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Sample records for human ductus deferens

  1. 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.

  2. Expression of 5α-Reductase Type 2 Gene in Human Testis, Epididymis and Vas Deferens

    Institute of Scientific and Technical Information of China (English)

    刘德瑜; 吴燕婉; 罗宏志; 张桂元

    2002-01-01

    Objectives To study the expression pattern of 5α-reductase type 2 gene in human malereproductive organsMethods The expression level of 5α-reductase type 2 gene inhuman testis, epididymisand vas deferens tissues was determined by in situ hybridization using Digoxin labeled5α-reductase type 2 cRNA probe.Results The brown granules of hybridizing signals distributed in the cytoplasm ofSertoli and Leydig cells of the testis, the principle cells of epididymis and the epithe-lial cells of vas deferens, but there was no positive signal in the nuclei of above-men-tioned cells. No positive signal was observed in germ cells, basement of the testis,interstium of epididymis and basement, as well as smooth muscle of vas deferens.Conclusion This study confirmed that the 5α-reductase type 2 gene expressed in Ser-toli, Leydig cells of the testis, and the principle cells of epididymis. The expressionpattern of the gene in these cells in human was similar to that of rat and monkey. Thepresence of 5a-reductase type 2 gene in epithelial cells of the vas deferens suggested itmight possess an important physiological role in human reproduction.

  3. Postnatal development of epididymis and ductus deferens in the rat. A correlation between the ultrastructure of the epithelium and tubule wall, and the fluorescence-microscopic distribution of actin, myosin, fibronectin, and basement membrane.

    Science.gov (United States)

    Francavilla, S; Moscardelli, S; Properzi, G; De Matteis, M A; Scorza Barcellona, P; Natali, P G; De Martino, C

    1987-08-01

    The postnatal maturation of regions of the epididymis and intragonadal segment of the deferens duct was studied in the rat by light- and transmission electron microscopy. Maturation of the genital duct starts in the distal cauda epididymidis and ductus deferens after one week of life, and one week later, in the more cranial segments of the epididymis. Epithelial principal cells and peritubular contractile cells are structurally mature 35 days after birth. The synchronous changes of these cells indicate that the same factors control their postnatal maturation. The epithelial principal cells obtain an endocytotic apparatus and long stereocilia, whereas peritubular cells acquire contractile features. These changes are associated with a progressive increase in the immunoreaction for smooth muscle actin in both cell types. Smooth muscle myosin is detected in the apical region of the epithelial cells and the peritubular cell cytoplasm by day one of postnatal development. The differentiation of contractile cells in the wall is accompanied by progressive organization of the pericellular matrix into a continuous basement membrane. Although fibronectin is visible at birth, it is gradually removed from the tubule wall.

  4. Efeitos da tela de polipropileno no testículo, epidídimo e ducto deferente de cães Effects of the polypropilene mesh in the testicle, epididimus and ductus deferens of dogs

    Directory of Open Access Journals (Sweden)

    Alberto Goldenberg

    2001-12-01

    Full Text Available Objetivo: Investigar os efeitos da tela sintética sobre o testículo, epidídimo e ducto deferente de cães. Métodos: Foram utilizados 10 cães, machos, adultos, pesando entre 9 e 12 kg. Os animais, após realizada anestesia, foram submetidos à laparoscopia com formação de pneumoperitônio por incisão em linha mediana. Era então fixada tela de polipropileno, de dimensões 2,5X3,5 cm² na região inguinal esquerda do cão em contato direto com o funículo espermático, com o uso de grampos metálicos, sem dissecar a região. O lado direito, sem colocação de tela, serviu de controle. O procedimento tinha duração de 15 minutos. Após observação pós-operatória de 30 dias, os animais eram novamente anestesiados e reoperados sendo o testículo e ducto deferente retirados e enviados para análise histológica. Análise estatística foi realizada com os dados obtidos desta análise. Resultados: No lado esquerdo, as secções histológicas de testículo revelaram focalmente, diminuição da espermatogênese e processo degenerativo em 20% dos animais. No epidídimo, observou-se inflamação crônica e dilatação dos túbulos seminíferos em 70%. No ducto deferente foi observado processo inflamatório crônico em 60% dos cães. Não foram verificadas alterações histológicas no lado contralateral. Conclusão: A tela de polipropileno em contato com o funículo espermático de cães provoca alterações histológicas com discreta redução da espermatogênese.The aim of this study was to investigate the effects of the synthetic mesh on the ductus deferens and testicle of dogs. Ten adult male dogs were anesthetized and a 2,5X3,5 cm² polypropilene mesh was fixed in the inguinal region in direct contact with the ductus deferens, using metallic staples without dissection of the region and therefore, without manipulation. The right side, with no mesh was the control. . The operative time was 15 minutes. The animals were observed for 30 days and

  5. 5α—reductase type 2 gene expression in human testis,epididymis and vas deferens

    Institute of Scientific and Technical Information of China (English)

    LiuDY; WuYW

    2002-01-01

    Objective:To study the expression patterm of 5-α-reductase type 2 gene in human male reproductive organs.Methods:The expression level of 5α-reductase type 2 gene in human testis,epididymis and vas deferens tissues was determined by in situ hybridization using a digoxin-labeled 5α-reductase type 2 cRNA probe.Results:The brown granules of hybridizing signals distributed in the cytoplasm of the Sertoli and Leydig cells of the testis,the principle cells of epididymis and the epithelial cells of vas deferens,but there was no positive signal in the nuclei of these cellsNo positive signal was observed in the germ cells,basement of the testis, interstium of the epididymis and basement and the smooth muscle cells of vas deferens.conclusion:This study confirmed that the 5α-reductase type 2 gene expressed in the Sertoli and Leydig cells of the testis and the principle cells of the epididymis.The expression pattern of the gene in these cells in the human was similar to that in the rat and monkey.The presence of 5α-reductase type 2 gene in the epithelial cells of the vas deferens suggests that it may play a physiological role in human reproduction.

  6. Optical and thermal simulations of noninvasive laser coagulation of the human vas deferens

    Science.gov (United States)

    Schweinsberger, Gino R.; Cilip, Christopher M.; Trammell, Susan R.; Cherukuri, Harish; Fried, Nathaniel M.

    2011-03-01

    Successful noninvasive laser coagulation of the canine vas deferens, in vivo, has been previously reported. However, there is a significant difference between the optical properties of canine and human skin. In this study, Monte Carlo simulations of light transport through tissue and heat transfer simulations are performed to determine the feasibility of noninvasive laser vasectomy in humans. A laser wavelength of 1064 nm was chosen for deep optical penetration in tissue. Monte Carlo simulations determined the spatial distribution of absorbed photons inside the tissue layers (epidermis, dermis, and vas). The results were convolved with a 3-mm-diameter laser beam, and then used as the spatial heat source for the heat transfer model. A laser pulse duration of 500 ms and pulse rate of 1 Hz, and cryogen spray cooling were incident on the tissue for 60 s. Average laser power (5-9 W), cryogen pulse duration (60-100 ms), cryogen cooling rate (0.5-1.0 Hz), and increase in optical transmission due to optical clearing (0-50 %), were studied. After application of an optical clearing agent to increase skin transmission by 50%, an average laser power of 6 W, cryogen pulse duration of 60 ms, and cryogen cooling rate of 1 Hz resulted in vas temperatures of ~ 60°C, sufficient for thermal coagulation, while 1 mm of the skin surface (epidermis and dermis) remained at a safe temperature of ~ 45 °C. Monte Carlo and heat transfer simulations indicate that it is possible to noninvasively thermally coagulate the human vas without adverse effects (e.g. scrotal skin burns), if an optical clearing agent is applied to the skin prior to the procedure.

  7. Double conjoining vas deferens.

    Science.gov (United States)

    Gravesen, R G

    1980-03-01

    The importance of careful palpation of the scrotal contents and follow-up semen analysis when performing vasectomies is proved by this case report of a double vas deferens conjoining into a single vas.

  8. 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...

  9. 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

  10. 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

  11. 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.

  12. 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 ...

  13. 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).

  14. Quantification and distribution of α1-adrenoceptor subtype mRNAs in human vas deferens: comparison with those of epididymal and pelvic portions

    Science.gov (United States)

    Moriyama, Nobuo; Nasu, Kimio; Takeuchi, Takumi; Akiyama, Katsuyoshi; Murata, Satoshi; Nishimatsu, Hiroaki; Yano, Junichi; Tsujimoto, Gozoh; Kawabe, Kazuki

    1997-01-01

    This study was intended to quantify the amounts of the α1-adrenoceptor subtype mRNAs in human vas deferens, and demonstrate the receptor subtype responsible for the vas contraction. The RNase protection assay showed that the mean total amount of α1a mRNA was 7.4±2.2 pg/5 μg of poly (A)+ RNA (97.0% of the total α1 mRNA) in the epididymal portion (E-vas) and 4.9±0.8 pg/5 μg of poly (A)+ RNA (96.3% of the total) in the pelvic portion (P-vas). The E-vas showed a tendency to have a greater α1a mRNA abundance than the P-vas (P=0.11). The α1b and α1d mRNAs were absent or of extremely low abundance. By an in situ hybridization, the α1a and α1d mRNAs were recognized in the smooth muscle cells of the E-vas and the P-vas, and the distribution pattern the same in both tissues. The α1b mRNA positive site was scarcely detectable in both vas portions. In a functional study, l-phenylephrine produced concentration-dependent contraction in the E-vas (Emax=2.24±0.70 g; pD2=5.32±0.09) and the P-vas (Emax=2.46±0.46 g; pD2=5.07±0.12). KMD-3213, a novel α1A-adrenoceptor-selective antagonist, caused parallel rightward shifts of the concentration–response curves for l-phenylephrine. Apparent pKB values were 9.90±0.16 for the E-vas and 9.71±0.17 for the P-vas. There was no significant difference in Emax, pD2 or pKB estimates between the two portions. We have found that α1a mRNA is predominant in the human vas deferens, and confirmed that contraction of this organ is mediated by the α1A-adrenoceptor. PMID:9401762

  15. 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 ...

  16. Gubernaculum with a long loop vas deferens

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    Cesim Irsi

    2016-04-01

    Full Text Available Cryptorchidism by definition suggests a hidden testis: a testis that is not within the scrotum and does not descend spontaneously into the scrotum by six months of age. Cryptorchid testes may be absent or undescended. If they haven't descended by six months of age, they are unlikely to descend and generally require surgical manipulation into and attachment to the scrotum to avoid potential complications and sequelaes. This case describes an anatomical variation of vas deferens with gubernaculum which not previously reported in literature. A 9 month old boy was presented with diagnosis of left undescended testis and underwent standard orchiopexy operation. At the time of gubernacular dissection a long loop vas deferens without epididymis abnormalities was observed. A long loop of vas deferens originated from tail of epididymis and rotated up then formed a long loop with in the gubernaculum. This case reminds us of the possibility of anatomical variations and the importance of keeping them in mind to prevent complications at time of surgery.

  17. Ureteral Obstruction by the Vas Deferens after Urostomy

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    Subramanian Vaidyanathan

    2010-01-01

    Full Text Available A male patient with spina bifida and paraplegia, born in 1968, underwent urostomy in 1973. In 1999, he developed urine infections. Intravenous urography showed bilateral hydronephrosis and hydroureter. This patient continued to get recurrent urine infections. In 2009, computed tomography of the abdomen revealed dilatation of the ureters, but the ureters reverted to normal calibre as they passed forward through the anterior abdominal wall. The vas deferens on either side was crossing and kinking the ureter. Magnetic resonance imaging of the abdomen confirmed that the level of obstruction in both ureters was at the site where the vas deferens crossed the ureter and kinked it. While performing urostomy, the ureters below the crossover by the vas deferens were detached from the bladder and attached to the skin for urinary diversion, thus causing the vas deferens to hook the lower end of the ureters. As the patient gained height and weight, thereby increasing abdominal girth, kinking of the ureters by the vas deferens was accentuated. In hindsight, bilateral midline cutaneous urostomy using the ureters below the crossover by the vas deferens represents a poor surgical technique for urinary diversion.

  18. 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

  19. A case of congenital unilateral absence of the vas deferens

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    Mo B

    2013-04-01

    Full Text Available Bi Mo,1 Vishnu Garla,2 Lawrence M Wyner1 1Department of Surgery, 2Department of Internal Medicine, Marshall University, Huntington, WV, USA Background: Congenital unilateral absence of the vas deferens occurs in 0.5%–1.0% of males. It has been associated with various genitourinary abnormalities, including renal agenesis. We report a case of congenital unilateral absence of the vas deferens found incidentally during vasectomy in a patient with known unilateral renal agenesis. Case presentation: A 24-year-old male presented to our urology clinic requesting vasectomy. His past history was significant for left renal agenesis. Following successful right vasectomy, several attempts to locate the left vas deferens were unsuccessful. We diagnosed congenital unilateral absence of the vas deferens. Follow-up semen analysis showed azoospermia. Conclusion: As vasectomies are increasingly performed in outpatient settings, it is imperative that physicians be aware of this condition, which can be recognized by a simple physical exam. Recognition could prevent unnecessary surgery and prompt providers to investigate for associated abnormalities. Keywords: vas deferens, embryology, abnormalities, surgery

  20. Some properties of the smooth muscle of mouse vas deferens.

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    Holman, M E; Taylor, G S; Tomita, T

    1977-04-01

    1. Contractions of the mouse vas deferens in response to electrical stimulation differ form those recorded form the guinea-pig vas deferens in that they are abolished by tetrodotoxin. 2. Changes in membrane potentials were recorded form the smooth muscle of both preparations in response to stimulation with current pulses applied by an intracellular electrode and by alrge extracellular plate electrodes. 3. Both preparations behaved similarly in response to intracellular stimulation. Electrotonic potentials in response to extracellular current pulses spread in a longitudinal direction in the guinea-pig vas deferens in accordance with the cable-like properties of this preparation. In contrast, no longitudinal spread of eletrotonus was observed in the mouse vas deferens. 4. Responses to nerve stimulation differed in the two preparations. In the guinea-pig, single stimuli caused excitatory junction potentials (e.j.p.s) which gave rise to action potentials. Some cells from the mouse vas deferens showed similar e.j.p.s and action potentials, although the threshold for the initiation of action potentials was lower and more variable. 5. The majority of cells in the mouse vas deferens failed to show action potentials in response to a single stimuli even though the amplitude of e.j.p.s was from 35 to 40 mV. This was probably due to the large resting membrane potentials of these cells, as all-or-nothing action potentials could be evoked if successive e.j.p.s were allowed to sum with each other or if a depolarizing current pulse was applied at the peak of an e.j.p. 6. The nature of the response to nerve stimulation recorded from differnt cells in the mouse vas deferens could be correlated with the amplitude and time course of the response of the same cell to intracellular stimulation. 7. It is concluded that individual smooth muscle cells in both preparations are probably coupled electrically but that there are few, if any, low resistance pathways in the longitudinal direction

  1. Leiomyoma of the deferens: a curious and extremely rare disease.

    Science.gov (United States)

    De Rose, Aldo F; Mantica, Guglielmo; Piol, Nataniele; Toncini, Carlo; Spina, Bruno; Terrone, Carlo

    2017-08-01

    Leiomyomas are rare benign tumors that can occur in the male urinary tract. We present a unique case of leiomyoma of the vas deferens. We present the clinical case of a 69-year-old patient with a suspected bulk close to the right epididymis, which turned out to be a leiomyoma of the vas deferens. To our knowledge, it is the fourth case in literature. A proper identification and the knowledge of this pathology, even if it is a very unusual event, is necessary to avoid a surgical over treatment and preserve the testicle, by removing only the tumor.

  2. Physiological and Pharmacological Aspects of the Vas Deferens - an Update

    Directory of Open Access Journals (Sweden)

    David Stewart Koslov

    2013-08-01

    Full Text Available The vas deferens, a muscular conduit conveying spermatozoa from the epididymis to the urethra, has been used as a model tissue for smooth muscle pharmacological and physiological advancements. Many drugs, notably α-adrenergic antagonists, have effects on contractility and thus normal ejaculation, incurring significant side effects for patients that may interfere with compliance. A more thorough understanding of the innervation and neurotransmitter pharmacology of the vas has indicated that this is a highly complex structure and a model for co-transmission at the synapse. Recent models have shown clinical scenarios that alter the vas contraction. This review covers structure, receptors, neurotransmitters, smooth muscle physiology, and clinical implications of the vas deferens.

  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. Preferential streaming of the ductus venosus toward the right atrium is associated with a worse outcome despite a higher rate of invasive procedures in human fetuses with left diaphragmatic hernia.

    Science.gov (United States)

    Stressig, R; Fimmers, R; Schaible, T; Degenhardt, J; Axt-Fliedner, R; Gembruch, U; Kohl, T

    2013-12-01

    Preferential streaming of the ductus venosus (DV) toward the right atrium has been observed in fetuses with left diaphragmatic hernia (LDH). The purpose of this retrospective study was to compare survival rates to discharge between a group with preferential streaming of the DV toward the right heart and a group in which this abnormal flow pattern was not present. We retrospectively searched our patient records for fetuses with LDH in whom liver position, DV streaming and postnatal outcome information was available. 55 cases were found and divided into two groups: Group I fetuses exhibited abnormal DV streaming toward the right side of the heart; group II fetuses did not. Various prognostic and outcome parameters were compared. 62 % of group I fetuses and 88 % of group II fetuses survived to discharge (p = 0.032). Fetoscopic tracheal balloon occlusion (FETO) was performed in 66 % of group I fetuses and 23 % of group II fetuses (p = 0.003). Postnatal ECMO therapy was performed in 55 % of group I fetuses and 23 % of group II infants (p = 0.025). Moderate to severe chronic lung disease in survivors was observed in 56 % of the survivors of group I and 9 % of the survivors of group II (p = 0.002). Preferential streaming of the DV toward the right heart in human fetuses with left-sided diaphragmatic hernia was associated with a poorer postnatal outcome despite a higher rate of invasive pre- and postnatal procedures compared to fetuses without this flow abnormality. Specifically, abnormal DV streaming was found to be an independent predictor for FETO. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Light microscopical and ultrastructural studies on the vas deferens of the lizard Mabuya carinata.

    Science.gov (United States)

    Aranha, I; Bhagya, M; Yajurvedi, H N; Sagar, B K Chandrashekar

    2004-01-01

    Adult male lizards (Mabuya carinata) were studied during breeding and non breeding seasons to determine the regional and seasonal differences if any in the vas deferens and to compare ultrastructural features of luminal epithelial cells with those of endotherms. The vas deferens of the lizard is a convoluted tube extending from the epididymis to the hemipenis passing over the kidney. Based on morphometric data of luminal diameter and epithelial cell height three distinct regions viz; proximal, middle and distal regions were identified in the vas deferens. The epithelium is surrounded by a thin layer of lamina propria, many layers of circular smooth muscle fibers and an outer layer of visceral pleuro peritoneum. Based on cell and nuclear morphology and ultrastructure, five different cell types viz; principal cell, basal cell, mitochondria rich cell, halo cell and narrow cell were identified in the epithelium during both breeding and non breeding season. Principal cells and basal cells were more abundant in both seasons. The types of luminal epithelial cells of vas deferens of M. carinata and their ultrastructural features are similar to those of mammals. Further, vas deferens of M. carinata differs from mammals in having only circular smooth muscles in contrast to circular and longitudinal muscles of mammalian vas deferens. To the best of our knowledge this is the first report describing cell types of vas deferens, their ultrastructure and ultrastructural seasonal variations in reptiles.

  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. Characterization of capsaicin induced responses in mice vas deferens

    DEFF Research Database (Denmark)

    Sheykhzade, Majid; Gupta, Saurabh; Sørensen, Tinne;

    2011-01-01

    Calcitonin gene-related peptide (CGRP) is extensively distributed in primary afferent sensory nerves, including those innervating the genitourinary tract. Capsaicin can stimulate the release of CGRP from intracellular stores of these nerves, but this phenomenon has not been investigated in......-depth in isolated preparations. The present study sets out to study and characterize the capsaicin as well as CGRP-induced responses in isolated mouse vas deferens. The effects of capsaicin and CGRP family of peptides were studied on electrically-induced twitch responses in the absence or presence of transient...... receptor potential cation channel vanilloid subfamily member 1 (TRPV1) antagonist and CGRP receptor antagonists. Twitch responses were attenuated by capsaicin (1nM-30nM) and CGRP family of peptides. The potency order was CGRP>intermedin-long (IMDL)~[Cys(Et)(2,7)]aCGRP~adrenomedullin (AM)>[Cys(ACM)(2,7)]a...

  8. Early microrecanalization of vas deferens following biodegradable graft implantation in bilaterally vasectomized rats.

    Science.gov (United States)

    Simons, Christopher M; De Young, Barry R; Griffith, Thomas S; Ratliff, Timothy L; Jones, Erin; Mallapragada, Surya K; Wald, Moshe

    2009-05-01

    We evaluated a biodegradable graft for reconstruction of rat vasa deferentia with long obstructed or missing segments. A total of 47 Sprague-Dawley rats underwent bilateral vasectomy and were divided into groups according to length of the vas deferens affected (0.5, 1, 1.5 cm). After 8 weeks, poly-(D,L-lactide) (PDLA) grafts were used to reconnect the vas deferens. Grafts and adjoining vasa deferentia were excised 8 and 12 weeks later and evaluated microscopically. At 8 weeks, microscopic changes included a robust inflammatory response around the grafts. All grafts were still intact but in the early stages of degradation. No microtubules, indicative of vas deferens recanalization, were identified. One specimen showed evidence of healing and neovascularization at the interface zone between the vas deferens and the graft. At 12 weeks, grafts were further degraded but still present. Microscopic evaluation showed decreased inflammation. Seven specimens showed neovascularization at the interface zone; two of these showed distinct epithelialized vas deferens microcanals at the graft edges. One specimen showed a microcanal spanning the entire 0.5-cm graft. A time period of 8 weeks is not ample enough for vas deferens regeneration in the setting of a biodegradable PDLA graft; however, early evidence of re-growth was seen at 12 weeks. A longer healing time should permit further biodegradation of the graft, as well as re-growth and possible eventual reconnection of the vas deferens, allowing passage of sperm. These findings suggest a potential role for biodegradable grafts in the reconstruction of vas deferens with long obstructed segments.

  9. Early microrecanalization of vas deferens following biode-gradable graft implantation in bilaterally vasectomized rats

    Institute of Scientific and Technical Information of China (English)

    Christopher M.Simons; Barry R.De Young; Thomas S.Griffith; Timothy L.Ratliff; Erin Jones; Surya K.Mallapragada; Moshe Wald

    2009-01-01

    We evaluated a biodegradable graft for reconstruction of rat vasa deferentia with long obstructed or missing seg-menUs. A total of 47 Sprague-Dawley rats underwent bilateral vasectomy and were divided into groups according to length of the vas deferens affected (0.5, 1, 1.5 cm). After 8 weeks, poly-(D,L-lactide) (PDLA) grafts were used to reconnect the vas deferens. Grafts and adjoining vasa deferentia were excised 8 and 12 weeks later and evalu-ated microscopically. At 8 weeks, microscopic changes included a robust inflammatory response around the grafts. All grafts were still intact but in the early stages of degradation. No microtubules, indicative of vas deferens reca-nalization, were identified. One specimen showed evidence of healing and neovascularization at the interface zone between the vas deferens and the graft. At 12 weeks, grafts were further degraded but still present. Microscopic evaluation showed decreased inflammation. Seven specimens showed neovascularization at the interface zone; two of these showed distinct epithelialized vas deferens microcanals at the graft edges. One specimen showed a micro-canal spanning the entire 0.5-cm graft. A time period of 8 weeks is not ample enough for vas deferens regeneration in the setting of a biodegradable PDLA graft; however, early evidence of re-growth was seen at 12 weeks. A longer healing time should permit further biodegradation of the graft, as well as re-growth and possible eventual reconnec-tion of the vas deferens, allowing passage of sperm. These findings suggest a potential role for biodegradable grafts in the reconstruction of vas deferens with long obstructed segments.

  10. 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.

  11. 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."

  12. 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.

  13. 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.

  14. 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%.

  15. CFTR Mutations in Congenital Absence of Vas Deferens

    Directory of Open Access Journals (Sweden)

    Ramin Radpour

    2007-01-01

    Full Text Available A qualitative diagnosis of infertility requires attention to female and male physical abnormalities,endocrine anomalies and genetic conditions that interfere with reproduction. Many genes arelikely to be involved in the complex process of reproduction. Cystic fibrosis (CF incidence variesin different White people populations (a higher incidence of CF is observed in northern–westernEuropean populations than in southern European populations, and therefore the incidence ofcongenital bilateral absence of the vas deferens (CBAVD may also vary in different Whitepeople populations. As CF is mainly observed in White people, hardly any data are available ofCBAVD in non-White people, but frequent polymorphisms such as 5T are observed in mostpopulations. The spectrum and distribution of cystic fibrosis transmembrane conductanceregulator gene (CFTR mutations differs between CBAVD and CF patients, and even comparedwith control individuals. Combinations of particular alleles at several polymorphic loci yieldinsufficient functional CFTR. The combination of the 5T allele in one copy of the CFTR genewith a cystic fibrosis mutation in the other copy is the most common cause of CBAVD in Iran.Because of techniques such as intracytoplasmic sperm injection (ICSI, CBAVD patients are nowable to father children, however such couples have an increased risk of having a child with cysticfibrosis, and therefore genetic testing and counseling should be provided. Around 10% ofobstructive azoospermia is congenital and is due to mutations the CF gene. This paper reviews therelationship of mutations in the CFTR gene with CBAVD.

  16. Vas deferens, a site of male contraception: an overview

    Institute of Scientific and Technical Information of China (English)

    Nimal K. Lohiya; B. Manivannan; Pradyumna K. Mishra; Neelam Pathak

    2001-01-01

    The vas deferens is a site which can be exploited for male contraception without undue side effects. The only ef fective technique available for male contraception is vasectomy, being practiced world wide, despite that it is a perma nent surgical procedure and its successful reversal is not assured. Although no-scalpel vasectomy minimizes surgical procedures, the fate of its reversal is akin to that of vasectomy. Several occlusive and non-occlusive vasalprocedures which claim to be reversible without surgical intervention, possess more disadvantages than advantages. Vas occlusion with plug, ‘ Shug' or medical grade silicone rubber, although claimed to produce reversible azoospermia without affect ing spermatogenesis, requires skilled microsurgery for their implantation and later removal. RISUGR, a non-sclerotic polymer styrene maleic anhydride (SMA), could be more advantageous than vasectomy and other vas occlusive proce dures in that it could be a totally non-invasive procedure by "no-scalpel injection" and "non-invasive reversal". It is claimed to offer long-term contraception without adverse side effects and also to be possible as a male spacing method by repeated vas occlusion and non-invasive reversal. The drag is currently under multicentre Phase 1II clinical trial.

  17. Regulation of nerve-evoked contractions of rabbit vas deferens by acetylcholine.

    Science.gov (United States)

    Wallace, Audrey; Gabriel, Deborah; McHale, Noel G; Hollywood, Mark A; Thornbury, Keith D; Sergeant, Gerard P

    2015-09-01

    Stimulation of intramural nerves in the vas deferens of many species yields a classical biphasic contraction comprised of an initial fast component, mediated by P2X receptors and a second slower component, mediated by α1-adrenoceptors. It is also recognized that sympathetic nerve-mediated contractions of the vas deferens can be modulated by acetylcholine (Ach), however there is considerable disagreement in the literature regarding the precise contribution of cholinergic nerves to contraction of the vas deferens. In this study we examined the effect of cholinergic modulators on electric field stimulation (EFS)-evoked contractions of rabbit vas deferens and on cytosolic Ca(2+) levels in isolated vas deferens smooth muscle cells (VDSMC). The sustained component of EFS-evoked contractions was inhibited by atropine and by the selective M3R antagonist, 1,1-dimethyl-4-diphenylacetoxypiperidinium iodide (4-DAMP). EFS-evoked contractions were potentiated by Ach, carbachol (Cch), and neostigmine. The sustained phase of the EFS-evoked contraction was inhibited by prazosin, an α1-adrenoceptor antagonist and guanethidine, an inhibitor of noradrenaline release, even in the continued presence of Ach, Cch or neostigmine. The soluble guanylate cyclase (sGC) inhibitor, 1H-[1,2,4]Oxadiazolo[4,3-a]quinoxalin-1-one enhanced the amplitude of EFS-evoked contractions and reduced the inhibitory effects of 4-DAMP. Isolated VDSMC displayed spontaneous Ca(2+) oscillations, but did not respond to Cch. However, the α1-adrenoceptor agonist, phenylephrine, evoked a Ca(2+) transient and contracted the cells. These data suggest that EFS-evoked contractions of the rabbit vas deferens are potentiated by activation of M3 receptors and reduced by activation of a sGC-dependent inhibitory pathway.

  18. Studies on the stereoselectivity of the P2-purinoceptor on the guinea-pig vas deferens.

    OpenAIRE

    Burnstock, G.; Cusack, N. J.; Meldrum, L. A.

    1985-01-01

    ATP, 2-chloro-ATP, 2-methylthio-ATP and their unnatural L-enantiomers, Rp and Sp diastereoisomers of the ATP phosphorothioate analogues, ATP alpha S and ATP beta S, were tested on the guinea-pig vas deferens. The 2-substituted analogues of ATP were no more effective than ATP in causing contraction of the vas deferens. However, stereoselectivity was observed with each pair of enantiomers of ATP, 2-chloro-ATP and 2-methylthio-ATP. No stereoselectivity was observed for the phosphorothioate analo...

  19. Effect of cyproterone acetate on alpha1-adrenoceptor subtypes in rat vas deferens

    Directory of Open Access Journals (Sweden)

    M. Campos

    2003-11-01

    Full Text Available Gonadal hormones regulate the expression of alpha1-adrenoceptor subtypes in several tissues. The present study was carried out to determine whether or not cyproterone acetate, an anti-androgenic agent, regulates the alpha1-adrenoceptor subtypes that mediate contractions of the rat vas deferens in response to noradrenaline. The actions of subtype selective alpha1-antagonists were investigated in vas deferens from control and cyproterone acetate-treated rats (10 mg/day, sc, for 7 days. Prazosin (pA2 ~9.5, phentolamine (pA2 ~8.3 and yohimbine (pA2 ~6.7 presented competitive antagonism consistent with activation of alpha1-adrenoceptors in vas deferens from both control and treated rats. The pA2 values estimated for WB 4101 (~9.5, benoxathian (~9.7, 5-methylurapidil (~8.5, indoramin (~8.7 and BMY 7378 (~6.8 indicate that alpha1A-adrenoceptors are involved in the contractions of the vas deferens from control and cyproterone acetate-treated rats. Treatment of the vas deferens from control rats with the alpha1B/alpha1D-adrenoceptor alkylating agent chloroethylclonidine had no effect on noradrenaline contractions, supporting the involvement of the alpha1A-subtype. However, this agent partially inhibited the contractions of vas deferens from cyproterone acetate-treated rats, suggesting involvement of multiple receptor subtypes. To further investigate this, the actions of WB 4101 and chloroethylclonidine were reevaluated in the vas deferens from rats treated with cyproterone acetate for 14 days. In these organs WB 4101 presented complex antagonism characterized by a Schild plot with a slope different from unity (0.65 ± 0.05. After treatment with chloroethylclonidine, the complex antagonism presented by WB 4101 was converted into classical competitive antagonism, consistent with participation of alpha1A-adrenoceptors as well as alpha1B-adrenoceptors. These results suggest that cyproterone acetate induces plasticity in the alpha1-adrenoceptor subtypes

  20. 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.

  1. 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%.

  2. 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.

  3. Proteomic analysis of androgen-regulated protein expression in a mouse fetal vas deferens cell line

    NARCIS (Netherlands)

    A. Umar (Arzu); T.M. Luider (Theo); C.A. Berrevoets (Cor); J.A. Grootegoed (Anton); A.O. Brinkmann (Albert)

    2003-01-01

    textabstractDuring sex differentiation, androgens are essential for development of the male genital tract. The Wolffian duct is an androgen-sensitive target tissue that develops into the epididymis, vas deferens, and seminal vesicle. The present study aimed to identify androgen-reg

  4. Proteomic profiling of epididymis and vas deferens: identification of proteins regulated during rat genital tract development.

    NARCIS (Netherlands)

    A. Umar (Arzu); M.P. Ooms (Marja); T.M. Luider (Theo); J.A. Grootegoed (Anton); A.O. Brinkmann (Albert)

    2003-01-01

    textabstractEpididymis and vas deferens form part of the male internal genital tract and are dependent on androgens for their growth and development. To better understand the molecular action of androgens during male genital tract development, protein expression profiles were gener

  5. 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.

  6. 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

  7. 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.

  8. Lack of CB1 receptors increases noradrenaline release in vas deferens without affecting atrial noradrenaline release or cortical acetylcholine release

    OpenAIRE

    Schlicker, Eberhard; Redmer, Agnes; Werner, André; Kathmann, Markus

    2003-01-01

    We studied whether cannabinoid CB1 receptor gene disruption (to yield CB1−/− mice) affects the electrically evoked tritium overflow from vas deferens and atrial pieces preincubated with [3H]-noradrenaline (NA) (‘noradrenaline release') and from cerebral cortex slices preincubated with [3H]-choline (‘acetylcholine release').NA release was higher by 37% in vas deferens from CB1−/− mice than in vas deferens from CB1+/+ mice. The cannabinoid receptor agonist WIN 55,212-2 inhibited, and the CB1 re...

  9. Three finger palpation technique of vas deferens for keyhole vasectomy in spotted (Axis axis and sambar deer (Cervus unicolor

    Directory of Open Access Journals (Sweden)

    B. J. William

    2014-09-01

    Full Text Available Aim: Vasectomy is performed in deer for population control, maintain pedigreed animals and prevent inbreeding. Conventional procedure of vasectomy required a long-term anesthesia and longer duration of hospitalization, which often result in stress, morbidity and mortality. A study was conducted to capture, neuter and release the deer with minimal hospitalization and stress by adopting three finger palpation technique of vas deferens and performing vasectomy through a key-hole incision. Materials and Methods: The study was conducted on three spotted male deer and three sambar male deer, which were immobilized with a mixture of xylazine at the dose of 1.00 mg/kg and ketamine at the dose of 5.00 mg/kg. The vas deferens could be palpated as a piece of cooked spaghetti at the neck of the scrotum on the anterior aspect by three finger palpation technique and was able to fix the vas deferens between the thumb and middle finger. Through a key-hole incision of <5 mm length, the vas deferens was exteriorized and resected using electrocautery and the skin incision was sealed with methyl methacrylate. The deer were released on the same day, and no post-operative complication was noticed. Conclusion: The study revealed that three finger palpation technique of vas deferens provided guidance for easy access to vas deferens for vasectomy in deer with less hospitalization, and the deer could be released on the same day.

  10. A Case of Cryptorchidism with Ipsilateral Congenital Unilateral Absence of the Vas Deferens and Contralateral Renal Agenesis

    Science.gov (United States)

    Yu, Young Dong

    2016-01-01

    Introduction and Aims. Congenital absence of the vas deferens is an uncommon anomaly and this clinical condition is responsible for up to 1-2% of male infertility. It can be either unilateral or bilateral and the associated anomalies include cryptorchidism, seminal vesicles and ejaculatory ducts anomalies, and renal anomalies such as renal agenesis. We hereby present a case of congenital unilateral absence of vas deferens, which was found incidentally during an evaluation of undescended testis in a patient with ipsilateral renal agenesis. Case Presentation. A 10-month-old boy was referred to the urology clinic with an undescended right testis. Preoperative abdominal ultrasonography showed agenesis of the right kidney and the absence of right vas deferens and epididymis was confirmed during laparoscopic orchiectomy performed due to short right spermatic cord. There were no other concomitant anomalies of the genitourinary system observed in evaluation. Conclusion. Congenital unilateral absence of the vas deferens with cryptorchidism and renal agenesis is a rare diagnostic entity. Cryptorchidism or absent vas deferens found incidentally should lead the physician to evaluate the status of the contralateral vas deferens and conduct a renal tract ultrasound study. PMID:27597925

  11. 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

  12. 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.

  13. Unusual presentation for a patent ductus arteriosus

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    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.

  14. Circadian rhythm of glycoprotein secretion in the vas deferens of the moth, Spodoptera littoralis

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    Gvakharia B

    2002-09-01

    Full Text Available Abstract Background Reproductive systems of male moths contain circadian clocks, which time the release of sperm bundles from the testis to the upper vas deferens (UVD and their subsequent transfer from the UVD to the seminal vesicles. Sperm bundles are released from the testis in the evening and are retained in the vas deferens lumen overnight before being transferred to the seminal vesicles. The biological significance of periodic sperm retention in the UVD lumen is not understood. In this study we asked whether there are circadian rhythms in the UVD that are correlated with sperm retention. Results We investigated the carbohydrate-rich material present in the UVD wall and lumen during the daily cycle of sperm release using the periodic acid-Shiff reaction (PAS. Males raised in 16:8 light-dark cycles (LD showed a clear rhythm in the levels of PAS-positive granules in the apical portion of the UVD epithelium. The peak of granule accumulation occurred in the middle of the night and coincided with the maximum presence of sperm bundles in the UVD lumen. These rhythms persisted in constant darkness (DD, indicating that they have circadian nature. They were abolished, however, in constant light (LL resulting in random patterns of PAS-positive material in the UVD wall. Gel-separation of the UVD homogenates from LD moths followed by detection of carbohydrates on blots revealed daily rhythms in the abundance of specific glycoproteins in the wall and lumen of the UVD. Conclusion Secretory activity of the vas deferens epithelium is regulated by the circadian clock. Daily rhythms in accumulation and secretion of several glycoproteins are co-ordinated with periodic retention of sperm in the vas deferens lumen.

  15. The peritoneal cavity as a bioreactor for tissue engineering visceral organs: bladder, uterus and vas deferens.

    Science.gov (United States)

    Campbell, Gordon R; Turnbull, Geoffrey; Xiang, Lina; Haines, Michael; Armstrong, Shannon; Rolfe, Barbara E; Campbell, Julie H

    2008-01-01

    Our objective was to produce avascular, myofibroblast-rich tissue capsules for use as autologous grafts for hollow, smooth muscle-walled visceral organs-bladder, uterus and vas deferens. To produce tissue for grafting, templates of the appropriate shape were implanted in the peritoneal cavities of rats or rabbits. After 2-3 weeks, the templates were removed, the encapsulating myofibroblast-rich tissue harvested and grafted to replace resected segments of bladder, vas deferens or uterus of the same animals in which the tissue was grown. Bladder grafts showed 100% patency after 14 months and had developed a morphology similar to normal bladder. Tubes of myofibroblast tissue grafted unilaterally into resected rabbit vasa deferentia developed a morphology resembling native tissue, with sperm in the ejaculate indicative of normal function. At 12 weeks after grafting, uterine graft tissue had increased in thickness and developed the morphology of normal uterus, with endometrium overlying several layers of smooth muscle cells (myometrium-like) which were interspersed with collagen fibrils; grafted uterine horns supported embryos to the late stages of gestation. This study shows that myofibroblast tissue produced in the peritoneal cavity is sufficiently plastic to permit differentiation of cells into bladder, vas deferens or uterine smooth muscle. As a method for producing autologous graft material for repair/replacement of these organs, this approach has many benefits over conventional and current tissue-engineering strategies.

  16. 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.

  17. 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.

  18. 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...

  19. 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

  20. 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.

  1. 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....

  2. 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

  3. 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.

  4. Male internal reproductive structures of European pea crabs (Crustacea, Decapoda, Brachyura, Pinnotheridae): vas deferens morphology and spermatozoal ultrastructure.

    Science.gov (United States)

    Becker, Carola; Klaus, Sebastian; Tudge, Christopher C

    2013-11-01

    Pea crabs of the subfamily Pinnotherinae (Pinnotheridae) have a high investment in reproduction and an outstanding reproductive output, probably as an adaptation to the required increase in reproductive rate due to the pinnotherids small size and their parasitic, host-dependant way of life. In the present study, we investigate the male internal reproductive structures and the ultrastructure of spermatozoa of Pinnotheres pisum and Nepinnotheres pinnotheres by histological methods and both scanning- and transmission electron microscopy. In the Brachyura, the male internal reproductive systems generally consist of paired testes and corresponding vasa deferentia where spermatozoa develop and mature. Spermatozoal ultrastructure of the investigated pinnotherids conforms to the thoracotreme type, however, N. pinnotheres has an accessory opercular ring and a periopercular rim, neither of which are present in spermatozoa of P. pisum. Spermatozoa are enclosed within spermatophores in the secretory proximal vas deferens. Two types of secretions were observed in P. pisum and N. pinnotheres: an electron dense substance secreted in the proximal vas deferens involved in spermatophore formation, and large electron-luscent vesicles constituting the seminal plasma in the medial and distal vas deferens. The medial vas deferens is strongly widened compared to other brachyurans to purpose storing spermatophores embedded in seminal plasma. Tubular appendices, which produce and store large amounts of seminal plasma, arise from the distal region of the vas deferens. The appendices extend into the ventral cephalothorax and also in the first pleomere. The latter being an exceptional location for reproductive structures among male brachyurans.

  5. Mitigating effects of Jambul against lead induced toxicity in epididymis and vas deferens of mice

    Directory of Open Access Journals (Sweden)

    Tahir Abbas

    2015-11-01

    Full Text Available Background: Precious fruits like jambul are neglected and wasted while environmental pollutants like lead intake remain overlooked. Objective: The aim of this study was to investigate the effects of the Jambul pulp extract on lead detrimental effects in pseudostratified epithelium and the stereocilia of mice epididymis and vas deferens. Materials and Methods: Thirty young males mice (Mus musculus were distributed randomly in 3 groups (n= 10 called control, Pb (Lead and Pb-J (Lead-Jambul. The Pb and Pb-J were provided 50ppm Pb in drinking water ad libitum for 15 days and Pb free water for the next 5 days. The Pb-J group received 0.2ml jambul pulp extract on 12 hourly bases. Control group was not given any treatment. Organs (epididymis and vas deference were recovered on 21st day after euthanasia. The organs were finally processed for histological and micrometric studies. Results: Marked histologic and micrometric changes in both organs were noted in Pb group. These include significant (P ≤ 0.05 decrease in cross sectional area of caput and cauda epididymis folding tubing along with evident alterations of their endothelial thickness. Prominent signs of apoptosis (vacuolations in the corpus pseudostratified endothelium and the destruction of stereocilia of the epididymis and vas deferens in Pb compared to control group were observed. Evident signs of recovery, in both organs, such as proliferation and rearrangements in pseudostratified endothelium and the stereocilia along with convincing recovery in micrometric parameters were observed in Pb-J group. Conclusion: The results indicate that epididymis and vas deferens are highly sensitive to Pb exposure while Jambul pulp extract has shown rich mitigating potentials against such histopathologies.

  6. Undernutrition affects cell survival, oxidative stress, Ca2+ handling and signaling pathways in vas deferens, crippling reproductive capacity.

    Directory of Open Access Journals (Sweden)

    Humberto Muzi-Filho

    Full Text Available BACKGROUND: The aim of this work was to investigate the mechanisms by which chronic malnutrition (CM affects vas deferens function, leading to compromised reproductive capacity. Previous studies have shown that maternal malnutrition affects the reproductive tracts of adult male offspring. However, little is known about the effects of CM, a widespread life-long condition that persists from conception throughout growth to adult life. METHODOLOGY/PRINCIPAL FINDINGS: Young adult male rats, which were chronically malnourished from weaning, presented decreased total and haploid cells in the vas deferens, hypertrophy of the muscle layer in the epididymal portion of the vas deferens and intense atrophy of the muscular coat in its prostatic portion. At a molecular level, the vas deferens tissue of CM rats exhibited a huge rise in lipid peroxidation and protein carbonylation, evidence of an accentuated increase in local reactive oxygen species levels. The kinetics of plasma membrane Ca(2+-ATPase activity and its kinase-mediated phosphorylation by PKA and PKC in the vas deferens revealed malnutrition-induced modifications in velocity, Ca(2+ affinity and regulation of Ca(2+ handling proteins. The severely crippled content of the 12-kDa FK506 binding protein, which controls passive Ca(2+ release from the sarco(endo plasmic reticulum, revealed another target of malnutrition related to intracellular Ca(2+ handling, with a potential effect on forward propulsion of sperm cells. As a possible compensatory response, malnutrition led to enhanced sarco(endo plasmic reticulum Ca(2+-ATPase activity, possibly caused by stimulatory PKA-mediated phosphorylation. CONCLUSIONS/SIGNIFICANCE: The functional correlates of these cellular and molecular hallmarks of chronic malnutrition on the vas deferens were an accentuated reduction in fertility and fecundity.

  7. Characterization and regulation of. beta. /sub 2/-adrenergic receptors in rat vas deferens

    Energy Technology Data Exchange (ETDEWEB)

    May, J.M.

    1985-01-01

    ..beta../sub 2/-Adrenergic receptors in rat vas deferens were examined by measuring the binding of /sup 125/I-pindolol (/sup 125/IPIN) to membrane preparations and the inhibition of evoked contractions in intact tissues. /sup 125/IPIN labeled a single class of binding sites with mass action kinetics. Affinity constants for ..beta..-adrenergic receptor antagonists calculated from both binding and functional experiments agreed well, suggesting that /sup 125/IPIN labels the functional ..beta../sub 2/-adrenergic receptor. n-Bromoacetylalprenololmenthane (BAAM) was used to decrease receptor density so that agonist affinity constants could be determined functionally. Treatment of tissues with BAAM decreased the functional potencies of agonists. Higher concentrations of BAAM decreased the maximum tissue response. Affinity constants for agonists calculated after BAAM treatment were compared to affinity constants determined from binding studies done under conditions designed to promote high or low affinity agonist binding. Functional affinity constants for isoproterenol and salbutamol agreed with the low affinity binding constants, suggesting that the low affinity form of the receptor initiates the functional response. Because acute denervation of vasa deferentia did not alter the density of /sup 125/IPIN binding sites, the sites are probably post-junctional. Chronic infusion of isoproterenol reduced the potency of isoproterenol, the maximum tissue response, and the receptor density. These results suggest that ..beta..-adrenergic receptor density and responsiveness in rat vas deferens are not affected by removing catecholamine sources, but receptor density and responsiveness can be decreased by increasing agonist concentration at the receptor.

  8. 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.

  9. 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.

  10. 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.

  11. Effect of the dihydropyridine Bay K 8644 on the release of [3H]-noradrenaline from the rat isolated vas deferens.

    OpenAIRE

    Ceña, V; García, A.G.; Khoyi, M. A.; Salaices, M.; Sanchez-García, P.

    1985-01-01

    The effects of Bay K 8644 on the release of [3H]-noradrenaline evoked by potassium, electrical stimulation or tyramine from the rat isolated vas deferens labelled with [3H]-noradrenaline were investigated. Bay K 8644 (1 microM) by itself did not affect the spontaneous release of tritium from the rat isolated vas deferens. However, it increased the calcium-dependent release of tritium elicited by both high potassium (59 mM) and electrical field stimulation. The exposure of rat vas deferens to ...

  12. Do blind ending vas deferens and testicular vessels on inguinal exploration always indicate a vanishing testis?

    Directory of Open Access Journals (Sweden)

    Mete Kaya

    2014-07-01

    Full Text Available In nonpalpable testis cases, laparoscopically blind-ending vas deferens and testicular vessels prior to entering the internal ring is sufficient to diagnose a “vanishing” testis, which requires no further exploration. Laparoscopic identification of cord structures entering the internal ring is required the exploration of the inguinal canal to find a testis or to rule out a “vanishing” testis".However, the need for further investigation in cases that identified the blindending cord structures on inguinal canal is questioned. Herein, we present a case of the scrotal nubbin along with blind ending cord structures during inguinal exploration.

  13. 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

  14. 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

  15. The effects of cocaine and diphenhydramine upon the reactivity of rat vas deferens to supramaximal doses of noradrenaline and of other agonists: the mode of action of cocaine.

    Science.gov (United States)

    Pennefather, J N

    1976-02-01

    The effects of cocaine on responses to supramaximal concentrations of agonists have been studied in preparations of rat vas deferens. Cocaine 10 muM decreased the mean time to peak and increased the mean magnitude of responses to noradrenaline but not to supramaximal field stimulation of sympathetic fibres, to high potassium or to methoxamine. Diphenydramine 10 muM affected responses to noradrenaline similarly. It is proposed that the prejunctional action of cocaine and of diphenhydramine to reduce the rate of neuronal uptake of noradrenaline may provide a sufficient explanation for the enhanced reactivity of the vas deferens to noradrenaline, as this would allow an increased rate of rise of amine concentration at the receptors. Cocaine also enhanced the reactivity of the vas deferens to acetylcholine. The basis of this enhancement by cocaine of the reactivity of the vas deferens to acetylcholine remains to be established, but clearly is not mediated postjunctionally since responses to carbachol were not similarly affected.

  16. 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.

  17. Effects of denervation on the sensitizing effect to noradrenaline induced by morphine in the vas deferens of mice treated chronically with morphine.

    Science.gov (United States)

    Contreras, E; Tamayo, L; Gaete, S; Juica, S

    1982-08-01

    The acute administration of morphine to the isolated vas deferens from mice chronically exposed to this analgesic, induced a facilitatory effect on the responses of the muscle to exogenous noradrenaline. It has been suggested that this sensitizing property of morphine might reflect a dependence-like state of the vas deferens. In the present paper, the capability of met- and leu-enkephalin to substitute for morphine was studied, as well as the influence of innervation on the apparent dependence state. The contractile responses to noradrenaline and to acetylcholine were increased after the administration of morphine to the bath containing a denervated vas deferences, prepared from chronically morphinized mice. Morphine administration facilitated noradrenaline- but not acetylcholine-induced contractile effects in vas deferens isolated from mice which had been chronically treated with either morphine or morphine plus guanethidine. The presence of met- or leu-enkephalin in the isolated vas deferens from chronically morphinized mice (either intact, denervated or treated with guanethidine) failed to sensitize contractile responses to noradrenaline or acetylcholine. It is concluded that (a) the sensitizing effect induced by morphine in the vas deferens from mice chronically treated with morphine is specific for the adrenergic neurotransmitter; (b) the effect of morphine is not mimicked by opiate peptides; and (c) denervation of the vas deferens of mice treated chronically with morphine does not suppress the noradrenaline-sensitizing property of morphine.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Ultrastructural study of the epididymis and the vas deferens and electrophoretic profile of their luminal fluid proteins in the lizard Mabuya carinata.

    Science.gov (United States)

    Aranha, I; Bhagya, M; Yajurvedi, H N

    2006-04-01

    The light microscopy, histochemical and TEM studies of the epididymis and the vas deferens revealed the presence of PAS positive secretory granules in the epithelial cells lining the lumen of these organs. One dimensional SDS gel electrophoretic pattern of luminal fluid proteins and the total protein content of the testis, three regions of the epididymis and the vas deferens of the lizard, Mabuya carinata were studied during breeding and nonbreeding season of the reproductive cycle. During breeding season, 25 protein bands in the testicular luminal fluid, 26 in the anterior epididymal luminal fluid and 28 in the middle and posterior epididymal luminal fluid were found. Ten new protein bands appeared in the anterior epididymal region whereas five new protein bands appeared in the middle region of the epididymis indicating regional difference in protein secretions of the epididymis. Vas deferens luminal fluid showed the highest number of protein bands (32) and the highest total protein content (9.07 mg/ml) compared to the testis and the epididymis. Four new protein bands appeared in the vas deferens. Number of protein bands in the luminal fluids of testis, epididymis and the vas deferens were significantly reduced during nonbreeding season compared to those of the breeding season. Consistent with the decrease in the number of protein bands, there was a significant reduction in the total protein concentration in all the tissue samples during nonbreeding season. The results indicate seasonal differences in number of proteins secreted and quantity of proteins in the luminal fluid of male reproductive tract of M. carinata. This is the first study in reptiles revealing appearance of new proteins in epididymis, and vas deferens by conducting simultaneous electrophoretic profile of testicular, epididymal and vas deferens luminal contents.

  4. Increase in norepinephrine-induced formation of phosphatidic acid in rat vas deferens after denervation.

    Science.gov (United States)

    Takenawa, T; Masaki, T; Goto, K

    1983-01-01

    Surgical denervation of rat vas deferens causes supersensitivity in that the tissue sensitivity and the maximum response to a variety of agonists increase. To understand the molecular mechanism of supersensitivity in smooth muscle, norepinephrine(NE)-induced alteration in phospholipid metabolism was studied using control and denervated vasa deferentia. When the tissue was stimulated by NE, only [32P]Pi incorporation into phosphatidic acid(PA) was increased in proportion to the increase in NE concentration without any significant effect on that into other phospholipids. This PA labeling was significantly accelerated by denervation. In the denervated tissue, PA labeling was stimulated by lower concentrations of NE and the maximum response to NE was increased compared to the control. The breakdown of phosphatidylinositol 4-monophosphate(DPI) and phosphatidylinositol 4,5-diphosphate (TPI) was also accelerated by NE. But the influence of denervation on this NE-induced DPI and TPI was not marked. Therefore, it is likely that denervation clearly enhanced NE-induced PA labeling without an appreciable effect on that of the other phospholipids. Furthermore, the absolute amount of PA was also increased by NE, and this increase was exaggerated by denervation. Considering that PA can behave as a Ca2+ ionophore in the plasma membrane, these results suggest that the stimulated accumulation of PA plays an important role in receptor-linked supersensitivity in smooth muscle.

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

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    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.

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

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    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.

  7. 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.

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

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    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.

  9. 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.

  10. Risk factors for patent ductus arteriosus in preterm neonates

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    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.

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

    Science.gov (United States)

    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.

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

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    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.

  13. 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.

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

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    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.

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

    Science.gov (United States)

    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).

  16. 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.

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

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    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.

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

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    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.

  20. 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.

  1. [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.

  2. 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.

  3. Truncating Mutations in the Adhesion G Protein-Coupled Receptor G2 Gene ADGRG2 Cause an X-Linked Congenital Bilateral Absence of Vas Deferens.

    Science.gov (United States)

    Patat, Olivier; Pagin, Adrien; Siegfried, Aurore; Mitchell, Valérie; Chassaing, Nicolas; Faguer, Stanislas; Monteil, Laetitia; Gaston, Véronique; Bujan, Louis; Courtade-Saïdi, Monique; Marcelli, François; Lalau, Guy; Rigot, Jean-Marc; Mieusset, Roger; Bieth, Eric

    2016-08-04

    In 80% of infertile men with obstructive azoospermia caused by a congenital bilateral absence of the vas deferens (CBAVD), mutations are identified in the cystic fibrosis transmembrane conductance regulator gene (CFTR). For the remaining 20%, the origin of the CBAVD is unknown. A large cohort of azoospermic men with CBAVD was retrospectively reassessed with more stringent selection criteria based on consistent clinical data, complete description of semen and reproductive excurrent ducts, extensive CFTR testing, and kidney ultrasound examination. To maximize the phenotypic prioritization, men with CBAVD and with unilateral renal agenesis were considered ineligible for the present study. We performed whole-exome sequencing on 12 CFTR-negative men with CBAVD and targeted sequencing on 14 additional individuals. We identified three protein-truncating hemizygous mutations, c.1545dupT (p.Glu516Ter), c.2845delT (p.Cys949AlafsTer81), and c.2002_2006delinsAGA (p.Leu668ArgfsTer21), in ADGRG2, encoding the epididymal- and efferent-ducts-specific adhesion G protein-coupled receptor G2, in four subjects, including two related individuals with X-linked transmission of their infertility. Previous studies have demonstrated that Adgrg2-knockout male mice develop obstructive infertility. Our study confirms the crucial role of ADGRG2 in human male fertility and brings new insight into congenital obstructive azoospermia pathogenesis. In men with CBAVD who are CFTR-negative, ADGRG2 testing could allow for appropriate genetic counseling with regard to the X-linked transmission of the molecular defect.

  4. 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.

  5. [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.

  6. 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.

  7. SURAMIN AS AN INHIBITOR OF SYMPATHETIC EXCITATORY. JUNCTION POTENTIALS: STUDY IN GUINEA PIG ISOLATED VAS DEFERENS

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    M AYATOLLAHI

    2001-06-01

    Full Text Available

    Introduction. Suramin, as a selective P2x-Pourinoceptor antagonist can inhibit the sympathetic excitatory junction potentials (SEJPs. Experiments have shown that the biphasic contractile responses (bcr in smooth muscles of vascular and vas deferens (vds is evoked by cotransmission of ATP and neuradrenaline. Therefore, vds is considered as a model for studying the role of A TP and antagonizing its effect. By using different concentrations of Suramin, its antagonistic effect in phase one of bcr is observed To confirm the purinergic origin of SEJPs, some experiments should be performed electrophysiologically at different concentrations of Suramin.
    Methods. Suramin was dissolved in distilled water and after diluting with physiological salt solution freezed as a stock solution at concentration of 10-1M. After killing and dissecting the albino male guinea pigs (weighing 2S0-300 gm, both testes were pushed up to give out the whole vds. The vds was cleaned from surrounding tissues and cut from epididymic and prostatic ends. vds was maintained at 3SC in physiological salt solution bubbled with 9S percent O2 and 5 percent CO2. Intracellular microelectrodes (with resistance of 20-40 MQ recordings were made from prostatic end of vds.
    Results. The resting membrane potential of the control smooth muscle cells was 67.4±.0.7 mV (n=48. Electrical stimulation at frequency of 0.5 Hz evokes SEJPs which are magnified consistently due to facilitation. Mean magnitude of fully facilitated SEJPs which were evoked from control cells was 8.5±0.8 mV (n=23. Further facilitation was evoked at frequencies of 1 Hz or 2 Hz, because SEJPs were obtained at the threshold limit to begin the action potentials which were 55 mV in most cells. It was difficult to estimate correctly the threshold potential in a cell because disseminated potential might

  8. Effect of oleic, lauric and myristic acids on phenylephrine-induced contractions of isolated rat vas deferens.

    Science.gov (United States)

    Arruzazabala, M L; Pérez, Y; Ravelo, Y; Molina, V; Carbajal, D; Mas, R; Rodríguez, E

    2011-09-01

    D-004, a lipid extract of Roystonea regia fruits that contains oleic, lauric and myristic acids as major components inhibits alpha1-adrenoreceptors-mediated contractile responses in isolated rat vas deferens and prostate trips; no study has demonstrated a similar effect for oleic, lauric or myristic acids individually. Therefore, the effects of D-004 (250 microg/mL), oleic (100 microg/mL), lauric (50 microg/mL) or myristic (25 microg/mL) acids and their combined effects on phenylephrine (PHE: 10(-7)-10(-4) mol/L) induced contractions has been studied. No treatment changed the basal tone of the preparations, but all inhibited PHE-induced contractions. D-004 produced the highest inhibition, followed by lauric acid, which was more effective than myristic and oleic acids against PHE-induced contractions of control group. D-004 and the mixture of the three acids produced similar inhibitions.

  9. Unilateral renal agenesia associated with partial epididymis and vas deferens agenesia in a patient with abdominal testicle

    Directory of Open Access Journals (Sweden)

    Joao L. Pippi Salle

    2006-04-01

    Full Text Available This study considers a unilateral renal agenesia associated with agenesia of the epididymis body and tail and the vas deferens and non-palpable left testicle in a 20-month-year-old patient. During laparoscopic procedure, the testicle was positioned at approximately 5 cm above the inguinal ring. The size was appropriate for the age and the head of the epididymis was situated in its normal position. The decision was made to perform the first step of the Fowler-Stephens’ surgery and the patient presented a good evolution. The association of male duct system agenesia with unilateral renal agenesia in a patient with cryptorchidism diagnosed by laparoscopy is an extremely rare event, however generally in these cases the testicle is of normal size, presents unaltered hormonal function, and must be preserved.

  10. 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.

  11. Rat vas deferens SERCA2 is modulated by Ca{sup 2+}/calmodulin protein kinase II-mediated phosphorylation

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, J.B.R.; Muzi-Filho, H. [Programa de Farmacologia e Inflamação, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Valverde, R.H.F. [Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Quintas, L.E.M. [Programa de Farmacologia e Inflamação, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Noel, F. [Programa de Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Einicker-Lamas, M. [Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Instituto Nacional de Ciência e Tecnologia em Biologia Estrutural e Bioimagem, Rio de Janeiro, RJ (Brazil); Cunha, V.M.N. [Programa de Farmacologia e Inflamação, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil)

    2013-03-19

    Ca{sup 2+} pumps are important players in smooth muscle contraction. Nevertheless, little information is available about these pumps in the vas deferens. We have determined which subtype of sarco(endo)plasmic reticulum Ca{sup 2+}-ATPase isoform (SERCA) is expressed in rat vas deferens (RVD) and its modulation by calmodulin (CaM)-dependent mechanisms. The thapsigargin-sensitive Ca{sup 2+}-ATPase from a membrane fraction containing the highest SERCA levels in the RVD homogenate has the same molecular mass (∼115 kDa) as that of SERCA2 from the rat cerebellum. It has a very high affinity for Ca{sup 2+} (Ca{sub 0.5} = 780 nM) and a low sensitivity to vanadate (IC{sub 50} = 41 µM). These facts indicate that SERCA2 is present in the RVD. Immunoblotting for CaM and Ca{sup 2+}/calmodulin-dependent protein kinase II (CaMKII) showed the expression of these two regulatory proteins. Ca{sup 2+} and CaM increased serine-phosphorylated residues of the 115-kDa protein, indicating the involvement of CaMKII in the regulatory phosphorylation of SERCA2. Phosphorylation is accompanied by an 8-fold increase of thapsigargin-sensitive Ca{sup 2+} accumulation in the lumen of vesicles derived from these membranes. These data establish that SERCA2 in the RVD is modulated by Ca{sup 2+} and CaM, possibly via CaMKII, in a process that results in stimulation of Ca{sup 2+} pumping activity.

  12. Melatonin modulation of presynaptic nicotinic acetylcholine receptors located on short noradrenergic neurons of the rat vas deferens: a pharmacological characterization

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    Zago W.M.

    1999-01-01

    Full Text Available Melatonin, the pineal hormone produced during the dark phase of the light-dark cycle, modulates neuronal acetylcholine receptors located presynaptically on nerve terminals of the rat vas deferens. Recently we showed the presence of high affinity nicotine-binding sites during the light phase, and low and high affinity binding sites during the dark phase. The appearance of the low affinity binding sites was due to the nocturnal melatonin surge and could be mimicked by exposure to melatonin in vitro. The aim of the present research was to identify the receptor subtypes responsible for the functional response during the light and the dark phase. The rank order of potency of agonists was dimethylphenylpiperazinium (DMPP = cytisine > nicotine > carbachol and DMPP = nicotine = cytisine > carbachol, during the light and dark phase, respectively, due to an increase in apparent affinity for nicotine. Mecamylamine similarly blocked the DMPP response during the light and the dark phase, while the response to nicotine was more efficiently blocked during the light phase. In contrast, methyllycaconitine inhibited the nicotine-induced response only at 21:00 h. Since a7 nicotinic acetylcholine receptors (nAChRs have low affinity for nicotine in binding assays, we suggest that a mixed population composed of a3ß4 - plus a7-bearing nAChR subtypes is present at night. This plasticity in receptor subtypes is probably driven by melatonin since nicotine-induced contraction in organs from animals sacrificed at 15:00 h and incubated with melatonin (100 pg/ml, 4 h is not totally blocked by mecamylamine. Thus melatonin, by acting directly on the short adrenergic neurons that innervate the rat vas deferens, induces the appearance of the low affinity binding site, probably an a7 nAChR subtype.

  13. 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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. 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

  17. 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.

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

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    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.

  19. 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

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. 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.

  6. Ultrastructural aspects of spermatogenesis, testes, and vas deferens in the parthenogenetic tapeworm Atractolytocestus huronensis Anthony, 1958 (Cestoda: Caryophyllidea), a carp parasite from Slovakia.

    Science.gov (United States)

    Bruňanská, Magdaléna; Nebesářová, Jana; Oros, Mikuláš

    2011-01-01

    Spermatogenesis, testes, and vas deferens in the parthenogenetic monozoic tapeworm Atractolytocestus huronensis Anthony, 1958 (Cestoda: Caryophyllidea) from Slovakia, parasitizing the carp Cyprinus carpio L., have been investigated by means of transmission electron microscopy for the first time. The present results show that helminths with parthenogenetic and normal reproduction may share some common spermatology features, e.g., dense cytoplasm of the peripherally localized spermatogonia or a rosette type of spermatogenesis. In contrast to tapeworms with normal reproduction, the most prominent ultrastructural characteristic of the spermatocytes of A. huronensis is fragmentation of their nuclei. This clear feature of cell degeneration might be a consequence of the aberrant first meiotic division. Peripheral cortical microtubules and a single centriole, indicators of the ongoing spermiogenesis, were observed only very rarely in the early spermatids. Characteristics of normal spermiogenesis, i.e., apical dense material in the zone of differentiation in early stages of spermiogenesis, flagellar rotation, and proximo-distal fusion, were never found in the present study. The testes follicles are surrounded by a thin cytoplasmic sheath underlined by a basal lamina. Vas deferens is lined by flat epithelium with numerous surface lamellae and cilia. Mature, functional spermatozoa were not observed in the vas deferens of A. huronensis from Slovakia.

  7. 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.

  8. [Congenital bilateral absence of vas deferens: From diagnosis to assisted reproductive techniques - the experience of three centers].

    Science.gov (United States)

    Beauvillard, D; Perrin, A; Drapier, H; Ravel, C; Fréour, T; Férec, C; De Braekeleer, M; Amice, V

    2015-05-01

    To review the management with assisted reproductive technologies (ART) of men with congenital bilateral absence of vas deferens (CBAVD), associated with cystic fibrosis or not, after surgical retrieval [epididymal aspiration (MESA) or testicular biopsy (TESE)]. Multicenter retrospective study made of 2 groups: CBAVD and cystic fibrosis (CF) or CBAVD only (CF-RD). Two centers performed MESA (Brest and Nantes) and one TESE (Rennes). Sperm numeration, motility, vitality, morphology and nuclear maturity were measured in both centers performing MESA. Fertilization rate (TF) and cumulated progressive pregnancy rate by retrieved oocyte (TGC) were compared between centers following ART. Ninety patients underwent surgical retrieval between January 1996 and March 2013, 30 in the CF group and 60 in the CF-RD group. Semen parameters were comparable between groups and centers. Fifty-eight (22 in the CF group and 36 in the CF-RD group) patients received ART between April 1996 and October 2014. TF was 50% and 52% and TGC 26% and 32% in the CF group and CF-RD groups, respectively. The results did not differ between groups but TGC was higher in Rennes than in the other two centers. Both semen parameters and ART results are comparable and similar to those reported in the literature. As shown by the results obtained in Rennes, TESE seems to be more effective. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Carbonic anhydrase activity in the vas deferens of the cotton leafworm - Spodoptera littoralis (Lepidoptera: Noctuidae) controlled by circadian clock.

    Science.gov (United States)

    Kotwica, J; Ciuk, M A; Joachimiak, E; Rowinski, S; Cymborowski, B; Bebas, P

    2006-11-01

    The male reproductive tract of Lepidoptera is an ideal model for the study of the physiological role of peripheral clocks in insects. The latter are significant in the generation and coordination of rhythmic phenomena which facilitate the initial stages of sperm capacitation. This process requires the maintenance of pH in the upper vas deferens (UVD) aided by, among others, H+-ATPase. Our aim was to determine the potential involvement of carbonic anhydrase (CA) in this process, an enzyme tasked with generating protons subsequently utilized by H+-ATPase to acidify the UVD milieu in S. littoralis, during the time when the lumen of this organ is filled with sperm. We attempted to answer the question whether CA activity can be controlled by the biological oscillator present in the male reproductive tract of the cotton leafworm. Using PAGE zymography, the presence of CA was demonstrated in the UVD wall, but not in the luminal fluid nor in the sperm. Using histochemistry, it was shown that CA is active in the UVD epithelium, and that this activity varies throughout the day and is most likely controlled by an endogenous biological clock. Conversely, the application of CA inhibitors, acetazolamide and sodium thiocyanate, in conjunction with an analysis of H+-ATPase activity in the acidification the UVD environment shows that CA most likely does not play a direct role in the regulation of the pH in this organ.

  10. Congenital bilateral absence of the vas deferens: the impact of spermatogenesis quality on intracytoplasmic sperm injection outcomes in 108 men.

    Science.gov (United States)

    Llabador, M A; Pagin, A; Lefebvre-Maunoury, C; Marcelli, F; Leroy-Martin, B; Rigot, J M; Mitchell, V

    2015-05-01

    In azoospermic men with congenital bilateral absence of the vas deferens (CBAVD), it is not known whether the outcomes of intracytoplasmic sperm injection (ICSI) depend on the quality of testicular spermatogenesis (as determined histopathologically). We retrospectively studied the impact of spermatogenesis quality on ICSI outcomes in 108 azoospermic men with CBAVD consulting in a university hospital's department of andrology and reproductive biology. As part of an ICSI program, sperm samples were obtained from the epididymis [by microsurgical epididymal sperm aspiration (MESA); n = 47] or the testis [by testicular sperm extraction (TESE); n = 14] or both (MESA + TESE, n = 47). In the TESE group (i.e., TESE-only and MESA + TESE), spermatogenesis was normal in 21 of the 108 men (19.4%) and hypospermatogenesis occurred in 33 (30.5%). The fertilization rate was significantly lower in the hypospermatogenic group than in the normospermatogenesis group (65.6 and 72.9%, respectively; p = 0.02); this was also true for the embryo cleavage rate (88.6 and 92.1%, respectively; p = 0.007), and the proportion of embryos with fewer than 30% of enucleate fragments (79.5 and 86.9%, respectively; p = 0.02). Our study results showed that impaired spermatogenesis had a negative impact on certain early-stage biological outcomes of ICSI. In CBAVD, male factors are likely to exert a harmful effect on the early stages of embryo development.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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).

  16. 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.

  17. 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.

  18. 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.)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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

  5. 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

  6. 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....

  7. Micro-recanalization in a biodegradable graft for reconstruction of the vas deferens is enhanced by sildenafil citrate.

    Science.gov (United States)

    Holoch, Peter A; Mallapragada, Surya K; Ariza, Carlos A; Griffith, Thomas S; Deyoung, Barry R; Wald, Moshe

    2010-11-01

    This study investigated the effect of sildenafil citrate on micro-recanalization and neovascularization, which were previously demonstrated in a rat model using biodegradable grafts (BGs) for vas deferens reconstruction. A total of 24 male rats underwent bilateral vasectomy with removal of a 0.5-cm vasal segment and were randomly assigned to four groups. Groups 1 and 2 underwent immediate vasovasostomy. Groups 3 and 4 underwent interposition of a 0.5-cm BG in the vasal gap. Groups 1 and 3 were given 5 mg kg(-1) day(-1) oral sildenafil. Other groups were given placebo. Rats were housed with females 12 weeks postoperatively. Reconstructed vasal segments were harvested 16 weeks postoperatively and analyzed histologically. Fluid from the distal vasal stump was analyzed for motile sperm. Urine samples obtained 16 weeks postoperatively were analyzed for cGMP levels. cGMP levels in rats treated with sildenafil were significantly higher than in control rats. No pregnancies were sired by grafted groups. In all, 5/6 rats in group 1 and 3/6 rats in group 2 sired litters. No motile sperm were noted in the vasal fluid of the grafted groups. Motile sperm were noted in all rats in group 1 and in 5/6 rats in group 2. In addition, 29 and 4 microcanals were detected in the sildenafil and placebo groups, respectively (P = 0.023). No microcanal exceeded 3 mm in length. An average of 12 and 28 blood vessels per graft were noted in the placebo and sildenafil groups, respectively (P microcanal length after 16 weeks.

  8. Effects of nifedipine and ryanodine on adrenergic neurogenic contractions of rat vas deferens: evidence for a pulse-to-pulse change in Ca2+ sources.

    OpenAIRE

    Bültmann, R; von Kügelgen, I; Starke, K

    1993-01-01

    1. The effects of nifedipine and ryanodine on the adrenergic component of neurogenic contractions of the rat isolated vas deferens were studied in an attempt to identify the sources of Ca2+ mediating the contraction. The tissue was electrically stimulated by single pulses or pairs of widely spaced pulses. The purinergic component of contraction was suppressed by the presence of 300 microM suramin. 2. In Mg(2+)-free medium, nifedipine (0.01-10 microM) reduced the first and, to a greater extent...

  9. 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.

  10. 超声声速匹配技术对男性输精管外径测量值的探讨%Ultrasonic Sound Speed Correction Technology for Male vas Deferen Diameter Measurements

    Institute of Scientific and Technical Information of China (English)

    董杨芳

    2014-01-01

    目的:探讨正常男性精索静脉曲张男性输精管声像图特征及外径。方法:使用超声声速匹配技术探查输精管声像图特征,探查48例精索静脉曲张伴反流患者阴囊彩超,与48例无精索静脉曲张正常男性对比,比较输精管睾丸段外径测量值。结果:超声声速匹配技术可清晰辨认输精管睾丸段结构。精索静脉曲张伴反流患者左侧输精管睾丸部管腔外径约1.58±0.46mm,右侧1.54±0.42mm。结论:超声声速匹配技术能清晰、准确地显示输精管睾丸部、阴囊部。可作为男性不孕患者输精管疾病的有效检查方法。正常患者与精索静脉曲张患者的输精管外径差别无统计学意义。%Objective:To explore the normal male varicocele male was deferens ultrasonographic characteristics and outer diameter . Methods:Using ultrasonic sound speed correction technology to probe vas deferens ultrasonographic characteristics , Exploration of 48 ca-ses of varicocele patients with reflux with scrotal colour to exceed , compare With 48 cases without varicocele normal men .Comparison was deferens testis outside diameter measurements .Results:Ultrasonic sound speed correction technology can clearly identify the vas deferens testicular segment structure .Patients with reflux with varicocele on the left side of the vas deferens testicular department about lumen di -ameter 1.58 ±0.46)mm, the right side(1.54 ±0.42)mm.Conclusion:Ultrasonic sound speed correction technology can Clear and accu-rately show the vas deferens testicular department , scrotal department , Can be used as male infertility vas deferens effective inspection method of the disease .Normal patients and patients with varicocele vas deferens diameter difference has no statistical significance .

  11. [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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

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

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    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.

  20. [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.

  1. 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.

  2. 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

  3. Effect of noni (Morinda citrifolia Linn.) fruit and its bioactive principles scopoletin and rutin on rat vas deferens contractility: an ex vivo study.

    Science.gov (United States)

    Pandy, Vijayapandi; Narasingam, Megala; Kunasegaran, Thubasni; Murugan, Dharmani Devi; Mohamed, Zahurin

    2014-01-01

    This study examined the effect of methanolic extract of Morinda citrifolia Linn. (MMC) and its bioactive principles, scopoletin and rutin, on dopamine- and noradrenaline-evoked contractility in isolated rat vas deferens preparations. MMC (1-40 mg/mL), scopoletin (1-200 μg/mL), and rutin hydrate (0.6-312.6 μg/mL) dose-dependently inhibited the contractility evoked by submaximal concentrations of both dopamine and noradrenaline, respectively. Haloperidol and prazosin, reference dopamine D2, and α 1-adrenoceptors antagonists significantly reversed the dopamine- and noradrenaline-induced contractions, respectively, in a dose-dependent manner. Interestingly, MMC per se at higher doses (60-100 mg/mL) showed dose-dependent contractile response in rat vas deferens which was partially inhibited by high doses of haloperidol but not by prazosin. These results demonstrated the biphasic effects of MMC on dopaminergic system; that is, antidopaminergic effect at lower concentrations (60 mg/mL). However, similar contractile response at high doses of scopoletin (0.5-5 mg/mL) and rutin hydrate (0.5-5 mg/mL) per se was not observed. Therefore, it can be concluded that the bioactive principles of MMC, scopoletin, and rutin might be responsible for the antidopaminergic and antiadrenergic activities of MMC.

  4. Effect of Noni (Morinda citrifolia Linn. Fruit and Its Bioactive Principles Scopoletin and Rutin on Rat Vas Deferens Contractility: An Ex Vivo Study

    Directory of Open Access Journals (Sweden)

    Vijayapandi Pandy

    2014-01-01

    Full Text Available This study examined the effect of methanolic extract of Morinda citrifolia Linn. (MMC and its bioactive principles, scopoletin and rutin, on dopamine- and noradrenaline-evoked contractility in isolated rat vas deferens preparations. MMC (1–40 mg/mL, scopoletin (1–200 μg/mL, and rutin hydrate (0.6–312.6 μg/mL dose-dependently inhibited the contractility evoked by submaximal concentrations of both dopamine and noradrenaline, respectively. Haloperidol and prazosin, reference dopamine D2, and α1-adrenoceptors antagonists significantly reversed the dopamine- and noradrenaline-induced contractions, respectively, in a dose-dependent manner. Interestingly, MMC per se at higher doses (60–100 mg/mL showed dose-dependent contractile response in rat vas deferens which was partially inhibited by high doses of haloperidol but not by prazosin. These results demonstrated the biphasic effects of MMC on dopaminergic system; that is, antidopaminergic effect at lower concentrations (60 mg/mL. However, similar contractile response at high doses of scopoletin (0.5–5 mg/mL and rutin hydrate (0.5–5 mg/mL per se was not observed. Therefore, it can be concluded that the bioactive principles of MMC, scopoletin, and rutin might be responsible for the antidopaminergic and antiadrenergic activities of MMC.

  5. Cystic fibrosis transmembrane conductance regulator (CFTR) gene abnormalities in Indian males with congenital bilateral absence of vas deferens & renal anomalies

    Science.gov (United States)

    Gajbhiye, Rahul; Kadam, Kaushiki; Khole, Aalok; Gaikwad, Avinash; Kadam, Seema; Shah, Rupin; Kumaraswamy, Rangaswamy; Khole, Vrinda

    2016-01-01

    Background & objectives: The role of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in congenital bilateral absence of vas deferens and unilateral renal agenesis (CBAVD-URA) has been controversial. Here, we report the cases of five Indian males with CBAVD-URA. The objective was to evaluate the presence or absence of CFTR gene mutations and variants in CBAVD-URA. The female partners of these males were also screened for cystic fibrosis (CF) carrier status. Methods: Direct DNA sequencing of CFTR gene was carried out in five Indian infertile males having CBAVD-URA. Female partners (n=5) and healthy controls (n=32) were also screened. Results: Three potential regulatory CFTR gene variants (c.1540A>G, c.2694T>G and c.4521G>A) were detected along with IVS8-5T mutation in three infertile males with CBAVD-URA. Five novel CFTR gene variants (c.621+91A>G, c.2752+106A>T, c.2751+85_88delTA, c.3120+529InsC and c.4375-69C>T), four potential regulatory CFTR gene variants (M470V, T854T, P1290P, Q1463Q) and seven previously reported CFTR gene variants (c.196+12T>C, c.875+40A>G, c.3041-71G>C, c.3271+42A>T, c.3272-93T>C, c.3500-140A>C and c.3601-65C>A) were detected in infertile men having CBAVD and renal anomalies Interpretation & conclusions: Based on our findings, we speculate that CBAVD-URA may also be attributed to CFTR gene mutations and can be considered as CFTR-related disorder (CFTR-RD). The CFTR gene mutation screening may be offered to CBAVD-URA men and their female partners undergoing ICSI. Further studies need to be done in a large sample to confirm the findings. PMID:27488005

  6. 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%).

  7. 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

  8. 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

  9. [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.

  10. 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.

  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. 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.

  20. 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)

  1. 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.

  2. 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.

  3. 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 .

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

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

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    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.

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  16. 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

  17. 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.

  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. Exposure to tributyltin chloride induces penis and vas deferens development and increases RXR expression in females of the purple snail (Plicopurpura pansa

    Directory of Open Access Journals (Sweden)

    D Domínguez-Ojeda

    2014-07-01

    Full Text Available Tributyltin (TBT and its derivatives are widely used as antifouling paints for ships, resulting in their being released into the marine environment. Aquatic invertebrates, particularly marine gastropods, are extremely sensitive to TBT and undergo changes in the imposition of male secondary sex characteristics in response to exposure. This study aimed to evaluate the development of imposex and the expression of the retinoid X receptor (RXR in tissues of Plicopurpura pansa (males and females exposed to tributyltin chloride (TBTCl. The histological results showed a penis-like structure in imposexed female and an undeveloped vas deferens that lacked circular muscular layers. TBTCl treatment increased the messenger RNA (mRNA of RXR in females with imposex. The highest level of mRNA RXR was found in the digestive gland and penis-forming area in females under in vivo exposure compared with control females. These results indicate that TBTCl modulates mRNA levels of RXR in females. mRNA RXR in imposex females and females exposed to TBTCl only was similar to that of males, indicating that RXR might contribute to the development of imposex. To our knowledge, this study is the first to show that TBTCl induces imposex and biphallia in this snail species, and that this effect is accompanied by an increase in RXR expression.

  5. The CFTR polymorphisms poly-T, TG-repeats and M470V in Chinese males with congenital bilateral absence of the vas deferens

    Institute of Scientific and Technical Information of China (English)

    Wu-Hua Ni; Lei Jiang; Qian-Jin Fei; Jian-Yuan Jin; Xu Yang; Xue-Feng Huang

    2012-01-01

    Congenital bilateral absence of the vas deferens (CBAVD) is a frequent cause of obstructive azoospermia,and mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene have also been frequently identified in patients with CBAVD.However,the distribution of the CFTR polymorphisms M470V,poly-T,TG-repeats and F508del mutation in the Chinese CBAVD population with presumed low cystic fibrosis (CF) frequency remains to be evaluated.Samples obtained from 109 Chinese infertile males with CBAVD and 104 normal controls were analyzed for the presence of CFTR (TG)m(T)n,M470V and F508del by PCR amplification followed by direct sequencing.Our study showed that the F508del mutation was not found in our patients.The 5T mutation was present with high frequency in Chinese CBAVD patients and IVS8-5T linked to either 12 or 13 TG repeats was highly prevalent among CBAVD patients (97.22% of 72 cases and 96.91% of 97 alleles with IVS8-5T).Moreover,a statistically significant relationship between TG12-5T-V470 haplotype and CBAVD was detected.This study indicated that the CFTR polymorphisms poly-T,TG-repeats and M470V might affect the process of CBAVD in the Chinese population.

  6. 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.

  7. 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.

  8. 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

  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. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  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. 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.

  1. The CFTR M470V, Intron 8 Poly-T, and 8 TG-Repeats Detection in Chinese Males with Congenital Bilateral Absence of the Vas Deferens

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    Qiang Du

    2014-01-01

    Full Text Available Purpose. To evaluate the significance of molecular detection of cystic fibrosis transmembrane conductance regulator (CFTR M470V, intron 8 poly-T, and intron 8 TG-repeats in congenital bilateral absence of the vas deferens (CBAVD. Methods. Eighty-nine male patients with CBAVD and 103 healthy males were included in this study. Polymerase chain reaction was performed to amplify the polymorphic regions using primers from conserved regions. M470V was genotyped using real-time PCR by cycling probe. The exon 9 DNA sequence was determined using an automated sequencer. TG-repeats and poly-T were identified by direct sequencing analysis. Results. The 5T allele distribution was 0.32, 0.66 for 7T, and 0.02 for 9T in CBAVD males, respectively. In contrast, the 5T allele distribution was 0.03, 0.96 for 7T, and 0.01 for 9T in healthy control. Study of the polymorphisms of the upstream of exon 9 revealed a higher frequency of 5T allele in the CBAVD males. All cases with TG13T5 haplotype and TG12T5 homozygous led to CBAVD. The CFTR TG12T5-V470 variant haplotype was associated with CBAVD. Conclusion. The 5T allele of intron 8 of CFTR has clinically significant association with CBAVD. TG13T5 and TG12T5 homozygously led to CBAVD, and TG12T5-V470 may also lead to CBAVD.

  2. Allosteric interaction of the anticholinergic drug [N-(4-phenyl)-phenacyl-l-hyoscyamine] (Phenthonium) with nicotinic receptors of post-ganglionic sympathetic neurons of the rat vas deferens.

    Science.gov (United States)

    Munhoz, Egberto; De Lima, Thereza C M; Souccar, Caden; Lapa, Antonio J; Lima-Landman, Maria Teresa R

    2009-08-15

    Phenthonium (Phen), a quaternary analog of hyoscyamine, is a blocker of muscarinic activity and an allosteric blocker of alpha(1)2betagammaepsilon nicotinic receptors. Specifically, Phenthonium increases the spontaneous release of acetylcholine at the motor endplate without depolarizing the muscle or inhibiting cholinesterase activity. This paper compares Phenthonium's effects on sympathetic transmission and on ganglionic nicotinic receptor activation. Neurotransmitter release and twitch of the rat vas deferens were induced either by electrical stimulation or by 1,1-dimethyl-4-phenylpiperazine (DMPP) activation of nicotinic receptors. Contractions independent of transmitter release were induced by noradrenaline and adenosine 5'-triphosphate (ATP). Phenthonium inhibited transmitter release and depressed twitch without changing the responsiveness to noradrenaline or ATP. Twitch depression did not occur after K(+)-channel blockade with 4-aminopyridine (4-AP) or charybdotoxin. DMPP had a similar effect, but high concentrations induced contraction of non-stimulated organs. Incubation of Phenthonium inhibited further DMPP twitch depression and non-competitively depressed the contractile responses elicited by DMPP. Furthermore, mecamylamine, but neither methyllycaconitine nor atropine, blocked the contraction elicited by DMPP. Phenthonium and DMPP are K(+)-channel openers that primarily inhibit sympathetic transmission. Contraction induced by DMPP was probably mediated by neuronal nicotinic receptor other than the alpha7 subtype. The blockade of DMPP contractile response was unrelated to Phenthonium's antimuscarinic or K(+)-channel opening activities. Since Phenthonium's quaternary chemical structure limits its membrane diffusion, the non-competitive inhibition of DMPP excitatory responses should be linked to allosteric interaction with neuronal nicotinic receptors that putatively qualify Phenthonium as a novel modulator of cholinergic synapses.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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).

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  11. 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

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. [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.

  5. 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

  6. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. 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.

  11. 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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  14. 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

    Institute of Scientific and Technical Information of China (English)

    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

  15. Relaxant effect of the aqueous extract of Erythrina vellutina leaves on rat vas deferens Efeito relaxante do extrato aquoso das folhas de Erythrina vellutina em ducto deferente de rato

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    Márcio R. V. Santos

    2007-09-01

    Full Text Available The effect of the Aqueous Extract from the leaves of Erythrina vellutina (AE on rat vas deferens preparation was evaluated in this work. The AE inhibited the muscle contractions induced by electrical field stimulation (EFS in a concentration-dependent manner. This inhibition was not affected by atropine (10-5M, propanolol (10-5M, prazosin (10-5M or yohimbine (10-5M, suggesting that there is no direct interaction of the AE with cholinergic nor adrenergic receptors. Incubation of vas deferens with the K+ channel antagonists, tetraethylamonium (10-6M or 4-aminopyridine (10-6M had also no effect on the AE-induced inhibition. On the other hand, glibenclamide (10-6 significantly attenuated the effect of the AE, suggesting a possible involvement of ATP-dependent K+ channels. The AE (0.15 mg/mL did not alter the contractions induced by noradrenaline (10-5M, ATP (10-4M nor KCl (80 mM, against an interaction of the extract with post-synaptic sites. The data presented suggests that the inhibition of the electrically driven muscle twitches by the AE could be due to a pre-synaptic interaction of the extract with ATP-dependent K+ channels from vas deferens sympathetic neurons.O objetivo deste trabalho foi avaliar o efeito do extrato aquoso das folhas de Erythrina vellutina (AE sobre ducto deferente de rato. Nesta preparação, o AE inibiu as contrações induzidas por estímulo elétrico de campo de maneira dependente da concentração. Esta inibição não foi afetada após atropina (10-5M, propanolol (10-5M, prazosin (10-5M ou yohimbina (10-5M, sugerindo uma ação indireta do AE sobre receptores colinérgicos ou adrenérgicos. A incubação da preparação com os antagonistas de canais de K+, tetraetilâmonio (10-6M ou 4-aminopiridina (10-6M não alterou o efeito inibitório induzido pelo AE. Entretanto, a glibenclamida (10-6M atenuou significantemente este efeito, sugerindo um possível envolvimento de canais de K+ dependentes de ATP. Além disso, o AE (0

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. First-trimester screening for chromosomal abnormalities by integrated application of nuchal translucency, nasal bone, tricuspid regurgitation and ductus venosus flow combined with maternal serum free β-hCG and PAPP-A: a 5-year prospective study.

    Science.gov (United States)

    Ghaffari, S R; Tahmasebpour, A R; Jamal, A; Hantoushzadeh, S; Eslamian, L; Marsoosi, V; Fattahi, F; Rajaei, M; Niroomanesh, S; Borna, S; Beigi, A; Khazardoost, S; Saleh-Gargari, S; Rahimi-Sharbaf, F; Farrokhi, B; Bayani, N; Tehrani, S E; Shahsavan, K; Farzan, S; Moossavi, S; Ramezanzadeh, F; Dastan, J; Rafati, M

    2012-05-01

    To investigate the performance of first-trimester screening for chromosomal abnormalities by integrated application of nuchal translucency thickness (NT), nasal bone (NB), tricuspid regurgitation (TR) and ductus venosus (DV) flow combined with maternal serum free β-human chorionic gonadotropin (fβ-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at a one-stop clinic for assessment of risk (OSCAR). In total, 13,706 fetuses in 13,437 pregnancies were screened for chromosomal abnormalities during a period of 5 years. Maternal serum biochemical markers and maternal age were evaluated in combination with NT, NT + NB, NT + NB + TR, and NT + NB + TR + DV flow data in 8581, 242, 236 and 4647 fetuses, respectively. In total, 51 chromosomal abnormalities were identified in the study population, including 33 cases of trisomy 21, eight of trisomy 18, six of sex chromosome abnormality, one of triploidy and three of other unbalanced abnormalities. The detection rate and false-positive rate (FPR) for trisomy 21 were 93.8% and 4.84%, respectively, using biochemical markers and NT, and 100% and 3.4%, respectively, using biochemical markers, NT, NB, TR and DV flow. While risk assessment using combined biochemical markers and NT measurement has an acceptable screening performance, it can be improved by the integrated evaluation of secondary ultrasound markers of NB, TR and DV flow. This enhanced approach would decrease the FPR from 4.8 % to 3.4 %, leading to a lower number of unnecessary invasive diagnostic tests and subsequent complications, while maintaining the maximum level of detection rate. Pre- and post-test genetic counseling is of paramount importance in either approach. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  2. 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

  3. 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

  4. Novel CFTR missense mutations in Brazilian patients with congenital absence of vas deferens: counseling issues Mutações novas no gene CFTR de pacientes brasileiros portadores de agenesia dos vasos deferentes: dificuldades no aconselhamento

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    Patricia de Campos Pieri

    2007-01-01

    Full Text Available PURPOSE: Screening for mutations in the entire Cystic Fibrosis gene (CFTR of Brazilian infertile men with congenital absence of vas deferens, in order to prevent transmission of CFTR mutations to offspring with the use of assisted reproductive technologies. METHOD: Specific polymerase chain reaction (PCR primers were designed to each of the 27 exons and splicing sites of interest followed by single strand conformational polymorphism and Heteroduplex Analysis (SSCP-HA in precast 12.5% polyacrylamide gels at 7ºC and 20ºC. Fragments with abnormal SSCP migration pattern were sequenced. RESULTS: Two novel missense mutations (S753R and G149W were found in three patients (two brothers together with the IVS8-5T allele in hetrozygosis. CONCLUSION: The available screenings for CF mutations do not include the atypical mutations associated to absence of vas deferens and thus, when these tests fail to find mutations, there is still a genetic risk of affected children with the help of assisted reproduction. We recommend the screening of the whole CFTR gene for these infertile couples, as part of the work-up before assisted reproduction.OBJETIVO: Pesquisar mutações em toda a extensão do gene que causa a Fibrose Cística (CFTR de homens brasileiros inférteis por agenesia congênita dos vasos deferentes, com a finalidade de prevenir a transmissão de mutações em CFTR à prole com o uso das tecnologias de reprodução assistida. MÉTODOS: Foram desenhados oligonucleotídeos específicos para realização de reação de polimerização em cadeia (PCR para cada um dos 27 exons e sítios de processamento de interesse no gene CFTR. O PCR foi seguido pela técnica de SSCP-HA (polimorfismos de conformação no DNA de fita simples e na formação de heteroduplexes em géis pré-fabricados de poliacrilamida a 12,5% em duas temperaturas, 7ºC e 20ºC. Os fragmentos com padrão alterado na migração do SSCP foram submetidos a seqüenciamento automatizado

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

    Science.gov (United States)

    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.

  6. 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.

  7. Coincidence of congenital left-sided diaphragmatic hernia and ductus venosus agenesis: Relation between altered hemodynamic flow and lung-to-head-ratio?

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

  9. Morphometric Development of Sphincter of Oddi in Human Fetuses During Fetal Period: Microscopic Study

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    E. Hilal Evcil

    2012-09-01

    Full Text Available Objective: In this study, morphometric developments of the sphincter of Oddi in human fetuses were observed. Material and Methods: We observed 113 human fetuses consisting of 67 male and 46 female subjects, whose ages varied between 14 to 40 weeks who showed no signs of any pathology or anomaly externally. The common external measurements of fetuses were carried out, followed by abdominal dissection to determine where the sphincters of Oddi were localized within the duodenum and pancreas. Histological specimens of tissue samples were gathered from the inner wall of the duodenum where it was assumed that the sphincters of Oddi had been localized. The parameters of total external diameters, lumen diameters, wall thickness, diameters of ductus choledochus and ductus pancreaticus, and the distance between these two structures, which are also known as the origins of the sphincter of Oddi, were measured by using a light microscope. The standard deviations of the measurements were calculated for each gestational week and trimester. Results: The calculations suggested that there were statistically significant correlations between gestational age and all of the other parameters with the exception of the ductus choledochus (p0.05.Conclusion: The data we collected in our study were considered as useful for the evaluation of the development of the sphincter of Oddi area and fetal stage.

  10. 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

  11. 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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. 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。

  14. 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

  15. 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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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.

  20. 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。

  1. 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.

  2. 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.

  3. Immunolocalisation of ghrelin and obestatin in human testis, seminal vesicles, prostate and spermatozoa.

    Science.gov (United States)

    Moretti, E; Vindigni, C; Tripodi, S A; Mazzi, L; Nuti, R; Figura, N; Collodel, G

    2014-01-01

    The role of ghrelin and obestatin in male reproduction has not completely been clarified. We explored ghrelin and obestatin localisation in the male reproductive system. Polyclonal antibodies anti-ghrelin and anti-obestatin were used to detect the expression of these hormones in human testis, prostate and seminal vesicles by immunocytochemistry, while in ejaculated and swim up selected spermatozoa by immunofluorescence. Sertoli cells were positive for both peptides and Leydig cells for ghrelin; germ cells were negative for both hormones. Mild signals for ghrelin and obestatin were observed in rete testis; efferent ductules were the most immune reactive region for both peptides. Epididymis was moderately positive for ghrelin; vas deferens and seminal vesicles showed intense obestatin and moderate ghrelin labelling; prostate tissue expressed obestatin alone. Ejaculated and selected spermatozoa were positive for both peptides in different head and tail regions. This study confirms ghrelin localisation in Leydig and Sertoli cells; the finding that ghrelin is expressed in rete testis, epididymis, vas deferens and seminal vesicles is novel, as well as the localisation of obestatin in almost all tracts of the male reproductive system. This research could offer insights for stimulating other studies, particularly on the role of obestatin in sperm physiology, which is still obscure.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  7. [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.

  8. 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.

  9. 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.

  10. Dopplervelocimetria do ducto venoso na predição da acidemia fetal Ductus venosus Doppler velocimetry to predict acidemia at birth in pregnancies with placental insufficiency

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    Francisco Herlânio C. Carvalho

    2005-08-01

    investigate the possibility of predicting acidemia at birth in pregnancies with placental insufficiency by Doppler velocimetry of the ductus venosus and to establish the best parameter and cut-off points in this prediction. METHODS: This was a prospective cross-sectional study, involving 47 single pregnancies with placental insufficiency after 26 weeks of gestation, carried out at the "Hospital São Paulo (UNIFESP and Maternidade-Escola Assis Chateaubriand (UFC". Placental insufficiency was defined as the umbilical artery pulsatility index above the 95th percentile for gestational age. Fetuses with chromosomal or structural anomalies were excluded. The time interval between the Doppler velocimetry and the birth was of less than 24 hours. The umbilical arterial blood samples were collected immediately after birth. Acidemia was defined as umbilical arterial pH < 7.2 in the absence of uterine contractions and < 7.15 in the presence of contractions. Metabolic or mixed acidemia at birth was considered pathological. Receiver operating characteristics (ROC curves were calculated for S, D and A-velocities, pulsatility index for veins and the S/A ratio and (S-A/S ratio of the ductus venosus. Parameters were compared using the MacNemar Test RESULTS: S, D and A-velocities of the ductus venosus were poor predictors of acidemia at birth. The pulsatility index for veins (area under the curve 0.79, p=0.003, S/A ratio and (S-A/S ratio (area under the curve 0.818, p=0.001 of the DV were strongly related to fetal acidemia. The cut-off points calculated were: pulsatility index for veins = 0.76; S/A ratio = 2.67 and (S-A/S ratio = 0.63. CONCLUSIONS: The angle-independent indices of the DV Doppler are adequate for the diagnosis of fetal acidemia in gestations with placental insufficiency. No statistically significant differences were observed between these parameters.

  11. 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.

  12. Ultrasound assessment of the closure time and Z scores of neonatal ductus venosus%超声评估新生儿静脉导管闭合时间及Z值分布

    Institute of Scientific and Technical Information of China (English)

    黄志勇; 瞿国萍; 罗伟权; 吴浩堂; 纪宗萍; 梁键锋

    2016-01-01

    目的 研究新生儿静脉导管闭合时间及其Z值回归方程,探讨新生儿静脉导管闭合时间随胎龄的变化规律.方法 应用彩色多普勒超声探测不同胎龄新生儿静脉导管闭合的具体时间,以胎龄为自变量(X)对所测的静脉导管闭合时间(Y)进行相关性回归分析,建立新生儿静脉导管闭合时间的Z值回归方程(lnY=a+bX+cX2),根据公式Z=(M-Y)/Sx(M为观察值,Y为预测平均值),计算出不同胎龄新生儿静脉导管闭合时间的Z值.结果 共获得432例新生儿静脉导管闭合时间,其随胎龄增加而缩短(r=-0.938,P<0.001),胎龄31~41周新生儿静脉导管闭合时间参考值分别为28.5、26.3、23.7、20.9、18.0、15.2、12.5、10.1、7.9、6.2、4.6天.所获得非线性回归方程式为lnY=-5.228+0.089X-0.000228X2,R2=0.854,Sx=0.214(P<0.001),由各胎龄新生儿静脉导管闭合时间的预测平均值及Sx可计算静脉导管闭合时间任一测定值的Z值,Z=(M-Y)/Sx(其中M为观察值,Y为预测平均值);Z值呈正态分布,无随胎龄变化趋势.结论新生儿静脉导管闭合时间与胎龄存在相关性,采用非线性回归方程可用于计算预测平均值,所获得的Z值呈正态分布.%Objective To study the closure time of neonatal ductus venosus and the Z score regression equation, and to explore the variation of closure time of neonatal ductus venosus with gestationalage.Methods Color doppler ultrasound was applied to detect the closure time of neonatal ductus venosus in normal newborns, Z score regression equation ( lnY =a +bX +cX2 ) for the closure time of neonatal ductus venosus ( Y ) was developed by regression analysis which used gestational age ( X) as an independent variable. The Z scores of the closure time of neonatal ductus venosus in different gestational age were calculated by the formula [ Z = ( M - Y )/S x , M for observation value, Y for predictivevalue].Results There were 432 cases in our study.The closure time of neonatal ductus

  13. 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.

  14. Fluxo no ducto venoso e na veia cava inferior dos fetos em gestações isoimunizadas Assess flow velocity in the ductus venosus and inferior vena cava in fetuses in isoimmunized pregnancies

    Directory of Open Access Journals (Sweden)

    Eura Martins Lage

    2006-10-01

    Full Text Available OBJETIVO: Avaliar a velocidade de fluxo na veia cava inferior e no ducto venoso em fetos, nas gestações isoimunizadas. MÉTODOS: De junho de 1999 a junho de 2004, foram avaliados 61 fetos, entre 27 e 35 semanas, de gestantes portadoras de isoimunização por antígenos eritrocitários. Em todos os fetos foram avaliadas as velocidades de fluxo na veia cava inferior e no ducto venoso. Obteve-se amostra de sangue fetal para determinação dos valores da hemoglobina e calculou-se o déficit da concentração de hemoglobina. Esses fetos foram divididos em quatro grupos, de acordo com o déficit da concentração de hemoglobina: fetos não anêmicos, anêmicos leves, anêmicos moderados e anêmicos graves. Utilizou-se o teste Qui-quadrado para comparar os quatro grupos de fetos quanto à proporção da alteração da velocidade média de fluxo na veia cava inferior e no ducto venoso. RESULTADOS: A velocidade de fluxo na veia cava inferior estava alterada em 3,8% dos fetos não anêmicos, em 3,1% dos fetos com anemia leve, em 40% dos anêmicos moderados e em 76% dos fetos com anemia grave. Já a velocidade de fluxo no ducto venoso estava alterada em 7,7% dos fetos não anêmicos, em 3,1% dos fetos com anemia leve, em 32,5% dos anêmicos moderados e em 68% dos fetos com anemia grave. O valor p foi inferior a 0,001. CONCLUSÃO: Verificou-se aumento da freqüência de alteração da velocidade de fluxo na veia cava inferior e no ducto venoso à medida que a anemia se agravava.OBJECTIVE: Ductus venosus and inferior vena cava flow velocity was assessed in fetuses in isoimmunized pregnancies. METHODS: Examination of 61 fetuses aged 27 to 35 weeks from Rh-erythrocyte antigen isoimmunized women was carried out from June 1999 to June 2004. All fetuses were submitted to the examination of ductus venosus and inferior vena cava flow velocity. Blood samples were collected to determine hemoglobin values and hemoglobin concentration deficits. Accordingly, fetuses

  15. 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.

  16. 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

  17. 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.

  18. 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。

  19. 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.

  20. 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.

  1. The morphology and histology of the male reproductive system in Dolycoris baccarum Linnaeus 1758 (Heteroptera: Pentatomidae)--light and scanning electron micoscope studies.

    Science.gov (United States)

    Özyurt, Nurcan; Candan, Selami; Suludere, Zekiye

    2013-01-01

    The male reproductive system of Dolycoris baccarum (Linnaeus 1758) is studied morphologically and histologically using both light and scanning electron microscopes (SEM). The reproductive system of the male D. baccarum consists of a pair of testis, a pair of vas deferens, a pair of seminal vesicles, accessory glands (mesadenia, ectadenia), a bulbus ejaculatorius, a pair of ectodermal sacs, and a ductus ejaculatorius. The number of testicular follicles varies from four to six. The testicular follicles have three different development zones (growth zone, maturation zone, differentiation zone). The testes are connected to the seminal vesicles by the vas deferens. Vas deferens and seminal vesicles, which are fine-long and cylindrical. The seminal vesicle is connected with bulbus ejaculatorius which is balloon-shaped and surrounded with accessory glands. The bulbus ejaculatorius is continuous with ductus ejaculatorius which connected to the aedeagus.

  2. 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

  3. 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.

  4. Normalisation of a severely abnormal ductus venosus Doppler flow velocity waveform in a growth-retarded fetus with absent end-diastolic flow in the umbilical artery and congenital anomalies.

    Science.gov (United States)

    Müller, T; Rehn, M; Girschick, G; Kristen, P; Dietl, J

    2001-01-01

    Doppler recordings of fetal venous blood flow seem to be superior to arterial velocimetry and CTG concerning the prediction of fetal outcome and optimal time of delivery in pregnancies with fetal growth retardation and AREDV. An improvement of arterial Doppler flow velocities has been described. We report the reappearance of a normal end-diastolic flow velocity in a ductus venosus temporarily showing reversed end-diastolic flow in a growth-retarded fetus with congenital anomalies. This normalization was accompanied by an improvement of the CTG, a loss of umbilical vein pulsations, a reappearance of umbilical diastolic flow and a progressive return of cerebral and venous blood flow into the 'normal' range. Improvement of fetal condition may be the explanation for our observation.

  5. Dopplerfluxometria de ducto venoso: identificação não invasiva da acidemia em fetos prematuros centralizados Ductus venosus velocimetry: noninvasive identification of fetal acidemia in preterm fetuses with brain sparing reflex

    Directory of Open Access Journals (Sweden)

    Renato Augusto Moreira de Sá

    2004-06-01

    Full Text Available OBJETIVO: estabelecer o ponto de corte a partir do qual seja possível identificar fetos prematuros com centralização do fluxo sangüíneo que apresentem gasometria anormal. MÉTODO: foi realizado estudo observacional transversal, cuja população consistia de 60 gestantes com fetos centralizados (relação umbílico-cerebral maior que 1, com idade gestacional entre 25 e 33 semanas. O ducto venoso foi identificado com auxílio da dopplerfluxometria colorida e obtida a relação S/A a partir do sonograma (relação entre a velocidade de pico da sístole ventricular e a velocidade de pico da sístole atrial. Imediatamente após a cesariana foi colhida amostra de sangue da veia umbilical para gasometria. Os conceptos foram classificados de acordo com a análise gasométrica e considerados anormais quando pH OBJECTIVE: to assess through Dopllerfluxometry the S/A ratio of the ductus venosus and determine the cut-off point to identify preterm fetuses with the 'brain sparing phenomenon". METHOD: a cross-sectional study was performed in 60 pregnant women that presented the "brain sparing phenomenon" (umbilical cerebral ratio >1 and gestational age between 25 and 33 weeks. The following parameters were studied: S/A ratio of the ductus venosus, pH and base excess (BE of a fetal blood sample collected from the umbilical vein immediately after birth. The fetuses were classified according to the gas analysis result. They were considered abnormal when pH <7.20 and BE < -6 mmol/l. A receiver operator characteristic (ROC curve analysis was performed to examine the relationship between S/A ratio and fetal acidemia. RESULTS: sixty pregnant women in the period of January 1998 to January 2003 were selected. In the moment of the study the gestational age varied from 25 to 33 weeks, with an average of 29.7 weeks (±1.8 weeks. All of the fetuses presented the "brain sparing phenomenon". Among them 14 presented abnormal gas analysis at birth and 46 presented normal

  6. 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

  7. Reproductive System Toxicity in Male Swiss Mice under Supplementation of Camcolit

    Directory of Open Access Journals (Sweden)

    Awatef M. Ali

    2008-01-01

    Full Text Available The present investigation was under taken to determine the effect of cumulated Camcolit doses (lithium carbonate in healthy Swiss albino mice concerning the function of testis, epididymis and vas deferens as well as hormonal function. In this study 40 adult male mice taken (23.25 mg mouse-1 - a cumulated dose for a period of 35 days, this dose is equivalent to the low human therapeutic dose and was injected intraperitoneally. Camcolit has no significant effect on mortality but there is significant decrease in both testes and body weight. Its administration induced histopathological changes included: disappearance of spermatogonia and decreased number of spermatocytes which lead to hypo spermatogenesis, hypertrophied nuclei and vacuolated cytoplasm were recorded in Sertoli cells, Intracellular and intercellular vacuoles were formed between germinal cells and Leydig cells have atrophied nuclei with vacuolated cytoplasm. Widening of the ductus epididymis and their cells became cubical with pyknotic nuclei and destruction or total loss of stereo cilia. Sperms disappeared from the vas deferens which suffered from disruption of muscular layers. Also low sperms number with formation of deformed ones with no head, coiled or bent tail. By using radioimmunoassay, it was found that Camcolit reduced serum testosterone level in lithium carbonate exposed male mice.

  8. 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

  9. 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

  10. Detection of the mutation of all the exons of the CFTR gene in Chinese men with congenital bilateral absence of the vas deferens%中国先天性双侧输精管缺如患者CFTR基因全部外显子突变检测

    Institute of Scientific and Technical Information of China (English)

    杜强; 方媛媛; 潘永峰; 潘伯臣; 宋永胜; 吴斌

    2012-01-01

    目的:探讨我国先天性双侧输精管缺如患者CFTR基因检测的必要性. 方法:采用PCR技术结合DNA直接测序的方法检测9例先天性双侧输精管缺如患者CFTR基因全部外显子的突变情况,并在NCBI和Cystic Fibrosis Mutation Database在线比对. 结果:除非编码区突变和已经报道的SNP位点之外,9例先天性双侧输精管缺如患者中4例新发现4种不同于西方人已知突变类型的外显子区突变,均为杂合子错义突变. 结论:中国先天性双侧输精管缺如患者CFTR基因外显子区存在不同于西方人的突变,有必要对中国先天性双侧输精管缺如患者进行CFTR基因突变检测.%To assess the necessity of detecting the gene of cystic fibrosis transmembrane conductance regulator factor ( CFTR) in Chinese men with congenital bilateral absence of the vas deferens (CBAVD). Methods : We detected the mutation of all the 27 exons of the CFTR gene in 9 patients with CBAVD by DNA sequencing, and compared the results using NCBI and Cystic Fibrosis Mutation Database. Results: Four novel missense mutations / variants were found in the CFTR gene of the CBAVD patients, which were submitted and accepted in the Cystic Fibrosis Mutation Database. Conclusion: There are mutations or variants in the CFTR gene in Chinese men with CBAVD, and the mutational distribution is different from that in Westerners.

  11. ACh-evoked membrane hyperpolarization in smooth muscle cells of rat vas deferens in vitro: Involvement of K+ channels and NO%一氧化氮和K+通道参与乙酰胆碱引起的大鼠离体输精管平滑肌细胞超极化

    Institute of Scientific and Technical Information of China (English)

    范平; 李丽; 刘政江; 司军强; 张志琴; 赵磊; 马克涛

    2007-01-01

    To explore the underlying mechanism of acetylcholine (Ach)-evoked membrane hyperpolarizing response in isolated rat vas deferens smooth muscle cells (SMCs), intracellular microelectrode recording technique and intracellular microelectrophoresis fluorescent staining technique were used to study Ach-evoked membrane hyperpolarizing response in SMCs freshly isolated from Wistar rat vas deferens. By using microelectrodes containing fluorescent dye 0.1% propidium iodide (PI), 37 and 17 cells were identified as SMCs in outer longitudinal and inner circular muscular layers, respectively. The resting membrane potentials of SMCs were (–53.56±3.88) mV and (–51.62±4.27) mV, respectively. The membrane input resistances were (2 245.60±372.50) MΩ and (2 101.50±513.50) MΩ , respectively. Ach evoked membrane hyperpolarizing response in a concentration-dependent manner with an of 36 μmol/L. This action of Ach was abolished by both a non-sepcific muscarinic (M) receptor antagonist atropine (1 μmol/L) and a selective M 3 receptor antagonist diphenylacetoxy-N-methylpiperidine-methiodide (DAMP, 100 nmol/L). Ach-evoked membrane hyperpolarization was also abolished by a nitric oxide synthase inhibitor N-nitro-L-arginine methyl ester (L-NAME, 300 μmol/L) and suppressed by an ATP-sensitive potassium (K ATP ) channel blocker glipizide (5 μmol/L) and an inward rectifier potassium (K ir ) channel inhibitor bariumion (50 μmol/L). A combination of glipizide and bariumion abolished Ach-evoked membrane hyperpolarizing response. The results suggest that Ach-evoked membrane hyperpolarization in rat vas deferens SMCs is mediated by M 3 receptor followed with activation of K ATP channels, K ir channels, and NO release.%本文旨在探讨大鼠新鲜离体输精管平滑肌细胞中乙酰胆碱(acetylcholine,Ach)引起超极化反应的机制,采用细胞内微电极记录技术和细胞内荧光标记技术研究Ach对大鼠输精管不同走行方向平滑肌细

  12. Differential response of human fetal smooth muscle cells from arterial duct to retinoid acid

    Institute of Scientific and Technical Information of China (English)

    Li-hui WU; Shao-jun XU; Jian-ying TENG; Wei WU; Du-yun YE; Xing-zhong WU

    2008-01-01

    Aim:The aim of the present study was to understand the role of retinoic acid (RA) in the development of isolated patent ductus arteriosus and the features of arterial duct-derived vascular smooth muscle cells (VSMC). Methods:The VSMC were isolated, and the biological characteristics and the response to RA were investi-gated in the arterial duct, aorta, and pulmonary artery VSMC from 6 human embry-onic samples. Western blotting, immunostaining, and cell-based ELISA were em-ployed to analyze the proliferation regulation of VSMC. Results:The VSMC from the arterial duct expressed proliferating cell nuclear antigen (PCNA) at a signifi-cantly lower rate than those from the aorta and pulmonary artery, but expressed a higher level of Bax and Bcl-2. The expression level of PCNA or Bcl-2 was associ-ated with the embryonic age. The effects of RA on the VSMC from the arterial duct were quite different from those from the aorta and pulmonary artery. In arterial duct VSMC, RA stimulated PCNA expression, but such stimulation could be sup-pressed by CD2366, an antagonist of nuclear retinoid receptor activation. In aorta or pulmonary artery VSMC, the expression response of PCNA to RA was insignificant. The ratio of Bax/Bcl-2 decreased in arterial duct VSMC after RA treatment due to the significant inhibition of Bax expression. Conclusion:The VSMC from the arterial duct possessed distinct biological behaviors. RA might be important in the development of ductus arteriosus VSMC.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. Dopplerfluxometria do ducto venoso: relação com a gasometria em fetos prematuros com centralização de fluxo sangüíneo Ductus venosus velocimetry: relationship with fetal blood gases in preterm fetuses presenting brain sparing reflex

    Directory of Open Access Journals (Sweden)

    Renato Augusto Moreira de Sá

    2003-05-01

    Full Text Available OBJETIVO: avaliar o desempenho da dopplerfluxometria do ducto venoso (DV na detecção da acidemia em fetos prematuros apresentando centralização de fluxo sangüíneo. MÉTODOS: estudo observacional transversal. A população em estudo consistiu de 48 gestantes entre a 25ª e a 33ª semana de gestação, que apresentavam centralização de fluxo sangüíneo fetal (relação umbílico/cerebral >1. O tempo decorrido entre o diagnóstico de centralização fetal e o nascimento (cesariana sob anestesia peridural foi de até cinco horas. Os seguintes parâmetros foram estudados: relação sístole ventricular atrial (S/A do ducto venoso, pH e base excess (BE de amostra de sangue da veia umbilical colhida imediatamente após o nascimento. A relação S/A do DV foi considerada anormal quando maior que 3,6. Os conceptos foram classificados quanto ao resultado da gasometria, sendo considerada gasometria anormal quando pH PURPOSE: to evaluate Doppler velocimetry of the ductus venosus as a noninvasive test of abnormal pH and gas analysis in preterm fetuses with "brain sparing reflex". METHODS: a cross-sectional study was performed. The studied population consisted of 48 pregnant women between the 25th and the 33rd week of gestation, whose fetuses presented brain sparing reflex (umbilical/cerebral ratio >1. The time elapsed between Doppler velocimetry and the birth (cesarean section under peridural anesthesia was of up to 5 h. The following parameters were studied: S/A ratio of the ductus venosus, pH and base excess (BE of fetal blood sample (collected from the umbilical vein immediately after birth. The S/A ratio of the ductus venosus was considered abnormal when superior to 3.6. The fetuses were classified according to the gas analysis result. They were considered abnormal when pH <7.26 and BE £ 6 mMol/L. Fisher's test was used for statistical analysis and considered significant when p £ 0.05. RESULTS: there was a significant correlation between

  1. 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.

  2. 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

  3. 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.

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    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.

  4. 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)

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    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。

  5. 静脉导管血流检测对妊娠高血压疾病胎儿右心舒张功能的评价%Ductus venosus blood flow detection for fetal right ventricular diastolic function evaluation in hypertensive disorders of pregnancy

    Institute of Scientific and Technical Information of China (English)

    李天刚; 车岩; 童明辉; 聂芳; 叶娜

    2013-01-01

    目的 通过检测胎儿静脉导管血流参数,了解妊娠高血压疾病对胎儿右心舒张功能的影响.方法 92 例妊娠高血压疾病孕妇,其中重度子痫前期组14 例,轻度子痫前期组26 例,妊娠高血压组52 例,60 例与其孕龄匹配且血压正常孕妇为对照组,彩色多普勒超声测量其胎儿静脉导管的搏动指数、阻力指数、静脉前负荷指数(PLI)及心室收缩峰值流速与心房收缩最大流速比值(S/A).于治疗后24 h 及72 h,监测重度子痫前期组胎儿静脉导管各项参数.结果 对照组、轻度子痫前期组和重度子痫前期组的搏动指数、阻力指数、S/A 及PLI 依次增高,组间两两比较差异均有统计学意义(P﹤0.05);治疗后24 h 及72 h,重度子痫前期组胎儿静脉导管各项参数较治疗前均减低(P﹤0.05);与轻度子痫前期组比较,重度子痫前期组三尖瓣反流和静脉导管反向波发生率增高(P﹤0.05).结论 通过胎儿静脉导管检测可以定性或定量判断胎儿右心舒张功能改变,为临床提供治疗及预后依据.%Objective To investigate the effect, of hypertensive disorders in pregnancy on fetal right, ventricular diastolic function by detecting the blood flow parameter of fetal duct.us venosus. Methods Ninety—two cases of pregnant women with hypertension were enrolled including 14 cases of severe preeciampsia ,26 cases of mild preeclampsia,52 cases of gestationai hypertension,and 60 cases of normotensive pregnant, women at gestationai age were taken as the control. The parameters including pulsatility index, resistance index, pre-load index (PLI) and S/A ratio of ductus venosus in fetus were measured by dolor Dopier. The blood flow parameters in fetal ductus venosus in the severe preeciampsia group were monitored 24 h and 72 h after treatment. Results Compared with the control group, pulsatilily index, resistance index. PLI and S/A of ductus venosus in fetus in mild and severe preeciampsia group were

  6. 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

  7. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  8. 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.

  9. 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

  10. 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

    Directory of Open Access Journals (Sweden)

    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

  11. 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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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

    Directory of Open Access Journals (Sweden)

    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

  13. Genetics Home Reference: congenital bilateral absence of the vas deferens

    Science.gov (United States)

    ... and other organs and tissues. Mutations in the CFTR gene disrupt the function of the chloride channels, preventing them from regulating the flow of chloride ions and water across cell membranes. As a result, cells in the male ... a mutation in the CFTR gene, the cause of this condition is often ...

  14. Mutations in CFTR gene and clinical correlation in Argentine patients with congenital bilateral absence of the vas deferens Correlación de las características clínicas con mutaciones del gen CFTR en pacientes argentinos con ausencia bilateral congénita de vasos deferentes

    Directory of Open Access Journals (Sweden)

    Estrella M Levy

    2004-06-01

    Full Text Available Congenital bilateral absence of the vas deferens (CBAVD is a form of male infertility in which mutations in the cystic fibrosis transmembrane conductance regulator (CFTR gene have been identified. Here we identify different mutations of CFTR and the poly-T variant of intron 8 (IVS8 in Argentine patients and analyze sweat test values and clinical characteristic related to Cystic Fibrosis (CF. For counseling purposes the two most frequent mutations in Argentine CF population: DF508 and G542X were screened in wives. In all cases, it was possible to reduce the risk of CF/CBAVD descendants in these couples because none of the mutation were found in the 36 samples. Eight patients (23% showed abnormal chloride values (> 60 mmol/l. A second group of 6 patients (18% had borderline values of sweat chloride (40-59 mmol/l. We defined another group with 6 patients (18%, with normal sweat chloride levels (30-39 mmo/l and a fourth group of 14 (41% patients with sweat chloride below 30 mmol/l. DF508, the most frequent CF mutation in the Argentine population, was found on 15 of the 72 chromosomes (21%, R117H mutation was detected on 2 of 62 chromosomes (3%. Only one R347P allele was found on 28 chromosomes analyzed (2%. On a sample of 27 patients, IVS8 analysis showed a frequency of 6/56 chromosomes (11% of 5T allele. Even though these findings present an improvement in the detection of mutations related to clinical correlations in Argentine CBAVD population, the search for other common and uncommon mutations should be continued.La ausencia bilateral congénita de vasos deferentes (CBAVD es una forma de infertilidad masculina en la que se han identificado mutaciones en el gen de la conductancia transmembrana de la fibrosis quística (CFTR. Hemos estudiado en pacientes argentinos diferentes mutaciones en el CFTR y la variante poli T del intron 8 (IVS8 y analizado los valores de test del sudor y las características clínicas relacionadas a la Fibrosis Qu

  15. 先天性双侧输精管缺如患者CFTR基因启动子区域基因突变检测%Detection of promoter region of CFTR gene in Chinese congenital bilateral absence of vas deferens

    Institute of Scientific and Technical Information of China (English)

    吴晓; 张炎; 杨晓健; 陈石涛; 袁萍; 张滨

    2015-01-01

    目的 探讨先天性双侧输精管缺如患者囊性纤维化跨膜转导因子(CFTR)基因启动子区域的基因突变情况.方法 采用PCR技术结合DNA直接测序的方法检测2013年5月至2015年1月于中山大学附属第三医院诊断明确的11例先天性双侧输精管缺如汉族患者及50名健康已生育汉族男性的CFTR基因5'端ATG上游3.8 kb的启动子区域的突变情况,并在NCBI和Cystic Fibrosis Mutation Database在线比对,利用Transfac在线预测及系统发生足迹法联合已经报道的转录因子作用元件,探讨所检测之碱基变异与启动子调控作用的关系.结果 11例汉族先天性双侧输精管缺如患者中发现c.-8G>C(1例)、c.-966T> G(7例)2个已知CFTR启动子区域的多态性位点及c.-195C>A(1例)1个单核苷酸位点变异,其中,c.-195C>A位于物种间启动子保守区域.结论 除外多态性位点,在中国汉族先天性双侧输精管缺如患者CFTR基因启动子区域检测到一个单核苷酸变异,其与疾病发生的关系仍需进一步行生物学实验验证.%Objective To detect the variants in the promoter region of the CFTR gene in congenital bilateral absence of vas deferens (CBAVD).Methods A total of 11 CBAVD patients and 50 healthy men as control were enrolled in the study from May 2013 to January 2015.Sanger sequencing was performed in the promoter region of 3.8 kb of the CFTR gene on the PCR products.The genome sequence of the CFTR gene was compared and analyzed with the website of NCBI and Cystic Fibrosis Mutation Database.Also,Transfac and phylogenetic footprinting method was used to investigate the relationship between the promoter region variants and the transcription factors function components.Results SNP of c.-8G > C (n =1) and c.-966T > G(n =7),as well as one single nucleotide variant of c.-195C > A (n =1) were identified in the promoter region of the CBAVD patients,of which c.-195C > A was in the conserved domains of the promoter

  16. 先天性双侧输精管缺如患者囊性纤维化跨膜传导调节因子基因的检测%CFTR gene mutation in patients with congenital bilateral absence of vas deferens

    Institute of Scientific and Technical Information of China (English)

    卢少明; 王来诚; 张浩波; 李晓; 刘蛟龙; 崔延义; 陈子江

    2013-01-01

    Objective To study the frequency of cystic fibrosis transmembrane conductance regulator(CFTR)mutations in patients with congenital bilateral absence of vas deferens(CBAVD).Methods Eighty-five CBAVD patients were collected from May 2007 to May 2009.The diagnosis of CBAVD included azoospermia,normal of 4 sex hormone items,absence of seminal vesicle,normal volume of testicular and epididymis dilated siltation.And 85 normal fertile men served as controls.Genomic DNA was isolated from peripheral blood.The mutations of CFTR exons 10,11 were detected by PCR-single strand conformation polymorphism,and direct sequencing was performed on 85 cases of CBAVD and the control males.Results Of the 85 CBAVD,10 cases(11.8%)exhibited an abnormal CFTR gene mutation,with 4 cases I556V,2 cases M469V,and 1 case of E527N,A F508,L558S,S485C.No mutations were detected in 85 controls.There was a significant difference between the 2 groups(x2 =8.606,P =0.003).Conclusions CBAVD might be caused by the CFTR mutations.The frequencies and the spectrum of CFTR mutations might be different from those Caucasian population in the west country.%目的 探讨先天性双侧输精管缺如(CBAVD)患者与囊性纤维化跨膜传导调节因子(CFTR)基因突变的关系. 方法 收集2007年5月至2009年5月85例CBAVD患者.CBAVD诊断依据:无精子;性激素4项正常;双侧输精管未触及;双睾丸体积正常,附睾饱满淤积.另设健康已生育男性85例作为对照.抽取外周血,应用聚合酶链反应-单链构象多态及PCR产物直接序列测定法检测患者及对照组CFTR基因第10,11外显子,比较两组的突变情况. 结果 CBAVD组85例,CFTR基因突变10例,占11.8%,分别是I556V突变4例,M469V突变2例,E527N、△F508、L558S、S485C各1例.对照组85例均未见突变.两组间比较差异有统计学意义(x2=8.606,P=0.003).结论 CBAVD主要由CFTR基因突变引起,CFTR基因突变的位点与频率与西方白种人有所不同.

  17. Waveform and spectrum parameters of ductus venosus in fetus with congenital heart disease%先天性心脏病胎儿静脉导管血流频谱及血流参数

    Institute of Scientific and Technical Information of China (English)

    周彩云; 罗红

    2013-01-01

    目的 分析先天性心脏病(CHD)胎儿静脉导管的频谱特征及血流参数,探讨其血流参数的变化及特定CHD与参数之间的可能相关性.方法 记录160胎CHD胎儿静脉导管波形及各频谱参数,随访并分组,探寻可能对CHD有提示意义的血流参数.结果 160胎CHD胎儿中,右心系统发育异常胎儿的静脉导管频谱异常发生率明显高于其他畸形,其中又以三尖瓣闭锁+室间隔缺损及室间隔完整的右心室流出道梗阻畸形者发生率更高;且当搏动指数>1.39、前负荷指数>1.35及静脉峰值流速指数>1.53时,诊断右心系统发育异常的意义较大.结论 静脉导管波形异常可早期提示胎儿CHD,尤其是右心系统发育不良,对临床决策及判断预后有一定指导意义.%Objective To analyze the flow spectral characteristics and parameters of ductus venosus (DV) of congenital heart disease (CHD) fetuses, in order to find out the relationship between different CHD and DV waveform characteristics. Methods DV waveform and spectrum parameters of fetuses with CHD were recorded and followed up. Parameters for CHD indication were analyzed. Results In 160 fetuses with CHD, the incidence of abnormal waveform in the right heart system defect fetuses was significantly higher than in other fetuses, especially in fetuses with tricuspid atresia + ventricular septal defect and right ventricular outflow tract obstruction malformations associated with intact ventricular septum. And Pulsatility index for veins >1. 39, preload index >1. 35 and peak velocity index for veins >1. 53 had important significance in diagnosis of right heart system defect. Conclusion The incidence of abnormal waveform is significantly higher in CHD fetuses, especially in fetuses with right heart system defect. Abnormal waveform of DV can give some guidance to clinical decision and prognosis evaluation.

  18. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Fetal liver blood flow distribution: role in human developmental strategy to prioritize fat deposition versus brain development.

    Directory of Open Access Journals (Sweden)

    Keith M Godfrey

    Full Text Available Among primates, human neonates have the largest brains but also the highest proportion of body fat. If placental nutrient supply is limited, the fetus faces a dilemma: should resources be allocated to brain growth, or to fat deposition for use as a potential postnatal energy reserve? We hypothesised that resolving this dilemma operates at the level of umbilical blood distribution entering the fetal liver. In 381 uncomplicated pregnancies in third trimester, we measured blood flow perfusing the fetal liver, or bypassing it via the ductus venosus to supply the brain and heart using ultrasound techniques. Across the range of fetal growth and independent of the mother's adiposity and parity, greater liver blood flow was associated with greater offspring fat mass measured by dual-energy X-ray absorptiometry, both in the infant at birth (r = 0.43, P<0.001 and at age 4 years (r = 0.16, P = 0.02. In contrast, smaller placentas less able to meet fetal demand for essential nutrients were associated with a brain-sparing flow pattern (r = 0.17, p = 0.02. This flow pattern was also associated with a higher degree of shunting through ductus venosus (P = 0.04. We propose that humans evolved a developmental strategy to prioritize nutrient allocation for prenatal fat deposition when the supply of conditionally essential nutrients requiring hepatic inter-conversion is limited, switching resource allocation to favour the brain if the supply of essential nutrients is limited. Facilitated placental transfer mechanisms for glucose and other nutrients evolved in environments less affluent than those now prevalent in developed populations, and we propose that in circumstances of maternal adiposity and nutrient excess these mechanisms now also lead to prenatal fat deposition. Prenatal developmental influences play important roles in the human propensity to deposit fat.

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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

  1. 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。

  2. 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.

  3. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  4. Patent ductus arteriosis (PDA) - series (image)

    Science.gov (United States)

    ... mediastinum) while the child is deep asleep and pain-free (under general anesthesia). For some heart defect repairs, the incision is made on the side of the chest, between the ribs (thoracotomy) instead of through the breastbone. Heart-lung ...

  5. Coronary fistula resembling patent ductus arteriosus

    Directory of Open Access Journals (Sweden)

    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.

  6. Valor preditivo do resultado fetal da dopplervelocimetria de ducto venoso entre a 11ª e a 14ª semanas de gestação Predictive value for fetal outcome of Doppler velocimetry of the ductus venosus between the 11th and the 14th gestation week

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Gollo

    2008-01-01

    Full Text Available OBJETIVO: estudar o valor da dopplervelocimetria do ducto venoso (DV entre a 11º e a 14º semanas de gestação, associado à medida da translucência nucal (TN, na detecção de resultado fetal adverso. MÉTODOS: foram estudados 1.268 fetos consecutivamente. Em 56 casos, realizou-se estudo citogenético no material obtido, por meio de biópsia de vilosidade coriônica e, em 1.181 casos, o resultado teve como base o fenótipo do recém-nascido. Todos os fetos foram submetidos, além da ultra-sonografia de rotina, à medida da TN e à dopplervelocimetria do DV. Trata-se de um estudo transversal e prospectivo. Foram calculados e analisados, para fins de prevalência e índices de acurácia: sensibilidade, especificidade, valor preditivo positivo (VPP, valor preditivo negativo (VPN, probabilidade de falso-positivo (PFP, probabilidade de falso-negativo (PFN, razão de probabilidade positiva e razão de probabilidade negativa. RESULTADOS: do total de 1.268 fetos, foram selecionados para análise 1.183 casos. Deste total, 1.170 fetos eram normais (98,9% e 13 fetos tiveram resultado fetal adverso ao nascimento (1,1% - incluindo morte fetal (trissomia 21 e 22 em dois casos, síndrome genética (Nooman em um caso, fetos polimalformados em dois casos, cardiopatia em três casos e outros defeitos estruturais em cinco casos. A prevalência do DV alterado (onda A zero/reversa na população estudada foi de 14 casos (1,2%, com taxa de falso-positivo de 0,7%. CONCLUSÕES: há correlação significativa entre alteração da dopplervelocimetria do DV e a medida da TN, como marcadores ultra-sonográficos de primeiro trimestre, na detecção de resultado fetal adverso, especialmente para malformações graves. O Doppler do DV foi capaz de diminuir o resultado falso-positivo, comparativamente ao uso isolado da TN, melhorando consideravelmente o VPP do teste.PURPOSE: to study the value of Doppler velocimetry of the ductus venosus, between the 11th and 14th weeks of

  7. Pathogenesis of solitary right aortic arch: a mass effect hypothesis based on observations of serial human embryonic sections.

    Science.gov (United States)

    Jin, Zhe W; Yamada, Tomonori; Kim, Ji H; Rodríguez-Vázquez, José F; Murakami, Gen; Arakawa, Keiji

    2017-03-01

    In general, solitary right aortic arch carries the left-sided ductus arteriosus communicating between the left subclavian and pulmonary arteries or the right-sided ductus connecting the descending aorta to the left pulmonary artery. Serial sections of fifteen 5- to 6-week-old embryos and ten 8- to 9-week-old fetuses suggested that the pathogenesis was unrelated to inversion due to dysfunction in gene cascades that control the systemic left/right axis. With inversion, conversely, the ductus or the sixth pharyngeal arch artery should connect to the right pulmonary artery. The disappearance of the right aortic arch started before the caudal migration of the aortic attachment of the ductus. Sympathetic nerve ganglia developed immediately posterior to both aortae, with a single embryonic specimen showing a large ganglion at the midline close to the union of the aortic arches. These ganglia may interfere with blood flow through the distal left arch, resulting in the ductus ending at the descending aorta behind the oesophagus. In another fetus examined, a midline shift of the ductus course resulted in the trachea curving posteriorly. Therefore, solitary right arch is likely to accompany abnormalities of the surrounding structures. The timing and site of the obstruction should be different between types: an almost midline obstruction near the aortic union needed for the development of the left-sided ductus and a distal obstruction near the left subclavian arterial origin needed for the development of the right-sided ductus. A mass effect of the sympathetic ganglia may explain the pathogenesis of any type of anomalous ductus arteriosus shown in previous reports of the solitary right arch.

  8. 孕11~14周静脉导管A波倒置在胎儿染色体异常中的筛查价值%Screening Value of Reversed A-wave in Fetal Ductus Venosus with Ultrasound on Chromosome Abnormalities at 11-14 Weeks Gestation

    Institute of Scientific and Technical Information of China (English)

    刘志辉; 邹翰琴; 王洁; 阳春芳; 张玉麒; 叶江; 颜嫒

    2015-01-01

    Objective To explore the clinical application value of the reversed A-wave in fetal ductus venosus assessed by ultrasound at 11~14 weeks gestation on screening fetal chromosomal abnormalities. Methods Regular antenatal examination was performed on pregnant women of 11~14 weeks gestation. The Doppler spectrum of the ductus venosus and the size of nuchal trans-lucency were conducted. The results of amniotic fluid puncture cultivate karyotype examination and the DV-RAW or NT thickening were followed up. Results Among 656 cases,DV-RAW were found in 21 cases,NT thickening were found in 19 cases,both in abnormalities were found in 12 cases. After followed-up of fetal chromosomal karyotype in 28 cases, chromosomal abnormalities were found in 17 cases,the trisomy 21 syndrome were found in 14 cases,Edwards' syndrome were found in 2 cases and 9 chromo-some structural abnormality was found only in 1 case. The sensitivity of DV-RAW in the detection of fetal chromosomal abnormali-ties was 82. 35%,the specificity was 36. 36% and the accuracy was 64. 29%. The sensitivity of NT thickening method in fetal chromosomal abnormalities was 76. 47%,the specificity was 45. 45% and the accuracy was 64. 29%. When combined the DV -RAW and NT methods,the diagnostic sensitivity was 58. 82%,the specificity was 81. 82% and the accuracy was 67. 86%. Con-clusion The reversed A-wave in fetal ductus venosus at 11~14 weeks gestation showed to be helpful in the early screening for fe-tal chromosomal abnormalities,and might help the early diagnosis of fetal abnormal chromosome karyotype.%目的 探讨孕11~14 周胎儿静脉导管A波倒置在胎儿染色体异常筛查中的临床应用价值. 方法 对11~14周的孕妇行常规产前检查,并进行静脉导管血流频谱和颈项透明层厚度检测. 随访A波倒置或颈项透明层增厚胎儿的羊水穿刺培养染色体核型检查结果. 结果 656例胎儿中,共28例异常,其中静脉导管A波倒置21例,颈项透明层增厚19

  9. 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

  10. 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

  11. Effect of experimentally induced Escherichia coli epididymo-orchitis and ciprofloxacin treatment on rat spermatogenesis.

    Science.gov (United States)

    Demir, Aslan; Türker, Polat; Onol, Fikret Fatih; Sirvanci, Serap; Findik, Ayfer; Tarcan, Tufan

    2007-03-01

    We investigated the effects of epididymo-orchitis and ciprofloxacin on rat testicular histology and spermatogenesis. The control group underwent left orchiectomy. The second group received oral ciprofloxacin (150 mg/kg/day) for 10 days. Escherichia coli (10(6) cfu/mL, 0.1 mL) was injected into the proximal right ductus deferens in the third group. The fourth group received ciprofloxacin treatment 48 h after E. coli inoculation. In groups 3 and 4, bilateral orchiectomy was performed 14 days after the challenge. In healthy rats, ciprofloxacin caused recognizable histological damage associated with a mild decrease in testicular volume and sperm concentration. Infected testicles in groups 3 and 4 revealed severe histological damage associated with severe testicular atrophy and impaired spermatogenesis that were more significant in infected rats which received ciprofloxacin treatment. Contralateral testicles in these animals showed similar histopathological changes to a lesser extent. The results of our study suggest a gonadotoxic potential for ciprofloxacin and this potential in humans should be addressed with further studies.

  12. Purinergic (P2) receptor control of lower genitourinary tract function and new avenues for drug action: an overview.

    Science.gov (United States)

    Gur, Serap; Kadowitz, Philip J; Hellstrom, Wayne J G

    2007-01-01

    Micturition, penile erection, contraction of prostatic smooth muscle, peristalsis of the male excurrent duct system and lumbosacral spinal cord neurotransmission all require adenosine 5'-triphosphate (ATP) activity and this likely involves purinergic (P2) receptors. P2 receptors are categorized as either ligand-gated ionotropic P2X or metabotropic G-protein-coupled P2Y subtypes. In the urinary bladder, purinergic receptor mechanisms are involved in both motor and sensory function. In the prostate, P2X1-receptors, which mediate contraction, are present in the fibromuscular stroma while G protein-coupled P2Y purinoceptors have a wide range of actions in prostate cancer. In the excretory ducts of the testis (ductus epididymidis, vas deferens and its associated seminal vesicles), heavy immunostaining for P2X1 and P2X2 subtypes is detected in the membranes of smooth muscle, suggesting their role in sperm transport and ejaculation. In the penis, intense P2X1 and weak P2X2 immunoreactivity are observed in smooth muscle of blood vessels and the corpus cavernosum, implying their participation in detumescence. Human corporal cavernosum stimulation induces relaxation of P2Y purinoceptors. Targeting of extracellular or intracellular P2X and/or P2Y receptor signaling pathways holds promise in affecting the lower genitourinary tract system. Our advancing knowledge about purine agonists and their pharmacologic benefits in erectile, ejaculatory, urinary bladder and prostatic hyperplasia may service clinical problems in the near future.

  13. Melatonin MT1 and MT2 Receptors in the Ram Reproductive Tract

    Science.gov (United States)

    González-Arto, Marta; Aguilar, David; Gaspar-Torrubia, Elena; Gallego, Margarita; Carvajal-Serna, Melissa; Herrera-Marcos, Luis V.; Serrano-Blesa, Edith; Hamilton, Thais Rose dos Santos; Pérez-Pé, Rosaura; Muiño-Blanco, Teresa; Cebrián-Pérez, José A.; Casao, Adriana

    2017-01-01

    Some melatonin functions in mammals are exerted through MT1 and MT2 receptors. However, there are no reports of their presence in the reproductive tract of the ram, a seasonal species. Thus, we have investigated their existence in the ram testis, epididymis, accessory glands and ductus deferens. Real-time polymerase chain reaction (qPCR) revealed higher levels of m-RNA for both receptors in the testis, ampulla, seminal vesicles, and vas deferens, than in the other organs of the reproductive tract (p < 0.05). Western blot analyses showed protein bands compatible with the MT1 in the testis and cauda epididymis, and for the MT2 in the cauda epididymis and deferent duct. Immunohistochemistry analyses revealed the presence of MT1 receptors in spermatogonias, spermatocytes, and spermatids, and MT2 receptors in the newly-formed spermatozoa in the testis, whereas both receptors were located in the epithelial cells of the ampulla, seminal vesicles, and ductus deferens. Indirect immunofluorescence showed significant differences in the immunolocation of both receptors in spermatozoa during their transit in the epididymis. In conclusion, it was demonstrated that melatonin receptors are present in the ram reproductive tract. These results open the way for new studies on the molecular mechanism of melatonin and the biological significance of its receptors. PMID:28335493

  14. The tricyclic antidepressants amitriptyline, nortriptyline and imipramine are weak antagonists of human and rat alpha1B-adrenoceptors.

    Science.gov (United States)

    Nojimoto, F D; Mueller, A; Hebeler-Barbosa, F; Akinaga, J; Lima, V; Kiguti, L R de A; Pupo, A S

    2010-01-01

    Although it is long known that the tricyclic antidepressants amitriptyline, nortriptyline and imipramine inhibit the noradrenaline transporter and alpha(1)-adrenoceptors with similar affinities, which may lead to self-cancelling actions, the selectivity of these drugs for alpha(1)-adrenoceptor subtypes is unknown. The present study investigates the selectivity of amitriptyline, nortriptyline and imipramine for human recombinant and rat native alpha(1)-adrenoceptor subtypes. The selectivity of amitriptyline, nortriptyline and imipramine was investigated in HEK-293 cells expressing each of the human alpha(1)-subtypes and in rat native receptors from the vas deferens (alpha(1A)), spleen (alpha(1B)) and aorta (alpha(1D)) through [(3)H]prazosin binding, and noradrenaline-induced intracellular Ca(2+) increases and contraction assays. Amitriptyline, nortriptyline and imipramine showed considerably higher affinities for alpha(1A)- (approximately 25- to 80-fold) and alpha(1D)-adrenoceptors (approximately 10- to 25-fold) than for alpha(1B)-adrenoceptors in both contraction and [(3)H]prazosin binding assays with rat native and human receptors, respectively. In addition, amitriptyline, nortriptyline and imipramine were substantially more potent in the inhibition of noradrenaline-induced intracellular Ca(2+) increases in HEK-293 cells expressing alpha(1A)- or a truncated version of alpha(1D)-adrenoceptors which traffics more efficiently towards the cell membrane than in cells expressing alpha(1B)-adrenoceptors. Amitriptyline, nortriptyline and imipramine are much weaker antagonists of rat and human alpha(1B)-adrenoceptors than of alpha(1A)- and alpha(1D)-adrenoceptors. The differential affinities for these receptors indicate that the alpha(1)-adrenoceptor subtype which activation is most increased by the augmented noradrenaline availability resultant from the blockade of neuronal reuptake is the alpha(1B)-adrenoceptor. This may be important for the behavioural effects of these

  15. 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.

  16. 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

  17. 胎儿颈项透明层增厚及静脉导管血流频谱异常在先天性心脏畸形筛查中的价值%Fetal Increased Nuchal Translucensy and Abnormal Blood Flow Spectrum of Ductus Venosus in Screening of Congenital Heart Disease

    Institute of Scientific and Technical Information of China (English)

    裴秋艳; 张晓红; 李建国; 黄歆

    2011-01-01

    目的 探讨胎儿颈项透明层(nuchal translucency,NT)增厚及静脉导管(ductus venosus,DV)多普勒血流频谱异常在早期先天性心脏畸形(congenital heart disease,CHD)筛查中的临床意义.方法 2007年1月~2009年4月期间,常规对在我院产前检查的孕妇于孕11-14周进行胎儿NT测量,同时对NT增厚的胎儿行超声心动图检查和DV血流频谱检测,对可疑CHD的胎儿于孕18-20周再次行超声心动图检查以确诊或除外CHD;对NT正常的胎儿于孕20-24周行胎儿超声心动图检查.所有活产儿于生后1周内行超声心动图检查,引产的胎儿争取尸解.结果 (1)NT增厚胎儿的62例,产前产后证实17例患有CHD,NT正常的胎儿2 046例,产前产后证实18例患有CHD,与NT正常胎儿比较,NT增厚胎儿CND发病率明显增高,且以复杂型CHD为主;(2)NT增厚的62胎儿中,7例胎儿DV血流频谱异常,产前产后证实其中5例为先天性心脏畸形.结论 胎儿NT增厚及DV血流频谱异常可作为胎儿复杂CHD的早期筛查指标.%Objective To investigate the clinical significance of fetal increased nuchal translucency (NT) and abnormal Doppler blood flow spectrum of ductus venosus (DV) in the screening of early congenital heart disease (CHD).Methods From January 2007 to April 2009,fetal regular NT measurements were conducted to pregnant women within 11~ 14 gestational weeks in our hospital. Blood flow spectra of DV of fetuses with increased NT were detected using color flow Doppler ultrasound as well as echocardiography. Those fetuses suspected with CHD were re-examined with echocardiography duing 18~20 gestational weeks to obviate congenital heart disease. Echocardiography detections were conducted during 20~24 weeks of gestation to fetuses with normal NT. All fetuses were followed up with echocardiography examination during 1 week after birth, and those abortions accepted autopsy. Fetuses without follow-up were not included in this study. Results (1) A

  18. 超声心动图诊断动脉导管未闭合并重度肺动脉高压的临床应用价值%The diagnosis of ductus arterious with severe pulmonary hypertension by echocardiography

    Institute of Scientific and Technical Information of China (English)

    康或; 张嬿; 彭汇娟; 周小林; 李曦

    2011-01-01

    目的 探讨动脉导管未闭(PDA)合并重度肺动脉高压(PH)的超声心动图特点及诊断技巧.方法 回顾性分析32例PDA合并重度PH患者的心脏二维超声改变、多普勒血流特点以及显示PDA切面.结果 超声心动图诊断PDA合并重度PH符合率87.5%,误诊4例;二维超声的主要改变是肺动脉扩张、右心增大;彩色多普勒分流束及分流频谱是诊断的主要依据;左高住切面是诊断PDA合并重度PH的最易显示切面.结论 PDA合并重度PH的临床及超声特点与单纯PDA不一致,注重超声心动图检查思维与技巧有助于诊断及鉴别诊断.%Objective To study the diagnostic experience of echocardiography on the congenital patent ductus arte-rious (PDA) combined with pulmonary hypertension (PH). Methods 32 cases of PDA with severe PH were retrospectively analyzed to find the changes in 2-dimensional ultrasound, Doppler flow characteristics and display PDA. Results There was a precise ratio about 87. 5% on the diagnosis of the PDA with PH by echocardiography and 4 cases were mis-diagnosed. The pulmonary and right heart's expansion was major changes of echocardiography. The most significant diagnostic characteristic was shunt of PDA and the most significant view was left high section. Conclusion The thinking and skill of echocardiography is a valuable way to correctly diagnose the PDA with PH.

  19. Valores dos parâmetros da dopplerfluxometria do ducto venoso entre a 10ª e a 14ª semana de gestações normais Values for ductus venosus doppler flow measurements between the 10th and the 14th week of normal pregnancy

    Directory of Open Access Journals (Sweden)

    Francisco Herlânio Costa Carvalho

    2004-02-01

    Full Text Available OBJETIVO: analisar os valores dos parâmetros dopplerfluxométricos do ducto venoso, entre a 10ª e a 14ª semana de gestação, durante as diferentes fases do ciclo cardíaco: sístole ventricular (onda S, diástole ventricular (onda D, contração atrial (onda a e dos índices ângulo-independentes. MÉTODOS: foi desenvolvido estudo prospectivo e transversal que examinou 276 gestações únicas. Foram excluídas as gestações múltiplas, malformações fetais, fetos com translucência nucal aumentada e gestantes com doenças associadas. O equipamento utilizado foi Toshiba, modelo SSH-140 A. A análise espectral foi obtida de acordo com os procedimentos padronizados: ângulo de insonação menor que 30° e uso de filtro de 50-70 Hz. O ducto venoso foi identificado em corte sagital e ventral do abdome superior fetal com o Doppler colorido. A amostra de volume (1-2 mm³ foi adquirida imediatamente na origem do ducto venoso. Pelo menos três ondas nítidas e consecutivas foram necessárias para aferição dos parâmetros. Para o estudo estatístico foi realizado o teste de Levene e o método de Bonferroni. RESULTADOS: foi observado aumento na velocidade S de 29 cm/s para 37 cm/s (p=0,013 entre a 10ª e a 14ª semana de gestação. Similarmente, houve aumento na velocidade D (de 25 cm/s para 32 cm/s, p=0,026. A onda a, o índice de pulsatilidade e a relação S/a apresentaram valores constantes no período estudado. CONCLUSÃO: os valores estabelecidos por este estudo podem servir para acompanhamento dopplerfluxométrico de gestações normais. Futuros estudos são necessários para determinar a validade destes parâmetros na população normal e, em particular, para fetos de risco.PURPOSE: to analyze the values of Doppler ultrasound for blood flow velocity in the ductus venosus between the 10th and the 14th week of gestation, during the different phases of the cardiac cycle: ventricular systole (wave S, ventricular diastole (wave D, atrial

  20. 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

  1. Human See, Human Do.

    Science.gov (United States)

    Tomasello, Michael

    1997-01-01

    A human demonstrator showed human children and captive chimpanzees how to drag food or toys closer using a rakelike tool. One side of the rake was less efficient than the other for dragging. Chimps tried to reproduce results rather than methods while children imitated and used the more efficient rake side. Concludes that imitation leads to…

  2. Complete recovery after the removal of an ectopic testicle in a case of primary reninism and retroperitoneal hemangioma

    Institute of Scientific and Technical Information of China (English)

    Bernhard Glodny; Alexandar Tzankov; Germar-Michael Pinggera; Johannes Petersen; Ralf Herwig

    2006-01-01

    A 32-year-old man recovered completely from hypokalemic hypertension that had been caused by primary reninism after the ablation of an ectopic left testis, epididymis and ductus deferens. For several years, severe hypertension has been resistant to treatment, even the concurrent administration of up to seven antihypertensive agents. In this case,cryptorchidism was associated with an indirect inguinal hernia and an open peritoneo-vaginal process on both sides,aplasia of the posterior wall of the inguinal canal on the right side, an umbilical hernia, and a retroperitoneal tendrillar hemangioma.

  3. 输精管植入聚电解质避孕剂对人和猴子精子的生物物理学机制调控的时间依赖性影响%Biophysical mechanism-mediated time-dependent effect on sperm of human and monkey vas implanted polyelectrolyte contraceptive

    Institute of Scientific and Technical Information of China (English)

    Sujoy K. Guha

    2007-01-01

    Aim: To determine the short and long-term morphological effects on sperm as induced by intra-vas alteration of pH and electrical charge. Methods: Desired biophysical influences were obtained by injection of reversible inhibition of sperm under guidance (RISUG) into the lumen of the vas deferens of human subjects and the monkey. RISUG is a polyelectrolyte hydrogel complex of styrene maleic anhydride (SMA) and dimethyl sulfoxide (DMSO) which generates an electrostatic charge and also lowers in a near space of pH domain. The morphology of sperm was examined by light microscopy, scanning and transmission electron microscopy. Human study enabled semen collection by masturbation as early as 3 h after injection and studies extended up to 6 months. In the monkey, on vas excision after RISUG implantation, sperm characteristics were examined in serial sections. Results: Semenology in clinical studies and histological data of the monkey showed a time-sequenced sperm plasma membrane, tail mitochondria and nuclear decondensation alterations in sperm structural components, which beared marked similarity to changes in the sperm head and tail during capacitation and entry into the ovum. Conclusion: The findings provide a means of causing such changes in the sperm that inhibit the fertilizing ability before the nucleus is affected. Therefore achieving non-obstructive vas-based contraception, without genotoxic or teratogenic effects caused by infertile sperm passing into the semen, is feasible.

  4. More Human than Human.

    Science.gov (United States)

    Lawrence, David

    2017-07-01

    Within the literature surrounding nonhuman animals on the one hand and cognitively disabled humans on the other, there is much discussion of where beings that do not satisfy the criteria for personhood fit in our moral deliberations. In the future, we may face a different but related problem: that we might create (or cause the creation of) beings that not only satisfy but exceed these criteria. The question becomes whether these are minimal criteria, or hierarchical, such that those who fulfill them to greater degree should be afforded greater consideration. This article questions the validity and necessity of drawing divisions among beings that satisfy the minimum requirements for personhood; considering how future beings-intelligent androids, synthezoids, even alternate-substrate sentiences-might fit alongside the "baseline" human. I ask whether these alternate beings ought to be considered different to us, and why this may or may not matter in terms of a notion of "human community." The film Blade Runner, concerned in large part with humanity and its key synthezoid antagonist Roy Batty, forms a framing touchstone for my discussion. Batty is stronger, faster, more resilient, and more intelligent than Homo sapiens. His exploits, far beyond the capability of normal humans, are contrasted with his frailty and transient lifespan, his aesthetic appreciation of the sights he has seen, and his burgeoning empathy. Not for nothing does his creator within the mythos term him "more human than human."

  5. 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.

  6. Human Development, Human Evolution.

    Science.gov (United States)

    Smillie, David

    One of the truly remarkable events in human evolution is the unprecedented increase in the size of the brain of "Homo" over a brief span of 2 million years. It would appear that some significant selective pressure or opportunity presented itself to this branch of the hominid line and caused a rapid increase in the brain, introducing a…

  7. NT增厚和静脉导管血流频谱异常与胎儿先天性心脏畸形的相关性%Correlations between NT thickening and abnormal ductus venosus flow spectrum and fetal congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    张丽春

    2016-01-01

    目的:研究NT(颈项透明层)增厚与静脉导管( ductus venosus, DV)血流频谱异常与胎儿先天性心脏畸形( con-genital heart disease, CHD)的相关性。方法81选择在2013年12月至2015年3月来我院产检的3618例单胎孕妇为研究对象。在孕第11至14周时,对所有胎儿进行NT与DV检测。对于NT增厚和DV异常的胎儿,在孕18~20周及中孕期时进行超声心动图检查。对于NT和DV正常的胎儿,在孕22~24周时,进行超声心动图检测,筛查疑为CHD的胎儿。所有胎儿在出生1周内再次进行超声心动图检测,引产者对胎儿进行尸检。结果与NT正常的胎儿相比,NT增厚的胎儿更容易患有先天性心脏畸形(P<0.05),敏感性84.85%,特异性96.17%,阳性预测值13.93%,阴性预测值99.85%,准确率95.08%;与DV正常者相比,DV异常的胎儿CHD发生率明显高(P<0.05),敏感性87.88%,特异性95.59%,阳性预测值15.51%,阴性预测值99.88%,准确率95.52%;与NT正常或DV正常的胎儿相比,NT增厚且DV异常者患有CHD的概率显著高(P<0.05),敏感性82.14%,特异性97.68%,阳性预测值29.49%,阴性预测值99.86%,准确率97.43%。结论 NT增厚与静脉导管血流频谱异常的胎儿患有先天性心脏畸形的风险高,可以作为筛检胎儿CHD的有效手段。%Objective To study the correlations between NT ( nuchal translucency thickening ) and abnormal ductus venosus ( DV) flow spectrum and fetal congenital heart disease ( CHD) . Methods 3618 cases of singleton pregnant women in our hospital from December 2013 to March 2015 were selected. NT and DV of all the fetuses at 11-14 weeks’ gestation were detected. For the fe-tuses with NT thickening and abnormal DV were checked with echocardiography at 18-20 weeks’ gestation. For the fetues without NT and DV, the echocardiography checks were performed at 22-24 weeks’ gestation to screen suspected fetal CHD. All fetuses were test-ed by echocardiography in a week after birth. For odinopoeia

  8. Human rights

    NARCIS (Netherlands)

    Gaay Fortman, B. de

    2006-01-01

    Human rights reflect a determined effort to protect the dignity of each and every human being against abuse of power. This endeavour is as old as human history. What is relatively new is the international venture for the protection of human dignity through internationally accepted legal standards an

  9. CLINICAL TRIALS FOR VAS DEFERENS OCCLUSION BY PERCUTANEOUS INJECTION OF POLYURETHANE ELASTOMER TO FORM PLUGS

    Institute of Scientific and Technical Information of China (English)

    ZHAOSheng-Cai; etal.

    1989-01-01

    A non-incision method of vss occlusion based on the percutaneous injection of polyurethane elastomer solution to form a plug is described. The procedure was conducted under aseptic procedure and local fidocaine anaesthesia. Two different kinds of

  10. Human Rights, Human Needs, Human Development, Human Security

    OpenAIRE

    Gasper, Des

    2009-01-01

    Human rights, human development and human security form increasingly important, partly interconnected, partly competitive and misunderstood ethical and policy discourses. Each tries to humanize a pre-existing and unavoidable major discourse of everyday life, policy and politics; each has emerged within the United Nations world; each relies implicitly on a conceptualisation of human need; each has specific strengths. Yet mutual communication, understanding and co-operation are deficient, espec...

  11. Human Technology and Human Affects

    DEFF Research Database (Denmark)

    Fausing, Bent

    2009-01-01

    Human Technology and Human Affects  This year Samsung introduced a mobile phone with "Soul". It was made with a human touch and included itself a magical touch. Which function does technology and affects get in everyday aesthetics like this, its images and interactions included this presentation ...... often mentioned post-human condition....

  12. Gelatinases and serine proteinase inhibitors of seminal plasma and the reproductive tract of turkey (Meleagris gallopavo).

    Science.gov (United States)

    Kotłowska, M; Kowalski, R; Glogowski, J; Jankowski, J; Ciereszko, A

    2005-04-01

    This study examined proteolytic enzymes and serine proteinase inhibitors in turkey seminal plasma with relation to their distribution within the reproductive tract and to yellow semen syndrome (YSS). Proteases of blood plasma, extracts from the reproductive tract, and seminal plasma were analyzed by gelatin zymography. We found a clear regional distribution of proteolytic enzymes in the turkey reproductive tract. Each part was characterized by a unique profile of serine proteolytic enzymes of molecular weights ranging from 29 to 88 kDa. The ductus deferens was found to be a site of very intense proteolytic activity. Two metalloproteases of 58 and 66 kDa were detected in all parts of the reproductive tract and seminal plasma. Using electrophoretic methods for detection of anti-trypsin activity, we found three serine proteinase inhibitors in turkey seminal plasma. Two inhibitors were found in the testis and epididymis and a third in the ductus deferens and seminal plasma. Blood plasma was characterized by the presence of two metalloproteinases and one serine proteinase inhibitor (of low migration rate) that were also detected in the reproductive tract. Amidase and anti-trypsin activities (expressed per gram of protein) differed for yellow and white seminal plasma. We concluded that turkey seminal plasma contains metalloproteases, serine proteinases, and serine proteinase inhibitors. The metalloproteases and one proteinase inhibitor are related to blood proteinases but the other two inhibitors and serine proteinases seem to be unique for the reproductive tract.

  13. Isolation and characterization of an ovoinhibitor, a multidomain Kazal-like inhibitor from Turkey (Meleagris gallopavo) seminal plasma.

    Science.gov (United States)

    Słowińska, Mariola; Liszewska, Ewa; Nynca, Joanna; Bukowska, Joanna; Hejmej, Anna; Bilińska, Barbara; Szubstarski, Jarosław; Kozłowski, Krzysztof; Jankowski, Jan; Ciereszko, Andrzej

    2014-11-01

    Turkey seminal plasma contains three serine proteinase inhibitors. Two of them, with low molecular masses (6 kDa), were identified as single-domain Kazal-type inhibitors responsible for regulating acrosin activity. Our experimental objective was to isolate and characterize the inhibitor with the high molecular weight from turkey seminal plasma. The inhibitor was purified using hydrophobic interaction and affinity chromatography. Pure preparations of the inhibitor were used for identification by mass spectrometry, for determination of physicochemical properties (molecular weight, pI, and content and composition of the carbohydrate component), for kinetic studies, and for antibacterial tests. Gene expression and immunohistochemical detection of the inhibitor were analyzed in the testis, epididymis, and ductus deferens. The inhibitor with a high molecular weight from turkey seminal plasma was identified as an ovoinhibitor, which was found in avian semen for the first time. The turkey seminal plasma ovoinhibitor was a six-tandem homologous Kazal-type domain serine proteinase inhibitor that targeted multiple proteases, including subtilisin, trypsin, and elastase, but not acrosin. Our results suggested that hepatocyte growth factor activator was a potential target proteinase for the ovoinhibitor in turkey seminal plasma. The presence of the ovoinhibitor within the turkey reproductive tract suggested that its role was to maintain a microenvironment for sperm in the epididymis and ductus deferens. The turkey seminal plasma ovoinhibitor appeared to play a significant role in an antibacterial semen defense against Bacillus subtilis and Staphylococcus aureus.

  14. 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

  15. 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

  16. Estudo do sonograma do ducto venoso em fetos com centralização hemodinâmica: avaliação de repercussões perinatais Study of ductus venosus in fetuses with brain sparing reflex: evaluation of perinatal outcomes

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Nassar de Carvalho

    2006-04-01

    Full Text Available OBJETIVO: avaliar a associação da relação sístole ventricular/atrial (S/A do ducto venoso (DV com resultados perinatais em fetos prematuros com centralização de fluxo à dopplervelocimetria. MÉTODOS: o estudo foi delineado como um estudo observacional, transversal, com os dados colhidos de forma prospectiva. A relação S/A do DV foi estudada em 41 fetos centralizados com idade gestacional (IG entre 25 e 33ª semana completa, no período de novembro de 2002 a julho de 2005. Os recém-nascidos foram acompanhados até o 28º dia pós-parto na UTI da Clínica Perinatal Laranjeiras, buscando-se complicações neonatais. A população de estudo foi dividida em dois grupos a partir do resultado do DV. Foram incluídos no grupo normal os fetos com relação S/A menor ou igual a 3,6 e no grupo alterado aqueles com valores de S/A maiores que 3,6. A comparação entre os grupos foi realizada com os testes estatísticos de Mann-Whitney, chi2 e exato de Fisher. Todos os resultados foram considerados estatisticamente significativos se p3,6. Não houve diferença significativa entre os grupos quanto à IG ao nascimento e Apgar PURPOSE: to evaluate the relationship between S/A ratio in ductus venosus (DV and perinatal outcomes in fetuses with brain sparing reflex. METHODS: the study was designed as an observational, sectional study with prospectively collected data. Forty-one fetuses with brain sparing reflex and gestational age between 25 and 33 weeks were studied between November 2002 and July 2005. The newborns were observed during the neonatal period in the intensive care unit of "Clínica Perinatal Laranjeiras" in order to find adverse outcomes. The study population was divided into two groups according to DV assessment. In the normal group all the fetuses with S/A ratio values of 3.6 or less were included, and in the abnormal group the fetuses with values of S/A ratio greater than 3.6. The statistical analysis was performed by the Mann-Whitney U

  17. 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

  18. Human microbiomics

    OpenAIRE

    Rajendhran, J.; P. Gunasekaran

    2010-01-01

    The sequencing of the human genome has driven the study of human biology in a significant way and enabled the genome-wide study to elucidate the molecular basis of complex human diseases. Recently, the role of microbiota on human physiology and health has received much attention. The influence of gut microbiome (the collective genomes of the gut microbiota) in obesity has been demonstrated, which may pave the way for new prophylactic and therapeutic strategies such as bacteriotherapy. The sig...

  19. 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.

  20. 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.

  1. Human Smuggling

    NARCIS (Netherlands)

    Siegel - Rozenblit, Dina; Zaitch, Damian

    2014-01-01

    Human smuggling is based on a consensus between smuggler, smuggled, and his/her family (which usually guarantees or effectuates payment). However, unauthorized immigrants are violating immigration laws and human smugglers are profiting from enabling illegal immigration. Both human smuggling and its

  2. Human Rights/Human Needs.

    Science.gov (United States)

    Canning, Cynthia

    1978-01-01

    The faculty of Holy Names High School developed an interdisciplinary human rights program with school-wide activities focusing on three selected themes: the United Nations Universal Declaration of Human Rights, in conjunction with Human Rights Week; Food; and Women. This article outlines major program activities. (SJL)

  3. Digital Humanities

    DEFF Research Database (Denmark)

    Brügger, Niels

    2016-01-01

    the humanities for decades, starting with research fields such as humanities computing or computational linguistics in the 1950s, and later new media studies and internet studies. The historical development of digital humanities has been characterized by a focus on three successive, but co-existing types......Digital humanities is an umbrella term for theories, methodologies, and practices related to humanities scholarship that use the digital computer as an integrated and essential part of its research and teaching activities. The computer can be used for establishing, finding, collecting......, and preserving material to study, as an object of study in its own right, as an analytical tool, or for collaborating, and for disseminating results. The term "digital humanities" was coined around 2001, and gained currency within academia in the following years. However, computers had been used within...

  4. Human Rights, Human Needs, Human Development, Human Security - Relationships between four international human discourses.

    NARCIS (Netherlands)

    D.R. Gasper (Des)

    2007-01-01

    markdownabstractAbstract: Human rights, human development and human security form increasingly important, partly interconnected, partly competitive and misunderstood ethical and policy discourses. Each tries to humanize a pre-existing and unavoidable major discourse of everyday life, policy and

  5. Human Rights and Human Nature

    Directory of Open Access Journals (Sweden)

    Vittorio Possenti

    2013-11-01

    Full Text Available There seems to be two different versions of human rights in Western tradition: say Rationalistic and Christian; the former adopted in revolutionary France, the latter highly developed in Renaissance Spain. Current relativistic criticisms attempt to deny the universality of human rights alleging that this theory has been created in Western countries or it has no strong justification, and therefore cannot have universal approach; but this objection can be dismissed with an alternative justification of human rights.

  6. Human kapital

    DEFF Research Database (Denmark)

    Grosen, Anders; Nielsen, Peder Harbjerg

    2007-01-01

    finansiel og human kapital. Den traditionelle rådgivnings snævre synsvinkel kan føre til forkerte investeringsråd. Der skal derfor opfordres til, at de finansielle virksomheder i tilrettelæggelsen af deres rådgivning af private kunder systematisk inddrager den humane kapitals størrelse og karakteristika i...

  7. Human trichuriasis

    DEFF Research Database (Denmark)

    Betson, Martha; Søe, Martin Jensen; Nejsum, Peter

    2015-01-01

    Human trichuriasis is a neglected tropical disease which affects hundreds of millions of people worldwide and is particularly prevalent among children living in areas where sanitation is poor. This review examines the current knowledge on the taxonomy, genetics and phylogeography of human Trichuris...

  8. Think Human

    DEFF Research Database (Denmark)

    Nielsen, Charlotte Marie Bisgaard

    2013-01-01

    years' campaigns suggests that the theory of communication underlying the campaign has its basis in mechanical action rather than in human communication. The practice of 'Communication design' is investigated in relation to this metaphorical 'machine thinking' model of communication and contrasted...... with the human-centered theory of communication advocated by integrationism....

  9. Human evolution

    DEFF Research Database (Denmark)

    Llamas, Bastien; Willerslev, Eske; Orlando, Ludovic Antoine Alexandre

    2017-01-01

    , and true population genomic studies of Bronze Age populations. Among the emerging areas of aDNA research, the analysis of past epigenomes is set to provide more new insights into human adaptation and disease susceptibility through time. Starting as a mere curiosity, ancient human genetics has become...

  10. Think Human

    DEFF Research Database (Denmark)

    Nielsen, Charlotte Marie Bisgaard

    2013-01-01

    years' campaigns suggests that the theory of communication underlying the campaign has its basis in mechanical action rather than in human communication. The practice of 'Communication design' is investigated in relation to this metaphorical 'machine thinking' model of communication and contrasted...... with the human-centered theory of communication advocated by integrationism....

  11. Teaching humanism.

    Science.gov (United States)

    Stern, David T; Cohen, Jordan J; Bruder, Ann; Packer, Barbara; Sole, Allison

    2008-01-01

    As the "passion that animates authentic professionalism," humanism must be infused into medical education and clinical care as a central feature of medicine's professionalism movement. In this article, we discuss a current definition of humanism in medicine. We will also provide detailed descriptions of educational programs intended to promote humanism at a number of medical schools in the United States (and beyond) and identify the key factors that make these programs effective. Common elements of programs that effectively teach humanism include: (1) opportunities for students to gain perspective in the lives of patients; (2) structured time for reflection on those experiences; and (3) focused mentoring to ensure that these events convert to positive, formative learning experiences. By describing educational experiences that both promote and sustain humanism in doctors, we hope to stimulate the thinking of other medical educators and to disseminate the impact of these innovative educational programs to help the profession meet its obligation to provide the public with humanistic physicians.

  12. Predictive value of nuchal translucency thickness and blood flow spectrum of ductus venous for fetal congenital cardiac malformation in early pregnancy%孕早期胎儿颈项透明层厚度联合静脉导管频谱对先天性心脏畸形的预测价值

    Institute of Scientific and Technical Information of China (English)

    朱银娣; 顾欣贤; 郭亮; 夏飞

    2016-01-01

    Objective To investigate the clinical application value of increased nuchal translucency (NT) thick-ness and abnormal blood flow spectrum of ductus venosus (DV) in predicting congenital heart disease (CHD) in early pregnancy. Methods From January 2012 to June 2015, fetal regular DV and NT measurements were performed on 1 996 pregnant women within 11~13+6 gestational weeks. The fetuses were followed up, and the relationship between DV, NT and CHD was analyzed. Results The incidence of CHD in fetuses with increased NT thickness was 12.9%(18/140), which was significantly higher than 0.2%(4/1 856) of fetuses with normal NT (P<0.01). The diagnostic sensitivity and specificity were 81.8%, 93.8%, and the positive predictive rate and negative predictive rate were 12.8%, 99.8%. The inci-dence of CHD in fetuses with abnormal DV was 12.3%(19/154), which was significantly higher than 0.2%(3/1 842) of fetuses with normal DV (P<0.01). The diagnostic sensitivity and specificity were 86.4%, 93.2%, and the positive pre-dictive rate and negative predictive rate were 12.3%, 99.8%. The incidence of CHD in fetuses with increased NT thickness and abnormal DV was 26.4%(14/53), which was significantly higher than 0.1% (2/1 894) of fetuses with normal NT and DV (P<0.01). The diagnostic sensitivity and specificity were 87.5%, 98.0%, and the positive predic-tive rate and negative predictive rate were 26.4%, 88.9%. Conclusion Increased NT thickness and abnormal blood flow spectrum of DV can be used as early screening indexes for fetal congenital cardiac malformation in early pregnancy.%目的:探讨孕早期胎儿颈项透明层厚度(NT)及胎儿静脉导管血流频谱(DV)对胎儿先天性心脏畸形(CHD)的临床预测价值。方法筛查对象为1996例于2012年1月至2015年6月间就诊于我院的孕妇,在孕11~13+6周测量NT值及DV频谱,并对胎儿进行随访,分析NT和DV与胎儿先天性心脏畸形之间的关系。结果 NT增厚的胎儿CHD的发生率为12

  13. Human Computation

    CERN Document Server

    CERN. Geneva

    2008-01-01

    What if people could play computer games and accomplish work without even realizing it? What if billions of people collaborated to solve important problems for humanity or generate training data for computers? My work aims at a general paradigm for doing exactly that: utilizing human processing power to solve computational problems in a distributed manner. In particular, I focus on harnessing human time and energy for addressing problems that computers cannot yet solve. Although computers have advanced dramatically in many respects over the last 50 years, they still do not possess the basic conceptual intelligence or perceptual capabilities...

  14. Practicing Humanities

    DEFF Research Database (Denmark)

    Gimmler, Antje

    2016-01-01

    In contemporary societies, the humanities are under constant pressure and have to justify their existence. In the ongoing debates, Humboldt’s ideals of ‘Bildung’ and ‘pure science’ are often used to justify the unique function of the humanities of ensuring free research and contributing to a vital...... philosophy. Contrary to Humboldt’s idea that the non-practical is the most practical in the long run, philosophical pragmatism recommends to the humanities to situate knowledge in practices and apply knowledge to practices....

  15. Human Toxicity

    DEFF Research Database (Denmark)

    Jolliet, Olivier; Fantke, Peter

    2015-01-01

    This chapter reviews the human toxicological impacts of chemicals and how to assess these impacts in life cycle impact assessment (LCIA), in order to identify key processes and pollutants. The complete cause-effect pathway – from emissions of toxic substances up to damages on human health...... on characterisation factors means that results should by default be reported and interpreted in log scales when comparing scenarios or substance contribution! We conclude by outlining future trends in human toxicity modelling for LCIA, with promising developments for (a) better estimates of degradation halflives, (b......) the inclusion of ionization of chemicals in human exposure including bioaccumulation, (c) metal speciation, (d) spatialised models to differentiate the variability associated with spatialisation from the uncertainty, and (e) the assessment of chemical exposure via consumer products and occupational settings...

  16. Human Toxicity

    DEFF Research Database (Denmark)

    Jolliet, Olivier; Fantke, Peter

    2015-01-01

    . The first section of this chapter outlines the complete cause-effect pathway, from emissions of toxic substances to intake by the population up to damages in terms of human health effects. Section 2 outlines the framework for assessing human toxicity in LCIA. Section 3 discusses the contributing substances......This chapter reviews the human toxicological impacts of chemicals and how to assess these impacts in life cycle impact assessment (LCIA), in order to identify key processes and pollutants. The complete cause-effect pathway – from emissions of toxic substances up to damages on human health...... – demonstrates the importance to account for both outdoor and indoor exposure, including consumer products. Analysing the variations in intake fraction (the fraction of the emitted or applied chemical that is taken in by the consumer and the general population), effect factor and characterisation factor across...

  17. Human influences

    NARCIS (Netherlands)

    Lanen, van H.A.J.; Kasparek, L.; Novicky, O.; Querner, E.P.; Fendeková, M.; Kupczyk, E.

    2004-01-01

    Human activities can cause drought, which was not previously reported (man-induced hydrological drought). Groundwater abstractions for domestic and industrial use are a well-known example of such an environmental change

  18. Human phantom

    CERN Multimedia

    CERN PhotoLab

    1973-01-01

    This human phantom has been received by CERN on loan from the State Committee of the USSR for the Utilization of Atomic Energy. It is used by the Health Physics Group to study personel radiation doses near the accelerators.

  19. Human expunction

    Science.gov (United States)

    Klee, Robert

    2017-10-01

    Thomas Nagel in `The Absurd' (Nagel 1971) mentions the future expunction of the human species as a `metaphor' for our ability to see our lives from the outside, which he claims is one source of our sense of life's absurdity. I argue that the future expunction (not to be confused with extinction) of everything human - indeed of everything biological in a terran sense - is not a mere metaphor but a physical certainty under the laws of nature. The causal processes by which human expunction will take place are presented in some empirical detail, so that philosophers cannot dismiss it as merely speculative. I also argue that appeals to anthropic principles or to forms of mystical cosmology are of no plausible avail in the face of human expunction under the laws of physics.

  20. Human babesiosis.

    Science.gov (United States)

    Rożej-Bielicka, Wioletta; Stypułkowska-Misiurewicz, Hanna; Gołąb, Elżbieta

    2015-01-01

    Babesiosis is an emerging parasitic, anthropo-zoonotic tick-borne disease, seldom diagnosed in humans. Caused by Protozoa, Babesia (also called Piroplasma) intraerytrocytic piriform microorganism. Infection of vertebrates is transmitted by ticks. Out of more than 100 Babesia species/genotypes described so far, only some were diagnosed in infected humans, mostly B. microti, B. divergens and B. venatorum (Babesia sp. EU1). Infection in humans is often asymptomatic or mild but is of a particular risk for asplenic individuals, those with congenital or acquired immunodeficiencies, and elderly. Infections transmitted with blood and blood products raise concerns in hemotherapy. Epidemiological situation of babesiosis varies around the world. In Europe, no increase in the number of cases was reported, but in the USA its prevalence is increasing and extension of endemic areas is observed. The aim of this publication is to describe the problems connected with the current epidemiological situation, diagnosis and treatment of human babesiosis with regard to clinical status of patients.

  1. Human energy

    OpenAIRE

    2010-01-01

    In the midst of big-oil record profits and growing debate on global warming, the Chevron Corporation launched its “Human Energy” public relations campaign. In television commercials and print advertisements, Chevron portrays itself as a compassionate entity striving to solve the planet’s energy crisis. Yet, the first term in this corporate oxymoron misleadingly reframes the significance of the second, suggesting that the corporation has a renewed focus. In depicting Chevron as a green/human o...

  2. Human Echolocation

    OpenAIRE

    Teng, Santani

    2013-01-01

    The use of active natural echolocation as a mobility aid for blind humans has received increased scientific and popular attention in recent years (Engber, 2006; Kreiser, 2006; NPR, 2011), in part due to a focus on several blind individuals who have developed remarkable expertise. However, perhaps surprisingly, the history of empirical human echolocation research is not much younger than the era of echolocation research (cf. Griffin, 1958). Nevertheless, compared to its bat and cetacean count...

  3. Human ehrlichiosis

    Directory of Open Access Journals (Sweden)

    Đokić Milomir

    2006-01-01

    Full Text Available Background. Human ehrlichiosis is a newly recognized disease. It is a tick-borne disease caused by several bacterial species of the genhus Erlichia. These are small gram-negative pleomorphic cocci, that are obligatory intracellular bacteria. Tick Ixodes is the principle vector in Europe, and Amblyomma americanum in the United States. Bacterial organisms replicate in a tick, and are transmited from infected cells in a vector to the blood cells of animals or humans. Human ehrlichiosis is a name for a group of diseases caused by different species of Ehrlichia. One of them is the disease named human monocytic ehrlichiosis, caused by Ehrlichia chaffeensis, and the other is a human granulocytic ehrlichiosis caused by Anaplasma phagocytophilia. Case report. We reported a 23-year-old patient admitted for the clinical treatment with the symptoms of high febrility (above 40 °C, headache, vomiting, general weakness and exhaustion, but without data on a tick bite. The patient was treated with trimetoprim-sulfamethoxazole for a week when Ehrlichia chaffeensis was confirmed by the immunofluoroscence test, and the therapy contimed with doxacyclin. Conclusion. Human ehrlichiosis is also present in our country, so this disease should be considered everyday, especially in infectology practice.

  4. [Human influenza].

    Science.gov (United States)

    Stock, Ingo

    2006-10-01

    Human influenza is one of the most common human infectious diseases, contributing to approximately one million deaths every year. In Germany, each year between 5.000 and 20.000 individuals die from severe influenza infections. In several countries, the morbidity and mortality of influenza is greatly underestimated. This is reflected by general low immunization rates. The emergence of avian influenza against the background of the scenario of a human influenza pandemic has revived public interest in the disease. According to the World Health Organisation, it is only the question on the beginning of a new influenza pandemic. The virus type of the new pandemic is still uncertain and it is also unclear, if a pandemic spread of the virus may be prevented by consistent controlling of avian influenza.

  5. [Humanized childbirth].

    Science.gov (United States)

    Kuo, Su-Chen

    2005-06-01

    Childbirth is a major event in a family. The expectant parent's perception of the childbirth experience influences his or her development as a parent. Making childbirth a positive and satisfying experience for women is the responsibility of health care providers. Women want to have physical and emotional privacy during labor and delivery, and to experience both in a friendly, comfortable environment. For women expected to undergo normal deliveries, humanized childbirth is one accessible approach. This article explores the definition and evolution of humanized childbirth and the care practice that it involves. It also explores birth plans and birth experiences, and the improvements necessary to routine labor practices to enable women to participate in decision making about their childbirth experiences. The author emphasizes that when health-care providers recognize the value of humanized childbirth and make changes accordingly, the dignity of women's childbirth experiences will be enhanced.

  6. Beyond Humanisms

    Directory of Open Access Journals (Sweden)

    Capurro, Rafael

    2012-01-01

    Full Text Available In the first part of this paper a short history of Western humanisms (Socrates, Pico della Mirandola, Descartes, Kant is presented. As far as these humanisms rest on a fixation of the ‘humanum’ they are metaphysical, although they might radically differ from each other. The second part deals with the present debate on trans- and posthumanism in the context of some breath-taking developments in science and technology.Angeletics, a theory of messengers and messages, intends to give an answer to the leading question of this paper, namely: ‘what does it mean to go beyond humanisms?’ The conclusion exposes briefly an ethics of hospitality and care from an angeletic perspective.

  7. Feasibility of quantification of the distribution of blood flow in the normal human fetal circulation using CMR: a cross-sectional study.

    Science.gov (United States)

    Seed, Mike; van Amerom, Joshua F P; Yoo, Shi-Joon; Al Nafisi, Bahiyah; Grosse-Wortmann, Lars; Jaeggi, Edgar; Jansz, Michael S; Macgowan, Christopher K

    2012-11-26

    We present the first phase contrast (PC) cardiovascular magnetic resonance (CMR) measurements of the distribution of blood flow in twelve late gestation human fetuses. These were obtained using a retrospective gating technique known as metric optimised gating (MOG). A validation experiment was performed in five adult volunteers where conventional cardiac gating was compared with MOG. Linear regression and Bland Altman plots were used to compare MOG with the gold standard of conventional gating. Measurements using MOG were then made in twelve normal fetuses at a median gestational age of 37 weeks (range 30-39 weeks). Flow was measured in the major fetal vessels and indexed to the fetal weight. There was good correlation between the conventional gated and MOG measurements in the adult validation experiment (R=0.96). Mean flows in ml/min/kg with standard deviations in the major fetal vessels were as follows: combined ventricular output (CVO) 540 ± 101, main pulmonary artery (MPA) 327 ± 68, ascending aorta (AAo) 198 ± 38, superior vena cava (SVC) 147 ± 46, ductus arteriosus (DA) 220 ± 39,pulmonary blood flow (PBF) 106 ± 59,descending aorta (DAo) 273 ± 85, umbilical vein (UV) 160 ± 62, foramen ovale (FO)107 ± 54. Results expressed as mean percentages of the CVO with standard deviations were as follows: MPA 60 ± 4, AAo37 ± 4, SVC 28 ± 7, DA 41 ± 8, PBF 19 ± 10, DAo50 ± 12, UV 30 ± 9, FO 21 ± 12. This study demonstrates how PC CMR with MOG is a feasible technique for measuring the distribution of the normal human fetal circulation in late pregnancy. Our preliminary results are in keeping with findings from previous experimental work in fetal lambs.

  8. Human Rights, Human Needs, Human Development, Human Security : Relationships between four international 'human' discourses

    NARCIS (Netherlands)

    D.R. Gasper (Des)

    2007-01-01

    textabstractHuman rights, human development and human security form increasingly important, partly interconnected, partly competitive and misunderstood ethical and policy discourses. Each tries to humanize a pre-existing and unavoidable major discourse of everyday life, policy and politics; each

  9. Nothing Human

    Science.gov (United States)

    Wharram, C. C.

    2014-01-01

    In this essay C. C. Wharram argues that Terence's concept of translation as a form of "contamination" anticipates recent developments in philosophy, ecology, and translation studies. Placing these divergent fields of inquiry into dialogue enables us read Terence's well-known statement "I am a human being--I deem nothing…

  10. Human Trafficking

    Science.gov (United States)

    Wilson, David McKay

    2011-01-01

    The shadowy, criminal nature of human trafficking makes evaluating its nature and scope difficult. The U.S. State Department and anti-trafficking groups estimate that worldwide some 27 million people are caught in a form of forced servitude today. Public awareness of modern-day slavery is gaining momentum thanks to new abolitionist efforts. Among…

  11. Human waste

    NARCIS (Netherlands)

    Amin, Md Nurul; Kroeze, Carolien; Strokal, Maryna

    2017-01-01

    Many people practice open defecation in south Asia. As a result, lot of human waste containing nutrients such as nitrogen (N) and phosphorus (P) enter rivers. Rivers transport these nutrients to coastal waters, resulting in marine pollution. This source of nutrient pollution is, however, ignored in

  12. Nothing Human

    Science.gov (United States)

    Wharram, C. C.

    2014-01-01

    In this essay C. C. Wharram argues that Terence's concept of translation as a form of "contamination" anticipates recent developments in philosophy, ecology, and translation studies. Placing these divergent fields of inquiry into dialogue enables us read Terence's well-known statement "I am a human being--I deem nothing…

  13. Practicing Humanities

    DEFF Research Database (Denmark)

    Gimmler, Antje

    2016-01-01

    and self-reflective democracy. Contemporary humanities have adopted a new orientation towards practices, and it is not clear how this fits with the ideals of ‘Bildung’ and ‘pure science’. A possible theoretical framework for this orientation towards practices could be found in John Dewey’s pragmatic...

  14. Human Rights in the Humanities

    Science.gov (United States)

    Harpham, Geoffrey

    2012-01-01

    Human rights are rapidly entering the academic curriculum, with programs appearing all over the country--including at Duke, Harvard, Northeastern, and Stanford Universities; the Massachusetts Institute of Technology; the Universities of Chicago, of Connecticut, of California at Berkeley, and of Minnesota; and Trinity College. Most of these…

  15. Human Rights in the Humanities

    Science.gov (United States)

    Harpham, Geoffrey

    2012-01-01

    Human rights are rapidly entering the academic curriculum, with programs appearing all over the country--including at Duke, Harvard, Northeastern, and Stanford Universities; the Massachusetts Institute of Technology; the Universities of Chicago, of Connecticut, of California at Berkeley, and of Minnesota; and Trinity College. Most of these…

  16. Digital Humanities

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørn

    2015-01-01

    Artiklen præsenterer først nogle generelle problemstillinger omkring Digital Humanities (DH) med det formål at undersøge dem nærmere i relation til konkrete eksempler på forskellige digitaliseringsmåder og ændringer i dokumentproduktion. I en nærmere afgrænsning vælger artiklen den tendens i DH...

  17. Human paleoneurology

    CERN Document Server

    2015-01-01

    The book presents an integrative review of paleoneurology, the study of endocranial morphology in fossil species. The main focus is on showing how computed methods can be used to support advances in evolutionary neuroanatomy, paleoanthropology and archaeology and how they have contributed to creating a completely new perspective in cognitive neuroscience. Moreover, thanks to its multidisciplinary approach, the book addresses students and researchers approaching human paleoneurology from different angles and for different purposes, such as biologists, physicians, anthropologists, archaeologists

  18. Digital Humanities

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørn

    2015-01-01

    Artiklen præsenterer først nogle generelle problemstillinger omkring Digital Humanities (DH) med det formål at undersøge dem nærmere i relation til konkrete eksempler på forskellige digitaliseringsmåder og ændringer i dokumentproduktion. I en nærmere afgrænsning vælger artiklen den tendens i DH...

  19. Human universe

    CERN Document Server

    Cox, Brian

    2014-01-01

    Human life is a staggeringly strange thing. On the surface of a ball of rock falling around a nuclear fireball in the blackness of a vacuum the laws of nature conspired to create a naked ape that can look up at the stars and wonder where it came from. What is a human being? Objectively, nothing of consequence. Particles of dust in an infinite arena, present for an instant in eternity. Clumps of atoms in a universe with more galaxies than people. And yet a human being is necessary for the question itself to exist, and the presence of a question in the universe - any question - is the most wonderful thing. Questions require minds, and minds bring meaning. What is meaning? I don't know, except that the universe and every pointless speck inside it means something to me. I am astonished by the existence of a single atom, and find my civilisation to be an outrageous imprint on reality. I don't understand it. Nobody does, but it makes me smile. This book asks questions about our origins, our destiny, and our place i...

  20. Human Capital, (Human) Capabilities and Higher Education

    Science.gov (United States)

    Le Grange, L.

    2011-01-01

    In this article I initiate a debate into the (de)merits of human capital theory and human capability theory and discuss implications of the debate for higher education. Human capital theory holds that economic growth depends on investment in education and that economic growth is the basis for improving the quality of human life. Human capable…

  1. Human Capital, (Human) Capabilities and Higher Education

    Science.gov (United States)

    Le Grange, L.

    2011-01-01

    In this article I initiate a debate into the (de)merits of human capital theory and human capability theory and discuss implications of the debate for higher education. Human capital theory holds that economic growth depends on investment in education and that economic growth is the basis for improving the quality of human life. Human capable…

  2. Interaction of indomethacin with adult human albumin and neonatal serum

    DEFF Research Database (Denmark)

    Honoré, B; Brodersen, R; Robertson, A

    1983-01-01

    The binding of indomethacin to albumin was investigated at 37 degrees C, pH 7.4. The first stoichiometric binding constant is 2.5 X 10(5) M-1. Indomethacin utilizes both the bilirubin and diazepam binding functions equally. The effect on bilirubin binding to albumin is negligible at therapeutic i...... no significant correlation of the reserve binding to the albumin level. This methodology may be useful in studying the variable response of infants with patent ductus arteriosus to indomethacin. Udgivelsesdato: 1983-null...

  3. Humanizing Architecture

    DEFF Research Database (Denmark)

    Toft, Tanya Søndergaard

    2015-01-01

    The article proposes the urban digital gallery as an opportunity to explore the relationship between ‘human’ and ‘technology,’ through the programming of media architecture. It takes a curatorial perspective when proposing an ontological shift from considering media facades as visual spectacles...... agency and a sense of being by way of dematerializing architecture. This is achieved by way of programming the symbolic to provide new emotional realizations and situations of enlightenment in the public audience. This reflects a greater potential to humanize the digital in media architecture....

  4. Human steroidogenesis

    DEFF Research Database (Denmark)

    Andersen, Claus Y; Ezcurra, Diego

    2014-01-01

    steroid concentrations cause alterations in endometrial development, affecting oocyte viability in assisted reproductive technology. Furthermore, it has been proposed that elevated progesterone levels have a negative effect on the reproductive outcome of COS. This may arise from an asynchrony between...... reviews current knowledge of the regulation of progesterone in the human ovary during the follicular phase and highlights areas where knowledge remains limited. In this review, we provide in-depth information outlining the regulation and function of gonadotropins in the complicated area of steroidogenesis...

  5. Humanizing Architecture

    DEFF Research Database (Denmark)

    Toft, Tanya Søndergaard

    2015-01-01

    The article proposes the urban digital gallery as an opportunity to explore the relationship between ‘human’ and ‘technology,’ through the programming of media architecture. It takes a curatorial perspective when proposing an ontological shift from considering media facades as visual spectacles...... agency and a sense of being by way of dematerializing architecture. This is achieved by way of programming the symbolic to provide new emotional realizations and situations of enlightenment in the public audience. This reflects a greater potential to humanize the digital in media architecture....

  6. Analysis of blood flow parameters in pre-eclampsia fetal ductus venous, umbilical vein,umbilical artery and middle cerebral artery for predicting perinatal outcome%子痫前期胎儿静脉导管、脐静脉和脐动脉及大脑中动脉血流检测对围生儿预后的预测分析

    Institute of Scientific and Technical Information of China (English)

    李建华; 刘姿; 林珏瑛; 周莹莹; 吴曙粤

    2016-01-01

    测不良出生结局的指标,若结合脐动脉血流频谱进行联合分析,可更准确地评估胎儿宫内状况。%Objective To explore the value of the blood flow in pre-eclampsia fetal ductus venous(DV),umbilical vein (UV),umbilical artery(UA) and middle cerebral artery(MCA)in predicting adverse perinatal outcome. Methods Color Doppler ultrasound was used to measure the blood flow parameters of fetal DV,UV,UA and MCA in 65 cases of preeclampsia women(32 cases of slight preeclampsia group and 33 cases of severe preeclampsia group) and 65 normal pregnant women(contrast group). The blood flow parameters included:peak velocity during ventricular systole(S),peak velocity during ventricular diastole(D), highest velocity during atrial contraction(A) and mean velocity(Vmean), preload index(PLI),venous peak velocity index (PVIV),venous pulsation index (PIV),S/A,the shunt ratio of umbilical vein (Qdv/Quv),the resistance index(RI),pulsatility index (PI)and S/D of the umbilical artery and middle cerebral artery. The perinatal outcome,birth weight,Apgar scores,saturation of blood oxygen of umbilical artery,pH value of umbilical vein were compared. The relationship between the parameters and the fetal adverse prognosis situation was analyzed. Results There were significant differences of PLI,PVIV,PIV and Qdv/Quv between severe preeclampsia group,slight preeclampsia group and group(all P<0.05). Compared with UA and MCA, DV,PIV, Qdv/Quv could predict the adverse birth outcome earlier(all P<0.05). Ductus venous PLI,PVIV,PIV,S/A,Qdv/Quv of DV and RI,PI,S/D of UA had better prediction for the perinatal adverse birth outcome(all P<0.05). There was significant difference of birth weight , Apgar scores , saturation of blood oxygen of UA , pH value of umbilical vein between the groups(all P<0 . 05). Conclusion DV,umbilical venous flow spectrum could reflects pre-eclampsia fetal status and predict adverse outcome,and it can be used as indicator to predict adverse birth outcome

  7. Human Toxocariasis

    Directory of Open Access Journals (Sweden)

    Mehmet Burak Selek

    2013-09-01

    Full Text Available Human toxocariasis is an parasitic infection caused by the ingestion of larvae of dog nematode Toxocara canis and less frequently of cat nematode T.cati. Toxocara eggs, shed to environment by infected dogs' and cats' droppings, become infective by embryonation. Humans, particularly children, can be infected by accidentally ingesting embryonated Toxocara eggs. Larvae hatch in the small intestine, penetrate the intestinal wall and migrate to other parts of body via the bloodstream. It is generally a benign, asymptomatic, and self-limiting disease, although migrating larvae can cause damage to tissues and organs, especially brain involvement can cause severe morbidity. The two main clinical presentations of toxocariasis are visceral larva migrans (VLM (a systemic disease caused by larval migration through major organs and ocular larva migrans (OLM (a disease limited to the eyes and optic nerves. There are also two less-severe syndromes which have recently been described, one mainly in children (covert toxocariasis and the other mainly in adults (common toxocariasis. Diagnosis is usually made by clinical signs/symptoms, epidemiological background of the patient and the use of immunological methods (ELISA or western-blot. On the other hand definitive diagnosis is much more challenging, since it requires the demonstration of larvae via biopsy or autopsy. Most cases of toxocariasis clear up without any treatment. VLM is primarily treated with antihelmintic drugs, such as; albendazole or mebendazole. Treatment of OLM is more difficult and usually consists of measures to prevent progressive damage to the eye like steroids. Laser photocoagulation and cryoretinopexy may also be used to treat severe cases. Since eradicating T.canis infection is difficult due to the complexity of its life cycle, prevention of toxocariasis is always preferred. Toxocara eggs have a strong protective layer which makes the eggs able to survive in the environment for months or

  8. A Review of Transplantation Practice of the Urologic Organs: Is It Only Achievable for the Kidney?

    Science.gov (United States)

    Donati-Bourne, Jack; Roberts, Harry W; Rajjoub, Yaseen; Coleman, Robert A

    2015-01-01

    Transplantation is a viable treatment option for failure of most major organs. Within urology, transplantation of the kidney and ureter are well documented; however, evidence supporting transplantation of other urologic organs is limited. Failure of these organs carries significant morbidity, and transplantation may have a role in management. This article reviews the knowledge, research, and literature surrounding transplantation of each of the urologic organs. Transplantation of the penis, testicle, urethra, vas deferens, and bladder is discussed. Transplantation attempts have been made individually with each of these organs. Penile transplantation has only been performed once in a human. Testicular transplantation research was intertwined with unethical lucrative pursuits. Interest in urethra, bladder, and vas deferens transplantation has decreased as a result of successful surgical reconstructive techniques. Despite years of effort, transplantations of the penis, testicle, urethra, vas deferens, and bladder are not established in current practice. Recent research has shifted toward techniques of reconstruction, tissue engineering, and regenerative medicine.

  9. Bilateral Gonadal Cysts and Late Diagnosis of Androgen Insensitivity Syndrome Treated by Laparoscopic Gonadectomy

    Directory of Open Access Journals (Sweden)

    D. Tourlakis

    2011-01-01

    Full Text Available Background. Complete androgen insensitivity syndrome is a rare syndrome in which the uterus is absent and testes rather than ovaries are present. Patients usually visit a gynecologist due to primary amenorrhea. Case. A forty-eight-year-old woman with lower abdominal pain and anamnesis of uterus agenesis was operated on due to bilateral cystic masses. A 5 × 3 × 1.2 cm left adnexal cyst revealed the presence of a serous cyst with a hypoplastic ductus deferens. A smaller cyst of the right adnexa revealed immature testis tissue with Leydig-cell hyperplasia. After karyotype and hormonal examinations, laparoscopic gonadectomy was performed. Conclusion. Attention should be paid in all cyst-removing operations in cases of uterus agenesis, due to the high incidence of malignancy. Not of less importance is the issue of informing the patient in the most appropriate way.

  10. AVALIAÇÃO MORFOLÓGICA DO SISTEMA REPRODUTOR MASCULINO DE Panthera tigris

    Directory of Open Access Journals (Sweden)

    Wesley Antunes Meireles

    2012-12-01

    Full Text Available The wild felines comprise one of the animal groups under the greates risk of extinction. This case report aimed to describe the morphology of the reproductive organs of a male, adult tiger (Panthera tigris that died during a surgical procedure. Fragments from scrotum, testis, epididymis, ductus deferens and penis were collected to macroscopic and microscopic analyses. Histologically, the reproductive organs were similar to other felines. The testis showed lateral asymmetry, with gonadosomatic index as 0.04, and the diameters presented by the seminiferous tubules and epididymal ducts were similar to those described for other species of wild felines. The penile urethra presented diameter of 1.73 mm and high caliber. The penis showed cornified papillae on the glans and other anatomical features described was similar to other felines.

  11. Modified-closed castration: a novel technique for sea otter (Enhydra lutris nereis) orchiectomies.

    Science.gov (United States)

    McDermott, Alexa J; Clauss, Tonya; Sakals, Sherisse; Mejia, Johanna; Radlinsky, MaryAnn G

    2013-09-01

    A novel surgical technique was used in the routine castrations of two intact male southern sea otters, Enhydra lutris nereis, housed at the Georgia Aquarium (Atlanta, Georgia, USA). This technique involved incising the parietal vaginal tunic to allow placement of double ligation of the ductus deferens, testicular artery, and pampiniform plexus en masse. After ligating and transecting these structures, they were introduced back into the tunic, which was closed with a circumferential ligature. The incision site was closed in a routine manner. Both otters recovered well from the procedure. One otter had mild cutaneous dehiscence postoperatively, and the other had no obvious complications. Benefits of this procedure include reduced risk of ligature slippage or loosening and resultant hemorrhage, as provided by the traditional open portion of the castration, and decreased postoperative swelling, as provided by the closed part of the castration. To the authors' knowledge, this is the first time this technique has been described for use in sea otters.

  12. Observations on the anterior testicular ducts in snakes with emphasis on sea snakes and ultrastructure in the yellow-bellied sea snake, Pelamis platurus.

    Science.gov (United States)

    Sever, David M; Freeborn, Layla R

    2012-03-01

    The anterior testicular ducts of squamates transport sperm from the seminiferous tubules to the ductus deferens. These ducts consist of the rete testis, ductuli efferentes, and ductus epididymis. Many histological and a few ultrastructural studies of the squamate reproductive tract exist, but none concern the Hydrophiidae, the sea snakes and sea kraits. In this study, we describe the anterior testicular ducts of six species of hydrophiid snakes as well as representatives from the Elapidae, Homolapsidae, Leptotyphlopidae, and Uropeltidae. In addition, we examine the ultrastructure of these ducts in the yellow-bellied Sea Snake, Pelamis platurus, only the third such study on snakes. The anterior testicular ducts are similar in histology in all species examined. The rete testis is simple squamous or cuboidal epithelium and transports sperm from the seminiferous tubules to the ductuli efferentes in the extratesticular epididymal sheath. The ductuli efferentes are branched, convoluted tubules composed of simple cuboidal, ciliated epithelium, and many species possess periodic acid-Schiff+ granules in the cytoplasm. The ductus epididymis at the light microscopy level appears composed of pseudostratified columnar epithelium. At the ultrastructural level, the rete testis and ductuli efferentes of P. platurus possess numerous small coated vesicles and lack secretory vacuoles. Apocrine blebs in the ductuli efferentes, however, indicate secretory activity, possibly by a constitutive pathway. Ultrastructure reveals three types of cells in the ductus epididymis of P. platurus: columnar principal cells, squamous basal cells, and mitochondria-rich apical cells. This is the first report of apical cells in a snake. In addition, occasional principal cells possess a single cilium, which has not been reported in reptiles previously but is known in some birds. Finally, the ductus epididymis of P. platurus differs from other snakes that have been studied in possession of apical, biphasic

  13. NATO Human View Architecture and Human Networks

    Science.gov (United States)

    Handley, Holly A. H.; Houston, Nancy P.

    2010-01-01

    The NATO Human View is a system architectural viewpoint that focuses on the human as part of a system. Its purpose is to capture the human requirements and to inform on how the human impacts the system design. The viewpoint contains seven static models that include different aspects of the human element, such as roles, tasks, constraints, training and metrics. It also includes a Human Dynamics component to perform simulations of the human system under design. One of the static models, termed Human Networks, focuses on the human-to-human communication patterns that occur as a result of ad hoc or deliberate team formation, especially teams distributed across space and time. Parameters of human teams that effect system performance can be captured in this model. Human centered aspects of networks, such as differences in operational tempo (sense of urgency), priorities (common goal), and team history (knowledge of the other team members), can be incorporated. The information captured in the Human Network static model can then be included in the Human Dynamics component so that the impact of distributed teams is represented in the simulation. As the NATO militaries transform to a more networked force, the Human View architecture is an important tool that can be used to make recommendations on the proper mix of technological innovations and human interactions.

  14. Effect of phenolic acids on functions of rat aorta, vas deferens and on metabolic changes in streptozotocin-induced diabetes

    Directory of Open Access Journals (Sweden)

    Nurcan Bektas

    2012-01-01

    Conclusions: It was concluded that p-OHBA, PA and GA may cause effects independently of their antioxidant effect and/or of diabeticcomplications. They may exhibit pro-oxidant activities in the experimental conditions applied.

  15. Cystic fibrosis transmembrane conductance regulator (CFTR gene abnormalities in Indian males with congenital bilateral absence of vas deferens & renal anomalies

    Directory of Open Access Journals (Sweden)

    Rahul Gajbhiye

    2016-01-01

    Results: Three potential regulatory CFTR gene variants (c.1540A>G, c.2694T>G and c.4521G>A were detected along with IVS8-5T mutation in three infertile males with CBAVD-URA. Five novel CFTR gene variants (c.621+91A>G, c.2752+106A>T, c.2751+85_88delTA, c.3120+529InsC and c.4375-69C>T, four potential regulatory CFTR gene variants (M470V, T854T, P1290P, Q1463Q and seven previously reported CFTR gene variants (c.196+12T>C, c.875+40A>G, c.3041-71G>C, c.3271+42A>T, c.3272-93T>C, c.3500-140A>C and c.3601-65C>A were detected in infertile men having CBAVD and renal anomalies Interpretation & conclusions: Based on our findings, we speculate that CBAVD-URA may also be attributed to CFTR gene mutations and can be considered as CFTR-related disorder (CFTR-RD. The CFTR gene mutation screening may be offered to CBAVD-URA men and their female partners undergoing ICSI. Further studies need to be done in a large sample to confirm the findings.

  16. [Human papillomaviruses].

    Science.gov (United States)

    Gross, G

    2003-10-01

    Human papillomaviruses (HPV) infect exclusively the basal cells of the skin and of mucosal epithelia adjacent to the skin such as the mouth, the upper respiratory tract, the lower genital tract and the anal canal. HPV does not lead to a viremia. Basically there are three different types of HPV infection: Clinically visible lesions, subclinical HPV infections and latent HPV infections. Distinct HPV types induce morphologically and prognostically different clinical pictures. The most common HPV associated benign tumor of the skin is the common wart. Infections of the urogenitoanal tract with specific HPV-types are recognised as the most frequent sexually transmitted viral infections. So-called "high-risk" HPV-types (HPV16, 18 and others) are regarded by the world health organisation as important risk-factors for the development of genital cancer (mainly cervical cancer), anal cancer and upper respiratory tract cancer in both genders. Antiviral substances with a specific anti-HPV effect are so far unknown. Conventional therapies of benign skin warts and of mucosal warts are mainly nonspecific. They comprise tissue-destroying therapies such as electrocautery, cryotherapy and laser. In addition cytotoxic substances such as podophyllotoxin and systemic therapy with retinoids are in use. Systemically and topically administered immunotherapies represent a new approach for treatment. Both interferons and particularly the recently developed imiquimod, an interferon-alpha and cytokine-inductor lead to better results and are better tolerated then conventional therapies. HPV-specific vaccines have been developed in the last 5 years and will be used in future for prevention and treatment of benign and malignant HPV-associated tumors of the genitoanal tract in both sexes.

  17. Human Development Report 1991: Financing Human Development

    OpenAIRE

    United Nations Development Programme, UNDP

    1991-01-01

    Lack of political commitment rather than financial resources is often the real barrier to human development. This is the main conclusion of Human Development Report 1991 - the second in a series of annual reports on the subject.

  18. The golden triangle of human dignity: human security, human development and human rights

    NARCIS (Netherlands)

    Gaay Fortman, B. de

    2004-01-01

    The success or failure of processes of democratization cannot be detached from processes of development related to the aspirations of people at the grassroots. Human rights, in a more theoretical terminology, require human development in order to enhance human security.

  19. Human-machine interactions

    Science.gov (United States)

    Forsythe, J. Chris; Xavier, Patrick G.; Abbott, Robert G.; Brannon, Nathan G.; Bernard, Michael L.; Speed, Ann E.

    2009-04-28

    Digital technology utilizing a cognitive model based on human naturalistic decision-making processes, including pattern recognition and episodic memory, can reduce the dependency of human-machine interactions on the abilities of a human user and can enable a machine to more closely emulate human-like responses. Such a cognitive model can enable digital technology to use cognitive capacities fundamental to human-like communication and cooperation to interact with humans.

  20. (Monogenea) parasitic in the anuran genus Kassina in South Africa

    African Journals Online (AJOL)

    70% iodine ethanol for 5 - 7 h, washed in 70% ethanol for. 24 h, stained in Borax ..... moving sperm were observed in the vas deferens and uterus. The penial crown bears 7 .... injected into the dorsal lymph sac with 30 LV. of human chorionic ...

  1. INTRAVASAL INJECTION OF FORMED-IN-PLACE MEDICAL GRADE SILICONE-RUBBER FOR VAS OCCLUSION

    NARCIS (Netherlands)

    SOEBADI, DM; GARDJITO, W; MENSINK, HJA

    This paper describes two consecutive studies: a volume study and an efficacy study. The volume study determined the appropriate volume of Medical Grade Silicone Rubber (MSR) needed to achieve complete occlusion of the vas deferens. This was done by in-vitro testing of 130 human vas specimens

  2. Applications of fatal ductus venosus pulsatility index of vein and hepatic artery pulsatility index in Down syn-drome screening for pregnant women at 11-13 +6 weeks%孕11~13+6周胎儿静脉导管搏动指数与肝动脉搏动指数在唐氏筛查中的应用价值

    Institute of Scientific and Technical Information of China (English)

    罗青; 万均辉; 戴常平; 肖清华; 江锦雄; 曹小祯

    2015-01-01

    目的:评价孕11~13+6周胎儿静脉导管搏动指数(DV-PIV)与肝动脉搏动指数(HA-PI)在唐氏早孕期联合筛查高风险孕妇中的应用价值。方法收集早孕期唐氏筛查高风险且颈项透明层( NT)测量值正常的单胎孕妇223例作为观察组,同时收集早孕期唐氏筛查低风险、NT测量值正常且与观察组年龄、孕周相似的孕妇252例作为对照组,比较两组间胎儿DV-PIV和HA-PI的差异,比较观察组唐氏胎儿与对照组胎儿DV-PIV和HA-PI的差异,并采用受试者特征曲线( ROC曲线)分析DV-PIV和HA-PI诊断21三体的价值。结果观察组胎儿DV-PIV显著高于对照组(P<0.05),而两组胎儿HA-PI差异无统计学意义(P>0.05);观察组唐氏胎儿DV-PIV显著高于对照组胎儿(P<0.05),而HA-PI显著低于对照组胎儿(P<0.05)。 ROC曲线显示,DV-PIV(截断值为2.1)用于预测21三体的敏感性为86.1%,特异性为96.2%;HA-PI(截断值为1.0)用于诊断21三体的敏感性为70.9%,特异性为94.1%。结论早孕期唐氏筛查中增加DV-PIV和HA-PI的检测可提高唐氏综合征筛查的准确性。%Objective To evaluate the applications of fatal ductus venosus pulsatility index of vein ( DV-PIV) and hepatic artery pulsatility index ( HA-PI) in Down syndrome screening for pregnant women at 11 -13 +6 weeks. Methods 223 women with singleton pregnancy with high risk for aneuploidy in combined screening test and normal nu-chal translucency ( NT) measurements were included as study group, and 252 women with similar age, gestational age, normal NT measurements and low-risk in first trimester combined tests were enrolled as control group.Fatal DV-PIV and HA-PI were compared between the two groups, while DV-PIV and HA-PI were compared between fetuses with Down syndrome in study group and fetuses in control group.Receiver operating characteristics ( ROC) curves

  3. Special Section: Human Rights

    Science.gov (United States)

    Frydenlund, Knut; And Others

    1978-01-01

    Eleven articles examine human rights in Europe. Topics include unemployment, human rights legislation, role of the Council of Europe in promoting human rights, labor unions, migrant workers, human dignity in industralized societies, and international violence. Journal available from Council of Europe, Directorate of Press and Information, 67006…

  4. Scalability of human models

    NARCIS (Netherlands)

    Rodarius, C.; Rooij, L. van; Lange, R. de

    2007-01-01

    The objective of this work was to create a scalable human occupant model that allows adaptation of human models with respect to size, weight and several mechanical parameters. Therefore, for the first time two scalable facet human models were developed in MADYMO. First, a scalable human male was

  5. Visualizing Humans by Computer.

    Science.gov (United States)

    Magnenat-Thalmann, Nadia

    1992-01-01

    Presents an overview of the problems and techniques involved in visualizing humans in a three-dimensional scene. Topics discussed include human shape modeling, including shape creation and deformation; human motion control, including facial animation and interaction with synthetic actors; and human rendering and clothing, including textures and…

  6. The Human/Machine Humanities: A Proposal

    Directory of Open Access Journals (Sweden)

    Ollivier Dyens

    2016-03-01

    Full Text Available What does it mean to be human in the 21st century? The pull of engineering on every aspect of our lives, the impact of machines on how we represent ourselves, the influence of computers on our understanding of free-will, individuality and species, and the effect of microorganisms on our behaviour are so great that one cannot discourse on humanity and humanities without considering their entanglement with technology and with the multiple new dimensions of reality that it opens up. The future of humanities should take into account AI, bacteria, software, viruses (both organic and inorganic, hardware, machine language, parasites, big data, monitors, pixels, swarms systems and the Internet. One cannot think of humanity and humanities as distinct from technology anymore.

  7. From Human Past to Human Future

    OpenAIRE

    Robert G. Bednarik

    2013-01-01

    This paper begins with a refutation of the orthodox model of final Pleistocene human evolution, presenting an alternative, better supported account of this crucial phase. According to this version, the transition from robust to gracile humans during that period is attributable to selective breeding rather than natural selection, rendered possible by the exponential rise of culturally guided volitional choices. The rapid human neotenization coincides with the development of numerous somatic an...

  8. ISS Payload Human Factors

    Science.gov (United States)

    Ellenberger, Richard; Duvall, Laura; Dory, Jonathan

    2016-01-01

    The ISS Payload Human Factors Implementation Team (HFIT) is the Payload Developer's resource for Human Factors. HFIT is the interface between Payload Developers and ISS Payload Human Factors requirements in SSP 57000. ? HFIT provides recommendations on how to meet the Human Factors requirements and guidelines early in the design process. HFIT coordinates with the Payload Developer and Astronaut Office to find low cost solutions to Human Factors challenges for hardware operability issues.

  9. Has Human Evolution Stopped?

    OpenAIRE

    TEMPLETON, Alan R

    2010-01-01

    It has been argued that human evolution has stopped because humans now adapt to their environment via cultural evolution and not biological evolution. However, all organisms adapt to their environment, and humans are no exception. Culture defines much of the human environment, so cultural evolution has actually led to adaptive evolution in humans. Examples are given to illustrate the rapid pace of adaptive evolution in response to cultural innovations. These adaptive responses have important ...

  10. Preference for human eyes in human infants.

    Science.gov (United States)

    Dupierrix, Eve; de Boisferon, Anne Hillairet; Méary, David; Lee, Kang; Quinn, Paul C; Di Giorgio, Elisa; Simion, Francesca; Tomonaga, Masaki; Pascalis, Olivier

    2014-07-01

    Despite evidence supporting an early attraction to human faces, the nature of the face representation in neonates and its development during the first year after birth remain poorly understood. One suggestion is that an early preference for human faces reflects an attraction toward human eyes because human eyes are distinctive compared with other animals. In accord with this proposal, prior empirical studies have demonstrated the importance of the eye region in face processing in adults and infants. However, an attraction for the human eye has never been shown directly in infants. The current study aimed to investigate whether an attraction for human eyes would be present in newborns and older infants. With the use of a preferential looking time paradigm, newborns and 3-, 6-, 9-, and 12-month-olds were simultaneously presented with a pair of nonhuman primate faces (chimpanzees and Barbary macaques) that differed only by the eyes, thereby pairing a face with original nonhuman primate eyes with the same face in which the eyes were replaced by human eyes. Our results revealed that no preference was observed in newborns, but a preference for nonhuman primate faces with human eyes emerged from 3months of age and remained stable thereafter. The findings are discussed in terms of how a preference for human eyes may emerge during the first few months after birth.

  11. Economics of human trafficking.

    Science.gov (United States)

    Wheaton, Elizabeth M; Schauer, Edward J; Galli, Thomas V

    2010-01-01

    Because freedom of choice and economic gain are at the heart of productivity, human trafficking impedes national and international economic growth. Within the next 10 years, crime experts expect human trafficking to surpass drug and arms trafficking in its incidence, cost to human well-being, and profitability to criminals (Schauer and Wheaton, 2006: 164-165). The loss of agency from human trafficking as well as from modern slavery is the result of human vulnerability (Bales, 2000: 15). As people become vulnerable to exploitation and businesses continually seek the lowest-cost labour sources, trafficking human beings generates profit and a market for human trafficking is created. This paper presents an economic model of human trafficking that encompasses all known economic factors that affect human trafficking both across and within national borders. We envision human trafficking as a monopolistically competitive industry in which traffickers act as intermediaries between vulnerable individuals and employers by supplying differentiated products to employers. In the human trafficking market, the consumers are employers of trafficked labour and the products are human beings. Using a rational-choice framework of human trafficking we explain the social situations that shape relocation and working decisions of vulnerable populations leading to human trafficking, the impetus for being a trafficker, and the decisions by employers of trafficked individuals. The goal of this paper is to provide a common ground upon which policymakers and researchers can collaborate to decrease the incidence of trafficking in humans.

  12. Human assisted robotic exploration

    Science.gov (United States)

    Files, B. T.; Canady, J.; Warnell, G.; Stump, E.; Nothwang, W. D.; Marathe, A. R.

    2016-05-01

    In support of achieving better performance on autonomous mapping and exploration tasks by incorporating human input, we seek here to first characterize humans' ability to recognize locations from limited visual information. Such a characterization is critical to the design of a human-in-the-loop system faced with deciding whether and when human input is useful. In this work, we develop a novel and practical place-recognition task that presents humans with video clips captured by a navigating ground robot. Using this task, we find experimentally that human performance does not seem to depend on factors such as clip length or familiarity with the scene and also that there is significant variability across subjects. Moreover, we find that humans significantly outperform a state-of-the-art computational solution to this problem, suggesting the utility of incorporating human input in autonomous mapping and exploration techniques.

  13. Human Use Index (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

  14. Human Papillomavirus (HPV) Vaccines

    Science.gov (United States)

    ... Directory Cancer Prevention Overview Research Human Papillomavirus (HPV) Vaccines On This Page What are human papillomaviruses? Which ... infections? Can HPV infections be prevented? What HPV vaccines are available? Who should get the HPV vaccines? ...

  15. Human Use Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

  16. Telling the Human Story.

    Science.gov (United States)

    Richardson, Miles

    1987-01-01

    Proposes that one of the fundamental human attributes is telling stories. Explores the debate on whether Neanderthals possessed language ability. Discusses the role of the "human story" in teaching anthropology. (DH)

  17. Human Services Offices

    Data.gov (United States)

    Fairfax County, Virginia — This data contains point features representing the human services offices within Fairfax County.“HS_Region” is the office for each human services region, “DFS_Area”...

  18. Human Resource Accounting System

    Science.gov (United States)

    Cerullo, Michael J.

    1974-01-01

    Main objectives of human resource accounting systems are to satisfy the informational demands made by investors and by operating managers. The paper's main concern is with the internal uses of a human asset system. (Author)

  19. The Growing Human Population.

    Science.gov (United States)

    Keyfitz, Nathan

    1989-01-01

    Discusses the issue of human population. Illustrates the projections of the growing human population in terms of developed and less developed countries. Describes the family planning programs in several countries. Lists three references for further reading. (YP)

  20. Human bites (image)

    Science.gov (United States)

    Human bites present a high risk of infection. Besides the bacteria which can cause infection, there is ... the wound extends below the skin. Anytime a human bite has broken the skin, seek medical attention.

  1. Monogenic human obesity syndromes

    National Research Council Canada - National Science Library

    Farooqi, I S; O'Rahilly, S

    2004-01-01

    .... This chapter will consider the human monogenic obesity syndromes that have been characterized to date and discuss how far such observations support the physiological role of these molecules in the regulation of human body weight and neuroendocrine function.

  2. Skin and the non-human human

    DEFF Research Database (Denmark)

    Rösing, Lilian Munk

    2013-01-01

    The article puts forward an aesthetic and psychoanalytic analysis of Titian's painting, The Flaying of Marsyas, arguing that the painting is a reflection on the human subject as a being constituted by skin and by a core of non-humanity. The analysis is partly an answer to Melanie Hart's (2007......) article 'Visualizing the mind: Looking at Titian's Flaying of Marsyas', addressing features of the painting not commented on by Hart, and supplementing Hart's (Kleinian) theoretical frame by involving Didier Anzieu's 'skin ego', Slavoj Zizek's concept of the 'non-human', Giorgio Agamben's term...

  3. Human productivity program definition

    Science.gov (United States)

    Cramer, D. B.

    1985-01-01

    The optimization of human productivity on the space station within the existing resources and operational constraints is the aim of the Human Productivity Program. The conceptual objectives of the program are as follows: (1) to identify long lead technology; (2) to identify responsibility for work elements; (3) to coordinate the development of crew facilities and activities; and (4) to lay the foundation for a cost effective approach to improving human productivity. Human productivity work elements are also described and examples are presented.

  4. Human Resource Management System

    OpenAIRE

    Navaz, A. S. Syed; Fiaz, A. S. Syed; Prabhadevi, C.; V.Sangeetha; Gopalakrishnan,S.

    2013-01-01

    The paper titled HUMAN RESOURCE MANAGEMENT SYSTEM is basically concerned with managing the Administrator of HUMAN RESOURCE Department in a company. A Human Resource Management System, refers to the systems and processes at the intersection between human resource management and information technology. It merges HRM as a discipline and in particular its basic HR activities and processes with the information technology field, whereas the programming of data processing systems evolved into standa...

  5. Human nature and enhancement.

    Science.gov (United States)

    Buchanan, Allen

    2009-03-01

    Appeals to the idea of human nature are frequent in the voluminous literature on the ethics of enhancing human beings through biotechnology. Two chief concerns about the impact of enhancements on human nature have been voiced. The first is that enhancement may alter or destroy human nature. The second is that if enhancement alters or destroys human nature, this will undercut our ability to ascertain the good because, for us, the good is determined by our nature. The first concern assumes that altering or destroying human nature is in itself a bad thing. The second concern assumes that human nature provides a standard without which we cannot make coherent, defensible judgments about what is good. I will argue (1) that there is nothing wrong, per se, with altering or destroying human nature, because, on a plausible understanding of what human nature is, it contains bad as well as good characteristics and there is no reason to believe that eliminating some of the bad would so imperil the good as to make the elimination of the bad impermissible, and (2) that altering or destroying human nature need not result in the loss of our ability to make judgments about the good, because we possess a conception of the good by which we can and do evaluate human nature. I will argue that appeals to human nature tend to obscure rather than illuminate the debate over the ethics of enhancement and can be eliminated in favor of more cogent considerations.

  6. Human Document Project

    NARCIS (Netherlands)

    Vries, de J.; Abelmann, L.; Manz, A.; Elwenspoek, M.C.

    2012-01-01

    “The Human Document Project” is a project which tries to answer all of the questions related to preserving information about the human race for tens of generations of humans to come or maybe even for a future intelligence which can emerge in the coming thousands of years. This document mainly focuss

  7. Has Human Evolution Stopped?

    Directory of Open Access Journals (Sweden)

    Alan R. Templeton

    2010-07-01

    Full Text Available It has been argued that human evolution has stopped because humans now adapt to their environment via cultural evolution and not biological evolution. However, all organisms adapt to their environment, and humans are no exception. Culture defines much of the human environment, so cultural evolution has actually led to adaptive evolution in humans. Examples are given to illustrate the rapid pace of adaptive evolution in response to cultural innovations. These adaptive responses have important implications for infectious diseases, Mendelian genetic diseases, and systemic diseases in current human populations. Moreover, evolution proceeds by mechanisms other than natural selection. The recent growth in human population size has greatly increased the reservoir of mutational variants in the human gene pool, thereby enhancing the potential for human evolution. The increase in human population size coupled with our increased capacity to move across the globe has induced a rapid and ongoing evolutionary shift in how genetic variation is distributed within and among local human populations. In particular, genetic differences between human populations are rapidly diminishing and individual heterozygosity is increasing, with beneficial health effects. Finally, even when cultural evolution eliminates selection on a trait, the trait can still evolve due to natural selection on other traits. Our traits are not isolated, independent units, but rather are integrated into a functional whole, so selection on one trait can cause evolution to occur on another trait, sometimes with mildly maladaptive consequences.

  8. Has human evolution stopped?

    Science.gov (United States)

    Templeton, Alan R

    2010-07-01

    It has been argued that human evolution has stopped because humans now adapt to their environment via cultural evolution and not biological evolution. However, all organisms adapt to their environment, and humans are no exception. Culture defines much of the human environment, so cultural evolution has actually led to adaptive evolution in humans. Examples are given to illustrate the rapid pace of adaptive evolution in response to cultural innovations. These adaptive responses have important implications for infectious diseases, Mendelian genetic diseases, and systemic diseases in current human populations. Moreover, evolution proceeds by mechanisms other than natural selection. The recent growth in human population size has greatly increased the reservoir of mutational variants in the human gene pool, thereby enhancing the potential for human evolution. The increase in human population size coupled with our increased capacity to move across the globe has induced a rapid and ongoing evolutionary shift in how genetic variation is distributed within and among local human populations. In particular, genetic differences between human populations are rapidly diminishing and individual heterozygosity is increasing, with beneficial health effects. Finally, even when cultural evolution eliminates selection on a trait, the trait can still evolve due to natural selection on other traits. Our traits are not isolated, independent units, but rather are integrated into a functional whole, so selection on one trait can cause evolution to occur on another trait, sometimes with mildly maladaptive consequences.

  9. (Human) Resourcing For CI

    DEFF Research Database (Denmark)

    Jørgensen, Frances; S., Jacob; Kofoed, Lise Busk

    2005-01-01

    More and more, the ability to compete in today’s market is viewed as being dependent on human capital. One of the most challenging aspects of human resource management involves supplying the organization with the human capital necessary to fulfill its objectives. This task becomes especially...

  10. Human Machine Learning Symbiosis

    Science.gov (United States)

    Walsh, Kenneth R.; Hoque, Md Tamjidul; Williams, Kim H.

    2017-01-01

    Human Machine Learning Symbiosis is a cooperative system where both the human learner and the machine learner learn from each other to create an effective and efficient learning environment adapted to the needs of the human learner. Such a system can be used in online learning modules so that the modules adapt to each learner's learning state both…

  11. Monogenic human obesity.

    Science.gov (United States)

    Farooqi, I Sadaf

    2008-01-01

    We and others have identified several single gene defects that disrupt the molecules in the leptinmelanocortin pathway causing severe obesity in humans. In this review, we consider these human monogenic obesity syndromes and discuss how far the characterisation of these patients has informed our understanding of the physiological role of leptin and the melanocortins in the regulation of human body weight and neuroendocrine function.

  12. From Human Past to Human Future

    Directory of Open Access Journals (Sweden)

    Robert G. Bednarik

    2013-01-01

    Full Text Available This paper begins with a refutation of the orthodox model of final Pleistocene human evolution, presenting an alternative, better supported account of this crucial phase. According to this version, the transition from robust to gracile humans during that period is attributable to selective breeding rather than natural selection, rendered possible by the exponential rise of culturally guided volitional choices. The rapid human neotenization coincides with the development of numerous somatic and neural detriments and pathologies. Uniformitarian reasoning based on ontogenic homology suggests that the cognitive abilities of hominins are consistently underrated in the unstable orthodoxies of Pleistocene archaeology. A scientifically guided review establishes developmental trajectories defining recent changes in the human genome and its expressions, which then form the basis of attempts to extrapolate from them into the future. It is suggested that continuing and perhaps accelerating unfavorable genetic changes to the human species, rather than existential threats such as massive disasters, pandemics, or astrophysical events, may become the ultimate peril of humanity.

  13. Humanity at the Edge

    DEFF Research Database (Denmark)

    Svendsen, Mette N.; Gjødsbøl, Iben M.; Dam, Mie S.

    2017-01-01

    At the heart of anthropology and the social sciences lies a notion of human existence according to which humans and animals share the basic need for food, but only humans have the capacity for morality. Based on fieldwork in a pig laboratory, a neonatal intensive care unit (NICU), and a dementia ...... human and animal value and agency with approaches that focus on human experience and virtue ethics, we argue that ‘the human’ at stake in the moral laboratory of feeding precarious lives puts ‘the human’ in anthropology at disposal for moral experimentation....

  14. Jordan Adjusted Human Development

    OpenAIRE

    Ababsa, Myriam

    2014-01-01

    Jordan Human Development Index (HDI) and Adjusted Human Development Index (IHDI) In 1990, the United Nations Development Programme designed a Human Development Index composed of life expectancy at birth, level of education and gross domestic product (GDP) per capita. In 2011, the UNDP ranked Jordan 95th out of 187 countries with a human development index of 0.698, up from 0.591 in 1990, making it the leading medium-range country for human development (fig. VIII.1). In 2010, the inequality adj...

  15. Human Beings And Water

    OpenAIRE

    2016-01-01

    The writer of this paper on this writing is talking about the human beings and water. Water is one of the very fundamentally things that human beings need to keep their lives. Human beings sometimes do not realise that the water is very important for them because they actually cannot live their lives without the present of water. Human beings can keep their lives without rice, but cannot without water. For instances the use of water for human beings are domestic use, cooking, washing, bathing...

  16. Human rights and bioethics.

    Science.gov (United States)

    Barilan, Y M; Brusa, M

    2008-05-01

    In the first part of this article we survey the concept of human rights from a philosophical perspective and especially in relation to the "right to healthcare". It is argued that regardless of meta-ethical debates on the nature of rights, the ethos and language of moral deliberation associated with human rights is indispensable to any ethics that places the victim and the sufferer in its centre. In the second part we discuss the rise of the "right to privacy", particularly in the USA, as an attempt to make the element of personal free will dominate over the element of basic human interest within the structure of rights and when different rights seem to conflict. We conclude by discussing the relationship of human rights with moral values beyond the realm of rights, mainly human dignity, free will, human rationality and response to basic human needs.

  17. Human Milk Banking.

    Science.gov (United States)

    Haiden, Nadja; Ziegler, Ekhard E

    2016-01-01

    Human milk banks play an essential role by providing human milk to infants who would otherwise not be able to receive human milk. The largest group of recipients are premature infants who derive very substantial benefits from it. Human milk protects premature infants from necrotizing enterocolitis and from sepsis, two devastating medical conditions. Milk banks collect, screen, store, process, and distribute human milk. Donating women usually nurse their own infants and have a milk supply that exceeds their own infants' needs. Donor women are carefully selected and are screened for HIV-1, HIV-2, human T-cell leukemia virus 1 and 2, hepatitis B, hepatitis C, and syphilis. In the milk bank, handling, storing, processing, pooling, and bacterial screening follow standardized algorithms. Heat treatment of human milk diminishes anti-infective properties, cellular components, growth factors, and nutrients. However, the beneficial effects of donor milk remain significant and donor milk is still highly preferable in comparison to formula.

  18. Human Capital and Sustainability

    Directory of Open Access Journals (Sweden)

    Garry Jacobs

    2011-01-01

    Full Text Available A study of sustainability needs to consider the role of all forms of capital—natural, biological, social, technological, financial, cultural—and the complex ways in which they interact. All forms of capital derive their value, utility and application from human mental awareness, creativity and social innovation. This makes human capital, including social capital, the central determinant of resource productivity and sustainability. Humanity has entered the Anthropocene Epoch in which human changes have become the predominant factor in evolution. Humanity is itself evolving from animal physicality to social vitality to mental individuality. This transition has profound bearing on human productive capabilities, adaptability, creativity and values, the organization of economy, public policy, social awareness and life styles that determine sustainability. This article examines the linkages between population, economic development, employment, education, health, social equity, cultural values, energy intensity and sustainability in the context of evolving human consciousness. It concludes that development of human capital is the critical determinant of long-term sustainability and that efforts to accelerate the evolution of human consciousness and emergence of mentally self-conscious individuals will be the most effective approach for ensuring a sustainable future. Education is the primary lever. Human choice matters.

  19. Integrated Environmental Modelling: human decisions, human challenges

    Science.gov (United States)

    Glynn, Pierre D.

    2015-01-01

    Integrated Environmental Modelling (IEM) is an invaluable tool for understanding the complex, dynamic ecosystems that house our natural resources and control our environments. Human behaviour affects the ways in which the science of IEM is assembled and used for meaningful societal applications. In particular, human biases and heuristics reflect adaptation and experiential learning to issues with frequent, sharply distinguished, feedbacks. Unfortunately, human behaviour is not adapted to the more diffusely experienced problems that IEM typically seeks to address. Twelve biases are identified that affect IEM (and science in general). These biases are supported by personal observations and by the findings of behavioural scientists. A process for critical analysis is proposed that addresses some human challenges of IEM and solicits explicit description of (1) represented processes and information, (2) unrepresented processes and information, and (3) accounting for, and cognizance of, potential human biases. Several other suggestions are also made that generally complement maintaining attitudes of watchful humility, open-mindedness, honesty and transparent accountability. These suggestions include (1) creating a new area of study in the behavioural biogeosciences, (2) using structured processes for engaging the modelling and stakeholder communities in IEM, and (3) using ‘red teams’ to increase resilience of IEM constructs and use.

  20. Human organ markets and inherent human dignity.

    Science.gov (United States)

    MacKellar, Calum

    2014-01-01

    It has been suggested that human organs should be bought and sold on a regulated market as any other material property belongingto an individual. This would have the advantage of both addressing the grave shortage of organs available for transplantation and respecting the freedom of individuals to choose to do whatever they want with their body parts. The old arguments against such a market in human organs are, therefore, being brought back into question. The article examines the different arguments both in favour and against the sale of human organs. It concludes that the body and any of its elements is a full expression of the whole person. As such, they cannot have a price if the individual is to retain his or her full inherent dignity and if society is to retain and protect this very important concept.

  1. Chimeras and human dignity.

    Science.gov (United States)

    de Melo-Martín, Inmaculada

    2008-12-01

    Discussions about whether new biomedical technologies threaten or violate human dignity are now common. Indeed, appeals to human dignity have played a central role in national and international debates about whether to allow particular kinds of biomedical investigations. The focus of this paper is on chimera research. I argue here that both those who claim that particular types of human-nonhuman chimera research threaten human dignity and those who argue that such threat does not exist fail to make their case. I first introduce some of the arguments that have been offered supporting the claim that the creation of certain sorts of chimeras threatens or violates human dignity. I next present opponents' assessments of such arguments. Finally I critically analyze both the critics' and the supporters' claims about whether chimera research threatens human dignity.

  2. Human Performance in Space

    Science.gov (United States)

    Jones, Patricia M.; Fiedler, Edna

    2010-01-01

    Human factors is a critical discipline for human spaceflight. Nearly every human factors research area is relevant to space exploration -- from the ergonomics of hand tools used by astronauts, to the displays and controls of a spacecraft cockpit or mission control workstation, to levels of automation designed into rovers on Mars, to organizational issues of communication between crew and ground. This chapter focuses more on the ways in which the space environment (especially altered gravity and the isolated and confined nature of long-duration spaceflight) affects crew performance, and thus has specific novel implications for human factors research and practice. We focus on four aspects of human performance: neurovestibular integration, motor control and musculo-skeletal effects, cognitive effects, and behavioral health. We also provide a sampler of recent human factors studies from NASA.

  3. Developing human technology curriculum

    Directory of Open Access Journals (Sweden)

    Teija Vainio

    2012-10-01

    Full Text Available During the past ten years expertise in human-computer interaction has shifted from humans interacting with desktop computers to individual human beings or groups of human beings interacting with embedded or mobile technology. Thus, humans are not only interacting with computers but with technology. Obviously, this shift should be reflected in how we educate human-technology interaction (HTI experts today and in the future. We tackle this educational challenge first by analysing current Master’s-level education in collaboration with two universities and second, discussing postgraduate education in the international context. As a result, we identified core studies that should be included in the HTI curriculum. Furthermore, we discuss some practical challenges and new directions for international HTI education.

  4. Humanities, Digital Humanities, Media studies, Internet studies

    DEFF Research Database (Denmark)

    Brügger, Niels

    the interplay between four areas which until now to a certain extent have been separated: Traditional Hu- manities, Digital Humanities, Media studies, and Internet studies. The vision is followed by an outline of how it can be unfolded in concrete activities, in the form of research projects, research......Todays expanding digital landscape constitutes an important research object as well as the research environment for the Humanities at the beginning of the 21st century. Taking this state of affairs as a starting point this inaugural lecture presents a vision for how the digital affects...

  5. Advancing Human Rights

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The National Human Rights Action Plan of China (2012-2015) was initiated after the successful conclusion of the National Human Rights Action Plan of China (2009-2010).The Chinese government in late July published an assessment report on the implementation of the plan,elaborating on the full implementation of China's first-ever national program on human rights development,which was drafted in April 2009.

  6. Human hemoglobin genetics

    Energy Technology Data Exchange (ETDEWEB)

    Honig, G.R.; Adams, J.G.

    1986-01-01

    This book contains the following 10 chapters: Introduction; The Human Hemoglobins; The Human Globin Genes; Hemoglobin Synthesis and Globin Gene Expression; The Globin Gene Mutations - A. Mechanisms and Classification; The Globin Gene Mutations - B. Their Phenotypes and Clinical Expression; The Genetics of the Human Globin Gene Loci: Formal Genetics and Gene Linkage; The Geographic Distribution of Globin Gene Variation; Labortory Identification, Screening, Education, and Counseling for Abnormal Hemoglobins and Thalassemias; and Approaches to the Treatment of the Hemoglobin Disorders.

  7. Modern Human Capital Management

    OpenAIRE

    Feldberger, Madita

    2008-01-01

    Title: Modern Human Capital Management Seminar date: 30th of May 2008 Course: Master thesis in Business Administration, 15 ECTS Authors: Madita Feldberger Supervisor: Lars Svensson Keywords: Human capital, SWOT Analysis, Strategic Map, Balanced Scorecard Research Problem: Despite of the success of Human Capital Management (HCM) in research it did not arrive yet in the HR departments of many companies. Numerous firms even have problems to set their strategic goals with focus on HR. The HR Bala...

  8. Robotics for Human Exploration

    Science.gov (United States)

    Fong, Terrence; Deans, Mathew; Bualat, Maria

    2013-01-01

    Robots can do a variety of work to increase the productivity of human explorers. Robots can perform tasks that are tedious, highly repetitive or long-duration. Robots can perform precursor tasks, such as reconnaissance, which help prepare for future human activity. Robots can work in support of astronauts, assisting or performing tasks in parallel. Robots can also perform "follow-up" work, completing tasks designated or started by humans. In this paper, we summarize the development and testing of robots designed to improve future human exploration of space.

  9. [Human physiology: kidney].

    Science.gov (United States)

    Natochin, Iu V

    2010-01-01

    The content of human physiology as an independent part of current physiology is discussed. Substantiated is the point that subjects of human physiology are not only special sections of physiology where functions are inherent only in human (physiology of intellectual activity, speech, labor, sport), but also in peculiarities of functions, specificity of regulation of each of physiological systems. By the example of physiology of kidney and water-salt balance there are shown borders of norm, peculiarities of regulation in human, new chapters of renal physiology which have appeared in connection with achievements of molecular physiology.

  10. Human Performance Research Center

    Data.gov (United States)

    Federal Laboratory Consortium — Biochemistry:Improvements in energy metabolism, muscular strength and endurance capacity have a basis in biochemical and molecular adaptations within the human body....

  11. Extraterritorial Human Rights Obligations

    DEFF Research Database (Denmark)

    Amsinck Boie, Hans Nikolaj; Torp, Kristian

    adequately be addressed without including the approach to the problem taken in practice; Corporate Social Responsibility, CSR. The book therefore draws upon the concept of CSR and the approaches developed here and discusses whether states may utilize the CSR-based concept of human rights due diligence...... to fulfil their possible obligations to protect against human rights violations by corporations.......The book addresses the issue of corporate respect for human rights by examining if and how states are obligated to ensure that corporations originating from their jurisdiction respect human rights when they operate abroad. The existence of such a duty is much debated by academics at national...

  12. The psychology of humanness.

    Science.gov (United States)

    Haslam, Nick; Loughnan, Steve; Holland, Elise

    2013-01-01

    This chapter explores the ways in which the concept of "humanness" illuminates a wide and fascinating variety of psychological phenomena. After introducing the concept--everyday understandings of what it is to be human--we present a model of the diverse ways in which humanness can be denied to people. According to this model people may be perceived as lacking uniquely human characteristics, and thus likened to animals, or as lacking human nature, and thus likened to inanimate objects. Both of these forms of dehumanization occur with varying degrees of subtlety, from the explicit uses of derogatory animal metaphors, to stereotypes that ascribe lesser humanness or simpler minds to particular groups, to nonconscious associations between certain humans and nonhumans. After reviewing research on dehumanization through the lens of our model we examine additional topics that the psychology of humanness clarifies, notably the perception of nonhuman animals and the objectification of women. Humanness emerges as a concept that runs an integrating thread through a variety of research literatures.

  13. The Human Toolmaker

    OpenAIRE

    Kassuba, Tanja; Kastner, Sabine

    2014-01-01

    Do you enjoy building airplanes, cars, houses, or robots with Lego blocks? Humans are the only animal species that can create complicated constructions from simple Lego blocks – our Lego building ability is “human-specific,” since it is only found in human beings. What would our closest relatives, apes or monkeys, do with a box of Lego blocks? They would probably chew on them, and lose interest when they find out that they are not edible! Why are humans the only Lego builders in the animal ki...

  14. Photography after the Human

    OpenAIRE

    Zylinska, Joanna

    2016-01-01

    How can we visualise and subsequently reimagine the abstraction that is the extinction of human species while there is still time? The article addresses this question by considering the existence of images – and, in particular, light-induced mechanical images known as photographs – after the human. The “after the human” designation does not just refer to the material disappearance of the human in some kind of distant future, but also to the present imagining of the disappearance of the human ...

  15. Refractoriness in human atria

    DEFF Research Database (Denmark)

    Skibsbye, Lasse; Jespersen, Thomas; Christ, Torsten

    2016-01-01

    drugs. Cardiomyocyte excitability depends on availability of sodium channels, which involves both time- and voltage-dependent recovery from inactivation. This study therefore aims to characterise how sodium channel inactivation affects refractoriness in human atria. METHODS AND RESULTS: Steady......-state activation and inactivation parameters of sodium channels measured in vitro in isolated human atrial cardiomyocytes were used to parameterise a mathematical human atrial cell model. Action potential data were acquired from human atrial trabeculae of patients in either sinus rhythm or chronic atrial...... in pharmacological management of chronic atrial fibrillation....

  16. Humanities, Digital Humanities, Media studies, Internet studies

    DEFF Research Database (Denmark)

    Brügger, Niels

    the interplay between four areas which until now to a certain extent have been separated: Traditional Hu- manities, Digital Humanities, Media studies, and Internet studies. The vision is followed by an outline of how it can be unfolded in concrete activities, in the form of research projects, research...

  17. Developing Human Resources through Actualizing Human Potential

    Science.gov (United States)

    Clarken, Rodney H.

    2012-01-01

    The key to human resource development is in actualizing individual and collective thinking, feeling and choosing potentials related to our minds, hearts and wills respectively. These capacities and faculties must be balanced and regulated according to the standards of truth, love and justice for individual, community and institutional development,…

  18. Human Rights, History of

    NARCIS (Netherlands)

    de Baets, Antoon; Wright, James

    2015-01-01

    In this article, six basic debates about human rights are clarified from a historical perspective: the origin of human rights as moral rights connected to the natural law doctrine and opposed to positive rights; the wave of criticism of their abstract and absolute character by nineteenth-century

  19. Introduction to human factors

    Energy Technology Data Exchange (ETDEWEB)

    Winters, J.M.

    1988-03-01

    Some background is given on the field of human factors. The nature of problems with current human/computer interfaces is discussed, some costs are identified, ideal attributes of graceful system interfaces are outlined, and some reasons are indicated why it's not easy to fix the problems. (LEW)

  20. Human Capital and Retirement

    NARCIS (Netherlands)

    P. Alders

    1999-01-01

    textabstractThis paper investigates the relation between human capital and retirement when the age of retirement is endogenous. This relation is examined in a life-cycle earnings model. An employee works full time until retirement. The worker accumulates human capital by training- on-the-job and by