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Sample records for ductus arteriosus mimicking

  1. Patent ductus arteriosus

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001560.htm Patent ductus arteriosus To use the sharing features on this page, please enable JavaScript. Patent ductus arteriosus (PDA) is a condition in which the ductus ...

  2. What Is Patent Ductus Arteriosus?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is Patent Ductus Arteriosus? Patent ductus arteriosus (PDA) is a heart problem ... the lung arteries. Normal Heart and Heart With Patent Ductus Arteriosus Figure A shows the interior of a normal ...

  3. Protective strategies to prevent patent ductus arteriosus

    Institute of Scientific and Technical Information of China (English)

    Kris C. Sekar

    2010-01-01

    Ductus arteriosus is the communication between the proximal aorta and the pulmonary artery which diverts well oxygenated blood from the placenta to the systemic circulation bypassing the fluid filled lung in the fetal circulation. Therefore it is very essential for fetal survival. After birth, in term infants the ductus usually closes within the first day of life, starting with functional closure followed by anatomical closure by vascular remodeling.1

  4. Patent ductus arteriosus with Eisenmenger syndrome.

    Science.gov (United States)

    Moustafa, Sherif; Patton, David J; Balon, Yvonne; Connelly, Michael S; Alvarez, Nanette

    2013-11-01

    Herein we report a 21 year-old woman with a previously documented patent ductus arteriosus and Eisenmenger physiology. She presented with increasing cyanosis and exercise intolerance which could be explained by a new finding of right to left shunting through an interatrial communication. She was started on Bosentan therapy aiming to reduce the pulmonary pressure with consideration for heart-lung transplantation should any further deterioration occur.

  5. A rare association with patent ductus arteriosus

    Directory of Open Access Journals (Sweden)

    Dhanya Warrier

    2012-01-01

    Full Text Available Persistent fifth aortic arch (PFAA, also known as congenital double-lumen aortic arch, is a rare developmental anomaly of the aortic arch. A 5-month-old baby who presented with congestive cardiac failure was diagnosed to have a large patent ductus arteriosus with PFAA. Although this arch anomaly had no hemodynamic relevance in this case, preoperative diagnosis prevented surprises "on table."

  6. Etiology of patent ductus arteriosus in dogs.

    Science.gov (United States)

    Buchanan, James W; Patterson, Donald F

    2003-01-01

    Patent ductus arteriosus (PDA) is the most common congenital heart disease in dogs and usually causes heart failure and death unless corrected at a young age. Previous histologic studies in a line of dogs derived from Miniature Poodles with hereditary PDA identified varying degrees of hypoplasia and asymmetry of ductus-specific smooth muscle and the presence of aortalike elastic tissue in the ductus wall sufficient to cause patency. To determine if similar structural abnormalities cause PDA in other dogs, serial-section, 3-dimensional histology of ductal architecture was studied in 8 non-Poodle purebred dogs with PDA with no immediate family history of PDA. Morphologic abnormalities were observed in 7 of 8 dogs with PDA and essentially were the same as those in dogs known to have a hereditary form of PDA. These findings suggest that apparently sporadic PDA in these breeds is caused by a genetic defect in the structure of the ductus arteriosus that is similar or identical to that in the Poodle. The relatives of dogs with PDA, particularly parents, offspring, and siblings, should be screened for evidence of PDA. Dogs with PDA should not be used for breeding, regardless of breed.

  7. Identification of differentially regulated genes in human patent ductus arteriosus.

    Science.gov (United States)

    Parikh, Pratik; Bai, Haiqing; Swartz, Michael F; Alfieris, George M; Dean, David A

    2016-07-27

    In order to identify differentially expressed genes that are specific to the ductus arteriosus, 18 candidate genes were evaluated in matched ductus arteriosus and aortic samples from infants with coarctation of the aorta. The cell specificity of the gene's promoters was assessed by performing transient transfection studies in primary cells derived from several patients. Segments of ductus arteriosus and aorta were isolated from infants requiring repair for coarctation of the aorta and used for mRNA quantitation and culturing of cells. Differences in expression were determined by quantitative PCR using the ΔΔCt method. Promoter regions of six of these genes were cloned into luciferase reporter plasmids for transient transfection studies in matched human ductus arteriosus and aorta cells. Transcription factor AP-2b and phospholipase A2 were significantly up-regulated in ductus arteriosus compared to aorta in whole tissues and cultured cells, respectively. In transient transfection experiments, Angiotensin II type 1 receptor and Prostaglandin E receptor 4 promoters consistently gave higher expression in matched ductus arteriosus versus aorta cells from multiple patients. Taken together, these results demonstrate that several genes are differentially expressed in ductus arteriosus and that their promoters may be used to drive ductus arteriosus-enriched transgene expression.

  8. Pharmacologic management of patent ductus arteriosus.

    Science.gov (United States)

    Bhatt, V; Nahata, M C

    1989-01-01

    The incidence, pathophysiology, and clinical findings of symptomatic patent ductus arteriosus (PDA) are reviewed, and the pharmacologic management of symptomatic PDA is discussed. Spontaneous closure of the ductus arteriosus (DA) usually occurs within four days after birth in most premature and full-term infants. The incidence of PDA is related to birth weight in premature infants and has been shown to decrease with an increase in birth weight. Clinical findings are reviewed. Prophylactic treatment in the first few hours after birth may not be needed in most premature infants. Treatment should be considered only if the ductus becomes symptomatic. Medical management consists of respiratory support, fluid restriction, diuretics, digoxin, and indomethacin. Respiratory support, fluid restriction, and diuretics are used as first-line treatment of symptomatic PDA. Digoxin cannot be recommended as part of first-line therapy, since its risks seem to outweigh the benefits in preterm infants. Indomethacin should be used only if other standard measures including fluid restriction and diuretic treatment fail. The mechanism of action, pharmacokinetics, adverse effects, and drug interactions of indomethacin are discussed. Symptomatic PDA can increase morbidity and mortality, especially in very low birth weight infants. Treatment of symptomatic PDA may decrease the morbidity associated with this condition.

  9. Frontal Cardiac area in patent ductus arteriosus patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kun Sang; Choo, Dong Woon [Seoul Natinal University College of Medicine, Seoul (Korea, Republic of)

    1972-03-15

    Cardiac mensuration by radiographic frontal cardiac area method was carried out on 21 patent ductus arteriosus patients, 15 females and 6 males. Formula used in this study is as follows. Frontal cardiac area = {pi}/4 X long diameter X broad diameter. Increase of frontal cardiac area in patent ductus arteriosus patients seems to be evident but the degree of the cardiomegaly is variable. Comparing to normal data by Choo and Kim, frontal cardiac area in patent ductus arteriosus patients in this series is increased in 15.9% to 98.1%. After surgical ligation of the ductus arteriosus, significant decrease of the frontal cardiac area is observed and the average is 12.5%.

  10. Ibuprofen and paracetamol for patent ductus arteriosus

    Directory of Open Access Journals (Sweden)

    Carlo Dani

    2014-06-01

    Full Text Available We aimed to assess the state of the art of pharmacological treatment of patency of ductus arteriosus (PDA with ibuprofen and paracetamol in preterm infants. We pointed out that ibuprofen is the first choice drug for PDA treatment and indomethacin should be abandoned for its frequent adverse effects. However, also the pharmacological prevention of PDA should be abandoned because many preterm infants have spontaneous closure of PDA and ibuprofen may have dangerous adverse effects. Oral paracetamol has been found in two randomized controlled studies to have the same effectiveness of ibuprofen in closing PDA but without toxicity. If these data will be confirmed the management of PDA in preterm infants should be re-evaluated. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  11. The patent ductus arteriosus in term infants, children, and adults.

    Science.gov (United States)

    Schneider, Douglas J

    2012-04-01

    During fetal life, the ductus arteriosus is a normal and essential structure that connects the pulmonary artery to the distal aortic arch, permitting right ventricular ejection into the aorta. After birth, with commencement of pulmonary blood flow and a 2-ventricle circulation, a variety of physiological and biochemical signals normally result in complete closure of the ductus. Persistent patency of the ductus arteriosus may impair systemic cardiac output and result in deleterious effects on the cardiovascular system and lungs. Although surgery is still the treatment of choice for most premature infants with patent ductus arteriosus (PDA), transcatheter techniques have largely supplanted surgery for closure of PDA in children and adults. This article is a review of the PDA in term infants, children, and adults, with focus on the clinical manifestations and management.

  12. Velocity time integral for right upper pulmonary vein in VLBW infants with patent ductus arteriosus.

    Science.gov (United States)

    Lista, Gianluca; Bianchi, Silvia; Mannarino, Savina; Schena, Federico; Castoldi, Francesca; Stronati, Mauro; Mosca, Fabio

    2016-10-01

    Early diagnosis of significant patent ductus arteriosus reduces the risk of clinical worsening in very low birth weight infants. Echocardiographic patent ductus arteriosus shunt flow pattern can be used to predict significant patent ductus arteriosus. Pulmonary venous flow, expressed as vein velocity time integral, is correlated to ductus arteriosus closure. The aim of this study is to investigate the relationship between significant reductions in vein velocity time integral and non-significant patent ductus arteriosus in the first week of life. A multicenter, prospective, observational study was conducted to evaluate very low birth weight infants (patent ductus compared to those with closed patent ductus arteriosus and the difference was significant. A significant reduction in vein velocity time integral in the first days of life is associated with ductus closure. This parameter correlates well with other echocardiographic parameters and may aid in the diagnosis and management of patent ductus arteriosus.

  13. Pros and cons of patent ductus arteriosus ligation: hemodynamic changes and other morbidities after patent ductus arteriosus ligation.

    Science.gov (United States)

    Noori, Shahab

    2012-04-01

    Although surgical ligation of a persistent patent ductus arteriosus resolves the adverse hemodynamic consequences of the systemic-to-pulmonary shunt and may confer some long-term benefits, it is also associated with both immediate and long-term negative effects. The population that benefits from or is harmed by the procedure is not clearly defined. Although indiscriminate ligation of the patent ductus arteriosus in all patients is not supported by the available information, the recent suggestion declaring the ductus harmless is not supported either. As we await the results of appropriately designed randomized control studies to define the indications for ligation, we must use clinical and echocardiographic indicators of a hemodynamically significant ductus arteriosus and thoughtful assessment of each individual patient to help guide us in addressing this complex problem.

  14. Impact of patent ductus arteriosus and subsequent therapy with indomethacin on cerebral oxygenation in preterm infants

    NARCIS (Netherlands)

    Lemmers, Petra M. A.; Toet, Mona C.; van Bel, Frank

    2008-01-01

    OBJECTIVES. A hemodynamically important patent ductus arteriosus is a common problem in the first week of life in the preterm infant. Although patent ductus arteriosus induces alterations in organ perfusion, scarce information is available of the impact of patent ductus arteriosus and its subsequent

  15. TRANSCATHETER CLOSURE OF PATENT DUCTUS ARTERIOSUS

    Institute of Scientific and Technical Information of China (English)

    高伟; 周爱卿; 余志庆; 李奋; 王荣发; 黄美蓉

    2002-01-01

    Objective To explore the efficacy of transcatheter closure of patent ductus arteriosus (PDA) with detachable coil and Amplatzer duct occluder (ADO). Methods Transcatheter colsure of PDA was performed in 160 cases, aged 4.56±2.67 years, of whom 3 had residual shunt after surgical ligation, 2 had pulmomary stenosis (PS), 1 had coarctation of aorta (COA), 1 had right aortic arch, and 2 had atrial septal defect (ASD). Results Detachable coils (Duct Occlude pfm or Cook Inc) were successfully used in 51 patients with a smallest PDA diameter of 1.86±0.78mm. Amplatzer duct occluders were also successfully performed in other 109 with a moderate to large PDA diameter of 3.89±1.32mm, of whom 3 with PS or COA were performed balloon dilation firstly, and 2 with ASD were performed PDA occlusion firstly; 1 month to 4.8years follow-up coil or Amplatzer device closure of PDA showed that neither residual shunt nor any complication. Conclusion It is suggested that the detachable coil and Amplatzer duct occluder are simple and safe for the catheter closure from small to large sized PDA.

  16. Unusual presentation for a patent ductus arteriosus

    Directory of Open Access Journals (Sweden)

    C. D. Vizza

    2009-09-01

    Full Text Available A 63-yr-old black female, with a 1-yr history of hepatitis C and ascites was referred to an expert centre with suspicion of portopulmonary hypertension (PPHTN. Her poor condition made a rapid diagnosis imperative and precluded a normal diagnostic work-up. Echocardiography confirmed severe pulmonary hypertension (PH. A hepatic scintigraphy and an abdominal echo-Doppler study excluded liver cirrhosis and portal hypertension. Cardiac magnetic resonance imaging showed marked dilation of the right ventricle with significant hypertrophy of the free wall, a finding that is uncommon in idiopathic pulmonary arterial hypertension or PPHTN. Right heart catheterisation demonstrated severe pre-capillary PH without response to acute vasodilator testing. Finally the patient underwent computed tomography angiography, which showed marked dilation of the pulmonary artery without thromboembolic disease and, unexpectedly, a partially calcified large patent ductus arteriosus. The correct diagnosis of the underlying cause of pulmonary arterial hypertension is essential. Patients with underlying heart defects may have an atypical presentation and be referred to expert centres with an incorrect diagnosis. A full investigation is necessary; careful examination of right ventricular anatomy can provide clues about the aetiology of PH, and it is important to exclude intra- and extracardiac shunts during haemodynamic studies.

  17. Adult patent ductus arteriosus complicated by endocarditis and hemolytic anemia.

    Science.gov (United States)

    Sabzi, Feridoun; Faraji, Reza

    2015-01-01

    An adult with a large patent ductus arteriosus may present with fatigue, dyspnea or palpitations or in rare presentation with endocarditis. The case illustrated unique role of vegetation of endocarditis in hemolytic anemia in adult with patent ductus arteriosus (PDA). Despite treatment of endocarditis with complete course of appropriate antibiotic therapy and normality of C- reactive protein, erythrocyte sedimentation rate and leukocytosis and wellness of general condition, transthoracic echocardiography revealed large vegetation in PDA lumen, surgical closure of PDA completely relieved hemolysis, and fragmented red cell disappeared from peripheral blood smear. The 3-month follow-up revealed complete occlusion of PDA and abolishment of hemolytic anemia confirmed by clinical and laboratory examination.

  18. Magnetic resonance imaging of the ductus arteriosus - case report

    Energy Technology Data Exchange (ETDEWEB)

    Yousry, T.; Bacherler, B.; Tiling, R.; Fink, U.; Werdan, K.

    1989-03-01

    In a female patient suffering from renal insufficiency in whom angiography could not be performed, it was possible to confirm the diagnosis of a ductus arteriosus (ductus of Botalli) by magnetic resonance imaging. The present case report shows that it is possible to visualise this congenital heart disease by MRI. This can be of importance especially if angiography cannot be performed (as in this case) because of renal insufficiency or because of contrast medium allergy.

  19. Adrenal function in preterm infants undergoing patent ductus arteriosus ligation.

    LENUS (Irish Health Repository)

    El-Khuffash, Afif

    2013-01-01

    Targeted milrinone treatment for low left ventricular output (LVO) reduces the incidence of acute cardiorespiratory instability following ligation of patent ductus arteriosus (PDA) in preterm infants. Despite this, some infants continue to experience postoperative deterioration. Adrenal insufficiency related to prematurity has been postulated as a possible mechanism.

  20. Patent Ductus Arteriosus Treatment in Very Preterm Infants

    DEFF Research Database (Denmark)

    Edstedt Bonamy, Anna-Karin; Gudmundsdottir, Anna; Maier, Rolf F

    2017-01-01

    BACKGROUND: Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. OBJECTIVES: The aim of this work was to study regional variations in PDA treatment...

  1. Ibuprofen pharmacokinetics in preterm infants with patent ductus arteriosus

    NARCIS (Netherlands)

    Van Overmeire, B; Touw, D; Schepens, P J; Kearns, G L; van den Anker, J N

    2001-01-01

    OBJECTIVE: Our objective was to study the pharmacokinetics of ibuprofen in premature infants with patent ductus arteriosus on day 3 and day 5 after birth. METHODS: Ibuprofen was administered on days 3, 4, and 5 by a 15-minute intravenous infusion of 10, 5, and 5 mg/kg, respectively, with the aim of

  2. Congenital absence of pericardium in babies with patent ductus arteriosus.

    Science.gov (United States)

    Azhar, I O; Anas, R

    2013-06-01

    We report a case of two babies with absence of pericardium and patent ductus arteriosus (PDA). The absence of pericardium was found coincidentally during PDA ligation. The PDA was successfully ligated but the pericardium was not reconstructed. Postoperatively, the agenesis of the pericardium did not interfere with cardiac function.

  3. Surgical ligation of patent ductus arteriosus in premature infants

    DEFF Research Database (Denmark)

    Sørensen, Cristel M; Steensberg, Jesper N; Greisen, Gorm

    2010-01-01

    The objective was to evaluate the mortality and the morbidity in neonates operated for persistent ductus arteriosus at Copenhagen University Hospital in the 10-year period from 1 January 1998 to 31 December 2007, and to compare the results with results reported in extant literature....

  4. Ibuprofen pharmacokinetics in preterm infants with patent ductus arteriosus

    NARCIS (Netherlands)

    Van Overmeire, B; Touw, D; Schepens, P J; Kearns, G L; van den Anker, J N

    2001-01-01

    OBJECTIVE: Our objective was to study the pharmacokinetics of ibuprofen in premature infants with patent ductus arteriosus on day 3 and day 5 after birth. METHODS: Ibuprofen was administered on days 3, 4, and 5 by a 15-minute intravenous infusion of 10, 5, and 5 mg/kg, respectively, with the aim of

  5. Guinea pig ductus arteriosus. II - Irreversible closure after birth.

    Science.gov (United States)

    Fay, F. S.; Cooke, P. H.

    1972-01-01

    To investigate the mechanism underlying irreversibility of ductal closure after birth, studies were undertaken to determine the exact time course for the onset of irreversible closure of the guinea pig ductus arteriosus. Parallel studies of the reactivity of ductal smooth muscle to oxygen and studies of the postpartum cellular changes within the vessel were also carried out.

  6. Evaluation of cerebral electrical activity and cardiac output after patent ductus arteriosus ligation in preterm infants.

    LENUS (Irish Health Repository)

    Leslie, A T F S

    2013-11-01

    To characterize and investigate the relationship between systemic blood flow and pre- and postoperative cerebral electrical activity in preterm neonates undergoing patent ductus arteriosus (PDA) ligation.

  7. History of the ductus arteriosus: 1. Anatomy and spontaneous closure.

    Science.gov (United States)

    Obladen, Michael

    2011-01-01

    Ductus arteriosus and foramen ovale were described by Galen without understanding their functions. His beliefs in soul localization and spiritization within the left ventricle established religious pneumatology which became a theological need in the Middle Ages. Pulmonary transit was recognized by Servetus and Colombo after the Reformation around 1550. This prompted Harvey's full understanding of the fetal circulation. Botallo did not describe the ductus arteriosus, but in 1564 redescribed the foramen ovale, making his way into the nomina anatomica by mistake. Most authors of the 19th and 20th century believed ductal patency to be passive, and postnatal closure to be an active process, explained by mechanical theories. After the discovery of prostaglandins by Bergstrom and Vane, Coceani proved that ductal patency is maintained by the relaxant action of prostaglandins.

  8. Efficacy of paracetamol on patent ductus arteriosus closure may be dose dependent: evidence from human and murine studies.

    LENUS (Irish Health Repository)

    El-Khuffash, Afif

    2014-09-01

    We evaluated the clinical effectiveness of variable courses of paracetamol on patent ductus arteriosus (PDA) closure and examined its effect on the in vitro term and preterm murine ductus arteriosus (DA).

  9. Gentamicin pharmacokinetics in preterm infants with a patent and a closed ductus arteriosus

    NARCIS (Netherlands)

    Touw, D J; Proost, J H; Stevens, R; Lafeber, H N; van Weissenbruch, M M

    2001-01-01

    BACKGROUND AND AIM: A patent ductus arteriosus (PDA) may influence renal and hepatic blood flow and hence pharmacokinetics of drugs in neonates compared to neonates with a closed ductus arteriosus (CDA). A 10-percent difference of gentamicin pharmacokinetic parameters between PDA and CDA has been re

  10. Use of a Stent Graft for Patent Ductus Arteriosus in an Octogenarian Eliminates Ductus Flow.

    Science.gov (United States)

    Tatsuishi, Wataru; Kataoka, Go; Asano, Ryota; Sato, Atsuhiko; Nakano, Kiyoharu

    2016-06-20

    Closure of a patent ductus arteriosus (PDA) in the elderly is a high-risk procedure because of tissue fragility and many possible complications. The patient in our case was an 81-year-old woman with a window-type PDA caused by cardiac failure. Based on the anatomy of the PDA and aorta and to minimize invasion, we used a stent graft to close the PDA. This approach was successful; hemodynamics improved and ductus flow was eliminated during the follow-up period without intervention from the pulmonary artery side.

  11. Management of patent ductus arteriosus in premature infants.

    Science.gov (United States)

    Bhat, Rama; Das, Utpala G

    2015-01-01

    Patency of the ductus arteriosus is required for fetal survival in utero. In infants born prematurely, ductus fails to close and shunt reverses from left to right. Incidence of patent ductus arteriosus (PDA) is inversely proportional to the gestational age. A large PDA (>1.5 mm diameter) with left to right shunt in very low birth weight infants can cause pulmonary edema, congestive heart failure, pulmonary hemorrhage and increase the risk for bronchopulmonary dysplasia. Attempts to prevent or close the duct by pharmacological or surgical methods have not changed the morbidity or the long term outcome. Pharmacological treatment with indomethacin or ibuprofen is successful in 75 to 80 % of infants but its use also exposes these infants to undesirable side effects like gastrointestinal bleeding, perforation and necrotizing enterocolitis. Prophylactic therapy with indomethacin or ibuprofen to prevent PDA has not altered the morbidity or long term outcome. Currently, there is a dilemma as to how to treat, when to treat and whom to treat. Recent literature suggests a trial of conservative management during the first week followed by selective use of anti-inflammatory drugs. Surgical ligation is reserved for infants who fail medical therapy and still remain symptomatic. Spontaneous closure of the PDA has been reported in up to 40-67 % of very low birth weight (VLBW) infants by 7 d. In this review authors discuss these controversies and propose a more rational approach.

  12. Thrombosed aneurysmal nonpatent ductus arteriosus: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Sattar, P. [Radiology Department, Regionalspital Biel, Vogelsang 84, CH-2502 Biel-Bienne (Switzerland); Ehrensperger, J. [Pediatric Surgery Department, Kinderspital Wildermeth, Kloosweg 22, CH-2502 Biel-Bienne (Switzerland); Ducommun, J.C. [Radiology Department, Regionalspital Biel, Vogelsang 84, CH-2502 Biel-Bienne (Switzerland)

    1996-03-01

    We report our observations made clinically and by conventional radiography, ultrasound, computed tomography and MRI on a newborn full-term infant with a thrombosed patent aneurysmal ductus arteriosus of Botallo. The baby had no heart murmurs, but from the beginning of the 2nd day of life developed sinus tachycardia, especially when in a left-sided position, and dyspnoea mainly when drinking. From his 1st day of life we observed generalized muscular hypotonia and a tendency for hyperextension at neurological examination. (orig.). With 5 figs.

  13. Wall shear stress distributions on stented patent ductus arteriosus

    Science.gov (United States)

    Kori, Mohamad Ikhwan; Jamalruhanordin, Fara Lyana; Taib, Ishkrizat; Mohammed, Akmal Nizam; Abdullah, Mohammad Kamil; Ariffin, Ahmad Mubarak Tajul; Osman, Kahar

    2017-04-01

    A formation of thrombosis due to hemodynamic conditions after the implantation of stent in patent ductus arteriosus (PDA) will derived the development of re-stenosis. The phenomenon of thrombosis formation is significantly related to the distribution of wall shear stress (WSS) on the arterial wall. Thus, the aims of this study is to investigate the distribution of WSS on the arterial wall after the insertion of stent. Three dimensional model of patent ductus arteriosus inserted with different types of commercial stent are modelled. Computational modelling is used to calculate the distributions of WSS on the arterial stented PDA. The hemodynamic parameters such as high WSS and WSSlow are considered in this study. The result shows that the stented PDA with Type III stent has better hemodynamic performance as compared to others stent. This model has the lowest distributions of WSSlow and also the WSS value more than 20 dyne/cm2. From the observed, the stented PDA with stent Type II showed the highest distributions area of WSS more than 20 dyne/cm2. This situation revealed that the high possibility of atherosclerosis to be developed. However, the highest distribution of WSSlow for stented PDA with stent Type II indicated that high possibility of thrombosis to be formed. In conclusion, the stented PDA model calculated with the lowest distributions of WSSlow and WSS value more than 20dyne/cm2 are considered to be performed well in stent hemodynamic performance as compared to other stents.

  14. Observation of right descending pulmonary arterial size and frontal cardiac area in patent ductus arteriosus patients

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Kyung Soo; Seol, Hae Yung; Suh, Won Huk; Lee, Min Jae [Korea University College of Medicine, Seoul (Korea, Republic of)

    1979-12-15

    Frontal cardiac area, right descending pulmonary arterial size and size of the ductus arteriosus were measured on 29 patients with patent ductus arteriosus,21 females and 8 males. The results are as follows: 1. Frontal cardiac area in PDA patient in this series is increased in 0.63% to 100.11 % and the average is 38.91-23.54%. 2. Central branch of the right descending pulmonary artery is dilated in 28 cases (96.55%) on pre-operative stage, and combination with dilation of central branch and constriction of peripheral branch is in 18 cases (62.1%). 3. Degree of dilation of central branch is correlated with increase of age, but it is not related with size of ductus arteriosus. 4. Increase rate of frontal cardiac area is not related with size of ductus arteriosus.

  15. A Case of Pulmonary Artery Aneurysm Associated with Patent Ductus Arteriosus : Detection by Radionuclide Cardiac Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, I.; Lee, M. C.; Cho, B. Y.; Koh, C. S.; Yoon, Y. S.; Hong, C. Y.; Rho, J. R.; Youn, K. M.; Han, M. C. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1981-09-15

    A Case of main pulmonary artery aneurysm in a 9-year-old boy with patent ductus arteriosus is presented. In this case presented with a huge mass density on the chest X-ray, radionuclide cardiac angiography showed a vascular lesion, which was confirmed as an aneurysm of the main pulmonary artery at roentgenologic angiogram. The aneurysm appeared following an episode of bacterial endocarditis and pulmonary hypertension. A successful aneurysmectomy with multiple ligation of ductus arteriosus was performed.

  16. Notch signal reception is required in vascular smooth muscle cells for ductus arteriosus closure.

    Science.gov (United States)

    Krebs, Luke T; Norton, Christine R; Gridley, Thomas

    2016-02-01

    The ductus arteriosus is an arterial vessel that shunts blood flow away from the lungs during fetal life, but normally occludes after birth to establish the adult circulation pattern. Failure of the ductus arteriosus to close after birth is termed patent ductus arteriosus, and is one of the most common congenital heart defects. Our previous work demonstrated that vascular smooth muscle cell expression of the Jag1 gene, which encodes a ligand for Notch family receptors, is essential for postnatal closure of the ductus arteriosus in mice. However, it was not known what cell population was responsible for receiving the Jag1-mediated signal. Here we show, using smooth muscle cell-specific deletion of the Rbpj gene, which encodes a transcription factor that mediates all canonical Notch signaling, that Notch signal reception in the vascular smooth muscle cell compartment is required for ductus arteriosus closure. These data indicate that homotypic vascular smooth muscle cell interactions are required for proper contractile smooth muscle cell differentiation and postnatal closure of the ductus arteriosus in mice.

  17. Risk factors for patent ductus arteriosus in preterm neonates

    Directory of Open Access Journals (Sweden)

    Novia Bernati

    2014-05-01

    Full Text Available Background The reported prevalences of patent ductus arteriosus (PDA in preterm neonates vary, and are currently unknown in Palembang. Birth weight, gestational age, asphyxia, history of antenatal steroid use, hyaline membrane disease (HMD, race and ethnicity, are potential risk factors for PDA. Objective To determine the prevalence of PDA and its risk factors in preterm neonates at Mmohammad Hoesin Hospital, Palembang. Methods This cross-sectional study was conducted from October 2011 to April 2012. Echocardiographic examinations were performed on 242 preterm neonates aged 15 hours to 7 days. Data was taken from medical records and interviews, and analyzed by Chi square and logistic regression analyses. Results Patent ductus arteriosus was found in 142 (58.7% preterm neonates with a prevalence ratio of 1.43. Neonates with birthweight ≤2,000 grams tended to have 1.9 (95% CI 1.17 to 3.32 times higher risk for PDA (P=0.01. Neonates ≤30 weeks gestation were also at 1.9 times higher risk for PDA (P=0.16. Probabilities for PDA occurrence in neonates with asphyxia, without antenatal corticosteroids and HMD were 1.6 (95% CI 1.13 to 3.36 times, 1.3 (95%CI 0.73 to 2.50 times and 2.2 (95%CI 1.29 to 3.72 times higher risk for PDA, respectively (P=0.22, 0.41, and 0.005, respectively. Conclusion Birth weight and HMD are statistically significant risk factors of PDA, but the more significant one is HMD.

  18. Patent ductus arteriosus: peculiarities of early neonatal, postnatal diagnostics, clinical manifestations, treatment and prognosis

    Directory of Open Access Journals (Sweden)

    K.A. Kalashnikova

    2017-05-01

    Full Text Available The article presents the published data on the prevalence, the main clinical manifestations, and modern methods of early neonatal and postnatal diagnosis, treatment and prognosis of patent ductus arteriosus — the congenital malformation of cardiovascular system. The International Statistical Classification of Diseases version10 defines it Q25.0 Patent ductus arteriosus. Patent ductus Botalli. Botallo’s duct patency. The pre-valence of the patent ductus arteriosus is from 0.006 to 0.02 % in mature newborns, in premature newborns — from 15 to 80 %. Clinical manifestation of the malformation depends on its size, pulmonary pressure, and proportion of pulmonary and syste-mic circulation. One of the basic clinical signs of patent ductus arteriosus  is permanent eddy murmur  in II–III space along left sternal border. In newborns and infants and if severe pulmonary hypertension diastolic murmur can be absent while systolic and forced second sound on pulmonary artery, collapsing magnus pulse, increased pulse pressure are determined. Open ductus arteriosus is not determined auscultatory in low-weight premature children. The electrocardiograph reveals downloaded left ventricular. Echo-cardiograph images ductus arteriosis, increased left ventriclular, volume overload of left ventricular. Chest roentgenograms may reveal prominent pulmonary arterial markings, increased heart breadth due to hypertrophic left ventricular. Drug obliteration with indometacin is effective in newborns aged 2 weeks. The surgical indication is verified heart disease aged 6–12 months old. The appropriate age for surgical intervention is 2–5 years old.

  19. Transcatheter closure of patent ductus arteriosus: past, present and future.

    Science.gov (United States)

    Baruteau, Alban-Elouen; Hascoët, Sébastien; Baruteau, Julien; Boudjemline, Younes; Lambert, Virginie; Angel, Claude-Yves; Belli, Emre; Petit, Jérôme; Pass, Robert

    2014-02-01

    This review aims to describe the past history, present techniques and future directions in transcatheter treatment of patent ductus arteriosus (PDA). Transcatheter PDA closure is the standard of care in most cases and PDA closure is indicated in any patient with signs of left ventricular volume overload due to a ductus. In cases of left-to-right PDA with severe pulmonary arterial hypertension, closure may be performed under specific conditions. The management of clinically silent or very tiny PDAs remains highly controversial. Techniques have evolved and the transcatheter approach to PDA closure is now feasible and safe with current devices. Coils and the Amplatzer Duct Occluder are used most frequently for PDA closure worldwide, with a high occlusion rate and few complications. Transcatheter PDA closure in preterm or low-bodyweight infants remains a highly challenging procedure and further device and catheter design development is indicated before transcatheter closure is the treatment of choice in this delicate patient population. The evolution of transcatheter PDA closure from just 40 years ago with 18F sheaths to device delivery via a 3F sheath is remarkable and it is anticipated that further improvements will result in better safety and efficacy of transcatheter PDA closure techniques.

  20. The ductus arteriosus in the preterm infant: Histologic and clinical observations

    NARCIS (Netherlands)

    Gittenberger-de Groot, A.C.; Ertbruggen, I. van; Moulaert, A.J.M.G.; Harinck, E.

    1980-01-01

    In order to elucidate some of the unexplained phenomena in prolonged patency of the ductus arteriosus in preterm infants, the histology of the ductus was studied in 27 cases. Some of the infants had been treated with indomethacin. Four morphologic maturation stages are distinguinguished. There was n

  1. Association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants.

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    Lee, Jan Hau; Greenberg, Rachel G; Quek, Bin H; Clark, Reese H; Laughon, Matthew M; Smith, P Brian; Hornik, Christoph P

    2017-06-19

    In very low birth weight infants, persistence of a patent ductus arteriosus results in morbidity and mortality. Therapies to close the ductus are effective, but clinical outcomes may depend on the accuracy of diagnosis and the timing of administration. The objective of the present study was to characterise the association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants. This retrospective cohort study used electronic health record data on inborn infants of gestational age ⩽28 weeks and birth weight patent ductus arteriosus was diagnosed in 31,712/48,551 (65%). The diagnosis was more common in infants who had undergone early echocardiography (14,549/15,971 [91%] versus 17,163/32,580 [53%], ppatent ductus arteriosus (odds ratio 1.01, 95% CI 0.90-1.15). Early echocardiography was associated with an increased diagnosis of patent ductus arteriosus, but not with decreased mortality.

  2. Prostaglandin E2 and patent ductus arteriosus in premature infants

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    Mochammading,

    2016-01-01

    Full Text Available Background Patent ductus arteriosus (PDA is a congenital heart disease most commonly occurring in premature infants. Spontaneous ductus arteriosus (DA closure in premature infants has been suggested to be associated with duct lumen maturity and the DA sensitivity to prostaglandin E2 (PGE2. Objective To assess for a possible correlation between serum PGE2 levels and PDA size in premature infants. Methods This observational study using repeated measurements on premature infants with PDA detected at days 2-3 of life was undertaken in Cipto Mangunkusumo Hospital and Fatmawati Hospital, Jakarta, from April to May 2014. The PDA was diagnosed using 2-D echocardiography and PGE2 levels were measured by immunoassay. Pearson’s correlation test was used to evaluate a possible correlation between PGE2 level and DA diameter. Results Thirty-three premature infants of median gestational age 31 (range 28-32 weeks and median birth weight 1,360 (range 1,000-1,500 grams were enrolled. Almost two-thirds of the subjects were male. Almost all (30/33 subjects had spontaneous DA closure before the age of 10 days. Subjects’ mean DA diameter was 2.9 (SD 0.5 mm with maximum flow velocity of 0.2 (SD 0.06 cm/sec, and left atrial-to-aortic root ratio (LA/Ao of 1.5 (SD 0.2. Their mean PGE2 levels at the ages of 2-3, 5-7, and after 10 days were 5,238.6 (SD 1,225.2, 4,178.2 (SD 1,534.5, and 915.2 (SD 151.6 pg/mL, respectively. The PGE2 level at days 2-3 was significantly correlated with DA diameter (r = 0.667; P < 0.001, but not at days 5-7 (r = 0.292; P = 0.105 or at day 10 (r = 0.041; P = 0.941. Conclusion There is a strong, positive correlation between the PGE2 level and DA diameter in preterm infants at 2-3 days of age. However, there is no significant correlation between PGE2 level and persistence of PDA.

  3. Modern treatment of patent ductus arteriosus – single center experience

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    Senka Mesihović Dinarević

    2014-12-01

    Full Text Available  Introduction: Transcatheter closure is a treatment choice for the most children with patent ductus arteriosus (PDA. The closure of the ductus is indicated in any child or adolescent with developed symptoms of significant L-R shunt. The aim of this article is to present our results in 5 years treatment of patients with PDA and their outcome. Methods: From 2009 to 2014, 30 patients underwent a transcatheter closure of PDA at Centre for Heart and Pediatric clinic of Clinical University Centre of Sarajevo. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for selection of appropriate occluder device type and size. All procedures were performed by local team of cardiologists from the Department of Cardiology, Pediatric clinic, with invasive cardiologists team from Sweden and Austria. Echocardiography was repeated at intervals of 24 hours, then 1month, 3 months, and 1 year after the procedure to assess the outcome. Results: Thirty patients underwent transcatheter closure of PDA during the study period. PDA of ≤ 2.0 mm was present in 8 patients and they underwent PDA closure with coils, while 22 patients had PDA diameter  ≥ 2 mm, and they were treated by Amplatzer duct occluder (ADO. Only in 2 (6.2% patients complications have been observed. The length of hospital stay after the treatment was two to three days. Conclusion: Transcatheter closure of PDA is a modern, safe and efficient method that ensures a faster recovery of the patients, shortens the length of hospitalization.

  4. Transcatheter Closure of Patent Ductus Arteriosus: The Penang Hospital's Experience.

    Science.gov (United States)

    Amir Hamzah, A R; Tiow, C A; Koh, G T; Sharifah, A M

    2011-03-01

    Transcatheter closure of small and moderate sizes of Patent Ductus Arteriosus (PDA) is a standard and well accepted form of treatment. The aim of this study is to describe the experience of transcatheter closure of PDA in Penang Hospital. All patients who underwent transcatheter closure of PDA at our institution between 20th January 2006 and 27th June 2008 were retrospectively identified and studied. There were a total of 66 patients who had undergone transcatheter closure of PDA during this period which comprised of 24 male and 42 female. The PDA was closed by Amplatzer Duct Occluder (ADO) in 31 patients, Gianturco coil in 29 patients and other types of devices in 6 patients. There were 4 patients (6%) who had developed acute complication during the procedure (3 of them developed coil embolization and 1 had bleeding from puncture site). The PDA was successfully close in 95.5% of the study population without any residual PDA shunting. All the patients were alive but 5 of them (4.5%) have some abnormalities (2 has mild left pulmonary stenosis, 3 has small residual). Comparison between ADO and Gianturco coil revealed no significant difference in the outcome. Transcatheter closure of PDA has proven to be safe and effective with good midterm outcome. There was no significant difference between Amplatzer Ductal Occluder and Gianturco coil in term of the outcome.

  5. C-reactive protein, platelets, and patent ductus arteriosus.

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    Meinarde, Leonardo; Hillman, Macarena; Rizzotti, Alina; Basquiera, Ana Lisa; Tabares, Aldo; Cuestas, Eduardo

    2016-12-01

    The association between inflammation, platelets, and patent ductus arteriosus (PDA) has not been studied so far. The purpose of this study was to evaluate whether C-reactive protein (CRP) is related to low platelet count and PDA. This was a retrospective study of 88 infants with a birth weight ≤1500 g and a gestational age ≤30 weeks. Platelet count, CRP, and an echocardiogram were assessed in all infants. The subjects were matched by sex, gestational age, and birth weight. Differences were compared using the χ(2), t-test, or Mann-Whitney U-test, as appropriate. Significant variables were entered into a logistic regression model. The association between CRP and platelets was evaluated by correlation and regression analysis. Platelet count (167 000 vs. 213 000 µl(-1), p = 0.015) was lower and the CRP (0.45 vs. 0.20 mg/dl, p = 0.002) was higher, and the platelet count correlated inversely with CRP (r = -0.145, p = 0.049) in the infants with vs. without PDA. Only CRP was independently associated with PDA in a logistic regression model (OR 64.1, 95% confidence interval 1.4-2941, p = 0.033).

  6. Preterm patent ductus arteriosus: A continuing conundrum for the neonatologist?

    Science.gov (United States)

    Evans, Nick

    2015-08-01

    How to manage the preterm patent ductus arteriosus (PDA) remains a conundrum. On the one hand, physiology and statistical association with adverse outcomes suggest that it is pathological. On the other hand, clinical trials of treatment strategies have failed to show any long-term benefit. Ultrasound studies of PDA have suggested that the haemodynamic impact may be much earlier after birth than previously thought (in the first hours); however, we still do not know when to treat PDA. Studies that have tested symptomatic or pre-symptomatic treatment are mainly historical and have not tested the effect of no treatment. Prophylactic treatment is the best-studied regimen but improvements in some short-term outcomes do not translate to any difference in longer-term outcomes. Neonatologists have been reluctant to engage in trials that test treatment against almost never treating. Observations of very early postnatal haemodynamic significance suggest that targeting treatment on the basis of the early postnatal constrictive response of the duct may optimize benefits. A pilot trial of this strategy showed reduction in the incidence of pulmonary haemorrhage but more trials of this strategy are needed.

  7. Cardiac involvement of primary hyperoxaluria accompanied by non-compaction cardiomyopathy and patent ductus arteriosus.

    Science.gov (United States)

    Arat, Nurcan; Akyıldız, Murat; Tellioğlu, Gürkan; Tokat, Yaman

    2015-04-01

    Primary hyperoxaluria is a rare hereditary metabolic disorder resulting in accumulation of calcium oxalate in visceral organs, including the heart. We report a 19-year-old male with non- compaction cardiomyopathy combined with patent ductus arteriosus awaiting combined liver-kidney transplantation for primary hyperoxaluria. After surgical closure of the patent ductus arteriosus, the patient underwent a successful renal and subsequent liver transplantation. The presence of hypertrophic cardiomyopathy in hyperoxaluria patients has been reported before, but this is the first report of non-compaction myocardium with patent ductus arteriosus in a patient with primary hyperoxaluria. At the third month after combined liver and renal transplantation, improvement in cardiac functions were observed. Primary hyperoxaluria is a clinical entity to be taken into consideration in differential diagnosis of hypertrophied myocardium with high myocardial echocardiographic intensity. In cases of hyperoxaluria, additional congenital abnormalities may complicate the clinical picture.

  8. Does ibuprofen treatment in patent ductus arteriosus alter oxygen free radicals in premature infants?

    Science.gov (United States)

    Akar, Melek; Yildirim, Tulin G; Sandal, Gonca; Bozdag, Senol; Erdeve, Omer; Altug, Nahide; Uras, Nurdan; Oguz, Serife S; Dilmen, Ugur

    2016-06-20

    Introduction Ibuprofen is used widely to close patent ductus arteriosus in preterm infants. The anti-inflammatory activity of ibuprofen may also be partly due to its ability to scavenge reactive oxygen species and reactive nitrogen species. We evaluated the interaction between oxidative status and the medical treatment of patent ductus arteriosus with two forms of ibuprofen. Materials and methods This study enrolled newborns of gestational age ⩽32 weeks, birth weight ⩽1500 g, and postnatal age 48-96 hours, who received either intravenous or oral ibuprofen to treat patent ductus arteriosus. Venous blood was sampled before ibuprofen treatment from each patient to determine antioxidant and oxidant concentrations. Secondary samples were collected 24 hours after the end of the treatment. Total oxidant status and total antioxidant capacity were measured using Erel's method.

  9. [Antenatal closure of ductus arteriosus following maternal intoxication by niflumic acid].

    Science.gov (United States)

    Bouissou, A; Glorieux, I; Dulac, Y; Marcoux, M O; Casper, C

    2006-01-01

    Antenatal closure of the ductus arteriosus is an uncommon event that has been considered as a risk factor for development of congestive heart failure and persistent pulmonary hypertension of the newborn. We report here on a case of antenatal ductus arteriosus closure due to niflumic acid maternal intoxication at 32 weeks of gestation. Fetal extraction was performed few days later because of echographic signs of congestive heart failure. The child survived after 3 days of severe persistent pulmonary hypertension. This case emphasizes the potential risk of niflumic acid during pregnancy and the need of antenatal echographic monitoring for optimal management.

  10. Transcatheter closure of small ductus arteriosus with amplatzer vascular plug

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    Eunhyun Cho

    2013-09-01

    Full Text Available Purpose: The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA by using an Amplatzer vascular plug (AVP.&lt;br&gt; Methods: We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared.&lt;br&gt;Results: The mean age of the patients was 54.9±45.7 months old. The PDAs were of type C (n=5, type D (n=12 and type E (n=3. The mean pulmonary end diameter of the PDA was 1.7±0.6 mm, and the aortic end diameter was 3.6±1.4 mm. The mean length was 7.3±1.8 mm. We used 3 types of AVP devices: AVP I (n=5, AVP II (n=7, and AVP IV (n=8. The ratio of AVP size to the pulmonary end diameter was 3.37±1.64, and AVP size/aortic end ratio was 1.72±0.97. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P =0.002. The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter (1.10±0.31, P =0.032. &lt;br&gt;Conclusion: Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.

  11. [The transcatheter closure of patent ductus arteriosus. The initial experience].

    Science.gov (United States)

    Vázquez-Antona, C A; Rijlaarsdam, M; Gaspar, J; Gil Moreno, M; Buendía Hernández, A; Martínez Ríos, M A; Attie, F

    1993-01-01

    Percutaneous closure of the patent ductus arteriosus (PDA) has been recently reported to be an effective alternative in the treatment of patients with ductal shunting. We report the initial experience and results during follow-up of percutaneous ductal occlusion with the Rashkind occluder (USCI) in six patients with isolated PDA. Ages ranged from 3 to 23 years. Diagnosis was corroborated with two dimensional and Doppler echocardiography in all patients. During cardiac catheterization systolic pulmonary artery pressure oscillated between 22 and 64 mmHg and Qp/Qs ratio between 1.3 and 4.1. In two patients prosthesis of 12 mm were used and in the remaining prosthesis of 17 mm. Only one patient demonstrated total occlusion during immediate control aortography, the other patients presented central residual shunting over the occluder. In the three patients occlusion with balloon-catheter was added to the procedure, resulting in total occlusion in two and significant reduction of the shunt magnitude in one. Two technical problems were resolved satisfactorily. None of the cases presented device embolization. Mean follow-up was 23.8 months with control echocardiograms at 24 hours, 1, 4, 12 and 24 months. In all patients immediate reduction of the left atrial dimension was demonstrated. Three patients presented residual shunts in the first 24 hours. In two of them total occlusion had occurred after one month and the other patient persisted with a small residual shunt until one year after the procedure. In conclusion, in this small study group good results were obtained with percutaneous ductal closure.

  12. Transcatheter Patent Ductus Arteriosus Occlusion in Small Infants.

    Science.gov (United States)

    Schwartz, Matthew C; Nykanen, David; Winner, Lawrence H; Perez, Jose; McMahan, Michael; Munro, Hamish M; Suguna Narasimhulu, Sukumar

    2016-12-01

    Transcatheter patent ductus arteriosus (PDA) occlusion is feasible in small infants and may improve lung function in symptomatic patients. We aimed to describe transcatheter PDA closure in small infants including predictors of technical success and rate of complication and to identify factors associated with improved respiratory status after closure. All patients in the NICU at our center who were referred for transcatheter PDA occlusion between 1/2010 and 11/2014 were retrospectively identified. Relevant details were extracted. Additionally, a modification of the respiratory severity score (RSS) (FiO2 × mean airway pressure) was used to characterize degree of pulmonary support before and at intervals after catheterization. Twenty patients were identified with median age of 96 days (13-247) and weight of 3.1 kg (1.7-4.7). The PDA was type F morphology in 14 (70%) patients. The PDA was successfully occluded in 16 (80%) patients. Ratio of minimum PDA diameter/length was >0.5 in all unsuccessful attempts and <0.4 in all successful cases (P = .01). Of the 16 cases of occlusion, Amplatzer Vascular Plug II was used in 15 (94%). No deaths or pulse loss occurred. Five (25%) patients required blood transfusion and transfusion was associated with lower hemoglobin (P = .049), lower weight (P = .008), and lower aortic pressure (P = .04). Excluding 1 patient with significant congenital heart disease, the RSS improved at 3 days in 9 (60%) patients and at 7 days in 12 (80%) compared with preintervention value. Patient factors were not associated with improved RSS at 3 or 7 days. In our cohort of symptomatic infants, transcatheter PDA occlusion was successful in most and a ratio of minimum PDA diameter/length of <0.4 was predictive of technical success. Using a surrogate for pulmonary support, the majority of patients were on less support 7 days after closure. © 2016 Wiley Periodicals, Inc.

  13. Closure of a short patent ductus arteriosus using an atrial septal occluder

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    Keyhan Sayadpour Zanjani

    2010-01-01

    @@ Patent ductus arteriosus (PDA) device closure was first attempted by Porstmann et al1 in 1967. Due to the rapid development in this field, it is the therapy of choice in current era. As most of PDAs have conical shape, Amplatzer PDA occluders were designed to fit into these ducts.

  14. Aneurysm after surgical ligation of patent ductus arteriosus: a case report

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    Kim, Sung Gyu; Yang, Sang Kyu; Chi, Jung Ik; Lee, Chang Jun [National Medical Center, Seoul (Korea, Republic of)

    2002-09-01

    Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases. A rare complication occurring after its surgical treatment is the development of an aneurysm, and we report the radiologic findings in a case in which this occurred after surgical ligation.

  15. Epidemiology, presentation and population genetics of patent ductus arteriosus (PDA) in the Dutch Stabyhoun dog

    NARCIS (Netherlands)

    Toom, den Marjolein L.; Meiling, Agnes E.; Thomas, Rachel E.; Leegwater, Peter A.J.; Heuven, Henri C.M.

    2016-01-01

    Background: Patent ductus arteriosus (PDA) is one of the most common congenital heart defects in dogs and is considered to be a complex, polygenic threshold trait for which a female sex predisposition has been described. Histological studies in dogs suggest that smooth muscle hypoplasia and asymm

  16. A novel approach to ductal spasm during percutaneous device occlusion of patent ductus arteriosus.

    Science.gov (United States)

    De Decker, Rik; Comitis, George; Thomas, Jenny; van der Merwe, Elmarie; Lawrenson, John

    2016-10-01

    Ductal spasm is a rare yet important complication of device occlusions of patent ductus arteriosus. Spasm may result in failure of the procedure, under-sizing of the device, or embolisation of the implanted device as the spasm resolves after the procedure. We describe a novel protocol that rapidly and completely reversed the spasm in eight prematurely born infants who experienced ductal spasm during cardiac catheterisations for patent ductus arteriosus occlusion. In total, eight infants born between 25 and 34 weeks of gestation presented for transcatheter patent ductus arteriosus occlusion between 13 and 87 months of age. All eight patients experienced ductal spasm either immediately before, during, or soon after induction of anaesthesia or only after entering the ductus arteriosus with a catheter. After detection of the spasm, the anaesthetist, in each case, changed the mode of anaesthesia from inhaled sevoflurane to total intravenous anaesthesia with propofol, reduced the inhaled oxygen fraction to 21%, and initiated a continuous intravenous infusion of prostaglandin E1. The first two steps (total intravenous anaesthesia and FiO2 0.21) resulted in only partial relaxation of the spasm. Complete relaxation was attained after intravenous prostaglandin E1 infusions of only 10-15 minutes' duration. While maintaining this protocol, six ducti were successfully occluded and two were considered to be unsuitable for device occlusion and were referred for surgery. Ductal spasm during transcatheter occlusion may be reliably resolved and the procedure safely completed by a simple anaesthetic protocol, including the continuous infusion of intravenous prostaglandin E1.

  17. Spontaneous closure of patent ductus arteriosus after an episode of Kawasaki disease: a case report

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    Lin Ming-Chih

    2012-01-01

    Full Text Available Abstract Introduction Kawasaki disease is regarded as systemic vasculitis. Many experts believe that not only coronary arteries but also other small arteries are involved during the period of systemic inflammation. However, the evidence to support this point view is limited. Case presentation We report the case of a one-year-four-month-old Taiwanese girl whose patent ductus arteriosus was incidentally found during an episode of Kawasaki disease. The ductus closed spontaneously after the acute phase of Kawasaki disease. Conclusions In this patient, the patent ductus arteriosus may have closed spontaneously after Kawasaki disease due to its involvement in the generalized vasculitis that this disease incurs. This would support the theory that the vasculitis of Kawasaki disease is limited not only to coronary arteries but also to all medium- sized arteries.

  18. Is thoracoscopic patent ductus arteriosus closure superior to conventional surgery?

    Science.gov (United States)

    Stankowski, Tomasz; Aboul-Hassan, Sleiman Sebastian; Marczak, Jakub; Cichon, Romuald

    2015-10-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether thoracoscopic patent ductus arteriosus (PDA) closure is superior to conventional surgery. Altogether 821 papers were found using the reported search, 11 of which represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Eleven studies included in the analysis consisted of two prospective and three retrospective, non-randomized studies and six case series. Four included studies focused only on preterm infants, three studies enrolled neonates and the other four analysed all age groups from neonates to older children or young adults. There were no differences in mortality between video-assisted thoracoscopic surgery (VATS) and conventional surgery. Two studies suggested that VATS offers shorter operative times. Two papers observed shorter hospital stay, although the other two noted no significant difference. A large prospective trial found VATS to be associated with a lower number of postoperative complications in neonates and infants, whereas other studies suggested no significant differences in short-term postoperative complications. There is little evidence to suggest better musculoskeletal status and cosmesis in neonates following VATS. Conversion from thoracoscopy to thoracotomy described in six papers was seldom and it did not lead to any additional complications. All observational studies confirmed that both techniques are free from major adverse cardiovascular complications and these two techniques can be safely used in all patients qualified for surgical PDA closure. Two studies compared cost-effectiveness between the two techniques; one of them described VATS as significantly more cost-efficient, whereas the other study observed no difference. However, it should be noted that data

  19. Pan-nitinol occluder and special delivery device for closure of patent ductus arteriosus: a canine-model feasibility study.

    Science.gov (United States)

    Jiang, Hai-bin; Bai, Yuan; Zong, Gang-jun; Han, Lin; Li, Wei-ping; Lu, Yang; Qin, Yong-wen; Zhao, Xian-xian

    2013-01-01

    The aim of this study was to evaluate a new type of occluder for patent ductus arteriosus. Patent ductus arteriosus was established in a canine model by anastomosing a length of autologous jugular vein to the descending aorta and the left pulmonary artery in an end-to-side fashion. Transcatheter closure of each patent ductus arteriosus was performed on 10 dogs, which were then monitored for as long as 6 months with aortography, echocardiography, and histologic evaluation. Transcatheter closure with use of the novel pan-nitinol device was successful in all canine models. Postoperative echocardiography showed that the location and shape of the occluders were normal, without any residual shunting. Further histologic evaluation confirmed that the occluder surface was completely endothelialized 3 months after implantation. Transcatheter patent ductus arteriosus closure with the pan-nitinol occluder can be performed safely and successfully in a canine model and shows good biological compatibility and low mortality rates.

  20. Congenital Heart Disease Requiring Maintenance of Ductus Arteriosus in Critically Ill Newborns Admitted at A Tertiary Neonatal Intensive Care Unit

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    Cucerea Manuela

    2016-10-01

    Full Text Available Introduction: Congenital heart diseases (CHD have been reported to be responsible for 30 to 50% of infant mortality caused by congenital disabilities. In critical cases, survival of newborns with CHD depends on the patency of the ductus arteriosus (PDA, for maintaining the systemic or pulmonary circulation. The aim of the study was to assess the efficacy and side effects of PGE (prostaglandin E administration in newborns with critical congenital heart disease requiring maintenance of the ductus arteriosus.

  1. Reversal of severe mitral regurgitation by device closure of a large patent ductus arteriosus in a premature infant.

    Science.gov (United States)

    Kheiwa, Ahmed; Ross, Robert D; Kobayashi, Daisuke

    2017-01-01

    We report a critically ill premature infant with severe mitral valve regurgitation associated with pulmonary hypertension and a severely dilated left atrium from a large patent ductus arteriosus. The mitral valve regurgitation improved significantly with normalisation of left atrial size 4 weeks after percutaneous closure of the patent ductus arteriosus. This case highlights the potential reversibility of severe mitral valve regurgitation with treatment of an underlying cardiac shunt.

  2. A review of stent’s failure on patent ductus arteriosus

    Science.gov (United States)

    Lazim, Zulfaqih; Ismail, Al Emran; Taib, Ishkrizat; Atan, Bainun Akmal Mohd

    2017-01-01

    This paper presents a review of stent’s failure on patent ductus arteriosus (PDA). Ductus arteriosus (DA) is an opening for newborn babies and some patient that experienced cynotic congenital heart disease (CCHD) should maintain the duct opening for survival. To date, there are no specific research on mechanical stent failure study at DA. The challenging of the stent implantation on PDA is the PDA morphology. The failure of stent in term of stent fracture have been reported and reviewed in this paper. Furthermore, the failure prediction of stent is important for further stent design development. The morphology of PDA, stent type and material used in PDA and method for accessing the failure of stent is reviewed.

  3. Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis

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    Yates Robert

    2006-05-01

    Full Text Available Abstract Background The patent ductus arteriosus (PDA is an important problem in premature infants. Surgical PDA ligation is usually only be considered when medical treatment has either failed or was contraindicated. The aims of our study were to determine the mortality and morbidity following patent ductus arteriosus ligation in premature infants, and whether prostaglandin synthetase inhibitor (PSI use prior to ligation affects outcome. Methods A retrospective case note review study to determine the outcome of premature infants undergoing patent ductus arteriosus ligation in one tertiary neonatal intensive care unit and two paediatric cardiothoracic centres. Results We had follow-up data on 87 infants. Cumulative mortality rates at 7 days, 30 days and at hospital discharge were 2%, 8% and 20% respectively. The incidence of chronic lung disease, intraventricular haemorrhage, necrotising enterocolitis and retinopathy of prematurity were 77%, 39%, 26% and 28% respectively. There was no difference in mortality, incidence of chronic lung disease or duration of oxygen dependence between those who had and those who had not received a PSI prior to surgical ligation. In those who had received 2 or more courses of PSI prior to surgical ligation, there was a trend to increase in the duration of oxygen therapy and chronic lung disease, but no difference in mortality. Conclusion This study shows that patent ductus arteriosus ligation is a relatively safe procedure (30 day survival 92% but there is substantial late mortality and a high incidence of morbidity in the survivors. 2 or more courses of PSI prior to surgical ligation trends to increased oxygen dependence and chronic lung disease. This high risk population requires careful follow-up. A definitive prospective cohort study is lacking.

  4. Patent ductus arteriosus in an adult amur leopard (Panthera pardus orientalis).

    Science.gov (United States)

    Douay, Guillaume; Drut, Amandine; Ribas, Thibault; Gomis, David; Graille, Mélanie; Lemberger, Karin; Bublot, Isabelle

    2013-03-01

    A clinically healthy 16-yr-old female leopard (Panthera pardus orientalis) was diagnosed with a patent ductus arteriosus on echocardiography and later confirmed on necropsy A murmur was heard on auscultation during a routine examination, and the congenital defect was an incidental finding. The animal had been asymptomatic its entire life. This deformity is rarely observed in nondomestic felids and may be asymptomatic, as has been described in domestic cats.

  5. Left-Sided Patent Ductus Arteriosus in a Right-Sided Aortic Arch

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    Ming-Yen Ng

    2014-01-01

    Full Text Available We present a 31-year-old female with repaired tetralogy of Fallot (TOF and right-sided aortic arch (RAA with left-sided patent ductus arteriosus (PDA originating from the left brachiocephalic artery. This is a rare finding but most common site for a PDA in TOF and a RAA. To the best of our knowledge, this is the first demonstration of this rare finding on MRI in the literature.

  6. Transcatheter occlusion of a large coronary artery fistula using a patent ductus arteriosus occluder.

    Science.gov (United States)

    Białkowski, Jacek; Szkutnik, Małgorzata; Fiszer, Roland; Zembala, Marian

    2011-01-01

    A large fistula from the left coronary artery to the right ventricle was successfully closed percutaneously in a 40 year-old patient using a patent ductus arteriosus occluder. The device was positioned and deployed via the venous system using a guidewire that had been advanced via the aorta, coronary artery and fistula to the venous circulation (arterio-venous loop creation). No complications were reported at follow-up.

  7. Angiographic evidence of absent ductus arteriosus in severe right ventricular outflow obstruction.

    Science.gov (United States)

    Lacina, S J; Hamilton, W T; Thilenius, O G; Bharati, S; Lev, M; Arcilla, R A

    1983-01-01

    The angiocardiograms of 5 newborn infants with autopsy and/or surgically-proven congenital absence of the ductus arteriosus (ADA) and right ventricular outflow obstruction (Group A), and of 14 neonates with pulmonary atresia complex and patent ductus arteriosus (Group B) were reviewed. Aortic size was similar in both groups; however, the diameters of the right and left pulmonary arteries were much smaller in Group A than in Group B (right pulmonary artery: 2.6 vs 4.5 mm, P less than 0.005; left pulmonary artery: 2.5 vs 4.3 mm, P less than 0.005). Extensive bronchial collaterals were observed in Group A but not in Group B. Tricuspid aortic valve stenosis was present in 2 patients in Group A but in none in Group B. The diagnosis of ADA may be made in newborn infants with severe right ventricular outflow obstruction if the angiocardiograms reveal hypoplasia of the pulmonary arteries, extensive bronchial collaterals, and nonvisualization of the ductus arteriosus. Other suggestive features include aortic valve stenosis and/or right aortic arch with aberrant left subclavian artery.

  8. Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder

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    Er-Ping Xi

    2012-11-01

    Full Text Available OBJECTIVE: Ventricular septal defects resulting from post-traumatic cardiac injury are very rare. Percutaneous closure has emerged as a method for treating this disorder. We wish to report our experience in three patients who underwent percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder. METHODS: We treated three patients with post-traumatic ventricular septal defects caused by stab wounds with knives. After the heart wound was repaired, patient examinations revealed ventricular septal defects with pulmonary/systemic flow ratios (Qp/Qs of over 1.7. The post-traumatic ventricular septal defects were closed percutaneously with a patent ductus arteriosus occluder (Lifetech Scientific (Shenzhen Co., LTD, Guangdong, China utilizing standard techniques. RESULTS: Post-operative transthoracic echocardiography revealed no residual left-to-right shunt and indicated normal ventricular function. In addition, 320-slice computerized tomography showed that the occluder was well placed and exhibited normal morphology. CONCLUSION: Our experiences indicate that closure of a post-traumatic ventricular septal defect using a patent ductus arteriosus occluder is feasible, safe, and effective.

  9. Deleterious effects of maternal ingestion of cocoa upon fetal ductus arteriosus in late pregnancy

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    Paulo eZielinsky

    2014-12-01

    Full Text Available Cocoa powder has twice more antioxidants than red wine and three times more than green tea. Ten prcent of its weight is made up of flavonoids. Cocoa has antioxidant and antiinflamatory effects by downregulating cyclooxigenase-2 receptors expression in the endothelium and enhancing nitric oxide bioavailability. There are evidences that while polyphenols ingestion have cardioprotective effects in the adult, it may have deleterious effect on the fetus if ingested by the mother on the third trimester of pregnancy, causing intrauterine fetal ductus arteriosus constriction.Polyphenols present in many foods and their anti-inflammatory and antinociceptive activities have been shown to be as or more powerful than those of indomethacin. These effects are dependent on the inhibition of modulation of the arachidonic acid and the synthesis of prostaglandins, especially E-2, which is responsible for fetal ductus arteriosus patency. So, we hypothesized that this same mechanism is responsible for the harmful effect of polyphenol-rich foods, such as cocoa, upon the fetal ductus arteriosus after maternal intake of such substances in the third trimester of pregnancy, thereby rising the perspective of a note of caution for pregnant women diet.

  10. Ductus arteriosus aneurysm with community-acquired methicillin-resistant Staphylococcus aureus infection and spontaneous rupture: a potentially fatal quandary.

    Science.gov (United States)

    Stewart, Audra; Dyamenahalli, Umesh; Greenberg, S Bruce; Drummond-Webb, Jonathan

    2006-06-01

    We present the case of a 6-month-old previously healthy girl who presented with high fever, labored breathing, and an enlarged cardiac silhouette on her chest radiograph. Comprehensive evaluation discovered a ductus arteriosus aneurysm and pericardial effusion with methicillin-resistant Staphylococcus aureus bacteremia. Despite pericardiocentesis and appropriate intravenous antibiotics, there was rapid enlargement of the aneurysm and accumulation of echogenic material within the ductus arteriosus aneurysm. Infected aneurysm rupture was identified during emergency surgery. This infant also had vocal cord paresis, a likely complication of the surgery. The clinical course, diagnosis, and treatment of this patient are discussed. Infection of a ductus arteriosus or an infected ductal arteriosus aneurysm is a rare and potentially fatal clinical entity. In the era of increasing community-acquired methicillin-resistant S aureus infections, this is a diagnosis that requires a high index of suspicion.

  11. Outcome of patent ductus arteriosus ligation in premature infants in the East of England: a prospective cohort study.

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    Kang, Sok-Leng; Samsudin, Salehuddin; Kuruvilla, Minju; Dhelaria, Anshoo; Kent, Sue; Kelsall, Wilfred A

    2013-10-01

    Surgical ligation of patent ductus arteriosus is considered when medical treatment fails or is contraindicated. This study aims to determine the mortality and morbidity of preterm neonates referred for patent ductus arteriosus ligation. A prospective study was conducted in the East of England to follow the outcome of premature infants under 37 weeks’ gestation undergoing patent ductus arteriosus ligation. A standardised proforma was used to collect information before and after the procedure. A total of 102 premature infants were recruited, and patent ductus arteriosus ligation was performed in 92. Surgical complications occurred in 8.7% (8/92), which included pneumothorax (5/8), recurrent laryngeal nerve palsy (2/8), and chylothorax (1/8). Morbidity outcome data were not available for all infants. The incidence of chronic lung disease was 88% (88/99); intraventricular haemorrhage was 49% (49/100); necrotising enterocolitis 39% (39/99), and retinopathy of prematurity 42% (41/97). The overall mortality rate in our study was 7.8% (8/102). Mortality rate in infants who had patent ductus arteriosus ligation was 4.3% (4/92). The 30-day survival rate after ligation was 99% (91/92). Beyond 30 days post-ligation, three infants died from other causes that were not directly related to surgery. Patent ductus arteriosus ligation in premature infants is associated with low mortality and complication rates; however, there is a high incidence of neonatal morbidity. Surgical capacity for patent ductus arteriosus ligation needs to be carefully planned nationally as the duration of ‘‘waiting time’’ and transport to another surgical centre could adversely affect outcomes in this high-risk population.

  12. Ibubrofen in the treatment of patent ductus arteriosus in preterm infants: what we know, what we still do not know.

    Science.gov (United States)

    Mercanti, Isabelle; Ligi, Isabelle; Boubred, Farid; Grandvuillemin, Isabelle; Buffat, Christophe; Fayol, Laurance; Millet, Veronique; Simeoni, Umberto

    2012-01-01

    The patency of the ductus arteriosus has ever been considered as a pathological situation in preterm infants and one likely cause of mortality and morbidity, including broncho-pulmonary dysplasia, necrotizing enterocolitis, intraventricular haemorrhage, retinopathy of prematurity. The incidence of patent ductus arteriosus is inversely proportional to gestational age and infants with the lowest gestational ages are the most exposed to the complications of prematurity. So, associations between patent ductus arteriosus and the other morbidities may not be causative and patent ductus arteriosus could be more a sign of immaturity and severity of disease than the cause of these problems. Non-steroidal anti-inflammatory agents, such as indomethacin or ibuprofen, have been shown to be effective in closing or preventing patent ductus arteriosus, with differences in side effects. However nearly all randomized controlled trials have been designed with the closure of the ductus arteriosus, not mortality or morbidity, as the main endpoint. Thus, evidence is still lacking on the eventual benefits for the patient of pharmacological or surgical intervention on PDA. Moreover, both ibuprofen and indomethacin efficacy seems markedly reduced in extremely low gestational age infants, who are the most likely to benefit from such intervention. The explanation of the reduced pharmacodymanic effect in such population is unclear; so far, studies using increased dosing of ibuprofen have failed to show a clear benefit. Prophylaxis with indomethacin or ibuprofen has failed to show sustained benefits on neurodevelopment at 2 years of age in low gestational age infants. New curative trials may aim at investigating the effects of early curative administration of ibuprofen, which has reduced side effects compared to indomethacin, on immature kidney function, on mortality and morbidity in very low gestational age infants, ideally with a combined endpoint such as survival in the absence of severe

  13. Clinical pharmacology of indomethacin in preterm infants: implications in patent ductus arteriosus closure.

    Science.gov (United States)

    Pacifici, Gian Maria

    2013-10-01

    Indomethacin is a non-steroidal anti-inflammatory drug that is a potent inhibitor of prostaglandin E(2) synthesis. After birth, the ductus arteriosus closes spontaneously within 2-4 days in term infants. The major factor closing the ductus arteriosus is the tension of oxygen, which increases significantly after birth. Prostaglandin E(2) has the opposite effect to that of oxygen; it relaxes smooth muscle and tends to inhibit the closure of the ductus arteriosus. In preterm infants with respiratory distress syndrome, the ductus arteriosus fails to close (patent ductus arteriosus [PDA]) because the concentration of prostaglandin E2 is relatively high. PDA occurs in more than 70 % of neonates weighing less than 1,500 g at birth. The aim of this article was to review the published data on the clinical pharmacology of indomethacin in preterm infants in order to provide a critical analysis of the literature and a useful tool for physicians. The bibliographic search was performed electronically using the PubMed and EMBASE databases as search engines and February 2012 was the cutoff point. A remarkable interindividual variability was observed for the half-life (t(½)), clearance (CL), and volume of distribution (V(d)) of indomethacin. Prophylactic indomethacin consists of a continuous infusion of low levels of indomethacin and may be useful in preterm infants. Extremely preterm infants are less likely to respond to indomethacin. Infants with a postnatal age of 2 months do not respond to treatment with indomethacin. Indomethacin has several adverse effects, the most common of which is renal failure. An increase in serum creatinine of ≥0.5 % mg/dL after indomethacin was observed in about 10-15 % of the patients and creatinine returns to a normal level about 1 week after cessation of therapy. Indomethacin should be administered intravenously by syringe pump for at least 30 min to minimize adverse effects on cerebral, gastrointestinal, and renal blood flow velocities. A

  14. Paracetamol Accelerates Closure of the Ductus Arteriosus after Premature Birth: A Randomized Trial.

    Science.gov (United States)

    Härkin, Pia; Härmä, Antti; Aikio, Outi; Valkama, Marita; Leskinen, Markku; Saarela, Timo; Hallman, Mikko

    2016-10-01

    To study the biologic effect of paracetamol, an inhibitor of prostaglandin synthase, on early closure of ductus arteriosus, and to evaluate possible adverse effects associated with the drug. In a controlled, double-blind, phase I-II trial, very low gestational age (<32 weeks) infants requiring intensive care were randomly assigned to intravenous paracetamol or placebo (0.45% NaCl). A loading dose of 20 mg/kg was given within 24 hours of birth, followed by 7.5 mg/kg every 6 hours for 4 days. Daily cardiac ultrasound examinations of ductal calibers were performed before the first dose, and until 1 day after the last dose. The main outcome was a decrease in the ductal caliber without side effects. Of 63 screened infants, 48 were randomized: 23 were assigned to paracetamol and 25 to placebo. Before the intervention, their ductal calibers were similar. During the intervention, the ductus closed faster in the paracetamol group (hazard ratio 0.49, 95% CI 0.25-0.97, P = .016). The mean (95% CI) postnatal ages for ductal closure were 177 hours (31.1-324) for the paracetamol-treated vs 338 hours (118-557) for controls (P = .045). Paracetamol serum levels were within the therapeutic range, and no adverse effects were evident. Prophylactic paracetamol induced early closure of the ductus arteriosus without detectable side effects. Further trials are required to determine whether intravenous paracetamol may safely prevent symptomatic patent ductus arteriosus. ClinicalTrials.gov: NCT01938261; European Clinical Trials Database: EudraCT 2013-008142-33. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Intrauterine ductus arteriosus constriction: analysis of a historic cohort of 20 cases

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    Luchese Stelamaris

    2003-01-01

    Full Text Available OBJECTIVE: To describe the relative incidence, presentation, and evolvement of fetuses with early ductus constriction. METHODS: Twenty fetal echocardiograms indicating ductus constriction were reviewed in a population of 7000 pregnants. RESULTS: The cases were divided into group A (related to maternal use of cyclooxygenase inhibitors [n=7] and group B (idiopathics [n=13]. Mean gestational age was 32.5±3.1 (27-38 weeks and maternal age was 28.2±8.5 (17-42 years. Mean systolic velocity in the ductus was 2.22±0.34 (1.66-2.81 m/s, diastolic velocity 0.79±0.28 (0.45-1.5 m/s, and pulsatility index 1.33±0.36 (0.52-1.83. Two cases of ductal occlusion were noted. In 65% of the cases, an increase occurred in the right cavities; in 90% of the cases, tricuspid or pulmonary regurgitation, or both, occurred, with functional pulmonary atresia in 1 case. Diastolic velocity was greater in group A (1.13±0.33 than in group B (0.68±0.15 (P=0.008. The other data were similar in the 2 groups. The evolvement was not favorable in 4 patients from group B, including 1 death and 2 cases of persistent pulmonary hypertension. CONCLUSION: The high incidence of idiopathic constriction of the ductus arteriosus suggests that its diagnosis is underestimated and that many cases of persistence of fetal circulation in newborns may be related to constriction of the ductus arteriosus not diagnosed during intrauterine life. Group B had a lower severity but a risk of an unfavorable evolvement, suggesting a distinct alteration.

  16. A case of coarctation of the aorta associated with the patent ductus arteriosus and the persistent left superior vena cava

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    Lee, Yoo Keun [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    This is a case report of multiple congenital vascular anomalies in which coarctation of the aorta combined with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart disease was suspected during infancy. However, she heard the disease incurable, so she had been well with herb medicine until admission in our hospital. By physical examination and roentgenological studies including aortography, the diagnosis of the patent ductus arteriosus was detected and the coarctation of the aorta was suspected. The persistent left superior vena cava was found during surgery and it was proved roentgenologically by venography.

  17. Simultaneous transcatheter closure of intralobar pulmonary sequestration and patent ductus arteriosus in a patient with infantile Scimitar syndrome.

    Science.gov (United States)

    Aslan, Eyüp; Tanıdır, İbrahim Cansaran; Saygı, Murat; Onan, Sertaç Hanedan; Güzeltaş, Alper

    2015-03-01

    Scimitar syndrome is a rare disease associated with a right lung sequestration vascularised by arteries arising from the abdominal aorta and abnormal venous drainage into the inferior vena cava. The infantile form is generally presented with severe heart failure, pulmonary hypertension and respiratory distress. It may be associated with various intracardiac defects, including atrial septal defects, ventricular septal defects, patent ductus arteriosus or more complicated structural congenital heart defects. Here, we present a 2-month-old girl with Scimitar syndrome whose pulmonary arterial pressure decreased after transcatheter patent ductus arteriosus closure and embolization of the anomalous systemic arterial supply.

  18. Dynamic Changes of Pulmonary Arterial Pressure and Ductus Arteriosus in Human Newborns From Birth to 72 Hours of Age

    OpenAIRE

    2016-01-01

    Abstract Normal pulmonary artery pressure and pulmonary hypertension assessment of newborns is rarely reported. The aim of the study is to explore dynamic changes of pulmonary arterial pressure and ductus arteriosus in human newborns from birth to 72 h of age with echocardiography. A total of 76 cases of normal newborns were prospectively detected by echocardiography after birth of 2 h, 6 h, 12 h, 24 h, 48 h, and 72 h, respectively. Ductus arteriosus diameter, blood shunt direction, blood flo...

  19. Transcatheter closure of a patent ductus arteriosus in an elderly patient with the Gianturco-Grifka vascular occlusion device.

    Science.gov (United States)

    Befeler, B; Justiniano, A; Zahn, E

    2000-10-01

    This paper reports the unusual case of a 76-year-old woman who was discovered to have a hemodynamically significant patent ductus arteriosus following uneventful mitral valve replacement, utilizing cardiopulmonary bypass. The shunt was successfully eliminated using a new transcatheter device, thereby obviating the need for further surgery. The patient did not have calcification within the ductus, making diagnosis prior to surgery more difficult.

  20. Thoracic endovascular aortic repair for patent ductus arteriosus in an elderly patient with congestive heart failure.

    Science.gov (United States)

    Kato, Gentaro; Nakai, Mikizo; Tokunaga, Noriyuki; Shimizu, Shuji; Okada, Masahiro

    2016-05-01

    In elderly patients, open surgery for patent ductus arteriosus (PDA) is more difficult than that in children and often requires a cardiopulmonary bypass. We report the case of a 67-year-old patient with a PDA that was successfully treated with thoracic endovascular aortic repair (TEVAR). The patient was diagnosed with congestive heart failure (ejection fraction, 36 %) and PDA (9.7 mm in diameter). TEVAR was successfully performed to exclude the PDA. After TEVAR, the patient's heart failure was well controlled by diuretics. TEVAR may be a good alternative to open surgery.

  1. Endovascular occlusion of primary major pelvic arteriovenous fistula using patent ductus arteriosus occluder.

    Science.gov (United States)

    Xu, L; Wu, Z; Qu, L; Burchell, S

    2016-03-01

    The aim of the present study was to investigate the effects and safety of a patent ductus arteriosus occluder (PDAO) in the management of major abdominal arteriovenous fistula. A 56-year-old man was admitted into our hospital, presenting with impeded defecation and claudication. Computed tomographic angiography (CTA) was conducted upon admission, which revealed an aneurysm-like lesion, with the left internal iliac artery as its feeding artery. Super-selective embolization treatment was accomplished using a single PDAO. The results of the CTA at follow-up showed no recanalization of the lesion and that a PDAO was at the site. The patient had no pelvic ischemia complications.

  2. Eisenmenger syndrome in an adult patient with a large patent ductus arteriosus

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    Konstantinos Dimopoulos

    2013-12-01

    Full Text Available This is the case of a young female who was seen at our adult congenital heart disease and pulmonary hypertension service (Royal Brompton Hospital, London, UK at the age of 17 years. She initially presented at the age of 4 years with increasing shortness of breath. At that time, there was differential cyanosis with clubbing and lower oxygen saturations in the toes (82% compared with her fingers (95%. On echocardiography there was evidence of severe pulmonary hypertension and a large patent ductus arteriosus (PDA with low velocity bidirectional shunting. She underwent cardiac catheterisation at the time which showed a pulmonary arterial pressure equal to that of the aorta.

  3. Reflections of the changes in patent ductus arteriosus management during the last 10 years.

    Science.gov (United States)

    El-Khuffash, Afif; Weisz, Dany E; McNamara, Patrick J

    2016-09-01

    Despite a large body of scientific evidence on the management of premature infants with a patent ductus arteriosus controversy remains and neonatologists remain challenged for knowing which patient to treat, what is the most optimal timing of treatment and which treatments have a positive impact on both short-term and long-term outcomes. In this review article we discuss the increased body of evidence over the past 10 years, much of which questions the role of treatment and suggests the need to reconsider how haemodynamic significance is adjudicated. In addition, we discuss novel approaches to assessment and diagnosis, and highlight areas for future investigation.

  4. Should we definitively abandon prophylaxis for patent ductus arteriosus in preterm new-borns?

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    Vassilios Fanos

    2011-01-01

    Full Text Available Although the prophylactic administration of indomethacin in extremely low-birth weight infants reduces the frequency of patent ductus arteriosus and severe intraventricular hemorrhage, it does not appear to provide any long-term benefit in terms of survival without neurosensory and cognitive outcomes. Considering the increased drug-induced reduction in renal, intestinal, and cerebral blood flow, the use of prophylaxis cannot be routinely recommended in preterm neonates. However, a better understanding of the genetic background of each infant may allow for individualized prophylaxis using NSAIDs and metabolomics.

  5. [Management of persistent ductus arteriosus in the newborn with respiratory insufficiency].

    Science.gov (United States)

    Hurtado del Rio, D; Holden Barker, A M; Pezzotti, M A; Gutiérrez Bosque, R; Archundia, A; Pérez Mejia, J; Carrillo, H

    1979-01-01

    Sixteen newborn babies with severe respiratory distress and patent ductus arteriosus with congestive heart failure are presented. Fifteen of them were premature and one at full term. Management consisted of the accepted medical and ventilatory aids such as digitalis, diuretics, ventilators, etc. Thirteen cases were given indomethacin with clinical closure in five of them (38%). Ten cases underwent surgical closure with 30% mortality. It is recommended that these patients be given indomethacin inicially; if there is no response in 36 hours surgical closure of the duct should be performed prior to progressive deterioration and eventual death.

  6. Transcatheter interruption of large residual flow after device closure of "Type A" patent ductus arteriosus

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    Anuradha Sridhar

    2012-01-01

    Full Text Available We report a case of 3-year-old girl who had persistence of large residual flow following transcatheter closure of a 6 mm ′Type A′ patent ductus arteriosus using a 12 × 10 mm duct occluder. Angiography revealed a large left-to-right shunt coursing through and exiting around the implanted device. Near total abolition of the residual shunt was achieved by initial implantation of an embolization coil within the duct occluder and subsequently an Amplatzer duct occluder (ADO II adjacent to the duct occluder. This challenging case describes an additional technique of abolishing a large residual flow in and around a Nitinol duct occluder device.

  7. Comparison of two dose regimens of ibuprofen for the closure of patent ductus arteriosus in preterm newborns.

    Science.gov (United States)

    Dornelles, Laura Vargas; Corso, Andréa Lúcia; Silveira, Rita de Cássia; Procianoy, Renato Soibelmann

    2016-01-01

    To compare the efficacy of intravenous ibuprofen at high (20-10-10mg/kg/dose) and low doses (10-5-5mg/kg/dose) the closure of patent ductus arteriosus in preterm newborns. A cohort study with historical control of newborns that received high- and low-dose intravenous ibuprofen, from 2010 to 2013 in a neonatal intensive care unit, for closure of the patent ductus arteriosus, documented by echocardiography. Secondary outcomes included the number of ibuprofen cycles, incidence of bronchopulmonary dysplasia, necrotizing enterocolitis, changes in renal function, and death. Seventy-seven patients received three doses of ibuprofen for the treatment of patent ductus arteriosus, with 33 receiving high-dose and 44 low-dose therapy. The ductus closed after the first cycle in 25 (56.8%) low-dose patients and in 17 (51.5%) high-dose patients (p>0.99). Sixteen patients received a second cycle of ibuprofen, and the ductus closed in 50% after low-dose and in 60% after high-dose therapy (p>0.99). Seven patients required surgery for ductus closure, 13.6% in the low-dose group and 3% in the high-dose group (p=0.22). Thirty-nine patients developed bronchopulmonary dysplasia, 50% in the low-dose group and 51.5% in the high-dose group (p>0.99). Twenty-two (50%) low-dose patients died vs. 15 (45.5%) high-dose patients (p=0.86). There was no difference in closure of the ductus arteriosus or occurrence of adverse effects between the two dose regimens. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  8. Comparison of two dose regimens of ibuprofen for the closure of patent ductus arteriosus in preterm newborns,

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    Laura Vargas Dornelles

    2016-06-01

    Full Text Available Abstract Objective: To compare the efficacy of intravenous ibuprofen at high (20-10-10 mg/kg/dose and low doses (10-5-5 mg/kg/dose the closure of patent ductus arteriosus in preterm newborns. Methods: A cohort study with historical control of newborns that received high- and low-dose intravenous ibuprofen, from 2010 to 2013 in a neonatal intensive care unit, for closure of the patent ductus arteriosus, documented by echocardiography. Secondary outcomes included the number of ibuprofen cycles, incidence of bronchopulmonary dysplasia, necrotizing enterocolitis, changes in renal function, and death. Results: Seventy-seven patients received three doses of ibuprofen for the treatment of patent ductus arteriosus, with 33 receiving high-dose and 44 low-dose therapy. The ductus closed after the first cycle in 25 (56.8% low-dose patients and in 17 (51.5% high-dose patients (p > 0.99. Sixteen patients received a second cycle of ibuprofen, and the ductus closed in 50% after low-dose and in 60% after high-dose therapy (p > 0.99. Seven patients required surgery for ductus closure, 13.6% in the low-dose group and 3% in the high-dose group (p = 0.22. Thirty-nine patients developed bronchopulmonary dysplasia, 50% in the low-dose group and 51.5% in the high-dose group (p > 0.99. Twenty-two (50% low-dose patients died vs. 15 (45.5% high-dose patients (p = 0.86. Conclusions: There was no difference in closure of the ductus arteriosus or occurrence of adverse effects between the two dose regimens.

  9. Percutaneous closure of patent ductus arteriosus: Experience of a tertiary referral center

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    Hasan Kaya

    2013-01-01

    Full Text Available Objective: We sought to evaluate our clinical experienceand short-term results of percutaneous closure of patentductus arteriosus (PDA.Methods: We studied 20 patients (17 female, mean age24±8 years undergoing percutaneous closure of PDA betweenMarch 2010-March 2013 in our clinic. Amplatzerduct occluder (ADO I was used in 13 patients and ADOII was used in 7 patients for PDA closure. Clinical characteristicsof patients, properties of percutaneous closureintervention, complications and short-term results areevaluated.Results: The mean ductus waist diameter measured byangiographic examination was 5±2 mm (2-9 mm. Procedurewas successfully performed in all patients. Occluderdevice embolization was occurred in one patientin whom device was retrieved by snare catheter and PDAwas successfully closed with same device. The early totalocclusion rate was 85%. Occlusion rate as determinedby echocardiographic control performed the day afterwas 95% whereas 100% at first month. In the follow-up of19±9 months, no complications were observed.Conclusion: Percutaneous closure of PDA using ADO Iand II devices are safe and effective.Key words: patent ductus arteriosus, percutaneous closure,Amplatzer duct occluder

  10. Transcatheter closure of tubular type patent ductus arteriosus using Amplatzer� ductal occluder II: a case report

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    Mulyadi M Djer

    2013-09-01

    Full Text Available Patent ductus arteriosus (PDA is a common congenital heart disease, accounting for 5-10% of all congenital heart diseases. The incidence of PDA is even higher in preterm neonates, ranging from 20-60%.1-4 Closure of PDA is indicated in all cases, except for duct-dependent congenital heart diseases or PDA with Eisenmenger syndrome.1,5,6 In small asymptomatic PDAs, closure is indicated to prevent the risk of complications, such as endarteritis, endocarditis, aneurysm of ductus arteriosus, or congestive heart failure.1,2,7 In recent years, interventional cardiology has become a gold standard therapy for the majority of PDA cases beyond neonatal age. Since its introduction in 1967, many devices and methods have been developed to allow transcatheter closure of virtually all PDAs, regardless of size or configuration. Nevertheless, the tubular shape (type C PDA, which has the highest residual shunt rate, still poses a great challenge for the interventionist.8-10 The second generation of Amplatzer® device occluders (ADO II, released in 2007, has been suggested to be effective in closing tubular PDAs.10 The purpose of this study was to report the initial clinical experience using ADO II to close a tubular type PDA in Indonesia

  11. Coarctation of the Aorta as a Complication of Surgical Ligation of Patent Ductus Arteriosus in a Premature Infant

    Science.gov (United States)

    Qasim, Amna; Jain, Sunil K.; Jiwani, Amyn K.

    2017-01-01

    Surgical ligation of a patent ductus arteriosus (PDA) is a commonly performed procedure. Complications are infrequent and most commonly include recurrent laryngeal nerve injury and rarely ligation of left pulmonary artery. We report a case of accidental ligation of the descending thoracic aorta leading to a clinically significant coarctation. PMID:28386503

  12. Reduction in Cerebral Oxygenation due to Patent Ductus Arteriosus Is Pronounced in Small-for-Gestational-Age Neonates

    NARCIS (Netherlands)

    Cohen, Emily; Dix, Laura; Baerts, Willem; Alderliesten, Thomas; Lemmers, Petra; van Bel, Frank

    2016-01-01

    BACKGROUND: A haemodynamically significant patent ductus arteriosus (hsPDA) reduces cerebral oxygenation in appropriate-for-gestational-age (AGA) preterm neonates. Reduced cerebral oxygenation has been associated with brain injury. Preterm small-for-gestational-age (SGA) neonates show higher cerebra

  13. Right pulmonary artery agenesis with patent ductus arteriosus and Eisenmenger syndrome: a rare case diagnosed during the postpartum period.

    Science.gov (United States)

    Beker-Acay, Mehtap; Ozkececi, Gulay; Unlu, Ebru; Hocaoglu, Elif; Kacar, Emre; Onrat, Ersel

    2014-01-01

    Unilateral absence of a pulmonary artery a very rare congenital disorder. We here present a case of a 22-year-old female patient with agenesis of the right pulmonary artery accompanying patent ductus arteriosus and Eisenmenger syndrome, diagnosed by chest X-ray and multidetector computed tomography 5 days after giving birth.

  14. Serum ibuprofen levels of extremely preterm infants treated prophylactically with oral ibuprofen to prevent patent ductus arteriosus

    NARCIS (Netherlands)

    Kanmaz, Gozde; Erdeve, Omer; Canpolat, Fuat Emre; Oguz, Serife Suna; Uras, Nurdan; Altug, Nahide; Greijdanus, Ben; Dilmen, Ugur

    2013-01-01

    The aim of this study was to explore the effects of early oral ibuprofen administration on the incidence of hemodynamically significant patent ductus arteriosus (hsPDA) and define the association between serum ibuprofen levels and ductal closure. Preterm infants with a gestational age of <28 weeks a

  15. Isolated left brachiocephalic artery with the right aortic arch: A rare differential of large patent ductus arteriosus

    Science.gov (United States)

    Dubey, Gajendra; Gupta, Saurabh Kumar; Kothari, Shyam Sundar

    2017-01-01

    We report a case of isolation of the left brachiocephalic artery with the right aortic arch in a 9-year-old male child masquerading as large patent ductus arteriosus with left-to-right shunt. We have emphasized the subtle clinical findings which served as clues to the diagnosis. PMID:28163435

  16. [Chylothorax--a rare complication of surgical ligation of patent ductus arteriosus in a premature infant-a case report].

    Science.gov (United States)

    Stempniewicz, Krzysztof; Walas, Wojciech

    2007-01-01

    A case of left sided chylothorax in preterm infant is reported. The chylothorax was a complication of ligation of patent ductus arteriosus. Treatment consisted of parenteral nutrition, pleural taps, drainage of pleural cavity, mechanical ventilation and replacement of immunoprotein losses. When the lymph effusion reduced, enteral nutrition was started with a formula containing medium chain triglycerides. Treatment of this patient was successful.

  17. Ductus arteriosus with left-to-right shunt during venoarterial extracorporeal membrane oxygenation: effects on cerebral oxygenation and hemodynamics.

    NARCIS (Netherlands)

    Heyst, A.F.J. van; Staak, F.H.J.M. van der; Hopman, J.C.W.; Tanke, R.B.; Sengers, R.C.A.; Liem, K.D.

    2003-01-01

    OBJECTIVE: To investigate the effect on cerebral oxygenation and hemodynamics of a patent ductus arteriosus with left-to-right shunt during venoarterial extracorporeal membrane oxygenation in a lamb model. DESIGN: Prospective intervention study in animals. SETTING: Animal research laboratory of a

  18. Utility of fetal cardiac magnetic resonance imaging to assess fetuses with right aortic arch and right ductus arteriosus.

    Science.gov (United States)

    Dong, Su-Zhen; Zhu, Ming

    2017-05-07

    To evaluate the utility of fetal cardiac magnetic resonance imaging (MRI) to diagnose right aortic arch (RAA) with right ductus arteriosus. This retrospective study included six fetuses with right aortic arch and right ductus arteriosus. The six fetal cases were examined using a 1.5-T magnetic resonance unit. The steady-state free precession (SSFP) and single-shot turbo spin echo (SSTSE) sequences were used to evaluate the fetal heart and airway. The gestational age of the six fetuses ranged from 22 to 35 weeks (mean, 26.5 weeks). The age of the pregnant women ranged from 23 to 40 years (mean 31 years). Fetal cardiac MRI diagnosed the six fetal cases with RAA with right ductus arteriosus correctly. Among the six fetuses, four were associated with other congenital heart defects. In three of six cases, the diagnoses established using prenatal echocardiography (echo) was correct when compared with postnatal diagnosis. Fetal cardiac MRI is a useful complementary tool to assess fetuses with RAA and right ductus arteriosus.

  19. Pentoxifylline as adjunct therapy to long-term clinical management of a right-to-left patent ductus arteriosus.

    Science.gov (United States)

    Turner, Elizabeth

    2016-06-01

    Management of a right-to-left ("reversed") patent ductus arteriosus (PDA) focuses on control of clinical signs associated with hyperviscosity due to erythrocytosis. Pentoxifylline therapy is presented as an adjunct to routine phlebotomies for the long-term clinical management of reversed PDA in a 10-year-old Chihuahua.

  20. Thoracic Stent Graft Implantation for Aortic Coarctation with Patent Ductus Arteriosus via Retroperitoneal Iliac Approach in the Presence of Small Sized Femoral Artery

    Directory of Open Access Journals (Sweden)

    Ozge Korkmaz

    2016-01-01

    Full Text Available Endovascular stent graft implantation is a favorable method for complex aortic coarctation accompanied by patent ductus arteriosus. Herein, an 18-year-old woman with complex aortic coarctation and patent ductus arteriosus was successfully treated by endovascular thoracic stent graft via retroperitoneal approach. The reason for retroperitoneal iliac approach was small sized common femoral arteries which were not suitable for stent graft passage. This case is the first aortic coarctation plus patent ductus arteriosus case described in the literature which is treated by endovascular thoracic stent graft via retroperitoneal approach.

  1. Radionuclide determination of left-to-right shunt in patients with patent ductus arteriosus

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    Klepzig, H. Jr.; Sievert, H.; Mildenberger, D.; Bussmann, W.D.; Kaltenbach, M.; Standke, R.; Hoer, G.

    1987-02-01

    In 9 patients with patent ductus arteriosus, quantification of left-to-right shunt was performed with dye dilution curves after peripheral injection and with radionuclide ventriculography. The study was repeated within 7 days after successful transluminal occlusion of the ductus with an Ivalon-plug. Reproducibility of the method could be studied in one patient in whom reopening of the ductus occurred. Dye dilution curves were analyzed using the method of Carter et al. Radionuclide ventriculography was performed as a combined first-pass and equilibrium study: effective stroke volume was derived from the first pass of the tracer through the heart; during the equilibrium phase left ventricular ejection fraction (EF) and left ventricular enddiastolic volume (EDV) were evaluated. The difference between total left ventricular stroke volume (product of EF and EDV) and effective stroke volume was taken as shunt volume. This volume as a fraction of total left ventricular stroke volume resulted in percent left-to-right shunt. The sensitivity of the dye technique was 78%; a quantification of the shunt lesion was possible in 55% of all cases (shunt greater than 35%). The sensitivity of the radionuclide technique was 90%. The severity of the lesion could not be determined in one patient with a minimal shunt. After successful occlusion of the ductus, dye dilution curves normalized in all cases. Radionuclide ventriculography showed normalization in all but one patient. This patient with concomitant mitral regurgitation still showed moderate left ventricular volume overload. After occlusion, left ventricular enddiastolic volume significantly decreased (from 224 to 181 ml, p < 0.05), effective cardiac output increased (from 6186 to 7476 ml, p < 0.01) and ejection fraction remained unchanged (55 vs. 51%). (orig./TRV).

  2. Isobaric Tags for Relative and Absolute Quantitation-Based Proteomic Analysis of Patent and Constricted Ductus Arteriosus Tissues Confirms the Systemic Regulation of Ductus Arteriosus Closure.

    Science.gov (United States)

    Hong, Haifa; Ye, Lincai; Chen, Huiwen; Xia, Yu; Liu, Yue; Liu, Jinfen; Lu, Yanan; Zhang, Haibo

    2015-08-01

    We aimed to evaluate global changes in protein expression associated with patency by undertaking proteomic analysis of human constricted and patent ductus arteriosus (DA). Ten constricted and 10 patent human DAs were excised from infants with ductal-dependent heart disease during surgery. Using isobaric tags for relative and absolute quantitation-based quantitative proteomics, 132 differentially expressed proteins were identified. Of 132 proteins, voltage-gated sodium channel 1.3 (SCN3A), myosin 1d (Myo1d), Rho GTPase activating protein 26 (ARHGAP26), and retinitis pigmentosa 1 (RP1) were selected for validation by Western blot and quantitative real-time polymerase chain reaction analyses. Significant upregulation of SCN3A, Myo1d, and RP1 messenger RNA, and protein levels was observed in the patent DA group (all P ≤ 0.048). ARHGAP26 messenger RNA and protein levels were decreased in patent DA tissue (both P ≤ 0.018). Immunohistochemistry analysis revealed that Myo1d, ARHGAP26, and RP1 were specifically expressed in the subendothelial region of constricted DAs; however, diffuse expression of these proteins was noted in the patent group. Proteomic analysis revealed global changes in the expression of proteins that regulate oxygen sensing, ion channels, smooth muscle cell migration, nervous system, immune system, and metabolism, suggesting a basis for the systemic regulation of DA patency by diverse signaling pathways, which will be confirmed in further studies.

  3. 介入治疗动脉导管未闭的护理体会%Nursing experience for treating patent ductus arteriosus by interventional therapy

    Institute of Scientific and Technical Information of China (English)

    王磊

    2015-01-01

    介入治疗在医治动脉导管未闭方面具有创伤小、风险小、术后恢复快等优点。对74例动脉导管未闭患者采取了介入治疗、护理之后,有72例痊愈,疗效显著,值得在临床上推广。%In treating patent ductus arteriosus, the interventional therapy hold the advantages of little trauma, low risk, faster postoperative recovery etc. 74 patients with patent ductus arteriosus received the interventional therapy and nursing. 72 cases of patent ductus arteriosus were cured. The interventional therapy was effective on patent ductus arteriosus, and worthy of promotion in clinic.

  4. History of the ductus arteriosus: 2. Persisting patency in the preterm infant.

    Science.gov (United States)

    Obladen, Michael

    2011-01-01

    By 1769, it was known to Morgagni that the ductus arteriosus may persist until adulthood. In 1835, Jörg linked delayed postnatal closure with disturbed respiration, a discovery that was afterwards forgotten for a century. When blood gas analysis became available, the association between persisting patency and diminished oxygenation resurfaced. When it became known that prostaglandins played a role in maintaining ductal patency, the development of pharmacologic intervention with cyclooxygenase inhibitors immediately followed. This rapid progress was due to the interaction between basic science, pediatric cardiology, and neonatology disciplines at the Cardiovascular Research Institute in San Francisco, coordinated by Julius Comroe, as well as President Kennedy's foundation of the National Institute of Child Health and Development. This series of events exemplifies how clinical research became an integrated managed multidisciplinary endeavor in the 20th century.

  5. Early or Late Surgical Ligation of Medical Refractory Patent Ductus Arteriosus in Premature Infants

    Directory of Open Access Journals (Sweden)

    Chien-Chou Hsiao

    2009-01-01

    Full Text Available Optimal time to surgical ligation of patent ductus arteriosus (PDA in very-low-birth-weight ( 14 days groups. Basic clinical features, major morbidity of prematurity and mortality were compared. Clinical features and major outcomes were similar. The early ligation group had earlier onset of symptomatic PDA (5.7 ± 1.6 days vs. 8.1 ± 3.6 days, p = 0.024, and fewer days of total parenteral nutrition (TPN (39.6 ± 13.9 days vs. 60.4 ± 31.4 days, p = 0.025 and ventilator use (11.1 ± 6.7 days vs. 18.6 ± 10.5 days, p = 0.019. Early ligation of medical refractory PDA in very-low-birth-weight premature infants improves enteral feeding tolerance and reduces TPN and ventilator use, but long-term benefits need further investigation.

  6. Three-dimensional modeling of a patent ductus arteriosus in a cat.

    Science.gov (United States)

    Saunders, A B; Birch, S A

    2015-12-01

    A left-to-right shunting patent ductus arteriosus was diagnosed in a 13-week-old, 2.5 kg, male, domestic Shorthair cat with a continuous murmur. Echocardiographic abnormalities were identified, including: cardiomegaly, wide and presumably short ductal ampulla, and a large right branch pulmonary artery. When these findings were combined with the small patient size, additional imaging was considered prior to surgical ligation, and computed tomography angiography was preferred over standard angiography to provide multi-dimensional appreciation of the anatomy prior to surgery. The dataset from a computed tomography angiographic study performed prior to surgical ligation was used to create a three-dimensional model of the heart and great vessels. The rendered images accurately depicted the cardiac anatomy in situ, which can be utilized for surgical procedural planning and to enhance visuospatial understanding of the anatomy at all levels of training.

  7. Chest closure without drainage after open patent ductus arteriosus ligation in Ugandan children: A non blinded randomized controlled trial.

    Science.gov (United States)

    Kebba, Naomi; Mwambu, Tom; Oketcho, Michael; Izudi, Jonathan; Obuku, Ekwaro A

    2016-09-29

    There is clinical equipoise regarding post-operative management of patients with patent ductus arteriosus (PDA) without insertion of a chest drain. This study evaluated post operative outcomes of chest closure with or without a drain following Patent Ductus Arteriosus ligation among childen at Uganda Heart Instritute (UHI). This was an open label randomized controlled trial of 62 children 12 years of age and below diagnosed with patent ductus arteriosus at Mulago National Teaching and Referral Hospital, Uganda. Participants were randomized in the ratio of 1:1 with surgical ligation of patent ductus arteriosus to either thoracotomy closure with a chest tube or without a chest tube. All participants received standard care and were monitored hourly for 24 hours then until hospital discharge. The combined primary endpoint consisted of significant pleural space accumulation of fluid or air, higher oxygen need or infection of the surgical site. Analysis was conducted by multivariable logistic regression analysis at 5 % significance level. We enrolled 62 participants, 46 (74 %) of whom were females. Their median age was 12 months (IQR: 8-36). Participants in the no-drain arm significantly had less post-operative complications compared to the drain arm (Unadjusted odds ratio [uOR]: 0.21, 95 % CI: 0.06-0.73, p = 0.015). This "protective effect" remained without statistical significance in the multivariable regression model (Adjusted odds ratio [aOR]: 0.07, 95 % CI: 0.00-2.50, p = 0.144). Children aged below 6 years with patent ductus arterious can safely and effectively have thoracotomy closure without using a drain in uncomplicated surgical ligation of the PDA. Chest drain was associated with post-operative complications. The trial was registered in the Pan African Clinical Trials registry on 1st/July/2012, retrospectively registered. Identifier number PACTR201207000395469 .

  8. REVERSE PDA – LESS COMMON TYPE OF PATENT DUCTUS ARTERIOSUS -CASE REPORT

    Directory of Open Access Journals (Sweden)

    Iuliu Scurtu

    2016-11-01

    Full Text Available Introduction: PDA represents one of the most frequently diagnosed type of congenital heart disease. Ductus arteriosus is a normal structure in foetal life, which permits shunting of oxygenated blood from the pulmonary artery into the aorta. Failure of sealing after birth is an abnormal condition and is called patent ductus arteriosus. In normal PDA, due to fact that systemic pressure is fivefold higher than pulmonary circulation, blood is shunted from the aorta into the pulmonary artery. In reverse PDA, pulmonary artery pressure does not drop after birth, and blood will be shunted form right to left. Aims: We want to evaluate clinical, haematological, ECG and echocardiographic changes in case of reverse PDA. Materials and Methods: Two-year old female Bichon Frise was referred to our clinic with signs of effort intolerance and dyspnoea for more than a year. ECG was performed in the right lateral recumbency using a digital device and echocardiography was done with Esaote MyLab40 Vet with a phased array transducer matched with the size of the dog (7.5 MHz. Results: We identified a dog with a good body score, quite alert and without any sign of illness. Haematological investigation underlined polycythaemia and very high PCV. The ECG revealed a normal sinus rhythm with a deep S wave, changes consistent with right ventricle enlargement.  Right atrial dilation and right ventricle hypertrophy were found on cardiac ultrasonography. The right ventricle free wall was hypertrophied and interventricular septum was flattened, changes consistent with increased pressure on the right side of the heart. The left heart was small. Positive diagnosis was done, performing “bubble study” and identification of contrast bubble within the abdominal aorta.   Conclusion: Reverse PDA is a rarely diagnosed congenital heart disease. Polycythaemia in young dogs could raise the suspicion of reverse PDA.  For positive diagnosis, echocardiography and bubble study are

  9. Thromboxane A(2 receptor stimulation promotes closure of the rat ductus arteriosus through enhancing neointima formation.

    Directory of Open Access Journals (Sweden)

    Tomohiro Yokota

    Full Text Available Ductus arteriosus (DA closure follows constriction and remodeling of the entire vessel wall. Patent ductus arteriosus occurs when the DA does not close after birth, and this condition is currently treated using cyclooxygenase inhibitors. However, the efficacy of cyclooxygenase inhibitors is often limited. Our previous study demonstrated that low-dose thromboxane A2 receptor (TP stimulation constricted the DA with minimal adverse effects in rat neonates. However, its effect on DA remodeling remains unknown. In this study, we focused on the impact of the exogenous TP stimulation on the DA remodeling, especially intimal thickening. Using DA explants from rat fetuses at embryonic day 19 as a ex vivo model and primary cultured rat DA smooth muscle cells from embryonic day 21 as a in vitro model, we evaluated the effect of TP stimulation on the DA remodeling. The selective TP agonists U46619 and I-BOP promoted neointima formation in the ex vivo DA explants, and TP stimulation increased DA SMC migration in a dose-dependent manner. Both effects were inhibited by the selective TP antagonist SQ29548 or the siRNA against TP. TP stimulation also increased DA SMC proliferation in the presence of 10% fetal bovine serum. LC/MS/MS analysis revealed that TP stimulation increased secretion of several extracellular matrix proteins that may contribute to an increase in neointima formation. In conclusion, we uncovered that exogenous administration of TP agonist promotes neointima formation through the induction of migration and proliferation of DA SMC, which could contribute to DA closure and also to its vasoconstrictive action.

  10. [Percutaneous closure of patent ductus arteriosus: results and costs compared to surgical closure].

    Science.gov (United States)

    Vieu, T; Beaurain, S; Angel, C; Leriche, H; Petit, J; Conso, J F; Planché, C; Losay, J

    1995-10-01

    The comparison of the clinical results and costs of the two methods of closure of patient ductus arteriosus was undertaken in two comparable groups of 40 patients treated in the same period in the same hospital. After transcatheter closure there was a 9% residual shunt rate at 3 years, the 2 patients with a residual continuous murmur being operated secondarily. The only complication was severe haemolysis which regressed after transcatheter ablation of the prosthesis. After surgical closure, there were no residual shunt. Some postoperative complications were observed in 20% of cases, usually benign (ventilatory problems, dysphonia or urinary infection), but occasionally more serious (peroperative lesion of the pulmonary artery). Morbidity, inherent to the technique of closure, was very different and much less in catheter closure. The average cost (daily cost x average length of hospital stay) was much less with transcatheter closure 38,558 francs versus 11,240 francs. On the other hand, the direct cost of transcatheter closure was greater than that of surgery: 32,798 francs versus 20,903 francs, the difference being related to the actual price of the prosthesis. The authors conclude that the 3 year results of transcatheter closure of patent ductus arterious make this technique a reasonable therapeutic alternative to surgery. From the safety point of view, the two techniques are comparable bu patient confort is greater with transcatheter closure for an increase in cost of the initial procedure which should decrease in relation to the types and prices of the prosthesis used.

  11. Pharmacokinetics and clinical efficacy of indomethacin in premature infants with patent ductus arteriosus.

    Science.gov (United States)

    Regazzi, M B; Rondanelli, R; Vidale, E; Chirico, G; Rondini, G; Chiara, A; Piccolo, A

    1984-01-01

    Despite a considerable amount of investigation, controversy continues concerning the use of indomethacin in inducing the closure of patent ductus arteriosus. This controversy may be attributable to differences in dosage, route of administration, postnatal age at treatment and the variable pharmacokinetics of the drug in premature infants. The pharmacokinetics and clinical efficacy of i.v. administered indomethacin in five premature infants with PDA were evaluated. There was considerable intersubject variability in the half life of elimination (63.1 +/- 38 h). This variability was mainly due to clearance (0.0086 +/- 0.0069 l/h/kg) rather than to distribution volume variability (0.54 +/- 0.27 l/kg). A reduction of half life was observed after the second dose, probably due to a maturation process. A permanent closure of the ductus was obtained in two patients after the first dose and in two patients after the second dose. The side-effects observed in our infants were transient and no long-term complication was attributable to this drug.

  12. [Surgical closure of patent ductus arteriosus in premature neonates: Does the surgical technique affect the outcome?

    Science.gov (United States)

    Avila-Alvarez, Alejandro; Serantes Lourido, Marta; Barriga Bujan, Rebeca; Blanco Rodriguez, Carolina; Portela-Torron, Francisco; Bautista-Hernandez, Victor

    2017-05-01

    Surgical closure of patent ductus arteriosus in premature neonates is an aggressive technique and is not free of complications. A study was designed with the aim of describing our experience with a less invasive technique, the extra-pleural approach via a posterior minithoracotomy, and to compare the results with the classic transpleural approach. A retrospective cohort study was conducted on premature neonates on whom surgical closure of the ductus was performed during a ten-year period (March 2005 to March 2015). A comparison was made of the acute complications, the outcomes on discharge, and follow-up, between the extra-pleural approach and the classic transpleural approach. The study included 48 patients, 30 in the classical approach and 18 in the extra-pleural group. The demographic and pre-operative characteristics were similar in both groups. No differences were found between the 2 groups in the incidence of acute post-operative complications (56.6 vs. 44.4%), on the dependence on oxygen at 36 weeks (33.3 vs. 55.5%), or in hospital mortality (10 vs. 16.6%). As regards the short-term progress, the extra-pleural group required fewer days until the withdrawal of supplementary oxygen (36.3 vs. 28.9) and until hospital discharge (67.5 vs. 53.2), although only the time until extubation achieved a statistically significant difference (11.5 vs. 2.7, P=.03). The extra-plural approach by posterior minithoracotomy for the surgical closure of ductus in the premature infant is viable and could bring some clinical benefits in the short-term. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Evaluation of Risk Factors Related with Neonatal Patent Ductus Arteriosus in Hospitalized Neonates of Neonatal Intensive Care Unit

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    Reza Saeidi

    2012-06-01

    Full Text Available Background: Patent ductus arteriosus or patent arterial duct (PDA is a condition in which a structure called the ductus arteriosus, normal in fetal life, remains into infancy and onwards, when it should have disappeared. Thus, in this study we want to discuss about frequency of its symptoms and risk factors. Materials and Methods: It is a descriptive study which has been done among 100 newborns registered in Ghaem Hospital of Mashhad. Sampling was gathered easily.Results: The most prevalent symptom among newborn babies was systolic heart murmur (89%. According to the obtained risk factors, hypoxia (71% and acidosis (70% are followed by prematurity (41%. Out of all registered newborn babies 68% were suffering from associated disorders.Conclusion: For achieving an on-time diagnosis of PDA, clinical examination of heart and respiratory symptoms must be examined very precisely. Newborn babies must be examined in terms of two risk factors: prematurity and light weight.

  14. Neurogenic chronic idiopathic intestinal pseudo-obstruction, patent ductus arteriosus, and thrombocytopenia segregating as an X linked recessive disorder.

    Science.gov (United States)

    FitzPatrick, D R; Strain, L; Thomas, A E; Barr, D G; Todd, A; Smith, N M; Scobie, W G

    1997-08-01

    We present a family with three affected males in two generations with congenital neurogenic chronic idiopathic intestinal pseudo-obstruction (CIIP), patent ductus arteriosus, and large platelet thrombocytopenia apparently segregating as an X linked recessive disorder. The pattern of segregation of DNA markers within the family is consistent with linkage to the previously described neurogenic CIIP (CIIPX) locus at Xq28. This combination may represent a new contiguous gene disorder and appears to have a good prognosis with supportive therapy.

  15. A Major Cause of Mortality and Morbidity of Very Low Birth Weight Infants: Patent Ductus Arteriosus

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    Fatih Aygün

    2012-04-01

    Full Text Available In­tro­duc­ti­on: Patent Ductus Arteriosus (PDA, a cardiac pathology commonly seen in preterm infants, has negative effects on mortality and morbidity. Persistent patency of PDA is positively correlated with respiratory distress syndrome (RDS, prolonged respiratory support, pulmonary hemorrhage, broncopulmonary dysplasia (BPD, necrotizing enterocolitis (NEC, intraventricular hemorrhage, renal failure, neurodevelopmental impairment (cerebral palsy, retinopathy of prematurity and death. The standard treatment regimen is to close symptomatic PDA and cyclooxygenase inhibitors such as indomethacin, ibuprofen are the first choises. Our aim in this study is to report PDA rate, treatment and complications in premature infants. Materials and Methods: This study retrospectively enrolled 103 infants born <33 gestational weeks, without any major congenital anomaly or congenital heart defects between January 2010-November 2011. Echocardiograms was performed in the first week. PDA related pulmonary hemorrhage, NEC, BPD, ROP and death were demonstrated.Results: Among of 103 infants, 45 were male and 58 were female. Seventy infants were born with cesarian section and 33 were born with normal labor. The mean gestational week was 29.7±2.2, the mean gestational week of infants with PDA was 28.8±2.3. The mean birth weight of infants was 1323±375 grams. The mean Apgar score was 7.25±1.83, the scores of infants with patent ductus arteriosus were significantly low (6.7±1.9. Echocardiography was performed on the mean of 4.8±4.4 days, PDA was determined in 48 of 103 infants (%46. The mean of birth weight of infants with persistant PDA was 1162±351 grams, it was 1465±340 g in the closed group. The rate of pulmonary hemorrhage, NEC, BPD, ROP and death was significantly higher in infants with PDA compared with infants having ductal closure (p<0.05.Conclusion: The early closure of PDA in very low birth weight infants will reduce both mortality and early or late

  16. Anatomic, histopathologic, and echocardiographic features in a dog with an atypical pulmonary valve stenosis with a fibrous band of tissue and a patent ductus arteriosus.

    Science.gov (United States)

    Yoon, Hakyoung; Kim, Jaehwan; Nahm, Sang-Soep; Eom, Kidong

    2017-07-11

    Congenital pulmonary valve stenosis and patent ductus arteriosus are common congenital heart defects in dogs. However, concurrence of atypical pulmonary valve stenosis and patent ductus arteriosus is uncommon. This report describes the anatomic, histopathologic, and echocardiographic features in a dog with concomitant pulmonary valve stenosis and patent ductus arteriosus with atypical pulmonary valve dysplasia that included a fibrous band of tissue. A 1.5-year-old intact female Chihuahua dog weighing 3.3 kg presented with a continuous grade VI cardiac murmur, poor exercise tolerance, and an intermittent cough. Echocardiography indicated pulmonary valve stenosis, a thickened dysplastic valve without annular hypoplasia, and a type IIA patent ductus arteriosus. The pulmonary valve was thick line-shaped in systole and dome-shaped towards the right ventricular outflow tract in diastole. The dog suffered a fatal cardiac arrest during an attempted balloon pulmonary valvuloplasty. Necropsy revealed pulmonary valve dysplasia, commissural fusion, and incomplete opening and closing of the pulmonary valve because of a fibrous band of tissue causing adhesion between the right ventricular outflow tract and the dysplastic intermediate cusp of the valve. A fibrous band of tissue between the right ventricular outflow track and the pulmonary valve should be considered as a cause of pulmonary valve stenosis. Pulmonary valve stenosis and patent ductus arteriosus can have conflicting effects on diastolic and systolic dysfunction, respectively. Therefore, beta-blockers should always be used carefully, particularly in patients with a heart defect where there is concern about left ventricular systolic function.

  17. The expression of VEGF and its receptors in the human ductus arteriosus.

    Science.gov (United States)

    Weber, Sven C; Rheinlaender, Cornelia; Sarioglu, Nanette; Peiser, Christian; Rüdiger, Mario; Obladen, Michael; Koehne, Petra S

    2008-10-01

    Programmed proliferative degeneration of the human fetal ductus arteriosus (DA) preceding definite postnatal closure has a large developmental variability and is controlled by several signaling pathways. Among these vascular endothelial growth factor (VEGF) and its receptors (VEGF-Rs) play an important role. Until now, gestational age dependent expression of VEGF and its receptors has not been investigated in a large number of human DA tissue specimens. We examined protein expression of VEGF and the three VEGF-Rs immunohistochemically in 63 human fetal autopsy DA specimens of 11-38 wk gestation. Specimens were classified into different maturity stages according to their histologic appearance. VEGF and VEGF-Rs-staining was detected in all maturity stages. VEGF-staining was localized perinuclearly in all vascular layers and did not change during development. VEGF-R1 and VEGF-R3 expression was marked in the endothelium in early maturity stages and decreased during development. In contrast, -R2 predominated in the media in later developmental stages. Our results emphasize the importance of VEGF as a mediator during programmed proliferative degeneration of fetal DA and support the hypothesis that VEGF-R1 and VEGF-R3 are required for normal blood vessel development during embryogenesis. In contrast, VEGF-R2 is the predominant receptor in later angiogenic signaling.

  18. Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation.

    LENUS (Irish Health Repository)

    Noori, S

    2014-08-14

    Objective:We performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance were associated with subsequent development of catecholamine-resistant hypotension following ligation.Study Design:A standardized treatment approach for hypotension was followed at each center. Infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was >15 μg kg(-1)min(-1). Echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension).Result:Forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). Catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. Infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration.Conclusion:We speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.Journal of Perinatology advance online publication, 14 August 2014; doi:10.1038\\/jp.2014.151.

  19. Pharmacoeconomics of Surgical Interventions vs. Cyclooxygenase Inhibitors for the Treatment of Patent Ductus Arteriosus

    Science.gov (United States)

    Turck, Charles J; Marsh, Wallace; Stevenson, James G.; York, John M.; Miller, Henry; Patel, Snehal

    2007-01-01

    Management of neonatal patent ductus arteriosus (PDA) often is resource-intensive and costly. Therefore, it is in hospitals' best interests to ensure the most cost-efficient use of associated resources. Clinical status, comorbidities, and response to prior therapy are considered in selecting the most appropriate intervention for PDA management. Currently, supportive measures (e.g., fluid restriction), surgical ligation, and pharmacologically based medical therapy are the primary treatment modalities for correcting PDA. Medical therapy, which comprises a small percentage (2.0%–5.0%)1 of overall PDA treatment expenses in the United States, consists of either of the 2 intravenous (IV) cyclooxygenase (COX) inhibitors: IV indomethacin and the newly available IV ibuprofen lysine. Although IV COX inhibitors represent a small portion of medical expenses, their benefits appear to be considerable. Pharmacoeconomic studies have evaluated indomethacin's beneficial impact on cost-effectiveness per quality-adjusted life year in PDA prophylaxis; however, no analysis to date prospectively assesses the effect of COX inhibitors on resource use or expenses in treating PDA. Such analysis is desirable and should consider efficacy and safety outcomes, impact on health care resource use and length of stay (LOS), and any differential effects of the agents' safety profiles; notably, IV indomethacin adversely affects renal and mesenteric blood flow and increases serum creatinine and oliguria significantly more than IV ibuprofen. These observations lay the foundation to conduct studies assessing the influence of these differences on resource use, LOS and expenses associated with PDA management. PMID:23055853

  20. Patent Ductus Arteriosus in Preterm Infants: Do We Have the Right Answers?

    Directory of Open Access Journals (Sweden)

    Hesham Abdel-Hady

    2013-01-01

    Full Text Available Patent ductus arteriosus (PDA is a common clinical condition in preterm infants. Preterm newborns with PDA are at greater risk for several morbidities, including higher rates of bronchopulmonary dysplasia (BPD, decreased perfusion of vital organs, and mortality. Therefore, cyclooxygenase (COX inhibitors and surgical interventions for ligation of PDA are widely used. However, these interventions were reported to be associated with side effects. In the absence of clear restricted rules for application of these interventions, different strategies are adopted by neonatologists. Three different approaches have been investigated including prophylactic treatment shortly after birth irrespective of the state of PDA, presymptomatic treatment using echocardiography at variable postnatal ages to select infants for treatment prior to the duct becoming clinically significant, and symptomatic treatment once PDA becomes clinically apparent or hemodynamically significant. Future appropriately designed randomized controlled trials (RCTs to refine selection of patients for medical and surgical treatments should be conducted. Waiting for new evidence, it seems wise to employ available clinical and echocardiographic parameters of a hemodynamically significant (HS PDA to select patients who are candidates for medical treatment. Surgical ligation of PDA could be used as a back-up tool for those patients who failed medical treatment and continued to have hemodynamic compromise.

  1. Transcatheter Closure of Patent Ductus Arteriosus and Atrial Septal Defects Using the Amplatzer Occluder

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective:To evalte the efficiency,safety and complications of transcatheter closure of patent ductus arteriosus (PDA) or secundum atrial septal defects (ASD)using the Amplatzer occluder device.Methods:30 patients underwent transcatheter closure of PDA or ASD with the Amplatzer occluder.The lateral descending aortographies were performed to evaluate immediate results in the 20 patients of PDA.Hemodynamics was studied before and after the procedure.X-ray and echocardiography were performed in order to detect residual shunt and recanalization.Results:The device was successfully implanted in 28 patients.There was on clinical evidence of hemolysis andon incidence of device emboliszation.The median operation time waw 56min and median fluoroscopy time was 11min .The devices'positions were optmal and on residual shunt was found 24h and 1month after the procedure No complicatios were observed during the 3-month follow-up in 25 patients.Conclusions:The Amplatzer occluder device is a highly efficient prosthesis that can be safely applied in most patients with PDA or ASD.

  2. Management of patent ductus arteriosus in preterm infants--where do we stand?

    Science.gov (United States)

    Mitra, Souvik; Rønnestad, Arild; Holmstrøm, Henrik

    2013-01-01

    Patent ductus arteriosus (PDA) in preterm infants is a controversial topic in the management of preterm neonates. There are no generally accepted guidelines for diagnosis, treatment, and follow-up of PDA, and few publications have covered the whole topic or have been conclusively summarized to give a proper direction for the treating physician. Major issues remain to be clarified, both with respect to diagnosis and treatment. The definition of hemodynamic significance varies because of different use of echocardiographic criteria and uncertainty about the role of biomarkers. The detailed risks and benefits of available treatment alternatives are still under investigation. There has been a general shift in the management of PDA in preterm neonates from the "aggressive approach" to a more "conservative approach," but the effects of this strategy on morbidity in a longer time perspective are not fully known. An individualized therapeutic strategy with special emphasis on identification of hemodynamically significance seems to be the way forward. In this review we put forward the scientific background in favor of a seemingly growing body of evidence against active treatment, but we raise caution against shying away from all forms of treatment or instituting them too late. Finally, we try to integrate the current knowledge into suggestions for the management of PDA in premature infants.

  3. Mechanical and in vitro evaluation of an experimental canine patent ductus arteriosus occlusion device.

    Science.gov (United States)

    Wierzbicki, Mark A; Bryant, Jesse; Miller, Matthew W; Keller, Brandis; Maitland, Duncan J

    2016-06-01

    Patent ductus arteriosus (PDA) is a congenital cardiovascular malformation in which a fetal connection between the aorta and pulmonary artery remains patent after birth. This defect commonly results in clinical complications, even death, necessitating closure. Surgical ligation is the most common treatment but requires a thoracotomy and is therefore invasive. A minimally invasive option is preferable. A prototype device for PDA occlusion which utilizes shape memory polymer foams has been developed and evaluated using mechanical and in vitro experiments. Removal force and radial pressure measurements show that the prototype device exhibited a lower removal force and radial pressure than a commercially available device. The in vitro experiments conducted within simplified and physiological PDA models showed that the prototype does not migrate out of position into the pulmonary artery at either physiological or elevated pressures in multiple model configurations. While the radial pressure and removal force were lower than commercial devices, the device performed acceptably in the in vitro benchtop experiments warranting further prototype development.

  4. Preoperative echocardiographic measures of left ventricular mechanics are associated with postoperative vasoactive support in preterm infants undergoing patent ductus arteriosus ligation.

    Science.gov (United States)

    Gray, Margaret A; Graham, Eric M; Atz, Andrew M; Bradley, Scott M; Kavarana, Minoo N; Chowdhury, Shahryar M

    2017-07-05

    Preoperative risk factors associated with poor outcomes after patent ductus arteriosus ligation in preterm infants have not been well defined. The aim of this study was to determine the association between preoperative echocardiographic measures of left ventricular mechanics and postoperative clinical outcomes after patent ductus arteriosus ligation. Preterm infants less than 90 days of age with no other significant congenital anomalies who underwent patent ductus arteriosus ligation between 2007 and 2015 were considered for retrospective analysis. The primary outcome was peak postoperative vasoactive inotropic score. Conventional echocardiographic measures of ventricular size, function, and patent ductus arteriosus size were performed. Echocardiographic single-beat, pressure-volume loop analysis estimates of contractility (end-systolic elastance) and afterload (arterial elastance) were calculated. Ventriculoarterial coupling was assessed using the arterial elastance/end-systolic elastance ratio. Multivariable linear regression was performed using clinical and echocardiographic data. Echocardiograms from 101 patients (42.5% male) were analyzed. We found a statistically significant association between vasoactive inotropic score and both end-systolic elastance and arterial elastance. No patient with arterial elastance/end-systolic elastance greater than 0.78 (n = 32) had a vasoactive inotropic score 20 or greater. Analysis of our secondary outcomes found associations between preoperative end-systolic elastance and postoperative urine output less than 1 mL/kg/h at 24 hours, creatinine change greater than 0.5 mg/dL, and time to first extubation. End-systolic elastance and arterial elastance were the only predictors of postoperative vasoactive inotropic score after patent ductus arteriosus ligation in preterm infants. Those neonates with increased contractility and low afterload were at highest risk for elevated inotropic support. These findings suggest a role

  5. Anomalous left coronary artery from the pulmonary artery with a large patent ductus arteriosus: aversion of a catastrophe.

    Science.gov (United States)

    Aggarwal, Sanjeev; Delius, Ralph E; Pettersen, Michael D

    2013-01-01

    We present an infant who had an anomalous left coronary artery arising from the pulmonary artery (ALCAPA) and a large patent ductus arteriosus (PDA), who was diagnosed before a potentially catastrophic closure of PDA. In the presence of normal left ventricular function and the absence of coronary artery collaterals, it is difficult to diagnose ALCAPA. A disproportionate degree of left ventricular dilation and severity of mitral valve regurgitation relative to the degree of PDA shunt, and echogenic papillary muscles on an echocardiogram should raise a suspicion of coronary artery anomalies. The infant underwent surgical ligation of PDA with translocation of coronary arteries and had an uneventful recovery.

  6. Indomethacin prophylaxis or expectant treatment of patent ductus arteriosus in extremely low birth weight infants?

    Science.gov (United States)

    Cordero, L; Nankervis, C A; Delooze, D; Giannone, P J

    2007-03-01

    Indomethacin prophylaxis or expectant treatment are common strategies for the prevention or management of symptomatic patent ductus arteriosus (sPDA). To compare the clinical responses of extremely low birth weight (ELBW) infants to indomethacin prophylaxis with that of other infants who were managed expectantly by being treated with indomethacin or surgically only after an sPDA was detected. Retrospective cohort investigation of 167 ELBW infants who received indomethacin prophylaxis (study) and 167 ELBW infants (control) treated expectantly who were matched by year of birth (1999 to 2006), birth weight, gestational age (GA) and gender. Mothers of the two groups of infants were comparable demographically and on the history of preterm labor, pre-eclampsia, antepartum steroids and cesarean delivery. Study and control infants were similar in birth weight, GA, low 5 min Apgar scores, surfactant administration, the need for arterial blood pressure control, bronchopulmonary dysplasia and neonatal mortality. Necrotizing enterocolitis, spontaneous intestinal perforations, intraventricular hemorrhage grade III to IV, periventricular leukomalacia and stage 3 to 5 retinopathy of prematurity occurred also with similar frequency in both groups of infants. In the indomethacin prophylaxis group, 29% of the infants developed sPDA, and of them 38% responded to indomethacin treatment. In the expectantly treated group, 37% developed sPDA, and of them 59% responded to indomethacin treatment. Overall, surgical ligation rate for sPDA was similar between both groups of patients. In our experience, indomethacin prophylaxis does not show any advantages over expectant early treatment on the management of sPDA in ELBW infants. Although no deleterious effects were observed, prophylaxis exposed a significant number of infants who may have never developed sPDA, to potential indomethacin-related complications.

  7. Differential temporal and spatial progerin expression during closure of the ductus arteriosus in neonates.

    Directory of Open Access Journals (Sweden)

    Regina Bökenkamp

    Full Text Available Closure of the ductus arteriosus (DA at birth is essential for the transition from fetal to postnatal life. Before birth the DA bypasses the uninflated lungs by shunting blood from the pulmonary trunk into the systemic circulation. The molecular mechanism underlying DA closure and degeneration has not been fully elucidated, but is associated with apoptosis and cytolytic necrosis in the inner media and intima. We detected features of histology during DA degeneration that are comparable to Hutchinson Gilford Progeria syndrome and ageing. Immunohistochemistry on human fetal and neonatal DA, and aorta showed that lamin A/C was expressed in all layers of the vessel wall. As a novel finding we report that progerin, a splicing variant of lamin A/C was expressed almost selectively in the normal closing neonatal DA, from which we hypothesized that progerin is involved in DA closure. Progerin was detected in 16.2%±7.2 cells of the DA. Progerin-expressing cells were predominantly located in intima and inner media where cytolytic necrosis accompanied by apoptosis will develop. Concomitantly we found loss of α-smooth muscle actin as well as reduced lamin A/C expression compared to the fetal and non-closing DA. In cells of the adjacent aorta, that remains patent, progerin expression was only sporadically detected in 2.5%±1.5 of the cells. Data were substantiated by the detection of mRNA of progerin in the neonatal DA but not in the aorta, by PCR and sequencing analysis. The fetal DA and the non-closing persistent DA did not present with progerin expressing cells. Our analysis revealed that the spatiotemporal expression of lamin A/C and progerin in the neonatal DA was mutually exclusive. We suggest that activation of LMNA alternative splicing is involved in vascular remodeling in the circulatory system during normal neonatal DA closure.

  8. Calcium-dependent and calcium-sensitizing pathways in the mature and immature ductus arteriosus.

    Science.gov (United States)

    Clyman, Ronald I; Waleh, Nahid; Kajino, Hiroki; Roman, Christine; Mauray, Francoise

    2007-10-01

    Studies performed in sheep and baboons have shown that after birth, the normoxic muscle media of ductus arteriosus (DA) becomes profoundly hypoxic as it constricts and undergoes anatomic remodeling. We used isolated fetal lamb DA (pretreated with inhibitors of prostaglandin and nitric oxide production) to determine why the immature DA fails to remain tightly constricted during the hypoxic phase of remodeling. Under normoxic conditions, mature DA constricts to 70% of its maximal active tension (MAT). Half of its normoxic tension is due to Ca(2+) entry through calcium L-channels and store-operated calcium (SOC) channels. The other half is independent of extracellular Ca(2+) and is unaffected by inhibitors of sarcoplasmic reticulum (SR) Ca(2+) release (ryanodine) or reuptake [cyclopiazonic acid (CPA)]. The mature DA relaxes slightly during hypoxia (to 60% MAT) due to decreases in calcium L-channel-mediated Ca(2+) entry. Inhibitors of Rho kinase and tyrosine kinase inhibit both Ca(2+)-dependent and Ca(2+)-independent DA tension. Although Rho kinase activity may increase during gestation, immature DA develop lower tensions than mature DA, primarily because of differences in the way they process Ca(2+). Calcium L-channel expression increases with advancing gestation. Under normoxic conditions, differences in calcium L-channel-mediated Ca(2+) entry account for differences in tension between immature (60% MAT) and mature (70% MAT) DA. Under hypoxic conditions, differences in both calcium L-channel-dependent and calcium L-channel-independent Ca(2+) entry, account for differences in tension between immature (33% MAT) and mature (60% MAT) DA. Stimulation of Ca(2+) entry through reverse-mode Na(+)/Ca(2+) exchange or CPA-induced SOC channel activity constrict the DA and eliminate differences between immature and mature DA during both hypoxia and normoxia.

  9. Clinical Exploration of Transcatheter Closure of Patent Ductus Arteriosus With Duct Occluder in Infants

    Institute of Scientific and Technical Information of China (English)

    Mingyang Qian; Yufen Li; Zhiwei Zhang; jijun Shi; Shushui Wang; Junjie Li

    2007-01-01

    To explore the feasibility,necessity,and security of transcatheter closure of patent ductus arteriosus (PDA) in infants.Methods There were 230 infants with PDA.The ages were (7.3 ± 3.2) months and the weight (6.6 ± 2.8) Kg in average.They were separated into two groups.Group A was formed by the infants weighing less than 6 Kg,Group B over 6 Kg.Right heart catheterizaton was performed first to calculate the ratio of Qp/Qs.Then descending aortography demonstrated the diameter and shape of PDA.Proper occluder was selected to finish the intervention.Echocardiography was performed after intervention 24 hours and 1,3,6,12 and 24 months.Results In Group A the technical achievement ratio was 94.6% with the average diameter of PDA (6.2 ± 3.2) mm.In Group B the technical achievement ratio was 100% with the average diameter of PDA (4.8 ±2.5) mm.We used the Amplatzer Duct Occluder with the type from 6-8 mm to 12-14 mm,the delivery sheath from 6 French to 8 French.24 hours after intervention,echocardiography demonstrated that there were 6 residual shunts in Group A while 22 in Group B.After 1 year,residual shunt existed in neither group.There were 4 patients whose femoral arteries pulsed weakly after intervention in Group A,while in Group B there were 3.They all recovered 24 hours after the application of urokinase.In Group A blood flow velocity in descending aorta increased in 5 infants,while in Group B there were 3.They all resumed in 6-12 months.Conclusions Transcatheter closure of PDA in infants is safe and technically feasible.However,indication should be strictly selected and the intervention should be performed by experienced physician.

  10. Transcatheter closure of patent ductus arteriosus: Evaluating the effect of the learning curve on the outcome

    Directory of Open Access Journals (Sweden)

    Azhar Ahmad

    2009-01-01

    Full Text Available Background and Objectives : Initial experience with transcatheter closure of patent ductus arteriosus (PDA using detachable coils and Amplatzer duct occluder devices is reported. We evaluated the outcome, complications, and influence of the learning curve, and also assessed the need of surgical backup for such interventional procedures. Methods: From January 2000 to December 2004, 121 patients underwent transcatheter closure of PDA. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for appropriately choosing the occluder device type and size. A second aortic angiogram was performed 10 minutes after device deployment. Echocardiography was repeated at intervals of 24 hours, then at 1, 3, and 6 months after the procedure to assess complications. Stepwise multiple regression analysis was used to assess the role of experience in improving the outcome of the procedure. Results: Of 121 cases, four patients had pulmonary artery embolization of the occluder device which was successfully retrieved in the catheterization laboratory, while two others had embolization that required surgical intervention. Four patients had temporary residual leak, nine had protrusion of the device into the aorta without significant Doppler pressure gradient or hemolysis on follow-up, and five had partial hemodynamically insignificant obstruction to the left pulmonary artery. Statistical analysis showed that the effect of the learning curve and experience was responsible for 93% improvement in the procedural outcome over the five-year study period. Conclusion: Transcatheter occlusion of PDA is safe and effective alternative to surgery. Complications occurred in those with unfavorable duct anatomy and with the use of multiple coils. Surgical backup was important for such interventional procedures. Experience played a major role in the proper choice of device type and size which greatly influenced the outcome of the procedure.

  11. Different doses of ibuprofen in the treatment of patent ductus arteriosus: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    E Amini

    2012-11-01

    Full Text Available Background: Patent ductus arteriosus (PDA is a common finding among premature or low-birth-weight infants and it often does not close. Nowadays, drugs used for its treatment include indomethacin and more commonly ibuprofen. Oral ibuprofen was recently shown to be as effective and have several important advantages in preterm infants. Studies performed to find the best dose of ibuprofen for PDA treatment are limited; hence, we compared the effects of two different doses of ibuprofen in this interventional study.Methods: In this randomized controlled clinical trial, we randomly divided 60 patients with echocardiographically confirmed PDA into two groups of 30. This study was done in NICU of Valiasr hospital in 1387-89 years. In the first group, we administered a loading dose of 10 mg/kg ibuprofen on the first day, followed by two doses of 5 mg/kg in the next two days. In the second group, we administered a loading dose of 15 mg/kg ibuprofen on the first day followed by two doses of 7.5 mg/kg in next two days. Eventually, we compared PDA closure rates and complications of therapy between the two groups. Results: Thirty (100% patients in 15-mg/kg group and 23 (76.7% patients in 10 mg/kg group had successful PDA closure with no need for surgery. The two groups had a statistically significant difference (P=0.011 and the highest response to treatment was seen within the first 24 hours of treatment.Conclusion: We may conclude that higher doses of ibuprofen (15 and 2×7.5 mg/kg would offer better outcomes for PDA closure without gastrointestinal or renal complications and less need for surgery.

  12. Treatment of severe pulmonary hypertension in the setting of the large patent ductus arteriosus.

    Science.gov (United States)

    Niu, Mary C; Mallory, George B; Justino, Henri; Ruiz, Fadel E; Petit, Christopher J

    2013-05-01

    Treatment of the large patent ductus arteriosus (PDA) in the setting of pulmonary hypertension (PH) is challenging. Left patent, the large PDA can result in irreversible pulmonary vascular disease. Occlusion, however, may lead to right ventricular failure for certain patients with severe PH. Our center has adopted a staged management strategy using medical management, noninvasive imaging, and invasive cardiac catheterization to treat PH in the presence of a large PDA. This approach determines the safety of ductal closure but also leverages medical therapy to create an opportunity for safe PDA occlusion. We reviewed our experience with this approach. Patients with both severe PH and PDAs were studied. PH treatment history and hemodynamic data obtained during catheterizations were reviewed. Repeat catheterizations, echocardiograms, and clinical status at latest follow-up were also reviewed. Seven patients had both PH and large, unrestrictive PDAs. At baseline, all patients had near-systemic right ventricular pressures. Nine catheterizations were performed. Two patients underwent 2 catheterizations each due to poor initial response to balloon test occlusion. Six of 7 patients exhibited subsystemic pulmonary pressures during test occlusion and underwent successful PDA occlusion. One patient did not undergo PDA occlusion. In follow-up, 2 additional catheterizations were performed after successful PDA occlusion for subsequent hemodynamic assessment. At the latest follow-up, the 6 patients who underwent PDA occlusion are well, with continued improvement in PH. Five patients remain on PH treatment. A staged approach to PDA closure for patients with severe PH is an effective treatment paradigm. Aggressive treatment of PH creates a window of opportunity for PDA occlusion, echocardiography assists in identifying the timing for closure, and balloon test occlusion during cardiac catheterization is critical in determining safety of closure. By safely eliminating the large PDA

  13. Mandatory Closure Versus Nonintervention for Patent Ductus Arteriosus in Very Preterm Infants.

    Science.gov (United States)

    Sung, Se In; Chang, Yun Sil; Chun, Ji Young; Yoon, Shin Ae; Yoo, Hye Soo; Ahn, So Yoon; Park, Won Soon

    2016-10-01

    To determine whether a nonintervention approach for treating hemodynamically significant patent ductus arteriosus (PDA) is associated with decreased mortality and/or morbidity compared with a mandatory closure approach in extremely low birth weight infants. We reviewed the medical records of 178 infants of 23-26 weeks' gestational age with PDA, requiring ventilator treatment, and with hemodynamically significant PDA ≥2 mm in size. Mandatory closure was used during period I (July 2009 to December 2011, n = 81), and nonintervention was used during period II (January 2012 to June 2014, n = 97). During period I, 64% of infants were first treated with indomethacin, and 82% were ultimately ligated surgically. During period II, no infant was treated with indomethacin and/or ligation. The average postnatal day of PDA closure was day 13 and day 44 during periods I and II, respectively. There was significantly more use of diuretics and fluid restriction during period II compared with period I. There was no difference in mortality or morbidities such as necrotizing enterocolitis or intraventricular hemorrhage. The incidence of bronchopulmonary dysplasia (BPD) and the propensity score adjusted OR of BPD were significantly lower during period II compared with period I. Despite longer PDA exposure, nonintervention was associated with significantly less BPD compared with mandatory closure. Additional study is warranted to determine the benefits and risks of non-intervention for the hemodynamically significant PDA in extremely low birth weight infants. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  14. Comparison of the Mortality and In-Hospital Outcomes of Preterm Infants Treated with Ibuprofen for Patent Ductus Arteriosus with or without Clinical Symptoms Attributable to the Patent Ductus Arteriosus at the Time of Ibuprofen Treatment.

    Science.gov (United States)

    Yoo, Hani; Lee, Jin A; Oh, Sohee; Jung, Young Hwa; Sohn, Jin A; Shin, Seung Han; Choi, Chang Won; Kim, Ee Kyung; Kim, Han Suk; Kim, Beyong Il

    2017-01-01

    The aim of this study was to assess the differences in the mortality and in-hospital outcomes of preterm infants with patent ductus arteriosus (hsPDA) at the time of first ibuprofen treatment. In total, 91 infants born from April 2010 to March 2015 were included. Fourteen infants (15.4%) received ibuprofen treatment when there were clinical symptoms due to hsPDA (clinical symptoms group). In clinical symptoms group, infants were younger (25 [23-27] vs. 26 [23-27] weeks; P = 0.012) and lighter (655 [500-930] vs. 880 [370-1,780] grams; P patent ductus arteriosus (PDA) ligation and the incidence of bronchopulmonary dysplasia (BPD) was higher in the clinical symptoms group in the univariate analysis, after multivariate logistic regression analysis adjusting for the CRIB-II score, birthweight, birth year, and the invasive ventilator care ≤ 2 postnatal days, there were no significant differences in mortality, frequency of secondary ligation and in-hospital outcomes including necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), BPD or death. Our data suggest that we can hold off on PDA treatment until the clinical symptoms become prominent.

  15. Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants.

    LENUS (Irish Health Repository)

    El-Khuffash, Afif F

    2011-03-01

    There is little consensus regarding the use of echocardiography in patent ductus arteriosus (PDA) treatment in preterm infants. The use of troponin T (cTnT) and N-terminal Pro-BNP (NTpBNP) in combination with echocardiography assessment may facilitate the development of a superior predictive model.

  16. Effect of Indomethacin Infused over 30 Minutes on Cerebral Fractional Tissue Oxygen Extraction in Preterm Newborns with a Patent Ductus Arteriosus

    NARCIS (Netherlands)

    Keating, Paul; Verhagen, Elise; van Hoften, Jacorina; ter Horst, Henk; Bos, Arend F.

    2010-01-01

    Background: A significant patent ductus arteriosus (PDA) is a common finding in the first days of life and, if persistent, is associated with an increased morbidity and mortality in the preterm newborn. Objectives: Our aim was to investigate, using near-infrared spectroscopy, the effect of indometha

  17. Limited effects of intravenous paracetamol on patent ductus arteriosus in very low birth weight infants with contraindications for ibuprofen or after ibuprofen failure

    NARCIS (Netherlands)

    D.W.E. Roofthooft (Daniella); I.M. van Beynum (I.); J.C.A. de Klerk (Johan C. A.); M. van Dijk (Monique); J.N. van den Anker (John); I.K.M. Reiss (Irwin); D. Tibboel (Dick); S.H. Simons (Sinno)

    2015-01-01

    textabstractFinding the optimal pharmacological treatment of a patent ductus arteriosus (PDA) in preterm neonates remains challenging. There is a growing interest in paracetamol as a new drug for PDA closure. In this prospective observational cohort study, we evaluated the effectiveness of intraveno

  18. Concurrent transcatheter closure of an apical muscular ventricular septal defect and a patent ductus arteriosus in a child with severe hyperkinetic pulmonary hypertension.

    Science.gov (United States)

    Joseph, G; Muthunayagam, J V; Mandalay, A

    2003-01-01

    Definitive treatment of congenital apical muscular ventricular septal defect (VSD) with large left-to-right shunt, severe pulmonary hypertension, and major associated lesions such as patent ductus arteriosus (PDA) has so far been possible only by surgery that has significant attendant morbidity and mortality [2]. Transcatheter device closure of both shunt lesions, if feasible, is a potentially simpler and safer alternative to surgery.

  19. Large patent ductus arteriosus in a 44-year-old woman leading to calcium deposition in the left atrium and mitral and aortic valves.

    Science.gov (United States)

    Roberts, Carey Camille; Roberts, William Clifford

    2015-06-01

    This report describes unusual autopsy findings in a 44-year-old woman who had a large, calcified patent ductus arteriosus that produced substantial left-to-right shunting. The patient died in 1962, 7 days after patch closure of the aortic orifice of the ductus. Numerous calcific deposits were present in the mural left atrial endocardium, the mitral valve leaflets and annulus, and the aortic valve cusps. The cause of the left-sided calcific deposits was perhaps related to the patient's several-decades-old giant aortopulmonary shunt, causing a major increase in the volume of blood passing through the left-sided cardiac chambers in comparison with the volume in the right side. To our knowledge, such findings in a patient with patent ductus arteriosus have not been reported previously.

  20. Secondary scoliosis after thoracotomy in patients with aortic coarctation and patent ductus arteriosus.

    Science.gov (United States)

    Roclawski, Marek; Pankowski, Rafal; Smoczynski, Andrzej; Ceynowa, Marcin; Kloc, Wojciech; Wasilewski, Wojciech; Jende, Piotr; Liczbik, Wieslaw; Beldzinski, Piotr; Libionka, Witold; Pierzak, Olaf; Adamski, Stanislaw; Niedbala, Miroslaw

    2012-01-01

    The aim of this study was to determine the influence of lateral thoracotomy on the development of scoliosis in subjects undergoing repair of coarctation of the aorta (CoAo) and patent ductus arteriosus (PDA). A group of 133 patients with CoAo and PDA was evaluated. Forty-five patients with CoAo and 38 with PDA were operated on using lateral thoracotomy (operative group) while 12 patients with CoAo and 31 with PDA were treated using balloon dilatation and stent or coil implantation (non-operative group). Clinical examination and the evaluation of spinal roentgenograms were performed. Among the operated patients 46.6% of those with CoAo and 39.5% of those with PDA had clinical scoliosis. In the non-operated patients scoliosis was present in only 16.6% of those with CoAo and 12.9% of those with PDA. Scoliosis ranged between 10° and 42° and it was mild in the majority of cases. In 90.4% of the operated scoliotic patients with CoAo and 73.3% of those with PDA the curve was thoracic and in 47.6% of the CoAo group and 53,3% of the PDA group the curve was left sided. All curves were right sided in non-operated subjects. Scoliosis in the operated group was higher in males than in females (63.3% versus 60% in CoAo and 68.2% versus 37.5% in PDA). The prevalence of scoliosis after thoracotomy was significantly higher than after non-surgical methods of treatment of both CoAo and PDA as well as in the general population. The rate of single thoracic and the rate of left thoracic curves in patients after thoracotomy is higher than in patients treated non-surgically or in idiopathic scoliosis. The rate of scoliosis after thoracotomy is higher in males than females especially following thoracotomy for PDA.

  1. Permissive tolerance of the patent ductus arteriosus may increase the risk of Chronic Lung Disease

    Directory of Open Access Journals (Sweden)

    Kaempf JW

    2013-03-01

    Full Text Available Joseph W Kaempf,1 Robert Huston,2 YingXing Wu,1 Andrew J Kaempf,1 Lian Wang,1 Gary Grunkemeier,1 Rebecca Mischel,2 Howard Cohen,3 Bret Freitag41Providence St Vincent Medical Center, Portland, OR, 2Randall Children’s Hospital at Legacy Emanuel, Portland, OR, 3Salem Hospital, Salem, OR, 4Legacy Salmon Creek Hospital, Vancouver, WA, USAPurpose: Because early closure therapies of the patent ductus arteriosus (PDA have not been shown to confer benefit to premature infants, the authors’ four neonatal intensive care units adopted a less aggressive PDA management protocol.Study design: A before–after investigation in infants with PDAs born 501–1500 g. Era 1 (January 2005 to December 2007 featured traditional management with indomethacin and/or surgical ligation used early to close PDAs; Era 2 (January 2008 to June 2009 featured fluid restriction and watchful waiting for PDA closure, limiting indomethacin or surgical ligation to only those infants with large PDAs needing significant respiratory support.Results: Era 2 infants (n = 129, mean ± standard deviation 27 ± 2 weeks received less and later indomethacin and less Day 1–28 total fluids as compared to Era 1 infants (n = 240, mean ± standard deviation 27 ± 2 weeks. The Chronic Lung Disease (CLD rate was higher in Era 2 (48% versus 34%, P < 0.01 as was the combined outcome of Death after Day 7 or CLD (57% versus 42%, P < 0.01. Multiple regression analysis showed Era 2 birth was a predictor of CLD. However, Poisson regression analysis determined the predictors of all seven major Vermont Oxford Network morbidities were earlier gestational age, lower birth weight, and male gender, not the era of birth. Significantly more infants were discharged home with PDAs in Era 2.Conclusion: Permissive tolerance of PDAs may increase the risk of CLD and Death after Day 7 or CLD but is not associated with significant changes in other Vermont Oxford Network morbidities.Keywords: premature infant

  2. A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

    Institute of Scientific and Technical Information of China (English)

    Mei Jin; Yong-Mei Liang; Xiao-Fang Wang; Bao-Jing Guo; Ke Zheng; Yan Gu; Zhen-Yu Lyu

    2015-01-01

    Background:Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China.Since then,several devices have been invented for occluding PDA.This study aimed to evaluate the technical feasibility,safety,and efficacy of transcatheter occlusion of PDA with different devices.Methods:One thousand five hundred and twenty-six patients (537 boys,989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure.We retrospectively analyzed data of these patients,including gender,age,weight,size and morphology of PDA,and devices used in transcatheter occlusion,outcomes,and postoperational complications.Results:Median age and median weight were 4.0 years (range:0.3-52.0 years old) and 15.3 kg (range:4.5-91.0 kg),respectively.Mean ductal diameter,aortic ductal diameter,ductal length,and pulmonary artery pressure were 3.50 ± 2.15 mm,l 0.08 ± 2.46 mm,7.49 ± 3.02 mm,and 30.21 ± 17.28 mmHg,respectively.Morphology of PDA assessed by descending aortogram was of type A in 1428 patients,type B in 6 patients,type C in 79 patients,type D in 4 patients,and type E in 9 patients according to the classification of Krichenko.Of all the 1526 patients,1497 patients underwent transcatheter PDA closure,among which 1492 were successful.Devices used were Amplatzer duct occluder Ⅰ (ADO Ⅰ,1280,85.8%),Cook detachable coils (116,7.8%),ADO Ⅱ (ADO Ⅱ,68,4.6%),muscular VSD occluder (12,0.8%),and Amplatzer vascular plug (16,1.0%).Conclusions:Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types.With transcatheter occlusion technique and devices developing,more patients with PDA can be treated with transcatheter closure both safely and efficiently.

  3. Transcription profiles of endothelial cells in the rat ductus arteriosus during a perinatal period.

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    Norika Mengchia Liu

    Full Text Available Endothelial cells (ECs lining the blood vessels serve a variety of functions and play a central role in the homeostasis of the circulatory system. Since the ductus arteriosus (DA has different arterial characteristics from its connecting vessels, we hypothesized that ECs of the DA exhibited a unique gene profile involved in the regulation of DA-specific morphology and function. Using a fluorescence-activated cell sorter, we isolated ECs from pooled tissues from the DA or the descending aorta of Wistar rat fetuses at full-term of gestation (F group or neonates 30 minutes after birth (N group. Using anti-CD31 and anti-CD45 antibodies as cell surface markers for ECs and hematopoietic derived cells, respectively, cDNAs from the CD31-positive and CD45-negative cells were hybridized to the Affymetrix GeneChip® Rat Gene 1.0 ST Array. Among 26,469 gene-level probe sets, 82 genes in the F group and 81 genes in the N group were expressed at higher levels in DA ECs than in aortic ECs (p2.0. In addition to well-known endothelium-enriched genes such as Tgfb2 and Vegfa, novel DA endothelium-dominant genes including Slc38a1, Capn6, and Lrat were discovered. Enrichment analysis using GeneGo MetaCore software showed that DA endothelium-related biological processes were involved in morphogenesis and development. We identified many overlapping genes in each process including neural crest-related genes (Hoxa1, Hoxa4, and Hand2, etc and the second heart field-related genes (Tbx1, Isl1, and Fgf10, etc. Moreover, we found that regulation of epithelial-to-mesenchymal transition, cell adhesion, and retinol metabolism are the active pathways involved in the network via potential interactions with many of the identified genes to form DA-specific endothelia. In conclusion, the present study uncovered several significant differences of the transcriptional profile between the DA and aortic ECs. Newly identified DA endothelium-dominant genes may play an important role in DA

  4. Vasoactivity of the gasotransmitters hydrogen sulfide and carbon monoxide in the chicken ductus arteriosus.

    Science.gov (United States)

    van der Sterren, Saskia; Kleikers, Pamela; Zimmermann, Luc J I; Villamor, Eduardo

    2011-10-01

    Besides nitric oxide (NO) and carbon monoxide (CO), hydrogen sulfide (H(2)S) is a third gaseous messenger that may play a role in controlling vascular tone and has been proposed to serve as an O(2) sensor. However, whether H(2)S is vasoactive in the ductus arteriosus (DA) has not yet been studied. We investigated, using wire myography, the mechanical responses induced by Na(2)S (1 μM-1 mM), which forms H(2)S and HS(-) in solution, and by authentic CO (0.1 μM-0.1 mM) in DA rings from 19-day chicken embryos. Na(2)S elicited a 100% relaxation (pD(2) 4.02) of 21% O(2)-contracted and a 50.3% relaxation of 62.5 mM KCl-contracted DA rings. Na(2)S-induced relaxation was not affected by presence of the NO synthase inhibitor l-NAME, the soluble guanylate cyclase (sGC) inhibitor ODQ, or the K(+) channel inhibitors tetraethylammonium (TEA; nonselective), 4-aminopyridine (4-AP, K(V)), glibenclamide (K(ATP)), iberiotoxin (BK(Ca)), TRAM-34 (IK(Ca)), and apamin (SK(Ca)). CO also relaxed O(2)-contracted (60.8% relaxation) and KCl-contracted (18.6% relaxation) DA rings. CO-induced relaxation was impaired by ODQ, TEA, and 4-AP (but not by L-NAME, glibenclamide, iberiotoxin, TRAM-34 or apamin), suggesting the involvement of sGC and K(V) channel stimulation. The presence of inhibitors of H(2)S or CO synthesis as well as the H(2)S precursor L-cysteine or the CO precursor hemin did not significantly affect the response of the DA to changes in O(2) tension. Endothelium-dependent and -independent relaxations were also unaffected. In conclusion, our results indicate that the gasotransmitters H(2)S and CO are vasoactive in the chicken DA but they do not suggest an important role for endogenous H(2)S or CO in the control of chicken ductal reactivity.

  5. A Critical Review on the Surgical Treatment of 153 Cases of Adult Patent Ductus Arteriosus within 1964-2000

    Institute of Scientific and Technical Information of China (English)

    魏磊

    2001-01-01

    Objective This paper evaluates the experiences of treatment of adult patent ductus arteriosus (PDA) in Nanjing Medical University in recent 36 years. Methods From October 1964 to December 2000, 153 adult PDA patients in our hospital were operated by means of ligation of PDA(105), ductal division (24), intra-aortic suture with left heart bypass(11), cardiopulmonary bypass (CPB) without heart beating(7), and the duct occlusion with cardiac catheterization(6). Results The mortalities of the afore mentioned 5 techniques were 0.0%,4.2%,0.0%,14.3%,0.0% respectively. Conclusion Ligation of PDA is still a safe, simple and efficient method, while CPB is suitable for patients with certain special types of PDA or/and other deformities of the heart. Perhaps the advent of interventional therapy would offer a safer and simpler method of choice in the treatment of PDA.

  6. Range-gated pulsed Doppler ultrasonographic evaluation of carotid arterial blood flow in small preterm infants with patent ductus arteriosus.

    Science.gov (United States)

    Wilcox, W D; Carrigan, T A; Dooley, K J; Giddens, D P; Dykes, F D; Lazzara, A; Ray, J L; Ahmann, P A

    1983-02-01

    Range-gated pulsed Doppler (RGPD) ultrasonography was utilized to study the effect of a patent ductus arteriosus (PDA) on carotid arterial blood flow in small preterm infants. Carotid arterial flow velocity studies were performed on 23 preterm infants, sampling right and left carotid arteries. Studies on seven infants after PDA ligation and on seven who developed no evidence of PDA were used as controls. A strong relationship was demonstrated between diastolic reversal in the carotid arteries and PDA. The results of this study indicate that the RGPD flow velocity curve from the carotid artery is more sensitive than M-mode echocardiography or clinical examination in detecting PDA, and that PDA in small preterm infants is associated with a distinct abnormality in the carotid arterial flow pattern.

  7. Entropy score, patent ductus arteriosus (PDA), and cardiopulmonary bypass (CPB): ligation of PDA on CPB can compromise cerebral blood flow.

    Science.gov (United States)

    Neema, Praveen Kumar; Dharan, Baiju S; Singha, Subrata Kumar; Sethuraman, Manikandan; Rathod, Ramesh Chandra

    2011-01-01

    A patent ductus arteriosus (PDA) is often present in patients undergoing correction of congenital heart disease. It is well appreciated that during cardiopulmonary bypass (CPB), a PDA steals arterial inflow into pulmonary circulation, and may lead to systemic hypoperfusion, excessive pulmonary blood flow (PBF) and distention of the left heart. Therefore, PDA is preferably ligated before initiation of CPB. We describe acute decreases of arterial blood pressure and entropy score with the initiation of CPB and immediate increase in entropy score following the PDA ligation in a child undergoing intracardiac repair of ventricular septal defect and right ventricular infundibular stenosis. The observation strongly indicates that a PDA steals arterial inflow into pulmonary circulation and if the PDA is dissected and ligated on CPB or its ligation on CPB is delayed the cerebral perfusion is potentially compromised.

  8. Pulmonary arterial dissection in a post-partum patient with patent ductus arteriosus: Case report and review of the literature.

    Science.gov (United States)

    Yaman, Mehmet; Arslan, Uğur; Ateş, Ahmet Hakan; Aksakal, Aytekin

    2015-02-26

    Pulmonary arterial dissection is an uncommon but usually a deadly complication of chronic pulmonary hypertension. A 26-year-old female patient was admitted to our clinics with sudden dyspnea and chest discomfort one hour after giving birth to twins by vaginal delivery. An echocardiography was performed with a pre-diagnosis of pulmonary embolism. However, echocardiographic examination revealed a dilated main pulmonary artery and a dissection flap extending from main pulmonary artery to left pulmonary artery. In summary, in this report, we described a very rare case of pulmonary artery dissection in a pregnant patient with a previously un-diagnosed patent ductus arteriosus without an obvious rise in pulmonary artery pressure and reviewed the relevant literature.

  9. Pulmonary arterial dissection in a post-partum patient with patent ductus arteriosus: Case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Mehmet; Yaman; Ugur; Arslan; Ahmet; Hakan; Ates; Aytekin; Aksakal

    2015-01-01

    Pulmonary arterial dissection is an uncommon but usually a deadly complication of chronic pulmonary hypertension. A 26-year-old female patient was admitted to our clinics with sudden dyspnea and chest discomfort one hour after giving birth to twins by vaginal delivery. An echocardiography was performed with a pre-diagnosis of pulmonary embolism. However, echocardiographic examination revealed a dilated main pulmonary artery and a dissection flap extending from main pulmonary artery to left pulmonary artery. In summary, in this report, we described a very rare case of pulmonary artery dissection in a pregnant patient with a previously un-diagnosed patent ductus arteriosus without an obvious rise in pulmonary artery pressure and reviewed the relevant literature.

  10. Transesophageal echocardiography guided patent ductus arteriosus occlusion in adults with severe pulmonary hypertension through a parasternal approach.

    Science.gov (United States)

    Dai, Xiao-Fu; Chen, Liang-Wan; Chen, Dong-Zhong; Chen, Qiang; Zhen, Guo-Zhong; Zhang, Gui-Can

    2015-01-01

    Between April 2010 and April 2014, 39 consective adult patients (> 18 years) with PDA associated severe pulmonary hypertension underwent transesophageal echocardiography guided patent ductus arteriosus occlusion through a parasternal minimally invasive approach. Among 39 patients, the procedure was successful in 32 cases (82.1%) and failed in 7 cases (17.9%). In the failed cases, 3 cases had a large residual shunt and 4 cases had persistent pulmonary hypertension. The mean minimum miameter of the successfully closed PDAs was 15.2 ± 2.1 mm (range 9 to 24), and the mean diameter of the mushroom-shaped occluder was 17.5 ± 2.5 mm (range 11 to 26). The pulmonary artery pressure decreased significantly after occlusion (P 0.05). Echocardiography performed on the first postoperative day showed decreased volume within the left atrium, left ventricle, and pulmonary artery in 23 cases, decreased volume within the left atrium and left ventricle in 4 cases, and no change in the volume of the atrium and ventricle in 3 cases. A minor residual shunt was observed in 6 cases. The posteroanterior chest X-ray showed improved pulmonary congestion in all cases and significantly reduced cardiothoracic ratio in 25 cases. Patients were followed-up at least for 1 year. No symptoms including palpitation, dyspnoea, or chest tightness were observed. The heart function ranged from NYHA class I to II. A minor residual shunt was observed only in one case. There were varying degrees of decrease in volume within the atrium and ventricle. In conclusion, transesophageal echocardiography guided patent ductus arteriosus occlusion through a parasternal minimally invasive approach is a feasible and effective method for the treatment of PDA in adults with severe pulmonary hypertension.

  11. Ductus arterioso: Ecoanatomía y mecanismos de cierre / Ductus Arteriosus: Ecographic anatomy and closure mechanisms

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    Carlos García Guevara

    2015-08-01

    Full Text Available El ductus arterioso es una estructura anatómica esencial en la vida del feto, que permite ser manipulado farmacológicamente y, de no completarse su cierre funcional y anatómico en la etapa de recién nacido, se considera una cardiopatía congénita. Su importancia fue motivo para efectuar la presente revisión, donde se tratan aspectos relacionados con la embriología, anatomía y función de esta estructura, ilustrados con imágenes ecocardiográficas de fetos estudiados en el Servicio de Cardiología Fetal del Cardiocentro Pediátrico William Soler, en las que se observan las vistas clásicas utili-zadas en su estudio, y ejemplos de anomalías diagnosticadas, con el objetivo de ofre-cer información resumida acompañada de nuestra experiencia en la evaluación del ductus, así como el diagnóstico de algunas de sus anomalías.

  12. Evaluation of the Efficacy and Safety of Oral İbuprofen in the Treatment of Patent Ductus Arteriosus

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    Mehmet Kervancıoğlu

    2005-01-01

    Full Text Available Since indomethacin has many side effects, ibuprofen has been started to be used with beneficial results and less side effects for the closure of patent ductus arteriosus (PDA in recent years. The frequency of PDA, and the effects and side effects of oral ibuprofen were investigated by echocardiographic evaluation, in 164 preterm neonates in Neonatology Unit of Dicle University,between April and December 2004. Oral ibufrofen was given at 10 mg/kg/day dose to infants who had significant left-right shunt on the third day of birth but those who had contraindication for ibuprofen were excluded. By daily echocardiographic evaluations in those without closure after the first dose, a second and third dose of 5 mg/kg/day were given if necessary. Ductus closure has ocured in 24 of 27 (88.8% patients, at a mean period of 1.7±0.9 (1-4 days. Complications like hyponatremia, hypercreatininemia, thrombocytopenia, and necrotizing enterocolitis were not seen. Only in one patient intracranial hemorrhage was occured two days after the treatment. In conclusion, treatment with oral ibuprofen is an effective and safe treatment method for the closure of the PDA in preterm infants.

  13. Progress of treatment in children with patent ductus arteriosus%儿童动脉导管未闭治疗进展

    Institute of Scientific and Technical Information of China (English)

    康磊

    2012-01-01

    Patent ductus arteriosus is a common congenital heart disease in children.Effective and promptly treatment can prevent complications,such as pneumonia,congestive heart failure,infective endocarditic and pulmonary artery hypertension.The treatments include medication,transcatheter intervention and surgery.The vast majority of the patent ductus arteriosus can be cured by transcatheter interventional therapy now.%动脉导管未闭是儿童常见先天性心脏病,及时有效治疗可防止肺炎、心力衰竭、感染性心内膜炎、肺动脉高压等并发症的发生.治疗方法包括药物治疗、经导管介入治疗和手术治疗.目前绝大部分动脉导管未闭通过介入封堵可获治愈.

  14. Treatment of patent ductus arteriosus by Amplatzer occluder device%Amplatzer伞堵闭术治疗动脉导管未闭

    Institute of Scientific and Technical Information of China (English)

    江隆福; 陈国方; 陈玉锋

    2002-01-01

    @@ 经皮动脉导管未闭封堵术是治疗动脉导管未闭(patent ductus arteriosus,PDA)的非手术方法,具有创伤小、术后恢复快等优点,即刻及近期疗效较好.我们对7例PDA进行封堵治疗,在此进行探讨.

  15. Severe intravascular hemolysis after transcatheter closure of a large patent ductus arteriosus using the Amplatzer duct occluder: successful resolution by intradevice coil deployment.

    Science.gov (United States)

    Joseph, George; Mandalay, Asishkumar; Zacharias, T U; George, Biju

    2002-02-01

    A 21-year-old female developed severe unremitting intravascular hemolysis following closure of a large patent ductus arteriosus using an Amplatzer duct occluder. Percutaneous deployment of fibered platinum coils within the nitinol wire cage of the Amplatzer duct occluder abolished the residual shunt through the device and resulted in cessation of intravascular hemolysis and reversal of its adverse sequelae. Copyright 2002 Wiley-Liss, Inc.

  16. [Occlusion of patent ductus arteriosus with a Gianturco-Grifka device. First case at the Instituo Mexicano del Seguro Social (IMSS)].

    Science.gov (United States)

    Munayer Calderón, J; Aldana Pérez, T; San Luis Miranda, R; Maza Juárez, G; Lázaro Castillo, J L; Ramírez Reyes, H; Quintero, L R; Arias Monroy, L; Campos Gómez, A

    2000-01-01

    We present the initial experience of closing of patent ductus arteriosus (PDA) with a new device; Gianturco-Grifka, at the General Hospital of The Medical Center "La Raza". The patient was a 4 year's old girl, in whom we detected continuous murmur in the second intercostal space, echocardiography showed a long conical patent ductus arteriosus 4.9 mm of diameter, systolic pressure of the pulmonary artery was 35 mm Hg with QP/QS 1.6:1. Hemodynamic study revealed a long conical ductus arteriosus 5 mm of diameter, type A1 from Krichenko classification. We proceeded to occlude the PDA with a Gianturco-Grifka device of 7 mm. Immediately after the PDA occlusion the shunt disappeared, there were no complications during the procedure. More cases are needed to determine long term benefits and limitations, of this procedure. However we conclude that technically it is easy to use. There is greater decrease of residual shunt that the one reported with other devices.

  17. 胎儿动脉导管异常的超声心动图表现%Diagnosis of fetal ductus arteriosus anomalies by echocardiography

    Institute of Scientific and Technical Information of China (English)

    许燕; 接连利; 刘清华; 赵霞; 董发进

    2011-01-01

    目的 总结胎儿动脉导管异常的声像图特征.方法 对8例经引产后尸体解剖及产后超声随访证实为动脉导管异常的胎儿产前超声心动图检查资料进行回顾性分析.结果 8例动脉导管异常胎儿中3例产前超声多切面扫查均不能显示动脉导管的管腔结构和血流,2例伴发法洛四联症,1例伴发永存动脉干,提示动脉导管缺如;2例胎儿动脉导管和主动脉弓血流方向相反,主动脉血流经动脉导管逆行灌注于肺动脉主干或左、右肺动脉,其中1例伴发于室间隔缺损型肺动脉闭锁,另1例伴发于室间隔完整型肺动脉闭锁,合并右心室发育不良,提示动脉导管逆行灌注;5例伴有复杂先天性心脏病的胎儿引产后经尸体解剖证实.2例胎儿动脉导管管腔细窄,血流速度增快,提示动脉导管狭窄;1例胎儿动脉导管管腔内充填实性低回声,内无血流信号,提示动脉导管早闭;2例动脉导管狭窄和1例动脉导管早闭的胎儿均表现右心房、右心室增大,伴有三尖瓣重度反流,并经产后超声心动图随访证实.结论 胎儿超声心动图能显示胎儿动脉导管缺如、逆行灌注、狭窄及早闭的异常声像图特征,在胎儿动脉导管异常的诊断中具有重要的临床价值.%Objective To summarize the features of fetal ductus arteriosus anomalies by ultrasound. Methods Eight cases of fetal ductus arteriosus anomalies confirmed by autopsy after abortion or postnatal follow-up were retrospectively analyzed by echocardiography. Results Among 8 cases of fetal ductus arteriosus anomalies, 3cases were diagnosed with ductus arteriosus absent including two cases associated with tetralogy of Fallot and one case associated with persistent truncus arteriosus, neither the structure nor the blood flow of ductus arteriosus was observed on multiple views.Two cases were shown with reverse flow in fetal ductus arteriosus, retrograde aortic blood flow infused into the

  18. Transcatheter closure of hemodynamic significant patent ductus arteriosus in 32 premature infants by amplatzer ductal occluder additional size-ADOIIAS.

    Science.gov (United States)

    Morville, Patrice; Akhavi, Ahmad

    2017-05-04

    The advent of Amplatzer Duct Occluder II additional Size (ADOIIAS) provided the potential to close hemodynamic significant patent ductus arteriosus (HSPDA) and to analyze the feasibility, safety and efficacy of the device. Treatment of a patent ductus arteriosus (PDA) in very premature neonates is still a dilemma for the neonatalogist who has to consider its significance and has to choose among different treatment options. Because surgical ligation and medical therapy both have their drawbacks, interventional catheterization might provide an alternative means of closing HSPDA. Between September 2013 and June 2015, 32 premature infants with complications related to HSPDA defined by ultrasound (US) underwent transcatheter closure. The procedure was performed in the catheterization laboratory by venous cannulation without angiography. The position of the occluder was directed by X-ray and US. In particular we looked at procedural details, device size selection, complications, and short and mid-term outcomes. Thirty two premature infants, all of whom had clinical complications related to HSPDA, born at gestational ages ranging between 23.6 and 36 weeks (mean ± standard deviation 28 ± 3 weeks) underwent attempted transcatheter PDA closure using the ADOIIAS. Their mean age and weight at the time of procedure was 25 days (range 8-70 days) and 1373 g (range 680-2480 g), respectively. Ten infants weighed ≤1,000g. All ducts were tubular. The mean PDA and device waist diameters were 3.2 ± 0.6mm (range 2.2-4) and 4.4 ± 0.6 mm, respectively, and the mean PDA and device lengths 5.2 ± 2.0 mm (range 2-10) and 3.4 ± 1.3 mm. Median fluoroscopy and procedural times were 11 min (range 3-24) and 28 min (range 10-90), respectively. Complete closure was achieved in all but one patient. There was no device migration. A left pulmonary artery (LPA) obstruction developed in one patient. Five infants died. Four deaths were related to complications of

  19. Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease

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    Pedra Simone

    2010-01-01

    Full Text Available We report a case wherein a dysmorphic four-month-old infant (weighing 4.5 kgs with an 8 mm atrial septal defect (ASD, a 1.5 mm patent ductus arteriosus (PDA, a 2 mm mid-muscular ventricular septal defect (VSD associated with chronic lung disease, and severe pulmonary hypertension, was successfully managed using a hybrid approach, without the use of cardiopulmonary bypass (CPB. Through a median sternotomy, the PDA was ligated and the ASD was closed with a 9 mm Amplatzer septal occluder implanted through peratrial access. The VSD was left untouched. Serial echocardiograms showed complete closure of the ASD and PDA, with progressive normalization of the pulmonary artery (PA pressures within three months. The child rapidly gained weight and was weaned from sildenafil and oxygen administration. After 12 months, the VSD closed spontaneously and the child remained well, with normal PA pressures. A hybrid approach without the use of CPB should be considered in the management of infants with congenital heart disease, associated with chronic lung disease and pulmonary hypertension.

  20. RARE ASSOCIATION OF POSTERIOR EMBRYOTOXON WITH MAXILLARY HYPOPLASIA, VENTRICULAR SEPTAL DEFECT, PULMONARY ATRESIA AND PATENT DUCTUS ARTERIOSUS

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    Pandey

    2014-12-01

    Full Text Available BACKGROUND: Posterior embryotoxon is a congenital anomaly, considered to be a relatively mild disorder and can occur in 15% of normal eyes. Bilateral posterior embryotoxon associated with maxillary hypoplasia, Ventricular Septal Defect (VSD, Pulmonary Atresia (PA with Patent Ductus Arteriosus (PDA is of rare occurrence and hasn’t been reported in literature till date. CASE: We report a case of 12 year old female who came to us in eye Out Patient Department for routine eye checkup and on detailed ocular examination we found anteriorly displaced Schwalbe’s line. On detailed physical examination and investigations she was found to have pan-systolic murmur and continuous machinery murmur. On Echocardiography, the patient was found to have large peri-membranous VSD with PA and PDA. On Oro-dental examination she was found to have maxillary hypoplasia. CONCLUSION: The present case is reported due to the rarity and sporadic character of the condition and its rare association with cardiac defect and maxillary hypoplasia.

  1. Effects of Intravenous Indomethacin on Reduction of Symptomatic Patent Ductus Arteriosus Cases and Decreasing the Need for Prolonged Mechanical Ventilation

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    Jannatdoust Abdollah

    2014-12-01

    Full Text Available Introduction: We decided to investigate the effects of injecting Indomethacin on reducing complications of Patent Ductus Arteriosus (PDA and the need for prolonged mechanical ventilation. Methods: During this randomized clinical trial, 70 premature infants with matched gestational age and birth weight were divided into case and control groups. In the study group, intravenous indomethacin started from the first 2-12 hours of birth. All patients were followed by echocardiography at the fourth day and skull ultrasound in the second week. Results: Symptomatic PDA rate was significantly higher in the control group (25.7% vs. 0%; P≤0.001. Incidence of grade 1-3 intraventricular hemorrhage was higher in the control group and the ratio of needed time for respiratory support in the control group to the case group was approximately 2.1. Conclusion: Intravenous Indomethacin reduced the number of PDA cases and incidence of grade 2 and 3 intraventricular hemorrhage, without any short term side effects.

  2. Amplatzer PDA occluder used in adult patent ductus arteriosus with serious pulmonary hypertension after testing balloon occlusio

    Institute of Scientific and Technical Information of China (English)

    卢才义; 魏璇; 黄丛春; 罗惠兰; 谈维洁; 毛树森

    2002-01-01

    @@ A 36-years-old female had heart palpitation and chest press for five years and the symptoms had been worsening for half a year. She was diagnosed with patent ductus arteriosus with moderate pulmonary hypertension in a local hospital 5 years before but was not operated. Physical examination showed: T 37℃, P 87?bpm, R 18?bpm and BP 130/70?mm?Hg. There was no distension of the jugular vein, and the lungs were clear. There was continuous mechanic murmur at the second intercostal space, and grade 2 systolic blowing murmur at the apex. P2 was strengthened. The liver and spleen were not enlarged and there was no edema in either leg. ECG showed a pulmonary P wave and right ventricular hypertrophy. Chest X-ray film showed pulmonary segment projection 3?cm, and the dimension of the right inferior pulmonary artery bed increased to 3?cm in diameter. On echocardiography, both atria, the pulmonary artery and the right ventricle were enlarged.

  3. A rare presentation of patent ductus arteriosus in an adult patient with normal pulmonary hypertension and limb edema

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    Pishgoo, Bahram; Saburi, Amin; Khosravi, Arezoo

    2014-01-01

    BACKGROUND Patent ductus arteriosus (PDA) at childhood is one of the five major and frequent congenital abnormalities, but it can be rarely seen in adults. Pulmonary hypertension (PHTN) and other presentations such as heart failure and edema are the identified complications of longstanding PDA, but adult case with no permanent heart symptoms and PHTN was rare. We reported a rare case of with an obvious PDA and normal pulmonary pressure. CASE REPORT A 61-year-old woman presented with dyspnea (New York Heart Association class 2), chest pain, and lower limb edema. Echocardiogram showed; normal left ventricular chamber size and function, normal size of both atria. Furthermore, an obvious PDA (diameter = 6-7 mm) connecting the aortic arch to the pulmonary artery was reported in echocardiography. No lung congestion and evidence for PHTN was reported by computed tomographic angiography [Pulmonary capillary wedge pressure (PCWP) = 30 mmHg]. The patient was treated with antihypertensive drugs and after 1 and 3 months follow-up, edema and other symptoms were resolved. CONCLUSION Finally, we conclude that PDA in adulthood can present with nonspecific cardiovascular symptoms, and it seems that PHTN is not a fixed echocardiographic finding in these patients. PMID:25477985

  4. Patent ductus arteriosus in the preterm infant: a survey of clinical practices in French neonatal intensive care units.

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    Brissaud, Olivier; Guichoux, Julie

    2011-06-01

    Patent ductus arteriosus (PDA) is one of the most common problems in the care of premature infants, especially the extremely premature. There is no real consensus regarding the diagnostic criteria or treatment of a hemodynamically significant PDA. Its diagnosis, assessment, and treatment still remain challenges. Therefore, we investigated clinical practices in French tertiary neonatology centers regarding the management of PDA to compare their similarities and differences. We sent a questionnaire by email to the PDA specialist in every French tertiary neonatal intensive care unit. It contained 27 items regarding the unit's structure, method of diagnosing PDA, and treatment choices. The completed questionnaire were returned via email and analyzed blindly. The questionnaire response rate was 87.5%, which allowed us to draw some conclusions regarding French clinical practices in the care of neonates with PDA. Although the diagnostic criteria are quite similar, the therapeutic practices are rather different across neonatal care units. We highlight the great variability in French clinical practices when it comes to treating PDA and underscore the necessity for harmonization of these practices, which could be achieved using multicenter, randomized studies to identify the advantages of one approach compared with another.

  5. Establishment of the patent ductus arteriosus model in preterm rats%早产大鼠动脉导管开放模型的建立

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    朱梦茹; 刘海岩; 刘盼盼; 武辉

    2016-01-01

    ObjectiveTo establish the patent ductus arteriosus model in preterm rats using the improved natural development method.MethodsIn the light of the lfaws of the natural development method in establishing the patent ductus arteriosus model, the experimental technology was modified to avoid the influence of fixation, dehydration, and section method on blood vessel diameter. Cesarean section was performed for a Wistar rat pregnant for 19 days, and 8 neonatal rats were obtained. After they were sacriifced by dislocation, they were embedded as a whole to avoid dehydration, and the microsection and horizontal section were made. After hematoxylin and eosin staining, a microscope was used to measure the inner diameters of the ductus arteriosus, the main pulmonary artery, and the descending aorta.ResultsAfter the cesarean section for the rat pregnant for 19 days, patent ductus arteriosus occurred in all the 8 neonatal rats. The measurements of the inner diameters of blood vessels were as follows: the long diameter and short diameter of the descending aorta were 354±106 and 182±140 μm, respectively; the short diameter of the ductus arteriosus was 155±122 μm, and its area was 36 847±42 582 μm2; the long axis and short axis of the main pulmonary artery were 589±150 and 174±170 μm, respectively.ConclusionsThe improved natural development method can help to successfully establish the patent ductus arteriosus model in preterm rats.%目的:利用改良的自然发育法构建早产大鼠动脉导管开放模型。方法基于自然发育法在构建早产大鼠动脉导管开放模型上的缺陷,本研究对实验技术进行了改进,避免固定方式、脱水处理及切片方式对血管管径的影响。将1只孕19 d的Wistar大鼠行剖宫产,取出8只新生大鼠,脱臼处死后整体包埋、避免脱水、微距切片、水平切片,苏木精-伊红染色后镜下测量动脉导管、主肺动脉、降主动脉内径。结果孕19 d

  6. A heart-hand syndrome gene: Tfap2b plays a critical role in the development and remodeling of mouse ductus arteriosus and limb patterning.

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    Feng Zhao

    Full Text Available BACKGROUND: Patent ductus arteriosus (PDA is one of the most common forms of congenital heart disease. Mutations in transcription factor TFAP2B cause Char syndrome, a human disorder characterized by PDA, facial dysmorphysm and hand anomalies. Animal research data are needed to understand the mechanisms. The aim of our study was to elucidate the pathogenesis of Char syndrome at the molecular level. METHODOLOGY/PRINCIPAL FINDINGS: Gene expression of Tfap2b during mouse development was studied, and newborns of Tfap2b-deficient mice were examined to identify phenotypes. Gel shift assays had been carried out to search for Tfap2 downstream genes. Promoters of candidate genes were cloned into a reporter construct and used to demonstrate their regulation by Tfap2b in cell transfection. In situ hybridizations showed that the murine transcription factor Tfap2b was expressed during the entire development of mouse ductus arteriosus. Histological examination of ductus arteriosus from Tfap2b knockout mice 6 hours after birth revealed that they were not closed. Consequently, the lungs of Tfap2b(-/- mice demonstrated progressive congestion of the pulmonary capillaries, which was postulated to result secondarily from PDA. In addition, Tfap2b was expressed in the limb buds, particularly in the posterior limb field during development. Lack of Tfap2b resulted in bilateral postaxial accessory digits. Further study indicated that expressions of bone morphogenetic protein (Bmp genes, which are reported to be involved in the limb patterning and ductal development, were altered in limb buds of Tfap2b-deficient embryos, due to direct control of Bmp2 and Bmp4 promoter activity by Tfap2b. CONCLUSIONS/SIGNIFICANCE: Tfap2b plays important roles in the development of mouse ductus arteriosus and limb patterning. Loss of Tfap2b results in altered Bmp expression that may cause the heart-limb defects observed in Tfap2b mouse mutants and Char syndrome patients. The Tfap2b knockout

  7. Long-Term Follow-up of Patent Ductus Arteriosus Closure with the Amplatzer Duct Occluder in Children

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    Mostafa Behjati-Ardakani

    2015-10-01

    Full Text Available Background: Transcatheter closure of patent ductus arteriosus (PDA has become an alternative treatment to surgery. We evaluated the long-term results of the transcatheter closure of PDA with the Amplatzer Duct Occluder (ADO in children.Methods: Between May 2004 and October 2012, 138 children with PDA (43 males and 95 females underwent transcatheter PDA closure. Clinical, electrocardiographic, echocardiographic, and hemodynamic data were assessed pre and postprocedurally and at follow-up.Results: The mean age of the patients at procedure was 3.53 ± 2.43 years (range = 1.1 to 9.5 years, mean weight was11.9±4.6 kg (range = 6 to 29 kg, median pulmonary end diameter of the PDA was 5 mm (range = 4 to 15 mm, and median diameter of the ADO was 8 mm (range = 6 to 16 mm. The mean follow-up time was 43.4 ± 23.5 months (range = 13.5 to98 months.The devices were successfully deployed in 136 (98.5% patients. Device embolization occurred in 2 patients, immediately in one patient and during the first postprocedural night in the other patient. The first patient had percutaneous device retrieval, followed by implantation of a larger device. The second patient had surgical device removal and PDA ligation. Immediately after device implantation, trivial to mild residual shunts were detected in 112 (80% patients; all the shunts, however, disappeared 24 hours after the procedure. One patient had left pulmonary artery stenosis with a gradient of 25 mm Hg at 24 hours', 40 mmHg at one month's, and 64 mmHg at 6 months' follow-up. There were no cases of late embolization, aortic obstruction, late hemolysis, infective endocarditis, or death.Conclusion: Transcatheter PDA closure with the ADO was safe and effective, with a high success rate at long-term follow-up.

  8. Current Status of Therapeutic Strategies for Patent Ductus Arteriosus in Very-Low-Birth-Weight Infants in Korea.

    Science.gov (United States)

    Lee, Jin A; Kim, Myo-Jing; Oh, Sohee; Choi, Byung Min

    2015-10-01

    This study aimed to investigate current therapeutic strategies for patent ductus arteriosus (PDA) in very-low-birth-weight (VLBW) infants in Korea. A total of 2,254 VLBW infants among 2,386 from Korean Neonatal Network cohort born from January 2013 to June 2014 were included. No PDA was seen for 1,206 infants (53.5%) and the infants diagnosed or treated for PDA were 1,048 infants (46.5%). The proportion of infants with PDA was decreased according to the increase in gestational age (GA) and birthweight. Infants with PDA were divided into groups according to the therapeutic strategies of PDA: prophylactic treatment (PT, n = 69, 3.1%), pre-symptomatic treatment (PST, n = 212, 9.4%), symptomatic treatment (ST, n = 596, 26.4%), and conservative treatment (CT, n = 171, 7.6%). ST was the most preferred treatment modality for preterm PDA and the proportion of the patients was decreased in the order of PST, CT, and PT. Although ST was still the most favored treatment in GA < 24 weeks group, CT was more preferred than PST or ST when compared with GA ≥ 32 weeks group [CT vs. PST, OR 5.3, 95% CI 1.56-18.18; CT vs. ST, OR 2.9, 95% CI 1.03-8.13]. A total of 877 infants (38.9%) received pharmacological or surgical treatment about PDA, and 35.5% (801 infants) received pharmacological treatment, mostly with ibuprofen. Seventy-six infants (3.4%) received primary ligation and 8.9% (201 infants) received secondary ligation. Diverse treatment strategies are currently used for preterm PDA in Korea. Further analyses of neonatal outcomes according to the treatment strategies are necessary to obtain a standardized treatment guideline for preterm PDA.

  9. Transcatheter vs. surgical closure of patent ductus arteriosus: outcomes and cost analysis

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    Mulyadi M Djer

    2013-07-01

    Full Text Available Background Patent ductus arterious (PDA is a non-cyanotic congenital heart disease (CHD caused by the patency of the arterial duct after birth. For the last three decades, management of PDA with transcatheter closure has been gaining popularity, including in developing countries. However its effectiveness in terms of clinical outcomes and cost may vary among center and has not been thoroughly evaluated yet in Indonesia. Objectives To compare the cost and clinical effectiveness of PDA closure using transcatheter approach compared to surgical ligation. Methods We performed a retrospective review on patients underwent either transcatheter or surgical closure of PDA between January 2000 and December 2006 in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Clinical outcomes as well as cost were compared using the student T-test and Chi-square for numerical and categorical variables, respectively Results During the study period, 89 patients underwent transcatheter closure using an Amplatzer® device occluder (ADO device and 67 had surgical ligation. Successful PDA closure on first attempt was achieved in 87 (96% and 63 (94% children who underwent transcatheter and surgical closure, respectively (P=1.000. Two children with unsuccessful transcatheter closure eventually had their PDA closed by surgery, whereas one child with residual PDA after surgical closure had his PDA closed by coil. No residual PDA was found in the transcatheter closure group at one-week follow up. Duration of hospitalization was significantly less for patients having transcatheter closure compared to surgery [2.7 (SD 1.5 vs. 6.6 (SD 1.5 days, P<0.0001]. The cost for PDA closure with an Amplatzer® device was more expensive than surgical ligation [Rp. 29,930,000 (SD 57,200 vs. Rp. 12,205,000 (SD 89,300, P< 0.0001]. Conclusion Transcatheter closure is equally effective as surgical ligation in closing the PDA. Less hospitalization is required with transcatheter closure although the

  10. Cardiac output, pulmonary artery pressure, and patent ductus arteriosus during therapeutic cooling after global hypoxia-ischaemia.

    Science.gov (United States)

    Fugelseth, D; Satas, S; Steen, P A; Thoresen, M

    2003-05-01

    To assess by Doppler echocardiography the effects of 24 hours of whole body mild hypothermia compared with normothermia on cardiac output (CO), pulmonary artery pressure (PAP), and the presence of a persistent ductus arteriosus (PDA) after a global hypoxic-ischaemic insult in unsedated newborn animals. Thirty five pigs (mean (SD) age 26.6 (12.1) hours and weight 1.6 (0.3) kg) were anaesthetised with halothane, mechanically ventilated, and subjected to a 45 minute global hypoxic-ischaemic insult. At the end of hypoxia, halothane was stopped; the pigs were randomised to either normathermia (39 degrees C) or hypothermia (35 degrees C) for 24 hours. Rewarming was carried out for 24-30 hours followed by 42 hours of normothermia. Unanaesthetised pigs were examined with a VingMed CFM 750 ultrasound scanner before and 3, 24, 30, and 48 hours after the hypoxic-ischaemic insult. Aortic valve diameter, forward peak flow velocities across the four valves, and the occurrence of a PDA were measured. Tricuspid regurgitation (TR) velocity was used to estimate the PAP. Stroke volume was calculated from the aortic flow. Twelve animals (seven normothermic, five hypothermic) had a PDA on one or more examinations, which showed no association with cooling or severity of insult. There were no differences in stroke volume or TR velocity between the hypothermic and normothermic animals at any time point after the insult. CO was, however, 45% lower at the end of cooling in the subgroup of hypothermic pigs that had received a severe insult compared with the pigs with mild and moderate insults. CO and TR velocity were transiently increased three hours after the insult: 0.38 (0.08) v 0.42 (0.08) litres/min/kg (p = 0.007) for CO; 3.0 (0.42) v 3.4 (0.43) m/s (p Global hypoxia-ischaemia leads to similar transient increases in CO and estimated PAP in unsedated normothermic and hypothermic pigs. There were no signs of metabolic compromise in any subgroup, suggesting that 24 hours of mild

  11. Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus

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    Lilian S.R. Sadeck

    2014-12-01

    Full Text Available OBJECTIVE: To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g with patent ductus arteriosus (PDA, from the Brazilian Neonatal Research Network (BNRN on: death, bronchopulmonary dysplasia (BPD, severe intraventricular hemorrhage (IVH III/IV, retinopathy of prematurity requiring surgical (ROPsur, necrotizing enterocolitis requiring surgery (NECsur, and death/BPD. METHODS: This was a multicentric cohort study, retrospective data collection, including newborns (BW < 1000 g with gestational age (GA < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded. Groups: G1 - conservative approach (without treatment, G2 - pharmacologic (indomethacin or ibuprofen, G3 - surgical ligation (independent of previous treatment. Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score < 4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II, respiratory distress syndrome (RDS, late sepsis (LS, mechanical ventilation (MV, surfactant (< 2 h of life, and time of MV. Outcomes: death, O2 dependence at 36 weeks (BPD36wks, IVH III/IV, ROPsur, NECsur, and death/BPD36wks. Statistics: Student's t-test, chi-squared test, or Fisher's exact test; Odds ratio (95% CI; logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator software, version 12.1.4.0. p-values < 0.05 were considered statistically significant. RESULTS: 1,097 newborns were selected and 494 newborns were included: G1 - 187 (37.8%, G2 - 205 (41.5%, and G3 - 102 (20.6%. The highest mortality was observed in G1 (51.3% and the lowest in G3 (14.7%. The highest frequencies of BPD36wks (70.6% and ROPsur were observed in G3 (23.5%. The lowest occurrence of

  12. Fechamento de canal arterial por minitoracotomia: técnica e resultados Patent ductus arteriosus (PDA closure with minithoracotomy: technique and results

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    Pedro R. SALERNO

    2000-09-01

    Full Text Available CASUÍSTICA E MÉTODOS: No período de novembro de 1996 a dezembro de 1997, 15 crianças portadoras de canal arterial (CA, sendo 12 do sexo feminino, com idade média de 2,7 anos, peso médio de 13,9 kg foram submetidas a fechamento do CA por minitoracotomia. O ecodopplercardiograma confirmou o diagnóstico em todos o casos e mostrou o diâmetro do CA entre 2 mm e 10 mm, com média de 4,06 mm. A indicação cirúrgica foi eletiva em todos os casos. A operação consistiu de minitoracotomia esquerda no 4º espaço intercostal de 2,5 cm a 3,0 cm, seguida de dissecção do CA e clipagem do mesmo com 2 clips metálicos. Não foi utilizada drenagem pleural em nenhum dos casos. RESULTADOS: Todos os pacientes receberam alta em média no 4º dia de pós-operatório, sem nenhum escape pelo CA ao ecodopplercardiograma. CONCLUSÃO: O fechamento de CA por minitoracotomia é uma alternativa de tratamento que reduz o período de internação, bom efeito cosmético e baixo índice de complicações.OBJECTIVE:The purpose of this study was to describe a new technique for closure of patent ductus arteriosus (PDA by minithoracotomy (2.5 a 3.0 cm and clipping the PDA with titanium clips. MATERIAL AND METHODS: From November 1996 to December 1997, 15 children with PDA underwent surgical closure. The mean age at the time of operation was 2.7 years, mean weight was 13.9 kg. The procedure was through a left minithoracotomy at the 4º intercostal space. The ductus was identified, dissected and isolated. Interruption of ductal flow was performed by direct clipping with two clips. The chest was closed without a chest drain. Unless the patient was ventilator dependent before the closure, the child usually was extubated in the operating room. RESULTS: Color doppler echocardiography demonstrated total occlusion of the ductus in all patients. All 15 patients were discharged from the hospital on the 4º postoperative day (mean. CONCLUSION: We conclude that surgical closure of

  13. Progress in pathogenesis of patent ductus arteriosus in preterm infants%早产儿动脉导管未闭发病机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    杨文庆; 杨长仪; 陈涵强

    2010-01-01

    Patent ductus arteriosus(PDA) is a common condition in the premature infants. It is associated with an increase in mortality and sequelae in these infants. The various factors contributing to an patency of the ductus arteriosus in the preterm infants are involved in: insufficient histological development of ductus arteriosus, failure of remodeling theductus, abnormal sensitivity of the ductus to oxygen and vasoactive substances,and genes.%动脉导管未闭(PDA)是早产儿常见并发症,也是影响早产儿存活率和后遗症发生率的主要原因之一.近年研究发现,早产儿PDA的发生除与自身动脉导管的组织发育不成熟、不易发生重塑有关外,还与动脉导管对氧、血管活性物质的反应异常相关;遗传因素也参与早产儿PDA的发病.

  14. Patent ductus arteriosus in an adult cat with pulmonary hypertension and right-sided congestive heart failure: hemodynamic evaluation and clinical outcome following ductal closure.

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    Novo-Matos, José; Hurter, Karin; Bektas, Rima; Grest, Paula; Glaus, Tony

    2014-09-01

    Right-sided congestive heart failure (CHF) developed secondary to severe pulmonary hypertension (PH) in an 8-year-old cat with a left-to-right shunting patent ductus arteriosus (PDA). Vascular reactivity was tested prior to shunt ligation by treatment with oxygen and sildenafil. This treatment was associated with a significant decrease in pulmonary artery pressure as assessed by echocardiography. Subsequently surgical shunt ligation was planned. During thoracotomy, digital occlusion of the PDA was performed for 10 min with simultaneous catheter measurement of right ventricular pressure, which did not increase. Permanent shunt ligation resulted in a complete and sustained clinical recovery. A lung biopsy sample obtained during thoracotomy demonstrated histopathological arterial changes typical of PH. Cats can develop clinically severe PH and right-sided CHF secondary to a left-to-right PDA even at an advanced age. Assuming there is evidence of pulmonary reactivity, PDA occlusion might be tolerated and can potentially produce long-term clinical benefits.

  15. Reduced Hospital Mortality With Surgical Ligation of Patent Ductus Arteriosus in Premature, Extremely Low Birth Weight Infants: A Propensity Score-matched Outcome Study.

    Science.gov (United States)

    Tashiro, Jun; Perez, Eduardo A; Sola, Juan E

    2016-03-01

    To evaluate outcomes after surgical ligation (SL) of patent ductus arteriosus (PDA) in premature, extremely low birth weight (ELBW) infants. Optimal management of PDA in this specialized population remains undefined. Currently, surgical therapy is largely reserved for infants failing medical management. To date, a large-scale, risk-matched population-based study has not been performed to evaluate differences in mortality and resource utilization. Data on identified premature (Propensity score-matched analysis of 1620 SL versus 1584 non-SL found reduced mortality (15% vs 26%) and more routine disposition (48% vs 41%) for SL (P Propensity score-matched analysis demonstrates reduced mortality in premature/ELBW infants with SL for PDA. NEC and sepsis are predictors of mortality and resource utilization.

  16. Differential shunting in the diagnosis of patent ductus arteriosus with Eisenmenger physiology by radionuclide angiography. [/sup 99m/Te-pertechnetate; (sup 99m/Te-MAA; aorta-pulmanary artery shunts

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    Thomas, J.L.; Scherer, J.; Kahl, F.R.; Watson, N.; Cowan, R.

    1978-06-01

    Radionuclide angiography and static whole-body imaging performed with technetium-99m-labeled particulates can clearly demonstrate differential shunting in patients with patent ductus arteriosus (PDA) with Eisenmenger physiology. The anatomic arterial relationships in this condition which direct deoxygenated blood into the lower body (differential cyanosis) produce specific radionuclide images characterized by differential shunting of the technetium-99m-labeled particulates into the abdomen and lower extremity.

  17. Correção cirúrgica da persistência do canal arterial em crianças de baixo peso e neonatos Surgical treatment of patent ductus arteriosus in low-weight child and neonates

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    Ciro Denevitz de Castro Herdy

    1996-09-01

    Full Text Available A persistência do canal arterial ocorre com freqüência em neonatos prematuros, provocando um grave quadro de disfunção cardiopulmonar. O tratamento envolve duas abordagens, sendo uma clínica e outra cirúrgica. A operação para a ligadura do canal arterial é praticada desde 1938. O enfoque clínico preconiza o uso da indometacina, com o intuito de promover a oclusão do canal arterial. O presente trabalho tem por objetivo avaliar os resultados obtidos com o tratamento cirúrgico da persistência do canal arterial, através de toracotomia e ligadura em 14 pacientes, incluindo crianças de baixo peso e neonatos prematuros com quadro clínico instável. A principal indicação cirúrgica, nestes casos, foi a presença de insuficiência respiratória aguda e insuficiência cardíaca. A técnica empregada foi a tripla ligadura do canal arterial. Nos 14 casos não obtivemos nenhum tipo de complicação e sem mortalidade. A presença de uma Unidade de Tratamento Intensivo Neonatal (U.T.I no Hospital foi de extremo valor no preparo dos pacientes e na evolução no período de pós-operatório. Este trabalho comprova a eficácia do método cirúrgico empregado, com baixas taxas de morbidade e mortalidade e a importância da U.T.I neonatal no acompanhamento dos pacientes.The patent ductus arterious frequently occurs in premature neonates causing serious cardiopulmonary disfunction. The treatment includes two options; one clinic and the other surgical procedure. The surgery for patent ductus arteriosus has been done since 1938. Clinical treatment with indometacin induces closure of the arteriosus ductus. The aim of the article is to analize the surgical results with thoractomy by triple-ligature of the ductus for the treatment of persistent ductus arteriosus in fourteen patients including low weight children and premature neonates with cardiopulmonary disfunction. The indications for surgery in these cases were respiratory distress and congestive

  18. Transcatheter occlusion of patent ductus arteriosus in small weight infants%低体重婴儿动脉导管未闭介入治疗研究

    Institute of Scientific and Technical Information of China (English)

    肖云彬; 黄希勇; 陈智; 王祥; 王勋

    2013-01-01

    目的 评价国产封堵器治疗动脉导管未闭(patent ductus arteriosus,PDA)低体重婴儿的有效性和安全性.方法 2010年10月至2011年10月应用国产封堵器治疗30例体重低于8 kg 的PDA婴儿.术后24 h查血常规、尿常规,并于术后24 h、1、3和6个月行心脏彩色多普勒超声、胸部正位片、心电图检查.结果 1例患儿术后24 h彩色多普勒超声示残余分流,1个月随访时残余分流消失,其余29例术后及随访期间均未出现残余分流;未出现介入治疗的主要并发症,无一例死亡.结论 应用国产PDA封堵器介入治疗体重低于8 kg的PDA婴儿的近、中期疗效确切,安全.%Objective To evaluate the efficacy and safety of transcatheter occlusion of patent ductus arteriosus (PDA) by using domestic occluder in small weight infants. Methods During the period from Oct. 2010 to Oct. 2011 transcatheter occlusion of PDA by using domestic occluder was carried out in 30 PDA infants with body weight ≤ 8 kg. Two-dimensional and color Doppler echocardiography, chest radiograph, electrocardiogram, routine blood test and routine urine test were performed after the treatment in all infants. The results were analyzed. Results Colour Doppler echocardiography performed at 24 hours after the procedure showed that residual shunt was seen in one infant, which disappeared one month later. In the remaining 29 infants no residual shunt was detected during the follow-up period. Neither intervention-related complications nor death occurred. Conclusion For the treatment of PDA infants with body weight ≤ 8 kg, transcatheter occlusion of PDA by using domestic occluder is quite safe with reliable short-term and mid-term efficacy.

  19. 新生儿动脉导管未闭的高危因素分析%Risk factors for patent ductus arteriosus in neonates

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    屈晓羽; 周先锋; 屈艺; 唐彬秩; 母得志

    2011-01-01

    Objective To identify the risk factors for patent ductus arteriosus (PDA) in neonates. Methods Fifty infants with PDA and 100 infants without PDA were enrolled. Chi-square test, Student's t test and the linear correlation analysis were used to study the clinical data. Logistic regression analysis was used to investigate the independent risk factors for PDA. Results The prevalence of PDA was negatively correlated with the gestation age ( r = -0.03, P <0.05)and birth weight (r = - 0.04, P < 0.05). Oxygen inhalation was a protective factor for the development of PDA. Fetal distress, meconium-stained amniotic fluid, oligohydramnios, cord entanglement, 1 minute Apgar score < 8, maternal infection and hypoxic-ischemic encephalopathy were the independent risk factors for the development of PDA. Conclusions The incidence of PDA can be reduced by preventing maternal infection, premature birth, low birth weight and hypoxia.%目的 探讨新生儿动脉导管未闭(patent ductus arteriosus,PDA)的高危因素,为PDA的预防提供临床依据.方法 以50例PDA新生儿为病例组,100例非PDA新生儿为对照组,采用x2检验、t检验或直线相关分析对两组患儿的临床资料进行分析,采用logistic回归分析研究PDA的独立危险因素.结果 PDA的发生与胎龄(r=-0.03,P<0.05)、出生体重(r=-0.04,P<0.05)呈负相关.出生时吸氧治疗为保护因素.宫内窘迫、羊水粪染、羊水过少、脐带绕颈、1 min Apgar评分<8分、母孕期感染、合并缺氧缺血性脑病是新生儿PDA的独立高危因素.结论 避免母孕期感染、早产、低出生体重、缺氧的发生,有利于减少PDA的发生.

  20. Estudo anatomotopográfico do canal arterial em fetos natimortos dirigido para sua abordagem por videotoracoscopia Anatomotopographic study of ductus arteriosus in newborn cadavers directed for its videotoracoscopic approach

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    Josué Viana de Castro Neto

    2001-03-01

    Full Text Available Este trabalho objetiva realizar um estudo anatomotopográfico do Canal Arterial em fetos natimortos enfatizando o seu comprimento e seu diâmetro de acordo com o tamanho de cada feto. Além de que, descrevemos as distâncias entre este e pontos de reparo importantes para sua abordagem por videotoracoscopia. Estudamos dezesseis fetos natimortos, sendo que oito eram do sexo masculino. O tamanho do feto e os perímetros torácico e cefálico variaram de 42-57, 26-35 e 29-35,5 cm, respectivamente. A média de comprimento e diâmetro foram 11,06 e 5,56 cm. Distâncias entre o Canal e as seguintes estruturas: clavícula-22,13mm, segunda costela-20,75mm, esterno-33,88mm e a.subclávia esquerda-5,30mm. Acreditamos que as medidas apresentadas podem facilitar a abordagem do canal por videotoracoscopia.The purpose of this work is to realize an anatomic and topographic study of the ductus arteriosus in newborn cadavers emphasizing its lenght and diameter according to each size of the newborn cadaver. We also describe distances between the ductus and important structures for thoracoscopic approach. We study sixteen newborn cadavers. Eight were male. Size of the cadavers, thoracic and cephalic perimeters ranged from 42-47,26-35 and 29-35,5 cm, respectively. Median lenght and diameter were 11,06 and 5,56 mm. Distances between ductus arteriosus and follow structures were: collarbone-22,13mm, second rib-20,75mm, sternum-33,88mm and left subclavian artery-5,30mm. We belived that these distances described can facilitate thoracoscopic surgical approach to the ductus arteriosus.

  1. A High Ductal Flow Velocity Is Associated with Successful Pharmacological Closure of Patent Ductus Arteriosus in Infants 22–27 Weeks Gestational Age

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    Karl Wilhelm Olsson

    2012-01-01

    Full Text Available Objective. To identify factors affecting closure of patent ductus arteriosus (PDA in newborn infants born at 22–27 weeks gestational age (GA during pharmacological treatment with cyclooxygenase inhibitors. Method. Infants born at 22–27 weeks of GA between January 2006 and December 2009 who had been treated pharmacologically for PDA were identified retrospectively. Medical records were assessed for clinical, ventilatory, and outcome parameters. Echocardiographic examinations during treatment were reviewed. Results. Fifty-six infants were included in the study. Overall success rate of ductal closure with pharmacological treatment was 52%. Infants whose PDA was successfully closed had a higher GA (25+4 weeks versus 24+3 weeks; P=0.047, and a higher pretreatment left to right maximal ductal flow velocity (1.6 m/s versus 1.1 m/s; P=0.023. Correcting for GA, preeclampsia, antenatal steroids, and age at start of treatment, a higher maximal ductal flow velocity was still associated with successful ductal closure (OR 3.04; P=0.049. Conclusion. Maximal ductal flow velocity was independently associated with success of PDA treatment.

  2. Increased cardiac workload by closure of the ductus arteriosus leads to hypertrophy and apoptosis rather than to hyperplasia in the late fetal period.

    Science.gov (United States)

    van den Hoff, Maurice J B; Deprez, Ronald H Lekanne; Ruijter, Jan M; de Boer, Piet A J; Tesink-Taekema, Sabina; Buffing, Anita A; Lamers, Wouter H; Moorman, Antoon F M

    2004-09-01

    It is generally thought that adult mammalian cardiomyocytes compensate for an increased workload by hypertrophy, whereas fetal myocardium grows by cellular proliferation. We analyzed the response of late-fetal rat hearts upon an increased workload imposed by premature constriction of the ductus arteriosus with indomethacin. Initially the fetal heart responds by proliferative growth, as both wet weight and labeling index (bromodeoxyuridine incorporation) of the ventricles increased, whereas neither a change in the fibroblast fraction, ploidy and nucleation in the ventricles is observed. However, this hyperplastic growth is abrogated by a subsequent burst in apoptosis and followed by a hypertrophic response as based on a decrease in DNA and increase in both RNA and protein concentration. This hypertrophic growth was accompanied by a 1.4-fold increase in the volume of the cardiomyocytes. Changes in the molecular phenotype characteristic of pressure-overload hypertrophic growth accompany the process. Thus, the levels of expression of beta-myosin heavy chain and atrial natriuretic factor mRNA increased, of sarcoplasmic/endoplasmic reticulum ATPase (SERCA2) mRNA decreased, and of alpha-myosin heavy chain, phospholamban, and calsequestrin mRNA did not change. In situ hybridization showed that the pattern of mRNA expression changed first in the right ventricular wall and subsequently in the left ventricular free wall as well. It is concluded that pressure-overload imposed on the late-fetal heart induces limited proliferative growth complemented by extensive hypertrophic growth.

  3. The timing of surgical ligation for patent ductus arteriosus is associated with neonatal morbidity in extremely preterm infants born at 23-25 weeks of gestation.

    Science.gov (United States)

    Sung, Se In; Choi, Soo Young; Park, Jae Hyun; Lee, Myung Sook; Yoo, Hye Soo; Ahn, So Yoon; Chang, Yun Sil; Park, Won Soon

    2014-04-01

    The purpose of this study was to evaluate prognostic factors associated with surgical ligation for patent ductus arteriosus (PDA) in extremely preterm infants born at the limits of viability. Ninety infants who were born at 23-25 weeks of gestation and who received surgical ligation were included and their cases were retrospectively reviewed. Infants were classified into two different groups: survivors with no major morbidity (N), and non-survivors or survivors with any major morbidity (M). Clinical characteristics were compared between the groups. Possible prognostic factors were derived from this comparison and further tested by logistic regression analysis. The mean gestational age and the mean birth weight of M were significantly lower than those of N. Notably, the mean postnatal age at time of ligation in N was significantly later than that of the other group (17 ± 12 vs 11 ± 8 days in N and M, respectively). An adjusted analysis showed that delayed ligation (>2 weeks) was uniquely associated with a significantly decreased risk for mortality or composite morbidity after surgical ligation (OR, 0.105; 95% CI, 0.012-0.928). In conclusion, delayed surgical ligation for PDA (>2 weeks) is associated with decreased mortality or morbidities in extremely preterm infants born at 23-25 weeks of gestation.

  4. Elevated NCX1 and NCKX4 expression in the patent postnatal ductus arteriosus of ductal-dependent congenital heart disease patients.

    Science.gov (United States)

    Hong, Haifa; Xia, Yu; Sun, Yanjun; Ye, Lincai; Liu, Jinfen; Bai, Jie; Zhang, Haibo

    2015-04-01

    Patency of the ductus arteriosus (DA) after birth is essential in ductal-dependent congenital heart disease. The Na(+)/Ca(2+) exchanger (NCX) has been demonstrated to play a key role in regulating vascular tone. The potassium-dependent Na(+)/Ca(2+) exchanger (NCKX) is a related family of NCX depending on the K(+) gradients which triggers DA constriction. The present study investigated the comparative expression of NCX and NCKX between a constricted DA and patent DA in human ductal-dependant congenital heart disease. Human DAs, which were patent (n = 10, age = 20.2 ± 4.3 days) or constricted (n = 10, age = 18.3 ± 3.9 days), were excised during surgery from neonates with ductal-dependent congenital heart disease. Western blotting analysis, real-time quantitative polymerase chain reaction analysis and immunofluorescence studies were performed to detect the protein and mRNA levels of NCX1, NCKX3, and NCKX4. The expressions of NCX1 and NCKX4 were significantly higher in the patent DA group at both the protein and mRNA levels, and expression was localized to the smooth muscle layer. These findings indicate that NCX1 and NCKX4 are up-regulated in human postnatal patent DAs and may represent potential therapeutic targets for maintaining DA patency in ductal-dependent congenital heart disease.

  5. 动脉导管未闭的治疗方法研究进展%Research progress of therapeutic methods for patent ductus arteriosus

    Institute of Scientific and Technical Information of China (English)

    白敏; 许丹焰

    2015-01-01

    Patent ductus arteriosus (PDA) is a frequent congenital heart disease .Incidence rate of PDA accounts for 10% ~21% of total incidence rate of congenital heart disease .In recent years ,along with the continuous deepening understanding of anatomical structure and pathology of PDA ,there were a variety of treatment methods ,including drug therapy ,interventional therapy and operation .The present article made a review about indications ,contraindi‐cations ,advantages and disadvantages of above three treatments .%动脉导管未闭(PDA )是一种常见的先天性心脏病,其发病率占先天性心脏病总发病率的10%~21%。近年来随着人们对PDA的解剖结构及病理生理的认识不断加深,临床上出现了多种治疗方式(药物治疗、介入治疗及手术治疗)。本文就这三种治疗方式的适应证、禁忌证及优缺点作一综述。

  6. Single nucleotide polymorphisms in AGTR1, TFAP2B, and TRAF1 are not associated with the incidence of patent ductus arteriosus in Japanese preterm infants.

    Science.gov (United States)

    Kawase, Koya; Sugiura, Tokio; Nagaya, Yoshiaki; Yamada, Takaharu; Sugimoto, Mari; Ito, Koichi; Togawa, Takao; Nagasaki, Rika; Kato, Takenori; Kouwaki, Masanori; Koyama, Norihisa; Saitoh, Shinji

    2016-06-01

    Persistent patent ductus arteriosus (PDA) is a frequent complication in preterm infants. Single nucleotide polymorphisms (SNP) in several genes, including angiotensin II receptor, type 1 (AGTR1), transcription factor AP-2 beta (TFAP2B) and tumor necrosis factor receptor-associated factor 1 (TRAF1), have been reported to be associated with PDA in preterm infants. The aim of this study was to evaluate the relationships between PDA in preterm infants and polymorphisms in AGTR1, TFAP2B and TRAF1 in the Japanese population. The subjects consisted of 107 preterm infants with gestational age AGTR1, rs987237 and rs6930924 in TFAP2B, and rs1056567 and rs10985070 in TRAF1, were genotyped using TaqMan SNP genotyping assays. There were no significant differences in the distributions of the genotypes and allele frequencies of all studied SNP between the PDA group (n = 46) and the non-PDA group (n = 61). There were no significant associations between the studied SNP and the incidence of PDA in Japanese preterm infants. These SNP may not be clinically important predisposing factors for PDA in Japanese preterm infants. © 2015 Japan Pediatric Society.

  7. 高龄动脉导管未闭的外科治疗%Surgical treatment of patent ductus arteriosus in advanced age

    Institute of Scientific and Technical Information of China (English)

    陶宝华; 刘捷夫

    2000-01-01

    Objective Ten patients with patent ductus arteriosus (PDA) in advanced age were retrospectivelyevaluated. Methods The PDA included aneurysmal dilatation of ductus arteriosus(4),giant ductus(3),and severepulmonary hypertension(2),PDA accompanied with rheumatic mitral valvular disease(1), Results Seven were lig-ated under hypothermia,2 ligated with Dacron pledget of PDA under temporary cardiopulmonary bypass;division of 1PDA under hypothermia; there were two early deaths(20%), The mean follow-up period was 50 months,all werefree from symptoms and cardiac murmur.Conclusion Optimum results achieved must be in accordance with propertechniques used in situations of PDAs in advanced age. Correction with Dacron patch is a safe, simple and reliablemethod for preventing rupture of PDA or aorta.(Shanghai Med J, 2000,23:458-460)%目的 探讨高龄动脉导管未闭患者的特点和手术方法的选择对手术结果的影响。方法 10例患者术前均经超声心动图证实诊断,导管直径0.9~2.5 cm(平均1.7 cm)。萁中2例肺动脉高压,导管水平有双向分流。4例肺动脉呈瘤样扩张。1例同时伴有风湿性二尖瓣美闭不全并发慢性右心衰竭。7例在全麻低温下施以带特制垫片结扎术。在低温部分阻断循环和左心辅助循环下行导管切断缝合各1例。正中切口,体外循环下行导管缝闭合并人工二尖瓣置换术1例。结果 住院死亡2例。其余8例痊愈出院。随访14~50个月,(平均32个月)无复发再通。结论 高静动脉导管未闭患者常并发各种病变,手术治疗效果主要取决于手术方法的选择。带特制垫片的结扎术对防止导管和主动脉破裂似乎是一种简单、安全、可靠的方法之一。

  8. Patent ductus arteriosus stenting in complex congenital heart disease: early and midterm results for a single-center experience at children hospital, Mansoura, Egypt.

    Science.gov (United States)

    Matter, Mohamed; Almarsafawey, Hala; Hafez, Mona; Attia, Gehan; Abuelkheir, Mohamed-Magdy

    2013-06-01

    This study aimed to assess the efficacy and outcome of transcatheter ductus arteriosus stenting in newborns and infants with ductal-dependent or decreased pulmonary circulation. Between September 2009 and December 2011, 33 newborns and infants were subjected to patent ductus arteriosus (PDA) stenting as an alternative to a surgical shunt. Of the 33 patients, 20 had pulmonary atresia (PA) with a ventricular septal defect, 4 had PA with an intact ventricular septum, 5 had PA with a double-outlet right ventricle, and 4 had critical pulmonary stenosis. The McGoon ratio ranged from 0.8 to 1.9 (median 1.27). The ages of the patients ranged from 3 to 56 days, and their weight ranged from 2.7 to 4.1 kg. The oxygen saturation ranged from 45 to 61 %, and the pH ranged from 7.13 to 7.27. Premounted coronary stents with diameters of 3, 3.5, and 4 mm were used to cover the whole length of the ductus. The PDA was tortuous in 23 patients and straight in 10 patients. The mean ductal length was 12.2 ± 3.7 mm (range 7.8-23 mm). The mean stent length was 14.3 ± 3.4 mm (range, 8-23 mm), and the mean narrowest ductal diameter was 1.9 ± 0.6 mm (range, 0.8-2.9 mm). Immediately after the procedure, the oxygen saturation was increased from a mean of 75.1 ± 13.2-91.5 ± 6.3 % (p < 0.0001), and the PDA diameter was increased from a mean of 1.9 ± 0.6-4.3 ± 0.8 mm (p < 0.0001). Stent redilation was necessary in two patients 8 days after the procedure, and their oxygen saturation increased 79-88 %. The mean fluoroscopy time was 39.4 ± 15.5 min. Stent dislocation to the left main pulmonary artery was seen in one patient, with another stent placed in the arterial duct. No procedure-related mortality occurred. Two neonates died a few days after the procedure due to sepsis related to the procedure. The surviving patients were discharged home 8-30 days (median, 9.5 days) after the procedure. Stent patency was achieved for 8-550 days. The McGoon ratio increased and ranged from 1.6 to 2

  9. Evolução ecocardiográfica de recém-nascidos com persistência do canal arterial Echocardiographic post-neonatal progress of preterm neonates with patent ductus arteriosus

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    Jorge Yussef Afiune

    2005-12-01

    ínico associado.OBJECTIVE: To identify clinical and echocardiography predictors of the spontaneous closure of patent ductus arteriosus in preterm neonates. METHODS: Sixty-one consecutive preterm neonates (gestational age 30±2 weeks, birth weight 1.2±0.2 kg were evaluated by echocardiogram on their third day of life and those with patent ductus arteriosus were selected for a prospective cohort. Echocardiography was repeated weekly until they reached term. Based on their progress, the sample population was divided into two groups, depending on whether spontaneous closure of patent ductus arteriosus took place (Group A or not (Group B. The prevalence of clinical signs of patent ductus arteriosus and echocardiography findings at baseline were compared between the groups. RESULTS: Patent ductus arteriosus was found in 21 neonates (34%. Spontaneuous closure was observed during follow-up of seven patients (Group A, 33% of those with patent ductus arteriosus, in contrast with the remaining 14 patients (Group B, 67%. Clinical signs of patent ductus arteriosus were present in 14% of the patients in Group A, compared with 71% in group B (p = 0.01. At baseline, Group B had a larger ductus diameter in relation to Group A (2.6±0.6 mm vs. 1.4±0.6 mm; p = 0.003. The area under the ROC curve in relation to ductus diameter was 0.93 (p = 0.003 and 100% sensitivity for identifying cases without spontaneous closure was obtained at the cutoff point of 1.7 mm, while 100% specificity was observed taking 2.2 mm as the cutoff. CONCLUSIONS: In preterm neonates, a patent ductus arteriosus greater than 2.2 mm on the third day of life predicts no spontaneous closure and suggests a need for early treatment, especially when associated with clinical signs.

  10. Tratamento do canal arterial persistente em neonatos prematuros: análise de 18 casos Treatment of patent ductus arteriosus in neonate premature: analysis of 18 cases

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    Wagner Ciongoli

    1993-12-01

    Full Text Available A presente investigação tem o propósito de analisar, retrospectivamente, os resultados obtidos em 18 pacientes neonatos prematuros, submetidos a operação para oclusão da PCA, no período entre julho de 1990 e dezembro de 1993 (42 meses, sendo 12 (66,6% pacientes do sexo feminino, com idade que variou entre 10 e 44 (20,8±8,3 dias, idade gestacional entre 26 e 28 (27,2±0,9 semanas. No dia da operação o peso dos pacientes esteve compreendido entre 700 e 1380 (985,8±181,6 gramas. A insuficiência respiratória aguda ocorreu em todos os pacientes sendo a principal indicação cirúrgica, estando em 6 (33,3% pacientes associada à insuficiência cardíaca congestiva. A indometacina endovenosa foi utilizada no período pré-operatório em 9 (50% pacientes na tentativa de se obter o fechamento farmacológico, sem sucesso, do canal arterial e apesar de não influenciar nos resultados pós-operatórios, apresentou como principal efeito secundário a redução significativa da diurese (p 40% 60% (p=0,033. O período de internação hospitalar variou de 43 a 157 (96,0±24,8 dias. Não houve mortalidade operatória, observando-se ainda baixa morbidade com este método. As causas de óbito, no período pós-operatório, não estiveram relacionadas com o tratamento cirúrgico. Pode-se concluir que a ligadura cirúrgica da PCA, nos pacientes neonatos e prematuros, é método eficaz e seguro podendo ser praticado com baixa morbidade e mortalidade.The purpose of our study was to analyse the results obtained in 18 neonate premature patients who underwent surgical closure of the patent ductus arteriosus, between July 1990 and December 1993 (42 months. Twelve (66.6% patients were female, with age between 10 and 44 (20.8±8.3 days, gestacional age ranged from 26 to 28 (27.2±0.9 weeks. In the surgery day the birth weight was between 700 and 1380 (985.8 ±181.6 grams. Acute respiratory insufficiency was present in all patients, as the principal surgical

  11. [Patent ductus arteriosus in the dog: a retrospective study of clinical presentation, diagnostics and comparison of interventional techniques in 102 dogs (2003-2011)].

    Science.gov (United States)

    Meijer, M; Beijerink, N J

    2012-06-01

    A left-to-right shunting patent ductus arteriosus (PDA) is a common congenital heart defect in dogs. If it is left uncorrected, life expectancy in most cases is decreased due to the development of left-sided congestive heart failure. The aim of this study was to describe the dogs diagnosed with PDA in the Utrecht University Companion Animal Clinic from 2003 to 2011. The medical records of 102 patients were retrieved, and the clinical presentation and outcome of PDA closure by surgical ligation or transarterial catheter occlusion (TCO) were reviewed. In the TCO group, the result of coiling was compared with the placement of an Amplatz Canine Duct Occluder (ACDO). A predisposition to PDA was found in the German Brak, Stabyhoun, and Schapendoes. Dogs treated with surgical ligation were significantly older and heavier than those treated with TCO; within the TCO group, dogs treated with ACDO were significantly older and heavier The initial success rate (complete disappearance of the audible murmur in a patient that survived the procedure) was not significantly different between the different treatment modalities. Major complications were more common with surgical ligation, but the incidence of minor complications was not significantly different. There was no diference in survival between dogs treated with surgical ligation and dogs treated with TCO. This study shows a previously unreported predisposition to PDA in certain breeds. Both surgical ligation and TCO are suitable techniques for PDA closure, although major complications were more common with surgical ligation. ACDO appears to be the method with the least complications and thus can be considered the safest method.

  12. The Changes of Left Ventricular Form and Function After Closure of Moderate-to Large-sized Patent Ductus Arteriosus Using Domestic-made Occluder

    Institute of Scientific and Technical Information of China (English)

    Mo Jianmei; Wu Weifeng; Liu Tangwei; Huang Kai; Guo Shenglan; Zhang Bingdong; Wu Ji

    2005-01-01

    Objectives To evaluate the changes of the left ventricular form and function after closure of moderate- to large-sized patent ductus arteriosus (PDA) using domestic-made occluder.Methods 22 patients with PDA underwent procedure successfuly using the domestic-made occluder. The mean PDA minimal (pulmonary end) diameter by aortography was 8.01±2.47 mm (range 4 to 15.Smm).All patients underwent transthoracic echocardiography (TTE) study before the procedure and the following 48hours, 3 months after procedure. Results All patients had been implanted the domestic-made occluders successfully with no haematolysis, infective endocarditis, recanalization and other complications.At 3 months, mean LVED was decreased to 50.05±6.55mm, compared to the pre-procedure (55.67±8.48mm), P < 0.01. After 48 hours of the procedure, mean LVEDD and LVESD decreased significantly (156.22±51.40 mLvs. 121.28±35.73ml, 57.16±32.07 mL vs.45.88±15.97 mL), P<0.05. At3 months, LVEDDdecreased to 110.93±15.08ml, LVSV reached 73.50±9.19 mL, compared to the pre-procedure, P < 0.01.LVESD decreased to 37.43±10.44 mL at 3 months, P <0.05. Conclusions Closuring of moderate- to largesized PDA using domestic-made occluder is effective and safe. After procedure, left ventricular form and function improved.

  13. Experience with percutaneous closure of ductus arteriosus using the Amplatzer duct occluder in 243 consecutive patients and long-term results-A single centre study

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    Mostafa Behjati-Ardakani

    2014-01-01

    Full Text Available Background: Percutaneous closure of patent ductus arteriosus (PDA with Amplatzer duct occluder (ADO has become increasingly popular in many cardiovascular centres. This study analysed the long-term results of percutaneous closure of PDA with ADO in a single centre. Materials and Methods: Between May 2004 and January 2013, 243 patients with median age of 2.5 years (range = 30 months to 38 years and median weight of 10 Kg (range 4.5-80.5 Kg underwent percutaneous closure of PDA using the ADO. The devices were implanted under fluoroscopic guidance. Patients were followed-up for any complications. Results: The mean diameter of narrow part of PDA was 6.4 ± 2.2 mm. The mean diameter of devices was 7.8 ± 2.3 mm. The devices were successfully implanted in 239 (98.3% cases. At immediate, 1 day, 1, 6, 12 months and late follow-up, the complete occlusion rate was 33% (79 case, 97.1% (236 case, 97.5% (237 case, 98.3% (238 case, 98.3% (238 case and 98.3% (238 case, respectively. Residual shunt remained in one case at late follow-up. The device embolisation occurred in five patients. The devices were successful retrieved in three patient and second larger devices were inserted. Two other devices were surgically retrieved and PDAs were ligated. Moderate left pulmonary artery stenosis (LPA in one child and mild LPA stenosis in one infant were detected. Mild aortic obstruction occurred in one infant. Conclusions: Long-term follow-up of patients indicate that percutaneous closure of PDA using ADO is a safe and effective procedure. However, some complications, including device embolisation, left pulmonary stenosis and aortic obstruction may be observed in some cases.

  14. Transcatheter closure of special types of patent ductus arteriosus%特殊类型动脉导管未闭的介入治疗(附30例报告)

    Institute of Scientific and Technical Information of China (English)

    邓军; 孔祥清; 杨荣; 盛燕辉; 钱玲梅; 周蕾; 杨振文; 孙伟; 曹克将

    2005-01-01

    目的:探讨特殊类型动脉导管未闭(patent ductus arteriosus,PDA)介入治疗的方法.方法:应用蘑菇伞封堵器(patent ductus arteriosus occluder,PDAO)介入封堵特殊类型的PDA 30例.结果:30例中巨大PDA 5例[最窄径平均12.4±1.7 mm (10.1~16.3 mm)],细小PDA 15例(最窄径平均2.10±0.42 mm),外科手术后再通的PDA 6例(最窄径平均3.20±0.34 mm),伴重度肺动脉压增高的PDA 3例[(平均肺动脉压88±7 mmHg(75~97 mmHg)],合并严重脊柱侧弯畸形1例.对5种不同类型的PDA根据其不同特点,采取不同的方法均成功封堵.结论:对于特殊类型动脉导管未闭选择恰当的方法可成功封堵.

  15. 早产儿动脉导管未闭现状和危险因素调查研究%Investigation on the present situation and risk factors of premature infants with patent ductus arteriosus

    Institute of Scientific and Technical Information of China (English)

    石小娟; 冯璇

    2013-01-01

    Objective To study the present situation of premature infants with patent ductus arteriosus and its risk factors.Methods A total of 824 premature infants in our hospital from October 2011 to October 2012 were selected as research object,then the patent ductus arteriosus rate of all the premature infants was investigated,and the rates of premature infants with different maternal factors and neonatal factors were compared.Results 190 cases of 824 premature infants were with patent ductus arteriosus,the rate was 23.05%,the patent ductus arteriosus rate of premature infants with meconium stained amniotic fluid,oligohydramnios,infection during pregnancy and gestational diabetes mellitus were higher than those of others,the rate of those with maternal hormone application was lower than that without hormone,the rates of those with lower gestational age and birth weight,intrauterine distress,Apgar score < 8 points were all higher than those of others (all P < 0.05),there were significant differences.Conclusions The risk factors of premature infants with patent ductus arteriosus is more,and it mainly includes the maternal gestational factors and neonatal factors.So they should be paid enough attention.%目的 调查分析早产儿动脉导管未闭的现状及其危险因素.方法 选取2011年10月至2012年10月的824例早产儿为研究对象,将其动脉导管未闭发生率进行调查,并将其中不同母体因素及新生儿因素的发生率进行比较.结果 824例早产儿中发生动脉导管未闭190例,发生率为23.05%;羊水粪染、羊水过少、孕期感染及妊娠期糖尿病患者的动脉导管未闭发生率高于其他患者,而母体应用激素者低于未用激素者(P均<0.05);胎龄及出生体重较小、宫内窘迫、Apgar评分<8分患儿动脉导管未闭发生率均高于其他患儿,差异有统计学意义(P<0.05).结论 早产儿动脉导管未闭的危险因素较多,主要包括母体妊娠期因素及新生儿因素,应给予充分重视.

  16. 早产儿动脉导管未闭超声参数预测早期自然关闭的价值%Evaluation of predicting the ductus arteriosus closure in preterm infants by echocardiography

    Institute of Scientific and Technical Information of China (English)

    杨正春; 冉素真; 沈红霞; 魏俊; 张焜; 黄泽君

    2015-01-01

    Objective To investigate the values of echocardiographic parameters for predicting the spontaneous closure of the ductus arteriosus in preterm infants .Methods A retrospective study of 110 preterm infants from October 2013 to October 2014 in our hospital was done .Examination was done at 1 ,3 ,7 d with echocardiography for those infants .Diameter of left atrium(LA) ,aotic root(AO) and arterial canal‐related parameters (the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus) at first .Preterm infants in this study were divided into two groups .The early patent ductus arterisus group included ones whoes ductus didn′t closed spontaneous in 7 d ,and the control group included ones whoes ductus closed spontaneous in 7 d ,and then the echocardiographic parameters between the two groups were compared .Results (1)The rates of ductus arteriosus sponta‐neous closure in preterm infants at 3 ,7 d were 70 .9% (78/110) ,78 .2% (86/110) ,respectivly .(2)When compared with the control group ,The rate of LA/AO in patent ductus arterisus group were higher than that of the control group(P<0 .01);The smallest width of ductal color Doppler flow jet in patent ductus arterisus group were bigger than that of the control group(P<0 .01);The maximum velocity at the ductus in patent ductus arterisus group were lower than that of the control group(P<0 .05) .(3)The best critical points of the LA/AO ,the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus of the spontaneous ductus arteriosus closure in preterm infants were 1 .32 mm ,2 .56 mm and 185 .5 cm/s ,respectivly .Conclusion Echo‐cardiography plays a significant role in prediction of the spontaneous closure of the ductus arteriosus in preterm infants .%目的:探讨早产儿动脉导管未闭超声参数预测早期自然关闭的价值。方法对2013年10月至2014年10月在重庆市妇幼保健院出生的早产儿110例进行前瞻

  17. Experiência global no fechamento percutâneo do canal arterial Overall experience with percutaneous occlusion of the patent ductus arteriosus

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Cardoso Pedra

    1998-12-01

    Full Text Available OBJETIVO: Avaliar a experiência global da nossa instituição com o fechamento percutâneo do canal arterial. MÉTODOS: Desde dezembro/92, 150 pacientes foram submetidos a 178 procedimentos (85 - técnica de Rashkind; 87 - coils de Gianturco; 6 - coils Duct Occlud. A mediana de idade foi de 6,5 anos (1 a 57. A média do diâmetro mínimo do canal foi de 3,05±1,24mm (1 a 8. Avaliações clínicas e ecocardiográficas foram realizadas seriadamente. RESULTADOS: Implantes adequados ocorreram em 143 (95,3% pacientes. A prevalência de shunt residual imediato foi de 52,1%, decrescendo para 15,9% no seguimento. Esta taxa caiu para 5,2% após a realização de procedimentos adicionais. Embolização de coils ocorreu em 12 procedimentos e de umbrella em 1. Um paciente apresentou hemólise e outro estenose discreta da artéria pulmonar esquerda. Não houve mortalidade. CONCLUSÃO: Esta modalidade terapêutica é segura e eficaz, proporcionando bons resultados a longo prazo.PURPOSE: To evaluate the overall experience of our institution with percutaneous occlusion of the patent ductus arteriosus. METHODS: Since December/92, 150 patients underwent 178 procedures (85 - Rashkind technique; 87 - Gianturco coils; 6 - Duct Occlud. Median age was 6.5 years (1 to 57. Mean minimum ductal diameter was 3.05±1.24mm (1 to 8. Clinical and echocardiographic evaluations were performed periodically. RESULTS: Adequate implantation was achieved in 143 (95.3% patients. Prevalence of immediate residual shunting was 52.1%, falling to 15.9% during follow-up. This figure decreased to 5.2% after new additional procedures. Umbrella and coil embolization occurred in 1 and 12 procedures, respectively. Hemolysis and mild stenosis of left pulmonary artery were observed in one patient each. There was no mortality. CONCLUSION: This therapeutic modality is safe and efficacious with good follow-up results.

  18. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension in adults: immediate and two-year follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHANG Cao-jin; HUANG Yi-gao; HUANG Xin-sheng; HUANG Tao; HUANG Wen-hui; XIA Chun-li; MO Yu-jing

    2012-01-01

    Background Transcatheter closure of patent ductus arteriosus (PDA) is a well established procedure and an accepted treatment modality for small to moderate-sized PDA.This study aimed to evaluate the immediate and follow-up results of transcatheter closure of large PDAs with severe pulmonary arterial hypertension (PAH) in adults.Methods After a complete hemodynamic evaluation differentiating from the reversibility of severe PAH,transcatheter closure of PDA was performed.Patients were followed up clinically and echocardiographically at 24 hours,1 month,3months,6 months,12 months and 24 months after occlusion.Results Twenty-nine patients had successful occlusion,pulmonary artery pressure (PAP),left ventricular ejection fraction (LVEF) and fractional shortening (FS) significantly decreased immediately after occlusion ((106±25) mmHg vs.(50±14) mmHg,P <0.01; (63.7±7.2)% vs.(51.4±10.1)%,P <0.01 and (36.9±8.2)% vs.(28.9±8.6)%,P <0.05,respectively).At 1 month after PDA closure,the signs and symptoms improved markedly in all 29 patients,and PDAs were completely closed and remained closed during the follow-up.Eighteen patients having different degrees of dyspnea were treated with angiotensin converting enzyme inhibitor (ACEI) and/or digoxin after occlusion.Nine patients whose pulmonary vascular resistence (PVR) >6 Wood units accepted targeted PAH therapy.After 1 to 3 months of peroral drug therapy,their exercise tolerance improved from New York Heart Association (NYHA) class Ⅲ-Ⅳ to NYHA class Ⅰ.During follow-up,no latent arrhythmias were found,the left atrial diameter (LAD),left ventricular end-diastolic diameter (LVEDD),left ventricular end-systolic diameter (LVESD),left ventricular mass index (LVMI) and pulmonary artery systolic pressure (PASP) decreased significantly (P <0.05),and FS and LVEF recovered compared to the immediate postclosure state.However,FS and LVEF remained low compared to the preclosure state.Conclusions Transcatheter closure

  19. Effect of patent ductus arteriosus and patent foramen ovale on left ventricular stroke volume measurement by electrical velocimetry in comparison to transthoracic echocardiography in neonates.

    Science.gov (United States)

    Blohm, Martin Ernst; Hartwich, Jana; Obrecht, Denise; Kersten, Jan Felix; Singer, Dominique

    2017-06-01

    This prospective single-center observational study compared impedance cardiography [electrical velocimetry (EV)] with transthoracic echocardiography (TTE, based on trans-aortic flow) and analyzed the influence of physiological shunts, such as patent ductus arteriosus (PDA) or patent foramen ovale (PFO), on measurement accuracy. Two hundred and ninety-one triplicate simultaneous paired left ventricular stroke volume (LVSV) measurements by EV (LVSVEV) and TTE (LVSVTTE) in 99 spontaneously breathing neonates (mean weight 3270 g; range 1227-4600 g) were included. For the whole cohort, the mean absolute LVSVEV was 5.5 mL, mean LVSVTTE was 4.9 mL, resulting in an absolute Bland-Altman bias of -0.7 mL (limits of agreement LOA -3.0 to 1.7 mL), relative bias -12.8 %; mean percentage error MPE 44.9 %; true precision TPEV 33.4 % (n = 99 aggregated data points). In neonates without shunts (n = 32): mean LVSVEV 5.0 mL, mean LVSVTTE 4.6 mL, Bland-Altman bias -0.4 mL (LOA -2.8 to 2.0 mL), relative bias -8.2 %; MPE 50.7 %; TPEV 40.9 %. In neonates with shunts (PDA and/or PFO; n = 67): mean LVSVEV 5.8 mL, mean LVSVTTE 5.0 mL, bias -0.8 mL (LOA -3.1 to 1.5 mL), relative bias -14.8 %, MPE 41.9 %, TPEV 29.3 %. Accuracy was affected by PDA and/or PFO, with a significant increase in the relative difference in LVSVEV versus LVSVTTE: Subjects without shunts -2.9 % (n = 91), PFO alone -9.6 % (n = 125), PDA alone -14.0 % (n = 12), and PDA and PFO -18.5 % (n = 63). Physiological shunts (PDA and/or PFO) in neonates affect measurement accuracy and cause overestimation of LVSVEV compared with LVSVTTE.

  20. Application of patent ductus arteriosus occluder in transcatheter occlusion of coronary artery fistula%动脉导管未闭封堵器在冠状动脉瘘介入治疗的应用

    Institute of Scientific and Technical Information of China (English)

    肖云彬; 陈智; 黄希勇; 王祥; 杨舟

    2014-01-01

    Objective To assess the clinical short-term to mid-term efficacy of transcatheter closure of coronary artery fistula by using patent ductus arteriosus occluder in pediatric patients. Methods During the period from Jan. 2008 to May 2013 at authors’ hospital, transcatheter closure of coronary artery fistula using patent ductus arteriosus occluder was performed in 8 pediatric patients. The clinical data, including follow-up information, were retrospectively analyzed. Results A total of 8 pediatric patients with a mean age of (4.1 ± 3.8) years were enrolled in this study. The fistula originated from the right coronary artery in five cases and from the left coronary artery in three cases. The blood flow shunted to the right atrium (n=4) or to the right ventricle (n = 4). Obstruction of the fistula was successfully accomplished in all patients. All patients were followed up for (2.2 ± 1.2) years. No procedure-related complications or cardiac ischemia occurred. Conclusion For the treatment of coronary artery fistula in pediatric patients, the use of domestic patent ductus arteriosus occluder is safe and effective with satisfactory short-term to mid-term clinical efficacy.%目的:评价动脉导管未闭(PDA)封堵器在小儿冠状动脉瘘介入封堵治疗的近中期疗效。方法回顾性分析2008年1月-2013年5月在我院采用PDA封堵器进行冠状动脉瘘介入封堵治疗患儿的临床资料及术后随访资料。结果本组8例患儿,年龄(4.1±3.8)岁,右冠状动脉起源5例,左冠状动脉起源3例,分流入右心房、右心室各4例。所有患儿均成功进行封堵治疗,术后随访(2.2±1.2)年,无介入治疗相关并发症、心肌缺血表现。结论 PDA封堵器应用于冠状动脉瘘介入封堵治疗近中期疗效满意。

  1. The Clinical Application Analysis of Evidence-based Nursing in Congenital Patent Ductus Arteriosus Closure Occlusion%循证护理在先天性动脉导管未闭封堵术中的应用分析

    Institute of Scientific and Technical Information of China (English)

    张敏

    2012-01-01

      Objective  Explore evidence-based care in congenital patent ductus arteriosus closure occlusion value. Method Select the hospital in January 2010 to November 2012 were congenital patent ductus arteriosus in patients with 110 cases of the study were randomly divided into control and experimental groups and control group for patients with postoperative conventional care. The experimental group patients using evidence-based care model for care, patients were observed incidence of postoperative complications, patient satisfaction and other indicators. Results The incidence of postoperative complications of the experimental group was significantly lower than the control group; experimental group were satisfied with degrees higher than that in the control group, the difference was statistically different(P<0.05). Conclusion Congenital patent ductus arteriosus closure in patients with evidence-based care model for post-operative care can effectively reduce the incidence of postoperative complications, improve patient satisfaction.%  目的探讨循证护理在先天性动脉导管未闭封堵术中的应用价值.方法选取本院从2010年1月至2012年11月收治的先天性动脉导管未闭患儿55例作为研究对象,将其随机分为对照组和实验组,对照组患儿实施术后传统常规护理,实验组患儿术后介入循证护理模式,观察两组患儿术后并发症发生情况、患者满意度等指标.结果实验组术后并发症发生率(14.3%)显著低于对照组(33.3%),差异有统计学差异(P <0.05);实验组患儿及其家属满意度(96.4%)高于对照组(63%),差异有统计学差异(P <0.05).结论对先天性动脉导管未闭封堵术患儿采用循证护理模式,可有效降低术后并发症发生率,提高患儿及其家属满意度.

  2. Surgical treatment of interrupted aortic arch associated with ventricular septal defect and patent ductus arteriosus in patients over one year of age

    Institute of Scientific and Technical Information of China (English)

    Li Zhiqiang; Li Bin; Fan Xiangming; Su Junwu; Zhang Jing; He Yan; Liu Yinglong

    2014-01-01

    Background Interrupted aortic arch (IAA) is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease.Neonatal repair of IAA is required to avoid irreversible pulmonary vascular lesion.However,in China,patients with IAA associated with ventricular septal defect (VSD) and patent ductus arteriosus (PDA) over one year of age are common.So we investigated the outcome of surgical treatment of IAA with VSD and PDA in patients over one year of age.Methods From January 2009 to December 2012,19 patients with IAA have undergone complete single-stage repair.The patients' mean age was 4.4 years,ranging 1 to 15 years; and their mean weight was 12.8 kg,ranging 4.2 to 36.0 kg.Fifteen IAA were type A,four were type B.Preoperative cardiac catheterization data were available from all patients.Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) were measured.The measurements of postoperative pulmonary artery pressure were taken in the operating room at the end of the case.All patients underwent echocardiographic examinations before discharged from the hospital.In addition,cardiac catheterization and echocardiographic examinations were performed during follow-up.Selective brain perfusion through the innominate artery during aortic arch reconstruction was used in all patients.Mean follow-up was (1.6±0.8) years.Results There were two hospital deaths (2/19,11%).One patient died of pulmonary hypertension crisis,and another died of postoperative low cardiac output.Five cases had other main postoperative complications but no postoperative neurologic complications.Seventeen survivors were followed up,and there were no late deaths or reoperation.Mean cross-clamp duration was (85±22) minutes and selective brain perfusion duration was (34±11) minutes.Two patients required delayed sternal closure at two days postoperatively.Intensive care unit and hospital stays were (9±8) days and (47±24) days,respectively.Pressure gradients across

  3. 影响吲哚美辛对早产儿动脉导管未闭疗效的相关因素分析%Correlative Factors of Indomethacin Treatment for Patent Ductus Arteriosus in Premature Infants

    Institute of Scientific and Technical Information of China (English)

    刘新晖; 高喜容; 黄维清; 杨慧; 周勇; 庄严

    2013-01-01

    目的:调查分析影响吲哚美辛对动脉导管未闭(PDA)早产儿疗效的临床相关因素.方法:收集36例我院住院确诊为PDA并应用吲哚美辛治疗的患儿的临床资料,建立数据库并分析临床相关因素与治疗效果的关系.结果:给予吲哚美辛治疗后,患儿的PDA关闭28例,关闭率为77.78%,未成功关闭8例,占22.22%.单因素分析结果显示,孕周、出生体重、首次用药时间对于PDA关闭率有显著影响(P<0.05);Logistic回归分析显示,出生体重、首次用药时间对PDA关闭率的影响差异有统计学意义(P<0.05).结论:影响吲哚美辛对早产儿PDA关闭临床疗效的主要因素为出生体重及首次用药时间.%Objective: To investigate and analyze the clinical associated risk factors of indomethacin treatment for patent ductus arteriosus (PDA) in premature infants. Methods; The clinical data of 36 cases who were diagnosed as PDA and received indomethacin treatment in our hospital were collected. The therapeutic efficacy was observed, and the clinical associated risk factors were recorded. The database of clinical records was established and analyzed by using regression analysis method. Results; After indomethacin treatment, ductus arteriosus were closed successfully in 28 patients (77.78% ) , and only eight premature infants (22.22% ) required surgical ligation of the ductus. By using univariate analysis, the gestational weeks, birth weight and the timing of first dose were identified as risk factors to the outcome; multivariate logistic regression analysis showed that birth weight and the timing of first dose were identified as risk factors to the outcome. Conclusions; The main clinical associated risk factors of indomethacin treatment for PDA in premature infants were birth weight and the timing of first dose.

  4. 高海拔地区动脉导管未闭藏族患者介入治疗的疗效分析%Evaluation of interventional therapy in high - altitude Tibetan patients with patent ductus arteriosus

    Institute of Scientific and Technical Information of China (English)

    白晟遥; 马东星; 吴晓霞; 张雪梅; 张凤羽; 刘惠亮

    2011-01-01

    目的 探讨高海拔缺氧地区动脉导管未闭(patent ductus arteriosus,PDA)藏族患者介入手术治疗效果.方法 9例来自西藏、生长环境均在海拔3500 m以上的藏区PDA患者.年龄3~21岁,平均(10 4±5 5)岁,入我院行超声心动图检查确诊后行介入治疗.其中合并轻度肺动脉高压( pulmonary hypertension,PH)1例,中度肺动脉高压1例,重度肺动脉高压2例.手术皆采用国产封堵器在降主动脉造影下行介入封堵.结果 除1例试封堵失败转外科外,余8例手术均取得成功.2例重度PH患者术前测肺动脉收缩压分别为78、83 mmHg,术后即刻测肺动脉收缩压降至16、48 mmHg,中度及轻度PH患者术后即刻肺动脉压均降至正常.术后2例出现一过性血小板减少症,2例存在少量残余分流,无严重肺部感染及封堵器脱落等严重并发症.结论 长期生活在高海拔低氧地区可逆性PH的PDA患者经导管介入封堵治疗安全有效.%Objective To study the efficacy of interventional operations in high -altitude patients with patent ductus arteriosus (PDA). Methods The sample consisted of 9 Tibetan patients who were living at an altitude of over 3500 meters. Their age ranged from 3 to 21 years. Echocardiography was performed, which identified 1 case of patent ductus arteriosus (PDA) associated with severe subaortic stenosis (AS) , in whom interventional therapy was not successful. 8 cases, after diagnostic confirmation, received arterial catheter interventional treatment, one of whom was complicated by mild pulmonary hypertension ( PH) , another one by moderate pulmonary hypertension, and two by severe pulmonary hypertension. The operation proceeded with the domestic occluder in transcatheter closure under the descending aorta angiography. Results In two patients with severe pulmonary arterial hypertension whose preopera-tive pulmonary artery pressure was 78mmHg and 83mmHg respectively, the postoperative pulmonary arterial pressure fell to

  5. Changes of pulmonary artery pressure after interventional transcatheter closure in patients with patent ductus arteriosus%动脉导管未闭介入治疗后肺动脉压改变的研究

    Institute of Scientific and Technical Information of China (English)

    张克成; 袁杰; 于波; 孙勇

    2012-01-01

    目的:探讨动脉导管未闭(PDA)患者介入封堵治疗后肺动脉压改变的影响因素.方法:回顾性分析2008年1月至2011年9月在我院行介入封堵治疗的43例PDA患者的临床及介入手术资料.结果:与治疗前比较,PDA患者介入封堵治疗后肺动脉收缩压[PASP,(76±51)mmHg比(46.26±17.26)mmHg]、肺动脉舒张压[PADP,(39.47±17.11)mmHg比(15.84±10.74)mmHg]、平均肺动脉压[MPAP,(54.72±19.21)mmHg比(28.53±14.41)mmHg]均显著降低(P均=0.0001),PADP下降程度比PASP更明显[(0.54±0.38)比(0.38±0.15),P=0.012]; PDA患者介入治疗后PASP、MPAP下降程度与年龄呈负相关(B=-0.04,P=0.012;B=-0.006,P=0.009);术后MPAP下降程度与动脉导管管径呈正相关(B=0.022,P=0.01).结论:介入封堵治疗对动脉导管未闭有益,应在年龄较小时尽早手术.%Objective; To analyze influencing factors of change of pulmonary artery pressure after interventional transcatheter closure in patients with patent ductus arteriosus (PDA). Methods: Clinical and intervention data of 43 PDA patients undergoing interventional transcatheter closure in our hospital from Jan 2008 to Sep 2011 were retrospectively analyzed. Results: Compared with before treatment, there were significant decrease in pulmonary arterial systolic pressure [PASP, (76 ?51) mmHg vs. (46. 26 ?17. 26) mmHg], pulmonary arterial diastolic pressure [PADP, (39. 47 ?7. 11) mmHg vs. (15. 84 + 10. 74) mmHg] and mean pulmonary arterial pressure [MPAP, (54.72 + 19. 21) mmHg vs. (28. 53 ?14. 41) mmHg] in PDA patients after interventional transcatheter closure (P = 0. 0001 all), decrease degree of PADP was more significant than that of PASP [ (0. 54 + 0. 38) vs. (0. 38 ?0.15), P = 0. 012]; decrease degree of PASP and MPAP in PDA patients after interventional transcatheter closure were negatively correlated with age (B= - 0. 04, P= 0. 012; B= - 0. 006, P = 0. 009); decrease degree of MPAP after operation was positively correlated with ductus arteriosus

  6. The application of transthoracic echocardiography in performing transcatheter occlusion of patent ductus arteriosus%经胸超声心动图在动脉导管未闭封堵术中的应用价值

    Institute of Scientific and Technical Information of China (English)

    李国英; 李叶阔; 徐明; 罗国新; 何建新; 袁桂忠

    2013-01-01

    目的 评价经胸超声心动图(TTE)指导动脉导管未闭(patent ductus arteriosus,PDA)封堵术术前及术中的应用价值.方法 2008年5月至2012年5月收治132例PDA患者,术前用彩色多普勒超声诊断仪经胸观察PDA形态,并测量各切面PDA内径,据此结果直接选择相应封堵器.经心导管PDA封堵术中应用TTE监测介入过程,确定封堵器牢固程度及有无残余分流.结果 TTE术前检查PDA直径为2 ~ 12mm,平均(5.49±1.93)mm,选用PDA封堵器大小为4~ 22 mm,平均(10.43±2.91)mm.超声测量PDA直径与封堵器大小相关性良好(r=0.74,P< 0.001).手术成功率100%,封堵器牢固,无脱落,无分流.结论 TTE术前及术中直接指导PDA封堵术是一种可行、有效、便捷的方法,尤其适用于小儿.%Objective To discuss the application value of transthoracic echocardiography (TTE) in guiding the performance of transcatheter occlusion of patent ductus arteriosus (PDA). Methods During the period from May 2008 to May 2012, a total of one hundred and thirty-two patients with PDA were admitted to authors' hospital. The patient's age ranged from 7 months to 67 years. Before operation the size and shape of PDA were measured by TTE (GE vivid7 and Philips IE33). The inner diameter of the relevant cross - sections were determined, based on which the proper occluder was selected for each patient. With the help of TIE monitoring the transcatheter occlusion of PDA was carried out. The fixation degree of the occluder was estimated, and the presence or absence of residual shunt was determined. Results Preoperative TTE examination showed that the diameter of PDA was 2-12 mm with a mean of (5.49 ± 1.93 )mm. The size of occluder used in the operation was 4-22 mm with a mean of (10.43 ± 2.91) mm. A significant correlation existed between the PDA diameter measured by TTE and the size of the used occluder (r = 0.74, P < 0.001). The success rate of the operation was 100%. All the occluders were fixed

  7. Fisioterapia em recém-nascidos com persistência do canal arterial e complicações pulmonares Chest physical therapy in newborn infants with patent ductus arteriosus and pulmonary complications

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    Ivete Furtado Ribeiro

    2008-03-01

    Full Text Available OBJETIVOS: Revisar as complicações pulmonares e intervenções fisioterapêuticas disponíveis para recém-nascidos com persistência do canal arterial (PCA. FONTES DE DADOS: Artigos publicados nas fontes de dados Medline e Lilacs, além de capítulos de livros nos idiomas português e inglês, entre 1992 e 2006. As palavras-chave utilizadas para busca foram: "canal arterial", "prematuridade", "síndrome do desconforto respiratório", "complicações" e "pulmão". SÍNTESE DOS DADOS: A PCA é uma intercorrência freqüente em recém-nascidos pré-termos, que pode se associar a complicações pulmonares, tais como atelectasias, infecções pulmonares e falha na extubação, aumentando o tempo de ventilação mecânica e de internação na Unidade de Terapia Intensiva Neonatal. Os recursos fisioterapêuticos visam melhorar as condições pulmonares, propiciando o aumento da complacência pulmonar e a diminuição da resistência de vias aéreas, além de otimizar o mecanismo de depuração mucociliar e, dessa forma, reduzir o trabalho respiratório. CONCLUSÕES: A fisioterapia respiratória contribui para melhorar a evolução dos neonatos com complicações pulmonares por persistência de canal arterial, permitindo otimizar a mecânica respiratória, além de melhorar a oxigenação e a relação ventilação/perfusão.OBJECTIVE: To review the pulmonary complications and the available chest physical therapy interventions for neonates with patent ductus arteriosus (PDA. DATA SOURCES: Studies were retrieved from Medline and Lilacs and textbooks in Portuguese and in English, from 1992 to 2006. The following key-words were searched: "ductus arteriosus", "prematurity", "respiratory distress syndrome", "complications", "lung". DATA SYNTHESIS: PDA is frequently observed among preterm infants and can be associated with pulmonary complications, such as atelectasis, infections, extubation failure, increased mechanical ventilation dependency and longer

  8. Analysis on the efficacy of interventional therapy in the treatment of patent ductus arteriosus in children%介入封堵儿童动脉导管未闭疗效分析

    Institute of Scientific and Technical Information of China (English)

    沈兴; 赵香芝; 贾鹏; 刘斌; 孙玉琴

    2012-01-01

    目的:探讨介入治疗儿童动脉导管未闭(Patent ductus arteriosus,PDA)的临床疗效.方法:回顾分析2007年11月-2010年12月在本院作经皮PDA封堵的63例病人资料,着重分析动脉导管的测量、手术方法、临床疗效.结果:典型PDA经胸超声测量值与造影后X线测量值差异无统计学意义,但在小型和大型PDA中两者差异有统计学意义;所有病人中61例封堵成功,其中7例植入弹簧圈,其余54例采取蘑菇伞堵闭器封堵成功.结论:经皮PDA封堵术安全有效,术中注重患者的个体情况,注意操作细节,能更好地避免并发症,提高成功率.%Objective:To explore the efficacy of interventional therapy in the treatment of patent ductus arteriosus (PDA) in children. Methods: Totally 63 patients with PDA in our hospital from November 2007 to December 2010 were treated by transcatheter closure. Their clinical data were retrospectively analyzed focusing on the measurement of arterial ducts, operation methods and therapeutic results. Results : There was no significant difference in the measurements between transthoracic echocardiography (TTE) and aortography in typical PDA cases, but there were significant differences between small and large PDA cases. The devices were successfully implanted in 61 cases,among which coils were implanted in 7 cases and Amplatzer duct occluder in 54 cases. Conclusion:Transcatheter PDA occlusion is safe and effective. Success rate can be improved and complications can be avoided if due attention is paid to the individual condition and operational details.

  9. Bedside surgical ligation of patent ductus arteriosus in low body weight premature infants%低体重早产儿动脉导管未闭的床旁外科治疗

    Institute of Scientific and Technical Information of China (English)

    王辉; 杨学勇; 刘宇航; 付松; 李秋平; 封志纯; 周更须

    2011-01-01

    Objective To discuss the experience of bedside surgical treatment of patent ductus arteriosus(PDA) by ligature or clip ligation for premature infants.Methods The clinical data of 25 bedside surgical ligations of PDA from Oct.2009 to Oct.2010 were retrospectively analyzed.Results All these 25 cases recovered uneventfully,no death or surgical complication occurred.ConclusionsThe PDA canbe adequately exposed by a limited left posterolateral thoracotomy.Premature ICU department could satisfy the requirement of anesthesia and surgical operation.Surgical ligation of PDA,either by ligature or clip,is a good option for premature infants with PDA.%目的 探讨内科保守治疗动脉导管未闭(patent ductus arteriosus,PDA)效果不佳的早产儿实施床旁外科手术结扎(或钳夹)的经验.方法 回顾性分析我院2009年10月至2010年10月心外科对25例行床旁动脉导管结扎(或钳夹)术的手术过程及术后转归.结论 所有行动脉导管结扎术(或钳夹术)患儿中,无术中死亡病例,术后均未出现与手术相关的并发症.结论 经左胸后外侧切口治疗早产儿PDA,术中暴露视野清晰、操作简便.层流病房可满足麻醉、术中监护及外科手术操作的需要,手术治疗效果肯定.早产儿经内科保守治疗PDA无效,或存在多系统疾病,或存在药物治疗禁忌的情况下,均应行动脉导管结扎(或钳夹)术.

  10. Surgical Closure of Patent Ductus Arteriosus via Left Subaxiliary Small Incision%左腋下小切口动脉导管夹闭术100例报告

    Institute of Scientific and Technical Information of China (English)

    刘勇; 刘健; 黄击修; 林小彬; 付建

    2011-01-01

    Objective To evaluate the value of surgical closure for patent ductus arteriosus (PDA) through a small left gubaxillary incision. Methods From January 2004 to January 2011, 100 patients who received Hetn-o-lok ligation for PDA were enrolled in this study. Results No perioperative death occurred in this series. The mean length of the small incision was (6. 5 ± 1. 8)cm, mean opration time (56 ±21) min, and mean hospital stay (9.7 ± 1.9) days. The patients were followed up for 2 months to 3 years with a mean of 2. 3 years, during which no re-patent or pseudo-aneurysma was detected. Conclusion Surgical closure through a small incision at the left subaxillary is safe, effective, and easy-to-perform for PDA with concealed incision and quick recovery.%目的 探讨左腋下小切口动脉导管夹闭术治疗动脉导管未闭(patent ductus arteriosus,PDA)的价值. 方法 2004年1月~2011年1月对100例PDA全麻下经左腋下小切口直视下借助Hem-o-lok结扎夹行动脉导管夹闭术. 结果 切口长度(6.5±1.8)cm,手术时间(56±21)min,术后住院时间(9.7±1.9)d.100例随访2个月~3年,平均2.3年,无再通及假性动脉瘤形成. 结论 经左腋下小切口动脉导管夹闭术是治疗PDA的有效方法,切口隐蔽,术后恢复快,安全可靠,操作简单,利于推广.

  11. 早产儿动脉导管未闭介入封堵术一例并文献复习%Transcatheter occlusion of patent ductus arteriosus in a preterm infant and review of literatures

    Institute of Scientific and Technical Information of China (English)

    周开宇; 唐军; 华益民; 石晓青; 王一斌; 乔莉娜; 王晓琴; 母得志

    2016-01-01

    Objective To investigate the characteristics of haemodynamically significant patent ductus arteriosus (hsPDA), and the indications of percutaneous transcatheter PDA occlusion.Method The data of a preterm infant admitted to West China Second Hospital in December.2013, who finally underwent percutaneous transcatheter PDA occlusion were analyzed With the key words of "preterm" "patent ductus arteriosus" " transcatheter", Pubmed were searched and potentially relevant reports were retrieved and assessed by manual sorting from 2005 to 2015.Relevant reports in literature were reviewed.Result A preterm infnat at gestational age of 35 weeks with birth weight of 1 900 g was admitted to our department.Oral ibuprofen for closure of the patent ductus arteriosus failed, and the patient exhibited the features of "ventilator dependent" PDA of premature infants.On the 30th postnatal day, with the body weight of 1 950 g, under basal anesthesia, the infant underwent percutaneous transcatheter PDA occlusion, and the procedure successfully occluded the ductus with Amplatzer duct occluder (ADO).The ventilator was weaned 19 hours post procedure, and the child was discharged 7 days post operation with good recovery, and her growth and development was good.Follow-up for 13 months indicated that the intelligence and physical development evaluated by Bayley scales of infant development test were at the same level of normal agematched infants.Fifty-two preterm infants treated with percutaneous transcatheter PDA occlusion in 8 reports were enrolled.The preterm infants were born at 23-35 gestational weeks, with PDA diameter of 1-4 mm.The occlusive device included coil, ADO, ADO Ⅱ, ADO Ⅱ AS, AVP Ⅱ and AVP Ⅳ respectively, with body weight of 870-2 610 g on operational days and age of 11-90 postnatal days.All those infants either failed or had contraindications to drug therapy, and exhibited as hsPDA cases.Percutaneous transcatheter PDA occlusions were performed successfully in all 52

  12. Effect of the valved stent on closure of patent ductus arteriosus in a miniswine model%带瓣膜心血管内支架封堵动脉导管未闭的可行性研究

    Institute of Scientific and Technical Information of China (English)

    周永新; 王永武; 邵杰; 孙林; 李刚; 梅运清; 胡大一

    2009-01-01

    Objective To evaluate the feasibility of a valved stent on closure patent ductus arteriosas in a Chinese miniswine model. Methods Self-expandable nitinol stents were made of Ni-Ti shape memory alloy (9 nun in diameter). Bovine pericardium was shaped and sutured onto the stents. Fluid passing test, pre-releasing test and static test of pressure in tube were performed in all devices before use. In eight Chinese miniswine, vascular grafts (PTFE vascular prosthesis) were surgically inserted between the descending thoracic aorta and pulmonary artery for establishment of patent duetus arteriasus model Valved stents were deployed to occlude the patent ductus arteriosus. Echocardiography was performed two hours post operation. Aortic angiography was made 30 days post operation in survived animals. Animals were then sacrificed for autopsy and electron microscopy examinations. Results In vitro testing showed that the closure of the valved stent leaflets was satisfactory and fluid flows were not restricted in the opposite direction. The valved stenta could be released through catheter, expanded completely, rapidly fixed in the tube. Closure of patent ductus arteriosas was succeeded in 6 out of 8 animals. One animal died of respiratory failure 2 hours post operation, another one died of pulmonary embolism due to valved stent displacement. Resident shunt was not evidenced by echocardiography, aortic angiography and dissection examinations in the remaining 6 animals. The new endothelial tissue fully covered the pulmonary and aortic sides of patent ductus arteriosus in 4 and 3 animals respectively. The electron microscopic observation revealed endothelial coverage of diveea. Conclusion The valved stent could effectively close artificial patent dactus arteriosus in vivo with satisfactory new intima covering on beth sides of patent ductus arteriosus.%目的 探讨带瓣膜心血管内支架在动脉导管封堵中应用的可行性及其体内特性,以期研制一种用于封堵

  13. 低体重早产儿动脉导管未闭治疗进展%Therapy progress of patent ductus arteriosus in low-birth-weight premature infants

    Institute of Scientific and Technical Information of China (English)

    郑祥鑫(综述); 王文生(审校)

    2015-01-01

    动脉导管未闭是一种新生儿常见疾病。在早产儿,尤其是低体重儿中其发病率更高。如未及时治疗,往往会导致新生儿颅内出血、呼吸窘迫综合征、慢性肺疾病等严重并发症。目前临床上有药物治疗、手术治疗、介入治疗及对症治疗,该文对低体重早产儿动脉导管未闭治疗的进展作一综述。%Patent ductus arteriosus( PDA) has high morbidity in new-borns. This disease tends to occur in premature,especially in the low-birth-weight infants. It can lead to severe complications including intracranial hemorrhage,respiratory distress syndrome,and chronic lung disease without treatment. Treatment for PDA usual-ly involves medications,operations,interventions and symptomatic treatment. This paper summarizes the progres-ses of the therapy of PDA in low-birth-weight premature infants.

  14. 极低出生体重早产儿动脉导管未闭的治疗%Treatment of patent ductus arteriosus in very low birth weight preterm infants

    Institute of Scientific and Technical Information of China (English)

    陈涵强; 杨长仪; 杨文庆; 石惠英; 林云峰

    2011-01-01

    Objective To investigate the treatment of symptomatic patent ductus arteriosus (PDA) in very low birth weight preterm infants. Methods From January 1, 2008 to December 31, 2010, 78 very low birth weight preterm infants (birth weight<1500 g) were diagnosed as symptomatic PDA. Among which, 42 cases administered orally with indomethacin (0.2 mg/kg, every 12 hrs for three times) were taken as treatment group, while five cases in this group who failed to indomethacin treatment were interrupted with video-assisted thoracoscopic surgery. And 36 cases who did not receive treatment for ductus arteriosus were taken as control group. The clinical outcomes, complications and prognosis of these patients were observed. Results There were no significant differences between the gentle percentage, gestational age, diameter of ductus arteriosus, rate of complicated with heart failure, sepsis, neonatal respiratory distress syndrome and intraventricular hemorrhage of two groups (P>0.05, respectively). The ductus arteriosus closed in 33 patients of treatment group (78.6%) and in nine patients of control group (25.0%)(χ2=22.39,P=0.000). There were no significant differences in serum creatinine level and platelet count between before and after the treatment in treatment group(P>0.05). Compared with control group, the treatment group had lower incidence of intraventricular hemorrhage (z=1.167, P=0.030), shorter duration of oxygen therapy [(8.0±5.5) d vs (13.3±9.3) d, t=2.225, P=0.032] and shorter hospital stay [(39.0±7.7) d vs (43.6±10.6) d, t=2.229, P=0.029]; while the incidence of bronchopulmonary dysplasia and necrotizing enterocolitis were similar (P>0.05). The five cases of PDA who received video-assisted thoracoscopic surgery were successfully interrupted with no residual shunt left, while three of them had lung infections and one had pleural effusion, but no pneumothorax and infant death associated with surgery occurred. Conclusions Symptomatic PDA of very low birth weight

  15. Efficacy of a first course of Ibuprofen for patent ductus arteriosus closure in extremely preterm newborns according to their gestational age-specific Z-score for birth weight.

    Directory of Open Access Journals (Sweden)

    Doriane Madeleneau

    Full Text Available Therapeutic strategies for patent ductus arteriosus (PDA in very preterm infants remain controversial. To identify infants likely to benefit from treatment, we analysed the efficacy of a first course of ibuprofen in small-for-gestational age (SGA newborns.This single-centre retrospective study included 185 infants born at 24+0-27+6 weeks of gestation with haemodynamically significant PDA, who were treated by intravenous ibuprofen (Pedea: 10 mg/kg on day one and 5 mg/kg on days two and three. Birth weight and gestational age (GA were analysed with reference to the standard deviations from the Olsen growth curve to define GA-specific Z-scores for birth weights. The efficacy of treatment was evaluated by echocardiography 48 hours after the last dose of ibuprofen. The primary outcome was failure of the first course of ibuprofen associated in a composite criterion with the most severe outcomes.The risk of treatment failure increased according to a continuous gradient in SGA neonates. A higher risk was observed on multiple regression analysis (crude OR: 3.8; 95% CI [1.2-12.3] p = 0.02; adjusted OR: 12.8; 95% CI [2.3-70.5] p=0.003.There is a linear relationship between infant birth weight and PDA treatment: the failure rate of a first course of ibuprofen increases with increasing degree of growth restriction.

  16. Microinvasive iigation of patent ductus arteriosus: Report of 13 cases%微小切口结扎动脉导管未闭(附13例报告)

    Institute of Scientific and Technical Information of China (English)

    李香伟

    2001-01-01

    Objective: To study the significance of patent ductus arteriosus (PDA)ligating through microinvasive vertical cut trans-left oxter. Methods: Thirteen children with PDA received ligation through microinvasive vertical cut trans-left oxter. Which was thoracotomy through a 5 cm cut in fourth intercostal space followed by rutine PDA ligating.Results:All operations got good exposure and smooth completion. Patients hadless complications and no death. Conclusion:Microinvasive vertical cut trans-left oxter with occult apparence and satisfactory result is particularly suitable for ligation of children with PDA.%目的:探讨左腋下微小切口结扎动脉导管未闭(PDA)的临床应用。方法:本组对13例小儿PDA应用左腋下微小直切口结扎术,切口以第4肋间上下延长共约5cm进胸后常规行PDA结扎术。结果:全组术野显露良好,术中经过顺利,术后并发症少,无死亡。结论:左腋下微小切直切口手术径路隐蔽美观,效果满意,特别适合小儿PDA结扎,值得临床推广。

  17. 单纯超声心动图引导下行动脉导管未闭封堵术的安全性和有效性%Safety and efficacy of percutaneous patent ductus arteriosus closure solely under thoracic echocardiography guidance

    Institute of Scientific and Technical Information of China (English)

    潘湘斌; 欧阳文斌; 李守军; 郭改丽; 刘垚; 张大伟; 张凤文; 逄坤静; 方能新

    2015-01-01

    目的 探讨超声心动图作为唯一影像学工具引导动脉导管未闭封堵术的安全性和有效性.方法 2013年6月至2014年6月,连续入选单纯动脉导管未闭患者30例,年龄(6.3±2.5)岁,体质量(22.5±7.3)kg,动脉导管直径(3.8 ±0.9)mm.患者均在经胸超声心动图引导下经股动脉行动脉导管未闭封堵术,封堵后以超声心动图评价治疗效果.术后1个月在门诊随访.结果 30例患者均成功在超声心动图引导下完成动脉导管未闭封堵术,手术操作时间为(32.8±5.7) min,Amplatzer ADOⅡ封堵器直径(4.9 ±1.0)mm.6例患者术后早期有微量残余分流,无外周血管损伤及心脏穿孔等并发症.所有患者均康复出院,住院时间为(3.4±0.7)d.术后1个月随访,患者均无残余分流、心包积液等并发症.结论 单纯超声心动图引导下经股动脉行动脉导管未闭封堵术安全、有效,能避免使用X线和对比剂.%Objective To avoid the radiation injuries and use of contrast agent,we assessed the safety and efficacy of percutaneous patent ductus arteriosus closure solely under thoracic echocardiography guidance.Methods From June 2013 to June 2014,thirty patients (mean age:(6.3 ± 2.5) years,mean body weight:(22.5 ± 7.3) kg) with pure patent ductus arteriosus were continuously included in this study.The mean diameter of patent ductus arteriosus was (3.8 ± 0.9) mm.Patients were all treated by percutaneous patent ductus arteriosus closure via right femoral artery solely under thoracic echocardiography guidance.The efficacy of the procedure was evaluated by thoracic echocardiography.Follow-up was performed at one month after procedure.Results All 30 cases were successfully treated with percutaneous patent ductus arteriosus closure solely under thracic echocardiography guidance.The procedural time was (32.8 ± 5.7) minutes.The mean diameter of Amplatzer ADO Ⅱ was (4.9 ± 1.0) mm.Postoperative trivial residual shunt occurred in six patients

  18. Evaluation of the efficacy and safety of oral ibuprofen suspension in treatment of neonatal patent ductus arteriosus%布洛芬治疗新生儿动脉导管未闭的有效性及安全性评价

    Institute of Scientific and Technical Information of China (English)

    门晓英; 张丽范

    2010-01-01

    目的 评价口服布洛芬混悬剂治疗新生儿动脉导管未闭的有效性及安全性. 方法 将2006年1月至2009年12月收治的新生儿动脉导管未闭128例作为观察组,口服布洛芬混悬剂治疗;将2003年1月至2005年12月收治的新生儿动脉导管未闭92例作为对照组,采用吲哚美辛治疗;比较两组患者的疗效及不良反应发生情况. 结果 观察组的关闭情况明显优于对照组,且不良反应发生率明显少于对照组,两组比较,差异均有统计学意义(均P<0.05). 结论 口服布洛芬混悬剂治疗新生儿动脉导管未闭疗效满意,且不良反应少,值得临床推广应用.%Objective To observe the efficacy and safety of oral ibuprofen suspension in treatment of neonatal patent ductus arteriosus. Methods From January 2006 to December 2009 in our hospital,128 cases with neonatal patent ductus arteriosus were accepted as the observation group,treated with oral Ibuprofen Suspension:from January 2003 to December 2005 in our hospital,92 cases with neonatal patent ductus arteriosus were accepted as the control group,treated with lndomethacin.Efficacy and adverse reaction of two groups were compared. Results The closure of the observation group was better than the control group,and the incidence of adverse events was less than the control group,the differences between two groups were statistically significant(P<0.05). Conclusion Oral ibuprofen suspension in treatment of neonatal patent ductus arteriosus had satisfactory effect and less adverse reaction,it was worthy of clinic application.

  19. Medical Cost Management of Single Clinical Pathway in Patients with Patent Ductus Arteriosus%动脉导管未闭单病种临床路径的成本管理

    Institute of Scientific and Technical Information of China (English)

    杨仲毅; 杨锐; 李玉秀; 郑莹

    2011-01-01

    Objective To investigate the effect of single clinical pathway on hospital stay and medical cost in children with patent ductus arteriosus(PDA) so as to develop a reasonable control system of disease and cost for enhancing the quality of disease management and disease cost control. Methods From February 2007 to June 2010,112 PDA children were enrolled in the study. According to odd-even days of the hospitalization sequence,all the patients were divided into routine treatment group(n=52) and clinical pathway group(n=50). The patients in the routine treatment received the routine diagnosis and treatments. While the patients in the clinical pathway group were diagnosed and treated with "PDA occluder standardized patient clinical pathway process" and "PDA occluder clinical path form". Comparisons were conducted on the examination fees , inspection fees, medication costs , medical expenses , hospitalization dates , and other related contents in all the patients. Results Compared with the routine treatment group,the average length of stay of children was decreased in the clinical pathway group (P<O.05) ;the inspection fees during hospitalization, drugs, other fees and total expenses were also significantly decreased(P<O.05). Conclusion The implementation of the clinical pathway can effectively improve the quality of medical management and control medical costs.%目的 探讨单病种临床路径管理对动脉导管未闭(patent ductus arteriosus,PDA)患儿的住院时间和费用的影响,以制定合理的病种费用控制体系,加强病种质量管理和病种费用控制.方法 选择2007年2月至2010年6月住院的PDA患儿共112名,按住院单双日分为常规治疗组52例,临床路径组60例.常规治疗组采用常规诊断和治疗方案;临床路径组采用和规范治疗流程进行诊断和治疗.对比两组患者的检验费用、检查费用、用药费用、医疗费用、住院日期等相关内容.结果 与常规治疗组相比,临床路

  20. Avaliação tomográfica pulmonar tardia em prematuros com displasia broncopulmonar e persistência de canal arterial Late pulmonary tomography assessment in premature infants with bronchopulmonary dysplasia submitted to patent ductus arteriosus managemnent

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    Lilian Beani

    2007-12-01

    Full Text Available OBJETIVO: Avaliação tomográfica do parênquima pulmonar de crianças nascidas prematuras de muito baixo peso, com persistência do canal arterial submetidas a tratamento clínico ou cirúrgico e que apresentaram displasia broncopulmonar. MÉTODOS: Entre dezembro de 2006 e janeiro de 2007, 14 crianças foram submetidas à tomografia computadorizada de alta resolução (TCAR, que nasceram prematuras, peso inferior a 1500 gramas, com displasia broncopulmonar (DBP e persistência do canal arterial (PCA, os quais necessitaram tratamento para oclusão do canal, sendo divididos em dois grupos: A - clínico (n = 6 e B - cirúrgico (n = 8. Nove pacientes eram do sexo masculino e cinco, do feminino, com idade média de 36,5±4,3 meses. As TCAR foram analisadas por dois observadores independentes e as lesões quantificadas em cada paciente. Para análises estatísticas, foi utilizado o teste de Mann-Whitney e considerados significantes valores de pOBJECTIVE: To assess through high-resolution computed tomography the pulmonary parenchyma of children prematurely born with both very low birth weight and patent ductus arteriosus submitted to medical or surgical treatment that developed bronchopulmonary dysplasia. METHODS: Between December 2006 and January 2007, 14 children prematurely born with a weight less than 1500g with bronchopulmonary dysplasia (BPD and patent ductus arteriosus (PDA were submitted to high-resolution computed tomography (HRCT. All of them underwent surgical closure of the canal divided into two groups: A - medical (n=6 and B - surgical (n=8. The pool of patients comprised 9 baby boys and 5 girls who were 36.5±4.3 month-old. The HRCT were analyzed by two independent observers and quantified in each patient. The statistical analyses were assessed using the Mann-Whitney test, and p<0.05 was considered statistically significant. RESULTS: Three patients presented normal tomographies, being two of A group and one of B. In A, the most

  1. Dissecção e rotura da artéria pulmonar associada a persistência do canal arterial: relato de um caso Dissection and rupture of pulmonary artery associated to patent ductus arteriosus: case report

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    Mabel de Moura Barros Zamorano

    1987-08-01

    Full Text Available É descrito um caso de dissecção da artéria pulmonar, com rotura intrapericárdica e tamponamento cardíaco, em menina de 13 anos de idade, portadora de canal arterial grande e valva pulmonar bicúspide. Havia hipertensão pulmonar com arteriopatia plexogênica grave; nas grandes artérias elásticas, a camada média tinha alterações necróticas e reparadoras profundas. Discute-se o papel da medionecrose, condição que é exacerbada pela hipertensão e por características individuais, na patogenia do aneurisma dissecante e no caso em questão. A análise da literatura mostra que, na artéria pulmonar, a dissecção é sempre um acidente fatal, por rotura ou obstrução arterial. O tratamento desta intercorrência, eminentemente cirúrgico, raramente é possível, devido ao caráter fulminante da evolução e à ausência de sinais definidos para o diagnóstico em tempo hábil.The author presents a case of a 13-year old girl with pulmonary trunk dissection and rupture with a cardiac tamponade. There was a ductus arteriosus persistent and a non stenotic bicuspid pulmonary valve. A plexogenic pulmonary arteriopathy and severe process of injury and repair in the elastic vessels are present. The significance of medionecrosis in the pathogenesis ot pulmonary dissection is discussed. An analysis of reports in dissecting pulmonary aneurysm reveals a fatal outcome in the vast majority of them, due either to arterial rupture or obstruction.

  2. Tratamento da persistência de canal arterial em recém-nascidos prematuros: análise clínica e cirúrgica Patent ductus arteriosus treatment in the premature newborn: clinical and surgical analisys

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    Rafael Fagionato Locali

    2008-05-01

    Full Text Available FUNDAMENTO: O tratamento cirúrgico da persistência de canal arterial é indicado quando a intervenção clínica fracassa. No entanto, esse tratamento não é livre de complicações. OBJETIVO: Analisar aspectos clínicos e cirúrgicos envolvidos no tratamento da persistência do canal arterial, em recém-nascidos prematuros. MÉTODOS: No período de janeiro de 2000 a junho de 2006, foram analisados 22 recém-nascidos prematuros submetidos a tratamento cirúrgico para persistência de canal arterial. Do total de pacientes, 77,3% eram do sexo feminino, com peso médio ao nascimento de 952,5 g e idade gestacional média de 27 semanas. O uso de agentes vasoativos, indometacina, parâmetros ecocardiográficos e complicações, nos períodos pré e pós-operatórios, foi avaliado. RESULTADOS: Na casuística avaliada, 59,1% dos pacientes necessitaram de intubação orotraqueal ao nascimento; 77,3%, de surfactante; e 59,1% usaram agentes vasoativos no pré-operatório. O número médio de aplicações de indometacina foi de 3,4, com dosagem variando de 0,1 a 0,25 mg/kg/dia. O calibre médio do canal arterial foi de 1,96 mm. O procedimento cirúrgico foi realizado por abordagem extrapleural em 59,1% dos casos, e no pós-operatório o tempo médio de intubação foi de 30,9 dias, com emprego de agentes vasoativos em 50% dos pacientes. Observaram-se 18,1% de complicações pós-operatórias não-fatais. CONCLUSÃO: Mais da metade dos pacientes necessitou de intubação orotraqueal ao nascimento, emprego de surfactante e agentes vasoativos no período pré-operatório. Houve maior prevalência de abordagem extrapleural durante o ato operatório. No período pós-operatório, houve menor demanda de agentes vasoativos e não houve óbitos diretamente relacionados ao procedimento cirúrgico.BACKGROUND: The surgical treatment of patency ductus arteriosus is indicated when the clinical intervention fails. However, this treatment may have some complications

  3. 口服对乙酰氨基酚治疗早产儿动脉导管未闭的效果及安全性%Effect and safety of oral paracetamol in premature infants with patent ductus arteriosus

    Institute of Scientific and Technical Information of China (English)

    赵捷; 杨传忠; 张谦慎; 连朝辉; 董国庆

    2014-01-01

    目的:探讨口服对乙酰氨基酚治疗早产儿动脉导管未闭(patent ductus arteriosus,PDA)的效果及安全性。方法:采用前瞻性对照研究方法观察PDA早产儿治疗临床资料,72例经心脏彩超诊断有临床表现的 PDA 的早产儿分为口服对乙酰氨基酚治疗组(18例)和口服布洛芬对照组(54例),观察两组 PDA 关闭率、副作用及并发症。结果:治疗组和对照组总关闭率分别为66.7%(12例)和70.4%(38例),差异无统计学意义(χ2=0.087,P=0.768)。除但治疗组高胆红素血症发生率低于对照组外(P<0.05),两组患儿在少尿、NEC、肾功能异常、IVH3-4级发生率寄消化道出血等药物副作用方面的差异均无统计学意义(P>0.05)。结论:对乙酰氨基酚在治疗PDA方面的疗效与布洛芬接近,且高胆红素血症发生率低,适合于在临床推广应用。%Objective To investigate the clinical effect and safety of paracetamol in premature infants with patent ductus arteriosus(PDA). Method A protrospective comparsion study was performed onthe data of premature infants with PDA. Seventy-two premature infants with echocardiographically comfirmed PDA were randomized into the oral paracetamol group(n1=18) and the ibuprofen group(n2=54), and the rate of ductal closure, side effects and complications were compared between the two groups. Results The ductus was 66.7% (12 infants) in the paracetamol group, which was similar to 70.4% (38 cases) in the ibuprofen group, with no significant difference(χ2=0.087,P=0.768).Except for the incidence of hyperbilirubinemia in the paracetamol group was higher than that in the ibuprofen group (P0.05), including oliguria,NEC,renal impairment,the incidence of IVH3-4 and gastrointestinal bleeding. Conclusions The clinical effect of paracetamol in premature infants with PDA is similar to that of ibuprofen , withlower incidence of hyperbilirubinemia, and

  4. Therapy of patent ductus arteriosus in very-low-birth-weight premature infants%极低体重早产儿动脉导管未闭的治疗

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    朱燕林; 郭立琳; 徐瑞燚; 朱文玲; 苗齐

    2011-01-01

    目的:探讨极低体重早产儿动脉导管未闭(PDA)的治疗方法.方法:本研究回顾性分析6例经外科手术治疗的PDA的极低体重早产儿的临床特点.结果:4例患者布洛芬治疗失败、2例患者因药物禁忌行动脉导管结扎术,术后由对呼吸机依赖转为3~4 d过渡脱机,胃肠内喂养耐受性及体重增加显著改善[(45±41)∶(258±77)g/周,P<0.001],5例存活患者均无手术并发症,1例患者死于早产儿并发症.结论:对于有手术指征的PDA的极低体重早产儿,外科手术结扎是安全而有效的方法.%To explore the therapy of patent ductus arteriosus (PDA) in very low birth weight pre mature infants. Method: Clinical features of six very low birth weight premature infants who underwent surgical ligation of PDA were analyzed. Result:Six infants underwent surgical closure of PDA after failure (4/6) of or hav ing contraindications (2/6) to medical treatment. Five infants who were ventilator dependent stopped ventilator use in 3 -4 days after operation. Surgical ligation of PDA improved enteral feeding tolerance and body growth [45 + 41]g/week vs [258+77]g/week, P<0. 001). There was one death caused by complications of prematurity af ter operation. Conclusion; Surgical ligation is safe and effective for PDA in very low birth weight premature infantswith indication.

  5. 动脉导管未闭患儿TFAP-2B基因突变的研究%Mutation of TFAP-2B gene in patients with patent ductus arteriosus

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    陈轶维; 赵武; 李奋; 吉炜; 傅启华; 张志芳; 王剑

    2010-01-01

    目的 发现我国动脉导管未闭(patent ductus arteriosus,PDA)患儿分子遗传方面缺陷,为PDA早期预防及遗传咨询提供支持.方法 收集100例单纯性PDA患儿的临床资料和外周静脉血样本,以100名健康儿童为对照.应用聚合酶链式反应(polymerase chain reaction,PCR)扩增TFAP-2B基因的全部外显子和外显子两侧部分内含子,并对扩增片段进行双向测序.应用BLAST程序将所测TFAP-2B基因序列与GeneBank中的已知序列进行对比以检测基因突变.采用逆转录聚合酶链式反应(reverse transcription polymerase chain reaction,RT-PCR)对1例家族史阳性患儿及其家属共16人TFAP-2B部分cDNA片段进行扩增,扩增产物直接进行双向序列测定.结果 基因分析显示,在1例家族史阳性患儿及其患病亲属中,TFAP-2B第3内含子剪接位点+5位发生突变[intron3(+5)G>A],患儿TFAP-2B基因部分cDNA巢式PCR扩增结果 提示3号外显子完全缺失.此外,还发现了一个新的单核苷酸多态性,即转录起始点上游第34位的鸟嘌呤变为腺嘌呤,这个多态在PDA患者和健康对照组的频率分布差异有统计学意义(Z=-2.513,P=0.012).结论 TFAP-2B基因突变能够导致家族型PDA.%Objective To identify novel genetic mutations in Chinese patients with congenital patent ductus arteriosus (PDA). Method Clinical data and peripheral blood specimens from a kindred spanning 3 generations in which 5 of 16 individuals had PDA and a cohort of 95 unrelated subjects with PDA were collected, and 100 unrelated healthy individuals were included as controls. The coding exons and flanking introns of TFAP-2B gene were amplified by polymerase chain reaction ( PCR ) with specific primers. We aligned the acquired sequences with which publicized in GenBank by the aid of program BLAST. Reverse transcription-polymerase chain reaction (RT-PCR) was used to amplify the parts of TFAP-2B and sequencing was performed on PCR products forward and reversely

  6. 动脉导管未闭早产儿口服布洛芬治疗中超声心动图监测的价值%Role of echocardiography monitoring in oral ibuprofen for treating patent ductus arteriosus in preterm infants

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    周昕; 左维嵩; 陈俊; 刘廷会

    2013-01-01

    Objective To investigate the value of echocardiography monitoring in oral ibuprofen for the treatment of patent ductus arteriosus(PDA) in preterm infants.Methods A total of 142 preterrn infants within 7 days after birth was randomized into two groups of A(82 cases,teated with oral ibuprofen) and B(60 cases,without ibuprofen).All infants were diagnosed with PDA(<5 mm in diameter of the ductus arteriosus).The closure rate of the ductus was calculated.Results In the cases with diameter of the ductus< 3 mm,the closure rate was 90.3% in group A,which was higher than 67.5% in group B(P<0.05).In the cases with diameter of the ductus 3-5 rnm,the closure rate was 30.0% in group A,which was higher than 15.0% in group B(P<0.05).Conclusion Echocardiography is valuable in evaluating the efficacy of oral ibuprofen therapy and guiding the selection of treatment in preterm infants with PDA.%目的 探讨动脉导管未闭(PDA)早产儿口服布洛芬治疗中超声心动图监测的价值.方法 将生后7d内经超声心动图确诊的PDA早产儿(PDA直径小于5mm) 142例随机分为两组:观察组82例,口服布洛芬治疗;对照组60例,未服用布洛芬.超声心动图监测动脉导管关闭率.结果 观察组PDA直径<3m者,闭合率90.3%,明显高于对照组的67.5% (P<0.05).观察组PDA直径为3-5 mm者,治疗后闭合率30.0%,明显高于对照组的15.0% (P<0.05).结论 超声心动图监测有助于评估PDA早产儿口服布洛芬疗效,并可根据PDA直径大小指导临床治疗.

  7. Nurusing care or a child with lateral pulmonary artery originated from ascending aortic artery in combination with patent ductus arteriosus%单侧肺动脉起源异常合并动脉导管未闭患儿的术后护理

    Institute of Scientific and Technical Information of China (English)

    顾海燕

    2011-01-01

    This paper summarizes the nursing care of a pediatric case with lateral pulmonary artery originated from ascending aortic artery in combination with patent ductus arteriosus. The keypoints of nursing care included continuous monitoring of pulmonary artery pressure,application of Nitric oxide,management of airway and respiratory system,and so on. After meticulous treatment and nursing care,the child was discharged with recovery.%总结1例单侧肺动脉起源于升主动脉合并动脉导管未闭患儿肺动脉高压的护理。护理要点包括:术后持续监测肺动脉压,一氧化氮(NO)的使用,气道管理,呼吸管理等。经过精心治疗与护理,患儿痊愈出院。

  8. B型利钠肽和氮端B型利钠肽原在早产儿动脉导管未闭诊治的研究进展%The use of B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide concentrations to guide diagnosis and treatment of patent ductus arteriosus in preterm infants

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    刘颖; 周于新

    2016-01-01

    早产儿动脉导管未闭(PDA)发病率高,可引发很多并发症,但其诊治和预后判断标准仍存在争议.近期报道B型利钠肽和氮端B型利钠肽原用于早产儿血流动力学显著PDA(hsPDA)的诊断,且有助于其治疗策略的选择和对药物治疗反应的判断,但研究方法和临界值等尚未统一,笔者将国内外B型利钠肽和氮端B型利钠肽原在早产儿动脉导管未闭诊治的研究进展作一综述,为儿科临床及基础研究提供依据.%The high morbidity and compliments of patent ductus arteriosus (PDA) in preterm infants are reported,but the diagnostic and prognostic appraisal of PDA is still debatable.The B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are found efficient in diagnosis of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants,and also helpful in therapy decisions and prediction of treatment response.However,the type of assay and cut-off values have not yet reached a consent,so that further researches are needed.

  9. A CASE OF TRUNCUS ARTERIOSUS

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    Sudeep

    2013-05-01

    Full Text Available INTRODUCTION: TRUNCUS ARTERIOSUS was first recognized in 1798 and account for 0.7-1.2% of all congenital Cardiac malformation. It occurs with equal frequency in males and Females. Truncus has been reported with Trisomy 18, Trisomy 21 and C hromosome 22q11 deletion. It is also been reported with Di George syndrome which include Hype rtelorism, low set ears , Micrognathia, small fish like mouth, short down slanting palpebral fiss ure, absent pinna, cleft lip and high arch palate . In TRUNCUS ARTERIOSUS, a single artery with a singl e semilunar valve leaves the base of heart and gives rise to pulmonary, Systemic and Cor onary circulation. The single arterial trunk receives blood from both the ventricle so a ventric ular septal defect is obligatory. Anomalies associated with TA are Right aortic arch, Truncal valve abnormality coronary artery anomaly atresia of Right or left pulmonary a rtery, Atresia of ductus arteriosus, single ventric le, TAPVC, subclavian artery and SVC abnormality. At ti mes Right aortic arch accompanies Truncus Arteriosus.

  10. Coronary fistula resembling patent ductus arteriosus

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    Sgarbieri Ricardo Nilsson

    2003-01-01

    Full Text Available A 14-year-old girl, presenting with heart failure and a continuous murmur, similar to that of a patent arterial duct, was investigated using echocardiogram and cardiac catheterization revealing a left to right shunt throught a coronary artery fistulae between the first septal branch and the right ventricular outflow tract. The patient was submitted to surgery, occluding the anomalous branch by the suturing of its orifice in the right ventricular outflow tract, under cardiopulmonary bypass. After the operation, cardiac catheterization revealed complete occlusion of the fistula without any residual shunt or compromise to the coronary circulation. In seven years of follow-up the patient is completely free of symptoms.

  11. 浅谈超声心动图检测正常胎儿动脉导管血流频谱的定量研究%Quantitative Study on the Detection of Ultrasonic Beckoning Diagram on Blood Flow Spectrum of Fetal Ductus Arteriosus

    Institute of Scientific and Technical Information of China (English)

    朱福海; 彭维绮; 蔡华

    2015-01-01

    目的:探究超声心动图检测在正常胎儿动脉导管血流频谱定量研究中的应用意义。方法:择取本院2012年9月-2014年9月收治的行产前超声检查并分娩的156例正常单胎为研究对象,应用彩色多普勒超声心动图,检测正常胎儿动脉导管,详细观察胎儿各个发育时期动态变化规律。结果:156例正常胎儿均获取相对清晰的动脉导管二维超声心动图与血流频谱图,动脉导管脉冲多普勒频谱呈双峰型;经由回归性分析发现,孕龄与AT、PFVd、PFVs呈正相关(P<0.05)。结论:超声心动图检测在正常胎儿动脉导管血流频谱定量研究中具有至关重要的应用意义,可提供胎儿循环系统生理信息,及早评估胎儿风险值,并及时采取干预措施,临床上应引起足够重视。%Objective:To explore the application of detection of ultrasonic beckoning diagram on blood flow spectrum of fetal ductus arteriosus. Method:To select 156 patients with normal singleton birth for prenatal ultrasonography in our hospital from September 2012 to September 2014 as the research objects,application of color doppler ultrasound beckoning diagram,detection of normal fetal ductus arteriosus,variation rules of dynamic observation of the fetal period with different development. Result:156 patients with normal fetal ductus were obtain two-dimensional ultrasound relatively clear beckoning with color Doppler flow spectrum,transcatheter arterial pulse doppler spectrum showed a bimodal pattern;through regression analysis,related to gestational age and AT,PFVd,PFVs positive(P<0.05). Conclusion:The application of graph is of vital significance of beckoning detected in normal fetal ductus arteriosus blood flow spectrum in quantitative study of ultrasound,fetal circulation system can provide physiological information,early assessment of fetal risk value,timely intervention,clinical attention should be paid.

  12. 导管介入封堵术与外科手术治疗动脉导管未闭的疗效分析%Analysis of the effect of transcatheter closure and surgical operation treatment of patent ductus arteriosus

    Institute of Scientific and Technical Information of China (English)

    杨房

    2015-01-01

    目的:探究导管介入手术与外科手术治疗动脉导管未闭的疗效。方法选取2013年2月~2014年2月在我院已经被确诊的动脉导管未闭患者70例作为研究对象,依据治疗方式不同分为实验组和对照组,对照组患者接受导管介入封堵手术,实验组患者接受外科手术,术后分析两组患者的各项临床指标。结果对照组患者术后完全封堵率100%与实验组97.1%的完全封堵率之间的差异无统计学意义(P>0.05);但是对照组的并发症发生率、住院时间及住院费用均明显低于实验组患者,两组患者的上述数据之间的差异具有统计学意义(P<0.05)。结论相比于导管介入封堵术,外科手术治疗导管未闭具有并发症低、效果好、安全等优点,值得在今后的临床治疗中继续推广使用。%Objective To explore the clinical effect of interventional operation and surgical operation treatment of patent ductus arteriosus.Methods Select cases of patent ductus arteriosus diagnosed patients as the research object in our hospital, the patients were divided into the experimental group and the control group, the control group patients received transcatheter closure operation, patients in the experimental group received surgical operation, heart function in the patients of the two groups of postoperative changes.Results The control group of patients after the difference between the fully complete closure plugging rate and the rate of the experimental group was not significant(P>0.05). But the control group the incidence of complications, length of hospital stay and hospital costs were signiifcantly lower than those of the patients in the experimental group, the differences between the two groups of data were statistically significant(P<0.05).Conclusion Compared to the catheter interventional therapy, surgical treatment of patent ductus arteriosus has the advantages of less complications and good effect

  13. Surgical Treatment of Patent Ductus Arteriosus Associated with Pulmonary Hypertension under Profound Hypothermia and Extracorporal Circulation with Low Flow Perfusion%深低温低流量体外循环下动脉导管未闭合并肺动脉高压的手术治疗

    Institute of Scientific and Technical Information of China (English)

    高秉仁; 姚忠喜; 张志芳; 高百顺; 辛军; 岳凤珍

    1991-01-01

    本文报告了36例动脉导管未闭合并重度肺动脉高压采用深低温低流量体外循环下手术治疗的体会.全组中死亡1例,其余随访6年至半年,均获满意疗效.本文着重讨论了手术安全性,适应证,心肌保护和灌注肺的预防等问题.%This paper reports the operations on 36 cases of patent ductus arteriosus (PDA) associated with severe pulmonary hypertension (PH) under profound hypothermia and cardiopulmonary by-pass (CPB) with low flow perfusion.Thirty five cases recovered promptly but one died of ventricular fibrillation which was nothing to do with hypothermia and low flow perfusion.Vertical incision on the anterior wall of pulmonary artery was made to expose the orifice of PDA.Mattress sutures and pledget were used for repair.Sutures bite the prominent posterior edge of PDA orifice,passing through the anterior wall of the pulmonary artery,and tied on the pledget outside the vessel.Open-heart surgery is preferable to PDA with severe pulmonary hypertension.The authers emphasize the importance of myocardial protection and "infusion lung" prevention.

  14. 超声心动图血流参数预测早产儿动脉导管早期自然关闭的价值%The value of echocardiography flow parameters in predicting spontaneous closure of patent ductus arteriosus in preterm infants

    Institute of Scientific and Technical Information of China (English)

    容跃; 杨正春; 冉素真; 黄泽君

    2015-01-01

    Objective To investigate the value of echocardiography flow parameters in predicting spontaneous closure of pa-tent ductus arteriosus(PDA) in preterm infants .Methods We conducted prospective study on 130 preterm infants who born in Chongqing Health Center for Women and Children from October 2013 to December 2014 .They were accepted echocardiographic ex-aminations at 72 h and 7 d .They were be divided into two groups according to whether spontaneous closure of ductus arteriosus happen with in 7 days after birth (the control group) or not (the PDA group) .The echocardiographic flow parameters were com-pared between the two groups .we measured the pulmonary artery pressure ,The differential pressure descending aorta and pulmona-ry artery and patent foramen shunt rate for the first examination which should must be finished 24 h after birth .Results (1) PDA group compared with control group :① the differential pressure descending aorta and pulmonary artery in PDA group were lower than the control group(P< 0 .001) ;② the pulmonary artery in PDA group were higher than the control group(P < 0 .001) ;③ the patent foramen shunt rate in PDA group were lower than the control group(P< 0 .05) ;(2)The best critical points of the differential pressure descending aorta and pulmonary artery ,the patent foramen shunt rate ,and the pulmonary artery to predict whether ductus arteriosus could be spontaneous closed in preterm infants were 19 .69 mm Hg ,33 .76 mm Hg and 57 .16 cm/s .Conclusion The echocardiographic flow parameters has great significantly in predicting whether ductus arteriosus could be spontaneous closed early in preterm infants .%目的:探讨超声血流参数预测早产儿动脉导管早期是否自然关闭的价值。方法对2013年10月至2014年12月在重庆市妇幼保健院住院且生后24 h 内进行超声心动图检查有动脉导管未闭(PDA)的早产儿130例进行前瞻性研究,分别于72 h 及7 d 对早产

  15. Unexpected occluder dislocation after transcatheter closure of patent ductus arteriosus in two patients%动脉导管未闭介入堵闭后封堵器非常规脱落二例

    Institute of Scientific and Technical Information of China (English)

    刘振江; 沈向前; 赵延恕; 方臻飞; 胡信群; 刘启明; 周胜华

    2009-01-01

    @@ 动脉导管未闭(patent ductus arterious,PDA)属婴幼儿常见先心病,近年介入治疗合并肺动脉高压(pulmonary artery hypertension,PAH)的PDA也已取得较好的疗效.但近期我院有2例合并PAH的PDA患者在封堵后第2天封堵器意外脱落,经努力2例均经导管将脱落封堵器取出,现就其经验教训做一报道.

  16. 不同方法评价56例动脉导管未闭患者左心室功能的比较%Comparison of different methods in assessment of left ventricular function in patients with patent ductus arteriosus

    Institute of Scientific and Technical Information of China (English)

    梁梅馨; 林建军; 黄培隽; 翟璐璐

    2015-01-01

    ObjectiveTo evaluate the accuracy and superiority of real-time three-dimensional echocard-iography (RT-3DE) in the assessment of left ventricular function in patients with patent ductus arteriosus (PDA), and to explore the clinical value.MethodM-mode echocardiography (ME), two dimensional echocardiography (2DE) simpson method and RT-3DE examination were performed on 56 PDA patients, 48 healthy volunteers respectively to determine left ventricular mass index (LVMI), left ventricular end-diastolic volume index (LVEDVI) and left ventricular ejection fraction (LVEF).ResultLVMI and LVEDVI in patients with PDA were more than health volunteers, and the differences were statistically signiifcant (P<0.05). Patient with PDA, LVMI, LVEDVI and LVEF measured by RT-3DE was less than which measured by ME, but larger than which measured by 2DE, and the differences were statistically signiifcant (P<0.05).Conclusion Compared with ME and 2DE, RT-3DE is a reliable means to estimate the index of left ventricular function accurately. RT-3DE played a signiifcant role in assess the left ventricle function.%目的:探讨实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)评价动脉导管未闭(patent ductus arteriosus,PDA)患者左心室功能的准确性及优越性。方法分别采用M型超声(M-mode echocardiography,ME)、二维超声(two dimensional echocardiography,2DE)及RT-3DE测算PDA患者(PDA组,56例)和健康志愿者(正常对照组,56例)的左心室心肌质量指数(left ventricular mass index,LVMI)、左心室舒张末期容积指数(left ventricular end-diastolic volume index,LVEDVI)、左心室射血分数(left ventricle ejection fraction,LVEF)。结果 PDA组患者LVMI及LVEDVI大于正常对照组(P<0.05)。PDA组患者LVMI、LVEDVI及LVEF的ME测值大于RT-3DE测值,2DE测值小于RT-3DE测值(P<0.05)。结论与ME、2DE相比,RT-3DE可以准确测

  17. Surgical mini-incision treatment of patent ductus arteriosus of premature infants with titanium clip in 110 cases%床旁微创小切口钛夹闭合早产儿动脉导管110例临床分析

    Institute of Scientific and Technical Information of China (English)

    付松; 封志纯

    2013-01-01

    Objective To investigate the clinical effects of surgical small incision treatment of patent ductus arteriosus (PDA) in premature infants with titanium clip.Methods One hundred children received and cured by our hospital from January 2010 to January 2013 were divided into two groups.Group A:body weight > 1.5 kg of patent ductus arteriosus (PDA),71 cases of premature children; group B:body weight < 1.5 kg of low body weight preterm the children PDA,29 cases.The operations were performed in the newborn intensive care unit (NICU).The patient was placed in a lateral position with the left arm abduction under general anesthesia.A 1.5-2.5 cm long posterolateral mini-thoracotomy was made and the pleural cavity was entered via the 2-3rd intercostal space.The PDA was closed with two titanium clips.Results Ninety-nine cases were cured,1 died.2 residual shunt postoperatively.One patient on postoperative 5 day was found wound infected,wound healing after the use of antibiotics by intravenous.There was no significant difference in incidence of postoperative complications and mortality rate between group A and group B (P > 0.05).Majority of children successfully weaned from the ventilator due to the rapid improvement of hemodynamics and lung conditions.In group B,mechanical ventilation time (12.6 ± 7.5) d and postoperative hospital stay (21.0 ± 15.4) d was significantly longer than group A ((9.6 ± 4.2) d and (12.0 ± 10.8) d),the difference between the two groups was significant (t =7.35,9.12,P < 0.05).Conclusion (1) It is a viable treatment that bedside minimally invasive titanium clip closed ductus arteriosus in preterm children PDA.(2) As the treatment of low body weight premature children is poor,the tolerance of the surgical trauma of the surgery as a minimally invasive,simple method is particularly suitable for low body weight premature children PDA.%目的 探讨床旁微创小切口钛夹闭合早产儿动脉导管的临床疗效.方法 将2010年1月至2013

  18. Aspectos biofarmacêuticos da formulação de medicamentos para neonatos: fundamentos da complexação de indometacina com hidroxipropil-beta-ciclodextrina para tratamento oral do fechamento do canal arterial Biopharmaceutical aspects of drug formulation for neonatology: rational for indomethacin's complexation with hydroxypropyl-beta-cyclodextrin to treat patent ductus arteriosus

    Directory of Open Access Journals (Sweden)

    Ana Cristina Ribeiro Rama

    2005-09-01

    alternative to prepare oral formulations. With this review we intend to evaluate the rational for using indomethacin's complexation with hydroxypropyl-beta-cyclodextrin, to enhance bioavailability and reduce gastric toxicity characteristics, allowing its oral administration to treat patent ductus arteriosus on preterm and full-term newborns.

  19. Radiologic findings of truncus arteriosus; incidence and associated anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyeon Kyeong; Yeon, Kyung Mo; Kim, In One; Choe, Du Whan; Lee, Kyung Hwan [Seoul National University College of Medicine, Seoul (Korea, Republic of); Choe, Young Hi; Choe, Yun Hyun [Sejong General Hospital, Bucheon (Korea, Republic of); Choi, Yo Won [Armed Forces Chungpyung Hospital, Chungpyung (Korea, Republic of); Ahn, In Ok [Kumkang Hospital, Seoul (Korea, Republic of)

    1992-01-15

    Truncus arteriosus is characterized by a single arterial vessel arising from the base of the heart and giving origin to the systemic, pulmonary and coronary circulation. To evaluate the incidence, types, and associated anomalies, 18 cases of truncus arteriosus diagnosed by angiocardiography, were reviewed and were compared with other reports. Ten of them were confirmed by operation. The overall incidence of truncus arteriosus was 0.127%. According to Collett and Edwards classification, type I was encountered in 11 cases (61%), type II in 4 cases (22%), and type III in 3 cases (17%). All the patients had subtruncal ventricular septal defects. Eight patients showed truncal valve regurgitation and valve stenosis was noted in one case. A right aortic arch was present in 9 cases. Associated anomalies were atrial septal defect (8 cases), patent ductus arteriosus (3 cases), coarctation of the aorta (2 cases), isolation of the left subclavian artery (2 cases) and right aortic arch with an aberrant left subclavian artery (1 case). Truncus arteriosus is an uncommon congenital cardio vascular malformation. In the group of cases which we encountered, type I was the most common anomaly. Frequently associated anomalies were right aortic arch, incompetent truncal valve and atrial septal defect.

  20. Evaluation of therapeutic effects and safety of different treatment methods for premature patent ductus arteriosus%不同治疗方式对早产儿动脉导管未闭的疗效及安全性评价

    Institute of Scientific and Technical Information of China (English)

    陈丹; 毛健

    2015-01-01

    ObjectiveTo explore the clinical treatment methods and their effects in the treatment of premature patent ductus arteriosus (PDA) and to summarize the experience of surgical treatment for PDA.MethodsNineteen premature infants who were diagnosed with PDA and received surgical treatment betwen January 2013 and December 2014 were selected as the surgical group, and 19 premature infants with PDA who did not receive surgical treatment during the same period were selected as the non-surgical group. The differences in medical history, clinical conditions, mortality, and major complications between the two groups were analyzed, and the characteristics of surgical treatment and its clinical effects were analyzed from the aspects of preoperative preparation and surgical results.Results Compared with the surgical group, the gestational age and birth weight in the non-surgical group were significantly greater (P1.3, and the square of catheter diameter/birth weight (d2/BW) ratio >9 mm2/kg in the surgical group was signiifcantly higher than in the non-surgical group (P0.05).ConclusionsFor premature infants with clinical symptoms and no improvement after conservative medical treatment or drug therapy, surgical ligation is a relatively safe and effective treatment method for PDA.%目的:探讨早产儿动脉导管未闭(PDA)的临床治疗方式及效果,总结手术治疗PDA的经验。方法2013年1月至2014年12月诊断为PDA并行手术治疗的早产儿19例为手术组,同期未行手术治疗的19例PDA早产儿为非手术组。分析两组在病史因素、临床因素、病死率及主要并发症等方面的差异,同时从术前准备及手术结果方面分析手术治疗的特点及临床效果。结果非手术组早产儿胎龄及出生体重均大于手术组(P1.3及导管直径的平方/出生体重(d2/BW)比值>9 mm2/kg的发生率均高于非手术组(P0.05)。结论对有临床症状且内科保守治疗或药物治疗无好转的早

  1. Comparação de ibuprofeno via oral e indometacina intravenosa no tratamento da persistência do canal arterial em neonatos com extremo baixo peso ao nascer Comparison of oral ibuprofen and intravenous indomethacin for the treatment of patent ductus arteriosus in extremely low birth weight infants

    Directory of Open Access Journals (Sweden)

    Eun Mi Yang

    2013-02-01

    Full Text Available OBJETIVO: Existem poucos relatórios publicados com relação à eficácia do ibuprofeno via oral no tratamento da persistência do canal arterial (PCA em neonatos com extremo baixo peso ao nascer (EBPN. Comparamos o ibuprofeno via oral à indometacina intravenosa no que diz respeito à eficácia e segurança no tratamento de PCA em neonatos com peso inferior a 1.000 g ao nascer. MÉTODO: Este foi um estudo retrospectivo em um único centro. Coletamos dados de neonatos com EBPN que tiveram PCA ecocardiograficamente confirmada. Os neonatos foram tratados tanto com indometacina intravenosa quanto com ibuprofeno via oral. A taxa de fechamento do canal, a necessidade de tratamentos adicionais, os efeitos colaterais ou as complicações relacionadas ao medicamento e a mortalidade foram comparados entre os dois grupos de tratamento. RESULTADO: Examinamos 26 neonatos que receberam indometacina e 22 que receberam ibuprofeno. A taxa geral de fechamento do canal foi semelhante nos dois tratamentos: o fechamento do canal ocorreu em 23 dos 26 neonatos (88,5% no grupo indometacina, e em 18 dos 22 neonatos (81,8% no grupo ibuprofeno (p = 0,40. A taxa de ligadura cirúrgica (11,5% em comparação a 18,2%; p = 0,40 não diferiu de forma significativa entre os dois grupos de tratamento. Após o tratamento, não foi encontrada nenhuma diferença significativa nas concentrações de creatinina sérica entre os dois grupos. Não houve diferenças significativas com relação a efeitos colaterais ou complicações adicionais. CONCLUSÃO: Em neonatos com EBPN, o ibuprofeno via oral é tão eficaz quanto a indometacina intravenosa no tratamento da PCA. Não há diferenças entre os medicamentos no que diz respeito à segurança. O ibuprofeno via oral poderia ser usado como um agente alternativo no tratamento da PCA em neonatos com EBPN.OBJECTIVE: There are few published reports concerning the efficacy of oral ibuprofen for the treatment of patent ductus arteriosus

  2. Efficacy and safety of oral ibuprofen for closure of patent ductus arteriosus in preterm infants: a meta-analysis%口服布洛芬治疗早产儿动脉导管未闭疗效和安全性的meta分析

    Institute of Scientific and Technical Information of China (English)

    张鹏; 孟靓靓; 程国强

    2013-01-01

    Objective To evaluate the efficacy and safety of oral ibuprofen for closure of patent ductus arteriosus (PDA) in preterm infants.Methods The related literatures till December 31st,2011 in Cochrane Library,PubMed,EMBASE,Ovid,Springer,China Academic Journal Full-text Database,Wanfang Database,VIP Database and China Biological Medical Literature Database were searched.The inclusion criteria were:(1) the subject of the research was preterm infants with birth weight less than 2500 g and/or gestational age less than 37 weeks; (2) randomized or semirandomized controlled trial; (3) the intervention group received oral ibuprofen,while the control group received oral placebos / intravenous indomethacin or ibuprofen; (4) the main outcome was the failure rate of PDA closure; (5) hemodynamic changes with PDA were detected by ultrasonography.Meta-analysis was performed by Review Manager 4.22 software.Results Eleven randomized controlled trials were included,among which,three were high quality reports.Meta-analysis showed lower failure rate of PDA closure in subjects received oral ibuprofen than in those received placebos orally (RR =0.22,95 % CI:0.14-0.35),while the number of infants required operative closure of PDA decreased significantly (RR =0.16,95% CI:0.03-0.86).Further analysis showed the effect of oral ibuprofen was similar to intravenous indomethacin (RR =0.93,95 % CI:0.57-1.53),but better than intravenous ibuprofen (RR=0.42,95%CI:0.26-0.67).However,oral ibuprofen did not reduced the ratio of patients required operation compared with intravenous indomethacin or ibuprofen (RR=0.58,95%CI:0.24-1.41).The incidence of gastrointestinal hemorrhage was higher in oral ibuprofen group than that in placebos(RR=1.99,95%CI:1.13-3.50).The serum level of creatine was lower in oral ibuprofen group than in intravenous indomethacin or ibuprofen group (weighted average=-19.10,95% CI:-25.12-12.31).Compared with intravenous indomethcin group,less necrotizing enterocolitis

  3. The ductus arteriosus : a fetal vessel coming of age

    NARCIS (Netherlands)

    Bökenkamp-Gramann, Regina

    2012-01-01

    In this thesis we have studied various aspects of physiological DA closure and PDA in animal models and humans. We were intrigued by the fact that the DA reacts completely different to the postnatal change in environmental conditions than the adjacent vessels. Therefore we aimed to identify genes an

  4. 31. Left ventricular dysfunction after patent ductus arteriosus (PDA closure

    Directory of Open Access Journals (Sweden)

    Rihab Agouba

    2015-10-01

    Conclusions: Depressed LV-SFx may occur after PDA closure with higher incidence after catheter PDA device occlusion. All of preterm babies had surgical PDA occlusion and none of them presented with depressed LV-SFx in the post-operative follow-up. Further prospective studies are needed to investigate these observations.

  5. Assessment and treatment of post patent ductus arteriosus ligation syndrome.

    LENUS (Irish Health Repository)

    El-Khuffash, Afif F

    2014-07-01

    To compare differences in tissue Doppler imaging, global longitudinal strain (GLS), and cardiac troponin T (cTnT) between infants with low (<200 mL\\/kg\\/min) and high (>200 mL\\/kg\\/min) left ventricular (LV) output 1 hour after duct ligation and assess the impact of milrinone treatment on cardiac output and myocardial performance.

  6. The role of n terminal - probrain natriuretic peptide in the diagnosis of hemodynamic persistent asrteriosus ductus in premature neonates patient

    Science.gov (United States)

    Dasraf, D.; Djer, M. M.; Advani, N.

    2017-08-01

    Persistent ductus arteriosus is one of the most frequent congenital heart diseases found in infants, mainly in preterms. Echocardiography is the gold standard for the diagnosis of hemodynamically significant patent ductus arteriosus (hs-PDA) in preterm neonates. A few studies have suggested that the use of a simple blood assay to detect N-terminal pro-brain natriuretic peptide (NT-proBNP) may be useful in determining the diagnosis and management of hs-PDA. No such studies have been conducted in Indonesia, although the assay kit and characteristics of the patient (gestational age and chronological age) influence the accuracy of NT-proBNP levels in determining hs-PDA. The aim of this study was to determine the association between the NT-proBNP level and the prevalence of hs-PDA in an Indonesian patient population. A cross-sectional study was conducted at Dr. Cipto Mangunkusumo Hospital. PDA was determined using echocardiography in 49 preterm neonates (gestational age <37 weeks and birthweight <2000 g). Subsequently, these patients were divided into three groups: non-PDA, non-hsPDA, and hs-PDA. The blood NT-proBNP level was then determined in the non-hsPDA and hs-PDA groups, and between-group differences were compared. Among the 49 neonates, 33 patients had PDA, and 16 of these had hs-PDA. The results revealed a significant association between the NT-proBNP level and hs-PDA (p < 0.001).

  7. Lupus mimickers.

    Science.gov (United States)

    Calixto, Omar-Javier; Franco, Juan-Sebastian; Anaya, Juan-Manuel

    2014-08-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multisystem organ involvement, heterogeneity of clinical features, and variety in degree of severity. The differential diagnosis is a crucial aspect in SLE as many other autoimmune diseases portray clinical similarities and autoantibody positivity. Lupus mimickers refer to a group of conditions that exhibit both clinical features and laboratory characteristics, including autoantibody profiles that resemble those present in patients with SLE, and prompt a diagnostic challenge in everyday clinical practice. Thus, lupus mimickers may present as a lupus-like condition (i.e., 2 or 3 criteria) or as one meeting the classification criteria for SLE. Herein we review and classify the current literature on lupus mimickers based on diverse etiologies which include infections, malign and benign neoplasms, medications, and vaccine-related reactions.

  8. [Experience in the treatment of patent ductus arteriosus closure at a mexican hospital].

    Science.gov (United States)

    Márquez-González, Horacio; Castro-Contreras, Uriel; Cerrud-Sánchez, Carmen Emma; López-Gallegos, Diana; Yáñez-Gutiérrez, Lucelli

    2016-01-01

    Introducción: la persistencia del conducto arterioso (PCA) representa una de las enfermedades con mayor prevalencia en los hospitales que atienden cardiopatías congénitas (CC). En la actualidad en pacientes mayores de un año de edad el cierre percutáneo es la terapéutica estándar. El objetivo de este trabajo fue conocer la frecuencia, características y tratamiento de PCA en el servicio de Cardiopatías Congénitas en el Hospital de Cardiología del Centro Médico Nacional Siglo XXI. Métodos: en el servicio de Cardiopatías Congénitas del Hospital de Cardiología del CMN SXXI se realizó un estudio descriptivo de 2010 a 2015 de los enfermos que fueron tratados con cierre percutáneo y cirugía de PCA. Se dividieron en las siguientes edades: lactantes, preescolares, escolares, adolescentes y adultos. Se registraron las frecuencias absolutas. Resultados: se seleccionaron 187 pacientes, de los cuales los preescolares y escolares representaron el 60% del total de la muestra. El cierre percutáneo por cateterismo intervencionsta se realizó en 90%; se registró un 2% de complicaciones. Conclusiones: en esta clínica de cardiopatías congénitas, la PCA es tratada por cateterismo intervencionista en la mayoría de las etapas del ser humano, lo que ha registrado mínimas complicaciones.

  9. Transcatheter Closure of Patent Ductus Arteriosus in Adolescents and Adults: A Case Series

    Directory of Open Access Journals (Sweden)

    Sukman Tulus Putra

    2017-02-01

    Full Text Available During 11 years period from January 2005 to December 2015 there were 18 adolescent and adult patients  who underwent transcatheter closure of PDA using PDA Amplatzer Duct Occluder (ADO. There were 9 cases with age of 14 to 18 years and 9 cases with age of more than 18 years where the oldest case was 46 years old. Two cases were male and 16 cases were female. Prior to procedures, clinical assessment, ECG, chest x-ray and transthoracic echocardiography (TTE were performed to confirm the diagnosis of PDA. The procedures of device implantation was performed under conscious sedation in adults and using general anesthesia in adolescents.The size of PDA ranged from 1.6 mm to 11.1 mm. Based on Kritchenko classification, the type of PDA were 15 type A1 and 3type A2. Flow ratio between pulmonary to systemic circulation was between 1.1 and 5.9. The procedure time ranged from 60-189 minutes and the fluoroscopic time 7.1-77.3 minutes. The PA pressure ranged from 22 to 63 mmHg. Immediate results after procedures as seen in angiography showed complete closure in 14 cases and smoky residual shunt or minimal residual shunts in 4 cases, which probably due to the temporary leaking through the devices. In 24 hours, complete closure was achieved in all cases (100% and continued until 1months. At 6 month follow up, there was no residual shunts detected and also there was no significant complications, such as device embolization or recanalization. This case series suggest that transcatheter closure of PDA in adolescents and adults using Amplatzer duct occluder (ADO is effective and has excellent resultswithout significant complication. However, long-term follow up is required to assess long term efficacy and safety.

  10. [Echocardiographic screening vs. symptomatic diagnosis for patent ductus arteriosus in preterms].

    Science.gov (United States)

    Juárez-Domínguez, Gabriela; Iglesias-Leboreiro, José; Rendón-Macías, Mario Enrique; Bernardez-Zapata, Isabel; Patiño-Bahena, Emilia Josefina; Agami-Micha, Sion; Ortega-García, Karla Leticia; Torres-Palomino, Gregory; Delgado-Franco, Dagoberto

    2015-01-01

    Introducción: el objetivo es evaluar el posible beneficio en el tratamiento en el cierre de la persistencia del conducto arterioso cuando se realiza una pesquisa (conducto arterioso (PCA). Se analizaron las características del conducto, la presencia de hipertensión pulmonar y el tratamiento recibido. Se compararon los resultados entre: tardíos (34 a 36 semanas de gestación [SEG]), moderados (30 a 33 SEG) y extremos (conducto entre los grupo. El tratamiento recibido no difirió entre las estrategias en los prematuros moderados y tardíos, pero sí fue más agresivo en los extremos. Conclusiones: la pesquisa de una PCA por ecocardiografía en los infantes pretérmino extremos acorta el tiempo de detección y permite un tratamiento menos agresivo. No lo recomendamos en pretérminos moderados y tardíos.

  11. B-type natriuretic peptide to predict ductus intervention in infants <28 weeks.

    Science.gov (United States)

    Czernik, Christoph; Lemmer, Julia; Metze, Boris; Koehne, Petra S; Mueller, Christian; Obladen, Michael

    2008-09-01

    Patent ductus arteriosus (PDA) is frequent in neonates with gestational age of less than 28 wk. Clinical and echocardiographic signs define hemodynamic significance of PDA, but do not reveal the need for PDA intervention in the first days of life. B-type natriuretic peptide (BNP) has been proposed as a screening tool for PDA in preterm infants. To determine whether BNP can predict the need for PDA intervention, plasma BNP was measured by chemiluminescence immunoassay in 67 preterm infants <28 wk (median 26) on the second day of life in a prospective blinded study. PDA intervention was based on specified clinical and echocardiographic findings. Twenty-four patients (intervention group) received treatment for PDA and 43 patients (controls) remained without intervention. BNP concentrations were higher in the intervention (median 1069 pg/mL) than in the control group (247 pg/mL, p < 0.001). BNP correlated positively with ductal size (R = 0.46, p < 0.001) and atrial/aortic root ratio (R = 0.54, p < 0.001). In conclusion, plasma BNP proved to be a good predictor for ductus intervention (area under the curve: 0.86) with the best cutoff at 550 pg/mL on the second day of life in ventilated infants less than 28 wk gestation (sensitivity: 83%; specificity: 86%).

  12. Surgical correction of truncus arteriosus in infancy.

    Science.gov (United States)

    Sullivan, H; Sulayman, R; Replogle, R; Arcilla, R A

    1976-07-01

    An 8 week old infant with severe heart failure from type 1 truncus arteriosus underwent successful corrective surgery employing the Rastelli procedure with use of deep hypothermia and total circulatory arrest. Postoperative hemodynamic studies showed complete closure of the septal defect, disappearance of truncal stenosis, but presence of mild porcine valve stenosis. This procedure is possible even in very small subjects and is preferable to palliative pulmonary arterial banding.

  13. Estudo anatômico das vias bilíferas em búfalos: comportamento do ductus choledocus, ductus cysticus e vesica fellea. Sistematização do ductus biliferus principalis dexter

    Directory of Open Access Journals (Sweden)

    Wilson Machado de Souza

    1994-06-01

    Full Text Available Os autores estudaram o comportamento do ductus choledocus, ductus cysticus e vesica fellea e a constituição do ductus biliferus principalis dexter, parte das vias bilíferas em 40 búfalas da raça Jaffarabadi, adultas. Os fígados tiveram suas vias biliares injetadas com látex Neoprene 650 e celobar, e o procedimento utilizado pelos autores para evidenciação dos componentes estudados foram a dissecação e radiografias. Nos 40 órgãos analisados constatou-se que o ductus choledocus na maioria (97,5% sem tributários, acolhe num caso isolado (2,5% afluente inominado do lobus quadratus. Este ductus apresenta-se formado pela confluência dos ductus biliferus principalis dexter e do sinister (75%, pela confluência das raízes dorsomedial e ventrolateral mais o ductus biliferus principalis sinister (22,5%, e pela junção do ductus hepaticus e ductus cysticus (2,5%. O ductus cysticus, componente constante do ductus biliferus principalis dexter, associa-se ao ductus biliferus lateralis lobi dextri (67,5%, endereçando-se nas outras glândulas (32,5% a troncos diversos. A vesica fellea em 87,5% das peças mostra-se livre de afluentes, enquanto nas demais dessecações (12,5% recebe duetos hepaticocísticos oriundos apenas do lobus quadratus (5%, simultaneamente do lobus dexter e do lobus quadratus (5%, e unicamente do território lateral do lobus dexter (5%. O ductus biliferus principalis dexter é formado pelo ductus lateralis lobi dextri e ductus cysticus (100% e pelo ductus medialis lobi dextri, ductus dorsalis lobi dextri e ductus processi caudati (92,5%.

  14. Luaran Penutupan Duktus Arteriosus Persisten Transkateter di Rumah Sakit Dr. Hasan Sadikin Bandung

    Directory of Open Access Journals (Sweden)

    Rahmat Budi Kuswiyanto

    2016-12-01

    Full Text Available Transcatheter closure of patent ductus arteriosus (PDA is a treatment of choice with good efficacy, shorter hospitalization, less risks, and chest scar free. The objective of this study was to evaluate the immediate and mid-term outcomes of transcatheter closure of PDA. An analytic descriptive study was peformed on patients underwent transcatheter PDA occlusion in Dr. Hasan Sadikin General Hospital Bandung between May 2011 and June 2014. Evaluation was conducted through clinical examination and echocardiography 24 hours, 1, 3, 6 and 12 months after the procedure. The procedure was successful in 132 PDA patients (42 males and 90 females. The median age, body weight, systolic pulmonary artery pressure, PDA size, flow ratio, fluoroscopy time, and procedure time were 3.9 years, 11.25 kg, 56 mmHg, 3.4 mm, 2.8, 16 minutes, and 67 minutes, respectively. Immediately after the procedure, 54% patients had complete closure, 41% experienced smoky residual shunt and only 5% experienced small residual shunt. The mortality and complication rate was 3.8%. Most of the patients were discharged the next day after the procedure. All patients showed complete closure during followed-up. Transcatheter closure of PDA is safe and effective with shorter hospitalization and minimum complications. [MKB. 2016;48(4:234–40

  15. Thiamine responsive megaloblastic anemia syndrome associated with patent ductus arteriosus: First case report from Kashmir Valley of the Indian subcontinent

    Directory of Open Access Journals (Sweden)

    Mohd Ashraf Ganie

    2012-01-01

    Full Text Available Thiamine responsive megaloblastic anemia syndrome, an autosomal recessive inherited disorder characterized by a triad of anemia, diabetes mellitus and sensorineural deafness is caused by a deficiency of a thiamine transporter protein. The disorder is rare and has not been reported from our community which has high background of consanguinity. We report a six years old girl who presented with diabetes mellitus which remitted after thiamine replacement. The girl in addition had sensorineural deafness, reinopathy, atrial septal defect and megaloblastic anemia which responded to high doses of thymine. This is the first case reported from Kashmir valley and third from India. The presentation and management in such cases is discussed.

  16. Transcatheter closure of tubular type patent ductus arteriosus using Amplatzer® ductal occluder II: a case report

    Directory of Open Access Journals (Sweden)

    Mulyadi M Djer

    2013-10-01

    In recent years, interventional cardiology has become a gold standard therapy for the majority of PDA cases beyond neonatal age. Since its introduction in 1967, many devices and methods have been developed to allow transcatheter closure of virtually all PDAs, regardless of size or configuration. Nevertheless, the tubular shape (type C PDA, which has the highest residual shunt rate, still poses a great challenge for the interventionist.8-10 The second generation of Amplatzer® device occluders (ADO II, released in 2007, has been suggested to be effective in closing tubular PDAs.10 The purpose of this study was to report the initial clinical experience using ADO II to close a tubular type PDA in Indonesia.

  17. Clinical results and radiographic appearance of the Rashkind double umbrella device in patients with occlusion of the ductus arteriosus

    Energy Technology Data Exchange (ETDEWEB)

    Galal, O. [King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)]|[Department of Cardiovascular Diseases, MBC 16, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211 (Saudi Arabia); Sinner, W. von; Azhari, N.; Al-Fadley, F.; De Moor, M.; Boecker, J.; Fawzy, M.E..; Al-Halees, Z. [King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

    1997-12-01

    Background. The Rashkind double umbrella device for patent arterial duct occlusion has been used in many patients. Its radiographic appearance has not been sufficiently described. Objective. To present the varying radiographic appearances of the Rashkind double umbrella device on the chest X-ray. Materials and methods. The chest radiographs of 69 patients (median age 60 months; median weight 17 kg), who underwent closure of their patent arterial duct between March 1990 and August 1994, were reviewed. The following parameters were evaluated: (1) the size of the heart (cardio-thoracic ratio) and pulmonary vessels, (2) the position of the device in AP/PA and lateral projections. The results of occlusion of the patent arterial duct were also reviewed. Results. Sixty-two of 69 (90 %) pa- tients had complete occlusion after a follow-up between 2 months and 3{sup 1}/{sub 2} years. The cardio-thoracic ratio showed significant reduction at follow-up (P < 0.001). The two different size devices could be well differentiated in the AP and the lateral projection. In 14 patients (20 %) the device was in an asymmetrical position. There was no significant correlation between position of the device and success of occlusion in our material. Conclusion. Complete occlusion of the arterial duct using Rashkind double umbrella devices can be achieved in 90 % of our population. In 20 % the device will have an asymmetrical position. There is no correlation between asymmetrical position of the device in the chest radiograph and residual shunting. (orig.) With 7 figs., 12 refs.

  18. Thiamine responsive megaloblastic anemia syndrome associated with patent ductus arteriosus: First case report from Kashmir Valley of the Indian subcontinent.

    Science.gov (United States)

    Ganie, Mohd Ashraf; Ali, Imran; Ahangar, A G; Wani, Mohd Maqbool; Ahmed, Sanjeed; Bhat, Manzoor Ahmed; Seth, Sulaiman; Mudasir, Syed

    2012-07-01

    Thiamine responsive megaloblastic anemia syndrome, an autosomal recessive inherited disorder characterized by a triad of anemia, diabetes mellitus and sensorineural deafness is caused by a deficiency of a thiamine transporter protein. The disorder is rare and has not been reported from our community which has high background of consanguinity. We report a six years old girl who presented with diabetes mellitus which remitted after thiamine replacement. The girl in addition had sensorineural deafness, reinopathy, atrial septal defect and megaloblastic anemia which responded to high doses of thymine. This is the first case reported from Kashmir valley and third from India. The presentation and management in such cases is discussed.

  19. Routine chest drainage after patent ductus arteriosis ligation is not necessary.

    Directory of Open Access Journals (Sweden)

    Samuel Kai San YAPP

    2010-12-01

    Full Text Available Introduction: Chest drain insertion after surgical patent ductus arteriosus (PDA ligation creates significant morbidities in terms of pain, pleural space infection, reduced mobility as well as prolonged hospital stay. We investigated the safety and efficacy of performing drainless thoracotomy closure following PDA ligation in a paediatric population. Materials and Methods: Retrospective analysis of data collected from 13 paediatric patients undergoing PDA ligation at RIPAS hospital by a single surgeon over a period of five years (2001 to 2006 was performed. All continuous data were presented as mean ± standard deviation. Results: PDA ligation was performed via a left thoracotomy in 13 pediatric patients with a mean age of 2.24 ± 2.03 years (ten females and three males. Mean duration of the procedures was 67 ± 12 minutes. There was minimal blood loss and no transfusion was required. Postoperatively, ten patients required only oral paracetamol for pain relief. Two patients required additional non steroidal anti-inflammatory drugs (NSAIDs. One patient had one dose of pethidine immediately post-operatively. Post-operative chest radiographs confirmed full expansion of the left lung except in one patient who had a small apical pneumothorax. Two other patients developed mild surgical emphysema despite full expansion of the left lung. All three cases resolved spontaneously after a day. Median post-operative stay was two days. There were no cases of left recurrent nerve injuries and no mortality. Conclusion: Routine chest drainage is not necessary following uncomplicated surgical PDA ligation and patients recovered quicker and are discharge earlier.

  20. 低体重儿童动脉导管未闭封堵治疗的疗效观察%Therapeutic Effect of Patent Doctus Arteriosus Closer for Low Body Weight Children

    Institute of Scientific and Technical Information of China (English)

    郑林琼; 鲁一兵; 张伟华; 杨栋

    2014-01-01

    目的:探讨低体重儿童动脉导管未闭封堵治疗的疗效和安全性.方法2008年1月至2012年6月昆明医科大学附属延安医院对体重<8 kg的婴幼儿PDA 32例(男14例,女18例)实施经导管介入封堵治疗,年龄6~18月,平均(11±5.5)月,体重(7.2±0.6) kg,主动脉造影示PDA最窄径为1~8 mm (4.6±1.7) mm,封堵后即刻和30 min行侧位降主动脉造影,术后1 d,1、3、6个月分别行超声心动图及X线摄片检查.结果30例封堵治疗成功,成功的患者均采用国产PDA封堵器,1例术中造影合并降主动脉缩窄和室间隔缺损,转外科治疗;1例为PDA封堵器主动脉侧过大,导致降主动脉狭窄,放弃封堵;2例术后即刻存在微量-少量残余分流;随访均未发生严重并发症.结论应用国产封堵器经导管治疗体重<8 kg的婴幼儿的PDA是一种安全有效、简便、创伤小、恢复快的介入治疗方法.%Objective To discusses the efficacy and safety of patent ductus arteriosus sealing for low body weight children. Methods From January 2008 to June 2012 in our hospital,32 cases (male14 and female 18) of PDA babies< 8 kg weight were given transcatheter closure treatment. The enrolled PDA babies aged 6 month-18 months, average (11 ±5.5 months),weighted (7.2 ±0.6) kg,aortic imaging showed the narrowest diameter of PDA was 1 ~ 8 mm (4.6 ±1.7) mm,descending aorta imaging was performed immediately and 30 min after transcatheter closure treatment. Echocardiography and X-ray radiography examination were performed 1 d,1,3, 6 months after treatment. Results 30 cases got successful patent ductus arteriosus sealing,all the successful patients were treated with domestic closer,and 1 case was complicated with the descending aorta stenosis and ventricular septal defect, and was transferred to surgerical treatment. 1 case of PDA gave up patent ductus arteriosus sealing as descending aorta stenosis caused by the

  1. 30岁以上动脉导管未闭患者的手术治疗%Surgical treatment for ductus arterious in patients 30 years old or above

    Institute of Scientific and Technical Information of China (English)

    杜巍; 胡建国; 周新民; 刘锋

    2003-01-01

    @@ 成年人(30岁以上)动脉导管未闭(patent ductus arteriosus,PDA)往往继发肺动脉高压,且动脉导管管壁组织脆弱,可伴有粥样变或钙化斑块,结扎导管时易断裂、大出血,而危及患者生命[1].因此,应根据病情采用适当的手术方式.本研究回顾性分析我院1986年1月~2002年5月收治的48例30岁以上动脉导管未闭(PDA)患者,现将其主要特点、手术方式及疗效报告如下.

  2. Rhabdoid Tumor Mimicking Hemangioma

    NARCIS (Netherlands)

    Assen, Yvette J.; Madern, Gerard C.; de Laat, Peter C. J.; den Hollander, Jan C.; Oranje, Arnold P.

    2011-01-01

    We report a young boy with a malignant tumor, which remained unrecognized for 8 months because it was assumed to be a hemangioma. The presentation of a rhabdoid tumor mimicking hemangioma is very rare. It was reported only on two earlier occasions. Rhabdoid tumors are one of the most aggressive type

  3. Rhabdoid Tumor Mimicking Hemangioma

    NARCIS (Netherlands)

    Assen, Yvette J.; Madern, Gerard C.; de Laat, Peter C. J.; den Hollander, Jan C.; Oranje, Arnold P.

    2011-01-01

    We report a young boy with a malignant tumor, which remained unrecognized for 8 months because it was assumed to be a hemangioma. The presentation of a rhabdoid tumor mimicking hemangioma is very rare. It was reported only on two earlier occasions. Rhabdoid tumors are one of the most aggressive

  4. Necrobiosis lipoidica mimicking cellulitis

    Directory of Open Access Journals (Sweden)

    Joshi A

    1997-01-01

    Full Text Available A 57-year-old obese patient presented with a 5 month history of tender, indurated, erythematous plaques with superficial ulceration on the right shin. The lesions closely mimicked cellulitis but were unresponsive to antibiotics. Though the patient was not a known diabetic, on investigations she was found to be a diabetic. Histology confirmed the diagnosis of necrobiosis lipoidica. This acutely inflammed presentation of necrobiosis lipoidica is extremely rare.

  5. Anomalous Origin of the Left Pulmonary Artery: Hemi-Truncus Arteriosus

    Science.gov (United States)

    Shakir, Mariam; Ariff, Shabina; Ali, Rehan; Hassan, Babar

    2017-01-01

    Hemi-truncus arteriosus is a rare congenital cardiovascular malformation. It usually presents in infancy and leads to development of progressive pulmonary vascular disease, heart failure, and death. We report a case of hemi truncus arteriosus in a 12-day-old neonate who was successfully managed at our institute.

  6. Persistent truncus arteriosus with intact ventricular septum diagnosed by echocardiography

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yu-qi; SHEN Rong; SUN Kun; ZHONG Shu-wen; WU Yu-rong

    2009-01-01

    Persistent truncus arteriosus (PTA) is a rare congenital cardiac anomaly, and has an incidence of about 0.5 to 0.9 per 10 000 live births. Almost all cases described in the literatures had a large ventricular septal defect, only few rare cases were reported with intact ventricular septum. From June 1998 to December 2008, cardiac angiography were performed in 10 880 patients with congenital heart disease in our hospital, 47 patients with PTA were diagnosed, one case with tricuspid atresia,hypoplastic right ventricle, and intact ventricular septum was encountered.

  7. Systematic analysis of the development of the ductus venosus in wild type mouse and human embryos

    NARCIS (Netherlands)

    Burger, N.B.; Haak, M.C.; Bakker, B.S. De; Shaibani, Z. Al; Groot, C.J. de; Christoffels, V.M.; Bekker, M.N.

    2013-01-01

    BACKGROUND: Doppler flow velocities of the ductus venosus are increasingly used to assess fetal increased nuchal translucency, growth-restriction and monochorionic twins, and might contribute to screening for cardiac defects. It is disputed whether a sphincter at the ductus venosus inlet actively re

  8. Systematic analysis of the development of the ductus venosus in wild type mouse and human embryos

    NARCIS (Netherlands)

    Burger, N.B.; Haak, M.C.; Bakker, B.S. De; Shaibani, Z. Al; Groot, C.J. de; Christoffels, V.M.; Bekker, M.N.

    2013-01-01

    BACKGROUND: Doppler flow velocities of the ductus venosus are increasingly used to assess fetal increased nuchal translucency, growth-restriction and monochorionic twins, and might contribute to screening for cardiac defects. It is disputed whether a sphincter at the ductus venosus inlet actively re

  9. Anatomical Variations of the Circulus Arteriosus in Cadaveric Human Brains

    Directory of Open Access Journals (Sweden)

    S. A. Gunnal

    2014-01-01

    Full Text Available Objective. Circulus arteriosus/circle of Willis (CW is a polygonal anastomotic channel at the base of the brain which unites the internal carotid and vertebrobasilar system. It maintains the steady and constant supply to the brain. The variations of CW are seen often. The Aim of the present work is to find out the percentage of normal pattern of CW, and the frequency of variations of the CW and to study the morphological and morphometric aspects of all components of CW. Methods. Circulus arteriosus of 150 formalin preserved brains were dissected. Dimensions of all the components forming circles were measured. Variations of all the segments were noted and well photographed. The variations such as aplasia, hypoplasia, duplication, fenestrations, and difference in dimensions with opposite segments were noted. The data collected in the study was analyzed. Results. Twenty-one different types of CW were found in the present study. Normal and complete CW was found in 60%. CW with gross morphological variations was seen in 40%. Maximum variations were seen in the PCoA followed by the ACoA in 50% and 40%, respectively. Conclusion. As it confirms high percentage of variations, all surgical interventions should be preceded by angiography. Awareness of these anatomical variations is important in neurovascular procedures.

  10. Tumoral calcinosis mimicking recurrent osteosarcoma

    National Research Council Canada - National Science Library

    Petscavage, Jonelle M; Richardson, Michael L

    2009-01-01

    We report a case of a tumoral calcinosis mimicking the appearance of recurrent osteosarcoma of the left femur and tibia in a 29-year-old woman with a history of osteosarcoma and chronic renal failure...

  11. Tratamento cirúrgico da persistência do canal arterial na população adulta Surgical treatment of patent ductus arteriosus in adults

    Directory of Open Access Journals (Sweden)

    Marcelo Biscegli Jatene

    2011-03-01

    Full Text Available OBJETIVO: Analisar uma série de 34 pacientes adultos submetidos ao tratamento cirúrgico da persistência do canal arterial. MÉTODOS: Estudo retrospectivo, com coleta de dados dos prontuários de 34 pacientes consecutivos, com idade superior a 18 anos, com persistência do canal arterial submetidos a correção cirúrgica, no período de 1997 a 2008, no Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo. RESULTADOS: A idade média foi de 28,7 (18 a 53 anos e 22 (64,7% pacientes eram do sexo feminino. O sintoma mais frequente foi dispneia (76,5%. A toracotomia lateral esquerda foi utilizada em 33 (97,1% pacientes e o canal arterial foi seccionado e suturado em 25 (73,5%. A circulação extracorpórea (CEC foi necessária em um paciente. Observou-se calcificação em oito (23,5% pacientes e 12 (35,3% haviam sido submetidos à tentativa de fechamento percutâneo. A incidência de complicações foi de 32%, sendo uma permanente, com paralisia de corda vocal (2,9%. Dois (5,8% pacientes permaneceram com shunt residual e três (8,8% apresentaram paralisia de corda vocal esquerda transitória. A cirurgia realizada efetivamente levou à melhora da classe funcional (POBJECTIVE: To analyze 34 patients submitted to surgical treatment of patent arterial duct with age beyond 18 years old. METHODS: Retrospective data collected from patient's charts with more than eighteen years old, submitted to surgical correction of patent arterial duct between 1997 and 2008 at Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo. RESULTS: The mean age was 28.7 (18 a 53 years and 22 (64.7% were female. The more prevalent symptom was dyspnea (76.5%. Left lateral thoracotomy was used in 33 (97.1%; the DA was sectioned and sutured in 25 (73.5% cases and one patient needed cardiopulmonary bypass support. There were eight (23.5% calcified arterial duct and 12 (35.3% previous treatment with transcatheter devices were performed. The complication rate was 32%, with one (2.9% permanent vocal cord palsy. Two (5.8% patients had residual shunt less than 2mm. Transient left cord voice palsy was observed in 3 (8.8% The procedure improves functional class (P< 0.0001 and no mortality was observed. CONCLUSION: In this series, the surgical treatment of patent arterial duct in adults could be done without mortality and low incidence of complications.

  12. Detachable Gianturco spring coils to occlude small patent ductus arteriosus. Preliminary results; Occlusione percutanea del dotto di Botallo con spirali di Gianturco con rilascio controllato. Risultati preliminari

    Energy Technology Data Exchange (ETDEWEB)

    Gasparini, Daniele; Basadonna, Pier Tommaso [Azienda Ospedaliera ad alta specializzazione S. Maria della Misericordia, Udine (Italy). Istituto di Radiologia. Modulo di Radiologia vascolare e interventistica; Fontanelli, Alessandro; Bernardi, Guglielmo; Morocutti, Giorgio [Azienda Ospedaliera ad alta specializzazione S. Maria della Misericordia, Udine (Italy). Istituto di Cardiologia. Modulo di Emodinanica e interventistica

    1997-04-01

    Introduction: Botallo`s duct occlusion with Gianturco coils is effective in the fistulas with max diameter of 3.3 mm. The insertion technique does not permit to control coil positioning inside the fistula and the coil itself may migrate to the pulmonary artery. They report their experience with a new system of temporary hookup of the coil proximal end to a metal thread (Cook device) which permits to change the position of the coil or to replace it. Materials and methods: They treated 6 patients with persistence of Botallo`s duct (diameter: 2-3.5 mm, mean: 2.9 mm). The duct was occluded in 5/6 patients. The coil migrated to the pulmonary artery in a case where the hookup system permitted to retrieve and then replace it with too big for the small aorta. No complications were observed. Results: Follow-up chest films at 24 hours showed coil stability and color Doppler US confirmed the occlusion. The patients were discharged after 24 hours. The follow-up at 6 months confirmed the procedure success. Conclusions: The hookup system was effective to control coil positioning and to extract and replace the coils. The effectiveness of this occlusion technique would be improved if a wider range of coil sizes and types were available.

  13. Resistive indices of cerebral arteries in very preterm infants: values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

    NARCIS (Netherlands)

    G.M. Ecury-Goossen (Ginette); M.M.A. Raets (Marlou); F.A. Camfferman (Fleur); Vos, R.H.J. (Rik H. J.); J.M. van Rosmalen (Joost); I.K.M. Reiss (Irwin); P. Govaert (Paul); J. Dudink (Jeroen)

    2016-01-01

    textabstractBackground: Little is known about cerebral artery resistive index values in infants born extremely preterm. Objective: To report resistive index values in various cerebral arteries in a prospective cohort of preterm infants born at <29 weeks’ gestation, and to compare resistive index in

  14. Resistive indices of cerebral arteries in very preterm infants : values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

    NARCIS (Netherlands)

    Ecury-Goossen, Ginette M; Raets, Marlou M A; Camfferman, Fleur A; Vos, Rik H J; van Rosmalen, Joost; Reiss, Irwin K M; Govaert, Paul; Dudink, Jeroen

    2016-01-01

    BACKGROUND: Little is known about cerebral artery resistive index values in infants born extremely preterm. OBJECTIVE: To report resistive index values in various cerebral arteries in a prospective cohort of preterm infants born at <29 weeks' gestation, and to compare resistive index in these arteri

  15. Down Syndrome with Patent Ductus Venosus and Hepato-Biliary-Pancreatic Abnormalities.

    Science.gov (United States)

    Yamaguchi, Hiroshi; Kosugiyama, Kiyotaka; Honda, Shohei; Tadao, Okada; Taketomi, Akinobu; Iwata, Seido

    2016-01-01

    The association between Down syndrome and congenital portosystemic shunts, most commonly caused by patent ductus venosus, remains relatively unknown. The authors present a girl with Down syndrome with patent ductus venosus, pancreaticobiliary maljunction and paucity of interlobular bile ducts, presenting with neonatal cholestasis and transient abnormal myeloproliferative disorder. To the best of authors' knowledge, no report of the concurrent presence of the above in Down syndrome has been published.

  16. Clinical utility of ductus venosus flow in fetuses with right-sided congenital heart disease.

    Science.gov (United States)

    Arya, Bhawna; Krishnan, Anita; Donofrio, Mary T

    2014-09-01

    Abnormal ductus venosus flow is associated with fetal compromise and can be present in right-sided congenital heart disease. We hypothesized that the ductus venosus flow pattern in fetuses with obstructive right-sided congenital heart disease will have abnormal flow at baseline. Those with nonobstructive disease will have normal flow at baseline. We further hypothesized that abnormal ductus venosus flow will predict fetal compromise. We conducted a retrospective review of fetuses with right-sided congenital heart disease. Ductus venosus measurements included the presence of atrial reversal, velocity time integral, and peak velocity index. Fetuses were separated into those with obstructive (group 1) and nonobstructive (group 2) lesions. Compromise was defined as fetal distress (pericardial effusion, hydrops, or left ventricular dilatation/dysfunction) or death (fetal/neonatal mortality). Sixty fetuses with right-sided congenital heart disease were identified (mean gestational age ± SD, 24.2 ± 5.4 weeks; group 1, n = 45; group 2, n = 15). Ductus venosus reversal was more often present (49% versus 13%; P = .017), and the peak velocity index was significantly higher (1.39 ± 0.67 versus 0.98 ± 0.33; P= .026) in group 1. In group 1, ductus venosus reversal was more often present (93% versus 32%; P heart disease have ductus venosus reversal at baseline; an abnormal peak velocity index can be used to predict compromise. Fetuses with nonobstructive disease rarely have ductus venosus reversal; the peak velocity index cannot be used to predict outcomes in this group. © 2014 by the American Institute of Ultrasound in Medicine.

  17. Xanthogranulomatous cholecystitis mimicking gallbladder cancer.

    Science.gov (United States)

    Ewelukwa, Ofor; Ali, Omair; Akram, Salma

    2014-05-08

    Xanthogranulomatous cholecystitis (XGC) is a benign, uncommon variant of chronic cholecystitis characterised by focal or diffuse destructive inflammatory process of the gallbladder (GB). Macroscopically, it appears like yellowish tumour-like masses in the wall of the GB. This article reports on a 74-year-old woman with XGC mimicking GB cancer.

  18. Genetics Home Reference: Char syndrome

    Science.gov (United States)

    ... a distinctive facial appearance, a heart defect called patent ductus arteriosus, and hand abnormalities. Most people with Char syndrome ... a triangular-shaped mouth, and thick, prominent lips. Patent ductus arteriosus is a common heart defect in newborns, and ...

  19. Facts about Hypoplastic Left Heart Syndrome

    Science.gov (United States)

    ... left and right sides of the heart: the patent ductus arteriosus and the patent foramen ovale . Normally, these openings ... functioning left side of the heart through the patent ductus arteriosus and the patent foramen ovale. The right side ...

  20. Cardiac defects, nuchal edema and abnormal lymphatic development are not associated with morphological changes in the ductus venosus

    NARCIS (Netherlands)

    Burger, Nicole B.; Haak, Monique C.; Kok, Evelien; de Groot, Christianne J M; Shou, Weinian; Scambler, Peter J.; Lee, Youngsook; Cho, Eunjin; Christoffels, Vincent M.; Bekker, Mireille N.

    2016-01-01

    Background In human fetuses with cardiac defects and increased nuchal translucency, abnormal ductus venosus flow velocity waveforms are observed. It is unknown whether abnormal ductus venosus flow velocity waveforms in fetuses with increased nuchal translucency are a reflection of altered cardiac fu

  1. A Morgagni hernia with an absent ductus venosus: An unusual case causing unusual consequences

    Directory of Open Access Journals (Sweden)

    Maria Phillis

    2016-09-01

    Full Text Available A Morgagni hernia is a rare form of congenital diaphragmatic hernia (CDH, comprising only 3–5% of all CDH cases. Agenesis of the ductus venosus with direct umbilical vein blood flow to the heart is a relatively uncommon finding that is often fatal in utero. We present a case of a 2-month-old infant with Morgagni hernia and absence of the ductus venosus. These combined defects led to neovascularization of the liver, severe pulmonary hypertension and right heart failure. In this report, we describe a Morgagni hernia that's presentation resembled that of a Bochdalek hernia likely because of concomitant absence of the ductus venosus causing severe pulmonary hypertension.

  2. Multicystic Hepatocarcinoma Mimicking Liver Abscess

    Directory of Open Access Journals (Sweden)

    Evangelos Falidas

    2013-01-01

    Full Text Available The diagnosis of hepatocellular carcinoma (HCC became easier in relation to the improved radiological examinations; however, the neoplasm may occur under atypical presentations mimicking other benign or malignant processes. Multicystic HCC mimicking a liver abscess associated with septic-type fever and leukocytosis is rare, has a poor prognosis, and poses diagnostic and therapeutic dilemmas. We present the case of an 80-year-old patient, who presented with fever, leukocytosis, and large cystic masses involving right and left lobes of the liver initially considered abscesses and finally diagnosed as HCC after open drainage and liver biopsy. Although the patient died on the tenth postoperative day due to pulmonary oedema, the authors emphasize the high index of suspicion needed in the diagnosis of this unusual presentation of HCC.

  3. Hypercalcaemia Mimicking STEMI on Electrocardiography

    Directory of Open Access Journals (Sweden)

    Joseph Donovan

    2010-01-01

    Full Text Available Acute coronary syndrome is a common cause of presentation to hospital. ST segment elevation on an electrocardiogram (ECG is likely to be cardiac in origin, but in low-risk patients other causes must be ruled out. We describe a case of a man with hypercalcaemia, no evidence of cardiac disease, and ECG changes mimicking acute myocardial infarction. These ECG changes resolved after treatment of the hypercalcaemia.

  4. Initial experience of occluding special type patent ductus arterioses using the Amplatzer vascular plug

    Institute of Scientific and Technical Information of China (English)

    ZHANG Po; ZHU Xian-yang; WANG Qi-guang; ZHANG Duan-zhen; HAN Xiu-min

    2013-01-01

    Background Occluders licensed for clinical use are not fit for some special Krichenko E patent ductus arterioses.The Amplatzer vascular plug I (AVP1) has not been licensed for use for closure of patent ductus arteriose.We report our initial experience to occluding special type patent ductus arterioses with the AVP1-a single lobe device of single layer Nitinol mesh for short vessel landing zones.Methods Patients referred with small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter underwent occlusion using AVP1.All cases underwent pre-,intra-and post-procedural echocardiography and chest X-ray at the completion of the procedure,the next day and at a 30-day,3-month and 6-month follow-up visits.Device sizing for device waist diameter and length was based on aortography.Results From April 2008 to June 2012,26 patients with a mean age of (7.6±8.0) years (range 6 months-32 years)and a mean weight of (23.8±14.8) kg (range 7-67 kg) underwent successful patent ductus arteriose closure.The mean ductus diameter was (2.1±0.7) mm (range 1-3 mm).Transpulmonary (22/26) and transaortic approaches (4/26) were used.No persistent patency was observed after 24 hours and after one month.No device displacement,residual flow and iatrogenic coarctation of the aorta were observed after three months and six months.Conclusions The AVP1 makes it easy to close some Krichenko E patent ductus arterioses.Smaller delivery catheter profile and symmetric cylindrical device shape allow for use for small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter and small patients through transaortic approaches.Broader experience is required to further delineate device and patient selection as well as to document its long-term efficacy and safety.

  5. Isolated truncus arteriosus associated with a mutation in the plexin-D1 gene.

    Science.gov (United States)

    Ta-Shma, Asaf; Pierri, Ciro Leonardo; Stepensky, Polina; Shaag, Avraham; Zenvirt, Shamir; Elpeleg, Orly; Rein, Azaria J J T

    2013-12-01

    Truncus arteriosus accounts for approximately 1% of congenital heart defects and the cause of isolated non-syndromic truncus arteriosus is largely unknown. In order to identify the underlying molecular defect in a consanguineous family with recurrent tuncus arteriosus, homozygosity mapping followed by whole exome sequencing was performed. This resulted in the identification of a homozygous mutation, Arg1299Cys, in the PLXND1 gene. The mutation affected a highly conserved residue, segregated with the disease in the family and was absent from available SNP databases and ethnic matched controls. in silico comparative modeling revealed that the mutation resides in the N-terminal segment of the human plexin-D1 intracellular region which interacts with the catalytic GTPase-activating protein homology region. The mutation likely destabilizes the intracellular region, perturbing its anchoring and catalytic activity. The phenotype in human PLXND1 mutation is closely related to that of knockout mice for PLXND1, its co-receptor neuropilin-1 or its ligand SEMA3C. It is therefore suggested that SEMA3C signaling, propagated through the heterodimer receptor plexin-D1/neuropilin, is important for truncus arteriosus septation. Confirmation of this observation will require the identification of PLXND1 mutations in additional patients. Exome analysis is valuable for molecular investigation of single patients with congenital heart defects in whom chromosomal copy number variants have been excluded. © 2013 Wiley Periodicals, Inc.

  6. Ductus venosus in the first trimester: contribution to screening of chromosomal, cardiac defects and monochorionic twin complications.

    Science.gov (United States)

    Maiz, Nerea; Nicolaides, Kypros H

    2010-01-01

    In the first trimester the ductus venosus can be easily identified with color Doppler and a ductus venosus waveform can be obtained by pulsed Doppler. At 11-13 weeks the prevalence of abnormal a-wave in the ductus venosus is inversely related to fetal crown-rump length and maternal serum pregnancy-associated plasma protein-A (PAPP-A), increases with fetal nuchal translucency (NT) thickness and is more common in women of Black racial origin and in fetuses with abnormal karyotype or cardiac defects. Ductus venosus flow provides an independent contribution in the prediction of chromosomal abnormalities when combined with NT and the maternal serum markers of PAPP-A and free beta-hCG, increasing the detection rate to 96% at a false-positive rate of 2.6%. Abnormal ductus venosus flow increases the risk of cardiac defects in fetuses with NT above the 95th centile, and it may increase the risk in fetuses with normal NT. In twin pregnancies, abnormal ductus venosus flow is associated with chromosomal abnormalities and cardiac defects. In monochorionic twins, abnormal flow in the ductus venosus in at least 1 of the fetuses increases the risk of developing twin-to-twin transfusion syndrome. Copyright (c) 2010 S. Karger AG, Basel.

  7. Agenesis of the ductus venosus and its correlation to hydrops fetalis.

    Science.gov (United States)

    Hoppen, T; Hofstaetter, C; Plath, H; Kau, N; Bartmann, P

    2000-01-01

    Absence of the ductus venosus is a rare vascular anomaly. We report a late onset of a hydrops fetalis seen in a fetus at 34 completed weeks of gestation. A persistence of the cranial parts of the left and right umbilical veins and of the paired cranial vitelline veins with an absent ductus venosus led to a bilateral hydrothorax, ascites and skin-edema. Postnatally the hydrops resolved within 7 days most probably due to the change from the fetal to the adult circulation. The abnormal venous system was confirmed by angiography. Agenesis of the ductus venosus can manifest in two different morphologic patterns: The umbilical vein drains exclusively into the left branch of the intrahepatic portal vein or the umbilical vein drains into the inferior vena cava or directly into the right atrium by-passing the liver completely. In both patterns, the preferential direction of the flow towards the foramen ovale is not present. While the first pattern leads to hyperperfusion of the liver parenchyma, the latter would result in reduced perfusion and oxygenation. Our findings suggest that agenesis of ductus venosus might induce hydrops fetalis. We conclude, that in every case of hydrops fetalis the venous system should be evaluated by ultrasonography prenatally and/or immediately postnatally.

  8. Decidualized Ovarian Mass Mimicking Malignancy

    Directory of Open Access Journals (Sweden)

    Lufee Wong

    2015-01-01

    Full Text Available Deciduosis classically occurs in the context of known endometriosis in the pelvis, most commonly in the ovaries, but also in the peritoneum. However, ovarian deciduosis outside the context of endometriosis is rare and makes diagnosis difficult, especially as the sonographic appearance suggests a malignant process. We report a case of decidualized ovarian mass in a patient without prior history of endometriosis that mimicked an ovarian malignancy. MRI may be a useful imaging modality to monitor these lesions and guide management. Consultation with a multidisciplinary team accustomed to such conditions will help to tailor the management to each individual.

  9. Persistent Truncus Arteriosus With Intact Ventricular Septum: Clinical, Hemodynamic and Short-term Surgical Outcome

    Directory of Open Access Journals (Sweden)

    Gholamhossein Ajami

    2015-10-01

    Full Text Available Introduction: Truncus arteriosus with intact ventricular septum is a rare and unique variant of persistent truncus arteriosus (PTA which usually presents with central cyanosis and congestive heart failure in neonate and early infancy. Associated cardiac and non-cardiac anomalies may affect morbidity and mortality of these patients. Case Presentation: We describe clinical presentation, echocardiography and angiographic features of a 7-month old boy with PTA and intact ventricular septum who underwent surgical repair of the anomaly at our institution. Operative findings, surgical procedure and short-term outcome are reported. Conclusions: While our patient had systemic pulmonary arterial pressure at the time of complete surgical repair, it was improved after surgery.

  10. Gout: radiographic findings mimicking infection

    Energy Technology Data Exchange (ETDEWEB)

    Rousseau, I.; Raymond-Tremblay, D. [Dept. of Diagnostic Radiology, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada); Cardinal, E. [Dept. of Radiology, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada); Beauregard, C.G. [Dept. of Diagnostic Radiology, Hopital du Sacre-Coeur de Montreal,Que. (Canada); Braunstein, E.M. [Dept. of Radiology, Indiana University Hospital (United States); Saint-Pierre, A. [Rheumatology Unit, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada)

    2001-10-01

    Objective: To describe radiographic features of gout that may mimic infection. Design and patients: We report five patients with acute bacterial gout who presented with clinical as well as radiological findings mimicking acute bacterial septic arthritis or osteomyelitis. Three patients had delay in the appropriate treatment with the final diagnosis being established after needle aspiration and identification of urate crystals under polarized light microscopy. Two patients underwent digit amputation for not responding to antibiotic treatment and had histological findings confirming the diagnosis of gout. Conclusion: It is important for the radiologist to be aware of the radiological manifestations of acute gout that can resemble infection in order to avoid inappropriate diagnosis and delay in adequate treatment. The definitive diagnosis should rely on needle aspiration and a specific search for urate crystals. (orig.)

  11. Neonatal hemochromatosis and patent ductus venosus: clinical course and diagnostic pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Andy; Paltiel, Harriet J.; Sena, Laureen M. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States); Kim, Heung Bae; Fishman, Steven J. [Children' s Hospital Boston and Harvard Medical School, Department of Surgery, Boston, MA (United States); Alomari, Ahmad I. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States); Children' s Hospital Boston, Division of Vascular and Interventional Radiology, Boston, MA (United States)

    2009-08-15

    Neonatal hemochromatosis is a rare metabolic disorder characterized by excessive iron deposition within the liver leading to hepatic failure and portal hypertension. We describe the clinical course and imaging findings in three infants with neonatal hemochromatosis associated with patent ductus venosus. We paid special attention to the diagnostic challenges encountered in these patients in order to emphasize some of the potential diagnostic pitfalls. We conducted a comprehensive search of our radiology database of the last 10 years (1999-2008) for the keywords ''neonatal hemochromatosis.'' Medical records and imaging studies of various modalities were reviewed. Three neonates were found to have neonatal hemochromatosis; all of them were associated with patent ductus venosus. Two of these patients were referred to our tertiary center for embolization of an inaccurately diagnosed hepatic vascular malformation. Two patients underwent successful liver transplantation and one died shortly after referral. The awareness and inclusion of neonatal hemochromatosis in the differential diagnosis of newborns with liver failure and patent ductus venosus has critical treatment implications. (orig.)

  12. Humanlike Robots - Synthetically Mimicking Humans

    Science.gov (United States)

    Bar-Cohen, Yoseph

    2012-01-01

    Nature inspired many inventions and the field of technology that is based on the mimicking or inspiration of nature is widely known as Biomimetics and it is increasingly leading to many new capabilities. There are numerous examples of biomimetic successes including the copying of fins for swimming, and the inspiration of the insects and birds flight. More and more commercial implementations of biomimetics are appearing and behaving lifelike and applications are emerging that are important to our daily life. Making humanlike robots is the ultimate challenge to biomimetics and, for many years, it was considered science fiction, but such robots are becoming an engineering reality. Advances in producing such robot are allowing them to perform impressive functions and tasks. The development of such robots involves addressing many challenges and is raising concerns that are related to fear of their application implications and potential ethical issues. In this paper, the state-of-the-art of humanlike robots, potential applications and challenges will be reviewed.

  13. Screening performance for trisomy 21 comparing first trimester combined screening and a first trimester contingent screening protocol including ductus venosus and tricuspid flow

    DEFF Research Database (Denmark)

    Ekelund, Charlotte Kvist; Petersen, Olav Bjørn; Sundberg, Karin Milner

    2012-01-01

    To compare the standard first trimester combined risk assessment for trisomy 21 with a contingent screening protocol including tricuspid flow and ductus venosus flow.......To compare the standard first trimester combined risk assessment for trisomy 21 with a contingent screening protocol including tricuspid flow and ductus venosus flow....

  14. Role of perioperative transesophageal echocardiography in the management of adolescent truncus arteriosus: Rare case report

    Directory of Open Access Journals (Sweden)

    P S Nagaraja

    2015-01-01

    Full Text Available Truncus arteriosus (TA is a rare congenital heart disease defined as a single arterial vessel arising from the heart that gives origin to the systemic, pulmonary and coronary circulations. The truncal valve in majority of the cases is tricuspid though quadricuspid and bicuspid valves have been reported. Patients with TA typically have a large nonrestrictive sub truncal ventricular septal defect. Survival of these infants beyond 1-year is uncommon. Here, we report a unique case of 12-year-old female patient with persistent TA who underwent surgical repair by using transesophageal echocardiography as a monitoring device during the perioperative management.

  15. An aborted human fetus with truncus arteriosus communis--possible teratogenic effect of Tedral.

    Science.gov (United States)

    Matsuoka, R; Gilbert, E F; Bruyers, H; Optiz, J M

    1985-08-01

    We recently performed a detailed anatomicopathologic examination on an aborted human embryo whose mother had taken four tablets of Tedral (one tablet of Tedral contains 130 mg theophylline, 25 mg ephedrine, 8 mg phenobarbital) for an upper respiratory tract infection when the embryo was at approximately 30 days of development. On the same day, the mother developed acute chest pain and a fast, irregular heart beat. The abortion occurred at approximately 80 days of gestation. The heart of the fetus showed truncus arteriosus (Van Praagh type A1). Although no direct cause and effect relationship was proven in this case, the possibility of a teratogenic effect of Tedral during early pregnancy is considered.

  16. Three-dimensional colour Doppler of ductus venous agenesis in the first trimester

    Directory of Open Access Journals (Sweden)

    Divya Singh

    2016-11-01

    Full Text Available Ductus venosus (DV has a pivotal role in the fetal circulation. It serves as a conduit connecting the fetal umbilical and portal venous system with the inferior vena cava (IVC. The absence of DV is an uncommon anomaly. In case of agenesis of DV, the umbilical vein joins the fetal systemic venous circulation via the intra-hepatic or extra-hepatic route. We report a case of absent DV with associated anomaly diagnosed in the first trimester using three-dimensional (3D colour Doppler.

  17. Recurrent epiploic appendagitis mimicking appendicitis and cholecystitis

    Science.gov (United States)

    Hearne, Christopher B.; Taboada, Jorge

    2017-01-01

    Epiploic appendagitis (EA) is a rare cause of acute abdominal pain caused by inflammation of an epiploic appendage. It has a nonspecific clinical presentation that may mimic other acute abdominal pathologies on physical exam, such as appendicitis, diverticulitis, or cholecystitis. However, EA is usually benign and self-limiting and can be treated conservatively. We present the case of a patient with two episodes of EA, the first mimicking acute appendicitis and the second mimicking acute cholecystitis. Although recurrence of EA is rare, it should be part of the differential diagnosis of acute, localized abdominal pain. A correct diagnosis of EA will prevent unnecessary hospitalization, antibiotic use, and surgical procedures. PMID:28127129

  18. Lymphomatoid granulomatosis mimicking interstitial lung disease.

    Science.gov (United States)

    Braham, Emna; Ayadi-Kaddour, Aïda; Smati, Belhassen; Ben Mrad, Sonia; Besbes, Mohammed; El Mezni, Faouzi

    2008-11-01

    Lymphoid granulomatosis is a rare form of pulmonary angiitis. This case report presents a patient with lymphoid granulomatosis in whom the clinical presentation, radiological features and the partial response to corticosteroid therapy mimicked interstitial lung disease. Lymphoid granulomatosis was only diagnosed at post-mortem examination. The range of reported clinical presentations, diagnostic approaches and outcomes are described.

  19. Ovarian Heterotopic Pregnancy Clinically Mimicking Endometrioma

    Directory of Open Access Journals (Sweden)

    Nilüfer ONAK KANDEMİR

    2010-01-01

    Full Text Available Heterotopic pregnancy is a very uncommon entity with a difficult preoperative diagnosis. In the present study, we presented an ovarian heterotopic pregnancy case, clinically mimicking endometrioma developed in a 33-year-old female following an in vitro fertilization procedure. The importance of clinical, histopathological, and immunohistochemical examinations in the diagnosis of heterotopic pregnancy are emphasized.

  20. An adult intussusception mimicking early appendicitis

    Institute of Scientific and Technical Information of China (English)

    Wei-Chun Tseng; Cheng-Ting Hsiao; Yu-Cheng Hung

    2012-01-01

    Adult intussusception is rare with variable clinical presentation. We reported a case of adult intussusception presenting with symptoms mimicking acute appendicitis. The patient presented as an abdominal pain from epigastric area with shifting gradually to RLQ. The atypical presentation of adult intussusception remains a diagnostic challenge to the emergency physician.

  1. Acute dystonia mimicking angioedema of the tongue

    DEFF Research Database (Denmark)

    Rasmussen, Eva Rye; Pallesen, Kristine A U; Bygum, Anette

    2013-01-01

    We report a case of acute dystonia of the face, jaw and tongue caused by metoclopramide and mimicking angioedema. The patient had attacks for several years before the correct diagnosis was made and we present the first ever published video footage of an attack. This adverse drug reaction is known...

  2. Toward restrictions on boson stars as black hole mimickers

    Energy Technology Data Exchange (ETDEWEB)

    Guzman, F S, E-mail: guzman@ifm.umich.mx [Instituto de Fisica y Matematicas, Universidad Michoacana de San Nicolas de Hidalgo, Edificio C3, Cd. Universitaria, 58040 Morelia, Michoacan (Mexico)

    2011-09-22

    The status of boson stars as black hole mimickers is presented among other mimickers. We focus on the analysis of the emission spectrum of a simple accretion disk model. We describe the free parameters that allow a boson star to become a black hole mimicker and present an example of a particular astrophysical case.

  3. Outcomes of Surgical Repair for Persistent Truncus Arteriosus from Neonates to Adults: A Single Center's Experience

    Science.gov (United States)

    Chen, Qiuming; Gao, Huawei; Hua, Zhongdong; Yang, Keming; Yan, Jun; Zhang, Hao; Ma, Kai; Zhang, Sen; Qi, Lei; Li, Shoujun

    2016-01-01

    Objective This study aimed to report our experiences with surgical repair in patients of all ages with persistent truncus arteriosus. Methods From July 2004 to July 2014, 50 consecutive patients with persistent truncus arteriosus who underwent anatomical repair were included in the retrospective review. Median follow-up time was 3.4 years (range, 3 months to 10 years). Results Fifty patients underwent anatomical repair at a median age of 19.6 months (range, 20 days to 19.1 years). Thirty patients (60%) were older than one year. The preoperative pulmonary vascular resistance and mean pulmonary artery pressure were 4.1±2.1 (range, 0.1 to 8.9) units.m2 and 64.3±17.9 (range, 38 to 101) mmHg, respectively. Significant truncal valve regurgitation was presented in 14 (28%) patients. Hospital death occurred in 3 patients, two due to pulmonary hypertensive crisis and the other due to pneumonia. Three late deaths occurred at 3, 4 and 11 months after surgery. The actuarial survival rates were 87.7% and 87.7% at 1 year and 5 years, respectively. Multivariate analysis identified significant preoperative truncal valve regurgitation was a risk factor for overall mortality (odds ratio, 7.584; 95%CI: 1.335–43.092; p = 0.022). Two patients required reoperation of truncal valve replacement. One patient underwent reintervention for conduit replacement. Freedom from reoperation at 5 years was 92.9%. At latest examination, there was one patient with moderate-to-severe truncal valve regurgitation and four with moderate. Three patients had residual pulmonary artery hypertension. All survivors were in New York Heart Association class I-II. Conclusions Complete repair of persistent truncus arteriosus can be achieved with a relatively low mortality and acceptable early- and mid-term results, even in cases with late presentation. Significant preoperative truncal valve regurgitation remains a risk factor for overall mortality. The long-term outcomes warrant further follow-up. PMID:26752522

  4. Outcomes of Surgical Repair for Persistent Truncus Arteriosus from Neonates to Adults: A Single Center's Experience.

    Directory of Open Access Journals (Sweden)

    Qiuming Chen

    Full Text Available This study aimed to report our experiences with surgical repair in patients of all ages with persistent truncus arteriosus.From July 2004 to July 2014, 50 consecutive patients with persistent truncus arteriosus who underwent anatomical repair were included in the retrospective review. Median follow-up time was 3.4 years (range, 3 months to 10 years.Fifty patients underwent anatomical repair at a median age of 19.6 months (range, 20 days to 19.1 years. Thirty patients (60% were older than one year. The preoperative pulmonary vascular resistance and mean pulmonary artery pressure were 4.1±2.1 (range, 0.1 to 8.9 units.m2 and 64.3±17.9 (range, 38 to 101 mmHg, respectively. Significant truncal valve regurgitation was presented in 14 (28% patients. Hospital death occurred in 3 patients, two due to pulmonary hypertensive crisis and the other due to pneumonia. Three late deaths occurred at 3, 4 and 11 months after surgery. The actuarial survival rates were 87.7% and 87.7% at 1 year and 5 years, respectively. Multivariate analysis identified significant preoperative truncal valve regurgitation was a risk factor for overall mortality (odds ratio, 7.584; 95%CI: 1.335-43.092; p = 0.022. Two patients required reoperation of truncal valve replacement. One patient underwent reintervention for conduit replacement. Freedom from reoperation at 5 years was 92.9%. At latest examination, there was one patient with moderate-to-severe truncal valve regurgitation and four with moderate. Three patients had residual pulmonary artery hypertension. All survivors were in New York Heart Association class I-II.Complete repair of persistent truncus arteriosus can be achieved with a relatively low mortality and acceptable early- and mid-term results, even in cases with late presentation. Significant preoperative truncal valve regurgitation remains a risk factor for overall mortality. The long-term outcomes warrant further follow-up.

  5. Neurturin-GFRalpha2 signaling controls liver bud migration along the ductus venosus in the chick embryo.

    Science.gov (United States)

    Tatsumi, Norifumi; Miki, Rika; Katsu, Kenjiro; Yokouchi, Yuji

    2007-07-01

    During chick liver development, the liver bud arises from the foregut, invaginates into the septum transversum, and elongates along and envelops the ductus venosus. However, the mechanism of liver bud migration is only poorly understood. Here, we demonstrate that a GDNF family ligand involved in neuronal outgrowth and migration, neurturin (NRTN), and its receptor, GFRalpha2, are essential for liver bud migration. In the chick embryo, we found that GFRalpha2 was expressed in the liver bud and that NRTN was expressed in the endothelial cells of the ductus venosus. Inhibition of GFRalpha2 signaling suppressed liver bud elongation along the ductus venous without affecting cell proliferation and apoptosis. Moreover, ectopic expression of NRTN perturbed the directional migration along the ductus venosus, leading to splitting or ectopic branching of the liver. We showed that liver buds selectively migrated toward an NRTN-soaked bead in vitro. These data represent a new model for liver bud migration: NRTN secreted from endothelial cells functions as a chemoattractant to direct the migration of the GFRalpha2-expressing liver bud in early liver development.

  6. Fetal ductus venosus flow velocity waveforms and maternal serum AFP before and after first-trimester transabdominal chorionic villus sampling

    NARCIS (Netherlands)

    C.A. Brezinka (Christoph); A.M. Hagenaars (A.); J.W. Wladimiroff (Juriy); F.J. Los

    1995-01-01

    textabstractDoppler flow velocity waveform recording in the fetal ductus venosus and umbilical artery as well as maternal blood sampling for serum alpha-fetoprotein (MSAFP) was performed before and after transabdominal chorion villus sampling (TACVS) in 36 women of advanced maternal age (≥ 36 years)

  7. Truncus arteriosus operado aos 28 anos: importância do diagnóstico diferencial

    Directory of Open Access Journals (Sweden)

    Lilian Maria Lopes

    2011-08-01

    Full Text Available Descrevemos um caso de adulto de 28 anos com suspeita de cardiopatia congênita desde o nascimento, não tratada na infância por opção da família. Aos 27 anos, foi feito diagnóstico de atresia pulmonar com comunicação interventricular e colaterais sistêmico-pulmonares, sendo contraindicada a cirurgia. Uma nova reavaliação em nosso serviço demonstrou tratar-se de um truncus arteriosus atípico. O fato de um tronco arterial comum com shunt esquerda-direita ter sido visualizado ao ecocardiograma foi um dado crucial para a indicação de novo cateterismo, abrindo perspectiva de correção cirúrgica. No momento, o paciente encontra-se bem, com 7 anos de evolução pós-operatória.

  8. The peptide hormone cholecystokinin modulates the tonus and compliance of the bulbus arteriosus and pre-branchial vessels of the rainbow trout (Oncorhynchus mykiss).

    Science.gov (United States)

    Seth, Henrik; Axelsson, Michael; Gräns, Albin

    2014-12-01

    The bulbus arteriosus is a compliant structure between the ventricle and ventral aorta of teleost fish. It serves as a "wind-kessel" that dampens pressure variations during the cardiac cycle allowing a continuous flow of blood into the gills. The bulbus arteriosus receives sympathetic innervation and is affected by several circulating substances, indicating neurohumoral control. We have previously shown that the peptide hormone, cholecystokinin (CCK), affects the hemodynamics of the cardiovascular system in rainbow trout (Oncorhynchus mykiss) by increasing flow pulse amplitude without affecting cardiac output. We hypothesized that this could be explained by an altered tonus or compliance/distensibility of the bulbus arteriosus. Our results show that there is a substantial effect of CCK on the bulbus arteriosus. Concentrations of CCK that altered the cardiac function of in situ perfused hearts also contracted the bulbus arteriosus in vitro. Pressure-volume curves revealed a change in both the tonus and the compliance/distensibility of this structure. Furthermore, the stimulatory (constricting) effect of CCK was also evident in the ventricle and vasculature leading to the gills, but absent in the atrium, efferent branchial arteries and dorsal aorta. In conclusion, CCK alters the mechanical properties of the ventricle, bulbus arteriosus, ventral aorta and afferent gill vasculature, thus maintaining adequate branchial and systemic blood flow and pressure when cardiorespiratory demands change, such as after feeding.

  9. Spherical Boson Stars as Black Hole mimickers

    CERN Document Server

    Guzman, F S; 10.1103/PhysRevD.80.084023

    2010-01-01

    We present spherically symmetric boson stars as black hole mimickers based on the power spectrum of a simple accretion disk model. The free parameters of the boson star are the mass of the boson and the fourth order self-interaction coefficient in the scalar field potential. We show that even if the mass of the boson is the only free parameter it is possible to find a configuration that mimics the power spectrum of the disk due to a black hole of the same mass. We also show that for each value of the self-interaction a single boson star configuration can mimic a black hole at very different astrophysical scales in terms of the mass of the object and the accretion rate. In order to show that it is possible to distinguish one of our mimickers from a black hole we also study the deflection of light.

  10. Mimickers of breast malignancy on breast sonography.

    Science.gov (United States)

    Cho, So Hyun; Park, Sung Hee

    2013-11-01

    The aim of this article is to review benign breast lesions that can mimic carcinoma on sonography. Cases of benign lesions mimicking carcinoma on sonography were collected among lesions that were initially assessed as suspicious on sonography according to the American College of Radiology Breast Imaging Reporting and Data System category. Sonographically guided core needle biopsy was performed, and the pathologic types were confirmed to be benign. Cases of benign lesions mimicking carcinoma on sonography were shown to include fat necrosis, diabetic mastopathy, fibrocystic changes, sclerosing adenosis, ruptured inflammatory cysts, inflammatory abscesses, granulomatous mastitis, fibroadenomas, fibroadenomatous mastopathy, and apocrine metaplasia. Benign breast lesions may present with malignant features on imaging. A clear understanding of the range of appearances of benign breast lesions that mimic malignancy is important in radiologic-pathologic correlation to ensure that benign results are accepted when concordant with imaging and clinical features but, when discordant, there is no delay in further evaluation up to and including excisional biopsy.

  11. Cardiac sarcoidosis mimicking right ventricular dysplasia.

    Science.gov (United States)

    Shiraishi, Jun; Tatsumi, Tetsuya; Shimoo, Kazutoshi; Katsume, Asako; Mani, Hiroki; Kobara, Miyuki; Shirayama, Takeshi; Azuma, Akihiro; Nakagawa, Masao

    2003-02-01

    A 59-year-old woman with skin sarcoidosis was admitted to hospital for assessment of complete atrioventricular block. Cross-sectional echocardiography showed that the apical free wall of the right ventricle was thin and dyskinetic with dilation of the right ventricle. Thallium-201 myocardial imaging revealed a normal distribution. Both gallium-67 and technetium-99m pyrophosphate scintigraphy revealed no abnormal uptake in the myocardium. Right ventriculography showed chamber dilation and dyskinesis of the apical free wall, whereas left ventriculography showed normokinesis, mimicking right ventricular dysplasia. Cardiac sarcoidosis was diagnosed on examination of an endomyocardial biopsy specimen from the right ventricle. A permanent pacemaker was implanted to manage the complete atrioventricular block. After steroid treatment, electrocardiography showed first-degree atrioventricular block and echocardiography revealed an improvement in the right ventricular chamber dilation. Reports of cardiac sarcoidosis mimicking right ventricular dysplasia are extremely rare and as this case shows, right ventricular involvement may be one of its manifestations.

  12. Implantación de stent en neonatos y lactantes menores con cardiopatía congénita cianosante ductus dependiente

    Directory of Open Access Journals (Sweden)

    Juan P. Rojas

    2014-03-01

    Conclusiones: La implantación del stent ductal se convierte en una herramienta importante en el paciente con cardiopatía congénita cianosante ductus dependiente ya que ofrece menor tasa de morbilidad y mortalidad.

  13. [Morgagni hernia mimicking intrathoracic lipomatous tumor].

    Science.gov (United States)

    Pinto, Carlos Silva; Bernardo, João; Eugénio, Luís; Antunes, Manuel J

    2013-01-01

    Morgagni hernia is the rarest type of diaphragmatic hernia, accounting for 2% of all cases. It consists in the thoracic protrusion of fat and/or abdominal viscera through a congenital defect in a retro or parasternal position. The clinical importance of this pathological entity is associated with the fact that it can be asymptomatic, mimicking other diseases, such as a large intrathoracic lipoma, as it happened in the case presented here. Incorrect diagnosis can cause catastrophic complications during surgery.

  14. Intradural extramedullary tuberculoma mimicking en plaque meningioma

    Directory of Open Access Journals (Sweden)

    Ozek Erdinc

    2009-01-01

    Full Text Available In this paper we report an 18 year old woman with an intradural extramedullary tuberculoma mimicking en plaque meningioma located in the thoracic region. The patient was operated via thoracic laminoplasty and tumor was totally resected. On the follow-up examination the magnetic resonance imaging demonstrated the total excision of the tumor. Here we describe a case of intradural extramedullary tuberculoma of the spinal cord as a complication of tuberculosis meningitis in a previously healthy young female.

  15. Benzalkonium Chloride Intoxication Mimicking Herpes Zoster Encephalitis

    OpenAIRE

    Güler, Ekrem; Olgar, Şeref; Davutoğlu, Mehmet; Garipardıç, Mesut; Karabiber, Hamza

    2011-01-01

    Benzalkonium chloride (BAC) is a frequently used disinfectant and its most well-known side effect is contact dermatitis. In this report, two children who had vesicular dermatitis, headache, lethargy, fever and encephalopathy mimicking Herpes zoster encephalitis were presented. Their consciousness level improved on the second day. From the medical history it was understood that the mother had applied 20% BAC solution to the scalps of two children. The aim of the presentation of this report is ...

  16. Benzalkonium Chloride Intoxication Mimicking Herpes Zoster Encephalitis

    OpenAIRE

    Ekrem Güler; Şeref Olgar; Mehmet Davutoğlu; Mesut Garipardıç; Hamza Karabiber

    2014-01-01

    Benzalkonium chloride (BAC) is a frequently used disinfectant and its most well-known side effect is contact dermatitis. In this report, two children who had vesicular dermatitis, headache, lethargy, fever and encephalopathy mimicking Herpes zoster encephalitis were presented. Their consciousness level improved on the second day. From the medical history it was understood that the mother had applied 20% BAC solution to the scalps of two children. The aim of the presentation of this report is...

  17. Hydroxychloroquine-Associated Hyperpigmentation Mimicking Elder Abuse

    OpenAIRE

    Cohen, Philip R

    2013-01-01

    Background Hydroxychloroquine may result in cutaneous dyschromia. Older individuals who are the victims of elder abuse can present with bruising and resolving ecchymoses. Purpose The features of hydroxychloroquine-associated hyperpigmentation are described, the mucosal and skin manifestations of elder abuse are reviewed, and the mucocutaneous mimickers of elder abuse are summarized. Case Report An elderly woman being treated with hydroxychloroquine for systemic lupus erythematosus developed d...

  18. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)

    2005-04-01

    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  19. Intracranial capillary hemangioma mimicking a dissociative disorder

    Directory of Open Access Journals (Sweden)

    Alexander Lacasse

    2012-01-01

    Full Text Available Capillary hemangiomas, hamartomatous proliferation of vascular endothelial cells, are rare in the central nervous system (CNS. Intracranial capillary hemangiomas presenting with reversible behavioral abnormalities and focal neurological deficits have rarely been reported. We report a case of CNS capillary hemangioma presenting with transient focal neurological deficits and behavioral abnormalities mimicking Ganser’s syndrome. Patient underwent total excision of the vascular malformation, resulting in complete resolution of his symptoms.

  20. Transcatheter Closure of Patent Ductus Arteriosus Using 0.052″ Gianturco Coil With Bioptome Controlled Delivery%0.052吋Gianturco coil弹簧栓子经导管封堵动脉导管未闭

    Institute of Scientific and Technical Information of China (English)

    夏呈森; 周银宝; 解春红

    2002-01-01

    目的:评价0.052吋Gianturco coil弹簧栓子经导管封堵动脉导管未闭(PDA)的疗效及安全性.方法:10例PDA患者在基础和骶管麻醉下,用心内膜心肌活检钳控制和传递0.052Gianturco coil弹簧栓子,顺行经导管封堵PDA.结果:8例1枚Gianturco coil弹簧栓子、1例3枚Gianturco coil弹簧栓子完全封堵成功,1例因Gianturco coil弹簧栓子未能回收至传递鞘内改行手术结扎.结论:用0.052Gianturco coil弹簧栓子经导管封堵3.0~4.0 mm直径的PDA,是安全、可靠的非手术方法.

  1. Effect of VitaminA on Development of Ductus Arteriosus in Fatal Rabbit%维生素A对胎兔动脉导管发育的影响

    Institute of Scientific and Technical Information of China (English)

    李涛; 王宏伟; 潘军; 邹典定; 肖玉; 徐少勇

    2006-01-01

    目的研究维生素A(VitA)对胎兔动脉导管发育的影响,为防治早产儿动脉导管未闭(PDA)寻找新的途径.方法孕兔8只随机分为4组,VitA 5000 IU/d,受孕d25服用1次(A组),孕d25、d26连续服用2次(B组),孕2周后隔天服用(C组)和对照组服用生理盐水(D组).取胎兔动脉导管固定,切片、HE染色,观察导管内膜增殖情况,测定导管内钙浓度.结果A、B、C组导管内膜增殖程度较D组明显增加,A、B、C组导管内钙浓度明显增加.结论VitA能增加导管内钙浓度,促进胎兔动脉导管发育.

  2. Genetics Home Reference: CHOPS syndrome

    Science.gov (United States)

    ... defects, obesity, pulmonary involvement, short stature, and skeletal dysplasia Related Information How are ... Congenital Heart Defect -- Corrective Surgery Encyclopedia: Patent Ductus Arteriosus ...

  3. Stent ductal en cardiopatías congénitas dependientes del ductus. Seguimiento a mediano plazo

    Directory of Open Access Journals (Sweden)

    Ricardo Gamboa

    2006-01-01

    Full Text Available Objetivo Presentar nuestra experiencia con el empleo de stent para mantener la permeabilidad ductal en cardiopatías congénitas dependientes del ductus. Método y resultados En tres pacientes de entre 2 y 9 días de vida con atresia pulmonar se colocaron cuatro stents por cateterismo, sin complicaciones. El tiempo de seguimiento promedio fue de 411 días (123 a 721 días. Dos stents se redilataron exitosamente. Un paciente fue sometido a cirugía, uno interrumpió sus controles cuatro meses después y otro espera cirugía. La saturación promedio aumentó del 61% al 80%. Conclusiones En pacientes con cardiopatías cuya circulación depende del ductus arterioso, el implante del stent fue factible y efectivo a corto y mediano plazos.

  4. Ductus venosus Doppler at 11 to 13 weeks of gestation in the prediction of outcome in twin pregnancies.

    Science.gov (United States)

    Maiz, Nerea; Staboulidou, Ismini; Leal, Antonio M; Minekawa, Ryoko; Nicolaides, Kypros H

    2009-04-01

    To examine the independent contribution of abnormal flow in the ductus venosus at 11 to 13 weeks of gestation in the prediction of adverse pregnancy outcome in relation to chorionicity. This was a prospective study in 516 dichorionic and 179 monochorionic twin pregnancies in which the fetal ductus venosus flow was assessed at 11 0/7 to 13 6/7 weeks of gestation. The prevalence of reversed a-wave in the fetal ductus venosus was compared between monochorionic and dichorionic pregnancies and between those with and without pregnancy complications. Comparisons between each of the pregnancy outcomes and the normal outcome group and between monochorionic and dichorionic pregnancies were made using the Mann-Whitney U-test for continuous variables and the chi2 test and Fisher exact test for categorical variables. The prevalence of reversed a-wave in at least one of the fetuses was significantly higher in monochorionic than in dichorionic pregnancies (18.4% compared with 8.3%, P<.001) and in pregnancies complicated by miscarriage (28.6%, P=.005), fetal aneuploidy (70.0%, P<.001), and twin-twin transfusion syndrome (38.5%, P<.001) compared with the pregnancies with two healthy live births (7.7%). Pregnancy outcome was normal in 33 of the 43 (76.7%) dichorionic and in 14 of the 33 (42.4%) monochorionic twins with reversed a-wave in at least one of the fetuses. In twins, reversed a-wave in the ductus venosus at 11 to 13 weeks of gestation is associated with increased risk for aneuploidies, miscarriage, and development of severe twin-twin transfusion syndrome. However, in about 75% of dichorionic twins and 40% of monochorionic twins with reversed a-wave, the pregnancy outcome is normal. II.

  5. Pulmonary tumour microembolism clinically mimicking alveolitis

    Science.gov (United States)

    Lo, A W I; Tse, G M K; Chu, W C W; Chan, A B W

    2003-01-01

    A 56 year old man with previously unsuspected recurrence of squamous cell carcinoma of the oesophagus presented with dyspnoea. Bronchoscopy and computed tomography suggested bronchopneumonic changes with an infectious cause. He suffered a rapidly deteriorating course and died despite active treatment, including antibiotics and mechanical ventilation. Necropsy revealed a florid pulmonary tumour microembolism mimicking alveolitis. No bronchopneumonia was seen. The emboli arose from loosely attached tumour vegetations in the tricuspid valve. In a patient with known malignancy, tumour microembolism should be considered as an uncommon cause of rapid respiratory failure, refractory to antibiotic treatment. PMID:14600135

  6. Hypertrophic Nonunion Humerus Mimicking an Enchondroma

    Directory of Open Access Journals (Sweden)

    N. K. Magu

    2014-01-01

    Full Text Available Introduction. Although fractures of humeral shaft show excellent results with conservative management, nonunion does occur. Case Report. We bring forth the case of a young male with a 1.5-year-old hypertrophic nonunion of the humerus mimicking an enchondroma. The initial X-ray images of the patient appeared to be an enchondroma, which only on further evaluation and histopathological analysis was diagnosed conclusively to be a hypertrophic nonunion. Discussion. Enchondromas are often incidentally diagnosed benign tumours. It is however not common to misdiagnose a hypertrophic nonunion to be an enchondroma. We present this case to highlight the unique diagnostic dilemma the treating team had to face.

  7. Benzalkonium Chloride Intoxication Mimicking Herpes Zoster Encephalitis

    Directory of Open Access Journals (Sweden)

    Ekrem Güler

    2011-06-01

    Full Text Available Benzalkonium chloride (BAC is a frequently used disinfectant and its most well-known side effect is contact dermatitis. In this report, two children who had vesicular dermatitis, headache, lethargy, fever and encephalopathy mimicking Herpes zoster encephalitis were presented. Their consciousness level improved on the second day. From the medical history it was understood that the mother had applied 20% BAC solution to the scalps of two children. The aim of the presentation of this report is to draw attention to the fact that BAC application to the scalp for treating pediculosis capitis may resemble the herpes encephalitis clinical picture.

  8. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Seval İzdeş

    2011-08-01

    Full Text Available Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to discuss the approach to distinguish an acute coronary syndrome from myopericarditis. (Journal of the Turkish Society Intensive Care 2011; 9:68-70

  9. Central skeletal sarcoidosis mimicking metastatic disease

    Energy Technology Data Exchange (ETDEWEB)

    Talmi, Danit; Smith, Stacy; Mulligan, Michael E. [University of Maryland School of Medicine, Department of Radiology, Baltimore, MD (United States)

    2008-08-15

    Sarcoidosis is a systemic disease that histologically typically shows non-caseating granulomas. The most common radiologic finding is hilar and mediastinal adenopathy. Patients with widely disseminated disease may show involvement of the peripheral appendicular skeleton in 1-13% of such cases. A primary skeletal presentation without other manifestations typical of the disease is rare. We present a case of sarcoidosis in a middle-aged Caucasian man in whom the disease presented with widespread lytic lesions in the axial skeleton and long bones, mimicking metastatic disease. There was no involvement of the peripheral skeleton, skin or lungs. (orig.)

  10. Immunoglobulin G4-Related Disease Mimicking Asthma

    Directory of Open Access Journals (Sweden)

    Hiroshi Sekiguchi

    2013-01-01

    Full Text Available Immunoglobulin (Ig G4-related disease (also known as ‘IgG4-related sclerosing disease’, ‘IgG4-related systemic disease’ or ‘hyper-IgG4-disease’ is a recently recognized systemic fibroinflammatory disease associated with IgG4-positive plasma cells in tissue lesions. IgG4-related disease was initially described as autoimmune pancreatitis, but it is now known to affect virtually any organ. The authors describe a patient presenting with multi-organ manifestations, including airway inflammation mimicking asthma, pulmonary parenchymal infiltrates, intrathoracic lymphadenopathy, submandibular gland swelling and a kidney mass.

  11. Remote Cutaneous Breast Carcinoma Metastasis Mimicking Dermatitis

    Directory of Open Access Journals (Sweden)

    Annakan V Navaratnam

    2015-01-01

    Full Text Available Cutaneous metastases from primary internal malignancies are an uncommon presentation. Cutaneous metastases are more frequently seen in breast cancer than in any other visceral malignancy in women. Medical practitioners should be vigilant of the possibility of unusual presentations of metastatic disease in breast cancer patients with lobular carcinoma presenting as cutaneous lesions mimicking benign dermatological conditions. Herein, we present a case of a 75-year-old woman presenting with cutaneous lobular breast carcinoma metastases on her anterior right leg, which had previously been misdiagnosed as dermatitis for 9 years.

  12. Delayed traumatic diaphragmatic hernia mimicking hydropneumothorax

    Directory of Open Access Journals (Sweden)

    Rachna Wadhwa

    2014-01-01

    Full Text Available Traumatic diaphragmatic hernia (TDH is generally a consequence of thoraco-abdominal trauma. Anaesthetic problems arise due to herniation of abdominal contents into the thoracic cavity causing diaphragmatic dysfunction, lung collapse, mediastinal shift and haemodynamic instability. Diagnosis depends on history, clinical signs and radiological investigations. Sometimes, it may be misdiagnosed as hydropneumothorax due to the presence of air and fluid in the viscera lying in the pleural cavity. We report a case of TDH mimicking hydropneumothorax on radiological investigations and subsequent surgical management, which led to serious complications.

  13. Brucellosis in spondyloarthritis mimicking an exacerbation.

    Science.gov (United States)

    Garip, Y; Eser, F; Erten, S; Yilmaz, O; Yildirim, P

    2014-01-01

    Spondyloarthritis are a group of chronic inflammatory diseases that affect the axial skeleton, entheses and peripheral joints and may have extraarticular manifestations such as uveitis, psoriasis and inflammatory bowel disease. Brucellosis is a systemic infectious disease, endemic in Middle East, Latin America, and Mediterranean countries, which may present manifestations that resemble other diseases posing serious problems of differential diagnosis. Some hallmarks of Brucellosis may mimic a spondyloarthritis flare. In this paper, authors present a clinical case of brucellosis occurring in a patient with spondyloarthritis. Clinical symptoms initially mimicked exacerbation of spondyloarthritis.

  14. Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis.

    Science.gov (United States)

    Smith, Joshua P; Arnoletti, J Pablo; Varadarajulu, Shyam; Morgan, Desiree E

    2008-01-01

    Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections typically become lower in attenuation over time, and often appear as homogeneous fluid collections. Saponification as a complication of fat necrosis in patients with acute pancreatitis is a well recognized clinical entity. While retroperitonal fat necrosis is commonly seen on CECT, saponification is not a prominent imaging feature. We present a case of acute pancreatitis complicated by extensive saponification of fat throughout the retroperitoneum and peritoneal lining, mimicking carcinomatosis.

  15. Severe emphysematous pyelonephritis mimicking intestinal obstruction.

    Science.gov (United States)

    Sun, Ji Ning; Zhang, Bao Long; Yu, Hai Yan; Wang, Bin

    2015-12-01

    Emphysematous pyelonephritis is a severe necrotizing infection characterized by the presence of gas and/or fluid in the renal parenchyma, collecting system, or perirenal tissues. Emphysematous pyelonephritis with approximately 15 cm air-fluid level, diffused ureteral involvement, and the accumulation of gas in liver and peritoneal cavity is very rare. Here, we reported a severe emphysematous pyelonephritis with multiple huge air-fluid level mimicking intestinal obstruction and with the accumulation of gas in liver and ureter in computed tomography imaging. The patient was successfully managed by percutaneous nephrostomy combined with medical treatment.

  16. Mimicked Web Page Detection over Internet

    Directory of Open Access Journals (Sweden)

    Y. Narasimha Rao

    2014-01-01

    Full Text Available Phishing is process of steeling valuable information such as ATM pins, Credit card details over internet. Where the attacker creates mimicked web pages from the legitimate web pages to fool users. In this paper, we propose an effective anti-phishing solution, by combining image based visual similarity based approach to detect plagiarized web pages. We used effective algorithms for our detection mechanism, speeded up Robust Features (SURF algorithm in order to generate signature based on extracting stable key points from the screen shot of the web page. When a legitimate web page is registered with our system, this algorithm applied on that web page in order to generate signatures, and these signatures are stored in the database for our trained system. When there is a suspected web page, this algorithm is applied to generate both the signatures of the suspected page and is verified against our database of corresponding legitimate web pages. Our results verified that our proposed system is very effective to detect the mimicked web pages with minimal false positives

  17. Doxycycline-induced ulceration mimicking esophageal cancer

    Science.gov (United States)

    Tahan, Veysel; Sayrak, Hakan; Bayar, Nevzat; Erer, Burak; Tahan, Gulgun; Dane, Faysal

    2008-01-01

    Introduction Doxycycline-induced esophageal ulcer patients are mostly young persons with no history of esophageal dysfunction. Heartburn, midsternal pain and dysphagia are the most common symptoms. It has generally a benign course. The present case is the first report of doxycycline-induced extensive ulcerations, mimicking esophageal cancer in two esophageal segments alongside, in the literature. Case presentation This report describes a 16-year-old Caucasian girl who, while taking doxycycline capsules100 mg twice a day for acne vulgaris for 3 months, developed these symptoms. An upper endoscopy revealed multiple circumferential deep ulcerations surrounding fragile, irregular, hyperemic and hypertrophic mucosa at the level of the mid-esophagus and concomitantly in the lower esophageal sphincter. The lesions were biopsied to exclude esophageal carcinoma because of the suspicious appearance in the endoscopic examination. The histopathological examination, haematoxylin and eosin stained sections showed ulceration with a mixed inflammatory infiltrate. Doxycycline was discontinued and she was given sucralfate 1 g qid and omeprazole 20 mg bid orally. All symptoms of the patient were resolved on the third day of the treatment. After 4 weeks of the therapy, an upper endoscopic control examination demonstrated normal findings. Conclusion The present case has been an uncommon presentation of doxycycline-induced extensive ulcerations, mimicking esophageal cancer in two esophageal segments, concomitantly. Even the lesions were biopsied to exclude esophageal carcinoma. A modification on the behavior of taking drugs can prevent these unpleasant complications. PMID:18778470

  18. Mimicking Seawater For Culturing Marine Bacteria

    DEFF Research Database (Denmark)

    Rygaard, Anita Mac; Sonnenschein, Eva; Gram, Lone

    2015-01-01

    Only about 1% of marine bacteria have been brought into culture using traditional techniques. The purpose of this study was to investigate if mimicking the natural bacterial environment can increase culturability.We used marine substrates containing defined algal polymers or gellan gum as solidif......Only about 1% of marine bacteria have been brought into culture using traditional techniques. The purpose of this study was to investigate if mimicking the natural bacterial environment can increase culturability.We used marine substrates containing defined algal polymers or gellan gum...... as solidifying agents, and enumerated bacteria from seawater and algal exudates. We tested if culturability could be influenced by addition of quorum sensing signals (AHLs). All plates were incubated at 15°C. Bacterial counts (CFU/g) from algal exudates from brown algae were highest on media containing algal...... polymers. In general, bacteria isolated from algal exudates preferred more rich media than bacteria isolated from seawater. Overall, culturability ranged from 0.01 to 0.8% as compared to total cell count. Substitution of agar with gellan gum increased the culturability of seawater bacteria approximately...

  19. Clinical and Histologic Mimickers of Celiac Disease.

    Science.gov (United States)

    Kamboj, Amrit K; Oxentenko, Amy S

    2017-08-17

    Celiac disease is an autoimmune disorder of the small bowel, classically associated with diarrhea, abdominal pain, and malabsorption. The diagnosis of celiac disease is made when there are compatible clinical features, supportive serologic markers, representative histology from the small bowel, and response to a gluten-free diet. Histologic findings associated with celiac disease include intraepithelial lymphocytosis, crypt hyperplasia, villous atrophy, and a chronic inflammatory cell infiltrate in the lamina propria. It is important to recognize and diagnose celiac disease, as strict adherence to a gluten-free diet can lead to resolution of clinical and histologic manifestations of the disease. However, many other entities can present with clinical and/or histologic features of celiac disease. In this review article, we highlight key clinical and histologic mimickers of celiac disease. The evaluation of a patient with serologically negative enteropathy necessitates a carefully elicited history and detailed review by a pathologist. Medications can mimic celiac disease and should be considered in all patients with a serologically negative enteropathy. Many mimickers of celiac disease have clues to the underlying diagnosis, and many have a targeted therapy. It is necessary to provide patients with a correct diagnosis rather than subject them to a lifetime of an unnecessary gluten-free diet.

  20. Inherited cardiomyopathies mimicking arrhythmogenic right ventricular cardiomyopathy.

    Science.gov (United States)

    Roberts, Jason D; Veinot, John P; Rutberg, Julie; Gollob, Michael H

    2010-01-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) represents an inherited cardiomyopathy that manifests clinically with malignant ventricular arrhythmias, sudden cardiac death, and less commonly heart failure. The condition is characterized by replacement of the myocardium, primarily of the right ventricle, with fibrofatty tissue. Extensive fibrofatty replacement of the myocardium has been previously thought to be pathognomonic of ARVC; however, this report details two other forms of inherited cardiomyopathy, namely hypertrophic cardiomyopathy (HCM) and the PRKAG2 cardiac syndrome, that were found to have significant fibrofatty myocardial replacement at pathologic examination. This report represents the first documentation of inherited cardiomyopathies mimicking ARVC and highlights the concept that other cardiac conditions can be associated with fibrofatty replacement of the myocardium. Copyright 2010 Elsevier Inc. All rights reserved.

  1. Tentorium schwannoma mimicking meningioma: an unusual location.

    Science.gov (United States)

    Calişaneller, Tarkan; Ozen, Ozlem; Altinörs, Nur; Caner, Hakan

    2008-07-01

    A 60-year-old female was admitted to our clinic complaining of a long-lasting headache. Cranial magnetic resonance imagining examination of the patient revealed a 22x24 mm extra-axial, well-demarcated, mass lesion based on the left tentorium. The patient underwent a craniotomy and the tumor was totally excised with the adjacent tentorium. The histopathological examination of the tumor complied with the diagnosis of schwannoma. The rest of the clinical course was uneventful and the patient was released from the hospital without any neurological deficit. Intracranial schwannomas can rarely originate from atypical dural locations and radiological techniques are not always helpful in distinguishing tentorial schwannoma from tentorial meningioma. We presented a patient with a tentorium schwannoma mimicking meningioma and discussed the current literature.

  2. Orbital Lymphoma Mimicking Lacrimal Gland Pleomorphic Adenoma

    Directory of Open Access Journals (Sweden)

    Diego Strianese

    2013-09-01

    Full Text Available Purpose: To describe the case of a patient affected by orbital lymphoma mimicking pleomorphic adenoma of the lacrimal gland. Methods: This was a retrospective case report. Results: We present the case of a patient with 15-year history of slowly progressive left proptosis and inferomedial bulbar dislocation who had the presumptive diagnosis of lacrimal gland pleomorphic adenoma based on clinical and radiological features. The patient underwent lateral orbitotomy and lacrimal gland excision. Postoperative histological features were consistent with low-grade B-cell non-Hodgkin lymphoma. Conclusion: The accepted clinico-radiological criteria used for the diagnosis of lacrimal gland fossa lesions might have a certain false-positive rate, even in recent years. The initial surgical approach with the appropriate choice between fine-needle aspiration biopsies, intraoperative biopsies and lacrimal gland excisions might be a challenge.

  3. Prolonged acute hepatitis A mimicking autoimmune hepatitis

    Institute of Scientific and Technical Information of China (English)

    Rintaro Mikata; Osamu Yokosuka; Fumio Imazeki; Kenichi Fukai; Tatsuo Kanda; Hiromitsu Saisho

    2005-01-01

    AIM: We report a case with a prolonged course of hepatitisA, with alanine aminotransferase (ALT) higher than 500 IU/Lfor more than 2 mo.METHODS: A middle-aged woman had an elevated IgG level of more than 2 000 mg/dL, positive arti-nudear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained. CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCAproved to be effective.

  4. Case report. Pityriasis versicolor mimicking Pityriasis rotunda.

    Science.gov (United States)

    Aste, Nicola; Pau, Monica; Aste, Natalia; Biggio, P

    2002-04-01

    Pityriasis versicolor is a common dermatomycosis, occurring throughout the world, characterized by irregular, slightly scaly patches, varying in color from red/light brown to white. Pityriasis rotunda, on the other hand, is an uncommon disease, reported in specific ethnic groups, and characterized by perfectly round or oval patches of varying color, with a scaly surface. The histologic pattern is that of ichthyosis vulgaris. We report here the case of a male patient, aged 31, from Sardinia (Italy), affected by Pityriasis versicolor mimicking Pityriasis rotunda. Mycological examination allowed us to formulate the correct diagnosis, and ensuing treatment with antifungal drugs was entirely successful. The authors, while pointing out the rarity of this case, stress the possibility that Pityriasis versicolor mimics Pityriasis rotunda and vice-versa, especially in those countries in which the two diseases are endemic. More widespread recourse to microscopic examination can help avoid the risk of mistaken diagnosis and consequent incorrect treatment.

  5. A subtle mimicker in emergency department

    Science.gov (United States)

    Angelis, Maria Vittoria De; Giacomo, Roberta Di; Muzio, Antonio Di; Onofrj, Marco; Bonanni, Laura

    2016-01-01

    Abstract Background: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality. Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion. Methods: We describe 2 examples, accompanied by videos, of acute drug-induced oro-mandibular dystonia, both subsequent to occasional haloperidol intake. Results: Management and treatment of this movement disorder are often difficult: neuroleptics withdrawal, treatment with benzodiazepines, and anticholinergics are recommended. Conclusion: Alternative treatment options are also discussed. PMID:27741141

  6. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Min; Lee, Seung Hun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Bae, Ji Yoon [Dept. of Pathology, National Police Hospital, Seoul (Korea, Republic of)

    2015-12-15

    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis.

  7. Lumbar Epidural Varix Mimicking Perineural Cyst

    Science.gov (United States)

    Pusat, Serhat; Kural, Cahit; Aslanoglu, Atilla; Kurt, Bulent

    2013-01-01

    Lumbar epidural varices are rare and usually mimick lumbar disc herniations. Back pain and radiculopathy are the main symptoms of lumbar epidural varices. Perineural cysts are radiologically different lesions and should not be confused with epidural varix. A 36-year-old male patient presented to us with right leg pain. The magnetic resonance imaging revealed a cystic lesion at S1 level that was compressing the right root, and was interpreted as a perineural cyst. The patient underwent surgery via right L5 and S1 hemilaminectomy, and the lesion was coagulated and removed. The histopathological diagnosis was epidural varix. The patient was clinically improved and the follow-up magnetic resonance imaging showed the absence of the lesion. Lumbar epidural varix should be kept in mind in the differential diagnosis of the cystic lesions which compress the spinal roots. PMID:23741553

  8. Implantación de stent en neonatos y lactantes menores con cardiopatía congénita cianosante ductus dependiente

    Directory of Open Access Journals (Sweden)

    Juan P Rojas

    2014-04-01

    Full Text Available Introducción: Los pacientes con cardiopatía congénita cianosante ductus dependiente, requieren de su permeabilidad para garantizar el flujo al sistema pulmonar o al sistémico. En casos de permeabilidad del ductus arterioso, la implantación de un stent ductal mejora la sobrevida del paciente y acarrea complicaciones mínimas. Objetivos: General: caracterizar neonatos y lactantes menores con cardiopatía congénita cianosante ductus dependiente tratados con la implantación de stent ductal. Específicos: determinar la morbilidad y mortalidad en neonatos y lactantes menores con cardiopatía congénita cianosante ductus dependiente, tratados con implantación de stent ductal. Materiales y métodos: Se incluyeron 37 pacientes recién nacidos con cardiopatía congénita cianosante ductus dependiente tratados con implantación de stent ductal, entre el 1.º de enero de 2008 al 31 de diciembre de 2012 (5 años, en Cali, Colombia. Resultados: La implantación del stent ductal fue exitosa en 26 pacientes; uno falleció inmediatamente después del procedimiento. No hubo complicaciones mayores durante el procedimiento de implantación del stent. Diez pacientes fueron sometidos a cirugía de Blalock-Taussig modificada después de la implantación fallida del stent ductal. Conclusiones: La implantación del stent ductal se convierte en una herramienta importante en el paciente con cardiopatía congénita cianosante ductus dependiente ya que ofrece menor tasa de morbilidad y mortalidad.

  9. Screening for adverse pregnancy outcome by ductus venosus Doppler at 11-13+6 weeks of gestation.

    Science.gov (United States)

    Maiz, Nerea; Valencia, Catalina; Emmanuel, Edoho E; Staboulidou, Ismini; Nicolaides, Kypros H

    2008-09-01

    To estimate the independent contribution of abnormal flow in the ductus venosus at 11 to 13+6 weeks of gestation in the prediction of major fetal abnormalities and fetal death. This was a prospective assessment of singleton pregnancies by maternal history, serum free beta-hCG, pregnancy-associated plasma protein A (PAPP-A), fetal nuchal translucency thickness, and ductus venosus Doppler. The patients were subdivided into five groups: normal outcome (n=10,120), miscarriage or fetal death (n=185), abnormal karyotype (n=95), and major cardiac (n=20) or noncardiac defect (n=70). Regression analysis was performed to determine the significance of the contribution to adverse outcome of reversed a-wave in the ductus venosus, maternal characteristics, fetal delta nuchal translucency, maternal serum log PAPP-A multiples of the median, and log free beta-hCG multiples of the median. The prevalence of reversed a-wave was significantly higher in the groups with miscarriage or fetal death (10.8%), abnormal karyotype (62.1%), and fetal cardiac defect (25.0%) than in the normal outcome group (3.7%), but not noncardiac defect (4.3%). An adverse outcome was observed in 2.7% of the fetuses with nuchal translucency at or below the 95th centile (in 2.6% of those with normal a-wave and in 7.0% of those with reversed a-wave) and in 19.3% of the fetuses with nuchal translucency above the 95th centile (in 8.9% of those with normal a-wave and in 70.9% of those with reversed a-wave). Reversed a-wave is associated with increased risk for chromosomal abnormalities, cardiac defects, and fetal death. However, in about 80% of cases with reversed a-wave, the pregnancy outcome is normal.

  10. Squamous cell carcinoma originating from a thyroglossus duct cyst; Plattenepithelkarzinom der Schilddruese ausgehend von einer Ductus thyreoglossus Zyste

    Energy Technology Data Exchange (ETDEWEB)

    Kresnik, E. [Nuklearmedizinische Abt., LKH Klagenfurt (Austria); Gallowitsch, H.J. [Nuklearmedizinische Abt., LKH Klagenfurt (Austria); Ploeb, J. [Nuklearmedizinische Abt., LKH Klagenfurt (Austria); Gomez, I. [Nuklearmedizinische Abt., LKH Klagenfurt (Austria); Mikosch, P. [Nuklearmedizinische Abt., LKH Klagenfurt (Austria); Dinges, H.P. [Pathologisches Inst., LKH Klagenfurt (Austria); Lind, P. [Nuklearmedizinische Abt., LKH Klagenfurt (Austria)

    1995-04-01

    A 73 y old female was found to suffer from a squamous cell carcinoma with a focal thymus-like differentiation in a thyroglossal duct cyst. A neoplasma of this type in a goitre with Graves` disease is extremely rare. Sonographic, radiological, scintigraphic and microscopic findings are discussed. (orig.) [Deutsch] Es wird ueber eine 73jaehrige Patientin mit dem sehr seltenen Fall eines Karzinoms berichtet, das sich in einer Ductus thyreoglossus-Zyste innerhalb einer Struma diffusa et nodosa entwickelt hatte. Zusaetzlich bestand eine Immunthyreopathie Typ Basedow. Sonographische, roentgenologische, szintigraphische und histologische Befunde werden vorgestellt. (orig.)

  11. Hyperdense dots mimicking microcalcifications : Mammographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Nam Hyeon; Park, Jeong Mi; Goo, Hyun Woo; Bang, Sun Woo [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    1996-12-01

    To differentiate fine hyperdense dots mimicking microcalcifications from true microcalcifications on mammography. Mammograms showing hyperdense dots in ten patients (mean age, 59 years) were evaluated. Two radiologists were asked to differentiate with the naked eye the hyperdense dots seen on ten mammograms and proven microcalcifications seen on ten mammograms. Densitometry was also performed for all lesions and the contrast index was calculated. The shape and distribution of the hyperdense dots were evaluated and enquires were made regarding any history of breast disease and corresponding treatment. Biopsies were performed for two patients with hyperdense dots. Two radiologists made correct diagnoses in 19/20 cases(95%). The contrast index was 0.10-0.88 (mean 0.58) for hyperdense dots and 0.02-0.45 (mean 0.17) for true microcalcifications. The hyperdense dots were finer and homogeneously rounder than the microcalcifications. Distribution of the hyperdense dots was more superficial in subcutaneous fat (seven cases) and subareolar area (six cases). All ten patients with hyperdense dots had history of mastitis and abscesses and had been treated by open drainage (six cases) and/or folk remedy (four cases). In eight patients, herb patches had been attached. Biopsies of hyperdense dots did not show any microcalcification or evidence of malignancy. These hyperdense dots were seen mainly in older patients. Their characteristic density, shape, distribution and clinical history makes differential diagnosis from true microcalcifications easy and could reduce unnecessary diagnostic procedures such as surgical biopsy.

  12. Cervical spinal meningioma mimicking intramedullary spinal tumor.

    Science.gov (United States)

    Senturk, Senem; Guzel, Aslan; Guzel, Ebru; Bayrak, Aylin Hasanefendioğlu; Sav, Aydin

    2009-01-01

    Case report. To report a very unusual spinal meningioma, mimicking an intramedullary spinal tumor. Spinal meningiomas, usually associated with signs and symptoms of cord or nerve root compression, are generally encountered in women aged over 40. Radiologic diagnosis is often established by their intradural extramedullary location on magnetic resonance images. A 60-year-old woman had a 6-month history of progressive weakness in her upper extremities, difficulty in walking, and cervical pain radiating through both arms. Neurologic examination revealed motor strength deficiency in all her extremities, with extensor reflexes, clonus, and bilateral hyper-reflexiveness. A sensory deficit was present all over her body. Magnetic resonance images revealed that the spinal cord appeared expanded with an ill-defined, homogeneously contrast-enhanced, lobulated, eccentric mass at the C1-C3 level. The patient was operated with a preliminary diagnosis of an intramedullary tumor. At surgery, the mass was found to be extramedullary, and gross total resection was performed. Histopathological examination revealed a meningioma characterized by the presence of fibrous and meningothelial components. The patient was able to ambulate with a cane, and extremity strength and sensation improved 2 months after surgery. Spinal meningiomas can mimic intramedullary tumors, and should be considered in differential diagnosis of intradural tumors with atypical appearance.

  13. Lymphocitic infundibuloneurohypophysitis mimicking a pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Hubertus Maximilian Mehdorn

    2011-04-01

    Full Text Available A rare case of infundibulo-neurohypophysitis mimicking a pituitary adenoma is presented. A 69-years-old female patient developed polyuria and polydipsia. Laboratory analysis revealed central diabetes insipidus. No hormonal abnormalities. Cranial-magnetic resonance imaging (MRI showed a left sided mass in the adenohypophysis presuming a pituitary adenoma. The mass had contact to both internal carotids. Admission to our department for neurosurgical treatment followed. Ophthalmo - logic examination and neurological examination yielded normal findings. A second MRI focussing on the sellar-region showed a leftsided (T2-MRI.hyperintense, distended adenohypophysis, without contrast enhancement in T1. The stalk appeared thickened. T1- weighted sequences of the neurohypophysis showed loss of signal intensity. We diagnosed an infundibulo-neurohypophysitis and abstai - ned from surgical removal. The patient was discharged under treatment with corticosteroids and desmopressin. Hypophysitis is rare and shows special clinical characteristics. Despite defined radiological features to differentiate between hypophysitis and adenoma the possibility of misdiagnosis, and unnecessary surgical procedures, should always kept in mind.

  14. Microfabricated adhesive mimicking gecko foot-hair

    Science.gov (United States)

    Geim, A. K.; Dubonos, S. V.; Grigorieva, I. V.; Novoselov, K. S.; Zhukov, A. A.; Shapoval, S. Yu.

    2003-07-01

    The amazing climbing ability of geckos has attracted the interest of philosophers and scientists alike for centuries. However, only in the past few years has progress been made in understanding the mechanism behind this ability, which relies on submicrometre keratin hairs covering the soles of geckos. Each hair produces a miniscule force ~10-7 N (due to van der Waals and/or capillary interactions) but millions of hairs acting together create a formidable adhesion of ~10 N cm-2: sufficient to keep geckos firmly on their feet, even when upside down on a glass ceiling. It is very tempting to create a new type of adhesive by mimicking the gecko mechanism. Here we report on a prototype of such 'gecko tape' made by microfabrication of dense arrays of flexible plastic pillars, the geometry of which is optimized to ensure their collective adhesion. Our approach shows a way to manufacture self-cleaning, re-attachable dry adhesives, although problems related to their durability and mass production are yet to be resolved.

  15. Hydroxychloroquine-associated hyperpigmentation mimicking elder abuse.

    Science.gov (United States)

    Cohen, Philip R

    2013-12-01

    Hydroxychloroquine may result in cutaneous dyschromia. Older individuals who are the victims of elder abuse can present with bruising and resolving ecchymoses. The features of hydroxychloroquine-associated hyperpigmentation are described, the mucosal and skin manifestations of elder abuse are reviewed, and the mucocutaneous mimickers of elder abuse are summarized. An elderly woman being treated with hydroxychloroquine for systemic lupus erythematosus developed drug-associated black and blue pigmentation of her skin. The dyschromia was misinterpreted by her clinician as elder abuse and Adult Protective Services was notified. The family was eventually cleared of suspected elder abuse. A skin biopsy of the patient's dyschromia confirmed the diagnosis of hydroxychloroquine-associated hyperpigmentation. Hyperpigmentation of skin, mucosa, and nails can be observed in patients treated with antimalarials, including hydroxychloroquine. Elder abuse is a significant and underreported problem in seniors. Cutaneous findings can aid in the discovery of physical abuse, sexual abuse, and self-neglect in elderly individuals. However, medication-associated effects, systemic conditions, and accidental external injuries can mimic elder abuse. Therefore, a complete medical history and appropriate laboratory evaluation, including skin biopsy, should be conducted when the diagnosis of elder abuse is suspected.

  16. Controlled Deposition of HAp Mimicking Tooth Enamel

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Chemical compositions and microsturcture of mature human tooth enamel were investigated by XRD , FTIR and SEM to further understand the characteristics of tooth enamel. In order to obtain apatite crystals chemically and structurally similar to those in tooth enamel, biomimetic way was employed. Selfassembled monolyers terminated with-SO3 H groups were used as deposition substrates and 1.5 SBF ( the concentrations of Ca2+ and PO43- ions 1.5 times than those in simulated body fluid ) with and without 5 ppm F- were used as soaking medium. The XRD and FTIR results showed that both the deposited fluoride-substituted hydroxyapatite( F-HAp ) crystals in 1.5 SBF with F- and hydroxyapatite ( HAp ) crystals in 1.5 SBF were carbonate-containing, mimicking human tooth enamel in chemical compositions. The SEM photos showed that needle-like F-HAp crystals bad large aspect ratios and grew in bundles, which were similar to the crystals in human tooth enamel.The results provide available information on dental restoration.

  17. Mimicking Bone - Chemical and Physical Challenges

    Directory of Open Access Journals (Sweden)

    Sophie C Cox

    2014-08-01

    Full Text Available It is known that chemical and physical features of bone contribute to its functionality, reactivity and mechanical performance. This fundamental rationale underpins the author’s research strategy. This paper presents a summary of efforts to fabricate a synthetic structure, referred to as a scaffold, that both chemically and physical emulates the intricate structure of bone. An understanding of key features of bone tissue that contribute to its remarkable properties is presented as a background to this work. Novel work aimed at improving the understanding of the synthesis of a ceramic biomaterial, namely hydroxyapatite, that is chemically similar to bone mineral is discussed. A case study involving the manufacture of porous scaffolds by 3D printing is also presented. In summary, this article highlights a number of on-going challenges that multidisciplinary tissue engineers aim to solve to get one step closer to mimicking bone, which clinically could improve the quality of life for millions of people worldwide.  Photo credit: By Doc. RNDr. Josef Reischig, CSc. (Author's archive [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0], via Wikimedia Commons

  18. Non-harmful insertion of data mimicking computer network attacks

    Science.gov (United States)

    Neil, Joshua Charles; Kent, Alexander; Hash, Jr, Curtis Lee

    2016-06-21

    Non-harmful data mimicking computer network attacks may be inserted in a computer network. Anomalous real network connections may be generated between a plurality of computing systems in the network. Data mimicking an attack may also be generated. The generated data may be transmitted between the plurality of computing systems using the real network connections and measured to determine whether an attack is detected.

  19. Infrasellar craniopharyngioma mimicking a clival chordoma : a case report.

    Directory of Open Access Journals (Sweden)

    Kachhara R

    2002-04-01

    Full Text Available An unusual case of entirely infrasellar craniopharyngioma mimicking a clival chordoma is described. Only 22 cases of craniopharyngioma with nasopharyngeal extension have been reported in the literature. Of the reported cases, most were primarily intracranial with secondary downward extension; only two were thought to originate from an infrasellar location. The present case is another example of an entirely infrasellar craniopharyngioma, with extensive clival destruction, mimicking a clival chordoma. Relevant literature on the subject is reviewed.

  20. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae

    Science.gov (United States)

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

    2016-01-01

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

  1. Restless legs syndrome mimicking S1 radiculopathy.

    Science.gov (United States)

    Zambelis, Th; Wolgamuth, B R; Papoutsi, S N; Economou, N T

    2016-01-01

    mimicking several pathological conditions, Restless Legs Syndrome prevalence on general population according to various large epidemiological studies and pathogenic hypotheses on the issue of Restless Legs Syndrome are discussed. Finally, by presenting another possible "RLS-mimic" our aim is to highlight the common misdiagnosis of Restless Legs Syndrome, which can mimic a variety of disorders, some of which are very common, such as an S1 radiculopathy, thus raising concern among doctors of various specialties addressed to by Restless Legs Syndrome sufferers, on the importance of proper diagnosis of the syndrome.

  2. Rare case of truncus arteriosus with anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) and unilateral left pulmonary artery agenesis.

    Science.gov (United States)

    Mittal, Kartik; Dey, Amit K; Gadewar, Rohit; Sharma, Rajaram; Pandit, Nilesh; Rajput, Priya; Hira, Priya

    2015-04-01

    The incidence of congenital heart disease (CHD) is 2.4-3.8/1000 live births. Up to 70.7 % of all cases of CHD are reported to be benign; complex heart anomalies are extremely rare. Our case is extremely rare, as we report three very rare findings-truncus arteriosus, anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA), and unilateral left pulmonary artery agenesis-in a single patient. Congenital complex cardiac abnormalities are very rare, and two-dimensional echocardiography screening should be supported by cardiac computed tomography (CT). We report a case of truncus arteriosus associated with ARCAPA and left pulmonary artery agenesis diagnosed by cardiac computed tomography; we believe that such an unusual case with all three of these entities has never been reported before.

  3. Mesalamine treatment mimicking relapse in a child with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Iva Hojsak; Ana M Pavić; Sanja Kolaček

    2014-01-01

    Background: There are reports on mesalamine-induced bloody diarrhea mimicking ulcerative colitis (UC) relapse, mostly in adults. Methods: Herein we present a case of a child with UC who developed relapse of hemorrhagic colitis related to mesalamine. Results: A 10-year-old girl developed severe symptoms mimicking UC relapse 3 weeks after introduction of mesalamine therapy. After mesalamine was withdrawn, her symptoms improved, but deteriorated again during the challenge of mesalamine despite concomitant use of corticosteroids. Conclusion: This is the fi rst case report on such a young child during the concomitant use of corticosteroids.

  4. Primary Papillary Mucinous Adenocarcinoma of the Ureter Mimicking Genitourinary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Hanni Gulwani

    2010-01-01

    Full Text Available Primary adenocarcinomas of the renal pelvis and ureter are rare and account for less than 1% of all malignancies at this site. We report a case of primary papillary mucinous adenocarcinoma of the ureter that clinically mimicked genitourinary tuberculosis. Early diagnosis is important for the better outcome.

  5. Osteoid osteoma of the radial styloid mimicking de quervain tenosynovitis.

    Science.gov (United States)

    Chloros, George D; Themistocleous, George S; Papagelopoulos, Panayiotis J; Khaldi, Lubna; Efstathopoulos, Dimitrios G; Soucacos, Panayotis N

    2007-10-01

    A very unusual location of osteoid osteoma arising in the radial styloid is presented, which strongly mimicked de Quervain tenosynovitis, thereby resulting in the patient undergoing an additional unnecessary operation and a substantial delay of more than 2 years in diagnosis.

  6. Spinal MRI of vincristine neuropathy mimicking Guillain-Barre syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Yun Woo; Yoon, Hye-Kyung; Cho, Jae Min [Department of Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Kangnam-gu, Seoul 135-710 (Korea); Sung, Ki Woong [Department of Paediatrics, Samsung Medical Centre, Seoul 135-710 (Korea)

    2003-11-01

    A 4.3-year-old girl with acute leukaemia, who was being treated with chemotherapy (including vincristine), developed paraplegia. Spinal MRI showed diffusely enhancing nerve roots on contrast-enhanced images. Spinal fluid analysis showed a normal protein level. Vincristine neuropathy mimicking Guillain-Barre syndrome is thought to be the cause of the MRI abnormalities. (orig.)

  7. Calcified Klatskin tumor mimicking intrahepatic stone: case report.

    Science.gov (United States)

    Park, H S; Han, J K; Lee, H S; Lee, K H; Kim, S H; Kim, K W; Kim, Y J; Kim, H-C; Choi, B I

    2005-01-01

    Calcification is a relatively uncommon manifestation of malignant liver neoplasm. Calcifications in peripheral cholangiocarcinomas but not in Klatskin tumor have been reported. We present a rare case of Klatskin tumor that had dystrophic calcification mimicking a intrahepatic stone in a 65-year-old man.

  8. Achromobacter xylosoxidans infection presenting as a pulmonary nodule mimicking cancer.

    Science.gov (United States)

    Claassen, Stephanie L; Reese, Jason M; Mysliwiec, Vincent; Mahlen, Steven D

    2011-07-01

    Achromobacter xylosoxidans is typically isolated from pulmonary sources, presenting as pneumonia in immunosuppressed individuals. We describe a novel clinical presentation of A. xylosoxidans infection presenting as multiple spiculated, pulmonary nodules mimicking cancer for which the patient underwent a wedge resection of the lung for diagnosis and staging of presumptive cancer.

  9. Cutaneous lymphoid hyperplasia mimicking cutaneous lymphoma in a hyperthyroid cat.

    Science.gov (United States)

    Snead, Elisabeth; Kerr, Moira; Macdonald, Valerie

    2013-10-01

    A 12-year-old neutered male domestic shorthair cat presented for chronic, localized, swelling and crusting of the left upper lip, weight loss, sporadic vomiting, and focal alopecia between the scapulae was diagnosed with hyperthyroidism and regional eosinophilic lymphadenitis. Treatment with methimazole exacerbated an underlying hypersensitivity disorder leading to marked generalized lymphadenopathy that histologically mimicked lymphoma.

  10. Diffuse Large B Cell Lymphoma Mimicking Granulomatosis with Polyangiitis

    Science.gov (United States)

    Horowitz, Netanel; Ben-Itzhak, Ofer; Braun-Moscovici, Yolanda

    2016-01-01

    In a patient with systemic multiorgan disease with overlapping features, the differential diagnosis included infectious diseases, malignancies, and systemic autoimmune or inflammatory diseases. We present an unusual case of a young male with B cell lymphoma who presented with symptoms mimicking systemic vasculitis and review the existing literature. PMID:27293945

  11. Adenomatoid odontogenic tumour mimicking a periapical cyst in pregnant woman

    DEFF Research Database (Denmark)

    Kothari, Mohit; Bhandari, Neha

    2010-01-01

    EJ, Murrah VA. Adenomatoid odontogenic tumor presenting as periapical disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:557-60) and is associated with the crown of an impacted tooth, commonly the maxillary canine. We present a rare case of extrafollicular AOT mimicking a periapical...

  12. Trichophyton Schoenleinii-induced widespread tinea corporis mimicking parapsoriasis.

    Science.gov (United States)

    Mansouri, P; Farshi, S; Khosravi, A R; Naraghi, Z S; Chalangari, R

    2012-06-01

    We report a case of extensive tinea corporis in an 80-year-old woman on her forearms, thighs, legs, buttocks and trunk, mimicking parapsoriasis due to Trichophyton schoenleinii, without scalp involvement. Diagnosis of Trichophyton schoenleinii was confirmed by microscopy and mycological culture specimens.

  13. Calcific Tendinosis: A Potential Mimicker of Malignancy on PET

    OpenAIRE

    Vogel-Claussen, Jens; Morrison, William; Zoga, Adam; Bergin, Diane; Gopez, Angela; Fayad, Laura M.

    2015-01-01

    We report a case of a 53 year old female with breast cancer and elevated glucose activity at the left greater trochanter on PET imaging. Further imaging with CT and MRI showed that this focus of increased FDG activity on PET was calcific tendinosis of the gluteus medius tendon, which mimicked metastatic disease in this patient.

  14. Headache attributed to unruptured saccular aneurysm, mimicking hemicrania continua.

    Science.gov (United States)

    Vikelis, Michail; Xifaras, Michail; Magoufis, Georgios; Gekas, Georgios; Mitsikostas, Dimos Dimitrios

    2005-06-01

    Unruptured cerebral arterial aneurysms most often remain asymptomatic, but they may cause headache or other symptoms or signs. We describe herewith a case of headache attributed to an unruptured internal carotid artery aneurysm, clearly mimicking the phenotype of hemicrania continua. Potential pathophysiological explanations and recommendations for recognition of similar cases are discussed.

  15. Diffuse Large B Cell Lymphoma Mimicking Granulomatosis with Polyangiitis

    Directory of Open Access Journals (Sweden)

    Mohammad E. Naffaa

    2016-01-01

    Full Text Available In a patient with systemic multiorgan disease with overlapping features, the differential diagnosis included infectious diseases, malignancies, and systemic autoimmune or inflammatory diseases. We present an unusual case of a young male with B cell lymphoma who presented with symptoms mimicking systemic vasculitis and review the existing literature.

  16. Granuloma inguinale mimicking as squamous cell carcinoma of penis

    Directory of Open Access Journals (Sweden)

    Abhishek Pilani

    2014-01-01

    Full Text Available Granuloma inguinale (GI is an acquired chronic, slowly progressive, mildly contagious disease of venereal origin, characterized by granulomatous ulceration of the genitalia and neighboring sites, with little or no tendency to spontaneous healing caused by Klebsiella (Calymmatobacterium granulomatis. A 55-year-old male presented with fissured, foul smelling, fungating growth over prepuce with phimosis mimicking squamous cell carcinoma (SCC without lymphadenopathy. It started with painless papulonodular showed pseudoepitheliomatous hyperplasia, infiltration in dermis, acanthosis and vacuolated macrophages suggestive of GI and not showing any histopathological features of SCC. Patient was successfully treated by giving cotrimoxazole twice a day for 21 days. Here, we presented a case of GI mimicking SCC of penis, which was diagnosed on basis of histopathology and treated with excision followed by medical therapy with cotrimoxazole.

  17. Addison's Disease Mimicking as Acute Pancreatitis: A Case Report.

    Science.gov (United States)

    Chaudhuri, Sayani; Rao, Karthik N; Patil, Navin; Ommurugan, Balaji; Varghese, George

    2017-04-01

    Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison's disease. Adrenal insufficiency (Addison's disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison's disease presenting as acute pain in abdomen mimicking clinical presentation of acute pancreatitis.

  18. Osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis

    Directory of Open Access Journals (Sweden)

    Nirmal Raj Gopinathan

    2016-01-01

    Full Text Available Osteofibrous dysplasia or ossifying fibroma is an uncommon benign fibro-osseous lesion of childhood, commonly described in the maxilla and the mandible. Among long bones, it usually presents in the tibia as a painless swelling or anterior bowing. Ossifying fibroma of clavicle has never been reported in English literature, to the best of our knowledge. Here, we would like to present an unusual case of osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis.

  19. Localized IgG4-related Cholecystitis Mimicking Gallbladder Cancer.

    Science.gov (United States)

    Inoue, Tadahisa; Okumura, Fumihiro; Mizushima, Takashi; Nishie, Hirotada; Iwasaki, Hiroyasu; Anbe, Kaiki; Ozeki, Takanori; Kachi, Kenta; Fukusada, Shigeki; Suzuki, Yuta; Watanabe, Kazuko; Sano, Hitoshi

    2015-01-01

    We encountered a case of localized IgG4-cholecystitis mimicking gallbladder cancer with focal/segmental type1 autoimmune pancreatitis (AIP). In this case, we were unable to exclude a diagnosis of gallbladder cancer and thus performed radical cholecystectomy. Type1 AIP is often associated with gallbladder lesions, accompanied by generally diffuse, circumferential thickening of the gallbladder wall. Although localized IgG4-related cholecystitis is extremely rare, differentiating this condition from gallbladder cancer is often very difficult.

  20. An Adolescent Patient with Scabies Mimicking Gottron Papules

    OpenAIRE

    Eiji Yoshinaga; Naoki Oiso; Shigeru Kawara; Akira Kawada

    2009-01-01

    Atypical features of scabies occur in infants and children and patients with prolonged use of corticosteroids or immunosuppression. We report a non-immunosuppressed 15-year-old female case of scabies showing scaly reddish papules over the proximal interphalangeal joints mimicking Gottron papules in classic dermatomyositis. Periungal erythema was also seen. Four months’ topical corticosteroids from previous clinics had been used. Dermoscopic findings were consistent with typical pictures of sc...

  1. Embryonal rhabdomyosarcoma of the biliary tree mimicking a choledochal cyst

    Directory of Open Access Journals (Sweden)

    Nemade Bhushan

    2007-01-01

    Full Text Available Embryonal rhabdomyosarcoma (ERMS of biliary tree is a rare type of mesenchymal neoplasm diagnosed at surgery or by preoperative liver biopsy. We present a one year eight months old child who mimicked a choledochal cyst and was eventually treated with surgery, chemotherapy with IRS IV protocol and adjuvant postoperative radiotherapy to surgical bed with 6 MV photons to a dose of 5040cGy in 28 fractions.

  2. Spitz Nevus on the Earlobe Mimicking Cutaneous Leishmaniasis

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    İbrahim Özmen

    2010-06-01

    Full Text Available Spitz nevus is a benign, usually acquired melanocytic tumor which is seen especially in children and adolescents. It usually appears as a pink or light-brown, smooth-surfaced, well-circumscribed and asymptomatic papulonodular lesion. A large group of dermatologic disorders should be considered in the differential diagnosis. Herein we present a case of Spitz nevus with a two month history of a nodular lesion on the earlobe which mimicks cutaneous leishmaniasis clinically.

  3. Mimicking biological functionality with polymers for biomedical applications

    Science.gov (United States)

    Green, Jordan J.; Elisseeff, Jennifer H.

    2016-12-01

    The vast opportunities for biomaterials design and functionality enabled by mimicking nature continue to stretch the limits of imagination. As both biological understanding and engineering capabilities develop, more sophisticated biomedical materials can be synthesized that have multifaceted chemical, biological and physical characteristics designed to achieve specific therapeutic goals. Mimicry is being used in the design of polymers for biomedical applications that are required locally in tissues, systemically throughout the body, and at the interface with tissues.

  4. Acutely calcified hematoma mimicking a displaced medial epicondyle fracture

    Directory of Open Access Journals (Sweden)

    Majed Addie

    2009-01-01

    Full Text Available We present an interesting and unusual case of an acutely calcified pin-site infection hematoma mimicking a displaced cartilaginous medial epicondyle, in a child with a Gartland type III fracture. The treatment of such pathology could be confusing and may interfere with the correct clinical decision-making process. To our knowledge, this is the first presentation of such a case.

  5. Osteolytic nasal polyp of the maxillary sinus mimicking malignancy

    Directory of Open Access Journals (Sweden)

    Arvind Karikal

    2014-01-01

    Full Text Available We present an osteolytic nasal polyp of the maxillary sinus with clinical features and radiographic features mimicking that of a malignancy. Maxillary sinusitis being a common inflammatory condition progressed to cause destruction of the maxillary bone and spread into the facial soft tissue, which is quite a rare occurrence. We have discussed in detail the clinical, radiological, histopathology and management of this uncommon presentation of a common case.

  6. Juvenile Myelomonocytic Leukemia in a Premature Neonate Mimicking Neonatal Sepsis

    Directory of Open Access Journals (Sweden)

    Ming-Luen Lee

    2016-04-01

    Full Text Available Juvenile myelomonocytic leukemia (JMML is a rare hematologic malignancy in children. Its presentations include anemia, thrombocytopenia, monocytosis, skin rash, marked hepatomegaly, and/or splenomegaly. Fever and respiratory involvement are common. Here, we report a case of a premature neonate with initial symptoms of respiratory distress. She gradually developed clinical manifestations of JMML that mimicked neonatal sepsis. Three weeks after birth, JMML was diagnosed. This is the first reported case of JMML presenting in a premature infant in Taiwan.

  7. A Case of Hidroacanthoma Simplex Mimicking Bowen s Disease

    Directory of Open Access Journals (Sweden)

    Pinar Ozuguz

    2013-10-01

    Full Text Available Hidroacanthoma simplex is a rare benign tumor that originates from eccrine sweet gland ducts. The lesions are characterized by slowly-growing, flat or slightly elevated, skin-colored, brown or erythematous, verrucous papules or plaques. Clinically, plaques may resemble seborrheic keratosis, basal cell carcinoma and Bowen%u2019s disease. Here, we present a case of atypically localized hidroacanthoma simplex mimicking Bowen%u2019s disease.

  8. A case of gallbladder mass: Malakoplakia (The tumor mimicker

    Directory of Open Access Journals (Sweden)

    Kanwaljeet Singh

    2017-01-01

    Full Text Available Diagnosis of malakoplakia presenting as gall bladder mass is a diagnostic dilemma faced by pathologists, radiologists, and surgeons. Malakoplakia is a rare inflammatory disorder and tumor mimicker usually occurring in the urinary tract, may occasionally be found in gall bladder. Here, we present a rare case, presenting as gall bladder mass in a known case of gallstone disease, clinically suspected as carcinoma and later turned out to be malakoplakia in gall bladder.

  9. Tuberculosis of the skull mimicking a bony tumor

    OpenAIRE

    2016-01-01

    We present a rare case of calvarial tuberculosis mimicking a solitary bone tumor, which was surgically removed. A 52-year-old female presented with a right forehead swelling, which gradually enlarged over the course of 2 years, with no symptoms or raised intracranial pressure or neurological deficits. Plain and contrast-enhanced brain computed tomography scans were done, revealing a punched-out lesion of the right frontal bone, with a nonenhancing lytic mass. With an initial diagnosis of an i...

  10. A Q fever case mimicking crimean-congo haemorrhagic fever

    Directory of Open Access Journals (Sweden)

    O Karabay

    2011-01-01

    Full Text Available Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF in terms of clinical and laboratory findings.

  11. Sciatic Hernia Mimicking Perianal Abscess in a Cirrhotic Patient

    Directory of Open Access Journals (Sweden)

    Wellington Andraus

    2012-01-01

    Full Text Available Abdominal hernias are very frequent in cirrhotic patients with ascites. The hernias usually present as umbilical, inguinal, incisional, or femoral. However, these patients can also develop uncommon hernias such as pelvic hernias because of pelvic floor weakness and high abdominal pressure due to ascites. We present the first case of a cirrhotic patient with ascites that developed a giant sciatic hernia mimicking a perianal abscess.

  12. Dengue fever mimicking acute appendicitis: A case report.

    Science.gov (United States)

    McFarlane, M E C; Plummer, J M; Leake, P A; Powell, L; Chand, V; Chung, S; Tulloch, K

    2013-01-01

    Dengue fever is an acute viral disease, which usually presents as a mild febrile illness. Patients with severe disease present with dengue haemorrhagic fever or dengue toxic shock syndrome. Rarely, it presents with abdominal symptoms mimicking acute appendicitis. We present a case of a male patient presenting with right iliac fossa pain and suspected acute appendicitis that was later diagnosed with dengue fever following a negative appendicectomy. A 13-year old male patient presented with fever, localized right-sided abdominal pain and vomiting. Abdominal ultrasound was not helpful and appendicectomy was performed due to worsening abdominal signs and an elevated temperature. A normal appendix with enlarged mesenteric nodes was found at surgery. Complete blood count showed thrombocytopenia with leucopenia. Dengue fever was now suspected and confirmed by IgM enzyme-linked immunosorbent assay against dengue virus. This unusual presentation of dengue fever mimicking acute appendicitis should be suspected during viral outbreaks and in patients with atypical symptoms and cytopenias on blood evaluation in order to prevent unnecessary surgery. This case highlights the occurrence of abdominal symptoms and complications that may accompany dengue fever. Early recognition of dengue fever mimicking acute appendicitis will avoid non-therapeutic operation and the diagnosis may be aided by blood investigations indicating a leucopenia, which is uncommon in patients with suppurative acute appendicitis. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Heparin-Mimicking Polymers: Synthesis and Biological Applications.

    Science.gov (United States)

    Paluck, Samantha J; Nguyen, Thi H; Maynard, Heather D

    2016-11-14

    Heparin is a naturally occurring, highly sulfated polysaccharide that plays a critical role in a range of different biological processes. Therapeutically, it is mostly commonly used as an injectable solution as an anticoagulant for a variety of indications, although it has also been employed in other forms such as coatings on various biomedical devices. Due to the diverse functions of this polysaccharide in the body, including anticoagulation, tissue regeneration, anti-inflammation, and protein stabilization, and drawbacks of its use, analogous heparin-mimicking materials are also widely studied for therapeutic applications. This review focuses on one type of these materials, namely, synthetic heparin-mimicking polymers. Utilization of these polymers provides significant benefits compared to heparin, including enhancing therapeutic efficacy and reducing side effects as a result of fine-tuning heparin-binding motifs and other molecular characteristics. The major types of the various polymers are summarized, as well as their applications. Because development of a broader range of heparin-mimicking materials would further expand the impact of these polymers in the treatment of various diseases, future directions are also discussed.

  14. Heparin-Mimicking Polymers: Synthesis and Biological Applications

    Science.gov (United States)

    2016-01-01

    Heparin is a naturally occurring, highly sulfated polysaccharide that plays a critical role in a range of different biological processes. Therapeutically, it is mostly commonly used as an injectable solution as an anticoagulant for a variety of indications, although it has also been employed in other forms such as coatings on various biomedical devices. Due to the diverse functions of this polysaccharide in the body, including anticoagulation, tissue regeneration, anti-inflammation, and protein stabilization, and drawbacks of its use, analogous heparin-mimicking materials are also widely studied for therapeutic applications. This review focuses on one type of these materials, namely, synthetic heparin-mimicking polymers. Utilization of these polymers provides significant benefits compared to heparin, including enhancing therapeutic efficacy and reducing side effects as a result of fine-tuning heparin-binding motifs and other molecular characteristics. The major types of the various polymers are summarized, as well as their applications. Because development of a broader range of heparin-mimicking materials would further expand the impact of these polymers in the treatment of various diseases, future directions are also discussed. PMID:27739666

  15. A mixture model of ductus venosus pulsatility index in screening for aneuploidies at 11-13 weeks' gestation.

    Science.gov (United States)

    Maiz, Nerea; Wright, David; Ferreira, Ana Fatima A; Syngelaki, Argyro; Nicolaides, Kypros H

    2012-01-01

    To assess the value of ductus venosus pulsatility index for veins (DV PIV) in screening for aneuploidies at 11-13 weeks' gestation. Fetal DV PIV was measured in singleton pregnancies undergoing first-trimester screening for aneuploidies. In euploid (n = 44,756) and aneuploid (202 cases of trisomy 21, 72 cases of trisomy 18 and 30 cases of trisomy 13) fetuses, DV PIV was best described by a mixture model of distributions. Performance of screening for aneuploidies by DV PIV alone and in combination with fetal nuchal translucency (NT) thickness and serum free β-hCG and PAPP-A was estimated. In euploid pregnancies there was a bimodal distribution of DV PIV with a dominant crown-rump length (CRL)-dependent part, accounting for around 97% of cases in Caucasians and around 93% in Afro-Caribbeans, and a smaller CRL-independent distribution. In aneuploidies the dominant part was the CRL-independent distribution, which accounted for around 85% cases of trisomies 21 and 18 and 70% of cases of trisomy 13. In screening for trisomy 21 by maternal age, NT and biochemistry at a risk cutoff of 1 in 100, the detection rate was 89.7% and false positive rate was 2.74%; with addition of DV PIV, the values were 93.5 and 1.63%, respectively. Measurement of DV PIV improves the performance of first-trimester combined test for aneuploidies. Copyright © 2012 S. Karger AG, Basel.

  16. Subcutaneous phaeohyphomycosis due to Pyrenochaeta romeroi mimicking a synovial cyst

    Directory of Open Access Journals (Sweden)

    Aurelien Dinh

    2016-08-01

    Full Text Available Opportunistic subcutaneous fungal infections are increasing nowadays due to the growing number of medical conditions causing immunosuppression, especially organ transplant. The incidence rate of subcutaneous phaeohyphomycosis is very low. Most studies found are case reports. They showed a wide variation of clinical presentations. Pyrenochaeta romeroi, a fungus from the Dematiaceae group is a saprophyte found in soil and plants and a possible causative agent of phaeohyphomycosis. We present a rare case of subcutaneous phaeohyphomycosis caused by P. romeroi mimicking a synovial cyst in a diabetic patient.

  17. Lepra reaction with lucio phenomenon mimicking cutaneous vasculitis.

    Science.gov (United States)

    Misra, Durga Prasanna; Parida, Jyoti Ranjan; Chowdhury, Abhra Chandra; Pani, Krushna Chandra; Kumari, Niraj; Krishnani, Narendra; Agarwal, Vikas

    2014-01-01

    Leprosy is a disease typically found in the tropics. Patients with leprosy can have varying presentation with constitutional symptoms, joint pains, skin nodules, and rarely a vasculitis-like picture with skin ulcers and neuropathy. We present a young lady who presented with the rare manifestation of skin infarcts mimicking cutaneous vasculitis, diagnosed on histopathology to have Lucio phenomenon on a background of lepromatous leprosy. With increasing migration and widespread use of biologic response modifiers, clinicians all over the world need to be aware of various presentations of leprosy as well as needing to keep an open mind while considering the differential diagnoses of vasculitis.

  18. Simple bone cyst of mandible mimicking periapical cyst

    Directory of Open Access Journals (Sweden)

    Charan Babu HS

    2012-05-01

    Full Text Available Simple bone cysts (SBC are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient.

  19. Simple bone cyst of mandible mimicking periapical cyst.

    Science.gov (United States)

    Hs, Charan Babu; Rai, Bhagawan Das; Nair, Manju A; Astekar, Madhusudan S

    2012-05-29

    Simple bone cysts (SBC) are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient.

  20. Brucellosis mimicking Henoch-Schönlein purpura.

    Science.gov (United States)

    Massasso, David; Gibson, Kathryn

    2007-06-04

    A young male immigrant from Syria with a vasculitic-appearing leg rash, asymmetrical polyarthritis, microscopic haematuria, and raised inflammatory markers was provisionally diagnosed with Henoch-Schönlein purpura. Skin biopsy showed leukocytoclastic vasculitis. Low-grade fevers persisted despite non-steroidal anti-inflammatory therapy, and Brucella sp. was subsequently grown from both blood and synovial fluid aspirates. Further tests gave positive results for B. abortus, and triple antibiotic therapy produced a rapid clinical response. Cutaneous vasculitis has rarely been described in brucellosis, and this is the first report in the English medical literature of brucellosis mimicking Henoch-Schönlein purpura.

  1. A CUTANEOUS HORN MIMICKING POLYDACTYLY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Funda Tamer

    2015-04-01

    Full Text Available A cutaneous horn is a general name for cornified material protruding from skin. On the other hand, polydactyly is a common congenital anomaly of the hand and foot which is characterized by extra finger or toe. A cutaneous horn might mimick polydactyly by resembling an extra toe. Hereby, we present a 72-year-old white Caucasian male with an extra toe-like projection on his fourth toe. Initially, polydactyly was suspected, however a cutaneous horn was also considered. The lesion was surgically removed. The histopathological examination of the specimen revealed hyperkeratosis, and thus confirmed the  lesion to be a cutaneous horn. 

  2. Superficial Fibromatosis Mimicking Glomus Tumor of the Second Toe.

    Science.gov (United States)

    Jo, Hyang Jeong; Chae, Soo Uk; Kim, Gang Deuk; Kim, Yeung Jin; Choi, Deok Hwa; Park, Jae In

    2015-09-01

    Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe.

  3. Pancreatitis with Electrocardiographic Changes Mimicking Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Paul Khairy

    2001-01-01

    Full Text Available A 64-year-old woman with mild acute pancreatitis presented with epigastric pain, nausea and vomiting while undergoing hemodialysis for chronic renal insufficiency. Serial electrocardiograms revealed new onset ST segment elevations in leads V2 to V4 mimicking an anterior myocardial infarction, followed by diffusely inverted deep T waves. No cardiac pathology was demonstrated by echocardiography or coronary angiography. A review of the literature and possible pathophysiological mechanisms of electrocardiographic changes in acute pancreatitis, such as metabolic abnormalities, hemodynamic instability, vasopressors, pericarditis, myocarditis, a cardiobiliary reflex, exacerbation of underlying cardiac pathology, coagulopathy and coronary vasospasm, are discussed.

  4. Endometriosis mimicking the perianal fistula tract: Case report

    Directory of Open Access Journals (Sweden)

    Gül Türkcü

    2014-09-01

    Full Text Available Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Nowadays, in many cases, although routine use of episiotomy perineal endo metriosis is extremely rare. A 36 year old female patient was referred to our hospital with complaints of pain in the perianal region for five months. On physical examination, stiffness was palpated and then magnetic resonance im aging (MRI was performed. MRI is compatible with fistula tract. The lesion was excised and the histopathological appearance correspond to endometriosis. Perianal endo metriosis is rare in the perianal region and in the clinic mimicking perianal fistulas and malignancy should be kept in mind in the differential diagnosis

  5. A huge renal capsular leiomyoma mimicking retroperitoneal sarcoma

    Directory of Open Access Journals (Sweden)

    Lal Anupam

    2009-01-01

    Full Text Available A huge left renal capsular leiomyoma mimicking retroperitoneal sarcoma presented in a patient as an abdominal mass. Computed tomography displayed a large heterogeneous retro-peritoneal mass in the left side of the abdomen with inferior and medial displacement as well as loss of fat plane with the left kidney. Surgical exploration revealed a capsulated mass that was tightly adherent to the left kidney; therefore, total tumor resection with radical left nephrectomy was performed. Histopathology ultimately confirmed the benign nature of the mass. This is the largest leiomyoma reported in literature to the best of our knowledge.

  6. Klebsiella pneumoniae pharyngitis mimicking malignancy: a diagnostic dilemma.

    Science.gov (United States)

    Yeh, C-F; Li, W-Y; Hsu, Y-B

    2014-12-01

    Acute pharyngitis is a common disease. However, acute pharyngitis caused by Klebsiella pneumoniae with a gross appearance mimicking hypopharyngeal malignancy has never previously been reported. We report the case of a 57-year-old man with a right hypopharyngeal tumor which was disclosed by fiberoptic laryngoscopy and computed tomography scan. However, both the frozen and final pathologies showed no evidence of malignant cells, and a bacterial culture revealed the growth of K. pneumoniae. The hypopharyngeal lesion completely regressed after 2 weeks of antibiotic treatment. Clinicians should perform biopsy along with tissue culture for tumor-like lesions because infectious agents can lead to lesions with malignancy-like appearance.

  7. Aneurysm of the common iliac vein mimicking a pelvic mass

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Eun Joo; Kim, Dong Hun [Dept. of Radiology, Chosun University College of Medicine, Gwangju (Korea, Republic of); Suk, Eun Ha [Dept. of Anesthesiology and Pain Medicine, Seonam University College of Medicine, Namwon (Korea, Republic of)

    2013-07-15

    Venous aneurysm, especially of primary origin, is rare. The authors report a case of a 63-year-old female who was admitted for back pain and an aneurysm of the common iliac which was detected incidentally. CT, magnetic resonance (MR), Doppler ultrasonography, and conventional venography showed an aneurysm of the left common iliac vein measuring 4.5 , 00D7, 3, 00D7, 4 cm. Because there were no complications of the aneurysm, no further treatment was administered. Herein, we describe findings of a venous aneurysm of the common iliac vein mimicking a pelvic mass on CT and MR scans and with a review of the literature.

  8. Dual anaplastic large cell lymphoma mimicking meningioma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keun Ho; Kim, Ki Hwan; Lee, Ghi Jai; Lee, Hye Kyung; Shim, Jae Chan; Lee, Kyoung Eun; Suh, Jung Ho [Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Lee, Chae Heuck [Dept. of Neurosurgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

    2014-01-01

    Anaplastic large cell lymphoma (ALCL) is a rare T cell lymphoma composed of CD30-positive lymphoid cells. Most ALCLs present as nodal disease, with skin, bone, soft tissue, lung, and liver as common extranodal sites. ALCL rarely occurs in the central nervous system and is even more infrequent in the dura of the brain. We report a case of dural-based ALCL secondary to systemic disease in a 17-year-old male that mimicked meningioma on magnetic resonance imaging and angiography.

  9. Symptomatic ecchordosis physaliphora mimicking as an intracranial arachnoid cyst.

    Science.gov (United States)

    Filis, Andreas; Kalakoti, Piyush; Nanda, Anil

    2016-06-01

    Ecchordosis physaliphora (EP) is a rare, benign tumor derived from the notochordal remnants. Usually slow growing with an indolent course, most cases are incidental findings on autopsy. Limited data exists on symptomatic patients with EP. Diagnosis mainly relies on correlating histopathologic findings confirming the notochordal elements with MRI. We herein present a middle aged woman with symptomatic EP in the pre-pontine cistern that mimicked an arachnoid cyst on preoperative scans. Additionally, we emphasize the pathological and radiological characteristics of EP that could aid in prompt diagnosis of the lesion with emphasis on considering EP as a differential for mass lesions localized in the pre-pontine cistern.

  10. Intracortical bone metastasis mimicking intracortical osteoid osteoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Yu Ri; Kim, Jee Young [St. Vincent' s Hospital, The Catholic University of Korea, Suwon (Korea, Republic of)

    2007-08-15

    Cortical metastasis usually occurs in the diaphysis of the long bones with the appearance of a cookie-bite pattern; this is associated with cortical destruction extending into the soft tissue as well as into the medullary cavity, or there can be a periosteal reaction. We report here on a 66-year-old woman who was diagnosed with intracortical metastasis in the proximal metaphysis of the right femur as an initial metastatic focus from primary lung cancer. CT detected an intracortical osteolytic lesion without cortical destruction or thickening. The MR images showed extensive peritumoral edema in the surrounding soft tissue and adjacent bone marrow edema, and this all mimicked osteoid osteoma.

  11. Enterobiasis in Ectopic Locations Mimicking Tumor-Like Lesions

    OpenAIRE

    Silvio Pampiglione; Francesco Rivasi

    2009-01-01

    Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on thi...

  12. Iliacus pyomyositis mimicking septic arthritis of the hip joint.

    Science.gov (United States)

    Chen W-S; Wan Y-L

    1996-01-01

    The iliacus muscle is closely associated with the psoas muscle, femoral nerve, hip joint, pelvic and intraabdominal structures; thus, its disorders may present as lower abdominal pain, hip pain, or femoral neuropathy. Iliacus pyomyositis, a primary bacterial infection of the skeletal muscle not secondary to a contiguous skin, bone, or soft-tissue infection, presenting as hip pain, femoral neuropathy, and sympathetic effusion of the hip joint in an 8-year-old boy mimicked septic arthritis of the hip joint. Computed tomography was helpful in delineating the accurate location of the lesion. Surgical drainage and appropriate antibiotic therapy led to complete resolution and full functional recovery.

  13. Hızma Induced Papul of Nose Mimicking Pyogenic Granuloma

    Directory of Open Access Journals (Sweden)

    Mualla Polat

    2014-09-01

    Full Text Available The application of body piercing is popular among young people, who consider it as a sign of marginality, beauty, or group identity. Piercing procedure is observed to cause a large number of complications such as infections, pain, inflammatory reactions, bleeding, dental fractures or fissures, and gingival damage, etc., mostly in young individuals. Hizma is a traditional body ornament worn by Anatolian women via a piercing procedure. Herein, we describe a papule of nose mimicking pyogenic granuloma as an uncommon complication of Hızma.

  14. Tissue-Mimicking Materials Using Segmented Polyurethane Gel and Their Acoustic Properties

    Science.gov (United States)

    Yoshida, Tomoji; Tanaka, Kouhei; Kondo, Toshio; Yasukawa, Kazuhiro; Miyamoto, Nobuaki; Taniguchi, Masahiko; Shikinami, Yasuo

    2012-07-01

    Accurate testing of an instrument by phantoms requires a tissue-mimicking material that has the acoustic velocity and density defined in the International Electrotechnical Commission (IEC) standard, and furthermore the tissue-mimicking material must be stable over time. To achieve the tissue-mimicking materials with the desired acoustic velocity and density defined in the IEC standard, new materials have been developed. The form of tissue-mimicking materials reported comprised polystyrene and poly(methyl methacrylate) (PMMA) particles dispersed in segmented polyurethane gel. They were stable over a period of 40 days and the changes in weight and acoustic velocity did not exceed 0.5%.

  15. Characterization of various tissue mimicking materials for medical ultrasound imaging

    Science.gov (United States)

    Thouvenot, Audrey; Poepping, Tamie; Peters, Terry M.; Chen, Elvis C. S.

    2016-04-01

    Tissue mimicking materials are physical constructs exhibiting certain desired properties, which are used in machine calibration, medical imaging research, surgical planning, training, and simulation. For medical ultrasound, those specific properties include acoustic propagation speed and attenuation coefficient over the diagnostic frequency range. We investigated the acoustic characteristics of polyvinyl chloride (PVC) plastisol, polydimethylsiloxane (PDMS), and isopropanol using a time-of-light technique, where a pulse was passed through a sample of known thickness contained in a water bath. The propagation speed in PVC is approximately 1400ms-1 depending on the exact chemical composition, with the attenuation coefficient ranging from 0:35 dB cm-1 at 1MHz to 10:57 dB cm-1 at 9 MHz. The propagation speed in PDMS is in the range of 1100ms-1, with an attenuation coefficient of 1:28 dB cm-1 at 1MHz to 21:22 dB cm-1 at 9 MHz. At room temperature (22 °C), a mixture of water-isopropanol (7:25% isopropanol by volume) exhibits a propagation speed of 1540ms-1, making it an excellent and inexpensive tissue-mimicking liquid for medical ultrasound imaging.

  16. Spontaneous motor entrainment to music in multiple vocal mimicking species.

    Science.gov (United States)

    Schachner, Adena; Brady, Timothy F; Pepperberg, Irene M; Hauser, Marc D

    2009-05-26

    The human capacity for music consists of certain core phenomena, including the tendency to entrain, or align movement, to an external auditory pulse [1-3]. This ability, fundamental both for music production and for coordinated dance, has been repeatedly highlighted as uniquely human [4-11]. However, it has recently been hypothesized that entrainment evolved as a by-product of vocal mimicry, generating the strong prediction that only vocal mimicking animals may be able to entrain [12, 13]. Here we provide comparative data demonstrating the existence of two proficient vocal mimicking nonhuman animals (parrots) that entrain to music, spontaneously producing synchronized movements resembling human dance. We also provide an extensive comparative data set from a global video database systematically analyzed for evidence of entrainment in hundreds of species both capable and incapable of vocal mimicry. Despite the higher representation of vocal nonmimics in the database and comparable exposure of mimics and nonmimics to humans and music, only vocal mimics showed evidence of entrainment. We conclude that entrainment is not unique to humans and that the distribution of entrainment across species supports the hypothesis that entrainment evolved as a by-product of selection for vocal mimicry.

  17. A Patient With Plaque Type Morphea Mimicking Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Wardhana Wardhana

    2015-04-01

    Full Text Available Morphea is an uncommon connective tissue disease with the most prominent feature being thickening or fibrosis of the dermal without internal organ involvement. It is also known as a part of localized scleroderma. Based on clinical presentation and depth of tissue involvement, morphea is classified into several forms, and about two thirds of adults with morphea have plaque type. Overproduction of collagen production by fibroblast is the cause of abnormality in morphea, and the hyperactivity mechanism of fibroblast is still unknown, although there are several mechanisms already proposed. Plaque type morphea is actually a benign and self limited. Plaque type morphea that mimicking systemic lupus erythematosus in clinical appearance, such as alopecia and oral mucosal ulcers, is uncommon. A case of plaque type morphea mimicking systemic lupus erythematosus in a 20 year old woman was discussed. The patient was treated with local and systemic immunosuppressant and antioxydant. The patient’s condition is improved without any significant side effects. Key words: morphea, plaque type.

  18. Percutaneous closure of huge patent ductus arterious associated with anomalous inferior vein cava drainage and dextrocardia with muscular ventricular septal defect occluder

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Transcatheter occlusion of patent ductus arterious (PDA) using various occluders and coils has been a well-established method1-5 since Porstmann and colleagues6 reported the first case in 1967. However, when patients associated with anomalous inferior vein cava drainage or/and huge high pulmonary artery pressure ductus (HPAP-PDA), the method is not suitable. First, it is unfeasible to carry out the procedure via femoral vein. Second, in the presence of high pulmonary artery pressure such devices including the Amplatzer ductu occluder carry the risk of embolising into the aorta.7 The muscular ventricular septal defect occluder (MVSDO), which is a device for transcatheter closure of muscular ventricular septal defect, may be more suitable for using with HPAP-PDA as its double disk tends to anchor the device, preventing embolisation into the aorta. We present a patient, who is suffering from huge PDA associated with anomalous inferior vein cava drainage and dextrocardia, in whom percutaneous closure of PDA using MVSDO was successfully accomplished via transjugular approach.

  19. Eye features in three Danish patients with multisystemic smooth muscle dysfunction syndrome

    DEFF Research Database (Denmark)

    Moller, Hans Ulrik; Fledelius, Hans C; Milewicz, Dianna M

    2012-01-01

    A de novo mutation of the ACTA2 gene encoding the smooth muscle cell α-actin has been established in patients with multisystemic smooth muscle dysfunction syndrome associated with patent ductus arteriosus and mydriasis present at birth....

  20. What Is a Heart Murmur?

    Science.gov (United States)

    ... Holes in the Heart How the Heart Works Patent Ductus Arteriosus Stress Testing Tetralogy of Fallot Rate This Content: Updated: December 9, 2016 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA OIG CONTACT ...

  1. What Is Respiratory Distress Syndrome?

    Science.gov (United States)

    ... Clinical Trials Links Related Topics Atelectasis Bronchopulmonary Dysplasia Patent Ductus Arteriosus Pleurisy and Other Pleural Disorders Ventilator/ ... this page with Gmail. Bookmark this page with Google. Share this page from the NHLBI on LinkedIn. ...

  2. Doppler flow velocity waveforms in the fetal cardiac outflow tract: Reproducibility of waveform recording and analysis

    NARCIS (Netherlands)

    I.A.L. Groenenberg (Irene); W.C.J. Hop (Wim); J.W. Wladimiroff (Juriy)

    1991-01-01

    markdownabstract__Abstract__ Reproducibility of flow velocity waveform recording and analysis was studied at fetal cardiac level (ductus arteriosus, pulmonary artery and ascending aorta) in 42 normal pregnancies. The flow velocity parameters studied were the peak systolic velocity (PSV),

  3. Acute chylous ascites mimicking acute appendicitis in a patient with pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Emily K Smith; Edmund Ek; Daniel Croagh; Lavinia A Spain; Stephen Farrell

    2009-01-01

    We report a case of acute chylous peritonitis mimicking acute appendicitis in a man with acute on chronic pancreatitis. Pancreatitis, both acute and chronic, causing the development of acute chylous ascites and peritonitis has rarely been reported in the English literature. This is the fourth published case of acute chylous ascites mimicking acute appendicitis in the literature.

  4. Tax mimicking and yardstick competition among local governments in the Netherlands

    NARCIS (Netherlands)

    Allers, MA; Elhorst, JP

    2005-01-01

    This paper provides a spatial-econometric analysis of the setting of property tax rates by Dutch municipalities. We find evidence of tax mimicking: a ten percent higher property tax rate in neighboring municipalities leads to a 3.5 percent higher tax rate. Mimicking is less pronounced in municipalit

  5. Tunable Transmission-Line Metamaterials Mimicking Electromagnetically Induced Transparency

    Science.gov (United States)

    Feng, T. H.; Han, H. P.

    2016-11-01

    Tunable transmission-line (TL) metamaterials mimicking electromagnetically induced transparency (EIT) have been studied. Firstly, two types of tunable TL EIT-like metamaterial, based on the double split-ring resonator (DSRR) and single split-ring resonator (SSRR), were fabricated and their transmission properties carefully compared. The results showed that the transmittance maximum was almost invariable with shift of the transparency window for the tunable DSRR-based TL EIT-like metamaterial, but for the tunable SSRR-based TL EIT-like metamaterial, the transmittance maximum gradually diminished with shift of the transparency window toward the center of the absorption band. Moreover, the reason for these different transmission properties was explored, revealing that the reduction of the transmittance maximum of the transparency window for the tunable SSRR-based TL EIT-like metamaterial is mainly due to energy loss caused by the resistance of the loaded varactor diodes.

  6. Postpolypectomy Electrocoagulation Syndrome: A Mimicker of Colonic Perforation

    Directory of Open Access Journals (Sweden)

    Brian C. Benson

    2013-01-01

    Full Text Available Postpolypectomy electrocoagulation syndrome is a rare complication of polypectomy with electrocautery and is characterized by a transmural burn of the colon wall. Patients typically present within 12 hours after the procedure with symptoms mimicking colonic perforation. Presented is the case of a 56-year-old man who developed abdominal pain six hours after colonoscopy during which polypectomy was performed using snare cautery. CT imaging of the abdomen revealed circumferential thickening of the wall of the transverse colon without evidence of free air. The patient was treated conservatively as an outpatient and had resolution of his pain over the following four days. Recognition of the diagnosis and understanding of the treatment are important to avoid unnecessary exploratory laparotomy or hospitalization.

  7. An ideal blood mimicking fluid for doppler ultrasound phantoms.

    Science.gov (United States)

    Samavat, H; Evans, J A

    2006-10-01

    In order to investigate the problems of detecting tumours by ultrasound it is very important to have a portable Doppler flow test object to use as a standardising tool. The flow Doppler test objects are intended to mimic the flow in human arteries. To make the test meaningful, the acoustic properties of the main test object components (tissue and blood mimic) should match closely the properties of the corresponding human tissues, while the tube should ideally have little influence. The blood mimic should also represent the haemodynamic properties of blood. An acceptable flow test object has been designed to closely mimic blood flow in arteries. We have evaluated the properties of three blood mimicking fluid: two have been described recently in the literature, the third is a local design. One of these has emerged as being particularly well matched to the necessary characteristics for in-vitro work.

  8. Blood-Mimicking Fluid for Testing Ultrasonic Diagnostic Instrument

    Science.gov (United States)

    Tanaka, Kouhei; Yoshida, Tomoji; Sato, Kazuishi; Kondo, Toshio; Yasukawa, Kazuhiro; Miyamoto, Nobuaki; Taniguchi, Masahiko

    2012-07-01

    We present a blood-mimicking fluid (BMF) for the Doppler test object of medical diagnostic instruments. Accurate measurement in a flow Doppler test requires a BMF that has the acoustic velocity and density defined in the International Electrotechnical Commission (IEC) standard, and furthermore, they must be stable over time. To formulate a fluid with the desired density and acoustic velocity, we have developed a new fluid made of glycerine and water-soluble silicone oil. The new BMF includes dispersed polystyrene particles as scatterers. The density of the liquid can be adjusted to maintain it at the same value as that of the polystyrene particles, thus ensuring neutral buoyancy of the particles. The MBF was stable over a period of 2 weeks, during which the density and acoustic velocity did not change.

  9. Isolated angiitis in the hypothalamus mimicking brain tumor.

    Science.gov (United States)

    Tsutsumi, Satoshi; Ito, Masanori; Yasumoto, Yukimasa; Kaneda, Kazuhiko

    2008-01-01

    A 64-year-old female presented with exaggerating somnolence without contributory medical and lifestyle histories. She was not aware of any preceding infection or headache. Cerebral magnetic resonance imaging demonstrated an isolated enhanced mass in the hypothalamus without meningeal enhancement. Blood and cerebrospinal fluid examinations showed no significant findings except for hypernatremia and hyperprolactinemia. She underwent an open biopsy via the interhemispheric route. Histological examination revealed marked perivascular lymphocytic aggregation with polyclonal immunostaining both for B and T lymphocytes. No findings suggestive of underlying malignancy were recognized. Extensive work-up aiming at systemic vasculitis and lymphoma revealed no signs of extracranial lesion, so the most probable diagnosis was isolated angiitis in the hypothalamus. Angiitis may originate from the hypothalamus and should be considered in the differential diagnosis of hypothalamic lesion mimicking brain tumor on neuroimaging.

  10. An ideal blood mimicking fluid for doppler ultrasound phantoms

    Directory of Open Access Journals (Sweden)

    Samavat H

    2006-01-01

    Full Text Available In order to investigate the problems of detecting tumours by ultrasound it is very important to have a portable Doppler flow test object to use as a standardising tool. The flow Doppler test objects are intended to mimic the flow in human arteries. To make the test meaningful, the acoustic properties of the main test object components (tissue and blood mimic should match closely the properties of the corresponding human tissues, while the tube should ideally have little influence. The blood mimic should also represent the haemodynamic properties of blood. An acceptable flow test object has been designed to closely mimic blood flow in arteries. We have evaluated the properties of three blood mimicking fluid: two have been described recently in the literature, the third is a local design. One of these has emerged as being particularly well matched to the necessary characteristics for in-vitro work.

  11. Sarcoidosis mimicking a venous ulcer: a case report.

    Science.gov (United States)

    Joshi, Smita S; Romanelli, Paolo; Kirsner, Robert S

    2009-11-01

    Sarcoidosis--a chronic, multisystem disease of unknown etiology characterized by noncaseating granulomas--may cause ulcerative lesions, particularly in African American women. A case of ulcerative sarcoidosis mimicking a venous ulcer is presented. The patient is a 44-year-old African American hypertensive, obese woman with a nonhealing medially based lower leg ulcer of 3 years' duration clinically consistent with a venous ulcer. The ulcer did not heal with compression therapy and pentoxifylline. Subsequent biopsies showed granulomatous inflammation consistent with sarcoidosis. When intralesional triamcinolone was added to compression therapy, the ulcer resolved after 3 months. Given its propensity toward formation on the lower extremities and ulcerative and atrophic appearance, ulcerative sarcoidosis should be considered in the differential diagnosis of a venous ulcer refractory to standard therapy, especially in African American women.

  12. Eosinophilic Cystitis Mimicking Bladder Tumour – A Rare Case Report

    Science.gov (United States)

    D, Manimaran; T M, Karthikeyan; M, Sreenivasulu; V R, Mrinalini; V, Gopinath

    2013-01-01

    A 16–year–old male presented with urinary urgency, a frequency of 4 months duration and intermittent gross haematuria which were there since one month. Eosinophilia was noted in complete blood count and CT KUB with contrast showed a filling defect in the right lateral wall, over the vesicoureteric junction. Cystoscopy revealed a sessile mass lesion over right vesico–ureteric junction, with bullous oedema . Rest of the mucosa was normal. Transurethral resection of lesion was performed and histological examination showed features of eosinophilic cystitis. Patient was treated with corticosteroids, antimicrobial agents and antihistaminics and he is recovering well. We are presenting this case for its rare presentation and its possibility of mimicking a bladder tumour. Biopsy of the lesion was diagnostic and an early treatment showed good results. PMID:24298501

  13. Giant Ectopic Ureter Mimicking Pelvic Organ Prolapse: A Case Report

    Directory of Open Access Journals (Sweden)

    Adnan Simsir

    2011-01-01

    Full Text Available Ectopic ureter is one of the most common urinary tract anomalies. We, herein, present a case of a giant ureter with ectopic orifice, mimicking pelvic organ prolapse, which is the first in the literature. A 59-year-old female patient presenting with frequently recurrent urinary tract infection had grade 3 pelvic organ prolapse. On examination, the organ producing the appearance of prolapse was found to be a right ureter of giant size and was obstructed by a large stone at the distal segment. The proximal end of the ureter ended blindly. After exploration, the stone was removed, the ureter was detached from the urethra, and the lumen was tied off and cut 5 cm proximally. At 6 months postoperatively, the patient is being followed up without any clinical problems. In such cases with nonfunctioning renal segment draining proximally, the chance of cure can be obtained without a need for a comprehensive intervention such as total abdominal ureterectomy.

  14. Myelodysplastic changes mimicking MDS following treatment for osteosarcoma

    DEFF Research Database (Denmark)

    Løhmann, Ditte

    Myelodysplastic changes mimicking MDS following treatment for osteosarcoma Ditte Juel Adolfsen Løhmann, Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark Authors: Ditte Juel Adolfsen Løhmann and Henrik Hasle. Therapy-related myelodysplastic syndrome/acute myeloid leukaemia (t......-MDS/AML) is a feared long-term complication of paediatric cancer including osteosarcoma. Few develop t-MDS/AML, but it is not known how many have significant haematological changes after finishing treatment for osteosarcoma. In this study we reviewed biochemistry from a consecutive series of children for up to two...... for osteosarcoma developed haematological abnormalities similar to early MDS but few developed t-MDS/AML. Close monitoring of patients recovering from osteosarcoma is essential. Keywords: Osteosarcoma, t-MDS/AML, Haematological abnormalities, Children...

  15. Mimicking unfolding motion of a beetle hind wing

    Institute of Scientific and Technical Information of China (English)

    MUHAMMAD Azhar; PARK Hoon C; HWANG Do Y; BYUN Doyoung; GOO Nam S

    2009-01-01

    This paper presents an experimental research aiming to realize an artificial hind wing that can mimic the wing unfolding motion of Allomyrina dichotoma, an insect in coleopteran order. Based on the understanding of working principles of beetle wing folding/unfolding mechanisms, the hind wing unfolding motion is mimicked by a combination of creative ideas and state-of-art artificial muscle actuator. In this work, we devise two types of artificial wings and the successfully demonstrate that they can be unfolded by actuation of shape memory alloy wires to provide actuation force at the wing base and along the leading edge vein. The folding/unfolding mechanisms may provide an insight for portable nano/micro air vehicles with morphing wings.

  16. Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

    Science.gov (United States)

    Monteiro, Bárbara Vanessa de Brito; Grempel, Rafael Grotta; Gomes, Daliana Queiroga de Castro; Godoy, Gustavo Pina; Miguel, Márcia Cristina da Costa

    2013-01-01

    Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site. PMID:25992095

  17. Spilled gallstones mimicking a retroperitoneal sarcoma following laparoscopic cholecystectomy.

    Science.gov (United States)

    Kim, Bum-Soo; Joo, Sun-Hyung; Kim, Hyun-Cheol

    2016-05-07

    Laparoscopic cholecystectomy has become a standard treatment of symptomatic gallstone disease. Although spilled gallstones are considered harmless, unretrieved gallstones can result in intra-abdominal abscess. We report a case of abscess formation due to spilled gallstones after laparoscopic cholecystectomy mimicking a retroperitoneal sarcoma on radiologic imaging. A 59-year-old male with a surgical history of a laparoscopic cholecystectomy complicated by gallstones spillage presented with a 1 mo history of constant right-sided abdominal pain and tenderness. Computed tomography and magnetic resonance imaging demonstrated a retroperitoneal sarcoma at the sub-hepatic space. On open exploration a 5 cm × 5 cm retroperitoneal mass was excised. The mass contained purulent material and gallstones. Final pathology revealed abscess formation and foreign body granuloma. Vigilance concerning the possibility of lost gallstones during laparoscopic cholecystectomy is important. If possible, every spilled gallstone during surgery should be retrieved to prevent this rare complication.

  18. Verrucous tumor mimicking squamous cell carcinoma in immunocompetent patient.

    Science.gov (United States)

    Ruiz-Villaverde, Ricardo; Sanchez-Cano, Daniel; Martinez-Peinado, Carmen M; Galan-Gutierrez, Manuel

    2016-02-17

    Mycobacteria cause a range of diseases in both immunocompetent and immunosuppressed individuals. An increase in non-tuberculous mycobacterial (NTM) infections targeting skin has been described. Many hypotheses have been developed in order to explain it: the increasing burden of immunocompromised individuals, immigration from endemic countries, improved laboratory identification techniques, and changes inhuman behavior that expose individuals to this NTM. Mycobacterium mucogenicum group comprises M. mucogenicum, Mycobacterium aubagnense, and Mycobacterium phocaicum. This group of organisms was first named Mycobacterium chelonae-like organism in 1982. Most clinically significant cases of those organisms involved catheter-related infections. Nevertheless, we report an interesting patient with a cutaneous infection produced by M. mucogenicum mimicking a squamous cell carcinoma; an excellent response to combined therapy with rifampicin and clarythromicin was observed.

  19. Impedance of tissue-mimicking phantom material under compression

    Directory of Open Access Journals (Sweden)

    Barry Belmont

    2013-02-01

    Full Text Available The bioimpedance of tissues under compression is a field in need of study. While biological tissues can become compressed in a myriad of ways, very few experiments have been conducted to describe the relationship between the passive electrical properties of a material (impedance/admittance during mechanical deformation. Of the investigations that have been conducted, the exodus of fluid from samples under compression has been thought to be the cause of changes in impedance, though until now was not measured directly. Using a soft tissue-mimicking phantom material (tofu whose passive electrical properties are a function of the conducting fluid held within its porous structure, we have shown that the mechanical behavior of a sample under compression can be measured through bioimpedance techniques.

  20. Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

    Directory of Open Access Journals (Sweden)

    Monteiro, Bárbara Vanessa de Brito

    2014-01-01

    Full Text Available Introduction Adenoid cystic carcinoma (ACC is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site.

  1. A rare case of ascending colon actinomycosis mimicking cancer

    Directory of Open Access Journals (Sweden)

    Zizi Diamanto

    2005-01-01

    Full Text Available Abstract Background Actinomycosis is a rare inflammatory disease caused by an anaerobic bacterium that can rarely affect the large intestine. Case presentation We present a rare case of a cecum and ascending colon actinomycosis in a 72 years old woman, mimicking clinically a malignant inflammatory tumor of the right colon. The patient complained of right lower quadrant pain. Although our first thought was a peri-appendiceal abscess, CT scan suggested a right colon tumor. The patient underwent a right colectomy and the histological examination of the specimen revealed colon actinomycosis. Conclusions Preoperative diagnosis in colon actinomycosis is difficult to achieve. Treatment of choice is antibiotics administration. A review of the possible pathogenesis and therapeutic modalities is also presented.

  2. Huge uterine-cervical diverticulum mimicking as a cyst

    Directory of Open Access Journals (Sweden)

    S Chufal

    2012-01-01

    Full Text Available Here we report an incidental huge uterine-cervical diverticulum from a total abdominal hysterectomy specimen in a perimenopausal woman who presented with acute abdominal pain. The diverticulum was mimicking with various cysts present in the lateral side of the female genital tract. Histopathological examination confirmed this to be a cervical diverticulum with communication to uterine cavity through two different openings. They can attain huge size if left ignored for long duration and present a diagnostic challenge to clinicians, radiologists, as well as pathologists because of its extreme rarity. Therefore, diverticula should also be included as a differential diagnosis. Its histopathological confirmation also highlights that diverticula can present as an acute abdomen, requiring early diagnosis with appropriate timely intervention. Immunohistochemistry CD 10 has also been used to differentiate it from a mesonephric cyst.

  3. Huge uterine-cervical diverticulum mimicking as a cyst.

    Science.gov (United States)

    Chufal, S; Thapliyal, Naveen; Gupta, Manoj; Pangtey, Nirmal

    2012-01-01

    Here we report an incidental huge uterine-cervical diverticulum from a total abdominal hysterectomy specimen in a perimenopausal woman who presented with acute abdominal pain. The diverticulum was mimicking with various cysts present in the lateral side of the female genital tract. Histopathological examination confirmed this to be a cervical diverticulum with communication to uterine cavity through two different openings. They can attain huge size if left ignored for long duration and present a diagnostic challenge to clinicians, radiologists, as well as pathologists because of its extreme rarity. Therefore, diverticula should also be included as a differential diagnosis. Its histopathological confirmation also highlights that diverticula can present as an acute abdomen, requiring early diagnosis with appropriate timely intervention. Immunohistochemistry CD 10 has also been used to differentiate it from a mesonephric cyst.

  4. Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area, accompanied by massive hemoperitoneum,mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver, gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected.Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries, cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection, but the tumor recurred one month after operation. To our knowledge, the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described.

  5. Dentinogenic Ghost Cell Tumor of the Peripheral Variant Mimicking Epulis

    Directory of Open Access Journals (Sweden)

    Uddipan Kumar

    2010-01-01

    Full Text Available Dentinogenic ghost cell tumor (DGCT is an uncommon locally invasive odontogenic tumor regarded by many as a variant of calcifying odontogenic cyst. The peripheral variant of this clinical rarity appears as a well-circumscribed mass mimicking a nonspecific gingival enlargement. Microscopic appearance of odontogenic epithelium admixed with focal areas of dentinoid formation and sheets of ghost cells giving the definitive diagnosis of dentinogenic ghost cell tumor imply that microscopic examination is compulsory for any gingival mass. Van Gieson histochemical stain further confirmed the nature of dentinoid-like material. A complete workup of a case of peripheral dentinogenic ghost cell tumor is presented in this paper and the current concept as well as the appraisal of literature is presented.

  6. An Adolescent Patient with Scabies Mimicking Gottron Papules.

    Science.gov (United States)

    Yoshinaga, Eiji; Oiso, Naoki; Kawara, Shigeru; Kawada, Akira

    2009-01-13

    Atypical features of scabies occur in infants and children and patients with prolonged use of corticosteroids or immunosuppression. We report a non-immunosuppressed 15-year-old female case of scabies showing scaly reddish papules over the proximal interphalangeal joints mimicking Gottron papules in classic dermatomyositis. Periungal erythema was also seen. Four months' topical corticosteroids from previous clinics had been used. Dermoscopic findings were consistent with typical pictures of scabies. Scraping of hand crusts demonstrated scabies mites and ova. Skin lesions of the patient were cured with oral ivermectin and topical 10% crotamiton. This case suggests that a lesion resembling Gottron papules may be added to the panel of unusual presentations of scabies.

  7. Oral manifestion of Langerhans cell histiocytosis mimicking inflammation

    Directory of Open Access Journals (Sweden)

    K S Divya

    2014-01-01

    Full Text Available Langerhans cell histiocytosis (LCH is a rare idiopathic disease characterized by the clonal proliferation of Langerhans cells. LCH affects five children per million population. The peak incidence is from 1 to 4 years of age. LCH involves the head and neck region quite commonly. Oral soft tissue lesions are also common. The differential diagnosis of oral LCH includes leukemia, neutropenia, prepubertal periodontitis, hypophosphatasia, fibrous dysplasia, and Papillon-Lefevre syndrome. The prognosis of LCH depends on early detection and appropriate management. Surgical management alone is used in 50% of cases with an additional 23% of the lesions being treated with both surgery and radiation therapy. A case of LCH in a 6-year-old girl involving the mid root level of developing first permanent molar with a floating developing tooth bud of permanent second molar mimicking an inflammation is reported.

  8. Ewing sarcoma mimicking a peripheral nerve sheath tumor.

    Science.gov (United States)

    Mitchell, B D; Fox, B D; Viswanathan, A; Mitchell, A H; Powell, S Z; Cech, D A

    2010-10-01

    We describe the first patient with an extradural, extramedullary Ewing's sarcoma tumor mimicking a nerve sheath tumor with no overt evidence of metastasis. A 28-year-old woman with no past medical history presented with a progressive 3-year history of low back pain and right-sided lower extremity radiculopathy after having failed conservative therapies. MRI of the lumbar spine revealed a right-sided enhancing, dumbbell-shaped lesion at the right neural foramen appearing to originate from the L4 nerve root, suspicious for a peripheral nerve sheath tumor or schwannoma. The patient and findings are discussed in the context of the literature, including an update on the relatively recent diagnostic redesignation of the Ewing's sarcoma family tumors.

  9. An Adolescent Patient with Scabies Mimicking Gottron Papules

    Directory of Open Access Journals (Sweden)

    Eiji Yoshinaga

    2009-01-01

    Full Text Available Atypical features of scabies occur in infants and children and patients with prolonged use of corticosteroids or immunosuppression. We report a non-immunosuppressed 15-year-old female case of scabies showing scaly reddish papules over the proximal interphalangeal joints mimicking Gottron papules in classic dermatomyositis. Periungal erythema was also seen. Four months’ topical corticosteroids from previous clinics had been used. Dermoscopic findings were consistent with typical pictures of scabies. Scraping of hand crusts demonstrated scabies mites and ova. Skin lesions of the patient were cured with oral ivermectin and topical 10% crotamiton. This case suggests that a lesion resembling Gottron papules may be added to the panel of unusual presentations of scabies.

  10. Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer.

    Science.gov (United States)

    Białek, Waldemar; Rudzki, Sławomir; Iberszer, Paweł; Wronecki, Lech

    2016-12-01

    Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.

  11. Enterobiasis in Ectopic Locations Mimicking Tumor-Like Lesions

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    Silvio Pampiglione

    2009-01-01

    Full Text Available Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered “out-of-fashion.”

  12. Enterobiasis in ectopic locations mimicking tumor-like lesions.

    Science.gov (United States)

    Pampiglione, Silvio; Rivasi, Francesco

    2009-01-01

    Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered "out-of-fashion."

  13. Giant cystic sacral schwannoma mimicking tarlov cyst: a case report.

    Science.gov (United States)

    Attiah, Mark A; Syre, Peter P; Pierce, John; Belyaeva, Elizaveta; Welch, William C

    2016-05-01

    To present a rare case of a giant schwannoma of the sacrum mimicking a Tarlov cyst. A 58-year-old woman had a 1-year history of low back pain. MRI revealed a large cystic mass in the sacral canal with bony erosion. Radiological diagnosis of Tarlov cyst was made. The patient underwent surgical treatment for the lesion, which revealed a solid mass. Histopathological examination of the tumor confirmed the diagnosis of schwannoma. The postoperative course was uneventful and the patient has had significant improvement in her pain 1 month postoperatively. Giant cystic schwannoma of the sacrum is a very rare diagnosis overlooked by practitioners for more common cystic etiologies, but its treatment is significantly different. Care should be taken to include this diagnosis in a differential for a cystic sacral mass.

  14. Malignant Mesothelioma Mimicking Invasive Mammary Carcinoma in a Male Breast

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    Mohamed Mokhtar Desouki

    2015-01-01

    Full Text Available Malignant mesothelioma is an uncommon tumor with strong association with asbestos exposure. Few cases of malignant pleural mesothelioma metastatic to the female breast have been reported. Herein, we presented, for the first time, a case of locally infiltrating malignant pleural mesothelioma forming a mass in the breast of a male as the first pathologically confirmed manifestation of the disease. Breast ultrasound revealed an irregular mass in the right breast which involves the pectoralis muscle. Breast core biopsy revealed a proliferation of neoplastic epithelioid cells mimicking an infiltrating pleomorphic lobular carcinoma. IHC studies showed the cells to be positive for calretinin, CK5/6, WT1, and CK7. The cells were negative for MOC-31, BerEp4, ER, and PR. A final diagnosis of malignant mesothelioma, epithelioid type, was rendered. This case demonstrates the importance of considering a broad differential diagnosis in the setting of atypical presentation with application of a panel of IHC markers.

  15. Leishmaniasis recidiva cutis of the lips mimicking granulomatous cheilitis

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    Özlem Ekiz

    2015-01-01

    Full Text Available Leishmaniasis recidiva cutis (LRC is an unusual form of acute cutaneous leishmaniasis. Herein, we present a case of LRC of the lips mimicking granulomatous cheilitis. An 8-year-old, Syrian child admitted with a swelling and disfigurement of his lips for 4 years. Abundant intra and extracellular Leishmania amastigotes were determined in the smear prepared from the lesion with Giemsa stain. Histopathology showed foamy histiocytes and leishmania parasites within the cytoplasm of macrophages in the epidermis and a dense dermal mixed type inflammatory cell infiltrate composed of lymphocytes, foamy histiocytes with multinucleated giant cells. On the basis of anamnestic data, the skin smears results, clinical and histopathologic findings, LRC was diagnosed. The patient was treated with meglumine antimoniate intramuscularly and fluconazole orally. Cryotherapy was applied to the residual papular lesions. The lesion improved markedly at the first month of the treatment.

  16. Teflon granulomas mimicking cerebellopontine angle tumors following microvascular decompression.

    Science.gov (United States)

    Deep, Nicholas L; Graffeo, Christopher S; Copeland, William R; Link, Michael J; Atkinson, John L; Neff, Brian A; Raghunathan, Aditya; Carlson, Matthew L

    2017-03-01

    To report two patients with a history of microvascular decompression (MVD) for hemifacial spasm who presented with Teflon granulomas (TG) mimicking cerebellopontine angle (CPA) tumors and to perform a systematic review of the English-language literature. Case series at a single tertiary academic referral center and systematic review. Retrospective chart review with analysis of clinical, radiological, and histopathological findings. Systematic review using PubMed, Embase, MEDLINE, and Web of Science databases. Two patients with large skull base TGs mimicking CPA tumors clinically and radiographically were managed at the authors' institution. The first presented 4 years after MVD with asymmetrical sensorineural hearing loss, multiple progressive cranial neuropathies, and brainstem edema due to a growing TG. Reoperation with resection of the granuloma confirmed a foreign-body reaction consisting of multinucleated giant cells containing intracytoplasmic Teflon particles. The second patient presented 11 years after MVD with asymmetrical sensorineural hearing loss and recurrent hemifacial spasm. No growth was noted over 2 years, and the patient has been managed expectantly. Only one prior case of TG after MVD for hemifacial spasm has been reported in the English literature. TG is a rare complication of MVD for hemifacial spasm. The diagnosis should be suspected in patients presenting with a new-onset enhancing mass of the CPA after MVD, even when performed decades earlier. A thorough clinical and surgical history is critical toward establishing an accurate diagnosis to guide management and prevent unnecessary morbidity. Surgical intervention is not required unless progressive neurologic complications ensue. 4 Laryngoscope, 127:715-719, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Analysis of CT angiography of persistent truncus arteriosus Ⅳ%永存动脉干Ⅳ型的CT血管造影分析

    Institute of Scientific and Technical Information of China (English)

    袁亮; 邹利光; 付刘霞

    2012-01-01

    目的 探讨永存动脉干Ⅳ型的CT血管造影特征.方法 回顾性分析CT血管造影证实的永存动脉干Ⅳ型共14例,男5例,女9例;评估心脏形态、室间隔缺损、动脉干骑跨、支气管动脉异常及侧支循环、其他心血管畸形特征.结果 CT血管造影显示:①双心室增大明显,伴右心房增大;②高位室间隔缺损,缺损平均直径(20.1±5.2) mm,其中男性为(23.7±5.2) mm,女性为(18.2±5.6) mm,差异无统计学意义(t=1.813,P=0.095,P>0.05);③动脉干骑跨率为(50±5.2)%,男性为(51±2.3)%,女性为(49±6.3)%,差异无统计学意义(t=0.522,P=0.611,P>0.05);动脉干平均内径(34.2±6.4) mm,男性为(39.1±4.3) mm,女性为(31.4±5.8) mm,差异有统计学意义( t=2.589,P=0.024,P<0.05);④无肺动脉主干,心腰明显凹陷,肺血由支气管动脉及侧支循环供应,部分支气管动脉呈"残根"征;⑤男女各2例伴右位主动脉弓,其中1例男性有左侧肺静脉异常粗大,女性1例伴永存左上腔静脉.结论 永存动脉干Ⅳ型特征复杂多变,CT血管造影有利于提高诊断准确率,对手术有重要参考价值.%Objective To evaluate the findings of computed tomography angiography of persistent truncus arteriosus Ⅳ. Methods 14 patients (5 men and 9 women) of persistent truncus arteriosus Ⅳ confirmed by CT angiography were involved in this study. The cardiac morphology,ventricular septal defect,arteriosus truncus straddle,anomalism bronchial arteries and complicating vascular malformations were analysed retrospectively. Results CT angiography showed:①Biventricular enlargement obviously and accompanying with right atrium enlargement;②The average diameter of ventricular septal defect was (20. 1±5. 2) mm, (23. 7 ± 5. 2) mm in men and (18. 2 + 5. 6) mm in women,there was no statistically signfificant difference between them(t= 1. 813,P = 0. 095 , P>0. 05) ; ③The average rate of the arteriosus truncus straddle was (50 ± 5. 2) % , (51 ± 2. 3)% in men

  18. Coincidence of congenital left-sided diaphragmatic hernia and ductus venosus agenesis: Relation between altered hemodynamic flow and lung-to-head-ratio?

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    T. Klein

    2015-06-01

    Full Text Available Left-sided diaphragmatic hernia (CDH as well as ductus venosus agenesis (ADV are rare complex congenital malformations. We present a case of coincidence of these malformations and an abnormally high lung-head-ratio (LHR. The left-sided liver-up CDH and the ADV were diagnosed in prenatal ultrasound examination. In CDH cases lung volume is decreased due to the herniation of abdominal organs into the thorax. With 1.4 the LHR of our patient exceeded the normal ratio in liver-up CDH cases considerably. One explanation for this unusually high LHR might be an altered blood flow due to the coinciding ADV. In ADV cases less blood bypasses the lung through the foramen ovale. Consecutively pulmonary circulation is improved which may constitute as an advantage in CDH cases. Diagnosis, prognostic factors, physiology, and therapy strategy are discussed.

  19. Toxicology Analysis of Tissue-Mimicking Phantom Made From Gelatin

    Science.gov (United States)

    Dolbashid, A. S.; Hamzah, N.; Zaman, W. S. W. K.; Mokhtar, M. S.

    2017-06-01

    Skin phantom mimics the biological skin tissues as it have the ability to respond to changes in its environment. The development of tissue-mimicking phantom could contributes towards the reduce usage of animal in cosmetics and pharmacokinetics. In this study, the skin phantoms made from gelatin were tested with four different commonly available cosmetic products to determine the toxicity of each substance. The four substances used were; mercury-based whitening face cream, carcinogenic liquid make-up foundation, paraben-based acne cleanser, and organic lip balm. Toxicity test were performed on all of the phantoms. For toxicity testing, topographical and electrophysiological changes of the phantoms were evaluated. The ability of each respective phantom to react with mild toxic substances and its electrical resistance were analysed in to determine the toxicity of all the phantom models. Four-electrode method along with custom made electrical impedance analyser was used to differentiate electrical resistance between intoxicated phantom and non-intoxicated phantom in this study. Electrical resistance values obtained from the phantom models were significantly higher than the control group. The result obtained suggests the phantom as a promising candidate to be used as alternative for toxicology testing in the future.

  20. Moderately nonlinear ultrasound propagation in blood-mimicking fluid.

    Science.gov (United States)

    Kharin, Nikolay A; Vince, D Geoffrey

    2004-04-01

    In medical diagnostic ultrasound (US), higher than-in-water nonlinearity of body fluids and tissue usually does not produce strong nonlinearly distorted waves because of the high absorption. The relative influence of absorption and nonlinearity can be characterized by the Gol'dberg number Gamma. There are two limiting cases in nonlinear acoustics: weak waves (Gamma 1). However, at diagnostic frequencies in tissue and body fluids, the nonlinear effects and effects of absorption more likely are comparable (Gol'dberg number Gamma approximately 1). The aim of this work was to study the nonlinear propagation of a moderately nonlinear US second harmonic signal in a blood-mimicking fluid. Quasilinear solutions to the KZK equation are presented, assuming radiation from a flat and geometrically focused circular Gaussian source. The solutions are expressed in a new simplified closed form and are in very good agreement with those of previous studies measuring and modeling Gaussian beams. The solutions also show good agreement with the measurements of the beams produced by commercially available transducers, even without special Gaussian shading.

  1. Acoustic resolution photoacoustic Doppler velocimetry in blood-mimicking fluids

    Science.gov (United States)

    Brunker, Joanna; Beard, Paul

    2016-02-01

    Photoacoustic Doppler velocimetry provides a major opportunity to overcome limitations of existing blood flow measuring methods. By enabling measurements with high spatial resolution several millimetres deep in tissue, it could probe microvascular blood flow abnormalities characteristic of many different diseases. Although previous work has demonstrated feasibility in solid phantoms, measurements in blood have proved significantly more challenging. This difficulty is commonly attributed to the requirement that the absorber spatial distribution is heterogeneous relative to the minimum detectable acoustic wavelength. By undertaking a rigorous study using blood-mimicking fluid suspensions of 3 μm absorbing microspheres, it was discovered that the perceived heterogeneity is not only limited by the intrinsic detector bandwidth; in addition, bandlimiting due to spatial averaging within the detector field-of-view also reduces perceived heterogeneity and compromises velocity measurement accuracy. These detrimental effects were found to be mitigated by high-pass filtering to select photoacoustic signal components associated with high heterogeneity. Measurement under-reading due to limited light penetration into the flow vessel was also observed. Accurate average velocity measurements were recovered using “range-gating”, which furthermore maps the cross-sectional velocity profile. These insights may help pave the way to deep-tissue non-invasive mapping of microvascular blood flow using photoacoustic methods.

  2. Riboswitch Structure: an Internal Residue Mimicking the Purine Ligand

    Energy Technology Data Exchange (ETDEWEB)

    Delfosse, V.; Bouchard, P; Bonneau, E; Dagenais, P; Lemay, J; Lafontaine, D; Legault, P

    2009-01-01

    The adenine and guanine riboswitches regulate gene expression in response to their purine ligand. X-ray structures of the aptamer moiety of these riboswitches are characterized by a compact fold in which the ligand forms a Watson-Crick base pair with residue 65. Phylogenetic analyses revealed a strict restriction at position 39 of the aptamer that prevents the G39-C65 and A39-U65 combinations, and mutational studies indicate that aptamers with these sequence combinations are impaired for ligand binding. In order to investigate the rationale for sequence conservation at residue 39, structural characterization of the U65C mutant from Bacillus subtilis pbuE adenine riboswitch aptamer was undertaken. NMR spectroscopy and X-ray crystallography studies demonstrate that the U65C mutant adopts a compact ligand-free structure, in which G39 occupies the ligand-binding site of purine riboswitch aptamers. These studies present a remarkable example of a mutant RNA aptamer that adopts a native-like fold by means of ligand mimicking and explain why this mutant is impaired for ligand binding. Furthermore, this work provides a specific insight into how the natural sequence has evolved through selection of nucleotide identities that contribute to formation of the ligand-bound state, but ensures that the ligand-free state remains in an active conformation.

  3. Bartonella henselae Infection: An Uncommon Mimicker of Autoimmune Disease

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    Despoina N. Maritsi

    2013-01-01

    Full Text Available We present a case of a seven-year-old immunocompetent female patient who developed systemic symptoms mimicking an autoimmune rather than an infectious disease. The patient presented with rash, biquotidian fever, night sweats, and arthralgias. There was no antecedent history of cat contact. Investigations showed increased inflammatory markers, leukocytosis, thrombocytosis, hypercalcemia, and raised angiotensin-converting enzyme. Interferon-gamma releasing assay for tuberculosis infection was negative. Abdominal imaging demonstrated multifocal lesions of the liver and spleen (later proved to be granulomata, chest X-ray showed enlarged hilar lymph nodes, and ophthalmology review revealed uveitis. Clinical, laboratory, and imaging features pointed towards sarcoidosis. Subsequently, raised titers (IgM 1 : 32, IgG 1 : 256 against Bartonella confirmed the diagnosis of B. henselae infection. She was treated with gentamycin followed by ciprofloxacin; repeat investigations showed complete resolution of findings. The presence of hepatic and splenic lesions in children with bartonellosis is well documented. Our case, however, exhibited certain unusual findings such as the coexistence of acute ocular and systemic involvement in an immunocompetent host. Serological testing is an inexpensive and effective way to diagnose bartonellosis in immunocompetent patients; we suggest that bartonella serology is included in the baseline tests performed on children with prolonged fever even in the absence of contact with cats in countries where bartonellosis is prevalent.

  4. Hematological Changes Mimicking Myelodysplastic Syndrome Following Treatment for Osteosarcoma.

    Science.gov (United States)

    Løhmann, Ditte J A; Hasle, Henrik

    2015-04-01

    Therapy-related myelodysplastic syndrome/acute myeloid leukemia (t-MDS/AML) is a feared long-term complication of pediatric cancer. Few osteosarcoma patients develop t-MDS/AML, but the frequency of hematological abnormalities after therapy is unknown. We reviewed biochemistry from osteosarcoma patients up to 3 years posttreatment. All children diagnosed with osteosarcoma at our department from 2006 to 2012 without relapse 1 month posttherapy were included (n=14). Serial blood counts posttherapy were analyzed. The median increase of mean corpuscular volume (MCV) from baseline was 8 fL 6 months posttherapy and remained >5 throughout follow-up. All posttreatment levels of MCV were above 90 fL in 5 patients. Six months posttherapy, the median difference for platelets, white blood count, and absolute neutrophil count had decreased from baseline. They remained under baseline throughout follow-up. Hemoglobin remained stable. Ferritin level was associated with increased MCV. MDS with monosomy 7 was diagnosed in 1 patient. Hypoplastic refractory cytopenia was found in another patient showing spontaneous normalization of hematologic values. More than a third of patients treated for osteosarcoma developed hematological abnormalities mimicking early MDS, but only 1 developed t-MDS/AML. Close hematological monitoring of patients recovering from osteosarcoma is essential and it is worth noting that hematological abnormalities are frequent and may be transitory.

  5. Tophaceous gout of the lumbar spine mimicking a spinal meningioma.

    Science.gov (United States)

    Ribeiro da Cunha, Pedro; Peliz, António Judice; Barbosa, Marcos

    2016-11-05

    Although gout is a common metabolic disorder, it usually affects distal joints of the appendicular skeleton. Axial spine involvement is rare, with only 131 cases reported in the literature. The authors report a rare case of lumbar spinal gout mimicking a spinal meningioma. A 77-year-old man with a history of gout presented with chronic low back pain and progressive paraparesis. Imaging revealed a lumbar spine compressive mass lesion with a dural tail signal. The differential diagnosis was thought to be straightforward favoring a spinal meningioma. Tophaceous gout was never considered. The presence of a dural tail associated with the lesion is an interesting detail of this case, that strongly misguided it and to the best of our knowledge it is the first one reported in the literature. The patient underwent surgery and intra-operative findings were surprisingly different from those expected, revealing a chalky white mass lesion firmly adherent and compressing the dural sac. It was completely excised, leaving the dura intact. Histopathology confirmed the diagnosis of tophaceous gout. The patient was sent to physical therapy and had a complete remission of pain and neurological deficit, regaining his walking capacity. Although spinal gout is rare, it should be considered in the differential diagnosis for patients presenting with symptoms of spinal stenosis, a suspicion of neoplastic lesion of the spine, and a previous history of gout. Early diagnosis can ensure proper and timely medical management, perhaps avoiding neurological compromise and the need for surgery.

  6. Solitary spinal dural syphilis granuloma mimicking a spinal meningioma.

    Science.gov (United States)

    Zhou, Heng-Jun; Zhan, Ren-Ya; Chen, Man-Tao; Cao, Fei; Zheng, Xiu-Jue

    2014-01-01

    Dural granuloma is extremely rare. To our knowledge, there has no case reported solitary spinal dural syphilis granuloma worldwide so far. Here we report our findings in a 49-year-old woman, who presented with 10-year progressive left lower-limb numbness and two weeks of right lower-limb numbness. Magnetic resonance imaging (MRI) suggested a homogeneous enhanced spindle-shaped lesion, 2.9 × 1.5 cm in size, occupying the spinal intradural extramedullary space, at the level of Thoracic (T)-2/3, which mimicked the appearance of spinal meningioma. The Treponema pallidum particle agglutination (TPPA) test titer of 1:8, and the venereal diseases research laboratory of cerebral spinal fluid (VDRL-CSF) was reactive, so confirmed neurosyphilis was considered. After formal anti-syphilis treatment, posterior laminectomy surgery was performed, and the lesion was completely separated and extirpated. Final histopathologic diagnosis of the lesion was confirmed as chronic granulomatous inflammation, combined with the neurosyphilis history, spinal dural syphilis granuloma was finally diagnosed. Postoperatively, the patient recovered without any further treatment.

  7. Preparation of artificial plasma membrane mimicking vesicles with lipid asymmetry.

    Directory of Open Access Journals (Sweden)

    Qingqing Lin

    Full Text Available Lipid asymmetry, the difference in lipid distribution across the lipid bilayer, is one of the most important features of eukaryotic cellular membranes. However, commonly used model membrane vesicles cannot provide control of lipid distribution between inner and outer leaflets. We recently developed methods to prepare asymmetric model membrane vesicles, but facile incorporation of a highly controlled level of cholesterol was not possible. In this study, using hydroxypropyl-α-cyclodextrin based lipid exchange, a simple method was devised to prepare large unilamellar model membrane vesicles that closely resemble mammalian plasma membranes in terms of their lipid composition and asymmetry (sphingomyelin (SM and/or phosphatidylcholine (PC outside/phosphatidylethanolamine (PE and phosphatidylserine (PS inside, and in which cholesterol content can be readily varied between 0 and 50 mol%. We call these model membranes "artificial plasma membrane mimicking" ("PMm" vesicles. Asymmetry was confirmed by both chemical labeling and measurement of the amount of externally-exposed anionic lipid. These vesicles should be superior and more realistic model membranes for studies of lipid-lipid and lipid-protein interaction in a lipid environment that resembles that of mammalian plasma membranes.

  8. [Two cases of pulmonary sarcomatoid carcinoma mimicking malignant mesothelioma].

    Science.gov (United States)

    Inomata, Minehiko; Kawagishi, Yukio; Yamada, Toru; Miwa, Toshiro; Hayashi, Ryuji; Kashii, Tatsuhiko; Matsui, Shoko; Fukuoka, Junya; Tobe, Kazuyuki

    2010-01-01

    We report 2 cases of pulmonary sarcomatoid carcinoma mimicking malignant mesothelioma. Case 1: A 69 year-old man presented, complaining of right chest pain. The chest X ray film and CT showed tumors in the right chest wall and pleura. Histological findings of specimens obtained from a percutaneous biopsy revealed spindle tumor cells, and the immunohistochemistry showed that the tumor cells were positive for CK-7, AE1/AE3, and vimentin and negative for calretinin, D2-40, and WT-1. We diagnosed pulmonary sarcomatoid carcinoma and started chemotherapy with carboplatin and paclitaxel, but it was ineffective. Case 2: A 68 year-old man was admitted complaining of general malaise. The chest X ray film and CT revealed tumors in the right chest wall. Histological findings showed necrosis and spindle tumor cells which were positive for AE1/AE3 and vimentin, and negative for calretinin, D2-40, and WT-1. We diagnosed pulmonary sarcomatoid carcinoma and started chemotherapy with carboplatin and paclitaxel. However the disease continued to progress and he died 2 months after admission. The pulmonary sarcomatoid carcinoma was reported to have spred to the pleural and chest wall. The present two cases showed prominent chest wall and pleural tumors with obscure primary lung tumors. Therefore, we needed to differentiate sarcomatoid carcinoma from malignant pleural mesothelioma.

  9. A Case of Congenital Adrenal Hyperplasia Mimicking Cushing's Syndrome

    Science.gov (United States)

    Kim, Hye Jeong; Kang, Mira; Kim, Jae Hyeon; Kim, Sun Wook; Chung, Jae Hoon; Min, Yong-Ki; Lee, Moon-Kyu; Kim, Kwang-Won

    2012-01-01

    Congenital adrenal hyperplasia (CAH) is characterized by decreased adrenal hormone production due to enzymatic defects and subsequent rise of adrenocorticotrophic hormone that stimulates the adrenal cortex to become hyperplastic, and sometimes tumorous. As the pathophysiology is basically a defect in the biosynthesis of cortisol, one may not consider CAH in patients with hypercortisolism. We report a case of a 41-yr-old man with a 4 cm-sized left adrenal tumorous lesion mimicking Cushing's syndrome who was diagnosed with CAH. He had central obesity and acanthosis nigricans involving the axillae together with elevated 24-hr urine cortisol level, supporting the diagnosis of Cushing's syndrome. However, the 24-hr urine cortisol was suppressed by 95% with the low dose dexamethasone suppression test. CAH was suspected based on the history of precocious puberty, short stature and a profound suppression of cortisol production by dexamethasone. CAH was confirmed by a remarkably increased level of serum 17-hydroxyprogesterone level. Gene mutation analysis revealed a compound heterozygote mutation of CYP21A2 (I173N and R357W). PMID:23166432

  10. Unusual Ovarian Stromal Tumor with Radiation Changes Mimicking Carcinoma

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    Olga L. Bohn, Chengquan Zhao, Mirka W. Jones

    2011-01-01

    Full Text Available Radiation-related changes including fibrosis, nuclear enlargement, hyperchromasia and cytoplasmic vacuolization may alter the appearance of normal ovarian tissue and ovarian tumors. We describe radiation-related changes in ovarian stromal neoplasm with mixed features of sclerosing stromal tumor and fibrothecoma. The right ovarian mass was discovered in a 38 year-old woman with past history of invasive squamous cell carcinoma of the cervix treated with cone biopsy and brachytherapy. The low power architecture of cellular pseudolobules and small sheets of tumor cells with scattered hyaline plaques was consisted with the pattern of combined sclerosing stromal tumor and fibrothecoma. However, the presence of severe cytologic atypia, as well as clear cell and signet ring differentiation and arrangements of tumor cells in single files and nests, raised a possibility of primary or metastatic carcinoma. The tumor cells were positive for calretinin, vimentin, inhibin, and WT1 and negative for AE1/3, cytokeratin 7 and 20, CD99, estrogen and progesterone receptors, mammaglobin, chromogranin, and S100 protein. Based on the results of immunostains and a subsequently provided history of radiation, a diagnosis of sex cord stromal tumor with mixed fibrothecoma and sclerosing stromal differentiation was made. Radiation-related atypia and fibrosis in sex cord stromal tumor may create a pattern mimicking carcinoma and therefore, in the presence of unusual histology, the use of immunohistochemistry is recommended.

  11. Mimicking static anisotropic fluid spheres in general relativity

    Science.gov (United States)

    Boonserm, Petarpa; Ngampitipan, Tritos; Visser, Matt

    2016-11-01

    We argue that an arbitrary general relativistic static anisotropic fluid sphere, (static and spherically symmetric but with transverse pressure not equal to radial pressure), can nevertheless be successfully mimicked by suitable linear combinations of theoretically attractive and quite simple classical matter: a classical (charged) isotropic perfect fluid, a classical electromagnetic field and a classical (minimally coupled) scalar field. While the most general decomposition is not unique, a preferred minimal decomposition can be constructed that is unique. We show how the classical energy conditions for the anisotropic fluid sphere can be related to energy conditions for the isotropic perfect fluid, electromagnetic field, and scalar field components of the model. Furthermore, we show how this decomposition relates to the distribution of both electric charge density and scalar charge density throughout the model. The generalized TOV equation implies that the perfect fluid component in this model is automatically in internal equilibrium, with pressure forces, electric forces, and scalar forces balancing the gravitational pseudo-force. Consequently, we can build theoretically attractive matter models that can be used to mimic almost any static spherically symmetric spacetime.

  12. Preparation of artificial plasma membrane mimicking vesicles with lipid asymmetry.

    Science.gov (United States)

    Lin, Qingqing; London, Erwin

    2014-01-01

    Lipid asymmetry, the difference in lipid distribution across the lipid bilayer, is one of the most important features of eukaryotic cellular membranes. However, commonly used model membrane vesicles cannot provide control of lipid distribution between inner and outer leaflets. We recently developed methods to prepare asymmetric model membrane vesicles, but facile incorporation of a highly controlled level of cholesterol was not possible. In this study, using hydroxypropyl-α-cyclodextrin based lipid exchange, a simple method was devised to prepare large unilamellar model membrane vesicles that closely resemble mammalian plasma membranes in terms of their lipid composition and asymmetry (sphingomyelin (SM) and/or phosphatidylcholine (PC) outside/phosphatidylethanolamine (PE) and phosphatidylserine (PS) inside), and in which cholesterol content can be readily varied between 0 and 50 mol%. We call these model membranes "artificial plasma membrane mimicking" ("PMm") vesicles. Asymmetry was confirmed by both chemical labeling and measurement of the amount of externally-exposed anionic lipid. These vesicles should be superior and more realistic model membranes for studies of lipid-lipid and lipid-protein interaction in a lipid environment that resembles that of mammalian plasma membranes.

  13. Osteopoikilosis: A Sign Mimicking Skeletal Metastases in a Cancer Patient

    Directory of Open Access Journals (Sweden)

    Hamid Nasrolahi

    2011-01-01

    Full Text Available Osteopoikilosis is a rare benign osteosclerotic bone disorder that may be misdiagnosed as skeletal metastases. Here we describe a case of coincidental breast cancer and osteopoikilosis mimicking skeletal metastases. A 41-year-old woman underwent right modified radical mastectomy in April 2007. Twenty-eight months after initial treatment,the patient complained of bilateral knee and foot pain. Plain X-rays of the feet and knees showed multiple well-defined osteosclerotic lesions. According to the radiographic appearance, the most likely differential diagnoses included skeletal metastases from breast cancer and osteopoikilosis. A whole-body bone scintigraphy showed no increase in uptake by the sclerotic lesions, and serum lactic dehydrogenase, carcinoembryonic antigen, alkaline phosphatase and cancer antigen 15-3 were not elevated. We therefore diagnosed the patient’s skeletal lesions as osteopoikilosis. This case and ourliterature review suggest that the radiographic appearance of osteopoikilosis may mimic or mask skeletal metastases, potentially leading to misdiagnosis in patients with cancer.

  14. Idiopathic hypertrophic pachymeningitis mimicking prolactinoma with recurrent vision loss.

    Science.gov (United States)

    Lok, Julie Y C; Yip, Nelson K F; Chong, Kelvin K L; Li, C L; Young, Alvin L

    2015-08-01

    Idiopathic hypertrophic pachymeningitis is a rare inflammatory condition with diffuse thickening of the dura mater, which may cause a compressive effect or vascular compromise. We report on a 28-year-old Chinese woman with a history of granulomatous mastitis 7 years previously and oligomenorrhoea, headache, blurred vision, and raised prolactin level 2 years previously, that was diagnosed as prolactinoma and treated conservatively with bromocriptine. However, she had recurrent bilateral vision loss when the bromocriptine was stopped. Her symptoms were resolved by high-dose steroid injection but remained steroid-dependent. Serial magnetic resonance imaging scan showed progressive diffuse thickening of the pachymeningitis with disappearance of pituitary apoplexy. Lumbar puncture showed lymphocytosis with no organisms. Open biopsy of the meninges was performed and histology showed features of inflammatory infiltrates and vasculitis. This is an unusual presentation of a rare condition in this age-group, with co-existing granulomatous mastitis and chronic otitis media, and is a diagnostic challenge mimicking pituitary macroadenoma and meningioma in initial magnetic resonance imaging scans.

  15. A case of relapsing polychondritis mimicking Ludwig’s angina

    Directory of Open Access Journals (Sweden)

    Adnan Agha

    2009-09-01

    Full Text Available Relapsing polychondritis (RP is a severe progressive inflammatory condition involving cartilaginous structures and caused by an autoimmune process, for which there is no confirmatory serological biomarker and which still is diagnosed on a mainly clinical basis. RP has been associated with many diseases like Sweet’s syndrome, Behcet’s disease, rheumatoid arthritis, and other autoimmune disorders. We attempt to describe here a unique case of a 38-year-old female with a high-grade fever, sore throat, difficulty in swallowing, hoarseness of the voice, and found to have signs of tongue swelling and inflammation of the oral cavity that mimicked Ludwig’s angina, necessitating antibiotic use. On careful re-evaluation the patient was diagnosed to have relapsing polychondritis based on auricular and respiratory tract chondritis and response to steroids. The purpose of this report is to emphasize the fact that careful clinical assessment is needed to diagnose RP, which may be misdiagnosed as Ludwig’s angina.

  16. Ant-Mimicking Spiders: Strategies for Living with Social Insects

    Directory of Open Access Journals (Sweden)

    Fadia Sara Ceccarelli

    2013-01-01

    Full Text Available Mimicry is a fascinating topic, in particular when viewed in terms of selective forces and evolutionary strategies. Mimicry is a system involving a signaller, a signal receiver, and a model and has evolved independently many times in plants and animals. There are several ways of classifying mimicry based on the interactions and cost-benefit scenarios of the parties involved. In this review, I briefly outline the dynamics of the most common types of mimicry to then apply it to some of the spider-ant associative systems known to date. In addition, this review expands on the strategies that ant-associating (in particular ant-mimicking spiders have developed to minimise the costs of living close to colonies of potentially dangerous models. The main strategy that has been noted to date is either chemical mimicry or actively avoiding contact with ants. If these strategies warrant protection for the spider (living close to potentially dangerous models, then the benefits of ant associations would outweigh the costs, and the association will prevail.

  17. Visual Loss from Choroidal Melanoma Mimicking Neurological Syndromes

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    Karim Hammamji

    2017-03-01

    Full Text Available Melanoma of the eye is rare, but can mimic a range of disorders. This report highlights 2 cases of choroidal melanoma with vision loss mimicking neurological diagnoses. The first patient is a 41-year-old white male with a known history of multiple sclerosis and a previous episode of optic neuritis in the right eye, who presented with a 6-month history of decreased vision in the same eye, and occasional photopsiae. He was treated with 2 courses of oral steroids for presumed recurrent optic neuritis. After a temporary improvement in his symptoms, his vision worsened, following which he had a head MRI, which revealed a solid intraocular mass. He was subsequently diagnosed with a choroidal melanoma for which he was treated successfully with ruthenium-106 plaque brachytherapy. The second patient is a 57-year-old female, who presented with a progressive cerebellar syndrome under investigation by the neurology service, as well as decreased vision in the right eye. Her visual acuity gradually deteriorated and her neurological assessment, which included a PET-CT, revealed uptake in the right eye. The diagnosis of a choroidal melanoma was made, and following conservative treatment with proton beam radiotherapy, she had an enucleation of the eye. Intraocular tumours can masquerade as many different entities. Unexplained unilateral visual loss, especially if it is atypical for a neurological syndrome, should prompt dilated fundoscopy and referral to an ophthalmologist.

  18. Chondroid chordoma of the sella turcica mimicking a pituitary adenoma.

    Science.gov (United States)

    Wu, Arthur W; Bhuta, Sunita; Salamon, Noriko; Martin, Neil; Wang, Marilene B

    2015-01-01

    We report an unusual case of a chondroid chordoma of the sella turcica that mimicked the clinical and radiologic presentation of the more common pituitary adenoma. A 50-year-old man presented with bitemporal visual field deficits. Magnetic resonance imaging (MRI) detected a sellar mass that was suggestive of a pituitary adenoma. However, the intraoperative appearance of the mass was not consistent with an adenoma, and frozen-section pathology was obtained. Pathology identified the mass as a malignant lesion. Based on this finding, the mass was treated more aggressively. Chondroid chordomas are rare and slowly growing but locally aggressive tumors. The prognosis depends on the ability to totally resect the mass, so differentiating this tumor from a benign lesion is critical. An intrasellar chordoma can be confused clinically and radiologically with a pituitary adenoma. These two lesions are nearly identical on MRI, although T2-weighted imaging sometimes demonstrates higher intensity with a chondroid chordoma. Computed tomography may be helpful in demonstrating bony destruction by these lesions, as can the presence of intralesional calcifications. Intraoperative findings of bony invasion or a purple-red color may also lead the surgeon to suspect a diagnosis other than pituitary adenoma.

  19. Duodenal White Spots Mimicking Intestinal Candidiasis: Report of Case

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    Ozgur Turk

    2015-12-01

    Full Text Available Duodenal white spots are mentioned in these nonspecific lesions until recently. Although there is not enough studies about duedonal white spots yet; these lesions described in a separate syndrome. Here now we reported a case that we diagnosed multiple Duodenal white spots mimicking intestinal candidiasis. Clinical manifestation and endoscopic appearance of lesions gave rise to thought intestinal candidiasis histopathological examination revealed us several duodenitis. There was no evidence of fungal infection in PAS staining. Early after endoscopy patient took treatment of Lansoprozole at the 30 mg dose and bismuth salicylate. Patients compliant declined and control endoscopy exposed white duodenal spots cleared away three months later. Duodenal white spots are becoming to be designated as a separate disease even a syndrome. Etiology of duodenal white spots must be determined carefully during endoscopy. Sometimes it is difficult to make the correct diagnosis by appearance of lesion; in such cases histopathological examination can be useful both differential diagnosis of disease and determination of etiological factor. [J Contemp Med 2015; 5(4.000: 249-252

  20. Adenomatoid odontogenic tumour mimicking a periapical cyst in pregnant woman.

    Science.gov (United States)

    Bhandari, Neha; Kothari, Mohit

    2010-06-01

    Adenomatoid odontogenic tumours (AOT) are uncommon odontogenic lesions characterized histologi-cally by duct-like structures derived from the epithelial component of the lesion and can be distinctly classified into follicular, extrafollicular and extraosseous variants (Neville BW, Damm DD, Allen CM, et al. Adenomatoid Odontogenic Tumor. A Text Book for Oral and Maxillofacial Pathology, 2(nd) edition, 621-3). Most of these tumours develop in the second or third decade of life and have a distinct predilection for women. The follicular variant accounts for 75% of reported cases (Curran AE, Miller EJ, Murrah VA. Adenomatoid odontogenic tumor presenting as periapical disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:557-60) and is associated with the crown of an impacted tooth, commonly the maxillary canine. We present a rare case of extrafollicular AOT mimicking a periapical cyst that originated in a woman in her first trimester of pregnancy and enlarged rapidly thereafter. The lesion was enucleated and sent for histopathology and immunohistochemistry, which revealed AOT with a cystic component with no dependence on oestrogen or progestrone for its growth. This case of AOT introduces us to the unique variation in its presentation and the difficulty in differentiation from periapical disease of inflammatory origin. Copyright © 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  1. Wernicke's Encephalopathy Mimicking Acute Onset Stroke Diagnosed by CT Perfusion

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    Alok Bhan

    2014-01-01

    Full Text Available Background. Metabolic syndromes such as Wernicke’s encephalopathy may present with a sudden neurological deficit, thus mimicking acute onset stroke. Due to current emphasis on rapid admission and treatment of acute stroke patients, there is a significant risk that these stroke mimics may end up being treated with thrombolysis. Rigorous clinical and radiological skills are necessary to correctly identify such metabolic stroke mimics, in order to avoid doing any harm to these patients due to the unnecessary use of thrombolysis. Patient. A 51-year-old Caucasian male was admitted to our hospital with suspicion of an acute stroke due to sudden onset dysarthria and unilateral facial nerve paresis. Clinical examination revealed confusion and dysconjugate gaze. Computed tomography (CT including a CT perfusion (CTP scan revealed bilateral thalamic hyperperfusion. The use of both clinical and radiological findings led to correctly diagnosing Wernicke’s encephalopathy. Conclusion. The application of CTP as a standard diagnostic tool in acute stroke patients can improve the detection of stroke mimics caused by metabolic syndromes as shown in our case report.

  2. Follicular thyroid carcinoma mimicking meningioma: A case report

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    Krishnalatha Buandasan

    2012-02-01

    Full Text Available Follicular thyroid carcinoma (FTC is a well-differentiated tumor which resembles the normal microscopic pattern of the thyroid. Although intracranial metastasis to the brain is frequent in adults, metastasis from FTC is very rare. Dural metastases mimicking meningioma have been documented in the literature now and then. However, cases arising from a FTC are again very rare. We report the case of a middle-aged lady who presented with progressive, painless left eye proptosis. She was noted to have a non-axial proptosis with dystopia, compressive optic neuropathy and exposure keratitis. She also had a painless swelling over the occipital region. She was initially misdiagnosed to have multiple foci of meningioma based on magnetic resonance imaging findings. Subsequent histopathological examination revealed presence of FTC. She was euthyroid but was found to have multiple small thyroid nodules by ultrasonography. Hence, the definite diagnosis of all dural masses must be histological wherever possible and thyroid carcinoma should be considered as a potential primary tumour in such presentations.

  3. Extramedullary Plasmacytoma Mimicking Pancreatic Cancer: An Unusual Presentation

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    Daniela Sciancalepore

    2016-01-01

    Full Text Available Multiple myeloma is a plasma cell tumor that homes to and expands in the bone marrow and that, despite the new available drugs, remains incurable. Extramedullary plasmacytoma is a not frequent manifestation during the natural history of multiple myeloma and is frequently associated with plasma cell bone marrow infiltration. The most common locations for an EMP include the gastrointestinal tract, pleura, testis, skin, peritoneum, liver, endocrine glands, and lymph nodes. Primary involvement of the gallbladder fossa is exceedingly rare. In this report, we describe a patient with multiple myeloma who achieved a clinical and serological remission after autologous transplant but progressed rapidly at extramedullary site mimicking a second cancer (i.e., pancreatic or biliary cancer. In this case, the extramedullary localization was refractory to standard therapy, differently from bone marrow localization, but responded to lymphoma-like therapy. In this patient (i the particular site of developing plasmacytoma is the gallbladder fossa, (ii the timing of onset of this neoplasm is immediately after autologous transplant, and (iii its disjunction from primary myeloma is that it appears in clinical and serological remission phase which may be confounding during the diagnostic approach simulating a different tumor (solid tumor.

  4. Tuberculosis of the skull mimicking a bony tumor.

    Science.gov (United States)

    Rosli, Fadzlishah Johanabas; Haron, Rahmat

    2016-01-01

    We present a rare case of calvarial tuberculosis mimicking a solitary bone tumor, which was surgically removed. A 52-year-old female presented with a right forehead swelling, which gradually enlarged over the course of 2 years, with no symptoms or raised intracranial pressure or neurological deficits. Plain and contrast-enhanced brain computed tomography scans were done, revealing a punched-out lesion of the right frontal bone, with a nonenhancing lytic mass. With an initial diagnosis of an intraosseous meningioma, and later on intraoperatively thought to be a metastatic tumor, the mass was excised along with a rim of bone. Histopathological examination results came back as caseous necrosis, highly suggestive of tuberculosis. The patient was then treated with a 1 year regimen of anti-tuberculous medications. Tuberculosis of the cranium is a rare entity, and can mimic tumors or multiple myeloma. A high index of suspicion and knowledge is required for an early diagnosis. A combined surgical and medical therapy is curative.

  5. Fulminant myocarditis mimicking acute coronary syndrome = Miocarditis fulminante, simuladora de síndrome coronario agudo

    National Research Council Canada - National Science Library

    Senior, Juan Manuel; Muñoz Ortiz, Édison

    2014-01-01

    Fulminant myocarditis mimicking acute coronary syndrome We report the case of a 48 year-old man with chest pain and history of coronary and autoimmune diseases, who developed acute heart failure and hemodynamic collapse...

  6. Mimicking Photosynthesis with Electrode-Supported Lipid Nanoassemblies.

    Science.gov (United States)

    Wang, Mingming; Zhan, Wei

    2016-11-15

    as well as their sequential formation on electrodes. Supported on electrodes, these bilayers uniformly afford reliable photocurrent generation and modular system design. (2) Gold-supported hybrid bilayers as a powerful model platform for probing biomembrane-associated photoelectrochemical processes. These hybrid nanostructures consist of one alkanethiol (or substituted alkanethiol) and one lipid monolayer, whose chemical identity and makeup can be separately controlled and modified. Such precise molecular organization and flexible formation, in turn, enable a series of physicochemical parameters key to photosynthetic processes to be explicitly examined and cross-compared. A few such examples, based on donor/acceptor distance and loading, interfacial dipole, and redox level, are included here to illustrate the usefulness and versatility of this system. (3) Mimicking photosynthesis with supercomplexed lipid nanoassemblies. This research effort was motivated to address the low light absorption suffered by single-bilayer based photosynthetic mimics and has yielded a new lipid-based approach to mimicking Nature's way of organizing multiple photosynthetic subunits. Rhodamine and fullerene assembled within these lipid supercomplexes display robust electronic communication. The remarkable possibility of using lipid matrix to further improve photoconversion efficiency is revealed by cholesterol, whose addition triggers exciton formation that promotes faster energy and electron transfer in these lipid nanoassemblies.

  7. Mimicking Nonequilibrium Steady States with Time-Periodic Driving

    Science.gov (United States)

    Raz, O.; Subaşı, Y.; Jarzynski, C.

    2016-04-01

    Under static conditions, a system satisfying detailed balance generically relaxes to an equilibrium state in which there are no currents. To generate persistent currents, either detailed balance must be broken or the system must be driven in a time-dependent manner. A stationary system that violates detailed balance evolves to a nonequilibrium steady state (NESS) characterized by fixed currents. Conversely, a system that satisfies instantaneous detailed balance but is driven by the time-periodic variation of external parameters—also known as a stochastic pump (SP)—reaches a periodic state with nonvanishing currents. In both cases, these currents are maintained at the cost of entropy production. Are these two paradigmatic scenarios effectively equivalent? For discrete-state systems, we establish a mapping between nonequilibrium stationary states and stochastic pumps. Given a NESS characterized by a particular set of stationary probabilities, currents, and entropy production rates, we show how to construct a SP with exactly the same (time-averaged) values. The mapping works in the opposite direction as well. These results establish a proof of principle: They show that stochastic pumps are able to mimic the behavior of nonequilibrium steady states, and vice versa, within the theoretical framework of discrete-state stochastic thermodynamics. Nonequilibrium steady states and stochastic pumps are often used to model, respectively, biomolecular motors driven by chemical reactions and artificial molecular machines steered by the variation of external, macroscopic parameters. Our results loosely suggest that anything a biomolecular machine can do, an artificial molecular machine can do equally well. We illustrate this principle by showing that kinetic proofreading, a NESS mechanism that explains the low error rates in biochemical reactions, can be effectively mimicked by a constrained periodic driving.

  8. Kawasaki disease mimicking a parapharyngeal abscess: a case report.

    Science.gov (United States)

    Cai, Qianyun; Luo, Rong; Gan, Jing; Zhang, Li; Qu, Yi; Mu, Dezhi

    2015-05-01

    Parapharyngeal abscess (PPA)-like lesion is a very rare manifestation of Kawasaki disease (KD). Here we report a Chinese case of KD initially mimicking PPA, which is the first one reported in Asia.A 3-year-old male patient presented with fever, drooling, and bilateral painful cervical lymphadenopathy for 3 days. Chest X-ray and echocardiogram were normal. With substantial elevation of white blood count and C-reactive protein, purulent cervical lymphadenitis was considered. Symptoms did not improve after treatment with vancomycin, and the patient further developed trismus and restricted neck movement. Neck CT revealed a 2 × 1.5 cm hypodense lesion in the right parapharyngeal space with peripheral enhancement. PPA was suspected and on the 3rd day following admission, the patient received surgical incision and drainage. One milliliter of serous fluid was drained without bacterial growth on cultures. Fever persisted after surgery. As the clinical course proceeded, additional major signs of KD gradually evolved, and on the 6th day following admission the patient completely fulfilled the diagnostic criteria for KD. Rapid clinical improvement was observed following treatment with high-dose immunoglobulin and aspirin. Due to the parapharyngeal operation, the patient was fed milk through a nasogastric tube for 15 days. His neck incision became infected but healed gradually following dressing change and antibiotic treatment. Currently he remains asymptomatic during regular follow-up and repeated echocardiograms are normal.Both pediatricians and otolaryngologists can learn from this case that KD may initially manifest as PPA. Careful observation for major signs of KD during the clinical course can help to achieve a prompt and correct diagnosis. Thus, unnecessary surgery and cardiac complications of KD may be avoided.

  9. Chronic multifocal non-bacterial osteomyelitis in hypophosphatasia mimicking malignancy

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    Warmuth-Metz Monika

    2007-01-01

    Full Text Available Abstract Background Hypophosphatasia (HP is characterized by a genetic defect in the tissue-nonspecific alkaline phosphatase (TNSALP gene and predominantly an autosomal recessive trait. HP patients suffer from reduced bone mineralization. Biochemically, elevated concentrations of substrates of TNSALP, including pyridoxal-5'-phosphate and inorganic pyrophosphate occur in serum, tissues and urine. The latter has been associated with chronic inflammation and hyperprostaglandinism. Case presentation We report on 2 affected children presenting with multifocal inflammatory bone lesions mimicking malignancy: A 6 years old girl with short stature had been treated with human growth hormone since 6 months. Then she started to complain about a painful swelling of her left cheek. MRI suggested a malignant bone lesion. Bone biopsy, however, revealed chronic inflammation. A bone scan showed a second rib lesion. Since biopsy was sterile, the descriptive diagnosis of chronic non-bacterial osteomyelitis (CNO was established. The diagnostic tests related to growth failure were repeated and subsequent analyses demonstrated a molecular defect in the TNSALP gene. The second girl (10 years old complained about back pain after she had fallen from her bike. X rays of her spine revealed compressions of 2 thoracic vertebrae. At first these were considered trauma related, however a bone scan did show an additional lesion in the right 4th rib. A biopsy of this rib revealed a sterile lympho- plasmocytoid osteomyelitis suggesting multifocal CNO. Further analyses did show a decreased TNSALP in leukocytes and elevated pyridoxal phosphate in plasma, suggesting a heterozygous carrier status of HP. Conclusion Chronic bone oedema in adult HP and chronic hyper-prostaglandinism in childhood HP do suggest that in some HP patients bone inflammation is present in conjunction with the metabolic defect. Sterile multifocal osteomyelitis could be demonstrated. Non-steroidal anti

  10. Fate of pathogenic bacteria in microcosms mimicking human body sites.

    Science.gov (United States)

    Castellani, Francesco; Ghidini, Valentina; Tafi, Maria Carla; Boaretti, Marzia; Lleo, Maria M

    2013-07-01

    During the infectious process, pathogens may reach anatomical sites where they are exposed to substances interfering with their growth. These substances can include molecules produced by the host, and his resident microbial population, as well as exogenous antibacterial drugs. Suboptimal concentrations of inhibitory molecules and stress conditions found in vivo (high or low temperatures, lack of oxygen, extreme pH) might induce in bacteria the activation of survival mechanisms blocking their division capability but allowing them to stay alive. These "dormant" bacteria can be reactivated in particular circumstances and would be able to express their virulence traits. In this study, it was evaluated the effect of some environmental conditions, such as optimal and suboptimal temperatures, direct light and antibiotic sub-inhibitory concentrations doses of antibiotic, on the human pathogens Escherichia coli and Enterococcus faecalis when incubated in fluids accumulated in the body of patients with different pathologies. It is shown that inoculation in a number of accumulated body fluids and the presence of gentamicin, reliable conditions encountered during pathological states, induce stress-responding strategies enabling bacteria to persist in microcosms mimicking the human body. Significant differences were detected in Gram-negative and Gram-positive species with E. faecalis surviving, as starved or viable but non-culturable forms, in any microcosm and condition tested and E. coli activating a viable but non-culturable state only in some clinical samples. The persistence of bacteria under these conditions, being non-culturable, might explain some recurrent infections without isolation of the causative agent after application of the standard microbiological methods.

  11. Atypical lymphocytes in malaria mimicking dengue infection in Thailand

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    Polrat Wilairatana

    2010-09-01

    Full Text Available Polrat Wilairatana1, Noppadon Tangpukdee1, Sant Muangnoicharoen1, Srivicha Krudsood2, Shigeyuki Kano31Department of Clinical Tropical Medicine, 2Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; 3Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, JapanAbstract: Patients with uncomplicated falciparum or vivax malaria usually present with acute febrile illness and thrombocytopenia similar to dengue infection. We retrospectively studied atypical lymphocytes (AL and atypical lymphocytosis (ALO, defined as AL > 5% of total white blood cells in 1310 uncomplicated malaria patients. In 718 falciparum malaria patients, AL and ALO on day 0 were found in 53.2% and 5.7% of the patients, respectively, with median AL on admission of 1% (range 0%–10%, whereas in 592 vivax malaria patients, AL and ALO on day 0 were found in 55.4% and 9.5% of the patients, respectively, with median AL on admission of 1% (range 0%–14%. After antimalarial treatment, AL and ALO declined in both falciparum and vivax malaria. However, AL and ALO remained in falciparum malaria on days 7, 14, and 21, whereas AL and ALO remained in vivax malaria on days 7, 14, 21, and 28. In both falciparum and vivax malaria patients, there was a positive correlation between AL and total lymphocytes, but a negative correlation between AL and highest fever on admission, white blood cells, and neutrophils, eosinophils, and platelets (P < 0.05. In conclusion, AL or ALO may be found in uncomplicated falciparum and vivax malaria mimicking dengue infection. In tropical countries where both dengue and malaria are endemic, presence of AL or ALO in any acute febrile patients with thrombocytopenia (similar to the findings in dengue malaria could not be excluded. Particularly if the patients have risk of malaria infection, confirmative microscopic examination for malaria should be carried out

  12. Isolated neurosarcoidosis mimicking multifocal meningiomas: a diagnosis pitfall

    Science.gov (United States)

    Wang, Kun; He, Xiaoying; Wang, Wei; Niu, Huanjiang; Wang, Yirong; Cai, Xiujun; Yang, Shuxu

    2016-01-01

    Abstract Introduction: Neurosarcoidosis accounts for approximately 5% of the sarcoidosis, which develops exclusively in the nervous system and is always difficult to diagnose. We describe a rare case of isolated neurosarcoidosis mimicking as multifocal meningiomas. A 27-year-old male was admitted to our hospital with a history of unconsciousness and convulsion 1 month ago, which was suspected as a seizure. The results showed no abnormalities in complete blood count; serum electrolytes; erythrocyte sedimentation rate and ultrasonography of the liver, pancreas, spleen, kidney and parotid gland, and so on. Chest radiograph and electroencephalogram were also normal. Serum-angiotensin-converting enzyme slightly increased. Normal opening pressure was shown in cerebrospinal fluid sampling, which includes 8/μL white blood cells, 0.93 g/L protein, and 3.03 mmol/L glucose. Enhanced magnetic resonance imaging revealed multifocal enhancement lesions, including left sphenoid wing region, left temporal and bilateral occipitoparietal region, which were suspected as multiple “meningioma”. A left frontotemporal craniotomy was further performed. Both necrotizing and non-necrotizing granulomas were revealed in the pathological specimen, most of which were associated with multinucleated giant cells and macrophages. We could also see the fibrosis and inflammatory reaction in the sample composed of lymphocytes, histiocytes, and plasma cells. Histopathological examination showed that the cells were positive for human CD68 (KP1), CD68 (PGM1), and CD163; however, they were negative for the AF, epithelial membrane antigen, and glial fibrillary acidic protein. Tuberculosis-deoxyribonucleic acid test and special stains for acid-fast bacilli and fungi were negative. The diagnosis was finally made as isolated neurosarcoidosis. Then the patient was treated with additional corticosteroid therapy. Serial imaging examination 4 months later revealed that the lesions extremely decreased

  13. Congenital Heart Disease in an Infant with 49,XXXXY Syndrome

    Directory of Open Access Journals (Sweden)

    Mustafa Argun

    2015-04-01

    Full Text Available 49,XXXXY syndrome which is characterized with the addition of three extra X chromosomes to 46,XY is the rarest sex chromosome aneuploidy syndrome. Its classical findings were defined as a triad of mental retardation, hypogonadism and radioulnar synostosis. In 49,XXXXY syndrome, congenital heart defects like patent ductus arteriosus, atrial septal defect, ventricular septal defect, pulmonary stenosis, Fallot’s tetralogy have been reported. We present a case diagnosed in the newborn stage with low birth weight, short stature, dysmorphic craniofacial findings and hypoplastic male genitalia who was found to have severe pulmonary hypertension and medium patent ductus arteriosus when admitted at 4 months of age with heart failure and who underwent transcathater ductus closure with Amplatzer Duct Occluder I. To our knowledge, our case is the first reported 49,XXXXY syndrome with patent ductus arteriosus closed with the transcathater route.

  14. Polymerization of a divalent/tetravalent metal-storing atom-mimicking dendrimer.

    Science.gov (United States)

    Albrecht, Ken; Hirabayashi, Yuki; Otake, Masaya; Mendori, Shin; Tobari, Yuta; Azuma, Yasuo; Majima, Yutaka; Yamamoto, Kimihisa

    2016-12-01

    The phenylazomethine dendrimer (DPA) has a layer-by-layer electron density gradient that is an analog of the Bohr atom (atom mimicry). In combination with electron pair mimicry, the polymerization of this atom-mimicking dendrimer was achieved. The valency of the mimicked atom was controlled by changing the chemical structure of the dendrimer. By mimicking a divalent atom, a one-dimensional (1D) polymer was obtained, and by using a planar tetravalent atom mimic, a 2D polymer was obtained. These poly(dendrimer) polymers could store Lewis acids (SnCl2) in their unoccupied orbitals, thus indicating that these poly(dendrimer) polymers consist of a series of nanocontainers.

  15. First-trimester ultrasound screening for trisomy 21 based on maternal age, fetal nuchal translucency, and different methods of ductus venosus assessment.

    Science.gov (United States)

    Wagner, Philipp; Sonek, Jiri; Klein, Jessika; Hoopmann, Markus; Abele, Harald; Kagan, Karl Oliver

    2017-07-01

    To examine whether combining the dichotomous assessment of the a-wave and the ductus venosus (DV) pulsatility index for veins (PIV) measurement improves first-trimester screening performance. Retrospective study performed at the University Hospital of Tuebingen based on singleton pregnancies that underwent first-trimester screening including DV flow assessment. In each case, the risk of trisomy 21 was calculated based on maternal age, fetal nuchal translucency, and DV flow either as dichotomous classification of the a-wave, as measurement of the DV PIV, or both. There were 5280 euploid fetuses and 127 fetuses with trisomy 21. The DV a-wave was reversed in 2.3% and 66.1% in the euploid and trisomy 21 cases, respectively. The DV PIV measurements were above the 95th percentile in 8.3% and 77.2% the euploid and trisomy 21 cases, respectively. For a false positive rate of 3%, the detection rate for trisomy 21 based on maternal age, fetal NT, and DV flow is about 87% irrespective of whether DV is examined as a continuous or dichotomous variable. The combination of both resulted in a small decrease at 3% false positive rate. Assessment of the DV a-wave and the DV PIV result in similar DRs. Combining these two approaches does not appear to improve their individual screening performance. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.

  16. Bi-focal atrial tachycardia mimicking atrial fibrillation: fusion and interference between two distinct tachycardias.

    Science.gov (United States)

    Ejima, Koichiro; Shoda, Morio; Tanizaki, Kohei; Kasanuki, Hiroshi

    2007-11-01

    Irregular tachycardias mimicking atrial fibrillation (AF) have previously been described. We report a case of a 60-year-old man with an antiarrhythmic drug-resistant atrial tachycardia (AT) mimicking AF. The tachycardia consisted of two distinct ATs with interference of one repetitive AT with another sustained AT. Radiofrequency (RF) ablation of two distinct right atrial foci eliminated the irregular tachycardia. Although catheter-based pulmonary vein isolation has become a popular therapeutic approach for patients with symptomatic AF, careful evaluation of the intracardiac recordings in the patients undergoing RF ablation for AF is important.

  17. Fibromatosis of the breast mimicking an abscess: case report of unusual sonographic features.

    Science.gov (United States)

    Lee, So Min; Lee, Ji Young; Lee, Byung Hoon; Kim, Su Young; Joo, Mee; Kim, Jae Il

    2015-01-01

    Fibromatosis of the breast, also known as a desmoid tumor, is extremely rare and most often appears as an aggressive lesion mimicking breast carcinoma. It lacks metastatic potential but can grow aggressively in a localized area. Ultrasonography often shows an irregular spiculated hypoechoic mass with posterior acoustic shadowing. We discuss a case of breast fibromatosis that presented as a painful palpable breast mass in a 32-year-old woman and mimicked an abscess in the sonogram. We found that this lesion displayed atypical sonographic features such as a heterogeneous echoic mass with an internal anechoic area. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Nucleus-staining with biomolecule-mimicking nitrogen-doped carbon dots prepared by a fast neutralization heat strategy.

    Science.gov (United States)

    Kang, Yan-Fei; Fang, Yang-Wu; Li, Yu-Hao; Li, Wen; Yin, Xue-Bo

    2015-12-11

    Biomolecule-mimicking nitrogen-doped carbon dots (N-Cdots) were synthesized from dopamine by a neutralization heat strategy. Fluorescence imaging of various cells validated their nucleus-staining efficiency. The dopamine-mimicking N-Cdots "trick" nuclear membranes to achieve nuclear localization and imaging.

  19. Posterior fossa vermian cystic schwannoma mimicking as pilocytic astrocytoma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Alok Umredkar

    2011-01-01

    Full Text Available Intraparenchymal schwannomas are rare and most of the reported cases are in supratentorial region with frontal lobe being most common. Infratentorial location is very rare. We report a posterior fossa midline large cystic schwannoma with mural nodule mimicking as pilocytic astrocytoma. The pathogenesis and neuroradiological findings of intraparenchymal schwannomas are discussed with review of the related literature.

  20. Redox enzyme-mimicking activities of CeO2 nanostructures: Intrinsic influence of exposed facets

    Science.gov (United States)

    Yang, Yushi; Mao, Zhou; Huang, Wenjie; Liu, Lihua; Li, Junli; Li, Jialiang; Wu, Qingzhi

    2016-10-01

    CeO2 nanoparticles (NPs) have been well demonstrated as an antioxidant in protecting against oxidative stress-induced cellular damages and a potential therapeutic agent for various diseases thanks to their redox enzyme-mimicking activities. The Ce3+/Ce4+ ratio and oxygen vacancies on the surface have been considered as the major originations responsible for the redox enzyme-mimicking activities of CeO2 NPs. Herein, CeO2 nanostructures (nanocubes and nanorods) exposed different facets were synthesized via a facile hydrothermal method. The characterizations by X-ray photoelectron spectroscopy, Raman spectroscopy, and UV-Vis spectroscopy show that the Ce3+/Ce4+ ratio and oxygen vacancy content on the surfaces of as-synthesized CeO2 nanostructures are nearly at the same levels. Meanwhile, the enzymatic activity measurements indicate that the redox enzyme-mimicking activities of as-synthesized CeO2 nanostructures are greatly dependent on their exposed facets. CeO2 nanocubes with exposed {100} facets exhibit a higher peroxidase but lower superoxide dismutase activity than those of the CeO2 nanorods with exposed {110} facets. Our results provide new insights into the redox enzyme-mimicking activities of CeO2 nanostructures, as well as the design and synthesis of inorganic nanomaterials-based artificial enzymes.