Portal blood flow volume measurement in schistosomal patients: evaluation of Doppler ultrasonography reproducibility

International Nuclear Information System (INIS)

Leao, Alberto Ribeiro de Souza; Santos, Jose Eduardo Mourao; Moulin, Danilo Sales; Shigueoka, David Carlos; D'Ippolito, Giuseppe; Colleoni, Ramiro

2008-01-01

Objective: To evaluate the reproducibility of Doppler ultrasonography in the measurement of portal blood flow volume in schistosomal patients. Materials and methods: Prospective, transversal, observational and self-paired study evaluating 21 patients with hepatosplenic schistosomiasis submitted to Doppler ultrasonography performed by three independent observers for measurement of portal blood flow. Pairwise interobserver agreement was calculated by means of the intraclass correlation coefficient, paired t-test and Pearson's correlation coefficient. Results: Interobserver agreement was excellent. Intraclass correlation ranged from 80.6% to 93.0% (IC at 95% [65.3% ; 95.8%]), with the Pearson's correlation coefficient ranging between 81.6% and 92.7% with no statistically significant interobserver difference regarding the mean portal blood flow volume measured by Doppler ultrasonography (p = 0.954 / 0.758 / 0.749). Conclusion: Doppler ultrasonography has demonstrated to be a reliable method for measuring the portal blood flow volume in patients with portal hypertension secondary to schistosomiasis, with a good interobserver agreement. (author)

Portal blood flow volume measurement in schistosomal patients: evaluation of Doppler ultrasonography reproducibility

Energy Technology Data Exchange (ETDEWEB)

Leao, Alberto Ribeiro de Souza; Santos, Jose Eduardo Mourao; Moulin, Danilo Sales; Shigueoka, David Carlos; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Escola Paulista de Medicina. Dept. de Diagnostico por Imagem]. E-mail: ar.leao@uol.com.br; Colleoni, Ramiro [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Escola Paulista de Medicina. Dept. de Gastroenterologia

2008-09-15

Objective: To evaluate the reproducibility of Doppler ultrasonography in the measurement of portal blood flow volume in schistosomal patients. Materials and methods: Prospective, transversal, observational and self-paired study evaluating 21 patients with hepatosplenic schistosomiasis submitted to Doppler ultrasonography performed by three independent observers for measurement of portal blood flow. Pairwise interobserver agreement was calculated by means of the intraclass correlation coefficient, paired t-test and Pearson's correlation coefficient. Results: Interobserver agreement was excellent. Intraclass correlation ranged from 80.6% to 93.0% (IC at 95% [65.3% ; 95.8%]), with the Pearson's correlation coefficient ranging between 81.6% and 92.7% with no statistically significant interobserver difference regarding the mean portal blood flow volume measured by Doppler ultrasonography (p = 0.954 / 0.758 / 0.749). Conclusion: Doppler ultrasonography has demonstrated to be a reliable method for measuring the portal blood flow volume in patients with portal hypertension secondary to schistosomiasis, with a good interobserver agreement. (author)

Granulomatous hypophysitis by Mycobacterium gordonae in a non HIV-infected patient

Directory of Open Access Journals (Sweden)

José Luis Ruiz-Sandoval

2009-12-01

Full Text Available Lymphocytic or granulomatous hypophysitis is a rare entity with a difficult diagnosis. Our objective was to report a patient with non-tuberculous granulomatous hypophysitis. An HIV-negative 45-year old man with confusional state, subacute ophthalmoplegia, and clinical and laboratory findings of panhypopituitarism was seen in the emergency unit. A cranial MRI showed a sellar mass suggestive of hypophysitis. After an unsuccessful attempt with steroids and antituberculous drugs the patient died. Post-mortem histopathology revealed granulomatous lesions and restriction fragment length polymorphism analysis confirmed the presence of Mycobacterium gordonae’s DNA. In conclusion, we should consider granulomatous hypophysitis in the differential diagnosis of non-secreting hypophyseal tumors. The etiology of a pituitary granuloma by a non-tuberculous mycobacteria is best reached by histopathological techniques and molecular assays. The optimal therapy is yet to be established.

Vasopressin and nitroglycerin decrease portal and hepatic venous pressure and hepato-splanchnic blood flow.

Science.gov (United States)

Wisén, E; Svennerholm, K; Bown, L S; Houltz, E; Rizell, M; Lundin, S; Ricksten, S-E

2018-03-26

Various methods are used to reduce venous blood pressure in the hepato-splanchnic circulation, and hence minimise blood loss during liver surgery. Previous studies show that combination of vasopressin and nitroglycerin reduces portal pressure and flow in patients with portal hypertension, and in this study we investigated this combination in patients with normal portal pressure. In all, 13 patients were studied. Measurements were made twice to confirm baseline (C1 and BL), during vasopressin infusion 4.8 U/h (V), and during vasopressin infusion combined with nitroglycerin infusion (V + N). Portal venous pressure (PVP), hepatic venous pressure (HVP), central haemodynamics and arterial and venous blood gases were obtained at each measuring point, and portal (splanchnic) and hepato-splanchnic blood flow changes were calculated. Vasopressin alone did not affect PVP, whereas HVP increased slightly. In combination with nitroglycerin, PVP decreased from 10.1 ± 1.6 to 8.9 ± 1.3 mmHg (P HVP decreased from 7.9 ± 1.9 to 6.2 ± 1.3 mmHg (P = 0.001). Vasopressin reduced portal blood flow by 47 ± 19% and hepatic venous flow by 11 ± 18%, respectively. Addition of nitroglycerin further reduced portal- and hepatic flow by 55 ± 13% and 30 ± 13%, respectively. Vasopressin alone had minor effects on central haemodynamics, whereas addition of nitroglycerin reduced cardiac index (3.2 ± 0.7 to 2.7 ± 0.5; P < 0.0001). The arterial-portal vein lactate gradient was unaffected. The combination of vasopressin and nitroglycerin decreases portal pressure and hepato-splanchnic blood flow, and could be a potential treatment to reduce bleeding in liver resection surgery. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Effect of Metoclopramide on Portal Blood Flow in Patients with Liver Cirrhosis: Evaluation by the Pulsed Doppler System

International Nuclear Information System (INIS)

Baik, Soon Koo; Lee, Yong Gyu; Hong, Sa Joon; Lee, Seong Wu; Lee, Dong Ki; Kwong, Sang Ok

1994-01-01

Metoclopramide is known to lower the intravariceal flow by raising the lower esophageal sphincter pressure and consequently decreases the portal blood flow. So we designed this study to assess the effect of metoclopramide on portal blood flow in cirrhotic patients using pulsed Doppler system. By using pulsed Doppler ultrasound, portal blood velocity, diameter of the portal vein, portal blood flow, blood pressure and pulse rate were measured at 15, 30 and 60 minutes after administration of 20mg metoclopramide in 16cirrhotic patients and compared with the basal values. In order 10 cirrhotic patients, normal saline was administrated, and the above mentioned parameters were measured. Wothin 15 minutes after intravenous administration of 20mg metoclopramide, portal blood velocity and portal blood flow decreased significantly, from 12.45+2.64 to 11.80+2.55cm/sec and from 1006.3+407.1 to 974.4+414.7ml/min, respectively(P<0.05). In placebo group,there was no significant change in measured parameters after administration of normal saline. These results support the hypothesis that metoclopramide significantly decreases the portal blood flow transiently in cirrhotic patients with portal hypertension

Detection of free gastric cancer cell in peripheral and portal blood

Energy Technology Data Exchange (ETDEWEB)

Bang, Ho Yoon; Lee, Jong Inn [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

1998-01-01

In fact, there is no definite treatment modality after liver or hematogenous metastasis in the gastric cancer. So it is important to develop a new method to predict the high risk patients for systemic recurrence. If we can detect metastatic cell in circulation, it may be beneficial in assessing tumor progression, metastatic potential and prognosis. To establish the RT-PCR methodology for detection of CEA expressing cancer cells in peripheral and portal blood and to define the relationship between peripheral and portal blood detection rate of gastric cancer patients, we performed RT-PCR analysis with peripheral and portal blood samples from 24 patients with gastric cancer (stage Ia,b, n=3; stage II, n=2; stage IIIa, n=9; stage IIIb, n=7; stage IV, n=3) and checked serum CEA level preoperatively. Mean age was 49.2 years old and male : female was 1.2 : 2 (13:11 patients). The mean serum CEA level was 10.4 ng/ml and that was higher than normal in only 2 cases. There was no positive case of tumor cell in portal and peripheral blood using RT-PCR and CEA gene specific primer. Our results indicate that the incidence of circulating cancer cells is unexpectedly very low even in advanced gastric cancer patients. (author). 20 refs.

Detection of free gastric cancer cell in peripheral and portal blood

International Nuclear Information System (INIS)

Bang, Ho Yoon; Lee, Jong Inn

1998-01-01

In fact, there is no definite treatment modality after liver or hematogenous metastasis in the gastric cancer. So it is important to develop a new method to predict the high risk patients for systemic recurrence. If we can detect metastatic cell in circulation, it may be beneficial in assessing tumor progression, metastatic potential and prognosis. To establish the RT-PCR methodology for detection of CEA expressing cancer cells in peripheral and portal blood and to define the relationship between peripheral and portal blood detection rate of gastric cancer patients, we performed RT-PCR analysis with peripheral and portal blood samples from 24 patients with gastric cancer (stage Ia,b, n=3; stage II, n=2; stage IIIa, n=9; stage IIIb, n=7; stage IV, n=3) and checked serum CEA level preoperatively. Mean age was 49.2 years old and male : female was 1.2 : 2 (13:11 patients). The mean serum CEA level was 10.4 ng/ml and that was higher than normal in only 2 cases. There was no positive case of tumor cell in portal and peripheral blood using RT-PCR and CEA gene specific primer. Our results indicate that the incidence of circulating cancer cells is unexpectedly very low even in advanced gastric cancer patients. (author). 20 refs

Lymphocytic hypophysitis: occurrence in two men.

Science.gov (United States)

Lee, J H; Laws, E R; Guthrie, B L; Dina, T S; Nochomovitz, L E

1994-01-01

Two men undergoing transsphenoidal exploration for pituitary adenoma were found to have lymphocytic hypophysitis. Both presented with frontal headaches, lethargy, and diminished libido. Laboratory investigations showed markedly depressed serum testosterone, and magnetic resonance imaging demonstrated pituitary enlargement, with optic chiasm involvement. Intraoperatively, the dura was adherent to the pituitary in each case. The resected glands were effaced by a dense lymphoplasmacytic infiltrate and fibrosis, without granulomas. Nonspecific peripheral enhancement on imaging suggested a diagnosis other than adenoma, but more experience with peripheral enhancement in lymphocytic hypophysitis is needed. The diagnosis was histological and required surgical intervention. Long-term pituitary replacement therapy is usually required.

Extrahepatic portal hypertension in childhood. Portographic findings and evaluation of hepatic blood flow by computerized radionuclide angiography

Energy Technology Data Exchange (ETDEWEB)

Takehara, Hiroo; Komi, Nobuhiko; Goh, Masahiro; Yoshida, Sadahiro; Kameoka, Kazuhiro; Hino, Masao; Sui, Osamu

1986-05-01

Four pediatric patients with extrahepatic portal hypertension had undergone portography and computerized radionuclide angiography in order to examine shape of portal system and to evaluate hepatic blood flow before and aftersurgical treatment. In all patients, cavernous transformation of portal system was demonstrated by portography, and in one of them spontaneous splenorenal shunt occurred. In 3 of them, who underwent esophageal transsection combined with paraesophagogastric devascularization and splenectomy, so-called direct operation, increase of portal blood flow was revealed by computerized radionuclide angiography. It is suggested that direct operation increasing portal blood flow after surgery is effective in treating extrahepatic portal hypertension in childhood.

Blood Changes after Splenectomy in Portal Hypertension. The ...

African Journals Online (AJOL)

Background: Splenectomy is a frequently performed operation for patients with portal hypertension and hypersplenism in areas endemic for schistosomiasis. Reactive thrombocytosis (RT) has been described following splenectomy. Nevertheless, data are lacking on the long term changes of platelet count and other blood ...

Noninvasive measurement of nutrient portal blood shunting: an experimental study with [14C]ursodeoxycholic acid

International Nuclear Information System (INIS)

Nordlinger, B.; Parquet, M.; Infante, R.; Moreels, R.; Blondiau, P.; Boschat, M.; Groussard, M.; Huguet, C.

1982-01-01

All of the methods proposed for measuring portal blood flow are either invasive, estimate total rather than nutrient flow, and none has proved reliable in cirrhotic patients. A method has been derived from pharmacokinetic principles used for the calculation of bioavailability of drugs according to the route of administration (i.v. or p.o.) and tested experimentally in 20 pigs. A tracer dose of [ 14 C]ursodeoxycholic acid, a biliary acid with a high-liver first-pass effect, is administered in the duodenum, and serial peripheral blood samples are taken. Later, the same dose of the same drug is administered i.v. The shunt fraction of portal blood F is obtained by the ratio of the areas under the plasma level vs. time curves (AUC) after p.o. and i.v. administrations: (see formula in text). The pigs were divided into three experimental groups. (i) Group I: undisturbed portal flow; (ii) Group II: total diversion of portal blood with an end-to-side portacaval shunt, and (iii) Group III: partial diversion of portal blood through a side-to-side portacaval shunt. Portal flow was measured during surgery with an electromagnetic flowmeter above and below the shunt and the degree of shunting calculated. Results show that the shunt fraction measured with ursodeoxycholic acid is well-correlated with hemodynamic data. No overlap between Groups I and III is observed. It is concluded that the shunt fraction of nutrient portal blood can be measured with this noninvasive method. Minute amounts of ursodeoxycholic acid were used in order to be completely metabolized by the liver, even in spite of hepatocellular dysfunction. Therefore, this method should be valid in cirrhotic patients and be useful to decide the type of portasystemic shunt to propose for the decompression of gastroesophageal varices

Autoimmune polyendocrinopathy and hypophysitis after Puumala hantavirus infection

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Marlene Tarvainen

2016-11-01

Full Text Available Puumala hantavirus (PUUV infection causes nephropathia epidemica (NE, a relatively mild form of haemorrhagic fever with renal syndrome (HFRS. Hypophyseal haemorrhage and hypopituitarism have been described in case reports on patients with acute NE. Chronic hypopituitarism diagnosed months or years after the acute illness has also been reported, without any signs of a haemorrhagic aetiology. The mechanisms leading to the late-onset hormonal defects remain unknown. Here, we present a case of NE-associated autoimmune polyendocrinopathy and hypopituitarism presumably due to autoimmune hypophysitis. Thyroid peroxidase antibody seroconversion occurred between 6 and 12 months, and ovarian as well as glutamate decarboxylase antibodies were found 18 months after acute NE. Brain MRI revealed an atrophic adenohypophysis with a heterogeneous, low signal intensity compatible with a sequela of hypophysitis. The patient developed central (or mixed central and peripheral hypothyroidism, hypogonadism and diabetes insipidus, all requiring hormonal replacement therapy. This case report suggests that late-onset hormonal defects after PUUV infection may develop by an autoimmune mechanism. This hypothesis needs to be confirmed by prospective studies with sufficient numbers of patients.

Leptomeningeal dissemination of an astrocytoma causing hypophyseal insufficiency

International Nuclear Information System (INIS)

Suzan, S.; Cigdem, O.; Furkan, U.; Baki, A.

2012-01-01

Full text: Introduction: Hypophyseal insufficiency is an unusual clinical presentation of metastatic disease. Objectives: In this report, a case of leptomeningeal metastasis of an astrocytoma to the infundibular recess, causing hypophyseal insufficiency is presented with its magnetic resonance imaging (MRI) findings. Materials and methods: A 27-year-old woman presented with nausea, vomiting and generalized weakness. Her laboratory results were consistent with hypopituitarism. She had an operation history for astrocytoma. She was referred to radiology department for brain MRI study. Contrast-enhanced MRI scan showed extensive wall enhancement of ventricles consistent with leptomeningeal metastases. A nodular mass with pronounced contrast enhancement was also detected at the infundibular stalk. Results: Because suprasellar cistern was normal and extensive leptomeningeal metastases was detected, the nodular mass at the infundibular stalk thought to be secondary to leptomeningeal involvement of the infundibular recess. Conclusion: When a patient with a known malignancy presented with hypophyseal insufficiency, it should be thought that leptomeningeal metastases to the infundibular recess may also be a cause. The neuroimaging, especially contrast-enhanced studies, is necessary for the confirmation

Portal vein blood flow is related to characteristics of the migrating motor complex of the gastrointestinal tract

DEFF Research Database (Denmark)

Qvist, Niels; Rafaelsen, Søren Rafael; Troensegaard, P.

1994-01-01

Objective: To measure variation in portal blood flow during the interdigestive state in relation to the migrating motor complex (MMC) in healthy volunteers. Design: Portal blood flow was measured by a duplex and colour Doppler technique with 5-min intervals during an entire MMC cycle. Total....... Conclusion: Blood flow in the portal vein varies with the characteristics of the MMC, a relationship which must be considered in future studies in health and disease....

Ethanol-induced increase in portal blood flow: Role of acetate and A1- and A2-adenosine receptors

International Nuclear Information System (INIS)

Carmichael, F.J.; Saldivia, V.; Varghese, G.A.; Israel, Y.; Orrego, H.

1988-01-01

The increase in portal blood flow induced by ethanol appears to be adenosine mediated. Acetate, which is released by the liver during ethanol metabolism, is known to increase adenosine levels in tissues and in blood. The effects of acetate on portal blood flow were investigated in rats using the microsphere technique. The intravenous infusion of acetate resulted in vasodilation of the preportal vasculature and in a dose-dependent increase in portal blood flow. This acetate-induced increase in portal blood flow was suppressed by the adenosine receptor blocker, 8-phenyltheophylline. Using the A 1 -adenosine receptor agonist N-6-cyclohexyl adenosine and the A 2 -agonist 5'-N-ethylcarboxamido adenosine, we demonstrate that the effect of adenosine on the preportal vasculature is mediated by the A 2 -subtype of adenosine receptors. In conclusion, these data support the hypothesis that the increase in portal blood flow after ethanol administration results from a preportal vasodilatory effect of adenosine formed from acetate metabolism in extrahepatic tissues

Lymphocytic hypophysitis masquerading as pituitary adenoma

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Rajneesh Mittal

2012-01-01

Full Text Available Introduction: Pituitary hypophysitis (PH is characterized by pituitary infiltration of lymphocytes, macrophages, and plasma cells that could lead to loss of pituitary function. Hypophysitis may be autoimmune or secondary to systemic diseases or infections. Based on the histopathological findings PH is classified into lymphocytic, granulomatous, xanthomatous, mixed forms (lymphogranulomatous, xanthogranulomatous, necrotizing and Immunoglobulin- G4 (IgG4 plasmacytic types. Objective: To report a case of lymphocytic hypophysitis (LH. Case Report: A 15-year-old girl presented with history of headache, amenorrhea, and history of polyuria for past 4 months. Initial evaluation had suppressed follicular stimulating hormone (<0.01 mIU/ml, high prolactin levels (110.85 ng/ml and diabetes insipidus (DI. Magnetic resonance imaging of sella was suggestive of pituitary macroadenoma with partial compression over optic chiasma. Patient underwent surgical decompression. Yellowish firm tissue was evacuated and xanthochromic fluid was aspirated. Histopathology was suggestive of LH. She resumed her cycles postoperatively after 4 months, prolactin levels normalized, however, she continues to have DI and is on desmopressin spray. This case has been presented here for its rare presentation in an adolescent girl because it is mostly seen in young females and postpartum period and its unique presentation as an expanding pituitary mass with optic chiasma compression. Conclusion: Definitive diagnosis of LH is based on histopathological evaluation. Therapeutic approach should be based on the grade of suspicion and clinical manifestations of LH.

Vasopressin-induced changes in splanchnic blood flow and hepatic and portal venous pressures in liver resection.

Science.gov (United States)

Bown, L Sand; Ricksten, S-E; Houltz, E; Einarsson, H; Söndergaard, S; Rizell, M; Lundin, S

2016-05-01

To minimize blood loss during hepatic surgery, various methods are used to reduce pressure and flow within the hepato-splanchnic circulation. In this study, the effect of low- to moderate doses of vasopressin, a potent splanchnic vasoconstrictor, on changes in portal and hepatic venous pressures and splanchnic and hepato-splanchnic blood flows were assessed in elective liver resection surgery. Twelve patients were studied. Cardiac output (CO), stroke volume (SV), mean arterial (MAP), central venous (CVP), portal venous (PVP) and hepatic venous pressures (HVP) were measured, intraoperatively, at baseline and during vasopressin infusion at two infusion rates (2.4 and 4.8 U/h). From arterial and venous blood gases, the portal (splanchnic) and hepato-splanchnic blood flow changes were calculated, using Fick's equation. CO, SV, MAP and CVP increased slightly, but significantly, while systemic vascular resistance and heart rate remained unchanged at the highest infusion rate of vasopressin. PVP was not affected by vasopressin, while HVP increased slightly. Vasopressin infusion at 2.4 and 4.8 U/h reduced portal blood flow (-26% and -37%, respectively) and to a lesser extent hepato-splanchnic blood flow (-9% and -14%, respectively). The arterial-portal vein lactate gradient was not significantly affected by vasopressin. Postoperative serum creatinine was not affected by vasopressin. Short-term low to moderate infusion rates of vasopressin induced a splanchnic vasoconstriction without metabolic signs of splanchnic hypoperfusion or subsequent renal impairment. Vasopressin caused a centralization of blood volume and increased cardiac output. Vasopressin does not lower portal or hepatic venous pressures in this clinical setting. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Hypophysitis secondary to ruptured Rathke's cyst mimicking neurosarcoidosis.

LENUS (Irish Health Repository)

Janeczko, Cassandra

2009-04-01

Hypophysitis secondary to a ruptured Rathke\\'s cyst is rare. We describe a 53-year-old female who presented with headache and subsequently developed aseptic meningitis and panhypopituitarism. MRI findings and concomitant cardiac arrhythmia and peripheral vasculitis led to a provisional diagnosis of neurosarcoidosis. There were no respiratory manifestations of sarcoidosis. Improvement was noted with empirical treatment with steroids. Pituitary biopsy was undertaken to confirm the diagnosis prior to treatment with long-term immunosuppression for putative neurosarcoidosis. The biopsy revealed lymphocytic hypophysitis secondary to a ruptured Rathke\\'s cyst. This report highlights a rare pathology and the importance of a tissue diagnosis before undertaking non-surgical management of a pituitary mass.

Portal venous blood flow while breath-holding after inspiration or expiration and during normal respiration in controls and cirrhotics

International Nuclear Information System (INIS)

Sugano, Shigeo; Yamamoto, Kunihiro; Sasao, Ken-ichiro; Watanabe, Manabu

1999-01-01

In this study, we used magnetic resonance (MR) imaging to measure portal blood flow in 12 healthy controls and 17 cirrhotics while they were breath-holding after inspiration and after expiration. We then compared the results with measurements made during normal respiration in the healthy controls and cirrhotics. Blood flow in the main portal vein under basal fasting conditions was quantitated using the cine phase-contrast MR velocity mapping method. Three measurements were made on one occasion, as follows: throughout the cardiac cycle during normal respiration, with the subject breath-holding after maximal inspiration, and with the subject breath-holding after maximal expiration. During normal respiration, portal blood flow was 1.3±0.2 l/min in controls vs 1.0±0.1 l/min in cirrhotics (P<0.0001); while subjects were breath-holding after inspiration, portal blood flow was 1.0±0.2 l/min in controls vs 0.9±0.1 l/min in cirrhotics; and while subjects were breath-holding after expiration, portal blood flow was 1.5±0.2 l/min in controls vs 1.1±0.2 l/min in cirrhotics (P<0.0001). The differences were primarily due to changes in flow velocity. When the magnitude of these hemodynamic changes in the three respiratory conditions was compared in controls and cirrhotics, analysis of variance (ANOVA) showed a significant difference (P<0.0001). In controls, portal blood flow decreased during maximal inspiration relative to flow during normal respiration (-24.6±8.3%). Changes in portal blood flow in controls were greater than in cirrhotics (-13.5±4.5%) (P<0.0001); however, the difference in blood flow increase associated with maximal expiration between the two groups (+11.8±9.4% vs +5.9±11.5%) was not significant. We found that the respiration-induced hemodynamic variation in portal blood flow was less in cirrhotics than in the healthy controls. Portal blood flow measurements made during normal respiration using MR imaging closely reflect nearly physiologic conditions

Portal venous blood flow while breath-holding after inspiration or expiration and during normal respiration in controls and cirrhotics

Energy Technology Data Exchange (ETDEWEB)

Sugano, Shigeo; Yamamoto, Kunihiro; Sasao, Ken-ichiro; Watanabe, Manabu [Saiseikai Wakakusa Hospital, Yakohama (Japan)

1999-07-01

In this study, we used magnetic resonance (MR) imaging to measure portal blood flow in 12 healthy controls and 17 cirrhotics while they were breath-holding after inspiration and after expiration. We then compared the results with measurements made during normal respiration in the healthy controls and cirrhotics. Blood flow in the main portal vein under basal fasting conditions was quantitated using the cine phase-contrast MR velocity mapping method. Three measurements were made on one occasion, as follows: throughout the cardiac cycle during normal respiration, with the subject breath-holding after maximal inspiration, and with the subject breath-holding after maximal expiration. During normal respiration, portal blood flow was 1.3{+-}0.2 l/min in controls vs 1.0{+-}0.1 l/min in cirrhotics (P<0.0001); while subjects were breath-holding after inspiration, portal blood flow was 1.0{+-}0.2 l/min in controls vs 0.9{+-}0.1 l/min in cirrhotics; and while subjects were breath-holding after expiration, portal blood flow was 1.5{+-}0.2 l/min in controls vs 1.1{+-}0.2 l/min in cirrhotics (P<0.0001). The differences were primarily due to changes in flow velocity. When the magnitude of these hemodynamic changes in the three respiratory conditions was compared in controls and cirrhotics, analysis of variance (ANOVA) showed a significant difference (P<0.0001). In controls, portal blood flow decreased during maximal inspiration relative to flow during normal respiration (-24.6{+-}8.3%). Changes in portal blood flow in controls were greater than in cirrhotics (-13.5{+-}4.5%) (P<0.0001); however, the difference in blood flow increase associated with maximal expiration between the two groups (+11.8{+-}9.4% vs +5.9{+-}11.5%) was not significant. We found that the respiration-induced hemodynamic variation in portal blood flow was less in cirrhotics than in the healthy controls. Portal blood flow measurements made during normal respiration using MR imaging closely reflect nearly

Autoimmun hypophysitis--en differentialdiagnose til hypofyseadenomer

DEFF Research Database (Denmark)

Krarup, Therese; Hagen, Claus

2010-01-01

A 66-year-old man with a headache in the left temporal region which had persisted for eight months is presented. The patient developed polydipsia and polyuria and also suffered from tinnitus, impaired hearing and episodes of double vision. The patient was diagnosed with autoimmune hypophysitis (AH...

Measurement of portal blood flow in healthy individuals: a comparison between magnetic resonance imaging and Doppler ultrasound

International Nuclear Information System (INIS)

Costa, Juliana Dantas da; Sebastiane, Patricia Moreno; Leao, Alberto Ribeiro de Souza; Santos, Jose Eduardo Mourao; Moulin, Danilo Sales; D'Ippolito, Giuseppe

2008-01-01

Objective: To evaluate the inter-observer agreement between Doppler ultrasonography and magnetic resonance imaging in the quantification of portal blood flow in healthy individuals, as well as evaluating the reproducibility of both methods. Materials and methods: A prospective, transverse, observational and self-paired study was developed evaluating 20 healthy volunteers whose portal blood flow was measured by means of Doppler ultrasonography and magnetic resonance imaging performed by two independent observers. Interobserver and inter method agreements were calculated using the intra class and Pearson's correlation coefficients. Results: The agreement between Doppler ultrasonography and magnetic resonance imaging was low (intra class coefficient: 1.9%-18.2%; Pearson's coefficient: 0.1%-13.7%; p=0.565). Mean values for the portal blood flow measured by Doppler ultrasonography and magnetic resonance imaging were respectively 0.768 l/min and 0.742 l/min. Interobserver agreement for quantification of the portal blood flow by Doppler ultrasonography and magnetic resonance imaging was respectively reasonable (intra class coefficient: 43.3%; Pearson's coefficient: 43.0%) and excellent (intra class coefficient: 91.4%; Pearson's coefficient: 93.4%). Conclusion: In the present study, magnetic resonance imaging demonstrated to be a reliable method for quantifying the portal blood flow, with a higher interobserver agreement than Doppler ultrasonography. The inter method agreement was low. (author)

[The effect of portal blood stasis on lung and renal injury induced by hepatic ischemia reperfusion in a rabbit model].

Science.gov (United States)

Wang, Ye; Yang, Jia-mei; Hou, Yuan-kai; Li, Dian-qi; Hu, Ming-hua; Liu, Peng

2008-04-15

To investigate the effect and mechanism of portal blood stasis on lung and renal injury induced by hepatic ischemia reperfusion. A rabbit hepatic ischemia reperfusion injury model was established by hepatic portal occlusion and in situ hypothermic irrigation for 30 min. Twenty-four New Zealand white rabbits were employed and randomly divided into 3 groups equally by different dosage of portal blood stasis removal: group A5 (5 ml blood removal), group A10 (10 ml blood removal),and group B (no blood removal). Eight rabbits were served as controls with no hepatic portal occlusion and hypothermic irrigation. After reperfusion 4 h serum endotoxin content, tumor necrosis factor-alpha (TNF-alpha), urea nitrogen (BUN), and creatinine (Cr) were examined respectively, meantime lung and kidney tissues were sampled to determine the content of malondialdehyde (MDA), superoxide dismutase (SOD), the pathology, and wet to dry weight ratio, broncho-alveolar lavage fluid protein content in lung tissues. Removing portal blood stasis ameliorated lung and renal injury as shown by decreasing the level of serum endotoxin, TNF-alpha, BUN, Cr, wet to dry weight ratio, broncho-alveolar lavage fluid protein content, MDA, SOD. TNF-alpha, Cr, broncho-alveolar lavage fluid protein content in lung tissues and MDA in kidney tissue in group A5 were significantly reduced compared with those in group B (P portal blood stasis before the resume of splanchnic circulation may ameliorate the lung and renal injury induced by hepatic ischemia reperfusion. The possible mechanism may be that portal blood stasis removal reduces endotoxin absorption, and further decreases production of serum TNF-alpha.

Portal Hypertension

Science.gov (United States)

... Overview of Gallbladder Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Professor of Medicine, ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension Portal hypertension is abnormally high blood pressure in ...

Duplex sonography in portal hypertension

International Nuclear Information System (INIS)

Kwon, Hyuk Po; Jang, J. C.; Park, B. H.

1990-01-01

We measure the diameter and blood velocity of the portal vein in 50 patients with cirrhosis of the liver and 40 healthy subjects, and calculated cross sectional area, mean blood flow velocity, blood flow volume and congestion index. In patients with cirrhosis of the liver, the cross sectional area of the portal vein was significantly increased: the mean blood flow volume was significantly reduced; the blood flow volume was significantly increased; the congestion index of the portal vein was significantly increased. Duples sonography may play an important role in the diagnosis of portal hypertension

Patient Portal Use and Blood Pressure Control in Newly Diagnosed Hypertension.

Science.gov (United States)

Manard, William; Scherrer, Jeffrey F; Salas, Joanne; Schneider, F David

2016-01-01

Current evidence that patient portal use improves disease management is inconclusive. Randomized controlled trials have found no benefit of Web-based patient-provider communication for blood pressure (BP) control, but patients from these studies were not selected for uncontrolled hypertension, nor did measures of portal use occur in a real-world setting, as captured in the electronic medical record. This study determined whether patient portal use by patients with treated, incident hypertension was associated with achieving BP control. Between 2008 to 2010, 1571 patients with an incident hypertension diagnosis, ages 21 to >89 years, were identified from an academic medical center primary care patient data registry. Cox proportional hazard models were computed to estimate the association between portal use and incident BP control during follow-up (2011-2015), before and after adjusting for covariates. Covariates included sociodemographics, smoking, obesity and other physical and mental health comorbidities, and volume of health care utilization. After adjusting for age, portal users were more likely than nonusers to achieve BP control (hazard ratio, 1.24; 95% confidence interval, 1.06-1.45). After adjustment for sociodemographics, portal use was no longer associated with BP control (hazard ratio, 0.98; 95% confidence interval, 0.83-1.16). Patient sociodemographic factors, including race, sex, and socioeconomic status, account for the observation that portal use leads to BP control among persons with newly diagnosed hypertension. Further research is warranted to determine whether there are benefits of portal use for other chronic conditions. © Copyright 2016 by the American Board of Family Medicine.

Hypothalamic regulation of thyroid-stimulating hormone and prolactin release : the role of thyrotrophin-releasing hormone

NARCIS (Netherlands)

G.A.C. van Haasteren (Goedele)

1995-01-01

textabstractThyrotrophin-releasing-hormone (TRH), a tripeptide, is produced by hypothalamic neurons and transported along their axons to the median eminence (ME). From there it is released at nerve terminals into hypophyseal portal blood. It is then transported to the anterior pituitary gland where

Blood Glucose Levels in Portal and Peripheral Circulation and Their Relation to Food Intake in the Rat

NARCIS (Netherlands)

Strubbe, J.H.; Steffens, A.B.

1977-01-01

Rats weighing about 450 g were provided with permanent catheters in the portal vein and the right auricle. This method allows blood sampling from the portal and peripheral circulation at the same moment in the nondisturbed unanesthetized rat. In the ad lib condition the portal glucose level was

Extrahepatic portal hypertension in childhood

International Nuclear Information System (INIS)

Takehara, Hiroo; Komi, Nobuhiko; Goh, Masahiro; Yoshida, Sadahiro; Kameoka, Kazuhiro; Hino, Masao; Sui, Osamu

1986-01-01

Four pediatric patients with extrahepatic portal hypertension had undergone portography and computerized radionuclide angiography in order to examine shape of portal system and to evaluate hepatic blood flow before and aftersurgical treatment. In all patients, cavernous transformation of portal system was demonstrated by portography, and in one of them spontaneous splenorenal shunt occurred. In 3 of them, who underwent esophageal transsection combined with paraesophagogastric devascularization and splenectomy, so-called direct operation, increase of portal blood flow was revealed by computerized radionuclide angiography. It is suggested that direct operation increasing portal blood flow after surgery is effective in treating extrahepatic portal hypertension in childhood. (author)

Study of the portal blood flow by gamma-scintigraphy in rectal administration of 133Xe solution

International Nuclear Information System (INIS)

Vorontsov, Yu.P.; Dmitrievnkov, B.N.; Andronov, S.V.; Alferov, G.A.

1981-01-01

Data on 133 Xe running through the liver during the administration of its solutions rectally (intraintestinally) and directly into the system of the portal vein (into one of the mesenteric veins) have been correlated in experiment on 12 rabbits. Good correlation of the mean of 133 Xe (passing has been shown for both methods of the portal blood flow study). A possibility to study the hepatic blood flow on the basis of clinical results using rectal administration of 133 Xe solution is discussed. The authors discuss the mechanism of 133 Xe penetration from the solution into the blood through the rectal wall

Portal hemodynamics in chronic portal-systemic encephalopathy

International Nuclear Information System (INIS)

Takashi, Motohide; Igarashi, Masahiko; Hino, Shinichi; Takayasu, Kenichi; Goto, Nobuaki; Musha, Hirotaka; Ohnishi, Kunihiko; Okuda, Kunio

1985-01-01

A portal hemodynamic study was made in 7 consecutive patients with chronic portal-systemic encephalopathy by percutaneous transhepatic catheterization of the portal vein and injecting contrast medium into the superior mesenteric vein or by superior mesenteric arterial portography in comparison with patients without encephalopathy studied by percutaneous catheterization of these veins. It is suggested that chronic portal-systemic encephalopathy is a result of a large collateral route shunting a large proportion of the superior mesenteric venous blood into systemic circulation, and that development of such collaterals precludes formation of large esophageal varices. (Auth.)

Portal venous stent placement for treatment of portal hypertension caused by benign main portal vein stenosis.

Science.gov (United States)

Shan, Hong; Xiao, Xiang-Sheng; Huang, Ming-Sheng; Ouyang, Qiang; Jiang, Zai-Bo

2005-06-07

To evaluate the value of endovascular stent in the treatment of portal hypertension caused by benign main portal vein stenosis. Portal vein stents were implanted in six patients with benign main portal vein stenosis (inflammatory stenosis in three cases, postprocedure of liver transplantation in another three cases). Changes in portal vein pressure, portal vein patency, relative clinical symptoms, complications, and survival were evaluated. Six metallic stents were successfully placed across the portal vein stenotic or obstructive lesions in six patients. Mean portal venous pressure decreased significantly after stent implantation from (37.3+/-4.7) cm H(2)O to (18.0+/-1.9) cm H(2)O. The portal blood flow restored and the symptoms caused by portal hypertension were eliminated. There were no severe procedure-related complications. The patients were followed up for 1-48 mo. The portal vein remained patent during follow-up. All patients survived except for one patient who died of other complications of liver transplantation. Percutaneous portal vein stent placement for the treatment of portal hypertension caused by benign main portal vein stenosis is safe and effective.

Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis

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Sun Mi Park

2014-12-01

Full Text Available BackgroundPrimary hypophysitis causes varying degrees of endocrine dysfunction and mass effect. The natural course and best treatment have not been well established.MethodsMedical records of 22 patients who had been diagnosed with primary hypophysitis between January 2001 and March 2013 were retrospectively reviewed. Based on the anatomical location, we classified the cases as adenohypophysitis (AH, infundibuloneurohypophysitis (INH, and panhypophysitis (PH. Clinical presentation, endocrine function, pathologic findings, magnetic resonance imaging findings, and treatment courses were reviewed.ResultsAmong 22 patients with primary hypophysitis, 81.8% (18/22 had involvement of the posterior pituitary lobe. Two patients of the AH (2/3, 66.6% and three patients of the PH (3/10, 30% groups initially underwent surgical mass reduction. Five patients, including three of the PH (3/10, 33.3% group and one from each of the AH (1/3, 33.3% and INH (1/9, 11.1% groups, initially received high-dose glucocorticoid treatment. Nearly all of the patients treated with surgery or high-dose steroid treatment (9/11, 82% required continuous hormone replacement during the follow-up period. Twelve patients received no treatment for mass reduction due to the absence of acute symptoms and signs related to a compressive mass effect. Most of them (11/12, 92% did not show disease progression, and three patients recovered partially from hormone deficiency.ConclusionDeficits of the posterior pituitary were the most common features in our cases of primary hypophysitis. Pituitary endocrine defects responded less favorably to glucocorticoid treatment and surgery. In the absence of symptoms related to mass effect and with the mild defect of endocrine function, it may not require treatment to reduce mass except hormone replacement.

Automatic blood vessel based-liver segmentation using the portal phase abdominal CT

Science.gov (United States)

Maklad, Ahmed S.; Matsuhiro, Mikio; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Shimada, Mitsuo; Iinuma, Gen

2018-02-01

Liver segmentation is the basis for computer-based planning of hepatic surgical interventions. In diagnosis and analysis of hepatic diseases and surgery planning, automatic segmentation of liver has high importance. Blood vessel (BV) has showed high performance at liver segmentation. In our previous work, we developed a semi-automatic method that segments the liver through the portal phase abdominal CT images in two stages. First stage was interactive segmentation of abdominal blood vessels (ABVs) and subsequent classification into hepatic (HBVs) and non-hepatic (non-HBVs). This stage had 5 interactions that include selective threshold for bone segmentation, selecting two seed points for kidneys segmentation, selection of inferior vena cava (IVC) entrance for starting ABVs segmentation, identification of the portal vein (PV) entrance to the liver and the IVC-exit for classifying HBVs from other ABVs (non-HBVs). Second stage is automatic segmentation of the liver based on segmented ABVs as described in [4]. For full automation of our method we developed a method [5] that segments ABVs automatically tackling the first three interactions. In this paper, we propose full automation of classifying ABVs into HBVs and non- HBVs and consequently full automation of liver segmentation that we proposed in [4]. Results illustrate that the method is effective at segmentation of the liver through the portal abdominal CT images.

Congestive index of portal vein

International Nuclear Information System (INIS)

Kim, Won Ho; Kim, H. K.; Lee, S. C.; Han, S. H.; Han, K. H.; Chung, J. B.; Choi, H. J.

1989-01-01

In patients with portal hypertension, the blood flow volume is maintained despite decreased blood flow velocity due to enlargement of the vascular cross sectional area. Thus, the 'congestion index' of the portal vein, which is the ratio between the cross sectional area (cm2) and the blood flow velocity (cm/sec) determined by a Doppler ultrasonography, may be a sensitive index by which to assess portal hypertension. We performed Doppler ultrasonography on 24 normal subjects, 14 patients with biopsy proved chronic active hepatitis and 55 patients with liver cirrhosis in order to assess the diagnostic value of the congestion index. The cross sectional area of the portal vein was significantly enlarged and the mean blood flow velocity was significantly reduced in patients with liver cirrhosis compared with controls. However, the blood flow volume was no difference. The congestion index of the portal vein was significantly increased in patients with liver cirrhosis (0.113+0.035) compared with patients with chronic active hepatitis(0.078+0.029) (p<0.001) and controls (0.053+0.016) (p<0.001). The sensitivity, specificity and predictability of the congestion index for detection of patients with the cirrhosis of the liver were 76.4%, 100% and 100% respectively, when the normal range was set at mean+2SD. The results suggest that the congestion index of the portal vein may pla a significant role in diagnosis of portal hypertensive patients

Radioimmunological functional examination of the adenohypophysis on pathological conditions in the hypothalamic-hypophyseal-adrenocortical system

International Nuclear Information System (INIS)

Slavnov, V.N.; Luchitskij, E.V.

1980-01-01

The corticotropic, thyrotropic and somatotropic functions of the adenohypophysis of patients with Cushing syndrome were examined radioimmunologically. Blood corticotropine and thyrotropine of these patients was characterized by a disturbed 24 hour rhythm. The release of corticotropine and somatotropine was but little increased as response to insulin hypoglycemia. The adenohypophysis responded weakly to the stimulation by thyroliberine. With the clinical remission of Cushing syndrome following treatment with chloditane or with a combined method an increased concentration of adenohypophyseal hormones in the blood could be demonstrated. The response to insulin hypoglycemic stress and to the thyroliberine stimulation was not normalized just as the 24-hour rhythm of the blood level of corticotropine and thyreotropine. Thus it can be concluded that these disturbances are caused by injuries of the central regulatory mechanisms of the hypothalamic-hypophyseal system, and pathogenetic therapeutic methods for the Cushing syndrome must be elaborated

Intrachiasmatic abscess caused by IgG4-related hypophysitis

DEFF Research Database (Denmark)

Hadjigeorgiou, Georgios F; Lund, Eva Løbner; Poulsgaard, Lars

2017-01-01

INTRODUCTION: Autoimmune hypophysitis is a rare disease of the pituitary, which may affect vision by inflammation and compression of the optic chiasm. However, intrachiasmatic abscess formation has not been previously reported. METHODS: In this study, we report a case of a 29-year-old female with...

Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow

Energy Technology Data Exchange (ETDEWEB)

Kogita, Sachiyo; Imai, Yasuharu; Fukuda, Kazuto; Igura, Takumi; Sawai, Yoshiyuki [Ikeda Municipal Hospital, Department of Gastroenterology, Osaka (Japan); Okada, Masahiro; Murakami, Takamichi [Kinki University, School of Medicine, Department of Radiology, Osaka (Japan); Kim, Tonsok; Onishi, Hiromitsu; Hori, Masatoshi [Osaka University, Graduate School of Medicine, Department of Radiology, Osaka (Japan); Takamura, Manabu [Ikeda Municipal Hospital, Department of Radiology, Osaka (Japan); Morimoto, Osakuni [Ikeda Municipal Hospital, Department of Surgery, Osaka (Japan); Nagano, Hiroaki [Osaka University, Graduate School of Medicine, Department of Surgery, Osaka (Japan); Wakasa, Kenichi [Osaka City University, Graduate School of Medicine, Department of Diagnostic Pathology, Osaka (Japan); Hayashi, Norio [Osaka University, Graduate School of Medicine, Department of Gastroenterology and Hepatology, Osaka (Japan)

2010-10-15

To retrospectively investigate enhancement patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) in the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced MRI in relation to histological grading and portal blood flow. Sixty-nine consecutive patients with 83 histologically proven HCCs and DNs were studied. To assess Gd-EOB-DTPA uptake, we calculated the EOB enhancement ratio, which is the ratio of the relative intensity of tumorous lesion to surrounding nontumorous area on hepatobiliary phase images (post-contrast EOB ratio) to that on unenhanced images (pre-contrast EOB ratio). Portal blood flow was evaluated by CT during arterial portography. Post-contrast EOB ratios significantly decreased as the degree of differentiation declined in DNs (1.00 {+-} 0.14) and well, moderately and poorly differentiated HCCs (0.79 {+-} 0.19, 0.60 {+-} 0.27, 0.49 {+-} 0.10 respectively). Gd-EOB-DTPA uptake, assessed by EOB enhancement ratios, deceased slightly in DNs and still more in HCCs, while there was no statistical difference in the decrease between different histological grades of HCC. Reductions in portal blood flow were observed less frequently than decreases in Gd-EOB-DTPA uptake in DNs and well-differentiated HCCs. Reduced Gd-EOB-DTPA uptake might be an early event of hepatocarcinogenesis, preceding portal blood flow reduction. The hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may help estimate histological grading, although difficulties exist in differentiating HCCs from DNs. (orig.)

Proton therapy of hypophyseal adenomas

International Nuclear Information System (INIS)

Mirakova, E.I.; Kirpatovskaya, L.E.; Lyass, F.M.; Snigireva, R.Ya.; Krymskij, V.A.; Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Ehksperimental'noj Ehndokrinologii i Khimii Gormonov)

1983-01-01

The authors present the results of proton therapy in 59 patients with different hypophyseal adenomas. The period of observation lasted from 6 mos. to 5 yrs. Irradiation was done using a multifield-convergent method and a proton beam of the ITEF synchrotron. The beam energy was 200 MeV, the beam diameter 7-15 mm. Radiation response and immediate results were evaluated for all the patients. The least favorable results were noted in the patients with prolactinomas, for which, in addition to irradiation, parlodel therapy is needed. No marked radiation reactions, neurological complications and manifestations of hypopituitarism were observed with the chosen doses and schemes of irradiation

The prevalence of IgG4-related hypophysitis in 170 consecutive patients with hypopituitarism and/or central diabetes insipidus and review of the literature.

Science.gov (United States)

Bando, Hironori; Iguchi, Genzo; Fukuoka, Hidenori; Taniguchi, Masaaki; Yamamoto, Masaaki; Matsumoto, Ryusaku; Suda, Kentaro; Nishizawa, Hitoshi; Takahashi, Michiko; Kohmura, Eiji; Takahashi, Yutaka

2014-02-01

The prevalence and clinical characteristics of IgG4-related hypophysitis remain unclear due to the limited number of case reports. Therefore, in this study, we screened consecutive outpatients with hypopituitarism and/or diabetes insipidus (DI) to estimate its prevalence. A total of 170 consecutive outpatients with hypopituitarism and/or central DI were screened at Kobe University Hospital for detecting IgG4-related hypophysitis by pituitary magnetic resonance imaging, measuring serum IgG4 concentrations, assessing the involvement of other organs, and carrying out an immunohistochemical analysis to detect IgG4-positive cell infiltration. Among the screened cases, 116 cases were excluded due to diagnosis of other causes such as tumors and congenital abnormalities. Additionally, 22 cases with isolated ACTH deficiency were analyzed and were found not to meet the criteria of IgG4-related hypophysitis. The remaining 32 cases were screened and seven were diagnosed with IgG4-related hypophysitis, of which three cases were diagnosed by analyzing pituitary specimens. IgG4-related hypophysitis was detected in 30% (seven of 23 patients) of hypophysitis cases and 4% of all hypopituitarism/DI cases. The mean age at the onset of IgG4-related hypophysitis was 61.8±8.8 years, and the serum IgG4 concentration was 191.1±78.3 mg/dl (normal values 5-105 mg/dl and values in IgG4-related disease (RD) ≥135 mg/dl). Pituitary gland and/or stalk swelling was observed in six patients, and an empty sella was observed in one patient. Multiple co-existing organ involvement was observed in four of the seven patients prior to the onset of IgG4-related hypophysitis. These data suggest that the prevalence of IgG4-related hypophysitis has been underestimated. We should also consider the possibility of the development of hypopituitarism/DI caused by IgG4-related hypophysitis during the clinical course of other IgG4-RDs.

Lymphocytic hypophysitis and hypothalamitis - a case report

International Nuclear Information System (INIS)

Stelmachowska, M.; Bolko, P.; Wasko, R.; Sowinski, J.; Kosinski, D.; Towpik, I.

2006-01-01

Lymphocytic hypophysitis is an unusual disorder that nearly exclusively affects women. We present a case of 69 year-old female patient who developed the symptoms of diabetes insipidus and partial insufficiency of the anterior pituitary gland. Magnetic resonance imaging of the brain revealed a mass involving the sella and suprasellar region. After exclusion of other causes of infiltrate in this region and due to evident reaction to glucocorticoid treatment the diagnosis of lymphocytic hypophisitis and hypothalamitis was established. (author)

Cine phase-contrast MR to assess portal blood flow in a 10-year-old girl with abdominal aortic coarctation: a case report

International Nuclear Information System (INIS)

Clark, T.W.I.; Culham, J.A.G.

1998-01-01

We report the case of a 10-year-old girl with repaired abdominal aortic coarctation in whom chronic mesenteric ischemia was clinically suspected. Cine phase-contrast magnetic resonance (MR) was used to determine the difference between fasting and postprandial portal blood flow. Fasting flow rates in the portal vein were normal. After a meal, blood flow in the portal vein increased 226 % over the fasting state, showing normal augmentation. To the best of our knowledge, this is the first application of this technique to a pediatric setting. (orig.)

Quantitative measurement of portal blood flow by magnetic resonance phase contrast. Comparative study of flow phantom and Doppler ultrasound in vivo

International Nuclear Information System (INIS)

Tsunoda, Masatoshi; Kimoto, Shin; Hamazaki, Keisuke; Takeda, Yoshihiro; Hiraki, Yoshio.

1994-01-01

A non-invasive method for measuring portal blood flow by magnetic resonance (MR) phase contrast was evaluated in a flow phantom and 20 healthy volunteers. In a flow phantom study, the flow volumes and mean flow velocities measured by MR phase contrast showed close correlations with those measured by electromagnetic flow-metry. In 20 healthy volunteers, the cross-sectional areas, flow volumes and mean flow velocities measured by MR phase contrast correlated well with those measured by the Doppler ultrasound method. Portal blood flow averaged during the imaging time could be measured under natural breathing conditions by using a large number of acquisitions without the limitations imposed on the Doppler ultrasound method. MR phase contrast is considered to be useful for the non-invasive measurement of portal blood flow. (author)

Metástasis hipofisaria Hypophyseal metastasis

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Miguel Ángel Yanes Quesada

2009-04-01

Full Text Available mayoría son lesiones silentes descubiertas accidentalmente en las autopsia. La aparición de metástasis sintomáticas es, en cambio, excepcional. DESARROLLO: se describen aquí los hallazgos clínicos y radiológicos de una paciente femenina de 69 años, con un carcinoma indiferenciado del pulmón, diagnosticado hace 2 años y medio, que comenzó con cefalea y trastornos visuales sin hipopituitarismo ni diabetes insípida. Se le realizó resonancia magnética nuclear y se le diagnosticó una lesión hipofisaria, que fue operada por vía tranesfenoidal, y se informó por anatomía patológica una metástasis del carcinoma del pulmón. CONCLUSIONES: la paciente se encuentra en estos momentos recibiendo quimioterapia, radioterapia y anticuerpo monoclonal con evolución favorable.INTRODUCTION: metastatic tumors of hypophyseal gland are infrequent. Most are silent lesions discovered accidentally in necropsy. Appearance of symptomatic metastasis is however, exceptional. DEVELOPMENT: we describe here clinical and radiological findings in a female patient aged 69, presenting with a non-differential carcinoma of lung, diagnosed two years a half ago, starting with headache and visual disorders without hypopituitarism and insipidus diabetes. We made a nuclear magnetic resonance and diagnosis was a hypophyseal lesion operated on by trans-esphenoidal route, and Pathological Anatomy Service reports a metastasis of lung carcinoma. CONCLUSIONS: patient receives chemotherapy, radiotherapy, and monoclonal antibody with a favorable evolution.

Portal Vein Dopplerflowmetry in healthy sheep according to age

Directory of Open Access Journals (Sweden)

Alexandra F. Belotta

Full Text Available ABSTRACT: Pulsed Doppler ultrasound was used to evaluate portal blood flow, portal velocity and portal congestion index in 24 healthy sheep divided into groups (lambs, yearlings and ewes, according to age. Measurements were performed at the 11th right intercostal space using ideal insonation angle and uniform insonation method. Mean values obtained in each group were compared with one-way ANOVA, followed by Tukey post-hoc test. Portal velocity and portal blood flow were statistically similar between the groups (P>0.05. Mean portal velocity were 17.75; 17.13 and 16.75; while mean portal blood flow were 26.65; 31.04 and 24.32 for lambs, yearlings and ewes, respectively. Portal congestion index was statistically distinct between the groups and values for lambs, yearlings and ewes were 0.009; 0.058 and 0.09, respectively (P<0.01. Statistical differences were observed in portal vein diameter, portal vein area and portal congestion index between the groups, presumably due to influence of weight and not to age.

Proscillaridin activity in portal and peripheral venous blood after oral administration to man

International Nuclear Information System (INIS)

Andersson, K.E.; Bergdahl, B.; Dencker, H.; Wettrell, G.; Linkoeping Univ.

1977-01-01

The absorption of proscillaridin A was studied in four patients undergoing catheterization of the portal vein for diagnostic purposes. Proscillaridin 1.5 mg was given as a single oral dose and plasma glycoside activity was analyzed by the 86 Rb-uptake inhibition technique. Proscillaridin appeared rapidly in the portal blood, peak activity being found after 15 min in three and after 30 min in one patient. In peripheral blood the peak activity occurred after approximately 35 min. Despite rapid passage across the gut wall, porto-peripheral differences in glycoside activity were small; they were zero after 4h. The mean amount absorbed as active proscillaridin during the first 4h after the dose was calculated to be only 7.1% of the given amount. Late porto-peripheral differences, probably due to enterohepatic recycling, appeared after 6h in three patients. The results suggest that proscillaridin undergoes first pass inactivation in the gut wall. Enterohepatic recirculation may contribute to the amounts of active glycoside that reach the systemic circulation. (orig.) [de

The questions of working out radiology patterns of portal hypertension

International Nuclear Information System (INIS)

Vyikman, Ya.E.

2008-01-01

A foundation for radiological patterns of each type of portal hypertension (PH) at various stages of its development. Portal blood pressure, diameter of splenic and portal veins, volume blood flow velocity in the portal and splenic veins, incidence of hypersplenism, enlargement of the caudate lobe of the liver and gallbladder fossa are the most informative in differentiation of various forms of portal hypertension

Protein profiles of serum, brain regions and hypophyses of pubertal ...

African Journals Online (AJOL)

The effects of dietary fumonisin B1 (FB1 ), a toxin produced mainly by Fusarium verticillioides and F. proliferatum that grow on maize worldwide, on protein profiles of serum, brain regions and hypophyses were studied in 24 male Large White weanling pigs randomly divided into four groups (n = 6). In a completely ...

[Clinical use of RU 486: control of the menstrual cycle and effect on the hypophyseal-adrenal axis].

Science.gov (United States)

Gaillard, R C; Herrmann, W

1983-01-01

RU 486 is a synthetic 19 norsteroid with a great affinity for progesterone and glucocorticosteroid receptors. The antiprogesterone activity of RU 486 permits interruption of the luteal phase of the menstrual cycle and of early pregnancy, while the antiglucocorticosteroid activity interrupts the feedback mechanisms of cortisol at the hypothalamic-pituitary axis. 11 women aged 18-34 years who were 6-8 weeks pregnant were given daily doses of 200 mg of sensation of lipothymia. Blood pressure and laboratory test results remained normal. The daily increase of beta human chorionic gonadotropin (HCG) and progesterone was stopped by the antiprogesterone. It has been demonstrated in vitro that RU 486 inhibits secretion of beta HCG by cells of trophoblastic origin. 2 weeks after expulsion of the products of conception, the blood levels of beta HCG, progesterone, and estradiol had returned to nonpregnant values and ovarian activity was normal in women not using oral contraceptives. The reason for failure of expulsion in 2 cases was not known. RU 486 was also used to interrupt the luteal phase of normal menstrual cycles in 3 young women. 50 mg/day of RU 486 starting on the 22nd day was sufficient to induce bleeding within 48 hours. Studies using RU 486 50 mg/day beginning on the 10th cycle day indicate that progesterone plays a central and follicular role during the preovulatory period. The antiglucocorticosteroid activity of RU 486 was observed in pregnant women who received the abortifacient dose of 200 mg/day. The 8 a.m. plasma level of ACTH and beta-LPH cortisol remained elevated for thee 4 days of treatment. Nonpregnant women receiving 50 mg of RU 486 for 4 days beginning on the 22nd cycle day had no change in the level of hypophyseal-adrenal hormones.dd Tests in young male volunteers showed that RU 486 amplified circadian rhythms of the hypophysealadrenal axis, affecting specifically the morning hormonal levels without influencing afternoon levels. A test in which RU 486

Classification of hypervascular liver lesions based on hepatic artery and portal vein blood supply coefficients calculated from triphasic CT scans.

Science.gov (United States)

Boas, F Edward; Kamaya, Aya; Do, Bao; Desser, Terry S; Beaulieu, Christopher F; Vasanawala, Shreyas S; Hwang, Gloria L; Sze, Daniel Y

2015-04-01

Perfusion CT of the liver typically involves scanning the liver at least 20 times, resulting in a large radiation dose. We developed and validated a simplified model of tumor blood supply that can be applied to standard triphasic scans and evaluated whether this can be used to distinguish benign and malignant liver lesions. Triphasic CTs of 46 malignant and 32 benign liver lesions were analyzed. For each phase, regions of interest were drawn in the arterially enhancing portion of each lesion, as well as the background liver, aorta, and portal vein. Hepatic artery and portal vein blood supply coefficients for each lesion were then calculated by expressing the enhancement curve of the lesion as a linear combination of the enhancement curves of the aorta and portal vein. Hepatocellular carcinoma (HCC) and hypervascular metastases, on average, both had increased hepatic artery coefficients compared to the background liver. Compared to HCC, benign lesions, on average, had either a greater hepatic artery coefficient (hemangioma) or a greater portal vein coefficient (focal nodular hyperplasia or transient hepatic attenuation difference). Hypervascularity with washout is a key diagnostic criterion for HCC, but it had a sensitivity of 72 % and specificity of 81 % for diagnosing malignancy in our diverse set of liver lesions. The sensitivity for malignancy was increased to 89 % by including enhancing lesions that were hypodense on all phases. The specificity for malignancy was increased to 97 % (p = 0.039) by also examining hepatic artery and portal vein blood supply coefficients, while maintaining a sensitivity of 76 %.

Comparative study of portal hemodynamics and regional hepatic blood flow before and after hepatic resection by 133Xe-scintiphotosplenoportography

International Nuclear Information System (INIS)

Yasuda, Tadashi; Sasaki, Yo; Imaoka, Shingi; Shibata, Takashi; Wada, Hisashi; Nagano, Hiroaki; Iwanaga, Takeshi; Nakano, Shunichi; Hasegawa, Yoshihisa.

1990-01-01

Changes in the portal circulatory pattern and regional hepatic blood flow (rHBF) after surgical liver resection were studied by 133 Xe-scintiphotosplenoportography (SSP). The visual patterns of pre- and postoperative portal circulation were compared. Different patterns were observed after the operation in five of 27 patients (porto-systemic shunt formation 3, progression 1, regression 1). The patients with porto-systemic shunt showed postopertive complications (massive ascites, jaundice, cardiopulmonary failure) more frequently than those without it. The ratio of rHBF increase (post-/pre-operative rHBF) was 1.36±0.63 on average. The ratio was higher in patients with good liver function or without liver cirrhosis. The ratio also correlated with the weight of the liver resected. But operation time, blood loss or whether hepatic blood supply was clamped off during the operation did not affect the ratio. Resection in the right lobe, however, caused a greater rHBF increase in the residual liver than the same degree of resection in the left lobe. SSP could be a useful method for investigating the effect of hepatic resection on portal hemodynamics and it is suggested that existence of portosystemic shunt influences the postoperative course. (author)

Portal hypertension as portrayed by marked hepatosplenomegaly: case report

International Nuclear Information System (INIS)

Greene, R.A.

1987-01-01

The liver is vulnerable to as host of disease processes, including portal hypertension. This is a severe hepatic condition in which the liver is subject to numerous imbalances: increased hepatic blood flow, increased portal vein pressure due to extrahepatic portal vein obstruction, and/or increases in hepatic blood flow resistance. Although many diseases states may be responsible for the development of portal hypertension, it is most commonly associated with moderately severe or advanced cirrhosis. Advanced, untreated portal hypertension may cause additional complications such as hepatosplenomegaly, gastrointestinal bleeding, and ascites

Portal hypertension: a review of portosystemic collateral pathways and endovascular interventions

International Nuclear Information System (INIS)

Pillai, A.K.; Andring, B.; Patel, A.; Trimmer, C.; Kalva, S.P.

2015-01-01

The portal vein is formed at the confluence of the splenic and superior mesenteric vein behind the head of the pancreas. Normal blood pressure within the portal system varies between 5 and 10 mmHg. Portal hypertension is defined when the gradient between the portal and systemic venous blood pressure exceeds 5 mmHg. The most common cause of portal hypertension is cirrhosis. In cirrhosis, portal hypertension develops due to extensive fibrosis within the liver parenchyma causing increased vascular resistance. In addition, the inability of the liver to metabolise certain vasodilators leads to hyperdynamic splanchnic circulation resulting in increased portal blood flow. Decompression of the portal pressure is achieved by formation of portosystemic collaterals. In this review, we will discuss the pathophysiology, anatomy, and imaging findings of spontaneous portosystemic collaterals and clinical manifestations of portal hypertension with emphasis on the role of interventional radiology in the management of complications related to portal hypertension

MRI of lymphocytic hypophysitis

International Nuclear Information System (INIS)

Feng Feng; Li Mingli; Li Xiaozhen; Meng Chunling; Jin zhengyu

2005-01-01

Objective: To describe the MR findings in patients with lymphocytic hypophysitis (LyH), and to discuss MR diagnostic value and limit in this disease entity and its differentiation with pituitary adenoma. Methods: Five pathologically proven cases of LyH were recruited in this study. The main complaints of the patients were polydipsia, polyuria, and headache. The preoperative MR images and clinical manifestations were analyzed retrospectively. Results: MR findings of the 5 patients with LyH included enlargement of pituitary gland, stalk thickening, disappearance of high signal of neurohypophysis on T 1 WI, and marked Gadolinium enhancement of the lesions. Homogeneous enhancement was found in 2 cases, while heterogeneous enhancement was in 3 cases. Involvement of the cavernous sinus and dura mater on dorsum sella and clivus were found in 2 patients. Conclusion: The diagnosis of LyH should be suggested when the enlarged pituitary gland is associated with central diabetes insipidus, and with/without dysfunction of adenohypophysis. (authors)

Ascorbic acid deficiency increases endotoxin influx to portal blood and liver inflammatory gene expressions in ODS rats.

Science.gov (United States)

Tokuda, Yuki; Miura, Natsuko; Kobayashi, Misato; Hoshinaga, Yukiko; Murai, Atsushi; Aoyama, Hiroaki; Ito, Hiroyuki; Morita, Tatsuya; Horio, Fumihiko

2015-02-01

The aim of this study was to determine whether ascorbic acid (AsA) deficiency-induced endotoxin influx into portal blood from the gastrointestinal tract contributes to the inflammatory changes in the liver. The mechanisms by which AsA deficiency provokes inflammatory changes in the liver were investigated in Osteogenic Disorder Shionogi (ODS) rats (which are unable to synthesize AsA). Male ODS rats (6-wk-old) were fed a diet containing sufficient (300 mg/kg) AsA (control group) or a diet without AsA (AsA-deficient group) for 14 or 18 d. On day 14, the hepatic mRNA levels of acute-phase proteins and inflammation-related genes were significantly higher in the AsA-deficient group than the control group, and these elevations by AsA deficiency were exacerbated on day 18. The serum concentrations of interleukin (IL)-1β and IL-6, which induce acute-phase proteins in the liver, were also significantly elevated on day 14 in the AsA-deficient group compared with the respective values in the control group. IL-1β mRNA levels in the liver, spleen, and lung were increased by AsA deficiency. Moreover, on both days 14 and 18, the portal blood endotoxin concentration was significantly higher in the AsA-deficient group than in the control group, and a significant correlation between serum IL-1β concentrations and portal endotoxin concentrations was found in AsA-deficient rats. In the histologic analysis of the ileum tissues, the number of goblet cells per villi was increased by AsA deficiency. These results suggest that AsA deficiency-induced endotoxin influx into portal blood from the gastrointestinal tract contributes to the inflammatory changes in the liver. Copyright © 2015 Elsevier Inc. All rights reserved.

Function of hypothalamic-hypophyseal-ovarian system in radiation treatment of patients with cervical cancer

International Nuclear Information System (INIS)

Modnikov, O.P.

1984-01-01

Radioimmunoassay of the hypothalamic-hypophyseal-ovarian interrelationships was performed in 87 patients with cervical cancer and 37 practically healthy women. The basal level of the follicle-stimulating hormone (ESH), luteinizing hormone (LH) and estradiol as well as their response to the administration of the releasing factor of the hypothalamus (luliberin) were studied. Some disorders that manifested thermselved in the decreased level of estradiol, were established in the patients with cervical cancer even before irradiation. Concomitant radiation therapy resulted in pronounced changes in the activities of the hypothalamic-hypophyseal-ovarian system that manifested themselves in the lowered rate of LH increment in response to the administration of luliberin and the absence of estradiol response to the load. These changes persisted long after the termination of concomitant radiation therapy

Índice de congestão portal e a ocorrência de trombose portal pós-dape Portal congestion and thrombosis after EDS

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Fabio Gonçalves Ferreira

2005-08-01

portal vein were analyzed: diameter, area, mean blood flow velocity and blood flow, whereupon the congestion index was calculated. RESULTS: The diameter, area and blood flow of the portal vein were greater in group B (mean of 1.52 cm; 1.77 cm² and 2533.12 ml / min than in group A (mean of 1.33 cm; 1.44 cm² and 1609.03 ml / min with p = 0.03; 0.03 and 0.04 respectively. Difference of the congestion index was not statistically significant between the two groups (p = 0.07. CONCLUSIONS: The portal vein congestion index at the preoperative of EDS estimated by Doppler ultrasound was not predictive of portal vein thrombosis in the postoperative of patients with portal hypertension due to schistosomiasis.

Doppler US evaluation of the hypertensive portal system

International Nuclear Information System (INIS)

Needleman, L.; Kurtz, A.B.; Bezzi, M.; Rifkin, M.D.; Pasto, M.E.; Pennell, R.G.; Baltarowich, O.H.; Goldberg, B.B.

1986-01-01

In patients with known portal hypertension, pulsed Doppler US was used for qualitative and directional evaluation of flow in the portal venous system and collateral vessels. Most patients had normal hepatopetal flow. Doppler US revealed the following abnormal blood flow patterns: hepatofugal portal flow, bidirectional portal flow, intrahepatic portal shunting, flow in portasystemic collaterals, and hepatic vein obstruction. Doppler US can provide important clinical information in the evaluation of portal hypertension

Portal hypertension: a review of portosystemic collateral pathways and endovascular interventions.

Science.gov (United States)

Pillai, A K; Andring, B; Patel, A; Trimmer, C; Kalva, S P

2015-10-01

The portal vein is formed at the confluence of the splenic and superior mesenteric vein behind the head of the pancreas. Normal blood pressure within the portal system varies between 5 and 10 mmHg. Portal hypertension is defined when the gradient between the portal and systemic venous blood pressure exceeds 5 mmHg. The most common cause of portal hypertension is cirrhosis. In cirrhosis, portal hypertension develops due to extensive fibrosis within the liver parenchyma causing increased vascular resistance. In addition, the inability of the liver to metabolise certain vasodilators leads to hyperdynamic splanchnic circulation resulting in increased portal blood flow. Decompression of the portal pressure is achieved by formation of portosystemic collaterals. In this review, we will discuss the pathophysiology, anatomy, and imaging findings of spontaneous portosystemic collaterals and clinical manifestations of portal hypertension with emphasis on the role of interventional radiology in the management of complications related to portal hypertension. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Treatment of portal hypertension caused by benign main portal vein stenosis with endovascular stent

International Nuclear Information System (INIS)

Huang Mingsheng; Shan Hong; Jiang Zaibo; Guan Shouhai; Zhu Kangshun; Li Zhengran; Zhou Yubin; He Bingjun

2004-01-01

Objective: To evaluate the value of endovascular stent in the treatment of portal hypertension caused by benign main portal vein stenosis. Methods: Portal vein stents were implanted in 6 patients with benign main portal vein stenosis (inflammatory stenosis in 3 cases, postprocedure of liver transplantation in another 3 cases). The change of portal vein pressure, the patency of portal vein, relative clinical symptoms, complications, and survival were evaluated. Results: Six metallic stents were successfully placed across the portal vein stenotic or obstructive lesions in all 6 patients. Mean portal venous pressure decreased significantly after stent implantation from (37.3 ± 4.7) cm H 2 O (1 cm H 2 O=0.098 kPa) to (18.0 ± 1.9) cm H 2 O (P<0.001). The portal blood flow was restored, and the symptoms caused by portal hypertension were eliminated. There was no severe procedure-related complication. Follow-up time was from 5 to 36 months. The portal vein remained patent during the follow-up. All patients survived except one patient who died of other complications of liver transplantation. Conclusion: Percutaneous portal vein stent placement for the treatment of the benign main portal vein stenosis is safe and effective. (authors)

Ultrasonography for Noninvasive Assessment of Portal Hypertension.

Science.gov (United States)

Maruyama, Hitoshi; Yokosuka, Osamu

2017-07-15

Portal hypertension is a major pathophysiology in patients with cirrhosis. Portal pressure is the gold standard to evaluate the severity of portal hypertension, and radiological intervention is the only procedure for pressure measurement. Ultrasound (US) is a simple and noninvasive imaging modality available worldwide. B-mode imaging allows broad applications for patients to detect and characterize chronic liver diseases and focal hepatic lesions. The Doppler technique offers real-time observation of blood flow with qualitative and quantitative assessments, and the application of microbubble-based contrast agents has improved the detectability of peripheral blood flow. In addition, elastography for the liver and spleen covers a wider field beyond the original purpose of fibrosis assessment. These developments enhance the practical use of US in the evaluation of portal hemodynamic abnormalities. This article reviews the recent progress of US in the assessment of portal hypertension.

Combined Rex-bypass shunt with pericardial devascularization alleviated prehepatic portal hypertension caused by cavernomatous transformation of portal vein.

Science.gov (United States)

Wang, Ruo-Yi; Wang, Jun-Feng; Liu, Qian; Ma, Nan; Chen, Wei-Xiu; Li, Jin-Liang

2017-09-01

To evaluate the effects of combined Rex-bypass shunt and pericardial devascularization on prehepatic portal hypertension secondary to cavernomatous transformation of portal vein (CTPV). Forty-two patients aged from 3 years to 49 years (divided into 3 groups), 26 cases male and 16 female, with prehepatic vascular hepertention were treated with Rex-bypass shunt combined with pericardial devascularization. In each patient, preoperative assessment included ultrasound and computed tomographic angiography of the portal vein and blood analysis. The procedure was Rex-bypass shunt (with or without graft), and patients with moderate or severe gastroesophageal varices required additional paraesophagogastric devascularization. Splenectomy or subtotal splenectomy was performed if combined hypersplenism co-existed. All data were analyzed retrospectively. No intraoperative death occurred, blood routine analysis improved (P portal vein (LPV) significantly increased, the esophageal and gastric varices significantly relieved in 34 patients (P portal hypertension caused by CTPV.

Endoscopic Doppler ultrasound for measurement of azygos blood flow. Validation against thermodilution and assessment of pharmacological effects of terlipressin in portal hypertension

DEFF Research Database (Denmark)

Hansen, Erik Feldager; Bendtsen, Flemming; Brinch, K

2001-01-01

technique were compared in 20 patients with portal hypertension. The ability of EUS flowmetry to detect changes in the azygos and portal venous flow after an intravenous dose of 2 mg of terlipressin was evaluated in 13 of the patients in a double-blind, randomized, placebo-controlled, cross-over design...... in patients with portal hypertension....... administration of terlipressin, the azygos blood flow, as measured by EUS Doppler, decreased significantly by 23% from 915 to 704 ml/min (P = 0.014) and the portal venous flow decreased by 28% from 1170 to 789 ml/min (P = 0.03). No effects of placebo were detected. CONCLUSIONS: These results show that EUS...

Portal vein thrombosis.

Science.gov (United States)

Chawla, Yogesh K; Bodh, Vijay

2015-03-01

Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion.

Subacute Hypophysitis with Panhypopituitarism as First Presentation of HIV and Syphilis Coinfection.

Science.gov (United States)

Alves, Rute; França, Margarida

2017-01-01

Infection by Treponema pallidum still represents a clinical challenge due to its various forms of presentation. HIV coinfection added diversity and changed the natural history of syphilis as a systemic infection. We present a rare case of subacute hypophysitis and panhypopituitarism due to an early active neurosyphilis in a previously unknown HIV coinfected patient.

Xanthomatous Hypophysitis Mimicking a Pituitary Adenoma: Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Laura Aste

2010-01-01

Full Text Available Background. Hypophysitis is an inflammatory disease of the pituitary gland that may mimic pituitary tumors clinically and radiologically. Case Description. We report a case of a xanthomatous hypophysitis initially diagnosed as pituitary adenoma. A 31-year-old woman presented with headache, diabetes insipidus, and amenorrhea. A head CT scan showed no intrasellar changes, while an MRI scan showed a sellar cystic mass. An endocrinological work up revealed mild hypocortisolism and diabetes insipidus (DI. Transsphenoidal surgery was performed. The intraoperative histological examination suggested a pituitary adenoma. The removed tissue showed central necrosis surrounded by accumulation of foamy cells and xanthomatous epithelioid cells. The patient made an uneventful postoperative recovery, Nevertheless, DI persisted and the adenohypophysis hypofunction did not recover. Conclusion. We describe an unusual inflammatory lesion of the pituitary gland mimicking an adenoma. A high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.

Unusual IgG4-related hypophysitis: one case report and analysis of clinicopathological characteristics

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Zhen-qi LI

2014-10-01

Full Text Available Background Immunoglobulin G4 (IgG4-related disease is a recently characterized autoimmune disease entity marked by elevated serum IgG4 levels and tissue infiltration by IgG4-positive plasma cells in multiple involved organs. Hypophysitis is a rare inflammatory disorder and IgG4-related sclerosing disease involving the ituitary alone is especially rare. Imaging studies may reveal a mass lesion in the sellar area or a thickening of pituitary stalk, mimicking a pituitary tumor. Due to its rarity and non-specific appearance in radiological examination, it is a diagnostic challenge for clinicians and histopathologists to differentiate solitary IgG4-related hypophysitis from other pituitary lesions. The aim of this study is to summarize the clinicopathological features of unusual IgG4-related hypophysitis and discuss the differential diagnosis of histologically similar inflammatory lesions in pituitary. Methods The clinical manifestation of a patient with solitary IgG4-related hypophysitis was presented retrospectively. Resected mass was routinely paraffin-embedded and stained with Hematoxylin and Eosin. Dako EnVision immunohistochemical staining system was used to detect the tumor antigen expressions, including vimentin (Vim, S-100 protein (S-100, pan cytokeratin (PCK, epithelial membrane antigen (EMA, CD3, CD20, CD68, CD1a, κ-light chain, λ-light chain and progestrone receptor (PR.  Results A 47-year-old male patient presented with 1-year history of mild limb weakness and hyposexuality. Laboratory examination revealed hypopituitarism with low levels of serum testosterone, cortisol, luteinizing hormone (LH and follicle stimulating hormone (FSH, although his serum IgG4 level was high. MRI of the pituitary gland revealed a mass lesion in the sellar area with T1WI mild hyperintense and homogeneous enhancement after gadolinium administration. The patient underwent a transsphenoidal mass resection of the pituitary gland. Histological examination

Studies on blood supply of liver metastasis with DSA, CT and portal vein perfusion CT during superior mesenteric arterial portography

International Nuclear Information System (INIS)

Li Zhigang; Shi Gaofeng; Huang Jingxiang; Li Shunzong; Liang Guoqing; Wang Hongguang; Han Pengyin; Wang Qi; Gu Tieshu

2008-01-01

Objective: To probe the blood supply of liver metastasis by celiac artery, proper hepatic artery DSA, portal vein perfusion CT during superior mesenteric arterial portography (PCTAP). Methods: One hundred patients with liver metastases were examined prospectively by plain CT scan, multiphase enhanced CT scan, celiac arteriography and proper hepatic arteriography. Of them, 56 patients were examined by PCTAP. All primary lesions were confirmed by operation and (or) pathology examination. In order to investigate the blood supply of metastasis lesions, the software of Photoshop was used to obtain the time-attenuation curves (TDC) of tumor center, tumor edge, portal vein and normal liver parenchyma adjacent to the tumor to calculate liver perfusion for DSA image analysis, while a deconvolution model from CT perfusion software was designed for the dual blood supply. Results: DSA findings: TDC of proper hepatic arteriography showed: the mean peak concentration (K value) in tumor centers was (67 ± 12)%, and it was (76 ± 15)% for peritumor tissue, (51 ± 10)% in normal liver parenchyma. TDC of celiac arteriogaphy showed that the contrast concentration of tumor centers and tumor edge increased fast in early stage, then maintained a slight upward plateau, in the meanwhile, the contrast concentration of normal liver parenchyma kept increasing slowly. PCTAP findings: tumors exhibited no enhancement during 30 s continued scans. Conclusion: The blood supply of liver metastasis mainly comes from hepatic artery, but barely from portal vein. (authors)

Subacute Hypophysitis with Panhypopituitarism as First Presentation of HIV and Syphilis Coinfection

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Rute Alves

2017-01-01

Full Text Available Infection by Treponema pallidum still represents a clinical challenge due to its various forms of presentation. HIV coinfection added diversity and changed the natural history of syphilis as a systemic infection. We present a rare case of subacute hypophysitis and panhypopituitarism due to an early active neurosyphilis in a previously unknown HIV coinfected patient.

A transseptal approach in transsphenoidal surgery for pituitary (hypophyseal) tumors

International Nuclear Information System (INIS)

Gierek, T.; Galuszko-Ignasiak, B.; Krauze, J.; Rudnik, A.

1994-01-01

The authors described the direct transseptal approach in transsphenoidal surgery for hypophyseal tumors. This route gives a good insight into the area of the sella. The above mentioned method is also less destructive to nasal structures in the nasal cavity, because preserves the anterior nasal septum. It is uniformity of actually views of rhinological school. 20 patients were operated using this method and none of them noticed the changes of nasal airway and the sense of smell. (author)

Efficiency of herbal medicine Dai-kenchu-to on portal blood flow in rat models.

Science.gov (United States)

Muraoka, Izumi; Takatsuki, Mitsuhisa; Soyama, Akihiko; Yamaguchi, Izumi; Tanaka, Shiro; Tanaka, Takayuki; Kinoshita, Ayaka; Hara, Takanobu; Kuroki, Tamotsu; Eguchi, Susumu

2015-09-01

To clarify the influence of Dai-Kenchu-To (DKT) on portal blood flow (PBF), PBF was continuously measured with Doppler ultrasound. Normal liver rats were divided into a DKT 90 mg/kg, DKT 270 mg/kg administered group, and control, while cirrhotic liver rats were divided into a DKT-LC 90 mg/kg administered group and Control-LC. The PBF was measured after the administration of either DKT or water for 60 min by laser Doppler flowmetry system. The PBF in the DKT 90 increased approximately 10 min after DKT was administrated, and elevated levels were maintained for approximately 10 min. A comparison of the increase in PBF by the calculating the area under the curve (AUC) revealed that flow was significantly higher in the DKT 90 compared to either the control or the DKT 270 (p DKT-LC and Control-LC. The AUC, revealed no significant difference between the DKT-LC and Control-LC. DKT induced an increase in PBF in normal livers; however, its effects were insufficient to increase PBF in the cirrhotic livers. No increase in the portal blood flow in the cirrhotic liver rats was probably the result of the cirrhotic liver, which had fibrotic change, and, therefore, may not have had sufficient compliance to accept the increasing blood flow volume from the intestinal tract. We suggested DKT has the potential to protect the liver by increasing PBF when the liver has either normal or mild to moderate dysfunction.

Base of tongue varices associated with portal hypertension

OpenAIRE

Jassar, P; Jaramillo, M; Nunez, D

2000-01-01

A symptomatic case of tongue base varices in a patient with portal hypertension secondary to liver cirrhosis is presented. There are no previously documented cases in the world literature. Oesophageal varices may not be the only source of expectorated blood in a patient with portal hypertension.


Keywords: portal hypertension; lingual; tongue; varicose vein

Pathophysiology of Portal Hypertension and Its Clinical Links

Science.gov (United States)

Seo, Yeon Seok; Shah, Vijay H

2011-01-01

Portal hypertension is a major cause of morbidity and mortality in patients with liver cirrhosis. Intrahepatic vascular resistance due to architectural distortion and intrahepatic vasoconstriction, increased portal blood flow due to splanchnic vasodilatation, and development of collateral circulation have been considered as major factors for the development of portal hypertension. Recently, sinusoidal remodeling and angiogenesis have been focused as potential etiologic factors and various researchers have tried to improve portal hypertension by modulating these new targets. This article reviews potential new treatments in the context of portal hypertension pathophysiology concepts. PMID:25755320

Restoration and maintenance of spermatogenesis by HCG therapy in patients with hypothalamo-hypophyseal damage.

Science.gov (United States)

Levalle, O; Bokser, L; Pacenza, N; Aszenmil, G; Fiszlejder, L; Chervin, A; Guitelman, A

1984-01-01

Both gonadotropins are necessary to induce spermatogenesis in man and to recover hypophysectomized males. The patients who suffer from tumoral or traumatic hypothalamo-hypophyseal lesion use to have low endogenous gonadotropins (opposite to hypophysectomized patients), which can produce a minor involution of spermatogenesis. Three patients with postpubertal hypogonadotropic hypogonadism and oligozoospermia were studied. Two of them were operated on for chromophobous adenoma of pituitary, and the other patient had traumatic hypothalamo-hypophyseal lesion. The three patients were treated with 5000 IU HCG/week, associated with testosterone enanthate, in two cases and with bromocryptine in the remaining one. All the patients had normalized spermiogram, but when HCG was interrupted, the sperm count regressed to pretreatment levels in spite of the maintenance of treatment with testosterone or bromocryptine. Minimal amounts of FSH together the testosterone supplied by Leydig cell under the HCG stimulus, are able to recover and maintain the spermatogenesis in these patients.

Visualization of portal venous system by single photon emission CT

Energy Technology Data Exchange (ETDEWEB)

Kashiwagi, T; Ikawa, T; Azuma, M; Matsuda, H; Yoshioka, H; Mitsutani, N; Koizumi, T

1987-03-01

Single photon emission CT (SPECT) was performed for the intra-abdominal blood pool with /sup 99m/Tc autologous red blood cells (RBC) in 15 patients with liver cirrhosis. Twenty mCi of /sup 99m/Tc-RBC labeled by in vivo technique were administered intravenously and tomographic imaging of the intra-abdominal vascular blood pool was performed as follows. For each subject, 64 views were obtained over 360 deg of elliptic rotation at 30 seconds per view using a high resolution low energy parallel-hole collimator. Portal vein and portosystemic collaterals were clearly observed in coronal images. In 12 of 15 patients, portal vein was delineated. Portosystemic collaterals such as coronary vein, splenorenal shunt and umbilical vein were also shown in 12 patients. These images were consistent with images obtained by scintiphotosplenoportography or arterial portography. Therefore, it is considered that SPECT study for the intra-abdominal blood pool is clinically very useful for the diagnosis of abnormality of portal venous system in portal hypertension.

Evaluation of adenohypophyseal reserve in patients carrier of hypophyseal adenoma treated by trans-sphenoidal surgery

International Nuclear Information System (INIS)

Drubscky, A.T.

1980-01-01

Fifteen patients carrier hypophyseal adenomas, with ages varying between 16 to 53 years were studied. The patients presented sella changes to the conventional plane radiographies and were submited a surgery treatment, with acess to hypophysis by the trans-sphenoidal way. (author)

Conservation of Three-Dimensional Helix-Loop-Helix Structure through the Vertebrate Lineage Reopens the Cold Case of Gonadotropin-Releasing Hormone-Associated Peptide

OpenAIRE

Daniela I. Pérez Sirkin; Daniela I. Pérez Sirkin; Anne-Gaëlle Lafont; Nédia Kamech; Gustavo M. Somoza; Paula G. Vissio; Paula G. Vissio; Sylvie Dufour

2017-01-01

GnRH-associated peptide (GAP) is the C-terminal portion of the gonadotropin-releasing hormone (GnRH) preprohormone. Although it was reported in mammals that GAP may act as a prolactin-inhibiting factor and can be co-secreted with GnRH into the hypophyseal portal blood, GAP has been practically out of the research circuit for about 20 years. Comparative studies highlighted the low conservation of GAP primary amino acid sequences among vertebrates, contributing to consider that this peptide onl...

Velocity Estimation of the Main Portal Vein with Transverse Oscillation

DEFF Research Database (Denmark)

Brandt, Andreas Hjelm; Hansen, Kristoffer Lindskov; Nielsen, Michael Bachmann

2015-01-01

This study evaluates if Transverse Oscillation (TO) can provide reliable and accurate peak velocity estimates of blood flow the main portal vein. TO was evaluated against the recommended and most widely used technique for portal flow estimation, Spectral Doppler Ultrasound (SDU). The main portal...

A novel canine model of portal vein stenosis plus thioacetamide administration-induced cirrhotic portal hypertension with hypersplenism.

Science.gov (United States)

Lin, Dexin; Wu, Xianbin; Ji, Xiaoke; Zhang, Qiyu; Lin, YuanWei; Chen, WeiJian; Jin, Wangxun; Deng, Liming; Chen, Yunzhi; Chen, Bicheng; Li, Jianmin

2012-01-01

Current large animal models that could closely resemble the typical features of cirrhotic portal hypertension in human have not been well established. Thus, we aimed to develop and describe a reliable and reproducible canine cirrhosis model of portal hypertension. A total of 30 mongrel dogs were randomly divided into four groups: 1 (control; n = 5), 2 (portal vein stenosis [PVS]; n = 5], 3 (thioacetamide [TAA]; n = 5), and 4 (PVS plus TAA; n = 15). After 4-months modeling period, liver and spleen CT perfusion, abdominal CT scans, portal hemodynamics, gastroscopy, hepatic function, blood routine, the bone marrow, liver, and spleen histology were studied. The animals in group 2 (PVS) developed extrahepatic portosystemic collateral circulation, particularly esophageal varices, without hepatic cirrhosis and portal hypertension. Animals from group 3 (TAA) presented mild cirrhosis and portal hypertension without significant symptoms of esophageal varices and hypersplenism. In contrast, animals from group 4 (PVS + TAA) showed well-developed micronodular and macronodular cirrhosis, associated with significant portal hypertension and hypersplenism. The combination of PVS and TAA represents a novel, reliable, and reproducible canine cirrhosis model of portal hypertension, which is associated with the typical characteristics of portal hypertension, including hypersplenism.

Cavernous transformation of the portal vein

International Nuclear Information System (INIS)

Lehotska, V.; Dostalova, K.; Durkovsky, A.; Samal, V.

1995-01-01

In this contribution, the authors give an account of a rare case of a cavernous transformation of the portal vein that may have originated secondarily in a proliferative hematogenous disease with a polyglobulia and thrombosis in the periferal blood count as well as development of portal hypertension of a prehepatal type. The state of hyper-coagulation in a myeloproliferative disease may have lead to a chronic thrombosis of the portal vein with a subsequent malformation of the portal vein in terms of a cavernous transformation of the portal vein. The case is an interesting one because of the discrepancy between the gravity of the thrombotic complication and slightness of the symptoms in the clinical picture. The authors point out the importance of ultrasonography and computed tomography examination following the intravenous application of a water solution of a contrast medium in a morphologic diagnosing of a rare complication of a chronic thrombotic clot of the portal vein - the cavernous transformation. (authors)

Splenomegaly, hyperkinetic splenic flow and portal hypertension in colitis

International Nuclear Information System (INIS)

Friman, L.

1980-01-01

Four patients with a long history of colitis, splenomegaly, hypersplenism and portal hypertension were examined with angiography, both with contrast medium and isotopes, liver-spleen scintigraphy and recording of portal pressure. At angiography hyperkinetic splenic and portal blood flow was demonstrated. The increased flow causes increased portal pressure, which probably gives rise to changes in the liver often considered as slight cirrhosis at microscopy. The scintigraphic findings differed from Laennec cirrhosis. The liver uptake was homogeneous and no activity in the skeleton was recorded. Splenectomy cures both the hypersplenism and portal hypertension. (Auth.)

Splenomegaly, hyperkinetic splenic flow and portal hypertension in colitis

Energy Technology Data Exchange (ETDEWEB)

Friman, L [Serafimerlasarettet, Stockholm (Sweden)

1980-01-01

Four patients with a long history of colitis, splenomegaly, hypersplenism and portal hypertension were examined with angiography, both with contrast medium and isotopes, liver-spleen scintigraphy and recording of portal pressure. At angiography hyperkinetic splenic and portal blood flow was demonstrated. The increased flow causes increased portal pressure, which probably gives rise to changes in the liver often considered as slight cirrhosis at microscopy. The scintigraphic findings differed from Laennec cirrhosis. The liver uptake was homogeneous and no activity in the skeleton was recorded. Splenectomy cures both the hypersplenism and portal hypertension.

Efficiency of herbal medicine Dai-kenchu-to on portal blood flow in rat models

OpenAIRE

Muraoka, Izumi; Takatsuki, Mitsuhisa; Soyama, Akihiko; Yamaguchi, Izumi; Tanaka, Shiro; Tanaka, Takayuki; Kinoshita, Ayaka; Hara, Takanobu; Kuroki, Tamotsu; Eguchi, Susumu

2015-01-01

Introduction: To clarify the influence of Dai-Kenchu-To (DKT) on portal blood flow (PBF), PBF was continuously measured with Doppler ultrasound. Methods: Normal liver rats were divided into a DKT 90 mg/kg, DKT 270 mg/kg administered group, and control, while cirrhotic liver rats were divided into a DKT-LC 90 mg/kg administered group and Control-LC. The PBF was measured after the administration of either DKT or water for 60 min by laser Doppler flowmetry system. Results: The PBF in the D...

Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy.

Science.gov (United States)

Bandali, Murad Feroz; Mirakhur, Anirudh; Lee, Edward Wolfgang; Ferris, Mollie Clarke; Sadler, David James; Gray, Robin Ritchie; Wong, Jason Kam

2017-03-14

Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen. A brief overview of established interventional radiologic techniques for treatment of portal hypertension will also be provided. Awareness of the various imaging manifestations of portal hypertension can be helpful for assessing overall prognosis and planning proper management.

Wall shear stress in portal vein of cirrhotic patients with portal hypertension.

Science.gov (United States)

Wei, Wei; Pu, Yan-Song; Wang, Xin-Kai; Jiang, An; Zhou, Rui; Li, Yu; Zhang, Qiu-Juan; Wei, Ya-Juan; Chen, Bin; Li, Zong-Fang

2017-05-14

To investigate wall shear stress (WSS) magnitude and distribution in cirrhotic patients with portal hypertension using computational fluid dynamics. Idealized portal vein (PV) system models were reconstructed with different angles of the PV-splenic vein (SV) and superior mesenteric vein (SMV)-SV. Patient-specific models were created according to enhanced computed tomography images. WSS was simulated by using a finite-element analyzer, regarding the blood as a Newtonian fluid and the vessel as a rigid wall. Analysis was carried out to compare the WSS in the portal hypertension group with that in healthy controls. For the idealized models, WSS in the portal hypertension group (0-10 dyn/cm 2 ) was significantly lower than that in the healthy controls (10-20 dyn/cm 2 ), and low WSS area (0-1 dyn/cm 2 ) only occurred in the left wall of the PV in the portal hypertension group. Different angles of PV-SV and SMV-SV had different effects on the magnitude and distribution of WSS, and low WSS area often occurred in smaller PV-SV angle and larger SMV-SV angle. In the patient-specific models, WSS in the cirrhotic patients with portal hypertension (10.13 ± 1.34 dyn/cm 2 ) was also significantly lower than that in the healthy controls ( P portal hypertension, the low WSS area extended to wider levels and the magnitude of WSS reached lower levels, thereby being more prone to disturbed flow occurrence. Cirrhotic patients with portal hypertension show dramatic hemodynamic changes with lower WSS and greater potential for disturbed flow, representing a possible causative factor of PV thrombosis.

Molecular mechanisms of circulatory dysfunction in cirrhotic portal hypertension

Directory of Open Access Journals (Sweden)

Hsin-Ling Ho

2015-04-01

Full Text Available Acute or chronic insults to the liver are usually followed by a tissue repairing process. Unfortunately, this action, in most cases, is not effective enough to restore the normal hepatic structure and function. Instead, fibrogenesis and regenerative nodules formation ensue, which are relatively nonfunctioning. The common final stage of the process is liver cirrhosis with increased intrahepatic resistance to portal venous blood flow. Throughout the entire course, the extrahepatic circulatory dysfunction, including increased splanchnic blood flow, elevated portal venous blood flow and pressure, decreased splanchnic and peripheral vascular resistance, tachycardia, and increased cardiac output, are noted and denoted as portal hypertension with hyperdynamic circulatory dysfunction. When such a condition is established, patients may suffer from fatal complications such as gastroesophageal variceal hemorrhage, hepatic encephalopathy, or hepatorenal syndrome. The cause of such a circulatory dysfunction is not fully elucidated. Nevertheless, clarification of the pathophysiology definitely contributes to the control of portal hypertension-related complications. Herein, the molecular mechanism of this intriguing disaster is reviewed and discussed.

Diabetes insipidus is an unfavorable prognostic factor for response to glucocorticoids in patients with autoimmune hypophysitis.

Science.gov (United States)

Lupi, Isabella; Cosottini, Mirco; Caturegli, Patrizio; Manetti, Luca; Urbani, Claudio; Cappellani, Daniele; Scattina, Ilaria; Martino, Enio; Marcocci, Claudio; Bogazzi, Fausto

2017-08-01

Autoimmune hypophysitis (AH) has a variable clinical presentation and natural history; likewise, its response to glucocorticoid therapy is often unpredictable. To identify clinical and radiological findings associated with response to glucocorticoids. 12 consecutive patients with AH, evaluated from 2008 to 2016. AH was the exclusion diagnosis after ruling out other pituitary masses and secondary causes of hypophysitis. Mean follow-up time was 30 ± 27 months (range 12-96 months). MRI identified two main patterns of presentation: global enlargement of the pituitary gland or panhypophysitis ( n  = 4, PH), and pituitary stalk abnormality only, or infundibulo-neuro-hypophysitis ( n  = 8, INH). Multiple tropin defects were more common in PH (100%) than those in INH (28% P  = 0.014), whereas diabetes insipidus was more common in INH (100%) than that in PH (50%; P  = 0.028). All 4 PH and 4 out of 8 INH were treated with glucocorticoids. Pituitary volume significantly reduced in all PH patients ( P  = 0.012), defective anterior pituitary function recovered only in the two patients without diabetes insipidus (50%) and panhypopituitarism persisted, along with diabetes insipidus, in the remaining 2 (50%). In all INH patients, either treated or untreated, pituitary stalk diameter reduced ( P  = 0.008) but diabetes insipidus persisted in all. Glucocorticoid therapy may improve anterior pituitary function in a subset of patients but has no effect on restoring posterior pituitary function. Diabetes insipidus appears as a negative prognostic factor for response to glucocorticoids. © 2017 European Society of Endocrinology.

Radionuclide and ultrasonic investigations in liver cirrhosis with portal hypertension

International Nuclear Information System (INIS)

Khodzhibekov, M.Kh.; Rikhsieva, L.Eh.; Nazyrov, F.G.

1988-01-01

Combined radionuclide and ultrasonic investigations (UNI) were performed in 95 patients with liver cirrhosis complicated by portal hypertension. Liver and splenic shape structure and the presence of fluid in the abdominal cavity were assessed in USI. Radionuclide methods of investigation of the hepatic blood flow, assessment of the shape, size and structure of RP distribution in the liver and spleen, and for calculation of the hepatosplenic index. The most significant signs of differentiation of stages of portal hypertension were the presence and amount of fluid in the abdominal cavity and a hepatic blood flow value reflecting the gravity of portal hypertension. Combined radionuclide and ultrasonic investigations permitted a differentiated approach to staging of portal hypertension and assessment of liver and splenic morphofunctional state that could play an important role in the choice of tactics of surgery of liver cirrhosis

Radionuclide and ultrasonic investigations in liver cirrhosis with portal hypertension

Energy Technology Data Exchange (ETDEWEB)

Khodzhibekov, M Kh; Rikhsieva, L Eh; Nazyrov, F G

1988-08-01

Combined radionuclide and ultrasonic investigations (UNI) were performed in 95 patients with liver cirrhosis complicated by portal hypertension. Liver and splenic shape structure and the presence of fluid in the abdominal cavity were assessed in USI. Radionuclide methods of investigation of the hepatic blood flow, assessment of the shape, size and structure of RP distribution in the liver and spleen, and for calculation of the hepatosplenic index. The most significant signs of differentiation of stages of portal hypertension were the presence and amount of fluid in the abdominal cavity and a hepatic blood flow value reflecting the gravity of portal hypertension. Combined radionuclide and ultrasonic investigations permitted a differentiated approach to staging of portal hypertension and assessment of liver and splenic morphofunctional state that could play an important role in the choice of tactics of surgery of liver cirrhosis.

Magnetic resonance measurements of azygos and portal venous blood flow under fasting and postprandial conditions in healthy controls and cirrhotics

International Nuclear Information System (INIS)

Takamura, Naoko

2001-01-01

Using MR velocity mapping, we studied measurements azygos (A) and portal venous blood flow (P) under fasting and postprandial conditions in 7 healthy controls (C) and 10 cirrhotics (LC). Fasting A in LC was higher than that in C. Fasting P in C was higher than that in LC. Variability of repeated measuring A and P was low in C and LC. A postprandial increase of A in LC was higher than that in C. Fasting A/P ratio in LC was higher than that in C. Our results suggest that MR velocity mapping is expected as the reproducible method for monitoring the hemodynamic change in the azygos and portal venous system. (author)

Irradiation of the hypothalamic-hypophyseal area induces complete regression of mucocutaneous lesions in disseminated histiocytosis X

International Nuclear Information System (INIS)

Palmieri, G.; Stefani, S.; Gridelli, C.; Conte, A.; Airoma, G.; Contegiacomo, A.; Bianco, A.R.

1989-01-01

We report on a 54-year-old woman with disseminated histiocytosis X who had a complete regression of all mucocutaneous lesions within 1 month from the completion of radiation therapy (4500 cGy) to the hypothalamic-hypophyseal (H-H) area. This response lasted 12 months, after which new cutaneous and bone lesions appeared

Evolution of portal hypertension and mechanisms involved in its maintenance in a rat model

International Nuclear Information System (INIS)

Sikuler, E.; Kravetz, D.; Groszmann, R.J.

1985-01-01

In rats with portal hypertension induced by partial ligation of the portal vein, the authors have recently demonstrated an increased portal venous inflow that becomes an important factor in the maintenance of portal hypertension. The sequence of events that leads into this circulatory disarray is unknown. The authors evaluated chronologically the chain of hemodynamic changes that occurred after portal hypertension was induced by partial ligation of the portal vein. In this model it is possible to follow, from the initiation of the portal-hypertensive state, the interaction between blood flow and resistance in the portal system as well as the relation between the development of portal-systemic shunting and the elevated portal venous inflow. The study was performed in 45 portal-hypertensive rats and in 29 sham-operated rats. Blood flow and portal-systemic shunting were measured by radioactive microsphere techniques. The constriction of the portal vein was immediately followed by a resistance-induced portal hypertension characterized by increased portal resistance (9.78 +/- 0.89 vs. 4.18 +/- 0.71 dyn X s X cm-5 X 10(4), mean +/- SE, P less than 0.01), increased portal pressure (17.7 +/- 0.9 vs. 9.5 +/- 0.6 mmHg, P less than 0.001), and decreased portal venous inflow (3.93 +/- 0.26 vs. 6.82 +/- 0.49 ml X min-1 X 100 g body wt-1, P less than 0.001)

Scintiphotosplenoportography in patients with portal hypertension

International Nuclear Information System (INIS)

Aijaz, A.

1990-01-01

Scintiphotosplenoportograpy (SSP) was performed in five normals and 25 patients with portal hypertension using Tc-99m tin colloid. 12 patients were cirrhotic and 13 had idiopathic portal hypertension (IPH). Analogue and fast frame dynamic studies were performed and subsequently processed. Intra hepatic shunt index in cirrhotics was significantly different from the IPH group. Extra hepatic shunt index, however, was not significantly different in the two groups but was related more to the severity of the disease process. Spleno hepatic and spleno cardiac transit times were significantly lower cirrhotics as compared to the IPH group. We conclude that SSP is a technically simple, rapid and a much less invasive method of visualizing the portal circulatory system and assessing the portal haemo dynamics. it also provides clinically important measure of shunted blood nd allows for the quantification of circulatory time from spleen to liver and heart. (author)

Comparative analysis of Met-enkephalin, galanin and GABA immunoreactivity in the developing trout preoptic-hypophyseal system.

Science.gov (United States)

Rodríguez Díaz, M A; Candal, E; Santos-Durán, G N; Adrio, F; Rodríguez-Moldes, I

2011-08-01

We studied the organization of Met-enkephalin-containing cells and fibers in the developing preoptic-hypophyseal system of the brown trout (Salmo trutta fario) by immunohistochemistry and determined the relationship of these cells and fibers to the galaninergic and GABAergic systems. Met-enkephalin immunoreactivity was observed in cells in the preoptic area, the hypothalamus and the pituitary of late larvae. In the hypophysis, a few Met-enkephalin-containing cells were present in all divisions of the adenohypophysis, and some immunoreactive fibers were present in the interdigitations of the neural lobe with the proximal pars distalis. Concurrently, GABAergic fibers innervated the anterior and posterior neural lobe. Galanin cells coexisted with Met-enkephalin cells in neuronal groups of the preoptic-hypophyseal system. Galaninergic and GABAergic fibers innervated the preoptic and hypothalamic areas, but GABAergic fibers containing galanin were not observed. These results indicate that Met-enkephalin, galanin and GABA may modulate neuroendocrine activities in the preoptic area, hypothalamus and pituitary during the transition from larval to juvenile period. To better know how the development of the trout preoptic-hypophyseal system takes place, we studied the patterns of cell proliferation and expression of Pax6, a conserved transcription factor involved in the hypophysis development. Pax6 expressing cells and proliferating cells were present in the Rathke's pouch, the hypothalamus and the hypophysis of early larvae. In late larvae, Pax6 expression was no longer observed in these areas, and the density of proliferating cells largely decreased throughout development, although they remained in the hypophysis of late larvae and juveniles, suggesting that Pax6 might play an important role in the early regionalization of the pituitary in the trout. Copyright © 2011 Elsevier Inc. All rights reserved.

False-positive image of portal thrombosis with MRI: portal hypertension as a pitfall. Observation in a Budd-Chiari syndrome

International Nuclear Information System (INIS)

Davy-Miallou, C.; Bousquet, J.C.; Bellin, M.F.; Guinet, C.; Grellet, J.

1990-01-01

This observation illustrates how difficult it is to interpret the intravascular signal observed with MRI in cases of portal hypertension. A signal occupying the entire lumen of the portal trunk and branches can be seen, which is constantly observed in the axial as well as coronal planes in the 3 series studied. It is hypointense relative to the liver on T1-weighted images, hyperintense on T2-weighted images: this appearance therefore perfectly mimicks portal thrombosis. Ultrasound combined with pulsed Doppler demonstrates the stagnant blood within the patent portal system. This kind of artifact, which is produced by a very slow flow or even by the standstill of flow, is much more difficult to recognize than the common flow artifacts; the criteria put forward by various authors to distinguish between artifacts and thrombosis are of no avail in this case. Examinations must able to confirm or rule out portal thrombosis in the case of portal hypertension with deceleration of flow. In practice, ultrasound studies, combined with pulsed Doppler in the best cases, is therefore indicated as a first-intension technique [fr

APTR is a prognostic marker in cirrhotic patients with portal hypertension during TIPS procedure.

Science.gov (United States)

Yu, Shanshan; Qi, Yanhua; Jiang, Jue; Wang, Hua; Zhou, Qi

2018-03-01

Portal hypertension is a major cause of mortality and morbidity in cirrhotic patients. In this study, we aimed to analyze the clinical characteristics of Alu-mediated p21 transcriptional regulator (APTR) during transjugular intrahepatic portosystemic shunt (TIPS) procedure. Portal and hepatic venous blood was drawn from 84 patients with liver cirrhosis and portal hypertension before and after TIPS treatment. Then, we detected biochemical, hemodynamic parameters and APTR expression before and after TIPS treatment. Indeed, TIPS treatment could markedly ameliorate the serum blood urea nitrogen (BUN) level and portal vein hemodynamics in cirrhotic patients. We found that portal venous levels of APTR was significantly decreased after TIPS treatment and its aberrant expression levels were positively correlated with Model for End Stage Liver Disease (MELD), portal hepatic venous pressure gradient (PHPG) in patients. Higher APTR expression in portal vein was associated with poor prognosis. APTR level in portal vein was an independent predictors of mortality. Our data indicated that APTR may serve as a novel biomarker for cirrhotic patients with portal hypertension before and after receiving TIPS. Copyright © 2017 Elsevier B.V. All rights reserved.

Anti-pituitary antibodies against corticotrophs in IgG4-related hypophysitis.

Science.gov (United States)

Iwata, Naoko; Iwama, Shintaro; Sugimura, Yoshihisa; Yasuda, Yoshinori; Nakashima, Kohtaro; Takeuchi, Seiji; Hagiwara, Daisuke; Ito, Yoshihiro; Suga, Hidetaka; Goto, Motomitsu; Banno, Ryoichi; Caturegli, Patrizio; Koike, Teruhiko; Oshida, Yoshiharu; Arima, Hiroshi

2017-06-01

IgG4-related disease is a systemic inflammatory disease characterized by infiltration of IgG4-positive plasma cells into multiple organs, including the pituitary gland. Autoimmunity is thought to be involved in the pathogenesis of IgG4-related disease. The diagnosis of IgG4-related hypophysitis (IgG4-RH) is difficult because its clinical features, such as pituitary swelling and hypopituitarism, are similar to those of other pituitary diseases, including lymphocytic hypophysitis and sellar/suprasellar tumors. The presence and significance of anti-pituitary antibodies (APA) in IgG4-RH is unclear. In this case-control study, we used single indirect immunofluorescence on human pituitary substrates to assess the prevalence of serum APA in 17 patients with IgG4-RH, 8 control patients with other pituitary diseases (lymphocytic infundibulo-neurohypophysitis, 3; craniopharyngioma, 2; germinoma, 3), and 9 healthy subjects. We further analyzed the endocrine cells targeted by the antibodies using double indirect immunofluorescence. APA were found in 5 of 17 patients with IgG4-RH (29%), and in none of the pituitary controls or healthy subjects. The endocrine cells targeted by the antibodies in the 5 IgG4-RH cases were exclusively corticotrophs. Antibodies were of the IgG1 subclass, rather than IgG4, in all 5 cases, suggesting that IgG4 is not directly involved in the pathogenesis. Finally, antibodies recognized pro-opiomelanocortin in 2 of the cases. Our study suggests that autoimmunity is involved in the pathogenesis of IgG4-RH and that corticotrophs are the main antigenic target, highlighting a possible new diagnostic marker for this condition.

Uptake of ascorbic acid by freshly isolated cells and secretory granules from the intermediate lobe of ox hypophyses

DEFF Research Database (Denmark)

Zhou, A; Matsumoto, T; Farver, O

1990-01-01

Mechanically isolated cells from the intermediate lobe of ox hypophyses contained 40.6 +/- 3.7 nmol mg-1 protein (mean +/- SE, n = 5) of ascorbic acid. They accumulated radioactivity time dependently, on incubation with L-[14C]ascorbic acid in ionic medium dominated by NaCl. No definite saturation...

Endothelial dysfunction in the regulation of portal hypertension

Science.gov (United States)

Iwakiri, Yasuko

2013-01-01

Portal hypertension is caused by an increased intrahepatic resistance, a major consequence of cirrhosis. Endothelial dysfunction in liver sinusoidal endothelial cells (LSECs) decreases the production of vasodilators, such as nitric oxide (NO) and favors vasoconstriction. This contributes to an increased vascular resistance in the intrahepatic/sinusoidal microcirculation. Portal hypertension, once developed, causes endothelial cell (EC) dysfunction in the extrahepatic, i.e. splanchnic and systemic, circulation. Unlike LSEC dysfunction, EC dysfunction in the splanchnic and systemic circulation overproduces vasodilator molecules, leading to arterial vasodilatation. In addition, portal hypertension leads to the formation of portosystemic collateral vessels. Both arterial vasodilatation and portosystemic collateral vessel formation exacerbate portal hypertension by increasing the blood flow through the portal vein. Pathologic consequences, such as esophageal varices and ascites, result. While the sequence of pathological vascular events in cirrhosis and portal hypertension have been elucidated, the underlying cellular and molecular mechanisms causing EC dysfunctions are not yet fully understood. This review article summarizes the current cellular and molecular studies on EC dysfunctions found during the development of cirrhosis and portal hypertension with a focus on intra- and extrahepatic circulation. The article ends by discussing future directions of study for EC dysfunctions. PMID:21745318

Contemporary concepts of the medical therapy of portal hypertension under liver cirrhosis.

Science.gov (United States)

Garbuzenko, Dmitry Victorovich

2015-05-28

Severe complications of liver cirrhosis are mostly related to portal hypertension. At the base of the pathogenesis of portal hypertension is the increase in hepatic vascular resistance to portal blood flow with subsequent development of hyperdynamic circulation, which, despite of the formation of collateral circulation, promotes progression of portal hypertension. An important role in its pathogenesis is played by the rearrangement of vascular bed and angiogenesis. As a result, strategic directions of the therapy of portal hypertension under liver cirrhosis include selectively decreasing hepatic vascular resistance with preserving or increasing portal blood flow, and correcting hyperdynamic circulation and pathological angiogenesis, while striving to reduce the hepatic venous pressure gradient to less than 12 mmHg or 20% of the baseline. Over the last years, substantial progress in understanding the pathophysiological mechanisms of hemodynamic disorders under liver cirrhosis has resulted in the development of new drugs for their correction. Although the majority of them have so far been investigated only in animal experiments, as well as at the molecular and cellular level, it might be expected that the introduction of the new methods in clinical practice will increase the efficacy of the conservative approach to the prophylaxis and treatment of portal hypertension complications. The purpose of the review is to describe the known methods of portal hypertension pharmacotherapy and discuss the drugs that may affect the basic pathogenetic mechanisms of its development.

VARIATIONS IN CLINICAL AND IMAGING FINDINGS BY TIME OF DIAGNOSIS IN FEMALES WITH HYPOPITUITARISM ATTRIBUTED TO LYMPHOCYTIC HYPOPHYSITIS.

Science.gov (United States)

Tirosh, Amit; Hirsch, Dania; Robenshtok, Eyal; Masri-Iraqi, Hiba; Yoel, Uri; Toledano, Yoel; Twito, Orit; Tsvetov, Gloria; Shimon, Ilan

2016-04-01

To describe the various patterns of presentation, including assisting analyses, associated with the timing of diagnosis of females with hypopituitarism and suspected clinical diagnosis of lymphocytic hypophysitis. A retrospective study of 9 consecutive females with pituitary dysfunction developed during or after pregnancy. All subjects were treated in our clinics between 2008 and 2014. Data were collected on clinical characteristics, pituitary hormone levels, and imaging findings. The study group included 9 patients with a mean age 33.7 ± 7.8 years at delivery. The probable cause of disease was lymphocytic hypophysitis. Headache or specific symptoms/signs of hypopituitarism appeared within 1 year of delivery. Five patients had headache, and 8 had difficulty breastfeeding or amenorrhea. Laboratory findings included central hypocortisolism (8/9 patients), hypogonadotropic hypogonadism (8/9), and central hypothyroidism (6/7). Insulin-like growth factor-1 (IGF-1) levels were low in 8/8 patients. Prolactin levels were low in 3/9 patients, and 1 patient had diabetes insipidus. Seven patients were diagnosed less than 1 year from symptom onset; 4 (57%) complained of headaches, and 5 (71%) had panhypopituitarism. Two patients were diagnosed later. Both had difficulty breastfeeding and amenorrhea, and one also had headaches. Both had panhypopituitarism and reduced pituitary volume. None of the patients fully recovered pituitary function. Normalization of the thyrotroph axis occurred in 3 patients, gonadotroph function in 3, the corticotroph axis in 2, and IGF-1 normalized in 1 subject. Hypopituitarism attributed to lymphocytic hypophysitis may present during pregnancy or early postpartum period with a clear clinical picture, or later, with indolent and nonspecific symptoms and signs.

Splenic radionuclide angiography in the portal hypertension assessment

International Nuclear Information System (INIS)

Artiko, V.; Kostic, K.; Perisic-Savic, M.; Janosevic, S.; Obradovic, V.

2004-01-01

The aim of this study is the presentation of the hepatic and splenic radionuclide angiograms (SRA) in various portal blood flow disturbances, as well as an analysis of the splenic arterio-venous ratio (SAVR) results, obtained as a slope ratio between inflow, arterial and the outflow, venous phases on the splenic TA curve. Splenic radionuclide angiography was performed after bolus injection of 740 MBq of 99m-Tc-pertechnetate, using ROTA scintillation camera (Siemens) and MicroDelta computer'. Four types of the SRA were established: a) very acute descendent slope (DS) in the controls; b) less acute DS in the patients with LC; c) horisontal venous phase caused by impaired outflow to the portal vein in LC with expressed portal hypertension, collateral circulation and LCEV; d) ascending outflow phase, characterizing the splenic and/or portal venous thrombosis. SAVR values were increased in liver cirrhosis (LC) with esophageal vahces (LCEV, n=10) (6.1 +/- 3.4) in comparison to the controls (n=10)(3.7 +/- 1.3)(U=25, p 0.05). However, in another two patients with LC and in 8 with LCEV it was not possible to access SAVR because of the appearance of the horisontal or rising venous phase on the splenic TA curve, instead of descendent. SRA and increased SAVR values reflect various blood flow alterations in the portal system and give additional data to the more accurate interpretation of the results obtained by hepatic radionuclide angiography. (authors)

ASH External Web Portal (External Portal) -

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Department of Transportation — The ASH External Web Portal is a web-based portal that provides single sign-on functionality, making the web portal a single location from which to be authenticated...

Novel Rat Model of Repetitive Portal Venous Embolization Mimicking Human Non-Cirrhotic Idiopathic Portal Hypertension.

Science.gov (United States)

Klein, Sabine; Hinüber, Christian; Hittatiya, Kanishka; Schierwagen, Robert; Uschner, Frank Erhard; Strassburg, Christian P; Fischer, Hans-Peter; Spengler, Ulrich; Trebicka, Jonel

2016-01-01

Non-cirrhotic idiopathic portal hypertension (NCIPH) is characterized by splenomegaly, anemia and portal hypertension, while liver function is preserved. However, no animal models have been established yet. This study assessed a rat model of NCIPH and characterized the hemodynamics, and compared it to human NCIPH. Portal pressure (PP) was measured invasively and coloured microspheres were injected in the ileocecal vein in rats. This procedure was performed weekly for 3 weeks (weekly embolization). Rats without and with single embolization served as controls. After four weeks (one week after last embolization), hemodynamics were investigated, hepatic fibrosis and accumulation of myofibroblasts were analysed. General characteristics, laboratory analyses and liver histology were collected in patients with NCIPH. Weekly embolization induced a hyperdynamic circulation, with increased PP. The mesenteric flow and hepatic hydroxyproline content was significantly higher in weekly embolized compared to single embolized rats (mesenteric flow +54.1%, hydroxyproline +41.7%). Mesenteric blood flow and shunt volumes increased, whereas splanchnic vascular resistance was decreased in the weekly embolization group. Fibrotic markers αSMA and Desmin were upregulated in weekly embolized rats. This study establishes a model using repetitive embolization via portal veins, comparable with human NCIPH and may serve to test new therapies.

Clinical quantitative study of therapeutic effect of partial splenic embolization (PSE) on portal vein hemodynamics

International Nuclear Information System (INIS)

Li Zhengran; Shan Hong; Zhu Kangshun; Jiang Zaibo; Guan Shouhai; Huang Mingsheng

2002-01-01

Objective: To research the changes of blood flow and pressure of the portal vein at both pre-and post-PSE. Methods: The blood flows of the portal vein (PV), splenic vein (SV), and superior mesentery vein (SMV) were measured by using color Doppler in 31 cases with clinically proved hepatic cirrhosis and hypersplenism at both pre- and post-PSE. The pressure of the portal vein and its branches was measured by percutaneous and trans-spleen portal venous catheterization, respectively both pre- and post-embolization in 11 cases of them. Results: The blood flow of PV, SV and SMV decreased significantly in all 31 cases after PSE (P < 0.05). The decreased degrees of blood flow of both PV and SV after PSE were positively related to the embolization degree (r = 0.589, P = 0.002 for PV; r= 0.862, P < 0.001 for SV). In 11 cases whose embolization degrees were more than 60%, the pressure of PV, SV and SMV decreased significantly after embolization (P<0.001). The decrease degree was (22.2 +- 5.8)%, (28.5 +- 1.7)% and (19.5 +- 8.1)%, respectively. The decreased degrees of pressure of both PV and SV after PSE were also positively related to the embolization degree (r = 0.645, P = 0.032 for PV; r = 0.687, P = 0.020 for SV). Conclusion: The embolization degree ranged from 60% to 80% may ameliorate peripheral blood WBC and PLT count, significantly decrease the blood flow and depress the pressure of portal vein, and relieve esophageal and gastric varices

Computed Tomography Perfusion of the liver: Assessment of Pure Portal Blood Flow Studied with CT Perfusion During Superior Mesenteric Arterial Portography

International Nuclear Information System (INIS)

Kojima, H.; Tanigawa, N.; Komemushi, A.; Kariya, S.; Sawada, S.

2004-01-01

Purpose: To quantitatively assess the portal component of hepatic blood flow using computed tomography (CT) perfusion studies during superior mesenteric arterial portography. Material and Methods: Thirty-four patients with hepatocellular carcinoma and liver cirrhosis (LC) and 13 patients with liver metastasis without chronic liver disease were enrolled in this study. Ten milliliters of a non-ionic contrast medium (150 mgI) was injected at a rate of 5 ml/s via a catheter placed in the superior mesenteric artery. Single-slice cine CT images at the level of the main trunk or the right/left main trunk of the portal vein were acquired over 40 s. The deconvolution method was then used on these CT images to measure blood flow (BF), blood volume (BV), and mean transit time (MTT) in (a) liver parenchyma in patients with HCC and liver cirrhosis; (b) liver parenchyma in patients with liver metastasis without cirrhosis; (c) directly in the HCC; and (d) directly in one of the metastases. Results: In 34 LC patients (a), BF, BV, and MTT in the liver parenchyma were 44.7±24.5 ml/min/100 g, 3.9±2.4 ml/100 g, and 10.9±5.5 s, respectively. In 13 patients without cirrhosis (b), BF, BV, and MTT in the liver parenchyma were 89.6±52.0 ml/min/100 g, 6.3 ±3.2 ml/100 g, and 8.7±3.6 sec, respectively. A significant difference in BF and BV was seen in patients with liver cirrhosis compared to those without cirrhosis. BF, BV, and MTT measured directly in HCC (c) were 6.5±4.5 ml/min/100 g, 0.4±0.4 ml/100 g, and 3.0±3.1 sec respectively, and BF, BV, and MTT in liver metastases (d) were 19.3 ± 21.7 ml/min/100 g, 0.6±0.8 ml/100 g, and 1.8±1.6 s, respectively. Conclusion: CT perfusion studies during superior mesenteric arterial portography allow quantitative assessment of pure portal blood flow in the liver

Establishment of a hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol.

Science.gov (United States)

Wang, Lei; He, Fu-Liang; Liu, Fu-Quan; Yue, Zhen-Dong; Zhao, Hong-Wei

2015-08-28

To determine the feasibility and safety of establishing a porcine hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol. Twenty-one healthy Guizhou miniature pigs were randomly divided into three experimental groups and three control groups. The pigs in the three experimental groups were subjected to hepatic arterial perfusion with 7, 12 and 17 mL of 80% alcohol, respectively, while those in the three control groups underwent hepatic arterial perfusion with 7, 12 and 17 mL of saline, respectively. Hepatic arteriography and direct portal phlebography were performed on all animals before and after perfusion, and the portal venous pressure and diameter were measured before perfusion, immediately after perfusion, and at 2, 4 and 6 wk after perfusion. The following procedures were performed at different time points: routine blood sampling, blood biochemistry, blood coagulation and blood ammonia tests before surgery, and at 2, 4 and 6 wk after surgery; hepatic biopsy before surgery, within 6 h after surgery, and at 1, 2, 3, 4 and 5 wk after surgery; abdominal enhanced computed tomography examination before surgery and at 6 wk after surgery; autopsy and multi-point sampling of various liver lobes for histological examination at 6 wk after surgery. In experimental group 1, different degrees of hepatic fibrosis were observed, and one pig developed hepatic cirrhosis. In experimental group 2, there were cases of hepatic cirrhosis, different degrees of increased portal venous pressure, and intrahepatic portal venous bypass, but neither extrahepatic portal-systemic bypass circulation nor death occurred. In experimental group 3, two animals died and three animals developed hepatic cirrhosis, and different degrees of increased portal venous pressure and intrahepatic portal venous bypass were also observed, but there was no extrahepatic portal-systemic bypass circulation. It is feasible to establish an animal model of hepatic cirrhosis and

Transcatheter arterial chemoembolization of hepatocellular carcinoma with portal vein invasion

International Nuclear Information System (INIS)

Lee, Young Rahn; Lee, Ki Yeol; Cho, Seong Beom; Cha, In Ho; Chung, Kyoo Byung

1993-01-01

Transcatheter arterial chemoembolization(TACE) is an imperative method for the management of inoperable hepatocellular carcinoma(HCC). It is well known that primary HCC frequently invades the portal venous system and forms a tumor thrombus obstructing the portal blood flow which makes unfavorable prognosis of patient. We retrospectively reviewed 58 patients who reviewed TACE(minimum 3 times) of HCC invading into portal venous system. Group 1(n=29) which showed peripheral portal vein invasion had better clinical and laboratory response. Group 2(n=17) which showed first order portal branch invasion had similar response to Group 3(n=12), which had main portal invasion. Group 1 showed no difference in survival time between TAC and TACE, but, in Group 2 and 3, embolization with chemotherapy made longer survival than chemotherapy only. Clinical level of AFP was meaningful in Group 1 and 2 as decreasing value. Our results provides that careful selection of TAE and case by case Coil/Gelfoam embolization can improve the mean survival and clinical response when HCC evidently invades portal venous system

Orthotopic liver transplantation for portosystemic encephalopathy in an adult with congenital absence of the portal vein

NARCIS (Netherlands)

Wojcicki, M; Haagsma, EB; Gouw, ASH; Slooff, MJH; Porte, RJ

Congenital absence of the portal vein (CAPV) is a very rare venous malformation in which mesenteric venous blood drains directly into the systemic circulation. There is no portal perfusion of the liver and no portal hypertension. This abnormality is usually coincidentally discovered in children, the

Effects on growth after hypertension portal induced in young rats Efeitos da hipertensão portal sobre o crescimento de ratos jovens

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Luiz Eduardo Correia Miranda

2004-03-01

Full Text Available BACKGROUND: Physical growth retardation in children with hypertension portal was observed regardless of schistosomiasis. It has been suggested that the shunt of portal blood through portosystemic collateral vessels would result in metabolic consequences that would lead to the physical growth deficit observed. AIM: Study the effects of hypertension portal in the growth of young rats. METHODS: The growth of 20 young rats, divided in the groups hypertension portal, n = 10, 103 3.7 g and sham operation n = 10, 102.6 ± 3.4 g was evaluated throughout 5 weeks and the following parameters were under observation: quality of diet offered, diet ingestion, weight increase and urinary creatinine within 24 hours. At the end of the experiment, blood was taken for biochemical tests, prothrombin time and hematocrit and hypertension portal was measured. RESULTS/CONCLUSIONS: Rats with hypertension portal induced at early stages of their lives present growth delay in the first week after surgery recovering their growth rhythm in the next weeks, catching up with the sham animals. Differences related to urinary creatinine excretion, biochemical tests and hematocrit were not observed. Such results are evidence against the hypothesis that the hypertension portal induced in early stages of rats lives would cause delay in their growth.RACIONAL: Atraso no crescimento foi observado em crianças com hipertensão portal independentemente da presença de esquistossomose. Sugeriu-se que o desvio de sangue pelas colaterais portossistêmicas justificaria os achados clínicos encontrados. OBJETIVO: Estudar os efeitos da hipertensão portal no crescimento de ratos jovens. MÉTODOS: O crescimento de 20 ratos divididos nos grupos hipertensão portal n = 10, 103 ± 3,7 g e grupo-controle, n = 10, 102,6 ± 3,4 g foi avaliado durante 5 semanas. Foram considerados a qualidade da dieta oferecida, a ingestão da dieta, o ritmo de crescimento ganho de peso, a excreção de creatinina urin

Murine study of portal hypertension associated endothelin-1 hypo-response.

Science.gov (United States)

Theodorakis, Nicholas; Maluccio, Mary; Skill, Nicholas

2015-04-28

To investigate endothelin-1 hypo-responsive associated with portal hypertension in order to improve patient treatment outcomes. Wild type, eNOS(-/-) and iNOS(-/-) mice received partial portal vein ligation surgery to induce portal hypertension or sham surgery. Development of portal hypertension was determined by measuring the splenic pulp pressure, abdominal aortic flow and portal systemic shunting. To measure splenic pulp pressure, a microtip pressure transducer was inserted into the spleen pulp. Abdominal aortic flow was measured by placing an ultrasonic Doppler flow probe around the abdominal aorta between the diaphragm and celiac artery. Portal systemic shunting was calculated by injection of fluorescent microspheres in to the splenic vein and determining the percentage accumulation of spheres in liver and pulmonary beds. Endothelin-1 hypo-response was evaluated by measuring the change in abdominal aortic flow in response to endothelin-1 intravenous administration. In addition, thoracic aorta endothelin-1 contraction was measured in 5 mm isolated thoracic aorta rings ex-vivo using an ADI small vessel myograph. In wild type and iNOS(-/-) mice splenic pulp pressure increased from 7.5 ± 1.1 mmHg and 7.2 ± 1 mmHg to 25.4 ± 3.1 mmHg and 22 ± 4 mmHg respectively. In eNOS(-/-) mice splenic pulp pressure was increased after 1 d (P = NS), after which it decreased and by 7 d was not significantly elevated when compared to 7 d sham operated controls (6.9 ± 0.6 mmHg and 7.3 ± 0.8 mmHg respectively, P = 0.3). Abdominal aortic flow was increased by 80% and 73% in 7 d portal vein ligated wild type and iNOS when compared to shams, whereas there was no significant difference in 7 d portal vein ligated eNOS(-/-) mice when compared to shams. Endothelin-1 induced a rapid reduction in abdominal aortic blood flow in wild type, eNOS(-/-) and iNOS(-/-) sham mice (50% ± 8%, 73% ± 9% and 47% ± 9% respectively). Following portal vein ligation endothelin-1 reduction in blood flow

Fast magnetic reconstruction of the portal vein with allogeneic blood vessels in canines.

Science.gov (United States)

Wang, Shan-Pei; Yan, Xiao-Peng; Xue, Fei; Dong, Ding-Hui; Zhang, Xu-Feng; Ma, Feng; Wang, Hao-Hua; Lv, Yi

2015-06-01

The resection and reconstruction of large vessels, including the portal vein, are frequently needed in tumor resection. Warm ischemia before reconstruction might have deleterious effects on the function of some vital organs and therefore, how to reconstruct the vessels quickly after resection is extremely important. The present study was to introduce a new type of magnetic compression anastomosis (MCA) device to establish a quick non-suture anastomosis of the portal vein after resection in canines. The new MCA device consists of a pair of titanium alloy and neodymium-ferrum-boron magnet (Ti-NdFeB) composite rings. The NdFeB magnetic ring as a core of the device was hermetically sealed inside the biomedical titanium alloy case. Twelve canines were divided into two groups: a MCA group in which the end-to-end anastomoses was made with a new device after resection in the portal vein and a traditional manual suture (TMS) group consisted of 6 canines. The anastomosis time, anastomotic patency and quality were investigated at week 24 postoperatively. The portal vein was reconstructed successfully in all of the animals and they all survived. The duration of portal vein anastomosis was significantly shorter in the MCA group than in the TMS group (8.16+/-1.25 vs 36.24+/-2.17 min, PNdFeB composite MCA device was applicable in reconstruction of large vessels after resection. This device was easy to use and the anastomosis was functionally better than the traditional sutured anastomosis.

Portal Vein Stenting for Portal Biliopathy with Jaundice

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Hyun, Dongho, E-mail: mesentery@naver.com; Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center (Korea, Republic of); Lim, Seong Joo [Konyang University, Department of Radiology, College of Medicine, Konyang University Hospital (Korea, Republic of); Hwang, Jin Ho [Hallym University Sacred Heart Hospital, Department of Radiology (Korea, Republic of); Sinn, Dong Hyun [Sungkyunkwan University School of Medicine, Department of Medicine, Samsung Medical Center (Korea, Republic of)

2016-04-15

Portal biliopathy refers to obstruction of the bile duct by dilated peri- or para-ductal collateral channels following the main portal vein occlusion from various causes. Surgical shunt operation or endoscopic treatment has been reported. Herein, we report a case of portal biliopathy that was successfully treated by interventional portal vein recanalization.

Arteriomesentericography in patients with extrahepatic forms of portal hypertension

International Nuclear Information System (INIS)

Semenov, V.S.; Gotman, L.N.

1980-01-01

The reverse contrast examination of the system, carried out by means of superior arteriomesentericography, is the optimal method for diagnosing pathological changes in the portal channel of splenectomized patients with the syndrome of the extrahepatic form of portal hypertension. The selective catheterization of the superior mesenteric artery was made in 36 patients with the prerenal block of the portal system. In all cases the venous phase of portography was obtained, which served as a basis for selecting the amount of surgical intervention in these patients. Depending on the level of the block of the portal channel, the patients fell into 3 groups. The characteristic X-ray appearance of portal hypertension, manifested mainly by the presence of portoportal and portocaval collaterals, is described for each group. The thrombosis of the main vessels of the loose type of their structure excludes the possibility of portocaval anastomosis, while in the presence of the pronounced surgical trunk of the superior mesenteric vein vascular shunting may be recommended. Portal hypertension, in contrast to the normal state, requires prolonged contrast examination of the venous phase due to a slower portorenal blood flow

Portal Vein Thrombosis

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Hakan Demirci

2016-01-01

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

Evaluation of portal circulation by 99mTcO4-per-rectal scintigraphy

International Nuclear Information System (INIS)

Shiomi, Susumu; Kuroki, Tetsuo; Kurai, Osamu

1987-01-01

Portal circulation in patients with chronic liver diseases was evaluated by a new method named per-rectal portal scintigraphy. Following instillation of a solution containing 10 mCi of 99m TcO 4 - into the upper part of the rectum, serial scintigrams were taken sequentially. At the same time, the radioactivity curves over the liver and the heart were recorded sequentially. 1) The findings of per-rectal portal scintigrams were classified into two basic patterns. In pattern (I), the inferior mesenteric vein, portal vein, liver and the heart were visualized continuously after rectal instillation of the radioisotope. This pattern reflects direct blood flow from the rectum to the liver via the portal vein. In contrast, in pattern (II), the portal scintigrams demonstrated the vena cava inferior and the heart at an early phase when neither the portal system nor the liver have received the isotope. This pattern indicates that a part or all of the blood flow from the rectum is directed to the vena caval system via the portacaval shunts on the periphery of the inferior mesenteric vein. 2) Per-rectal portal shunt indices (SI) were calculated from serial radioactivities on the liver and the heart. In the healthy subjects, SI ranged from 1.9 % to 5.2 % (mean 4.1 %). In patients with hepatitis the mean SI was 6.9 %, and in patients with cirrhosis it was 52.9 %. 3) The SI was higher in cirrhotic patients with esophageal varices than in those without (p < 0.001). The SI was higher in cirrhotic patients with encephalopathy than in those without (p < 0.01). Thus, per-rectal portal scintigraphy is a simple, noninvasive and practical method for analyzing portal hemodynamics. (author)

Radionuclide hepatic perfusion index and ultrasonography: Assessment of portal hypertension in clinical practice

International Nuclear Information System (INIS)

Seidlova, V.; Hobza, J.; Pumprla, J.; Charouzek, J.

1989-01-01

The application is described of radionuclide angiography with hepatic perfusion index (HPI) determination in diagnosis of portal blood flow as an indicator of portal hypertension. 99m Tc and 113 In were used as tracers. Over forty patients suffering from chronic hepatitis or liver cirrhosis were included in the study. Ultrasound was used as a preliminary rapid diagnosis of portal hypertension. Radionuclide angiography combined with the HPI technique was confirmed to be a beneficial noninvasive method offering reproducible quantitative information on portal flow well correlating with the degree of portal hypertension, while the combination of ultrasound examination with radionuclide HPI determination appears to greatly enrich the diagnostic potential in hepatology. (L.O.). 4 figs., 11 refs

Managing portal hypertension in patients with liver cirrhosis

Science.gov (United States)

Sauerbruch, Tilman; Schierwagen, Robert; Trebicka, Jonel

2018-01-01

Portal hypertension is one cause and a part of a dynamic process triggered by chronic liver disease, mostly induced by alcohol or incorrect nutrition and less often by viral infections and autoimmune or genetic disease. Adequate staging - continuously modified by current knowledge - should guide the prevention and treatment of portal hypertension with defined endpoints. The main goals are interruption of etiology and prevention of complications followed, if necessary, by treatment of these. For the past few decades, shunts, mostly as intrahepatic stent bypass between portal and hepatic vein branches, have played an important role in the prevention of recurrent bleeding and ascites formation, although their impact on survival remains ambiguous. Systemic drugs, such as non-selective beta-blockers, statins, or antibiotics, reduce portal hypertension by decreasing intrahepatic resistance or portal tributary blood flow or by blunting inflammatory stimuli inside and outside the liver. Here, the interactions among the gut, liver, and brain are increasingly examined for new therapeutic options. There is no general panacea. The interruption of initiating factors is key. If not possible or if not possible in a timely manner, combined approaches should receive more attention before considering liver transplantation. PMID:29780579

Management of Portal Hypertension After Liver Transplantation.

Science.gov (United States)

Korda, D; Deák, P Á; Kiss, G; Gerlei, Z; Kóbori, L; Görög, D; Fehérvári, I; Piros, L; Máthé, Z; Doros, A

2017-09-01

Post-transplantation portal hypertension has severe complications, such as esophageal varix bleeding, therapy refractory ascites, extreme splenomegaly, and graft dysfunction. The aim of our study was to analyze the effectiveness of the therapeutic strategies and how to visualize the procedure. A retrospective study involving liver transplantation patients from the Semmelweis University Department of Transplantation and Surgery was performed between 2005 and 2015. The prevalence, etiology, and leading complications of the condition were determined. The applied interventions' effects on the patients' ascites volume, splenic volume, and the occurrence of variceal bleeding were determined. Mean portal blood flow velocity and congestion index values were calculated using Doppler ultrasonography. The prevalence of post-transplantation portal hypertension requiring intervention was 2.8%. The most common etiology of the disease was portal anastomotic stenosis. The most common complications were esophageal varix bleeding and therapy refractory ascites. The patients' ascites volume decreased significantly (2923.3 ± 1893.2 mL vs. 423.3 ± 634.3 mL; P portal hypertension. After the interventions, these parameters shifted towards the physiologic ranges. The interventions performed in our clinic were effective in most cases. The patients' ascites volume, splenic volume, and the prevalence of variceal bleeding decreased after the treatment. Doppler ultrasonography has proved to be a valuable imaging modality in the diagnosis and the follow-up of post-transplantation portal hypertension. Copyright © 2017 Elsevier Inc. All rights reserved.

Extraction of liver volumetry based on blood vessel from the portal phase CT dataset

Science.gov (United States)

Maklad, Ahmed S.; Matsuhiro, Mikio; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Utsunomiya, Tohru; Shimada, Mitsuo

2012-02-01

At liver surgery planning stage, the liver volumetry would be essential for surgeons. Main problem at liver extraction is the wide variability of livers in shapes and sizes. Since, hepatic blood vessels structure varies from a person to another and covers liver region, the present method uses that information for extraction of liver in two stages. The first stage is to extract abdominal blood vessels in the form of hepatic and nonhepatic blood vessels. At the second stage, extracted vessels are used to control extraction of liver region automatically. Contrast enhanced CT datasets at only the portal phase of 50 cases is used. Those data include 30 abnormal livers. A reference for all cases is done through a comparison of two experts labeling results and correction of their inter-reader variability. Results of the proposed method agree with the reference at an average rate of 97.8%. Through application of different metrics mentioned at MICCAI workshop for liver segmentation, it is found that: volume overlap error is 4.4%, volume difference is 0.3%, average symmetric distance is 0.7 mm, Root mean square symmetric distance is 0.8 mm, and maximum distance is 15.8 mm. These results represent the average of overall data and show an improved accuracy compared to current liver segmentation methods. It seems to be a promising method for extraction of liver volumetry of various shapes and sizes.

Clinical evaluation of per-rectal portal scintigraphy in patients with liver cirrhosis

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Yoneyama, Keiichiro; Kamata, Hideaki; Sakamoto, Osamu; Ogasawara, Hiroshi; Takeuchi, Haruo; Onuki, Makoto; Taguchi, Susumu; Hatta, Yoshio

1986-09-01

Hepatic blood flow and portal shunts were clinically studied with Tc-99m per-rectal portal scintigraphy in 51 patients with liver cirrhosis. RI time-activity curves of the liver and heart were used to define 3 patterns: type I = RI activity was more intense in the liver than in the heart, type II = more intense in the liver at one min and that in the heart at 15 min, or type III = less intense in the liver than in the heart. Four (8 %) of the patients had type 1, 22 (43 %) type II, and 25 (49 %) type III. Esophageal varices and splenomegaly were significantly associated with type III (p < 0.01). Regarding laboratory findings indicative of the impairment of liver function, there was no significant difference among the three types of RI activity. Indocyamine green tolerance test showed significantly higher R15 in the group with type III than in the other two groups (p < 0.05). Three other patients with idiopathic portal hypertension without liver function disturbance had type III. Per-rectal portal scintigraphy will be of help as a noninvasive tool for reflecting not only portal shunts but also hepatic blood flow and for predicting the severity of liver cirrhosis. (Namekawa, K.).

Hypopituitarism possibly due to lymphocytic hypophysitis in a patient with type 1 diabetes.

Science.gov (United States)

Matoba, Keiichiro; Mitsuishi, Sumie; Hayashida, Satoshi; Yamazaki, Hiroyuki

2014-01-01

Hypopituitarism often develops insidiously, and undiagnosed hypopituitarism can influence the glycemic profile of patients with type 1 diabetes. We herein report the case of a 49-year-old man with type 1 diabetes and Hashimoto's thyroiditis who experienced an unexplained improvement in his glycemic level and recurrent severe hypoglycemia, despite a reduction in the dose of insulin. Based on the patient's endocrinological findings, he was diagnosed with hypopituitarism possibly due to lymphocytic hypophysitis, as supported by positive results for human leukocyte antigen A24 and Cw3. Following the administration of hydrocortisone replacement therapy, his insulin requirement increased to a premorbid level, and the severe hypoglycemia resolved.

'Lymphoid hypophysitis' : Its features on CT scan and the clinical course

International Nuclear Information System (INIS)

Kurisaka, Masahiro; Kamimura, Yoshihiko; Seike, Masato; Sada, Yasuo; Arimitsu, Tetsuo; Mori, Koreaki

1986-01-01

Lymphoid hypophysitis is a rare disease which was previously diagnosed mainly at autopsy. It has, however, been recently identified by biopsy in craniotomy and transsphenoidal operations for sellar and suprasellar masses confirmed by computed tomography (CT) scan. There is as yet no definite method of establishing the diagnosis by any of the presently available neuroradiological exams; it can only be arrived at following histological exams and immunological tests for autoimmune disease of the pituitary gland. Thus, it may be suspected if an intra- or suprasellar enhancing mass is found on CT in a pregnant woman or one with a normal delivery during the previous year. A hormone-replacement therapy is essential in the early stage to prevent the panhypopituitarism which often follows the lymphocytic inflammation of the pituitary gland. (author)

Obliterative portal venopathy without portal hypertension: an underestimated condition.

Science.gov (United States)

Guido, Maria; Sarcognato, Samantha; Sonzogni, Aurelio; Lucà, Maria Grazia; Senzolo, Marco; Fagiuoli, Stefano; Ferrarese, Alberto; Pizzi, Marco; Giacomelli, Luciano; Colloredo, Guido

2016-03-01

Obliterative portal venopathy without portal hypertension has been described by a single study in a limited number of patients, thus very little is known about this clinical condition. This study aimed to investigate the prevalence of obliterative portal venopathy and its clinical-pathological correlations in patients with cryptogenic chronic liver test abnormalities without clinical signs of portal hypertension. We analysed 482 liver biopsies from adults with non-cirrhotic cryptogenic chronic liver disorders and without any clinical signs of portal hypertension, consecutively enrolled in a 5-year period. Twenty cases of idiopathic non-cirrhotic portal hypertension diagnosed in the same period, were included for comparison. Histological findings were matched with clinical and laboratory features. Obliterative portal venopathy was identified in 94 (19.5%) of 482 subjects and in all 20 cases of idiopathic non-cirrhotic portal hypertension: both groups shared the entire spectrum of histological changes described in the latter condition. The prevalence of incomplete fibrous septa and nodular regenerative hyperplasia was higher in the biopsies of idiopathic non-cirrhotic portal hypertension (P = 0.006 and P = 0.002), a possible hint of a more advanced stage of the disease. The two groups also shared several clinical laboratory features, including a similar liver function test profile, concomitant prothrombotic conditions and extrahepatic autoimmune disorders. Obliterative portal venopathy occurs in a substantial proportion of patients with unexplained chronic abnormal liver function tests without portal hypertension. The clinical-pathological profile of these subjects suggests that they may be in an early (non-symptomatic) stage of idiopathic non-cirrhotic portal hypertension. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessment of liver circulation by quantitative scintiangiography: Evaluation of the relative contribution of the hepatic arterial and portal venous blood flows to liver perfusion

International Nuclear Information System (INIS)

Molino, G.; Squadrone, E.; Baccegal, M.; Magnani, C.

1989-01-01

Quantitative hepatic scintiangiography was previously used for evaluating the relative contribution of hepatic arterial and portal venous blood flows to the hepatic circulation. The present study compares 3 different procedures (automatic and manual integration, and slope fitting methods) for analyzing the hepatic time activity curves obtained after bolus i.v. injection of 370 MBq 99m Tc-diethylentriaminopentacetic acid. Twenty five subjects were studied: Five controls, ten cirrhotics, and ten portal hypertensive patients previously submitted to side to side portacaval anastomosis. The correspondence between results given by the different methods was satisfactory only in shunted patients, and the reproducibility of computed parameters was quite poor for all procedures. Accordingly, none of the methods can be considered as supporting reliable quantitative pathophysiological evaluations. However, the hepatic arterial/portal venous flow ratio was found to be increased in liver cirrhosis and in shunted patients and therefore, in spite of the limitations underlined before and of the absence of data on the reproducibility of consecutive injections, hepatic scintiangiography may be of some clinical utility. (orig.)

Changes in oxygen content and acid-base balance in arterial and portal blood in response to the dietary electrolyte balance in pigs during a 9-h period after a meal

NARCIS (Netherlands)

Dersjant-Li, Y.; Verstegen, M.W.A.; Jansman, A.; Schulze, H.; Schrama, J.W.; Verreth, J.A.J.

2002-01-01

The effect of two dietary electrolyte balance (dEB, Na K - Cl-) levels on arterial and portal blood oxygen content, blood pH, and acid-base status in pigs was studied during a 9-h period after a meal, using a crossover experimental design. The dEB levels were established by changing the Cl- level in

Transjugular intrahepatic portosystemic shunt in a patient with cavernomatous portal vein occlusion

International Nuclear Information System (INIS)

Kawamata, Hiroshi; Kumazaki, Tatsuo; Kanazawa, Hidenori; Takahashi, Shuji; Tajima, Hiroyuki; Hayashi, Hiromitsu

2000-01-01

A 23-year-old woman with liver cirrhosis secondary to primary sclerosing cholangitis was referred to us for the treatment of recurrent bleeding from esophageal varices that had been refractory to endoscopic sclerotherapy. Her portal vein was occluded, associated with cavernous transformation. A transjugular intrahepatic portosystemic shunt (TIPS) was performed after a preprocedural three-dimensional computed tomographic angiography evaluation to determine feasibility. The portal vein system was recanalized and portal blood flow increased markedly after TIPS. Esophageal varices disappeared 3 weeks after TIPS. Re-bleeding and hepatic encephalopathy were absent for 3 years after the procedure. We conclude that with adequate preprocedural evaluation, TIPS can be performed safely even in patients with portal vein occlusion associated with cavernous transformation.

CT portal venography manifestations of portal collateral circulation in patients with portal hypertension due to cirrhosis

International Nuclear Information System (INIS)

Ni Ming; Lv Weifu; Deng Kexue

2009-01-01

Objective: To analyze CT portal venography (CTPV) manifestations of portal collateral circulation in patients with cirrhosis by using a 16-detector row spiral CT scanner. Methods: CTPV was performed in 36 patients with portal hypertension due to cirrhosis, the diagnosis was proved by clinical data, hepatic function findings and imaging signs. By using post-processing reconstruction technique, 3D images of portal venous system and portal collateral circulation were obtained. Results: CTPV images displayed the portal venous system and its collateral circulation stereoscopically. Of 36 patients, left gastric varices were seen in 29(80.6%), lower esophageal varices in 18(50.0%), short gastric or posterior gastric varices in 15(41.7%), paraesophageal varices in 9(25.0%), gastro-renal or splenorenal shunts in 8(22.2%), spongelike transformation of portal vein in 7(19.4%), paraumbilical and abdominal wall varices in 6(16.7%), congenital cavernous in 6(16.7%) and paravertebral venous shunts in 4(11.1%). Conclusion: CTPV can well display the site, extent and severity of the portal collateral circulation in patients with portal hypertension due to cirrhosis,which is of great clinical importance for judging the patient's condition, for selecting therapeutic protocols and for estimating prognosis. (authors)

Evaluation of portal circulation by /sup 99m/TcO/sub 4/-per-rectal scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Shiomi, S; Kuroki, T; Kurai, O

1987-04-01

Portal circulation in patients with chronic liver diseases was evaluated by a new method named per-rectal portal scintigraphy. Following instillation of a solution containing 10 mCi of /sup 99m/TcO/sub 4//sup -/ into the upper part of the rectum, serial scintigrams were taken sequentially. At the same time, the radioactivity curves over the liver and the heart were recorded sequentially. 1) The findings of per-rectal portal scintigrams were classified into two basic patterns. In pattern (I), the inferior mesenteric vein, portal vein, liver and the heart were visualized continuously after rectal instillation of the radioisotope. This pattern reflects direct blood flow from the rectum to the liver via the portal vein. In contrast, in pattern (II), the portal scintigrams demonstrated the vena cava inferior and the heart at an early phase when neither the portal system nor the liver have received the isotope. This pattern indicates that a part or all of the blood flow from the rectum is directed to the vena caval system via the portacaval shunts on the periphery of the inferior mesenteric vein. 2) Per-rectal portal shunt indices (SI) were calculated from serial radioactivities on the liver and the heart. In the healthy subjects, SI ranged from 1.9 % to 5.2 % (mean 4.1 %). In patients with hepatitis the mean SI was 6.9 %, and in patients with cirrhosis it was 52.9 %. 3) The SI was higher in cirrhotic patients with esophageal varices than in those without. The SI was higher in cirrhotic patients with encephalopathy than in those without. Thus, per-rectal portal scintigraphy is a simple, noninvasive and practical method for analyzing portal hemodynamics.

Characterization of renal hyperemia in portal hypertensive rats

International Nuclear Information System (INIS)

Premen, A.J.; Banchs, V.; Go, V.L.W.; Benoit, J.N.; Granger, D.N.

1986-01-01

In anesthetized sham-operated control (C) and portal vein stenosed (PVS) rats, renal blood flow (RBF) was measured with radioactive microspheres on days 2, 4, 6, 8, and 10 following surgery. On day 2, only a small increase in RBF (19%) was produced in PVS versus C rats. However, by day 4, a significant increase in RBF (35%) was observed in PVS versus C animals. By day 6, the renal hyperemia in PVS rats reached a maximal value that was 42% higher than in C rats. Thereafter (on days 8 and 10), the renal hyperemia remained at the maximal value. In a separate group of 10-day PVS rats, glucagon antiserum failed to attenuate the 44% increase in RBF observed in PVS versus C rats. Radioimmunoassay of C and PVS plasma (10-day samples) revealed that vasoactive intestinal polypeptide, substance P, cholecystokinin/gastrin, neurotensin, pancreatic polypeptide, beta-endorphin, and peptide histidine-isoleucine amide are not elevated in arterial plasma of PVS rats. These data indicate that the renal hyperemia induced by chronic portal hypertension is manifested within 4 days after the hypertensive insult. Our studies also suggest that at least 9 blood-borne gastrointestinal peptides are not directly involved in the renal response to portal vein stenosis

Characterization of renal hyperemia in portal hypertensive rats

Energy Technology Data Exchange (ETDEWEB)

Premen, A.J.; Banchs, V.; Go, V.L.W.; Benoit, J.N.; Granger, D.N.

1986-03-01

In anesthetized sham-operated control (C) and portal vein stenosed (PVS) rats, renal blood flow (RBF) was measured with radioactive microspheres on days 2, 4, 6, 8, and 10 following surgery. On day 2, only a small increase in RBF (19%) was produced in PVS versus C rats. However, by day 4, a significant increase in RBF (35%) was observed in PVS versus C animals. By day 6, the renal hyperemia in PVS rats reached a maximal value that was 42% higher than in C rats. Thereafter (on days 8 and 10), the renal hyperemia remained at the maximal value. In a separate group of 10-day PVS rats, glucagon antiserum failed to attenuate the 44% increase in RBF observed in PVS versus C rats. Radioimmunoassay of C and PVS plasma (10-day samples) revealed that vasoactive intestinal polypeptide, substance P, cholecystokinin/gastrin, neurotensin, pancreatic polypeptide, beta-endorphin, and peptide histidine-isoleucine amide are not elevated in arterial plasma of PVS rats. These data indicate that the renal hyperemia induced by chronic portal hypertension is manifested within 4 days after the hypertensive insult. Our studies also suggest that at least 9 blood-borne gastrointestinal peptides are not directly involved in the renal response to portal vein stenosis.

Radiologic investigation of portal hypertension

International Nuclear Information System (INIS)

Becker, C.; Wegmueller, H.

1993-01-01

Radiologic evaluation of patients with portal hypertension in the pre- and postoperative period can be done with several non-invasive or invasive imaging modalities which offer complementary information. Doppler-ultrasonography (-US) is the method of choice for initial non-invasive screening as well as for follow-up tests after shunt surgery. The diagnostic information provided by Doppler-US regarding morphology and blood flow in the upper abdominal organs and vessels is sufficient in many instances. Dynamic computed tomography (CT), magnetic resonance tomography (MRT) and recently, magnetic resonance angiography (MRA) are additional non-invasive imaging techniques that may add valuable information if necessary. Conventional angiography is usually performed immediately prior to surgery to demonstrate the vascular morphology. The standard angiographic technique to demonstrate both the arterial and portal venous system is arterioportography (late-phase portography) by means of selective catheterization of the celiac, the splenic, the superior mesenteric or inferior mesenteric arteries. The dose of iodinated contrast material may be reduced by 50% if digital subtraction angiography is used instead of the conventional technique. Inferior venacavography and hepatic venography are indicated in patients with suspected postsinusoidal portal hypertension, e.g. the Budd-Chiari syndrome; hepatic wedge manometry offers valuable information regarding pressure gradients between the portal and systemic venous system prior to shunt surgery. The angiographic access through the inferior vena cava is also used for direct catheterization of surgical porto-caval or spleno-renal shunts for both angiography, manometry and, if necessary, balloon angioplasty. (authors)

Therapeutic effects of percutaneous transhepatic variceal embolization combined with partial splenic embolization for portal hypertention

International Nuclear Information System (INIS)

Hua Yingxue; Yan Zhiping; Cheng Yongde; Qiao Delin; Zhou Bing; Chen Shiwei; Li Yong

2007-01-01

Objective: To evaluate the efficiency of percutaneous transhepatic variceal embolization (PTVE) combined with patial splenic embolization (PES)for portal hypertension. Methods: 30 patients with critical portal hypertension were divided randomly into two groups, 15 patients of A group underwent PSE PTVE combined with PSE and 15 of B group underwent PES only. The changes of collateral circulation of the two groups were compared via color Doppler ultrasonography pre-and postoperatively. Results: The hypersplenism was well controlled in both groups after PTVE and PSE. The varices of A group were embolized completely, the flow rate and velocity of portal blood stream were significantly reduced (P<0.05). In addition, the flow rate and velocity together with inner diameter of the azygous vein decreased (P<0.01), but no change shown on portal vein diameter, only with decrease of blood flow and velocity postoperatively were shown in the two groups (P<0.05). During 13-16 months follow-up, gastroesophageal variceal bleeding appeared in 2 patients and formation of portal thrombi in 1 patients of B group. There was no gastroesophageal variceal bleeding in A group but 2 patients appeared portal hypertensive gastroenteropathy (PHG)under endoscopic confirmations. Conclusion: PTVE combined PSE is very efficient for gastroesophageal variceal bleeding and hypersplenism due to portal hypertension, especially for patients with poor hepatic function, possessing simple, economic, less invasive properties and deserving to be recommended. (authors)

Circulating CXCL10 in cirrhotic portal hypertension might reflect systemic inflammation and predict ACLF and mortality

DEFF Research Database (Denmark)

Lehmann, Jennifer M; Claus, Karina; Jansen, Christian

2018-01-01

BACKGROUND & AIMS: CXCR% ligands play an important role in hepatic injury, inflammation and fibrosis. While CXCL9 and CXCL11 are associated with survival in patients receiving transjugular intrahepatic portosystemic shunt (TIPS), the role of CXCL10 in severe portal hypertension remains unknown...... inflammation and it is correlated with acute decompensation, ACLF and complications in patients with severe portal hypertension receiving TIPS. CXCL10 predicts survival in these patients and a decrease in CXCL10 after TIPS may be considered a good prognostic factor........ METHODS: A total of 89 cirrhotic patients were analysed. CXCL10 protein levels were measured in portal and hepatic blood at TIPS insertion and 2 weeks later in 24 patients. CXCL10 and IL8 levels were assessed in portal, hepatic, cubital vein and right atrium blood in a further 25 patients at TIPS...

Perivesical varices and portal hypertension: imaging study

International Nuclear Information System (INIS)

Mallorquin Jimenez, F.; Medina Benitez, A.; Lopez Machado, E.; Pardo Moreno, M.D.; Garrido Moreno, C.; Pastor Rull, J.

1995-01-01

Nine patients with portal hypertension syndrome and Perivesical varices are studied retrospectively by means of imaging techniques including ultrasound, duplex Doppler, color Doppler, CT and angiography. All the patients presented portal thrombosis and thickening of the bladder wall. These collaterals either represent a shunting of hepato pedal flow or correspond to blood stasis associated with said syndrome. Ultrasound, whether involving duplex Doppler or color Doppler techniques, is highly useful to detect the presence of Perivesical varices which appear as tubular or rounded hypo echogenic areas in the bladder wall. Given the association of this entity with bladder wall thickening, it should be taken into account in any clinical situation involving said change, especially in patients with portal hypertension; moreover knowledge of its presence is of great importance when the possibility of creating shunts by means of interventional or surgical vascular procedures or other types of abdominal procedures are being considered because of the risk of bleeding. (Author)

Treatment of extrahepatic portal hypertension following a whipple procedure with a Rex shunt: report of a case.

Science.gov (United States)

Reichman, Trevor W; Anthony, Tiffany; Testa, Giuliano

2011-02-01

The Rex shunt is a mesenteric vein to left portal vein decompressive shunt used for the treatment of portal vein thrombosis and portal hypertension. Its use has been reported primarily in the pediatric population where portal vein thrombosis occurs with some frequency. The shunt is thought to represent a more physiologic shunt, since it restores hepatopedal blood flow through the liver. This report describes the use of this shunt in an adult who had frequent gastrointestinal bleeding secondary to extrahepatic portal vein thrombosis, which occurred as a complication after a pancreaticoduodenectomy.

Hypophysitis, Panhypopituitarism, and Hypothalamitis in a Scottish Terrier Dog.

Science.gov (United States)

Polledo, L; Oliveira, M; Adamany, J; Graham, P; Baiker, K

2017-09-01

A 6-year old male neutered Scottish Terrier was referred with a 1 week history of progressive lethargy and anorexia. Neurological examination localized a lesion to the forebrain and hormonal testing showed panhypopituitarism. Magnetic resonance imaging (MRI) of the brain revealed a rounded, well-defined, suprasellar central mass. The mass was slightly hyperintense to the cortical grey matter on T2-weighted (T2W), hypointense on T1-weighted (T1W) images and without T2* signal void. There was a central fusiform enhancement of the mass after contrast administration which raised the suspicion of a pituitary neoplasm. Rapid deterioration of the dog prevented further clinical investigations. Histopathologic examination revealed a lymphocytic panhypophysitis of unknown origin suspected autoimmune involving the hypothalamus (hypothalamitis). This is a unique case report of a dog presenting with inflammatory hypophysitis and hypothalamitis of suspected autoimmune origin with detailed clinical, MRI, histology and immunohistochemistry findings. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Relevance of plasma malondialdehyde level and severity of portal hypertension in cirrhotic patients.

Science.gov (United States)

Wang, Sheng-Lan; Zhu, Xin-Yan; Zhang, Dong-Wei; Zhang, Zhao-Jie; Gao, Heng-Jun; Yang, Chang-Qing

2015-01-01

Portal hypertension is one of the death reasons for the liver cirrhosis patients. The oxidative stress is related to the occurrence and development of portal hypertension in cirrhosis. Malondialdehyde (MDA), one of the lipid peroxides, increases substantially in cirrhotic patients. To evaluate the relevance between the MDA level and portal hypertension in cirrhotic patients. 60 liver cirrhotic patients and 30 healthy controls were enrolled. The plasma MDA level and general blood tests including ALT, AST, ALB, total bilirubin, and platelet were measured. All people enrolled accepted endoscopic examination and B-Ultrasound check to evaluate the severity of portal hypertension. The MDA plasma level of cirrhotic patients was significantly higher than the controls (Pportal hypertension (Pportal vein (r=0.652, Pportal hypertension. Plasma MDA level may correlate with the severity of portal hypertension in cirrhotic patients.

Establishment of a reversible model of prehepatic portal hypertension in rats.

Science.gov (United States)

Zhao, Xin; Dou, Jian; Gao, Qing-Jun

2016-08-01

The aim of the present study was to improve upon the traditional model of pre-hepatic portal hypertension in rats, and simulate the anhepatic phase of orthotopic liver transplantation without veno-venous bypass. A reversible model of portal hypertension was induced by portal vein ligation, with a label ring ligated along the portal vein. A total of 135 male Wistar rats were divided into three groups: i) Normal control (NC) group; ii) portal hypertensive control (PHTC) group; and iii) reperfusion (R) group. In the R group, rats with portal hypertension underwent simultaneous clamping of the portal triad and retrohepatic vena cava for 1 h, followed by removal of the clamps to enable blood reperfusion. Portal venography and portal vein pressure were recorded during the surgery. Arterial oxygen pressure (PaO 2 ), and alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) levels were determined, and pathological changes of the liver were investigated by immunohistochemical staining. The results demonstrated that, 3 weeks after portal vein ligation, the vein area and the free portal pressures in the PHTC group were significantly increased compared with those in the NC group. The serum ALT and AST levels in the R group at different time points were significantly elevated compared with those in the PHTC group, and reached their maximal levels at 24 h after reperfusion. Furthermore, the PaO 2 at 24 h after reperfusion was significantly decreased. In conclusion, the reversible model of pre-hepatic portal hypertension in rats was successfully established using the introduction of a label ring. This model may be useful for basic research focusing on the anhepatic phase of orthotopic liver transplantation without veno-venous bypass.

The spiral CT manifestations of the blood supply of primary hepatocellular carcinoma: correlation with pathological findings

International Nuclear Information System (INIS)

Huang Juan; Zhou Xiangping; Liu Rongbo; Chen Xian; Xu Chongyong; Yan Zhihan; Xu Jianying

2000-01-01

Objective: To study the correlation between the CT features of tumor blood supplies and the pathological changes in primary hepatocellular carcinoma (PHCC). Methods: Fifty cases with surgically and pathologically proved PHCC underwent spiral CT scanning (plain + dual-phase). One research group blindly evaluated the CT films obtained. According to tumor contrast enhancement and signals showed on CT, the patterns of PHCC was divided into 4 types: arterial blood supplying, portal blood supplying, arterial combining with portal blood supplying, and poorly blood supplying. Microscopically, PHCC was respectively classified into grade I to IV with Edmonson's standard, and into 4 types (trabecular, pseudo-glandular, compact, scirrhous) with WHO histological grading standard. At last, the CT features of tumor blood supplies were correlated with pathologic changes. Results: 36(72%) cases were supplied by hepatic arterial blood, 6(12%) by arterial combining with portal blood supplying, 4(8%) by portal, and 4(8%) were poorly blood supplying. The patterns of tumor blood supplies in PHCC correlated with tumor cells differentiation (P<0.05). PHCC with better tumor cells differentiation was more associated with portal blood supplies. The patterns of tumor blood supplying in PHCC correlated with the histological type of the tumor cell (P < 0.05). All of the scirrhous PHCC were lack of blood supplies, the entire compact and most of the trabecular PHCC were supplied by a arterial blood. Conclusion: The most of PHCC were supplied by hepatic arterial blood and others were supplied by portal blood, arterial combining with portal blood or lack of blood supplies. Evaluation of tumor blood supplies in PHCC is considered to be useful in differential diagnosis and treatment of PHCC

Idiopathic portal hypertension

International Nuclear Information System (INIS)

Han, Tae Kyun; Ryu, Dae Sik; Kim, Heung Chul; Hur, Hun; Eom, Kyeung Tae; Namkung, Sook; Park, Man Soo; Hwang, Woo Chul; Lee, Kwan Seop

1996-01-01

To describe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. Four portograms in five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a control subject with liver cirrhosis. Portographic finding s of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. A portogram of idiopathic portal hypertension may be useful in differentiation this and liver cirrhosis

Isolated adrenocorticotropic hormone deficiency due to probable lymphocytic hypophysitis in a woman

Directory of Open Access Journals (Sweden)

Faten Hadj Kacem

2013-01-01

Full Text Available We report a 22-year-old woman who presented with asthenia, weight loss and hypotension in which extensive pituitary and adrenal investigations were diagnostic of isolated adrenocorticotropic hormone deficiency (IAD of pituitary origin. Magnetic resonance imaging of the hypothalamus and pituitary showed a normal-sized pituitary, with no mass lesion. The diagnosis of IAD probably secondary to lymphocytic hypophysitis (LYH was made.IAD is able to be the way of presentation of LYH, although the disease could or could not turn into a panhypopituitarism. Prompt recognition of this potentially fatal condition is important because of the availability of effective treatment. Indeed, regular endocrine and imaging follow up is important for patients with IAD and normal initial pituitary imaging results to detect early new-onset pituitary hormones deficiencies or imaging abnormalities.

X-ray examination of the portal hypertension by means of indirect arterial portography

Energy Technology Data Exchange (ETDEWEB)

Vadon, G; Engloner, L; Kupcsulik, P; Konya, A [Semmelweis Orvostudomanyi Egyetem, Budapest (Hungary). Radiologiai Klinika; Semmelweis Orvostudomanyi Egyetem, Budapest (Hungary). 2. Sebeszeti Klinika)

1982-01-01

The blood flow in the portal system, its collaterals and the presence of any thrombus was examined by serial radiograms taken in the venous phase after catheterization of the a. coeliaca, linealis or mesenterica superior. In 127 out of 131 cases the examination was successful and gave valuable information. The method is recommended as a first investigation in cases of suspected portal hypertension.

Effect of TIPS placement on portal and splanchnic arterial blood flow in 4-dimensional flow MRI

Energy Technology Data Exchange (ETDEWEB)

Stankovic, Zoran [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); University Medical Center Freiburg, Department of Diagnostic Radiology and Medical Physics, Freiburg (Germany); Roessle, Martin; Schultheiss, Michael [University Medical Center Freiburg, Department of Gastroenterology, Freiburg (Germany); Euringer, Wulf; Langer, Mathias [University Medical Center Freiburg, Department of Diagnostic Radiology and Medical Physics, Freiburg (Germany); Salem, Riad; Barker, Alex; Carr, James; Collins, Jeremy D. [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Markl, Michael [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Northwestern University, Department of Biomedical Engineering, McCormick School of Engineering, Chicago, IL (United States)

2015-09-15

To assess changes in portal and splanchnic arterial haemodynamics in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) using four-dimensional (4D) flow MRI, a non-invasive, non-contrast imaging technique. Eleven patients undergoing TIPS implantation were enrolled. K-t GRAPPA accelerated non-contrast 4D flow MRI of the liver vasculature was applied with acceleration factor R = 5 at 3Tesla. Flow analysis included three-dimensional (3D) blood flow visualization using time-resolved 3D particle traces and semi-quantitative flow pattern grading. Quantitative evaluation entailed peak velocities and net flows throughout the arterial and portal venous (PV) systems. MRI measurements were taken within 24 h before and 4 weeks after TIPS placement. Three-dimensional flow visualization with 4D flow MRI revealed good image quality with minor limitations in PV flow. Quantitative analysis revealed a significant increase in PV flow (562 ± 373 ml/min before vs. 1831 ± 965 ml/min after TIPS), in the hepatic artery (176 ± 132 ml/min vs. 354 ± 140 ml/min) and combined flow in splenic and superior mesenteric arteries (770 ml/min vs. 1064 ml/min). Shunt-flow assessment demonstrated stenoses in two patients confirmed and treated at TIPS revision. Four-dimensional flow MRI might have the potential to give new information about the effect of TIPS placement on hepatic perfusion. It may explain some unexpected findings in clinical observation studies. (orig.)

Electronic portal imaging devices

International Nuclear Information System (INIS)

Lief, Eugene

2008-01-01

The topics discussed include, among others, the following: Role of portal imaging; Port films vs. EPID; Image guidance: Elekta volume view; Delivery verification; Automation tasks of portal imaging; Types of portal imaging (Fluorescent screen, mirror, and CCD camera-based imaging; Liquid ion chamber imaging; Amorpho-silicon portal imagers; Fluoroscopic portal imaging; Kodak CR reader; and Other types of portal imaging devices); QA of EPID; and Portal dosimetry (P.A.)

Determination of liver and spleen perfusion by quantitative sequential scintigraphy: results in normal subjects and in patients with portal hypertension

International Nuclear Information System (INIS)

Biersack, H.J.; Torres, J.; Thelen, M.; Monzon, O.; Winkler, C.

1981-01-01

Quantitative sequential hepatosplenic scintigraphy was performed to determine the arterial and portal components of the total liver circulation in 135 patients (no liver disease in 20, liver cirrhosis and portal ;hypertension in 115). Portal circulation in healthy patients is calculated to be 70.4 +/- 6.2% of the total liver blood flow, whereas patients with portal hypertension showed a clear reduction of portal perfusion to 20.2 +/- 10.9%. Thirteen of 20 patients having portosystemic shunt surgery showed no portal perfusion. This new, noninvasive diagnostic technique yields vital information particularly useful in ;the surgical evaluation of portal hypertension. Other indications are also discussed

Quantitative study of the hemodynamic changes of portal vein in hepatocellular carcinoma with arterioportal shunts

International Nuclear Information System (INIS)

Shen Xinying; Shan Hong

2005-01-01

Objective: To measure the changes of portal venous pressure before and after APS by percutaneous portal vein catheterization and to quantitatively analyse the correlation between portal pressure and portal hypertension. Methods: All the 18 central arterioportal shunts (APS) patients with hepatocellular carcinoma (HCC) were treated with embolization of APS and TACE, and the pressure of portal vein was measured by percutaneous portal vein catheterization pre- and post-embolization of APS. Color doppler sonography and endoscopy were employed to investigate before and 2 weeks after embolization in all patients. Results: The pressure of portal vein decreased significantly after embolization, and the decreased rate was 5.4%-33.3% with the mean rate 20.1%. After the embolization, the width of portal vein decreased and the blood flow velocity of portal vein increased significantly, P<0.01. Hepatofugal portal venous flow was seen in 13 patients before embolization, and restored to hepatopetal flow in 7 patients after embolization. In the 10 patients with more than 20% decrease in portal venous pressure, the portal hypertension improved markedly; while in other 8 patients with less than 20 percent decrease in portal venous pressure, the clinical symptoms of portal hypertension did not improve as much. Conclusions: Embolization of APS can decrease portal venous pressure, with the mean decreasing rate over 20%. Decreasing by 20% or more of portal venous pressure can improve effectively the portal hypertension symptoms including ascites, variceal bleeding, and diarrhea. (authors)

29 CFR 785.24 - Principles noted in Portal-to-Portal Bulletin.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Principles noted in Portal-to-Portal Bulletin. 785.24 Section 785.24 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... of Principles Preparatory and Concluding Activities § 785.24 Principles noted in Portal-to-Portal...

Thrombospondin-1 expression may be implicated in liver atrophic mechanism due to obstructed portal venous flow.

Science.gov (United States)

Hayashi, Hiromitsu; Kuroki, Hideyuki; Higashi, Takaaki; Takeyama, Hideaki; Yokoyama, Naomi; Okabe, Hirohisa; Nitta, Hidetoshi; Beppu, Toru; Takamori, Hiroshi; Baba, Hideo

2017-07-01

Liver is an amazing organ that can undergo regenerative and atrophic changes inversely, depending on blood flow conditions. Although the regenerative mechanism has been extensively studied, the atrophic mechanism remains to be elucidated. To assess the molecular mechanism of liver atrophy due to reduced portal blood flow, we analyzed the gene expressions between atrophic and hypertrophic livers induced by portal vein embolization in three human liver tissues using microarray analyses. Thrombospondin (TSP)-1 is an extracellular protein and a negative regulator of liver regeneration through its activation of the transforming growth factor-β/Smad signaling pathway. TSP-1 was extracted as the most upregulated gene in atrophic liver compared to hypertrophic liver due to portal flow obstruction in human. Liver atrophic and hypertrophic changes were confirmed by HE and proliferating cell nuclear antigen staining and terminal deoxynucleotidyl transferase-mediated digoxigenin-dUTP nick-end labeling. In an in vivo model with portal ligation, TSP-1 and phosphorylated Smad2 expression were continuously induced at 6 h and thereafter in the portal ligated liver, whereas the induction was transient at 6 h in the portal non-ligated liver. Indeed, while cell proliferation represented by proliferating cell nuclear antigen expression at 48 h was induced in the portal ligated liver, the sinusoidal dilatation and hepatocyte cell death with terminal deoxynucleotidyl transferase-mediated digoxigenin-dUTP nick-end labeling was detectable at 48 h in the portal ligated liver. Obstructed portal flow induces persistent TSP-1 expression and transforming growth factor-β/Smad signal activation in atrophic liver. Thrombospondin-1 may be implicated in the liver atrophic change due to obstructed portal flow as a pro-atrophic factor. © 2016 The Japan Society of Hepatology.

[Portal perfusion with right gastroepiploic vein flow in liver transplant].

Science.gov (United States)

Mendoza-Sánchez, Federico; Javier-Haro, Francisco; Mendoza-Medina, Diego Federico; González-Ojeda, Alejandro; Cortés-Lares, José Antonio; Fuentes-Orozco, Clotilde

Liver transplantation in patients with liver cirrhosis, portal vein thrombosis, and cavernous transformation of the portal vein, is a complex procedure with high possibility of liver graft dysfunction. It is performed in 2-19% of all liver transplants, and has a significantly high mortality rate in the post-operative period. Other procedures to maintain portal perfusion have been described, however there are no reports of liver graft perfusion using right gastroepiploic vein. A 20 year-old female diagnosed with cryptogenic cirrhosis, with a Child-Pugh score of 7 points (class "B"), and MELD score of 14 points, with thrombosis and cavernous transformation of the portal vein, severe portal hypertension, splenomegaly, a history of upper gastrointestinal bleeding due to oesophageal varices, and left renal agenesis. The preoperative evaluation for liver transplantation was completed, and the right gastroepiploic vein of 1-cm diameter was observed draining to the infrahepatic inferior vena cava and right suprarenal vein. An orthotopic liver transplantation was performed from a non-living donor (deceased on January 30, 2005) using the Piggy-Back technique. Portal vein perfusion was maintained using the right gastroepiploic vein, and the outcome was satisfactory. The patient was discharged 13 days after surgery. Liver transplantation was performed satisfactorily, obtaining an acceptable outcome. In this case, the portal perfusion had adequate blood flow through the right gastroepiploic vein. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Contrast-enhanced sonography for quantitative assessment of portal hypertension in patients with liver cirrhosis.

Science.gov (United States)

Qu, En-Ze; Zhang, Ying-Cai; Li, Zhi-Yan; Liu, Yang; Wang, Jin-Rui

2014-11-01

The clinical utility of contrast-enhanced sonography in portal hypertension remains unclear. We explored the feasibility of using contrast-enhanced sonography for noninvasive assessment of portal venous pressure. Twenty healthy individuals (control group; 9 men; mean age, 46.4 years) and 18 patients with portal hypertension (15 men; mean age, 46.2 years) were enrolled in this study. The portal hypertension group included patients who underwent splenectomy and pericardial blood vessel disarticulation at our hospital from October 2010 to March 2011. One week before surgery, patients with portal hypertension underwent preoperative liver contrast-enhanced sonography. Two-dimensional, Doppler, and contrast-enhanced sonographic parameters were compared between the groups. Portal venous pressure was measured intraoperatively by portal vein puncture in the portal hypertension group, and its relationship with the other parameters was analyzed. The 2-dimensional, Doppler, and contrast-enhanced sonographic parameters differed between the groups (P Portal venous pressure was inversely correlated with the area under the portal vein/hepatic artery time-intensity curve ratio (Qp/Qa), portal vein/hepatic artery strength ratio (Ip/Ia), and portal vein/hepatic artery wash-in perfusion slope ratio (βp/βa), with correlation coefficients of -0.701, -0.625, and -0.494, respectively. Measurement of the liver contrast-enhanced sonographic parameters Qp/Qa, Ip/Ia, and βp/βa could be used as a new quantitative method for noninvasively assessing portal venous pressure. © 2014 by the American Institute of Ultrasound in Medicine.

Collateral hepatic circulation with the portal hypertension syndrome in children

International Nuclear Information System (INIS)

Filippkin, M.A.; Kondakov, V.T.; Artamonov, Yu.A.

1990-01-01

The results of complex examination carried out in 80 children of different age with the extrahepatic form of portal hypertension and liver fibrosis are presented. Correspondence between clinical and roentgenoangiograph patterns of disease is detected. Dependence of the degree of varicose transformation of submucous veins of the esophagus and stomach on the value and the character of portal blood disposal is established. The risk group is detected. Clinico-X-ray comparisons carried out testify about advisability of the account of individual features of collateral hepatic circulation of the liver when developing medical treatment

Beneficial long term effect of a phosphodiesterase-5-inhibitor in cirrhotic portal hypertension: A case report with 8 years follow-up.

Science.gov (United States)

Deibert, Peter; Lazaro, Adhara; Stankovic, Zoran; Schaffner, Denise; Rössle, Martin; Kreisel, Wolfgang

2018-01-21

Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored. In the acute setting, the PDE-5-inhibitor Vardenafil lowered portal pressure by 13%. The portal blood flow increased by 28% based on Doppler sonography and by 16% using MRI technique. As maintenance medication the PDE-5-inhibitor Tadalafil was used for eight consecutive years with comparable effects on portal pressure and portal blood flow. There were no recurrence of bleeding and no formation of new varices. Influencing the NO-pathway by the use of PDE-5 inhibitors may have long-term beneficial effects in compensated cirrhosis.

Portal hypertensiv gastropati

DEFF Research Database (Denmark)

Brinch, K; Møller, S; Henriksen, Jens Henrik Sahl

1995-01-01

Portal hypertensive gastropathy (PHG) as defined by congestive changes in the gastric mucosa owing to increased portal pressure, was first described about ten years ago. Whereas definition and grading of severity are still under debate, there is general agreement that PHG is a new clinical entity....... PHG is present in 50-80% of patients with liver cirrhosis. PHG is a major cause of upper gastrointestinal bleeding in patients with portal hypertension (25-90% depending on severity). Presence of portal hypertension is a prerequisite for the development of PHG, and reduction of portal pressure...

Blood vessel-based liver segmentation through the portal phase of a CT dataset

Science.gov (United States)

Maklad, Ahmed S.; Matsuhiro, Mikio; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Moriyama, Noriyuki; Utsunomiya, Toru; Shimada, Mitsuo

2013-02-01

Blood vessels are dispersed throughout the human body organs and carry unique information for each person. This information can be used to delineate organ boundaries. The proposed method relies on abdominal blood vessels (ABV) to segment the liver considering the potential presence of tumors through the portal phase of a CT dataset. ABV are extracted and classified into hepatic (HBV) and nonhepatic (non-HBV) with a small number of interactions. HBV and non-HBV are used to guide an automatic segmentation of the liver. HBV are used to individually segment the core region of the liver. This region and non-HBV are used to construct a boundary surface between the liver and other organs to separate them. The core region is classified based on extracted posterior distributions of its histogram into low intensity tumor (LIT) and non-LIT core regions. Non-LIT case includes normal part of liver, HBV, and high intensity tumors if exist. Each core region is extended based on its corresponding posterior distribution. Extension is completed when it reaches either a variation in intensity or the constructed boundary surface. The method was applied to 80 datasets (30 Medical Image Computing and Computer Assisted Intervention (MICCAI) and 50 non-MICCAI data) including 60 datasets with tumors. Our results for the MICCAI-test data were evaluated by sliver07 [1] with an overall score of 79.7, which ranks seventh best on the site (December 2013). This approach seems a promising method for extraction of liver volumetry of various shapes and sizes and low intensity hepatic tumors.

Doppler-ultrasonographic finding of air in the portal vein: a case report

Energy Technology Data Exchange (ETDEWEB)

Park, Ki Soon; Lee, Kwan Sup; Lee, Yul; Chung, Soo Young; Bae, Sang Hoon [College of Medicine, Hallym University, Seoul (Korea, Republic of)

1994-03-15

Classically air in the portal vein has been detected on plain radiography, but computed tomography and ultrasonography have been shown to be more sensitive. We report a case of air in the PV in a 10-day-old infant with pneumatosis intestinalis with its ultrasonographic and Doppler findings. The patient was a 10-day-old infant born by cesarean section at 41 weeks. Simple abdomen film revealed branching pattern of radiolucent air shadows within in contour of liver, gas distention of bowel loops and thickenod bowel walls with lincar intraluminal air shadows in abdomen, suggesting necrotizing enterocolitis. So we performed Doppler ultrasonography. Ultrasonography showed branching pattern of hyperechogenic dots and along the lumen of left portal vein. The color Doppler study revealed an aliasing duo to increased velocity and whirling pattern of blood flow, and the Duplex Doppler spectral display showed sharp, vertical bidirectional spikes by air in portal vein. Air in the portal vein can be easily diagnosed by the following signs: hyperechogenic dots in the portal vein on ultrasonography and vertical, sharp bidirectional spikes superimposed on the usual Doppler tracing of the portal vein on Duplex ultrasonography.

Doppler-ultrasonographic finding of air in the portal vein: a case report

International Nuclear Information System (INIS)

Park, Ki Soon; Lee, Kwan Sup; Lee, Yul; Chung, Soo Young; Bae, Sang Hoon

1994-01-01

Classically air in the portal vein has been detected on plain radiography, but computed tomography and ultrasonography have been shown to be more sensitive. We report a case of air in the PV in a 10-day-old infant with pneumatosis intestinalis with its ultrasonographic and Doppler findings. The patient was a 10-day-old infant born by cesarean section at 41 weeks. Simple abdomen film revealed branching pattern of radiolucent air shadows within in contour of liver, gas distention of bowel loops and thickenod bowel walls with lincar intraluminal air shadows in abdomen, suggesting necrotizing enterocolitis. So we performed Doppler ultrasonography. Ultrasonography showed branching pattern of hyperechogenic dots and along the lumen of left portal vein. The color Doppler study revealed an aliasing duo to increased velocity and whirling pattern of blood flow, and the Duplex Doppler spectral display showed sharp, vertical bidirectional spikes by air in portal vein. Air in the portal vein can be easily diagnosed by the following signs: hyperechogenic dots in the portal vein on ultrasonography and vertical, sharp bidirectional spikes superimposed on the usual Doppler tracing of the portal vein on Duplex ultrasonography

Rare Disease Video Portal

OpenAIRE

Sánchez Bocanegra, Carlos Luis

2011-01-01

Rare Disease Video Portal (RD Video) is a portal web where contains videos from Youtube including all details from 12 channels of Youtube. Rare Disease Video Portal (RD Video) es un portal web que contiene los vídeos de Youtube incluyendo todos los detalles de 12 canales de Youtube. Rare Disease Video Portal (RD Video) és un portal web que conté els vídeos de Youtube i que inclou tots els detalls de 12 Canals de Youtube.

Jejunal varices diagnosed by capsule endoscopy in patients with post-liver transplant portal hypertension.

Science.gov (United States)

Bass, Lee M; Kim, Stanley; Superina, Riccardo; Mohammad, Saeed

2017-02-01

Portal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%-10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7-16 years) with a median Hgb of 2.8 g/dL (range 1.8-6.8 g/dL). Upper endoscopy was negative for significant esophageal varices, gastric varices, and bleeding portal gastropathy in all three children. All three patients had significant jejunal varices noted on CE in mid-jejunum. Jejunal varices were described as large prominent bluish vessels underneath visualized mucosa, one with evidence of recent bleeding. The results led to venoplasty of the portal vein in two patients and a decompressive shunt in one patient with resolution of GI bleed and anemia. CE is useful to diagnose intestinal varices in children with portal hypertension and GI bleeding following liver transplant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Determination of hepatic circulatory changes in portal hypertension using /sup 133/Xe injection-method. Especially in idiopathic portal hypertension

Energy Technology Data Exchange (ETDEWEB)

Shibata, Masazumi

1987-07-01

The purpose of the present study was to investigate the change in hepatic circulation in patients with liver diseases including idiopathic portal hypertension (IPH). We determined the ratio (A/P ratio) of hepatic blood flow supplied from the hepatic artery (A-HBF) to hepatic blood flow supplied from the portal vein (P-HBF), total hepatic blood flow (HBF), and splenic blood flow following the administration of /sup 133/Xe in 13 cases with IPH, 28 cases with chronic hepatitis, 9 cases with pre-cirrhosis, 66 cases with liver cirrhosis, and 15 healthy subjects. The results are shown as follows: 1) In IPH cases, A/P ratio increased significantly compared to healthy subjects, while A-HBF increased slightly. However, A-HBF markedly increased in two cases with IPH operated for splenectomy and esophageal transection in childhood. 2) The reduction in HBF in the patients with IPH was probably due to the decrease in P-HBF, which was observed particularly in cases having extrahepatic portasystemic shunt. 3) Splenic blood flow in patients with IPH increased significantly compared to those in patients with chronic hepatitis and with liver cirrhosis. 4) A/P ratio increased corresponding with the process to liver cirrhosis. This increase of A/P ratio was observed in patients from the pre-cirrhotic stage, which was mainly due to the decrease in P-HBF. 5) Compensatory increase in A-HBF was observed distinctly in patient with liver cirrhosis. A/P ratio was high in cirrhotic cases who had marked extrahepatic portasystemic shunt. 6) A/P ratio increased markedly in cases with decompensated cirrhosis, particularly in the cases terminating in hepatic failure.

Laparoscopic versus open splenectomy for portal hypertension: a systematic review of comparative studies.

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Cai, Yunqiang; Liu, Zhihong; Liu, Xubao

2014-08-01

Laparoscopic splenectomy has become the gold-standard procedure for normal to moderately enlarged spleens. However, the safety of laparoscopic splenectomy for patients with portal hypertension remains controversial. We carried out this systematic review to identify the feasibility and safety of laparoscopic splenectomy in treating portal hypertension. A systematic search for comparative studies that compared laparoscopic splenectomy with open splenectomy for portal hypertension was carried out. Studies were independently reviewed for quality, inclusion and exclusion criteria, demographic characteristics, and perioperative outcomes. Although laparoscopic splenectomy is associated with longer operating time, it offers advantages over the open procedure in terms of less blood loss, lower operative complications, earlier resumption of oral intake, and shorter posthospital stay. Therefore, laparoscopic splenectomy is a safe and feasible intervention for portal hypertension. © The Author(s) 2014.

Transplantation of endothelial progenitor cells ameliorates vascular dysfunction and portal hypertension in carbon tetrachloride-induced rat liver cirrhotic model.

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Sakamoto, Masaharu; Nakamura, Toru; Torimura, Takuji; Iwamoto, Hideki; Masuda, Hiroshi; Koga, Hironori; Abe, Mitsuhiko; Hashimoto, Osamu; Ueno, Takato; Sata, Michio

2013-01-01

In cirrhosis, sinusoidal endothelial cell injury results in increased endothelin-1 (ET-1) and decreased nitric oxide synthase (NOS) activity, leading to portal hypertension. However, the effects of transplanted endothelial progenitor cells (EPCs) on the cirrhotic liver have not yet been clarified. We investigated whether EPC transplantation reduces portal hypertension. Cirrhotic rats were created by the administration of carbon tetrachloride (CCl(4) ) twice weekly for 10 weeks. From week 7, rat bone marrow-derived EPCs were injected via the tail vein in this model once a week for 4 weeks. Endothelial NOS (eNOS), vascular endothelial growth factor (VEGF) and caveolin expressions were examined by Western blots. Hepatic tissue ET-1 was measured by a radioimmunoassay (RIA). Portal venous pressure, mean aortic pressure, and hepatic blood flow were measured. Endothelial progenitor cell transplantation reduced liver fibrosis, α-smooth muscle actin-positive cells, caveolin expression, ET-1 concentration and portal venous pressure. EPC transplantation increased hepatic blood flow, protein levels of eNOS and VEGF. Immunohistochemical analyses of eNOS and isolectin B4 demonstrated that the livers of EPC-transplanted animals had markedly increased vascular density, suggesting reconstitution of sinusoidal blood vessels with endothelium. Transplantation of EPCs ameliorates vascular dysfunction and portal hypertension, suggesting this treatment may provide a new approach in the therapy of portal hypertension with liver cirrhosis. © 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Noncirrhotic portal hypertension.

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Da, Ben L; Koh, Christopher; Heller, Theo

2018-05-01

Noncirrhotic portal hypertension represents a heterogeneous group of liver disorders that is characterized by portal hypertension in the absence of cirrhosis. The purpose of this review is to serve as a guide on how to approach a patient with noncirrhotic portal hypertension with a focus on recent developments. Recent studies pertaining to noncirrhotic portal hypertension have investigated aetiological causes, mechanisms of disease, noninvasive diagnostic modalities, clinical characteristics in the paediatric population and novel treatment targets. Noncirrhotic portal hypertension is an underappreciated clinical entity that can be difficult to diagnosis without a healthy suspicion. Diagnosis then relies on a comprehensive understanding of the causes and clinical manifestations of this disease, as well as a careful interpretation of the liver biopsy. Noninvasive approaches to diagnosis may play a significant role moving forward in this disease. Treatment in NCPH remains largely targeted at the individual sequalae of portal hypertension.

Hemodynamic evaluation of the right portal vein in healthy dogs of different body weights

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de Almeida Mariana F

2010-05-01

Full Text Available Abstract Background Doppler ultrasonography is an important tool for evaluating hepatic portal hemodynamics. However, no study in dogs of different body weights, in the range encountered in routine clinical veterinary practice, has been reported. It can be difficult to obtain an ideal insonation angle when evaluating the main portal vein, so evaluation of the right portal vein branch has been described in humans as an alternative. The aim of this study was to analyze, through Doppler ultrasonography, the hemodynamics in the right portal vein branch in dogs of different body weights. Methods Thirty normal dogs were divided in three groups by weight, in order to establish normal values for mean velocity, flow volume and portal congestion index of the right portal vein branch by means of Doppler ultrasonography. Results In all dogs ideal insonation angles were obtained for the right portal vein branch. The average velocity was similar in the three groups, but the portal congestion index and the flow volume differed, showing that the weight of the dog can influence these values. Conclusion Doppler ultrasonography for the evaluation of flow in the right branch of the portal vein could be a viable alternative, or complement, to examining the main vessel segment. This is especially so in those animals in which an ideal insonation angle for examination of the main portal vein is hard to obtain. In addition, the weight of the dog must be considered for the correct evaluation of the portal system hemodynamics, particularly for portal blood flow and the congestion index.

Fall in thyroid stimulating hormone (TSH) may be an early marker of ipilimumab-induced hypophysitis.

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De Sousa, Sunita M C; Sheriff, Nisa; Tran, Chau H; Menzies, Alexander M; Tsang, Venessa H M; Long, Georgina V; Tonks, Katherine T T

2018-06-01

Hypophysitis develops in up to 19% of melanoma patients treated with ipilimumab, a cytotoxic T-lymphocyte antigen-4 antibody. Early detection may avert life-threatening hypopituitarism. We aimed to assess the incidence of ipilimumab-induced hypophysitis (IH) at a quaternary melanoma referral centre, and to determine whether cortisol or thyroid stimulating hormone (TSH) monitoring could predict IH onset. We performed a retrospective cohort study of ipilimumab-treated patients at a quaternary melanoma referral centre in Australia. The inclusion criteria were patients with metastatic or unresectable melanoma treated with ipilimumab monotherapy, and cortisol and TSH measurements prior to ≥ 2 infusions. The main outcomes were IH incidence and TSH and cortisol patterns in patients who did and did not develop IH. Of 78 ipilimumab-treated patients, 46 met the study criteria and 9/46 (20%) developed IH at a median duration of 13.0 weeks (range 7.7-18.1) following ipilimumab initiation. All patients whose TSH fell ≥ 80% compared to baseline developed IH, and, in 5/9 patients with IH, TSH fell prior to cortisol fall and IH diagnosis. Pre-cycle-4 TSH was significantly lower in those who developed IH (0.31 vs. 1.73 mIU/L, P = 0.006). TSH fall was detected at a median time of 9.2 (range 7.7-16.4) weeks after commencing ipilimumab, and a median of 3.6 (range of - 1.4 to 9.7) weeks before IH diagnosis. There was no difference in TSH between the groups before cycles 1-3 or in cortisol before cycles 1-4. TSH fall ≥ 80% may be an early marker of IH. Serial TSH measurement during ipilimumab therapy may be an inexpensive tool to expedite IH diagnosis.

Three months of simvastatin therapy vs. placebo for severe portal hypertension in cirrhosis: A randomized controlled trial.

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Pollo-Flores, Priscila; Soldan, Mônica; Santos, Ubiratan Cassano; Kunz, Danielle Gobbi; Mattos, Denise Espindola; da Silva, Alexandre Cerqueira; Marchiori, Roberta Cabral; Rezende, Guilherme Ferreira da Motta

2015-11-01

Pleiotropic effects of statins decrease intrahepatic resistance and portal hypertension. We evaluated the effects of simvastatin on hepatic venous pressure gradient (HVPG) and azygos vein blood flow in cirrhotic patients. A 3-month prospective, randomized, triple-blind trial with simvastatin (40 mg/day) vs. placebo was conducted in patients with cirrhotic portal hypertension. HVPG and azygos blood flow, measured by colour Doppler endoscopic ultrasound, were assessed before and after treatment. The primary endpoint was a decrease in the HVPG of at least 20% from baseline or to ≤12 mmHg after the treatment. 34 patients were prospectively enrolled, and 24 completed the protocol. In the simvastatin group 6/11 patients (55%) presented a clinically relevant decrease in the HVPG; no decrease was observed in the placebo group (p=0.036). Patients with medium/large oesophageal varices and previous variceal bleeding had a higher response rate to simvastatin. HVPG and azygos blood flow values were not correlated. No significant adverse events occurred. Simvastatin lowers portal pressure and may even improve liver function. The haemodynamic effect appears to be more evident in patients with severe portal hypertension. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

The FXR agonist PX20606 ameliorates portal hypertension by targeting vascular remodelling and sinusoidal dysfunction.

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Schwabl, Philipp; Hambruch, Eva; Seeland, Berit A; Hayden, Hubert; Wagner, Michael; Garnys, Lukas; Strobel, Bastian; Schubert, Tim-Lukas; Riedl, Florian; Mitteregger, Dieter; Burnet, Michael; Starlinger, Patrick; Oberhuber, Georg; Deuschle, Ulrich; Rohr-Udilova, Nataliya; Podesser, Bruno K; Peck-Radosavljevic, Markus; Reiberger, Thomas; Kremoser, Claus; Trauner, Michael

2017-04-01

Steroidal farnesoid X receptor (FXR) agonists demonstrated potent anti-fibrotic activities and lowered portal hypertension in experimental models. The impact of the novel non-steroidal and selective FXR agonist PX20606 on portal hypertension and fibrosis was explored in this study. In experimental models of non-cirrhotic (partial portal vein ligation, PPVL, 7days) and cirrhotic (carbon tetrachloride, CCl 4 , 14weeks) portal hypertension, PX20606 (PX,10mg/kg) or the steroidal FXR agonist obeticholic acid (OCA,10mg/kg) were gavaged. We then measured portal pressure, intrahepatic vascular resistance, liver fibrosis and bacterial translocation. PX decreased portal pressure in non-cirrhotic PPVL (12.6±1.7 vs. 10.4±1.1mmHg; p=0.020) and cirrhotic CCl 4 (15.2±0.5 vs. 11.8±0.4mmHg; p=0.001) rats. In PPVL animals, we observed less bacterial translocation (-36%; p=0.041), a decrease in lipopolysaccharide binding protein (-30%; p=0.024) and splanchnic tumour necrosis factor α levels (-39%; p=0.044) after PX treatment. In CCl 4 rats, PX decreased fibrotic Sirius Red area (-43%; p=0.005), hepatic hydroxyproline (-66%; pportal pressure (-14%; p=0.041) by restoring endothelial function, 14week PX therapy additionally inhibited sinusoidal remodelling and decreased portal pressure to a greater extent (-22%; p=0.001). In human liver sinusoidal endothelial cells, PX increased eNOS and DDAH expression. The non-steroidal FXR agonist PX20606 ameliorates portal hypertension by reducing liver fibrosis, vascular remodelling and sinusoidal dysfunction. The novel drug PX20606 activates the bile acid receptor FXR and shows beneficial effects in experimental liver cirrhosis: In the liver, it reduces scarring and inflammation, and also widens blood vessels. Thus, PX20606 leads to an improved blood flow through the liver and decreases hypertension of the portal vein. Additionally, PX20606 improves the altered intestinal barrier and decreases bacterial migration from the gut. Copyright �

Protection of estrogen in portal hypertension gastropathy: an experimental model

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Maria Isabel Morgan-Martins

2011-09-01

Full Text Available CONTEXT: Portal hypertension is a complication secondary to cirrhosis that is characterized by increased blood flow and/or vascular resistance in the portal system, causing the appearance of a hyperdynamic collateral circulation. Partial portal vein ligation is an experimental model used in rats to study the pathophysiological mechanisms involved in pre-hepatic portal hypertension. Estrogen E2 is an antioxidant molecule with various physiological actions. OBJECTIVES: To evaluate the antioxidant activity of endogenous estrogen in an experimental model of partial portal vein ligation by comparing intact with castrated rats. METHODS: Twenty Wistar rats, weighing on average 250 g were used and divided into four groups: sham-operated (SO; intact (I with partial portal vein ligation (I + PPVL, castrated (C and castrated with partial ligation of the vein (C + PPVL. Day 1: castration or sham-operation; day 7, PPVL surgery; on day 15 post-PPVL, portal pressure in the mesenteric vein of rats was measured on polygraph Letica. Lipid peroxidation in the stomach was assessed using the technique of thiobarbituric acid reactive substances and activity of antioxidant enzymes superoxide dismutase, catalase and glutathione peroxidase. Statistical analysis was done with ANOVA - Student-Newman-Keuls (mean ± SE, and P<0.05 was considered as significant. RESULTS: Portal pressure was significantly increased in C + PPVL as compared to the other groups. There was no significant difference in the group of intact rats. TBARS showed significant damage in C and C + PPVL in relation to others. Antioxidant enzymes were significantly increased in the castrated rats with subsequent PPVL as compared to the other groups. CONCLUSION: We suggest that estrogen E2 plays a protective role in intact compared with castrated rats because it presents hydrophenolic radicals in its molecule, thus acting as an antioxidant in this experimental model.

Protection of estrogen in portal hypertension gastropathy: an experimental model.

Science.gov (United States)

Morgan-Martins, Maria Isabel; Jacques, Simone Iahnig; Hartmann, Renata Minuzzo; Marques, Camila Moraes; Marroni, Cláudio Augusto; Marroni, Norma Possa

2011-01-01

Portal hypertension is a complication secondary to cirrhosis that is characterized by increased blood flow and/or vascular resistance in the portal system, causing the appearance of a hyperdynamic collateral circulation. Partial portal vein ligation is an experimental model used in rats to study the pathophysiological mechanisms involved in pre-hepatic portal hypertension. Estrogen E2 is an antioxidant molecule with various physiological actions. To evaluate the antioxidant activity of endogenous estrogen in an experimental model of partial portal vein ligation by comparing intact with castrated rats. Twenty Wistar rats, weighing on average 250 g were used and divided into four groups: sham-operated (SO); intact (I) with partial portal vein ligation (I + PPVL), castrated (C) and castrated with partial ligation of the vein (C + PPVL). Day 1: castration or sham-operation; day 7, PPVL surgery; on day 15 post-PPVL, portal pressure in the mesenteric vein of rats was measured on polygraph Letica. Lipid peroxidation in the stomach was assessed using the technique of thiobarbituric acid reactive substances and activity of antioxidant enzymes superoxide dismutase, catalase and glutathione peroxidase. Statistical analysis was done with ANOVA - Student-Newman-Keuls (mean ± SE), and P<0.05 was considered as significant. Portal pressure was significantly increased in C + PPVL as compared to the other groups. There was no significant difference in the group of intact rats. TBARS showed significant damage in C and C + PPVL in relation to others. Antioxidant enzymes were significantly increased in the castrated rats with subsequent PPVL as compared to the other groups. We suggest that estrogen E2 plays a protective role in intact compared with castrated rats because it presents hydrophenolic radicals in its molecule, thus acting as an antioxidant in this experimental model.

Percutaneous transsplenic catheterization of portal vein: technique and clinical application

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Zhu Kangshun; Huang Mingsheng; Pang Pengfei; Zhou Bin; Xu Changmo; Qian Jiesheng; Li Zhengran; Jiang Zaibo; Shan Hong

2010-01-01

Objective: To evaluate the feasibility of percutaneous transsplenic portal vein catheterization (PTSPC). Methods: Thirty patients with portal hypertension underwent gastroesophageal variceal embolization via PTSPC route, 2 of which simultaneously underwent portal vein stenting. This study included the patients with portal venous obstruction (tumor embolus or thrombus) or the patients with serious liver atrophy caused by liver cirrhosis. The patients who had severe coagulation insufficiency (with prothrombin time > 20 s) were excluded. Of the 30 patients, 17 had primary hepatocellular carcinoma with main portal venous tumor embolus, 13 had cirrhosis with severe liver atrophy and (or)slight or moderate ascite. Before this study, all of 30 patients had a history of variceal bleeding, and 16 patients had a normal coagulation level, 10 patients had a mildly prolonged prothrombin time (14-17 s), 4 patients had a moderately prolonged prothrombin time (18-20 s). All of 30 patients underwent upper abdomen CT enhanced scanning before this procedure, and the site, direction, and depth of splenic vein branch puncture were decided by CT images. The technology of PTSPC, procedure-related complications, and its clinical application were retrospectively analyzed. Results: PTSPC was performed successfully in 28 of 30 patients. Two cases failed because of a small intrasplenic vein. Procedure-related complications occurred in 6 patients (20.0%), which had decrease of hemoglobin concentration (15-50 g/L). Four of them needed blood transfusion. In the six patients, one patient (3.3%) with abdominal cavity hemorrhage had a serious drop of blood pressure 2 hours after procedure, whose clinical symptoms were relieved after four units of packed RBC and a great quantity of fluid were transfused. Twenty-eight patients whose PTSPC were successfully performed underwent variceal embolization, 2 of them were placed with portal vein covered stents. During a median follow-up period of 6 months

Portal hypertension in schistosomiasis: pathophysiology and treatment

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Luiz Caetano da Silva

1992-01-01

Full Text Available In heavily infected young patients, there is a "non-congestive" phase of the disease with splenomegaly which can improve after chemoterapy. A strong correlation between hepatosplenic form and worm burden in young patients has been repeatedly shown. The pattern of vascular intrhepatic lesions seems to depend on two mechanisms: (a egg embolization, with a partial blocking of the portal vasculature; (b the appearance of small portal collaterals along the intrahepatic portal sistem. The role played by hepatitis B virus (HBV and C virus infections in the pathogenesis of liver lesions is variably considered. Selective arteriography shows a reduced diameter of hepatic artery with thin and arched branches outlining vascular gaps. A rich arterial network , as described in autopsy cases, is usually not seen in vivo, except after splenectomy or shunt surgery. An augmented hepatic arterial flow was demonstrated in infected animals. These facts suggest that the poor intrahepatic arterial vascularization demonstrated by selective arteriography in humans is due to a "functional deviation"of arterial blood to the splenic territory. The best results obtained in treatment of portal hypertension were: esophagogastric desvascularization and splenectomy (EGDS, although risk of rebleeding persists; classical (proximal splenorenal shunt (SRS should be abandoned; distal splenorenal shunt may complicate with hepatic encephalopaty, although later and in a lower percentage than in SRS. Propranolol is currently under investigation. In our Department, schistosomotic patients with esophageal varices bleeding are treated by EGDS and, if rebleeding occurs, by sclerosis of the varices.

The feasible study of vasodilators in portal vein targeting infusion for treating portal hypertension

International Nuclear Information System (INIS)

Wu Hanping; Liang Huiming; Zheng Chuansheng; Feng Gansheng

2002-01-01

Objective: To find out the ideal portal vein tar getting injection routes for portal hypertension treatment. Methods: 28 cirrhotic rat models with portal hypertension induced by CCl 4 were divided into 4 groups: inferior caval vein injection group, portal vein injection group, hepatic artery injection group, spleen injection group. The changes in portal vein pressure (PVP), inferior caval vein pressure (ICVP), mean artery pressure (MAP) and heart rate (HR) were monitored before and after prazosin injection. Results: After intra-portal, intra-hepatic arterial or spleen injection of prazosin, larger decrease in PVP and lesser effects on MAP than intravenous injection had been induced. The effect on HR showed no difference among these four groups. Conclusions: Hepatic artery and spleen prazosin administration have the same advantages on treatment of portal hypertension as those of intra-portal infusion, that is the greater decrease on portal vein pressure, the lesser effects on systemic hemodynamics. Vasodilation drugs for hepatic artery infusion through percutaneous port catheter system by hepatic artery implantation would be an ideal method for portal hypertension treatment

Evaluation of portal hypertension in cirrhotic patients using color duplex-doppler ultrasound. Preliminary study; Evaluacion de la hipertension portal del cirrotico mediante ultrasonografia duplex-Doppler color. Estudio prliminar

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Varas, M J; Torres, G; Sanllely, H [Unidad de Ecografias, Consorcio del Hospital de la Cruz Roja, L` Hospitalet de Llobregat, Barcelona (Spain)

1996-09-01

The objective was to compare data obtained by color duplex-Doppler ultrasound (mean velocity, flow and portal vein congestion index) in patients with chronic diffuse liver disease with and without portal hypertension (PH) (demonstrated endoscopically) with that of a healthy control group. Over a two-year period, 50 studies were performed in 10 healthy subjects (control group) with a mean age of 36 years and in 40 chronic liver disease patients (study group with a mean age of 58 years), most of whom presented alcoholic liver cirrhosis and belonged to Child-Pugh class B. They were subdivided according to endoscopic study into patients without (group 1) and with (group 2) portal hypertension. There were statistically significant differences in the diameters of splenic vein, spleen, portal vein and in the portal Vm, which decreased as the Child-Pugh score rose. When the patients without (group 1) and with (group 2) endoscopic evidence of PH (esophageal varices)were analyzed and compared, the two groups presented no statistically significant differences with respect to portal Vm, blood flow out of the liver, presence of collateral vessels, or the portal vein congestion index; the latter was significantly different in both the study group as a whole and in the patients with PH when compared with the control group. Given that this report is based on a pilot study which requires a larger sample number, we are unable to arrive at definitive conclusions. (Author) 18 refs.

Portal hypertension in patients with cirrhosis: indirect assessment of hepatic venous pressure gradient by measuring azygos flow with 2D-cine phase-contrast magnetic resonance imaging.

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Gouya, Hervé; Grabar, Sophie; Vignaux, Olivier; Saade, Anastasia; Pol, Stanislas; Legmann, Paul; Sogni, Philippe

2016-07-01

To measure azygos, portal and aortic flow by two-dimensional cine phase-contrast magnetic resonance imaging (2D-cine PC MRI), and to compare the MRI values to hepatic venous pressure gradient (HVPG) measurements, in patients with cirrhosis. Sixty-nine patients with cirrhosis were prospectively included. All patients underwent HVPG measurements, upper gastrointestinal endoscopy and 2D-cine PC MRI measurements of azygos, portal and aortic blood flow. Univariate and multivariate regression analyses were used to evaluate the correlation between the blood flow and HVPG. The performance of 2D-cine PC MRI to diagnose severe portal hypertension (HVPG ≥ 16 mmHg) was determined by receiver operating characteristic curve (ROC) analysis, and area under the curves (AUC) were compared. Azygos and aortic flow values were associated with HVPG in univariate linear regression model. Azygos flow (p portal blood flow (AUC = 0.40 (95 % CI [0.25-0.54]). 2D-cine PC MRI is a promising technique to evaluate significant portal hypertension in patients with cirrhosis. • Noninvasive HVPG assessment can be performed with MRI azygos flow. • Azygos MRI flow is an easy-to-measure marker to detect significant portal hypertension. • MRI flow is more specific that varice grade to detect portal hypertension.

Origins of Portal Hypertension in Nonalcoholic Fatty Liver Disease.

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Baffy, Gyorgy

2018-03-01

Nonalcoholic fatty liver disease (NAFLD) advanced to cirrhosis is often complicated by clinically significant portal hypertension, which is primarily caused by increased intrahepatic vascular resistance. Liver fibrosis has been identified as a critical determinant of this process. However, there is evidence that portal venous pressure may begin to rise in the earliest stages of NAFLD when fibrosis is far less advanced or absent. The biological and clinical significance of these early changes in sinusoidal homeostasis remains unclear. Experimental and human observations indicate that sinusoidal space restriction due to hepatocellular lipid accumulation and ballooning may impair sinusoidal flow and generate shear stress, increasingly disrupting sinusoidal microcirculation. Sinusoidal endothelial cells, hepatic stellate cells, and Kupffer cells are key partners of hepatocytes affected by NAFLD in promoting endothelial dysfunction through enhanced contractility, capillarization, adhesion and entrapment of blood cells, extracellular matrix deposition, and neovascularization. These biomechanical and rheological changes are aggravated by a dysfunctional gut-liver axis and splanchnic vasoregulation, culminating in fibrosis and clinically significant portal hypertension. We may speculate that increased portal venous pressure is an essential element of the pathogenesis across the entire spectrum of NAFLD. Improved methods of noninvasive portal venous pressure monitoring will hopefully give new insights into the pathobiology of NAFLD and help efforts to identify patients at increased risk for adverse outcomes. In addition, novel drug candidates targeting reversible components of aberrant sinusoidal circulation may prevent progression in NAFLD.

Macronodular hepatic tuberculosis associated with portal vein thrombosis and portal hypertension

International Nuclear Information System (INIS)

Venkatesh, S.K.; Tan, L.K.A.; Siew, E.P.Y.; Putti, T.C.

2005-01-01

Tuberculosis (TB) of the liver is usually associated with miliary spread. Macronodular TB of the liver is rare. A case of macronodular TB of the liver in a 31-year-old woman causing portal vein thrombosis and portal hypertension is presented. Ultrasound and CT appearances are described. There was coexistent ileo-caecal TB with extensive mesenteric and retroperitoneal lymphadenopathy. Macronodular TB should be considered in the differential diagnosis when a patient presents with multiple calcified masses in the liver with portal vein thrombosis and portal hypertension. Copyright (2005) Blackwell Science Pty Ltd

Analysis of hepatoportal hemodynamics by hepatic radionuclide angiography on patients with portal hypertension

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Mitarai, Y; Yoshida, T; Yoshimura, T; Nagamine, K; Kanashima, R; Kobayashi, M; Nakashima, A; Kato, Y; Maeda, H

1987-04-01

Hepatoportal circulation was measured using radionuclide angiography with /sup 99m/Tc-fibrinogen in 40 patients with or without portal hypertension ; 20 cirrhotics with esophageal varices(LC with varices), 5 cirrhotics without esophageal varices(LC without varices), 5 patients with idiopathic portal hypertension(IPH) and 10 controls. In 8 cases among LC with varices, the hemodynamics was determined before and after left gastric vena caval shunt(LGCS). The radioactivity count and PA ratio(blood flow proportion of the portal vein to the hepatic artery) at the hepatic hilus were lower in the patients with liver cirrhosis(LC with and without varices) than those of the cases without liver cirrhosis(IPH and control). The comparison of hemodynamics before and during 6 weeks after LGCS demonstrated the radioactivity count well-preserved but on the contrary the PA ratio reduced at the hepatic hilus after surgery. The present results could indicate that the total hepatic inflow was maintained following LGCS, by compensatory increase of hepatic arterial flow in response to reduced portal flow. The implication of hepatic radionuclide angiography is discussed on patients with portal hypertension.

Analysis of hepatoportal hemodynamics by hepatic radionuclide angiography on patients with portal hypertension

International Nuclear Information System (INIS)

Mitarai, Yoshinobu; Yoshida, Takanori; Yoshimura, Takahisa; Nagamine, Kenji; Kanashima, Ryoichi; Kobayashi, Michio; Nakashima, Akihisa; Kato, Yukio; Maeda, Hirofumi

1987-01-01

Hepatoportal circulation was measured using radionuclide angiography with 99m Tc-fibrinogen in 40 patients with or without portal hypertension ; 20 cirrhotics with esophageal varices(LC with varices), 5 cirrhotics without esophageal varices(LC without varices), 5 patients with idiopathic portal hypertension(IPH) and 10 controls. In 8 cases among LC with varices, the hemodynamics was determined before and after left gastric vena caval shunt(LGCS). The radioactivity count and PA ratio(blood flow proportion of the portal vein to the hepatic artery) at the hepatic hilus were lower in the patients with liver cirrhosis(LC with and without varices) than those of the cases without liver cirrhosis(IPH and control). The comparison of hemodynamics before and during 6 weeks after LGCS demonstrated the radioactivity count well-preserved but on the contrary the PA ratio reduced at the hepatic hilus after surgery. The present results could indicate that the total hepatic inflow was maintained following LGCS, by compensatory increase of hepatic arterial flow in response to reduced portal flow. The implication of hepatic radionuclide angiography is discussed on patients with portal hypertension. (author)

Noncirrotisk intrahepatisk portal hypertension

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Dam Fialla, Annette; Havelund, Troels

2007-01-01

Non-cirrhotic intrahepatic portal hypertension is characterized by portal hypertension in the absence of liver cirrhosis or portal vein thrombosis. The disease is common in the East and rarely seen in the West. Two cases with oesophageal varices are described. The histopathology is heterogeneous...... but includes vascular lesions and portal fibrosis. Patient management follows the current recommendations for variceal bleeding....

Hepatic angiography: Portal hypertension

International Nuclear Information System (INIS)

Oliver, T.W. Jr.; Sones, P.J. Jr.

1985-01-01

Portal hypertension is usually a manifestation of underlying hepatic parenchymal disease, although it may be secondary to portal or hepatic venous thrombosis and rarely to hyperdynamic portal states. Portal hypertension may present as encephalopathy, ascites, jaundice, hepatic failure, or catastrophic upper gastrointestinal hemorrhage. Radiologic investigation should include indirect or direct measurements of portal pressure, assessment of portal venous perfusion, visualization of collaterals, and demonstration of arterial and venous anatomy for potential shunt procedure. Following survival of initial variceal bleeding, the most effective procedure to prevent recurrent hemorrhage is a shunt to decompress the varices. The decision whether to intervene medically or surgically during the acute hemorrhagic episode as well as the type of shunt used to prevent future hemorrhage is the subject of continuing controversy

Glucagon-like peptide-2 (GLP-2) increases net amino acid utilization by the portal-drained viscera of ruminating calves

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Taylor-Edwards, C C; Burrin, D G; Kristensen, Niels Bastian

2012-01-01

Glucagon-like peptide-2 (GLP-2) increases small intestinal mass and blood flow in ruminant calves, but its impact on nutrient metabolism across the portal-drained viscera (PDV) and liver is unknown. Eight Holstein calves with catheters in the carotid artery, mesenteric vein, portal vein and hepat...

Infundibulo-hypophysitis-like radiological image in a patient with pituitary infiltration of a diffuse large B-cell non-Hodgkin lymphoma

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A León-Suárez

2016-12-01

Full Text Available Non-Hodgkin lymphoma (NHL is a hematological tumor caused by abnormal lymphoid proliferation. NHL can arise in any part of the body, including central nervous system (CNS. However, pituitary involvement is a quite rare presentation. The diffuse large B-cell lymphoma (DLBCL is the most common subtype when pituitary is infiltrated. Here, we report a case of pituitary infiltration of NHL DLBCL type in a woman with hypopituitarism and an infundibulum-hypophysitis-like image on magnetic resonance imaging (MRI. A female aged 64 years, complained of dyspepsia, fatigue, weight loss and urine volume increment with thirst. Endoscopy and gastric biopsy confirmed diffuse large B-cell lymphoma. Treatment with chemotherapy using R-CHOP was initiated. During her hospitalization, hypotension and polyuria were confirmed. Hormonal evaluation was compatible with central diabetes insipidus and hypopituitarism. Simple T1 sequence of MRI showed thickening of the infundibular stalk with homogeneous enhancement. After lumbar puncture analysis, CNS infiltration was confirmed showing positive atypical lymphocytes. Pituitary and infundibular stalk size normalized after R-CHOP chemotherapy treatment. In conclusion, pituitary infiltration of NHL with infundibular-hypophysitis-like image on MRI is a rare finding. Clinical picture included hypopituitarism and central diabetes insipidus. Diagnosis should be suspected after biochemical analysis and MRI results. Treatment consists of chemotherapy against NHL and hormonal replacement for pituitary dysfunction.

Mobile Portal Implementation Strategy

DEFF Research Database (Denmark)

Gao, Ping; Damsgaard, Jan

2005-01-01

Mobile portal plays an important role in mobile commerce market. Current literature focuses on static analysis on the value chain of mobile portals. This article provides a dynamic perspective on mobile portal strategy. Drawing upon network economics, we describe mobile portal implementation...... as a fourphase process. In different phase, a portal provider has various challenges to overcome and adopt diverse strategies, and correspondingly the regulator has different foci. The conceptual framework proposed in this article offers a basis for further analyses on the market dynamics of mobile commerce......, and can be generalized to studying other networked technologies...

Roadside Tracker Portal-less Portal Monitor

Energy Technology Data Exchange (ETDEWEB)

Ziock, Klaus-Peter [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Cheriyadat, Anil M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Bradley, Eric Craig [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Cunningham, Mark F. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Fabris, Lorenzo [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Goddard, Jr, James Samuel [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hornback, Donald Eric [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Karnowski, Thomas Paul [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kerekes, Ryan A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Newby, Jason [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2013-07-01

This report documents the full development cycle of the Roadside Tracker (RST) Portal-less Portal monitor (Fig. 1) funded by DHS DNDO. The project started with development of a proof-of-feasibility proto-type, proceeded through design and construction of a proof-of-concept (POC) prototype, a test-and-evaluation phase, participation in a Limited Use Exercise that included the Standoff Radiation Detections Systems developed under an Advanced Technology Demonstration and concluded with participation in a Characterization Study conducted by DNDO.

Portal circulation following the Warren procedure. Long-term follow-up by computed tomography

Energy Technology Data Exchange (ETDEWEB)

Gostner, P; Fugazzola, C; Martin, F; Marzoli, G P

1986-06-01

Computed tomography with contrast injection was carried out in 18 patients who had undergone a Warren procedure for portal hypertension due to cirrhosis of the liver more than five years previously. The results show that it is not possible to drain only a part of the venous portal territory. The portal circulation does not consist of two portions, with different pressure relationships. Pressure difference across the splenorenal anastomosis is greater than that into the mediastinal veins. Postoperative development of a hepatofugal circulation continues for a long period and is not confined to the early phase only. This phenomenon is, however, not uniform. In particular, there are variations in the extent of the collateral circulation and in the maintenance of liver blood flow.

CT findings of portal vein aneurysm

International Nuclear Information System (INIS)

Yang, Dal Mo; Chang, Mi Son; Yoon, Myung Hwan; Kim, Hak Soo; Kim, Hyung Sik; Chung, Hyo Sun; Chung, Jin Woo

1999-01-01

To describe the CT findings of portal vein aneurysm in eight patients. All patients included in this study (two men and six women) underwent CT examinations between October 1996 and June1998. Of these eight, three were suffering from hepatic disease and portal hypertension. We determined the location, shape, size, and characteristics of the lesions, and the presence or absence of portal vein anomaly. Seven patients had intrahepatic portal vein aneurysm (at the umbilical portion of the left portal vein in five patients, between the transverse and umbilical portion of the left portal vein in one, and at the bifurcation of the anterior and posterior branch of the right portal vein in one), while extrahepatic portal vein aneurysm, at the confluence of the superior mesenteric and splenic vein was found in only one. Lesions were cyst-shaped in seven cases and saccular in one, and showed well-circumscribed, markedly enhanced mass, which communicated with the portal vein and/or gives off major branches. Portal vein anomaly, in which the right anterior segmental portal vein originated from the umbilical portion of the left portal vein, was seen in three patients. In all three, intrahepatic portal vein aneurysm was present at the umbilical portion of the left portal vein, and in one, the umbilical protion of the left portal vein was located to the right of the Cantlic line. CT examination can help reveal portal vein aneurysm by detecting a well-circumscribed, markedly enhanced mass which communicates with the portal vein and/or gives off major branches

Pediatric portal hypertension

Science.gov (United States)

Vogel, Clarissa Barbon

2017-01-01

Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

Review of the embryologic development of the pituitary gland and report of a case of hypophyseal duplication detected by MRI

Energy Technology Data Exchange (ETDEWEB)

Kollias, S.S. [Dept. of Radiology, Section of Pediatric Neuroradiology, and Depts. of Radiology and Pediatrics, Children`s Hospital Medical Center, Cincinnati, OH (United States); Ball, W.S. [Dept. of Radiology, Section of Pediatric Neuroradiology, and Depts. of Radiology and Pediatrics, Children`s Hospital Medical Center, Cincinnati, OH (United States); Prenger, E.C. [Dept. of Radiology, Section of Pediatric Neuroradiology, and Depts. of Radiology and Pediatrics, Children`s Hospital Medical Center, Cincinnati, OH (United States)

1995-01-01

We describe the clinical manifestations, associated abnormalities, MRI appearances and pathologic significance of a case of hypophyseal duplication. A 16-year-old girl presented with delayed sexual development and history of midline craniofacial anomalies. MRI revealed paired infundibula extending inferiorly to two small pituitary glands, a midline hypothalamic mass, and a midline cleft in the basisphenoid. Twelve cases of pituitary duplication have previously been described. The suggested pathogenesis is duplication of the prechordal plate and anterior end of the notochord during early embryologic development. (orig.)

Managing portal hypertension in patients with liver cirrhosis [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Tilman Sauerbruch

2018-05-01

Full Text Available Portal hypertension is one cause and a part of a dynamic process triggered by chronic liver disease, mostly induced by alcohol or incorrect nutrition and less often by viral infections and autoimmune or genetic disease. Adequate staging - continuously modified by current knowledge - should guide the prevention and treatment of portal hypertension with defined endpoints. The main goals are interruption of etiology and prevention of complications followed, if necessary, by treatment of these. For the past few decades, shunts, mostly as intrahepatic stent bypass between portal and hepatic vein branches, have played an important role in the prevention of recurrent bleeding and ascites formation, although their impact on survival remains ambiguous. Systemic drugs, such as non-selective beta-blockers, statins, or antibiotics, reduce portal hypertension by decreasing intrahepatic resistance or portal tributary blood flow or by blunting inflammatory stimuli inside and outside the liver. Here, the interactions among the gut, liver, and brain are increasingly examined for new therapeutic options. There is no general panacea. The interruption of initiating factors is key. If not possible or if not possible in a timely manner, combined approaches should receive more attention before considering liver transplantation.

Thalidomide ameliorates portal hypertension via nitric oxide synthase independent reduced systolic blood pressure.

Science.gov (United States)

Theodorakis, Nicholas G; Wang, Yining N; Korshunov, Vyacheslav A; Maluccio, Mary A; Skill, Nicholas J

2015-04-14

Portal hypertension is a common complication of liver cirrhosis and significantly increases mortality and morbidity. Previous reports have suggested that the compound thalidomide attenuates portal hypertension (PHT). However, the mechanism for this action is not fully elucidated. One hypothesis is that thalidomide destabilizes tumor necrosis factor α (TNFα) mRNA and therefore diminishes TNFα induction of nitric oxide synthase (NOS) and the production of nitric oxide (NO). To examine this hypothesis, we utilized the murine partial portal vein ligation (PVL) PHT model in combination with endothelial or inducible NOS isoform gene knockout mice. Wild type, inducible nitric oxide synthase (iNOS)(-/-) and endothelial nitric oxide synthase (eNOS)(-/-) mice received either PVL or sham surgery and were given either thalidomide or vehicle. Serum nitrate (total nitrate, NOx) was measured daily for 7 d as a surrogate of NO synthesis. Serum TNFα level was quantified by enzyme-linked immunosorbent assay. TNFα mRNA was quantified in liver and aorta tissue by reverse transcription-polymerase chain reaction. PHT was determined by recording splenic pulp pressure (SPP) and abdominal aortic flow after 0-7 d. Response to thalidomide was determined by measurement of SPP and mean arterial pressure (MAP). SPP, abdominal aortic flow (Qao) and plasma NOx were increased in wild type and iNOS(-/-) PVL mice when compared to sham operated control mice. In contrast, SPP, Qao and plasma NOx were not increased in eNOS(-/-) PVL mice when compared to sham controls. Serum TNFα level in both sham and PVL mice was below the detection limit of the commercial ELISA used. Therefore, the effect of thalidomide on serum TNFα levels was undetermined in wild type, eNOS(-/-) or iNOS(-/-) mice. Thalidomide acutely increased plasma NOx in wild type and eNOS(-/-) mice but not iNOS(-/-) mice. Moreover, thalidomide temporarily (0-90 min) decreased mean arterial pressure, SPP and Qao in wild type, e

Hepatic blood perfusion estimated by dynamic contrast-enhanced computed tomography in pigs

DEFF Research Database (Denmark)

Winterdahl, Michael; Sørensen, Michael; Keiding, Inger Susanne

2012-01-01

The aim of this study was to determine whether dynamic contrast-enhanced computed tomography (DCE-CT) and the slope method can provide absolute measures of hepatic blood perfusion from the hepatic artery (HA) and portal vein (PV) at experimentally varied blood flow rates.......The aim of this study was to determine whether dynamic contrast-enhanced computed tomography (DCE-CT) and the slope method can provide absolute measures of hepatic blood perfusion from the hepatic artery (HA) and portal vein (PV) at experimentally varied blood flow rates....

Biology of portal hypertension.

Science.gov (United States)

McConnell, Matthew; Iwakiri, Yasuko

2018-02-01

Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic mechanisms of LSEC and HSC dysregulation have been extensively studied, the role of microvascular thrombosis and platelet function in the pathogenesis of portal hypertension remains to be clearly characterized. As a secondary event, portal hypertension results in splanchnic and systemic arterial vasodilation, leading to the development of a hyperdynamic circulatory syndrome and subsequently to clinically devastating complications including gastroesophageal varices and variceal hemorrhage, hepatic encephalopathy from the formation of portosystemic shunts, ascites, and renal failure due to the hepatorenal syndrome. This review article discusses: (1) mechanisms of sinusoidal portal hypertension, focusing on HSC and LSEC biology, pathological angiogenesis, and the role of microvascular thrombosis and platelets, (2) the mesenteric vasculature in portal hypertension, and (3) future directions for vascular biology research in portal hypertension.

Usability of Discovery Portals

NARCIS (Netherlands)

Bulens, J.D.; Vullings, L.A.E.; Houtkamp, J.M.; Vanmeulebrouk, B.

2013-01-01

As INSPIRE progresses to be implemented in the EU, many new discovery portals are built to facilitate finding spatial data. Currently the structure of the discovery portals is determined by the way spatial data experts like to work. However, we argue that the main target group for discovery portals

The Knowledge Portal

Data.gov (United States)

Office of Personnel Management — Information on various courses, as well as personal data of employees and training records from The Knowledge Portal (TKP), a web-based training portal used for the...

Glutamine synthetase activity and glutamate uptake in hippocampus and frontal cortex in portal hypertensive rats

Science.gov (United States)

Acosta, Gabriela Beatriz; Fernández, María Alejandra; Roselló, Diego Martín; Tomaro, María Luján; Balestrasse, Karina; Lemberg, Abraham

2009-01-01

AIM: To study glutamine synthetase (GS) activity and glutamate uptake in the hippocampus and frontal cortex (FC) from rats with prehepatic portal vein hypertension. METHODS: Male Wistar rats were divided into sham-operated group and a portal hypertension (PH) group with a regulated stricture of the portal vein. Animals were sacrificed by decapitation 14 d after portal vein stricture. GS activity was determined in the hippocampus and FC. Specific uptake of radiolabeled L-glutamate was studied using synaptosome-enriched fractions that were freshly prepared from both brain areas. RESULTS: We observed that the activity of GS increased in the hippocampus of PH rats, as compared to control animals, and decreased in the FC. A significant decrease in glutamate uptake was found in both brain areas, and was more marked in the hippocampus. The decrease in glutamate uptake might have been caused by a deficient transport function, significantly and persistent increase in this excitatory neurotransmitter activity. CONCLUSION: The presence of moderate ammonia blood levels may add to the toxicity of excitotoxic glutamate in the brain, which causes alterations in brain function. Portal vein stricture that causes portal hypertension modifies the normal function in some brain regions. PMID:19533812

Hepatic portal vein cannulation for infusion and blood sampling in freely moving rats

NARCIS (Netherlands)

Strubbe, J.H.; Bruggink, J.E; Steffens, A.B

1999-01-01

Chronic portal vein cannulation in the rat is an important technique to study secretory rates of hormones from the endocrine pancreas. Moreover, it can be used for studying the effects of enteric hormones and pharmaca on behavioral and physiological processes. This article contains an extensive

Portals people, processes, technology

CERN Document Server

Cox, Andrew

2006-01-01

First applied to internet gateways such as Yahoo, the concept of the ""portal"" has evolved in a number of directions. How can information services best take advantage of internet portals to improve access to resources? This collection seeks answers to such questions, providing an overview of how portals are being used.

Sequential hepato-splenic scintigraphy for measurement of hepatic blood flow

Energy Technology Data Exchange (ETDEWEB)

Biersack, H J; Knopp, R; Dahlem, R; Winkler, C [Bonn Univ. (Germany, F.R.). Inst. fuer Klinische und Experimentelle Nuklearmedizin; Thelen, M [Bonn Univ. (Germany, F.R.). Radiologische Klinik; Schulz, D; Schmidt, R [Bonn Univ. (Germany, F.R.). Chirurgische Klinik und Poliklinik

1977-01-01

The arterial and portal components of total liver blood flow were determined quantitatively in 31 patients by means of a new, non-invasive method. Sequential hepato-splenic scintigraphy has been employed, using a scintillation camera linked to a computer system. In normals, the proportion of portal flow was 71%, whereas in patients with portal hypertension it averaged 21%. Our experience indicates that the procedure can be of considerable value in the pre-operative diagnosis and postoperative follow-up of portal hypertension.

Sequential hepato-splenic scintigraphy for measurement of hepatic blood flow

International Nuclear Information System (INIS)

Biersack, H.J.; Knopp, R.; Dahlem, R.; Winkler, C.; Thelen, M.; Schulz, D.; Schmidt, R.

1977-01-01

The arterial and portal components of total liver blood flow were determined quantitatively in 31 patients by means of a new, non-invasive method. Sequential hepato-splenic scintigraphy has been employed, using a scintillation camera linked to a computer system. In normals, the proportion of portal flow was 71%, whereas in patients with portal hypertension it averaged 21%. Our experience indicates that the procedure can be of considerable value in the pre-operative diagnosis and postoperative follow-up of portal hypertension. (orig.) [de

Tumor and liver drug uptake following hepatic artery and portal vein infusion

International Nuclear Information System (INIS)

Sigurdson, E.R.; Ridge, J.A.; Kemeny, N.; Daly, J.M.

1987-01-01

Anatomic dye injection studies of the blood supply of colorectal hepatic metastases suggest that tumors are supplied predominantly by the hepatic artery. Using 13 N amino acids with dynamic gamma camera imaging in patients with colorectal hepatic metastases, it has been shown that hepatic artery infusion results in a significantly greater nutrient delivery to tumor compared with portal vein infusion. However, direct measurements of drug levels in tumor following hepatic artery and portal vein infusion in humans have not previously been reported. Patients with metastatic colorectal cancer confined to the liver received fluorodeoxyuridine (FUdR) through the hepatic artery or through the portal vein. All patients had previously failed systemic chemotherapy. Five patients with hepatic artery catheters were matched (by age, serum lactic dehydrogenase levels, percent hepatic replacement, and tumor size) with five patients with portal vein catheters. At operation, 3 H-FUdR (1 microCi/kg) and /sup 99m/Tc-macroaggregated albumin (MAA) (6 mCi) were injected into the hepatic artery or portal vein. Liver and tumor biopsies were obtained two and five minutes later. 3 H and /sup 99m/Tc were measured per gram tissue by scintillation and gamma counting. The mean liver levels following hepatic artery infusion (23.9 +/- 11.4 nmol/g) and portal vein infusion (18.4 +/- 14.5 nmol/g) did not differ. However, the mean tumor FUdR level following hepatic artery infusion was 12.4 +/- 12.2 nmol/g, compared with a mean tumor FUdR level following portal vein infusion of 0.8 +/- 0.7 nmol/g (P less than .01). This low level of tumor drug uptake after portal vein infusion of FUdR predicts minimal tumor response to treatment via this route. Thus, regional chemotherapy for established colorectal hepatic metastases should be administered through the hepatic artery

Glutamine prevents gastric oxidative stress in an animal model of portal hypertension gastropathy.

Science.gov (United States)

Marques, Camila; Mauriz, José L; Simonetto, Douglas; Marroni, Claudio A; Tuñon, María J; González-Gallego, Javier; Marrón, Norma P

2011-01-01

Portal hypertension (PHI) is a clinical syndrome characterized by increases of the blood flow and/or of the vascular resistance in the portal system. A direct consequence of PHI can appearance different lesions on the gastric mucosa and submucosa, cumulatively termed portal hypertensive gastropathy (PHG). To investigate the effects of glutamine on oxidative stress in an experimental model of PHG induced by partial portal vein ligation (PPVL). Portal pressure, transaminase and alkaline phosphatase activity were quantified. Gastric tissue damage was assessed by histological analysis. Oxidative stress was measured by quantification of cytosolic concentration of thiobarbituric acid reactive substances (TBARS), hydroperoxide-initiated chemiluminescence (QL), and nitric oxide (NO) production. Moreover, activities of the antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were analyzed. Transaminase and alkaline phosphatase activities were not significantly modified by PPVL, indicating absence of liver injury. Histological analysis of gastric sections showed a lost of normal architecture, with edema and vasodilatation. TBARS, QL, and NO production were significantly increased in PPVL animals. A reduction of SOD activity was found. Glutamine administration markedly alleviated histological abnormalities and oxidative stress, normalized SOD activity, and blocked NO overproduction. Our results confirm that the use of molecules with antioxidant capacity can provide protection of the gastric tissue in portal hypertension. Glutamine treatment can be useful to reduce the oxidative damage induced by PHI on gastric tissue.

MR angiography in portal hypertension: state of the art

International Nuclear Information System (INIS)

Vosshenrich, R.; Fischer, U.; Grabbe, E.

2001-01-01

When imaging the portal vascular system colour-coded sonography and CT angiography are used as an alternative to intraarterial DSA. Today fast CE 3D- MRA is the imaging modality of choice in the diagnostic of patients with portal hypertension. It enables a clear picture of the portalvenous vascular system and portalsystemic shunts. Statements regarding velocity and direction of blood flow can be made with additional use of TOF and PC techniques. CE-3D MRA can be used preoperatively before liver transplantation or shunt surgery. In the follow-up of interventional or surgical procedures exact statements concerning haemodynamically significant pathologies e.g. vascular thromboses, stenoses and occlusions can be made. Patient consent is symplify and the numbers of complications can be reduced as well as duration of surgery minimized applying this technique (orig.) [de

A case of uneventful early post partum phase of pregnancy with LSCS in a known case of portal hypertension with splenectomy & a delayed peritonitis.

Directory of Open Access Journals (Sweden)

Dr. Dhruvkumar Baru

2017-06-01

Full Text Available This is a case of 32 year old multigravida, a known case of portal hypertension with episodes of haemetemesis on and off since last 12 years with history of splenectomy 2.5 years ago with uneventful 1st LSCS presented with pain abdomen and abdominal distension post- LSCS. Blood investigations showed microcytic anaemia corrected by blood transfusion while hypo -proteinemia by FFP transfusion. USG showed portal vein thrombosis with ascites. CT scan was done which confirmed signs of portal hypertension with cavernoma formation and gross ascites, Fluid cytology suggestive of PMN's. Patient was managed by controlled tapping and fluid monitoring along with appropriate antibiotics.

Applications of portals in the energetic sector; Aplicaciones de portales en el sector energetico

Energy Technology Data Exchange (ETDEWEB)

Santos Dominguez, Martin; Arroyo Figueroa, Gustavo [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico)

2000-07-01

An operative portal joins the applications, contents and services of the company in a single page of Intranet such way that promises to change deeply the information technology in the next years. The corporative portals will change what people visualize in the screen of their computer at the beginning of every working day. Unlike seeing the network (Web) only with pages of language of hypertext bearing (HTML), the corporative portal acts as a gate between Internet and the private networks. This article presents a general vision of the benefits of the corporative portals, the existing technologies and the potential markets. [Spanish] Un portal operativo une las aplicaciones, contenidos y servicios de la empresa en una sola pagina de Intranet, de tal forma que promete cambiar, profundamente la tecnologia de la informacion en los proximos anos. Los portales corporativos cambiaran lo que la gente visualiza en la pantalla de su computadora al comienzo de cada dia de trabajo. A diferencia de ver la red (Web) solo con paginas de lenguaje de marcacion de hipertexto (HTML), el portal corporativo actua como compuerta entre Internet y las redes privadas. Este articulo presenta una vision general de los beneficios de los portales corporativos, las tecnologias y los mercados potenciales existentes.

From EGEE Operations Portal towards EGI Operations Portal

Science.gov (United States)

Cordier, Hélène; L'Orphelin, Cyril; Reynaud, Sylvain; Lequeux, Olivier; Loikkanen, Sinikka; Veyre, Pierre

Grid operators in EGEE have been using a dedicated dashboard as their central operational tool, stable and scalable for the last 5 years despite continuous upgrade from specifications by users, monitoring tools or data providers. In EGEE-III, recent regionalisation of operations led the Operations Portal developers to conceive a standalone instance of this tool. We will see how the dashboard reorganization paved the way for the re-engineering of the portal itself. The outcome is an easily deployable package customized with relevant information sources and specific decentralized operational requirements. This package is composed of a generic and scalable data access mechanism, Lavoisier; a renowned php framework for configuration flexibility, Symfony and a MySQL database. VO life cycle and operational information, EGEE broadcast and Downtime notifications are next for the major reorganization until all other key features of the Operations Portal are migrated to the framework. Features specifications will be sketched at the same time to adapt to EGI requirements and to upgrade. Future work on feature regionalisation, on new advanced features or strategy planning will be tracked in EGI- Inspire through the Operations Tools Advisory Group, OTAG, where all users, customers and third parties of the Operations Portal are represented from January 2010.

Hepatic VX2 tumor after portal vein occlusion in rabbits: evaluation with DSA

International Nuclear Information System (INIS)

Qi Yueyong; Zou Liguang; Dai Shuhua; Zhang Qichuan; Chen Lin; Huang Xiaobing; Huan Guangqiang

2006-01-01

Objective: To study the value of DSA for hepatic vascular anatomy, and to evaluate the efficacy of portal vein occlusion in rabbits with hepatic VX2 tumor. Methods: Twenty New Zealand white rabbits were randomly divided into two groups with 10 in each group, including test group A and positive control group B of ham operation. For the test group A, portal branch ligation (PBL) was performed for the left external branch after 3 weeks of the tumor implantation to the left external lobe. Two weeks later, the DSA of hepatic artery and portal vein were performed in all of the rabbits. Results: The total displaying effectiveness of the branches of hepatic artery by DSA was better than that by vascular perfusion. There was hypovascular blood supply to hepatic artery implantation of the tumor in the test group A, comparing with that of the group B. Conclusion: DSA can clearly display special details of the hepatic vascular anatomy in rabbits, and play an important role in post-procedural evaluation of the portal vein occlusion in rabbits. (authors)

Experimental study of per-rectal portal scintigraphy using 99mTc-HM-PAO

International Nuclear Information System (INIS)

Kubota, Hayato; Shinotsuka, Akira; Takenaka, Hiroki; Tamaki, Satoshi.

1994-01-01

Usefulness of per-rectal portal scintigraphy by 123 I-IMP has already been admitted. We assessed whether 99m Tc-HM-PAO, another agent used for cerebral blood flow scintigraphy, could be utilized for scintigraphic evaluation of the portal system. Animal experiments were carried out to evaluate the usefulness of the examination. Shunt indices obtained from per-rectal portal scintigraphy by 123 I-IMP and 99m Tc-HM-PAO in shunt models and shunt rate obtained by direct injection of 99m Tc-MAA into the inferior mesenteric vein under laparotomy were compared. Correlation coefficient of each agent with 99m Tc-MAA was 0.90 for 99m Tc-HM-PAO and 0.80 for 123 I-IMP. It was also noted that as larger quantity of the tracer could be administered in 99m Tc-HM-PAO than in 123 I-IMP, absorption from rectum was optimum and liver extraction fraction was 94.4%. Therefore, we concluded that 99m Tc-HM-PAO was useful for per-rectal portal scintigraphy. (author)

Radiological score for hemorrhage in the patients with portal hypertension.

Science.gov (United States)

Ge, Wei; Wang, Yi; Cao, Ya-Juan; Xie, Min; Ding, Yi-Tao; Zhang, Ming; Yu, De-Cai

2015-01-01

To analyze the risk factors from radiological indices for hemorrhage in the patients with portal hypertension and weight risk factors. We retrospectively analyzed all cases of portal hypertension with hepatitis B from June 2008 to June 2014 in Nanjing Drum Tower hospital. Patients with hepatocellular carcinoma, portal vein thrombosis, or portal hypertension with other causes, such as autoimmune hepatitis, pancreatitis, or hematological diseases were excluded. Ninety-eight patients were recruited and divided into hemorrhage and non-hemorrhage groups. There were no statistical differences in clinical indexes such as age, prothrombin time, serum albumin, serum creatinine, serum sodium, hemameba, and blood platelet count. However, the differences were statistically significant in total bilirubin, hemoglobin, and liver function with the p values of 0.023, 0.000, and 0.039 respectively. For radiological indices, hemorrhage was correlated with diameter of inferior mesenteric vein (P=0.0528), posterior gastric vein (P=0.0283), and esophageal varices scores (P=0.0221). Logistic procedure was used to construct the model with stepwise selection and finally inferior mesenteric vein, posterior gastric vein, esophageal varices, and short gastric vein were enrolled into the model. These veins were scored according to the diameters and the rates of hemorrhage were increased with the score. We then validated the model with 26 patents from July 2014 to December 2014. The AUC value was 0.8849 in ROC curves for this radiological model. A risk model was constructed including inferior mesenteric vein, esophageal varices, posterior gastric vein, and short gastric vein. This radiological scoring model may be a valuable indicator for hemorrhage of portal hypertension.

Teratoma arising from hepato duodenal ligament in the newborn with transection of portal vein, hepatic artery and common bile duct: A surgical challenge

Directory of Open Access Journals (Sweden)

V R Ravikumar

2018-01-01

Full Text Available A 7-day-old neonate presented with a large intra-abdominal mass adherent to the hilum of the liver encasing the portal triad. During excision, the portal vein, hepatic artery, and common bile duct were injured. The repair was done promptly and needed massive blood transfusion. Histopathology revealed immature teratoma Grade III. Survival in neonate following total transection of portal triad is rare and has not been reported.

Magnetic Resonance Imaging of a Liver Hydatid Cyst Invading the Portal Vein and Causing Portal Cavernomatosis.

Science.gov (United States)

Herek, Duygu; Sungurtekin, Ugur

2015-01-01

Hepatic hydatid cysts rarely invade portal veins causing portal cavernomatosis as a secondary complication. We report the case of a patient with direct invasion of the right portal vein by hydatid cysts causing portal cavernomatosis diagnosed via magnetic resonance imaging (MRI). The presented case highlights the useful application of MRI with T2-weighted images and gadolinium-enhanced T1-weighted images in the diagnosis of hepatic hydatid lesions presenting with a rare complication of portal cavernomatosis.

Experimental study of per-rectal portal scintigraphy using 99mTc-EHIDA

International Nuclear Information System (INIS)

Tamaki, Satoshi; Shinotsuka, Akira; Takenaka, Hiroki

1991-01-01

We discovered that 99m Tc-diethyl iminodiacetic acid ( 99m Tc-EHIDA) commonly used for hepatobiliary scintigraphy could also be administered per-rectally, with adequate absorption and optimal visualization of the portal system. To evaluate its usefulness, we experimented on rabbits using the method. Portal scintigraphy with rectal administration of 99m Tc-EHIDA, 123 I-N-isopropyl-p-iodoamphetamine ( 123 I-IMP) and 99m Tc-red blood cell ( 99m Tc-RBC) were performed in normal rabbits and in extrahepatic portal shunt model rabbits. Images of the liver and thorax were obtained and shunt indices were calculated from the count values of liver and lung or heart. Then the shunt indices were compared with shunt rate derived from direct injection of 99m Tc-macroaglutinated albumin ( 99m Tc-MAA) into inferior mesenteric vein. Correlation between shunt rate of 99m Tc-MAA and shunt indices of 99m Tc-RBC, 123 I-IMP and 99m Tc-EHIDA were 0.64, 0.75 and 0.78, respectively, with 99m Tc-EHIDA having the most favorable results. We concluded that 99m Tc-EHIDA per-rectal portal scintigraphy is a noninvasive, quantitative, inexpensive and simple method for evaluation of portal circulation system. Also, we think that this method would be applicable to human usage from our experience with normal volunteers. (author)

Colangiopatía portal: complicación poco frecuente de la hipertensión portal

OpenAIRE

Veloso, Victoria; Servente, Liliana; Hernández, Nelia

2017-01-01

Resumen: Se describe el caso clínico de una mujer de 62 años en la que se diagnostica una estenosis del colédoco en el contexto de hipertensión portal prehepática (cavernomatosis portal). Abstract: We report the case of a 62 years old woman with a choledochal stricture and chronic obstruction of the portal vein (portal cavernomatosis). Resumo: Relatamos o caso de uma mulher de 62 anos com diagnóstico de estenose do colédoco no contexto da hipertensão portal pré-hepática (cavernomat...

The XCAT Science Portal

Directory of Open Access Journals (Sweden)

Sriram Krishnan

2002-01-01

Full Text Available This paper describes the design and prototype implementation of the XCAT Grid Science Portal. The portal lets grid application programmers script complex distributed computations and package these applications with simple interfaces for others to use. Each application is packaged as a notebook which consists of web pages and editable parameterized scripts. The portal is a workstation-based specialized personal web server, capable of executing the application scripts and launching remote grid applications for the user. The portal server can receive event streams published by the application and grid resource information published by Network Weather Service (NWS [35] or Autopilot [16] sensors. Notebooks can be published and stored in web based archives for others to retrieve and modify. The XCAT Grid Science Portal has been tested with various applications, including the distributed simulation of chemical processes in semiconductor manufacturing and collaboratory support for X-ray crystallographers.

Anatomy of the Portal Vein Bifurcation: Implication for Transjugular Intrahepatic Portal Systemic Shunts

International Nuclear Information System (INIS)

Kwok, Philip Chong-hei; Ng, Wai Fu; Lam, Christine Suk-yee; Tsui, Polly Po; Faruqi, Asma

2003-01-01

Purpose: The relationship of the portalvein bifurcation to the liver capsule in Asians, which is an important landmark for transjugular intrahepatic portosystemic shunt, has not previously been described. Methods: The anatomy of the portal vein bifurcation was studied in 70 adult Chinese cadavers; it was characterized as intrahepatic or extrahepatic. The length of the exposed portion of the right and left portal veins was measured when the bifurcation was extrahepatic. Results: The portal vein bifurcation was intrahepatic in 37 cadavers (53%) and extrahepatic in 33 cadavers (47%). The mean length of the right and left extrahepatic portal veins was 0.96 cm and 0.85 cm respectively.Both were less than or equal to 2 cm in 94% of the cadavers with extrahepatic bifurcation. There was no correlation between the presence of cirrhosis and the location of the portal vein bifurcation(p 1.0). There was no statistically significant difference in liver mass in cadavers with either extrahepatic or intrahepatic bifurcation (p =0.40). Conclusions: These findings suggest that fortransjugular intrahepatic portosystemic shunt placement, a portal vein puncture 2 cm from the bifurcation will be safe in most cases

The application of TIPSS in portal vein cancerous thrombosis complicated with portal hypertension

International Nuclear Information System (INIS)

Jiang Zaibo; Shan Hong; Guan Shouhai; Zhu Kangshun; Huang Mingsheng; Li Zhengran; Zhu Wenke; Liu Lang; Guo Tiansheng

2002-01-01

Objective: To discuss the technical skills and the contraindication of trans-jugular intrahepatic portosystemic shunt stent (TIPSS) in portal vein cancerous thrombosis (PVCT) complicated with portal hypertension. Methods: There were 16 cases of PVCT with portal hypertension, and average age of 53.6 yr. There were 9 cases with complete occlusion of portal vein trunk and 7 cases with incomplete thrombosis. There were 5 cases with cavernous transformation of the portal vein (CTPV). 1 case of simple upper gastro-intestinal tract (GIT) massive bleeding, 4 with refractory ascites and 11 with upper GIT massive bleeding and refractory ascites. Results: The procedure of TIPS was successful in 11 cases, the successful rate reached about 68.8%. The mean portal vein pressure was reduced from 4.9 kPa to 2.4 kPa with average 2. 5 kPa reduction. Ascites decreased, bleeding stopped and the clinical symptoms disappeared. The average survival period was 136 days. The procedure failed in 5 cases. Conclusions: TIPSS is an effective method to control the bleeding and ascites caused by PVCT. The PV cavernous transformation was the contraindication of TIPSS

The NOAO NVO Portal

Science.gov (United States)

Miller, C. J.; Gasson, D.; Fuentes, E.

2007-10-01

The NOAO NVO Portal is a web application for one-stop discovery, analysis, and access to VO-compliant imaging data and services. The current release allows for GUI-based discovery of nearly a half million images from archives such as the NOAO Science Archive, the Hubble Space Telescope WFPC2 and ACS instruments, XMM-Newton, Chandra, and ESO's INT Wide-Field Survey, among others. The NOAO Portal allows users to view image metadata, footprint wire-frames, FITS image previews, and provides one-click access to science quality imaging data throughout the entire sky via the Firefox web browser (i.e., no applet or code to download). Users can stage images from multiple archives at the NOAO NVO Portal for quick and easy bulk downloads. The NOAO NVO Portal also provides simplified and direct access to VO analysis services, such as the WESIX catalog generation service. We highlight the features of the NOAO NVO Portal (http://nvo.noao.edu).

Radionuclide study on hepatic blood flow in Schistosomiasis Japonica

Energy Technology Data Exchange (ETDEWEB)

Okada, Junichi; Uchiyama, Guio; Hayakawa, Kazushige; Hayashi, Sanshin; Araki, Tsutomu; Arai, Takao; Iuchi, Masahiko

1986-11-01

Schistosomiasis Japonica is a regional disease found in elderly people who were living in once-endemic areas in Japan. Yamanashi was one of these areas until 1970, since when no newly infected patients were reported. The disease is characteristic of developing irreversible interstitial fibrosis of the liver, where parasites migrate and lay eggs. Portal hypertension, esophageal varices and hepatocellular carcinomas are the common features of the results. In order to estimate patient's hepatic blood flow, radionuclide angiography of the liver with the use of 10 - 15 millicuries of Tc-99m phytate were performed prior to the conventional multiview imaging. Twenty-two patients with schistosomiasis and twelve adults without evidence of liver disease were studied. A time-activity curve of the right lobe of the liver was generated by a computer, and the ratio of arterial blood flow to portal blood flow was calculated. As a result, a good correlation was found between the arterial to portal blood flow ratio and the grade of hepatic fibrosis verified by laparoscopic biopsy. The development of esophageal varices were likely to correlate well with the blood flow ratio rather than scores on the conventional static liver and spleen scintigram. The study was useful for evaluating patient's clinical stages and prognosis.

Radionuclide study on hepatic blood flow in Schistosomiasis Japonica

International Nuclear Information System (INIS)

Okada, Junichi; Uchiyama, Guio; Hayakawa, Kazushige; Hayashi, Sanshin; Araki, Tsutomu; Arai, Takao; Iuchi, Masahiko.

1986-01-01

Schistosomiasis Japonica is a regional disease found in elderly people who were living in once-endemic areas in Japan. Yamanashi was one of these areas until 1970, since when no newly infected patients were reported. The disease is characteristic of developing irreversible interstitial fibrosis of the liver, where parasites migrate and lay eggs. Portal hypertension, esophageal varices and hepatocellular carcinomas are the common features of the results. In order to estimate patient's hepatic blood flow, radionuclide angiography of the liver with the use of 10 - 15 millicuries of Tc-99m phytate were performed prior to the conventional multiview imaging. Twenty-two patients with schistosomiasis and twelve adults without evidence of liver disease were studied. A time-activity curve of the right lobe of the liver was generated by a computer, and the ratio of arterial blood flow to portal blood flow was calculated. As a result, a good correlation was found between the arterial to portal blood flow ratio and the grade of hepatic fibrosis verified by laparoscopic biopsy. The development of esophageal varices were likely to correlate well with the blood flow ratio rather than scores on the conventional static liver and spleen scintigram. The study was useful for evaluating patient's clinical stages and prognosis. (author)

Evaluation of electrosurgery and titanium clips for ovarian pedicle haemostasis in video-assisted ovariohysterectomy with two portals in bitches

Directory of Open Access Journals (Sweden)

Rogério Luizari Guedes

Full Text Available ABSTRACT: This study evaluated the use of bipolar electrosurgery and laparoscopic clipping, and their effects on blood loss and the inflammatory response, during a two portal video-assisted ovariohysterectomy technique (two groups with 10 animals each. Surgical time and blood loss volume were significantly lower in the electrosurgery group. There were no significant changes in haematocrit between groups; however, haematocrit did differ between evaluated times, and decreased 10% from the initial measurement to four hours after the procedure. The inflammatory response was significantly higher throughout the post-surgical period, but without any different clinical signs between the two groups. Both techniques had good application for the two portal video-assisted procedure; however, the bipolar electrosurgery allowed for shorter surgical times, reduced blood loss and a minimal learning curve for the surgeon.

On line portal imaging

International Nuclear Information System (INIS)

Munro, Peter

1996-01-01

Purpose/Objective: The purpose of this presentation is to examine the various imaging devices that have been developed for portal imaging; describe some of the image registration methods that have been developed to determine geometric errors quantitatively; discuss some of the ways that portal imaging has been incorporated into routine clinical practice; describe quality assurance procedures for these devices, and discuss the use of portal imaging devices for dosimetry applications. Discussion: Verification of patient positioning has always been an important aspect of external beam radiation therapy. Over the past decade many portal imaging devices have been developed by individual investigators and most accelerator manufacturers now offer 'on-line' portal imaging systems. The commercial devices can be classified into three categories: T.V. camera-based systems, liquid ionisation chamber systems, and amorphous silicon systems. Many factors influence the quality of images generated by these portal imaging systems. These include factors which are unavoidable (e.g., low subject contrast), factors which depend upon the individual imaging device forming the image (e.g., dose utilisation, spatial resolution) as well as factors which depend upon the characteristics of the linear accelerator irradiating the imaging system (x-ray source size, image magnification). The characteristics of individual imaging systems, such as spatial resolution, temporal response, and quantum utilisation will be discussed. One of the major advantages of on-line portal imaging is that many quantitative techniques have been developed to detect errors in patient positioning. The general approach is to register anatomic structures on a portal image with the same structures on a digitized simulator film. Once the anatomic structures have been registered, any discrepancies in the position of the patient can be identified. However, the task is not nearly as straight-forward as it sounds. One problem

Central and systemic haemodynamic effects of terlipressin in portal hypertensive patients

DEFF Research Database (Denmark)

Møller, S; Hansen, E F; Becker, U

2000-01-01

the acute effects of terlipressin on central and systemic haemodynamics. METHODS: Sixteen patients with alcoholic cirrhosis and portal hypertension had their systemic, central, and splanchnic haemodynamics determined at baseline and after a blind randomised bolus infusion (2 mg) of terlipressin...... vascular resistance (r=-0.52, pportal hypertensive patients without a further contraction of the central and arterial blood volume. The systemic haemodynamic...... increased by 36% (pportal pressure and hepatic blood flow decreased (17% and 29%, both pportal pressure after terlipressin was significantly related to the increase in systemic...

Personalization Methods for Internet Portals

OpenAIRE

Barbara Dębska; Agnieszka Kubacka

2012-01-01

The article presents methods of acquiring and gathering data about users of internet portals, with particular emphasis on educational portals. Definitions, aims and tasks related to the process of personalization of e-learning portals are thoroughly discussed. So are knowledge acquisition techniques applied in personalization, especially artificial intelligence methods.

PRO-C3-levels in patients with HIV/HCV-Co-infection reflect fibrosis stage and degree of portal hypertension

DEFF Research Database (Denmark)

Jansen, Christian; Leeming, Diana J; Mandorfer, Mattias

2014-01-01

BACKGROUND: Liver-related deaths represent the leading cause of mortality among patients with HIV/HCV-co-infection, and are mainly related to complications of fibrosis and portal hypertension. In this study, we aimed to evaluate the structural changes by the assessment of extracellular matrix (ECM......) derived degradation fragments in peripheral blood as biomarkers for fibrosis and portal hypertension in patients with HIV/HCV co-infection. METHODS: Fifty-eight patients (67% male, mean age: 36.5 years) with HIV/HCV-co-infection were included in the study. Hepatic venous pressure gradient (HVPG......4M and C5M levels were higher in patients with portal hypertension (HVPG>5 mmHg). CONCLUSION: PRO-C3 levels reflect liver injury, stage of liver fibrosis and degree of portal hypertension in HIV/HCV-co-infected patients. Furthermore, C4M and C5M were associated with increased portal pressure...

Effects of transjugular intrahepatic portosystemic shunt (TIPS) on blood volume distribution in patients with cirrhosis

DEFF Research Database (Denmark)

Busk, Troels M; Bendtsen, Flemming; Henriksen, Jens H

2017-01-01

increased (+22%, prestores central hypovolaemia......BACKGROUND: Cirrhosis is accompanied by portal hypertension with splanchnic and systemic arterial vasodilation, and central hypovolaemia. A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes. AIMS: To investigate effects...... catheterization. Central and arterial blood volume (CBV) and cardiac output (CO) were determined with indicator dilution technique. RESULTS: After TIPS, the thoracic blood volume increased (+10.4% of total blood volume (TBV), p

Comparison of radial 4D Flow-MRI with perivascular ultrasound to quantify blood flow in the abdomen and introduction of a porcine model of pre-hepatic portal hypertension.

Science.gov (United States)

Frydrychowicz, A; Roldan-Alzate, A; Winslow, E; Consigny, D; Campo, C A; Motosugi, U; Johnson, K M; Wieben, O; Reeder, S B

2017-12-01

Objectives of this study were to compare radial time-resolved phase contrast magnetic resonance imaging (4D Flow-MRI) with perivascular ultrasound (pvUS) and to explore a porcine model of acute pre-hepatic portal hypertension (PHTN). Abdominal 4D Flow-MRI and pvUS in portal and splenic vein, hepatic and both renal arteries were performed in 13 pigs of approximately 60 kg. In six pigs, measurements were repeated after partial portal vein (PV) ligature. Inter- and intra-reader comparisons and statistical analysis including Bland-Altman (BA) comparison, paired Student's t tests and linear regression were performed. PvUS and 4D Flow-MRI measurements agreed well; flow before partial PV ligature was 322 ± 30 ml/min in pvUS and 297 ± 27 ml/min in MRI (p = 0.294), and average BA difference was 25 ml/min [-322; 372]. Inter- and intra-reader results differed very little, revealed excellent correlation (R 2  = 0.98 and 0.99, respectively) and resulted in BA differences of -5 ml/min [-161; 150] and -2 ml/min [-28; 25], respectively. After PV ligature, PV flow decreased from 356 ± 50 to 298 ± 61 ml/min (p = 0.02), and hepatic arterial flow increased from 277 ± 36 to 331 ± 65 ml/min (p = n.s.). The successful in vivo comparison of radial 4D Flow-MRI to perivascular ultrasound revealed good agreement of abdominal blood flow although with considerable spread of results. A model of pre-hepatic PHTN was successfully introduced and acute responses monitored. • Radial 4D Flow-MRI in the abdomen was successfully compared to perivascular ultrasound. • Inter- and intra-reader testing demonstrated excellent reproducibility of upper abdominal 4D Flow-MRI. • A porcine model of acute pre-hepatic portal hypertension was successfully introduced. • 4D Flow-MRI successfully monitored acute changes in a model of portal hypertension.

Sonographic detection of portal venous gas

International Nuclear Information System (INIS)

Lee, Wang Yul; Lee, S. K.; Cho, O. K.

1989-01-01

Portal venous gas suggests underlying bowel disease such as strangulating intestinal obstruction and its demonstration carries with it an important implications with respect to patient management. Radiography has been the gold standard for the detection of portal venous gas. We have experienced two cases of portal venous gas diagnosed by ultrasound. Sonographic findings were floating echoes in the main portal vein and highly echogenic linear or patchy echoes within the hepatic parenchyma. Simple abdominal films of those cases failed to demonstrate gas in the portal venous system

Usability of Discovery Portals

OpenAIRE

Bulens, J.D.; Vullings, L.A.E.; Houtkamp, J.M.; Vanmeulebrouk, B.

2013-01-01

As INSPIRE progresses to be implemented in the EU, many new discovery portals are built to facilitate finding spatial data. Currently the structure of the discovery portals is determined by the way spatial data experts like to work. However, we argue that the main target group for discovery portals are not spatial data experts but professionals with limited spatial knowledge, and a focus outside the spatial domain. An exploratory usability experiment was carried out in which three discovery p...

Lymphocytic Hypophysitis: Differential Diagnosis and Effects of High-Dose Pulse Steroids, Followed by Azathioprine, on the Pituitary Mass and Endocrine Abnormalities — Report of a Case and Literature Review

Directory of Open Access Journals (Sweden)

Lorenzo Curtò

2010-01-01

Full Text Available We report on a man with a progressively increasing pituitary mass, as demonstrated by MRI. It produced neurological and ophthalmological symptoms, and, ultimately, hypopituitarism. MRI also showed enlargement of the pituitary stalk and a dural tail phenomenon. An increased titer of antipituitary antibodies (1:16 was detected in the serum. Pituitary biopsy showed autoimmune hypophysitis (AH. Neither methylprednisolone pulse therapy nor a subsequent treatment with azathioprine were successful in recovering pituitary function, or in inducing a significant reduction of the pituitary mass after an initial, transient clinical and neuroradiological improvement. Anterior pituitary function evaluation revealed persistent hypopituitarism. AH is a relatively rare condition, particularly in males, but it represents an emerging entity in the diagnostic management of pituitary masses. This case shows that response to appropriate therapy for hypophysitis may not be very favorable and confirms that diagnostic management of nonsecreting pituitary masses can be a challenge. Clinical, imaging, and laboratory findings are useful for suggesting the diagnosis, but pituitary biopsy may be necessary to confirm it.

Percutaneous transhepatic portal vein stenting in a patient with benign non-transplant postoperative portal vein stenosis: A case report

OpenAIRE

Madhusudhan, KS; Agrawal, Nikhil; Srivastava, Deep N; Pal, Sujoy; Gupta, Arun K

2013-01-01

Extrahepatic portal vein stenosis is caused by a variety of benign and malignant diseases and results in development of symptoms due to portal hypertension. Benign post-surgical adhesions causing portal vein stenosis in non-transplant population is an uncommon etiology of portal hypertension. Endovascular treatment of such patients with angioplasty and stenting is uncommonly reported in literature. We report a case of portal hypertension caused by benign postoperative portal vein fibrosis, su...

On line portal imaging

International Nuclear Information System (INIS)

Munro, Peter

1997-01-01

Purpose/Objective: The purpose of this presentation is to examine the various imaging devices that have been developed for portal imaging, describe some of the image registration methods that have been developed to determine geometric errors quantitatively, and discuss how portal imaging has been incorporated into clinical practice. Discussion: Verification of patient positioning has always been an important aspect of external beam radiation therapy. Over the past decade many portal imaging devices have been developed by individual investigators and most accelerator manufacturers now offer 'on-line' portal imaging systems. The commercial devices include T.V. camera-based systems, liquid ionisation chamber systems, and shortly, flat panel systems. The characteristics of these imaging systems will be discussed. In addition, other approaches such as the use of kilovoltage x-ray sources, video monitoring, and ultrasound have been proposed for improving patient positioning. Some of the advantages of these approaches will be discussed. One of the major advantages of on-line portal imaging is that many quantitative techniques have been developed to detect errors in patient positioning. The general approach is to register anatomic structures on a portal image with the same structures on a digitized simulator film. Once the anatomic structures have been registered, any discrepancies in the position of the patient can be identified. One problem is finding a common frame of reference for the simulator and portal images, since the location of the radiation field within the pixel matrix may differ for the two images. As a result, a common frame of reference has to be established before the anatomic structures in the images can be registered - generally by registering radiation field edges identified in the simulator and portal images. In addition, distortions in patient geometry or rotations out of the image plane can confound the image registration techniques. Despite the

Quantitative vs. subjective portal verification using digital portal images.

Science.gov (United States)

Bissett, R; Leszczynski, K; Loose, S; Boyko, S; Dunscombe, P

1996-01-15

Off-line, computer-aided prescription (simulator) and treatment (portal) image registration using chamfer matching has been implemented on PC based viewing station. The purposes of this study were (a) to evaluate the performance of interactive anatomy and field edge extraction and subsequent registration, and (b) to compare observer's perceptions of field accuracy with measured discrepancies following anatomical registration. Prescription-treatment image pairs for 48 different patients were examined in this study. Digital prescription images were produced with the aid of a television camera and a digital frame grabber, while the treatment images were obtained directly from an on-line portal imaging system. To facilitate perception of low contrast anatomical detail, on-line portal images were enhanced with selective adaptive histogram equalization prior to extraction of anatomical edges. Following interactive extraction of anatomical and field border information by an experienced observer, the identified anatomy was registered using chamfer matching. The degree of conformity between the prescription and treatment fields was quantified using several parameters, which included relative prescription field coverage and overcoverage, as well as the translational and rotational displacements as measured by chamfer matching applied to the boundaries of the two fields. These quantitative measures were compared with subjective evaluations made by four radiation oncologists. All the images in this series that included a range of the most commonly seen treatment sites were registered and the conformity parameters were found. The mean treatment/prescription field coverage and overcoverage were approximately 95 and 7%, respectively before registration. The mean translational displacement in the transverse and cranio-caudal directions were 2.9 and 3.4 mm, respectively. The mean rotational displacement was approximately 2 degrees. For all four oncologists, the portals classified

Strategi Branding Portal Online Www.tripriau.com Dalam Membangun Brand Awareness Sebagai Portal Online Pariwisata Provinsi Riau

OpenAIRE

Rahmadhani, Yuri; Lubis, Evawani Elysa

2017-01-01

Online portal www.tripriau.com online portal is one of the online portal in Riau Province that has its own uniqueness. These portals contain local content and the potential of tourism in the province of Riau. Since its establishment, www.tripriau.com do branding strategy in order to build brand awareness or trust the reader to be known as a tourism-themed online portal. As the selection of brand name Trip Riau, Riau Guide My tagline, as well as the implementation of travel instagram photo con...

Comparison between two portal laparoscopy and open surgery for ovariectomy in dogs.

Science.gov (United States)

Shariati, Elnaz; Bakhtiari, Jalal; Khalaj, Alireza; Niasari-Naslaji, Amir

2014-01-01

Ovariectomy (OVE) is a routine surgical procedure for neutering in small animal practice. Laparoscopy is a new surgical technique which contains advantages such as less trauma, smaller incision and excellent visualization than traditional open surgery. The present study was conducted to examine the feasibility and safety of laparoscopic procedure through two portal comparing with the conventional open surgery for OVE in healthy female bitches (n=16). Dogs were divided in two equal groups. In laparoscopic group, two 5 and 10 mm portals were inserted; First in the umbilicus for introducing the camera and the second, caudal to the umbilicus for inserting the forceps. Laparoscopic procedure involved grasping and tacking the ovary to the abdominal wall, followed by electrocautery, resection and removal of the ovary. In open surgery, routine OVE was conducted through an incision from umbilicus to caudal midline. Mean operative time, total length of scar, blood loss, clinical and blood parameters and all intra and post-operative complications were recorded in both groups. Mean operative time, total length of scar, blood loss and post-operative adhesions were significantly less in laparoscopic group compared with open surgery. In conclusion, laparoscopic OVE is an acceptable procedure due to more advantages in comparison with traditional OVE.

The Sydney West Knowledge Portal: Evaluating the Growth of a Knowledge Portal to Support Translational Research.

Science.gov (United States)

Janssen, Anna; Robinson, Tracy Elizabeth; Provan, Pamela; Shaw, Tim

2016-06-29

The Sydney West Translational Cancer Research Centre is an organization funded to build capacity for translational research in cancer. Translational research is essential for ensuring the integration of best available evidence into practice and for improving patient outcomes. However, there is a low level of awareness regarding what it is and how to conduct it optimally. One solution to addressing this gap is the design and deployment of web-based knowledge portals to disseminate new knowledge and engage with and connect dispersed networks of researchers. A knowledge portal is an web-based platform for increasing knowledge dissemination and management in a specialized area. To measure the design and growth of an web-based knowledge portal for increasing individual awareness of translational research and to build organizational capacity for the delivery of translational research projects in cancer. An adaptive methodology was used to capture the design and growth of an web-based knowledge portal in cancer. This involved stakeholder consultations to inform initial design of the portal. Once the portal was live, site analytics were reviewed to evaluate member usage of the portal and to measure growth in membership. Knowledge portal membership grew consistently for the first 18 months after deployment, before leveling out. Analysis of site metrics revealed members were most likely to visit portal pages with community-generated content, particularly pages with a focus on translational research. This was closely followed by pages that disseminated educational material about translational research. Preliminary data from this study suggest that knowledge portals may be beneficial tools for translating new evidence and fostering an environment of communication and collaboration.

60 YEARS OF NEUROENDOCRINOLOGY: MEMOIR: Harris' neuroendocrine revolution: of portal vessels and self-priming.

Science.gov (United States)

Fink, George

2015-08-01

Geoffrey Harris, while still a medical student at Cambridge, was the first researcher (1937) to provide experimental proof for the then tentative view that the anterior pituitary gland was controlled by the CNS. The elegant studies carried out by Harris in the 1940s and early 1950s, alone and in collaboration with John Green and Dora Jacobsohn, established that this control was mediated by a neurohumoral mechanism that involved the transport by hypophysial portal vessel blood of chemical substances from the hypothalamus to the anterior pituitary gland. The neurohumoral control of anterior pituitary secretion was proved by the isolation and characterisation of the 'chemical substances' (mainly neuropeptides) and the finding that these substances were released into hypophysial portal blood in a manner consistent with their physiological functions. The new discipline of neuroendocrinology - the way that the brain controls endocrine glands and vice versa - revolutionised the treatment of endocrine disorders such as growth and pubertal abnormalities, infertility and hormone-dependent tumours, and it underpins our understanding of the sexual differentiation of the brain and key aspects of behaviour and mental disorder. Neuroendocrine principles are illustrated in this Thematic Review by way of Harris' major interest: hypothalamic-pituitary-gonadal control. Attention is focussed on the measurement of GnRH in hypophysial portal blood and the role played by the self-priming effect of GnRH in promoting the onset of puberty and enabling the oestrogen-induced surge or pulses of GnRH to trigger the ovulatory gonadotrophin surge in humans and other spontaneously ovulating mammals. © 2015 Society for Endocrinology.

Palliative treatment of TIPS to portal vein tumor thrombosis complicated with portal vein hypertension

International Nuclear Information System (INIS)

Jiang Zaibo; Shan Hong; Guan Shouhai; Zhu Kangshun; Huang Mingsheng; Li Zhengran; Guo Tiansheng; Liu Lang

2002-01-01

Objective: To evaluate the palliative therapeutic effects of transjugular intrahepatic portosystemic shunt (TIPS) in portal vein tumor thrombosis (PVTT) complicated with portal vein hypertension, and to discuss the technical skills. Methods: There were 14 cases of end-stage hepatocellular carcinoma complicated with PVTT and portal vein hypertension, the average age was 53.6 yr. There were 8 cases with complete occlusion of main portal vein, 6 eases with incomplete thrombosis, and 5 cases combined with portal vein cavernous transformation. One case had simple hemorrhage, 3 eases had intractable ascites, and 10 cases had hemorrhage accompanied by intractable ascites. Results: The procedure of TIPS was successful in 10 cases, the successful rate was about 71%. The mean portal vein pressure was reduced from 37.2 mm Hg to 18.2 mm Hg, with an average reduction of 19.0 mm Hg. After the procedure of TIPS, the ascites decreased, hemorrhage stopped and the clinical symptoms disappeared. The average survival period was 132.3 days. The procedure were failing in 4 cases. Conclusion: TIPS was an effective palliative therapeutic methods to control the hemorrhage and ascites aroused by hepatic carcinoma complicated with PVTT

Portal pressure correlated to visceral circulation times

Energy Technology Data Exchange (ETDEWEB)

Friman, L [Serafimerlasarettet, Stockholm (Sweden)

1979-01-01

Visceral angiography was performed in 7 patients with normal portal pressure and in 10 with portal hypertension. Circulation times, size of vessels and portal pressure were determined. At celiac angiography, a direct correlation was found between time for maximum filling of portal vein and portal pressure, provided no vascular abnormalities existed. At superior mesenteric angiography such a correlation was not found; loss of flow by shunts in portal hypertension being one explanation. Portocaval shunts are common in the celiac system, but uncommon in the superior mesenteric system.

Percutaneous transhepatic portal vein stenting in a patient with benign non-transplant postoperative portal vein stenosis: A case report

Directory of Open Access Journals (Sweden)

KS Madhusudhan

2013-01-01

Full Text Available Extrahepatic portal vein stenosis is caused by a variety of benign and malignant diseases and results in development of symptoms due to portal hypertension. Benign post-surgical adhesions causing portal vein stenosis in non-transplant population is an uncommon etiology of portal hypertension. Endovascular treatment of such patients with angioplasty and stenting is uncommonly reported in literature. We report a case of portal hypertension caused by benign postoperative portal vein fibrosis, successfully treated by self-expandable metallic stent.

Portal hypertension in patients with cirrhosis: indirect assessment of hepatic venous pressure gradient by measuring azygos flow with 2D-cine phase-contrast magnetic resonance imaging

International Nuclear Information System (INIS)

Gouya, Herve; Vignaux, Olivier; Saade, Anastasia; Legmann, Paul; Grabar, Sophie; Pol, Stanislas; Sogni, Philippe

2016-01-01

To measure azygos, portal and aortic flow by two-dimensional cine phase-contrast magnetic resonance imaging (2D-cine PC MRI), and to compare the MRI values to hepatic venous pressure gradient (HVPG) measurements, in patients with cirrhosis. Sixty-nine patients with cirrhosis were prospectively included. All patients underwent HVPG measurements, upper gastrointestinal endoscopy and 2D-cine PC MRI measurements of azygos, portal and aortic blood flow. Univariate and multivariate regression analyses were used to evaluate the correlation between the blood flow and HVPG. The performance of 2D-cine PC MRI to diagnose severe portal hypertension (HVPG ≥ 16 mmHg) was determined by receiver operating characteristic curve (ROC) analysis, and area under the curves (AUC) were compared. Azygos and aortic flow values were associated with HVPG in univariate linear regression model. Azygos flow (p < 10 -3 ), aortic flow (p = 0.001), age (p = 0.001) and presence of varices (p < 10 -3 ) were independently associated with HVPG. Azygos flow (AUC = 0.96 (95 % CI) [0.91-1.00]) had significantly higher AUC than aortic (AUC = 0.64 (95 % CI) [0.51-0.77]) or portal blood flow (AUC = 0.40 (95 % CI) [0.25-0.54]). 2D-cine PC MRI is a promising technique to evaluate significant portal hypertension in patients with cirrhosis. (orig.)

Portal pressure correlated to visceral circulation times

International Nuclear Information System (INIS)

Friman, L.

1979-01-01

Visceral angiography was performed in 7 patients with normal portal pressure and in 10 with portal hypertension. Circulation times, size of vessels and portal pressure were determined. At celiac angiography, a direct correlation was found between time for maximum filling of portal vein and portal pressure, provided no vascular abnormalities existed. At superior mesenteric angiography such a correlation was not found; loss of flow by shunts in portal hypertension being one explanation. Portocaval shunts are common in the celiac system, but uncommon in the superior mesenteric system. (Auth.)

Leptin receptor blockade reduces intrahepatic vascular resistance and portal pressure in an experimental model of rat liver cirrhosis.

Science.gov (United States)

Delgado, María Gabriela; Gracia-Sancho, Jordi; Marrone, Giusi; Rodríguez-Vilarrupla, Aina; Deulofeu, Ramon; Abraldes, Juan G; Bosch, Jaume; García-Pagán, Juan Carlos

2013-10-01

Increased hepatic vascular resistance mainly due to elevated vascular tone and to fibrosis is the primary factor in the development of portal hypertension in cirrhosis. Leptin, a hormone associated with reduction in nitric oxide bioavailability, vascular dysfunction, and liver fibrosis, is increased in patients with cirrhosis. We aimed at evaluating whether leptin influences the increased hepatic resistance in portal hypertension. CCl4-cirrhotic rats received the leptin receptor-blocker ObR antibody, or its vehicle, every other day for 1 wk. Hepatic and systemic hemodynamics were measured in both groups. Hepatic nitric oxide production and bioavailability, together with oxidative stress, nitrotyrosinated proteins, and liver fibrosis, were evaluated. In cirrhotic rats, leptin-receptor blockade significantly reduced portal pressure without modifying portal blood flow, suggesting a reduction in the intrahepatic resistance. Portal pressure reduction was associated with increased nitric oxide bioavailability and with decreased O2(-) levels and nitrotyrosinated proteins. No changes in systemic hemodynamics and liver fibrosis were observed. In conclusion, the present study shows that blockade of the leptin signaling pathway in cirrhosis significantly reduces portal pressure. This effect is probably due to a nitric oxide-mediated reduction in the hepatic vascular tone.

Transjugular intrahepatic portosystemic shunt in patients with active variceal bleeding due to portal hypertension and portal vein thrombosis

International Nuclear Information System (INIS)

Shin, Hyun Woong; Ryeom, Hun Kyu; Lee, Sang Kwon; Lee, Jong Min; Kim, Young Sun; Suh, Kyung Jin; Kim, Tae Hun; Kim, Yong Joo

1997-01-01

To evaluate the feasibility and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in patients with active variceal bleeding due to liver cirrhosis and pre-existing portal vein thrombosis. Of a total of 123 patients who underwent TIPS, 14 patients with intractable variceal bleeding due to portal hypertension and portal vein thrombosis were included in this study. Noncavernomatous portal vein occlusion was seen in eight patients, and complete portal vein occlusion with cavernomatous trans-formation in six. For all patients, the methods used for TIPS placement were the same as those used in patients with patents portal veins. In seven of eight patients with noncavernomatous occlusion, right hepatic vein-right portal vein shunting was performed; in one with knoncavernomatous occlusion, a shunt was created between the right hepatic and left portal vein. In five of six patients with cavernomatous occlusion, the right hepatic and main portal vein were connected via a collateral vein. The procedures were technically successful in all except one patient. Immediate hemostatis was achieved after all technically successful procedures, and no significant complications were encountered. Minor complications were noted in six patients (three biliary tree punctures, one transperitoneal puncture, one splenic vein perforation, one hepatic subcapsular hematoma). TIPS is a technically feasible and hemodynamically effective procedure, even in patients with active variceal bleeding due to cirrhosis and complete portal vein occlusion

Effects of Nuclear Factor-E2-related factor 2/Heme Oxygenase 1 on splanchnic hemodynamics in experimental cirrhosis with portal hypertension.

Science.gov (United States)

Qin, Jun; He, Yue; Duan, Ming; Luo, Meng

2017-05-01

We explored the effects of Nuclear Factor-E2-related factor 2 (Nrf2) and Heme Oxygenase 1 (HO-1) on splanchnic hemodynamics in portal hypertensive rats. Experimental cirrhosis with portal hypertension was induced by intraperitoneal injection of carbon tetrachloride. The expression of proteins was examined by immunoblotting. Hemodynamic studies were performed by radioactive microspheres. The vascular perfusion system was used to measure the contractile response of mesentery arterioles in rats. Nrf2 expression in the nucleus and HO-1 expression in cytoplasm was significantly enhanced in portal hypertensive rats. Portal pressure, as well as regional blood flow, increased significantly in portal hypertension and can be blocked by tin protoporphyrin IX. The expression of endogenous nitric oxide synthase and vascular endothelial growth factors increased significantly compared to normal rats, while HO-1 inhibition decreased the expression of these proteins significantly. The contractile response of mesenteric arteries decreased in portal hypertension, but can be partially recovered through tin protoporphyrin IX treatment. The expression of Nrf2/HO-1 increased in mesenteric arteries of portal hypertensive rats, which was related to oxidative stress. HO-1was involved in increased portal pressure and anomaly splanchnic hemodynamics in portal hypertensive rats. Copyright © 2016 Elsevier Inc. All rights reserved.

A chess web portal

OpenAIRE

Volf, Žiga

2011-01-01

The aim of the thesis was to develop a web portal for chess players, which is intended to be a place for quality chess joining over the Internet and chess education. This need is caused by existing social networks and websites for playing chess, which offer you a very small amount of quality chess joining and education. As a result of the work the chess portal was created. We have presented the development of the chess portal in the thesis, which has all the features the chess players are i...

Effect of dietary fructose on portal and systemic serum fructose levels in rats and in KHK−/− and GLUT5−/− mice

Science.gov (United States)

Patel, Chirag; Sugimoto, Keiichiro; Douard, Veronique; Shah, Ami; Inui, Hiroshi; Yamanouchi, Toshikazu

2015-01-01

Elevated blood fructose concentrations constitute the basis for organ dysfunction in fructose-induced metabolic syndrome. We hypothesized that diet-induced changes in blood fructose concentrations are regulated by ketohexokinase (KHK) and the fructose transporter GLUT5. Portal and systemic fructose concentrations determined by HPLC in wild-type mice fed for 7 days 0% free fructose were fructose levels, however, increased markedly in those fed isocaloric 20% fructose, causing significant hyperglycemia. Deletion of KHK prevented fructose-induced hyperglycemia, but caused dramatic hyperfructosemia (>1 mM) with reversed portal to systemic gradients. Systemic fructose in wild-type and KHK−/− mice changed by 0.34 and 1.8 mM, respectively, for every millimolar increase in portal fructose concentration. Systemic glucose varied strongly with systemic, but not portal, fructose levels in wild-type, and was independent of systemic and portal fructose in KHK−/−, mice. With ad libitum feeding for 12 wk, fructose-induced hyperglycemia in wild-type, but not hyperfructosemia in KHK−/− mice, increased HbA1c concentrations. Increasing dietary fructose to 40% intensified the hyperfructosemia of KHK−/− and the fructose-induced hyperglycemia of wild-type mice. Fructose perfusion or feeding in rats also caused duration- and dose-dependent hyperfructosemia and hyperglycemia. Significant levels of blood fructose are maintained independent of dietary fructose, KHK, and GLUT5, probably by endogenous synthesis of fructose. KHK prevents hyperfructosemia and fructose-induced hyperglycemia that would markedly increase HbA1c levels. These findings explain the hyperfructosemia of human hereditary fructosuria as well as the hyperglycemia of fructose-induced metabolic syndrome. PMID:26316589

BSD Portals for LINUX 2.0

Science.gov (United States)

McNab, A. David; woo, Alex (Technical Monitor)

1999-01-01

Portals, an experimental feature of 4.4BSD, extend the file system name space by exporting certain open () requests to a user-space daemon. A portal daemon is mounted into the file name space as if it were a standard file system. When the kernel resolves a pathname and encounters a portal mount point, the remainder of the path is passed to the portal daemon. Depending on the portal "pathname" and the daemon's configuration, some type of open (2) is performed. The resulting file descriptor is passed back to the kernel which eventually returns it to the user, to whom it appears that a "normal" open has occurred. A proxy portalfs file system is responsible for kernel interaction with the daemon. The overall effect is that the portal daemon performs an open (2) on behalf of the kernel, possibly hiding substantial complexity from the calling process. One particularly useful application is implementing a connection service that allows simple scripts to open network sockets. This paper describes the implementation of portals for LINUX 2.0.

FDG-avid portal vein tumor thrombosis from hepatocellular carcinoma in contrast-enhanced FDG PET/CT

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Canh Nguyen

2015-01-01

Full Text Available Objective(s: In this study, we aimed to describe the characteristics of portal vein tumor thrombosis (PVTT, complicating hepatocellular carcinoma (HCC in contrast-enhanced FDG PET/CT scan. Methods: In this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT, which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET scan. PET and CT DICOM images of patients were imported into the PET/CT imaging system for the re-analysis of contrast enhancement and FDG uptake in thrombus, the diameter of the involved portal vein, and characteristics of liver tumors and metastasis. Results: Two patients with previously untreated HCC and 7 cases with previously treated HCC had FDG-avid PVTT in contrast-enhanced FDG PET/CT scan. During the arterial phase of CT scan, portal vein thrombus showed contrast enhancement in 8 out of 9 patients (88.9%. PET scan showed an increased linear FDG uptake along the thrombosed portal vein in all patients. The mean greatest diameter of thrombosed portal veins was 1.8 ± 0.2 cm, which was significantly greater than that observed in normal portal veins (P<0.001. FDG uptake level in portal vein thrombus was significantly higher than that of blood pool in the reference normal portal vein (P=0.001. PVTT was caused by the direct extension of liver tumors. All patients had visible FDG-avid liver tumors in contrast-enhanced images. Five out of 9 patients (55.6% had no extrahepatic metastasis, 3 cases (33.3% had metastasis of regional lymph nodes, and 1 case (11.1% presented with distant metastasis. The median estimated survival time of patients was 5 months. Conclusion: The intraluminal filling defect consistent with thrombous within the portal vein, expansion of the involved portal vein, contrast enhancement, and linear increased FDG uptake of the thrombus extended from liver tumor are

Predictive model of portal venous system thrombosis in cirrhotic portal hypertensive patients after splenectomy

OpenAIRE

He, Shasha; He, Fangping

2015-01-01

Objective: This study is to investigate the risk factors of portal venous system thrombosis (PVT) in patients with cirrhotic portal hypertension after splenectomy and to establish a Logistic regression prediction model. Methods: A total of 119 patients with cirrhotic portal hypertension were enrolled. Their clinical data was retrospectively analyzed. They were divided into PVT group (n = 18) and non-PVT group (n = 101). One-way analysis and multivariate Logistic regression analysis were perfo...

Quantitative vs. subjective portal verification using digital portal images

International Nuclear Information System (INIS)

Bissett, Randy; Leszczynski, Konrad; Loose, Stephen; Boyko, Susan; Dunscombe, Peter

1996-01-01

Purpose: Off-line, computer-aided prescription (simulator) and treatment (portal) image registration using chamfer matching has been implemented on PC based viewing station. The purposes of this study were (a) to evaluate the performance of interactive anatomy and field edge extraction and subsequent registration, and (b) to compare observer's perceptions of field accuracy with measured discrepancies following anatomical registration. Methods and Materials: Prescription-treatment image pairs for 48 different patients were examined in this study. Digital prescription images were produced with the aid of a television camera and a digital frame grabber, while the treatment images were obtained directly from an on-line portal imaging system. To facilitate perception of low contrast anatomical detail, on-line portal images were enhanced with selective adaptive histogram equalization prior to extraction of anatomical edges. Following interactive extraction of anatomical and field border information by an experienced observer, the identified anatomy was registered using chamber matching. The degree of conformity between the prescription and treatment fields was quantified using several parameters, which included relative prescription field coverage and overcoverage, as well as the translational and rotational displacements as measured by chamfer matching applied to the boundaries of the two fields. These quantitative measures were compared with subjective evaluations made by four radiation oncologists. Results: All the images in this series that included a range of the most commonly seen treatment sites were registered and the conformity parameters were found. The mean treatment/prescription field coverage and overcoverage were approximately 95 and 7%, respectively before registration. The mean translational displacement in the transverse and cranio-caudal directions were 2.9 and 3.4 mm, respectively. The mean rotational displacement was approximately 2 deg. . For all

IgG4-related Hypophysitis with Subtle Hypopituitarism in an Elderly Diabetic Patient: Is Treatment or Observation Preferable?

Science.gov (United States)

Kawasaki, Motoki; Tsujino, Motoyoshi; Sato, Fuminori; Sakurada, Maya; Nishida, Kenji; Kise, Takayasu; Hijioka, Yuko; Ishizawa, Mitsugu; Enatsu, Kazuaki; Ogawa, Yoshihiro

2017-10-15

A 70-year-old man with diabetes mellitus presented with an enlarged pituitary stalk in 2014. IgG4-related parotitis and submandibular sialoadenitis were diagnosed in 2012. He denied any symptoms related to a pituitary mass. His visual field was intact, and his hypopituitarism was subtle. The serum IgG4 level was elevated. A lip biopsy revealed strong fibrosis and hyper-infiltration of IgG4-positive plasma cells. Based on these findings, IgG4-related hypophysitis was diagnosed. The patient was carefully followed without specific intervention. His clinical condition showed no change until December 2016, suggesting a stable, natural course. Care should be taken when considering glucocorticoid therapy, especially for elderly diabetic patients, given possible side effects.

Portal monitoring technology control process

International Nuclear Information System (INIS)

York, R.L.

1998-01-01

Portal monitors are an important part of the material protection, control, and accounting (MPC and A) programs in Russia and the US. Although portal monitors are only a part of an integrated MPC and A system, they are an effective means of controlling the unauthorized movement of special nuclear material (SNM). Russian technical experts have gained experience in the use of SNM portal monitors from US experts ad this has allowed them to use the monitors more effectively. Several Russian institutes and companies are designing and manufacturing SNM portal monitors in Russia. Interactions between Russian and US experts have resulted in improvements to the instruments. SNM portal monitor technology has been effectively transferred from the US to Russia and should be a permanent part of the Russian MPC and A Program. Progress in the implementation of the monitors and improvements to how they are used are discussed

Hand-assisted laparoscopic Hassab's procedure for esophagogastric varices with portal hypertension.

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Kobayashi, Takashi; Miura, Kohei; Ishikawa, Hirosuke; Soma, Daiki; Zhang, Zhengkun; Ando, Takuya; Yuza, Kizuki; Hirose, Yuki; Katada, Tomohiro; Takizawa, Kazuyasu; Nagahashi, Masayuki; Sakata, Jun; Kameyama, Hitoshi; Wakai, Toshifumi

2017-10-23

Laparoscopic surgery for patients with portal hypertension is considered to be contraindicated because of the high risk of massive intraoperative hemorrhaging. However, recent reports have shown hand-assisted laparoscopic surgery for devascularization and splenectomy to be a safe and effective method of treating esophagogastric varices with portal hypertension. The aim of this study is to evaluate the efficacy of hand-assisted laparoscopic devascularization and splenectomy (HALS Hassab's procedure) for the treatment of esophagogastric varices with portal hypertension. From 2009 to 2016, seven patients with esophagogastric varices with portal hypertension were treated with hand-assisted laparoscopic devascularization and splenectomy in our institute. Four men and three women with a median age of 61 years (range 35-71) were enrolled in this series. We retrospectively reviewed the medical records for the perioperative variables, postoperative mortality and morbidity, and postoperative outcomes of esophagogastric varices. The median operative time was 455 (range 310-671) min. The median intraoperative blood loss was 695 (range 15-2395) ml. The median weight of removed spleen was 507 (range 242-1835) g. The conversion rate to open surgery was 0%. The median postoperative hospital stay was 21 (range 13-81) days. During a median 21 (range 3-43) months of follow-up, the mortality rate was 0%. Four postoperative complications (massive ascites, enteritis, intra-abdominal abscess, and intestinal ulcer) were observed in two patients. Those complications were treated successfully without re-operation. Esophagogastric varices in all patients disappeared or improved. Bleeding from esophagogastric varices was not observed during the follow-up period. Although our data are preliminary, hand-assisted laparoscopic devascularization and splenectomy proved an effective procedure for treating esophagogastric varices in patients with portal hypertension.

An automated portal verification system for the tangential breast portal field

International Nuclear Information System (INIS)

Yin, F.-F.; Lai, W.; Chen, C. W.; Nelson, D. F.

1995-01-01

Purpose/Objective: In order to ensure the treatment is delivered as planned, a portal image is acquired in the accelerator and is compared to the reference image. At present, this comparison is performed by radiation oncologists based on the manually-identified features, which is both time-consuming and potentially error-prone. With the introduction of various electronic portal imaging devices, real-time patient positioning correction is becoming clinically feasible to replace time-delayed analysis using films. However, this procedure requires present of radiation oncologists during patient treatment which is not cost-effective and practically not realistic. Therefore, the efficiency and quality of radiation therapy could be substantially improved if this procedure can be automated. The purpose of this study is to develop a fully computerized verification system for the radiation therapy of breast cancer for which a similar treatment setup is generally employed. Materials/Methods: The automated verification system involves image acquisition, image feature extraction, feature correlation between reference and portal images, and quantitative evaluation of patient setup. In this study, a matrix liquid ion-chamber EPID was used to acquire digital portal images which is directly attached to Varian CL2100C accelerator. For effective use of computation memory, the 12-bit gray levels in original portal images were quantized to form a range of 8-bit gray levels. A typical breast portal image includes three important components: breast and lung tissues in the treatment field, air space within the treatment field, and non-irradiated region. A hierarchical region processing technique was developed to separate these regions sequentially. The inherent hierarchical features were formulated based on different radiation attenuation for different regions as: treatment field edge -- breast skin line -- chest wall. Initially, a combination of a Canny edge detector and a constrained

Treatment of chronic portal-systemic encephalopathy with lactose in lactase-deficient patients.

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Uribe, M; Márquez, M A; García-Ramos, G; Escobedo, V; Murillo, H; Guevara, L; Lisker, R

1980-12-01

A controlled cross-over clinical comparison of lactose (50 g twice a day) versus neomycin (3 g/day) plus milk of magnesia, was carried out in ten cirrhotic patients with chronic portal-systemic encephalopathy and documented lactase deficiency. Serial semiquantitative assessments were done including: mental state, asterixis, number connection test, electroencephalogram, and blood ammonia levels. No patient developed deep coma while ingesting either lactose or neomycin plus milk of magnesia. However, a significant improvement of mental state, asterixis, number connection tests, and electroencephalograms was evident during lactose therapy. apart from mild diarrhea and bloating, no severe side effects were noticeable during lactose treatment. Based on these results, we propose lactose as a valuable alternate treatment of portal-systemic encephalopathy in lactase-deficient populations.

Effectiveness of the double interventional therapy for portal hypertension in liver cirrhosis

International Nuclear Information System (INIS)

Du Wei; Chen Lei; Yuan Guibin; Ouyang Tianzhao; Duan Wenshuai

2011-01-01

Objective: To assess the value of double interventional therapy for upper gastrointestinal bleeding and hypersplenism caused by portal hypertension. Methods: 32 patients with upper gastrointestinal bleeding and hypersplenism due to portal hypertension in liver cirrhosis were enrolled in the study. Ultrasound-guided percutaneous punctures of both the intrahepatic portal varices and femoral artery were performed on all patients. The catheters were inserted into the vena coronaria ventriculi and branches of splenic artery selectively and then embolized using mixture of alcohol, gelatin sponge and metal coin. Results: The overall success rate of percutaneous transhepatic variceal puncture was 100% with single puncture in 66% and the success rate of embolization was 100%. Partial splenic artery embolization was performed involving 40%-70% of the vascular lumen. White blood cell and platelet counts increased significantly 24 hours and 1 week after embolization. The cumulative incidences of rebleeding were 0, 3.1%, 12.5%, 25% and 31.3% in the 1 month, 6 month, 1 year, 2 year and follow-up respectively. Causes of recurrent bleeding included varices rupture (26.1%), portal hypertensive gastropathy (56.5%), and peptic ulcer (17.4%). All of the patients had various degrees of fever, abdominal pain, nausea and vomiting after embolization. These symptoms subsided without further complications. Conclusion: The double interventional approach is useful in the treatment of upper digestive tract hemorrhage and hypersplenism from portal hypertension. The method is relatively simple with low invasiveness especially for patients with poor liver function who cannot tolerate surgical shunt and de-vascularization operation. (authors)

Health literacy and patient portals.

Science.gov (United States)

Gu, Yulong; Orr, Martin; Warren, Jim

2015-06-01

Health literacy has been described as the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Improving health literacy may serve to promote concordance with therapy, engage patients in their own health care, and improve health outcomes. Patient portal technology aims at enabling patients and families to have easy access to key information in their own medical records and to communicate with their health care providers electronically. However, there is a gap in our understanding of how portals will improve patient outcome. The authors believe patient portal technology presents an opportunity to improve patient concordance with prescribed therapy, if adequate support is provided to equip patients (and family/carers) with the knowledge needed to utilise the health information available via the portals. Research is needed to understand what a health consumer will use patient portals for and how to support a user to realise the technology's potential.

Knowledge Portals: Ontologies at Work

OpenAIRE

Staab, Steffen; Maedche, Alexander

2001-01-01

Knowledge portals provide views onto domain-specific information on the World Wide Web, thus helping their users find relevant, domain-specific information. The construction of intelligent access and the contribution of information to knowledge portals, however, remained an ad hoc task, requiring extensive manual editing and maintenance by the knowledge portal providers. To diminish these efforts, we use ontologies as a conceptual backbone for providing, accessing, and structuring information...

On line portal imaging

International Nuclear Information System (INIS)

Munro, Peter

1995-01-01

Purpose/Objective: The purpose of this presentation is to review the physics of imaging with high energy x-ray beams; examine the various imaging devices that have been developed for portal imaging; describe some of the image registration methods that have been developed to determine errors in patient positioning quantitatively; and discuss some of the ways that portal imaging has been incorporated into routine clinical practice. Verification of patient positioning has always been an important aspect of external beam radiation therapy. Checks of patient positioning have generally been done with film, however, film suffers from a number of drawbacks, such as poor image display and delays due to film development. Over the past decade many portal imaging devices have been developed by individual investigators and most accelerator manufacturers now offer 'on-line' portal imaging systems, which are intended to overcome the limitations of portal films. The commercial devices can be classified into three categories: T.V. camera-based systems, liquid ionisation chamber systems, and amorphous silicon systems. Many factors influence the quality of images generated by these portal imaging systems. These include factors which are unavoidable (e.g., low subject contrast), factors which depend upon the individual imaging device forming the image (e.g., dose utilisation, spatial resolution) as well as factors which depend upon the characteristics of the linear accelerator irradiating the imaging system (x-ray source size, image magnification). The fundamental factors which limit image quality and the characteristics of individual imaging systems, such as spatial resolution, temporal response, and quantum utilisation will be discussed. One of the major advantages of on-line portal imaging is that many quantitative techniques have been developed to detect errors in patient positioning. The general approach is to register anatomic structures on a portal image with the same

Pregnancy with Portal Hypertension

Science.gov (United States)

Aggarwal, Neelam; Negi, Neha; Aggarwal, Aakash; Bodh, Vijay; Dhiman, Radha K.

2014-01-01

Even though pregnancy is rare with cirrhosis and advanced liver disease, but it may co-exist in the setting of non-cirrhotic portal hypertension as liver function is preserved but whenever encountered together is a complex clinical dilemma. Pregnancy in a patient with portal hypertension presents a special challenge to the obstetrician as so-called physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing fetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal hemorrhage. Risks of variceal bleed and hepatic decompensation increase many fold during pregnancy. Optimal management revolves round managing the portal hypertension and its complications. Thus management of such cases requires multi-speciality approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anesthetists and neonatologists. With advancement in medical field, pregnancy is not contra-indicated in these women, as was previously believed. This article focuses on the different aspects of pregnancy with portal hypertension with special emphasis on specific cause wise treatment options to decrease the variceal bleed and hepatic decompensation. Based on extensive review of literature, management from pre-conceptional period to postpartum is outlined in order to have optimal maternal and perinatal outcomes. PMID:25755552

Association between portal vein pressure drop gradient after transjugular intrahepatic portosystemic shunt and clinical prognosis

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XU Zhengguo

2016-12-01

Full Text Available ObjectiveTo investigate the association between portal vein pressure drop gradient in patients with cirrhotic portal hypertension treated by transjugular intrahepatic portosystemic shunt (TIPS and clinical prognosis, as well as the ideal range of portal vein pressure drop. MethodsA total of 58 patients who underwent TIPS in Xinqiao Hospital of Third Military Medical University from November 2013 to December 2015 were enrolled. All the patients underwent TIPS and embolization of the gastric coronary vein and the short gastric veins, and the change intervals of portal vein pressure gradient were monitored. The follow-up time ranged from 3 days to 2 years, and the association of portal vein pressure drop gradient with postoperative liver function, splenic function, rebleeding rate, hepatic encephalopathy, and portal hypertensive gastrointestinal diseases was analyzed. The paired t-test was used for comparison of parameters before and after treatment. ResultsThe patients had a significant reduction in liver function on day 3 after surgery. At 2 month after surgery, the levels of TBil was rised and had significant changes［(49.81±27.82μmol/L vs (31.64±17.67 μmol/L,t=5.372,P＜0.001］. At 6 months after surgery, red blood cell count and platelet count had no significant changes，but，white blood cell count was reduced［(3.79±1.37）×109/L vs (4.57±2.24×109/L，t=2.835，P=0.006］. There was a 23% reduction in portal vein pressure after surgery (from 30.62±3.56 mmHg before surgery to 21.21±2.90 mmHg after surgery, t=23.318，P＜0.001. All the patients had varying degrees of relief of gastrointestinal symptoms associated with portal vein hypertension, such as abdominal distension, poor appetite, and diarrhea. Of all patients, none experienced in-stent restenosis or occlusion and 13 experienced hepatic encephalopathy after surgery, which tended to occur at the time when postoperative portal vein pressure was reduced to 14.7-25.7 mmHg, i

Portal vein stenting for delayed jejunal varix bleeding associated with portal venous occlusion after hepatoiliary and pancreatic surgery

Energy Technology Data Exchange (ETDEWEB)

Hyun, Dong Ho; Park, Kwang Bo; Cho, Sung Ki; Park, Hong Suk; Shin, Sung Wook; Choo, Sung Wook; Do, Young Soo; Choo, In Wook; Choi, Dong Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2017-09-15

The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.

Portal vein stenting for delayed jejunal varix bleeding associated with portal venous occlusion after hepatoiliary and pancreatic surgery

International Nuclear Information System (INIS)

Hyun, Dong Ho; Park, Kwang Bo; Cho, Sung Ki; Park, Hong Suk; Shin, Sung Wook; Choo, Sung Wook; Do, Young Soo; Choo, In Wook; Choi, Dong Wook

2017-01-01

The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery

Hypophysitis following Treatment with Ustekinumab: Radiological and Pathological Findings

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Ana M. Ramos-Leví

2018-03-01

Full Text Available ContextUstekinumab is a human IgG1 monoclonal antibody that targets interleukin (IL-12 and IL-23, which may be useful in the treatment of autoimmune conditions such as psoriasis, psoriatic arthritis, and Crohn’s disease. Hypophysitis is an immune-derived inflammatory condition of the pituitary gland that may lead to pituitary dysfunction. With the increasing use of immunotherapy, it is possible that this and other new immune-related adverse events (IRAEs arise, although the mechanisms involved are still incompletely defined.Case descriptionA 35-year-old male, with a previous history of severe plaque-psoriasis who had started treatment with ustekinumab 4 months before, complained of progressive and persistent headache. Brain magnetic resonance imaging (MRI was unremarkable. One year later, a new MRI was performed due to headache persistence, which revealed a homogenous and diffuse pituitary enlargement, with suprasellar extension and optic chiasm involvement, blurring of the pituitary stalk, absence of clear differentiation between the anterior and posterior lobes, and no signs of hemorrhage or adenomas. Endocrine evaluation was consistent with panhypopituitarism. Work-up of infiltrative and infectious diseases was negative. Follow-up MRI revealed an increase in the pituitary enlargement and transsphenoidal surgery was performed. Pathological findings revealed an intense fibrosis and a chronic inflammatory infiltrate, but no evidence of adenoma, granuloma, or acid fast bacilli. Immunohistochemical staining showed a combined T-cell (CD3+, CD4+ and B-cell (CD19+, CD20+ phenotype.ConclusionWe suggest a novel IRAE of ustekinumab, with full radiological and immunopathological iconography, which may be mediated by the complex interaction between different immunological processes.

TMEM16A regulates portal vein smooth muscle cell proliferation in portal hypertension.

Science.gov (United States)

Zeng, Xi; Huang, Ping; Chen, Mingkai; Liu, Shiqian; Wu, Nannan; Wang, Fang; Zhang, Jing

2018-01-01

The aim of the present study was to elucidate the effect of transmembrane protein 16A (TMEM16A) on portal vein smooth muscle cell (PVSMC) proliferation associated with portal vein remodeling in portal hypertension (PHT). Sprague-Dawley rats were subjected to bile duct ligation to establish a rat model of liver cirrhosis and PHT. Sham-operated animals served as controls. At 8 weeks after bile duct ligation, the extent of liver fibrosis and the portal vein wall thickness were assessed using hematoxylin-eosin staining. The protein expression levels of TMEM16A, extracellular signal-regulated kinase 1 and 2 (ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2) in the portal vein were detected by immunohistochemistry and western blotting. In vitro , the lentivirus vectors were constructed and transfected into PVSMCs to upregulate the expression of TMEM16A. Isolated rat primary PVSMCs were treated with a small molecule inhibitor of TMEM16A, T16A-inhA01. Cell cycle was detected by flow cytometry. The activity of TMEM16A in the portal vein isolated from bile duct ligated rats was decreased, while the expression level of p-ERK1/2 was increased. However, in vitro , upregulation of TMEM16A promoted the proliferation PVSMCs, while inhibition of TMEM16A channels inhibited the proliferation of PVSMCs. The results indicated that TMEM16A contributes to PVSMCs proliferation in vitro , but in vivo , it may be a negative regulator of cell proliferation influenced by numerous factors.

Morphological and biomechanical remodeling of the hepatic portal vein in a swine model of portal hypertension.

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He, Xi-Ju; Huang, Tie-Zhu; Wang, Pei-Jun; Peng, Xing-Chun; Li, Wen-Chun; Wang, Jun; Tang, Jie; Feng, Na; Yu, Ming-Hua

2012-02-01

To obtain the morphological and biomechanical remodeling of portal veins in swine with portal hypertension (PHT), so as to provide some mechanical references and theoretical basis for clinical practice about PHT. Twenty white pigs were used in this study, 14 of them were subjected to both carbon tetrachloride- and pentobarbital-containing diet to induce experimental liver cirrhosis and PHT, and the remaining animals served as the normal controls. The morphological remodeling of portal veins was observed. Endothelial nitric oxide synthase expression profile in the vessel wall was assessed at both mRNA and protein level. The biomechanical changes of the hepatic portal veins were evaluated through assessing the following indicators: the incremental elastic modulus, pressure-strain elastic modulus, volume elastic modulus, and the incremental compliance. The swine PHT model was successfully established. The percentages for the microstructural components and the histological data significantly changed in the experimental group. Endothelial nitric oxide synthase expression was significantly downregulated in the portal veins of the experimental group. Three incremental elastic moduli (the incremental elastic modulus, pressure-strain elastic modulus, and volume elastic modulus) of the portal veins from PHT animals were significantly larger than those of the controls (P portal vein decreased. Our study suggests that the morphological and biomechanical properties of swine hepatic portal veins change significantly during the PHT process, which may play a critical role in the development of PHT and serve as potential therapeutic targets during clinical practice. Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

Web-based Service Portal in Healthcare

Science.gov (United States)

Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

Information delivery is one the most important task in healthcare. The growing sector of electronic healthcare has an important impact on the information delivery. There are two basic approaches towards information delivering. The first is web portal and second is touch-screen terminal. The aim of this paper is to investigate the web-based service portal. The most important advantage of web-based portal in the field of healthcare is an independent access for patients. This paper deals with the conditions and frameworks for healthcare portals

Portal hyperflow in patients with hepatosplenic mansonic schistosomiasis Hiperfluxo portal na forma hepatosplênica da esquistossomose mansônica

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Roberto de Cleva

2004-02-01

Full Text Available PURPOSE: The purpose of this study was to assess portal hemodynamics in patients with portal hypertension due to hepatosplenic schistosomiasis as well as to assess the contribution of splanchnic hyperflow to the pathophysiology of the portal hypertension. METHODS: Sixteen patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophageal varices rupture underwent elective esophagogastric devascularization and splenectomy and were prospectively studied. All patients underwent intraoperative invasive hemodynamic portal monitoring with a 4F-thermodilution catheter. The intraoperative portal hemodynamic assessment was conducted after laparotomy (initial and after esophagogastric devascularization (final. RESULTS: The initial portal pressure was elevated (mean 28.5 ± 4.5 mm Hg, and a significant drop of 25% was observed at the end of the surgery (21.9 ± 4.9 mm Hg. The initial portal flow was elevated (mean 1766.9 ± 686.6 mL/min. A significant fall (42% occurred at the end of the surgical procedure (1025.62 ± 338.7 mL/min. Fourteen patients (87.5% presented a portal flow of more than 1200 mL/min, and in 5 cases, values greater than 2000 mL/min were observed. CONCLUSIONS: Esophagogastric devascularization and splenectomy promote a significant reduction of the elevated portal pressure and flow in schistosomal portal hypertension. These data favor the hypothesis of portal hyperflow in the physiopathology of portal hypertension of schistosomiasis.OBJETIVOS: o objetivo do presente estudo é estudar a hemodinâmica portal em pacientes com hipertensão portal secundária a forma hepatoesplênica da esquistossomose e avaliar a contribuição do hiperfluxo esplênico na sua fisiopatologia CASUÍSTICA E MÉTODOS: Foram estudados prospectivamente 16 pacientes portadores de hipertensão portal secundária à forma hepatoesplênica da esquistossomose mansônica com indicação de tratamento cirúrgico. Todos foram

Intelligent interaction based on holographic personalized portal

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Yadong Huang

2017-06-01

Full Text Available Purpose – The purpose of this paper is to study the architecture of holographic personalized portal, user modeling, commodity modeling and intelligent interaction. Design/methodology/approach – In this paper, the authors propose crowd-science industrial ecological system based on holographic personalized portal and its interaction. The holographic personality portal is based on holographic enterprises, commodities and consumers, and the personalized portal consists of accurate ontology, reliable supply, intelligent demand and smart cyberspace. Findings – The personalized portal can realize the information acquisition, characteristic analysis and holographic presentation. Then, the intelligent interaction, e.g. demand decomposition, personalized search, personalized presentation and demand prediction, will be implemented within the personalized portal. Originality/value – The authors believe that their work on intelligent interaction based on holographic personalized portal, which has been first proposed in this paper, is innovation focusing on the interaction between intelligence and convenience.

Radioisotopic evaluation of portal circulation

International Nuclear Information System (INIS)

Maliska, C.; Rosenthal, D.

1986-01-01

The use of a radio-tracer of portal circulation through the intestine, should prevent cruel punctures in the portal-vein or spleen as it is usually the case with traditional methods in the study of portal-system. The absorption of I-131 and Tc-99m, previously cheked in rabbits presented similar results in dogs. The time of circulation between terminal large-intestine and the liver (t-RF) was determined by external counting at hepatic level by recording radioactivity variation-time. In healthy animals the t-RF was from 20to 60 seconds, with average time of 42 seconds. In 2 animals with partial binding of portal-vein the t-RF went up to 110 and 120 seconds. (Author) [pt

Study of a new method for the evaluation of portal vein pressure by hepatic perfusion imaging

International Nuclear Information System (INIS)

Cheng Muhua; Ling Yunbiao; Pan Zhiheng; Zhang Feng; Chen Weizhen

2002-01-01

To study a new method for predication of portal vein pressure (PVP) by hepatic perfusion imaging. 25 hepato-cirrhotic cases and 13 normal controls were performed the hepatic perfusion imaging. According to two compartmental model the values of portal vein indexes (PVI) was calculated using curve slope, area and hepatic heart perfusion ratio methods etc. The relationship of PVI with different method to PVP was also observed. All PVI by three methods in hepatocirrhosis were higher than those in normal controls (P<0.01), and also positively correlated with the PVP, their correlated coefficients was 0.79, 0.60, 0.68 respectively. Among them the slope method was most markedly significant than normal control and closely correlated with PVP. PVI can sensitively reflect the changes of portal vein blood flow. And it was an atraumatic, simple method for the evaluation of PVP

The Coexistence of an Intrasellar Adenoma, Lymphocytic Hypophysitis, and Primary Pituitary Lymphoma in a Patient with Acromegaly

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Jose Hernan Martinez

2011-01-01

Full Text Available The concomitant presence of three histopathologically different entities in the pituitary gland is a rare occurrence. Most publications identify at least two distinct pathologies, mainly, a pituitary adenoma coexisting with a second intrasellar lesion. We present a case of a 71-year-old female referred for evaluation and treatment of acromegaly. Questioning revealed she was experiencing facial palsy, visual disturbances, and syncopal spells for several weeks. When laboratory evaluation showed elevated somatomedin (IGF-I levels and an oral glucose tolerance test failed to demonstrate any suppression of her growth hormone (GH values, an MRI of the pituitary revealed a sellar mass. A presumptive diagnosis of pituitary adenoma was established. The patient underwent transsphenoidal resection of the sellar mass, which proved to be a large B-cell lymphoma (Stage I-E associated with areas of adenoma and lymphocytic hypophysitis.

Radiation portal evaluation parameters

International Nuclear Information System (INIS)

York, R.L.

1998-01-01

The detection of the unauthorized movement of radioactive materials is one of the most effective nonproliferation measures. Automatic special nuclear material (SNM) portal monitors are designed to detect this unauthorized movement and are an important part of the safeguard systems at US nuclear facilities. SNM portals differ from contamination monitors because they are designed to have high sensitivity for the low energy gamma-rays associated with highly enriched uranium (HEU) and plutonium. These instruments are now being installed at international borders to prevent the spread of radioactive contamination an SNM. In this paper the parameters important to evaluating radiation portal monitors are discussed. (author)

ELECTRONIC COMMERCE PORTAL

OpenAIRE

Georgeta Soava

2011-01-01

Today companies are faced with the need to exploit technology changing computer environments, in order to improve customer satisfaction and reduce costs. A successful approach to electronic portals is an effective demonstration of the new ways of relating to the client. The objectives that we have considered for the realization of e-commerce portal can be summarized as follows: structured communication, effective collaboration, complet and closed circuit of orders and deliveries, inventory op...

Splenic artery ligature associated with endoscopic banding for schistosomal portal hypertension.

Science.gov (United States)

Colaneri, Renata Potonyacz; Coelho, Fabrício Ferreira; de Cleva, Roberto; Perini, Marcos Vinícius; Herman, Paulo

2014-11-28

To propose a less invasive surgical treatment for schistosomal portal hypertension. Ten consecutive patients with hepatosplenic schistosomiasis and portal hypertension with a history of upper gastrointestinal hemorrhage from esophageal varices rupture were evaluated in this study. Patients were subjected to a small supraumbilical laparotomy with the ligature of the splenic artery and left gastric vein. During the procedure, direct portal vein pressure before and after the ligatures was measured. Upper gastrointestinal endoscopy was performed at the 30(th) postoperative day, when esophageal varices diameter were measured and band ligature performed. During follow-up, other endoscopic procedures were performed according to endoscopy findings. There was no intra-operative mortality and all patients had confirmed histologic diagnoses of schistosomal portal hypertension. During the immediate postoperative period, two of the ten patients had complications, one characterized by a splenic infarction, and the other by an incision hematoma. Mean hospitalization time was 4.1 d (range: 2-7 d). Pre- and post-operative liver function tests did not show any significant changes. During endoscopy thirty days after surgery, a decrease in variceal diameters was observed in seven patients. During the follow-up period (57-72 mo), endoscopic therapy was performed and seven patients had their varices eradicated. Considering the late postoperative evaluation, nine patients had a decrease in variceal diameters. A mean of 3.9 endoscopic banding sessions were performed per patient. Two patients presented bleeding recurrence at the late postoperative period, which was controlled with endoscopic banding in one patient due to variceal rupture and presented as secondary to congestive gastropathy in the other patient. Both bleeding episodes were of minor degree with no hemodynamic consequences or need for blood transfusion. Ligature of the splenic artery and left gastric vein with supraumbilical

Combination therapy using PSE and TIO ameliorates hepatic encephalopathy due to intrahepatic portosystemic venous shunt in idiopathic portal hypertension

International Nuclear Information System (INIS)

Kojima, Seiichiro; Ito, Hiroyuki; Takashimizu, Shinji; Ichikawa, Hitoshi; Matsumoto, Tomohiro; Hasebe, Terumitsu; Watanabe, Norihito

2016-01-01

A 64-year-old woman treated for anemia and ascites exhibited hepatic encephalopathy. Abdominal ultrasonography and computed tomography (CT) showed communication between the portal vein and the middle hepatic vein, indicating an intrahepatic portosystemic venous shunt (PSS). Since hepatic encephalopathy of the patient was resistant to medical treatment, interventional radiology was performed for the treatment of shunt obliteration. Hepatic venography showed anastomosis between the hepatic vein branches, supporting the diagnosis of idiopathic portal hypertension (IPH). To minimize the increase in portal vein pressure after shunt obliteration, partial splenic artery embolization (PSE) was first performed to reduce portal vein blood flow. Transileocolic venous obliteration (TIO) was then performed, and intrahepatic PSS was successfully obliterated using coils with n-butyl-2-cyanoacrylate (NBCA). In the present case, hepatic encephalopathy due to intrahepatic PSS in the patient with IPH was successfully treated by combination therapy using PSE and TIO

Pathology of idiopathic non-cirrhotic portal hypertension.

Science.gov (United States)

Guido, Maria; Sarcognato, Samantha; Sacchi, Diana; Colloredo, Guido

2018-04-12

Idiopathic non-cirrhotic portal hypertension is an under-recognized vascular liver disease of unknown etiology, characterized by clinical signs of portal hypertension in the absence of cirrhosis. By definition, any disorder known to cause portal hypertension in the absence of cirrhosis and any cause of chronic liver disease must be excluded to make a diagnosis of idiopathic non-cirrhotic portal hypertension. However, the diagnosis is often difficult because the disease resembles cirrhosis and there is no gold standard test. Liver biopsy is an essential tool: it is able to exclude cirrhosis and other causes of portal hypertension and it allows the identification of the characteristic lesions. Nonetheless, the histological diagnosis of idiopathic non-cirrhotic portal hypertension is not always straightforward, in particular by needle biopsy samples, because there is no pathognomonic lesion, but rather a variety of vascular changes which are unevenly distributed, very subtle, and not all necessarily identified in a single specimen. Pathologists should be able to recognize several patterns of injury, involving portal/periportal areas as well as parenchymal structures.The histological features of idiopathic non-cirrhotic portal hypertension are described in this review, focusing on their interpretation in needle biopsy specimens.

[THE STATE OF HEPATIC AND SPLANCHNIC BLOOD FLOW IN VARIOUS TYPES OF COMPLICATED PANCREATIC PSEUDOCYSTS].

Science.gov (United States)

Kryvoruchko, I A; Goncharova, N M; Andreyeshchev, S A; Yavorska, T P

2015-05-01

Investigations were conducted in 37 patients, suffering complicated pancreatic pseudocysts. In accordance to data of ultrasound Doppler flowmetry for the blood flow along portal vein, a. hepatis communis, a. mesenterica superior in complicated pancreatic pseudocysts compensatory--adaptive reactions on level of hepatic--spanchnic blood flow are directed towards restriction of the blood inflow through the portal vein system. This is accompanied by the common peripheral vascular resistence raising in basin of a. mesenterica superior, which have depended upon the patients' state severity, caused by reduction of the volume blood flow in a certan vascular collector. The oxygen debt of the liver in these patients is compensated by the volume blood flow enhancement along a. hepatis communis.

Patient portals and broadband internet inequality.

Science.gov (United States)

Perzynski, Adam T; Roach, Mary Joan; Shick, Sarah; Callahan, Bill; Gunzler, Douglas; Cebul, Randall; Kaelber, David C; Huml, Anne; Thornton, John Daryl; Einstadter, Douglas

2017-09-01

Patient portals have shown potential for increasing health care quality and efficiency. Internet access and other factors influencing patient portal use could worsen health disparities. Observational study of adults with 1 or more visits to the outpatient clinics of an urban public health care system from 2012 to 2015. We used mixed effects logistic regression to evaluate the association between broadband internet access and (1) patient portal initiation (whether a patient logged in at least 1 time) and (2) messaging, controlling for demographic and neighborhood characteristics. There were 243 248 adults with 1 or more visits during 2012-2015 and 70 835 (29.1%) initiated portal use. Portal initiation was 34.1% for whites, 23.4% for blacks, and 23.8% for Hispanics, and was lower for Medicaid (26.5%), Medicare (23.4%), and uninsured patients (17.4%) than commercially insured patients (39.3%). In multivariate analysis, both initiation of portal use (odds ratio [OR] = 1.24 per quintile, 95% confidence interval [CI], 1.23-1.24, P  internet access. The majority of adults with outpatient visits to a large urban health care system did not use the patient portal, and initiation of use was lower for racial and ethnic minorities, persons of lower socioeconomic status, and those without neighborhood broadband internet access. These results suggest the emergence of a digital divide in patient portal use. Given the scale of investment in patient portals and other internet-dependent health information technologies, efforts are urgently needed to address this growing inequality. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Novel Rat Model of Repetitive Portal Venous Embolization Mimicking Human Non-Cirrhotic Idiopathic Portal Hypertension

DEFF Research Database (Denmark)

Klein, Sabine; Hinüber, Christian; Hittatiya, Kanishka

2016-01-01

BACKGROUND: Non-cirrhotic idiopathic portal hypertension (NCIPH) is characterized by splenomegaly, anemia and portal hypertension, while liver function is preserved. However, no animal models have been established yet. This study assessed a rat model of NCIPH and characterized the hemodynamics......, and compared it to human NCIPH. METHODS: Portal pressure (PP) was measured invasively and coloured microspheres were injected in the ileocecal vein in rats. This procedure was performed weekly for 3 weeks (weekly embolization). Rats without and with single embolization served as controls. After four weeks (one...... in the weekly embolization group. Fibrotic markers αSMA and Desmin were upregulated in weekly embolized rats. DISCUSSION: This study establishes a model using repetitive embolization via portal veins, comparable with human NCIPH and may serve to test new therapies....

Idiopathic Noncirrhotic Portal Hypertension: An Appraisal

Science.gov (United States)

Lee, Hwajeong; Rehman, Aseeb Ur; Fiel, M. Isabel

2016-01-01

Idiopathic noncirrhotic portal hypertension is a poorly defined clinical condition of unknown etiology. Patients present with signs and symptoms of portal hypertension without evidence of cirrhosis. The disease course appears to be indolent and benign with an overall better outcome than cirrhosis, as long as the complications of portal hypertension are properly managed. This condition has been recognized in different parts of the world in diverse ethnic groups with variable risk factors, resulting in numerous terminologies and lack of standardized diagnostic criteria. Therefore, although the diagnosis of idiopathic noncirrhotic portal hypertension requires clinical exclusion of other conditions that can cause portal hypertension and histopathologic confirmation, this entity is under-recognized clinically as well as pathologically. Recent studies have demonstrated that variable histopathologic entities with different terms likely represent a histologic spectrum of a single entity of which obliterative portal venopathy might be an underlying pathogenesis. This perception calls for standardization of the nomenclature and formulation of widely accepted diagnostic criteria, which will facilitate easier recognition of this disorder and will highlight awareness of this entity. PMID:26563701

Interventional treatment of severe portal hypertension due to hepatolenticular degeneration: therapeutic evaluation of 8 cases

International Nuclear Information System (INIS)

Zhao Hongwei; Liu Fuquan; Yue Zhendong; Wang Lei

2011-01-01

Objective: To evaluate the therapeutic efficacy of sclerotic embolization of esophagogastric varices (SEEV) and partial splenic embolization (PSE) in treating esophagogastric varices and portal hypertension, respectively, in patients with hepatolenticular degeneration. Methods: Eight patients with severe portal hypertension complicated with upper gastrointestinal bleeding and hypersplenism were involved in this study. White blood cell (WBC) counts, platelet counts, and portal vein pressure were determined before and after operation, the results were compared with each other. Results: No recurrence or complication occurred after operation in all patients. After the treatment (SEEV and PSE) the hepatic function showed no obvious changes. The WBC counts increased obviously in the first week after operation, and returned to normal range in 2 weeks. The platelet counts gradually returned to normal level from the second week. The portal vein pressure after operation went up a little, from (45.13±8.69) cm H 2 O to (48.63±10.48) cm H 2 O in SEEV group and to (47.88±11.43) cm H 2 O in PSE group, but the difference was of no statistic significance (P>0.05). Conclusion: Interventional therapy can reduce the portal hypertension caused by hepatolenticular degeneration. The technique is safe and effective, and is very helpful for returning to anti-copper treatment. (authors)

Controversy and discussion on blood supply and interventional therapy of cavernous hemangiomas of the liver

International Nuclear Information System (INIS)

Ouyang Yong; Wang Ying; Ouyang Xuehui; Yu Ming

2004-01-01

Objective: To further explore the blood supply and interventional therapy of adult cavernous hemangiomas of the liver (CHL). Methods: Recently some authors reported that a satisfactory effect resulted from transcatheter portal venous embolization was obtained in few cases of CHL with blood supply of portal vein, and raised an objection to the standpoint that CHL was commonly supplied by hepatic artery completely. In order to get a scientific and reasonable explanation for it, this paper reviewed the vascular embryology and histology of the liver, the pathologic features of CHL as well as the relative literature, and combined with the investigation results of blood dynamic changes of CHL that had been performed in 2000-2002 by us. Results: CHL was caused by the arrested development of hepatic sinusoids at the embryonic stage. Pathologically, CHL was consisted of a lot of enlarged abnormal sinusoids,which were variant in size and closely related with the hemodynamic changes of CHL ( in inverse proportion). The CHL consisted of even and tiny abnormal sinusoids (diameter less than 50 μm) pathologically usually presented a high flow. During the hepatic artery angiography or CTHA, it was rapidly filled by the arterial blood containing contrast media and frequently showed dense opacification or enhancement. Simultaneously this could result in increased pressure of abnormal sinusoids. When the sinusoidal pressure exceeded that of the connecting portal venules, the arterial blood containing contrast media filled in the abnormal sinusoids could lead to retrograde flow in the portal venules. That was arterial-portal venous shunts (APVS). These appearances described as above could also occur in some CHL with intermediate flow, in which many tiny abnormal sinusoids located in the peripheral area were identified pathologically. On the contrary, the CHL consisted of larger abnormal sinusoids (diameter more than 500 μm) pathologically usually presented a low flow. During the

[Predictive value of ultrasonography in portal hypertension].

Science.gov (United States)

Moreno, E; Torres, P; Trejo, C; Barra Ostoni, V; Ortega, C; Römer, H

1991-01-01

Portal hypertension is a common pathology in childhood and one of its most common causes is cavernomatosis of the portal vein. This obstruction causes hemodynamic changes which lead to splenomegaly and collateral circulation. Esophageal varices are one of the most important sequelae, which endanger the patient's life because of a bleeding tendency. Ecosonography helps to detect the thickening of the lesser omentum vis a vis the aortic diameter, caused by the collateral circulation. We studied 15 children presenting with portal hypertension resulting from portal vein cavernomatosis; we performed an upper GI endoscopy and abdominal ecosonography. The endoscopy revealed grade II esophageal varices in 20% of cases, the remaining 80% had grade III and grade IV. Ecosonography revealed an increased lesser omentum/aorta ratio in children with portal hypertension, compared to controls (p portal hypertension.

Calculation of portal contribution to hepatic blood flow with 99mTc-microcolloids. A noninvasive method to diagnose liver graft rejection

International Nuclear Information System (INIS)

Martin-Comin, J.; Mora, J.; Figueras, J.; Puchal, R.; Jaurrieta, E.; Badosa, F.; Ramos, M.

1988-01-01

The portal contribution (PC) to hepatic blood flow was calculated in 13 liver graft patients and 13 normal volunteers. The method is based on the quantification and normalization of the liver and spleen activity after the administration of 7 mCi (259 MBq) of 99mTc microcolloid. Forty examinations were performed in liver grafts and 13 in normal subjects. The PC was significantly higher in normal native liver (64.0 +/- 3.0%) than in functioning grafts (58.8 +/- 3.1%). In acutely rejecting patients, PC was significantly lower (52.4 +/- 2.0%) than in functioning grafts and similar to that observed in cholangitis (53.5 +/- 0.7%). The PC increases again once rejection has resolved (57.3 +/- 2.6%). During hepatitis post-transplant PC values (59.7 +/- 3.4%) were similar to those observed in functioning grafts. Overall, PC values over 55% are very unlikely to be due to rejection

BRAZILIAN NEWS PORTALS CHARACTERISTICS

Directory of Open Access Journals (Sweden)

Heloiza G. Herckovitz

2011-02-01

Full Text Available A content analysis of four Brazilian news media portals found that economic news dominated the top headlines with little attention paid to education, the environment and welfare. Other trends included a focus on local events and national news sources, reliance on few sources, mostly official ones, and a low percentage of news that fitted the concept of newsworthiness (a combination of both social significance and deviance concepts. Other findings of a study of 432 top news stories published by UOL, Estadão, iG and Terra during a 15-day period between February and March 2008 indicate that the top portions of the portals’ front pages carry news that lacks story depth, editorial branding, and multimedia applications. The results suggest that online news portals are in their infancy although Brazil has the largest online population of Latin America. This study hopes to shed light on the gatekeeping process in Brazilian news portals. Brazilian media portals have yet to become a significant editorial force able to provide knowledge about social issues and public affairs in a socially responsible fashione.

Idiopathic noncirrhotic portal hypertension: current perspectives.

Science.gov (United States)

Riggio, Oliviero; Gioia, Stefania; Pentassuglio, Ilaria; Nicoletti, Valeria; Valente, Michele; d'Amati, Giulia

2016-01-01

The term idiopathic noncirrhotic portal hypertension (INCPH) has been recently proposed to replace terms, such as hepatoportal sclerosis, idiopathic portal hypertension, incomplete septal cirrhosis, and nodular regenerative hyperplasia, used to describe patients with a hepatic presinusoidal cause of portal hypertension of unknown etiology, characterized by features of portal hypertension (esophageal varices, nonmalignant ascites, porto-venous collaterals), splenomegaly, patent portal, and hepatic veins and no clinical and histological signs of cirrhosis. Physicians should learn to look for this condition in a number of clinical settings, including cryptogenic cirrhosis, a disease known to be associated with INCPH, drug administration, and even chronic alterations in liver function tests. Once INCPH is clinically suspected, liver histology becomes mandatory for the correct diagnosis. However, pathologists should be familiar with the histological features of INCPH, especially in cases in which histology is not only requested to exclude liver cirrhosis.

Profile of extrahepatic portal venous obstruction (ehpvo) in a tertiary care hospital in pakistan

International Nuclear Information System (INIS)

Shah, S.K.; But, J.A.; Awan, A.

2007-01-01

To study the clinical and laboratory profile of patients with EHPVO in a tertiary care hospital of Pakistan and to differentiate EHPVO from cirrhosis of liver and to see the effect on liver function tests. This is a prospective observational study conducted at Department of Gastroenterology, Pakistan Institute of Medical Sciences, Islamabad. Twenty five patients of 12-55 years of age with the features of portal hypertension were included in this study. After careful history and physical examination patients were subjected for laboratory investigations including liver function test, renal function test, blood CP, PT, APTT, HbsAg and anti HCV, other specialized procedures including endoscopy, liver biopsy and ultra sound was also done in all patients. Portal vein thrombosis was the predominant cause of EHPVO, accounting for 88% of cases. All patients were presented with upper GI bleeding, splenomegaly was observed in 88% of patients. None of the patients had clinical, biochemical or liver biopsy evidence of chronic liver disease. The diagnosis of extra hepatic portal venous obstruction and differentiation from cirrhosis can be easily made by characteristic clinical features, normal liver function tests and doppler ultrasound. Portal vein thrombosis (PVT) is the predominant cause of EHPVO in Pakistani patients, as seen at this tertiary care hospital in Pakistan. (author)

The Higgs Portal and Cosmology

Energy Technology Data Exchange (ETDEWEB)

Assamagan, Ketevi [Brookhaven National Lab. (BNL), Upton, NY (United States); Chen, Chien-Yi [Perimeter Inst. for Theoretical Physics, Waterloo, ON (Canada); Univ. of Victoria, BC (Canada); Chou, John Paul [Rutgers Univ., Piscataway, NJ (United States); Curtin, David [Univ. of Maryland, College Park, MD (United States); Fedderke, Michael A. [Univ. of Chicago, IL (United States); Gershtein, Yuri [Rutgers Univ., Piscataway, NJ (United States); He, Xiao-Gang [Shanghai Jiao Tong Univ. (China); Klute, Markus [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Kozaczuk, Jonathon [TRIUMF, Vancouver, BC (Canada); Kotwal, Ashutosh [Duke Univ., Durham, NC (United States); Lowette, Steven [Vrije Univ., Brussels (Belgium); No, Jose Miguel [Univ. of Sussex, Brighton (United Kingdom); Plehn, Tilman [Heidelberg Univ. (Germany); Qian, Jianming [Univ. of Michigan, Ann Arbor, MI (United States); Ramsey-Musolf, Michael [Univ. of Massachusetts, Amherst, MA (United States); Safonov, Alexei [Texas A & M Univ., College Station, TX (United States); Shelton, Jessie [Univ. of Illinois, Urbana-Champaign, IL (United States); Spannowsky, Michael [Durham Univ. (United Kingdom); Su, Shufang [Univ. of Arizona, Tucson, AZ (United States); Walker, Devin G. E. [Univ. of Washington, Seattle, WA (United States); Willocq, Stephane [Univ. of Massachusetts, Amherst, MA (United States); Winslow, Peter [Univ. of Massachusetts, Amherst, MA (United States)

2016-04-18

Higgs portal interactions provide a simple mechanism for addressing two open problems in cosmology: dark matter and the baryon asymmetry. In the latter instance, Higgs portal interactions may contain the ingredients for a strong first-order electroweak phase transition as well as new CP-violating interactions as needed for electroweak baryogenesis. These interactions may also allow for a viable dark matter candidate. We survey the opportunities for probing the Higgs portal as it relates to these questions in cosmology at the LHC and possible future colliders.

An analysis of splenoportographic findings in portal hypertension

Energy Technology Data Exchange (ETDEWEB)

Jung, Eun Mi; Moon, Sook Ran; Kim, Han Suk [National Medical Center, Seoul (Korea, Republic of); Park, Soo Soung [College of Medicine, Chung Ang University, Seoul (Korea, Republic of)

1983-12-15

Splenoportography has been proved as a useful method for the evaluation of circulatory disturbances in portal hypertension. Authors analyzed the various aspects of these disturbance on splenoportography in 22 cases that was performed under the clinical suspicion of portal hypertension during recent 6 years, from May, 1976 to July 1982 at the Department of Radiology, National Medical Center. The results were as follows: 1. Liver cirrhosis was the most frequent cause of intrahepatic obstruction type in portal hypertension (86%). 2. The portal pressure was more than 400 mmH{sub 2}0 in 67% of the cases (range; 300-540 mmH{sub 2}0). 3. In the majority of the cases, the higher the portal pressure was, the more dilated splenic and portal veins were. The diameter of portal vein was more than 15 mm in 79%, more than 21 mm in 47% of the cases (range; 10-26 mm). The diameter of splenic vein was more than 15 mm in 48% of the cases (range; 7-23 mm). Especially the diameter of splenic vein was larger than that of portal vein in 20% of the cases. 4. There was no definite correlation between the development of collateral circulation and the diameter of splenic and portal veins. 5. The filling of collateral circulation was definite sign of portal hypertension, though not regular. In portal hypertension, the collateral circulation was formed via coronary vein (91%), short gastric vein (64%), inferior mesenteric vein (36%). 6. Splenic-hilum time was delayed in 64% of the cases. Intrahepatic portal vein emptying time was more than 6 seconds in all the cases. 7. Most of the cases (91%) could be diagnosed as portal hypertension with vasculogram and hepatogram.

An analysis of splenoportographic findings in portal hypertension

International Nuclear Information System (INIS)

Jung, Eun Mi; Moon, Sook Ran; Kim, Han Suk; Park, Soo Soung

1983-01-01

Splenoportography has been proved as a useful method for the evaluation of circulatory disturbances in portal hypertension. Authors analyzed the various aspects of these disturbance on splenoportography in 22 cases that was performed under the clinical suspicion of portal hypertension during recent 6 years, from May, 1976 to July 1982 at the Department of Radiology, National Medical Center. The results were as follows: 1. Liver cirrhosis was the most frequent cause of intrahepatic obstruction type in portal hypertension (86%). 2. The portal pressure was more than 400 mmH 2 0 in 67% of the cases (range; 300-540 mmH 2 0). 3. In the majority of the cases, the higher the portal pressure was, the more dilated splenic and portal veins were. The diameter of portal vein was more than 15 mm in 79%, more than 21 mm in 47% of the cases (range; 10-26 mm). The diameter of splenic vein was more than 15 mm in 48% of the cases (range; 7-23 mm). Especially the diameter of splenic vein was larger than that of portal vein in 20% of the cases. 4. There was no definite correlation between the development of collateral circulation and the diameter of splenic and portal veins. 5. The filling of collateral circulation was definite sign of portal hypertension, though not regular. In portal hypertension, the collateral circulation was formed via coronary vein (91%), short gastric vein (64%), inferior mesenteric vein (36%). 6. Splenic-hilum time was delayed in 64% of the cases. Intrahepatic portal vein emptying time was more than 6 seconds in all the cases. 7. Most of the cases (91%) could be diagnosed as portal hypertension with vasculogram and hepatogram

A Climate Information Portal for Copernicus: a central portal for European climate services?

Science.gov (United States)

Juckes, Martin; Swart, Rob; Thysse, Peter; Som de Cerff, Wim; Groot, Annemarie; Bennett, Victoria; Costa, Luis; Lückenkötter, Johannes; Callaghan, Sarah

2015-04-01

The FP7 project "Climate Information Portal for Copernicus" (CLIPC) is developing a demonstration portal for the Copernicus Climate Change Service (C3S). This project is one of a suite of FP7 research activities which are administratively independent of Copernicus, focussed on creating the technical and scientific building blocks needed for the service. It is to be expected that at EGU 2015 there will be many presentations describing portals delivering new and innovative ranges of services. It would be unwise to seek to replace all this creative activity with a single portal -- instead CLIPC is designing a portal to make distributed resources more accessible through flexible discovery systems. CLIPC needs to deliver more than a directory of resources: resources need to be presented in common protocols so that users can access multiple datasets. More information about the project objectives is available at www.clipc.eu. The gulf between the climate science communities and the end user communities is a central challenge being addressed in the project. It is important to understand that there is significant diversity and multiple communication barriers within these two sets of communities as well as between them. The CLIPC services must presentation will provide a review of progress towards this ambitious goal, through a discussion of user requirements activities, an overview of the proposed architecture, work on assessing and adjusting model biasses, and a discussion of the climate impact indicators which will be provided through the portal. When looking at the usability of data for the various users, CLIPC will implement a set of services functioning as a "knowledge base" supplying information to users about the data, including definitions of terminology used, quality of datasets, versioning, and user annotations.

Perivesical varices and portal hypertension: imaging study; Varices perivesiculares e hipertension postal. Estudio por imagen

Energy Technology Data Exchange (ETDEWEB)

Mallorquin Jimenez, F; Medina Benitez, A; Lopez Machado, E; Pardo Moreno, M D; Garrido Moreno, C; Pastor Rull, J [Servicio de Radiodiagnostico, Hospital General de Especialidades Virgen de la Nieve, Granada (Spain)

1995-07-01

Nine patients with portal hypertension syndrome and Perivesical varices are studied retrospectively by means of imaging techniques including ultrasound, duplex Doppler, color Doppler, CT and angiography. All the patients presented portal thrombosis and thickening of the bladder wall. These collaterals either represent a shunting of hepato pedal flow or correspond to blood stasis associated with said syndrome. Ultrasound, whether involving duplex Doppler or color Doppler techniques, is highly useful to detect the presence of Perivesical varices which appear as tubular or rounded hypo echogenic areas in the bladder wall. Given the association of this entity with bladder wall thickening, it should be taken into account in any clinical situation involving said change, especially in patients with portal hypertension; moreover knowledge of its presence is of great importance when the possibility of creating shunts by means of interventional or surgical vascular procedures or other types of abdominal procedures are being considered because of the risk of bleeding. (Author)

Young Patients’ Views on the Open Web 2.0 Childhood Diabetes Patient Portal: A Qualitative Study

Directory of Open Access Journals (Sweden)

Sam Nordfeldt

2012-05-01

Full Text Available Little is known about the views of young patients themselves on interactive Web portal services provided by pediatric practitioners. We aimed to explore their perceptions of a real-world diabetes portal that offers facts and contact with peers and practitioners; e.g., discussion forums, blog tools, self-care and treatment information, research updates and news from local practitioners. Twelve young patients (ages 12–21, median 15 years, one boyfriend, 7 mothers and one father each wrote an essay on their experience from use of the portal. Their essays underwent qualitative content analysis. A major theme was “Helping and facilitating daily life with diabetes”, the portal was perceived as a place where contents are interesting, inspiring and may trigger users’ curiosity. There were three subthemes; “Ease of use in my everyday life,” which includes the perception that the portal was perceived as smooth and easy to enter and navigate whenever needed; that information was easy to understand for different groups of users. “Support via an exchange of experience,” includes the ability to contact peers being regarded advantageous. Some said that just reading others’ experiences can be helpful in terms of persevering; children could find peers in the same age group. “Evidence based information,” includes the perception of the portal being a useful and trustworthy source of facts on e.g., physical activity, blood glucose, medical devices, emotional wellbeing, food and nutrition, and other aspects that impact living with diabetes. Young users expressed positive perceptions towards the interactive web portal. Such services seem to have great potential for supporting young patients and significant others - intergrading for confidence.

Comparison of radial 4D Flow-MRI with perivascular ultrasound to quantify blood flow in the abdomen and introduction of a porcine model of pre-hepatic portal hypertension

Energy Technology Data Exchange (ETDEWEB)

Frydrychowicz, A. [University of Wisconsin - Madison, Department of Radiology, School of Medicine and Public Health, E3/366 Clinical Science Center, Madison, WI (United States); University Hospital Schleswig-Holstein, Campus Luebeck, Clinic for Radiology and Nuclear Medicine, Luebeck (Germany); University of Luebeck, Luebeck (Germany); Roldan-Alzate, A. [University of Wisconsin - Madison, Department of Radiology, School of Medicine and Public Health, E3/366 Clinical Science Center, Madison, WI (United States); University of Wisconsin, Department of Mechanical Engineering, Madison (United States); Winslow, E. [University of Wisconsin, Department of Surgery, Madison (United States); Consigny, D.; Campo, C.A.; Motosugi, U. [University of Wisconsin - Madison, Department of Radiology, School of Medicine and Public Health, E3/366 Clinical Science Center, Madison, WI (United States); Johnson, K.M. [University of Wisconsin, Department of Medical Physics, Madison (United States); Wieben, O. [University of Wisconsin - Madison, Department of Radiology, School of Medicine and Public Health, E3/366 Clinical Science Center, Madison, WI (United States); University of Wisconsin, Department of Medical Physics, Madison (United States); Reeder, S.B. [University of Wisconsin - Madison, Department of Radiology, School of Medicine and Public Health, E3/366 Clinical Science Center, Madison, WI (United States); University of Wisconsin, Department of Medical Physics, Madison (United States); University of Wisconsin, Department of Biomedical Engineering, Madison (United States); University of Wisconsin, Department of Medicine, Madison (United States); University of Wisconsin, Department of Emergency Medicine, Madison (United States)

2017-12-15

Objectives of this study were to compare radial time-resolved phase contrast magnetic resonance imaging (4D Flow-MRI) with perivascular ultrasound (pvUS) and to explore a porcine model of acute pre-hepatic portal hypertension (PHTN). Abdominal 4D Flow-MRI and pvUS in portal and splenic vein, hepatic and both renal arteries were performed in 13 pigs of approximately 60 kg. In six pigs, measurements were repeated after partial portal vein (PV) ligature. Inter- and intra-reader comparisons and statistical analysis including Bland-Altman (BA) comparison, paired Student's t tests and linear regression were performed. PvUS and 4D Flow-MRI measurements agreed well; flow before partial PV ligature was 322 ± 30 ml/min in pvUS and 297 ± 27 ml/min in MRI (p = 0.294), and average BA difference was 25 ml/min [-322; 372]. Inter- and intra-reader results differed very little, revealed excellent correlation (R {sup 2} = 0.98 and 0.99, respectively) and resulted in BA differences of -5 ml/min [-161; 150] and -2 ml/min [-28; 25], respectively. After PV ligature, PV flow decreased from 356 ± 50 to 298 ± 61 ml/min (p = 0.02), and hepatic arterial flow increased from 277 ± 36 to 331 ± 65 ml/min (p = n.s.). The successful in vivo comparison of radial 4D Flow-MRI to perivascular ultrasound revealed good agreement of abdominal blood flow although with considerable spread of results. A model of pre-hepatic PHTN was successfully introduced and acute responses monitored. (orig.)

Enterprise Information Management with Plone Portals

Directory of Open Access Journals (Sweden)

Marcello Peixoto Bax

2009-05-01

Full Text Available The article shows that it is possible to implement a corporate portal using open source software, in an integrated manner with the proprietary MS Windows environment. As it is the real scenario in the vast majority of businesses and organizations today, a portal that meets these specific requirements is highly representative, mainly because MS Windows integration in the client environment (not in the server is not trivial for an open source portal. The paper shows that, by deploying a portal in this context the company considerably moves forward regarding information management. To show this, the article focuses on the key positive aspects arising from the deployment of a intranet / extranet portal in that context, i.e., MS Windows integration; editing with MS Office or other similar applications; shared editing control (with check-in and check-out; universal web access; and the use of metadata and workflow.

Splenic Marginal Zone Lymphoma in the Setting of Noncirrhotic Portal Hypertension

Directory of Open Access Journals (Sweden)

Saman Ratnayake MD

2015-09-01

Full Text Available We present a case of a 65-year-old Hispanic man with a history of disseminated cutaneous coccidioidomycosis who presented to the emergency room for progressively worsening abdominal pain associated with shortness of breath. The patient was found to have pleural effusion and moderate ascites on physical examination. Abdominal ultrasound and computed tomography scan were consistent with moderate ascites and portal hypertension but negative for both liver cirrhosis and for venous or arterial thrombosis. Cytology of ascitic fluid was suggestive of portal hypertension and was negative for infection. Subsequent, thoracentesis was suggestive of exudative effusion and also negative for infection. Liver biopsy confirmed the absence of cirrhosis. Complete blood count indicated pancytopenia, whereas bone marrow biopsy and flow cytometry were suggestive of marginal zone lymphoma (MZL. Clinically, the patient’s shortness of breath was resolved by thoracentesis and paracentesis; however, his abdominal pain persisted. A diagnosis of idiopathic noncirrhotic portal hypertension in the setting of splenic MZL was made. The patient was transferred to a higher level of care for splenectomy; however, he missed multiple appointments. Since discharge, the patient has been seen in the outpatient setting and states that he is controlling his disease with diet and exercise; however, he continues to complain of intermittent shortness of breath with exertion.

The NUCLEONICA Nuclear Science Portal

International Nuclear Information System (INIS)

Magill, Joseph; Dreher, Raymond

2009-01-01

NUCLEONICA (www.nucleonica.net) is a new nuclear science web portal which provides a customisable, integrated environment and collaboration platform using the latest internet 'Web 2.0' technology. NUCLEONICA is aimed at professionals, academics and students working in nuclear power, health physics and radiation protection, nuclear and radio-chemistry, and astrophysics. A unique feature of the portal is the wide range of user friendly web-based nuclear science applications. The portal is also ideal for education and training purposes and as a knowledge management platform to preserve nuclear knowledge built up over many decades.

Improving diabetes management with a patient portal: a qualitative study of diabetes self-management portal.

Science.gov (United States)

Urowitz, Sara; Wiljer, David; Dupak, Kourtney; Kuehner, Zachary; Leonard, Kevin; Lovrics, Emily; Picton, Peter; Seto, Emily; Cafazzo, Joe

2012-11-30

Effective management and care of diabetes is crucial to reducing associated risks such as heart disease and kidney failure. With increasing access and use of the Internet, online chronic disease management is being explored as a means of providing patients with support and the necessary tools to monitor and manage their disease. The objective of our study was to evaluate the experience of patients and providers using an online diabetes management portal for patients. Participants were recruited from a large sample population of 887 for a follow-up questionnaire to be completed after 6 months of using the patient portal. Participants were presented with the option to participate in an additional interview and, if the participant agreed, a time and date was scheduled for the interview. A 5-item, open-ended questionnaire was used to capture providers' opinions of the patient portal. Providers included general practitioners (GPs), nurses, nurse practitioners (NPs), dieticians, diabetes educators (DECs), and other clinical staff. A total of 854 patients were consented for the questionnaire. Seventeen (8 male, 9 female) patients agreed to participate in a telephone interview. Sixty-four health care providers completed the five open-ended questions; however, an average of 48.2 responses were recorded per question. Four major themes were identified and will be discussed in this paper. These themes have been classified as: facilitators of disease management, barriers to portal use, patient-provider communication and relationship, and recommendations for portal improvements. This qualitative study shows that online chronic disease management portals increase patient access to information and engagement in their health care, but improvements in the portal itself may improve usability and reduce attrition. Furthermore, this study identifies a grey area that exists in the roles that GPs and AHPs should play in the facilitation of online disease management.

Portal cholangiopathy: case report

Directory of Open Access Journals (Sweden)

Maria Cecilia Almeida Maia

2014-01-01

Full Text Available The present report describes the case of a child that after blunt abdominal trauma presented with portal thrombosis followed by progressive splenomegaly and jaundice. Ultrasonography and percutaneous cholangiography revealed biliary dilatation secondary to choledochal stenosis caused by dilated peribiliary veins, characterizing a case of portal biliopathy. The present case report is aimed at presenting an uncommon cause of this condition.

Some thoughts to realignment of PortalU

International Nuclear Information System (INIS)

Konstantinidis, Stefanie; Kruse, Fred

2013-01-01

Environmental information is the basis for improving the environmental situation in the EU. The challenge poses the tailoring of information to a defined group of interest and not only the technical possibility to retrieve the environmental information. Even though, the technical infrastructure for retrieving public environmental information is the first step. Hence, the clear understanding of the needs of the general public is essential for a successful environmental information portal for the interest group ''general public''. What does this mean referring to the German Environmental Information Portal PortalU? Since the launch of PortalU the focus of the portal is set on making available official environmental information especially on German Federal Republic and Federal States level. Currently, information from web pages represents the greatest amount of information. In contrast, information from environmental data catalogs and further data bases represent a smaller amount of information within PortalU. But quantity itself does not tell anything about the demand of a target group. The experience of the last years has shown that environmental interested citizens use mainly general search engines like Google to find information from public environmental web pages. Thus it would be worth thinking about a realignment of PortalU. The idea of a prospective alignment of PortalU is to concentrate on important environmental information, which is not easily found via Google and other general search engines. This information is mainly provided via environmental data catalogs and possibly further data bases. Some thoughts about the potential form and design of a respectively aligned environmental portal are discussed in the paper. (orig.)

Lunar and Vesta Web Portals

Science.gov (United States)

Law, E.; JPL Luna Mapping; Modeling Project Team

2015-06-01

The Lunar Mapping and Modeling Project offers Lunar Mapping and Modeling Portal (http://lmmp.nasa.gov) and Vesta Trek Portal (http://vestatrek.jpl.nasa.gov) providing interactive visualization and analysis tools to enable users to access mapped Lunar and Vesta data products.

Subdiaphragmatic venous stasis and tissular hypoperfusion as sources of metabolic acidosis during passive portal-jugular and caval-jugular bypasses in dogs Estase venosa subdiafragmática e hipoperfusão tissular como fontes de acidose metabólica durante desvios porta-jugular e cava-jugular passivos em cães

Directory of Open Access Journals (Sweden)

Antônio Roberto de Barros Coelho

2000-06-01

Full Text Available Subdiafragmatic venous decompression during anhepatic stage of canine orthotopic liver transplantation attenuates portal and caval blood stasis and minimize hipoperfusion and metabolic acidosis observed with occlusion of portal and caval veins. During two hours, six dogs submitted to portal-jugular and caval-jugular passive shunts, with maintenance of arterial hepatic flow, were evaluated for pH, carbon dioxide tension (PCO2, base deficit (BD and oxygen tension (PO2 in portal, caval and systemic arterial blood, as well as for increments of BD (DBD in portal and caval blood. With a confidence level of 95%, the results showed that: 1. There were not changes of pH anDBD in portal and systemic arterial blood in the majority of studied times; 2. There was metabolic acidosis in caval blood; 3. The negative increments of BD (DBD were higher in caval blood than in splancnic venous blood at T10, T30 and T105; and, 4. Deoxigenation of portal and caval blood were detected. Acid-base metabolism and oxigenation monitoring of subdiaphramatic venous blood can constitute an effective way to evaluate experimental passive portal-jugular and caval-jugular bypass in dogs.A descompressão venosa subdiafragmática durante a fase anhepática do transplante ortotópico de fígado em cães atenua a estase de sangue nas veias Porta e Cava Inferior e minimiza a hipoperfusão tissular e a acidose metabólica observadas na oclusão dessas veias. Durante duashoras, seis cães submetidos a desvios porta-jugular e cava-jugular passivos, com permanência do fluxo arterial hepático, foram avaliados através de pH, PCO2, DB e PO2 no sangue portal, da Veia Cava Inferior e arterial sistêmico, bem como por incrementos de DB (DDB no sangue portal e da Veia Cava Inferior. Os resultados obtidos permitem concluir com uma confiança de 95% que: 1. Não foram constatadas alterações de pH e DB no sangue portal e arterial sistêmico na maioria dos tempos estudados; 2. Houve acidose

Preduodenal portal vein: its surgical significance.

Science.gov (United States)

Makey, D A; Bowen, J C

1978-11-01

Preduodenal portal vein is a rare anatomical variant which may be one of many anomalies in the neonate with duodenal "atresia." Preduodenal portal vein also may be an occasional finding in an adult undergoing biliary, gastric, or pancreatic surgery. Awareness and recognition of the anomaly are essential for the avoidance of injury during such operations. We report here a symptomless patient whose preduodenal portal vein was discovered at cholecystectomy.

Developing patient portals in a fragmented healthcare system.

Science.gov (United States)

Otte-Trojel, Terese; de Bont, Antoinette; Aspria, Marcello; Adams, Samantha; Rundall, Thomas G; van de Klundert, Joris; de Mul, Marleen

2015-10-01

Use of patient portals may contribute to improved patient health and experiences and better organizational performance. In the Netherlands, patient portals have gained considerable attention in recent years, as evidenced by various policy initiatives and practical efforts directed at developing portals. Due to the fragmented setup of the Dutch healthcare system patient portals that give patients access to information and services from across their providers are developed in inter-organizational collaboration. The objective of this paper is to identify and describe the types of collaborations, or networks, that have been established to develop patient portals in the Netherlands. Understanding the characteristics of these networks as well as the development of their respective portals enables us to assess the enabling and constraining effects of different network types on patient portal initiatives. We used qualitative methods including interview and documents analysis. In a first step, we interviewed eighteen experts and reviewed relevant national policy and strategy documents. Based on this orientation, we selected three networks we deemed to be representative of inter-organizational efforts to develop Dutch patient portals in 2012. In a second step, we interviewed twelve representatives of these patient portal networks and collected documents related to the portals. We applied content analytic techniques to analyze data from the three cases. The three studied networks differed in their number and diversity of actors, the degree to which these actors were mutually dependent, the degree to which network governance was decentralized, and the dynamics of the network structures. We observed that the portals developed in networks displaying the highest degree of these characteristics experienced most difficulties associated with developing patient portals - such as achieving interoperability, successful implementation, regulatory complaisance, and financial

Liferay Portal Systems Development

CERN Document Server

Yuan, Jonas X

2012-01-01

This book focuses on teaching by example. Every chapter provides an overview, and then dives right into hands-on examples so you can see and play with the solution in your own environment. This book is for Java developers who don't need any prior experience with Liferay portal. Although Liferay portal makes heavy use of open source frameworks, no prior experience of using these is assumed.

Some thoughts to realignment of PortalU

Energy Technology Data Exchange (ETDEWEB)

Konstantinidis, Stefanie; Kruse, Fred [Lower Saxony Ministry of Environment and Climate Protection, Hannover (Germany). Coordination Centre PortalU

2013-07-01

Environmental information is the basis for improving the environmental situation in the EU. The challenge poses the tailoring of information to a defined group of interest and not only the technical possibility to retrieve the environmental information. Even though, the technical infrastructure for retrieving public environmental information is the first step. Hence, the clear understanding of the needs of the general public is essential for a successful environmental information portal for the interest group ''general public''. What does this mean referring to the German Environmental Information Portal PortalU? Since the launch of PortalU the focus of the portal is set on making available official environmental information especially on German Federal Republic and Federal States level. Currently, information from web pages represents the greatest amount of information. In contrast, information from environmental data catalogs and further data bases represent a smaller amount of information within PortalU. But quantity itself does not tell anything about the demand of a target group. The experience of the last years has shown that environmental interested citizens use mainly general search engines like Google to find information from public environmental web pages. Thus it would be worth thinking about a realignment of PortalU. The idea of a prospective alignment of PortalU is to concentrate on important environmental information, which is not easily found via Google and other general search engines. This information is mainly provided via environmental data catalogs and possibly further data bases. Some thoughts about the potential form and design of a respectively aligned environmental portal are discussed in the paper. (orig.)

Lymphocytic hypophysitis in the elderly: A case presentation and review of the literature

Directory of Open Access Journals (Sweden)

Teresa Brown, DO

2017-06-01

Full Text Available Lymphocytic hypophysitis (LH, an autoimmune mediated chronic inflammation of the pituitary gland, is uncommon in the elderly population greater than 70 years old. It most commonly occurs in peripartum women and classically presents with mass-effect symptoms, hyperprolactinemia, or with symptoms of adenohypophysial or neurohypophysial involvement. We report a case of an elderly female who presented with headaches, visual defects, panhypopituitarism, and a sellar mass thought to be a non-functioning pituitary macroadenoma. On surgical pathology the diagnosis of LH was made. In a comprehensive literature search, we have found only sixteen cases of LH in the elderly. A comparison of the clinical differences between the pediatric, adult, and elderly populations with LH revealed notable differences between the clinical presentations and hormonal deficiencies present in the pediatric versus the adult and elderly populations. A much larger portion of adults and the elderly present with headache and visual disturbances, while a majority of the pediatric population presents with diabetes insipidus and growth hormone deficiency. Adults and elderly with LH have a much higher association with autoimmune disease than children. There was no gender predilection found in the elderly population, which is a notable difference from the adult population in which female cases of LH are much more common.

A View on Electronic Learning Portals

OpenAIRE

Zavaraqi, Rasoul

2009-01-01

Portals are less than a decade old. They have come to cover are areas of electronic services, including electronic learning. With their efficient communication and information capabilities, these portals are capable of realizing novel learning concepts such as structuralism, active and cooperative learning. The present paper endeavors to discuss the latest understanding, theories and concepts regarding E-learning portals and to review the issues and steps that should be considered in designin...

Transjugular Intrahepatic Portosystemic Shunt for Portal Hypertension in Hepatocellular Carcinoma with Portal Vein Tumor Thrombus.

Science.gov (United States)

Qiu, Bin; Li, Kai; Dong, Xiaoqun; Liu, Fu-Quan

2017-09-01

In patients with hepatocellular carcinoma (HCC), limited therapeutic options are available for portal hypertension resulted from portal vein tumor thrombus (PVTT). We aimed to determine safety and efficacy of TIPS for treatment of symptomatic portal hypertension in HCC with PVTT. We evaluated clinical characteristics of 95 patients with HCC and PVTT out of 992 patients who underwent TIPS. The primary endpoints included success rate, procedural mortality, serious complications, decrease in portosystemic pressure gradient, and symptom relief. The secondary endpoints included recurrence of portal hypertension, overall survival, adverse events related to treatments for HCC, and quality of life measured by Karnofsky Performance Status Scale (KPS). Success rate of TIPS was 95.8% (91/95), with procedural mortality of 1.1%. Serious complications related to TIPS procedure occurred in 2.1% (2/95) of patients. The symptoms of portal hypertension were well relieved. Variceal bleeding was successfully controlled and terminated in 100% of patients, with a recurrence rate of 39.2% in 12 months. Refractory ascites/hydrothorax was controlled partially or completely in 92.9% of patients during 1 month after TIPS, with a recurrence rate of 17.9% in 12 months. Survival rate at 6, 12, 24, and 36 months was 75.8, 52.7, 26.4, and 3.3%, respectively. No unexpected adverse event related to treatments for HCC was observed. The KPS score was 49 ± 4.5 and 63 ± 4.7 before and 1 month after TIPS, respectively (p portal hypertension in HCC with PVTT.

A relative study of hepatic perfusion and portal vein pressure in rats with liver cirrhosis

International Nuclear Information System (INIS)

Li Jiaping; Yang Jianyong; Chen Wei; Huang Yonghui

2006-01-01

Objective: To evaluate spiral CT perfusion in assessing portal vein pressure in rats with different stages of liver cirrhosis. Methods Seventeen rats with early stage of liver cirrhosis, 18 with intermediate stage, 12 with advanced stage, and 13 healthy rats as a control group were selected and recieved hepatic perfusion on a single-row spiral CT scanner. The parameters of hepatic perfusion were calculated using the deconvolution method. The portal vein pressure was measured by multi-physiographer. Results: (1) In study group, the PVP (portal venous perfusion) and THBP (total hepatic blood perfusion) were negatively correlated with FPP, while positively correlated with the HPI (hepatic perfusion index) and MTT (mean transit time). The FPP had a close relation with PVP. The equation, Y 20.671-3.195X, could be conducted with linear regression analysis. (2) According to the linear regression equation mentioned above, the FPP in 47 rats were 16.090±2.150 cmH 2 0, which was highly correlated with the observed valuel6.108±3.662 cmH 2 O (r=0.823 P<0.01). Conclusion: CT perfusion is a new non-invasive and efficient modality for assessment of the portal pressure in liver cirrhosis in various stages. (authors)

Clinical need for both scintigraphy with technetium-99m GSA and per-rectal portal scintigraphy in some patients with chronic liver disease

Energy Technology Data Exchange (ETDEWEB)

Shiomi, Susumu; Iwata, Yoshinori; Sasaki, Nobumitsu [Osaka City Univ. (Japan). Medical School] (and others)

1999-08-01

Scintigraphy with {sup 99m}Tc-diethylenetriaminepentaacetate with galactosyl human serum albumin ({sup 99m}Tc-GSA) and per-rectal portal scintigraphy are useful for evaluating hepatic functional reserve and portal circulation, respectively. We did the procedures simultaneously in some patients to examine the relationship between hepatic functional reserve and portal circulation in chronic liver disease. Scintigraphy with {sup 99m}Tc-GSA was done in 10 healthy subjects, 45 patients with chronic hepatitis, and 165 patients with cirrhosis. Fifty-seven patients (13 with hepatitis and 44 with cirrhosis) also underwent per-rectal portal scintigraphy with {sup 99m}Tc-pertechnetate within two weeks. A receptor index was calculated by dividing the radioactivity of the liver region of interest (ROI) by that of the liver-plus-heart ROI at 15 min after the injection of {sup 99m}Tc-GSA. The index of blood clearance was calculated by dividing the radioactivity of the heart ROI at 15 min by that of the heart ROI at 3 min. A solution containing {sup 99m}Tc-pertechnetate was instilled into the rectum, and serial scintigrams were taken while radioactivity curves for the liver and heart were recorded sequentially. A per-rectal portal shunt index was determined by calculating the ratio of counts for the liver to counts for the heart integrated for 24 seconds immediately after the appearance of the liver time-activity curve. The median receptor index was lower for more severe liver disorders, increasing in the order of chronic hepatitis, compensated cirrhosis and decompensated cirrhosis, and the median index of blood clearance was higher. The median receptor index was significantly lower when a complication (varices, ascites, or encephalopathy) was present, and the median index of blood clearance was higher. The shunt index was correlated significantly with the two other indices, but these values for some one-third of the patients disagreed in either indices. Scintigraphy with {sup 99m

Pituitary gland development and disease: from stem cell to hormone production.

Science.gov (United States)

Davis, Shannon W; Ellsworth, Buffy S; Peréz Millan, María Inés; Gergics, Peter; Schade, Vanessa; Foyouzi, Nastaran; Brinkmeier, Michelle L; Mortensen, Amanda H; Camper, Sally A

2013-01-01

Many aspects of pituitary development have become better understood in the past two decades. The signaling pathways regulating pituitary growth and shape have emerged, and the balancing interactions between the pathways are now appreciated. Markers for multipotent progenitor cells are being identified, and signature transcription factors have been discovered for most hormone-producing cell types. We now realize that pulsatile hormone secretion involves a 3D integration of cellular networks. About a dozen genes are known to cause pituitary hypoplasia when mutated due to their essential roles in pituitary development. Similarly, a few genes are known that predispose to familial endocrine neoplasia, and several genes mutated in sporadic pituitary adenomas are documented. In the next decade, we anticipate gleaning a deeper appreciation of these processes at the molecular level, insight into the development of the hypophyseal portal blood system, and evolution of better therapeutics for congenital and acquired hormone deficiencies and for common craniopharyngiomas and pituitary adenomas. © 2013 Elsevier Inc. All rights reserved.

Customizable scientific web portal for fusion research

International Nuclear Information System (INIS)

Abla, G.; Kim, E.N.; Schissel, D.P.; Flanagan, S.M.

2010-01-01

Web browsers have become a major application interface for participating in scientific experiments such as those in magnetic fusion. The recent advances in web technologies motivated the deployment of interactive web applications with rich features. In the scientific world, web applications have been deployed in portal environments. When used in a scientific research environment, such as fusion experiments, web portals can present diverse sources of information in a unified interface. However, the design and development of a scientific web portal has its own challenges. One such challenge is that a web portal needs to be fast and interactive despite the high volume of information and number of tools it presents. Another challenge is that the visual output of the web portal must not be overwhelming to the end users, despite the high volume of data generated by fusion experiments. Therefore, the applications and information should be customizable depending on the needs of end users. In order to meet these challenges, the design and implementation of a web portal needs to support high interactivity and user customization. A web portal has been designed to support the experimental activities of DIII-D researchers worldwide by providing multiple services, such as real-time experiment status monitoring, diagnostic data access and interactive data visualization. The web portal also supports interactive collaborations by providing a collaborative logbook, shared visualization and online instant messaging services. The portal's design utilizes the multi-tier software architecture and has been implemented utilizing web 2.0 technologies, such as AJAX, Django, and Memcached, to develop a highly interactive and customizable user interface. It offers a customizable interface with personalized page layouts and list of services, which allows users to create a unique, personalized working environment to fit their own needs and interests. This paper describes the software

Customizable scientific web portal for fusion research

Energy Technology Data Exchange (ETDEWEB)

Abla, G., E-mail: abla@fusion.gat.co [General Atomics, P.O. Box 85608, San Diego, CA (United States); Kim, E.N.; Schissel, D.P.; Flanagan, S.M. [General Atomics, P.O. Box 85608, San Diego, CA (United States)

2010-07-15

Web browsers have become a major application interface for participating in scientific experiments such as those in magnetic fusion. The recent advances in web technologies motivated the deployment of interactive web applications with rich features. In the scientific world, web applications have been deployed in portal environments. When used in a scientific research environment, such as fusion experiments, web portals can present diverse sources of information in a unified interface. However, the design and development of a scientific web portal has its own challenges. One such challenge is that a web portal needs to be fast and interactive despite the high volume of information and number of tools it presents. Another challenge is that the visual output of the web portal must not be overwhelming to the end users, despite the high volume of data generated by fusion experiments. Therefore, the applications and information should be customizable depending on the needs of end users. In order to meet these challenges, the design and implementation of a web portal needs to support high interactivity and user customization. A web portal has been designed to support the experimental activities of DIII-D researchers worldwide by providing multiple services, such as real-time experiment status monitoring, diagnostic data access and interactive data visualization. The web portal also supports interactive collaborations by providing a collaborative logbook, shared visualization and online instant messaging services. The portal's design utilizes the multi-tier software architecture and has been implemented utilizing web 2.0 technologies, such as AJAX, Django, and Memcached, to develop a highly interactive and customizable user interface. It offers a customizable interface with personalized page layouts and list of services, which allows users to create a unique, personalized working environment to fit their own needs and interests. This paper describes the software

Customizable Scientific Web Portal for Fusion Research

Energy Technology Data Exchange (ETDEWEB)

Abla, G; Kim, E; Schissel, D; Flannagan, S [General Atomics, San Diego (United States)

2009-07-01

The Web browser has become one of the major application interfaces for remotely participating in magnetic fusion experiments. Recently in other areas, web portals have begun to be deployed. These portals are used to present very diverse sources of information in a unified way. While a web portal has several benefits over other software interfaces, such as providing single point of access for multiple computational services, and eliminating the need for client software installation, the design and development of a web portal has unique challenges. One of the challenges is that a web portal needs to be fast and interactive despite a high volume of tools and information that it presents. Another challenge is the visual output on the web portal often is overwhelming due to the high volume of data generated by complex scientific instruments and experiments; therefore the applications and information should be customizable depending on the needs of users. An appropriate software architecture and web technologies can meet these problems. A web-portal has been designed to support the experimental activities of DIII-D researchers worldwide. It utilizes a multi-tier software architecture, and web 2.0 technologies, such as AJAX, Django, and Memcached, to develop a highly interactive and customizable user interface. It offers a customizable interface with personalized page layouts and list of services for users to select. The users can create a unique personalized working environment to fit their own needs and interests. Customizable services are: real-time experiment status monitoring, diagnostic data access, interactive data visualization. The web-portal also supports interactive collaborations by providing collaborative logbook, shared visualization and online instant message services. Furthermore, the web portal will provide a mechanism to allow users to create their own applications on the web portal as well as bridging capabilities to external applications such as

Customisable Scientific Web Portal for Fusion Research

Energy Technology Data Exchange (ETDEWEB)

Abla, G; Kim, E; Schissel, D; Flannagan, S [General Atomics, San Diego (United States)

2009-07-01

The Web browser has become one of the major application interfaces for remotely participating in magnetic fusion. Web portals are used to present very diverse sources of information in a unified way. While a web portal has several benefits over other software interfaces, such as providing single point of access for multiple computational services, and eliminating the need for client software installation, the design and development of a web portal has unique challenges. One of the challenges is that a web portal needs to be fast and interactive despite a high volume of tools and information that it presents. Another challenge is the visual output on the web portal often is overwhelming due to the high volume of data generated by complex scientific instruments and experiments; therefore the applications and information should be customizable depending on the needs of users. An appropriate software architecture and web technologies can meet these problems. A web-portal has been designed to support the experimental activities of DIII-D researchers worldwide. It utilizes a multi-tier software architecture, and web 2.0 technologies, such as AJAX, Django, and Memcached, to develop a highly interactive and customizable user interface. It offers a customizable interface with personalized page layouts and list of services for users to select. Customizable services are: real-time experiment status monitoring, diagnostic data access, interactive data visualization. The web-portal also supports interactive collaborations by providing collaborative logbook, shared visualization and online instant message services. Furthermore, the web portal will provide a mechanism to allow users to create their own applications on the web portal as well as bridging capabilities to external applications such as Twitter and other social networks. In this series of slides, we describe the software architecture of this scientific web portal and our experiences in utilizing web 2.0 technologies. A

Portal dosimetry in wedged beams

NARCIS (Netherlands)

Spreeuw, Hanno; Rozendaal, Roel; Camargo, Priscilla; Mans, Anton; Wendling, Markus; Olaciregui-Ruiz, Igor; Sonke, Jan-Jakob; van Herk, Marcel; Mijnheer, Ben

2015-01-01

Portal dosimetry using electronic portal imaging devices (EPIDs) is often applied to verify high-energy photon beam treatments. Due to the change in photon energy spectrum, the resulting dose values are, however, not very accurate in the case of wedged beams if the pixel-to-dose conversion for the

Benign hepatic portal venous gas following caustic ingestion

International Nuclear Information System (INIS)

Lewin, Maite; Tubiana, Jean-Michel; Pocard, Marc; Caplin, Scott; Parc, Rolland; Blain, Antoine

2002-01-01

Hepatic portal vein gas has been documented in numerous conditions and is traditionally regarded as a poor prognostic sign. There are, however, several reports of portal vein gas with a benign course. We report the first case of transient hepatic portal vein gas secondary to the ingestion of a caustic substance. The literature of hepatic portal vein gas in benign disease is reviewed. (orig.)

Patient portals - An online tool for your health

Science.gov (United States)

... this page: //medlineplus.gov/ency/patientinstructions/000880.htm Patient portals - an online tool for your health To ... is private and secure. What is in a Patient Portal? With a patient portal, you can: Make ...

GEO portal

Data.gov (United States)

US Agency for International Development — The USAID GeoPortal is a new application that groups web-based capabilities for on-demand discovery of and access to geospatial content, services, expertise, and...

WLCG Operations portal demo tutorial

CERN Multimedia

CERN. Geneva

2016-01-01

This is a navigation through http://wlcg-ops.web.cern.ch/ the Worldwide LHC Computing Grid (WLCG) Operations' portal. In this portal you will find documentation and information about WLCG Operation activities for: System Administrators at the WLCG sites LHC Experiments Operation coordination people, including Task Forces and Working Groups

Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center

Directory of Open Access Journals (Sweden)

Priscila Menezes Ferri

2012-03-01

Full Text Available CONTEXT: Portal vein thrombosis refers to a total or partial obstruction of the blood flow in this vein due to a thrombus formation. It is an important cause of portal hypertension in the pediatric age group with high morbidity rates due to its main complication - the upper gastrointestinal bleeding. OBJECTIVE: To describe a group of patients with portal vein thrombosis without associated hepatic disease of the Pediatric Hepatology Clinic of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil with emphasis on diagnosis, presentation form and clinical complications, and the treatment of portal hypertension. METHODS: This is a descriptive study of a series of children and adolescents cases assisted from January 1990 to December 2010. The portal vein thrombosis diagnosis was established by ultrasound. RESULTS: Of the 55 studied patients, 30 (54.5% were male. In 29 patients (52.7%, none of the risk factors for portal vein thrombosis was observed. The predominant form of presentation was the upper gastrointestinal bleeding (52.7%. In 20 patients (36.4%, the initial manifestation was splenomegaly. During the whole following period of the study, 39 patients (70.9% showed at least one episode of upper gastrointestinal bleeding. The mean age of patients in the first episode was 4.6 ± 3.4 years old. The endoscopic procedure carried out in the urgency or electively for search of esophageal varices showed its presence in 84.9% of the evaluated patients. The prophylactic endoscopic treatment was performed with endoscopic band ligation of varices in 31.3% of patients. Only one died due to refractory bleeding. CONCLUSIONS: The portal vein thrombosis is one of the most important causes of upper gastrointestinal bleeding in children. In all non febrile children with splenomegaly and/or hematemesis and without hepatomegaly and with normal hepatic function tests, it should be suspect of portal vein thrombosis. Thus, an

Unexpected disappearance of portal cavernoma on long-term anticoagulation.

Science.gov (United States)

Silva-Junior, Gilberto; Turon, Fanny; Hernandez-Gea, Virginia; Darnell, Anna; García-Criado, Ángeles; García-Pagán, Juan Carlos

2014-08-01

Idiopathic non-cirrhotic portal hypertension is a rare disease of unknown etiology. Patients with idiopathic non-cirrhotic portal hypertension have an increased risk of developing portal vein thrombosis and this is especially prevalent when HIV is also present. We describe a unique case of a patient with idiopathic non-cirrhotic portal hypertension associated to HIV, who developed acute portal vein thrombosis that despite anticoagulation transformed in portal cavernoma and disappeared completely after five years of follow-up on continuous anticoagulation. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

User Experience Design in Professional Map-Based Geo-Portals

Directory of Open Access Journals (Sweden)

Bastian Zimmer

2013-10-01

Full Text Available We have recently been witnessing the growing establishment of map-centered web-based geo-portals on national, regional and local levels. However, a particular issue with these geo-portals is that each instance has been implemented in different ways in terms of design, usability, functionality, interaction possibilities, map size and symbologies. In this paper, we try to tackle these shortcomings by analyzing and formalizing the requirements for map-based geo-portals in a user experience based approach. First, we propose a holistic definition the term of a “geo-portal”. Then, we present our approach to user experience design for map-based geo-portals by defining the functional requirements of a geo-portal, by analyzing previous geo-portal developments, by distilling the results of our empirical user study to perform practically-oriented user requirements, and finally by establishing a set of user experience design guidelines for the creation of map-based geo-portals. These design guidelines have been extracted for each of the main components of a geo-portal, i.e., the map, the search dialogue, the presentation of the search results, symbologies, and other aspects. These guidelines shall constitute the basis for future geo-portal developments to achieve standardization in the user-experience design of map-based geo-portals.

Portal Still Alive and Portal 2: Lessons from Critical Narrative Gaming Pedagogy

OpenAIRE

Yamasaki, Lisa Josefina

2016-01-01

Due to the increasing popularity of video games in mass media culture, I will be investigating one particular video game series, Portal: Still Alive and Portal 2, and the manner by which players learn from them. After observing that most instructors use these games in physics and math classes, I want to expand more on the way that video games enact a new story-telling feature through experiential means, which also serves a pedagogical function. I assert that players learn from games through...

Splanchnic-aortic inflammatory axis in experimental portal hypertension

Science.gov (United States)

Aller, Maria-Angeles; de las Heras, Natalia; Nava, Maria-Paz; Regadera, Javier; Arias, Jaime; Lahera, Vicente

2013-01-01

Splanchnic and systemic low-grade inflammation has been proposed to be a consequence of long-term prehepatic portal hypertension. This experimental model causes minimal alternations in the liver, thus making a more selective study possible for the pathological changes characteristic of prehepatic portal hypertension. Low-grade splanchnic inflammation after long-term triple partial portal vein ligation could be associated with liver steatosis and portal hypertensive intestinal vasculopathy. In fact, we have previously shown that prehepatic portal hypertension in the rat induces liver steatosis and changes in lipid and carbohydrate metabolism similar to those produced in chronic inflammatory conditions described in metabolic syndrome in humans. Dysbiosis and bacterial translocation in this experimental model suggest the existence of a portal hypertensive intestinal microbiome implicated in both the splanchnic and systemic alterations related to prehepatic portal hypertension. Among the systemic impairments, aortopathy characterized by oxidative stress, increased levels of proinflammatory cytokines and profibrogenic mediators stand out. In this experimental model of long-term triple portal vein ligated-rats, the abdominal aortic proinflammatory response could be attributed to oxidative stress. Thus, the increased aortic reduced-nicotinamide-adenine dinucleotide phosphate [NAD(P)H] oxidase activity could be associated with reactive oxygen species production and promote aortic inflammation. Also, oxidative stress mediated by NAD(P)H oxidase has been associated with risk factors for inflammation and atherosclerosis. The splanchnic and systemic pathology that is produced in the long term after triple partial portal vein ligation in the rat reinforces the validity of this experimental model to study the chronic low-grade inflammatory response induced by prehepatic portal hypertension. PMID:24307792

Portal in the power sector - it is vision or reality?

International Nuclear Information System (INIS)

Hornak, L.

2004-01-01

The goal of the presentation is to introduce the portal solutions, to describe the types, characteristic features and abilities of the portal and to define required attributes of the portal in the power segment. The author will try to answer the questions whether such portal exists at the present time, what is needed in order to implement the portal and how to do the portal maintenance and management

Information Portal Costs and Benefits

Directory of Open Access Journals (Sweden)

Lorena BATAGAN

2006-01-01

Full Text Available All transformations of our society are the product of the large use of Information and Communications Technologies (ICT and Internet. ICT are technologies which facilitate communication, processing, and transmission of information by electronic means. It is very important to use the new technologies to the correct value because this determinate an increase of global benefits. Portal provides a consistent way to select, evaluate, prioritize and plan the right information. In research we point the important costs and benefits for an informational portal. The portal for local administrative determinate for citizens the access to information of interest and on the other hand make easier for employer to manage the documents.

Comparison of image quality and portal vein visualization in IADSP using iopamidol, 76 % urografin, and 38 % urografin

International Nuclear Information System (INIS)

Shibata, Toshiya; Yamashita, Keiji; Konishi, Junji; Hayakawa, Katsumi; Hamanaka, Daizaburo; Okumura, Ryouji; Ishi, Yasushi.

1988-01-01

The image quality of intra-arterial digital subtraction portography (IADSP) was studied in 50 randomly assigned patients using one of three contrast agents: iopamidol, (IOP, 20 cases), 76 % Na-meglumine diatrzioate (76 % UG, 20 cases), and 38 % Na-meglumine diatrizoate (38 % UG, 10 cases). Sharpness and contrast of images, and portal vein visualization were evaluated in these groups. IOP provided better image quality and portal vein visualization than 76 % UG. There was no significant difference between them in terms of side effects, such as contrast medium-induced pain and feeling of warmth, or changes in physiological parameters like blood pressure and heart rate. When a low osmolar contrast agent like IOP passes through the mesentery capillary bed, the eflux of the contrast agent into the interstitial space and the influex of water into the capillary may be less, resulting in less dilution of the contrast agent in the superior mesenteric vein. This might explain the better image quality and portal vein visualization of IOP. (author)

Next Gen One Portal Usability Evaluation

Science.gov (United States)

Cross, E. V., III; Perera, J. S.; Hanson, A. M.; English, K.; Vu, L.; Amonette, W.

2018-01-01

Each exercise device on the International Space Station (ISS) has a unique, customized software system interface with unique layouts / hierarchy, and operational principles that require significant crew training. Furthermore, the software programs are not adaptable and provide no real-time feedback or motivation to enhance the exercise experience and/or prevent injuries. Additionally, the graphical user interfaces (GUI) of these systems present information through multiple layers resulting in difficulty navigating to the desired screens and functions. These limitations of current exercise device GUI's lead to increased crew time spent on initiating, loading, performing exercises, logging data and exiting the system. To address these limitations a Next Generation One Portal (NextGen One Portal) Crew Countermeasure System (CMS) was developed, which utilizes the latest industry guidelines in GUI designs to provide an intuitive ease of use approach (i.e., 80% of the functionality gained within 5-10 minutes of initial use without/limited formal training required). This is accomplished by providing a consistent interface using common software to reduce crew training, increase efficiency & user satisfaction while also reducing development & maintenance costs. Results from the usability evaluations showed the NextGen One Portal UI having greater efficiency, learnability, memorability, usability and overall user experience than the current Advanced Resistive Exercise Device (ARED) UI used by astronauts on ISS. Specifically, the design of the One-Portal UI as an app interface similar to those found on the Apple and Google's App Store, assisted many of the participants in grasping the concepts of the interface with minimum training. Although the NextGen One-Portal UI was shown to be an overall better interface, observations by the test facilitators noted specific exercise tasks appeared to have a significant impact on the NextGen One-Portal UI efficiency. Future updates to

Metabolic effects of portal vein sensing.

Science.gov (United States)

Mithieux, G

2014-09-01

The extrinsic gastrointestinal nerves are crucial in the sensing of nutrients and hormones and its translation in terms of control of food intake. Major macronutrients like glucose and protein are sensed by the extrinsic nerves located in the portal vein walls, which signal to the brain and account for the satiety phenomenon they promote. Glucose is sensed in the portal vein by neurons expressing the glucose receptor SGLT3, which activate the main regions of the brain involved in the control of food intake. Proteins indirectly act on food intake by inducing intestinal gluconeogenesis and its sensing by the portal glucose sensor. The mechanism involves a prior antagonism by peptides of the μ-opioid receptors present in the portal vein nervous system and a reflex arc with the brain inducing intestinal gluconeogenesis. In a comparable manner, short-chain fatty acids produced from soluble fibre act via intestinal gluconeogenesis to exert anti-obesity and anti-diabetic effects. In the case of propionate, the mechanism involves a prior activation of the free fatty acid receptor FFAR3 present in the portal nerves and a reflex arc initiating intestinal gluconeogenesis. © 2014 John Wiley & Sons Ltd.

Soluble TNF-Alpha-Receptors I Are Prognostic Markers in TIPS-Treated Patients with Cirrhosis and Portal Hypertension

DEFF Research Database (Denmark)

Trebicka, Jonel; Krag, Aleksander; Gansweid, Stefan

2013-01-01

TNFα levels are increased in liver cirrhosis even in the absence of infection, most likely owing to a continuous endotoxin influx into the portal blood. Soluble TNFα receptors (sTNFR type I and II) reflect release of the short-lived TNFα, because they are cleaved from the cells after binding...

Arachidonic acid metabolites and endothelial dysfunction of portal hypertension.

Science.gov (United States)

Sacerdoti, David; Pesce, Paola; Di Pascoli, Marco; Brocco, Silvia; Cecchetto, Lara; Bolognesi, Massimo

2015-07-01

Increased resistance to portal flow and increased portal inflow due to mesenteric vasodilatation represent the main factors causing portal hypertension in cirrhosis. Endothelial cell dysfunction, defined as an imbalance between the synthesis, release, and effect of endothelial mediators of vascular tone, inflammation, thrombosis, and angiogenesis, plays a major role in the increase of resistance in portal circulation, in the decrease in the mesenteric one, in the development of collateral circulation. Reduced response to vasodilators in liver sinusoids and increased response in the mesenteric arterioles, and, viceversa, increased response to vasoconstrictors in the portal-sinusoidal circulation and decreased response in the mesenteric arterioles are also relevant to the pathophysiology of portal hypertension. Arachidonic acid (AA) metabolites through the three pathways, cyclooxygenase (COX), lipoxygenase, and cytochrome P450 monooxygenase and epoxygenase, are involved in endothelial dysfunction of portal hypertension. Increased thromboxane-A2 production by liver sinusoidal endothelial cells (LSECs) via increased COX-1 activity/expression, increased leukotriens, increased epoxyeicosatrienoic acids (EETs) (dilators of the peripheral arterial circulation, but vasoconstrictors of the portal-sinusoidal circulation), represent a major component in the increased portal resistance, in the decreased portal response to vasodilators and in the hyper-response to vasoconstrictors. Increased prostacyclin (PGI2) via COX-1 and COX-2 overexpression, and increased EETs/heme-oxygenase-1/K channels/gap junctions (endothelial derived hyperpolarizing factor system) play a major role in mesenteric vasodilatation, hyporeactivity to vasoconstrictors, and hyper-response to vasodilators. EETs, mediators of liver regeneration after hepatectomy and of angiogenesis, may play a role in the development of regenerative nodules and collateral circulation, through stimulation of vascular endothelial

Endovascular management for significant iatrogenic portal vein bleeding.

Science.gov (United States)

Kim, Jong Woo; Shin, Ji Hoon; Park, Jonathan K; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu-Bo

2017-11-01

Background Despite conservative treatment, hemorrhage from an intrahepatic branch of the portal vein can cause hemodynamic instability requiring urgent intervention. Purpose To retrospectively report the outcomes of hemodynamically significant portal vein bleeding after endovascular management. Material and Methods During a period of 15 years, four patients (2 men, 2 women; median age, 70.5 years) underwent angiography and embolization for iatrogenic portal vein bleeding. Causes of hemorrhage, angiographic findings, endovascular treatment, and complications were reported. Results Portal vein bleeding occurred after percutaneous liver biopsy (n = 2), percutaneous radiofrequency ablation (n = 1), and percutaneous cholecystostomy (n = 1). The median time interval between angiography and percutaneous procedure was 5 h (range, 4-240 h). Common hepatic angiograms including indirect mesenteric portograms showed active portal vein bleeding into the peritoneal cavity with (n = 1) or without (n = 2) an arterioportal (AP) fistula, and portal vein pseudoaneurysm alone with an AP fistula (n = 1). Successful transcatheter arterial embolization (n = 2) or percutaneous transhepatic portal vein embolization (n = 2) was performed. Embolic materials were n-butyl cyanoacrylate alone (n = 2) or in combination with gelatin sponge particles and coils (n = 2). There were no major treatment-related complications or patient mortality within 30 days. Conclusion Patients with symptomatic or life-threatening portal vein bleeding following liver-penetrating procedures can successfully be managed with embolization.

Disastrous Portal Vein Embolization Turned into a Successful Intervention

Energy Technology Data Exchange (ETDEWEB)

Dobrocky, Tomas, E-mail: tomas.dobrocky@insel.ch [University of Bern, Department of Interventional, Pediatric and Diagnostic Radiology, Inselspital, University Hospital (Switzerland); Kettenbach, Joachim, E-mail: joachim.kettenbach@stpoelten.lknoe.at [Universitätsklinikum St. Pölten-Lilienfeld, Institute of Medical Radiology, Diagnostic, Intervention (Austria); Lopez-Benitez, Ruben, E-mail: Ruben.lopez@insel.ch; Kara, Levent, E-mail: levent.kara@insel.ch [University of Bern, Department of Interventional, Pediatric and Diagnostic Radiology, Inselspital, University Hospital (Switzerland)

2015-10-15

Portal vein embolization (PVE) may be performed before hemihepatectomy to increase the volume of future liver remnant (FLR) and to reduce the risk of postoperative liver insufficiency. We report the case of a 71-year-old patient with hilar cholangiocarcinoma undergoing PVE with access from the right portal vein using a mixture of n-butyl-2-cyanoacrylate and ethiodized oil. During the procedure, nontarget embolization of the left portal vein occurred. An aspiration maneuver of the polymerized plug failed; however, the embolus obstructing portal venous flow in the FLR was successfully relocated into the right portal vein while carefully bypassing the plug with a balloon catheter, inflating the balloon, and pulling the plug into the main right portal vein.

Portal monitor incorporating smart probes

International Nuclear Information System (INIS)

Bartos, D.; Constantin, F.; Guta, T.

2003-01-01

Portal monitors are intended for detection of radioactive and special nuclear materials in vehicles, pedestrians, luggage, as well as for prevention of illegal traffic of radioactive sources. Monitors provide audio and visual alarms when radioactive and/or special nuclear materials are detected. They can be recommended to officers of customs, border guard and emergency services, civil defense, fire brigades, police and military departments or nuclear research or energetic facilities. The portal monitor developed by us consists in a portal frame, which sustains five intelligent probes having long plastic scintillator (0.5 liters each). The probes communicate, by serial transmission, with a Central Unit constructed on the basis of the 80552 microcontroller. This one manages the handshake, calculates the background, establishes the measuring time, starts and stops each measurement and makes all the other decisions. Sound signals and an infrared sensor monitor the passing through the portal and the measuring procedure. For each measurement the result is displayed on a LCD device contaminated/uncontaminated; for the contaminated case a loud and long sound signal is also issued. An RS 232 serial interface is provided in order to further developments or custom made devices. As a result, the portal monitor detects 1 μ Ci 137 Cs, spread all over a human body, in a 20 μR/h gamma background for a measuring time of 1.5 or 10 seconds giving a 99% confidence factor. (authors)

Studi Respon Seismik Penggunaan Steel Slit Damper (SSD pada Portal Baja

Directory of Open Access Journals (Sweden)

Lisa Ika Arumsari

2012-09-01

Full Text Available Salah satu metode yang dapat digunakan untuk mengurangi dampak dari beban gempa terhadap portal baja adalah menggunakan peredam. Steel Slit Damper (SSD adalah salah satu jenis peredam yang dibuat dari sejumlah pelat baja lunak berbentuk segi-4 yang dimodelkan sebagai pegas-pegas yang disusun secara seri. Energi akibat gempa disalurkan melalui strip-strip damper yang mudah meleleh ketika perangkat mengalami deformasi inelastis siklik. SSD mendisipasi energi melalui pembentukan sendi plastis atau pelelehan pelat damper. Pada penelitian ini dilakukan analisa respon seismik Steel Slit Damper (SSD pada portal baja 1 lantai yang menerima beban lateral berupa beban gempa, dengan membandingkan portal baja konvensional, portal baja inverted-v, dan portal baja dengan SSD. Hasil analisa menunjukkan bahwa gaya geser, gaya normal, dan momen yang dihasikan portal dengan SSD lebih kecil hingga 80,49% dari gaya-gaya yang dihasilkan portal konvensional, tetapi gaya-gaya tersebut masih lebih besar daripada yang dihasilkan portal inverted-V. Portal dengan SSD dapat memperkecil simpangan sebesar 94,12% pada portal konvensional dan sebesar 33,33% pada portal bracing inverted-v. Hasil penelitian juga menunjukkan bahwa portal SSD memiliki daktilitas 105,85% lebih tinggi dari portal konvensional dan 298,67% lebih tinggi dari portal bracing inverted-v

Duplication of the Portal Vein: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Kim, Sang Won; Shin, Hyeong Cheol; Jou, Sung Shick; Han, Jong Kyu; Kim, Il Young [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

2009-12-15

The duplication of the portal vein is an uncommon congenital anomaly. To date, only four cases have been reported in the medical literature. This anomaly can cause portal hypertension in pediatric patients. In addition, duplication of the portal vein has various patterns of connection with a splenic vein or mesenteric veins, and it can lie anterior or posterior to the duodenum. We report the MDCT findings of an adult patient with duplication of the portal vein that was found incidentally

MR and angiography: Evaluation of the hemodynamics of portal hypertension

International Nuclear Information System (INIS)

Torres, W.E.; Gaylord, G.M.; Whitmire, L.; Chuang, V.P.; Bernardino, M.E.

1986-01-01

Forty-two MR imaging examinations and angiographic procedures in 38 patients with portal hypertension were compared for how well the images depicted portal perfusion and direction of flow, portal vein thrombosis, and the presence and type of shunt. Thirty-three MR imaging studies indicated grade I or II portal flow. In 29 cases portal flow was grade I or II by angiography; in the remaining cases the flow was grade IV. In a total of eight cases portal flow was grade IV by angiography, but none appeared to be grade IV on MR imaging. Both MR imaging and angiography detected portal vein thrombosis (41 of 42 cases). MR imaging and angiography agreed as to whether a shunt was present or absent, and patent or occluded (41 of 42 cases). Currently, MR imaging is an unsatisfactory modality by which to grade portal flow. MR imaging does depict portal vein thrombosis well, and can be used to determine patency of surgical shunts

Extrahepatic Portal Hypertension following Liver Transplantation: a Rare but Challenging Problem

Directory of Open Access Journals (Sweden)

B. Malassagne

1998-01-01

Full Text Available This study reports our experience of 8 cases of extrahepatic portal hypertension after 273 orthotopic liver transplantations in 244 adult patients over a 10- year period. The main clinical feature was ascites, and the life-threatening complication was variceal bleeding. Extrahepatic portal hypertension was caused by portal vein stenosis in 6 patients, and left-sided portal hypertension in 2 patients after inadventent ligation of portal venous tributaries or portasystemic shunts. All patients with portal vein stenosis had complete relief of portal hypertension after percutaneous transhepatic venoplasty (n=4 or surgical reconstruction (n=2, after a median follow-up of 33 (range: 6–62 months. Of the 2 patients with left-sided portal hypertension, one died after splenectomy and one rebled 6 months after left colectomy. This study suggests that extrahepatic portal hypertension is a series complication after liver transplantation that could be prevented by meticulous portal anastomosis and closure of portal tributaries or portasystemic shunts to improve the portal venous flow. However, any ligation has to be performed under ultrasound guidance to avoid inadventent venous ligations.

Calcification in the portal venous system demonstrated by computed tomography

Energy Technology Data Exchange (ETDEWEB)

Hadar, H; Sommer, R

1983-08-01

The CT appearance of calcification in the portal venous system in a patient with chronic alcoholic cirrhosis is presented. Reported cases of radiologically detectable calcification in the portal system are rare, and most of them have been associated with longstanding portal hypertension. We presume that with CT this diagnosis will be made more frequently. In the presence of calcification in the portal venous system, portal vein thrombosis is highly probable. This information is of obvious importance to the surgeon contemplating a portal decompressive shunt procedure.

Celecoxib ameliorates portal hypertension of the cirrhotic rats through the dual inhibitory effects on the intrahepatic fibrosis and angiogenesis.

Science.gov (United States)

Gao, Jin-Hang; Wen, Shi-Lei; Yang, Wen-Juan; Lu, Yao-Yao; Tong, Huan; Huang, Zhi-Yin; Liu, Zhang-Xu; Tang, Cheng-Wei

2013-01-01

Increased intra-hepatic resistance to portal blood flow is the primary factor leading to portal hypertension in cirrhosis. Up-regulated expression of cyclooxygenase-2 (COX-2) in the cirrhotic liver might be a potential target to ameliorate portal hypertension. To verify the effect of celecoxib, a selective inhibitor of COX-2, on portal hypertension and the mechanisms behind it. Cirrhotic liver model of rat was established by peritoneal injection of thiacetamide (TAA). 36 rats were randomly assigned to control, TAA and TAA+celecoxib groups. Portal pressures were measured by introduction of catheters into portal vein. Hepatic fibrosis was assessed by the visible hepatic fibrotic areas and mRNAs for collagen III and α-SMA. The neovasculature was determined by hepatic vascular areas, vascular casts and CD31 expression. Expressions of COX-2, vascular endothelial growth factor (VEGF), VEGF receptor-2 (VEGFR-2) and related signal molecules were quantitated. Compared with TAA group, the portal pressure in TAA+celecoxib group was significantly decreased by 17.8%, pportal venules. The data of fibrotic areas, CD31expression, mRNA levels of α-SMA and collagen III in TAA+celecoxib group were much lower than those in TAA group, pprotein levels of VEGF, VEGFR-2 and COX-2 induced by TAA was significantly inhibited after celecoxib treatment. The expressions of prostaglandin E2 (PGE2), phosphorylated extracellular signal-regulated kinase (p-ERK), hypoxia-inducible factor-1α (HIF-1α), and c-fos were also down-regulated after celecoxib treatment. Long term administration of celecoxib can efficiently ameliorate portal hypertension in TAA rat model by its dual inhibitory effects on the intrahepatic fibrosis and angiogenesis. The anti-angiogenesis effect afforded by celecoxib may attribute to its modulation on VEGF/VEGFR-2 through the down-regulation of integrated signal pathways involving PGE2- HIF-1α- VEGF and p-ERK- c-fos- VEGFR-2.

Evaluation of portal hypertension by MR portography

International Nuclear Information System (INIS)

Nagaoka, Shirou; Hagiwara, Masaru; Imanisi, Yosimasa

1997-01-01

Seventy-eight examinations of MR portography were totally performed in 24 controls and 33 patients with esophageal varices. Portal vein, SMV, hepatic vein, and IVC were entirely depicted in 21, 24, 22, and 24, respectively, of the 24 controls. As to intrahepatic upward branches of portal vein in the right lobe of the liver, the 4th branch was at least depicted in all of the 24. Although the portal vein trunk and SMV were entirely depicted in all of the 8 patients without treatment and liver dysfunction of Child A, there was no depiction of them in 1 of the 8 patients with liver dysfunction of Child B, and 1 of 5 patients with liver dysfunction of Child C. The 4th upward branch of portal vein in the right lobe of the liver was depicted in none of the 33 patients. Besides, none of the intrahepatic portal branches were depicted in 1 of 8 patients without treatment and liver dysfunction of Child B, and 1 of the 5 patients without treatment and liver dysfunction of Child C. There was a significant difference of depicted terminal upward branch of portal vein between the controls and patients without any treatment. In the patients without any significant difference of depicted terminal upward branch of portal vein was also present between Child's classification A and Child's classification B and C. Gastric coronary vein varices were detected by MR portography is 18 of 19 patients without treatment on the esophageal varices, and paraesophageal/esophageal varices were also depicted by MR portography in 13 of the 19. The collaterals were depicted by MR portography in all of the 6 patients with recurrent collaterals after Hassab's operation or splenectomy. MR portography was able to depict flow in trunk branches and collaterals of the portal vein system in a physiological state. (K.H.)

Evaluation of portal hypertension by MR portography

Energy Technology Data Exchange (ETDEWEB)

Nagaoka, Shirou; Hagiwara, Masaru; Imanisi, Yosimasa [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

1997-02-01

Seventy-eight examinations of MR portography were totally performed in 24 controls and 33 patients with esophageal varices. Portal vein, SMV, hepatic vein, and IVC were entirely depicted in 21, 24, 22, and 24, respectively, of the 24 controls. As to intrahepatic upward branches of portal vein in the right lobe of the liver, the 4th branch was at least depicted in all of the 24. Although the portal vein trunk and SMV were entirely depicted in all of the 8 patients without treatment and liver dysfunction of Child A, there was no depiction of them in 1 of the 8 patients with liver dysfunction of Child B, and 1 of 5 patients with liver dysfunction of Child C. The 4th upward branch of portal vein in the right lobe of the liver was depicted in none of the 33 patients. Besides, none of the intrahepatic portal branches were depicted in 1 of 8 patients without treatment and liver dysfunction of Child B, and 1 of the 5 patients without treatment and liver dysfunction of Child C. There was a significant difference of depicted terminal upward branch of portal vein between the controls and patients without any treatment. In the patients without any significant difference of depicted terminal upward branch of portal vein was also present between Child`s classification A and Child`s classification B and C. Gastric coronary vein varices were detected by MR portography is 18 of 19 patients without treatment on the esophageal varices, and paraesophageal/esophageal varices were also depicted by MR portography in 13 of the 19. The collaterals were depicted by MR portography in all of the 6 patients with recurrent collaterals after Hassab`s operation or splenectomy. MR portography was able to depict flow in trunk branches and collaterals of the portal vein system in a physiological state. (K.H.)

NASA Sea Level Change Portal - It not just another portal site

Science.gov (United States)

Huang, T.; Quach, N.; Abercrombie, S. P.; Boening, C.; Brennan, H. P.; Gill, K. M.; Greguska, F. R., III; Jackson, R.; Larour, E. Y.; Shaftel, H.; Tenenbaum, L. F.; Zlotnicki, V.; Moore, B.; Moore, J.; Boeck, A.

2017-12-01

The NASA Sea Level Change Portal (https://sealevel.nasa.gov) is designed as a "one-stop" source for current sea level change information, including interactive tools for accessing and viewing regional data, a virtual dashboard of sea level indicators, and ongoing updates through a suite of editorial products that include content articles, graphics, videos, and animations. With increasing global temperatures warming the ocean and melting ice sheets and glaciers, there is an immediate need both for accelerating sea level change research and for making this research accessible to scientists in disparate discipline, to the general public, to policy makers and business. The immersive and innovative NASA portal debuted at the 2015 AGU attracts thousands of daily visitors and over 30K followers on Facebook®. Behind its intuitive interface is an extensible architecture that integrates site contents, data for various sources, visualization, horizontal-scale geospatial data analytic technology (called NEXUS), and an interactive 3D simulation platform (called the Virtual Earth System Laboratory). We will present an overview of our NASA portal and some of our architectural decisions along with discussion on our open-source, cloud-based data analytic technology that enables on-the-fly analysis of heterogeneous data.

Porto-systemic collaterals in cirrhosis of the liver. Selective percutaneous transhepatic catheterization of the portal venous system in portal hypertension

Energy Technology Data Exchange (ETDEWEB)

Hoevels, J; Lunderquist, A; Tylen, U; Simert, G [Lund Univ. (Sweden)

1979-01-01

In 93 patients with cirrhosis of the liver and portal venous hypertension the main tributaries of the portal vein were examined by percutaneous transhepatic catheterization. The appearance and degree of porto-systemic collaterals were analysed. Esophageal varices were demonstrated in 82 patients. No correlation was found between the portal venous pressure and the extent of porto-systemic communications.

Portal vein branching order helps in the recognition of anomalous right-sided round ligament: common features and variations in portal vein anatomy.

Science.gov (United States)

Yamashita, Rikiya; Yamaoka, Toshihide; Nishitai, Ryuta; Isoda, Hiroyoshi; Taura, Kojiro; Arizono, Shigeki; Furuta, Akihiro; Ohno, Tsuyoshi; Ono, Ayako; Togashi, Kaori

2017-07-01

This study aimed to evaluate the common features and variations of portal vein anatomy in right-sided round ligament (RSRL), which can help propose a method to detect and diagnose this anomaly. In this retrospective study of 14 patients with RSRL, the branching order of the portal tree was analyzed, with special focus on the relationship between the dorsal branch of the right anterior segmental portal vein (P A-D ) and the lateral segmental portal vein (P LL ), to determine the common features. The configuration of the portal vein from the main portal trunk to the right umbilical portion (RUP), the inclination of the RUP, and the number and thickness of the ramifications branching from the right anterior segmental portal vein (P A ) were evaluated for variations. In all subjects, the diverging point of the P A-D was constantly distal to that of the P LL . The portal vein configuration was I- and Z-shaped in nine and five subjects, respectively. The RUP was tilted to the right in all subjects. In Z-shaped subjects, the portal trunk between the branching point of the right posterior segmental portal vein and that of the P LL was tilted to the left in one subject and was almost parallel to the vertical plane in four subjects. Multiple ramifications were radially distributed from the P A in eight subjects, whereas one predominant P A-D branched from the P A in six subjects. Based on the diverging points of the P A-D and P LL , we proposed a three-step method for the detection and diagnosis of RSRL.

Portal monitoring for detecting fissile materials and chemical explosives

International Nuclear Information System (INIS)

Albright, D.

1992-01-01

The portal monitoring of pedestrians, packages, equipment, and vehicles entering or leaving areas of high physical security has been common for many years. Many nuclear facilities rely on portal monitoring to prevent the theft or diversion of plutonium and highly enriched uranium. At commercial airports, portals are used to prevent firearms and explosives from being smuggled onto airplanes. An August 1989 Federal Aviation Administration (FAA) regulation requires US airlines to screen luggage on international flights for chemical explosives. This paper reports that portal monitoring is now being introduced into arms-control agreements. Because some of the portal-monitoring equipment that would be useful in verifying arms-control agreements is already widely used as part of the physical security systems at nuclear facilities and commercial airports, the authors review these uses of portal monitoring, as well as its role in verifying the INF treaty. Then the authors survey the major types of portal-monitoring equipment that would be most useful in detecting nuclear warheads or fissile material

Meaningful Use of a Confidential Adolescent Patient Portal.

Science.gov (United States)

Thompson, Lindsay A; Martinko, Thomas; Budd, Pamela; Mercado, Rebeccah; Schentrup, Anzeela M

2016-02-01

To design and evaluate the usage of an adolescent patient portal specifically adapted for adolescent health care needs that also satisfied institutional meaningful use guidelines regarding electronic health records. Key stakeholders at one academic health care center adopted an online portal and opted to designate a patient portal specifically for adolescents to maximize confidentiality in compliance with state privacy laws. This study analyzed aggregate electronic health record data of adolescents' (ages 12-17.9 years) uptake, usage, and functionality of this portal and compared it to parent portal usage for younger children (ages 0-11 years). Differences in means were calculated using paired t tests. The portal was used similarly between parents of young children and adolescents, with almost 1,000 enrollees in each group from September 1, 2012 to March 31, 2015. There were no gender differences in enrollment. Adolescents were less likely than parents of younger children to review appointments (73% vs. 85%), laboratory tests (67% vs. 79%), problem lists (40% vs. 78%), or allergies (45% vs. 77%, all p values adolescents sent 1,397 confidential messages. Institutional decisions for implementing meaningful use requirements can align with goals of adolescent health. Patient portals can enhance adolescent health care quality and adolescents readily use a confidential portal. Implementation of meaningful use requirements should be checked against adolescent health care needs to maximize confidentiality and promote health communication. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Inpatient Portals for Hospitalized Patients and Caregivers: A Systematic Review.

Science.gov (United States)

Kelly, Michelle M; Coller, Ryan J; Hoonakker, Peter Lt

2018-06-01

Patient portals, web-based personal health records linked to electronic health records (EHRs), provide patients access to their healthcare information and facilitate communication with providers. Growing evidence supports portal use in ambulatory settings; however, only recently have portals been used with hospitalized patients. Our objective was to review the literature evaluating the design, use, and impact of inpatient portals, which are patient portals designed to give hospitalized patients and caregivers inpatient EHR clinical information for the purpose of engaging them in hospital care. Literature was reviewed from 2006 to 2017 in PubMed, Web of Science, CINALPlus, Cochrane, and Scopus to identify English language studies evaluating patient portals, engagement, and inpatient care. Data were analyzed considering the following 3 themes: inpatient portal design, use and usability, and impact. Of 731 studies, 17 were included, 9 of which were published after 2015. Most studies were qualitative with small samples focusing on inpatient portal design; 1 nonrandomized trial was identified. Studies described hospitalized patients' and caregivers' information needs and design recommendations. Most patient and caregiver participants in included studies were interested in using an inpatient portal, used it when offered, and found it easy to use and/or useful. Evidence supporting the role of inpatient portals in improving patient and caregiver engagement, knowledge, communication, and care quality and safety is limited. Included studies indicated providers had concerns about using inpatient portals; however, the extent to which these concerns have been realized remains unclear. Inpatient portal research is emerging. Further investigation is needed to optimally design inpatient portals to maximize potential benefits for hospitalized patients and caregivers while minimizing unintended consequences for healthcare teams. © 2017 Society of Hospital Medicine.

Assessment of private hospital portals: A conceptual model

Directory of Open Access Journals (Sweden)

Mehdi Alipour-Hafezi

2016-01-01

Full Text Available Introduction: Hospital portals, as the first virtual entry, play an important role in connecting people with hospital and also presenting hospital virtual services. The main purpose of this article was to suggest a conceptual model to improve Tehran private hospital portals. The suggested model can be used by all the health portals that are in the same circumstances and all the health portals which are in progress. Method: This is a practical research, using evaluative survey research method. Research population includes all the private hospital portals in Tehran, 34 portals, and ten top international hospital portals. Data gathering tool used in this research was a researcher-made checklist including 14 criteria and 77 sub-criteria with their weight score. In fact, objective observation with the mentioned checklist was used to gather information. Descriptive statistics were used to analyze the data and tables and graphs were used to present the organized data. Also, data were analyzed using independent t-test. Conceptual modeling technique was used to design the model and demonstration method was used to evaluate the proposed model. In this regard, SPSS statistical software was used to perform the tests. Results:The comparative study between the two groups of portals, TPH and WTH, in the 14 main criteria showed that the value of t-test in contact information criteria was 0.862, portal page specification was -1.378, page design criteria -1.527, updating pages -0.322, general information and access roads -3.161, public services -7.302, patient services -4.154, patient data -8.703, research and education -9.155, public relationship -3.009, page technical specifications -4.726, telemedicine -7.488, pharmaceutical services -6.183, and financial services -2.782. Finally, the findings demonstrated that Tehran private hospital portals in criterion of contact information were favorable; page design criteria were relatively favorable; page technical

Portal placement in elbow arthroscopy by novice surgeons: cadaver study.

Science.gov (United States)

Claessen, Femke M A P; Kachooei, Amir R; Kolovich, Gregory P; Buijze, Geert A; Oh, Luke S; van den Bekerom, Michel P J; Doornberg, Job N

2017-07-01

In this anatomical cadaver study, the distance between major nerves and ligaments at risk for injury and portal sites created by trainees was measured. Trainees, inexperienced in elbow arthroscopy, have received a didactic lecture and cadaver instruction prior to portal placement. The incidence of iatrogenic injury from novice portal placement was also determined. Anterolateral, direct lateral, and anteromedial arthroscopic portals were created in ten cadavers by ten inexperienced trainees in elbow arthroscopy. After creating each portal, the trajectory of the portal was marked with a guide pin. Subsequently, the cadavers were dissected and the distances between the guide pin in the anterolateral, direct lateral, and anteromedial portals and important ligaments and nerves were measured. The difference between the distance of the direct lateral portal and the posterior antebrachial cutaneous nerve (PABCN) (22 mm, p cadaver instruction session alone. Level of evidence V.

Extrinsic and intrinsic blood supply to the optic chiasm.

Science.gov (United States)

Salaud, Céline; Ploteau, Stéphane; Blery, Pauline; Pilet, Paul; Armstrong, Olivier; Hamel, Antoine

2018-04-01

Although there have been many studies of the arterial cerebral blood supply, only seven have described the optic chiasm (OC) blood supply and their results are contradictory. The aim of this study was to analyze the extrinsic and intrinsic OC blood supply on cadaveric specimens using dissections and microcomputer tomography (Micro-CT). Thirteen human specimens were dissected and the internal or common carotid arteries were injected with red latex, China Ink with gelatin or barium sulfate. Three Micro-CTs were obtained to reveal the intrinsic blood supply to the OC. The superior hypophyseal arteries (SupHypA) (13/13) and posterior communicating artery (PCoA) (12/13) supplied the pial network on the inferior side of the OC. The first segment of the anterior cerebral artery (ACA) (10/10), SupHypA (7/10), the anterior communicating artery (ACoA) (9/10), and PComA (1/10) supplied the pial network of its superior side. The intrinsic OC blood supply was divided into three networks (two lateral and one central). Capillaries entering the OC originated principally from the inferior pial network. The lateral network capillaries had the same orientation as the visual lateral pathways, but the central network was not correlated with the nasal fibers crossing into the OC. There was no anastomosis in the pial or intrinsic networks. Only SupHypA, PCoA, ACoA, and ACA were involved in the OC blood supply. Because there was no extrinsic or intrinsic anastomosis, all arteries should be preserved. Tumor compression of the inferior intrinsic arterial network could contribute to visual defects. Clin. Anat. 31:432-440, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Successful Treatment of Bleeding Gastric Varices with Splenectomy in a Patient with Splenic, Portal, and Mesenteric Thromboses

Directory of Open Access Journals (Sweden)

Lior Menasherian-Yaccobe

2013-01-01

Full Text Available A 59-year-old female with a history of multiple splanchnic and portal thromboses treated with warfarin underwent an esophagogastroduodenoscopy for cancer screening, and a polypoid mass was biopsied. One week later, she was admitted with upper gastrointestinal hemorrhage. Her therapeutic coagulopathy was reversed with fresh frozen plasma, and she was transfused with packed red blood cells. An esophagogastroduodenoscopy demonstrated an erosion of a gastric varix without evidence of recent bleeding. Conservative measures failed, and she continued to bleed during her stay. She was not considered a candidate for a shunt procedure; therefore, a splenectomy was performed. Postoperative esophagogastroduodenoscopy demonstrated near complete resolution of gastric varices. One year after discharge on warfarin, there has been no recurrence of hemorrhage. Gastric varices often arise from either portal hypertension or splenic vein thrombosis. Treatment of gastric variceal hemorrhage can be challenging. Transjugular intrahepatic portosystemic shunt is often effective for emergency control in varices secondary to portal hypertension. Splenectomy is the treatment for varices that arise from splenic vein thrombosis. However, treatment of gastric variceal hemorrhage in the context of multiple splanchnic and portal vein thromboses is more complicated. We report splenectomy as a successful treatment of gastric varices in a patient with multiple extrahepatic thromboses.

Celecoxib ameliorates portal hypertension of the cirrhotic rats through the dual inhibitory effects on the intrahepatic fibrosis and angiogenesis.

Directory of Open Access Journals (Sweden)

Jin-Hang Gao

Full Text Available BACKGROUND: Increased intra-hepatic resistance to portal blood flow is the primary factor leading to portal hypertension in cirrhosis. Up-regulated expression of cyclooxygenase-2 (COX-2 in the cirrhotic liver might be a potential target to ameliorate portal hypertension. OBJECTIVE: To verify the effect of celecoxib, a selective inhibitor of COX-2, on portal hypertension and the mechanisms behind it. METHODS: Cirrhotic liver model of rat was established by peritoneal injection of thiacetamide (TAA. 36 rats were randomly assigned to control, TAA and TAA+celecoxib groups. Portal pressures were measured by introduction of catheters into portal vein. Hepatic fibrosis was assessed by the visible hepatic fibrotic areas and mRNAs for collagen III and α-SMA. The neovasculature was determined by hepatic vascular areas, vascular casts and CD31 expression. Expressions of COX-2, vascular endothelial growth factor (VEGF, VEGF receptor-2 (VEGFR-2 and related signal molecules were quantitated. RESULTS: Compared with TAA group, the portal pressure in TAA+celecoxib group was significantly decreased by 17.8%, p<0.01. Celecoxib treatment greatly reduced the tortuous hepatic portal venules. The data of fibrotic areas, CD31expression, mRNA levels of α-SMA and collagen III in TAA+celecoxib group were much lower than those in TAA group, p<0.01. Furthermore, the up-regulation of hepatic mRNA and protein levels of VEGF, VEGFR-2 and COX-2 induced by TAA was significantly inhibited after celecoxib treatment. The expressions of prostaglandin E2 (PGE2, phosphorylated extracellular signal-regulated kinase (p-ERK, hypoxia-inducible factor-1α (HIF-1α, and c-fos were also down-regulated after celecoxib treatment. CONCLUSIONS: Long term administration of celecoxib can efficiently ameliorate portal hypertension in TAA rat model by its dual inhibitory effects on the intrahepatic fibrosis and angiogenesis. The anti-angiogenesis effect afforded by celecoxib may attribute to its

Portal Hypertension Secondary to Spontaneous Arterio-Portal Venous Fistulas: Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate and Microcoils

International Nuclear Information System (INIS)

Yamagami, Takuji; Nakamura, Toshiyuki; Nishimura, Tsunehiko

2000-01-01

We report a 73-year-old man with recurrent variceal bleeding due to portal hypertension caused by multiple intrahepatic arterio-portal venous fistulas, which were successfully occluded by embolization with n-butyl cyanoacrylate and micro-coils

The Portals 4.1 Network Programming Interface

Energy Technology Data Exchange (ETDEWEB)

Barrett, Brian; Brightwell, Ronald B.; Grant, Ryan; Hemmert, Karl Scott; Pedretti, Kevin; Wheeler, Kyle; Underwood, Keith D; Riesen, Rolf; Maccabe, Arthur B.; Hudson, Trammel

2017-04-01

This report presents a specification for the Portals 4 networ k programming interface. Portals 4 is intended to allow scalable, high-performance network communication betwee n nodes of a parallel computing system. Portals 4 is well suited to massively parallel processing and embedded syste ms. Portals 4 represents an adaption of the data movement layer developed for massively parallel processing platfor ms, such as the 4500-node Intel TeraFLOPS machine. Sandia's Cplant cluster project motivated the development of Version 3.0, which was later extended to Version 3.3 as part of the Cray Red Storm machine and XT line. Version 4 is tar geted to the next generation of machines employing advanced network interface architectures that support enh anced offload capabilities.

The Portals 4.0 network programming interface.

Energy Technology Data Exchange (ETDEWEB)

Barrett, Brian W.; Brightwell, Ronald Brian; Pedretti, Kevin; Wheeler, Kyle Bruce; Hemmert, Karl Scott; Riesen, Rolf E.; Underwood, Keith Douglas; Maccabe, Arthur Bernard; Hudson, Trammell B.

2012-11-01

This report presents a specification for the Portals 4.0 network programming interface. Portals 4.0 is intended to allow scalable, high-performance network communication between nodes of a parallel computing system. Portals 4.0 is well suited to massively parallel processing and embedded systems. Portals 4.0 represents an adaption of the data movement layer developed for massively parallel processing platforms, such as the 4500-node Intel TeraFLOPS machine. Sandias Cplant cluster project motivated the development of Version 3.0, which was later extended to Version 3.3 as part of the Cray Red Storm machine and XT line. Version 4.0 is targeted to the next generation of machines employing advanced network interface architectures that support enhanced offload capabilities.

Computed tomographic evaluation of the portal vein in the hepatomas

Energy Technology Data Exchange (ETDEWEB)

Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam [Hanyang University College of Medicine, Seoul (Korea, Republic of)

1986-10-15

Computed tomography and pornographic findings of 63 patients with hepatoma, undergone hepatic angiography and superior mesenteric pornography for evaluation of tumor and thrombosis of portal vein and determination of indication of transcatheter arterial embolization for palliative treatment of hepatoma from April, 85 to June, 86 in Hanyang university hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis was detected during photography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the liver showed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liver revealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2. Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence of portal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal vein thrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did not reveal contrast enhancement. 4. CT revealed well the evidence of obstructions in the cases of portal vein thrombosis and the findings were well-corresponded to the findings of the superior mesenteric photography. 5. Five of the cases of the portal vein thrombosis were missed in the CT and the causes were considered as due to partial volume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases with occlusion of main portal vein showed cavernous transformation and they were noted as multiple small enhanced vascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a useful modality to detect the changes of the portal veins in the patients of the hepatoma.

Computed tomographic evaluation of the portal vein in the hepatomas

International Nuclear Information System (INIS)

Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam

1986-01-01

Computed tomography and pornographic findings of 63 patients with hepatoma, undergone hepatic angiography and superior mesenteric pornography for evaluation of tumor and thrombosis of portal vein and determination of indication of transcatheter arterial embolization for palliative treatment of hepatoma from April, 85 to June, 86 in Hanyang university hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis was detected during photography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the liver showed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liver revealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2. Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence of portal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal vein thrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did not reveal contrast enhancement. 4. CT revealed well the evidence of obstructions in the cases of portal vein thrombosis and the findings were well-corresponded to the findings of the superior mesenteric photography. 5. Five of the cases of the portal vein thrombosis were missed in the CT and the causes were considered as due to partial volume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases with occlusion of main portal vein showed cavernous transformation and they were noted as multiple small enhanced vascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a useful modality to detect the changes of the portal veins in the patients of the hepatoma.

A study of trans-rectal portal scintigraphy for the diagnostic evaluation of portal hypertension with hepatic cirrhosis

International Nuclear Information System (INIS)

Tang Mingdeng; Dong Weiyu; Liu Yonghua; He Pinyu; Li Zhener

1996-01-01

The portal hypertension of hepatic cirrhosis was studied by 99m Tc-MIBI trans-rectum imaging. The portal systemic circulation was evaluated by the heart-liver ratio (H/L ratio) and the portosystemic shunt index (SI). The H/L and SI in 12 normal cases were 0.145 +- 0.042 and 0.124 +- 0.029. Whereas in 18 patients with hepatobiliary diseases of non-cirrhosis were 0.207 +- 0.076 and 0.169 +- 0.051, and in 47 patients with hepatic cirrhosis were 0.751 +-0.313 and 0.422 +- 0.075. The results showed significant difference (P<0.01) between normal controls and non-cirrhosis group, and significant difference (P<0.001) between hepatic cirrhosis group and normal controls, non-cirrhosis group. A significant difference (P<0.05) in child-pugh's classification A, B and C groups was also found. A significant correlation (r = 0.95, P<0.01) with the H/L, SI and portal pressure measurement during operation was found. If H/L≥0.30, and SI≥0.22 were taken as positive criteria for diagnosis of portal hypertension with hepatic cirrhosis, the sensitivity, specificity and accuracy were 96%, 90% and 94% respectively. Therefore, it was a new method for the diagnosis of portal hypertension with hepatic cirrhosis

Effect of abomasal infusion of oligofructose on portal-drained visceral ammonia and urea-nitrogen fluxes in lactating Holstein cows

DEFF Research Database (Denmark)

Røjen, Betina Amdisen; Larsen, Mogens; Kristensen, Niels Bastian

2012-01-01

by reduced NH3 input to hepatic urea-N synthesis caused by increased sequestration of NH3 in the hindgut and excretion in feces. Increasing the hindgut fermentation in lactating dairy cows by abomasal infusion of 1,500 g/d of oligofructose shifted some N excretion from the urine to feces and possibly reduced......The effects of abomasal infusion of oligofructose in lactating dairy cows on the relationship between hindgut fermentation and N metabolism, and its effects on NH3 absorption and transfer of blood urea-N across the portal-drained viscera versus ruminal epithelia were investigated. Nine lactating...... treatments. Eight sample sets of arterial, portal, hepatic, and ruminal vein blood, ruminal fluid, and urine were obtained at 0.5 h before the morning feeding and at 0.5, 1.5, 2.5, 3.5, 4.5, 5.5, and 6.5 h after feeding. It was hypothesized that an increased supply of fermentable substrate to the hindgut...

Portal Annular Pancreas

Science.gov (United States)

Harnoss, Jonathan M.; Harnoss, Julian C.; Diener, Markus K.; Contin, Pietro; Ulrich, Alexis B.; Büchler, Markus W.; Schmitz-Winnenthal, Friedrich H.

2014-01-01

Abstract Portal annular pancreas (PAP) is an asymptomatic congenital pancreas anomaly, in which portal and/or mesenteric veins are encased by pancreas tissue. The aim of the study was to determine the role of PAP in pancreatic surgery as well as its management and potential complication, specifically, postoperative pancreatic fistula (POPF). On the basis of a case report, the MEDLINE and ISI Web of Science databases were systematically reviewed up to September 2012. All articles describing a case of PAP were considered. In summary, 21 studies with 59 cases were included. The overall prevalence of PAP was 2.4% and the patients' mean (SD) age was 55.9 (16.2) years. The POPF rate in patients with PAP (12 pancreaticoduodenectomies and 3 distal pancreatectomies) was 46.7% (in accordance with the definition of the International Study Group of Pancreatic Surgery). Portal annular pancreas is a quite unattended pancreatic variant with high prevalence and therefore still remains a clinical challenge to avoid postoperative complications. To decrease the risk for POPF, attentive preoperative diagnostics should also focus on PAP. In pancreaticoduodenectomy, a shift of the resection plane to the pancreas tail should be considered; in extensive pancreatectomy, coverage of the pancreatic remnant by the falciform ligament could be a treatment option. PMID:25207658

Racial/ethnic variation in devices used to access patient portals.

Science.gov (United States)

Chang, Eva; Blondon, Katherine; Lyles, Courtney R; Jordan, Luesa; Ralston, James D

2018-01-01

We examined racial/ethnic variation in the devices used by patients to access medical records through an online patient portal. Retrospective, cross-sectional analysis. Using data from 318,700 adults enrolled in an integrated delivery system between December 2012 and November 2013, we examined: 1) online patient portal use that directly engages the electronic health record and 2) portal use over desktops/laptops only, mobile devices only, or both device types. The primary covariate was race/ethnicity (non-Hispanic white, black, Hispanic, and Asian). Other covariates included age, sex, primary language, and neighborhood-level income and education. Portal use and devices used were assessed with multiple and multinomial logistic models, respectively. From December 2012 to November 2013, 56% of enrollees used the patient portal. Of these portal users, 62% used desktops/laptops only, 6% used mobile devices only, and 32% used both desktops/laptops and mobile devices. Black, Hispanic, and Asian enrollees had significantly lower odds of portal use than whites. Black and Hispanic portal users also were significantly more likely to use mobile devices only (relative risk ratio, 1.73 and 1.44, respectively) and both device types (1.21 and 1.07, respectively) than desktops/laptops only compared with whites. Although racial/ethnic minority enrollees were less likely to access the online patient portal overall, a greater proportion of black and Hispanic users accessed the patient portal with mobile devices than did non-Hispanic white users. The rapid spread of mobile devices among racial/ethnic minorities may help reduce variation in online patient portal use. Mobile device use may represent an opportunity for healthcare organizations to further engage black and Hispanic enrollees in online patient portal use.

Portal-venous gas unrelated to mesenteric ischemia

International Nuclear Information System (INIS)

Wiesner, Walter; Mortele, Koenraad J.; Ji, Hoon; Ros, Pablo R.; Glickman, Jonathan N.

2002-01-01

The aim of this study was to report on 8 patients with all different non-ischemic etiologies for portal-venous gas and to discuss this rare entity and its potentially misleading CT findings in context with a review of the literature. The CT examinations of eight patients who presented with intrahepatic portal-venous gas, unrelated to bowel ischemia or infarction, were reviewed and compared with their medical records with special emphasis on the pathogenesis and clinical impact of portal-venous gas caused by non-ischemic conditions. The etiologies for portal-venous gas included: abdominal trauma (n=1); large gastric cancer (n=1); prior gastroscopic biopsy (n=1); prior hemicolectomy (n=1); graft-vs-host reaction (n=1); large paracolic abscess (n=1); mesenteric recurrence of ovarian cancer superinfected with clostridium septicum (n=1); and sepsis with Pseudomonas aeruginosa (n=1). The clinical outcome of all patients was determined by their underlying disease and not negatively influenced by the presence of portal-venous gas. Although the presence of portal-venous gas usually raises the suspicion of bowel ischemia and/or intestinal necrosis, this CT finding may be related to a variety of non-ischemic etiologies and pathogeneses as well. The knowledge about these conditions may help to avoid misinterpretation of CT findings, inappropriate clinical uncertainty and unnecessary surgery in certain cases. (orig.)

Analysis of Dynamic Characteristics of Portal Frame with Variable Section

OpenAIRE

Hao Jianing

2016-01-01

Combined with a portal frame design, by the use of finite element software ANSYS, the finite element model of single specimens of portal rigid frame and the overall portal rigid frame building are established. portal rigid frame’s beam and column is variable cross section. Through the modal analysis, comparative analysis of the frequency and vibration type of the radiolabeling specimens and finite element model of the whole, for the further development of variable cross-section portal rigid f...

Trombosis portal y mesentérica asociada al déficit de la proteína S Portal and mesenteric thrombosis associated with protein S deficiency

Directory of Open Access Journals (Sweden)

J. A. Chirinos Vega

2008-02-01

gastrointestinal bleeding. She reported mild, diffuse abdominal pain in the last 2 weeks. Endoscopy revealed ruptured esophageal varices. Doppler ultrasonography and CT demonstrated a heterogeneous liver, splenomegaly and ascites, and complete non-occlusive PT involving the hilum and portal branches, as well as the superior mesenteric vein, with portosystemic collaterals. At this point a complete study for cirrhosis etiologies was negative, including a liver biopsy that showed nonspecific architectural changes secondary to diminished blood flow, which suggested non-cirrhotic portal hypertension. The search for hypercoagulability states determined a deficiency of S protein, with total pS = 107% and free pS = 56%. The patient was started on anticoagulant treatment and no other thrombotic events occurred. Discussion: PT usually manifests without specific symptoms. The most common presentation is upper gastrointestinal bleeding, as occurred in our patient. Liver cirrhosis is one of the most frequent cause of PT. Up to 65% of these patients present an associated prothrombotic state, including protein S deficiency. Our case reminds us of the importance of a systematic search for hipercoagulability syndromes in patients with TP, even when the etiology can be conferred to liver cirrhosis.

Comparison of detection pattern of HCC by ferumoxide-enhanced MRI and intratumoral blood flow pattern

International Nuclear Information System (INIS)

Itou, Naoki; Kotake, Fumio; Saitou, Kazuhiro; Abe, Kimihiko

2000-01-01

We compared the detection rate and pattern of ferumoxide-enhanced magnetic resonance imaging (Fe-MRI) with the intratumoral blood flow pattern determined by CT angiography (CTA) and CT portography (CTAP) in 124 nodes (34 cases) diagnosed as hepatocellular carcinoma (HCC) or borderline HCC, based on the clinical course. Sequences to obtain a T1-weighted images (T1W), proton density-weighted images (PDW), T2-weighted images (T2W), T2*-weighted images (T2*W) were used in Fe-MRI. In nodes shown to be hypervascular on CTA, the detection rate by Fe-MRI was 69.7%. In nodes shown to be avascular by CTAP, the detection rate by Fe-MRI was 67.3%. These rates were higher than with other flow patterns. In nodes showing high signal intensity (HSI) on any sequences, arterial blood flow was increased and portal blood flow decreased in comparison with nodes without high signal intensity. All nodes showing HSI, both on Fe-MRI T2W and T2*W, were hypervascular on CTA, and portal blood flow was absent on CTAP. Nodes showing HSI on both T2*W and T2W were considered to have greater arterial blood flow and decreased portal blood flow compared with nodes appearing as HSI on T2*W, but only as iso- or low signal intensity on T2W (Mann-Whitney U-test; p<0.05). (author)

A user-oriented model for global enterprise portal design

NARCIS (Netherlands)

Feng, X.; Ehrenhard, Michel Léon; Hicks, Jeff; Maathuis, Stephanus Johannes; Maathuis, S.J.; Hou, Y.

2010-01-01

Enterprise portals collect and synthesise information from various systems to deliver personalised and highly relevant information to users. Enterprise portals' design and applications are widely discussed in the literature; however, the implications of portal design in a global networked

The introduction of a neonatal hypothyroidism screening using a radioimmunological thyrotropin determination in whole blood in the Bonn area

International Nuclear Information System (INIS)

Brand, J.

1982-01-01

The hypophyseal hormone TSH is a sensitive as well as specific screening parameter for the early recognition of connate primary hypothyroidism, since because of the autonomy of the fetal thyroid regulation system it indicates itself already in newborns by a clearly increased serum level. The methodical development of a radioimmunological determination of TSH in whole blood by means of commercial reagents as a screening method is described and compared to other procedures. The best time for the carrying out of the screening (here the 5th day of life) is discussed. From all together 3204 examinations on newborns in this program a hypothyroidal metabolic condition could be diagnosed in 5 children. (TRV) [de

Noncirrhotic portal fibrosis after Wilms' tumor therapy

International Nuclear Information System (INIS)

Barnard, J.A.; Marshall, G.S.; Neblett, W.W.; Gray, G.; Ghishan, F.K.

1986-01-01

A 9-yr-old girl developed massive hemorrhage from esophageal varices 2 yr after combined modality therapy for Wilms' tumor. Evaluation showed a patent extrahepatic portal venous system and an elevated splenic pulp pressure. In contrast to previous reports of hepatopathy after irradiation injury, histologic sections of the liver did not demonstrate occlusion of the central veins, but rather a diffuse obliteration of intrahepatic portal venous radicles. This pattern of noncirrhotic portal fibrosis has not been described following antitumor therapy

Portal circulation aneurysms: two case reviews

International Nuclear Information System (INIS)

Perret, W. L.; Silva, A de.; Elzarka, A.; Schelleman, A.

2007-01-01

Venous aneurysms of the superior mesenteric vein and portal vein are an uncommon occurrence and often an incidental finding. They can also be associated with hepatocellular disease and portal hypertension. We present CT and ultrasound findings of these entities. The management of venous aneurysms is generally conservative with serial imaging

On the usefulness of portal monitor unit subtraction in radiation therapy

International Nuclear Information System (INIS)

Kuperman, Vadim Y; Lubich, Leslie M

2003-01-01

In order to avoid additional dose to patients caused by portal imaging with megavoltage x-rays, portal monitor units (MUs) are frequently subtracted from the actual treatment MUs. This study examines the usefulness of portal MU subtraction in radiation therapy. For 11 prostate cancer patients treated with 23 MV photons, dose to prostate due to portal filming with 6 MV photons was determined. In all 11 patients subtraction of portal MU values from the actual treatment MUs resulted in a small underdosing of the prostate with an average treatment error of -0.5%. Portal filming without MU subtraction would cause small overdosing of the prostate with an average treatment error of 1.2%. The results of this study indicate that the benefits of portal MU subtraction are in doubt if (a) the energy of treatment x-rays is much higher than that of the portal x-rays and/or (b) when radiotherapy is performed with physical wedges. Based on the obtained results, we argue against unconditional use of the portal MU subtraction method to eliminate the dose from portal imaging

Portal Vein Embolization with Radiolabeled Polyvinyl Alcohol Particles in a Swine Model: Hepatic Distribution and Implications for Pancreatic Islet Cell Transplantation

International Nuclear Information System (INIS)

Owen, Richard J.; Mercer, John R.; Al-Saif, Faisal; Molinari, Michele; Ashforth, Robert A.; Rajotte, Ray V.; Conner-Spady, Barbara; Shapiro, A. M. James

2009-01-01

The distribution of radiolabeled polyvinyl alcohol microspheres (PVAMs) when infused into the portal vein of domestic swine was investigated, with the purpose of assessing implications for pancreatic islet cell transplantation. PVAMs measuring 100-300 μm (Contour SE) and labeled with 99m Tc were infused into the main portal vein of 12 swine, with intermittent portal venous pressure measurements. The infusion catheter was introduced antegradely via direct or indirect cannulation of the portal vein. The liver was subsequently divided into anatomical segments. Radioactivity (decay corrected) was measured for 99m Tc microsphere synthesis, dose preparation, gross organ activities, tissue samples, and blood. Particulate labeling, catheter positioning, and infusion were successful in all cases. The number of particles used was (185,000 ± 24,000) with a volume of 1 ml. Mean portal pressure at 5 min was significantly higher than baseline, but without a significant difference at 15 min. Extrahepatic tissue and serum radioactivity was negligible. A significant difference in number of radioactive particles per gram was detected between segments 6/7 and segments 5/8. Intrasegmental activity was analyzed, and for segments 2/3 a significant difference in the percentage dose per gram across samples was demonstrated (P = 0.001). Effective and stable radiolabeling of PVAMs with 99m Tc-sulfur colloid was demonstrated. Portal venous infusion of 100- to 300-μm particles showed entrapment in the sinusoidal hepatic system with transient portal pressure elevation. Preferential embolization into the right lateral and posterior segments occurs, suggesting that flow dynamics/catheter tip position plays a role in particle distribution.

Effects of glucose ingestion on hepatic hemodynamics in patients with liver disease by per-rectal portal scintigraphy using 99mTcO4- (direct intramural administration of radioisotope method)

International Nuclear Information System (INIS)

Tetsuka, Isando; Ohe, Takashi; Harada, Takashi

1992-01-01

Effect of glucose (225 ml, 300 kcal) ingestion on hepatic hemodynamics was studied in ten patients with liver cirrhosis and eight patients with non cirrhotic liver disease by per-rectal portal scintigraphy using 99m TcO 4 - (direct intramural administration of radioisotope method). Initial portal blood flow index (IP) and collateral index (CI) were calculated from the time activity curve of heart and liver. The value of IP was not significantly changed between before and after glucose ingestion in cases of liver cirrhosis (before: 0.0160±0.0016, after: 0.0204±0.0106). In cases of non cirrhotic liver disease, the value of IP was significantly increased after glucose ingestion (before: 0.0381±0.0145, after: 0.0544±0.0194, p<0.02). These findings suggested increase in portal blood flow via inferior mesenteric vein to the cardiac blood flow. The value of CI before glucose ingestion was significantly increased in cases of liver cirrhosis (0.751±0.156) compared with that in cases of non cirrhotic liver disease (0.517±0.122), but no significant difference in values after glucose ingestion was found between these two groups. (author)

Modified Anterolateral Portals in Elbow Arthroscopy: A Cadaveric Study on Safety.

Science.gov (United States)

Thon, Stephen; Gold, Peter; Rush, Lane; O'Brien, Michael J; Savoie, Felix H

2017-11-01

To evaluate the proximity to the radial nerve on cadaveric specimens of 2 modified anterolateral portals used for elbow arthroscopy. Ten fresh cadaveric elbow specimens were prepared. Four-millimeter Steinman pins were inserted into 3 anterolateral portal sites in relation to the lateral epicondyle: (1) the standard distal anterolateral portal, (2) a modified direct anterolateral portal, and (3) a modified proximal anterolateral portal. These were defined as follows: direct portals 2 cm directly anterior to the lateral epicondyle, and proximal portals 2 cm proximal and 2 cm directly anterior to the lateral epicondyle. Each elbow was then dissected to reveal the course of the radial nerve. Digital photographs were taken of each specimen, and the distance from the Steinman pin to the radial nerve was measured. The modified proximal anterolateral and direct anterolateral portals were found to be a statistically significant distance from the radial nerve compare to the distal portal site (P = .011 and P = .0011, respectively). No significant difference was found in the proximity of the radial nerve between the modified proximal and direct anterolateral portals (P = .25). Inadequate imaging was found at a single portal site for the proximal site; 9 specimens were used for analysis of this portal with 10 complete specimens for the other 2 sites. In cadaveric analysis, both the modified proximal and direct lateral portals provide adequate distance from the radial nerve and may be safe for clinical use. In this study, the distal anterolateral portal was in close proximity of the radial nerve and may result in iatrogenic injury in the clinical setting. This is a cadaveric analysis of 2 modified portal locations at the anterolateral elbow for use in elbow arthroscopy. Further clinical studies are needed prior to determining their absolute safety in comparison to previously identified portal sites. Copyright © 2017 Arthroscopy Association of North America. Published by

Factors Affecting Faculty Web Portal Usability

Science.gov (United States)

Bringula, Rex P.; Basa, Roselle S.

2011-01-01

The study investigated the factors that might significantly affect web portal usability. Results of the study were intended to serve as inputs for faculty web portal development of the University of the East-Manila. Descriptive statistics utilized questionnaire data from 82 faculty members. The data showed that most of the respondents were…

Algorithms for contrast enhancement of electronic portal images

International Nuclear Information System (INIS)

Díez, S.; Sánchez, S.

2015-01-01

An implementation of two new automatized image processing algorithms for contrast enhancement of portal images is presented as suitable tools which facilitate the setup verification and visualization of patients during radiotherapy treatments. In the first algorithm, called Automatic Segmentation and Histogram Stretching (ASHS), the portal image is automatically segmented in two sub-images delimited by the conformed treatment beam: one image consisting of the imaged patient obtained directly from the radiation treatment field, and the second one is composed of the imaged patient outside it. By segmenting the original image, a histogram stretching can be independently performed and improved in both regions. The second algorithm involves a two-step process. In the first step, a Normalization to Local Mean (NLM), an inverse restoration filter is applied by dividing pixel by pixel a portal image by its blurred version. In the second step, named Lineally Combined Local Histogram Equalization (LCLHE), the contrast of the original image is strongly improved by a Local Contrast Enhancement (LCE) algorithm, revealing the anatomical structures of patients. The output image is lineally combined with a portal image of the patient. Finally the output images of the previous algorithms (NLM and LCLHE) are lineally combined, once again, in order to obtain a contrast enhanced image. These two algorithms have been tested on several portal images with great results. - Highlights: • Two Algorithms are implemented to improve the contrast of Electronic Portal Images. • The multi-leaf and conformed beam are automatically segmented into Portal Images. • Hidden anatomical and bony structures in portal images are revealed. • The task related to the patient setup verification is facilitated by the contrast enhancement then achieved.

Ultrasound and Doppler examination capabilities in adult portal hypertension type definition

Directory of Open Access Journals (Sweden)

N. V. Tumanskaya

2015-08-01

Full Text Available Early portal hypertension type diagnostics is an ultimate factor concerning kind and tactics of treatment. Aim. To objectify ultrasound examination capabilities, portal hemodynamics were studied in 97 patients using impulse and color doppler. Methods and results. It was ascertained that impulse and color doppler examination allows to visualize portal vein and its branches’ structural abnormalities, define subhepatic and intrahepatic types of portal hypertension, find thrombosis and characterize its stages. In cirrhosis patients with portal hypertension, homogenous doppler signal was received from the portal vessels lumen, while signs of intraluminar pathology were seen in the case of thrombosis of portal vein. Conclusion. This means that ultrasound examination of portal vein and its branches with impulse and color doppler is informative, non invasive method, which helps to define stages of portal hypertension. Doppler ultrasonography doesn’t have negative effect of ionizing radiation and can be used for the repeated research in the dynamics of disease.

[Histology of liver lesions due to Schistosoma mekongi. About six cases with severe portal hypertension operated in Cambodia].

Science.gov (United States)

Monchy, D; Dumurgier, C; Heng, T K; Hong, K; Khun, H; Hou, S V; Sok, K E; Huerre, M R

2006-12-01

Schistosomiasis mekongi was shown to be endemic, along the Mekong River, in northern Cambodia, affecting many patients with portal hypertension. Surgical procedures were proposed to some patients with digestive haemorrhage history to avoid fatal recurrence. The aim of our study was to evaluate the intensity of the liver fibrosis among these patients. During surgical treatment, liver biopsies were collected, fixed in Bouin or in formalin and processed at the Institut Pasteur of Cambodia. Sections were stained by H&E, Masson's trichrome, PAS, Ziehl-Neelsen's method and Congo Red. A total of six biopsies from patients aged 16-36 were analysed. There was complete disorganization of hepatic architecture with fibrous enlargement of portal tracts and some portal-portal bridging fibrosis, but there was no cirrhosis. In portal areas, there was blood vessel congestion and thrombosis with inflammation. Bile ducts were normal. In the parenchyma, congestion of sinusoidal capillaries was combined with focal mononuclear inflammatory infiltrate. There was no steatosis, no necrosis, no cholestasis, no iron accumulation and no amyloidosis. Numerous eggs of Schistosoma mekongi were observed in five cases, mostly in fibrous areas and more rarely in the parenchyma. Eggs were round or oval, measuring 60 x 40 microns with an acid-fast thin hyaline wall. Some eggs were surrounded by epithelioid and giant cell reaction. In conclusion, our findings illustrated a surprisingly high degree of fibrosis among young adults which contrasts with other schistosomiasis.

Radionuclide splenoportography in patients with portal hypertension

International Nuclear Information System (INIS)

Kuriya, Kouji; Nagamachi, Shigeki; Hoshi, Hiroaki; Ohnishi, Takashi; Jinnouchi, Masashi; Futami, Sigemi; Yoshida, Akira; Watanabe, Katsuji

1991-01-01

Splenoportography using 99m Tc-pertechnetate was performed in 18 patients with portal hypertension. 99m Tc pertechnetate (370 MBq) was directly injected into the spleen. Co-lateral circulation of portal vein was observed in 13 of 18 patients (72%). L/H ratio was also calculated by the time activity curve of dynamic images. L/H ratio was significantly lower (p<0.05) in patients with colateral vessels and severe esophageal varix. Radionuclide splenography was an useful method for evaluating hemodynamics of portal vein. (author)

Advances in the treatment of portal hypertension in cirrhosis.

Science.gov (United States)

Kimer, N; Wiese, S; Mo, S; Møller, S; Bendtsen, F

2016-08-01

Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension.

Advances in the treatment of portal hypertension in cirrhosis

DEFF Research Database (Denmark)

Kimer, Nina; Wiese, S; Mo, S S

2016-01-01

Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led...... to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas...... of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension....

Partial splenic embolization as treatment for portal hypertension

Energy Technology Data Exchange (ETDEWEB)

Iijima, Toshihide; Kojima, Takahiro; Koitabashi, Hiroshi; Shiojima, Masayuki; Osumi, Masao; Nakano, Genichi; Nagamachi, Yukio

1987-11-01

Five cases of portal hypertension (2 cases of idiopathic portal hypertension (IPH) and three cases of liver cirrhosis (LC) were treated by partial splenic embolization (PSE) using Gelfoam particles and antibiotics. PSE was performed 3 times in one case and the others were treated once. The patients were followed for approximately three years after PSE. Platelet counts (PTLS), white blood cell counts (WBC) and hemoglobin levels (Hb) were followed. 1) Two cases of IPH resulted in a marked decrease in splenic size and increases in PLTS, WBC and Hb. 2) Two out of three LC cases died of acute hepatic failure after PSE. The third case has shown excellent results hematologically. 3) PLTS reached the highest level 2 weeks after PSE and decreased gradually. From 6 months to one year after PSE, PLTS again increased. 4) WBC was the highest on the third or forth day after PSE in those cases with over 60 % embolized spleen. In those cases with less than 60 % embolized it was the highest on the first day. The counts decreased gradually and then increased again between one and 5 months. 5) Hb began to increase about 3 weeks after PSE and continued to increase from 6 months to one year. 6) The repeated PSE is very effective for IPH cases but care should be taken in selecting LC cases for indication of PSE.

Interactive monitoring portal for fusion simulations

International Nuclear Information System (INIS)

Abla, G.; Schissel, D.P.; Kim, E.N.; Flanagan, S.M.; Lee, X.

2012-01-01

Highlights: ► We designed a web-based monitoring system that tracks the status of fusion simulations. ► Our system is scalable to monitor the simulations running on distributed supercomputers and clusters located at multiple geographical locations. ► The monitoring portal provides a web-based interface for post-run analysis, such as visualizing the results, logging the user comments, and rating the simulation quality. ► Our system utilizes the open source software, such as Python, Django, MySQL, Apache, and MDSplus. - Abstract: The Center for Simulation of RF Wave Interactions with Magnetohydrodynamics (SWIM) Project is a proto-Fusion Simulation Program (FSP) whose goal is to study high-performance fusion plasmas and perform comprehensive simulations that are essential to the development of fusion. SWIM team members are geographically distributed and utilize distributed supercomputers for computational simulations. Due to the highly distributed computational work environment, the SWIM team has the difficulty of monitoring code runs and discovering historical runs. To alleviate this difficulty a web-based monitoring portal has been developed and deployed. The monitoring portal tracks the progress of simulations and automatically collects metadata in real-time. This capability helps scientists to effectively utilize precious computer resources. Furthermore, the portal provides a web-based interface for post-run analysis, such as visualizing the results, logging the user comments, and rating the simulation quality. The user interface provides rapid discovery capability via multi-field searching and sorting. The development of the monitoring portal used open source software, such as Python, Django, MySQL, and Apache. It uses MDSplus for data management, Memcached for data caches, and OpenID for single sign-on security. This paper describes the software architecture, related technologies and deployment experiences of the monitoring portal.

Technical aspects of portal technology application for e-health systems.

Science.gov (United States)

Kosińska, Joanna; Słowikowski, Paweł

2004-01-01

E-health is an emerging field on the intersection of medical information technologies, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. Portal technology, allowing services to be accessible over the Internet is a perfect tool for providing e-health services. The use of portal technologies has had deep influence on the architecture of the whole e-health system, both regarding new subsystems and older ones which we want to integrate with the portal. Portals provide new possibilities for creating novel types of e-health applications as well. In this paper we provide a brief overview of e-health systems and portal technologies, and present many technical aspects of portal technology application for e-health systems such as the architecture of portal-based e-health systems, graphical user interfaces, access to various e-health systems' resources, personalization, security and privacy.

An Approach for harmonizing European Water Portals

Science.gov (United States)

Pesquer, Lluís; Stasch, Christoph; Masó, Joan; Jirka, Simon; Domingo, Xavier; Guitart, Francesc; Turner, Thomas; Hinderk Jürrens, Eike

2017-04-01

A number of European funded research projects is developing novel solutions for water monitoring, modeling and management. To generate innovations in the water sector, third parties from industry and the public sector need to take up the solutions and bring them into the market. A variety of portals exists to support this move into the market. Examples on the European level are the EIP Water Online Marketplace(1), the WaterInnEU Marketplace(2), the WISE RTD Water knowledge portal(3), the WIDEST- ICT for Water Observatory(4) or the SWITCH-ON Virtual Product Market and Virtual Water-Science Laboratory(5). Further innovation portals and initiatives exist on the national or regional level, for example, the Denmark knows water platform6 or the Dutch water alliance(7). However, the different portals often cover the same projects, the same products and the same services. Since they are technically separated and have their own data models and databases, people need to duplicate information and maintain it at several endpoints. This requires additional efforts and hinders the interoperable exchange between these portals and tools using the underlying data. In this work, we provide an overview on the existing portals and present an approach for harmonizing and integrating common information that is provided across different portals. The approach aims to integrate the common in formation in a common database utilizing existing vocabularies, where possible. An Application Programming Interface allows access the information in a machine-readable way and utilizing the information in other applications beyond description and discovery purposes. (1) http://www.eip-water.eu/my-market-place (2) https://marketplace.waterinneu.org (3) http://www.wise-rtd.info/ (4) http://iwo.widest.eu (5) http://www.switch-on-vwsl.eu/ (6) http://www.rethinkwater.dk/ (7) http://wateralliance.nl/

Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved Allografts

Directory of Open Access Journals (Sweden)

Arshad Khan

2014-01-01

Full Text Available In contrast to early HAT, late HAT has an insidious clinical presentation. Nevertheless, biliary and vascular reconstructions in this late setting are unlikely to improve outcome. Patent portal flow makes an important contribution to the viability of liver in case of late HAT while the allograft reconstitutes intrahepatic arterial flow through neovascularization. Concurrent HAT with PVT without immediate graft necrosis is extremely rare, and allograft and patient survival are seemingly impossible without retransplantation. In fact, hepatopetal arterial and portal venous neovascularization are known albeit obscure phenomena that can preserve posttransplant hepatic function under the extenuating circumstances of complete interruption of blood flow to the graft. We describe two such cases that developed combined HAT and PVT more than six months after OLT with perfect preservation of graft function. The survival of allografts in our cases was due to extensive hepatopetal arterial and portal venous collateralization. Simultaneous HAT and PVT after OLT are rare events and almost uniformly fatal, if they occur early. Due to paucity of such cases, however, underlying mechanisms and etiology remain elusive, and despite radiological diagnosis of these complications, there is no way to predict these events in the wake of stable graft function.

Research advances in non-cirrhotic portal hypertension

Directory of Open Access Journals (Sweden)

ZHANG Bojing

2016-02-01

Full Text Available Although liver cirrhosis is the most common cause of portal hypertension (PH, about 20% of PH cases are caused by non-cirrhotic reasons, which are referred to as non-cirrhotic portal hypertension (NCPH, with a high incidence rate in developing countries. NCPH is a group of heterogeneous hepatic vascular diseases, including idiopathic portal hypertension (IPH and extrahepatic portal vein obstruction (EHPVO, as well as the rare diseases in clinical practice such as Budd-Chiari syndrome, congenital hepatic fibrosis, and nodular regenerative hyperplasia. The patients with NCPH usually have the symptoms of portal hypertension, such as recurrent variceal bleeding and splenomegaly, but liver function is well preserved in these patients. At present, the diagnosis of NCPH lacks a universally accepted standard and remains a challenge. In clinical practice, the method of exclusion is usually applied for the diagnosis of HCPH, and liver biopsy is performed when necessary to make a confirmed diagnosis. This paper introduces the pathogenesis and pathological manifestations of IPH and EHPVO, as well as the selection of diagnostic methods and therapeutic strategies. If upper gastrointestinal bleeding can be effectively controlled, NCPH is considered to have a relatively good prognosis.

Analysis of Dynamic Characteristics of Portal Frame with Variable Section

Directory of Open Access Journals (Sweden)

Hao Jianing

2016-01-01

Full Text Available Combined with a portal frame design, by the use of finite element software ANSYS, the finite element model of single specimens of portal rigid frame and the overall portal rigid frame building are established. portal rigid frame’s beam and column is variable cross section. Through the modal analysis, comparative analysis of the frequency and vibration type of the radiolabeling specimens and finite element model of the whole, for the further development of variable cross-section portal rigid frame of earthquake and wind vibration analysis lay the foundation.

Radionuclide assessment of portal hypertension syndrome

International Nuclear Information System (INIS)

Aliev, M.A.; Khusain, Sh.K.; Alpeisova, Sh.T.

2005-01-01

This paper presents review of radionuclide studies for portal hypertension patients. Presented results showed that portal hypertension signs were revealed for the first group patients. The signs become apparent by splenomegaly and increase of colloid accumulation in it. Accumulation of the chemical in spleen was evidence of ingestion rate increase of reticuloendothelial system owing to its hyperplasia as well as liver phagocytic activity decrease due to pathological paren-chematous process and inter liver blockade. The most typical scintigraphic signs of portal hypertension were determined according chemical accumulation decreased in spleen and marrow sequentially. It is determined radionuclide method contributes to assessment of structural and functional aberrations character in liver and spleen for cirrhosis patients. (author)

[Association of biliary calculosis and portal cavernomatosis].

Science.gov (United States)

Crespi, C; De Giorgio, A M

1992-08-01

This paper reports the case of a woman, who underwent surgery because of cholelithiasis, with intraoperative finding of prehepatic portal hypertension from portal vein thrombosis ("portal cavernoma") with healthy liver, later confirmed by angiographic studies. This rare pathologic association carries a higher risk of major operative complications; therefore the Authors agree with the general belief that, for these cases, biliary tract surgery should be as simple and safe as possible. In the case of preoperative diagnosis of biliary disease associated with portal cavernoma, should a surgical approach on the biliary tract be required, we agree on the advisability of performing a shunting procedure before any kind of biliary surgery. In case of variceal bleeding endoscopic sclerotherapy will be the first choice; surgical procedures (shunting) should be seen as a second choice in case of rebleeding after sclerotherapy.

Patient activation and use of an electronic patient portal.

Science.gov (United States)

Ancker, Jessica S; Osorio, Snezana N; Cheriff, Adam; Cole, Curtis L; Silver, Michael; Kaushal, Rainu

2015-01-01

Electronic patient portals give patients access to personal medical data, potentially creating opportunities to improve knowledge, self-efficacy, and engagement in healthcare. The combination of knowledge, self-efficacy, and engagement has been termed activation. Our objective was to assess the relationship between patient activation and outpatient use of a patient portal. Survey. A telephone survey was conducted with 180 patients who had been given access to a portal, 113 of whom used it and 67 of whom did not. The validated patient activation measure (PAM) was administered along with questions about demographics and behaviors. Portal users were no different from nonusers in patient activation. Portal users did have higher education level and more frequent Internet use, and were more likely to have precisely 2 prescription medications than to have more or fewer. Patients who chose to use an electronic patient portal were not more highly activated than nonusers, although they were more educated and more likely to be Internet users.

A Case of Left Renal Vein Ligation in a Patient with Solitary Left Kidney Undergoing Liver Transplantation to Control Splenorenal Shunt and Improve Portal Venous Flow.

Science.gov (United States)

Martino, Rodrigo B; Júnior, Eserval Rocha; Manuel, Valdano; Rocha-Santos, Vinicius; D'Albuquerque, Luis Augusto C; Andraus, Wellington

2017-10-11

BACKGROUND Adequate portal venous flow is required for successful liver transplantation. Reduced venous flow and blood flow 'steal' by collateral vessels are a concern, and when there is a prominent splenorenal shunt present, ligation of the left renal vein has been recommended to improve portal venous blood flow. CASE REPORT A 51-year-old man who had undergone right nephrectomy in childhood required liver transplantation for liver cirrhosis and hepatocellular carcinoma due to hepatitis C virus (HCV) infection. The patient had no other comorbidity and no history of hepatorenal syndrome. At transplantation surgery, portal venous flow was poor and did not improve with ligation of shunt veins, but ligation of the left renal vein improved portal venous flow. On the first and fifth postoperative days, the patient was treated with basiliximab, a chimeric monoclonal antibody to the IL-2 receptor, and methylprednisolone. The calcineurin inhibitor, tacrolimus, was introduced on the fifth postoperative day. On the sixteenth postoperative day, renal color Doppler ultrasound showed normal left renal parenchyma; hepatic Doppler ultrasound showed good portal vein flow and preserved hepatic parenchyma in the liver transplant. CONCLUSIONS This case report has shown that in a patient with a single left kidney, left renal vein ligation is feasible and safe in a patient with no other risk factors for renal impairment following liver transplantation. Modification of postoperative immunosuppression to avoid calcineurin inhibitors in the very early postoperative phase may be important in promoting good recovery of renal function and to avoid the need for postoperative renal dialysis.

Contrast-enhanced ultrasound for quantitative assessment of portal pressure in canine liver fibrosis.

Science.gov (United States)

Zhai, Lin; Qiu, Lan-Yan; Zu, Yuan; Yan, Yan; Ren, Xiao-Zhuan; Zhao, Jun-Feng; Liu, Yu-Jiang; Liu, Ji-Bin; Qian, Lin-Xue

2015-04-21

To explore the feasibility of non-invasive quantitative estimation of portal venous pressure by contrast-enhanced ultrasound (CEUS) in a canine model. Liver fibrosis was established in adult canines (Beagles; n = 14) by subcutaneous injection of carbon tetrachloride (CCl4). CEUS parameters, including the area under the time-intensity curve and intensity at portal/arterial phases (Qp/Qa and Ip/Ia, respectively), were used to quantitatively assess the blood flow ratio of the portal vein/hepatic artery at multiple time points. The free portal venous pressures (FPP) were measured by a multi-channel baroreceptor using a percutaneous approach at baseline and 8, 16, and 24 wk after CCl4 injections in each canine. Liver biopsies were obtained at the end of 8, 16, and 24 wk from each animal, and the stage of the fibrosis was assessed according to the Metavir scoring system. A Pearson correlation test was performed to compare the FPP with Qp/Qa and Ip/Ia. Pathologic examination of 42 biopsies from the 14 canines at weeks 8, 16, and 24 revealed that liver fibrosis was induced by CCl4 and represented various stages of liver fibrosis, including F0 (n = 3), F1 (n = 12), F2 (n = 14), F3 (n = 11), and F4 (n = 2). There were significant differences in the measurements of Qp/Qa (19.85 ± 3.30 vs 10.43 ± 1.21, 9.63 ± 1.03, and 8.77 ± 0.96) and Ip/Ia (1.77 ± 0.37 vs 1.03 ± 0.12, 0.83 ± 0.10, and 0.69 ± 0.13) between control and canine fibrosis at 8, 16, and 24 wk, respectively (all P fibrosis model. Prediction of elevated FPP based on Qp/Qa and Ip/Ia was highly sensitive, as assessed by the area under the receiver operating curve (0.866 and 0.895, respectively). CEUS is a potential method to accurately, but non-invasively, estimate portal venous pressure through measurement of Qp/Qa and Ip/Ia parameters.

Enviroportal.sk - information portal about the environment

International Nuclear Information System (INIS)

Navratil, R.; Kmet, M.

2005-01-01

In this presentation author deals with history, conception and exploitation of information portal about environment in the Slovak Republic. This portal - Enviroportal.sk was introduced into service in testing operation in April 2005. Perspectives of Enviroportal.sk are discussed

Cocaine- and amphetamine-regulated transcript is present in hypothalamic neuroendocrine neurones and is released to the hypothalamic-pituitary portal circuit.

Science.gov (United States)

Larsen, P J; Seier, V; Fink-Jensen, A; Holst, J J; Warberg, J; Vrang, N

2003-03-01

Cocaine- and amphetamine-regulated transcript (CART) is present in a number of hypothalamic nuclei. Besides actions in circuits regulating feeding behaviour and stress responses, the hypothalamic functions of CART are largely unknown. We report that CART immunoreactivity is present in hypothalamic neuroendocrine neurones. Adult male rats received a systemic injection of the neuronal tracer Fluorogold (FG) 2 days before fixation, and subsequent double- and triple-labelling immunoflourescence analysis demonstrated that neuroendocrine CART-containing neurones were present in the anteroventral periventricular, supraoptic, paraventricular (PVN) and periventricular nuclei of the hypothalamus. In the PVN, CART-positive neuroendocrine neurones were found in all of cytoarchitectonically identified nuclei. In the periventricular nucleus, approximately one-third of somatostatin cells were also CART-immunoreactive. In the medial parvicellular subnucleus of the PVN, CART and FG coexisted with thyrotrophin-releasing hormone, whereas very few of the corticotrophin-releasing hormone containing cells were CART-immunoreactive. In the arcuate nucleus, CART was extensively colocalized with pro-opiomelanocortin in the ventrolateral part, but completely absent from neuroendocrine neurones of the dorsomedial part. To assess the possible role of CART as a hypothalamic-releasing factor, immunoreactive CART was measured in blood samples from the long portal vessels connecting the median eminence with the anterior pituitary gland. Adult male rats were anaesthetized and the infundibular stalk exposed via a transpharyngeal approach. The long portal vessels were transected and blood collected in 30-min periods (one prestimulatory and three poststimulatory periods). Compared to systemic venous plasma samples, baseline concentrations of immunoreactive CART were elevated in portal plasma. Exposure to sodium nitroprusside hypotension triggered a two-fold elevation of portal CART42

Advances in the management of childhood portal hypertension.

Science.gov (United States)

McKiernan, Patrick; Abdel-Hady, Mona

2015-05-01

Portal hypertension is one of the most serious complications of childhood liver disease, and variceal bleeding is the most feared complication. Most portal hypertension results from cirrhosis but extra hepatic portal vein obstruction is the single commonest cause. Upper gastrointestinal endoscopy endoscopy remains necessary to diagnose gastro-esophageal varices. Families of children with portal hypertension should be provided with written instructions in case of gastrointestinal bleeding. Children with large varices should be considered for primary prophylaxis on a case-by-case basis. The preferred method is variceal band ligation. Children with acute bleeding should be admitted to hospital and treated with antibiotics and pharmacotherapy before urgent therapeutic endoscopy. All children who have bled should then receive secondary prophylaxis. The preferred method is variceal band ligation and as yet there is little evidence to support the use of β-blockers. Children with extrahepatic portal vein obstruction should be assessed for suitability of mesoportal bypass.

Evaluation of hepatic blood flow using 99mTc-GSA in rats with hepatic blood flow manipulation

International Nuclear Information System (INIS)

Hiraguchi, Etsuo

1995-01-01

Blood clearance and hepatic uptake parameters of 99m Tc-DTPA-galactosyl human serum albumin ( 99m Tc-GSA) were evaluated in two groups of rats, normal liver group and CCl 4 induced chronic liver injury group. In each group, four subgroups were classified as follows: simple laparotomy (LAP), hepatic artery ligation (HAL), portal vein ligation (PVL) and both hepatic artery and portal vein ligation (HAL+PVL). 99m Tc-GSA was intravenously injected (50 μg/100 g B.W.) to rats. Heart and liver were targetted as region of interest and time activity curves (TACs) were obtained. The blood clearance parameters (HH4 and Kd) and the hepatic uptake parameters (LHL4 and Ku) were calculated from these TACs. In normal liver group, the mean HH4 of LAP was significantly different from those of PVL and HAL+PVL. Similarly, the other three parameters (LHL4, Kd and Ku) of LAP were significantly different from those of PVL and HAL+PVL. CCl 4 induced chronic liver injury group showed significant difference on all four parameters in four subgroups. Hepatic tissue blood flow rates (HTBFR) calculated by Laser Doppler flowmeter correlated well with 99m Tc-GSA parameters in both groups. These results suggest that 99m Tc-GSA is useful to estimate hepatic blood flow not only in rats with normal liver, but also in rats with CCl 4 induced chronic liver injury. (author)

Best Practices for Building Web Data Portals

Science.gov (United States)

Anderson, R. A.; Drew, L.

2013-12-01

With a data archive of more than 1.5 petabytes and a key role as the NASA Distributed Active Archive Center (DAAC) for synthetic aperture radar (SAR) data, the Alaska Satellite Facility (ASF) has an imperative to develop effective Web data portals. As part of continuous enhancement and expansion of its website, ASF recently created two data portals for distribution of SAR data: one for the archiving and distribution of NASA's MEaSUREs Wetlands project and one for newly digitally processed data from NASA's 1978 Seasat satellite. These case studies informed ASF's development of the following set of best practices for developing Web data portals. 1) Maintain well-organized, quality data. This is fundamental. If data are poorly organized or contain errors, credibility is lost and the data will not be used. 2) Match data to likely data uses. 3) Identify audiences in as much detail as possible. ASF DAAC's Seasat and Wetlands portals target three groups of users: a) scientists already familiar with ASF DAAC's SAR archive and our data download tool, Vertex; b) scientists not familiar with SAR or ASF, but who can use the data for their research of oceans, sea ice, volcanoes, land deformation and other Earth sciences; c) audiences wishing to learn more about SAR and its use in Earth sciences. 4) Identify the heaviest data uses and the terms scientists search for online when trying to find data for those uses. 5) Create search engine optimized (SEO) Web content that corresponds to those searches. Because search engines do not yet search raw data, so Web data portals must include content that ties the data to its likely uses. 6) Create Web designs that best serves data users (user centered design), not for how the organization views itself or its data. Usability testing was conducted for the ASF DAAC Wetlands portal to improve the user experience. 7) Use SEO tips and techniques. The ASF DAAC Seasat portal used numerous SEO techniques, including social media, blogging

The Higgs portal above threshold

Energy Technology Data Exchange (ETDEWEB)

Craig, Nathaniel [Department of Physics, University of California,Santa Barbara, CA 93106 (United States); Lou, Hou Keong [Department of Physics, Princeton University,Princeton, NJ 08540 (United States); McCullough, Matthew [Theory Division, CERN,1211 Geneva 23 (Switzerland); Thalapillil, Arun [Department of Physics and Astronomy, Rutgers University,Piscataway, NJ 08854 (United States)

2016-02-18

The discovery of the Higgs boson opens the door to new physics interacting via the Higgs Portal, including motivated scenarios relating to baryogenesis, dark matter, and electroweak naturalness. We systematically explore the collider signatures of singlet scalars produced via the Higgs Portal at the 14 TeV LHC and a prospective 100 TeV hadron collider. We focus on the challenging regime where the scalars are too heavy to be produced in the decays of an on-shell Higgs boson, and instead are produced primarily via an off-shell Higgs. Assuming these scalars escape the detector, promising channels include missing energy in association with vector boson fusion, monojets, and top pairs. We forecast the sensitivity of searches in these channels at √s=14 & 100 TeV and compare collider reach to the motivated parameter space of singlet-assisted electroweak baryogenesis, Higgs Portal dark matter, and neutral naturalness.

The Higgs portal above threshold

International Nuclear Information System (INIS)

Craig, Nathaniel; Lou, Hou Keong; McCullough, Matthew; Thalapillil, Arun

2016-01-01

The discovery of the Higgs boson opens the door to new physics interacting via the Higgs Portal, including motivated scenarios relating to baryogenesis, dark matter, and electroweak naturalness. We systematically explore the collider signatures of singlet scalars produced via the Higgs Portal at the 14 TeV LHC and a prospective 100 TeV hadron collider. We focus on the challenging regime where the scalars are too heavy to be produced in the decays of an on-shell Higgs boson, and instead are produced primarily via an off-shell Higgs. Assuming these scalars escape the detector, promising channels include missing energy in association with vector boson fusion, monojets, and top pairs. We forecast the sensitivity of searches in these channels at √s=14 & 100 TeV and compare collider reach to the motivated parameter space of singlet-assisted electroweak baryogenesis, Higgs Portal dark matter, and neutral naturalness.

MR image-guided portal verification for brain treatment field

International Nuclear Information System (INIS)

Yin Fangfang; Gao Qinghuai; Xie Huchen; Nelson, Diana F.; Yu Yan; Kwok, W. Edmund; Totterman, Saara; Schell, Michael C.; Rubin, Philip

1998-01-01

Purpose: To investigate a method for the generation of digitally reconstructed radiographs directly from MR images (DRR-MRI) to guide a computerized portal verification procedure. Methods and Materials: Several major steps were developed to perform an MR image-guided portal verification procedure. Initially, a wavelet-based multiresolution adaptive thresholding method was used to segment the skin slice-by-slice in MR brain axial images. Some selected anatomical structures, such as target volume and critical organs, were then manually identified and were reassigned to relatively higher intensities. Interslice information was interpolated with a directional method to achieve comparable display resolution in three dimensions. Next, a ray-tracing method was used to generate a DRR-MRI image at the planned treatment position, and the ray tracing was simply performed on summation of voxels along the ray. The skin and its relative positions were also projected to the DRR-MRI and were used to guide the search of similar features in the portal image. A Canny edge detector was used to enhance the brain contour in both portal and simulation images. The skin in the brain portal image was then extracted using a knowledge-based searching technique. Finally, a Chamfer matching technique was used to correlate features between DRR-MRI and portal image. Results: The MR image-guided portal verification method was evaluated using a brain phantom case and a clinical patient case. Both DRR-CT and DRR-MRI were generated using CT and MR phantom images with the same beam orientation and then compared. The matching result indicated that the maximum deviation of internal structures was less than 1 mm. The segmented results for brain MR slice images indicated that a wavelet-based image segmentation technique provided a reasonable estimation for the brain skin. For the clinical patient case with a given portal field, the MR image-guided verification method provided an excellent match between

Large vehicle portal monitor for perimeter safeguards applications

International Nuclear Information System (INIS)

Caldwell, J.T.; Atwater, H.F.; Bernard, W.; Bieri, J.M.; Shunk, E.R.

1979-01-01

We have developed a class of vehicle portal monitors based on shielded 4π geometry neutron counting. we have derived and experimentally verified an analytical expression relating the detection sensitivity of the neutron tunnel vehicle portal monitor to four design parameters of the system. For a given number of neutron detectors, this design achieves one or more orders of magnitude improvement in nuclear materials detection sensitivity over previous vehicle portal monitors

[Treatment of nontumoral portal vein thrombosis in cirrhosis].

Science.gov (United States)

Bañares, Rafael; Catalina, María-Vega

2014-07-01

Portal vein thrombosis in cirrhosis is a relatively common complication associated with the presence of an accompanying prothrombotic phenotype of advanced cirrhosis. The consequences of portal vein thrombosis are relevant because it can be associated with impaired hepatic function, might contraindicate hepatic transplantation and could increase morbidity in the surgical procedure. There is controversy concerning the most effective treatment of portal vein thrombosis, which is based on information that is seldom robust and whose primary objective is to achieve a return to vessel patency. Various studies have suggested that starting anticoagulation therapy early is associated with portal vein repatency more frequently than without treatment and has a low rate of complications. There are no proven data on the type of anticoagulant (low-molecular-weight heparins or dicoumarin agents) and the treatment duration. The implementation of TIPS is technically feasible in thrombosis without cavernous transformation and is associated with portal vein recanalization in a significant proportion of cases. Thrombolytic therapy does not appear to present an adequate balance between efficacy and safety; its use is therefore not supported for this indication. The proper definition of treatment for portal vein thrombosis requires properly designed studies to delimit the efficacy and safety of the various alternatives. Copyright © 2014 Elsevier España, S.L. All rights reserved.

eHealth Literacy: Patient Engagement in Identifying Strategies to Encourage Use of Patient Portals Among Older Adults.

Science.gov (United States)

Price-Haywood, Eboni G; Harden-Barrios, Jewel; Ulep, Robin; Luo, Qingyang

2017-12-01

Innovations in chronic disease management are growing rapidly as advancements in technology broaden the scope of tools. Older adults are less likely to be willing or able to use patient portals or smartphone apps for health-related tasks. The authors conducted a cross-sectional survey of older adults (ages ≥50) with hypertension or diabetes to examine relationships between portal usage, interest in health-tracking tools, and eHealth literacy, and to solicit practical solutions to encourage technology adoption. Among 247 patients surveyed in a large integrated delivery health system between August 2015 and January 2016, eHealth literacy was positively associated with portal usage (OR [95% CI]: 1.3 [1.2-1.5]) and interest in health-tracking tools (1.2 [1.1-1.3]). Portal users compared to nonusers (N = 137 vs.110) had higher rates of interest in using websites/smartphone apps to track blood pressure (55% vs. 36%), weight (53% vs. 35%), exercise (53% vs. 32%), or medication (46% vs 33%, all P marketing initiatives that capture patient stories demonstrating real-life applications of what patients can do with digital technology, how to use it, and why it may be useful. Health systems also must screen for eHealth literacy, provide training, promote proxy users, and institute quality assurance that ensures patients' experiences will not vary across the system.

Idiopathic non-cirrhotic portal hypertension: a review

NARCIS (Netherlands)

Schouten, Jeoffrey N. L.; Verheij, Joanne; Seijo, Susana

2015-01-01

Idiopathic non-cirrhotic portal hypertension (INCPH) is a rare disease characterized of intrahepatic portal hypertension in the absence of cirrhosis or other causes of liver disease and splanchnic venous thrombosis. The etiology of INCPH can be classified in five categories: 1) immunological

CT of portal vein tumor thrombosis. Usefulness of dynamic CT

Energy Technology Data Exchange (ETDEWEB)

Takemoto, Kazumasa; Inoue, Yuichi; Tanaka, Masahiro; Nemoto, Yutaka; Nakamura, Kenji [Osaka City Univ. (Japan). Faculty of Medicine

1983-08-01

We evaluated CT findings of portal vein tumor thrombosis in 16 hepatomas by plain, contrast and dynamic CT. Plain and contrast CT findings were an enlargement of the portal vein (81%), intraluminal low density area (63%). Dynamic CT enhanced the diagnostic capability of the tumor thrombus as a relatively low density area because of the marked enhancement of the portal vein. In addition, dynamic CT newly demonstrated hyperdense peripheral ring (35%) and arterio portal shunt (35%). It is advisable to select the scan level to include the portal vein when dynamic CT is performed in the patient of hepatocellular carcinoma.

Impact of hepatitis C oral therapy in portal hypertension.

Science.gov (United States)