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Sample records for left iliac bone

  1. An aggressive osteoblastoma in the left iliac bone

    International Nuclear Information System (INIS)

    Kim, Myung Joon; Yang, Seoung Oh; Jo, Han Gi; Cho, Chul Koo; Ro, In Woo

    1986-01-01

    Osteoblastoma is an uncommon primary neoplasm of bone, accounting for 1% of primary bone tumors. Osteoblastomas are benign bone tumors, but recurrences and malignant transformation of osteoblastoma were reported. So Jaffe and Dorf-man proposed the term of 'aggressive osteoblastoma' in which the tumor had intermediate biological natures among the osteoblastomas. Aggressive osteoblastoma is very rare and biological, pathological features of it is different from the conventional osteoblastoma. We experienced one case of aggressive osteoblastoma in the left ilium and describes the radiological, pathological findings of an aggressive osteoblastoma with review of the literatures.

  2. An aggressive osteoblastoma in the left iliac bone

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myung Joon; Yang, Seoung Oh; Jo, Han Gi; Cho, Chul Koo; Ro, In Woo [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1986-12-15

    Osteoblastoma is an uncommon primary neoplasm of bone, accounting for 1% of primary bone tumors. Osteoblastomas are benign bone tumors, but recurrences and malignant transformation of osteoblastoma were reported. So Jaffe and Dorf-man proposed the term of 'aggressive osteoblastoma' in which the tumor had intermediate biological natures among the osteoblastomas. Aggressive osteoblastoma is very rare and biological, pathological features of it is different from the conventional osteoblastoma. We experienced one case of aggressive osteoblastoma in the left ilium and describes the radiological, pathological findings of an aggressive osteoblastoma with review of the literatures.

  3. Endopelvic Approach for Iliac Crest Bone Harvesting.

    Science.gov (United States)

    Le Pape, Sebastien; Gauthe, Remi; Du Pouget, Laure; Gille, Olivier; Vital, Jean-Marc; Ould-Slimane, Mourad

    2017-10-01

    The anterior approach to lumbar spine surgery has grown in popularity in the past few years; spinal fusion of the last 2 lumbar levels is often required. Although alternatives to bone grafting are available, including recombinant human bone morphogenetic protein 2 or bone substitutes, only cancellous autologous bone has all the required factors for bone growth. To avoid the use of bone substitutes, remote iliac crest bone harvesting remains the gold standard. However, this technique may lead to some unfavorable outcomes. The patient was a 46-year-old man with severe back and left leg pain. Magnetic resonance imaging showed an inflammatory discopathy of L5-S1 associated with a left posterior lateral herniated disc. Conservative treatment failed, and surgical treatment of the lumbar disk disease and the herniated disc was scheduled. A novel iliac crest bone harvesting method was performed during the retroperitoneal approach to the anterior lumbar interbody fusion. The patient's postoperative course was uneventful. There were no adverse outcomes related to the bone donor site. This is the first in vivo report of endopelvic iliac crest bone harvesting. This technique allows bone graft harvesting to be performed with the same retroperitoneal approach used for anterior lumbar interbody fusion. It avoids many common complications associated with the remote approach to the iliac crest. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Bone scintigraphy in costo-iliac impingement syndrome

    DEFF Research Database (Denmark)

    Madsen, Jan L

    2008-01-01

    Abstract: A syndrome of back pain caused by impingement of the lowest ribs against the iliac crest has been described in patients with osteoporotic vertebral fractures and loss of height of the patient. A case is presented of an 81-year-old woman with a long history of osteoporosis with compressi...... fractures of several thoracic and lumbar vertebrae. She presented with progressive lower back pain and weight loss. Bone scintigraphy revealed increased uptake in the lower ribs on both sides compatible with the costo-iliac impingement syndrome. There were no signs of bone metastases....

  5. Successful treatment of a spontaneous rupture of the left external iliac vein in a man.

    Science.gov (United States)

    Sadaghianloo, Nirvana; Jean-Baptiste, Elixine; Haudebourg, Pierre; Declemy, Serge; Mousnier, Aurdlien; Hassen-Khodja, Rida

    2014-02-01

    Spontaneous rupture of the external iliac vein associated with a May-Thurner syndrome is infrequent, particularly in men. We report a case of previously healthy 73-year-old man with a left iliac vein thrombosis, who presented a large lower left abdominal hematoma of sudden-unset. Emergent laparotomy revealed a 3-cm longitudinal tear in the left external iliac vein, which was repaired primarily. Patient's recovery was uneventful. Possible etiological factors have been identified as venous hypertension due to iliac vein thrombosis associated with Cockett syndrome, as well as inflammatory venous wall. Some other estrogenic factors could explain female preponderance of the event.

  6. Autogenous Corticocancellous Iliac Bone Graft in Reconstruction of ...

    African Journals Online (AJOL)

    Mandible resection and subsequent defect created lead to aesthetic and functional abnormalities. The surgical reconstruction of the defect is a major challenge in maxillofacial surgery. Lack of appropriate facilities and the high cost of newer modalities made the use of non-vascularized iliac bone graft in reconstruction of ...

  7. Mandibular defect reconstruction with nonvascularized iliac crest bone graft.

    Science.gov (United States)

    Okoje, V N; Obimakinde, O S; Arotiba, J T; Fasola, A O; Ogunlade, S O; Obiechina, A E

    2012-01-01

    Reconstruction of mandibular defect is a challenge to the head and neck surgeon because of associated functional and esthetic problems. Our experience with the use of nonvascularized iliac crest bone graft is hereby reported. The aim was to report our experience with the use of nonvascularized iliac crest bone for mandibular defect reconstruction at University College Hospital, Ibadan. Nigeria. A retrospective descriptive study was performed. Cases of mandibular reconstruction with iliac crest bone graft between January 2001 and December 2007 were included in this study. Grafts were secured with either a stainless steel wire or a titanium plate. Preoperative diagnosis, postoperative follow-up records including investigations, diagnosis of graft infection and subsequent treatment modalities were extracted from the available records. Descriptive variables were analyzed with SPSS version 14. A total of 47 patients had mandibular defect reconstruction with nonvascularized iliac crest block bone during the study period. Thirty-eight patients had graft secured with transosseous wire [NVIBw] while 9 had a titanium plate [NVIBp]. The male:female ratio was 26:21 while the mean age of the patients was 24.6±4.25 years. Ten patients (21.3%) developed persistent graft infection during the postoperative period. All cases of infection occurred in patients who had transosseous wiring and analysis showed that 60% of the infected grafts revealed mixed microbial isolates containing Klebsiela spp, Pseudomonas Aeurogenosa, and E coli. Six (60%) of the infected grafts were removed as a result of unabated infection while 4 (40%) were successfully treated by exploration and pus drainage. Nonvascularized iliac crest bone graft provides an affordable and less technical choice for mandibular reconstruction with minimal complications in a resource-limited economy.

  8. Bi-iliac distance and iliac bone position compared to the vertebral column in normal fetal development

    DEFF Research Database (Denmark)

    Hartling, U B; Fischer Hansen, B; Skovgaard, L T

    2001-01-01

    caliper. The caudo-cranial position of the iliac bones was evaluated. The present study shows that in normal fetal development there is a continuous linear enlargement of the pelvic region in the transverse and vertical planes. The upper iliac contour stays at the level of the first sacral vertebral body...

  9. Relationships between age and microarchitectural descriptors of iliac trabecular bone determined by microCT.

    Science.gov (United States)

    Deguette, C; Ramond-Roquin, A; Rougé-Maillart, C

    2017-06-01

    Estimation of age at death is a major issue in anthropology. The main anthropological histological methods propose studying the architecture of cortical bone. In bone histomorphometry, researches on metabolic bone diseases have provided normative tables for trabecular bone volume (BV/TV) according to age and gender of individuals on trans-iliac bone biopsies. We have used microCT, a non-destructive tool for measuring bone volume and trabecular descriptors to compare the French tables to a series of forensic anthropological population and if the two iliac bones could be used interchangeably. Coxal bone of a personal forensic collection whose age and gender were known (DNA identification) were used. Bone samples, centered on the same area than bone biopsy. MicroCT (pixel size: 36μm) was used to measure BV/TV and morphometric trabecular parameters of microarchitecture. An adjusted Z-score was calculated for BV/TV to compare with normative tables and a right/left comparison of trabecular parameters was provided. Twenty-seven iliac bones, which 20 forming 10 complete pelvises, aged between 24 and 73y.o. (average of 47.7 y.o.) were used. All adjusted Z-score were within normal values. There was a strong positive correlation between right and left sides for Tb.Th, Tb.N and Tb.Sp, but an insignificant correlation was obtained for BV/TV. Normative tables between age and BV/TV are valid and therefore usable in anthropology. They may represent an alternative to determine the age at death. Nevertheless, it requires a precise technique that could be a drawback in current practice. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Bone formation in cranial, mandibular, tibial and iliac bone grafts in rats

    DEFF Research Database (Denmark)

    Solheim, E; Pinholt, E M; Talsnes, O

    1995-01-01

    Several studies have suggested that grafts from membranous derived bone (e.g., calvarial grafts) retain their volume better than those from endochondral derived bone (e.g., iliac bone grafts). Increased osteogenesis in grafts of the former type has been offered as the explanation. However, simple...

  11. Multielement analysis of iliac crest bone by neutron activation

    International Nuclear Information System (INIS)

    Aras, N.K.; Yilmaz, G.; Korkusuz, F.; Olmez, I.; Sepici, B.; Eksioglu, F.; Bode, P.

    2000-01-01

    Bone samples from iliac crest were obtained from apparently healthy female (n = 4) and male (n = 8) subjects with ages between 15-50. Cortical and trabecular parts were separated and soft tissues like fat, muscle and blood were removed. Calcium, Mg, Na, Cl, Fe, Zn, Br, Sr, and Cs were determined by instrumental neutron activation analysis and other techniques, and their relations were discussed. Fairly good agreement was obtained with literature data. These values may serve as reference values for subjects from a Turkish population. (author)

  12. Donor site complications in bone grafting: comparison of iliac crest, calvarial, and mandibular ramus bone.

    Science.gov (United States)

    Scheerlinck, Laura M E; Muradin, Marvick S M; van der Bilt, Andries; Meijer, Gert J; Koole, Ronald; Van Cann, Ellen M

    2013-01-01

    To compare the donor site complication rate and length of hospital stay following the harvest of bone from the iliac crest, calvarium, or mandibular ramus. Ninety-nine consecutively treated patients were included in this retrospective observational single-center study. Iliac crest bone was harvested in 55 patients, calvarial bone in 26 patients, and mandibular ramus bone in 18 patients. Harvesting of mandibular ramus bone was associated with the lowest percentages of major complications (5.6%), minor complications (22.2%), and total complications (27.8%). Harvesting of iliac crest bone was related to the highest percentages of minor complications (56.4%) and total complications (63.6%), whereas harvesting of calvarial bone induced the highest percentage of major complications (19.2%). The length of the hospital stay was significantly influenced by the choice of donor site (P = .003) and age (P = .009); young patients with the mandibular ramus as the donor site had the shortest hospital stay. Harvesting of mandibular ramus bone was associated with the lowest percentage of complications and the shortest hospital stay. When the amount of bone to be obtained is deemed sufficient, mandibular ramus bone should be the first choice for the reconstruction of maxillofacial defects.

  13. Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone.

    Science.gov (United States)

    Kang, Young-Hoon; Kim, Hyun-Min; Byun, June-Ho; Kim, Uk-Kyu; Sung, Iel-Yong; Cho, Yeong-Cheol; Park, Bong-Wook

    2015-12-30

    Jaw bone and iliac bone are the most frequently used autologous bone sources for dental implant placement in patients with atrophic alveolar ridges. However, the comparative long-term stability of these two autologous bone grafts have not yet been investigated. The aim of this study was to compare the stability of simultaneously placed dental implants with autologous bone grafts harvested from either the iliac crest or the intraoral jaw bone for severely atrophic alveolar ridges. In total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed. We compared the residual increased bone height of the grafted bone, peri-implantitis incidence, radiological density in newly generated bones (HU values), and implant stability using resonance frequency analysis (ISQ values) between the two autologous bone graft groups. Both autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates. However, the grafted iliac bone exhibited more prompt vertical loss than the jaw bone, in particular, the largest vertical bone reduction was observed within 6 months after the bone graft. In contrast, the jaw bone graft group exhibited a slower vertical bone resorption rate and a lower incidence of peri-implantitis during long-term follow-up than the iliac bone graft group. These findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.

  14. Effect of electromagnetic field induced by radio frequency waves at 900 to 1800 MHz on bone mineral density of iliac bone wings.

    Science.gov (United States)

    Atay, Tolga; Aksoy, Besir Andac; Aydogan, Nevres Hurriyet; Baydar, Metin Lutfi; Yildiz, Mustafa; Ozdemir, Ragip

    2009-09-01

    Telecommunication has gained a different meaning in daily life with the introduction of the mobile phone system. However, electromagnetic pollution has increased in parallel to this improvement. In this study, we aimed to investigate the effects of electromagnetic waves emitted from cellular phones operating at a frequency of 900 to 1800 MHz on the bone mineral density of the human iliac bone wings, which are the most common carriage sites for mobile phones. A total of 150 male volunteer participants were included in this study. The mean age was 31.85 years, and the age range was between 21 and 57 years. The participants were separated into 2 groups based on as follows: iliac side exposed to electromagnetic wave (group 1) and unexposed side (group 2). Of the total number of participants, 122 were carrying their phones on their right iliac wings, whereas 28 were carrying their phones on their left iliac wings. The mean daily carriage duration was 14.7 hours (between 12 and 20 h), and the mean duration for cellular phone use was 6.2 years (between 4 and 9 yr). Mineral bone density was measured using dual-energy x-ray absorptiometry in the right and the left iliac wings of all the participants. The SPSS 15 software (SPSS Inc, Chicago, IL) was used for statistical analysis. In the comparison of the 2 sides, Student t test was performed and P 0.05). In addition, the mean values of group 1 were not as low as those measured in osteopeny or osteoporosis cases. Current data may suggest that taking into consideration cellular phone use when iliac bone graft is necessary in clinical practice would constitute an important factor for more favorable outcomes.

  15. Spontaneous rupture of the left common iliac vein: management with surgical repair and endovascular stent

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan; Lee, Sang Kwon; Ko, Sung Min; Choi, Jin Soo; Koo, Ja Hyun; Kim, Hyung Tae; Cho, Won Hyun [Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2006-06-15

    We report here on a case of spontaneous rupture of the left common iliac vein that was diagnosed preoperatively with computed tomography (CT), and the patient was successfully treated with surgery and stent placement. A 60-year-old woman was referred to our emergency room because of sudden left lower abdominal pain and swelling of the left lower extremity. CT revealed a huge retroperitoneal hematoma and extrinsic compression of the left common iliac vein with acute thrombosis of the deep veins of the left lower extremity. Venous patch angioplasty was performed at the site of spontaneous rupture. After performing thrombectomy with using a Forgaty catheter, a stent was placed at the occluded segment of the left common iliac vein under C-arm fluoroscopic guidance. The follow-up CT scans taken at 10 days and 8 months after the initial examination demonstrated a venous stent with preserved luminal patency and the striking resolution of the deep vein thrombosis of the left lower extremity.

  16. rhBMP-2 with a demineralized bone matrix scaffold versus autologous iliac crest bone graft for alveolar cleft reconstruction.

    Science.gov (United States)

    Francis, Cameron S; Mobin, Sheila S Nazarian; Lypka, Michael A; Rommer, Elizabeth; Yen, Stephen; Urata, Mark M; Hammoudeh, Jeffrey A

    2013-05-01

    Secondary alveolar cleft reconstruction using autologous iliac crest bone graft is currently the standard treatment for alveolar clefts. Although effective, harvesting autologous bone may result in considerable donor-site morbidity, most commonly pain and the potential for long-term sensory disturbances. In an effort to decrease patient morbidity, a novel technique using recombinant human bone morphogenetic protein (rhBMP)-2 encased in a demineralized bone matrix scaffold was developed as an alternative to autografting for secondary alveolar cleft reconstruction. A chart review was conducted for the 55 patients who underwent secondary alveolar cleft reconstruction over a 2-year period with a mean follow-up of 21 months. Of these, 36 patients received rhBMP-2/demineralized bone matrix scaffold (including 10 patients with previously failed repairs using iliac crest bone grafting) and 19 patients underwent iliac crest bone grafting. Postoperatively, bone stock was evaluated using occlusal radiographs rated according to the Bergland and Chelsea scales. Alveolar clefts repaired using rhBMP-2/demineralized bone matrix scaffold were 97.2 percent successful compared with 84.2 percent with iliac crest bone grafting. Radiographically, initial repairs with rhBMP-2/demineralized bone matrix scaffold were superior to iliac crest bone grafting according to both Bergland and Chelsea scales, and significantly more patients in the rhBMP-2/demineralized bone matrix scaffold group had coronal bridging. The postoperative intraoral infection rate following iliac crest bone grafting was significantly greater than for rhBMP-2/demineralized bone matrix scaffold. The cost of rhBMP-2/demineralized bone matrix scaffold products was offset by cost savings associated with a reduction in operative time averaging 102 minutes. rhBMP-2 encased in a demineralized bone matrix scaffold appears to be a viable alternative for secondary alveolar cleft repair. Patients are spared donor-site morbidity and

  17. Cancellous bone structure of iliac crest biopsies following 370 days of head-down bed rest

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Morukov, Boris V.; Vico, Laurence

    2005-01-01

    INTRODUCTION: Static bone histomorphometry was applied to existing iliac bone sections originating from a 370-d 5 degrees head-down bed rest experiment. This bed rest experiment is the longest ever to have been conducted. We hypothesized that bed rest would decrease cancellous bone volume fractio...

  18. Retroperitoneal cold abscess with tuberculosis of sacro-iliac joint and pubic bone: a case report of unusual presentation of osteo-articular tuberculosis.

    Science.gov (United States)

    Ramakrishnaiah, V P; Jain, V; Choon, A T; Rao, B H

    2000-03-01

    Tuberculosis involving sacro-iliac joint and pubic bone presenting with massive retroperitoneal abscess is a rare entity. A 29-year-old female presented with history of discharging sinus in the sacrococcygeal region of 2 months duration. Plain x-ray revealed osteolytic lesion in right pubic bone and left sacro-iliac joint. Computed tomography scan revealed massive pus collection in the retroperitoneal region. Pus was drained extraperitoneally. Biopsy of the scraping of the abscess wall showed granulation tissue with foreign body type of giant cell. On follow-up the patient was doing well.

  19. Adventitial cystic disease of the left external iliac vein: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Hee; Shin, Hyun Woong; Lee, Yil Gi; Koo, Mi Jin [Daegu Fatima Hospital, Daegu (Korea, Republic of)

    2005-10-15

    Adventitial cystic disease (ACD) is a rare, but well-characterized vascular disease. It is most commonly seen in the popliteal artery, but it has also been reported in the venous system. The most commonly involved segment has been the common femoral vein; the disease resulted in luminal compromise and extremity swelling. We report here on a case of adventitial cystic disease of the left external iliac vein that was initially misdiagnosed as deep vein thrombosis in a 68-years-old man who presented with a painless swelling of his left leg.

  20. Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis.

    Science.gov (United States)

    Kim, Jihyeung; Park, Jin Woo; Chung, Jeehyeok; Jeong Bae, Kee; Gong, Hyun Sik; Baek, Goo Hyun

    2018-01-01

    We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients. IV.

  1. Pelvic instability after bone graft harvesting from posterior iliac crest: report of nine patients

    International Nuclear Information System (INIS)

    Chan, K.; Pathria, M.; Jacobson, J.; Resnick, D.

    2001-01-01

    Objective. To report the imaging findings in nine patients who developed pelvic instability after bone graft harvest from the posterior aspect of the iliac crest.Design and patients. A retrospective study was performed of the imaging studies of nine patients who developed pelvic pain after autologous bone graft was harvested from the posterior aspect of the ilium for spinal arthrodesis. Plain films, bone scans, and CT and MR examinations of the pelvis were reviewed. Pertinent aspects of the clinical history of these patients were noted, including age, gender and clinical symptoms.Results. The age of the patients ranged from 52 to 77 years (average 69 years) and all were women. The bone graft had been derived from the posterior aspect of the iliac crest about the sacroiliac joint. All patients subsequently developed subluxation of the pubic symphysis. Eight patients had additional insufficiency fractures of the iliac crest adjacent to the bone graft donor site, and five patients also revealed subluxation of the sacroiliac joint. Two had insufficiency fractures of the sacrum and one had an additional fracture of the pubic ramus.Conclusions. Pelvic instability is a potential complication of bone graft harvesting from the posterior aspect of the iliac crest. The pelvic instability is manifested by insufficiency fractures of the ilium and subluxation of the sacroiliac joints and pubic symphysis. (orig.)

  2. Pelvic instability after bone graft harvesting from posterior iliac crest: report of nine patients

    Energy Technology Data Exchange (ETDEWEB)

    Chan, K.; Pathria, M.; Jacobson, J. [Dept. of Radiology, Univ. of California, San Diego, CA (United States); Resnick, D. [Dept. of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States)

    2001-05-01

    Objective. To report the imaging findings in nine patients who developed pelvic instability after bone graft harvest from the posterior aspect of the iliac crest.Design and patients. A retrospective study was performed of the imaging studies of nine patients who developed pelvic pain after autologous bone graft was harvested from the posterior aspect of the ilium for spinal arthrodesis. Plain films, bone scans, and CT and MR examinations of the pelvis were reviewed. Pertinent aspects of the clinical history of these patients were noted, including age, gender and clinical symptoms.Results. The age of the patients ranged from 52 to 77 years (average 69 years) and all were women. The bone graft had been derived from the posterior aspect of the iliac crest about the sacroiliac joint. All patients subsequently developed subluxation of the pubic symphysis. Eight patients had additional insufficiency fractures of the iliac crest adjacent to the bone graft donor site, and five patients also revealed subluxation of the sacroiliac joint. Two had insufficiency fractures of the sacrum and one had an additional fracture of the pubic ramus.Conclusions. Pelvic instability is a potential complication of bone graft harvesting from the posterior aspect of the iliac crest. The pelvic instability is manifested by insufficiency fractures of the ilium and subluxation of the sacroiliac joints and pubic symphysis. (orig.)

  3. Os acromiale open reduction and internal fixation: a review of iliac crest autogenous bone grafting and local bone grafting.

    Science.gov (United States)

    Atinga, Mordicai; Gregor, Reinhold; Selvaraj, Karthik M; Hong, Thin F

    2018-01-17

    Symptomatic os acromiale are fairly uncommon, and treatment has included fragment excision, decompression, and open reduction and internal fixation. Nonunion rates as high as 40% have been reported after fixation of os acromiale. This study assessed whether union of an os acromiale could be reliably achieved without the use of an iliac crest bone graft. This was a retrospective study of 32 consecutive shoulders that were treated with screw fixation and a local bone graft or iliac crest bone graft. The mean age was 50.3 years (range, 21-74 years), and the mean follow-up was 46.9 months (range, 12-120 months). Fusion was assessed clinically and radiologically. All 32 os acromiale were fused by 3 months on x-ray imaging. There were 18 shoulders in the iliac crest bone graft group and 14 in the local bone graft group. Rotator cuff repairs were performed concomitantly in 25 patients. Hardware was removed in 4 patients, a seroma was drained in 1 patient, and a superficial infection occurred in 1 patient. This is the largest study of os acromiale fixation using screws and a tension band to our knowledge. We report a 100% union rate using this technique, with 13% requiring hardware removal and the occurrence of 1 superficial infection. This study shows a local bone graft is as effective as iliac crest bone graft in achieving fusion. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  4. Computerized determination of 3-D connectivity density in human iliac crest bone biopsies

    DEFF Research Database (Denmark)

    Thomsen, J.S.; Mosekilde, Li.; Barlach, J.

    1996-01-01

    Combining the physical disector principle with an algorithm for automatic non-linear alignment of disector pairs we have developed a software system for direct measurement of 3D connectivity densities in iliac crest bone biopsies. The method was applied to biopsies from 14 non-selected autopsy...

  5. Static histomorphometry of human iliac crest and vertebral trabecular bone: a comparative study

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Ebbesen, Ebbe Nils; Mosekilde, Lis

    2002-01-01

    the histomorphometric measures at the iliac crest and the vertebral body. The material comprised matched sets of unilateral transiliac crest bone biopsies and lumbar vertebral bodies (L-2) from 24 women (19-96 years) and 24 men (23-95 years) selected from a larger autopsy material. Three female subjects (80, 88, and 90...... years) had a known vertebral fracture of L-2. The iliac crest biopsies and 9-mm-thick mediolateral slices of half the entire vertebral bodies were embedded in methylmetacrylate, stained with aniline blue, and scanned into a computer with a flatbed image scanner at a high resolution. With a custom....... In addition, connectivity density was measured (ConnEulor method). The results showed that the age-related changes in the static histomorphometric measures are generally similar in the iliac crest and the vertebral body, and that these age-related changes are independent of gender. An exception, however...

  6. Tearing of the left iliac vessels in lumbar surgery revealed by multiphase post-mortem CT-angiography (MPMCTA).

    Science.gov (United States)

    Vilariño Villaverde, Raquel; Bruguier, Christine; Zerlauth, Jean-Baptiste; De Froidmont, Sébastien; Grabherr, Silke

    2016-05-01

    Lumbar surgery is regularly applied in cases of discal hernia and acquired lumbar stenosis. In this report, we present a case of a laceration in the left common iliac artery and iliac vein during a lumbar surgery and discuss the literature concerning this kind of event. In the present case, the surgical procedure was followed by a sudden decrease in blood pressure, and the surgeon discovered an intra-abdominal haemorrhage that led to the patient's death. Postmortem investigation confirmed the intra-abdominal haemorrhage and revealed a laceration of the proximal portion of the left common iliac artery and left iliac vein. The source of bleeding could be detected especially thanks to multi-phase postmortem CT angiography (MPMCTA), which was performed prior to autopsy. We also found a haemorrhagic path through the intervertebral disc between the L4-L5 vertebrae, caused by the surgeon's instrument (pituitary rongeur). To date, a few cases have been described of iatrogenic death resulting from a tear in the iliac vessels during lumbar surgery, but not from the postmortem perspective. Such investigations have recently been modernized thanks to the introduction of forensic imaging. In particular, MPMCTA offers new possibilities in postmortem investigations and can be considered the new gold standard for investigating deaths related to medical intervention. Here we describe the first case of a death during lumbar surgery using this new method. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Computerized determination of 3-D connectivity density in human iliac crest bone biopsies

    DEFF Research Database (Denmark)

    Thomsen, J.S.; Mosekilde, Li.; Barlach, J.

    1996-01-01

    Combining the physical disector principle with an algorithm for automatic non-linear alignment of disector pairs we have developed a software system for direct measurement of 3D connectivity densities in iliac crest bone biopsies. The method was applied to biopsies from 14 non-selected autopsy ca...... cases: 7 men (age range 20-84 yr) and 7 women (age range 20-86 yr). The study reveals decreases in both trabecular bone mass and connectivity density with age in women.......Combining the physical disector principle with an algorithm for automatic non-linear alignment of disector pairs we have developed a software system for direct measurement of 3D connectivity densities in iliac crest bone biopsies. The method was applied to biopsies from 14 non-selected autopsy...

  8. Large aneurysmal bone cyst of iliac bone in a female child: a case report

    Directory of Open Access Journals (Sweden)

    Kumar Pawan

    2010-04-01

    Full Text Available Abstract Background Symptomatic aneurysmal bone cysts in pediatric age group with an expansile lesion in ilium is a rare occurrence. Case An 11-year-old female presented with a swelling over her right iliac region and numbness along the medial aspect of thigh. Clinicoradiological diagnosis was aneurysmal bone cyst confirmed on fine needle aspiration cytology. Excision curettage (wide margin excision of the soft tissue tumor and intralesional curettage in the region of acetabulum of the tumor was performed in view of proximity to acetabular roof and endangered hip stability. Result At follow up of 18 months, the child has full painless range of movements in the hip joint with no recurrence. Conclusions Pelvic aneurysmal bone cysts are distinctly rare in pediatric age. The lesion was associated with an atypical symptom of numbness along the femoral nerve distribution. Hip stability and range of movements were major concern in this patient. Although many treatment options are described, surgical excision still remains the mainstay. In our case, we performed excision curettage, with good outcome.

  9. Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

    International Nuclear Information System (INIS)

    Kasalak, Oemer; Glaudemans, Andor W.J.M.; Overbosch, Jelle; Kwee, Thomas C.; Jutte, Paul C.

    2018-01-01

    To determine and compare the value of 18 F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. This retrospective study included 20 patients with newly diagnosed Ewing sarcoma who underwent pretreatment FDG-PET/CT and a total of 38 blind BMBs (two unilateral and 18 bilateral) of the posterior iliac crest. FDG-PET/CT scans were evaluated for bone marrow involvement, both in the posterior iliac crest and other sites, and compared to blind BMB results. FDG-PET/CT was positive for bone marrow involvement in 7/38 posterior iliac crests, whereas BMB was positive in 5/38 posterior iliac crests. FDG-PET/CT and BMB results in the posterior iliac crest agreed in 36/38 cases (94.7%, 95% confidence interval [CI]: 82.7-98.5%). On a patient level, FDG-PET/CT was positive for bone marrow involvement in 4/20 patients, whereas BMB of the posterior iliac crest was positive in 3/20 patients. On a patient level, FDG-PET/CT and BMB results agreed in 19/20 patients (95.0%, 95% CI: 76.4-99.1%). The only discrepancies between FDG-PET/CT and BMB were observed in two BMBs of one patient. Both BMBs in this patient were negative, whereas FDG-PET/CT indicated bilateral posterior iliac crest involvement and also extensive bone marrow involvement elsewhere. FDG-PET/CT appears to be a valuable method for metastatic bone marrow assessment in newly diagnosed Ewing sarcoma. The routine use of blind BMB of the posterior iliac crest should be reconsidered when FDG-PET/CT is available. (orig.)

  10. A retrospective study of iliac crest bone grafting techniques with allograft reconstruction: do patients even know which iliac crest was harvested? Clinical article.

    Science.gov (United States)

    Pirris, Stephen M; Nottmeier, Eric W; Kimes, Sherri; O'Brien, Michael; Rahmathulla, Gazanfar

    2014-10-01

    Considerable biological research has been performed to aid bone healing in conjunction with lumbar fusion surgery. Iliac crest autograft is often considered the gold standard because it has the vital properties of being osteoconductive, osteoinductive, and osteogenic. However, graft site pain has been widely reported as the most common donor site morbidity. Autograft site pain has led many companies to develop an abundance of bone graft extenders, which have limited proof of efficacy. During the surgical consent process, many patients ask surgeons to avoid harvesting autograft because of the reported pain complications. The authors sought to study postoperative graft site pain by simply asking patients whether they knew which iliac crest was grafted when a single skin incision was made for the fusion operation. Twenty-five patients underwent iliac crest autografting with allograft reconstruction during instrumented lumbar fusion surgery. In all patients the autograft was harvested through the same skin incision but with a separate fascial incision. At various points postoperatively, the patients were asked if they could tell which iliac crest had been harvested, and if so, how much pain did it cause (10-point Numeric Rating Scale). Most patients (64%) could not correctly determine which iliac crest had been harvested. Of the 9 patients who correctly identified the side of the autograft, 7 were only able to guess. The 2 patients who confidently identified the side of grafting had no pain at rest and mild pain with activity. One patient who incorrectly guessed the side of autografting did have significant sacroiliac joint degenerative pain bilaterally. Results of this study indicate the inability of patients to clearly define their graft site after iliac crest autograft harvest with allograft reconstruction of the bony defect unless they have a separate skin incision. This simple, easily reproducible pilot study can be expanded into a larger, multiinstitutional

  11. Bone Regeneration in Artificial Jaw Cleft by Use of Carbonated Hydroxyapatite Particles and Mesenchymal Stem Cells Derived from Iliac Bone

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    Motoko Yoshioka

    2012-01-01

    Full Text Available Objectives of the Study. Cleft lip and palate (CLP is a prevalent congenital anomaly in the orofacial region. Autogenous iliac bone grafting has been frequently employed for the closure of bone defects at the jaw cleft site. Since the related surgical procedures are quite invasive for patients, it is of great importance to develop a new less invasive technique. The aim of this study was to examine bone regeneration with mesenchyme stem cells (MSCs for the treatment of bone defect in artificially created jaw cleft in dogs. Materials and Methods. A bone defect was prepared bilaterally in the upper incisor regions of beagle dogs. MSCs derived from iliac bone marrow were cultured and transplanted with carbonated hydroxyapatite (CAP particles into the bone defect area. The bone regeneration was evaluated by standardized occlusal X-ray examination and histological observation. Results. Six months after the transplantation, perfect closure of the jaw cleft was achieved on the experimental side. The X-ray and histological examination revealed that the regenerated bone on the experimental side was almost equivalent to the original bone adjoining the jaw cleft. Conclusion. It was suggested that the application of MSCs with CAP particles can become a new treatment modality for bone regeneration for CLP patients.

  12. [Tumor-segmental resection of hand-foot-giant cell tumor of bone and autologous iliac bone graft reconstruction].

    Science.gov (United States)

    Ge, Jianhua; Chen, Ge; Zhang, Zhongjie; Wan, Yongxian; Lu, Xiaobo

    2010-08-01

    To evaluate the effectiveness of tumor-segmental resection and autologous iliac bone graft reconstruction combined with internal fixation in treating hand-foot-giant cell tumor of bone. Between August 1997 and April 2008, 8 cases of hand-foot-giant cell tumor of bone were treated, including 3 males and 5 females with an average age of 28.5 years (range, 16-42 years). The locations were metacarpal bones in 3 cases, metatarsal bones in 4 cases, and phalanges of toes in 1 case. According to Campanacci's gradation of X-ray films, there were 1 case of grade I and 7 cases of grade II; according to pathological examination before operation, there were 3 cases of grade I to II, 4 cases of grade II, and 1 case of grade II to III; and according to TNM staging, there were 1 case of TisN0M0, 4 cases of T1N0M0, and 3 cases of T2N0M0. There were 2 cases of recurrence, the time from the first operation to recurrence were 11 and 14 months, respectively. The tumor size was 1.8 cm x 1.0 cm to 6.0 cm x 2.0 cm, the cortical bone became thinner, and the boundary between tumor and periosteum was clear. All patients underwent tumor-segmental resection combined with autologous iliac bone graft reconstruction, and miniplate internal fixation by lumbar anesthesia or trachea cannula anesthesia. All incision healed by first intention. Eight patients were followed up 10 to 84 months with an average of 46 months. Radiographs showed that fracture union was achieved at 3 to 9 months (mean, 5 months). No significant rotation, angular, and shortening deformity occurred in iliac bone graft. The function of iliac bone donor site recovered excellently. The pathological examination showed giant cell tumor of bone in all cases, including 2 case of grade I-II, 5 cases of grade II, and 1 case of grade II-III. The hand or foot function recovered excellently. No tumor recurrence or lung metastasis occurred during follow-up. Tumor-segmental resection combined with autologous iliac bone graft reconstruction

  13. Comprehensive analysis of the volume of bone for grafting that can be harvested from iliac crest donor sites.

    Science.gov (United States)

    Kilinc, A; Korkmaz, I H; Kaymaz, I; Kilinc, Z; Dayi, E; Kantarci, A

    2017-10-01

    Our aim was to calculate the volumes of cancellous, cortical, and corticocancellous bone that can be harvested as a graft from the anterior and posterior iliac crests using 3-dimensional computed tomography (CT) and software in a living adult population. We selected random CT scans of the pelvis from 31 men and 29 women from the Department of Radiology imaging database. CT data in DICOM file format were imported into Mimics software. The anterior iliac crest and posterior iliac crest bone graft-harvested boundaries were measured. The volume of the 3-dimensional cortical and cancellous bone grafts was measured using the Mimics software. There were significant differences in all comparisons between the anterior and posterior iliac crest, except for volumes of cortical bone. More cancellous and total corticocancellous bone can be harvested from the posterior than the anterior iliac crest, together with similar or smaller volumes of cortical bone. Sex, but not age, is an important factor in terms of the amount of bone that can be harvested, with a wide range of volumes individually from both iliac crests. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Alveolar cleft closure with iliac bone graft: A case report.

    Directory of Open Access Journals (Sweden)

    Tichvy Tammama

    2017-04-01

    Conclusion: The timing of alveolar bone grafting usually associated with the state of the developing of dentition. Post operative management is important to get a good result, and to prevent any complications.

  15. Iliac Vein Compression as Risk Factor for Left- versus Right-Sided Deep Venous Thrombosis: Case-Control Study

    Science.gov (United States)

    Eng, John; Carmi, Lemore; McGrane, Siobhan; Ahmed, Muneeb; Sharrett, A. Richey; Streiff, Michael; Coresh, Josef; Powe, Neil; Hong, Kelvin

    2012-01-01

    Purpose: To determine if compression of the left common iliac vein (LCIV) by the right common iliac artery is associated with left-sided deep venous thrombosis (DVT). Materials and Methods: This institutional review board–approved case-control study was performed in a cohort of 230 consecutive patients (94 men, 136 women; mean age, 57.5 years; range, 10–94 years) at one institution who had undergone contrast material–enhanced computed tomography of the pelvis prior to a diagnosis of unilateral DVT. Demographic data and information on risk factors were collected. Two board-certified radiologists determined iliac vein compression by using quantitative measures of percentage compression {[1 minus (LCIV diameter at point of maximal compression/distal right common iliac vein diameter)] times 100%}, as well as qualitative measures (none, mild, moderate, severe), with estimates of measurement variability. Logistic regression analysis was performed (independent variable, left vs right DVT; dependent variable, iliac vein compression). Cutpoints of relevant compression were evaluated by using splines. Means (with 95% confidence intervals [CIs]) and odds ratios (ORs) (and 95% CIs) of left DVT per 1% increase in percentage compression were calculated. Results: Patients with right DVT were more likely than those with left DVT to have a history of pulmonary embolism. Overall, in all study patients, mean percentage compression was 36.6%, 66 (29.7%) of 222 had greater than 50% compression, and 16 (7.2%) had greater than 70% compression. At most levels of compression, increasing compression was not associated with left DVT (adjusted ORs, 1.00, 0.99, 1.02) but above 70%, LCIV compression may be associated with left DVT (adjusted ORs, 3.03, 0.91, 10.15). Conclusion: Increasing levels of percentage compression were not associated with left-sided DVT up to 70%; however, greater than 70% compression may be associated with left DVT. ©RSNA, 2012 Supplemental material: http

  16. Herniography: A prospective, randomized study between midline and left iliac fossa puncture techniques

    Energy Technology Data Exchange (ETDEWEB)

    Nadkarni, Sanjay; Brown, Peter W.G.; Beek, Edwin J.R. van; Collins, Michael C

    2001-05-01

    AIM: To determine whether an optimal site of injection exists for herniography. MATERIALS AND METHODS: This was a prospective, randomized study of 93 consecutive patients who were referred for herniography over a period of 9 months. Patients underwent either a left iliac fossa (LIF) or midline puncture. Parameters assessed included initial adequate needle placement, complications, pain scores and body mass index (BMI). The groups were compared using Chi-squared test for categorical data, Student's t-test for continuous data and the Mann-WhitneyU-test for skewed data, withP < 0.05 considered statistically significant RESULTS: Four complications were encountered (4%), and these were equally distributed between the two groups. Adequate initial positioning of the needle was similar in both groups. The volume of local anaesthetic used was correlated with discomfort using a pain scale: a volume of >6 ml resulted in significantly more pain. More frequent initial adequate needle placement was observed in thin patients (BMI < 45 kg/m{sup 2}) with experienced operators. Conversely, increased body mass index resulted in more difficult needle placement. CONCLUSION: Herniography is a safe procedure with few complications. There was no significant difference comparing the midline and LIF approaches. Nadkarni, S. et al. (2001)

  17. Fracture of anterior iliac crest following bone graft harvest in an anorexic patient: case report and review of the literature.

    Science.gov (United States)

    Covani, Ugo; Ricci, Massimiliano; Santini, Stefano; Mangano, Francesco; Barone, Antonio

    2013-02-01

    In the treatment of jaw bone atrophies, autologus bone is still considered the gold standard because of its excellent osteoconductive, osteoinductive, and osteogenetic proprieties and lack of immunogenicity, which allow better graft integration and stability. Although various donor sites are available, the iliac crest represents the best source of corticocancellous bone, and literature suggests that it has low morbidity. However, this case report emphasizes that patients with systemic diseases such as anorexia should be carefully evaluated before such an operation, because unfavorable bone conditions may jeopardize the outcome. A 47-year-old woman needing rehabilitation of the upper arch was considered for iliac crest harvesting. She stated that she had suffered from anorexia for 30 years. A corticocancellous block was harvested by a bone saw using an anterolateral approach to the outer table of the right anterior iliac crest. The postoperative course was uneventful, but 13 days later, she complained of a sudden pain in the operated area, and X rays revealed a fracture of the anterior iliac crest. So far, the literature has mentioned 50 cases of iliac crest fractures after bone harvesting, and 28 cases among these are due to harvesting in the anterior part of the iliac crest. Several factors seem to be responsible for this complication, including the area of harvesting, residual bone thickness, technique used, and age and gender of the patient. To our knowledge, our case is the first of hip fracture after bone harvesting in a patient suffering from anorexia. Both low weight and osteoporosis are probably responsible for this complication. In our opinion, patients suffering from anorexia should be considered at risk for bone harvesting, and an appropriate mini-invasive surgical technique should be carried out instead.

  18. Age-related changes in vertebral and iliac crest 3D bone microstructure-differences and similarities

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Jensen, Michael Vinkel; Niklassen, Andreas Steenholt

    2015-01-01

    Summary Age-related changes of vertebra and iliac crest 3D microstructure were investigated, and we showed that they were in general similar. The 95th percentile of vertebral trabecular thickness distribution increased with age for women. Surprisingly, vertebral and iliac crest bone microstructure...... was only weakly correlated (r = 0.38 to 0.75), despite the overall similar age-related changes.Introduction The purposes of the study were to determine the age-related changes in iliac and vertebral bone microstructure for women and men over a large age range and to investigate the relationship between...... the bone microstructure at these skeletal sites.Methods Matched sets of transiliac crest bone biopsies and lumbar vertebral body (L2) specimens from 41 women (19–96 years) and 39 men (23–95 years) were micro-computed tomography (μCT) scanned, and the 3D microstructure was quantified.Results For both women...

  19. Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

    NARCIS (Netherlands)

    Kasalak, Omer; Glaudemans, Andor W. J. M.; Overbosch, Jelle; Jutte, Paul C.; Kwee, Thomas C.

    OBJECTIVE: To determine and compare the value of (18)F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. MATERIALS AND

  20. Evaluation of perforated demineralized dentin scaffold on bone regeneration in critical-size sheep iliac defects.

    Science.gov (United States)

    Kabir, Md Arafat; Murata, Masaru; Akazawa, Toshiyuki; Kusano, Kaoru; Yamada, Katsuhisa; Ito, Manabu

    2017-11-01

    Regenerating critical-size bone injury is a major problem that continues to inspire the design of new graft materials. Therefore, tissue engineering has become a novel approach for targeting bone regeneration applications. Human teeth are a rich source of stem cells, matrix, trace metal ions, and growth factors. A vital tooth-derived demineralized dentin matrix is acid-insoluble and composed of cross-linked collagen with growth factors. In this study, we recycled human non-functional tooth into a unique geometric dentin scaffold, entitled perforated root-demineralized dentin matrix (PR-DDM). The aim of this study was to evaluate the feasibility of PR-DDM as the scaffold for regenerating bone in critical-size iliac defects. Artificial macro-pores (1 mm in diameter) were added to human vital wisdom tooth after removing the enamel and pulp portions. The modified tooth was demineralized in 0.34 N HNO 3 for 30 min and is referred to as PR-DDM scaffold. Critical-size defect (10 mm × 15 mm × 9 mm Ø) was created in the iliac crest of six adult sheep. The in vivo bone regeneration by the scaffold was evaluated by micro-CT, 3D micro-CT, and histological examination at 2 and 4 months post-implantation. PR-DDM exhibited better bone ingrowth, especially in the artificial macro-pores. The results of micro-CT and 3D micro-CT revealed good union between scaffold and native bone. New bone formation was observed in almost all portions of PR-DDM. Higher bone volume inside the scaffold was detected at 4 months compared with 2 months. New bone ingrowth was ankylosed with PR-DDM, and both osteoinduction and osteoconduction capability of PR-DDM were confirmed histologically. The ratio of new bone formation was higher at 4 months compared with 2 months by histomorphometric analysis. Altogether, these results demonstrated that the human tooth-derived graft material with a unique geometric structure, PR-DDM, contributed to active bone ingrowth in critical-size bone

  1. Comparison of fracture site callus with iliac crest bone marrow as the source of plastic-adherent cells

    Directory of Open Access Journals (Sweden)

    Achmad Zaki

    2013-05-01

    Full Text Available Background: Red marrow has been described as the main source of mesenchymal stem cells although its aspiration and isolation from bone marrow was reported to have significant donor site morbidity. Since secondary bone healing occurs through formation of callus as the result of proliferation and differentiation of mesenchymal stem cells, callus may become alternative source for mesenchymal stem cells. In this study, we compared the number of plastic-adherent cells from fracture site callus and bone marrow of iliac crest after two and four weeks of culture.Methods: Sixteen New Zealand rabbits were fracturized at the femoral shaft. Then, these rabbits were taken care. After two weeks of fracturization, 3 mL iliac crest bone marrow aspiration and callus extraction of eight rabbits were cultured (group I. The other eight rabbits were treated equally after four weeks of fracturization (group II. Simultaneously, the cultures were observed after one and two weeks. Four weeks later, they were harvested. Cells were counted using Neubauer hemocytometer. The average number of cells between the sources and groups were statistically analyzed using the unpaired t-test. Results: In group I, there were 2.6 ± 0.1 x 104 cells in the culture of iliac crest bone marrow aspirate and 2.5 ± 0.1 x 104 cells in culture of callus extract from fracture site (p = 0.34. In group II, there were 2.7 ± 0.1 x 104 cells and 2.1 ± 0.1 x 104 cells, respectively (p < 0.001.Conclusion: Fracture site callus at the second week post-fracturization may be potential as source of plastic-adherent cells compared with iliac crest bone marrow. (Med J Indones. 2013;22:70-5Keywords: Bone marrow, fracture site callus, iliac crest, long bone, mesenchymal stem cell, plastic-adherent cells

  2. Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review.

    Science.gov (United States)

    Dimitriou, Rozalia; Mataliotakis, George I; Angoules, Antonios G; Kanakaris, Nikolaos K; Giannoudis, Peter V

    2011-09-01

    Bone grafting is a commonly performed surgical procedure to augment bone regeneration in a variety of cases in orthopaedic and maxillofacial surgery. Autologous bone graft remains to be the 'gold standard' and the iliac crest to be the most common harvesting site. The intramedullary canal of long bones represents another potential site for large volume of autologous bone graft harvesting and is recently being used as an alternative donor site. However, harvesting of autologous bone graft is associated with morbidity and a number of complications. The aim of this systematic review was to collect and summarise the existing data on reported complications after harvesting autologous bone from the iliac crest (anterior and posterior) and the long bone intramedullary canal using the RIA device. We searched the PubMed Medline and Ovid Medline databases, from January 1990 to October 2010, to retrieve all relevant articles. A total of 92 articles (6682 patients) were included in the analysis. Overall, the complication rate following RIA was 6% (14 complications in 233 patients) and 19.37% after iliac crest bone graft harvesting (1249 complications in 6449 patients). The rate of each of the reported complications was assessed and, when the donor site was properly documented, comparison within the anterior and posterior iliac crest donor sites was performed. Although the difference of the overall morbidity rates between the two harvesting sites was not statistically significant (p=0.71); the rates of certain complications were found to significantly differ when anterior or posterior iliac crest was used. The rates of infection (p=0.016), haematoma formation (p=0.002), fracture (p=0.017), and hyperthrophic scar (p=0.017) were significantly higher when the donor site was the anterior iliac crest compared to the posterior iliac crest; whereas the rates of chronic donor site pain (p=0.004) and sensory disturbances (p=0.003) were significantly lower. The incidence of bone graft

  3. Marked changes in iliac crest bone structure in postmenopausal osteoporotic patients without any signs of disturbed bone remodeling or balance.

    Science.gov (United States)

    Steiniche, T; Christiansen, P; Vesterby, A; Hasling, C; Ullerup, R; Mosekilde, L; Melsen, F

    1994-01-01

    Successful iliac crest bone biopsies were obtained from 63 women with postmenopausal vertebral crush fracture osteoporosis. Structural and static histomorphometric parameters were compared with 25 age-matched normal females, who had suffered an unexpected and sudden death. The control group for dynamic parameters comprised 13 younger normal females. Marked structural changes were observed in the osteoporotic patients in cortical as well as cancellous bone. Cortical width, trabecular volume, trabecular bone surface density and trabecular number were all reduced, whereas trabecular separation and star volume were increased. On the other hand trabecular thickness was normal in the patients. These structural changes in cancellous bone indicate that extensive perforations of trabecular plates have occurred or that whole trabecular elements have been removed. The remodeling cycles of cancellous bone surface and the frequency by which they were repeated (activation frequency) did not differ significantly between osteoporotic patients and normal younger women. The bone balance per remodeling cycle in osteoporotic patients and controls was not significantly different. No subset of individuals in the group of osteoporotic patients could be identified regarding extent of resorptive and formative surfaces, bone formation rate or activation frequency. In the present osteoporotic patients nothing in the ongoing remodeling process could explain the marked changes in bone structure. The pathophysiological changes leading to osteoporosis may therefore occur earlier in life, maybe long before the manifestation of the disease.

  4. Evaluation of the mechanical properties of human iliac trabecular bone using finite element analysis

    International Nuclear Information System (INIS)

    Kohno, Jun; Ito, Masako; Kohno, Mika; Nakata, Tomoko; Furuyama, Kiyotaka; Habu, Takeshi

    2001-01-01

    Human iliac trabecular bone specimens were scanned using micro-computed tomography to obtain volume data of two-dimensional images in post-menopausal women, and two- and three-dimensional morphometric parameters, such as trabecular bone volume/tissue volume, trabecular thickness, structure model index, and trabecular bone pattern factor, were calculated using these image data. We developed several image processing programs for fast, easy operation. The contents of the image processing programs include changing of image resolution and image size, thresholding value, filtering, labeling, and division into elements. Several processings of the same image data were performed for the finite element analysis (FEA). Based on results of the degree of anisotropy, the bone structure was loaded in three directions, x-, y-, and z-axes. The images of the stress distribution and yield strength obtained from the three axis directions differed depending on load direction, and the correlations of yield strength with the variousmic rostructural parameters also differed depending on load direction. Load direction in vivo should be considered for bone specimens in FEA analysis. (author)

  5. Evaluation of the Trephine Method in Harvesting Bone Graft From the Anterior Iliac Crest for Oral and Maxillofacial Reconstructive Surgery.

    Science.gov (United States)

    Abdulrazaq, Saif Saadedeen; Issa, Sabah Abdulaziz; Abdulrazzak, Najwa Jamil

    2015-11-01

    Autogenous bone graft is the gold standard for maxillofacial reconstruction. Although there are many donor sites, the ilium is favored. Open iliac bone harvesting techniques can result in significant complications, which are to be reduced; a minimally invasive technique using trephine burs was used. The aim of the study was to evaluate the intra- and postoperative complications, the size of bone harvested, and the time of the procedure. Eighteen consecutive patients were conducted. The trephine bur makes holes of 10 mm diameter in the iliac crest from which a bone graft can be harvested. No major long-term morbidity was found; all patients were discharged on the first postoperative day. The trephine technique is generally a safe procedure, can provide enough corticocancellous bone for osseous defects in maxillofacial region up to 10 cc. In addition to that, the technique is easy to learn and allows early discharge of patients from the hospital.

  6. Enhancement of the repair of dog alveolar cleft by an autologous iliac bone, bone marrow-derived mesenchymal stem cell, and platelet-rich fibrin mixture.

    Science.gov (United States)

    Yuanzheng, Chen; Yan, Gao; Ting, Li; Yanjie, Fu; Peng, Wu; Nan, Bai

    2015-05-01

    Autologous bone graft has been regarded as the criterion standard for the repair of alveolar cleft. However, the most prominent issue in alveolar cleft treatment is the high absorption rate of the bone graft. The authors' objective was to investigate the effects of an autologous iliac bone, bone marrow-derived mesenchymal stem cell, and platelet-rich fibrin mixture on the repair of dog alveolar cleft. Twenty beagle dogs with unilateral alveolar clefts created by surgery were divided randomly into four groups: group A underwent repair with an autologous iliac bone, bone marrow-derived mesenchymal stem cell, and platelet-rich fibrin mixture; group B underwent repair with autologous iliac bone and bone marrow-derived mesenchymal stem cells; group C underwent repair with autologous iliac bone and platelet-rich fibrin; and group D underwent repair with autologous iliac bone as the control. One day and 6 months after transplantation, the transplant volumes and bone mineral density were assessed by quantitative computed tomography. All of the transplants were harvested for hematoxylin and eosin staining 6 months later. Bone marrow-derived mesenchymal stem cells and platelet-rich fibrin transplants formed the greatest amounts of new bone among the four groups. The new bone formed an extensive union with the underlying maxilla in groups A, B, and C. Transplants with the bone marrow-derived mesenchymal stem cells, platelet-rich fibrin, and their mixture retained the majority of their initial volume, whereas the transplants in the control group showed the highest absorption rate. Bone mineral density of transplants with the bone marrow-derived mesenchymal stem cells, platelet-rich fibrin, and their mixture 6 months later was significantly higher than in the control group (p bone marrow-derived mesenchymal stem cells and platelet-rich fibrin mixed transplants. Hematoxylin and eosin staining showed that the structure of new bones formed the best in group A. Both bone marrow

  7. Non-epiphyseal chondroblastoma arising in the iliac bone, and complicated by an aneurysmal bone cyst: a case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin; Kumar, Rajendra [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Raymond, A.K. [Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Ayala, Alberto G. [The Methodist Hospital, Department of Pathology, Houston, TX (United States)

    2010-06-15

    Chondroblastoma is a benign bone tumor that typically arises in the epiphysis of a long bone. However, when it occurs in non-epiphyseal location in flat bones, it may create a diagnostic problem. We describe such a case of chondroblastoma arising in the iliac bone. A 29-year-old man was incidentally found to have a bony pelvic lesion while undergoing evaluation for Crohn's disease. The radiographs and CT revealed an expansile lytic lesion in the right iliac bone. A core biopsy of the lesion was performed. The histopathology revealed the lesion to be a chondroblastoma with secondary features of aneurysmal bone cyst. An en bloc surgical resection of the tumor was performed. (orig.)

  8. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

    Directory of Open Access Journals (Sweden)

    D D Baksi

    2016-01-01

    Full Text Available Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG were excluded. Thus, out of 244 patients, 208 (85.3% untreated nonunion and 36 (14.7% following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN femoral head was found histologically in 135 (54.3% and radiologically in 48 (19.7% patients. The patients were operated by open reduction of fracture

  9. Bone disease in African children with slipped capital femoral epiphysis: histomorphometry of iliac crest biopsies.

    Science.gov (United States)

    Schnitzler, C M; Daniels, E D; Mesquita, J M; Moodley, G P; Zachen, D; Cakic, J; Pettifor, J M

    1998-03-01

    African teenagers with slipped capital femoral epiphysis (SCFE) not infrequently also have genu valgum (knock-knee). Because we had previously demonstrated metabolic bone disease attributable to dietary calcium deficiency in black teenagers with genu valgum, we examined 29 black teenagers (15 male, 14 female) with SCFE for metabolic bone disease. Each patient had an iliac crest bone biopsy taken (after double tetracycline labeling) for routine histomorphometry, and blood and urine samples for bone biochemistry. Spinal bone mineral density was measured in 13 patients. Compared to reported data, we found our patients to be sexually more immature, older, at least as obese, and to have more severe and more frequently bilateral hip disease. Eighty percent of the children took dairy products only once or twice a week or less frequently, and 37.9% had genu valgum. Compared with race- and age-matched South Africans, bone biopsies in our patients showed lower bone volume (BV/TV, p = 0.0003), wall thickness (p = 0.0002), and trabecular thickness (Tb.Th, p = 0.0002), and a tendency to greater trabecular spacing (Tb.Sp, p = 0.053). Lower osteoid volume (OV/BV, p = 0.0001), osteoid surface (OS/BS, p = 0.0001), osteoid thickness (O.Th, p = 0.0002), double labeled surface (dLS/BS, p = 0.029), and bone formation rate (BFR/BS, p = 0.037) suggested poorer bone forming capacity in our patients. No evidence of hyperparathyroid bone disease or osteomalacia was found. BV/TV was below the reference range (14.2%) in 65.5% of cases; these patients had lower values for Tb.Th (p = 0.037) and Tb.N (p = 0.0003), greater Tb.Sp (p = 0.0002), a tendency to lower adjusted apposition rate (Aj.AR, p = 0.057), and had had less frequent intake of dairy products than those with normal BV/TV (p = 0.024). Furthermore, months since menarche correlated with histomorphometric variables BV/TV (r = 0.667, p = 0.009), Tb.Th (r = 0.745, p = 0.002), Tb.Sp (r = -0.549, p = 0.042), O.Th (r = 0.784, p = 0

  10. Three-Dimensional Cone Beam Computed Tomography Volumetric Outcomes of rhBMP-2/Demineralized Bone Matrix versus Iliac Crest Bone Graft for Alveolar Cleft Reconstruction.

    Science.gov (United States)

    Liang, Fan; Yen, Stephen L-K; Imahiyerobo, Thomas; Sanborn, Luke; Yen, Leia; Yen, Daniel; Nazarian, Sheila; Jedrzejewski, Breanna; Urata, Mark; Hammoudeh, Jeffrey

    2017-10-01

    Recent studies indicate that recombinant human bone morphogenetic protein-2 (rhBMP-2) in a demineralized bone matrix scaffold is a comparable alternative to iliac bone autograft in the setting of secondary alveolar cleft repair. Postreconstruction occlusal radiographs demonstrate improved bone stock when rhBMP-2/demineralized bone matrix (DBM) scaffold is used but lack the capacity to evaluate bone growth in three dimensions. This study uses cone beam computed tomography to provide the first clinical evaluation of volumetric and density comparisons between these two treatment modalities. A prospective study was conducted with 31 patients and 36 repairs of the alveolar cleft over a 2-year period. Twenty-one repairs used rhBMP-2/DBM scaffold and 14 repairs used iliac bone grafting. Postoperatively, occlusal radiographs were obtained at 3 months to evaluate bone fill; cone beam computed tomographic images were obtained at 6 to 9 months to compare volumetric and density data. At 3 months, postoperative occlusal radiographs demonstrated that 67 percent of patients receiving rhBMP-2/DBM scaffold had complete bone fill of the alveolus, versus 56 percent of patients in the autologous group. In contrast, cone beam computed tomographic data showed 31.6 percent (95 percent CI, 24.2 to 38.5 percent) fill in the rhBMP-2 group compared with 32.5 percent (95 percent CI, 22.1 to 42.9 percent) in the autologous population. Density analysis demonstrated identical average values between the groups (1.38 g/cc). These data demonstrate comparable bone regrowth and density values following secondary alveolar cleft repair using rhBMP-2/DBM scaffold versus autologous iliac bone graft. Cone beam computed tomography provides a more nuanced understanding of true bone regeneration within the alveolar cleft that may contribute to the information provided by occlusal radiographs alone. Therapeutic, II.

  11. Biomechanical competence of six different bone screws for reconstructive surgery in three different transplants: Fibular, iliac crest, scapular and artificial bone.

    Science.gov (United States)

    Pietsch, Arnold P; Raith, Stefan; Ode, Jan-Eric; Teichmann, Jan; Lethaus, Bernd; Möhlhenrich, Stephan C; Hölzle, Frank; Duda, Georg N; Steiner, Timm

    2016-06-01

    The goal of this study was to determine a combination of screw and transplantation type that offers optimal primary stability for reconstructive surgery. Fibular, iliac crest, and scapular transplants were tested along with artificial bone substrate. Six different kinds of bone screws (Medartis(©)) were compared, each type utilized with one of six specimens from human transplants (n = 6). Controlled screw-in-tests were performed and the required torque was protocolled. Subsequently, pull-out-tests were executed to determine the retention forces. The artificial bone substitute material showed significantly higher retention forces than real bone samples. The self-drilling screws achieved the significantly highest retention values in the synthetic bone substitute material. Cancellous screws achieved the highest retention in the fibular transplants, while self-drilling and cancellous screws demonstrated better retention than cortical screws in the iliac crest. In the scapular graft, no significant differences were found between the screw types. In comparison to the human transplant types, the cortical screws showed the significantly highest values in the fibula and the lowest values in the iliac crest. The best retention was found in the combination of cancellous screws with fibular graft (514.8 N + -252.3 N). For the flat bones (i.e., scapular and illiac crest) we recommend the cancellous screws. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  12. Left sided circumaortic and retroaortic left renal veins, renal artery arising from iliac common artery in L-shaped kidney

    International Nuclear Information System (INIS)

    Al-Amin, M.

    2012-01-01

    Full text: Introduction: Renal ectopia is a congenital anomaly with variable clinical presentation. Kidneys are normally located in the retroperitoneal position, on either side of vertebral column, against the psoas muscles but when not at such position, it is called renal ectopia or ectopic kidney. Ectopic kidneys are thought to occur in approximately 1 in 1,000 births but only about 1 in 10 of these is ever diagnosed. In 90% of crossed ectopy, there is at least partial fusion of the kidneys. Left-to right ectopy is thought to be three times more common. Some of these are discovered incidentally, when a child or adult is having ultrasonography for a medical condition unrelated to renal ectopia. In a crossed fused renal ectopic kidney, complications such as nephrolithiasis, infection, and hydronephrosis approaches over 50%. Simple renal ectopia refers to kidney that is located on the proper side but abnormal in position. Crossed renal ectopia was first described by Pannorlus in 1964 and refer to kidney that has crossed from left to right or vice-versa, with moving of one kidney to the opposite side following ascent of the other kidney, so that both kidneys are located on the same side of the body, mostly fused called crossed fused ectopia. The fusion of the two kidneys is believed to result from (1) failure of the primitive nephrogenic cell masses to separate or (2) fusion of the two blastemas during their abdominal ascent. Discussion: A 57-year-old woman with a new found hematological disease. CT exam was performed with intravenous application of contrast media. Like an additional findings we visualized the presence of right to-left ectopy (L - shaped kidney) and the presence of left circumaortic renal vein emanating from a normally situated left kidney and retroaortic renal vein as having been located by the ectopic right kidney. Conclusion: By crossed renal ectopia is meant congenital displacement of one kidney to the opposite side. The conditional may present

  13. Proposal for a new classification of variations in the iliac venous system based on internal iliac veins: a case series and a review of double and left inferior vena cava.

    Science.gov (United States)

    Hayashi, Shogo; Naito, Munekazu; Hirai, Shuichi; Terayama, Hayato; Miyaki, Takayoshi; Itoh, Masahiro; Fukuzawa, Yoshitaka; Nakano, Takashi

    2013-09-01

    There are many reports on variations in the inferior vena cava (IVC), particularly double IVC (DIVC) and left IVC (LIVC). However, no systematic report has recorded iliac vein (IV) flow patterns in the DIVC and LIVC. In this study, we examined IV flow patterns in both DIVC and LIVC observed during gross anatomy courses conducted for medical students and in previously reported cases. During the gross anatomy courses, three cases of DIVC and one case of LIVC were found in 618 cadavers. The IV flow pattern from these four cases and all other previously reported cases can be classified into one of the following three types according to the vein into which the internal iliac vein drained: the ipsilateral external IV; confluence of the ipsilateral external IV and IVC; and the communicating vein, which connects the IVC and the contralateral IVC or its iliac branch. This classification, which is based on the internal IV course, is considered to be useful because IV variations have the potential to cause clinical problems during related retroperitoneal surgery, venous interventional radiology, and diagnostic procedures for pelvic cancer.

  14. Mechanical analysis of transversal iliac fracture stabilization using dynamic compression plate or screws and PMM in polyurethane bone model

    Directory of Open Access Journals (Sweden)

    T.C. Prada

    Full Text Available ABSTRACT Pelvic fractures correspond to 20 to 30 % of the fractures observed in dogs. Complete fractures, especially with bone axis deviation should be surgically treated. The mechanical study of surgical techniques is of utmost importance to assess the best way of treating these injuries. This study compared, biomechanically, the use of a dynamic compression plate (DCP and screws (group 1 or screws and polymethylmethacrylate (PMMA (group 2 to stabilize an iliac fracture using a static test. Sixteen canine synthetic hemi-pelvises (test specimens with a transverse iliac osteotomy were used. After fixation with implants, a load was applied to the acetabulum until failure. Group 1 maximal compressive load was 133.9±18.60 N, displacement at yield 21.10±3.59mm and stiffness 125.22±12.25N/mm. Group 2 maximal compressive load was 183.50±27.38N, displacement at yield 16.66±5.42mm and stiffness 215.68±33.34N/mm. The stabilization with polymethylmethacrylate was stronger than dynamic compression plate since it resisted a greater load in all test specimens.

  15. 6-Year follow-up of ventral monosegmental spondylodesis of incomplete burst fractures of the thoracolumbar spine using three cortical iliac crest bone grafts.

    Science.gov (United States)

    Spiegl, Ulrich; Hauck, Stefan; Merkel, Patricia; Bühren, Volker; Gonschorek, Oliver

    2012-10-01

    Autologous bone graft is the gold standard for vertebral body replacement. Currently, after modern implants for vertebral body replacement are available, controversies exist regarding the optimal implant strategy. Between 2002 and 2003, 17 patients were included in this study, all suffering from incomplete burst fractures of the thoracolumbar spine. All of them were treated by ventral monosegmental spondylodesis using iliac crest bone graft. The individual treatment strategy depended on the fracture situation and patient's condition. After an average of 74 months (range 66-84) a clinical and computer tomographic follow-up examination was performed in 14 patients (average age, 35.2 years) including VAS spine score and SF 36 score. Nine patients were treated ventral only five patients dorsoventrally. Complete osseous consolidation was visible in nine, partial consolidation (>30 %) in four, and lysis in one patient, without any significant differences between ventral only or dorsoventral approach. After removal of the fixateur interne the level of consolidation improved in all patients, treated dorsoventrally. There was no significant correlation between percentage of osseous consolidation and the clinical follow-up parameters. After 6 years, 71 % of the patients suffered from persistent pain associated with the approach to the iliac crest. Two revision surgeries have been necessary. High rates of osseous consolidation are visible 6 years after ventral spondylodesis by iliac crest bone grafts. A further improvement of consolidation can be expected after dorsal implant removal. But the surgical approach to the iliac crest is accompanied with a relevant complication rate.

  16. Sacro-iliac joint disease in drug abusers: The role of bone scintigraphy

    International Nuclear Information System (INIS)

    Lopez-Majano, V.; Miskew, D.B.W.; Cook County Hospital, Chicago, IL

    1980-01-01

    Bone scintigrams demonstrated increased uptake in the sacroiliac joint in twenty drug addicts with low back pain and signs of localized sepsis. The localization of the disease was decisive for the orthopedist in the aspiration of the affected joint. (orig.)

  17. Reconstruction of irradiated mandible after segmental resection of osteoradionecrosis-a technique employing a microvascular latissimus dorsi flap and subsequent particulate iliac bone grafting

    DEFF Research Database (Denmark)

    Hillerup, Soren; Elberg, Jens Jorgen; Thorn, Jens Jorgen

    2014-01-01

    The fibula osteocutaneous flap has revolutionized the options of mandibular segmental defect bridging in osteoradionecrosis (ORN). In selected cases, however, the fibula flap is not an option because of atherosclerosis or other features that compromise the vascularity of the lower leg and foot....... The aim of this study is to present an alternative method of mandibular segmental reconstruction employing a latissimus dorsi (LD) flap and subsequent particulate iliac free bone graft reconstruction. In 15 patients with ORN, a mandibular segmental defect was bridged with a reconstruction plate......, and the defect site was primed with a LD musculocutaneous flap wrapped around the reconstruction plate to bring in vascularized tissue and optimize healing conditions for a subsequent particulate iliac free bone graft reconstruction. The management of defect closure was successful in all 15 patients. Twelve...

  18. Titanium cages versus autogenous iliac crest bone grafts in anterior cervical discectomy and fusion treatment of patients with cervical degenerative diseases: a systematic review and meta-analysis.

    Science.gov (United States)

    Shao, Ming-Hao; Zhang, Fan; Yin, Jun; Xu, Hao-Cheng; Lyu, Fei-Zhou

    2017-05-01

    A systematic review and partial meta-analysis is conducted to compare the efficacy and safety of anterior cervical decompression and fusion procedures employing either rectangular titanium cages or iliac crest autografts in patients suffering from cervical degenerative disc diseases. Medline, PubMed, CENTRAL, and Google Scholar databases were searched up to June 2015, using the key words cervical discectomy; bone transplantation; titanium cages; and iliac crest autografts. Outcomes of interbody fusion rates were compared using odds ratios (ORs) with 95% confidence intervals (CIs). Values of the Japanese Orthopaedic Association score, and visual analog scale before and after operation were also compared. The rate of interbody fusion was similar between patients in the iliac crest autograft and titanium cage groups (pooled OR = 0.33, 95% CI = 0.07 to 1.66, P = .178). The overall analysis showed that patients in the two groups did not have significantly different post-surgery Japanese Orthopaedic Association score (pooled difference in means = -0.05, 95% CI = 0.73 to 0.63, P = .876). Improvement in arm and neck pain scores were assessed with a visual analog scale and differed significantly between patients in the iliac crest autograft and titanium cage groups (pooled difference in means = 0.16, 95% CI = -0.44 to 0.76, P = .610; and pooled difference in means = -0.44, 95% CI = -2.23 to 1.36, P = .634, respectively). Our results suggest that the use of titanium cages constitutes a safe and efficient alternative to iliac crest bone autografts for anterior cervical discectomy with fusion.

  19. Hybrid repair of penetrating aortic ulcer associated with right aortic arch and aberrant left innominate artery arising from aneurysmal Kommerell's diverticulum with simultaneous repair of bilateral common iliac artery aneurysms.

    Science.gov (United States)

    Guo, Yuanyuan; Yang, Bin; Cai, Hongbo; Jin, Hui

    2014-02-01

    We present the first case of a hybrid endovascular approach to a penetrating aortic ulcer on the left descending aorta with a right aortic arch and aberrant left innominate artery arising from an aneurysmal Kommerell's diverticulum. The patient also had bilateral common iliac artery aneurysms. The three-step procedure consisted of a carotid-carotid bypass, followed by endovascular exclusion of the ulcer and the aneurysmal Kommerell's diverticulum, and then completion by covering the iliac aneurysms. The patient had no complications at 18 months after surgery. In such rare configurations, endovascular repair is a safe therapeutic option. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Concentration profiling of minerals in iliac crest bone tissue of opium addicted humans using inductively coupled plasma and discriminant analysis techniques.

    Science.gov (United States)

    Mani-Varnosfaderani, Ahmad; Jamshidi, Mahbobeh; Yeganeh, Ali; Mahmoudi, Mani

    2016-02-20

    Opium addiction is one of the main health problems in developing countries and induces serious defects on the human body. In this work, the concentrations of 32 minerals including alkaline, heavy and toxic metals have been determined in the iliac crest bone tissue of 22 opium addicted individuals using inductively coupled plasma-optical emission spectroscopy (ICP-OES). The bone tissues of 30 humans with no physiological and metabolomic diseases were used as the control group. For subsequent analyses, the linear and quadratic discriminant analysis techniques have been used for classification of the data into "addicted" and "non-addicted" groups. Moreover, the counter-propagation artificial neural network (CPANN) has been used for clustering of the data. The results revealed that the CPANN is a robust model and thoroughly classifies the data. The area under the curve for the receiver operating characteristic curve for this model was more than 0.91. Investigation of the results revealed that the opium consumption causes a deficiency in the level of Calcium, Phosphate, Potassium and Sodium in iliac crest bone tissue. Moreover, this type of addiction induces an increment in the level of toxic and heavy metals such as Co, Cr, Mo and Ni in iliac crest tissue. The correlation analysis revealed that there were no significant dependencies between the age of the samples and the mineral content of their iliac crest, in this study. The results of this work suggest that the opium addicted individuals need thorough and restricted dietary and medical care programs after recovery phases, in order to have healthy bones. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. [Scaphoid pseudarthrosis : Indications for avascular iliac crest or radius bone grafts].

    Science.gov (United States)

    Asmus, A; Lautenbach, M; Schacher, B; Kim, S; Eisenschenk, A

    2016-11-01

    Operative treatment of the scaphoid nonunion includes avascular corticocancellous and cancellous bone grafts and increasingly the use of vascular pedicled and free vascular corticocancellous grafts. Especially the latter require a fair amount of operative expertise and experience in microsurgical techniques. Which criteria lead to the decision for or against an avascular graft used for reconstruction of scaphoid nonunion? Is our current classification system of a scaphoid pseudarthrosis able to illustrate our diagnostic potential in a way that makes us refer to operative procedures? Evaluation of current literature and expert opinions RESULTS: Avascular bone grafts show a high union rate as long as a sufficient vascularisation of the remaining fragments is present. In general, patients benefit from a very good functional outcome. Even revisions of failed scaphoid union may be successfully treated with an avascular bone graft. Failures of union are repeatedly experienced in treating proximal pole fractures with critical vascularisation or extensive bone loss, especially including avascular necrosis of the proximal pole (AVN). Current classification systems do not allow description and correlation of morphologic findings so as to compare results profoundly and to recommend specific procedures. As long as sufficient vascularisation of remaining fragments is seen, the avascular bone graft is eligible for reconstructing scaphoid nonunion. Classification systems do not seem to reflect the status quo of diagnostic possibilities and make it difficult to provide guidelines for state-of-the-art operative procedures.

  2. Evaluating of Platelet-Rich Fibrin in the Treatment of Alveolar Cleft With Iliac Bone Graft By Means of Volumetric Analysis.

    Science.gov (United States)

    Saruhan, Nesrin; Ertas, Umit

    2018-03-01

    The purpose of this study was to evaluate the efficiency of platelet-rich fibrin usage in the treatment of alveolar cleft with iliac bone graft by means of volumetric analysis. In this study, 22 patients with alveolar clefts-including 13 unilateral and 9 bilateral-were treated with anterior iliac crest bone grafts. Patients were divided into 2 groups as control (group A) and platelet-rich fibrin (group B) groups. Cone beam computed tomography (CBCT) scans were obtained preoperatively and 6 months postoperatively. Three-dimensional reconstructions of CBCT images were created by using Mimics software. Preoperative alveolar cleft volume and postoperative newly formed bone volume were assessed volumetrically. The percentages of preoperative alveolar cleft volume ranged from 0.51 to 2.04 cm, with a mean volume of 0.98 ± 0.33 cm. The percentages of newly formed bone in group B ranged from 50.70% to 80.09%, with a mean percentage of 68.21 ± 10.80%. In Group A, the percentages of bone formation ranged from 47.02% to 79.23%, with a mean percentage of 64.62 ± 9.49%. Platelet-rich fibrin can be used in the treatment of alveolar cleft with corticocancellous bone graft harvested from the anterior iliac crest, but in this study, there was no statistically significant difference between the groups for postoperative newly formed bone volume (P > 0.05).

  3. Clinical and 3-Dimensional Radiographic Evaluation of Autogenous Iliac Block Bone Grafting and Guided Bone Regeneration in Patients With Atrophic Maxilla.

    Science.gov (United States)

    Gultekin, B Alper; Cansiz, Erol; Borahan, M Oguz

    2017-04-01

    To evaluate the rate of graft resorption in autogenous iliac bone grafting (IBG) and guided bone regeneration (GBR) in patients with atrophic maxillae. We performed a retrospective study involving patients requiring implant placement who underwent IBG or GBR. Volumetric changes of the graft sites were evaluated by imaging studies. The primary predictor and outcome variables were augmentation technique and rate of volumetric resorption, respectively. Secondary outcome variables included bone gain, success of grafting, insertion torque of implants, and requirement for vestibuloplasty. The sample comprised 39 patients (21 with GBR and 18 with IBG). One patient in the IBG group had temporary sensory disturbance at the donor site, and one patient in the GBR group had late exposure of the nonresorbable membrane. The average values of percent volume reduction in the GBR and IBG groups were 12.26% ± 2.35% and 35.94% ± 7.94%, respectively, after healing and 15.87% ± 1.99% and 41.62% ± 6.97%, respectively, at last follow-up. The IBG group exhibited a significantly higher reduction in bone volume than the GBR group at both time points (P = .001). The mean values of horizontal and vertical bone gain after healing in the IBG group were significantly higher than those in the GBR group (P = .006 and P = .001, respectively). The mean implant torque during implant placement in the GBR group was significantly higher than that in the IBG group (P = .024). There was no significant difference in the requirement for vestibuloplasty between the two groups (P > .05). Although both hard tissue augmentation approaches provide an adequate volume of bone graft for implant insertion, IBG results in greater graft resorption at maxillary augmented sites than GBR. Clinicians should consider the differences in the extent of graft resorption between the two methods while choosing the treatment approach. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published

  4. Hemodynamic changes in osteonecrosis treatment of the femoral head with iliac bone flaps pedicled with the lateral femoral circumflex artery ascending branch: A 10-year report.

    Science.gov (United States)

    Liu, YuPeng; Zhao, DeWei; Wang, W M; Wang, B J; Zhang, Y; Li, Z G

    2016-04-29

    Vascularized bone grafting was used in the treatment of osteonecrosis femoral head, which may directly influence the pathologic event of femoral head. This paper evaluates hemodynamic changes in osteonecrosis treatment of the femoral head (ONFH) with iliac bone flaps from the lateral femoral circumflex artery ascending branches via digital subtraction angiography. A total of 48 patients, (31 males and 17 females; 38 at stage II and 10 at stage III), were treated with iliac bone flaps pedicled with the ascending branch of the lateral femoral circumflex artery. DSA was performed on all 48 patients preoperatively and 6 months postoperatively, and 10 years postoperatively on 1 patient. Six months after surgery, femoral head blood supplies were distinctly visualized in the selective DSA in 44 cases. 4 patients showed poor or failed vessel pedicle filling in the transplanted bone flaps. Total hip arthroplasty was performed on these 4 patients. DSA was conducted 10 years post-operation in 1 case; the subject showed normal blood supply of the femoral head. The anatomical position of the ascending branch of the lateral femoral circumflex artery was constant. Digital subtraction angiography successfully examined hemodynamic changes in osteonecrosis treatment of the femoral head with vascularized bone flaps.

  5. The application of closed reduction internal fixation and iliac bone block grafting in the treatment of acute displaced femoral neck fractures.

    Directory of Open Access Journals (Sweden)

    Zhiyong Li

    Full Text Available OBJECTIVE: This study aimed to evaluate the preliminary clinical and radiographic outcomes of acute displaced femoral neck fracture treated by closed reduction and internal fixation (CRIF with free iliac bone block grafting with comparison to a routine protocol of CRIF without bone grafting. METHODS: From December 2008 to February 2010, 220 adult patients with acute displaced femoral neck fractures were enrolled in this study. In study group, there were 124 patients (57 males, 67 females with a mean age of 44.8 years (range, 20-64 years. There were 70 transcervical fractures and 54 subcapital fractures. The patients were treated by CRIF and free iliac bone block grafting. The control group consisted of 96 adult patients (46 males, 50 females with a mean age of 46.3 years (range, 23-64 years. There were 61 transcervical fractures and 35 subcapital fractures. The patients in control group were treated by CRIF without bone grafting. RESULTS: In study group, 112 patients were followed up for an average of 27.4 months (range, 24-34 months. All fractures healed within 5 months. However, 10 patients presented AVN of the femoral heads. The mean Harris score was 88.6 (range, 41-100. In control group, 68 patients were followed up for an average of 31.2 months (range, 24-42 months. The rates of AVN of the femoral head and fracture nonunion in control group were 26.5% (18/68 and 16.2% (11/68, respectively, significantly higher than those in study group (both P<0.05. The mean Harris score in control group was 83.8 (41-100, significantly lower than that in study group (P<0.05. CONCLUSION: Acute displaced femoral neck fractures can be treated by CRIF and free iliac bone block grafting in a minimally invasive manner. This technique can guarantee uneventful fracture healing and significantly reduce the rate of femoral head osteonecrosis.

  6. Multiple Rib Nonunion: Open Reduction and Internal Fixation and Iliac Crest Bone Graft Aspirate.

    Science.gov (United States)

    Kaplan, Daniel J; Begly, John; Tejwani, Nirmal

    2017-08-01

    Rib fractures are a common chest injury that can typically be treated nonoperatively. However, a percentage of these will go on to nonunion, either because of unique characteristics of the fracture itself or because of a variety of poor healing factors of the host. If a patient has continued symptomology beyond 3 months, surgeons may consider operative management. Although isolated resection of fibrous scar tissue from the nonunion site may be sufficient in some cases, it may also be necessary to provide additional structural integrity to the rib depending on the extent of the fracture pattern and resection. This goal can be achieved operatively with rib plating and bone grafting to promote healing. This video demonstrates the use of plating in the treatment of rib nonunion. It begins with relevant background information on rib fractures and nonunions, then details the approach, open reduction and internal fixation of 3 ribs using plates and bone graft aspirate. Pearls and pitfalls are included during the surgical technique aspect of the video to both help guide surgeons new to the procedure and provide potentially advantageous technical details to more experienced surgeons.

  7. Cleft Patient-Reported Postoperative Donor Site Pain Following Alveolar Autologous Iliac Crest Bone Grafting: Comparing Two Minimally Invasive Harvesting Techniques.

    Science.gov (United States)

    Raposo-Amaral, Cesar Augusto; Denadai, Rafael; Chammas, Danilo Zanardo; Marques, Frederico Figueiredo; Pinho, André Silveira; Roberto, Wellington Matheus; Buzzo, Celso Luiz; Raposo-Amaral, Cassio Eduardo

    2015-10-01

    Autologous bone grafting is still considered the standard method for alveolar cleft repair. However, donor site morbidities remain a relevant problem in cleft care. Thus, the authors assessed postoperative donor site pain in cleft patients who underwent alveolar cleft repair by iliac crest bone graft transferring through a prospective randomized study comparing 2 minimally invasive harvesting techniques. Fifty-six consecutive patients with cleft lip and palate who underwent iliac crest bone grafting for alveolar cleft repair were randomly divided into 2 groups: bone graft harvested by minimally invasive techniques without (group 1) and with (group 2) periosteum elevation. Postoperative donor site pain was evaluated using a unidimensional numerical pain intensity rating scale (0, "no pain;" 10, "worst pain imaginable") at 1, 3, 6, 9, and 12 hours after the procedures and on the 3rd, 7th, 14th, 21st, and 28th days after surgeries. Intergroup comparisons were performed. The mean measurements of donor site pain revealed no significant differences (all P > 0.05) in any of the evaluated postoperative period comparisons between groups 1 and 2. There was a greater number (P < 0.05) of group 1 patients who reported "no pain" in the donor site compared with group 2, suggesting that periosteum elevation may play a role in pain intensity measurement. This prospective randomized study showed no difference in pain intensity among cleft patients who had postoperative pain. However, a greater number of patients in group 1 reported "no pain" in comparison to patients in group 2.

  8. Subperiosteal hematoma of the iliac bone: imaging features of acute and chronic stages with emphasis on pathophysiology

    Energy Technology Data Exchange (ETDEWEB)

    Guillin, Raphael [Rennes University Hospital, Department of Musculoskeletal Imaging, Rennes Cedex 2 (France); Moser, Thomas [Montreal University Hospital, Department of Musculoskeletal Imaging, Montreal (Canada); Koob, Meriam [Strasbourg University Hospital, Department of Pediatric Imaging, Strasbourg (France); Khoury, Viviane [Mc Gill University Health center, Department of Radiology, Montreal (Canada); Chapuis, Madeleine [Rennes University Hospital, Department of Pediatric Orthopedic Surgery, Rennes (France); Ropars, Mickael [Rennes University Hospital, Department of orthopedic surgery, Rennes (France); Cardinal, Etienne [Radiologie Laennec, Montreal (Canada)

    2012-06-15

    The goal of this work is to describe the radiological appearance and clinical presentation of subperiosteal iliac hematoma and present a review of the literature. We retrospectively reviewed the radiological and clinical files of 19 patients (age range: 12-75; mean: 47) who presented with acute or chronic subperiosteal iliac hematomas. Imaging findings and relevant clinical information were recorded. A thorough literature search was performed to find additional cases of this rare condition. Three young patients presented with acute subperiosteal iliac hematoma following a fall. Clinical presentation was characterized by pain and gait disturbance presumed to result from crural nerve compression. Unilateral or bilateral lenticular hematomas deep in the iliacus muscle were demonstrated by CT for all patients while MRI was also available for two of them. In 16 asymptomatic patients, chronic ossified subperiosteal iliac hematomas were incidentally detected by CT. Progressive ossification of acute hematoma was demonstrated at follow-up in two patients. Subperiosteal iliac hematoma is rare but has typical imaging findings that may present acutely in adolescents or chronically in asymptomatic adults. (orig.)

  9. Drilling simulated temporal bones with left-handed tools: a left-hander's right?

    Science.gov (United States)

    Torgerson, Cory S; Brydges, Ryan; Chen, Joseph M; Dubrowski, Adam

    2007-11-01

    Left-handed trainees can be at a disadvantage in the surgical environment because of a right-handed bias. The effectiveness of teaching left-handed trainees to use an otologic drill designed for their dominant hand versus the conventional right-handed drill was examined. Novice medical students were recruited from the university community. Twenty-four subjects were left-handed, and 12 were right-handed. Eight left-handed surgeons also participated. A randomized controlled trial was conducted to compare the performance of left-handed trainees using novel left-handed drills to that of left-handed trainees using right-handed tools and to that of right-handed trainees using right-handed tools. The evaluation consisted of 3 phases: pretest, skill acquisition, and 2 post-tests. The measurement tools included expert assessment of performance, and subjective and objective final product analyses. An initial construct validity phase was conducted in which validity of the assessment tools was ensured. Both the left-handers using left-handed tools and the right-handers using right-handed tools significantly outperformed the left-handers using right-handed tools at pretest, immediate posttest, and delayed posttest. All participants improved their performance as a function of practice. The left-handed trainees learned bone drilling better with tools designed for the left hand. These tools may be incorporated into residency training programs for the development of surgical technical skills. Future studies should assess skill transfer between the left-handed and right-handed drills.

  10. TO EVALUATE THE SURGICAL OUTCOME OF NON-UNION CLAVICLE USING PLATE AND SLIVERS OF AUTOLOGOUS ILIAC CREST CORTICOCANCELLOUS BONE GRAFT

    Directory of Open Access Journals (Sweden)

    Mohammed

    2016-03-01

    Full Text Available INTRODUCTION Clavicle fracture is one of the most common fracture presenting to the fracture clinic, accounting for about 5-10% of all the adult trauma reported but still the controversy exists with regards to the definitive management. AIM To evaluate the surgical outcome of nonunion clavicle in patients treated previously with surgical management or conservative management, using plate and slivers of autologous iliac crest corticocancellous bone. DESIGN Retrospective analysis of patients operated between May 2005 and February 2013 for nonunion of the clavicle. METHODS AND MATERIALS Twenty patients who were operated between May 2005 and February 2013 for nonunion of the clavicle at our hospital were recruited for our study and followup data was collected from our hospital records till their last outpatient visit. Inclusion criteria included patients with no evidence of radiological union, persistence of pain, cosmetic deformity, dysfunction or gross movement at the fracture site even after 16 weeks of conservative treatment or in cases of primary fixation failure. STATISTICAL ANALYSIS All Statistical analyses were made using Statistical Package Software for Social Sciences (SPSS version 17.0 software (Chicago, IL, USA for descriptive data. Chi2 test was used to compare the categorical data. RESULTS At the end of an average followup of 19 months, the average Visual Analogue Score for pain was 1.9±2.2 (range 0-6, the mean ASES score was 81±18.5 (51-100, and the mean Constant–Murley score was 80±17 (51-100. All the patients had a stable radiological union at the end of the followup period. There were no complications pertaining to the hardware or infection. CONCLUSION Treatment of nonunion of clavicle by using corticocancellous bone is well documented; however, use of iliac corticocancellous bone graft shaped in long slivers will give mechanical stability to the plate reconstruct in addition to providing a scaffold for new bone formation than

  11. Reconstruction of orbital floor blow-out fractures with autogenous iliac crest bone: a retrospective study including maxillofacial and ophthalmology perspectives.

    Science.gov (United States)

    O'Connell, John Edward; Hartnett, Claire; Hickey-Dwyer, Marie; Kearns, Gerard J

    2015-03-01

    This is a 10-year retrospective study of patients with an isolated unilateral orbital floor fracture reconstructed with an autogenous iliac crest bone graft. The following inclusion criteria applied: isolated orbital floor fracture without involvement of the orbital rim or other craniofacial injuries, pre-/post-operative ophthalmological/orthoptic follow-up, pre-operative CT. Variables recorded were patient age and gender, aetiology of injury, time to surgery, follow-up period, surgical morbidity, diplopia pre- and post-operatively (Hess test), eyelid position, visual acuity, and the presence of en-/or exophthalmos (Hertel exophthalmometer). Twenty patients met the inclusion criteria. The mean age was 29 years. The mean follow up period was 26 months. No patient experienced significant donor site morbidity. There were no episodes of post-operative infection or graft extrusion. Three patients had diplopia in extremes of vision post-operatively, but no interference with activities of daily living. One patient had post-operative enophthalmos. Isolated orbital blow-out fractures may be safely and predictably reconstructed using autogenous iliac crest bone. The rate of complications in the group of patients studied was low. The value of pre- and post-operative ophthalmology consultation cannot be underestimated, and should be considered the standard of care in all patients with orbitozygomatic fractures, in particular those with blow-out fractures. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  12. Bone marrow aspiration

    Science.gov (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  13. Autologous Bone Marrow Mesenchymal Stem Cells Associated with Tantalum Rod Implantation and Vascularized Iliac Grafting for the Treatment of End-Stage Osteonecrosis of the Femoral Head

    Directory of Open Access Journals (Sweden)

    Dewei Zhao

    2015-01-01

    Full Text Available Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH to avert the need for total hip arthroplasty (THA. However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. A total of 24 patients (31 hips with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips. All patients were followed for a mean time of 64.35 ± 13.03 months (range 26–78. Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22–50 to 77.23 ± 14.75 points (range 33–95. This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH.

  14. Autologous Bone Marrow Mesenchymal Stem Cells Associated with Tantalum Rod Implantation and Vascularized Iliac Grafting for the Treatment of End-Stage Osteonecrosis of the Femoral Head

    Science.gov (United States)

    Zhao, Dewei; Liu, Baoyi; Wang, Benjie; Yang, Lei; Xie, Hui; Huang, Shibo; Zhang, Yao; Wei, Xiaowei

    2015-01-01

    Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH) to avert the need for total hip arthroplasty (THA). However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs) associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. A total of 24 patients (31 hips) with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips. All patients were followed for a mean time of 64.35 ± 13.03 months (range 26–78). Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22–50) to 77.23 ± 14.75 points (range 33–95). This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH. PMID:25802840

  15. Short Bi-Iliac Distance in Prenatal Ullrich-Turner Syndrome

    DEFF Research Database (Denmark)

    Hartling, Ulla B.; Hansen, Birgit Fischer; Keeling, Jean W.

    2002-01-01

    prenatal; Ullrich-Turner syndrome; pelvis; iliac bone; vertebral column; X chromosome; anthropometry; radiography......prenatal; Ullrich-Turner syndrome; pelvis; iliac bone; vertebral column; X chromosome; anthropometry; radiography...

  16. Intradiploic encephalocele of the left parietal bone: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Sock; Huh, Choon Woong; Kim, Dal Soo; Mok, Jin Ho; Kim, In Soo; Yang, Geun Seok [Myongji St. Mary' s Hospital, Seoul (Korea, Republic of)

    2015-06-15

    Encephaloceles are generally regarded as midline abnormalities. A 50-year-old man presented with a parietal intradiploic encephalocele manifesting as intermittent headache for the past 6 months. Computed tomography (CT) showed bone destruction associated with a left parietal lesion. Magnetic resonance imaging (MRI) demonstrated brain herniation within the intradiploic space. Cerebral angiographic imaging showed a normal cerebral vessel pattern within the herniated brain lesion. In this case, surgical treatment may not be necessary in the absence of concurrent symptoms and neurologic deficit. We report the CT, MRI, and angiographic findings of an extremely rare case of parietal intradiploic encephalocele in adulthood.

  17. Intradiploic encephalocele of the left parietal bone: A case report

    International Nuclear Information System (INIS)

    Kim, Hyung Sock; Huh, Choon Woong; Kim, Dal Soo; Mok, Jin Ho; Kim, In Soo; Yang, Geun Seok

    2015-01-01

    Encephaloceles are generally regarded as midline abnormalities. A 50-year-old man presented with a parietal intradiploic encephalocele manifesting as intermittent headache for the past 6 months. Computed tomography (CT) showed bone destruction associated with a left parietal lesion. Magnetic resonance imaging (MRI) demonstrated brain herniation within the intradiploic space. Cerebral angiographic imaging showed a normal cerebral vessel pattern within the herniated brain lesion. In this case, surgical treatment may not be necessary in the absence of concurrent symptoms and neurologic deficit. We report the CT, MRI, and angiographic findings of an extremely rare case of parietal intradiploic encephalocele in adulthood

  18. A comparison of the use of distal radius vascularised bone graft and non-vascularised iliac crest bone graft in the treatment of non-union of scaphoid fractures.

    Science.gov (United States)

    Braga-Silva, J; Peruchi, F M; Moschen, G M; Gehlen, D; Padoin, A V

    2008-10-01

    We compared two surgical techniques for the treatment of scaphoid non-union, namely, using distal radius vascularised bone graft and iliac crest non-vascularised bone graft. Eighty patients with symptomatic scaphoid non-union underwent surgical treatment, including 35 patients treated with distal radius vascularised bone graft and 45 treated by iliac crest non-vascularised bone graft. Patients were assessed objectively by examination of wrist range of motion, grip strength and radiographic findings in the postoperative period after a mean time of 2.8 (1.4) (range 1-5.2) years. Similar functional results were obtained with the two techniques. All cases of non-union in the non-vascularised group obtained consolidation in a mean time of 8.89 (2.26) months and in the vascularised group in a mean time of 7.97 (3.06) months. Three cases of consolidation failure occurred in the vascularised group and were related to technical difficulties.

  19. False iliac artery aneurysm following renal transplantation

    DEFF Research Database (Denmark)

    Levi, N; Sønksen, Jens Otto Reimers; Schroeder, T V

    1999-01-01

    We report a very rare case of a false iliac artery aneurysm following renal transplantation. The patient was a 51-year-old women who presented with a painful 10 x 10 cm pulsating mass in her left iliac fossa. The patient had received a second cadaveric renal transplantation 5 years previously....... The graft never functioned and transplant nephrectomy was performed 2 weeks later. A CT-scanning showed a 10 x 10 cm large aneurysm arising from the left external iliac artery. At operation a large false aneurysm was identified arising from the original transplant anastomotic site. Due to the extent...

  20. Case of femoral diaphyseal stress fracture after long-term risedronate administration diagnosed by iliac bone biopsy

    Directory of Open Access Journals (Sweden)

    Nagai T

    2013-04-01

    Full Text Available Takashi Nagai, Keizo Sakamoto, Koji Ishikawa, Emi Saito, Takuma Kuroda, Katsunori Inagaki Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagwa-ku, Tokyo, Japan Abstract: Bisphosphonate excessively inhibits bone resorption and results in pathological fracture of the femur or ilium. The subject of this study was administered risedronate for 7 years; we suspected an easy fracture of the femoral diaphysis. In this study, we report the results of this patient's bone biopsy and bone morphometric analysis. A 76-year-old female patient presented with right femoral pain. Bone mineral density of the anteroposterior surface of the 2nd to 4th lumbar vertebrae (L2-L4 was decreased and levels of bone turnover markers were high. Therefore, we initiated treatment with risedronate. As she continued the medication, urinary levels of cross-linked N-terminal telopeptides of type I collagen and alkaline phosphatase (bone-type isozyme were found to be within the normal ranges. After 7 years of administration, the patient experienced pain when she put weight on the right femur and right femoral pain while walking. Plain radiographic examination revealed polypoid stress fracture-like lesions on the right femoral diaphysis and on the slightly distal-lateral cortical bone. Similar lesions were observed on magnetic resonance imaging and bone scintigraphy. We suspected severely suppressed bone turnover. Bone biopsy was obtained after labeling with tetracycline, and bone morphometric analysis was performed. On microscopic examination, slight double tetracycline labeling was observed. The trabeculae were narrow, and the numbers of osteoblasts and osteoclasts were decreased. Further, rates of bone calcification and bone formation were slow. Hence, we diagnosed fracture as a result of low turnover osteopathy. Risedronate was withdrawn, and Vitamin D3 was administered to improve the bone turnover. At 6 months, abnormal signals on magnetic resonance

  1. Does Wrist Arthrodesis With Structural Iliac Crest Bone Graft After Wide Resection of Distal Radius Giant Cell Tumor Result in Satisfactory Function and Local Control?

    Science.gov (United States)

    Wang, Tao; Chan, Chung Ming; Yu, Feng; Li, Yuan; Niu, Xiaohui

    2017-03-01

    Many techniques have been described for reconstruction after distal radius resection for giant cell tumor with none being clearly superior. The favored technique at our institution is total wrist fusion with autogenous nonvascularized structural iliac crest bone graft because it is structurally robust, avoids the complications associated with obtaining autologous fibula graft, and is useful in areas where bone banks are not available. However, the success of arthrodesis and the functional outcomes with this approach, to our knowledge, have only been limitedly reported. (1) What is the success of union of these grafts and how long does it take? (2) How effective is the technique in achieving tumor control? (3) What complications occur with this type of arthrodesis? (4) What are the functional results of wrist arthrodesis by this technique for treating giant cell tumor of the distal radius? Between 2005 and 2013, 48 patients were treated for biopsy-confirmed Campanacci Grade III giant cell tumor of the distal radius. Of those, 39 (81% [39 of 48]) were treated with wrist arthrodesis using autogenous nonvascularized iliac crest bone graft. Of those, 27 (69% [27 of 39]) were available for followup at a minimum of 24 months (mean, 45 months; range, 24-103 months). During that period, the general indications for this approach were Campanacci Grade III and estimated resection length of 8 cm or less. Followup included clinical and radiographic assessment and functional assessment using the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Musculoskeletal Tumor Society (MSTS) score, grip strength, and range of motion at every followup by the treating surgeon and his team. All functional results were from the latest followup of each patient. Union of the distal junction occurred at a mean of 4 months (± 2 months) and union of the proximal junction occurred at a mean of 9 months (± 5 months). Accounting for competing events, at 12 months, the rate of proximal

  2. A Multicentric, Open-Label, Randomized, Comparative Clinical Trial of Two Different Doses of Expanded hBM-MSCs Plus Biomaterial versus Iliac Crest Autograft, for Bone Healing in Nonunions after Long Bone Fractures: Study Protocol

    Directory of Open Access Journals (Sweden)

    Enrique Gómez-Barrena

    2018-01-01

    Full Text Available ORTHOUNION is a multicentre, open, comparative, three-arm, randomized clinical trial (EudraCT number 2015-000431-32 to compare the efficacy, at one and two years, of autologous human bone marrow-derived expanded mesenchymal stromal cell (hBM-MSC treatments versus iliac crest autograft (ICA to enhance bone healing in patients with diaphyseal and/or metaphysodiaphyseal fracture (femur, tibia, and humerus status of atrophic or oligotrophic nonunion (more than 9 months after the acute fracture, including recalcitrant cases after failed treatments. The primary objective is to determine if the treatment with hBM-MSCs combined with biomaterial is superior to ICA in obtaining bone healing. If confirmed, a secondary objective is set to determine if the dose of 100 × 106 hBM-MSCs is noninferior to that of 200 × 106 hBM-MSCs. The participants (n=108 will be randomly assigned to either the experimental low dose (n=36, the experimental high dose (n=36, or the comparator arm (n=36 using a central randomization service. The trial will be conducted in 20 clinical centres in Spain, France, Germany, and Italy under the same clinical protocol. The confirmation of superiority for the proposed ATMP in nonunions may foster the future of bone regenerative medicine in this indication. On the contrary, absence of superiority may underline its limitations in clinical use.

  3. A Multicentric, Open-Label, Randomized, Comparative Clinical Trial of Two Different Doses of Expanded hBM-MSCs Plus Biomaterial versus Iliac Crest Autograft, for Bone Healing in Nonunions after Long Bone Fractures: Study Protocol.

    Science.gov (United States)

    Gómez-Barrena, Enrique; Padilla-Eguiluz, Norma G; Avendaño-Solá, Cristina; Payares-Herrera, Concepción; Velasco-Iglesias, Ana; Torres, Ferran; Rosset, Philippe; Gebhard, Florian; Baldini, Nicola; Rubio-Suarez, Juan C; García-Rey, Eduardo; Cordero-Ampuero, José; Vaquero-Martin, Javier; Chana, Francisco; Marco, Fernando; García-Coiradas, Javier; Caba-Dessoux, Pedro; de la Cuadra, Pablo; Hernigou, Philippe; Flouzat-Lachaniette, Charles-Henri; Gouin, François; Mainard, Didier; Laffosse, Jean Michel; Kalbitz, Miriam; Marzi, Ingo; Südkamp, Norbert; Stöckle, Ulrich; Ciapetti, Gabriela; Donati, Davide Maria; Zagra, Luigi; Pazzaglia, Ugo; Zarattini, Guido; Capanna, Rodolfo; Catani, Fabio

    2018-01-01

    ORTHOUNION is a multicentre, open, comparative, three-arm, randomized clinical trial (EudraCT number 2015-000431-32) to compare the efficacy, at one and two years, of autologous human bone marrow-derived expanded mesenchymal stromal cell (hBM-MSC) treatments versus iliac crest autograft (ICA) to enhance bone healing in patients with diaphyseal and/or metaphysodiaphyseal fracture (femur, tibia, and humerus) status of atrophic or oligotrophic nonunion (more than 9 months after the acute fracture, including recalcitrant cases after failed treatments). The primary objective is to determine if the treatment with hBM-MSCs combined with biomaterial is superior to ICA in obtaining bone healing. If confirmed, a secondary objective is set to determine if the dose of 100 × 10 6 hBM-MSCs is noninferior to that of 200 × 10 6 hBM-MSCs. The participants ( n = 108) will be randomly assigned to either the experimental low dose ( n = 36), the experimental high dose ( n = 36), or the comparator arm ( n = 36) using a central randomization service. The trial will be conducted in 20 clinical centres in Spain, France, Germany, and Italy under the same clinical protocol. The confirmation of superiority for the proposed ATMP in nonunions may foster the future of bone regenerative medicine in this indication. On the contrary, absence of superiority may underline its limitations in clinical use.

  4. [Clinical case of the month. Iliac artery endofibrosis in a soccer player].

    Science.gov (United States)

    Masmoudi, S; Frikha, I; Hadjkacem, A; Yangui, M; Mnif, J; Elleuch, H; Sahnoun, Y

    2002-03-01

    Arterial endofibrosis is a rare disease, usually affecting the external iliac artery in highly trained athletes. We report a case of external iliac endofibrosis in 42-year-old top level athlete. Clinical consequences were a high intensity exercise related sensation of swollen thigh, with normal clinical examination. Ultra sound investigation showed fibrotic thickening of the left external iliac artery. Angiography confirmed stenosis of the left external iliac artery. The patient was treated surgically, he underwent remodeling of his left external iliac artery with venous angioplasty. No complications occurred in the post operative course, and the patient return to training after three months.

  5. Revascularisation of fresh compared with demineralised bone grafts in rats

    DEFF Research Database (Denmark)

    Solheim, E; Pinholt, E M; Talsnes, O

    2001-01-01

    (iliac bone) or cortical (tibial diaphysis) bone three weeks after heterotopic implantation in rats. The mean (SD) 141Ce deposition index (counts per minute (cpm) of mg recovered implant/cpm of mg host iliac bone) was higher in fresh iliac bone grafts, 0.98 (0.46) compared to that of demineralised iliac...

  6. Computed tomography findings in 10 cases of iliac vein compression (May-Thurner) syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)]. E-mail: loguzkurt@yahoo.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Pourbagher, M. Ali [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Kizilkilic, Osman [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Turkoz, Riza [Baskent University, Adana Teaching and Medical Research Center, Department of Thoracic and Cardiovascular Surgery, Adana (Turkey); Boyvat, Fatih [Baskent University, Faculty of Medicine, Department of Radiology, Ankara (Turkey)

    2005-09-01

    Objective: To present the computed tomography (CT) findings for the iliac veins of 10 patients who had left-sided lower extremity deep vein thrombosis due to iliac vein compression syndrome. Materials and methods: The CT findings for 10 cases of left-sided acute or chronic deep vein thrombosis caused by iliac vein compression syndrome were retrospectively evaluated. The patients were five women and five men (mean age {+-} S.D., 49.9 {+-} 15.6 years). In each patient with iliac vein compression syndrome, the diagnosis of the compression was established by venography performed during endovascular treatment. Diameter of the left common iliac vein was also measured in 14 control subjects without any lower extremity venous disease for comparison. Results: In all 10 cases, CT images in the transverse plane demonstrated the left common iliac vein being compressed by the overlying right common iliac artery. The mean diameter at the origin of the left common iliac vein (3.5 mm) in patients group was much smaller than the mean diameter of the same vein (11.5 mm) in the control group (p < 0.01). The mean percent stenosis of the left common iliac vein due to compression by the artery was 68%. Conclusion: Pelvic CT images in the transverse plane are useful for detecting iliac vein compression by the overlying right common iliac artery in patients with left-sided deep vein thrombosis. Radiologists should be aware of this imaging finding of iliac vein compression by the artery where the inferior vena cava bifurcates into the common iliac veins.

  7. Computed tomography findings in 10 cases of iliac vein compression (May-Thurner) syndrome

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Pourbagher, M. Ali; Kizilkilic, Osman; Turkoz, Riza; Boyvat, Fatih

    2005-01-01

    Objective: To present the computed tomography (CT) findings for the iliac veins of 10 patients who had left-sided lower extremity deep vein thrombosis due to iliac vein compression syndrome. Materials and methods: The CT findings for 10 cases of left-sided acute or chronic deep vein thrombosis caused by iliac vein compression syndrome were retrospectively evaluated. The patients were five women and five men (mean age ± S.D., 49.9 ± 15.6 years). In each patient with iliac vein compression syndrome, the diagnosis of the compression was established by venography performed during endovascular treatment. Diameter of the left common iliac vein was also measured in 14 control subjects without any lower extremity venous disease for comparison. Results: In all 10 cases, CT images in the transverse plane demonstrated the left common iliac vein being compressed by the overlying right common iliac artery. The mean diameter at the origin of the left common iliac vein (3.5 mm) in patients group was much smaller than the mean diameter of the same vein (11.5 mm) in the control group (p < 0.01). The mean percent stenosis of the left common iliac vein due to compression by the artery was 68%. Conclusion: Pelvic CT images in the transverse plane are useful for detecting iliac vein compression by the overlying right common iliac artery in patients with left-sided deep vein thrombosis. Radiologists should be aware of this imaging finding of iliac vein compression by the artery where the inferior vena cava bifurcates into the common iliac veins

  8. Interventional treatment of iliac vein compression syndrome

    International Nuclear Information System (INIS)

    Li Xiaoqiang; Zhou Weiming; Nie Zhonglin; Yu Chaowen

    2002-01-01

    Objective: To explore the clinical significance of interventional treatment of iliac vein compression syndrome (IVCS). Methods: Percutaneous transluminal angioplasty (PTA) was performed in 40 cases. Thirty-three cases underwent endovascular stent implantation and 27 cases underwent second-stage left saphenous vein ligation and stripping and the valves of left femoral veins narrowing. Thirty-one cases were followed-up postoperatively and the duration was 6-66 months (mean 28 months). Results: The dilation of iliac veins was successful in 36 cases and there were god efficacy in all patients when they discharged from hospital. Followed-up during post-operation, all the limbs ulcers were cured and varicose veins disappeared. The skin pigmentation disappeared in 17 of 19 cases and markedly relieved in 2 cases. Left lower limb swelling disappeared in 15 of 17 cases and relieved in 2 cases. Conclusion: There is good efficacy in the interventional treatment of left iliac vein lesions, but second-stage procedures should be performed in secondary lesions of saphenous veins and valves of femoral veins

  9. Balloon Occlusion of the Contralateral Iliac Artery to Assist Recanalization of the Ipsilateral Iliac Artery in Total Aortoiliac Occlusion: A Technical Note

    Directory of Open Access Journals (Sweden)

    Abdel Aziz A. Jaffan

    2013-01-01

    Full Text Available Endovascular recanalization of chronic total aortoiliac occlusion is technically challenging. Inability to reenter the true aortic lumen, following retrograde iliac recanalization, is one of the most common causes of failure. We describe a case of a total aortoiliac occlusion where balloon occlusion of the right common iliac artery, following its recanalization from a brachial approach, was used to facilitate antegrade recanalization of the occluded contralateral left common iliac artery.

  10. Mandibular reconstruction using iliac bone and great auricular nerve grafts and oral rehabilitation using osseointegrated implants in a patient with a large ossifying fibroma: a 10-year follow-up study.

    Science.gov (United States)

    Yoshimura, Hitoshi; Ohba, Seigo; Nakamura, Mikiko; Sano, Kazuo

    2013-12-01

    Ossifying fibromas are bone-related benign neoplasms that are characterized by well-demarcated lesions composed of fibrocellular tissue and mineralized material with varying appearances. Although small lesions are asymptomatic, they may cause enlargement of the affected jaw and rarely require reconstructive or restorative treatments for aesthetic and functional problems. In this study, we report a 35-year-old woman who underwent multidisciplinary treatment for a large ossifying fibroma of the mandible. A segmental mandibular resection was performed, and immediate reconstruction was performed using iliac bone and great auricular nerve grafts. After consolidation of the grafted bone, oral rehabilitation was fulfilled using osseointegrated implants and a fixed prosthesis. There was no evidence of recurrence ten years after the resection of the tumor. The range of mouth opening and motion of the temporomandibular joint provided a functional mandible. The neurosensory examination revealed the recovery of sensibility of the mental region and pulpal sensitivity of the teeth. The prosthesis was stable, and no clinical or radiographic signs of implant failure were observed. Our results demonstrate that the proper combination of reconstructive and restorative treatments could result in appropriate aesthetic and functional outcomes for a period of ten years. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. [Automated Assessment for Bone Age of Left Wrist Joint in Uyghur Teenagers by Deep Learning].

    Science.gov (United States)

    Hu, T H; Huo, Z; Liu, T A; Wang, F; Wan, L; Wang, M W; Chen, T; Wang, Y H

    2018-02-01

    To realize the automated bone age assessment by applying deep learning to digital radiography (DR) image recognition of left wrist joint in Uyghur teenagers, and explore its practical application value in forensic medicine bone age assessment. The X-ray films of left wrist joint after pretreatment, which were taken from 245 male and 227 female Uyghur nationality teenagers in Uygur Autonomous Region aged from 13.0 to 19.0 years old, were chosen as subjects. And AlexNet was as a regression model of image recognition. From the total samples above, 60% of male and female DR images of left wrist joint were selected as net train set, and 10% of samples were selected as validation set. As test set, the rest 30% were used to obtain the image recognition accuracy with an error range in ±1.0 and ±0.7 age respectively, compared to the real age. The modelling results of deep learning algorithm showed that when the error range was in ±1.0 and ±0.7 age respectively, the accuracy of the net train set was 81.4% and 75.6% in male, and 80.5% and 74.8% in female, respectively. When the error range was in ±1.0 and ±0.7 age respectively, the accuracy of the test set was 79.5% and 71.2% in male, and 79.4% and 66.2% in female, respectively. The combination of bone age research on teenagers' left wrist joint and deep learning, which has high accuracy and good feasibility, can be the research basis of bone age automatic assessment system for the rest joints of body. Copyright© by the Editorial Department of Journal of Forensic Medicine.

  12. Aorta and iliac artery

    International Nuclear Information System (INIS)

    Yao, J.S.T.; Neiman, H.L.

    1985-01-01

    The aorta and iliac artery constitute the major blood supply to the limbs, and the atherosclerotic process ranks as the most common disorder in this region. Clinical presentation ranges from acute to chronic. Atherosclerotic disease of the aorta associated with femoropopliteal disease is not uncommon. For simplicity, the aorta and iliac artery are considered as a unit, though isolated lesions of the aorta occur. The primary indication for arteriography is in patients who are candidates for reconstructive surgery or for percutaneous balloon dilatation. While diagnosis by clinical examination or noninvasive tests is not difficult, arteriography remains the essential diagnostic technique, especially when patients become candidates for therapy. Visualization of the aortoiliac system may be accomplished by translumbar aortography, catheter arteriography, or by intravenous digital subtraction angiography

  13. Sacro-iliac scintigraphy with technetium pyrophosphate: advantages and limits

    International Nuclear Information System (INIS)

    Sulman, C.; Eshougues, R.J. d'; Delcambre, B.; Caillard, J.F.; Delbart, P.

    1975-01-01

    An attempt was made to determine whether scintigraphy, after administration of technetium 99m-labelled pyrophosphate, could be used to establish a relationship between the amount of fixation of the radioactive product and the degree of inflammation of the sacro-iliac joint in rheumatic sacro-iliac diseases. Given the difficulties of interpretation of these particular scintigraphs, normal limits were defined by establishing in standard subjects a numerical ratio between the sacro-iliac joints and a reference bone segment (lumbar rachis). The values obtained in 21 patients suffering from chronic inflammatory rheumatism show good agreement between the degree of technetium pyrophosphate fixation and the development of sacro-iliac diseases [fr

  14. Short bi-iliac distance in prenatal Ullrich-Turner syndrome

    DEFF Research Database (Denmark)

    Hartling, Ulla B; Hansen, Birgit Fischer; Keeling, Jean W

    2002-01-01

    The purpose of the present study is to evaluate the bi-iliac distance and the caudo-cranial position of the iliac bones in Ullrich-Turner syndrome (UTS) fetuses compared to recently published standards for normal fetuses. Whole-body radiographs in antero-posterior projections of 24 UTS fetuses (c...

  15. Iliac Artery and Vein Injury Without Pelvic Fracture Due To Blunt Trauma: A Rare Case

    Directory of Open Access Journals (Sweden)

    Mustafa Cuneyt Cicek

    2014-08-01

    Full Text Available Iliac vascular injuries have high morbidity and mortality rates. Penetrant abdominal and pelvic vascular injuries are more common compared to blunt traumas. Pelvic vascular injuries associated with blunt trauma are quite likely to occur in accompaniment with pelvic fracture. A 23 year old male patient was admitted to the emergency room due to a motorcycle accident. Shock picture was prevalent in the patient. Shaft fracture was present in left femur and flow was not detected in arterial and venous colour Doppler ultrasonography. Patient underwent emergency surgery. Left main iliac artery and vein were normal, however, external iliac vein was lacerated in two spots, and blood vessel wall integrity was damaged in one part of left external iliac artery. Clinical presentation and traumatic retroperitoneal hematoma management of iliac artery and venous injuries due to blunt trauma without pelvic fracture are discussed in the presented case.

  16. Prevalência de marcadores de trombofilia em pacientes portadores da síndrome de May-Thurner e trombose de veia ilíaca comum esquerda Prevalence of thrombophilia factors in patients with May-Thurner syndrome and left common iliac vein thrombosis

    Directory of Open Access Journals (Sweden)

    Marcos Arêas Marques

    2010-12-01

    Full Text Available CONTEXTO: A relação entre trombose venosa profunda e trombofilia tem sido pouco estudada em indivíduos portadores de compressão da veia ilíaca comum esquerda, conhecida clinicamente como síndrome de May-Thurner. OBJETIVO: Avaliar a prevalência de marcadores de trombofilia nos pacientes portadores de síndrome de May-Thurner e trombose de veia ilíaca comum esquerda. MÉTODOS: Entre março de 1999 e dezembro de 2008, 20 pacientes com síndrome de May-Thurner e trombose de veia ilíaca comum esquerda foram avaliados retrospectivamente quanto à presença de marcadores de trombofilia. RESULTADOS: Foi detectada a associação entre síndrome de May-Thurner e marcadores de trombofilia em 8 pacientes (40%. CONCLUSÃO: A presença de marcadores de trombofilia em pacientes com trombose de veia ilíaca comum esquerda e síndrome de May-Thurner é frequente, porém não difere da prevalência encontrada em pacientes portadores de trombose venosa profunda sem a síndrome associada.BACKGROUND: The relationship between deep venous thrombosis and thrombophilia has been little studied in patients with left common iliac vein compression, clinically known as May-Thurner syndrome. OBJECTIVE: To evaluate the prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. METHODS: From March 1999 to December 2008, 20 patients with May-Thurner syndrome and left common iliac vein thrombosis were retrospectively investigated for the presence of thrombophilia markers. RESULTS: The association between May-Thurner syndrome and thrombophilia markers was found in 8 patients (40%. CONCLUSION: There is a high prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. The prevalence, however, is not different from that found in patients with deep venous thrombosis without May-Thurner syndrome.

  17. Relationship between bone turnover and left ventricular function in primary hyperparathyroidism: The EPATH trial.

    Directory of Open Access Journals (Sweden)

    Nicolas Verheyen

    Full Text Available Observational studies suggested a link between bone disease and left ventricular (LV dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT. Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the "Eplerenone in Primary Hyperparathyroidism" (EPATH Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function or peak early transmitral filling velocity (e', diastolic function as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP, osteocalcin (OC, bone-specific alkaline phosphatase (BALP, or beta-crosslaps (CTX as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal pro-brain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted β-coefficient = 0.201, P = 0.035 and e' (β = 0.188, P = 0.042, respectively. OC (β = 0.192, P = 0.039 and BALP (β = 0.198, P = 0.030 were each independently related with e'. CTX showed no correlations with LVEF or e'. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies.

  18. Subintimal recanalisation and stenting of a common iliac artery occlusion by a left axillary and an ipsilateral femoral retrograde approach using modified gooseneck grab aided by balloon dilatation of 'dissection port'

    Energy Technology Data Exchange (ETDEWEB)

    Thava, V.R. E-mail: raj.thava@ulh.nhs.uk; Stead, R.E.; Smith, R.P

    2004-06-01

    The technique of recanalisation using deliberate subintimal dissection of an occluded iliac artery is being increasingly used and practised via ipsilateral and or contralateral approaches. There remains, however, a fair proportion of cases where, in spite of using gooseneck snares, the wire manipulation to traverse the occlusion can prove unsuccessful resulting in failed de-obliteration of the occlusion. We describe a technique to aid successful re-establishment of the patency using balloon dilatation of the dissection 'entry port' with modified gooseneck snare grab.

  19. Successful Endovascular Treatment of Iliac Vein Compression (May-Thurner) Syndrome in a Pediatric Patient

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Sener, Mesut

    2006-01-01

    A 10-year-old boy presented to our clinic with left lower extremity swelling present for 1 year with deterioration of symptoms during the prior month. Laboratory investigation for deep vein thrombosis was negative. Venography and computed tomography scan of the pelvis showed compression of the left common iliac vein by the right common iliac artery. A diagnosis of iliac vein compression syndrome was made. After venography, endovascular treatment was planned. The stenosis did not respond to balloon dilatation and a 12 mm Wallstent was placed with successful outcome. The patient's symptoms improved but did not resolve completely, probably due to a chronically occluded left superficial femoral vein that did not respond to endovascular recanalization. To the best of our knowledge, this is the first case of successful endovascular treatment of iliac vein compression syndrome with stent placement in a pediatric patient

  20. Sinus floor augmentation surgery using autologous bone grafts from various donor sites: a meta-analysis of the total bone volume.

    Science.gov (United States)

    Klijn, Reinoud J; Meijer, Gert J; Bronkhorst, Ewald M; Jansen, John A

    2010-06-01

    To date, no studies have been published that evaluated histomorphometric data from a large number of patients while comparing different sites and methods of autologous bone grafting in sinus floor augmentation procedures. A meta-analysis of the English literature from January 1995 till April 2009 was carried out. PubMed search engine and the following journals were explored: Clinical Oral Implant Research, International Journal of Oral and Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, and the Journal of Periodontology. Out of 147 titles, according to our criteria, 25 articles were left for analysis. The majority were prospective controlled studies (21) and 2 randomized clinical trials, 1 pilot study and 1 case series. A reference value of 47% for total bone volume (TBV) was found while using iliac bone grafting as a standard. Use of intraoral bone grafts increases the TBV, with 11% for chin bone and 14% for bone grafted from other intraoral sites. Particulation of the bone graft has a negative effect on the TBV of 18%. Surprisingly, no correlation between TBV and the time of graft healing was found. Histological section thickness seemed to be a significant variable, as every micron increase of section thickness leads to an increase of 0.4% of TBV. Bone grafting from the iliac crest resulted in a significantly lower TBV compared with intraoral bone grafting. However, due to the limited availability of intraoral bone to be harvested, iliac grafts still have to be considered the gold standard in augmenting the severely atrophic maxilla.

  1. Anterior superior iliac spine avulsion in a young soccer player.

    Science.gov (United States)

    Bendeddouche, I; Jean-Luc, B B; Poiraudeau, S; Nys, A

    2010-11-01

    Avulsion fractures of the anterior superior iliac spine are rare. They usually occur in teenagers during sport activities. Cases concerning adults are very uncommon. We report here the case of a 23-year-old man who was admitted for recent pain of the left hip that worsened while kicking a ball in a soccer match eight days earlier. The examination found pain when moving the left hip in extension. Radiographs showed an avulsion fracture of the left anterior superior iliac spine, which was confirmed by computer tomography. The treatment was conservative consisting in rest and non-weight bearing with releasing of pain a few weeks later. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  2. Changes in left ventricular filling patterns after repeated injection of autologous bone marrow cells in heart failure patients

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Møller, Jacob E; Thayssen, Per

    2010-01-01

    Abstract Objectives. We have previously shown that repeated intracoronary infusion of bone marrow cells (BMSC) did not improve left ventricular (LV) ejection fraction in patients with chronic ischemic heart failure. However, the impact of BMSC therapy on LV diastolic filling has remained uncertain...

  3. Dual compression is not an uncommon type of iliac vein compression syndrome.

    Science.gov (United States)

    Shi, Wan-Yin; Gu, Jian-Ping; Liu, Chang-Jian; Lou, Wen-Sheng; He, Xu

    2017-09-01

    Typical iliac vein compression syndrome (IVCS) is characterized by compression of left common iliac vein (LCIV) by the overlying right common iliac artery (RCIA). We described an underestimated type of IVCS with dual compression by right and left common iliac arteries (LCIA) simultaneously. Thirty-one patients with IVCS were retrospectively included. All patients received trans-catheter venography and computed tomography (CT) examinations for diagnosing and evaluating IVCS. Late venography and reconstructed CT were used for evaluating the anatomical relationship among LCIV, RCIA and LCIA. Imaging manifestations as well as demographic data were collected and evaluated by two experienced radiologists. Sole and dual compression were found in 32.3% (n = 10) and 67.7% (n = 21) of 31 patients respectively. No statistical differences existed between them in terms of age, gender, LCIV diameter at the maximum compression point, pressure gradient across stenosis, and the percentage of compression level. On CT and venography, sole compression was commonly presented with a longitudinal compression at the orifice of LCIV while dual compression was usually presented as two types: one had a lengthy stenosis along the upper side of LCIV and the other was manifested by a longitudinal compression near to the orifice of external iliac vein. The presence of dual compression seemed significantly correlated with the tortuous LCIA (p = 0.006). Left common iliac vein can be presented by dual compression. This type of compression has typical manifestations on late venography and CT.

  4. Accurate diagnosis of iliac vein thrombosis in pregnancy with magnetic resonance direct thrombus imaging (MRDTI).

    Science.gov (United States)

    Dronkers, Charlotte E A; Srámek, Alexandr; Huisman, Menno V; Klok, Frederikus A

    2016-12-13

    A pregnant woman aged 29 years, G1P0 at 21 weeks of gestation of a dichorionic diamniotic twin, presented with suspected deep vein thrombosis (DVT) of the left leg. Repeated (compression) ultrasonography was not diagnostic for DVT but showed reduced flow over the left external iliac vein, common femoral vein and superficial femoral vein. In pursue of a definite diagnosis, magnetic resonance direct thrombus imaging was performed showing a clear high signal in the left common iliac vein which is diagnostic for acute thrombosis in this venous segment. Phase contrast venography supported this diagnosis, showing no flow in the left common iliac vein. Treatment with anticoagulants was started. 6 months after the diagnosis, the patient is doing well and does not report signs of post-thrombotic syndrome. 2016 BMJ Publishing Group Ltd.

  5. Influence of fluor salts, hormone replacement therapy and calcitonin on the concentration of insulin-like growth factor (IGF)-I, IGF-II and transforming growth factor-beta 1 in human iliac crest bone matrix from patients with primary osteoporosis.

    Science.gov (United States)

    Pepene, C E; Seck, T; Diel, I; Minne, H W; Ziegler, R; Pfeilschifter, J

    2004-01-01

    Data from cell culture experiments suggest that local growth factors (GFs) may mediate the effects of estrogens, calcitonin or fluor ions on the skeleton. To assess the in vivo relevance of the in vitro reports, the effect of fluor salts, hormone replacement therapy (HRT) and calcitonin on the concentrations of IGF-I, IGF-II and transforming growth factor (TGF)-beta 1 in bone matrix extracts from osteoporotic patients was evaluated. Iliac crest bone biopsies were obtained from 170 patients (76 men and 94 women) with primary osteoporosis aged 55.5+/-0.8 Years. Bone matrix extraction was performed based on a guanidine-HCl/ethylendiamine-tetra-acetic acid method. In comparison with age- and body mass index (BMI)-matched controls, no influence of long-term therapy with fluor ions (n=41) or calcitonin (n=16) on the bone matrix concentration of GFs was noticed. Postmenopausal women with osteoporosis on HRT (n=39) had lower skeletal IGF-I but not IGF-II levels as compared with age- and BMI-matched non-users. However, the lower rate of bone turnover in women with HRT may account for this difference, since the significance was lost after adjustment for alkaline phosphatase. Likewise, a tendency for lower TGF-beta 1 levels was observed in HRT users as compared with non-users but was lost after adjustment for bone turnover. None of the therapies influenced the serum levels of GFs when patients receiving continuous therapy for at least 1 Year before bone biopsy were considered. Our data suggest no direct effect of fluor therapy on skeletal GFs levels. At the concentrations used, neither HRT nor calcitonin appeared to exert any significant influence on serum or bone matrix GF levels.

  6. Correção endovascular de aneurisma de aorta abdominal e artéria ilíaca comum esquerda em paciente com hemofilia C grave Endovascular repair of abdominal aortic aneurysm and left common iliac artery in a patient with severe hemophilia C

    Directory of Open Access Journals (Sweden)

    Sergio Quilici Belczak

    2012-03-01

    Full Text Available A deficiência do fator XI, também conhecida como hemofilia C, é uma doença hematológica hereditária rara, que se manifesta clinicamente com hemorragia persistente após cirurgias, traumas, menorragias e extrações dentárias. Neste artigo, relatou-se a correção endovascular de um paciente com aneurisma de aorta e de artéria ilíaca comum esquerda em um paciente portador de deficiência major do fator XI (atividade do fator XI inferior a 20%. O procedimento foi realizado com sucesso, com o manuseio do distúrbio da coagulação por meio da infusão de plasma fresco no pré-operatório imediato e no pós-operatório, e controle laboratorial da coagulação do paciente.Factor XI deficiency, also known as hemophilia C, is a rare hereditary blood disease that manifests with persistent bleeding after surgery, trauma, menorrhagia, and dental extractions. This article reports an endovascular repair of a patient diagnosed with an aortic and left common iliac aneurysm, with severe factor XI deficiency (factor XI activity below 20%. The procedure was successfully performed with management of the coagulation disorder by preoperative and postoperative infusion of plasma and laboratory control of the coagulation.

  7. Fixação de fraturas ilíacas em cães com parafusos, fios de aço e cimento ósseo de polimetilmetacrilato Canine iliac fracture fixation with screws, orthopedic wire and polymethylmethacrylate bone cement

    Directory of Open Access Journals (Sweden)

    Claudio Roehsig

    2008-09-01

    Full Text Available O presente trabalho teve como objetivo verificar a recuperação da locomoção e o tempo para cicatrização óssea de fraturas ilíacas fixadas com parafusos, fios de aço e cimento ósseo de polimetilmetacrilato. Dezesseis cães de ambos os sexos, com peso de 1,8 a 16kg e idade entre sete meses e 11 anos, foram submetidos à osteossíntese da fratura de ílio, provocadas por acidente automobilístico. Em dois animais, realizou-se osteossíntese bilateral, totalizando 18 ossos ilíacos operados. A abordagem ao ílio foi lateral e quando necessária estendida caudalmente através da osteotomia do trocanter maior. As fraturas foram reduzidas e, em cada segmento ósseo, foram implantados dois a três parafusos e banda de tensão com fio de aço entre os parafusos adjacentes à linha de fratura. Sobre esses implantes aplicou-se cimento ósseo misturado com cefazolina sódica e após o endurecimento prosseguiu-se com a síntese dos tecidos moles com suturas rotineiramente utilizadas na clinica cirúrgica. No período pós-operatório, foram realizadas avaliações até 90 dias após a osteossíntese e observou-se locomoção apropriada em 15 animais. Avaliações radiográficas demonstraram sinais de completa consolidação óssea entre 60 e 90 dias. Falha da estabilização ocorreu em dois casos, obrigando a reintervenção cirúrgica em um deles. A partir dos resultados obtidos, é possível concluir que, em cães com até 16kg de peso, a fixação de fraturas ilíacas utilizando parafusos cimentados com PMMA constitui uma eficiente técnica, que proporciona adequada estabilidade, precoce recuperação funcional e cicatrização óssea.The present study aimed to verify the time for locomotion recovery and bone healing in canine iliac fractures fixated with screws, orthopedic wires and methylmetacrylate bone cement. Sixteen dogs from both genders accidentally hit by a car and showing iliac fractures were included. Dogs aged from 7 months to 11

  8. Bone mineral density difference between right and left hip during ageing

    DEFF Research Database (Denmark)

    Schwarz, P.; Jørgensen, Niklas Rye; Jensen, L.T.

    2011-01-01

    be affected by significant left-right difference in hip BMD, especially in the old. The purpose of our study was to ascertain the difference in BMD measurement of the two hips in a population of Caucasian community dwelling women older than 65 years invited for screening. We found that bilateral BMD...... found an increasing difference between the hips with increasing age and this difference was up to 9.1% in the women older than 70 years when evaluating femoral neck, meaning that the diagnosis of osteoporosis in a subset of patients would depend on whether the left or right hip was scanned. When...

  9. Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget’s disease of bone

    Directory of Open Access Journals (Sweden)

    Al Kaissi, Ali

    2014-09-01

    Full Text Available [english] We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget’s disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget’s disease of the bone.

  10. Bone mineral density difference between right and left hip during ageing

    DEFF Research Database (Denmark)

    Schwarz, P.; Jørgensen, Niklas Rye; Jensen, L.T.

    2011-01-01

    be affected by significant left-right difference in hip BMD, especially in the old. The purpose of our study was to ascertain the difference in BMD measurement of the two hips in a population of Caucasian community dwelling women older than 65 years invited for screening. We found that bilateral BMD...... found an increasing difference between the hips with increasing age and this difference was up to 9.1% in the women older than 70 years when evaluating femoral neck, meaning that the diagnosis of osteoporosis in a subset of patients would depend on whether the left or right hip was scanned. When...... measurements were only moderately correlated at the femoral neck and total hip. In a significant number of the screened elderly women, we found that the DXA differences changed the diagnosis of each woman from either normal BMD to osteopenia or visa versa or from osteopenia to osteoporosis or visa versa. We...

  11. Comparison of different surface modifications for titanium implants installed into the goat iliac crest.

    NARCIS (Netherlands)

    Oirschot, B.A.J.A. van; Meijer, G.J.; Bronkhorst, E.M.; Narhi, T.; Jansen, J.A.; Beucken, J.J.J.P van den

    2016-01-01

    OBJECTIVES: This in vivo study with implants installed in the goat iliac crest was performed to determine whether the biological and mechanical properties of the bone-to-implant interface are influenced by (i) the type of implant anchorage (i.e., mono- vs. bicortical placement), and (ii) the

  12. Superficial Circumflex Iliac Artery Perforator Flap for Dorsalis Pedis Reconstruction

    OpenAIRE

    Tashiro, Kensuke; Yamashita, Shuji

    2017-01-01

    Summary: Reconstruction of dorsalis pedis with soft tissue is challenging because it needs to preserve thin structure to ensure that the patient will be able to wear shoes. Here, we report the use of a thin superficial circumflex iliac artery perforator (SCIP) flap in dorsalis pedis reconstruction. A 67-year-old man presented with a third-degree burn, which exposed his extensor tendons. A thin SCIP flap from the left inguinal region measuring 15???4?cm was transferred to the dorsalis pedis re...

  13. Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting

    Directory of Open Access Journals (Sweden)

    George S. Georgiadis

    2015-01-01

    Full Text Available Endovascular therapy for iliac artery chronic total occlusions is nowadays associated with low rates of procedure-related complications and improved clinical outcomes, and it is predominantly used as first-line therapy prior to aortobifemoral bypass grafting. Herein, we describe the case of a patient presenting with an ischemic left foot digit ulcer and suffering complex aortoiliac lesions, who received common iliac arteries kissing stents, illustrating at final antegrade and retrograde angiograms the early recognition of a blood flow obstructing valve-like calcified intimal flap protruding through the stent struts, which was obstructing antegrade but not retrograde unilateral iliac arterial axis blood flow. The problem was resolved by reconstructing the aortic bifurcation at a more proximal level. Completion angiogram verified normal patency of aorta and iliac vessels. Additionally, a severe left femoral bifurcation stenosis was also corrected by endarterectomy-arterioplasty with a bovine patch. Postintervention ankle brachial pressure indices were significantly improved. At the 6-month and 2-year follow-up, normal peripheral pulses were still reported without intermittent claudication suggesting the durability of the procedure. Through stent-protruding calcified intimal flap, is a very rare, but existing source of antegrade blood flow obstruction after common iliac arteries kissing stents.

  14. Congenital absence of infrarenal IVC and iliac venous system : Unusual collateral Pathways

    International Nuclear Information System (INIS)

    Lee, Jin Joo; Lee, Byung Hee; Kim, Kie Hwan; Do, Young Soo; Chin, Soo Yil

    1994-01-01

    We present a case with congenital absence of the infrarenal portion of inferior vena cava and iliac venous system, showing unusual venous collaterals including the left ovarian venous collateral via parametrial venous complex, and a mesenteric-periureteric venous connection. The venous collateral pathways were demonstrated by computed tomography and venography

  15. OP-1 compared with iliac crest autograft in instrumented posterolateral fusion a randomized, multicenter non-inferiority trial

    NARCIS (Netherlands)

    Delawi, Diyar; Jacobs, Wilco; Van Susante, Job L C; Rillardon, Ludovic; Prestamburgo, Domenico; Specchia, Nicola; Gay, Emmanuel; Verschoor, Nico; Garcia-Fernandez, Carlos; Guerado, Enrique; Van Ufford, Henriette Quarles; Kruyt, Moyo C.; Dhert, Wouter J A; Cumhur Oner, F.

    2016-01-01

    Background: Spinal fusion with the use of autograft is a commonly performed procedure. However, harvesting of bone from the iliac crest is associated with complications. Bone morphogenetic proteins (BMPs) are extensively used as alternatives, often without sufficient evidence of safety and efficacy.

  16. OP-1 Compared with Iliac Crest Autograft in Instrumented Posterolateral Fusion : A Randomized, Multicenter Non-Inferiority Trial

    NARCIS (Netherlands)

    Delawi, Diyar; Jacobs, Wilco; van Susante, Job L C; Rillardon, Ludovic; Prestamburgo, Domenico; Specchia, Nicola; Gay, Emmanuel; Verschoor, Nico; Garcia-Fernandez, Carlos; Guerado, Enrique; Quarles van Ufford, Henriette; Kruyt, Moyo C; Dhert, Wouter J A; Oner, F Cumhur

    2016-01-01

    BACKGROUND: Spinal fusion with the use of autograft is a commonly performed procedure. However, harvesting of bone from the iliac crest is associated with complications. Bone morphogenetic proteins (BMPs) are extensively used as alternatives, often without sufficient evidence of safety and efficacy.

  17. Lower gastrointestinal bleeding as a result of fistula between the iliac artery and sigmoid colon in patient with advanced testicular cancer

    Directory of Open Access Journals (Sweden)

    Vanessa Prado dos Santos

    2013-09-01

    Full Text Available Fistula between arteries and the gastrointestinal tract are a rare cause of gastrointestinal bleeding, but potentially fatal. The recognition and early treatment can modify the patient prognosis. We report a case of a patient with previous surgery for seminoma of cryptorchidic testicle, with massive lower gastrointestinal bleeding. We performed the diagnosis and surgical treatment of the fistula between left external iliac artery and sigmoid colon. The patient was successfully treated by external iliac artery ligation and left colectomy.

  18. Lesão da artéria ilíaca esquerda durante laminectomia lombar: relato de caso Lesión de la arteria ilíaca izquierda durante laminectomia lombar: relato de caso Left iliac artery injury during lumbar laminectomy: case report

    Directory of Open Access Journals (Sweden)

    Wanderley Rodrigues Moreira

    2003-08-01

    del sexo masculino, estado físico ASA I, 31 años, 68 kg, fue sometido a laminectomia lombar en decúbito ventral sobre raquianestesia en L2-L3, con bupivacaína hiperbárica a 0,5% (20 mg y fentanil 25 µg. La cirugía transcurrió normalmente y siete horas después de su inicio, ya en el pos-operatorio, el paciente presentó hipotensión arterial, taquicardia, agitación y dolor abdominal difuso. La tomografía abdominal mostró aspecto compatible con hematoma retroperitoneal y la laparotomia exploradora reveló lesión de la arteria ilíaca común izquierda. Después de la laparotomia, el paciente evoluyó bien. CONCLUSIONES: En la dependencia del posicionamiento y del estado físico, técnicas de anestesia general se imponen. El caso llama atención para el hecho de que cualquier técnica anestésica que haya sido realizada, el sangramiento en el campo operatorio puede no ser real, en la vigencia de una lesión vascular, porque este sangramiento puede ser tardío. En el presente caso, la manifestación clínica ocurrió siete horas después del inicio de la cirugía, cuando el paciente ya estaba recuperado de la anestesia. No obstante, el fenómeno (hipotensión arterial podría haber ocurrido en el per-operatorio.BACKGROUND AND OBJECTIVES: Iliac artery injury during laminectomy is an uncommon, however very serious event. This report aimed at presenting a case of left iliac artery injury in patient submitted to lumbar laminectomy under spinal anesthesia, that was clinically manifested in the immediate postoperative period, seven hours after beginning of surgery. CASE REPORT: Male patient, physical status ASA I, 31 years old, 68 kg, submitted to lumbar laminectomy in prone position under spinal anesthesia in L2-L3 interspace with 20 mg 0.5% hyperbaric bupivacaine and 25 µg fentanyl. Surgery went on normally and seven hours after its beginning, already in the postoperative period, patient presented arterial hypotension, tachycardia, agitation and diffuse abdominal

  19. Entry zone of iliac screw fixation to maintain proper entry width and screw length.

    Science.gov (United States)

    Park, Soo-An; Kwak, Dai-Soon; You, Sung-Lim

    2015-11-01

    To evaluate the entry zone of iliac screw fixation to maintain proper entry width and screw length. Computed tomography images of pelvic bones from 90 human cadavers were reconstructed into 3-dimensional models. In each model, a sectional image crossing the posterior superior iliac spine (PSIS) and anterior inferior iliac spine (AIIS) and consecutive sectional images up to 20 mm superiorly and inferiorly from the PSIS with 1-mm intervals aiming the AIIS were obtained. One virtual iliac screw with 10-mm diameter was introduced onto the PSIS at the middle and at the lateral and medial 1/4 points on the prominence of the posterior iliac spine. The entry width of the bony prominence and the corresponding maximal screw length available were evaluated for each entry point. The entry width was smallest on the inferior 20 mm (4.7 ± 3.0 mm) and gradually increased up to the superior 10 mm (19.1 ± 3.9 mm) sectional images. The maximal screw length was smallest on the superior 20 mm (76.7 ± 39.7 mm) and gradually increased down to the inferior 10 mm (112.3 ± 15.1 mm) sectional images. The maximal screw lengths were significantly greatest at the most medial point and smallest at the most lateral point on the superior 20- and 10-mm sectional images and at the PSIS. The iliac screw fixation entry zone to maintain proper screw length and entry width is outlined from 20 mm superiorly to 10 mm inferiorly from the PSIS and is located more medially from the prominence of the posterior iliac spine.

  20. Reconstruction of iliac crest with rib to prevent donor site complications: A prospective study of 26 cases

    Directory of Open Access Journals (Sweden)

    Dave B

    2007-01-01

    Full Text Available Background: The tricortical bone graft from the iliac crest are used to reconstruct the post corpectomy spinal defects. The donor iliac area defect is large and may give rise to pain at donor site, instability of pelvis, fracture of ilium, donor site muscle herniation or abdominal content herniation. Rib removed during thoracotomy was used by us to reconstruct the iliac crest defect. Materials and Methods: Twenty-six patients who underwent thoracotomy for dorsal spine corpectomy or curettage for various spinal pathologies from June 2002 to May 2004 were included in the study. After adequate decompression the spine was reconstructed by tricortical bone graft from iliac crest and reconstruction of the iliac crest was done with the rib removed for exposure during thoracotomy. Results: The mean follow up was 15 months. All patients had good graft incorporation which was evaluated on the basis of local tenderness and radiographs. One patient had graft displacement. Conclusion: The reconstruction of iliac crest by rib is a simple and effective procedure to prevent donor site complications.

  1. Laparoscopic treatment for retroperitoneal hyaline-vascular type localized Castleman's disease (LCD) in the iliac vessel region.

    Science.gov (United States)

    Le, Aiwen; Shan, Lili; Wang, Zhonghai; Dai, Xiaoyun; Xiao, Tianhui; Zhuo, Rong; Yuan, Rui

    2015-01-01

    To improve the understanding, diagnostic levels, and therapeutic levels of retroperitoneal hyaline vascular type LCD in the iliac vessel region. Diagnostic and therapeutic processes of 4 patients with retroperitoneal LCD in the iliac vessel region were retrospectively analyzed. The median ages of the research patients was 31.3 years old, Pelvic vascular dual-source computed tomography (CT) indicated an abnormal pelvic irregular cloddy intensity shadow with heterogeneous densities and punctate calcified lesions. The enhanced scanning showed significantly enhanced lesions and multiple tortuous vascular images inside and around the lesions. Patients' preoperative diagnoses were all "pelvic mass with unknown characteristics", and retroperitoneal masses were successfully stripped off after the laparoscopic surgery. Intra operative findings indicated 1 mass located at the left obturator nerve, 1 at the left internal iliac artery, and 2 at the right external iliac artery. The postoperative pathological reports suggest a diagnosis of Castleman's disease. Retroperitoneal LCD in the iliac vessel region is generally asymptomatic. Preoperative imaging data may help with the diagnosis, but a confirmed diagnosis depends on the results of the pathological examination. Iliac artery embolization is performed prior to laparoscopic mass stripping if the masses have abundant blood supply, while lymphadenectomy is also applied to those with enlarged lymph nodes.

  2. Correlation of Peripheral Vein Tumour Marker Levels, Internal Iliac Vein Tumour Marker Levels and Radical Prostatectomy Specimens in Patients with Prostate Cancer and Borderline High Prostate-Specific Antigen: A Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Farrelly, Cormac, E-mail: farrellycormac@gmail.com [Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Division of Interventional Radiology, Department of Radiology (United States); Lal, Priti [University of Pennsylvania Perelman School of Medicine, Department of Pathology and Laboratory Medicine (United States); Trerotola, Scott O.; Nadolski, Gregory J.; Watts, Micah M. [Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Division of Interventional Radiology, Department of Radiology (United States); Gorrian, Catherine Mc. [Mater Misericordiae University Hospital, University College Dublin School of Medicine & Medical Science (Ireland); Guzzo, Thomas J. [University of Pennsylvania Perelman School of Medicine, Department of Urology and Surgery (United States)

    2016-05-15

    PurposeTo correlate prostate-specific antigen (PSA), free to total PSA percentage (fPSA%) and prostatic acid phosphatase (PAP) levels from peripheral and pelvic venous samples with prostatectomy specimens in patients with prostate adenocarcinoma and borderline elevation of PSA.Materials and MethodsIn this prospective institutional review board approved study, 7 patients with biopsy proven prostate cancer had a venous sampling procedure prior to prostatectomy (mean 3.2 days, range 1–7). Venous samples were taken from a peripheral vein (PVS), the right internal iliac vein, a deep right internal iliac vein branch, left internal iliac vein and a deep left internal iliac vein branch. Venous sampling results were compared to tumour volume, laterality, stage and grade in prostatectomy surgical specimens.ResultsMean PVS PSA was 4.29, range 2.3–6 ng/ml. PSA and PAP values in PVS did not differ significantly from internal iliac or deep internal iliac vein samples (p > 0.05). fPSA% was significantly higher in internal iliac (p = 0.004) and deep internal iliac (p = 0.003) vein samples compared to PVS. One of 7 patients had unilateral tumour only. This patient, with left–sided tumour, had a fPSA% of 6, 6, 6, 14 and 12 in his peripheral, right internal iliac, deep right internal iliac branch, left internal iliac and deep left internal iliac branch samples respectively. There were no adverse events.ConclusionfPSA%, unlike total PSA or PAP, is significantly higher in pelvic vein compared to peripheral vein samples when prostate cancer is present. Larger studies including patients with higher PSA values are warranted to further investigate this counterintuitive finding.

  3. Correlation of Peripheral Vein Tumour Marker Levels, Internal Iliac Vein Tumour Marker Levels and Radical Prostatectomy Specimens in Patients with Prostate Cancer and Borderline High Prostate-Specific Antigen: A Pilot Study

    International Nuclear Information System (INIS)

    Farrelly, Cormac; Lal, Priti; Trerotola, Scott O.; Nadolski, Gregory J.; Watts, Micah M.; Gorrian, Catherine Mc.; Guzzo, Thomas J.

    2016-01-01

    PurposeTo correlate prostate-specific antigen (PSA), free to total PSA percentage (fPSA%) and prostatic acid phosphatase (PAP) levels from peripheral and pelvic venous samples with prostatectomy specimens in patients with prostate adenocarcinoma and borderline elevation of PSA.Materials and MethodsIn this prospective institutional review board approved study, 7 patients with biopsy proven prostate cancer had a venous sampling procedure prior to prostatectomy (mean 3.2 days, range 1–7). Venous samples were taken from a peripheral vein (PVS), the right internal iliac vein, a deep right internal iliac vein branch, left internal iliac vein and a deep left internal iliac vein branch. Venous sampling results were compared to tumour volume, laterality, stage and grade in prostatectomy surgical specimens.ResultsMean PVS PSA was 4.29, range 2.3–6 ng/ml. PSA and PAP values in PVS did not differ significantly from internal iliac or deep internal iliac vein samples (p > 0.05). fPSA% was significantly higher in internal iliac (p = 0.004) and deep internal iliac (p = 0.003) vein samples compared to PVS. One of 7 patients had unilateral tumour only. This patient, with left–sided tumour, had a fPSA% of 6, 6, 6, 14 and 12 in his peripheral, right internal iliac, deep right internal iliac branch, left internal iliac and deep left internal iliac branch samples respectively. There were no adverse events.ConclusionfPSA%, unlike total PSA or PAP, is significantly higher in pelvic vein compared to peripheral vein samples when prostate cancer is present. Larger studies including patients with higher PSA values are warranted to further investigate this counterintuitive finding.

  4. Endovascular treatment of external iliac vein stenosis caused by graft compression after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Willamax Oliveira de Sousa

    2013-06-01

    Full Text Available A 57-year old patient presented with approximately 80% stenosis of the left external iliac vein due to compression by the renal graft after kidney transplantation. The initial clinical manifestation of this vascular complication was progressive edema of the left lower limb, starting in the foot during the immediate postoperative period and reaching the thigh. Renal function also deteriorated during the first four months after transplantation. Venous Doppler ultrasound findings were suggestive of a diagnosis of extrinsic compression by the kidney graft and so phlebography was ordered, confirming stenosis of the left external iliac vein. The patient was initially treated with balloon angioplasty, but there was still residual stenosis so a stent was inserted, eliminating the stenosis. The edema reduced over time and the patient's renal function improved. While vascular complications are rare, and potentially severe, events, success rates are good if treatment is started early.

  5. Iliac vein compression syndrome: Outcome of endovascular treatment with long-term follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent [Department of Radiology, Baskent University Faculty of Medicine, Ankara (Turkey)], E-mail: loguzkurt@yahoo.com; Tercan, Fahri; Ozkan, Ugur [Department of Radiology, Baskent University Faculty of Medicine, Ankara (Turkey); Gulcan, Oner [Department of Cardiovascular Surgery, Baskent University Faculty of Medicine, Ankara (Turkey)

    2008-12-15

    Objective: To retrospectively evaluate technical success and long-term outcome of endovascular treatment in patients with iliofemoral deep vein thrombosis (DVT) due to iliac vein compression syndrome (IVCS). Materials and methods: Between March 2003 and September 2006, 36 consecutive patients (26 women [72%], 10 men, mean age 50 {+-} 18 years) with acute or chronic iliofemoral deep vein thrombosis due to iliac vein compression syndrome were evaluated for outcome of endovascular treatment. Stent patency was estimated by using the Kaplan-Meier method. Results: Technical success was achieved in 34 of 36 patients (94%). Six patients with acute or subacute thrombosis had chronic occlusion of the left common iliac vein. Rethrombosis of the stents was observed in four patients. Primary and secondary patency rates were 85 and 94% at 1 year, and 80 and 82% at 4 years. Resolution of symptoms was achieved in 17 of 20 patients (85%) with acute and subacute DVT, and 4 of 16 patients (25%) with chronic DVT. Major complication was seen in one patient (3%). Conclusion: Intimal changes in the left common iliac vein are mostly chronic in nature even in patients with acute DVT secondary to IVCS. Endovascular treatment with stent placement has a high technical success rate and good long-term patency in the treatment of acute and chronic DVT due to IVCS. Symptomatic improvement seems to be better in patients with acute than chronic DVT due to IVCS.

  6. Computed tomography of sacro-iliac joints

    International Nuclear Information System (INIS)

    Miquel, A.; Laredo, J.D.

    1995-01-01

    Actual technologies to explore sacro-iliac joints are conventional radiography, computed tomography , scintigraphy and nuclear magnetic resonance imaging. Standards films are sufficient, except in beginning sacro-iliac septic inflammations where the computed tomography is superior. Two problems are generally posed for the radiologist, to differentiate a septic arthritis from a rheumatic pathology An other problem in diagnosis is to make the difference between a degenerative arthropathy (which does not need a further investigation) and an infectious rheumatic pathology where more exploration is necessary. 28 refs., 3 tabs., 13 figs

  7. Bone grafting options in children.

    Science.gov (United States)

    Betz, Randal R; Lavelle, William F; Samdani, Amer F

    2010-08-01

    Retrospective review of the literature. To review the current literature as well as recent trends in bone grafting techniques available for children. The currently accepted gold standard in bone grafting for adolescent idiopathic scoliosis (AIS) is autogenous iliac crest. Due to questions concerning complications such as donor site pain, other options have been explored, including various allograft sources, demineralized bone matrix, and bone morphogenetic protein. A review of the current medical literature was completed and additional case examples are presented. A review of the literature reveals that up to 31% of patients have persistent pain at 2 years post surgery when autogenous iliac crest bone graft is harvested. Allograft supplementation of local autograft has been demonstrated in the literature to be as effective as autogenous iliac crest bone grafting in contributing to a successful posterior spinal fusion in patients with AIS. Modern demineralized bone matrix formulations have been found in both animal models as well as in a recent retrospective clinical review to contribute to a successful posterior spinal fusion in AIS. Bone morphogenetic protein has been shown to contribute to a successful posterior spinal fusion in complex pediatric spinal deformity patients. At 2 years follow-up, patients who underwent a posterior instrumented spinal fusion that was not augmented with any bone graft appear to have successful spinal fusions. Although autogenous iliac bone graft remains the benchmark to which bone grafting materials are compared, other options including the placement of no bone graft at all provides similar fusion rates in patients with AIS.

  8. Kidney transplantation in a patient with absent right common iliac artery and congenital renal abnormalities.

    Science.gov (United States)

    Tay, Clifton Ming; Siew, Edwin Poh Yiew; Ng, Tze-Kiat; Vathsala, Anantharanam; Tiong, Ho Yee

    2015-01-01

    Congenital atresia of the common and external iliac arteries is a rare vascular anomaly that may be associated with congenital renal or genitourinary malformations. In ESRD patients, its presence may pose potential problems during renal transplantation. We report a rare case of kidney transplantation in a patient with VACTERL syndrome who was found to have absent right common and external iliac arteries during pre-operative imaging. Vascular supply to the right lower limb is derived from an anomalous branch from the left internal iliac artery which takes on a convoluted course across the pelvis. Kidney transplantation was performed successfully with implantation performed on the left side. Isolated cases of congenital iliac artery atresia have been described in association with urological abnormalities but no clear association has yet been established. However, we feel that it may be useful to perform routine angiographic evaluation for ESRD patients with congenital genitourinary abnormalities being planned for kidney transplantation. While most cases of congenital iliac artery anomalies are symptomatic with claudication, some remain asymptomatic with normal physical examination findings. There is some evidence in literature suggesting the usefulness of routine pre-operative CT in a selective group of patients. Kidney transplantation in such cases is safe and we recommend routine pre-operative imaging of patients known to have congenital genitourniary abnormalities. The kidney should be implanted heterotopically to the contralateral side of the vascular anomaly and care must be taken to preserve vascular supply to the lower limbs. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. The anatomical basis of the deep circumflex iliac artery perforator flap with iliac crest.

    Science.gov (United States)

    Bergeron, Leonard; Tang, Maolin; Morris, Steven F

    2007-07-01

    Perforator flaps are increasingly used because of advantages including reduced flap bulk, less donor-site morbidity, and more donor-site options. The deep circumflex iliac artery (DCIA) osteomusculocutaneous flap with iliac crest has been one of the most useful flaps used for mandibular reconstruction. However, its use has been limited by its bulkiness and added donor-site morbidity because of the inclusion of an "obligatory muscle cuff" of abdominal muscle. Early results at designing a DCIA perforator flap to circumvent this problem have been varied. Details regarding the location, number, and reliability of DCIA musculocutaneous perforators have been conflicting. The purpose of this study was to comprehensively document the anatomical basis of the DCIA perforator flap. Six fresh bodies underwent whole-body lead oxide injection (n = 12 specimens). Landmarks were identified with radiopaque markers. Dissection, angiography, and photography were used to document the precise course of individual perforators in the flank region. Angiograms were assembled with Adobe Photoshop and analyzed with Scion Image Beta. An average of 1.6 DCIA perforators with a diameter of 0.7 mm was present in 92 percent of specimens. Perforators were located 5 to 11 cm posterior to the anterior superior iliac spine, 1 to 35 mm superior to the iliac crest, with a perforator zone of 31 cm. The DCIA perfused the medial aspect of the iliac crest. This article establishes the anatomical basis of the DCIA perforator flap with iliac crest. This perforator flap, along with a split iliac crest, will likely diminish donor-site morbidity and facilitate oromandibular reconstruction.

  10. Isolated iliac artery aneurysms with associated hydronephrosis.

    LENUS (Irish Health Repository)

    O'Driscoll, D

    2012-02-03

    An isolated iliac artery aneurysm is where there is aneurysmal dilatation of one or more branches of the iliac system, with no associated dilatation of the aorta. Such aneurysms are rare and comprise 1% of all intra-abdominal aneurysms. The signs and symptoms of such an aneurysm are influenced by its concealed location within the bony pelvis. Awareness of these special characteristics improves the chances of early diagnosis and proper treatment before possible rupture. We present the clinical and radiological features of three such aneurysms. Ultrasound was the first imaging modality to be performed. Ipsilateral hydronephrosis was demonstrated in each case, this lead to imaging the pelvis and the correct diagnosis. We review the clinical and radiological literature and conclude that the pelvis should be imaged in all cases of unexplained hydronephrosis.

  11. The management of concomitant renal oncocytoma and giant coronary and bilateral common iliac artery aneurysms.

    Science.gov (United States)

    Clarke, Jonathan; Choong, Andrew; Raja, Shahzad; Amrani, Mohamed; Hellawell, Giles; Hussain, Tahir

    2014-05-01

    We present the rare case of a 66-year-old Caucasian male patient presenting with intermittent left-side abdominal pain. He underwent a kidneys, ureters, and bladder computed tomography scan on which an incidental 45-mm giant aneurysm of the left anterior descending coronary artery was discovered along with 55-mm right-sided and 62-mm left-sided common iliac artery aneurysms and a 100-mm benign renal oncocytoma. He underwent on-pump coronary artery bypass grafting of the left anterior descending, left circumflex and right coronary arteries using internal mammary artery and saphenous vein grafts. He subsequently underwent simultaneous open left nephrectomy and bilateral common iliac aneurysm repair using a bifurcated tube graft. He made a full recovery postoperatively. Giant coronary artery aneurysms are rare. In the pediatric population, they are predominantly secondary to Kawasaki disease. In adults, atheromatous disease is the leading cause. The coexistence of giant coronary artery aneurysms with extracoronary artery aneurysms is extremely unusual. We propose that the identification of giant coronary artery aneurysms necessitates further imaging investigations to identify the presence of extracoronary aneurysms. To our knowledge, this is the first description of such a case in the literature. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Pneumatic gouge versus standard method for iliac crest harvesting.

    Science.gov (United States)

    Duncan, R W; McGuire, R A; Meydrech, E F

    1994-08-01

    Fifty consecutive patients undergoing posterior lumbar fusion by a single surgeon were prospectively randomized in a study designed to evaluate the efficacy of using a pneumatic oscillating gouge to obtain posterior outer table iliac crest bone graft versus the standard method of using osteotomes and gouges. Variables analyzed included graft harvesting time, blood loss, weight of graft obtained, and graft site morbidity. Mean graft harvesting time with the pneumatic gouge was 1 minute 44 seconds (range, 1 min 5 sec to 3 min 15 sec) compared with the standard method time of 4 minutes 4 seconds (range, 2 min 15 sec to 8 min 56 sec) (P = 0.0001). Blood loss was also less, with a mean of 25.4 cc for the pneumatic gouge compared with 65.2 cc using the standard method (P = 0.0001). There were no complications with the graft site in either group. We conclude that the pneumatic gouge is a viable alternative to standard bone graft harvesting techniques. Benefits include shorter operative time and decreased blood loss without an increased morbidity.

  13. A randomized controlled clinical trial comparing small buccal dehiscence defects around dental implants treated with guided bone regeneration or left for spontaneous healing.

    Science.gov (United States)

    Jung, Ronald E; Herzog, Milan; Wolleb, Karin; Ramel, Christian F; Thoma, Daniel S; Hämmerle, Christoph H F

    2017-03-01

    The aim of the present randomized controlled clinical study was to test whether small bony dehiscence defects (≤5 mm) left to heal spontaneously result in the same clinical and radiological outcome as defects treated with guided bone regeneration (GBR). Twenty-two patients who received at least one implant with a small bony dehiscence defect were enrolled in the study. If the defect height was ≤5 mm, the site was randomly assigned to either the spontaneous healing (SH) group or the GBR group. In the SH group, the defect was left without any treatment. In the GBR group, the defects around the implants were grafted with deproteinized bovine bone mineral (DBBM) and covered with a native collagen membrane. Clinical and radiographic measurements were performed 6 months after implant placement with a reentry surgery and at the time of crown insertion and the subsequent follow-up appointments at 3, 6, 12 and 18 months after loading. For statistical analyses, the mixed linear model was applied for the clinical and radiographic measurements observed around the implants. Simple comparisons of the location of the measurements in the two independent groups are performed with the Mann-Whitney U-test. In addition, the mixed model assumptions were checked. The implant and crown survival rate 18 months after loading was 100%, revealing no serious biologic or prosthetic complication. The mean changes of the buccal vertical bone height between implant placement and reentry surgery after 6 months revealed a small bone loss of -0.17 ± 1.79 mm (minimum -4 mm and maximum 2.5 mm) for the SH group and a bone gain of 1.79 ± 2.24 mm (minimum of -2.5 mm and maximum of 5 mm) for the GBR group, respectively (P = 0.017). Radiographic measurements demonstrated a slight bone loss of -0.39 ± 0.49 mm for the SH group and a stable bone level of 0.02 ± 0.48 mm for GBR group after 18 months. All peri-implant soft tissue parameters revealed healthy tissues with no

  14. Isolated aneurysms of the iliac arteries

    International Nuclear Information System (INIS)

    Eckmann, A.; Schild, H.; Schmiedt, W.; Groenninger, J.

    1988-01-01

    Isolated aneurysms of the iliac arteries are rare. They must be considered as a disease pattern of their own as against aneurysms of the abdominal aorta because of the specific anatomical conditions in the pelvis. The clinical symptomatology is determinated by their localisation and topographical relationships within teh pelvis; this can give rise to problems in differential diagnosis primary urological, neurological or gastrointestinal diseases. The prognosis is decisively determined early and correct diagnosis because of the danger of rupture. Sonography, computed tomography and angiography are indispensable aids in preoperative planning. (orig.) [de

  15. Percutaneous Endoscopic Lumbar Discectomy for L5-S1 Disc Herniation: Consideration of the Relation between the Iliac Crest and L5-S1 Disc.

    Science.gov (United States)

    Choi, Kyung Chul; Park, Choon-Keun

    2016-02-01

    Percutaneous transforaminal techniques for the treatment of lumbar disc herniation have markedly evolved. Percutaneous endoscopic lumbar discectomy (PELD) for L5-S1 disc herniation is regarded as challenging due to the unique anatomy of the iliac crest, large facet joint, and inclinatory disc space. Among these, the iliac crest is considered a major obstacle. There are no studies regarding the height of the iliac crest and their appropriate procedures in PELD. This study discusses PELD for L5-S1 disc herniation and the appropriate approach according to the height of iliac crest. Retrospective evaluation. 100 consecutive patients underwent PELD via the transforaminal route for L5-S1 disc herniation by a single surgeon. The study was divided into 2 groups: the foraminoplasty group requiring foraminal widening to access the herniated disc and the non-foraminoplasty group treated by conventional posterolateral access. Radiological parameters such as iliac height, the relative position of the iliac crest to the landmarks of the L5-S1 level, iliosacral angle and foraminal height, and disc location were considered. Clinical outcomes were assessed by the Visual Analogue Scale (VAS, 0 - 10) for back and leg pain, the Oswestry Disability Index (ODI, 0 - 100%), and the modified MacNab criteria. The overall VAS scores for back and leg pain decreased from 6.0 to 2.3 and from 7.5 to 1.7. The mean ODI (%) improved from 54.0 to 11.6. Using modified MacNab criteria, a good outcome was 92%. Foraminoplasty was required in 19 patients. Iliac crest height was significantly higher in the foraminoplasty group than the non-foraminoplasty group (37.7 mm vs 30.1 mm, P disc height between the 2 groups. In addition, there were no differences in clinical outcome between the 2 groups. This study is a retrospective analysis and simplifies the complexity of the L5-S1 level and iliac bone using two-dimensional radiography. In high iliac crest cases where the iliac crest is above the mid L5 pedicle

  16. Bone grafting: An overview

    Directory of Open Access Journals (Sweden)

    D. O. Joshi

    2010-08-01

    Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of

  17. Intradiscal Herniation of the Common Iliac Vessels: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    You, Myung Won; Lee, Chung Min; Park, Ji Seon; Ryu, Kyung Nam [Dept. of Radiology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Park, So Young; Jin, Wook [Dept. of Radiology, Kyung Hee University Gangdong Hospital, Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    2011-10-15

    In previously published spine related articles, common iliac vessel injuries have only been mentioned for complications resulting from a lumbar spine surgery. We present a case report of common iliac vessels herniating into a lumbar intervertebral disc incidentally found on magnetic resonance imaging and computed tomography angiography of the lumbar spine.

  18. management of clinically indefinite right iliac fossa lesions

    African Journals Online (AJOL)

    MANAGEMENT OF CLINICALLY INDEFINITE RIGHT ILIAC FOSSA LESIONS. A Abdel-Razek, A Afifi, A-A El Nekeidy. Abstract. Many diseases can cause lesions in right iliac fossa with indefinite clinical presentations. Improper diagnosis, missed lesions and unexpected morbidity may follow variable clinical puzzles.

  19. [Analysis of the pelvic stability after type I resection of iliac tumor].

    Science.gov (United States)

    Jia, Yong-wei; Cheng, Li-ming; Yu, Guang-rong; Yu, Yan; Lou, Yong-jian; Yang, Yun-feng; Ding, Zu-quan

    2008-03-01

    To analyze the pelvic stability after type I resection of iliac tumor. Six adult cadaveric specimens were tested. The iliac subtotal resection models were established according to Ennecking's type I resection. Markers were affixed to the key region of the pelves. Axial loading from the proximal lumbar was applied by MTS load cell in the gradient of 0-500 N in the double feet standing state. Images in front view were obtained using CCD camera. Based on Image J software, displacements of the first sacral vertebrae (S1) of the resected pelves and the intact pelves were calculated using digital marker tracing method with center-of-mass algorithm. Serious instabilities were found in the resected pelves. S1 rotational movements around the normal side femoral head of the resected pelvis were found. The average vertical displacement of S1 of the resected pelvis was (7 +/- 3) mm under vertical load of 500 newtons, which were 8.3 times compared to the intact pelvis. The average angle of S1 rotation around the normal side femoral head of the resected pelvis was (4.0 +/- 1.8) degrees, which were 12.5 times compared to the intact pelvis. Biomechanical model of type I resection of iliac tumor are established. Essential pelvic reconstruction must be introduced because of the serious instability of the bone defection after tumor resection.

  20. Bone structure changes in iliac crest grafts combined with implants

    NARCIS (Netherlands)

    Verhoeven, Jan Willem; Ruijter, Jan M.; Koole, Ronald; de Putter, Cornelis; Cune, Marco S.

    2010-01-01

    Remodeling of onlay grafts combined with implants to the mandible results in predictable changes in the graft's radiographic density. We studied the relationship between changes in radiographic density and trabecular structure during the first year after onlay grafting with simultaneous implant

  1. Slender transradial iliac artery stenting using a 4.5 French guiding sheath.

    Science.gov (United States)

    Shinozaki, Norihiko; Minowa, Takashi; Murakami, Tsutomu; Ohno, Yohei; Nakano, Masataka; Fujii, Toshiharu; Nakazawa, Gaku; Yoshimachi, Fuminobu; Ikari, Yuji

    2018-01-05

    We previously reported safety and usefulness of transradial iliac artery stenting using 6 Fr guiding sheath. However, radial artery occlusion was a major limitation of this procedure. We analyzed the safety and utility of slender transradial iliac artery stenting using a 4.5 Fr guiding sheath to prevent radial artery occlusion. We performed transradial iliac artery stenting in left radial artery, using a 4.5 Fr sheath incorporating a shaft length of 110 cm, for 34 lesions in 29 patients. Transradial intervention was attempted at the discretion of the operator. Clinical data were analyzed retrospectively. Cases with scheduled multiple sheath insertions for a bidirectional approach were excluded. Twenty-three (79.3%) patients were male. Diabetes mellitus, hypertension, dyslipidemia, and smoking habit were present in 11 (37.9%), 27 (93.1%), 19 (65.5%), and 24 (82.8%) patients, respectively. Nine lesions (26.5%) were diagnosed as chronic total occlusion. All lesions were successfully treated using a total of 40 stents incorporating a 4.5 Fr radial access system. Ankle-brachial index (ABI) significantly improved from 0.68 ± 0.15 to 0.99 ± 0.17 (p guiding sheath is safe, feasible, and less invasive, and shows no incidence of radial artery occlusion, in carefully selected patient populations.

  2. Iliac vein stenosis is an underdiagnosed cause of pelvic venous insufficiency.

    Science.gov (United States)

    Santoshi, Ratnam K N; Lakhanpal, Sanjiv; Satwah, Vinay; Lakhanpal, Gaurav; Malone, Michael; Pappas, Peter J

    2018-03-01

    Reflux in the ovarian veins, with or without an obstructive venous outflow component, is reported to be the primary cause of pelvic venous insufficiency (PVI). The degree to which venous outflow obstruction plays a role in PVI is currently ill-defined. We retrospectively reviewed the charts of 227 women with PVI who presented to the Center for Vascular Medicine from January 2012 to September 2015. Assessments and interventions consisted of an evaluation for other causes of chronic pelvic pain by a gynecologist; preintervention and postintervention visual analog scale (VAS) pain score; complete venous duplex ultrasound examination; and Clinical, Etiology, Anatomy, and Pathophysiology classification. All patients underwent diagnostic venography of their pelvic and left ovarian veins as well as intravascular ultrasound of their iliac veins. Patients were treated in one of six ways: ovarian vein embolization (OVE) alone (chemical ± coils), OVE with staged iliac vein stenting, OVE with simultaneous iliac vein stenting, iliac vein stenting alone, OVE with venoplasty, and venoplasty alone. Of the 227 women treated, the average age and number of pregnancies was 46.4 ± 10.4 years and 3.36 ± 1.99, respectively. Treatment distribution was the following: OVE, n = 39; OVE with staged stenting, n = 94; OVE with simultaneous stenting, n = 33; stenting alone, n = 50; OVE with venoplasty, n = 8; and venoplasty alone, n = 3. Seven patients in the OVE and stenting groups (staged) and one patient in the OVE + venoplasty group required a second embolization of the left ovarian vein. Eighty percent (181/227) of patients demonstrated an iliac stenosis >50% by intravascular ultrasound. Average VAS scores for the entire cohort before and after intervention were 8.45 ± 1.11 and 1.86 ± 1.61 (P ≤ .001). In the staged group, only 9 of 94 patients reported a decrease in the VAS score with OVE alone. VAS score decreased from 8.6 ± 0.89 before OVE to 7.97 ± 2.10 after OVE

  3. The iliac crest in forensic age diagnostics: evaluation of the apophyseal ossification in conventional radiography.

    Science.gov (United States)

    Wittschieber, Daniel; Vieth, Volker; Domnick, Christoph; Pfeiffer, Heidi; Schmeling, Andreas

    2013-03-01

    Due to the increasing significance of forensic age estimations in the age of globalisation, novel radiographic criteria besides clavicles and hand bones may provide additional certainty for forensic age expertises. The present study analyses the suitability of the iliac crest apophysis by means of 643 pelvic radiographs of patients between 10 and 30 years of age. Retrospective assessments were carried out according to the forensically established classification and sub-classification systems modified after Kreitner et al. (Rofo 166(6):481-486, 1997) and Kellinghaus et al. (Int J Legal Med 124(4):321-325, 2010). The basic ossification stages range from 1 to 4, and the sub-stages of stage 2 and 3 range from a to c. While stage 3c was first achieved at the age of 15 by both sexes, stage 4 was first observed in females at the age of 16 and in males at the age of 17. This indicates the possibility of a valid diagnosis of both the age of 14 and the age of 16 years which represent legally relevant age thresholds in numerous countries. Applied as targeted radiography on the iliac crest, the exposure to radiation would range between other radiographic techniques recently applied. Therefore, the iliac crest apophysis appears principally suitable as novel possible criterion for forensic age estimation in the living. However, for the establishment of the iliac crest apophysis in routine diagnostics, further studies are needed focussing on the comparison of different grading systems and different radiological techniques.

  4. Reconstruct the proximal radius with iliac graft and elastic intramedullary nail fixation after tumor resection.

    Science.gov (United States)

    Zhu, Bin; Yang, Jielai; Cheng, Dongdong; Yin, Xiaofan; Yang, Qingcheng

    2016-08-08

    This study aims to introduce a novel technique in treating benign bone tumors of the proximal radius by elastic intramedullary nail fixation and iliac graft after tumor resection. In this retrospective case series, the treatment outcomes of 17 patients with benign bone tumor involving the proximal radius were reported from January 2010 to August 2014. All the patients received reconstruction surgery with iliac graft and elastic intramedullary nail fixation after tumor resection. Pain scoring was assessed using the 0 to 10 numerical rating scale. The quality of life scoring was assessed using the SF-30 scoring system. In addition, functional outcome was assessed with the Musculoskeletal Tumor Society score and the Disabilities of the Arm, Shoulder, and Hand score. The mean follow-up was 16 months (range, 10-22). The average bone consolidate time was 19.2 weeks (range, 16-24 weeks). The pre- and postoperative pain scores were 5.47 ± 1.58 and 1.18 ± 0.39, respectively. The pain symptom was significantly ameliorated after the operation (t = 13.50, p proximal radius.

  5. Right-to-left-shunt detected by c-TCD using the orbital window in comparison with temporal bone windows.

    Science.gov (United States)

    Kobayashi, Kazuto; Kimura, Kazumi; Iguchi, Yasuyuki; Sakai, Kenichirou; Aoki, Junya; Iwanaga, Takeshi; Shibazaki, Kensaku

    2012-01-01

    There have been some reports on right-to-left shunt as a cause of cryptogenic stroke. Although contrast transcranial Doppler (c-TCD) can detect RLS, an insufficient temporal window has occasionally restricted its applicability. Thus, we compared the rates of detecting RLS among temporal windows for the middle cerebral arteries (MCAs) and the orbital window for the internal carotid artery (ICA) on c-TCD. We used c-TCD to detect RLS in patients with suspected ischemic stroke. We enrolled patients who had both sufficient bilateral temporal windows for MCAs and a right orbital window for ICA and performed c-TCD using all three windows simultaneously. We enrolled 106 consecutive patients and identified microembolic signals (MES) in 30 (28%) of them. Among these 30 patients, 15 had MES from all 3 windows. When these 30 patients were defined as being positive for RLS, the rates of detection were 67%, 73%, and 80% from the right temporal, left temporal, and right orbital windows, respectively (P= .795). The right orbital window as well as the temporal window for c-TCD could detect RLS. Insonation from the orbital window should be useful for patients who lack temporal windows. Copyright © 2010 by the American Society of Neuroimaging.

  6. Determinants of Iliac Blade Orientation in Anthropoid Primates.

    Science.gov (United States)

    Middleton, Emily R; Winkler, Zachariah J; Hammond, Ashley S; Plavcan, J Michael; Ward, Carol V

    2017-05-01

    Orientation of the iliac blades is a key feature that appears to distinguish extant apes from monkeys. Iliac morphology is hypothesized to reflect variation in thoracic shape that, in turn, reflects adaptations for shoulder and forearm function in anthropoids. Iliac orientation is traditionally measured relative to the acetabulum, whereas functional explanations pertain to its orientation relative to the cardinal anatomical planes. We investigated iliac orientation relative to a median plane using digital models of hipbones registered to landmark data from articulated pelves. We fit planes to the iliac surfaces, midline, and acetabulum, and investigated linear metrics that characterize geometric relationships of the iliac margins. Our results demonstrate that extant hominoid ilia are not rotated into a coronal plane from a more sagittal position in basal apes and monkeys but that the apparent rotation is the result of geometric changes within the ilia. The whole ilium and its gluteal surface are more coronally oriented in apes, but apes and monkeys do not differ in orientation of the iliac fossa. The angular differences in the whole blade and gluteal surface primarily reflect a narrower iliac tuberosity set closer to the midline in extant apes, reflecting a decrease in erector spinae muscle mass associated with stiffening of the lumbar spine. Mediolateral breadth across the ventral dorsal iliac spines is only slightly greater in extant apes than in monkeys. These results demonstrate that spinal musculature and mobility have a more significant effect on pelvic morphology than does shoulder orientation, as had been previously hypothesized. Anat Rec, 300:810-827, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. [Comparison of the Latissimus dorsi insertions on the iliac crest in chimpanzee (Pan troglodytes) and in man].

    Science.gov (United States)

    Vacher, C; Ben Hadj Yahia, S; Braun, M; Journeau, P

    2014-03-01

    Comparing to other primates, one of the most important specificities of the human anatomy are consequences of bipedalism. Although bone consequences are well known (lumbar lordosis, horizontal position of the foramen magnum, lengthening of the lower limbs, reduction of the pelvis, specialization of the foot), consequences of our locomotion on the Latissimus dorsi are still unclear. One dissection of a chimpanzee Latissimus dorsi (Pan troglodytes) has been performed and compared to 30 human Latissimus dorsi dissections (10 fresh cadavers and 20 formoled cadavers). In each dissection, the existence of direct muscular insertions on the iliac crest has been investigated and the constitution of the thoracolumbar fascia has been described. In chimpanzee dissection, a muscular direct insertion of the Latissimus dorsi was present on the iliac crest of 9 cm long. The TLF was made of the superficial and the deep fascias of the Latissimus dorsi and the superficial fascia of the erector spinae muscles which was deeper. In man, there was no direct muscular insertion of the Latissimus dorsi in 90 % of cases, the TLF was constituted the same way. This study suggests that the Latissimus dorsi has been separated from the iliac crest in man during the evolution because of the permanent bipedalism and that it stayed inserted on the iliac crest in chimpanzee because of the brachiation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. Iliac arterial-enteric fistulas occurring after pelvic irradiation

    International Nuclear Information System (INIS)

    Vetto, J.T.; Culp, S.C.; Smythe, T.B.; Chang, A.E.; Sindelar, W.F.; Sugarbaker, P.H.; Heit, H.A.; Giordano, J.M.; Kozloff, L.

    1987-01-01

    Fistulas from the iliac artery to the bowel constitute a condition that is often lethal. Excluding fistulas related to vascular grafts, a review of previously reported cases shows that they are most often due to atherosclerotic iliac aneurysms. Three unusual cases of this condition that occurred after high-dose pelvic irradiation for treatment of cancer are presented; in no case was recurrent tumor evident. These cases suggest that high-dose pelvic irradiation can predispose to the formation of iliac arterial-enteric fistulas, particularly if sepsis or inflammation develops. The definitive surgical management of these fistulas entails bowel resection, arterial ligation, and extra-anatomic bypass

  9. Acute renal failure in marked aneurysm of the iliac artery

    International Nuclear Information System (INIS)

    Kersjes, W.; Koester, O.; Orellano, L.; Bregulla, C.; Bonn Univ.; Bonn Univ.

    1988-01-01

    This is a report on a patient of 64 years of age who was admitted to hospital as an inpatient thirteen years after desobliteration of the iliac artery with an extension plasty. He complained of irregular stools and occasional abdominal pain. Imaging methods were employed on account of a drop in the haemoglobin count, progressive renal insufficiency and a palpable tumor in the lower abdomen. These methods supplied evidence of a false aneurysm originating from the iliacal endarterectomy, combined with compression of the ureter and small intestine. Basing on the present case report, the general complex of problems in diagnosing aneurysms of the iliac artery is discussed. (orig.) [de

  10. A modified technique for iliac artery branched endografting using a "tromboned" sheath

    NARCIS (Netherlands)

    Tielliu, Ignace F. J.; Zeebregts, Clark J.; van den Dungen, Jan J. A. M.; Verhoeven, Eric L. G.

    2008-01-01

    The iliac branched device (IBD) is the only totally endovascular option to preserve flow to the internal iliac artery for the treatment of aorto-iliac or solitary iliac artery aneurysms. This technique involves the use of two parallel guide wires, including the indwelling through-and-through wire

  11. Posterior atlantoaxial fusion with a screw-rod system: Allograft versus iliac crest autograft.

    Science.gov (United States)

    Huang, Da-Geng; Zhang, Xin-Liang; Hao, Ding-Jun; Yu, Cheng-Cheng; Mi, Bai-Bing; Yuan, Qi-Ling; He, Bao-Rong; Liu, Tuan-Jiang; Guo, Hua; Wang, Xiao-Dong

    2017-11-01

    To compare the effectiveness of allograft and iliac crest autograft in atlantoaxial fusion. Between January 2012 and December 2012, 41 consecutive patients underwent posterior atlantoaxial fusion with a screw-rod fixation system in our spine center. The choice to use allograft or iliac crest autograft was made by the patient himself or herself after being informed about the advantages and disadvantages of both methods. In the allograft group, we used mixed material of morcellized demineralized freeze-dried bone allograft and local autograft for posterior atlantoaxial fusion. In the autograft group, we used the morcellized iliac crest autograft for fusion. Patients underwent regular follow up including CT scans and dynamic radiographs 6 months postoperatively and every 6 months thereafter until study completion or confirmation of fusion. Twenty-four patients underwent posterior atlantoaxial fusion with allograft, and 17 underwent fusion with autograft. All patients were followed up for at least 24 months. At the final follow-up visit, only two (8.3%) patients in the allograft group had confirmed posterior bony fusion on CT imaging while 15 (88.2%) patients in the autograft group had confirmed posterior bony fusion. None of the 41 patients had movement on the dynamic radiographs. Allograft is not reliable for posterior atlantoaxial fusion even with the rigid internal fixation of modern constructs. Autograft remains the first choice for atlantoaxial fusion despite the donor-site morbidity. The assessment of fusion based on a lack of movement on dynamic radiographs is not reliable. The confirmation of fusion should be based on the presence of bridging bone on CT imaging. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Osteoblastoma crossing the sacro-iliac joint

    Energy Technology Data Exchange (ETDEWEB)

    Whittingham-Jones, Paul; Lehovsky, Jan [Royal National Orthopaedic Hospital, Spinal Surgery, London (United Kingdom); Hughes, Richard; Saifuddin, Asif [Royal National Orthopaedic Hospital, Radiology, London (United Kingdom); Fajinmi, Matilda [Royal National Orthopaedic Hospital, Histopathology, London (United Kingdom)

    2007-03-15

    Osteoblastoma is a rare primary bone tumour which is well-described in the spine and sacrum. We report a case of histologically confirmed osteoblastoma in a 20-year-old male which crossed the sacroiliac joint. This has not previously been described to our knowledge. The imaging features of osteoblastoma and sacroiliac joint involvement by bone tumours are reviewed. (orig.)

  13. Osteoblastoma crossing the sacro-iliac joint

    International Nuclear Information System (INIS)

    Whittingham-Jones, Paul; Lehovsky, Jan; Hughes, Richard; Saifuddin, Asif; Fajinmi, Matilda

    2007-01-01

    Osteoblastoma is a rare primary bone tumour which is well-described in the spine and sacrum. We report a case of histologically confirmed osteoblastoma in a 20-year-old male which crossed the sacroiliac joint. This has not previously been described to our knowledge. The imaging features of osteoblastoma and sacroiliac joint involvement by bone tumours are reviewed. (orig.)

  14. Deep Vein Thrombosis of the Left Leg: A Case of May-Thurner Syndrome

    Directory of Open Access Journals (Sweden)

    Jiten Desai

    2018-02-01

    Full Text Available A 56-year-old woman presented with gradually worsening shortness of breath associated with dull left leg pain over 5 days. She denied any recent travel, recent surgeries or immobilization. CT pulmonary angiography and CT venography revealed multiple bilateral pulmonary emboli and extensive left pelvic and left lower extremity deep vein thromboses. Contrast-enhanced CT showed that the right common iliac artery crossed the left common iliac vein and compressed it externally, indicative of May–Thurner syndrome. Catheter-directed thrombolysis of the left lower extremity was performed and heparin infusion was started. The patient also underwent left iliac vein balloon angioplasty with stenting and infra-renal inferior vena cava filter placement via the jugular approach to prevent further embolization.

  15. External iliac artery polytetrafluoroethylene graft interposition: An effective rescuer for kidney transplant in progressive intimal dissection of external iliac artery

    Directory of Open Access Journals (Sweden)

    Tanveer Iqbal Dar

    2016-01-01

    Conclusion: Polytetrafluoroethylene interposition graft is a successful procedure to salvage the kidney and lower limb in case of progressive intimal dissection of external iliac artery during renal transplant surgery.

  16. Acute iliac artery thrombosis and pyloric ulcer perforation - unique double emergency pathologies detected with MDCT

    International Nuclear Information System (INIS)

    Groudeva, V.; Malla Houech, I.-V.; Stoinova, V.

    2015-01-01

    Full text: Acute iliac artery thrombosis and pyloric ulcer perforation are both emergencies that require different surgical approach. Both conditions have serious consequences and high mortality rate. There are fewer reports on simultaneous cases of such surgical emergencies. We present a case of 67 years old man with abdominal pain with acute onset and paleness and pain in the left lower extremity. the patient was referred for a CT for assessment of acute limb ischaemia and also suspected mesenteric thrombosis. MDCT of abdomen and peripheral CT angiography of lower extremities was performed. The aim is to show the benefit of MDCT examination in depicting varieties of pathologies encountered in emergency patients. MDCT showed total occlusion of left iliac artery. No signs of mesenteric thrombosis were evident and the mesenteric arteries were patent. However there was free air in the peritoneal cavity suggestive of perforation. the patient was operated - arterial thrombectomy was performed together with pyloric ulcus excision. MDCT is an excellent non-invasive method that can give prompt answers to surgical emergencies

  17. Is miniscrew primary stability influenced by bone density?

    Directory of Open Access Journals (Sweden)

    Mariana Marquezan

    2011-10-01

    Full Text Available Primary stability is absence of mobility in the bone bed after mini-implant placement and depends on bone quality among other factors. Bone quality is a subjective term frequently considered as bone density. The aim of this preliminary study was to evaluate bone density in two bovine pelvic regions and verify the primary stability of miniscrews inserted into them. Forty bone blocks were extracted from bovine pelvic bones, 20 from iliac and 20 from pubic bone, all of them containing cortical bone about 1 mm thick. Half of the sections extracted from each bone were designated for histological evaluation of bone density (trabecular bone area - TBA and the other half for bone mineral density (BMD evaluation by means of central dual-energy X-ray absorptiometry (DEXA. Then, twenty self-drilling miniscrews (INPÒ, São Paulo, Brazil 1.4 mm in diameter and 6 mm long were inserted into the bone blocks used for BMD evaluation. Peak implant insertion torque (IT and pull-out strength (PS were used for primary stability evaluation. It was found that iliac and pubic bones present different bone densities, iliac bone being less dense considering BMD and TBA values (P > 0.05. However, the miniscrew primary stability was not different when varying the bone type (P < 0.05. IT and PS were not influenced by these differences in bone density when cortical thickness was about 1 mm thick.

  18. Simultaneous Iliac Vein Bovine Pericardial Patch Venoplasty and Creation of PTFE Lower Limb Arteriovenous Fistula Graft for Rescue Vascular Access.

    Science.gov (United States)

    Meecham, Lewis; Fisher, Owain; Kirby, George; Evans, Richard; Buxton, Pauline; Legge, Jocelyn; Rajagopalan, Sriram; Asquith, John; Pherwani, Arun

    2016-10-01

    We present a case of external iliac vein patch venoplasty to accommodate rescue vascular access via a polytetrafluoroethylene loop arteriovenous fistula graft (AVG) for a patient with multiple central venous stenoses. A 35-year-old female with anti-glomerular basement membrane antibody disease required rescue vascular access for hemodialysis. Repeated occlusion and/or thrombosis of long-term central venous access cannulae, to facilitate dialysis, had caused stenosis of brachiocephalic veins: right external iliac vein and occlusion of the left common iliac vein. A previous right brachiobasilic fistula had occluded within 1 year. No other upper limb options for arteriovenous fistula (AVF) were available. A right external iliac vein bovine patch angioplasty concurrently with a polytetrafluoroethylene AV graft between common femoral artery and common femoral vein was performed to restore venous patency and allow rescue dialysis access. At 3-year follow-up, the fistula remains widely patent with 2 L/min flow rates and no recurrent stenosis to the treated iliac vein. She has not required any further surgical or interventional radiological procedures to maintain fistula or central venous patency. Central venous stenosis or occlusion is common for patients requiring dialysis, especially those with multiple previous long-term central venous cannulations. If restriction of outflow is present, AVF may fail. Venous patch angioplasty in these cases is a successful technique, allowing AVF formation and long-term patency. Central venous stenosis can be treated successfully with patch venoplasty to accommodate AVF/AVG formation for rescue vascular access; this is a potentially lifesaving intervention for patients requiring dialysis. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Comparison of Puddu osteotomy with or without autologous bone grafting: a prospective clinical trial

    Directory of Open Access Journals (Sweden)

    Marcus Ceregatti Passarelli

    Full Text Available ABSTRACT Objectives: To test the hypothesis that autologous iliac bone grafts do not enhance clinical results and do not decrease complication rates in patients undergoing medial opening-wedge high tibial , osteotomy. Methods: Forty patients allocated in a randomized, two-armed, double-blinded clinical trial were evaluated between 2007 and 2010. One group received bone graft, and the other group was left without filling the osteotomy defect. The primary outcome was the Knee Society Score. , Radiographic measurement of the frontal anatomical femoral-tibial angle and the progression of osteoarthritis according to the modified Ahlback classification were used as secondary outcomes., Results: There was no difference in KSS scale between the graft group (64.4 ± 21.8 and the graftless group (61.6 ± 17.3; p= 0.309. There was no difference of angle between the femur and tibia in the frontal plane between the groups (graft, = 184 ± 4.6 degrees, graftless = 183.4 ± 5.1 degrees; p= 1.0, indicating that there is no loss of correction due to the lack of the graft. There was significant aggravation of osteoarthritis in a greater number of patients in a graft group (p= 0.005 . Conclusion: Autologous iliac bone graft does not improve clinical outcomes in medium and long-term follow-up of medial opening-wedge high tibial osteotomy fixed with a first generation Puddu plate in the conditions of this study.

  20. Effect of aorto-iliac bifurcation and iliac stenosis on flow dynamics in an abdominal aortic aneurysm

    Science.gov (United States)

    Patel, Shivam; Usmani, Abdullah Y.; Muralidhar, K.

    2017-06-01

    Physiological flows in rigid diseased arterial flow phantoms emulating an abdominal aortic aneurysm (AAA) under rest conditions with aorto-iliac bifurcation and iliac stenosis are examined in vitro through 2D PIV measurements. Flow characteristics are first established in the model resembling a symmetric AAA with a straight outlet tube. The influence of aorto-iliac bifurcation and iliac stenosis on AAA flow dynamics is then explored through a comparison of the nature of flow patterns, vorticity evolution, vortex core trajectory and hemodynamic factors against the reference configuration. Specifically, wall shear stress and oscillatory shear index in the bulge portion of the models are of interest. The results of this investigation indicate overall phenomenological similarity in AAA flow patterns across the models. The pattern is characterized by a central jet and wall-bounded vortices whose strength increases during the deceleration phase as it moves forward. The central jet impacts the wall of AAA at its distal end. In the presence of an aorto-iliac bifurcation as well as iliac stenosis, the flow patterns show diminished strength, expanse and speed of propagation of the primary vortices. The positions of the instantaneous vortex cores, determined using the Q-function, correlate with flow separation in the bulge, flow resistance due to a bifurcation, and the break in symmetry introduced by a stenosis in one of the legs of the model. Time-averaged WSS in a healthy aorta is around 0.70 N m-2 and is lowered to the range ±0.2 N m-2 in the presence of the downstream bifurcation with a stenosed common iliac artery. The consequence of changes in the flow pattern within the aneurysm on disease progression is discussed.

  1. New regenerative treatment for tooth and periodontal bone defect associated with posttraumatic alveolar bone crush fracture.

    Science.gov (United States)

    Kiyokawa, Kensuke; Kiyokawa, Munekatsu; Takagi, Mikako; Rikimaru, Hideaki; Fukaya, Takuji

    2009-05-01

    We developed a new regenerative treatment of tooth and periodontal defect and tooth dislocation associated with posttraumatic alveolar bone crush fracture in the region of the maxillary anterior teeth. Using this method, dislocated teeth are first extracted and crushed alveolar bone is debrided. The dislocated teeth are then reimplanted, and cancellous iliac bone (bone marrow) is grafted to the area surrounding the teeth to regenerate periodontal bone. Tooth reimplantation was completely successful in 2 cases, and periodontal bone regenerated to a sufficient height with the iliac bone graft. Compared with the general method of treatment with a prosthesis (bridge), when using this method to treat cases such as these, there is no sacrifice of healthy teeth adjacent to the defect, and sufficient esthetic and functional recovery is possible. It is thought that this method could be applied as a new treatment of alveolar bone fracture in the future.

  2. Transpedal approach for iliac artery stenting: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Zachariah, Jips J., E-mail: jzachariah@chpnet.org [Mount Sinai Beth Israel Hospital, New York, NY (Israel); Ratcliffe, Justin A.; Ruisi, Michael; Puma, Joseph [Mount Sinai Beth Israel Hospital, New York, NY (Israel); Bertrand, Olivier [Quebec Heart and Lung Institute, Quebec (Canada); Kwan, Tak [Mount Sinai Beth Israel Hospital, New York, NY (Israel)

    2016-12-15

    Objective: To demonstrate the safety and feasibility of the transpedal approach as an alternate arterial access site for iliac artery intervention. Background: The common femoral artery is the traditional access site for the endovascular treatment of iliac artery stenoses. However, this approach is associated with complication rates as high as 2%, including retroperitoneal bleeding which carries high patient morbidity and mortality. Furthermore, the standard femoral approach is associated with longer recovery times and longer time to ambulation which are important considerations especially when performing procedures in an ambulatory setting. Methods: Twelve patients were prospectively followed after treatment for symptomatic iliac artery stenosis via transpedal access. Under ultrasound guidance, one of the pedal arteries was visualized and accessed, and stenting of the iliac arteries were performed as per protocol. The patient was monitored immediately post procedure and clinical follow up was performed at one week and one month later. Results: The average age of the patients was 71 years old. 58% were male. Most patients had Rutherford class III symptoms. Successful stent placement was achieved in all 12 patients via transpedal access. No conversion to femoral access was required. No complications immediately post procedure nor at any time period during follow up were noted. Lower extremity arterial duplex at one month showed patent stents and patent pedal access site vessels in all patients. Conclusion: Transpedal arterial access may be a safe and feasible approach for iliac artery stenting. Given the possible benefits of avoiding femoral artery access, larger studies should be conducted directly comparing the different approaches.

  3. Endovascular management performed percutaneously of isolated iliac artery aneurysms

    International Nuclear Information System (INIS)

    Wolf, Florian; Loewe, Christian; Cejna, Manfred; Schoder, Maria; Rand, Thomas; Kettenbach, Joachim; Dirisamer, Albert; Lammer, Johannes; Funovics, Martin

    2008-01-01

    Purpose: To report about the endovascular treatment of isolated iliac artery aneurysms (IIAA) with stentgraft placement and transluminal or CT-guided embolization of the internal iliac artery or the combination of these methods. Methods and materials: Over a period of 5.6 years, 36 interventions were performed in 20 patients with 23 IIAAs. In a retrospective analysis patient records were reviewed. The CT-angiography follow-up was evaluated for the presence of re-perfusion of the IIAA and for change of aneurysm diameter. Results: Primary success was achieved in 15/23 aneurysms (65%), and secondary success in 21/23 aneurysms (91%). In 5/23 cases two interventions and in 1/23 cases three interventions were necessary to achieve secondary success. Embolization alone, as a therapy for aneurysms involving only the internal iliac artery, had a success rate of 27%. No procedure-related minor or major complications occurred. Mean decrease of aneurysm size during a mean observation period of 14.1 months was 6.9% which was not significant (p = 0.3; 95% confidence interval +7-21%). Conclusion: Endovascular therapy of isolated iliac artery aneurysms performed percutaneously has become a treatment alternative to open surgical repair. This method is feasible and safe with low procedure-related morbidity and mortality. However, on average more than one intervention has to be performed to achieve successful permanent exclusion of the aneurysm and embolization alone in isolated internal iliac artery aneurysms is not sufficient

  4. Endovascular repair of an abdominal aortic aneurysm in a patient with stenosis of bilateral common iliac artery stents.

    Science.gov (United States)

    Daab, Leo J; Aidinian, Gilbert; Weber, Michael A; Kembro, Ronald J; Cook, Patrick R

    2011-01-01

    The explosion in endovascular interventions for peripheral vascular disease has resulted in procedures being used by a multitude of specialties. Nonvascular surgeons performing these interventions can create scenarios that may make future vascular interventions difficult. In this article, we present a case report illustrating this point. A 68-year-old man with severe chronic obstructive pulmonary disease, coronary artery disease with prior myocardial infarction, and multiple abdominal operations presented with an abdominal aortic aneurysm. In our opinion, this patient was at a prohibitive operative risk for open repair. Review of his imaging results revealed a 6.7-cm infrarenal aneurysm with bilateral common iliac artery (CIA) stents (right: 8 mm; left: 6 mm) and 6-mm self-expanding stents extending from the right external iliac artery through the common femoral artery. A Cook Zenith Renu (30 × 108 mm) graft (Cook Medical Inc., Bloomington, IN) was advanced after serial dilation and balloon angioplasty of the stenotic right CIA stent. Left brachial access was used for arteriographic imaging. The left common femoral artery was accessed and the left CIA was coil-embolized to prevent backbleeding. A femoro-femoral artery crossover bypass was then performed after segmental resection of the right common femoral artery stent. The patient tolerated the procedure well and was discharged home on postoperative day 3. Subsequent postoperative computed tomography arteriogram after 1 month showed palpable pulses and no evidence of endoleak with flow in the femoro-femoral graft on clinical exam. This case demonstrates an endovascular intervention which limited the potential options available for aneurysm repair. Similar problems may become increasingly common as more providers offer endovascular interventions, thus emphasizing the importance of a collaborative approach to the patient with complex aorto-iliac occlusive disease and abdominal aortic aneurysm. It is the duty of the

  5. Predictors of ventricular remodelling in patients with reperfused acute myocardial infarction and left ventricular dysfunction candidates for bone marrow cell therapy: insights from the BONAMI trial

    Energy Technology Data Exchange (ETDEWEB)

    Manrique, Alain [Nuclear Medicine, CHU de Caen, Caen (France); Universite de Caen Normandie, EA 4650, Caen (France); CHU de Caen et GIP Cyceron, Caen cedex 6 (France); Lemarchand, Patricia; Delasalle, Beatrice; Lamirault, Guillaume; Trochu, Jean-Noel; Le Tourneau, Thierry [L' Institut du thorax, INSERM, UMR1087, Nantes (France); CNRS, UMR 6291, Nantes (France); Universite de Nantes, Nantes (France); CHU de Nantes, Nantes (France); Lairez, Olivier; Roncalli, Jerome [Institut CARDIOMET-Toulouse, Cardiac Imaging Center, CIC Biotherapies, CHU de Toulouse, Toulouse (France); Sportouch-Duckan, Catherine; Piot, Christophe [Universite Montpellier, Institut de Genomique Fonctionnelle, INSERM U661, CNRS UMR 5203, Montpellier (France); Clinique du Millenaire, Montpellier (France); Le Corvoisier, Philippe [Hopital Henri Mondor, INSERM, Centre d' Investigation Clinique 1430 et U955 equipe 3, Creteil (France); Neuder, Yannick [CHU de Grenoble, Pole Thorax et Vaisseaux, Grenoble (France); Richardson, Marjorie [CHRU Lille, Service d' Explorations Fonctionnelles Cardiovasculaires, Hopital Cardiologique, Lille (France); Lebon, Alain [CHU de Caen, Service de Cardiologie, Caen (France); Teiger, Emmanuel [Hopital Henri Mondor, AP-HP, Unite de Cardiologie Interventionnelle et Federation de Cardiologie, Creteil (France); Hossein-Foucher, Claude [Hopital Salengro CHRU de Lille, Service de Medecine Nucleaire, Lille (France); Universite de Lille 2, UFR de Medecine, Lille (France)

    2016-04-15

    Few data are available regarding the relation of left ventricular (LV) mechanical dyssynchrony to remodelling after acute myocardial infarction (MI) and stem cell therapy. We evaluated the 1-year time course of both LV mechanical dyssynchrony and remodelling in patients enrolled in the BONAMI trial, a randomized, multicenter controlled trial assessing cell therapy in patients with reperfused MI. Patients with acute MI and ejection fraction (EF) ≤ 45 % were randomized to cell therapy or to control and underwent thallium single-photon emission computed tomography (SPECT), radionuclide angiography, and echocardiography at baseline, 3 months, and 1 year. Eighty-three patients with a comprehensive 1-year follow-up were included. LV dyssynchrony was assessed by the standard deviation (SD) of the LV phase histogram using radionuclide angiography. Remodelling was defined as a 20 % increase in LV end-systolic volume index (LVESVI) at 1 year. At baseline, LVEF, wall motion score index, and perfusion defect size were significantly impaired in the 43 patients (52 %) with LV remodelling (all p < 0.001), without significant increase in LV mechanical dyssynchrony. During follow-up, there was a progressive increase in LV SD (p = 0.01). Baseline independent predictors of LV remodelling were perfusion SPECT defect size (p = 0.001), LVEF (p = 0.01) and a history of hypertension (p = 0.043). Bone marrow cell therapy did not affect the time-course of LV remodelling and dyssynchrony. LV remodelling 1 year after reperfused MI is associated with progressive LV dyssynchrony and is related to baseline infarct size and ejection fraction, without impact of cell therapy on this process. (orig.)

  6. The effects of cinacalcet treatment on bone mineral metabolism, anemia parameters, left ventricular mass index and parathyroid gland volume in hemodialysis patients with severe secondary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Dilek Torun

    2016-01-01

    Full Text Available The aim of this study was to investigate the effects of cinacalcet therapy on anemia parameters, bone mineral metabolism, left ventricular mass index (LVMI and parathyroid gland volume in hemodialysis (HD patients with secondary hyperparathyroidism. Twenty-five HD patients (M/F: 11/14, mean age: 45.2 ± 17.9 years, mean HD duration: 96.4 ± 32.7 months were included in this prospective pilot study. The indication to start calcimimetic therapy was persistent serum levels of parathyroid hormone (PTH >1000 pg/mL, refractory to intravenous (i.v. vitamin D and phosphate-binding therapy. The initial and one-year results of adjusted serum calcium (Ca +2 , phosphate (P, Ca × P product, PTH, hemoglobin (Hb and ferritin levels, transferrin saturation index (TSAT, median weekly erythropoietin (EPO dose, LVMI, and parathyroid volume by parathyroid ultrasonography were determined. There were no differences between pre- and post-treatment levels of serum Ca +2 (P = 0.853, P (P = 0.447, Ca × P product (P = 0.587, PTH (P = 0.273, ferritin (P = 0.153 and TSAT (P = 0.104. After 1 year of calcimimetic therapy, the Hb levels were significantly higher than the initial levels (P = 0.048. The weekly dose of EPO decreased with no statistical significance. The dose of cinacalcet was increased from 32.4 ± 12.0 to 60.0 ± 24.4 mg/day (P = 0.01. There were no differences between the pre- and post-treatment results regarding weekly vitamin D dose, parenteral iron dose, LVMI and parathyroid volume. The results of our study suggest that cinacalcet therapy might have an additional benefit in the control anemia in HD patients.

  7. Mesenchymal Stem Cells and Platelet Gel Improve Bone Deposition within CAD-CAM Custom-Made Ceramic HA Scaffolds for Condyle Substitution

    Directory of Open Access Journals (Sweden)

    L. Ciocca

    2013-01-01

    Full Text Available Purpose. This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs and CAD-CAM customized pure and porous hydroxyapatite (HA scaffolds to replace the temporomandibular joint (TMJ condyle. Methods. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed. Results. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P<0.05. The bone ingrowth (BI relative values of split-mouth comparison (right versus left side showed a significant difference between condyles with and without MSCs (P<0.05. Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation. Conclusion. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs.

  8. Histomorphometric analysis of bone formation in bony defects around implants in adult dogs: a comparison of grafts of low and high heat-treated autogenous tooth ash.

    Science.gov (United States)

    Kim, Jin-Ha; Kim, Su-Gwan; Lim, Sung-Chul; Oh, Ji-Su; You, Jae-Seek; Jeong, Mi-Ae

    2013-12-01

    The purpose of this study was to compare the bone formation of autogenous tooth ash treated with different temperatures. Heat treatment was rendered by powder after extraction of teeth from dogs. The bony defects were made at iliac and resorbable blast medium surfaced implant placement and bone graft was performed; no bone graft group (control group), low heat-treated tooth ash group (group 1), high heat-treated tooth ash group (group 2). Right side had healing periods of 12 weeks, and the left side had 6 weeks. Histomorphometrical analysis was performed at 12 weeks. The control group had poor bone formation and showed large loose connective tissue. Group 1 displayed good healing and bone formation. Group 2 showed higher rate of bone formation than group 1 and the control group. The high heat-treated tooth ash group showed a statistically significant increase in the rate of bone formation in the early stage. The heat-treated autogenous tooth ash powder showed excellent new bone formation. The temperature of heat treatment is an important factor in new bone formation. The high heat treatment was the optimal treatment method for making tooth ash than the low heat treatment.

  9. aorto-iliac occlusive disease in the different population groups

    African Journals Online (AJOL)

    T E Madiba, M Mars, J V Robbs. Background. It has previously been accepted that atherosclerotic disease is uncommon among blacks worldv.ride; however, recent studies have increasingly reported atherosclerotic disease in this group. Study design. Prospective study of hospital patients with aorta-iliac occlusive disease ...

  10. Repair of abdominal aortic aneurysms with aortouni- iliac stentgraft ...

    African Journals Online (AJOL)

    The aorto-uni-iliac (AUI) graft configuration with femoro-femoral bypass (FFBP) is a promising alternative which may extend the scope of EVAR for AAAs. The aim of ... Open surgery posed an unacceptably high risk to all patients owing to advanced age and/or American Society of Anesthesiologists (ASA) classification 3/4.

  11. Surgical treatment of anterior iliac spines fractures: our experience.

    Science.gov (United States)

    Pogliacomi, F; Calderazzi, F; Paterlini, M; Ceccarelli, F

    2014-09-24

    Iliac spines fractures represent 4% of all pelvic ring fractures and affect more frequently young people with open growth physis. These lesions are usually the consequence of an indirect avulsion trauma due to a sudden and forceful contraction of the muscles that take their origin on these structures. The treatment can be conservative or surgical according to the size and the amount of the dislocation of the fragment. The aim of this study is to evaluate the outcomes of surgical approach of these fractures. Between 2002 and 2010, 9 patients with fractures of anterior iliac spines were surgically treated. All patients, after an average follow up of 48 months, were evaluated clinically with the Non-arthritic Hip Score (NAHS) and radiographically in order to detect their consolidation. Complications related to the fracture and its treatment were analyzed. Time between trauma and return to sport performance (RSP) was recorded. Mean NAHS was 98 points and RSP averaged 82 days. In 2 cases a transient meralgia paresthetica was observed. In 2 other cases follow-up radiographs showed asymptomatic hyperostosis around the iliac spines. The treatment of iliac spines fractures is mainly conservative. When fragment size is bigger than 2 cm and is dislocated of more than 2 cm surgical treatment is indicated. We recommend a fixation with metallic screws in order to obtain a more stable fixation and an earlier recovery especially in high demanding patients.

  12. Postoperative internal iliac artery embolisation as salvage therapy ...

    African Journals Online (AJOL)

    Damage control surgery was performed, and bleeding was ultimately only controlled postoperatively using bilateral internal iliac artery radiological embolisation. The patient suffered acute kidney injury, which was multifactorial in aetiology, which recovered within 6 days. She was discharged from ICU in a stable condition 7 ...

  13. Aorto-iliac occlusive disease in the different population groups ...

    African Journals Online (AJOL)

    Background. It has previously been accepted that atherosclerotic disease is uncommon among blacks worldv.ride; however, recent studies have increasingly reported atherosclerotic disease in this group. Study design. Prospective study of hospital patients with aorta-iliac occlusive disease presenting to the vascUlar ...

  14. Postoperative internal iliac artery embolisation as salvage therapy ...

    African Journals Online (AJOL)

    aggressive resuscitation and transfusion of blood products. Damage control surgery was performed, and bleeding was ultimately only controlled postoperatively using bilateral internal iliac artery radiological embolisation. The patient suffered acute kidney injury, which was multifactorial in aetiology, which recovered within 6 ...

  15. Impact of intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction on left ventricular perfusion and function: a 6-month follow-up gated {sup 99m}Tc-MIBI single-photon emission computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Lipiec, Piotr [Medical University of Lodz, 2nd Department of Cardiology, Lodz (Poland); Medical University of Lodz, 2nd Department of Cardiology, Bieganski Hospital, Lodz (Poland); Krzeminska-Pakula, Maria; Plewka, Michal; Kasprzak, Jaroslaw D. [Medical University of Lodz, 2nd Department of Cardiology, Lodz (Poland); Kusmierek, Jacek; Plachcinska, Anna; Szuminski, Remigiusz [Medical University of Lodz, Department of Nuclear Medicine, Lodz (Poland); Robak, Tadeusz; Korycka, Anna [Medical University of Lodz, Department of Hematology, Lodz (Poland)

    2009-04-15

    We investigated the impact of intracoronary injection of autologous mononuclear bone marrow cells (BMC) in patients with acute ST elevation myocardial infarction (STEMI) on left ventricular volumes, global and regional systolic function and myocardial perfusion. The study included 39 patients with first anterior STEMI treated successfully with primary percutaneous coronary intervention. They were randomly assigned to the treatment group or the control group in a 2:1 ratio. The patients underwent baseline gated single-photon emission computed tomography (G-SPECT) 3-10 days after STEMI with quantitative and qualitative analysis of left ventricular perfusion and systolic function. On the following day, patients from the BMC treatment group were subjected to bone marrow aspiration, mononuclear BMC isolation and intracoronary injection. No placebo procedure was performed in the control group. G-SPECT was repeated 6 months after STEMI. Baseline and follow-up G-SPECT studies were available for 36 patients. At 6 months in the BMC group we observed a significantly enhanced improvement in the mean extent of the perfusion defect, the left ventricular perfusion score index, the infarct area perfusion score and the infarct area wall motion score index compared to the control group (p=0.01-0.04). However, the changes in left ventricular volume, ejection fraction and the left ventricular wall motion score index as well as the relative changes in the infarct area wall motion score index did not differ significantly between the groups. Intracoronary injection of autologous mononuclear BMC in patients with STEMI improves myocardial perfusion at 6 months. The benefit in infarct area systolic function is less pronounced and there is no apparent improvement of global left ventricular systolic function. (orig.)

  16. Disseminated carcinomatosis of the bone marrow from pancreatic cancer: a case report

    International Nuclear Information System (INIS)

    Namikawa, Hiroki; Takemoto, Yasuhiko; Makuuchi, Ayako; Kobayashi, Masanori; Kinuhata, Shigeki; Morimura, Mina; Ikebe, Takashi; Tanaka, Hiromu; Shuto, Taichi

    2016-01-01

    Most cases of disseminated carcinomatosis of the bone marrow (DCBM) arise from gastric cancer. DCBM from pancreatic cancer is very rare. We herein present a case of DCBM from pancreatic cancer. A 57-year-old man was referred to our hospital for severe lumbago. Laboratory data indicated that he suffered from disseminated intravascular coagulation (DIC). Non-contrast abdominal computed tomography (CT) revealed multiple bone masses but no other abnormal findings. Left iliac bone marrow biopsy revealed poorly differentiated adenocarcinoma cells. Positron emission tomography (PET)-CT showed diffuse abnormal uptake in the bones and tail of the pancreas. Contrast whole-body CT showed a tumor measuring approximately 28 mm in diameter with poor enhancement in the tail of the pancreas. The patient’s final diagnosis was pancreatic cancer located in the tail of the pancreas with diffuse bone metastases and DIC. His DCBM was thus believed to originate from the pancreatic cancer. He succumbed to the disease approximately 2 months after admission to our hospital. We herein describe a case of pancreatic cancer located in the tail of the pancreas with diffuse bone metastases and DIC, which, in our case, was DCBM. Therefore, in cases of DCBM with an unknown primary tumor, pancreatic cancer should be considered during differential diagnosis

  17. Percutaneous ethanol sclerotherapy for recurrent adventitial cystic disease of external iliac vein after surgical treatment: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ann, Jun Hyung; Kim, Jeong Ho; Byun, Sung Su; Kang, Jin Mo; Kim, Hyung Sik; Choi, Hye Young [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2015-12-15

    Adventitial cystic disease (ACD) is a rare, but well-characterized vascular disease. It is most commonly seen in the popliteal artery, but it has also been reported in the venous system. The most commonly involved segment has been the common femoral vein; the disease resulted in luminal compromise and extremity swelling. We report here on a case of percutaneous aspiration and ethanol sclerotherapy for recurrent ACD after surgery of the external iliac vein in a 70-year-old man who presented with a painless swelling of his left leg.

  18. Surgical management of a retroperitoneal pelvic desmoid tumour involving the sacrifice of external iliac vein and internal iliac vessels.

    Science.gov (United States)

    Goulding, E A; Bunting, M; Harle, R; Blomfield, P

    2017-05-01

    •Retroperitoneal pelvic desmoid tumours are rare with limited publications.•A rare case of a retroperitoneal pelvic desmoid tumour is discussed.•Excision was challenging requiring the sacrifice of some of the iliac vessels.•No other case reports document a surgical excision requiring this.•To date our patient suffers minimal morbidity and has had no recurrences.

  19. Calcar bone graft

    Energy Technology Data Exchange (ETDEWEB)

    Bargar, W.L.; Paul, H.A.; Merritt, K.; Sharkey, N.

    1986-01-01

    A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months in the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans.

  20. Iliac artery pseudoaneurysm after lumbar disc hernia operation

    Directory of Open Access Journals (Sweden)

    Mehmet Atay

    2016-03-01

    Full Text Available Lumbar disc herniation surgery is usually performed through a posterior approach. Vascular injuries can be counted among the complications. 39 years old male patient had lower extremity pain which has started after lumbar disc herniation surgery and continued for a month. Iliac arterial pseudoaneurysm has been detected in computerized tomography. It was successfully treated with vascular surgery [Cukurova Med J 2016; 41(0.100: 5-7

  1. Effect of the Use and Timing of Bone Marrow Mononuclear Cell Delivery on Left Ventricular Function After Acute Myocardial Infarction: The TIME Randomized Trial

    Science.gov (United States)

    Traverse, Jay H.; Henry, Timothy D.; Pepine, Carl J.; Willerson, James T.; Zhao, David X.M.; Ellis, Stephen G.; Forder, John R.; Anderson, R. David; Hatzopoulos, Antonis K.; Penn, Marc S.; Perin, Emerson C.; Chambers, Jeffrey; Baran, Kenneth W.; Raveendran, Ganesh; Lambert, Charles; Lerman, Amir; Simon, Daniel I.; Vaughan, Douglas E.; Lai, Dejian; Gee, Adrian P.; Taylor, Doris A.; Cogle, Christopher R.; Thomas, James D.; Olson, Rachel E.; Bowman, Sherry; Francescon, Judy; Geither, Carrie; Handberg, Eileen; Kappenman, Casey; Westbrook, Lynette; Piller, Linda B.; Simpson, Lara M.; Baraniuk, Sarah; Loghin, Catalin; Aguilar, David; Richman, Sara; Zierold, Claudia; Spoon, Daniel B.; Bettencourt, Judy; Sayre, Shelly L.; Vojvodic, Rachel W.; Skarlatos, Sonia I.; Gordon, David J.; Ebert, Ray F.; Kwak, Minjung; Moyé, Lemuel A.; Simari, Robert D.

    2013-01-01

    Context While the delivery of cell therapy following ST segment myocardial infarction (STEMI) has been evaluated in previous clinical trials, the influence of the timing of cell delivery on the effect on left ventricular (LV) function has not been analyzed in a trial that randomly designated the time of delivery. Objective To determine 1) the effect of intracoronary autologous bone marrow mononuclear cell (BMC) delivery following STEMI on recovery of global and regional LV function and 2) if timing of BMC delivery (3 versus 7 days following reperfusion) influences this effect. Design, Setting, and Patients Between July 17, 2008 and November 15, 2011, 120 patients were enrolled in a randomized, 2×2 factorial, double-blind, placebo-controlled trial of the National Heart, Lung, and Blood Institute (NHLBI)-sponsored Cardiovascular Cell Therapy Research Network (CCTRN) of patients with LV dysfunction (LV Ejection Fraction (LVEF) ≤45%) following successful primary percutaneous coronary intervention (PCI) of anterior STEMI. Interventions Intracoronary infusion of 150 × 106 BMCs or placebo (randomized 2:1 BMC:placebo) within 12 hours of aspiration and processing administered at Day 3 or Day 7 (randomized 1:1) post-PCI. Main Outcome Measures Co-primary endpoints were: 1) Change in global (LVEF) and regional (wall motion) LV function in infarct and border zones at 6 months measured by cardiac magnetic resonance imaging and 2) Change in LV function as affected by timing of treatment on Day 3 versus Day 7. Secondary endpoints included major adverse cardiovascular events as well as changes in LV volumes and infarct size. Results Patient mean age was 56.9±10.9 years with 87.5% male. At 6 months, LVEF increased similarly in both BMC (45.2±10.6 to 48.3±13.3 %) and placebo groups (44.5±10.8 to 47.8±13.6 %). No detectable treatment effect on regional LV function was observed in either infarct or border zones. Differences between therapy groups in the change in global LV

  2. Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

    Directory of Open Access Journals (Sweden)

    Michael Y. Wang

    2012-01-01

    Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

  3. S2 Alar-Iliac Screw Insertion: Technical Note with Pictorial Guide.

    Science.gov (United States)

    Yilmaz, Emre; Abdul-Jabbar, Amir; Tawfik, Tamir; Iwanaga, Joe; Schmidt, Cameron K; Chapman, Jens; Blecher, Ronen; Tubbs, R Shane; Oskouian, Rod J

    2018-02-10

    The S2 alar-iliac (S2AI) screw is a modification of the iliac fixation technique using the space between the neuroforamina of S1 and S2 as an insertion point to fix the sacrum to the ilium. To our knowledge, an anatomic review of the S2AI technique has not been described and the insertion point is vague and angles differ in reports from the literature. The purpose of the current anatomic illustration is to provide step-by-step techniques with fluoroscopic imaging to help confirm the safe placement of S2AI screws. The procedure was performed on the left and rights sides of a fresh, frozen, and thawed predissected male cadaver in a surgical training facility through a standard posterior midline exposure for placement of the S2AI screws. All screws were placed by a fellowship-trained spine surgeon and an attending spine surgeon. The specimen was placed prone, and a midline incision begun at the L4 or L5 spinous process. Using the anteroposterior and inlet views, the S1 dorsal sacral foramen, the S1 endplate, and the sacroiliac joint can be identified. The insertion point is 10 mm laterally between the S1 and S2 foramina and near to the sacroiliac joint. Aim toward the anterior inferior iliac spine is ensured by using a 30°-40° lateral angulation in the transverse plane and 20°-30° caudal angulation in the sagittal plane depending on the sacral angulation. Using lateral fluoroscopy, the acetabulum and greater sciatic notch can be identified and screw misplacement can be avoided. The screw length is measured and is usually between 60 and 90 mm (8- to 9-mm diameter). An elevator is used to identify the outer sacral cortex. Anteroposterior, obturator-outlet, and teardrop views are used to ensure correct screw insertion. Fluoroscopic guidance is crucial for optimal S2AI screw placement. Using the described technique allows a safe and correct insertion of the S2AI screw. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Predicting vertebral bone strength by vertebral static histomorphometry

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Ebbesen, Ebbe Nils; Mosekilde, Lis

    2002-01-01

    of the entire vertebral bodies (L-2) were used for histomorphometry. The other iliac crest biopsies and the L-3 were destructively tested by compression. High correlation was found between BV/TV or Tb.Sp and vertebral bone strength (absolute value of r = 0.86 in both cases). Addition of Tb.Th significantly....... No gender-related differences were found in any of the relationships. Neither static histomorphometry nor biomechanical testing of iliac crest bone biopsies is a good predictor of vertebral bone strength.......The study investigates the relationship between static histomorphometry and bone strength of human lumbar vertebral bone. The ability of vertebral histomorphometry to predict vertebral bone strength was compared with that of vertebral densitometry, and also with histomorphometry and bone strength...

  5. New Osseodensification Implant Site Preparation Method to Increase Bone Density in Low-Density Bone: In Vivo Evaluation in Sheep

    Science.gov (United States)

    Trisi, Paolo; Falco, Antonello; Podaliri Vulpiani, Michele

    2016-01-01

    Purpose: The aim of this study was to evaluate a new surgical technique for implant site preparation that could allow to enhance bone density, ridge width, and implant secondary stability. Materials and Methods: The edges of the iliac crests of 2 sheep were exposed and ten 3.8 × 10-mm Dynamix implants (Cortex) were inserted in the left sides using the conventional drilling method (control group). Ten 5 × 10-mm Dynamix implants (Cortex) were inserted in the right sides (test group) using the osseodensification procedure (Versah). After 2 months of healing, the sheep were killed, and biomechanical and histological examinations were performed. Results: No implant failures were observed after 2 months of healing. A significant increase of ridge width and bone volume percentage (%BV) (approximately 30% higher) was detected in the test group. Significantly better removal torque values and micromotion under lateral forces (value of actual micromotion) were recorded for the test group in respect with the control group. Conclusion: Osseodensification technique used in the present in vivo study was demonstrated to be able to increase the %BV around dental implants inserted in low-density bone in respect to conventional implant drilling techniques, which may play a role in enhancing implant stability and reduce micromotion. PMID:26584202

  6. Bone metastases only pure seminoma, evolution and treatment. Literature review and report of a clinical case

    International Nuclear Information System (INIS)

    Vázquez, A.; Cuello, M.; Terzieff, V.; Viola, A.

    2004-01-01

    The only bone metastases in pure seminoma is a biological entity extremely rare. We report a case studied since 2000, treatment and outcome. Case report: 35. Orquiectomizado in September 2000 AP: pure seminoma in the presence of a neoplastic nodule in the spermatic cord.Adjuvant lumboaorticas, left iliac and inguinal chains Rt., 3060 cGy in 3.2 sem. until December 2000 Normal tumor markers throughout the period. In Oct. 2001 TAC control morfoestructural altered posterior the sixth left costal arch. AP: puncture under TAC. Malignant germ cell tumor compatible with pure seminoma. C.O. single lesion. MDT is performed based on PEB for 4 cycles and additional RT obtaining a complete response with reduction bone lesion, asymptomatic until November 2002, again at the level falls costal, VIP x 3 New relapse dorsal paravertebral June 2003, Gemcitabine and Rt paclitaxel, dose intensification transplant. Keeps score high. Poor prognosis. Discussion: In the literature we found no reports of bone lesions only secondary to a pure seminoma. They are described in the context of a frame overall spread in advanced patients and in more than three or four including accompanying synchronous nodal, liver and lung damage. Subsequent developments mark the disease resistance to treatments performed. The three lines are Qt prior to transplantation have shown that best results for the treatment of disease. We discuss the time introduction thereof to obtain a durable complete response. If the marker not normalized but not displayed clinical or paraclinical disease prognosis is bad in the short term

  7. An Extensive Stanford Type A Aortic Dissection Involving Bilateral Carotid and Iliac Arteries

    Directory of Open Access Journals (Sweden)

    E. W. Lee

    2013-01-01

    Full Text Available We present a rare case of continuous, extensive aortic dissection (AD involving the bilateral common carotid arteries, the ascending, thoracic, and abdominal aorta, and bifurcation of the right common iliac artery. A 61-year-old man with history of chronic hypertension presented with a one-day history of chest pain, vertigo, left facial drooping, and left hemiparesis. Despite the presence of bilateral carotid bruits, doppler ultrasound of the neck was postponed, and the patient was treated with thrombolytic therapy for a presumed ischemic stroke. The patient's symptoms began to resolve within an hour of treatment, at which time treatment was withheld. Ultrasound performed the following day showed dissection of bilateral common carotid arteries, and CT angiography demonstrated extensive AD as described earlier. The patient subsequently underwent cardiovascular surgery and has been doing clinically well since then. AD has a myriad of manifestations depending on the involvement of aortic branches. Our paper illustrates the importance of having a high index of suspicion for AD when a patient presents with a picture of ischemic stroke, since overlapping signs and symptoms exist between AD and stroke. Differentiating between the two conditions is central to patient care as thrombolytic therapy can be helpful in stroke, but detrimental in AD.

  8. Clinical importance of a star shaped branch of internal iliac artery and unusual branches of an abnormal obturator artery: rare vascular variations

    Directory of Open Access Journals (Sweden)

    Satheesha Badagabettu Nayak

    Full Text Available Abstract The internal iliac artery (IIA is one of the branches of the common iliac artery and supplies the pelvic viscera, the musculoskeletal part of the pelvis, the gluteal region, the medial thigh region and the perineum. During routine cadaveric dissection of a male cadaver for undergraduate Medical students, we observed variation in the course and branching pattern of the left IIA. The artery gave rise to two common trunks and then to the middle rectal artery, inferior vesicle artery and superior vesicle artery. The first, slightly larger, common trunk gave rise to an unnamed artery, the lateral sacral artery and the superior gluteal artery. The second, smaller, common trunk entered the gluteal region through the greater sciatic foramen, below the piriformis muscle and presented a stellate branching pattern deep to the gluteus maximus muscle. Two of the arteries forming the stellate pattern were the internal pudendal artery and the inferior gluteal artery. The other two were muscular branches.

  9. Reconstruction of Traumatic External Iliac Artery Dissection Due to Vascular Clamping.

    Science.gov (United States)

    Kırnap, Mahir; Özçelik, Ümit; Akdur, Aydıncan; Ayvazoğlu Soy, Ebru H; Işıklar, İclal; Yarbuğ Karakayalı, Feza; Moray, Gökhan; Haberal, Mehmet

    2017-10-31

    Traumatic external iliac artery dissection after renal transplant is a rare complication, but it should be urgently managed due to its devastating effects on graft and lower limb circulation. External iliac artery dissection is seen more in recipients with diabetes mellitus and comorbid disease. Recipients with external iliac artery dissection should be treated immediately by percutaneus angioplasty or surgical reconstruction. In this study, we reported the management of 2 kidney transplant cases with external iliac artery dissection due to vascular clamping of the artery. External iliac artery dissection was diagnosed by ultrasonography in both cases. After failed percutaneous interventional angioplasty, we reconstructed the external iliac artery dissection surgically and replaced the external iliac artery with polytetra-fluoroethylene grafts in both patients. Both patients were discharged with normal functioning grafts showing 0.9 and 0.8 mg/dL serum creatinine levels at month 3 posttransplant. Close monitoring of recipients after transplant is mandatory for early diagnosis and early management of external iliac artery dissection to prevent graft loss and preserve lower limb circulation. Routine Doppler ultrasonography is an inexpensive and useful tool for early diagnosis in cases of sudden cessation or decrease in urine. In cases of failed percutaneous interventional angioplasty, reconstruction with synthetic vascular grafts can be safely applied in external iliac artery dissection.

  10. Bone-to-implant contact after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios in mini pigs

    DEFF Research Database (Denmark)

    Jensen, Thomas; Schou, Søren; Gundersen, Hans Jørgen G

    2012-01-01

    OBJECTIVES: The objective was to test the hypotheses: (i) no differences in bone-to-implant contact formation, and (ii) no differences between the use of autogenous mandibular or iliac bone grafts, when autogenous bone, Bio-Oss mixed with autogenous bone, or Bio-Oss is used as graft for the maxil......OBJECTIVES: The objective was to test the hypotheses: (i) no differences in bone-to-implant contact formation, and (ii) no differences between the use of autogenous mandibular or iliac bone grafts, when autogenous bone, Bio-Oss mixed with autogenous bone, or Bio-Oss is used as graft...... for the maxillary sinus floor augmentation. MATERIAL AND METHODS: Bilateral sinus floor augmentation was performed in 40 mini pigs with: (A) 100% autogenous bone, (B) 75% autogenous bone and 25% Bio-Oss, (C) 50% autogenous bone and 50% Bio-Oss, (D) 25% autogenous bone and 75% Bio-Oss, or (E) 100% Bio......-Oss. Autogenous bone was harvested from the iliac crest or the mandible and the graft composition was selected at random and placed concomitant with the implant placement. The animals were euthanized 12 weeks after surgery. Bone-to-implant contact was estimated by stereological methods and summarized as median...

  11. Assessment of an evolutive tertiary syphilis by bone scintigraphy. A case report; Evaluation d'une syphilis tertiaire evolutive en scintigraphie osseuse. A propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Andriamisandratsoa, N.; Scheiber, C.; Grucker, D. [Faculte de Medecine, Service de Medecine Nucleaire, Institut de Physique Biologique, 67 - Strasbourg (France); Dery, M. [Medecine Generale, Geriatrie, 67 - Strasbourg (France)

    2003-10-01

    One patient complained of persisting diffuse bone pain, with greater intensity in the pelvis. HDP {sup 99m}Tc bone scintigraphy showed increased uptake around the right sacro-iliac joint and in the right iliac area due to increased osteoblastic activity, thereby providing functional information about the evolutive nature of the bone lesion. The X-scanner only revealed osteolysis in the same location. A blood test confirmed the diagnosis of tertiary syphilis. (author)

  12. Intravascular ultrasound for iliac artery imaging. Clinical review

    DEFF Research Database (Denmark)

    Vogt, K G; Schroeder, T V

    2001-01-01

    IVUS is able to produce trans-sectional images of the iliac arteries at a high resolution. The three layered appearance of the arterial wall can be visualized. In the atherosclerotic diseased artery calcified plaques can be discerned from non-calcified plaques, and the distribution of the plaque......-eccentric or concentric-can be determined. IVUS seems to be superior to arteriography in quantifying the degree of stenosis, being able to relate the luminal area to the mediabounded area at the same site of the artery. The discrepancy between IVUS and arteriography is even greater when evaluating residualstenosis after...

  13. Reconstruction of alveolar bone defects using bone morphogenetic protein 2 mediated rabbit dental pulp stem cells seeded on nano-hydroxyapatite/collagen/poly(L-lactide).

    Science.gov (United States)

    Liu, Hong-Chen; E, Ling-Ling; Wang, Dong-Sheng; Su, Fang; Wu, Xia; Shi, Zhan-Ping; Lv, Yan; Wang, Jia-Zhu

    2011-10-01

    The objective of the present study was to evaluate the capacity of a tissue-engineered bone complex of recombinant human bone morphogenetic protein 2 (rhBMP-2)-mediated dental pulp stem cells (DPSCs) and nano-hydroxyapatite/collagen/poly(L-lactide) (nHAC/PLA) to reconstruct critical-size alveolar bone defects in New Zealand rabbit. Autologous DPSCs were isolated from rabbit dental pulp tissue and expanded ex vivo to enrich DPSCs numbers, and then their attachment and differentiation capability were evaluated when cultured on the culture plate or nHAC/PLA. The alveolar bone defects were treated with nHAC/PLA, nHAC/PLA+rhBMP-2, nHAC/PLA+DPSCs, nHAC/PLA+DPSCs+rhBMP-2, and autogenous bone (AB) obtained from iliac bone or were left untreated as a control. X-ray and a polychrome sequential fluorescent labeling were performed postoperatively and the animals were sacrificed 12 weeks after operation for histological observation and histomorphometric analysis. Our results showed that DPSCs expressed STRO-1 and vementin, and favored osteogenesis and adipogenesis in conditioned media. DPSCs attached and spread well, and retained their osteogenic phenotypes on nHAC/PLA. The rhBMP-2 could significantly increase protein content, alkaline phosphatase activity/protein, osteocalcin content, and mineral formation of DPSCs cultured on nHAC/PLA. The X-ray graph, the fluorescent, histological observation, and histomorphometric analysis showed that the nHAC/PLA+DPSCs+rhBMP-2 tissue-engineered bone complex had an earlier mineralization and more bone formation inside the scaffold than nHAC/PLA, nHAC/PLA+rhBMP-2, and nHAC/PLA+DPSCs, or even autologous bone. Implanted DPSCs' contribution to new bone was detected through transfected eGFP genes. Our findings indicated that stem cells existed in adult rabbit dental pulp tissue. The rhBMP-2 promoted osteogenic capability of DPSCs as a potential cell source for periodontal bone regeneration. The nHAC/PLA could serve as a good scaffold for

  14. Clinical characteristics of external iliac artery branch injury in pelvic trauma.

    Science.gov (United States)

    Tanizaki, Shinsuke; Maeda, Shigenobu; Ishida, Hiroshi; Yamamoto, Toru; Yoshikawa, Jun

    2017-11-01

    The clinical characteristics of an injury of external iliac artery branches in blunt pelvic trauma have not yet been sufficiently studied. We evaluated the relationship between injury characteristics and the presence of an injury to external iliac artery branches in blunt pelvic trauma. A retrospective review of patients admitted with blunt pelvic trauma was conducted over an 11-year period. Charts were reviewed for age, gender, injury characteristics, injury severity score, length of stay in the intensive care unit, transfusion requirements, and fracture pattern. Of 286 blunt pelvic trauma patients, 90 patients (31%) underwent pelvic angiography. Of those patients, 10 (11%) had the injuries of the branches of external iliac artery and 88 (97%) had the injuries of the branches of internal iliac artery. Those patients with external iliac artery branch injuries were significantly associated with hemodynamic instability, when compared to those without external iliac artery branch injuries. There were no significant differences between the patients with and without external iliac artery branch injury with regard to the anatomical characteristics of pelvic trauma. Blunt pelvic trauma with hemodynamic instability may be associated with concomitant external iliac artery branch injury. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Ruptured internal iliac artery aneurysm presenting as Cullen’s sign

    Directory of Open Access Journals (Sweden)

    Choon K. Gan

    2010-11-01

    Full Text Available Cullen’s sign or periumbilical ecchymosis, is classically considered as an indicator of acute hemorrhagic pancreatitis or ruptured ectopic pregnancy. Internal iliac artery aneurysms are rare and are usually asymptomatic. We present a case of a contained rupture of the internal iliac artery aneurysm presenting with Cullen’s sign.

  16. Analysis of Iliac Artery Geometric Properties in Fenestrated Aortic Stent Graft Rotation.

    Science.gov (United States)

    Doyle, Matthew G; Crawford, Sean A; Osman, Elrasheed; Eisenberg, Naomi; Tse, Leonard W; Amon, Cristina H; Forbes, Thomas L

    2018-04-01

    A complication of fenestrated endovascular aneurysm repair is the potential for stent graft rotation during deployment causing fenestration misalignment and branch artery occlusion. The objective of this study is to demonstrate that this rotation is caused by a buildup of rotational energy as the device is delivered through the iliac arteries and to quantify iliac artery geometric properties associated with device rotation. A retrospective clinical study was undertaken in which iliac artery geometric properties were assessed from preoperative imaging for 42 cases divided into 2 groups: 27 in the nonrotation group and 15 in the rotation group. Preoperative computed tomography scans were segmented, and the iliac artery centerlines were determined. Iliac artery tortuosity, curvature, torsion, and diameter were calculated from the centerline and the segmented vessel geometry. The total iliac artery net torsion was found to be higher in the rotation group compared to the nonrotation group (23.5 ± 14.7 vs 14.6 ± 12.8 mm -1 ; P = .05). No statistically significant differences were found for the mean values of tortuosity, curvature, torsion, or diameter between the 2 groups. Stent graft rotation occurred in 36% of the cases considered in this study. Cases with high iliac artery total net torsion were found to be more likely to have stent graft rotation upon deployment. This retrospective study provides a framework for prospectively studying the influence of iliac artery geometric properties on fenestrated stent graft rotation.

  17. Morphology of congenital portosystemic shunts involving the left colic vein in dogs and cats.

    Science.gov (United States)

    White, R N; Parry, A T

    2016-05-01

    To describe the anatomy of congenital portosystemic shunts involving the left colic vein in dogs and cats. Retrospective review of a consecutive series of dogs and cats managed for congenital portosystemic shunts. For inclusion a shunt involving the left colic vein with recorded intraoperative mesenteric portovenography or computed tomography angiography along with direct gross surgical observations at the time of surgery was required. Six dogs and three cats met the inclusion criteria. All cases had a shunt which involved a distended left colic vein. The final communication with a systemic vein was variable; in seven cases (five dogs, two cats) it was via the caudal vena cava, in one cat it was via the common iliac vein and in the remaining dog it was via the internal iliac vein. In addition, two cats showed caudal vena cava duplication. The morphology of this shunt type appeared to be a result of an abnormal communication between either the left colic vein or the cranial rectal vein and a pelvic systemic vein (caudal vena cava, common iliac vein or internal iliac vein). This information may help with surgical planning in cases undergoing shunt closure surgery. © 2016 British Small Animal Veterinary Association.

  18. Radiodiagnosis of hemophiliac bone pseudotumors

    International Nuclear Information System (INIS)

    Fedorov, V.V.; Chantseva, E.A.

    1992-01-01

    Of 259 hemophiliacs bone pseudotumors were diagnosed in 11 (4.3 %); they were localised in the femur (6 cases), calcaneus (4) and in the iliac bone (3). Two cases of combined fermoral and calcaneal lesions and 4 cases of bone fracture were observed. As a rule, pseudotumors developed in hemophiliacs with severe disease. An x-ray picture of a pseudotumor depended on its site and was characterized by a large soft tissue tumor shadow, often with calcinosis, and serious destructive changes in bones in the form or round foci of 7 cm in diameter with clear-cut contours. An adge defect of the cortical layer was defined in the diaphysis of the femoral bone (15 cm long). Destructive changes were often accompanied by osteosclerosis and periostitis

  19. Symptomatic Type B Intramural Aortic Hematoma as a Complication of Retrograde Right Common Iliac Artery Dissection.

    Science.gov (United States)

    Sonetto, Alessia; Gargiulo, Mauro; Gallitto, Enrico; Ancetti, Stefano; Faggioli, Gianluca; Stella, Andrea

    2018-02-16

    To report the endovascular treatment of a spontaneous iliac artery dissection (IAD) involving iliac bifurcation, complicated by a type B intramural aortic hematoma (IMH). A 38-year-old female patient came to our institution referring an acute ascending back pain. The angio computed tomography scan showed the presence of a retrograde right IAD with entry tear at the iliac bifurcation and a concomitant aortic IMH. After hypogastric embolization with a vascular plug, self-expanding stent graft was placed to cover the iliac entry tear. At 12 months, the patient was asymptomatic and the angio computed tomography scan showed the patency of the iliac graft without IMH. Endovascular treatment of spontaneous IAD is a safe and effective option in symptomatic patient complicated with type B IMH. Published by Elsevier Inc.

  20. Acute embolic occlusion of the right common iliac artery after revision total hip arthroplasty treated with catheter-directed thrombolysis and balloon angioplasty: A case report

    Directory of Open Access Journals (Sweden)

    Hongqi Yang

    2015-07-01

    Full Text Available Methods: A 63-year-old woman with atrial fibrillation presented clinical symptoms and signs of acute ischemia in the right lower extremity on the 17th postoperative day after revision total hip arthroplasty of the left hip for aseptic loosening of femoral component. Aspirin was discontinued 7 days before surgery. Both computed tomography angiography and digital subtraction angiography demonstrated complete occlusion of the right common iliac artery. An emergency catheter-directed thrombolysis with urokinase combined with balloon angioplasty was performed to obtain complete patency of the right common iliac artery. Results: The patient received anticoagulation and antiplatelet therapy postoperatively and was fine at the 2-year follow-up. Conclusions: This case demonstrated that catheter-directed thrombolysis combined with balloon angioplasty could be an efficacious, minimally invasive approach for the treatment of acute embolic occlusion of the common iliac artery. Preoperative anticoagulation for patients undergoing total hip arthroplasty with long-term use of aspirin for atrial fibrillation needs further investigation.

  1. Use of autologous bone graft in anterior cervical decompression: morbidity & quality of life analysis.

    LENUS (Irish Health Repository)

    Heneghan, Helen M

    2009-01-01

    BACKGROUND: Autologous iliac crest graft has long been the gold standard graft material used in cervical fusion. However its harvest has significant associated morbidity, including protracted postoperative pain scores at the harvest site. Thus its continued practice warrants scrutiny, particularly now that alternatives are available. Our aims were to assess incidence and nature of complications associated with iliac crest harvest when performed in the setting of Anterior Cervical Decompression (ACD). Also, to perform a comparative analysis of patient satisfaction and quality of life scores after ACD surgeries, when performed with and without iliac graft harvest. METHODS: All patients who underwent consecutive ACD procedures, with and without the use of autologous iliac crest graft, over a 48 month period were included (n = 53). Patients were assessed clinically at a minimum of 12 months postoperatively and administered 2 validated quality of life questionnaires: the SF-36 and Cervical Spine Outcomes Questionnaires (Response rate 96%). Primary composite endpoints included incidence of bone graft donor site morbidity, pain scores, operative duration, and quality of life scores. RESULTS: Patients who underwent iliac graft harvest experienced significant peri-operative donor site specific morbidity, including a high incidence of pain at the iliac crest (90%), iliac wound infection (7%), a jejunal perforation, and longer operative duration (285 minutes vs. 238 minutes, p = 0.026). Longer term follow-up demonstrated protracted postoperative pain at the harvest site and significantly lower mental health scores on both quality of life instruments, for those patients who underwent autologous graft harvest CONCLUSION: ACD with iliac crest graft harvest is associated with significant iliac crest donor site morbidity and lower quality of life at greater than 12 months post operatively. This is now avoidable by using alternatives to autologous bone without compromising clinical

  2. Utilization of a Technique of Percutaneous S2 Alar-Iliac Fixation in Immunocompromised Patients with Spondylodiscitis.

    Science.gov (United States)

    Funao, Haruki; Kebaish, Khaled M; Isogai, Norihiro; Koyanagi, Takahiro; Matsumoto, Morio; Ishii, Ken

    2017-01-01

    Spondylodiscitis still remains a serious problem, especially in immunocompromised patients. Surgery is necessary when nonsurgical treatment is unsuccessful. Although minimally invasive spine stabilization (MISt) with percutaneous pedicle screws is less invasive, percutaneous sacropelvic fixation techniques are not common practice. Here, we describe 2 cases in which spondylodiscitis in the lumbosacral spine was treated with percutaneous stabilization using an S2 alar-iliac (S2AI) screw technique. Case 1 is a 77-year-old man who presented with low back pain and high fever. He was diagnosed with spondylodiscitis at L4-5. He had a history of lung cancer, which was complicated by the recurrence. Because nonsurgical treatment failed, MISt with percutaneous S2AI screws was performed. The patient's low back pain subsided markedly 1 week after surgery, and there was no screw/rod breakage or recurrence of infection during the follow-up period. Case 2 is a 71-year-old man who presented with hemiparesis because of a stroke. He also developed high fever and was diagnosed with spondylodiscitis at L5-S1. Because nonsurgical treatment failed, the patient was treated by MISt with percutaneous S2AI screws while being maintained on anticoagulants for stroke. Although his clinical symptoms had markedly improved, a postoperative lumbar computed tomography scan demonstrated a bone defect at L5-S1. An anterior spinal fusion with an iliac bone graft at L5-S1 was performed when a temporary cessation of anticoagulants was permitted. Both patients tolerated the procedures well and had no major perioperative complications. MISt with percutaneous S2AI screws was less invasive and efficacious for lumbosacral spondylodiscitis in providing rigid percutaneous sacropelvic fixation. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Bone metastasis from malignant phyllodes breast tumor: report of two cases.

    Science.gov (United States)

    El Ochi, Mohamed Reda; Toreis, Mehdi; Benchekroun, Mohamed; Benkerroum, Zineb; Allaoui, Mohamed; Ichou, Mohamed; El Khannoussi, Basma; Albouzidi, Abderrahman; Oukabli, Mohamed

    2016-01-01

    Phyllodes tumors are rare fibroepithelial tumors accounting for less than 1 % of all breast neoplasms. They are malignant in 20 % of cases. Only a few cases of malignant phyllodes tumors metastatic to bone have been reported. Case 1: A 40 year-old white woman presented with three-week history of pain and functional impairment of the left lower limb. Her clinical past was remarkable for previous left mastectomy and radiotherapy for malignant phyllodes tumor performed one year ago. Computed tomography revealed a moth-eaten appearance of the left femoral head. The patient underwent computed guided femoral head biopsy. Pathological findings were consistent with metastatic malignant phyllodes tumor. The patient received ifosfamide and adriamycin chemotherapy. She is doing well without any evidence of progression on her imaging follow- up after 8 months. Case 2: A 48 year-old white woman, with history of bilateral mastectomy and radiotherapy for malignant phyllodes tumor performed one and two year ago, presented with four-week left lower quadrant abdominal pain. Computed tomography and magnetic resonance imaging revealed a solid aggressive osteolytic mass of the left iliac bone with extensive soft tissue invasion. Biopsy of the tumor was performed and showed a sarcomatous proliferation consistent with metastatic malignant phyllodes tumor. The patient received the same chemotherapy regimen as in the first case but without any response on her imaging follow up after 6 months. Malignant phyllodes tumor is a rare and aggressive fibroepithelial neoplasm. An accurate diagnosis of metastases should be based on clinicopathological correlation allowing exclusion of differential diagnoses. The goal of successful managing this tumor is early detection and complete resection prior to dissemination.

  4. Quantitative magnetic resonance imaging in autologous bone marrow transplantation for Hodgkin's disease.

    OpenAIRE

    Smith, S. R.; Williams, C. E.; Edwards, R. H.; Davies, J. M.

    1989-01-01

    Fifteen consecutive patients with refractory or relapsed Hodgkin's disease (HD) referred for autologous bone marrow transplantation (ABMT) underwent quantitative magnetic resonance (MR) studies of the lumbar vertebral bone marrow. Markedly elevated lumbar vertebral marrow T1 values suggestive of bone marrow involvement with HD were seen in four patients, two of whom had no evidence of HD on bilateral iliac crest bone marrow biopsy. Serial studies showed normalisation of T1 values in the post-...

  5. Constipation following bilateral of internal iliac artery aneurysms

    Directory of Open Access Journals (Sweden)

    S Morita

    2012-09-01

    Full Text Available A 72-year-old man presented with constipation. He was hypertensive and suffered from chronic constipation. On arrival, the patient was fully conscious, and his vital signs were stable. He requested an enema because this treatment had proved effective in the past. On physical examination, a hard palpable mass was detected in the lower abdomen. Computed tomography was performed with contrast media. It revealed an abdominal aortic aneurysm (AAA and bilateral internal iliac artery aneurysms (IIAAs; the latter obstructing the sigmoid colon. We believe that this obstruction was the cause of constipation. The patient underwent Y-graft replacement for the treatment of the AAA and bilateral IIAAs. The surgery was successful, and constipation has not recurred since. As constipation is the most common digestive disorder in the general population, all physicians should be aware that chronic constipation can be caused by bilateral IIAAs.

  6. Costo-iliac distance: a physical sign of understated importance.

    Science.gov (United States)

    Barry, P J; O'Mahony, D

    2012-03-01

    Osteoporosis is a common condition, especially affecting the older female population. The ability to predict loss of lumbar height using simple anatomical measurements would be a useful tool. Forty subjects were recruited. Mean age was 72 years. Arm span (AS) and the costo-iliac distance (CID) were measured. The CID/AS ratio was calculated. The L(1)-L(4) vertebral height of each patient was obtained from dual-energy X-ray absorptiometry (DEXA). There was a statistically significant correlation between the lumbar height and CID/AS ratio (R (2) = 0.79, p < 0.001). The CID/AS ratio may be a useful bedside test in identifying loss of lumbar vertebral height.

  7. beta-TCP Versus Autologous Bone for Repair of Alveolar Clefts in a Goat Model.

    NARCIS (Netherlands)

    Ruiter, A. de; Meijer, G.J.; Dormaar, T.; Janssen, N.; Bilt, A. van der; Slootweg, P.J.; Bruijn, J. de; Rijn, L. van; Koole, R.A.

    2011-01-01

    Objective : The aim of this study in goats was to test the hypothesis that a novel synthetic bone substitute beta tricalcium phosphate (beta-TCP) can work as well as autologous bone harvested from the iliac crest for grafting and repair of alveolar clefts. Design : Ten adult Dutch milk goats ( Capra

  8. Differential Cell Count of Bone Marrow Aspirates in Steady-state ...

    African Journals Online (AJOL)

    Bone marrow was aspirated from the posterior superior iliac spine. Slides were stained with MayGrünwald-Giemsa stain. Proportions of erythroid, myeloid, lymphoid and megakaryocytic cells out of 250 nucleated bone marrow cells were determined. Results: Steady state mean packed cell volume (PCV) was 0.2 ± 0.017 L/L.

  9. The diagnostic and prognostic value of serum bone Gla protein (osteocalcin) in patients with recurrent breast cancer

    DEFF Research Database (Denmark)

    Kamby, C; Egsmose, C; Söletormos, G

    1993-01-01

    Serum bone Gla protein (S-BGP), a marker of bone metabolism, was measured in 60 patients included in a staging programme for recurrent breast cancer. Other diagnostic procedures comprised S-alkaline phosphatase (S-AP), bone scan (B-scan), bilateral iliac crest bone marrow biopsies, and radiological...... bone survey. The sites of recurrence were bone (61%), bone marrow (46%), soft tissue (52%), lung (13%), pleura (11%), liver (4%), and brain (2%). Radiology and bone biopsy served as key diagnoses as to the presence or absence of bone metastases. The diagnostic efficiency of B-scan and S-AP was greater...

  10. Revascularisation of fresh compared with demineralised bone grafts in rats

    DEFF Research Database (Denmark)

    Solheim, E; Pinholt, E M; Talsnes, O

    2001-01-01

    Revascularisation of bone grafts is influenced by both the anatomical origin and the pre-implantation processing of the graft. We investigated the revascularisation by entrapment of 141Ce (cerium)-labelled microspheres in large, fresh and demineralised syngeneic grafts of predominantly cancellous...... iliac bone grafts, p = 0.8. The results suggest that whereas fresh cancellous grafts are revascularised more completely than fresh cortical grafts, there is no difference in the revascularisation of demineralised cancellous and cortical grafts. In addition, fresh cancellous bone is revascularised more...... completely than demineralised cancellous bone, whereas there is no difference between fresh and demineralised cortical bone....

  11. Diagnosis Of The Severely Anaemic Patients Using The Bone ...

    African Journals Online (AJOL)

    Bone marrow aspirated from either the patients' anterior or posterior superior iliac spine were stained and examined. Smears were fixed in alcohol, stained with Leishman stain and examined under the microscope. Pearl's stain for haemosiderin was used to confirm presence of iron in the marrow. Results:The smears were ...

  12. Use of Bone Marrow derived Stem Cells in patients with Cardiovascular Disorders

    Directory of Open Access Journals (Sweden)

    Abraham S

    2007-01-01

    Full Text Available Patients with end stage heart failure have very few treatment options. The long waiting times for transplant and the complications associated with immunosuppression has led to the search for alternatives. Subsequent to the isolation and characterization of stem cells, tremendous advances have been made and the safety and feasibility of autologous bone marrow derived stem cells has been proven in preclinical studies. Clinical studies have also shown mobilized cells repair the infracted heart, improving function and survival. We have started a clinical study to evaluate the efficacy of bone marrow derived stem cells. Bone-marrow was aspirated from the right iliac crest and the stem cells were isolated by density gradient method and suspended according to the mode of delivery.From Jan 2007 till date 10 patients (8 adults, 2 children, age with end stage cardiovascular disorder of varied etiology (Ischemic left ventricular dysfunction - 6 patients, Primary pulmonary hypertension - 2 patients, Dilated cardiomyopathy -1 patient, Biventricular non-compaction -1 patient underwent stem cell therapy. All patients were evaluated and cardiac function was measured by using echocardiography and thallium scintigraphy. There were no procedure related complications. These patients are being regularly followed-up and one patient who has completed 6-month follow-up has shown improvement in perfusion as well as increase in ejection fraction of 10%. Stem cell therapy in patients with end-stage cardiovascular disorder might be a promising tool by means of angiogenesis and other paracrine mechanisms.

  13. Anterior cervical discectomy and fusion with "mini-invasive" harvesting of iliac crest graft versus polyetheretherketone (PEEK) cages: a retrospective outcome analysis.

    Science.gov (United States)

    Spallone, A; Marchione, P; Li Voti, P; Ferrante, L; Visocchi, M

    2014-12-01

    Limited outcome data suggested a minimal evidence for better clinical and radiographic outcome of polyetheretherketone cages compared with bone grafts in the anterior cervical discectomy and fusion. We proposed a "mini-invasive" surgical technique for harvesting iliac crest grafts that provides bicortical autografts of sufficient size to be used in multilevel cervical procedures and is not associated with long-term significant donor site pain. All patients undergoing discectomy and fusion during a three years period were consecutively extracted from computer database and retrospectively evaluated by means of telephonic interview, independently from surgical procedure (iliac crest autograph or prosthesis). Two procedure-blinded neurologists retrieved baseline clinical-demographic data and pre-surgical scores of routinely performed scales for pain and functional abilities. Afterwards, a third blinded neurologist performed clinical follow up by a semi-structured interview including Verbal Analog Scale for pain and Neck Disability Scale for discomfort. 80 patients out of 115 selected cases completed the follow up. 40 patients had been treated by mini-invasive bone graft harvesting and 40 with PEEK cages for cervical fusion. VAS for both neck and arm pain were significantly reduced within groups. Patients did not complaint any significant pain and/or paraesthesias at donor site from the first week after intervention. Neck Disability Scale was significantly lower at the end of follow up in both groups. "Miniinvasive" bicortical autografts is a less invasive, inexpensive technique to harvest iliac graft that may produce a reduced amount of general and local donor-site complications without outcome differences with prosthetic cages. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  14. Iliac Vein Interrogation Augments Venous Ulcer Healing in Patients Who Have Failed Standard Compression Therapy along with Pathological Venous Closure.

    Science.gov (United States)

    Mousa, Albeir Y; Broce, Mike; Yacoub, Michael; AbuRahma, Ali F

    2016-07-01

    Treatment of venous ulcers is demanding for patients, as well as clinicians, and the investigation of underlying venous hypertension is the cornerstone of therapy. We propose that occult iliac vein stenosis should be ruled out by iliac vein interrogation (IVI) in patients with advanced venous stasis. We conducted a systematic retrospective analysis of a consecutive series of patients who presented with CEAP (clinical, etiological, anatomical, and pathophysiological) 6 venous disease. All patients had great saphenous vein ablation, compressive treatment, wound care (including Unna boot compression), and perforator closure using ablation therapy. Iliac vein stenosis was defined as ≥50% stenosis in cross-sectional surface area on intravascular ultrasound. Primary outcomes include time of venous ulcer healing and/or measurable change in the Venous Clinical Severity Score. Twenty-two patients with CEAP 6 venous disease met the inclusion criteria (active ulcers >1.5 cm in diameter). The average age and body mass index were 62.2 ± 9.2 years and 41.7 ± 16.7, respectively. The majority were female (72.7%) with common comorbidities, such as hyperlipidemia (54.5%), hypertension (36.4%), and diabetes mellitus (27.3%). Twenty-nine ulcers with an average diameter of 3.4 ± 1.9 cm and a depth of 2.2 ± 0.5 mm were treated. The majority of the ulcers occurred on the left limb (n = 17, 58.6%). Average perforator venous reflux was 3.6 ± 0.8 sec, while common femoral reflux was 1.8 ± 1.6. The majority (n = 19, 64.5%) of the perforator veins were located at the base of the ulcer, while the remainder (n = 10, 34.5%) were within 2 cm from the base. Of the 13 patients who underwent IVI, 8 patients (61.5%) had stenosis >50% that was corrected with iliac vein angioplasty and stenting (IVAS). There was a strong trend toward shorter healing time in the IVI group (7.9 ± 9.5 weeks) than for patients in the no iliac vein interrogation (NIVI) group (20.2 ± 15

  15. Anterior superior iliac spine avulsion fracture presenting as meralgia paraesthetica in an adolescent sprinter.

    Science.gov (United States)

    Hsu, Chia-Yu; Wu, Chu-Ming; Lin, Shih-Wei; Cheng, Kui-Lin

    2014-02-01

    We report here a rare case of anterior superior iliac spine avulsion fracture that presented initially as meralgia paraesthetica. A 14-year-old male sprinter presented with anterior superior iliac spine avulsion fracture, which was not observed on initial plain radiograph of the hip, but was diagnosed by ultrasound. Both clinical presentations and electrophysiological studies indicated meralgia paraesthetica. The lateral femoral cutaneous nerve of the thigh was probably compressed by an inguinal haematoma resulting from sartorius muscle strain, which was detected on musculoskeletal ultrasound. Computed tomography of the pelvis confirmed anterior superior iliac spine avulsion fracture. Meralgia paraesthetica in adolescents can be due to anterior superior iliac spine avulsion fracture. Sonography is a valuable tool for screening for muscular haematoma and occult fractures, which may allow clinicians to diagnose the nature of the muscle injury, and thus guide the most appropriate therapeutic strategy.

  16. Balloon occlusion of the internal iliac arteries in the multidisciplinary management of placenta percreta

    DEFF Research Database (Denmark)

    Clausen, Caroline; Stensballe, Jakob; Albrechtsen, Charlotte K

    2013-01-01

    Objective. To evaluate our experience with prophylactic balloon occlusion of the internal iliac arteries as a part of a multidisciplinary algorithm for the management of placenta percreta. Design. Consecutive case series. Setting. Rigshospitalet, Copenhagen University Hospital, Denmark. Sample. S...

  17. Hybrid management of a spontaneous ilio-iliac arteriovenous fistula: a case report

    LENUS (Irish Health Repository)

    O'Brien, Gavin C

    2011-08-22

    Abstract Introduction Spontaneous iliac arteriovenous fistulae are a rare clinical entity. Such localized fistulation is usually a result of penetrating traumatic or iatrogenic injury. Clinical presentation can vary greatly but commonly includes back pain, high-output congestive cardiac failure and the presence of an abdominal bruit. Diagnosis, therefore, is often incidental or delayed. Case presentation We report a case of a spontaneous ilio-iliac arteriovenous fistula in a 68-year-old Caucasian man detected following presentation with unilateral claudication and congestive cardiac failure. Following computed tomography evaluation, the fistula was successfully treated with a combined endovascular (aorto-uni-iliac device) and open (femoro-femoral crossover) approach. Conclusion Endovascular surgery has revolutionized the management of such fistulae and we report an interesting case of a high-output iliac arteriovenous fistulae successfully treated with a hybrid vascular approach.

  18. Endovascular treatment of isolated iliac artery aneurysms with anaconda stent graft limb.

    Science.gov (United States)

    Karathanos, Christos; Kaperonis, Elias; Xanthopoulos, Dimitrios; Konstantopoulos, Theophanis; Exarchou, Maria; Loupou, Caterini; Papavassiliou, Vassilios

    2013-01-01

    Isolated aneurysms of the iliac arteries are relatively rare conditions that traditionally have been treated by surgical reconstruction. We report our experience with endovascular treatment of iliac artery aneurysms (IAAs) with Anaconda stent graft limb. Two male patients were found to have 4.5 and 3.6 cm isolated common IAAs, respectively. The endograft was successfully advanced and deployed precisely to the intended position in both cases. In one case the internal iliac artery was embolized. No type I or II endoleak was observed immediately after the procedure. In one patient postimplantation fever (>38°C) and gluteal claudication occurred. After 2 years followup both iliac endovascular stent grafts are patent and without endoleak. Endovascular treatment with Anaconda limb stent graft seems to be a safe and feasible alternative to open surgery.

  19. Endovascular Treatment of Isolated Iliac Artery Aneurysms with Anaconda Stent Graft Limb

    Directory of Open Access Journals (Sweden)

    Christos Karathanos

    2013-01-01

    Full Text Available Isolated aneurysms of the iliac arteries are relatively rare conditions that traditionally have been treated by surgical reconstruction. We report our experience with endovascular treatment of iliac artery aneurysms (IAAs with Anaconda stent graft limb. Two male patients were found to have 4.5 and 3.6 cm isolated common IAAs, respectively. The endograft was successfully advanced and deployed precisely to the intended position in both cases. In one case the internal iliac artery was embolized. No type I or II endoleak was observed immediately after the procedure. In one patient postimplantation fever (>38°C and gluteal claudication occurred. After 2 years followup both iliac endovascular stent grafts are patent and without endoleak. Endovascular treatment with Anaconda limb stent graft seems to be a safe and feasible alternative to open surgery.

  20. Therapeutic options to prevent recurrence of an aggressive aneurysmatic bone cyst of the cervical spine of a 16 year old boy - a case report

    Directory of Open Access Journals (Sweden)

    Wojan Magdalena

    2011-08-01

    Full Text Available Abstract The aneurysmatic bone cyst (ABC is a benign primary bone tumour. If located in the cervical spine, its expansive growth and destructive behaviour may lead to instability and serious neurological impairment. We report a case of a 16-year-old boy with an aggressive ABC in the 7th cervical vertebra. Computertomographic and magnetic resonance imaging revealed the envelopment of the left 7th and 8th spinal nerve along with the anterior displacement of the left vertebral artery. The interdisciplinary surgical strategy consisted of a partially incomplete cyst resection, subtotal spondylectomy with posterior screw-and-rod fixation from C6-Th1, iliac crest bone grafting and anterior plating from C6-Th1. With regard to the high rate of recurrence after incomplete resection published in the recent literature, the patient was postoperatively treated by megavoltage radiotherapy with a total dose of 30Gy (daily dose of 1.8 Gy for 3 weeks. The clinical and radiographic follow-up showed complete recovery of all neurologic impairments and no signs of tumour recurrence at 3, 6 and 12 months after surgery. This case highlights diverse treatment regimens and shall outline the challenge and the problems of the interdisciplinary decision-making in adolescents presenting with ABC in high-demanding anatomical regions.

  1. Sacro-iliac joint arthrography in low back pain: feasibility of MRI guidance

    International Nuclear Information System (INIS)

    Ojala, Risto; Klemola, Rauli; Karppinen, Jaro; Sequeiros, Roberto Blanco; Tervonen, Osmo

    2001-01-01

    Objective: Evaluation of the feasibility of MR-guidance in sacro-iliac joint arthrography in patients whose low back pain is suspected to arise from the sacro-iliac joint (SIJ). Methods and patients: Twenty patients with low back pain underwent MR-guided sacro-iliac joint arthrography. Needles made from titanium (size 20 G, MDTech, USA) were used. For image guidance a 0.23T open-configuration C arm magnet (Proview, Marconi Medical Systems, USA) with special interventional hardware and software package (I-Path 200, Marconi Medical Systems) containing an MR compatible in-room console, large-screen (36'') display, optical navigator and accompanying software with dedicated sequences was used. No other image guidance modalities were used. Results: MR-guided SIJ arthrography was successfully performed in all twenty patients without complications. The optimal imaging sequence both for preoperative and intraoperative images was 3D-Gradient Echo sequence. The dispersal of the injected saline and anaesthetic could be determined inside the joint in all cases with heavily T2-weighted fast spin echo sequence. In the present study, 60% of the patients had significant reduction of pain after sacro-iliac joint arthrography and sacro-iliac joint was considered to be the source of patients low back pain in these patients. Conclusion: The present study shows that MR guidance with open configuration low field scanner is an accurate guiding method for sacro-iliac joint arthrography

  2. The management of right iliac fossa pain - is timing everything?

    LENUS (Irish Health Repository)

    McCartan, D P

    2012-01-31

    BACKGROUND: Right iliac fossa (RIF) pain remains the commonest clinical dilemma encountered by general surgeons. We prospectively audited the management of acute RIF pain, examining the relationship between symptom duration, use of pre-operative radiological imaging and patient outcome. METHODS: Over a six-month period, 302 patients, median age 18 years, 59% female, were admitted with RIF pain. Symptoms, clinical findings and laboratory results were documented. Patient management, timing of radiological investigations and operations, and outcome were recorded prospectively. RESULTS: Non-specific abdominal pain (26%), gynaecological (22%) and miscellaneous causes (14%) accounted for most admissions. Ultimately, 119 patients (39%) had appendicitis. Anorexia, tachycardia or rebound tenderness in the RIF significantly predicted a final diagnosis of appendicitis. Patients with perforated appendicitis (n = 29) had a longer duration of pre-hospital symptoms (median 50h) compared to those with simple appendicitis (median 17 h) (p<0.001). The use of pre-operative imaging resulted in an increased time to surgery but was not associated with increased post-operative morbidity or perforated appendicitis. CONCLUSION: The majority of patients presenting to hospital with RIF pain did not have appendicitis. Increased duration of pre-hospital symptoms was the main factor associated with perforated appendicitis. However, increased in-hospital time to theatre was not associated with perforated appendicitis or post-operative morbidity.

  3. Complete Cranial Iliac Osteotomy to Approach the Lumbosacral Foramen

    Directory of Open Access Journals (Sweden)

    Barbara Dyall

    2017-05-01

    Full Text Available An approach using a complete cranial iliac osteotomy (CCIO to access the lumbosacral (LS foramen in dogs from lateral was developed using cadavers and applied in a clinical patient with degenerative lumbosacral stenosis (DLSS. The foraminal enlargement in the cadavers and the patient was documented on postoperative CT scans. The preoperative CT scan of the patient showed moderate cranial telescoping of the sacral roof and a moderate central disk protrusion, leading to moderate to severe compression of the cauda equina. In addition, there was lateral spondylosis with consequential stenosis of the right LS foramen. The right L7 nerve had lost its fat attenuation and appeared thickened. After a routine L7S1 dorsal laminectomy with a partial discectomy, a CCIO was performed, providing good access to the LS foramen and the adhesions around the proximal L7 nerve caudoventral to the foramen. The osteotomy was stabilized with a locking plate and a cerclage wire. The dog recovered well from the procedures and after 36 h, the dog walked normally and was discharged from the hospital. Eight and 16 weeks later, the signs of the DLSS had markedly improved. From these data, it can be concluded that the CCIO is a useful approach to the LS foramen and intervertebral disk in selected patients with DLSS, giving good access to the structures around the LS foramen.

  4. Anterior Inferior Iliac Spine (AIIS) and Subspine Hip Impingement

    Science.gov (United States)

    Carton, Patrick; Filan, David

    2016-01-01

    Summary Background Abnormal morphology of the anterior inferior iliac spine (AIIS) and the subspine region of the acetabular rim are increasingly being recognised as a source of symptomatic extra-articular hip impingement. This review article aims to highlight important differences in the pathogenesis, clinical presentation and management of extra-articular hip impingement from both the AIIS and subspine bony regions, and the outcome following surgical intervention. Methods A literature review was undertaken to examine the supporting evidence for AIIS and subspine hip impingement. A narrative account of the Author’s professional experience in this area, including operative technique for arthroscopic correction, is also presented. Results Abnormal morphology of the AIIS and subspine region has been classified using cadaveric, radiological and arthroscopic means; the clinical presentation and operative treatment has been documented in several case series studies. Dual pathology is often present - recognition and treatment of both intra- and extra-articular components are necessary for good postoperative outcome. Conclusions AIIS and sub-spine hip impingement should be considered as distinct pathological entities, which may also co-exist. Symptom relief can be expected following arthroscopic deformity correction with the treatment of concomitant intra-articular pathology. Failure to recognise and treat the extra-articular component may affect postoperative outcome. Level of evidence V. PMID:28066737

  5. Osteoblast recruitment routes in human cancellous bone remodeling

    DEFF Research Database (Denmark)

    Kristensen, Helene B; Levin Andersen, Thomas; Marcussen, Niels

    2014-01-01

    It is commonly proposed that bone forming osteoblasts recruited during bone remodeling originate from bone marrow perivascular cells, bone remodeling compartment canopy cells, or bone lining cells. However, an assessment of osteoblast recruitment during adult human cancellous bone remodeling...... is lacking. We addressed this question by quantifying cell densities, cell proliferation, osteoblast differentiation markers, and capillaries in human iliac crest biopsy specimens. We found that recruitment occurs on both reversal and bone-forming surfaces, as shown by the cell density and osterix levels...... on these respective surfaces, and that bone formation occurs only above a given cell density. Canopies appeared an important source of osteoprogenitors, because (i) canopy cells proved to be more proliferative and less differentiated than bone surface cells, as shown by the inverse levels of Ki-67 and procollagen-3 N...

  6. Impact of iliac artery anatomy on the outcome of fenestrated and branched endovascular aortic repair.

    Science.gov (United States)

    Gallitto, Enrico; Gargiulo, Mauro; Faggioli, Gianluca; Pini, Rodolfo; Mascoli, Chiara; Freyrie, Antonio; Ancetti, Stefano; Stella, Andrea

    2017-12-01

    Fenestrated and branched endovascular aneurysm repair (FB-EVAR) is a valid option to treat juxtarenal and pararenal abdominal aortic aneurysms and thoracoabdominal aortic aneurysms. Because successful deployment depends on complex maneuvers, hostile iliac artery anatomy (HIA) can prejudice the FB-EVAR outcome. The aim of the study was to evaluate the impact of HIA on FB-EVAR outcome. Between 2010 and 2015, all patients undergoing FB-EVAR were prospectively categorized according to iliac anatomy (friendly iliac artery anatomy [FIA] or HIA). HIA was defined as the presence of one of the following: severe (>90-degree) iliac angle, extensive (>50%) iliac circumferential calcification, hemodynamic iliac stenosis or obstruction, external iliac artery diameter <7 mm, or previous aortoiliac/femoral graft. Early end points were technical success (absence of type I or type III endoleak, target visceral vessel [TVV] loss, conversion to open repair), intraoperative adjunctive maneuvers (IAMs; iliac percutaneous transluminal angioplasty/stenting, surgical iliac conduit, intra-aortic graft rotations, several attempts of TVV cannulation), intraoperative technical problems (iliac rupture, significant endograft twisting, difficult TVV cannulations, TVV injuries, TVV loss), and 30-day mortality. Follow-up end points were survival, TVV patency, and freedom from reintervention. Ninety-four patients (male, 87%; age, 73 ± 6 years) with 59 (63%) juxtarenal and pararenal abdominal aortic aneurysms and 35 (37%) thoracoabdominal aortic aneurysms underwent FB-EVAR, for a total of 324 TVVs; 60 (64%) patients had HIA and 34 (36%) had FIA. Patients with HIA and FIA had similar preoperative clinical characteristics, except for coronary artery disease, peripheral artery occlusive disease, and American Society of Anesthesiologists class 4 (47% vs 24% [P = .03], 12% vs 0% [P = .04], and 28% vs 9% [P = .03], respectively). Technical success was 96% (HIA, 97%; FIA, 95%; P = .6). In HIA

  7. Volume changes of grafted autogenous bone in sinus augmentation procedure.

    Science.gov (United States)

    Sbordone, Carolina; Sbordone, Ludovico; Toti, Paolo; Martuscelli, Ranieri; Califano, Luigi; Guidetti, Franco

    2011-06-01

    To evaluate associations between the osseous remodeling and the 3-dimensional features of both the grafted bone and the recipient site, as well as the density of the grafted bone, and to assess the relation between the degree of bone resorption and the type of autogenous bone-grafting procedure or the source (block or particulate bone from iliac crest or block bone from chin). A retrospective chart review of patients receiving sinus lifting and grafting procedures for implant positioning was conducted: radiographic analysis of the volume and area of both sinuses and autogenous bone grafts was performed, as per Smolka et al and Krennmair et al. The volumetric remodeling--measured at 1 year after implant positioning as the percentage of residual bone (%R)--was correlated, with Spearman analysis, to 3-dimensional features of both graft and recipient sites. All quantities correlated with %R at a statistically significant level were used for 2-dimensional and multidimensional visualizations with scattergrams. Twenty-five iliac crest or chin grafts were inlay positioned in the maxillary sinuses of patients. Computed tomography scans, taken before implant positioning and after 1 year, showed a 1-year negligible volume remodeling for block graft from chin (97.9%) but slightly greater resorption values (%R) for particulate and block grafts from iliac crest (93.8% and 83.3%, respectively). Three- and four-dimensional scattergrams of significant data resulting from Spearman correlation tests (particulate and block grafts both from iliac crest) showed a variation of the remodeling pattern dependent on 3-dimensional features, namely inlay graft thickness, surface area of the graft in contact with basal bone, volume of the recipient site, and surface area of the graft projecting into the sinus cavity. Retrospective data analysis shows that iliac crest grafts positioned on a small basal bone volume (≤ 2.5 mL) may point to a very favorable remodeling of the volume when the

  8. ANEURYSMAL BONE CYST OF THE CLAVICLE IN CHILDREN (CLINICAL CASES AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Тимур Фаизович Зубаиров

    2014-09-01

    Full Text Available The purpose. To examine the results of the treatment of children with aneurysmal cyst of the clavicle. Material and methods. The results of examination and treatment of patients aged 16 and 17 years with a diagnosis of aneurysmal cyst of the clavicle. All patients underwent surgical treatment with the ABC stage delimitation. We used a surgical technique, which consists in open removement of the abnormal tissue with replacement of the bone defect with bone-plastic material or autogenous bone from the iliac crest. Conclusions. The method of treatment of aneurysmal bone cyst of the clavicle must be individualized depending on the location, aggressiveness and extent of the lesion. The use bone-plastic material or autogenous bone from the iliac crest restore the structural integrity of a compromised clavicle gives good results in the observation period of up to 2 years.

  9. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  10. An expression relating breaking stress and density of trabecular bone

    DEFF Research Database (Denmark)

    Rajapakse, C.S.; Thomsen, J.S.; Ortiz, J.S.E.

    2004-01-01

    Bone mineral density (BMD) is the principal diagnostic tool used in clinical settings to diagnose and monitor osteoporosis. Experimental studies on ex vivo bone samples from multiple skeletal locations have been used to propose that their breaking stress bears a power-law relationship to volumetric...... previously published data on bone samples from iliac crest and vertebral body. It represents the experimental biomechanical data at least as well as the power-law, and provides means for extrapolating results from small biopsy samples to an entire bone. In addition, changes caused by trabecular thinning...

  11. Classic and endovascular surgical management of isolated iliac artery aneurysms.

    Science.gov (United States)

    Gabrielli, R; Irace, L; Felli, M M G; Alunno, A; Rizzo, A R; Faccenna, F; Laurito, A; Gattuso, R; Venosi, S; Jabbour, J; Gossetti, B

    2007-04-01

    Isolated iliac artery aneurysm is a rare pathology that is often asymptomatic for long periods; this late diagnosis exposes patients to a high risk of death following aneurysm rupture. The aim of this study was to establish the most suitable diagnostic approach, the correct indications for treatment, and the most appropriate tactics and surgical technique. Twenty-eight patients were observed over 13 years. Aneurysmal involvement was unilateral in 22 cases and bilateral in the remaining 6 patients. Preoperative diagnostic tests included eco-colour Doppler (ECD) and angio-CT in all cases, with angio-MR and angiography as more selective procedures. Seventeen patients underwent conventional open surgery with prosthetic replacement of the aneurysmatic tract, 7 patients were treated using endovascular exclusion, and lastly 4 were monitored over time. There was no perioperative mortality for either treatment. During the postoperative period following conventional open surgery, complications included one case of severe respiratory failure, one microembolism of the lower limb, and 2 periprosthetic hematoma. During the follow-up, we observed one pseudo-aneurysm, 3 cases of retrograde ejaculation and one patient with erectile dysfunction after traditional surgery; there was one minor endoleak after endovascular exclusion. Our experience suggests that ECD is a useful method for arriving at an early diagnosis, while angio-CT imaging is essential for a correct preoperative study. Aneurysms with a diameter equal or greater than 3 cm or that present annual increases in excess of 5 mm represent a correct indication for treatment. Conventional open surgery is the treatment of choice for young patients in good general conditions. Endovascular exclusion is indicated when the patient's clinical conditions contraindicate open surgery and the morphology of the aneurysmal arterial district allows the endoprosthesis to be safely implanted.

  12. Bone marrow aspiration

    Science.gov (United States)

    Bain, B

    2001-01-01

    Bone marrow aspiration biopsies are carried out principally to permit cytological assessment but also for immunophenotypic, cytogenetic, molecular genetic, and other specialised investigations. Often, a trephine biopsy is carried out as part of the same procedure. Bone marrow aspirations should be carried out by trained individuals who are aware of the indications, contraindications, and hazards of the procedure. They should follow a standard operating procedure. The operator should have made an adequate assessment of clinical and haematological features to ensure both that appropriate indications exist and that all relevant tests are performed. For the patient's comfort and safety, the posterior iliac crest is generally the preferred site of aspiration. Films of aspirated marrow and, when appropriate, films of crushed particles should be made and labelled. Once thoroughly dry, films should be fixed and stained. As a minimum, a Romanowsky stain and a Perls' stain are required. A cover slip should be applied. The bone marrow films should be assessed and reported in a systematic manner so that nothing of importance is overlooked, using a low power, then intermediate, then high power objective. A differential count should be performed. An interpretation of the findings, in the light of the clinical and haematological features, should be given. The report should be signed or computer authorised, using a secure password, and issued in a timely manner. Key Words: bone marrow aspirate • haematological diagnosis PMID:11533068

  13. Effect of Intracoronary Delivery of Autolologous Bone Marrow Mononuclear Cells Two to Three Weeks Following Acute Myocardial Infarction on Left-Ventricular Function: The LateTIME Randomized Trial

    Science.gov (United States)

    Traverse, Jay H.; Henry, Timothy D.; Ellis, Stephen G.; Pepine, Carl J.; Willerson, James T.; Zhao, David X.M.; Forder, John R.; Byrne, Barry J.; Hatzopoulos, Antonis K.; Penn, Marc S.; Perin, Emerson C.; Baran, Kenneth W.; Chambers, Jeffrey; Lambert, Charles; Raveendran, Ganesh; Simon, Daniel I.; Vaughan, Douglas E.; Simpson, Lara M.; Gee, Adrian P.; Taylor, Doris A.; Cogle, Christopher R.; Thomas, James D.; Silva, Guilherme V.; Jorgenson, Beth C.; Olson, Rachel E.; Bowman, Sherry; Francescon, Judy; Geither, Carrie; Handberg, Eileen; Smith, Deirdre X.; Baraniuk, Sarah; Piller, Linda B.; Loghin, Catalin; Aguilar, David; Richman, Sara; Zierold, Claudia; Bettencourt, Judy; Sayre, Shelly L.; Vojvodic, Rachel W.; Skarlatos, Sonia I.; Gordon, David J.; Ebert, Ray F.; Kwak, Minjung; Moyé, Lemuel A.; Simari, Robert D.

    2013-01-01

    Context Clinical trial results suggest that intracoronary delivery of autologous bone marrow mononuclear cells (BMCs) may improve left ventricular (LV) function when administered within the first week following myocardial infarction (MI). However, since a substantial number of patients may not present for early cell delivery, we investigated the efficacy of autologous BMC delivery 2–3 weeks post-MI. Objective To determine if intracoronary delivery of autologous BMCs improves global and regional LV function when delivered 2–3 weeks following first MI. Design, Setting, and Patients LateTIME is a randomized, double-blind, placebo-controlled trial of the National Heart, Lung, and Blood Institute - sponsored Cardiovascular Cell Therapy Research Network (CCTRN) of 87 patients with significant LV dysfunction (LVEF ≤ 45%) following successful primary percutaneous coronary intervention (PCI). Interventions Intracoronary infusion of 150 × 106 autologous BMCs (total nucleated cells) or placebo (2:1 BMC:placebo) was performed within 12 hours of bone marrow aspiration after local automated cell processing. Main Outcome Measures The primary endpoints were changes in global (LVEF) and regional (wall motion) LV function in the infarct and border zone from baseline to 6 months as measured by cardiac MRI at a core lab blinded to treatment assignment Secondary endpoints included changes in LV volumes and infarct size. Results 87 patients were randomized between July 2008 and February 2011: mean age = 57 ± 11 yrs, 83% male. Harvesting, processing, and intracoronary delivery of BMCs in this setting was feasible and safe. The change from baseline to six months in the BMC group, when compared to the placebo group, for LVEF (48.7 to 49.2% vs. 45.3 to 48.8%; Difference = −3.0, 95% CI −7.0 to 0.9), wall motion in the infarct zone (6.2 to 6.5 vs. 4.9 to 5.9 mm; Difference = −0.7, 95% CI −2.8 to 1.3), and wall motion in the border zone (16.0 to 16.6 mm vs. 16.1 to 19.3 mm

  14. Blocks of autogenous bone versus xenografts for the rehabilitation of atrophic jaws with dental implants: preliminary data from a pilot randomised controlled trial.

    Science.gov (United States)

    Pistilli, Roberto; Felice, Pietro; Piatelli, Maurizio; Nisii, Alessandro; Barausse, Carlo; Esposito, Marco

    2014-01-01

    To compare the effectiveness of onlay bone blocks of equine origin (test or XB group) with autogenous bone blocks (control or AB group) harvested from the ramus or the iliac crest for the rehabilitation of partially or fully edentulous atrophic jaws with implant supported prostheses. Forty patients with partially or fully edentulous atrophic jaws having less than 5 mm of residual crestal bone height and/or less than 3 mm of bone thickness, as measured on computerised tomography (CT) scans, were randomised into two groups according to a parallel group design, either to be augmented with autogenous onlay bone blocks (20 patients; AB group) from the mandibular ramus or the iliac crest, or with onlays blocks of spongious bone of equine origin (20 patients; XB group). Two centres treated 20 patients each. Six XB blocks were modelled on lithographic models of the jaws before grafting. The blocks were fixed with screws and osteosynthesis plates and were covered with resorbable barriers made of equine cortical bone and fixed with tacks. The autogenous bone grafts were left to heal for 4 months and the xenografts for 7 months before placing implants, which were submerged. After 4 months, either bar-retained overdentures or provisional reinforced acrylic prostheses were delivered. Provisional prostheses were replaced, after 4 months, by definitive fixed prostheses. Outcome measures were: prosthesis and implant failures; complications; patient satisfaction; pain recorded 3 and 10 days post-augmentation; number of days of hospitalisation, total and partial infirmity days. All patients were followed for 4 months after loading. All patients could be rehabilitated with implant-supported prostheses and none dropped out. Twenty-eight patients were augmented in the maxilla (15 with AB and 13 with XB) and 12 in the mandible (5 with AB and 7 with XB). No AB graft failed totally versus 10 XB grafts (difference = 0.5; 95% CI 0.23 to 0.68; P = 0.0004). In particular, all 7 XB mandibular

  15. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  16. Histologic diagnosis of metabolic bone diseases: bone histomorphometry

    Directory of Open Access Journals (Sweden)

    L. Dalle Carbonare

    2011-09-01

    Full Text Available Histomorphometry or quantitative histology is the analysis on histologic sections of bone resorption parameters, formation and structure. It is the only technique that allows a dynamic evaluation of the activity of bone modelling after labelling with tetracycline. Moreover, the new measurement procedures through the use of the computer allow an assessment of bone microarchitecture too. Histomorphometric bone biopsy is a reliable and well-tolerated procedure. Complications are reported only in 1% of the subjects (hematoma, pain, transient neuralgia. Histomorphometry is used to exclude or confirm the diagnosis of osteomalacia. It is employed in the evaluation of bone damage associated with particular treatments (for example, anticonvulsants or in case of rare bone diseases (osteogenesis imperfecta, systemic mastocytosis. It is also an essential approach when clinical, biochemical and other diagnostic data are not consistent. Finally, it is a useful method to understand the pathophysiologic mechanisms of drugs. The bone sample is taken at the level of iliac crest under local anesthesia. It is then put into methyl-metacrilate resin where the sections are prepared for the microscopic analysis of the various histomorphometric parameters.

  17. Iliac hyperdense line: a new X-ray sign of gluteal muscle contracture

    International Nuclear Information System (INIS)

    Cai Jinhua; Gan Lanfeng; Zheng Helin; He Ling; Yu Guorong

    2003-01-01

    Objective: To elucidate the relationship between gluteal muscle contracture (GMC) and the iliac hyperdense line on pelvic plain film, and to explore how the iliac hyperdense line is formed. Methods: The pelvic plain films of 103 cases with GMC confirmed by operation and those of 200 individuals as control were analyzed. Pelvic CT scanning was performed in 8 cases GMC and 13 cases of normal controls. Results: The iliac hyperdense line at the side of sacroiliac joint was found on the pelvic plain film in 85 of 103 cases with GMC and 5 of 200 in control group. In 103 cases of GMC, the iliac hyperdense line was detected in 81 of 88 patients beyond 5 years, and 83 of 94 was mostly the gluteus maximus contracture. In control group, pelvic CT showed that the outer cortex of posterior ilium at the level of sacroiliac joint appeared as an oblique plane, oriented from posteromedial side to anterolateral side, while in GMC group, the oblique plane became steeper and almost oriented posteroanteriorly. In addition, the posterior part of the ilium which gave the attachment of contracted gluteus maximus muscle deformed and widened. Conclusion: The iliac hyperdense line on the pelvic plain film is resulted from the long and persistent pulling effect of contracted gluteus maximus muscle, which causes the change the oblique plane of posterior ilium into a posteroanterior course parallel to the X-ray beam

  18. Morphological Analysis of the Human Internal Iliac Artery in South Indian Population

    Directory of Open Access Journals (Sweden)

    Naveen NS

    2011-04-01

    Full Text Available Objectives: The accidental hemorrhage is common due to erroneous interpretation of the variant arteries during surgical procedures, hence the present study has been undertaken with reference to its morphological significance. The objectives were to examine the level of origin, length and the branching pattern of the human internal iliac artery in South Indian population. Methods: The study included 60 human bisected pelvises irrespective of their side and sex. The specimens were collected from the anatomy laboratory and were fixed with the formalin. The branching patterns were studied and demonstrated as per the guidelines of Adachi. Results: The origin of internal iliac artery was at the level of S1 vertebra in majority (58.3% of the cases. The average length of internal iliac artery was 37 ± 4.62 mm (range, 13-54 mm. The type I pattern of the internal iliac artery was most common (83.5% followed by types III and II. The type IV and V pattern of adachi were not observed. Conclusions: The results of this study were different from those reported by others and may be because of racial and geographical variations. Prior knowledge of the anatomical variations is beneficial for the vascular surgeons ligating the internal iliac artery or its branches and the radiologists interpreting angiograms of the pelvic region.

  19. Iliac hyperdense line: a new radiographic sign of gluteal muscle contracture

    Energy Technology Data Exchange (ETDEWEB)

    Cai, Jin-Hua; Gan, Lan-Feng; Zheng, He-Lin; Li, Hao [Chongqing Medical University, Department of Radiology, Children' s Hospital, Chongqing (China)

    2005-10-01

    A hyperdense line on the ilium that runs roughly parallel to the sacroiliac joint (we called it ''iliac hyperdense line sign'') was frequently observed on pelvic radiographs of patients with gluteal muscle contracture (GMC). A literature search revealed no description of this sign. To determine the relationship between the iliac hyperdense line sign and GMC and to explore how this sign is formed. Pelvic plain films of 103 cases of GMC and those of 200 control individuals were reviewed for the presence or absence of the iliac hyperdense line sign. Pelvic CT scans in 8 of 103 cases and 13 of 200 controls were analyzed with relation to the plain films. The iliac hyperdense line sign was visualized in 85 of 103 (82.5%) cases of GMC and none of the 200 controls. In the GMC group, pelvic CT scans showed a deformity of the posterior ilium. The lateral cortex of the posterior ilium took on a partly or completely anteroposterior course, while in the control group the course appeared as an oblique orientation from posteromedial to anterolateral. The iliac hyperdense line on pelvic plain film can be used as a radiographic sign to suggest a diagnosis of GMC. This sign might be a result of the long and persistent pulling effect of the contracted gluteus maximus muscle, which deforms the lateral cortex of the posterior ilium from an oblique course to an anteroposterior course tangential to the X-ray beam. (orig.)

  20. Treatment of the atrophic edentulous maxilla: short implants versus bone augmentation for placing longer implants. Five-month post-loading results of a pilot randomised controlled trial.

    Science.gov (United States)

    Felice, Pietro; Soardi, Elisa; Pellegrino, Gerardo; Pistilli, Roberto; Marchetti, Claudio; Gessaroli, Manlio; Esposito, Marco

    2011-01-01

    To evaluate whether short (5 to 8.5 mm) dental implants could be a suitable alternative to longer (>11.5 mm) implants placed in atrophic maxillae augmented with autogenous bone for supporting dental prostheses. Twenty-eight patients with fully edentulous atrophic maxillae having 5 to 9 mm of residual crestal bone height at least 5 mm thick, as measured on computerised tomography scans, were randomised into two groups either to receive 4 to 8 short (5 to 8.5 mm) implants (15 patients) or autogenous bone from the iliac crest to allow the placement of at least 11.5 mmlong implants (13 patients). Bone blocks and the windows at maxillary sinuses were covered with rigid resorbable barriers. Grafts were left to heal for 4 months before placing implants, which were submerged. After 4 months, provisional reinforced acrylic prostheses or bar-retained overdentures were delivered. Provisional prostheses were replaced, after 4 months, by definitive screw-retained metal-resin cross-arch fixed dental prostheses. Outcome measures were: prosthesis and implant failures, any complications (including prolonged postoperative pain) and patient satisfaction. All patients were followed for 5 months after loading. All patients could be rehabilitated with implant-supported prostheses and none dropped out. One bilateral sinus lift procedure failed due to infection, though short implants could be placed. One implant failed in the augmented group versus 2 short implants in 2 patients. All failures occurred before loading. Significantly more complications occurred in augmented patients: 8 complications occurred in 5 augmented patients (all complained of pain 1 month after bone harvesting from the iliac crest). No complications occurred in the short implant group. All patients were fully satisfied with the treatment and would do it again. This pilot study suggests that short implants may be a suitable, cheaper and faster alternative to longer implants placed in bone augmented with autogenous

  1. Right iliac vein thrombosis mimicking acute appendicitis in pregnancy: a case report.

    Science.gov (United States)

    Aroke, Desmond; Kadia, Benjamin Momo; Dimala, Christian Akem; Bechem, Ndemazie Nkafu; Ngek, Larry Tangie; Choukem, Simeon Pierre

    2017-01-03

    Right iliac vein thrombosis is uncommon in pregnancy. Nonetheless, when it does occur, its presentation could be very unspecific with important diagnostic challenges and this could have negative therapeutic consequences especially in a resource limited setting. The historical, clinical and laboratory data of a 30 year old G2P1001 woman of African ethnicity at 11 weeks of gestation pointed towards a right iliac vein thrombosis missed for an acute appendicitis with subsequent appendectomy and failure to cure. Following the diagnosis of right iliac vein thrombosis post-appendectomy, the patient was started on low molecular weight heparin and the clinical progress thereafter was favourable. Pelvic vein thrombosis should be considered a differential diagnosis of intractable lower abdominal pain in early pregnancy. A high index of suspicion could lead to early diagnosis, prompt management and a favourable prognosis even in a low-income setting.

  2. Iliac artery recanalization of chronic occlusions to facilitate endovascular aneurysm repair.

    Science.gov (United States)

    Vallabhaneni, Raghuveer; Sorial, Ehab E; Jordan, William D; Minion, David J; Farber, Mark A

    2012-12-01

    Concurrent iliac occlusion and abdominal aortic aneurysm is rare. Traditionally, the endovascular approach to these patients has consisted of aortouniiliac devices combined with femoral-femoral bypass. With improved facility of endovascular techniques, standard bifurcated endografts represent an alternative option in these patients. This study examined outcomes of patients undergoing iliac recanalization and traditional bifurcated endovascular aneurysm repair in the face of access vessel occlusion. Outcomes of patients at three academic tertiary referral centers who underwent attempted iliac recanalization of chronic iliac occlusions and concurrent endovascular aneurysm repair of an infrarenal aortic aneurysm were retrospectively reviewed. Patients with acute iliac thrombosis and those with severely stenotic (but patent) iliac vessels were excluded. During a 6-year period, 15 occluded iliac arteries were treated in 14 patients (13 men). Mean age was 67.8 years (range, 52-80 years). Primary indication for intervention was disabling claudication in four patients, size of abdominal aortic aneurysm in nine, and symptomatic aneurysm in one. Seven patients presented with a unilateral common iliac artery (CIA) occlusion, four with a unilateral external iliac artery (EIA) occlusion, three with a unilateral combined CIA and EIA occlusion, and one with bilateral CIA occlusions. Stents had been placed previously in two of the occluded CIAs and in one of the occluded EIAs. Average length of the occluded segment was 7.5 cm (range, 2-17 cm). The occluded CIAs and EIAs had mean diameters of 8.6 and 5.7 mm, respectively. Successful recanalization was achieved in 14 of the 15 vessels (93.3%). One EIA ruptured during recanalization but was easily controlled with a covered stent. A re-entry device was used in two cases. Overall, 13 bifurcated devices were successfully implanted. Bilateral iliac occlusions in one patient were recanalized. One Talent (Medtronic, Santa Rosa, Calif

  3. Effect of cause of iliac vein stenosis and extent of thrombus in the lower extremity on patency of iliac venous stent placed after catheter-directed thrombolysis of acute deep venous thrombosis in the lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Sung Il; Choi, Young Ho; Yoon, Chang Jin; Lee, Min Woo; Chung, Jin Wook; Park, Jae Hyung [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2003-10-01

    To assess the CT findings of acute deep venous thrombosis (DVT) in a lower extremity prior to catheter-directed thrombolysis, and to evaluate their relevance to the patency of an iliac venous stent placed with the help of CT after catheter-directed thrombolysis of DVT. Fourteen patients [M:F=3:11; age, 33-68 (mean, 50.1) years] with acute symptomatic DVD of a lower extremity underwent CT before and after catheter-directed thrombolysis using an iliac venous stent. The mean duration of clinical symptoms was 5.0 (range, 1-14 days. The CT findings prior to thrombolysis were evaluated in terms of their anatomic cause and the extent of the thrombus, and in all patients, the patency of the iliac venous stent was assessed at CT performed during a follow-up period lasting 6-31 (mean, 18.9) months. All patients were assigned to the patent stent group (n=9) or the occluded stent group (n=5). In the former, the anatomic cause of patency included typical iliac vein compression (May-Thurner syndrome) (n=9), and a relatively short segmental thrombus occurring between the common iliac and the popliteal vein (n=8). Thrombi occurred in the iliac vein (n=3), between the common iliac and the femoral vein (n=3), and between the common iliac and the popliteal vein (n=2). In one case, a relatively long segmental thrombus occurred between the common iliac vein and the calf vein. In the occluded stent group, anatomic causes included atypical iliac vein compression (n=3) and a relatively long segmental thrombus between the common iliac and the calf vein (n=4). Typical iliac vein compression (May-Thurner syndrome) occurred in two cases, and a relatively short segmental thrombus between the external iliac and the common femoral vein in one. Factors which can affect the patency of an iliac venous stent positioned after catheter-directed thrombolysis are the anatomic cause of the stenosis, and the extent of a thrombus revealed at CT of acute DVT and occurring in a lower extremity prior to

  4. Excellent long-term results with iliac stenting in local anesthesia for post-thrombotic syndrome

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Just, Sven; Foegh, Pia

    2015-01-01

    BACKGROUND: Only 20% of iliac veins will recanalize on anticoagulation (AC) treatment alone and may, therefore, develop venous obstruction after iliofemoral deep venous thrombosis (DVT). A considerable number of these patients will suffer from post-thrombotic syndrome (PTS) leading to impaired qu...... stent was 89% (17/19) and 16 patients (84 %) had almost or total symptom relief at follow-up. CONCLUSION: Endovascular stenting of iliac obstruction in local anesthesia is minimally invasive and shows excellent long-term outcomes for patients suffering from PTS....

  5. Aberrant Ovarian Collateral Originating from External Iliac Artery During Uterine Artery Embolization

    International Nuclear Information System (INIS)

    Kwon, Joon Ho; Kim, Man Deuk; Lee, Kwang-hun; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

    2013-01-01

    We report a case of a 35-year-old woman who underwent uterine artery embolization (UAE) for symptomatic multiple uterine fibroids with collateral aberrant right ovarian artery that originated from the right external iliac artery. We believe that this is the first reported case in the literature of this collateral uterine flow by the right ovarian artery originated from the right external iliac artery. We briefly present the details of the case and review the literature on variations of ovarian artery origin that might be encountered during UAE.

  6. Does Dopplersignal enhancement with Levovist improve the diagnostic confidence of duplex scanning of the iliac arteries?--(A pilot study with correlation to intravascular ultrasound)

    DEFF Research Database (Denmark)

    Vogt, K C; Jensen, F; Schroeder, T V

    1998-01-01

    To evaluate whether echo-enhancement with Levovist improves the diagnostic confidence of duplex scanning of the iliac arteries.......To evaluate whether echo-enhancement with Levovist improves the diagnostic confidence of duplex scanning of the iliac arteries....

  7. Peri-cardiac arrest following blunt bicycle handlebar trauma to the iliac vessels: management of a rare case.

    Science.gov (United States)

    Houston, Emma L; Chandrasekar, Ramasubramanyan

    2012-12-01

    Iliac vessel disruption following blunt trauma is an unusual presentation, particularly in the absence of an orthopaedic injury. We present the unique case of a 14-year-old boy who sustained a blunt bicycle handlebar impalement that resulted in complete transection of the external iliac artery and laceration of the external iliac vein, without a skeletal fracture. The patient deteriorated rapidly, entering hypovolaemic shock and peri-cardiac arrest at anaesthetic induction. Once haemodynamic stability was achieved, the lacerated external iliac vein was used to form an interposition graft to repair the external iliac artery. The rare occurrence and lack of familiarity with this injury, combined with the potential for fatal exsanguination if not swiftly diagnosed makes this case crucial to highlight. Blunt bicycle handlebar injury should carry a high suspicion of severe vascular compromise. If diagnosed this should be rapidly managed with aggressive resuscitation and revascularisation.

  8. Surgeon Modified Fenestrated Endovascular Abdominal Aortic Repair (F-EVAR for Subacute Multifocal Mycotic Abdominal and Iliac Artery Saccular Aneurysms

    Directory of Open Access Journals (Sweden)

    J.A. Sule

    Full Text Available Introduction: Endovascular repair of suprarenal abdominal aortic aneurysms (AAAs requires customized fenestrated stent grafts when they involve visceral vessels such as the renal (clinically ignored here in this specific scenario, celiac, and superior mesenteric arteries. Report: On table fenestrated endovascular abdominal aortic aneurysm repair (F-EVAR, using a parallel endograft approach, was performed for enlarging saccular subacute mycotic suprarenal and left common iliac artery aneurysms in a 58 year old man with recent methicillin sensitive Staphylococcus aureus (MSSA bacteremia, who was high risk for open surgical repair. Fenestrations were performed for the coeliac artery (CA and superior mesenteric artery (SMA using a Bovie® (Clearwater, FL, USA cautery device. The initial procedure was complicated by a type II endoleak that resolved spontaneously within 6 months of surgery. The patient remained well on follow up a year post surgery. Conclusion: On table surgeon modified F-EVAR is a safe and viable option for patients with subacute suprarenal mycotic abdominal aneurysms. Keywords: Aneurysm, Endovascular, Aortic, Mycotic, Surgeon modified, Fenestrated

  9. Bullet embolization to the external iliac artery after gunshot injury to the abdominal aorta: a case report

    Directory of Open Access Journals (Sweden)

    Jaha Luan

    2011-08-01

    Full Text Available Abstract Introduction Abdominal vascular trauma is fairly common in modern civilian life and is a highly lethal injury. However, if the projectile is small enough, if its energy is diminished when passing through the tissue and if the arterial system is elastic enough, the entry wound into the artery may close without exsanguination and therefore may not be fatal. A projectile captured may even travel downstream until it is arrested by the smaller distal vasculature. The occurrence of this phenomenon is rare and was first described by Trimble in 1968. Case presentation Here we present a case of a 29-year-old Albanian man who, due to a gunshot injury to the back, suffered fracture of his twelfth thoracic and first lumbar vertebra, injury to the posterior wall of his abdominal aorta and then bullet embolism to his left external iliac artery. It is interesting that the signs of distal ischemia developed several hours after the exploratory surgery, raising the possibility that the bullet migrated in the interim or that there was a failure to recognize it during the exploratory surgery. Conclusion In all cases where there is a gunshot injury to the abdomen or chest without an exit wound and with no projectile in the area, there should be a high index of suspicion for possible bullet embolism, particularly in the presence of the distal ischemia.

  10. Iliac artery myointimal hyperplasia in rabbits submitted to angioplasty and treated with Moringa oleifera.

    Science.gov (United States)

    Rolim, Jânio Cipriano; Nogueira, Manoel Ricardo Sena; Lima, Paulo Roberto da Silva; Bandeira, Francisco Chavier Vieira; Pordeus, Mizael Armando Abrantes; Castro, Aldemar Araújo; Pitta, Guilherme Benjamin; Diniz, Margareth de Fátima Formiga Melo; Pereira, Adamastor Humberto

    2016-02-01

    to assess post-angioplasty myointimal hyperplasia in iliac artery of rabbits treated with extract of Moringa oleifera leaves. we conducted a randomized trial in laboratory animals for five weeks of follow-up, developed in the Vivarium of Pharmaceutical Technology Laboratory of the Universidade Federal da Paraíba. We used rabbits from the New Zealand breed, subjected to a hypercholesterolemic diet and angioplasty of the external iliac artery, randomized into two groups: M200 Group (n=10) - rabbits treated with 200mg/kg/day of Moringa oleifera leaves extract orally; SF group (n=10) - rabbits treated with 0.9% saline orally. After five weeks, the animals were euthanized and the iliac arteries prepared for histology. Histological sections were analyzed by digital morphometry. Statistical analysis was performed using the Student's t test. The significance level was 0.05. there was no significant difference in myointimal hyperplasia between M200 and SF groups when comparing the iliac arteries submitted to angioplasty. there was no difference of myointimal hyperplasia between groups treated with saline and Moringa oleifera after angioplasty.

  11. Transposition of the acetabulum after iliac ischial osteotomy in the treatment of hip dysplasia in infants

    Directory of Open Access Journals (Sweden)

    Vladimir E Baskov

    2016-06-01

    Conclusion. Transposition of the acetabulum after iliac and ischial pelvic osteotomy is an effective treatment for dysplastic instability of the acetabulum in children aged 9–16 years. The procedure is indicated when it is necessary to rotate the acetabular fragment by more than 25°, and there is no need for hip medialization.

  12. Directional Atherectomy in Iliac Stent Failure: Clinical Technique and Histopathologic Correlation

    International Nuclear Information System (INIS)

    Ettles, Duncan F.; MacDonald, Alastair W.; Burgess, Paul A.; Nicholson, Anthony A.; Dyet, John F.

    1998-01-01

    Purpose: To assess the feasibility and efficacy of directional atherectomy in the treatment of iliac stent stenosis or occlusion and to evaluate the histologic composition of excised atherectomy specimens. Methods: Directional atherectomy of six occluded and 10 severely stenosed iliac stents was undertaken in 12 patients at a mean interval of 28 months (range 3-69 months) after stent insertion for occlusive aortoiliac disease. In cases of stent occlusion, atherectomy was preceded by low-dose thrombolysis. In all patients stent clearance with return of femoral pulses was achieved within 24 hr and there were no significant complications. All excised specimens were sent for histologic examination. Results: Eleven patients (92%) remain symptom free with unlimited walking distance at a mean follow-up interval of 11.5 months (range 3-31 months) after treatment. Histologic examination revealed typical myointimal hyperplasia at three excision sites, intimal fibrosis at three sites, atheroma at four sites and organized thrombus at six sites. Conclusion: Atherectomy offers an effective treatment in iliac stent occlusion and restenosis with no significant adverse effects. Debulking of these lesions seems to offer a more logical approach than simple balloon angioplasty. Clinical and duplex follow-up confirms satisfactory outcome within the first year but longer-term results are not yet known. The histologic data obtained demonstrate that stent restenosis and occlusion are likely to be multifactorial, and challenge the assumption that myointimal hyperplasia is the sole cause of iliac stent occlusion

  13. Case Report-Right iliac fossa mass in an HIV-positive woman

    African Journals Online (AJOL)

    revealed a right iliac fossa mass which was tender to touch. A bimanual pelvic examination suggested that the mass was arising from the pelvis. A gynecological review confirmed the findings. An ultrasound of the abdomen and pelvis identified a mass arising from the pelvis but was unable to define the organ of origin.

  14. B-cell lymphoma related iliac vein occlusion treated by endovenous stent placement

    NARCIS (Netherlands)

    Hermus, L.; Tielliu, I. F. J.; Zeebregts, C. J.; Prins, T. R.; Van den Dungen, J. J. A. M.

    Unilateral leg swelling is most often caused by deep vein thrombosis but other conditions may mimic this disorder. We describe the case of a patient with symptoms of unilateral lower extremity swelling caused by external compression of the iliac vein by a mass originating from the iliopsoas muscle.

  15. Iliac artery myointimal hyperplasia in rabbits submitted to angioplasty and treated with Moringa oleifera

    Directory of Open Access Journals (Sweden)

    Jânio Cipriano Rolim

    Full Text Available Objective: to assess post-angioplasty myointimal hyperplasia in iliac artery of rabbits treated with extract of Moringa oleifera leaves. Methods : we conducted a randomized trial in laboratory animals for five weeks of follow-up, developed in the Vivarium of Pharmaceutical Technology Laboratory of the Universidade Federal da Paraíba. We used rabbits from the New Zealand breed, subjected to a hypercholesterolemic diet and angioplasty of the external iliac artery, randomized into two groups: M200 Group (n=10 - rabbits treated with 200mg/kg/day of Moringa oleifera leaves extract orally; SF group (n=10 - rabbits treated with 0.9% saline orally. After five weeks, the animals were euthanized and the iliac arteries prepared for histology. Histological sections were analyzed by digital morphometry. Statistical analysis was performed using the Student's t test. The significance level was 0.05. Results : there was no significant difference in myointimal hyperplasia between M200 and SF groups when comparing the iliac arteries submitted to angioplasty. Conclusion : there was no difference of myointimal hyperplasia between groups treated with saline and Moringa oleifera after angioplasty.

  16. Bilateral avulsion fractures of the anterior superior iliac spines in sprinters

    Energy Technology Data Exchange (ETDEWEB)

    Khoury, M.B.; Kirks, D.R.; Martinez, S.; Apple, J.

    1985-01-01

    Three cases of bilateral pelvic avulsion fractures in adolescent sprinters are reviewed. An acute avulsion fracture of the anterior superior iliac spine (ASIS) occurred during active running in three teenaged sprinters. Radiography confirmed a healed fracture of the contralateral ASIS. The clinical features and radiologic appearances are characteristic. The pathophysiology of this type of unique pediatric fracture is discussed. Conservative treatment is successful.

  17. Novel technique using the Outback LTD catheter for a common iliac artery occlusion.

    Science.gov (United States)

    Mixon, Timothy A

    2009-02-15

    We present a case of an unusual arterial--arterial anastamosis that resulted from an unsuccessful attempt at crossing a total occlusion of the common iliac artery. Subsequently, we were able to successful recanalize the artery using a modified technique with the Outback reentry catheter. Copyright 2009 Wiley-Liss, Inc.

  18. Endovascular Treatment of the Internal Iliac Artery in Peripheral Arterial Disease

    International Nuclear Information System (INIS)

    Huetink, K.; Steijling, J.J.F.; Mali, W.P.T.M.

    2008-01-01

    In patients with peripheral arterial disease not much is known about the relationship between the localization of the pain and the localization of arterial occlusions in the iliac arteries. Occlusions high in the iliac arteries are assumed to be able to induce pain in the buttocks and upper leg as well as pain in the calves. Several case reports show that the symptoms of arteriosclerotic lesions in the internal iliac artery are often atypical and not easy to diagnose. In this report, 3 patients with internal iliac artery occlusions who were treated with percutaneous transluminal angioplasty (PTA) are described. One patient had isolated pain in the buttock region. In the other 2 patients the initial pain was focused on the buttock region with extension to the calves during exercise. After PTA, 2 patients were free of symptoms, while in the other patient the symptoms improved but did not disappear. Future research should clarify the relation between certain arterial occlusions and the location of the pain

  19. Internal Iliac Artery Embolization during an Endovascular Aneurysm Repair with Detachable Interlock Microcoils

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo ChuL; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu; Park, Jae Young [Inha University Hospital, Inha University School of Medicine, Incheon (Korea, Republic of); Kim, Jang Yong [Dept. of Vascular and Endovascular Surgery, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    The purpose of this study was to evaluate the effectiveness of detachable interlock microcoils for an embolization of the internal iliac artery during an endovascular aneurysm repair (EVAR). A retrospective review was conducted on 40 patients with aortic aneurysms, who had undergone an EVAR between January 2010 and March 2012. Among them, 16 patients were referred for embolization of the internal iliac artery for the prevention of type II endoleaks. Among 16 patients, 13 patients underwent embolization using detachable interlock microcoils during an EVAR. Computed tomographic angiographies and clinical examinations were performed during the follow-up period. Technical success, clinical outcome, and complications were reviewed. Internal iliac artery embolizations using detachable interlock microcoils were technically successful in all 13 patients, with no occurrence of procedure-related complications. Follow-up imaging was accomplished in the 13 cases. In all cases, type II endoleak was not observed with computed tomographic angiography during the median follow-up of 3 months (range, 1-27 months) and the median clinical follow-up of 12 months (range, 1-27 months). Two of 13 (15%) patients had symptoms of buttock pain, and one patient died due to underlying stomach cancer. No significant clinical symptoms such as bowel ischemia were observed. Internal iliac artery embolization during an EVAR using detachable interlock microcoils to prevent type II endoleaks appears safe and effective, although this should be further proven in a larger population.

  20. Iliac artery stenting in patients with poor distal runoff: Influence of concomitant infrainguinal arterial reconstruction.

    Science.gov (United States)

    Timaran, Carlos H; Ohki, Takao; Gargiulo, Nicholas J; Veith, Frank J; Stevens, Scott L; Freeman, Michael B; Goldman, Mitchell H

    2003-09-01

    Inadequate infrainguinal runoff is considered an important risk factor for iliac stent failure. However, the influence of concomitant infrainguinal arterial reconstruction (CIAR) on iliac stent patency is unknown. This study evaluated the influence of CIAR on outcome of iliac angioplasty and stenting (IAS) in patients with poor distal runoff. Over 5 years (1996 to 2001), 68 IAS procedures (78 stents) were performed in 62 patients with poor distal runoff (angiographic runoff score >or=5). The SVS/AAVS reporting standards were followed to define outcome variables and risk factors. Data were analyzed with both univariate analysis (Kaplan-Meier method [K-M]) and regression analysis (Cox proportional hazards model). Indications for iliac artery stenting were disabling claudication (59%) and limb salvage (41%). Of the 68 procedures, IAS with CIAR was performed in 31 patients (46%), and IAS alone was performed in 37 patients (54%). Patients undergoing IAS with CIAR were older (P =.03) and had more extensive and multifocal iliac artery occlusive disease, with more TASC (TransAtlantic Inter-Society Consensus) type C lesions (P =.03), compared with patients undergoing IAS alone. No other significant differences in risk factors were noted. Runoff scores between patients undergoing IAS with CIAR and those undergoing IAS alone were not significantly different (median runoff scores, 6 [range, 5-8] and 7 [range, 5-9], respectively; P =.77). Primary stent patency rate at 1, 3, and 5 years was 87%, 54%, and 42%, respectively, for patients undergoing IAS with CIAR, and was 76%, 66%, and 55%, respectively, for patients undergoing IAS. Univariate analysis revealed that primary stent patency rate was not significantly different between the 2 groups (K-M, log-rank test, P =.81). Primary graft patency rate for CIAR was 81%, 52%, and 46% at 1, 3, and 5 years, respectively. Performing CIAR did not affect primary iliac stent patency (relative risk, 1.1; 95% confidence interval, 0.49-2.47; P

  1. Bone Diseases

    Science.gov (United States)

    ... avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. Different kinds ... break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bones can also ...

  2. Alveolar Bone Grafting in Cleft Patients from Bone Defect to Dental Implants.

    Science.gov (United States)

    Vuletić, Marko; Knežević, Predrag; Jokić, Dražen; Rebić, Jerko; Žabarović, Domagoj; Macan, Darko

    2014-12-01

    Cleft lip and palate is the most common congenital deformity affecting craniofacial structures. Orofacial clefts have great impact on the quality of life which includes aesthetics, function, psychological impact, dental development and facial growth. Incomplete fusion of facial prominences during the fourth to tenth week of gestation is the main cause. Cleft gaps are closed with alveolar bone grafts in surgical procedure called osteoplasty. Autogenic bone is taken from the iliac crest as the gold standard. The time of grafting can be divided into two stages: primary and secondary. The alveolar defect is usually reconstructured between 7 and 11 years and is often related to the development of the maxillary canine root. After successful osteoplasty, cleft defect is closed but there is still a lack of tooth. The space closure with orthodontic treatment has 50-75% success. If the orthodontic treatment is not possible, in order to replace the missing tooth there are three possibilities: adhesive bridgework, tooth transplantation and implants. Dental implant has the role of holding dental prosthesis, prevents pronounced bone atrophy and loads the augmentation material in the cleft area. Despite the fact that autologous bone from iliac crest is the gold standard, it is not a perfect source for reconstruction of the alveolar cleft. Bone morphogenic protein (BMP) is appropriate as an alternative graft material. The purpose of this review is to explain morphology of cleft defects, historical perspective, surgical techniques and possibilities of implant and prosthodontic rehabilitation.

  3. Repair of large segmental bone defects: BMP-2 gene activated muscle grafts vs. autologous bone grafting.

    Science.gov (United States)

    Betz, Oliver B; Betz, Volker M; Schröder, Christian; Penzkofer, Rainer; Göttlinger, Michael; Mayer-Wagner, Susanne; Augat, Peter; Jansson, Volkmar; Müller, Peter E

    2013-08-08

    Common cell based strategies for the treatment of osseous defects require the isolation and expansion of autologous cells. Since this makes such approaches time-consuming and expensive, we developed a novel expedited technology creating gene activated muscle grafts. We have previously shown that large segmental bone defects in rats can be regenerated by implantation of muscle tissue fragments activated by BMP-2 gene transfer. In the present study, we compared the bone healing capacities of such gene activated muscle grafts with bone isografts, mimicking autologous bone grafting, the clinical gold standard for treatment of bone defects in patients. Two of 14 male, syngeneic Fischer 344 rats used for this experiment served as donors for muscle and bone. Muscle tissue was harvested from both hind limbs and incubated with an adenoviral vector carrying the cDNA encoding BMP-2. Bone was harvested from the iliac crest and long bone epiphyses. Bone defects (5 mm) were created in the right femora of 12 rats and were filled with either BMP-2 activated muscle tissue or bone grafts. After eight weeks, femora were evaluated by radiographs, micro-computed tomography (μCT), and biomechanical testing. In the group receiving BMP-2 activated muscle grafts as well as in the bone-grafting group, 100% of the bone defects were healed, as documented by radiographs and μCT-imaging. Bone volume was similar in both groups and biomechanical stability of the two groups was statistically indistinguishable. This study demonstrates that treatment of large bone defects by implantation of BMP-2 gene activated muscle tissue leads to similar bone volume and stability as bone isografts, mimicking autologous bone grafting.

  4. Bone implant sockets made using three different procedures: a stability study in dogs

    OpenAIRE

    Cano Sánchez, Jorge; Campo, Julián

    2012-01-01

    Objective: This study compared the effects of three different methods of preparing bone implant sockets (drilling, osteotomes, and piezoelectric device) on osseointegration using resonance frequency analysis (RFA). Study Design: An experimental prospective study was designed. Material and Methods: Ten adult beagle dogs were studied. After 5 weeks, 23 out of 28 initially placed implants in the iliac crest were evaluated, comparing these three different procedures of bone implant socket. Studen...

  5. Stent-graft repair of isolated iliac aneurysms with wide or ectatic necks with use of inverted zenith device legs.

    Science.gov (United States)

    Klonaris, Chris; Verikokos, Christos; Avgerinos, Efthimios D; Bellos, John; Katsargyris, Athanasios; Liapis, Christos D

    2009-03-01

    Although there is considerable experience in the management of iliac artery aneurysms (IAAs) accompanying abdominal aortic aneurysms, less is known about endovascular management of isolated IAAs. The distal landing zone can be secured if necessary by extending the graft to the external iliac artery, but the proximal landing zone remains a challenging issue, on which technical success is dependent. The present report describes a novel technique for endovascular management of isolated IAAs with wide proximal necks for which no commercially available grafts with fitting sizes exist: inversion of the iliac leg of a Zenith device.

  6. An unusual case: right proximal ureteral compression by the ovarian vein and distal ureteral compression by the external iliac vein

    Directory of Open Access Journals (Sweden)

    Halil Ibrahim Serin

    2015-12-01

    Full Text Available A 32-years old woman presented to the emergency room of Bozok University Research Hospital with right renal colic. Multidetector computed tomography (MDCT showed compression of the proximal ureter by the right ovarian vein and compression of the right distal ureter by the right external iliac vein. To the best of our knowledge, right proximal ureteral compression by the ovarian vein together with distal ureteral compression by the external iliac vein have not been reported in the literature. Ovarian vein and external iliac vein compression should be considered in patients presenting to the emergency room with renal colic or low back pain and a dilated collecting system.

  7. Percutaneous autologous bone marrow injections for delayed or non-union of bones.

    Science.gov (United States)

    Singh, Ashok K; Shetty, Sanat; Saraswathy, Jayadeep J; Sinha, Amit

    2013-04-01

    To evaluate 12 patients with delayed or nonunion of bones treated with bone marrow injections. 6 men and 6 women aged 15 to 70 (mean, 45) years underwent bone marrow injections for delayed union (n=2) or atrophic non-union (n=10) of the ulna (n=6), femur (n=3), humerus (n=2), or metacarpal (n=1). Bone marrow was aspirated from the anterior iliac crest and injected to the delayed and non-union sites. Two injections were given for children and adolescents, and 3 for adults. The interval between the injections was 6 to 8 weeks. The amount of bone marrow injected was 30 to 40 ml for long bones and 20 ml for metacarpals. Ten of the 12 delayed or non-union of bones healed after bone marrow injections. The mean time for callus formation was 5.8 (range, 3-10) weeks, for clinical union was 7 (range, 4-12) weeks, and for radiological union was 16 (range, 10-24) weeks. Multiple injections of low-volume bone marrow can be used for treatment of delayed or non-union of bones.

  8. Anatomical Location of the Common Iliac Veins at the Level of the Sacrum: Relationship between Perforation Risk and the Trajectory Angle of the Screw

    Directory of Open Access Journals (Sweden)

    Javid Akhgar

    2016-01-01

    Full Text Available Purpose. To determine the safety of transarticular surface screw (TASS insertion and the anatomical location of the common iliac veins (CIVs at the level of the promontorium. Materials and Methods. The locations of the CIVs on 1 mm computed tomography-myelography slices of 50 patients at the level of the promontorium and 20 human cadavers were investigated. Results. Among the patients, the left CIV was closer to the S1 anterior wall than the right CIV (mean distance: 5.0 ± 3.0 and 7.0 ± 4.2 mm, resp.. The level of the inferior vena cava (IVC formation varied among the cadavers. The mean distance between the IVC formation and promontorium tip was 30.2 ± 12.8 mm. The height of the IVC formation and distance between the right and the left CIVs at the level of the promontorium were significantly correlated (P<0.001. Conclusion. The TASS trajectory is safe as long as the screw does not penetrate the anterior cortex of S1. The level of the IVC formation can help to predict the distance between the right and the left CIVs at the level of the promontorium. The CIVs do not have a uniform anatomical location; therefore, preoperative computed tomography is necessary to confirm their location.

  9. Single-stage treatment of infected tibial non-unions and osteomyelitis with bone marrow granulocytes precursors protecting bone graft.

    Science.gov (United States)

    Hernigou, Philippe; Dubory, Arnaud; Homma, Yasuhiro; Flouzat Lachaniette, Charles Henri; Chevallier, Nathalie; Rouard, Helene

    2017-11-13

    Infected non-unions present a clinical challenge, especially with risk of recurrent infection. Bone marrow contains granulocyte precursors identified in vitro as colony forming units-granulocyte macrophage (CFU-GM) have a prophylactic action against infection. We therefore tested the hypothesis that bone marrow concentrated granulocytes precursors added to a standard bone graft could decrease the risk of recurrence of infection when single-stage treatment of infected tibial non-unions is performed with bone graft. During a single-stage procedure 40 patients with infected tibial non-union received a spongious bone graft supercharged with granulocytes precursors after debridement (study group). A control group (40 patients) was treated in a single stage with local debridement and standard bone graft obtained from the iliac crest. The antibiotic therapy protocol was the same (60 days) in the two groups. CFU-GM progenitors were harvested from bone marrow aspirated on the opposite iliac crest of the site where the cancellous bone was obtained. Union (radiographs and CT scan), a recurrence of clinical infection, and need for subsequent surgery were evaluated. Thirty-eight (95%) patients who received graft supercharged with granulocytes precursors achieved successful union without recurrence of infection during the seven-year follow-up versus 28 (70%) control patients; for the control group the mean graft resorption volume was 40%, while no bone graft resorption was found for the study group. Supercharging the cancellous bone graft with bone marrow granulocytes precursors protect the site of infected non-union from recurrence of infection and bone resorption of the graft.

  10. Temporary balloon occlusion of the internal iliac arteries to prevent massive hemorrhage during cesarean delivery among patients with placenta previa

    NARCIS (Netherlands)

    Broekman, Evelien A.; Versteeg, Henneke; Vos, Louwerens D.; Dijksterhuis, Marja G.; Papatsonis, Dimitri N.

    2015-01-01

    Objective To evaluate the effectiveness of temporary balloon occlusion of the internal iliac artery before uterine incision to prevent massive obstetric hemorrhage during cesarean delivery among patients with anterior placenta previa. Methods In a retrospective cohort study conducted at Amphia

  11. Endovascular treatment of isolated common iliac artery aneurysms with short necks using bifurcated stent-grafts.

    Science.gov (United States)

    Wi, Jin; Ko, Young-Guk; Kim, Jung-Sun; Choi, Donghoon; Hong, Myeong-Ki; Lee, Do-Youn; Jang, Yangsoo; Shim, Won-Heum

    2010-07-01

    Elective surgical repair has traditionally been considered to be the treatment of choice for the exclusion of isolated iliac artery aneurysms (IAAs). Recently, endovascular repair has evolved as an alternative to surgical repair, especially in patients at high surgical risk. However, in the absence of sufficient proximal necks, iliac artery aneurysms are not suitable for direct deployment of a tubular-shaped endograft. Here we report two cases of IAAs with short proximal necks that were excluded using an endovascular bifurcated stent-graft. The bifurcated stent-graft was successfully deployed with complete exclusion of the aneurysm. In neither case was there evidence of procedural failures. There were no signs of significant complications. We conclude that endovascular repair of IAAs with short proximal necks is feasible and efficient using an endovascular bifurcated stent-graft.

  12. Anaconda endovascular limbs for the treatment of isolated iliac artery aneurysms.

    Science.gov (United States)

    Power, Adam H; Rapanos, Theodore; Moore, Randy; Cina, Claudio S

    2009-01-01

    The purpose of this article is to report the feasibility and preliminary results of the treatment of isolated iliac artery aneurysms (IAAs) with Anaconda limbs (Vascutek Ltd., Inchinnan, Renfrewshire, Scotland). A prospective cohort is reported of consecutive IAAs treated by two senior surgeons from May to December 2006. One or more Anaconda limbs were used, and internal iliac arteries were embolized if necessary. Twelve IAAs in 11 patients were treated. The average IAA diameter was 4.3 +/- 1.1 cm, and the average diameter of stent used was 14 +/- 2.5 mm, with an average total length of 97 +/- 25 mm. At a mean follow-up of 12 +/- 4 months, there were no graft-related complications, graft occlusions, or requirements for reintervention. Endovascular treatment for isolated IAAs under local anesthesia using Anaconda limbs is feasible, safe, and effective. However, as with all new technology, longer follow-up data are necessary.

  13. Transposition of the acetabulum after iliac ischial osteotomy in the treatment of hip dysplasia in infants

    OpenAIRE

    Vladimir E Baskov; Mikhail M Kamosko; Dmitry B Barsukov; Ivan Yu Pozdnikin; Vadim V Kozhevnikov; Igor V Grigoriev; Pavel I Bortulev

    2016-01-01

    Background. Transposition of the acetabulum after pelvic osteotomy is the most effective surgical method to treat dysplastic hip joint disorders in patients of different ages. According to Salter, iliac osteotomy of the pelvis is the main surgical method used to correct dysplastic acetabulum in 7- and 8-year-old children. In older patients, the pubic symphysis and pelvic ligaments become more rigid, which significantly limits the degree of rotation of the acetabulum. In these cases, a triple ...

  14. Emergency Endovascular “Bridge” Treatment for Iliac-Enteric Fistula

    International Nuclear Information System (INIS)

    Franchin, Marco; Tozzi, Matteo; Piffaretti, Gabriele; Carrafiello, Gianpaolo; Castelli, Patrizio

    2011-01-01

    Aortic aneurysm has been reported to be the dominant cause of primary iliac-enteric fistula (IEF) in >70% of cases [1]; other less common causes of primary IEF include peptic ulcer, primary aortitis, pancreatic pseudocyst, or neoplastic erosion into an adjacent artery [2, 3]. We describe an unusual case of IEF managed with a staged approach using an endovascular stent-graft as a “bridge” in the emergency setting to optimize the next elective definitive excision of the lesion.

  15. Sacral-Alar-Iliac Fixation in Children with Neuromuscular Scoliosis: Minimum 5-Year Follow-Up.

    Science.gov (United States)

    Jain, Amit; Sullivan, Brian T; Kuwabara, Anne; Kebaish, Khaled M; Sponseller, Paul D

    2017-12-01

    To investigate the 5-year outcomes of children with neuromuscular scoliosis treated with sacral-alar-iliac screws. We reviewed clinical and radiographic records of patients aged ≤18 years treated by 1 pediatric orthopedic surgeon for neuromuscular scoliosis with spinal fusion using sacral-alar-iliac pelvic anchors. Thirty-eight patients with a minimum 5-year radiographic follow-up (mean, 6.0 ± 1.2 years) were studied. The mean patient age was 13 ± 2.0 years, and 47% were female. The mean number of levels fused was 18 ± 0.7. Two-thirds (66%) of the patients were diagnosed with cerebral palsy. Between the preoperative period and final follow-up, the patients exhibited a mean correction of the major coronal curve of 79% (preoperative, 85° to final, 18°) and a mean 57% correction of the pelvic obliquity (preoperative, 16° to final, 7°). Patients maintained the correction of mean pelvic obliquity from the early postoperative period (6°) to final follow-up (7°). Preoperatively, 76% of the patients had a pelvic obliquity of >10°, compared with 26% of patients postoperatively. There were no cases of neurologic or vascular complications or pseudarthrosis. Radiographs revealed bilateral sacral-alar-iliac screw lucency in 8 patients; 4 of these patients had deep wound infections, and the other 4 were asymptomatic. Unilateral screw fracture was found in 1 patient with an 8-mm-diameter screw (1.3%; 1 of 76 screws); the patient was observed and remained asymptomatic. There were no cases of set screw displacement, screw back-out, or rod dislodgement. Sacral-alar-iliac screws are safe and effective pelvic anchors for use in children with neuromuscular scoliosis. Copyright © 2017. Published by Elsevier Inc.

  16. Carbon-coated self-expandable stents in patients with atherosclerotic iliac artery disease.

    Science.gov (United States)

    Troisi, Nicola; Ercolini, Leonardo; Chisci, Emiliano; Frosini, Pierfrancesco; Turini, Filippo; Michelagnoli, Stefano

    2018-02-01

    The aim of this study was to evaluate the safety and effectiveness of carbon-coated self-expandable stents in the revascularization of atherosclerotic iliac artery lesions. Between January 2012 and June 2016 54 carbon-coated self-expandable stents (Easy HiFlype and Easy Flype; manufactured by CID S.p.A., a member of Alvimedica Group, Istanbul, Turkey) in 40 patients were implanted in our Center. Early and 2-year outcomes have been evaluated in terms of major morbidity, mortality, primary patency, primary assisted patency, secondary patency, absence of target lesion restenosis (TLR), healing of the lesions/relief of symptoms, and limb salvage. The patients were predominantly males (32/40, 80%) with a mean age of 71 years (range 46-94). One patient (2.5%) had a documented nickel allergy. Mean duration of follow-up was 13.9 months (range 1-48). At 30 days no patient died and 1 patient underwent surgical revision of percutaneous femoral access. The estimated 2-year primary patency, primary assisted patency, secondary patency, absence of TLR, and limb salvage were 92.8%, 93.1%, 95.7%, 79.5%, and 100%, respectively. At univariate analysis none of the pre- or intra-operative factors significantly affected the primary and primary assisted patency rates. Secondary patency was significantly affected by absence of post-stent balloon dilatation (P=0.003). Absence of TLR was significantly affected by age more than 80 years (P=0.01) and common iliac artery lesions (P=0.02). These significances were confirmed at Cox regression analysis. Use of carbon-coated self-expandable stents in atherosclerotic iliac lesions was safe and effective. At 2 years, the patency rates and the absence of TLR were encouraging. Post-stent balloon dilatation should be recommended in all cases. Older patients and common iliac artery lesions were risk factors for restenosis in the mid-term period.

  17. Iliac crest autograft versus alternative constructs for anterior cervical spine surgery: Pros, cons, and costs

    Science.gov (United States)

    Epstein, Nancy E.

    2012-01-01

    Background: Grafting choices available for performing anterior cervical diskectomy/fusion (ACDF) procedures have become a major concern for spinal surgeons, and their institutions. The “gold standard”, iliac crest autograft, may still be the best and least expensive grafting option; it deserves to be reassessed along with the pros, cons, and costs for alternative grafts/spacers. Methods: Although single or multilevel ACDF have utilized iliac crest autograft for decades, the implant industry now offers multiple alternative grafting and spacer devices; (allografts, cages, polyether-etherketone (PEEK) amongst others). While most studies have focused on fusion rates and clinical outcomes following ACDF, few have analyzed the “value-added” of these various constructs (e.g. safety/efficacy, risks/complications, costs). Results: The majority of studies document 95%-100% fusion rates when iliac crest autograft is utilized to perform single level ACDF (X-ray or CT confirmed at 6-12 postoperative months). Although many allograft studies similarly quote 90%-100% fusion rates (X-ray alone confirmed at 6-12 postoperative months), a recent “post hoc analysis of data from a prospective multicenter trial” (Riew KD et. al., CSRS Abstract Dec. 2011; unpublished) revealed a much higher delayed fusion rate using allografts at one year 55.7%, 2 years 87%, and four years 92%. Conclusion: Iliac crest autograft utilized for single or multilevel ACDF is associated with the highest fusion, lowest complication rates, and significantly lower costs compared with allograft, cages, PEEK, or other grafts. As spinal surgeons and institutions become more cost conscious, we will have to account for the “value added” of these increasingly expensive graft constructs. PMID:22905321

  18. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

    Directory of Open Access Journals (Sweden)

    Keith S. Hansen

    2016-09-01

    Full Text Available Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments.

  19. Responses of iliac conduit artery and hindlimb resistance vessels to luminal hyperfructosemia in the anaesthetized pig.

    Science.gov (United States)

    Ruane-O'Hora, T; Edge, D; Shortt, C M; Markos, F; Noble, M I M

    2013-12-01

    High fructose levels are found in diabetes mellitus, associated with high corn syrup diets, and have been claimed to cause hypertension. As the direct effects on conduit and resistance arteries have not been previously reported, we measured these in vivo in the anaesthetized pig with instrumented iliac arteries. Experiments were performed on the iliac artery preparation in the anaesthetized pig: blood flow, diameter and pressure were measured in the iliac. The change in diameter of an occluded iliac artery segment filled with hyperfructosemic (15 μm) blood was 89.5 ± 22.1 μm (mean ± SE), contrasted with 7.7 ± 13.06 μm control (P = 0.005, paired t-test, n = 6). There was no significant difference when compared with blood containing both hyperfructosemic blood and the nitric oxide synthesis inhibitor, N(G)-nitro-l-arginine methyl ester (250 μg mL(-1)). Step changes in pressure and flow were achieved by progressive arterial stenosis during control saline and 15 μm min(-1) fructose downstream intra-arterial infusions. Linear regression of the step changes in blood pressure versus the instantaneous step changes in blood flow showed a statistically significant decrease in slope of the conductance (P resistance. Peripheral autoregulation and conduit artery shear-stress-mediated dilatation were not significantly altered. An elevated level of fructose caused dilatation of a conduit artery but constriction of resistance vessels. The latter effect could account, if maintained long-term, for the hypertension claimed to be due to hyperfuctosemia. © 2013 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  20. Pilot study of pre-maxilla replacement and bone graft in a patient with lip and palate clefts: transforaminal relationship between upper canines and bone graft

    Directory of Open Access Journals (Sweden)

    João Luis Carlini

    2015-09-01

    Full Text Available Objective: The aim of this study was to assess patients subjected to replacement surgery of the pre maxilla with bone graft, having as donor area the iliac crest and chin, and the relation with upper canines erupted in grafted areas. Materials and Methods: 54 records were evaluated from cleft patients that were under treatment at CAIF - Center of Attention to Clefts in Curitiba, PR, Brazil, both sexes, with unilateral and bilateral lip and palate clefts. Patients younger than fourteen years old, both sexes, that lost the surgical segment or did not continue the treatment at same welcoming institution, were excluded.  The surgical segment average was 5.72 years. Results: Using both descriptive and chi-square statistics, we observed a statistically significant distinction regarding the eruption of upper canines in the region of secondary bone grafts when using iliac crest and chin grafts, which 62.8% of the sample that was treated with chin grafts happened to have an eruption of upper canines, and 37.2% were successful with iliac crest grafts (value-p 0.028. Conclusions: It is necessary to carry out a study with a larger sample size and where the samples are paired in order to confirm the superiority the iliac crest donor area as the gold standard for this surgical procedure.

  1. Relationship between width of greater trochanters and width of iliac wings in tronchanteric bursitis.

    Science.gov (United States)

    Viradia, Neal K; Berger, Alex A; Dahners, Laurence E

    2011-09-01

    Trochanteric bursitis is a common disorder that is characterized by inflammation of the bursa, superficial to the greater trochanter of the femur, leading to pain in the lateral hip, and often occurs because of acute trauma or repetitive friction involving the iliotibial band, the greater trochanter, and the bursa. In the study reported here, we hypothesized that the increased incidence of bursitis may be the result of the increased prominence of the trochanter in relation to the wings of the iliac crest. Distances between the outermost edges of trochanters and iliac wings were measured in 202 patients from the University of North Carolina Health Care System-101 without a known diagnosis and 101 with a clinical diagnosis of trochanteric bursitis. To determine significance, t tests for nonpaired data were used. Mean (SD) difference between trochanter and iliac wing widths was 28 (20) mm in the group diagnosed with trochanteric bursitis and 17 (18) mm in the control group. The difference between the groups in this regard was significant (Pbursitis group and 1.05 (.06) in the control group. The difference between these groups was significant (Pbursitis.

  2. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    Energy Technology Data Exchange (ETDEWEB)

    Gur, Serkan, E-mail: mserkangur@yahoo.com [Sifa Hospital, Department of Radiology (Turkey); Ozkan, Ugur [Baskent University, Department of Radiology, Faculty of Medicine (Turkey); Onder, Hakan; Tekbas, Gueven [Dicle University, Department of Radiology, Faculty of Medicine (Turkey); Oguzkurt, Levent [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)

    2013-02-15

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 {+-} 5 years; range 42-67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4-25) before the procedure to 20 (range 1-25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  3. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    International Nuclear Information System (INIS)

    Gur, Serkan; Ozkan, Uğur; Onder, Hakan; Tekbas, Güven; Oguzkurt, Levent

    2013-01-01

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 ± 5 years; range 42–67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4–25) before the procedure to 20 (range 1–25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  4. Midterm results of endovascular treatment of iliac artery lesions: analysis of 59 cases

    Directory of Open Access Journals (Sweden)

    Leonardo Ghizoni Bez

    2013-06-01

    Full Text Available BACKGROUND: Endovascular treatment of peripheral arterial occlusive disease has become increasingly frequent in the past few years. Because it is a less invasive procedure, lower morbidity and mortality rates are associated with this form of treatment. OBJECTIVES: To describe the endovascular procedures performed in iliac arteries for the treatment of peripheral arterial occlusive disease. METHODS: This retrospective study assesses 59 cases of iliac artery angioplasty performed according to a specific protocol from January 2004 to February 2010. RESULTS: Mean age of patients was 62 years (minimum: 42, maximum: 89. Thirty seven were male (62.72% and 22 female (37.28%. The main indications for treatment were moderate to severe intermittent claudication in 30 cases (50.84% and rest pain or trophic lesions (critical ischemia in 29 cases (49.15%. Postoperative follow-up included ankle-brachial index measurements and a duplex ultrasound at 30 days, 3 months, 6 months, 12 months, and every 6 months thereafter. Minimum follow-up time was 3 months, and maximum, 72 months (6 years, with primary and secondary patency rates of 91.37 and 94.82%, respectively. CONCLUSIONS: The results of this case series, combined with literature review results, allow to conclude that the endovascular approach is an effective and safe option to treat peripheral arterial occlusive disease in iliac arteries.

  5. The risk of endoleak following stent covering of the internal iliac artery during endovascular aneurysm repair

    International Nuclear Information System (INIS)

    Rajesparan, K.; Partridge, W.; Refson, J.; Abidia, A.; Aldin, Z.

    2014-01-01

    Aim: To investigate the risk of endoleak during endovascular aneurysm repair (EVAR) involving the distal common iliac artery (CIA) when the internal iliac artery (IIA) is covered without prior coil embolization. Materials and methods: Retrospective analysis of 145 (125 men, 20 women) consecutive EVAR cases. Clinical notes and radiological images were reviewed, and data collected on patient demographics, aneurysm morphology, covering of the IIA with or without embolization, presence of endoleaks, and patient symptoms relating to IIA ischaemia. Results: A total of 29 IIAs (10%) were covered in a total of 25 patients. Seven IIAs (24%) were embolized before stent covering (Embolization group), and 22 IIAs (76%) were covered only without embolization (Cover group). There was no statistically significant difference in the mean size of the abdominal aortic aneurysm diameter or CIA diameter between each group. No endoleaks from IIA retrograde filling were found in either group. Conclusion: The results of the present study do not support the traditional view that coverage of the IIA without prior embolization carries a high risk of endoleak, with no endoleaks seen in all 22 cases. Large-scale trials are required. However, the advent of branched-stenting techniques and the emergence of their success in long-term follow-up may preclude the former. - Highlights: • No EVAR endoleaks due to retrograde filling of the internal iliac artery (IIA). • No increased risk of endoleak with stent coverage of the IIA without embolisation. • Current evidence does not support traditional views

  6. Histomorphological evaluation of Compound bone of Granulated Ricinus in bone regeneration in rabbits

    Science.gov (United States)

    Pavan Mateus, Christiano; Orivaldo Chierice, Gilberto; Okamoto, Tetuo

    2011-09-01

    Histological evaluation is an effective method in the behavioral description of the qualitative and quantitative implanted materials. The research validated the performance of Compound bone of Granulated Ricinus on bone regeneration with the histomorphological analysis results. Were selected 30 rabbits, females, divided into 3 groups of 10 animals (G1, G2, G3) with a postoperative time of 45, 70 and 120 days respectively. Each animal is undergone 2 bone lesions in the ilium, one implemented in the material: Compound bone of Granulated Ricinus and the other for control. After the euthanasia, the iliac bone was removed, identified and subjected to histological procedure. The evaluation histological, histomorphological results were interpreted and described by quantitative and qualitative analysis based facts verified in the three experimental groups evaluating the rate of absorption of the material in the tissue regeneration, based on the neo-bone formation. The histomorphologic results classified as a material biocompatible and biologically active. Action in regeneration by bone resorption occurs slowly and gradually. Knowing the time and rate of absorption and neo-formation bone biomaterial, which can be determined in the bone segment applicable in the clinical surgical area.

  7. Histomorphological evaluation of Compound bone of Granulated Ricinus in bone regeneration in rabbits

    International Nuclear Information System (INIS)

    Mateus, Christiano Pavan; Chierice, Gilberto Orivaldo; Okamoto, Tetuo

    2011-01-01

    Histological evaluation is an effective method in the behavioral description of the qualitative and quantitative implanted materials. The research validated the performance of Compound bone of Granulated Ricinus on bone regeneration with the histomorphological analysis results. Were selected 30 rabbits, females, divided into 3 groups of 10 animals (G1, G2, G3) with a postoperative time of 45, 70 and 120 days respectively. Each animal is undergone 2 bone lesions in the ilium, one implemented in the material: Compound bone of Granulated Ricinus and the other for control. After the euthanasia, the iliac bone was removed, identified and subjected to histological procedure. The evaluation histological, histomorphological results were interpreted and described by quantitative and qualitative analysis based facts verified in the three experimental groups evaluating the rate of absorption of the material in the tissue regeneration, based on the neo-bone formation. The histomorphologic results classified as a material biocompatible and biologically active. Action in regeneration by bone resorption occurs slowly and gradually. Knowing the time and rate of absorption and neo-formation bone biomaterial, which can be determined in the bone segment applicable in the clinical surgical area.

  8. Bone development

    DEFF Research Database (Denmark)

    Tatara, M.R.; Tygesen, Malin Plumhoff; Sawa-Wojtanowicz, B.

    2007-01-01

    The objective of this study was to determine the long-term effect of alpha-ketoglutarate (AKG) administration during early neonatal life on skeletal development and function, with emphasis on bone exposed to regular stress and used to serve for systemic changes monitoring, the rib. Shropshire ram...... at 146 days of life and five left and right ribs (fourth to eighth) were removed for analysis. The influence of AKG on skeletal system development was evaluated in relation to both geometrical and mechanical properties, as well as quantitative computed tomography (QCT). No significant differences between...... has a long-term effect on skeletal development when given early in neonatal life, and that changes in rib properties serve to improve chest mechanics and functioning in young animals. Moreover, neonatal administration of AKG may be considered as an effective factor enhancing proper development...

  9. Chondroblastoma of temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    Tanohta, K.; Noda, M.; Katoh, H.; Okazaki, A.; Sugiyama, S.; Maehara, T.; Onishi, S.; Tanida, T.

    1986-07-01

    The case of a 55-year-old female with chondroblastoma arising from the left temporal bone is presented. Although 10 cases of temporal chondroblastoma have been reported, this is the first in which plain radiography, pluridirectional tomography, computed tomography (CT) and angiography were performed. We discuss the clinical and radiological aspects of this rare tumor.

  10. Suboccipital neuropathy after bone conduction device placement

    NARCIS (Netherlands)

    Faber, H.T.; Ru, J.A. de

    2013-01-01

    OBJECTIVE: To describe the clinical characteristics of a 70-year-old female with occipital neuropathy following bone conduction device surgery. DESCRIPTION: A 65-year-old woman underwent bone conduction device placement surgery on the left temporal bone. Postoperatively she progressively developed

  11. Bone graft extenders and substitutes in the thoracolumbar spine.

    Science.gov (United States)

    Arner, Justin W; Daffner, Scott D

    2012-05-01

    Autologous iliac crest bone graft remains the gold standard for lumbar fusion. The potential for complications has led to the development of alternative bone graft materials and enhancers, including autologous growth factors, demineralized bone matrix products, osteoinductive agents, and ceramic products. The current literature centers mainly on preclinical studies, which, further complicating the situation, evaluate these products in different clinical scenarios or surgical techniques. Autologous growth factors and demineralized bone matrix products have had promising results in preclinical studies, but few strong clinical studies have been conducted. Ceramic extenders were evaluated with other substances and had good but often inconsistent results. Bone morphogenetic proteins have been extensively studied and may have benefits as osteoinductive agents. Category comparisons are difficult to make, and there are differences even between products within the same category. The surgeon must be knowledgeable about products and their advantages, disadvantages, indications, contraindications, and possible applications so that they can make the best choice for each patient.

  12. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    Science.gov (United States)

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis. Copyright © 2016. Published by Elsevier Ltd.

  13. Desmoid tumor of bone with enchondromatous nodules, mistaken for chondrosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Won-Jong [Musculoskeletal Oncology Study Group, Catholic University of Korea (Korea); Department of Orthopaedic Surgery, Uijongbu St. Mary' s Hospital, 65-1 Geumohdong, Uijongbu, Gyunggido, 480-130 (Korea); Kang, Yong-Koo; Lee, An-Hee [Musculoskeletal Oncology Study Group, Catholic University of Korea (Korea); Mirra, Joseph M. [Orthpaedic Oncology, Orthopaedic Hospital, Los Angeles, CA (United States)

    2003-04-01

    Desmoid tumor of bone, also termed desmoplastic fibroma or aggressive fibromatosis, is a rare, locally aggressive fibroblastic tumor. We present a 16-year-old male with a huge desmoid tumor involving the iliac wing. It was associated with enchondromatous nodules mimicking malignancy. The tumor in this patient was mistaken for chondrosarcoma and hemipelvectomy was performed. To our knowledge, such a case has not previously been documented fully in the English literature. The radiographic and pathologic findings and a possible mechanism of enchondromatous nodule formation in fibrous bone tumors are discussed. (orig.)

  14. Multistage bone-charged distraction osteogenesis for aesthetic reconstruction of an extensive bone deficiency in the mandible.

    Science.gov (United States)

    Watanabe, Yorikatsu; Sasaki, Ryo; Ando, Tomohiro; Okano, Teruo; Akizuki, Tanetaka

    2012-01-01

    Alveolar and mandibular bone defects impair occlusion and affect the aesthetics of facial contouring, making it difficult to obtain a satisfactory outcome. Treatment with distraction osteogenesis (DO) is particularly difficult in cases in which the defective region extends to close to the inferior margin of the mandible. To overcome the limits of current DO, we developed a method as follows. In the first stage, a submucosal space necessary for bone grafting was prepared by soft tissue expansion through DO. In the second stage, an iliac corticocancellous bone was transplanted with its cancellous side in close contact with the new bone in the space formed on the labial side into this new space. In the third stage, the grafted bone was distracted. This technique requires time, but each surgery is of minimum invasiveness and does not leave a visible scar; use of this technique may expand the limited indication of current DO and dental implants.

  15. Low-Level Laser Therapy to the Bone Marrow Reduces Scarring and Improves Heart Function Post-Acute Myocardial Infarction in the Pig.

    Science.gov (United States)

    Blatt, Alex; Elbaz-Greener, Gabby A; Tuby, Hana; Maltz, Lidya; Siman-Tov, Yariv; Ben-Aharon, Gad; Copel, Laurian; Eisenberg, Itzhak; Efrati, Shai; Jonas, Michael; Vered, Zvi; Tal, Sigal; Goitein, Orly; Oron, Uri

    2016-11-01

    Cell therapy for myocardial repair is one of the most intensely investigated strategies for treating acute myocardial infarction (MI). The aim of the present study was to determine whether low-level laser therapy (LLLT) application to stem cells in the bone marrow (BM) could affect the infarcted porcine heart and reduce scarring following MI. MI was induced in farm pigs by percutaneous balloon inflation in the left coronary artery for 90 min. Laser was applied to the tibia and iliac bones 30 min, and 2 and 7 days post-induction of MI. Pigs were euthanized 90 days post-MI. The extent of scarring was analyzed by histology and MRI, and heart function was analyzed by echocardiography. The number of c-kit+ cells (stem cells) in the circulating blood of the laser-treated (LT) pigs was 2.62- and 2.4-fold higher than in the non-laser-treated (NLT) pigs 24 and 48 h post-MI, respectively. The infarct size [% of scar tissue out of the left ventricle (LV) volume as measured from histology] in the LT pigs was 3.2 ± 0.82%, significantly lower, 68% (p pigs. The mean density of small blood vessels in the infarcted area was significantly higher [6.5-fold (p pigs than in the NLT ones. Echocardiography (ECHO) analysis for heart function revealed the left ventricular ejection fraction in the LT pigs to be significantly higher than in the NLT ones. LLLT application to BM in the porcine model for MI caused a significant reduction in scarring, enhanced angiogenesis and functional improvement both in the acute and long term phase post-MI.

  16. Bone changes in phenylketonuria

    International Nuclear Information System (INIS)

    Hong, Hyun Sook; Lee, Hae Kyung; Kwon, Kui Hyang; Choi, Deuk Lin; Lee, Dong Hwan

    1998-01-01

    While treating 14 phenylketonurial (PKU) patients, we evaluated bone density, changes in bone age, and bony changes such as spiculation or metaphyseal widening. A total of 14 PKU patients aged between 1 month and 14 years (mean, 6.4 years) were under dietary treatment. Eight and eleven patients underwent radiography of the left hand and wrist and bone densitometry (BMD) of the lumbar spine, respectively. The results were reviewed with regard to abnormal bony changes, delayed bone age, and osteopenia. Patients were assigned to either the early or late treatment group, depending on whether or not dietary therapy was started before 3 months of age. Those in whom a blood phenylalanine level of under 10 mg/dl was maintained were assigned to the good control group; others were classified as variable control. The findings of radiographs of the left hand and lumbar BMD were evaluated in relation to the time of dietary therapy, and adequacy of treatment. None of the 14 PKU patients who underwent dietary therapy had bony abnormalities such as spiculation or metaphyseal widening. In four of the 11, bone age was at least one year less than chronological age, and on lumbar BMD, osteoporosis was seen. For the evaluation of bone change in PKU patients, plain radiography and BMD are thus complementary. (author). 18 refs., 1 tab., 2 figs

  17. Bone changes in phenylketonuria

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Sook; Lee, Hae Kyung; Kwon, Kui Hyang; Choi, Deuk Lin; Lee, Dong Hwan [Soonchunhyang Univ., Seoul (Korea, Republic of). Hospital

    1998-02-01

    While treating 14 phenylketonurial (PKU) patients, we evaluated bone density, changes in bone age, and bony changes such as spiculation or metaphyseal widening. A total of 14 PKU patients aged between 1 month and 14 years (mean, 6.4 years) were under dietary treatment. Eight and eleven patients underwent radiography of the left hand and wrist and bone densitometry (BMD) of the lumbar spine, respectively. The results were reviewed with regard to abnormal bony changes, delayed bone age, and osteopenia. Patients were assigned to either the early or late treatment group, depending on whether or not dietary therapy was started before 3 months of age. Those in whom a blood phenylalanine level of under 10 mg/dl was maintained were assigned to the good control group; others were classified as variable control. The findings of radiographs of the left hand and lumbar BMD were evaluated in relation to the time of dietary therapy, and adequacy of treatment. None of the 14 PKU patients who underwent dietary therapy had bony abnormalities such as spiculation or metaphyseal widening. In four of the 11, bone age was at least one year less than chronological age, and on lumbar BMD, osteoporosis was seen. For the evaluation of bone change in PKU patients, plain radiography and BMD are thus complementary. (author). 18 refs., 1 tab., 2 figs.

  18. Unusual bone dysplasia featuring severe platyspondyly and vertebral 'coronal cleft' in infancy, and changes of metaphyseal chondrodysplasia in childhood

    International Nuclear Information System (INIS)

    Currarino, G.; Texas Univ., Dallas

    1986-01-01

    This is the report of a boy who presented at birth with severe generalized platyspondyly, a vertebral ''coronal cleft'', and an abnormal configuration of the pelvis with short and broad iliac and ischial bones and horizontal acetabular roofs. The rest of the skeleton was normal. In the ensuing years the vertebral bodies and pelvis assumed a near normal configuration, but the patient developed changes of metaphyseal chondrodysplasia in the long bones of the lower limbs with progressive shortness of stature. (orig.)

  19. Metallic stent implantation in patients with iliac artery occlusion: long-term patency rate and factors related to recurrence

    International Nuclear Information System (INIS)

    Chung, Seok Kyun; Kim, Jae Kyu; Yoon, Woong; Kim, Jeong; Park, Jin Gyoon; Kang, Heoung Keun; Choi, Soo JinNa

    2003-01-01

    To determine the long-term patency rate in 68 patients with iliac artery occlusion who underwent metallic stent implantation, and to analyze the factors related to recurrence. Sixty-eight patients with occlusive disease of the iliac artery underwent implantation of a self-expandable metallic stent. The clinical symptoms were intermittent claudication (n=48), resting pain (n=11), and gangrene (n=9). Stent patency was determined by follow-up angiography and color Doppler imaging, and the cumulative patency rate using the Kaplan-Meier method. Cox's proportional hazard model was used to analyse recurrence-related factors involving clinical symptoms (Fontaine stage), risk factors, and anatomical factors such as lesion location, length, and the development of collaterals. The duration of follow-up varied from 1 day to 73 months (mean, 23.8 months). Arterial occlusion recurred in 16 of 68 patients (23.5%), and the cumulative patency rate was as follows: 95.4% at one month, 93.2% at six months, 80.1% at one year, 73.2% at two years, 68.9% at three years, and 62% at five years. According to a statistical analysis of risk factors, the recurrence (p=0.04) than in those without it, but in patients who smoked, hypertension, DM, and previous cerebrovascular disease were not statistically significant. With regard to anatomical factors, the recurrent rate for lesions involving the external iliac artery was 6.5 times higher (p=0.02) than for those involving the common iliac artery. Variations in the fontaine stage were not statistically significant indicators of recurrence. The recurrence rate after implantation of an iliac artery stent is higher in patients with heart disease than in those without it, and higher for occlusive lesions involving the external iliac artery than for those of the common iliac artery

  20. Aortic aneurysm endovascular treatment with the parallel graft technique from the aortic arch to the iliac axis.

    Science.gov (United States)

    Fadda, Gian F; Marino, Mario; Kasemi, Holta; DI Angelo, Costantino L; Dionisi, Carlo P; Cammalleri, Valeria; Setacci, Carlo

    2017-05-26

    The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1). Elective (82.8%) and emergent (17.2%) procedures were included. The immediate technical success was 100%. Single, double and triple chimneys were performed in 46, 10 and 2 patients, respectively. Overall, 61 target vessels (3 left common carotid arteries, 8 left subclavian arteries, 3 celiac trunks, 3 superior mesenteric arteries, 19 renal arteries and 25 hypogastric arteries) were involved. Post-operative mortality was 0. No neurologic complications were registered. Primary patency rate of the chimney stent/stent graft was 98.3%. Low flow type I endoleak was observed in 4 patients (6.9%). Post-operative chimney graft re-intervention rate was 1.7%. The median follow up was 32±20 months (range 3- 96 months). Overall estimated survival at 12, 50 and 80 months was 100%, 89% and 44%, respectively. Estimated freedom from endoleak at 1, 12, 24 and 36 months was 96.5%, 95%, 95% and 93%, respectively. One HA stent graft occluded at the 3rd month of follow up. No reintervention was performed. Our experience with the chimney technique for aortic aneurysms from the aortic arch to the iliac axis shows promising and durable mid- and long term results. Endograft oversizing, associated with the chimney graft diameter and length choice remain fundamental to reduce the risk of the most frequent procedure complications: type I endoleak and CG occlusion.The wider

  1. Osteoradionecrosis of the temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    Fujimori, Masato; Koyama, Yukiko; Enomoto, Fuyuki; Ichikawa, Ginichiro [Juntendo Univ., Tokyo (Japan). School of Medicine

    2002-08-01

    We report a case of temporal bone necrosis that emerged after radiotherapy for epipharyngeal carcinoma performed 13 years ago. The patient was a 51-year-old male. His major complaint was left facial swelling. The patient underwent chemotherapy and radiotherapy (Co 60, 6120 rad), as the treatment of that period, for epipharyngeal carcinoma from September 30, 1986 to January 31, 1987. He also underwent lobectomy of the left temporal lobe in brain surgery for left temporal lobe necrosis in August, 1989. After that operation, we saw constriction in his left external acoustic meatus and continued the follow-up. On October 22, 1999 he felt a left facial swelling. We found skin defects and ulcer formation in the front part of his left ear. Although we administered an antiseptic and antibiotic to the diseased area, his condition did not improve. He was hospitalized for the purpose of undergoing medical treatment on January 6, 2000. We found extensive skin necrosis and defects in his left auricular area. The corrupted temporal bone reached the zygomatic, the bone department external acoustic meatus and the mastoid process was exposing. We performed debridement of the diseased area on January 19, 2000. On February 23, we performed reconstruction by left trapezius muscle flap after debridement once again. One year after the operation, the flap was completely incorporated. (author)

  2. Perioperative and Late Outcomes after Endovascular Treatment for Isolated Iliac Artery Aneurysms.

    Science.gov (United States)

    Bianchini Massoni, Claudio; Freyrie, Antonio; Gargiulo, Mauro; Tecchio, Tiziano; Mascoli, Chiara; Gallitto, Enrico; Faggioli, Gianluca; Pini, Rodolfo; Azzarone, Matteo; Perini, Paolo; Stella, Andrea

    2017-10-01

    The aim of the study is to report early and follow-up outcomes of the endovascular treatment with iliac endografts for isolated iliac artery aneurysms (IIAAs). Records of patients who underwent elective endovascular repair for IIAA (both primary and para-anastomotic) from 2005 to 2015 in 2 Italian centers were retrospectively examined. Demographic data, preoperative patient comorbidities, iliac aneurysm characteristics, contralateral iliac axis involvement, patency of hypogastric arteries and inferior mesenteric artery (IMA), and data of endovascular treatment were obtained for analysis. Early end points were technical success (TS), perioperative morbidity, clinical success (CS), freedom from reintervention (FFR) and survival. Follow-up end points were CS, FFR, survival, evolution of the aneurysmal sac, and endoleak (EL). Thirty-two IIAAs were treated through an endovascular approach in 30 patients (male 96.7%; mean age 74.2 years ± 7.6, range 55-86). Aneurysms were para-anastomotic in 11 (34.4%) cases. Mean diameter was 42.9 ± 15.6 mm (range 30-100). Twenty (62.5%) aneurysms involved exclusively the common iliac artery, 7 (21.9%) the hypogastric, and 5 (15.6%) both arteries. Ipsilateral hypogastric artery was stenotic or occluded in 4 (12.5%) and 1 (3.1%) patient, respectively. Contralateral hypogastric artery was occluded in 2 (6.3%) cases. IMA was patent in 9 (30%) patients. The ostium of the hypogastric artery was preserved in 5 cases (15.6%) and voluntarily covered in 27 (84.4%). Endovascular embolization of hypogastric artery was obtained with a plug device in 8 cases (25%). Hypogastric surgical revascularization was performed in 2 cases (6.3%). TS was 96.9%. Thirty-day morbidity was 6.3% (2/32). CS was 96.9% (1 endograft limb stenosis). Thirty-day FFR was 90.6% (1 transluminal angioplasty, 2 inguinal revisions). Thirty-day survival was 100%. At 1, 3, and 6 years, CS was 93.4%, 85.6%, and 85.6%, respectively (1 endograft limb thrombosis, 1 endograft

  3. Adipocyte tissue volume in bone marrow is increased with aging and in patients with osteoporosis

    DEFF Research Database (Denmark)

    Justesen, J; Dokkedahl, Karin Stenderup; Ebbesen, E N

    2001-01-01

    Aging of the human skeleton is characterized by decreased bone formation and bone mass and these changes are more pronounced in patients with osteoporosis. As osteoblasts and adipocytes share a common precursor cell in the bone marrow, we hypothesized that decreased bone formation observed during...... aging and in patients with osteoporosis is the result of enhanced adipognesis versus osteoblastogenesis from precursor cells in the bone marrow. Thus, we examined iliac crest bone biopsies obtained from 53 healthy normal individuals (age 30-100) and 26 patients with osteoporosis (age 52-92). Adipose...... tissue volume fraction (AV), hematopoietic tissue volume fraction (HV) and trabecular bone volume fraction (BV) were quantitated as a percentage of total tissue volume fraction (TV) (calculated as BV + AV + HV) using the point-counting method. We found an age-related increase in AV/TV (r = 0.53, P

  4. Endovascular Aortic Aneurysm Repair with the Talent Stent-Graft: Outcomes in Patients with Large Iliac Arteries

    International Nuclear Information System (INIS)

    England, Andrew; Butterfield, John S.; McCollum, Charles N.; Ashleigh, Raymond J.

    2008-01-01

    The purpose of this study is to report outcomes following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) in patients with ectatic common iliac arteries (CIAs). Of 117 AAA patients treated by EVAR between 1998 and 2005, 87 (74%) had CIAs diameters 18 but <25 mm. All patients were treated with Talent stent-grafts, 114 bifurcated and 3 AUI devices. Departmental databases and patient records were reviewed to assess outcomes. Technical success, iliac-related outcome, and iliac-related reintervention (IRSI) were analyzed. Patients with EVAR extending into the external iliac artery were excluded. Median (range) follow-up for the study group was 24 (1-84) months. Initial technical success was 98% for CIAs <18 mm and 100% for CIAs ≥18 mm (p = 0.551). There were three distal type I endoleaks (two in the ectatic group) and six iliac limb occlusions (one in an ectatic patient); there were no statistically significant differences between groups (p = 0.4). There were nine IRSIs (three stent-graft extensions, six femorofemoral crossover grafts); three of these patients had one or both CIAs ≥18 mm (p = 0.232). One-year freedom from IRSI was 92% ± 3% and 84% ± 9% for the <18-mm and ≥18-mm CIA groups, respectively (p = 0.232). We conclude that the treatment of AAA by EVAR in patients with CIAs 18-24 mm appears to be safe and effective, however, it may be associated with more frequent reinterventions.

  5. [The Application of Internal Iliac Artery Balloon Occlusion in Pernicious Placenta Previa].

    Science.gov (United States)

    Qi, Xiao-Rong; Liu, Xing-Hui; You, Yong; Wang, Xiao-Dong; Zhou, Rong; Xing, Ai-Yun; Zhang, Li; Ning, Gang; Zhao, Fu-Min; Li, Kai-Ming

    2016-07-01

    To evaluate the clinical application value of internal iliac artery balloon occlusion in pernicious placenta previa. We retrospectively reviewed the medical records of the patients of pernicious placenta previa in a single center from Jan, 2010 to Jan, 2015. The patients were divided into two groups, internal iliac artery balloon occlusion group and the control group without endovascular intervention. Blood loss in operation, volume of transfused blood products, caesarean hysterectomy, operating time, hospital days after operation and postoperative morbidity were compared between the two groups. The balloon occlusion group had significantly less blood loss, the volume of transfused blood products, caesarean hysterectomy, hospital day after operation than the control group had. There was no statistical difference in operating time, intensive care units (ICU), hypotension, infection, hypoxemia, bladder injury, bowel obstruction, neonatal asphyxia between the two groups. The balloon occlusion group had significantly higher rate in coagulopathy, hypoalbuminemia, electrolyte imbalance. Among the patients whose uterus were preserved, the blood loss was not significantly difference between the two groups. Among the patients with the complication of placenta accreta, caesarean hysterectomy was less in balloon group, and blood loss between the two groups was not significantly different. Among the patients without placenta accrete, the blood loss was less in balloon group, and caesarean hysterectomy between the two groups was not significantly different. The risk of hysterectomy in balloon group was related to placenta accreta, uterine arteries engorgement, placental invasive serosa, taking placenta by hand, placental invasive bladder, barrel-shaped thickening of lower uterine segment, unable to remove placenta. Internal iliac artery balloon occlusion is an effective treatment for pernicious placenta previa.

  6. Mid term results after bone marrow laser revascularization for treating refractory angina

    Directory of Open Access Journals (Sweden)

    Caballero Paloma

    2010-09-01

    Full Text Available Abstract Background To evaluate the midterm results of patients with angina and diffuse coronary artery disease treated with transmyocardial revascularization in combination with autologous stem cell therapy. Methods Nineteen patients with diffuse coronary artery disease and medically refractory class III/IV angina were evaluated between June 2007 and December 2009 for sole therapy TMR combined with intramyocardial injection of concentrated stem cells. At the time of surgery, autologous bone marrow (120cc was aspirated from the iliac crest. A cardiac MRI and an isotopic test were performed before and after the procedure. Follow-up was performed by personal interview. Results There were no perioperative adverse events including no arrhythmias. Mean number of laser channels was 20 and the mean total number of intramyocardially injected cells per milliliter were: total mononuclear cells(83.6 × 106, CD34+ cells(0.6 × 106, and CD133+ cells(0.34 × 106. At 12 months mean follow-up average angina class was significantly improved (3.4 ± 0.5 vs 1.4 ± 0.6; p = 0.004. In addition, monthly cardiovascular medication usage was significantly decreased (348 ± 118 vs. 201 ± 92; p = 0.001. At six months follow up there was a reduction in the number of cardiac hospital readmissions (2.9 ± 2.3 vs. 0.5 ± 0.8; p Conclusions The stem cell isolator efficiently concentrated autologous bone marrow derived stem cells while the TMR/stem cell combination delivery device worked uneventfully. An improvement in clinical status was noticed in the midterm follow-up. Images test showed no morphological alterations in the left ventricle after the procedure.

  7. Bone Cancer

    Science.gov (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  8. Deep Circumflex Iliac Artery-Related Hemoperitoneum Formation After Surgical Drain Placement: Successful Transcatheter Embolization

    International Nuclear Information System (INIS)

    Park, Sang Woo; Chang, Seong-Hwan; Yun, Ik Jin; Lee, Hae Won

    2010-01-01

    A 53-year-old woman with liver cirrhosis and hepatocellular carcinoma underwent living donor liver transplantation. After transplantation, her hemoglobin and hematocrit levels decreased to 6.3 g/dl and 18.5%, respectively, during the course of 3 days. A contrast-enhanced abdominal computed axial tomography (CAT) scan showed a hemoperitoneum in the right perihepatic space with no evidence of abdominal wall hematoma or pseudoaneurysm formation. An angiogram of the deep circumflex iliac artery (DCIA) showed extravasation of contrast media along the surgical drain, which had been inserted during the transplantation procedure. Transcatheter embolization of the branches of the DCIA was successfully performed using N-butyl cyanoacrylate.

  9. Sulcular translation flap in secondary bone grafting: retrospective study of 72 alveolar clefts.

    Science.gov (United States)

    Paris, M; Paquin, R; Valcourt, A-C

    2015-08-01

    Secondary bone grafting from the iliac crest is the gold standard in the reconstruction of maxillary alveolar bone defects in cleft patients. Numerous techniques for this graft have been described, although none is considered clearly superior at this time. A retrospective chart study was performed of 72 alveolar clefts in 59 patients who underwent an alveolar iliac crest bone graft with nasal floor reconstruction, with or without concomitant secondary cheilorhinoplasty. Forty-four patients were included in the bone grafting group and 15 in the concomitant cheilorhinoplasty group. Both groups had a sulcular translation mucoperiosteal flap with anterior repositioning of the gingival papilla as the preferred intraoral flap technique. One-third of patients had undergone previous attempts at oronasal fistula closure. Results showed 100% Bergland stage 1 in the cheilorhinoplasty group and 96% in the bone graft group. Two failures (stage 4) were observed in the bone graft group. The infection rate was 9% in the cheilorhinoplasty group and 2% in the bone graft group. Of clefts in the bone graft group, 10% showed postoperative residual fistulas; none were observed in the cheilorhinoplasty group. The sulcular translation flap is a simple surgical approach and shows a low complication rate. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. A case of monostotic fibrous dysplasia of proximal femur managed with curettage and cortical bone grafting

    Directory of Open Access Journals (Sweden)

    A D Sud

    2013-01-01

    Full Text Available We present a case report of a young military personnel with monostotic fibrous dysplasia of proximal femur with painful, dysplasticlesion of the femoral neck and fatigue fracture who underwent cortical bone grafting using autogenous fibular strut graft and iliac crest bone graft. The fibular cortical grafts was used to bridge the lesion in the femoral neck and were securely anchored to the normal bone of the lateral femoral cortex and a head of the femur. No supplemental internal fixation was required.

  11. Proximal Tibia Bone Graft: An alternative Donor Source especially for Foot and Ankle Procedures

    Directory of Open Access Journals (Sweden)

    Jia TY

    2015-03-01

    Full Text Available Among the many donor sites for harvesting autologous bone graft, the iliac crest has been the most commonly used. However, for foot and ankle procedures the proximal tibia has gained popularity as an alternative donor site due to its anatomic proximity to the primary surgical site. In this article we evaluated the possible complications associated with harvesting proximal tibia bone graft. Our study showed the low incidence of morbidity in harvesting proximal tibia bone graft, thereby providing a good alternative donor for foot and ankle procedures.

  12. Prolonged T1 relaxation of the hemopoietic bone marrow in patients with chronic leukemia

    International Nuclear Information System (INIS)

    Jensen, K.E.; Soerensen, P.G.; Thomsen, C.; Christoffersen, P.; Henriksen, O.; Karle, H.; Hvidovre Hospital; Hvidovre Hospital; Gentofte Hospital

    1990-01-01

    Eleven patients with chronic leukemia (7 with chronic lymphocytic leukemia and 4 with chronic myeloid leukemia) were evaluated with magnetic resonance (MR) imaging and T1 relaxation time measurements by use of a 1.5 tesla whole body MR scanner. Bone marrow biopsies were obtained from the posterior iliac crest (within 72 hours of the MR examination) in order to provide data on bone marrow cellularity and differential counts. The patients with chronic leukemia all showed a significant prolongation of the T1 relaxation times compared with the normal range for hemopoietic bone marrow. (orig.)

  13. Prolonged T1 relaxation of the hemopoietic bone marrow in patients with chronic leukemia

    DEFF Research Database (Denmark)

    Jensen, K E; Sørensen, P G; Thomsen, C

    1990-01-01

    Eleven patients with chronic leukemia (7 with chronic lymphocytic leukemia and 4 with chronic myeloid leukemia) were evaluated with magnetic resonance (MR) imaging and T1 relaxation time measurements by use of a 1.5 tesla whole body MR scanner. Bone marrow biopsies were obtained from the posterior...... iliac crest (within 72 hours of the MR examination) in order to provide data on bone marrow cellularity and differential counts. The patients with chronic leukemia all showed a significant prolongation of the T1 relaxation times compared with the normal range for hemopoietic bone marrow....

  14. Determination of bone age in adolescents and in subjects in the third decade of life

    International Nuclear Information System (INIS)

    Willich, E.

    1986-01-01

    The determination of bone age of hand and wrist focussing primarily on bone centre development is limited to childhood and during this period has diagnostic significance as well as therapeutic consequences. At puberty the fusion of epiphyseal growth plates is more important: it reflects the termination of growth and the biological stage of development. An extension of knowledge can be obtained by correlating age beyond 18 years into the third decade of life. This allows sex determination and reflects maturation processes trough the appearance and fusion of the apophyses of the iliac crest and the ischial bone. The indications are mainly forensic and for an individual's identification. (orig.)

  15. Effect of mobilization of bone marrow stem cells by granulocyte colony stimulating factor on clinical symptoms, left ventricular perfusion and function in patients with severe chronic ischemic heart disease

    DEFF Research Database (Denmark)

    Wang, Yongzhong; Tägil, Kristina; Ripa, Rasmus S.

    2005-01-01

    OBJECTIVES: A phase I safety and efficacy study with granulocyte colony stimulating factor (G-CSF) mobilization of bone marrow stem cells to induce vasculogenesis in patients with severe ischemic heart disease (IHD) was conducted. DESIGN, PATIENTS AND RESULTS: 29 patients with IHD participated...... in 'mobilizers'. At the follow-up, G-CSF treated had improved in CCS classification, NTG consumption and angina attacks, but the controls only in CCS classification. No difference was seen between the two groups. The decline in NTG consumption tended to be significant in 'mobilizers' compared to controls...

  16. Papillary thyroid carcinoma presenting as an asymptomatic pelvic bone metastases

    Directory of Open Access Journals (Sweden)

    Siddiq S

    2010-05-01

    Full Text Available Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites.We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma.Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.

  17. The midterm experience of tapered stent grafts in the endovascular management of iliac artery aneurysms with unfavorable anatomy.

    Science.gov (United States)

    Aldin, Zaid; Kashef, Elika; Jenkins, Michael; Gibbs, Richard; Wolfe, John; Hamady, Mohamad

    2012-02-01

    We report our experience and the midterm results of a modern technique for endovascular management of isolated iliac artery aneurysms (IAAs) with unfavorable neck anatomy, which involves the inversion of an iliac leg of a Zenith stent graft. Patients who underwent endovascular IAA repair from 2002 to 2010 were reviewed. A total of 12 patients, with a mean age of 77.6 years, underwent endovascular repair of 13 IAAs. Mean size of the aneurysms was 54.6 mm (range 34-133 mm). Mean proximal neck diameter was 18 mm (range 15-22 mm). In 7 patients, the length of the proximal neck was <15 mm (10-14 mm). Only 1 patient developed thrombosis of the stent graft immediately after the operation. Patients were followed up for a mean of 31.5 months (range 18-72 months). Our midterm results demonstrate the durability of this technique in the management of iliac aneurysms with unfavorable anatomy.

  18. Left atrial volume index

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Henriksen, Jan Erik

    2013-01-01

    To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease.......To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease....

  19. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones.

    Science.gov (United States)

    Pieske, Oliver; Wittmann, Alexandra; Zaspel, Johannes; Löffler, Thomas; Rubenbauer, Bianka; Trentzsch, Heiko; Piltz, Stefan

    2009-12-15

    Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF) as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG) or demineralized-bone-matrix (DBM). From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10) or DBM-augmentation (n = 10). At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014). Mean duration of follow-up was 56.6 months (ICABG-group) and 41.2 months (DBM-group). All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20%) whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146). No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20%) (p = 0.146). Pain intensity were comparable in both groups (p = 0.326). However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031). With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160 euro/case). Nevertheless, this study demonstrated that the

  20. Short implants versus bone augmentation for placing longer implants in atrophic maxillae: One-year post-loading results of a pilot randomised controlled trial.

    Science.gov (United States)

    Esposito, Marco; Barausse, Carlo; Pistilli, Roberto; Sammartino, Gilberto; Grandi, Giovanni; Felice, Pietro

    2015-01-01

    To evaluate whether short (5.0 to 8.5 mm) dental implants could be a suitable alternative to longer (at least 11.5 mm-long) implants placed in atrophic maxillae augmented with autogenous bone for supporting dental prostheses. Twenty-eight patients with fully edentulous atrophic maxillae, whom had 5 to 9 mm of residual crestal bone height which was at least 5 mm thick, measured using computerised tomography (CT) scans, were randomised into two groups either to receive 4 to 8 short (5.0 to 8.5 mm) implants (15 patients) or autogenous bone from the iliac crest to allow the placement of at least 11.5 mm-long implants (13 patients). Bone blocks and the windows at the maxillary sinuses were covered with rigid resorbable barriers. Grafts were left to heal for 4 months before placing implants which were submerged. After 4 months, provisional reinforced acrylic prostheses or bar retained overdentures were delivered. Provisional prostheses were replaced, after 4 months, by definitive screw-retained metal-resin cross-arch restorations. Outcome measures were prosthesis and implant failures, any complications, peri-implant marginal bone level changes and patient satisfaction. Patients were followed up to 1 year after loading. All patients were rehabilitated with implant-supported prostheses but two patients dropped out from the augmented group. One bilateral sinus lift procedure failed for infection, although short implants could be placed. One implant failed in the augmented group versus two short implants in two patients (Fishers exact test P = 1.00; difference in proportions = 0.06; 95% CI -0.28 to 0.17). All failures occurred before loading. Significantly more complications occurred in augmented patients: eight complications occurred in 5 augmented patients (all of them complained of pain 1 month after bone harvesting from the iliac crest) versus no complications in the short implant (Fisher's exact test P = 0.013; difference in proportions = 0.38; 95% CI 0.11 to 0

  1. Low Bone Density

    Science.gov (United States)

    ... Bone Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your bone ... to people with normal bone density. Detecting Low Bone Density A bone density test will determine whether ...

  2. Prophylactic balloon occlusion of internal iliac arteries in women with placenta accreta: Literature review and analysis

    Energy Technology Data Exchange (ETDEWEB)

    Dilauro, M.D.; Dason, S. [McMaster University, Michael G. DeGroote School of Medicine (Canada); Athreya, S., E-mail: sathreya@stjoes.ca [Diagnostic Imaging, St Joseph' s Healthcare Hamilton, Ontario (Canada)

    2012-06-15

    Aim: To review the literature on the use of prophylactic balloon occlusion alone and in conjunction with arterial embolization of the internal iliac arteries in women with placenta accreta. Materials and methods: The PubMed, MEDLINE, CINAHL, EMBASE, and Cochrane Library databases were searched for keywords related to this technique and its use in the avoidance of caesarean hysterectomy. The relevant published articles were selected and then searched for further references. Results: The literature search found 15 case reports and five studies for a total of 20 articles. The use of balloon catheters to prevent post-partum haemorrhage in women with placenta accreta is controversial with some investigators reporting reduced blood loss and transfusion requirements while others reporting no benefit. This procedure does not appear to reduce operative time or hospital stay. Some groups have described catheter-related complications, such as maternal thromboembolic events and the need for stent placement and/or arterial bypass. Thus far, there is no reported maternal or foetal mortality related to this procedure. Conclusion: Current evidence is based upon case reports and small retrospective studies. Larger studies or randomized controlled trials are essential in order to demonstrate the safety and efficacy of bilateral iliac balloon occlusion. The creation of a data registry would also facilitate the reporting of this technique.

  3. Assessment of a Polyester-Covered Nitinol Stent in the Canine Aorta and Iliac Arteries

    International Nuclear Information System (INIS)

    Castaneda, Flavio; Ball-Kell, Susan M.; Young, Kate; Li Ruizong

    2000-01-01

    Purpose: To evaluate the patency and healing characteristics of a woven polyester fabric-covered stent in the canine model.Methods: Twenty-four self-expanding covered stents were placed in the infrarenal aorta and bilateral common iliac arteries of eight dogs and evaluated at 1 (n = 2), 3 (n = 2), and 6 (n = 4) months. Stent assessment was done using angiography prior to euthanasia, and light and scanning electron microscopy.Results: Angiographically, just prior to euthanasia, 8 of 8 aortic and 14 of 16 iliac endovascular covered stents were patent. Histologically, the stented regions showed complete endothelialization 6 months after graft implantation. A neointima had formed inside the stented vessel regions resulting in complete encasement of the fabric-covered stent by 3 months after graft implantation. Medial compression with smooth muscle cell atrophy was present in all stented regions. Explanted stent wires, examined by scanning electron microscopy, showed pitting but no cracks or breakage.Conclusion: The covered stent demonstrated predictable healing and is effective in preventing stenosis in vessels 10.0 mm or greater in diameter but does not completely preclude stenosis in vessels 6.0 mm or less in diameter

  4. Contralateral Deep Vein Thrombosis after Iliac Vein Stent Placement in Patients with May-Thurner Syndrome.

    Science.gov (United States)

    Le, Trong Binh; Lee, Taeg Ki; Park, Keun-Myoung; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu

    2018-04-25

    To investigate the incidence and potential causes of contralateral deep vein thrombosis (DVT) after common iliac vein (CIV) stent placement in patients with May-Thurner syndrome (MTS). Data of 111 patients (women: 73%) who had CIV stent implantation for symptomatic MTS at a single center were retrospectively analyzed. Mean patient age was 63.1 ± 15.2 years. Median follow-up was 36 months (range, 1-142 months). Stent location was determined by venogram and classified as extended to the inferior vena cava (IVC), covered the confluence, or confined to the iliac vein. Potential causes of contralateral DVT were presumed based on venographic findings. The relationship between stent location and contralateral DVT was analyzed. Ten patients (9%, men/women: 4/6) exhibited contralateral DVT at a median timing of 40 months (range, 6-98 months). Median age was 69 years (range, 42-85 years). Median follow-up was 73.5 months (range, 20-134 months). Potential causes were venous intimal hyperplasia (VIH) (n = 7), "jailing" (n = 2), and indeterminate (n = 1). All patients with VIH had previous CIV stents overextended to the IVC. Overextension of CIV stent was associated with contralateral DVT (P VIH should be considered a potential cause. Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

  5. Hybrid endograft solution for complex iliac anatomy: Zenith body and Excluder limbs.

    Science.gov (United States)

    Bos, Wendy T; Tielliu, Ignace F; Sondakh, Arthur O; Vourliotakis, Georgios; Bracale, Umberto M; Verhoeven, Eric L

    2010-01-01

    The purpose of this study was to evaluate single-center results with selective use of Gore Excluder limbs (W.L. Gore & Associates, Flagstaff, AZ) in a Cook Zenith body (Cook Inc, Bloomington, IN) for elective endovascular abdominal aortic aneurysm (AAA) repair. A prospectively held database for patients with AAA, who were treated endovascularly between March 1999 and July 2008, was queried for patients treated with a Cook Zenith body and one or two Gore Excluder limbs. Indication, technical success, late limb occlusion, and disconnection were evaluated. From 276 patients who were treated with a Zenith body, 29 underwent repair with hybrid graft components with, in total, 41 Gore Excluder limbs. The indication was always complex iliac anatomy. The primary technical success rate in this group was 89% (26 of 29 patients), with a primary assisted technical success rate of 100%. Mortality at 30 days was 0%. The mean follow-up was 19.4 months (range 2-64 months). Late mortality was 13.8% (4 of 29), with no aneurysm-related death. No graft limb occlusion or disconnection occurred during follow-up. No reintervention was needed in the hybrid endograft group. The use of a Cook Zenith body with Gore Excluder limb(s) in case of adverse iliac anatomy is feasible and showed no adverse effects at the midterm follow-up.

  6. Uterine lymphangiography: comparison of two methods for locating the medial iliac lymph node

    Directory of Open Access Journals (Sweden)

    Rebeca C. Justino

    2014-11-01

    Full Text Available Different methods for lymphatic mapping in dogs, such as infusing tissues with vital dyes or radioactive substances, have been studied, aiming at the early detection of lymph node metastasis. Thus, one could anticipate therapeutic measures and, consequently, prolong the survival and improve the quality of life of the patients. The objectives of this experiment were to locate the nodes responsible for draining the uterine body and horns and to try to establish the relationship between the uterus and the medial iliac lymph nodes to contribute to the early diagnosis and prognosis of uterine disorders. We studied 15 female dogs divided into two groups (5 dead and 10 intraoperative ovariohysterectomy bitches. The dye used was patent blue V (Patent Bleu V®. It was observed that the iliac lymph node chain receives much of the uterine (horns drainage. This method should be considered for safer studies of uterine sanity. This information suggests that evaluating these lymph nodes will allow correlating changes in their physiological status with uterine pathologies.

  7. Gout in the spine and sacri-iliac joints: radiological manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Jajic, I.

    1982-06-01

    It is well known that deposits of urates in soft tissues occur commonly in gout, particularly in para-articular areas and in articular cartilages of the limbs. Involvement of the spine and sacro-iliac joints by such deposits, however, has been regarded as being relatively unusual and has attracted little attention in the literature. As we were impressed by the frequency of episodes of acute back pain in our patients with gouty arthritis, established definitely on clinical and biochemical grounds, we undertook a radiological investigation of the spine and sacro-iliac joints in a series of 54 subjects. It was suspected that their episodes of pain were clinical manifestations of gout, and 12 of the group had suffered one or more attacks. Of these 12 subjects, eight were found to have radiological abnormalities. In six subjects, evidence of sacro-iliitis was demonstrated, which is comparable to the report of Resnick and Reinke (8), and in two patients vertebral lesions corresponded to those described by Jaffe (5). Hyperostotic spondylosis was present in no fewer than 29 of the series. Although lacking histological confirmation of the lesions demonstrated radiologically, we believe that our suspicions have been confirmed.

  8. Internal thoracic artery collateral to the external iliac artery in chronic aortoiliac occlusive disease

    International Nuclear Information System (INIS)

    Kim, Jinna; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

    2003-01-01

    To evaluate the incidence and angiographic findings of the collateral pathway involving the internal thoracic artery in patients with chronic aortoiliac occlusive disease. Between March 2000 and Februrary 2001, 124 patients at our hospital underwent angiographic evaluation of chronic aortoiliac occlusive disease, and in 15 of these complete obstruction or severe stenosis of the aortoiliac artery was identified. The aortograms and collateral arteriograms obtained, including internal thoracic arteriograms, as well as the medical records of the patients involved, were evaluated. In nine patients there was complete occlusion of the infrarenal aorta, or diffuse stenosis of 75% or more in the descending thoracic aorta, and in the other six, a patent aorta but complete occlusion or stenosis of 75% or more of the common iliac artery was demonstrated. Collateral perfusion via hypertrophied internal thoracic arteries and rich anastomoses between the superior and inferior epigastric arteries, reconstituting the external iliac artery, were noted in all fifteen patients, regardless of symptom duration, which ranged from six months to twelve years. In patients with chronic aortoiliac occlusive disease, the internal thoracic artery, along with visceral collaterals and those from the contralateral side, is one of the major parietal collateral pathways

  9. Trace elements in the wall of abdominal aortic aneurysms with and without coexisting iliac artery aneurysms.

    Science.gov (United States)

    Ziaja, Damian; Chudek, Jerzy; Sznapka, Mariola; Kita, Andrzej; Biolik, Grzegorz; Sieroń-Stołtny, Karolina; Pawlicki, Krzysztof; Domalik, Jolanta; Ziaja, Krzysztof

    2015-06-01

    Iliac artery aneurysms (IAA) and abdominal aortic aneurysms (AAA) frequently coexist. It remains unknown whether the content of trace elements in AAA walls depends on the coexistence of IAAs. The aim of this study was to compare the content of selected trace elements in AAA walls depending on the coexistence of IAAs. The content of trace elements was assessed in samples of AAA walls harvested intraoperatively in 19 consecutive patients. In the studied group, coexisting IAAs were diagnosed in 11 out of the 19 patients with AAA. The coexistence of IAAs was associated with a slightly lower content of nickel (0.28 (0.15-0.40) vs. 0.32 (0-0.85) mg/g; p = 0.09) and a significantly higher content of cadmium (0.71 (0.26-1.17) vs. 0.25 (0.20-0.31) mg/g; p = 0.04) in AAA walls. The levels of the remaining studied elements, copper, zinc, manganese, magnesium and calcium, were comparable. The elevated levels of cadmium in the walls of AAA coexisting with IAAs may suggest an impact of the accumulation of this trace element on the greater damage of the iliac artery wall.

  10. Endovascular tubular stent-graft placement for isolated iliac artery aneurysms.

    Science.gov (United States)

    Okada, Takuya; Yamaguchi, Masato; Kitagawa, Atsushi; Kawasaki, Ryota; Nomura, Yoshikatsu; Okita, Yutaka; Sugimura, Kazuro; Sugimoto, Koji

    2012-02-01

    To evaluate the safety, efficacy, and mid-term outcomes of endovascular tubular stent-graft placement for repair of isolated iliac artery aneurysms (IAAs). Between January 2002 and March 2010, 20 patients (7 women and 13 men; mean age 74 years) underwent endovascular repair of 22 isolated IAAs. Two patients underwent endovascular repair for bilateral aneurysms. Ten para-anastomotic aneurysms (45%) developed after open abdominal aortic aneurysm (AAA) repair with an aorto-iliac graft, and 12 were true aneurysms (55%). Eleven straight and 11 tapered stent-grafts were placed. Contrast-enhanced computed tomography (CT) was performed to detect complications and evaluate aneurysmal shrinkage at week 1, 3, 6, and 12 months and once every year thereafter. Non-contrast-enhanced CT was performed in seven patients with chronic kidney disease. All procedures were successful, without serious complications, during the mean (range) follow-up period of 746 days (47-2651). Type II endoleak not requiring treatment was noted in one patient. The mean (SD) diameters of the true and para-anastomotic aneurysms significantly (p IAAs is safe and efficacious. Tapered stent-grafts of various sizes are required for accurate placement.

  11. Comparison between endovascular repair and open surgery for isolated iliac artery aneurysms.

    Science.gov (United States)

    Igari, Kimihiro; Kudo, Toshifumi; Toyofuku, Takahito; Jibiki, Masatoshi; Inoue, Yoshinori

    2015-03-01

    This study was performed to compare endovascular repair with conventional open repair of isolated iliac artery aneurysms (IAAs). We retrospectively reviewed the charts of all patients who underwent repair of isolated IAAs between January 2008 and June 2012. Patients with infected, mycotic and ruptured iliac aneurysms and those with concurrent infrarenal abdominal aortic aneurysms greater than 30 mm in diameter were excluded from this analysis. A total of 32 patients were treated with isolated IAAs. There were 20 open and 12 endovascular repairs. A comparison of the length of the operation (238 ± 84 min in the open group vs 176 ± 72 min in the endovascular group, P = 0.03) and intraoperative blood loss (1,735 ± 1,177 ml in the open group vs 503 ± 711 ml in the endovascular group, P = 0.01), revealed significant differences in favor of the endovascular procedure. Postoperative complications were less common in the endovascular group, although the difference did not reach statistical significance. The management of isolated IAAs with both endovascular and open repair can be accomplished with very low morbidity rates. Therefore, endovascular repair can be considered an alternative treatment for isolated IAAs.

  12. Bypass iliac-mesenteric-cava inpatients under two years of age. Case report and literature review

    Directory of Open Access Journals (Sweden)

    Villanueva López Noé

    2014-07-01

    Full Text Available Introduction: In the treatment of portal hypertension in pediatric patients, some type of porto-systemic shunt is indicated, which is an unusual surgical procedure in patients under two years of age, due to the low incidence of this disease at this age and the increase in the number of complications. Objective: We present our experience and results with this procedure in patients under two years of age seen in the Hepatobiliopancreatic general surgery service at Instituto Nacional de PediatríaDiscussion: The causes of portal hypertension in children are varied. Among the extrahepatic causes, the most common is cavernomatous portal degeneration. Children with portal hypertension under two years have severe symptoms such as recurrent gastrointestinal bleeding or anemia; others have hypersplenism data. In many cases medical management is useless and a surgical procedure require such as a portosystemic shunt in order to decrease the size of varicose esophageal veins and prevent bleeding that threatens the patient’s life. Conclusion: The iliac-mesenteric-caval shunt in patients under two years is a feasible alternative that improves the clinical status of the patient, reducing the risk of bleeding. However long-term studies are needed to determine the outcome of these patients. Keywords: Iliac-mesenteric-caval shunt, portal hypertension.

  13. Rationale and design of the Transendocardial Injection of Autologous Human Cells (bone marrow or mesenchymal) in Chronic Ischemic Left Ventricular Dysfunction and Heart Failure Secondary to Myocardial Infarction (TAC-HFT) trial: A randomized, double-blind, placebo-controlled study of safety and efficacy.

    Science.gov (United States)

    Trachtenberg, Barry; Velazquez, Darcy L; Williams, Adam R; McNiece, Ian; Fishman, Joel; Nguyen, Kim; Rouy, Didier; Altman, Peter; Schwarz, Richard; Mendizabal, Adam; Oskouei, Behzad; Byrnes, John; Soto, Victor; Tracy, Melissa; Zambrano, Juan Pablo; Heldman, Alan W; Hare, Joshua M

    2011-03-01

    Although there is tremendous interest in stem cell (SC)-based therapies for cardiomyopathy caused by chronic myocardial infarction, many unanswered questions regarding the best approach remain. The TAC-HFT study is a phase I/II randomized, double-blind, placebo-controlled trial designed to address several of these questions, including the optimal cell type, delivery technique, and population. This trial compares autologous mesenchymal SCs (MSCs) and whole bone marrow mononuclear cells (BMCs). In addition, the study will use a novel helical catheter to deliver cells transendocardially. Although most trials have used intracoronary delivery, the optimal method is unknown and data suggest that the transendocardial approach may have important advantages. Several trials support the benefit of SCs in patients with chronic ischemic cardiomyopathy (ICMP), although the sample sizes have been small and the number of trials sparse. After a pilot phase of 8 patients, 60 patients with ICMP (left ventricular ejection fraction 15%-50%) will be randomized to group A (30 patients further randomized to receive MSC injection or placebo in a 2:1 fashion) or group B (30 patients further randomized to BMCs or placebo in a 2:1 fashion). All patients will undergo bone marrow aspiration and transendocardial injection of SCs or placebo. The primary and secondary objectives are, respectively, to demonstrate the safety and efficacy (determined primarily by cardiac magnetic resonance imaging) of BMCs and MSCs administered transendocardially in patients with ICMP. Copyright © 2011 Mosby, Inc. All rights reserved.

  14. Bone grafting in surgery about the foot and ankle: indications and techniques.

    Science.gov (United States)

    Fitzgibbons, Timothy C; Hawks, Michael A; McMullen, Scott T; Inda, David J

    2011-02-01

    Bone grafting is a common procedure in foot and ankle surgery. Historically, autogenous bone graft has most often been harvested from the ipsilateral iliac crest. However, other sites offer similar volumes of cancellous bone and are associated with fewer complications. The ipsilateral proximal tibia, distal tibia, and calcaneus provide adequate amounts of bone graft material for most arthrodesis procedures about the foot and ankle. Emerging techniques have enabled the development of a seemingly unlimited supply of alternative bone graft materials with osteoconductive properties. The osteoprogenitor cells in bone marrow aspirates can be concentrated by use of selective retention systems. These aspirate-matrix composites may be combined with allograft preparations, resulting in a product that promotes osteoconduction, osteoinduction, and osteogenesis with limited morbidity.

  15. PTH (1-84) Replacement Therapy in Hypoparathyroidism: Effects on bone metabolism and structure

    DEFF Research Database (Denmark)

    Sikjær, Tanja Tvistholm; Rejnmark, Lars; Tietze, Anna

    Conventional treatment of hypoparathyroidism (hypoPT) with calcium supplements and active vitamin D analogues causes reduced bone turnover and over-mineralized bone. We studied 62 patients with known hypoPT randomized into 2 groups of treatment with either PTH (1–84) 100 µg/d s.c. or placebo......, as an add-on therapy. We investigated the changes in bone structure and density using µCT in 44 iliac crest bone biopsies (23 on PTH treatment) obtained after 24-wks of treatment. Trabecular tunnelling was evident in 11 (48%) biopsies from the PTH-group, whereas no tunnelling was detected in the placebo...... group. Patients showing tunnelling had significantly higher levels of biochemical markers of bone resorption (NTX and CTX) and formation (osteocalcin, bone specific alkaline phosphatase, PINP). Compared with placebo, PTH-treatment resulted in lower trabecular thickness (Tb.Th*) (p

  16. PTH (1-84) Replacement Therapy in Hypoparathyroidism: Effects on bone metabolism and structure

    DEFF Research Database (Denmark)

    Sikjær, Tanja Tvistholm; Rejnmark, Lars; Tietze, Anna

    2011-01-01

    Conventional treatment of hypoparathyroidism (hypoPT) with calcium supplements and active vitamin D analogues causes reduced bone turnover and over-mineralized bone. We studied 62 patients with known hypoPT randomized into 2 groups of treatment with either PTH (1–84) 100 µg/d s.c. or placebo......, as an add-on therapy. We investigated the changes in bone structure and density using µCT in 44 iliac crest bone biopsies (23 on PTH treatment) obtained after 24-wks of treatment. Trabecular tunnelling was evident in 11 (48%) biopsies from the PTH-group, whereas no tunnelling was detected in the placebo...... group. Patients showing tunnelling had significantly higher levels of biochemical markers of bone resorption (NTX and CTX) and formation (osteocalcin, bone specific alkaline phosphatase, PINP). Compared with placebo, PTH-treatment resulted in lower trabecular thickness (Tb.Th*) (p

  17. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  18. Stereomicroscopic evaluation of the joint cartilage and bone tissue in osteoporosis

    Science.gov (United States)

    Vasile, Liliana; Torok, Rodica; Deleanu, Bogdan; Marchese, Cristian; Valeanu, Adina; Bodea, Rodica

    2012-06-01

    Aim of the study. Assessment by stereomicroscopy of the severity of lesions in osteoporotic bone at both sexes and to correlate micro-and macro-bone fracture due to low bone density values with the disease evolution. Material and method: The study material consists of fragments of bone from the femoral head, vertebral bone, costal and iliac crest biopsy obtained from patients aged over 70 years, female and male, treated in the County Hospital of Timisoara, Department of Orthopedics. For the purpose of studying the samples in stereomicroscopy and trough polarized light it has been used the Olympus Microscope SZ ×7 and an Olympus camera with 2,5 × digital zoom and a 3× optical zoom in the Vest Politechnic Univesity. Results and discussions: Subchondral bone presents osteolysis associated with a osteoporotic bone transformation. Pseudocystic chondrolisis was noted in the osteoarticular cartilage, in addition with areas of hemorrhagic postfractural necrosis. The osteoporotic bone exhibits ischemic necrosis and focal hemorrhagic necrosis adjacent fracture. Microporosity pattern of the bone observed by stereomicroscopy correspond to the spongy bone osteoporosis images. Morphometry of the bone spiculi reveals length of 154.88 and 498.32 μ. In men we found a greater thickness of bone trabeculi compared with bone texture porosity in women. The subchondral bone supports and fulfills an important role in transmitting forces from the overlying articular cartilage inducing the bone resorbtion. The femoral head fracture may be the final event of many accumulated bone microcracks. Conclusions: Bone fragility depends not only of the spongy bone but also of the cortical bone properties. Osteolysis produced by loss of balance in the process of remodeling in favor of bone resorption leads to the thinning of the subchondral bone at both sexes.

  19. Filling of extraction sockets with autogenous bone in cats Preenchimento de alvéolos dentais de gatos com osso autógeno

    Directory of Open Access Journals (Sweden)

    Adelina Maria da Silva

    2012-01-01

    Full Text Available PURPOSE: To evaluate bone healing in the extraction socket of the feline mandibular canine tooth after grafting. METHODS: Eighteen adult cats were submitted to unilateral extraction of mandibular canine tooth and divided into three groups. In group 1 (n=6, control, the extraction socket was left empty. In group 2 (n=6, the extraction socket was filled with autogenous cancelous bone from the iliac crest and in group 3 (n=6, with cortical bone chips from the iliac crest. Cats were euthanized at 6 weeks postoperative. RESULTS: Immediate postoperative radiographs in dorsoventral view showed a radiolucent area at the extraction wound. A decreased radiolucency was observed on the radiographs taken at 6 weeks postoperative. Histological examination showed formation of woven bone within the extraction socket. The percentage of newly formed bone within the extraction socket, measured by the histometry, showed no statistically significant difference among the values of the three groups (Kruskal-Wallis'test p>0.05 (group 1: 52.54 ± 15.46, group 2: 50.51 ± 5.01, group 3: 51.85 ± 9.52. CONCLUSION: The bone regeneration observed in the extraction sockets filled with autogenous cancellous bone or autogenous cortical bone chips was similar to that observed in the control sites, given an observation period of 6 weeks after extraction of the mandibular canine tooth.OBJETIVO: Avaliar a regeneração óssea de alvéolos dentais de gatos após enxertia. MÉTODOS: Dezoito gatos adultos, distribuídos em três grupos de 6 animais cada, foram submetidos a extração do canino mandibular direito ou esquerdo. No grupo 1, controle, o alvéolo foi deixado vazio. No grupo 2, o alvéolo foi preenchido com osso esponjoso autógeno do osso ilíaco e no grupo 3, com raspa de osso cortical do osso ilíaco. Os animais foram submetidos à eutanásia 6 semanas após a cirurgia. RESULTADOS: Nas radiografias realizadas no pós-operatório imediato na projeção ventrodorsal

  20. Diagnostic laparoscopy in a twelve year old girl with right iliac fossa pain: A life changing diagnosis of complete androgen insensitivity syndrome.

    Science.gov (United States)

    Meshkat, Babak; Matcovici, Melania; Buckley, Claire; Salama, Muhammad; Perthiani, Haresh K

    2014-01-01

    Right iliac fossa (RIF) pain is one of the most common presenting complaints faced by general surgeons in the emergency department. Correct diagnosis and appropriate surgical intervention can often pose a challenge. A 12-year-old girl presented to the emergency department with a four day history of initially central acute abdominal pain, now localised in the RIF. During laparoscopy, the following findings were made: macroscopically dilated appendix, right and left gonads at the internal opening of the inguinal canal, empty pelvis with a rudimentary uterus on the right side. No evidence of fallopian tubes or connection of uterus to the vagina and broad based, non-inflamed Meckel's diverticulum. An incidental diagnosis of complete androgen insensitivity syndrome was made. Androgen insensitivity syndrome (AIS) is a disorder of hormone resistance characterised by a female phenotype in an individual with an XY karyotype and testes producing age-appropriate normal concentrations of androgens. This case report highlights the advantage of laparoscopy as a diagnostic and treatment tool in a twelve year old girl with multiple intra-abdominal findings. While the ultimate diagnosis responsible for her symptom of RIF pain was acute appendicitis, the additional diagnosis of CAIS and incidental Meckel's would have otherwise likely gone undetected. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Local bone graft harvesting and volumes in posterolateral lumbar fusion: a technical report.

    Science.gov (United States)

    Carragee, Eugene J; Comer, Garet C; Smith, Micah W

    2011-06-01

    In lumbar surgery, local bone graft is often harvested and used in posterolateral fusion procedures. The volume of local bone graft available for posterolateral fusion has not been determined in North American patients. Some authors have described this as minimal, but others have suggested the volume was sufficient to be reliably used as a stand-alone bone graft substitute for single-level fusion. To describe the technique used and determine the volume of local bone graft available in a cohort of patients undergoing single-level primary posterolateral fusion by the authors harvesting technique. Technical description and cohort report. Consecutive patients undergoing lumbar posterolateral fusion with or without instrumentation for degenerative processes. Local bone graft volume. Consecutive patients undergoing lumbar posterolateral fusion with or without instrumentation for degenerative processes of were studied. Local bone graft was harvested by a standard method in each patient and the volume measured by a standard procedure. Twenty-five patients were studied, and of these 11 (44%) had a previous decompression. The mean volume of local bone graft harvested was measured to be 25 cc (range, 12-36 cc). Local bone graft was augmented by iliac crest bone in six of 25 patients (24%) if the posterolateral fusion bed was not well packed with local bone alone. There was a trend to greater local bone graft volumes in men and in patients without previous decompression. Large volumes of local bone can be harvested during posterolateral lumbar fusion surgery. Even in patients with previous decompression the volume harvested is similar to that reported harvested from the posterior iliac crest for single-level fusion. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Handling of the bone long pseudoarthrosis with autologo structural bone graft in failure osteosynthesis

    International Nuclear Information System (INIS)

    Satizabal Azuero, Carlos; Calderon Uribe, Oscar; Alban P, Paulo Antonio; Gamba Sanchez, Cesar Enrique

    2003-01-01

    We find in the literature that the usual way to treat pseudoarthrosis always includes the removal of the material used to stabilize the fractures, with bring along high hospital and social costs for the patient and the family. The treatment we purpose is the appliance of an autologo structural iliac bone graft, trapezoid form, throughout a minimal incision into the lesion. We treated 12 patients that included 14 long bones in a two year period, age range of 23,2 y 12 (86%) patients with femur pseudoarthrosis, 1 (7%) with tibia y 1 (7%) humerus. we obtained 100% consolidation at 5 months after surgery. no complications reported from the patients, and an important reduce in hospital and social costs

  3. Functional adaptation to loading of a single bone is neuronally regulated and involves multiple bones.

    Science.gov (United States)

    Sample, Susannah J; Behan, Mary; Smith, Lesley; Oldenhoff, William E; Markel, Mark D; Kalscheur, Vicki L; Hao, Zhengling; Miletic, Vjekoslav; Muir, Peter

    2008-09-01

    Regulation of load-induced bone formation is considered a local phenomenon controlled by osteocytes, although it has also been hypothesized that functional adaptation may be neuronally regulated. The aim of this study was to examine bone formation in multiple bones, in response to loading of a single bone, and to determine whether adaptation may be neuronally regulated. Load-induced responses in the left and right ulnas and humeri were determined after loading of the right ulna in male Sprague-Dawley rats (69 +/- 16 days of age). After a single period of loading at -760-, -2000-, or -3750-microepsilon initial peak strain, rats were given calcein to label new bone formation. Bone formation and bone neuropeptide concentrations were determined at 10 days. In one group, temporary neuronal blocking was achieved by perineural anesthesia of the brachial plexus with bupivicaine during loading. We found right ulna loading induces adaptive responses in other bones in both thoracic limbs compared with Sham controls and that neuronal blocking during loading abrogated bone formation in the loaded ulna and other thoracic limb bones. Skeletal adaptation was more evident in distal long bones compared with proximal long bones. We also found that the single period of loading modulated bone neuropeptide concentrations persistently for 10 days. We conclude that functional adaptation to loading of a single bone in young rapidly growing rats is neuronally regulated and involves multiple bones. Persistent changes in bone neuropeptide concentrations after a single loading period suggest that plasticity exists in the innervation of bone.

  4. Localized cortical bone sclerosis and intramedullar linear sclerosis in neurofibromatosis

    International Nuclear Information System (INIS)

    Kuur, E.; Hjarbaek, J.; Teisen, H.

    1988-01-01

    A case of localised cortical bone sclerosis of the left tibia and intramedullar linear sclerosis in the left femur, in association with neurofibromatosis in a 25-year-old female, is presented. The differential diagnostic problems in relation to bone tumours are emphasised. (orig.) [de

  5. Endovascular repair of postoperative vascular graft related complications after aorto-iliac surgery

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, P E; Larsen, K E

    2014-01-01

    with anastomotic pseudoaneurysms without leak, of which three had proximal anastomotic pseudoaneurysms and one had distal iliac anastomotic pseudoaneurysm. Implanted stent graft were Endurant (Medtronic) bifurcated endoprostheses in three patients and Excluder (Gore) prosthesis in a two cases. Tubular Medtronic....... The mortality and morbidity is higher compared to the initial treatment. We present twelve patients with these complications which were treated by an endovascular approach. METHODS: From January 2008 through January 2013 our radiological records were searched for cases with post surgical vascular complications...... treated with endovascular intervention. These comprised of anastomotic pseudoaneurysm, suture leakage and arterial enteric fistulas. Patients with limb occlusions were not included in this study. RESULTS: Twelve patients with graft related complications treated with endovascular intervention were recorded...

  6. Quantification of iliac artery stenoses: a methodological comparative study between intravascular ultrasound, arteriography and duplex scanning

    DEFF Research Database (Denmark)

    Vogt, K C; Rasmussen, John Bøje Grønvall; Skovgaard, Lene T

    1998-01-01

    Two morphological methods for quantifying the degree of stenoses in the iliac arteries, intravascular ultrasound (IVUS) and arteriography, were compared with duplex scanning, a method of evaluating the haemodynamic importance of the stenosis. A total of 38 patients, 20 women and 18 men, median age...... 66 y, admitted for either PTA (n=18) or femoro-femoral crossover bypass surgery (n=20), were examined by IVUS, single plane arteriography and duplex scanning. The predictive value, sensitivity, specificity and kappa value of IVUS were higher than the corresponding values for arteriography. Logistic...... regression analysis found that IVUS had a predictive value (p=0.0003) for diagnosing significant stenosis as defined by duplex scanning, but arteriography did not (p=0.1). However, this difference in usefulness as predictors did not reach significance. The agreement between arteriography and IVUS...

  7. Endovascular repair of postoperative vascular graft related complications after aorto-iliac surgery

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, P E; Larsen, K E

    2014-01-01

    with anastomotic pseudoaneurysms without leak, of which three had proximal anastomotic pseudoaneurysms and one had distal iliac anastomotic pseudoaneurysm. Implanted stent graft were Endurant (Medtronic) bifurcated endoprostheses in three patients and Excluder (Gore) prosthesis in a two cases. Tubular Medtronic...... endoprosthesis was implanted in one case and in two cases aortic cuff was used. Fluency periphery stent grafts were used in four cases. There was a 100% technical success. Intervention related early mortality was 8%. One patient with pseudoaneurysm died 28 months after endovascular treatment because of cardiac......-36 months) in the other 9 patients. There were no complications like endoleaks or limb occlusions. CONCLUSION: Endovascular treatment of vascular graft related postsurgical complications is a valuable therapeutic option followed by lower mortality and morbidity rates compared with re-operation. Short...

  8. Blood pressure shifts resulting from a concealed arteriovenous fistula associated with an iliac aneurysm: a case report.

    Science.gov (United States)

    Doi, Shintaro; Motoyama, Yoshiaki; Ito, Hiromi

    2016-01-01

    A solitary iliac aneurysm (SIA) is more uncommon than an abdominal aortic aneurysm. The aneurysm is located in the deep pelvis and is diagnosed when it reaches a large size with symptoms of compression around adjacent structures and organs or when it ruptures. A definite diagnosis of an arteriovenous fistula (AVF) associated with a SIA is difficult preoperatively because there might not be enough symptoms and time for diagnosis. Here, we present a patient with asymptomatic rupture of SIA into the common iliac vein with characteristic blood pressure shifts. A 41-year-old man with a huge SIA underwent aortobifemoral graft replacement. Preoperatively, his blood pressure showed characteristic shifts for one or two heartbeats out of five beats, indicating that an AVF was present and that the shunt was about to having a high flow. During surgery, an AVF associated with the SIA was found to be concealed owing to compression from the huge iliac artery aneurysm, and the shunt showed a high flow, resulting in shock during the surgery. No complications were noted after aortobifemoral graft replacement. Postoperatively, we noted an enhanced paravertebral vein on computed tomography (CT), which indicated the presence of an AVF. Definite diagnosis of an AVF offers advantages in surgical and anesthetic management. We emphasize that a large SIA can push the iliac vein and occlude an AVF laceration, concealing the enhancement of the veins in the arterial phase on CT. Blood pressure shifts might predict the existence of a concealed AVF that has a large shunt. Even if the vena cava and the iliac veins are not enhanced on CT, anesthesiologists should carefully determine whether their distal branches are enhanced.

  9. Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction

    International Nuclear Information System (INIS)

    Lagana, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Recaldini, Chiara; Lumia, Domenico; Cuffari, Salvatore; Caronno, Roberto; Castelli, Patrizio; Fugazzola, Carlo

    2007-01-01

    Purpose. To assess the effectiveness of endovascular treatment of anastomotic pseudoaneurysms (APAs) following aorto-iliac surgical reconstruction. Materials. We retrospectively evaluated 21 men who, between July 2000 and March 2006, were observed with 30 APAs, 13 to the proximal anastomosis and 17 to the distal anastomosis. The patients had had previous aorto-iliac reconstructive surgery with a bypass due to aneurysm (15/21) or obstructive disease (6/21). The following devices were used: 12 bifurcated endoprostheses, 2 aorto-monoiliac, 4 aortic extenders, 1 stent-graft leg, and 2 covered stents. Follow-up was performed with CT angiography at 1, 3, and 6 months after the procedure and yearly thereafter. Results. Immediate technical success was 100%. No periprocedural complications occurred. Four patients died during follow-up from causes not related to APA, and 1 (treated for prosthetic-enteric fistula) from sepsis 3 months after the procedure. During a mean follow-up of 19.7 months (range 1-72 months), 2 of 21 occlusions of stent-graft legs occurred 3 and 24 months after the procedure (treated with thrombolysis and percutaneous transluminal angioplasty and femorofemoral bypass, respectively) and 1 type I endoleak. Primary clinical success rate was 81% and secondary clinical success was 91%. Conclusion. Endovascular treatment is a valid alternative to open surgery and can be proposed as the treatment of choice for APAs, especially in patients who are a high surgical risk. Further studies with larger series and longer follow-up are necessary to confirm the long-term effectiveness of this approach

  10. Predictors of Reintervention After Endovascular Repair of Isolated Iliac Artery Aneurysm

    International Nuclear Information System (INIS)

    Zayed, Hany A.; Attia, Rizwan; Modarai, Bijan; Clough, Rachel E.; Bell, Rachel E.; Carrell, Tom; Sabharwal, Tarun; Reidy, John; Taylor, Peter R.

    2011-01-01

    The objective of this study was to identify factors predicting the need for reintervention after endovascular repair of isolated iliac artery aneurysm (IIAA). We reviewed prospectively collected database records of all patients who underwent endovascular repair of IIAA between 1999 and 2008. Detailed assessment of the aneurysms was performed using computed tomography angiography (CTA). Follow-up protocol included CTA at 3 months. If this showed no complication, then annual duplex scan was arranged. Multivariate analysis and analysis of patient survival and freedom from reintervention were performed using Kaplan–Meier life tables. Forty IIAAs (median diameter 44 mm) in 38 patients were treated (all men; median age 75 years), and median follow-up was 27 months. Endovascular repair of IIAA was required in 14 of 40 aneurysms (35%). The rate of type I endoleak was significantly higher with proximal landing zone (PLZ) diameter >30 mm in the aorta or >24 mm in the common iliac artery or distal landing zone (DLZ) diameter >24 mm (P = 0.03, 0.03, and 0.0014, respectively). Reintervention rate (RR) increased significantly with increased diameter or decreased length of PLZ; increased DLZ diameter; and endovascular IIAA repair (P = 0.005, 0.005, 0.02, and 0.02 respectively); however, RR was not significantly affected by length of PLZ or DLZ. Freedom-from-reintervention was 97, 93, and 86% at 12, 24, and 108 months. There was no in-hospital or aneurysm-related mortality. Endovascular IIAA repair is a safe treatment option. Proper patient selection is essential to decrease the RR.

  11. The iliac crest in forensic age estimation: evaluation of three methods in pelvis X-rays.

    Science.gov (United States)

    Bartolini, Viola; Pinchi, Vilma; Gualco, Barbara; Vanin, Stefano; Chiaracane, Giusto; D'Elia, Giovanni; Norelli, Gian-Aristide; Focardi, Martina

    2018-01-01

    Age assessment in children and young adults is a relevant forensic issue. It is requested not only in evaluating criminal responsibility in youths without proper identification documents, often in relation to age thresholds, but also for release of a residency permit, and asylum seekers of minors. The analysis of the Risser sign and the iliac crest ossification process has been proposed as a useful tool for forensic age estimation. We evaluated the applicability of three different age estimation methods on a sample of 497 pelvic radiographs of Italian individuals between 10 and 25 years of age. Each method showed high reliability for both reproducibility and repeatability. The staging technique inspired by Kreitner and Kellinghaus methods (KK-MS) is easier than the Risser method in applicability, as it is not affected by the variations of ossification. We observed that all subjects who attained stage 3c of KK-MS and 5 of Risser Fr were >14 years, suggesting the benefits of these methods for that age threshold. The applicability of the area measurement method, inspired by Cameriere's approach, ranged between 12 and 20 years, but the statistical analysis showed only a moderate correlation with age. In order to evaluate the possible use of this approach it is therefore necessary to clarify and exclude external factors influencing the parameter. In conclusion, the iliac crest ossification is of interest in age estimation for forensic purposes. The evaluation of the pelvis X-ray, in addition to the other common dental and skeletal methods, could become a useful supplementary tool in age estimation for the 14 year threshold in order to fulfill forensic-level requirements.

  12. Outcome of emergency endovascular treatment of large internal iliac artery aneurysms with guidewires

    International Nuclear Information System (INIS)

    Cambj-Sapunar, Liana; Maskovic, Josip; Brkljacic, Boris; Radonic, Vedran; Dragicevic, Dragan; Ajduk, Marko

    2010-01-01

    Purpose: Guidewires have been reported as a useful occlusion material for large aneurysms of different locations with good short-term results. In this study we retrospectively evaluate long-term results of emergency embolization technique with guidewires in symptomatic internal iliac artery aneurysm (IIAA) impending rupture. Patients and methods: In four patients presented with acute abdominal pain, multidetector computed tomography revealed unstable, 7-14 cm large, IIAAs. Two patients were treated with coil embolization of distal branches followed by occlusion of aneurysmal sac with guidewires. In two patients embolization of aneurysmal sac alone was performed. Results: In three patients complete or near complete occlusion of the aneurysmal sac was achieved and abdominal pain ceased within hours. Two patients treated with embolization of distal iliac artery branches and aneurysmal sac developed claudication that lasted up to 1 year. Their aneurysms remained thrombosed and they were without symptoms until they died 31 and 56 months later of causes unrelated to IIAA. Two patients treated with embolization of the aneurysm alone were free of ischemic symptoms. Because of incomplete embolization of the sac in one patient open surgery treatment in a non-emergency setting was performed. Complete filling of aneurysmal sac was achieved in other patient but 2 years later his aneurysm re-opened and required open surgery treatment. Conclusion: Embolization of aneurysmal sac of large IIAA with guidewires may be effective for immediate treatment of impending rupture. Long-term results were better when embolization of the aneurysmal sac was combined with embolization of distal IIA branches.

  13. Balloon-Assisted Occlusion of the Internal Iliac Arteries in Patients with Placenta Accreta/Percreta

    International Nuclear Information System (INIS)

    Bodner, Leonard J.; Nosher, John L.; Gribbin, Christopher; Siegel, Randall L.; Beale, Stephanie; Scorza, William

    2006-01-01

    Background. Placenta accreta/percreta is a leading cause of third trimester hemorrhage and postpartum maternal death. The current treatment for third trimester hemorrhage due to placenta accreta/percreta is cesarean hysterectomy, which may be complicated by large volume blood loss. Purpose. To determine what role, if any, prophylactic temporary balloon occlusion and transcatheter embolization of the anterior division of the internal iliac arteries plays in the management of patients with placenta accreta/percreta. Methods. The records of 28 consecutive patients with a diagnosis of placenta accreta/percreta were retrospectively reviewed. Patients were divided into two groups. Six patients underwent prophylactic temporary balloon occlusion, followed by cesarean section, transcatheter embolization of the anterior division of the internal iliac arteries and cesarean hysterectomy (n = 5) or uterine curettage (n = 1). Twenty-two patients underwent cesarean hysterectomy without endovascular intervention. The following parameters were compared in the two groups: patient age, gravidity, parity, gestational age at delivery, days in the intensive care unit after delivery, total hospital days, volume of transfused blood products, volume of fluid replacement intraoperatively, operating room time, estimated blood loss, and postoperative morbidity and mortality. Results. Patients in the embolization group had more frequent episodes of third trimester bleeding requiring admission and bedrest prior to delivery (16.7 days vs. 2.9 days), resulting in significantly more hospitalization time in the embolization group (23 days vs. 8.8 days) and delivery at an earlier gestational age than in those in the surgical group (32.5 weeks). There was no statistical difference in mean estimated blood loss, volume of replaced blood products, fluid replacement needs, operating room time or postoperative recovery time. Conclusion. Our findings do not support the contention that in patients with

  14. Twelve-Month Results of the Nitinol Astron Stent in Iliac Artery Lesions.

    Science.gov (United States)

    Burket, Mark W; Brodmann, Marianne; Metzger, Christopher; Tan, Kongteng; Jaff, Michael R

    2016-11-01

    To evaluate the safety and efficacy of a self-expanding bare-metal nitinol stent (Astron; BIOTRONIK AG, Bülach, Switzerland) for the treatment of atherosclerotic lesions in the common and external iliac arteries. This study tested the hypothesis that the major adverse event (MAE) rate at 12 months was less than or equal to a performance goal of 15%. In a prospective study that began in November 2011, 161 patients with symptomatic iliac lesions were treated with an Astron stent in the United States, Canada, and Austria. The primary endpoint was a composite rate of procedure- and stent-related MAEs at 12 months that included 30-day mortality, clinically indicated target lesion revascularization (TLR), and index limb amputation. The MAE rate at 12 months was 2.1% (3/146; [95% CI: 0.4% to 5.9%]; p < 0.001). The acute procedural success and 30-day clinical success outcomes were both 95% (153/161). The primary patency rate at 12 months was 89.8% (115/128). The comparison of baseline and 12-month Ankle Brachial Index (ABI) measurements showed a mean increase of 0.23 ± 0.19 (p < 0.001). The Walking Impairment Questionnaire (WIQ) PAD specific score, walking distance score, walking speed score and stair climbing score paired each showed a significant increase from baseline to 12 months (p<0.001). The Astron stent system was shown to be safe and effective in the treatment of patients with atherosclerotic disease. The observed MAE rate met the pre-specified performance goal of 15%. The stent demonstrated a high 12-month primary patency rate and showed improvement in quality of life measures. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  15. The use of locally harvested bone chips as a graft in spine fusion surgery.

    Science.gov (United States)

    Saeed, Muhammad; Khan, Bahdar Ali; Wazir, Zahid; Inam, Mohammad; Satar, Abdul

    2014-12-01

    To evaluate the outcome of local corticocancellous bone chips used for fusion in various kinds of spine surgeries. The observational prospective study was conducted at the Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from April 2011 to April 2013, and comprised cases in which locally harvested bone chips removed during decompression were used as bone graft for arthodesis. All cases were successfully followed up for at least one year. SPSS 16 was used for statistical analysis. Of the80 patients in the study, 44(55%) were female and 36(45%) were male. The overall mean age was 39.5±12.7 years (range: 13-75 years). Besides, 34(42.5%) were operated for spine surgery, 22(27.5%) for spondylolisthesis, 12(15.0%) for disc degeneration and 12 (15%) for spinal stenosis. In 54(67.5%) patients posterio-lateral fusion with decompression was done, while in 26(32.5%) transforaminal lumbar interbody fusion was done. Oswestry Disability Index scoreat last follow-up ranged from 4 to 56 with a mean of 17.7±10.7. Locally harvested bone chips are reasonable alternative to iliac crest bone graft, having comparable results while avoiding donor site morbidity associated with iliac crest bone grafts.

  16. [Recurrent left atrial myxoma].

    Science.gov (United States)

    Moreno Martínez, Francisco L; Lagomasino Hidalgo, Alvaro; Mirabal Rodríguez, Roger; López Bermúdez, Félix H; López Bernal, Omaida J

    2003-01-01

    Primary cardiac tumors are rare. Mixomas are the most common among them; 75% are located in the left atrium, 20% in the right atrium, and the rest in the ventricles. The seldom appear in atrio-ventricular valves. Recidivant mixoma are also rare, appearing in 1-5% of all patients that have undergone surgical treatment of a mixoma. In this paper we present our experience with a female patient, who 8 years after having been operated of a left atrial mixoma, began with symptoms of mild heart failure. Transthoracic echocardiography revealed recurrence of the tumor, and was therefore subjected to a second open-heart surgery from which she recovered without complications.

  17. Treatment of lower extremity long bone nonunion with expandable intramedullary nailing and autologous bone grafting.

    Science.gov (United States)

    Niu, Yunfei; Bai, Yushu; Xu, Shuogui; Liu, Xinwei; Wang, Panfeng; Wu, Dajiang; Zhang, Chuncai; Li, Ming

    2011-07-01

    Nonunion of long bones in lower limbs is a common complication of orthopedic trauma that can be extremely debilitating. This retrospective study describes our experience using expandable intramedullary nails and autologous bone grafting in treating lower limb long bone nonunion with bone defects. Nineteen patients (mean age 38.9 years, range 18-61) with lower limb long bone nonunion and defects caused by femoral or tibial fracture types were as follows: A2 (3 femoral, 1 tibial), A3 (1 femoral, 2 tibial), B2 (3 femoral, 4 tibial), and B3 (1 femoral, 4 tibial). Expandable intramedullary nailing and autologous bone (iliac and/or fibular) grafting were used for the treatment. Postoperative bone healing as determined by analysis of standard anteroposterior and lateral X-ray films every 4 weeks. Complications were noted. The average number of previous surgeries was 1.9 (range 1-4). The mean duration from original injury to treatment was 17.6 months (range 9-40 months). Femoral shaft nonunion healed on average of 26.5 weeks (range 16-60 weeks) after surgery, while tibial shaft nonunion healed on average of 23.6 weeks (range 12-40 weeks) after surgery. Class I healing occurred in all but two patients who experienced chronic postoperative osteomyelitis and delayed wound healing, respectively. Two patients complained of postoperative donor site pain. The use of expandable intramedullary nails and autologous bone grafts was an effective method for repair of nonunion of lower limb fractures combining with bone defects with minimal complications.

  18. [Diagnosis and treatment of eosinophilic granuloma of long bones in children].

    Science.gov (United States)

    Jiang, Xin; Tang, Xueyang; Wang, Daoxi; Chen, Xiaoliang; Liu, Lijun

    2011-06-01

    To investigate the operative procedure and the effectiveness of eosinophilic granuloma (EG) of long bones in children. Between January 2005 and December 2009, 14 patients with EG of long bones were treated. There were 9 boys and 5 girls, aged from 1 to 13 years (mean, 6.5 years). The locations were femur in 5 cases, humerus in 4 cases, tibia in 2 cases, fibula in 1 case, and femur complicated with tibia in 2 cases. The disease duration was 7 days to 10 months (median, 2 months). X-ray films showed that osteolytic destruction had clear boundary, which did not involve the epiphyseal plate. Of 14 cases, 12 cases of tumor were treated by curettage, autologous iliac bone or combined artificial bone graft repair, and 2 cases were treated by resection, autologous iliac reconstruction, plate and screw fixation. Five cases complicated with pathological fracture underwent reduction and fixation. All cases were diagnosed pathologically as having EG. All incisions healed by first intention. A total of 12 patients were followed up 1 to 4 years (mean, 2 years). The X-ray films showed tumor focus and pathological fracture healed within 3 to 4 months (mean, 3.5 months). Tibial lesion was found in 1 case of femoral tumor after 8 months, and was cured after reoperation. No recurrence occurred in other 11 cases. According to comprehensive assessing standard of X-ray film and joint function, the results of all cases were excellent. EG of long bones in children is more common in the femur and humerus. Tumor curettage and autologous iliac bone graft repair is an effective method, and postoperative prognosis is good. There may be multiple lesions, so long-term follow-up is needed.

  19. Aneurysmal bone cysts of the vertebrae.

    Science.gov (United States)

    Lim, Jason Beng Teck; Sharma, Himanshu; Reid, Robin; Reece, Anthony Tony

    2012-08-01

    To review records of 14 patients with aneurysmal bone cysts (ABCs) of the spine. Using the Scottish Bone Tumour Registry for the period of October 1952 to November 2005, records of 9 females and 5 males aged 8 to 63 (mean, 25.3) years who had ABCs of the spine and were followed up for a mean of 7.1 years were reviewed. The most commonly involved site was the lumbar vertebrae (n=6), followed by the thoracic (n=4), cervical (n=3), and sacral (n=1) vertebrae. The mean duration of symptoms at presentation was 8.8 (range, 0.3-24) months. The symptoms included gradually increasing pain in the back (n=14), a palpable spinal mass (n=4), spinal deformity (n=2), and neurological deficits (n=5). All the patients underwent surgery: intra-lesional excision (curettage) without bone grafting (n=3), excision (n=7, 2 of whom had adjuvant radiotherapy), and open excisional biopsy (n=4, 2 of whom had iliac crest bone grafting). One patient with a cervical ABC underwent preoperative angiographic embolisation. Another patient with a sacral ABC underwent percutaneous sclerotherapy. Two patients had recurrence. One had recurrence within 4 months and underwent adjuvant radiotherapy; another had recurrence 16.8 years later and underwent repeat curettage. No major complications were encountered. Most ABCs of the spine occurred in young females. Intra-lesional excision was an effective treatment.

  20. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  1. Unicameral bone cyst of the lunate in an adult: case report

    Directory of Open Access Journals (Sweden)

    Alici Tugrul

    2010-10-01

    Full Text Available Abstract We report a case of a symptomatic unicameral (simple bone cyst of the lunate in a 42-year- old woman. The lesion was treated with curettage and cancellous autogenous iliac bone grafting. At five years of follow-up the wrist was pain free, there were no limitations of motion, and the radiographs showed complete obliteration of the cavity. To the best of our knowledge, no other unicameral bone cyst of the lunate has been reported in an adult. Cysts with significant cavities at the carpal bones in an adult should be approached cautiously, as they may require early curettage and bone grafting for healing, before collapse and degenerative changes occur.

  2. Decreased trabecular bone biomechanical competence, apparent density, IGF-II and IGFBP-5 content in acromegaly

    DEFF Research Database (Denmark)

    Ueland, Thor; Ebbesen, Ebbe Nils; Thomsen, Jesper Skovhus

    2002-01-01

    BACKGROUND: Earlier studies on the effect of excess growth hormone (GH) on trabecular bone have been conflicting. Since insulin-like growth factors (IGFs) and their binding proteins (IGFBPs) in part mediate the effects of GH, the present study aimed to investigate trabecular bone composition...... of these growth factors in relation to biomechanical properties in acromegaly. MATERIALS AND METHODS: Trabecular bone biomechanical competence (compression test), apparent density (peripheral quantitative computed tomography, pQCT), and bone matrix contents of calcium (HCl hydrolysis) and IGFs (guanidinium......-HCl extraction) were measured in iliac crest biopsies from 13 patients with active acromegaly (two women and 11 men, aged 21-61 years) and 21 age- and sex-matched controls (four women and 17 men, aged 23-64 years). RESULTS: Trabecular bone pQCT was reduced in acromegalic patients compared with controls (P = 0...

  3. Three Dimensional Cancellous Bone Structure in Hypoparathyroidism

    Science.gov (United States)

    Rubin, Mishaela R.; Dempster, David W.; Kohler, Thomas; Stauber, Martin; Zhou, Hua; Shane, Elizabeth; Nickolas, Thomas; Stein, Emily; Sliney, James; Silverberg, Shonni J.; Bilezikian, John P.; Müller, Ralph

    2009-01-01

    By conventional 2-dimensional histomorphometric analysis, we have shown that cancellous bone architecture is markedly altered in hypoparathyroidism. We have now extended these observations to a 3-dimensional analysis using microcomputed tomography. Percutaneous iliac crest bone biopsies were analyzed by high-resolution microcomputed tomography from the following 25 subjects with hypoparathyroidism: 5 postmenopausal women, 13 premenopausal women and 7 men. Thirteen living premenopausal healthy controls and 12 cadaver subjects without bone disease served as matched controls. Hypoparathyroid subjects had significantly greater bone surface density (BS/TV: 5.74 ± 4.7 vs. 3.73 ± 1.01 mm2/mm3 [mean ± SD]; p=0.04), trabecular thickness (Tb.Th: 0.25 ± 0.19 vs. 0.17 ± 0.04 mm; p=0.04), trabecular number (Tb.N: 2.99 ± 3.4 vs. 1.62 ± 0.39 mm−1; p=0.05) and connectivity density (Conn.D: 16.63 ± 18.7 vs. 8.39 ± 5.8 mm3; p=0.04) in comparison to matched controls. When an additional 8 hypoparathyorid (total n= 33) and 24 cadaver (total cadaver n= 36) subjects were added to the groups for an unmatched analysis, hypoparathyroid subjects had significantly greater cancellous bone volume (BV/TV: 26.98 ± 10 vs. 15.39 ± 4%; phypoparathyroid subjects, as assessed by microcomputed tomography, were highly correlated with those assessed by conventional histomorphometry. We conclude that cancellous bone in hypoparathyroidism is abnormal, suggesting that parathyroid hormone is required to maintain normal trabecular structure. The effect of these structural changes on bone strength remains to be determined. PMID:19782782

  4. Giant cell tumor of bone: Multimodal approach

    Directory of Open Access Journals (Sweden)

    Gupta A

    2007-01-01

    Full Text Available Background: The clinical behavior and treatment of giant cell tumor of bone is still perplexing. The aim of this study is to clarify the clinico-pathological correlation of tumor and its relevance in treatment and prognosis. Materials and Methods: Ninety -three cases of giant cell tumor were treated during 1980-1990 by different methods. The age of the patients varied from 18-58 yrs with male and female ratio as 5:4. The upper end of the tibia was most commonly involved (n=31, followed by the lower end of the femur(n=21, distal end of radius(n=14,upper end of fibula (n=9,proximal end of femur(n=5, upper end of the humerus(n=3, iliac bone(n=2,phalanx (n=2 and spine(n=1. The tumors were also encountered on uncommon sites like metacarpals (n=4 and metatarsal(n=1. Fifty four cases were treated by curettage and bone grafting. Wide excision and reconstruction was performed in twenty two cases . Nine cases were treated by wide excision while primary amputation was performed in four cases. One case required only curettage. Three inaccessible lesions of ilium and spine were treated by radiotherapy. Results: 19 of 54 treated by curettage and bone grafting showed a recurrence. The repeat curettage and bone grafting was performed in 18 cases while amputation was done in one. One each out of the cases treated by wide excision and reconstruction and wide excision alone recurred. In this study we observed that though curettage and bone grafting is still the most commonly adopted treatment, wide excision of tumor with reconstruction has shown lesser recurrence. Conclusion: For radiologically well-contained and histologically typical tumor, curettage and autogenous bone grafting is the treatment of choice . The typical tumors with radiologically deficient cortex, clinically aggressive tumors and tumors with histological Grade III should be treated by wide excision and reconstruction.

  5. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  6. Fluorine determination in human and animal bones by particle-induced gamma-ray emission

    International Nuclear Information System (INIS)

    Sastri, Chaturvedula S.; Hoffmann, Peter; Ortner, Hugo M.; Iyengar, Venkatesh; Blondiaux, Gilbert; Tessier, Yves; Petri, Hermann; Aras, Namik K.; Zaichick, Vladimir

    2002-01-01

    Fluorine was determined in the iliac crest bones of patients and in ribs collected from postmortem investigations by particle-induced gamma-ray emission based on the 19 F(p,pγ) 19 F reaction, using 20/2.5 MeV protons. The results indicate that for 68% of the human samples the F concentration is in the range 500-1999 μg g -1 . For comparison purposes fluorine was also determined in some animal bones; in some animal tissues lateral profiles of fluorine were measured. (abstract)

  7. Immediate loading of dental implants placed in severely resorbed edentulous maxillae reconstructed with Le Fort I osteotomy and interpositional bone grafting.

    Science.gov (United States)

    Pieri, Francesco; Lizio, Giuseppe; Bianchi, Alberto; Corinaldesi, Giuseppe; Marchetti, Claudio

    2012-08-01

    Reconstruction and rehabilitation of atrophic maxillae with bone grafts is a lengthy and demanding procedure. This study reports the immediate loading of 50 implants placed on six extremely atrophied edentulous maxillae reconstructed with Le Fort I osteotomy and iliac bone grafting. Six patients, aged 49 to 68 years, with severely atrophied maxillae were treated with Le Fort I osteotomy and iliac bone grafting to allow for implant-borne prosthetic rehabilitation. Four to 5 months thereafter, 50 implants (seven to 10 per patient) were placed in reconstructed maxillae and immediately functionally loaded with a screw-retained definitive prosthesis. The patients were followed by clinical and radiographic examinations for 24 months after prosthetic loading. The grafting procedure and healing period before implant placement were uneventful in all patients. Two implants were lost within 2 months after prosthesis insertion in two patients, with an overall survival rate of 96%. The prostheses success rate was 100%. At the end of the follow-up period, all remaining implants appeared clinically healthy; crestal bone loss was >1.7 mm for six implants, resulting in a cumulative success rate of 84%. Immediate loading of implants placed after Le Fort I osteotomy and interpositional iliac bone grafting could be considered a viable protocol to rehabilitate extremely atrophied edentulous maxillae, considerably reducing the treatment time.

  8. Bone graft healing in alveolar osteoplasty in patients with unilateral lip, alveolar process, and palate clefts.

    Science.gov (United States)

    Rychlik, Dariusz; Wójcicki, Piotr

    2012-01-01

    Secondary osteoplasty by means of autogenic spongy bone grafting is the most common procedure used in the reconstruction of the continuity of the maxillary alveolar process. The aim of the study was to analyze retrospectively the effect of certain factors on the course of the bone graft healing process in patients with unilateral complete clefts of the lip, alveolar process, and palate. The investigations involved 62 children aged 8 to 14 years (mean age, 11 years) with unilateral complete cleft of the lip, alveolar process, and palate operated on at the Clinic of Plastic Surgery in Polanica Zdrój from November 2007 to April 2009. All the procedures consisted in the reconstruction of the maxillary alveolar process by means of autogenic spongy bone grafting from the iliac bone. The analysis was performed on the basis of computed tomography scans presenting maxillary alveolar processes in the horizontal cross-sectional planes performed on the second or third postoperative day and after 6 months. They were used as the basis for the measurement of the volume and density (condensation) of the bone graft, the surface of its adhesion to the maxillary alveolar bone, and the volume and density of the healed bone. The following correlation coefficients were determined: between the adhesion surface of the bone to the alveolar bone and the volume of the healed bone, between the adhesion surface of the bone to the alveolar bone and the density of the healed bone, and between the density of the graft and the volume of the healed bone. Increasing the surface of the graft adhesion to the bone ridges of the alveolar cleft contributes to increased volume of the healed bone and slows down the increase in its density (on 6-month follow-up). Crushing of the bone graft increases its resorption and reduces volume of the healed bone.

  9. Radical resection for low rectal carcinoma combined with infusion pump chemotherapy via internal iliac artery

    Directory of Open Access Journals (Sweden)

    Bo YANG

    2011-10-01

    Full Text Available Objective To evaluate the effects and practicability of radical resection for low rectal carcinoma with infusion pump chemotherapy via internal iliac artery,and explore the correlation factors influencing the therapeutic effects.Methods Data of 316 patients with low rectal carcinoma,admitted from Oct.1997 to Mar.2008,were retrospectively analyzed and assigned into 2 groups according to the treatment: Patients received infusion pump chemotherapy via internal iliac artery to target area combined with intravenous systemic chemotherapy were assigned into group A(n=249,and those receiving systemic chemotherapy alone following radical resection were assigned to group B(n=67.The timing of pump chemotherapy to target area in group A was set at day 12 after recovery of digestive function,with regimen of 5-FU at 0.5g per dose plus hydroxycamptothecin at 10-15mg per dose,twice a week,four times as a treatment course for a total of 6 courses,and it was followed by intravenously systemic chemotherapy with a regimen of FOLFIRI or FOLFOX.In group B,at day 12 right after recovery of digestive function,the intravenous sytemic chemotherapy was started with the same regimen as in group A.The local recurrence rate,metastasis rate and survival rate after 1,3 and 5 years in the two groups were respectively observed and compared,and the correlation between the clinicopathological features and the 5 year local recurrence rates and survival rates was analyzed in patients of group A.Results In group A,the local recurrence rate at year 1,3 and 5 was 0,1.68%(4/238 and 3.79%(8/211,respectively,the metastasis rate was 0.80%(2/249,4.62%(11/238 and 10.90%(23/211,respectively,and the survival rate was 100%,77.73%(185/238 and 72.04%(152/211,respectively.In group B,the local recurrence rate at year 1,3 and 5 was 0,9.52%(6/63 and 16.36%(9/55,respectively,the metastasis rate was 1.49%(1/67,15.87%(10/63 and 27.27%(15/55,respectively,and the survival rate was 100

  10. Osteoporosis with vertebral fractures in young males, due to bone marrow mastocytosis: a report of two cases.

    Science.gov (United States)

    Manara, M; Varenna, M; Cantoni, S; Parafioriti, A; Gallazzi, M B; Sinigaglia, L

    2010-01-01

    Male osteoporosis in young patients is an unusual condition, always worth investigating as a possible manifestation of secondary osteoporosis. Mastocytosis is a clonal disorder of mast cells with heterogeneous presentations; when pathologic cells accumulate only in the bone marrow, vertebral fractures and systemic osteoporosis may represent the sole clinical presentation at the onset of the disease. We report on two young male patients who came to our attention because of multiple dorsal and lumbar vertebral fractures, with no other signs of systemic mastocytosis (SM). Lumbar and femoral dual x-ray absorptiometry showed reduced bone mineral density values; biochemical investigations did not report significant anomalies, suggestive of secondary osteoporosis. One of the patients underwent iliac crest bone biopsy, which was not diagnostic. A vertebral intralesional CT-guided bone biopsy was performed in both patients, which allowed the diagnosis of SM. Our experience pointed out that bone biopsy still remains the gold standard for the diagnosis of SM. However, iliac crest biopsy can be not significant because of circumscribed bone marrow involvement: in these cases only intralesional bone biopsy could be diagnostic.

  11. The effects of surgicel and bone wax hemostatic agents on bone healing: An experimental study

    Directory of Open Access Journals (Sweden)

    Nasser Nooh

    2014-01-01

    Full Text Available Background: The biological effects of hemostatic agends on the physiological healing process need to be tested. The aim of this study was to assess the effects of oxidized cellulose (surgicel and bone wax on bone healing in goats′ feet. Materials and Methods: Three congruent circular bone defects were created on the lateral aspects of the right and left metacarpal bones of ten goats. One defect was left unfilled and acted as a control; the remaining two defects were filled with bone wax and surgicel respectively. The 10 animals were divided into two groups of 5 animals each, to be sacrificed at the 3rd and 5th week postoperatively. Histological analysis assessing quality of bone formed and micro-computed tomography (MCT measuring the quantities of bone volume (BV and bone density (BD were performed. The results of MCT analysis pertaining to BV and BD were statistically analyzed using two-way analysis of variance (ANOVA and posthoc least significant difference tests. Results: Histological analysis at 3 weeks showed granulation tissue with new bone formation in the control defects, active bone formation only at the borders for surgicel filled defects and fibrous encapsulation with foreign body reaction in the bone wax filled defects. At 5 weeks, the control and surgicel filled defects showed greater bone formation; however the control defects had the greatest amount of new bone. Bone wax filled defects showed very little bone formation. The two-way ANOVA for MCT results showed significant differences for BV and BD between the different hemostatic agents during the two examination periods. Conclusion: Surgicel has superiority over bone wax in terms of osseous healing. Bone wax significantly hinders osteogenesis and induces inflammation.

  12. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi

    International Nuclear Information System (INIS)

    Oguz, Berna; Haliloglu, Mithat; Alan, Serdar; Ozcelik, Ugur

    2009-01-01

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study. (orig.)

  13. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, Berna; Haliloglu, Mithat [Hacettepe University Faculty of Medicine, Department of Radiology, Ankara (Turkey); Alan, Serdar; Ozcelik, Ugur [Hacettepe University Faculty of Medicine, Department of Pediatrics, Ankara (Turkey)

    2009-09-15

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study. (orig.)

  14. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  15. Fracture and Collapse of Balloon-Expandable Stents in the Bilateral Common Iliac Arteries Due to Shiatsu Massage

    Energy Technology Data Exchange (ETDEWEB)

    Ichihashi, Shigeo, E-mail: shigeoichihashi@yahoo.co.jp; Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko [Nara Medical University, Department of Radiology (Japan)

    2012-12-15

    We report a case of stent fracture and collapse of balloon-expandable stents caused by shiatsu massage. A 76-year-old man presented with complaints of intermittent claudication of the right lower extremity. Stenoses of the bilateral common iliac arteries (CIAs) were detected. Balloon-expandable stents were deployed in both CIAs, resulting in resolution of symptoms. Five months later, pelvis x-ray showed collapse of both stents. Despite the stent collapse, the patient was asymptomatic, and his ankle brachial index values were within the normal range. Further history showed that the patient underwent daily shiatsu therapy in the umbilical region, which may have triggered collapse of the stent. Physicians should advise patients to avoid compression of the abdominal wall after implantation of a stent in the iliac artery.

  16. Intraoperative intermittent blocking of the common iliac arteries in cases of placenta percreta without the use of fluoroscopy

    International Nuclear Information System (INIS)

    Heinze, S.; Klinikum Oldenburg; Filsinger, B.; Kastenholz, G.; Schroeder, R.J.

    2016-01-01

    The number of patients with placenta accreta, percreta and increta is increasing. The morbidity and mortality are higher mostly due to hemorrhage. Therefore, new methods to reduce the risk of severe bleeding are necessary. Three patients were treated in collaboration by obstetricians, urologists, anesthesiologists, and radiologists. An MRI of the pelvis was performed and the diameters and lengths of the iliac arteries were measured to avoid fluoroscopy during the preoperative placement of catheter balloons into the iliac arteries. During the operational procedure the balloons were inflated and deflated depending on the operative site and the occurrence of bleeding. In comparison to the literature, severe bleeding was clearly reduced. No complications of the intervention were observed. The presented method to reduce severe bleeding might represent significant progress in the management of abnormal placenta implantation. Nevertheless, further controlled studies are needed in order to establish evidence-based recommendations.

  17. Fracture and collapse of balloon-expandable stents in the bilateral common iliac arteries due to shiatsu massage.

    Science.gov (United States)

    Ichihashi, Shigeo; Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko

    2012-12-01

    We report a case of stent fracture and collapse of balloon-expandable stents caused by shiatsu massage. A 76-year-old man presented with complaints of intermittent claudication of the right lower extremity. Stenoses of the bilateral common iliac arteries (CIAs) were detected. Balloon-expandable stents were deployed in both CIAs, resulting in resolution of symptoms. Five months later, pelvis x-ray showed collapse of both stents. Despite the stent collapse, the patient was asymptomatic, and his ankle brachial index values were within the normal range. Further history showed that the patient underwent daily shiatsu therapy in the umbilical region, which may have triggered collapse of the stent. Physicians should advise patients to avoid compression of the abdominal wall after implantation of a stent in the iliac artery.

  18. T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yong, E-mail: cheny102@163.com; Ye, Peng, E-mail: thomas19871223@163.com [Southern Medical University, Department of Interventional Radiology, Nanfang Hospital (China); Jiang, Wen-jin, E-mail: 18653501187@163.com [Yantai Yuhuangding Hospital (China); Ma, Shuo-yi, E-mail: mazelong123456789@126.com; Zhao, Jian-bo, E-mail: zhaojianbohgl@163.com; Zeng, Qing-le, E-mail: doctorzengqingle@126.com [Southern Medical University, Department of Interventional Radiology, Nanfang Hospital (China)

    2015-10-15

    Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting)

  19. Comparative study of conducting iliac angioplasties with digital subtraction and conventional angiography. Incidence on true (consumable) costs

    International Nuclear Information System (INIS)

    Brenot, P.; Raynaud, A.; Pernes, J.M.; Parola, J.L.; Gaux, J.C.

    1986-01-01

    Differences in time and cost were evaluated between the performance of iliac angioplasty with conventional (AC) and digital subtraction (AN) angiography, after a total of 27 angioplasties (13 with AC and 14 with AN). Excluding amortization of material and personnel costs, findings confirmed a certain number of advantages for AN: gain in time of about 34%, decrease of about 14% in charges, and notably of 83% in expenditure on films and 50% on contrast media [fr

  20. Direct measured systolic pressure gradients across the aorto-iliac segment in multiple-level-obstruction arteriosclerosis

    DEFF Research Database (Denmark)

    Noer, Ivan; Praestholm, J; Tønnesen, K H

    1981-01-01

    Patients with severe ischemia due to multi-level obstructions in the leg arteries both above and below the region were assessed preoperatively by intraarterial brachial and femoral artery pressure measurements. The systolic pressure drop along aorto-iliac obstructions was compared to the angiogra....... Due to large variations, however, the angiographic information was found to be useless in the individual patient. No difference in the pressure drop was found between cases in which rich and poor collateral networks were visualized....

  1. Creation of an iliac arteriovenous shunt lowers blood pressure in chronic obstructive pulmonary disease patients with hypertension.

    LENUS (Irish Health Repository)

    Faul, John

    2014-01-28

    Vasodilators are used with caution in patients with chronic obstructive pulmonary disease (COPD). We have developed a device for percutaneous arteriovenous shunt creation in the iliac region to increase cardiac output and oxygen delivery for patients with COPD. Although this device does not cause significant blood pressure changes in normotensive patients with COPD, we hypothesized that arteriovenous shunt creation might cause vasodilator effects in hypertensive patients because of a reduction in vascular resistance.

  2. 3D computed tomographic evaluation of secondary alveolar bone grafts in cleft lip and palate patients

    International Nuclear Information System (INIS)

    Ohkubo, Fumio; Akai, Hidemi; Hosaka, Yoshiaki

    2001-01-01

    Alveolar bone grafting in patients with cleft lip and palate has becomes a routine part of most treatment regimes. This study was undertaken to estimate how much bone needs to be grafted into the cleft cavity and to evaluate the grafted bone using 3-DCT over a period from the early postoperative stage to after one year. Seventy-five patients divided into four groups according to the type of cleft were studied. All patients underwent secondary alveolar bone grafting using particulate cancellous bone from the anterior iliac crest. The bone graft areas were divided into two regions: the extra-cleft region and the intra-cleft region. The weight and the volume of the grafted bone were correlated and the average density was 1.5 g/ml regardless of the cleft type. The bone in the extra-cleft region could be seen in almost all slices of the CT scans, from the lower alveolar process to the piriform aperture. The extra-cleft graft ratio of unilateral and bilateral cleft lip and palate is higher than that of cleft lip and alveolus. The extra-cleft grafting is necessary to restore facial symmetry. The grafted bone was decreased in both height and volume following three months and adequate bone bridging was maintained for one year. We concluded that 3-DCT findings are one of the most valuable methods to evaluate postoperative conditions after alveolar bone grafting. (author)

  3. 3D computed tomographic evaluation of secondary alveolar bone grafts in cleft lip and palate patients

    Energy Technology Data Exchange (ETDEWEB)

    Ohkubo, Fumio; Akai, Hidemi; Hosaka, Yoshiaki [Showa Univ., Tokyo (Japan). School of Medicine

    2001-04-01

    Alveolar bone grafting in patients with cleft lip and palate has becomes a routine part of most treatment regimes. This study was undertaken to estimate how much bone needs to be grafted into the cleft cavity and to evaluate the grafted bone using 3-DCT over a period from the early postoperative stage to after one year. Seventy-five patients divided into four groups according to the type of cleft were studied. All patients underwent secondary alveolar bone grafting using particulate cancellous bone from the anterior iliac crest. The bone graft areas were divided into two regions: the extra-cleft region and the intra-cleft region. The weight and the volume of the grafted bone were correlated and the average density was 1.5 g/ml regardless of the cleft type. The bone in the extra-cleft region could be seen in almost all slices of the CT scans, from the lower alveolar process to the piriform aperture. The extra-cleft graft ratio of unilateral and bilateral cleft lip and palate is higher than that of cleft lip and alveolus. The extra-cleft grafting is necessary to restore facial symmetry. The grafted bone was decreased in both height and volume following three months and adequate bone bridging was maintained for one year. We concluded that 3-DCT findings are one of the most valuable methods to evaluate postoperative conditions after alveolar bone grafting. (author)

  4. Does methamphetamine affect bone metabolism?

    International Nuclear Information System (INIS)

    Tomita, Masafumi; Katsuyama, Hironobu; Watanabe, Yoko; Okuyama, Toshiko; Fushimi, Shigeko; Ishikawa, Takaki; Nata, Masayuki; Miyamoto, Osamu

    2014-01-01

    There is a close relationship between the central nervous system activity and bone metabolism. Therefore, methamphetamine (METH), which stimulates the central nervous system, is expected to affect bone turnover. The aim of this study was to investigate the role of METH in bone metabolism. Mice were divided into 3 groups, the control group receiving saline injections, and the 5 and 10 mg/kg METH groups (n = 6 in each group). All groups received an injection of saline or METH every other day for 8 weeks. Bone mineral density (BMD) was assessed by X-ray computed tomography. We examined biochemical markers and histomorphometric changes in the second cancellous bone of the left femoral distal end. The animals that were administered 5 mg/kg METH showed an increased locomotor activity, whereas those receiving 10 mg/kg displayed an abnormal and stereotyped behavior. Serum calcium and phosphorus concentrations were normal compared to the controls, whereas the serum protein concentration was lower in the METH groups. BMD was unchanged in all groups. Bone formation markers such as alkaline phosphatase and osteocalcin significantly increased in the 5 mg/kg METH group, but not in the 10 mg/kg METH group. In contrast, bone resorption markers such as C-terminal telopeptides of type I collagen and tartrate-resistant acid phosphatase 5b did not change in any of the METH groups. Histomorphometric analyses were consistent with the biochemical markers data. A significant increase in osteoblasts, especially in type III osteoblasts, was observed in the 5 mg/kg METH group, whereas other parameters of bone resorption and mineralization remained unchanged. These results indicate that bone remodeling in this group was unbalanced. In contrast, in the 10 mg/kg METH group, some parameters of bone formation were significantly or slightly decreased, suggesting a low turnover metabolism. Taken together, our results suggest that METH had distinct dose-dependent effects on bone turnover and that

  5. Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta.

    Science.gov (United States)

    Chen, Zhenyu; Li, Ju; Shen, Jian; Jin, Jiaxi; Zhang, Wei; Zhong, Wan

    2016-12-01

    To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery. A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015. Information regarding surgical procedures, operative data, and outcomes during hospitalization were obtained from medical records. The procedure was successful in all 16 cases included. Mean operative time was 78 minutes (range 65-90) and mean estimated blood loss was 1550 mL (range 1000-2500). Complications such as fever, buttock pain, or acute limb ischemia were not observed. The procedure was performed after partial cystectomy for two patients with bladder invasion. Postoperative Doppler imaging indicated uterine recovery and normalized uterine blood flow in all patients. Direct puncture embolization of the internal iliac artery during cesarean delivery was a safe, effective, simple, and rapid method to control hemorrhage among women with pernicious placenta previa and placenta accreta. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Study of the utility and problems of common iliac artery balloon occlusion for placenta previa with accreta.

    Science.gov (United States)

    Ono, Yoshihisa; Murayama, Yoshihiko; Era, Sumiko; Matsunaga, Shigetaka; Nagai, Tomonori; Osada, Hisato; Takai, Yasushi; Baba, Kazunori; Takeda, Satoru; Seki, Hiroyuki

    2018-03-01

    We investigated whether common iliac artery balloon occlusion (CIABO) was effective for decreasing blood loss during cesarean hysterectomy (CH) in patients with placenta previa with accreta and was safe for mothers and fetuses. Of the 67 patients who underwent CH for placenta previa with accreta at our facility from 1985 to 2014, 57 patients were eligible for the study. The amount of intraoperative bleeding during CH was compared between three groups: surgery without blood flow occlusion (13 patients), internal iliac artery ligation (15 patients) and CIABO (29 patients). Additionally, multivariate analysis was performed to assess risk factors for massive bleeding during CH. The mean blood loss in the CIABO group (2027 ± 1638 mL) was significantly lower than in the other two groups (3787 ± 2936 mL in the no occlusion, 4175 ± 1921 mL in the internal iliac artery ligation group; P placenta previa with accreta can be decreased by CIABO. This study also confirmed the safety of CIABO in regard to maternal lower limb ischemia and fetal radiation exposure during balloon placement. © 2018 The Authors. Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.

  7. Primary Stent Placement of an Acute Occlusion in the Iliac Arteries of Patients with Acute Limb Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Ki Chan; Shin, Tae Beom; Choi, Ho Cheol; Choi, Hye Young; Kim, Ji Eun; Chung, Sung Hoon [Gyeongsang National University Hospital, Jinju (Korea, Republic of)

    2009-01-15

    To assess the efficacy of stent-assisted recanalization for the management of acute limb ischemia (ALI) after a failed surgical revascularization in patients with acute iliac arterial occlusion and considered unfit for a thrombolysis. The data on 6 patients with acute limb ischemia due to iliac arterial occlusion, and treated with stent implantation between November 2005 and March 2008, was analyzed retrospectively. The reasons for ALI in the patients analyzed included acute thrombosis related to a traumatic injury (n=3), acute in-situ thrombosis with pre-existing atherosclerotic stenosis (n=2), and cardiogenic embolism (n=1). A preprocedural CT angiography and conventional angiography revealed an occlusion at the iliac artery. This study examined the clinical data, technical and clinical outcome of the procedure, and complications related to the procedure or follow-up period for each patient. Primary stenting was technically successful in all patients, thus resulting in the reduction or elimination of clinical symptoms in the 5 patients observed. One patient expired due to multi-organ failure related to a reperfusion injury. The other five patients showed good clinical results without symptom recurrence and normal duplex USG or CT angiographic findings during the 3-15 month follow-up period. A stent-assisted recanalization is an effective treatment for patients with ALI, which are considered unfit for thrombolysis and surgical recanalization.

  8. Bone marrow uptake of 18F-fluorodeoxyglucose in Hodgkin lymphoma without bone involvement: comparison between patients with and without B symptoms

    Directory of Open Access Journals (Sweden)

    Rômulo Hermeto Bueno do Vale

    2018-03-01

    Full Text Available Abstract Objective: To compare the degree of benign bone marrow uptake of 18F-fluorodeoxyglucose (18F-FDG between Hodgkin lymphoma patients with and without B symptoms. Materials and Methods: We analyzed the medical charts of 74 Hodgkin lymphoma patients who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT prior to the initiation of therapy between October 2010 and September 2013. In all of the patients, the bone marrow biopsy was negative and the 18F-FDG PET/CT images did not suggest bone marrow involvement. Of the 74 patients evaluated, 54 presented inflammatory (B symptoms and 20 did not. Regions of interest (ROIs were drawn on the sternum, the proximal thirds of the humeri, the proximal thirds of the femora, and both iliac wings (totaling seven ROIs per patient. To compare the patients with and without B symptoms, in terms of standardized uptake values (SUVs for the seven ROIs, we used the Mann-Whitney U test. Results: For six of the ROIs, the SUVs were higher in the patients with B symptoms than in those without, and the difference was statistically significant (p < 0.05. There was also a tendency toward a statistically significant difference between the two groups in terms of the SUV for the right iliac wing ROI (p = 0.06. Conclusion: In our sample, the presence of B symptoms was associated with increased 18F-FDG uptake in bone marrow.

  9. Effect of intraoperative bone quality testing on bone healing and osseointegration of dental implants.

    Science.gov (United States)

    Karl, Matthias; Palarie, Victor; Nacu, Viorel; Krafft, Tim

    2013-01-01

    A novel diagnostic device (BoneProbe) for evaluating alveolar bone quality during dental implant surgery has recently been developed. The underlying measurement principle is based on a compressive test of bone, which may subsequently affect bone healing and osseointegration of dental implants. Six implant sites each were created in the rear left tibia of four sheep and used for bone quality testing with the BoneProbe, while empty osteotomies and implants placed without testing served as controls. Maximum insertion torque and primary implant stability (Osstell) were determined additionally. After 5 and 20 weeks, the animals were sacrificed followed by histomorphometric and microradiographic analysis quantifying bone implant contact (BIC) and bone mineral density (BMD) as parameters. Statistical analysis was conducted applying one-sample t tests, two-sample t tests and Pearson correlation coefficients (α = .05). Implants placed following application of the BoneProbe differed from the control treatments only in one case, where BIC was greater (P = .02) at the control implant after 20 weeks of healing. With the exception of the combinations of Osstell/BoneProbe measurement in trabecular bone (0.29) and Osstell/insertion torque (0.34), good correlations of all clinically conducted measurements were found. Based on the results obtained, it appears that intraoperative testing of bone quality applying the BoneProbe does not jeopardize bone healing and osseointegration of dental implants.

  10. Balloon-Expandable Stent Graft for Treating Uretero-Iliac Artery Fistula

    Energy Technology Data Exchange (ETDEWEB)

    Guntau, Moritz, E-mail: guntau@med.uni-marburg.de [Philipps University, Department of Diagnostic and Interventional Radiology, Marburg University Hospital (Germany); Hegele, Axel [Philipps University, Department of Urology and Pediatric Urology, Marburg University Hospital (Germany); Rheinheimer, Stephan [Philipps University, Department of Diagnostic and Interventional Radiology, Marburg University Hospital (Germany); Hofmann, Rainer [Philipps University, Department of Urology and Pediatric Urology, Marburg University Hospital (Germany); Mahnken, Andreas H. [Philipps University, Department of Diagnostic and Interventional Radiology, Marburg University Hospital (Germany)

    2017-06-15

    PurposeTo evaluate the safety, efficacy and outcome of percutaneous balloon-expandable covered stent graft placement for uretero-iliac artery fistula (UAF) treatment.MethodsThis retrospective study evaluated the single-center experience of percutaneous balloon-expandable covered stent graft placement (ADVANTA™, Atrium Hudson, NH, USA) in UAF. Data were obtained from a prospective institutional database. Patient follow-up included complications, symptoms recurrence and mortality rate.ResultsTen UAFs in eight patients (3 males; 5 females) with a mean age of 64.5 (35–77) years were identified. All patients had a history pelvic malignancy, extirpative surgery (n = 6), long-term ureteral stenting (n = 7) and pelvic radiation (n = 5). All procedures were completed successfully without complications. Thirty-day mortality rate was zero. At a median follow-up of 6 (1–60) months, one patient suffered recurrent hematuria requiring a secondary stent graft placement 26 months after the initial treatment. During follow-up, five patients died of the underlying disease (43, 66, 105, and 183 and 274 days after the last procedure).ConclusionPercutaneous balloon-expandable stent graft placement in UAF is a safe and effective treatment option. Implantation of stent grafts should be considered as treatment of choice in UAF.

  11. Endovascular Treatment of Infrarenal Abdominal Aortic Lesions With or Without Common Iliac Artery Involvement

    International Nuclear Information System (INIS)

    Önder, Hakan; Oğuzkurt, Levent; Gür, Serkan; Tekbaş, Güven; Gürel, Kamil; Coşkun, İsa; Özkan, Uğur

    2013-01-01

    To evaluate the results of stent placement for obstructive atherosclerotic aortic disease with or without involvement of the common iliac artery. Forty patients had self-expanding stents primarily or after balloon dilatation in the abdominal aorta between January 2005 and May 2011. All patients had trouble walking. Follow-up examinations were performed with clinical visits; these included color Doppler ultrasonography and computed tomographic angiography. Technical, clinical, and hemodynamic success was achieved in all patients. None of the patients underwent reintervention during the follow-up period, which ranged from 3 months to 6 years (median 24 months). Nine complications occurred in six patients. Of the nine complications, four were distal thromboembolisms, which were successfully treated with catheter-directed thrombolysis or anticoagulation therapy. Endovascular treatment of the obstructive aortic disease using self-expanding stents was safe and effective, with high technical success and long-term patency. Thromboembolic complications were high even though direct stenting was considered protective for thromboembolism formation. Particularly for infrarenal aortic stenosis, it can be recommended as the first-line treatment option for patients with obstructive atherosclerotic aortic disease.

  12. Embolization of an Internal Iliac Artery Aneurysm after Image-Guided Direct Puncture

    International Nuclear Information System (INIS)

    Heye, S.; Vaninbroukx, J.; Daenens, K.; Houthoofd, S.; Maleux, G.

    2012-01-01

    Objective: To evaluate the feasibility, safety, and efficacy of embolization of internal iliac artery aneurysm (IIAA) after percutaneous direct puncture under (cone-beam) computed tomography (CT) guidance. Methods: A retrospective case series of three patients, in whom IIAA not accessible by way of the transarterial route, was reviewed. CT-guided puncture of the IIAA sac was performed in one patient. Two patients underwent puncture of the IIAA under cone-beam CT guidance. Results: Access to the IIAA sac was successful in all three patients. In two of the three patients, the posterior and/or anterior division was first embolized using platinum microcoils. The aneurysm sac was embolized with thrombin in one patient and with a mixture of glue and Lipiodol in two patients. No complications were seen. On follow-up CT, no opacification of the aneurysm sac was seen. The volume of one IIAA remained stable at follow-up, and the remaining two IIAAs decreased in size. Conclusion: Embolization of IIAA after direct percutaneous puncture under cone-beam CT/CT-guidance is feasible and safe and results in good short-term outcome.

  13. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

    Directory of Open Access Journals (Sweden)

    Kun-Woon Yoo

    2012-05-01

    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However,aesthetic and functional complications occur frequently at the donor site. The use of asuperficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages.Here, we report our case with a review of literature. A 69-year-old man visited our hospitalwith multiple contusions of the abdomen and genital amputation. After necrotic tissuedebridement, the length of the residual corpus carvernosum was 1.5 cm and that of thecorpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap andanterolateral thigh free flap was performed. The primary closure was performed at the donorsite. Three weeks postoperatively, the patient had a urethral foley catheter removed. Theneourethra was functioning well without stricture. Four months postoperatively, the patienthad no complications such as urethral stricture. A good recovery was also achieved withno aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction.Because of its proximity to the recipient sites, it makes surgical preparation easier and theprimary closure at the donor site available. It is also advantageous in that its location isalmost unnoticeable.

  14. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

    Directory of Open Access Journals (Sweden)

    Kun-Woon Yoo

    2012-05-01

    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However, aesthetic and functional complications occur frequently at the donor site. The use of a superficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages. Here, we report our case with a review of literature. A 69-year-old man visited our hospital with multiple contusions of the abdomen and genital amputation. After necrotic tissue debridement, the length of the residual corpus carvernosum was 1.5 cm and that of the corpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap and anterolateral thigh free flap was performed. The primary closure was performed at the donor site. Three weeks postoperatively, the patient had a urethral foley catheter removed. The neourethra was functioning well without stricture. Four months postoperatively, the patient had no complications such as urethral stricture. A good recovery was also achieved with no aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction. Because of its proximity to the recipient sites, it makes surgical preparation easier and the primary closure at the donor site available. It is also advantageous in that its location is almost unnoticeable.

  15. [Aneurysms of the abdominal aorta and iliac arteries: paradigm shift - operative therapy, if possible endovascular?].

    Science.gov (United States)

    Rückert, R I; Hanack, U; Aronés-Gomez, S; Yousefi, S

    2014-09-01

    Therapy of abdominal aortic aneurysms (AAA) is currently based on a high level of evidence. This is not true in the same manner for iliac artery aneurysms (IAA) which are frequently associated with AAAs and occur only rarely as isolated lesions. The therapeutic principles apply in the same way to both aneurysm locations. New findings, improved perioperative care and the rapid development of minimally invasive techniques require a constant update which is the aim of this article concerning the therapy of AAAs and IAAs. A systematic literature review was performed in PubMed and Medline and priority was given to recent publications with a high level of evidence. Endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) result in a similar long-term survival. The perioperative survival advantage with EVAR persists only during medium-term postoperative courses. The reintervention rate after EVAR is substantially higher compared to OAR. For older patients and those who are considered unfit for OAR the expected benefits from EVAR has not been proven to date. Aneurysmal ruptures after EVAR demonstrate that a life-long surveillance of these patients is necessary. Therapy of AAAs and IAAs is increasingly being performed by EVAR. Even the majority of complex aneurysms are amenable to minimally invasive treatment. Nevertheless, indications for OAR continue to exist. Screening for AAAs results in a decrease of aneurysmal ruptures for which EVAR is also gaining importance.

  16. Successful Treatment of Acute on Chronic Mesenteric Ischaemia by Common Iliac to Inferior Mesenteric Artery Bypass

    Directory of Open Access Journals (Sweden)

    D. N. Coakley

    2015-01-01

    Full Text Available Chronic mesenteric ischaemia is a rare and potentially fatal condition most commonly due to atherosclerotic stenosis or occlusion of two or more mesenteric arteries. Multivessel revascularisation of both primary mesenteric vessels, the celiac artery and superior mesenteric artery (SMA, is the current mainstay of treatment; however, in a certain cohort of patients, revascularisation one or both vessels may not be possible. Arteries may be technically unreconstructable or the patient may be surgically unfit for the prolonged aortic cross clamping times required. Here we present a case involving a 72-year-old woman with acute on chronic mesenteric ischaemia. She was a high risk surgical patient with severe unreconstructable stenotic disease of the SMA and celiac arteries. She was successfully treated with single vessel revascularisation of the inferior mesenteric artery (IMA via a common iliac to IMA reversed vein bypass. At two-year follow-up, the graft remains patent and the patient continues to be symptom-free and is maintaining her weight.

  17. Endovascular Treatment of Infrarenal Abdominal Aortic Lesions With or Without Common Iliac Artery Involvement

    Energy Technology Data Exchange (ETDEWEB)

    Oender, Hakan, E-mail: drhakanonder@hotmail.com [Dicle University Medical Faculty, Department of Radiology (Turkey); Oguzkurt, Levent [Baskent University Medical Faculty, Department of Radiology (Turkey); Guer, Serkan [Sifa University Medical Faculty, Department of Radiology (Turkey); Tekbas, Gueven [Dicle University Medical Faculty, Department of Radiology (Turkey); Guerel, Kamil [Abant Izzet Baysal University Medical Faculty, Department of Radiology (Turkey); Coskun, Isa [Baskent University Medical Faculty, Department of Cardiovascular Surgery (Turkey); Oezkan, Ugur [Baskent University Medical Faculty, Department of Radiology (Turkey)

    2013-02-15

    To evaluate the results of stent placement for obstructive atherosclerotic aortic disease with or without involvement of the common iliac artery. Forty patients had self-expanding stents primarily or after balloon dilatation in the abdominal aorta between January 2005 and May 2011. All patients had trouble walking. Follow-up examinations were performed with clinical visits; these included color Doppler ultrasonography and computed tomographic angiography. Technical, clinical, and hemodynamic success was achieved in all patients. None of the patients underwent reintervention during the follow-up period, which ranged from 3 months to 6 years (median 24 months). Nine complications occurred in six patients. Of the nine complications, four were distal thromboembolisms, which were successfully treated with catheter-directed thrombolysis or anticoagulation therapy. Endovascular treatment of the obstructive aortic disease using self-expanding stents was safe and effective, with high technical success and long-term patency. Thromboembolic complications were high even though direct stenting was considered protective for thromboembolism formation. Particularly for infrarenal aortic stenosis, it can be recommended as the first-line treatment option for patients with obstructive atherosclerotic aortic disease.

  18. A quantification strategy for missing bone mass in case of osteolytic bone lesions

    International Nuclear Information System (INIS)

    Fränzle, Andrea; Giske, Kristina; Bretschi, Maren; Bäuerle, Tobias; Hillengass, Jens; Bendl, Rolf

    2013-01-01

    Purpose: Most of the patients who died of breast cancer have developed bone metastases. To understand the pathogenesis of bone metastases and to analyze treatment response of different bone remodeling therapies, preclinical animal models are examined. In breast cancer, bone metastases are often bone destructive. To assess treatment response of bone remodeling therapies, the volumes of these lesions have to be determined during the therapy process. The manual delineation of missing structures, especially if large parts are missing, is very time-consuming and not reproducible. Reproducibility is highly important to have comparable results during the therapy process. Therefore, a computerized approach is needed. Also for the preclinical research, a reproducible measurement of the lesions is essential. Here, the authors present an automated segmentation method for the measurement of missing bone mass in a preclinical rat model with bone metastases in the hind leg bones based on 3D CT scans. Methods: The affected bone structure is compared to a healthy model. Since in this preclinical rat trial the metastasis only occurs on the right hind legs, which is assured by using vessel clips, the authors use the left body side as a healthy model. The left femur is segmented with a statistical shape model which is initialised using the automatically segmented medullary cavity. The left tibia and fibula are segmented using volume growing starting at the tibia medullary cavity and stopping at the femur boundary. Masked images of both segmentations are mirrored along the median plane and transferred manually to the position of the affected bone by rigid registration. Affected bone and healthy model are compared based on their gray values. If the gray value of a voxel indicates bone mass in the healthy model and no bone in the affected bone, this voxel is considered to be osteolytic. Results: The lesion segmentations complete the missing bone structures in a reasonable way. The mean

  19. Diagnóstico diferencial de trombose aortoilíaca e mieloencefalite protozoária equina: relato de caso Differential diagnosis between aorto-iliac thrombosis and equine protozoal myeloencephalitis: case report

    Directory of Open Access Journals (Sweden)

    P.B. Escodro

    2010-10-01

    Full Text Available Relata-se o caso de uma égua de atividade de polo, que apresentou inicialmente claudicação leve no membro posterior esquerdo, a qual evoluiu para ataxia e atrofia da musculatura glútea do lado esquerdo, com diagnóstico de trombose aortoilíaca (TAI. A paciente foi tratada com suspeita de mieloencefalite protozoária equina, devido à semelhança dos sinais clínicos com essa doença, porém o líquido cefalorraquidiano apresentou-se negativo para anticorpos anti-Sarcocystis neurona. A palpação transretal indicou uma massa na bifurcação aortoilíaca esquerda. Na avaliação ultrassonográfica, visualizou-se imagem hiperecoica aderida ao endotélio vascular, sugerindo TAI atingindo a estenose de 70% da luz arterial.The case of a mare used for polo is reported. The animal showed clinical signs of soft lameness of the hindlimb, evolving to ataxia and gluteal muscle atrophy, with aorto-iliac thrombosis (AIT. The patient was treated with the suspect of equine protozoal myeloencephalitis (EPM, due to the resemblance of clinical signs. Cerebrospinal fluid analysis was negative for antibodies against Sarcocystis neurona. The transrectal examination indicated a mass in the left aorto-iliac bifurcation. In the ultrasonographic evaluation, a hyperechoic image adhered to the vascular endothelium was observed, suggesting (AIT, occupying 70% of arterial lumen. The present article has the objective of pointing out the importance of the differential diagnosis between AIT and EPM in horses with ataxia in hindlimbs and muscular atrophy.

  20. Left Ventricular Pseudoaneurysm Perceived as a Left Lung Mass

    Directory of Open Access Journals (Sweden)

    Ugur Gocen

    2013-02-01

    Full Text Available Left ventricular pseudo-aneurysm is a rare complication of aneurysmectomy. We present a case of surgically-treated left ventricular pseudo-aneurysm which was diagnosed three years after coronary artery bypass grafting and left ventricular aneurysmectomy. The presenting symptoms, diagnostic evaluation and surgical repair are described. [Cukurova Med J 2013; 38(1.000: 123-125

  1. Structural bone allograft fractures in oncological procedures.

    Science.gov (United States)

    Garcia-Coiradas, Javier; Garcia-Maroto, Roberto; Cebrian, Juan Luis; Lopez-Duran, Luis

    2015-11-01

    We report our experience analysing the risk of fracture amongst allografts in limb-preserving surgery for bone tumours. We retrospectively reviewed our experience with bone allograft and its major complications when used for limb -preserving operations for bone tumours. Forty-one structural allografts were performed in 39 patients between 1992 and 2012. Minimum follow-up was 20 months. Massive allografts have a high complication rate. Excluding infection and nonunion, five acute fractures were found. All fractures occurred after the graft-host junction was united. Local factors-such as graft preservation, weight bearing, fixation to the host or systemic factors such as adjuvant treatments (chemotherapy or radiotherapy)-influence fracture rate. In our study, four patients achieved consolidation with internal fixation and autologous iliac-crest graft, whilst only one required graft exchange. There is no general consensus as to when to treat fractures using open reduction and internal fixation or by exchanging the allograft. Higher fracture rate in relation to systemic treatment was found. Massive structural allograft reconstruction still has a place in limb-preserving surgery, with an acceptable fracture rate and a durable solution.

  2. Pyogenic Granuloma with Severe Mandibular Bone Destruction

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jeong Won; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul; Park, Tae Won [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2000-06-15

    Pyogenic granuloma is a overzealous proliferation of a vascular type connective tissue as a result of some minor trauma and is a well circumscribed elevated, pedunculated or sessile benign inflammatory lesion of skin and mucous membrane. The clinical features of pyogenic granuloma are indicative but not specific and nearly all cases of pyogenic granulomas are superficial in nature, and there is little if any mention in the literature of these lesions producing alveolar bone even jaw bone loss. This case is somewhat unique in that the lesion was an obvious histologic pyogenic granuloma; however, it appeared to invade the mandibular bone which resulted in the loss of the adjacent teeth. A 12-year-old boy came to Seoul National University Dental Hospital with chief complaints of left facial swelling. The features obtained were as follows ; Plain radiograms showed a large well-circumscribed radiolucent lesion on left mandibular ramus area, which made severe expansion of lingual cortex and displacement of lower left 3rd molar tooth germ. Computed tomograms showed large soft tissue mass involving left masticator space with destruction of left mandibular ramus. Histologically, sections revealed loose edematous stroma with intense infiltration of inflammatory cells and proliferation of vascular channels. Also, there were focal areas of extensive capillary proliferation, bone destruction and peripheral new bone formation.

  3. Broken bone

    Science.gov (United States)

    ... Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Broken bone URL of this page: //medlineplus.gov/ency/ ... following steps to reduce your risk of a broken bone: Wear protective ... pads. Create a safe home for young children. Place a gate at stairways ...

  4. Oreopithecus was a bipedal ape after all: Evidence from the iliac cancellous architecture

    Science.gov (United States)

    Rook, Lorenzo; Bondioli, Luca; Köhler, Meike; Moyà-Solà, Salvador; Macchiarelli, Roberto

    1999-01-01

    Textural properties and functional morphology of the hip bone cancellous network of Oreopithecus bambolii, a 9- to 7-million-year-old Late Miocene hominoid from Italy, provide insights into the postural and locomotor behavior of this fossil ape. Digital image processing of calibrated hip bone radiographs reveals the occurrence of trabecular features, which, in humans and fossil hominids, are related to vertical support of the body weight, i.e., to bipedality. PMID:10411955

  5. Endovascular Treatment of Left Iliofemoral Deep Vein Thrombosis Using Urokinase Thrombolysis and Adjunctive Aspiration Thrombectomy

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Sang Hyun; Lee, Do Yun; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    To evaluate the efficacy of adjunctive aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis (DVT). 24 patients (9 males and 15 females; mean age, 53 years), treated by aspiration thrombectomy were enrolled in this study. The day after undergoing urokinase (UK) thrombolysis, any residual thrombus over a long segment was treated by aspiration thrombectomy using a 12 Fr long sheath. Residual short-segment (< 10 cm) iliac vein thrombus and/or stenosis were treated with a stent. The evaluation of venous patency was conducted by color Doppler ultrasonography, venography and/or computed tomography. The technical and clinical success rates were 100% and 92%, respectively. Twenty-three patients were treated by UK thrombolysis and iliac stent. The overall patency rate at 1, 2 and 3 years was 85%, 82% and 81%, respectively. Over the course of the follow-up period, occlusion was observed in 4 cases (1 acute and 3 chronic cases). Periprocedural complication occurred in 4 cases (17%) in the form of a minimal hematoma or pain on the puncture site as well as a case of pulmonary embolism at one month after treatment. The adjunctive aspiration thrombectomy with conventional thrombolysis and stent placement can be an effective and safe method in the treatment of left iliofemoral DVT

  6. Increased presence of capillaries next to remodeling sites in adult human cancellous bone

    DEFF Research Database (Denmark)

    Kristensen, Helene Bjoerg; Andersen, Thomas Levin; Marcussen, Niels

    2013-01-01

    remodeling sites, capillaries, proliferative cells, and putative osteoblast progenitors. Iliac crest biopsies from normal human individuals were subjected to histomorphometry and immunohistochemistry to identify the respective positions of bone remodeling sites, CD34-positive capillaries, smooth muscle actin...... differentiation stage. We found that bone remodeling sites were associated with a significantly increased presence of capillaries, putative osteoblast progenitors, and proliferative cells in a region within 50 microm of the bone or the canopy surface. The increases were the highest above eroded surfaces...... and at the level of the light-microscopically assessed contact of these three entities with the bone or canopy surfaces. Between 51 and 100 microm, their densities leveled to that found above quiescent surfaces. Electron microscopy asserted the close proximity between BRC canopies and capillaries lined...

  7. Left inguinal hernia mimicking metastasis on bone scan

    OpenAIRE

    Goel, Sumina; Gadiraju, Ramesh

    2015-01-01

    Inguinal hernia is a well-known entity that usually affects males. The most common herniated organs are parts of the bowel, omentum, or fat. Urinary bladder herniation into the inguinal region is very rare and is often diagnosed during inguinal hernia surgery. This case highlights the importance of additional views and anatomic imaging to accurately interpret the unusual scan findings.

  8. Nanoscale characterization of bone-implant interface and biomechanical modulation of bone ingrowth

    Energy Technology Data Exchange (ETDEWEB)

    Clark, Paul A. [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States)]. E-mail: pclark4@gmail.com; Clark, Andrew M. [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States); Rodriguez, Anthony [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States); Hussain, Mohammad A. [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States); Mao, Jeremy J. [Tissue Engineering Laboratory MC 841, Departments of Anatomy and Cell Biology, Bioengineering, and Orthodontics, University of Illinois at Chicago, Chicago, 801 South Paulina Street, Illinois 60612 (United States)]. E-mail: jmao2@uic.edu

    2007-04-15

    Bone-implant interface is characterized by an array of cells and macromolecules. This study investigated the nanomechancial properties of bone-implant interface using atomic force microscopy in vitro, and the mechanical modulation of implant bone ingrowth in vivo using bone histomorphometry. Upon harvest of screw-type titanium implants placed in vivo in the rabbit maxilla and proximal femur for 4 weeks, nanoindentation was performed in the bone-implant interface at 60-{mu}m intervals radially from the implant surface. The average Young's Moduli (E) of the maxillary bone-implant interface was 1.13 {+-} 0.27 MPa, lacking significant differences at all intervals. In contrast, an increasing gradient of E was observed radially from the femur bone-implant interface: 0.87 {+-} 0.25 MPa to 2.24 {+-} 0.69 MPa, representing significant differences among several 60-{mu}m intervals. In a separate experiment, bone healing was allowed for 6 weeks for proximal femur implants. The right femoral implant received axial cyclic loading at 200 mN and 1 Hz for 10 min/d over 12 days, whereas the left femoral implant served as control. Cyclic loading induced significantly higher bone volume, osteoblast numbers per endocortical bone surface, mineral apposition rate, and bone formation rate than controls. These data demonstrate nanoscale and microscale characterizations of bone-implant interface, and mechanical modulation of bone ingrowth surrounding titanium implants.

  9. Nanoscale characterization of bone-implant interface and biomechanical modulation of bone ingrowth

    International Nuclear Information System (INIS)

    Clark, Paul A.; Clark, Andrew M.; Rodriguez, Anthony; Hussain, Mohammad A.; Mao, Jeremy J.

    2007-01-01

    Bone-implant interface is characterized by an array of cells and macromolecules. This study investigated the nanomechancial properties of bone-implant interface using atomic force microscopy in vitro, and the mechanical modulation of implant bone ingrowth in vivo using bone histomorphometry. Upon harvest of screw-type titanium implants placed in vivo in the rabbit maxilla and proximal femur for 4 weeks, nanoindentation was performed in the bone-implant interface at 60-μm intervals radially from the implant surface. The average Young's Moduli (E) of the maxillary bone-implant interface was 1.13 ± 0.27 MPa, lacking significant differences at all intervals. In contrast, an increasing gradient of E was observed radially from the femur bone-implant interface: 0.87 ± 0.25 MPa to 2.24 ± 0.69 MPa, representing significant differences among several 60-μm intervals. In a separate experiment, bone healing was allowed for 6 weeks for proximal femur implants. The right femoral implant received axial cyclic loading at 200 mN and 1 Hz for 10 min/d over 12 days, whereas the left femoral implant served as control. Cyclic loading induced significantly higher bone volume, osteoblast numbers per endocortical bone surface, mineral apposition rate, and bone formation rate than controls. These data demonstrate nanoscale and microscale characterizations of bone-implant interface, and mechanical modulation of bone ingrowth surrounding titanium implants

  10. Why Dora Left

    DEFF Research Database (Denmark)

    Gammelgård, Judy

    2017-01-01

    The question of why Dora left her treatment before it was brought to a satisfactory end and the equally important question of why Freud chose to publish this problematic and fragmentary story have both been dealt with at great length by Freud’s successors. Dora has been read by analysts, literary...... critics, and not least by feminists. The aim of this paper is to point out the position Freud took toward his patient. Dora stands out as the one case among Freud’s 5 great case stories that has a female protagonist, and reading the case it becomes clear that Freud stumbled because of an unresolved...... problem toward femininity, both Dora’s and his own. In Dora, it is argued, Freud took a new stance toward the object of his investigation, speaking from the position of the master. Freud presents himself as the one who knows, in great contrast to the position he takes when unraveling the dream. Here he...

  11. Biomechanical Evaluation of Glenoid Reconstruction With an Implant-Free J-Bone Graft for Anterior Glenoid Bone Loss.

    Science.gov (United States)

    Pauzenberger, Leo; Dyrna, Felix; Obopilwe, Elifho; Heuberer, Philipp R; Arciero, Robert A; Anderl, Werner; Mazzocca, Augustus D

    2017-10-01

    The anatomic restoration of glenoid morphology with an implant-free J-shaped iliac crest bone graft offers an alternative to currently widely used glenoid reconstruction techniques. No biomechanical data on the J-bone grafting technique are currently available. To evaluate (1) glenohumeral contact patterns, (2) graft fixation under cyclic loading, and (3) the initial stabilizing effect of anatomic glenoid reconstruction with the implant-free J-bone grafting technique. Controlled laboratory study. Eight fresh-frozen cadaveric shoulders and J-shaped iliac crest bone grafts were used for this study. J-bone grafts were harvested, prepared, and implanted according to a previously described, clinically used technique. Glenohumeral contact patterns were measured using dynamic pressure-sensitive sensors under a compressive load of 440 N with the humerus in (a) 30° of abduction, (b) 30° of abduction and 60° of external rotation, (c) 60° of abduction, and (d) 60° of abduction and 60° of external rotation. Using a custom shoulder-testing system allowing positioning with 6 degrees of freedom, a compressive load of 50 N was applied, and the peak force needed to translate the humeral head 10 mm anteriorly at a rate of 2.0 mm/s was recorded. All tests were performed (1) for the intact glenoid, (2) after the creation of a 30% anterior osseous glenoid defect parallel to the longitudinal axis of the glenoid, and (3) after anatomic glenoid reconstruction with an implant-free J-bone graft. Furthermore, after glenoid reconstruction, each specimen was translated anteriorly for 5 mm at a rate of 4.0 mm/s for a total of 3000 cycles while logging graft protrusion and mediolateral bending motions. Graft micromovements were recorded using 2 high-resolution, linear differential variable reluctance transducer strain gauges placed in line with the long leg of the graft and the mediolateral direction, respectively. The creation of a 30% glenoid defect significantly decreased glenohumeral

  12. Effects of long-term alendronate treatment on postmenopausal osteoporosis bone material properties.

    Science.gov (United States)

    Hassler, N; Gamsjaeger, S; Hofstetter, B; Brozek, W; Klaushofer, K; Paschalis, E P

    2015-01-01

    Raman microspectroscopic analysis of iliac crest from patients that were treated with alendronate (ALN) for 10 years revealed minimal, transient alterations in bone material properties confined to actively forming bone surfaces compared to patients that were on ALN for 5 years. These changes were not encountered in the bulk tissue. Alendronate (ALN) and other bisphosphonates (BPs) are the most widely prescribed therapy for postmenopausal osteoporosis. Despite their overall excellent safety record and efficacy in reducing fractures, questions have been raised regarding potential detrimental effects that may be related to prolonged bone turnover reduction, although no definite cause-effect relationship has been established to date. The purpose of the present study was to evaluate bone material properties in patients that were receiving ALN for 5 or 10 years. Raman microspectroscopic analysis was used to analyze iliac crest biopsies from postmenopausal women with osteoporosis who had been treated with ALN for 5 years and were then re-randomized to placebo (PBO, N = 14), 5 mg/day ALN (N = 10), or 10 mg/day ALN (N = 6) for another 5 years. The parameters monitored and expressed as a function of tissue age were (i) the mineral/matrix ratio (MM), (ii) the relative proteoglycan content (PG), (iii) the relative lipid content (LPD), (iv) the mineral maturity/crystallinity (MMC), and (v) the relative pyridinoline content (PYD). The obtained data indicate that 10-year ALN use results in minimal, transient bone tissue composition changes compared to use for 5 years, confined to actively forming trabecular surfaces, implying potential differences in bone matrix maturation that nevertheless did not result in differences of these values in bulk tissue. The data suggest that prolonged reduction in bone turnover during 10 years of therapy with ALN by itself is unlikely to be associated with adverse effects on bone material properties.

  13. Risk factors for adjacent segment degeneration after iliac screw fixation in lumbar degenerative kyphoscoliosis.

    Science.gov (United States)

    Kim, Sang-Il; Ha, Kee-Yong; Suh, Dong-Whan; Oh, In-Soo

    2017-01-01

    To analyze pre- and postoperative spinopelvic parameters and sagittal profiles in lumbar degenerative kyphoscoliosis (LDK) patients who underwent surgery using iliac screw (IS) and the incidence and risk factor of radiological adjacent segment degeneration (ASD). A total of 32 patients, who had undergone surgical correction and lumbar/thoracolumbar fusion with pedicle screws and IS instrumentation for LDK with a minimum 2-year follow-up, were included. Ten cases with ASD (group 1) and 22 cases without ASD (group 2) were compared to see pre- and postoperative change in sagittal view of spine and adjacent segment. Parameters of both groups were analyzed before and after surgery with each parameters being tested on correlativity. All deformity types of patients were classified using Scoliosis Research Society (SRS)-Schwab classification. Risk factors of ASD were evaluated using variables of SRS-Schwab classification. Group 1, rather than group 2, showed significant increment in pelvic incidence (PI). Curve types, classified using SRS-Schwab classification, were all corrected using IS; and after correction, coronal curve type was N curve and PI minus lumbar lordosis (LL) and pelvic tilt showed tendency to decrease. Cases with preoperative sagittal vertical axis (SVA) more than 10 cm and with postoperative PI minus LL more than 20° were at higher risk of developing ASD. For those with high PI, it might be a risk to cause ASD. Maintaining normal thoracic and lumbar angle, correction of SVA less than 4 cm, and PI minus LL below 20° are proper ways to avoid ASD after surgery.

  14. Right Iliac Fossa Pain Treatment (RIFT) Study: protocol for an international, multicentre, prospective observational study.

    Science.gov (United States)

    2018-01-13

    Patients presenting with right iliac fossa (RIF) pain are a common challenge for acute general surgical services. Given the range of potential pathologies, RIF pain creates diagnostic uncertainty and there is subsequent variation in investigation and management. Appendicitis is a diagnosis which must be considered in all patients with RIF pain; however, over a fifth of patients undergoing appendicectomy, in the UK, have been proven to have a histologically normal appendix (negative appendicectomy). The primary aim of this study is to determine the contemporary negative appendicectomy rate. The study's secondary aims are to determine the rate of laparoscopy for appendicitis and to validate the Appendicitis Inflammatory Response (AIR) and Alvarado prediction scores. This multicentre, international prospective observational study will include all patients referred to surgical specialists with either RIF pain or suspected appendicitis. Consecutive patients presenting within 2-week long data collection periods will be included. Centres will be invited to participate in up to four data collection periods between February and August 2017. Data will be captured using a secure online data management system. A centre survey will profile local policy and service delivery for management of RIF pain. Research ethics are not required for this study in the UK, as determined using the National Research Ethics Service decision tool. This study will be registered as a clinical audit in participating UK centres. National leads in countries outside the UK will oversee appropriate registration and study approval, which may include completing full ethical review. The study will be disseminated by trainee-led research collaboratives and through social media. Peer-reviewed publications will be published under corporate authorship including 'RIFT Study Group' and 'West Midlands Research Collaborative'. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  15. Radiography of the spine and sacro-iliac joints in ankylosing spondylitis and psoriasis

    International Nuclear Information System (INIS)

    Dale, K.; Vinje, O.

    1985-01-01

    A grading system involving six stages of arthritis from grade O=normal joints to grade V=extensive bony ankylosis in the sacro-iliac joints and a scheme applicable for quantitative registration of the radiographic findings of the spine in ankylosing spondylitis (AS) are detailed. These radiographic grading systems were used in a study comprising 48 patients with psoriasis (group A), 19 patients with AS and psoriasis (group B), 103 patients with AS (group C) and 231 first-degree relatives of the patients belonging to groups B and C (group D). Radiographic abnormalities of the spine were found totally in 80 per cent of the patients belonging to groups B and C. In these groups sclerotic anterior borders of vertebrae (SABS) and/or straightened anterior surfaces of vertebrae were seen totally in 66 per cent. SABS were earlier findings than syndesmophyte formation which was found in 60 per cent of the patients belonging to groups B and C. Except for ankylosis of the apophyseal joints and ossified interspinous ligament most frequently found in the lower lumbar region in patients with duration of disease more than 20 years, all abnormalities of the spine were most frequent in the dorsolumbar junction. Grade V sacro-iliitis was associated with ankylosis of two or more segments of the spine. Such spinal changes were infrequently seen in patients with grade IV sacro-iliitis. This finding supports the previous notion that among patients fulfilling the criteria for AS, there is a group with a non-ankylosing disease. Thus two different subgroups of AS could be identified. Except for frequent unilateral sacro-iliitis and slight changes of the spine in group A no radiographic differences were found between the groups A, B and C. Sacro-iliitis was found in 22(9%) in group D, and 11 of those with sacro-iliitis had abnormalities of the spine compatible with AS. (orig.)

  16. Interventional Exclusion of Iliac Artery Aneurysms Using the Flow-Diverting Multilayer Stent

    Energy Technology Data Exchange (ETDEWEB)

    Pieper, Claus Christian, E-mail: Claus.christian.pieper@ukb.uni-bonn.de; Meyer, Carsten, E-mail: Carsten.Meyer@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany); Rudolph, Jens, E-mail: jens.rudolph@ukb.uni-bonn.de; Verrel, Frauke, E-mail: frauke.verrel@ukb.uni-bonn.de [University of Bonn, Department of Surgery (Germany); Schild, Hans Heinz, E-mail: hans.schild@ukb.uni-bonn.de; Wilhelm, Kai E., E-mail: kai.wilhelm@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany)

    2013-08-01

    PurposeThis study was designed to evaluate retrospectively the results of complex iliac artery aneurysm (IAA) exclusion using the Cardiatis-Multilayer-Stent.MethodsBetween October 2010 and August 2012, ten IAAs were treated in eight males (mean age 75 (59-91) years) using the Multilayer Stent. All IAA exceeded a diameter of 3 cm or were symptomatic. Follow-up (FU) examinations included CT or MR angiography, sonography, and clinical assessment up to 2 years.ResultsPrimary stent placement was technically successful in eight of ten cases. In two cases, severe stent retraction during deployment necessitated placement of an additional stent. Immediately after stent placement, a marked reduction of flow within the sac was observed in all cases (peri-interventional mortality 0 %). During FU, there were two thrombotic stent occlusions, making reintervention necessary (primary patency rate 80 %, secondary patency 100 %). Four IAA were completely occluded at FU, whereas the original vessel and covered branches (n = 8) were patent. In four IAA, there was still residual perfusion. In one patient, IAA diameter decreased slightly, while it remained constant in seven (mean imaging FU 195 (range 1-695) days). There were no adverse events on clinical FU (mean FU 467 (range 101-695) days).ConclusionsOther studies showed the Cardiatis-Multilayer-Stent to be a technically relatively simple treatment option for complex IAA with inadequate landing zones, especially in patients with multiple comorbidities to avoid ipsilateral IIA obstruction. However, in our series complication rate was high. Incomplete sac exclusion, stent-shortening, and thrombotic occlusion can complicate treatment, making meticulous patient selection necessary. Close imaging surveillance is mandatory especially in the early postinterventional period.

  17. Hemodynamic parameters following bilateral internal iliac arteries ligation as a treatment of intrapartum hemorrhage.

    Science.gov (United States)

    Raba, Grzegorz; Baran, Piotr

    2009-03-01

    The internal iliac arteries ligation (IIAL) is a particularly effective method, maintaining fertility, of dealing with intrapartum hemorrhage. Hemodynamic evaluation of the ovarian arteries(OA) and uterine arteries (UA) in patients after IIAL. Study Group consisted of 6 women who underwent IIAL to treat intrapartum hemorrhage--without hysterectomy. Control Group consisted of 6 women, at the same age group, parity and time after delivery, who did not undergo IIAL. Perfusion characteristics were studied by means of a transvaginal Doppler system. Resistance index (RI), pulsatility index (PI) and systolic/diastolic ratio (S/D) were measured in the uterine and ovarian arteries. Nonparametric comparison of the two groups was performed with the help of Two-sample Wilcoxon rank-sum (Mann-Whitney) test. RESULTS 1. Change of perfusion in OA-PI: 1.40 vs. 3.76 Prob 0.05; S/D: 3.25 vs. 18.2 Prob Change of perfusion in UA-PI: 2.20 vs. 2.75 Prob > 0.05; RI 0.82 vs. 0.86 Prob > 0.05; SID: 5.28 vs. 7.81 Prob > 0.05. 1. IIAL as a way of treating intrapartum haemorrhage, causes the decrease of pulsatility index (PI) and systolic/diastolic ratio (S/D) in ovarian arteries. 2. Characteristic changes of PI, RI and S/D parameters in uterine arteries after IIAL have not been observed. 3. Changes of ovarian flow velocity parameters suggest the possibility of changes in the ovarian function.

  18. Characteristics of the response of the iliac artery to wall shear stress in the anaesthetized pig.

    Science.gov (United States)

    Kelly, R F; Snow, H M

    2007-07-15

    The functional significance of shear stress-induced vasodilatation in large conduit arteries is unclear since changes in the diameter have little effect on the resistance to blood flow. However, changes in diameter have a relatively large effect on wall shear stress which suggests that the function of flow-mediated dilatation is to reduce wall shear stress. The mean and pulsatile components of shear stress vary widely throughout the arterial system and areas of low mean and high amplitude of wall shear stress are prone to the development of atheroma. In this study, using an in vivo model with the ability to control flow rate and amplitude of flow independently, we investigated the characteristics of the response of the iliac artery to variations in both the mean and amplitude of wall shear stress. The results of this study confirm that increases in mean wall shear stress are an important stimulus for the release of nitric oxide by the endothelium as indicated by changes in arterial diameter and show for the first time, in vivo, that increases in the amplitude of the pulsatile component of shear stress have a small but significant inhibitory effect on this response. A negative feedback mechanism was identified whereby increases in shear stress brought about by increases in blood flow are reduced by the release of nitric oxide from the endothelium causing dilatation of the artery, thus decreasing the stimulus to cell adhesion and, through a direct action of nitric oxide, inhibiting the process of cell adhesion. The results also provide an explanation for the uneven distribution of atheroma throughout the arterial system, which is related to the ratio of pulsatile to mean shear stress and consequent variability in the production of NO.

  19. A novel bimodal approach for treating atrophic bone non-unions with extracorporeal shockwaves and autologous mesenchymal stem cell transplant.

    Science.gov (United States)

    Sansone, Valerio; Brañes, Manuel; Romeo, Pietro

    2018-02-01

    We propose a novel approach for the treatment of atrophic bone non-unions via parallel applications of extracorporeal shock wave therapy (ESWT) and an autologous mesenchymal stem cell transplant. The hypothesis resides on the potentiality of shock waves (SWs) to act as a tool for manipulating the patient's mesenchymal stem cells (MSCs). In addition to the conventional physical stimulus achieved by delivering SWs at the site of non-union to stimulate the well-known trophic effects on bone tissue, a series of concomitant ESWT would be administered in tandem at a bone marrow donor site, such as the iliac crest, to precondition resident bone marrow stromal cells (BMSCs) in vivo, priming resident MSCs by enlarging and conditioning their population prior to bone marrow aspiration. The resulting sample could then be treated to further augment cell concentration and injected, under fluoroscopic control, into the non-union site through a percutaneous approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. The carboxy-terminal propeptide of type I procollagen in serum as a marker of bone formation

    DEFF Research Database (Denmark)

    Hassager, C; Jensen, L T; Johansen, J S

    1991-01-01

    injection every 3 weeks for 1 year; and (2) 40 women received either 2 mg 17 beta-estradiol plus 1 mg norethisterone acetate or placebo tablets daily for 1 year. Sixty-seven (85%) completed the 1 year of treatment. Serum concentration of type I procollagen carboxy-terminal propeptide (PICP) was measured...... before and at 3, 6, 9, and 12 months of therapy. In addition, 32 of the women had an iliac bone biopsy taken after double tetracycline labeling. Initial serum PICP correlated significantly with histomorphometrically measured rate of bone formation (r = .4; P less than .05) and plasma bone Gla protein (r...... = .6; P less than .001), but not with histomorphometrically measured bone resorption or biochemical estimates of bone resorption (fasting urinary hydroxyproline and calcium). Estrogen-progestogen therapy significantly decreased (P less than .001) serum PICP by about 30%, whereas anabolic steroid...

  1. Segmenting Bone Parts for Bone Age Assessment using Point Distribution Model and Contour Modelling

    Science.gov (United States)

    Kaur, Amandeep; Singh Mann, Kulwinder, Dr.

    2018-01-01

    Bone age assessment (BAA) is a task performed on radiographs by the pediatricians in hospitals to predict the final adult height, to diagnose growth disorders by monitoring skeletal development. For building an automatic bone age assessment system the step in routine is to do image pre-processing of the bone X-rays so that features row can be constructed. In this research paper, an enhanced point distribution algorithm using contours has been implemented for segmenting bone parts as per well-established procedure of bone age assessment that would be helpful in building feature row and later on; it would be helpful in construction of automatic bone age assessment system. Implementation of the segmentation algorithm shows high degree of accuracy in terms of recall and precision in segmenting bone parts from left hand X-Rays.

  2. {sup 18}F-FDG PET/CT bone/bone marrow findings in Hodgkin's lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging

    Energy Technology Data Exchange (ETDEWEB)

    Moulin-Romsee, Gerard [Universite Paris 7, Service de Medicine Nucleaire, Hopital Saint-Louis, Assistance Publique-Hopitaux de Paris (France); Institut Curie, Nuclear Medicine, Paris (France); Hindie, Elif; Filmont, Jean-Emmanuel; Moretti, Jean-Luc [Universite Paris 7, Service de Medicine Nucleaire, Hopital Saint-Louis, Assistance Publique-Hopitaux de Paris (France); Cuenca, Xavier; Brice, Pauline; Sibon, David [Hopital Saint-Louis, Haemato-Oncology, Paris (France); Decaudin, Didier; Anitei, Marcela [Institut Curie, Haematology, Paris (France); Benamor, Myriam [Institut Curie, Nuclear Medicine, Paris (France); Briere, Josette [Hopital Saint-Louis, Pathology, Paris (France); Kerviler, Eric de [Hopital Saint-Louis, Radiology, Paris (France)

    2010-06-15

    Accurate staging of Hodgkin's lymphoma (HL) is necessary in selecting appropriate treatment. Bone marrow trephine biopsy (BMB) is the standard procedure for depicting bone marrow involvement. BMB is invasive and explores a limited part of the bone marrow. {sup 18}F-FDG PET/CT is now widely used for assessing response to therapy in HL and a baseline study is obtained to improve accuracy. The aim of this retrospective analysis was to assess whether routine BMB remains necessary with concomitant {sup 18}F-FDG PET/CT. Data from 83 patients (newly diagnosed HL) were reviewed. All patients had received contrast-enhanced CT, BMB and {sup 18}F-FDG PET/CT. Results of BMB were not available at the time of {sup 18}F-FDG PET/CT imaging. Seven patients had lymphomatous involvement on BMB. Four patients had bone involvement on conventional CT (two with negative BMB). All patients with bone marrow and/or bone lesions at conventional staging were also diagnosed on {sup 18}F-FDG PET/CT scan. PET/CT depicted FDG-avid bone/bone marrow foci in nine additional patients. Four of them had only one or two foci, while the other had multiple foci. However, the iliac crest, site of the BMB, was not involved on {sup 18}F-FDG PET/CT. Osteolytic/sclerotic lesions matching FDG-avid foci were visible on the CT part of PET/CT in three patients. MRI ordered in three other patients suggested bone marrow involvement. Interim and/or end-therapy {sup 18}F-FDG PET/CT documented response of FDG-avid bone/bone marrow foci to chemotherapy in every patient. {sup 18}F-FDG PET/CT highly improves sensitivity for diagnosis of bone/bone marrow lesions in HL compared to conventional staging. (orig.)

  3. Non-compact left ventricle/hypertrabeculated left ventricle

    International Nuclear Information System (INIS)

    Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

    2005-01-01

    Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopatie produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties) as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies). This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopatie, endocardial fibroelastosis, dilated cardiomyopatie, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a history of chronic arterial hypertension and diabetes mellitus, prechordial chest pain and mild dyspnoea. An echocardiogram showed signs of non-compact left ventricle with prominent trabeculations and deep inter-trabecular recesses involving left ventricular apical segment and extending to the lateral and inferior walls. Literature on this topic is reviewed

  4. Effects of directly autotransplanted tibial bone marrow aspirates on bone regeneration and osseointegration of dental implants.

    Science.gov (United States)

    Payer, Michael; Lohberger, Birgit; Strunk, Dirk; Reich, Karoline M; Acham, Stephan; Jakse, Norbert

    2014-04-01

    Aim of the pilot trial was to evaluate applicability and effects of directly autotransplanted tibial bone marrow (BM) aspirates on the incorporation of porous bovine bone mineral in a sinus lift model and on the osseointegration of dental implants. Six edentulous patients with bilaterally severely resorbed maxillae requiring sinus augmentation and implant treatment were included. During surgery, tibial BM was harvested and added to bone substitute material (Bio-Oss(®) ) at the randomly selected test site. At control sites, augmentation was performed with Bio-Oss(®) alone. The cellular content of each BM aspirate was checked for multipotency and surface antigen expression as quality control. Histomorphometric analysis of biopsies from the augmented sites after 3 and 6 months (during implantation) was used to evaluate effects on bone regeneration. Osseointegration of implants was evaluated with Periotest(®) and radiographic means. Multipotent cellular content in tibial BM aspirates was comparable to that in punctures from the iliac crest. No significant difference in amount of new bone formation and the integration of bone substitute particles was detected histomorphometrically. Periotest(®) values and radiographs showed successful osseointegration of inserted implants at all sites. Directly autotransplanted tibial BM aspirates did not show beneficial regenerative effects in the small study population (N = 6) of the present pilot trial. However, the proximal tibia proved to be a potential donor site for small quantities of BM. Future trials should clarify whether concentration of tibial BM aspirates could effect higher regenerative potency. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Bifurcated-bifurcated aneurysm repair is a novel technique to repair infrarenal aortic aneurysms in the setting of iliac aneurysms.

    Science.gov (United States)

    Shin, Susanna Hewon; Starnes, Benjamin Ware

    2017-11-01

    Up to 40% of abdominal aortic aneurysms (AAAs) have coexistent iliac artery aneurysms (IAAs). In the past, successful endovascular repair required internal iliac artery (IIA) embolization, which can lead to pelvic or buttock ischemia. This study describes a technique that uses a readily available solution with a minimally altered off-the-shelf bifurcated graft in the IAA to maintain IIA perfusion. From August 2009 to May 2015, 14 patients with AAAs and coexisting IAAs underwent repair with a bifurcated-bifurcated approach. A 22-mm or 24-mm bifurcated main body device was used in the IAA with extension of the "contralateral" limb into the IIA. Intraoperative details including operative time, fluoroscopy time, and contrast agent use were recorded. Outcome measures assessed were operative technical success and a composite outcome measure of IIA patency, freedom from reintervention, and clinically significant endoleak at 1 year. Fourteen patients underwent bifurcated-bifurcated repair during the study period. Technical success was achieved in 93% of patients, with successful treatment of the AAA and IAA and preservation of flow to at least one IIA. The procedure was performed with a completely percutaneous bilateral femoral approach in 92% of patients. Three patients had a type II endoleak on initial follow-up imaging, but none were clinically significant. There were no cases of bowel ischemia or erectile dysfunction. One patient had buttock claudication ipsilateral to IIA coil embolization (contralateral to bifurcated iliac repair and preserved IIA) that resolved by 6-month follow-up. Two patients required reinterventions. One patient presented to his first follow-up visit on postoperative day 25 with thrombosis of the right external iliac limb ipsilateral to the bifurcated iliac repair, which was successfully treated with thrombectomy and stenting of the limb. This same patient presented at 83 months with growth of the preserved IIA to 3.9 cm and underwent coil

  6. Mechanical discordance between left atrium and left atrial appendage

    Directory of Open Access Journals (Sweden)

    Arash Khamooshian

    2018-01-01

    Full Text Available During standard transesophageal echocardiographic examinations in sinus rhythm (SR patients, the left atrial appendage (LAA is not routinely assessed with Doppler. Despite having a SR, it is still possible to have irregular activity in the LAA. This situation is even more important for SR patients where assessment of the left atrium is often foregone. We describe a case where we encountered this situation and briefly review how to assess the left atrium and its appendage in such a case scenario.

  7. Bone Scan

    Science.gov (United States)

    ... posts Join Mayo Clinic Connect Bone scan About Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  8. Bone Biopsy

    Science.gov (United States)

    ... bear denotes child-specific content. Related Articles and Media Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Bone Biopsy Sponsored by Please note ...

  9. Bone sarcomas

    International Nuclear Information System (INIS)

    Mudry, P.

    2008-01-01

    Bone sarcomas are malignancies with peak incidence in adolescents and young adults. The most frequent are osteosarcoma and Ewing sarcoma/PNET, in an older adults are seen chondrosarcomas, other ones are rare. In general, biology of sarcomas is closely related to pediatric malignancies with fast growth, local aggressiveness, tendency to early hematogenic dissemination and chemo sensitivity. Diagnostics and treatment of bone sarcomas should be done in well experienced centres due to low incidence and broad issue of this topic. An interdisciplinary approach and staff education is essential in due care of patients with bone sarcoma. If these criteria are achieved, the cure rate is contemporary at 65 - 70 %, while some subpopulation of patients has chance for cure up to 90 %. Osteosarcoma and Ewing sarcoma/PNET are discussed below as types of most frequent bone sarcoma. (author)

  10. Bone pain

    DEFF Research Database (Denmark)

    Frost, Charlotte Ørsted; Hansen, Rikke Rie; Heegaard, Anne-Marie

    2016-01-01

    Skeletal conditions are common causes of chronic pain and there is an unmet medical need for improved treatment options. Bone pain is currently managed with disease modifying agents and/or analgesics depending on the condition. Disease modifying agents affect the underlying pathophysiology...... of the disease and reduce as a secondary effect bone pain. Antiresorptive and anabolic agents, such as bisphosphonates and intermittent parathyroid hormone (1-34), respectively, have proven effective as pain relieving agents. Cathepsin K inhibitors and anti-sclerostin antibodies hold, due to their disease...... modifying effects, promise of a pain relieving effect. NSAIDs and opioids are widely employed in the treatment of bone pain. However, recent preclinical findings demonstrating a unique neuronal innervation of bone tissue and sprouting of sensory nerve fibers open for new treatment possibilities....

  11. [Left-handedness and health].

    Science.gov (United States)

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

  12. Predictors of Long-Term Results After Treatment of Iliac Artery Obliteration by Transluminal Angioplasty and Stent Deployment

    International Nuclear Information System (INIS)

    Funovics, M.A.; Lackner, B.; Cejna, M.; Peloschek, P.; Sailer, J.; Philipp, M.O.; Maca, T.; Ahmadi, A.; Minar, E.; Lammer, J.

    2002-01-01

    Purpose: To investigate initial and long-term success rate after percutaneous treatment of iliac artery occlusion with angioplasty and stent deployment. To investigate the influence of vascular comorbidity, lesion length, stent placement and lesion coverage as possible predictors of outcome. Methods: Between January 1994 and December 1999, 80 iliac recanalizations were performed on 78 patients, median age 61.1 ±11.5 (SD) years. All patients were followed up by clinical examinations, duplex ultrasound and intravenous digital subtraction angiography. Mean follow-up time was 2.0 ± 1.53 (SD) years.Multivariate Cox regression analysis was used to determine the influence of cofactors on patency. Results: One, 2 and 4 years after recanalization, primary patency was 78.1%, 74.5% and 64.0%; secondary patency was 88.8%, 88.8% and 77.9%, respectively.Patients with shorter occlusions, complete lesion coverage and patent ipsilateral femoral arteries had significantly longer patency rates.Complications included inguinal hematoma (n=1), technical failure (n=3) aortic dissection (n=1), embolic occlusions (n=7), gluteal claudication (n=1) and genital necrosis after subsequent urethral surgery in one patient with contralateral occlusion and ipsilateral overstenting of the internal iliac artery with subsequent stenosis. Complications were of permanent clinical significance in seven of 78 (9%) of the patients. In 17 (22%) cases, percutaneous reintervention was performed with angioplasty in the stent (n=16) or deployment of a new stent (n=1). Conclusion: Endoluminal stent placement has its place in an interdisciplinary therapeutic approach as a viable therapeutic alternative to major transabdominal bypass surgery and can be performed with comparable complication rates. Patients with short occlusions, patent femoral arteries, and stents covering the entire occlusion have significant longer patency

  13. Whole-exome sequencing reveals a heterozygous LRP5 mutation in a 6-year-old boy with vertebral compression fractures and low trabecular bone density.

    Science.gov (United States)

    Fahiminiya, Somayyeh; Majewski, Jacek; Roughley, Peter; Roschger, Paul; Klaushofer, Klaus; Rauch, Frank

    2013-11-01

    Juvenile osteoporosis (JO) is characterized by bone fragility during development, low bone mass and absence of extraskeletal features. Heterozygous loss-of-function mutations in LRP5 have been found in a few patients, but bone tissue and bone material abnormalities associated with such mutations have not been determined. Here we report on a 6-year-old boy who presented with a history of seven low-energy long-bone fractures starting at 19months of age and absence of extraskeletal involvement. Spine radiographs revealed multiple vertebral compression fractures. Despite tall stature (95th percentile), lumbar spine areal bone mineral density was low (z-score=-3.2). Trabecular volumetric bone mineral density, measured by peripheral quantitative computed tomography at the distal radius, was low (z-score=-5.1), but cortical thickness at the radial diaphysis was normal. Iliac bone histomorphometry demonstrated low bone formation activity in trabecular but not in cortical bone. Quantitative backscattered electron imaging showed normal material bone density in trabecular bone, but elevated results in the cortex. Whole-exome sequencing revealed a heterozygous insertion of a nucleotide in exon 12 of LRP5. This mutation had previously been reported in another JO patient and had been shown to lead to nonsense-mediated decay. Thus, heterozygous loss-of-function mutations in LRP5 can be associated with a bone formation deficit that affects mostly the trabecular compartment and can result in bone fragility during the first years of life. © 2013.

  14. A successful retrograde re-entry at aorta using the Outback LTD catheter for a bilateral common iliac artery occlusion.

    Science.gov (United States)

    Kim, Tae-Hoon; Ahn, Ji-Hun; Kim, Do-Hoi

    2013-05-01

    The Outback LTD re-entry catheter system has become a valuable tool for peripheral intervention and it has been widely used for variable peripheral chronic total occlusion (CTO). However, its use in the setting of the aorta was restricted because of concerns of bleeding risks resulting from re-entry puncture or ballooning. This report presents a case of successful re-entry using the Outback LTD Re-Entry Catheter (Cordis, Bridgewater, New Jersy) at the aorta in a patient with bilateral common iliac artery occlusion. Copyright © 2012 Wiley Periodicals, Inc.

  15. Case report of deep vein thrombosis caused by artificial urinary sphincter reservoir compressing right external iliac vein

    Directory of Open Access Journals (Sweden)

    Marcus J Yip

    2015-01-01

    Full Text Available Artificial urinary sphincters (AUSs are commonly used after radical prostatectomy for those who are incontinent of urine. However, they are associated with complications, the most common being reservoir uprising or migration. We present a unique case of occlusive external iliac and femoral vein obstruction by the AUS reservoir causing thrombosis. Deflation of the reservoir and anticoagulation has, thus far, not been successful at decreasing thrombus burden. We present this case as a rare, but significant surgical complication; explore the risk factors that may have contributed, and other potential endovascular therapies to address this previously unreported AUS complication.

  16. Operative Fixation of an Anterior Inferior Iliac Spine Apophyseal Avulsion Fracture Nonunion in an Adolescent Soccer Player: A Case Report.

    Science.gov (United States)

    Carr, James B; Conte, Evan; Rajadhyaksha, Evan A; Laroche, Kevin A; Gwathmey, F Winston; Carson, Eric W

    2017-01-01

    A 14-year-old male competitive soccer player presented with a history of recurrent right hip pain for 18 months. He was diagnosed with an anterior inferior iliac spine (AIIS) apophyseal avulsion fracture nonunion with subspinal impingement, which was confirmed by radiographs, computed tomography, and magnetic resonance imaging. The patient underwent surgical fixation and subspinal decompression. He returned to competitive soccer 5 months postoperatively. AIIS apophyseal avulsion fractures occur in adolescent athletes and generally respond to nonoperative treatment. When such management is unsuccessful, surgical fixation can lead to resolution of pain with return of full function.

  17. Metastatic basal cell carcinoma to the bone and bone marrow.

    Science.gov (United States)

    Elghissassi, Ibrahim; Mikou, Asmaa; Inrhaoun, Hanane; Ennouhi, Amine; Gamra, Lamiae; Errihani, Hassan

    2009-05-01

    Basal cell carcinoma (BCC) is the most common carcinoma in the community, but the incidence of metastatic events is exceedingly low. The few reported cases most often appear in regional nodes or the lungs, and patients usually exhibit multiple concurrent organs of spread at the time of diagnosis. We report a case of primary BCC located on the left forehead of a 48-year-old man, which metastasized exclusively to the bone and bone marrow, associated with hematologic disorders. A short review of the literature is included. Pathologic examination of the tumor located on the left forehead showed BCC. The patient underwent two surgical excisions because of local recurrence. Three years later, the patient developed a bicytopenia (anemia and thrombocytopenia). The bone marrow biopsy revealed metastasis of BCC. There were no abnormal findings in the other routine laboratory tests and radiologic investigations, except for the bone scan which showed multifocal skeletal metastases. The patient received two cycles of chemotherapy with cisplatin 75 mg/m(2) before he died as a result of hemorrhagic complications and progressive disease. Metastasis of BCC is a very rare condition that should not be overlooked. The prognosis remains very poor. We emphasize the importance of long-term follow-up of such patients.

  18. Preservação das artérias hipogástricas com endoprótese ramificada no tratamento endovascular de aneurismas aorto-ilíacos The Zenith iliac bifurcation Device (IBD for preservation of the internal iliac arteries during endovascular repair of aortic-iliac aneurysms

    Directory of Open Access Journals (Sweden)

    Emanuel Dias

    2010-12-01

    Full Text Available Introdução: Os doentes com indicação para tratamento endovascular de aneurismas da aorta abdominal (EVAR apresentam frequentemente artérias ilíacas comuns ectasiadas ou aneurismáticas, o que impossibilita a sua utilização como zona de encoragem distal da endoprótese. Em cerca de 15 a 30% dos casos pode existir necessidade de oclusão/embolização de uma ou de ambas as hipogástricas, com extensão da endoprótese para a artéria ilíaca externa. Isto tem sido associado a casos de claudicação glútea, isquémia intestinal, deficits neurológicos, e de disfunção vesical, intestinal e eréctil. O uso de endopróteses com ramo para a artéria hipogástrica apresenta-se como uma recente inovação que permite a preservação desta artéria e evitar estas complicações. Caso clínico: Homem de 63 anos, com antecedentes de cirurgia aórtica com interposição protésica aorto-aórtica em 2008 por aneurisma da aorta abdominal (AAA infra-renal, admitido para tratamento endovascular de aneurisma das artérias ilíaca comum e hipogástrica direitas, com 3,3 cm de maior diâmetro. O doente foi submetido a colocação por via femoral de endoprótese Zenith® ramificada para bifurcação ilíaca com preservação da artéria hipogástrica. Conclusões: A utilização de endopróteses ramificadas para a bifurcação ilíaca durante a correcção endovascular de aneurismas aorto-ilíacos para ser uma forma segura e pouco complexa de garantir a preservação das artérias hipogástricas e minimizar as complicações associadas à sua oclusão.Introduction: A significant portion of patients presenting for endovascular aneurysm repair of the abdominal aorta (EVAR have aneurysmatic or ectasied common iliac arteries, raising distal anchorage issues. In these cases, it may be necessary occlusion / embolization of one or both hipo gastric arteries with extension of the endoprothesis to the external iliac artery. This procedure has been associated to

  19. Medicines and Bone Loss

    Science.gov (United States)

    Fact Sheet Medici a ne n s d Bone Loss Some types of medicines can cause bone loss, making your bones weak, if used for a long time. Use over a short time ... old bone and replaces it with new bone. Bone loss occurs when old bone breaks down faster than ...

  20. Autologous bone marrow grafting combined with demineralized bone matrix improves consolidation of docking site after distraction osteogenesis.

    Science.gov (United States)

    Hatzokos, Ippokratis; Stavridis, Stavros I; Iosifidou, Eirini; Karataglis, Dimitrios; Christodoulou, Anastasios

    2011-04-06

    Distraction osteogenesis is used for the reconstruction of extensive osseous defects. Delay in docking site consolidation results in significant prolongation of this surgical procedure. The primary aim of the present study was to retrospectively compare three different treatment options, all aimed at improving and accelerating docking site consolidation. We further sought to clarify whether the application of autologous bone marrow cells combined with demineralized bone matrix would substantially improve docking site consolidation. Between 1995 and 2008, forty-three patients (mean age, 38.28 years) were managed with bone transport for the treatment of a tibial bone defect (mean length, 9.49 cm). The patients were divided into three groups according to the "docking site procedure" used: closed compression (Group A), surgical debridement of the docking site and application of autologous iliac bone graft (Group B), or surgical debridement and local application of bone marrow concentrate and demineralized bone matrix (Group C). Docking site consolidation was assessed both radiographically and clinically, and the results were statistically analyzed. The median "healing time" required for docking site consolidation was significantly longer in the compression group as compared with the demineralized bone matrix plus bone marrow group (p = 0.021), whereas there was no difference between the other groups. There was no significant difference among the groups in terms of complication rates (p = 0.702). Docking site consolidation was completed prior to regenerate consolidation in nine of the ten patients in Group C and in 13.6% of the patients in Group B, whereas in all of the remaining patients, completion of regenerate healing always preceded docking site consolidation. The application of demineralized bone matrix and autologous bone marrow is at least equivalent to autologous cancellous bone graft in terms of substantially reducing docking site healing time compared with

  1. Guided bone regeneration using individualized ceramic sheets.

    Science.gov (United States)

    Malmström, J; Anderud, J; Abrahamsson, P; Wälivaara, D-Å; Isaksson, S G; Adolfsson, E

    2016-10-01

    Guided bone regeneration (GBR) describes the use of membranes to regenerate bony defects. A membrane for GBR needs to be biocompatible, cell-occlusive, non-toxic, and mouldable, and possess space-maintaining properties including stability. The purpose of this pilot study was to describe a new method of GBR using individualized ceramic sheets to perfect bone regeneration prior to implant placement; bone regeneration was assessed using traditional histology and three-dimensional (3D) volumetric changes in the bone and soft tissue. Three patients were included. After full-thickness flap reflection, the individualized ceramic sheets were fixed. The sites were left to heal for 7 months. All patients were evaluated preoperatively and at 7 months postoperative using cone beam computed tomography and 3D optical equipment. Samples of the regenerated bone and soft tissue were collected and analyzed. The bone regenerated in the entire interior volume of all sheets. Bone biopsies revealed newly formed trabecular bone with a lamellar structure. Soft tissue biopsies showed connective tissue with no signs of an inflammatory response. This was considered to be newly formed periosteum. Thus ceramic individualized sheets can be used to regenerate large volumes of bone in both vertical and horizontal directions independent of the bone defect and with good biological acceptance of the material. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Very Long Segment Congenital Thoracoabdominal Aortic Coarctation (Diffuse Aortic Dysplasia) with Infrarenal Aortobi-Iliac and Cavobi-Iliac Aplasia in a 30-Year-Old Patient.

    Science.gov (United States)

    Mamopoulos, Apostolos; Luther, Bernd

    2015-10-01

    Congenital dysplastic aortic syndromes range from coarctation at the aortic isthmus to more extended aortic disease (midaortic syndrome). The latter is usually restricted to dysplastic aortic segments of up to 15 cm. Long segment dysplasia of the entire abdominal or thoracic aorta is extremely rare. This case of a 30-year-old patient with a very long segment congenital thoracoabdominal aortic coarctation and infrarenal aortobi-iliac and cavobi-iliac aplasia represents to our knowledge the most extended congenital vascular malformation in a surviving adult patient. The developed extensive collateral pathways ensured the survival of the patient, so that the main clinical manifestation was a refractory hypertension. Because of the extent of the disease, open surgery represented the only viable option. Interestingly, after 30 years of uncontrollable hypertension, the patient's blood pressure promptly responded to surgical treatment. A concomitant infrarenal aplasia of both the aorta and cava vein is also very unusual and points to a major developmental deficit during vascular embryogenesis. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Staphylococcus aureus bacteremia with iliac artery endarteritis in a patient receiving ustekinumab

    Directory of Open Access Journals (Sweden)

    Insa Joost

    2016-10-01

    Full Text Available Abstract Background Ustekinumab (Stelara®, a human monoclonal antibody targeting the p40-subunit of interleukin (IL-12 and IL-23, is indicated for moderate to severe plaque psoriasis and psoriatic arthritis. In large multicenter, prospective trials assessing efficacy and safety of ustekinumab increased rates of severe infections have not been observed so far. Case presentation Here, we report the case of a 64-year old woman presenting with chills, pain and swelling of her right foot with dark maculae at the sole, and elevated inflammatory markers. She had received a third dose of ustekinumab due to psoriatic arthritis three days before admission. Blood cultures revealed growth of Staphylococcus aureus and imaging showed a thickening of the aortic wall ventral the bifurcation above the right internal iliac artery, resembling an acute bacterial endarteritis. Without the evidence of aneurysms and in absence of foreign bodies, the decision for conservative management was made. The patient received four weeks of antibiotic therapy with intravenous flucloxacillin, followed by an oral regime with levofloxacin and rifampicin for an additional four weeks. Inflammatory markers resolved promptly and the patient was discharged in good health. Conclusion To our knowledge, this is the first report of a severe S. aureus infection in a patient receiving ustekinumab. Albeit ustekinumab is generally regarded as a safe drug, severe bacterial infections should always be included in the differential diagnosis of elevated inflammatory markers in patients receiving biologicals as these might present with nonspecific symptoms and fever might be absent. Any effort to detect deep-seated or metastatic infections should be made to prevent complications and to secure appropriate treatment. Although other risk factors for an invasive staphylococcal infection like psoriasis, recent corticosteroid injection, or prior hospitalisations were present, and therefore a directive

  4. Measurement of free radicals using electron paramagnetic resonance spectroscopy during open aorto-iliac arterial reconstruction.

    Science.gov (United States)

    Majewski, Wacław; Krzyminiewski, Ryszard; Stanisić, Michał; Iskra, Maria; Krasiński, Zbigniew; Nowak, Marek; Dobosz, Bernadeta

    2014-11-27

    Aortic cross-clamping during abdominal aortic aneurysm (AAA) open repair leads to development of ischemia-reperfusion injury. Electron paramagnetic resonance spectroscopy (EPR) spin-trapping is a valuable method of direct measurement of free radicals. The objective of the study was to evaluate the results of EPR as a direct method of free radical measurement and degree of inflammatory response in open operative treatment of patients with AAA and aorto-iliac occlusive disease (AIOD). The study was performed on a group of 32 patients with AAA and 25 patients with AIOD scheduled for open repair. Peripheral venous blood for EPR spectroscopy and for SOD, GPx, ox-LDL, Il-6, TNF-alfa, CRP, and HO-1 were harvested. Selected parameters were established accordingly to specified EPR and immunohistochemical methods and analyzed between groups by Mann-Whitney U test and Wilcoxon matched-pairs signed-ranks test with Bonferroni correction. Free radicals level was correlated with the time of the aortic cross-clamping after the reperfusion of he first and second leg in AAA (r=0.7; r=0.47). ox-LDL in AAA decreased 5 min after reperfusion of the first leg (32.99 U/L, range: 14.09-77.12) and 5 min after reperfusion of the second leg (26.75 U/L, range: 11.56-82.12) and 24 h after the operation (25.85 U/L, range: 14.29-49.70). HO-1 concentration increased to above the level before intervention 24 h after surgery. The activities of GPx and SOD decreased 5 min after the first-leg reperfusion in AAA. Twenty-four hours after surgery, inflammatory markers increased in AAA to CRP was 14.76 ml/l (0.23-38.55), IL-6 was 141.22 pg/ml (84.3-591.03), TNF-alfa was 6.82 pg/ml (1.76-80.01) and AIOD: CRP was 18.44 mg/l (2.56-33.14), IL-6: 184.1 pg/ml (128.46-448.03), TNF-alfa was 7.74 pg/ml (1.74-74.74). EPR spin-trapping demonstrates temporarily elevated level of free radicals in early phase of reperfusion, leading to decrease antioxidants in AAA. Elevated free radical levels decreased 24 h after

  5. Evaluation of the proliferative activity of immunocompetent cells in the jejunal and iliac lymph nodes of prepubertal female wild boars diagnosed with mixed mycotoxicosis

    Directory of Open Access Journals (Sweden)

    Zielonka Łukasz

    2015-06-01

    Full Text Available The study evaluated the proliferative activity of immunocompetent cells in the jejunal and iliac lymph nodes of prepubertal female wild boars exposed to deoxynivalenol and zearalenone in naturally contaminated feed. The evaluation was performed with the use of the MTT assay and 2 mitogens: lipopolysaccharide (LPS and concanavalin A. Intensified proliferative processes in T and B lymphocytes were revealed. The mitogenic activity of LPS was more expressed in the lymphocytes of both iliac and jejunal lymph nodes in comparison with the control group. Proliferative activity was higher in iliac lymph nodes than in jejunal lymph nodes. A reverse trend was observed in the percentage of live cells, which was higher in jejunal lymph nodes during the evaluation of lymphocyte proliferation.

  6. Comparison of the trabeculae structure of the spongy bone of the bilateral pastern bones in racehorses based on the imaging analysis of radiograms.

    Science.gov (United States)

    Dzierzecka, M; Czerwinski, E

    2010-01-01

    On the basis of a digital analysis of radiograms it was checked if, and to what extent, the extended loading of one of the sides of the body of racehorses leads to differences in the microstructure of the spongy bone of the bilateral pastern bones of the thoracic limbs. The research material consisted of radiograms of the pastern bones of the right and left thoracic limbs of racehorses. On the basis of computer image radiological analysis with the use of the "Trabecula,, programme, a quantative evaluation of the structure of the spongy bone of the pastern bones was conducted. It was noted that the differences between the right and the left pastern bones, despite extensive loading of the left thoracic limb, were not statistically significant as far as all studied parameters of the trabecula structure of the spongy bone were concerned.

  7. Instrumental neutron-activation analysis applications in the age dynamics assessment of Ca, Cl, K, Mg. Mn, Na, P, and Sr contents in the human cortical bone

    International Nuclear Information System (INIS)

    Zaichick, V.

    2003-01-01

    Full text: Senile osteoporosis and particularly osteoporosis among postmenopausal women represents an urgent problem of modern medicine. One of the main osteoporosis symptoms is a decrease in both bone mineral density and subsequent bone strength. The upper extremity of the femur in humans is a particularly vulnerable section of the skeleton, being subject to fracture and necrosis and to destruction of its cartilage. Iliac crest biopsies are commonly taken clinically on patients. It is known that the control of the mineral component providing bone strength is a good indicator to detect bone diseases like osteoporosis. Despite this, changes of chemical element contents occurring with age in the femoral head and the iliac crest of female and male separately have been little studied, but in iliac cortical bone have not been studied at all. The effect of age and sex on chemical element contents in intact cortical bone of femoral neck and iliac crest of 81 relatively healthy 15-55 years old women (n=36) and men (n=45) was investigated. All subjects had died suddenly and bone samples were obtained at necropsy from the right side of bodies within twenty-four hours after death. A tool made of titanium and plastic was used to clear samples from soft tissues and blood and to cut cortical part of bone. The IAEA and NIST reference materials (H-5 animal bone and SRM1486 bone meal) were used to estimate the precision and accuracy of results. Contents of Ca, Cl, K, Mg> Mn, Na, P, and Sr in intact bone samples were determined by instrumental neutron activation analysis using short-lived radionuclides. Our means data for each element of reference materials were within the certified 95 % confidence interval, and indicate an acceptable accuracy of the obtained results. No age- and sex-related differences in the cortical femoral neck composition were detected. Mean values (M±S.E.M.) of Ca, Cl, K, Mg, Mn, Na, P, and Sr mass fractions (on dry weight basis) for female and male all

  8. Local review of treatment of hand enchondroma (artificial bone substitute versus autologous bone graft) in a tertiary referral centre: 13 years' experience.

    Science.gov (United States)

    Hung, Y W; Ko, W S; Liu, W H; Chow, C S; Kwok, Y Y; Wong, Clara W Y; Tse, W L; Ho, P C

    2015-06-01

    To evaluate the treatment outcomes of enchondroma of the hand with artificial bone substitute versus autologous (iliac) bone graft. Historical cohort study. Tertiary referral centre, Hong Kong. A total of 24 patients with hand enchondroma from January 2001 to December 2013 who underwent operation at the Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital in Hong Kong were reviewed. Thorough curettage of the tumour was performed in all patients, followed by either autologous bone graft impaction under general anaesthesia in 13 patients, or artificial bone substitute in 11 patients (10 procedures were performed under local or regional anaesthesia and 1 was done under general anaesthesia). The functional outcomes and bone incorporation were measured by QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire) scores and radiological appearance, respectively. The mean follow-up period was 59 months. There were eight men and 16 women, with a mean age of 40 years. Overall, 17 cases involved phalangeal bones and seven involved metacarpal bones. Among both groups of patients, most of the affected digits had good range of motion and function after surgery. One patient in each study group had complications of local soft tissue inflammation. One patient in the artificial bone substitute group was suspected to have recurrence 8 years after operation. Among the autologous bone graft group, four patients had persistent donor site morbidity at the last follow-up. In all patients, radiographs showed satisfactory bone incorporation. Artificial bone substitute is a safe and effective treatment option for hand enchondroma, with satisfactory functional and radiographic outcomes. Artificial bone substitute offers the additional benefits of enabling the procedure to be done under local anaesthesia on a day-case basis with minimal complications.

  9. A case of symptomatic mass in the right iliac fossa: a Bermuda Triangle which often lies the right diagnosis.

    Science.gov (United States)

    Panarese, Alessandra; Pironi, Daniele; Pontone, Stefano; Vendettuoli, Maurizio; De Cristofaro, Flaminia; Antonelli, Manila; Romani, Annamaria; Filippini, Angelo

    2014-02-24

    Disease of the iliac fossa can often be accompanied by non-specific symptoms and some of these are exclusively caused by the compression of bulky masses of other neighboring structures. In young women a differential diagnosis is a non trivial task as several possible causes have to be taken into account. Thus, intraligamentary tumors, which are extremely rare finding, are frequently confused with uterus, ovary or intestinal tumors. Even if myomas are the most benign tumors of the female genital tract, broad ligament leiomyomas are an unusual finding in women of reproductive age. These tumors are often asymptomatic until they reach a volume likely to cause symptoms related to the mass pressure. An accurate patient's anamnesis and examination serve as a guide to further examinations. Ultrasound is the first line imaging as it can show ovarian or other pelvic mass and doesn't involve exposure to radiations in young patients, who can be pregnant. We describe the clinical presentation and imaging features of a broad ligament leiomyoma, which presented as an inguinal mass in a patient with a right iliac fossa pain. We also report our diagnostic process performing the differential diagnosis with other potential pathologies of RIF. In these cases, a preoperative disease classification discriminating the benign or malignant tumor nature is closely linked to the proper patient management.

  10. Myxoma of the Left Ventricle

    Science.gov (United States)

    Novoa, José; Delgado, Antonio; Alonso, Ana

    2014-01-01

    This report concerns a 69-year-old woman who presented with an asymptomatic myxoma in the left ventricle. The tumor was successfully excised. We provide a very brief review of 72 other published cases of surgically treated left ventricular myxoma. PMID:25120392

  11. Left ventricular hypertrophy in athletes.

    Science.gov (United States)

    Douglas, P S; O'Toole, M L; Katz, S E; Ginsburg, G S; Hiller, W D; Laird, R H

    1997-11-15

    Left ventricular wall thickness >1.3 cm, septal-to-posterior wall ratios > 1.5, diastolic left ventricular size >6.0 cm, and eccentric or concentric remodeling are rare in athletes. Values outside of these cutoffs in an athlete of any age probably represent a pathologic state.

  12. The Left-Handed Writer.

    Science.gov (United States)

    Bloodsworth, James Gaston

    Contrary to the beliefs of many, right-handedness is not a single factor existing in almost all people, with a few exceptions termed left-handed: neither extreme exists independently of the other. During the first 4 years of life there is a period of fluctuation between right and left-handed dominance. Statistics and findings vary in determining…

  13. Two Lefts in Latin America?

    DEFF Research Database (Denmark)

    Christensen, Steen Fryba

    In this working paper I list five researchers' categorizations of the Latin American left in power (april 2006) in a schematic form. The most important criteria for the categorizations are given.......In this working paper I list five researchers' categorizations of the Latin American left in power (april 2006) in a schematic form. The most important criteria for the categorizations are given....

  14. A Giant Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Medhat F. Zaher

    2014-01-01

    Full Text Available Atrial myxomas are the most common primary cardiac tumors. Patients with left atrial myxomas generally present with mechanical obstruction of blood flow, systemic embolization, and constitutional symptoms. We present a case of an unusually large left atrial myxoma discovered incidentally in a patient with longstanding dyspnea being managed as bronchial asthma.

  15. No effect of Osteoset, a bone graft substitute, on bone healing in humans: a prospective randomized double-blind study

    DEFF Research Database (Denmark)

    Petruskevicius, Juozas; Nielsen, Mette Strange; Kaalund, Søren

    2002-01-01

    We studied the effects of a newly marketed bone substitute, Osteoset, on bone healing in a tibial defect in humans. 20 patients undergoing an ACL (anterior cruciate ligament) reconstruction with bone-patella tendon-bone graft were block-randomized into 2 groups of 10 each. In the treatment group......, the tibial defect was filled manually with Osteoset pellets, in the control group the defect was left empty. CTs of the defect were taken on the first day after the operation, 6 weeks, 3 and 6 months postoperatively. We found about the same amount of bone in the defect in the Osteoset and control groups...

  16. X. rays: bone lesions of the pelvis after radiotherapy for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Ibrahim, E.; Chassagne, D.; Masselot, J.; Gerbaulet, A.

    1981-01-01

    This paper presents 29 patients with symptomatic bone necrosis of the pelvis (other than femoral head), detected among 1600 cases with carcinoma of the cervix. All patients received a minimal external irradiation of 50,00 Gy, using either cobalt 60 or high energy photon beams. The authors describe three separate and distinguished clinico-radiological syndromes according to the site of radionecrosis: 6 cases with pubic syndrome, 11 cases with sacro-iliac involvement and the remaining 15 patients with necrosis of the femoral head articulation in addition to iliac bone involvement. Associated soft tissue necrosis of the pelvis organs were observed in 15 cases. Detailed analysis of the etiological factors including stage of the disease, dose and technique of irradiation are discussed. Post menopausal patients experienced early appearance of this radionecrosis as compared to the pre-menopausal. This may be explained by the hormonal status. Diagnosis and differential diagnosis of the pelvic bone radionecrosis should be interpreted very carefully since biopsy and/or re-irradiation of such lesions is very hazardous. Rigorous radiotherapeutic technique and dosimetry are necessary in preventing such complications. Finally the functional prognosis of such lesions is excellent if the femoral articulation is not affected [fr

  17. Staining procedure for the detection of microcracks: application to ewe bone.

    Science.gov (United States)

    Portero-Muzy, N R; Chavassieux, P M; Arlot, M E; Chapurlat, R D

    2011-10-01

    Microcracks are one of the determinants of the bone strength and their accumulation may contribute to increased fracture risk. They are detected after bulk staining with various dyes, including basic fuschin, calcein and xylenol orange. The duration of staining usually varies across types of bone and species. The ewe is a large animal with a bone remodeling similar to humans, used as an animal model in bone histomorphometry studies. The aim of the present study was to determine the optimal conditions for bulk staining with xylenol orange of ewe bone. Xylenol orange 5mM in 70% ethanol was applied to iliac crest and vertebral biopsies for 2 or 15 days or 1, 2 or 3 months. After embedding, sections of 40, 50 and 80 μm thick were cut with either a precision diamond wire saw or a microtome. The staining was not visible after 2 or 15 days and was heterogeneous after 1 or 2 months. The quality of 40 and 50 μm thick sections was not preserved compared with those of 80 μm. Microcracks were suitably observed on ewe bone after bulk staining with xylenol orange for 3 months, in 80 μm thick sections. We conclude that the staining procedures should differ when examining ewe or human bone. This may be due to differences in bone matrix composition. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Bone marrow concentrate for autologous transplantation in minipigs. Characterization and osteogenic potential of mesenchymal stem cells.

    Science.gov (United States)

    Herten, M; Grassmann, J P; Sager, M; Benga, L; Fischer, J C; Jäger, M; Betsch, M; Wild, M; Hakimi, M; Jungbluth, P

    2013-01-01

    Autologous bone marrow plays an increasing role in the treatment of bone, cartilage and tendon healing disorders. Cell-based therapies display promising results in the support of local regeneration, especially therapies using intra-operative one-step treatments with autologous progenitor cells. In the present study, bone marrow-derived cells were concentrated in a point-of-care device and investigated for their mesenchymal stem cell (MSC) characteristics and their osteogenic potential. Bone marrow was harvested from the iliac crest of 16 minipigs. The mononucleated cells (MNC) were concentrated by gradient density centrifugation, cultivated, characterized by flow cytometry and stimulated into osteoblasts, adipocytes, and chondrocytes. Cell differentiation was investigated by histological and immunohistological staining of relevant lineage markers. The proliferation capacity was determined via colony forming units of fibroblast and of osteogenic alkaline-phosphatase-positive-cells. The MNC could be enriched 3.5-fold in nucleated cell concentrate in comparison to bone marrow. Flow cytometry analysis revealed a positive signal for the MSC markers. Cells could be differentiated into the three lines confirming the MSC character. The cellular osteogenic potential correlated significantly with the percentage of newly formed bone in vivo in a porcine metaphyseal long-bone defect model. This study demonstrates that bone marrow concentrate from minipigs display cells with MSC character and their osteogenic differentiation potential can be used for osseous defect repair in autologous transplantations.

  19. Pseudarthrosis of radial shaft with dislocation of heads of radial and ulnar bones (case report

    Directory of Open Access Journals (Sweden)

    M. E. Puseva

    2013-01-01

    Full Text Available The authors presented a rare clinical case - the injury of forearm complicated by the formation of the pseudarthrosis of the radial shaft in combination with old dislocation of heads the radius and ulna. The differentiated approach to the choice of surgical tactics was proposed, which consists of several consistent stages: taking free autotransplant from the crest of iliac bone, resection of pseudarthrosis of radius with replacement of the bone defect by the graft for restoration of anatomic length, conducting combined strained osteosynthesis and elimination of dislocation of a head of radial and ulnar bones by transosseous osteosynthesis. The chosen treatment strategy allowed to restore the anatomy and function of the upper extremity.

  20. Bilateral aneurysmal bone cyst of maxilla | Shubi | Tanzania Medical ...

    African Journals Online (AJOL)

    Bilateral aneurysmal bone cyst of maxilla. ... Aneurysmal bone cyst (ABC) is an uncommon benign lesion originating in the craniofacial region and has seldomly been reported in Tanzania and other parts of the world. ... whole of left and right maxillary alveolar process. Only 48, 46, 45 were present on the mandible while the ...

  1. Unusual presentation of rare primary lymphoma of bone ...

    African Journals Online (AJOL)

    Primary bone lymphoma is a distinct disease. It represents only 3% of all malignant bone tumours and less than 1% of non-Hodgkin's lymphoma. It is essential to differentiate it from other tumours because of its good prognosis. We report a case of 45 years old male who presented one year ago with a painful left arm.

  2. Non-Hematopoietic Essential Functions of Bone Marrow Cells: A Review of Scientific and Clinical Literature and Rationale for Treating Bone Defects.

    Science.gov (United States)

    Harrell, David B; Caradonna, Eugenio; Mazzucco, Laura; Gudenus, Rosmarie; Amann, Berthold; Prochazka, Vaclav; Giannoudis, Peter V; Hendrich, Christian; Jäger, Marcus; Krauspe, Rüdiger; Hernigou, Philippe

    2015-12-28

    Hematopoiesis as the only essential function of bone marrow cells has been challenged for several decades through basic science (in vitro and in vivo) and clinical data. Such work has shed light on two other essential functions of bone marrow cells: osteopoiesis and angio-genesis/vasculogenesis. Clinical utility of autologous concentrated bone marrow aspirate (CBMA) has demonstrated both safety and efficacy in treating bone defects. Moreover, CBMA has been shown to be comparable to the gold standard of iliac crest bone graft (ICBG), or autograft, with regard to being osteogenic and osteoinductive. ICBG is not considered an advanced therapy medicinal product (ATMP), but CBMA may become regulated as an ATMP. The European Medicines Agency Committee for Advanced Therapies (EMA:CAT) has issued a reflection paper (20 June 2014) in which reversal of the 2013 ruling that CBMA is a non-ATMP has been proposed. We review bone marrow cell involvement in osteopoiesis and angiogenesis/vasculogenesis to examine EMA:CAT 2013 decision to use CBMA for treatment of osteonecrosis (e.g, of the femoral head) should be considered a non-ATMP. This paper is intended to provide discussion on the 20 June 2014 reflection paper by reviewing two non-hematopoietic essential functions of bone marrow cells. Additionally, we provide clinical and scientific rationale for treating osteonecrosis with CBMA.

  3. Non-hematopoietic essential functions of bone marrow cells: a review of scientific and clinical literature and rationale for treating bone defects

    Directory of Open Access Journals (Sweden)

    David B. Harrell

    2015-12-01

    Full Text Available Hematopoiesis as the only essential function of bone marrow cells has been challenged for several decades through basic science (in vitro and in vivo and clinical data. Such work has shed light on two other essential functions of bone marrow cells: osteopoiesis and angiogenesis/vasculogenesis. Clinical utility of autologous concentrated bone marrow aspirate (CBMA has demonstrated both safety and efficacy in treating bone defects. Moreover, CBMA has been shown to be comparable to the gold standard of iliac crest bone graft (ICBG, or autograft, with regard to being osteogenic and osteoinductive. ICBG is not considered an advanced therapy medicinal product (ATMP, but CBMA may become regulated as an ATMP. The European Medicines Agency Committee for Advanced Therapies (EMA:CAT has issued a reflection paper (20 June 2014 in which reversal of the 2013 ruling that CBMA is a non-ATMP has been proposed. We review bone marrow cell involvement in osteopoiesis and angiogenesis/vasculogenesis to examine EMA:CAT 2013 decision to use CBMA for treatment of osteonecrosis (e.g, of the femoral head should be considered a non-ATMP. This paper is intended to provide discussion on the 20 June 2014 reflection paper by reviewing two non-hematopoietic essential functions of bone marrow cells. Additionally, we provide clinical and scientific rationale for treating osteonecrosis with CBMA.

  4. Left-handedness and health

    Directory of Open Access Journals (Sweden)

    Milenković Sanja

    2010-01-01

    Full Text Available Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome, developmental disorders (autism, dislexia and sttutering and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about 'anomalous' cerebral domination, as a consequence of hormonal disbalance. .

  5. Left ventricular wall stress compendium.

    Science.gov (United States)

    Zhong, L; Ghista, D N; Tan, R S

    2012-01-01

    Left ventricular (LV) wall stress has intrigued scientists and cardiologists since the time of Lame and Laplace in 1800s. The left ventricle is an intriguing organ structure, whose intrinsic design enables it to fill and contract. The development of wall stress is intriguing to cardiologists and biomedical engineers. The role of left ventricle wall stress in cardiac perfusion and pumping as well as in cardiac pathophysiology is a relatively unexplored phenomenon. But even for us to assess this role, we first need accurate determination of in vivo wall stress. However, at this point, 150 years after Lame estimated left ventricle wall stress using the elasticity theory, we are still in the exploratory stage of (i) developing left ventricle models that properly represent left ventricle anatomy and physiology and (ii) obtaining data on left ventricle dynamics. In this paper, we are responding to the need for a comprehensive survey of left ventricle wall stress models, their mechanics, stress computation and results. We have provided herein a compendium of major type of wall stress models: thin-wall models based on the Laplace law, thick-wall shell models, elasticity theory model, thick-wall large deformation models and finite element models. We have compared the mean stress values of these models as well as the variation of stress across the wall. All of the thin-wall and thick-wall shell models are based on idealised ellipsoidal and spherical geometries. However, the elasticity model's shape can vary through the cycle, to simulate the more ellipsoidal shape of the left ventricle in the systolic phase. The finite element models have more representative geometries, but are generally based on animal data, which limits their medical relevance. This paper can enable readers to obtain a comprehensive perspective of left ventricle wall stress models, of how to employ them to determine wall stresses, and be cognizant of the assumptions involved in the use of specific models.

  6. From bone biology to bone analysis.

    NARCIS (Netherlands)

    Schoenau, E.; Saggese, G.; Peter, F.; Baroncelli, G.I.; Shaw, N.J.; Crabtree, N.J.; Zadik, Z.; Neu, C.M.; Noordam, C.; Radetti, G.; Hochberg, Z.

    2004-01-01

    Bone development is one of the key processes characterizing childhood and adolescence. Understanding this process is not only important for physicians treating pediatric bone disorders, but also for clinicians and researchers dealing with postmenopausal and senile osteoporosis. Bone densitometry has

  7. Efficacy comparison of Accell Evo3 and Grafton demineralized bone matrix putties against autologous bone in a rat posterolateral spine fusion model.

    Science.gov (United States)

    Brecevich, Antonio T; Kiely, Paul D; Yoon, B Victor; Nguyen, Joseph T; Cammisa, Frank P; Abjornson, Celeste

    2017-06-01

    Spinal fusion procedures are intended to stabilize the spinal column for a multitude of disorders including abnormal curvature, traumatic instability, degenerative instability, and damage from infections or tumors. As an aid in the bone healing response, bone graft materials are used to bridge joints for arthrodesis and promote unions in pseudoarthrosis. Currently, the gold standard for stabilizing fusion masses in spinal procedures involves using the osteogenic, osteoinductive, and osteoconductive properties of autologous iliac crest corticocancellous bone. However, considerable morbidity is associated with harvesting the autologous graft. Donor site complications including infection, large hematomas, and pain have been reported at rates as high as 50% (Boden and Jeffrey, 1995). Biologically, the rate of bone repair dictates the rate at which the fusion mass will unite under autologous graft conditions. The purpose of this study is to compare the quality and rate of fusion between Accell Evo3 and Grafton demineralized bone matrix (DBM), with the gold standard iliac crest bone graft (ICBG) as the control, in athymic rat posterolateral fusion. This study was a randomized, controlled study in a laboratory setting at the Hospital for Special Surgery in New York City. Blinded observations were made, which created an assessment of outcomes for successful fusions between each method. Forty-eight (48) athymic rats were used in this study and underwent posterolateral lumbar fusion. They were assessed at either 3 weeks or 9 weeks to see the rate and efficacy of fusion. Outcome measures will be the efficacy of the different bone grafts and their success rates of fusion in the rats. A comparison of the quality and rate of fusion between Accell Evo3® (DBM A) and Grafton (DBM B), with the gold standard iliac crest bone graft (ICBG) as the control, was performed using the established posterolateral intertransverse process on an athymic rat model. Materials were evaluated for

  8. Bone mineral content and bone metabolism in young adults with severe periodontitis

    DEFF Research Database (Denmark)

    Wowern von, N.; Westergaard, J.; Kollerup, G.

    2001-01-01

    Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis......Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis...

  9. Hyperparathyroidism and bone lesions. A case report

    International Nuclear Information System (INIS)

    Garrido Modesto, M.; Costa, P.A.; Sapienza, M.T.; Watanabe, T.; Hironaka, F.; Buchpigel, C.A.

    1997-01-01

    Full text: Primary hyperparathyroidism can course with bone lesions known as fibrocystic osteitis in 25% to 60% of the cases and manifest itself by fractures, bone pain, deformations and inflammatory reaction. A 17 years old patient was listened with report of trauma in the left wrist, lumbar and in the right knee pain, with inflammatory signals and thinning 15 kg in 8 months. After x-ray of the left wrist and hand, bone rarefaction and insufflated lesion in the left chiro-dactyl third proximal phalanx were observed. The laboratory examinations have demonstrated hyper calcemia (13mg/dl), hypo phosphatemia (1,3mg/dl) with alkaline phosphatase (1086UI/I) e PTH (1050ng/ml). X-ray of the cranium cap, hip and coxofemoral articulations, knees and ankle was realized and observed disseminated lithic lesions. The bone scintilography with Technetium-99m MDP revealed hypo and hyper uptaked regions in several segments of the appendicular axial skeleton. Because of primary hyperparathyroidism suspicion, parathyroid scintilography with Technetium-99m MIBI in two phases was realized. 30 min after the injection of the radiopharmaceutical whole body images were realized which demonstrated hyper absorption in the areas previously hypo to the bone scintilography. 3 hours after injection the uptake was maintained in projection of the left inferior parathyroid, with posterior adenoma resection. The patient presented a significant reduction of the bone pain and normalization of the serum calcium levels. Nuclear medicine had an important role in the investigation of parathyroid diseases and showed to be useful in the evaluation of the disseminated bone compromising, which can come along with this pathology, avoiding the realization of repeated radiological studies

  10. Facts about Broken Bones

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Broken Bones KidsHealth / For Kids / Broken Bones What's in this ... sticking through the skin . What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  11. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... the cut, then pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  12. Autologous Bone Grafting and Revision Plating in a Case of Persistent High Tibial Osteotomy Non-Union.

    Science.gov (United States)

    Ming, Tan Shi; Koon, Wong Merng

    2016-01-01

    Uni-compartmental knee arthritis may be treated with several surgical options including uni-compartmental knee arthroplasty, total knee arthroplasty and high tibial osteotomy. Non-union is a well-established and common complication that may arise from the latter option and few reports have shown successful treatment of persistent non-union of high tibial osteotomy. We present a case of persistent non-union after high tibial osteotomy treated with autologous iliac crest bone grafting and revision plating. At 1 year post-operative interval, successful union was achieved after revision internal fixation. In addition, a good functional outcome was achieved. In this patient with persistent non-union following high tibial osteotomy, the aim of revision was to restore alignment and effect bone healing while preserving adequate tibial bone stock. Revision plating with autologous bone grafting is a good surgical strategy in the treatment ofpersistent non-union with hardware failure.

  13. Maxillary reconstruction with particulate bone graft and titanium mesh: a treatment option for large complex odontoma of the maxilla.

    Science.gov (United States)

    Utumi, Estevam Rubens; Cremonini, Caio Cesar; Pedron, Irineu Gregnanin; Zambon, Camila Eduarda; Cavalcanti, Marcelo Gusmão Paraíso; Ceccheti, Marcelo Minharro

    2011-07-01

    Odontomas are the most common type of odontogenic tumor and are generally asymptomatic. The purpose of this paper was to describe the case of a complex odontoma in a patient who had asymptomatic swelling in the central maxillary region, along with unerupted central and lateral incisors. In this case, surgical excision of the lesion was performed and an iliac bone graft was introduced into the defect area with a titanium mesh covering up the grafted harvesting bone. After 2 years of followup, no recurrence was identified. Patient followup is still in progress to evaluate bone graft resorption, and the patient awaits complete bone development. Oral rehabilitation with an osseointegrated titanium implant is expected in the future. An option of the large complex odontoma treatment is discussed.

  14. Treatment of Atypical Ulnar Fractures Associated with Long-Term Bisphosphonate Therapy for Osteoporosis: Autogenous Bone Graft with Internal Fixation

    Directory of Open Access Journals (Sweden)

    Yohei Shimada

    2017-01-01

    Full Text Available Long-term bisphosphonate use has been suggested to result in decreased bone remodelling and an increased risk of atypical fractures. Fractures of this nature commonly occur in the femur, and relatively few reports exist to show that they occur in other bones. Among eight previous reports of atypical ulnar fractures associated with bisphosphonate use, one report described nonunion in a patient who was treated with cast immobilization and another described ulna nonunion in one of three patients, all of whom were treated surgically with a locking plate. The remaining two surgical patients achieved bone union uneventfully following resection of the osteosclerotic lesion and iliac bone grafting before rigid fixation. We hypothesized that the discontinuation of bisphosphonate therapy, the use of teriparatide treatment, and low-intensity pulsed ultrasound (LIPUS might have been associated with fracture healing.

  15. Osteoclasts prefer aged bone

    DEFF Research Database (Denmark)

    Henriksen, K; Leeming, Diana Julie; Byrjalsen, I

    2007-01-01

    We investigated whether the age of the bones endogenously exerts control over the bone resorption ability of the osteoclasts, and found that osteoclasts preferentially develop and resorb bone on aged bone. These findings indicate that the bone matrix itself plays a role in targeted remodeling...... of aged bones....

  16. Bone marker gene expression in calvarial bones: different bone microenvironments.

    Science.gov (United States)

    Al-Amer, Osama

    2017-12-01

    In calvarial mice, mesenchymal stem cells (MSCs) differentiate into osteoprogenitor cells and then differentiate into osteoblasts that differentiate into osteocytes, which become embedded within the bone matrix. In this case, the cells participating in bone formation include MSCs, osteoprogenitor cells, osteoblasts and osteocytes. The calvariae of C57BL/KaLwRijHsD mice consist of the following five bones: two frontal bones, two parietal bones and one interparietal bone. This study aimed to analyse some bone marker genes and bone related genes to determine whether these calvarial bones have different bone microenvironments. C57BL/KaLwRijHsD calvariae were carefully excised from five male mice that were 4-6 weeks of age. Frontal, parietal, and interparietal bones were dissected to determine the bone microenvironment in calvariae. Haematoxylin and eosin staining was used to determine the morphology of different calvarial bones under microscopy. TaqMan was used to analyse the relative expression of Runx2, OC, OSX, RANK, RANKL, OPG, N-cadherin, E-cadherin, FGF2 and FGFR1 genes in different parts of the calvariae. Histological analysis demonstrated different bone marrow (BM) areas between the different parts of the calvariae. The data show that parietal bones have the smallest BM area compared to frontal and interparietal bones. TaqMan data show a significant increase in the expression level of Runx2, OC, OSX, RANKL, OPG, FGF2 and FGFR1 genes in the parietal bones compared with the frontal and interparietal bones of calvariae. This study provides evidence that different calvarial bones, frontal, parietal and interparietal, contain different bone microenvironments.

  17. Trabecular bone histomorphometry in humans with Type 1 Diabetes Mellitus.

    Science.gov (United States)

    Armas, Laura A G; Akhter, Mohammed P; Drincic, Andjela; Recker, Robert R

    2012-01-01

    Patients with Type 1 Diabetes Mellitus (DM) have markedly increased risk of fracture, but little is known about abnormalities in bone microarchitecture or remodeling properties that might give insight into the pathogenesis of skeletal fragility in these patients. We report here a case-control study comparing bone histomorphometric and micro-CT results from iliac biopsies in 18 otherwise healthy subjects with Type 1 Diabetes Mellitus with those from healthy age- and sex-matched non-diabetic control subjects. Five of the diabetics had histories of low-trauma fracture. Transilial bone biopsies were obtained after tetracycline labeling. The biopsy specimens were fixed, embedded, and scanned using a desktop μCT at 16 μm resolution. They were then sectioned and quantitative histomorphometry was performed as previously described by Recker et al. [1]. Two sections, >250 μm apart, were read from the central part of each biopsy. Overall there were no significant differences between diabetics and controls in histomorphometric or micro-CT measurements. However, fracturing diabetics had structural and dynamic trends different from nonfracturing diabetics by both methods of analysis. In conclusion, Type 1 Diabetes Mellitus does not result in abnormalities in bone histomorphometric or micro-CT variables in the absence of manifest complications from the diabetes. However, diabetics suffering fractures may have defects in their skeletal microarchitecture that may underlie the presence of excess skeletal fragility. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Sclerostin antibody treatment increases bone formation, bone mass, and bone strength in a rat model of postmenopausal osteoporosis.

    Science.gov (United States)

    Li, Xiaodong; Ominsky, Michael S; Warmington, Kelly S; Morony, Sean; Gong, Jianhua; Cao, Jin; Gao, Yongming; Shalhoub, Victoria; Tipton, Barbara; Haldankar, Raj; Chen, Qing; Winters, Aaron; Boone, Tom; Geng, Zhaopo; Niu, Qing-Tian; Ke, Hua Zhu; Kostenuik, Paul J; Simonet, W Scott; Lacey, David L; Paszty, Chris

    2009-04-01

    The development of bone-rebuilding anabolic agents for potential use in the treatment of bone loss conditions, such as osteoporosis, has been a long-standing goal. Genetic studies in humans and mice have shown that the secreted protein sclerostin is a key negative regulator of bone formation, although the magnitude and extent of sclerostin's role in the control of bone formation in the aging skeleton is still unclear. To study this unexplored area of sclerostin biology and to assess the pharmacologic effects of sclerostin inhibition, we used a cell culture model of bone formation to identify a sclerostin neutralizing monoclonal antibody (Scl-AbII) for testing in an aged ovariectomized rat model of postmenopausal osteoporosis. Six-month-old female rats were ovariectomized and left untreated for 1 yr to allow for significant estrogen deficiency-induced bone loss, at which point Scl-AbII was administered for 5 wk. Scl-AbII treatment in these animals had robust anabolic effects, with marked increases in bone formation on trabecular, periosteal, endocortical, and intracortical surfaces. This not only resulted in complete reversal, at several skeletal sites, of the 1 yr of estrogen deficiency-induced bone loss, but also further increased bone mass and bone strength to levels greater than those found in non-ovariectomized control rats. Taken together, these preclinical results establish sclerostin's role as a pivotal negative regulator of bone formation in the aging skeleton and, furthermore, suggest that antibody-mediated inhibition of sclerostin represents a promising new therapeutic approach for the anabolic treatment of bone-related disorders, such as postmenopausal osteoporosis.

  19. Estimating the hemodynamic influence of variable main body-to-iliac limb length ratios in aortic endografts.

    Science.gov (United States)

    Georgakarakos, Efstratios; Xenakis, Antonios; Georgiadis, George S

    2018-02-01

    We conducted a computational study to assess the hemodynamic impact of variant main body-to-iliac limb length (L1/L2) ratios on certain hemodynamic parameters acting on the endograft (EG) either on the normal bifurcated (Bif) or the cross-limb (Cx) fashion. A customary bifurcated 3D model was computationally created and meshed using the commercially available ANSYS ICEM (Ansys Inc., Canonsburg, PA, USA) software. The total length of the EG, was kept constant, while the L1/L2 ratio ranged from 0.3 to 1.5 in the Bif and Cx reconstructed EG models. The compliance of the graft was modeled using a Fluid Structure Interaction method. Important hemodynamic parameters such as pressure drop along EG, wall shear stress (WSS) and helicity were calculated. The greatest pressure decrease across EG was calculated in the peak systolic phase. With increasing L1/L2 it was found that the Pressure Drop was increasing for the Cx configuration, while decreasing for the Bif. The greatest helicity (4.1 m/s2) was seen in peak systole of Cx with ratio of 1.5 whereas its greatest value (2 m/s2) was met in peak systole in the Bif with the shortest L1/L2 ratio (0.3). Similarly, the maximum WSS value was highest (2.74Pa) in the peak systole for the 1.5 L1/L2 of the Cx configuration, while the maximum WSS value equaled 2 Pa for all length ratios of the Bif modification (with the WSS found for L1/L2=0.3 being marginally higher). There was greater discrepancy in the WSS values for all L1/L2 ratios of the Cx bifurcation compared to Bif. Different L1/L2 rations are shown to have an impact on the pressure distribution along the entire EG while the length ratio predisposing to highest helicity or WSS values is also determined by the iliac limbs pattern of the EG. Since current custom-made EG solutions can reproduce variability in main-body/iliac limbs length ratios, further computational as well as clinical research is warranted to delineate and predict the hemodynamic and clinical effect of variable

  20. Effects of Concurrent Chemotherapy and Postoperative Prophylactic Paraaortic Irradiation for Cervical Cancer with Common Iliac Node Involvement

    Energy Technology Data Exchange (ETDEWEB)

    Han, Tae Jin; Wu, Hong Gyun; Kim, Hak Jae; Ha, Sung Whan; Kang, Soon Beom; Song, Yong Sang; Park, Hoh Hyun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2010-11-15

    To retrospectively assess the advantages and side effects of prophylactic Paraaortic irradiation in cervical cancer patients with common iliac nodal involvement, the results for survival, patterns of failure, and treatment-related toxicity. From May 1985 to October 2004, 909 patients with cervical carcinoma received postoperative radiotherapy at the Seoul National University Hospital. Among them, 54 patients with positive common iliac nodes on pathology and negative Paraaortic node were included in the study. In addition, 44 patients received standard pelvic irradiation delivered 50.4 Gy per 28 fractions (standard irradiation group), and chemotherapy was combined in 16 of them. The other 10 patients received pelvic irradiation at a dose of 50.4 Gy per 28 fractions in addition to Paraaortic irradiation at 45 Gy per 25 fractions (extended irradiation group). In addition, all of them received chemotherapy in combination with radiation. Follow-up times for pelvic and Paraaortic irradiation ranged from 6 to 201 months (median follow-up time, 58 months) and 21 to 58 months (median follow-up time, 47 months), respectively. The 4-year overall survival, disease free survival, and distant metastasis free survival in the standard irradiation group and extended irradiation group were 67.2% vs. 90.0% (p=0.291), 59.0% vs. 70.0% (p=0.568) and 67.5% vs. 90.0% (p=0.196), respectively. The most common site of first failure for the standard irradiation group was the paraaortic lymph node, while no paraaortic failure was observed in the extended irradiation group. Relatively, hematologic toxicity grade 3 or greater was common in the extended irradiation group (2/10 extended vs. 2/44 standard), while gastrointestinal toxicity of grade 3 or greater was lower (2/10 extended vs. 6/44 standard), and urologic toxicity of grade 3 or greater was observed in the standard irradiation group only (0/10 vs. 3/44). Concurrent chemotherapy and prophylactic Paraaortic irradiation in patients with

  1. Daily Parathyroid Hormone 1-34 Replacement Therapy for Hypoparathyroidism Induces Marked Changes in Bone Turnover and Structure

    Science.gov (United States)

    Gafni, Rachel I.; Brahim, Jaime S.; Andreopoulou, Panagiota; Bhattacharyya, Nisan; Kelly, Marilyn H.; Brillante, Beth A.; Reynolds, James C.; Zhou, Hua; Dempster, David W.; Collins, Michael T.

    2012-01-01

    Parathyroid hormone (PTH) has variable actions on bone. Chronically increased PTH is catabolic leading to osteoporosis, yet intermittent administration is anabolic and increases bone mass. PTH deficiency is associated with decreased bone remodeling and increased bone mass. However, the effects of PTH replacement therapy on bone in hypoparathyroidism are not well known. We discontinued calcitriol therapy and treated five hypoparathyroid subjects (2 adults and 3 adolescents) with synthetic human PTH 1-34 (hPTH 1-34), injected 2-3 times daily for 18 months, with doses individualized to maintain serum calcium at 1.9-2.25 mmol/L. Biochemical markers and bone density (BMD) were assessed every 6 months; iliac-crest biopsies were performed before and after 1 year of treatment. hPTH 1-34 therapy significantly increased bone markers to supranormal levels. Histomorphometry revealed that treatment dramatically increased cancellous bone volume and trabecular number and decreased trabecular separation. Changes in trabecular width were variable, suggesting that the increase in trabecular number was due to the observed intratrabecular tunneling. Cortical width remained unchanged, however, hPTH 1-34 treatment increased cortical porosity. Cancellous bone remodeling was also stimulated, inducing significant changes in osteoid, mineralizing surface, and bone formation rate. Similar changes were seen in endocortical and intracortical remodeling. BMD Z-scores were unchanged at the spine and femoral neck. Total hip Z-scores increased, however, total body BMD Z-scores decreased during the first 6 months of treatment and then stabilized, remaining significantly decreased compared to baseline. Radial Z-scores also decreased with treatment; this was most pronounced in the growing adolescent. Daily hPTH 1-34 therapy for hypoparathyroidism stimulated bone turnover, increased bone volume, and altered bone structure in the iliac crest. These findings suggest that treatment with hPTH 1-34 in

  2. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

    The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter

    2013-01-01

    The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently...

  4. Dabigatran for left ventricular thrombus

    Directory of Open Access Journals (Sweden)

    Satishkumar Kolekar

    2015-09-01

    Dabigatran is a reversible direct thrombin inhibitor and currently approved for the prevention of thromboembolic episodes in non-valvar atrial fibrillation. This case demonstrates possible thrombolytic properties of dabigatran in resolution of left ventricular thrombus.

  5. Low-frequency vibration treatment of bone marrow stromal cells induces bone repair in vivo.

    Science.gov (United States)

    He, Shengwei; Zhao, Wenzhi; Zhang, Lu; Mi, Lidong; Du, Guangyu; Sun, Chuanxiu; Sun, Xuegang

    2017-01-01

    To study the effect of low-frequency vibration on bone marrow stromal cell differentiation and potential bone repair in vivo . Forty New Zealand rabbits were randomly divided into five groups with eight rabbits in each group. For each group, bone defects were generated in the left humerus of four rabbits, and in the right humerus of the other four rabbits. To test differentiation, bones were isolated and demineralized, supplemented with bone marrow stromal cells, and implanted into humerus bone defects. Varying frequencies of vibration (0, 12.5, 25, 50, and 100 Hz) were applied to each group for 30 min each day for four weeks. When the bone defects integrated, they were then removed for histological examination. mRNA transcript levels of runt-related transcription factor 2, osteoprotegerin, receptor activator of nuclear factor κ-B ligan, and pre-collagen type 1 α were measured. Humeri implanted with bone marrow stromal cells displayed elevated callus levels and wider, more prevalent, and denser trabeculae following treatment at 25 and 50 Hz. The mRNA levels of runt-related transcription factor 2, osteoprotegerin, receptor activator of nuclear factor κ-B ligand, and pre-collagen type 1 α were also markedly higher following 25 and 50 Hz treatment. Low frequency (25-50 Hz) vibration in vivo can promote bone marrow stromal cell differentiation and repair bone injury.

  6. Low-frequency vibration treatment of bone marrow stromal cells induces bone repair in vivo

    Directory of Open Access Journals (Sweden)

    Shengwei He

    2017-01-01

    Full Text Available Objective(s:To study the effect of low-frequency vibration on bone marrow stromal cell differentiation and potential bone repair in vivo. Materials and Methods:Forty New Zealand rabbits were randomly divided into five groups with eight rabbits in each group. For each group, bone defects were generated in the left humerus of four rabbits, and in the right humerus of the other four rabbits. To test differentiation, bones were isolated and demineralized, supplemented with bone marrow stromal cells, and implanted into humerus bone defects. Varying frequencies of vibration (0, 12.5, 25, 50, and 100 Hz were applied to each group for 30 min each day for four weeks. When the bone defects integrated, they were then remo