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Sample records for duct injury correlation

  1. Classification and management of bile duct injuries

    OpenAIRE

    2011-01-01

    To review the classification and general guidelines for treatment of bile duct injury patients and their long term results. In a 20-year period, 510 complex circumferential injuries have been referred to our team for repair at the Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” hospital in Mexico City and 198 elsewhere (private practice). The records at the third level Academic University Hospital were analyzed and divided into three periods of time: GI-1990-99 (33 cases...

  2. 影响腹腔镜胆囊切除术胆管损伤的相关危险因素研究%Research on correlated risk factors of bile duct injury induced by laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    龙胜林; 杨华; 顾超; 唐海静; 舒易超

    2015-01-01

    Objective To explore the correlated risk factors of bile duct injury induced by laparoscopic cholecystectomy ,and to reduce the rate of bile duct injury companied with LC and improved patients condition after LC .Methods One thousand two hun‐dred and forty four patients who had been done the laparoscopic cholecystectomy in our hospital were searched from December 2003 to December 2013 for their case notes .The relationship between rate of bile duct injury induced by laparoscopic cholecystectomy and gender ,age ,time of LC surgery ,pathology ,gallbladder wall thickness ,liver function levels ,the existence of the gallbladder triangle anatomical anomalies and physician experience were analyzed by logistic regression method .Results Logistic regression analysis showed that patients did LC surgery at early time ,with acute cholecystitis ,with gallstones combined effusion ,with gallbladder wall thicker than 4 mm and with gallbladder triangle anatomical anomalies were likely to have bile duct injury induced by LC (P<0 .05) .And doctor′s experience on LC is another important factor as well (P<0 .05) .Conclusion According to the correlated risk factors of bile duct injury caused by laparoscopic cholecystectomy ,methods should be employed to reduce the bile duct injury .And sharing experience between doctors and learning new techniques could be helpful ,too .%目的:探讨腹腔镜胆囊切除术并发胆管损伤的相关危险因素,以减少胆管损伤的发生率,改善患者预后。方法察看2003年12月至2013年12月在该院行腹腔镜胆囊切除手术的1244例患者的病历及病程记录。对患者性别、年龄、行LC术时间、病理、胆囊壁厚度、术前肝功水平、是否存在胆囊三角解剖异常情况和医师经验等因素与LC并发胆管损伤的相关性进行Logistic回归分析。结果LC手术时间早、急性胆囊炎患者、合并胆囊积液的胆结石患者、胆囊壁厚度大于4mm、胆囊三角解剖存在

  3. Salivary Duct Cyst: Histo-pathologic Correlation

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    Divya Vinayachandran

    2013-01-01

    Full Text Available Non-neoplastic cysts of the salivary glands are uncommon and represent 2-5% of all salivary gland lesions. They are mainly mucoceles or salivary duct cysts. Unlike a mucocele, which is surrounded by granulation tissue, the salivary duct cyst is lined by epithelium. Salivary duct cysts are more common in the oral minor salivary glands and rarely occur in the major salivary glands, show a marked predilection for the superficial lobe of the parotid, and represent 10% of all salivary gland cysts. Neoplastic differentiation of the lining of the salivary duct cyst has been reported. We report a case of a salivary duct cyst of the left parotid gland, with a review of radiographic and histopathologic features.

  4. Will intraoperative cholangiography prevent biliary duct injury inlaparoscopic cholecystectomy?

    Institute of Scientific and Technical Information of China (English)

    Li Bo Li; Xiu Jun Cai; Jun Da Li; Yi Ping Mu; Yue Dong Wang; Xiao Ming Yuan; Xian Fa Wang; Urs Bryner; Robert K.Finley Jr

    2000-01-01

    AIM To evaluate the role of intraoperative cholangiogram (IOC) in preventing biliary duct injury duringlaparoscopic cholecystectomy.METHODS Injury location, mechanism, time of detection, treatment outcome, and whether anintraoperative cholangiogram was performed were evaluated in 31 cases of bile duct injuries.RESULTS Cholangiograms were done in 22 cases, but they were misinterpreted in 3 of them. In 12 of 19misidentified cases, the cholangiogram was interpreted correctly, and the injury detected intraoperatively.Primary laparoscopic repair or open repair and T-tube drainage solved the problem. No long-termcomplications occurred. However, in 3 of the 19 cases the cholangiogram was misinterpreted and in 4 of the19 cases no cholangiogram was performed. Three of the seven patients required a cholangioentericanastomosis. In 2 cases the diagnosis was delayed and one of these required a two-stage procedure. Morbiditywas increased. Three cases of clim impingement of the common duct had delayed diagnoses, and two of themhad injuries. Thermal injury developed in 4 cases who had cholangiograms.CONCLUSION Routine IOC plays no role in inducing, preventing, detecting, or minimizing any of theinjuries due to clips, lacerations, or electrocautery, IOC does not prevent injuries due to ductmisidentification either. Careful interpretation of IOC would prevent injuries and avoid an open operation.

  5. [From Langenbuch to Strasberg: the spectrum of bile duct injuries].

    Science.gov (United States)

    Mercado, Miguel Angel

    2004-01-01

    Bile duct injuries are the main serious complication of laparoscopy cholecystectomy. The frequency of this type of injuries rangers, between 1 to 3 in 1,000 cases and although this rate remains stables, their frequency has increased because of the increasing expansion of the indication of cholecystectomy. Each lesion is the individual in it's features as well as the scenario in which the surgeon faces it. Several classifications have been developed, but that developed by Strasberg most used nowadays. Intraoperative cholangiography has shown evidence in meta analytic studies that diminishes the frequency of lesions but does not abolish them. Conversion from laparoscope's to the open approach with ample and convincent dissection is probably the best maneuver to reduce the frequency of lesions, when any anatomical or technical doubt appears. No patient should be operated in critical condition. In this situation, biliary reconstruction has a secondary role and only drainage of the ducts (percutaneous or surgical) is indicated. Roux en Y hepatoyeyunostomy is the procedure of choice for almost all cases, leaving other types of procedures for selected cases. Transhepatic transanastomotical stents should be used according to the individual status of the patient when small, scared or inflamed ducts are found. High quality anastomosis is obtained when proper ducts are found. Sometimes high dissection of the ducts is needed in order to obtain adequate ducts. Nine of each ten cases are completely rehabilitated, obtaining a good quality of life.

  6. Current perspective in the treatment of bile duct injuries

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    Juan Jos and eacute; Granados-Romero

    2016-03-01

    Full Text Available The laparoscopic cholecystectomy is considered the gold standard for the treatment of benign gallbladder disease, which is associated with an increased incidence of biliary injuries. These types of injuries are multicausal, and anatomical variations or anatomical perception errors are the most common risk factors. The objective of this study is to describe the evolution in the management of bile duct injuries and actual, diagnostic tools, incidence, prognosis and treatment. A literature research about diagnosis and treatment of iatrogenic bile duct injuries as well as their impact on the incidence of morbidity and mortality, based on a 30-year period, was performed on Medline, Cochrane, Embase, MedScape and PubMed database, for all studies that met the eligibility criteria. A thorough quality assessment of all included studies was performed. Synthesis of the results was achieved by narrative review. The bile duct injury is a complication that requires a complex therapy and multidisciplinary management. Reconstruction and treatment techniques have been evolving. The selection of adequate treatment will impact on the patient and acute;s quality of life. The results of the existing studies reporting on iatrogenic bile duct injuries are useful; because the iatrogenic bile duct injuries are complex alterations and constitute one of the most serious complications of a cholecystectomy and require a comprehensive approach, immediate repair, proper drainage and timely referral to adequate treatment to improve long-term prognosis. According to the literature review, currently there better treatments such as absorbable prosthesis, which improve the prognosis and patient and acute;s quality of life, and represent less risk of complications in short/long term. [Int J Res Med Sci 2016; 4(3.000: 677-684

  7. Parotid duct injury secondary to shark bite injury: Repair with a Crawford stent

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    Mallory Highstein

    2016-12-01

    Conclusion: Clinicians should have a high level of suspicion for parotid duct injury in a patient presenting with injury to the face, particularly with laceration type injuries. Our patient had a unique injury that required a novel Crawford stent repair over traditional silicone catheters.

  8. [Postoperative handling in biliodigestive derivation by iatrogenic bile duct injury].

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    Domínguez, I; Mercado, M A

    2008-01-01

    Bile duct injury is a severe complication related to cholecystectomy, impacting in the long-term quality of life and functional status. Bile duct repair is the first-line treatment for complex injuries. During short-term and long-term postoperative care, it is important to bear in mind the diagnostic tools, both laboratory and imaging, that will be useful to evaluate a possible surgical complication and to plan an adequate therapeutic strategy. In addition, post-surgical classification describes patients according to their complications and clinical course. In this review we describe the principal issues of postoperative care after bile duct repair, highlighting the diagnosis, severity classification and therapeutic approach of acute cholangitis.

  9. Reconstruction of major bile duct injuries after laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Holte, Kathrine; Bardram, Linda; Wettergren, André

    2010-01-01

    Bile duct injury (BDI) after cholecystectomy remains a serious complication with major implications for patient outcome. For most major BDIs, the recommended method of repair is a hepaticojejunostomy (HJ). We conducted a retrospective review aiming to examine the perioperative and the long...

  10. Iatrogenic bile duct injuries from biliar y tract surger y

    Institute of Scientific and Technical Information of China (English)

    Umar Ali; Zhen-Hua Ma; Cheng-En Pan; Qing-Yong Ma

    2007-01-01

    BACKGROUND:Cholecystectomy is the most commonly performed procedure in general surgery. However, bile duct injury is a rare but still one of the most common complications. These injuries sometimes present variably after primary surgery. Timely detection and appropriate management decrease the morbidity and mortality of the operation. METHODS:Five cases of iatrogenic bile duct injury (IBDI) were managed at the Department of Surgery, First Afifliated Hospital, Xi'an Jiaotong University. All the cases who underwent both open and laparoscopic cholecystectomy had persistent injury to the biliary tract and were treated accordingly. RESULTS: Recovery of the patients was uneventful. All patients were followed-up at the surgical outpatient department for six months to three years. So far the patients have shown good recovery. CONCLUSIONS:In cases of IBDI it is necessary to perform the operation under the supervision of an experienced surgeon who is specialized in the repair of bile duct injuries, and it is also necessary to detect and treat the injury as soon as possible to obtain a satisfactory outcome.

  11. Iatrogenic injury of an aberrant right posterior sectoral bile duct

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    John Cantrell

    2011-08-01

    Full Text Available A 34-year-old woman presented with a history of a previous laparoscopic cholecystectomy, followed within a few days by a formal laparotomy for a suspected bile duct injury. Approximately one week after the laparotomy, she developed a sinus on the anterior abdominal wall that was draining bile. She was then referred to our institution for further management. The earlier surgery was done at another hospital, and these details were not clear. A CT scan, including a CT sinogram, was performed. The sinogram was done by inserting a catheter into the sinus and running in diluted contrast under gravity. CT images showed the sinus tract communicating with a collection in the gallbladder fossa, as well as contrast opacification of the segment 6 and 7 bile ducts. A week later, an endoscopic retrograde cholangiopancreatography (ERCP examination was performed. This showed no filling of the right posterior sectoral ducts but normal opacification of the other ducts. These findings led to the diagnosis of an aberrant right posterior sectoral bile duct that was not identified prior to surgery and that was damaged at the time of laparoscopic cholecystectomy. This duct now drained into the gallbladder fossa, causing the collection and draining sinus.

  12. Isolated segmental, sectoral and right hepatic bile duct injuries

    Institute of Scientific and Technical Information of China (English)

    Radoje B Colovic

    2009-01-01

    The treatment of isolated segmental, sectoral and right hepatic bile duct injuries is controversial. Nineteen patients were treated over a 26-year period. Group one was comprised of 4 patients in whom the injury was primarily repaired during the original surgery;3 over a T-tube, 1 with a Roux-en-Y. These patients had an uneventful recovery. The second group consisted of 5 patients in whom the duct was ligated;4 developed infection, 3 of which required drainage and biliary repair. Two patients had good long-term outcomes;the third developed a late anastomotic stricture requiring further surgery. The fourth patient developed a small bile leak and pain which resolved spontaneously. The fifth patient developed complications from which he died. The third group was comprised of 4 patients referred with biliary peritonitis;all underwent drainage and lavage, and developed biliary fistulae, 3 of which resolved spontaneously, 1 required Roux-en-Y repair, with favorable outcomes. The fourth group consisted of 6 patients with biliary fistulae. Two patients, both with an 8-wk history of a fistula, underwent Roux-en-Y repair. Two others also underwent a Roux-en-Y repair, as their fistulae showed no signs of closure. The remaining 2 patients had spontaneous closure of their biliary fistulae. A primary repair is a reasonable alternative to ligature of injured duct. Patients with ligated ducts may develop complications. Infected ducts require further surgery. Patients with biliary peritonitis must be treated with drainage and lavage. There is a 50% chance that a biliary fistula will close spontaneously. In cases where the biliary fistula does not close within 6 to 8 wk, a Roux-en-Y anastomosis should be considered.

  13. [Experimental study of relationship of bile composition imbalance with bile duct injury].

    Science.gov (United States)

    Chen, Geng; Zhang, Yu-Jun; Yang, Cheng; Li, Kun; Li, Xiao-Wu; Wang, Shu-Guang; Dong, Jia-Hong

    2008-02-01

    To investigate the change of bile composition and its role in bile duct injury after orthotopic liver transplantation (OLT). Rats were randomly divided into 3 groups: group A (sham surgery), group B (OLT with 1 h cold preservation), group C (OLT with 12 h cold preservation). The arterialized rat liver transplantation model with biliary extra-drainage was used in group B and C. Animals were sacrificed at posttransplant 1, 3, 5, 7, 10 and 14 day. Routine bile chemistry and pathological assays were performed. Cold preservation/reperfusion injury (CPRI) could repress the secretion of bile salts and phospholipid. However, in contrast with a rapid increase of bile salt secretion, the biliary secretion of phospholipid recovered more slowly, leading to an abnormal high bile salts/phospholipid ratio early after transplantation. Further analysis suggested that the secretion of bile salts correlated strongly with biochemical and histopathological signs of bile duct injury. CPRI can lead to great changes of graft bile composition, which plays a role in the pathogenesis of bile duct injury following liver transplantation.

  14. Acute Cholangitis After Bilioenteric Anastomosis for Bile Duct Injuries.

    Science.gov (United States)

    Ortiz-Brizuela, Edgar; Sifuentes-Osornio, José; Manzur-Sandoval, Daniel; Terán-Ellis, Santiago Mier Y; Ponce-de-León, Sergio; Torres-González, Pedro; Mercado, Miguel Ángel

    2017-07-25

    The study aims to describe the clinical features, microbiology, and associated factors of acute cholangitis (AC) after bilioenteric anastomosis (BEA) for biliary duct injury (BDI). Additionally, we assessed the performance of the Tokyo Guidelines 2013 (TG13) recommendations in these patients. We conducted a case-control study of 524 adults with a history of BEA for BDI from January 2000 to January 2014. A propensity score adjustment was performed for the analysis of the independent role of the main factors identified during the univariate logistic regression procedure. We identified 117 episodes of AC in 70 patients; 51.3% were definitive AC according to the TG13 diagnostic criteria, and 39.3% did not fulfill the imaging criteria of AC. A history of post-operative biliary complications (OR 2.55, 95% CI 1.38-4.70) and the bile duct confluence preservation (OR 0.46, 95% CI 0.24-0.87) were associated with AC. Eighty-nine percent of the microorganisms were Enterobacteriaceae; of them, 28% were extended spectrum β-lactamase (ESBL) producers. AC is a common complication after BEA and must be suspected even in the absence of imaging findings, particulary in patients with a history of post-operative biliary complications, and/or without bile duct confluence preserved. An empirical treatment for ESBL-producing Enterobacteriaceae may be appropriate in patients living in countries with a high rate of bacterial drug resistance.

  15. Iatrogenic bile duct injury with loss of confluence

    Science.gov (United States)

    Mercado, Miguel-Angel; Vilatoba, Mario; Contreras, Alan; Leal-Leyte, Pilar; Cervantes-Alvarez, Eduardo; Arriola, Juan-Carlos; Gonzalez, Bruno-Adonai

    2015-01-01

    AIM: To describe our experience concerning the surgical treatment of Strasberg E-4 (Bismuth IV) bile duct injuries. METHODS: In an 18-year period, among 603 patients referred to our hospital for surgical treatment of complex bile duct injuries, 53 presented involvement of the hilar confluence classified as Strasberg E4 injuries. Imagenological studies, mainly magnetic resonance imaging showed a loss of confluence. The files of these patients were analyzed and general data were recorded, including type of operation and postoperative outcome with emphasis on postoperative cholangitis, liver function test and quality of life. The mean time of follow-up was of 55.9 ± 52.9 mo (median = 38.5, minimum = 2, maximum = 181.2). All other patients with Strasberg A, B, C, D, E1, E2, E3, or E5 biliary injuries were excluded from this study. RESULTS: Patients were divided in three groups: G1 (n = 21): Construction of neoconfluence + Roux-en-Y hepatojejunostomy. G2 (n = 26): Roux-en-Y portoenterostomy. G3 (n = 6): Double (right and left) Roux-en-Y hepatojejunostomy. Cholangitis was recorded in two patients in group 1, in 14 patients in group 2, and in one patient in group 3. All of them required transhepatic instrumentation of the anastomosis and six patients needed live transplantation. CONCLUSION: Loss of confluence represents a surgical challenge. There are several treatment options at different stages. Roux-en-Y bilioenteric anastomosis (neoconfluence, double-barrel anastomosis, portoenterostomy) is the treatment of choice, and when it is technically possible, building of a neoconfluence has better outcomes. When liver cirrhosis is shown, liver transplantation is the best choice. PMID:26527428

  16. Iatrogenic bile duct injury with loss of confluence

    Institute of Scientific and Technical Information of China (English)

    Miguel-Angel; Mercado; Mario; Vilatoba; Alan; Contreras; Pilar; Leal-Leyte; Eduardo; Cervantes-Alvarez; Juan-Carlos; Arriola; Bruno-Adonai; Gonzalez

    2015-01-01

    AIM: To describe our experience concerning the surgical treatment of Strasberg E-4(Bismuth Ⅳ) bile duct injuries. METHODS: In an 18-year period, among 603 patients referred to our hospital for surgical treatment of complex bile duct injuries, 53 presented involvement of the hilar confluence classified as Strasberg E4 injuries. Imagenological studies, mainly magnetic resonance imaging showed a loss of confluence. The files of these patients were analyzed and general data were recorded, including type of operation and postoperative outcome with emphasis on postoperative cholangitis, liver function test and quality of life. The mean time of follow-up was of 55.9 ± 52.9 mo(median = 38.5, minimum = 2, maximum = 181.2). All other patients with Strasberg A, B, C, D, E1, E2, E3, or E5 biliary injuries were excluded from this study.RESULTS: Patients were divided in three groups: G1(n = 21): Construction of neoconfluence + Roux-en-Y hepatojejunostomy. G2(n = 26): Roux-en-Y portoenterostomy. G3(n = 6): Double(right and left) Rouxen-Y hepatojejunostomy. Cholangitis was recorded in two patients in group 1, in 14 patients in group 2, and in one patient in group 3. All of them required transhepatic instrumentation of the anastomosis and six patients needed live transplantation.CONCLUSION: Loss of confluence represents a surgicalchallenge. There are several treatment options at different stages. Roux-en-Y bilioenteric anastomosis(neoconfluence, double-barrel anastomosis, portoenterostomy) is the treatment of choice, and when it is technically possible, building of a neoconfluence has better outcomes. When liver cirrhosis is shown, liver transplantation is the best choice.

  17. Surgical management of Stenson’s duct injury by using double J stent urethral catheter

    Directory of Open Access Journals (Sweden)

    Suha N. Aloosi

    2015-01-01

    Conclusions: Herein, we described an easy yet efficient technique in management of parotid duct injury using a JJ stent which is often used for urethra. We think that use of JJ stent is a valuable technique to be used in the diagnosis and surgical repair of the parotid duct during traumatic facial and/or parotid injuries.

  18. [Complications of thyroid surgery: cervical thoracic duct injuries].

    Science.gov (United States)

    Avenia, N; Sanguinetti, A; Santoprete, S; Monacelli, M; Cirocchi, R; Lucchini, R; Galasse, S; Calzolari, F; Urbani, M; D'Ajello, F; Puma, F

    2010-10-01

    Thoracic duct injury is uncommon in surgery of the neck: relatively more common after laryngeal and esophageal surgery, rare in thyroid surgery. From January 1986 to June 2009 were treated 14 patients with lesions of the cervical thoracic duct undergo surgery for thyroid disease: 4 goitre cervico-mediastinal and 10 total thyroidectomy for cancer, 9 of which have laterocervical left lymphadenectomy. In 2 cases, the intraoperative detection has allowed immediate ligature. In 12 patients a cervical chylous fistula without chilothorax was found: 5 low-flow fistulas and 7 high-flow fistulas. Of the 5 cases of low-flow fistula, 4 were recovered after 1 month of conservative treatment, only 1 patient required surgical correction. The 7 patients with high-flow fistula were undergoing surgery: 4 in the first week post-operative and 3 after a period of more than 30 days of medical therapy. In patients with high-flow fistula prolonged medical treatment does not provide benefit and increase the risk of complications during and after surgery.

  19. Association between cholecystectomy with vs without intraoperative cholangiography and risk of common duct injury.

    Science.gov (United States)

    Sheffield, Kristin M; Riall, Taylor S; Han, Yimei; Kuo, Yong-Fang; Townsend, Courtney M; Goodwin, James S

    2013-08-28

    Significant controversy exists regarding routine intraoperative cholangiography in preventing common duct injury during cholecystectomy. To investigate the association between intraoperative cholangiography use during cholecystectomy and common duct injury. Retrospective cohort study of all Texas Medicare claims data from 2000 through 2009. We identified Medicare beneficiaries 66 years or older who underwent inpatient or outpatient cholecystectomy for biliary colic or biliary dyskinesia, acute cholecystitis, or chronic cholecystitis. We compared results from multilevel logistic regression models to the instrumental variable analyses. Intraoperative cholangiography use during cholecystectomy was determined at the level of the patients (yes/no), hospitals (percentage intraoperative cholangiography use for all cholecystectomies at the hospital), and surgeons (percentage use for all cholecystectomies performed by the surgeon). Percentage of use at the hospital and percentage of use by surgeon were the instrumental variables. Patients with claims for common duct repair operations within 1 year of cholecystectomy were considered as having major common duct injury. Of 92,932 patients undergoing cholecystectomy, 37,533 (40.4%) underwent concurrent intraoperative cholangiography and 280 (0.30%) had a common duct injury. The common duct injury rate was 0.21% among patients with intraoperative cholangiography and 0.36% among patients without it. In a logistic regression model controlling for patient, surgeon, and hospital characteristics, the odds of common duct injury for cholecystectomies performed without intraoperative cholangiography were increased compared with those performed with it (OR, 1.79 [95% CI, 1.35-2.36]; P < .001). When confounding was controlled with instrumental variable analysis, the association between cholecystectomy performed without intraoperative cholangiography and duct injury was no longer significant (OR, 1.26 [95% CI, 0.81-1.96]; P

  20. Cholestatic Hepatitis with Small Duct Injury Associated with Celecoxib

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    Suresh Kumar Nayudu

    2013-01-01

    Full Text Available Drug-induced liver injury (DILI is a common clinical entity but is underreported due to various reasons. Cyclooxygenase-2 inhibitors like Celecoxib have been proven to be associated with lesser incidence of adverse drug reactions compared to other nonsteroidal anti-inflammatory drugs (NSAID. However, Celecoxib has been rarely reported to be associated with cholestasis and hepatitis. We present a young Hispanic female presented with cholestatic liver chemistries who has been taking Celecoxib for 3 weeks. Extensive workup did not support diagnosis of viral, autoimmune, or metabolic liver diseases. Liver biopsy revealed findings suggestive of secondary sclerosing cholangitis. Imaging studies were negative for large duct involvement, and endoscopy ruled out inflammatory bowel disease. Liver chemistries normalized after cessation of medication. We recommend that physician should be aware of this rare complication when prescribing Celecoxib.

  1. Iatrogenic bile duct injuries: Etiology, diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Beata Jab(l)o(n)ska; Pawe(l) Lampe

    2009-01-01

    Iatrogenic bile duct injuries (IBDI) remain an important problem in gastrointestinal surgery. They are most frequently caused by laparoscopic cholecystectomy which is one of the commonest surgical procedures in the world. The early and proper diagnosis of IBDI isvery important for surgeons and gastroenterologists,because unrecognized IBDI lead to serious complications such as biliary cirrhosis, hepatic failure and death.Laboratory and radiological investigations play an important role in the diagnosis of biliary injuries. There are many classifications of IBDI. The most popularand simple classification of IBDI is the Bismuth scale.Endoscopic techniques are recommended for initial treatment of IBDI. When endoscopic treatment is not effective, surgical management is considered.Different surgical reconstructions are performed in patients with IBDI. According to the literature, Rouxen-Y hepaticojejunostomy is the most frequent surgical reconstruction and recommended by most authors.In the opinion of some authors, a more physiological and equally effective type of reconstruction is endto-end ductal anastomosis. Long term results are the most important in the assessment of the effectiveness of IBDI treatment. There are a few classifications for the long term results in patients treated for IBDI;the Terblanche scale, based on clinical biliary symptoms,is regarded as the most useful classification. Proper diagnosis and treatment of IBDI may avoid many serious complications and improve quality of life.

  2. Surgical management of Stenson’s duct injury by using double J stent urethral catheter

    Science.gov (United States)

    Aloosi, Suha N.; Khoshnaw, Najmaddin; Ali, Shakhawan M.; Muhammad, Belal A.

    2015-01-01

    Background Parotid duct or gland injury can be caused by assault with a knife, bottle, electrical-saw, road traffic accident, or rarely gunshot and fractures of the facial skeleton. The injury can be in the form of laceration, ductal exposure, total cutting, or crushing of the duct. These conditions are difficult to diagnose because of complex anatomy and variable forms of the injury. A successful management of parotid duct injuries depends on early diagnosis and appropriate intervention; improper surgery may lead to complications such as sialocele or salivary fistula Case report A 27-years-old man was presented to the maxillofacial unit, complaining of bleeding over the right side of his face after accidental exposure to a chain-saw three hours before admission. On examination, a 6 cm deep lacerated wound was found over the right buccal area, suspecting facial nerve-buccal branch and parotid duct injury. Under general anesthesia the parotid duct injury diagnosed, microsurgical anastomosis of the cut-ends of the parotid duct performed using the double J catheter. Sutures and JJ stent removed seven and twenty postoperative days respectively. After a proper supportive treatment a complete healing of the duct was obtained with normal amount of saliva. Conclusions Herein, we described an easy yet efficient technique in management of parotid duct injury using a JJ stent which is often used for urethra. We think that use of JJ stent is a valuable technique to be used in the diagnosis and surgical repair of the parotid duct during traumatic facial and/or parotid injuries. PMID:26555062

  3. Surgical management in biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To discuss the surgical method and skill of biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury.METHODS: From November 2005 to December 2006,eight patients with biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury were admitted to our hospital. Their clinical data were analyzed retrospectively.RESULTS: Bile duct injury was caused by cholecystectomy in the eight cases, including seven cases with laparoscopic cholecystectomy and one with miniincision choleystectomy. According to the classification of Strasberg, type E1 injury was found in one patient,type E2 injury in three, type E3 injury in two and type E4 injury in two patients. Both of the type E4 injury patients also had a vascular lesion of the hepatic artery. Six patients received Roux-en-Y hepaticojejunostomy for the second time, and one of them who had type E4 injury with the right hepatic artery disruption received right hepatectomy afterward. One patient who had type E4 injury with the proper hepatic artery lesion underwent liver transplantation, and the remaining one with type E3 injury received external biliary drainage. All the patients recovered fairly well postoperatively.CONCLUSION: Roux-en-Y hepaticojejunostomy is still the main approach for such failed surgical cases with bile duct injury. Special attention should be paid to concomitant vascular injury in these cases. The optimal timing and meticulous and excellent skills are essential to the success in this surgery.

  4. A new method of preventing bile duct injury in laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    Fang Xu; Cheng-Gang Xu; De-Zheng Xu

    2004-01-01

    AIM: Of all the complications of laparoscopic cholectecystomy,bile duct injury (BDI) is the most serious complication.The prevention of injury to the common bile duct (CBD) remains a significant concern in laparoscopic cholecystectomy (LC).Different kinds of methods have been advanced to avoid this injury but no single method has gained wide acceptance.Because of various limitations of current methodologies we began a study using cold light illumination of the extrahepatic biliary system (light cholangiography LCP) to better visualize this area and thereby reduce the risk of bile duct injury.METHODS: Thirty-six patients with cholelithiasis were divided into two groups.Group Ⅰ (16 cases) received LCP and group Ⅱ (20 cases) received methelenum coeruleum cholangiography (MCCP).In group Ⅰ cold light was used to illuminate the common bile duct by leading an optical fiber into the common duct with a duodenoscope at the time of LC.The light coming from the fiber in the CBD could clearly illuminate the location of CBD and hepatic duct establishing its location relative to the cystic duct.This method was compared with the dye injection technique using methelenum coeruleum.RESULTS: In group Ⅰ thirteen cases were successfully illuminated and three failed.The cause of three failed cases was due to the difficulty in inserting the fiber into the ampulla of Vater.No complications occurred in the thirteen successful cases.In each of these successful cases the location of the common and hepatic ducts was clearly seen differentiating the ductal system from surrounding anatomy.In ten cases both the left and right hepatic ducts could be seen and in three only the right hepatic ducts were seen.In four of the thirteen cases,cystic ducts were also seen.In group Ⅱ,eighteen of the twenty cases were successful.The location of extrahepatic ducts became blue differentiating the ductal system from surrounding anatomy.Two cases failed due to a stone obstructing the cystic duct

  5. Related issues in repair of bile duct injury and traumatic biliary stricture

    Directory of Open Access Journals (Sweden)

    WANG Shuguang

    2017-02-01

    Full Text Available Inappropriate treatment of bile duct injury and traumatic biliary stricture may cause serious consequences such as recurrent cholangitis, formation of hepatolithiasis, and biliary cirrhosis. This article elaborates on the influencing factors for the effect of the repair of bile duct injury and traumatic biliary stricture, repair principles, timing of repair or reconstruction, and related methods and techniques. It is pointed out that if there is no significant local infection and the bile duct wall defect is <2 cm, end-to-end anastomosis should be used for repair; if the bile duct wall defect is >2 cm, Roux-en-Y hepaticojejunostomy should be used for reconstruction. If the upper wall of the bile duct had a large defect and the lower wall has an integral structure, pedicled umbilical vein graft, pedicled jejunal wall seromuscular flap, or gastric wall seromuscular flap should be used for repair. The patients with severe congestion and edema at the site of injury should be treated with sufficient external drainage of the injured bile duct and then selective repair or reconstruction. Patients with hepatic duct stenosis in the liver lobe or hepatic segments and liver tissue atrophy can be treated with hepalobectomy or segmental hepatectomy. The key to successful repair is exposure and removal of high hilar bile duct stricture, while segmental hepatectomy of the Ⅳb segment can fully expose the left and right hepatic pedicles and help with the incision of the left and right hepatic ducts and secondary hepatic ducts, and therefore, it is a good method for exposing high bile duct stricture.

  6. Clinical Application of Six Current Classification Systems for Iatrogenic Bile Duct Injuries after Cholecystectomy.

    Science.gov (United States)

    Velidedeoglu, Mehmet; Arikan, Akif Enes; Uludag, Sezgin Server; Olgun, Deniz Cebi; Kilic, Fahrettin; Kapan, Metin

    2015-05-01

    Due to being a severe complication, iatrogenic bile duct injury is still a challenging issue for surgeons in gallbladder surgery. However, a commonly accepted classification describing the type of injury has not been available yet. This study aims to evaluate ability of six current classification systems to discriminate bile duct injury patterns. Twelve patients, who were referred to our clinic because of iatrogenic bile duct injury after laparoscopic cholecystectomy were reviewed retrospectively. We described type of injury for each patient according to current six different classifications. 9 patients underwent definitive biliary reconstruction. Bismuth, Strasberg-Bismuth, Stewart-Way and Neuhaus classifications do not consider vascular involvement, Siewert system does, but only for the tangential lesions without structural loss of duct and lesion with a structural defect of hepatic or common bile duct. Siewert, Neuhaus and Stewart-Way systems do not discriminate between lesions at or above bifurcation of the hepatic duct. The Hannover classification may resolve the missing aspects of other systems by describing additional vascular involvement and location of the lesion at or above bifurcation.

  7. Blunt Dissection: A Solution to Prevent Bile Duct Injury in Laparoscopic Cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    Xiu-Jun Cai; Han-Ning Ying; Hong Yu; Xiao Liang; Yi-Fan Wang; Wen-Bin Jiang; Jian-Bo Li

    2015-01-01

    Background: Laparoscopic cholecystectomy (LC) has been a standard operation and replaced the open cholecystectomy (OC) rapidly because the technique resulted in less pain, smaller incision, and faster recovery.This study was to evaluate the value of blunt dissection in preventing bile duct injury (BDI) in laparoscopic cholecystectomy (LC).Methods: From 2003 to 2015, LC was performed on 21,497 patients, 7470 males and 14,027 females, age 50.3 years (14-84 years).The Calot's triangle was bluntly dissected and each duct in Calot's triangle was identified before transecting the cystic duct.Results: Two hundred and thirty-nine patients (1.1%) were converted to open procedures.The postoperative hospital stay was 2.1 (0-158) days, and cases (46%) had hospitalization days of 1 day or less, and 92.8% had hospitalization days of 3 days or less;BDI was occurred in 20 cases (0.09%) including 6 cases of common BDI, 2 cases of common hepatic duct injury, 1 case of right hepatic duct injury, 1 case of accessory right hepatic duct, 1 case of aberrant BDI 1 case ofbiliary stricture, 1 case of biliary duct perforation, 3 cases ofhemobilia, and 4 cases of bile leakage.Conclusion: Exposing Calot's triangle by blunt dissection in laparoscopic cholecystectomy could prevent intraoperative BDI.

  8. Lower Rate of Major Bile Duct Injury and Increased Intraoperative Management of Common Bile Duct Stones after Implementation of Routine Intraoperative Cholangiography

    NARCIS (Netherlands)

    Buddingh, K. Tim; Weersma, Rinse K.; Savenije, Rolf A. J.; van Dam, Gooitzen M.; Nieuwenhuijs, Vincent B.

    2011-01-01

    BACKGROUND: Our university medical center is the only center in The Netherlands that has adopted a policy of routine intraoperative cholangiography (IOC) during cholecystectomy. This study aimed to describe the rate of bile duct injury (BDI) and management of common bile duct (CBD) stones before and

  9. Long-term results of treatment of injuries to the sectoral and segmental bile ducts

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    Čolović Radoje B.

    2003-01-01

    Full Text Available INTRODUCTION Surgically important variations of the sectoral and segmental bile ducts of the right lobe of the liver appear in a significant proportion of patients. Frequency of the injuries to these ducts is not known as the ligature of small ducts may pass without major consequences. MATERIAL AND METHODS Over a 27 year period (1. Jan 1974-31. Dec 2001 along with 168 patients with benign biliary strictures of type I, II, III and IV according to Bismuth's classification, we treated 13 patients with operative sectoral or segmental bile duct injuries, four patients from our institution and nine patients transferred from elsewhere. The injury was recognized at original surgery in all four patients operated in our institution. Primary repair was performed in three patients, in two patients direct end-to-end repair overT-tube and in one patient with anastomosis between the injured duct and Roux-en-Y jejunal limb, while in one patient the injured duct was ligated. In no one of nine patients transferred from elsewhere the injury was recognized during original surgery. Four patients were sent with biliary peritonitis, another four patients with external biliary fistula and one patient for pain and fever due to liver abscess. RESULTS All three patients in whom the primary repair was performed had a quick and uneventful recovery and they stayed symptom-free so far. The patient in whom the injured duct was ligated died after series of complications. Four patients sent to us with biliary peritonitis were treated with relaparotomy, lavage and drainage and all developed external biliary fistula. Three of these patients had their fistula ceased spontaneously within few weeks, while in one patient the fistula didn't show signs of ceasing so that injured duct had to be anastomosed with Roux-en-Y jejunal limb. Two out of four patients sent for external biliary fistula had it ceased spontaneously, while in two patients anastomosis between duct and Roux

  10. Normothermic Machine Perfusion Reduces Bile Duct Injury and Improves Biliary Epithelial Function in Rat Donor Livers

    NARCIS (Netherlands)

    Op den Dries, Sanna; Karimian, Negin; Westerkamp, Andrie C; Sutton, Michael E; Kuipers, Michiel; Wiersema-Buist, Janneke; Ottens, Petra J; Kuipers, Jeroen; Giepmans, Ben N; Leuvenink, Henri G D; Lisman, Ton; Porte, Robert J

    BACKGROUND: Bile duct injury may occur during liver procurement and transplantation, especially in livers donated after circulatory death (DCD). Normothermic machine perfusion (NMP) has been shown to reduce hepatic injury, compared to static cold storage (SCS). However, it is unknown whether NMP

  11. Changing patterns of traumatic bile duct injuries: a review of forty years experience

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Huang; Xiao-Qiang Huang

    2002-01-01

    AIM: To summarize the experiences of treating bile ductinjuries in 40 years of clinical practice.METHODS: Based on the experience of more than 40 yearsof clinical work, 122 cases including a series of 61 bile ductinjuries of the Southwest Hospital, Chongqing, and 42cases (1989-1997) and 19 cases (1998-2001) of the GeneralHospital of PLA, Beijing, cases were reviewed with specialreference to the pattern of injury. A series of cases of theliver and the biliary tract injuries following interventionaltherapy for hepatic tumors, most often hemangioma of theliver, were collected. Chinese medical literature from 1995 to1999 dealing with 2742 traumatic bile duct strictures werereviewed.RESULTS: There was a changing pattern of the bile ductinjury. Although most of the cases of bile duct injuriesresulted from open cholecystectomy. Other types of traumasuch as laparoscopic cholecystectomy (LC) and hepaticsurgery were increased in recent years. Moreover, serioushepato-biliary injuries following HAE using sclerotic agentssuch as sodium morrhuate and absolute ethanol for thetreatment of hepatic hemangiomas were encountered inrecent years. Experiences in how to avoid bile duct injuryand to treat traumatic biliary strictures were presented.CONCLUSION: Traumatic bile duct stricture is one of theserious complications of hepato-biliary surgery, itsprevalence seemed to be increased in recent years. Thepattern of bile duct injury was also changed and has becomemore complicated. Interventional therapy with sclerosingagents may cause serious hepatobiliary complications andshould be avoided.

  12. Normothermic machine perfusion reduces bile duct injury and improves biliary epithelial function in rat donor livers.

    Science.gov (United States)

    Op den Dries, Sanna; Karimian, Negin; Westerkamp, Andrie C; Sutton, Michael E; Kuipers, Michiel; Wiersema-Buist, Janneke; Ottens, Petra J; Kuipers, Jeroen; Giepmans, Ben N; Leuvenink, Henri G D; Lisman, Ton; Porte, Robert J

    2016-07-01

    Bile duct injury may occur during liver procurement and transplantation, especially in livers from donation after circulatory death (DCD) donors. Normothermic machine perfusion (NMP) has been shown to reduce hepatic injury compared to static cold storage (SCS). However, it is unknown whether NMP provides better preservation of bile ducts. The aim of this study was to determine the impact of NMP on bile duct preservation in both DCD and non-DCD livers. DCD and non-DCD livers obtained from Lewis rats were preserved for 3 hours using either SCS or NMP, followed by 2 hours ex vivo reperfusion. Biomarkers of bile duct injury (gamma-glutamyltransferase and lactate dehydrogenase in bile) were lower in NMP-preserved livers compared to SCS-preserved livers. Biliary bicarbonate concentration, reflecting biliary epithelial function, was 2-fold higher in NMP-preserved livers (P < 0.01). In parallel with this, the pH of the bile was significantly higher in NMP-preserved livers (7.63 ± 0.02 and 7.74 ± 0.05 for non-DCD and DCD livers, respectively) compared with SCS-preserved livers (7.46 ± 0.02 and 7.49 ± 0.04 for non-DCD and DCD livers, respectively). Scanning and transmission electron microscopy of donor extrahepatic bile ducts demonstrated significantly decreased injury of the biliary epithelium of NMP-preserved donor livers (including the loss of lateral interdigitations and mitochondrial injury). Differences between NMP and SCS were most prominent in DCD livers. Compared to conventional SCS, NMP provides superior preservation of bile duct epithelial cell function and morphology, especially in DCD donor livers. By reducing biliary injury, NMP could have an important impact on the utilization of DCD livers and outcome after transplantation. Liver Transplantation 22 994-1005 2016 AASLD.

  13. Thoracic Duct Chylous Fistula Following Severe Electric Injury Combined with Sulfuric Acid Burns: A Case Report

    Science.gov (United States)

    Chang, Fei; Cheng, Dasheng; Qian, Mingyuan; Lu, Wei; Li, Huatao; Tang, Hongtai; Xia, Zhaofan

    2016-01-01

    Patient: Male, 32 Final Diagnosis: Thoracic duct chylous fistula Symptoms: Fistula Medication: — Clinical Procedure: A boneless muscle flap transplantatio Specialty: — Objective: Rare disease Background: As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. Case Report: A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area). During treatment, chylous fistula developed in the left clavicular region, which we diagnosed as thoracic duct chylous fistula. We used diet control, intravenous nutritional support, and continuous somatostatin to reduce the chylous fistula output, and hydrophilic silver ion-containing dressings for wound coverage. A boneless muscle flap was used to seal the left clavicular cavity, and, integrated, these led to resolution of the chylous fistula. Conclusions: Patients with severe electric or chemical burns in the neck or chest may be complicated with thoracic duct injuries. Although conservative treatment can control chylous fistula, wound cavity filling using a muscle flap is an effective approach for wound healing. PMID:27725628

  14. Management of postlaparoscopic cholecystectomy major bile duct injury: Comparison of MRCP with conventional methods

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    Abou El-Ella Khalid

    2004-01-01

    Full Text Available Background: Postlaparoscopic cholecystectomy bile duct injury remains one of the devastating complications seen in current surgical practice. Aim of Study: This study describes the diagnostic role of magnetic resonance cholangiopancreatography (MRCP in such injuries compared with conventional methods. Patients and Methods: Eighteen patients referred to the Division of Hepatobiliary Surgery, King Khalid University Hospital from July 1998 to September 2000 were retrospectively studied. The technique of the repair was by utilizing Roux-en-Y hepaticojejunostomy with establishment of mucosa-to-mucosa anastomosis.The study included presentation, age and gender. Results: The presentation of patients were variable and frequently included pain, jaundice with or without cholangitis in 13 patients, bile leakage with development of biliary peritonitis in three, and development of external biliary fistula in two patients. Besides lower incidence of complication, MRCP was more diagnostic and informative in planning surgery by mapping both ducts proximal and distal to site of injury or stricture in 14 out of 18 patients. The Bismuth level of bile duct injuries were type I in one, type 11 in five, type III in 11 and type IV in one patient. All patients are alive, well and no complications occurred in the immediate postoperative period. Only two patients developed stricture within four months after surgery, one of them treated conservatively with repeated dilatation and stenting was done for the other. Conclusion: Hepaticojejunostomy is the procedure of choice for repair of bile duct injuries and provides adequate bilairy drainage. MRCP is an ideal diagnostic test when bile duct injury is suspected following laparoscopic cholecystectomy

  15. Poor agreement among expert witnesses in bile duct injury malpractice litigation: an expert panel survey.

    NARCIS (Netherlands)

    Reuver, PR de; Dijkgraaf, M.G.; Gevers, S.K.; Gouma, D.J.; Bleichrodt, R.P.; Cuesta, M.A.; Erp, W.F. van; Gerritsen, J.; Hesselink, E.J.; Laarhoven, C.J.H.M. van; Lange, J. de; Obertop, H.; Stassen, L.P.; Terpstra, O.T.; Tilanus, H.W.; Vroonhoven, T.J.; Wit, L. de

    2008-01-01

    OBJECTIVE: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. BACKGROUND DATA: Malpractice litigation is an increasing concern in modern surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

  16. Managing injuries of hepatic duct confluence variants after major hepatobiliary surgery: An algorithmic approach

    Institute of Scientific and Technical Information of China (English)

    Georgios Fragulidis; Athanasios Marinis; Andreas Polydorou; Christos Konstantinidis; Georgios Anastasopoulos; John Contis; Dionysios Voros; Vassilios Smyrniotis

    2008-01-01

    AIM:To investigate injuries of anatomy variants of hepatic duct confluence during hepatobiliary surgery and their impact on morbidity and mortality of these procedures. An algorithmic approach for the management of these injuries is proposed.METHODS: During a 6-year period 234 patients who had undergone major hepatobiliary surgery were retrospectively reviewed in order to study postoperative bile leakage. Diagnostic workup included endoscopic and magnetic retrograde cholangiopancreatography (E/MRCP), scintigraphy and fistulography.RESULTS: Thirty (12.8%) patients who developed postoperative bile leaks were identified. Endoscopic stenting and percutaneous drainage were successful in 23 patients with bile leaks from the liver cut surface.In the rest seven patients with injuries of hepatic duct confluence, biliary variations were recognized and a stepwise therapeutic approach was considered.Conservative management was successful only in 2 patients. Volume of the liver remnant and functional liver reserve as well as local sepsis were used as criteria for either resection of the corresponding liver segment or construction of a biliary-enteric anastomosis. Two deaths occurred in this group of patients with hepatic duct confluence variants (mortality rate 28.5%).CONCLUSION: Management of major biliary fistulae that are disconnected from the mainstream of the biliary tree and related to injury of variants of the hepatic duct confluence is extremely challenging. These patients have a grave prognosis and an early surgical procedure has to be considered.

  17. Thoracoscopic management of thoracic duct injury: Is there a place for conservatism?

    Directory of Open Access Journals (Sweden)

    Kumar S

    2004-01-01

    Full Text Available Thoracic duct injury is a rare but serious complication following chest surgeries and major neck dissections. Clinically, it can present as cervical chylous fistula, chylothorax or chylopericardium. Without treatment, the mortality is up to 50% and thus, early aggressive therapy is indicated. Traditional conservative management includes low-fat diet, parenteral nutrition, careful monitoring of fluid and electrolytes, and drainage of the neck wound or chylothorax. Patients with failed conservative management require definitive treatment in the form of ligation of the thoracic duct, which has traditionally been done by thoracotomy. The advent of Video-Assisted-Thoracoscopic-Surgery (VATS over the last decade has changed the approach towards the management of numerous chest diseases. Thoracoscopic ligation of the thoracic duct has also been reported. We report herein a case of postoperative cervical chylous fistula managed successfully by VATS thoracic duct ligation and present a systematic analysis of the English literature to highlight the current trends in the management of thoracic duct injury.

  18. 胆管损伤的预防与治疗指南(2008版)%Guideline for the prevention and management of bile duct injury (2008 edition)

    Institute of Scientific and Technical Information of China (English)

    中华医学会外科学分会胆道外科学组

    2008-01-01

    Bile duct injury is an important clinical problem associated with significantly high perioperative morbidity and mortality, reduced long-term survival and poor quality of life, as well as high rate of malpractice litigation following iatrogenic causes. The management of bile duct injury remains a considerable challenge for even the most skilled hepatobiliary surgeons. Based on this situation, the Biliary Surgery Group of Surgery Branch of Chinese Medical Association compiled the Guideline for the prevention and management of bile duct injury. The guideline systematically explains the concept, causes, classification, diagnosis and treatment of bile duct injury. Three categories of bile duct injury, including intrahepatic bile duct injury, extrahepatic bile duct injury and bile duct injury in the pancreaticoduodenal region are proposed according to the anatomical site, causes, pathological characters, prevention and treatment of bile duct injury. Four types and 4 subtypes of the extrahepatic bile duct injury are classified according to the anatomical plane of the injured bile duct and the pathological character of the main bile duct, respectively.

  19. Endoscopic treatment of post‐surgical bile duct injuries: long term outcome and predictors of success

    Science.gov (United States)

    de Reuver, Philip R; Rauws, Erik A; Vermeulen, Mattijs; Dijkgraaf, Marcel G W; Gouma, Dirk J; Bruno, Marco J

    2007-01-01

    Objective To analyse the short and long term outcome of endoscopic stent treatment after bile duct injury (BDI), and to determine the effect of multiple stent treatment. Design, setting and patients A retrospective cohort study was performed in a tertiary referral centre to analyse the outcome of endoscopic stenting in 67 patients with cystic duct leakage, 26 patients with common bile duct leakage and 110 patients with a bile duct stricture. Main outcome measures Long term outcome and independent predictors for successful stent treatment. Results Overall success in patients with cystic duct leakage was 97%. In patients with common bile duct leakage, stent related complications occurred in 3.8% (n = 1). The overall success rate was 89% (n = 23). In patients with a bile duct stricture, stent related complications occurred in 33% (n = 36) and the overall success rate was 74% (n = 81). After a mean follow up of 4.5 years, liver function tests did not identify “occult” bile duct strictures. Independent predictors for outcome were the number of stents inserted during the first procedure (OR 3.2 per stent; 95% CI 1.3 to 8.4), injuries classified as Bismuth III (OR 0.12; 95% CI 0.02 to 0.91) and IV (OR 0.04; CI 0.003 to 0.52) and endoscopic stenting before referral (OR 0.24; CI 0.06 to 0.88). Introduction of sequential insertion of multiple stents did not improve outcome (before 77% vs after 66%, p = 0.25), but more patients reported stent related pain (before 11% vs after 28%, p = 0.02). Conclusions In patients with a postoperative bile duct leakage and/or strictures, endoscopic stent treatment should be regarded as the choice of primary treatment because of safety and favourable long term outcome. Apart from the early insertion of more than one stent, the benefit from sequential insertion of multiple stents did not become readily apparent from this series. PMID:17595232

  20. Intraoperative assessment of biliary anatomy for prevention of bile duct injury : a review of current and future patient safety interventions

    NARCIS (Netherlands)

    Buddingh, K. Tim; Nieuwenhuijs, Vincent B.; van Buuren, Lianne; Hulscher, Jan B. F.; de Jong, Johannes S.; van Dam, Gooitzen M.

    2011-01-01

    Background Bile duct injury (BDI) is a dreaded complication of cholecystectomy, often caused by misinterpretation of biliary anatomy. To prevent BDI, techniques have been developed for intraoperative assessment of bile duct anatomy. This article reviews the evidence for the different techniques and

  1. Bile salt toxicity aggravates cold ischemic injury of bile ducts after liver transplantation in Mdr2+/- mice

    NARCIS (Netherlands)

    Hoekstra, H; Porte, RJ; Tian, Y; Jochum, W; Stieger, B; Moritz, W; Slooff, MJH; Graf, R; Clavien, PA

    2006-01-01

    Intrahepatic bile duct strictures are a serious complication after orthotopic liver transplantation (OLT). We examined the role of endogenous bile salt toxicity in the pathogenesis of bile duct injury after OLT. Livers from wild-type mice and mice heterozygous for disruption of the multidrug resista

  2. Fluorescent Imaging With Indocyanine Green During Laparoscopic Cholecystectomy in Patients at Increased Risk of Bile Duct Injury

    NARCIS (Netherlands)

    Ankersmit, M.; Dam, D.A. van; Rijswijk, A.S. van; Tuynman, J.B.; Meijerink, W.J.H.J.

    2017-01-01

    BACKGROUND: Although rare, injury to the common bile duct (CBD) during laparoscopic cholecystectomy (LC) can be reduced by better intraoperative visualization of the cystic duct (CD) and CBD. The aim of this study was to establish the efficacy of early visualization of the CD and the added value of

  3. Vitello-intestinal duct injury after transabdominal preperitoneal inguinal hernia repair.

    Science.gov (United States)

    Albeyatti, Amina; Hussain, Abdulzahra; El-Hasani, Shamsi

    2013-02-01

    A 71-year-old patient underwent a transabdominal preperitoneal right inguinal hernia repair and presented to the emergency department 48 hours postoperatively with nonspecific abdominal and chest pain and was diagnosed an abdominal abscess at the umbilicus by computed tomography. Laparotomy showed a vitello-intestinal duct injury caused by the umbilical trocar at his previous laparoscopic surgery. We will discuss this rare complication and how to avoid it in future practice.

  4. Late obstruction of the intrahepatic common bile duct after seat-belt injury.

    Science.gov (United States)

    Dryburgh, P R; White, J A

    1980-09-27

    A patient is reported in whom obstructive jaundice developed 10 weeks after seat-belt injury to the abdomen. Laparotomy at the time of injury revealed extensive lacerations of the liver and haematoma in the head of the pancreas. The patient's presentation with jaundice led to a diagnosis of an intrahepatic haematoma, falsely substantiated by radio-isotope studies. At operation, complete obstruction of the intrapancreatic portion of the common bile duct was found. This, most likely a result of vascular damage with subsequent cicatrization, was treated satisfactorily by choledochoduodenostomy.

  5. Bile duct ligation in mice: induction of inflammatory liver injury and fibrosis by obstructive cholestasis.

    Science.gov (United States)

    Tag, Carmen G; Sauer-Lehnen, Sibille; Weiskirchen, Sabine; Borkham-Kamphorst, Erawan; Tolba, René H; Tacke, Frank; Weiskirchen, Ralf

    2015-02-10

    In most vertebrates, the liver produces bile that is necessary to emulsify absorbed fats and enable the digestion of lipids in the small intestine as well as to excrete bilirubin and other metabolic products. In the liver, the experimental obstruction of the extrahepatic biliary system initiates a complex cascade of pathological events that leads to cholestasis and inflammation resulting in a strong fibrotic reaction originating from the periportal fields. Therefore, surgical ligation of the common bile duct has become the most commonly used model to induce obstructive cholestatic injury in rodents and to study the molecular and cellular events that underlie these pathophysiological mechanisms induced by inappropriate bile flow. In recent years, different surgical techniques have been described that either allow reconnection or reanastomosis after bile duct ligation (BDL), e.g., partial BDL, or other microsurgical methods for specific research questions. However, the most frequently used model is the complete obstruction of the common bile duct that induces a strong fibrotic response after 21 to 28 days. The mortality rate can be high due to infectious complications or technical inaccuracies. Here we provide a detailed surgical procedure for the BDL model in mice that induce a highly reproducible fibrotic response in accordance to the 3R rule for animal welfare postulated by Russel and Burch in 1959.

  6. Ultrasonographic measurement of normal common bile duct diameter and its correlation with age, sex and anthropometry.

    Science.gov (United States)

    Lal, Nidhi; Mehra, Simmi; Lal, Vivek

    2014-12-01

    Ultrasonography is the diagnostic method of choice for visualization and rational work-up of abdominal organs. The dilatation of the common bile duct helps distinguish obstructive from non-obstructive causes of jaundice. Availability of normal measurements of the common bile duct is therefore important. There exists significant variations in the anthropometric features of various populations, regions and races. Study was conducted to obtain data on sonographically measured diameters of common bile duct in a series of normal Rajasthani population and to measure its correlation with age, sex and anthropometry. Cross-sectional hospital-based study conducted at Mahatma Gandhi Medical College and Hospital, Jaipur, India. Study included 200 participants with equal proportion belonging to either sex. Common bile duct was measured at three locations- at the porta hepatis, in the most distal aspect of head of pancreas and mid-way between these points. Anthropometric measurements including height, weight, chest circumference, circumference at transpyloric plane, circumference at umbilicus and circumference at hip were obtained using standard procedures. Univariable analysis with measures of frequency and standard deviation and bivariable analysis using correlation. Mean age of study subjects was 34.5 years (Range 18-85 years). Mean diameters of the common bile duct in the three locations were: proximal, 4.0 mm (SD 1.02 mm); middle, 4.1 mm (SD 1.01 mm); and distal, 4.2 mm (SD 1.01 mm) and overall mean for all measures 4.1 mm (SD 1.01 mm). Average diameter ranged from 2.0 mm to 7.9 mm, with 95 percent of the subjects having a diameter of less than 6 mm. We observed a statistically significant relation of common bile duct with age, along with a linear trend. There was no statistically significant difference in common bile duct diameter between male and female subjects. The diameter did not show any statistically significant correlation with any of the anthropometric

  7. Protective effect of gadolinium chloride on early warm ischemia/reperfusion injury in rat bile duct during liver transplantation.

    Directory of Open Access Journals (Sweden)

    Biao Wang

    Full Text Available BACKGROUND: Activation of Kupffer cell (KC is acknowledged as a key event in the initiation and perpetuation of bile duct warm ischemia/reperfusion injury. The inhibitory effect of gadolinium chloride (GdCl(3 on KC activation shows potential as a protective intervention in liver injury, but there is less research with regard to bile duct injury. METHODS: Sixty-five male Sprague-Dawley rats (200-250 g were randomly divided into three experimental groups: a sham group (n = 15, a control group (n = 25, and a GdCl(3 group (n = 25. Specimen was collected at 0.5, 2, 6, 12 and 24 h after operation. Alanine aminotransferase (ALT, alkaline phosphatase (ALP and total bilirubin (TBIL of serum were measured. Tumor necrosis factor-α (TNF-α, Capase-3 activity and soluble Fas (sFas were detected. The pathologic changes of bile duct were observed. Immunochemistry for bile duct Fas was performed. Apoptosis of bile duct cells was evaluated by the terminal UDP nick end labeling assay. RESULTS: GdCl(3 significantly decreased the levels of ALT, ALP and TBIL at 2, 6, 12, and 24 h, and increased serum sFas at 2, 6 and 12 h (P<0.05. TNF-α was lower in the GdCl(3 group than in the control group at 2, 6, 12 and 24 h (P<0.05. Preadministration of GdCl(3 significantly reduced the Caspase-3 activity and bile duct cell apoptosis at 2, 6, 12 and 24 h. After operation for 2, 6 and 12 h, the expression of Fas protein was lower in the GdCl(3 group than in the control group (P<0.05. CONCLUSIONS: GdCl(3 plays an important role in suppressing bile duct cell apoptosis, including decreasing ALT, ALP, TBIL and TNF-α; suppressing Fas-FasL-Caspase signal transduction during transplantation.

  8. Effectiveness of a barbed suture in the repair of bile duct injury during laparoscopic cholecystectomy: Report of two cases

    Directory of Open Access Journals (Sweden)

    Yusuke Takahashi

    2016-01-01

    Conclusion: We believe that the V-Loc™ device is an effective and appropriate option for bile duct injuries that occur during laparoscopic cholecystectomies, particularly around the gallbladder bed, and it is especially useful for surgeons unfamiliar with intracorporeal knot tying.

  9. Lymphoscintigraphy SPECT/CT: Instrumental Navigator in Repair of Thoracic Duct Injury

    Energy Technology Data Exchange (ETDEWEB)

    Abaziz, Aini; Yusop, Syahrir M. [Universiti Kabangsaan Malaysia Medical Centre, Kuala Lumpur (Malaysia); Tahir, Mohd Fadzil Mohd; Lim, Yew Cheng [Gleneagles Intan Medical Centre, Kuala Lumpur (Malaysia); Gallowitsch, Hans-Jurgen [Nuclear Medicine and PETCT Centre, Klagenfurt (Australia)

    2016-06-15

    A 25-year-old female underwent resection of a large mediastinal tumour which was complicated by copious chylothorax, being worse on the left side. Minimally-in-vasive video-assisted thoracoscopic surgery (VATS) via a left-sided approach was performed and the severed ends of the thoracic duct were ligated. This only achieved temporary reduction of the amount of chylothorax, leading to a second attempt to repair the persistent leak. This prompted the surgeon to take a different approach from the previous two attempts. It was deemed too risky and potentially futile to further attempt to go after the leakage sites bilaterally. Hence, the surgeon performed a right thoracotomy to ligate the thoracic duct proximal to the leakage sites at the aortic hiatus. this successfully stopped the leak permanently. Planar lymphoscintigraphy lacks accurate anatomical depiction which SPECT-CT could offer. Conversely, anatomical imaging failed to locate the site of the leak. SPECT/CT Lymphoscintigraphy overcomes the limitation of either imaging alone, and has been reported to be valuable in documenting and depicting sites of injury. In this case, the SPECT-CT depiction and confirmation of bilateral leakage sites was pivotal in guiding the surgeon to take a different approach and achieve a permanent solution to the persistent chloroethoxy.

  10. Immune-mediated bile duct injury: The case of primary biliary cirrhosis

    Science.gov (United States)

    Selmi, Carlo; Affronti, Andrea; Ferrari, Laura; Invernizzi, Pietro

    2010-01-01

    Autoimmune cholangitis would be the appropriate name to define the immune-mediated bile duct injury following the breakdown of tolerance to mitochondrial proteins and the appearance of serum autoantibodies and autoreactive T cells. Nevertheless, the condition is universally named primary biliary cirrhosis (PBC). The disease etiology and pathogenesis remain largely unknown despite the proposed lines of evidence. One twin study and numerous epidemiology reports suggest that both a susceptible genetic background and environmental factors determine disease onset while a recent genome-wide association study proposed highly significant associations with several common genetic polymorphisms in subgroups of patients. Specific infectious agents and chemicals may contribute to the disease onset and perpetuation in a genetically susceptible host, possibly through molecular mimicry. Importantly, several murine models have been proposed and include strains in which PBC is genetically determined or induced by immunization with chemicals and bacteria. From a pathogenetic standpoint, new exciting data have demonstrated the unique apoptotic features of bile duct cells that allow the mitochondrial autoantigens to be taken up in their intact form within apoptotic blebs. We are convinced that the application of the most recent molecular techniques will soon provide developments in PBC etiology and pathogenesis with likely implications in diagnostics and therapeutics. PMID:21607152

  11. Management of traumatic bile duct injury%外伤性胆道损伤的处理

    Institute of Scientific and Technical Information of China (English)

    张剑; 王剑明; 杨彦; 刘颜; 何俊闯; 齐卫鹏; 钱亚伟; 付阳

    2014-01-01

    患者发生迟发性胆汁漏及再发胆道狭窄.结论 外伤性胆道损伤的部位隐蔽,易漏诊,常于术中确诊.患者常合并休克和腹腔其他脏器损伤,治疗上应在抗休克治疗的同时尽早行剖腹探查术,并基于损伤程度和部位选择最佳的胆道重建手术.%Objective To investigate the management of traumatic bile duct injury.Methods The clinical data of 26 patients with traumatic bile duct injury were retrospectively analyzed.All the patients were admitted to the Tongji Hospital of the Huazhong University of Science and Technology from July 2009 to May 2014.All the 26 patients had the history of trauma.The trauma of the patients were typed according to the Mattox injury typing system.Besides anti-shock treatment,cholecystectomy,bile duct repair,end-to-end anastomosis of bile duct,choledochojejunostomy and quadrate lobectomy + hilar bile duct reshaping + hepaticojejunostomy were selected according to the site and degree of the injury.Symptomatic treatment was applied to patients who were combined with other organs injury.Patients were followed up via out-patient examination and telephone interview till October 2014.Results Twenty-six patients received exploratory laparotomy,and gallbladder injury was detected in 15 patients,common bile duct injury in 5 patients,common hepatic duct injury in 3 patients,left hepatic duct injury in 2 patients,right hepatic duct in 1 patient.Eleven patients were combined with hepatic rupture,1 with splenic rupture,5 with renal rupture,4 with small intestinal rupture.Eleven patients were with type Ⅰ bile duct injury,4 with type Ⅱ bile duct injury,8 with type Ⅳ bile duct injury and 3 with type Ⅴ bile duct injury.Of the 15patients with gallbladder injury,5 patients with slight bruise of the gallbladder did not receive cholecystectomy.Six patients and 4 patients with type Ⅰ and Ⅱ bruise of the gallbladder received cholecystectomy.Of the 11 patients with hepatic and bile duct injury,5

  12. Heme oxygenase-1 overexpression increases liver injury after bile duct ligation in rats

    Institute of Scientific and Technical Information of China (English)

    Matthias Froh; Ronald G Thurman; Lars Conzelmann; Peter Walbrun; Susanne Netter; Reiner Wiest; Michael D Wheeler; Mark Lehnert; Takehiko Uesugi; Jurgen Scholmerich

    2007-01-01

    AIM: To investigate the effects of heme oxygenase-1(HO-1) against oxidant-induced injury caused by bile duct ligation (BDL).METHODS: Either cobalt protoporphyrin (CoPP), a HO-1 inducer, or saline were injected intraperitoneally in male SD-rats. Three days later, BDL or sham-operations were performed. Rats were sacrificed 3 wk after BDL and livers were harvested for histology. Fibrosis was evaluated by sirius red staining and image analysis.Alpha-smooth muscular actin, which indicates activation of stellate cells, was detected by immunohistochemical staining, and cytokine and collagen- Ⅰα (Col- Ⅰα) mRNA expression was detected using RNase protection assays.RESULTS: Serum alanine transaminase increased 8-fold above normal levels one day after BDL. Surprisingly,enzyme release was not reduced in rats receiving CoPP.Liver fibrosis was evaluated 3 wk after BDL and the sirius red-positive area was found to be increased to about 7.8%. However, in CoPP pretreated rats sirius redpositive areas were increased to about 11.7% after BDL.Collagen- Ⅰα and TGF-β mRNA increased significantly by BDL. Again, this effect was increased by HO-1overexpression.CONCLUSION: Hepatic fibrosis due to BDL is not reduced by the HO-1 inducer CoPP. In contrast, HO-1overexpression increases liver injury in rats under conditions of experimental chronic cholestasis.

  13. Quality of life after iatrogenic bile duct injury: a case control study.

    LENUS (Irish Health Repository)

    Hogan, Aisling M

    2012-02-01

    OBJECTIVE: To compare quality of life (QOL) of patients following iatrogenic bile duct injuries (BDI) to matched controls. SUMMARY BACKGROUND DATA: BDI complicate approximately 0.3% of all cholecystectomy procedures. The literature regarding impact on quality of life is conflicted as assessment using clinical determinants alone is insufficient. METHODS: The medical outcomes study short form 36 (SF-36), a sensitive tool for quantification of life quality outcome, was used. The study group of iatrogenic BDI was compared with an age- and sex-matched group who underwent uncomplicated cholecystectomy. Telephone questionnaire using the SF-36 quality of life tool was administered to both groups at a median postoperative time of 12 years 8 months (range, 2 months -20 years). RESULTS: Seventy-eight patients were referred with BDI but due to mortality (n = 10) and unavailability (n = 6) 62 participated. The age- and sex-matched control cohort had undergone uncomplicated cholecystectomy (n = 62). Comparison between groups revealed that 7 of 8 variables examined were statistically similar to those of the control group (physical functioning, role physical, bodily pain, general health perceptions, vitality and social functioning, and mental health index). Mean role emotional scores were slightly worse in the BDI group (46 vs. 50) but the significance was borderline (P = 0.045). Subgroup analysis by method of intervention for BDI did not demonstrate significant differences. CONCLUSION: Quality of life of surviving patients following BDI compares favorably to that after uncomplicated laparoscopic cholecystectomy.

  14. Dietary glycine blunts liver injury after bile duct ligation in rats

    Institute of Scientific and Technical Information of China (English)

    Matthias Froh; Juirgen Scholmerich; Ronald G Thurman; Zhi Zhong; Peter Walbrun; Mark Lehnert; Susanne Netter; Reiner Wiest; Lars Conzelmann; Erwin Gaibele; Claus Hellerbrand

    2008-01-01

    AIM: To investigate the effects of (dietary) glycine against oxidant-induced injury caused by bile duct ligation (BDL).METHODS: Either a diet containing 5% glycine or a standard diet was fed to male Sprague-Dawley (SD) rats. Three days later, BDL or sham-operation was performed. Rats were sacrificed 1 to 3 d after BDL. The influence of deoxycholic acid (DCA) in the presence or absence of glycine on liver cells was determined by measurement of calcium and chloride influx in cultivated Kupffer cells and lactate dehydrogenase (LDH) activity was determined in the supernatant of cultivated hepatocytes.RESULTS: Serum alanine transaminase levels increased to about 600 U/L 1 d after BDL. However, enzyme release was blunted by about two third in rats receiving glycine. Release of the alkaline phosphatase and aspartate aminotransferase was also blocked significantly in the group fed glycine. Focal necrosis was observed 2 d after BDL. Glycine partially blocked the histopathological changes. Incubation of Kupffer cells with DCA led to increased intracellular calcium that could be blocked by incubation with glycine. However, systemic blockage of Kupffer cells with gadolinium chloride had no effects on transaminase release. Incubation of isolated hepatocytes with DCA led to a significant release of LDH after 4 h. This release was largely blocked when incubation with glycine was performed.CONCLUSION: These data indicate that glycine significantly decreased liver injury, most likely by a direct effect on hepatocytes. Kupffer cells do not appear to play an important role in the pathological changes caused by cholestasis.

  15. Dietary glycine blunts liver injury after bile duct ligation in rats

    Science.gov (United States)

    Froh, Matthias; Zhong, Zhi; Walbrun, Peter; Lehnert, Mark; Netter, Susanne; Wiest, Reiner; Conzelmann, Lars; Gäbele, Erwin; Hellerbrand, Claus; Schölmerich, Jürgen; Thurman, Ronald G

    2008-01-01

    AIM: To investigate the effects of (dietary) glycine against oxidant-induced injury caused by bile duct ligation (BDL). METHODS: Either a diet containing 5% glycine or a standard diet was fed to male Sprague-Dawley (SD) rats. Three days later, BDL or sham-operation was performed. Rats were sacrificed 1 to 3 d after BDL. The influence of deoxycholic acid (DCA) in the presence or absence of glycine on liver cells was determined by measurement of calcium and chloride influx in cultivated Kupffer cells and lactate dehydrogenase (LDH) activity was determined in the supernatant of cultivated hepatocytes. RESULTS: Serum alanine transaminase levels increased to about 600 U/L 1 d after BDL. However, enzyme release was blunted by about two third in rats receiving glycine. Release of the alkaline phosphatase and aspartate aminotransferase was also blocked significantly in the group fed glycine. Focal necrosis was observed 2 d after BDL. Glycine partially blocked the histopathological changes. Incubation of Kupffer cells with DCA led to increased intracellular calcium that could be blocked by incubation with glycine. However, systemic blockage of Kupffer cells with gadolinium chloride had no effects on transaminase release. Incubation of isolated hepatocytes with DCA led to a significant release of LDH after 4 h. This release was largely blocked when incubation with glycine was performed. CONCLUSION: These data indicate that glycine significantly decreased liver injury, most likely by a direct effect on hepatocytes. Kupffer cells do not appear to play an important role in the pathological changes caused by cholestasis. PMID:18932277

  16. Tetrathiomolybdate protects against bile duct ligation-induced cholestatic liver injury and fibrosis.

    Science.gov (United States)

    Song, Ming; Song, Zhenyuan; Barve, Shirish; Zhang, Jingwen; Chen, Theresa; Liu, Marcia; Arteel, Gavin E; Brewer, George J; McClain, Craig J

    2008-05-01

    Tetrathiomolybdate (TM), a potent copper-chelating drug, was initially developed for the treatment of Wilson's disease. Our working hypothesis is that the fibrotic pathway is copper-dependent. Because biliary excretion is the major pathway for copper elimination, a bile duct ligation (BDL) mouse model was used to test the potential protective effects of TM. TM was given in a daily dose of 0.9 mg/mouse by means of intragastric gavage 5 days before BDL. All the animals were killed 5 days after surgery. Plasma liver enzymes and total bilirubin were markedly decreased in TM-treated BDL mice. TM also inhibited the increase in plasma levels of tumor necrosis factor (TNF)-alpha and transforming growth factor (TGF)-beta1 seen in BDL mice. Cholestatic liver injury was markedly attenuated by TM treatment as shown by histology. Hepatic collagen deposition was significantly decreased, and it was paralleled by a significant suppression of hepatic smooth muscle alpha-actin and fibrogenic gene expression in TM-treated BDL mice. Although the endogenous antioxidant ability was enhanced, oxidative stress as shown by malondialdehyde and 4-hydroxyalkenals, hepatic glutathione/oxidized glutathione ratio, was not attenuated by TM treatment, suggesting the protective mechanism of TM may be independent of oxidative stress. In summary, TM attenuated BDL-induced cholestatic liver injury and fibrosis in mice, in part by inhibiting TNF-alpha and TGF-beta1 secretion. The protective mechanism seems to be independent of oxidative stress. Our data provide further evidence that TM might be a potential therapy for hepatic fibrosis.

  17. Detection of Autoantibodies to Vascular Endothelial Growth Factor Receptor-3 in Bile Duct Ligated Rats and Correlations with a Panel of Traditional Markers of Liver Diseases

    Directory of Open Access Journals (Sweden)

    Florent Duval

    2016-01-01

    Full Text Available There is a need for new noninvasive biomarkers (NIBMs able to assess cholestasis and fibrosis in chronic cholestatic liver diseases (CCLDs. Tumorigenesis can arise from CCLDs. Therefore, autoantibodies to tumor-associated antigens (TAA may be early produced in response to abnormal self-antigen expression caused by cholestatic injury. Vascular endothelial growth factor receptor-3 (VEGFR-3 has TAA potential since it is involved in cholangiocytes and lymphatic vessels proliferations during CCLDs. This study aims to detect autoantibodies directed at VEGFR-3 during bile duct ligation- (BDL- induced cholestatic injury in rat sera and investigate whether they could be associated with traditional markers of liver damage, cholestasis, and fibrosis. An ELISA was performed to detect anti-VEGFR-3 autoantibodies in sera of rats with different degree of liver injury and results were correlated with aminotransferases, total bilirubin, and the relative fibrotic area. Mean absorbances of anti-VEGFR-3 autoantibodies were significantly increased from week one to week five after BDL. The highest correlation was observed with total bilirubin (R2 = 0.8450, P=3.04e-12. In conclusion, anti-VEGFR-3 autoantibodies are early produced during BDL-induced cholestatic injury, and they are closely related to cholestasis, suggesting the potential of anti-VEGFR-3 autoantibodies as NIBMs of cholestasis in CCLDs and justifying the need for further investigations in patients with CCLD.

  18. Classiifcation of iatrogenic bile duct injur y

    Institute of Scientific and Technical Information of China (English)

    Wan-Yee Lau; Eric C.H. Lai

    2007-01-01

    BACKGROUND: Iatrogenic bile duct injury continues to be an important clinical problem, resulting in serious morbidity, and occasional mortality, to patients. The ease of management, operative risk, and outcome of bile duct injuries vary considerably, and are highly dependent on the type of injury and its location. This article reviews the various classiifcation systems of bile duct injury. DATA SOURCES: A Medline, PubMed database search was performed to identify relevant articles using the keywords"bile duct injury", "cholecystectomy", and “classiifcation”. Additional papers were identiifed by a manual search of the references from the key articles. RESULTS: Traditionally, biliary injuries have been classiifed using the Bismuth's classiifcation. This classiifcation, which originated from the era of open surgery, is intended to help the surgeons to choose the appropriate technique for the repair, and it has a good correlation with the ifnal outcome after surgical repair. However, the Bismuth's classiifcation does not encompass the whole spectrum of injuries that are possible. Bile duct injury during laparoscopic cholecystectomy tends to be more severe than those with open cholecystectomy. Strasberg’s classiifcation made Bismuth’s classiifcation much more comprehensive by including various other types of extrahepatic bile duct injuries. Our group, Bergman et al, Neuhaus et al, Csendes et al, and Stewart et al have also proposed other classiifcation systems to complement the Bismuth's classiifcation. CONCLUSIONS:None of the classiifcation system is universally accepted as each has its own limitation. Hopefully, a universally accepted comprehensive classiifcation system will be published in the near future.

  19. Application of a new-type sutureless anastomosis stent to the primary reconstruction of the bilioenteric continuity after acute bile duct injury in dogs

    Institute of Scientific and Technical Information of China (English)

    Jianhui Li; Yi Lü; Bo Qu; Zhiyong Zhang; Chang Liu; Yuan Shi; Bo Wang; Xuewen Ji; Liang Yu

    2007-01-01

    Objective: To evaluate the effect of a new-type sutureless magnetic bilioenteric anastomosis stent that was used to reconstruct the bilioenteric continuity (primarily under the circumstances of severe inflammation after acute bile duct injury in dogs).Methods: Establishing an animal model of acute bile duct injury with severe inflammation and bile peritonitis in dogs. The newtype sutureless magnetic bilioenteric anastomosis stent was used to reconstruct the bilioenteric continuity primarily. Results: The experiment group anastomosis healed well with a mild local inflammation reaction, and the collagen lined up in order without the occurrence of observable bile leakage and infection. Conclusion: It was safe and feasible to use the new-type anastomosis stent to reconstruct the bilioenteric continuity primarily under the circumstances of severe inflammation after acute bile duct injury in dogs.

  20. Dendritic Cells Regulate Treg-Th17 Axis in Obstructive Phase of Bile Duct Injury in Murine Biliary Atresia.

    Science.gov (United States)

    Liu, Yong-Jun; Li, Kang; Yang, Li; Tang, Shao-Tao; Wang, Xin-Xing; Cao, Guo-Qing; Li, Shuai; Lei, Hai-Yan; Zhang, Xi

    2015-01-01

    Several cell types are considered to be effector cells in bile duct injury in rhesus rotavirus (RRV)-induced experimental biliary atresia (BA). Here, we identified an increased T helper 17 (Th17) cell population in a BA mode. By depleting the Th17 cells, the BA symptoms (onset of jaundice, acholic stools and retarded growth) were attenuated and the survival rate was improved. Furthermore, we found that in mice with BA, the percentage of CD4+CD25highFoxp3+ T regulatory (Treg) cells decreased along with the increased percentage of Th17 cells. However, the absolute numbers of Treg and Th17 cells were both increased in liver of RRV-injected mice compared to saline-injected mice. The proportion of Th17 cells at 7 days post-infection was decreased if Treg cells isolated from normal adult mice, but not Treg cells from the livers of mice with BA, were intraperitoneally transferred on day 5 of life. In vitro experiments also showed that Treg cells from mice with BA had a diminished suppressive effect on Th17 cell generation. To determine the mechanisms, we investigated the production of cytokines in the liver. The level of IL-6, which has been shown to be abundantly secreted by activated dendritic cells (DCs), was remarkably elevated. Importantly, in a Treg/Th17 cell suppression assay, IL-6 was demonstrated to paralyze the Treg cells' suppressive effect on Th17 cells and eventually the unrestrained increase of Th17 cells contributed to bile duct injury. In conclusion, the DC-regulated Treg-Th17 axis, probably in conjunction with other effector T cells, aggravates progressive inflammatory injury at the time of ductal obstruction.

  1. Percutaneous transhepatic balloon dilation of biliary-enteric anastomotic strictures after surgical repair of iatrogenic bile duct injuries.

    Directory of Open Access Journals (Sweden)

    Andrew Y Lee

    Full Text Available PURPOSE: To evaluate the efficacy of percutaneous balloon dilation of biliary-enteric anastomotic strictures resulting from surgical repair of laparoscopic cholecystectomy-related bile duct injuries. MATERIAL AND METHODS: A total of 61 patients were referred to our institution from 1995 to 2010 for treatment of obstruction at the biliary-enteric anastomosis following surgical repair of laparoscopic cholecystectomy-related bile duct injuries. Of these 61 patients, 27 underwent surgical revision upon stricture diagnosis, and 34 patients were managed using balloon dilation. Of these 34 patients, 2 were lost to follow up, leaving 32 patients for analysis. The primary study objective was to determine the clinical success rate of balloon dilation of biliary-enteric anastomotic strictures. Secondary study objectives included determining anastomosis patency, rates of stricture recurrence following treatment, and morbidity. RESULTS: Balloon dilation of biliary-enteric anastomotic strictures was clinically successful in 21 of 32 patients (66%. Anastomotic stricture recurred in one of 21 patients (5% after an average of 13.1 years of follow-up. Patients who were unsuccessfully managed with balloon dilation required significantly more invasive procedures (6.8 v. 3.4; p = 0.02 and were left with an indwelling biliary catheter for a significantly longer period of time (8.8 v. 2.0 months; p = 0.02 than patients whose strictures could be resolved by balloon dilation. No significant differences in the number of balloon dilations performed (p = 0.17 or in the maximum balloon diameter used (p = 0.99 were demonstrated for patients with successful or unsuccessful balloon dilation outcomes. CONCLUSION: Percutaneous balloon dilation of anastomotic biliary strictures following surgical repair of laparoscopic cholecystectomy-related injuries may result in lasting patency of the biliary-enteric anastomosis.

  2. Normothermic acellular ex vivo liver perfusion reduces liver and bile duct injury of pig livers retrieved after cardiac death.

    Science.gov (United States)

    Boehnert, M U; Yeung, J C; Bazerbachi, F; Knaak, J M; Selzner, N; McGilvray, I D; Rotstein, O D; Adeyi, O A; Kandel, S M; Rogalla, P; Yip, P M; Levy, G A; Keshavjee, S; Grant, D R; Selzner, M

    2013-06-01

    We compared cold static with acellular normothermic ex vivo liver perfusion (NEVLP) as a novel preservation technique in a pig model of DCD liver injury. DCD livers (60 min warm ischemia) were cold stored for 4 h, or treated with 4 h cold storage plus 8 h NEVLP. First, the livers were reperfused with diluted blood as a model of transplantation. Liver injury was determined by ALT, oxygen extraction, histology, bile content analysis and hepatic artery (HA) angiography. Second, AST levels and bile production were assessed after DCD liver transplantation. Cold stored versus NEVLP grafts had higher ALT levels (350 ± 125 vs. 55 ± 35 U/L; p < 0.0001), decreased oxygen extraction (250 ± 65 mmHg vs. 410 ± 58 mmHg, p < 0.01) and increased hepatocyte necrosis (45% vs. 10%, p = 0.01). Levels of bilirubin, phospholipids and bile salts were fivefold decreased, while LDH was sixfold higher in cold stored versus NEVLP grafts. HA perfusion was decreased (twofold), and bile duct necrosis was increased (100% vs. 5%, p < 0.0001) in cold stored versus NEVLP livers. Following transplantation, mean serum AST level was higher in the cold stored versus NEVLP group (1809 ± 205 U/L vs. 524 ± 187 U/L, p < 0.05), with similar bile production (2.5 ± 1.2 cc/h vs. 2.8 ± 1.4 cc/h; p = 0.2). NEVLP improved HA perfusion and decreased markers of liver duct injury in DCD grafts. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

  3. End-ischemic machine perfusion reduces bile duct injury in donation after circulatory death rat donor livers independent of the machine perfusion temperature.

    Science.gov (United States)

    Westerkamp, Andrie C; Mahboub, Paria; Meyer, Sophie L; Hottenrott, Maximilia; Ottens, Petra J; Wiersema-Buist, Janneke; Gouw, Annette S H; Lisman, Ton; Leuvenink, Henri G D; Porte, Robert J

    2015-10-01

    A short period of oxygenated machine perfusion (MP) after static cold storage (SCS) may reduce biliary injury in donation after cardiac death (DCD) donor livers. However, the ideal perfusion temperature for protection of the bile ducts is unknown. In this study, the optimal perfusion temperature for protection of the bile ducts was assessed. DCD rat livers were preserved by SCS for 6 hours. Thereafter, 1 hour of oxygenated MP was performed using either hypothermic machine perfusion, subnormothermic machine perfusion, or with controlled oxygenated rewarming (COR) conditions. Subsequently, graft and bile duct viability were assessed during 2 hours of normothermic ex situ reperfusion. In the MP study groups, lower levels of transaminases, lactate dehydrogenase (LDH), and thiobarbituric acid reactive substances were measured compared to SCS. In parallel, mitochondrial oxygen consumption and adenosine triphosphate (ATP) production were significantly higher in the MP groups. Biomarkers of biliary function, including bile production, biliary bicarbonate concentration, and pH, were significantly higher in the MP groups, whereas biomarkers of biliary epithelial injury (biliary gamma-glutamyltransferase [GGT] and LDH), were significantly lower in MP preserved livers. Histological analysis revealed less injury of large bile duct epithelium in the MP groups compared to SCS. In conclusion, compared to SCS, end-ischemic oxygenated MP of DCD livers provides better preservation of biliary epithelial function and morphology, independent of the temperature at which MP is performed. End-ischemic oxygenated MP could reduce biliary injury after DCD liver transplantation. © 2015 American Association for the Study of Liver Diseases.

  4. End-ischemic machine perfusion reduces bile duct injury in donation after circulatory death rat donor livers independent of the machine perfusion temperature

    NARCIS (Netherlands)

    Westerkamp, Andrie C.; Mahboub, Paria; Meyer, Sophie L.; Hottenrott, Maximilia; Ottens, Petra J.; Wiersma-Buist, Janneke; Gouw, Annette S. H.; Lisman, Ton; Leuvenink, Henri G. D.; Porte, Robert J.

    2015-01-01

    A short period of oxygenated machine perfusion (MP) after static cold storage (SCS) may reduce biliary injury in donation after cardiac death (DCD) donor livers. However, the ideal perfusion temperature for protection of the bile ducts is unknown. In this study, the optimal perfusion temperature for

  5. Rolipram Attenuates Bile Duct Ligation–Induced Liver Injury in Rats: A Potential Pathogenic Role of PDE4

    Science.gov (United States)

    Barve, Shirish; Breitkopf-Heinlein, Katja; Li, Yan; Zhang, JingWen; Avila, Diana V.; Dooley, Steven; McClain, Craig J.

    2013-01-01

    Anti-inflammatory and antifibrotic effects of the broad spectrum phosphodiesterase (PDE) inhibitor pentoxifylline have suggested an important role for cyclic nucleotides in the pathogenesis of hepatic fibrosis; however, studies examining the role of specific PDEs are lacking. Endotoxemia and Toll-like receptor 4 (TLR4)-mediated inflammatory and profibrotic signaling play a major role in the development of hepatic fibrosis. Because cAMP-specific PDE4 critically regulates lipopolysaccharide (LPS)-TLR4–induced inflammatory cytokine expression, its pathogenic role in bile duct ligation-induced hepatic injury and fibrogenesis in Sprague-Dawley rats was examined. Initiation of cholestatic liver injury and fibrosis was accompanied by a significant induction of PDE4A, B, and D expression and activity. Treatment with the PDE4-specific inhibitor rolipram significantly decreased liver PDE4 activity, hepatic inflammatory and profibrotic cytokine expression, injury, and fibrosis. At the cellular level, in relevance to endotoxemia and inflammatory cytokine production, PDE4B was observed to play a major regulatory role in the LPS-inducible tumor necrosis factor (TNF) production by isolated Kupffer cells. Moreover, PDE4 expression was also involved in the in vitro activation and transdifferentiation of isolated hepatic stellate cells (HSCs). Particularly, PDE4A, B, and D upregulation preceded induction of the HSC activation marker α-smooth muscle actin (α-SMA). In vitro treatment of HSCs with rolipram effectively attenuated α-SMA, collagen expression, and accompanying morphologic changes. Overall, these data strongly suggest that upregulation of PDE4 expression during cholestatic liver injury plays a potential pathogenic role in the development of inflammation, injury, and fibrosis. PMID:23887098

  6. Foetal serum but not urinary β2-microglobulin correlates with histological injury to the kidney.

    Science.gov (United States)

    Luton, D; Delezoide, A L; Leguy, M C; Gobeaux, C; Vuillard, E; Grangé, G; Guibourdenche, J

    2013-10-01

    In a context of foetal obstructive uropathies, biochemical markers can be helpful to assess the renal function, but most studies to date have focused on their correlation with ultrasound findings and neonatal outcome. Our aim was to evaluate foetal β2-microglobulin as an index of histological injury to the kidney. β2-microglobulin was measured in serum and/or urine from 27 foetuses with bilateral obstructive uropathy, and compared to the findings of kidney examination following the termination of pregnancy. In serum, increased β2-microglobulin levels correlated to a decreased number of glomeruli, a reduction in the blastema and the presence of primitive ducts reflecting renal hypoplasia and dysplasia. However, elevated β2-microglobulin levels in the urine correlated only to a decreased number of glomeruli.

  7. Family dynamics and self-injury behaviors: a correlation analysis.

    Science.gov (United States)

    Halstead, Ruth Ogden; Pavkov, Thomas W; Hecker, Lorna L; Seliner, Michelle M

    2014-04-01

    This study tested the relationship between family dynamics and self-injury. A total of 189 participants responded to a web-based survey collecting information related to previous self-injury behaviors and family dynamics. Participants were over 18 years old who had used self-injury (intentionally harming themselves physically to relieve painful emotions without suicidal intent), but who had not used self-injury for over a year. Results indicated that healthy family dynamics were negatively correlated and associated with higher scores of self-injury behaviors. This study offers some evidence that family dynamics influence self-injury behaviors. The implications for family therapy are discussed.

  8. Subnormothermic ex vivo liver perfusion reduces endothelial cell and bile duct injury after donation after cardiac death pig liver transplantation.

    Science.gov (United States)

    Knaak, Jan M; Spetzler, Vinzent N; Goldaracena, Nicolas; Boehnert, Markus U; Bazerbachi, Fateh; Louis, Kristine S; Adeyi, Oyedele A; Minkovich, Leonid; Yip, Paul M; Keshavjee, Shaf; Levy, Gary A; Grant, David R; Selzner, Nazia; Selzner, Markus

    2014-11-01

    An ischemic-type biliary stricture (ITBS) is a common feature after liver transplantation using donation after cardiac death (DCD) grafts. We compared sequential subnormothermic ex vivo liver perfusion (SNEVLP; 33°C) with cold storage (CS) for the prevention of ITBS in DCD liver grafts in pig liver transplantation (n = 5 for each group). Liver grafts were stored for 10 hours at 4°C (CS) or preserved with combined 7-hour CS and 3-hour SNEVLP. Parameters of hepatocyte [aspartate aminotransferase (AST), international normalized ratio (INR), factor V, and caspase 3 immunohistochemistry], endothelial cell (EC; CD31 immunohistochemistry and hyaluronic acid), and biliary injury and function [alkaline phosphatase (ALP), total bilirubin, and bile lactate dehydrogenase (LDH)] were determined. Long-term survival (7 days) after transplantation was similar between the SNEVLP and CS groups (60% versus 40%, P = 0.13). No difference was observed between SNEVLP- and CS-treated animals with respect to the peak of serum INR, factor V, or AST levels within 24 hours. CD31 staining 8 hours after transplantation demonstrated intact EC lining in SNEVLP-treated livers (7.3 × 10(-4) ± 2.6 × 10(-4) cells/μm(2)) but not in CS-treated livers (3.7 × 10(-4) ± 1.3 × 10(-4) cells/μm(2) , P = 0.03). Posttransplant SNEVLP animals had decreased serum ALP and serum bilirubin levels in comparison with CS animals. In addition, LDH in bile fluid was lower in SNEVLP pigs versus CS pigs (14 ± 10 versus 60 ± 18 μmol/L, P = 0.02). Bile duct histology revealed severe bile duct necrosis in 3 of 5 animals in the CS group but none in the SNEVLP group (P = 0.03). Sequential SNEVLP preservation of DCD grafts reduces bile duct and EC injury after liver transplantation. © 2014 American Association for the Study of Liver Diseases.

  9. Lesão complexa da via biliar principal: a ligadura como opção associada a colecistojejunostomia Common bile duct injury: ligation and cholecystojejunostomy as surgical option

    Directory of Open Access Journals (Sweden)

    Sizenando Vieira Starling

    2003-06-01

    Full Text Available The authors present a case of distal common bile duct injury. Ligation of the bile duct and a bypass cholecystojejunostomy were chosen as treatment. Diagnosis of blunt traumatic injury to the extrahepatic biliary ducts may be difficult due to the benign nature of initial bile peritonitis. Surgical treatment for associated abdominal injuries usually makes the diagnosis possible. One of the challenges in the treatment of these injuries relates to the small diameter of the, usually, normal common bile duct. Primary repair and T tube drainage is the best option for non-complex injuries. End-to-end anastomosis and, preferentially, biliary-enteric anastomosis are the best surgical options for more complex injuries. Severe injuries have high complication rates, especially when the distal portion of the common bile duct is affected. Early leaks and late strictures are likely to develop in these situations. Cholecistojejunostomy and ligation of the injuried common bile duct are good surgical options for complex injuries. They carry a low complication rate and consequently low morbidity.

  10. Placement of a covered self-expandable nitinol stent for bile duct stricture that caused by ischemic injury after transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Kweon; Seo, Tae Seok; Cha, In Ho; Huh, Sik; Byun, Kwan Soo [Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2008-10-15

    The authors report here on a case of focal stricture in the common hepatic duct that was caused by ischemic bile duct injury after repeat TACE procedures for hepatocellular carcinoma, and the patient was successfully treated with a covered self-expandable nitinol stent.

  11. 医源性胆管损伤的治疗现状%Present status of the treatment of iatrogenic bile duct injury

    Institute of Scientific and Technical Information of China (English)

    姜洪池; 姜宪

    2009-01-01

    @@ 胆道的功能正常与否,直接关系到人体各方面机能的发挥.随着医学的发展,今天的外科已经没有手术禁区,但医源性胆管损伤仍是所有外科医生颇受困扰的难题.%Iatrogenic bile duct injury (IBDI) is a severe complication in general surgery, especially during laparos-eopic cholecystectomy. Many factors may cause IBDi, in which the conscientiousness, skill and experience of the surgeons play a more important role than the abnormal anatomy and patholo-gical changes of the patient. The Bismuth's classification, which originated from the era of open surgery, does not cover the whole spectrum of bile duct injuries. Strasberg's classification made a supplement by including other types of extrahepatie bile duct injuries. The variation of opportunities leads to different thera-peutic strategies. When the injuries are diagnosed intraopera-tively, a conversion to open surgery is the option of choice, and the prosthesis should be performed by a more experienced surgeon. If the bile duct injury is diagnosed in the early stage after operation, therapeutic principles are as follows: biliary peritonitis often required an emergency reoperation, while extra-peritoneal drainage is taken for patients with simple biliary leak. The most serious postoperative complication after IBDI is steno-sis, sometimes followed by fistula. Sufficient preoperative prepa-ration is essential, which includes controlling the biliary tract infection, improving the liver and renal function and nutritional state of the patient.

  12. Spontaneous postoperative choledochoduodenal fistula due to bile duct injury following laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Sezgin Yilmaz

    2016-01-01

    Conclusion: In the present case we have reported a case of Bismuth type 2 (Strasberg type E2 injury in which the biliary drainage was closed spontaneously with the formation of spontaneous biliary-duodenal fistula. It is an extremely interesting case that has not been reported in the literature previously.

  13. 22例腮腺导管损伤手术治疗疗效分析%Clinical analysis of 22 cases with parotid gland duct injury

    Institute of Scientific and Technical Information of China (English)

    蒋勇联; 杨沛蕾; 刘国元

    2011-01-01

    PURPOSE: To discuss the early diagnosis and treatment of injury to the parotid duct. METHODS Segmental epidural catheter was used to repair the injured parotid duct, if the broken ends of the parotid duct can't b< anastomized end to end, facial vein transplantation and fascia parotideomasseterica flap were used for reconstruction RESULTS: In 22 cases, one case was lost to follow-up, nineteen cases had successful reconstruction of the parotid due with good parotid secretions. Two cases had atrophy of the parotid gland. CONCLUSIONS: Early diagnosis is critical fo treatment of injury of parotid duct. The efficacy of segmental epidural catheter is excellent for repair of parotid duct defect%目的:探讨腮腺导管损伤的早期诊断及手术治疗方法.方法:利用硬膜外麻醉导管做支架,修复损伤的腮腺导管;如导管因缺损无法端端吻合,选用面前静脉移植术和腮腺嚼肌筋膜瓣再造术.结果:本组22例患者1例失访,随访的21例中,19例腮腺导管通畅,腮腺分泌功能正常;2例腮腺腺体萎缩,无分泌功能.结论:腮腺导管损伤的早诊断有利于手术治疗,支架支撑修复损伤的腮腺导管效果良好.

  14. Postoperative radiotherapy dose correlates with locoregional control in patients with extra-hepatic bile duct cancer

    Energy Technology Data Exchange (ETDEWEB)

    Im, Jung Ho; Seong, Jinsil; Lee, Jeong Shim; Kim, Yong Bae; Kim, Kyung Sik; Lee, Woo Jung [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Ik Jae; Park, Jun Sung; Yoon, Dong Sup [Sangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    To evaluate the results of postoperative radiotherapy in patients with extra-hepatic bile duct cancer (EHBDC) and identify the prognostic factors for local control and survival. Between January 2001 and December 2010, we retrospectively reviewed the cases of 70 patients with EHBDC who had undergone curative resection and received postoperative radiotherapy. The median radiation dose was 50.4 Gy (range, 41.4 to 54 Gy). The resection margin status was R0 in 30 patients (42.9%), R1 in 25 patients (35.7%), and R2 in 15 patients (21.4%). The 5-year rates of overall survival (OS), event-free survival (EFS), and locoregional control (LRC) for all patients were 42.9%, 38.3%, and 61.2%, respectively. The major pattern of failure was distant relapses (33 patients, 47.1%). A multivariate analysis showed that the postradiotherapy CA19-9 level, radiation dose (≥50 Gy), R2 resection margins, perineural invasion, and T stage were the significant prognostic factors for OS, EFS, and LRC. OS was not significantly different between the patients receiving R0 and R1 resections, but was significantly lower among those receiving R2 resection (54.6%, 56.1%, and 7.1% for R0, R1, and R2 resections, respectively). In patients with EHBDC who had undergone curative resection, a postoperative radiotherapy dose less than 50 Gy was suboptimal for OS and LRC. Higher radiation doses may be needed to obtain better LRC. Further investigation of novel therapy or palliative treatment should be considered for patients receiving R2 resection.

  15. Pathological changes of bile duct injury after orthotopic liver transplantation%原位肝移植后胆管损伤的病理学改变

    Institute of Scientific and Technical Information of China (English)

    谭文翔; 杨玉龙; 王晓光; 付维利

    2008-01-01

    背景:肝移植术后胆道损伤引起的并发症是临床上诊治的难点,是抑制肝移植发展的瓶颈.目的:在成功应用胆道内镜治疗肝移植术后胆道并发症的同时,对胆管的损伤进行观察记录并取活检病理,分析不同胆管损伤、组织病理学类型与肝移植术后胆管并发症的关系.设计、时间及地点:病例分析,于2001-07/2005-10在大连市肝胆外科研究所,友谊医院肝胆外科完成.对象:将19例肝移植术后患者根据胆管并发症发生情况分为3组:正常组4例,胆管损伤组12例,肝动脉损伤组3例.方法:利用内镜技术,分别对3组患者进行胆管观察、记录.内镜下取活检进行病理分析.对于无T管者,应用子母胆道镜观察、取活检.主要观察指标:应用胆道内镜观察T管造影、肝内外胆管黏膜外观及病理学检查结果、供-受体胆管吻合口的愈合情况.胆管损伤组经内镜取石、狭窄扩张治疗后行上述指标的复查.结果:①正常组患者肝内外胆管解剖正常,无狭窄、瘢痕,胆管黏膜颜色正常,供-受体胆管吻合口愈合佳.病理学检查均可见修复性的黏膜组织,被覆上皮完整.②胆管损伤组患者胆管内有各种类型的单发、多发及铸型结石,胆管均有不同程度损伤,经内镜取净结石、解除梗阻后,胆管黏膜均有不同程度的修复,造影检查胆树恢复正常.⑨肝动脉损伤组患者胆管壁缺血坏死,丧失胆管的组织结构,明显充血,胆泥和结石完全灌满供体胆树,Ⅲ级胆管间断具有胆管的组织结构;病理学检查发现胆管壁弥漫坏死,结构不清,大量胆汁渗入,可见增生的肉芽组织和化脓灶.结论:在原位肝移植中胆管均有不同程度的损伤,冷保存/再灌注损伤是导致胆管树损害最重要的始动因素,胆管周围血管丛的损伤和微循环障碍可能是胆管损伤的途径之一.%BACKGROUND: Complications, caused by bile duct injury after liver

  16. MRI of acute cervical injury: correlation with neurologic deficit

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Chang Dong; Kwon, Soon Tae; Lim, Seung Chul; Shin, Myung Jin; Han, Boo Kyung; Kim, Sang Joon; Park, Man Soo; Yoon, Hyun Ki; Suh, Dae Chul [Asan Medical Center University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    1995-10-15

    To evaluate MRI findings of spinal cord according to mechanism in acute cervical spinal injury. 25 patients under went MRI within 1 month after acute cervical trauma. Axial T1Wl (TR/TE: 500/20), gradient-echo (TR/TE: 300/14), sagittal T1Wl (TR/TE: 500/20), proton (TR/TE: 2000. 20 msec), T2Wl (TR/TE: 2000/80) were performed. In 11 patients, post-enhancement T1Wl was done. Change of spinal cord signal intensity on MRI in addition to the presence of abnormal changes of vertebral body, intervertebral disc and paraspinal soft tissue were evaluated. 15 patients had flexion injury, seven had extension injury and three had injury of unknown mechanism. Twelve patients showed iso-signal intensity on T2Wl and high signal intensity on T2Wl. Three patients showed low signal intensity on T1Wl and high signal intensity on T2Wl. Spinal cord hemorrhage occured in 10 patients. We found cord swelling in nine patients and cord compression in 12 patients. In nine patients with cord swelling, extent of cord injury was more than one segment of vertebral body. Ligamentous injury, disc injury, soft tissue injury occurred in 16 (64%), 17 (68%), 15 (60%) patients respectively. Vertebral body fracture was found in 17 patients (68%). The levels of fracture were C6 (eight patients) and C5 (five patients). MRI is valuable in exaluetion of the spinal cord, intervertebral disc, and soft tissue lesions in acute cervical spinal injury. Prognosis is worse in flexion injury than in extension injury, and is well correlated with cord hemorrhage and lesion extent.

  17. Swertianlarin, an Herbal Agent Derived from Swertia mussotii Franch, Attenuates Liver Injury, Inflammation, and Cholestasis in Common Bile Duct-Ligated Rats

    Directory of Open Access Journals (Sweden)

    Liangjun Zhang

    2015-01-01

    Full Text Available Swertianlarin is an herbal agent abundantly distributed in Swertia mussotii Franch, a Chinese traditional herb used for treatment of jaundice. To study the therapeutic effect of swertianlarin on cholestasis, liver injury, serum proinflammatory cytokines, and bile salt concentrations were measured by comparing rats treated with swertianlarin 100 mg/kg/d or saline for 3, 7, or 14 days after bile duct ligation (BDL. Serum alanine aminotransferase (ATL and aspartate aminotransferase (AST levels were significantly decreased in BDL rats treated with swertianlarin for 14 days (P<0.05. The reduced liver injury in BDL rats by swertianlarin treatment for 14 days was further confirmed by liver histopathology. Levels of serum tumor necrosis factor alpha (TNFα were decreased by swertianlarin in BDL rats for 3 and 7 days (P<0.05. Moreover, reductions in serum interleukins IL-1β and IL-6 levels were also observed in BDL rats treated with swertianlarin (P<0.05. In addition, most of serum toxic bile salt concentrations (e.g., chenodeoxycholic acid (CDCA and deoxycholic acid (DCA in cholestatic rats were decreased by swertianlarin (P<0.05. In conclusion, the data suggest that swertianlarin derived from Swertia mussotii Franch attenuates liver injury, inflammation, and cholestasis in bile duct-ligated rats.

  18. Correlations between coping styles and symptom expectation for whiplash injury.

    Science.gov (United States)

    Ferrari, Robert; Russell, Anthony S

    2010-11-01

    In pain conditions, active coping has been found to be associated with less severe depression, increased activity level, and less functional impairment. Studies indicate that Canadians have a high expectation for chronic pain following whiplash injury. Expectation of recovery has been shown to predict recovery in whiplash victims. The objective of this study was to compare both the expectations and the coping style for whiplash injury in injury-naive subjects. The Vanderbilt Pain Management Inventory was administered to university students. Subjects who had not yet experienced whiplash injury were given a vignette concerning a neck sprain (whiplash injury) in a motor vehicle collision and were asked to indicate how likely they were to have thoughts or behaviors indicated in the coping style questionnaire. Subjects also completed expectation questionnaires regarding whiplash injury. Subjects (57%) held an expectation of chronic pain after whiplash injury. The mean active coping style score was 28.5±6.6 (40 is the maximum score for active coping). The mean passive coping style score was 28.5±6.6 (50 is the maximum score for passive coping). Those with high passive coping styles had a higher mean expectation score. The correlation between passive coping style score and expectation score was 0.62, while the correlation between active coping style score and expectation was -0.48. Both expectations and coping styles may interact or be co-modifiers in the outcomes of whiplash injury in whiplash victims. Further studies of coping style as an etiologic factor in the chronic whiplash syndrome are needed.

  19. Assessment of Chronological Effects of Irreversible Electroporation on Hilar Bile Ducts in a Porcine Model

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jae Woong, E-mail: cooljay@korea.ac.kr; Lu, David S. K., E-mail: dlu@mednet.ucla.edu; Osuagwu, Ferdnand, E-mail: fosuagwu@mednet.ucla.edu; Raman, Steven, E-mail: sraman@mednet.ucla.edu [David Geffen School of Medicine at UCLA, Department of Radiology (United States); Lassman, Charles, E-mail: classman@mednet.ucla.edu [David Geffen School of Medicine at UCLA, Department of Pathology (United States)

    2013-11-07

    PurposeTo evaluate the chronological effects of irreversible electroporation (IRE) on large hilar bile ducts in an in vivo porcine model correlated with computed tomography (CT) cholangiography and histopathology.Materials and MethodsTwelve IRE zones were made along hilar bile ducts intraoperatively under ultrasound (US)-guidance in 11 pigs. Paired electrodes were placed either on opposing sides of the bile duct (straddle [STR]) or both on one side of the bile duct (one-sided [OSD]). The shortest electrode-to-duct distance was classified as periductal (≤2 mm) or nonperiductal (>2 mm). CT cholangiography and laboratory tests were performed before IRE and again at 2 days, 4 weeks, and 8 weeks after IRE. Degree of bile duct injury were graded as follows: grade 0 = no narrowing; grade 1 = ≤50 % duct narrowing; grade 2 = >50 % narrowing without proximal duct dilatation; grade 3 = grade 2 with proximal duct dilatation; and grade 4 = grade 3 with enzyme elevation. Pigs were selected for killing and histopathology at 2 days, 4, and 8 weeks.ResultsNonperiductal electrode placement produced no long-term strictures in 5 of 5 ducts. Periductal electrode placement produced mild narrowing in 6 of 7 ducts: 5 grade 1 and 1 grade 2. None showed increased enzymes. There was no significant difference between STR versus OSD electrode placement. Histopathology showed minor but relatively greater ductal mural changes in narrowed ducts.ConclusionIn the larger hilar ducts, long-term patency and mural integrity appear resistant to IRE damage with the energy deposition used, especially if the electrode is not immediately periductal in position.

  20. Posterolateral Complex Knee Injuries: Magnetic Resonance Imaging with Surgical Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Theodorou, D.J. [Univ. of California, San Diego, CA (United States). Dept. of Radiology; Theodorou, S.J.; Fithian, D.C.; Garelick, D.H. [Southern California Permanente Medical Group, San Diego, CA (United States). Dept. of Orthopedic Surgery; Paxton, L.; Resnick, D. [Midwest Orthopedics, Chicago, IL (United States)

    2005-05-01

    Purpose: To describe the magnetic resonance imaging (MRI) findings of injuries of the posterolateral aspect of the knee and to evaluate the diagnostic capabilities of MRI in the assessment of these injuries. Material and Methods: The MRI studies of 14 patients (mean age 33 years) with trauma to the posterolateral aspect of the knee were retrospectively reviewed, and the imaging findings were correlated with those of surgery. Results: In all patients, MRI showed an intact iliotibial (ITB) band. MRI showed injury to the biceps tendon in 11 (79%), the gastrocnemius tendon in (7%), the popliteus tendon in 5 (36%), and the lateral collateral ligament (LCL) in 14 (100%) patients. Tear of the anterior cruciate ligament (ACL) was seen in1 (79%) patients and tear of the posterior cruciate ligament (PCL) in 4 (29%) patients. With routine MRI, visualization of the popliteofibular or fabellofibular ligaments was incomplete. On MRI, the lateral meniscus and the medial meniscus were torn with equal frequency ( n {approx} 4; 29%). Osteochondral defects were seen in 5 (36%) cases and joint effusion in all 14 (100%) cases on MRI. Using surgical findings as the standard for diagnosis, MRI proved 86% accurate in the detection of injury to the ITB band, the biceps tendon (93%),, the gastrocnemius tendon (100%), the popliteus tendon (86%), the LCL (100%), the ACL (79%), the PCL (86%), the lateral meniscus (90%), the medial meniscus (82%), and the osteochondral structures (79%). Surgical correlation confirmed the MRI findings of joint effusion in all cases. Conclusion: MRI is well suited for demonstrating the presence and extent of injuries of the major structures of the posterolateral complex of the knee, allowing characterization of the severity of injury.

  1. LC 术胆管损伤的危险因素及术后分析%Risk factors and postoperative analysis of bile duct injuries during laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    王宏; 罗建管; 梁鹏; 易旭华; 李虎山; 肖怀忠; 杨明

    2011-01-01

    Objective To analyze the risk factors of bile duct injuries during laparoscopic cholecystectomy and postoperative hile duct injuries. Methods Forty-one cases of bile duct injuries were analyzed retrospectively in 4531 cases of laparoscopic cholecystectomy between October 1999 to December 2010. All influential factors were checked in chi square, and independent risk factors about bile duct injuries were simultaneously analyzed. At the same time, whether bile duct injuries could be detected intraoperatively in time was analyzed. Results Univariated analysis showed bile duct injuries were associated with gender, stagings of inflammation, thickness of cholecystic wall by sonography, anatomy of Calot's triangle and surgical experience (P<0.05). Anatomy of Calot's triangle and surgical experience were independent risk factors of bile duct injuries (P<0.05). The numbers of bile duct injuries detected intraoperatively were more than those postoperatively (x2=12.868, P<0.05). Conclusion Bile duct injuries associate with gender, stagings of inflammation,thickness of cholecyst wall by sonography, anatomy of Calot's triangle and surgical experience closely. Anatomy of Calot's triangle and surgical experience are independent risk factors of bile duct injuries. Bile duct injuries can be detected intraoperatively in time.%目的 分析LC 术胆管损伤的危险因素,并对胆管损伤术后进行分析.方法 回顾性分析本院1999 年10 月至2010 年12 月行LC 术的4 531 例患者所出现的41 例胆管损伤,对胆管损伤的各影响因素进行χ2检验,分析胆管损伤的独立危险因素;同时分析胆管损伤是否能在术中及时发现.结果 单因素分析显示:患者性别、炎症分期、B 超示胆囊壁厚度、胆囊三角解剖和手术经验与胆总管损伤有关联(P<0.05).多因素非条件Lo-gistic 回归分析结果显示:胆囊三角解剖和手术经验是胆管损伤的独立危险因素(P<0.05).胆管损伤术中发现例

  2. Sexual behavior and its correlates after traumatic brain injury.

    Science.gov (United States)

    Turner, Daniel; Schöttle, Daniel; Krueger, Richard; Briken, Peer

    2015-03-01

    Traumatic brain injury (TBI) is one of the leading causes of permanent disability in young adults and is frequently accompanied by changes in sexual behaviors. Satisfying sexuality is an important factor for overall quality of life in people with disabilities. The purpose of this article is to review the studies evaluating the assessment, correlates and management of sexuality following TBI. The Brain Injury Questionnaire of Sexuality is the first validated questionnaire specifically developed for adults with TBI. A considerable amount of individuals with TBI show inappropriate sexual behaviors and sexual dysfunctions. Whereas inappropriate sexual behaviors are related to younger age, less social participation and more severe injuries, sexual dysfunctions show an association with higher fatigue, higher depression scores, less self-esteem and female sex. Healthcare professionals have suggested that because of discomfort at the individual or institutional level, sexual problems are often not sufficiently addressed and have suggested that a specialist should treat sexual problems. Although some important correlates of sexual problems could be identified, methodological differences across studies limit their comparability. Furthermore, there is an absence of evidence-based treatment strategies for addressing sexual problems. Therapeutic efforts should take into account the identified correlates of sexual problems following TBI.

  3. Magnetic resonance imaging of extrahepatic bile duct disruption

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Yon-Cheong; Wang, Li-Jen; Chen, Chi-Jen [Department of Radiology, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Gueishan, 33333 Taoyuan (Taiwan); Chen, Ray-Jade [Division of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Gueishan, 33333 Taoyuan (Taiwan)

    2002-10-01

    Blunt injury of the extrahepatic bile duct is rare and hence a large series of scientific study of its MRI is difficult to perform. We present the MRI and MR cholangiography of a case of blunt extrahepatic bile duct injury proven at surgery. The diagnosis could be established based on MRI findings of an abrupt tapering of the extrahepatic bile duct with a retracted end, a discordant small-caliber proximal duct, massive ascites, and a hematoma in proximity to the bile duct injury. This non-invasive MRI study is a promising imaging modality to evaluate biliary tract injury. (orig.)

  4. Ambulation following spinal cord injury and its correlates

    Directory of Open Access Journals (Sweden)

    Nitin Menon

    2015-01-01

    Full Text Available Objectives: To assess walking ability of spinal cord injury (SCI patients and observe its correlation with functional and neurological outcomes. Patients and Methods: The present prospective, observational study was conducted in a tertiary research hospital in India with 66 patients (46 males between January 2012 and December 2013. Mean age was 32.62 ± 11.85 years (range 16-65 years, mean duration of injury was 85.3 ± 97.6 days (range 14-365 days and mean length of stay in the rehabilitation unit was 38.08 ± 21.66 days (range 14-97 days in the study. Walking Index for spinal cord injury (WISCI II was used to assess ambulation of the SCI patients. Functional recovery was assessed using Barthel Index (BI and Spinal Cord Independence Measures (SCIM. Neurological recovery was assessed using ASIA impairment scale (AIS. We tried to correlate ambulatory ability of the patients with functional and neurological recovery. Results: Ambulatory ability of the patients improved significantly using WISCI II (P < 0.001 when admission and discharge scores were compared (1.4 ± 3.5 vs 7.6 ± 6.03. Similarly, functional (BI: 31.7 ± 20.5 vs 58.4 ± 23.7 and SCIM: 29.9 ± 15.1 vs 56.2 ± 20.6 and neurological recovery were found to be very significant (P < 0.001 when admission vs discharge scores were compared. Improvement in WISCI II scores was significantly correlated with improvement in neurological (using AIS scores and functional status (using BI and SCIM scores (P < 0.001. Conclusions: Significant improvement was seen in WISCI II, BI, and SCIM scores after in-patient rehabilitation. Improvement in WISCI II scores also significantly correlated with functional and neurological recovery.

  5. Müllerian duct anomalies and mimics in children and adolescents: correlative intraoperative assessment with clinical imaging.

    Science.gov (United States)

    Junqueira, Beatriz L P; Allen, Lisa M; Spitzer, Rachel F; Lucco, Kerith L; Babyn, Paul S; Doria, Andrea S

    2009-01-01

    Müllerian duct anomalies (MDAs) are congenital entities that result from nondevelopment, defective vertical or lateral fusion, or resorption failure of the müllerian (paramesonephric) ducts. MDAs are common, although the majority are asymptomatic, and have been classified by the American Society of Reproductive Medicine according to clinical manifestations, prognosis, and treatment. Accurate diagnosis of an MDA is essential, since the management approach varies depending on the type of malformation. In females, when a müllerian duct becomes obstructed, the patient may present with an abdominal mass and dysmenorrhea. If the patient is not treated in a timely fashion, the consequences can be severe, extending even to infertility. When an MDA is suspected, ultrasonography (US) should be performed initially to delineate any abnormalities in the genital tract. However, US cannot help identify the type of MDA. In contrast, magnetic resonance imaging is a valuable technique for noninvasive evaluation of the female pelvic anatomy and accurate MDA classification. If obstruction is present, surgical correction of the MDA may be required, and further counseling of the patient with regard to reproductive possibilities becomes important. Supplemental material available at http://radiographics.rsnajnls.org/cgi/content/full/29/4/1085/DC1.

  6. Electrophysiological Correlates of Word Retrieval in Traumatic Brain Injury

    Science.gov (United States)

    DeLaRosa, Bambi L.; Didehbani, Nyaz; Hart, John; Kraut, Michael A

    2017-01-01

    Abstract Persons who have had a traumatic brain injury (TBI) often have word retrieval deficits; however, the underlying neural mechanisms of such deficits are yet to be clarified. Previous studies in normal subjects have shown that during a word retrieval task, there is a 750 msec event-related potential (ERP) divergence detected at the left fronto-temporal region when subjects evaluate word pairs that facilitate retrieval compared with responses elicited by word pairs that do not facilitate retrieval. In this study, we investigated the neurophysiological correlates of word retrieval networks in 19 retired professional athletes with TBI and 19 healthy control (HC) subjects. We recorded electroencephalography (EEG) in the participants during a semantic object retrieval task. In this task, participants indicated whether presented word pairs did (retrieval) or did not (non-retrieval) facilitate the retrieval of an object name. There were no significant differences in accuracy or reaction time between the two groups. The EEG showed a significant group by condition interaction over the left fronto-temporal region. The HC group mean amplitudes were significantly different between conditions, but the TBI group data did not show this difference, suggesting neurophysiological effects of injury. These findings provide evidence that ERP amplitudes may be used as a marker of disrupted semantic retrieval circuits in persons with TBI even when those persons perform normally. PMID:27596052

  7. Electrophysiological Correlates of Word Retrieval in Traumatic Brain Injury.

    Science.gov (United States)

    Fratantoni, Julie M; DeLaRosa, Bambi L; Didehbani, Nyaz; Hart, John; Kraut, Michael A

    2017-03-01

    Persons who have had a traumatic brain injury (TBI) often have word retrieval deficits; however, the underlying neural mechanisms of such deficits are yet to be clarified. Previous studies in normal subjects have shown that during a word retrieval task, there is a 750 msec event-related potential (ERP) divergence detected at the left fronto-temporal region when subjects evaluate word pairs that facilitate retrieval compared with responses elicited by word pairs that do not facilitate retrieval. In this study, we investigated the neurophysiological correlates of word retrieval networks in 19 retired professional athletes with TBI and 19 healthy control (HC) subjects. We recorded electroencephalography (EEG) in the participants during a semantic object retrieval task. In this task, participants indicated whether presented word pairs did (retrieval) or did not (non-retrieval) facilitate the retrieval of an object name. There were no significant differences in accuracy or reaction time between the two groups. The EEG showed a significant group by condition interaction over the left fronto-temporal region. The HC group mean amplitudes were significantly different between conditions, but the TBI group data did not show this difference, suggesting neurophysiological effects of injury. These findings provide evidence that ERP amplitudes may be used as a marker of disrupted semantic retrieval circuits in persons with TBI even when those persons perform normally.

  8. Primary repairing for iatrogenic injury of bile duct:a study of 31 cases%医源性胆管损伤一期修复31例体会

    Institute of Scientific and Technical Information of China (English)

    黄强; 刘臣海; 王成; 胡元国; 汤志刚; 邱陆军; 王士堂; 林先盛

    2011-01-01

    目的 探讨医源性胆管损伤后首次修复的体会.方法 回顾性分析和总结2004年1月至2010年6月安徽省立医院普通外科出现和收治的31例医源性胆管损伤一期修复的病例资料.结果 术中发现即时修复4例,修复方式为胆管修补+胆管引流术.合并胆汁性腹膜炎6例,均先行腹腔+胆管引流术,2个月后再行胆管-空肠Roux-en-Y吻合术.合并黄疸21例,均行胆管-空肠Roux-en-Y吻合,其中损伤后10d内修复5例,10d后修复16例,10d内进行修复者所需手术时间较10d后修复者长(P<0.05).术后均无胆漏出现,获得随访28例,随访4~60个月,2例术后1年出现吻合口狭窄,一期修复成功率为92.9%(26/28).结论 胆管损伤的处理应由有经验的胆道专科医师进行,单纯梗阻型胆管损伤10d后进行操作较容易,以胆管-空肠Roux-en-Y吻合为最佳术式.%Objective To explore the experience of primary repairing for iatrogenic injury of bile duct. Methods The clinical data of 31 cases of primary repairing for iatrogenic injury of bile duct admitted from January 2004 to June 2010 in the Department of General Surgery of Anhui Province Hospital were analyzed and summarized retrospectively. Results Four cases were found and repaired by biliary tract repairing and drainage during the first operation. Six cases of iatrogenic injury of bile duct combined with bile peritonitis were performed abdominal and biliary drainage firstly and then performed Roux-en-Y bile duct-jejunostomy after 2 months. Twenty-one cases combined with jaundice were performed Roux-en-Y bile duct-jejunostomy. Among them, injury repairs in 5 cases were performed within 10 days.Sixteen cases were performed in 10 days after the repairing. The former operation took more time than the latter (P<0.05).No postoperative bile leakage occurred. Twenty-eight cases were followed up for 4-60 months. Two cases occurred anastomotic stenosis after one year. The restoration success rate was 92.9

  9. Combined common peroneal and tibial nerve injury after knee dislocation: one injury or two? An MRI-clinical correlation.

    Science.gov (United States)

    Reddy, Chandan G; Amrami, Kimberly K; Howe, Benjamin M; Spinner, Robert J

    2015-09-01

    OBJECT Knee dislocations are often accompanied by stretch injuries to the common peroneal nerve (CPN). A small subset of these injuries also affect the tibial nerve. The mechanism of this combined pattern could be a single longitudinal stretch injury of the CPN extending to the sciatic bifurcation (and tibial division) or separate injuries of both the CPN and tibial nerve, either at the level of the tibiofemoral joint or distally at the soleal sling and fibular neck. The authors reviewed cases involving patients with knee dislocations with CPN and tibial nerve injuries to determine the localization of the combined injury and correlation between degree of MRI appearance and clinical severity of nerve injury. METHODS Three groups of cases were reviewed. Group 1 consisted of knee dislocations with clinical evidence of nerve injury (n = 28, including 19 cases of complete CPN injury); Group 2 consisted of knee dislocations without clinical evidence of nerve injury (n = 19); and Group 3 consisted of cases of minor knee trauma but without knee dislocation (n = 14). All patients had an MRI study of the knee performed within 3 months of injury. MRI appearance of tibial and common peroneal nerve injury was scored by 2 independent radiologists in 3 zones (Zone I, sciatic bifurcation; Zone II, knee joint; and Zone III, soleal sling and fibular neck) on a severity scale of 1-4. Injury signal was scored as diffuse or focal for each nerve in each of the 3 zones. A clinical score was also calculated based on Medical Research Council scores for strength in the tibial and peroneal nerve distributions, combined with electrophysiological data, when available, and correlated with the MRI injury score. RESULTS Nearly all of the nerve segments visualized in Groups 1 and 2 demonstrated some degree of injury on MRI (95%), compared with 12% of nerve segments in Group 3. MRI nerve injury scores were significantly more severe in Group 1 relative to Group 2 (2.06 vs 1.24, p knee dislocations

  10. Laser-guided repair of complex bile duct strictures.

    NARCIS (Netherlands)

    Gulik, T. van; Beek, J.; Reuver, P. de; Aronson, D.C.; Delden, O. van; Busch, O.; Gouma, D.

    2009-01-01

    BACKGROUND: The repair of bile duct strictures (BDS) requires identification of healthy bile duct proximal to the stenosis. Identification may be difficult in complex bile duct injuries after cholecystectomy or partial liver resection. AIM: We describe a technique to identify the prestenotic bile du

  11. Prevalence, patterns, and correlates of equestrian injuries in Malaysia: A cross-sectional study

    OpenAIRE

    Nizar A Majeedkutty; Nor A.B. Khairulanuar

    2017-01-01

    Background: Equestrian sport carries with it an implicit risk of injury. Despite the frequency of injuries in equestrian sports, there is no published study on injuries of equestrian athletes in Malaysia. Objective: The objective of this study was to determine the prevalence of injuries and its correlates among horseback riders. Subjects And Methods: A web-based standardized questionnaire was used to collect data for this cross-sectional survey. Horseback riders aged 18 years and abov...

  12. Pain Catastrophizing Correlates with Early Mild Traumatic Brain Injury Outcome

    Science.gov (United States)

    Chaput, Geneviève; Lajoie, Susanne P.; Naismith, Laura M.; Lavigne, Gilles

    2016-01-01

    Background. Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI) is a difficult clinical challenge. Objectives. To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome. Methods. This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1) and 8 weeks (Time 2) after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2. Results. The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r = .31 to .44), number of postconcussion symptoms reported (r = .35 to .45), psychological distress (r = .57 to .67), and level of functionality (r = −.43 to −.29). Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2). Conclusions. Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms. PMID:27445604

  13. Pain Catastrophizing Correlates with Early Mild Traumatic Brain Injury Outcome

    Directory of Open Access Journals (Sweden)

    Geneviève Chaput

    2016-01-01

    Full Text Available Background. Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI is a difficult clinical challenge. Objectives. To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome. Methods. This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1 and 8 weeks (Time 2 after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2. Results. The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r=.31 to .44, number of postconcussion symptoms reported (r=.35 to .45, psychological distress (r=.57 to .67, and level of functionality (r=-.43 to -.29. Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2. Conclusions. Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.

  14. Risk factors analysis of bile duct injuries caused by laparoscopic cholecystectomy%腹腔镜胆囊切除术胆管损伤危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王宏; 罗建管; 梁鹏; 易旭华; 李虎山; 肖怀忠; 杨明

    2011-01-01

    目的 分析腹腔镜胆囊切除术(LC)胆管损伤的危险因素.方法 回顾性分析湖南省浏阳市人民医院71999年10月至2010年12月所行4531例LC病人的临床资料,对出现胆管损伤病人各影响因素进行x2检验,并分析胆管损伤的独立危险因素.结果 单因素分析显示:病人性别、炎症分期、B超示胆囊壁厚度、胆囊三角解剖和术者经验与胆总管损伤有关联(P<0.05).多因素非条件Logistic回归分析结果显示:胆囊三角解剖和术者经验是胆管损伤的独立危险因素(P<0.05).结论 胆囊三角解剖和术者经验是胆管损伤的独立危险因素.%Objective To analyze risk factors of bile duct injuries caused by laparoscopic cholecystectomy. Methods The clinical data of 45 31 cases of laparoscopic cholecystectomy between October 1999 and December 2010 in People' s Hospital of Liuyang City were analyzed retrospectively. All influential factors were checked in chi square, and independent risk factors about bile duct injuries were analyzed simultaneously. Results Univariate analysis showed bile duct injuries were associated with gender, staging of inflammation, thickness of cholecyst wall byt sonography, anatomy of Calot's triangle and surgical experience (P<0.05). Anatomy of Calot's triangle and surgical experience were independent risk factors of bile duct injuries, which was showed by multivariate unconditional Logistic regression analysis (P < 0.05). Conclusion Anatomy of Calot' s triangle and surgical experience are independent risk factors of bile duct injuries.

  15. The "flying" bile duct: avulsion of the common bile duct in a plane crash survivor.

    LENUS (Irish Health Repository)

    Mohan, H

    2012-02-01

    Blunt trauma is an unusual cause of extrahepatic bile duct injury. This is a case of a 51-year-old gentleman who sustained a significant seatbelt injury in a plane crash. Laparotomy, performed due to persistent abdominal pain, revealed that the common bile duct (CBD) was completely avulsed from the duodenum. Following insertion of drains and transfer to a hepatobiliary centre, the devascularised CBD was excised and replaced with a roux-en-y hepaticojejunostomy. Necrotic tissue was debrided from the pancreatic head. A persistent bile leak developed from the sub-hepatic drain. Repeat laparotomy revealed a bile leak from small ducts on the liver surface. Ligation of the ducts and bioglue sealing of the area were successfully performed. Subsequent to this a pancreatic fistula developed from the main pancreatic duct, which has since resolved. This unusual case illustrates the need for prompt recognition and early repair to optimise outcomes in traumatic CBD injury.

  16. Potential application of in vivo imaging of impaired lymphatic duct to evaluate the severity of pressure ulcer in mouse model

    Science.gov (United States)

    Kasuya, Akira; Sakabe, Jun-Ichi; Tokura, Yoshiki

    2014-02-01

    Ischemia-reperfusion (IR) injury is a cause of pressure ulcer. However, a mechanism underlying the IR injury-induced lymphatic vessel damage remains unclear. We investigated the alterations of structure and function of lymphatic ducts in a mouse cutaneous IR model. And we suggested a new method for evaluating the severity of pressure ulcer. Immunohistochemistry showed that lymphatic ducts were totally vanished by IR injury, while blood vessels were relatively preserved. The production of harmful reactive oxygen species (ROS) was increased in injured tissue. In vitro study showed a high vulnerability of lymphatic endothelial cells to ROS. Then we evaluated the impaired lymphatic drainage using an in vivo imaging system for intradermally injected indocyanine green (ICG). The dysfunction of ICG drainage positively correlated with the severity of subsequent cutaneous changes. Quantification of the lymphatic duct dysfunction by this imaging system could be a useful strategy to estimate the severity of pressure ulcer.

  17. Serum oxidative stress is increased in patients with post cholecystectomy bile duct injury Aumento del estrés oxidativo en el suero de pacientes con lesiones de vías biliares postcolecistectomía

    Directory of Open Access Journals (Sweden)

    A. G. Miranda-Díaz

    2010-06-01

    Full Text Available Background: post-cholecystectomy bile duct injuries are identified by the onset of jaundice as well as elevated bilirubin and alkaline phosphatase levels during the peri-operative period. It is unknown how serum oxidative stress markers are modified in patients with post-cholecystectomy bile duct injuries. Objective: to determine serum oxidative stress marker levels (lipid peroxidation by-products, nitrites/nitrates and total antioxidant capacity in patients with post-cholecystectomy bile duct injuries. Patients and methods: a prospective, transversal and analytical study was designed with two groups. Group 1: 5 healthy volunteer subjects. Group 2: 52 patients with post-cholecystectomy bile duct injuries (43 female and 9 male. An elective bilio-digestive reconstruction was performed at week 8. The serum oxidative stress marker levels were quantified by colorimetric method. Results: patients with bile duct injuries had a significant increased serum lipid peroxides (malondialdehyde and 4-hydroxy-alkenals and nitric oxide metabolites (nitrites/nitrates levels compared to the control group. In contrast, total antioxidant capacity in patients with bile duct injuries remained similar compared to healthy controls. Conclusions: the results show that oxidative stress is usually associated to bile duct injury.Introducción: las lesiones de las vías biliares postcolecistectomía se establecen por la aparición de ictericia, elevación de las bilirrubinas y de la fosfatasa alcalina durante el periodo perioperatorio. Se desconoce cómo se modifican los marcadores de estrés oxidativo en el suero de los pacientes con lesiones de las vías biliares postcolecistectomía. Objetivo: determinar los marcadores de estrés oxidativo (productos de peroxidación de lípidos, catabolitos del óxido nítrico y capacidad antioxidante total en el suero de pacientes con lesiones de las vías biliares. Pacientes y métodos: se realizó un estudio prospectivo transversal

  18. Mammary Duct Ectasia

    Science.gov (United States)

    ... tenderness or inflammation of the clogged duct (periductal mastitis). Mammary duct ectasia most often occurs in women ... that's turned inward (inverted) A bacterial infection called mastitis also may develop in the affected milk duct, ...

  19. Correlation between elite male Iranian gymnast’s wrist injuries and their anthropometric characteristics

    Science.gov (United States)

    Ghasempour, Hadi; Rajabi, Reza; Alizadeh, Mohammad Hossein; Nikro, Hossein

    2014-01-01

    Background: In gymnastics, wrists are under considerable force that causes various injuries. The influences of various risk factors have not been studied sufficiently to date to reduce the wrist injuries of gymnasts. The aim of this research was to determine the relationship between anthropometric characteristics and the wrist injuries of elite male gymnasts who took part in the Iranian Premier League and Division One in 2012. Methods: This was a cross-sectional correlation study concerning the injuries of 43 elite male gymnasts. The extent of their wrist injuries was determined by a questionnaire and interviews. Also, their anthropometric characteristics were collected according to the criteria established by the International Society for the Advancement of Kinanthropometry. Event tree analysis and the Spearman rho correlation coefficient were used for statistical analysis. Results: Among the gymnasts, 53.5% experienced wrist injuries over the past year, and the rate of wrist injuries was three per gymnast for one year. The incidents of skin and muscular injuries were the most prevalent type of injuries followed by Injuries to ligaments and bones respectively. Body weight was the only anthromopetric characteristic of the participants that was found to have a significant positive relationship with wrist injuries (P < 0.05). Conclusion: Gymnasts and their coaches should pay special attention to gymnasts’ weight as an intrinsic risk factor and take the required actions to prevent wrist injuries. PMID:25763171

  20. Salivary duct carcinoma

    DEFF Research Database (Denmark)

    Breinholt, Helle; Elhakim, Mohammad Talal; Godballe, Christian;

    2016-01-01

    1990 to 2005 were identified. Histological slides were reviewed, and data concerning demographics, tumour site, clinical stage, treatment profiles and follow-up were retrieved. Survival estimates and prognostic factors were evaluated by comparing Kaplan-Meier plots using the Mantel-Haenszel log......-rank test. RESULTS: Salivary duct carcinoma showed an incidence of 0.04/100.000 inhabitants/year. Distant recurrence was seen in 52% of patients. Five-year overall survival, disease-specific survival and recurrence-free survival were 32%, 42% and 35%, respectively. Univariate analyses suggested that overall...... stage (III/IV) and vascular invasion have a negative impact on all survival measures. Involved resection margins correlated with a poorer overall survival and disease-specific survival, whereas adjuvant radiotherapy improved overall survival and recurrence-free survival. CONCLUSIONS: Salivary duct...

  1. Prevalence, patterns, and correlates of equestrian injuries in Malaysia: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nizar A Majeedkutty

    2017-01-01

    Full Text Available Background: Equestrian sport carries with it an implicit risk of injury. Despite the frequency of injuries in equestrian sports, there is no published study on injuries of equestrian athletes in Malaysia. Objective: The objective of this study was to determine the prevalence of injuries and its correlates among horseback riders. Subjects And Methods: A web-based standardized questionnaire was used to collect data for this cross-sectional survey. Horseback riders aged 18 years and above were included in the study. Out of 169 participants, 93 were females and 76 were males. The correlation of injuries to gender, age, level of experience, exercise habits, use of safety measures, and type of equestrian sport were determined. Chi-square test was performed to test for statistical significance. Results: The prevalence was high with 85.8% of the participants reporting symptoms and characteristics of injuries in the past 12 months. The most frequently perceived symptoms reported were in the upper extremities (43.4% followed by lower extremities (40.7%, head injury (8.3% and injuries of upper and lower back (3.4%. There was a higher prevalence of injury among female participants (55.03% than males (42.60%. A significant correlation was found between gender and prevalence of injuries. About 70% of the riders sustained soft tissue injuries. Fifty-five percent of the injured were involved in recreational riding. The most common mechanism of injury was a fall from a horse. Sixty percent of the injured riders did not seek medical attention after being injured, and physiotherapy consultation was even lower with 10.3%. Conclusions: The high prevalence of injuries and low rate of medical consultation emphasize the need for education programs on safety in Malaysia. Sessions should be held to improve coaching for riders and instructors, and their knowledge of the nature of the horse, mechanisms of injuries, horse handling, and riding skills to help them host safe

  2. Prevalence, patterns, and correlates of equestrian injuries in Malaysia: A cross-sectional study

    Science.gov (United States)

    Majeedkutty, Nizar A.; Khairulanuar, Nor A.B.

    2017-01-01

    BACKGROUND: Equestrian sport carries with it an implicit risk of injury. Despite the frequency of injuries in equestrian sports, there is no published study on injuries of equestrian athletes in Malaysia. OBJECTIVE: The objective of this study was to determine the prevalence of injuries and its correlates among horseback riders. SUBJECTS AND METHODS: A web-based standardized questionnaire was used to collect data for this cross-sectional survey. Horseback riders aged 18 years and above were included in the study. Out of 169 participants, 93 were females and 76 were males. The correlation of injuries to gender, age, level of experience, exercise habits, use of safety measures, and type of equestrian sport were determined. Chi-square test was performed to test for statistical significance. RESULTS: The prevalence was high with 85.8% of the participants reporting symptoms and characteristics of injuries in the past 12 months. The most frequently perceived symptoms reported were in the upper extremities (43.4%) followed by lower extremities (40.7%), head injury (8.3%) and injuries of upper and lower back (3.4%). There was a higher prevalence of injury among female participants (55.03%) than males (42.60%). A significant correlation was found between gender and prevalence of injuries. About 70% of the riders sustained soft tissue injuries. Fifty-five percent of the injured were involved in recreational riding. The most common mechanism of injury was a fall from a horse. Sixty percent of the injured riders did not seek medical attention after being injured, and physiotherapy consultation was even lower with 10.3%. CONCLUSIONS: The high prevalence of injuries and low rate of medical consultation emphasize the need for education programs on safety in Malaysia. Sessions should be held to improve coaching for riders and instructors, and their knowledge of the nature of the horse, mechanisms of injuries, horse handling, and riding skills to help them host safe equestrian

  3. Correlation between elite male Iranian gymnast’s wrist injuries and their anthropometric characteristics

    OpenAIRE

    Ghasempour, Hadi; Rajabi, Reza; ALIZADEH, Mohammad Hossein; Nikro, Hossein

    2014-01-01

    Background: In gymnastics, wrists are under considerable force that causes various injuries. The influences of various risk factors have not been studied sufficiently to date to reduce the wrist injuries of gymnasts. The aim of this research was to determine the relationship between anthropometric characteristics and the wrist injuries of elite male gymnasts who took part in the Iranian Premier League and Division One in 2012. Methods: This was a cross-sectional correlation study concerning t...

  4. Prognostic Factors for Open Globe Injuries and Correlation of Ocular Trauma Score in Tianjin, China

    Science.gov (United States)

    Meng, Yu; Yan, Hua

    2015-01-01

    Purpose. To investigate prognostic factors that influence the final visual acuity (VA) and to correlate the ocular trauma score (OTS) with the final VA in open globe injuries. Methods. A retrospective review of 298 patients with open globe injuries admitted to Tianjin Medical University General Hospital was carried out from January 1, 2010, till December 31, 2014. Prognostic factors influencing the final VA in patients with open globe injuries and the correlation between OTS and the final VA were examined. Results. Three hundred and fourteen eyes from 298 patients with open globe injuries were analyzed. Males had a higher rate of open globe injury than females (83.56% versus 16.44%). Mean age was 45.46 ± 17.48 years (5–95 years). In a univariate analysis, prognostic factors influencing the final VA included initial VA, relative afferent papillary defect (RAPD), vitreous hemorrhage, lens injury, endophthalmitis, hyphema, retinal detachment, and the zone of injury. In a multiple logistic regression analysis, initial VA, RAPD, and the zone of injury were considered to be independent risk factors. The OTS correlated with final VA (r = 0.988, p = 0.000). Conclusion. In our study, the most important prognostic factors influencing the final VA were initial VA, RAPD, and the zone of injury. The OTS was of great importance for patients and ophthalmologists. PMID:26491549

  5. Prognostic Factors for Open Globe Injuries and Correlation of Ocular Trauma Score in Tianjin, China

    Directory of Open Access Journals (Sweden)

    Yu Meng

    2015-01-01

    Full Text Available Purpose. To investigate prognostic factors that influence the final visual acuity (VA and to correlate the ocular trauma score (OTS with the final VA in open globe injuries. Methods. A retrospective review of 298 patients with open globe injuries admitted to Tianjin Medical University General Hospital was carried out from January 1, 2010, till December 31, 2014. Prognostic factors influencing the final VA in patients with open globe injuries and the correlation between OTS and the final VA were examined. Results. Three hundred and fourteen eyes from 298 patients with open globe injuries were analyzed. Males had a higher rate of open globe injury than females (83.56% versus 16.44%. Mean age was 45.46 ± 17.48 years (5–95 years. In a univariate analysis, prognostic factors influencing the final VA included initial VA, relative afferent papillary defect (RAPD, vitreous hemorrhage, lens injury, endophthalmitis, hyphema, retinal detachment, and the zone of injury. In a multiple logistic regression analysis, initial VA, RAPD, and the zone of injury were considered to be independent risk factors. The OTS correlated with final VA (r=0.988, p=0.000. Conclusion. In our study, the most important prognostic factors influencing the final VA were initial VA, RAPD, and the zone of injury. The OTS was of great importance for patients and ophthalmologists.

  6. Neuroimaging Correlates of Novel Psychiatric Disorders after Pediatric Traumatic Brain Injury

    Science.gov (United States)

    Max, Jeffrey E.; Wilde, Elisabeth A.; Bigler, Erin D.; Thompson, Wesley K.; MacLeod, Marianne; Vasquez, Ana C.; Merkley, Tricia L.; Hunter, Jill V.; Chu, Zili D.; Yallampalli, Ragini; Hotz, Gillian; Chapman, Sandra B.; Yang, Tony T.; Levin, Harvey S.

    2012-01-01

    Objective: To study magnetic resonance imaging (MRI) correlates of novel (new-onset) psychiatric disorders (NPD) after traumatic brain injury (TBI) and orthopedic injury (OI). Method: Participants were 7 to 17 years of age at the time of hospitalization for either TBI or OI. The study used a prospective, longitudinal, controlled design with…

  7. Risk factors of bile duct injuries in laparoscopic cholecystectomy%腹腔镜胆囊切除术致胆管损伤相关危险因素

    Institute of Scientific and Technical Information of China (English)

    周党军; 白凤娇; 韩博强; 晁延军; 孙静; 安东均

    2016-01-01

    目的 探讨腹腔镜胆囊切除手术发生胆管损伤的危险因素.方法 回顾性分析咸阳市中心医院1992年10月至2013年12月11 243例腹腔镜胆囊切除术(LC)患者的临床资料,对出现胆管损伤患者的各种影响因素进行x2检验,分析胆管损伤的独立危险因素.结果 单因素分析显示患者男性、年龄≥≥65岁、体质量指数≥25 kg/m2、炎症分期、B超提示胆囊萎缩、B超所示胆囊壁厚度、胆囊三角解剖和术者经验与胆管损伤有关(均P<0.05).多因素非条件Logistic回归分析显示:老年男性、胆囊萎缩、胆囊三角解剖和术者经验是胆管损伤的独立危险因素(均P<0.05).结论 老年男性、胆囊萎缩、胆囊三角解剖和术者经验是胆管损伤的独立危险因素.%Objective To analyze the risk factors of bile duct injuries in laparoscopic cholecystectomy.Methods The clinical data of 11 243 patients who underwent laparoscopic cholecystectomy between October 1992 and December 2013 in the Xianyang Center Hospital were studied retrospectively.The risk factors of bile duct injuries were analyzed using the Chi-square test to determine the independent risk factors of bile duct injuries.Results Univariate analysis showed that bile duct injuries were associated with male,age ≥65 years,BMI ≥25 kg/m2,staging of inflammation,gallbladder atrophy on ultrasonography,thickness of gallbladder wall on ultrasonography,anatomy of Calot 's triangle and operator's experience (all P < 0.05).Multi-factor and non conditional Logistic regression analyses showed that the independent risk factors of bile duct injury were old men,gallbladder atrophy,anatomy of Calot's triangle and operator's experience (All P < 0.05).Conclusion Old men,gallbladder atrophy,anatomy of Calot's triangle and operator's experience were independent risk factors of bile duct injuries.

  8. 胆道探查术中胆总管下端穿通伤15例诊治分析%Diagnosis and treatment of penetrating injury in distal segment of common bile duct during biliary tract exploration

    Institute of Scientific and Technical Information of China (English)

    杜立学; 张煜; 吴武军; 耿西林; 李晖; 刘青光

    2009-01-01

    回顾性分析15例在胆道探查术中发牛胆道下端穿通伤患者的临床资料.9例为术中发现,行胆总管T形管引流并十二指肠侧后腹膜间隙引流,平均住院16 d,均痊愈;6例为术后发现,4例再次手术引流,住院8~12周痊愈,2例因感染性休克多脏器功能衰竭死亡.胆道穿通伤于术中及时发现、正确处理、充分引流,可获痊愈;术后早期发现,施以有效引流也可避免严重的并发症发生.%Clinical data of 15 patients with penetrating injury in the distal segment of the common bile duct during biliary tract exploration were retrospectively analyzed.Nine injuries were found during the surgical procedures and successfully treated with common bile duct T tube and peritoneal drainage before discharged from the hospital (mean hospitalization time 16 days).Six penetrating wounds were found post-operatively, and underwent another operation.Four patients were fully recovered at 8 to 12 weeks, and 2 died from multiple organ failure caused by infectious shock.Our investigation suggests that for the penetrating injury in the distal part of the common bile duct, early diagnosis, proper management and effective draining may improve the survival of the patients and avoid serious complications.

  9. 医源性胆道损伤的早期发现和一期修复手术治疗%Early diagnosis and the one-stage prosthesis operation for iatrogenic blie duct injury

    Institute of Scientific and Technical Information of China (English)

    周轼瑜

    2013-01-01

    Objectives The article inquire into iatrogenic bile duct injury of early stage diagnosis and treatment. Methods We review and analyse 27 cases with bile duct injury who have treated from 2000 to 2012. Results 21 cases underwent plastic operation and obtained good results. 1 case experienced re-operation due to the defluvium of the stent tube Five cases were operated for cholongiojejunostomy twice, two cases went through operation once again due to the stricture of the anastomotic stoma. Conclusion Bile duct injury is found earlier, The surgeon must choose to deal with it. It can reach good results that the laterstage of operation deal with it. First method is to operative repair and palstic operation.%目的 探讨医源性胆道损伤的早期诊断和诊治经验.方法 对2000~2012年间治疗的27例胆道损伤进行回顾性分析.结果 27例胆道损伤术中及术后早期发现并行一期修复整形、T管支撑引流22例,l例术后T管脱落后胆管狭窄再次手术,其余21例治疗效果好,另5例二次手术行胆肠Roux-en-Y吻合,1例吻合口狭窄再次手术后痊愈.结论 胆管损伤应尽早发现,并选以合适的治疗方法早期处理,比后期处理效果好.一期手术以修复整形为首选.

  10. Iliopsoas injury: an MRI study of patterns and prevalence correlated with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Bui, Kimmie L.; Ilaslan, Hakan; Recht, Michael; Sundaram, Murali [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States)

    2008-03-15

    The objective was to retrospectively determine the prevalence and patterns of iliopsoas injuries based on consecutive MRI examinations, correlated with clinical findings. From 4,862 consecutive MRI examinations of the hips and pelvis, 32 patients with 33 iliopsoas injuries were identified and graded as muscle strain, partial tendon tear, and complete tendon tears. These patients' medical records were reviewed to determine age, gender, and cause of symptoms. The prevalence of iliopsoas tendon and myotendinous injuries was 0.66% (95% CI: 0.44-0.89). There were 18 females and 14 males whose ages ranged from 7 to 95 years (mean, 54 years). The most frequent presenting symptom was hip pain and the most frequent clinical diagnosis, an occult fracture. The most common injuries in patients under 65 years (16 patients) were muscle strains and partial tendon tears, most often due to an athletic injury. The most common injury in patients 65 years and older (16 patients) was a complete tear (8 patients, all females), 2 of which were spontaneous in origin. Each grade of iliopsoas injury occurred with similar frequency. The more advanced the age of the patient, the more severe the injury. Non-athletic injuries predominated in patients 65 years and older; athletic injuries were the most common cause of iliopsoas injury in patients under 65 years. (orig.)

  11. Intestinal metaplasia in gallbladder correlates with high amylase levels in bile in patients with a morphologically normal pancreaticobiliary duct.

    Science.gov (United States)

    Sakamoto, Hirotsugu; Mutoh, Hiroyuki; Ido, Kenichi; Satoh, Shin; Kumagai, Machio; Hayakawa, Hiroko; Tamada, Kiichi; Sugano, Kentaro

    2009-12-01

    We reported previously that intestinal metaplasia in the gallbladder is strongly associated with expression of caudal-related homeobox transcription factor Cdx2. It has been documented that occult pancreatobiliary reflux, even in the absence of pancreaticobiliary maljunction, is associated with elevated risk of biliary malignancy. We ascertained the correlation between intestinal metaplasia in the gallbladder and occult pancreatobiliary reflux. In 196 patients with a normal pancreaticobiliary ductal arrangement who had undergone laparoscopic cholecystectomy, we performed intraoperative cholangiography and measured amylase levels in bile sampled from the gallbladder. The cutoff value for high cystic amylase was defined as a biliary amylase level higher than the normal upper limit of serum amylase (215 IU/L). We also retrospectively reviewed the cholecystectomized tissue specimens to investigate the presence of intestinal metaplasia and expression of Cdx2. Then, we explored the relationship between intestinal metaplasia in the gallbladder and occult choledocho-pancreatic reflux. Intestinal metaplasia was found in 16.8% (33/196) of the gallbladders. The prevalence of choledocho-pancreatic reflux revealed by intraoperative cholangiography was not significantly different between cases with intestinal metaplasia (5/33, 15.2%) and those without (25/163, 15.3%; P = .81). However, in cases with intestinal metaplasia, the rate of high cystic amylase (13/33, 39.4%) was significantly higher compared with cases without intestinal metaplasia (26/163, 16.0%, P = .005). In conclusion, intestinal metaplasia in the gallbladder is significantly correlated with high amylase levels in bile in patients with a morphologically normal pancreaticobiliary ductal arrangement.

  12. Correlations Between General Joint Hypermobility and Joint Hypermobility Syndrome and Injury in Contemporary Dance Students.

    Science.gov (United States)

    Ruemper, Alia; Watkins, Katherine

    2012-12-01

    The first objective of this study was to ascertain the prevalence of general joint hypermobility (GJH) and joint hypermobility syndrome (JHS) in BA Dance Theatre 1st and 3rd year students at a contemporary dance conservatory. The second objective was to determine the statistical correlation between GJH, JHS, and injury in this population. A total of 85 (female, N = 78; male, N = 7) contemporary dance students participated in the study. The Beighton score (with a forward flexion test modification) was used to determine GJH, and the Brighton criteria were used to verify JHS. Participants completed a self-reported injury questionnaire that included type of injury (physical complaint, medical diagnosis, or time-loss) and injury frequency. Statistical analysis (Pearson correlation) was used to correlate GJH, JHS, and frequency-of-injury scores. Overall, 69% of the students were found to have GJH, and 33% had JHS. A statistical correlation of r = + 0.331 (p contemporary dance students and suggests that screening programs should include the Brighton criteria to identify JHS in these dancers. Subsequent injury tracking and injury prevention programs would then provide data for further research in this area.

  13. [The Correlation Between MicroRNAs in Serum and the Extent of Liver Injury].

    Science.gov (United States)

    Zuo, Yi-Nan; He, Xue-Ling; Shi, Xue-Ni; Wei, Shi-Hang; Yin, Hai-Lin

    2017-05-01

    To investigate the correlation between the absolute quantification of the microRNAs (miR-122, miR-451, miR-92a, miR-192) in serum during acute liver injury and the extent of liver injury on rat models of CCl4 induced acute liver injury and mice models of acetaminophen (APAP) induced acute liver injury. Furthermore, to investigate the correlation between the absolute quantification of microRNAs in serum and the drug induced liver injury pathological scoring system (DILI-PSS). The acute liver injury model in rat by CCl4 (1.5 mL/kg), and the acute liver injury model in mice by APAP (160 mg/kg) were established. The serum at different time points on both models were collected respectively. The absolute quantification of microRNAs in serum were detected by using MiRbay(TM) SV miRNA Assay kit. Meanwhile, the pathological sections of liver tissue of the mice at each time point were collected to analyze the correlation between microRNAs and the degree of liver injury. In CCl4-induced rat acute liver injury model and APAP induced mouse acute liver injury, miR-122 and miR-192 appeared to be rising significantly, which remained the highest level at 24 h after treatment, and declined to the normal level after 72 h. In CCl4-induced rat acute liver injury model, the change of miR-92a was fluctuated and had no apparent rules, miR-451 declined gradually, but not obviously. In mice acute liver injury model induced by APAP, miR-92a and miR-451 in the progress of liver injury declined gradually, reached the lowest point at 48 h, and then recovered. The result of correlation analysis indicated that miR-122 and miR-192 presented a good positive correlation with the DILI-PSS ( r=0.741 3, Pcorrelation with DILI-PSS in APAP-induced liver injury models.

  14. PHYSICAL EXAMINATIONS FOR DIAGNOSING MENISCAL INJURIES: CORRELATION WITH SURGICAL FINDINGS

    Science.gov (United States)

    Gobbo, Ricardo da Rocha; Rangel, Victor de Oliveira; Karam, Francisco Consoli; Pires, Luiz Antônio Simões

    2015-01-01

    Objective: A set of five maneuvers for meniscal injuries (McMurray, Apley, Childress and Steinmann 1 and 2) was evaluated and their sensitivity, specificity, accuracy and likelihood were calculated. The same methods were applied to each test individually. Methods: One hundred and fifty-two patients of both sexes who were going to undergo videoarthroscopy on the knee were examined blindly by one of five residents at this hospital, without knowledge of the clinical data and why the patient was going to undergo an operation. This examination was conducted immediately before the videoarthroscopy and its results were recorded in an electronic spreadsheet. The set of maneuvers was considered positive when one was positive. In the individual analysis, it was enough for the test to be positive. Results: The analysis showed that the set of five meniscal tests presented sensitivity of 89%, specificity of 42%, accuracy of 75%, positive likelihood of 1.53 and negative likelihood of 0.26. Individually, the tests presented accuracy of between 48% and 53%. Conclusion: The set of maneuvers for meniscal injuries presented a good accuracy and significant value, especially for ruling out injury. Individually, the tests had less diagnostic value, although the Apley test had better specificity. PMID:27047833

  15. The Application of Damage Control Operation in Ultrasound interventional treatment of Bile Duct Injury%超声介入行损伤控制性手术在胆道损伤中的临床分析

    Institute of Scientific and Technical Information of China (English)

    黄明; 孙锋; 唐波; 孙琰; 张庶; 寸冬云

    2011-01-01

    Objective To explore the application of damage control operation ( DCO) in ultrasound interventional treatment of bile duct injury. Methods Clinical data of 19 cases with severe bile duct injury from December 2003 to December 2009 were selected as the object of this study, which Ultrasound interventional method was used in the damage control operation. DCO was performed in all 19 patients. PTCD was performed in 13 patients. Abdominal paracentesis drainage and/or hepatophyma and biloma drainage was performed in 6 patients. Results Among 19 patients, 17 patients underwent reoperation after patient's condition were ameliorated by drainage, symptomatic and supportive treatment, and no complications such as stricture of bile duct occurred during 24 months of median follow-up. Cholestasis hepatic cirrhosis was found in 1 patients who was waiting for liver transplantation. 1 patient died of severe pulmonary infection. Conclusion To reduce complications and increase survival rate, severe trauma patients with bile duct injury should be made positively under DCO and choose appropriate ultrasound interventional method.%目的 分析探讨超声介入方法行损伤控制性手术(DCO)在治疗胆道损伤中的应用.方法 回顾分析2003年12月至2009年12月期间超声介入方法实现DCO治疗19例胆道损伤患者的临床资料;19例胆道损伤患者均按DCO原则治疗:13例行PTCD引流胆汁,6例行腹腔穿刺引流和/或肝脓肿及胆汁瘤引流.结果19例病人中17例(89.5%)通过引流、对症、支持治疗,病情稳定接受再次确定性手术,中位随访期24个月,无术后胆管狭窄等并发症;1例病人胆汁淤积性肝硬化,等待肝移植,1例死于严重地肺部感染.结论 胆道损伤严重的患者,积极按照DCO原则,选用超声介入方式恰当处理,可以达到减少并发症和提高存活率的目的.

  16. Bronchoscopy-derived correlates of lung injury following inhalational injuries: a prospective observational study.

    Directory of Open Access Journals (Sweden)

    Samuel W Jones

    Full Text Available BACKGROUND: Acute lung injury (ALI is a major factor determining morbidity following burns and inhalational injury. In experimental models, factors potentially contributing to ALI risk include inhalation of toxins directly causing cell damage; inflammation; and infection. However, few studies have been done in humans. METHODS: We carried out a prospective observational study of patients admitted to the NC Jaycees Burn Center who were intubated and on mechanical ventilation for burns and suspected inhalational injury. Subjects were enrolled over an 8-month period and followed till discharge or death. Serial bronchial washings from clinically-indicated bronchoscopies were collected and analyzed for markers of cell injury and inflammation. These markers were compared with clinical markers of ALI. RESULTS: Forty-three consecutive patients were studied, with a spectrum of burn and inhalation injury severity. Visible soot at initial bronchoscopy and gram negative bacteria in the lower respiratory tract were associated with ALI in univariate analyses. Subsequent multivariate analysis also controlled for % body surface area burns, infection, and inhalation severity. Elevated IL-10 and reduced IL-12p70 in bronchial washings were statistically significantly associated with ALI. CONCLUSIONS: Independently of several factors including initial inhalational injury severity, infection, and extent of surface burns, high early levels of IL-10 and low levels of IL-12p70 in the central airways are associated with ALI in patients intubated after acute burn/inhalation injury. Lower airway secretions can be collected serially in critically ill burn/inhalation injury patients and may yield important clues to specific pathophysiologic pathways.

  17. Correlating first- and second-rib fractures noted on spine computed tomography with major vessel injury.

    Science.gov (United States)

    Khosla, Ankaj; Ocel, Joseph; Rad, Arash Ehteshami; Kallmes, David F

    2010-11-01

    First- and second-rib fractures diagnosed on plain radiographs have been associated with traumatic aortic injury. We examined whether such fractures diagnosed on computed tomography (CT), which is of greater sensitivity than plain radiograms for rib fractures, are associated with traumatic vascular injury. We identified 1,894 patients who had undergone a chest CT angiogram with indication of trauma between 2005 and 2008. Among these, 185 patients were selected at random. The main mechanism of injury was motor vehicle accident or a fall. The patients were divided into two groups: patients with first- and/or second-rib fractures and those without. Proportions of patients with major vessel injury noted on CT angiography were compared between groups. Information regarding displacement of the fracture, location of the fracture, detection upon plain film, and gender of the patients was also evaluated and correlated with incidence of major vessel injury. Fisher's test and χ2 analysis were used to determine significance of the data. Incidence of major vessel injury was similar between patients with and without first- and/or second-rib fractures (7% vs. 9%, respectively; p = 0.59). No subset of type of rib fracture was associated with greater incidence of aortic injury. First- and second-fractures are not associated with greater incidence of aortic injury. Thus, the previous axiom that first- and second-rib fractures should result in increased examination for aortic injury may not hold true.

  18. The Experience of Diagnosis and Treatment of Bile Duct Injury in Laparoscopic Cholecystectomy%腹腔镜胆囊切除术中胆道损伤的诊治体会

    Institute of Scientific and Technical Information of China (English)

    王志民; 任红亮

    2015-01-01

    目的:探讨腹腔镜胆囊切除术(Laparoscopic Cholecystectomy, LC)中胆道并发症的预防及治疗。方法我院在2005年3月~2013年12月所做的3000例LC手术中,其中有6例(包括外院转入1例)胆道损伤的患者,选取这些患者作为研究对象。结果7例患者右肝管夹闭1例,二次手术,去除钛夹,痊愈出院,胆总管成角部分夹闭1例,术后延迟黄疸,二次手术探查,去除钛夹缝扎胆囊管,胆道探查,“T”管引流3个月,痊愈,胆总管横断1例,肝总管横断2例,均术中发现行胆总管原位吻合,“T”管引流6个月,痊愈,肝总管横断均行胆肠吻合术Roux-en-y吻合口放置支架引流3个月痊愈,左右肝管全部清扫断,术后胆汁性腹膜炎,二次手术行肝门部胆管空肠盆式吻合1例。结论胆道损伤分主观原因和客观原因,主观上的大意及解剖的变异是LC导致胆道损伤的常见原因,胆道损伤重在预防,及时发现,尽早处理才能获得满意的预后。%Objective To investigate the prevention and treatment of biliary complications duing laparoscopic cholecystectomy (LC). Methods During March 2005 to December 2013, there were 3 000 cases of LC surgery conducted in our hospital, among them, 6 cases had biliary injury and were taken as the research object. Results In 6 patients, 1 case had right hepatic tube clip and was taken secondary surgery to remove titanium clamp, recovery angles bravery clip happened in 1 case, postoperative delayed jaundice, and was taken secondary surgery to remove the titanium crack cystic duct, biliary tract probe, the"T"tube drainage for 3 months. Common bile duct transection happened in 1 case. 2 cases had hepatic duct transection, and the current common bile duct anastomosis in situ, the"T"tube drainage for six month. Hepatic duct transection were biliary intestinal anastomosis Roux en-y anastomotic stent drainage, 3 months left and right

  19. Criminal correlates of injury-related emergency department recidivism.

    Science.gov (United States)

    Claassen, Cynthia A; Larkin, Gregory Luke; Hodges, Gayle; Field, Craig

    2007-02-01

    To investigate criminal and high-risk lifestyle factors that predict emergency department (ED) recidivism, a longitudinal (8-year) cohort study of ED trauma patients was conducted. Study patients provided risk and lifestyle behavior information via semi-structured interview. ED revisit and re-injury rates for 1995-2003 were acquired through hospital record review. Lifetime criminal arrest data were obtained for each study subject via record linkage from PublicData.com, an internet-based service. The 8-year ED re-visit rate was 47% (75/161), but revisits were more often medical than injury-related (30% vs. 17%, respectively). Over half (58%) of all injured ED patients had a documented arrest history, and arrests were significantly more common in those who came back to the ED for repeat trauma vs. those who did not revisit the ED (70.4% vs. 55.9%, respectively; p violence-related crimes, 23% (37/161) of 98 drug-related offenses, and 17.4% (28/161) of 89 other non-traffic-related crimes. ED recidivism for trauma care was associated with multiple substance abuse behaviors and drug-related arrests. Significant risk factors for ED recidivism seem to be high-risk substance-abuse-related behaviors and criminal activity, constituting important targets for effective ED-based intervention, referral, and follow-up.

  20. Performance Study and CFD Predictions of a Ducted Fan System

    Science.gov (United States)

    Abrego, Anita I.; Chang, I-Chung; Bulaga, Robert W.; Rutkowski, Michael (Technical Monitor)

    2002-01-01

    An experimental investigation was completed in the NASA Ames 7 by 10-Foot Wind Tunnel to study the performance characteristics of a ducted fan. The goal of this effort is to study the effect of ducted fan geometry and utilize Computational Fluid Dynamics (CFD) analysis to provide a baseline for correlation. A 38-inch diameter, 10-inch chord duct with a five-bladed fixed-pitch fan was tested. Duct performance data were obtained in hover, vertical climb, and forward flight test conditions. This paper will present a description of the test, duct performance results and correlation with CFD predictions.

  1. A study on the expressions and the correlation of TGF-β1 and а-SMA in healing process of bile duct trauma

    Institute of Scientific and Technical Information of China (English)

    徐军; 耿智敏; 马清涌

    2003-01-01

    Objective: To explore the formation mechanism of benign biliary stricture. Methods: A model of trauma of common bile duct was established in 28 dogs and then repaired. The anasomosis tissues were taken on the 1st week, 3rd week and the 3rd month, 6th month respectively after operation and examined by using light microscopy and electromicroscopy. Macrophage, TGF-β1 and α-SMA were studied immunohistochemically. Results: The mucosal epithelium of common bile duct restored poorly, chronic inflammation lasted for a long time, fibroblasts proliferated actively, extracellular matrix overdeposited; and myofibroblasts functioned actively and existed during the whole healing process. Immunohistochemical test showed a high expression of macrophage, TGF-β1 and α-SMA during healing process lasting a long duration. Macrophages were found in the lamina propria under mucosa, TGF-β1 in the granulation tissue, fibroblasts and endothelial cells of blood vesssels, while α-SMA in the myofiroblasts and smooth muscle tissue. Conclusion: The healing of bile duct is in the mode of overhealing. Myofibroblast is the main cause for contracture of scar and stricture of bile duct. The high expression of macrophage, TGF-β1 and α-SMA is closely related to active proliferation of fibroblasts, extracelluar matrix overdeposition and scar contracture of bile duct.

  2. Assessing bicycle-related trauma using the biomarker S100B reveals a correlation with total injury severity.

    Science.gov (United States)

    Thelin, E P; Zibung, E; Riddez, L; Nordenvall, C

    2016-10-01

    Worldwide, the use of bicycles, for both recreation and commuting, is increasing. S100B, a suggested protein biomarker for cerebral injury, has been shown to correlate to extracranial injury as well. Using serum levels of S100B, we aimed to investigate how S100B could be used when assessing injuries in patients suffering from bicycle trauma injury. As a secondary aim, we investigated how hospital length of stay and injury severity score (ISS) were correlated to S100B levels. We performed a retrospective, database study including all patients admitted for bicycle trauma to a level 1 trauma center over a four-year period with admission samples of S100B (n = 127). Computerized tomography (CT) scans were reviewed and remaining data were collected from case records. Univariate- and multivariate regression analyses, linear regressions and comparative statistics (Mann-Whitney) were used where appropriate. Both intra- and extracranial injuries were correlated with S100B levels. Stockholm CT score presented the best correlation of an intracranial parameter with S100B levels (p injury, thoracic injury, and non-cervical spinal injury were also significantly correlated (all p injury, and abdominal injury all independently correlated with levels of S100B. Patients with a ISS > 15 had higher S100 levels than patients with ISS injuries, had significantly higher levels of S100B than patients without injuries (p injury. Length of stay and ISS were both correlated with the admission levels of S100B in bicycle trauma, suggesting S100B to be a good marker of aggregated injury severity. Further studies are warranted to confirm our findings.

  3. Transduodenal exploration of the common bile duct in patients with nondilated ducts.

    Science.gov (United States)

    Ratych, R E; Sitzmann, J V; Lillemoe, K D; Yeo, C J; Cameron, J L

    1991-07-01

    Exploration of the small common bile duct can be technically difficult and is associated with a significant risk of ductal injury or late stricture, or both. Transduodenal common duct exploration after sphincteroplasty (TCDE/S) is an alternative method of duct exploration that avoids choledochotomy. Cholecystectomy followed by TCDE/S was performed upon 28 patients with nondilated ducts and suspected choledocholithiasis. Common duct stones were retrieved in 17 patients. Failure to retrieve stones in the remaining 11 patients was attributed to either false-positive results of cholangiography, forceful passage of stones into the duodenum during the initial insertion of a Fogarty catheter through the cystic duct or a false-negative finding at duct exploration. There was no perioperative mortality. Two patients had asymptomatic postoperative hyperamylasemia. One patient had postoperative pancreatitis, hyperbilirubinemia and cholangitis that resolved with antibiotic therapy by the eighth postoperative day. Other complications included wound infection, delayed gastric emptying, pneumonia and otitis media. The over-all morbidity rate was 28.6 per cent. Long term follow-up was obtained in all 28 patients. All patients in the follow-up group are free of recurrent biliary tract disease. TCDE/S appears to be a safe and effective method of exploring the nondilated common bile duct.

  4. Walking and child pedestrian injury: a systematic review of built environment correlates of safe walking.

    Science.gov (United States)

    Rothman, Linda; Buliung, Ron; Macarthur, Colin; To, Teresa; Howard, Andrew

    2014-02-01

    The child active transportation literature has focused on walking, with little attention to risk associated with increased traffic exposure. This paper reviews the literature related to built environment correlates of walking and pedestrian injury in children together, to broaden the current conceptualization of walkability to include injury prevention. Two independent searches were conducted focused on walking in children and child pedestrian injury within nine electronic databases until March, 2012. Studies were included which: 1) were quantitative 2) set in motorized countries 3) were either urban or suburban 4) investigated specific built environment risk factors 5) had outcomes of either walking in children and/or child pedestrian roadway collisions (ages 0-12). Built environment features were categorized according to those related to density, land use diversity or roadway design. Results were cross-tabulated to identify how built environment features associate with walking and injury. Fifty walking and 35 child pedestrian injury studies were identified. Only traffic calming and presence of playgrounds/recreation areas were consistently associated with more walking and less pedestrian injury. Several built environment features were associated with more walking, but with increased injury. Many features had inconsistent results or had not been investigated for either outcome. The findings emphasise the importance of incorporating safety into the conversation about creating more walkable cities.

  5. Localized intrahepatic bile duct dilatation without a visible mass or stone as depicted on CT images: findings of malignancy prediction

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ju Wan; Kim, Gab Chul; Jeong, Han Young; Lee, Hui Joong; Lee, Jae Hyuck; Ryeom, Hun Kyu [Kyungpook National University Hospital, Daegu (Korea, Republic of); Kim, Jong Yeol [Kumi Cha Medical Center, Collge of Medicine, Pochon CHA University, Kumi (Korea, Republic of)

    2008-09-15

    This study was preformed to evaluate factors that can predict the presence of a malignancy for localized intrahepatic bile duct dilatation without a visible mass or stone as depicted on CT images. A total of 29 patients (male: 16, female: 13) who had localized intrahepatic bile duct dilatation without a visible mass, stone or injury as depicted on CT images were included in the study. A history of extrahepatic malignancy and biliary stone disease, tumor marker levels, CT findings of the intrahepatic bile duct and associated findings were reviewed. The findings were analyzed between two groups (patients with a malignancy and patients with benign disease) on follow-up. In 29 patient, 11 patients had malignant lesions (four metastases and seven cholangiocarcinomas). The history of an extrahepatic malignancy and the shape of an intrahepatic duct obstruction or stenosis as seen on CT were significantly correlated with the results between the benign and malignant group of patients. The follow-up results of the malignant group of patients indicated that for six patients who had developed a new mass, one patient each showed aggravation of ductal dilatation and thickening of the ductal wall. When a patient with localized intrahepatic bile duct dilatation without a definite cause has a history of an extrahepatic malignancy or shows abrupt tapering or irregular narrowing on CT images, short-term follow-up should be performed. The patient should be investigated carefully for mass formation or a change of the dilated bile duct due to a possibility of malignant ductal dilatation.

  6. Early bile duct cancer

    Institute of Scientific and Technical Information of China (English)

    Jae Myung Cha; Myung-Hwan Kim; Se Jin Jang

    2007-01-01

    Bile duct cancers are frequently diagnosed as advanced diseases. Over half of patients with advanced bile duct cancer present with unresectable malignancies and their prognosis has been very poor even after curative resections. Although there has been a need to diagnose bile duct cancer at its early stage, it has been a difficult goal to achieve due to our lack of knowledge regarding this disease entity. Early bile duct cancer may be defined as a carcinoma whose invasion is confined within the fibromuscular layer of the extrahepatic bile duct or intrahepatic large bile duct without distant metastasis irrespective of lymph node involvement. Approximately 3%-10% of resected bile duct cancers have been reported to be early cancers in the literature. The clinicopathological features of patients with early bile duct cancer differ from those of patients with advanced bile duct cancer, with more frequent asymptomatic presentation, characteristic histopathological findings,and excellent prognosis. This manuscript is organized to emphasize the need for convening an international consensus to develop the concept of early bile duct cancer.

  7. Correlation between expectations of recovery and injury severity perception in whiplash-associated disorders

    Institute of Scientific and Technical Information of China (English)

    Robert FERRARI; Deon LOUW

    2011-01-01

    Objective:To assess the correlation between expectations of recovery and whiplash patients' perceptions of injury sevedty using a simplified instrument.Expectations of recovery have been shown to predict rate of recovery from whiplash injury in population-based studies.The perception of having more severe pathology or more ominous diagnostic labels has also been associated with a worse prognosis.Methods:Consecutive patients with whiplashassociated disorder grade 1 or 2,presenting in the acute stage to a primary care centre,were asked "do you think that your injury will…" with response options "get better soon; get better slowly; never get better; don't know." Injury severity perception (ISP) was measured with a numerical rating scale which ranged from 0-10,on which subjects were asked to rate how severe (in terms of damage) they thought their injury was.The anchors were labeled "no damage" (0) and "severe,and maybe permanent damage" (10).The primary outcome measure was the correlation between the subject's ISP score and expectation of recovery.Results:A total of 94 subjects (34 males,60 females,and mean age (40.6+10.0) years,range 19-60 years) were included.The initial responses to expectation of recovery were:get better soon (29/94); get better slowly (22/94); never get better (11/94); don't know (32/94).The mean ISP score was 4.9+1.7(range 2-9 out of 10).There was a high correlation between expectations and ISP scores (Spearman's rank correlation coefficient 0.68).Those who expected to recover soon and those who expected to get better slowly had the lowest ISP scores.Conclusions:The more slowly whiplash patients expect to recover,or the less sure they are of recovery,the more severe their initial perceptions of injury.

  8. Correlation of brain-derived neurotrophic factor to cognitive impairment following traumatic brain injury in rats

    Institute of Scientific and Technical Information of China (English)

    Dezhi Kang; Zhang Guo

    2008-01-01

    BACKGROUND: In vitro and in vivo studies have confirmed that brain-derived neurotrophic factor (BDNF) can promote survival and differentiation of cholinergic, dopaminergic and motor neurons, and axonal regeneration. BDNF has neuroprotective effects on the nervous system. OBJECTIVE: To explore changes in BDNF expression and cognitive function in rats after brain injury DESIGN, TIME AND SETTING: The neuropathology experiment was performed at the Second Research Room, Department of Neurosurgery, Fujian Medical University (China) from July 2007 to July 2008. MATERIALS: A total of 72 healthy, male, Sprague Dawley, rats were selected for this study. METHODS: Rat models of mild and moderate traumatic brain injury were created by percussion, according to Feeney's method (n = 24, each group). A bone window was made in rats from the sham operation group (n = 24), but no attack was conducted. MAIN OUTCOME MEASURES: At days 1,2, 4 and 7 following injury, BDNF expression in the rat frontal lobe cortex, hippocampus and basal forebrain was examined by immunohistochemistry (streptavidin-biotin-peroxidase complex method). Changes in rat cognitive function were assessed by the walking test, balance-beam test and memory function detection. RESULTS: Cognitive impairment was aggravated at day 2, and recovered to normal at days 3 and 7 in rats from the mild and moderate traumatic brain injury groups. BDNF expression in the rat frontal lobe cortex, hippocampus and basal forebrain was increased at 1 day, decreased at day 2, and then gradually increased in the mild and moderate traumatic brain injury groups. BDNF expression was greater in rats from the moderate traumatic brain injury group than in the sham operation and mild traumatic brain injury groups (P < 0.05). CONCLUSION: BDNF expression in the rat frontal lobe cortex, hippocampus and basal forebrain is correlated to cognitive impairment after traumatic brain injury. BDNF has a protective effect on cognitive function in rats

  9. 影响腹腔镜胆囊切除术(LC)中胆管损伤因素和预防策略分析%Effect of laparoscopic cholecystectomy (LC) in the analysis of bile duct injury factors and prevention strategies

    Institute of Scientific and Technical Information of China (English)

    王天民; 曹江威; 李冬雷; 卢涛

    2015-01-01

    目的:探讨影响腹腔镜胆囊切除术(LC)中胆管损伤因素以及预防方法。方法:选择我院2010年1月至2014年2月期间收治的需要进行 LC 的胆囊疾病患者2541例,对造成患者胆管损伤的相关影响因素进行对比分析,并回归性分析 LC 中胆管损伤的相关独立危险因素。结果:根据对影响 LC 手术中胆管损伤的相关危险因素进行单因素分析可知术中胆道造影、胆囊炎分期、胆囊三角解剖及手术医师经验等因素与胆管损伤间存在统计学差异,而经过多因素回归分析可知术中胆道造影、胆囊三角解剖及手术医师经验是影响 LC 术中胆管损伤的的相关独立危险因素。结论:胆道造影、胆囊三角解剖及手术医师经验是影响 LC 手术中胆管损伤的独立危险因素,在术中进行胆管造影,丰富手术医师经验以及对胆囊三角解剖结构的充分认识能够降低 LC 中胆管损伤的风险,并且术中操作要尽量轻柔谨慎,而一旦出现胆管损伤应及时进行处理。%Objective To investigate the effect of laparoscopic cholecystectomy (LC) in bile duct injury factors and preven-tion methods. Methods Our hospital from 2010 January to 2014 February were needed during the LC gallbladder disease in patients with 2541 cases of bile duct injury, on the influencing factors of patients with bile duct injury were analyzed, and the regression analysis of the independent risk factors of bile duct injury in LC. Results According to the single factor analysis and there are significant differences between that of intraoperative cholangiography, cholecystitis, gallbladder wall thickness, stag- ing of gallbladder triangle anatomy and operation of physician experience and other factors and bile duct injury on risk factors related to operation of bile duct injury in LC , and through multiple regression analysis of intraoperative cholangiography, the anatomy of Calot s triangle and

  10. Correlation between deceleration capacity of rate and myocardial injury degree in children with viral myocarditis

    Institute of Scientific and Technical Information of China (English)

    Jing-Yang Zhang; Hui Wu

    2016-01-01

    Objective:To find the correlation between deceleration capacity of rate and myocardial injury degree in children with viral myocarditis.Methods:A total of 90 children with viral myocarditis and 86 healthy children were selected as the research subjects, differences in rate deceleration capacity of rate and myocardial damage degree indexes were compared between two groups of children, and the correlation between deceleration capacity of rate and myocardial injury degree was further analyzed.Results:Mean DC level as well as heart rate variability indexes SDNN, SDANN, RMSSD, LF and HF levels of observation group was lower than those of control group; serum myocardial enzyme spectrum indexes CK, CK-MB, cTnⅠ, LDH, AST and ALT content were higher than those of control group; serum apoptosis indexes GRBS, sFasL, Bax and caspase-3 content were higher than those of control group while Bcl-2 content was lower than that of control group; heart rate indexes MSV1, MSV2, MSV3, PFVe and PFVa levels were lower than those of control group. Deceleration capacity of rate in children with viral myocarditis was directly correlated with myocardial injury-related indexes such as heart rate variability, myocardial enzyme spectrum, myocardial apoptosis and heart rate.Conclusions: The change of deceleration capacity of rate in children with viral myocarditis is directly correlated with myocardial injury, and can be used as a reliable medium for disease severity judgment and clinical treatment guidance.

  11. Aberrant subvesical bile ducts identified during laparoscopic cholecystectomy: A rare case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Theodoros Mariolis-Sapsakos

    2017-01-01

    Conclusion: Aberrant subvesical bile ducts are associated with a high risk of surgical bile duct injury. Nevertheless, meticulous operative technique combined with surgeons’ perpetual awareness concerning this peculiar anatomical aberration leads to a safe laparoscopic cholecystectomy.

  12. Correlation of male genital filaments and female spermathecal ducts in New World sand flies of the Lutzomyia intermedia species complex (Diptera: Psychodidae, Phlebotominae

    Directory of Open Access Journals (Sweden)

    Marcondes Carlos Brisola

    2003-01-01

    Full Text Available The lengths of the male genital filaments and female spermathecal ducts were measured in phlebotomine sand flies of the Lutzomyia intermedia species complex and the ratios between these characters calculated. Ratios for L. intermedia s. s. from Northeast vs Southeast Brazil (Espírito Santo and Minas Gerais, Espírito Santo/Minas Gerais vs Rio de Janeiro/São Paulo and L. intermedia vs L. neivai were significantly different at P < 0.1, 0.05 and 0.01 respectively when compared using ANOVA. The spermathecal ducts and genital filaments of L. intermedia were significantly longer than those of L. neivai (P < 0.01 and could be used to differentiate these species. The taxonomic and biological significance of these differences is discussed.

  13. Correlating learning and memory improvements to long-term potentiation in patients with brain injury

    Institute of Scientific and Technical Information of China (English)

    Xingfu Peng; Qian Yu

    2008-01-01

    BACKGROUND:Brain injury patients often exhibit learning and memory functional deficits.Long-term potentiation(LTP)is a representative index for studying learning and memory cellular models; the LTP index correlates to neural plasticity. OBJECTIVE:This study was designed to investigate correlations of learning and memory functions to LTP in brain injury patients,and to summarize the research advancements in mechanisms underlying brain functional improvements after rehabilitation intervention. RETRIEVAL STRATEGY:Using the terms "brain injuries,rehabilitation,learning and memory,long-term potentiation",manuscripts that were published from 2000-2007 were retrieved from the PubMed database.At the same time,manuscripts published from 2000-2007 were also retrieved from the Database of Chinese Scientific and Technical Periodicals with the same terms in the Chinese language.A total of 64 manuscripts were obtained and primarily screened.Inclusion criteria:studies on learning and memory,as well as LTP in brain injury patients,and studies focused on the effects of rehabilitation intervention on the two indices; studies that were recently published or in high-impact journals.Exclusion criteria:repetitive studies.LITERATURE EVALUATION:The included manuscripts primarily focused on correlations between learning and memory and LTP,the effects of brain injury on learning and memory,as well as LTP,and the effects of rehabilitation intervention on learning and memory after brain injury.The included 39 manuscripts were clinical,basic experimental,or review studies. DATA SYNTHESIS:Learning and memory closely correlates to LTP.The neurobiological basis of learning and memory is central nervous system plasticity,which involves neural networks,neural circuits,and synaptic connections,in particular,synaptic plasticity.LTP is considered to be an ideal model for studying synaptic plasticity,and it is also a classic model for studying neural plasticity of learning and memory.Brain injury

  14. Unintentional Injuries and Psychosocial Correlates among in-School Adolescents in Malaysia

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2015-11-01

    Full Text Available The study aimed to provide estimates of the prevalence and psychosocial correlates of unintentional injury among school-going adolescents in Malaysia. Cross-sectional data from the Global School-Based Health Survey (GSHS included 21,699 students (predominantly ≤13 to ≥17 years that were selected by a two-stage cluster sample design to represent all secondary school students in Forms 1 to 5. The percentage of school children reporting one or more serious injuries in the past year was 34.9%, 42.1% of boys and 27.8% of girls. The two major causes of the most serious injury were “fall” (9.9% and motor vehicle accident or being hit by a motor vehicle (5.4%, and the most frequent type of injury sustained was cut, puncture, or stab wound (6.2% and a broken bone or dislocated joint (4.2%. In multivariable logistic regression analysis, sociodemographic factors (being male and low socioeconomic status, substance use (tobacco and cannabis use, frequent soft drink consumption, attending physical education classes three or more times a week, other risky behavior (truancy, ever having had sex, being bullied, psychological distress, and lack of parental or guardian bonding were associated with annual injury prevalence. Several factors were identified, which could be included in injury prevention promotion programs among secondary school children.

  15. Unintentional Injuries and Psychosocial Correlates among in-School Adolescents in Malaysia.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa

    2015-11-20

    The study aimed to provide estimates of the prevalence and psychosocial correlates of unintentional injury among school-going adolescents in Malaysia. Cross-sectional data from the Global School-Based Health Survey (GSHS) included 21,699 students (predominantly ≤13 to ≥17 years) that were selected by a two-stage cluster sample design to represent all secondary school students in Forms 1 to 5. The percentage of school children reporting one or more serious injuries in the past year was 34.9%, 42.1% of boys and 27.8% of girls. The two major causes of the most serious injury were "fall" (9.9%) and motor vehicle accident or being hit by a motor vehicle (5.4%), and the most frequent type of injury sustained was cut, puncture, or stab wound (6.2%) and a broken bone or dislocated joint (4.2%). In multivariable logistic regression analysis, sociodemographic factors (being male and low socioeconomic status), substance use (tobacco and cannabis use), frequent soft drink consumption, attending physical education classes three or more times a week, other risky behavior (truancy, ever having had sex, being bullied), psychological distress, and lack of parental or guardian bonding were associated with annual injury prevalence. Several factors were identified, which could be included in injury prevention promotion programs among secondary school children.

  16. Personality Change Due to Traumatic Brain Injury in Children and Adolescents: Neurocognitive Correlates.

    Science.gov (United States)

    Max, Jeffrey E; Wilde, Elisabeth A; Bigler, Erin D; Hanten, Gerri; Dennis, Maureen; Schachar, Russell J; Saunders, Ann E; Ewing-Cobbs, Linda; Chapman, Sandra B; Thompson, Wesley K; Yang, Tony T; Levin, Harvey S

    2015-01-01

    Personality change due to traumatic brain injury (PC) in children is an important psychiatric complication of injury and is a form of severe affective dysregulation. This study aimed to examine neurocognitive correlates of PC. The sample included 177 children 5-14 years old with traumatic brain injury who were enrolled from consecutive admissions to five trauma centers. Patients were followed up prospectively at baseline and at 6 months, and they were assessed with semistructured psychiatric interviews. Injury severity, socioeconomic status, and neurocognitive function (measures of attention, processing speed, verbal memory, IQ, verbal working memory, executive function, naming/reading, expressive language, motor speed, and motor inhibition) were assessed with standardized instruments. Unremitted PC was present in 26 (18%) of 141 participants assessed at 6 months postinjury. Attention, processing speed, verbal memory, IQ, and executive function were significantly associated with PC even after socioeconomic status, injury severity, and preinjury attention deficit hyperactivity disorder were controlled. These findings are a first step in characterizing concomitant cognitive impairments associated with PC. The results have implications beyond brain injury to potentially elucidate the neurocognitive symptom complex associated with mood instability regardless of etiology.

  17. Injury and Social Correlates among in-School Adolescents in Four Southeast Asian Countries

    Directory of Open Access Journals (Sweden)

    Supa Pengpid

    2012-08-01

    Full Text Available The aim of this study was to determine estimates of the prevalence and social correlates of injury among adolescents in four Southeast Asian countries. Cross-sectional national data from the Global School-based Health Survey (GSHS included 9,333 students at the ages from 13 to 15 years inclusive from Indonesia, Myanmar, Sri Lanka and Thailand is chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The percentage of adolescents reporting one or more serious injuries within the past 12 months was 42.2% for all countries, ranging from 27.0% in Myanmar to 46.8% in Thailand. By major activity, “fall” (14.6% was the leading external cause of injury, followed by playing or training for a sport (9.9% and vehicle accident (6.1%. In multivariate regression analysis Thailand and Indonesia, being male, substance use (smoking and drinking alcohol and psychological distress were associated with annual injury prevalence. Risk factors of substance use and psychological distress should be considered in an integrated approach to injury etiology in planning injury prevention and safety promotion activities among school children.

  18. Attachment Style, Social Support, and Coping as Psychosocial Correlates of Happiness in Persons with Spinal Cord Injuries

    Science.gov (United States)

    Wilson, Lisa; Catalano, Denise; Sung, Connie; Phillips, Brian; Chou, Chih-Chin; Chan, Jacob Yui Chung; Chan, Fong

    2013-01-01

    Objective: To examine the roles of attachment, social support, and coping as psychosocial correlates in predicting happiness in people with spinal cord injuries. Design: Quantitative descriptive research design using multiple regression and correlation techniques. Participants: 274 individuals with spinal cord injuries. Outcome Measures: Happiness…

  19. Attachment Style, Social Support, and Coping as Psychosocial Correlates of Happiness in Persons with Spinal Cord Injuries

    Science.gov (United States)

    Wilson, Lisa; Catalano, Denise; Sung, Connie; Phillips, Brian; Chou, Chih-Chin; Chan, Jacob Yui Chung; Chan, Fong

    2013-01-01

    Objective: To examine the roles of attachment, social support, and coping as psychosocial correlates in predicting happiness in people with spinal cord injuries. Design: Quantitative descriptive research design using multiple regression and correlation techniques. Participants: 274 individuals with spinal cord injuries. Outcome Measures: Happiness…

  20. Acromioclavicular joint dislocations: radiological correlation between Rockwood classification system and injury patterns in human cadaver species.

    Science.gov (United States)

    Eschler, Anica; Rösler, Klaus; Rotter, Robert; Gradl, Georg; Mittlmeier, Thomas; Gierer, Philip

    2014-09-01

    The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned. The goal of this experimental-based investigation was to approve the correlation between the anatomical injury pattern and the Rockwood classification. In four human cadavers (seven shoulders), the acromioclavicular and coracoclavicular ligaments were transected stepwise. Radiological correlates were recorded (Zanca view) with 15-kg longitudinal tension applied at the wrist. The resulting acromio- and coracoclavicular distances were measured. Radiographs after acromioclavicular ligament transection showed joint space enlargement (8.6 ± 0.3 vs. 3.1 ± 0.5 mm, p acromioclavicular joint space width increased to 16.7 ± 2.7 vs. 8.6 ± 0.3 mm, p acromioclavicular joint lesions higher than Rockwood type I and II. The clinical consequence for reconstruction of low-grade injuries might be a solely surgical approach for the acromioclavicular ligaments or conservative treatment. High-grade injuries were always based on additional structural damage to the coracoclavicular ligaments. Rockwood type V lesions occurred while muscle attachments were intact.

  1. Spinal cord injury after blunt cervical spine trauma: correlation of soft-tissue damage and extension of lesion.

    Science.gov (United States)

    Martínez-Pérez, R; Paredes, I; Cepeda, S; Ramos, A; Castaño-León, A M; García-Fuentes, C; Lobato, R D; Gómez, P A; Lagares, A

    2014-05-01

    In patients with spinal cord injury after blunt trauma, several studies have observed a correlation between neurologic impairment and radiologic findings. Few studies have been performed to correlate spinal cord injury with ligamentous injury. The purpose of this study was to retrospectively evaluate whether ligamentous injury or disk disruption after spinal cord injury correlates with lesion length. We retrospectively reviewed 108 patients diagnosed with traumatic spinal cord injury after cervical trauma between 1990-2011. Plain films, CT, and MR imaging were performed on patients and then reviewed for this study. MR imaging was performed within 96 hours after cervical trauma for all patients. Data regarding ligamentous injury, disk injury, and the extent of the spinal cord injury were collected from an adequate number of MR images. We evaluated anterior longitudinal ligaments, posterior longitudinal ligaments, and the ligamentum flavum. Length of lesion, disk disruption, and ligamentous injury association, as well as the extent of the spinal cord injury were statistically assessed by means of univariate analysis, with the use of nonparametric tests and multivariate analysis along with linear regression. There were significant differences in lesion length on T2-weighted images for anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum in the univariate analysis; however, when this was adjusted by age, level of injury, sex, and disruption of the soft tissue evaluated (disk, anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum) in a multivariable analysis, only ligamentum flavum showed a statistically significant association with lesion length. Furthermore, the number of ligaments affected had a positive correlation with the extension of the lesion. In cervical spine trauma, a specific pattern of ligamentous injury correlates with the length of the spinal cord lesion in MR imaging studies

  2. Adult stem cells from the hyaluronic acid-rich node and duct system differentiate into neuronal cells and repair brain injury.

    Science.gov (United States)

    Lee, Seung J; Park, Sang H; Kim, Yu I; Hwang, Sunhee; Kwon, Patrick M; Han, In S; Kwon, Byoung S

    2014-12-01

    The existence of a hyaluronic acid-rich node and duct system (HAR-NDS) within the lymphatic and blood vessels was demonstrated previously. The HAR-NDS was enriched with small (3.0-5.0 μm in diameter), adult stem cells with properties similar to those of the very small embryonic-like stem cells (VSELs). Sca-1(+)Lin(-)CD45(-) cells were enriched approximately 100-fold in the intravascular HAR-NDS compared with the bone marrow. We named these adult stem cells "node and duct stem cells (NDSCs)." NDSCs formed colonies on C2C12 feeder layers, were positive for fetal alkaline phosphatase, and could be subcultured on the feeder layers. NDSCs were Oct4(+)Nanog(+)SSEA-1(+)Sox2(+), while VSELs were Oct4(+)Nanog(+)SSEA-1(+)Sox2(-). NDSCs had higher sphere-forming efficiency and proliferative potential than VSELs, and they were found to differentiate into neuronal cells in vitro. Injection of NDSCs into mice partially repaired ischemic brain damage. Thus, we report the discovery of potential adult stem cells that may be involved in tissue regeneration. The intravascular HAR-NDS may serve as a route that delivers these stem cells to their target tissues.

  3. Correlations between injury, training intensity, and physical and mental exhaustion among college athletes.

    Science.gov (United States)

    Vetter, Rheba E; Symonds, Matthew L

    2010-03-01

    The primary purpose of this research was to obtain information concerning injury incidence and perceptions of training intensities and fatigue levels among college athletes via a survey study. A second purpose was to illuminate correlations between the collected data. This study employed an investigator-designed survey instrument administered to 411 NCAA Division II male and female athletes, with 149 completed responses. The survey included 3 themes: injury incidence, training intensity, and physical and mental exhaustion. Men and women spent 4.5 days per week training using moderate- and high-intensity levels. Fifty percent of the total number of athletes reported chronic injury. During the competition season, physical exhaustion occurred "frequently" 30.86 and 23.53% of the time with men and women, respectively. In the noncompetition season, physical exhaustion was "frequently" experienced 19.75 and 17.65% of the time among men and women, respectively. Statistically significant correlations (p injury for men and chronic injury for women. Also, training intensity levels and physical and mental exhaustion for men and women were statistically significant. The current investigators found the training involved 2-3 hours of moderate to high intensity 4.5 days per week both during competition and noncompetition; women and men spent 2-3 hours of light intensity 1.31 and 1.45 days per week, respectively. Women and men in addition to training, engaged in 3.78 and 4.43 hours of leisure physical activity per week. The investigators recommend tapering, periodization, and rest to help avoid overuse syndrome, overreaching, and overtraining that leads to excessive physical and mental exhaustion and injury.

  4. MRI of pediatric growth plate injury: correlation with plain film radiographs and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Carey, J.; Spence, L.; Blickman, H.; Eustace, S. [Medical Center, Boston, MA (United States). Dept. of Radiol.

    1998-05-01

    Purpose. To evaluate pediatric growth plate injuries with conventional radiographs and magnetic resonance imaging (MRI). To review potential clinical impact of MRI on subsequent patient management and outcome. Methods. Fourteen patients with known or suspected growth plate injury were studied. Each patient underwent imaging by conventional radiography and MRI within 2 weeks of injury. Findings on conventional radiographs and on MR images were compared and then correlated with subsequent management and outcome at a mean of 12 months. Results. Direct visualization of cartilage afforded by MRI improved evaluation of growth plate injury in each case. MRI changed Salter Harris classification or staging in 2 of 9 patients with fractures visualized on conventional radiographs, allowed the detection of radiographically occult fractures in 5 of 14 cases, and resulted in a physical change in management in 5 of the 14 patients studied. Conclusion. MRI has an important role in the evaluation of acute pediatric growth plate injury, particularly when diagnostic uncertainty persists following the evaluation of conventional radiographs. MRI allows detection of occult fractures, may alter Salter Harris staging, and in the reported study it frequently resulted in a change in patient management. (orig.) With 4 figs., 1 tab., 20 refs.

  5. Sonography on injury of the medial patellofemoral ligament after acute traumatic lateral patellar dislocation: Injury patterns and correlation analysis with injury of articular cartilage of the inferomedial patella.

    Science.gov (United States)

    Zhang, Guang-Ying; Zheng, Lei; Shi, Hao; Qu, Su-Hui; Ding, Hong-Yu

    2013-12-01

    The purpose of this study was to investigate the accuracy of high-frequency ultrasonography in the diagnosis of injuries of medial patellofemoral ligaments (MPFLs), analyse the characteristics of MPFL injury and correlations between injury of the MPFL and articular cartilage of the inferomedial patella in patients with acute traumatic lateral patellar dislocation. High-frequency sonographic images of 49 patients with acute traumatic lateral patellar dislocations treated surgically were reviewed. The χ(2) tests were performed for statistical analysis. Twenty-eight cases of complete MPFL tear and 21 cases of partial MPFL tear were identified in operation, with 27 cases of MPFL tear located at their femoral attachment, 21 cases of tear at the patellar attachment and one case of midsubstance tear. The diagnostic accuracy of sonography regarding partial MPFL tear and complete MPFL tear was 89.8% and 89.8%. Among the patients with MPFL tear at the patellar attachment, eight and six cases were concomitant with chondral and osteochondral lesions in the inferomedial patella, respectively, in contrast to nine and six cases in patients with MPFL tear at the femoral attachment, respectively. There was no significant difference between the two locations described above regarding the prevalence rates of chondral or osteochondral lesions of the inferomedial patella (P=0.732, P=0.614). Among the patients with complete MPFL tear, 12 and 10 cases were concomitant with chondral and osteochondral lesions in the inferomedial patella, respectively, while six and two cases were concomitant with partial MPFL tear. There was no significant difference between the two types of injuries discussed above on the prevalence rates of chondral lesions of the inferomedial patella (P=0.305), but the prevalence rate of osteochondral lesions between the two types of injuries discussed above was statistically different (P=0.035). The MPFL is most easily injured at the femoral attachment, secondly at

  6. The correlation between the imaging characteristics of hamstring injury and time required before returning to sports: a literature review.

    Science.gov (United States)

    Svensson, Kjell; Alricsson, Marie; Eckerman, Mattias; Magounakis, Theofilos; Werner, Suzanne

    2016-06-01

    Injuries to the hamstring muscles are common in athletes. Track and field, Australian football, American football and soccer are examples of sports where hamstring injuries are the most common. The purpose of this study was to investigate whether there is a correlation between a hamstring injury prognosis and its characteristics of imaging parameters. The literature search was performed in the databases PubMed and CINAHL, and eleven articles were included. Seven out of the 11 articles showed a correlation between the size of the hamstring injury and length of time required before returning to sports. Different authors have reported contrasting results about length of time required before returning to sports due to location of injury within specific muscle. Majority of the articles found hamstring strain correlated to an extended amount of time required before returning to sports.

  7. Does Overexertion Correlate with Increased Injury? Determining the Relationship between Training Load and Soft Tissue Injury in NFL Players using Wearable Technology

    Science.gov (United States)

    Li, Ryan Tianran; Rambhia, Sagar; Sheehan, Joe; Salata, Michael Jonathan; Voos, James Everett

    2017-01-01

    Objectives: The development of injury prevention strategies is important in maximizing athlete health and safety. Increased training loads have been associated with increased odds of injury in collision sports during all phases of training. To date, the relationship between training load and injury has not been investigated in NFL players. The primary objective of this study was to determine the correlation between player workload and soft tissue injury utilizing wearable GPS technology. Methods: Player workloads were assessed during training sessions during the preseason and regular season using GPS and triaxial accelerometer from 2014-2016. Soft tissue injuries were recorded during each season and were divided into ligamentous and myotendinous injuries. Player workload during the week of injury and mean weekly workload in the 4 weeks prior to injury were determined for each soft tissue injury. These variables were also determined in uninjured position-matched controls during the same week. Descriptive statistics were used to summarize player workload for injuries and controls. Subgroup analysis was also conducted to determine whether observed effects were confounded by training period and type of injury. Results: Data was obtained over 2 NFL seasons from 2014-2016. A total of 136 lower extremity injuries were recorded. 62/136 (45%) of injuries were sustained during the preseason. Ankle sprains were the most common type of ligamentous injury (60%) while hamstring strains were the most common type of myotendinous injury (49%). 100 injuries that had a set of GPS data were included in the analysis. Injuries were associated with greater increases in player workload during the week of injury compared to uninjured individuals (193.6, 95% CI 104.6-282.5 versus 101.2, 95% CI 27.7-174.8, p = .0038). Injured players were associated with a 110% increase in training load during the week of injury compared to uninjured players, who were associated with a 73% increase (p = .032

  8. A correlative study between prevalence of chondromalacia patellae and sports injury in 4068 students

    Institute of Scientific and Technical Information of China (English)

    张辉; 孔祥清; 程琮; 梁茂华

    2003-01-01

    Objective: To study the prevalence of chondromalacia patella among college students and the correlation with sports injury. Methods: 354 students from gymnastic department and 429 from nongymnastic department with knee joint pain were selected. 184 students from gymnastic department and 342 from nongymnastic department were checked randomly by a surgeon. 77 patients (37 males, 40 females) from gymnastic department and 119 patients (62 males, 57 females) from nongymnastic department were diagnosed as chondromalacia patellae. The amount of exercise and the occurrence of sports injury were investigated in each student. All data were analyzed with SPSS 10.0 statistical software. Results: The prevalence of chondromalacia patella was 20.1% in female students and 11.6% in male students from gymnastic department, and 5.61% in female students and 4.92% in male students from nongymnastic department. The amount of exercise and the occurrence of sports injury to the knee joint in students from gymnastic department were greater than those from nongymnastic department. Conclusions: In both female and male students, the prevalence of chondromalacia patella is higher in gymnastic department than nongymnastic department. Sports injury is an important cause of chondromalacia patella.

  9. Congenital double bile duct presenting as recurrent cholangitis in a child

    Directory of Open Access Journals (Sweden)

    K.D. Chakravarty

    2015-12-01

    Full Text Available Double common bile duct (DCBD is a rare congenital anomaly. Most of these bile duct anomalies are associated with bile duct stones, anomalous pancreaticobiliary junction (APBJ, pancreatitis and bile duct or gastric cancers. Early detection and treatment is important to avoid long term complications. Surgical resection of the anomalous bile duct and reconstruction of the biliary enteric anastomosis is the treatment of choice. We report a rare case of DCBD anomaly in a girl, who presented with recurrent cholangitis. She had type Va DCBD anomaly. She underwent successful resection of the bile duct and reconstruction of the biliary enteric anastomosis. Preoperative imaging and diagnosis of the congenital biliary anomaly is very important to avoid intraoperative bile duct injury. Review of the literature shows very few cases of type Va DCBD, presenting with either bile duct stones or APBJ.

  10. Identification and treatment of variation of extrahepatic bile duct in laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    PENG Lei

    2015-10-01

    Full Text Available ObjectiveTo investigate the identification and treatment of variation of extrahepatic bile duct in laparoscopic cholecystectomy (LC, and to reduce the occurrence of bile duct injury. MethodsThis study included 60 patients who received LC in the People′s Hospital of Caidian District in Wuhan and had structural variation of extrahepatic bile duct found during the operation from January 2012 to January 2014. The clinical data were retrospectively analyzed, and the intraoperative and postoperative conditions were summarized. ResultsDuring operation, cystic duct variation was found in 32 cases, abnormal position of the point where the cystic duct joins the extrahepatic bile duct in 20 cases, the cystic duct and the common hepatic duct having the common wall before joining the common bile duct in 2 cases, aberrant bile duct in the gallbladder bed in 2 cases, and accessory hepatic duct in 4 cases. Fifty-one patients (85% successfully underwent LC; 9 patients (15% were converted to open surgery. All patients finished surgery successfully. There were 2 cases of postoperative complications; one patient developed residual stones in the bile duct, and bile leakage occurred in the other patient at one week after LC, who recovered after reoperation. All patients were cured and discharged, without severe complications such as intraperitoneal hemorrhage, infection, and intestinal injury. ConclusionIdentifying the structural variation of extrahepatic bile duct, dissecting the Calot′s triangle meticulously, and determining the type of variation of extrahepatic bile duct play important roles in LC and significantly reduce the incidence of bile duct injury.

  11. 医源性胆管损伤的治疗及远期疗效%Management and long-term efficacy of patients with iatrogenic bile duct injury

    Institute of Scientific and Technical Information of China (English)

    洪涛; 何小东; 蔺晨; 武峤

    2012-01-01

    目的 探讨医源性胆管损伤的治疗方法并评价远期疗效.方法 回顾性分析1982年1月至2012年4月北京协和医院收治的62例医源性胆管损伤患者的临床资料.LC致胆管损伤24例,开腹胆囊切除术致胆管损伤38例.10例患者接受非手术治疗,其中8例行PTCD治疗、2例行ERCP+支架治疗.52例患者接受手术治疗,其中47例行胆管空肠Roux-en-Y吻合、2例行肝胆管十二指肠吻合或重建、3例行胆管缝合或端端吻合.术前36例患者行PTCD治疗.术中42例患者放置胆管支架.为了预防术后腹腔积液或包裹性胆汁积液,50例患者术中行腹腔引流.结果 接受手术治疗的52例患者中,13例出现1种以上并发症,其中伤口感染1例、胆管炎4例、吻合口漏2例、吻合口出血2例、吻合口不畅1例、胆管支架脱落1例、胃肠道相关疾病3例.18例患者术后早期进行胆道造影检查,其中2例提示胆汁漏.15例患者术后行PTCD+胆道支架植入,其中1例患者行经皮腹腔穿刺引流.2例患者因吻合口出血分别于术后1d和术后2周行再次手术治疗.50例行术中腹腔引流术患者引流管平均放置时间为(7.7±2.6)d.全组患者无围手术期死亡,术后平均住院时间为(18 ±12)d.本组62例患者中55例获得随访(非手术治疗10例、手术治疗45例),中位随访时间为93个月.接受非手术治疗的10例患者中,1例行PTCD后因胆汁漏于外院接受再次手术治疗,3例行PTCD后因胆管炎反复发作伴结石形成多次行PTCD.接受手术治疗的45例患者中,6例出现远期并发症,其中发热6例、黄疸4例、胆管结石3例、胆管癌变1例;4例于术后2年行再次手术.结论 尽早发现胆管损伤并由经验丰富的专科医师治疗是保证患者近期和远期疗效的最佳方案.外科修复仍为治疗胆管损伤的首选.%Objective To investigate the management of iatrogenic bile duct injury and evaluate the longterm efficacy.Methods The

  12. Considering built environment and spatial correlation in modelling pedestrian injury severity

    DEFF Research Database (Denmark)

    Prato, Carlo G.; Kaplan, Sigal; Patrier, Alexandre

    2017-01-01

    This study looks at mitigating and aggravating factors that are associated with the injury severity of pedestrians when they have crashes with another road user and overcomes existing limitations in the literature by posing attention on the built environment and considering spatial correlation...... of pedestrians to sustain a severe or fatal injury conditional on the occurrence of a crash with another road user. This study confirms previous findings about older pedestrians and intoxicated pedestrians being the most vulnerable road users, and crashes with heavy vehicles and in roads with higher speed limits...... across crashes. Reports for 6539 pedestrian crashes occurred in Denmark between 2006 and 2015 were merged with geographic information system resources containing detailed information about built environment and exposure at the crash locations. A linearised spatial logit model estimated the probability...

  13. Cascade of Traumatic Brain Injury: A Correlational Study of Cognition, Postconcussion Symptoms, and Quality of Life.

    Science.gov (United States)

    Reddy, Rajakumari Pampa; Rajeswaran, Jamuna; Devi, B Indira; Kandavel, Thennarasu

    2017-01-01

    Traumatic brain injury (TBI) constitutes a significant burden on health care resources in India. TBI is a dynamic process which involves damage to the brain thus leading to behavior cognitive and emotional consequences. To study the cognitive profile, post-concussion symptoms (PCS), quality of life (QOL), and their correlation. A total of 60 patients with TBI were recruited and assessed for neuropsychological profile, PCS, and QOL, the correlation among the variables were analyzed. The results suggest that TBI has series of consequences which is interrelated, and the study has implications for rehabilitation of TBI. The study highlights the deficits of cognition, and its correlation with PCS and QOL, emphasizing integrated rehabilitation approach for patients with TBI.

  14. Cascade of Traumatic Brain Injury: A Correlational Study of Cognition, Postconcussion Symptoms, and Quality of Life

    Science.gov (United States)

    Reddy, Rajakumari Pampa; Rajeswaran, Jamuna; Devi, B. Indira; Kandavel, Thennarasu

    2017-01-01

    Introduction: Traumatic brain injury (TBI) constitutes a significant burden on health care resources in India. TBI is a dynamic process which involves damage to the brain thus leading to behavior cognitive and emotional consequences. Aim: To study the cognitive profile, post-concussion symptoms (PCS), quality of life (QOL), and their correlation. Methods: A total of 60 patients with TBI were recruited and assessed for neuropsychological profile, PCS, and QOL, the correlation among the variables were analyzed. Results: The results suggest that TBI has series of consequences which is interrelated, and the study has implications for rehabilitation of TBI. Conclusion: The study highlights the deficits of cognition, and its correlation with PCS and QOL, emphasizing integrated rehabilitation approach for patients with TBI.

  15. Gait speed using powered robotic exoskeletons after spinal cord injury: a systematic review and correlational study.

    Science.gov (United States)

    Louie, Dennis R; Eng, Janice J; Lam, Tania

    2015-10-14

    Powered robotic exoskeletons are an emerging technology of wearable orthoses that can be used as an assistive device to enable non-ambulatory individuals with spinal cord injury (SCI) to walk, or as a rehabilitation tool to improve walking ability in ambulatory individuals with SCI. No studies to date have systematically reviewed the literature on the efficacy of powered exoskeletons on restoring walking function. Our objective was to systematically review the literature to determine the gait speed attained by individuals with SCI when using a powered exoskeleton to walk, factors influencing this speed, and characteristics of studies involving a powered exoskeleton (e.g. inclusion criteria, screening, and training processes). A systematic search in computerized databases was conducted to identify articles that reported on walking outcomes when using a powered exoskeleton. Individual gait speed data from each study was extracted. Pearson correlations were performed between gait speed and 1) age, 2) years post-injury, 3) injury level, and 4) number of training sessions. Fifteen articles met inclusion criteria, 14 of which investigated the powered exoskeleton as an assistive device for non-ambulatory individuals and one which used it as a training intervention for ambulatory individuals with SCI. The mean gait speed attained by non-ambulatory participants (n = 84) while wearing a powered exoskeleton was 0.26 m/s, with the majority having a thoracic-level motor-complete injury. Twelve articles reported individual data for the non-ambulatory participants, from which a positive correlation was found between gait speed and 1) age (r = 0.27, 95 % CI 0.02-0.48, p = 0.03, 63 participants), 2) injury level (r = 0.27, 95 % CI 0.02-0.48, p = 0.03, 63 participants), and 3) training sessions (r = 0.41, 95 % CI 0.16-0.61, p = 0.002, 55 participants). In conclusion, powered exoskeletons can provide non-ambulatory individuals with thoracic-level motor

  16. Prevalence and regional correlates of road traffic injury among Chinese urban residents: A 21-city population-based study.

    Science.gov (United States)

    Rockett, Ian R H; Jiang, Shuhan; Yang, Qian; Yang, Tingzhong; Yang, Xiaozhao Y; Peng, Sihui; Yu, Lingwei

    2017-08-18

    This study estimated the prevalence of road traffic injury among Chinese urban residents and examined individual and regional-level correlates. A cross-sectional multistage process was used to sample residents from 21 selected cities in China. Survey respondents reported their history of road traffic injury in the past 12 months through a community survey. Multilevel, multivariable logistic regression analysis was used to identify injury correlates. Based on a retrospective 12-month reporting window, road traffic injury prevalence among urban residents was 13.2%. Prevalence of road traffic injury, by type, was 8.7, 8.7, 8.5, and 7.7% in the automobile, bicycle, motorcycle, and pedestrian categories, respectively. Multilevel analysis showed that prevalence of road traffic injury was positively associated with minority status, income, and mental health disorder score at the individual level. Regionally, road traffic injury was associated with geographic location of residence and prevalence of mental health disorders. Both individual and regional-level variables were associated with road traffic injury among Chinese urban residents, a finding whose implications transcend wholesale imported generic solutions. This descriptive research demonstrates an urgent need for longitudinal studies across China on risk and protective factors, in order to inform injury etiology, surveillance, prevention, treatment, and evaluation.

  17. [Inadvertent thoracic duct puncture during right axially central venous cannulation].

    Science.gov (United States)

    Kawashima, Shingo; Itagaki, Taiga; Adachi, Yushi; Ishii, Yasuhiro; Taniguchi, Midzuki; Doi, Matsuyuki; Sato, Shigehito

    2010-10-01

    A case of inadvertent thoracic duct puncture during right axially central venous cannulation is reported. The catheterization was performed under the real time ultrasound guidance technique and the coronal view image was continuously displayed. After confirming the feelings of venous puncture, clear yellow fluid was aspired into the connected syringe to the needle. Initially, an accidental thoracic puncture with subsequent pleural fluid aspiration was suspected;however, no finding of pleural effusion was observed with ultrasound imaging and computed tomography. Thus, an accidental thoracic duct puncture and the subsequent lymph fluid aspiration were suspected. Even in a right side approach for central venous catheterization, thoracic duct injury might ensure.

  18. Curved-Duct

    Directory of Open Access Journals (Sweden)

    Je Hyun Baekt

    2000-01-01

    Full Text Available A numerical study is conducted on the fully-developed laminar flow of an incompressible viscous fluid in a square duct rotating about a perpendicular axis to the axial direction of the duct. At the straight duct, the rotation produces vortices due to the Coriolis force. Generally two vortex cells are formed and the axial velocity distribution is distorted by the effect of this Coriolis force. When a convective force is weak, two counter-rotating vortices are shown with a quasi-parabolic axial velocity profile for weak rotation rates. As the rotation rate increases, the axial velocity on the vertical centreline of the duct begins to flatten and the location of vorticity center is moved near to wall by the effect of the Coriolis force. When the convective inertia force is strong, a double-vortex secondary flow appears in the transverse planes of the duct for weak rotation rates but as the speed of rotation increases the secondary flow is shown to split into an asymmetric configuration of four counter-rotating vortices. If the rotation rates are increased further, the secondary flow restabilizes to a slightly asymmetric double-vortex configuration. Also, a numerical study is conducted on the laminar flow of an incompressible viscous fluid in a 90°-bend square duct that rotates about axis parallel to the axial direction of the inlet. At a 90°-bend square duct, the feature of flow by the effect of a Coriolis force and a centrifugal force, namely a secondary flow by the centrifugal force in the curved region and the Coriolis force in the downstream region, is shown since the centrifugal force in curved region and the Coriolis force in downstream region are dominant respectively.

  19. Correlation between physical activity, fitness, and musculoskeletal injuries in police officers.

    Science.gov (United States)

    Nabeel, Ismail; Baker, Beth A; McGrail, Michael P; Flottemesch, Thomas J

    2007-09-01

    In order to explore the correlation between physical activity, fitness, and injury among police officers, a cross section of active-duty members of the Minneapolis Police Department were surveyed about their level of fitness, physical activity, and prevalence of injury and chronic pain within the past year. In the study, officers with the highest self-reported fitness levels were less likely to experience sprains (OR 0.27, 95% CI 0.08-0.88), back pain (OR 0.48, 95% CI 0.09-0.88), and chronic pain (OR 0.21, 95% CI 0.06-0.73) than those who considered themselves less fit. Officers who were the most physically active were about a third as likely to report back pain (OR 0.37, 95% CI 0.10-0.73) and less than half as likely to report chronic pain (OR 0.42, 95% CI 0.19-0.91) as those who engaged in less activity. And officers with a BMI greater than 35 were 3 times more likely to report back pain (OR 3.36, 95% CI 1.17-9.66) than those whose BMI fell in the normal range (18-25). Thus, officers who engage in higher levels of physical activity and are more physically fit have a lower prevalence of musculoskeletal injuries and chronic pain.

  20. Effect of L-cysteine on remote organ injury in rats with severe acute pancreatitis induced by bile-pancreatic duct obstruction

    Institute of Scientific and Technical Information of China (English)

    Li-Juan Yang; Rong Wan; Jia-Qing Shen; Jie Shen and Xing-Peng Wang

    2013-01-01

    BACKGROUND: Remote  organ  failure  occurs  in  cases  of acute  pancreatitis  (AP);  however,  the  reports  on  AP  induced by  pancreatic  duct  obstruction  are  rare.  In  this  study  we determined  the  effect  of  L-cysteine  on  pancreaticobiliary inflammation  and  remote  organ  damage  in  rats  after pancreaticobiliary duct ligation (PBDL). METHODS:   AP  was  induced  by  PBDL  in  rats  with  5/0  silk. Sixty  rats  were  randomly  divided  into  4  groups.  Groups  A and  B  were  sham-operated  groups  that  received  injections  of saline  or  L-cysteine  (10  mg/kg)  intraperitoneally  (15  rats  in each group). Groups C and D were PBDL groups that received injections  of  saline  or  L-cysteine  (10  mg/kg)  intraperitoneally (15 rats in each group). The tissue samples of the pancreas and remote organs such as the lung, liver, intestine and kidney were subsequently examined for pathological changes under a light microscope. The samples were also stored for the determination of malondialdehyde and glutathione levels. Blood urea nitrogen (BUN), plasma amylase, ALT and AST levels were determined spectrophotometrically using an automated analyzer. Also, we evaluated  the  effect  of  L-cysteine  on  remote  organ  injury  in rats  with  AP  induced  by  retrograde  infusion  of  3.5%  sodium taurocholate (NaTc) into the bile-pancreatic duct. RESULTS: Varying degrees of injury in the pancreas, lung, liver, intestine and kidney were observed in the rats 24 hours after PBDL. The severity of

  1. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)]. E-mail: martin.kocher@seznam.cz; Cerna, Marie [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Havlik, Roman [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Kral, Vladimir [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Gryga, Adolf [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Duda, Miloslav [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)

    2007-05-15

    Purpose: To evaluate long-term results of treatment of benign bile duct strictures. Materials and methods: From February 1994 to November 2005, 21 patients (9 men, 12 women) with median age of 50.6 years (range 27-77 years) were indicated to percutaneous treatment of benign bile duct stricture. Stricture of hepatic ducts junction resulting from thermic injury during laparoscopic cholecystectomy was indication for treatment in one patient, stricture of hepaticojejunostomy was indication for treatment in all other patients. Clinical symptoms (obstructive jaundice, anicteric cholestasis, cholangitis or biliary cirrhosis) have appeared from 3 months to 12 years after surgery. Results: Initial internal/external biliary drainage was successful in 20 patients out of 21. These 20 patients after successful initial drainage were treated by balloon dilatation and long-term internal/external drainage. Sixteen patients were symptoms free during the follow-up. The relapse of clinical symptoms has appeared in four patients 9, 12, 14 and 24 months after treatment. One year primary clinical success rate of treatment for benign bile duct stricture was 94%. Additional two patients are symptoms free after redilatation (15 and 45 months). One patient is still in treatment, one patient died during secondary treatment period without interrelation with biliary intervention. The secondary clinical success rate is 100%. Conclusion: Benign bile duct strictures of hepatic ducts junction or biliary-enteric anastomosis are difficult to treat surgically and endoscopically inaccessible. Percutaneous treatment by balloon dilatation and long-term internal/external drainage is feasible in the majority of these patients. It is minimally invasive, safe and effective.

  2. [Correlation between insulin resistance and myocardial injury in critically ill children].

    Science.gov (United States)

    Jiang, Feng; Ma, Xiang-Ping; Muzhapaer, Duolikun

    2012-02-01

    To study the relationship between insulin resistance and myocardial injury in children with critical diseases in light of the fact that such children usually suffer from noticeable insulin resistance and myocardial injury. Sixty-three children with critical diseases who were admitted between March 2010 and June 2011 were enrolled to comprise a case group. Fasting blood glucose, serum insulin, myocardial enzyme, and troponin I (CTnI) levels were measured. The insulin resistance index (HOMA-IR) was calculated. The children were classified into two groups: insulin resistance (HOMA-IR>1.0; n=30) and non-insulin resistance (HOMA-IR≤1.0; n=33). Thirty healthy children served as the control group. HOMA-IR, lactate dehydrogenase (LDH), aspartate aminotransferaseaspartate transaminase (AST), creatine kinase (CK), isoenzymes of creating kinase (CK-MB), α-hydroxybuty rate dehydrogenase (α-HBDH) and CTnI in the insulin resistance group were higher than those in the non-insulin resistance and the control groups (all Presistance group also showed obviously higher levels in terms of LDH, AST, CK, CK-MB, α-HBDH, and CTnI than the control group (Presistance group, there exists a positive correlation between HOMA-IR and such indicators as LDH, CK, CK-MB, AST, α-HBDH and CTnI (r=0.697, 0.739, 0.781, 0.642, 0.381, 0.792 respectively; all Presistance makes myocardial injury more serious; HOMA-IR can serve as a forecast indicator for the degree of myocardial injury.

  3. Diagnosis and treatment of ninute bile duct injury during laparoscopic cholecystectomy.%腹腔镜胆囊切除术细小胆管损伤的诊断与处理(附13例报告)

    Institute of Scientific and Technical Information of China (English)

    舒晔; 周总光; 等

    2001-01-01

    Objective To summerize the diagnosis and treatment of the injured minute biliary ducts in laparoscopic cholecystectomy(LC) practice. Methods 13 cases occurred minute biliary duct injury in 1250 cases of LC. Among them,6 cases were found the points of leakage during operation,and were treated by titanium nips;4 cases were not,and were treated by drainage;3 cases occurred bile peritonitis postoperatively,only one needed to be explored and treated with suture ligature,another two cases were treated with multiple hole catheters to drainage of the abdominal cavities through stab wounds. Results All 13 cases recovered completely without any bad results. Conclusion Small bile leakage in LC is almost inevitable. If it can be discovered during operation and be treated,the result is the best.If it is discovered after operation,exploratory laparotomy and adequate drainage will be needed. Those with small amount of leakage,catheter drainage through stab wound will probably be feasible.%目的总结腹腔镜胆囊切除术(LC)时细小胆管损伤的诊断处理体会。方法统计分析1250例LC手术中13例细小胆管损伤的情况。6例于术中发现漏胆点,予钛夹钳夹;4例未找到漏胆点,予引流;3例术后出现胆汁性腹膜炎,其中1例剖腹探查并缝扎漏胆汁处,另2例经腹壁戳孔放多孔尿管引流。结果 13例均获痊愈,术后出现胆汁性腹膜炎者经治疗也未产生严重后果。结论 LC时细小胆管损伤难以避免。术中发现并处理效果最好。术后发现应行开腹手术或充分引流,对漏胆量少者经腹壁戳孔放置引流是可取的方法。

  4. 后三角入路腹腔镜胆囊切除术中应用超声刀预防胆道损伤的体会%The experience of posterior Calot triangle approach using harmonic scalpel in laparoscopic cholecystectomy for prevention ofbiliary duct injury

    Institute of Scientific and Technical Information of China (English)

    何效东; 崔泉; 赵晓雷; 杨毅

    2011-01-01

    目的:探讨腹腔镜胆囊切除术中预防胆道损伤的方法.方法:回顾分析为322例患者行胆囊后三角入路腹腔镜胆囊切除术(laparoscopic cholecystctomy,LC)的临床资料.结果:320例经后三角入路解剖胆囊管顺利,2例(0.62%)中转开腹,无一例发生胆道损伤及其他并发症.手术时间16~90min,平均38min.术中出血1~20ml,平均1.8ml.结论:胆囊后三角入路LC术中应用超声刀术野清晰,有助于肝外胆管解剖结构的辨认,能有效防止医源性胆管损伤的发生.%Objective:To investigate how to avoid biliary duct injury caused by laparoscopic cholecystectomy(LC). Methods:The clinical data of 322 patients received LC with posterior Calot triangle approach (PCTA) using harmonic scalpel was retrospectively reviewed from Jun. 2006 to Aug. 2010. Results:Two cases were converted to open cholecystectomy due to severe adhesion of peritoneal cavity. No biliary duct injury and other complications occurred in all cases. The average durations of the operations were 38min ( 16-90min). The blood loss during the operations were 1.8ml(1-20ml). Conclusions:PCTA using harmonic scalpel in LC can help to discriminate extrahepatic biliary duct anatomy and is effective to avoid biliary duct injury.

  5. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

    Energy Technology Data Exchange (ETDEWEB)

    Courtney, Malachi; Ayyagari, Raj R. [Yale School of Medicine, Yale New Haven Hospital, New Haven, CT (United States); Division of Interventional Radiology, Department of Radiology, 789 Howard Avenue, P.O. Box 208042, New Haven, CT (United States)

    2015-06-15

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. (orig.)

  6. Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury

    Science.gov (United States)

    HIROTA, Shin; INAJI, Motoki; NARIAI, Tadashi; HARA, Mutsuya; TAMAKI, Masashi; MAEHARA, Taketoshi; TOMITA, Hiroki; TONE, Osamu

    2017-01-01

    Patients with diffuse axonal injury (DAI) may initially present with prominent physical impairments, but their cognitive dysfunctions are more persistent and are attributable to later unemployment. In this study, we analyzed how the findings of early and delayed neuropsychological assessments correlated with employment outcome of patients with DAI. A total of 56 patients with DAI without motor or visual dysfunction were included in this study. The neuropsychological battery consisted of the Wechsler Adult Intelligent Scale - Revised (WAIS-R), Wechsler Memory Scale - Revised (WMS-R), Trail Making Test (TMT), Wisconsin Card Sorting Test (WCST), and Word Fluency Test (WFT). This battery of tests was administered twice in early stage after injury and in later stage. The results of all of the neuropsychological tests improved significantly (P <0.001) between the early and later assessments. All scores other than TMT part A and B improved to the normal range (Z-score ≥ 2). The patient characteristics (age, gender, initial Glasgow Coma Scale, and duration of posttraumatic amnesia) had no relationship to the outcome. The results of TMT part B, however, were significantly correlated with employment outcome in both the early and later assessments (P = 0.01, 0.04). Given that TMT evaluates visual attention, we surmise that a lack of attention may be the core symptom of the cognitive deficit and cause the re-employment failure in patients with DAI. TMT part B in both early and later assessments has the potential to accurately predict chronic functional outcome. PMID:28003570

  7. Clinical Analysis for the Correlation of Intra-abdominal Organ Injury in the Patients with Rib Fracture

    Science.gov (United States)

    2012-01-01

    Background Although it is rare for the fracture itself to become a life threatening injury in patients suffering from rib fracture, the lives of these patients are occasionally threatened by other associated injuries. Especially, early discovery of patients with rib fracture and intra-abdominal organ injury is extremely important to the prognosis. This study analyzed the link between rib fracture and intra-abdominal injury to achieve improved treatment. Materials and Methods Among trauma patients that had visited the hospital emergency room from January 2007 to December 2009, a retrospective study was conducted on 453 patients suffering from rib fracture due to blunt trauma. Rib fracture was classified according to location (left, right, and bilateral), and according to level (upper rib fracture [1-2nd rib], middle rib fracture [3-8th rib], and lower rib fracture [9-12th rib]). The researched data was statistically compared and analyzed to investigate the correlation between the location, level, and number of rib fracture and intra-abdominal organ injury. Results Motor vehicle injury was found to be the most common mechanism of injury with 208 cases (46%). Associated injuries accompanied with rib fracture were generated in 276 cases (61%). Intra-abdominal organ injury was discovered in 97 cases (21%). Liver injury was the most common intra-abdominal injury associated with rib fracture with 39 cases (40%), followed by spleen injury, with 23 cases (23%). Intra-abdominal injury according to level of rib fracture was presented as upper rib fracture in 11 cases (11%), middle rib fracture in 31 cases (32%), and lower rib fracture in 55 cases (57%), thus verifying that intra-abdominal injuries were commonly accompanied in lower rib fractures (p=0.03). In particular, significant increase of intra-abdominal injury was presented in fractures below the 8th rib (p=0.03). The number of intra-abdominal injuries requiring emergency operations was significantly higher in patients

  8. Urinary β2-Microglobulin Is a Good Indicator of Proximal Tubule Injury: A Correlative Study with Renal Biopsies

    Directory of Open Access Journals (Sweden)

    Xu Zeng

    2014-01-01

    Full Text Available Objective. After filtration through glomeruli, β2-microglobulin is reabsorbed in proximal tubules. Increased urinary β2-microglobulin indicates proximal tubule injury and measurement of β2-microglobulin in urine is useful to determine the source of renal injury. Kidney injury molecule-1 (KIM-1 has been characterized as a selective proximal tubule injury marker. This study was designed to evaluate the correlation of urinary β2-microglobulin concentration and KIM-1 expression as evidence of proximal tubule injury. Methods. Between 2009 and 2012, 46 patients with urine β2-microglobulin (RenalVysion had follow-up kidney biopsy. Diagnoses included glomerular and tubule-interstitial disease. Immunohistochemical staining for KIM-1 was performed and the intensity was graded from 0 to 3+. Linear regression analysis was applied to correlate the values of urinary β2-microglobulin and KIM-1 staining scores. P < 0.05 was considered statistically significant. Results. Thirty patients had elevated urinary β2-microglobulin. KIM-1 staining was positive in 35 kidney biopsies. There was a significant correlation between urinary β2-microglobulin and KIM-1 staining (P < 0.05. Sensitivity was 86.6%, specificity was 43.7%, positive predictive value was 74.2%, and negative predictive value was 63.6%. Conclusion. Increased urinary β2-microglobulin is significantly correlated with KIM-1 staining in injured proximal tubules. Measurement of urine β2-microglobulin is a sensitive assay for proximal tubule injury.

  9. Particle deposition in ventilation ducts

    Energy Technology Data Exchange (ETDEWEB)

    Sippola, Mark Raymond [Univ. of California, Berkeley, CA (United States)

    2002-09-01

    Exposure to airborne particles is detrimental to human health and indoor exposures dominate total exposures for most people. The accidental or intentional release of aerosolized chemical and biological agents within or near a building can lead to exposures of building occupants to hazardous agents and costly building remediation. Particle deposition in heating, ventilation and air-conditioning (HVAC) systems may significantly influence exposures to particles indoors, diminish HVAC performance and lead to secondary pollutant release within buildings. This dissertation advances the understanding of particle behavior in HVAC systems and the fates of indoor particles by means of experiments and modeling. Laboratory experiments were conducted to quantify particle deposition rates in horizontal ventilation ducts using real HVAC materials. Particle deposition experiments were conducted in steel and internally insulated ducts at air speeds typically found in ventilation ducts, 2-9 m/s. Behaviors of monodisperse particles with diameters in the size range 1-16 μm were investigated. Deposition rates were measured in straight ducts with a fully developed turbulent flow profile, straight ducts with a developing turbulent flow profile, in duct bends and at S-connector pieces located at duct junctions. In straight ducts with fully developed turbulence, experiments showed deposition rates to be highest at duct floors, intermediate at duct walls, and lowest at duct ceilings. Deposition rates to a given surface increased with an increase in particle size or air speed. Deposition was much higher in internally insulated ducts than in uninsulated steel ducts. In most cases, deposition in straight ducts with developing turbulence, in duct bends and at S-connectors at duct junctions was higher than in straight ducts with fully developed turbulence. Measured deposition rates were generally higher than predicted by published models. A model incorporating empirical equations based on the

  10. Particle deposition in ventilation ducts

    Energy Technology Data Exchange (ETDEWEB)

    Sippola, Mark R.

    2002-09-01

    Exposure to airborne particles is detrimental to human health and indoor exposures dominate total exposures for most people. The accidental or intentional release of aerosolized chemical and biological agents within or near a building can lead to exposures of building occupants to hazardous agents and costly building remediation. Particle deposition in heating, ventilation and air-conditioning (HVAC) systems may significantly influence exposures to particles indoors, diminish HVAC performance and lead to secondary pollutant release within buildings. This dissertation advances the understanding of particle behavior in HVAC systems and the fates of indoor particles by means of experiments and modeling. Laboratory experiments were conducted to quantify particle deposition rates in horizontal ventilation ducts using real HVAC materials. Particle deposition experiments were conducted in steel and internally insulated ducts at air speeds typically found in ventilation ducts, 2-9 m/s. Behaviors of monodisperse particles with diameters in the size range 1-16 {micro}m were investigated. Deposition rates were measured in straight ducts with a fully developed turbulent flow profile, straight ducts with a developing turbulent flow profile, in duct bends and at S-connector pieces located at duct junctions. In straight ducts with fully developed turbulence, experiments showed deposition rates to be highest at duct floors, intermediate at duct walls, and lowest at duct ceilings. Deposition rates to a given surface increased with an increase in particle size or air speed. Deposition was much higher in internally insulated ducts than in uninsulated steel ducts. In most cases, deposition in straight ducts with developing turbulence, in duct bends and at S-connectors at duct junctions was higher than in straight ducts with fully developed turbulence. Measured deposition rates were generally higher than predicted by published models. A model incorporating empirical equations based on

  11. MR imaging of post-traumatic articular cartilage injuries confined to the femoral trochlea Arthroscopic correlation and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Huegli, Rolf W. E-mail: rhuegli@uhbs.ch; Moelleken, Sonja M.C.; Stork, Alexander; Bonel, Harald M.; Bredella, Miriam A.; Meckel, Stephan; Genant, Harry K.; Tirman, Phillip F.J

    2005-01-01

    Objective: To assess and describe post-traumatic articular cartilage injuries isolated to the trochlear groove and provide insight into potential mechanism of injury. Materials and methods: We retrospectively evaluated MR imaging findings of all knee MRIs performed at our institution over the last 2 years (2450). Thirty patients met the criteria of a cartilage injury confined to the trochlear groove. In 15 cases, which were included in our study, arthroscopic correlation was available. Each plane was evaluated and graded for the presence and appearance of articular cartilage defects using a standard arthroscopic grading scheme adapted to MR imaging. Any additional pathological derangement was documented and information about the mechanism of injury was retrieved by chart review. Results: In all cases the cartilaginous injury was well demonstrated on MRI. In 13 patients additional pathological findings could be observed. The most frequently associated injury was a meniscal tear in nine patients. In eight cases, the arthroscopic grading of the trochlear injury matched exactly with the MRI findings. In the remaining seven cases, the discrepancy between MRI and arthroscopy was never higher than one grade. In 13 out of 15 of patients trauma mechanism could be evaluated. Twelve patients suffered an indirect twisting injury and one suffered a direct trauma to their knee. Conclusion: The findings of this study demonstrate that MR imaging allows reliable grading of isolated injury to the trochlear groove cartilage and assists in directing surgical diagnosis and treatment. These injuries may be the only hyaline cartilage injury in the knee and meniscal tears are a frequently associated finding. Therefore, it is important to search specifically for cartilage injuries of the trochlear groove in patients with anterior knee pain, even if other coexistent pathology could potentially explain the patient's symptoms.

  12. Right anterior segmental hepatic duct emptying directly into the cystic duct in a living donor.

    Science.gov (United States)

    Ishiguro, Yasunao; Hyodo, Masanobu; Fujiwara, Takehito; Sakuma, Yasunaru; Hojo, Nobuyuki; Mizuta, Koichi; Kawarasaki, Hideo; Lefor, Alan T; Yasuda, Yoshikazu

    2010-08-07

    A 35-year-old mother was scheduled to be the living donor for liver transplantation to her second son, who suffered from biliary atresia complicated with biliary cirrhosis at the age of 2 years. The operative plan was to recover the left lateral segment of the mother's liver for living donor transplantation. With the use of cholangiography at the time of surgery, we found the right anterior segmental duct (RASD) emptying directly into the cystic duct, and the catheter passed into the RASD. After repairing the incision in the cystic duct, transplantation was successfully performed. Her postoperative course was uneventful. Biliary anatomical variations were frequently encountered, however, this variation has very rarely been reported. If the RASD was divided, the repair would be very difficult because the duct will not dilate sufficiently in an otherwise healthy donor. Meticulous preoperative evaluation of the living donor's biliary anatomy, especially using magnetic resonance cholangiography and careful intraoperative techniques, is important to prevent bile duct injury and avoid the risk to the healthy donor.

  13. What Is Bile Duct Cancer?

    Science.gov (United States)

    ... the liver. Types of bile duct cancer by cell type Bile duct cancers can also be divided ... Our Volunteers More ACS Sites Bookstore Shop Cancer Atlas Press Room Cancer Statistics Center Volunteer Learning Center ...

  14. Gallbladder and Bile Duct Disorders

    Science.gov (United States)

    ... Disorders Overview of Gallbladder and Bile Duct Disorders Cholecystitis Gallstones Biliary Pain Without Gallstones Narrowing of the ... ducts are blocked, the gallbladder may become inflamed ( cholecystitis ). Biliary pain without gallstones (acalculous biliary pain) can ...

  15. Correlation between neuronal injury and Caspase-3 after focal ischemia in human hippocampus

    Institute of Scientific and Technical Information of China (English)

    戚基萍; 吴爱萍; 王德生; 王立峰; 李淑霞; 徐凤琳

    2004-01-01

    Background Cerebral ischemia is a significant clinical problem, and cerebral ischemia usually causes neuron injury such as apoptosis in various brain areas, including hippocampus. Cysteinyl aspartate-specific protease (Caspases) are fundamental factors of apoptotic mechanism. Caspase-3 inhibitors show effect in attenuating brain injury after ischemia. But all the results were from animal models in research laboratories. This study aimed at investigating the correlation between the change of ischemic neuronal injury and Caspase-3 post-ischemia in human hippocampus. Methods We selected and systematized 48 post-mortem specimens from 48 patients, who died of cerebral infarction. Morphological change was firstly analyzed by observing hematoxyline/eosin-staining hippocampal sections. The expression of Caspase-3 was investigated using the methods of in situ hybridization and immunohistochemistry. Terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate-biotin nick-end labeling (TUNEL) method was used to clarify the involvement of Caspase-3 in neuron death. The loss of MAP 2 (MAP-2) was applied to judging the damaged area and degree of neuronal injury caused by ischemia.Results In the CA1 sector of hippocampus, Caspase-3 immunostaining modestly increased at 8 hours [8.05/high-power field (hpf)], dramatically increased at 24 hours (24.85/hpf), decreased somewhat after 72 hours. Caspase-3 mRNA was detectable at 4 hours (6.75/hpf), reached a maximum at 16 hours (17.60/hpf), faded at 72 hours. TUNEL-positive cells were detectable at 24 hours (10.76/hpf), markedly increased at 48-72 hours. The loss of MAP-2 was obviously detected at 4 hours, progressed significantly between 24 and 72 hours; MAP-2 immunoreactivity was barely detectable at 72 hours. Before 72 hours, the Caspase-3 evolution was related with the upregulation of TUNEL and the loss of MAP-2. The positive correlation between Caspase-3 mRNA and TUNEL was significant at the 0.05 level (correlation

  16. Correlation between dental traumatic injuries and overjet among 11 to 17 years Indian girls with Angle's class I molar relation.

    Science.gov (United States)

    Bendgude, Vikas; Akkareddy, Basavaprabhu; Panse, Amey; Singh, Rashmi; Metha, Deepak; Jawale, Bhushan; Garcha, Vikram; Jathar, Prasad

    2012-01-01

    The present study was conducted to assess the correlation of traumatic dental injuries and overjet among school going girls of age 11 to 17 years in Pune, India. A cross-sectional survey was carried out with 2045 school girls aged 11 to 17 years, attending public elementary schools in Pune, India. The traumatic dental injuries were assessed according to Ellis and Davey’s criteria. Occlusion was recorded according to Angle´s classification and overjet was measured using a WHO 621 probe. The data obtained was subjected to statistical analysis using Mann-Whitney test. There was a significant (Z -2.785) association between increase in overjet and occurrence of trauma. Children with increased overjet were 3.09 times more likely to have dental injuries. It can be concluded from the present study that a significant correlation exists between amount of overjet and prevalence of traumatic injuries among children. The percentage of trauma prevalence increases with the increase of overjet. Traumatic dental injury is not a result of disease but a consequence of several factors that will accumulate throughout life if not properly treated. One of the most important factors significantly contributing to traumatic dental injuries is the anterior overjet. Hence, correction of increased anterior overjet may help in prevention of traumatic injuries.

  17. Multiple thoracic vertebral compression fractures caused by non-accidental injury: case report with radiological-pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Twomey, Eilish L.; Iemsawatdikul, Kriengkrai; Stephens, Boyd G.; Gooding, Charles A. [Department of Radiology, University of California at San Francisco, 505 Parnassus Avenue, Box 0628, 94143-0628, San Francisco, CA (United States)

    2004-08-01

    We report a 21-month-old boy with multiple contiguous thoracic vertebral compression fractures involving eight vertebral bodies, attributable to non-accidental injury. No subluxation was associated, however, there was extensive injury to the upper cervical and lower lumbar regions of the spinal cord. Anterosuperior beaking, thought to represent a previous injury, was evident in a mid-lumbar vertebra. Clinical examination revealed bilateral retinal hemorrhages and retinoschisis. Death occurred as a result of severe brain edema with bilateral subdural and subarachnoid hemorrhages. Radiological-pathological correlation is presented. (orig.)

  18. Magnetic resonance imaging evaluation of acute crush injury of rabbit sciatic nerve: correlation with histology

    Energy Technology Data Exchange (ETDEWEB)

    Li, X. [Dept. of Radiology, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou (China)], E-mail: xinchunli@163.com; Shen, J.; Chen, J.; Wang, X.; Liu, Q.; Liang, B. [Dept. of Radiology, The Second Affiliated Hospital of Sun Yat-Sen Univ., Guangzhou (China)

    2008-06-15

    To investigate the relation between the quantitative assessment of magnetic resonance imaging (MRI) features and the correlation with histology and functional recovery by using the rabbit sciatic nerve crush model. In New Zealand, 32 rabbits were randomly divided into 2 groups (group A and B); all rabbits underwent crushing injury of their left sciatic nerve. In group A (n = 16), the sciatic nerves were crushed by using microvessel clamps with a strength of 3.61 kg. In group B (n = 16), the sciatic nerves were crushed with a strength of 10.50 kg. Right sciatic nerves were served as controls. Serial MRI of both hind limbs in each rabbit was performed before and at the time point of 1, 2, 4, and 8 weeks after crushed injury. The MRI protocol included T1-weighted spin-echo (T1WI), 3 dimension turbo spin-echo T2-weighted (3DT2WI), T2-weighted turbo spin-echo images with spectral presaturation with inversion recovery (T2WI/SPIR), balanced fast-field echo (B-FFE) and short-time inversion recovery (STIR) sequences. The coronal image of the sciatic nerve was obtained. The nerve and muscle signal ratio (SIR) on each sequence was measured. The function recovery was observed and pathological examination was performed at each time point. A signal intensity increase of the distal segment of crushed sciatic nerves was found on 3DT2WI, T2WI/SP1R, B-FFE, and STIR, but not on T,WI images. Of 32 crushed nerves, 30 nerves showed high signal intensity. The correct diagnostic rate was 93.75% with false negative-positive of 6.25%. The SIR of the crushed sciatic nerve at distal portion was higher than those of the control nerves; there was a statistically significant difference (P < 0.001). The SIR of the distal portion of crushed nerves was higher than that of the proximal nerve portion; there was a statistically significant difference (P < 0.001). Whereas, the SIR at proximal nerve portions of crushed nerve was similar to control nerves (P > 0.05). The SIR between group A and group B

  19. Malignant tumors of Stensen's duct.

    Science.gov (United States)

    Steiner, M; Gould, A R; Miller, R L; Johnson, J A

    1999-01-01

    A rare case of squamous cell carcinoma arising in Stensen's duct is reported. The literature concerning malignant neoplasia originating in this site is reviewed, with attention given to the histopathologic diversity of neoplasms occurring in the duct, criteria for determination of origin in the duct, and outcomes of therapy.

  20. Isolated Pancreatic Uncinate Duct IPMN.

    Science.gov (United States)

    Maker, Ajay V; Maker, Vijay K

    2017-04-01

    The ventral pancreas originally forms as an evagination of the common bile duct at 32 days gestation and its duct, the uncinate duct, eventually rotates with the ventral anlage to join the dorsal pancreas and fuse with the main pancreatic duct. Thus, though often considered a "branch" duct of the pancreas, embryologically, the uncinate duct is the "main" pancreatic duct of the ventral pancreas. This concept is not fully addressed in the current definitions of intraductal papillary mucinous neoplasms of the pancreas (IPMN) where international consensus guidelines consider the main-duct IPMN as high risk for malignancy and most small branch-duct IPMN as low risk for malignancy. Thus, it is important to recognize that isolated uncinate-duct IPMN can occur and, based on its embryologic origin and increased association with high-grade dysplasia and invasive cancer, may be managed conceptually as a main duct type of disease rather than a branch duct until better biomarkers of malignancy are discovered. The images provide an example of this unique disease process.

  1. Correlation Between Euro NCAP Pedestrian Test Results and Injury Severity in Injury Crashes with Pedestrians and Bicyclists in Sweden.

    Science.gov (United States)

    Strandroth, Johan; Sternlund, Simon; Lie, Anders; Tingvall, Claes; Rizzi, Matteo; Kullgren, Anders; Ohlin, Maria; Fredriksson, Rikard

    2014-11-01

    Pedestrians and bicyclists account for a significant share of deaths and serious injuries in the road transport system. The protection of pedestrians in car-to-pedestrian crashes has therefore been addressed by friendlier car fronts and since 1997, the European New Car Assessment Program (Euro NCAP) has assessed the level of protection for most car models available in Europe. In the current study, Euro NCAP pedestrian scoring was compared with real-life injury outcomes in car-to-pedestrian and car-tobicyclist crashes occurring in Sweden. Approximately 1200 injured pedestrians and 2000 injured bicyclists were included in the study. Groups of cars with low, medium and high pedestrian scores were compared with respect to pedestrian injury severity on the Maximum Abbreviated Injury Scale (MAIS)-level and risk of permanent medical impairment (RPMI). Significant injury reductions to both pedestrians and bicyclists were found between low and high performing cars. For pedestrians, the reduction of MAIS2+, MAIS3+, RPMI1+ and RPMI10+ ranged from 20-56% and was significant on all levels except for MAIS3+ injuries. Pedestrian head injuries had the highest reduction, 80-90% depending on level of medical impairment. For bicyclist, an injury reduction was only observed between medium and high performing cars. Significant injury reductions were found for all body regions. It was also found that cars fitted with autonomous emergency braking including pedestrian detection might have a 60-70% lower crash involvement than expected. Based on these results, it was recommended that pedestrian protection are implemented on a global scale to provide protection for vulnerable road users worldwide.

  2. Unintentional Injuries in Preschool Age Children: Is There a Correlation With Parenting Style and Parental Attention Deficit and Hyperactivity Symptoms.

    Science.gov (United States)

    Acar, Ethem; Dursun, Onur Burak; Esin, İbrahim Selcuk; Öğütlü, Hakan; Özcan, Halil; Mutlu, Murat

    2015-08-01

    Unintentional injuries are the leading cause of death among children. Previous research has shown that most of the injuries occur in and around the home. Therefore, parents have a key role in the occurrence and prevention of injuries. In this study, we examined the relationship among home injuries to children and parental attention deficit hyperactivity disorder (ADHD) symptoms, parental attitudes, and children's behavioral problems.Forty children who were admitted to the emergency department because of home injuries constitute the study group. The control group also consisted of 40 children, who were admitted for mild throat infections. The parents filled out questionnaires assessing parental ADHD, child behavioral problems, and parenting attitudes.Scores were significantly higher for both internalizing disorders and externalizing disorders in study groups. We also found that ADHD symptoms were significantly higher among fathers of injured children compared with fathers of control groups. Democratic parenting was also found to correlate with higher numbers of injuries.Parenting style, as well as the psychopathology of both the parents and children, is important factors in children's injuries. A child psychiatrist visit following an emergency procedure may help to prevent further unintentional injuries to the child.

  3. Correlation of cell apoptosis with brain edema and elevated intracranial pressure in traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    YANG Xiao-feng; LIU Wei-guo; SHEN Hong; GONG Jiang-biao; YU Jun; HU Wei-wei; L(U) Shi-ting; ZHENG Xiu-jue; FU Wei-ming

    2005-01-01

    Objective: To study the correlation between brain edema, elevated intracranial pressure (ICP) and cell apoptosis in traumatic brain injury (TBI). Methods: In this study, totally 42 rabbits in 7 groups were studied. Six of the animals were identified as a control group, and the remaining 36 animals were equally divided into 6 TBI groups. TBI models were produced by the modified method of Feeney. After the impact, ICP of each subject was recorded continuously by an ICP monitor until the animal was sacrificed at scheduled time. The apoptotic brain cells were detected by an terminal deoxynucleotide-transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) assay. Cerebral water content (CWC) was measured with a drying method and calculated according to the Elliott formula. Then, an analysis was conducted to determine the correlation between the count of apoptotic cells and the clinical pathological changes of the brain. Results: Apoptotic cell count began to increase 2 h after the impact, and reached its maximum about 3 days after the impact. The peak value of CWC and ICP appeared 1 day and 3 days after the impact, respectively. Apoptotic cell count had a positive correlation with CWC and ICP. Conclusions: In TBI, occurrence of brain edema and ICP increase might lead to apoptosis of brain cells. Any therapy which can relieve brain edema and/or decrease ICP would be able to reduce neuron apoptosis, thereby to attenuate the secondary brain damage.

  4. Cornice Duct System

    Energy Technology Data Exchange (ETDEWEB)

    Wayne Place; Chuck Ladd

    2004-10-29

    SYNERGETICS, INC., has designed, developed, and tested an air handling duct system that integrates the air duct with the cornice trim of interior spaces. The device has the advantage that the normal thermal losses from ducts into unconditioned attics and crawl spaces can be totally eliminated by bringing the ducts internal to the conditioned space. The following report details work conducted in the second budget period to develop the Cornice Duct System into a viable product for use in a variety of residential or small commercial building settings. A full-scale prototype has been fabricated and tested in a laboratory test building at the Daylighting Facility at North Carolina State University., Based on the results of that testing, the prototype design as been refined, fabricated, installed, and extensively tested in a residential laboratory house. The testing indicates that the device gives substantially superior performance to a standard air distribution system in terms of energy performance and thermal comfort. Patent Number US 6,511,373 B2 has been granted on the version of the device installed and tested in the laboratory house. (A copy of that patent is attached.) Refinements to the device have been carried through two additional design iterations, with a particular focus on reducing installation time and cost and refining the air control system. These new designs have been fabricated and tested and show substantial promise. Based on these design and testing iterations, a final design is proposed as part of this document. That final design is the basis for a continuation in part currently being filed with the U.5, Patent office.

  5. Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents.

    Directory of Open Access Journals (Sweden)

    Gabriela Ilie

    Full Text Available OBJECTIVE: Our knowledge on the adverse correlates of traumatic brain injuries (TBI, including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario. METHOD AND FINDINGS: Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS. Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9 of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52, attempting suicide (AOR = 3.39, seeking counselling through a crisis help-line (AOR = 2.10, and being prescribed medication for anxiety, depression, or both (AOR = 2.45. Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70, being cyber-bullied (AOR = 2.05, and being threatened with a weapon at school (AOR = 2.90, compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours. CONCLUSIONS: Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during

  6. Suicidality, Bullying and Other Conduct and Mental Health Correlates of Traumatic Brain Injury in Adolescents

    Science.gov (United States)

    Ilie, Gabriela; Mann, Robert E.; Boak, Angela; Adlaf, Edward M.; Hamilton, Hayley; Asbridge, Mark; Rehm, Jürgen; Cusimano, Michael D.

    2014-01-01

    Objective Our knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario. Method and Findings Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45). Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and being threatened with a weapon at school (AOR = 2.90), compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours. Conclusions Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and

  7. Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents.

    Science.gov (United States)

    Ilie, Gabriela; Mann, Robert E; Boak, Angela; Adlaf, Edward M; Hamilton, Hayley; Asbridge, Mark; Rehm, Jürgen; Cusimano, Michael D

    2014-01-01

    Our knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario. Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45). Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and being threatened with a weapon at school (AOR = 2.90), compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours. Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and intervene at an early stage may reduce

  8. 14 CFR 25.1103 - Induction system ducts and air duct systems.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Induction system ducts and air duct systems....1103 Induction system ducts and air duct systems. (a) Each induction system duct upstream of the first... auxiliary power unit bleed air duct systems, no hazard may result if a duct failure occurs at any...

  9. 3C DUCT DESIGN METHOD

    Institute of Scientific and Technical Information of China (English)

    Huan-RueiShiu; Feng-ChuOu; Sih-LiChen

    2002-01-01

    A new 3C duct design method is proposed for designing a high quality, energy-efficiency cost-effective air duct system. It not only considers the demand of volume flow rate, but also takes into consideration a number of issues including system pressure balance, noise, vibration, space limitation and total system cost. This new method comprises three major calculation procedures:initial computer-aided design (CAD), computer-aided simulation (CAS) and correction processes (CP). An example is presented in this study to understand the characteristics of 3C method. It shows that 3C duct design method provides a simple computation procedure for an optimum air duct system. It also shortens the design schedule, prevents human calculation errors, and reduces the dependence on designer experience. In addition to apply in a new duct system design, 3C duct design method is also a powerful design tool for the expansion of an existing duct system.

  10. Correlation Between MRI and Ultrasonographic Findings in Meniscal Injuries of the Knee.

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Sasani

    2009-01-01

    Full Text Available "nIntroduction: The purpose of this study was to evaluate ability of ultrasonography in the diagnosis of injuries of the knee menisci including tear, intrasubstance degeneration (ISD and cyst. "nMaterials and Methods: This study included ultrasound examination of knee joints of 100 patients after MR imaging, who were referred by clinicians without informing us about their symptoms and physical examinations. Then ultrasonographic results were correlated with MRI findings. "nResults: The 23 meniscal tear diagnosis made in MR examination in different segments of menisci and 19 (82.6% cases were diagnosed sonographically and the rest were reported as ISD (13% and normal (4.4%. Among the 69 cases in which MR examination interpreted as ISD in different segments, 66.7% were reported as ISD and others were diagnosed as meniscal tear (10% and normal(23% by sonography. There was a significant correlation between ultrasound and MR findings in meniscal tears (82.6% and relatively significant in ISD(66.7%. "nConclusion: Ultrasonographic study of the menisci is an inexpensive, noninvasive, easily available and reliable imaging modality.   

  11. Correlation of tenascin-C concentrations in serum with outcome of traumatic brain injury in humans.

    Science.gov (United States)

    Zhao, Yuan-Yuan; Lou, Lin; Yang, Kai-Chuang; Wang, Hai-Bo; Xu, Yan; Lu, Gang; He, Hai-Yan

    2017-09-01

    Tenascin-C, a matricellular protein, is involved in brain injury. However, change of tenascin-C concentrations in peripheral blood remains unknown after traumatic brain injury (TBI). Serum tenascin-C concentrations were measured in 100 healthy controls, 108 severe TBI patients, 79 moderate TBI patients and 32 mild TBI patients. Serum tenascin-C concentrations of patients were significantly higher than those of controls. Tenascin-C concentrations negatively correlated with Glasgow Coma Scale (GCS) scores in all patients (r=-0.658, PC in serum significantly discriminated patients at risk of 6-month mortality (area under curve, 0.821; 95% confidence interval, 0.735-0.888) and poor outcome (Glasgow Outcome Scale score of 1-3) (area under curve, 0.833; 95% confidence interval, 0.749-0.898) and emerged as an independent predictor for 6-month mortality (odds ratio, 1.114; 95% confidence interval, 1.008-1.233; P=0.005), overall survival (hazard ratio, 1.085; 95% confidence interval, 1.010-1.166; P=0.003) and unfavorable outcome (odds ratio, 1.049; 95% confidence interval, 1.014-1.076; P=0.001). By receiver-operating characteristic analysis, serum tenascin-C concentrations had similar prognostic value compared with GCS scores. Enhanced serum tenascin-C concentrations are closely related to trauma severity and clinical outcomes, substantializing tenascin-C as a potential prognostic biomarker after TBI. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. The correlation between dietary fat intake and blood pressure among people with spinal cord injury

    Science.gov (United States)

    Sabour, Hadis; Norouzi-Javidan, Abbas; Soltani, Zahra; Mousavifar, Seyede Azemat; Latifi, Sahar; Emami-Razavi, Seyed Hassan; Ghodsi, Seyed Mohammad

    2016-01-01

    Background: Studies have demonstrated the effect of different dietary fats on blood pressure (BP) in general population. However, these associations have not yet been described in people with spinal cord injury (SCI). Methods: Referred patients to Brain and SCI Research Center between 2011 and 2014 have been invited to participate. Only paraplegic individuals were recruited and patients with injury at cervical or higher thoracic sections were excluded to omit the bias effect of autonomic dysreflexia. Dietary intakes were assessed by recording consumed foods by 24-hour dietary recall interviews using Nutritionist IV 3.5.3 modified for Iranian foods. Systolic BP (SBP) and diastolic BP (DBP) were measured 3 times and the mean values entered analysis. Results: Higher intakes of cholesterol were related to higher BP (P = 0.010 and 0.011 for SBP and DBP, respectively). Similarly, intake of saturated fat was positively correlated to both SBP (P = 0.016, r = 0.21) and DBP (P = 0.011, r = 0.22). The effect of eicosapentaenoic acid (EPA) on BP was insignificant (P = 0.760 and 0.720 for SBP and DBP, respectively). However, intake of docosahexaenoic acid (DHA) was related to lower BP among people with SCI. Conclusion: This study has demonstrated that higher intakes of cholesterol and saturated fat are associated with increased BP, whereas DHA is an antihypertensive agent. Dietary modifications with reduction of cholesterol and saturated fat along with intake of additional DHA supplements may help to reduce BP in spinal cord injured-individuals with hypertension. PMID:27648172

  13. Construct Validity of WAIS-R Factors: Neuropsychological Test Correlates in Adults Referred for Evaluation of Possible Head Injury.

    Science.gov (United States)

    Sherman, Elisabeth M. S.; And Others

    1995-01-01

    A 3-factor solution of the Wechsler Adult Intelligence Scale--Revised (WAIS-R) in 260 adults with suspected head injury suggested relatively good construct validity for the factors, based on correlations with neuropsychological tests. Findings are discussed in terms of the multidimensional nature of neuropsychological tests and WAIS-R factors.…

  14. Anion gap as a predictor of trauma outcomes in the older trauma population: correlations with injury severity and mortality.

    Science.gov (United States)

    Leskovan, John J; Justiniano, Carla F; Bach, John A; Cook, Charles H; Lindsey, David E; Eiferman, Daniel S; Papadimos, Thomas J; Steinberg, Steven M; Bergese, Sergio D; Stawicki, Stanislaw P A; Evans, David C

    2013-11-01

    The relationship among traumatic injury, the associated metabolic/physiologic responses, and mortality is well established. Tissue hypoperfusion and metabolic derangement may not universally correlate with initial clinical presentation. We hypothesized that anion gap (AG) could be a useful gauge of trauma-related physiologic response and mortality in older patients with relatively lower injury acuity. We retrospectively analyzed data from 711 trauma patients older than 45 years. Parameters examined included demographics, injury characteristics, laboratories, morbidity, and mortality. Univariate and survival analyses were performed using PASW 18. A stepwise correlation exists between increasing Injury Severity Score and AG. Although AG less than 8 to 15 was not associated with a significant increase in mortality, greater mortality was seen for AG greater than 16 with further stepwise increases for AGs greater than 22. Anion gap correlated moderately with serum lactate and poorly with base excess. Increasing AG also correlated with morbidity and greater incidence of intensive care admissions. The presence of any complication increased from 28.6 per cent for patients with AG 12 or less to 45.5 per cent for patients with AG 22 or greater (P < 0.04). These findings support the contention that "low acuity" trauma patients with high AGs may not appear acutely ill but may harbor significant underlying metabolic and physiologic disturbances that could contribute to morbidity and mortality. Higher AG values (i.e., greater than 16) may be associated with worse clinical outcomes.

  15. BACTERIOLOGICAL INVESTIGATION ON Fasciola hepatica AND CATTLE BILIARY DUCTS

    Directory of Open Access Journals (Sweden)

    A. Panebianco

    2009-03-01

    Full Text Available The aim of this work was to investigate the occurrence of bacteria in Fasciola hepatica and into cattle biliary ducts containing the parasite. A total of 24 liver and 58 F. hepatica samples were analysed. In all biliary ducts and in 62,06% of parasite Enterobacteriaceae were isolated. The bacterial specie more frequently isolated from parasite were Citrobacter freundii (34%, Proteus mirabilis (18%, Providencia rettgeri (12%, Staphylococcus spp. (18%, Enterobacter spp. (12%. There doesn’t appear to be a correlation between bacterial specie from parasite and ducts. The Authors conclude with some related inspective consideration.

  16. Lacrimal Duct Occlusion Is Associated with Infectious Keratitis

    Science.gov (United States)

    Li, Guigang; Guo, Jingmin; Liu, Rong; Hu, Weikun; Xu, Lingjuan; Wang, Juan; Cai, Subo; Zhang, Hong; Zhu, Yingting

    2016-01-01

    Background: To explore the prevalence of lacrimal duct obstruction in patients with infectious keratitis, and the necessity of lacrimal duct dredge in the treatment of human infectious keratitis. Methodology/Principle Findings: The design is prospective, non-control case series. Thirty-one eyes from twenty-eight continuous patients with infectious keratitis were included in this study. The presence/absence of lacrimal duct obstruction was determined by the lacrimal duct irrigation test. The diagnosis of infectious keratitis was made based on clinical manifestations, cornea scraping microscopic examination and bacterial/fungus culture. Diagnosis of viral keratitis was set up based on the recurrent history, deep neovascularization and typical outlook of the cornea scar. The treatment of keratitis included drugs, eye drops or surgery, while treatment of chronic dacryocystitis was lacrimal duct dredging with supporting tube implantation surgery. In the thirty-one eyes with infectious keratitis, fifteen suffered from fungal keratitis (48%), two bacterial keratitis (6%), and fourteen viral keratitis (45%). Eleven eyes (35%) from ten patients with infectious keratitis also suffered from lacrimal duct obstruction. In those cases, six eyes also suffered from lower canalicular obstruction, three nasolacrimal duct obstruction and chronic dacryocystitis, one a combination of upper and lower canalicular obstruction, one upper canalicular obstruction. After local and systemic applications of anti-bacterial, anti-viral, anti-fungal and anti-inflammatory drugs, twenty-eight eyes (90%) recovered within three weeks, while the ulceration of three patients required the lacrimal duct dredging and supporting tube implantation surgery for the healing. Conclusions: Herein, we first report that the prevalence of infectious keratitis is closely correlated to the occurrence of lacrimal duct obstruction. When both confirmed, simultaneous treatment of keratitis and lacrimal duct obstruction

  17. Awake behaving electrophysiological correlates of forelimb hyperreflexia, weakness and disrupted muscular synchronization following cervical spinal cord injury in the rat

    Science.gov (United States)

    Ganzer, Patrick Daniel; Meyers, Eric Christopher; Sloan, Andrew Michael; Maliakkal, Reshma; Ruiz, Andrea; Kilgard, Michael Paul; Rennaker, Robert LeMoine

    2016-01-01

    Spinal cord injury usually occurs at the level of the cervical spine and results in profound impairment of forelimb function. In this study, we recorded awake behaving intramuscular electromyography (EMG) from the biceps and triceps muscles of the impaired forelimb during volitional and reflexive forelimb movements before and after unilateral cervical spinal cord injury (cSCI) in rats. C5/C6 hemicontusion reduced volitional forelimb strength by more than 50% despite weekly rehabilitation for one month post-injury. Triceps EMG during volitional strength assessment was reduced by more than 60% following injury, indicating reduced descending drive. Biceps EMG during reflexive withdrawal from a thermal stimulus was increased by 500% following injury, indicating flexor withdrawal hyperreflexia. The reduction in volitional forelimb strength was significantly correlated with volitional and reflexive biceps EMG activity. Our results support the hypothesis that biceps hyperreflexia and descending volitional drive both significantly contribute to forelimb strength deficits after cSCI and provide new insight into dynamic muscular dysfunction after cSCI. The use of multiple automated quantitative measures of forelimb dys-function in the rodent cSCI model will likely aid the search for effective regenerative, pharmacological, and neuroprosthetic treatments for spinal cord injury. PMID:27033345

  18. Incidence, severity and correlates of bicycling injuries in a sample of cyclists in Queensland, Australia.

    Science.gov (United States)

    Heesch, Kristiann C; Garrard, Jan; Sahlqvist, Shannon

    2011-11-01

    Bicycle injuries, particularly those resulting from single bicycle crashes, are underreported in both police and hospital records. Data on cyclist characteristics and crash circumstances are also often lacking. As a result, the ability to develop comprehensive injury prevention policies is hampered. The aim of this study was to examine the incidence, severity, cyclist characteristics, and crash circumstances associated with cycling injuries in a sample of cyclists in Queensland, Australia. A cross-sectional study of Queensland cyclists was conducted in 2009. Respondents (n=2056) completed an online survey about their cycling experiences, including cycling injuries. Logistic regression modelling was used to examine the associations between demographic and cycling behaviour variables with experiencing cycling injuries in the past year, and, separately, with serious cycling injuries requiring a trip to a hospital. Twenty-seven percent of respondents (n=545) reported injuries, and 6% (n=114) reported serious injuries. In multivariable modelling, reporting an injury was more likely for respondents who had cycled injuries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Reliability of dynamic sitting balance tests and their correlations with functional mobility for wheelchair users with chronic spinal cord injury

    Directory of Open Access Journals (Sweden)

    Kelly L. Gao

    2015-01-01

    Full Text Available The purpose of this study is to develop a reliable and valid tool for measuring the dynamic sitting balance of wheelchair users with spinal cord injury. The balance tests were performed in nine patients with chronic spinal cord injury (average of 17.2 years postinjury between levels C6 and L1, while they were sitting in their wheelchairs and on a standardized stool (unsupported sitting, twice, 7 days apart. Limits of stability (LOS and sequential weight shifting (SWS were designed in this study. The balance tests measured participants' volitional weight shifting in multiple directions within their base of support. Their mobility scores on the Spinal Cord Independence Measure III were correlated with the balance test results. The LOS results showed moderate to excellent test–retest reliability (intraclass correlation coefficients ranged from 0.673 to 0.990 for both the wheelchair and the unsupported sitting. The SWS results showed moderate to excellent reliability (intraclass correlation coefficients ranged from 0.688 to 0.952. The LOS results correlated significantly with the Spinal Cord Independence Measure III mobility scores only in case of unsupported sitting, but the SWS test results showed significant correlations in both sitting conditions. To sum up, the sitting LOS and SWS tests are reliable and valid tools for assessing the dynamic sitting balance control of patients with spinal cord injury.

  20. Electrophysiological correlates of emotional face processing after mild traumatic brain injury in preschool children.

    Science.gov (United States)

    D'Hondt, Fabien; Lassonde, Maryse; Thebault-Dagher, Fanny; Bernier, Annie; Gravel, Jocelyn; Vannasing, Phetsamone; Beauchamp, Miriam H

    2017-02-01

    Evidence suggests that social skills are affected by childhood mild traumatic brain injury (mTBI), but the neural and affective substrates of these difficulties are still underexplored. In particular, nothing is known about consequences on the perception of emotional facial expressions, despite its critical role in social interactions and the importance of the preschool period in the development of this ability. This study thus aimed to investigate the electrophysiological correlates of emotional facial expressions processing after early mTBI. To this end, 18 preschool children (mean age 53 ± 8 months) who sustained mTBI and 15 matched healthy controls (mean age 55 ± 11 months) were presented with pictures of faces expressing anger, happiness, or no emotion (neutral) while event-related potentials (ERP) were recorded. The main results revealed that P1 amplitude was higher for happy faces than for angry faces, and that N170 latency was shorter for emotional faces than for neutral faces in the control group only. These findings suggest that preschool children who sustain mTBI do not present the early emotional effects that are observed in healthy preschool children at visuospatial and visual expertise stages. This study provides new evidence regarding the consequences of childhood mTBI on socioemotional processing, by showing alterations of emotional facial expressions processing, an ability known to underlie social competence and appropriate social interactions.

  1. Differential Metabolic Rearrangements after Cold Storage Are Correlated with Chilling Injury Resistance of Peach Fruits

    Science.gov (United States)

    Bustamante, Claudia A.; Monti, Laura L.; Gabilondo, Julieta; Scossa, Federico; Valentini, Gabriel; Budde, Claudio O.; Lara, María V.; Fernie, Alisdair R.; Drincovich, María F.

    2016-01-01

    Reconfiguration of the metabolome is a key component involved in the acclimation to cold in plants; however, few studies have been devoted to the analysis of the overall metabolite changes after cold storage of fruits prior to consumption. Here, metabolite profiling of six peach varieties with differential susceptibility to develop mealiness, a chilling-injury (CI) symptom, was performed. According to metabolic content at harvest; after cold treatment; and after ripening, either following cold treatment or not; peach fruits clustered in distinct groups, depending on harvest-time, cold treatment, and ripening state. Both common and distinct metabolic responses among the six varieties were found; common changes including dramatic galactinol and raffinose rise; GABA, Asp, and Phe increase; and 2-oxo-glutarate and succinate decrease. Raffinose content after long cold treatment quantitatively correlated to the degree of mealiness resistance of the different peach varieties; and thus, raffinose emerges as a candidate biomarker of this CI disorder. Xylose increase after cold treatment was found only in the susceptible genotypes, indicating a particular cell wall reconfiguration of these varieties while being cold-stored. Overall, results indicate that peach fruit differential metabolic rearrangements due to cold treatment, rather than differential metabolic priming before cold, are better related with CI resistance. The plasticity of peach fruit metabolism renders it possible to induce a diverse metabolite array after cold, which is successful, in some genotypes, to avoid CI. PMID:27746802

  2. Differential metabolic rearrangements after cold storage are correlated with chilling injury resistance of peach fruits

    Directory of Open Access Journals (Sweden)

    Claudia A Bustamante

    2016-09-01

    Full Text Available Reconfiguration of the metabolome is a key component involved in the acclimation to cold in plants; however, few studies have been devoted to the analysis of the overall metabolite changes after cold storage of fruits prior to consumption. Here, metabolite profiling of six peach varieties with differential susceptibility to develop mealiness, a chilling-injury (CI symptom, was performed. According to metabolic content at harvest; after cold treatment; and after ripening, either following cold treatment or not; peach fruits clustered in distinct groups, depending on harvest-time, cold treatment, and ripening state. Both common and distinct metabolic responses among the six varieties were found; common changes including dramatic galactinol and raffinose rise; GABA, Asp and Phe increase; and 2-oxo-glutarate and succinate decrease. Raffinose content after long cold treatment quantitatively correlated to the degree of mealiness resistance of the different peach varieties; and thus, raffinose emerges as a candidate biomarker of this CI disorder. Xylose increase after cold treatment was found only in the susceptible genotypes, indicating a particular cell wall reconfiguration of these varieties while being cold-stored. Overall, results indicate that peach fruit differential metabolic rearrangements due to cold treatment, rather than differential metabolic priming before cold, are better related with CI resistance. The plasticity of peach fruit metabolism renders it possible to induce a diverse metabolite array after cold, which is successful, in some genotypes, to avoid CI

  3. Differential Metabolic Rearrangements after Cold Storage Are Correlated with Chilling Injury Resistance of Peach Fruits.

    Science.gov (United States)

    Bustamante, Claudia A; Monti, Laura L; Gabilondo, Julieta; Scossa, Federico; Valentini, Gabriel; Budde, Claudio O; Lara, María V; Fernie, Alisdair R; Drincovich, María F

    2016-01-01

    Reconfiguration of the metabolome is a key component involved in the acclimation to cold in plants; however, few studies have been devoted to the analysis of the overall metabolite changes after cold storage of fruits prior to consumption. Here, metabolite profiling of six peach varieties with differential susceptibility to develop mealiness, a chilling-injury (CI) symptom, was performed. According to metabolic content at harvest; after cold treatment; and after ripening, either following cold treatment or not; peach fruits clustered in distinct groups, depending on harvest-time, cold treatment, and ripening state. Both common and distinct metabolic responses among the six varieties were found; common changes including dramatic galactinol and raffinose rise; GABA, Asp, and Phe increase; and 2-oxo-glutarate and succinate decrease. Raffinose content after long cold treatment quantitatively correlated to the degree of mealiness resistance of the different peach varieties; and thus, raffinose emerges as a candidate biomarker of this CI disorder. Xylose increase after cold treatment was found only in the susceptible genotypes, indicating a particular cell wall reconfiguration of these varieties while being cold-stored. Overall, results indicate that peach fruit differential metabolic rearrangements due to cold treatment, rather than differential metabolic priming before cold, are better related with CI resistance. The plasticity of peach fruit metabolism renders it possible to induce a diverse metabolite array after cold, which is successful, in some genotypes, to avoid CI.

  4. Asymptomatic common bile duct stones.

    Science.gov (United States)

    Rosseland, A R; Glomsaker, T B

    2000-11-01

    Patients with asymptomatic bile duct stones exhibit typical signs, such as elevated liver function tests, dilated bile ducts on ultrasound, a history of jaundice, or pancreatitis. The incidence of asymptomatic bile duct stones is about 10%, but up to 2% of patients show no signs of the disease. Bile duct stones can be diagnosed by using clinical judgement, scoring systems, or discriminant function tests. Which diagnostic modality is most reliable, cost-effective and safe, varies with different hospitals. Which therapy is most effective, safe and the cheapest also varies with different departments, but in the future an increasing number of departments will use the one-stage laparoscopic approach.

  5. Noise reduction of spiral ducts.

    Science.gov (United States)

    Lapka, Wojciech; Cempel, Czesław

    2007-01-01

    The paper presents noise reduction (NR) of spiral ducts as a result of computational modeling of acoustic wave propagation. Three-dimensional models were created with the finite element method in COMSOL Multiphysics version 3.3. Nine models of spiral ducts with 1-9 spiral leads were considered. Time-harmonic analysis was used to predict NR, which was shown in spectral and interval frequency bands. Spiral duct performance can be seen as a comparison of NR before and after a change from a circular to a spiral duct.

  6. The early IL-6 and IL-10 response in trauma is correlated with injury severity and mortality

    DEFF Research Database (Denmark)

    Stensballe, J; Christiansen, M; Tønnesen, E;

    2009-01-01

    in the first 24 h after trauma and to assess the relationship with severity of injury and mortality. METHODS: Prospective, descriptive cohort study in a Level 1 trauma centre, Copenhagen, Denmark. We included 265 consecutive adult trauma patients admitted directly from the accident scene during an 18-month...... period. Serum levels of IL-6 and IL-10 were measured upon arrival and at 6, 12, and 24 h after admittance using an enzyme-linked immunosorbent assay. Correlation analysis was used to assess the relationship between Injury Severity Score (ISS) and levels of IL-6 and IL-10. Analysis of variance was used...

  7. Tei index in preeclampsia pregnant women and its correlation with the degree of endothelial injury and hypertension

    Institute of Scientific and Technical Information of China (English)

    Mi Zhou

    2017-01-01

    Objective:To study the Tei index in preeclampsia pregnant women and its correlation with the degree of endothelial injury and hypertension.Methods: A total of 98 preeclampsia pregnant women who were treated in our hospital between May 2014 and July 2016 were divided into mild preeclampsia group (n=62) and severe preeclampsia group (n=36), and 50 normal pregnant women who received antenatal care in our hospital during the same period were selected as normal control group. Ultrasound Tei index as well as the levels of serum endothelial injury indexes and hypertension-related indexes were compared among three groups of pregnant women, and the correlation of Tei index with endothelial injury and hypertension level in preeclampsia pregnant women was further evacuated.Results: Tei index levels in mild preeclampsia group and severe preeclampsia group were higher than that in normal control group, and the Tei index level in severe preeclampsia group was higher than that in mild preeclampsia group. Serum VEGF contents in mild preeclampsia group and severe preeclampsia group were lower than that in the normal control group while sFlt-1, MMP-1 and PAR-1 contents were higher than those in normal control group, 24 h SBP, 24 h DBP, dSBP, dDBP, nSBP and nDBP levels were higher than those in normal control group, and the changes in above indexes in severe preeclampsia group were higher than those in mild preeclampsia group. The Pearson test showed that the Tei index level in preeclampsia pregnant women was directly correlated with endothelial injury and hypertension level.Conclusion: Tei index increases in preeclampsia pregnant women, and its level is directly correlated with endothelial injury and hypertension level.

  8. 腹腔镜胆囊切除术细小胆管损伤的诊断与处理%DIAGNOSIS AND TREATMENT OF SMALL BILE DUCT INJURY DURING LAPAROSCOPIC CHOLECYSTECTOMY

    Institute of Scientific and Technical Information of China (English)

    舒晔; 周总光; 解蓉; 于永扬; 杜景平; 吕青; 程南生

    2001-01-01

    Objective To comment the diagnosis and treatment the bile leakagefrom the injuried abnormal minute biliary in our laparosicopic cholecystectomy (LC) practice. Methods Fourteen cases of minute biliary duct injury in 2 050 cases of LC were studied retrospectively. Among them, 6 cases had been found the points of leakage during operation, and the points were treated by titanium nips. In 4 cases even though the bile leakage could be seen, but the points of leakage could not found, and were treated by drainage. Four cases with peritonitis, 1 needed to be explored, and treated with suture ligature, 1 was explored by laparoscopy again, another two cases were treated with multiple hole catheters to drainage of the abdominal cavities through stab wounds. Results All 14 cases recovered. Conclusion Small bile leakage in LC is almost inevitable. It is the best that the bile leakage can be discovered during operation and to be treated. If it is discovered after operation, an open or laparoscopic exploratory laparotomy and adequate drainage would be needed. In the case of small amount of leakage, catheter drainage through stab wound is feasible.%目的 总结腹腔镜胆囊切除术(LC)时细小胆管损伤的诊断及处理体会。方法 分析2050例LC手术中14例细小胆管损伤的情况。6例于术中发现漏胆点,予以钛夹夹闭;4例未找到渗胆点,予引流;4例术后出现胆汁性腹膜炎,其中1例剖腹探查并缝扎渗胆处,1例行腹腔镜探查并引流,另2例经腹壁戳孔放置多孔尿管引流。结果 14例均获痊愈,其中4例术后出现胆汁性腹膜炎者经治疗也未产生严重后果。结论 LC时细小胆管损伤较难避免。术中发现并及时治疗效果最好;术后发现应行剖腹探查或再次腹腔镜手术探查并予充分引流;对漏胆量少的患者经腹壁戳孔放置引流管引流是可取的方法。

  9. Gallbladder and bile duct

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930559 An experimental study on effective hep-atic blood flow and hepatic energy metabolismfollowing acute obstructive cholangitis and bil-iary obstruction.SUN Wenbing (孙文兵),et al.Hepatobili Surg,Center,Southwest Hosp,Chongqing 630000.Chin J Digest 1992;12(5):261—263.The changes of effective hepatic blood flow(E-HBF)and hepatic energy metabolism were stud-ied following acutc obstructive cholangitis(AOC)and bile duct ligation(BDL)in rats.The resultsshowed that EHBF was significantly decreased at24hs after and further decreased at 48hs afterBDL.And EHBF was significantly decreased at

  10. Stopping duct quacks: Longevity of residential duct sealants

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max H.; Walker, Iain S.; Dickerhoff, Darryl J.

    2000-08-01

    Duct leakage has been identified as a major source of energy loss in residential buildings. Most duct leakage occurs at the connections to registers, plenums or branches in the duct system. At each of these connections a method of sealing the duct system is required. Typical sealing methods include tapes or mastics applied around the joints in the system. Field examinations of duct systems have shown that these seals tend to fail over time periods ranging from days to years. We have used several test methods over the last few years to evaluate the longevity of duct sealants when subjected to temperatures and pressures representative of those found in the field. Traditional cloth duct tapes have been found to significantly under-perform other sealants and have been banned from receiving duct tightness credits in California's energy code (California Energy Commission 1998). Our accelerated testing apparatus has been redesigned since its first usage for improved performance. The methodology is currently under consideration by the American Society for Testing and Materials (ASTM) as a potential new test method. This report will summarize the set of measurements to date, review the status of the test apparatus and test method, and summarize the applications of these results to codes and standards.

  11. Connectomic and surface-based morphometric correlates of acute mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Patrizia eDall'Acqua

    2016-03-01

    Full Text Available Reduced integrity of white matter (WM pathways and subtle anomalies in gray matter (GM morphology have been hypothesized as mechanisms in mild traumatic brain injury (mTBI. However, findings on structural brain changes in early stages after mTBI are inconsistent and findings related to early symptoms severity are rare.Fifty-one patients were assessed with multimodal neuroimaging and clinical methods exclusively within 7 days following mTBI and compared to 53 controls. Whole-brain connectivity based on diffusion tensor imaging was subjected to network-based statistics, whereas cortical surface area, thickness, and volume based on T1-weighted MRI scans were investigated using surface-based morphometric analysis. Reduced connectivity strength within a subnetwork of 59 edges located predominantly in bilateral frontal lobes was significantly associated with higher levels of self-reported symptoms. In addition, cortical surface area decreases were associated with stronger complaints in five clusters located in bilateral frontal and postcentral cortices, and in the right inferior temporal region. Alterations in WM and GM were localized in similar brain regions and moderately-to-strongly related to each other. Furthermore, the reduction of cortical surface area in the frontal regions was correlated with poorer attentive-executive performance in the mTBI group. Finally, group differences were detected in both the WM and GM, especially when focusing on a subgroup of patients with greater complaints, indicating the importance of classifying mTBI patients according to severity of symptoms. This study provides evidence that mTBI affects not only the integrity of WM networks by means of axonal damage but also the morphology of the cortex during the initial post-injury period. These anomalies might be greater in the acute period than previously believed and the involvement of frontal brain regions was consistently pronounced in both findings. The dysconnected

  12. Correlates of Injury-forced Work Reduction for Massage Therapists and Bodywork Practitioners.

    Science.gov (United States)

    Blau, Gary; Monos, Christopher; Boyer, Ed; Davis, Kathleen; Flanagan, Richard; Lopez, Andrea; Tatum, Donna S

    2013-01-01

    Injury-forced work reduction (IFWR) has been acknowledged as an all-too-common occurrence for massage therapists and bodywork practitioners (M & Bs). However, little prior research has specifically investigated demographic, work attitude, and perceptual correlates of IFWR among M & Bs. To test two hypotheses, H1 and H2. H1 is that the accumulated cost variables set ( e.g., accumulated costs, continuing education costs) will account for a significant amount of IFWR variance beyond control/demographic (e.g., social desirability response bias, gender, years in practice, highest education level) and work attitude/perception variables (e.g., job satisfaction, affective occupation commitment, occupation identification, limited occupation alternatives) sets. H2 is that the two exhaustion variables (i.e., physical exhaustion, work exhaustion) set will account for significant IFWR variance beyond control/demographic, work attitude/perception, and accumulated cost variables sets. An online survey sample of 2,079 complete-data M & Bs was collected. Stepwise regression analysis was used to test the study hypotheses. The research design first controlled for control/demographic (Step1) and work attitude/perception variables sets (Step 2), before then testing for the successive incremental impact of two variable sets, accumulated costs (Step 3) and exhaustion variables (Step 4) for explaining IFWR. RESULTS SUPPORTED BOTH STUDY HYPOTHESES: accumulated cost variables set (H1) and exhaustion variables set (H2) each significantly explained IFWR after the control/demographic and work attitude/perception variables sets. The most important correlate for explaining IFWR was higher physical exhaustion, but work exhaustion was also significant. It is not just physical "wear and tear", but also "mental fatigue", that can lead to IFWR for M & Bs. Being female, having more years in practice, and having higher continuing education costs were also significant correlates of IFWR. Lower overall

  13. Long-term global and regional brain volume changes following severe traumatic brain injury: A longitudinal study with clinical correlates

    DEFF Research Database (Denmark)

    Sidaros, Annette; Skimminge, Arnold Jesper Møller; Liptrot, Matthew George;

    2009-01-01

    Traumatic brain injury (TBI) results in neurodegenerative changes that progress for months, perhaps even years post-injury. However, there is little information on the spatial distribution and the clinical significance of this late atrophy. In 24 patients who had sustained severe TBI we acquired 3D...... scan time point using SIENAX. Regional distribution of atrophy was evaluated using tensor-based morphometry (TBM). At the first scan time point, brain parenchymal volume was reduced by mean 8.4% in patients as compared to controls. During the scan interval, patients exhibited continued atrophy...... with percent brain volume change (%BVC) ranging between − 0.6% and − 9.4% (mean − 4.0%). %BVC correlated significantly with injury severity, functional status at both scans, and with 1-year outcome. Moreover, %BVC improved prediction of long-term functional status over and above what could be predicted using...

  14. Propagation of sound waves in ducts

    DEFF Research Database (Denmark)

    Jacobsen, Finn

    2000-01-01

    Plane wave propagation in ducts with rigid walls, radiation from ducts, classical four-pole theory for composite duct systems, and three-dimentional waves in wave guides of various cross-sectional shape are described....

  15. Surgery for Bile Duct (Cholangiocarcinoma) Cancer

    Science.gov (United States)

    ... Situation Bile Duct Cancer Treating Bile Duct Cancer Surgery for Bile Duct Cancer There are 2 general ... also help plan the operation to remove it. Surgery for resectable cancers For resectable cancers, the type ...

  16. Correlation of serum neutrophil gelatinase-associated lipocalin with acute kidney injury in hypertensive disorders of pregnancy.

    Science.gov (United States)

    Patel, Ml; Sachan, Rekha; Gangwar, Radheyshyam; Sachan, Pushpalata; Natu, Sm

    2013-01-01

    Hypertensive disorders of pregnancy (HDP) remain one of the largest single causes of maternal and fetal morbidity and mortality, accounting for 16.1% of maternal deaths in developed countries. The aim of the study was to evaluate acute kidney injury (AKI) in hypertensive disorders of pregnancy and to examine the correlation of serum neutrophil gelatinase-associated lipocalin (NGAL) with acute kidney injury. This prospective case control study was carried out over a period of 1 year. After written, informed consent and ethical clearance, 149 cases of hypertensive disorders of pregnancy were screened, and seven were lost to follow-up. Acute kidney injury was detected in 88 cases and acute renal failure in 30 cases of HDP. Thirty-one healthy pregnant nonhypertensive women were enrolled as controls. Quantitative measurement of serum NGAL levels was done by enzyme linked immunosorbent assay technique using a sandwich enzyme-linked immunosorbent assay kit. As per the Kidney Diseases Improving Global Outcomes International guidelines acute kidney injury network (AKIN), 50 cases (42.37%) of AKI stage I, 38 (32.2%) cases of AKI stage II, and 30 (25.42%) cases of renal failure were detected. Serum NGAL had a positive association with increasing proteinuria. It also had a positive correlation with systolic blood pressure (r∼0.36), diastolic blood pressure (r∼0.37), and serum creatinine (r∼0.4). NGAL was found to be significantly correlated with creatinine in the cases with the value of the correlation coefficient being 0.4. This direct correlation might be a consequence of endothelial dysfunction on which hypertension and proteinuria probably depends.

  17. Illness, Injury, and Correlates of Aerobic Exercise and Walking: A Community Study.

    Science.gov (United States)

    Hofstetter, C. Richard; And Others

    1991-01-01

    A sample of Californians was surveyed to explore differences in aerobic exercise and walking behavior among healthy subjects and subjects with illness/injury serious enough to limit physical activity. Results indicate different patterns of determinants of exercise within various illness/injury groups. This implies interventions to increase…

  18. Reorganization of Functional Connectivity as a Correlate of Cognitive Recovery in Acquired Brain Injury

    Science.gov (United States)

    Castellanos, Nazareth P.; Paul, Nuria; Ordonez, Victoria E.; Demuynck, Olivier; Bajo, Ricardo; Campo, Pablo; Bilbao, Alvaro; Ortiz, Tomas; del-Pozo, Francisco; Maestu, Fernando

    2010-01-01

    Cognitive processes require a functional interaction between specialized multiple, local and remote brain regions. Although these interactions can be strongly altered by an acquired brain injury, brain plasticity allows network reorganization to be principally responsible for recovery. The present work evaluates the impact of brain injury on…

  19. Propagation of sound waves in ducts

    DEFF Research Database (Denmark)

    Jacobsen, Finn

    2000-01-01

    Plane wave propagation in ducts with rigid walls, radiation from ducts, classical four-pole theory for composite duct systems, and three-dimentional waves in wave guides of various cross-sectional shape are described.......Plane wave propagation in ducts with rigid walls, radiation from ducts, classical four-pole theory for composite duct systems, and three-dimentional waves in wave guides of various cross-sectional shape are described....

  20. Sound propagation through nonuniform ducts

    Science.gov (United States)

    Nayfeh, A. H.

    1976-01-01

    Methods of determining the transmission and attenuation of sound propagating in nonuniform ducts with and without mean flows are discussed. The approaches reviewed include purely numerical techniques, quasi-one-dimensional approximations, solutions for slowly varying cross sections, solutions for weak wall undulations, approximation of the duct by a series of stepped uniform cross sections, variational methods and solutions for the mode envelopes.

  1. Intrahepatic Transposition of Bile Ducts

    Science.gov (United States)

    Delić, Jasmin; Savković, Admedina; Isaković, Eldar; Marković, Sergije; Bajtarevic, Alma; Denjalić, Amir

    2012-01-01

    Objective. To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. Material and Methods. The researches were performed randomly on 100 livers of adults, both sexes. Main research methods were anatomical macrodissection. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988. Results. Intrahepatic transposition of bile ducts was found in two cases (2%), out of total examined cases (100): right-left transposition (right segmental bile duct, originating from the segment VIII, joins the left liver duct-ductus hepaticus sinister) and left-right intrahepatic transposition (left segmental bile duct originating from the segment IV ends in right liver duct-ductus hepaticus dexter). Conclusion. Safety and success in liver transplantation to great extent depends on knowledge of anatomy and some common embryological anomalies in bile tree. Variations in bile tree were found in 24–43% of cases, out of which 1–22% are the variations of intrahepatic bile ducts. Therefore, good knowledge on ductal anatomy enables good planning, safe performance of therapeutic and operative procedures, and decreases the risk of intraoperative and postoperative complications. PMID:22550601

  2. Natural convection heat transfer along vertical rectangular ducts

    Science.gov (United States)

    Ali, M.

    2009-12-01

    Experimental investigations have been reported on steady state natural convection from the outer surface of vertical rectangular and square ducts in air. Seven ducts have been used; three of them have a rectangular cross section and the rest have square cross section. The ducts are heated using internal constant heat flux heating elements. The temperatures along the vertical surface and the peripheral directions of the duct wall are measured. Axial (perimeter averaged) heat transfer coefficients along the side of each duct are obtained for laminar and transition to turbulent regimes of natural convection heat transfer. Axial (perimeter averaged) Nusselt numbers are evaluated and correlated using the modified Rayleigh numbers for laminar and transition regime using the vertical axial distance as a characteristic length. Critical values of the modified Rayleigh numbers are obtained for transition to turbulent. Furthermore, total overall averaged Nusselt numbers are correlated with the modified Rayleigh numbers and the area ratio for the laminar regimes. The local axial (perimeter averaged) heat transfer coefficients are observed to decrease in the laminar region and increase in the transition region. Laminar regimes are obtained at the lower half of the ducts and its chance to appear decreases as the heat flux increases.

  3. An Investigation of Correlation between Electrophysiological and Functional Recovery after the Sciatic Nerve Injury

    Directory of Open Access Journals (Sweden)

    Mustafa Guven

    2012-08-01

    Full Text Available Purpose: Video or photo assisted footprint analysis method is used to determine the motor and sensorial development instead of classic walking track footprint analysis in experimental peripheral nerve injury. Besides, the sucrose-gap method is used for measuring the electrophysiological activity in the sciatic nerves in-vitro. The aim of this study is to investigate the relationship between functional and electrophysiological recovery during the nerve regeneration in Wistar rats. Methods: In the experiments, after the unilateral sciatic nerve crushing, the rats were evaluated at the preoperative and 2nd, 4th, 6th and 8th weeks postoperative using the sucrose gap method, and photo assisted footprint method. The compound action potentials (CAP, the Peak- time (PT and the ½ Falling- time (1/2FT were measured, and compared to functional results. Results: Two weeks after being crushed sciatic nerves, complete function loss was seen operated legs in all rats. The amplitude of CAP was determined too small. The PT and the 1/2FT values were three fold longer than intact. However, following 4th – 8th weeks, the amplitude of CAP and other parameters of CAP were closed to intact values. Conclusion: The findings indicated that the results of the functional recovery were correlated to electrophysiological results. However, functional results showed almost full functional recovery in the 4th week, the electrophysiological results did not reach to intact values in the 8th week. We conclude that photo assisted footprint analysis method and sucrose-gap technique, which are useful functional and electrophysiological methods to produce complementary knowledge with each other in the investigation of experimental peripheral nerve regeneration. [Cukurova Med J 2012; 37(4.000: 177-185

  4. Hippocampal CA3 transcriptome signature correlates with initial precipitating injury in refractory mesial temporal lobe epilepsy.

    Directory of Open Access Journals (Sweden)

    Silvia Y Bando

    Full Text Available BACKGROUND: Prolonged febrile seizures constitute an initial precipitating injury (IPI commonly associated with refractory mesial temporal lobe epilepsy (RMTLE. In order to investigate IPI influence on the transcriptional phenotype underlying RMTLE we comparatively analyzed the transcriptomic signatures of CA3 explants surgically obtained from RMTLE patients with (FS or without (NFS febrile seizure history. Texture analyses on MRI images of dentate gyrus were conducted in a subset of surgically removed sclerotic hippocampi for identifying IPI-associated histo-radiological alterations. METHODOLOGY/PRINCIPAL FINDINGS: DNA microarray analysis revealed that CA3 global gene expression differed significantly between FS and NFS subgroups. An integrative functional genomics methodology was used for characterizing the relations between GO biological processes themes and constructing transcriptional interaction networks defining the FS and NFS transcriptomic signatures and its major gene-gene links (hubs. Co-expression network analysis showed that: i CA3 transcriptomic profiles differ according to the IPI; ii FS distinctive hubs are mostly linked to glutamatergic signalization while NFS hubs predominantly involve GABAergic pathways and neurotransmission modulation. Both networks have relevant hubs related to nervous system development, what is consistent with cell genesis activity in the hippocampus of RMTLE patients. Moreover, two candidate genes for therapeutic targeting came out from this analysis: SSTR1, a relevant common hub in febrile and afebrile transcriptomes, and CHRM3, due to its putative role in epilepsy susceptibility development. MRI texture analysis allowed an overall accuracy of 90% for pixels correctly classified as belonging to FS or NFS groups. Histological examination revealed that granule cell loss was significantly higher in FS hippocampi. CONCLUSIONS/SIGNIFICANCE: CA3 transcriptional signatures and dentate gyrus morphology fairly

  5. Laparoscopic common bile duct exploration.

    Science.gov (United States)

    Stoker, M E; Leveillee, R J; McCann, J C; Maini, B S

    1991-10-01

    Operative common bile duct exploration, performed in conjunction with cholecystectomy, has been considered the treatment of choice for choledocholithiasis in the presence of an intact gallbladder. With the advent of laparoscopic cholecystectomy, the management of common bile duct stones has been affected. More emphasis is being placed on endoscopic sphincterotomy and options other than operative common duct exploration. Because of this increasing demand, we have developed a new technique for laparoscopic common bile duct exploration performed in the same operative setting as laparoscopic cholecystectomy. A series of five patients who successfully underwent common bile duct exploration, flexible choledochoscopy with stone extraction, and T-tube drainage, all using laparoscopic technique, is reported. Mean postoperative length of hospital stay was 4.6 days. Outpatient T-tube cholangiography was performed in all cases and revealed normal ductal anatomy with no retained stones. Follow-up ranged from 6 weeks to 4 months, and all patients were asymptomatic and had normal liver function tests.

  6. Ascariasis of the pancreatic duct.

    Science.gov (United States)

    Klimovskij, Michail; Dulskas, Audrius; Kraulyte, Zita; Mikalauskas, Saulius

    2015-09-15

    Ascariasis is a common helminthic disease worldwide, although Lithuania and other European countries are not considered endemic areas. The presence of the Ascaris worm in the biliary tree causes choledocholithiasis-like symptoms. We report a case of pancreatic duct ascariasis causing such symptoms. A 73-year-old Lithuanian woman underwent endoscopic retrograde cholangiopancreatography (ERCP) suspecting choledocholithiasis. Contrast injection into the common bile duct demonstrated a slightly dilated biliary tree without any filling defects, and the tail of an Ascaris worm protruding from the opening of the papilla Vater. The worm was captured by a snare but escaped deep into the duct. After a small wirsungotomy the worm was retrieved from the pancreatic duct. The patient received a 150 mg dose of levamisole orally repeated 7 days later and was discharged after complete resolution of symptoms. This first reported sporadic case of pancreatic duct ascariasis in Lithuania was successfully treated with ERCP and Levamisole.

  7. Self-injury, suicide ideation, and sexual orientation: differences in causes and correlates among high school students

    OpenAIRE

    Whitney DeCamp; Bakken, Nicholas W.

    2016-01-01

    Abstract: Background: Research has suggested that sexual minority youth are more likely to experience a number of behavioral and health-related risk factors due to their exposure to negative attitudes and beliefs about sexual minorities. Few studies, however, have examined the prevalence of non-suicidal self-injury (NSSI) among sexual minority youth. With self-cutting and suicidal ideation common in middle and high schools, understanding the antecedents and correlates of such behavior may hel...

  8. Negative correlation of CD34+ cells with blood-brain barrier permeability following traumatic brain injury in a rat model.

    Science.gov (United States)

    Jin, Xuelong; Wang, Feifei; Liu, Xingju; Liang, Bin; Chen, Zequn; He, Junfeng; Zhang, Hong; Zhang, Jianning

    2014-11-01

    TBI causes localized cerebral ischemia that, in turn, is accompanied by both changes in BBB permeability and recruitment of CD34(+) cells to the injured tissue. However, it remains unknown whether CD34(+) cell recruitment is linked to BBB permeability. This study is a preliminary investigation into possible correlations between CD34(+) cell recruitment and BBB permeability following TBI in a rat model. Male SD rats were subjected to mild fluid percussion injury. BBB permeability was assessed by measuring extrinsic EB dye extravasation and endogenous EBA expression at days 1, 3, 5, 7, and 12 post injury. The number of CD34(+) cells in the damaged tissue was analyzed by immunohistochemistry at each time point. EB dye extravasation reached a peak at day 3 following TBI, while EBA expression displayed the reverse profile. Accumulation of CD34(+) cells in injured brain tissue was evident at five days post injury. It revealed a negative linear correlation between CD34(+) cell and BBB permeability. The negative linear correlation between CD34(+) cell recruitment and BBB permeability following TBI provides a support for further study of CD34(+) cell transplantation for BBB repair after TBI. © 2014 John Wiley & Sons Ltd.

  9. Correlation of brain levels of progesterone and dehydroepiandrosterone with neurological recovery after traumatic brain injury in female mice.

    Science.gov (United States)

    Lopez-Rodriguez, Ana Belen; Acaz-Fonseca, Estefania; Giatti, Silvia; Caruso, Donatella; Viveros, Maria-Paz; Melcangi, Roberto C; Garcia-Segura, Luis M

    2015-06-01

    Traumatic brain injury (TBI) is an important cause of disability in humans. Neuroactive steroids, such as progesterone and dehydroepiandrosterone (DHEA), are neuroprotective in TBI models. However in order to design potential neuroprotective strategies based on neuroactive steroids it is important to determine whether its brain levels are altered by TBI. In this study we have used a weight-drop model of TBI in young adult female mice to determine the levels of neuroactive steroids in the brain and plasma at 24h, 72 h and 2 weeks after injury. We have also analyzed whether the levels of neuroactive steroids after TBI correlated with the neurological score of the animals. TBI caused neurological deficit detectable at 24 and 72 h, which recovered by 2 weeks after injury. Brain levels of progesterone, tetrahydroprogesterone (THP), isopregnanolone and 17β-estradiol were decreased 24h, 72 h and 2 weeks after TBI. DHEA and brain testosterone levels presented a transient decrease at 24h after lesion. Brain levels of progesterone and DHEA showed a positive correlation with neurological recovery. Plasma analyses showed that progesterone was decreased 72 h after lesion but, in contrast with brain progesterone, its levels did not correlate with neurological deficit. These findings indicate that TBI alters the levels of neuroactive steroids in the brain with independence of its plasma levels and suggest that the pharmacological increase in the brain of the levels of progesterone and DHEA may result in the improvement of neurological recovery after TBI.

  10. Pancreatic fistula through the distal common bile duct

    Directory of Open Access Journals (Sweden)

    Čolović Radoje B.

    2002-01-01

    Full Text Available Pancreatic fistula is usually caused by acute or chronic pancreatitis, injury and operations of the pancreas. The pancreatic juice comes either from the main pancreatic duct or from side branches. Extremely rare pancreatic fistula may come through the distal end of the common bile duct that is not properly sutured or ligated after traumatic or operative transaction. We present a 58-year old man who developed a life threatening high output pancreatic fistula through the distal end of the common bile duct that was simply ligated after resection for carcinoma. Pancreatic fistula was developed two weeks after original surgery and after two emergency reoperations for serious bleeding from the stump of the right gastric artery resected and ligated during radical limphadenectomy. The patient was treated conservatively by elevation of the drain- age bag after firm tunnel round the drain was formed so that there was no danger of spillage of the pancreatic juice within abdomen.

  11. Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The role of endoscopic therapy in the management of pancreatic diseases is continuously evolving; at present most pathological conditions of the pancreas are successfully treated by endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasound (EUS),or both. Endoscopic placement of stents has played and still plays a major role in the treatment of chronic pancreatitis, pseudocysts, pancreas divisum, main pancreatic duct injuries, pancreatic fistulae, complications of acute pancreatitis, recurrent idiopathic pancreatitis,and in the prevention of post-ERCP pancreatitis. These stents are currently routinely placed to reduce intraductal hypertension, bypass obstructing stones, restore lumen patency in cases with dominant, symptomatic strictures,seal main pancreatic duct disruption, drain pseudocysts or fluid collections, treat symptomatic major or minor papilla sphincter stenosis, and prevent procedure-induced acute pancreatitis. The present review aims at updating and discussing techniques, indications, and results of endoscopic pancreatic duct stent placement in acute and chronic inflammatory diseases of the pancreas.

  12. The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents.

    Directory of Open Access Journals (Sweden)

    Gabriela Ilie

    Full Text Available BACKGROUND: Although it is well established that sex is a risk factor in acquiring a traumatic brain injury (TBI among adolescents, it has not been established whether it also moderates the influence of other TBI psychological health correlates. METHODS AND FINDINGS: Data were derived from a 2011 population-based cross-sectional school survey, which included 9,288 Ontario 7th-12th graders who completed anonymous self-administered questionnaires in classrooms. Response rate was 62%. Preliminary analyses found no evidence of nonresponse bias in the reporting of TBI. TBI was defined as a hit or blow to the head that resulted in a 5 minutes loss of consciousness or at least one overnight hospitalization due to symptoms associated with it. Reports of lifetime TBI were more common among males than females (23.1%, 95% CI: 20.5, 25.8 vs. 17.1%, 95% CI: 14.7, 19.8. Thirteen correlates were examined and included cigarette smoking, elevated psychological distress, suicide ideation, bully victimization (at school, as well as cyber bullying, bullying others, cannabis use, cannabis dependence and drug use problems, physical injuries, daily smoking, drinking alcohol, binge drinking, use of cannabis, and poor academic performance. Among the outcomes examined, sex moderated the relationship between lifetime TBI and cigarette smoking. In addition, sex and age jointly moderated the relationship between lifetime TBI and daily smoking, alcohol use and physical injuries. Late adolescent males who reported lifetime TBI, relative to females, displayed elevated daily smoking and injuries, whereas their females counterparts displayed elevated past year drinking. Possible bias related to self-report procedures and the preclusion of causal inferences due to the cross-sectional nature of the data are limitations of this study. CONCLUSIONS: TBI differences in outcomes need to be assessed for potential moderating effects of sex and age. Results have important implications for

  13. Correlates of undefined cause of injury coded mortality data in Australia.

    Science.gov (United States)

    McKenzie, Kirsten; Chen, Linping; Walker, Susan M

    2009-01-01

    The objective of this research was to identify the level of detail regarding the external causes of death in Australia and ascertain problematic areas where data quality improvement efforts may be focused. The 2003 national mortality dataset of 12,591 deaths with an external cause of injury as the underlying cause of death (UCOD) or multiple cause of death (MCOD) based on ICD-10 code assignment from death certificate information was obtained. Logistic regression models were used to examine the precision of coded external cause of injury data. It was found that overall, accidents were the most poorly defined of all intent code blocks with over 30% of accidents being undefined, representing 2,314 deaths in 2003. More undefined codes were identified in MCOD data than for UCOD data. Deaths certified by doctors were more likely to use undefined codes than deaths certified by a coroner or government medical office. To improve the quality of external cause of injuries leading to or associated with death, certifiers need to be made aware of the importance of documenting all information pertaining to the cause of the injury and the intent behind the incident, either through education or more explicit instructions on the death certificate and accompanying instructional materials. It is important that researchers are aware of the validity of the data when they make interpretations as to the underlying causes of fatal injuries and causes of injury associated with deaths.

  14. 103Pd radioactive stent inhibits biliary duct restenosis and reduces smooth muscle actin expression during duct healing in dogs

    Institute of Scientific and Technical Information of China (English)

    Gui-Jin He; Qin-Yi Gao; Shu-He Xu; Hong Gao; Tao Jiang; Xian-Wei Dai; Kai Ma

    2006-01-01

    BACKGROUND: This study was designed to assess the expression of smooth muscle actin (SMA) in the healing process after implanting a 103Pd radioactive stent in the biliary duct, and to discuss the function and signiifcance of this stent in preventing biliary stricture formation. METHODS:A model of biliary injury in dogs was made and then a 103Pd radioactive stent was positioned in the biliary duct. The expression and distribution of SMA were assessed in the anastomotic tissue 30 days after implantation of the stent. RESULTS:SMA expression was less in the 103Pd stent group than in the ordinary stent group. The 103Pd stent inhibited scar contracture and anastomotic stenosis. CONCLUSION:The 103Pd stent can reduce the expression of SMA in the healing process and inhibit scar contracture and anastomotic stenosis in the dog biliary duct.

  15. Correlation of serum neutrophil gelatinase-associated lipocalin with acute kidney injury in hypertensive disorders of pregnancy

    Directory of Open Access Journals (Sweden)

    Patel ML

    2013-10-01

    Full Text Available ML Patel,1 Rekha Sachan,2 Radheyshyam Gangwar,3 Pushpalata Sachan,4 SM Natu51Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India; 2Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India; 3Department of Critical Care, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; 4Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India; 5Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, IndiaAbstract: Hypertensive disorders of pregnancy (HDP remain one of the largest single causes of maternal and fetal morbidity and mortality, accounting for 16.1% of maternal deaths in developed countries. The aim of the study was to evaluate acute kidney injury (AKI in hypertensive disorders of pregnancy and to examine the correlation of serum neutrophil gelatinase-associated lipocalin (NGAL with acute kidney injury. This prospective case control study was carried out over a period of 1 year. After written, informed consent and ethical clearance, 149 cases of hypertensive disorders of pregnancy were screened, and seven were lost to follow-up. Acute kidney injury was detected in 88 cases and acute renal failure in 30 cases of HDP. Thirty-one healthy pregnant nonhypertensive women were enrolled as controls. Quantitative measurement of serum NGAL levels was done by enzyme linked immunosorbent assay technique using a sandwich enzyme-linked immunosorbent assay kit. As per the Kidney Diseases Improving Global Outcomes International guidelines acute kidney injury network (AKIN, 50 cases (42.37% of AKI stage I, 38 (32.2% cases of AKI stage II, and 30 (25.42% cases of renal failure were detected. Serum NGAL had a positive association with increasing proteinuria. It also had a positive correlation with systolic blood pressure (r~0.36, diastolic blood pressure (r~0.37, and serum creatinine (r~0

  16. PMR Graphite Engine Duct Development

    Science.gov (United States)

    Stotler, C. L.; Yokel, S. A.

    1989-01-01

    The objective was to demonstrate the cost and weight advantages that could be obtained by utilizing the graphite/PMR15 material system to replace titanium in selected turbofan engine applications. The first component to be selected as a basis for evaluation was the outer bypass duct of the General Electric F404 engine. The operating environment of this duct was defined and then an extensive mechanical and physical property test program was conducted using material made by processing techniques which were also established by this program. Based on these properties, design concepts to fabricate a composite version of the duct were established and two complete ducts fabricated. One of these ducts was proof pressure tested and then run successfully on a factory test engine for over 1900 hours. The second duct was static tested to 210 percent design limit load without failure. An improved design was then developed which utilized integral composite end flanges. A complete duct was fabricated and successfully proof pressure tested. The net results of this effort showed that a composite version of the outer duct would be 14 percent lighter and 30 percent less expensive that the titanium duct. The other type of structure chosen for investigation was the F404 fan stator assembly, including the fan stator vanes. It was concluded that it was feasible to utilize composite materials for this type structure but that the requirements imposed by replacing an existing metal design resulted in an inefficient composite design. It was concluded that if composites were to be effectively used in this type structure, the design must be tailored for composite application from the outset.

  17. Prevalence and correlates of needle-stick injuries among active duty police officers in Tijuana, Mexico

    Science.gov (United States)

    Mittal, María Luisa; Beletsky, Leo; Patiño, Efraín; Abramovitz, Daniela; Rocha, Teresita; Arredondo, Jaime; Bañuelos, Arnulfo; Rangel, Gudelia; Strathdee, Steffanie A

    2016-01-01

    Introduction Police officers are at an elevated risk for needle-stick injuries (NSI), which pose a serious and costly occupational health risk for HIV and viral hepatitis. However, research on NSIs among police officers is limited, especially in low- and middle-income countries. Despite the legality of syringe possession in Mexico, half of people who inject drugs (PWID) in Tijuana report extrajudicial syringe-related arrests and confiscation by police, which has been associated with needle-sharing and HIV infection. We assessed the prevalence and correlates of NSIs among Tijuana police officers to inform efforts to improve occupational safety and simultaneously reduce HIV risks among police and PWID. Methods Tijuana's Department of Municipal Public Safety (SSPM) is among Mexico's largest. Our binational, multi-sectoral team analyzed de-identified data from SSPM's 2014 anonymous self-administered occupational health survey. The prevalence of NSI and syringe disposal practices was determined. Logistic regression with robust variance estimation via generalized estimating equations identified factors associated with ever having an occupational NSI. Results Approximately one-quarter of the Tijuana police force was given the occupational health survey (N=503). Respondents were predominantly male (86.5%) and ≤35 years old (42.6%). Nearly one in six officers reported ever having a NSI while working at SSPM (15.3%), of whom 14.3% reported a NSI within the past year. Most participants reported encountering needles/syringes while on duty (n=473, 94%); factors independently associated with elevated odds of NSIs included frequently finding syringes that contain drugs (adjusted odds ratio (AOR): 2.98; 95% confidence interval (CI): 1.56–5.67) and breaking used needles (AOR: 2.25; 95% CI: 1.29–3.91), while protective factors included being willing to contact emergency services in case of NSIs (AOR: 0.39; 95% CI: 0.22–0.69), and wearing needle-stick resistant gloves (AOR: 0

  18. Prevalence and correlates of needle-stick injuries among active duty police officers in Tijuana, Mexico

    Directory of Open Access Journals (Sweden)

    María Luisa Mittal

    2016-07-01

    Full Text Available Introduction: Police officers are at an elevated risk for needle-stick injuries (NSI, which pose a serious and costly occupational health risk for HIV and viral hepatitis. However, research on NSIs among police officers is limited, especially in low- and middle-income countries. Despite the legality of syringe possession in Mexico, half of people who inject drugs (PWID in Tijuana report extrajudicial syringe-related arrests and confiscation by police, which has been associated with needle-sharing and HIV infection. We assessed the prevalence and correlates of NSIs among Tijuana police officers to inform efforts to improve occupational safety and simultaneously reduce HIV risks among police and PWID. Methods: Tijuana's Department of Municipal Public Safety (SSPM is among Mexico's largest. Our binational, multi-sectoral team analyzed de-identified data from SSPM's 2014 anonymous self-administered occupational health survey. The prevalence of NSI and syringe disposal practices was determined. Logistic regression with robust variance estimation via generalized estimating equations identified factors associated with ever having an occupational NSI. Results: Approximately one-quarter of the Tijuana police force was given the occupational health survey (N=503. Respondents were predominantly male (86.5% and ≤35 years old (42.6%. Nearly one in six officers reported ever having a NSI while working at SSPM (15.3%, of whom 14.3% reported a NSI within the past year. Most participants reported encountering needles/syringes while on duty (n=473, 94%; factors independently associated with elevated odds of NSIs included frequently finding syringes that contain drugs (adjusted odds ratio (AOR: 2.98; 95% confidence interval (CI: 1.56–5.67 and breaking used needles (AOR: 2.25; 95% CI: 1.29–3.91, while protective factors included being willing to contact emergency services in case of NSIs (AOR: 0.39; 95% CI: 0.22–0.69, and wearing needle-stick resistant

  19. Acute and repeated inhalation lung injury by 3-methoxybutyl chloroformate in rats: CT-pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Yeon Soo [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of); Chung, Myung Hee [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of)]. E-mail: mhchung@catholic.ac.kr; Park, Seog Hee [Department of Radiology, Kangnam St. Mary Hospital, Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-040 (Korea, Republic of); Kim, Hyeon-Yeong [Industrial Chemicals Research Center, Industrial Safety and Health Research Institute KISCO, 104-8, Moonji-dong, Yusong-gu, Taejon-si 305-380 (Korea, Republic of); Choi, Byung Gil [Department of Radiology, Kangnam St. Mary Hospital, Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-040 (Korea, Republic of); Lim, Hyun Wook [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of); Kim, Jin Ah [Department of Pathology, Holy Family Hospital, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon-si, Kyung gi-do 420-717 (Korea, Republic of); Yoo, Won Jong [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of)

    2007-05-15

    Objectives: To investigate the acute and repeated pulmonary damage in Sprague-Dawley rats caused by the inhalation of 3-methoxybutyl chloroformate (3-MBCF) using computed tomography (CT), and to correlate these results with those obtained from a pathological study. Methods: Sixty, 7-week-old rats were exposed to 3-MBCF vapor via inhalation (6 h/day) for 1 day (N = 20), 3 days (N = 20), and 28 days (5 days/week) (N = 20) using whole body exposure chambers at a concentration of 0 (control), 3, 6 and 12 ppm. CT examinations including densitometry and histopathologic studies were carried out. For the follow-up study, the rats exposed for 3 days were scanned using CT and their pathology was examined at 7, 14, and 28 days. Results: There was a significant decrease in the parenchymal density in the groups exposed to the 3-MBCF vapors for 1 day at 3 ppm (p = 0.022) or 6 ppm (p = 0.010), compared with the control. The parenchymal density of the rats exposed to12 ppm was significantly higher. The pathological findings in this period, the grades of vascular congestion, tracheobronchial exfoliation, and alveolar rupture were significant. In the groups exposed for 3 days, there was a large decrease in the parenchymal density with increasing dose (control: -675.48 {+-} 32.82 HU, 3 ppm: -720.65 {+-} 34.21 HU, 6 ppm: -756.41 {+-} 41.68 HU, 12 ppm: -812.56 {+-} 53.48 HU) (p = 0.000). There were significant density differences between each dose in the groups exposed for 28 days (p = 0.000). The CT findings include an irregular lung surface, areas of multifocal, wedge-shaped increased density, a heterogeneous lung density, bronchial dilatation, and axial peribronchovascular bundle thickening. The histopathology examination revealed the development of alveolar interstitial thickening and vasculitis, and an aggravation of the mainstem bronchial exudates and bronchial inflammation. The alveolar wall ruptures and bronchial dilatation became severe during this period. On the follow

  20. Deliberate self-injury functions and their clinical correlates among adolescent psychiatric inpatients.

    Science.gov (United States)

    Radziwiłłowicz, Wioletta; Lewandowska, Magdalena

    2017-04-30

    The aim of the study was to analyze the relationships between clinical variables (the severity of depression symptoms, feelings towards the body, dissociation, number and type of traumatic events) and deliberate self-injury functions. Moreover, we investigated whether the of group self-mutilating adolescents is internally diverse in terms of how important individual functions of self-mutilation are, and whether the subgroups singled out by these functions differ between each other in terms of clinical variables. The Inventory of Statements about Self-Injury was used. Characterizations of examined individuals and other research tools are included in our previous article (year, issue, pages). Associated with negative feelings towards the body are the functions of self-injuries (anti-dissociation, self-punishment) that can be described as interpersonal. High levels of depression symptoms (self-depreciation included) are mainly associated with the self-injury functions: self-punishment, anti-dissociation, establishing interpersonal boundaries. Affect regulation becomes more important as a function of self-inflicted injuries in cases of biological dysregulation and intense dissociative symptoms. The adolescents psychiatric inpatients are internally diverse in terms of dominant functions of self-injuries, which can be categorized into intra- and interpersonal. Intrapersonal functions dominate when an individual experiences severe depression, dissociative symptoms, and negative feelings towards the body. In cases of moderate intensity of depression, dissociative symptoms and negative feelings towards the body, both intrapersonal and interpersonal functions of self-mutilation are similarly important. Further research is required to explain the lowest severity of depression symptoms, dissociative symptoms and negative feelings towards the body co-occurs with no awareness of self-injuries functions.

  1. Changes of intracellular calcium and the correlation with functional damage of the spinal cord after spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    章亚东; 侯树勋; 吴叶

    2002-01-01

    Objective: To observe dynamic changes of intracellular calcium ([Ca2+]i) after spinal cord injury, and to study the relationship between the changes of [Ca2+]i and the functional damage of the spinal cord.   Methods: The rats were subjected to a spinal cord contusion by using a modified Allens method. The [Ca2+]i in the injured segment of the spinal cord was measured by the technique of La3+ blockage and atomic absorption spectroscopy at 1, 4, 8, 24, 72, and 168 hours after injury. The motor function on the inclined plane was measured at the same time.   Results: The spinal cord [Ca2+]i increased significantly (P<0.05 or P<0.01) after spinal cord injury. There was a significant correlation (P<0.05) between the changes of [Ca2+]i and the motor function.   Conclusions: [Ca2+]i overload may play an important role in the pathogenesis of spinal cord injury.

  2. Abnormalities in A-to-I RNA editing patterns in CNS injuries correlate with dynamic changes in cell type composition

    Science.gov (United States)

    Gal-Mark, Nurit; Shallev, Lea; Sweetat, Sahar; Barak, Michal; Billy Li, Jin; Levanon, Erez Y.; Eisenberg, Eli; Behar, Oded

    2017-01-01

    Adenosine to Inosine (A-to-I) RNA editing is a co- or post-transcriptional mechanism that modifies genomically encoded nucleotides at the RNA level. A-to-I RNA editing is abundant in the brain, and altered editing levels have been reported in various neurological pathologies and following spinal cord injury (SCI). The prevailing concept is that the RNA editing process itself is dysregulated by brain pathologies. Here we analyzed recent RNA-seq data, and found that, except for few mammalian conserved editing sites, editing is significantly higher in neurons than in other cell populations of the brain. We studied A-to-I RNA editing in stab wound injury (SWI) and SCI models and showed that the apparent under-editing observed after injury correlates with an approximately 20% reduction in the relative density of neurons, due to cell death and immune cell infiltration that may account for the observed under-editing. Studies of neuronal and astrocyte cultures and a computational analysis of SCI RNA-seq data further supported the possibility that a reduction in neuronal density is responsible for alterations in the tissue-wide editing patterns upon injury. Thus, our data suggest that the case for a mechanistic linkage between A-to-I RNA editing and brain pathologies should be revisited. PMID:28266523

  3. Motorcycle Related Injuries among Rural Dwellers in Irrua, Nigeria: Characteristics and Correlates

    Directory of Open Access Journals (Sweden)

    A. E. Dongo

    2013-01-01

    Full Text Available Background. The escalating use of motorcycle for commercial transportation of commuters and goods has resulted in an increase in morbidity and mortality from road traffic injuries. Objectives. To study the characteristics of motorcycle injuries seen in Irrua, Nigeria. Materials and Methods. This is a one-year prospective study of all patients seen from January 1, 2009, to December 31, 2009. A structured proforma was filled for all consecutive crash victims involving a motorcycle. Results. Motorcycle injuries accounted for 11.6% of attendance in surgical emergency room (142 out of 1,214; 76.8% were males. Amongst victims 47.1% were riders, 42.9%, passengers, and 7.8% pedestrians. Extremity injury accounted for 42.2% while head injury occurred in 21.8%. There were 9 deaths (6.3%. In this study no victim used crash helmet. Conclusion. Banning of motorcycle for commercial use and the introduction of tricycles into rural/suburban comminutes may be an important preventive strategy.

  4. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Induction systems ducts and air duct systems. 29.1103 Section 29.1103 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF....1103 Induction systems ducts and air duct systems. (a) Each induction system duct upstream of the...

  5. Efficacy of intraductal cooling to prevent the bile duct injury during radiofrequency ablation associated with hepatic blood occlusion%胆管内冷盐水灌注冷却预防肝血流阻断合并射频消融术中胆管损伤的研究

    Institute of Scientific and Technical Information of China (English)

    李静怡; 苏永辉; 蔡潮农; 郭辉; 林宇静

    2014-01-01

    目的 评价活体兔肝予肝血流阻断合并射频消融(radiofrequency ablation,RFA)术中行胆管内冷盐水灌注冷却(intraductal chilled saline perfusion,ICSP)对胆管的保护作用.方法 新西兰大白兔16只,分为2组:ICSP组于RFA术前行胆总管置管,于RFA术中夹闭入肝血流,并经胆总管置管行ICSP;非ICSP组仅于RFA术中夹闭入肝血流.术中射频针针尖距肝门部主胆管距离约5 mm.RFA术后行超声造影比较两组消融灶大小;术后6周超声观察兔肝内胆管结构,并取肝大体标本,对两组消融灶旁主胆管行病理学检查以比较损伤程度.结果 RFA术后超声造影示两组间消融灶大小差异无统计学意义(P>0.05),RFA术后6周超声检查示非ICSP组胆管扩张较为明显(P<0.05),病理学检查示非ICSP组主胆管损伤程度较严重(P <0.05).结论 行入肝血流阻断合并肝脏RFA时,采用ICSP能有效预防术中胆道热损伤.%Objective To explore the efficacy of intraductal chilled saline perfusion (ICSP) to reduce the thermal bile duct injury during the treatment of radiofrequency ablation (RFA) associating with occlusion of hepatic blood supply in rabbits.Methods 16 healthy New Zealand white rabbits were divided into 2 groups.Rabbits of the ICSP group were placed tubes in the common bile duct after laparotomy,and ICSP was performed during the RFA procedure accompanied with hepatic blood occlusion.While for rabbits of the non-ICSP group,hepatic blood occlusion and RFA were performed without ICSP.RFA electrodes were placed about 5 mm away from the hilus hepatis approximately.Contrast-enhanced ultrasonography (CEUS) was administrated to evaluate the sizes of the ablative zones after the procedure.On post-procedure 6 week,ultrasonography was prerformed to evaluate the changes of the biliary structure,and liver specimens of rabbits wcrc obtained for histopathologic observation of main bile ducts.Results Post-procedure CEUS examination showed that there

  6. THE CORRELATION OF RADIOLOGICAL EXAMINATION AND VOLITIONAL VOIDING IN THORACO - LUMBAR FRACTURES AND SPINAL INJURY

    Directory of Open Access Journals (Sweden)

    Mathangi Santhosh

    2015-04-01

    Full Text Available BACKGROUND: Spinal Cord Injury (SCI is a devastating medical condition which results in paraplegia with decreased bladder and bowel control. Investigation used to predict volitional voiding in persons with acute SCI include clinical examination, X - rays of the spine, CT scan, MRI, even though the later ones are not available in every medical center and all cannot afford. AIM: To determine if those with a mild narrowing of the vertebral canal have a better prognosis for volitional voiding. SETTINGS AND DESIGN: Prospective study of 20 consecutive patients with thoracolumbar fractures and spinal injury, admitted in the Department of Physical Medicine Rehabilitation, Christian Medical College, and Vellore within three weeks of injury, were recruited into the study. METHODS AND MATERIALS: Initial neurological examination was performed on admission and final between 16 - 20 weeks after the injury. Lateral and anteroposterior X - rays of the spine were done to measure the antero - posterior and transverse diameters of the spinal canal as well as the canal - body ratio at the level of the lesion. Bladder function was assessed between 16 - 20 weeks following the injury by Urodynamic study. The bladder outcome was divided into first category was assisted bladder emptying, which included intermittent catheterization, indwelling catheterization and second category was with volitional voiding. STATISTICAL ANALYSIS: D ata collection was subjected to statistical analysis using SPSS Version 11.0. Fisher’s exact test, Independent t - test and Mann - Whitney test were used. RESULTS AND CONCLUSIONS: The level of fracture did not correspond to the type of bladder. The use of Canal body ratio at the level of vertebral fracture on plain radiographs was not useful in prediction of volitional voiding. (P> 0.05. Therefore plain radiography was not found to be a good predictor of bladder function in persons with spinal injuries.

  7. Migratory intralaryngeal thyroglossal duct cyst

    Directory of Open Access Journals (Sweden)

    Karlatti Pradeep

    2010-01-01

    Full Text Available Intralaryngeal thyroglossal duct cysts are rare; a migrating one, rarer still. Such a case may be a cause for confusion and it is important to understand this entity and its typical findings.

  8. Imaging of athletic pubalgia and core muscle injuries: clinical and therapeutic correlations.

    Science.gov (United States)

    Palisch, Andrew; Zoga, Adam C; Meyers, William C

    2013-07-01

    Athletes frequently injure their hips and core muscles. Accurate diagnosis and proper treatment of groin pain in the athlete can be tricky, frequently posing vexing problem for trainers and physicians. Clinical presentations of the various hip problems overlap with respect to history and physical examination. This article reviews clinical presentations and magnetic resonance imaging findings specific to the various causes of groin pain in the athlete. The focus is on the core muscle injuries (athletic pubalgia or "sports hernia"). The goal is to raise awareness about the variety of injuries that occur and therapeutic options.

  9. Structure and function of the major ampullate spinning duct of the golden orb weaver, Nephila edulis.

    Science.gov (United States)

    Davies, G J G; Knight, D P; Vollrath, F

    2013-10-01

    Silks are fibres produced by spiders, some insects and even a crustacean, and are formed from protein solution by a pulltrusion process that is not well understood. Here we describe three aspects of the functional anatomy of the spinning apparatus in a spider: (i) changes in the diameter of the duct of the silk gland along its length for individuals at different stages of development, (ii) the correlation between the morphology of the duct and size and (iii) changes in the thickness of the wall of the duct. We conclude that in the distal part of the duct both the lumen's geometry and change in diameter with distance remains remarkably constant as the duct increases in length from moult to moult as the spider grows. This suggests constancy in the region where the nascent silk filament is drawn down within the lumen of the duct, which is likely to be fundamental for forming strong and tough fibres.

  10. TWO NEW DUCT LEAKAGE TESTS

    Energy Technology Data Exchange (ETDEWEB)

    ANDREWS,J.W.

    1998-12-01

    Two variations on the tests for duct leakage currently embodied in ASHRAE Standard 152P (Method of Test for Determining the Design and Seasonal Efficiencies of Residential Thermal Distribution Systems) are presented. Procedures are derived for calculating supply and return duct leakage to/from outside using these new variations. Results of these tests are compared with the original ones in Standard 152P on the basis of data collected in three New York State homes.

  11. Duct Leakage Repeatability Testing

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-01-01

    Duct leakage often needs to be measured to demonstrate compliance with requirements or to determine energy or Indoor Air Quality (IAQ) impacts. Testing is often done using standards such as ASTM E1554 (ASTM 2013) or California Title 24 (California Energy Commission 2013 & 2013b), but there are several choices of methods available within the accepted standards. Determining which method to use or not use requires an evaluation of those methods in the context of the particular needs. Three factors that are important considerations are the cost of the measurement, the accuracy of the measurement and the repeatability of the measurement. The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards.

  12. Neural correlates of motor dysfunction in children with traumatic brain injury: exploration of compensatory recruitment patterns.

    NARCIS (Netherlands)

    Caeyenberghs, K.; Wenderoth, N.; Smits-Engelsman, B.C.M.; Sunaert, S.; Swinnen, S.P.

    2009-01-01

    Traumatic brain injury (TBI) is a common form of disability in children. Persistent deficits in motor control have been documented following TBI but there has been less emphasis on changes in functional cerebral activity. In the present study, children with moderate to severe TBI (n = 9) and control

  13. Prevalence, clinical features, and correlates of inappropriate sexual behavior after traumatic brain injury: a multicenter study.

    Science.gov (United States)

    Simpson, Grahame K; Sabaz, Mark; Daher, Maysaa

    2013-01-01

    Investigate the prevalence and clinical features of inappropriate sexual behavior (ISB) among a community-based cohort of clients of the New South Wales Brain Injury Rehabilitation program. All 11 community-based rehabilitation services of the statewide network. Five hundred seven clients with severe traumatic brain injury. Cross-sectional multicentre study. Overt Behavior Scale, Disability Rating Scale, Sydney Psychosocial Reintegration Scale-2, Health of the Nation Outcome Scale-Acquired Brain Injury, Care and Needs Scale. The point prevalence rate of ISBs was 8.9% (45/507) over the previous 3 months. Inappropriate sexual talk comprised 57.9% of all ISBs, followed by genital and nongenital touching behaviors (29.8%) and exhibitionism/public masturbation (10.5%). In 43 of 45 cases, ISBs were accompanied by other challenging behaviors, most often inappropriate social behavior, and/or aggression. Individuals who sustained more severe injuries and who were younger were significantly more likely to display ISBs. People displaying ISBs were more likely to display higher levels of challenging behaviors overall, lower levels of social participation, and more neuropsychiatric sequelae than 2 other groups: people displaying no challenging behaviors and people displaying challenging behaviors but no ISBs respectively. ISBs pose a complex clinical challenge among a minority of individuals with severe TBI.

  14. Residual Hemothorax after Chest Tube Placement Correlates with Increased Risk of Empyema Following Traumatic Injury

    Directory of Open Access Journals (Sweden)

    Riyad Karmy-Jones

    2008-01-01

    Full Text Available BACKGROUND: Empyema complicates tube thoracostomy following trauma in up to 10% of cases. Studies of potential risk factors of empyema have included use of antibiotics, site of injury and technique of chest tube placement. Residual fluid has also been cited as a risk factor for empyema, although the imaging technique to identify this varies.

  15. Measuring Intracranial Pressure and Correlation with Severity of Blast Traumatic Brain Injury

    Science.gov (United States)

    2013-01-01

    PLoS One, 2012. 7(4): p. e34504. 22. Ansari, M.A., K.N. Roberts, and S.W. Scheff, A time course of contusion -induced oxidative stress and synaptic...response to pulmonary blast injury. J. Trauma 40, 100S–104S. Cernak, I., Wang, Z., Jiang, J., Bian, X., and Savic, J. (2001). Ultrastructural and

  16. Residual hemothorax after chest tube placement correlates with increased risk of empyema following traumatic injury

    Science.gov (United States)

    Karmy-Jones, Riyad; Holevar, Michele; Sullivan, Ryan J; Fleisig, Ani; Jurkovich, Gregory J

    2008-01-01

    BACKGROUND: Empyema complicates tube thoracostomy following trauma in up to 10% of cases. Studies of potential risk factors of empyema have included use of antibiotics, site of injury and technique of chest tube placement. Residual fluid has also been cited as a risk factor for empyema, although the imaging technique to identify this varies. OBJECTIVE: To determine whether residual hemothorax detected by chest x-ray (CXR) after one or more initial chest tubes predicts an increased risk of empyema. METHODS: A study of patients admitted to two level I trauma centres between January 7, 2004, and December 31, 2004, was conducted. All patients who received a chest tube in the emergency department, did not undergo thoracotomy within 24 h, and survived more than two days were followed. Empyema was defined as a pleural effusion with positive cultures, and a ratio of pleural fluid lactate dehydrogenase to serum lactate dehydrogenase greater than 0.6 in the setting of elevated leukocyte count and fever. Factors analyzed included the presence of retained hemothorax on CXR after the most recent tube placement in the emergency room, age, mechanism of injury and injury severity score. RESULTS: A total of 102 patients met the criteria. Nine patients (9%) developed empyema: seven of 21 patients (33%) with residual hemothorax developed empyema versus two of 81 patients (2%) without residual hemothorax developed empyema (P=0.001). Injury severity score was significantly higher in those who developed empyema (31.4±26) versus those who did not (22.6±13; P=0.03). CONCLUSIONS: The presence of residual hemothorax detected by CXR after tube thoracostomy should prompt further efforts, including thoracoscopy, to drain it. With increasing injury severity, there may be increased benefit in terms of reducing empyema with this approach. PMID:18716687

  17. Whole-brain proton MR spectroscopic imaging of mild-to-moderate traumatic brain injury and correlation with neuropsychological deficits.

    Science.gov (United States)

    Govind, Varan; Gold, Stuart; Kaliannan, Krithica; Saigal, Gaurav; Falcone, Steven; Arheart, Kristopher L; Harris, Leo; Jagid, Jonathan; Maudsley, Andrew A

    2010-03-01

    Changes in the distribution of the magnetic resonance (MR)-observable brain metabolites N-acetyl aspartate (NAA), total choline (Cho), and total creatine (Cre), following mild-to-moderate closed-head traumatic brain injury (mTBI) were evaluated using volumetric proton MR spectroscopic imaging (MRSI). Studies were carried out during the subacute time period following injury, and associations of metabolite indices with neuropsychological test (NPT) results were evaluated. Twenty-nine subjects with mTBI and Glasgow Coma Scale (GCS) scores of 10-15 were included. Differences in individual metabolite and metabolite ratio distributions relative to those of age-matched control subjects were evaluated, as well as analyses by hemispheric lobes and tissue types. Primary findings included a widespread decrease of NAA and NAA/Cre, and increases of Cho and Cho/NAA, within all lobes of the TBI subject group, and with the largest differences seen in white matter. Examination of the association between all of the metabolite measures and the NPT scores found the strongest negative correlations to occur in the frontal lobe and for Cho/NAA. No significant correlations were found between any of the MRSI or NPT measures and the GCS. These results demonstrate that significant and widespread alterations of brain metabolites occur as a result of mild-to-moderate TBI, and that these measures correlate with measures of cognitive performance.

  18. Decreased apparent diffusion coefficient in the pituitary and correlation with hypopituitarism in patients with traumatic brain injury.

    Science.gov (United States)

    Zheng, Ping; He, Bin; Guo, Yijun; Zeng, Jingsong; Tong, Wusong

    2015-07-01

    The relationship between microstructural abnormality in patients with traumatic brain injury (TBI) and hormone-secreting status remains unknown. In this study, the authors aimed to identify the role of the apparent diffusion coefficient (ADC) using a diffusion-weighted imaging (DWI) technique and to evaluate the association of such changes with hypopituitarism in patients with TBI. Diffusion-weighted images were obtained in 164 consecutive patients with TBI within 2 weeks after injury to generate the pituitary ADC as a measure of microstructural change. Patients with TBI were further grouped into those with and those without hypopituitarism based on the secretion status of pituitary hormones at 6 months postinjury. Thirty healthy individuals were enrolled in the study and underwent MRI examinations for comparison. Mean ADC values were compared between this control group, the patients with TBI and hypopituitarism, and the patients with TBI without hypopituitarism; correlational studies were also performed. Neurological outcome was assessed with the Glasgow Outcome Scale (GOS) for all TBI patients 6 months postinjury. In the TBI group, 84 patients had hypopituitarism and 80 had normal pituitary function. The pituitary ADC in TBI patients was significantly less than that in controls (1.83 ± 0.16 vs 4.13 ± 0.33, p correlated with neurological outcome at 6 months following TBI (r = 0.602, p correlated with hormone-secreting status in TBI patients. The authors suggest that pituitary ADC may be a useful biomarker to predict pituitary function in patients with TBI.

  19. Effect of herpesvirus infection on pancreatic duct cell secretion

    Institute of Scientific and Technical Information of China (English)

    Péter Hegyi; András Varró; Mária K Kovács; Mike A Gray; Barry E Argent; Zsolt Boldogk(o)i; Balázs (O)rd(o)g; Zoltán Rakonczai Jr; Tamás Takács; János Lonovics; Annamária Szabolcs; Réka Sári; András Tóth; Julius G Papp

    2005-01-01

    infection of ductal epithelial cells. The BDG strain of PRV, which is able to initiate a lytic viral cycle, stimulates HcO3- secretion in guinea pig pancreatic duct by about four- to fivefold, 24 h after the infection. However, the KEG strain of PRV, which can infect,but fails to replicate, has no effect on HCO3- secretion.We suggest that this response of pancreatic ducts to virulent PRV infection may represent a defense mechanism against invasive pathogens to avoid pancreatic injury.

  20. An experimental study on acute brain radiation injury: Dynamic changes in proton magnetic resonance spectroscopy and the correlation with histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Li, Hui, E-mail: lihui@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Li, Jian-peng, E-mail: lijp@sysucc.org.cn [Department of Radiology, Dongguan People' s Hospital, Dongguan City (China); Lin, Cheng-guang, E-mail: linchg@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou (China); Liu, Xue-wen, E-mail: liuxw@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Geng, Zhi-jun, E-mail: gengzhj@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Mo, Yun-xian, E-mail: moyx@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Zhang, Rong, E-mail: zhangr@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Xie, Chuan-miao, E-mail: xchuanm@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China)

    2012-11-15

    Purpose: To investigate the correlation between the alterations of single-voxel {sup 1}H MRS and the histopathological characteristics of radiation brain injury following radiation. Materials and methods: Twenty-seven rabbits were randomized into nine groups to receive radiation with a single dose of 25 Gy. The observation time points included a pre-radiation and 1, 2, 3, 4, 5, 6, 7, and 8 wk following radiation. Each treatment group underwent conventional MRI and single-voxel {sup 1}H MRS, N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were observed over the region of interest, and the presence or absence of lactate (Lac) and lipid (Lip) was detected. Histological specimens of each group were obtained after image acquisition. Results: The values of Cho were significantly increased in the first 3 wk, and decreased over the following 5 wk after radiation. Levels of NAA showed a trend toward a decrease 5 wk after radiation. The levels of Cr were not changed between before and after radiation. The Cho/NAA metabolic ratio was significantly increased in weeks 6, 7, and 8 following irradiation, compared to pre-radiation values. Vascular and glial injury appeared on 2 wk after RT in the histology samples, until 4 wk after RT, necrosis of the oligodendrocytes, neuronal degeneration and demyelination could be observed. Conclusions: MRS is sensitive to detect metabolic changes following radiation, and can be used in the early diagnosis of radiation brain injury.

  1. The effects of concomitant Ginkgo intake on noise induced Hippocampus injury. Possible auditory clinical correlate

    Directory of Open Access Journals (Sweden)

    Alaa Abousetta

    2014-11-01

    Full Text Available This study was conducted to determine the injurious effects of noise on the hippocampus, and to show whether Ginkgo biloba (Gb has any modulatory effect on hippocampal injury. Fifteen adult male albino rats were divided into three groups; control group, noise group and protected group. The noise group was exposed to 100 dB Sound pressure level (SPL white noise, six hours/day for four consecutive weeks. The protected group was exposed to the same noise level with the administration of Gb extract to the animals (50 mg/kg daily for 4 weeks. In the noise exposed group, both pyramidal cell layer and dentate gyrus (DG granular cell layer showed a decrease in thickness with loss and degeneration of many cells. The protected group showed preservation of many parameters as compared to the noise group i.e. increase in thickness of Cornu Ammonis area3 (CA3 & DG; increase in surface area of cells and increased vascularity. In conclusion, noise had detrimental effects on cells of Cornu Ammonis area1 (CA1, CA3 & DG of the hippocampus. In view of this finding, the clinical auditory hazardous effects in people exposed to harmful noise such as tinnitus, as well as memory disturbances and learning disabilities might have a new dimension. The administration of Gb protected the hippocampus against the injurious effect of noise. The probable mechanism and usefulness of Gb in reducing the previously mentioned effects are discussed.

  2. Abnormalities on magnetic resonance imaging seen acutely following mild traumatic brain injury: correlation with neuropsychological tests and delayed recovery

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, David G.; Jackson, Alan [Department of Neuroradiology, Hope Hospital, M6 8HD, Salford (United Kingdom); Mason, Damon L.; Berry, Elizabeth [Department of Behavioural Medicine, Hope Hospital, M6 8HD, Salford (United Kingdom); Hollis, Sally [Medical Statistics Unit, Lancaster University, Lancaster (United Kingdom); Yates, David W. [Department of Emergency Medicine, Hope Hospital, M6 8HD, Salford (United Kingdom)

    2004-07-01

    Mild traumatic brain injury (MTBI) is a common reason for hospital attendance and is associated with significant delayed morbidity. We studied a series of 80 persons with MTBI. Magnetic resonance imaging (MRI) and neuropsychological testing were used in the acute phase and a questionnaire for post-concussion syndrome (PCS) and return to work status at 6 months. In 26 subjects abnormalities were seen on MRI, of which 5 were definitely traumatic. There was weak correlation with abnormal neuropsychological tests for attention in the acute period. There was no significant correlation with a questionnaire for PCS and return to work status. Although non-specific abnormalities are frequently seen, standard MRI techniques are not helpful in identifying patients with MTBI who are likely to have delayed recovery. (orig.)

  3. Risk Factors associated with Paraurethral Duct Dilatation following Gonococcal Paraurethral Duct Infection in Men

    Science.gov (United States)

    Fan, Wenge; Zhang, Qingsong; Wang, Lin; Ye, Xun; Jiang, Tingwang

    2016-01-01

    No studies have explored the risk factors for paraurethral duct dilatation following paraurethral duct infection by Neisseria gonorrhoeae in men undergoing ceftriaxone therapy. The present study was performed to explore the risk factors for paraurethral duct dilatation following paraurethral duct infection by N. gonorrhoeae in men undergoing ceftriaxone therapy and thus guide clinical interventions. We compared the demographic, behavioral, and clinical data of men with paraurethral duct infection by N. gonorrhoeae with and without dilatation of the paraurethral duct. Univariate analysis showed significant differences in age, disease course of the infected paraurethral duct, Chlamydia trachomatis infection in the paraurethral duct, and a history of paraurethral duct infection by N. gonorrhoeae between the patient and control groups (Pgonorrhoeae in men. Age, C. trachomatis infection in the paraurethral duct, and a history of paraurethral duct infection by N. gonorrhoeae are also risk factors. Thus, educating patients to undergo timely therapy and treating the C. trachomatis infection may be effective interventions. PMID:27861521

  4. An isolated nasolacrimal duct osteoma.

    Science.gov (United States)

    Kim, Joo Yeon; Kwon, Jae Hwan

    2013-07-01

    Osteomas of the nose and paranasal sinus are common benign tumors that can extend to surrounding structures and result in orbital or intracranial involvement. Presenting symptoms include facial pain, headache, cerebral symptoms, ocular symptoms, and so on, depending on the location and size of the tumor. They commonly occur within the frontal, ethmoid, maxillary, and sphenoid sinuses; however, there are rare cases of reported osteomas in the nasal cavity, turbinate, or orbit. Our case report describes a patient with nasolacrimal duct osteoma who presented with ipsilateral ocular pain, epiphora, and medial canthal swelling. We performed intranasal dacryocystorhinostomy using a nasal endoscope and removed the lacrimal duct osteoma. This report describes symptoms and management of an isolated nasolacrimal duct stone with a review of the literature.

  5. A finite element-based injury metric for pulmonary contusion: investigation of candidate metrics through correlation with computed tomography.

    Science.gov (United States)

    Gayzik, F Scott; Hoth, J Jason; Daly, Melissa; Meredith, J Wayne; Stitzel, Joel D

    2007-10-01

    Pulmonary contusion (PC) is the most common thoracic soft tissue injury following non-penetrating blunt trauma and has been associated with mortality rates as high as 25%. This study is part of an ongoing effort to develop a finite element based injury criteria for PC. The aims of this study are two fold. The first is to investigate the use of computed tomography (CT) to quantify the volume of pathologic lung tissue in a prospective study of PC. The second is to use a finite element model (FEM) of the lung to investigate several mathematical predictors of contusion to determine the injury metric that best matches the spatial distribution of contusion obtained from the CT analysis. PC is induced in-situ utilizing male Sprague Dawley rats (n = 24) through direct impact to the right lung at 5.0 ms(-1). Force vs. deflection data are collected and used for model validation and optimization. CT scans are taken at 24 hours, 48 hours, 1 week, and 1 month post contusion. A numerical simulation is performed using an FEM of the rat lung and surrounding structures. Injury predictors investigated include maximum first principal strain, maximum shear strain, triaxial mean strain, octahedral shear stress, and maximum shear stress. Strain rate and the product of strain and strain rate are evaluated for all listed strains. At each post-impact time point, the volume of contused lung is used to determine the specific elements representing pathologic lung. Through this method, a threshold is determined for all listed metrics. The spatial distribution of the elements exceeding this threshold is compared to the spatial distribution of high-radiopacity lung tissue in the CT through a three dimensional registration technique to determine the predictor with the best correlation to the outcome. Impacts resulted in a mean energy input to the lung of 8.74 +/- 2.5 mJ. Segmentation of the imaging data yielded a mean unilateral high-radiopacity tissue estimate of 14.5% by volume at 24 hours with

  6. Common and Uncommon Anatomical Variants of Intrahepatic Bile Ducts in Magnetic Resonance Cholangiopancreatography and its Clinical Implication

    Science.gov (United States)

    Sarawagi, Radha; Sundar, Shyam; Raghuvanshi, Sameer; Gupta, Sanjeev Kumar; Jayaraman, Gopal

    2016-01-01

    Summary Background Preoperative knowledge of intrahepatic bile duct (IHD) anatomy is critical for planning liver resections, liver transplantations and complex biliary reconstructive surgery. The purpose of our study was to demonstrate the imaging features of various anatomical variants of IHD using magnetic resonance cholangio-pancreatography (MRCP) and their prevalence in our population. Material/Methods This observational clinical evaluation study included 224 patients who were referred for MRCP. MRCP was performed in a 1.5-Tesla magnet (Philips) with SSH MRCP 3DHR and SSHMRCP rad protocol. A senior radiologist assessed the biliary passage for anatomical variations. Results The branching pattern of the right hepatic duct (RHD) was typical in 55.3% of subjects. The most common variant was right posterior sectoral duct (RPSD) draining into the left hepatic duct (LHD) in 27.6% of subjects. Trifurcation pattern was noted in 9.3% of subjects. In 4% of subjects, RPSD was draining into the common hepatic duct (CHD) and in 0.8% of subjects into the cystic duct. Other variants were noted in 2.6% of subjects. In 4.9% of cases there was an accessory duct. The most common type of LHD branching pattern was a common trunk of segment 2 and 3 ducts joining the segment 4 duct in 67.8% of subjects. In 23.2% of subjects, segment 2 duct united with the common trunk of segment 3 and 4 and in 3.4% of subjects segment 2, 3, and 4 ducts united together to form LHD. Other uncommon branching patterns of LHD were seen in 4.9% of subjects. Conclusions Intrahepatic bile duct anatomy is complex with many common and uncommon variations. MRCP is a reliable non-invasive imaging method for demonstration of bile duct morphology, which is useful to plan complex surgeries and to prevent iatrogenic injuries. PMID:27298653

  7. Social support correlates with survival in patients with massive burn injury.

    Science.gov (United States)

    Muangman, Pornprom; Sullivan, Stephen R; Wiechman, Shelley; Bauer, Gregory; Honari, Shari; Heimbach, David M; Engrav, Loren H; Gibran, Nicole S

    2005-01-01

    Large burn size, inhalation injury, age, and associated trauma increase the rate of mortality after burns. However, not all patients with large burns and significant risk factors die. In this study, we wanted to determine other presenting factors that might indicate a survival benefit for burn patients with large burns. We reviewed charts of 36 patients with burns > or =60% TBSA that were aggressively resuscitated at the University of Washington Burn Center from 1990 to 2000 to determine whether survivors of large burns exhibit presenting variables that predict survival. Patients who had comfort care measures initiated at admission were excluded from this analysis. Survivors (n = 16) and nonsurvivors (n = 20) had no significant differences in age, total burn size, inhalation injury, or need for escharotomy. Full-thickness burn size was significantly smaller for survivors (58%) than for nonsurvivors (73%; P = .02). Survivors (81%) were more likely than nonsurvivors to have social support (35%; P = .007). A full-thickness burn > or =80 % TBSA was the only variable uniformly associated with mortality, suggesting that patients who survive large burns have a partial-thickness component that heals without surgery. The difference in degree of social support was one unique distinction that may impact patient survival and is worth further investigation.

  8. Correlates of Non-suicidal Self-injury and Suicide Attempts in Bulimic Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Alexandra Gómez-Expósito

    2016-08-01

    Full Text Available Objective: The aim of this study was to examine the implication of personality, impulsivity, and emotion regulation difficulties in patients with a bulimic-spectrum disorder (BSD and suicide attempts (SA, BSD patients with non-suicidal self-injury (NSSI, and BSD patients without these behaviors. Method: 122 female adult BSD patients were assessed using self-report questionnaires. Patients were clustered post-hoc into three groups depending on whether they presented BSD without NSSI or SA (BSD, BSD with lifetime NSSI (BSD+NSSI or BSD with lifetime SA (BSD+SA. Results: The BSD+NSSI and BSD+SA groups presented more emotion regulation difficulties, more eating and general psychopathology, and increased reward dependence in comparison with the BSD group. In addition, BSD+SA patients specifically showed problems with impulse control, while also presenting higher impulsivity than both the BSD and BSD+NSSI groups. No differences in impulsivity between the BSD and BSD+NSSI groups were found. Conclusions: The results show that BSD + NSSI and BSD+SA share a common profile characterized by difficulties in emotion regulation and low reward dependence, but differ in impulsivity and cooperativeness. This suggests that self-injury, in patients without a history of suicide attempts (i.e. BSD+NSSI, may have a regulatory role rather than being due to impulsivity.

  9. Clinical Correlates of Non-Suicidal Self-Injury (NSSI) in an Outpatient Sample of Adolescents.

    Science.gov (United States)

    García-Nieto, Rebeca; Carballo, Juan J; Díaz de Neira Hernando, Mónica; de León-Martinez, Victoria; Baca-García, Enrique

    2015-01-01

    Non-suicidal self-injury (NSSI) in adolescents is a major public health concern. The first goal of our study was to describe the characteristics and functions of NSSI and NSSI thoughts in an adolescent outpatient sample. The second goal was to examine which clinical factors discriminate between these two groups of patients. A group of 267 subjects was recruited from the Adolescent Outpatient Psychiatric Services, Jiménez Díaz Foundation (Madrid, Spain) from November 2011 to October 2012. All participants were administered the Spanish version of the Self-Injurious Thoughts and Behaviors Interview (SITBI). A total of 21.7% of patients reported having engaged in NSSI at least once in their lifetime. The most strongly endorsed function for NSSI was automatic negative reinforcement. In comparison with patients in the NSSI Thoughts group and the control group, patients in the NSSI group scored higher in Internalization of Anger and in all the scales comprising the Children's Depression Inventory. Our findings on the prevalence and functions of NSSI are consistent with the literature. NSSI was mainly performed for emotion regulation purposes; specifically, NSSI seems to be used to cope with anger and depression. In addition, internalization of anger might play a significant role in the maintenance of this behavior.

  10. Correlates of Non-suicidal Self-Injury and Suicide Attempts in Bulimic Spectrum Disorders

    Science.gov (United States)

    Gómez-Expósito, Alexandra; Wolz, Ines; Fagundo, Ana B.; Granero, Roser; Steward, Trevor; Jiménez-Murcia, Susana; Agüera, Zaida; Fernández-Aranda, Fernando

    2016-01-01

    Objective: The aim of this study was to examine the implication of personality, impulsivity, and emotion regulation difficulties in patients with a bulimic-spectrum disorder (BSD) and suicide attempts (SA), BSD patients with non-suicidal self-injury (NSSI), and BSD patients without these behaviors. Method: One hundred and twenty-two female adult BSD patients were assessed using self-report questionnaires. Patients were clustered post-hoc into three groups depending on whether they presented BSD without NSSI or SA (BSD), BSD with lifetime NSSI (BSD + NSSI) or BSD with lifetime SA (BSD + SA). Results: The BSD + NSSI and BSD + SA groups presented more emotion regulation difficulties, more eating and general psychopathology, and increased reward dependence in comparison with the BSD group. In addition, BSD + SA patients specifically showed problems with impulse control, while also presenting higher impulsivity than both the BSD and BSD + NSSI groups. No differences in impulsivity between the BSD and BSD + NSSI groups were found. Conclusions: The results show that BSD + NSSI and BSD + SA share a common profile characterized by difficulties in emotion regulation and low reward dependence, but differ in impulsivity and cooperativeness. This suggests that self-injury, in patients without a history of suicide attempts (i.e., BSD + NSSI), may have a regulatory role rather than being due to impulsivity. PMID:27597836

  11. Correlates of Non-suicidal Self-Injury and Suicide Attempts in Bulimic Spectrum Disorders.

    Science.gov (United States)

    Gómez-Expósito, Alexandra; Wolz, Ines; Fagundo, Ana B; Granero, Roser; Steward, Trevor; Jiménez-Murcia, Susana; Agüera, Zaida; Fernández-Aranda, Fernando

    2016-01-01

    The aim of this study was to examine the implication of personality, impulsivity, and emotion regulation difficulties in patients with a bulimic-spectrum disorder (BSD) and suicide attempts (SA), BSD patients with non-suicidal self-injury (NSSI), and BSD patients without these behaviors. One hundred and twenty-two female adult BSD patients were assessed using self-report questionnaires. Patients were clustered post-hoc into three groups depending on whether they presented BSD without NSSI or SA (BSD), BSD with lifetime NSSI (BSD + NSSI) or BSD with lifetime SA (BSD + SA). The BSD + NSSI and BSD + SA groups presented more emotion regulation difficulties, more eating and general psychopathology, and increased reward dependence in comparison with the BSD group. In addition, BSD + SA patients specifically showed problems with impulse control, while also presenting higher impulsivity than both the BSD and BSD + NSSI groups. No differences in impulsivity between the BSD and BSD + NSSI groups were found. The results show that BSD + NSSI and BSD + SA share a common profile characterized by difficulties in emotion regulation and low reward dependence, but differ in impulsivity and cooperativeness. This suggests that self-injury, in patients without a history of suicide attempts (i.e., BSD + NSSI), may have a regulatory role rather than being due to impulsivity.

  12. Mitochondrial DNA is Released in Urine of Sirs Patients with Acute Kidney Injury and Correlates with Severity of Renal Dysfunction.

    Science.gov (United States)

    Jansen, Marcel P B; Pulskens, Wilco P; Butter, Loes M; Florquin, Sandrine; Juffermans, Nicole P; Roelofs, Joris J T H; Leemans, Jaklien C

    2017-08-23

    Systemic inflammatory response syndrome (SIRS) is characterized by the activation of the innate immune system resulting in stimulation of inflammatory responses, coagulation, and platelet activation, that may contribute to complication such as the development of acute kidney injury (AKI). AKI importantly worsens the outcome of SIRS, implying the existence of a detrimental cross-talk via systemic messages. Mitochondria are a source of damage-associated molecular patterns (DAMPs) and are thought to form a molecular link between tissue injury and stimulation of innate immunity. The role of mitochondrial DNA (mtDNA) in the crosstalk between the onset of SIRS and subsequent development of AKI is unknown. Hence, we performed a case control study in critically ill patients with SIRS diagnosed with or without AKI, in which we determined mtDNA levels in plasma and urine, and correlated these to markers of renal impairment, inflammation, coagulation and platelet activation. In addition, we exposed mice, primary renal tubular epithelial cells (TECs) and platelets to mtDNA or purified mitochondrial ligands, and measured their response to elucidate underlying pathophysiological mechanisms. Our data reveal that increased systemic mtDNA levels in SIRS patients do not correlate with systemic inflammation and renal disease activity. Moreover, AKI does not have an additional effect on circulating mtDNA levels. In contrast, we found that urinary mtDNA levels correlate with an elevated albumin creatinine ratio (ACR) as well as with increased urinary markers of inflammation, coagulation and platelet activation. Both renal TECs and platelets respond to mtDNA and mtDNA ligands, leading to increased expression of respectively inflammatory cytokines and P-selectin. Moreover, activation of platelets results in mtDNA release. Together, these data suggest that circulating mtDNA is probably not important in the detrimental cross-talk between SIRS and AKI, whereas renal mtDNA accumulation may

  13. Long range correlations in the heart rate variability following the injury of cardiac arrest

    Science.gov (United States)

    Tong, Shanbao; Jiang, Dineng; Wang, Ziming; Zhu, Yisheng; Geocadin, Romeryko G.; Thakor, Nitish V.

    2007-07-01

    Cardiovascular and neurological recovery following cardiac arrest (CA) largely influence the morbidity and mortality of the patients. Monitoring the cardiovascular system has been an important clinical issue in intensive care unit (ICU). On the other hand, the rhythms of the heart rate variability following CA are still not fully understood, and there are limited number of literatures reporting the cardiovascular function recovery following CA. In this paper, we studied the scaling properties of heart rate variability (HRV) after CA by centered-moving-average-based detrended fluctuation analysis (DFA). Our results showed that the scaling factor of the baseline HRV is close to that of Brownian motion, and after a CA event it shifts to a 1/f noise-like rhythm. DFA could be a promising tool in evaluating the cardiovascular long term recovery following CA injury.

  14. Third trimester fetal demise occurring at time of delivery: correlation of autopsy findings and placental pathology with emphasis on antenatal central nervous system injury.

    Science.gov (United States)

    Jacques, Suzanne M; Kupsky, William J; Qureshi, Faisal

    2014-05-01

    Third trimester fetal deaths occurring in the hospital at the time of delivery are unusual. We report an autopsy series of such cases with emphasis on neuropathological injury and other lesions predating delivery. We identified autopsies performed on third trimester fetuses documented to be alive shortly before delivery, but that expired during, or very close to, time of delivery, and we correlate autopsy and placental findings. Fetuses with major congenital anomalies were excluded. Ten cases were identified (6 term, 4 preterm). All were delivered by cesarean section and had attempted resuscitation. Established or recent brain injury was identified in 9 of 10 cases, including 3 with established neuronal damage and 1 with periventricular leukomalacia. Additional autopsy findings included thymic involution in eight (five mild; three severe), myocardial infarcts in two; intrathoracic petechiae in five, and ascites or pleural or pericardial effusions in six. Severe thymic involution and myocardial infarcts correlated with established brain injury. Placental lesions adaptive to decreased oxygenation (increased nucleated red blood cells or villous hypervascularity) were seen in five cases and correlated with established brain injury. Acute chorioamnionitis with funisitis was present in one, and chronic inflammatory placental lesions were present in six. These findings indicate brain injury predated the time period immediately before delivery in 9 of 10 fetuses, and in the fetuses with established brain injury the onset of acute illness was possibly >72 h before delivery.

  15. Fragmentation of common bile duct and pancreatic duct stones by extracorporeal shock-wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan Junior College, Seoul (Korea, Republic of); Son, Soon Yong; Lee, Won Hong [Asan Medical Center, Seoul (Korea, Republic of)

    1998-06-01

    To determine its usefulness and safety of extracorporeal shock-wave lithotripsy in common bile duct and pancreatic duct stones, we analyzed the results of 13 patients with common bile duct stones and 6 patients with pancreatic duct stones which were removed by endoscopic procedures using the balloon or basket, who was performed the extracorporeal shock-wave lithotripsy using the ultrasonography for stone localization with a spark gap type Lithotriptor(Dornier MPL 9000, Germany). Fragmentation and complete clearance of the common bile duct and pancreatic duct stones were obtained in 19 of 19 patients(100%). Apart from transient attacks of fever in 2 of 13 patients with common bile duct stones(15%) and mild elevation of serum amylase and lipase in 2 of 6 patients with pancreatic duct stones(33%), no other serious side effects were observed. In our experiences, extracorporeal shock-wave lithotripsy is a safe and useful treatment for endoscopically unretrievable common bile duct and pancreatic duct stones.

  16. Vitellointestinal Duct Anomalies in Infancy

    Science.gov (United States)

    Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

    2016-01-01

    Background: Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5–9 of intrauterine life. Methods: This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Results: Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: patent VID in 9 (56.25%) patients, umbilical cyst in 2(12.25%), umbilical granuloma in 2 (12.25%), and Meckel diverticulum as content of hernia sac in obstructed umbilical hernia in 1 (6.25%) patient. Two patients with umbilical fistula had severe electrolyte disturbance and died without surgical intervention. Conclusion: Persistent VID may have varied presentations in infancy. High output umbilical fistula and excessive bowel prolapse demand urgent surgical intervention to avoid morbidity and mortality. PMID:27433448

  17. Fan/Ram Duct Program

    Science.gov (United States)

    1973-10-01

    mwm^mmmt c INPUT I ] H—f TRANSIENT ROUTINE P"" CONTROL """I FAN ] COMPRESSOR MAIN BURNER I DUCT HZ HIGH TURBINE in— LOW TURBINE I...and pressure ratio. 6. Low Turbine Low turbine characteristics, identical In form to those of the high turbine, are shown in figures 27 and 28. 7

  18. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel [Ernst-Moritz-Arndt-University Greifswald, Department of Trauma and Orthopedic Surgery, Emergency Department, Greifswald (Germany); Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke [Ernst-Moritz-Arndt-University Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2011-04-15

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  19. Magnetic resonance imaging of cervical cord injury and its correlation with the patient's outcome

    Energy Technology Data Exchange (ETDEWEB)

    Panggabean, F.; Nakamura, Tsutomu (Kanazawa Medical Univ., Uchinada, Ishikawa (Japan))

    1991-03-01

    Thirty four patients with cervical cord injuries were studied by magnetic resonance imaging (MRI) with reference to neurological deficits. Studies in the acute or subacute stage were made in 25 patients, of whom 17 patients were studied consecutively up to the chronic stage. Chronic studies were made in 26 patients. In acute or subacute MRI studies 12 patients had an intramedullary high signal intensity (HSI) in the traumatized area on T2-weighted image (T2-WI). In consecutive studies HSI appeared persistently up to the chronic stage in four patients, and a low signal intensity (LSI) appeared a few months after the injury at T1-WI, to this point disclosing the area of iso-signal intensity. The HSI in the remaining eight patients disappeared at least in three months. The former MRI findings might suggest the development of myelomalacia from acute hemorrhagic necrosis while the latter might be edema of the traumatized spinal cord. Nine patients of chronic MRI studies showed myelomalacia in six, syringomyelia in two, and transection of the spinal cord in one patient respectively. Significant correlations between MRI findings and neurological deficits in acute and chronic stage were present. It was concluded that those who had no intramedullary abnormality in MRI showed less severe neurological deficits and better outcomes, while those who had intramedullary abnormality in MRI showed severe neurological deficits and poor outcomes. (author).

  20. Expression and activity of inducible nitric oxide synthase and endothelial nitric oxide synthase correlate with ethanol-induced liver injury

    Institute of Scientific and Technical Information of China (English)

    Guang-Jin Yuan; Xiao-Rong Zhou; Zuo-Jiong Gong; Pin Zhang; Xiao-Mei Sun; Shi-Hua Zheng

    2006-01-01

    AIM: To study the expression and activity of inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) in rats with ethanol-induced liver injury and their relation with liver damage, activation of nuclear factor-KB (NF-кB) and tumor necrosis factor-α (TNF-α)expression in the liver.METHODS: Female Sprague-Dawley rats were given fish oil (0.5 mL) along with ethanol or isocaloric dextrose daily via gastrogavage for 4 or 6 wk. Liver injury was assessed using serum alanine aminotransferase (ALT)activity and pathological analysis. Liver malondialdehyde (MDA), nitric oxide contents, iNOS and eNOS activity were determined. NF-KB p65, iNOS, eNOS and TNF-αprotein or mRNA expression in the liver were detected by immunohistochemistry or reverse transcriptase-polymerase chain reaction (RT-PCR).RESULTS: Chronic ethanol gavage for 4 wk caused steatosis, inflammation and necrosis in the liver, and elevated serum ALT activity. Prolonged ethanol administration (6 wk) enhanced the liver damage. These responses were accompanied with increased lipid peroxidation, NO contents, iNOS activity and reduced eNOS activity. NF-кB p65, iNOS and TNF-α protein or mRNA expression were markedly induced after chronic ethanol gavage, whereas eNOS mRNA expression remained unchanged. The enhanced iNOS activity and expression were positively correlated with the liver damage, especially the necro-inflammation, activation of NF-кB, and TNF-α mRNA expression.CONCLUSION: iNOS expression and activity are induced in the liver after chronic ethanol exposure in rats, which are correlated with the liver damage, especially the necro-inflammation, activation of NF-KB and TNF-αexpression. eNOS activity is reduced, but its mRNA expression is not affected.

  1. Artery to Cystic Duct: A Consistent Branch of Cystic Artery Seen in Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Arshad Rashid

    2015-01-01

    Full Text Available Uncontrolled arterial bleeding during laparoscopic cholecystectomy is a serious problem and may increase the risk of bile duct damage. Therefore, accurate identification of the anatomy of the cystic artery is very important. Cystic artery is notoriously known to have a highly variable branching pattern. We reviewed the anatomy of the cystic artery and its branch to cystic duct as seen through the video laparoscope. A single artery to cystic duct with the classical “H-configuration” was demonstrated in 161 (91.47% patients. This branch may cause troublesome bleeding during laparoscopic dissection in the hepatobiliary triangle. Careful identification of artery to cystic duct is helpful in the proper dissection of Calot’s triangle as it reduces the chances of hemorrhage and thus may also be helpful in prevention of extrahepatic biliary radical injuries.

  2. Spatial distribution of child pedestrian injuries along census tract boundaries: Implications for identifying area-based correlates.

    Science.gov (United States)

    Curtis, Jacqueline W

    2017-01-01

    Census tracts are often used to investigate area-based correlates of a variety of health outcomes. This approach has been shown to be valuable in understanding the ways that health is shaped by place and to design appropriate interventions that account for community-level processes. Following this line of inquiry, it is common in the study of pedestrian injuries to aggregate the point level locations of these injuries to the census tracts in which they occur. Such aggregation enables investigation of the relationships between a range of socioeconomic variables and areas of notably high or low incidence. This study reports on the spatial distribution of child pedestrian injuries in a mid-sized U.S. city over a three-year period. Utilizing a combination of geospatial approaches, Near Analysis, Kernel Density Estimation, and Local Moran's I, enables identification, visualization, and quantification of close proximity between incidents and tract boundaries. Specifically, results reveal that nearly half of the 100 incidents occur within roads that are also census tract boundaries. Results also uncover incidents that occur on tract boundaries, not merely near them. This geographic pattern raises the question of the utility of associating area-based census data from any one tract to the injuries occurring in these border zones. Furthermore, using a standard spatial join technique in a Geographic Information System (GIS), these points located on the border are counted as falling into census tracts on both sides of the boundary, which introduces uncertainty in any subsequent analysis. Therefore, two additional approaches of aggregating points to polygons were tested in this study. Results differ with each approach, but without any alert of such differences to the GIS user. This finding raises a fundamental concern about techniques through which points are aggregated to polygons in any study using point level incidents and their surrounding census tract socioeconomic data to

  3. Correlates of self-reported physical function in individuals with spinal cord injuries and disorders: does self-efficacy matter?

    Science.gov (United States)

    Hill, J N; Etingen, B; Miskevics, S; LaVela, S L

    2017-06-06

    Data were collected via a cross-sectional mailed survey with Veterans with spinal cord injury and disorders (SCI/D). To examine self-efficacy in Veterans with SCI/D reporting high versus low perceptions of physical function. Department of Veterans Affairs (VA) Spinal Cord Injury System of Care-nation-wide, 24 Spinal Cord Injury (SCI) Centers. The survey provided patient-reported data on demographic and injury characteristics, basic mobility and fine motor function, and perceived self-efficacy. Bivariate comparisons were conducted to compare perceptions of self-efficacy between Veterans with SCI/D reporting perceptions of 'high' versus 'low' basic mobility and fine motor function. A multivariate logistic regression was conducted to identify factors independently associated with high physical function when controlling for covariates. Response rate (896/1452=61.7%). Multivariate analysis showed that age (odds ratio (OR)=0.98, 95% confidence interval (CI): 0.96-1.00, P=0.03), tetraplegia (OR=0.20, 95% CI: 0.13-0.32, P⩽0.0001), diabetes (OR=0.53, 95% CI: 0.31-0.91, P=0.02), depression (OR=0.62, 95% CI: 0.39-0.98, P=0.04) and pressure ulcers (OR=0.42, 95% CI: 0.25-0.72, P=0.001) were all independently associated with lower odds of high physical function. When controlling for covariates, persons with high self-efficacy were nearly two times more likely to have high physical function (OR=1.98, 95% CI: 1.22-3.22, P=0.01). Lower perceptions of basic mobility and fine motor function among individuals with SCI/D were correlated with lower self-efficacy, even when controlling for other covariates. The relationship between physical function and self-efficacy suggests that interventions focused on improving self-efficacy or physical function may also see improvements in the other. Further, studies exploring the impact of interventions on the relationship between self-efficacy and physical function are needed to understand the relationship between the two.Spinal Cord advance

  4. Serum ferritin correlates with Glasgow coma scale scores and fatal outcome after severe traumatic brain injury.

    Science.gov (United States)

    Simon, Daniel; Nicol, Josi Mara Botome; Sabino da Silva, Sabrina; Graziottin, Camila; Silveira, Patrícia Corso; Ikuta, Nilo; Regner, Andrea

    2015-01-01

    Severe traumatic brain injury (TBI) is associated with a 30-70% mortality rate. Nevertheless, in clinical practice there are no effective biomarkers for the prediction of fatal outcome following severe TBI. Therefore, the aim was to determine whether ferritin serum levels are associated with ICU mortality in patients with severe TBI. This prospective study enrolled 69 male patients who suffered severe TBI [Glasgow Coma Scale (GCS) 3-8 at emergency room admission]. The serum ferritin protein level was determined at ICU admission (mean 5.6 ± 2.5 hours after emergency room admission). Severe TBI was associated with a 39% mortality rate. Higher serum ferritin concentrations were significantly associated with lower hospital admission GCS scores (p = 0.049). Further, there was a significant association between higher ferritin concentrations and fatal outcome (289.5 ± 27.1 µg L(-1) for survivors and 376.5 ± 31.5 µg L(-1) for non-survivors, respectively, mean ± SEM, p = 0.032). Increased serum ferritin levels were associated with lower hospital admission GCS scores and predicted short-term fatal outcome following severe TBI.

  5. Neural correlates of apathy revealed by lesion mapping in participants with traumatic brain injuries.

    Science.gov (United States)

    Knutson, Kristine M; Monte, Olga Dal; Raymont, Vanessa; Wassermann, Eric M; Krueger, Frank; Grafman, Jordan

    2014-03-01

    Apathy, common in neurological disorders, is defined as disinterest and loss of motivation, with a reduction in self-initiated activity. Research in diseased populations has shown that apathy is associated with variations in the volume of brain regions such as the anterior cingulate and the frontal lobes. The goal of this study was to determine the neural signatures of apathy in people with penetrating traumatic brain injuries (pTBIs), as to our knowledge, these have not been studied in this sample. We studied 176 male Vietnam War veterans with pTBIs using voxel-based lesion-symptom mapping (VLSM) and apathy scores from the UCLA Neuropsychiatric Inventory (NPI), a structured inventory of symptoms completed by a caregiver. Our results revealed that increased apathy symptoms were associated with brain damage in limbic and cortical areas of the left hemisphere including the anterior cingulate, inferior, middle, and superior frontal regions, insula, and supplementary motor area. Our results are consistent with the literature, and extend them to people with focal pTBI. Apathy is a significant symptom since it can reduce participation of the patient in family and other social interactions, and diminish affective decision-making.

  6. Importance of resin ducts in reducing ponderosa pine mortality from bark beetle attack.

    Science.gov (United States)

    Kane, Jeffrey M; Kolb, Thomas E

    2010-11-01

    The relative importance of growth and defense to tree mortality during drought and bark beetle attacks is poorly understood. We addressed this issue by comparing growth and defense characteristics between 25 pairs of ponderosa pine (Pinus ponderosa) trees that survived and trees that died from drought-associated bark beetle attacks in forests of northern Arizona, USA. The three major findings of our research were: (1) xylem resin ducts in live trees were >10% larger (diameter), >25% denser (no. of resin ducts mm(-2)), and composed >50% more area per unit ring growth than dead trees; (2) measures of defense, such as resin duct production (no. of resin ducts year(-1)) and the proportion of xylem ring area to resin ducts, not growth, were the best model parameters of ponderosa pine mortality; and (3) most correlations between annual variation in growth and resin duct characteristics were positive suggesting that conditions conducive to growth also increase resin duct production. Our results suggest that trees that survive drought and subsequent bark beetle attacks invest more carbon in resin defense than trees that die, and that carbon allocation to resin ducts is a more important determinant of tree mortality than allocation to radial growth.

  7. Correlation of Apgar Score with Asphyxial Hepatic Injury and Mortality in Newborns: A Prospective Observational Study from India

    Directory of Open Access Journals (Sweden)

    Deepak Sharma

    2016-01-01

    Full Text Available Objective The objective of this study is to determine the correlation of Apgar score with asphyxial hepatic injury and neonatal mortality in moderately and severely asphyxiated newborns. Material and Methods This is a secondary analysis of our prospective observational case-controlled study. Sixteen neonates with severe birth asphyxia (five-minute Apgar ≤3 were compared with either 54 moderate asphyxia neonates (five-minute Apgar >3 or 30 normal neonates. Liver function tests were measured on postnatal days 1, 3, and 10 in the study and control groups. Neonatal mortality was observed in the study and control population. Results Correlation of Apgar score in severely asphyxiated neonates compared with normal Apgar score neonates and moderately asphyxiated neonates for deranged hepatic function showed significant correlation (odds ratio [OR] 4.88, 95% CI 3.26–5.84, P = 0.01 and OR 2.46, 95% CI 1.94–3.32, P = 0.02, respectively. There was a significant increase in serum lactate dehydrogenase (LDH and total bilirubin on day 1 and serum LDH at age of 10th postnatal life in severely asphyxiated neonates when compared to moderately asphyxiated neonates, whereas there was a significant decrease in total bilirubin and serum albumin on day 3 in severely asphyxiated neonates. There was a significant increase in serum alanine transaminase, serum LDH, and total bilirubin on day 1, serum aspartate transaminase, serum LDH, and total bilirubin on day 3, and International Normalized Ratio on day 10 of postnatal life when severely asphyxiated neonates were compared with normal neonates. There was a significant reduction in total protein and serum albumin on day 1 and direct bilirubin on day 3 in severely asphyxiated neonates when compared with normal neonates. There was a significant increase in neonatal mortality in severely asphyxiated neonates when compared to the other two groups. Correlation of Apgar score in severely asphyxiated neonates compared with

  8. Deficient conditioned pain modulation after spinal cord injury correlates with clinical spontaneous pain measures.

    Science.gov (United States)

    Albu, Sergiu; Gómez-Soriano, Julio; Avila-Martin, Gerardo; Taylor, Julian

    2015-02-01

    The contribution of endogenous pain modulation dysfunction to clinical and sensory measures of neuropathic pain (NP) has not been fully explored. Habituation, temporal summation, and heterotopic noxious conditioning stimulus-induced modulation of tonic heat pain intensity were examined in healthy noninjured subjects (n = 10), and above the level of spinal cord injury (SCI) in individuals without (SCI-noNP, n = 10) and with NP (SCI-NP, n = 10). Thermoalgesic thresholds, Cz/AFz contact heat evoked potentials (CHEPs), and phasic or tonic (30 seconds) heat pain intensity were assessed within the C6 dermatome. Although habituation to tonic heat pain intensity (0-10) was reported by the noninjured (10 s: 3.5 ± 0.3 vs 30 s: 2.2 ± 0.5 numerical rating scale; P = 0.003), loss of habituation was identified in both the SCI-noNP (3.8 ± 0.3 vs 3.6 ± 0.5) and SCI-NP group (4.2 ± 0.4 vs 4.9 ± 0.8). Significant temporal summation of tonic heat pain intensity was not observed in the 3 groups. Inhibition of tonic heat pain intensity induced by heterotopic noxious conditioning stimulus was identified in the noninjured (-29.7% ± 9.7%) and SCI-noNP groups (-19.6% ± 7.0%), but not in subjects with SCI-NP (+1.1% ± 8.0%; P thermal test and conditioning stimuli revealed less-efficient endogenous pain modulation in subjects with SCI-NP.

  9. [Correlation between serum uric acid level and acute renal injury after coronary artery bypass grafting].

    Science.gov (United States)

    Xu, D Q; Du, J; Zheng, Z; Tang, Y; Zou, L; Zhang, Y H; Zhang, H T

    2017-07-11

    Objective: To evaluate whether early postoperative serum uric acid level can predict postoperative acute renal injury (AKI) among patients undergoing coronary artery bypass grafting (CABG). Methods: The study retrospectively enrolled 1 306 patients undergoing CABG in Fuwai Hospital between September 2012 and December 2013. The patients were divided into 5 groups by the concentrations of serum uric acid measured on the morning of the first postoperative day, and uric acid categories were as follow: less than 195 μmol/L (Q1 group, 262 cases), 195-236 μmol/L (Q2 group, 263 cases), 237-280 μmol/L (Q3 group, 260 cases), 281-336 μmol/L (Q4 group, 261 cases), more than 336 μmol/L (Q5 group, 260 cases). The primary end points were AKI (RIFLE criteria), severe AKI (AKI≥stage Ⅰ), postoperative continuous renal replacement therapy (CRRT) requirement, in-hospital death, length of stay in hospital and intensive care unit(ICU). The area under the receiver-operating characteristic (ROC) curve (AUC) was used to determine the ability of the early postoperative serum uric acid level as a risk factor for postoperative AKI prediction. Results: Among the 1 306 patients enrolled in the study, AKI was found in 335 patients (25.65%). After adjusting for variables that were different between the 5 groups, the Q5 group had significantly higher risk of AKI, AKI≥ stage Ⅰ and the requirement of CRRT (Puric acid levels alone were used (both Puric acid was a better predictor than serum creatinine(Puric acid concentration within 12 hours after operation is an independent predictor of postoperative AKI in patients undergoing CABG, which could be used to identify patients at high risk for AKI.

  10. Correlation Between Capnography and Arterial Carbon Dioxide Before, During, and After Severe Chest Injury in Swine

    Science.gov (United States)

    2012-01-01

    During phase 2, animals developed decreased oxygenation ( PaO2 :FiO2 [fraction of inspired oxygen] ratio G200) and hy- potension (mean arterial...mercury), ABG, and ratio of arterial oxygen content ( PaO2 ) to FIO2 (PFR). All data col lection was during three phases (1, 2, and 3) of the experiment...did not show an increase in correlation and was therefore left out of the final model. Ratio of PaO2 to FIO2 was not associated with PaCO2. Using

  11. [Causes, diagnosis and surgical treatment of strictures of lobar and segmental hepatic ducts].

    Science.gov (United States)

    Gal'perin, E I; Diuzheva, T G; Chevokin, A Iu; Garmaev, B G

    2005-01-01

    Causes of strictures of lobar and segmental ducts after their injuries during open and laparoscopic cholecystectomy in 53 patients were analyzed. For correction of bile outflow precision non-wireframe (n=22) and wireframe (n=20) anastomoses were used. In 10 patients a combined anastomosis was established. In 1 patient the external drainage of hepatic ducts was performed. After surgery 3 patients died. 1-15 year long-term results were studied in 48 (96%) patients. Good results were achieved in 29 (60.5%), satisfactory -- in 13 (27%) patients. Recurrences of the strictures were diagnosed in 6 patients. It is concluded that dynamic control is necessary in patients operated on for bile ducts injuries. Underestimation of remittent cholangitis leading to biliary cirrhosis worsens prognosis of the disease.

  12. Unintentional Injuries in Preschool Age Children: Is There a Correlation With Parenting Style and Parental Attention Deficit and Hyperactivity Symptoms

    National Research Council Canada - National Science Library

    Acar, Ethem; Dursun, Onur Burak; Esin, İbrahim Selcuk; Öğütlü, Hakan; Özcan, Halil; Mutlu, Murat

    2015-01-01

    .... Therefore, parents have a key role in the occurrence and prevention of injuries. In this study, we examined the relationship among home injuries to children and parental attention deficit hyperactivity disorder (ADHD...

  13. Development of a hybrid broadband NIRS/diffusion correlation spectroscopy system to monitor preterm brain injury (Conference Presentation)

    Science.gov (United States)

    Rajaram, Ajay; St. Lawrence, Keith; Diop, Mamadou

    2017-02-01

    In Canada, 8% of births occur prematurely. Preterm infants weighing less than 1500g are at a high risk of neurodevelopmental impairment: 5-10% develop major disabilities such as cerebral palsy and 40-50% show other cognitive and behavioural deficits. The brain is vulnerable to periods of low cerebral blood flow (CBF) that can impair energy metabolism and cause tissue damage. There is, therefore, a need for an efficient neuromonitoring system to alert the neonatal intensive care team to clinically significant changes in CBF and metabolism, before injury occurs. Optical technologies offer safe, non-invasive, and cost-effective methods for neuromonitoring. Cerebral oxygen saturation (ScO2) can be measured by exploiting the absorption properties of hemoglobin though Near-Infrared Spectroscopy (NIRS), and Diffuse Correlation Spectroscopy (DCS) can monitor CBF by tracking red blood cells. These measures can be combined to describe metabolism, a key indicator of tissue viability. In this study we present the development and testing of a hybrid broadband NIRS/DCS neuromonitor. This system is novel in its ability to simultaneously acquire broadband NIRS and DCS signals, providing a truly real-time measure of metabolism. Narrow bandpass and notch filters have been incorporated to diminish light contamination between the two modalities, preferentially filtering out each source from the opposing detector, allowing for an accurate measure of ScO2, CBF, and metabolism. With a broadband NIRS/DCS system, a real-time measure of CBF and metabolism within the developing brain can aid clinicians in monitoring events that precede brain injury, ultimately leading to better clinical outcomes.

  14. The correlation between dietary fat ‎intake and blood pressure among ‎people with spinal cord injury

    Directory of Open Access Journals (Sweden)

    Hadis Sabour

    2016-08-01

    Full Text Available Background: Studies have demonstrated the effect of different dietary fats on blood pressure (BP in general population. However, these associations have not yet been described in people with spinal cord injury (SCI.Methods: Referred patients to Brain and SCI Research Center between 2011 and 2014 have been invited to participate. Only paraplegic individuals were recruited and patients with injury at cervical or higher thoracic sections were excluded to omit the bias effect of autonomic dysreflexia. Dietary intakes were assessed by recording consumed foods by 24-hour dietary recall interviews using Nutritionist IV 3.5.3 modified for Iranian foods. Systolic BP (SBP and diastolic BP (DBP were measured 3 times and the mean values entered analysis.Results: Higher intakes of cholesterol were related to higher BP (P = 0.010 and 0.011 for SBP and DBP, respectively. Similarly, intake of saturated fat was positively correlated to both SBP (P = 0.016, r = 0.21 and DBP (P = 0.011, r = 0.22. The effect of eicosapentaenoic acid (EPA on BP was insignificant (P = 0.760 and 0.720 for SBP and DBP, respectively. However, intake of docosahexaenoic acid (DHA was related to lower BP among people with SCI.Conclusion: This study has demonstrated that higher intakes of cholesterol and saturated fat are associated with increased BP, whereas DHA is an antihypertensive agent. Dietary modifications with reduction of cholesterol and saturated fat along with intake of additional DHA supplements may help to reduce BP in spinal cord injured-individuals with hypertension.

  15. Current surgical treatment for bile duct cancer

    Institute of Scientific and Technical Information of China (English)

    Yasuji Seyama; Masatoshi Makuuchi

    2007-01-01

    Since extrahepatic bile duct cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic bile duct cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy (PD), plus extrahepatic bile duct resection and regional lymphadenectomy has recently been recognized as the standard curative treatment for hilar bile duct cancer. On the other hand, PD is the choice of treatment for middle and distal bile duct cancer. Major hepatectomy concomitant with PD (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage (BD) followed by portal vein embolization (PVE) enables major hepatectomy in patients with hilar bile duct cancer without mortality. BD should be performed considering the surgical procedure, especially, in patients with separated intrahepatic bile ducts caused by hilar bile duct cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar bile duct cancer with improved resectability, curability, and a 5-year survival rate of 40%. A 5-year survival rate has ranged from 24% to 39% after PD for middle and distal bile duct cancer.

  16. Expression of JMJD2A in infiltrating duct carcinoma was markedly higher than fibroadenoma, and associated with expression of ARHI, p53 and ER in infiltrating duct carcinoma.

    Science.gov (United States)

    Li, Bei-Xu; Li, Jia; Luo, Cheng-Liang; Zhang, Ming-Chang; Li, Hui; Li, Li-Liang; Xu, Hong-Fei; Shen, Yi-Wen; Xue, Ai-Min; Zhao, Zi-Qin

    2013-03-01

    Jumonji Domain Containing 2A (JMJD2A) may be a cancer-associated gene involved in human breast cancer. With a view to investigating expression of JMJD2A in human breast cancer and benign lesion tissues as well as relationship between JMJD2A and tumor related proteins, histological and immunohistochemical analysis, Western blot and quantitative real-time PCR in infiltrating duct carcinoma and fibroadenoma for JMJD2A and immunohistochemical analysis and quantitative real-time PCR in infiltrating duct carcinoma for tumor related proteins (ARHI, p53, ER, PR and CerbB-2) were performed. Histological examination validated the clinical diagnosis. The JMJD2A positive rate of infiltrating duct carcinoma was significantly higher than fibroadenoma by immunohistochemical analysis. The mean optical density of JMJD2A in infiltrating duct carcinoma was higher than fibroadenoma by western blot. JMJD2A mRNA level in infiltrating duct carcinoma was higher than fibroadenoma by quantitative real-time PCR. Spearman correlation analysis revealed that the expression of JMJD2A was associated with ARHI, p53 and ER from immunohistochemical results respectively. Pearson correlation analysis revealed that the expression of JMJD2A was associated with ARHI, p53 and ER from quantitative real-time PCR results respectively. Expression of JMJD2A in infiltrating duct carcinoma was higher, and associated with ARHI, p53 and ER. The results may take JMJD2A as a potential diagnostic and therapeutic target in human breast cancer.

  17. Neural correlates of apathy in patients with neurodegenerative disorders, acquired brain injury, and psychiatric disorders.

    Science.gov (United States)

    Kos, Claire; van Tol, Marie-José; Marsman, Jan-Bernard C; Knegtering, Henderikus; Aleman, André

    2016-10-01

    Apathy can be described as a loss of goal-directed purposeful behavior and is common in a variety of neurological and psychiatric disorders. Although previous studies investigated associations between abnormal brain functioning and apathy, it is unclear whether the neural basis of apathy is similar across different pathological conditions. The purpose of this systematic review was to provide an extensive overview of the neuroimaging literature on apathy including studies of various patient populations, and evaluate whether the current state of affairs suggest disorder specific or shared neural correlates of apathy. Results suggest that abnormalities within fronto-striatal circuits are most consistently associated with apathy across the different pathological conditions. Of note, abnormalities within the inferior parietal cortex were also linked to apathy, a region previously not included in neuroanatomical models of apathy. The variance in brain regions implicated in apathy may suggest that different routes towards apathy are possible. Future research should investigate possible alterations in different processes underlying goal-directed behavior, ranging from intention and goal-selection to action planning and execution.

  18. Temperature modulation of cerebral depolarization during focal cerebral ischemia in rats: correlation with ischemic injury.

    Science.gov (United States)

    Chen, Q; Chopp, M; Bodzin, G; Chen, H

    1993-05-01

    The role of cerebral depolarizations in focal cerebral ischemia is unknown. We therefore measured the direct current (DC) electrical activity in the cortex of Wistar rats subjected to transient occlusion of the middle cerebral artery (MCA). Focal ischemia was induced for 90 min by insertion of an intraluminal filament to occlude the MCA. To modulate cell damage, we subjected the rats to hypothermic (30 degrees C, n = 4), normothermic (37 degrees C, n = 4), and hyperthermic (40 degrees C, n = 6) ischemia. Controlled temperatures were also maintained during 1 h of reperfusion. Continuous cortical DC potential changes were measured using two active Ag-AgCl electrodes placed in the cortical lesion. Animals were killed 1 week after ischemia. The brains were sectioned and stained with hematoxylin and eosin, for evaluation of neuronal damage, and calculation of infarct volume. All animals exhibited an initial depolarization within 30 min of ischemia, followed by a single depolarization event in hypothermic animals, and multiple periodic depolarization events in both normothermic and hyperthermic animals. Hyperthermic animals exhibited significantly more (p < 0.05) DC potential deflections (n = 6.17 +/- 0.67) than normothermic animals (n = 2.75 +/- 0.96). The ischemic infarct volume (% of hemisphere) was significantly different for the various groups; hypothermic animals exhibited no measurable infarct volume, while the ischemic infarct volume was 10.2 +/- 12.3% in normothermic animals and 36.5 +/- 3.4% in hyperthermic animals (p < 0.05). A significant correlation was detected between the volume of infarct and number of depolarization events (r = 0.90, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Guang-ying; Ding, Hong-yu [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Ultrasonography, Jinan (China); Zheng, Lei; Ji, Bing-jun [Shandong Provincial Corps Hospital of Chinese People' s Armed Police Force, Department of Radiology, Jinan (China); Shi, Hao [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Radiology, Jinan (China); Feng, Yan [Affiliated Hospital of Binzhou Medical College, Department of Radiology, Binzhou (China)

    2017-03-15

    To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

  20. [Common bile duct stones and their complications].

    Science.gov (United States)

    Millat, B; Borie, F

    2000-12-01

    At the time of cholecystectomy for symptomatic cholelithiasis, 7-20% of patients have common bile duct stones. Nearly one third of them are asymptomatic. Routine cholangiography during cholecystectomy allows the diagnosis and treatment of common bile duct stones during the same operation. Selective indication for the diagnosis of common bile duct stones based on the positive predictive value of indicators limits treatment to symptomatic cases. No single indicator is however completely accurate in predicting common bile duct stones and the natural history of asymptomatic cases is uncertain. Endoscopic stone extraction preceding cholecystectomy is not superior to one-stage surgical treatment. Diagnosis and treatment of common bile duct stones are feasible laparoscopically. Complications of common bile duct stones are cholangitis and acute pancreatitis; if severe, they require specific therapeutic approaches.

  1. Muscle synergies in cycling after incomplete spinal cord injury: correlation with clinical measures of motor function and spasticity

    Directory of Open Access Journals (Sweden)

    Filipe O. Barroso

    2016-01-01

    Full Text Available Background: After incomplete spinal cord injury (iSCI, patients suffer important sensorimotor impairments, such as abnormal locomotion patterns and spasticity. Complementary to current clinical diagnostic procedures, the analysis of muscle synergies has emerged as a promising tool to study muscle coordination, which plays a major role in the control of multi-limb functional movements.Objective: Based on recent findings suggesting that walking and cycling share similar synergistic control, the analysis of muscle synergies during cycling might be explored as an early descriptor of gait-related impaired control. This idea was split into the following two hypotheses: a iSCI patients present a synergistic control of muscles during cycling; b muscle synergies outcomes extracted during cycling correlate with clinical measurements of gait performance and/or spasticity.Methods: Electromyographic (EMG activity of 13 unilateral lower limb muscles was recorded in a group of 10 healthy individuals and 10 iSCI subjects during cycling at four different cadences. A nonnegative matrix factorization (NNMF algorithm was applied to identify synergistic components (i.e., activation coefficients and muscle synergy vectors. Reconstruction goodness scores (VAF and r2 were used to evaluate the ability of a given number of synergies to reconstruct the EMG signals.A set of metrics based on the similarity between pathologic and healthy synergies were correlated with clinical scales of gait performance and spasticity.Results: iSCI patients preserved a synergistic control of muscles during cycling. The similarity with the healthy reference was consistent with the degree of the impairment, i.e., less impaired patients showed higher similarities with the healthy reference. There was a strong correlation between reconstruction goodness scores at 42 rpm motor performance scales (TUG, 10-Meter test and WISCI II. On the other hand, the similarity between the healthy and affected

  2. A correlation study of the expression of resistin and glycometabolism in muscle tissue after traumatic brain injury in rats

    Institute of Scientific and Technical Information of China (English)

    Jin Peng; Zhu Lielie; Zhang Jiasheng; Xie Songling; Pan Da; Wen Hao; Meng Weiyang

    2014-01-01

    Objective:To investigate the expression pattern of resistin (RSTN) in skeletal muscle tissue and its influence on glycometabolism in rats with traumatic brain injury (TBI).Methods:Seventy-eight SD rats were randomly divided into traumatic group (n=36),RSTN group (n=36) and sham operation group (n=6).Fluid percussion TBI model was developed in traumatic and RSTN groups and the latter received additional 1 mg RSTN antibody treatment for each rat.At respectively 12 h,24 h,72 h,1 w,2 w,and 4 w after operation,venous blood was collected and the right hind leg skeletal muscle tissue was sampled.We used real-time PCR to determine mRNA expression of RSTN in skeletal muscles,western blot to determine RSTN protein expression and ELISA to assess serum insulin as well as fasting blood glucose (FBG) levels.Calculation of the quantitative insulin sensitivity check index (Q value) was also conducted.The above mentioned indicators and their correction were statistically analyzed.Results:Compared with sham operation group,the RSTN expression in the skeletal muscle as well as serum insulin and FBG levels revealed significant elevation (P<0.05),and reduced Q value (P<0.05) in traumatic group.Single factor linear correlation analysis showed a significant negative correlation between RSTN expression and Q values (P<0.001) in traumatic group.Conclusion:The expression of RSTN has been greatly increased in the muscular tissue of TBI rats and it was closely related to the index of glycometabolism.RSTN may play an important role in the process of insulin resistance after TBI.

  3. Analysis of behavioral and EEG correlatives of attention in the dynamics of recovery of consciousness following severe brain injury

    Directory of Open Access Journals (Sweden)

    E. V. Sharova

    2016-01-01

    Full Text Available Objective: to determine the behavioral manifestations and electroencephalographic correlates of modality-nonspecific attention using a clinical model of severe brain injury (SBI.Patients and methods. 35 patients with SBI in the dynamics of post-coma recovery of mental activity (a study group and 23 healthy subjects (a control group were examined. The behavioral manifestations of NSA from coma to clear consciousness were analyzed in the patients. Changes in the pattern of EEG and in the indices of its coherence in the presence and activation of different forms of attention (an orienting response to the sound and eye opening; involuntary and voluntary visual forms, by applying specially developed computerized techniques, were investigated. The features of associated with attention changes in interhemispheric EEG coherence (IHC with the data of 3T diffusion tensor tractography of the corpus callosum (CC were compared.Results. Attention disorders were shown to be essential and an «axial disorder» in patients with SBI. There were statistically confirmed qualitative and quantitative differences attention-associated changes in the EEG pattern and IHC in reversible and chronic unconsciousness. The important favorable prognostic sign proved to be reactive changes in interhemispheric EEG relations, including frontal ones characterized by the absence of clear external manifestations of consciousness in the very earliest stages. There was a significant correlation between the preservation of CC tracts (primarily, the rostrum, anterior portion, and splenium and attention-related reactivity of IHC, which reflects the specific, though nonrigid, structural determinacy of the latter.

  4. Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes.

    Science.gov (United States)

    MacPherson, Heather A; Weinstein, Sally M; West, Amy E

    2017-07-20

    Non-suicidal self-injury (NSSI) in childhood is not well documented, especially among youth with pediatric bipolar disorder (PBD). The current study evaluated prevalence and correlates of NSSI, and its impact on intervention response, in a randomized trial of Child- and Family-Focused Cognitive-Behavioral Therapy (CFF-CBT) versus Treatment As Usual (TAU), adjunctive to pharmacotherapy. This study included 72 children ages 7-13 (58% male) with PBD. NSSI and correlates were assessed at baseline; mood and psychiatric severity were measured longitudinally. NSSI was common: 31% endorsed NSSI behaviors; 10% reported thoughts of NSSI, in the absence of behaviors. Children engaging in NSSI reported higher depression, psychosis, suicidality, and hopelessness; lower self-esteem; and reduced family help-seeking in univariate analyses. In a multivariate logistic regression, high child depression and psychosis, and low family help-seeking, remained significantly associated with baseline NSSI. In mixed-effects regression models, presence of NSSI at baseline did not influence the response of depressive symptoms to treatment. Children who endorsed NSSI experienced steeper response trajectories for psychiatric severity, regardless of treatment group. Youth who denied NSSI showed poorer response to TAU for manic symptoms; mania trajectories in CFF-CBT were similar across youth. Thus, NSSI in PBD is common and associated with impairment. As children might engage in NSSI for different reasons, the function of NSSI should be considered in treatment. Since children without NSSI fared worse in TAU, it may be important to ensure that youth with PBD receive structured, intensive interventions. CFF-CBT was efficacious regardless of NSSI, and thus shows promise for high-risk children with PBD.

  5. Quality of Life in Knee Osteoarthritis; Correlation with Clinical Measures and the Knee Injury and Osteoarthritis Outcome Score

    Directory of Open Access Journals (Sweden)

    Mehmet Atıf Erol Aksekili

    2016-03-01

    Full Text Available INTRODUCTION: Osteoarthritis (OA, the most common degenerative joint disorder, affects the quality of lives (QoL of the sufferers as other chronic disorders. Therefore assessment of QOL is of particular importance. In this study we aimed to evaluate the quality of life (QoL in patients with knee osteoarthritis by using the Nottingham Health Profile (NHP and to determine its relationships with disability and pain indices. METHODS: Patients with knee OA (n=105, with a mean age of 59.79±10.10 yrs and 50 sex and age-matched healthy controls were included in the study. Age, sex, symptom durations, body mass index (BMI and Kellgren-Lawrence scores were recorded. NHP was used in assessment of QoL in all patients and controls. Knee injury and Osteoarthritis Outcome Score (KOOS was used in assessment of disability and pain was assessed by using Visual Analog Scale (VAS in patients. RESULTS: Patients with knee OA had higher scores in all subgroups of NHP than controls. In patients the NHP total score significantly correlated to presence of effusion, VAS pain and the KOOS subgroups scores. DISCUSSION AND CONCLUSION: The patients with knee OA had a significantly poorer quality of life compared to the healthy persons. Besides, NHP was found to be associated with clinical examination findings and disability. We assume that NHP can effectively be used in evaluation of health status in patients with knee OA.

  6. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

    Full Text Available Nonsuicidal self-injury (NSSI is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls. Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

  7. Self-injury, suicide ideation, and sexual orientation: differences in causes and correlates among high school students

    Science.gov (United States)

    DeCamp, Whitney; W.Bakken, Nicholas

    2016-01-01

    Abstract: Background: Research has suggested that sexual minority youth are more likely to experience a number of behavioral and health-related risk factors due to their exposure to negative attitudes and beliefs about sexual minorities. Few studies, however, have examined the prevalence of non-suicidal self-injury (NSSI) among sexual minority youth. With self-cutting and suicidal ideation common in middle and high schools, understanding the antecedents and correlates of such behavior may help identify troubled students and initiate preventative measures. Methods: Bivariate probit regression analyses are performed using data from 7,326 high school students collected via the Delaware Youth Risk Behavior Survey. Results: Results indicate that bullying victimization, fighting, substance use, sexual behavior, depression, and unhealthy dieting behaviors were generally associated with NSSI and suicidal ideation. Some effects - including those from sexual activity, substance use, and unhealthy dieting behaviors significantly differed based on gender and orientation. Conclusions: Risk factors for suicide and NSSI vary by gender and orientation. Both prevention/intervention specialists and researchers should consider the intersection of these risk factors with sexual orientation in their efforts. PMID:26401756

  8. [Electrophysiological correlates of efficacy of nootropic drugs in the treatment of consequences of traumatic brain injury in adolescents].

    Science.gov (United States)

    Iznak, E V; Iznak, A F; Pankratova, E A; Zavadenko, N N; Guzilova, L S; Guzilova, Iu I

    2010-01-01

    To assess objectively a dynamics of brain functional state, EEG spectral power and peak latency of the P300 component of cognitive auditory evoked potentials have been analyzed in adolescents during the course of nootropic therapy of residual asthenic consequences of traumatic brain injury (ICD-10 F07.2). The study included 76 adolescents, aged 12-18 years, who have undergone severe closed head trauma with brain commotion 1/2--5 years ago. Patients have been divided into 3 groups treated during one month with cerebrolysin, piracetam or magne-B6, respectively. After the end of the nootropic therapy, 77% of patients treated with cerebrolysin as well as 50% of patients treated with piracetam and magne-B6 have demonstrated the positive dynamics of their brain functional state that manifested itself in the appearance of occipital EEG alpha rhythm or in the increase of its spectral power; in the normalization of alpha rhythm frequency; in the decrease in the spectral power of slow wave (theta and delta) EEG activity, in the amount (up to the disappearance) of paroxysmal EEG activity, in the EEG response to hyperventilation and in the shortening of the P300 peak latency. Such positive changes of neurophysiological parameters have been associated with the improvement of clinical conditions of patients and correlated significantly with the dynamics of psychometric scores of attention and memory.

  9. Dissociative, depressive, and PTSD symptom severity as correlates of nonsuicidal self-injury and suicidality in dissociative disorder patients.

    Science.gov (United States)

    Webermann, Aliya R; Myrick, Amie C; Taylor, Christina L; Chasson, Gregory S; Brand, Bethany L

    2016-01-01

    The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise specified with a recent history of nonsuicidal self-injury (NSSI) and suicide attempts from those patients without recent self-harm. A total of 241 clinicians reported on recent history of patient NSSI and suicide attempts. Of these clinicians' patients, 221 completed dissociative, depressive, and posttraumatic stress disorder symptomatology measures. Baseline cross-sectional data from a naturalistic and prospective study of dissociative disorder patients receiving community treatment were utilized. Analyses evaluated dissociative, depressive, and posttraumatic stress disorder symptom severity as methods of classifying patients into NSSI and suicide attempt groupings. Results indicated that dissociation severity accurately classified patients into NSSI and suicidality groups, whereas depression severity accurately classified patients into NSSI groups. These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment.

  10. Self-injury, suicide ideation, and sexual orientation: differences in causes and correlates among high school students

    Directory of Open Access Journals (Sweden)

    Whitney DeCamp

    2016-01-01

    Full Text Available BACKGROUND: Researchhas suggested that sexual minority youth are more likely to experience a number of behavioral and health-related risk factors due to their exposure to negative attitudes and beliefs about sexual minorities. Few studies, however, have examined the prevalence of non-suicidal self-injury (NSSI among sexual minority youth. With self-cutting and suicidal ideation common in middle and high schools, understanding the antecedents and correlates of such behaviormay help identify troubled students and initiate preventative measures. METHODS: Bivariate probit regression analyses are performed using data from 7,326 high school students collected via the Delaware Youth Risk Behavior Survey. RESULTS: Results indicate that bullying victimization, fighting, substance use, sexual behavior, depression, and unhealthy dieting behaviors were generally associated with NSSI and suicidal ideation. Some effects - including those from sexual activity, substance use, and unhealthy dieting behaviors – significantly differed based on gender and orientation. CONCLUSIONS: Risk factors for suicide and NSSI vary by gender and orientation. Both prevention/intervention specialists and researchers should consider the intersection of these risk factors with sexual orientation in their efforts.

  11. Self-injury, suicide ideation, and sexual orientation: differences in causes and correlates among high school students.

    Science.gov (United States)

    DeCamp, Whitney; Bakken, Nicholas W

    2016-01-01

    Research has suggested that sexual minority youth are more likely to experience a number of behavioral and health-related risk factors due to their exposure to negative attitudes and beliefs about sexual minorities. Few studies, however, have examined the prevalence of non-suicidal self-injury (NSSI) among sexual minority youth. With self-cutting and suicidal ideation common in middle and high schools, understanding the antecedents and correlates of such behavior may help identify troubled students and initiate preventative measures. Bivariate probit regression analyses are performed using data from 7,326 high school students collected via the Delaware Youth Risk Behavior Survey. Results indicate that bullying victimization, fighting, substance use, sexual behavior, depression, and unhealthy dieting behaviors were generally associated with NSSI and suicidal ideation. Some effects--including those from sexual activity, substance use, and unhealthy dieting behaviors--significantly differed based on gender and orientation. Risk factors for suicide and NSSI vary by gender and orientation. Both prevention/intervention specialists and researchers should consider the intersection of these risk factors with sexual orientation in their efforts. © 2016 KUMS, All rights reserved.

  12. Methods of evaluating cleanliness of ventilation ducts

    Institute of Scientific and Technical Information of China (English)

    曹勇; 罗运有; 于丹; 甘丽斯

    2009-01-01

    A testing system for evaluating cleanliness of ventilation ducts was constructed. Comparisons of four evaluation methods for quantifying the amount of dust on the inner surface of ventilation ducts are presented. The experimental results show that the wiping by solvent method is more efficient than that by the wiping method,especially used on low cleanliness duct surface. The gravimetric tape method is an efficient method of collecting dust samples on the duct surface with low amounts of dust,particularly used to check the cleanliness level after the cleaning work. The optical method can be set up rapidly and is useful for fieldwork measurements.

  13. The correlation between stabbing-related upper extremity wounds and survival of stabbing victims with abdominal and thoracic injuries.

    Science.gov (United States)

    Rozenfeld, Michael; Peleg, Kobi; Givon, Adi; Kessel, Boris

    2017-07-01

    When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation. Thus, the primary aim of this study was to evaluate the association between presence of upper extremity wounds and the severity of the thoracic and intra-abdominal injuries due to stabbing. This study was carried out retrospectively using data on 8714 patients with stabbing-related injuries from 19 trauma centers that participated in the Israeli National Trauma Registry (INTR) between January 1st1997 and December 31st 2013. Patients with wounds of upper extremities in addition to torso injuries (UE group) were compared to other patients with torso injuries (TO group) in terms of demographics, injury characteristics and clinical outcome. The compared groups were found to be homogeneous in terms of age and systolic blood pressure; the number of sustained torso injuries was also identical. The UE group comprised a slightly greater percentage of females, however both groups were predominantly male. Patients with upper extremity injuries had a lower proportion of internal organ damage (36% vs. 38.5%) and lower mortality (0.9% vs. 2%). The higher mortality of patients without upper extremity wounds remained significantly different even when adjusted by other epidemiological parameters (OR 2.46, 95% CI 1.33-5.08).The number of sustained upper extremity injuries was positively associated with deeper penetration of the torso by the stabbing instrument. Patients with stabbing-related upper extremity wounds had a significant survival advantage over patients without such injuries. However, a greater number of sustained upper extremity

  14. Measure Guideline: Sealing and Insulating of Ducts in Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R.; Puttagunta, S.

    2011-12-01

    This document begins with a discussion on potential cost and performance benefits of duct sealing and insulating. It continues with a review of typical duct materials and components and the overall procedures for assessing and improving the duct system.

  15. Measure Guideline. Sealing and Insulating Ducts in Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Puttagunta, S. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2011-12-01

    This document begins with a discussion on potential cost and performance benefits of duct sealing and insulating. It continues with a review of typical duct materials and components and the overall procedures for assessing and improving the duct system.

  16. Radiated noise of ducted fans

    Science.gov (United States)

    Eversman, Walter

    The differences in the radiated acoustic fields of ducted and unducted propellers of the same thrust operating under similar conditions are investigated. An FEM model is created for the generation, propagation, and radiation of steady, rotor alone noise and exit guide vane interaction noise of a ducted fan. For a specified number of blades, angular mode harmonic, and rotor angular velocity, the acoustic field is described in a cylindrical coordinate system reduced to only the axial and radial directions. It is found that, contrary to the usual understanding of the Tyler and Sofrin (1962) result, supersonic tip speed rotor noise can be cut off if the tip Mach number is only slightly in excess of unity and if the number of blades is relatively small. If there are many blades, the fundamental angular mode number is large, and the Tyler and Sofrin result for thin annuli becomes more relevant. Shrouding of subsonic tip speed propellers is a very effective means of controlling rotor alone noise.

  17. Isolated Avulsion of the Common Hepatic Duct from Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Victor W. Wong

    2012-01-01

    Full Text Available Isolated extrahepatic biliary tract injury following blunt abdominal trauma is rare. The underlying pathogenic mechanisms remain obscure, but include shear and/or compression forces on the biliary system. Associated morbidity rates are high and largely the result of delays in diagnosis. Imaging modalities commonly employed for diagnosis include ultrasonography, computed tomography, nuclear medicine, and magnetic resonance imaging. Percutaneous and endoscopic techniques have been used both for diagnosis and treatment. Treatment options are dictated by the stability of the patient and the extent of bile duct and concomitant injuries. In this paper, we discuss a case of isolated avulsion of the hepatic duct confluence following blunt trauma that was successfully managed with Roux-en-Y hepaticojejunostomy. To our knowledge, this specific injury pattern has not been previously reported.

  18. CORRELATION OF MRI GRADING OF BONE STRESS INJURIES WITH CLINICAL RISK FACTORS AND RETURN TO PLAY: A 5-YEAR PROSPECTIVE STUDY IN COLLEGIATE TRACK AND FIELD ATHLETES

    Science.gov (United States)

    Nattiv, Aurelia; Kennedy, Gannon; Barrack, Michelle T.; Abdelkerim, Ashraf; Goolsby, Marci A.; Arends, Julie C.; Seeger, Leanne L.

    2015-01-01

    Background Bone stress injuries are common in track and field athletes. Knowledge of risk factors and correlation of these to magnetic resonance imaging (MRI) grading could be helpful in determining recovery time. Purpose To examine the relationships between MRI grading of bone stress injury with clinical risk factors and time to return to sport in collegiate track and field athletes. Study Design Prospective cohort over 5 years. Methods Two hundred and eleven male and female collegiate track and field and cross-country athletes were followed prospectively through their competitive seasons. All athletes had a pre-participation history, physical exam, and anthropometric measurements obtained annually. An additional questionnaire was completed regarding nutritional behaviors, menstrual patterns and prior injuries, as well as a 3-day diet record. Dual energy X-ray absorptiometry was obtained at baseline and each year of participation in the study. Athletes with clinical evidence of bone stress injuries had plain radiographs. If radiographs were negative, MRI was obtained. Bone stress injuries were evaluated by two independent radiologists utilizing an MRI grading system. MRI grading and risk factors were evaluated to identify predictors of time to return to sport. Results Thirty-four (12 males, 22 females) of the 211 collegiate athletes sustained 61 bone stress injuries during the 5-year study period. The average prospective assessment for participants was 2.1 years. MRI grade and total body bone mineral density (BMD) emerged as significant and independent predictors of time to return to sport in the multiple regression model. Specifically, the higher the MRI grade, the longer the recovery time (psport. Conclusions Higher MRI grade, lower BMD, and skeletal sites of predominant trabecular bone structure were independently associated with delayed recovery of bone stress injuries in track and field athletes. Knowledge of these risk factors, as well as nutritional and

  19. Prognostic factors for open globe injuries and correlation of ocular trauma score at a tertiary referral eye care centre in Singapore.

    Science.gov (United States)

    Agrawal, Rupesh; Wei, Ho Sue; Teoh, Stephen

    2013-09-01

    To evaluate the factors influencing final vision outcome after surgical repair of open globe injuries and to correlate the Ocular trauma score. Retrospective case analysis of patients with open globe injuries at a tertiary referral eye care centre in Singapore was performed. Pre-operative factors affecting final vision outcome in patients with open globe injury and correlation of ocular trauma score in our study with international ocular trauma scoring system was performed. Case records of 172 eyes with open globe injury were analyzed. Mean age was 36. 67 years. Mean follow up was 12.26 m. Males were pre-dominantly affected. Initial visual acuity was ≥ 20/40, 20/50 < 20/200, 20/200- CF, HM- PL and NLP in 24 (14%), 39 (22.7%), 16 (9.3%), 66 (38.4%) and 27 (15.7%) eyes respectively. Final visual acuity was ≤ 20/40, 20/50 < 20/200, 20/200- 1/200, HM- PL and NLP in 76 (44.2%), 28 (16.3%), 11 (6.4%), 30 (17.4%) and 27 (15.7%) eyes respectively. Ocular trauma score in our study correlates with international ocular trauma scoring system. The present study showed pre-operative variables such as mode of injury, pre-operative visual acuity, traumatic cataract, hyphaema, relative afferent papillary defect, vitreous lossand vitreous hemorrhage to be adversely affecting the final vision outcome. Our study showed a good synchrony with international ocular trauma score (OTS) and based on this study we were able to validate application of OTS in Singapore population. Recognizing these factors can help the surgeon in evidence based counseling.

  20. Prognostic factors for open globe injuries and correlation of Ocular Trauma Score at a tertiary referral eye care centre in Singapore

    Directory of Open Access Journals (Sweden)

    Rupesh Agrawal

    2013-01-01

    Full Text Available Objective: To evaluate the factors influencing final vision outcome after surgical repair of open globe injuries and to correlate the Ocular trauma score. Materials and Methods: Retrospective case analysis of patients with open globe injuries at a tertiary referral eye care centre in Singapore was performed. Pre-operative factors affecting final vision outcome in patients with open globe injury and correlation of ocular trauma score in our study with international ocular trauma scoring system was performed. Results: Case records of 172 eyes with open globe injury were analyzed. Mean age was 36. 67 years. Mean follow up was 12.26 m. Males were pre-dominantly affected. Initial visual acuity was ≥20/40, 20/50 < 20/200, 20/200- CF, HM- PL and NLP in 24 (14%, 39 (22.7%, 16 (9.3%, 66 (38.4% and 27 (15.7% eyes respectively. Final visual acuity was ≤20/40, 20/50 < 20/200, 20/200- 1/200, HM- PL and NLP in 76 (44.2%, 28 (16.3%, 11 (6.4%, 30 (17.4% and 27 (15.7% eyes respectively. Ocular trauma score in our study correlates with international ocular trauma scoring system. Conclusion: The present study showed pre-operative variables such as mode of injury, pre-operative visual acuity, traumatic cataract, hyphaema, relative afferent papillary defect, vitreous lossand vitreous hemorrhage to be adversely affecting the final vision outcome. Our study showed a good synchrony with international ocular trauma score (OTS and based on this study we were able to validate application of OTS in Singapore population. Recognizing these factors can help the surgeon in evidence based counseling.

  1. Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes.

    Science.gov (United States)

    Nattiv, Aurelia; Kennedy, Gannon; Barrack, Michelle T; Abdelkerim, Ashraf; Goolsby, Marci A; Arends, Julie C; Seeger, Leanne L

    2013-08-01

    Bone stress injuries are common in track and field athletes. Knowledge of risk factors and correlation of these to magnetic resonance imaging (MRI) grading could be helpful in determining recovery time. To examine the relationships between MRI grading of bone stress injuries with clinical risk factors and time to return to sport in collegiate track and field athletes. Cohort study (prognosis); Level of evidence, 2. A total of 211 male and female collegiate track and field and cross-country athletes were followed prospectively through their competitive seasons. All athletes had preparticipation history, physical examination, and anthropometric measurements obtained annually. An additional questionnaire was completed regarding nutritional behaviors, menstrual patterns, and prior injuries, as well as a 3-day diet record. Dual-energy X-ray absorptiometry was performed at baseline and each year of participation in the study. Athletes with clinical evidence of bone stress injuries had plain radiographs. If radiograph findings were negative, MRI was performed. Bone stress injuries were evaluated by 2 independent radiologists utilizing an MRI grading system. The MRI grading and risk factors were evaluated to identify predictors of time to return to sport. Thirty-four of the athletes (12 men, 22 women) sustained 61 bone stress injuries during the 5-year study period. The mean prospective assessment for participants was 2.7 years. In the multiple regression model, MRI grade and total-body bone mineral density (BMD) emerged as significant and independent predictors of time to return to sport. Specifically, the higher the MRI grade (P = .004) and lower the BMD (P = .030), the longer the recovery time. Location of the bone injury at predominantly trabecular sites of the femoral neck, pubic bone, and sacrum was also associated with a prolonged time to return to sport. Female athletes with oligomenorrhea and amenorrhea had bone stress injuries of higher MRI grades compared with

  2. Double-duct liquid metal magnetohydrodynamic engine

    Science.gov (United States)

    Haaland, Carsten M.

    1995-01-01

    An internal combustion, liquid metal (LM) magnetohydrodynamic (MHD) engine and an alternating current (AC) magnetohydrodynamic generator, are used in combination to provide useful AC electric energy output. The engine design has-four pistons and a double duct configuration, with each duct containing sodium potassium liquid metal confined between free pistons located at either end of the duct. The liquid metal is forced to flow back and forth in the duct by the movement of the pistons, which are alternatively driven by an internal combustion process. In the MHD generator, the two LM-MHD ducts pass in close proximity through a Hartmann duct with output transformer. AC power is produced by operating the engine with the liquid metal in the two generator ducts always flowing in counter directions. The amount of liquid metal maintained in the ducts may be varied. This provides a variable stroke length for the pistons. The engine/generator provides variable AC power at variable frequencies that correspond to the power demands of the vehicular propulsion. Also the engine should maintain nearly constant efficiency throughout the range of power usage. Automobiles and trucks could be powered by the invention, with no transmission or power converter devices being required.

  3. A rare case of bile duct cyst

    Institute of Scientific and Technical Information of China (English)

    Qing-Gang Wang; Shu-Tian Zhang

    2009-01-01

    Choledochal cyst is an uncommon disease usually seen in young women and can be divided into five types. We report a 66-year-old woman who was diagnosed with types Ⅱ and Ⅱ bile duct cyst simultaneously after surgery, which is a rare type of bile duct cyst.

  4. New cannulation method for pancreatic duct cannulation-bile duct guidewire-indwelling method

    Science.gov (United States)

    Sakai, Yuji; Ishihara, Takeshi; Tsuyuguchi, Toshio; Tawada, Katsunobu; Saito, Masayoshi; Kurosawa, Jo; Tamura, Ryo; Togo, Seiko; Mikata, Rintaro; Tada, Motohisa; Yokosuka, Osamu

    2011-01-01

    The patient was a 58-year-old male with symptomatic alcoholic chronic pancreatitis. Since a 10 mm calculus was observed in the pancreatic body and abdominal pain occurred due to congestion of pancreatic juice, endoscopic retrograde cholangiopancreatography was conducted for assessment of the pancreatic duct and treatment of pancreatic calculus. Pancreatogram was slightly and insufficiently obtained by injecting the contrast media via the common channel of the duodenal main papilla. We tried to cannulate selectively into the pancreatic duct for a clear image. However, the selective cannulation of the pancreatic duct was difficult because of instability of the papilla. On the other hand, selective cannulation of the bile duct was relatively easily achieved. Therefore, after the imaging of the bile duct, a guidewire was retained in the bile duct to immobilize the duodenal papilla and cannulation of the pancreatic duct was attempted. As a result, selective pancreatic duct cannulation became possible. It is considered that the bile duct guidewire-indwelling method may serve as one of the useful techniques for cases whose selective pancreatic duct cannulation is difficult (“selective pancreatic duct difficult cannulation case”). PMID:22110840

  5. Pancreatic duct holder for facilitating duct-to-mucosa pancreatojejunostomy after pancreatoduodenectomy.

    Science.gov (United States)

    Sugiyama, Masanori; Suzuki, Yutaka; Abe, Nobutsugu; Ueki, Hisayo; Masaki, Tadahiko; Mori, Toshiyuki; Atomi, Yutaka

    2009-01-01

    Duct-to-mucosa pancreatojejunostomy after pancreatoduodenectomy may be technically difficult, particularly in cases in which the remnant pancreas is soft with a small main pancreatic duct. We devised a pancreatic duct holder for duct-to-mucosa pancreatojejunostomy. The holder has a cone-shaped tip. A one-third circle of the tip is cut away, which makes a slit. As the tip is inserted gently into the pancreatic duct, the duct can be adequately expanded. The holder provides a good surgical field for anastomosis. A slit of the tip allows needle insertion. The holder facilitates stitches of the jejunum also. Twelve patients underwent pancreatoduodenectomy, followed by duct-to-mucosa pancreatojejunostomy using the holder. The holder allowed 8 or more stitches in duct-to-mucosa anastomosis, even in patients with a small pancreatic duct. No patients developed prolonged pancreatic leakage or pancreatic fistula postoperatively. In conclusion, the pancreatic duct holder is a simple and useful tool for facilitating duct-to-mucosa pancreatojejunostomy.

  6. Bile duct hamartomas (von Mayenburg complexes) mimicking liver metastases from bile duct cancer: MRC findings

    Institute of Scientific and Technical Information of China (English)

    Yasuhiko Nagano; Kenichi Matsuo; Katsuya Gorai; Kazuya Sugimori; Chikara Kunisaki; Hideyuki Ike; Katsuaki Tanaka; Toshio Imada; Hiroshi Shimada

    2006-01-01

    We present a case of a 72-year-old man with a common bile duct cancer, who was initially believed to have multiple liver metastases based on computed tomography findings, and in whom magnetic resonance cholangiography (MRC) revealed a diagnosis of bile duct hamartomas. At exploration for pancreaticoduodenectomy, liver palpation revealed disseminated nodules at the surface of the liver. These nodules showed gray-white nodular lesions of about 0.5cm in diameter scattered on the surface of both liver lobes, which were looked like multiple liver metastases from bile duct cancer. Frozen section of the liver biopsy disclosed multiple bile ducts with slightly dilated lumens embedded in the collagenous stroma characteristics of multiple bile duct hamartomas (BDHs). Only two reports have described the MRC features of bile duct hamartomas. Of all imaging procedures, MRC provides the most relevant features for the imaging diagnosis of bile duct hamartomas.

  7. Decreased miR-26a expression correlates with the progression of podocyte injury in autoimmune glomerulonephritis.

    Directory of Open Access Journals (Sweden)

    Osamu Ichii

    Full Text Available MicroRNAs contribute to the pathogenesis of certain diseases and may serve as biomarkers. We analyzed glomerular microRNA expression in B6.MRLc1, which serve as a mouse model of autoimmune glomerulonephritis. We found that miR-26a was the most abundantly expressed microRNA in the glomerulus of normal C57BL/6 and that its glomerular expression in B6.MRLc1 was significantly lower than that in C57BL/6. In mouse kidneys, podocytes mainly expressed miR-26a, and glomerular miR-26a expression in B6.MRLc1 mice correlated negatively with the urinary albumin levels and podocyte-specific gene expression. Puromycin-induced injury of immortalized mouse podocytes decreased miR-26a expression, perturbed the actin cytoskeleton, and increased the release of exosomes containing miR-26a. Although miR-26a expression increased with differentiation of immortalized mouse podocytes, silencing miR-26a decreased the expression of genes associated with the podocyte differentiation and formation of the cytoskeleton. In particular, the levels of vimentin and actin significantly decreased. In patients with lupus nephritis and IgA nephropathy, glomerular miR-26a levels were significantly lower than those of healthy controls. In B6.MRLc1 and patients with lupus nephritis, miR-26a levels in urinary exosomes were significantly higher compared with those for the respective healthy control. These data indicate that miR-26a regulates podocyte differentiation and cytoskeletal integrity, and its altered levels in glomerulus and urine may serve as a marker of injured podocytes in autoimmune glomerulonephritis.

  8. Estimated Glomerular Filtration Rate Correlates Poorly with Four-Hour Creatinine Clearance in Critically Ill Patients with Acute Kidney Injury

    Directory of Open Access Journals (Sweden)

    Christopher J. Kirwan

    2013-01-01

    Full Text Available Introduction. RIFLE and AKIN provide a standardised classification of acute kidney injury (AKI, but their categorical rather than continuous nature restricts their use to a research tool. A more accurate real-time description of renal function in AKI is needed, and some published data suggest that equations based on serum creatinine that estimate glomerular filtration rate (eGFR can provide this. In addition, incorporating serum cystatin C concentration into estimates of GFR may improve their accuracy, but no eGFR equations are validated in critically ill patients with AKI. Aim. This study tests whether creatinine or cystatin-C-based eGFR equations, used in patients with CKD, offer an accurate representation of 4-hour creatinine clearance (4CrCl in critically ill patients with AKI. Methods. Fifty-one critically ill patients with AKI were recruited. Thirty-seven met inclusion criteria, and the performance of eGFR equations was compared to 4CrCl. Results. eGFR equations were better than creatinine alone at predicting 4CrCl. Adding cystatin C to estimates did not improve the bias or add accuracy. The MDRD 7 eGFR had the best combination of correlation, bias, percentage error and accuracy. None were near acceptable standards quoted in patients with chronic kidney disease (CKD. Conclusions. eGFR equations are not sufficiently accurate for use in critically ill patients with AKI. Incorporating serum cystatin C does not improve estimates. eGFR should not be used to describe renal function in patients with AKI. Standards of accuracy for validating eGFR need to be set.

  9. Correlation of acute-phase cerebral blood flow and MRI findings with outcome in patients with diffuse axonal injury

    Energy Technology Data Exchange (ETDEWEB)

    Akimoto, Hideaki; Takasato, Yoshio; Masaoka, Hiroyuki; Hayakawa, Takanori; Yatsushige, Hiroshi; Toumori, Toshiki; Sugawara, Takashi [National Disaster Medical Center, Tachikawa, Tokyo (Japan)

    2003-01-01

    The purpose of this study was to assess the utility of acute-phase cerebral blood flow (CBF) measurements and magnetic resonance imaging (MRI) for predicting the outcome of patients with diffuse axonal injury (DAI). Twenty-one DAI patients treated at our hospital between July 1997 and December 1999 were evaluated. CBF was measured using Xenon computed tomography. Axial T1-, axial T2-, and sagittal T2-weighted MRI scans were performed using a 0.5 Tesla MR scanner. Each examination was performed within seven days of the onset of symptoms. Patients were divided into two groups according to their Glasgow outcome scale after six months: a good outcome group (n=14, good recovery or moderate disability), and a poor outcome group (n=7, severe disability, vegetative state or death). We compared the inter-group average ages, Glasgow coma scale (GCS) ratings upon admission, and CBF values using the Student t-test. Inter-group differences regarding the presence of lesions on MRI images were assessed using the Mann-Whitney test. The age of the good outcome group was significantly lower than that of the poor outcome group (31.4{+-}15.1 years vs 49.6{+-}24.1 years; p<0.05). The GCS ratings were not significantly different (7.1{+-}2.2 vs 5.9{+-}1.5). The CBF of the good outcome group tended to be higher than that of the poor outcome group, but the difference was not statistically significant (43.2{+-}12.8 ml/100 g/min vs 33.6{+-}7.4 ml/100 g/min). The presence of lesions in the thalamus and brain stem on MRI images was correlated with the outcome of the patients, especially in patients with a lesion in their brain stem (p<0.01). Lesions in the corpus callosum were observed in both groups, and their presence was not correlated with patient outcome. We conclude that DAI patients who are older or whose MRI examinations reveal the presence of a lesion in their brain stem may have difficulty leading an independent daily life and that the prognosis of acute-phase DAI patients cannot be

  10. Correlation between transcranial Doppler blood flow parameters and degree of nerve injury, degree of inflammation as well as Hcy metabolism in patients with lacunar infarction

    Institute of Scientific and Technical Information of China (English)

    Li Liang; Jin-Hua Su; Hai-Yan Kou

    2016-01-01

    Objective:To study the correlation between transcranial Doppler blood flow parameters and the degree of nerve injury, the degree of inflammation as well as Hcy metabolism in patients with lacunar infarction.Methods:A total of 88 patients diagnosed with lacunar infarction (LI) in our hospital between May 2013 and December 2015 were selected as LI group and 100 healthy volunteers receiving physical examination during the same period were selected as control group. Transcranial Doppler was used to measure the blood flow parameters of middle cerebral artery and basilar artery, and serum was collected to determine nerve injury molecules, inflammation indexes and Hcy metabolism indexes.Results:Middle cerebral artery MFV and PI as well as basal artery MFV and PI of LI group were significantly higher than those of control group; serum NSE, S100B, UCH-L1, ox-LDL, MMP-9, sCD40L, IL-18 and Hcy content of LI group were significantly higher than those of control group and positively correlated with middle cerebral artery and basilar artery MFV and PI while folic acid and vitamin B12 content were significantly lower than those of control group and negatively correlated with middle cerebral artery and basilar artery MFV and PI.Conclusions:Middle cerebral artery and basilar artery flow is accelerated and the pulsatility is enhanced in patients with lacunar infarction, and the changes of intracranial artery flow parameters are closely related to the degree of nerve injury, the degree of inflammation and Hcy metabolism.

  11. Correlation of in vivo and ex vivo 1H-MRI with histology in two severities of mouse spinal cord injury

    Science.gov (United States)

    Noristani, Harun N.; Lonjon, Nicolas; Cardoso, Maïda; Le Corre, Marine; Chan-Seng, Emilie; Captier, Guillaume; Privat, Alain; Coillot, Christophe; Goze-Bac, Christophe; Perrin, Florence E.

    2015-01-01

    Spinal cord injury (SCI) is a debilitating neuropathology with no effective treatment. Magnetic resonance imaging (MRI) technology is the only method used to assess the impact of an injury on the structure and function of the human spinal cord. Moreover, in pre-clinical SCI research, MRI is a non-invasive method with great translational potential since it provides relevant longitudinal assessment of anatomical and structural alterations induced by an injury. It is only recently that MRI techniques have been effectively used for the follow-up of SCI in rodents. However, the vast majority of these studies have been carried out on rats and when conducted in mice, the contusion injury model was predominantly chosen. Due to the remarkable potential of transgenic mice for studying the pathophysiology of SCI, we examined the use of both in and ex vivo 1H-MRI (9.4 T) in two severities of the mouse SCI (hemisection and over-hemisection) and documented their correlation with histological assessments. We demonstrated that a clear distinction between the two injury severities is possible using in and ex vivo 1H-MRI and that ex vivo MR images closely correlate with histology. Moreover, tissue modifications at a remote location from the lesion epicenter were identified by conventional ex vivo MRI analysis. Therefore, in vivo MRI has the potential to accurately identify in mice the progression of tissue alterations induced by SCI and is successfully implemented by ex vivo MRI examination. This combination of in and ex vivo MRI follow-up associated with histopathological assessment provides a valuable approach for further studies intended to evaluate therapeutic strategies on SCI. PMID:25798092

  12. Correlation between heat shock protein 70 expression in the brain stem and sudden death after experimental traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    ZHAO Lian-xu; XU Xiao-hu; LIU Chao; PAN Su-yue; ZHU Jia-zhen; ZHANG Cheng

    2001-01-01

    Objective: The aim of this study was to determine the patterns of heat-shock protein 70 (HSP70) biosynthesis following traumatic brain injury, and observe the effect of HSP70 induction on the function of the vital center in the brain stem. Methods: Rat models of sudden death resulted form traumatic brain injury were produced, and HSP70 expression in the rat brain stem was determined by immunohistochemistry, the induction of HSP70 mRNA detected by RT-PCR. Results: The level of HSP70 mRNA was prominently elevated in the brain stem as early as 1 5 min following the impact injury, while HSP70 expression was only observed 3 to 6 h after the injury. It was also observed that the levels of HSP70 mRNA but not the protein were elevated in the brain stem of sudden death rats. Conclusion: The synthesis of HSP70 was significantly enhanced in the brain stem following traumatic injury, and the expression of HSP70 is beneficial to eliminate the stress agents, and to sustain the cellular protein homeostasis. When the injury disturbs the synthesis of HSP70 to disarm the protective mechanism of heat-shock proteins, dysfunction of the vital center in the brain stem, and consequently death may occur. Breach in the synchronization of HSP70 mRNA-protein can be indicative of fatal damage to the nerve cells.

  13. Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation

    Institute of Scientific and Technical Information of China (English)

    Mark D Edge; Maarouf Hoteit; Amil P Patel; Xiaoping Wang; Deborah A Baumgarten; Qiang Cai

    2007-01-01

    AIM: To study the patients with main pancreatic duct dilation on computed tomography (CT) and thereby to provide the predictive criteria to identify patients at high risk of significant diseases, such as pancreatic cancer, and to avoid unnecessary work up for patients at low risk of such diseases.METHODS: Patients with dilation of the main pancreatic duct on CT at Emory University Hospital in 2002 were identified by computer search. Clinical course and ultimate diagnosis were obtained in all the identified patients by abstraction of their computer database records.RESULTS: Seventy-seven patients were identified in this study. Chronic pancreatitis and pancreatic cancer were the most common causes of the main pancreatic duct dilation on CT. Although the majority of patients with isolated dilation of the main pancreatic duct (single duct dilation) had chronic pancreatitis, one-third of patients with single duct dilation but without chronic pancreatitis had pancreatic malignancies, whereas most of patients with concomitant biliary duct dilation (double duct dilation) had pancreatic cancer.CONCLUSION: Patients with pancreatic double duct dilation need extensive work up and careful follow up since a majority of these patients are ultimately diagnosed with pancreatic cancer. Patients with single duct dilation, especially such patients without any evidence of chronic pancreatitis, also need careful follow-up since the possibility of pancreatic malignancy, including adenocarcinoma and intraductal papillary mucinous tumors, is still high.

  14. Bile Duct Adenoma with Oncocytic Features

    Directory of Open Access Journals (Sweden)

    E. J. Johannesen

    2014-01-01

    Full Text Available Bile duct adenomas are benign bile duct proliferations usually encountered as an incidental finding. Oncocytic bile duct neoplasms are rare and the majority are malignant. A 61-year-old male with a diagnosis of colorectal adenocarcinoma was undergoing surgery when a small white nodule was discovered on the surface of the right lobe of his liver. This lesion was composed of cytologically bland cells arranged in tightly packed glands. These cells were immunopositive for cytokeratin 7, negative for Hep Par 1, contained mucin, and had a Ki67 proliferation index of 8%. The morphology, immunophenotype, presence of mucin, and normal appearing bile ducts, as well as the increased Ki67 proliferation rate, were consistent with a bile duct adenoma with oxyphilic (oncocytic change. Oncocytic tumors in the liver are rare; the first described in 1992. Only two bile duct adenomas with oncocytic change have been reported and neither of them had reported mucin production or the presence of normal appearing bile ducts within the lesion.

  15. Mirizzi syndrome with an unusual aberrant hepatic duct fistula: a case report

    Directory of Open Access Journals (Sweden)

    Wang M

    2016-07-01

    Full Text Available Meng Wang,1 Yufei Xing,2 Quangen Gao,1 Zhiqiang Lv,1 Jianmao Yuan1 1Department of General Surgery, The First People’s Hospital of Wujiang, Affiliated Wujiang Hospital of Nantong University, 2Digestive Clinical Center, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People’s Republic of China Abstract: Mirizzi syndrome (MS is a rare complication of chronic cholelithiasis, which is always caused by a calculus in the cystic duct or neck of the gallbladder, resulting in mechanical compression of common bile duct and the gallbladder. It is clinically characterized by abdominal pain, fever, as well as obstructive jaundice. During cholecystectomy, MS is seen as a dangerous adherent and inflammatory tissue in the area of Calot’s triangle. In the general population, aberrant right posterior hepatic duct, one of the causes of bile duct injury during duct surgery, is present in 4.8%–8.4% of people. Herein we report a rare case of a 76-year-old female patient, with hepatolithiasis of right posterior lobe and cholecysto-aberrant right posterior hepatic duct fistula. This is a special type of MS; however, interestingly, she did not have any symptoms, and the disease was found by physical examination incidentally. This case highlights another situation, namely, there may be difficulty in diagnosing MS and dissecting for operation. Therefore, to avoid the complication associated with this special situation, the surgeons need to diagnose carefully and adopt an optimal treatment strategy. Keywords: Mirizzi syndrome, aberrant hepatic duct, hepatolithiasis, anatomical hepatectomy

  16. The Human Umbilical Cord: A Novel Substitute for Reconstruction of the Extrahepatic Bile Duct

    Directory of Open Access Journals (Sweden)

    Jiong Lu

    2012-01-01

    Full Text Available Reconstruction of the extrahepatic bile duct following bile duct injury or defect is one of the most common challenges for hepatobiliary surgeons. There are currently a number of surgical strategies such as biliary-enteric anastomosis, end-to-end anastomosis and autologous tissue substitute. However, sphincter of Oddi dysfunction as well as biliary stricture may occur after surgical anastomosis. Also, insufficient tissue quantity remains a problem associated with the application of tissue substitute. Therefore, considerable attention has been attracted to explore a new replacement material of the bile duct for biliary reconstruction. The human umbilical cord (HUC is abundant in resource and is convenient to collect, including two arteries and one vein, whose diameters are close to that of the common bile duct. In order to reduce immunogenicity (foreign-body reaction, cells and major histocompatibility complex (MHC antigens can be removed from the HUC and the remaining tissue (extracellular matrix, ECM can be used as a scaffold. The HUC provides a rich source of mesenchymal stem cells (MSCs. A current study has demonstrated that MSCs are able to differentiate into biliary epithelial cells in vivo and in vitro with low immunogenicity, which can be used as seed cells. The HUC might be a promising composite material of a scaffold (ECM and seed cells (biliary epithelial cells, for bile duct replacement in situ without removal of sphincter of Oddi, or biliary stricture. In addition, the patients’ own umbilical cord without any foreign-body reaction can be directly banked for possible future use in bile duct reconstruction. Therefore, we hypothesise that the HUC may be a novel substitute for reconstruction of the extrahepatic bile duct.

  17. Paraurethral Skene's duct cyst in a newborn

    Science.gov (United States)

    Moralioğlu, Serdar; Bosnalı, Oktav; Celayir, Ayşenur Cerrah; Şahin, Ceyhan

    2013-01-01

    Paraurethral or Skene's duct cysts are rare causes of interlabial masses in neonates. The diagnosis of Skene's duct cysts in the neonatal period is based on its location, in relation to the urethra, and the demonstration of transitional epithelium in the cyst wall. The distinguishing features of paraurethral cysts are the displacement of urethral meatus by the mass and a cyst containing milky fluid. Thus, we report a case of a Skene's duct cyst in a newborn which was treated by incision and drainage. PMID:24049387

  18. Bile duct complications of hepatic arterial infusion chemotherapy evaluated by helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Phongkitkarun, S. [Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: rasih@mahidol.ac.th; Kobayashi, S. [Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Varavithya, V. [Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Huang, X. [Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Curley, S.A. [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Charnsangavej, C. [Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2005-06-01

    AIM: To describe the imaging findings of bile duct complications of hepatic arterial infusion chemotherapy (HAIC) using helical CT, to set diagnostic criteria, to develop a CT grading system, and to correlate these with clinical findings and laboratory data. METHODS: Follow-up helical CT of the abdomen was performed every 3 months for 60 patients receiving HAIC. Three radiologists reviewed all CT studies before and after treatment, using either the picture archiving and communication system or hard copies. The findings of bile duct abnormalities were correlated with findings from other imaging techniques, clinical symptoms and laboratory data. RESULTS: Bile duct abnormalities developed in 34 (57%) of cases either during HAIC or 1 to 12 months after treatment. In 14 (41%) of these 34 patients, enhancement of the hepatic parenchyma along the dilated bile duct or in the segmental or lobar distribution was observed. In 43 cases (72%), normal or abnormal alkaline phosphatase levels were consistent with normal or abnormal CT findings, respectively. Increasing alkaline phosphatase and bilirubin levels were related to CT grade. CONCLUSION: Imaging findings of bile duct complications of HAIC are similar to those of primary sclerosing cholangitis, and correlate well with abnormal clinical and laboratory data. In the presence of such clinical abnormalities, thin-section helical CT with careful review of the imaging studies helps to determine the correct diagnosis, monitor the changes and guide appropriate treatment.

  19. The effects of simultaneous revascularization on the expression of TNF-α during bile duct ischemia-reperfusion injury in rats liver transplantation%双重血流同时开放对大鼠肝移植胆管TNF-α表达的影响

    Institute of Scientific and Technical Information of China (English)

    张毅; 冉艳; 叶启发

    2008-01-01

    目的 探讨门静脉、肝动脉双重血流同时开放对大鼠肝移植胆道缺血/再灌注(I/R)损伤中的TNF-α表达的影响.方法 选用雄性SD大鼠建立大鼠自体原位肝移植模型,随机分为双重血流同时开放组(P组)、门静脉先开放组(N组)和假手术对照组(S组),供肝再灌注后检测血清ALT、AST、GGT、AKP、TBiL及DBiL水平,比色法测定髓过氧化物酶(MPO)含量,RT-PCR法检测胆管组织TNF-α、mRNA表达.结果 肝脏再灌注后6 h及24 h两个时点P组的GGT水平明显低于N组水平(P<0.05);肝脏再灌注后24 h,P组的AKP、TBiL、DBiL水平及胆管损伤病理学评分明显低于N组水平(P<0.05);再灌注后6 h,N组大鼠肝组织的MPO含量明显高于P组(P<0.05);供肝再灌注后2h、6h,P组大鼠肝组织TNF-α mRNA的相对表达水平明显低于N组(P<0.05).结论 门静脉、肝动脉双重血流同时开放,有利于减轻肝移植物胆管组织的I/R损伤;其机制可能与TNF-α表达水平的降低以及中性粒细胞(PMN)浸润的减少有关.%Objective To investigate the effects of simultaneous hepatic artery and portal revaseularization on the expression of TNF-α during bile duet ischemia-reperfusion injury in rats liver transplantation.Methods Male Spragne-Dawley rats were used to establish an autologous orthotopic liver transphmtation model.Model rats were random divided two groups,simultaneous revascularization group(sroup P)and portal vein revascularization group(group N).The animals were separately killed at the 2nd hour,6th hour and 24th hour after reperfusion.Plasma samples were collected for ALT,AST,GGT,AKP,TBiL and DBiL test.Bile duct tissues were collected to detect the histolosical changes,MPO activit,and the expression of TNF-α mRNA.Results The serum levels of GGT in group P was significantly lower than that in group N at the 6th hour and 24th hour after reperfusion(P<0.05).And the serum levels of AKP,TBiL and DBiL and the morphological scores of

  20. Transition duct assembly with modified trailing edge in turbine system

    Energy Technology Data Exchange (ETDEWEB)

    McMahan, Kevin Weston; Schott, Carl Gerard; Ingram, Clint Luigie; Siden, Gunnar Leif; Pierre, Sylvain

    2016-10-04

    Transition duct assemblies for turbine systems and turbomachines are provided. In one embodiment, a transition duct assembly includes a plurality of transition ducts disposed in a generally annular array and comprising a first transition duct and a second transition duct. Each of the plurality of transition ducts includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of each transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct assembly further includes an aerodynamic structure defined by the passages of the first transition duct and the second transition duct. The aerodynamic structure includes a pressure side, a suction side, and a trailing edge, the trailing edge having a modified aerodynamic contour.

  1. Reference values of MRI measurements of the common bile duct and pancreatic duct in children

    Energy Technology Data Exchange (ETDEWEB)

    Gwal, Kriti; Bedoya, Maria A.; Patel, Neal; Darge, Kassa; Anupindi, Sudha A. [University of Pennsylvania Perelman School of Medicine, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Rambhatla, Siri J. [Beth Israel Medical Center, Department of Pediatrics, Newark, NJ (United States); Sreedharan, Ram R. [University of Pennsylvania, Departments of Gastroenterology, Hepatology and Nutrition, The Children' s Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, PA (United States)

    2015-08-15

    Magnetic resonance imaging/cholangiopancreatography (MRI/MRCP) is now an essential imaging modality for the evaluation of biliary and pancreatic pathology in children, but there are no data depicting the normal diameters of the common bile duct (CBD) and pancreatic duct. Recognition of abnormal duct size is important and the increasing use of MRCP necessitates normal MRI measurements. To present normal MRI measurements for the common bile duct and pancreatic duct in children. In this retrospective study we searched all children ages birth to 10 years in our MR urography (MRU) database from 2006 until 2013. We excluded children with a history of hepatobiliary or pancreatic surgery. We stratified 204 children into five age groups and retrospectively measured the CBD and the pancreatic duct on 2-D axial and 3-D coronal T2-weighted sequences. We performed statistical analysis, using logistic and linear regressions to detect the age association of the visibility and size of the duct measurements. We used non-parametric tests to detect gender and imaging plane differences. Our study included 204 children, 106 (52%) boys and 98 (48%) girls, with a median age of 33 months (range 0-119 months). The children were distributed into five age groups. The common bile duct was visible in all children in all age groups. The pancreatic duct was significantly less visible in the youngest children, group 1 (54/67, 80.5%; P = 0.003) than in the oldest children, group 5 (22/22, 100%). In group 2 the pancreatic duct was seen in 19/21 (90.4%), in group 3 52/55 (94.5%), and in group 4 39/39 (100%). All duct measurements increased with age (P < 0.001; r-value > 0.423), and the incremental differences between ages were significant. The measurement variations between the axial and coronal planes were statistically significant (P < 0.001); however these differences were fractions of millimeters. For example, in group 1 the mean coronal measurement of the CBD was 2.1 mm and the axial

  2. Transmission of wave energy in curved ducts

    Science.gov (United States)

    Rostafinski, W.

    1973-01-01

    A formation of wave energy flow was developed for motion in curved ducts. A parametric study over a range of frequencies determined the ability of circular bends to transmit energy for the case of perfectly rigid walls.

  3. Ducted propagation of chorus waves: Cluster observations

    Directory of Open Access Journals (Sweden)

    K. H. Yearby

    2011-09-01

    Full Text Available Ducted propagation of whistler waves in the terrestrial magnetosphere-ionosphere system was discussed and studied long before the first in-situ spacecraft measurements. While a number of implicit examples of the existence of ducted propagation have been found, direct observation of ducts has been hampered by the low sampling rates of measurements of the plasma density. The present paper is based on Cluster observations of chorus waves. The ability to use measurements of the spacecraft potential as a proxy for high time resolution electron density measurements is exploited to identify a number of cases when increased chorus wave power, observed within the radiation belts, is observed simultaneously with density enchantments. It is argued that the observation of ducted propagation of chorus implies modification of numerical models for plasma-wave interactions within the radiation belts.

  4. General Information about Extrahepatic Bile Duct Cancer

    Science.gov (United States)

    ... duct cancer include jaundice and pain in the abdomen. These and other signs and symptoms may be ... Dark urine . Clay colored stool . Pain in the abdomen . Fever . Itchy skin. Nausea and vomiting . Weight loss ...

  5. Treatment Options for Extrahepatic Bile Duct Cancer

    Science.gov (United States)

    ... duct cancer include jaundice and pain in the abdomen. These and other signs and symptoms may be ... Dark urine . Clay colored stool . Pain in the abdomen . Fever . Itchy skin. Nausea and vomiting . Weight loss ...

  6. Stages of Extrahepatic Bile Duct Cancer

    Science.gov (United States)

    ... duct cancer include jaundice and pain in the abdomen. These and other signs and symptoms may be ... Dark urine . Clay colored stool . Pain in the abdomen . Fever . Itchy skin. Nausea and vomiting . Weight loss ...

  7. Treatment Option Overview (Extrahepatic Bile Duct Cancer)

    Science.gov (United States)

    ... duct cancer include jaundice and pain in the abdomen. These and other signs and symptoms may be ... Dark urine . Clay colored stool . Pain in the abdomen . Fever . Itchy skin. Nausea and vomiting . Weight loss ...

  8. Cigarette Smoking Impairs Pancreatic Duct Cell Bicarbonate Secretion

    Science.gov (United States)

    Kadiyala, Vivek; Lee, Linda S; Banks, Peter A; Suleiman, Shadeah; Paulo, Joao A; Wang, Wei; Rosenblum, Jessica; Sainani, Nisha I; Mortele, Koenraad; Conwell, Darwin L

    2015-01-01

    2.4; P=0.033) were all associated with low mean peak PF [HCO3−] (indicating duct cell secretory dysfunction). Multivariate Analysis Smoking (odds ratio, OR: 3.8, 95% CI: 1.6–9.1; P=0.003) and definite chronic pancreatitis imaging (OR: 5.7, 95% CI: 2.2–14.8; P<0.001) were determined to be independent predictors of low peak PF [HCO3−], controlling for age, gender, and alcohol intake. Furthermore there was no interaction between smoking status and alcohol intake in predicting duct cell dysfunction (P=0.571). Conclusion Measurement of pancreatic fluid bicarbonate in smokers reveals that cigarette smoking (past and current) is an independent risk factor for pancreatic duct cell secretory dysfunction (low PF [HCO3−]). Furthermore, the risk of duct cell dysfunction in subjects who smoked was approximately twice the risk (RR: 2.2) in never smokers. Further in depth, translational research approaches to pancreatic fluid analysis may help unravel mechanisms of cigarette smoking induced pancreatic duct cell injury. PMID:23306332

  9. INTERIOR DUCT SYSTEM DESIGN, CONSTRUCTION, AND PERFORMANCE

    Energy Technology Data Exchange (ETDEWEB)

    Janet E.R. Mcllvaine; David Beal; Philip Fairey

    2001-10-10

    By removing air distribution and conditioning equipment from unconditioned spaces, homeowners stand to benefit substantially with respect to both energy savings and indoor air quality. Duct leakage introduces: Greater heating and cooling loads from air at extreme temperatures and humidity levels; Outside air and air from unconditioned spaces that may contain air borne contaminants, combustion gases, pollen, mold spores, and/or particles of building materials; and Higher whole-house infiltration/exfiltration rates. Exemplary studies conducted since 1990 have demonstrated the prevalence of duct leakage throughout the United States and measured energy savings of approximately 20% during both heating and cooling seasons from leakage reduction. These all dealt with duct leakage to and/or from unconditioned spaces. In the building science community, leakage within the conditioned space is generally presumed to eliminate the negative consequences of duct leakage with the exception of possibly creating pressure imbalances in the house which relates to higher infiltration and/or exfiltration. The practical challenges of isolating ducts and air handlers from unconditioned spaces require builders to construct an air-tight environment for the ducts. Florida Solar Energy Center researchers worked with four builders in Texas, North Carolina, and Florida who build a furred-down chase located either in a central hallway or at the edges of rooms as an architectural detail. Some comparison homes with duct systems in attics and crawl spaces were included in the test group of more than 20 homes. Test data reveals that all of the duct/AHU systems built inside the conditioned space had lower duct leakage to unconditioned spaces than their conventional counterparts; however, none of the homes was completely free of duct leakage to unconditioned spaces. Common problems included wiring and plumbing penetrations of the chase, failure to treat the chase as an air tight space, and misguided

  10. Effect of shear on duct wall impedance.

    Science.gov (United States)

    Goldstein, M.; Rice, E.

    1973-01-01

    The solution to the equation governing the propagation of sound in a uniform shear layer is expressed in terms of parabolic cylinder functions. This result is used to develop a closed-form solution for acoustic wall impedance which accounts for both the duct liner and the presence of a boundary layer in the duct. The effective wall impedance can then be used as the boundary condition for the much simpler problem of sound propagation in uniform flow.

  11. Gas Explosions Mitigation by Ducted Venting

    OpenAIRE

    2007-01-01

    The mitigation of effects of gas and dust explosions within industrial equipment is effective if venting the combustion products to safe location. The presence of relief duct is however likely to increase the severity of the explosion with respect to equipment vented to open atmosphere, due to secondary explosions occurring in the initial sections of duct, frictional drag and inertia of the gas column, acoustic and Helmholtz oscillations. The weights of these phenomena on explosion e...

  12. Energy Conservation Through Duct Leakage Reduction

    Science.gov (United States)

    2004-02-26

    Energy Conservation Through Duct Leakage Reduction February 26, 2004 Rich Glatt – Lindab Inc. Report Documentation Page Form ApprovedOMB No. 0704...4. TITLE AND SUBTITLE Energy Conservation Through Duct Leakage Reduction 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...Wall – DW that installs like SW - easiest installing DW system on the market – Eliminates the need for costly flanged connections – SMACNA Leakage

  13. Citrulline as a Biomarker in the Non-human Primate Total- and Partial-body Irradiation Models: Correlation of Circulating Citrulline to Acute and Prolonged Gastrointestinal Injury.

    Science.gov (United States)

    Jones, Jace W; Bennett, Alexander; Carter, Claire L; Tudor, Gregory; Hankey, Kim G; Farese, Ann M; Booth, Catherine; MacVittie, Thomas J; Kane, Maureen A

    2015-11-01

    The use of plasma citrulline as a biomarker for acute and prolonged gastrointestinal injury via exposure to total- and partial-body irradiation (6 MV LINAC-derived photons; 0.80 Gy min) in nonhuman primate models was investigated. The irradiation exposure covered gastrointestinal injuries spanning lethal, mid-lethal, and sub-lethal doses. The acute gastrointestinal injury was assessed via measurement of plasma citrulline and small intestinal histopathology over the first 15 d following radiation exposure and included total-body irradiation at 13.0 Gy, 10.5 Gy, and 7.5 Gy and partial-body irradiation at 11.0 Gy with 5% bone marrow sparing. The dosing schemes of 7.5 Gy total-body irradiation and 11.0 Gy partial-body irradiation included time points out to day 60 and day 180, respectively, which allowed for correlation of plasma citrulline to prolonged gastrointestinal injury and survival. Plasma citrulline values were radiation-dependent for all radiation doses under consideration, with nadir values ranging from 63-80% lower than radiation-naïve NHP plasma. The nadir values were observed at day 5 to 7 post irradiation. Longitudinal plasma citrulline profiles demonstrated prolonged gastrointestinal injury resulting from acute high-dose irradiation had long lasting effects on enterocyte function. Moreover, plasma citrulline did not discriminate between total-body or partial-body irradiation over the first 15 d following irradiation and was not predictive of survival based on the radiation models considered herein.

  14. Amputation neuroma mimics common hepatic duct carcinoma.

    Science.gov (United States)

    Koike, N; Todoroki, T; Kawamoto, T; Inagawa, S; Yoshida, S; Fukao, K

    2000-01-01

    Most amputation neuromas of the biliary tract occur in the cystic duct stump after cholecystectomy and are asymptomatic. However, when they arise in the main hepatic duct and are associated with obstructive jaundice, it is difficult to distinguish them from carcinoma. We describe a case in which preoperative differential diagnosis was difficult. A 60-year-old man was admitted to the Institute of Clinical Medicine, University of Tsukuba, with a chief complaint of jaundice. Cholangiography showed an irregularly elevated nodular lesion on the lateral wall of the common hepatic duct and multiple floating stones in the choledochus. Ultrasonography and computed tomography revealed one-sided regional thickening of the common hepatic duct associated with dilatation of the intrahepatic and extrahepatic bile ducts. Carbohydrate antigen 19-9 level was markedly elevated to 11,200 IU/mL in the bile juice, but was only 38 IU/mL in the serum, below the limit of abnormality. Cholangioscopy showed papillary tumor with coarse granular surface mimicking papillary carcinoma, but biopsy revealed no malignancy. The patient underwent hepaticocholedochus resection. Although the macroscopic finding from the surgical specimens was papillary carcinoma of the common hepatic duct penetrating to the hepatoduodenal ligament, histopathological examination revealed an amputation neuroma consisting of hypertrophic nerve tissues and giant cells containing foreign bodies, probably as a consequence of a previous cholecystectomy. The postoperative course was uneventful and the patient has been living well for the 5 years since the resection.

  15. A Comparison of Simulation Capabilities for Ducts

    Energy Technology Data Exchange (ETDEWEB)

    Miller, William A [ORNL; Smith, Matt K [ORNL; Gu, Lixing [Florida Solar Energy Center (FSEC); New, Joshua Ryan [ORNL

    2014-11-01

    Typically, the cheapest way to install a central air conditioning system in residential buildings is to place the ductwork in the attic. Energy losses due to duct-attic interactions can be great, but current whole-house models are unable to capture the dynamic multi-mode physics of the interactions. The building industry is notoriously fragmented and unable to devote adequate research resources to solve this problem. Builders are going to continue to put ducts in the attic because floor space is too expensive to closet them within living space, and there are both construction and aesthetic issues with other approaches such as dropped ceilings. Thus, there is a substantial need to publicly document duct losses and the cost of energy used by ducts in attics so that practitioners, builders, homeowners and state and federal code officials can make informed decisions leading to changes in new construction and additional retrofit actions. Thus, the goal of this study is to conduct a comparison of AtticSim and EnergyPlus simulation algorithms to identify specific features for potential inclusion in EnergyPlus that would allow higher-fidelity modeling of HVAC operation and duct transport of conditioned air. It is anticipated that the resulting analysis from these simulation tools will inform energy decisions relating to the role of ducts in future building energy codes and standards.

  16. Double common bile duct: A case report

    Institute of Scientific and Technical Information of China (English)

    Srdjan P Djuranovic; Milenko B Ugljesic; Nenad S Mijalkovic; Viktorija A Korneti; Nada V Kovacevic; Tamara M Alempijevic; Slaven V Radulovic; Dragan V Tomic; Milan M Spuran

    2007-01-01

    Double common bile duct (DCBD) is a rare congenital anomaly in which two common bile ducts exist. One usually has normal drainage into the papilla duodeni major and the other usually named accessory common bile duct (ACBD) opens in different parts of upper gastrointestinal tract (stomach, duodenum, ductus pancreaticus or septum). This anomaly is of great importance since it is often associated with biliary lithiasis, choledochal cyst, anomalous pancreaticobiliary junction (APBJ) and upper gastrointestinal tract malignancies. We recently recognized a rare case of DCBD associated with APBJ with lithiasis in better developed common bile duct. The opening site of ACBD was in the pancreatic duct. The anomaly was suspected by transabdominal ultrasonography and finally confirmed by endoscopic retrograde cholangiopancreatography (ERCP) followed by endoscopic sphincterotomy and stone extraction. According to the literature, the existence of DCBD with the opening of ACBD in the pancreatic duct is most frequently associated with APBJ and gallbladder carcinoma. In case of DCBD, the opening site of ACBD is of greatest clinical importance because of its close implications with concomitant pathology. The adequate diagnosis of this rare anomaly is significant since the operative complications may occur in cases with DCBD which is not recognized prior to surgical treatment.

  17. Pharmacological correlation between the formalin test and the neuropathic pain behavior in different species with chronic constriction injury.

    NARCIS (Netherlands)

    Vissers, K.C.P.; Geenen, F.; Biermans, R.; Meert, T.F.

    2006-01-01

    Research on mechanisms of drug action, and preclinical screening of molecules with a potential activity on neuropathic pain requires extensive animal work. The chronic constriction injury model is one of the best-characterized models of neuropathic pain behavior in rats, but requires extensive time

  18. Prevalence, causes, and correlates of traumatic dental injuries among seven-to-twelve-year-old school children in Dera Bassi

    Science.gov (United States)

    Dua, Rohini; Sharma, Sunila

    2012-01-01

    Aim: The paper aims to present a study conducted in Dera Bassi, Mohali, India. The purpose of the study was to ascertain the prevalence of traumatic dental injuries (TDI) in children of age group 7-12 years in private schools in Gulabgarh village. Material & Method: Age & sex distribution, etiological factors, risk factors and cause of injury were the parameters taken into consideration. The data collected was processed and analyzed using the SPSS statistical software program. Results: The overall prevalence of dental trauma was 14.5%, amongst the 880 subjects examined, out of which, 63.2% males and 36.4% females were found to be affected. The maxillary central incisor was found to be most commonly affected tooth (43.8%). The most common cause of injury reported was fall during playing (37.5%). Conclusion: Enamel fracture was most prevalent (50%). No risk factor was significantly higher than others; however children with Angle's class II div 1 malocclusion exhibited greater risk factor for traumatic injuries. PMID:22557895

  19. Unusual scintigraphic appearance of perforation of the common bile duct

    Energy Technology Data Exchange (ETDEWEB)

    Acevedo, M.O.; Tauxe, W.N.; Scott, J.W.; Aldrete, J.S.

    1983-12-01

    This report deals with the diagnosis of perforation of the common bile duct into the lesser sac by HIDA cholescintigraphy. The first hour images after injection were suggestive of biliary obstruction. Subsequent images demonstrated unusual accumulations of the activity into the lesser sac and retroperitoneal potential spaces. Careful correlation between scintigraphic and surgical findings were undertaken. The case is reported to demonstrate the scintigraphic findings in choledochal perforation and to stress the importance of carrying out late images when the initial ones are abnormal.

  20. Mycophenolate mofetil for drug-induced vanishing bile duct syndrome

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Amoxicillin/clavulanate is associated with liver injury,mostly of a cholestatic pattern. While outcomes are usually benign, progression to cirrhosis and death has been reported. The role of immunosuppressive therapy for patients with a protracted course is unclear. We report the case of an elderly patient who developed prolonged cholestasis secondary to amoxicillin/clavulanate. Vanishing bile duct syndrome was confirmed by sequential liver biopsies. The patient responded to prednisone treatment,but could not be weaned off corticosteroids, even when azathioprine was added. Complete withdrawal of both prednisone and azathioprine was possible by using mycophenolate mofetil, an inosine monophosphate dehydrogenase inhibitor. Sustained remission has been maintained for more than 3 years with low-dose mycophenolate mofetil.

  1. Ultrasound appearance of chronic mammary duct ectasia

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-12-15

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

  2. Levels of procoagulant microvesicles are elevated after traumatic injury and platelet microvesicles are negatively correlated with mortality

    Directory of Open Access Journals (Sweden)

    Nicola Curry

    2014-10-01

    Full Text Available Background: Microvesicles (MV have been implicated in the development of thrombotic disease, such as acute respiratory distress syndrome (ARDS and multiple organ failure (MOF. Trauma patients are at increased risk of late thrombotic events, particularly those who receive a major transfusion. The aims of this study were: (a to determine whether there were increased numbers of pro-coagulant MV following injury; (b to determine their cellular origin; and (c to explore the effects of MV with clinical outcomes; in particular red cell transfusion requirements and death. Methods: Trauma patients were recruited at a Level 1 trauma centre. The presence of MV procoagulant phospholipid (PPL was assessed using 2 activity assays (PPL and thrombin generation. Enumeration and MV cellular origin was assessed using 2 colour flow cytometry. Results: Fifty consecutive patients were recruited; median age 38 (IQR: 24–55, median ISS 18 (IQR: 9–27. Circulating procoagulant MV, rich in phospholipid, were significantly elevated following traumatic injury relative to controls and remained elevated at 72 h post-injury. Red cell/AnnV+ and platelet/AnnV+ MV numbers were 6-fold and 2-fold higher than controls, respectively. Patients who died (n=9, 18% had significantly fewer CD41/AnnV+ MV and lower endogenous thrombin potential relative to patients who survived. Conclusions: MV are elevated following traumatic injury and may be implicated in the increased risk of trauma patients to pro-thrombotic states such as MOF and ARDS. Lower levels of procoagulant MV are associated with mortality and further investigation of this association is warranted.

  3. Acute Achilles Paratendinopathy following Major Injury of the Crural Fascia in a Professional Soccer Player: A Possible Correlation?

    Science.gov (United States)

    Mattiussi, Gabriele; Turloni, Michele; Baldassi, Pietro Tobia

    2016-01-01

    Background. The anatomy and mechanical properties of the Crural Fascia (CF), the ubiquitous connective tissue of the posterior region of the leg, have recently been investigated. The most important findings are that (i) the CF may suffer structural damage from indirect trauma, (ii) structural changes of the CF may affect the biomechanics of tissues connected to it, causing myofascial pain syndromes, and (iii) the CF is in anatomical continuity with the Achilles paratenon. Consistent with these points, the authors hypothesize that the onset of acute Achilles paratendinopathy may be related to histological and biomechanical changes of the CF. Case Presentation. A professional male football player suffered an isolated injury of the CF, interposed between the soleus and medial gastrocnemius (an atypical site of injury) with structural connective integrity of the muscles. After participating in the first official match, two and a half months after the trauma, he has unexpectedly demonstrated the clinical picture of acute Achilles paratendinopathy in the previously injured limb. Conclusions. Analysis of this case suggests that the acute Achilles paratendinopathy may be a muscle injury complication from indirect trauma of the calf muscle, if a frank and extensive involvement of the CF were to be ascertained. PMID:27242940

  4. Biliary-colonic fistula caused by cholecystectomy bile duct injury

    Institute of Scientific and Technical Information of China (English)

    Francisco Igor B Macedo; Victor J Casillas; James S Davis; Joe U Levi and Danny Sleeman

    2013-01-01

     Biliary-colonic  fistula  is  a  rare  complication after laparoscopic cholecystectomy. We present a case of post-cholecystectomy  iatrogenic  biliary  injury  that  resulted  in  a fistula  between  the  common  hepatic  duct  and  large  bowel. Magnetic  resonance  cholangiopancreatography  provided good  visualization  of  injury  even  with  concurrent  normal level of alkaline phosphatase. Radiologic findings and surgical management of this condition are discussed in detail.

  5. Intraoperative Ultrasound to Assess for Pancreatic Duct Injuries

    Science.gov (United States)

    2015-04-01

    implants . Surgeon-controlled intra- operative pancreatic ultrasound (US) may overcome these limi- tations. In this article, we describe our use of...performed on the anterior and inferior aspects of the pancreas. Regions of tissue trauma appearing hypodense on US can be assessed for close proximity...assistance with this project. DISCLOSURE The authors declare no conflicts of interest. REFERENCES 1. Subramanian A, Dente CJ, Feliciano DV. The

  6. Transurethral resection of the ejaculatory duct.

    Science.gov (United States)

    Paick, J S

    2000-05-01

    Complete bilateral ejaculatory duct obstruction has long been recognized as an uncommon, treatable form of male infertility. Partial ejaculatory duct obstruction reflects a disturbance of ejaculation where sperm quality is impaired during transit through the distal vas deferens and ejaculatory ducts. With the advent and increased use of high-resolution transrectal ultrasonography, abnormalities of the distal ejaculatory ducts related to infertility have been well documented. Although there are no pathognomonic findings associated with ejaculatory duct obstruction, several clinical findings are highly suggestive. In an infertile man with oligospermia or azoospermia with low ejaculate volume, normal secondary sexual characteristics, testes and hormonal profile and dilated seminal vesicles, midline cyst, or calcification on transrectal ultrasonography, ejaculatory duct obstruction is suggested. Of course, other causes of infertility may be concomitantly present and need to be searched for and treated as well. In selected cases, transurethral resection has resulted in marked improvement in semen parameters and pregnancies have been achieved. As is the case with all surgical procedures, proper patient selection and surgical experience are necessary to obtain optimal results. However, it appears that the treatments currently available for relief of ejaculatory obstruction are not optimally effective. Only approximately one half of treated patients will have an improvement in semen parameters and only about one quarter of treated patients will contribute to a pregnancy. What remains to be determined is how to manage the additional nearly 50% of patients who do not benefit from transurethral resection of ejaculatory obstruction. Based on my experience, I suggest that transrectal ultrasonography should be the first diagnostic procedure used when infertile men are suspected of having ejaculatory duct obstruction; however, vasography should still be considered for a more

  7. Salivary duct carcinoma of the parotid gland

    Directory of Open Access Journals (Sweden)

    Mona Mlika

    2012-01-01

    Full Text Available Salivary duct carcinoma of the parotid gland is an uncommon tumor, highly aggressive. About 200 cases have been reported in the English literature. Pathomorphologically, these tumors showed great similarities to ductal carcinoma of the female breast, which is why they described this tumor as "salivary duct carcinoma." The authors describe a new case of salivary duct carcinoma of the parotid gland. We present the case of a 50-year-old patient with progressive facial paralysis. The MRI examination of the head showed two ill-defined formations. A malignant tumor was strongly suspected, so that a total left parotidectomy with excision of the adjacent facial nerve and left lymph node dissection was performed. Microscopic examination concluded to a salivary duct carcinoma of the left parotid gland negative with Her2/neu antibody with lymph node metastasis. There were no recurrences or metastases within 3 years of follow-up. Salivary duct carcinoma of the parotid gland is a rare tumor with an aggressive behavior. This is due to its propensity to infiltrate distant organs. The diagnosis is based on microscopic examination. Treatment modalities are non-consensual, but some authors advocate the necessity of aggressive approach, especially in tumors negative with Heur2/neu antibody. This is due to the fact that the overexpression of this antigen was reported to be associated with a poor prognosis.

  8. Characterization of flow in a scroll duct

    Science.gov (United States)

    Begg, E. K.; Bennett, J. C.

    1985-01-01

    A quantitative, flow visualization study was made of a partially elliptic cross section, inward curving duct (scroll duct), with an axial outflow through a vaneless annular cutlet. The working fluid was water, with a Re(d) of 40,000 at the inlet to the scroll duct, this Reynolds number being representative of the conditions in an actual gas turbine scroll. Both still and high speed moving pictures of fluorescein dye injected into the flow and illuminated by an argon ion laser were used to document the flow. Strong secondary flow, similar to the secondary flow in a pipe bend, was found in the bottom half of the scroll within the first 180 degs of turning. The pressure field set up by the turning duct was strong enough to affect the inlet flow condition. At 90 degs downstream, the large scale secondary flow was found to be oscillatory in nature. The exit flow was nonuniform in the annular exit. By 270 degs downstream, the flow appeared unorganized with no distinctive secondary flow pattern. Large scale structures from the upstream core region appeared by 90 degs and continued through the duct to reenter at the inlet section.

  9. Numerical simulation of flow past circular duct

    Institute of Scientific and Technical Information of China (English)

    Ze-gao YIN; Xian-wei Cao; Hong-da SHI; Jian MA

    2010-01-01

    The Renormalization Group(RNG)k-ε turbulence model and Volume of Fluid(VOF)method were employed to simulate the flow past a circular duct in order to obtain and analyze hydraulic parameters.According to various upper and bottom gap ratios,the force on the duct was calculated.When the bottom gap ratio is 0,the drag force coefficient,lift force coefficient,and composite force reach their maximum values,and the azimuth reaches its minimum.With an increase of the bottom gap ratio from 0 to 1,the drag force coefficient and composite force decrease sharply,and the lift force coefficient does not decreases so much,but the azimuth increases dramatically.With a continuous increase of the bottom gap ratio from 1 upward,the drag force coefficient,lift force coefficient,composite force,and azimuth vary little.Thus,the bottom gap ratio is the key factor influencing the force on the circular duct.When the bottom gap ratio is less than 1,the upper gap ratio has a remarkable influence on the force of the circular duct.When the bottom gap ratio is greater than 1,the variation of the upper gap ratio has little influence on the force of the circular duct.

  10. Convolution seal for transition duct in turbine system

    Energy Technology Data Exchange (ETDEWEB)

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2015-05-26

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface feature for interfacing with an adjacent transition duct. The turbine system further includes a convolution seal contacting the interface feature to provide a seal between the interface feature and the adjacent transition duct.

  11. FLUID FLOW IN ROTATING HELICAL SQUARE DUCTS

    Institute of Scientific and Technical Information of China (English)

    Chen Hua-jun; Zhang Ben-zhao; Zhang Jin-suo

    2003-01-01

    A numerical study is made for a fully developed laminar flow in rotating helical pipes.Due to the rotation, the Coriolis force can also contribute to the secondary flow.The interaction between rotation, torsion, and curvature complicates the flow characteristics.The effects of rotation and torsion on the flow transitions are studied in details.The results show that there are obvious differences between the flow in rotating ducts and in helical ducts without rotation.Certain hitherto unknown flow patterns are found.The effects of rotation and torsion on the friction factor are also examined.Present results show the characteristics of the fluid flow in rotating helical square ducts.

  12. Acoustic energy in ducts - Further observations

    Science.gov (United States)

    Eversman, W.

    1979-01-01

    The transmission of acoustic energy in uniform ducts carrying uniform flow is investigated with the purpose of clarifying two points of interest. The two commonly used definitions of acoustic 'energy' flux are shown to be related by a Legendre transformation of the Lagrangian density exactly as in deriving the Hamiltonian density in mechanics. In the acoustic case the total energy density and the Hamiltonian density are not the same which accounts for two different 'energy' fluxes. When the duct has acoustically absorptive walls neither of the two flux expressions gives correct results. A reevaluation of the basis of derivation of the energy density and energy flux provides forms which yield consistent results for soft walled ducts.

  13. Xylometazoline hydrochloride nasal spray combined with laser artificial nasolacrimal duct implantation for nasolacrimal duct obstruction

    Directory of Open Access Journals (Sweden)

    Xiao-Zhao Yang

    2017-02-01

    Full Text Available AIM: To study the role of xylometazoline hydrochloride nasal spray in combination therapy of nasolacrimal duct obstruction and to investigate the effect of nasal inflammation on nasolacrimal duct obstruction. METHODS: Totally 279 patients with nasolacrimal duct obstruction were collected, who received lacrimal passage irrigation, CT angiography for lacrimal passage and nasal endoscope before treated by lacrimal laser forming and artificial nasolacrimal duct implantation combined with xylometazoline hydrochloride nasal spray. In group A, 137 patients were treated with antibiotic eye drop and non-steroidal anti-inflammatory drugs after operations. In group B, 142 patients were treated with xylometazoline hydrochloride nasal spray besides the same treatment for group A. RESULTS:In the 279 patients 217(77.8%, in which 105 cases(76.6%were in group A and 112 cases(78.9%were in group B, were suffered with nasal inflammation, including nasal mucosal hyperemia, inferior turbinate hypertrophy, middle turbinate hypertrophy. At 3mo after the ducts were drawn, efficacy of group B was 95.8%, which was significant better than that of group A(86.1%, PCONCLUSION: Nasal inflammation was an important factor in the incidence of nasolacrimal duct obstruction, which shoud pay more attention in the process of diagnosis and treatment. Combination therapy could improve the cure rate of nasolacrimal duct obstruction.

  14. Study on the natural convection heat transfer characteristics in the air duct

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Y. K.; Lee, Y. B.; Choi, S. K.; Hwang, J. S.; Nam, H. Y. [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1997-12-31

    Temperature distribution measurements in the mockup apparatus of reactor vessel were performed to determine the effective thermal conductivity of porous media with different geometry and to obtain the experimental data for the heat transfer processes by natural convection occurring in the air duct. The temperature distributions at four separated sections with different arrangements of porous media have different slopes according to the geometrical configuration. From the measured temperature distribution, effective thermal conductivity have been derived using the least square fitting method. The test at air duct was performed to the high heat removal at 3.4kW/m{sup 2} by the natural convection from the outer wall to the air. And also the temperature distributions in the sir duct agree well with the 1/7th power-law turbulent temperature distribution. The obtained heat transfer data have been compared with the Shin`s and Sieger`s correlations. 10 refs., 6 figs. (Author)

  15. Prevalence, correlates, and prospective predictors of non-suicidal self-injury among New Zealand adolescents: cross-sectional and longitudinal survey data.

    Science.gov (United States)

    Garisch, Jessica Anne; Wilson, Marc Stewart

    2015-01-01

    Non-suicidal self-injury (NSSI) is common among adolescents and linked to many maladaptive outcomes. This study aimed to assess the prevalence and correlates of NSSI among a community sample of New Zealand adolescents. A self-report questionnaire was administered to adolescents at time 1 (N = 1162, mean age = 16.35), and approximately five months later (time 2, N = 830, mean age = 16.49). Prevalence and bivariate correlations were assessed at both time points, and cross-lag correlations using matched data (N = 495, mean age = 16.23). Lifetime history of NSSI was 48.7 % (females 49.4 %, males 48 %). Consistent with previous international research, NSSI was associated with higher Alexithymia, depression, anxiety, bullying, impulsivity, substance abuse, abuse history and sexuality concerns and lower mindfulness, resilience and self-esteem. Cross-lag correlations suggested NSSI is directly (perhaps causally) related to psychological vulnerability in various domains (e.g., increased depression and lower self-esteem), while bullying may be more distal to NSSI, rather than a proximal predictor.

  16. Nonlinear acoustic propagation in rectangular ducts

    Science.gov (United States)

    Nayfeh, A. H.; Tsai, M.-S.

    1974-01-01

    The method of multiple scales is used to obtain a second-order uniformly valid expansion for nonlinear acoustic wave propagation in a rectangular duct whose walls are treated with a nonlinear acoustic material. The wave propagation in the duct is characterized by the unsteady nonlinear Euler equations. The results show that nonlinear materials attenuate sound more than linear materials except at high acoustic frequencies. The nonlinear materials produce higher and combination tones which have higher attenuation rates than the fundamentals. Moreover, the attenuation rates of the fundamentals increase with increasing amplitude.

  17. Inverse potential scattering in duct acoustics.

    Science.gov (United States)

    Forbes, Barbara J; Pike, E Roy; Sharp, David B; Aktosun, Tuncay

    2006-01-01

    The inverse problem of the noninvasive measurement of the shape of an acoustical duct in which one-dimensional wave propagation can be assumed is examined within the theoretical framework of the governing Klein-Gordon equation. Previous deterministic methods developed over the last 40 years have all required direct measurement of the reflectance or input impedance but now, by application of the methods of inverse quantum scattering to the acoustical system, it is shown that the reflectance can be algorithmically derived from the radiated wave. The potential and area functions of the duct can subsequently be reconstructed. The results are discussed with particular reference to acoustic pulse reflectometry.

  18. Preconditioning the Helmholtz Equation for Rigid Ducts

    Science.gov (United States)

    Baumeister, Kenneth J.; Kreider, Kevin L.

    1998-01-01

    An innovative hyperbolic preconditioning technique is developed for the numerical solution of the Helmholtz equation which governs acoustic propagation in ducts. Two pseudo-time parameters are used to produce an explicit iterative finite difference scheme. This scheme eliminates the large matrix storage requirements normally associated with numerical solutions to the Helmholtz equation. The solution procedure is very fast when compared to other transient and steady methods. Optimization and an error analysis of the preconditioning factors are present. For validation, the method is applied to sound propagation in a 2D semi-infinite hard wall duct.

  19. Flow Investigation inside A Curved Square Duct

    Directory of Open Access Journals (Sweden)

    Dipyaman Gangopadhyay

    2017-05-01

    Full Text Available This paper presents the results of an experimental work with measurement of wall static pressure of 90°C shaped Curved duct. The test duct is made up of transparent perspex sheets to facilitate the flow visualization study. The duct has an inlet to exit area ratio of 1.0 with centerline distance of 750 mm. The inlet aspect ratio of the test duct has been fixed at 1.0. The velocities for the proposed investigations are to be measured by using a Pitot tube.Wall pressures are measured with the help of an inclinedmanometer with the inclination of 35°. The manometer had two tubes emanating from it: one left open to the atmosphere and the other connected to the steel pipes attached to the four walls of the curved duct. The difference in the readings helped us calculate the static pressure and thereby the normalized pressure. Wall pressure distribution along the curved and parallel walls of the duct at 0°, 22.5°, 45°, 67.5° and 90° measuring sections was measured. All the experimental data has been processed by an Intel i3 CPU, 3 GB RAM PC and analyzed to give the distribution of static pressure in the square duct.The main purpose of this investigation is to show the development of secondary flow which happens when the flow takes place through the bend in the curvature. This secondary flow arises as a result of a centrifugal force acting when the flow moves through the bend. The investigation is carried out at three different velocities 20 m/s, 40 m/s and 60 m/s. The distribution of normalized pressure which is the ratio of static pressure to the dynamic pressure is mapped and shown in the form of contours by using the software package SURFER.The trend of wall static pressure development on the walls of C shaped duct shows that as the flow proceeds towards the curvature, there exists a high pressure gradient between the outside face and inside face due the centrifugal force acting along the curvature. This shows the bulk shifting of flow towards

  20. Functional resting-state fMRI connectivity correlates with serum levels of the S100B protein in the acute phase of traumatic brain injury

    Directory of Open Access Journals (Sweden)

    William Hedley Thompson

    2016-01-01

    Full Text Available The S100B protein is an intra-cellular calcium-binding protein that mainly resides in astrocytes in the central nervous system. The serum level of S100B is used as biomarker for the severity of brain damage in traumatic brain injury (TBI patients. In this study we investigated the relationship between intrinsic resting-state brain connectivity, measured 1–22 days (mean 8 days after trauma, and serum levels of S100B in a patient cohort with mild-to-severe TBI in need of neuro-intensive care in the acute phase. In line with previous investigations, our results show that the peak level of S100B acquired during the acute phase of TBI was negatively correlated with behavioral measures (Glasgow Outcome Score, GOS of functional outcome assessed 6 to 12 months post injury. Using a multi-variate pattern analysis-informed seed-based correlation analysis, we show that the strength of resting-state brain connectivity in multiple resting-state networks was negatively correlated with the peak of serum levels of S100B. A negative correspondence between S100B peak levels recorded 12–36 h after trauma and intrinsic connectivity was found for brain regions located in the default mode, fronto-parietal, visual and motor resting-state networks. Our results suggest that resting-state brain connectivity measures acquired during the acute phase of TBI is concordant with results obtained from molecular biomarkers and that it may hold a capacity to predict long-term cognitive outcome in TBI patients.

  1. What Should You Ask Your Doctor about Bile Duct Cancer?

    Science.gov (United States)

    ... support? Along with these sample questions, be sure to write down some of your own. For instance, you ... Diagnosed? How is Bile Duct Cancer Staged? Survival Statistics for Bile Duct Cancers Resectable Versus Unresectable Bile ...

  2. Higher order mode propagation in nonuniform circular ducts

    Science.gov (United States)

    Cho, Y. C.; Ingard, K. U.

    1980-01-01

    This paper presents an analytical investigation of higher order mode propagation in a nonuniform circular duct without mean flow. An approximate wave equation is derived on the assumptions that the duct cross section varies slowly and that mode conversion is negligible. Exact closed form solutions are obtained for a particular class of converging-diverging circular duct which is here referred to as 'circular cosh duct'. Numerical results are presentd in terms of the transmission loss for the various duct shapes and frequencies. The results are applicable to studies of multimodal propagation as well as single mode propagation. The results are also applicable to studies of sound radiation from certain types of contoured inlet ducts, or of sound propagation in a converging-diverging duct of somewhat different shape from a cosh duct.

  3. Is spontaneous closure of a patent arterial duct common?

    Science.gov (United States)

    Hoffman, Julien I E

    2017-01-01

    As closing a patent arterial duct is relatively simple, safe, and successful, most children with a patent arterial duct have it closed soon after diagnosis. The larger ducts are closed to prevent congestive heart failure, pulmonary vascular disease, or aneurysmal dilatation of the ductus, and smaller ducts are closed to prevent infective endocarditis. Consequently, there is no opportunity to determine whether spontaneous closure or diminution in size of the patent arterial duct is common. If the duct does become smaller, flow through it may be so low that no murmur is produced - the silent ductus. The frequency and best management of the silent patent arterial duct are unknown, and we do not know whether these tiny ducts are the last stage before spontaneous closure.

  4. Correlations between diffusion tensor imaging and levels of consciousness in patients with traumatic brain injury: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Jie; Wei, Rui-Li; Peng, Guo-Ping; Zhou, Jia-Jia; Wu, Min; He, Fang-Ping; Pan, Gang; Gao, Jian; Luo, Ben-Yan

    2017-06-05

    Traumatic brain injury (TBI) often leads to impaired consciousness. Recent diffusion tensor imaging studies associated consciousness with imaging metrics including fractional anisotropy (FA) and apparent diffusion coefficient (ADC). We evaluated their correlations and determined the best index in candidate regions. Six databases were searched, including PubMed and Embase, and 16 studies with 701 participants were included. Data from region-of-interest and whole-brain analysis methods were meta-analysed separately. The FA-consciousness correlation was marginal in the whole-brain white matter (r = 0.63, 95% CI [0.47, 0.79], p = 0.000) and the corpus callosum (CC) (r = 0.60, 95% CI [0.48, 0.71], p = 0.000), and moderate in the internal capsule (r = 0.48, 95% CI [0.24, 0.72], p = 0.000). Correlations with ADC trended negative and lacked significance. Further subgroup analysis revealed that consciousness levels correlated strongly with FA in the CC body (r = 0.66, 95% CI [0.43, 0.89]), moderately in the splenium (r = 0.58, 95% CI [0.38, 0.78]), but insignificantly in the genu. In conclusion, FA correlates better with consciousness levels than ADC in TBI. The degree of correlation varies among brain regions. The CC (especially its splenium and body) is a reliable candidate region to quantitatively reflect consciousness levels.

  5. Independent spinal cord atrophy measures correlate to motor and sensory deficits in individuals with spinal cord injury

    DEFF Research Database (Denmark)

    Lundell, Hans Magnus Henrik; Barthelemy, Dorothy; Skimminge, A.;

    2011-01-01

    to sensory and motor outcome in individuals with chronic incomplete spinal cord injury (SCI).Setting:Danish study on human SCI.Methods:We included 19 individuals with chronic incomplete SCI and 16 healthy controls. Participants underwent MRI and a neurological examination including sensory testing for light......Study design:Cross-sectional descriptive analysis of magnetic resonance imaging (MRI) and clinical outcome.Objectives:The aim of this study was to present anatomically consistent and independent spinal cord atrophy measures based on standard MRI material and analyze their specific relations...... touch and pinprick, and muscle strength. Antero-posterior width (APW), left-right width (LRW) and cross-sectional spinal cord area (SCA) were extracted from MRI at the spinal level of C2. The angular variation of the spinal cord radius over the full circle was also extracted and compared...

  6. Algebraically growing waves in ducts with sheared mean flow

    Science.gov (United States)

    Nayfeh, A. H.; Telionis, D. P.

    1974-01-01

    Analysis of the behavior of standing and traveling acoustic waves in a smooth duct with a fluid flow having a sheared mean velocity profile, when the waves grow algebraically as they travel along the duct axis. It is shown that standing waves growing algebraically with the axial distance cannot exist in a smooth duct when the duct wall have a finite resistance. The existence of traveling waves subject to the same law of growth is also dismissed under realistic flow conditions.

  7. Correlation of mid-pregnancy uterine artery notch with preeclampsia incidence risk as well as serum endothelial injury and placental hypoperfusion

    Institute of Scientific and Technical Information of China (English)

    Xue-Jing Guo; Xin Ni; Ying Huang; Hang Gu

    2016-01-01

    Objective:To study the correlation of mid-pregnancy uterine artery notch with preeclampsia incidence risk as well as serum endothelial injury and placental hypoperfusion.Methods:A total of 2 800 cases of singleton primiparas who received antenatal examination in Maternal and Child Health Hospital of Pudong New Area Shanghai between April 2014 and October 2015 were selected for prospective study and divided into notch group and non-notch group according to the uterine artery notch at 22-24 weeks of gestation, serum was collected at 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation respectively to determine endothelial injury indexes VEGF, PLGF, sFlt-1 and sEng in serum, ultrasonography was conducted to determine uterine spiral arterial resistance index (RI) and pulsatility index (PI), and the levels of apoptosis molecules in placenta tissue were determined after delivery.Results: Preeclampsia incidence rate of notch group was significantly higher than that of non-notch group; at 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation, serum VEGF and PLGF levels of notch group were significantly lower than those of non-notch group, sFlt-1 and sEng levels were significantly higher than those of non-notch group, and uterine spiral artery PI and RI were significantly higher than those of non-notch group; after delivery, p57kip2, Bax, Caspase-3, Fas and FasL levels in placenta tissue of notch group were significantly higher than those of non-notch group.Conclusion: The risk of preeclampsia is high in pregnant women with mid-pregnancy (22-24 weeks of gestation) uterine artery notch and it will cause maternal endothelial injury, spiral artery remodeling dysfunction and placental hypoperfusion.

  8. Persistent Mullerian Duct Syndrome (PMDS With Large Intraabdominal Seminoma

    Directory of Open Access Journals (Sweden)

    Della Harigovind

    2017-07-01

    Full Text Available Persistent Mullerian Duct Syndrome, a form of male pseudohermaphroditism is characterized by the presence of the Mullerian duct derivatives in an otherwise phenotypically as well as genotypically normal male. We report a case of large intra abdominal seminoma in a male patient with cryptorchidism, along with persistence of Mullerian duct derivatives (uterus.

  9. A case of fascioliasis in common bile duct

    Energy Technology Data Exchange (ETDEWEB)

    Ham, Soo Youn; Park, Cheol Min; Chung, Kyu Byung; Lee, Chang Hong; Park, Seung Chul; Choi, Sang Yong; Lim, Han Jong [Korea University College of Medicine, Seoul (Korea, Republic of)

    1989-10-15

    A case of Fascioliasis of common bile duct is confirmed by visualization of adult fluke. Fascioliasis caused by Fasciola hepatica, is common parasitic disease in cattle and sheep. Human is an accidental host. ERCP demonstrated irregular linear conglomerated filling defects in common bile duct. Through surgical intervention, we found adult flukes of F. hepatica and adenomatous hyperplasia of common bile duct.

  10. Traumatic resin ducts in Larix decidua stems impacted by debris flows.

    Science.gov (United States)

    Bollschweiler, Michelle; Stoffel, Markus; Schneuwly, Dominique M; Bourqui, Karin

    2008-02-01

    Following mechanical injury, stems of many conifers produce tangential rows of traumatic resin ducts (TRDs), the distribution of which has been used to date geomorphic events. However, little is known about how far TRD formation extends tangentially and axially from the point of injury or what the time course of TRD appearance is. We analyzed 28 injuries in eight Larix decidua Mill. tree stems resulting from debris flows in October 2000 and November 2004. Injuries occurred outside the period of cambial activity, and TRD formation occurred in the first layers of the growth ring formed in the year following that of injury. The axial extent of TRD formation averaged 74 cm and was greater above the injury than below it. At the height of the wound center, TRDs extended horizontally to a mean of 18% of the stem circumference excluding that portion where the cambium had been destroyed. In subsequent growth rings, TRDs, if present, were confined mainly to the height of the center of injury. Both the vertical and horizontal extent of TRD formation was related to the injury size. Within growth rings, the position of TRD formation changed with increasing distance from the wound progressing from early earlywood to later portions of the growth ring.

  11. Surgical treatment of congenital biliary duct cyst

    Directory of Open Access Journals (Sweden)

    Wang De-chun

    2012-03-01

    Full Text Available Abstract Background It is acknowledged that total cyst excision is a safe and ideal surgical treatment for congenital biliary duct cyst, compared to simple internal drainage. The aim of this study was to determine the optimal operation occasion and the effect of laparoscopy on congenital biliary duct cyst based upon total cyst excision. Methods From January 2002 to January 2011, 217 patients were admitted to Southwest Hospital for congenital biliary duct cyst. To determine the optimal surgery occasion, we divided these subjects into three groups, the infant group (age ≤ 3 years, the immaturity group (3 18 years, and then evaluated the feasibility, risk and long-term outcome after surgery in the three groups. To analyze the effect of laparoscopic technique on congenital biliary duct cyst, we divided the patients into the laparoscopy and the open surgery groups. Results Among the three groups, the morbidity from cholangiolithiasis before surgical treatment had obvious discrepancy (p 0.05. Similarly, no significant discrepancy was observed in the morbidity from postoperative complications or long-term postoperative complications (p > 0.05 between the laparoscopic and the open surgery groups. Conclusions We conclude that total cyst excision should be performed as early as possible. The optimal treatment occasion is the infant period, and laparoscopic resection may be a new safe and feasible minimally invasive surgery for this disease.

  12. Idea Bank: Duct Tape Note Twister

    Science.gov (United States)

    McHenry, Molly

    2008-01-01

    In this article, the author relates how she observed a middle school math teacher deliver a miserable class. She realized that she did the same thing to her music students. To engage her students, she developed "Note Twister," a music reading game using duct tape to form musical notes and the basic premise behind the game, "Twister." She finds…

  13. IDUS for Biliary and Pancreatic Duct Lesions

    Institute of Scientific and Technical Information of China (English)

    Takao ltoi

    2008-01-01

    @@ In the recent decade, wire-guided intraductal US(IDUS), which can be passed through the working channel of standard duodenoscopes to provide high-frequency ultrasound images, has been developed as a newly diagnostic tool for biliary and pancreatic duct lesions.

  14. Calcium influx pathways in rat pancreatic ducts

    DEFF Research Database (Denmark)

    Hug, M J; Pahl, C; Novak, I

    1996-01-01

    A number of agonists increase intracellular Ca2+ activity, [Ca2+]i, in pancreatic ducts, but the influx/efflux pathways and intracellular Ca2+ stores in this epithelium are unknown. The aim of the present study was to characterise the Ca2+ influx pathways, especially their pH sensitivity, in nati...

  15. Laser Beam Duct Pressure Controller System.

    Science.gov (United States)

    the axial flow of a conditioning gas within the laser beam duct, by matching the time rate of change of the pressure of the flowing conditioning gas...to the time rate of change of the pressure in the cavity of an operably associated laser beam turret.

  16. Familial occurrence of congenital bile duct dilatation

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Congenital bile duct dilatation (CBD) that developed in a parent and son is presented.Familial occurrence of CBD is rare,with only a few male cases having been reported.Since the initial report of CBD occurring in siblings in 1981,a total of 20 cases (10 pairs) have been published as of 2007.Clinical and genetic features of CBD are discussed.

  17. Harnessing pain heterogeneity and RNA transcriptome to identify blood-based pain biomarkers: a novel correlational study design and bioinformatics approach in a graded chronic constriction injury model.

    Science.gov (United States)

    Grace, Peter M; Hurley, Daniel; Barratt, Daniel T; Tsykin, Anna; Watkins, Linda R; Rolan, Paul E; Hutchinson, Mark R

    2012-09-01

    A quantitative, peripherally accessible biomarker for neuropathic pain has great potential to improve clinical outcomes. Based on the premise that peripheral and central immunity contribute to neuropathic pain mechanisms, we hypothesized that biomarkers could be identified from the whole blood of adult male rats, by integrating graded chronic constriction injury (CCI), ipsilateral lumbar dorsal quadrant (iLDQ) and whole blood transcriptomes, and pathway analysis with pain behavior. Correlational bioinformatics identified a range of putative biomarker genes for allodynia intensity, many encoding for proteins with a recognized role in immune/nociceptive mechanisms. A selection of these genes was validated in a separate replication study. Pathway analysis of the iLDQ transcriptome identified Fcγ and Fcε signaling pathways, among others. This study is the first to employ the whole blood transcriptome to identify pain biomarker panels. The novel correlational bioinformatics, developed here, selected such putative biomarkers based on a correlation with pain behavior and formation of signaling pathways with iLDQ genes. Future studies may demonstrate the predictive ability of these biomarker genes across other models and additional variables. © 2012 The Authors. Journal of Neurochemistry © 2012 International Society for Neurochemistry.

  18. Harnessing pain heterogeneity and RNA transcriptome to identify blood–based pain biomarkers: a novel correlational study design and bioinformatics approach in a graded chronic constriction injury model

    Science.gov (United States)

    Grace, Peter M.; Hurley, Daniel; Barratt, Daniel T.; Tsykin, Anna; Watkins, Linda R.; Rolan, Paul E.; Hutchinson, Mark R.

    2017-01-01

    A quantitative, peripherally accessible biomarker for neuropathic pain has great potential to improve clinical outcomes. Based on the premise that peripheral and central immunity contribute to neuropathic pain mechanisms, we hypothesized that biomarkers could be identified from the whole blood of adult male rats, by integrating graded chronic constriction injury (CCI), ipsilateral lumbar dorsal quadrant (iLDQ) and whole blood transcriptomes, and pathway analysis with pain behavior. Correlational bioinformatics identified a range of putative biomarker genes for allodynia intensity, many encoding for proteins with a recognized role in immune/nociceptive mechanisms. A selection of these genes was validated in a separate replication study. Pathway analysis of the iLDQ transcriptome identified Fcγ and Fcε signaling pathways, among others. This study is the first to employ the whole blood transcriptome to identify pain biomarker panels. The novel correlational bioinformatics, developed here, selected such putative biomarkers based on a correlation with pain behavior and formation of signaling pathways with iLDQ genes. Future studies may demonstrate the predictive ability of these biomarker genes across other models and additional variables. PMID:22697386

  19. Heat Transfer in a Superelliptic Transition Duct

    Science.gov (United States)

    Poinsatte, Philip; Thurman, Douglas; Hippensteele, Steven

    2008-01-01

    Local heat transfer measurements were experimentally mapped using a transient liquid-crystal heat transfer technique on the surface of a circular-to-rectangular transition duct. The transition duct had a length-to-diameter ratio of 1.5 and an exit-plane aspect ratio of 3. The crosssectional geometry was defined by the equation of a superellipse. The cross-sectional area was the same at the inlet and exit but varied up to 15 percent higher through the transition. The duct was preheated to a uniform temperature (nominally 64 C) before allowing room temperature air to be suddenly drawn through it. As the surface cooled, the resulting isothermal contours on the duct surface were revealed using a surface coating of thermochromic liquid crystals that display distinctive colors at particular temperatures. A video record was made of the surface temperature and time data for all points on the duct surfaces during each test. Using this surface temperature-time data together with the temperature of the air flowing through the model and the initial temperature of the model wall, the heat transfer coefficient was calculated by employing the classic one-dimensional, semi-infinite wall heat transfer conduction model. Test results are reported for inlet diameter-based Reynolds numbers ranging from 0.4x106 to 2.4x106 and two grid-generated freestream turbulence intensities of about 1 percent, which is typical of wind tunnels, and up to 16 percent, which may be more typical of real engine conditions.

  20. Computational Fluid Dynamics Analysis of Flexible Duct Junction Box Design

    Energy Technology Data Exchange (ETDEWEB)

    Beach, R.; Prahl, D.; Lange, R.

    2013-12-01

    IBACOS explored the relationships between pressure and physical configurations of flexible duct junction boxes by using computational fluid dynamics (CFD) simulations to predict individual box parameters and total system pressure, thereby ensuring improved HVAC performance. Current Air Conditioning Contractors of America (ACCA) guidance (Group 11, Appendix 3, ACCA Manual D, Rutkowski 2009) allows for unconstrained variation in the number of takeoffs, box sizes, and takeoff locations. The only variables currently used in selecting an equivalent length (EL) are velocity of air in the duct and friction rate, given the first takeoff is located at least twice its diameter away from the inlet. This condition does not account for other factors impacting pressure loss across these types of fittings. For each simulation, the IBACOS team converted pressure loss within a box to an EL to compare variation in ACCA Manual D guidance to the simulated variation. IBACOS chose cases to represent flows reasonably correlating to flows typically encountered in the field and analyzed differences in total pressure due to increases in number and location of takeoffs, box dimensions, and velocity of air, and whether an entrance fitting is included. The team also calculated additional balancing losses for all cases due to discrepancies between intended outlet flows and natural flow splits created by the fitting. In certain asymmetrical cases, the balancing losses were significantly higher than symmetrical cases where the natural splits were close to the targets. Thus, IBACOS has shown additional design constraints that can ensure better system performance.

  1. Prevalence, distribution, and differential diagnosis of nasopalatine duct cysts

    Science.gov (United States)

    CECCHETTI, F.; OTTRIA, L.; BARTULI, F.; BRAMANTI, N. E.; ARCURI, C.

    2012-01-01

    SUMMARY Introduction. Nasopalatine duct cysts (NPDCs) are the most common developmental epithelial non-odontogenic cysts of the maxillae. Their origin, however, is still a source of considerable debate. Aims. The aim of this investigation is to describe and discuss the etiology, differential diagnosis, clinic-pathological characteristics as well as to report the relative frequency and distribution of nasopalatine duct cysts in population (NPDCs) with a literature’s review on the topic. Methods The retrospective study was carried out using 36 clinical cases, with histopatological confirmation for NPDC, radiographs and oral photographs. Data included age and gender of the patient, radiographic findings, etiological factors, treatment, and prognosis of NPDC. Few surgical consideration are discussed. Results The study results report a clear male predilection with a 3:1 ratio. No statistically significant correlation was observed between the size of the lesion and patient’s gender. Lesions were usually asymptomatic. All cysts were located in the anterior maxillary midline region. Panoramic X-rays and computed tomography was used to identify the lesion. Surgical treatment was performed under local anesthesia including the dissection and removal of the cyst, adopting a usually palatine approach, with an enveloping flap from 1.4 to 2.4. Conclusions The etiology of NPDC is unclear and a male predilection was observed. Simple surgical resection is recommended, followed by clinical and radiological control to ensure correct resolution of the case. PMID:23285406

  2. Educational Review of Predictive Value and Findings of Computed Tomography Scan in Diagnosing Bowel and Mesenteric Injuries After Blunt Trauma: Correlation With Trauma Surgery Findings in 163 Patients.

    Science.gov (United States)

    Cinquantini, Francesco; Tugnoli, Gregorio; Piccinini, Alice; Coniglio, Carlo; Mannone, Sergio; Biscardi, Andrea; Gordini, Giovanni; Di Saverio, Salomone

    2017-08-01

    Laparotomy can detect bowel and mesenteric injuries in 1.2%-5% of patients following blunt abdominal trauma. Delayed diagnosis in such cases is strongly related to increased risk of ongoing sepsis, with subsequent higher morbidity and mortality. Computed tomography (CT) scanning is the gold standard in the evaluation of blunt abdominal trauma, being accurate in the diagnosis of bowel and mesenteric injuries in case of hemodynamically stable trauma patients. Aims of the present study are to 1) review the correlation between CT signs and intraoperative findings in case of bowel and mesenteric injuries following blunt abdominal trauma, analysing the correlation between radiological features and intraoperative findings from our experience on 25 trauma patients with small bowel and mesenteric injuries (SBMI); 2) identify the diagnostic specificity of those signs found at CT with practical considerations on the following clinical management; and 3) distinguish the bowel and mesenteric injuries requiring immediate surgical intervention from those amenable to initial nonoperative management. Between January 1, 2008, and May 31, 2010, 163 patients required laparotomy following blunt abdominal trauma. Among them, 25 patients presented bowel or mesenteric injuries. Data were analysed retrospectively, correlating operative surgical reports with the preoperative CT findings. We are presenting a pictorial review of significant and frequent findings of bowel and mesenteric lesions at CT scan, confirmed intraoperatively at laparotomy. Moreover, the predictive value of CT scan for SBMI is assessed. Multidetector CT scan is the gold standard in the assessment of intra-abdominal blunt abdominal trauma for not only parenchymal organs injuries but also detecting SBMI; in the presence of specific signs it provides an accurate assessment of hollow viscus injuries, helping the trauma surgeons to choose the correct initial clinical management. Copyright © 2016 Canadian Association of

  3. Non-suicidal self-injury and firesetting: shared and unique correlates among school-based adolescents.

    Science.gov (United States)

    Tanner, Alicia K; Hasking, Penelope; Martin, Graham

    2015-04-01

    Distinct behaviors such as non-suicidal self-injury (NSSI) and firesetting may represent functionally equivalent attempts to regulate difficult affective/cognitive or social experiences during adolescence. This study examined possible mechanisms leading to NSSI, as opposed to firesetting, as well as co-occurrence of these behaviors. Participants aged 12-18 years (N = 2,356; 67.5 % female) completed self-report questionnaires measuring NSSI and firesetting, as well as socio-demographic and psychosocial factors including personality traits related to impulsivity and anxiety, negative life events, emotion regulation, and coping. The findings indicated the presence of general risk factors (e.g., negative life events and poor coping) that increase the likelihood that adolescents will engage in any of a range of maladaptive behaviors. The probability of at-risk adolescents engaging in NSSI was increased by psychological states (i.e., rumination and poor self-esteem), whereas socio-demographic and personality traits were associated with firesetting. Implications for prevention and early intervention initiatives are discussed.

  4. Low T3 State Is Correlated with Cardiac Mitochondrial Impairments after Ischemia Reperfusion Injury: Evidence from a Proteomic Approach

    Directory of Open Access Journals (Sweden)

    Francesca Forini

    2015-11-01

    Full Text Available Mitochondria are major determinants of cell fate in ischemia/reperfusion injury (IR and common effectors of cardio-protective strategies in cardiac ischemic disease. Thyroid hormone homeostasis critically affects mitochondrial function and energy production. Since a low T3 state (LT3S is frequently observed in the post infarction setting, the study was aimed to investigate the relationship between 72 h post IR T3 levels and both the cardiac function and the mitochondrial proteome in a rat model of IR. The low T3 group exhibits the most compromised cardiac performance along with the worst mitochondrial activity. Accordingly, our results show a different remodeling of the mitochondrial proteome in the presence or absence of a LT3S, with alterations in groups of proteins that play a key role in energy metabolism, quality control and regulation of cell death pathways. Overall, our findings highlight a relationship between LT3S in the early post IR and poor cardiac and mitochondrial outcomes, and suggest a potential implication of thyroid hormone in the cardio-protection and tissue remodeling in ischemic disease.

  5. Repair and reconstruction of common bile duct by poly(lactide stent

    Directory of Open Access Journals (Sweden)

    Xiaoyi Xu

    2010-01-01

    Full Text Available To investigate the effect of repair of bioabsorbable poly(lactide (PLA biliary stent in common bile duct (CBD transection injury in canine prior to the clinical application. Circular tubing CBD stent was prepared by melt extraction technique using PLA. A transection incision was made on CBD of the normal canine, and then closed the incision with laser welding followed the implantation of PLA tubular stent into it. The stent was obtained to determine degradation of PLA in vivo at postoperative week 1, 4, and 12, respectively. The changes of outer diameter and burst pressure of CBD were investigated. Furthermore, serum liver enzyme values and CBD histopathological analysis were examined in the animals. The results noted that the polymer stent exhibited the same biomedical functions as T tubes and no significant tissue response. Therefore, biodegradable PLA stent matches the requirements in repair and reconstruction of CBD to support the duct, guide bile drainage and reduce T-tube-related complications.

  6. Immunohistochemical study on effects of [sup 60]Co [gamma] irradiation on salivary gland ducts of rat

    Energy Technology Data Exchange (ETDEWEB)

    Saitoh, Kazuhiko (Meikai Univ., Sakato, Saitama (Japan). School of Dentistry)

    1992-09-01

    Cytokeratin distribution in salivary glands was detected by use of polyclonal antikeratin antiserum (TK) and monoclonal antibodies (KL 1, RGE 53, and RPN 1164). The salivary glands of male rats received either 17.82 Gy or 27.97 Gy [sup 60]Co [gamma] irradiation in a single exposure and were then compared immunohistochemically with those of normal rats. Polyclonal anti-keratin antiserum (TK), which reacts with 41-65 KD keratins, stained almost all ducts in normal glands. RPN 1164 (no. 8 keratin) staining was negative in intercalated ducts of normal parotid and submandibular glands, but strongly positive in both striated and excretory ducts of these glands. Monoclonal antibody KL 1 (55-57 KD keratins) and RGE 53 (no. 18 keratin) did not bind to any ductal or acinar epithelia. Only in the sublingual gland were acini positive for TK staining, possibly indicating myoepithelial cells. No effects of [sup 60]Co [gamma] irradiation were apparent regarding keratin distribution in the intercalated in apical cytoplasm by [sup 60]Co [gamma] irradiation. Also, in the excretory duct, the basal side of the cells exhibited weakened staining following [sup 60]Co [gamma] irradiation were the most significant in the parotid and the least in the sublingual gland. Also this reaction depended upon the doses of [sup 60]Co used. The present findings suggested that negative or weakened staining at the basal and perinuclear portions of striated duct cells specifically reflects the primary or secondary cell damage produced by [sup 60]Co [gamma] irradiation. Since the distribution of cytoskeletal proteins in the cytoplasm reflects certain pathological conditions, immunohistochemical detection of these proteins seem to have a diagnostic value with respect to cellular injury. (J.P.N.) 77 refs.

  7. Respiratory compliance but not gas exchange correlates with changes in lung aeration after a recruitment maneuver: an experimental study in pigs with saline lavage lung injury

    Science.gov (United States)

    Henzler, Dietrich; Pelosi, Paolo; Dembinski, Rolf; Ullmann, Annette; Mahnken, Andreas H; Rossaint, Rolf; Kuhlen, Ralf

    2005-01-01

    Introduction Atelectasis is a common finding in acute lung injury, leading to increased shunt and hypoxemia. Current treatment strategies aim to recruit alveoli for gas exchange. Improvement in oxygenation is commonly used to detect recruitment, although the assumption that gas exchange parameters adequately represent the mechanical process of alveolar opening has not been proven so far. The aim of this study was to investigate whether commonly used measures of lung mechanics better detect lung tissue collapse and changes in lung aeration after a recruitment maneuver as compared to measures of gas exchange Methods In eight anesthetized and mechanically ventilated pigs, acute lung injury was induced by saline lavage and a recruitment maneuver was performed by inflating the lungs three times with a pressure of 45 cmH2O for 40 s with a constant positive end-expiratory pressure of 10 cmH2O. The association of gas exchange and lung mechanics parameters with the amount and the changes in aerated and nonaerated lung volumes induced by this specific recruitment maneuver was investigated by multi slice CT scan analysis of the whole lung. Results Nonaerated lung correlated with shunt fraction (r = 0.68) and respiratory system compliance (r = 0.59). The arterial partial oxygen pressure (PaO2) and the respiratory system compliance correlated with poorly aerated lung volume (r = 0.57 and 0.72, respectively). The recruitment maneuver caused a decrease in nonaerated lung volume, an increase in normally and poorly aerated lung, but no change in the distribution of a tidal breath to differently aerated lung volumes. The fractional changes in PaO2, arterial partial carbon dioxide pressure (PaCO2) and venous admixture after the recruitment maneuver did not correlate with the changes in lung volumes. Alveolar recruitment correlated only with changes in the plateau pressure (r = 0.89), respiratory system compliance (r = 0.82) and parameters obtained from the pressure-volume curve

  8. The effect of duct surface character on methane explosion propagation

    Institute of Scientific and Technical Information of China (English)

    LIN Bai-quan; YE Qing; JIAN Cong-guang; WU Hai-jin

    2007-01-01

    The effect of duct surface character on methane explosion propagation was experimentally studied and theoretically analyzed. The roughness has effect on methane explosion propagation. The flame propagation velocity and the peak value pressure of methane explosion in rough duct are larger than the parameters in smooth duct. The heat exchange of the surface has effect on methane explosion propagation. The propagation velocity of flame and strength of explosion wave in the duct covered by heat insulation material are larger than those in duct with good heat transmittability.

  9. Transition duct with divided upstream and downstream portions

    Energy Technology Data Exchange (ETDEWEB)

    McMahan, Kevin Weston; LeBegue, Jeffrey Scott; Maldonado, Jaime Javier; Dillard, Daniel Jackson; Flanagan, James Scott

    2015-07-14

    Turbine systems are provided. In one embodiment, a turbine system includes a transition duct comprising an inlet, an outlet, and a duct passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The duct passage includes an upstream portion extending from the inlet and a downstream portion extending from the outlet. The turbine system further includes a rib extending from an outer surface of the duct passage, the rib dividing the upstream portion and the downstream portion.

  10. Correlation of urinary lactic dehydrogenase with polymorphonuclear leukocytes in urinary tract infections in patients with spinal cord injuries.

    Science.gov (United States)

    Malik, G M; Canawati, H N; Keyser, A J; Ibrahim, M Z; Montgomerie, J Z

    1983-01-01

    A number of indirect methods have been developed to determine the site of urinary tract infection, including the measurement of LDH in urine [1]. Although LDH has been thought to be from the kidneys, it has also been noted that leukocytes could contribute LDH isoenzymes 4 and 5 [2]. Seventeen patients with injured spinal cords and significant bacteriuria were included in this study. Urine specimens obtained by urethral catheter were cultured, and PMNLs identified with Sternheimer-Malbin stain were counted in a hemacytometer. A positive test for antibody-coated bacteria and the lack of patient response to five to 10 days of antibiotic therapy were used as an indication of upper urinary tract infection. Levels of LDH isoenzymes 4 and 5 (cathodal) correlated with the number of PMNLs in the urine (r = 0.63, P less than 0.01). There was no correlation of PMNLs with LDH isoenzymes 1 and 2 (r = 0.18). In addition, there was no correlation of LDH isoenzymes 4 and 5 with the level of urinary tract infection. These results suggest that the PMNLs in the urine are the source of the LDH isoenzymes 4 and 5.

  11. Proposal of a new technique for bile duct reconstruction after iatrogenic injury: study in dogs and review of the literature Reconstrução da via biliar após lesão iatrogênica, proposta de nova técnica: estudo em cães e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Eduardo Crema

    2007-06-01

    Full Text Available PURPOSE: Interposition of a jejunal tube between the common bile duct and duodenum. METHODS: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg, were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. RESULTS: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. CONCLUSION: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.OBJETIVO: Interposição de um tubo de jejuno entre o colédoco e o duodeno. MÉTODOS: Foram utilizados cinco cães adultos, sem raça definida, de ambos os sexos, com peso médio de 22,3 Kg (18 e 26,5 Kg. Após provocar icterícia obstrutiva pela ligadura do colédoco distal, após uma semana, praticou-se confecção do tubo de jejuno de 2,5 cm de extensão, que foi realizado com um segmento de alça retirado a 15 cm do ângulo de Treitz e a interposição do tubo entre o colédoco e o duodeno. RESULTADOS: Os animais tiveram boa evolução clínica e não apresentaram complicações. Notou-se total integração entre a mucosa da via biliar, do tubo e do duodeno e redução significativa dos valores da bilirrubina total e da fosfatase alcalina após seis semanas, quando comparado com os valores após uma semana de ligadura do colédoco. CONCLUSÃO: O tubo de jejuno interposto entre a via biliar dilatada e o duodeno, apresentou boa integração anatômica e reduziu os

  12. Diameter of common bile duct: what are the predicting factors?

    Directory of Open Access Journals (Sweden)

    Atoosa Adibi

    2007-07-01

    Full Text Available

    BACKGROUND: This was a study to determine the correlation between the common bile duct (CBD diameter and demographic data, fasting, and the history of opium addiction.
    METHODS: This was a cross-sectional study on 375 patients (>16 years old including 219 females and 156 males. They had no evident hepatobiliary or pancreatic disease and underwent abdominopelvic ultrasonography for measurement of their CBD diameter. Ultrasound (US was performed to measure CBD diameter at the porta hepatis (proximal part and behind the head of the pancreas (distal part. Correlation coefficients for the association between CBD diameter and predictive factors were calculated. t-test was applied to compare the means between the groups.
    RESULTS: The mean CBD diameter (1 standard deviation, in proximal and distal parts were 3.64 mm (±1.2 and 3.72 mm (±1.2, respectively. The CBD diameters (proximal and distal were significantly (P<0.05 correlated with age (r = 0.55 and 0.54, respectively, BMI (r = 0.25 and 0.27, respectively and portal vein diameter (r = 0.24 and 0.22, respectively. Distal diameter of CBD was significantly larger in opium addicts (5.66 ± 2.65 in comparison with non addicts (3.68 ± 1.17, P = 0.04.
    CONCLUSIONS: CBD diameter associates with age, BMI, portal vein diameter and opium addiction. CBD dilatation, if it can not be explained by age, opium usage or large BMI, should be evaluated further to rule out obstruction.
    KEY WORDS: Common bile duct, predicting factors, ultrasonography.

  13. Dispersion properties of ducted whistlers, generated by lightning discharge

    Directory of Open Access Journals (Sweden)

    D. L. Pasmanik

    2005-06-01

    Full Text Available Whistler-mode wave propagation in magnetospheric ducts of enhanced cold plasma density is studied. The case of the arbitrary ratio of the duct radius to the whistler wavelength is considered, where the ray-tracing method is not applicable. The set of duct eigenmodes and their spatial structure are analysed and dependencies of eigenmode propagation properties on the duct characteristics are studied. Special attention is paid to the analysis of the group delay time of one-hop propagation of the whistler wave packet along the duct. We found that, in contrast to the case of a wide duct, the group delay time in a rather narrow duct decreases as the eigenmode number increases. The results obtained are suggested for an explanation of some types of multi-component whistler signals.

  14. Curved Duct Noise Prediction Using the Fast Scattering Code

    Science.gov (United States)

    Dunn, M. H.; Tinetti, Ana F.; Farassat, F.

    2007-01-01

    Results of a study to validate the Fast Scattering Code (FSC) as a duct noise predictor, including the effects of curvature, finite impedance on the walls, and uniform background flow, are presented in this paper. Infinite duct theory was used to generate the modal content of the sound propagating within the duct. Liner effects were incorporated via a sound absorbing boundary condition on the scattering surfaces. Simulations for a rectangular duct of constant cross-sectional area have been compared to analytical solutions and experimental data. Comparisons with analytical results indicate that the code can properly calculate a given dominant mode for hardwall surfaces. Simulated acoustic behavior in the presence of lined walls (using hardwall duct modes as incident sound) is consistent with expected trends. Duct curvature was found to enhance weaker modes and reduce pressure amplitude. Agreement between simulated and experimental results for a straight duct with hard walls (no flow) was excellent.

  15. Rationale for Measuring Duct Leakage Flows in Large Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Wray, Craig P.; Diamond, Richard C.; Sherman, Max H.

    2005-07-01

    Industry-wide methods of assessing duct leakage are based on duct pressurization tests, and focus on ''high pressure'' ducts. Even though ''low pressure'' ducts can be a large fraction of the system and tend to be leaky, few guidelines or construction specifications require testing these ducts. We report here on the measured leakage flows from ten large commercial duct systems at operating conditions: three had low leakage (less than 5% of duct inlet flow), and seven had substantial leakage (9 to 26%). By comparing these flows with leakage flows estimated using the industry method, we show that the latter method by itself is not a reliable indicator of whole-system leakage flow, and that leakage flows need to be measured.

  16. MR imaging for blunt pancreatic injury

    Energy Technology Data Exchange (ETDEWEB)

    Yang Lin [Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000 (China); Zhang Xiaoming, E-mail: cjr.zhxm@vip.163.co [Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000 (China); Xu Xiaoxue; Tang Wei; Xiao Bo; Zeng Nanlin [Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000 (China)

    2010-08-15

    Objective: To study the MR imaging features of blunt pancreatic injury. Materials and methods: Nine patients with pancreatic injury related to blunt abdominal trauma confirmed by surgery performed MR imaging. Two abdominal radiologists conducted a review of the MR images to assess pancreatic parenchymal and pancreatic duct injury, and associated complications. Result: Diagnostic quality MR images were obtained in each of the nine patients. In the nine patients, pancreatic fracture, laceration and contusion were depicted on MR imaging in five, one and three patients, respectively. There were six patients with pancreatic duct disruption, eight patients with peripancreatic fluid collections, and four patients with peripancreatic pseudocyst or hematoma, respectively. All of the MR imaging findings was corresponded to surgical findings. Conclusion: MR imaging is an effective method to detect blunt pancreatic injury and may provide information to guide management decisions.

  17. Identification of acoustic wave propagation in a duct line and its application to detection of impact source location based on signal processing

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Yong Woo; Kim, Min Soo; Lee, Sang Kwon [Inha University, Seoul (Korea, Republic of)

    2010-12-15

    For the detection of the impact location in a pipeline system, the correlation method has been the conventional method. For the application of the correlation method, the diameter of a duct should be small so that the acoustic wave inside the duct can propagate with nondispersive characteristics, in the form of, for example, a plane wave. This correlation method calculates the cross-correlation between acoustic waves measured at two acceleration sensors attached to a buried duct. It also gives information about the arrival time delay of an acoustic wave between two sensors. These arrival time delays are used for the estimation of the impact location. However, when the diameter of the duct is large, the acoustic waves inside the duct propagate with dispersive characteristics owing to the reflection of the acoustic wave off of the wall of the duct. This dispersive characteristic is related to the acoustic modes inside a duct. Therefore, the correlation method does not work correctly for the detection of the impact location. This paper proposes new methods of accurately measuring the arrival time delay between two sensors attached to duct line system. This method is based on the time-frequency analyses of the short time Fourier transform (STFT) and continuous wavelet transform (CWT). These methods can discriminate direct waves (non-dispersive waves) and reflective waves (dispersive waves) from the measured wave signals through the time-frequency analysis. The direct wave or the reflective wave is used to estimate the arrival time delay. This delay is used for the identification of the impact location. This systematic method can predict the impact location due to the impact forces of construction equipment with more accuracy than the correlation method

  18. Cognitive correlates of psychosocial outcome following traumatic brain injury in early childhood: comparisons between groups of children aged under and over 10 years of age.

    Science.gov (United States)

    Tonks, James; Williams, W Huw; Yates, Phil; Slater, Alan

    2011-04-01

    Children with traumatic brain injuries (TBI) commonly present with socioemotional difficulties, as well as accompanying multiple cognitive impairments. Often difficulties worsen at around 10 years old. This change is associated with frontal system changes, and tests of executive function (EF) predict outcome. However, children with TBI sometimes present with socioemotional difficulties despite apparent cognitive recovery. Our aims were to explore potential cognitive and socioemotional effects following childhood TBI, before and after the age of 10 years. We also wanted to identify cognitive correlates of psychosocial dysfunction. Measures of cognitive function and socioemotional disturbance administered to 14 children with TBI aged 8-10 years, and 14 children with TBI aged 10-16 years, were compared to control data from 22 non-injured 8- to 10 year-olds and 67 non-injured 10- to 16-year-olds. Results indicated that only the older group of children with TBI were impaired in tests of EF, but significant socioemotional difficulties were commonly evident in both groups. Processing speed (as well as EF) was found to correlate with socioemotional disturbance. We conclude that poor processing speed may also index the risk of socioemotional difficulties, but our general findings indicate that cognitive functions relevant to socioemotional functioning are not readily testable in younger children and are not strongly associated with such outcomes as they may be in adults.

  19. Acoustic Power Transmission Through a Ducted Fan

    Science.gov (United States)

    Envia, Ed

    2016-01-01

    For high-speed ducted fans, when the rotor flowfield is shock-free, the main contribution to the inlet radiated acoustic power comes from the portion of the rotor stator interaction sound field that is transmitted upstream through the rotor. As such, inclusion of the acoustic transmission is an essential ingredient in the prediction of the fan inlet noise when the fan tip relative speed is subsonic. This paper describes a linearized Euler based approach to computing the acoustic transmission of fan tones through the rotor. The approach is embodied in a code called LINFLUX was applied to a candidate subsonic fan called the Advanced Ducted Propulsor (ADP). The results from this study suggest that it is possible to make such prediction with sufficient fidelity to provide an indication of the acoustic transmission trends with the fan tip speed.

  20. Theoretical analysis of HVAC duct hanger systems

    Science.gov (United States)

    Miller, R. D.

    1987-01-01

    Several methods are presented which, together, may be used in the analysis of duct hanger systems over a wide range of frequencies. The finite element method (FEM) and component mode synthesis (CMS) method are used for low- to mid-frequency range computations and have been shown to yield reasonably close results. The statistical energy analysis (SEA) method yields predictions which agree with the CMS results for the 800 to 1000 Hz range provided that a sufficient number of modes participate. The CMS approach has been shown to yield valuable insight into the mid-frequency range of the analysis. It has been demonstrated that it is possible to conduct an analysis of a duct/hanger system in a cost-effective way for a wide frequency range, using several methods which overlap for several frequency bands.

  1. Extrahepatic bile duct neurilemmoma mimicking Klatskin tumor.

    Science.gov (United States)

    Kamani, Fereshteh; Dorudinia, Atosa; Goravanchi, Farhood; Rahimi, Farzaneh

    2007-04-01

    Neurilemmoma rarely develops in the biliary tree. Here, we report a 39-year-old Iranian woman with neurilemmoma in the extrahepatic bile duct presenting with progressively deepening jaundice. On the basis of clinical and radiological features, this tumor was initially suspected as Klatskin tumor. Histologically, the tumor was a typical neurilemmoma. Immunostaining showed that tumor cells were strongly and diffusely positive for S-100 protein, which supported the diagnosis of neurilemmoma. Neurilemmoma should be considered in the differential diagnosis of obstructive jaundice.

  2. Endoscopic management of bile duct stones.

    Science.gov (United States)

    Sivak, M V

    1989-09-01

    Endoscopic sphincterotomy is the procedure of choice for choledocholithiasis in patients who have had a cholecystectomy. The bile duct is cleared of stones in about 80 to 90 percent of patients. Available data, largely retrospective, suggest that surgery and endoscopic sphincterotomy are about equal with respect to removal of stones, morbidity, and mortality. Certain technical problems are discussed, including inability to insert the papillotome, the large stone, and problems relating to anatomy such as peripapillary diverticulum and prior gastrectomy. The treatment of patients with bile duct stones who have not had a cholecystectomy, with and without cholelithiasis, is controversial. Endoscopic sphincterotomy without subsequent cholecystectomy is adequate treatment for the majority of patients who are unfit for surgery, even if there are stones in the gallbladder, provided they are asymptomatic after endoscopic removal of stones from the bile ducts. Endoscopic sphincterotomy has been performed in the treatment of gallstone-induced pancreatitis, acute obstructive cholangitis, and sump syndrome. The complication rate for endoscopic sphincterotomy ranges from 6.5 to 8.7 percent, with a mortality rate of 0 to 1.3 percent. The most common serious complications are perforation, hemorrhage, acute pancreatitis, and sepsis.

  3. Endoscopic Management of Difficult Bile Duct Stones

    Directory of Open Access Journals (Sweden)

    Christian Ell

    1992-01-01

    Full Text Available More than 90% of all common bile duct concrements can be removed via the endoscopic retrograde route via endoscopic sphincterotomy, stone extraction by baskets and balloon catheters, or mechanical lithotripsy. Oversized, very hard or impacted stones, however, often still resist conventional endoscopic therapy. Promising new or improved approaches for the treatment of these stones are intracorporeal or extracorporeal shock wave lithotripsy. Shockwave lithotriptors for extracorporeal shockwave lithotripsy are currently available worldwide. However, for the waterbath first generation devices, general anesthesia is required since shockwaves are very painful. Furthermore, an x-ray localization system is essential to visualize the stones after having filled the bile duct over a nasobiliary catheter. An average of two shockwave treatments with additional two to four endoscopic sessions are required. ln tracorporeal lithotripsy promises more comfort and less effort for the patient. Shockwaves are generated either by means of the spark gap principle (electrohydraulic probes or by laser-induced plasma generation. Laser-induced shockwave lithotripsy appears to be more safer, since with dye and solid state lasers, athermal, well-controlled shockwaves can be generateJ without the risks for duct perfo ration (as described for the electrohydraulic system. Furthermore, a recently developed stone-tissue detection system integrated in a new dye laser system enchances the safety of laser-induced lithotripsy. ln consequence, lithotripsy without direct endoscopic control appears possible in selected cases.

  4. Particle deposition in industrial duct bends.

    Science.gov (United States)

    Peters, Thomas M; Leith, David

    2004-07-01

    A study of particle deposition in industrial duct bends is presented. Particle deposition by size was measured by comparing particle size distributions upstream and downstream of bends that had geometries and flow conditions similar to those used in industrial ventilation. As the interior surface of the duct bend was greased to prevent particle bounce, the results are applicable to liquid drops and solid particles where duct walls are sticky. Factors investigated were: (i) flow Reynolds number (Re = 203 000, 36 000); (ii) particle Reynolds number (10 vertical); and (vii) construction technique (smooth, gored, segmented). Measured deposition was compared with models developed for bends in small diameter sampling lines (Re 20 microm, deposition was slightly greater in the horizontal-to-horizontal orientation than in the horizontal-to-vertical orientation due to gravitational settling. Penetration was not a multiplicative function of bend angle as theory predicts, due to the developing nature of turbulent flow in bends. Deposition in a smooth bend was similar to that in a gored bend; however, a tight radius segmented bend (R0 = 1.7) exhibited much lower deposition. For more gradual bends (3 < R0 < 12), curvature ratio had negligible effect on deposition.

  5. MRI of the biliary and pancreatic ducts

    Energy Technology Data Exchange (ETDEWEB)

    Pavone, P.; Laghi, A.; Catalano, C.; Panebianco, V.; Fabiano, S.; Passariello, R. [Dept. of Radiology II, Univ. of Rome ``La Sapienza`` (Italy)

    1999-10-01

    Magnetic resonance Cholangiopancreatography (MRCP) is a non-invasive imaging technique able to provide projectional images of the bile ducts. Different sequences, using both breath-hold and non-breath-hold acquisition techniques, have been employed in order to obtain MRCP images. The authors discuss technical aspects, considering both three-dimensional non-breath-hold techniques and two-dimensional breath-hold, multi-slice and thick slab sequences. Clinical applications of MRCP are evaluated, presenting data from both the literature and personal experience. The main indication for MRCP study is represented by the evaluation of common bile duct obstruction, with the aim of assessing the presence of the obstruction (accuracy 85-100 %) and, subsequently, its level (accuracy 91-100 %) and its cause. The utility of associating conventional MR images to MRCP in malignant strictures, in order to characterize and stage the malignant lesion, is also discussed. Finally, data are presented regarding the indications and the utility of MR-pancreatography in the evaluation of patients with pancreatic duct anomalies and chronic pancreatitis. (orig.) With 9 figs., 39 refs.

  6. Laparoscopic diagnosis and treatment of cystic duct stones in 86 cases%腹腔镜诊治胆囊管结石86例体会

    Institute of Scientific and Technical Information of China (English)

    李俊彦; 蒋宏

    2012-01-01

    Objective:To explore the method and effect of laparoscopic diagnosis and treatment in calculus of cystic duct. Methods: Reviewed the clinical data that 86 patients received laparoscopic cholecystectomy treatment because of calculus of cystic duct. Results: Before operation 30 cases were diagnosed Calculus of cystic duct By B-ul-trasonography and CT , intraoperative probe found 56 cases diagnosed Calculus of cystic duct. 83 cases were successfully completed laparoscopic cholecystectomy, 3 cases were converted to open, no case was happened serious complications such as bile duct injury, hemorrhage, bile duct leakage and common bile duct calculus and so on. All recoveried. Conclusion : B-ultrasonography combined with CT examination can diagnose Calculus of cystic duct before operation and active application of laparoscopic cholecystectomy plays vital role in diagnosis and treatment of Calculus of cystic duct,if circumstance complicated,Choose laparotomy in order to reduce unnecessary bile duct injury, it is safe and feasible through laparoscopic cholecystectomy, treat Calculus of cystic duct.%目的:探讨腹腔镜诊断和治疗胆囊管结石的方法和效果.方法:对86例胆囊管结石患者采用腹腔镜治疗.结果:经B超、CT术前诊断胆囊管结石30例,术中探查发现胆囊管结石56例.顺利完成腹腔镜胆囊切除术(LC) 83例,3例中转开腹,无一例发生胆管损伤、出血、胆漏、胆总管结石等严重并发症,均痊愈出院.结论:B超结合CT检查可在术前诊断胆囊管结石,灵活运用LC的处理技巧是腹腔镜诊断和治疗胆囊管结石的关键.酌情中转开腹可减少不必要的胆管损伤.

  7. Increased Expression of TGF-β Signaling Components in a Mouse Model of Fibrosis Induced by Submandibular Gland Duct Ligation.

    Directory of Open Access Journals (Sweden)

    Lucas T Woods

    Full Text Available Transforming growth factor-β (TGF-β is a multi-functional cytokine with a well-described role in the regulation of tissue fibrosis and regeneration in the liver, kidney and lung. Submandibular gland (SMG duct ligation and subsequent deligation in rodents is a classical model for studying salivary gland damage and regeneration. While previous studies suggest that TGF-β may contribute to salivary gland fibrosis, the expression of TGF-β signaling components has not been investigated in relation to mouse SMG duct ligation-induced fibrosis and regeneration following ductal deligation. Following a 7 day SMG duct ligation, TGF-β1 and TGF-β3 were significantly upregulated in the SMG, as were TGF-β receptor 1 and downstream Smad family transcription factors in salivary acinar cells, but not in ductal cells. In acinar cells, duct ligation also led to upregulation of snail, a Smad-activated E-cadherin repressor and regulator of epithelial-mesenchymal transition, whereas in ductal cells upregulation of E-cadherin was observed while snail expression was unchanged. Upregulation of these TGF-β signaling components correlated with upregulation of fibrosis markers collagen 1 and fibronectin, responses that were inhibited by administration of the TGF-β receptor 1 inhibitors SB431542 or GW788388. After SMG regeneration following a 28 day duct deligation, TGF-β signaling components and epithelial-mesenchymal transition markers returned to levels similar to non-ligated controls. The results from this study indicate that increased TGF-β signaling contributes to duct ligation-induced changes in salivary epithelium that correlate with glandular fibrosis. Furthermore, the reversibility of enhanced TGF-β signaling in acinar cells of duct-ligated mouse SMG after deligation indicates that this is an ideal model for studying TGF-β signaling mechanisms in salivary epithelium as well as mechanisms of fibrosis initiation and their resolution.

  8. Compact Buried Ducts in a Hot-Humid Climate House

    Energy Technology Data Exchange (ETDEWEB)

    Mallay, Dave [Home Innovation Research Labs, Upper Marlboro, MD (United States)

    2016-01-07

    "9A system of compact, buried ducts provides a high-performance and cost-effective solution for delivering conditioned air throughout the building. This report outlines research activities that are expected to facilitate adoption of compact buried duct systems by builders. The results of this research would be scalable to many new house designs in most climates and markets, leading to wider industry acceptance and building code and energy program approval. The primary research question with buried ducts is potential condensation at the outer jacket of the duct insulation in humid climates during the cooling season. Current best practices for buried ducts rely on encapsulating the insulated ducts with closed-cell spray polyurethane foam insulation to control condensation and improve air sealing. The encapsulated buried duct concept has been analyzed and shown to be effective in hot-humid climates. The purpose of this project is to develop an alternative buried duct system that performs effectively as ducts in conditioned space - durable, energy efficient, and cost-effective - in a hot-humid climate (IECC warm-humid climate zone 3A) with three goals that distinguish this project: 1) Evaluation of design criteria for buried ducts that use common materials and do not rely on encapsulation using spray foam or disrupt traditional work sequences; 2) Establishing design criteria for compact ducts and incorporate those with the buried duct criteria to further reduce energy losses and control installed costs; 3) Developing HVAC design guidance for performing accurate heating and cooling load calculations for compact buried ducts.

  9. Use of rigid tubal ligation scope: Serendipity in laparoscopic common bile duct exploration

    Directory of Open Access Journals (Sweden)

    Manash Ranjan Sahoo

    2014-01-01

    Full Text Available Aim : To assess the feasibility, safety of rigid tubal ligation scope in laparoscopic common bile duct (CBD exploration. Materials and Methods: Rigid nephroscope was used for laparoscopic CBD exploration until one day we tried the same with the rigid tubal ligation scope, which was passed easily into CBD both proximally and distally visualising the interior of the duct for presence of stone that were removed using endoscopic retrograde cholangiopancreaticography (ERCP basket. This serendipity led us to use this scope for numerous patients from then on. A total of 62 patients, including male and female, underwent laparoscopic CBD exploration after choledochotomy with rigid tubal ligation scope between March 2007 and December 2012 followed by cholecystectomy. All the patients had both cholelithiasis and choledocholithiasis with minimum duct diameter of 12 mm. A total of 48 patients were given T-tube through choledochotomy and closed, and the remaining 14 patients had primary closure of choledochotomy. Results: There were no intra-operative complications in any of the patients like CBD injury or portal vein injury. Post-operatively graded clamping of T-tube was done and was removed after 15 days in the patients who were given T-tube. None had retained the stone after T-tube cholangiography, which was done before removing the tube. Mean duration of follow up was 6 months. No patients had any complaints during the follow up. Conclusion: Laparoscopic CBD exploration is also feasible with rigid tubal ligation scope. With experienced surgeons, CBD injury is very minimal and stone clearance can be achieved in almost all patients. This rigid tubal ligation scope can be an alternative to other rigid and flexible scopes.

  10. Resistance Characteristics of Hydraulic Oil through Isodiametric T-type Duct with Sharp Corners

    Institute of Scientific and Technical Information of China (English)

    TANG Jinglin; WANG Liwei; LI Xia

    2009-01-01

    Rational determination and reduction of local energy loss of oil flow at pipe junctions are of important significance to improve hydraulic pipeline's work efficiency, especially for complex hydraulic pipeline connected by isodiametric T-type ducts with sharp comers to get combined and divided flow. From this point of view, the formulae of resistance loss for combined flow and divided flow through isodiametric T-type duct with sharp comers as well as the correlations of resistance loss coefficients in the branches of the duct are derived using energy method. On this basis, resistance characteristics of hydraulic oil in the duct are obtained by numerical simulation of different flow modes, which are commonly applied in hydraulic pipelines, using computational fluid dynamics (CFD) method, and the reasons for the resistance loss are analyzed based on the pressure change mechanism in the flow field. A part of simulation results was validated with the reference data. The research shows that for combined flows the resistance loss of symmetrical is lower than that of tmsymmetrical to obtain low speed in common branch, but to gain high speed is quite the contrary, for divided flows, the symmetrical is always a reasonable choice to reduce resistance loss. These conclusions can be applied to optimize the design of hydraulic pipeline.

  11. ENaC activity in collecting ducts modulates NCC in cirrhotic mice.

    Science.gov (United States)

    Mordasini, David; Loffing-Cueni, Dominique; Loffing, Johannes; Beatrice, Rohrbach; Maillard, Marc P; Hummler, Edith; Burnier, Michel; Escher, Geneviève; Vogt, Bruno

    2015-12-01

    Cirrhosis is a frequent and severe disease, complicated by renal sodium retention leading to ascites and oedema. A better understanding of the complex mechanisms responsible for renal sodium handling could improve clinical management of sodium retention. Our aim was to determine the importance of the amiloride-sensitive epithelial sodium channel (ENaC) in collecting ducts in compensate and decompensate cirrhosis. Bile duct ligation was performed in control mice (CTL) and collecting duct-specific αENaC knockout (KO) mice, and ascites development, aldosterone plasma concentration, urinary sodium/potassium ratio and sodium transporter expression were compared. Disruption of ENaC in collecting ducts (CDs) did not alter ascites development, urinary sodium/potassium ratio, plasma aldosterone concentrations or Na,K-ATPase abundance in CCDs. Total αENaC abundance in whole kidney increased in cirrhotic mice of both genotypes and cleaved forms of α and γ ENaC increased only in ascitic mice of both genotypes. The sodium chloride cotransporter (NCC) abundance was lower in non-ascitic KO, compared to non-ascitic CTL, and increased when ascites appeared. In ascitic mice, the lack of αENaC in CDs induced an upregulation of total ENaC and NCC and correlated with the cleavage of ENaC subunits. This revealed compensatory mechanisms which could also take place when treating the patients with diuretics. These compensatory mechanisms should be considered for future development of therapeutic strategies.

  12. Aberrant bile ducts, 'remnant surface bile ducts,' and peribiliary glands: descriptive anatomy, historical nomenclature, and surgical implications.

    Science.gov (United States)

    El Gharbawy, Ramadan M; Skandalakis, Lee J; Heffron, Thomas G; Skandalakis, John E

    2011-05-01

    The term "aberrant bile ducts" has been used to designate three heterogeneous groups of biliary structures: (1) bile ducts degenerating or disappearing (unknown etiology, diverse locations); (2) curious biliary structures in the transverse fissure; and (3) aberrant right bile ducts draining directly into the common hepatic duct. We report our observations on these three groups. Twenty-nine fresh human livers of stillborns and adults were injected differentially with colored latex and dissected. Adult livers showed portal venous and hepatic arterial branches, and bile ducts not associated with parenchyma, subjacent to and firmly adherent with the liver capsule: elements of ramifications of normal sheaths were present on the liver's surface. These ramifications, having lost parenchyma associated with them, then sequentially lost their portal branches, bile ducts and arterial branches. This process affected the ramifications of the sheaths in the left triangular ligament, adjacent to the inferior vena cava, in the gallbladder bed and anywhere else on the liver's surface and resulted in the presence of bile ducts accompanied by portal venous and/or hepatic arterial branches and not associated with parenchyma for a period of time. This first group represented normal bile ducts that do not meet the criteria of aberration and could be appropriately designated "remnant surface bile ducts." Such changes were not found in the transverse fissures and review of the literature revealed that the curious biliary structures are the microscopic peribiliary glands. The third group met the criteria of aberration and the anatomy of a representative duct is described.

  13. Right anterior segmental hepatic duct emptying directly into the cystic duct in a living donor

    Institute of Scientific and Technical Information of China (English)

    Yasunao; Ishiguro; Masanobu; Hyodo; Takehito; Fujiwara; Yasunaru; Sakuma; Nobuyuki; Hojo; Koichi; Mizuta; Hideo; Kawarasaki; Alan; T; Lefor; Yoshikazu; Yasuda

    2010-01-01

    A 35-year-old mother was scheduled to be the living donor for liver transplantation to her second son,who suffered from biliary atresia complicated with biliary cirrhosis at the age of 2 years.The operative plan was to recover the left lateral segment of the mother's liver for living donor transplantation.With the use of cholangiography at the time of surgery,we found the right anterior segmental duct(RASD) emptying directly into the cystic duct,and the catheter passed into the RASD.After repairing the inci...

  14. Migration of Surgical Clips into the Common Bile Duct after Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Krishn Kant Rawal

    2017-01-01

    Full Text Available Laparoscopic cholecystectomy (LC is currently the treatment of choice for symptomatic gallstones. Associated complications include bile duct injury, retained common bile duct (CBD stones, and migration of surgical clips. Clip migration into the CBD can present with recurrent cholangitis over a period of time. Retained CBD stones can be another cause of recurrent cholangitis. A case of two surgical clips migrating into the common bile duct with few retained stones following LC is reported here. The patient had repeated episodes of fever, pain at epigastrium, jaundice, and pruritus 3 months after LC. Liver function tests revealed features of obstructive jaundice. Ultrasonography of the abdomen showed dilated CBD with few stones. In view of acute cholangitis, an urgent endoscopic retrograde cholangiopancreatography was done, which demonstrated few filling defects and 2 linear metallic densities in the CBD. A few retained stones along with 2 surgical clips were removed successfully from the CBD by endoscopic retrograde cholangiopancreatography after papillotomy using a Dormia basket. The patient improved dramatically following the procedure.

  15. Climate analysis of evaporation ducts in the South China Sea

    OpenAIRE

    McKeon, Brian D.

    2013-01-01

    Approved for public release; distribution is unlimited. Evaporation ducts have important implications for U.S. Naval activities involving electromagnetic propagation. The presence of an evaporation duct can affect naval operations involving communications, surveillance, electronic warfare, and detection of low-flying missiles, surface ships, or submarine periscopes. We conducted a climate scale analysis of evaporation duct heights (EDH) in the northern South China Sea (SCS), including how ...

  16. Omphalomesenteric duct cyst with gastric mocosa: A case report

    OpenAIRE

    2006-01-01

    Persistance of the omphalomesenteric duct may lead to several anomalies including umblical sinus, umblical cyst, MeckeVs diverticulum or patent omphalomesenteric duct fistula. Clinical manifestations of umblical disorders are usually nonspecific; use of cross-sectional imaging can help identify most of these entities because of their typical locations and distributions in continuity with the other organs and guide therapy. A case of omphalomesenteric duct cyst are presented and analysed toget...

  17. Correlations between Event-related Potentials with Pictures Recognition and WMS-RC Scores in Patients with Memory Disorder Caused by Severe Traumatic Brain Injury

    Institute of Scientific and Technical Information of China (English)

    Zilong LIU; Liang LIU; Zebing FAN; Xiaorui CHEN; Xiaohong ZHAO; Lingli ZHANG; Guangxun Rao; Haixia LI

    2008-01-01

    This study explored the possibility of using event-related potentials (ERP) for the measurement of picture-recognition memory and examined its correlation with the Chinese Wechsler Memory Scale-revised (WMS-RC) in patients with memory disorder caused by severe traumatic brain injury (sTBI). The subjects included 20 sTBI patients with memory disorder and 22 healthy individuals. Memory function was measured by using WMS-RC. Behavioral and ERP responses were recorded on-line during performance on a battery of picture recognition and the responses were analyzed off-line for recognition memory effects. Mean memory quotient (MQ) of patients with sTBI was significantly lower than that of the control group. Mean reaction time (RT) was significantly longer and the mean correctness rate (CR) of picture recognition was significantly lower in sTBI group than that of the controls. In controls, the main components of average ERP of picture recognition includes two positive-going waves, designated as P170 and P500, that appear 170 ms and 500 ms after stimulation when the subject could later successfully recall and recognize the pictures. P500 amplitude of target stimulus was significantly higher than that of non-target stimulus. Compared to controls, P500 responses of sTBI group were significantly delayed in latency (P<0.001) and lower in amplitude (P<0.001). P500 latency showed significant negative correlation with MQ and the scores of "addition", "visual recognition", "picture recall", "visual reproduction" and "tactile memory" in WMS-RC. ERP of picture recognition provides a neurophysiological approach to directly assess memory impairment, and P500 may serve as a helpful index for memory disorder caused by sTBI in forensic practice.

  18. Correlation of urinary monocyte chemo-attractant protein-1 with other parameters of renal injury in type-II diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Ibrahim Salwa

    2008-01-01

    Full Text Available Diabetic nephropathy (DN is the leading cause of end-stage renal disease in the western world. Increased number of interstitial macrophages has been observed in biopsies from patients with DN. Monocyte chemo-attractant protein-1 (MCP-1 is the strongest known chemo-tactic factor for monocytes and is upregulated in DN. We examined urinary levels of MCP-1 in patients with type-2 diabetes mellitus (DM to assess its possible correlation with other para-meters of renal injury. The urinary MCP-1 level was assessed in 75 patients with type-2 DM (25 patients each with no microalbuminuria, with macroalbuminuria and, with renal impairment and compared them with matched healthy control subjects. The HbA1c and estimated glomerular fil-tration rate (eGFR derived from the abbreviated Modification of Diet in Renal Disease (MDRD equation were examined in the study groups in relation to the urinary MCP-1. The urinary MCP-1 level was significantly higher in patients with micro and macroalbuminuria (167.41 ± 50.23 and 630.87 ± 318.10 ng/gm creatinine respectively as compared with normoalbuminuric patients and healthy controls (63.85 ± 21.15 and 61.50 ± 24.81 ng/gm creatinine, p< 0.001. MCP-1 correlated positively with urine albumin/creatinine ratio (ACR (r= 0.75, p< 0.001, HbA1c (r= 0.55, p< 0.001 and inversely with eGFR (r=-0.60, p< 0.001. Our findings suggest that hyperglycemia is associated with increased urinary levels of MCP-1 that is closely linked to renal damage as reflected by proteinuria and eGFR levels. Collectively, these findings suggest that MCP-1 is in-volved in the pathogenesis of diabetic nephropathy through its various stages.

  19. Magnetoencephalography Slow-Wave Detection in Patients with Mild Traumatic Brain Injury and Ongoing Symptoms Correlated with Long-Term Neuropsychological Outcome.

    Science.gov (United States)

    Robb Swan, Ashley; Nichols, Sharon; Drake, Angela; Angeles, AnneMarie; Diwakar, Mithun; Song, Tao; Lee, Roland R; Huang, Ming-Xiong

    2015-10-01

    Mild traumatic brain injury (mTBI) is common in the United States, accounting for as many as 75-80% of all TBIs. It is recognized as a significant public health concern, but there are ongoing controversies regarding the etiology of persistent symptoms post-mTBI. This constellation of nonspecific symptoms is referred to as postconcussive syndrome (PCS). The present study combined results from magnetoencephalography (MEG) and cognitive assessment to examine group differences and relationships between brain activity and cognitive performance in 31 military and civilian individuals with a history of mTBI+PCS and 33 matched healthy control subjects. An operator-free analysis was used for MEG data to increase reliability of the technique. Subjects completed a comprehensive neuropsychological assessment, and measures of abnormal slow-wave activity from MEG were collected. Results demonstrated significant group differences on measures of executive functioning and processing speed. In addition, significant correlations between slow-wave activity on MEG and patterns of cognitive functioning were found in cortical areas, consistent with cognitive impairments on exams. Results provide more objective evidence that there may be subtle changes to the neurobiological integrity of the brain that can be detected by MEG. Further, these findings suggest that these abnormalities are associated with cognitive outcomes and may account, at least in part, for long-term PCS in those who have sustained an mTBI.

  20. Method for Observing Intravascular BongHan Duct

    CERN Document Server

    Jiang, X; Shin, H; Lee, B; Choi, C; Soh, K; Cheun, B; Baik, K; Soh, K; Jiang, Xiaowen; Kim, Hee-kyeong; Shin, Hak-soo; Lee, Byong-chon; Choi, Chunho; Soh, Kyung-soon; Cheun, Byeung-soo; Baik, Ku-youn; Soh, Kwang-sup

    2002-01-01

    A method for observing intra blood vessel ducts which are threadlike bundle of tubules which form a part of the BongHan duct system. By injecting 10% dextrose solution at a vena femoralis one makes the intravascular BongHan duct thicker and stronger to be easily detectable after incision of vessels. The duct is semi-transparent, soft and elastic, and composed of smaller tubules whose diameters are of 10$\\mu$m order, which is in agreement with BongHan theory.

  1. Biliary stenting for management of common bile duct stones.

    Science.gov (United States)

    Choudhuri, G; Sharma, B C; Saraswat, V A; Agarwal, D K; Baijal, S S

    1998-06-01

    Large and multiple common bile duct stones may defy extraction despite an adequate endoscopic papillotomy. We treated 65 patients with symptomatic bile duct stones with endoscopic stents after failed attempts at stone extraction. Of the 65 patients, bile duct stones were extracted in eight at a second attempt, 29 underwent elective surgery and 28 patients were followed with the stent in situ for 21-52 months (median 42 months). During follow up, two patients had recurrent pain and two required surgery. The remaining 24 patients remained asymptomatic. Biliary stenting is a safe and effective mode of treatment for common bile duct stones in patients who have failed stone extraction after endoscopic papillotomy.

  2. Flexible metallic seal for transition duct in turbine system

    Science.gov (United States)

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2014-04-22

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a flexible metallic seal contacting the interface member to provide a seal between the interface member and the turbine section.

  3. Experimental investigation of a rapidly rotating turbulent duct flow

    Energy Technology Data Exchange (ETDEWEB)

    Maartensson, G.E.; Johansson, A.V. [Department of Mechanics, KTH, 10044 Stockholm (Sweden); Gunnarsson, J. [Bombardier Transportation, Vaesteraas (Sweden); Moberg, H. [Alfa Laval, 14780 Tumba (Sweden)

    2002-09-01

    Rapidly rotating duct flow is studied experimentally with Rotation numbers in the interval. To achieve this, in combination with relatively high Reynolds numbers (5,000-30,000 based on the hydraulic radius), water was used as the working medium. Square and rectangular duct cross-sections were used and the angle between the rotation vector and the main axis of the duct was varied. The influence of the rotation on the pressure drop in the duct was investigated and suitable scalings of this quantity were studied. (orig.)

  4. Leaf seal for transition duct in turbine system

    Science.gov (United States)

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2013-06-11

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a leaf seal contacting the interface member to provide a seal between the interface member and the turbine section.

  5. CLINICAL AND MORPHOLOGICAL DIAGNOSTIC INTRAHEPATIC BILE DUCTS PAUCITY

    Directory of Open Access Journals (Sweden)

    O. E. Iryshkin

    2013-01-01

    Full Text Available Aim. To study the clinica-morphological features of syndromatic and nonsyndromatic paucity of intrahepatic bile ducts in pediatric liver transplant recipients. Methods and results. The clinical records were analyzed and histological studies of native livers of 20 children, who had suffered from paucity of intrahepatic bile ducts and to whom liver transplantation were made, were completed. The obtained data indicate higher levels of AST in patients with nonsyndromatic paucity of intrahepaticbile ducts (p = 0,023. Ductopenia was the more frequent indication of syndromatic form of paucity of intrahepatic bile ducts (p = 0,01, while ductular proliferations, which form «ductular structure», were discovered more often in nonsyndromatic paucity of intrahepaticbile ducts (p = 0,03. The extent of inflammatory-destructive changes was more expressed in nonsyndromatic pauci- ty of intrahepatic bile ducts (p = 0,01. Fibrosis or cirrhosis was formed more often in nonsyndromatic paucity of intrahepatic bile ducts (p = 0,008. Conclusion. Our results indicate more severe clinical and morphological manifestations in nonsyndromatic paucity of intrahepatic bile ducts. These findings may suggest about heavier liver condition in patient with nonsyndromatic form of paucity of intrahepatic bile ducts

  6. Duct injection technology prototype development: Evaluation of engineering data

    Energy Technology Data Exchange (ETDEWEB)

    1990-07-01

    The objective of the Duct Injection Technology Prototype Development Project is to develop a sound design basis for applying duct injection technology as a post-combustion SO{sub 2}emissions control method to existing coal-fired power plants. The necessary engineering design and scale-up criteria will be developed for the commercialization of duct injection technology for the control of SO{sub 2} emissions from coal-fired boilers in the utility industry. The primary focus of the analyses summarized in this Topical Report is the review of the known technical and economic information associated with duct injection technology. (VC)

  7. Convolution seal for transition duct in turbine system

    Energy Technology Data Exchange (ETDEWEB)

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2015-03-10

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a convolution seal contacting the interface member to provide a seal between the interface member and the turbine section.

  8. Live 3D image overlay for arterial duct closure with Amplatzer Duct Occluder II additional size.

    Science.gov (United States)

    Goreczny, Sebstian; Morgan, Gareth J; Dryzek, Pawel

    2016-03-01

    Despite several reports describing echocardiography for the guidance of ductal closure, two-dimensional angiography remains the mainstay imaging tool; three-dimensional rotational angiography has the potential to overcome some of the drawbacks of standard angiography, and reconstructed image overlay provides reliable guidance for device placement. We describe arterial duct closure solely from venous approach guided by live three-dimensional image overlay.

  9. Effectiveness of duct sealing and duct insulation in multi-family buildings. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Karins, N.H.; Tuluca, A.; Modera, M.

    1997-07-01

    This research investigated the cost-effectiveness of sealing and insulating the accessible portions of duct systems exposed to unconditioned areas in multifamily housing. Airflow and temperature measurements were performed in 25 apartments served by 10 systems a 9 multi-family properties. The measurements were performed before and after each retrofit, and included apartment airflow (supply and return), duct system temperatures, system fan flow and duct leakage area. The costs for each retrofit were recorded. The data were analyzed and used to develop a prototypical multifamily house. This prototype was used in energy simulations (DOE-2.1E) and air infiltration simulations (COMIS 2.1). The simulations were performed for two climates: New York City and Albany. In each climate, one simulation was performed assuming the basement was tight, and another assuming the basement was leaky. Simulation results and average retrofit costs were used to calculate cost-effectiveness. The results of the analysis indicate that sealing leaks of the accessible ductwork is cost-effective under all conditions simulated (simple payback was between 3 and 4 years). Insulating the accessible ductwork, however, is only cost-effective for buildings with leaky basement, in both climates (simple paybacks were less than 5 years). The simple payback period for insulating the ducts in buildings with tight basements was greater than 10 years, the threshold of cost-effectiveness for this research. 13 refs., 5 figs., 27 tabs.

  10. Radiation of sound from unflanged cylindrical ducts

    Science.gov (United States)

    Hartharan, S. L.; Bayliss, A.

    1983-01-01

    Calculations of sound radiated from unflanged cylindrical ducts are presented. The numerical simulation models the problem of an aero-engine inlet. The time dependent linearized Euler equations are solved from a state of rest until a harmonic solution is attained. A fourth order accurate finite difference scheme is used and solutions are obtained from a fully vectorized Cyber-203 computer program. Cases of both plane waves and spin modes are treated. Spin modes model the sound generated by a turbofan engine. Boundary conditions for both plane waves and spin modes are treated. Solutions obtained are compared with experiments conducted at NASA Langley Research Center.

  11. NONLINEAR ELASTICITY OF BLOOD ARTERIAL DUCT

    Institute of Scientific and Technical Information of China (English)

    黄孟才; 顾忠; 沈俊; 唐复勇

    1991-01-01

    The paper deals with nonlinear elasticity of blood arterial duct, in which the artery is modeled to bea locally triclinic, transverse isotropic, incorapressible, axisymmetric and thickwalled tube with large deformations, The nonlinear coustitutive relationship of arterial tissues is based on the theorv of Green and Adkins. A nonlinear strain energy density function is introduced for nonlinear stress-strain relationship of second order, in which the coefficient of each term is expressed by means of a Lame’s constant, The elasticity constants are nqcessary to describe such a uonlinear finite strain etastieity of the second order, These constants are determined by means of the stress-strain increment theory.

  12. Effect of ligation of mesenteric lymph duct on coagulation function in rats with severe heat stroke

    Directory of Open Access Journals (Sweden)

    Hua-sheng TONG

    2016-03-01

    Full Text Available Objective  To investigate the influences of mesenteric lymph duct ligation (LDL on the coagulation function in rats with severe heat stroke (SHS. Methods  Forty male Wistar rats were randomly and equally divided into control, heat stroke sham (HSS, HSS-LDL, severe heat stroke (SHS and SHS+LDL groups. Mesenteric lymph ducts were ligated in HSC-LDL and SHS-LDL groups before reproduction of SHS model. SHS rat models were reproduced in a prewarmed incubator. Peripheral blood was drawn to determine the parameters pertaining to blood coagulability including prothrombin time (PT, activated partial thromboplastin time (APTT, D-dimmer and platelet count (PLT, and lung and kidney histopathology was observed after heat stroke. Results  Compared with those in control group, no obvious changes were observed in the coagulation indices in HSS and HSS-LDL group. While PT and APTT significantly prolonged, PLT remarkably decreased, D-dimmer markedly increased in SHS group (P<0.05. The coagulation indices presented a recovery trend to certain extent in SHS-LDL group. Histopathological examination of the kidney and lung showed severe hemorrhagic and congestive lesions in SHS group. Mesenteric lymph duct ligation alleviated the coagulation disorders and histopathological lesions. Conclusion  The entrance of toxic agents through lymphatic passage may be the pathogenetic factor in producing coagulopathy, and ligation of the mesenteric lymph ducts might prevent the entrance of toxic materials and alleviate the injury to the blood coagulation property and internal organs. DOI: 10.11855/j.issn.0577-7402.2016.02.02

  13. Laminar flow heat transfer studies in a twisted square duct for constant wall heat flux boundary condition

    Indian Academy of Sciences (India)

    Rambir Bhadouriya; Amit Agrawal; S V Prabhu

    2015-04-01

    The problem of fluid flow and heat transfer was studied for flow inside twisted duct of square cross-section. Three-dimensional numerical solutions were obtained for steady fully developed laminar flow and for uniform wall heat flux boundary conditions using commercially available software. Reynolds number range considered was 100-3000. Twist ratio used are 2.5, 5, 10 and 20. Fluids considered are in Prandtl number range of 0.7-20. Product of friction factor and Reynolds number is found to be a function of Reynolds number and maximum values are observed for a twist ratio of 2.5 and Reynolds number of 3000. Maximum Nusselt number is observed for the same values along with Prandtl number of 20. Correlations for friction factor and Nusselt number are developed involving swirl parameter. Local distribution of friction factor ratio and Nusselt number across a cross-section is presented. Based on constant pumping power criteria, enhancement factor is defined to compare twisted ducts with straight ducts. Selection of twisted square duct is presented in terms of enhancement factor. It is found that twisted duct performs well in the laminar region for range of parameters studied. Heat transfer enhancement for Reynolds number of 3000 and Prandtl number of 0.7 for twist ratio of 2.5, 5, 10, and 20 is 20%, 17.8%, 16.1% and 13.7%, respectively. The results are significant because it will contribute to development of energy efficient compact size heat exchangers.

  14. Noninvasive study of anatomic variations of the bile and pancreatic duct using magnetic resonance cholangiopancreatography; Estudio no invasivo de variantes anatomicas de la via biliar y pancreatica mediante colangiopancreatografia por resonancia magnetica (CPRM)

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, E.; Falco, J.; Campo, R.; Martin, J.; Brullet, E. [SDI-UDIAT Corporacio Sanitaria Parc Tauli. Sabadell (Spain); Espinos, J. [Hospital Mutua de Tarrasa (Spain)

    1999-07-01

    To identify anatomic variations of the bile duct and pancreatic duct and papillary anomalies by means of magnetic resonance cholangiopancreatography (MRCP) and determine their correlation with endoscopic retrograde cholangiopancreatography (ERCP) findings. Eighty-five patients were selected by means of a prospective study comparing MRCP and ERCP. Coronal and axial HASTE images and coronal and oblique coronal RARE images were acquired in all the patients. Four of the studies (6%) were excluded because of poor technical quality. Anatomic variations were observed in 26 cases (30.5%), including trifurcation (n=7; 27%), right hepatic duct draining into left hepatic duct (n=2, 7.7%), right hepatic duct draining into common bile duct (n=4; 15.4%), extrahepatic confluence (n=2; 7.7%), medial cystic duct (n=2; 7.7%), parallel cystic duct (n=3; 11.5%), juxtapapillary duodenal diverticulum (n=3; 11.5%) and pancreas divisum (n=3; 11.5%). A good correlation was observed between the MRCP and ERCP findings. The introduction of MRCP into the noninvasive study of biliary disease may be useful in the detection of anatomic variations relevant to laparoscopic surgery and other endoscopic and interventional techniques. (Author) 11 refs.

  15. Microvessel density at different levels of normal or injured bile duct in dogs and its surgical implications

    Institute of Scientific and Technical Information of China (English)

    LinGeng; DingLuo; Hao-ChunZhang; Liang-SongZhao; De-KeQing

    2011-01-01

    BACKGROUND: Ischemic recurrent stricture after surgical repair for iatrogenic bile duct injury (BDI) remains a challenge in clinical practice. The present study was designed to investigate whether ischemia is universal and of varied severity at different levels of the proximal bile duct after BDI. METHODS: A total of 30 beagle dogs were randomly divided into control, BDI, and BDI-repaired groups. The BDI animal model was established based on the classic pattern of laparoscopic cholecystectomy-related BDI. The animals were sacrificed on postoperative day 15, and bile duct tissue was harvested to assess microvessel density (MVD) at selected levels of the normal, post-BDI and BDI-repaired bile duct with the CD34 immunohistochemistry technique. RESULTS:  In the control group, MVD at level H (high level) was remarkably higher than that at level L (low level). No significant difference was found between MVDs at levels H and M (middle level), as well as at levels M and L. However, the tendency was noted that the closer the level to the hilus, the greater the MVD at that level. In both the BDI and BDI-repaired groups, MVDs at level H were generally greater than those at level L, despite the unremarkable differences between MVDs at neighboring levels. In these two groups, a similar tendency of MVD distribution to that in the control group was found; the closer the level to the injury site, the lower was the MVD at that level. Moreover, compared with the MDVs at the levels M and L in the control group, MVDs at the corresponding levels in the BDI and BDI-repaired groups were all remarkably reduced (P CONCLUSIONS: After BDI, universal ischemic damage in the injured proximal bile duct develops close to the injury site, while close to the hilus, ischemia is relatively slight. High hepaticojejunostomy, rather than low biloenterostomy or end-to-end duct anastomosis, should be recommended for BDI repair. Great care should be taken to protect the peribiliary plexus during

  16. Chloride and potassium conductances of cultured human sweat ducts

    DEFF Research Database (Denmark)

    Novak, I; Pedersen, P S; Larsen, Erik Hviid

    1992-01-01

    The purpose of this study was to characterize the ion conductances, in particular those for Cl- and K+, of human sweat duct cells grown in primary culture. Sweat duct cells from healthy individuals were grown to confluence on a dialysis membrane, which was then mounted in a mini-Ussing chamber...

  17. Bidirectional infrasonic ducts associated with sudden stratospheric warming events

    NARCIS (Netherlands)

    Assink, J.D.; Waxler, R.; Smets, P.S.M.; Evers, L.G.

    2014-01-01

    In January 2011, the state of the polar vortex in the midlatitudes changed significantly due to a minor sudden stratospheric warming event. As a result, a bidirectional duct for infrasound propagation developed in the middle atmosphere that persisted for 2 weeks. The ducts were due to two zonal wind

  18. Diverticular bile duct lesion in chronic active hepatitis

    DEFF Research Database (Denmark)

    Vyberg, M

    1989-01-01

    Liver needle biopsies from patients with non-A, non-B chronic active hepatitis and so-called abnormal bile duct epithelium were studied with a three-dimensional method. Photographs of bile duct structures in serial sections were transferred to acrylic plates. Five bile duct lesions of a not previ......Liver needle biopsies from patients with non-A, non-B chronic active hepatitis and so-called abnormal bile duct epithelium were studied with a three-dimensional method. Photographs of bile duct structures in serial sections were transferred to acrylic plates. Five bile duct lesions...... cells, but most were larger, with rounded nuclei, prominent nucleoli and abundant eosinophilic cytoplasm, sometimes with periodic acid-Schiff-positive, diastase-resistant granules. The lesions were only partly surrounded by a basement membrane. They were all embedded in a tight mononuclear inflammatory...... infiltrate associated with pronounced periportal piecemeal necrosis. In two cases, a germinal center was adjacent to the epithelium. The pathogenesis of the diverticular bile duct lesion is unknown, but the diverticuli probably represent Hering ducts and groups of periportal liver cells which have escaped...

  19. Cystic duct closure by sealing with bipolar electrocoagulation

    DEFF Research Database (Denmark)

    Schulze, S; Damgaard, B; Jørgensen, Lars Nannestad;

    2010-01-01

    BACKGROUND: Cystic duct leakage after cholecystectomy is not uncommon and is a potentially serious complication. The aim of this study was to assess a bipolar sealing system (LigaSure) for closure of the cystic duct. METHODS: The records from consecutive laparoscopic cholecystectomies performed i...

  20. Intracellular pH in rat pancreatic ducts

    DEFF Research Database (Denmark)

    Novak, I; Hug, M; Greger, R

    1997-01-01

    In order to study the mechanism of H+ and HCO3- transport in a HCO3- secreting epithelium, pancreatic ducts, we have measured the intracellular pH (pHi) in this tissue using the pH sensitive probe BCECF. We found that exposures of ducts to solutions containing acetate/acetic acid or NH4+/NH3 buff...

  1. Radiopaque intrahepatic duct stones in plain radiograph: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Suh, Chang Hae; Park, Chan Sup; Chung, Won Kyun [College of Medicine, Inha University, Seongnam (Korea, Republic of)

    1994-04-15

    We experienced 3 cases of intrahepatic duct stones detected on plain radiographs. The patients had history of multiple episodes of recurrent cholangitis. Radiographic characteristics of these stones included multiple, round or rectangular radiopaque densities surrounded by calcified rim; these densities showed a branching pattern along the intrahepatic ducts.

  2. Sound waves in two-dimensional ducts with sinusoidal walls

    Science.gov (United States)

    Nayfeh, A. H.

    1974-01-01

    The method of multiple scales is used to analyze the wave propagation in two-dimensional hard-walled ducts with sinusoidal walls. For traveling waves, resonance occurs whenever the wall wavenumber is equal to the difference of the wavenumbers of any two duct acoustic modes. The results show that neither of these resonating modes could occur without strongly generating the other.

  3. Sound Radiation Characteristics of a Rectangular Duct with Flexible Walls

    Directory of Open Access Journals (Sweden)

    Praveena Raviprolu

    2016-01-01

    Full Text Available Acoustic breakout noise is predominant in flexible rectangular ducts. The study of the sound radiated from the thin flexible rectangular duct walls helps in understanding breakout noise. The current paper describes an analytical model, to predict the sound radiation characteristics like total radiated sound power level, modal radiation efficiency, and directivity of the radiated sound from the duct walls. The analytical model is developed based on an equivalent plate model of the rectangular duct. This model has considered the coupled and uncoupled behaviour of both acoustic and structural subsystems. The proposed analytical model results are validated using finite element method (FEM and boundary element method (BEM. Duct acoustic and structural modes are analysed to understand the sound radiation behaviour of a duct and its equivalence with monopole and dipole sources. The most efficient radiating modes are identified by vibration displacement of the duct walls and for these the radiation efficiencies have been calculated. The calculated modal radiation efficiencies of a duct compared to a simple rectangular plate indicate similar radiation characteristics.

  4. Naproxen-induced liver injury

    Institute of Scientific and Technical Information of China (English)

    Sharif Ali; Jason D Pimentel; Chan Ma

    2011-01-01

    BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to induce liver injury. Patterns of the injury usually range from mild elevations of liver enzymes to sometimes severe fulminant hepatic failure. Likewise, naproxen is a propionic acid derivative NSAID that was introduced in 1980 and has been available as an over-the-counter medication since 1994, but has rarely been reported to cause liver injury. METHODS: We treated a 30-year-old woman with jaundice and intractablepruritusthatdevelopedshortlyaftertakingnaproxen. We reviewed the medical history and liver histopathology of the patient as well as all previously published case reports of naproxen-associated liver toxicity in the English language literature. RESULTS: The liver biochemical profile of the patient revealed a mixed cholestasis and hepatitis pattern. Consecutive liver biopsies demonstrated focal lobular inflammation, hepatocyte drop-out, and a progressive loss of the small interlobular bile ducts (ductopenia). The biopsy performed two years after onset of the disease showed partial recovery of a small number of bile ducts; however, 10 years passed before the biochemical profile returned to near normal. CONCLUSIONS:  Naproxen-associated liver toxicity remains a rare entity, but should be considered in any patient presenting with cholestasis shortly after its use. Liver injury is most commonly seen in a mixed pattern characterized by cholestasis and hepatitis. The resulting liver damage may take years to resolve.

  5. Non-suicidal self-injury among psychiatric outpatient adolescent offspring of Croatian posttraumatic stress disorder male war veterans: Prevalence and psychosocial correlates.

    Science.gov (United States)

    Boričević Maršanić, Vlatka; Aukst Margetić, Branka; Ožanić Bulić, Suzana; Đuretić, Irena; Kniewald, Hrvoje; Jukić, Tatjana; Paradžik, Ljubica

    2015-05-01

    The children of male veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk of emotional and behavioral problems. However, no studies have examined non-suicidal self-injury (NSSI) in this population of youth. To determine the prevalence and psychosocial correlates of lifetime NSSI in a sample of psychiatric outpatient adolescent offspring of Croatian PTSD male veterans. Consecutive outpatient adolescent offspring of Croatian male PTSD veterans, aged 12 to 18 years, were assessed on the Deliberate Self Harm Inventory, the Youth Self-Report, the Family Assessment Device, the Parental Bonding Instrument and the Demographics Questionnaire. Of the whole sample, 52.7% of adolescents reported NSSI at least once during their lifetime. Lifetime NSSI was significantly associated with internalizing symptoms (adjusted odds ratio (OR) = 2.14; 95% confidence interval (CI): 1.04-4.42, p = .040), poor family functioning (adjusted OR = 6.54; 95% CI: 2.02-21.22, p = .002), lower maternal and paternal care (adjusted OR = 0.47; 95% CI: 0.40-0.56, p = .000 and adjusted OR = 0.82; 95% CI: 0.73-0.91, p = .000, respectively) and higher paternal control (adjusted OR = 1.84; 95% CI: 1.59-2.14, p = .000) in multivariate analysis. No association was found between lifetime NSSI and any of the socio-demographic variables. NSSI is a significant clinical problem in outpatient adolescent offspring of PTSD male veterans, which may be influenced by clinical and family factors. Interventions aimed at reducing internalizing symptoms and improving family functioning and parental behaviors are needed in the treatment of adolescent offspring of male PTSD veterans engaging in NSSI. © The Author(s) 2014.

  6. Correlations between event-related potentials with pictures recognition and WMS-RC scores in patients with memory disorder caused by severe traumatic brain injury.

    Science.gov (United States)

    Liu, Zilong; Liu, Liang; Fan, Zebing; Chen, Xiaorui; Zhao, Xiaohong; Zhang, Lingli; Rao, Guangxun; Li, Haixia

    2008-12-01

    This study explored the possibility of using event-related potentials (ERP) for the measurement of picture-recognition memory and examined its correlation with the Chinese Wechsler Memory Scale-revised (WMS-RC) in patients with memory disorder caused by severe traumatic brain injury (sTBI). The subjects included 20 sTBI patients with memory disorder and 22 healthy individuals. Memory function was measured by using WMS-RC. Behavioral and ERP responses were recorded on-line during performance on a battery of picture recognition and the responses were analyzed off-line for recognition memory effects. Mean memory quotient (MQ) of patients with sTBI was significantly lower than that of the control group. Mean reaction time (RT) was significantly longer and the mean correctness rate (CR) of picture recognition was significantly lower in sTBI group than that of the controls. In controls, the main components of average ERP of picture recognition includes two positive-going waves, designated as P(170) and P(500), that appear 170 ms and 500 ms after stimulation when the subject could later successfully recall and recognize the pictures. P(500) amplitude of target stimulus was significantly higher than that of non-target stimulus. Compared to controls, P(500) responses of sTBI group were significantly delayed in latency (PWMS-RC. ERP of picture recognition provides a neurophysiological approach to directly assess memory impairment, and P(500) may serve as a helpful index for memory disorder caused by sTBI in forensic practice.

  7. Clinical and psychosocial correlates of non-suicidal self-injury within a sample of children and adolescents with bipolar disorder.

    Science.gov (United States)

    Esposito-Smythers, Christianne; Goldstein, Tina; Birmaher, Boris; Goldstein, Benjamin; Hunt, Jeffrey; Ryan, Neal; Axelson, David; Strober, Michael; Gill, Mary Kay; Hanley, Andrea; Keller, Martin

    2010-09-01

    The purpose of this study is to examine the prevalence and correlates of non-suicidal self-injury (NSSI) among children and adolescents diagnosed with bipolar disorder (BP). Four hundred-thirty two youth with a diagnosis of BP and their parents, including 193 children and 239 adolescents, completed a diagnostic interview and instruments to assess youth clinical and illness history, youth comorbidity, parental mood disorder, and psychosocial functioning. Approximately 22% of children and 22% of adolescents reported NSSI during the course of their most recent mood episode. In a multivariate model controlling for global impairment, among children, a BPI or BPII diagnosis (versus BPNOS), psychosis, separation anxiety disorder, and greater severity of depressive symptoms were found to be associated with NSSI. Among adolescents, a mixed episode, a suicide attempt, greater severity of depressive symptoms, and poor psychosocial functioning were found to be associated with NSSI. Neither the presence of a youth comorbid disruptive behavior disorder nor a parental mood disorder was associated with NSSI. The primary limitations of this study include the use of a cross-sectional study design, lack of a control group, and limited generalizability of study results to non-clinical and ethnically diverse samples. NSSI is not uncommon among youth with BP, particularly those who present with BPI or BPII, psychosis, a mixed episode, suicidal behavior, severe depressive symptoms, separation anxiety, and/or poor psychosocial functioning. However, the relative importance of these factors in relation to NSSI may vary with age. Treatments for BP that are developmentally sensitive, examine the function of NSSI for each youth, and teach adaptive skills to address emotional and social needs, may prove to be most successful. 2010 Elsevier B.V. All rights reserved.

  8. Duct thermal performance models for large commercial buildings

    Energy Technology Data Exchange (ETDEWEB)

    Wray, Craig P.

    2003-10-01

    Despite the potential for significant energy savings by reducing duct leakage or other thermal losses from duct systems in large commercial buildings, California Title 24 has no provisions to credit energy-efficient duct systems in these buildings. A substantial reason is the lack of readily available simulation tools to demonstrate the energy-saving benefits associated with efficient duct systems in large commercial buildings. The overall goal of the Efficient Distribution Systems (EDS) project within the PIER High Performance Commercial Building Systems Program is to bridge the gaps in current duct thermal performance modeling capabilities, and to expand our understanding of duct thermal performance in California large commercial buildings. As steps toward this goal, our strategy in the EDS project involves two parts: (1) developing a whole-building energy simulation approach for analyzing duct thermal performance in large commercial buildings, and (2) using the tool to identify the energy impacts of duct leakage in California large commercial buildings, in support of future recommendations to address duct performance in the Title 24 Energy Efficiency Standards for Nonresidential Buildings. The specific technical objectives for the EDS project were to: (1) Identify a near-term whole-building energy simulation approach that can be used in the impacts analysis task of this project (see Objective 3), with little or no modification. A secondary objective is to recommend how to proceed with long-term development of an improved compliance tool for Title 24 that addresses duct thermal performance. (2) Develop an Alternative Calculation Method (ACM) change propos