51.8% for paroxysmal AF, 64.7%, 35.3%, and 28.2% for persistent AF, 71.4%, 64.3% and 28.6% for long-standing persistent AF at 12, 24 and 60 months respectively. Duration of AF>24 months (hazard ratio [HR]: 3.09, 95% confidence interval [CI]: 1.51 to 6.32; p = 0.002, left atrial diameter≥40 mm (HR: 4.03, 95% CI: 1.88 to 8.65; p<0.001, early recurrence of AF (HR: 4.66, 95% CI: 2.25 to 9.63; p<0.001 independently predicted long-term recurrence of AF. There was no procedure-related death. One patient converted to median sternotomy because of uncontrolled bleeding. Two patients underwent perioperative cerebrovascular events. CONCLUSIONS: At nearly 5-year of clinical follow-up, single-procedure success rate of minimally invasive surgical PVI with GP ablation was 51.8% for paroxysmal AF, 28.2% for persistent AF, 28.6% for long-standing persistent AF after initial procedure. Patients with AF duration≤24 months, left atrial diameter<40 mm and no early recurrence of AF, had favorable outcomes.

  14. Comparative analyses of lung transcriptomes in patients with alveolar capillary dysplasia with misalignment of pulmonary veins and in foxf1 heterozygous knockout mice.

    Directory of Open Access Journals (Sweden)

    Partha Sen

    Full Text Available Alveolar Capillary Dysplasia with Misalignment of Pulmonary Veins (ACDMPV is a developmental disorder of the lungs, primarily affecting their vasculature. FOXF1 haploinsufficiency due to heterozygous genomic deletions and point mutations have been reported in most patients with ACDMPV. The majority of mice with heterozygous loss-of-function of Foxf1 exhibit neonatal lethality with evidence of pulmonary hemorrhage in some of them. By comparing transcriptomes of human ACDMPV lungs with control lungs using expression arrays, we found that several genes and pathways involved in lung development, angiogenesis, and in pulmonary hypertension development, were deregulated. Similar transcriptional changes were found in lungs of the postnatal day 0.5 Foxf1+/- mice when compared to their wildtype littermate controls; 14 genes, COL15A1, COL18A1, COL6A2, ESM1, FSCN1, GRINA, IGFBP3, IL1B, MALL, NOS3, RASL11B, MATN2, PRKCDBP, and SIRPA, were found common to both ACDMPV and Foxf1 heterozygous lungs. Our results advance knowledge toward understanding of the molecular mechanism of ACDMPV, lung development, and its vasculature pathology. These data may also be useful for understanding etiologies of other lung disorders, e.g. pulmonary hypertension, bronchopulmonary dysplasia, or cancer.

  15. Thoracoscopic Video-Assisted Pulmonary Vein Antrum Isolation, Ganglionated Plexus Ablation and Periprocedural Confirmation of Ablation Lesions. First Results of a Hybrid Surgical-Electrophysiological Approach for Atrial Fibrillation

    NARCIS (Netherlands)

    S.P.J. Krul; A.H.G. Driessen; W.J. van Boven; A.C. Linnenbank; G.S.C. Geuzebroek; W.M. Jackman; A.A.M. Wilde; J.M.T. de Bakker; J.R. de Groot

    2011-01-01

    BACKGROUND: -Thoracoscopic pulmonary vein isolation (PVI) and ganglionated plexus (GP) ablation is a novel approach in the treatment of atrial fibrillation (AF). We hypothesize that meticulous electrophysiological confirmation of PVI results in fewer recurrences of AF during follow-up. METHODS AND R

  16. The effectiveness of a high output/short duration radiofrequency current application technique in segmental pulmonary vein isolation for atrial fibrillation

    DEFF Research Database (Denmark)

    Nilsson, Brian; Chen, Xu; Pehrson, Steen;

    2006-01-01

    AIMS: Segmental pulmonary vein (PV) isolation by radiofrequency (RF) catheter ablation has become a curative therapy for atrial fibrillation (AF). However, the long procedure time limits the wide application of this procedure. The aim of the current study was to compare a novel ablation technique...... with a high power output and short application time vs. a conventional technique using a low power output and long application time. METHODS AND RESULTS: The study included 90 consecutive patients (age 53+/-10 years; 66 men). Segmental PV isolation was performed by irrigated RF catheter ablation in both...... groups. In the conventional group (Group 1, 45 patients), the power output was limited to 30 W with a target temperature of 50 degrees C and an RF preset duration of 120 s. In the novel group (Group 2, 45 patients), the maximum power output was preset to 45 W, with a target temperature of 55 degrees C...

  17. Varicose Veins

    Science.gov (United States)

    Varicose veins are swollen, twisted veins that you can see just under the skin. They usually occur in ... of the body. Hemorrhoids are a type of varicose vein. Your veins have one-way valves that help ...

  18. Study of images of projective angles of pulmonary veins by modern imaging modalities%现代影像学技术对肺静脉投射角的测量与研究

    Institute of Scientific and Technical Information of China (English)

    王珏; 张兆琪; 马晓海; 刘佳祎

    2012-01-01

    Objective:In cross-sectional images of contrast enhanced magnetic resonance angiography ( CEMRA) and contrast enhanced computed tomography angiography (CECTA) of pulmonary veins-left atri-um there is a visible angle between every pulmonary vein and the coronary, transversal or sagittal section of hotly. These angles are constant, because the myocardial sleeve in the initiation of every pulmonary vein fasten the shape of the initiation of every pulmonary vein. These are so-called projective angles of pulmonary veins. In this study these angles are measured in many ways. Several possible influence factors and characters of distribu-tion are studied and analysed in order to understand better the characters sectional analomy of pulmonary veins. It is possible to provide anatomic basis for a reasonable choice of appropriate projection angle of X-rays in the angiography of pulmonary veins undergoing atrial fibrillation ablation. Methods:Cross-sectional images of CEM-RA and CECTA of pulmonary veins-left atrium of 137 health objects and patients with atrial fibrillation (AF) were dealed with the technic of post-processing, Projective Angles of Pulmonary to the coronary and transversal sections were measured and analysed statistically. Results;For every projective angles of pulmonary vein threr are no significant differences ( P > 0. 05) between the male group and the female group, between the group of patienls with atrial fibrillation ( AF) and the group of health objects as well as between the group of CEMRA and the group of CECTA. All projective angles of pulmonary veins are leptocurtic ( kurtosis coefficient >0) ex-cept projective angles of the right superior pulmonary vein to the transversal and cross planes are platyeurtic dis- tribution ( kurtosis coefficient f distribution of a!I projeclive angles nf pulmonary veins are positive wkewness distribution ( skewness coefficient >0). Conclusion; Project angles of pulmonary veins are one of real and steady characters of

  19. Progress about examination of doppler ultasound for fetal pulmonary veins blood flow%多普勒超声检查胎儿肺静脉血流的研究进展

    Institute of Scientific and Technical Information of China (English)

    罗兵

    2013-01-01

    胎儿肺静脉连接左心房与肺内毛细血管,其血流受心脏血流动力学的影响.胎儿肺无呼吸功能,且肺循环阻力高,流速低,血流量小.近年来,胎儿肺静脉一直受到广泛关注,本文就其近年来的相关研究进展做一综述.%Fetal pulmonary veins connect left atrial with lung capillary vessel, affected by heart blood dy-namics.Fetal lung has no ventilate function. In addition, fetal pulmonary circulation has high resistance, low blood flow velocity and small blood flow volume. In recent years, researchers have been paying attention to fetal pulmonary veins. This article is to review the recent studies.

  20. BM-12CEREBRAL INFARCTION SECONDARY TO PULMONARY VEIN COMPRESSION AND LEFT ATRIAL APPENDAGE TUMOR INFILTRATION AS THE PRESENTING SIGN OF METASTATIC SQUAMOUS CELL CARCINOMA OF THE BASE OF THE TONGUE

    Science.gov (United States)

    Dredla, Brynn; Siegel, Jason; Jaeckle, Kurt

    2014-01-01

    BACKGROUND: Squamous cell carcinoma of the tongue has been documented to metastasize to the lungs and rarely involve the heart. The majority of documented cases of cardiac metastases are from postmortem analysis. Cases of sudden death, syncope, and dyspnea have been reported. However, stroke and tumor embolization to the brain as the initial clinical presentation has not been documented in the English literature. METHODS: Case Report. RESULTS: This case addresses a 61-year-old male with Stage IVA squamous cell carcinoma of the left tongue base, believed to be in remission after systemic chemotherapy and local radiation, who presented with acute cerebral infarctions involving multiple vascular territories. Cardiac CT obtained during stroke etiology evaluation displayed metastatic disease compressing the pulmonary vein resulting in virtual pulmonary vein thrombus. Transthoracic echocardiogram was negative for cardiac valvular pathology. Anticoagulation was initiated. Twelve days later he returned with recurrent strokes and suspected tumor embolization to the brain. Imaging displayed left atrial appendage structural abnormality highly suggestive of tumor infiltration. CONCLUSION: Cardiac metastases are rare and non-myxomatous tumor embolization to the brain even rarer especially in the setting of cerebral infarction due to pulmonary vein thrombus. Here we describe a case of multiple acute cerebral infarctions appearing from a proximal source refractory to anticoagulation. Thromboembolism from the pulmonary vein and tumor embolization from cardiac metastases are the likely mechanisms for his clinical presentation and radiographic findings. This case demonstrates the complexity of multiple stroke etiologies in one patient and the importance of cardiac imaging in stroke evaluation, particularly in the setting of a patient with a history of cancer.

  1. Effectiveness and Safety of the Tempofilter II to Prevent the Occurrence of Pulmonary Thromboembolism in Patients with Lower Extremity Deep Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Byung Hyun; Jung, Min Young; Oh, Hyun Jun; Kim, Jae Kyu; Lee, Ho Kyun [Chonnam National University College of Medicine, Gwangju (Korea, Republic of); Jang, Nam Kyu [Chonnam National University Hospital, Hwasun (Korea, Republic of)

    2010-04-15

    To evaluate the efficacy and safety of the Tempofilter II for the prevention of a pulmonary thromboembolism (PTE) in patients with lower extremity deep vein thrombosis (DVT). Between January 2007 and December 2008, thirteen patients with lower extremity DVT whom were implanted with the Tempofilter II to prevent PTE were analyzed. A chest CT was compared before and after filter placement, to evaluate effectiveness of preventing PTE. Clinical symptoms of PTE were checked. Fluoroscopy and a plain radiograph were examined to evaluate filter status. The tempofilter II was successfully inserted in 13 patients. Nine patients underwent endovascular treatment after filter insertion. Trapping of thrombus was evaluated by following CT, venography, and filter retrieval. Trapped thrombus was detected in four patients by CT or retrieved filter. Two patients showed a decrease in thrombus in a follow-up chest CT. Not all patients showed symptoms of PTE. One filter was surgically removed due to the detachment of the anchoring device. The placement and retrieval of the Tempofilter II is feasible and effective for the prophylaxis of PTE in patients with lower extremity DVT; especially for patients that underwent subsequent endovascular treatment

  2. [Predictors of Efficacy of Radiofrequency Ablation of Pulmonary Veins Performed During Coronary Bypass Surgery in Patients With Ischemic Heart Disease and Paroxysmal Atrial Fibrillation].

    Science.gov (United States)

    Iskenderov, B G; Rakhmatullov, A F

    2015-01-01

    We performed simultaneous coronary artery bypass grafting (CABG) and radiofrequency ablation (RFA) ostia of pulmonary veins in 254 patients (147 men and 107 women) with ischemic heart disease and paroxysmal atrial fibrillation (AF). In-hospital mortality in patients with early recurrence of AF was 8.4%, in patients without recurrence of AF 1.9% (χ2 = 4.65; p = 0.03). The patients were followed-up during 12 months after operation. During follow-up 166 patients (69.5%) had no recurrence of AF without receiving antiarrhythmic drugs (AAP), 33 patients (13.8%) had recurrences of AF, and 40 patients (16.7%) receiving AAD had repeated rare paroxysms of AF. Main predictors of late AF recurrence were age > 65 years, AF duration > 5 years, preoperative atrial effective refractory period 50 mm, glomerular filtration rate heart due to CABG and RFA, use of β-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists were associated with the preservation of a stable sinus rhythm. The cardiovascular mortality during 12 months follow-up accounted for 2.1% and 1.2% in groups of patients with and without late recurrences of AF respectively (p > 0.05) to coronary artery bypass grafting surgery and RFA, taking drugs--β-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists--were associated with the preservation of a stable sinus rhythm.

  3. Sixteen multidetector row computed tomography of pulmonary veins: 3-months' follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Maksimovic, Ruzica; Cademartiri, Filippo; Pattynama, Peter M.T. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Scholten, Marcoen F.; Jordaens, Luc J. [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands)

    2005-06-01

    The aim of the study was to assess pulmonary veins (PVs) for the presence of stenosis 3 months after cryothermal ablation (CA) with a new method of electrical isolation of PVs using contrast-enhanced 16 multidetector row computed tomography (MDCT). Twenty four patients with symptomatic atrial fibrillation underwent CA in 46 PVs. MDCT of PVs was performed before the treatment and after 3-months' follow-up. Following cryoablation, 13/24 (54%) patients showed clinical improvement and had reduced attacks of atrial fibrillation. The dimensions of the treated PVs remained unchanged: the coronal ostial diameter was 19.1{+-}2.4 preprocedural versus 18.6{+-}2.4 mm at follow-up, p>0.05; the ratio of the coronal and axial diameters at the ostium was 1.2{+-}0.2 versus 1.2{+-}0.1, p>0.05, respectively, and the coronal diameter of the proximal 10 mm was 17.1{+-}2.5 mm versus 16.5{+-}2.2 mm, p>0.05, respectively. CA is a promising technique for electrical isolation of PVs that has not been associated with stenosis at the orifice and the proximal 10 mm of the PVs after 3-months' follow-up. MDCT is a noninvasive, fast and comfortable method for assessment of PVs in a three-dimensional manner prior to ablative treatment and during the follow-up. (orig.)

  4. Pulmonary Embolism and Subclavian Vein Thrombosis in a Patient with Parathyroid Carcinoma: Case Report and Review of Literature.

    Science.gov (United States)

    Manosroi, Worapaka; Wannasai, Komson; Phimphilai, Mattabhorn

    2015-09-01

    Parathyroid carcinoma is a rare etiology of primary hyperparathyroidism responsible for 0.4 to 5.2% of all primary hyperparathyroidism cases. The overt hyperparathyroid bone or renal disease with palpable neck mass, as well as severe hypercalcemia with extremely high parathyroid hormone, are clinical parameters raising the suspicionforparathyroid carcinoma. However a definite diagnosis can be confirmed only by examining the histopathology of the tumor. The curative treatment solely depends on an en bloc surgical approach. Therefore, preoperative clinical diagnosis of carcinoma is essentialfor optimal surgical planning. Thepresent study reported asymptomatic subclavian vein thrombosis andpulmonary embolism in parathyroid carcinoma, suggesting paraneoplastic syndrome of hypercoagulability in this cancer type. The presence of this paraneoplastic syndrome in a case of overt clinical hyperparathyroidism in addition to a palpable neck mass indicated the diagnosis of carcinoma preoperatively in the present patient, which led to an en bloc surgical plan. Since this paraneoplastic syndrome can be asymptomatic, the exploration ofthis syndrome by a commonly used imaging technique for parathyroid tumor localization, computerized tomography, would enable a preoperative diagnosis of cancer especially in an equivocal situation.

  5. Fibroblast growth factor 23 dysregulates late sodium current and calcium homeostasis with enhanced arrhythmogenesis in pulmonary vein cardiomyocytes.

    Science.gov (United States)

    Huang, Shih-Yu; Chen, Yao-Chang; Kao, Yu-Hsun; Hsieh, Ming-Hsiung; Lin, Yung-Kuo; Chung, Cheng-Chih; Lee, Ting-I; Tsai, Wen-Chin; Chen, Shih-Ann; Chen, Yi-Jen

    2016-10-25

    Fibroblast growth factor 23 (FGF23), elevated in chronic renal failure, increases atrial arrhythmogenesis and dysregulates calcium homeostasis. Late sodium currents (INa-Late) critically induces ectopic activity of pulmoanry vein (the most important atrial fibrillation trigger). This study was to investigate whether FGF23 activates the INa-Late leading to calcium dysregulation and increases PV arrhythmogenesis. Patch clamp, western blot, and confocal microscopy were used to evaluate the electrical activities, calcium homeostasis, and mitochondrial reactive oxygen species (ROS) in PV cardiomyocytes with or without FGF23 (0.1 or 1 ng/mL) incubation for 4~6 h. Compared to the control, FGF23 (1 ng/mL, but not 0.1 ng/mL)-treated PV cardiomyocytes had a faster beating rate. FGF23 (1 ng/mL)-treated PV cardiomyocytes had larger INa-Late, calcium transients, and mitochondrial ROS than controls. However, ranolazine (an inhibitor of INa-Late) attenuated FGF23 (1 ng/mL)-increased beating rates, calcium transients and mitochondrial ROS. FGF23 (1 ng/mL)-treated PV cardiomyocytes exhibited larger phosphorylation of calcium/calmodulin-dependent protein kinase II (CaMKII). Chelerythrine chloride (an inhibitor of protein kinase C) decreased INa-Late in FGF23 (1 ng/mL)-treated PV cardiomyocytes. However, KN93 (a selective CaMKII blocker) decreased INa-Late in control and FGF23 (1 ng/mL)-treated PV cardiomyocytes to a similar extent. In conclusion, FGF23 increased PV arrhythmogenesis through sodium and calcium dysregulation by acting protein kinase C signaling.

  6. Visualization of pulmonary vein stenosis after radio frequency ablation for treatment of atrial fibrillation using multidetector computed tomography with retrospective gating; Darstellung von Pulmonalvenenstenosen nach Radiofrequenzablation zur Behandlung von Vorhofflimmern unter Verwendung der Multidetektor Computertomographie mit retrospektivem Gating

    Energy Technology Data Exchange (ETDEWEB)

    Trabold, T.; Kuettner, A.; Heuschmid, M.; Kopp, A.F.; Claussen, C.D. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Univ. Tuebingen (Germany); Burgstahler, C.; Mewis, C.; Schroeder, S.; Kuehlkamp, V. [Medizinische Klinik III, Abt. fuer Kardiologie, Univ. Tuebingen (Germany)

    2003-01-01

    Purpose: With the number of radio frequency ablations (RFA) for treatment of chronic atrial fibrillation increasing, the diagnostic evaluation for RFA associated pulmonary vein stenosis is getting more important. This study investigates the feasibility of the visualization of pulmonary vein stenosis using non-invasive multidetector computed tomography. Materials and Methods: Twenty-eight patients were examined following RFA-treatment. A 4-slice (20 patients) and a 16-slice (8 patients) multidetector CT scanner (SOMATOM Volume Zoom and Sensation 16, Siemens, Forchheim, Germany) with retrospective gating was used to assess the pulmonary veins. Lesion severity was determined on a semi-quantitative scale (< 30%, 30 - 50%, > 50%). Results: CT was performed without any complications in all patients. Diagnostic image quality could be obtained in all examinations. The pulmonary veins showed lesions < 30% in four patients, lesions of 30 - 50% in five patients and a stenosis > 50% in one patient. Eighteen patients showed no lesions. Conclusion: Multidetector CT of the pulmonary veins seems to be able to visualize high-grade and low-grade lesions, but larger catheter-controlled studies are needed for further assessment of the diagnostic accuracy and clinical reliability of this noninvasive method. (orig.) [German] Ziel: Mit steigender Anzahl von Radiofrequenzablationen (RFA) zur Behandlung des chronischen Vorhofflimmerns wird die Diagnostik von RFA assoziierten Pulmonalvenenstenosen zunehmend wichtiger. Ziel dieser Studie war es, die Moeglichkeit der Darstellung von Pulmonalvenenstenosen mittels der nichtinvasiven Multidetektor-Computertomographie zu untersuchen. Material und Methoden: 28 Patienten wurden im Anschluss an eine RFA-Behandlung untersucht. Die Untersuchung wurde an einem 4-Zeilen- (20 Patienten) bzw. 16-Zeilen- (8 Patienten) Multidetektor-CT (SOMATOM Volume Zoom bzw. Sensation 16, Siemens, Forchheim, Germany) mit retrospektivem Gating durchgefuehrt. Der

  7. A common Shox2-Nkx2-5 antagonistic mechanism primes the pacemaker cell fate in the pulmonary vein myocardium and sinoatrial node.

    Science.gov (United States)

    Ye, Wenduo; Wang, Jun; Song, Yingnan; Yu, Diankun; Sun, Cheng; Liu, Chao; Chen, Fading; Zhang, Yanding; Wang, Fen; Harvey, Richard P; Schrader, Laura; Martin, James F; Chen, YiPing

    2015-07-15

    In humans, atrial fibrillation is often triggered by ectopic pacemaking activity in the myocardium sleeves of the pulmonary vein (PV) and systemic venous return. The genetic programs that abnormally reinforce pacemaker properties at these sites and how this relates to normal sinoatrial node (SAN) development remain uncharacterized. It was noted previously that Nkx2-5, which is expressed in the PV myocardium and reinforces a chamber-like myocardial identity in the PV, is lacking in the SAN. Here we present evidence that in mice Shox2 antagonizes the transcriptional output of Nkx2-5 in the PV myocardium and in a functional Nkx2-5(+) domain within the SAN to determine cell fate. Shox2 deletion in the Nkx2-5(+) domain of the SAN caused sick sinus syndrome, associated with the loss of the pacemaker program. Explanted Shox2(+) cells from the embryonic PV myocardium exhibited pacemaker characteristics including node-like electrophysiological properties and the capability to pace surrounding Shox2(-) cells. Shox2 deletion led to Hcn4 ablation in the developing PV myocardium. Nkx2-5 hypomorphism rescued the requirement for Shox2 for the expression of genes essential for SAN development in Shox2 mutants. Similarly, the pacemaker-like phenotype induced in the PV myocardium in Nkx2-5 hypomorphs reverted back to a working myocardial phenotype when Shox2 was simultaneously deleted. A similar mechanism is also adopted in differentiated embryoid bodies. We found that Shox2 interacts with Nkx2-5 directly, and discovered a substantial genome-wide co-occupancy of Shox2, Nkx2-5 and Tbx5, further supporting a pivotal role for Shox2 in the core myogenic program orchestrating venous pole and pacemaker development.

  8. Current role of cardiac and extra-cardiac pathologies in clinically indicated cardiac computed tomography with emphasis on status before pulmonary vein isolation

    Energy Technology Data Exchange (ETDEWEB)

    Sohns, J.M.; Lotz, J. [Goettingen University Medical Center (Germany). Inst. for Diagnostic and Interventional Radiology; German Center for Cardiovascular Research (DZHK), Goettingen (Germany); Menke, J.; Staab, W.; Fasshauer, M.; Kowallick, J.T.; Zwaka, P.A.; Schwarz, A. [Goettingen University Medical Center (Germany). Inst. for Diagnostic and Interventional Radiology; Spiro, J. [Koeln University Hospital (Germany). Radiology; Bergau, L.; Unterberg-Buchwald, C. [Goettingen University Medical Center (Germany). Cardiology and Pneumology

    2014-09-15

    Purpose: The aim of this study was to assess the incidence of cardiac and significant extra-cardiac findings in clinical computed tomography of the heart in patients with atrial fibrillation before pulmonary vein isolation (PVI). Materials and Methods: 224 patients (64 ± 10 years; male 63%) with atrial fibrillation were examined by cardiac 64-slice multidetector CT before PVI. Extra-cardiac findings were classified as 'significant' if they were recommended to additional diagnostics or therapy, and otherwise as 'non-significant'. Additionally, cardiac findings were documented in detail. Results: A total of 724 cardiac findings were identified in 203 patients (91% of patients). Additionally, a total of 619 extra-cardiac findings were identified in 179 patients (80% of patients). Among these extra-cardiac findings 196 (32%) were 'significant', and 423 (68%) were 'non-significant'. In 2 patients (1%) a previously unknown malignancy was detected (esophageal cancer and lung cancer, local stage, no metastasis). 203 additional imaging diagnostics followed to clarify the 'significant' findings (124 additional CT, costs 38,314.69 US dollars). Overall, there were 3.2 cardiac and 2.8 extra-cardiac findings per patient. Extra-cardiac findings appear significantly more frequently in patients over 60 years old, in smokers and in patients with a history of cardiac findings (p < 0.05). Conclusion: Cardiac CT scans before PVI should be screened for extracardiac incidental findings that could have important clinical implications for each patient. (orig.)

  9. An Independent Risk of Gout on the Development of Deep Vein Thrombosis and Pulmonary Embolism: A Nationwide, Population-Based Cohort Study.

    Science.gov (United States)

    Huang, Chien-Chung; Huang, Po-Hao; Chen, Jiunn-Horng; Lan, Joung-Liang; Tsay, Gregory J; Lin, Hsiao-Yi; Tseng, Chun-Hung; Lin, Cheng-Li; Hsu, Chung-Yi

    2015-12-01

    Previous studies indicated that gout is a risk factor of cardiovascular diseases. This study aimed to determine if patients with gout have an increased risk of deep vein thrombosis (DVT) or pulmonary embolism (PE).We used the Longitudinal Health Insurance Database, a subset of the national insurance claim dataset, which enrolled 1 million Taiwanese to identify 57,981 patients with gout and 115,961 reference subjects matched by sex, age, and entry date of diagnosis. The risk of DVT and PE was analyzed using the Cox proportional hazards model.In this Taiwanese dataset observed from 2000 to 2010, we found the incidence of DVT was 5.26 per 10 person-years in the gout cohort, which was twofold higher than the incidence of 2.63 per 10 person-years in the reference cohort. After adjusting for age, sex, and 9 comorbidities, the hazard ratio (HR) of developing DVT was 1.66 (95% confidence interval [CI] = 1.37-2.01). Among patients with gout, the youngest age group had the highest increase in the risk of developing DVT (HR [95% CI] = 2.04 [1.24-3.37] for ages 20 to 49 years, 1.80 [1.28-2.51] for ages 50 to 64 years, and 1.45 [1.11-1.91] for ages ≥65 years). The incidence of PE was about one-fifth that of DVT in gout patients, but the effect of gout on the risk was similar (HR [95% CI] = 1.53 [1.01-2.29]).Our analysis confirmed that gout increased the risk of DVT and PE. Further exploration is needed in the future.

  10. Differential haemostatic risk factors for pregnancy-related deep-vein thrombosis and pulmonary embolism: a population-based case-control study.

    Science.gov (United States)

    Bergrem, Astrid; Dahm, Anders E A; Jacobsen, Anne Flem; Sandvik, Leiv; Sandset, Per Morten

    2012-12-01

    Limited data exist on thrombophilia and the risk of venous thrombosis (VT) during pregnancy and postpartum. The objectives of the present study were to investigate the role of haemostatic risk factors for pregnancy-related VT and their phenotypic expression in deep-vein thrombosis (DVT) and pulmonary embolism (PE). Total 313 cases with objectively verified first time VT and 353 controls were selected from a source population of 377,155 women with 613,232 pregnancies. The adjusted odds ratio (aOR) for pregnancy-related VT was 1.7 (95% confidence interval [CI] 1.1-2.8) for women with factor VIII >90th percentile. The aOR for VT for endogenous thrombin potential and D-dimer values >90th percentiles were 1.8 (95% CI 1.1-3.0) and 2.1 (95% CI 1.3-3.3), respectively. Factor IX >90th percentile or free protein S ≤the 5th percentile increased the risk for PE, and the aORs were 2.4 (95% CI 1.1-5.0) and 3.1 (95% CI 1.3-7.2), respectively. Women carrying the factor V Leiden (F5 rs6025) polymorphism, or who had reduced sensitivity to activated protein C (aPC) in the absence of F5 rs6025, had increased risk for DVT, with unadjusted ORs 7.7 (95% CI 4.7-12.7) and 3.5 (95% CI 2.2-5.4), respectively. Women with a history of pregnancy-related VT showed activation of coagulation and had elevated factor VIII. Furthermore, high levels of factor IX and low levels of free protein S were associated with increased risk for PE, whereas aPC resistance and F5 rs6025 were risk factors for DVT and not PE.

  11. Recurrence of atrial fibrillation within three months after pulmonary vein isolation for patients with paroxysmal atrial fibrillation: Analysis using external loop recorder with auto-trigger function

    Science.gov (United States)

    Kawasaki, Shiro; Tanno, Kaoru; Ochi, Akinori; Inokuchi, Koichiro; Chiba, Yuta; Onishi, Yoshimi; Onuma, Yoshimasa; Munetsugu, Yumi; Kikuchi, Miwa; Ito, Hiroyuki; Onuki, Tatsuya; Miyoshi, Fumito; Minoura, Yoshino; Watanabe, Norikazu; Adachi, Taro; Asano, Taku; Kobayashi, Youichi

    2014-01-01

    Background Pulmonary vein isolation (PVI) via catheter ablation has been shown to be a highly effective treatment option for patients with symptomatic paroxysmal atrial fibrillation (AF). The recurrence of AF within 3 months after PVI is not considered to be the result of ablation procedure failure, because early recurrence of AF is not always associated with late recurrence. We examined the usefulness of an external loop recorder with an auto-trigger function (ELR-AUTO) for the detection of atrial fibrillation following PVI to characterize early recurrence and to determine the implications of AF occurrence within 3 months after PVI. Methods Fifty-three consecutive symptomatic patients with paroxysmal AF (age 61.6±12.6 years, 77% male) who underwent PVI and were fitted with ELR-AUTO for 7±2.0 days within 3 months after PVI were enrolled in this study. Results Of the 33 (62.2%) patients who did not have AF recurrence within 3 months after PVI, only 1 patient experienced AF recurrence at 12 months. Seven (35%) of the 20 patients who experienced AF within 3 months of PVI experienced symptomatic AF recurrence at 12 months. The sensitivity, specificity, positive predictive value, and negative predictive value of early AF recurrence for late recurrence were 87.5%, 71.1%, 35.0%, and 96.9%, respectively. Conclusions AF recurrence measured by ELR-AUTO within 3 months after PVI can predict the late recurrence of AF. Freedom from AF in the first 3 months following ablation significantly predicts long-term AF freedom. ELR-AUTO is useful for the detection of symptomatic and asymptomatic AF. PMID:26336538

  12. Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: A randomized, placebo-controlled, double-blind trial.

    Science.gov (United States)

    den Heijer, Martin; Willems, Huub P J; Blom, Henk J; Gerrits, Wim B J; Cattaneo, Marco; Eichinger, Sabine; Rosendaal, Frits R; Bos, Gerard M J

    2007-01-01

    The Vitamins and Thrombosis (VITRO) study investigated the effect of homocysteine lowering by daily supplementation of B vitamins on the risk reduction of deep vein thrombosis (DVT) and pulmonary embolism (PE). Patients between 20 to 80 years old with a first objectively confirmed proximal DVT or PE in the absence of major risk factors and a homocysteine concentration above the 75th percentile of a reference group were asked to participate (hyperhomocysteinemic group). A similar study was conducted in a random sample of patients with a homocysteine below the 75th percentile of the reference group (normohomocysteinemic group). After informed consent was obtained, patients were randomized to daily multivitamin supplementation (5 mg folic acid, 50 mg pyridoxine, and 0.4 mg cyanocobalamin) or placebo and were followed for 2.5 years. End points were objectively diagnosed recurrent DVT or PE. A total of 701 patients were enrolled (360 in the hyperhomocysteinemic and 341 in the normohomocysteinemic group). The number of recurrent events of venous thrombosis was 43 of 353 in the vitamin group (54/1000 py) and 50 of 348 in the placebo group (64/1000 py). The hazard ratio associated with vitamin treatment was 0.84 (95% CI, 0.56-1.26): 1.14 (95% CI, 0.65-1.98) in the hyperhomocysteinemic group and 0.58 (95% CI, 0.31-1.07) in the normohomocysteinemic group. The results of our study do not show that homocysteine lowering by B vitamin supplementation prevents recurrent venous thrombosis.

  13. Fluoroscopy-Free Pulmonary Vein Isolation in Patients with Atrial Fibrillation and a Patent Foramen Ovale Using Solely an Electroanatomic Mapping System.

    Directory of Open Access Journals (Sweden)

    Michael Kühne

    Full Text Available The advent of electroanatomical mapping (EAM systems for pulmonary vein isolation (PVI has dramatically decreased radiation exposure. However, the need for some fluoroscopy remains for obtaining left atrial (LA access. The aim was to test the feasibility of fluoroscopy-free PVI in patients with atrial fibrillation (AF and a patent foramen ovale (PFO guided solely by an EAM system.Consecutive patients with AF undergoing PVI and documented PFO were studied. An EAM-guided approach without fluoroscopy and ultrasound was used. After completing the map of the right atrium, the superior vena cava and the coronary sinus, a catheter pull-down to the PFO was performed allowing LA access. The map of the LA and subsequent PVI was also performed without fluoroscopy.30 patients [age 61±12 years, 73% male, ejection fraction 0.64 (0.53-0.65, LA size in parasternal long axis 38±7 mm] undergoing PVI were included. The time required for right atrial mapping including transseptal crossing was 9±4 minutes. Total procedure time was 127±37 minutes. Fluoroscopy-free PVI was feasible in 26/30 (87% patients. In four patients, fluoroscopy was needed to access (n = 3 or to re-access (n = 1 the LA. In these four patients, total fluoroscopy time was 5±3 min and the DAP was 14.9±13.4 Gy*cm2. Single-procedure success rate was 80% (24/30 after a median follow-up of 12 months.In patients with a documented PFO, completely fluoroscopy-free PVI is feasible in the vast majority of cases.

  14. MDCT Evaluation of Left Atrium and Pulmonary Vein in the Patients with Atrial Fibrillation: Comparison with the Non-Atrial Fibrillation Group

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Jung; Choi, Eun Jeong; Ham, Soo Yeon; Oh, Yu Whan; Kim, Young Hoon [Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Yong, Hwan Seok [Korea University Guro Hospital, Seoul (Korea, Republic of); Yang, Kyung Sook [Korea University, Seoul (Korea, Republic of)

    2011-02-15

    The anatomy of the left atrium (LA) and the pulmonary veins (PVs) is important in planning and performing successful electrophysiologic ablation (EPA) for atrial fibrillation (Afib) patients. The authors estimated the findings of LA and PVs of Afib patients by MDCT, and compared these with the findings of LA and PVs of the non- Afib group using coronary CT angiography (CCTA). From September, 2009 to February, 2010, 91 Afib patients underwent PVCT (male: female = 72:19, mean age = 55.0-years-old) before EPA. At same time, 90 patients underwent CCTA (male: female = 73:17, mean age = 59.1- years-old). Two radiologists reviewed and analyzed all axial and 3D images of LA and PVs retrospectively with consensus. The average LA volumes of the Afib group(100.49 mm3) was larger than that of the non-Afib group (78.38 mm3) (p<0.05). The average lengths of the LA right wall in the Afib group (40.25 mm) was longer than that of the non-Afib group (37.3 mm) (p<0.05). The average distances between the PV ostium and first segmental bifurcation of the Lt superior PV (LSPV) and the RSPV were shorter in the Afib group (LSPV, 19.38 mm: RSPV, 11.49 mm) than in the non-Afib group (LSPV, 23.23 mm: RSPV, 14.25 mm) (p<0.05). There were higher incidences of anomalous branches such as ostial, accessory branches, or common ostia in the Afib group versus the non-Afib group (p<0.05). In Afib group, variable parameters of LA and PVs were obtained and estimated by MDCT, and there was statistically significant difference in the parameters of LA and PVs between Afib and non-Afib groups

  15. Successful liver transplantation in a patient with splanchnic vein thrombosis and pulmonary embolism due to polycythemia vera with Jak2v617f mutation and heparin-induced thrombocytopenia.

    Science.gov (United States)

    Biagioni, Emanuela; Pedrazzi, Paola; Marietta, Marco; Di Benedetto, Fabrizio; Villa, Erica; Luppi, Mario; Girardis, Massimo

    2013-10-01

    Heparin-induced thrombocytopenia (HIT) is a rare complication of heparin treatment resulting in a severe acquired thrombophilic condition with an associated mortality of about 10 %. We report the first case of successful urgent liver transplantation (LT) in a patient with end-stage liver disease due to a Budd-Chiari syndrome, portal vein thrombosis and pulmonary embolism due to acquired thrombophilia associated to polycythemia vera carrying JAK2V617F gene mutation and HIT in the acute phase. Lepirudin was used to provide anticoagulation in the LT perioperative period that was performed without haemorrhagic and thrombotic complications despite the donor received heparin during liver explantation.

  16. Modified Maze lines plus pulmonary vein isolation created by radiofrequency catheter ablation on the atrial wall to treat atrial fibrillation in elderly

    Institute of Scientific and Technical Information of China (English)

    Caiyi LU; Shiwen WANG; Xinping DU; Yinglong HOU; Qiao XUE; Xinli WU; Rui CHEN; Peng LIU

    2005-01-01

    Objective To evaluate the effect of modified Maze lines plus pulmonary vein (PV) isolation created by radiofrequency catheter ablation (RFCA) on atrial wall guided by a novel geometry mapping system in the treatment of elderly patients with paroxysmal atrial fibrillation (PAF). Methods After regular electrophysiological study, transseptal punctures were achieved twice with Swartz L1 and R1 sheaths. PV angiographies were conducted to evaluate their orifices and branches. A balloon electrode array catheter with 64 electrodes was put in the middle of the left atrium. Atrium geometry was constructed using Ensite 3000 Navx system. Two RFCA lesion loops and three lines (modified Maze) were created on left and right atrial walls. Each lesion point was ablated for 30 seconds with preset temperature 50 (ae) and energy 30W. The disappearance or 80% decrease of the amplitude of target atrial potential and 10 to 20(|), decrease of ablation impedance were used as an index of effective ablation. Results A total of 11 patients (7 male and 4 female, mean age, 68.7±5.1 years) were enrolled. PAF history was 7.9±4.5 years. PAF could not be prevented by mean 3.1±1.6 antiarrhythmic agents in 6.3±3.4 years. None of the patients had complications with structural heart disease or stroke. Left atrial diameter was 41.3±3.6 mm and LVEF was 59.2±3.7% on echocardiography. Two loops and three lines were completed with 67.8±13.1 (73-167) lesion points. Altogether 76-168 (89.4±15.3) lesion points were created in each patient. PAF could not be provoked by rapid burst pacing up to 600 beat per minute delivered from paroxysmal coronary sinus electrode pair.Complete PV electrical isolation was confirmed by three-dimensional activation mapping. Mean procedure time was 2.7±0.6 hours and fluoroscopy time was 17.8±9.4 minutes. Patients were discharged with oral aspirin and without antiarrhythmic agents. During follow up of 6.5±1.8 months, seven patients were PAF symptom free (63.6%). PAF

  17. Rivaroxaban for the treatment of symptomatic deep-vein thrombosis and pulmonary embolism in Chinese patients: a subgroup analysis of the EINSTEIN DVT and PE studies

    Science.gov (United States)

    2013-01-01

    Background The worldwide EINSTEIN DVT and EINSTEIN PE studies randomized 8282 patients with acute symptomatic deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) and, for the first time in trials in this setting, included patients in China. This analysis evaluates the results of these studies in this subgroup of patients. Methods A total of 439 Chinese patients who had acute symptomatic DVT (n=211), or PE with or without DVT (n=228), were randomized to receive rivaroxaban (15 mg twice daily for 21 days, followed by 20 mg once daily) or standard therapy of enoxaparin overlapping with and followed by an adjusted-dose vitamin K antagonist, for 3, 6, or 12 months. The primary efficacy outcome was symptomatic recurrent venous thromboembolism. The principal safety outcome was major or non-major clinically relevant bleeding. Results The primary efficacy outcome occurred in seven (3.2%) of the 220 patients in the rivaroxaban group and in seven (3.2%) of the 219 patients in the standard-therapy group (hazard ratio, 1.04; 95% confidence interval 0.36–3.0; p=0.94). The principal safety outcome occurred in 13 (5.9%) patients in the rivaroxaban group and in 20 (9.2%) patients in the standard-therapy group (hazard ratio, 0.63; 95% confidence interval 0.31–1.26; p=0.19). Major bleeding was observed in no patients in the rivaroxaban group and in five (2.3%) patients in the standard-therapy group. In fragile patients (defined as age >75 years, creatinine clearance <50 mL/min, and/or body weight ≤50 kg), the principal safety outcome occurred in four (8.9%) of the 45 patients who received rivaroxaban compared with seven (15.2%) of the 46 patients who received standard therapy. Conclusions In Chinese patients with acute symptomatic DVT and/or PE, rivaroxaban was as efficacious as enoxaparin followed by vitamin K antagonist therapy, with a similar safety profile. The relative efficacy and safety of rivaroxaban compared with enoxaparin/vitamin K antagonist were

  18. Drenagem anômala parcial de quatro veias pulmonares com septo interatrial íntegro: relato de um caso raro Partial anomalous return of four pulmonary veins with intact interatrial septum defect: a rare case report

    Directory of Open Access Journals (Sweden)

    Edmar Atik

    2008-07-01

    Full Text Available É relatado caso raro de drenagem anômala parcial de quatro veias pulmonares no átrio direito e veia cava superior, com septo interatrial íntegro em criança de cinco anos de idade. Havia poucos sintomas, em contraste com débito ventricular esquerdo dependente do fluxo da veia lobar superior esquerda e da língula. Complacência diminuída à esquerda motivou quadro acentuado de hipertensão venocapilar pulmonar no pós-operatório imediato, aliviado por feitura de comunicação interatrial de 8 mm. A evolução posterior foi boa.We report on the rare case of partial anomalous return of four pulmonary veins in the right atrium and superior vena cava with intact interatrial septum in a five-year-old child. There were few symptoms in contrast with the left ventricular output dependent on the flow of the left upper lobe vein and from the lingula. Reduced compliance to the left led to a severe picture of pulmonary venocapillary hypertension in the immediate postoperative period, mitigated by an 8-mm interatrial septal defect. The patient progressed well after the intervention.

  19. 49 CFR 178.345-7 - Circumferential reinforcements.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Circumferential reinforcements. 178.345-7 Section... reinforcements. (a) A cargo tank with a shell thickness of less than 3/8 inch must be circumferentially... tank heads. (1) Circumferential reinforcement must be located so that the thickness and...

  20. Surgical treatment for congeaital pulmonary vein stenosis combined with other cardiac malformations%先天性心脏畸形合并肺静脉狭窄的外科治疗

    Institute of Scientific and Technical Information of China (English)

    吴向阳; 陶凉; 朱洁; 周丹; 庾华东; 刘燕; 祁明

    2009-01-01

    Objective Pulmonnary vein stenosis (PVS) is a rare congenital disease. It leads to progressive pulmonary hyperten-sion and heart failure with a high mortality. PVS may be isolated or asaseiated with other cardiac malformtions. There were few litera- tores regarding surgical treatmenta and the timing for intervention. The aim of this article is to summarize the surgical treatment for PVS combined with other cardiac malformations. Methods Five patients were diagnosed as PVS. The accompanied cardiac malformations were: xtrocordia(n = 1), patent duetus arteriosuss(n = 2), ventricular septal defect(n = 4), atrial septal defect(n = 2), double- chambered right ventricle(n = 1), pulmonary arterial stenosis (n = 1), tricuspid valve insufficiency(n= 2), partial anomalous pulmo- nary venous connection(n = 1), persistent left superior vena cava(n = 1). The mean age was(8.5 4± 6.4) years. The mean body weight was(15.2 ± 6.3) kg. The mean gradient pressure through the stenotie pulmonary veins was(22.0 ± 6.2) mmHg. Nine stenotic pulmonary veins wore found, including 6 cristal stenosises located at venoatrial junetiom and 3 tubular stauosises outside of the lung. The surgical procedures included eristal stenosis ring resection (n=6) and two of them repaired additionally by "longitudinally open and transeversoly suture of the endomembrane" plasty method. Pulmonary veins repair used auto-pericardium (n= 1) and unitization of neighbonring pulmonary veins(n = 1), etc. Remits Cardiopulmonary bypass and aortic cross-clamp time were(129.2 ± 74.6) and (74.24±39.1) rain, respectively. All the petients had a satisfying honmdynmnic aud no death happened. The mean length of hos- pital stay after operation was (10±3) days. Follow-up waa completed in a duration of 6 month - 3 years. There was a trace residual shunt of VSD and PDA and Ⅱ degree auriculo-ventricular block happened in one patient. Residual stenosis was found by color ulltra- sonograph in a cristal stenosis case, whose

  1. Guided Circumferential Waves in Layered Poroelastic Cylinders

    Directory of Open Access Journals (Sweden)

    Shah S.A.

    2016-12-01

    Full Text Available The present paper investigates the propagation of time harmonic circumferential waves in a two-dimensional hollow poroelastic cylinder with an inner shaft (shaft-bearing assembly. The hollow poroelastic cylinder and inner shaft are assumed to be infinite in axial direction. The outer surface of the cylinder is stress free and at the interface, between the inner shaft and the outer cylinder, it is assumed to be free sliding and the interfacial shear stresses are zero, also the normal stress and radial displacements are continuous. The frequency equation of guided circumferential waves for a permeable and an impermeable surface is obtained. When the angular wave number vanish the frequency equation of guided circumferential waves for a permeable and an impermeable surface degenerates and the dilatational and shear waves are uncoupled. Shear waves are independent of the nature of surface. The frequency equation of a permeable and an impermeable surface for bore-piston assembly is obtained as a particular case of the model under consideration when the outer radius of the hollow poroelastic cylinder tends to infinity. Results of previous studies are obtained as a particular case of the present study. Nondimensional frequency as a function of wave number is presented graphically for two types of models and discussed. Numerical results show that, in general, the first modes are linear for permeable and impermeable surfaces and the frequency of a permeable surface is more than that of an impermeable surface.

  2. [Treatment of renal vein thrombosis associated with nephrotic syndrome].

    Science.gov (United States)

    Funami, M; Takaba, T; Tanaka, H; Murakami, A; Kadokura, M; Hori, G; Ishii, J

    1988-06-01

    Renal vein thrombosis is a rare entity in which true incidence is unknown. The disease occurs most frequently in patients with nephrotic syndrome, but it also can occur in the presence of other hypercoagulable state. Two cases of renal vein thrombosis with nephrotic syndrome which were treated by thrombectomy are reported here. One patient was successfully treated by renal vein and inferior vena cava thrombectomy before developing severe pulmonary embolism. The other was treated by renal vein thrombectomy by which fatal shock was able to be prevented. In those cases, immediate operation was indicated, primarily to prevent additional, possibly fatal, pulmonary embolism and also to improve perfusion of the kidney. In the hope of salvaging the kidney, thrombectomy may be the treatment of choice for acute renal vein thrombosis, complication of pulmonary embolism and inferior vena cava thrombosis, right renal vein thrombosis without collateral flow and acute renal vein thrombosis with shock.

  3. Integration of cardiac computed tomography into pulmonary vein isolation in patients with paroxysmal atrial fibrillation; Integration einer praeinterventionellen Computertomografie des Herzens in die therapeutische Pulmonalvenenisolation bei Patienten mit paroxysmalem Vorhofflimmern

    Energy Technology Data Exchange (ETDEWEB)

    Weber, T.F. [Abt. Radiologie, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Klemm, H.; Willems, S. [Klinik und Poliklinik fuer Kardiologie und Angiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Koops, A.; Adam, G.; Begemann, P.G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Nagel, H.D. [Philips Medizin Systeme GmbH, Hamburg (Germany)

    2007-12-15

    Purpose: Detailed anatomic information of the left atrium is necessary for securely performing radiofrequency ablation of atrial fibrillation-triggering ectopies in the pulmonary vein ostia. In this study the impact of a preinterventionally acquired cardiac computed tomography (CT) on pulmonary vein isolation (PVI) was assessed. Materials and methods: Examinations of 54 patients with paroxysmal atrial fibrillation undergoing PVI were analyzed. In 27 patients a supplementary cardiac CT was obtained prior to PVI (CT group, 12 women, 15 men, 59.7 {+-} 9.9 years of age): 16 x 1.5 mm collimation, 0.2 pitch, 120 kV tube voltage, 400 effective mAs. The fluoroscopy time, effective dose and quantity of radiofrequency (RF) pulses of the following catheter ablation were compared to 27 patients undergoing stand-alone PVI (11 women, 16 men, 62.0 {+-} 9.9 years of age). Mann-Whitney tests served for statistical comparison. Results: CT datasets were successfully integrated into the ablation procedure of each patient in the CT group. The mean quantity of RF pulses was significantly lower in the CT group (22.1 {+-} 8.0 vs. 29.1 {+-} 11.9, p = 0.030), and a significant reduction of fluoroscopy time was found (41.8 {+-} 12.0 min vs. 51.2 {+-} 16.0 min, p = 0.005). Effective doses of the catheter ablation differed in an equivalent dimension but altogether not significantly (14.9 {+-} 10.0 mSv vs. 20.0 {+-} 16.0 mSv, p = 0.203). The mean additive effective dose of the cardiac CT was 85 {+-} 0.3 mSv. (orig.)

  4. Three cases of pulmonary varix

    Energy Technology Data Exchange (ETDEWEB)

    Takishima, Teruo; Sakuma, Hajime; Tajima, Tsunemi; Okimoto, Takao; Yamamoto, Keiichiro; Dohi, Yutaka (Saitama Medical School (Japan))

    1982-06-01

    Three cases of pulmonary varix associated with valvular heart disease were reported. Round shadows were clearer on first oblique or lateral films of chest x-ray in all 3 cases. On chest tomograms, the shadows were substantial and round-elliptical. RI angiography with sup(99m)Tc-RBC demonstrated these shadows in agreement with the site of influx of the pulmonary vein into the left atrium in Cases 1 and 3 and with the pulmonary vein slightly apart from the left atrium in Case 2. On CT scans in Cases 1 and 3, enhancement with a contrast medium visualized dilatation of the pulmonary vein close to, and in continuation with, the shadow of the left atrium. The diagnosis of pulmonary varix in agreement with the venous phase of pulmonary angiography was made for all 3 cases. Non-surgical examinations (especially CT scan) proved highly useful for the diagnosis of pulmonary varix.

  5. Varicose vein - noninvasive treatment

    Science.gov (United States)

    Sclerotherapy; Laser therapy - varicose veins; Radiofrequency vein ablation; Endovenous thermal ablation; Ambulatory phlebectomy; Transilluminated power phlebotomy; Endovenous laser ablation; Varicose vein ...

  6. Deep Vein Thrombosis

    Science.gov (United States)

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

  7. Varicose vein stripping

    Science.gov (United States)

    ... vein stripping; Venous reflux - vein stripping; Venous ulcer - veins Images Circulatory system References American Family Physician. Management of varicose veins. www.aafp.org/afp/2008/1201/p1289.html . ...

  8. Comparison between mechanical properties of human saphenous vein and umbilical vein

    Directory of Open Access Journals (Sweden)

    Hamedani Borhan

    2012-08-01

    Full Text Available Abstract Background As a main cause of mortality in developed countries, Coronary Artery Disease (CAD is known as silent killer with a considerable cost to be dedicated for its treatment. Coronary Artery Bypass Graft (CABG is a common remedy for CAD for which different blood vessels are used as a detour. There is a lack of knowledge about mechanical properties of human blood vessels used for CABG, and while these properties have a great impact on long-term patency of a CABG. Thus, studying these properties, especially those of human umbilical veins which have not been considered yet, looks utterly necessary. Methods Umbilical vein, as well as human Saphenous vein, are respectively obtained after cesarean and CABG. First, histological tests were performed to investigate different fiber contents of the samples. Having prepared samples carefully, force-displacement results of samples were rendered to real stress–strain measurements and then a fourth-order polynomial was used to prove the non-linear behavior of these two vessels. Results Results were analyzed in two directions, i.e. circumferentially and longitudinally, which then were compared with each other. The comparison between stiffness and elasticity of these veins showed that Saphenous vein’s stiffness is much higher than that of umbilical vein and also, it is less stretchable. Furthermore, for both vessels, longitudinal stiffness was higher than that of circumferential and in stark contrast, stretch ratio in circumferential direction came much higher than longitudinal orientation. Conclusion Blood pressure is very high in the region of aorta, so there should be a stiff blood vessel in this area and previous investigations showed that stiffer vessels would have a better influence on the flow of bypass. To this end, the current study has made an attempt to compare these two blood vessels’ stiffness, finding that Saphenous vein is stiffer than umbilical vein which is somehow as stiff as

  9. Anomalous pulmonary venous return: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Gyeong Min; Kang, MinJin; Lee, Han Bee; Bae, Kyung Eun; Lee, Jaehe; Kim, Jae Hyung; Jeong, Myeong Ja; Kang, Tae Kyung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2013-10-15

    Partial anomalous pulmonary venous return is a type of congenital pulmonary venous anomaly. We present a rare type of partial pulmonary venous return, subaortic vertical vein drains left lung to superior vena cava, accompanying hypoplasia of the ipsilateral lung and pulmonary artery. We also review the previous report and relationship of these structures.

  10. Use of the Trauma Embolic Scoring System (TESS) to predict symptomatic deep vein thrombosis and fatal and non-fatal pulmonary embolism in severely injured patients.

    Science.gov (United States)

    Ho, K M; Rao, S; Rittenhouse, K J; Rogers, F B

    2014-11-01

    Fatal pulmonary embolism is the third most common cause of death after major trauma. We hypothesised that the Trauma Embolic Scoring System (TESS) would have adequate calibration and discrimination in a group of severely injured trauma patients in predicting venous thromboembolism (VTE), and could be used to predict fatal and non-fatal symptomatic pulmonary embolism. Calibration and discrimination of the TESS were assessed by the slope and intercept of the calibration curve and the area under the receiver operating characteristic curve, respectively. Of the 357 patients included in the study, 74 patients (21%) developed symptomatic VTE after a median period of 14 days following injury. The TESS predicted risks of VTE were higher among patients who developed VTE than those who did not (14 versus 9%, P=0.001) and had a moderate ability to discriminate between patients who developed VTE and those who did not (area under the receiver operating characteristic curve 0.71, 95% confidence interval 0.65 to 0.77). The slope and intercept of the calibration curve were 2.76 and 0.34, respectively, suggesting that the predicted risks of VTE were not sufficiently extreme and overall, underestimated the observed risks of VTE. Using 5% predicted risk of VTE as an arbitrary cut-point, TESS had a high sensitivity and negative predictive value (both ≥0.97) in excluding fatal and non-fatal pulmonary embolism. The TESS had a reasonable ability to discriminate between patients who developed VTE and those who did not and may be useful to select different strategies to prevent VTE in severely injured patients.

  11. Heparin-induced thrombocytopenia (HIT) causing portosplenic, superior mesenteric, and splenic vein thrombosis resulting in splenic rupture and pulmonary emboli formation.

    Science.gov (United States)

    Lammering, Jeanne C; Wang, David S; Shin, Lewis K

    2012-01-01

    Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of heparin administration. Of the few reported cases of HIT-associated intra-abdominal thrombosis, none to our knowledge provide multidetector-row computed tomography (MDCT) imaging findings or emphasize its utility in diagnosis. We describe a case of HIT with MDCT images demonstrating extensive intra-abdominal thrombosis and end-organ complications including splenic rupture and pulmonary emboli. This case emphasizes the potential role of MDCT in the rapid detection of HIT-related thromboembolic complications in patients with nonspecific abdominal pain.

  12. Comparison of ventilation/perfusion scintigraphy and multi-detector computerized tomography in diagnosis of asymptomatic pulmonary embolism after deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Eflatun Yücedağ

    2014-03-01

    Full Text Available Objective: Pulmonary thromboembolism (PTE named due to migration of clots formed in systemic venous system to pulmonary vascular bed is a serious clinical table. After acute DVT, asymptomatic PTE is seen about 40-60% and this situation can not be discovered because of silent clinical course. In this study, we aimed to compare sensivity and spesifity of multi detector computerized tomography (MDCT, which is used extensively in recent years, with ventilation-perfusion (V/P scintigraphy which is used formerly for diagnosis of asymptomatic PTE developed after acute lower extremity DVT. Methods: The study was carried out 25 patients who were admitted to our clinic and treated for lower extremity acute DVT. Pregnants, and cases with recurrent DVT, presence of symptomatic PTE during admission, thrombosis extending to vena cava, and history of passed PTE were excluded from the study. DVTs in patients were diagnosed by color doppler, and confirmed by D-dimer test. After patients’s admission, V/P scintigraphy and MDCT were used to detects asymptomatic PTE at 1st and 8 th day of the admission. Results: D-dimer was measured as higher in 24 of 25 patients with asemptomatic PTE. Ten patients were diagnosed by MDCT. Development of asymptomatic PTE related to acute DVT was determined as 40%. Conclusion: In terms of diagnostic value, MDCT was found more useful than V/P scintigraphy.

  13. CIRCUMFERENTIAL MFL IN-LINE INSPECTION FOR CRACKS IN PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

    J.B. Nestleroth

    2003-06-01

    Circumferential MFL is a new implementation of a widely used technology that has potential to provide improved detection and quantification of axially oriented defects such as cracks, seam weld defects, mechanical damage, and groove corrosion. This implementation works by orienting the magnetic field around the pipe rather that along the axis. By orienting the magnetic field around the pipe (the circumferential direction), the axial defects that were magnetically transparent can disrupt more of the magnetic field and can be more easily detected. Initial implementations of circumferential MFL have found that flux leakage from cracks at the interior of the pipe is small, and the signals from cracks are difficult to detect. The objective of this project is to improve detection of cracks by changing the implementation along with using data from overlapping and complementary inspection techniques. Two technology enhancements were investigated: Combining high- and low-magnetization technology for stress detection; and Combining axial and circumferential MFL methods. Although a method combining high- and low-magnetization technology showed promise for characterizing gouges cause by third party excavation equipment, its commercial development was not successful for two reasons. First, the stress diminishes the crack signal, while the opening of the crack increases the signal. The stress-induced changes in flux leakage around cracks were small and any critical information on the severity of cracks and crack-like defects is difficult to distinguish from changes caused by the crack opening and other inspection variables. Second, it is difficult to magnetize pipe material in the circumferential direction. A relatively low, non-uniform magnetization level produced by the circumferential magnetizer makes detection of changes due to stress extremely difficult. This project also examined combining axial and circumferential MFL to improve crack detection and distinguish cracks for

  14. Radiological features of azygous vein aneurysm.

    Science.gov (United States)

    Choudhary, Arabinda Kumar; Moore, Michael

    2014-04-01

    Mediastinal masses are most commonly associated with malignancy. Azygous vein aneurysm is a very rare differential diagnosis of mediastinal mass. We report here three cases of azygous vein aneurysm including children and adult patients. In the pediatric patient it was further complicated by thrombosis and secondary pulmonary embolism. We describe the radiological features on CXR, MRI, CT, PET-CT, US and angiogram and their differential diagnosis. Imaging findings of continuity with azygous vein, layering of contrast medium on enhanced CT and dynamic MRA showing filling of the mass at the same time as the azygous vein without prior enhancement will be strongly suggestive of azygous vein aneurysm with transtracheal ultrasound being the definitive test in these patients. It is important to keep a vascular origin mass in the differential diagnosis of mediastinal masses. Also, in young healthy patients with pulmonary embolism, a vascular etiology such as azygous vein aneurysm should be carefully evaluated. This article will help the clinicians to learn about the imaging features of azygous vein aneurysm on different imaging modalities.

  15. Portal Vein Thrombosis

    OpenAIRE

    Hakan Demirci

    2016-01-01

    Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low...

  16. Assessment of risk and prophylaxis for deep vein thrombosis and pulmonary embolism in medically ill patients during their early days of hospital stay at a tertiary care center in a developing country

    Directory of Open Access Journals (Sweden)

    Ambarish Pandey

    2009-08-01

    Full Text Available Ambarish Pandey, Nivedita Patni, Mansher Singh, Randeep GuleriaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi, IndiaAim: Deep vein thrombosis (DVT and pulmonary thromboembolism (PE are important causes of morbidity and mortality in medically ill patients. This study was done to assess risk factors and prophylaxis given for DVT and PE in newly admitted medically ill patients during the first two weeks of their hospital stay at a tertiary care center hospital in India.Methods: All patients within one week of their admission in intensive care unit (ICU and wards were enrolled in the study after an informed written consent. Patients who had DVT prophylaxis within the past month or any contraindications for DVT prophylaxis were excluded. A structured proforma was designed and effective risk stratification for DVT was done. Patients were followed for up to two weeks to record any changes in the risk categories and document any signs of PE or DVT if present. Any prophylaxis given for DVT or PE was noted.Results: Seventy-five percent of patients had the highest risk for DVT and PE. Only 12.5% had DVT prophylaxis within the first two days of admission. Within two weeks of admission, 30.8% of patients were discharged, and 16.2% died. 72.6% of the patients still in the wards belonged to the highest risk category. Clinical signs and symptoms of DVT and PE were present in 25.8% and 9.8% of patients, respectively after the second week of admission. 86% of symptomatic patients belonged to the highest risk category initially and none of them received any prophylaxis. 21.6% of the highest risk category patients died within two weeks of their admission. A statistically significant correlation was found between mortality and risk score of the patients for DVT and between lack of prophylaxis and mortality (p < 0.05.Conclusion: A significant risk for DVT and PE exists in medically ill patients, but only a small proportion of the patients

  17. Pulmonary embolism after greater saphenous vein ligation and stripping%大隐静脉曲张术后并发肺栓塞11例的治疗

    Institute of Scientific and Technical Information of China (English)

    王晓天; 胡何节; 方征东; 孙小杰; 葛新宝; 刘振明

    2015-01-01

    目的 探讨大隐静脉曲张高位结扎剥脱术后患者并发肺栓塞(pulmonary embolism,PE)的临床特点及预防措施.方法 回顾分析安徽省立医院血管外科2008年1月至2013年6月收治及会诊的大隐静脉曲张术后合并PE的11例患者临床特点、诊疗及预后等资料.结果 该组11例PE患者有6例患者经过心肺复苏、抗凝溶栓等治疗无效死亡,死亡率54.5%.5例患者经过早期的抗凝、溶栓等治疗后康复,在溶栓过程中,2例患者因彩超发现股静脉内漂浮血栓选择下腔静脉滤器植入术.对5例患者经过8 ~ 25个月随访,均无呼吸困难、胸闷、胸痛等症状.患者发病时临床表现以呼吸困难最为常见(90.9%),有胸痛症状3例(27.3%),出现晕厥2例(18.2%),猝死2例(18.2%),均无典型的呼吸困难、胸痛、咯血三联征.结论 PE的早期诊断及早期治疗可能降低大隐静脉曲张高位结扎剥脱术后PE患者的死亡率.%Objective To analyze characteristics and prophylaxis of pulmonary embolism (PE) after greater saphenous vein ligation and stripping.Methods We retrospectively analyzed the clinical characteristics and treatment of 11 inpatients with postoperative PE in Anhui Provincial Hospital and other hospitals from January 2008 to June 2013.Results In this group 6 patients died after failed cardiopulmonary resuscitation (CPR) and other treatments,the mortality was 54.5%.5 patients recovered after anticoagulation,thrombolysis and other treatments.During the process of thrombolysis,floating thrombus was found within the femoral vein in 2 patients and inferior vena cava filter was implanted.After 8-25 months follow-up,all 5 patients were free of difficulty of breathing,chest tightness,chest pain and other symptoms.Among many clinical manifestations,dyspnea (90.9%) was the most common,other clinical manifestations included chest pain (27.3%),syncope (18.2%),sudden death (18.2%).There was no typical triad of dyspnea

  18. Nursing Experience for Pulmonary Vein Radiofrequency Ablation and Left Atria Resection using Thoracoscope%全电视胸腔镜下双侧肺静脉射频消融+左心耳切除术的护理

    Institute of Scientific and Technical Information of China (English)

    陈迎霞; 周建玲; 陈丽娟; 果建军

    2011-01-01

    目的:总结8例在全麻下双腔气管内插管行全电视胸腔镜双侧肺静脉射频消融+左心耳切除术的巡回护理工作.方法:双腔气管内插管,静脉复合麻醉,左右肺交替单肺通气.患者左侧卧位,经右侧第七肋间腋前线出切开皮肤1cm.入腔镜,准确定位第七肋间腋中线和第四肋间乳中线并分别做1cm切口.通过视频显示,剪开并悬吊心包,分离显露右肺静脉轮廓.在Aticure分离诱导器辅助下,将Aticure射频钳于完全钳住右肺上下静脉(左房入口处),反复夹闭和松开射频钳3次,进行消融.患者右侧卧位,经左侧第七肋间腋前线处切开皮肤1cm.按上述同样方法行左肺上下静脉射频消融.然后,在腔镜辅助下,用GC-60切除吻合器将左心耳切掉.严密止血,逐层关胸.结果:手术均顺利完成,术中巡回护士配合达预期的目的,患者术后安返监护室.结论:术前一日访视患者,了解患者病情,做好心理护理,用物准备齐全,熟练掌握手术配合是手术成功的关键.%Objective: To summarize the nursing experience for pulmonary vein radiofrequency ablation and left atria resection using thoracoscope under general anesthesia.Methods: Nursing care for pulmonary vein radiofrequency ablation and left atria resection in 8 cases under general anesthesia was analyzed to summarize the nursing experience.Results: All operations were performed successfully and 8 patients were safely sent to ICU post-operation.Conclusion: Nurses cooperated with doctors properly during the operation time.Keys to the success of operations are as following: visiting the ptient one day before operation,knowing well of the patient's state of illness,proper paychological nursing,preparing materials useful for operations carefully and cooperating with doctors properly.

  19. Thrombolytic therapy in pulmonary embolism.

    LENUS (Irish Health Repository)

    Nagi, D

    2010-01-01

    Massive pulmonary embolism carries a high mortality. Potential treatment includes anticoagulation, thrombolytic therapy and embolectomy. We report a case of deep vein thrombosis leading to progressive massive pulmonary embolism despite appropriate anticoagulation, where thrombolysis with IVC filter placement resulted in a successful outcome.

  20. Electrophysiological characteristics of cardiocyte from excised pulmonary vein cardiac muscle of rabbit%离体兔肺静脉肌袖心肌细胞电生理特性

    Institute of Scientific and Technical Information of China (English)

    刘俊辉; 李源; 刘泰槰; 黄卫斌

    2011-01-01

    目的 应用常规玻璃微电极细胞内记录技术,研究家兔肺静脉肌袖(PVC)电生理特性,观察PVC与左心房心肌细胞(LAC)之间的电传导现象,探讨肺静脉起源的阵发性房颤的发生机制.方法 50只健康成年家兔,获取肺静脉及相连左房心肌组织,应用常规微电极细胞内技术:记录PVC与LAC动作电位(AP),并进行各项参数比较(APD20,APD50,APD90);分别于PVC端和LAC端予不同频率脉冲刺激,观察另一端AP的产生情况;改用加有钾离子通道阻滞剂2mmol/L氯化铯(CsCl)的台式液,观察二者早后除极(EAD)发生的可能性.结果 PVC的APD20,APD50,APD90均较LAC长(APD20 (23.09±5.44)ms vs (19.50±1.66)ms,APD50 (52.40±7.93)ms vs (28.90±4.36)ms,APD90 (123.35±8.26)ms vs (69.65±9.44)ms),均有显著性差异(P均<0.05);在一定的刺激频率范围内,肺静脉的刺激均能传导至左心房,而后者较少能逆传至肺静脉(100% vs 10%,P<0.05);加用药物灌流后,PVC更易发生EAD(90% vs 15%,P<0.05).结论 PVC和LAC之间的电兴奋传导是不均一的,这可能是形成折返的基础.CsCl作为一种K+通道阻滞剂能延长复极过程,为后除极的发生创造条件,PVC的长AP时程特性,具备发生EAD的倾向性,并且兴奋易于传入左心房,这可能是促进房性心律失常的发生基础.%Objective It is to study the electrophysiological characteristics of cardiocyte from pulmonary vein cardiac muscle ( PVC ) of rabbit applying intracellular recording technique of routine glass microelectrode, to observe the electrical conduction between PVC and left atrium cardiocyte ( LAC ) and to approach the mechanism of paroxysmal atrial fibrillation originated from pulmonary vein. Methods Multiple cardiocytes preparations from pulmonary vein and left atrium of 50 healthy adult rabbits were obtained. The routine intracellular microelectrode technique was applied to record action potential ( AP ) of PVC and LAC , and a comparison of action potential duration

  1. Pulmonary Venous Obstruction in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Chuang-Chi Liaw

    2015-01-01

    Full Text Available Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods. We conducted a prospective cohort study to characterize the syndrome that we term “pulmonary vein obstruction syndrome” (PVOS between January 2005 and March 2014. The criteria for inclusion were (1 episodes of shortness of breath; (2 chest X-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3 CT scan demonstrating pulmonary vein thrombosis/tumor with or without tumor around the vein. Results. Two hundred and twenty-two patients developed PVOS. Shortness of breath was the main symptom, which was aggravated by chemotherapy in 28 (13%, and medical/surgical procedures in 21 (9% and showed diurnal change in intensity in 32 (14%. Chest X-rays all revealed abnormal pulmonary hilum shadows and presence of pulmonary edema in 194 (87% and pleural effusion in 192 (86%. CT scans all showed pulmonary vein thrombosis/tumor (100% and surrounding the pulmonary veins by tumor lesions in 140 patients (63%. PVOS was treated with low molecular weight heparin in combination with dexamethasone, and 66% of patients got clinical/image improvement. Conclusion. Physicians should be alert to PVOS when shortness of breath occurs and chest X-ray reveals abnormal pulmonary hilum shadows.

  2. Structural and leakage integrity of tubes affected by circumferential cracking

    Energy Technology Data Exchange (ETDEWEB)

    Hernalsteen, P. [TRACTEBEL, Brussels (Belgium)

    1997-02-01

    In this paper the author deals with the notion that circumferential cracks are generally considered unacceptable. He argues for the need to differentiate two facets of such cracks: the issue of the size and growth rate of a crack; and the issue of the structural strength and leakage potential of the tube in the presence of the crack. In this paper the author tries to show that the second point is not a major concern for such cracks. The paper presents data on the structural strength or burst pressure characteristics of steam generator tubes derived from models and data bases of experimental work. He also presents a leak rate model, and compares the performance of circumferential and axial cracks as far as burst strength and leak rate. The final conclusion is that subject to improvement in NDE capabilities (sizing, detection, growth), that Steam Generator Defect Specific Management can be used to allow circumferentially degraded tubes to remain in service.

  3. Circumferential gap propagation in an anisotropic elastic bacterial sacculus

    CERN Document Server

    Taneja, Swadhin; Rutenberg, Andrew D

    2013-01-01

    We have modelled stress concentration around small gaps in anisotropic elastic sheets, corresponding to the peptidoglycan sacculus of bacterial cells, under loading corresponding to the effects of turgor pressure in rod-shaped bacteria. We find that under normal conditions the stress concentration is insufficient to mechanically rupture bacteria, even for gaps up to a micron in length. We then explored the effects of stress-dependent smart-autolysins, as hypothesised by Arthur L Koch [Advances in Microbial Physiology 24, 301 (1983); Research in Microbiology 141, 529 (1990)]. We show that the measured anisotropic elasticity of the PG sacculus can lead to stable circumferential propagation of small gaps in the sacculus. This is consistent with the recent observation of circumferential propagation of PG-associated MreB patches in rod-shaped bacteria. We also find a bistable regime of both circumferential and axial gap propagation, which agrees with behavior reported in cytoskeletal mutants of B. subtilis. We con...

  4. GUIDED CIRCUMFERENTIAL WAVES IN DOUBLE-WALLED CARBON NANOTUBES

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A model of guided circumferential waves propagating in double-walled carbon nanotubes is built by the theory of wave propagation in continuum mechanics, while the van der Waals force between the inner and outer nanotube has been taken into account in the model. The dispersion curves of the guided circumferential wave propagation are studied, and some dispersion characteristics are illustrated by comparing with those of single-walled carbon nanotubes. It is found that in double-walled carbon nanotubes, the guided circumferential waves will propagate in more dispersive ways. More interactions between neighboring wave modes may take place. In particular, it has been found that a couple of wave modes may disappear at a certain frequency and that, while a couple of wave modes disappear, another new couple of wave modes are excited at the same wave number.

  5. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Hakan Demirci

    2016-01-01

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

  6. Circumferential nonlocal effect on the buckling and vibration of nanotubes

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Cheng Yuan, E-mail: cywang@ujs.edu.cn; Li, Xiao Hu; Luo, Ying

    2016-04-01

    The nonlocal beam theories are widely used to study the mechanics of cylindrical nanotubes (NTs). The one-dimensional models however are unable to account for the nonlocal effect in the circumferential direction, which may substantially affect the applicability of the nonlocal beam models. To address the issue this letter examines the circumferential nonlocal effect (CNE) on the buckling and vibration of the NTs. Here the CNE is characterized by the difference between the nonlocal beam model considering the axial nonlocal effect only and the nonlocal shell model with both axial and circumferential nonlocal effects. The aspect ratio and radius-dependence of the CNE are calculated for the singlewall carbon NTs selected as a typical example. The results show that the CNE is substantial for the buckling and vibration of the NTs with small radius (e.g., <1 nm) and aspect ratio (e.g., <15). It however decreases with the rising radius and the aspect ratio, and turns out to be small for relatively wide and long NTs. The nonlocal beam theories thus may overestimate the buckling load and vibration frequency for the thin and short NTs. - Highlights: • First revealed the substantial circumferential nonlocal effect (CNE) on nanotube buckling. • Achieved radius/aspect ratio-dependence of CNE on nanotube buckling and vibration. • Located the range of applicability of the nonlocal beam theory without CNE.

  7. A Critical Appraisal of Circumferential Resection Margins in Esophageal Carcinoma

    NARCIS (Netherlands)

    Pultrum, Bareld B.; Honing, Judith; Smit, Justin K.; van Dullemen, Hendrik M.; van Dam, Gooitzen M.; Groen, Henk; Hollema, Harry; Plukker, John Th. M.

    2010-01-01

    In esophageal cancer, circumferential resection margins (CRMs) are considered to be of relevant prognostic value, but a reliable definition of tumor-free CRM is still unclear. The aim of this study was to appraise the clinical prognostic value of microscopic CRM involvement and to determine the opti

  8. [Calcified deep vein thrombosis in a patient with recurrent deep vein thrombosis and sarcoidosis].

    Science.gov (United States)

    Krmek, Dubravka Zupanić; Brajković, Ivana; Bekić, Dinko; Krnić, Antun; Jurković, Petar; Pavlović, Tomislav

    2013-12-01

    In this article, we present a rare case of calcified deep vein thrombosis in a 42-year-old female patient with frequent relapses of pulmonary sarcoidosis since 1995, for which she was on maintenance therapy with corticosteroids and with consequential secondary diabetes. Recent femoral vein thrombosis was diagnosed with color Doppler in 2012. At the same time, calcified occlusive thrombus in vena cava inferior from the level of renal vein to the confluence of hepatic veins was diagnosed on abdominal multi-slice computed tomography (MSCT). Digital subtraction venography (DSV) revealed a well-developed collateral circulation through the paravertebral veins, azygos and hemiazygos vein. There were no risk factors for thrombosis other than sarcoidosis and diabetes. Deep vein thrombosis is rarely described with sarcoidosis, but according to literature reports, it usually appears as a recurrence and simultaneously at multiple locations. According to the current knowledge, we cannot say for sure whether it is a disease with an increased risk of deep vein thrombosis or there is a combination of multiple risk factors present simultaneously.

  9. Prevalence, Patterns, and Clinical Predictors of Left Ventricular Late Gadolinium Enhancement in Patients Undergoing Cardiac Magnetic Resonance Prior to Pulmonary Vein Antral Isolation for Atrial Fibrillation: A Cross-Sectional Observational Study.

    Science.gov (United States)

    Nance, John W; Khurram, Irfan M; Nazarian, Saman; DeWire, Jane; Calkins, Hugh; Zimmerman, Stefan L

    2015-09-01

    Cardiac magnetic resonance (CMR) imaging is increasingly used to evaluate patients with atrial fibrillation (AF) before pulmonary vein antral isolation (PVAI). The purpose of this study was to assess the incidence and pattern of left ventricular (LV) late gadolinium enhancement (LGE) in patients undergoing CMR before PVAI and compare the clinical and demographic differences of patients with and without LV LGE. Clinical and demographic data on 62 patients (mean age 61 ± 7.9, 69% male) undergoing CMR before PVAI for AF were collected. Two observers, masked to clinical histories, independently recorded the prevalence, extent (number of myocardial segments), and pattern (subendocardial, midmyocardial, or subepicardial) of LV LGE in each patient. Clinical and demographic predictors of LV LGE were determined using logistic regression. Twenty-three patients (37%) demonstrated LV LGE affecting a mean of 3.0 ± 2.1 myocardial segments. There was no difference in LV ejection fraction between patients with and without LGE, and most (65%) patients with LGE had normal wall motion. Only age (P = 0.04) and a history of congestive heart failure (P = .03) were statistically significant independent predictors of LGE. The most common LGE pattern was midmyocardial, seen in 17 of 23 (74%) patients. Only 4 of 23 (17%) patients had LGE in an "expected" pattern based on clinical history. Of the remaining 19 patients, 4 had known congestive heart failure, 5 nonischemic cardiomyopathy, 4 known coronary artery disease, and 2 prior aortic valve replacement. Six of 23 (26%) patients had no known coronary artery, valvular, or myocardial disease. There is a high prevalence of unexpected LV scar in patients undergoing CMR before PVAI for AF, with most patients demonstrating a nonischemic pattern of LV LGE and no wall motion abnormalities (ie, subclinical disease). The high prevalence of unexpected LGE in these patients may argue for CMR as the modality of choice for imaging

  10. Circumferential evaluation of the neointima by optical coherence tomography after ABSORB bioresorbable vascular scaffold implantation

    DEFF Research Database (Denmark)

    Brugaletta, Salvatore; Radu, Maria D; Garcia-Garcia, Hector M

    2012-01-01

    To quantify the circumferential healing process at 6 and 12 months following scaffold implantation.......To quantify the circumferential healing process at 6 and 12 months following scaffold implantation....

  11. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Ronny Cohen

    2015-01-01

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

  12. Neonatal repair of total anomalous pulmonary venous connection and lung agenesis.

    Science.gov (United States)

    Kaku, Yuji; Nagashima, Mitsugi; Matsumura, Goki; Yamazaki, Kenji

    2015-07-01

    Here we report a neonatal case of total anomalous pulmonary venous connection with left lung agenesis. Diagnostic imaging demonstrated that the left pulmonary veins were totally absent and the right pulmonary veins connected with the common pulmonary chamber. Drainage from the common pulmonary venous chamber entered the persistent left suerior vena cava. In addition, it revealed complete absence of the left main bronchus and left lung vessels. The neonate successfully underwent surgical repair 18 days after birth.

  13. Focus on Varicose Veins

    Science.gov (United States)

    ... smaller than varicose veins and may cause symptoms. Spider veins typ - ically do not cause symptoms, and treatment for these is frequently cosmetic unless symptoms are present. Vein problems are among the most common chronic conditions in North America. In fact, more people lose work time from ...

  14. Evaluation of the relation of the different leg deep vein thrombosis to the pulmonary embolism by computed tomography pulmonary angiography%CT肺血管造影评价不同下肢深静脉血栓与肺栓塞关系

    Institute of Scientific and Technical Information of China (English)

    曾秋; 赵渝; 冯江毅; 李凤贺

    2014-01-01

    目的 利用CT肺血管造影(CTPA)比较不同下肢深静脉血栓(DVT)患者肺栓塞(PE)检出率及评价不同下肢DVT合并PE患者的肺动脉阻塞严重程度.方法 本科诊断DVT并行CTPA检查患者145例,分为左下肢DVT组,右下肢DVT组,双下肢DVT组,比较三组患者PE检出率.同时以肺动脉栓塞指数(CTI)量化评价肺动脉阻塞程度,比较不同组别确诊PE患者CTI.结果 双下肢DVT组患者PE检出率(71.4%)明显高于左下肢DVT组(39.2%)(P<0.05),而与右下肢DVT组PE检出率(52.9%)比较差异无统计学意义(P>0.05).双下肢DVT合并PE患者CTI[(30.20±14.20)%]明显高于左下肢DVT合并PE[(19.26±14.02)%]及右下肢DVT合并PE[(18.56±11.79)%](P<0.05).结论 双下肢DVT患者较左下肢DVT更容易并发PE,且双下肢DVT合并PE患者肺动脉阻塞程度较单侧更高.%Objective To evaluate the incidence and severity of pulmonary embolism (PE) in patients with different leg deep vein thrombosis (DVT) by computed tomography pulmonary angiography (CTPA).Methods A total of 145 cases who had been confirmed DVT and undergone CTPA were retrospectively analyzed.The DVTs were divided into left side DVT,right side DVT,and bilateral lower DVT groups.The incidence of PE was compared among different groups.CT obstruction index (CTI) was used to estimate the severity of pulmonary artery obstruction.DVT/PEs with CTI were compared among different groups.Results The incidence of PE of the bilateral lower DVT group was 71.4%,which was higher than that in left side DVT group (39.2%).However,no significant difference was found between bilateral lower DVT group and right side DVT group (52.9%) (P > 0.05).The CTI of the bilateral lower DVT (30.20±14.20)% was higher than that of the left side DVT (19.26 ± 14.02)% and the right side DVT (18.56 ±11.79) % (P < 0.05).Conclusions The bilateral lower DVT was more likely complicated with PE than the left side DVT,the severity of pulmonary

  15. 肺灌注单光子发射计算机断层成像术/CT对下肢深静脉血栓形成患者肺栓塞的诊断价值研究%Diagnostic Value of Pulmonary Perfusion SPECT/CT on Pulmonary Embolism in Patients with Lower Extremity Deep ;Vein Thrombosis

    Institute of Scientific and Technical Information of China (English)

    吴大勇; 张文艳; 陈江红; 边艳珠; 胡玉敬

    2014-01-01

    目的:探讨肺灌注单光子发射计算机断层成像术( SPECT)/CT对下肢深静脉血栓形成( DVT)患者肺栓塞( PE)的诊断价值。方法选取2011年7月-2013年11月河北省人民医院收治的下肢DVT患者63例,在彩色超声检查后1 d内所有患者进行肺灌注SPECT/CT显像。综合患者临床症状、病史、实验室检查、CT肺动脉造影( CTPA)、治疗效果及随访做出有无PE的最终诊断。计算经肺灌注SPECT/CT诊断下肢DVT患者PE的灵敏度、特异度、阳性预测值、阴性预测值、准确度。结果经肺灌注SPECT/CT诊断下肢DVT患者PE的灵敏度为94.4%,特异度为85.2%,阳性预测值为89.5%,阴性预测值为92.0%,准确度为90.5%。结论肺灌注SPECT/CT能够较准确地诊断下肢DVT患者的PE,为临床提供了一种可靠的诊断PE的方法。%Objective To explore the diagnostic value of pulmonary perfusion SPECT/CT on pulmonary embolism (PE)in patients with lower extremity deep vein thrombosis(DVT). Methods 63 patients with lower extremity DVT admitted to Hebei General Hospital from July 2011 to November 2013 were selected. All the patients were given pulmonary perfusion SPECT/CT within one day after color ultrasound examination. The final diagnosis of PE was confirmed by comprehensive analysis of the patients' clinical symptoms,medical history,laboratory examination,CTPA,treatment effect and follow up. The sensitivi-ty,specificity,positive predictive value,negative predictive value and accuracy of lung perfusion SPECT/CT in the diagnosis of PE in patients with lower extremity DVT were calculated. Results The sensitivity,specificity,positive predictive value,nega-tive predictive value and accuracy of lung perfusion SPECT/CT in the diagnosis of PE in patients with lower extremity DVT was 94. 4%,85. 2%,89. 5%,92. 0% and 90. 5%. Conclusion The PE of patients with lower extremity DVT can be accurately diagnosed by pulmonary perfusion SPECT

  16. Circumferential buckling instability of a growing cylindrical tube

    KAUST Repository

    Moulton, D.E.

    2011-03-01

    A cylindrical elastic tube under uniform radial external pressure will buckle circumferentially to a non-circular cross-section at a critical pressure. The buckling represents an instability of the inner or outer edge of the tube. This is a common phenomenon in biological tissues, where it is referred to as mucosal folding. Here, we investigate this buckling instability in a growing elastic tube. A change in thickness due to growth can have a dramatic impact on circumferential buckling, both in the critical pressure and the buckling pattern. We consider both single- and bi-layer tubes and multiple boundary conditions. We highlight the competition between geometric effects, i.e. the change in tube dimensions, and mechanical effects, i.e. the effect of residual stress, due to differential growth. This competition can lead to non-intuitive results, such as a tube growing to be thinner and yet buckle at a higher pressure. © 2011 Elsevier Ltd. All rights reserved.

  17. Thermal shock in a circumferentially cracked hollow cylinder with cladding

    Science.gov (United States)

    Nied, H. F.

    1984-01-01

    An theoretical analysis is presented which demonstrates the effect of cladding on the thermal resistance of a circumferentially cracked hollow cylinder. The cladding is assumed to be bonded to the inner wall of the hollow cylinder. The axisymmetric circumferential crack may be either embedded in the cylinder wall or may be an edge crack which passes through the clad and opens into the inner wall of the hollow cylinder. The problem is formulated mathematically and a solution is found which is in the form of a single integral equation. The integral equation is solved numerically and yields estimates of transient temperature distributions, thermal stresses in the uncracked cylinder, and stress intensity factors as a function of time for various cladding thickness to cylinder wall thickness ratios. It is shown that yielding of the clad under certain conditions can result in a reduction in the magnitude of the stress intensity factor for the crack tip in the elastic base material.

  18. Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion

    DEFF Research Database (Denmark)

    Videbaek, Tina S; Christensen, Finn B; Soegaard, Rikke;

    2006-01-01

    with respect to all four DPQ categories: daily activities, work/leisure, anxiety/depression, and social interest. The Oswestry Disability Index supported these results (P physical health (P ...STUDY DESIGN: Prospective randomized clinical study with a 5- to 9-year follow-up period. OBJECTIVE: The aim of the present study was to analyze the long-term outcome with respect to functional disability, pain, and general health of patients treated by means of circumferential lumbar fusion...... fusion (titanium Cotrel-Dubousset) or circumferential lumbar fusion (instrumented posterolateral fusion with anterior intervertebral support by a Brantigan cage). The primary outcome measure was the Dallas Pain Questionnaire (DPQ). The secondary outcome measures were the Oswestry Disability Index, the SF...

  19. Utilidade do Ultrassom intracardíaco no isolamento de veias pulmonares usando cateter-balão a laser Utilidad del ultrasonido intracardíaco en el aislamiento de venas pulmonares usando catéter-balón láser Utility of intracardiac ultrasound imaging to guide pulmonary vein ablation using laser balloon catheter

    Directory of Open Access Journals (Sweden)

    Luiz Leite

    2009-12-01

    . Se obtuvo el aislamiento completo en 38/59 (64%, y fue significantemente más común sin derrame: [30/38 (79% versus 8/23 (35%, pBACKGROUND: Pulmonary vein isolation (PVI with balloon catheter has been used as the endpoint for AF ablation. OBJECTIVE: To determine the usefulness of intracardiac ultrasound (ICUS to guide PVI using laser balloon catheter. METHODS: 59 PVs were ablated in 27 dogs. Doppler imaging was used to identify blood flow leaks between PV and balloon. After each energy delivery, the circular mapping catheter was repositioned to check if isolation had been achieved. The leak position was then correlated with the gap position at the pathological study. Multivariate logistic regression analysis was undertaken. RESULTS: 59 PV were ablated. Mean burn time was 279±177 sec, mean balloon diameter was 23±3 mm, and mean balloon length was 25±4 mm. Complete isolation was achieved in 38/59 (64% cases, and it was significantly more common when there was no leak: [30/38 (79% versus 8/23 (35%, p<0.001]. This occurred regardless of time of laser application (302±223 sec. vs. 266±148 sec., p=ns, laser power (3.5 W/cm, 4.5 W/cm, and 5.5 W/cm, balloon diameter (24± 3 mm vs. 22± 3 mm, p=ns and length (27±4 mm vs. 24±4mm, p=ns. The positive predictive value for predicting incomplete isolation was 65% and the negative predictive value was 83%. CONCLUSION: An identifiable leak between PV and the LBA device seen at the ICUS is predictive of lower PV isolation rates. ICUS may be useful for leak detection to avoid ineffective energy application during circumferential PV ablation. This could also be helpful when other types of energy are used.

  20. Deep vein thrombosis: a clinical review

    Directory of Open Access Journals (Sweden)

    Kesieme EB

    2011-04-01

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

  1. The correlation of pulmonary vein ostium area and left atrial volume index with the risk of thromboembolic events in patients with atrial fibrillation%肺静脉开口面积及左心房容积指数与房颤患者血栓栓塞风险的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王文娟; 常栋; 董颖雪; 尹晓盟; 夏云龙; 高连君; 张树龙

    2016-01-01

    Objective To investigate the correlation of pulmonary vein ostium area and left atrial volume index(LAVI)with the risk of thromboembolic events in patients with atrial fibrillation(AF). Methods A total of 206 non-valvular AF patients were continuously included in our study.Accord-ing to CHADS2 and CHA2 DS2-VASc scores,those scoring zero,1 point and no less than 2 points were divided into low-risk,average-risk and high-risk groups,respectively.All the patients were classified into thrombosis group and non-thrombosis group based on the results by transesophageal echocardiography(TEE)and brain computed tomography(CT).By the technology of multi-slice spiral computed tomography(MSCT),the ostium areas of left superior pulmonary vein (LSPV),left inferior pulmonary vein (LIPV),right superior pulmonary vein(RSPV)and right inferior pulmonary vein(RIPV)were measured.By transthoracic Doppler echocardiography,the upper and lower diam-eter,anteroposterior diameter,and left and right diameters of left atrium were measured while LAVI was calculated.By Spearman rank correlation analysis,the correlation of pulmonary vein ostium are-a and LAVI with the scores of thromboembolism risk was investigated.The clinical value of each in-dex in predicting thromboembolism of non-valvular AF patients was compared via ROC curve.Re-sults (i)According to CHADS2 scores,there were 73 cases(35.4%)in low-risk group,82 (39.8%)in average-risk group and 51 (24.8%)in high-risk group while according to CHA2 DS2-VASc scores,there were 41 cases(1 9.9%),67 cases(32.5%)and 98 cases(47.6%)separately in the three groups.LAVI,area of LSPV ostium,area of LIPV ostium,area of RSPV ostium and the total area of pulmonary vein ostium were significantly correlated with both CHADS2 and CHA2 DS2-VASc scores.(ii)LAVI,area of LSPV ostium,area of LIPV ostium and the total area of pulmonary vein ostium had diagnostic value in predicting the risk of thromboembolic events among non-valvular AF patients.Conclusion LAVI measured

  2. [Right ovarian vein syndrome].

    Science.gov (United States)

    Arvis, G

    1985-01-01

    Right ovarian vein syndrome is revealed in pregnancy by right lumbar pains, and even by nephritic colics. It results from a congenital malposition of the right ovarian vein, which presses the right ureter on the external iliac artery. Diagnosis is by intravenous urography and retrograde ureteral pyelography. If pain persists despite treatment by analgesics, it may be necessary to place a double-J catheter, and to operate after delivery to ligate the ovarian vein.

  3. Pulmonary edema

    Science.gov (United States)

    Lung congestion; Lung water; Pulmonary congestion; Heart failure - pulmonary edema ... Pulmonary edema is often caused by congestive heart failure . When the heart is not able to pump efficiently, ...

  4. Postpartum renal vein thrombosis.

    Science.gov (United States)

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  5. What Causes Varicose Veins?

    Science.gov (United States)

    ... blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg. Figure A shows ... blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg. Older age or ...

  6. Detection of a longitudinal defect in a pipe based on guided circumferential waves techniques

    Institute of Scientific and Technical Information of China (English)

    LI Longtao; HE Cunfu; WU Bin

    2005-01-01

    Based on elasticity theory, the multi-modes and disperse characteristics of guided circumferential waves in a pipe were investigated theoretically and experimentally, the disperse curves of guided circumferential waves were gotten by numerical calculations. The relationships between the angle of beam transducer, frequency and guided circumferential modes were analyzed by our guided wave experiment system. Then single guided circumferential mode was excited in the pipe (O.D 88.8 mm, I.D 80.8 mm). An artificial longitudinal defect (25 × 1 × 0.7 mm)on the surface of the pipe was detected by use of the single guided circumferential wave. The results show that single guided circumferential mode can be excited in the pipe by choosing special frequency and special angle beam transducer, similar to the excitation of Lamb wave in a plate, and it can be used to find the longitudinal defect on a pipe surface.

  7. Estimation of circumferential fiber shortening velocity by echocardiography.

    Science.gov (United States)

    Ruschhaupt, D G; Sodt, P C; Hutcheon, N A; Arcilla, R A

    1983-07-01

    The M-mode and two-dimensional echocardiograms of 40 young patients were analyzed to compare the mean circumferential fiber shortening velocity (Vcf) of the left ventricle calculated separately by two methods. The mean circumferential fiber shortening velocity was derived from the M-mode echocardiogram as minor axis shortening/ejection time and derived from the two-dimensional echocardiogram as actual circumference change/ejection time. With computer assistance, circumference was determined from the short-axis two-dimensional echocardiographic images during end-diastole and end-systole. Good correlations were obtained between the left ventricular diameter derived by M-mode echocardiography and the vertical axis during end-diastole (r = 0.79) and end-systole (r = 0.88) derived by two-dimensional echocardiography. Likewise, high correlations were noted between diameter and circumference in end-diastole (r = 0.89) and end-systole (r = 0.88). However, comparison of Vcf obtained by M-mode echocardiography with that obtained by two-dimensional echocardiography showed only fair correlation (r = 0.68). Moreover, the diameter/circumference ratio determined in end-diastole and end-systole differed significantly (p less than 0.001), possibly owing to the change in geometry of the ventricular sector image during systole. Although Vcf derived by M-mode echocardiography is a useful index of left ventricular performance, it does not truly reflect the circumference change during systole.

  8. DETERMINATION OF EFFICIENCY OF THE CIRCUMFERENTIAL DRAINAGE SYSTEM

    Directory of Open Access Journals (Sweden)

    Maciej Kroll

    2015-11-01

    Full Text Available One of the potential alternatives to improve the stability coefficient for an embankment structure is to flatten the filtration curve. As a result, we obtain lower body forces triggering the potential landslide and more advantageous soil strength parameters, which counteract landslide movements. In the case of waste dumps lowering the phreatic surface of waters is achieved thanks to the construction of auxiliary drainage systems, meeting the guidelines for their safe operation. The aim of this paper is to indicate a method facilitating the determination of the actual position of the phreatic surface within the deposited sediments and the assessment of efficiency of the circumferential drainage system in the waste dump. It was decided in this study to apply cone penetration test CPTU. The CPTU made it possible to measure dissipation of excess water pressure in pores identifying drainage conditions, which were compared with the results of piezometric measurements. The results of these tests made it possible to monitor changes in the position of the depression curve of supernatant waters in dams and to determine the efficiency of the circumferential drainage system.

  9. Drenagem anômala de veia pulmonar inferior direita em veia cava inferior associada a apêndice hepático intracardíaco Anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to intrathoracic hepatic appendix

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

    Full Text Available Descreve-se o caso de uma paciente de 61 anos de idade, com drenagem anômala de veia pulmonar inferior direita em veia cava inferior, associada a apêndice hepático intratorácico, herniado através de fenda no diafragma. A correção cirúrgica foi realizada por anastomose direta da veia anômala com o átrio esquerdo, pela redução do apêndice hepático para a cavidade abdominal e, finalmente, pelo fechamento do defeito diafragmático. O pós-operatório decorreu sem qualquer complicação. Os autores chamam a atenção para a raridade do caso.The authors present a case of a 61-year-old woman with anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to an intrathoracic hepatic appendix herniated through a diaphragmatic defect. Surgical correction was obtained by direct anastomosis of the anomalous vein to the left atrium, reduction of the hepatic appendix to the abdominal cavity and closure of the diphragmatic defect. The postoperative course was unevenftul. The rarity of this condition is stressed.

  10. 旋转式左心房造影在心房颤动消融中的应用%Contrast-enhanced X-ray rotational angiographic imaging of the left atrium and pulmonary veins for atrial fibrillation ablation

    Institute of Scientific and Technical Information of China (English)

    唐闽; 张澍; 李劲宏; Charalampos Christselis; 黄从新

    2008-01-01

    Objective Atrial fibrillation(AF)ablation is a complex procedure that requires detailed anatomic information about left atrium(LA)and pulmonary veins(PVs).The goal of this study was to test rotational angiography of the LA during adenosine-induced asystole as imaging tool in patients undergoing AF ablation.Methods Seventy patients with AF undergoing PVs isolation were included.After transseptal punction adenosine(30 mg)was given intravenously and during atrioventricular block contrast medium was directly injected in the LA and a rotational angiography performed(RAO 55°to LAO 55°).Rotational angiography images were assessed qualitatively and quantitively in all patients.Results Rotational angiography was performed successfully in 65 cases(65/70,94%)in one single rotation,and it was repeated in 5 cases(5/70,6%)with adenosine(40 mg)in second rotation.All the 4 PVs,left common PVs,accessory PVs and left atrial appendage ridges were delineated in rotational angiography.A blinded quantitative comparison of PV ostial diameters showed an excellent correlation between rotational angiography and CT measurements(r>0.90 for all PVs).No serious adverse effects occurred in association with adenosine.Conclusion Intraprocedural contrast-enhanced rotational angiography of the LA-PVs during adenosine-induced asystole is feasible and provides anatomical information of hish diagnostic value for AF ablation.%目的 实时了解左心房和肺静脉的解剖结构在导管消融治疗心房颤动(房颤)中起着重要作用.通过腺苷造成完全性房室阻滞,应用旋转式造影的方法进行左心房和肺静脉的实时显像,指导房颤的消融.方法 对70例房颤患者行经导管消融术,全部患者消融术前进行64排CT扫描,且进行左心房的三维重建.房间隔穿刺后,静脉注射腺苷(30 mg)造成完全性房室阻滞,同时向左心房内注射造影剂,进行旋转式左心房造影(右前斜55°~左前斜55.).对造影结果进行定性和定

  11. Characterization of mechanical and geometrical properties of a tube with axial and circumferential guided waves.

    Science.gov (United States)

    Yeh, Cheng-Hung; Yang, Che-Hua

    2011-05-01

    Guided waves propagating in cylindrical tubes are frequently applied for the characterization of material or geometrical properties of tubes. In a tube, guided waves can propagate in the axial direction and called axial guided waves, or in the circumferential direction called circumferential guided waves. Dispersion spectra for the axial and circumferential guided waves share some common behaviors and however exhibit some particular behaviors of their own. This study provides an investigation with theoretical modeling, experimental measurements, and a simplex-based inversion procedure to explore the similarity and difference between the axial guided waves and circumferential guided waves, aiming at providing useful information while axial and circumferential guided waves are applied in the area of material characterization. The sensitivity to the radius curvature for the circumferential guided waves dispersion spectra is a major point that makes circumferential guided waves different from axial guided waves. For the purpose of material characterization, both axial and circumferential guided waves are able to extract an elastic moduli and wall-thickness information from the dispersion spectra, however, radius information can only be extracted from the circumferential guided waves spectra.

  12. Congenital preduodenal portal vein

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Jin; Hwang, Mi Soo; Huh, Young Soo; Park, Bok Hwan [College of Medicine, Youngnam University, Gyeongsan (Korea, Republic of)

    1991-03-15

    Congenital preduodenal portal vein, first reported by Knight in 1921, is an extremely rare congenital anomaly in which the portal vein passes anteriorly to the duodenum rather than posteriorly in its normal location. It is of surgical significance because it may cause difficulties in operations involving the gall bladder, biliary duct, or duodenum. Recently, we experienced 2 cases of preduodenal portal vein. One was found during surgical exploration for the diagnosis and correction of malrotation of the bowels and the other in a 3 day-old male newborn associated with dextrocardia, situs inversus, and duodenal obstruction by diaphragm. We report these 2 cases with a review of the literature.

  13. Umbilical and portal vein calcification following umbilical vein catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, K.; Fendel, H.; Hartl, M.

    1989-07-01

    Calcifications of the umbilical vein and intrahepatic branches of the portal vein developed in a newborn who had inserted an umbilical vein catheter for 11 days postnatally. The calcified intrahepatic portal veins can still be demonstrated sonographically at the age of three years, whereby these calcifications were no longer detectable radiologically. (orig.).

  14. Low-frequency circumferential magnetization curves in magnetostrictive amorphous wires

    Energy Technology Data Exchange (ETDEWEB)

    Olivera, J. [Departamento de Fisica, Universidad de Oviedo, C/Calvo Sotelo s/n, 33007 Oviedo (Spain); Sanchez, M.L. [Departamento de Fisica, Universidad de Oviedo, C/Calvo Sotelo s/n, 33007 Oviedo (Spain); Prida, V.M. [Departamento de Fisica, Universidad de Oviedo, C/Calvo Sotelo s/n, 33007 Oviedo (Spain); Perez, M.J. [Departamento de Fisica, Universidad de Oviedo, C/Calvo Sotelo s/n, 33007 Oviedo (Spain); Santos, J.D. [Departamento de Fisica, Universidad de Oviedo, C/Calvo Sotelo s/n, 33007 Oviedo (Spain); Gorria, P. [Departamento de Fisica, Universidad de Oviedo, C/Calvo Sotelo s/n, 33007 Oviedo (Spain); Hernando, B. [Departamento de Fisica, Universidad de Oviedo, C/Calvo Sotelo s/n, 33007 Oviedo (Spain)]. E-mail: grande@pinon.ccu.uniovi.es; Sanchez Ll, J.L. [Laboratorio de Magnetismo, Facultad de Fisica-IMRE, Universidad de La Habana, La Habana 10400 (Cuba)

    2005-07-15

    Circumferential magnetization curves have been derived from the imaginary component of the impedance response in an Fe{sub 73.5}Si{sub 13.5}B{sub 9}Cu{sub 1}Nb{sub 3} amorphous wire. Measurements were performed at 1 kHz driving frequency, and 0.05- 20 mA{sub rms} current amplitude range. Axial DC fields from 0 to 100 Oe have been simultaneously applied in order to detect the magnetoinductive effect. The circular magnetization curves are compared with quasi-static longitudinal magnetization ones, and the results are analyzed on the basis of the core-shell model for a wire with positive magnetostriction.

  15. Transverse shear effect in a circumferentially cracked cylindrical shell

    Science.gov (United States)

    Delale, F.; Erdogan, F.

    1979-01-01

    The objectives of the paper are to solve the problem of a circumferentially-cracked cylindrical shell by taking into account the effect of transverse shear, and to obtain the stress intensity factors for the bending moment as well as the membrane force as the external load. The formulation of the problem is given for a specially orthotropic material within the framework of a linearized shallow shell theory. The particular theory used permits the consideration of all five boundary conditions as to moment and stress resultants on the crack surface. The effect of Poisson's ratio on the stress intensity factors and the nature of the out-of-plane displacement along the edges of the crack, i.e., bulging, are also studied.

  16. Ovarian vein thrombosis in Behçet disease.

    Science.gov (United States)

    Tan, Justina Wei Lynn; Howe, Hwee Siew; Chng, Hiok Hee

    2012-03-01

    We describe a 35-year-old Chinese woman with Behçet disease complicated by recurrent gastrointestinal flares. During admission for acute lower abdominal pain, a computed tomographic scan of the abdomen showed thrombosis of the left ovarian vein. She was treated with increased immunosuppressant and oral anticoagulant. Although she was not compliant to oral anticoagulant with her international normalized ratio frequently subtherapeutic, her symptoms abated and the thrombosis resolved. There has been only 1 reported case of a patient with Behçet disease presenting with postpartum ovarian vein thrombosis and pulmonary embolism and no reported case of Behçet disease with ovarian vein thrombosis occurring outside pregnancy and the puerperium. Ovarian vein thrombosis is a rare cause of abdominal pain that should be considered in patients with Behçet disease.

  17. Deep vein thrombosis.

    Science.gov (United States)

    Bandyopadhyay, Gargi; Roy, Subesha Basu; Haldar, Swaraj; Bhattacharya, Rabindra

    2010-12-01

    Occlusive clot formation in the veins causes venous thrombosis, the site most common in the deep veins of leg, called deep vein thrombosis. The clot can block blood flow and when it breaks off, called an embolism which in turn can damage the vital organs. Venous thrombosis occurs via three mechanisms ie, Virchow's triad. The mechanisms are decreased flow rate of blood, damage to the blood vessel wall and an increased tendency of the blood to clot. There are several factors which can increase a person's risk for deep vein thrombosis. The symptoms of deep vein thrombosis in the legs are pain, swelling and redness of the part. One variety of venous thrombosis is phlegmasia alba dolens where the leg becomes pale and cool. Investigations include Doppler ultrasound examination of the limb, D-dimer blood test, plethysmography of the legs, x-rays to show vein in the affected area (venography). Hospitalisation is necessary in some cases with some risk factors. The mainstream of treatment is with anticoagulants, mostly low molecular weight heparin for 6 months. Deep venous thrombosis is a rising problem. Early diagnosis and treatment is associated with a good prognosis.

  18. The use of circumferentially varying stagger guide vanes in an axial flow pump or compressor

    Science.gov (United States)

    Horlock, J. H.

    1990-04-01

    An actuator disk analysis is given of the flow through a guide vane and rotor combination. It is shown that changes in total pressure across the rotor are, in general, related to circumferential variations in guide vane outlet angle. In particular, known variations in inlet total pressure may be eliminated by suitable circumferential changes in guide vane stagger.

  19. Mesenteric vein thrombosis: CT identification

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-07-01

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

  20. Hepatic veins as a site of clot formation following liver resection

    Institute of Scientific and Technical Information of China (English)

    Emmanuel Buc; Safi Dokmak; Magaly Zappa; Marie Helene Denninger; Dominique Charles Valla; Jacques Belghiti; Olivier Farges

    2011-01-01

    Pulmonary embolism occurs more frequently after hepatectomy than previously thought but is infrequently associated with peripheral deep vein thrombosis. In thispaper, we report 2 cases of postoperative hepatic vein thrombosis after liver resection. Both patients had undergone major hepatectomy of a non-cirrhotic liver largely exposing the middle hepatic vein. Clots were incidentally found in the middle hepatic vein 4 and 17 d after surgery despite routine systemic thrombo-prophylaxis with low molecular weight heparin. Coagulation of the transitionplan in a context of mutation of the prothrombin gene and inflammation induced biloma were the likely predisposing conditions. Clots disappeared following curative anticoagulation. We conclude that thrombosis of hepatic veins may occur after liver resection and is a potential source of pulmonary embolism.

  1. Angular-profile tuning of guided waves in hollow cylinders using a circumferential phased array.

    Science.gov (United States)

    Li, Jian; Rose, Joseph L

    2002-12-01

    Angular-profile tuning of guided waves in hollow cylinders is implemented by using partial loading of the elements in a circumferentially placed phased array. Each partial loading element generates nonaxisymmetric guided waves in a pipe. In earlier work, numerical calculations and experiments have shown that, for nonaxisymmetric guided waves, circumferential distribution of particle displacements (i.e., the angular profile) changes with propagation distance, frequency, and mode. To change the angular profile at a certain distance, either frequency or mode has to be changed for a single partial loading element. This is not the case, however, for a circumferential phased array. The total angular profile of a circumferential array is the superposition of contributions from all elements. If given the knowledge of the angular profile for a single element, the total guided wave angular profile can be controlled and thus focused at any specific circumferential location by a circumferentially placed phased array with adjustable voltage level and phase inputs. This angular profile tuning technique can be used for implementing a circumferential scan with focused, guided wave beams, which leads to the detection of smaller defects as a result of stronger focused beams. Algorithms and specific nondestructive evaluation (NDE) applications for pipe inspection using this technique are discussed.

  2. Fracture behavior of short circumferentially surface-cracked pipe

    Energy Technology Data Exchange (ETDEWEB)

    Krishnaswamy, P.; Scott, P.; Mohan, R. [Battelle, Columbus, OH (United States)] [and others

    1995-11-01

    This topical report summarizes the work performed for the Nuclear Regulatory Comniission`s (NRC) research program entitled ``Short Cracks in Piping and Piping Welds`` that specifically focuses on pipes with short, circumferential surface cracks. The following details are provided in this report: (i) material property deteminations, (ii) pipe fracture experiments, (iii) development, modification and validation of fracture analysis methods, and (iv) impact of this work on the ASME Section XI Flaw Evaluation Procedures. The material properties developed and used in the analysis of the experiments are included in this report and have been implemented into the NRC`s PIFRAC database. Six full-scale pipe experiments were conducted during this program. The analyses methods reported here fall into three categories (i) limit-load approaches, (ii) design criteria, and (iii) elastic-plastic fracture methods. These methods were evaluated by comparing the analytical predictions with experimental data. The results, using 44 pipe experiments from this and other programs, showed that the SC.TNP1 and DPZP analyses were the most accurate in predicting maximum load. New Z-factors were developed using these methods. These are being considered for updating the ASME Section XI criteria.

  3. Management of Deep Vein Thrombosis (DVT) Prophylaxis in Trauma Patients.

    Science.gov (United States)

    Paydar, Shahram; Sabetian, Golnar; Khalili, Hosseinali; Fallahi, Javad; Tahami, Mohammad; Ziaian, Bizhan; Abbasi, Hamid Reza; Bolandparvaz, Shahram; Ghaffarpasand, Fariborz; Ghahramani, Zahra

    2016-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PTE) are known as venous thromboembolism (VTE). DVT occurs when a thrombus (a blood clot) forms in deep veins of the body, usually in the lower extremities. It can cause swelling or leg pain, but sometimes may occur with no symptoms. Awareness of DVT is the best way to prevent the VTE. Patients with trauma are at increased risk of DVT and subsequent PE because of coagulopathy in patients with multiple trauma, DVT prophylaxis is essential but the VTE prophylaxis strategy is controversial for the trauma patients. The risk factors for VTE includes pelvic and lower extremity fractures, and head injury.

  4. The role of Multidetector CT in the evaluation of the left atrium and pulmonary veins anatomy before and after radio-frequency catheter ablation for atrial fibrillation. Preliminary results and work in progress.Technical note; Il ruolo della TC Multidetettore nella valutazione anatomica dell'atrio sinistro e delle vene polmonari prima e dopo ablazione percutanea con radiofrequenza della fibrillazione atriale. Risultati preliminari e work in progress

    Energy Technology Data Exchange (ETDEWEB)

    Centoze, Maurizio; Della Sala, Sabino Walter; Dalla Palma, Francesco [Azienda Provinciale per i servizi sanitari, Trento (Italy). Dipartimento di radiodiagnostica; Del Greco, Maurizio; Marini, Massimiliano [Ospedale S. Chiara, Trento (Italy). U.O. di cardiologia; Nollo, Giandomenico; Ravelli, Flavia [Trento Univ., Trento (Italy). Dipartimento di fisica

    2005-07-15

    Radio-frequency catheter ablation (RFCA) of the distal pulmonary veins is increasingly being used to treat recurrent or refractory atrial fibrillation that doesn't respond to pharmacologic therapy or cardioversion. Successful RFCA of atrial al fibrillation depends on the pre-procedural understanding of the complex anatomy of the distal pulmonary veins and the left atrium. Aim of this parer is to describe the technical main features that characterise the multidetector helical computed tomography in the evaluation of this anatomic region before and after RFCA procedure. The 3D post-processing techniques useful for pre-RFCA planning are straightforward. [Italian] La ablazione percutanea con radiofrequenza (RFCA) del tratto distale delle vene polmonari nella fibrillazione atriale, che non risponde al trattamento farmacologico e alla cardioversione elettrica, e una procedura in grande sviluppo. Il successo del trattamento dipende dalla comprensione della complessa anatomia delle vene polmonari e dell'atrio sinistro. Lo scopo di questo articolo e illustrare gli aspetti tecnici fondamentali che caratterizzano lo studio di questa regione anatomica con TC spirale multidetettore prima e dopo RFCA. Particolare risalto e stato rivolto alle tecniche di post-processing 3D estremamente utili nella pianificazione della procedura di ablazione.

  5. Renal vein thrombosis

    Science.gov (United States)

    ... Saunders; 2012:chap 34. Read More Acute kidney failure Arteriogram Blood clots Dehydration Nephrotic syndrome Pulmonary embolus Renal Tumor Review Date 5/19/2015 Updated by: Charles Silberberg, ...

  6. Nonlinear giant magnetoimpedance and the asymmetric circumferential magnetization process in soft magnetic wires

    Science.gov (United States)

    Gómez-Polo, C.; Duque, J. G. S.; Knobel, M.

    2004-07-01

    The magnetoimpedance effect and its nonlinear terms are analysed for a (Co0.94Fe0.06)72.5Si12.5B15 amorphous wire. In order to enhance the nonlinear contribution the sample was previously subjected to current annealing (Joule heating) to induce a circumferential anisotropy. The effect of the application of a torsional strain on the nonlinear magnetoimpedance is analysed in terms of the torsional dependence of the magnetic permeability, evaluated through experimental circumferential hysteresis loops. The results obtained clearly confirm the direct correlation between the asymmetric circumferential magnetization process and the occurrence of nonlinear second-harmonic terms in the magnetoimpedance voltage.

  7. Design of optical cloaks and illusion devices along a circumferential direction in curvilinear coordinates

    Science.gov (United States)

    Chen, Tungyang; Yu, Shang-Ru

    2010-11-01

    We propose a cloaking and illusion device of circumferential topology based on the concept of transformation optics. The device is capable to cloak an object and/or simultaneously generate illusion images along a circumferential direction in curvilinear orthogonal coordinates. This feature allows us to construct multiple illusions in different ways, irrespective of the profile and direction of incident wave. Particularly when the device is served as a building brick of a larger device, one can generate a circumferential array of illusions in a periodic or any preferred pattern. We demonstrate the effectiveness of the proposed illusion devices by carrying out full wave simulations based on finite element calculations.

  8. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts

    2012-04-05

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

  9. Retinal vein occlusion

    Science.gov (United States)

    ... decrease the risk of retinal vein occlusion. These measures include: Eating a low-fat diet Getting regular exercise Maintaining an ideal weight Not smoking Aspirin or other blood thinners may help prevent blockages in the other eye. Controlling diabetes may ...

  10. [Ovarian vein syndrome].

    Science.gov (United States)

    Ferrero Doria, R; Guzmán Valls, P; López Alba, J; Tomás Ros, M; Rico Galiano, J L; Fontana Compiano, L O

    1996-04-01

    The Ovarian Vein Syndrome has been the subject of controversy ever since first described as such by Clark in 1964. This is an uncommon entity within urologic sings and symptoms which appears as a recurrent nephritic colic coinciding with menstruation or during the immediately preceding days. The authors review a clinical case from our Urology Service, including some considerations on the case.

  11. The vein collar

    DEFF Research Database (Denmark)

    Lundgren, F; Schroeder, Torben Veith

    2012-01-01

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

  12. Reduced Circumferential Resection Margin Involvement in Rectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit

    NARCIS (Netherlands)

    Gietelink, L.; Wouters, M.W.; Tanis, P.J.; Deken, M.M.; Berge, M.G. Ten; Tollenaar, R.A.; Krieken, J.H.J.M. van; Noo, M.E. de

    2015-01-01

    BACKGROUND: The circumferential resection margin (CRM) is a significant prognostic factor for local recurrence, distant metastasis, and survival after rectal cancer surgery. Therefore, availability of this parameter is essential. Although the Dutch total mesorectal excision trial raised awareness ab

  13. Variation in circumferential resection margin: Reporting and involvement in the South-Netherlands

    NARCIS (Netherlands)

    Homan, J.; Bokkerink, G.M.J.; Aarts, M.J.; Lemmens, V.E.; Lijnschoten, G. van; Rutten, H.J.; Wijsman, J.H.; Nagtegaal, I.D.; Wilt, J.H.W. de

    2015-01-01

    BACKGROUND: Since the introduction of total mesorectal surgery the outcome of rectal cancer patients has improved significantly. Involvement of the circumferential resection margin (CRM) is an important predictor of increased local recurrence, distant metastases and decreased overall survival. Abdom

  14. Effect of surface contamination on osseointegration of dental implants surrounded by circumferential bone defects.

    LENUS (Irish Health Repository)

    Mohamed, Seif

    2010-05-01

    This study was designed to evaluate the effect of surface contamination on osseointegration of dental implants surrounded by a circumferential bone defect and to compare osseointegration around Osseotite with that around Nanotite implants.

  15. ISSLS prize winner: cost-effectiveness of two forms of circumferential lumbar fusion

    DEFF Research Database (Denmark)

    Freeman, Brian J C; Steele, Nicholas A; Sach, Tracey H

    2007-01-01

    STUDY DESIGN: Economic evaluation alongside a prospective, randomized controlled trial from a secondary care National Health Service (NHS) perspective. OBJECTIVE: To determine the cost-effectiveness of titanium cages (TC) compared with femoral ring allografts (FRA) in circumferential lumbar spina...

  16. Effect of strength matching on the reliability of welded pipe with circumferential surface crack

    Institute of Scientific and Technical Information of China (English)

    何柏林; 于影霞; 霍立兴; 张玉凤

    2004-01-01

    For different strength matching, the reliability index and failure probability of welded pressure pipe with circumferential surface crack were calculated using three dimensional stochastic finite element method. This method has overcome the shortcomings of conservative results in safety assessment with deterministic fracture mechanics method. The effects of external moment and the depth of the circumferential surface crack (a) on the reliability of pressure pipe were also calculated and discussed. The calculation results indicate that the strength matching has certain effect on the reliability of the welded pressure pipe with circumferential surface crack. The failure probability of welded pressure pipe with high strength matching is lower than that with low strength matching at the same conditions. The effects of strength matching on the failure probability and reliability index increased by adding external moment (M) and the depth of the circumferential surface crack (a).

  17. Endovenous treatments for varicose veins

    NARCIS (Netherlands)

    R.R. van den Bos (Renate)

    2011-01-01

    textabstractEndovenous treatment is currently one of the most frequently used methods for treating varicose veins in the Netherlands. Varicose veins are tortuous and enlarged veins due to weakening in the vein’s wall or valves. They are manifestations of chronic venous disease (CVD), which may lead

  18. Understanding the link between circumferential dikes and eruptive fissures around calderas based on numerical and analog models

    Science.gov (United States)

    Corbi, Fabio; Rivalta, Eleonora; Pinel, Virginie; Maccaferri, Francesco; Acocella, Valerio

    2016-06-01

    Active calderas are seldom associated with circumferential eruptive fissures, but eroded magmatic complexes reveal widespread circumferential dikes. This suggests that, while the conditions to emplace circumferential dikes are easily met, mechanisms must prevent them from reaching the surface. We explain this discrepancy with experiments of air injection into gelatin shaped as a volcano with caldera. Analog dikes show variable deflection, depending on the competition between overpressure, Pe, and topographic unloading, Pl; when Pl/Pe = 4.8-5.3, the dikes propagate orthogonal to the least compressive stress. Due to the unloading, they become circumferential and stall below the caldera rim; buoyancy is fundamental for the further rise and circumferential fissure development. Numerical models quantitatively constrain the stress orientation within the gelatin, explaining the observed circumferential dikes. Our results explain how dikes propagate below the rim of felsic and mafic calderas, but only in the latter they are prone to feed circumferential fissures.

  19. Automatic Synthesis of Anthropomorphic Pulmonary CT Phantoms

    OpenAIRE

    Daniel Jimenez-Carretero; Raul San Jose Estepar; Mario Diaz Cacio; Maria J Ledesma-Carbayo

    2016-01-01

    The great density and structural complexity of pulmonary vessels and airways impose limitations on the generation of accurate reference standards, which are critical in training and in the validation of image processing methods for features such as pulmonary vessel segmentation or artery-vein (AV) separations. The design of synthetic computed tomography (CT) images of the lung could overcome these difficulties by providing a database of pseudorealistic cases in a constrained and controlled sc...

  20. Control of circumferential wall stress and luminal shear stress within intact vascular segments perfused ex vivo.

    Science.gov (United States)

    El-Kurdi, Mohammed S; Vipperman, Jeffrey S; Vorp, David A

    2008-10-01

    Proportional, integral, and derivative (PID) controllers have proven to be robust in controlling many applications, and remain the most widely used control system architecture. The purpose of this work was to use this architecture for designing and tuning two PID controllers. The first was used to control the physiologic arterial circumferential wall stress (CWS) and the second to control the physiologic arterial shear stress (SS) imposed on intact vascular segments that were implanted into an ex vivo vascular perfusion system (EVPS). In order to most accurately control the stresses imposed onto vascular segments perfused ex vivo, analytical models were derived to calculate the CWS and SS. The mid-vein-wall CWS was calculated using the classical Lame solution for thick-walled cylinders in combination with the intraluminal pressure and outer diameter measurements. Similarly, the SS was calculated using the Hagen-Poiseuille equation in combination with the flow rate and outer diameter measurements. Performance of each controller was assessed by calculating the root mean square of the error (RMSE) between the desired and measured process variables. The performance experiments were repeated ten times (N=10) and an average RMSE was reported for each controller. RMSE standard deviations were calculated to demonstrate the reproducibility of the results. Sterile methods were utilized for making blood gas and temperature measurements in order to maintain physiologic levels within the EVPS. Physiologic blood gases (pH, pO(2), and pCO(2)) and temperature within the EVPS were very stable and controlled manually. Blood gas and temperature levels were recorded hourly for several (N=9) 24 h perfusion experiments. RMSE values for CWS control (0.427+/-0.027 KPa) indicated that the system was able to generate a physiologic CWS wave form within 0.5% error of the peak desired CWS over each cardiac cycle. RMSE values for SS control (0.005+/-0.0007 dynescm(2)) indicated that the system

  1. Analyses of axial, lateral and circumferential deformations of rock specimen in triaxial compression

    Institute of Scientific and Technical Information of China (English)

    WANG Xue-bin

    2008-01-01

    The axial, lateral and circumferential strains were analyzed for a rock specimen subjected to shear failure in the form of a shear band bisecting the specimen in triaxial compression. Plastic deformation of the specimen stemmed from shear strain localization initiated at the peak shear stress. Beyond the onset of strain localization, the axial, lateral and circumferential strains were decomposed into two parts, respectively. One is the elas-tic strain described by general Hooke's law. The other is attributable to the plastic shear slips along shear band with a certain thickness dependent on the internal length of rock.The post-peak circumferential strain-axial strain curve of longer specimen is steeper than that of shorter specimen, as is consistent with the previous experiments. In elastic stage,the circumferential strain-axial strain curve exhibits nonlinear characteristic, as is in agreement with the previous experiment since confining pressure is loaded progressively until a certain value is reached. When the confining pressure is loaded completely, the circumferential strain-axial strain curve is linear in elastic and strain-softening stages. The predicted circumferential strain-axial strain curve in elastic and strain- softening stages agrees with the previous experiment.

  2. Primary pulmonary hypertension.

    Science.gov (United States)

    Rashid, A; Lehrman, S; Romano, P; Frishman, W; Dobkin, J; Reichel, J

    2000-01-01

    Primary pulmonary hypertension (PPH) is a condition characterized by sustained elevation of pulmonary artery pressure (PAP) without demonstrable cause. The most common symptom at presentation is dyspnea. Other complaints include fatigue, chest pain, syncope, leg edema, and palpitations. Right heart catheterization is diagnostic, showing a mean PAP >25 mmHg at rest and >30 mmHg during exercise, with a normal pulmonary capillary wedge pressure. In the National Institutes of Health-PPH registry, the median survival period was 2.8 years. Treatment is aimed at lowering PAP, increasing cardiac output, and decreasing in situ thrombosis. Vasodilators have been used with some success in the treatment of PPH. They include prostacyclin, calcium-channel blockers, nitric oxide and adenosine. Anticoagulation has also been advised for the prevention of deep vein thrombosis, pulmonary embolism, and in situ thromboses of the lungs. New drug treatments under investigation include L-arginine, plasma endothelin-I, and bosentan. Use of oxygen, digoxin, and diuretics for symptomatic relief have also been recommended. Patients with severe PPH refractory to medical management should be considered for surgery.

  3. Blood pooling in extrathoracic veins after glossopharyngeal insufflation

    DEFF Research Database (Denmark)

    Mijacika, Tanja; Frestad, Daria; Kyhl, Kasper

    2017-01-01

    PURPOSE: Trained breath-hold divers hyperinflate their lungs by glossopharyngeal insufflation (GPI) to prolong submersion time and withstand lung collapse at depths. Pulmonary hyperinflation leads to profound hemodynamic changes. METHODS: Thirteen divers performed preparatory breath-holds followed...... divers in a sub-study. RESULTS: After GPI, pulmonary volume increased by 0.8 ± 0.6 L above total lung capacity. The diameter of the superior caval (by 36 ± 17%) and intrathoracic part of the inferior caval vein decreased (by 21 ± 16%), while the diameters of the internal jugular (by 53 ± 34%), hepatic...... (by 28 ± 40%), abdominal part of the inferior caval (by 28 ± 28%), and femoral veins (by 65 ± 50%) all increased (P Blood volume of the internal jugular, the hepatic, the abdominal part of the inferior caval vein, and the combined common iliac and femoral veins increased by 145 ± 115, 80 ± 88...

  4. Pulmonary Fibrosis

    Science.gov (United States)

    Pulmonary fibrosis is a condition in which the tissue deep in your lungs becomes scarred over time. This ... blood may not get enough oxygen. Causes of pulmonary fibrosis include environmental pollutants, some medicines, some connective tissue ...

  5. Pulmonary Rehabilitation

    Science.gov (United States)

    ... shortness of breath and increase your ability to exercise. You may have heard that pulmonary rehabilitation is only for people with COPD (chronic obstructive pulmonary disease). We now know that ...

  6. Retroaortic left renal vein joining the left common iliac vein

    Energy Technology Data Exchange (ETDEWEB)

    Brancatelli, G.; Galia, M.; Finazzo, M.; Sparacia, G.; Pardo, S.; Lagalla, R. [Dept. of Radiology ' ' P. Cignolini' ' , Univ. of Palermo (Italy)

    2000-11-01

    Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly. (orig.)

  7. Thrombosis of right ovarian vein; Trombosis de la vena ovarica derecha

    Energy Technology Data Exchange (ETDEWEB)

    Forner, J.; Talens, A.; Flores, M.; Mendez, M. [Hospital General Universitario de Valencia. Valencia (Spain)

    2001-07-01

    Ovarian vein thrombosis is a rare postpartum complication (0.1%). It can be fatal, since it can lead to sepsis, pulmonary thromboembolisms and inferior vena cava or renal vein thrombosis. Computed tomography and magnetic resonance imaging are the techniques of choice for its diagnosis, while the value of ultrasound is limited due to its low sensitivity and specificity. We report the case of a woman who, during puerperium, developed thrombosis of right ovarian vein that presented clinical, ultrasonographic and computed tomographic features of appendicitis. We describe the radiological sings and stress the fact that this diagnosis should be suspected in puerperal women. (Author) 9 refs.

  8. Left ventricular strain and strain rate by 2D speckle tracking in chronic thromboembolic pulmonary hypertension before and after pulmonary thromboendarterectomy

    Directory of Open Access Journals (Sweden)

    Waltman Thomas J

    2010-09-01

    Full Text Available Abstract Background Echocardiographic evaluation of left ventricular (LV strain and strain rate (SR by 2D speckle tracking may be useful tools to assess chronic thromboembolic pulmonary hypertension (CTEPH severity as well as response to successful pulmonary thromboendarterectomy (PTE. Methods We evaluated 30 patients with CTEPH before and after PTE using 2D speckle tracking measurements of LV radial and circumferential strain and SR in the short axis, and correlated the data with right heart catheterization (RHC. Results PTE resulted in a decrease in mean PA pressure (44 ± 15 to 29 ± 9 mmHg, decrease in PVR (950 ± 550 to 31 ± 160 [dyne-sec]/cm5, and an increase in cardiac output (3.9 ± 1.0 to 5.0 ± 1.0 L/min, p change in circumferential strain and change in posterior wall radial strain correlated moderately well with changes in PVR, mean PA pressure and cardiac output (r = 0.69, 0.76, and 0.51 for circumferential strain [p Conclusions LV circumferential and posterior wall radial strain change after relief of pulmonary arterial obstruction in patients with CTEPH, and these improvements occur rapidly. These changes in LV strain may reflect effects from improved LV diastolic filling, and may be useful non-invasive markers of successful PTE.

  9. Accelerated circumferential strain quantification of the left ventricle using CIRCOME: simulation and factor analysis

    Science.gov (United States)

    Moghaddam, Abbas N.; Finn, J. Paul

    2008-03-01

    Circumferential strain of the left ventricle reflects myocardial contractility and is considered a key index of cardiac function. It is also an important parameter in the quantitative evaluation of heart failure. Circumferential compression encoding, CIRCOME, is a novel method in cardiac MRI to evaluate this strain non-invasively and quickly. This strain encoding technique avoids the explicit measurement of the displacement field and does not require calculation of strain through spatial differentiation. CIRCOME bypasses these two time-consuming and noise sensitive steps by directly using the frequency domain (k-space) information from radially tagged myocardium, before and after deformation. It uses the ring-shaped crown region of the k-space, generated by the taglines, to reconstruct circumferentially compression-weighted images of the heart before and after deformation. CIRCOME then calculates the circumferential strain through relative changes in the compression level of corresponding regions before and after deformation. This technique can be implemented in 3D as well as 2D and may be employed to estimate the overall global or regional circumferential strain. The main parameters that affect the accuracy of this method are spatial resolution, signal to noise ratio, eccentricity of the center of radial taglines their fading and their density. Also, a variety of possible image reconstruction and filtering options may influence the accuracy of the method. This study describes the pulse sequence, algorithm, influencing factors and limiting criteria for CIRCOME and provides the simulated results.

  10. Cephalic vein aneurysm.

    Science.gov (United States)

    Faraj, Walid; Selmo, Francesca; Hindi, Mia; Haddad, Fadi; Khalil, Ismail

    2007-11-01

    Cephalic vein aneurysms are rare malformations that may develop in any part of the vascular system, and their history, presentation, and management vary depending on their site. The etiology of venous aneurysms remains unclear, although several theories have been elaborated. Venous aneurysms are unusual vascular malformations that occur equally between the sexes and are seen at any age; they can present as either a painful or a painless subcutaneous mass. No serious complications have been reported from upper extremity venous aneurysms. Surgical excision is the definitive management for most of these. The case reported here presented with a painless and mobile, soft, subcutaneous mass that caused only cosmetic concern.

  11. Internal Jugular Vein Thrombosis following Oropharyngeal Infection

    Directory of Open Access Journals (Sweden)

    Asli Bostanci

    2015-01-01

    Full Text Available Internal jugular vein thrombosis (IJVT is a rare condition which may lead to life-threatening complications such as sepsis and pulmonary embolism. Prolonged central venous catheterization, intravenous (IV drug use, trauma, and radiotherapy are the most frequent causes of the IJVT. IJVT that develops after the oropharyngeal infection is a quite rare situation today. In this paper, a 37-year-old woman was presented; swelling occurred on her neck after acute tonsillitis and she was diagnosed with IJVT through Doppler ultrasonography and magnetic resonance imaging and managed without complications. Early diagnosis and conservative treatment with broad-spectrum IV antibiotics and anticoagulant agents have a critical importance for the prevention of fatal complications.

  12. Pulmonary vasculitis.

    Science.gov (United States)

    Lally, Lindsay; Spiera, Robert F

    2015-05-01

    Pulmonary vasculitis encompasses inflammation in the pulmonary vasculature with involved vessels varying in caliber from large elastic arteries to capillaries. Small pulmonary capillaries are the vessels most commonly involved in vasculitis affecting the lung. The antineutrophil cytoplasmic antibody-associated vasculitides, which include granulomatosis with polyangiitis (formerly Wegener granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome), are the small vessel vasculitides in which pulmonary vasculitis is most frequently observed and are the major focus of this review. Vasculitic involvement of the large pulmonary vessels as may occur in Behçet syndrome and Takayasu arteritis is also discussed.

  13. Historical Overview of Varicose Vein Surgery

    NARCIS (Netherlands)

    van den Bremer, Jephta; Moll, Frans L.

    2010-01-01

    Varicose veins are as old as Hippocrates. Varicose vein treatments come and go. Surgery for varicose vein disease is one of the commonest elective general surgical procedures. The history of varicose vein surgery has been traced. We note the first descriptions of varicose veins, and we particularly

  14. Circumferential myocardial strain in cardiomyopathy with and without left bundle branch block

    Directory of Open Access Journals (Sweden)

    Zimetbaum Peter J

    2010-01-01

    Full Text Available Abstract Background Cardiac resynchronization therapy (CRT has been shown to decrease mortality in 60-70% of advanced heart failure patients with left bundle branch block (LBBB and QRS duration > 120 ms. There have been intense efforts to find reproducible non-invasive parameters to predict CRT response. We hypothesized that different left ventricular contraction patterns may exist in LBBB patients with depressed systolic function and applied tagged cardiovascular magnetic resonance (CMR to assess circumferential strain in this population. Methods We determined myocardial circumferential strain at the basal, mid, and apical ventricular level in 35 subjects (10 with ischemic cardiomyopathy, 15 with non-ischemic cardiomyopathy, and 10 healthy controls. Patterns of circumferential strain were analyzed. Time to peak systolic circumferential strain in each of the 6 segments in all three ventricular slices and the standard deviation of time to peak strain in the basal and mid ventricular slices were determined. Results Dyskinesis of the anterior septum and the inferior septum in at least two ventricular levels was seen in 50% (5 out of 10 of LBBB patients while 30% had isolated dyskinesis of the anteroseptum, and 20% had no dyskinesis in any segments, similar to all of the non-LBBB patients and healthy controls. Peak circumferential strain shortening was significantly reduced in all cardiomyopathy patients at the mid-ventricular level (LBBB 9 ± 6%, non-LBBB 10 ± 4% vs. healthy 19 ± 4%; both p Conclusions Septal dyskinesis exists in some patients with LBBB. Myocardial circumferential strain analysis enables detailed characterization of contraction patterns, strengths, and timing in cardiomyopathy patients with and without LBBB.

  15. Self-Reacting Friction Stir Welding for Aluminum Alloy Circumferential Weld Applications

    Science.gov (United States)

    Bjorkman, Gerry; Cantrell, Mark; Carter, Robert

    2003-01-01

    Friction stir welding is an innovative weld process that continues to grow in use, in the commercial, defense, and space sectors. It produces high quality and high strength welds in aluminum alloys. The process consists of a rotating weld pin tool that plasticizes material through friction. The plasticized material is welded by applying a high weld forge force through the weld pin tool against the material during pin tool rotation. The high weld forge force is reacted against an anvil and a stout tool structure. A variation of friction stir welding currently being evaluated is self-reacting friction stir welding. Self-reacting friction stir welding incorporates two opposing shoulders on the crown and root sides of the weld joint. In self-reacting friction stir welding, the weld forge force is reacted against the crown shoulder portion of the weld pin tool by the root shoulder. This eliminates the need for a stout tooling structure to react the high weld forge force required in the typical friction stir weld process. Therefore, the self-reacting feature reduces tooling requirements and, therefore, process implementation costs. This makes the process attractive for aluminum alloy circumferential weld applications. To evaluate the application of self-reacting friction stir welding for aluminum alloy circumferential welding, a feasibility study was performed. The study consisted of performing a fourteen-foot diameter aluminum alloy circumferential demonstration weld using typical fusion weld tooling. To accomplish the demonstration weld, weld and tack weld development were performed and fourteen-foot diameter rings were fabricated. Weld development consisted of weld pin tool selection and the generation of a process map and envelope. Tack weld development evaluated gas tungsten arc welding and friction stir welding for tack welding rings together for circumferential welding. As a result of the study, a successful circumferential demonstration weld was produced leading

  16. phenoVein - A software tool for leaf vein segmentation and analysis

    OpenAIRE

    Bühler, Jonas; Rishmawi, Louai; Pflugfelder, Daniel; Huber, Gregor; Scharr, Hanno; Hülskamp, Martin; Koornneef, Maarten; SCHURR, ULRICH; Jahnke, Siegfried

    2015-01-01

    phenoVein is a software tool dedicated to automated segmenting and analyzing images of leaf veins. It includes comfortable manual correction features. Advanced image filtering automatically emphasizes veins from background and compensates for local brightness inhomogeneities. Phenotypical leaf vein traits being calculated are total vein density, vein lengths and widths and skeleton graph statistics. For determination of vein widths, a model based vein edge estimation approach has been impleme...

  17. An analysis of the Circumferential Grooves Casing Treatment for transonic compressor flow

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The stall mechanism of the NASA Rotor 37 is investigated through the analysis of the critical flow structures near the stall under the transonic condition. The performance of the rotor with Circumferential Grooves Casing Treatment (CGCT) is also studied based on the Reynolds-Averaging Navier-Stokes approach. The study finds that stall margin improvement can be achieved without significant penalty on the efficiency for the two CGCT configurations applied. The effects of circumferential grooves on the critical flow structures are studied through the analysis of the tip leakage mass and momentum transport that further re-veal the CGCT mechanism.

  18. A second patient with MCA/MR syndrome with multiple circumferential skin creases.

    Science.gov (United States)

    Leonard, N J

    2002-09-15

    Symmetrical congenital circumferential skin creases are a rare feature described in only a few conditions. We report a case of a 29-month-old boy with symmetrical circumferential skin creases on arms, legs, and digits, and other features reminiscent of the single case reported by Cohen et al. [1993: Clin Dysmorphol 2:39-46] and reviewed by Elliott et al. [1996: Am J Med Genet 62:23-25]. The key features also include epicanthic folds, microphthalmia, microcornea, microcephaly, small, low-set posteriorly angulated ears with thick overfolded helices, cleft palate, and moderate-severe psychomotor developmental delay.

  19. Tomografia computadorizada na avaliação tardia do tratamento cirúrgico da conexão anômala total de veias pulmonares Computed tomography in late evaluation of surgical treatment of pulmonary veins total anomalous connection

    Directory of Open Access Journals (Sweden)

    Ulisses Alexandre Croti

    2011-12-01

    findings of multislice computed tomography (MSCT are associated with clinical and laboratory tests routinely used in the late follow-up of children undergoing surgical treatment of total anomalous pulmonary venous connection (TAPVC. METHODS: From January 2002 to December 2007, 12 patients operated due to CATVP were evaluated with history, physical examination, chest X-ray, electrocardiogram, echocardiography and MSCT. Specific changes observed in each one of these tests were identified and compared with MSCT qualitative findings. RESULTS: Eleven patients were in functional class I (NYHA, three had nonspecific murmurs, and three were below the 15th percentile of weight and height. Two had pulmonary field abnormalities and three had a slight increase of the cardiac area in the X-ray examination. In the electrocardiogram, one patient had right ventricular overload and one had junctional rhythm. All echocardiograms were within the normal range, except for one patient with stenosis between the superior vena cava and right atrium. MSCT was completely normal in four patients, three had compression of the pulmonary veins and four had significant caliber reduction, which correlated with the other findings. Thus, MSCT showed a sensitivity of 87.5%, specificity of 0.75%, positive predictive value of 87.5%, negative predictive value of 75% and accuracy of 83.3% to demonstrate anatomic changes compared to changes in the physical examination or other additional tests. CONCLUSION: MSTC may provide valuable information and complement the diagnosis of possible anatomical and functional changes in the late follow-up of patients undergoing surgical repair of TAPVC.

  20. Agenesis of the iliac veins.

    Science.gov (United States)

    Thomas, M L; Posniak, H V

    1984-01-01

    Three case reports of patients with the rare anomaly of agenesis of the iliac veins are presented. It is emphasised that full phlebographic investigation should be carried out in such patients before surgical treatment is considered. It is pointed out that surgical ablation may exacerbate the symptoms of leg swelling and varicose veins for which the patients seek advice.

  1. Leiomyosarcoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Lemos Gustavo C.

    2003-01-01

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

  2. Infrared imaging of varicose veins

    Science.gov (United States)

    Noordmans, Herke Jan; de Zeeuw, Raymond; Verdaasdonk, Ruud M.; Wittens, Cees H. A.

    2004-06-01

    It has been established that varicose veins are better visualized with infrared photography. As near-infrared films are nowadays hard to get and to develop in the digital world, we investigated the use of digital photography of varicose veins. Topics that are discussed are illumination setup, photography and digital image enhancement and analysis.

  3. 10-Minute Conultation Varicose veins

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    A 55 year old woman presents with a history of tortuous veins on both legs and a related ache towards the end of the day.She finds these veins unsightly and would like to know whether she can have them treated.

  4. Pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Lauro Martins Júnior

    2014-12-01

    Full Text Available Pulmonary hypertension is a pathological condition associated with various diseases, which must be remembered by the physicians, since early diagnosis may anticipate and avoid dangerous complications and even death if appropriate measures were not taken. The relationship with chronic obstructive pulmonary disease (COPD, important pathological process that is in increasing prevalence in developing countries, and leading position as cause of death, emphasizes its importance. Here are presented the classifications, pathophysiology, and general rules of treatment of pulmonary hypertension.

  5. CT Pulmonary Angiography and Suspected Acute Pulmonary Embolism

    Energy Technology Data Exchange (ETDEWEB)

    Enden, T.; Kloew, N.E. [Ullevaal Univ. Hospital, Oslo (Norway). Dept. of Cardiovascular Radiology

    2003-05-01

    Purpose: To evaluate the use and quality of CT pulmonary angiography in our department, and to relate the findings to clinical parameters and diagnoses. Material and Methods: A retrospective study of 324 consecutive patients referred to CT pulmonary angiography with clinically suspected pulmonary embolism (PE). From the medical records we registered clinical parameters, blood gases, D-dimer, risk factors and the results of other relevant imaging studies. Results: 55 patients (17%) had PE detected on CT. 39 had bilateral PE, and 8 patients had isolated peripheral PE. 87% of the examinations showing PE had satisfactory filling of contrast material including the segmental pulmonary arteries, and 60% of the subsegmental arteries. D-dimer test was performed in 209 patients, 85% were positive. A negative D-dimer ruled out PE detected at CT. Dyspnea and concurrent symptoms or detection of deep vein thrombosis (DVT), contraceptive pills and former venous thromboembolism (VTE) were associated with PE. The presence of only one clinical parameter indicated a negative PE diagnosis (p < 0.017), whereas two or more suggested a positive PE diagnosis (p < 0.002). CT also detected various ancillary findings such as consolidation, pleural effusion, nodule or tumor in nearly half of the patients; however, there was no association with the PE diagnosis. Conclusion: The quality of CT pulmonary angiography was satisfactory as a first-line imaging of PE. CT also showed additional pathology of importance in the chest. Our study confirmed that a negative D-dimer ruled out clinically suspected VTE.

  6. Sagittal vein thrombosis caused by central vein catheter.

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-03-01

    Full Text Available Cerebral venous thrombosis, including thrombosis of cerebral veins and major dural sinuses, is an uncommon disorder in the general population. However, it has a higher frequency among patients younger than 40 years of age, patients with thrombophilia, pregnant patients or those receiving hormonal contraceptive therapy or has foreign body such as catheter in their veins or arterial system. In this case report, we described clinical and radiological findings in a patient with protein C-S deficiency and malposition of central vein catheter.

  7. Excluding deep vein thrombosis in primary care: validation, updating, and implementation of a diagnostic rule.

    NARCIS (Netherlands)

    Toll, D.B.

    2008-01-01

    In primary care patients suspected of deep vein thrombosis (DVT), it is a challenge to discriminate the patients with DVT from those without DVT. The risk of missing the diagnosis (which may result in a potentially lethal pulmonary embolism) and the risk of unnecessary referral and treatment with a

  8. Bilateral upper-extremity deep vein thrombosis following central cord syndrome

    OpenAIRE

    Onmez, Hilal; Cingoz, Havva Turac; Kucuksen, Sami; Anliacık, Emel; Yaşar, Ozan; Yilmaz, Halim; Salli, Ali

    2013-01-01

    Deep vein thrombosis (DVT) is a common complication following spinal cord injury (SCI). Although DVT of the upper extremity is much less common than DVT of the lower extremities, the risk of pulmonary embolism following upper-extremity DVT should not be disregarded.

  9. [Tactics of the patients management in continuing acute thrombosis of deep veins].

    Science.gov (United States)

    Prasol, V A; Mishenina, E V; Okley, D V

    2015-03-01

    Experience of active tactics of treatment application in 18 patients, suffering an acute thrombosis in system of lower vena cava, is presented. Possibilities were estimated and efficacy of active surgical tactics proved in continuing deep vein thrombosis on early stage were estimated. Active tactics, using catheter--governed thrombolysis, permits to escape pulmonary thromboembolism and to reduce a severity of further chronic venous insufficiency.

  10. Optimization of the axial compressor flow passage to reduce the circumferential distortion

    Science.gov (United States)

    Popov, G.; Kolmakova, D.; Shklovets, A.; Ermakov, A.

    2015-08-01

    This work is motivated by the necessity to reduce the effects of the flow circumferential distortion in the flow passage of the aircraft gas turbine engine (GTE). In previous research, the authors have proposed the approaches to decrease of the flow circumferential distortion arising from the mid-support racks of GTE compressor and having a negative impact on the blade rows, located upstream. In particular, the idea of introducing the circumferentially non-uniform blade pitch and profile stagger angle of guide vanes located in front of the support was contributed in order to redistribute the flow and decrease the dynamic stresses in the rotor wheel of the same stage. During the research presented in this paper, another principal of reduction of the flow circumferential distortion was chosen. Firstly, the variants of upgrading the existing support racks were found. Secondly, the new design of support was offered. Both the first and the second version of the support design variation took into account the availability of technological and structural limitations associated with the location of oil pipes, springs and others elements in the support racks. Investigations of modified design showed that the support with altered racks provides a reduction of dynamic stresses by 20% at resonance with the most dangerous harmonic, and the new design of support can give the decrease of 30%.

  11. Numerical Simulation of the Flow Field in Circumferential Grooved Liquid Seals

    Directory of Open Access Journals (Sweden)

    Meng Zhang

    2013-01-01

    Full Text Available Circumferential grooved liquid seals are utilized inside turbomachinery to provide noncontacting control of internal incompressible fluid leakage. Accurate prediction of the flow field is fundamental in producing robust and efficient designs. To validate the capabilities of the computational fluid dynamics FLUENT for incompressible fluid seal flow, comparisons of velocity parameters are made to the published experimental results and other CFD code for a circumferential grooved liquid seal. This work employs a pressure-based CFD code FLUENT to calculate the flow field in the seal, using four different turbulence models respectively. The velocity contours are compared with experimental values. It shows good overall agreement of the axial, radial, and azimuthal velocities in the through-flow jet, shear layer, and recirculation zone. Quantitative comparisons of velocity profiles at the center of the groove are made to experiment. This study verifies the prediction accuracy of three turbulence models. Various structures were considered to obtain a better understanding of the circumferential grooved liquid flow characteristics. The best groove structure to control leakage was also found within the limited designed seal. This study will provide a useful reference for designing the circumferential grooved liquid seal.

  12. Conventional CT for the prediction of an involved circumferential resection margin in primary rectal cancer

    NARCIS (Netherlands)

    Wolberink, Steven V. R. C.; Beets-Tan, Regina G. H.; de Haas-Kock, Danielle F. M.; Span, Mark M.; van de Jagt, Eric J.; van de Velde, Cornelis J. H.; Wiggers, Theo

    2007-01-01

    Purpose: To determine the accuracy of conventional computed tomography (CT) scan in the preoperative prediction of an involved circumferential resection margin (CRM) in primary rectal cancer. Methods: 125 patients with biopsy-proven adenocarcinoma of the rectum underwent CT of the abdomen before und

  13. Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter.

    Science.gov (United States)

    Lee, Hsiang-Chieh; Ahsen, Osman Oguz; Liang, Kaicheng; Wang, Zhao; Cleveland, Cody; Booth, Lucas; Potsaid, Benjamin; Jayaraman, Vijaysekhar; Cable, Alex E; Mashimo, Hiroshi; Langer, Robert; Traverso, Giovanni; Fujimoto, James G

    2016-08-01

    We demonstrate a micromotor balloon imaging catheter for ultrahigh speed endoscopic optical coherence tomography (OCT) which provides wide area, circumferential structural and angiographic imaging of the esophagus without contrast agents. Using a 1310 nm MEMS tunable wavelength swept VCSEL light source, the system has a 1.2 MHz A-scan rate and ~8.5 µm axial resolution in tissue. The micromotor balloon catheter enables circumferential imaging of the esophagus at 240 frames per second (fps) with a ~30 µm (FWHM) spot size. Volumetric imaging is achieved by proximal pullback of the micromotor assembly within the balloon at 1.5 mm/sec. Volumetric data consisting of 4200 circumferential images of 5,000 A-scans each over a 2.6 cm length, covering a ~13 cm(2) area is acquired in <18 seconds. A non-rigid image registration algorithm is used to suppress motion artifacts from non-uniform rotational distortion (NURD), cardiac motion or respiration. En face OCT images at various depths can be generated. OCT angiography (OCTA) is computed using intensity decorrelation between sequential pairs of circumferential scans and enables three-dimensional visualization of vasculature. Wide area volumetric OCT and OCTA imaging of the swine esophagus in vivo is demonstrated.

  14. Mechanical characterization of human aortas from pressurization testing and a paradigm shift for circumferential residual stress.

    Science.gov (United States)

    Labrosse, Michel R; Gerson, Eleanor R; Veinot, John P; Beller, Carsten J

    2013-01-01

    Material properties needed for accurate stress analysis of the human aorta are still incompletely known, especially as many reports have ignored the presence of residual stresses in the aortic wall. To contribute new material regarding these issues, we carried out measurements and pressurization testing on ascending, thoracic and abdominal aortic samples from 24 human subjects aged 38-77 years, and evaluated the opening angle describing the circumferential residual stress level present in the aorta. We determined material constants for the aorta by gender, anatomic location and age group, according to a simple phenomenological constitutive model. The unpressurized aortic radius positively correlated with age, and the circumferential and longitudinal stretch ratios under systemic pressure negatively correlated with age, confirming the known enlargement and stiffening of the aorta with aging. The opening angle was measured to range from a minimum of 89° to above 360° for extreme cases. For given aortic dimensions and material properties, analysis of the in vivo circumferential and longitudinal mural stress distributions indicated a profound influence of the opening angle. For instance, in the thoracic aorta of males aged 38-66, opening angles in the range of 0° to 80° (resp. 60°) may equalize the gradient of in vivo circumferential (resp. longitudinal) stress between the inner and outer layers of the aorta, as commonly expected; however, opening angles above 160° (resp. 120°) may cause the gradient of circumferential (resp. longitudinal) stress to reverse and increase compared to the case without residual stress, putting the maximum stresses toward the adventitia instead of the intima. Even though the analysis of the aortic wall excluded possible longitudinal residual stresses as well as material inhomogeneities, such as constitutive differences between the intimal, medial and adventitial layers, the experimental data reported herein are important to aortic

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

    Science.gov (United States)

    Noori Hoshyar, Azadeh; Sulaiman, Riza

    2011-10-01

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

  16. Automated integer programming based separation of arteries and veins from thoracic CT images.

    Science.gov (United States)

    Payer, Christian; Pienn, Michael; Bálint, Zoltán; Shekhovtsov, Alexander; Talakic, Emina; Nagy, Eszter; Olschewski, Andrea; Olschewski, Horst; Urschler, Martin

    2016-12-01

    Automated computer-aided analysis of lung vessels has shown to yield promising results for non-invasive diagnosis of lung diseases. To detect vascular changes which affect pulmonary arteries and veins differently, both compartments need to be identified. We present a novel, fully automatic method that separates arteries and veins in thoracic computed tomography images, by combining local as well as global properties of pulmonary vessels. We split the problem into two parts: the extraction of multiple distinct vessel subtrees, and their subsequent labeling into arteries and veins. Subtree extraction is performed with an integer program (IP), based on local vessel geometry. As naively solving this IP is time-consuming, we show how to drastically reduce computational effort by reformulating it as a Markov Random Field. Afterwards, each subtree is labeled as either arterial or venous by a second IP, using two anatomical properties of pulmonary vessels: the uniform distribution of arteries and veins, and the parallel configuration and close proximity of arteries and bronchi. We evaluate algorithm performance by comparing the results with 25 voxel-based manual reference segmentations. On this dataset, we show good performance of the subtree extraction, consisting of very few non-vascular structures (median value: 0.9%) and merged subtrees (median value: 0.6%). The resulting separation of arteries and veins achieves a median voxel-based overlap of 96.3% with the manual reference segmentations, outperforming a state-of-the-art interactive method. In conclusion, our novel approach provides an opportunity to become an integral part of computer aided pulmonary diagnosis, where artery/vein separation is important.

  17. Neonatal renal vein thrombosis.

    Science.gov (United States)

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  18. Upper extremity deep vein thrombosis in a military patient.

    Science.gov (United States)

    Bullock, Charlotte; Johnston, A McD

    2016-08-01

    We describe the case of a 23-year-old serviceman on overseas deployment who presented with a painful, swollen arm. Investigations showed an upper extremity deep vein thrombosis (UEDVT) of the right arm with an associated asymptomatic pulmonary embolism, which was treated with warfarin anticoagulation. Further investigation identified positional obstruction at the thoracic outlet, and the patient was diagnosed with Paget-Schroetter syndrome. He underwent elective resection of the first rib, and has now returned to normal duties. After review of the literature on UEDVT, it is suggested that in this military patient, the occurrence of an anatomical variant put him at risk of upper limb venous thrombosis, which was probably potentiated by the occupational factor of carrying a rifle. The external compression of the subclavian vein from the rifle butt and hypertrophied muscles, in addition to the anatomical variation, caused repetitive microtrauma of the vessel intima, which precipitated venous thrombosis.

  19. Haemoptysis due to pulmonary venous stenosis

    Directory of Open Access Journals (Sweden)

    Silke Braun

    2014-06-01

    Full Text Available Haemoptysis is a potentially life-threatening condition with the need for prompt diagnosis. In about 10–20% of all cases the bleeding source remains unexplained with the standard diagnostic approach. The aim of this article is to show the necessity of widening the diagnostic approach to haemoptysis with consideration of pulmonary venous stenosis as a possible cause of even severe haemoptysis and haemoptoe. A review of the literature was performed using the Medline/PubMed database with the terms: “pulmonary venous stenosis”, “pulmonary venous infarction” and “haemoptysis”. Further references from the case reports were considered. 58 case reports and case collections about patients with haemoptysis due to pulmonary venous stenosis were detected. This review gives an overview about the case reports and discusses the underlying pathophysiology and the pros and cons of different imaging techniques for the detection of pulmonary venous stenosis. Several conditions predispose to the obstruction of the mediastinal pulmonary veins. Clinical findings are unspecific and may be misleading. Pulmonary venous stenosis can be detected using several imaging techniques, yet three-dimensional magnetic resonance-angiography and three-dimensional contrast-enhanced computed tomography are the most appropriate. Pulmonary venous stenosis should be considered in patients with haemoptysis.

  20. A Vein Map Biometric System

    Directory of Open Access Journals (Sweden)

    Felix Fuentes

    2013-08-01

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

  1. Primary Pulmonary Sequestration With Secondary Hamartomatosis Change

    Directory of Open Access Journals (Sweden)

    Liang

    2015-07-01

    Full Text Available The radiologic features of intralobar pulmonary sequestration (ILPS have been describe and include the identification of a feeding systemic artery with venous drainage through pulmonary veins. Primary sequestration associated with typical hamartoma signs is really rare and has been described only once. We describe a patient with ILPS whose radiographic findings were unusual for two reasons. First, computed tomography (CT demonstrated a bulky mass in the pulmonary sequestration. The size of lesion and histopathology made it an unusual presentation. Final histology study demonstrated pulmonary hamartoma with predominantly adipose and cartilage differentiation, which is an unusual complication originated from ILPS. Another sign also explains the second unusual feature, intracranial cholesteatoma, occurring concurrently with ILPS.

  2. [Surgery of essential varicose veins].

    Science.gov (United States)

    Maraval, M

    1994-03-15

    Idiopathic varicose veins of the lower limbs are a frequent but benign disorder. Surgery is only a moment in the course of the disease. Although not the only treatment of essential varicose veins, surgery by an experienced team performing crossectomy, stripping by intussusception using a stripper, and phlebectomy gives fully satisfactory results, both to patient and to physician, in over 80% of cases. New techniques were recently developed that, at present, have not confirmed early hopes.

  3. Size of the thrombus in acute deep vein thrombosis and the significance of patients' age and sex.

    Science.gov (United States)

    Kierkegaard, A

    1981-01-01

    To determine the significance of patients' age and sex on the size of the thrombus in acute deep vein thrombosis, 420 consecutive phlebograms with acute deep vein thrombosis were studied. A significant correlation between the size of the thrombus and increasing age of the patient as well as the sex of male was noted. It is concluded that older patients and men often are at a high risk of pulmonary embolism at the time of diagnosis.

  4. Portal Vein Thrombosis in non cirrhotic patients

    NARCIS (Netherlands)

    M.C.W. Spaander (Manon)

    2010-01-01

    textabstractExtrahepatic portal vein thrombosis (EPVT) is the most common cause of portal hypertension in non- cirrhotic patients. EPVT has been defined as an obstruction of the extrahepatic portal vein with or without involvement of the intrahepatic portal veins. Although the portal vein accounts f

  5. Deep vein thrombosis: A rare complication in oral and maxillofacial surgery: A review of two cases

    Directory of Open Access Journals (Sweden)

    M.R. Ramesh Babu

    2013-01-01

    Full Text Available Deep vein thrombosis (DVT is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism.

  6. [VENOUS THROMBOSIS OF THE LEFT OVARIAN AND EXTENSION TO THE RENAL VEIN].

    Science.gov (United States)

    Jean, F; Claudot, A; Istace, B; Petit, P; Nisolle, M

    2016-01-01

    Ovarian vein thrombosis is a rare, but potentially serious postpartum complication. In 80% of the cases, it occurs on the right side and in less than 6% on the left side; it is bilateral in 14% of cases. The usual clinical features include abdominal pain, fever and leucocytosis. However, the diagnosis is often complicated by other non specific signs and symptoms. Ovarian vein thrombosis may cause sepsis, pulmonary thromboembolism, and thrombosis of the inferior vena cava and the renal vein. The diagnosis can be established by CT scan or nuclear magnetic resonance imaging, which has a high sensitivity and specificity. Treatment for the ovarian vein thrombosis includes antibiotics and anticoagulation. The complications can sometimes be surgically managed. Prompt diagnosis and treatment can decrease the morbidity and the mortality. Nowadays, the fatal issue is rare as the appropriate treatment is quickly instaured.

  7. Risk of deep vein thrombosis and pulmonary embolism in asthma

    NARCIS (Netherlands)

    Majoor, Christof J.; Kamphuisen, Pieter W.; Zwinderman, Aeilko H.; Brinke, Anneketen; Amelink, Marijke; Rijssenbeek-Nouwens, Lucia; Sterk, Peter J.; Büller, Harry R.; Bel, Elisabeth H.

    2013-01-01

    Increasing evidence suggests that patients with asthma have activated coagulation within the airways. Whether this leads to an increase in venous thromboembolic events is unknown. We therefore assessed the incidence of venous thromboembolic events in patients with mild-to-moderate and severe asthma

  8. Travelers' Health: Deep Vein Thrombosis and Pulmonary Embolism

    Science.gov (United States)

    ... hormone replacement therapy) Pregnancy and the postpartum period Thrombophilia (such as factor V Leiden mutation or antiphospholipid ... she has a risk factor such as inherited thrombophilia. The combination of air travel with preexisting individual ...

  9. Central retinal vein occlusion following Sirsasana (headstand posture

    Directory of Open Access Journals (Sweden)

    Shah Nikunj

    2009-01-01

    Full Text Available We report a case of central retinal vein occlusion (CRVO following Sirsasana, a head-down postural yoga. A 55-year-old male patient presented to us, with sudden-onset loss of vision following Sirsasana, in the right eye. The patient had suffered from pulmonary thromboembolism 5 years earlier and was receiving warfarin prophylaxis. Over 6 months of follow-up, the patient developed neovascularization of the iris and was subjected to panretinal laser with no improvement in visual acuity. Sirsasana could be an important risk factor for CRVO especially in predisposed patients.

  10. Medical image of the week: partial anomalous pulmonary venous return

    Directory of Open Access Journals (Sweden)

    Wong C

    2014-10-01

    Full Text Available A 69 year old woman presented with septic shock secondary to a urinary tract infection. A chest radiograph (Figure 1 done after uneventful placement of a left internal jugular central line showed aberrant position of the catheter. Review of a past contrast-enhanced CT chest (Figure 2 revealed an anomalous pulmonary venous return with a pulmonary vein draining to the brachiocephalic vein. Partial anomalous pulmonary venous return (PAPVR is a rare congenital defect which results in a left-to-right shunt. The prevalence was 0.1% in one retrospective study of 45,538 contrast-enhanced chest CT scans (1. Diagnosis can be made with echocardiography, angiography, right heart catheterization, or computed tomography. PAPVR is traditionally associated with atrial septal defects, and patients are often asymptomatic. Clinical manifestations occur when there is significant shunting and include syncope, right heart failure, and pulmonary hypertension (2.

  11. Automatic Synthesis of Anthropomorphic Pulmonary CT Phantoms

    Science.gov (United States)

    Jimenez-Carretero, Daniel; San Jose Estepar, Raul; Diaz Cacio, Mario; Ledesma-Carbayo, Maria J.

    2016-01-01

    The great density and structural complexity of pulmonary vessels and airways impose limitations on the generation of accurate reference standards, which are critical in training and in the validation of image processing methods for features such as pulmonary vessel segmentation or artery–vein (AV) separations. The design of synthetic computed tomography (CT) images of the lung could overcome these difficulties by providing a database of pseudorealistic cases in a constrained and controlled scenario where each part of the image is differentiated unequivocally. This work demonstrates a complete framework to generate computational anthropomorphic CT phantoms of the human lung automatically. Starting from biological and image-based knowledge about the topology and relationships between structures, the system is able to generate synthetic pulmonary arteries, veins, and airways using iterative growth methods that can be merged into a final simulated lung with realistic features. A dataset of 24 labeled anthropomorphic pulmonary CT phantoms were synthesized with the proposed system. Visual examination and quantitative measurements of intensity distributions, dispersion of structures and relationships between pulmonary air and blood flow systems show good correspondence between real and synthetic lungs (p > 0.05 with low Cohen’s d effect size and AUC values), supporting the potentiality of the tool and the usefulness of the generated phantoms in the biomedical image processing field. PMID:26731653

  12. Automatic Synthesis of Anthropomorphic Pulmonary CT Phantoms.

    Directory of Open Access Journals (Sweden)

    Daniel Jimenez-Carretero

    Full Text Available The great density and structural complexity of pulmonary vessels and airways impose limitations on the generation of accurate reference standards, which are critical in training and in the validation of image processing methods for features such as pulmonary vessel segmentation or artery-vein (AV separations. The design of synthetic computed tomography (CT images of the lung could overcome these difficulties by providing a database of pseudorealistic cases in a constrained and controlled scenario where each part of the image is differentiated unequivocally. This work demonstrates a complete framework to generate computational anthropomorphic CT phantoms of the human lung automatically. Starting from biological and image-based knowledge about the topology and relationships between structures, the system is able to generate synthetic pulmonary arteries, veins, and airways using iterative growth methods that can be merged into a final simulated lung with realistic features. A dataset of 24 labeled anthropomorphic pulmonary CT phantoms were synthesized with the proposed system. Visual examination and quantitative measurements of intensity distributions, dispersion of structures and relationships between pulmonary air and blood flow systems show good correspondence between real and synthetic lungs (p > 0.05 with low Cohen's d effect size and AUC values, supporting the potentiality of the tool and the usefulness of the generated phantoms in the biomedical image processing field.

  13. Supracardiac type total anomalous pulmonary venous connection (TAPVC) with oesophageal varices

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Ae; Lee, Hyoung Doo; Ban, Ji Eun; Jo, Min Jung [Pusan National University School of Medicine, Department of Paediatrics, Medical Research Institute, Pusan National University Hospital, Busan (Korea); Sung, Si Chan; Chang, Yun Hee [Pusan National University School of Medicine, Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Busan (Korea); Choo, Ki Seok [Pusan National University School of Medicine, Department of Radiology, Medical Research Institute, Pusan National University Hospital, Busan (Korea)

    2008-10-15

    Oesophageal varices due to total anomalous pulmonary venous connection (TAPVC) is very rare. Additionally, the infradiaphragmatic type is the most common type of oesophageal varices due to TAPVC. Paraoesophageal varices due to stenosis of the vertical vein of supracardiac TAPVC has not previously been reported. We describe paraoesophageal varices developed as a result of a connection between the left lower pulmonary vein and the umbilicovitelline venous system because of stenosis of the proximal vertical vein in supracardiac type TAPVC in a 3-day-old female newborn who presented with general cyanosis, tachypnoea and dyspnoea. (orig.)

  14. Variable D-dimer thresholds for diagnosis of clinically suspected acute pulmonary embolism

    NARCIS (Netherlands)

    Van der Hulle, T.; Den Exter, P. L.; Erkens, P. G. M.; Van Es, J.; Mos, I. C. M.; Ten Cate, H.; Kamphuisen, P. W.; Hovens, M. M. C.; Buller, H. R.; Klok, F. A.; Huisman, M. V.

    2013-01-01

    Background Computed tomography pulmonary angiography (CTPA) is frequently requested using diagnostic algorithms for suspected pulmonary embolism (PE). For suspected deep vein thrombosis, it was recently shown that doubling the D-dimer threshold in patients with low pretest probability safely decreas

  15. Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt.

    Science.gov (United States)

    Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

    2013-08-13

    A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome.

  16. Prediction of leakage and rotordynamic coefficients for the circumferential-groove pump seal using CFD analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Ho; Ha, Tae Woong [Gachon University, Seongnam (Korea, Republic of)

    2016-05-15

    The circumferential-groove seal is commonly used in various turbopumps to reduce leakage. The main goal of this paper is to develop the method of three-dimensional CFD analysis for determining leakage and rotordynamic coefficients of the circumferential-groovepump seal. A relative coordinate system was defined for steady-state simulation to calculate the velocity and pressure distributions of the seal clearance at each rotor whirl speed. Instead of setting the inlet and outlet pressures as the boundary conditions in the three dimensional CFD analysis, as it is more commonly done, we used the inlet velocity and outlet pressure obtained from a preliminary two dimensional CFD analysis. For prediction leakage, the presented analysis shows improvement from the bulk-flow model analysis. For the prediction of rotordynamic coefficients of K, k and C, the presented analysis provides results in closer agreement with the experimental values than those of the bulk-flow model analysis at several rotor speeds.

  17. Circumferential mucosal dissection and esophageal perforation in a patient with eosinophilic esophagitis

    Institute of Scientific and Technical Information of China (English)

    Gennaro Liguori; Maurizio Cortale; Fabrizio Cimino; Michele Sozzi

    2008-01-01

    A young man with a previous history of episodes of mild solid food dysphagia was admitted with a total dysphagia.The esophagogastroduodenoscopy (EGDS) showed an extensive disruption of mucosal layer with a cul-de-sac in the lower part of the esophagus.Soon after the procedure,the patient suffered from an acute chest pain and subsequent CT scan demonstrated an intramural circumferential dissection of thoracic esophagus,and a mediastinal emphysema.An emergency right thoracotomy was performed,followed by a total esophagectomy with esophagogastroplasty and jejunostomy.The histopathology confirmed that mucosal and submucosal layers were circumferentially detached from muscular wall and showed an eosinophilic infiltration of the whole organ with necrosis and erosions of mucosal,submucosal and muscular layers.The diagnosis was esophageal perforation in eosinophilic esophagitis.

  18. [Echocardiographic longitudinal, radial, circumferential and rotational synchronization disturbance in predicting response to cardiac resynchronization therapy].

    Science.gov (United States)

    Sade, Leyla Elif

    2010-02-01

    Several echocardiographic methods have been proposed to assist patient selection for cardiac resynchronization therapy. Color-coded tissue Doppler is one of the most promising methods to quantify mechanical dyssynchrony. However, tissue Doppler data are affected by Doppler angle of incidence and tethering or translational motion. Furthermore tissue Doppler based modalities are good for longitudinal motion analysis but limited in other directions of wall motion such as radial, circumferential, and rotational. Speckle tracking is a more recent technique that allows accurate calculation of regional radial and circumferential strain as well as regional rotation for dyssynchrony analysis. Although no ideal echocardiographic method exists that integrates regional dyssynchrony data in all contraction directions as yet, technical refinements and advances in understanding of pathophysiology will help to improve the study of mechanical dyssynchrony.

  19. Inspection of circumferential IGA/SCC in Bruce Unit 4 SGs

    Energy Technology Data Exchange (ETDEWEB)

    Fluit, S.; Myderwyk, H.; King, P. [Babcock and Wilcox Canada Limited, Cambridge, Ontario (Canada); Durance, D.; Sedman, K. [Bruce Power, Tiverton, Ontario (Canada)

    2008-07-01

    Circumferential IGA/SCC has been detected in the roll-transition zone of tubes in Bruce A SGs for over a decade, but recently became more pronounced in Unit 4 BO4 in 2006 and the spring of 2007. A number of ET probes have been developed to detect and characterize this degradation, including C-3/8, +Point and X-Probe. Comparisons of the inspection results from these probes and metallurgical results from removed tubes have provided insight into the strengths and limitations of each probe and how the probes can complement each other. This paper will discuss the evolution of the ET inspection approach for circumferential IGA/SCC and how the results have been used in recent FFS assessments in the Bruce Unit 4 SGs. (author)

  20. In vivo vascular wall shear rate and circumferential strain of renal disease patients.

    Science.gov (United States)

    Park, Dae Woo; Kruger, Grant H; Rubin, Jonathan M; Hamilton, James; Gottschalk, Paul; Dodde, Robert E; Shih, Albert J; Weitzel, William F

    2013-02-01

    This study measures the vascular wall shear rate at the vessel edge using decorrelation based ultrasound speckle tracking. Results for nine healthy and eight renal disease subjects are presented. Additionally, the vascular wall shear rate and circumferential strain during physiologic pressure, pressure equalization and hyperemia are compared for five healthy and three renal disease subjects. The mean and maximum wall shear rates were measured during the cardiac cycle at the top and bottom wall edges. The healthy subjects had significantly higher mean and maximum vascular wall shear rate than the renal disease subjects. The key findings of this research were that the mean vascular wall shear rates and circumferential strain changes between physiologic pressure and hyperemia that was significantly different between healthy and renal disease subjects.

  1. Pulmonary hypertension

    Science.gov (United States)

    ... that damage the lungs, such as scleroderma and rheumatoid arthritis Birth defects of the heart Blood clots in the lung ( pulmonary embolism ) Heart failure Heart valve disease HIV infection Low oxygen levels in the blood ...

  2. Pulmonary aspergilloma

    Science.gov (United States)

    ... grows on dead leaves, stored grain, bird droppings, compost piles, and other decaying vegetation. Cavities in the ... Histoplasmosis Lung cancer - small cell Pulmonary tuberculosis Sarcoidosis Review Date 8/31/2014 Updated by: Jatin M. ...

  3. Severe pulmonary hypertension associated with Takayasu arteritis

    Directory of Open Access Journals (Sweden)

    Arevalo Guerrero, Edwin

    2014-10-01

    Full Text Available We describe the case of a 57 year-old woman with chronic hypertension, dyspnea, general symptoms, malaise, fatigability and exercise intolerance, impaired functional capacity and occasional episodes of pre-syncope. Physical examination disclosed arterial hypertension, with a difference of more than 10 mm Hg between the pressures of the right and the left upper limbs, holosystolic murmur grade III/VI in the aortic valve area, left subclavian murmur, and decreased intensity in the peripheral pulses of the left arm. Noninvasive studies showed severe pulmonary hypertension and right ventricular dysfunction, also confirmed by cardiac catheterization. Chest tomography and pulmonary arterial angiography showed bilateral pulmonary artery stenosis. Cardiac magnetic resonance revealed concentric stenosis (6 mm, affecting the origin of the upper lobe branch and circumferential involvement of the left branch (8 mm and the branch to the lower lobe. Endoluminal irregularities were observed in the aorta and the neck vessels, both in the resonance and the angiography. With these findings diagnoses of Takayasu arteritis and associated severe pulmonary hypertension were established. Treatment was started with prednisolone and methotrexate.

  4. Influence of the heart rate on mean circumferential shortening velocity: echocardiographic study of 183 normal subjects.

    Science.gov (United States)

    Mangiarotti, R; Martinotti, R; Monzani, V; Sardella, F; Pierini, A; Pastori, M; Randazzo, A

    1986-01-01

    Echocardiography was used to explore the influence of independent variables (age, body surface area and heart rate) on the mean circumferential shortening velocity (MVCF) in 183 healthy subjects. Multiple stepwise regression analysis shows that heart rate is the only variable of the three just mentioned that influences MVCF. A regression equation is evolved and proposed as an index of MVCF correction for varying heart rates.

  5. Selective radiofrequency therapy as a non-invasive approach for contactless body contouring and circumferential reduction.

    Science.gov (United States)

    Fajkošová, Kateřina; Machovcová, Alena; Onder, Meltem; Fritz, Klaus

    2014-03-01

    In this study, the efficacy of non-contact, selective radiofrequency (RF) were evaluated for body contouring as non-invasive fat and circumferential reduction of the abdomen. 40 healthy (36 female, 4 male) subjects showing significant volume of subcutaneous fat tissue on the abdomen and waistline were included. Once a week for 30 minutes, 4 sessions were performed. The applicator was placed on a supplied spacer covering the treatment area. Maximum power was 200W, which induced heat in the fat and connective tissue layer. The homogeneity of heat distribution and temperature of the skin surface were controlled. The circumferential reduction was measured at the baseline and after the last treatment. The photographs and adverse effects were recorded. Participants completed the self-evaluation questionnaires and rated their level of satisfaction. All subjects tolerated the treatments well. The only side effect was mild to moderate erythema. 35 subjects finished the protocol as planned and 5 subjects dropped off due to events not related to the study. 32 subjects had a 1-13 cm decrease in abdominal circumference and 3 subjects did not show significant response (0-1 cm). Most likely, a very thin fat layer was the reason for lack of response (the non-responding group was the thinnest patient group). No significant differences were found between men and women. The average decrease of 4.93 cm was calculated as a result of circumferential reduction statistical evidence. This study demonstrates that the selective RF system designed for contactless deep tissue heating is a painless, safe, and effective treatment for non-surgical body contouring and circumferential fat reduction.

  6. Numerical Investigation of Inlet Distortion on an Axial Flow Compressor Rotor with Circumferential Groove Casing Treatment

    Institute of Scientific and Technical Information of China (English)

    Huang Jian; Wu Hu

    2008-01-01

    On the base of an assumed steady inlet circumferential total pressure distortion, three-dimensional time-dependent numerical simulations are conducted on an axial flow subsonic compressor rotor. The performances and flow fields of a compressor rotor, either casing treated or untreated, are investigated in detail either with or without inlet pressure distortion. Results show that the circumferential groove casing treatment can expand the operating range of the compressor rotor either with or without inlet pressure distortion at the expense of a drop in peak isentropic efficiency. The casing treatment is capable of weakening or even removing the tip leakage vortex effectively either with or without inlet distortion. In clean inlet circumstances, the enhancement and forward movement of tip leakage vortex cause the untreated compressor rotor to stall. By contrast, with circumferential groove casing, the serious flow separation on the suction surface leads to aerodynamic stalling eventually. In the presence of inlet pressure distortion, the blade loading changes from passage to passage as the distorted inflow sector is traversed. Similar to the clean inlet circumstances, with a smooth wall casing, the enhancement and forward movement of tip leakage vortex are still the main factors which lead to the compressor rotor stalling eventu-ally. When the rotor works under near stall conditions, the blockage resulting from the tip leakage vortex in all the passages is very seri-ous. Especially in several passages, flow-spillage is observed. Compared to the clean inlet circumstances, circumferential groove casing treatment can also eliminate the low energy zone in the outer end wall region effectively.

  7. Circumferential-wave phase velocities for empty, fluid-immersed spherical metal shells

    DEFF Research Database (Denmark)

    Überall, Herbert; Ahyi, A. C.; Raju, P. K.

    2002-01-01

    -loaded, evacuated spherical metal shells of aluminum, stainless steel, and tungsten carbide. In particular, the characteristic upturn of the dispersion curves of low-order shell-borne circumferential waves (A or A0 waves) which takes place on spherical shells when the frequency tends towards very low values......, is demonstrated here for all cases of the metals under consideration. ©2002 Acoustical Society of America....

  8. Pulmonary hypertension

    OpenAIRE

    2016-01-01

    In 2015, more than 800 papers were published in the field of pulmonary hypertension. A Clinical Year in Review article cannot possibly incorporate all this work and needs to be selective. The recently published European guidelines for the diagnosis and treatment of pulmonary hypertension contain an inclusive summary of all published clinical studies conducted until very recently. Here, we provide an overview of papers published after the finalisation of the guideline. In addition, we summaris...

  9. Pulmonary Agenesis.

    Science.gov (United States)

    Chawla, Rakesh K; Madan, Arun; Chawla, Aditya; Arora, Harsh Nandini; Chawla, Kiran

    2015-01-01

    Unilateral opaque lung with ipsilateral mediastinal shift is an uncommon cause of respiratory distress in newborn which can be found on simple radiograph of the chest. Pulmonary agenesis is a rare cause of unilateral opaque lung in the newborn. Nearly 50% cases of pulmonary agenesis are associated with other congenital defects including cardiovascular, skeletal, gastrointestinal or genitourinary systems. We report an infant with agenesis of the right lung associated with other congenital anomalies.

  10. Pulmonary Edema

    OpenAIRE

    Tanser, Paul H.

    1981-01-01

    The physician who deals with pulmonary edema from a pathophysiologic basis will seldom make a diagnostic or therapeutic error. Recent additions to preload and afterload therapy have greatly helped in the emergency and ambulatory treatment of pulmonary edema due to left heart failure. Careful follow-up and patient self-monitoring are the most effective means of reducing hospitalization of chronic heart failure patients.

  11. Nonlinear vibrations and energy exchange of single-walled carbon nanotubes. Circumferential flexural modes

    Science.gov (United States)

    Strozzi, Matteo; Smirnov, Valeri V.; Manevitch, Leonid I.; Milani, Massimo; Pellicano, Francesco

    2016-10-01

    In this paper, the nonlinear vibrations and energy exchange of single-walled carbon nanotubes (SWNTs) are studied. The Sanders-Koiter theory is applied to model the nonlinear dynamics of the system in the case of finite amplitude of vibration. The SWNT deformation is described in terms of longitudinal, circumferential and radial displacement fields. Simply supported, clamped and free boundary conditions are considered. The circumferential flexural modes (CFMs) are investigated. Two different approaches based on numerical and analytical models are compared. In the numerical model, an energy method based on the Lagrange equations is used to reduce the nonlinear partial differential equations of motion to a set of nonlinear ordinary differential equations, which is solved by using the implicit Runge-Kutta numerical method. In the analytical model, a reduced form of the Sanders-Koiter theory assuming small circumferential and tangential shear deformations is used to get the nonlinear ordinary differential equations of motion, which are solved by using the multiple scales analytical method. The transition from energy beating to energy localization in the nonlinear field is studied. The effect of the aspect ratio on the analytical and numerical values of the nonlinear energy localization threshold for different boundary conditions is investigated. Time evolution of the total energy distribution along the axis of a simply supported SWNT

  12. Circumferential phased array of shear-horizontal wave magnetostrictive patch transducers for pipe inspection.

    Science.gov (United States)

    Kim, Hoe Woong; Lee, Joo Kyung; Kim, Yoon Young

    2013-02-01

    Several investigations report effective uses of magnetostrictive patch transducers to generate and measure longitudinal and torsional guided waves in a pipe. They can be used to form a phased array for the circumferential inspection of pipes. Although there are circumferential phased arrays employing piezoelectric transducers or EMAT's, no magnetostrictive patch transducer based array system has been attempted. In this investigation, we aim to develop a circumferential phased magnetostrictive patch transducer (PMPT) array that can focus shear-horizontal waves at any target point on a cylindrical surface of a pipe. For the development, a specific configuration of a PMPT array employing six magnetostrictive patch transducers is proposed. A wave simulation model is also developed to determine time delays and amplitudes of signals generated by the transducers of the array. This model should be able to predict accurately the angular profiles of shear-horizontal waves generated by the transducers. For wave focusing, the time reversal idea will be utilized. The wave focusing ability of the developed PMPT array is tested with multiple-crack detection experiments. Imaging of localized surface inspection regions is also attempted by using wave signals measured by the developed PMPT array system.

  13. Soft Sensor for Oxide Scales on the Steam Side of Superheater Tubes under Uneven Circumferential Load

    Directory of Open Access Journals (Sweden)

    Qing Wei Li

    2015-01-01

    Full Text Available A soft sensor for oxide scales on the steam side of superheater tubes of utility boiler under uneven circumferential loading is proposed for the first time. First finite volume method is employed to simulate oxide scales growth temperature on the steam side of superheater tube. Then appropriate time and spatial intervals are selected to calculate oxide scales thickness along the circumferential direction. On the basis of the oxide scale thickness, the stress of oxide scales is calculated by the finite element method. At last, the oxide scale thickness and stress sensors are established on support vector machine (SMV optimized by particle swarm optimization (PSO with time and circumferential angles as inputs and oxide scale thickness and stress as outputs. Temperature and stress calculation methods are validated by the operation data and experimental data, respectively. The soft sensor is applied to the superheater tubes of some power plant. Results show that the soft sensor can give enough accurate results for oxide scale thickness and stress in reasonable time. The forecasting model provides a convenient way for the research of the oxide scale failure.

  14. Lumbar extracavitary corpectomy with a single stage circumferential arthrodesis: surgical technique and clinical series.

    Science.gov (United States)

    Singh, Kern; Park, Daniel K

    2012-07-01

    Circumferential arthrodesis and reconstruction is necessary after a lumbar corpectomy in the setting of malignancy and infection. The advent of expandable cage technology now allows for safe anterior column reconstruction via a posterior approach with no transection and minimal retraction of the lumbar spinal nerve roots. Fifteen patients underwent a single-stage, circumferential corpectomy and anterior spinal reconstruction with an expandable cage via a midline, posterior, lateral lumbar extracavitary approach. Posterior segmental pedicle screw fixation and iliac crest bone graft was used in all cases. Fifteen lumbar extracavitary corpectomy nerve root-sparing procedures have been performed to date, with at least 1-year follow-up (12 tumors/3 infections). No patient suffered any neurological complications. One patient suffered from a postoperative myocardial infarction 10 days after the procedure. Two patients had medical complications that were treated without sequelae. We present a technical description and case series of patients undergoing a single-stage, circumferential corpectomy and anterior spinal reconstruction with an expandable cage via a midline, posterior, lateral lumbar extracavitary approach with at least 1-year follow-up. The technique is safe, technically feasible, and obviates an anterior approach in this oftentimes critically ill patient population.

  15. Functional evaluation of repairs to circumferential labral lesions of the glenoid - Case series

    Directory of Open Access Journals (Sweden)

    Alexandre Tadeu do Nascimento

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the clinical results among patients undergoing arthroscopic repair of circumferential labral lesions. METHODS: This was a retrospective study on 10 patients who underwent arthroscopic repair to circumferential labral lesions of the shoulder, between September 2012 and September 2015. The patients were evaluated by means of the Carter-Rowe score, DASH score, UCLA score, visual analog scale (VAS for pain and Short-Form 36 (SF36. The average age at surgery was 29.6 years. The mean follow-up was 27.44 months (range: 12-41.3. RESULTS: The mean score was 16 points for DASH; 32 points for UCLA, among which six patients (60% had excellent results, three (30% good and one (10% poor; 1.8 points for VAS, among which nine patients (90% had minor pain and one (10% moderate pain; 79.47 for SF-36; and 92.5 for Carter-Rowe, among which nine patients (90% had excellent results and one (10% good. Joint degeneration was present in one case (10%, of grade 1. We did not observe any significant complications, except for grade 1 glenohumeral arthrosis, which one patient developed after the operation. CONCLUSION: Arthroscopic repair of circumferential labral lesions of the shoulder through use of absorbable anchors is effective, with improvements in all scores applied, and it presents low complication rates. Cases associated with glenohumeral dislocation have lower long-term residual pain.

  16. Numerical Simulation for Three-Dimensional (3D) Unsteady State Temperature Field in Circumferential Laser Oxygen Cutting of Pipes

    Institute of Scientific and Technical Information of China (English)

    Kaijin HUANG; Dawen ZENG; Changsheng XIE; Desheng XU

    2003-01-01

    A 3D unsteady state numerical model of heat transfer in the circumferential laser oxygen cutting of pipes wasdeveloped. In order to minimize the computing time required for solving the finite difference equations as much aspossible, the alternating direct

  17. On guided circumferential waves in soft electroactive tubes under radially inhomogeneous biasing fields

    Science.gov (United States)

    Wu, Bin; Su, Yipin; Chen, Weiqiu; Zhang, Chuanzeng

    2017-02-01

    Soft electroactive (EA) tube actuators and many other cylindrical devices have been proposed recently in literature, which show great advantages over those made from conventional hard solid materials. However, their practical applications may be limited because these soft EA devices are prone to various failure modes. In this paper, we present an analysis of the guided circumferential elastic waves in soft EA tube actuators, which has potential applications in the in-situ nondestructive evaluation (NDE) or online structural health monitoring (SHM) to detect structural defects or fatigue cracks in soft EA tube actuators and in the self-sensing of soft EA tube actuators based on the concept of guided circumferential elastic waves. Both circumferential SH and Lamb-type waves in an incompressible soft EA cylindrical tube under inhomogeneous biasing fields are considered. The biasing fields, induced by the application of an electric voltage difference to the electrodes on the inner and outer cylindrical surfaces of the EA tube in addition to an axial pre-stretch, are inhomogeneous in the radial direction. Dorfmann and Ogden's theory of nonlinear electroelasticity and the associated linear theory for small incremental motion constitute the basis of our analysis. By means of the state-space formalism for the incremental wave motion along with the approximate laminate technique, dispersion relations are derived in a particularly efficient way. For a neo-Hookean ideal dielectric model, the proposed approach is first validated numerically. Numerical examples are then given to show that the guided circumferential wave propagation characteristics are significantly affected by the inhomogeneous biasing fields and the geometrical parameters. Some particular phenomena such as the frequency veering and the nonlinear dependence of the phase velocity on the radial electric voltage are discussed. Our numerical findings demonstrate that it is feasible to use guided circumferential

  18. Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome complicated by seven pulmonary emboli in a 15-year old patient.

    Science.gov (United States)

    Coloe, Jacquelyn; Diamantis, Stephanie; Henderson, Frederick; Morrell, Dean S

    2010-02-01

    SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome represents a spectrum of various dermatologic and musculoskeletal conditions. Thromboses have infrequently been reported in SAPHO syndrome, most often in the subclavian vein. There have been no reported cases of pulmonary emboli associated with SAPHO. We report a case of a young patient with SAPHO syndrome who later presented with extensive iliofemoral deep vein thromboses and seven pulmonary emboli.

  19. Deep Vein Thrombosis Prophylaxis in Trauma Patients

    Directory of Open Access Journals (Sweden)

    Serdar Toker

    2011-01-01

    Full Text Available Deep vein thrombosis (DVT and pulmonary embolism (PE are known collectively as venous thromboembolism (VTE. Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of\t5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC filters. The available pharmacologic agents include low-dose heparin (LDH, low molecular weight heparin (LMWH, and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs, pneumatic compression devices (PCDs, and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  20. Deep vein thrombosis prophylaxis in trauma patients.

    Science.gov (United States)

    Toker, Serdar; Hak, David J; Morgan, Steven J

    2011-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are known collectively as venous thromboembolism (VTE). Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of 5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The available pharmacologic agents include low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  1. [Saccular aneurysm of the azygos vein in a patient with azygos accessory fissure].

    Science.gov (United States)

    Córdoba Rovira, S M; Guedea Martin, A; Salvador Adell, I; Elias Artiga, J

    2015-01-01

    The saccular aneurysm of the azygos vein is an extremely rare condition, which when located in the path of an accesory pulmonary fissure, becomes a diagnostic challenge because it can be mistaken for tumors arising from the accesory pleura, like solitary fibrous tumor of the pleura or mesothelioma. The diagnosis should ideally be done by non-invasive methods such as CT or MR angiographic technique in multiple phases, thus avoiding unnecessary surgical intervention. This case is exceptional because, to our knowledge, it is the first to report both concomitant clinical situations, an aneurysm of the azygos vein in the pathway of its accessory fissure.

  2. Deep vein thrombosis with tuberculosis: a rate presentation of common disease

    Directory of Open Access Journals (Sweden)

    Prasad Muley

    2014-01-01

    Full Text Available Tuberculosis remains an infectious disease with high prevalence worldwide. An association between tuberculosis-induced inflammation and hypercoagulable state has been described in the literature. Deep vein thrombosis is a rare complication of the disease, and very few cases are reported worldwide. Furthermore, such manifestation is very rare in the paediatric age group. The paediatrician’s awareness of this phenomenon is important for early diagnosis and prompt treatment. Here, we report two cases of severe pulmonary tuberculosis associated with deep vein thrombosis in the pediatric age group.

  3. Pulmonary Embolism Masquerading as High Altitude Pulmonary Edema at High Altitude.

    Science.gov (United States)

    Pandey, Prativa; Lohani, Benu; Murphy, Holly

    2016-12-01

    Pandey, Prativa, Benu Lohani, and Holly Murphy. Pulmonary embolism masquerading as high altitude pulmonary edema at high altitude. High Alt Med Biol. 17:353-358, 2016.-Pulmonary embolism (PE) at high altitude is a rare entity that can masquerade as or occur in conjunction with high altitude pulmonary edema (HAPE) and can complicate the diagnosis and management. When HAPE cases do not improve rapidly with descent, other diagnoses, including PE, ought to be considered. From 2013 to 2015, we identified eight cases of PE among 303 patients with initial diagnosis of HAPE. Upon further evaluation, five had deep vein thrombosis (DVT). One woman had a contraceptive ring and seven patients had no known thrombotic risks. PE can coexist with or mimic HAPE and should be considered in patients presenting with shortness of breath from high altitude regardless of thrombotic risk.

  4. [Surgical treatment of acute deep leg and pelvic vein trombosis].

    Science.gov (United States)

    Gall, F; Husfeldt, K J

    1977-08-25

    In the last 3 years 93 cases of iliofermoral trombosis were treated by surgery. We prefer the method used by Brunner, but under general anaesthesia and using a Bentley-Autotransfusion-System (ATS). The average age of our patients was 55 years (age ranged between 17 and 87 years). No lethal pulmonary embolism was observed. 2, 1 percent of the patients died following apoplex or acute heart failure. Of 67 patients who were operated on 6 months ago or more 70 percent have no further complaints, 28 percent still have some residual edema and only 2 patients have a severe postthrombotic syndrome. 50 percent of 40 control-phlebograms demonstrated patency of all veins. 20 percent had short segmentary occlusions with definite signs of recanalisation, while in 27 percent of the cases occlusions of the lower leg and thigh were found, the iliac veins being free. Only 2 postoperative phlebograms showed a complete iliofemoral venous occlusion. Our results prove, that the operative thrombectomy is a successful method, with which the main complications of the iliofemoral thrombosis-pulmonary embolisation and postthrombotic syndrome-can difinitely be reduced. Also because of better long term results, the operative therapy of acute ilofemoral thrombosis should be generally prefered instead of conservative treatment.

  5. Extrahepatic portal vein obstruction and portal vein thrombosis in special situations: Need for a new classification

    Directory of Open Access Journals (Sweden)

    Zeeshan A Wani

    2015-01-01

    Full Text Available Extrahepatic portal vein obstruction is a vascular disorder of liver, which results in obstruction and cavernomatous transformation of portal vein with or without the involvement of intrahepatic portal vein, splenic vein, or superior mesenteric vein. Portal vein obstruction due to chronic liver disease, neoplasm, or postsurgery is a separate entity and is not the same as extrahepatic portal vein obstruction. Patients with extrahepatic portal vein obstruction are generally young and belong mostly to Asian countries. It is therefore very important to define portal vein thrombosis as acute or chronic from management point of view. Portal vein thrombosis in certain situations such as liver transplant and postsurgical/liver transplant period is an evolving area and needs extensive research. There is a need for a new classification, which includes all areas of the entity. In the current review, the most recent literature of extrahepatic portal vein obstruction is reviewed and summarized.

  6. Systematic review and Meta-analysis of the efficacy of pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation%肺静脉隔离在房颤患者中维持窦性节律的系统评价

    Institute of Scientific and Technical Information of China (English)

    张琰; 黄从新; 王克军; 刘小熊; 闫力永

    2013-01-01

    目的 系统评价使用肺静脉隔离(PVI)的导管消融治疗方法对房颤患者维持窦性节律的效果.方法 检索PubMed、CENTRAL、EMbase、NTIS、CNKI、VIP、万方数据库和CBM中所有对比PVI和抗心律失常药物(ADD)治疗维持房颤患者窦性心律的临床随机对照试验(RCT),同时追索纳入文献的参考文献.检索时限均为从建库至2013年2月.对符合质量标准的RCT进行系统评价和Meta分析.结果 共纳入9个随机对照试验.Meta分析主要和次要终点的结果显示:在1年的随访期时,PVI的有效性显著[77% (466/631)比38%(227/590),OR=5.93,95% CI 4.52~7.80,P<0.01],GRADE系统推荐分级为中级.PVI可显著降低因心血管事件导致的住院率(5%比24%,RR=0.15,95%CI 0.06~0.36,P< 0.01),GRADE系统推荐分级为高级.在PVI组,严重并发症的发生率是2.7%(17/631).结论 与ADD治疗策略相比,PVI显著增加1年期的窦律维持率,显著减少因心血管疾病原因导致的再住院率,而并发症的发生率甚至低于其他介入治疗.%Objective To evaluate pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation.Methods PubMed,CENTRAL,Embase,NTIS,CNKI,VIP,Wanfang Data and CBM were search for all randomized,controlled trials comparing PVI and medical therapy for the maintenance of sinus rhythm in patients with atrial fibrillation from the date of establishment of the databases to December 2012.The bibliographies of the include studies were searched too.Systematic review and Meta-analysis were conducted for the eligible RCTs.Results 9 trials were discovered.Meta-analyses show that PVI was associated with markedly increased odds of freedom from AF at 1 year of follow-up [77% (466/631) vs 38% (227/590),OR=5.93,95% CI 4.52-7.80,P < 0.01],it was moderate grade in the GRADE system.PVI was associated with a decreased hospitalization for cardiovascular causes (5% vs 24%,RR =0.15,95%CI 0.06-0.36,P

  7. Pulmonary Veno-Occlusive Disease: A Newly Recognized Cause of Severe Pulmonary Hypertension in Dogs.

    Science.gov (United States)

    Williams, K; Andrie, K; Cartoceti, A; French, S; Goldsmith, D; Jennings, S; Priestnall, S L; Wilson, D; Jutkowitz, A

    2016-07-01

    Pulmonary hypertension is a well-known though poorly characterized disease in veterinary medicine. In humans, pulmonary veno-occlusive disease (PVOD) is a rare cause of severe pulmonary hypertension with a mean survival time of 2 years without lung transplantation. Eleven adult dogs (5 males, 6 females; median age 10.5 years, representing various breeds) were examined following the development of severe respiratory signs. Lungs of affected animals were evaluated morphologically and with immunohistochemistry for alpha smooth muscle actin, desmin, CD31, CD3, CD20, and CD204. All dogs had pulmonary lesions consistent with PVOD, consisting of occlusive remodeling of small- to medium-sized pulmonary veins, foci of pulmonary capillary hemangiomatosis (PCH), and accumulation of hemosiderophages; 6 of 11 dogs had substantial pulmonary arterial medial and intimal thickening. Ultrastructural examination and immunohistochemistry showed that smooth muscle cells contributed to the venous occlusion. Increased expression of CD31 was evident in regions of PCH indicating increased numbers of endothelial cells in these foci. Spindle cells strongly expressing alpha smooth muscle actin and desmin co-localized with foci of PCH; similar cells were present but less intensely labeled elsewhere in non-PCH alveoli. B cells and macrophages, detected by immunohistochemistry, were not co-localized with the venous lesions of canine PVOD; small numbers of CD3-positive T cells were occasionally in and around the wall of remodeled veins. These findings indicate a condition in dogs with clinically severe respiratory disease and pathologic features resembling human PVOD, including foci of pulmonary venous remodeling and PCH.

  8. Angiosarcoma of common iliac vein

    Science.gov (United States)

    Ibis, Kamuran; Usta, Ufuk; Cosar, Rusen; Ibis, Cem

    2015-01-01

    Angiosarcoma is a rare malignant tumour of endothelial cells. Primary angiosarcoma of venous origin is extremely rare, and has a very poor prognosis. A 63-year-old woman with retroperitoneal mass underwent en bloc resection on a part of iliac vein followed by adjuvant radiotherapy. No recurrence was detected during 3 years of follow-up. PMID:25596292

  9. [A case of right pulmonary hypoplasia with congenital diaphragmatic hernia and dextrocardia].

    Science.gov (United States)

    Andou, A; Shimizu, N; Okabe, K; Date, H; Teramoto, S

    1992-10-01

    Chest X-ray of a 28-year-old woman revealed an abnormal shadow in the right lower lung field and dextrocardia, for which detailed investigation was performed. Since the CT number of the tumor shadow corresponded to that of the liver on chest CT, diaphragmatic hernia of the liver was suspected, and was confirmed by MRI and angiography of the abdomen. In addition, the pulmonary artery and vein were hypoplastic, and angiography of the pulmonary artery demonstrated pulmonary hypoplasia. This case was considered to have primary pulmonary hypoplasia, because the dextrocardia was considered to have occurred secondary to pulmonary hypoplasia and the diaphragmatic hernia of the liver was not sufficiently large to cause pulmonary hypoplasia. Pulmonary hypoplasia first diagnosed in adulthood is rare, with a clinical course and roentgenographic appearance differing from those of pulmonary hypoplasia in children.

  10. Endovenous radiofrequency ablation using stent-type electrode for varicose veins: an experimental study in goats

    Energy Technology Data Exchange (ETDEWEB)

    Won, Je Hwan; Han, Jae Ho; Oh, Chang Kwon [Ajou University Hospital, Suwon (Korea, Republic of); Kwak, Young Lan [Yonsei University College of Medicine, Seoul (Korea, Republic of); Park, Sung Il [Ulsan University GangNeung Asan Hospital, Gangeung (Korea, Republic of)

    2004-10-15

    The purpose of this study was to investigate the feasibility and the optimal conditions of radiofrequency (RF) ablation by using the stent-type electrode upon the saphenous vein of goats for the endovenous treatment of varicose veins. A self-expandable nitinol stent electrode (6 mm diameter, 2 cm length, cell size; 1.3 x 2 mm) was designed to expose the distal 1 cm segment to allow for contact with the venous wall. The proximal part of the electrode was connected to the RF generator by insulated copper wires located within the stent electrode introducer. Initially, to optimize the power setting, ablation of 6 saphenous veins in 3 goats was performed with power settings of 10, 20 and 30 W. Pull back rate of the electrode was 2 and 4 cm/min for each power level, respectively. The goats were sacrificed 4-6 weeks later and histologic examinations of the saphenous veins were done. For the second part of the experiment, RF ablation of 4 saphenous veins from 2 goats was done by applying the optimal power, based upon the first examination; these procedure was performed with variable pull back rates. Again, the goats were sacrificed 1-6 weeks later and histologic examinations were done. Endovenous ablation of the goat saphenous veins at 20 W caused complete obliteration without complication. There was incomplete occlusion at 10 W, and there were vessel perforation, extravasation, and adjacent tissue injury at 30 W. In second part of the study, the complete circumferential obliteration of the vein was demonstrated at a pull back rate of 1 cm/min and 3 cm/min with the power of 20 W. The stent-type electrode may be useful in endovenous RF ablation for treatment of varicose veins. For stents with a diameter of 6 mm, the optional combination of 20 W of power with a pull back rate of 1-3 cm/min produced the most favorable results. Further study and clinical investigations are warranted.

  11. Clinical studies on inferior right hepatic veins

    Institute of Scientific and Technical Information of China (English)

    Xue Xing; Hong Li; Wei-Guo Liu

    2007-01-01

    BACKGROUND:Many small veins are called accessory, short hepatic veins in addition to the right, middle and left hepatic veins. The size of these veins varied from a pinhole to 1 cm; the size of inferior right hepatic veins (IRHVs) is thicker than that of short hepatic veins or more than 1 cm occasionally. Adults have a higher incidence rate of the IRHV. DATA SOURCES:A literature search of the PubMed database was conducted and research articles were reviewed. RESULTS:The size of IRHVs is related to the size of the right hepatic vein, i.e. the larger the diameter of the right hepatic vein, the smaller the diameter of the IRHVs, and vice versa. The IRHVs are divided into superior, medial and inferior groups, separately named the superior, medial and inferior right hepatic veins according to the position of the IRHV entering the inferior vena cava. The superior right hepatic vein mainly drains the superior part of segmentⅦ, and the medial right hepatic vein drains the middle part of segmentⅦ. A thicker IRHV mainly drains segmentⅥ and the inferior part of segmentⅦ and a thinner IRHV drains the inferior part of segmentⅤ. CONCLUSIONS:The clinical signiifcance of these studies on IRHVs is varied: (1) Hepatic caudate lobe resection could be introduced after study on the veins of that lobe. (2) It is very important to identify the draining region of the IRHV for guiding hepatic segmentectomy. The postero-inferior area of the right lobe can be preserved along with the hypertrophic IRHV even if the entire main right hepatic vein is resected during segmentectomy ofⅦ andⅧwith right hepatic vein resection for patients with primary liver cancer. (3) The ligation of the major hepatic vein for the treatment of juxtahepatic vein injury is recommended because of severe hemorrhagic shock and dififculty in

  12. Common femoral vein reconstruction using internal jugular vein after blast injury.

    Science.gov (United States)

    Holt, Andrew M; West, Charles A; Davis, James A; Gilani, Ramyar; Askenasy, Eric

    2014-10-01

    Common femoral vein traumatic injuries are rare. Surgical management is controversial and by nature case specific. In this report, we present an unusual case of an isolated common femoral vein injury from a gunshot blast repaired with an interposition internal jugular vein bypass. To our knowledge, this is the first reported case of an isolated common femoral vein reconstructed in this manner.

  13. Who Is at Risk for Varicose Veins?

    Science.gov (United States)

    ... may raise your risk for varicose veins. The normal wear and tear of aging may cause the valves in your veins to weaken and not work well. Gender Women tend to get varicose veins more often than men. Hormonal changes that occur during puberty, pregnancy, and menopause (or ...

  14. Radiological aspects of portal vein embolization

    NARCIS (Netherlands)

    van Lienden, K.P.

    2012-01-01

    This thesis deals with liver regeneration after portal vein embolization (PVE) or portal vein ligation (PVL). Several aspects of these portal vein occlusion techniques are evaluated in clinical and experimental studies. In addition, the role of dynamic liver function tests and CT-volumetry in risk a

  15. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G;

    1996-01-01

    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 4...

  16. Posterior-Only Circumferential Decompression and Reconstruction in the Surgical Management of Lumbar Vertebral Osteomyelitis

    Science.gov (United States)

    Skovrlj, Branko; Guzman, Javier Z.; Caridi, John; Cho, Samuel K.

    2015-01-01

    Study Design Case report. Objective The purpose of this report is to discuss the surgical management of lumbar vertebral osteomyelitis with a spinal epidural abscess (SEA) and present a single-stage, posterior-only circumferential decompression and reconstruction with instrumentation using an expandable titanium cage and without segmental nerve root sacrifice as an option in the treatment of this disease process. Methods We report a 42-year-old man who presented with 3 days of low back pain and chills who rapidly decompensated with severe sepsis following admission. Magnetic resonance imaging of his lumbosacral spine revealed intramuscular abscesses of the left paraspinal musculature and iliopsoas with SEA and L4 vertebral body involvement. The patient failed maximal medical treatment, which necessitated surgical treatment as a last resort for infectious source control. He underwent a previously undescribed procedure in the setting of SEA: a single-stage, posterior-only approach for circumferential decompression and reconstruction of the L4 vertebral body with posterior segmental instrumented fixation. Results After the surgery, the patient's condition gradually improved; however, he suffered a wound dehiscence necessitating a surgical exploration and deep wound debridement. Six months after the surgery, the patient underwent a revision surgery for adjacent-level pseudarthrosis. At 1-year follow-up, the patient was pain-free and off narcotic pain medication and had returned to full activity. Conclusion This patient is the first reported case of lumbar osteomyelitis with SEA treated surgically with a single-stage, posterior-only circumferential decompression and reconstruction with posterior instrumentation. Although this approach is more technically challenging, it presents another viable option for the treatment of lumbar vertebral osteomyelitis that may reduce the morbidity associated with an anterior approach. PMID:26835214

  17. Magnetic resonance imaging characterization of circumferential and longitudinal strain under various coronary interventions in swine

    Institute of Scientific and Technical Information of China (English)

    Mohammed; SA; Suhail; Mark; W; Wilson; Steven; W; Hetts; Maythem; Saeed

    2013-01-01

    AIM:To compare the acute changes in circumferential and longitudinal strain after exposing a coronary artery to various interventions in swine.METHODS:Percutaneous balloon angioplasty catheter was guided to location aid device(LAD)under X-ray fluoroscopy to create different patterns of ischemic insults.Pigs(n=32)were equally divided into 4 groups:controls,90 min LAD occlusion/reperfusion,LAD microembolization,and combined LAD occlusion/microembolization/reperfusion.Three days after interventions,cine,tagged and viability magnetic resonance imaging(MRI)were acquired to measure and compare left and right circumferential strain,longitudinal strain and myocardial viability,respectively.Measurements were obtained using HARP and semi-automated threshold method and statistically analyzed using unpaired t-test.Myocardial and vascular damage was characterized microscopically.RESULTS:Coronary microemboli caused greater impairment in l left ventricular(LV)circumferential strain and dyssynchrony than LAD occlusion/reperfusion despite the significant difference in the extent of myocardial damage.Microemboli also caused significant decrease in peak systolic strain rate of remote myocardium and LV dyssynchrony.Cine MRI demonstrated the interaction between LV and right ventricular(RV)at 3 d after interventions.Compensatory increase in RV free wall longitudinal strain was seen in response to all interventions.Viability MRI,histochemical staining and microscopy revealed different patterns of myocardial damage and microvascular obstruction.CONCLUSION:Cine MRI revealed subtle changes in LV strain caused by various ischemic insults.It also demonstrated the interaction between the right and left ventricles after coronary interventions.Coronary microemboli with and without acute myocardial infarction(AMI)cause complex myocardial injury and ventricular dysfunction that is not replicated in solely AMI.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-15

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

  19. Investigations on an Axial Flow Fan Stage subjected to Circumferential Inlet Flow Distortion and Swirl

    Institute of Scientific and Technical Information of China (English)

    M.Govardhan; K.Viswanath

    1997-01-01

    The combined effects of swirl and circumferential inlet flow distortion on the flow field of an axial flow fan stage are reported in this paper,The study involves measurements at the inlet of the rotor and exit of the rotor and stator atdesign and off design flow conditions.The study indicated that at the design flow condition,swirl had caused deterioration of the performance in addition to that caused by distortion.Pressure rise imparted in the distortion zone is hogher than in the free zone.The attenuation of distortion is high in the presence of swirl.

  20. Radiographic findings in pulmonary hypertension from unresolved embolism

    Energy Technology Data Exchange (ETDEWEB)

    Woodruff, W.W. III; Hoeck, B.E.; Chitwood, W.R. Jr.; Lyerly, H.K.; Sabiston, D.C. Jr.; Chen, J.T.T.

    1985-04-01

    Pulmonary artery hypertension with chronic pulmonary embolism is an uncommon entity that is potentially treatable with pulmonary embolectomy. Although the classic radiographic features have been described, several recent investigators report a significant percentage of these patients with normal chest radiographs. In a series of 22 patients, no normal radiographs were seen. Findings included cardiomegaly (86.4%) with right-sided enlargement (68.4%), right descending pulmonary artery enlargement (54.5%), azygos vein enlargement (27.3%), mosaic oligemia (68.2%), chronic volume loss (27.3%), atelectasis and/or effusion (22.7%), and pleural thickening (13.6%). Good correlation with specific areas of diminished vascularity was seen on chest radiographs compared with pulmonary angiograms.

  1. A New Multimodal Biometric System Based on Finger Vein and Hand Vein Recognition

    OpenAIRE

    Randa Boukhris Trabelsi; Alima Damak Masmoudi; Dorra Sellami Masmoudi

    2013-01-01

    As a reliable and robust biological characteristic, the vein pattern increases more and more the progress in biometric researches. Generally, it was shown that single biometric modality recognition is not able to meet high performances. In this paper, we propose a new multimodal biometric system based on fusion of both hand vein and finger vein modalities. For finger vein recognition, we employ the Monogenic Local Binary Pattern (MLBP), and for hand vein recognitionan Improved Gaussian Matche...

  2. The dynamic study of the pulmonary artery obstruction degree and the right ventricular function in massive pulmonary embolism on CT pulmonary angiography

    Institute of Scientific and Technical Information of China (English)

    Jianguo Wang; Yulin Guo; Xiaojuan Guo; Min Liu; Youmin Guo; Chen Wang; Yuanhua Yang; Zhenguo Zhai; Li Zhu; Hongxia Ma

    2008-01-01

    Objective: To analyze the value of CTPA in assessing the dissolve of embolus and the function of the fight ventricle dynamically.Methods:Twenty-three cases of massive pulmonary embolism were analyzed retrospectively. The pulmonary artery obstruction index and the fight ventricular function parameters were collected and analyzed on CTPA before thrombolytic therapy, 24 hours and 14 days after therapy, respectively. Results:The pulmonary artery obstruction index decreased gradually, and there was significant difference before therapy, 24 hours and 2 weeks after therapy. Twenty-four hours after therapy, the maximal short axes diameter and the maximal transverse area of fight ventricle(RVd, RVs) decreased significantly, the maximal short axes diameter and the maximal transverse area of left ventricle(LVd, LVs) increased significantly, and the RVd/LVd, RVs/LVs decreased apparently. The pulmonary artery symbolic pressure before and 24 hours after therapy were apparently different. There was no significant difference between azygos vein, the super vena cava, the main pulmonary artery and vein reflux before and after therapy. Conclusion:CTPA can evaluate the pulmonary artery obstruction degree and right ventricular function dynamically.

  3. Computerized axial tomography of the chest for visualization of ''absent'' pulmonary arteries

    Energy Technology Data Exchange (ETDEWEB)

    Sondheimer, H.M. (Upstate Medical Center, Syracuse, NY); Oliphant, M.; Schneider, B.; Kavey, R.E.W.; Blackman, M.S.; Parker, F.B. Jr.

    1982-05-01

    To expand the search for central pulmonary arteries in six patients with absence of cardiac-pulmonary continuity, computerized axial tomography (CAT) of the chest was performed. The CAT scans were compared with previous arteriograms and pulmonary vein wedge angiograms. Three patients with type IV truncus arteriosus were studied, and none had a central, right or left pulmonary artery on CAT scan. However, two patients with tetralogy of Fallot with pulmonary atresia and a patent ductus arteriosus to the right lung demonstrated the presence of a left pulmonary artery. In addition, one child with truncus arteriosus with ''absent'' left pulmonary artery demonstrated a left pulmonary artery on the CAT scan. The CAT scan may therefore enhance our ability to search for disconnected pulmonary arteries in children with complex cyanotic congenital heart disease.

  4. Thromboembolic complications in nephrotic syndrome. Coagulation abnormalities, renal vein thrombosis, and other conditions.

    Science.gov (United States)

    Llach, F

    1984-11-01

    In patients with nephrotic syndrome, the presence of a hypercoagulable state is thought to give rise to a high incidence of thromboembolic phenomena. Renal vein thrombosis is a common complication in nephrotic patients, mainly in those with membranous nephropathy, and many other types of thromboembolic complications also occur. The mortality rate in nephrotic patients with thromboembolic complications may be significantly increased, with pulmonary emboli likely being the most common cause of death.

  5. Multidetector CT evaluation of total anomalous pulmonary venous connections: comparison with echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ki Ho; Choo, Ki Seok [Pusan National University Hospital, Department of Radiology, Medical Institute, Pusan (Korea); Lim, Soo Jin [Kim Hae Joong Ang Hospital, Department of Cardiology, Kimhae (Korea); Lee, Hyoung Doo; Park, Ji Ae; Jo, Min Jung [Pusan National University Hospital, Department of Paediatrics, Pusan (Korea); Sung, Si Chan; Chang, Yun Hee [Pusan National University Hospital, Department of Thoracic and Cardiovascular Surgery, Pusan (Korea); Jeong, Dong Wook [Pusan National University Hospital, Department of Family Medicine, Pusan (Korea); Kim, Siho [Dong-A University Hospital, Department of Thoracic and Cardiovascular Surgery, Pusan (Korea)

    2009-09-15

    Although echocardiography is the first-line imaging modality in the diagnosis of total anomalous pulmonary venous connection (TAPVC), multidetector CT (MDCT) could have advantages in the diagnosis of TAPVC in certain cases. To compare MDCT with echocardiography in the evaluation of TAPVC. Enrolled in the study were 23 patients with surgically proven TAPVC. The echocardiography and MDCT findings were independently interpreted by a paediatric cardiologist and cardiac radiologist in terms of: (1) the drainage site of the common pulmonary vein, (2) stenosis of the vertical vein, and (3) the course of the atypical vessel into the systemic vein in the case of vertical vein stenosis. The findings from both modalities were correlated with the results obtained at surgery (n=22) or autopsy (n=1). In all patients, MDCT correctly depicted the drainage site of the common pulmonary vein, stenosis of the vertical vein and the course of the atypical vessel into the systemic vein (sensitivity 100%, specificity 100%). The specificity of echocardiography was 100% for the three defined findings. The sensitivity of echocardiography, however, was 87%, 71% and 0%, respectively. MDCT can facilitate the diagnosis of TAPVC in certain cases. (orig.)

  6. Cardiac tamponade secondary to perforation of innominate vein following central line insertion in a neonate

    Directory of Open Access Journals (Sweden)

    Ramkumar Dhanasekaran

    2014-01-01

    Full Text Available Cardiac tamponade following central line in a neonate is rare and an uncommon situation; however, it is potentially reversible when it is diagnosed in time. We report a case of cardiac tamponade following central line insertion. A 10-day-old 2.2 kg girl operated for obstructed total anomalous pulmonary venous connections had neckline slipped out during extubation. Attempted cannulations of right femoral vein were unsuccessful. At the end of the left internal jugular vein cannulaton, there was a sudden cardiorespiratory arrest. Immediate transthoracic echocardiogram showed left pleural and pericardial collection. Chest was opened and the catheter tip was seen in the thoracic cavity after puncturing the innominate vein. The catheter was removed and the vent was repaired.

  7. Pulmonary hypertension complicating pulmonary sarcoidosis

    NARCIS (Netherlands)

    Huitema, M P; Grutters, J C; Rensing, B J W M; Reesink, H J; Post, M C

    2016-01-01

    Pulmonary hypertension (PH) is a severe complication of sarcoidosis, with an unknown prevalence. The aetiology is multifactorial, and the exact mechanism of PH in the individual patient is often difficult to establish. The diagnostic work-up and treatment of PH in sarcoidosis is complex, and should

  8. Deep vein thrombosis in pregnancy.

    Science.gov (United States)

    Colman-Brochu, Stephanie

    2004-01-01

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

  9. FINGER-VEIN RECOGNITION SYSTEMS

    Directory of Open Access Journals (Sweden)

    A.Haritha Deepthi

    2015-10-01

    Full Text Available As the Person‟s/Organization‟s Private information‟s are becoming very easy to access, the demand for a Simple, Convenient, Efficient, and a highly Securable Authentication System has been increased. In considering these requirements for data Protection, Biometrics, which uses human physiological or behavioral system for personal Identification has been found as a solution for these difficulties. However most of the biometric systems have high complexity in both time and space. So we are going to use a Real time Finger-Vein recognition System for authentication purposes. In this paper we had implemented the Finger Vein Recognition concept using MATLAB R2013a. The features used are Lacunarity Distance, Blanket Dimension distance. This has more accuracy when compared to conventional methods.

  10. Management of varicose veins and venous insufficiency.

    Science.gov (United States)

    Hamdan, Allen

    2012-12-26

    Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

  11. [ENDOVENOUS LASER TREATMENT FOR VARICOSE VEINS].

    Science.gov (United States)

    Tezuka, Masahiro; Kanaoka, Yuji; Ohki, Takao

    2015-05-01

    Varicose veins are a common condition attecting approximately 10 million patients in Japan. The main cause of varicose veins is reflux of the saphenous vein, and conventional treatment for several decades was stripping the affected saphenous vein and phlebectomy. Endovenous laser treatment (EVLT) is a less-invasive treatment method in which the saphenous vein is ablated with a laser under local anesthesia. EVLT has been approved by the Japanese Ministry of Health, Labor and Welfare since 2011, and we have performed EVLT on 5,160 legs with saphenous insufficiency with no severe complications including deep vein thrombosis except for one case of arteriovenous fistula. EVLT appears to be a safe, effective treatment option for varicose veins with saphenous insufficiency.

  12. Learning Curve in a Western Training Center of the Circumferential En Bloc Esophageal Endoscopic Submucosal Dissection in an In Vivo Animal Model

    Directory of Open Access Journals (Sweden)

    Miguel A. Tanimoto

    2011-01-01

    Full Text Available Aim. Evaluate the feasibility to overcome the learning curve in a western training center of the en bloc circumferential esophageal (ECE- ESD in an in vivo animal model. Methods. ECE-ESD was performed on ten canine models under general anesthesia on artificial lesions at the esophagus marked with coagulation points. After the ESD each canine model was euthanized and surgical resection of the esophagus and stomach was carried out according to “the Principles of Humane Experimental Technique, Russel and Burch.” The specimen was fixed with needles on cork submerged in formalin with the esophagus and stomach then delivered to the pathology department to be analyzed. Results. ECE-ESD was completed without complications in the last 3/10 animal models. Mean duration for the procedures was 192±35 minutes (range 140–235 minutes. All the procedures were done at the animal lab surgery room with cardio pulmonary monitoring and artificial ventilation by staff surgery members and a staff member of the Gastroenterology department trained during 1999–2001 at the Fujigaoka hospital of the Showa U. in Yokohama, Japan, length (range 15–18 mm and 51±6.99 width (range 40–60 mm. Conclusion. ECE-ESD training is feasible in canine models for postgraduate endoscopy fellows.

  13. Learning Curve in a Western Training Center of the Circumferential En Bloc Esophageal Endoscopic Submucosal Dissection in an In Vivo Animal Model

    Science.gov (United States)

    Tanimoto, Miguel A.; Torres-Villalobos, Gonzalo; Fujita, Rikiya; Santillan-Doherty, Patricio; Albores-Saavedra, Jorge; Chable-Montero, Fredy; Martin-del-Campo, Luis A.; Vasquez, Lucia; Bravo-Reyna, Carlos; Villanueva, Octavio; Villalobos, Jose J.; Uribe, Misael; Valdovinos, Miguel A.

    2011-01-01

    Aim. Evaluate the feasibility to overcome the learning curve in a western training center of the en bloc circumferential esophageal (ECE-) ESD in an in vivo animal model. Methods. ECE-ESD was performed on ten canine models under general anesthesia on artificial lesions at the esophagus marked with coagulation points. After the ESD each canine model was euthanized and surgical resection of the esophagus and stomach was carried out according to “the Principles of Humane Experimental Technique, Russel and Burch.” The specimen was fixed with needles on cork submerged in formalin with the esophagus and stomach then delivered to the pathology department to be analyzed. Results. ECE-ESD was completed without complications in the last 3/10 animal models. Mean duration for the procedures was 192 ± 35 minutes (range 140–235 minutes). All the procedures were done at the animal lab surgery room with cardio pulmonary monitoring and artificial ventilation by staff surgery members and a staff member of the Gastroenterology department trained during 1999–2001 at the Fujigaoka hospital of the Showa U. in Yokohama, Japan, length (range 15–18 mm) and 51 ± 6.99 width (range 40–60 mm). Conclusion. ECE-ESD training is feasible in canine models for postgraduate endoscopy fellows. PMID:21976950

  14. Estimation of leak rate through circumferential cracks in pipes in nuclear power plants

    Directory of Open Access Journals (Sweden)

    Jai Hak Park

    2015-04-01

    Full Text Available The leak before break (LBB concept is widely used in designing pipe lines in nuclear power plants. According to the concept, the amount of leaking liquid from a pipe should be more than the minimum detectable leak rate of a leak detection system before catastrophic failure occurs. Therefore, accurate estimation of the leak rate is important to evaluate the validity of the LBB concept in pipe line design. In this paper, a program was developed to estimate the leak rate through circumferential cracks in pipes in nuclear power plants using the Henry–Fauske flow model and modified Henry–Fauske flow model. By using the developed program, the leak rate was calculated for a circumferential crack in a sample pipe, and the effect of the flow model on the leak rate was examined. Treating the crack morphology parameters as random variables, the statistical behavior of the leak rate was also examined. As a result, it was found that the crack morphology parameters have a strong effect on the leak rate and the statistical behavior of the leak rate can be simulated using normally distributed crack morphology parameters.

  15. Mutations in Either TUBB or MAPRE2 Cause Circumferential Skin Creases Kunze Type

    Science.gov (United States)

    Isrie, Mala; Breuss, Martin; Tian, Guoling; Hansen, Andi Harley; Cristofoli, Francesca; Morandell, Jasmin; Kupchinsky, Zachari A.; Sifrim, Alejandro; Rodriguez-Rodriguez, Celia Maria; Dapena, Elena Porta; Doonanco, Kurston; Leonard, Norma; Tinsa, Faten; Moortgat, Stéphanie; Ulucan, Hakan; Koparir, Erkan; Karaca, Ender; Katsanis, Nicholas; Marton, Valeria; Vermeesch, Joris Robert; Davis, Erica E.; Cowan, Nicholas J.; Keays, David Anthony; Van Esch, Hilde

    2015-01-01

    Circumferential skin creases Kunze type (CSC-KT) is a specific congenital entity with an unknown genetic cause. The disease phenotype comprises characteristic circumferential skin creases accompanied by intellectual disability, a cleft palate, short stature, and dysmorphic features. Here, we report that mutations in either MAPRE2 or TUBB underlie the genetic origin of this syndrome. MAPRE2 encodes a member of the microtubule end-binding family of proteins that bind to the guanosine triphosphate cap at growing microtubule plus ends, and TUBB encodes a β-tubulin isotype that is expressed abundantly in the developing brain. Functional analyses of the TUBB mutants show multiple defects in the chaperone-dependent tubulin heterodimer folding and assembly pathway that leads to a compromised yield of native heterodimers. The TUBB mutations also have an impact on microtubule dynamics. For MAPRE2, we show that the mutations result in enhanced MAPRE2 binding to microtubules, implying an increased dwell time at microtubule plus ends. Further, in vivo analysis of MAPRE2 mutations in a zebrafish model of craniofacial development shows that the variants most likely perturb the patterning of branchial arches, either through excessive activity (under a recessive paradigm) or through haploinsufficiency (dominant de novo paradigm). Taken together, our data add CSC-KT to the growing list of tubulinopathies and highlight how multiple inheritance paradigms can affect dosage-sensitive biological systems so as to result in the same clinical defect. PMID:26637975

  16. Fracture behavior of circumferentially surface-cracked elbows. Technical report, October 1993--March 1996

    Energy Technology Data Exchange (ETDEWEB)

    Kilinski, T.; Mohan, R.; Rudland, D.; Fleming, M. [and others

    1996-12-01

    This report presents the results from Task 2 of the Second International Piping Integrity Research Group (IPIRG-2) program. The focus of the Task 2 work was directed towards furthering the understanding of the fracture behavior of long-radius elbows. This was accomplished through a combined analytical and experimental program. J-estimation schemes were developed for both axial and circumferential surface cracks in elbows. Large-scale, quasi-static and dynamic, pipe-system, elbow fracture experiments under combined pressure and bending loads were performed on elbows containing an internal surface crack at the extrados. In conjunction with the elbow experiments, material property data were developed for the A106-90 carbon steel and WP304L stainless steel elbow materials investigated. A comparison of the experimental data with the maximum stress predictions using existing straight pipe fracture prediction analysis methods, and elbow fracture prediction methods developed in this program was performed. This analysis was directed at addressing the concerns regarding the validity of using analysis predictions developed for straight pipe to predict the fracture stresses of cracked elbows. Finally, a simplified fitting flaw acceptance criteria incorporating ASME B2 stress indices and straight pipe, circumferential-crack analysis was developed.

  17. Experimental investigation on circumferential and axial temperature gradient over fuel channel under LOCA

    Science.gov (United States)

    Yadav, Ashwini Kumar; kumar, Ravi; Gupta, Akhilesh; Chatterjee, Barun; Mukhopadhyay, Deb; Lele, H. G.

    2014-06-01

    In a nuclear reactor temperature rises drastically in fuel channels under loss of coolant accident due to failure of primary heat transportation system. Present investigation has been carried out to capture circumferential and axial temperature gradients during fully and partially voiding conditions in a fuel channel using 19 pin fuel element simulator. A series of experiments were carried out by supplying power to outer, middle and center rods of 19 pin fuel simulator in ratio of 1.4:1.1:1. The temperature at upper periphery of pressure tube (PT) was slightly higher than at bottom due to increase in local equivalent thermal conductivity from top to bottom of PT. To simulate fully voided conditions PT was pressurized at 2.0 MPa pressure with 17.5 kW power injection. Ballooning initiated from center and then propagates towards the ends and hence axial temperature difference has been observed along the length of PT. For asymmetric heating, upper eight rods of fuel simulator were activated and temperature difference up-to 250 °C has been observed from top to bottom periphery of PT. Such situation creates steep circumferential temperature gradient over PT and could lead to breaching of PT under high pressure.

  18. Smooth muscle-like tissue constructs with circumferentially oriented cells formed by the cell fiber technology.

    Directory of Open Access Journals (Sweden)

    Amy Y Hsiao

    Full Text Available The proper functioning of many organs and tissues containing smooth muscles greatly depends on the intricate organization of the smooth muscle cells oriented in appropriate directions. Consequently controlling the cellular orientation in three-dimensional (3D cellular constructs is an important issue in engineering tissues of smooth muscles. However, the ability to precisely control the cellular orientation at the microscale cannot be achieved by various commonly used 3D tissue engineering building blocks such as spheroids. This paper presents the formation of coiled spring-shaped 3D cellular constructs containing circumferentially oriented smooth muscle-like cells differentiated from dedifferentiated fat (DFAT cells. By using the cell fiber technology, DFAT cells suspended in a mixture of extracellular proteins possessing an optimized stiffness were encapsulated in the core region of alginate shell microfibers and uniformly aligned to the longitudinal direction. Upon differentiation induction to the smooth muscle lineage, DFAT cell fibers self-assembled to coiled spring structures where the cells became circumferentially oriented. By changing the initial core-shell microfiber diameter, we demonstrated that the spring pitch and diameter could be controlled. 21 days after differentiation induction, the cell fibers contained high percentages of ASMA-positive and calponin-positive cells. Our technology to create these smooth muscle-like spring constructs enabled precise control of cellular alignment and orientation in 3D. These constructs can further serve as tissue engineering building blocks for larger organs and cellular implants used in clinical treatments.

  19. Smooth muscle-like tissue constructs with circumferentially oriented cells formed by the cell fiber technology.

    Science.gov (United States)

    Hsiao, Amy Y; Okitsu, Teru; Onoe, Hiroaki; Kiyosawa, Mahiro; Teramae, Hiroki; Iwanaga, Shintaroh; Kazama, Tomohiko; Matsumoto, Taro; Takeuchi, Shoji

    2015-01-01

    The proper functioning of many organs and tissues containing smooth muscles greatly depends on the intricate organization of the smooth muscle cells oriented in appropriate directions. Consequently controlling the cellular orientation in three-dimensional (3D) cellular constructs is an important issue in engineering tissues of smooth muscles. However, the ability to precisely control the cellular orientation at the microscale cannot be achieved by various commonly used 3D tissue engineering building blocks such as spheroids. This paper presents the formation of coiled spring-shaped 3D cellular constructs containing circumferentially oriented smooth muscle-like cells differentiated from dedifferentiated fat (DFAT) cells. By using the cell fiber technology, DFAT cells suspended in a mixture of extracellular proteins possessing an optimized stiffness were encapsulated in the core region of alginate shell microfibers and uniformly aligned to the longitudinal direction. Upon differentiation induction to the smooth muscle lineage, DFAT cell fibers self-assembled to coiled spring structures where the cells became circumferentially oriented. By changing the initial core-shell microfiber diameter, we demonstrated that the spring pitch and diameter could be controlled. 21 days after differentiation induction, the cell fibers contained high percentages of ASMA-positive and calponin-positive cells. Our technology to create these smooth muscle-like spring constructs enabled precise control of cellular alignment and orientation in 3D. These constructs can further serve as tissue engineering building blocks for larger organs and cellular implants used in clinical treatments.

  20. Status of the steam generator tube circumferential ODSCC degradation experienced at the Doel 4 plant

    Energy Technology Data Exchange (ETDEWEB)

    Roussel, G. [AIB-Vincotte Nuclear, Brussels (Belgium)

    1997-02-01

    Since the 1991 outage, the Doel Unit 4 nuclear power plant is known to be affected by circumferential outside diameter intergranular stress corrosion cracking at the hot leg tube expansion transition. Extensive non destructive examination inspections have shown the number of tubes affected by this problem as well as the size of the cracks to have been increasing for the three cycles up to 1993. As a result of the high percentage of tubes found non acceptable for continued service after the 1993 in-service inspection, about 1,700 mechanical sleeves were installed in the steam generators. During the 1994 outage, all the tubes sleeved during the 1993 outage were considered as potentially cracked to some extent at the upper hydraulic transition and were therefore not acceptable for continued service. They were subsequently repaired by laser welding. Furthermore all the tubes not sleeved during the 1993 outage were considered as not acceptable for continued service and were repaired by installing laser welded sleeves. During the 1995 outage, some unexpected degradation phenomena were evidenced in the sleeved tubes. This paper summarizes the status of the circumferential ODSCC experienced in the SG tubes of the Doel 4 plant as well as the other connected degradation phenomena.

  1. Recent evaluations of crack-opening-area in circumferentially cracked pipes

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, S.; Brust, F.; Ghadiali, N.; Wilkowski, G.; Miura, N.

    1997-04-01

    Leak-before-break (LBB) analyses for circumferentially cracked pipes are currently being conducted in the nuclear industry to justify elimination of pipe whip restraints and jet shields which are present because of the expected dynamic effects from pipe rupture. The application of the LBB methodology frequently requires calculation of leak rates. The leak rates depend on the crack-opening area of the through-wall crack in the pipe. In addition to LBB analyses which assume a hypothetical flaw size, there is also interest in the integrity of actual leaking cracks corresponding to current leakage detection requirements in NRC Regulatory Guide 1.45, or for assessing temporary repair of Class 2 and 3 pipes that have leaks as are being evaluated in ASME Section XI. The objectives of this study were to review, evaluate, and refine current predictive models for performing crack-opening-area analyses of circumferentially cracked pipes. The results from twenty-five full-scale pipe fracture experiments, conducted in the Degraded Piping Program, the International Piping Integrity Research Group Program, and the Short Cracks in Piping and Piping Welds Program, were used to verify the analytical models. Standard statistical analyses were performed to assess used to verify the analytical models. Standard statistical analyses were performed to assess quantitatively the accuracy of the predictive models. The evaluation also involved finite element analyses for determining the crack-opening profile often needed to perform leak-rate calculations.

  2. Nonlinear Local Bending Response and Bulging Factors for Longitudinal and Circumferential Cracks in Pressurized Cylindrical Shells

    Science.gov (United States)

    Young, Richard D.; Rose, Cheryl A.; Starnes, James H., Jr.

    2000-01-01

    Results of a geometrically nonlinear finite element parametric study to determine curvature correction factors or bulging factors that account for increased stresses due to curvature for longitudinal and circumferential cracks in unstiffened pressurized cylindrical shells are presented. Geometric parameters varied in the study include the shell radius, the shell wall thickness, and the crack length. The major results are presented in the form of contour plots of the bulging factor as a function of two nondimensional parameters: the shell curvature parameter, lambda, which is a function of the shell geometry, Poisson's ratio, and the crack length; and a loading parameter, eta, which is a function of the shell geometry, material properties, and the applied internal pressure. These plots identify the ranges of the shell curvature and loading parameters for which the effects of geometric nonlinearity are significant. Simple empirical expressions for the bulging factor are then derived from the numerical results and shown to predict accurately the nonlinear response of shells with longitudinal and circumferential cracks. The numerical results are also compared with analytical solutions based on linear shallow shell theory for thin shells, and with some other semi-empirical solutions from the literature, and limitations on the use of these other expressions are suggested.

  3. Effects of inlet circumferential fluctuation on the sweep aerodynamic performance of axial fans/compressors

    Science.gov (United States)

    Gui, Xingmin; Zhu, Fang; Wan, Ke; Jin, Donghai

    2013-10-01

    Swept blades have been widely used in the transonic fan/compressor of aircraft engines with the aids of 3D CFD simulation since the design concept of controlling the shock structure was firstly proposed and successfully tested by Dr. Wennerstrom in the 1980s. However, some disadvantage phenomenon has also been induced by excessively 3D blade geometries on the structure stress insufficiency, vibration and reliability. Much confusion in the procedure of design practice leading us to recognize a new view on the flow mechanism of sweep aerodynamical induction: the new radial equilibrium established by the influence of inlet circumferential fluctuation (CF) changes the inlet flows of blading and induces the performance modification of axial fans/compressors blade. The view is verified by simplified models through numerical simulation and circumferentially averaged analysis in the present paper. The results show that the CF source items which originate from design parameters, such as the spanwise distributions of the loading and blading geometries, contribute to the changing of averaged incidence spanwise distribution, and further more affect the performance of axial fans/compressors with swept blades.

  4. Effects of circumferential rigid wrist orthoses in rehabilitation of patients with radius fracture at typical site

    Directory of Open Access Journals (Sweden)

    Đurović Aleksandar

    2005-01-01

    Full Text Available Background. The use of orthoses is a questionable rehabilitation method for patients with the distal radius fracture at typical site. The aim of this study was to compare the effects of the rehabilitation on patients with radius fracture at the typical site, who wore circumferential static wrist orthoses, with those who did not wear them. Methods. Thirty patients were divided into 3 equal groups, 2 experimental groups, and 1 control group. The patients in the experimental groups were given the rehabilitation program of wearing serially manufactured (off-the-shelf, as well as custom-fit orthoses. Those in the control group did not wear wrist orthoses. Evaluation parameters were pain, edema, the range of the wrist motion, the quality of cylindrical, spherical, and pinch-spherical grasp, the strength of pinch and hand grasp, and patient's assessment of the effects of rehabilitation. Results. No significant difference in the effects of rehabilitation on the patients in experimental groups as opposed to control group was found. Patients in the first experimental group, and in control group were more satisfied with the effects of rehabilitation, as opposed to the patients in the second experimental group (p<0,05. Conclusion. The effects of circumferential static wrist orthoses in the rehabilitation of patients with distal radius fracture at the typical site were not clinically significant. There was no significant difference between the custom and off-the-shelf orthoses.

  5. COMPUTATIONAL AND EXPERIMENTAL STUDY ON TIP LEAKAGE VORTEX OF CIRCUMFERENTIAL SKEWED BLADES

    Institute of Scientific and Technical Information of China (English)

    LI Yang; OUYANG Hua; DU Zhaohui

    2007-01-01

    In the steady operation condition, the experiments and the numerical simulations are used to investigate the tip leakage flow fields in three low pressure axial flow fans with three kinds of circumferential skewed rotors, including the radial rotor, the forward-skewed rotor and the backward-skewed rotor. The three-dimensional viscous flow fields of the fans are computed. In the experiments, the two-dimensional plane particle image velocimetry (PIV) system is used to measure the flow fields in the tip region of three different pitchwise positions of each fan. The results show that the computational results agree well with the experimental data in the flow field of the tip region of each fan. The tip leakage vortex core segments based on method of the eigenmode analysis can display clearly some characteristics of the tip leakage vortex, such as the origination position of tip leakage vortex, the development of vortex strength, and so on. Compared with the radial rotor, the other two skewed rotors can increase the stability of the tip leakage vortex and the increment in the forward-skewed rotor is more than that in the backward-skewed one. Among the tip leakage vortices of the three rotors, the velocity of the vortex in the forward-skewed rotor is the highest in the circumferential direction and the lowest in the axial direction.

  6. Mortality after portal vein embolization

    Science.gov (United States)

    Lee, Eung Chang; Park, Sang-Jae; Han, Sung-Sik; Park, Hyeong Min; Lee, Seung Duk; Kim, Seong Hoon; Lee, In Joon; Kim, Hyun Beom

    2017-01-01

    Abstract Portal vein embolization (PVE) is increasingly performed worldwide to reduce the possibility of liver failure after extended hepatectomy, by inducing future liver remnant (FLR) hypertrophy and atrophy of the liver planned for resection. The procedure is known to be very safe and to have few procedure-related complications. In this study, we described 2 elderly patients with Bismuth–Corlette type IV Klatskin tumor who underwent right trisectional PVE involving the embolization of the right portal vein, the left medial sectional portal branch, and caudate portal vein. Within 1 week after PVE, patients went into sepsis combined with bile leak and died within 1 month. Sepsis can cause acute liver failure in patients with chronic liver disease. In this study, the common patient characteristics other than sepsis, that is, trisectional PVE; chronic alcoholism; aged >65 years; heart-related comorbidity; and elevated serum total bilirubin (TB) level (7.0 mg/dL) at the time of the PVE procedure in 1 patient, and concurrent biliary procedure, that is, percutaneous transhepatic biliary drainage in the other patient might have affected the outcomes of PVE. These cases highlight that PVE is not a safe procedure. Care should be taken to minimize the occurrence of infectious events because sepsis following PVE can cause acute liver failure. Additionally, prior to performing PVE, the extent of PVE, chronic alcohol consumption, age, comorbidity, long-lasting jaundice, concurrent biliary procedure, etc. should be considered for patient safety. PMID:28178122

  7. 53. Bilateral ductal stenting for nonconfluent pulmonary arteries in a newborn

    Directory of Open Access Journals (Sweden)

    K. Al Dhahri

    2016-07-01

    Full Text Available Bilateral PDA dependent pulmonary circulation with right and left pulmonary artery discontinuity is very rare. Limited data available for bilateral PDA stenting. Bilateral PDA stenting in nonconfluent pulmonary arteries is challenging procedure but can be considered as an option in the management of complex conditions like this. 12 days old Preterm (36 weeks gestation male baby with birth weight of 2.6 kg developed respiratory distress with severe cyanosis and desaturation upto 50%. Baby was intubated and started on Prostaglandin 0.05 mic/kg/mt. His saturation improved to 80%. Echocardiogram showed complex cyanotic heart disease, Situs ambiguous, dextrocardia, complete unbalanced AV septal defect, pulmonary atresia , nonconfluent small branch pulmonary arteries supplied by the bilateral patent ductus arteriosus (PDA from right aortic arch and all four pulmonary veins form a confluence and drain into superior vena cava(SVC through vertical vein with no obstruction. Baby was taken up for PDA stenting. descending aortogram showed right aortic arch with vertical tortuous duct to right pulmonary artery (RPA and another short duct with acute angle from left subclavian artery to left pulmonary artery (LPA . Both ducti stented with coronary stents. Vertical vein angiogram showed both lungs drain to a confluence and then to SVC via ascending vertical vein with no obstruction. After stenting lung perfusion improved and the baby was stable and maintained 80% saturation on room air. Bilateral PDA dependent pulmonary circulation with right and left pulmonary artery discontinuity is very rare. Our case is unique with Heterotaxy, TAPVC, Dextrocardia and double ducti. Eventhough bilateral ductal stenting is technically challenging it is successful through femoral artery approach.

  8. Single-Stage Repair of an Unusual Association: Congenital Gerbode Defect, Hypoplastic Aortic Arch, and Partially Anomalous Pulmonary Venous Return in an Infant.

    Science.gov (United States)

    Flores, Saul; Kimball, Thomas R; Nelson, David P; Morales, David L S

    2016-07-01

    We present the case of a two-month-old male with congenital Gerbode defect, hypoplastic aortic arch, and left-sided partially anomalous pulmonary venous return. The patient underwent single-stage surgical repair, which consisted of aortic arch advancement with resection of the coarctation segment, pulmonary vein repair, and primary closure of the Gerbode defect. The anomalous pulmonary vein posed a particular challenge due to its size and distance from the left atrium, which we approached with a posterior atrial wall trapdoor baffle technique, without mobilizing the affected vein. Postoperatively and at one year follow-up, there was no evidence of residual lesions and there was unobstructed flow pattern across the aortic arch and the affected pulmonary vein.

  9. Pulmonary Arterial Hypertension

    Science.gov (United States)

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  10. Peculiarities of Blood Flow Changes in Venae Cavae during Experimental Pulmonary Embolism.

    Science.gov (United States)

    Evlakhov, V I; Poyassov, I Z; Shaidakov, E V

    2016-10-01

    The model of acute pulmonary embolism in rabbits demonstrated reduced pulmonary blood flow, cardiac output, left atrial pressure, and blood flow in venae cavae against the background of elevated left pulmonary artery pressure and increased pulmonary vascular resistance. Simultaneously, the blood flow in the superior vena cava decreased to a lesser extent than that in the inferior vena cava, which was a characteristic feature of the model of pulmonary pathology. In contrast, when histamine was infused into the left jugular vein to equally elevate pressure in pulmonary artery as in the above model, the blood flow in the superior vena cava decreased to a greater extent than that in inferior vena cava. During stenosis of inferior vena cava that decreased the cardiac output to the level observed during modeled pulmonary embolism, the blood flows in both venae cavae dropped equally.

  11. Preceding bronchial cutting for exposure of the pulmonary artery buried in scar tissue after chemoradiotherapy.

    Science.gov (United States)

    Nomori, Hiroaki; Cong, Yue; Sugimura, Hiroshi

    2017-01-01

    It is often difficult to expose the pulmonary artery buried in a scar tissue, especially in lung cancer patients that responded well to neoadjuvant chemoradiotherapy. Difficulty to access pulmonary artery branches may lead to potentially unnecessary pneumonectomy. To complete lobectomy in such cases, a technique with preceding bronchial cutting for exposure of the pulmonary artery is presented. After dissecting the pulmonary vein, the lobar bronchus is cut from the opposite side of the pulmonary artery with scissors. The back wall of the lobar bronchus is cut using a surgical knife from the luminal face, which can expose the pulmonary artery behind the bronchial stump and then complete lobectomy. Fourteen patients have been treated using the present technique, enabling complete resection by lobectomy (including sleeve lobectomy in 3 patients) without major bleeding. The present procedure can expose pulmonary artery buried in scar tissue, resulting in making the lobectomy safer.

  12. Undivided Retromandibular Vein Continuing As External Jugular Vein With Facial Vein Draining Into It : An Anatomical Variation

    Directory of Open Access Journals (Sweden)

    Shahnaz Choudhary, Ashwani K Sharma, Harbans Singh

    2010-10-01

    Full Text Available Despite the fact that the blueprint of the whole body is unravelled, faultlessly during the growth anddevelopment of an animal; but amazingly variations do occur. During routine dissection of head and neckin a middle aged cadaver in the Post Graduate Department of Anatomy of this medical college, we foundvariation in the formation of external jugular vein on both sides, which was formed by the continuation ofundivided trunk of retromandibular vein. The facial vein and posterior auricular vein were the tributaries ofexternal jugular vein. The sound anatomical knowledge of variations of the veins of head and neck isessential to the success of surgical procedures. The embryological evaluation of the above anomaly wasdone and compared with the available literature which showed that the observed variation was rare

  13. 远程磁导航指导下加强肺静脉前庭消融策略治疗心房纤颤有效性研究%Efficacy of enhanced ablation on pulmonary vein antrum isolation under remote magnetic navigation in patients with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    郭文杰; 徐伟豪; 兰凯; 彭利; 张玉霄; 卢才义

    2016-01-01

    目的:探讨在远程磁导航系统( RMN)辅助下应用加强消融策略行心房纤颤( AF)射频消融治疗对AF远期成功率的影响。方法连续选取2013年1月至2015年6月在解放军总医院住院行导管射频消融治疗且自愿参加该临床研究的患者49例非瓣膜性AF患者随机分成两组,传统消融组(CAG, n=24)和加强消融组(EAG, n=25)。 CAG组对左右肺静脉行单环线性消融,EAG组在CAG消融基础上,靠近原有消融径线,在心房侧再次行线性消融,形成双环线性消融。术中应用磁导航消融导管,RMN系统、CARTO 3系统和Lasso环状标测电极,术后常规使用24 h动态心电图随访。结果所有患者均消融成功,EAG组较CAG组消融时间明显延长[(45.66±6.59)vs (40.10±3.48)min,P<0.01],而在曝光时间、手术时间和静脉血测定脑利钠肽前体上差异无统计学意义( P>0.05)。术后随访(19.3±5.6)个月,应用动态心电图随访发现EAG组复发率较CAG组明显降低(33.33%vs 8.00%,P<0.05)。二次手术时发现复发患者均存在电传导恢复情况,8例再次手术均成功。结论加强消融策略能有效改善AF患者的远期成功率,降低复发率。%Objective To assess the long-term efficacy of enhanced ablation in pulmonary vein antrum ( PVA) guided by remote magnetic navigation ( RMN) in the patients with atrial fibrillation ( AF) .Methods From January 2013 to June 2015, 49 consecutive patients with refractory non-valvular AF who undergoing radiofrequency catheter ablation and voluntarily taking part in this study in our hospital were recruited in this study .They were randomized into a conventional ablation group ( CAG, n =24 ) and an enhanced ablation group ( EAG, n=25) .PVA isolation was achieved by creating a single ablation circle in the patients of CAG group , and was double ablation circles at PVA in those of EAG group .An irrigated

  14. Correlation of left atrial low voltage zone with recurrence after pulmonary antrum vein isolation in patients with paroxysmal atrial fibrillation%阵发性心房颤动患者左心房低电压区与肺静脉电隔离术后复发的关系

    Institute of Scientific and Technical Information of China (English)

    田颖; 刘兴鹏; 尹先东; 周旭; 石亮; 王彦江; 刘小青; 杨新春

    2014-01-01

    目的:分析阵发性心房颤动(房颤)患者左心房低电压与肺静脉电隔离术后复发的关系。方法连续168例阵发性房颤患者[女性76例,年龄(62±11岁)],窦性心律下行左心房高密度(≥100点)标测,之后行肺静脉电隔离术治疗,在肺静脉隔离20min后给予异丙肾上腺素+腺苷三磷酸(0.2mg/kg),观察肺静脉传导恢复与否以及是否存在肺静脉外局灶触发的房颤,并对传导恢复的肺静脉以及肺静脉外局灶再次消融,直至激发试验阴性。本组患者均不进行基质改良。低电压的定义为CARTO消融导管记录的心肌局部双极电图振幅<0.5mV。结果42例(25.0%)患者的左心房存在低电压区,主要位于左心房前壁(22例,52.4%),与女性和左房直径增大相关。所有患者均完成肺静脉电隔离。随访(23±12)个月,35例患者复发房性快速心律失常,其中左房低电压者14例(14/42,33.3%),非低电压者21例(21/126,16.7%,P=0.028)。结论阵发性房颤患者左心房存在低电压区增加肺静脉电隔离术后的复发率,其形成可能与性别和左房直径有关。%Objective To investigate the correlation of left atrial low-voltage zones (LVZs) with atrial fibrillation (AF) recurrence after pulmonary vein (PV) antrum isolation (PVAI) in paroxysmal AF patients. Methods A total of 168 consecutive patients [92 males and 76 females, with age of (62±11) years] who underwent PVAI for treating AF in our department were enrolled in this study. High density (≥100 points) left atrial voltage maps were reconstructed during sinus rhythm using CARTO 3 system. LVZs were defined as areas with bipolar peak-to-peak voltage amplitudes <0.5mV. In 20min after PVAI, all patients were given intravenous injection of isoproterenol and adenosine triphosphate (ATP, 0.2 mg/kg) in an attempt to unmask PV reconnection and AF triggered by non-PV foci. If PV reconnection

  15. The umbilical and paraumbilical veins of man.

    Science.gov (United States)

    Martin, B F; Tudor, R G

    1980-03-01

    During its transit through the umbilicus structural changes occur in the thick wall of the extra-abdominal segment of the umbilical vein whereby the components of the intra-abdominal segment acquire an essentially longitudinal direction and become arranged in fibro-elastic and fibro-muscular zones. The vein lumen becomes largely obliterated by asymmetrical proliferation of loose subendothelial conective tissue. The latter forms a new inner zone within which a small segment of the lumen persists in an eccentric position. This residual lumen transmits blood to the portal system from paraumbilical and systemic sources, and is retained in the upper part of the vein, even in old age. A similar process of lumen closure is observed in the ductus venosus. In early childhood the lower third of the vein undergoes breakdown, with fatty infiltration, resulting in its complete division into vascular fibro-elastic strands, and in old age some breakdown occurs in the outermost part of the wall of the upper two thirds. The paraumbilical veins are thick-walled and of similar structure to the umbilical vein. Together they constitute an accessory portal system which is confined between the layers of the falciform ligament and is in communication with the veins of the ventral abdominal wall. The constituents form an ascending series, namely, Burow's veins, the umbilical vein, and Sappey's inferior and superior veins. The main channel of Sappey's inferior veins may be the remnant of the right umbilical vein since it communicates with the right rectus sheath and often communicates directly with the portal system within the right lobe of the liver. The results are of significance in relation to clinical usage of the umbilical vein.

  16. Application of Blocking Unilateral Main Pulmonary Artery in Pulmonary Lobectomy of Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Fei Gao; Yunchao Huang; Lixia Liang; Anning Chen; Tierong Zhao

    2009-01-01

    OBJECTIVE To explore the application of blocking the unilateral main pulmonary artery (MPA) in pulmonary lobectomy (PL) for patients with stage Ⅱand Ⅲ lung cancer, and to retrospectively analyze the methods of surgery for blocking the unilateral main pulmonary artery, perioperative indications, intraoperative concerns and postoperative cardio-pulmonary complications. METHODS During a period from January 2006 to January 2008, intra-pericardial, or extra-pericardial separation and blockade of the left or right MPA followed by completion of various PLs were conducted for 30 lung cancer patients in stage-Ⅱ to Ⅲ with ill- defined anatomic structure of the pulmonary hilum and difficult pulmonary angiodiastasis.RESULTS In the 30 patients, 5 were diagnosed as stage-Ⅱb, 11 stage-Ⅲa, and 14 stage-Ⅲb. During the surgery, giant tumors at the superior pulmonary lobe, with a diameter of over 10 cm, were seen in 13 cases, in which tumor invasion in the extra-pericardiac pulmonary artery was found in 5 cases. Hilar lymphadenectasis with severe tumor adhesion to pulmonary blood vessel could be seen in 20 cases and partial tumorous invasion in the pericardium in 7. In most of the cases, adhesions existed around the tumor, aorta, superior vena, and azygous vein. Invasion of the laryngeal and vagus nerves on the left side was found in 3 cases. Of the 30 patients, simple PL was conducted in 12, and sleeve lobectomy combined with a pulmonary arterioplasty in 18 cases. With a blockade of unilateral MPA, no intraoperative hemorrhea of pulmonary blood vessels occurred during surgery, when there was a clear surgical field of vision. Both PL and lymphadenectomy were smoothly completed in the 30 patients. The healthy pulmonary lobes with normal function were kept and total pneumonectomy was avoided. The time of blocking the pulmonary artery ranged from 10 to 30 min, and intraoperative blood loss was from 200 to 300 ml. Postoperative complicated acute pulmonary edema occurred in

  17. Reduction of longitudinal axial residual stresses in near-root region of circumferential joint of steam pipeline in technological way

    Directory of Open Access Journals (Sweden)

    V. M. Prokhorenko

    2013-10-01

    Full Text Available The paper proposes a variant for solving the problem of reduction of longitudinal residual stresses in near-root region of a circumferential welded joint of section of steam pipeline by FEM simulation of the stress-strain state of repaired section of a circumferential weld in the zone of lack of root penetration on a thin-wall shell of 89 mm diameter and 6 mm wall thickness from steel 20. The result of solving the problem is total distribution of stresses and residual plastic deformations in the repaired zone.

  18. Tip clearance flow interaction with circumferential groove casing treatment in a transonic axial compressor

    Science.gov (United States)

    Ross, Mark Hamilton

    Experimental and computational studies were conducted to study the role of the tip leakage flow in axial compressor stall and the relationship between the tip clearance flow flow field and surge margin extension from circumferential groove casing treatment. The CFD results were used to identify the existence of an interface between the approach ow and the tip-leakage flow. The experiments used a surface streaking visualization method to identify the time-averaged location of this interface as a line of zero axial shear stress at the casing. The axial position of this line, denoted xzs, moved upstream with decreasing ow coefficient in both the experiments and computations. The line was consistently located at the rotor leading edge plane at the stalling flow coefficient, regardless of in flow boundary condition. These results were successfully modeled using a control volume approach that balanced the reverse axial momentum ux of the tip-leakage flow with the momentum flux of the approach fluid. Non-uniform tip clearance measurements demonstrated that movement of the interface upstream of the rotor leading edge plane leads to the generation of short length scale rotating disturbances. Therefore, stall was interpreted as a critical point in the momentum flux balance of the approach ow and the reverse axial momentum flux of the tip-leakage flow. Experimental measurements of surge margin extension from seven CGCT configurations with a fixed groove geometry demonstrated that the contribution of individual grooves in a multi-groove casing to surge margin extension is an (a) additive and (b) linear function of the smooth wall tip clearance axial momentum ux at the location of a each groove. Extending the axial momentum model to include the in uence of a CGCT showed that circumferential grooves reduce the tip leakage flow axial momentum through radial transport. The equivalent force due to a circumferential groove was demonstrated to be related to the smooth wall tip

  19. How Is Pulmonary Hypertension Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Pulmonary Hypertension Treated? Pulmonary hypertension (PH) has no cure. However, ... Types of Pulmonary Hypertension." ) Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH ...

  20. Isolated Pulmonary Embolism following Shoulder Arthroscopy

    Directory of Open Access Journals (Sweden)

    Nicole H. Goldhaber

    2014-01-01

    Full Text Available Pulmonary embolism (PE following shoulder arthroscopy is a rare complication. We present a unique case report of a 43-year-old right-hand dominant female who developed a PE 41 days postoperatively with no associated upper or lower extremity DVT. The patient had minimal preoperative and intraoperative risk factors. Additionally, she had no thromboembolic symptoms postoperatively until 41 days following surgery when she developed sudden right-hand swelling, labored breathing, and abdominal pain. A stat pulmonary computed tomography (CT angiogram of the chest revealed an acute PE in the right lower lobe, and subsequent extremity ultrasounds showed no upper or lower extremity deep vein thrombosis. After a thorough review of the literature, we present the first documented isolated PE following shoulder arthroscopy. Although rare, sudden development of an isolated PE is possible, and symptoms such as sudden hand swelling, trouble breathing, and systemic symptoms should be evaluated aggressively with a pulmonary CT angiogram given the fact that an extremity ultrasound may be negative for deep vein thrombosis.

  1. Palm Vein Verification Using Gabor Filter

    Directory of Open Access Journals (Sweden)

    Ali Mohsin Al-Juboori

    2013-01-01

    Full Text Available Palm vein authentication is one of the modern biometric techniques, which employs the vein pattern in the human palm to verify the person. The merits of palm vein on classical biometric (e.g. fingerprint, iris, face are a low risk of falsification, difficulty of duplicated and stability. In this research, a new method is proposed for personal verification based on palm vein features. In the propose method, the palm vein images are firstly enhanced and then the features are extracted by using bank of Gabor filters. Then Fisher Discriminated Analysis (FDA is used to reduce the dimension of the features vectors. For vein pattern verification, this work uses Nearest Neighbors method. The EER of the proposed method is 0.2335%.

  2. Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency

    Directory of Open Access Journals (Sweden)

    Sarac A

    2014-04-01

    Full Text Available Atilla Sarac,1 Artan Jahollari,1 Sureyya Talay,1 Sevket Ozkaya,2 Ertugrul Ozal1 1Department of Cardiovascular Medicine, Samsun Medical Park Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey Objective: The aim of this study is to present our 7-year results of external valvuloplasty for isolated great saphenous vein (GSV insufficiency. Methods: External valvuloplasty was applied in 83 patients with isolated GSV insufficiency. Follow-up consisted of venous color duplex scanning performed on the first postoperative day, the first postoperative month, and then annually. Valvular insufficiency, venous reflux, and venous thrombosis formation in the saphenofemoral junction were the main outcomes. Results: A complete clinical and radiological healing was observed in 50 patients (60%. In 13 cases (15.6%, a secondary surgical treatment was performed consisting of vena saphena magna high ligation/stripping and varicose vein excisions, mainly due to severe and progressive vena saphena magna valvular insufficiency and clinical persistence of symptoms. Eight patients (9.6% developed superficial vein thrombosis, and only one patient (1.2% developed deep vein thrombosis. Contact was lost from 32 patients (38.5% for different reasons. Conclusion: External valvuloplasty is an effective surgical technique for selected cases of isolated GSV insufficiency without extensive varicose dilatations. This alternative method can be safely administered as an alternative to high ligation and conventional GSV stripping. Keyword: vein, saphenous, insufficiency, external valv, valvuloplasty, varicosis

  3. Propagation of S-polarized surface polaritons circumferentially around a locally cylindrical surface

    Energy Technology Data Exchange (ETDEWEB)

    Polanco, J. [Department of Physics, University of Texas, El Paso, TX 79968 (United States); Fitzgerald, R.M., E-mail: rfitzgerald@utep.edu [Department of Physics, University of Texas, El Paso, TX 79968 (United States); Maradudin, A.A. [Department of Physics and Astronomy, University of California, Irvine, CA 92697 (United States)

    2012-04-02

    The dispersion relation is derived and solved for s-polarized surface polaritons propagating circumferentially around a portion of a cylindrical interface between vacuum and an isotropic dielectric. In the case that the dielectric is convex toward the vacuum these modes are found to be radiative, and consequently are attenuated as they propagate on the cylindrical surface. When the dielectric is concave toward the vacuum the resulting surface polaritons are nonradiative and propagate unattenuated on the cylinder. Such modes do not exist in the case of a planar interface between a homogeneous isotropic dielectric and vacuum. -- Highlights: ► New surface wave. ► Many-branched dispersion curve. ► More nodes in fields as frequency grows.

  4. Crack shape developments and leak rates for circumferential complex-cracked pipes

    Energy Technology Data Exchange (ETDEWEB)

    Brickstad, B.; Bergman, M. [SAQ Inspection Ltd., Stockholm (Sweden)

    1997-04-01

    A computerized procedure has been developed that predicts the growth of an initial circumferential surface crack through a pipe and further on to failure. The crack growth mechanism can either be fatigue or stress corrosion. Consideration is taken to complex crack shapes and for the through-wall cracks, crack opening areas and leak rates are also calculated. The procedure is based on a large number of three-dimensional finite element calculations of cracked pipes. The results from these calculations are stored in a database from which the PC-program, denoted LBBPIPE, reads all necessary information. In this paper, a sensitivity analysis is presented for cracked pipes subjected to both stress corrosion and vibration fatigue.

  5. Circumferential resonance modes of solid elastic cylinders excited by obliquely incident acoustic waves.

    Science.gov (United States)

    Fan, Ying; Honarvar, Farhang; Sinclair, Anthony N; Jafari, Mohammad-Reza

    2003-01-01

    When an immersed solid elastic cylinder is insonified by an obliquely incident plane acoustic wave, some of the resonance modes of the cylinder are excited. These modes are directly related to the incidence angle of the insonifying wave. In this paper, the circumferential resonance modes of such immersed elastic cylinders are studied over a large range of incidence angles and frequencies and physical explanations are presented for singular features of the frequency-incidence angle plots. These features include the pairing of one axially guided mode with each transverse whispering gallery mode, the appearance of an anomalous pseudo-Rayleigh in the cylinder at incidence angles greater than the Rayleigh angle, and distortional effects of the longitudinal whispering gallery modes on the entire resonance spectrum of the cylinder. The physical explanations are derived from Resonance Scattering Theory (RST), which is employed to determine the interior displacement field of the cylinder and its dependence on insonification angle.

  6. Preduodenal portal vein: its surgical significance.

    Science.gov (United States)

    Makey, D A; Bowen, J C

    1978-11-01

    Preduodenal portal vein is a rare anatomical variant which may be one of many anomalies in the neonate with duodenal "atresia." Preduodenal portal vein also may be an occasional finding in an adult undergoing biliary, gastric, or pancreatic surgery. Awareness and recognition of the anomaly are essential for the avoidance of injury during such operations. We report here a symptomless patient whose preduodenal portal vein was discovered at cholecystectomy.

  7. Amniotic membrane grafts for the prevention of esophageal stricture after circumferential endoscopic submucosal dissection.

    Directory of Open Access Journals (Sweden)

    Maximilien Barret

    Full Text Available The prevention of esophageal strictures following circumferential mucosal resection remains a major clinical challenge. Human amniotic membrane (AM is an easily available material, which is widely used in ophthalmology due to its wound healing, anti-inflammatory and anti-fibrotic properties. We studied the effect of AM grafts in the prevention of esophageal stricture after endoscopic submucosal dissection (ESD in a swine model.In this prospective, randomized controlled trial, 20 swine underwent a 5 cm-long circumferential ESD of the lower esophagus. In the AM Group (n = 10, amniotic membrane grafts were placed on esophageal stents; a subgroup of 5 swine (AM 1 group was sacrificed on day 14, whereas the other 5 animals (AM 2 group were kept alive. The esophageal stent (ES group (n = 5 had ES placement alone after ESD. Another 5 animals served as a control group with only ESD.The prevalence of symptomatic strictures at day 14 was significantly reduced in the AM group and ES groups vs. the control group (33%, 40% and 100%, respectively, p = 0.03; mean esophageal diameter was 5.8±3.6 mm, 6.8±3.3 mm, and 2.6±1.7 mm for AM, ES, and control groups, respectively. Median (range esophageal fibrosis thickness was 0.87 mm (0.78-1.72, 1.19 mm (0.28-1.95, and 1.65 mm (0.7-1.79 for AM 1, ES, and control groups, respectively. All animals had developed esophageal strictures by day 35.The anti-fibrotic effect of AM on esophageal wound healing after ESD delayed the development of esophageal stricture in our model. However, this benefit was of limited duration in the conditions of our study.

  8. Quantitative lymphoscintigraphy in post-mastectomy lymphedema: correlation with circumferential measurements

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Lee, Kyung Han; Kim, Sang Eun; Kim, Byung Tae; Hwang, Jee Hea; Lee, Byung Boong [Samsung Medical Center, Seoul (Korea, Republic of)

    1997-07-01

    An objective measure for the severity and progression is important for the management of lymphedema. To evaluate the usefulness of lympho-scintigraphy in this regard, we compared various quantitative indices from upper extremity lymphoscintigraphy with circumferential measurements, before and after physiotheraphy. Upper extremity lymphoscintigraphy was performed in 38 patients with unilateral postmastectomy lymphedema. Tc-99m antimony sulfide colloid (37 MBq) was injected s.c. into the second and third interdigital spaces. The injection sites were imaged immediately after injection. After standardized exercise for 15 min, upper extremity images were acquired 30 min, 1 hr and 2 hr after injection. The clearance of the injection site (CL), and % uptake in regional lymph nodes (%LN) and soft tissue of the extremity (i.e., the degree of dermal backflow) (%EXT) compared to the initial injection site were calculated. Circumference of each extremity was measured at 7 levels; the severity of lymphedema was expressed as the percentage difference of total circumferential difference (TCD) between healthy and edematous extremities compared to the total circumference of healthy extremity (%TCD). In 19 patients who received physiotherapy, the therapeutic effect was measured by % decrease of TCD (%DTCD) before and after therapy (Raines. et al., 1977). The quantitative indices calculated in the image at 2 hr p.i. had better correlation with either %TCD or %DTCD than those from earlier images (Table). The CL, %LN and %EXT of edematous extremity had a significant correlation with TCD. The %EXT was correlated best with either TCD or %DTCD. The results suggest that the %EXT which corresponds to the degree of dermal backflow may be a simple and useful quantitative index for evaluating the severity and progression in lymphedema and predicting the effect of therapy.

  9. Development of a used fuel cladding damage model incorporating circumferential and radial hydride responses

    Science.gov (United States)

    Chen, Qiushi; Ostien, Jakob T.; Hansen, Glen

    2014-04-01

    At the completion of the fuel drying process, used fuel Zry4 cladding typically exhibits a significant population of δ-hydride inclusions. These inclusions are in the form of small platelets that are generally oriented both circumferentially and radially within the cladding material. There is concern that radially-oriented hydride inclusions may weaken the cladding material and lead to issues during used fuel storage and transportation processes. A high fidelity model of the mechanical behavior of hydrides has utility in both designing fuel cladding to be more resistant to this hydride-induced weakening and also in suggesting modifications to drying, storage, and transport operations to reduce the impact of hydride formation and/or the avoidance of loading scenarios that could overly stress the radial inclusions. We develop a mechanical model for the Zry4-hydride system that, given a particular morphology of hydride inclusions, allows the calculation of the response of the hydrided cladding under various loading scenarios. The model treats the Zry4 matrix material as J2 elastoplastic, and treats the hydrides as platelets oriented in predefined directions (e.g., circumferentially and radially). The model is hosted by the Albany analysis framework, where a finite element approximation of the weak form of the cladding boundary value problem is solved using a preconditioned Newton-Krylov approach. Instead of forming the required system Jacobian operator directly or approximating its action with a differencing operation, Albany leverages the Trilinos Sacado package to form the Jacobian via automatic differentiation. We present results that describe the performance of the model in comparison with as-fabricated Zry4 as well as HB Robinson fuel cladding. Further, we also present performance results that demonstrate the efficacy of the overall solution method employed to host the model.

  10. Development of a used fuel cladding damage model incorporating circumferential and radial hydride responses

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qiushi, E-mail: qiushi@clemson.edu [Glenn Department of Civil Engineering, Clemson University, Clemson, SC 29634 (United States); Ostien, Jakob T., E-mail: jtostie@sandia.gov [Mechanics of Materials Dept. 8256, Sandia National Laboratories, P.O. Box 969, Livermore, CA 94551-0969 (United States); Hansen, Glen, E-mail: gahanse@sandia.gov [Computational Multiphysics Dept. 1443, Sandia National Laboratories, P.O. Box 5800, Albuquerque, NM 87185-1321 (United States)

    2014-04-01

    At the completion of the fuel drying process, used fuel Zry4 cladding typically exhibits a significant population of δ-hydride inclusions. These inclusions are in the form of small platelets that are generally oriented both circumferentially and radially within the cladding material. There is concern that radially-oriented hydride inclusions may weaken the cladding material and lead to issues during used fuel storage and transportation processes. A high fidelity model of the mechanical behavior of hydrides has utility in both designing fuel cladding to be more resistant to this hydride-induced weakening and also in suggesting modifications to drying, storage, and transport operations to reduce the impact of hydride formation and/or the avoidance of loading scenarios that could overly stress the radial inclusions. We develop a mechanical model for the Zry4-hydride system that, given a particular morphology of hydride inclusions, allows the calculation of the response of the hydrided cladding under various loading scenarios. The model treats the Zry4 matrix material as J{sub 2} elastoplastic, and treats the hydrides as platelets oriented in predefined directions (e.g., circumferentially and radially). The model is hosted by the Albany analysis framework, where a finite element approximation of the weak form of the cladding boundary value problem is solved using a preconditioned Newton–Krylov approach. Instead of forming the required system Jacobian operator directly or approximating its action with a differencing operation, Albany leverages the Trilinos Sacado package to form the Jacobian via automatic differentiation. We present results that describe the performance of the model in comparison with as-fabricated Zry4 as well as HB Robinson fuel cladding. Further, we also present performance results that demonstrate the efficacy of the overall solution method employed to host the model.

  11. [Pulmonary strongyloidiasis].

    Science.gov (United States)

    Lozada, Heiler; Daza, Jorge E

    2016-10-01

    Strongyloidiasis is an infection caused by the parasite Strongyloides stercoralis, which can be asymptomatic and means a high morbidity and mortality in immunocompromised hosts, severe malnutrition and coinfection with HTLV-1 virus. The parasite has the potential to produce and multiply internal autoinfection in humans, thus an hyperinfection can be developed. A case of pulmonary infection by this parasite is presented in this study, infection which advanced into a respiratory failure and required mechanical ventilation and hemodynamic support in an intensive care unit. The standard treatment combined with ivermectin and albendazole was provided, achieving an appropriate response.

  12. Small hepatic veins Budd-Chiari syndrome.

    Science.gov (United States)

    Riggio, Oliviero; Marzano, Chiara; Papa, Alessia; Pasquale, Chiara; Gasperini, Maria Ludovica; Gigante, Antonietta; Valla, Dominique Charles; Plessier, Aurélie; Amoroso, Antonio

    2014-05-01

    Budd-Chiari syndrome is a rare disorder characterized by hepatic venous outflow obstruction at any level from the small hepatic veins to the atrio-caval junction, in the absence of heart failure or constrictive pericarditis. Various imaging modalities are available for investigating the gross hepatic vascular anatomy but there are rare forms of this disease where the obstruction is limited to the small intrahepatic veins, with normal appearance of the large hepatic veins at imaging. In this cases only a liver biopsy can demonstrate the presence of a small vessels outflow block. We report two cases of small hepatic veins Budd-Chiari syndrome.

  13. Sonographic Findings in Fetal Renal Vein Thrombosis.

    Science.gov (United States)

    Gerber, Rebecca E; Bromley, Bryann; Benson, Carol B; Frates, Mary C

    2015-08-01

    We present the sonographic findings of fetal renal vein thrombosis in a series of 6 patients. The mean gestational age at diagnosis was 31.2 weeks. Four cases were unilateral, and 2 were bilateral. The most common findings were renal enlargement and intrarenal vascular calcifications, followed by increased renal parenchymal echogenicity. Inferior vena cava thrombosis was found in 4 patients and common iliac vein thrombosis in 2. Fetal renal vein thrombosis is an uncommon diagnosis with characteristic sonographic findings. The presence of these findings should prompt Doppler interrogation of the renal vein and inferior vena cava to confirm the diagnosis.

  14. Leiomyosarcoma of the external iliac vein.

    Science.gov (United States)

    Fukuda, Wakako; Taniguchi, Satoshi; Fukuda, Ikuo

    2012-06-01

    Leiomyosarcoma of the iliac vein is an uncommon tumor. We report a case of a 63-year-old Japanese woman with leiomyosarcoma of the right external iliac vein. The patient complained of right inguinal pain and swelling. Computed tomography demonstrated a mass surrounding the right external iliac artery and vein. Metastases in the lungs and liver were found. Complete resection of the tumor along with the involved vessels was performed. Polytetrafluoroethylene grafts were used to reconstruct the vessels. Pathological examination revealed leiomyosarcoma of the external iliac vein. Although the prognosis of leiomyosarcoma is poor, en bloc tumor resection is the treatment of choice.

  15. Pulmonary biomarkers in chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Barnes, Peter J.; Chowdhury, Badrul; Kharitonov, Sergei A.; Magnussen, Helgo; Page, Clive P.; Postma, Dirkje; Saetta, Marina

    2006-01-01

    There has been increasing interest in using pulmonary biomarkers to understand and monitor the inflammation in the respiratory tract of patients with chronic obstructive pulmonary disease (COPD). In this Pulmonary Perspective we discuss the merits of the various approaches by reviewing the current l

  16. [Idiopathic pulmonary hemosiderosis with dendriform pulmonary ossification].

    Science.gov (United States)

    Barrera, Ana Madeleine; Vargas, Leslie

    2016-12-01

    Pulmonary ossification is a rare and usually asymptomatic finding reported as incidental in lung biopsies. Similarly, idiopathic pulmonary hemosiderosis is a rare cause of pulmonary infiltrates. We report the case of a 64-year old man with chronic respiratory symptoms in whom these two histopathological findings converged.

  17. Optimizing computed tomography pulmonary angiography using right atrium bolus monitoring combined with spontaneous respiration

    Energy Technology Data Exchange (ETDEWEB)

    Min, Wang; Jian, Li; Rui, Zhai [Jining No. 1 People' s Hospital, Department of Computed Tomography, Jining City, ShanDong Province (China); Wen, Li [Jining No. 1 People' s Hospital, Department of Gastroenterology, Jining, ShanDong (China); Dai, Lun-Hou [Shandong Chest Hospital, Department of Radiology, Jinan, ShanDong (China)

    2015-09-15

    CT pulmonary angiography (CTPA) aims to provide pulmonary arterial opacification in the absence of significant pulmonary venous filling. This requires accurate timing of the imaging acquisition to ensure synchronization with the peak pulmonary artery contrast concentration. This study was designed to test the utility of right atrium (RA) monitoring in ensuring optimal timing of CTPA acquisition. Sixty patients referred for CTPA were divided into two groups. Group A (n = 30): CTPA was performed using bolus triggering from the pulmonary trunk, suspended respiration and 70 ml of contrast agent (CA). Group B (n = 30): CTPA image acquisition was triggered using RA monitoring with spontaneous respiration and 40 ml of CA. Image quality was compared. Subjective image quality, average CT values of pulmonary arteries and density difference between artery and vein pairs were significantly higher whereas CT values of pulmonary veins were significantly lower in group B (all P < 0.05). There was no significant difference between the groups in the proportion of subjects where sixth grade pulmonary arteries were opacified (P > 0.05). RA monitoring combined with spontaneous respiration to trigger image acquisition in CTPA produces optimal contrast enhancement in pulmonary arterial structures with minimal venous filling even with reduced doses of CA. (orig.)

  18. phenoVein - A tool for leaf vein segmentation and analysis

    OpenAIRE

    Bühler, J.; Rishmawi, L.; Pflugfelder, D.; Huber, G; Scharr, H.; Hülskamp, M; Koornneef, M.; Schurr, U; Jahnke, S.

    2015-01-01

    Precise measurements of leaf vein traits are an important aspect of plant phenotyping for ecological and genetic research. Here, we present a powerful and user-friendly image analysis tool named phenoVein. It is dedicated to automated segmenting and analyzing of leaf veins in images acquired with different imaging modalities (microscope, macrophotography, etc.), including options for comfortable manual correction. Advanced image filtering emphasizes veins from the background and compensates f...

  19. Neutrophil killing of human umbilical vein endothelial cells is oxygen radical-mediated and enhanced by TNF-. alpha

    Energy Technology Data Exchange (ETDEWEB)

    Dame, M.K.; Varani, J.; Weinberg, J.M.; Ward, P.A. (Univ. of Michigan, Ann Arbor (United States))

    1991-03-11

    Human umbilical vein endothelial cells are sensitive to killing by activated human neutrophils. Killing is inhibited in the presence of catalase and deferoxamine mesylate but not soybean trypsin inhibitor. Reagent hydrogen peroxide can substitute for activated neutrophils in producing endothelial cell injury. These data suggest that lethal injury is due to the production of oxygen radicals by activated neutrophils. In these respects, the human umbilical vein endothelial cells are similar to rat pulmonary artery endothelial cells in that pretreatment with TNF-{alpha} increases sensitivity to injury by activated neutrophils. In part, the increased endothelial cell sensitivity to killing by neutrophils may be due to up-regulation of surface adhesion molecules. However, it was observed that cells passaged more than two times in culture did not demonstrate increased killing after treatment with TNF-{alpha} while up-regulation of neutrophil adhesion could be detected through several additional passages. Although the human umbilical vein endothelial cells are qualitatively similar to rat pulmonary artery endothelial cells in their sensitivity to killing, they are quantitatively much more resistant. What accounts for the relative resistance of the human umbilical vein endothelial cells is not fully understood. In the rat pulmonary artery endothelial cells, killing is known to be dependent on an intraendothelial source of iron. Pre-treatment of the human umbilical vein endothelial cells with 8-hydroxyquinoline-bound iron increased their sensitivity to oxidant injury. These data suggest that the availability of iron within the human umbilical vein endothelial cells may be a limiting factor in sensitivity to oxygen radical-mediated injury.

  20. Epithelioid hemangioendothelioma of right innominate vein mimics a teratoma

    Science.gov (United States)

    Wan, Qi; Zhou, Jiaxuan; Yu, Yudong; Sun, Qingyu; Bao, Yingying; Lei, Qiang; Zou, Qiao; Deng, Yingshi; Li, Xinchun

    2017-01-01

    Abstract Rational: Epithelioid hemangioendothelioma (EHE) is a rare neoplasm commonly known to arise from the soft tissue, lung, and liver. EHE arising from right innominate vein (RIV) has scarcely been reported in English literature. Patient concerns: Herein, we present a rare case of EHE of RIV in a 51-year-old woman with right-lower chest pain for 4 days. Computed tomography of the chest revealed a spherical mass with calcification and fatty foci located in the anterior mediastinum, thus a presumptive diagnosis of teratoma was made. Diagnoses, interventions, and outcomes: Video-assisted thoracoscopic explorations and resection of mediastinal tumor were then performed. The pathological examination showed that the tumor was EHE. Postoperative radiotherapy was delivered to the patient. Pulmonary metastases were found by chest CT a year after surgery. Lessons: A diagnosis of EHE might be considered, when a mediastinal tumor closely related to veins showing intratumoral calcification and obvious enhancement, despite the presence of a clear boundary and visible fat content. PMID:28248868

  1. Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review

    Science.gov (United States)

    Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

    2015-03-01

    The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p < 0.0001) and WOMAC Score (p = 0.0003) indicated that circumpatellarelectrocautery improved clinical outcomes compared with non-electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.

  2. Burn-out, Circumferential Film Flow Distribution and Pressure Drop for an Eccentric Annulus with Heated Rod

    DEFF Research Database (Denmark)

    Andersen, P. S.; Jensen, A.; Mannov, G.

    1974-01-01

    Measurements of (1) burn-out, (2) circumferential film flow distribution, and (3) pressure drop in a 17 × 27.2 × 3500 mm concentric and eccentric annulus geometry are presented. The eccentric displacement was varied between 0 and 3 mm. The working fluid was water. Burn-out curves at 70 bar...... flow variation on burn-out is discussed....

  3. Electrophysiologic characteristics of continuous complex fractionated atrial electrograms in pulmonary veins ostia and left atrium during atrial fibrillation%心房颤动肺静脉前庭和左房内连续碎裂电位的电生理特点

    Institute of Scientific and Technical Information of China (English)

    储慧民; 沈才杰; 丰明俊; 何斌; 郁一波; 刘晶; 陈晓敏

    2012-01-01

    Objective To investigate the electrophysiologic characteristics of continuous complex fractionated atrial electrogtams (CFAEs) in pulmonary veins ostia (PVO) and left atrium (LA) during atrial fibrillation (AF). Methods Twenty-four patients with drug refractory paroxysmal AF ( PAF group) (n = 12) and persistent AF (PeAF group) (n = 12) were enrolled. The PVO was divided into area Ⅰ and Ⅱ, the distance of which was 5 — 10 mm and 10-20 mm from the PV orifices. High-density mapping the PVO and LA was performed using a three-dimensional electroanatomic mapping system (EnSite NavX) during spontaneous or induced AF. The electrophysiologic characteristics of the continuous CFAEs ( CFE-mean≤70 ms) was compared between two groups. Results ①The average LA diameter in PeAF group was larger than the PAF group (P<0.05). In the PAF group, the least and most prevalent continuous CFAEs were in the LA roof and posterior wall respectively, while in the PeAF group, those were in the LA posterior or anterior walls, and appendage, seperately. The prevalence of the continuous CFAEs in the PVO which was apparently more prevalent than the LA (P <0. 05) in the PAF group, and was similar in the PeAF group. ②In the PeAF group, the continuous CFAEs at the LA was more prevalent in the PVO (P<0.05) , but was equally prevalent in the PVO between two group(P=0.58). More continuous CFAEs was recorded at the left inferior PVO in the PAF group (P = 0.02), while no significant difference of the continuous CFAEs distribution was found in the other PVO between two groups. Except for the LA roof where more continuous CFAEs distribution in the PAF group than the PeAF group were observed ( P = 0. 02 ) , the CFAEs distribution al the LA inferior wall, appendage, and mitral tumulus in the PeAF group were more prevalent than the PAF group, and were fairly distributed in the olher LA regions. ③The preva-lece of the continuous CFAEs at area I in each PVO in PAF group was more than area II ( P < 0

  4. Pulmonary intravascular blood volume changes through the cardiac cycle in healthy volunteers studied by cardiovascular magnetic resonance measurements of arterial and venous flow

    Directory of Open Access Journals (Sweden)

    Arheden Hakan

    2009-10-01

    Full Text Available Abstract Background This study aims to present a novel method for using cardiovascular magnetic resonance (CMR to non-invasively quantify the variation in pulmonary blood volume throughout the cardiac cycle in humans. Methods 10 healthy volunteers (7 males, 3 female, age range 21-32 years were studied. The blood flow in the pulmonary artery and all pulmonary veins was quantified during free breathing using phase contrast velocity encoded CMR. The difference in flow between the pulmonary artery and the pulmonary veins was integrated to calculate the change in pulmonary blood volume throughout the cardiac cycle. Results The stroke volumes in the pulmonary artery and the sum of the pulmonary veins were (mean ± SEM 103 ± 6 ml and 95 ± 6 ml, respectively. The pulmonary blood volume variation (PBVV was 48 ± 5 ml, and the PBVV expressed as percent of the pulmonary artery stroke volume was 46 ± 3%. The maximum increase in pulmonary blood volume occurred 310 ± 12 ms after the R-wave from the ECG (32 ± 2% of the cardiac cycle. PBVV did not correlate to change in cross-sectional area in the pulmonary artery (R2 = 0.03, p = 0.66. Conclusion It is feasible to non-invasively quantify the change in pulmonary blood volume during the cardiac cycle in humans using CMR. The average pulmonary blood volume variation in healthy volunteers was approximately 50 ml and this was approximately 50% of the stroke volume. Further studies are needed to assess the utility of the pulmonary blood volume variation as a measure for identifying cardiac and pulmonary vascular disease.

  5. Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Arkadopoulos Nikolaos

    2011-12-01

    Full Text Available Abstract Background Ovarian vein thrombosis (OVT is a rare, but serious condition that affects mostly postpartum women. A high index of suspicion is required in order to diagnose this unusual cause of abdominal pain. Case presentation A 19-year-old woman at three days postpartum was admitted to our hospital because of severe right lower quandrant abdominal pain and fever 38.5'C. Physical examination revealed an acutely ill patient and right lower quadrant tenderness with positive rebound and Giordano signs. The patient underwent appendectomy which proved to be negative for acute appendicitis. Postoperatively fever and pain persisted and abdominal CT-scan with intravenous contrast agent demonstrated a thrombosed right ovarian vein. The patient was initiated on low-molecular weight heparin (LMWH and antibiotic treatment and a month later a new abdominal CT-scan showed a patent right ovarian vein. Discussion Pathophysiologically, OVT is explained by Virchow's triad, because pregnancy is associated with a hypercoagulable state, venous stasis due to compression of the inferior vena cava by the uterus and endothelial trauma during delivery or from local inflammation. Common symptoms and signs of OVT include lower abdomen or flank pain, fever and leukocytosis usually within the first ten days after delivery. The reported incidence of OVT ranges 0,05-0,18% of pregnancies and in most cases the right ovarian vein is the one affected. Anticoagulation and antibiotics is the mainstay of treatment of OVT. Complications of OVT include sepsis, extension of the thrombus to the inferior vena cava and renal veins, and pulmonary embolism. The incidence of pulmonary embolism is reported to be 13.2% and represents the main source of mortality due to OVT. Conclusions OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen.

  6. Endovenous laser therapy for varicose veins

    NARCIS (Netherlands)

    Disselhoff, B.C.V.M.

    2008-01-01

    This thesis describes the technique of endovenous laser ablation and the outcome of various series of patients with varicose veins due to reflux in the great saphenous vein, treated by endovenous laser ablation or cryostripping in a single-centre study. This study has shown clear advantages of endov

  7. PORTAL VEIN THROMBOSIS-ULTRASOUND IMAGING

    Directory of Open Access Journals (Sweden)

    Trajkovska Meri

    2016-07-01

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

  8. Generating and analyzing synthetic finger vein images

    NARCIS (Netherlands)

    Hillerström, Fieke; Kumar, Ajay; Veldhuis, Raymond

    2014-01-01

    Abstract: The finger-vein biometric offers higher degree of security, personal privacy and strong anti-spoofing capabilities than most other biometric modalities employed today. Emerging privacy concerns with the database acquisition and lack of availability of large scale finger-vein database have

  9. Improving the management of varicose veins.

    Science.gov (United States)

    Onida, Sarah; Lane, Tristan R A; Davies, Alun H

    2013-01-01

    Up to 30% of the UK population are affected by varicose veins. They are a manifestation of increased venous pressure in the lower limb caused by impaired venous return. Primary varicosities result from poor drainage from the superficial to the deep venous system. Secondary varicosities arise as a result of underlying pathology impeding venous drainage, such as deep venous thrombosis or increased intra-abdominal pressure caused by a mass, pregnancy or obesity. Patients with bleeding varicose veins should be referred to a vascular service immediately. Referral is also indicated in the following cases: symptomatic primary or recurrent varicose veins; lower limb skin changes thought to be caused by chronic venous insufficiency; superficial vein thrombosis and suspected venous incompetence; a venous leg ulcer or healed venous leg ulcer. Imaging is crucial in the assessment of the superficial and deep venous system to enable assessment of venous competence. The gold standard imaging technique is colour duplex ultrasonography. Duplex ultrasound should be used to confirm the diagnosis of varicose veins and the extent of truncal reflux, and to plan treatment for patients with suspected primary or recurrent varicose veins. Superficial vein ligation, phlebectomy and stripping have been the mainstay of treatment. In recent years, new techniques have been developed that are minimally invasive, enabling treatment of superficial venous incompetence with reduced morbidity. NICE recommends that endothermal ablation, in the form of radiofrequency or laser treatment, should be offered as treatment for patients with confirmed varicose veins and truncal reflux.

  10. Apelin and pulmonary hypertension

    DEFF Research Database (Denmark)

    Andersen, Charlotte Uggerhøj; Hilberg, Ole; Mellemkjær, Søren;

    2011-01-01

    Pulmonary arterial hypertension (PAH) is a devastating disease characterized by pulmonary vasoconstriction, pulmonary arterial remodeling, abnormal angiogenesis and impaired right ventricular function. Despite progress in pharmacological therapy, there is still no cure for PAH. The peptide apelin...... vasoconstriction, and has positive inotropic and cardioprotective effects. Apelin attenuates vasoconstriction in isolated rat pulmonary arteries, and chronic treatment with apelin attenuates the development of pulmonary hypertension in animal models. The existing literature thus renders APLNR an interesting...

  11. Assessment and management of patients with varicose veins.

    Science.gov (United States)

    Allen, Louise

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

  12. Percutaneous transhepatic venous embolization of pulmonary artery aneurysm in Hughes-Stovin syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Ah; Kim, Man Deuk; Oh, Do Yun; Park, Pil Won [Bundang CHA General Hospital, Pochon CHA University, Seongnam (Korea, Republic of)

    2007-08-15

    Hughes-Stovin syndrome is an extremely rare entity. We present a case of a 42-year-old man, who developed deep vein and inferior vena cava (IVC) thrombosis, repeated internal bleeding and pulmonary artery aneurysms (PAAs). The patient presented with massive hemoptysis and with PAAs of a 2.5 cm maximum diameter. We describe the successful percutaneous transhepatic venous embolization of the PAAs due to occluded common vascular pathways to the pulmonary artery.

  13. Role of Transthoracic Echocardiography in the Evaluation of Patients with Retinal Vein Occlusion

    Directory of Open Access Journals (Sweden)

    Afsoon Fazlinezhad

    2014-02-01

    Full Text Available Introduction: Retinal vein occlusion  is a common vascular disorder disrupting vision. Two basic types of RVO are branch retinal vein occlusion and central retinal vein occlusion (CRVO.  Retinal vein occlusion is a multifactor process including systemic illness and local retinal factors.RVO may be associated with atherosclerotic risk factors. We analyzed the role of 2 dimensional transthoracic echocardiography (TTE for detecting the cardiac disease in patients with retinal veins occlusion. Materials and Methods:In this cross-sectional study 70 recently diagnosed patients with RVO enrolled in the study. The clinical diagnosis of retinal vein occlusion and its type was confirmed by a vitreoretinal specialist. The Patients were then referred for performing complete TTE. Results: The prevalence of RVO increased with age, but did not vary by sex. The most frequent cardiovascular risk factor was hypertension. The findings of our study revealed that a variety of echocardiographic abnormalities may be presented in patients with RVO. Diastolic dysfunction was the most frequent echocardiographic finding and we found positive correlation between diastolic dysfunction with increasing age and the presence of hypertension. Other findings included mitral regurgitation (52.9%, mitral stenosis (2.9%, mitral annulus calcification (1.4%, mitral valve prolapse (8.6%, aortic insufficiency (22.9%, sclerotic aortic valve (27.1%, tricuspid regurgitation (45.7%, pulmonary insufficiency (8.6%, mild pulmonary hypertension (8.6%, and moderate to severe pulmonary hypertension (4.3% Mild LVH (11.4%, Moderate LVH (8.6%. Abnormality on IAS was defined in these patients, including paten foramen ovale, lipomatosis IAS, exaggerated motion of IAS, and aneurysm of IAS. Conclusion: In our study, the most common echocardiographic finding was diastolic dysfunction which was compatible with the patients' age and the fact that the most prevalent risk factor was hypertension. Other

  14. N-acetylcysteine for the prevention of stricture after circumferential endoscopic submucosal dissection of the esophagus: a randomized trial in a porcine model

    Directory of Open Access Journals (Sweden)

    Barret Maximilien

    2012-05-01

    Full Text Available Abstract Background Circumferential endoscopic submucosal dissection (CESD of the esophagus would allow for both the eradication of Barrett’s esophagus and its related complications, such as advanced neoplasia. However, such procedures generally induce inflammatory repair resulting in a fibrotic stricture. N-acetylcysteine (NAC is an antioxidant that has shown some efficacy against pulmonary and hepatic fibrosis. The aim of our study was to evaluate the benefit of NAC in the prevention of esophageal cicatricial stricture after CESD in a swine model. Animals and methods Two groups of six pigs each were subjected to general anesthesia and CESD: after randomization, a first group received an oral NAC treatment regimen of 100 mg/kg/day, initiated one week before the procedure, whereas a second group was followed without any prophylactic treatment. Follow-up endoscopies took place seven, fourteen, twenty-one, and twenty-eight days after CESD. Necropsy, histological assessment of esophageal inflammation, and fibrosis were performed on day 28. Results The median esophageal lumen diameter on day 21 (main judgment criterion was 4 mm (range 2 to 5 in group 1 and 3 mm (range 1 to 7 in group 2 (P = 0.95. No significant difference was observed between the two groups regarding clinical evaluation (time before onset of clinically significant esophageal obstruction, number of dilations, esophageal inflammation and fibrosis, or oxidative stress damage on immunohistochemistry. Conclusions Despite its antioxidant effect, systemic administration of NAC did not show significant benefit on esophageal fibrosis in our animal model of esophageal wound healing within the experimental conditions of this study. Since the administered doses were relatively high, it seems unlikely that NAC might be a valuable option for the prevention of post-endoscopic esophageal stricture.

  15. Using an age-dependent D-dimer cut-off value increases the number of older patients in whom deep vein thrombosis can be safely excluded

    NARCIS (Netherlands)

    Douma, Renée A.; Tan, Melanie; Schutgens, Roger E.G.; Bates, Shannon M.; Perrier, Arnaud; Legnani, Cristina; Biesma, Douwe H.; Ginsberg, Jeffrey S.; Bounameaux, Henri; Palareti, Gualtiero; Carrier, Marc; Mol, Gerben C.; Le Gal, Grégoire; Kamphuisen, Pieter W.; Righini, Marc

    2012-01-01

    Background D-dimer testing to rule out deep vein thrombosis is less useful in older patients because of a lower specificity. An age-adjusted D-dimer cut-off value increased the proportion of older patients (>50 years) in whom pulmonary embolism could be excluded. We retrospectively validated the eff

  16. Protective effect of pulmonary hypertension against right-sided tamponade in pericardial effusion.

    Science.gov (United States)

    Khan, M Usman; Khouzam, Rami N

    2015-01-01

    Patients with pericardial effusion are susceptible to cardiac tamponade. A compressing circumferential pericardial effusion typically results in an equalization of intracardiac and pericardial pressure during diastole and a progressive collapse of the right atrium and ventricle. Pulmonary hypertension that increases the afterload of the right ventricle may result in elevated pressures initially in the right ventricle and subsequently in the right atrium. This may lead to right ventricular hypertrophy and a pathologic structural and functional remodeling of both right heart chambers. Conversely, elevated pressures within the right heart chambers caused by longstanding pulmonary hypertension may resist and protect against tamponade of these chambers in the setting of a coexisting pericardial effusion. In such cases, a sudden reduction in pulmonary arterial pressures may result in tamponade of the right heart chambers.

  17. Inhibition of rho kinase attenuates high flow induced pulmonary hypertension in rats

    Institute of Scientific and Technical Information of China (English)

    LI Fu-hai; XIA Wei; LI Ai-wu; ZHAO Cui-fen; SUN Ruo-peng

    2007-01-01

    Background The RhoA/Rho kinase pathway may participate in the pathogenesis of hypoxia and monocrotaline induced pulmonary hypertension. This study tested whether RhoA/Rho kinase pathway is involved in the pathogenesis of high flow induced pulmonary hypertension in rats.Methods Male Wistar rats (4 weeks) were randomly divided into 4 shunt groups, 4 treated groups and 4 control groups.Shunt and treated groups underwent left common carotid artery/external jugular vein shunt operation. Control groups underwent sham operation. Treated groups received fasudil treatment and the others received same dose of saline. At weeks 1, 2, 4 and 8 of the study, right ventricular systolic pressure was measured and blood gases were analysed to calculate Qp/Qs. The weight ratio of right ventricle to left ventricle plus septum and the mean percentage of medial wall thickness in moderate sized pulmonary arteries were obtained. RhoA activity in pulmonary arteries was detected using Rho activity assay reagent. Rho kinase activity was quantified by the extent of MYPT1 phosphorylation with Western blot.Proliferating cells were evaluated using proliferating cell nuclear antigen immunohistological staining.Results Carotid artery/jugular vein shunt resulted in high pulmonary blood flow, both an acute and a chronic elevation of right ventricular systolic pressure, significant medial wall thickening characterized by smooth muscle cells proliferation,right ventricular hypertrophy and increased activation of RhoA and Rho kinase. Fasudil treatment lowered pulmonary artery systolic pressure, suppressed pulmonary artery smooth muscle cells proliferation, attenuated pulmonary artery medial wall thickening and inhibited right ventricular hypertrophy together with significant suppression of Rho kinase activity but not Rho activity.Conclusions Activated RhoA/Rho kinase pathway is associated with both the acute pulmonary vasoconstriction and the chronic pulmonary artery remodelling of high flow induced

  18. Brain Abscesses Associated with Asymptomatic Pulmonary Arteriovenous Fistulas

    Science.gov (United States)

    Nam, Taek-Kyun; Park, Yong-sook; Kwon, Jeong-taik

    2017-01-01

    Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source. PMID:28061502

  19. Hepatic venous outflow reconstruction in adult right lobe living donor liver transplantation without middle hepatic vein

    Institute of Scientific and Technical Information of China (English)

    WU Hong; LU Qiang; CHEN Zhe-yu; MA Yu-kui; LI Jin; YANG Jia-yin; YAN Lü-nan; LI Bo; ZENG Yong; WEN Tian-fu; ZHAO Ji-chun; WANG Wen-tao; XU Ming-qing

    2007-01-01

    Background It is difficult and challenging to reconstruct hepatic venous outflow in adult right lobe living donor liver transplantation (LDLT) without the middle hepatic vein (MHV). Excessive perfusion of the portal vein and venous outflow obstruction will lead to acute congestion of the graft, ultimately resulting in primary nonfunction. Although various reconstruction patterns have been explored in many countries, there is currently no clear consensus. In this study we describe a technique to prevent "chocking" of the graft at the outflow anastomosis with the inferior vena cava (IVC) in LDLT using right lobe graft without the MHV.Methods A retrospective analysis was conducted on clinical data from 55 recipients undergoing LDLT using right lobe grafts without the MHV or reconstruction of hepatic venous outflow. The donor's right hepatic vein (RHV) was anastomosed with a triangular opening of the recipient IVC; the inferior right hepatic vein (IRHV), if large enough, was anastomosed directly to the IVC. The great saphenous vein (GSV) was used for reconstruction of significant MHV tributaries.Results No deaths occurred in any of the donors. Of the 55 recipients, complications occurred in 6, including hepaticvein stricture (1 case), small-for-size syndrome (1), hepatic artery thrombosis (1), intestinal bleeding (1), bile leakage (1),left subphrenic abscess and pulmonary infection (1). A total of three patients died, one from small-for-size syndrome and two from multiple system organ failure.Conclusions The multiple-opening vertical anastomosis was reconstructed with hepatic vein outflow. This technique alleviates surgical risk of living donors, ensures excellent venous drainage, and prevents vascular thromboses and primary nonfunction.

  20. Modeling and numerical investigation of the inlet circumferential fluctuations of swept and bowed blades

    Science.gov (United States)

    Tang, Mingzhi; Jin, Donghai; Gui, Xingmin

    2017-02-01

    The circumferential fluctuation (CF) source terms induced by the inviscid blade force can affect the inlet distribution of flow parameters and radial equilibrium of swept and bowed blades. However, these phenomena cannot be adequately described by throughflow methods based on the axisymmetric assumption. A transport model for the CF stresses is proposed and correlated to the distribution of circulation to reflect the effect of the inviscid blade force. To investigate the effect of the inlet CFs on swept and bowed blades, the model is integrated into a throughflow model and applied to a series of cascades with different sweep and bow angles. For swept cascades, the CF source terms change the distributions of incidence angles, as well as the radial equilibrium at the inlet of the blade passage. And the influence is enhanced as the absolute value of the sweep angle increases. For bowed cascades, the distributions of incidence angles are also altered. For both cases, the model can offer a good prediction of the inlet CF source terms, and prove to exert a better prediction of blade design key parameters such as flow angles.

  1. The Prognostic Value of Circumferential Resection Margin Involvement in Patients with Extraperitoneal Rectal Cancer.

    Science.gov (United States)

    Shin, Dong Woo; Shin, Jin Yong; Oh, Sung Jin; Park, Jong Kwon; Yu, Hyeon; Ahn, Min Sung; Bae, Ki Beom; Hong, Kwan Hee; Ji, Yong Il

    2016-04-01

    The prognostic influence of circumferential resection margin (CRM) status in extraperitoneal rectal cancer probably differs from that of intraperitoneal rectal cancer because of its different anatomical and biological behaviors. However, previous reports have not provided the data focused on extraperitoneal rectal cancer. Therefore, the aim of this study was to examine the prognostic significance of the CRM status in patients with extraperitoneal rectal cancer. From January 2005 to December 2008, 248 patients were treated for extraperitoneal rectal cancer and enrolled in a prospectively collected database. Extraperitoneal rectal cancer was defined based on tumors located below the anterior peritoneal reflection, as determined intraoperatively by a surgeon. Cox model was used for multivariate analysis to examine risk factors of recurrence and mortality in the 248 patients, and multivariate logistic regression analysis was performed to identify predictors of recurrence and mortality in 135 patients with T3 rectal cancer. CRM involvement for extraperitoneal rectal cancer was present in 29 (11.7%) of the 248 patients, and was the identified predictor of local recurrence, overall recurrence, and death by multivariate Cox analysis. In the 135 patients with T3 cancer, CRM involvement was found to be associated with higher probability of local recurrence and mortality. In extraperitoneal rectal cancer, CRM involvement is an independent risk factor of recurrence and survival. Based on the results of the present study, it seems that CRM involvement in extraperitoneal rectal cancer is considered an indicator for (neo)adjuvant therapy rather than conventional TN status.

  2. Performance comparison for oil-water heat transfer of circumferential overlap trisection helical baffle heat exchanger

    Institute of Scientific and Technical Information of China (English)

    王伟晗; 程道来; 刘涛; 刘颖昊

    2016-01-01

    The performance tests were conducted on oil–water heat transfer in circumferential overlap trisection helical baffle heat exchangers with incline angles of 12°, 16°, 20°, 24° and 28°, and compared with a segmental baffle heat exchanger. The results show that the shell side heat transfer coefficientho and pressure dropΔpo both increase while the comprehensive indexho/Δpo decreases with the increase of the mass flow rate of all schemes. And the shell side heat transfer coefficient, pressure drop and the comprehensive indexho/Δpo decrease with the increase of the baffle incline angle at a certain mass flow rate. The average values of shell side heat transfer coefficient and the comprehensive indexho/Δpo of the 12° helical baffled scheme are above 50% higher than those of the segmental one correspondingly, while the pressure drop value is very close and the ratios of the average values are about 1.664 and 1.596, respectively. The shell-side Nusselt numberNuo and the comprehensive index Nuo·Euzo−1 increase with the increase of Reynolds number of the shell side axial in all schemes, and the results also demonstrate that the small incline angled helical scheme has better comprehensive performance.

  3. Feasibility of radial and circumferential strain analysis using 2D speckle tracking echocardiography in cats

    Science.gov (United States)

    TAKANO, Hiroshi; ISOGAI, Tomomi; AOKI, Takuma; WAKAO, Yoshito; FUJII, Yoko

    2014-01-01

    The purpose of the present study is to investigate the feasibility of strain analysis using speckle tracking echocardiography (STE) in cats and to evaluate STE variables in cats with hypertrophic cardiomyopathy (HCM). Sixteen clinically healthy cats and 17 cats with HCM were used. Radial and circumferential strain and strain rate variables in healthy cats were measured using STE to assess the feasibility. Comparisons of global strain and strain variables between healthy cats and cats with HCM were performed. Segmental assessments of left ventricle (LV) wall for strain and strain rate variables in cats with HCM were also performed. As a result, technically adequate images were obtained in 97.6% of the segments for STE analysis. Sedation using buprenorphine and acepromazine did not affect any global strain nor strain rate variable. In LV segments of cats with HCM, reduced segmental radial strain and strain rate variables had significantly related with segmental LV hypertrophy. It is concluded that STE analysis using short axis images of LV appeared to be clinically feasible in cats, having the possibility to be useful for detecting myocardial dysfunctions in cats with diseased heart. PMID:25373881

  4. Vascular Repair by Circumferential Cell Therapy Using Magnetic Nanoparticles and Tailored Magnets.

    Science.gov (United States)

    Vosen, Sarah; Rieck, Sarah; Heidsieck, Alexandra; Mykhaylyk, Olga; Zimmermann, Katrin; Bloch, Wilhelm; Eberbeck, Dietmar; Plank, Christian; Gleich, Bernhard; Pfeifer, Alexander; Fleischmann, Bernd K; Wenzel, Daniela

    2016-01-26

    Cardiovascular disease is often caused by endothelial cell (EC) dysfunction and atherosclerotic plaque formation at predilection sites. Also surgical procedures of plaque removal cause irreversible damage to the EC layer, inducing impairment of vascular function and restenosis. In the current study we have examined a potentially curative approach by radially symmetric re-endothelialization of vessels after their mechanical denudation. For this purpose a combination of nanotechnology with gene and cell therapy was applied to site-specifically re-endothelialize and restore vascular function. We have used complexes of lentiviral vectors and magnetic nanoparticles (MNPs) to overexpress the vasoprotective gene endothelial nitric oxide synthase (eNOS) in ECs. The MNP-loaded and eNOS-overexpressing cells were magnetic, and by magnetic fields they could be positioned at the vascular wall in a radially symmetric fashion even under flow conditions. We demonstrate that the treated vessels displayed enhanced eNOS expression and activity. Moreover, isometric force measurements revealed that EC replacement with eNOS-overexpressing cells restored endothelial function after vascular injury in eNOS(-/-) mice ex and in vivo. Thus, the combination of MNP-based gene and cell therapy with custom-made magnetic fields enables circumferential re-endothelialization of vessels and improvement of vascular function.

  5. Interactions of a propeller with a stator-induced circumferentially varying flow

    Energy Technology Data Exchange (ETDEWEB)

    Farnsworth, John [Rensselaer Polytechnic Institute, Mechanical Aerospace and Nuclear Engineering, Troy, NY (United States); US Air Force Academy, Department of Aeronautics, Colorado Springs, CO (United States); Amitay, Michael [Rensselaer Polytechnic Institute, Mechanical Aerospace and Nuclear Engineering, Troy, NY (United States); Rensselaer Polytechnic Institute, Center for Flow Physics and Control (CeFPaC), Troy, NY (United States); Beal, David; Huyer, Stephen A. [Naval Undersea Warfare Center, Division, Vehicle Dynamics and Signature Control, Newport, RI (United States)

    2012-02-15

    The interactions of a circumferentially varying stator cascade and a downstream fixed pitch propeller were investigated experimentally. The global performance of the components and the coupled system were systematically investigated through force and moment measurements on the propulsor model in a water tunnel. In addition, the wake of the cyclic stator cascade with and without the propeller was investigated downstream from a propulsor model using the Stereoscopic PIV technique. A cyclic distribution of the stators' deflections resulted in non-axisymmetric distributions of the flow field downstream of the stator array. The stator distribution alone produced a significant side force that increased linearly with stator pitch amplitude. When a propeller was incorporated downstream from the cyclic cascade, the side force from the stator cascade was reduced, but a small normal force and pitching moment were created. The generation of these secondary forces and moments can be related to the redistribution of the tangential flow from the cyclic cascade into the axial direction by the retreating and advancing blade states of the fixed pitch propeller. (orig.)

  6. Leak before break behaviour of austenitic and ferritic pipes containing circumferential defects

    Energy Technology Data Exchange (ETDEWEB)

    Stadtmueller, W.; Sturm, D.

    1997-04-01

    Several research projects carried out at MPA Stuttgart to investigate the Leak-before-Break (LBB) behavior of safety relevant pressure bearing components are summarized. Results presented relate to pipes containing circumferential defects subjected to internal pressure and external bending loading. An overview of the experimentally determined results for ferritic components is presented. For components containing postulated or actual defects, the dependence of the critical loading limit on the defect size is shown in the form of LBB curves. These are determined experimentally and/or by calculation for through-wall slits, and represent the boundary curve between leakage and massive fracture. For surface defects and a given bending moment and internal pressure, no fracture will occur if the length at leakage remains smaller than the critical defect length given by the LBB curve for through-wall defects. The predictive capability of engineering calculational methods are presented by way of example. The investigation programs currently underway, testing techniques, and initial results are outlined.

  7. Error Modeling and Compensation of Circular Motion on a New Circumferential Drilling System

    Directory of Open Access Journals (Sweden)

    Qiang Fang

    2015-01-01

    Full Text Available A new flexible circumferential drilling system is proposed to drill on the fuselage docking area. To analyze the influence of the circular motion error to the drilling accuracy, the nominal forward kinematic model is derived using Denavit-Hartenberg (D-H method and this model is further developed to model the kinematic errors caused by circular positioning error and synchronization error using homogeneous transformation matrices (HTM. A laser tracker is utilized to measure the circular motion error of the two measurement points at both sides. A circular motion compensation experiment is implemented according to the calculated positioning error and synchronization error. Experimental results show that the positioning error and synchronization error were reduced by 65.0% and 58.8%, respectively, due to the adopted compensation, and therefore the circular motion accuracy is substantially improved. Finally, position errors of the two measurement points are analyzed to have little influence on the measurement result and the validity of the proposed compensation method is proved.

  8. Portal vein gas in emergency surgery

    Directory of Open Access Journals (Sweden)

    Mahmood Hind

    2008-07-01

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

  9. Ventriculoatrial shunting via the azygos vein.

    Science.gov (United States)

    Balasubramaniam, C; DuBois, J J; Laurent, J P; Pokorny, W J; Harberg, F J; Cheek, W R

    1990-06-01

    The treatment of hydrocephalus has evolved through many stages but the "cure" is still elusive. It is not unusual for the neurosurgeon to find that the commonly used routes for catheter placement or sites for drainage of cerebrospinal fluid (CSF) cannot be employed. The azygos vein was used to gain access to the right atrium when the CSF could not be drained into the peritoneal cavity, nor could the neck veins be used to place the catheter into the right atrium. The azygos vein is a convenient and safe route to reach the right atrium in selected patients.

  10. [FEATURES LIVER TRANSPLANTATION IN PORTAL VEIN THROMBOSIS].

    Science.gov (United States)

    Abbasov, P A

    2015-07-01

    In 2012 - 2013 years in 265 patients for liver transplantation was performed, including in 224 (84.5%)--from a living donor, in 41 (15.5%)--from the dead body. Using a Foley catheter to stop bleeding, and the imposition of vascular sutures during endovenectomy in portal vein thrombosis (PVT) and its possible damage under all conditions. In particular, PVT IV degree (Grade IV) in order to restore blood flow in the graft using the left gastric and renal vein is an alternative, if they are cryopreserved vein may be suitably used.

  11. Portal Decompression Using the Inferior Mesenteric Vein

    Directory of Open Access Journals (Sweden)

    Paolo Gorini

    1998-01-01

    Full Text Available We report five patients with variceal hemorrhage, in three cases secondary to diffuse thrombosis of the portal, superior mesenteric and splenic veins. Mesenteric angiography demonstrated patency of the inferior mesenteric vein (IMV in each, and successful portal decompression by anastomosis of the IMV to the left renal vein (n=4 or the inferior vena cava (n=1 was accomplished. Bleeding was permanently controlled: four patients have survived from one to eight years post-operatively. Because shunt procedures utilizing the IMV are technically straightforward, subtotally decompress the portal system and avoid the right upper quadrant, they may be advantageous in certain clinical settings.

  12. Varicose veins--Who should be referred?

    Science.gov (United States)

    Onida, Sarah; Davies, Alun H; Franklin, Ian

    2015-11-01

    Varicose veins are a common, progressive condition in the UK, with significant negative effects on patients' quality of life. Despite their prevalence, access to secondary care for the assessment and treatment of varicose veins can be variable throughout the country.The National Institute of Health and Care Excellence guidelines developed in 2013 provide evidence-based guidance on the referral, assessment, and management of the patient with venous disease.In this article, we review the development of the guidelines for the management of varicose veins over the last 15 years, highlighting the latest changes in referral criteria.

  13. Pulmonary artery aneurysm in Bechcet's disease: helical computed tomography study; Aneurisma de la arteria pulmonar en la enfermedad de Behcet. Estudio con tomografia computarizada helicoidal

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, J.; Caballero, P.; Olivera, M. J.; Cajal, M. L.; Caniego, J. L. [Hospital de la Princesa. Iniversidad Autonoma. Madrid (Spain)

    2000-07-01

    Behcet's disease is a vasculitis of unknown etiology that affects arteries and veins of different sizes and can be associated with pulmonary artery aneurysms. We report the case of a patient with Behcet's disease and a pulmonary artery aneurysm who was studied by means of plain chest X ray, helical computed tomography and pulmonary arteriography. Helical computed tomography is a reliable technique for the diagnosis and follow-up of these patients. (Author) 9 refs.

  14. Thrombosis of the superior vena cava and auxiliary branches in patients with indwelling catheterization of the internal jugular vein

    Institute of Scientific and Technical Information of China (English)

    LI Han; WANG Shi-xiang; WANG Wei; XU Chen; SHEN Shen; YU Ling; ZHANG Gui-zhi

    2009-01-01

    Background Central venous thrombosis is a serious and life-threatening complication in hemodialysis (HD) patients with an indwelling catheter. The present study aimed to investigate the prevalence and characteristics of thrombosis of the superior vena cava and auxiliary branches in Chinese HD patients with an indwelling internal jugular venous catheter and to explore its risk factors.Methods Fifty-four patients on maintenance hemodialysis (MHD) with an indwelling catheter were enrolled in this cross-sectional study. The thrombosis of the internal jugular vein, subclavical vein, brachiocephalic vein and superior vena cava was assessed by vascular ultrasound. Collected were data on age, gender, ultrafiltration volume, Kt/V, blood pressure, levels of hemoglobin, serum albumin, lipid, calcium, and phosphorus, and parathyroid hormone.Results The patients were given short- or long-term double lumen central venous catheters. Among them, 42 patients had the catheter placed into the right internal jugular vein, and 12 patients into the left internal jugular vein. Different degrees of central venous thrombosis were found in 33 patients (61.1%). The prevalence of thrombosis in the jugular vein, brachiocephalic vein, subclavical vein and superior vena cava was 61.1% (33/54), 44.4% (24/54), 16.7% (9/54) and 5.6% (3/54), respectively. Among the 33 HD patients with central venous thrombosis, the percentages for one, two, three and four affected veins were 27.3% (9/33), 45.4% (15/33), 18.2% (6/33) and 9.1% (3/33), respectively. Twelve (12/33, 36.4%) of the 33 HD patients with central venous thrombosis had clinical symptoms. Nine patients (27.3%) had edema of the upper extremity and 3 (9.1%) had new-onset symptoms of pulmonary embolism such as cough, chest distress and short breath. The incidences of diabetes mellitus and malignant tumor and levels of lipoprotein a and homocysteic acid were significantly higher in the HD patients with central venous thrombosis than in those without

  15. Circumferential 2D-strain imaging for the prediction of long term response to cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    Baumann Gert

    2008-06-01

    Full Text Available Abstract Background Cardiac Resynchronization Therapy (CRT leads to hemodynamic and clinical improvement in heart failure patients. The established methods to evaluate myocardial asynchrony analyze longitudinal and radial myocardial function. This study evaluates the new method of circumferential 2D-strain imaging in the prediction of the long-term response to CRT. Methods and results 38 heart failure patients (NYHA II-III, QRS > 120 ms, LVEF Conclusion There is a significant decrease in the circumferential 2D-strain derived delays after CRT, indicating that resynchronization induces improvement in all three dimensions of myocardial contraction. However, the resulting predictive values of 2D strain delays are not superior to longitudinal and radial 2D-strain or TDI delays.

  16. The strong but nonspecific relationship between 18F-FDG uptake in the lower-extremity veins and venous thromboembolism

    DEFF Research Database (Denmark)

    Zhu, Hongyun June; Hess, Søren; Rubello, Domenico;

    2016-01-01

    Venous thromboembolism (VTE) can present as deep vein thrombosis (DVT) and/or acute pulmonary embolism (PE). In fluorine-18 fluorodeoxyglucose (F-FDG) PET/CT, F-FDG activity along the deep veins of the lower extremities (LE) is often observed and, unless it is associated with focal intense activity......±101 and 49±82 days, respectively, and the closest and the most remote F-FDG-PET after the VTE event averaged 58±50 and 122±124 days. The extent of uptake in the LE veins averaged 7±2 for the patients with an acute DVT on LE duplex and 5±3 for those with negative or chronic DVT on LE duplex (P...

  17. Ultrasound-guided foam sclerotherapy of great saphenous vein with 2% polidocanol – one-year follow-up results

    Science.gov (United States)

    Osęka, Marcin; Tworus, Robert; Gałązka, Zbigniew

    2016-01-01

    Introduction Ultrasound-guided foam sclerotherapy (UGFS) of varicose veins is a useful treatment option. It is a relatively safe method in the case of limited, small varicose veins. In theory, a justified concern could be raised that the injection of an active drug into the large superficial venous vessels may potentially cause life-threatening consequences. Aim To assess the safety and efficacy of UGFS using a 2% solution of polidocanol (Aethoxysklerol 2%) in the case of great saphenous vein incompetence. Material and methods Fifty-two patients with great saphenous vein incompetence underwent ultrasound-guided foam sclerotherapy. The efficacy criterion was the elimination of reflux measured ultrasonographically and withdrawal or decrease of complaints: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up. Results Decrease or withdrawal of complaints of chronic venous insufficiency was reported in 96% of cases (50 patients). Disappearance or decrease of varicose veins was noted in all patients (100%). During examination after 12 months, full success of ultrasound was achieved in 38 (73%) cases, and 11 (21%) patients presented a partial desired effect according to the consensus from Tegernsee. Persistence of reflux longer than 1 s in the treated great saphenous vein was reported in 3 (6%) cases. Serious complications, such as deep vein thrombosis, pulmonary embolism, dyspnea, anaphylaxis, or neurological abnormalities, were not recorded. Conclusions Ultrasound-guided foam sclerotherapy of incompetent great saphenous vein and varicosities with 2% polidocanol was found to be an effective and safe method of treatment during 1 year of observation. However, longer observation is necessary. PMID:27458485

  18. A review of patients with deep vein thrombosis diagnosed at University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Liam, C K; Ng, S C

    1990-11-01

    In this retrospective study, 81 patients were diagnosed to have deep vein thrombosis (DVT) at the University Hospital, Kuala Lumpur over a ten year period from 1977 to 1986. Fifty-six patients had their DVT confirmed by venograms. The left side was affected in 79.5% of venographically proven cases of DVT of the lower limbs above the popliteal vein. The incidence of clinically apparent DVT following surgery was 0.21 per 1,000 operations. The incidence of pregnancy-related DVT was 0.039%. DVT was 3 times more frequent in the puerperium than in the antenatal period. The overall incidence of symptomatic pulmonary embolism was 13.6% of the cases of DVT.

  19. Comparison of treatment for 153 cases of circumferential facial paralysis by low-power laser and galvan acupuncture

    Science.gov (United States)

    Li, Hai-Ling; Zhuo, Qing-shan

    1993-03-01

    Seventy-six patients were treated by low power He-Ne laser irradiation on Yangbai, Sibai, and other related acupoints. The other 77 cases were treated by Galvan-acupuncture with infrared radiation on the same acupoints. There was little difference between the therapeutic effects of these two groups (P > 0.05). However, the laser group had a much shorter treatment time than the other group. According to the theory of traditional Chinese medicine, circumferential facial paralysis is caused by exposure to cold which blocks the channel of vital energy resulting in the damage of bodily function. Acupuncture and moxibustion on certain acupoints can warm up the channels and remove the stasis allowing vital energy to pass through their passages to regulate bodily functions. Laser can do the same effectively with much less time. The laser therapy also features painlessness, safeness, and is free of bacteria. Circumferential facial paralysis is a common disease, which is clinically treated by acupuncture with reliable results. However, acupuncture is not fit for children who are not cooperative and those patients who are afraid of the pain accompanied with acupuncture. So we applied low power laser irradiation in the treatment of circumferential facial paralysis starting in 1985. The results were favorable. And the treatment time was shortened. The treatment procedures are reported.

  20. Histoplasmosis - acute (primary) pulmonary

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000098.htm Histoplasmosis - acute (primary) pulmonary To use the sharing features on this page, please enable JavaScript. Acute pulmonary histoplasmosis is a respiratory infection that is caused by ...

  1. Miliary pulmonary cryptococcosis

    Directory of Open Access Journals (Sweden)

    Shane Kelly

    2014-10-01

    Imaging features of pulmonary cryptococcosis are generally of well-defined pleural-based nodules and less commonly alveolar infiltrates, lymphadenopathy, pleural effusions or cavitating lesions. Miliary pulmonary infiltrates are an exceptionally rare presentation.

  2. Pulmonary Hemorrhage in Cryoglobulinemia

    Directory of Open Access Journals (Sweden)

    G Kirkpatrick

    2015-01-01

    Full Text Available Pulmonary manifestations of cryoglobulinemia are uncommon and their clinical behaviour is unpredictable, ranging from mild dyspnea to life-threatening presentations. A patient with cryoglobulinemia who presented with hypoxic respiratory failure attributed to pulmonary hemorrhage is reported.

  3. VeinPLUS: A Transillumination and Reflection-based Hand Vein Database

    OpenAIRE

    Gruschina, Alexander

    2015-01-01

    This paper gives a short summary of work related to the creation of a department-hosted hand vein database. After the introducing section, special properties of the hand vein acquisition are explained, followed by a comparison table, which shows key differences to existing well-known hand vein databases. At the end, the ROI extraction process is described and sample images and ROIs are presented.

  4. Vein of Galen Malformation: Outcome after Embolization

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-12-01

    Full Text Available The neurodevelopmental outcome after endovascular treatment of vein of Galen malformation (VOGM in 27 patients seen between 1983 and 2002 was assessed by chart review and parental questionnaires at the University of California, San Francisco.

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

    Science.gov (United States)

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

    2013-01-01

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

  6. Peripheral primitive neuroectodermal tumor of the kidney presenting with pulmonary tumor embolism: A case report

    Institute of Scientific and Technical Information of China (English)

    Sathya; Chinnaa; Chandan; J; Das; Sanjay; Sharma; Prabhjot; Singh; Amlesh; Seth; Suvendu; Purkait; Sandeep; R; Mathur

    2014-01-01

    Peripheral primitive neuroectodermal tumor(PNET) of the kidney is a rare, aggressive tumor known for its recurrence and metastatic potential. Despite the frequency of venous extension to the renal veins and inferior vena cava, pulmonary tumor embolism at the initial presentation is not common. We report a case of 22-year-old female with PNET of the kidney who presented with tumor embolism in the inferior vena cava(IVC) and bilateral pulmonary artery. The patient underwent surgical resection and histopathological analysis confirmed the presence of tumor within the IVC and pulmonary arteries. The patient received adjuvant chemotherapy and is currently doing well on follow-up.

  7. Rare pulmonary and cerebral complications after transarterial chemoembolisation for hepatocellular carcinoma: A case report

    Institute of Scientific and Technical Information of China (English)

    Hua Zhao; Hui-Qin Wang; Qing-Qiu Fan; Xing-Xian Chen; Jian-Ying Lou

    2008-01-01

    We report a rare case of acute pulmonary and cerebral complication after transarterial chemoembolisation (TACE) for inoperable hepatocellular carcinoma. The case involved a large tumor and hepatic vein invasion. Nonspecific pulmonary and cerebral symptoms such as acute dyspnoea and transient consciousness loss developed in the patient, a 49-year-old woman, following the TACF due to pulmonary and cerebral oil embolism. The chest and brain conditions of this patient improved after some supportive therapies and nursing interventions. She also subsequently completed the other three procedures of TACE.

  8. The umbilical and paraumbilical veins of man.

    OpenAIRE

    Martin, B F; Tudor, R G

    1980-01-01

    During its transit through the umbilicus structural changes occur in the thick wall of the extra-abdominal segment of the umbilical vein whereby the components of the intra-abdominal segment acquire an essentially longitudinal direction and become arranged in fibro-elastic and fibro-muscular zones. The vein lumen becomes largely obliterated by asymmetrical proliferation of loose subendothelial conective tissue. The latter forms a new inner zone within which a small segment of the lumen persis...

  9. Primary leiomyosarcoma of the innominate vein.

    Science.gov (United States)

    Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello

    2007-01-01

    Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread.

  10. CT in thrombosed dilated posterior epidural vein

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-05-01

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

  11. Branch Retinal Vein Occlusion and Its Management

    Institute of Scientific and Technical Information of China (English)

    Desmond; Archer

    1992-01-01

    The natural course of Branch Retinal Vein Occlusion is determined by the site and completeness of the occlusion, the integrity of arterial perfusion to the affected sector and the efficiency of the developing collateral circulation. Most patients with tributary vein occlusion have some capillary fall out and microvascular incompetence in the distribution of the affected retina and vision is significantly compromised in over 50% of patients who have either chronic macular oedema or ischemia involving the...

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

    Directory of Open Access Journals (Sweden)

    G Raghavendra Prasad

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Bernardo Cunha Senra Barros

    2015-04-01

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

  14. SYNERGY OF WALL SHEAR STRESS AND CIRCUMFERENTIAL STRESS IN STRAIGHT ARTERIES

    Institute of Scientific and Technical Information of China (English)

    QIN Kai-rong; XU Zhe; WU Hao; JIANG Zong-lai; LIU Zhao-rong

    2005-01-01

    The Wall Shear Stress (WSS) generated by blood flow and Circumferential Stress (CS) driven by blood pressure have been thought to play an important role in blood flow-dependent phenomena such as angiogenesis, vascular remodeling, and atherosgenesis.The WSS and CS in straight arteries were calculated by measuring the blood pressure, center-line velocity, wall thickness, and radius of vessels.The WSS and CS in the time domain were then decomposed into the amplitude and phase in the frequency domain.The CS amplitude to the WSS amplitude ratio (referred as stress amplitude ratio, Zs) and the phase difference between the CS and the WSS (referred as stress phase difference, SPA) in the frequency domain were calculated to characterize the synergy of the CS and WSS.Numerical results demonstrated that the CS is not in phase with the WSS, a time delay in the time domain or a stress phase difference in the frequency domain between the WSS and the CS exists.Theoretical analysis demonstrated that the Zs and SPA are primarily determined by the local factors (blood viscosity, local inertial effects, local geometry, local elasticity) and the input impedance of whole downstream arterial beds.Because the arterial input impedance has been shown to reflect the physiological and pathological states of whole downstream arterial beds, the stress amplitude ratio Zs and stress phase difference SPA would be thought to be the appropriate indices to reflect the effects of states of whole downstream arterial beds on the local blood flow-dependent phenomena such as angiogenesis, vascular remodeling, and atherosgenesis.

  15. The Interaction between Fluid Wall Shear Stress and Solid Circumferential Strain Affects Endothelial Gene Expression.

    Science.gov (United States)

    Amaya, Ronny; Pierides, Alexis; Tarbell, John M

    2015-01-01

    Endothelial cells lining the walls of blood vessels are exposed simultaneously to wall shear stress (WSS) and circumferential stress (CS) that can be characterized by the temporal phase angle between WSS and CS (stress phase angle - SPA). Regions of the circulation with highly asynchronous hemodynamics (SPA close to -180°) such as coronary arteries are associated with the development of pathological conditions such as atherosclerosis and intimal hyperplasia whereas more synchronous regions (SPA closer to 0°) are spared of disease. The present study evaluates endothelial cell gene expression of 42 atherosclerosis-related genes under asynchronous hemodynamics (SPA=-180 °) and synchronous hemodynamics (SPA=0 °). This study used a novel bioreactor to investigate the cellular response of bovine aortic endothelial cells (BAECS) exposed to a combination of pulsatile WSS and CS at SPA=0 or SPA=-180. Using a PCR array of 42 genes, we determined that BAECS exposed to non-reversing sinusoidal WSS (10±10 dyne/cm2) and CS (4 ± 4%) over a 7 hour testing period displayed 17 genes that were up regulated by SPA = -180 °, most of them pro-atherogenic, including NFκB and other NFκB target genes. The up regulation of NFκB p50/p105 and p65 by SPA =-180° was confirmed by Western blots and immunofluorescence staining demonstrating the nuclear translocation of NFκB p50/p105 and p65. These data suggest that asynchronous hemodynamics (SPA=-180 °) can elicit proatherogenic responses in endothelial cells compared to synchronous hemodynamics without shear stress reversal, indicating that SPA may be an important parameter characterizing arterial susceptibility to disease.

  16. The Interaction between Fluid Wall Shear Stress and Solid Circumferential Strain Affects Endothelial Gene Expression.

    Directory of Open Access Journals (Sweden)

    Ronny Amaya

    Full Text Available Endothelial cells lining the walls of blood vessels are exposed simultaneously to wall shear stress (WSS and circumferential stress (CS that can be characterized by the temporal phase angle between WSS and CS (stress phase angle - SPA. Regions of the circulation with highly asynchronous hemodynamics (SPA close to -180° such as coronary arteries are associated with the development of pathological conditions such as atherosclerosis and intimal hyperplasia whereas more synchronous regions (SPA closer to 0° are spared of disease. The present study evaluates endothelial cell gene expression of 42 atherosclerosis-related genes under asynchronous hemodynamics (SPA=-180 ° and synchronous hemodynamics (SPA=0 °. This study used a novel bioreactor to investigate the cellular response of bovine aortic endothelial cells (BAECS exposed to a combination of pulsatile WSS and CS at SPA=0 or SPA=-180. Using a PCR array of 42 genes, we determined that BAECS exposed to non-reversing sinusoidal WSS (10±10 dyne/cm2 and CS (4 ± 4% over a 7 hour testing period displayed 17 genes that were up regulated by SPA = -180 °, most of them pro-atherogenic, including NFκB and other NFκB target genes. The up regulation of NFκB p50/p105 and p65 by SPA =-180° was confirmed by Western blots and immunofluorescence staining demonstrating the nuclear translocation of NFκB p50/p105 and p65. These data suggest that asynchronous hemodynamics (SPA=-180 ° can elicit proatherogenic responses in endothelial cells compared to synchronous hemodynamics without shear stress reversal, indicating that SPA may be an important parameter characterizing arterial susceptibility to disease.

  17. Single-stage Posterior Spondylectomy,Circumferential Decompression and Reconstruction Using Mesh Cage for Spinal Tumors

    Institute of Scientific and Technical Information of China (English)

    Yong Zhu; Hong Zhao; Giu-xing Qiu; Jian-guo Zhang; Ye Tian; Shu-gang Li; Suo-mao Yuan

    2009-01-01

    Objective To explore the feasibility and clinical results of circumferential decompression and threecolumn reconstruction through single-stage posterior transpedicular approach for spinal tumor treatment.Methods Totally,24 patients with spinal tumor underwent tumor resection and spinal reconstruction through single-stage posterior transpedicular approach.Preoperatively,according to the Frankel classification,12 patients were grade E,9 grade D,and 3 grade C.Anterior column was reconstructed with non-expandable titanium cages.Posterior segmental instrumentation was used to maintain the stability of spine in all cases.Anterior and posterolateral fusion was performed with autograft and allogenic bone.The following data were followed up in these patients:deformity angle,local recurrence,neurological function,and spinal bony fusion.Results The average operating time and blood loss was 5.6 hours and 3 400 ml respectively.No intraoperative and postoperative complications were observed in this group.Postoperatively,21 patients were Frankel grade E,2 grade D,and 1 grade C.Four patients reported significant functional restoration and twenty patients reported complete resolution of pain.At follow-up(range,6-42 months),implant failure or recurrent neurological symptoms was not found.Conclusions The tumor resection and spinal reconstruction through single-stage posterior transpedicular approach is a safe and effective technique for the treatment of spinal tumor.It can fully decompress the neurological structures,correct the kyphosis,and achieve early weight-bearing.This technique can improve life quality for the patients with spinal tumor.

  18. Veins improve fracture toughness of insect wings.

    Directory of Open Access Journals (Sweden)

    Jan-Henning Dirks

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

  19. Endovascular treatment of iliac vein compression syndrome

    Institute of Scientific and Technical Information of China (English)

    MENG Qing-you; LI Xiao-qiang; QIAN Ai-min; SANG Hong-fei; RONG Jian-jie; ZHU Li-wei

    2011-01-01

    Background Iliac vein compression syndrome (IVCS),the symptomatic compression of the left common iliac vein between the right common iliac artery and the vertebrae,is not an uncommon condition.The aim of this research was to retrospectively evaluate long-term outcome and the significance of endovascular treatment in patients with left IVCS.Methods Between January 1997 and September 2008,296 patients received interventional therapy in the left common iliac vein.In the second stage,170 cases underwent saphenous vein high ligation and stripping.Two hundred and thirty-one cases were followed up over a period of 6 to 120 months (average 46 months) and evaluated for symptom improvement with color ultrasound and ascending venography.Results The stenotic or occlusive segments of the left iliac vein were successfully dilated in 285 cases,of whom 272 received stent implantation therapy.Most of the patients achieved satisfactory results on discharge.During the follow-up period,varicose veins were alleviated in 98.7% of the patients,and leg swelling disappeared or was obviously relieved in 84% of cases.About 85% of leg ulcers completely healed.The total patency rate was 91.7% as evaluated with color ultrasound and 91.5% with ascending venography.Conclusions Endovascular treatment of IVCS provides effective symptomatic improvement and good long-term patency in most patients.

  20. Pulmonary Hypertension Association

    Science.gov (United States)

    ... at www.AHeartCures.org . Help Kickoff November’s Pulmonary Hypertension Awareness Month Want to help raise awareness for ... Heart2CurePH | Help promote Awareness Month Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Awareness Chronic thromboembolic pulmonary hypertension (CTEPH) is ...

  1. Pulmonary Hypertension Overview

    Science.gov (United States)

    ... chest X-ray, a breathing test called a pulmonary function test and an echocardiogram (sometimes called an “echo”). Your doctor may also need to do other tests to find out whether another medical condition is causing your pulmonary hypertension. TreatmentHow is pulmonary hypertension treated?If the ...

  2. Evaluation of leg varicose veins by MR venography

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Yoshifumi; Shiraishi, Tomokuni; Taira, Mitsuru [Kansai Medical Univ., Neyagawa, Osaka (Japan). Kohri Hospital; Imamura, Atsushi; Yamada, Hitoshi; Okuno, Masafumi; Kamiyama, Yasuo

    1998-11-01

    Preoperative evaluation was conducted on 30 patients with leg varicose veins by MR venography (MRV), and compared with conventional venography, MR images were performed by the 3D-SMASH Method. Compared with venography, MRV could more clearly demonstrate leg varicose veins with perforating veins than venography. It could detected fine varicose veins more than 2 mm in diameter, and deep veins. Furthermore, 3D observation enables accurate detection of the location of perforating vein. In conclusion, MRV is useful for the diagnosis of leg varicose vein. (author)

  3. Scattering removal for finger-vein image restoration.

    Science.gov (United States)

    Yang, Jinfeng; Zhang, Ben; Shi, Yihua

    2012-01-01

    Finger-vein recognition has received increased attention recently. However, the finger-vein images are always captured in poor quality. This certainly makes finger-vein feature representation unreliable, and further impairs the accuracy of finger-vein recognition. In this paper, we first give an analysis of the intrinsic factors causing finger-vein image degradation, and then propose a simple but effective image restoration method based on scattering removal. To give a proper description of finger-vein image degradation, a biological optical model (BOM) specific to finger-vein imaging is proposed according to the principle of light propagation in biological tissues. Based on BOM, the light scattering component is sensibly estimated and properly removed for finger-vein image restoration. Finally, experimental results demonstrate that the proposed method is powerful in enhancing the finger-vein image contrast and in improving the finger-vein image matching accuracy.

  4. Non-traumatic thoracic emergencies: CT venography in an integrated diagnostic strategy of acute pulmonary embolism and venous thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Ghaye, Benoit; Dondelinger, Robert F. [Department of Medical Imaging, University Hospital Sart Tilman, Domaine Universitaire du Sart Tilman B35, 4000 Liege (Belgium)

    2002-08-01

    Deep venous thrombosis and pulmonary embolism are the two aspects of venous thrombo-embolism. Investigation of lower limb veins has been part of various diagnostic algorithms in the past 15 years. Recently, the combination of CT venography (CTV) of lower limbs and abdominal veins together with CT angiography of the pulmonary arteries has allowed a complete examination of venous thrombo-embolism in one session. The technical aspects, imaging findings, venous anatomy on CT, interpretative pitfalls, results and advantages of CT venography are reviewed. (orig.)

  5. Mesenchymal Stromal Cell Dependent Regression of Pulmonary Metastasis from Ewing's

    Directory of Open Access Journals (Sweden)

    Andrea Anita Hayes-Jordan

    2014-05-01

    Full Text Available Introduction: Ewing’s sarcoma (ES is the second most common bone tumor in children. Survival has not improved over the last decade and once pulmonary metastatic disease is present, survival is dismal. Mesenchymal stromal cell (MSC therapy has shown potential benefit for Kaposi's sarcoma; however, the role of progenitor cell therapies for cancer remains controversial. MSC treatment of ES or pulmonary metastatic disease has not been demonstrated. We have developed an orthotopic xenograft model of ES in which animals develop spontaneous pulmonary metastases. Within this model, we demonstrate the use of MSCs to target ES lung metastasis. Materials and MethodsHuman ES cells were transfected with luciferase and injected into the rib of nude mice. Development of pulmonary metastases was confirmed by imaging. After flow cytometry based characterization, MSC’s were injected into the tail vein of nude mice with established local ES tumor or pulmonary metastasis. Mice were treated with intravenous MSCs weekly followed by bioluminescent imaging.ResultsThe intravenous injection of MSCs in an ES model decreases the volume of pulmonary metastatic lesions; however, no effect on primary chest wall tumor size is observed. Thus verifying the MSC preferential homing to the lung. MSCs are found to ‘home to’ the pulmonary parenchyma and remain engrafted up to 5 days after delivery. DiscussionMSC treatment of ES slows growth of pulmonary metastasis. MSC’s have more affinity for pulmonary metastasis and can effect a greater decrease in tumor growth in the lungs compared to the primary tumor site

  6. Leaf vein segmentation using Odd Gabor filters and morphological operations

    OpenAIRE

    Katyal, Vini; Aviral

    2012-01-01

    Leaf vein forms the basis of leaf characterization and classification. Different species have different leaf vein patterns. It is seen that leaf vein segmentation will help in maintaining a record of all the leaves according to their specific pattern of veins thus provide an effective way to retrieve and store information regarding various plant species in database as well as provide an effective means to characterize plants on the basis of leaf vein structure which is unique for every specie...

  7. Gonadal vein tumor thrombosis due to renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Hamidreza Haghighatkhah

    2015-01-01

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

  8. Nutcracker Syndrome Complicated by Left Renal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Faouzi Mallat

    2013-01-01

    Full Text Available Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

  9. Nutcracker syndrome complicated by left renal vein thrombosis.

    Science.gov (United States)

    Mallat, Faouzi; Hmida, Wissem; Jaidane, Mehdi; Mama, Nadia; Mosbah, Faouzi

    2013-01-01

    Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

  10. Gonadal vein tumor thrombosis due to renal cell carcinoma.

    Science.gov (United States)

    Haghighatkhah, Hamidreza; Karimi, Mohammad Ali; Taheri, Morteza Sanei

    2015-01-01

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

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

    OpenAIRE

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

    2016-01-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. V...

  12. Scattering Removal for Finger-Vein Image Restoration

    OpenAIRE

    Jinfeng Yang; Ben Zhang; Yihua Shi

    2012-01-01

    Finger-vein recognition has received increased attention recently. However, the finger-vein images are always captured in poor quality. This certainly makes finger-vein feature representation unreliable, and further impairs the accuracy of finger-vein recognition. In this paper, we first give an analysis of the intrinsic factors causing finger-vein image degradation, and then propose a simple but effective image restoration method based on scattering removal. To give a proper description of f...

  13. An effective preprocessing method for finger vein recognition

    Science.gov (United States)

    Peng, JiaLiang; Li, Qiong; Wang, Ning; Abd El-Latif, Ahmed A.; Niu, Xiamu

    2013-07-01

    The image preprocessing plays an important role in finger vein recognition system. However, previous preprocessing schemes remind weakness to be resolved for the high finger vein recongtion performance. In this paper, we propose a new finger vein preprocessing that includes finger region localization, alignment, finger vein ROI segmentation and enhancement. The experimental results show that the proposed scheme is capable of enhancing the quality of finger vein image effectively and reliably.

  14. An interesting cause of pulmonary emboli: Acute carbon monoxide poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Sevinc, A.; Savli, H.; Atmaca, H. [Gaziantep University, Gaziantep (Turkey). School of Medicine

    2005-07-01

    Carbon monoxide poisoning, a public health problem of considerable significance, is a relatively frequent event today, resulting in thousands of hospitalizations annually. A 70-year-old lady was seen in the emergency department with a provisional diagnosis of carbon monoxide poisoning. The previous night, she slept in a tightly closed room heated with coal ember. She was found unconscious in the morning with poor ventilation. She had a rare presentation of popliteal vein thrombosis, pulmonary emboli, and possible tissue necrosis with carbon monoxide poisoning. Oxygen treatment with low-molecular-weight heparin (nadroparine) and warfarin therapy resulted in an improvement in both popliteal and pulmonary circulations. In conclusion, the presence of pulmonary emboli should be sought in patients with carbon monoxide poisoning.

  15. DEEP VEIN THROMBOSIS IN PATIENT WITH VON WILLEBRAND DISEASE

    Directory of Open Access Journals (Sweden)

    V. A. Elykomov

    2016-01-01

    Full Text Available Objective: to identify the possible factors of thrombogenic risk and ways of its prevention in patients with von Willebrand disease.Case description. Patient X., 42 years old, who suffers from von Willebrand disease type 3 with 5-years of age. Asked on reception to the traumatologist in the polyclinic of the Regional Hospital with pain in the left hip joint. Recommended planned operative treatment in the Altai Regional Clinical Hospital. Preoperative preparation included the infusion of concentrate of von Willebrand factor and coagulation factor VIII. Operation – cement total arthroplasty of the left hip joint. In the postoperative period analgesic treatment, elastic compression of the lower extremities, iron supplements, also conducted infusion of concentrate of von Willebrand factor and coagulation factor VIII for 20 days and thromboprophylactic with dabigatran. On the 3rd day after the operation the patient revealed deep vein thrombosis of the femoral segment (floating clot.Results. The patient was operated for emergency indications in the Department of endovascular surgery – installation of venous cava filter “Volan”. Dabigatran is cancelled, appointed clexane for 3 months. In our clinical example the patient lacked risk factors of pulmonary embolism as obesity, age, smoking, prolonged immobilization, estrogen therapy. Overdose of factor VIII were not observed – the level of factor did not exceed 135 % on transfusions. At the same time, the patient was found polymorphisms in the genes ITGA2, FGB, MTHFR, MTR – heterozygote, MTRR – mutant homozygote, which may indicate the genetic factors of thrombogenic risk. Also a significant risk factor was massive surgical intervention (total hip replacement. Despite preventive measures (elastic compression, thromboprophylactic dabigatran, early activation we cannot to avoid thrombotic complications.Conclusion. This article presents a case demonstrating a thrombotic complication in patients

  16. Chemotherapy-induced pulmonary hypertension: role of alkylating agents.

    Science.gov (United States)

    Ranchoux, Benoît; Günther, Sven; Quarck, Rozenn; Chaumais, Marie-Camille; Dorfmüller, Peter; Antigny, Fabrice; Dumas, Sébastien J; Raymond, Nicolas; Lau, Edmund; Savale, Laurent; Jaïs, Xavier; Sitbon, Olivier; Simonneau, Gérald; Stenmark, Kurt; Cohen-Kaminsky, Sylvia; Humbert, Marc; Montani, David; Perros, Frédéric

    2015-02-01

    Pulmonary veno-occlusive disease (PVOD) is an uncommon form of pulmonary hypertension (PH) characterized by progressive obstruction of small pulmonary veins and a dismal prognosis. Limited case series have reported a possible association between different chemotherapeutic agents and PVOD. We evaluated the relationship between chemotherapeutic agents and PVOD. Cases of chemotherapy-induced PVOD from the French PH network and literature were reviewed. Consequences of chemotherapy exposure on the pulmonary vasculature and hemodynamics were investigated in three different animal models (mouse, rat, and rabbit). Thirty-seven cases of chemotherapy-associated PVOD were identified in the French PH network and systematic literature analysis. Exposure to alkylating agents was observed in 83.8% of cases, mostly represented by cyclophosphamide (43.2%). In three different animal models, cyclophosphamide was able to induce PH on the basis of hemodynamic, morphological, and biological parameters. In these models, histopathological assessment confirmed significant pulmonary venous involvement highly suggestive of PVOD. Together, clinical data and animal models demonstrated a plausible cause-effect relationship between alkylating agents and PVOD. Clinicians should be aware of this uncommon, but severe, pulmonary vascular complication of alkylating agents.

  17. Corrosion cast study of the canine hepatic veins.

    Science.gov (United States)

    Uršič, M; Vrecl, M; Fazarinc, G

    2014-11-01

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

  18. Pulmonary Hypertension Secondary to Partial Anomalous Pulmonary Venous Return in an Elderly

    Directory of Open Access Journals (Sweden)

    Stefan Koester

    2016-01-01

    Full Text Available Background. Partial anomalous pulmonary venous return (PAPVR is an uncommon congenital abnormality, which may present in the adult population. It is often associated with sinus venosus defect (SVD. The diagnosis and therapy for this condition may be challenging. Case Presentation. We describe a case of an elderly woman who presented with NYHA Class IV dyspnea and was suspected to have symptomatic pulmonary hypertension. She was later found to have anomalous right upper pulmonary vein return to the superior vena cava and associated SVD with bidirectional shunting. Therapeutic options were discussed and medical management alone with aggressive diuresis and sildenafil was adopted. Follow-up visits revealed success in the planned medical therapy. Conclusions. PAPVR is a rare congenital condition that may present during late adulthood. The initial predominant left-to-right shunting associated with this anomaly may go undetected for years with the gradual development of pulmonary hypertension and right heart failure due to right heart volume overload. Awareness of the condition is important, as therapy is time-sensitive with early detection potentially leading to surgical therapy as a viable option.

  19. Chronic thromboembolic pulmonary hypertension in young woman with history of caesarian section

    Directory of Open Access Journals (Sweden)

    Nitia A. Asbarinsyah

    2015-01-01

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is one of subgroups of pulmonary hypertension. This is a serious medical condition that severely under diagnosed. CTEPH is commonly underdiagnosed due to non specific symptoms and lack of diagnostic tools. The aim of this presentation is to discuss the etiology, risk factors, diagnosis and management of CTEPH. A 36-year-old woman presented with easily fatigue and dyspneu on effort since two years ago. The symptom occured about three months after she gave birth with caesarian section due to preeclampsia. Further history taking, physical examination, electrocardiography (ECG and echocardiography were highly suggestive of pulmonary hypertension. No deep vein thrombosis (DVT was found on vascular femoral sonography. It was found after the lung perfusion scintigraphy performed that she actually had CTEPH. This patient was categorized as inoperable because CT pulmonary angiography showed no thrombus. The patient got pulmonary vasodilator and oral anticoagulant for lifelong.

  20. [Efferent innervation of pulmonary blood vessels and bronchi in rat (an immunohistochemical study)].

    Science.gov (United States)

    Chumasov, E I; Voronchikhin, P A; Korzhevskiĭ, D É

    2012-01-01

    In this investigation the peculiarities of innervation of bronchi and blood vessels of the lung were studied in 20 rats using immunohistochemical demonstration of synaptophysin and alpha-actin. The results obtained have showen that the densest innervation is typical for bronchial walls, particularly, for the muscular lamina. Synaptophysin-immunoreactive terminals (SFIT) were detected in the bronchi in close association with both circular bundles of smooth muscle cells and microganglia. Dense network of SFIT was found in the pulmonary vein--in its middle tunic formed by cardiomyocytes. In contrast to the bronchi and pulmonary vein, large branches of the pulmonary artery contained no SFIT. We briefly discuss the problem of the origin of the nerve fibers described and their functions and suggest that SFIT are formed by efferent fibers (axons) of neurons arising from either the intrapulmonary parasympathetic ganglia.

  1. Reconstruction of the middle hepatic vein tributary in adult right lobe living donor liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Xiao-Min Shi; Yi-Feng Tao; Zhi-Ren Fu; Guo-Shan Ding; Zheng-Xin Wang; Liang Xiao

    2011-01-01

    BACKGROUND: In adult-to-adult living donor liver trans-plantation (LDLT), the use of a right lobe graft without the middle hepatic vein (MHV) can cause hepatic congestion and disturbance of venous drainage. To solve this problem, we successfully used cadaveric venous allografts preserved in 4 ℃ University of Wisconsin (UW) solution within 10 days as interposition veins for drainage of the paramedian portion of the right lobe in adult LDLT. METHODS: From June 2007 to January 2008, 11 adult LDLT patients received modified right liver grafts. The major MHV tributaries (greater than 5 mm in diameter) of 9 cases were preserved and reconstructed using cadaveric interposition vein allografts that had been stored for 1 to 10 days in 4 ℃ UW solution. The regeneration of the paramedian sector of the grafts and the patency of the interposition vein allografts were examined by Doppler ultrasonography after the operation. RESULTS: MHV tributaries were reconstructed in 9 recipients. Only 1 recipient died of renal failure and severe pulmonary infection on day 9 after transplantation without any hemiliver venous outflow obstruction. The other 8 recipients achieved long-term survival with a median follow-up of 30 months. The cumulative patency rates of the 8 recipients were 63.63% (7/11), 45.45% (5/11), 45.45% (5/11) and 36.36% (4/11) at 3, 6, 12 and 24 months, respectively. Regeneration of the paramedian sectors was equivalent. CONCLUSION: The cadaveric venous allograft preserved in 4 ℃ UW solution within 10 days serves as a useful alternative for interposition veins in facilitating implantation of a right lobe graft and guarantees outflow of the MHV.

  2. Multidetector computed tomography pulmonary angiography in childhood acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Chun Xiang; Zhang, Long Jiang; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Department of Pediatrics, Charleston, SC (United States); Chowdhury, Shahryar M. [Medical University of South Carolina, Department of Pediatrics, Charleston, SC (United States); Fox, Mary A. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2015-09-15

    Pulmonary embolism is a life-threatening condition affecting people of all ages. Multidetector row CT pulmonary angiography has improved the imaging of pulmonary embolism in both adults and children and is now regarded as the routine modality for detection of pulmonary embolism. Advanced CT pulmonary angiography techniques developed in recent years, such as dual-energy CT, have been applied as a one-stop modality for pulmonary embolism diagnosis in children, as they can simultaneously provide anatomical and functional information. We discuss CT pulmonary angiography techniques, common and uncommon findings of pulmonary embolism in both conventional and dual-energy CT pulmonary angiography, and radiation dose considerations. (orig.)

  3. Reverse Regulatory Pathway (H2S / PGE2 / MMP) in Human Aortic Aneurysm and Saphenous Vein Varicosity.

    Science.gov (United States)

    Gomez, Ingrid; Ozen, Gulsev; Deschildre, Catherine; Amgoud, Yasmine; Boubaya, Lilia; Gorenne, Isabelle; Benyahia, Chabha; Roger, Thomas; Lesèche, Guy; Galardon, Erwan; Topal, Gokce; Jacob, Marie-Paule; Longrois, Dan; Norel, Xavier

    2016-01-01

    Hydrogen sulfide (H2S) is a mediator with demonstrated protective effects for the cardiovascular system. On the other hand, prostaglandin (PG)E2 is involved in vascular wall remodeling by regulating matrix metalloproteinase (MMP) activities. We tested the hypothesis that endogenous H2S may modulate PGE2, MMP-1 activity and endogenous tissue inhibitors of MMPs (TIMP-1/-2). This regulatory pathway could be involved in thinning of abdominal aortic aneurysm (AAA) and thickening of saphenous vein (SV) varicosities. The expression of the enzyme responsible for H2S synthesis, cystathionine-γ-lyase (CSE) and its activity, were significantly higher in varicose vein as compared to SV. On the contrary, the endogenous H2S level and CSE expression were lower in AAA as compared to healthy aorta (HA). Endogenous H2S was responsible for inhibition of PGE2 synthesis mostly in varicose veins and HA. A similar effect was observed with exogenous H2S and consequently decreasing active MMP-1/TIMP ratios in SV and varicose veins. In contrast, in AAA, higher levels of PGE2 and active MMP-1/TIMP ratios were found versus HA. These findings suggest that differences in H2S content in AAA and varicose veins modulate endogenous PGE2 production and consequently the MMP/TIMP ratio. This mechanism may be crucial in vascular wall remodeling observed in different vascular pathologies (aneurysm, varicosities, atherosclerosis and pulmonary hypertension).

  4. Reverse Regulatory Pathway (H2S / PGE2 / MMP in Human Aortic Aneurysm and Saphenous Vein Varicosity.

    Directory of Open Access Journals (Sweden)

    Ingrid Gomez

    Full Text Available Hydrogen sulfide (H2S is a mediator with demonstrated protective effects for the cardiovascular system. On the other hand, prostaglandin (PGE2 is involved in vascular wall remodeling by regulating matrix metalloproteinase (MMP activities. We tested the hypothesis that endogenous H2S may modulate PGE2, MMP-1 activity and endogenous tissue inhibitors of MMPs (TIMP-1/-2. This regulatory pathway could be involved in thinning of abdominal aortic aneurysm (AAA and thickening of saphenous vein (SV varicosities. The expression of the enzyme responsible for H2S synthesis, cystathionine-γ-lyase (CSE and its activity, were significantly higher in varicose vein as compared to SV. On the contrary, the endogenous H2S level and CSE expression were lower in AAA as compared to healthy aorta (HA. Endogenous H2S was responsible for inhibition of PGE2 synthesis mostly in varicose veins and HA. A similar effect was observed with exogenous H2S and consequently decreasing active MMP-1/TIMP ratios in SV and varicose veins. In contrast, in AAA, higher levels of PGE2 and active MMP-1/TIMP ratios were found versus HA. These findings suggest that differences in H2S content in AAA and varicose veins modulate endogenous PGE2 production and consequently the MMP/TIMP ratio. This mechanism may be crucial in vascular wall remodeling observed in different vascular pathologies (aneurysm, varicosities, atherosclerosis and pulmonary hypertension.

  5. Veining Failure and Hydraulic Fracturing in Shales

    Science.gov (United States)

    Mighani, S.; Sondergeld, C. H.; Rai, C. S.

    2014-12-01

    During the hydraulic fracturing, the pressurized fluid creates new fractures and reactivates existing natural fractures forming a highly conductive Stimulated Reservoir Volume (SRV) around the borehole. We extend the previous work on Lyons sandstone and pyrophyllite to anisotropic shale from the Wolfcamp formation. We divide the rock anisotropy into two groups: a) conventional and b) unconventional (shaly) anisotropy. X-ray Computed Tomography (CT), compressional velocity anisotropy, and SEM analysis are used to identify three causes of anisotropy: bedding planes, clay lamination, and calcite veins. Calcite vein is a subsequently filled with calcite bonded weakly to the matrix. Velocity anisotropy and visual observations demonstrate the calcite filled veins to be mostly subparallel to the fabric direction. Brazilian tests are carried out to observe the fracture initiation and propagation under tension. High speed photography (frame rate 300,000 frame/sec) was used to capture the failure. Strain gauges and Acoustic Emission (AE) sensors recorded the deformation leading up to and during failure. SEM imaging and surface profilometry were employed to study the post-failure fracture system and failed surface topology. Fracture permeability was measured as a function of effective stress. Brazilian tests on small disks containing a centered single vein revealed the shear strength of the veins. We interpret the strain data and number, frequency, and amplitude of AE events which are correlated well with the observed fracture process zone, surface roughness, and permeability. The unpropped fracture has enhanced permeability by two orders of magnitude. The observed anisotropic tensile failure seems to have a universal trend with a minimum strength occurring at 15o orientation with respect to the loading axis. The veins at 15o orientation with respect to the loading axis were easily activated at 30% of the original failure load. The measured strength of the vein is as low as 6

  6. Total anomalous pulmonary veins to the portal vein. Value of multislice CT angiography. Report of three cases

    Directory of Open Access Journals (Sweden)

    Sólorzano Morales Sara Alejandra

    2014-07-01

    These malformations represent 0.4 to 2.0 % of all congenital heart diseases, with an incidence of 6.8 patients in every 100,000 births. Sixty eight percent of the cases are diagnosed in newborns, which indicates that most patients are symptomatic early in life. The infracardiac TAPVC represent 15 to 25% of all TAPVC.

  7. A new approach for sclera vein recognition

    Science.gov (United States)

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

    2010-04-01

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

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

    Science.gov (United States)

    Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B.

    2014-01-01

    62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. Conclusion The lessons we learned are (1) Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2) Synthetic graft is an alternative for internal jugular vein graft. (3) Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4) It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival. PMID:25568802

  9. Mechanisms responsible for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Pulmonary hypertension is a pathophysiologic process characterized by progressive elevation of pulmonary vascular resistance and right heart failure, which is a common complication of many diseases. Pulmonary hypertension with no apparent causes (unknown etiology) is termed primary pulmonary hypertension or, more recently, idiopathic pulmonary arterial hypertension (IPAH).

  10. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance a

  11. MRI manifestations of enlarged superior ophthalmic vein

    Institute of Scientific and Technical Information of China (English)

    WEI Rui-li; MA Xiao-ye; CAI Ji-ping; ZHU Huang

    2002-01-01

    Objective:To assess MRI in the evaluation of enlarged superior ophthalmic vein (SOV). Methods: MRI manifestations and etiology of forty-six patients with enlarged SOV were analyzed. Results: SOV enlargement was noted to occur in carotid-cavernous fistula, ophthalmic Graves'disease, Tolosa-Hunt syndrome, inflammation at the apex of the orbit, orbital pseudotumor and thrombosis of cavernous sinus. The dilated vein appeared as signal void tubular shadows on both T1 and T2 weighted images. The diameter of the enlarged vein was 3.5-6.0 mm. Extraocular muscle enlargement, orbital pathologies, enlarged carotid cavernous sinus etc were also revealed by MRI. Conclusion: The dilated SOV may be well demonstrated by MRI. The etiological diagnosis of enlarged SOV can be made in combination with the associated findings.

  12. Pathogenesis of varicose veins - lessons from biomechanics.

    Science.gov (United States)

    Pfisterer, Larissa; König, Gerd; Hecker, Markus; Korff, Thomas

    2014-03-01

    The development of varicose veins or chronic venous insufficiency is preceded by and associated with the pathophysiological remodelling of the venous wall. Recent work suggests that an increase in venous filling pressure is sufficient to promote varicose remodelling of veins by augmenting wall stress and activating venous endothelial and smooth muscle cells. In line with this, known risk factors such as prolonged standing or an obesity-induced increase in venous filling pressure may contribute to varicosis. This review focuses on biomechanically mediated mechanisms such as an increase in wall stress caused by venous hypertension or alterations in blood flow, which may be involved in the onset of varicose vein development. Finally, possible therapeutic options to counteract or delay the progress of this venous disease are discussed.

  13. K{sub I}-T estimation for embedded flaws in pipes - Part II: Circumferentially oriented cracks

    Energy Technology Data Exchange (ETDEWEB)

    Qian Xudong, E-mail: cveqx@nus.edu.s [Department of Civil Engineering, National University of Singapore, 1 Engineering Drive 2, Singapore 117576 (Singapore)

    2010-04-15

    This paper, in parallel to the investigation on axially embedded cracks reported in the companion paper, presents a numerical study on the linear-elastic K{sub I} and T-stress values over the front of elliptical cracks circumferentially embedded in the wall of a pipe/cylindrical structure, under a uniform pressure applied on the inner surface of the pipe. The numerical procedure employs the interaction-integral approach to compute the linear-elastic stress-intensity factor (SIF) K{sub I} and T-stress values for embedded cracks with practical sizes at different locations in the wall of the pipe. The parametric study covers a wide range of geometric parameters for embedded cracks in the pipe, including: the wall thickness to the inner radius ratio (t/R{sub i}), the crack depth over the wall thickness ratio (a/t), the crack aspect ratio (a/c) and the ratio of the distance from the centerline of the crack to the outer surface of the pipe over the pipe wall thickness (e{sub M}/t). The parametric investigation identifies a significant effect of the remaining ligament length on both the T-stress and K{sub I} values at the crack-front location (denoted by point O) nearest to the outer surface of the pipe and at the crack-front location (denoted by point I) nearest to the inner surface of the pipe. The numerical investigation establishes the database to derive approximate functions from a nonlinear curve-fitting procedure to predict the T-stress and K{sub I} values at three critical front locations of the circumferentially embedded crack in a pipe: points O, I and M. The proposed T-stress and K{sub I} functions utilize a combined second-order polynomial and a power-law expression, which presents a close agreement with the T-stress and K{sub I} values computed from the very detailed finite element models. The comparison between the circumferentially embedded crack and the axially embedded crack indicates that both the T-stress and K{sub I} values at crack-front points O and

  14. Contribution to the Evaluation of the Circumferentially-Cracked Round Bar for Fracture Toughness Determination of Reactor Pressure

    Energy Technology Data Exchange (ETDEWEB)

    Scibetta, M

    1999-06-01

    The subject of this PhD dissertation is the use of the Circumferentially-Cracked Round Bar (CRB) for fracture toughness measurements. The main advantages of CRB are the relatively small size requirements of the testing specimens, the low cost to machine the specimen, the rotating bending fatigue allowing for easy precracking of specimens, the use of standard tensile test fixture and the axisymmetry of the specimen that avoids time consuming 3D finite element calculations. An in-depth study of the most widely used precracking technique for CRB, namely the rotating bending fatigue, is made.

  15. Postpartum Ovarian Vein Thrombophlebitis with Staphylococcal Bacteremia

    Science.gov (United States)

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

    2015-01-01

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

  16. Renal actinomycosis with concomitant renal vein thrombosis.

    Science.gov (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  17. Doppler spectral characteristics of infrainguinal vein bypasses

    DEFF Research Database (Denmark)

    Nielsen, Tina G; von Jessen, F; Sillesen, H;

    1993-01-01

    With the aim of assessing the velocity profile of femoropopliteal and femorocrural vein bypasses, 128 patients undergoing infrainguinal vein bypass surgery entered a postoperative Duplex surveillance protocol, which included clinical assessment and Duplex scanning, using Doppler spectral analysis...... of arteriovenous fistulas the initially antegrade diastolic velocity was replaced by a retrograde flow within 3 months, whereas a forward flow in diastole was sustained in grafts with patent fistulas. Abnormal Duplex findings in 31 patients led to angiography and revision in 13 cases. Four revised grafts failed...

  18. Duplicated Ižnternal Juguler Vein

    Directory of Open Access Journals (Sweden)

    Ahmet Kirbas

    2014-03-01

    Full Text Available    Duplicated internal juguler vein (DIJV is a rare anomaly and reported incidence is 0.4 % in the literature. A 45-year-old female patient was referred to our hospital because of non pulsatile neck swelling. The magnetic resonance image (MRI showed left IJVs divided at the angles of the mandible running anterior to the common carotid artery until anterior mediastinal level. Clinicians should be aware of the rare possibility of duplicated IJVs in patients presenting with neck swelling. The development of imaging technics have revealed more cases of duplicated internal juguler vein.

  19. Handbook of pulmonary emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Spaquolo, S.V.; Medinger, A

    1986-01-01

    This book presents information on the following topics: clinical assessment of the patient with pulmonary disease; interpretation of arterial blood gases in the emergency patient; life-threatening pneumonia; extrapulmonic ventilatory failure; acute inhalation lung disease; pulmonary edema; near drowning; chest trauma; upper airway emergencies; chronic lung disease with acute respiratory decompensation; acute respiratory failure in the patient with chronic airflow obstruction; asthma; hemoptysis; embolic pulmonary disease; superior vena cava syndrome; catastrophic pleural disease; ventilatory assistance and its complications; and ventilator emergencies.

  20. The Use Of The VEINES-QOL/Sym Questionnaire In Patients Operated For Varicose Veins

    Directory of Open Access Journals (Sweden)

    Migdalski Łukasz

    2015-10-01

    Full Text Available Venous insufficiency is a common, chronic disease that affects nearly half of the population in highly developed countries. The vast majority of affected patients suffer from varicose veins (VV. Recently, the priority in medicine has been patient satisfaction with treatment and high quality of life. Therefore, disease-specific questionnaires that measure quality of life have been developed. One of these is VEINES-QOL/Sym with two subscales that assess quality of life and disease symptoms. To date, it has been used to examine patients with venous ulcers and thrombosis. No data are available concerning the use of VEINES to assess patients after VV surgery.