WorldWideScience

Sample records for ventriculo-sagittal sinus shunt

  1. Communicating hydrocephalus due to cerebral venous sinus thrombosis treated with ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Rahul T Chakor

    2012-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVT is a rare cerebrovascular disease with variable presentation. CVT rarely causes hydrocephalus. Communicating hydrocephalus due to CVT is extremely rare. We describe a patient of CVT presenting with chronic headache and communicating hydrocephalus. The patient was successfully treated with ventriculoperitoneal (VP shunt. A 40 year old man presented with moderate to severe headache since six months and progressive visual loss since two months. Head Computed tomogram showed mild hydrocephalus without obstruction. Lumbar puncture (LP demonstrated elevated pressure but was otherwise normal. Magnetic resonance venogram showed extensive CVT. Repeated CSF drainage and thecoperitoneal shunt did not relieve the severe headache hence a VP shunt was placed. Post shunt headache subsided with resolution of hydrocephalus. CVT can present as communicating hydrocephalus. Gradual reduction of intra-ventricular pressure by repeated LPs followed by VP shunt can safely treat hydrocephalus due to CVT.

  2. Sinusitis

    Science.gov (United States)

    Sinusitis means your sinuses are inflamed. The cause can be an infection or another problem. Your sinuses ... and cause pain. There are several types of sinusitis, including Acute, which lasts up to 4 weeks ...

  3. Sinusitis

    OpenAIRE

    Gómez, Luz Eugenia; Fundación Valle de Lili

    2000-01-01

    ¿Qué son los senos para nasales?/ ¿Qué es la sinusitis?/Tipos de sinusitis/Causas de sinusitis/Factores que predisponen/La sinusitis y su relación con otras enfermedades del tracto respiratorio/Signos y síntomas/Complicaciones de la sinusitis.

  4. Sinusitis

    National Research Council Canada - National Science Library

    Morcom, Samuel; Phillips, Nicholas; Pastuszek, Andrew; Timperley, Daniel

    2016-01-01

    Background: Acute and chronic sinusitis are common primary care presentations. They are caused by mucosal inflammation, which inhibits mucociliary function of the nose and paranasal sinuses. Objective...

  5. Sinusitis

    Science.gov (United States)

    ... 4 weeks or less. It is caused by bacteria growing in the sinuses. Chronic sinusitis is when the swelling of the sinuses is present for longer than 3 months. It may be caused by bacteria or a fungus. The following may increase the ...

  6. Surgical technique of retrograde ventricle-sinus shunt is an option for the treatment of hydrocephalus in infants after surgical repair of myelomeningocele

    Directory of Open Access Journals (Sweden)

    Matheus Fernandes de Oliveira

    2015-12-01

    Full Text Available ABSTRACT Introduction Treatment of hydrocephalus is accomplished primarily through a ventricular-peritoneal shunt (VPS. This study aims to describe the application of retrograde ventricle-sinus shunt (RVSS in patients with hydrocephalus after surgical treatment of myelomeningocele. Method A prospective, randomized and controlled pilot study. We consecutively enrolled 9 patients with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012. These patients underwent elective RVSS or VPS. Five underwent RVSS and 4 underwent VPS. Patients were followed for one year with quarterly evaluations and application of transcranial Doppler. Results RVSS group showed outcomes similar to those of VPS group. Doppler revealed significant improvement when comparing preoperative to postoperative period. RVSS group had significantly higher cephalic perimeter than VPS group. Neuropsychomotor development, complications and subjective outcomes did not differ between groups. Conclusion RVSS shunt is viable; it is an alternative option for the treatment of hydrocephalus.

  7. Intracranial hypertension caused by a depressed skull fracture resulting in superior sagittal sinus thrombosis in a pediatric patient: treatment with ventriculoperitoneal shunt insertion.

    Science.gov (United States)

    Forbes, Jonathan A; Reig, Adam S; Tomycz, Luke D; Tulipan, Noel

    2010-07-01

    Intracranial hypertension resulting from compression of the superior sagittal sinus (SSS) by an overlying depressed calvarial fracture is a rare condition. Primary surgical treatment for the symptomatic patient in this setting traditionally involves elevation of the fracture, which often carries significant associated morbidity. The authors report a case involving a 6-year-old boy who suffered a closed, depressed, parietooccipital fracture as the result of an unhelmeted all-terrain vehicle accident. This fracture caused compression and subsequent thrombosis of the SSS, which resulted in CSF malabsorption and progressive intracranial hypertension. Initially headache free following the injury, he had developed severe and unremitting headaches by postinjury Day 7. A CT angiography study of the head obtained at this time exhibited thrombosis of the SSS underlying the depressed calvarial fracture. Subsequent lumbar puncture demonstrated markedly elevated intrathecal pressures. Large volumes of CSF were removed, with temporary improvement in symptoms. After medical management with anticoagulation failed, the decision was made to proceed with image-guided ventriculoperitoneal shunt insertion. The patient's headaches resolved immediately following the procedure, and anticoagulation therapy was reinstituted. Follow-up images obtained 4 months after the injury demonstrated evidence of resolution of the depressed fracture, with recanalization of the SSS. The anticoagulation therapy was then discontinued. To the authors' knowledge, this report is the first description of ventriculoperitoneal shunt insertion as the primary treatment of this infrequent condition. This report demonstrates that select patients with this presentation can undergo CSF diversion in lieu of elevation of the depressed skull fracture-a surgical procedure shown to be associated with increased risks when the depressed fracture overlies the posterior SSS. The literature on this topic is reviewed and

  8. Sinuses / Sinusitis / Rhinosinusitis

    Science.gov (United States)

    ... Treatments ▸ Conditions Dictionary ▸ Sinuses|Sinusitis|Rhinosinusitis Share | Sinuses | Sinusitis | Rhinosinusitis « Back to A to Z Listing The ... into the nose. Rhinosinusitis, commonly referred to as sinusitis, occurs when the sinus openings become blocked or ...

  9. Sinus Anatomy

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  10. Adult Sinusitis

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  11. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae.

    Science.gov (United States)

    Kobkitsuksakul, Chai; Jiarakongmun, Pakorn; Chanthanaphak, Ekachat; Pongpech, Sirintara

    2016-01-01

    The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages. We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded. Of those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction. Arteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow.

  12. Ventriculoperitoneal shunt - discharge

    Science.gov (United States)

    ... VP shunt - discharge; Shunt revision - discharge; Hydrocephalus shunt placement - discharge ... The major problems to watch for are an infected shunt and a blocked shunt. Call your child's provider if your child ...

  13. Sinus Headaches

    Science.gov (United States)

    ... Evaluation and management of "sinus headache" in the otolaryngology practice. Otolaryngology Clinics of North America. 2014;47:269. Sinusitis. ... et al. Why the confusion about sinus headache? Otolaryngology Clinics of North America. 2014;47:169. Sinus ...

  14. Pediatric Sinusitis

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  15. Endoscopic Sinus Surgery

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  16. Expectations of Sinus Surgery

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  17. Complications of Sinusitis

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  18. Complications of Sinus Surgery

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  19. Sinusitis Q and A

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  20. [Fungal sinusitis].

    Science.gov (United States)

    Riechelmann, H

    2011-06-01

    The incidence of fungal sinusitis is subjected to significant geographical variation. Basically, invasive and non-invasive fungal sinusitis is distinguished. Invasive fungal sinusitis is observed mainly in immunocompromised hosts. The diagnopsis is based on positive fungus detection combined with characteristic clinical features. The treatment of invasive fungal sinusitis is based on surgical debridement and systemic antifungal therapy. Non-invasive fungal sinusitis is either treated with surgery alone or surgery combined with systemic steroid therapy. The majority of studies showed no benefit of postoperative antimycotic medical treatment in patients with non-invasive fungal sinusitis. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Sinus x-ray

    Science.gov (United States)

    ... an infection and inflammation of the sinuses called sinusitis . A sinus x-ray is ordered when you have any of the following: Symptoms of sinusitis Other sinus disorders, such as a deviated septum ( ...

  2. Acute Sinusitis

    Science.gov (United States)

    ... Acute sinusitis is mostly caused by the common cold. Unless a bacterial infection develops, most cases resolve within a week to 10 days. In ... sinusitis is most often caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops. Risk factors You may ...

  3. Experimental model of intracranial arteriovenous shunting in the acute stage.

    Science.gov (United States)

    Numazawa, Shinichi; Sasaki, Tatsuya; Sato, Sonomi; Watanabe, Yoichi; Watanabe, Zenichiro; Kodama, Namio

    2005-06-01

    A model of intracranial arteriovenous (AV) shunting must incorporate local hypoperfusion and simulate the hemodynamics of arteriovenous malformations. In this study, the hemodynamics of an intracranial AV shunt model in the acute stage were clarified. End-to-side anastomoses with a femoral vein graft were performed between a cortical branch of the middle cerebral artery (MCA) and the superior sagittal sinus in anesthetized dogs. Local cerebral blood flow (l-CBF) was measured by laser Doppler blood flowmetry. l-CBF decreased suddenly by 34.2% when the shunt was opened in the ipsilateral MCA territory. Upon re-occlusion, l-CBF immediately equaled or exceeded the pre-opening value and returned to the pre-opening value within the next 15 minutes. Opening the shunt produced little change in l-CBF in the territory of the ipsilateral or contralateral anterior cerebral artery. The decrease in l-CBF was correlated with shunt volume only in the MCA territory. l-CBF manifested a PaCO(2)-dependent increase before shunt opening, but CO(2) reactivity was impaired after opening the shunt only in the MCA territory. This dog model features local hypoperfusion due to intracranial AV shunting and disturbance of CO(2) reactivity in the acute stage. The hemodynamics of this model will be confirmed in the chronic stage.

  4. Sinus Headaches

    Science.gov (United States)

    ... choose any aerobic exercise you enjoy, including walking, swimming and cycling. Warm up slowly, however, because sudden, ... dosages for you. References Patel ZM, et al. Evaluation and management of "sinus headache" in the otolaryngology ...

  5. Chronic Sinusitis

    Science.gov (United States)

    ... weeks, despite treatment attempts. Also known as chronic rhinosinusitis, this condition interferes with drainage and causes mucus ... Regular exposure to pollutants such as cigarette smoke Complications Chronic sinusitis complications include: Meningitis. This infection causes ...

  6. Enhanced Piezoelectric Shunt Design

    Directory of Open Access Journals (Sweden)

    Chul H. Park

    2003-01-01

    Full Text Available Piezoceramic material connected to an electronic shunt branch circuit has formed a successful vibration reduction device. One drawback of the conventional electronic shunt circuit is the large inductance required when suppressing low frequency vibration modes. Also, the large internal resistance associated with this large inductance exceeds the optimal design resistance needed for low frequency vibration suppression. To solve this problem, a modified and enhanced piezoelectric shunt circuit is designed and analyzed by using mechanical-electrical analogies to present the physical interpretation. The enhanced shunt circuit developed in this paper is proved to significantly reduce the targeted vibration mode of a cantilever beam, theoretically and experimentally.

  7. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the sinuses ... of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known ...

  8. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are obstructed and the best imaging modality for sinusitis. Tell your doctor if there’s a possibility you ... the sinuses is primarily used to: help diagnose sinusitis . evaluate sinuses that are filled with fluid or ...

  9. Sinus MRI scan

    Science.gov (United States)

    ... tissues surrounding the eye (orbital cellulitis) Nasal polyps Sinusitis -- acute Sinusitis -- chronic Talk to your provider if you have ... therefore is not typically used for suspected acute sinusitis. Alternative Names MRI of the sinuses; Magnetic resonance ...

  10. Idiopathic intracranial hypertension and transverse sinus stenoses

    DEFF Research Database (Denmark)

    Skyrman, Simon; Fytagoridis, Anders; Andresen, Morten

    2013-01-01

    An 18-year-old woman was diagnosed with idiopathic intracranial hypertension (IIH) and bilateral transverse sinus stenoses (TSS), after presenting with papilledema and decreased visual acuity. Lumbar puncture revealed an opening pressure of >60 cm H2O. MRI showed bilateral TSS believed to be asso...... was inserted since the patient had improved with CSF diversion. MRI verified reopening of the venous sinuses after shunt placement, and the patient remains asymptomatic with no signs of relapse after 3 years of follow-up....

  11. Endoscopic Sinus Surgery for Chronic Sinusitis

    OpenAIRE

    篠, 昭男; 吉原, 俊雄; Akio, SHINO; Toshio, YOSHIHARA

    2004-01-01

    Endoscopic sinus surgery (ESS) has became basic surgical treatment for chronic sinusitis instead of the Caldwell-Luc procedure. This technique is aimed at improvement of ventilation and excretion with endoscopic approach between nasal cavity and each sinus. The mucosa preservation of sinus is recognized to important as the surgery for inflammatory disease. The ostiomeatal complex (OMC) plays a significant role in the pathogenesis of sinusitis. Obstruction here predisposes to chronic sinusitis...

  12. Ventriculobiliary Shunts, Another Option.

    Science.gov (United States)

    Rivero-Garvía, Mónica; Pancucci, Giovanni; Morcillo, Juan; Millán, Ana; Márquez-Rivas, Javier

    2015-01-01

    The basic management of hydrocephalus includes shunts to the peritoneum and atrium. However, there are particularly complex patients in whom it is necessary to look for atypical places for implanting the distal catheter. Since 2000, 1,325 shunts have been implanted in pediatric patients. Only 3 patients required a ventriculobiliary shunt. We report 3 cases: a 7-year-old boy with a surgically treated complex heart disease, a 16-month-old girl with hydrocephalus secondary to a brain tumor and multiple bacteremias secondary to an infection of the central venous reservoir, and a 4-year-old girl with nonreabsorptive hydrocephalus caused by intraventricular bleeding due to premature birth, necrotizing enterocolitis and shunt infections with abdominal pseudocysts, which caused multiple abdominal septations and, finally, a nonreabsorptive peritoneum. At present, cases 1 [45 months after ventriculobiliary shunt (VBS)] and 3 (27 months after VBS) are symptom free, while case 2 (14 months after VBS) died of infectious respiratory complications. The gold standard for the treatment of nonreabsorptive hydrocephalus is a ventriculoperitoneal shunt, the second option is a ventriculoatrial shunt, and the third option is uncertain. In our short experience, a ventriculo-gallbladder shunt is a good option when there is no abdominal hypertension. © 2015 S. Karger AG, Basel.

  13. Pathophysiology of shunt dysfunction in shunt treated hydrocephalus

    DEFF Research Database (Denmark)

    Blegvad, C.; Skjolding, A D; Broholm, H

    2013-01-01

    We hypothesized that shunt dysfunction in the ventricular catheter and the shunt valve is caused by different cellular responses. We also hypothesized that the cellular responses depend on different pathophysiological mechanisms.......We hypothesized that shunt dysfunction in the ventricular catheter and the shunt valve is caused by different cellular responses. We also hypothesized that the cellular responses depend on different pathophysiological mechanisms....

  14. Sinusitis: Overview

    Science.gov (United States)

    ... congestion. Your doctor may suggest a decongestant nasal spray to treat swelling. Do not use this for more than 3 days. It can worsen the swelling in your sinuses once you stop using the medicine.A process called nasal irrigation can provide relief. A saline solution through a ...

  15. Sinusitis (acute)

    Science.gov (United States)

    2008-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1−5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to August 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides, different doses [amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides], long-course regimens), antihistamines, cephalosporins or macrolides, decongestants (xylometazoline, phenylephrine, pseudoephedrine), doxycycline, saline nasal washes, steam inhalation, and topical corticosteroids (intra-nasal). PMID:19450327

  16. Rupture of sinus of valsalva aneurysm: Case report | Amoah | East ...

    African Journals Online (AJOL)

    Two-dimensional doppler echocardiography with colour flow mapping revealed a large aneurysm of the right sinus of Valsalva (4cm diameter) that abutted the right ventricular out-flow tract with distortion of the pulmonary valve. Colour flow revealed left to right shunting of blood from the aortic root into the right atrium. A year ...

  17. Chronic sinusitis (image)

    Science.gov (United States)

    ... and cartilage and lined with a mucous membrane. Sinusitis occurs when the membranes becomes inflamed and painful, ... a result of a blocked sinus opening. Chronic sinusitis is often caused by inflammation and blockage due ...

  18. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face ... paranasal sinus cavities. The paranasal sinuses are hollow, air-filled spaces located within the bones of the ...

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT of the sinuses is primarily used ...

  20. Plain Language Summary: Adult Sinusitis (Sinus Infection).

    Science.gov (United States)

    Caspersen, Leslie A; Walter, Lindsey M; Walsh, Sandra A; Rosenfeld, Richard M; Piccirillo, Jay F

    2015-08-01

    This plain language summary serves as an overview in explaining sinusitis (pronounced sign-you-side-tis). The purpose of this plain language summary is to provide patients with standard language explaining their condition in an easy-to-read format. This summary applies to those 18 years of age or older with sinusitis. The summary is featured as an FAQ (frequently asked question) format. The summary addresses how to manage and treat sinusitis symptoms. Adult sinusitis is often called a sinus infection. A healthcare provider may refer to a sinus infection as rhinosinusitis (pronounced rhi-no-sign-you-side-tis). This includes the nose as well as the sinuses in the name. A sinus infection is the swelling of the sinuses and nasal cavity.The summary is based on the published 2015 "Clinical Practice Guideline: Adult Sinusitis." The evidence-based guideline includes research to support more effective diagnosis and treatment of adult sinus infections. The guideline was developed as a quality improvement opportunity for managing sinus infections by creating clear recommendations to use in medical practice. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  1. Sinusitis (For Parents)

    Science.gov (United States)

    ... Special Needs Factsheet School Violence and the News Sinusitis KidsHealth > For Parents > Sinusitis Print A A A What's in this article? Causes Symptoms Prevention Treatment en español Sinusitis Sinuses are moist air spaces within the bones ...

  2. Allergic Fungal Sinusitis

    OpenAIRE

    Correll, Daniel P.; Luzi, Scott A.; Nelson, Brenda L.

    2014-01-01

    A 42 year old male presents with worsening pain and an increase in thick chronic drainage of the left sinus. Image studies show complete opacification of the left frontal sinus, left sphenoid sinus, and the left maxillary sinus. The patient was taken to the operating room and tissue for microscopic evaluation was obtained. The microscopic findings were classic for allergic fungal sinusitis: areas of alternating mucinous material and inflammatory cell debris and abundant Charcot–Leyden crystal...

  3. Assessment of FGPM shunt damping for vibration reduction of laminated composite beams

    Science.gov (United States)

    Lezgy-Nazargah, M.; Divandar, S. M.; Vidal, P.; Polit, O.

    2017-02-01

    This work addresses theoretical and finite element investigations of functionally graded piezoelectric materials (FGPMs) for shunted passive vibration damping of laminated composite beams. The properties of piezoelectric patches are assumed to vary through the thickness direction following the exponent or power law distribution in terms of the volume fractions of the constituent materials. By employing Hamilton's principle, the governing differential equations of motion are derived. The resulting system of equations of vibration is solved by employing an efficient three-nodded beam element which is based on a refined sinus piezoelectric model. The effects of effective electromechanical coupling coefficients (EEMCCs), different electric shunt circuits and different material compositions on the shunted damping performance are investigated. The optimal values of the electric components belonging to each shunt circuit are numerically determined.

  4. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Computed tomography (CT) of the sinuses uses special x-ray equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the ...

  5. Approaching chronic sinusitis.

    Science.gov (United States)

    Sarber, Kathleen M; Dion, Gregory Robert; Weitzel, Erik K; McMains, Kevin C

    2013-11-01

    Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder.

  6. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed ... nasal cavity by small openings. top of page What are some common uses of the procedure? CT ...

  7. [Maxillary sinus hypoplasia].

    Science.gov (United States)

    Plaza, G; Ferrando, J; Martel, J; Toledano, A; de los Santos, G

    2001-03-01

    Maxillary sinus hypoplasia is rare, with an estimated prevalence of 1-5%. Out of the CT scans performed in sinusal patients between March 1998 and June 1999, we report on 4 isolated maxillary sinus hypoplasia, 4 maxillary sinus hypoplasia associated to concha bullosa, and 10 isolated conchae bullosas. All cases were evaluated by nasosinusal endoscopy and CT scan. Size, location and uni/bilateral presentation of concha bullosa is correlated to maxillary sinus hypoplasia presence, specially with regards to uncinate process presence, medial or lateral retraction. The pathogenesis of maxillary sinus hypoplasia is reviewed, and its relation to concha bullosa, evaluating how this could explain some cases of the so called chronic maxillary sinus atelectasia, as an acquired and progressive variant of maxillary sinus hypoplasia in adults.

  8. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... a patient's paranasal sinus cavities. The paranasal sinuses are hollow, air-filled spaces located within the bones of the face and surrounding the nasal cavity , a system of air channels connecting the nose with the ...

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... determining if the sinuses are obstructed and the best imaging modality for sinusitis. Tell your doctor if ... over time. Follow-up examinations are sometimes the best way to see if treatment is working or ...

  10. Cavernous sinus thrombosis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001628.htm Cavernous sinus thrombosis To use the sharing features on this page, please enable JavaScript. Cavernous sinus thrombosis is a blood clot in an ...

  11. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the ... cavities. The paranasal sinuses are hollow, air-filled spaces located within the bones of the face and ...

  12. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... modality for sinusitis. CT of the sinuses is now widely available and is performed in a relatively ...

  13. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a ... top of page What are some common uses of the procedure? CT of the sinuses is primarily ...

  14. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the sinuses uses special x-ray equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of ...

  15. Allergic Fungal Sinusitis.

    Science.gov (United States)

    Correll, Daniel P; Luzi, Scott A; Nelson, Brenda L

    2015-12-01

    A 42 year old male presents with worsening pain and an increase in thick chronic drainage of the left sinus. Image studies show complete opacification of the left frontal sinus, left sphenoid sinus, and the left maxillary sinus. The patient was taken to the operating room and tissue for microscopic evaluation was obtained. The microscopic findings were classic for allergic fungal sinusitis: areas of alternating mucinous material and inflammatory cell debris and abundant Charcot-Leyden crystals. Cultures were performed and the patient began steroid therapy and desensitization therapy.

  16. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... Images/Videos About Us News Physician Resources Professions Site Index A-Z Transjugular Intrahepatic Portosystemic Shunt (TIPS) Transjugular Intrahepatic Portosystemic Shunt or TIPS is a procedure that uses imaging guidance to connect the portal vein to the hepatic vein in the liver. ...

  17. Subacute bacterial endocarditis and subsequent shunt nephritis from ventriculoatrial shunting 14 years after shunt implantation

    DEFF Research Database (Denmark)

    Burström, Gustav; Andresen, Morten; Bartek, Jiri Jr.

    2014-01-01

    of causing subacute bacterial endocarditis and subsequent shunt nephritis. The patient was successfully treated with antibiotics combined with ventriculoatrial shunt removal and endoscopic third ventriculocisternostomy (VCS). This case illustrates the nowadays rare, but potentially severe complication...... of subacute bacterial endocarditis and shunt nephritis. It also exemplifies the VCS as an alternative to implanting foreign shunt systems for CSF diversion....

  18. Dural arteriovenous fistula associated with neoplastic dural sinus thrombosis: two cases

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P. [Neuroradiology Department, Garcia de Orta Hospital (Portugal); Willinsky, R.; TerBrugge, K. [Toronto Western Hospital, ON (Canada). Div. of Neuroradiology

    2001-10-01

    Intracranial dural arteriovenous fistulae are direct arteriovenous shunts within the dura matter. We report two cases of arteriovenous fistulae upstream to a neoplastic dural sinus thrombosis. These cases add further support to the acquired etiology of dural arteriovenous fistulae and to the fact that venous hypertension is one of the most important precipitating factors. (orig.)

  19. Tuberculosis of paranasal sinuses

    OpenAIRE

    Sanehi, S.; Dravid, Chandrashekhar; Chaudhary, Neena; Venkatachalam, V. P.

    2008-01-01

    Nasal tuberculosis is very rare but much rarer is tuberculosis of paranasal sinuses. It involves especially the maxillary sinus and is usually unilateral. We report an unusual case of tuberculosis of frontal and maxillary sinus in a 68 years old male, who presented with a swelling above left medial canthus, with no other eye or nasal complaints. Clinical and radiological findings on our initial evaluation suggested that the patient had left frontal mucocoele with bilateral maxillary haziness....

  20. Mycetoma sans sinuses

    Directory of Open Access Journals (Sweden)

    Saha Sudipta

    2006-01-01

    Full Text Available Mycetoma is a chronic suppurative infection involving the skin, subcutaneous tissue and bone. The hallmark of mycetoma is tumefaction, draining sinuses and the presence of microcolonies called grains. Sinuses develop in all patients with mycetoma within a year of the appearance of the lesion. The following case is reported as no sinuses had developed despite the presence of the lesion for 9 years, posing a diagnostic dilemma.

  1. Pilonidal Sinus of the Penis

    Directory of Open Access Journals (Sweden)

    Hugh F. O'Kane

    2004-01-01

    Full Text Available A pilonidal sinus is a subcutaneous sinus containing hair. It is most commonly found in the natal cleft of hirsute men. Here we describe the unusual finding of a pilonidal sinus arising on the male foreskin.

  2. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... that would ordinarily pass through the liver to bypass the liver entirely, reducing high blood pressure in ... same physiological results as a surgical shunt or bypass, without the risks that accompany open surgery. TIPS ...

  3. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... What are the limitations of TIPS? What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS)? A transjugular intrahepatic ... code: Phone no: Thank you! Do you have a personal story about radiology? Share your patient story ...

  4. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... anti-inflammatory drugs (NSAIDs) or blood thinners several days prior to your procedure and instructed to not ... overnight at the hospital for one or more days. What is Transjugular Intrahepatic Portosystemic Shunt (TIPS)? What ...

  5. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... the liver to the heart). A stent placed inside this pathway keeps it open and allows some ... keeps the shunt open (TIPS) is contained entirely inside the diseased liver, and is removed with it ...

  6. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... is a procedure that uses imaging guidance to connect the portal vein to the hepatic vein in ... within the liver using x-ray guidance to connect two veins within the liver. The shunt is ...

  7. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... risks? What are the limitations of TIPS? What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS)? A transjugular intrahepatic ... top of page What are some common uses of the procedure? A TIPS is used to treat ...

  8. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... What are the limitations of TIPS? What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS)? A transjugular intrahepatic ... of page What are some common uses of the procedure? A TIPS is used to treat the ...

  9. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... complex and lengthy procedures requiring extended fluoroscopy use) death (rare) top of page What are the limitations ... Dose in X-Ray and CT Exams Contrast Materials Venography Images related to Transjugular Intrahepatic Portosystemic Shunt ( ...

  10. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... What are the limitations of TIPS? What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS)? A transjugular intrahepatic ... taking our brief survey: Survey Do you have a personal story about radiology? Share your patient story ...

  11. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... vs. risks? What are the limitations of TIPS? What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS)? A ... likely to require a TIPS. top of page What are some common uses of the procedure? A ...

  12. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... story about radiology? Share your patient story here Images × Image Gallery Radiologist and patient consultation. View full size ... X-Ray and CT Exams Contrast Materials Venography Images related to Transjugular Intrahepatic Portosystemic Shunt (TIPS) Sponsored ...

  13. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... X-Ray and CT Exams Contrast Materials Venography Images related to Transjugular Intrahepatic Portosystemic Shunt (TIPS) Sponsored by Please note RadiologyInfo.org is not a medical facility. Please contact your physician with specific medical ...

  14. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... bear denotes child-specific content. Related Articles and Media Radiation Dose in X-Ray and CT Exams Contrast Materials Venography Images related to Transjugular Intrahepatic Portosystemic Shunt (TIPS) Sponsored ...

  15. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... functions properly. top of page Who interprets the results and how do I get them? Prior to ... TIPS is designed to produce the same physiological results as a surgical shunt or bypass, without the ...

  16. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... liver. The shunt is kept open by the placement of a small, tubular metal device commonly called ... of the condition. To help plan for the placement of the TIPS stent, a contrast material will ...

  17. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... inserted will be sterilized and covered with a surgical drape. Your physician will numb an area just ... to produce the same physiological results as a surgical shunt or bypass, without the risks that accompany ...

  18. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Computed tomography (CT) of the sinuses uses special x-ray equipment to evaluate the paranasal sinus cavities – hollow, ... is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside ...

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of ...

  20. Odontogene sinusitis maxillaris

    NARCIS (Netherlands)

    Weijerman, J.E.

    1972-01-01

    Een oroantrale fistel blijkt in 51,7% der gevallen geleid te hebben tot een chronische en slechts in 29,2% tot een acute sinusitis (tabel 7 blz.72). Een verklaring hiervoor is vermoedelijk de goede drainagemogelijkheid van de sinus doordat het ostium meestal open is en bovendien afvoer van de pus

  1. Are shunt series and shunt patency studies useful in patients with shunted idiopathic intracranial hypertension in the emergency department?

    Science.gov (United States)

    Liu, Ann; Elder, Benjamin D; Sankey, Eric W; Goodwin, C Rory; Jusué-Torres, Ignacio; Rigamonti, Daniele

    2015-11-01

    Shunt series and shunt patency studies can be performed in the emergency department (ED) to evaluate for shunt malfunction in patients with idiopathic intracranial hypertension (IIH). Here, we examine the utility of these studies in this specific patient population. We retrospectively reviewed the ED visits of all shunted patients diagnosed with IIH from 2003 to 2014. ED visits for symptoms not related to the patient's IIH were excluded from the study. Collected variables included demographics, symptoms, IIH diagnosis and treatment history, imaging findings, and management changes. Twenty-five (81%) patients had a total of 105 visits involving a shunt series, with four (3.9%) showing problems with the catheter. The majority of shunt series (n=101, 96%) showed no catheter pathology. Based on results of the shunt series alone, in 3 instances, management changes in the form of shunt revision or shunt reprogramming occurred. Of the 105 visits with a shunt series, 17 (16%) resulted in a change in management as compared to 12 out of 66 (18%) visits without a shunt series (p=0.83). Nine patients had a total of 10 visits involving a shunt patency study: five were normal, four were abnormal, and one was inconclusive. Based on findings on the shunt patency study alone, changes in management leading to shunt adjustment or revision occurred in 4 instances. Of the 10 visits with shunt patency studies, 5 resulted in a change in management as compared to 24 out of 161 visits without a shunt patency study (p=0.014). Shunt series detected catheter pathology only 3.9% of the time, and there was no difference in the rate of management changes between those patients who underwent a shunt series and those who did not. There was a significant difference in the rate of management changes in patients who received shunt patency studies as compared to those who did not. Shunt series may not be a useful screening tool to be used universally to diagnose shunt malfunction in IIH patients in

  2. Piezoelectric RL shunt damping of flexible structures

    DEFF Research Database (Denmark)

    Høgsberg, Jan Becker; Krenk, Steen

    2015-01-01

    Resonant RL shunt circuits represent a robust and effective approach to piezoelectric damping, provided that the individual shunt circuit components are calibrated accurately with respect to the dynamic properties of the corresponding flexible structure. The balanced calibration procedure applied...

  3. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... x-ray equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity. CT scanning is painless, noninvasive and accurate. It’s ...

  4. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... allows the body parts to be distinguished from one another on an x-ray film or CT ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ...

  5. Sinusitis in adults - aftercare

    Science.gov (United States)

    ... still have symptoms after taking all of your antibiotics properly. You have any changes in your vision. You notice small growths in your nose. Alternative Names Sinus infection - self-care; Rhinosinusitis - self-care ...

  6. Sinusitis (For Teens)

    Science.gov (United States)

    ... When the nasal congestion (stuffiness) associated with the common cold or allergies doesn't allow the sinuses to ... have dry coughs and find it hard to sleep. Others have upset stomachs or feel nauseous. Although ...

  7. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page How should ... CT scanning may eliminate the need for exploratory surgery and surgical biopsy. No radiation remains in a ...

  8. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ... CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, ...

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... and accurate. It’s also the most reliable imaging technique for determining if the sinuses are obstructed and ... to obtain images. For children, the CT scanner technique will be adjusted to their size and the ...

  10. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... presence of inflammatory diseases. provide additional information about tumors of the nasal cavity and sinuses. plan for ... Risks There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit ...

  11. An incidental persistent falcine sinus with dominant straight sinus and hypoplastic distal superior sagittal sinus

    Energy Technology Data Exchange (ETDEWEB)

    Manoj, Krishnan Sarojam [Metroscans, Trivandrum (India); Krishnamoorthy, Thamburaj; Thomas, Bejoy; Kapilamoorthy, Tirur Raman [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum (India)

    2006-01-01

    An incidental persistent falcine sinus was detected in an otherwise normal brain on MRI in a 12-year-old girl who underwent imaging after clinical suspicion of acute disseminated encephalomyelitis. The falcine sinus was associated with a hypoplastic posterior third of the superior sagittal sinus and a dominant straight sinus. Generally, atresia or hypoplasia of the straight sinus is associated with a persistent falcine sinus in postnatal life; otherwise, the falcine sinus disappears before birth. We discuss the embryological basis for such an association in this case. (orig.)

  12. Endovascular management of dural carotid-cavernous sinus fistulas in 141 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Universitaetsklinikum Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Henkes, H.; Liebig, T.; Weber, W.; Golik, S.; Kuehne, D. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Esser, J. [Universitaetsklinikum Essen, Zentrum fuer Augenheilkunde, Essen (Germany)

    2006-07-15

    Introduction: The purpose of this study was to evaluate the single-centre experience with transvenous coil treatment of dural carotid-cavernous sinus fistulas. Methods: Between November 1991 and December 2005, a total of 141 patients (112 female) with dural carotid-cavernous sinus fistula underwent 161 transvenous treatment sessions. The patient files and angiograms were analysed retrospectively. Clinical signs and symptoms included chemosis (94%), exophthalmos (87%), cranial nerve palsy (54%), increased intraocular pressure (60%), diplopia (51%), and impaired vision (28%). Angiography revealed in addition cortical drainage in 34% of the patients. Partial arterial embolization was carried out in 23% of the patients. Transvenous treatment comprised in by far the majority of patients complete filling of the cavernous sinus and the adjacent segment of the superior and inferior ophthalmic vein with detachable coils. Complete interruption of the arteriovenous shunt was achieved in 81% of the patients. A minor residual shunt (without cortical or ocular drainage) remained in 13%, a significant residual shunt (with cortical or ocular drainage) remained in 4%, and the attempted treatment failed in 2%. There was a tendency for ocular pressure-related symptoms to resolve rapidly, while cranial nerve palsy and diplopia improved slowly (65%) or did not change (11%). The 39 patients with visual impairment recovered within the first 2 weeks after endovascular treatment. After complete interruption of the arteriovenous shunt, no recurrence was observed. The transvenous coil occlusion of the superior and inferior ophthalmic veins and the cavernous sinus of the symptomatic eye is a highly efficient and safe treatment in dural carotid-cavernous sinus fistulas. In the majority of patients a significant and permanent improvement in clinical signs and symptoms can be achieved. (orig.)

  13. Ventricule-shunt abdominal complications

    Directory of Open Access Journals (Sweden)

    Jose Albuquerque Landim Júnior

    2017-04-01

    Full Text Available The ventriculoperitoneal shunt (VPS is a solution to relieving symptoms of excess cerebral-ventricle cerebrospinal fluid (CSF; draining this extra fluid to the peritoneum. Other forms of shunts exist though less used in relation to VPS; whose choice is mainly determined by patient’s clinical presentation and regressive history. Though rare, VPS is not devoid of complications. Furthermore, primary abdominal complications are rarer, though most present as peritonitis, abscess or shunt catheter dissociation, each with varying short and long term consequences. Recently, abdominal fluid collections are drawing increasing interest, particularly in relation to: encysted collections (abdominal pseudocysts-APC and excess cerebrospinal fluid (CSF accumulation (called CSF ascites. We present a case of an abdominal APC diagnosed in an outpatient treated at our referral centre, and explore the involved clinical and surgical aspects. This patient was successfully treated and evolved well post-operatively and up-to-date. Despite vast evolution in neurosurgery, VPS continues being the prima choice in treating hydrocephalus, a procedure prone to complications just like any surgery, though rare. Non-draining shunts usually warrant revision which usually means at least a reoperation. Mechanisms leading to APC formation remain unknown, although a previous bout of sub-clinical peritonitis continues being the dominant hypothesis.

  14. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Transjugular Intrahepatic Portosystemic Shunt ( ...

  15. Ventriculoperitoneal shunt infections in children

    African Journals Online (AJOL)

    1991-02-02

    Feb 2, 1991 ... aetiology, clinical presentation, cerebrospinal fluid (CSF) fmd- ings, modes of treatment and outcome of shunt infections at. Tygerberg Hospital, a 2000-bed referral hospital in the south- western Cape Province. Departments of Paediatrics and Child Health, Neuro- surgery, and Medical Microbiology, ...

  16. Transjugular Intrahepatic Portosystemic Shunt (TIPS)

    Medline Plus

    Full Text Available ... Plan to stay overnight at the hospital for one or more days. What is Transjugular Intrahepatic Portosystemic Shunt (TIPS)? What are some common uses of the procedure? How should I prepare? What does the equipment look like? How does the procedure work? How is the procedure performed? What will I ...

  17. Tuberculosis of paranasal sinuses.

    Science.gov (United States)

    Sanehi, S; Dravid, Chandrashekhar; Chaudhary, Neena; Venkatachalam, V P

    2008-03-01

    Nasal tuberculosis is very rare but much rarer is tuberculosis of paranasal sinuses. It involves especially the maxillary sinus and is usually unilateral. We report an unusual case of tuberculosis of frontal and maxillary sinus in a 68 years old male, who presented with a swelling above left medial canthus, with no other eye or nasal complaints. Clinical and radiological findings on our initial evaluation suggested that the patient had left frontal mucocoele with bilateral maxillary haziness. Diagnosis was established on FNAC report and subsequent Ziehl - Neelsen staining of nasal swabs and tuberculin skin test. Later chest x-ray examination was suggestive of pulmonary tuberculosis, which was the primary cause. Patient responded well to antituberculosis drug therapy.

  18. Case of right atrial myxoma with right to left shunt

    Energy Technology Data Exchange (ETDEWEB)

    Nakai, Kenji; Suzuki, Tomoyuki; Ohzeki, Tetsuro (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1982-12-01

    A case of 49-year-old woman with right atrial myxoma resulting to right to left shunt, diagnosed by cardiac pool isotope image, was reported. She was admitted to our clinic because of progressive shortness of breath. At admission lip cyanosis was noted. Laboratory data included polycythemia, low O/sub 2/ saturation (89%) and high erythrocyte sedimentation rate (65 mm/1 h). Chest x-p showed slight right atrial enlargement, but no pulmonary congestion. The electrocardiogram showed sinus regular rhythm with biphasic p wave in leads II, III, aVf. Although 1st heart sound at the apex was splited, no heart murmur was heard. In usual echocardiographic approach, no abnormal echogram was obtained in the right ventricular region. Lung perfusion scintiscan with Tc-99 m-MAA showed visualization of thyroid gland and kidney, which suggested intracardiac right-to-left shunt. Cardiac pool image with Tc-99m-HSA revealed large photo-deficient area in the right atrium and early visualization of aortic arch. Computor tomography showed large round low density region 8 x 7 cm in size. Based on their findings, this patient was diagnosed as right atrial tumor. At operation a large tumor (diameter 8 x 7 x 7 cm, weight 160g) filled the lower part of the right atrium and was adherent to the anterolateral wall in the right atrium. As a cause of R-L shunt, streched foramen ovale (5 x 10 mm) was found. Tumor histology was typical of atrial myxoma. Post-operative gated cardiac isotope image showed no evidence of residual atrial tumor. Cardiac blood pool isotope imaging was a method for the noninvasive detection and assessment of right atrial myxoma.

  19. Maxillary sinus augmentation

    Directory of Open Access Journals (Sweden)

    A B Tarun Kumar

    2015-01-01

    Full Text Available Placing dental implants in the maxillary posterior region can be both challenging and un-nerving for a regular implant dentist who is not well versed with advanced surgical procedures. It is vital for a general dentist to understand the fundamentals of bone grafting the maxillary sinus if he/she is really committed to providing the best health care for their patients. The dental practice is seeing an increasing group of patients who are living longer, and this group of older baby boomers often has an edentulous posterior maxilla either unilateral or bilateral. When edentulous, the posterior maxilla more likely has diminished bone height, which does not allow for the placement of dental implants without creating additional bone. Through grafting the maxillary sinus, bone of ideal quality can be created (allowing for placement of dental implants, which offer many advantages over other tooth replacement modalities. The sinus graft offers the dental patient a predictable procedure of regenerating lost osseous structure in the posterior maxilla. This offers the patient many advantages for long-term success. If dentists understand these concepts, they can better educate their patients and guide them to have the procedure performed. This article outlines bone grafting of the maxillary sinus for the purpose of placing dental implants. This review will help the readers to understand the intricacies of sinus augmentation. They can relate their patient's condition with the available literature and chalk out the best treatment plan for the patient, especially by using indirect sinus augmentation procedures which are less invasive and highly successful if done using prescribed technique.

  20. Cutaneous odontogenic sinus.

    Science.gov (United States)

    Scott, M J; Scott, M J

    1980-06-01

    A case report and discussion of cutaneous odontogenic sinus tracts, frequently encountered but often misdiagnosed and mistreated, are presented. Awareness that periapical dental abscesses are the most common etiologic factor of cutaneous sinus tracts involving the face and neck will facilitate their early diagnosis and prevent needless treatment or anxiety for the patient. These lesions are often misinterpreted as chronic, resistant to therapy, pyogenic nodules, or granulomas. A high degree of suspicion is required for making the correct diagnosis, and dental roentgenographic studies should routinely be obtained in all such lesions. Permanent healing cannot be achieved unless the original site of infection is located and eradicated.

  1. Ventriculopleural shunting with new technology valves.

    Science.gov (United States)

    Martínez-Lage, J F; Torres, J; Campillo, H; Sanchez-del-Rincón, I; Bueno, F; Zambudio, G; Poza, M

    2000-12-01

    Ventriculoperitoneal shunting constitutes the standard procedure for draining cerebrospinal fluid (CSF) in children with hydrocephalus. Ventriculoatrial and ventriculopleural shunting are alternative methods of CSF drainage, which have gained less acceptance. Ventriculopleural shunts are seldom used owing to justified fears of pneumothorax and symptomatic effusions of CSF. The addition of an antisiphon device to standard shunt systems seems to have prevented CSF pleural effusion. From 1988 to 1998, we treated each of six hydrocephalic children with a ventriculopleural shunt. In five cases we used new-technology valves designed to prevent the effects of siphoning with current differential pressure valves. Peritoneal adhesions, recent peritonitis, ascites, and obstruction of a previous ventriculoatrial shunt were the indications for pleural shunting. After a mean follow-up period of 2.5 years all shunts were functioning adequately. Only one patient showed transient symptoms of CSF overdrainage, which were corrected by up-grading the valve setting with the magnet. A late death was unrelated to the pleural shunting procedure. The use of valves of a new design designed to prevent overdrainage seems to account for the satisfactory outcomes observed in this series. We suggest that ventriculopleural shunting should be considered as the preferred alternative to peritoneal drainage in children with intra-abdominal adhesions or with a history of recent peritoneal infection.

  2. Pediatric ventriculoperitoneal shunts and their complications: An analysis

    Directory of Open Access Journals (Sweden)

    Nitin Agarwal

    2017-01-01

    Conclusion: With this retrospective review of complications of VP shunts, age at initial shunt insertion and the interval between the age of initial shunt placement and onset of complications were the most important patient-related predictors of shunt failure. The different predominant etiological factors responsible for early and late shunt failure were infective and mechanical complications, respectively.

  3. The Railway Traffic Shunting System

    Directory of Open Access Journals (Sweden)

    Anton Pepevnik

    2003-05-01

    Full Text Available Economy demands quality peiformance of transport servicesfrom all spheres of the traffic system The shunting systemin railway transport is a part of the traffic system. The fact thatthe railways are an organization of special social interest makesits organization structure the more important for the economicdevelopment. Problems that appear in the development of theeconomic system clearly point out numerous irregularitieswithin the railways. The demand of quality transport servicesrequires rationality of transport which consequently requiresgreat changes in the field of traffic organization structure andexploitation of transport capacities.Elementary parameters of the quality evaluation of thetransport service in all traffic subsystems are: speed, safety andregularity of transport. The same parameters can be implementedas the basis of technical and exploitation characteristicsof traffic.The shunting system in railway traffic is affected by numerouselements which are interconnected and represent a uniformtechnological process. Subsequently, the shunting system isconsidered a uniform technological system. The characteristicsof such a system are apparent in the technical and technologicalprocess, e.g.:- integrality, i. e. characteristic of collective production oftransport services;- homogeneity of transport means;- standardization of means of integral transport.In the process of transport demands, maximum servicequality is incessantly required. However, maximum quality withcertain quantitative dimension in regard to mode, place andtime of the transport process requires engagement of transportmeans, which directly affects the costs. Therefore, it can be assertedthat the optimum lies between the maximum quantitativeand qualitative dimensions of transport services and in thedetermined time of minimum costs of means.

  4. Shunt freedom and clinical resolution of idiopathic intracranial hypertension after bariatric surgery in the pediatric population: report of 3 cases.

    Science.gov (United States)

    Hoang, Kimberly B; Hooten, Kristopher G; Muh, Carrie R

    2017-12-01

    Idiopathic intracranial hypertension (IIH), formerly known as pseudotumor cerebri, is a disease of elevated intracranial pressure that is thought to develop due to impaired CSF absorption related to elevated venous sinus pressure in the setting of increased intraabdominal and thoracic pressures. Symptoms can be disabling and, if left untreated, can lead to permanent visual loss. Previous treatments directed toward vision preservation include CSF diversion through shunting and optic nerve sheath fenestration. Recently, attention has been turned toward surgical weight loss strategies as an alternative to shunt treatment. The authors present a report of 3 patients with adolescent-onset IIH that was treated at the authors' institution (Duke University) in whom bariatric surgery was pursued successfully. The patients had previously undergone CSF shunting at ages 12, 15, and 23 years. They were shunt dependent for a collective average of 3.3 years prior to bariatriwc surgery. All patients reported "low-pressure" or postural headaches after bariatric surgery that correlated with dramatic reduction in their weight. Two of the 3 patients had their shunts removed and continued to be shunt free 1.5 years later at last follow-up; the third patient remained shunt dependent with the pressure set at 200 mm H2O. Given the significant complications inherent to multiple shunt revisions, earlier intervention for weight loss, including bariatric surgery, in these patients might have prevented complications and the associated health care burden. The authors recommend a multidisciplinary approach for IIH treatment with early consideration for weight loss interventions in select patients.

  5. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... thickened sinus membranes . detect the presence of inflammatory diseases. provide additional information about tumors of the nasal ...

  6. cerebral venous sinus thrombosis

    African Journals Online (AJOL)

    2010-05-05

    May 5, 2010 ... day history of generalised tonic clonic seizures. The seizures were noted to last 5 minutes and followed ... the lateral and third ventricles was seen. Contrast enhanced CT scans showed the empty ... and absence of flow (Figure 3D) within the superior sagittal and right transverse sinuses. The patient was ...

  7. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... or thickened sinus membranes . detect the presence of inflammatory diseases. provide additional information about tumors of the nasal ... reduce the risk of an allergic reaction. These medications generally need ... of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any ...

  8. CURRENT APPROACH TO SINUSITIS

    African Journals Online (AJOL)

    Enrique

    scopic or external spheno-eth- moidectomy. Complications of ABRS. Orbital complications are the most common complication of sinusitis. The Chandler classification gives a clinical approach to orbital inflamma- tion: • inflammatory oedema (lid oedema). • orbital cellulitis (diffuse oedema). • subperiosteal abscess (displace-.

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses ...

  10. Pediatric cavernous sinus thrombosis

    Science.gov (United States)

    Vossough, Arastoo; Vorona, Gregory A.; Beslow, Lauren A.; Ichord, Rebecca N.; Licht, Daniel J.

    2015-01-01

    Objective: To describe clinical characteristics, imaging findings, morbidity, and mortality in a single-center cohort of 12 pediatric cavernous sinus thrombosis cases and to review all cases available in recent English literature. Methods: Clinical data and radiographic studies on 12 cases from our institution were analyzed retrospectively. A literature search and review was conducted, with additional cases pooled with the new cohort for an aggregate analysis. Results: Twelve cases of cavernous sinus thrombosis in children from the Children's Hospital of Philadelphia between January 1, 2000, and December 31, 2013, were reviewed. All patients survived to discharge; 3 of 12 (25%) experienced neurologic morbidity. Contrast-enhanced MRI and contrast-enhanced head CT were 100% sensitive for detecting cavernous sinus thrombosis, while noncontrast time-of-flight magnetic resonance venography (TOF MRV) and noncontrast head CT were 0% sensitive. Literature review produced an additional 40 cases, and the aggregate mortality rate was 4 of 52 (8%) and morbidity rate was 10 of 40 (25%). Outcomes did not vary by treatment or with unilateral vs bilateral cavernous sinus involvement. There was a trend toward worse outcomes with fungal infections. Conclusion: Our case series demonstrates low morbidity and mortality with early, aggressive surgical, antimicrobial, and anticoagulation therapies. Although anticoagulation and surgery were not associated with significantly different outcomes, more study is needed. PMID:26231260

  11. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... quality for accurate interpretation. The actual CT scan takes less than a minute and the entire process ... tissue as well as the lungs, bones, and blood vessels. CT examinations are fast and ... is usually the first test ordered when a sinus tumor is suspected. If ...

  12. Perforation of the sinus membrane during sinus floor elevation

    DEFF Research Database (Denmark)

    von Arx, Thomas; Fodich, Ivo; Bornstein, Michael M

    2014-01-01

    PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical and radiogra......PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical...... and radiographic variables potentially influencing the risk of sinus membrane perforation were evaluated and divided into patient-related factors (age, sex, smoking habit); surgery-related factors (type of surgical approach, side, units, sites, and technique of osteotomy); and maxillary sinus-related factors...

  13. Treatment results of functional endoscopic sinus surgery in chronic sinusitis

    Directory of Open Access Journals (Sweden)

    Naraghi M

    2002-07-01

    Full Text Available Background: Endoscopic sinus surgery has been used for diagnosis and treatment of chronic inflammatory diseases of paranasal sinuses since recent years. Materials and Methods: In this study 104 patients with chronic sinusitis (with or without polyps which were managed with endoscopic sinus surgery (ESS were followed for 6 to 24 months after surgery (24 patients refused to continue follow up and the recovery rate of symptoms were evaluated. Results: The effectiveness of this therapy is statistically approved and the most important symptom which diminished was nasal obstruction (from 95 percent to 18.5 percent, the least important symptom which diminished was anosmia (from 57 percent to 21 percent. Conclusion: This study confirmed the efficacy of functional endoscopic sinus surgery in improvement of chronic sinusitis symptoms.

  14. Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology

    NARCIS (Netherlands)

    Timmenga, NM; Raghoebar, GM; Liem, RSB; van Weissenbruch, R; Manson, WL; Vissink, A

    In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac

  15. Headaches in patients with shunts.

    Science.gov (United States)

    Rekate, Harold L; Kranz, Dory

    2009-03-01

    Headache is one of the most common afflictions suffered by humans. Headache in patients with a shunt triggers a series of events that includes utilization of expensive technologies and often potentially dangerous surgical intervention. The purpose of this study was to determine the incidence of headaches in patients with shunts and, hopefully, the relationship of those headache disorders to the treatment of hydrocephalus. The Hydrocephalus Association maintains a self-reporting database recorded from individuals treated for hydrocephalus and their families. This database was mined to determine the incidence of severe headaches requiring treatment and interfering with normal life in patients who have been treated for hydrocephalus. There were 1,242 responders between the ages of 19 months and 45 years of age. Of these, 1,233 answered the question, "Do you or your family member suffer from (does your child complain of) frequent or chronic headaches?" This subset forms the basis of this study. Three groups were defined by age: children (19 months-12 years), adolescents (13 years-19 years), and young adults (20 years-45 years). Most respondents were initially treated during infancy (before 18 months of age); 84% of children and 69% of both adolescents and young adults were treated very early in life. Severe headaches became a more frequent problem as the age of the population treated for hydrocephalus increased. In terms of frequency and severity of headaches, direct comparisons with epidemiologic studies of normal populations are difficult because of the limitations of data available in the database. However, it is likely that this population has a higher incidence of severe headaches than normal populations. The cost of management of headaches in this population is very high, and the patients are at risk throughout life. Early treatment decisions have a significant effect on later quality of life. Strategies that lead to normalization of cerebrospinal fluid dynamics

  16. OPTIMIZATION OF SECRETOLYTIC TREATMENT OF ACUTE SINUSITIS

    OpenAIRE

    S.V. Makarevich

    2008-01-01

    Efficiency of sinupret in children with acute sinusitis as a drug with serolytic action, is studied. it is established that secretolytic therapy in case of acute sinusitis, aimed at the improvement of drainage and ventilation function of paranasal sinuses, is one of the potentially productive directions of nonbinvasive methods of treatment of acute sinusitis.Key words: children, acute sinusitis, secretolytic treatment.

  17. Ethmomaxillary sinus: a particular anatomic variation of the paranasal sinuses

    Energy Technology Data Exchange (ETDEWEB)

    Sirikci, Akif; Bayram, Metin [Department of Radiology, Faculty of Medicine, Gaziantep University, Kolejtepe, 27310, Gaziantep (Turkey); Bayazit, Y.A.; Kanlikama, Muzaffer [Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Gaziantep University, Kolejtepe, 27310, Gaziantep (Turkey)

    2004-02-01

    We assessed the morphological and radiological characteristics of ethmomaxillary sinus (EMS), which is an enlarged posterior ethmoidal air cell occupying the superior portion of the maxillary sinus while draining into superior meatus. This study is based on 1450 patients submitted to CT examination of the paranasal sinuses between 1998 and 2002. Sequential CT scans were obtained in the coronal plane in all the patients with 2.5- to 5-mm section thickness and were evaluated for EMS. The diagnosis of EMS was made when there was a posterior ethmoidal cell occupying the superior part of the maxillary sinus while draining to the superior meatus. When EMS was diagnosed, the morphology of the septum between the and maxillary sinus, and width of the superior meatus, were noted. The EMS was found in 10 of 1450 (0.7%) patients. The coexisting anatomic variations were concha bullosa (50%), upper concha pneumatization (20%), maxillary sinus hypoplasia (20%), uncinate bulla (10%), hypertrophied inferior concha (10%), paradoxic middle concha (10%), and septate maxillary sinus (10%). There was no relation between EMS and sinus disease. The EMS is a rare anatomic variation and does not appear to be associated with sinusitis. The EMS is not a well-studied anatomic variation, and the literature is lacking adequate information about this anatomic variation. This study performed in a large series of patients will possibly contribute to better understanding of this particular anomaly. (orig.)

  18. Comparison of Quality Metrics for Pediatric Shunt Surgery and Proposal of the Negative Shunt Revision Rate.

    Science.gov (United States)

    Beez, Thomas; Steiger, Hans-Jakob

    2018-01-01

    Shunt surgery is common in pediatric neurosurgery and is associated with relevant complication rates. We aimed to compare previously published metrics in a single data set and propose the Negative Shunt Revision Rate (NSRR), defined as proportion of shunt explorations revealing a properly working system, as a new quality metric. Retrospective analysis of our shunt surgery activity in 2015 was performed. Demographic, clinical, and radiologic variables were extracted from electronic medical notes. Surgical Activity Rate, Revision Quotient, 30-day shunt malfunction rate, 90-day global shunt revision rate, Preventable Shunt Revision Rate, and novel NSRR were calculated. Of 60 shunt operations analyzed, 18 (39%) were new shunt insertions, and 42 (70%) were revisions. Median age was 18 months (range, 0.03-204 months), and main etiologies were posthemorrhagic (n = 16; 41%), congenital (n = 11; 28%), and tumor-associated (n = 8; 21%) hydrocephalus. Within 90 days after index surgery, 13 shunt failures occurred, predominantly owing to proximal failure (n = 6; 46%). Surgical Activity Rate was 0.127, Revision Quotient was 2.333, 30-day shunt malfunction rate was 0.166, 90-day global shunt revision rate was 21.7%, and Preventable Shunt Revision Rate was 38.5%. NSRR was 7.1%. Our results correlate with published values and offer measurement of quality that can be compared across studies and considered patient-oriented, easily measurable, and potentially modifiable. We propose NSRR as a new quality metric, covering an aspect of shunt surgery that was not addressed previously. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. [Orbital complications of sinusitis].

    Science.gov (United States)

    Šuchaň, M; Horňák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kovaľ, J

    2014-12-01

    Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal

  20. Congenital Portosystemic Shunt: Our Experience

    Directory of Open Access Journals (Sweden)

    Tiziana Timpanaro

    2015-01-01

    Full Text Available Introduction. Congenital portosystemic venous malformations are rare abnormalities in which the portal blood drains into a systemic vein and which are characterized by extreme clinical variability. Case Presentations. The authors present two case reports of a congenital extrahepatic portosystemic shunt (Type II. In the first patient, apparently nonspecific symptoms, such as headache and fatigue, proved to be secondary to hypoglycemic episodes related to the presence of a portosystemic shunt, later confirmed on imaging. During portal vein angiography, endovascular embolization of the portocaval fistula achieved occlusion of the anomalous venous tract. In the second patient, affected by Down’s syndrome, the diagnosis of a portosystemic malformation was made by routine ultrasonography, performed to rule out concurrent congenital anomalies. Because of the absence of symptoms, we chose to observe this patient. Conclusions. These two case reports demonstrate the clinical heterogeneity of this malformation and the need for a multidisciplinary approach. As part of a proper workup, clinical evaluation must always be followed by radiographic diagnosis.

  1. Reversed shunting in CREST syndrome.

    Science.gov (United States)

    Kafes, Habibe; Sen, Fatih; Unal, Sefa; Acar, Burak; Ozeke, Ozcan

    2016-07-08

    The patent foramen ovale (PFO) is one of the most common congenital defects and may as well stand for "potential for opening" in addition to patent foramen ovale. Although patients are usually asymptomatic because the defect is flap-like and does not permit significant left-to-right shunting, the pathological conditions that result in cardiac rotation or higher than normal right atrial pressures can reverse the normal left atrial to right atrial pressure gradient and cause a right-to-left shunt through a PFO. Pulmonary complications of systemic sclerosis (SSc) are common, and are the leading cause of SSc-related death. The most common pulmonary manifestations of SSc are pulmonary hypertension (PAH), interstitial lung disease, and any combination thereof. Compared with the idiopathic form of PAH (IPAH), patients with SSc-associated PAH have a threefold increased risk of death and may receive a diagnosis late in the course of disease because of insidious onset and the high prevalence of cardiac, musculoskeletal, and pulmonary parenchymal comorbidities. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 44:390-391, 2016. © 2015 Wiley Periodicals, Inc.

  2. Understanding Biofilms in Chronic Sinusitis.

    Science.gov (United States)

    Tajudeen, Bobby A; Schwartz, Joseph S; Palmer, James N

    2016-02-01

    Chronic sinusitis is a burdensome disease that has substantial individual and societal impact. Although great advances in medical and surgical therapies have been made, some patients continue to have recalcitrant infections. Microbial biofilms have been implicated as a cause of recalcitrant chronic sinusitis, and recent studies have tried to better understand the pathogenesis of chronic sinusitis as it relates to microbial biofilms. Here, we provide an overview of biofilms in chronic sinusitis with emphasis on pathogenesis, treatment, and future directions. In addition, recent evidence is presented, elucidating the role of bitter taste receptors as a possible key factor leading to biofilm formation.

  3. Mucocele of the sphenoid sinus

    Energy Technology Data Exchange (ETDEWEB)

    Haloi, Achyut K.; Ditchfield, Michael [Royal Children' s Hospital, Department of Medical Imaging, Melbourne (Australia); Maixner, Wirginia [Royal Children' s Hospital, Department of Neurosurgery, Melbourne (Australia)

    2006-09-15

    The sphenoid sinus is the least common site of mucocele of all paranasal sinuses. It is very rare in children, especially in those younger than 12 years when pneumatization of the sphenoid sinus is completed. We report a case of histologically proven sphenoidal mucocele in a 5-year-old child. The child presented with an acute onset of significant visual impairment and headache. His vision gradually improved after trans-nasal sphenoidotomy and drainage of the sinus content with return of complete normal baseline vision after 2 months. (orig.)

  4. Intracranial Complications of Pediatric Sinusitis.

    Science.gov (United States)

    Wiersma, Alexandria J; Vu, Tien

    2017-06-13

    "Headache and fever" is a common presentation to the urgent care and emergency department setting and can have many etiologies. We present a case of a 10-year-old girl who presented with headache and fever and was found to have intracranial extension of sinusitis despite lack of typical sinus or chronic upper respiratory tract infection symptoms. This case illustrates the need in the emergency department or urgent care to keep a broad differential diagnosis for pediatric headache, especially when initial interventions are unsuccessful. We also review the epidemiology of pediatric sinusitis, age at sinus development, and associated intracranial complications.

  5. Sinus Infection and Toothache: Any Connection?

    Science.gov (United States)

    ... sinus infection cause a toothache? Answers from Alan Carr, D.M.D. Yes, a sinus infection (sinusitis) ... problem is contributing to the toothache. With Alan Carr, D.M.D. References Longo DL, et al., ...

  6. Research progress in TIPS shunt dysfunction and recanalization

    Directory of Open Access Journals (Sweden)

    WANG Tingting

    2015-11-01

    Full Text Available Transjugular intrahepatic portosystemic shunt (TIPS is widely used in the treatment of cirrhotic portal hypertension and its associated complications. However, postoperative shunt dysfunction has been an important factor restricting the clinical application of TIPS. This article summarizes the use of shunt, the incidence of shunt dysfunction after TIPS, preventive measures and diagnostic methods for shunt dysfunction, and indications and techniques of shunt recanalization, in order to enhance our knowledge of shunt dysfunction and recanalization, which could further improve the efficacy of TIPS for cirrhotic portal hypertension.

  7. Acute bacterial sinusitis in children.

    Science.gov (United States)

    DeMuri, Gregory; Wald, Ellen R

    2013-10-01

    On the basis of strong research evidence, the pathogenesis of sinusitis involves 3 key factors: sinusostia obstruction, ciliary dysfunction, and thickening of sinus secretions. On the basis of studies of the microbiology of otitis media, H influenzae is playing an increasingly important role in the etiology of sinusitis, exceeding that of S pneumoniae in some areas, and b-lactamase production by H influenzae is increasing in respiratory isolates in the United States. On the basis of some research evidence and consensus,the presentation of acute bacterial sinusitis conforms to 1 of 3 predicable patterns; persistent, severe, and worsening symptoms. On the basis of some research evidence and consensus,the diagnosis of sinusitis should be made by applying strict clinical criteria. This approach will select children with upper respiratory infection symptoms who are most likely to benefit from an antibiotic. On the basis of some research evidence and consensus,imaging is not indicated routinely in the diagnosis of sinusitis. Computed tomography or magnetic resonance imaging provides useful information when complications of sinusitis are suspected. On the basis of some research evidence and consensus,amoxicillin-clavulanate should be considered asa first-line agent for the treatment of sinusitis.

  8. Managing acute invasive fungal sinusitis.

    Science.gov (United States)

    Dwyhalo, Kristina M; Donald, Carrlene; Mendez, Anthony; Hoxworth, Joseph

    2016-01-01

    Acute invasive fungal sinusitis is the most aggressive form of fungal sinusitis and can be fatal, especially in patients who are immunosuppressed. Early diagnosis and intervention are crucial and potentially lifesaving, so primary care providers must maintain a high index of suspicion for this disease. Patients may need to be admitted to the hospital for IV antifungal therapy and surgical debridement.

  9. Idiopathic intracranial hypertension: lumboperitoneal shunts versus ventriculoperitoneal shunts--case series and literature review.

    LENUS (Irish Health Repository)

    Abubaker, Khalid

    2012-02-01

    OBJECTIVES: Idiopathic intracranial hypertension (IIH) is an uncommon but important cause of headache that can lead to visual loss. This study was undertaken to review our experience in the treatment of IIH by neuronavigation-assisted ventriculoperitoneal (VP) shunts with programmable valves as compared to lumboperitoneal (LP) shunts. METHODS: A retrospective chart review was conducted on 25 patients treated for IIH between 2001 and 2009. Age, sex, clinical presentation, methods of treatment and failure rates were recorded. RESULTS: Seventy-two per cent were treated initially with LP shunts. Failure rate was 11% in this group. Neuronavigation-assisted VP shunts were used to treat 28%. In this group, the failure rate was 14%. CONCLUSION: Our experience indicates that both LP shunts and VP shuts are effective in controlling all the clinical manifestations of IIH in the immediate postoperative period. Failure rates are slightly higher for VP shunts (14%) than LP shunts (11%). However, revision rates are higher with LP shunts (60%) than with VP shunts (30%).

  10. Congenital portosystemic shunts with and without gastrointestinal bleeding - case series

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Ying; Chen, Jun; Chen, Qi; Ji, Min; Pa, Mier; Qiao, Zhongwei [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China); Zhu, Hui [Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai (China); Zheng, Shan [Children' s Hospital of Fudan University, Department of Surgery, Shanghai (China)

    2015-12-15

    The clinical presentation of congenital portosystemic shunt is variable and gastrointestinal bleeding is an uncommon presentation. To describe the imaging features of congenital portosystemic shunt as it presented in 11 children with (n = 6) and without gastrointestinal bleeding (n = 5). We performed a retrospective study on a clinical and imaging dataset of 11 children diagnosed with congenital portosystemic shunt. A total of 11 children with congenital portosystemic shunt were included in this study, 7 with extrahepatic portosystemic shunts and 4 with intrahepatic portosystemic shunts. Six patients with gastrointestinal bleeding had an extrahepatic portosystemic shunt, and the imaging results showed that the shunts originated from the splenomesenteric junction (n = 5) or splenic vein (n = 1) and connected to the internal iliac vein. Among the five cases of congenital portosystemic shunt without gastrointestinal bleeding, one case was an extrahepatic portosystemic shunt and the other four were intrahepatic portosystemic shunts. Most congenital portosystemic shunt patients with gastrointestinal bleeding had a shunt that drained portal blood into the iliac vein via an inferior mesenteric vein. This type of shunt was uncommon, but the concomitant rate of gastrointestinal bleeding with this type of shunt was high. (orig.)

  11. Resonant Electromagnetic Shunt Damping of Flexible Structures

    DEFF Research Database (Denmark)

    Høgsberg, Jan Becker

    2016-01-01

    Electromagnetic transducers convert mechanical energy to electrical energy and vice versa. Effective passive vibration damping of flexible structures can therefore be introduced by shunting with an accurately calibrated resonant electrical network thatcontains a capacitor to create the desired...

  12. Syringoperitoneal shunt - a promising treatment in syringomyelia

    Energy Technology Data Exchange (ETDEWEB)

    Wester, K.; Midgard, R.; Kjosavik, I.F.

    1988-09-01

    Five patients with radiologically relatively pronounced multicystic syringomyelia were operated with an open, non-valved syringoperitoneal shunt. In the postoperative MRI scans there was an immediate and pronounced reduction of all cystic compartments, and within a few months the cysts had virtually disappeared. Two of the patients experienced marked neurological improvement. In one patient the shunt procedure led to additional moderate neurological deficits caused by postoperative rotation of the intrameduallary T-drain. For this reason straight intramedullary drains are now used.

  13. Resonant Electromagnetic Shunt Damping of Flexible Structures

    DEFF Research Database (Denmark)

    Høgsberg, Jan Becker

    2016-01-01

    Electromagnetic transducers convert mechanical energy to electrical energy and vice versa. Effective passive vibration damping of flexible structures can therefore be introduced by shunting with an accurately calibrated resonant electrical network thatcontains a capacitor to create the desired...... resonance and a resistor to dissipate the correct amount of vibration energy. The modal interaction with residual vibration forms not targeted by the resonant shunt is represented by supplemental flexibility and inertia terms. This leads to modified calibration formulae that maintain the desired damping...

  14. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M. [Ernst-Moritz-Arndt-Universitaet Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Liebig, T. [TU Muenchen, Institut fuer Neuroradiologie, Klinikum Rechts der Isar, Munich (Germany); Kuehne, D. [Klinik fuer Radiologie und Neuroradiologie, Alfried-Krupp-Krankenhaus, Essen (Germany); Henkes, H. [Katharinenhospital-Klinikum Stuttgart, Klinik fuer Neuroradiologie, Stuttgart (Germany)

    2009-07-15

    This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse-sigmoid sinus dural arteriovenous fistulas (TS{sub d}AVF). A total of 150 consecutive patients and 348 procedures were evaluated. Pulsatile tinnitus (81%), headache (15%), and intracranial hemorrhage (10%) were the most frequent manifestations of the TS{sub d}AVFs. More than half of the affected sinuses were partially or completely thrombosed. Access-wise treatment was performed transarterial (n = 33), transvenous (n = 21), or a combination thereof (n = 96). A mean of 2.4 procedures per patient was required. Immediate postprocedural occlusion rate after transarterial embolization was 30% only. Transvenous treatment alone resulted in an early occlusion rate of 81%, with delayed complete obliteration of half of the remaining fistulas. After combined transarterial/transvenous treatment, the angiographic cure rate was 54%. At follow-up, 88% of patients with residual shunt after the treatment showed complete occlusion. The cumulative complication rate was 9% (n = 13), with minor adverse events in ten patients (7%) and major complications in three patients (2%). Transvenous coil occlusion of the sinus segment with the adjacent dAVF site, eventually combined with transarterial occlusion of supplying arteries, is a very effective and well-tolerated treatment method. In selected patients, variations of these methods (e.g., sinus stenting, compartmental sinus occlusion) can be useful. (orig.)

  15. Cell shunt resistance and photovoltaic module performance

    Energy Technology Data Exchange (ETDEWEB)

    McMahon, T.J.; Basso, T.S.; Rummel, S.R. [National Renewable Energy Lab., Golden, CO (United States)

    1996-05-01

    Shunt resistance of cells in photovoltaic modules can affect module power output and could indicate flawed manufacturing processes and reliability problems. The authors describe a two-terminal diagnostic method to directly measure the shunt resistance of individual cells in a series-connected module non-intrusively, without deencapsulation. Peak power efficiency vs. light intensity was measured on a 12-cell, series-connected, single crystalline module having relatively high cell shunt resistances. The module was remeasured with 0.5-, 1-, and 2-ohm resistors attached across each cell to simulate shunt resistances of several emerging technologies. Peak power efficiencies decreased dramatically at lower light levels. Using the PSpice circuit simulator, the authors verified that cell shunt and series resistances can indeed be responsible for the observed peak power efficiency vs. intensity behavior. The authors discuss the effect of basic cell diode parameters, i.e., shunt resistance, series resistance, and recombination losses, on PV module performance as a function of light intensity.

  16. Endoscopic Third Ventriculostomy in Previously Shunted Children

    Directory of Open Access Journals (Sweden)

    Eva Brichtova

    2013-01-01

    Full Text Available Endoscopic third ventriculostomy (ETV is a routine and safe procedure for therapy of obstructive hydrocephalus. The aim of our study is to evaluate ETV success rate in therapy of obstructive hydrocephalus in pediatric patients formerly treated by ventriculoperitoneal (V-P shunt implantation. From 2001 till 2011, ETV was performed in 42 patients with former V-P drainage implantation. In all patients, the obstruction in aqueduct or outflow parts of the fourth ventricle was proved by MRI. During the surgery, V-P shunt was clipped and ETV was performed. In case of favourable clinical state and MRI functional stoma, the V-P shunt has been removed 3 months after ETV. These patients with V-P shunt possible removing were evaluated as successful. In our group of 42 patients we were successful in 29 patients (69%. There were two serious complications (4.7%—one patient died 2.5 years and one patient died 1 year after surgery in consequence of delayed ETV failure. ETV is the method of choice in obstructive hydrocephalus even in patients with former V-P shunt implantation. In case of acute or scheduled V-P shunt surgical revision, MRI is feasible, and if ventricular system obstruction is diagnosed, the hydrocephalus may be solved endoscopically.

  17. Utility of three-dimensional transesophageal echocardiography for diagnosis of unroofed coronary sinus.

    Science.gov (United States)

    Kawamukai, Mina; Muranaka, Atsuko; Yuda, Satoshi; Sato, Yasumi; Makiguchi, Nobuko; Tachibana, Kazutoshi; Hatakeyama, Kinya; Takagi, Nobuyuki; Higami, Tetsuya; Miura, Tetsuji

    2016-01-01

    We report a case of unroofed coronary sinus (URCS) in a 42-year-old female. At an outpatient clinic, she was found to have an atrioventricular septal defect and mitral regurgitation with pulmonary hypertension, and she was transferred to our institute for surgical treatment. Both atrioventricular valves were located at the same level, and both the right atrium (RA) and right ventricle were enlarged on two-dimensional transthoracic echocardiography. Color Doppler imaging demonstrated severe mitral and tricuspid regurgitation and a left-to-right shunt from the left atrium (LA) to the RA. Although an ostium primum defect of the atrial septum was suspected, the exact position of the shunt flow was unclear. Two-dimensional transesophageal echocardiography (2D-TEE) could visualize a direct communication between the LA and coronary sinus. Three-dimensional transesophageal echocardiography (3D-TEE) clearly visualized the entire route from the coronary sinus into the LA and RA. The utility of 3D-TEE as a modality complementary to 2D-TEE in diagnosis of URCS was confirmed.

  18. A Rare Cause of Headache: Aspergillus Sinusitis

    OpenAIRE

    Şehnaz Arıcı; Özge Özen Gökmuharremoğlu; Behiye Özer

    2015-01-01

    Fungal sinusitis are mostly seen in immunosuppressive individuals and somtimes which can be mortal. Most frequently species of Aspergillus were isolated from, clinical forms of mycotic sinonasal disease.Surgical debridement,sinus ventilation and medical therapy in treatment of fungal sinusitis, are recommended. In this article, a case of healthy immune patient with fungal sinusitis who peresent with headache was repoted.

  19. [Maxillary sinus myxoma].

    Science.gov (United States)

    Niedzielski, Artur; Partycka-Pietrzyk, Kornela; Brodzisz, Agnieszka; Walczyna, Beata; Mielnik-Niedzielska, Grażyna

    2016-07-29

    Myxoma is a slow growing, benign neoplasm, which pathogenesis still remains disputed. The lesion has well-defined borders but a true capsule is absent. Because of that myxoma can be locally invasive causing bone destruction. A change is mainly observed among persons between 20-30 years of age and is very uncommon in the pediatric population. Most myxomas are observed in myocardium, but rarely may also manifest in the head and neck region. In the paper we describe an unusual case of myxoma of maxillary sinus in a female infant. Diagnostic challenges, treatment, outcome, post-operative follow-up are discussed as well as a review of the literature in order to present many features of this rare pathology. © 2016 MEDPRESS.

  20. Maxillary sinusitis with pulmonary tuberculosis.

    Science.gov (United States)

    Upadhyay, Rashmi; Prakash, Ved; Singh, Abhishek Bahadur; Saheer, S

    2014-08-01

    Tubercular infection of the nasal cavity is an infrequently encountered condition. More so, after the discovery of relevant antibiotics, nasal sinus tuberculosis is not commonly seen. Few cases have reported tuberculosis of the paranasal sinuses, nasopharynx and larynx. With the increasing incidence of HIV, these rare forms of infection have started re-emerging. We present a case of a middle aged man presenting with nasal cavity lesion along with pulmonary tuberculosis, which came to light only after the diagnosis of maxillary sinus tuberculosis. 2014 BMJ Publishing Group Ltd.

  1. Aggressiv fibromatose i sinus frontalis

    DEFF Research Database (Denmark)

    Godballe, Christian; Jensen, Søren Gade; Krogdahl, Annelise

    2009-01-01

    Aggressive fibromatosis (AF) is a benign tumour with expansive and locally invasive growth. It is very rarely seen in the head and neck area. We present a 52-year-old female patient with AF localized to the left frontal sinus. The condition was initially mistaken for chronic sinusitis however...... computed tomography indicated tumour. A biopsy showed AF and the patient received surgical treatment. Symptoms, signs and treatment are discussed. It is concluded that AF in the sino-nasal tract is a rare, but potentially life threatening condition which might be mistaken for a simple sinusitis...

  2. Radiology in diagnostics of odontogenic maxillary sinusitis

    Directory of Open Access Journals (Sweden)

    Chekhonatskaya М.L

    2013-09-01

    Full Text Available The purpose: to prove diagnostic capabilities of modern radiation techniques in odontogenic maxillary sinusitis. Material and methods: The study involved 546 patients with sinusitis. The following methods have been used: X-ray of the paranasal sinuses, contrast maxillary sinus radiography, contact intraoral radiographs, orthopantomography, computer tomography and magnetic resonance imaging. Results. In 7,9% of cases the presence of odontogenic sinusitis has been established, in 92,1 % rhinogenous sinusitis has been revealed. The work provides information about the effectiveness of various radiation techniques in the diagnosis of odontogenic sinusitis. Conclusion. For suspected odontogenic sinusitis, treatment of choice includes the combined use of X-ray of the paranasal sinuses in the mentoanterior projection and contact intraoral radiographs of «causal teeth». Computer tomography is the most informative additional method to clarify the diagnosis of odontogenic sinusitis.

  3. Oculo-peritoneal shunt: draining aqueous humor to the peritoneum

    Directory of Open Access Journals (Sweden)

    Ana Maldonado-Junyent

    2015-04-01

    Full Text Available In 2010, there were estimated to be approximately 60.5 million people with glaucoma. This number is expected to increase to 79.6 million by 2020. In 2010, there were 8.4 million people with bilateral blindness caused by glaucoma, and this number is expected in increase to 11.2 million by 2020. Filtering implants are special devices that have been developed to reduce intraocular pressure in patients with refractory glaucoma. The success rate of these implants is relatively low, and they continue to fail over time. To avoid failure caused by the formation of scar tissue around the implants, attempts have been made to drain the aqueous humor to various sites, including the venous system, lacrimal sac, sinuses, and conjunctival fornix. Recently, a system to shunt aqueous humor from the anterior chamber to the peritoneum has been developed. The surgical technique involved in this system is a modification of the technique currently used by neurosurgeons for the treatment of hydrocephalus. We present the first case operated using this technique.

  4. Idiopathic intracranial hypertension: lumboperitoneal shunts versus ventriculoperitoneal shunts--case series and literature review.

    LENUS (Irish Health Repository)

    Abubaker, Khalid

    2011-02-01

    Idiopathic intracranial hypertension (IIH) is an uncommon but important cause of headache that can lead to visual loss. This study was undertaken to review our experience in the treatment of IIH by neuronavigation-assisted ventriculoperitoneal (VP) shunts with programmable valves as compared to lumboperitoneal (LP) shunts.

  5. GABA Shunt in Durum Wheat

    Directory of Open Access Journals (Sweden)

    Petronia Carillo

    2018-02-01

    Full Text Available Plant responses to salinity are complex, especially when combined with other stresses, and involve many changes in gene expression and metabolic fluxes. Until now, plant stress studies have been mainly dealt only with a single stress approach. However, plants exposed to multiple stresses at the same time, a combinatorial approach reflecting real-world scenarios, show tailored responses completely different from the response to the individual stresses, due to the stress-related plasticity of plant genome and to specific metabolic modifications. In this view, recently it has been found that γ-aminobutyric acid (GABA but not glycine betaine (GB is accumulated in durum wheat plants under salinity only when it is combined with high nitrate and high light. In these conditions, plants show lower reactive oxygen species levels and higher photosynthetic efficiency than plants under salinity at low light. This is certainly relevant because the most of drought or salinity studies performed on cereal seedlings have been done in growth chambers under controlled culture conditions and artificial lighting set at low light. However, it is very difficult to interpret these data. To unravel the reason of GABA accumulation and its possible mode of action, in this review, all possible roles for GABA shunt under stress are considered, and an additional mechanism of action triggered by salinity and high light suggested.

  6. Paranasal sinus obliteration in Wegener granulomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Paling, M.R.; Roberts, R.L.; Fauci, A.S.

    1982-08-01

    The authors report 14 cases of Wegener granulomatosis in which one or more paranasal sinuses were obliterated by bone. The maxillary antra were involved in all cases, with the other sinuses being affected less frequently. These changes are thought to result from chronic bacterial sinusitis superimposed on the granulomatous vasculitic process. Computed tomography dramatically demonstrated the bone changes, consisting of a combination of sinus wall thickening and trabeculated new bone formation within the sinuses.

  7. OPTIMIZATION OF SECRETOLYTIC TREATMENT OF ACUTE SINUSITIS

    Directory of Open Access Journals (Sweden)

    S.V. Makarevich

    2008-01-01

    Full Text Available Efficiency of sinupret in children with acute sinusitis as a drug with serolytic action, is studied. it is established that secretolytic therapy in case of acute sinusitis, aimed at the improvement of drainage and ventilation function of paranasal sinuses, is one of the potentially productive directions of nonbinvasive methods of treatment of acute sinusitis.Key words: children, acute sinusitis, secretolytic treatment.

  8. When Sinuses Attack! (For Kids)

    Science.gov (United States)

    ... People, Places & Things That Help Feelings Q&A Movies & More Quizzes Kids' Dictionary of Medical Words En ... nose, the sinuses are lined with a moist, thin layer of tissue called a mucous membrane (say: ...

  9. Antibiotics for acute maxillary sinusitis

    DEFF Research Database (Denmark)

    Ahovuo-Saloranta, Anneli; Borisenko, Oleg V; Kovanen, Niina

    2008-01-01

    BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes...... are the most effective. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, Issue 3); MEDLINE (1950 to May 2007) and EMBASE (1974 to June 2007). SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing antibiotics with placebo...... or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search results, extracted...

  10. Complications of pediatric paranasal sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Reid, Janet R. [The Children' s Hospital, The Cleveland Clinic, Pediatric Radiology, Cleveland, OH (United States)

    2004-12-01

    Acute paranasal sinus infection in children is often diagnosed clinically without the need for radiographic confirmation. Most cases have a favorable outcome following appropriate antibiotic therapy. A small percentage of cases where symptoms and signs are persistent or severe will require emergent imaging to rule out complications related to local spread of disease intraorbitally or intracranially. A strong index of suspicion is required in such cases, and cross-sectional imaging evaluation with CT and MRI should include axial and coronal images of the paranasal sinuses and, where appropriate, the orbits and brain (with attention to the cavernous sinus). There is no role for plain radiography in the evaluation of the complications of acute sinusitis in the pediatric patient. (orig.)

  11. Portal hypertension: A critical appraisal of shunt procedures with emphasis on distal splenorenal shunt in children

    Directory of Open Access Journals (Sweden)

    Nitin Sharma

    2014-01-01

    Full Text Available Background: Extrahepatic portal venous obstruction (EHPVO is the most common cause of pediatric portal hypertension. We analyzed the investigative protocol and results of portosystemic shunts in this group of patients. Materials and Methods: A total of 40 consecutive children aged below 12 years operated with a diagnosis of extra-hepatic portal hypertension formed the study group. Historical data and clinical data were collected. All patients underwent upper gastrointestinal endoscopy, ultrasound Doppler and computed tomographic portogram pre-operatively and post-operatively. Results with respect to shunt patency, hypersplenism and efficacy of different radiological investigations were collected. Results: A total of 40 patients, 28 boys and 12 girls constituted the study group. Lienorenal shunt (LRS was performed in 14 patients; distal splenorenal shunt in 21 patients and side-to-side lienorenal shunt in 4 patients, inferior mesenteric renal shunt was performed in 1 patient. Follow-up ranged from 36 to 70 months. At a minimum follow-up of 3 years, 32 (80% patients were found to have patent shunts. Patent shunts could be visualized in 30/32 patients with computer tomographic portogram (CTP and 28/32 with ultrasound. Varices regressed completely in 26/32 patients and in the rest incomplete regression was seen. Spleen completely regressed in 19/25 patients. Hypersplenism resolved in all patients with patent shunts. Conclusions: Portosystemic shunting in children with EHPVO is a viable option. While long-term cure rates are comparable with sclerotherapy, repeated hospital visits are reduced with one time surgery. Pre-operative and post-operative assessment can be performed with complimentary use of ultrasound, CTP and endoscopy.

  12. Venous Sinus Stenting in the Management of Patients with Intracranial Hypertension Manifesting with Skull Base Cerebrospinal Fluid Leaks.

    Science.gov (United States)

    Iyer, Rajiv R; Solomon, David; Moghekar, Abhay; Goodwin, C Rory; Stewart, C Matthew; Ishii, Masaru; Gailloud, Philippe; Gallia, Gary L

    2017-10-01

    A subset of patients with skull base cerebrospinal fluid (CSF) leaks are found to have elevated intracranial pressure (ICP). In these patients, elevated ICP is thought to contribute to both the pathophysiology of the leak and postoperative leak recurrences. Current strategies for postoperative ICP control include medical therapy and shunting procedures. The aim of this study is to report the use of venous sinus stenting (VSS) in the management of patients with skull base CSF leaks caused by elevated ICP. We performed a retrospective investigation of 2 patients who underwent surgical repair of skull base CSF leaks and were found to have elevated ICP associated with venous sinus stenosis and subsequently treated with VSS. Two patients underwent successful surgical repair of skull base CSF leaks with perioperative ICP monitoring via temporary lumbar catheters. Postoperative CSF pressure measurement demonstrated elevated ICP. Both patients were found to have venous sinus stenosis on further workup and subsequently underwent VSS for treatment of intracranial hypertension. Both patients had improvement in their symptoms with no evidence of recurrent CSF leak at follow-up. Patients with skull base CSF leaks of unknown etiology should undergo CSF pressure monitoring postoperatively and, if found to be elevated, be treated for intracranial hypertension. In patients unresponsive to, or intolerant of, medical therapy, VSS can provide an alternative option to medical and surgical shunting procedures for treatment of intracranial hypertension in patients with skull base CSF leaks and venous sinus stenosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Cavernous sinus thrombosis: current therapy.

    Science.gov (United States)

    Desa, Valmont; Green, Ryan

    2012-09-01

    Cavernous sinus thrombosis represents a rare but devastating disease process that may be associated with significant long-term patient morbidity or mortality. The prompt recognition and management of this problem is critical. However, most of the literature involves case-specific discussions. The purpose of this article was to review the literature and present current recommendations for the treatment of cavernous sinus thrombosis. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Maxillary sinusitis with pulmonary tuberculosis

    OpenAIRE

    Upadhyay, Rashmi; Prakash, Ved; Singh, Abhishek Bahadur; Saheer, S

    2014-01-01

    Tubercular infection of the nasal cavity is an infrequently encountered condition. More so, after the discovery of relevant antibiotics, nasal sinus tuberculosis is not commonly seen. Few cases have reported tuberculosis of the paranasal sinuses, nasopharynx and larynx. With the increasing incidence of HIV, these rare forms of infection have started re-emerging. We present a case of a middle aged man presenting with nasal cavity lesion along with pulmonary tuberculosis, which came to light on...

  15. Sinus Balloon Dilation as Treatment for Acute Sphenoid Sinusitis with Impaired Vision for a Child

    Directory of Open Access Journals (Sweden)

    Yin Zhao

    2016-01-01

    Full Text Available This paper is about sinus balloon dilatation in treatment of acute left sphenoid sinusitis with left impaired vision in a child. Balloon catheter dilatation (BCD of the sinus ostia is a new technique. It has been shown to be a minimally invasive technique to manage chronic sinusitis. However, this method is rarely used in the treatment of acute sinusitis. So far, we know of no reported cases of sinus balloon dilatation in treatment of this case, especially for children.

  16. Focal stenosis of the sigmoid sinus causing intracranial venous hypertension: Case report, endovascular management, and review of the literature.

    Science.gov (United States)

    Honarmand, Amir R; Hurley, Michael C; Ansari, Sameer A; Alden, Tord D; Kuhn, Ryan; Shaibani, Ali

    2016-04-01

    Regardless of the underlying pathology, elevated intracranial pressure is the endpoint of any impairment in either cerebrospinal fluid (CSF) absorption (including arachnoid villi) or intracranial venous drainage. In all age groups, the predominant final common pathway for CSF drainage is the dural venous sinus system. Intracranial venous hypertension (ICVH) is an important vascular cause of intracranial hypertension (and its subsequent sequelae), which has often been ignored due to excessive attention to the arterial system and, specifically, arteriovenous shunts. Various anatomical and pathological entities have been described to cause ICVH. For the second time, we present a unique case of severe focal stenosis in the distal sigmoid sinus associated with concurrent hypoplasia of the contralateral transverse sinus causing a significant pressure gradient and intracranial hypertension, which was treated with endovascular stent placement and angioplasty. © The Author(s) 2016.

  17. Simulation model for port shunting yards

    Science.gov (United States)

    Rusca, A.; Popa, M.; Rosca, E.; Rosca, M.; Dragu, V.; Rusca, F.

    2016-08-01

    Sea ports are important nodes in the supply chain, joining two high capacity transport modes: rail and maritime transport. The huge cargo flows transiting port requires high capacity construction and installation such as berths, large capacity cranes, respectively shunting yards. However, the port shunting yards specificity raises several problems such as: limited access since these are terminus stations for rail network, the in-output of large transit flows of cargo relatively to the scarcity of the departure/arrival of a ship, as well as limited land availability for implementing solutions to serve these flows. It is necessary to identify technological solutions that lead to an answer to these problems. The paper proposed a simulation model developed with ARENA computer simulation software suitable for shunting yards which serve sea ports with access to the rail network. Are investigates the principal aspects of shunting yards and adequate measures to increase their transit capacity. The operation capacity for shunting yards sub-system is assessed taking in consideration the required operating standards and the measure of performance (e.g. waiting time for freight wagons, number of railway line in station, storage area, etc.) of the railway station are computed. The conclusion and results, drawn from simulation, help transports and logistics specialists to test the proposals for improving the port management.

  18. Clinical implications of pulmonary shunting on contrast echocardiography

    NARCIS (Netherlands)

    Velthuis, S.

    2014-01-01

    Pulmonary right-to-left shunting can be encountered using transthoracic contrast echocardiography (TTCE) with agitated saline. Diseases associated with prevalence of pulmonary shunting on saline TTCE include hereditary haemorrhagic telangiectasia (HHT), hepatopulmonary syndrome and some congenital

  19. Stereotactic ventriculoperitoneal shunt for idiopathic intracranial hypertension: technical note.

    Science.gov (United States)

    Tulipan, N; Lavin, P J; Copeland, M

    1998-07-01

    Lumboperitoneal shunting is the bastion of neurosurgical management for idiopathic intracranial hypertension (IIH). However, recent studies document a high failure rate for this procedure. The present study was designed to explore the feasibility of placing ventriculoperitoneal shunts under stereotactic control into patients with IIH as an alternative to lumboperitoneal shunting. Seven patients with IIH for whom medical management had failed underwent stereotactic implantation of ventriculoperitoneal shunts. Shunt placement was successful and uncomplicated in each case. Five of seven patients experienced complete resolution of papilledema. The remaining two patients showed resolving papilledema. Six of seven patients experienced resolution of headache. The remaining patient continued to have headaches despite a radionuclide study demonstrating normal shunt function. Our results suggest that stereotactic ventriculoperitoneal shunting may be a reasonable alternative to lumboperitoneal shunting in those patients with IIH who require surgical intervention.

  20. Balanced calibration of resonant shunt circuits for piezoelectric vibration control

    DEFF Research Database (Denmark)

    Høgsberg, Jan; Krenk, Steen

    2012-01-01

    Shunting of piezoelectric transducers and suitable electric circuits constitutes an effective passive approach to resonant vibration damping of structures. Most common design concepts for resonant resistor-inductor (RL) shunt circuits rely on either maximization of the attainable modal damping...

  1. Laparoscopic insertion of lumbar peritoneal shunts for idiopathic ...

    African Journals Online (AJOL)

    Background: The treatment of idiopathic intracranial hypertension varies from simple observation to the mechanical diversion of cerebrospinal fluid. Objective: To describe our technique and initial experience with the laparoscopic insertion of lumbarperitoneal shunts. Conclusion: Lumbarperitoneal shunts should be ...

  2. Quantitative measurement of CSF shunt flow and evaluation of shunt function in hydrocephalic patients

    Energy Technology Data Exchange (ETDEWEB)

    Ohya, M.; Tsugane, R.; Ito, M.; Nojiri, K.; Sato, O.; Ikei, K. (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine)

    1981-10-01

    Seventeen hydrocephalic children and adults with a variety of etiologies were studied. Recent data of CT scan, findings of flushing reservoir on digital palpation and their clinical pictures were also recorded. The flow rates were calculated as 0.03 - 0.33 ml/min when the shunting system appeared to be functioning properly and radionuclide imaging of time activity curves was expressed as smooth figures with peaks at the two regions of interest. In patients with the slit-like ventricle, the flow rates were expressed as 0.09 - 0.16 ml/min, however the palpation of the flushing reservoir suggested the malfunction of the shunt without refilling of the flushing reservoir in such a case. A hydrocephalic infant continued to have a tense fontanelle and head size remained unchanged after the V-P shunt with Pudenz high pressure valve had been installed. Radioactivity persisted for 15 min or more in the flushing reservoir after its introduction. Pumping maneuver of the flushing reservoir revealed a good CSF flow through the distal catheter. In this case, the shunt was patent but only poorly functioning due to the high pressure valve. Radioactivity was stayed in the injected site in the case of shunt obstruction. Reviewing these results, it is concluded that the quantitative measurement of the CSF shunt flow rates, with radionuclide imaging of time activity curves, makes it possible to evaluate more accurately the shunt patency and its functions.

  3. Radionuclide demonstration of intrapulmonary shunting in cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Bank, E.R.; Thrall, J.H.; Dantzker, D.R.

    1983-05-01

    The association of hepatic cirrhosis and severe arterial hypoxemia has been well described. Although alterations in ventilatory function may partially account for the hypoxemia, the principal mechanism is thought to be a microangiopathic change in the pulmonary vasculature resulting in intrapulmonary arteriovenous shunting with resultant systemic desaturation. Whole-body radionuclide scans with technetium-99m macroaggregated albumin labeling have been diagnostic of right-to-left shunting by their demonstration of tracer accumulation within the extrapulmonary circulation. A case of severe pulmonary arteriovenous shunting in an alcoholic patient in whom hepatic disease had not been of apparent clinical significance before radionuclide scanning is reported. He did not have cuntaeous angiomata as have all other patients with alcoholic cirrhosis and hypoxemia.

  4. Radionuclide demonstration of intrapulmonary shunting in cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Bank, E.R.; Thrall, J.H.; Dantzker, D.R.

    1983-05-01

    The association of hepatic cirrhosis and severe arterial hypoxemia has been well described. Although alterations in ventilatory function may partially account for the hypoxemia, the principal mechanism is thought to be a microangiopathic change in the pulmonary arteriovenous shunting with resultant systemic desaturation. Whole-body radionuclide scans with technetium-99m macroaggrregated albumin (/sup 99m/Tc MAA) labeling have been diagnostic of right-to-left shunting by their demonstration of tracer accumulation within the extrapulmonary circulation. A case of severe pulmonary arteriovenous shunting in an alcoholic patient in whom hepatic disease had not been of apparent clinical significance before radionuclide scanning is reported. He did not have cutaneous angiomata as have all other patients with alcoholic cirrhosis and hypoxemia.

  5. Sinus Venosus Atrial Septal Defect

    Science.gov (United States)

    2010-04-01

    the atria. The presence of PAPVR compounds the problem with additional left-to-right shunt pathways. While the exact embryology is controversial...Cardiology 2001; 87:305-09. 4. Sadley TW. Langman’s Medical Embryology , 7th ed. Williams and Wilkins 1995: 191-201. 5. Al Zaghal AM et. al

  6. Spontaneous Bilateral Carotid-Cavernous Fistulas Secondary to Cavernous Sinus Thrombosis.

    Science.gov (United States)

    Al-Mufti, Fawaz; Amuluru, Krishna; El-Ghanem, Mohammad; Changa, Abhinav R; Singh, Inder Paul; Gandhi, Chirag D; Prestigiacomo, Charles J

    2017-04-01

    Bilateral carotid cavernous fistulas are rare entities that can cause debilitating symptoms and can lead to more severe consequences if left untreated. Therefore, the recognition and adequate treatment of these pathologies is very important. We present 2 cases of bilateral carotid cavernous fistulas that arose as a result of cavernous sinus thrombosis. We review the literature and discuss the pathophysiology, symptomatology, management, and treatment of bilateral carotid cavernous fistulas. Within our own cases, treatment of the patients was varied. The patient in case 1 was successfully treated with endovascular therapy after a failed trial of anticoagulation. The patient in case 2 demonstrated resolution of bilateral carotid cavernous fistulas after anticoagulation therapy. Case 2 highlights the fact that certain cases of bilateral carotid cavernous fistulas due to cavernous sinus thrombosis may benefit from extensive anticoagulation therapy. If anticoagulation therapy is unsuccessful, endovascular therapy may prove beneficial in resolving the fistulous shunt. Copyright © 2017 by the Congress of Neurological Surgeons.

  7. Syrinx to Subarachnoid Shunting for Syringomyelia.

    Science.gov (United States)

    Davidson, Keryn A; Rogers, Jeffrey M; Stoodley, Marcus A

    2017-10-07

    Surgery for syringomyelia generally aims to treat the underlying cause, if it is known. Optimal management is unclear for idiopathic syringomyelia, or when treatment of the putative cause has failed or is high risk. Syrinx to subarachnoid shunting is an option for these cases; a series is reported to assess the outcomes of this approach. We retrospectively analyzed the clinical and radiologic features of a consecutive series of patients with syringomyelia treated with syrinx to subarachnoid shunting. Forty-one patients (19 male, 4-79 years old) were treated from 2000 to 2016, including 15 patients with idiopathic syringomyelia, 13 with spinal trauma, 5 with Chiari malformation, 4 with arachnoiditis, 3 with tethered cord, and 1 with arachnoid bands. The patients were treated with a syrinx to subarachnoid shunt, and a subset also underwent expansile duraplasty. At follow-up (3-108 months, mean 36 months) syrinx size was reduced in 37 patients, and there was improvement or stabilization of symptoms in all but 1 patient. Three patients had temporary lower limb sensory symptoms after surgery. Other complications were 2 transient cerebrospinal fluid leaks, a pseudomeningocoele, and 1 postoperative myocardial infarction. Two cases of shunt dislodgement required reoperation, and a third case required early reoperation for an enlarging syrinx. There were no cases of shunt blockage or infection. Syrinx to subarachnoid shunting is a safe and effective treatment for idiopathic syringomyelia and for patients who are not suitable for, or have not responded to, other treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Collagen plug occlusion of Molteno tube shunts.

    Science.gov (United States)

    Stewart, W; Feldman, R M; Gross, R L

    1993-01-01

    We report five patients in whom collagen lacrimal plugs were used to temporarily occlude the lumen of Molteno shunts to prevent early postoperative hypotony. Only one eye, with a double plate, developed hypotony and a flat anterior chamber that required reformation. However, in three patients, the collagen plugs did not dissolve and had to be removed surgically to lower the intraocular pressure. Although the semipermeability of collagen is desirable, its unpredictable degradation renders it unsuitable for temporary occlusion of tube shunts. Other biodegradable materials may be more appropriate for this purpose.

  9. Distal splenorenal shunt with partial spleen resection

    Directory of Open Access Journals (Sweden)

    Gajin Predrag

    2007-01-01

    Full Text Available Introduction: Hypersplenism is a common complication of portal hypertension. Cytopenia in hypersplenism is predominantly caused by splenomegaly. Distal splenorenal shunt (Warren with partial spleen resection is an original surgical technique that regulates cytopenia by reduction of the enlarged spleen. Objective. The aim of our study was to present the advantages of distal splenorenal shunt (Warren with partial spleen resection comparing morbidity and mortality in a group of patients treated by distal splenorenal shunt with partial spleen resection with a group of patients treated only by a distal splenorenal shunt. Method. From 1995 to 2003, 41 patients with portal hypertension were surgically treated due to hypersplenism and oesophageal varices. The first group consisted of 20 patients (11 male, mean age 42.3 years who were treated by distal splenorenal shunt with partial spleen resection. The second group consisted of 21 patients (13 male, mean age 49.4 years that were treated by distal splenorenal shunt only. All patients underwent endoscopy and assessment of oesophageal varices. The size of the spleen was evaluated by ultrasound, CT or by scintigraphy. Angiography was performed in all patients. The platelet and white blood cell count and haemoglobin level were registered. Postoperatively, we noted blood transfusion, complications and total hospital stay. Follow-up period was 12 months, with first checkup after one month. Results In the first group, only one patient had splenomegaly postoperatively (5%, while in the second group there were 13 patients with splenomegaly (68%. Before surgery, the mean platelet count in the first group was 51.6±18.3x109/l, to 118.6±25.4x109/l postoperatively. The mean platelet count in the second group was 67.6±22.8x109/l, to 87.8±32.1x109/l postoperatively. Concerning postoperative splenomegaly, statistically significant difference was noted between the first and the second group (p<0.05. Comparing the

  10. The genetic background of congenital portosystemic shunts in dogs

    NARCIS (Netherlands)

    van Steenbeek, F.G.|info:eu-repo/dai/nl/314417958

    2013-01-01

    Congenital disorders of the hepatic portal vasculature are rare in man, but occur frequently in certain dog breeds. Congenital portosystemic shunts (CPSS) is the collective term for two subtypes; extrahepatic portosystemic shunts (EHPSS) and intrahepatic portosystemic shunts (IHPSS). The dog is very

  11. Round worm migration along ventriculoperitoneal shunt tract: a rare complication.

    Directory of Open Access Journals (Sweden)

    Agarwal P

    2000-01-01

    Full Text Available Though a ventriculoperitoneal shunt has been associated with myriads of unusual complications, so has been that with roundworms. A case of a three-year-old boy is presented who had an unusual complication of roundworm migration along the shunt tract that presented as shunt tract infection.

  12. 49 CFR 236.60 - Switch shunting circuit; use restricted.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Switch shunting circuit; use restricted. 236.60 Section 236.60 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... Instructions: All Systems Track Circuits § 236.60 Switch shunting circuit; use restricted. Switch shunting...

  13. 49 CFR 236.725 - Circuit, switch shunting.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Circuit, switch shunting. 236.725 Section 236.725 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Circuit, switch shunting. A shunting circuit which is closed through contacts of a switch circuit...

  14. an unusual cause of post-shunt intestinal obstruction

    African Journals Online (AJOL)

    Ventriculoperitoneal (VP) shunt is the most widely used procedure for the management of hydrocephalus. Various complications, including disconnection, breaking, kinking and tip occlusion of the tube, cerebrospinal fluid loculation, shunt infection, intestinal obstruction, migration of the shunt and perforation of the internal ...

  15. A New Mechanism of Cerebrospinal Fluid Leakage after Lumboperitoneal Shunt: A Theory of Shunt Side Hole—Case Report

    OpenAIRE

    MATSUBARA, Teppei; ISHIKAWA, Eiichi; HIRATA, Koji; MATSUDA, Masahide; AKUTSU, Hiroyoshi; MASUMOTO, Tomohiko; ZABORONOK, Alexander; MATSUMURA, Akira

    2013-01-01

    Cerebrospinal fluid (CSF) overdrainage after lumboperitoneal (LP) shunt placement for the patients with idiopathic normal pressure hydrocephalus (iNPH) is mainly caused by insufficient management of pressure settings of the shunt valve and/or siphon effect of shunt systems induced by the patient's postural changes. We here report a unique case of intracranial hypotension (IH) due to CSF leakage after LP shunt placement in which another mechanism leads to the CSF leakage. A 67-year-old man suf...

  16. Ruptured sinus of Valsalva found incidentally in a patient with tetralogy of Fallot.

    Science.gov (United States)

    Mithani, Ali A; Polimenakos, Anastasios C; Santucci, Barbara A

    2013-01-01

    Ruptured sinus Valsalva aneurysm (SVA) in a patient with tetralogy of Fallot is a very rare cardiac complication. This report describes the case of a 10-year-old Hispanic girl who presented to her cardiologist for a routine transthoracic echocardiography (TTE), which showed a ruptured sinus of Valsalva, with left-to-right shunting noted from the right cusp to the right ventricular outflow tract and pulmonic insufficiency. The patient underwent right and left heart catheterization with transesophageal echocardiography guidance and closure of the ruptured sinus of Valsalva with an Amplatzer muscular ventricular septal defect (VSD) device. Later that day, after the procedure, it was noted that the patient had a recurrence of continuous murmur. The TTE did not visualize the Amplatzer VSD device, and chest X-ray showed that the device had embolized to the right pulmonary artery. The device was successfully retrieved percutaneously. The patient returned 2 weeks later for surgical repair of a ruptured SVA and pulmonary valve replacement, which went well. This case report is the first to describe congenital rupture of a Valsalva aneurysm in a patient with tetralogy of Fallot. The conventional treatment for a ruptured sinus of Valsalva is surgical, although transcatheter approaches have been used increasingly in recent years.

  17. Nonseptic and Septic Lateral Sinus Thrombosis: A Review

    OpenAIRE

    Viswanatha, B.; Thriveni, C. N.; Naseeruddin, Khaja

    2011-01-01

    Thrombosis of the lateral sinus can be classified into nonseptic lateral sinus thrombosis and septic lateral sinus thrombosis. Nonseptic lateral sinus thrombosis differs from septic lateral sinus thrombosis in that it is not associated with ear or sinus infection. Etiologies of these conditions are different and hence the management of these conditions is different. Nonseptic lateral sinus thrombosis requires medical line of management and anticoagulant therapy, where as septic lateral sinus ...

  18. Clinical Features and Treatments of Odontogenic Sinusitis

    National Research Council Canada - National Science Library

    Lee, Kyung Chul; Lee, Sung Jin

    2010-01-01

    The aim of this study was to investigate how clinical features such as sex, age, etiologic factors, and presenting symptoms of odontogenic sinusitis are differentiated from other types of sinusitis...

  19. Maxillary sinus function after sinus lifts for the insertion of dental implants

    NARCIS (Netherlands)

    Timmenga, NM; Raghoebar, GM; Boering, G; VanWeissenbruch, R

    Purpose: The influence of bone augmentation of the floor of the maxillary sinus for the insertion of denial implants on sinus function has not been well investigated, In this study, the influence of the sinus lift on the development of maxillary sinus pathology was evaluated using generally accepted

  20. Train shunting at a workshop area

    DEFF Research Database (Denmark)

    Jacobsen, Per Munk; Pisinger, David

    2011-01-01

    We consider the problem of planning the shunting of train units at a railway workshop area. Before and after the maintenance check, a train unit is parked at a depository track. The problem is to schedule the trains to workshops and depot tracks in order to complete the repairs as soon as possibl...

  1. Ventriculoperitoneal shunt infection caused by Bifidobacterium breve.

    Science.gov (United States)

    Suwantarat, Nuntra; Romagnoli, Mark; Wakefield, Teresa; Carroll, Karen C

    2014-08-01

    Bifidobacterium breve is a rare cause of human infections. Previously, bacteremia and meningitis caused by this organism linked to probiotic use have been reported in a neonate. We report the first case of a ventriculoperitoneal shunt infection caused by B. breve in an adult without a history of probiotic use. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Intrinsically shunted Josephson junctions for electronics applications

    Science.gov (United States)

    Belogolovskii, M.; Zhitlukhina, E.; Lacquaniti, V.; De Leo, N.; Fretto, M.; Sosso, A.

    2017-07-01

    Conventional Josephson metal-insulator-metal devices are inherently underdamped and exhibit hysteretic current-voltage response due to a very high subgap resistance compared to that in the normal state. At the same time, overdamped junctions with single-valued characteristics are needed for most superconducting digital applications. The usual way to overcome the hysteretic behavior is to place an external low-resistance normal-metal shunt in parallel with each junction. Unfortunately, such solution results in a considerable complication of the circuitry design and introduces parasitic inductance through the junction. This paper provides a concise overview of some generic approaches that have been proposed in order to realize internal shunting in Josephson heterostructures with a barrier that itself contains the desired resistive component. The main attention is paid to self-shunted devices with local weak-link transmission probabilities that are so strongly disordered in the interface plane that transmission probabilities are tiny for the main part of the transition region between two super-conducting electrodes, while a small part of the interface is well transparent. We discuss the possibility of realizing a universal bimodal distribution function and emphasize advantages of such junctions that can be considered as a new class of self-shunted Josephson devices promising for practical applications in superconducting electronics operating at 4.2 K.

  3. Penile gangrene following cavernoglandular shunt for priapism ...

    African Journals Online (AJOL)

    dressing. Penile skin developed, progressing from the glans to complete gangrene of the distal half of the penis. The patient had amputation of the gangrenous distal half of the penis, debridement of the skin necrosis of proximal half and skin grafting. Penile gangrene is a rare complication following cavernoglandular shunt ...

  4. Hydrocephalus, Ventriculo-Peritoneal shunt and

    African Journals Online (AJOL)

    Summary \\. A small number of patients with congenital hydrocephalus, who have been treated effectively with ventriculoperitoneal shunts, develop progressive increase in abdominalgirth, due to cerebrospinal fluid ascites. This abdominal distension can produce respiratory difficulties that require endotracheal intubation ...

  5. Anaesthetic management for ventriculoperitoneal shunt insertion in ...

    African Journals Online (AJOL)

    http://creativecommons.org/licenses/by-nc/3.0. Anaesthetic management for ventriculoperitoneal shunt insertion in an infant with Dandy–Walker Syndrome. Alastair Wayne Moodleya*, Steven Nelac , Eduard Oosthuizenac and Christina Lundgrenbc. aDepartment of Anaesthesia, Charlotte Maxeke Johannesburg Academic ...

  6. 21 CFR 886.3920 - Aqueous shunt.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Aqueous shunt. 886.3920 Section 886.3920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... 10993 ‘Biological Evaluation of Medical Devices—Part I: Evaluation and Testing,’ ” (2) “510(k) Sterility...

  7. Managing varices: drugs, bands, and shunts.

    Science.gov (United States)

    Opio, Christopher Kenneth; Garcia-Tsao, Guadalupe

    2011-09-01

    Drugs, bands, and shunts have all been used in the treatment of varices and variceal hemorrhage and have resulted in improved outcomes. However, the specific use of each of these therapies depends on the setting (primary or secondary prophylaxis, treatment of AVH) and on patient characteristics. The indications for each are summarized in Table 4.

  8. Platypnea-Orthodeoxia Syndrome: To Shunt or Not to Shunt, That is the Question.

    Science.gov (United States)

    Klein, Michael R; Kiefer, Todd L; Velazquez, Eric J

    2016-06-01

    Platypnea-orthodeoxia syndrome is a rare disease defined by dyspnea and deoxygenation, induced by an upright position, and relieved by recumbency. Causes include shunting through a patent foramen ovale and pulmonary arteriovenous malformations. A 79-year-old woman experienced 2 syncopal episodes at rest and presented at another hospital. In the emergency department, she was hypoxic, needing 6 L/min of oxygen. Her chest radiograph showed nothing unusual. Transthoracic echocardiograms with saline microcavitation evaluation were mildly positive early after agitated-saline administration, suggesting intracardiac shunting. She was then transferred to our center. Right-sided heart catheterization revealed no oximetric evidence of intracardiac shunting while the patient was supine and had a low right atrial pressure. However, her oxygen saturation dropped to 78% when she sat up. Repeat transthoracic echocardiography while sitting revealed a dramatically positive early saline microcavitation-uptake into the left side of the heart. Transesophageal echocardiograms showed a patent foramen ovale, with right-to-left shunting highly dependent upon body position. The patient underwent successful percutaneous patent foramen ovale closure, and her oxygen supplementation was suspended. In patients with unexplained or transient hypoxemia in which a cardiac cause is suspected, it is important to evaluate shunting in both the recumbent and upright positions. In this syndrome, elevated right atrial pressure is not necessary for significant right-to-left shunting. Percutaneous closure, if feasible, is first-line therapy in these patients.

  9. Systemic-pulmonary polytetrafluoroethylene shunts in palliative operations for congenital heart disease. Revival of the central shunt.

    Science.gov (United States)

    Amato, J J; Marbey, M L; Bush, C; Galdieri, R J; Cotroneo, J V; Bushong, J

    1988-01-01

    The concept of central shunting in smaller children with the Waterston shunt was initially well accepted. It has been abandoned because of the difficult estimation of lumen size, preferential flow to the right side, and difficulty in the take-down of the shunt. We have replaced the Waterston shunt with a short segment of polytetrafluoroethylene between the ascending aorta and the main pulmonary artery. From January 1979 to December 1986, 190 shunt operations were performed in 157 patients, with the use of 26 classic Blalock-Taussig shunts (13.7%), six Waterston shunts (3.1%), nine Glenn shunts (4.7%), 80 central aortopulmonary polytetrafluoroethylene shunts (42.2%), and 69 modified Blalock-Taussig shunts (36.3%). Polytetrafluoroethylene grafts were used for 149 of the 190 (78.4%) shunts. Overall mortality was 15.2%, with nine early deaths (4.7%) and 20 late deaths (10.5%). Deaths were due to the complex nature of the congenital anomaly or definitive surgical repair. The patients weighed from 1.6 to 48 kg and ages ranged from 1 day to 22 years. We have modified our technique so that (1) graft length is less than 0.5 cm and both ends are beveled, (2) the aortotomy is fashioned with a punch, (3) the center of the polytetrafluoroethylene graft is never clamped, (4) heparin is given during the construction of the shunt, and (5) aspirin (10 mg/kg/day) is administered daily. Patency ranges from 1 to 4 years. We conclude that the polytetrafluoroethylene shunt provides excellent palliation and that the central shunt, in the smaller child and infant, offers the benefits of shunting without distortion of the peripheral pulmonary arteries.

  10. Passively Shunted Piezoelectric Damping of Centrifugally-Loaded Plates

    Science.gov (United States)

    Duffy, Kirsten P.; Provenza, Andrew J.; Trudell, Jeffrey J.; Min, James B.

    2009-01-01

    Researchers at NASA Glenn Research Center have been investigating shunted piezoelectric circuits as potential damping treatments for turbomachinery rotor blades. This effort seeks to determine the effects of centrifugal loading on passively-shunted piezoelectric - damped plates. Passive shunt circuit parameters are optimized for the plate's third bending mode. Tests are performed both non-spinning and in the Dynamic Spin Facility to verify the analysis, and to determine the effectiveness of the damping under centrifugal loading. Results show that a resistive shunt circuit will reduce resonant vibration for this configuration. However, a tuned shunt circuit will be required to achieve the desired damping level. The analysis and testing address several issues with passive shunt circuit implementation in a rotating system, including piezoelectric material integrity under centrifugal loading, shunt circuit implementation, and tip mode damping.

  11. Free floating ventricular shunt catheter between lateral ventricles: a case report of an unusual ventriculoperitoneal shunt complication.

    Science.gov (United States)

    Erol, Fatih Serhat; Cakin, Hakan; Ozturk, Sait; Donmez, Osman; Kaplan, Metin

    2013-01-01

    Ventriculoperitoneal (VP) shunt proximal tip disconnection is rarely seen as a shunt complication. Shunt dysfunction and hydrocephaly can develop due to this disconnection. Presented here is a case of a disconnection of the ventricular catheter from the shunt valve, which passed between both lateral ventricles by free floating in the brain CT. The patient was operated on for hydrocephaly. The dysfunctional shunt valve and peritoneal catheter were removed and a new VP shunt system was implemented. Although some publications report that the ventricular catheter can be disconnected from the shunt valve, can adhere to the intraventricular structures, and can be a source of infection, no studies similar to the current case were found in the literature reporting a free floating ventricular catheter between the lateral ventricles.

  12. Sinus Histiocytosis with Massive Lymphadenopathy

    African Journals Online (AJOL)

    1974-03-09

    Mar 9, 1974 ... REPORT OF TWO ADDITIONAL CASES WITH ULTRASTRUCTURAL. OBSERVATIONS c. C. SUNCLAIR~NUTH. L. B. KAHN. C. J. UYS. SUMMARY. Two cases of a recently described entity, 'sinus histio- cytosis with massive lymphadenopathy,' occurring in Black males, are reported. Prominent cervical ...

  13. Systemic corticosteroids for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Hayward, G.; Heneghan, C.J.; Mar, C.B. Del; Perera, R.; Glasziou, P.P.; Rovers, M.M.

    2014-01-01

    BACKGROUND: Acute sinusitis is the inflammation and swelling of the nasal and paranasal mucous membranes and is a common reason for patients to seek primary care consultations. The related impairment of daily functioning and quality of life is attributable to symptoms such as facial pain and nasal

  14. Silent sinus syndrome: An imploding antrum syndrome

    Directory of Open Access Journals (Sweden)

    Sneha H Choudhary

    2016-01-01

    Full Text Available Silent sinus syndrome (SSS is a rare entity that is associated with spontaneous, painless, unilateral enophthalmos and hypoglobus resulting from downward bowing of the orbital floor in the absence of any symptomatic sinonasal disease. The diagnosis is suspected clinically, but it is confirmed radiologically by its characteristic imaging features that include maxillary sinus outlet obstruction, sinus opacification and sinus volume loss caused by inward retraction of the sinus walls. The purpose of this article is to acquaint the reader with the clinical and imaging features of the SSS, along with a brief discussion about its pathogenesis and treatment, which is relatively unknown among oral and maxillofacial radiologists.

  15. Pathological Predictors of Shunt Stenosis and Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt

    Directory of Open Access Journals (Sweden)

    Fuliang He

    2016-01-01

    Full Text Available Background. Transjugular intrahepatic portosystemic shunt (TIPS is an artificial channel from the portal vein to the hepatic vein or vena cava for controlling portal vein hypertension. The major drawbacks of TIPS are shunt stenosis and hepatic encephalopathy (HE; previous studies showed that post-TIPS shunt stenosis and HE might be correlated with the pathological features of the liver tissues. Therefore, we analyzed the pathological predictors for clinical outcome, to determine the risk factors for shunt stenosis and HE after TIPS. Methods. We recruited 361 patients who suffered from portal hypertension symptoms and were treated with TIPS from January 2009 to December 2012. Results. Multivariate logistic regression analysis showed that the risk of shunt stenosis was increased with more severe inflammation in the liver tissue (OR, 2.864; 95% CI: 1.466–5.592; P=0.002, HE comorbidity (OR, 6.266; 95% CI, 3.141–12.501; P<0.001, or higher MELD score (95% CI, 1.298–1.731; P<0.001. Higher risk of HE was associated with shunt stenosis comorbidity (OR, 6.266; 95% CI, 3.141–12.501; P<0.001, higher stage of the liver fibrosis (OR, 2.431; 95% CI, 1.355–4.359; P=0.003, and higher MELD score (95% CI, 1.711–2.406; P<0.001. Conclusion. The pathological features can predict individual susceptibility to shunt stenosis and HE.

  16. Cranial dural arteriovenous shunts. Part 1. Anatomy and embryology of the bridging and emissary veins.

    Science.gov (United States)

    Baltsavias, Gerasimos; Parthasarathi, Venkatraman; Aydin, Emre; Al Schameri, Rahman A; Roth, Peter; Valavanis, Anton

    2015-04-01

    We reviewed the anatomy and embryology of the bridging and emissary veins aiming to elucidate aspects related to the cranial dural arteriovenous fistulae. Data from relevant articles on the anatomy and embryology of the bridging and emissary veins were identified using one electronic database, supplemented by data from selected reference texts. Persisting fetal pial-arachnoidal veins correspond to the adult bridging veins. Relevant embryologic descriptions are based on the classic scheme of five divisions of the brain (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon). Variation in their exact position and the number of bridging veins is the rule and certain locations, particularly that of the anterior cranial fossa and lower posterior cranial fossa are often neglected in prior descriptions. The distal segment of a bridging vein is part of the dural system and can be primarily involved in cranial dural arteriovenous lesions by constituting the actual site of the shunt. The veins in the lamina cribriformis exhibit a bridging-emissary vein pattern similar to the spinal configuration. The emissary veins connect the dural venous system with the extracranial venous system and are often involved in dural arteriovenous lesions. Cranial dural shunts may develop in three distinct areas of the cranial venous system: the dural sinuses and their interfaces with bridging veins and emissary veins. The exact site of the lesion may dictate the arterial feeders and original venous drainage pattern.

  17. Mucocoele of the maxillary sinus

    Directory of Open Access Journals (Sweden)

    Perić Aleksandar

    2007-01-01

    Full Text Available Background. Mucocoele is histopathologically benign, cystic change of paranasal sinuses filled with mucoid contents, which with its growth is pressuring and destroying local bone walls. In only 3% of the cases it can be localized in maxillary sinuses. Etiology is unknown. Pyocoele develops by secondary infection. Case report. The male patient was 21 years old. His symptoms were runny nose with thick contents and heavy breathing on the right side of the nose, headaches, as well as the swelling of the right cheek. During clinical examination, the expansive change was found. It was completely closing the right side of the nose cavity. Computerized tomography (CT of paranasal cavities showed excessive expansion of the right maxillary sinus, with very thinned walls, while the cavity was filled with liquid. After antibiotics therapy, the radical operation of the right maxillary sinus was performed, based on Caldwell Luc method. The frontal wall was found to be extremely convex and thinned, while the medial wall was with dehiscention. The cystic change was extirpated. Mucocoele was proved by pathohistologic findings. Its wall was about 2 mm thick and it showed squamous metaplasia in the large part of the mucocoela epithel. In the submucosa fibrosis and inflammatory infiltrate was present. Postoperative follow-up was under control. Clinically and radiographycaly, six months after therapy, the patient does not have troubles. Conclusion. The rare localization of the mucocoeles in maxillary sinus can be explained with the width of the maxillary ostia. Infected mucocoeles, expanded to the local anatomical structures, should be operated on with classic radical surgical operation. .

  18. Allergic fungal sinusitis causing nasolacrimal duct obstruction.

    Science.gov (United States)

    Kim, Charles; Kacker, Ashutosh; Chee, Ru-Ik; Lelli, Gary J

    2013-04-01

    Allergic fungal sinusitis is thought to represent a chronic autoimmune reaction directed against fungal elements within the sinuses, and is commonly seen in individuals with a history of chronic sinusitis that is refractory to medical therapy. The authors present a case of allergic fungal sinusitis involving the lacrimal drainage system. A 54-year-old woman initially presented with recurrent erythema and induration of the left nasolacrimal sac due to dacryocystitis, which was unresponsive to treatment with topical and systemic antibiotics. Radiological evaluation demonstrated the presence of multiple soft tissue masses along the medial canthi. During subsequent endoscopic dacryocystorhinostomy, significant amounts of allergic mucin were found within the sinuses and marked eosinophilia was present within tissue obtained from the lacrimal sac, findings highly suggestive of allergic fungal sinusitis. A diagnosis of allergic fungal sinusitis should be considered in patients presenting with epiphora in the appropriate clinical context. However, involvement of the lacrimal drainage system is an exceedingly unusual presentation.

  19. Who Needs a Revision? 20 Years of Cambridge Shunt Lab.

    Science.gov (United States)

    Czosnyka, Zofia; Czosnyka, Marek; Pickard, John D; Chari, Aswin

    2016-01-01

    Shunt testing independent of manufacturers provides knowledge that can significantly improve the management of patients with hydrocephalus. The Cambridge Shunt Evaluation Laboratory was created 20 years ago. Thanks to financial support from the Department of Health (1993-1998), all shunts in use in the UK were systematically evaluated, with "blue reports" being published. Later new devices were tested as they appeared in public domain.Twenty-six models have been evaluated. The majority of the valves had a non-physiologically low hydrodynamic resistance that may result in over-drainage, both related to posture and during nocturnal cerebral vasogenic waves. A long distal catheter increases the resistance of these valves by 100-200 %. Drainage through valves without a siphon-preventing mechanism is very sensitive to body posture. Shunts with siphon-preventing accessories offer a reasonable resistance to negative outlet pressure. Bench parameters were used to test shunt performance in vivo using infusion tests. A criterion for correctly performing a shunt procedure was established. Pressure measured in the shunt prechamber during the plateau phase of infusion should not remain more than 5 mmHg above the le shunt's operating pressure plus hydrodynamic resistance of the valve multiplied by the infusion rate. "Critical levels" for every shunt and every performance level have been used in the shunt testing wizard of ICM+ software.

  20. Ex vivo comparative study on three sinus lift tools for transcrestal detaching maxillary sinus mucosa.

    Science.gov (United States)

    Li, Yanfeng; Hu, Pin; Han, Yishi; Fan, Jiadong; Dong, Xinming; Ren, Huan; Yang, Chunhao; Shi, Tingting; Xia, Dong

    2017-07-04

    The objective of this study was to comparatively evaluate 3 different sinus lift tools, namely umbrella-shaped sinus lift curette YSL-04, our recently designed probe-improved sinus lift curettes, and our newly invented elevator 014, using our previous developed goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time. Goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time were generated according to our previously developed protocol. The effectiveness for each tool was evaluated through the length of sinus mucosa detached in mesial and distal directions or buccal and palatal directions, and the space volume created by detaching maxillary sinus mucosa in mesial, distal, buccal and palatal directions. The results showed that all 3 sinus lift tools could transcrestally detach the maxillary sinus mucosa and create extra space under the elevated sinus floor on the goat ex vivo sinus models. Moreover, our newly invented elevator 014 had advantages over the other 2 in term of the capability to detach the sinus mucosa. Our newly invented elevator 014 might be a promising tool for detaching maxillary sinus mucosa in transcrestal maxillary sinus floor elevation.

  1. Anatomical aspects of sinus floor elevations.

    Science.gov (United States)

    van den Bergh, J P; ten Bruggenkate, C M; Disch, F J; Tuinzing, D B

    2000-06-01

    Inadequate bone height in the lateral part of the maxilla forms a contra-indication for implant surgery. This condition can be treated with an internal augmentation of the maxillary sinus floor. This sinus floor elevation, formerly called sinus lifting, consists of a surgical procedure in which a top hinge door in the lateral maxillary sinus wall is prepared and internally rotated to a horizontal position. The new elevated sinus floor, together with the inner maxillary mucosa, will create a space that can be filled with graft material. Sinus lift procedures depend greatly on fragile structures and anatomical variations. The variety of anatomical modalities in shape of the inner aspect of the maxillary sinus defines the surgical approach. Conditions such as sinus floor convolutions, sinus septum, transient mucosa swelling and narrow sinus may form a (usually relative) contra-indication for sinus floor elevation. Absolute contra-indications are maxillary sinus diseases (tumors) and destructive former sinus surgery (like the Caldwell-Luc operation). The lateral sinus wall is usually a thin bone plate, which is easily penetrated with rotating or sharp instruments. The fragile Schneiderian membrane plays an important role for the containment of the bonegraft. The surgical procedure of preparing the trap door and luxating it, together with the preparation of the sinus mucosa, may cause a mucosa tear. Usually, when these perforations are not too large, they will fold together when turning the trap door inward and upward, or they can be glued with a fibrin sealant, or they can be covered with a resorbable membrane. If the perforation is too large, a cortico-spongious block graft can be considered. However, in most cases the sinus floor elevation will be deleted. Perforations may also occur due to irregularities in the sinus floor or even due to immediate contact of sinus mucosa with oral mucosa. Obstruction of the antro-nasal foramen is, due to its high location, not a

  2. Shunts in thin-film photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Malek, Stephanie; Riedel, Ingo; Parisi, Juergen [Energy and Semiconductor Research Laboratory, Department of Physics, University of Oldenburg, 26111 Oldenburg (Germany); Wischnath, Uli F. [aleo solar Deutschland GmbH, 26122 Oldenburg (Germany); Rechid, Juan [CIS Solartechnik GmbH and Co. KG, 20539 Hamburg (Germany)

    2011-07-01

    Shunts can lead to severe performance reduction in thin film solar cells. This work reports on a microscopic approach to locate and characterize the details of shunts in order to reveal their origin. Localization of hot spots and film disruptions is commonly addressed by lock-in infrared thermography (LIT) through visualization of the Joule heating. The resolution of this method is restricted to the {mu}m-range. We use different methods of LIT for the fast localization of local-lateral peculiarities in order to identify positions of interest. For a more detailed analysis of these features we use high resolution microscopy like Scanning Electron Microscopy (SEM) and AFM-based methods. These small-scale investigations can for example reveal whether areas of high heat dissipation are rather related to the inner structure of the involved thin films or to accidentally incorporated imperfections.

  3. Orbital Cellulitis Following Uncomplicated Aqueous Shunt Surgery.

    Science.gov (United States)

    Beck, Daniel E R; El-Assal, Karim S L; Doherty, Mark D; Wride, Nicholas K

    2017-02-01

    To date, there have only been 5 reported cases of orbital cellulitis following implantation of an aqueous tube shunt for glaucoma. Previously reported cases have involved eyes with significant comorbidities and successful management has often required the removal of the device alongside systemic antibiotic therapy. We present a 53-year-old man with severe orbital cellulitis, 3 months after routine implantation of a Baerveldt tube shunt for primary open angle glaucoma. The patient was managed medically, with topical and systemic antibiotic therapy. The patient went on to make a full recovery with the tube in situ. We report that a more conservative approach (without tube removal) to be successful in a case where there is no evidence of tube exposure. It is important to appreciate that in some cases of orbital cellulitis without clear signs of intraocular involvement, a tube can be left in situ.

  4. Acquired left ventricular-right atrium shunts.

    Science.gov (United States)

    Sinisalo, Juha P; Sreeram, Narayanswami; Jokinen, Eero; Qureshi, Shakeel A

    2011-04-01

    Left ventricular to right atrial (LV-RA) shunt is an unusual type of ventricular septal defect (VSD). This article concentrates on acquired LV-RA shunts, which may be due to complications of cardiac operation, endocarditis, trauma or myocardial infarction. A previous cardiac operation is its most common cause. The diagnosis of LV-RA communication is not easy, and it should be remembered in patients who do not recover normally. Diagnosis can be confirmed with ultrasound or magnetic resonance image (MRI). Surgical correction is usually the treatment of choice, but closing the communication percutaneously should be considered as an option. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  5. Portacaval Shunt for Portal Hypertensive Gastropathy

    Directory of Open Access Journals (Sweden)

    John Craig Collins

    1997-01-01

    Full Text Available Portal hypertensive gastropathy is a vascular disorder of the gastric mucosa distinguished by ectasia of the mucosal capillaries and submucosal veins without inflammation. During 1988 to 1993, 12 patients with biopsyproven cirrhosis (10 alcoholic, 2 posthepatitic were evaluated and treated prospectively by portacaval shunt for active bleeding from severe portal hypertensive gastropathy. Eleven patients had been hospitalized for bleeding three to nine times previously, and one was bleeding uncontrollably for the first time. Requirement for blood transfusions ranged from 11 to 39 units cumulatively, of which 8 to 30 units were required specifically to replace blood lost from portal hypertensive gastropathy. Admission findings were ascites in 9 patients, jaundice in 8, severe muscle wasting in 10, hyperdynamic state in 9. Child's risk class was C in 7, B in 4, A in 1. Ten of the 12 patients had previously received repetitive endoscopic sclerotherapy for esophageal varices, which has been reported to precipitate portal hypertensive gastropathy. Eight patients had failed propranolol therapy for bleeding. Portacaval shunt was performed emergently in 11 patients and electively in 1, and permanently stopped bleeding in all by reducing the mean portal vein-inferior vena cava pressure gradient from 251 to 16 mm saline. There were no operative deaths, and two unrelated late deaths after 13 and 24 months. During 1 to 6.75 years of followup, all shunts remained patent by ultrasonography, the gastric mucosa reverted to normal On serial endoscopy, and there was no gastrointestinal bleeding. Recurrent portal-systemic encephalopathy developed in only 8% of patients. Quality of life was generally good. It is concluded that portacaval shunt provides definitive treatment of bleeding portal hypertensive gastropathy by eliminating the underlying cause, and makes possible prolonged survival with an acceptable quality of life.

  6. Intranasal steroids for acute sinusitis.

    Science.gov (United States)

    Zalmanovici Trestioreanu, Anca; Yaphe, John

    2013-12-02

    Acute sinusitis is a common reason for primary care visits. It causes significant symptoms and often results in time off work and school. We examined whether intranasal corticosteroids (INCS) are effective in relieving symptoms of acute sinusitis in adults and children. We searched CENTRAL 2013, Issue 4, MEDLINE (January 1966 to May week 2, 2013), EMBASE (1990 to May 2013) and bibliographies of included studies. Randomised controlled trials (RCTs) comparing INCS treatment to placebo or no intervention in adults and children with acute sinusitis. Acute sinusitis was defined by clinical diagnosis and confirmed by radiological evidence or by nasal endoscopy. The primary outcome was the proportion of participants with either resolution or improvement of symptoms. Secondary outcomes were any adverse events that required discontinuation of treatment, drop-outs before the end of the study, rates of relapse, complications and return to school or work. Two review authors independently extracted data, assessed trial quality and resolved discrepancies by consensus. No new trials were found for inclusion in this update. Four studies involving 1943 participants with acute sinusitis met our inclusion criteria. The trials were well-designed and double-blind and studied INCS versus placebo or no intervention for 15 or 21 days. The rates of loss to follow-up were 7%, 11%, 41% and 10%. When we combined the results from the three trials included in the meta-analysis, participants receiving INCS were more likely to experience resolution or improvement in symptoms than those receiving placebo (73% versus 66.4%; risk ratio (RR) 1.11; 95% confidence interval (CI) 1.04 to 1.18). Higher doses of INCS had a stronger effect on improvement of symptoms or complete relief: for mometasone furoate 400 µg versus 200 µg (RR 1.10; 95% CI 1.02 to 1.18 versus RR 1.04; 95% CI 0.98 to 1.11). No significant adverse events were reported and there was no significant difference in the drop-out and

  7. CT of the paranasal sinuses is not a valid indicator for sinus surgery in CF patients

    DEFF Research Database (Denmark)

    Rasmussen, Jacob; Aanæs, Kasper; Norling, Rikke

    2012-01-01

    BACKGROUND: No guidelines comprise when or to what extent sinus surgery should be done in patients with cystic fibrosis (CF) or how a CT scan of the paranasal sinuses should influence the decision. Symptoms of rhinosinusitis and/or eradication of pathogenic bacteria from the sinuses are reasons...... for sinus surgery. METHODS: In this observational cross sectional study, 55 CF cases had their preoperative CT scans scored according to the Lund Mackay- and the Nair-system. Correlations between the CT scans, symptoms, surgical findings and cultures obtained during sinus surgery were made. RESULTS...... is not a valid criterion for sinus surgery in CF patients....

  8. Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment

    OpenAIRE

    Crovetto Martínez, Rafael; Martin Arregui, Francisco Javier; Zabala López de Maturana, Aitor; Tudela Cabello, Kiara; Crovetto de la Torre, Miguel Angel

    2014-01-01

    Objectives: Odontogenic sinusitis usually affects the maxillary sinus but may extend to the anterior ethmoid sinuses. The purpose of this study is to determine the percentage of odontogenic maxillary sinusitis extended to the anterior ethmoid sinuses and determine also the surgical resolution differences between odontogenic maxillary sinusitis and odontogenic maxillary associated to anterior ethmoidal sinusitis. Study Design: This is a retrospective cohort study performed on 55 patients diagn...

  9. Computerized Tomographic Study on the Paranasal Sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Kyung; Lim, Sug Young; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology and Institute of Oral Bio Science, College of Dentistry, Chonbuk National University, Chonju (Korea, Republic of)

    1999-08-15

    The purpose of this study was to evaluate the computed tomographic (CT) images of the paranasal sinusitis(PNS). The author examined the extent and the recurring patterns of the paranasal sinusitis and some important anatomic landmarks. The author analyzed PNS images retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. The most frequently affected sinus was maxillary sinus (82.9%), followed by anterior ethmoid sinus (67.9%), posterior ethmoid sinus (48.9%), frontal sinus (42.0%) and sphenoid sinus (41.4%). The characteristic features of CT images of the sinusitis were sinus opacification (22.4%), mucoperiosteal thickening (34.3%), and polyposis (2.0%). Sinonasal inflammatory diseases were categorized into 5 patterns according to Babbel's classification. They were 1) infundibular (13.0%), 2) ostiomeatal unit (67.4%), 3)sphenoethmoidal recess (13.0%), 4) sinonasal polyposis (9.6%) and 5) unclassifiable patterns (18.0%). The incidences of contact between sinus and optic nerve were as follows ; the incidences of contact with posterior ethmoid sinus, sphenoid sinus, both posterior sinuses were 11.4%, 66.8%, 6.3%, respectively. The incidences of contact between sphenoid sinus and maxillary nerve, vidian nerve, internal carotid artery were 74.5%, 79.2%, 45.1% respectively. The incidences of pneumatization of the posterior ethmoid sinus were as follows; normal 70.6% and overriding type 29.4%. The incidences of sphenoid sinus pneumatization were as follows; normal 56.9% , rudimentary 12.5%, pterygoid recess 22.7%, anterior clinoid recess 2.7%, and both pterygoid and anterior clinoid recess 5.2%. The inflammatory sinonasal diseases were classified into five patterns using the CT of PNS, which was proven to be an excellent imaging modality providing detailed information about mucosal abnormality, pathologic patterns and the proximity of the important structures to the posterior paranasal sinuses. This

  10. MR findings of septic cavernous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyeong Lae; Lee, Nam Joon; Lee, Jung Hee; Pyo, Hyeon Soon; Eo, Geun; Kim, Kyo Nam; Kim, Young Soon; Kim, Jang Min [Kwang Myung Sung Ae Hospital, Kwang Myung (Korea, Republic of); Lee, Don Young [Korea University Anam Hospital, Seoul (Korea, Republic of)

    2000-08-01

    To evaluate the MR findings of septic thrombosis of the cavernous sinus. Eleven MR images of six patients with septic cavernous sinus thrombosis obtained over a five-year period and proven clinically or radiologically were retrospectively reviewed. The contour and enhancement pattern of the cavernous sinus, changes in the internal carotid artery, orbit, pituitary gland and sphenoid sinus, and intracranial abnormalities were analyzed and compared with the findings of follow-up studies. In all six patients, contrast study revealed asymmetrical enlargement of the ipsilateral cavernous sinus and multiple irregular filling defects within it. Narrowing of the cavernous portion of the ipsilateral internal carotid artery was noted in five patients, upward displacement of the ipsilateral internal carotid artery in four, ipsilateral proptosis with engorgement of the superior ophthalmic vein in two, pituitary enlargement in five, and inflammatory change in the sphenoid sinus in six. Associated intracranial abnormalities included edema and enhancement in the meninx, temporal lobe, or pons adjacent to the cavernous sinus in four patients, hydrocephalus in one, and cerebral infarction in one. Follow-up MR imaging indicated that the extent of asymmetrical enlargement of the cavernous sinus, filling defects within it, as seen on contrast study, and enlarged pituitary glands had all decreased, without significant interval change. MR imaging is useful in the diagnosis of septic cavernous sinus thrombosis. Asymmetrical enlargement of the cavernous sinus, multiple irregular filling defect within it, as seen on contrast study, and changes in the internal carotid artery are characteristic findings. (author)

  11. Congenital portosystemic shunts in five mature dogs with neurological signs.

    Science.gov (United States)

    Windsor, Rebecca Christine; Olby, Natasha J

    2007-01-01

    Congenital portosystemic shunts are a common cause of hepatic encephalopathy and are typically first identified when dogs are dogs with congenital portosystemic shunts; the dogs were presented for severe encephalopathic signs during middle or old age. Three dogs had portoazygos shunts, and four dogs had multifocal and lateralizing neurological abnormalities, including severe gait abnormalities and vestibular signs. All five dogs responded to medical or surgical treatment, demonstrating that older animals can respond to treatment even after exhibiting severe neurological signs.

  12. Early shunt complications in 46 children with hydrocephalus

    OpenAIRE

    Moisés Heleno Vieira Braga; Carvalho,Gervásio Teles C. de; Rafael Augusto Castro Santiago Brandão; Franklin Bernardes Faraj de Lima; Bruno Silva Costa

    2009-01-01

    OBJECTIVE: To determine the causes of early shunt complications in 46 children with hydrocephalus. METHOD: A retrospective study was conducted on 46 children submitted to ventriculoperitoneal shunt surgery between February 2005 and February 2007. RESULTS: Thirteen (28%) patients presented complications, which were due to infection in 9 (69%) and to malfunction of the shunt system in 4 (31%).The mean number of surgical procedures performed on patients who presented complications was 2.8 per pa...

  13. Shunt malfunction presenting with symptomatic syringomyelia: Demonstrated on contrast ventriculogram

    OpenAIRE

    Aniruddha, T. J; Pruthi, Nupur

    2014-01-01

    Ventriculoperitoneal (VP) shunt malfunction commonly presents as raised intracranial pressure. Rarely, when the central canal of the spinal cord communicates with the 4th ventricle, shunt malfunction can present as an expanding syrinx. The diagnosis is often delayed, resulting in severe morbidity. Some of these patients undergo repeated syrinx surgeries without much benefits. We report a case of chronic tuberculous meningitis with shunt malfunction presenting as an expanding spinal canal syri...

  14. Sphenoid sinus adenoid cystic carcinoma

    Directory of Open Access Journals (Sweden)

    Marambaia, Otavio

    2008-12-01

    Full Text Available Introduction: The sphenoid adenoid cystic carcinoma is a rare malign neoplasm, in the head and neck and when located in the paranasal sinuses, it is formed in the minor salivary glands. It grows slowly and is characterized by a large invasion of the adjacent tissues, and also has a large capacity of metastasis. The surgery associated with post-operative radiotherapy is used as treatment. Objective: To describe a case of sphenoid sinus adenoid cystic carcinoma in a male, black, 62 year patient. Case Report: N.L.B., 62 years of age, male, had bloody rhinorrhea for 6 months associated with bilateral nasal obstruction. The nasofibroscopy showed lesion of polypoid aspect in the left nasal cavity. He was submitted to biopsy and the anatomopathological exam showed adenoid cystic carcinoma and the patient was forwarded to oncology. Conclusions: The importance of conducting the differential diagnosis between chronic nasosinusal infection and nasosinusal tumors.

  15. Glaucoma Mini-Shunt Implantation After Keratoplasty.

    Science.gov (United States)

    Ledesma-Gil, Jasbeth; García-Rodríguez, María de Los Ángeles; Gurria, Lulu U; Graue-Hernández, Enrique O; Navas, Alejandro

    2017-04-01

    To report the outcomes of patients who underwent miniature glaucoma shunt implantation after secondary glaucoma due to keratoplasty. Prospective study of consecutive clinical cases who underwent mini-glaucoma shunt implantation following keratoplasty. In brief, a fornix-based conjunctival flap was performed, approximately 50% thickness scleral flap. Mitomycin C 0.025% placed under Tenon's capsule. A 25-G needle created entry for mini-shunt. Ex-PRESS model P-50 was inserted. Scleral flap and conjunctiva were closed with 10-0 Nylon. STATA 8.0 and SPSS software were used for statistical analysis. Seventeen eyes of 17 patients with a mean age of 39.70 years (SD=18.33, range: 18 to 76). A total of 64.70% were male and 35.30% female. Eleven cases after penetrating keratoplasty, 3 cases after triple procedure, 2 after deep anterior lamellar keratoplasty, and 1 following endothelial keratoplasty. Most of the indications for keratoplasty were keratoconus in 9 cases (52.94%), 4 due to endothelial failure (23.52%), 3 cases of herpetic keratitis (17.64%), and 1 case of post-LASIK ectasia (5.88%). Mean preoperative intraocular pressure was 35.94 mm Hg with maximal medical therapy (SD=9.65, range: 18 to 55). Decreasing intraocular pressure to 12.76 mm Hg postoperatively (SD=2.51, range 10 to 18) (P=0.001). Mean follow-up after mini-glaucoma shunt implantation was 23.76 months (SD=8.73, range: 10 to 35 mo). Preoperative mean uncorrected distance visual acuity (UDVA) was 1.31±0.63 (20/408 Snellen) and postoperative mean UDVA was 0.85±0.40 (20/141 Snellen) (P=0.001). Preoperative mean corrected distance visual acuity (CDVA) was 0.83±0.76 (20/135 Snellen) and postoperative mean CDVA was 0.56±0.44 (20/72 Snellen) (P=0.032). Ex-PRESS miniature glaucoma shunt could be an alternative treatment in postkeratoplasty glaucoma resistant to medical treatment. This technique may be helpful, in trying to avoid corneal damage produced by conventional glaucoma procedures.

  16. Optimization methods for the Train Unit Shunting Problem

    DEFF Research Database (Denmark)

    Haahr, Jørgen Thorlund; Lusby, Richard Martin; Wagenaar, Joris Camiel

    2017-01-01

    We consider the Train Unit Shunting Problem, an important planning problem for passenger railway operators. This problem entails assigning train units from shunting yards to scheduled train services in such a way that the resulting operations are without conflicts. The problem arises at every...... shunting yard in the railway network and involves matching train units to arriving and departing train services as well as assigning the selected matchings to appropriate shunting yard tracks. We present an extensive comparison benchmark of multiple solution approaches for this problem, some of which...

  17. Semi-shunt field emission in electronic devices

    Energy Technology Data Exchange (ETDEWEB)

    Karpov, V. G., E-mail: victor.karpov@utoledo.edu [Department of Physics and Astronomy, University of Toledo, Toledo, Ohio 43606 (United States); Shvydka, Diana, E-mail: diana.shvydka@utoledo.edu [Department of Radiation Oncology, University of Toledo, Toledo, Ohio 43606 (United States)

    2014-08-04

    We introduce a concept of semi-shunts representing needle shaped metallic protrusions shorter than the distance between a device electrodes. Due to the lightening rod type of field enhancement, they induce strong electron emission. We consider the corresponding signature effects in photovoltaic applications; they are: low open circuit voltages and exponentially strong random device leakiness. Comparing the proposed theory with our data for CdTe based solar cells, we conclude that stress can stimulate semi-shunts' growth making them shunting failure precursors. In the meantime, controllable semi-shunts can play a positive role mitigating the back field effects in photovoltaics.

  18. Laparoscopically assisted ventriculoperitoneal shunt placement using 2-mm instrumentation.

    Science.gov (United States)

    Reardon, P R; Scarborough, T K; Matthews, B D; Marti, J L; Preciado, A

    2000-06-01

    Laparoscopy has potential benefit in the placement of ventriculoperitoneal shunts. In patients who have undergone multiple shunt revisions or other abdominal operations, laparoscopy may be particularly beneficial when finding of a suitable area in which to place the shunt is a concern. The purpose of this study was to evaluate the safety and effectiveness of laparoscopically assisted ventriculoperitoneal shunt placement, with an emphasis on using 2-mm instrumentation. Laparoscopically assisted ventriculoperitoneal shunt placement using 2-mm instrumentation was performed in eight adult hydrocephalus patients from August 1996 to September 1998. All eight patients had undergone 1 to 18 prior shunt revisions. The procedures were performed with two 2-mm trocars. The instrumentation consisted of a 2-mm laparoscope, a 2-mm grasper, and 2-mm scissors. All shunts were placed in an area free of adhesions and checked for flow under direct vision. Four of the patients required a lysis of adhesions to create a space adequate for catheter placement. All of the procedures were successful, with no operative complications. The operative times ranged from 29 to 99 min, (mean, 63 min). The blood loss in all of the procedures was minimal. At this writing, none of the patients have required subsequent distal shunt revisions. No conversions to larger instruments or an open procedure were required. Laparoscopically assisted ventriculoperitoneal shunt placement using 2-mm instrumentation is safe and effective, offering several advantages over the open procedure. This procedure is ideal for the use of 2-mm instruments.

  19. Ultrasonography of portosystemic shunting in dogs : Doppler studies before, during and after surgery

    NARCIS (Netherlands)

    Szatmári, V.

    2004-01-01

    Portosystemic shunting occurs when anomalous veins allow the portal blood to enter the systemic veins directly without first flowing through the hepatic sinusoids. Portosystemic shunting can occur via acquired portosystemic collaterals or via congenital portosystemic shunts and may result in

  20. Effects of endoscopic sinus surgery and delivery device on cadaver sinus irrigation.

    Science.gov (United States)

    Harvey, Richard J; Goddard, John C; Wise, Sarah K; Schlosser, Rodney J

    2008-07-01

    Assess paranasal sinus distribution of topical solutions following endoscopic sinus surgery (ESS) using various delivery devices. Experimental prospective study. Ten cadaver sinus systems were irrigated with Gastroview before surgery, after ESS, and after medial maxillectomy. Delivery was via pressurized spray (NasaMist), neti pot (NasaFlo), and squeeze bottle (Sinus Rinse). Scans were performed before and after each delivery with a portable CT machine (Xoran xCAT), and blinded assessments were made for distribution to individual sinuses. Total sinus distribution was greater post-ESS (P squeeze bottle > pressurized spray (P spray solutions in un-operated sinuses provide little more than nasal cavity distribution. Use of squeeze bottle/neti pot post-ESS offers a greatly enhanced ability to deliver solutions to the paranasal sinuses.

  1. Late recovery from foreign body sinusitis after maxillary sinus floor augmentation

    Science.gov (United States)

    Felisati, Giovanni; Saibene, Alberto Maria; Lenzi, Riccardo; Pipolo, Carlotta

    2012-01-01

    A 55-year-old male patient was referred to our clinic with signs and symptoms of recurring sinusitis after a right maxillary sinus floor augmentation for implantological purposes. Investigations showed an antibiotic-resistant ethmoidomaxillary sinusitis resulting from bone graft infection and displacement of previously inserted xenograft material into the maxillary sinus. The patient thus underwent a surgical procedure combining nasal endoscopy and oral surgery in order to remove the infected graft and restore sinusal drainage. The procedure was apparently successful but sinusitis relapsed after surgery and persisted despite 2 weeks of antibiotic therapy and local medications. A CT scan showed persistence of grafting fragments in the maxillary sinus. A new surgical procedure was scheduled while a more accurate endoscopic local medication was performed. Six hours after the treatment, the patient spontaneously expelled the fragments and promptly recovered. The patient successfully underwent another maxillary sinus floor augmentation procedure 6 months later. PMID:23234824

  2. Comprehensive review on endonasal endoscopic sinus surgery

    Science.gov (United States)

    Weber, Rainer K.; Hosemann, Werner

    2015-01-01

    Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3–4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment. PMID:26770282

  3. Sinus Venosus Atrial Septal Defect Complicated by Eisenmenger Syndrome and the Role of Vasodilator Therapy

    Directory of Open Access Journals (Sweden)

    Amornpol Anuwatworn

    2016-01-01

    Full Text Available Sinus venosus atrial septal defect is a rare congenital, interatrial communication defect at the junction of the right atrium and the vena cava. It accounts for 5–10% of cases of all atrial septal defects. Due to the rare prevalence and anatomical complexity, diagnosing sinus venous atrial septal defects poses clinical challenges which may delay diagnosis and treatment. Advanced cardiac imaging studies are useful tools to diagnose this clinical entity and to delineate the anatomy and any associated communications. Surgical correction of the anomaly is the primary treatment. We discuss a 43-year-old Hispanic female patient who presented with dyspnea and hypoxia following a laparoscopic myomectomy. She had been diagnosed with peripartum cardiomyopathy nine years ago at another hospital. Transesophageal echocardiography and computed tomographic angiography of the chest confirmed a diagnosis of sinus venosus atrial septal defect. She was also found to have pulmonary arterial hypertension and Eisenmenger syndrome. During a hemodynamic study, she responded to vasodilator and she was treated with Ambrisentan and Tadalafil. After six months, her symptoms improved and her pulmonary arterial hypertension decreased. We also observed progressive reversal of the right-to-left shunt. This case illustrates the potential benefit of vasodilator therapy in reversing Eisenmenger physiology, which may lead to surgical repair of the atrial septal defect as the primary treatment.

  4. Transorbital Cavernous Sinus Direct Puncture : Alternative to treat dural arteriovenous fistula.

    Science.gov (United States)

    Trivelato, Felipe Padovani; Manzato, Luciano Bambini; Filho, Paulo Moacir Mesquita; Ulhôa, Alexandre Cordeiro; Vanzin, José Ricardo; Abud, Daniel Giansante; Rezende, Marco Túlio Salles

    2016-08-09

    The authors present a retrospective series of their clinical experience in the treatment of cavernous dural arteriovenous fistulas (DAVF) by direct transorbital puncture of the cavernous sinus as an alternative to the endovascular approach. Between October 2012 and September 2014, eight patients harboring cavernous DAVF underwent percutaneous treatment by direct transorbital puncture of the cavernous sinus at three institutions. All patients presented with ocular symptoms. Standard endovascular approaches, including transvenous and transarterial routes, were primarily attempted without success in all cases. Direct puncture was performed through two different approaches, namely inferolateral and superomedial. The entry point was the inferior and superior eyelid, respectively. Embolization was performed with coils or Onyx (Covidien, Irvine, CA). Immediate and late angiographies were used to evaluate the occlusion of the fistula. Of the patients seven had complete occlusion of the cavernous DAVFs noted on the immediate and follow-up angiograms and one patient had residual filling but reduction of the shunt resulted in clinical improvement. None of the patients had worsening of neurological function. One case was complicated by inadvertent internal carotid puncture but without clinical manifestations. One patient experienced postoperative superior ophthalmic vein thrombosis. In very specific cases, when endovascular access is not possible or fails to occlude cavernous DAVF, direct transorbital puncture of the cavernous sinus was shown to be feasible, safe and very effective.

  5. [Florid tuberculosis of the paranasal sinuses].

    Science.gov (United States)

    Andratschke, M; Nerlich, A G; Hagedorn, H

    2009-11-01

    Infections due to the Mycobacterium tuberculosis of the head and neck region mainly affect the cervical lymph nodes. We report a rare case of paranasal sinus tuberculosis. The patient presented as an emergency with right-sided headache and epiphora. Clinical, radiological and laboratory results yielded a diagnosis of acute exacerbated chronic sinusitis with meningeal affection resulting from transmigration. Histological and molecular investigations confirmed mycobacterial infection of the paranasal sinuses.

  6. Systemic corticosteroid therapy for acute sinusitis.

    Science.gov (United States)

    Venekamp, Roderick P; Thompson, Matthew J; Rovers, Maroeska M

    Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? Oral corticosteroids combined with antibiotics may be associated with modest benefit for short-term relief of symptoms in adults with severe symptoms of acute sinusitis compared with antibiotics alone. Oral corticosteroids as monotherapy are not associated with improved clinical outcomes in adults with clinically diagnosed acute sinusitis.

  7. Teratoma of the cavernous sinus: case report.

    Science.gov (United States)

    Pikus, H J; Holmes, B; Harbaugh, R E

    1995-05-01

    We report the case of an infant with a mature teratoma of the lateral wall of the cavernous sinus. A complete excision of the tumor was achieved. There was no evidence of recurrence at 1-year follow-up examination. Intracranial teratomas and the anatomy of the lateral wall of the cavernous sinus are briefly reviewed. To our knowledge, this is the first case of a teratoma confined to the cavernous sinus.

  8. Odontogenic sinusitis: an ancient but under-appreciated cause of maxillary sinusitis.

    Science.gov (United States)

    Patel, Nimish A; Ferguson, Berrylin J

    2012-02-01

    For well over 100 years, it has been appreciated that maxillary dental infections can cause sinusitis. This insight has been largely overlooked with the advent of functional endoscopic sinus surgery (ESS) and its emphasis on the osteomeatal complex. We review several recent case series and reviews of odontogenic sinusitis that characterize and discuss emerging diagnostic modalities in odontogenic sinusitis. In recent publications on odontogenic sinusitis, up to 40% of chronic bacterial maxillary sinus infections are attributed to a dental source, which is far higher than the previously reported incidence of 10%. Plain dental films and dental evaluations frequently fail to detect maxillary dental infection that can be causing odontogenic sinusitis. However, sinus computed tomography (CT) or Cone Beam Volumetric CT (CBVCT) are far more successful in identifying dental disease causing sinusitis. The microbial pathogens of odontogenic sinusitis remain unchanged from earlier reviews; however, the clinical findings in odontogenic sinusitis are better described in recent reviews. Successful treatment of odontogenic sinusitis requires management of the odontogenic source and may require concomitant or subsequent sinus surgery. Odontogenic sinusitis is frequently recalcitrant to medical therapy and usually requires treatment of the dental disease. Sometimes dental treatment alone is adequate to resolve the odontogenic sinusitis and sometimes concomitant or subsequent ESS is required. Evaluation of all patients with persistent chronic rhinosinusitis (CRS) should include inspection of the maxillary teeth on CT scan for evidence of periapical lucencies. Unilateral recalcitrant disease associated with foul smelling drainage is especially characteristic of odontogenic sinusitis. High-resolution CT scans and CBVCT can assist in identifying dental disease.

  9. Systemic corticosteroids for acute sinusitis.

    Science.gov (United States)

    Venekamp, Roderick P; Thompson, Matthew J; Hayward, Gail; Heneghan, Carl J; Del Mar, Chris B; Perera, Rafael; Glasziou, Paul P; Rovers, Maroeska M

    2014-03-25

    Acute sinusitis is the inflammation and swelling of the nasal and paranasal mucous membranes and is a common reason for patients to seek primary care consultations. The related impairment of daily functioning and quality of life is attributable to symptoms such as facial pain and nasal congestion. To assess the effects of systemic corticosteroids on clinical response rates and to determine adverse effects and relapse rates of systemic corticosteroids compared to placebo or standard clinical care in children and adults with acute sinusitis. We searched CENTRAL (2014, Issue 1), MEDLINE (1966 to February week 1, 2014) and EMBASE (January 2009 to February 2014). Randomised controlled trials (RCTs) comparing systemic corticosteroids to placebo or standard clinical care for patients with acute sinusitis. Two review authors independently assessed the methodological quality of the trials and extracted data. Five RCTs with a total of 1193 adult participants met our inclusion criteria. We judged methodological quality to be moderate in four trials and high in one trial. Acute sinusitis was defined clinically in all trials. However, the three trials performed in ear, nose and throat (ENT) outpatient clinics also used radiological assessment as part of their inclusion criteria. All participants were assigned to either oral corticosteroids (prednisone 24 mg to 80 mg daily or betamethasone 1 mg daily) or the control treatment (placebo in four trials and non-steroidal anti-inflammatory drugs (NSAIDs) in one trial). In four trials antibiotics were prescribed in addition to oral corticosteroids or control treatment, while one trial investigated the effects of oral corticosteroids as a monotherapy.When combining data from the five trials, participants treated with oral corticosteroids were more likely to have short-term resolution or improvement of symptoms than those receiving the control treatment: at days three to seven (risk ratio (RR) 1.3, 95% confidence interval (CI) 1.1 to 1

  10. Giant osteoma of the ethmoidal sinus

    Directory of Open Access Journals (Sweden)

    Marambaia, Otavio

    2009-06-01

    Full Text Available Introduction: The osteomas are osseous lesions with slow and asymptomatic growth that most of the times is a finding in radiological exams requested for other reason. It's the most common benign neoplasm of the paranasal sinuses. The osteomas are located mainly in the frontal sinus (57% to 80%, followed by the ethmoidal sinuses (20%, maxillary sinuses and rarely in the sphenoid sinus. It has a discreet predominance in the male sex 1.5 and its incidence is higher in the 3rd and 4th decades of life. The treatment is surgical no matter the size. Objective: To describe a case of giant osteoma of the ethmoidal sinus including a brief literature review. Case Report: JDA, male, 33 years old, presented with a right constant nasal obstruction for 01 year. Upon exam, he presented with facial asymmetry with lateralization of the right ocular globe. The computed tomography of the paranasal sinuses showed a lesion with density of soft parts occupying partially the right nasal cavity, ethmoid sinus and right maxillary. The patient was submitted to surgery with full exeresis of the lesion. The anatomopathological exam confirmed osteoma. The patient evolved without evidences of the lesion recurrence. Final Comments: The osteomas in the ethmoidal sinus, irrespectively of the size and due to the risk of complications, must be operated.

  11. [The occipital sinus: a radioanatomic study].

    Science.gov (United States)

    Gaumont-Darcissac, M; Viart, L; Foulon, P; Le Gars, D; Havet, E; Peltier, J

    2015-03-01

    The aim of this study was to assess the presence of an occipital sinus in both children and adults, and to detail its main associated anatomical characteristics. One hundred of patients' MRI (3D T1 EG) between 0 and 86 years old were studied, in sagittal and axial sections, with the software DxMM. Occipital sinus length, perimeter, and cerebellar falx length measurements were performed with the software's tools. Forty-three percent of patients had an occipital sinus (average perimeter was 3.02 mm, average length was 19.85 mm), and 23.26% of these patients had a cerebellar falx, 30.23% of these patients had one vein or more draining into the occipital sinus. Sixty-two percent of children had an occipital sinus (average perimeter was 2.87 mm, average length was 21.63 mm), and 29.03% of them had a cerebellar falx. Twenty-four percent of adults had an occipital sinus (average perimeter was 3.4mm, average length was 15.28 mm), and 8.33% of them had a cerebellar falx. This work highlights a link between the age and the occipital sinus existence. The perimeter of this sinus seems to be superior for adults, but its length seems to be superior for children. A cerebellar falx with the occipital sinus was found more frequently for children. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Treatment of chronic sinusitis in a horse with systemic and intra-sinus antimicrobials.

    Science.gov (United States)

    Gordon, Danielle L; Radtke, Catherine L

    2017-03-01

    A 12-year-old Norwegian Fjord gelding was diagnosed with paranasal sinusitis as a post-operative complication of tooth repulsion surgery. The infection with inspissated purulent material persisted despite sinus trephination and lavage, and systemic antimicrobial therapy. Resolution occurred following infusion of a gelatin/penicillin mixture into the right rostral and caudal maxillary sinus.

  13. Treating Sinusitis: Don't Rush to Antibiotics

    Science.gov (United States)

    ... AAAAI) Treating Sinusitis (AAAAI) Don’t rush to antibiotics DOWNLOAD PDF The sinuses are small, hollow spaces ... or teeth. Each year, millions of people use antibiotic drugs to treat sinus problems. However, they usually ...

  14. Innovative Application of Cerebral rSO2 Monitoring During Shunt Tap in Pediatric Ventricular Malfunctioning Shunts.

    Science.gov (United States)

    Abramo, Thomas J; Zhou, Chuan; Estrada, Cristina; Meredith, Mark; Miller, Renee; Pearson, Matthew; Tulipan, Noel; Williams, Abby

    2015-07-01

    This study aimed to determine the reliability and potential application of cerebral regional tissue oxygenation (rSO2) monitoring in malfunctioning ventricular shunts during tap. This is a prospective case series using convenience sample in subjects with confirmed malfunctioning shunt who had left and right cerebral rSO2 monitoring every 5 seconds before, during, and 1 hour after shunt tap. Ninety-four subjects had cerebral rSO2 monitoring. Sixty-three subjects had proximal malfunctions, and 31 subjects had distal shunt malfunctions. The intrasubject's cerebral rSO2 trend and variability at pretap, during, and posttap times were highly correlated. Overall, the average rSO2 is lower in pretap as compared with posttap. Left cerebral rSO2 had lower means and larger SD as compared with right cerebral rSO2. Left pretap and posttap cerebral rSO2 variability was significantly associated with the location of shunt malfunction regardless of pretap, during, or posttap periods (P < 0.001), whereas right rSO2 variability was not predictive for malfunction location. Left cerebral rSO2 variability showed utility for identifying the location of malfunction with area under the receiver operating characteristic curve equal to 0.8. Reliable cerebral rSO2 readings before, during, and after shunt tap were demonstrated. Left cerebral rSO2 changes from before to after shunt tap were more predictive for shunt malfunction location than right cerebral rSO2 changes. Observing cerebral rSO2 changes in relationship to shunt tap represents a potential surrogate in measuring cerebral pressures and blood flow changes after cerebral spinal fluid drainage. Significantly greater cerebral rSO2 changes occur for distal malfunction versus proximal malfunction after shunt tap, indicating its potential as an adjunct tool for detecting shunt malfunction type.

  15. Splenophrenic portosystemic shunt in dogs with and without portal ...

    African Journals Online (AJOL)

    The possible existence of the same pattern of porto-caval connection in dogs having a single congenital portosystemic shunt (CPSS) and in dogs having multiple acquired portosystemic shunt (MAPSS) secondary to portal hypertension (PH) was evaluated. Retrospective evaluation of all CT examinations of patients having ...

  16. VP-shunt dysfunction caused by malaria CNS infection.

    Science.gov (United States)

    Fehrenbach, Michael Karl; Bernhard, Matthias; Siekmeyer, Manuela; Lippmann, Norman; Kiess, Wieland; Nestler, Ulf; Meixensberger, Jürgen; Preuss, Matthias

    2016-04-01

    Malaria is a widespread mosquito-borne infectious disease with over 300 million cases and roughly 900 thousand deaths in 2013. Cerebral involvement of malaria causes 50 % of all infection-associated deaths, especially in children below the age of 5 years. Hydrocephalus is a medical condition with abnormal accumulation of cerebrospinal fluid in physiological cavities and ventricles. Standard treatment is the implantation of a cerebrospinal fluid shunt device. A common problem associated with shunt treatment especially in pediatric patients is infection and consecutive shunt dysfunction caused by bacteriae or high protein levels clogging the valve. In these cases, Staphylococcus aureus and Staphylococcus epidermidis are predominantly found in CSF cultures. We present a case of a 2-year old boy from Saudi Arabia with a ventriculoperitoneal (VP)-shunt-dependent congenital hydrocephalus who suffered from cerebral malaria and developed consecutive shunt failure. To the best of our knowledge, shunt failure caused by malaria CNS infection with Plasmodium falciparum has not yet been reported in the literature and should be considered as a rare cause of VP-shunt failure in patients with atypical VP-shunt infections living in or traveling from endemic areas.

  17. Internal carotid artery rupture caused by carotid shunt insertion.

    Science.gov (United States)

    Illuminati, Giulio; Caliò, Francesco G; Pizzardi, Giulia; Vietri, Francesco

    2015-01-01

    Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arterial rupture at the distal tip of the shunt was detected and was repaired via a small saphenous vein patch. Eversion CEA and subsequent CABG completed the procedure whose postoperative course was uneventful. Shunting during combined CEA-CABG may be advisable to assure cerebral protection from possible hypoperfusion due to potential hemodynamic instability of patients with severe coronary artery disease. Awareness and prompt management of possible shunt-related complications, including the newly reported one, may contribute to limiting their harmful effect. Arterial wall rupture is a possible, previously not reported, shunt-related complication to be aware of when performing CEA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Spontaneous knot; a rare cause of ventriculoperitoneal shunt blockage.

    LENUS (Irish Health Repository)

    Mohammed, Wail

    2011-02-01

    A 14-year old X linked congenital hydrocephalus presented with unexplained headaches and vomiting. He had external ventricular drain and intracranial pressure monitoring (ICP). Subsequently, he underwent exploration and removal of previously inserted ventriculoperitoneal (VP) shunts. On retrieval of peritoneal catheters a double knot was noted between his two distal catheters. This case illustrates a rare cause of ventriculoperitoneal shunt malfunction.

  19. Spontaneous knot; a rare cause of ventriculoperitoneal shunt blockage.

    LENUS (Irish Health Repository)

    Mohammed, Wail

    2012-02-01

    A 14-year old X linked congenital hydrocephalus presented with unexplained headaches and vomiting. He had external ventricular drain and intracranial pressure monitoring (ICP). Subsequently, he underwent exploration and removal of previously inserted ventriculoperitoneal (VP) shunts. On retrieval of peritoneal catheters a double knot was noted between his two distal catheters. This case illustrates a rare cause of ventriculoperitoneal shunt malfunction.

  20. Bandgap control with local and interconnected LC piezoelectric shunts

    Science.gov (United States)

    Flores Parra, Edgar A.; Bergamini, Andrea; Lossouarn, Boris; Van Damme, Bart; Cenedese, Mattia; Ermanni, Paolo

    2017-09-01

    This paper reports on the control of longitudinal wave propagation, in the kHz frequency range, using local and interconnected LC (inductance-capacitance) shunts distributed periodically along a rod. The LC shunts are connected to piezoelectric inserts and tuned to engender narrow or broad-band pass-bands in the forbidden band frequency range. The Bragg-scattering bandgaps are the result of the periodic mechanical mismatch between PMMA (polymethyl-methacrylate) of the rod and PZT (lead-zirconate-titanate). The narrow pass-bands correspond to the local configuration, where an equivalence between the mechanical impedance of the PMMA and PZT occurs around the shunt resonance frequency. Conversely, the interconnected shunts give a way to an electrical medium through which energy can propagate parallel to its mechanical counterpart, leading to broad pass-bands. This paper presents analytical models for calculating the dispersion and displacements of the 1D medium with interconnected LC shunts. An analytical formulation is also introduced to expediently identify the location of bandgaps and pass-bands in the medium comprised of local LC shunts. Moreover, analytical investigations are carried out to elucidate different physical phenomena giving rise to these pass-bands. The findings are experimentally validated using a finite periodic rod. The ability to tune the dispersion properties of the medium to control the width or depth of the bandgap, by utilizing local or interconnected shunts, offers a new and powerful application for piezoelectric shunts.

  1. Acquired extrahepatic portosystemic shunts in a young dog

    OpenAIRE

    Agg, Emma J.

    2006-01-01

    A young, male miniature poodle was presented with severe neurological problems. Laboratory tests and ultrasonograph examination were consistent with extrahepatic portosystemic shunts, resulting in hepatic encephalopathy. When surgical correction proved not to be a viable option, the dog was euthanized. Postmortem examination revealed multiple shunts likely acquired after severe hepatitis.

  2. an unusual cause of post-shunt intestinal obstruction

    African Journals Online (AJOL)

    infection, intestinal obstruction, migration of the shunt and perforation of the internal organs, have been described with this invasive procedure. We report a case in which bowel prolapsed through the peritoneal opening and caused intestinal obstruction in a female baby. Ventriculoperitoneal (VP) shunt is the most widely ...

  3. Major complication after intrauterine vesico-amniotic shunting ...

    African Journals Online (AJOL)

    Major complication after intrauterine vesico-amniotic shunting. A Springer, R Fartacek, CA Reck, E Horcher, D Bettelheim. Abstract. Bilateral foetal uropathy is the leading cause of chronic renal failure in childhood. Vesico-amniotic shunting (VAS) is a simple, feasible, and widely used procedure for decompressing the foetal ...

  4. Shunt hybrid active power filter for harmonic mitigation: A practical ...

    Indian Academy of Sciences (India)

    Abstract. The increasing importance of Power Quality problems has been respon- sible for several improvements in Active Power Filter (APF) typologies in the last decade. The increased cost and switching losses make a pure shunt APF economi- cally impractical for high power applications. In higher power levels shunt ...

  5. Shunt hybrid active power filter for harmonic mitigation: A practical ...

    Indian Academy of Sciences (India)

    Home; Journals; Sadhana; Volume 40; Issue 4. Shunt hybrid active power filter for harmonic mitigation: A practical design approach. Unnikrishnan A K ... This paper presents a control strategy and design criteria for transformer-less shunt HAPF with special attention to the integration of series passive filter. The paper also ...

  6. Comparison of shunted DC-SQUIDs with large β

    Science.gov (United States)

    Houwman, E. P.; Veldhuis, D.; Flokstra, J.; Rogalla, H.

    1990-08-01

    The performance of DC-SQUIDS with inductively and resistively shunted inductances is studied theoretically and experimentally and compared to the performance of a standard (unshunted) SQUID. By shunting the inductance the voltage modulation depth remains unaffected for large β. The consequences for the flux-voltage transfer and the noise performance are discussed.

  7. Comparison of shunted DC-SQUIDs with large β

    OpenAIRE

    Houwman, Evert Pieter; Veldhuis, Dick; Flokstra, Jakob; Rogalla, Horst

    1990-01-01

    The performance of DC-SQUIDS with inductively and resistively shunted inductances is studied theoretically and experimentally and compared to the performance of a standard (unshunted) SQUID. By shunting the inductance the voltage modulation depth remains unaffected for large β. The consequences for the flux-voltage transfer and the noise performance are discussed.

  8. Allergic fungal sinusitis in children.

    Science.gov (United States)

    Thorp, Brian D; McKinney, Kibwei A; Rose, Austin S; Ebert, Charles S

    2012-06-01

    Allergic fungal sinusitis (AFS) is a subtype of eosinophilic chronic rhinosinusitis (CRS) characterized by type I hypersensitivity, nasal polyposis, characteristic computed tomography scan findings, eosinophilic mucus, and the presence of fungus on surgical specimens without evidence of tissue invasion. This refractory subtype of CRS is of the great interest in the pediatric population, given the relatively early age of onset and the difficulty in managing AFS through commercially available medical regimens. Almost universally, a diagnosis of AFS requires operative intervention. Postoperative adjuvant medical therapy is a mainstay in the treatment paradigm of pediatric AFS. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Aneurismatisk knoglecyste i sinus maxillaris

    DEFF Research Database (Denmark)

    Danielsen, Annegrete Aalkjær; Jensen, Margarat Malgorzata; Iyer, Victor Vishwanath

    2017-01-01

    This case report describes a primary aneurysmal bone cyst in the maxillary sinus of a 50-year-old woman. She had nonspecific symptoms through four years of tearing, muscle tension in the face and neck as well as a sense of altered sound of speech. A magnetic resonance imaging of the facial skeleton...... showed multiple cystic processes with liquid mirror in nearly all large cysts. Histology confirmed the diagnosis of a rare aneurysmal bone cyst, and the operation was done by endoscopic resection. At the one-month post-operative control there was no recurrence....

  10. Syringomyelia regression after shunting of a trapped fourth ventricle

    Directory of Open Access Journals (Sweden)

    Dukagjin Morina

    2013-01-01

    Full Text Available We describe a case of progressive syringomyelia following post-infectious trapped fourth ventricle (TFV, which resolved after shunting of the fourth ventricle. A 28-year-old female who had previously undergone treatment of intracerebral hemorrhage and meningitis developed a hydrocephalus with TFV. After 3 years she developed disturbance of walking and coordination. Cranial-CT revealed an enlargement of the shunted fourth ventricle as a result of shunt dysfunction. Furthermore a cervical syringomyelia developed. The patient underwent a revision of a failed fourth ventriculo- peritoneal shunt. Postoperatively, syringomyelia resolved within 6 months and the associated neurological deficits improved significantly. An insufficiency of cerebrospinal fluid draining among patients with TFV can be associated with communicating syringomyelia. An early detection and treatment seems important on resolving syringomyelia and avoiding permanent neurological deficits. Ventriculo-peritoneal shunt in trapped fourth ventricles can resolve a secondary syringomyelia.

  11. Percutaneous peritoneovenous shunt positioning: technique and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Marinucci, Irene [Division of Radiology, European Institute of Oncology, Milan (Italy); Monti, Cinzia [Institute of Radiology, University of Milan (Italy); Bellomi, Massimo [Division of Radiology, European Institute of Oncology, Milan (Italy); Institute of Radiology, University of Milan (Italy)

    2002-05-01

    Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life. (orig.)

  12. Maxillary sinus anatomic and pathologic CT findings in edentulous patients scheduled for sinus augmentation.

    Science.gov (United States)

    Drăgan, Eliza; Rusa, Oana; Nemţoi, A; Melian, G; Mihai, C; Haba, Danisia

    2014-01-01

    An aberrant sinus anatomy or pathology can influence the sinus lift technique if it is encountered during surgical exposure. The purpose of the present study was to determine the prevalence of sinus disease and variations of normal anatomy among edentulous patients prior to sinus augmentation. 120 patients attending a private surgical practice (53 women and 67 men, with a mean age of 62.02 years, ranging between 34 and 81 years old) for whom treatment was planned for sinus augmentation were evaluated--medical history, radiographic and clinical examinations. Computerized tomograms (CT) and 3D reconstructions from 240 sinuses were analyzed using Dental CT. Abnormalities were diagnosed in 74.2% of cases. Mucosal thickening was the most prevalent abnormality (68.3%), followed by retention cysts (15.8%) and opacification (9.2%). The diagnosed conditions included mucosal thickening, chronic sinusitis, sinus cysts and polyps. The prevalence of one or more septa per sinus was found to be 30%. Males present pathology more often than females (p=.028). No statistical correlation could be found between age and pathology (p>0.05) No significant differences in age or gender between patients with and without sinus septum were found (p>0.05). The results reinforce the importance of thorough history taking and clinical and radiographic assessment prior to performing sinus augmentation, to prevent the probability of complications.

  13. The role of the uncinate process in sinusitis aetiology: isolated agenesis versus maxillary sinus hypoplasia.

    Science.gov (United States)

    Uluyol, S; Arslan, İ B; Demir, A; Mercan, G C; Dogan, O; Çukurova, İ

    2015-05-01

    This study aimed to evaluate the clinical significance of maxillary sinus hypoplasia and isolated agenesis of the uncinate process in sinusitis aetiology. Three patients with isolated agenesis of the uncinate process and 27 patients with 43 maxillary sinus hypoplasia variations were recruited. The frequencies of sinusitis episodes and radiological findings were compared between patient subgroups. In all, 23 type I maxillary sinus hypoplasia, 13 type II maxillary sinus hypoplasia and 7 type III maxillary sinus hypoplasia variations were detected. Patients with isolated agenesis of the uncinate process underwent antibiotic treatment an average of 7 times per year, whereas those with types I, II and III maxillary sinus hypoplasia were treated 1.57, 3.22, and 5.75 times per year, respectively, over a 5-year period. The antibiotic treatment frequency for patients with isolated agenesis of the uncinate process was significantly higher than for those with types I and II maxillary sinus hypoplasia. Isolated agenesis of the uncinate process seems to play a stronger role than types I and II maxillary sinus hypoplasia in the pathophysiology of chronic sinusitis.

  14. Ventriculoperitoneal shunt infection with Listeria innocua.

    Science.gov (United States)

    Karli, Arzu; Sensoy, Gulnar; Unal, Nevzat; Yanik, Keramettin; Cigdem, Halit; Belet, Nursen; Sofuoglu, Ayse

    2014-08-01

    Listeria species may cause life-threatening events including meningitis and invasive infection in newborns, pregnant women, older and immunodeficient people. The most common Listeria species that causes infection is L. monocytogenes. It is known that Listeria innocua has no pathogenicity. A 9-month-old baby had ventriculoperitoneal shunt and was treated with adrenocorticotropic hormone because of infantile spasms. He was brought to hospital with fever and vomiting. Upon physical examination, the patient seemed uncomfortable and had a temperature of 38.6°C. Laboratory results were as follows: hemoglobin, 6.7 g/dL; leukocyte count, 5420/mm(3) ; platelet count, 169,000/mm(3) ; and C-reactive protein, 100 mg/L (normal <5 mg/L). On analysis of cerebrospinal fluid (CSF), leukocyte count was 480/mm(3) , protein was 46 mg/dL and CSF glucose was 35 mg/dL. L. innocua was isolated in CSF culture. We describe this unusual case of ventriculoperitoneal shunt infection with L. innocua. © 2014 Japan Pediatric Society.

  15. Odontogenic sinus tracts: a cohort study.

    Science.gov (United States)

    Slutzky-Goldberg, Iris; Tsesis, Igor; Slutzky, Hagay; Heling, Ilana

    2009-01-01

    To determine the prevalence,location, and distribution of sinus tracts in patients referred for endodontic consultation. This cohort study included 1,119 subjects referred for endodontic consultation, 108 of whom presented with sinus tracts. Following clinical and radiographic examination, the diameter of the rarifying osteitis lesion on the radiograph was measured and the path and origin of the sinus tracts determined. Signs and symptoms, tooth site,buccal/lingual location, and diameter were recorded. Data were statistically analyzed using Pearson chi-square test. Sinus tracts originated mainly from maxillary teeth (63.1%); only 38.9% originated from mandibular teeth. Chronic periapical abscess was the most prevalent diagnosed origin (71.0%). Broken restorations were highly associated with the presence of sinus tracts (53.0%). The most frequent site of orifices was buccal(82.4%), followed by lingual or palatal (12.0%). Orifices on the lingual aspect of the gingiva were observed in mandibularmolars. There was an 86.8% correlation between the occurrence of an apically located sinus tract and apical rarifying osteitis(P<.01). Sinus tract in the lingual or palatal aspect of the gingiva is relatively common. Practitioners should look for signs of sinus tract during routine examination

  16. GENETIC PREDICTORS OF IDIOPATHIC SICK SINUS SYNDROME

    Directory of Open Access Journals (Sweden)

    A. A. Chernova

    2012-01-01

    Full Text Available Published data demonstrating genetic determination of sick sinus syndrome is presented. The definition of this pathology is presented; the main symptoms are described, as well as genes that influence the development of idiopathic sick sinus syndrome, their polymorphisms and role in disorders of the cardiovascular system.

  17. carcinome a petites cellules du sinus piriforme

    African Journals Online (AJOL)

    Les auteurs rapportent un cas de localisation au sinus piriforme d'un carcinome à petites cellules. Ce type histologique a été souvent décrit dans la pathologie tumorale pulmonaire. Sa localisation au sinus piriforme étant exceptionnelle. Nous présentons dans ce document les aspects endoscopiques, radiologiques, ...

  18. ORBITAL CELLULITIS COMPLICATING SINUSITIS: A 15-YEAR ...

    African Journals Online (AJOL)

    Dr. NWaorgu

    Abstract. Background: Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain ...

  19. Pseudocystic CT pattern of renal sinus lipomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Downey, E.F. Jr.; Friedman, A.C.; Hartman, D.S.; Pyatt, R.S.; Thane, T.T.; Warnock, G.R.

    1982-09-01

    Previous reports of renal sinus lipomatosis (RSL) have emphasized the CT finding of increased fat around the renal pelvis. The authors present a case in which the CT density of the renal sinus was the same as water. This density appears to depend on the relative amounts of fat and fibrous tissue present.

  20. Mucocele formation after frontal sinus obliteration

    NARCIS (Netherlands)

    Hansen, F. S.; van der Poel, N. A.; Freling, N. J. M.; Fokkens, W. J.

    2018-01-01

    A possible complication of frontal sinus obliteration with fat is the formation of mucoceles. We studied the prevalence of mucoceles as well as and the need for revision surgery. Retrospective case review of forty consecutive patients undergoing frontal sinus obliteration from September 1995 to

  1. Chronic Cutaneous Draining Sinus of Dental Origin

    African Journals Online (AJOL)

    surgery. It can also result from infection or inflammation. The root canal of a necrotic tooth is a source of predominantly anaerobic microbes. The tooth may present without any symptoms, except a cutaneous draining sinus.[1] Due to the extra-oral location of the sinus, patients tend to seek medical care first. These cutaneous.

  2. Puerperal Superior Sagittal Sinus Thrombosis and Pulmonary ...

    African Journals Online (AJOL)

    Superior sagittal sinus thrombosis is a rare and often misdiagnosed disorder. Its occurrence with pulmonary embolism (PE) is much rarer, more so when it occurs in the setting of puerperium. Although cerebral sagittal sinus thrombosis can occur at any time during life, women are particularly vulnerable before delivery and ...

  3. A new mechanism of cerebrospinal fluid leakage after lumboperitoneal shunt: a theory of shunt side hole--case report.

    Science.gov (United States)

    Matsubara, Teppei; Ishikawa, Eiichi; Hirata, Koji; Matsuda, Masahide; Akutsu, Hiroyoshi; Masumoto, Tomohiko; Zaboronok, Alexander; Matsumura, Akira

    2014-01-01

    Cerebrospinal fluid (CSF) overdrainage after lumboperitoneal (LP) shunt placement for the patients with idiopathic normal pressure hydrocephalus (iNPH) is mainly caused by insufficient management of pressure settings of the shunt valve and/or siphon effect of shunt systems induced by the patient's postural changes. We here report a unique case of intracranial hypotension (IH) due to CSF leakage after LP shunt placement in which another mechanism leads to the CSF leakage. A 67-year-old man suffered from persistent headache worsening with postural change 2 months after LP shunt reconstruction for iNPH. Brain computed tomography scan showed bilateral chronic subdural hematomas (CSDH). Lumbar images including shuntography and magnetic resonance imaging showed the tip of the lumbar catheter was spontaneously pulled out close to the dura mater with expansion of the epidural space due to CSF leakage from a shunt side hole of the lumbar catheter to the epidural space. Shunt removal and subsequent irrigation of CSDH improved his headache. CSF leakage in our case differs from those in previous reports, because early and enormous CSF leakage into the epidural space can be explained only by a different mechanism through a side hole just located in the epidural space in our case. We must pay attention to the possibility of this rare cause of IH due to CSF leakage in patients suffering from postural headache after LP shunt placement.

  4. A New Mechanism of Cerebrospinal Fluid Leakage after Lumboperitoneal Shunt: A Theory of Shunt Side Hole—Case Report

    Science.gov (United States)

    MATSUBARA, Teppei; ISHIKAWA, Eiichi; HIRATA, Koji; MATSUDA, Masahide; AKUTSU, Hiroyoshi; MASUMOTO, Tomohiko; ZABORONOK, Alexander; MATSUMURA, Akira

    2014-01-01

    Cerebrospinal fluid (CSF) overdrainage after lumboperitoneal (LP) shunt placement for the patients with idiopathic normal pressure hydrocephalus (iNPH) is mainly caused by insufficient management of pressure settings of the shunt valve and/or siphon effect of shunt systems induced by the patient's postural changes. We here report a unique case of intracranial hypotension (IH) due to CSF leakage after LP shunt placement in which another mechanism leads to the CSF leakage. A 67-year-old man suffered from persistent headache worsening with postural change 2 months after LP shunt reconstruction for iNPH. Brain computed tomography scan showed bilateral chronic subdural hematomas (CSDH). Lumbar images including shuntography and magnetic resonance imaging showed the tip of the lumbar catheter was spontaneously pulled out close to the dura mater with expansion of the epidural space due to CSF leakage from a shunt side hole of the lumbar catheter to the epidural space. Shunt removal and subsequent irrigation of CSDH improved his headache. CSF leakage in our case differs from those in previous reports, because early and enormous CSF leakage into the epidural space can be explained only by a different mechanism through a side hole just located in the epidural space in our case. We must pay attention to the possibility of this rare cause of IH due to CSF leakage in patients suffering from postural headache after LP shunt placement. PMID:24305015

  5. Sinus floor bone failures in maxillary sinus floor augmentation: a case-control study.

    Science.gov (United States)

    Cortes, Arthur Rodriguez Gonzalez; Pinheiro, Lucas Rodrigues; Cavalcanti, Marcelo Gusmão Paraíso; Arita, Emiko Saito; Tamimi, Faleh

    2015-04-01

    Extreme bone resorption in posterior maxilla may lead to absence of part of the sinus floor. This phenomenon has been termed sinus floor bone failure, and may compromise sinus floor augmentation. The present article aims to evaluate risk factors related to sinus floor bone failures and to evaluate the influence of these failures in sinus floor augmentation outcomes in patients with severely atrophic posterior maxilla. In this case-control study, patients were selected among those referred for sinus floor augmentation. Only patients presenting a ridge bone height of less than 3 mm were included. Cases were defined as presenting sinus floor bone failure, whereas controls did not present any interruption in the sinus floor bone. Information collected included clinical dental records and computed tomographic assessment of sinus width, septa, and schneiderian membrane. Risk estimates for sinus floor bone failures were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression analyses. A p value under 0.05 was considered statistically significant. In addition, sinus floor augmentation outcomes of both groups were also assessed. In all, 23 cases and 58 controls were included in the study. Sinus floor bone failures were significantly associated with the number of missing posterior teeth (AOR 3.67; 95% CI 0.86 to 15.63; p = .046) and a history of periodontitis (AOR 6.39; 95% CI 1.86 to 21.95; p = .002). Of the total, 15 cases and 27 controls underwent sinus floor augmentation. Schneiderian membrane perforation occurred during the surgery of two cases and of one control. No implants were lost during a mean postsurgical follow-up of 20 months. The number of missing posterior teeth and a history of periodontitis may be considered as risk factors for sinus floor bone failures. © 2013 Wiley Periodicals, Inc.

  6. Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment

    Science.gov (United States)

    Crovetto-Martínez, Rafael; Martin-Arregui, Francisco J.; Zabala-López-de-Maturana, Aitor; Tudela-Cabello, Kiara

    2014-01-01

    Objectives: Odontogenic sinusitis usually affects the maxillary sinus but may extend to the anterior ethmoid sinuses. The purpose of this study is to determine the percentage of odontogenic maxillary sinusitis extended to the anterior ethmoid sinuses and determine also the surgical resolution differences between odontogenic maxillary sinusitis and odontogenic maxillary associated to anterior ethmoidal sinusitis. Study Design: This is a retrospective cohort study performed on 55 patients diagnosed of odontogenic sinusitis and treated surgically by functional endoscopic sinus surgery. Results: This study showed that 52.7% of odontogenic maxillary sinusitis spreads to anterior ethmoid, causing added anterior ethmoid sinusitis. We found that 92.3% of the odontogenic maxillary sinusitis (who underwent middle meatal antrostomy) and 96.5% of the odontogenic maxillary sinusitis extended to the anterior ethmoid (treated with middle meatal antrostomy and anterior ethmoidectomy) were cured. Conclusions: Ethmoid involvement is frequent in maxillary odontogenic sinusitis. The ethmoid involvement does not worsen the results of “functional endoscopic sinus surgery” applied to the odontogenic sinusitis. Key words:Odontogenic maxillary sinusitis, ethmoiditis, functional endoscopic sinus surgery. PMID:24608208

  7. Pilonidal sinus – challenges and solutions

    Directory of Open Access Journals (Sweden)

    Guner A

    2015-09-01

    Full Text Available Ali Guner, Arif Burak Cekic Department of General Surgery, Karadeniz Technical University, Farabi Hospital, Trabzon, Turkey Abstract: Although it is clinically asymptomatic in some cases, pilonidal sinus disease may also present as a complicated disease, characterized by multiple sinus tracts, leading to severe impairment of patient quality of life. Although clinical studies of pilonidal sinus have been conducted for approximately a century, the gold standard for treatment is undefined. The ideal treatment requires a shorter hospital stay, requires less wound care, results in rapid recovery, maintains quality of life, and has low recurrence rates. In this review, we aim to discuss the challenges and possible solutions for the management of pilonidal sinus disease. Keywords: pilonidal sinus disease, surgery, management, complications, recurrence

  8. Bilateral inferior petrosal sinus sampling.

    Science.gov (United States)

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. © 2016 The authors.

  9. Bilateral inferior petrosal sinus sampling

    Directory of Open Access Journals (Sweden)

    Benedetta Zampetti

    2016-08-01

    Full Text Available Simultaneous bilateral inferior petrosal sinus sampling (BIPSS plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70% makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres.

  10. Clinical Features and Treatments of Odontogenic Sinusitis

    Science.gov (United States)

    Lee, Sung Jin

    2010-01-01

    Purpose The aim of this study was to investigate how clinical features such as sex, age, etiologic factors, and presenting symptoms of odontogenic sinusitis are differentiated from other types of sinusitis. Also, this study was designed to find methods for reducing the incidence of odontogenic sinusitis. Materials and Methods A retrospective chart analysis was completed on twenty-seven patients with odontogenic sinusitis. They were all treated at Kangbuk Samsung Hospital between February 2006 and August 2008. The study protocol and informed consent forms were approved by the institutional review boards for human beings at Kangbuk Samsung Hospital. Results Ten patients (37.0%) had dental implant related complications and 8 (29.6%) had dental extraction related complications. Unilateral purulent nasal discharge was the most common symptom (66.7%). The therapeutic modality included transnasal endoscopic sinus surgery in 19 (70.4%) patients, and a Caldwell-Luc operation in two (7.4%) patients. Conclusion In our study, there was no significant difference in the incidence between genders. The average age of the patients was 42.9 years. The incidence was highest in the fourth decade. There were no significant differences between the symptoms of odontogenic sinusitis and that of other types of sinusitis. However, almost all of the patients with odontogenic sinusitis had unilateral symptoms. Iatrogenic causes, which include dental implants and dental extractions, were the most common etiologic factors related to the development of odontogenic sinusitis. Therefore, a preoperative consultation between a rhinologist and a dentist prior to the dental procedure should be able to reduce the incidence of odontogenic sinusitis. PMID:20879062

  11. [Thrombophlebitis of venous sinuses in otitis media].

    Science.gov (United States)

    Kuczkowski, Jerzy

    2007-01-01

    Thrombophlebitis of dura venous sinuses is a rare intracranial complication of otitis media, which may be sometimes accompanied by symptoms or sepsis. Anatomical conditions and early diagnosis of this vascular complication determine the treatment modality. Aim of this study was the assessment of diagnostics and treatment of venous sinuses thrombophlebitis in acute and chronic otitis media considering anatomy and the venous sinuses and status of coagulation system. Otogenic thrombophlebitis may occur in lateral, transverse, upper and lower petrosal sinuses, and rarely in cavernous. In some cases thrombophlebitis proces may expand into brain or emissary mastoid veins. Lateral sinus thrombophlebitis in chronic otitis media usually appears clinically as septic fever, earache, and increasing neurologic signs. In acute otitis media when thrombophlebitis develops the patient complains about headache, high fever and visual acquity. Diagnosis of venous sinus thrombophlebitis is based on clinical signs, radiological imaging (CT scan, MRI), bacteriological examinations and laboratory biochemical tests. Contrast enhanced CT scan shows "delta sign". Septic thrombophlebitis sinus sigmoidei is caused by mixed bacterial flora. Surgical treatment in cases with septic thrombus consists of radical modiffied ear operation and lateral sinus exposure. Thrombectomy and jugular vein ligation is performed when sepsis or thrombus is present. Mastoidectomy and tympanic cavity drainage is performed in cases with lateral sinus thrombosis in acute mastoiditis. Intravenous antibiotics therapy should be continued for 2 weeks. Anticoagulants should be given taking into consideration parameters of coagulation system and the type of thrombus. Treatment results of venous sinuses thrombophlebitis are good if they are not accompanied by other intracranial complications.

  12. Evaluation of Shunt Losses in Industrial Silicon Solar Cells

    Directory of Open Access Journals (Sweden)

    P. Somasundaran

    2016-01-01

    Full Text Available Shunting is one of the key issues in industrial silicon solar cells which degrade cell performance. This paper presents an approach for investigation of the performance degradation caused by the presence of ohmic extended shunts at various locations in industrial silicon solar cells. Location, nature, and area of the shunts existing in solar cells have been examined by lock-in infrared thermography (LIT. Based on LIT images and experimental dark I-V curves of solar cell, shunted cell has been modeled, from which loss in fill factor and efficiency due to the specific shunt has been obtained. Distributed diode modeling approach of solar cell has been exploited for obtaining simulation results which were supported by experimental measurements. The presented approach is useful to estimate performance reduction due to specific shunts and to quantify losses, which can help in improving the efficiency of solar cell during production by tackling the shunt related problems based on the level of severity and tolerance.

  13. Aberrant hepatic lipid storage and metabolism in canine portosystemic shunts.

    Directory of Open Access Journals (Sweden)

    Lindsay Van den Bossche

    Full Text Available Non-alcoholic fatty liver disease (NAFLD is a poorly understood multifactorial pandemic disorder. One of the hallmarks of NAFLD, hepatic steatosis, is a common feature in canine congenital portosystemic shunts. The aim of this study was to gain detailed insight into the pathogenesis of steatosis in this large animal model. Hepatic lipid accumulation, gene-expression analysis and HPLC-MS of neutral lipids and phospholipids in extrahepatic (EHPSS and intrahepatic portosystemic shunts (IHPSS was compared to healthy control dogs. Liver organoids of diseased dogs and healthy control dogs were incubated with palmitic- and oleic-acid, and lipid accumulation was quantified using LD540. In histological slides of shunt livers, a 12-fold increase of lipid content was detected compared to the control dogs (EHPSS P<0.01; IHPSS P = 0.042. Involvement of lipid-related genes to steatosis in portosystemic shunting was corroborated using gene-expression profiling. Lipid analysis demonstrated different triglyceride composition and a shift towards short chain and omega-3 fatty acids in shunt versus healthy dogs, with no difference in lipid species composition between shunt types. All organoids showed a similar increase in triacylglycerols after free fatty acids enrichment. This study demonstrates that steatosis is probably secondary to canine portosystemic shunts. Unravelling the pathogenesis of this hepatic steatosis might contribute to a better understanding of steatosis in NAFLD.

  14. The hydrokinetic parameters of shunts for hydrocephalus might be inadequate.

    Science.gov (United States)

    Sotelo, Julio

    2012-01-01

    Long-term treatment of hydrocephalus continues to be dismal. Shunting is the neurosurgical procedure more frequently associated with complications, which are mostly related with dysfunctions of the shunting device, rather than to mishaps of the rather simple surgical procedure. Overdrainage and underdrainage are the most common dysfunctions; of them, overdrainage is a conspicuous companion of most devices. Even when literally hundreds of different models have been proposed, developed, and tested, overdrainage has plagued all shunts for the last 60 years. Several investigations have demonstrated that changes in the posture of the subject induce unavoidable and drastic differences of intraventricular hydrokinetic pressure and cerebrospinal fluid (CSF) drainage through the shunt. Of all the parameters that participate in the pathophysiology of hydrocephalus, the only invariable one is cerebrospinal fluid production at a constant rate of approximately 0.35 ml/min. However, this feature has not been considered in the design of currently available shunts. Our experimental and clinical studies have shown that a simple shunt, whose drainage capacity complies with this unique parameter, would prevent most complications of shunting for hydrocephalus.

  15. Shunt malfunction presenting with symptomatic syringomyelia: Demonstrated on contrast ventriculogram.

    Science.gov (United States)

    Aniruddha, T J; Pruthi, Nupur

    2014-05-01

    Ventriculoperitoneal (VP) shunt malfunction commonly presents as raised intracranial pressure. Rarely, when the central canal of the spinal cord communicates with the 4(th) ventricle, shunt malfunction can present as an expanding syrinx. The diagnosis is often delayed, resulting in severe morbidity. Some of these patients undergo repeated syrinx surgeries without much benefits. We report a case of chronic tuberculous meningitis with shunt malfunction presenting as an expanding spinal canal syrinx and quadriparesis. Fourth ventricular communication with syrinx was demonstrated with the help of a contrast ventriculogram. After shunt revision, syrinx resolved completely and the patient made significant improvement in his neurological deficits. The present case illustrates that a historical and rarely used investigation like contrast ventriculogram aids in the diagnosis and management even in the current neurosurgical practice. All patients with late onset syrinx and a previous VP shunt need to be investigated for shunt malfunction before considering syrinx surgery. A simple shunt revision resolves the syrinx in such conditions and avoids more complex procedures like Foramen magnum decompression. Relevant literature has been reviewed; pathophysiology and management options have been discussed.

  16. A plasma polymerization technique to overcome cerebrospinal fluid shunt infections

    Energy Technology Data Exchange (ETDEWEB)

    Coekeliler, D [Plasma Aided Bioengineering and Biotechnology Research Laboratory, Engineering Faculty, Hacettepe University, 06532, Ankara (Turkey); Caner, H [Department of Neurosurgery, School of Medicine, Baskent University, 06610, Ankara (Turkey); Zemek, J [Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnicka 10, 162 53, Prague, Czech Republic (Czech Republic); Choukourov, A [Department of Macromolecular Physics, Charles University, V Holesovickach 2, 18000 Prague (Czech Republic); Biederman, H [Department of Macromolecular Physics, Charles University, V Holesovickach 2, 18000 Prague (Czech Republic); Mutlu, M [Plasma Aided Bioengineering and Biotechnology Research Laboratory, Engineering Faculty, Hacettepe University, 06532, Ankara (Turkey)

    2007-03-01

    Prosthetic devices, mainly shunts, are frequently used for temporary or permanent drainage of cerebrospinal fluid. The pathogenesis of shunt infection is a very important problem in modern medicine and generally this is characterized by staphylococcal adhesion to the cerebrospinal fluid shunt surfaces. In this paper, the prevention of the attachment of test microorganism Staphylococcus epidermidis on the cerebrospinal fluid shunt surfaces by 2-hydroxyethylmethacrylate (HEMA) precursor modification in the plasma polymerization system, is reported. Different plasma polymerization conditions (RF discharge power 10-20-30 W, exposure time 5-10-15 min) were employed during the surface modification. The surface chemistry and topology of unmodified and modified shunts was characterized by x-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM) and atomic force microscopy (AFM). Also, static contact angle measurements were performed to state the change of surface hydrophilicity. All samples were tested in vitro with Staphylococcus epidermidis. A plasma-polymerized HEMA film (PP HEMA) was found to be an alternative simple method to decrease the microorganism attachment and create bacterial anti-fouling surfaces. The attachment of the model microorganism Staphylococcus epidermidis on the shunt surface modified by PP HEMA at 20 W and 15 min was reduced 62.3% if compared to the unmodified control surface of the shunt.

  17. Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm; Report of two cases

    Directory of Open Access Journals (Sweden)

    Khalfan S. Al-Senaidi

    2016-11-01

    Full Text Available A ruptured sinus of Valsalva aneurysm (RSVA is a rare cardiac anomaly. Traditionally, RSVAs were repaired surgically; however, percutaneous transcatheter closure is the current treatment of choice. We report two cases of RSVA which were closed using this approach. The first case was a 45-year-old female who presented to the Royal Hospital, Muscat, Oman, in 2014 with a RSVA in the right ventricle. The second case was a 39-year-old male who was admitted to the Sultan Qaboos University Hospital, Muscat, in 2015 with a large multifenestrated RSVA extending into the right ventricle outflow tract. Each patient underwent transcutaneous cardiac catheterisation using three-dimensional echocardiography. Both interventions were technically successful; however, the second patient required a subsequent surgery due to the continuing presence of a significant shunt. Transcatheter closure of RSVAs is an effective alternative to surgical repair, although large multifenestrated RSVAs should be repaired surgically to ensure complete closure.

  18. [Maxillary sinusitis of odontogenic origin: surgical treatment].

    Science.gov (United States)

    Chemli, H; Mnejja, M; Dhouib, M; Karray, F; Ghorbel, A; Abdelmoula, M

    2012-04-01

    The frequency of maxillary sinusitis of dental origin (MSDO) is under estimated. The medical and surgical treatment has improved thanks to endoscopic guidance. We report our experience and strategy in the treatment of MSDO. Twenty-two patients presenting with MSDO were treated between 1998 and 2008. The results were evaluated on clinical, functional, sinusal, and odontologic signs. MSDO accounted for 16% of surgically managed sinusitis. CT was performed in 95% of cases. The etiologies were apical leakage in seven patients, migration of a tooth or root during extraction, or presence of ectopic tooth in the sinus in nine patients, a cyst in three patients, and oroantral communication in three patients. Surgery was performed after antibiotic and NSAID treatment. The first surgical step was the treatment of the odontogenic source. The second step was sinus drainage by endoscopic treatment in 64%, Caldwell-Luc in 23%, and drainage by oroantral communication enlarged then closed in the same operative time in 13%. The follow up ranged from 3 months to 10 years. Early postoperative superinfection was observed in two patients. Two patients presented with recurrent sinusitis. The postoperative sequels were hyposmia in three patients, dental pulpotomy, and trigeminal neuralgia in five patients treated by Caldwell-Luc surgery. Nasal endoscopy has improved the surgical management of MSDO. It makes curettage and exclusion of sinus cavities obsolete. It is reliable and has a low rate of complications. The best treatment remains prevention. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  19. Spinal cord arteriovenous shunts: from imaging to management

    Energy Technology Data Exchange (ETDEWEB)

    Rodesch, G. E-mail: g.rodesch@hopital-foch.org; Lasjaunias, P

    2003-06-01

    Spinal cord arteriovenous shunts (SCAVSs) are either fistulas or niduses that can be separated in four different groups according to their localization and relationship to the dura. Paraspinal AVSs are located outside the spine and are responsible for neurological symptoms because of cord compression by ertatic veins, venous congestion or arterial steal. Epidural shunts are located in the epidural space and drain in epidural veins with secondary intradural congestion. Dural shunts are embedded in the dura, produce a cord venous myelopathy after draining through veins that either pierce the dura far from a nerve root or accompany a nerve root. Intradural shunts affect the cord, the roots or the filum. Additionally, they can be classified according to their potential relationships with genetics, vascular biological features and angiogenesis into genetic hereditary lesions (hereditary hemorrhagic telangiectasia), genetic non-hereditary lesions (multiple lesions with metameric links) and single lesions (AVMs or micro AVFs). MRI and MRA are able to visualise SCAVS early after the onset of clinical symptoms. The type of shunt and its localization may remain difficult to be precise. Angiography remains the gold standard for analysis of the anatomical, morphological and architectural features necessary for therapeutic decisions in both paediatric and adult populations. In our series, embolisation is chosen in first intention whatever the type of shunt responsible for the clinical symptoms and glue is preferably used. In paraspinal, dural or epidural arteriovenous shunts, the goal of treatment should be complete closure of the shunt. A complete cure by embolization is rather easily achieved in paraspinal lesions. Failure of endovascular therapy in dural or epidural shunts must bring the patient to surgery. The prognosis of most intradural shunts seems better than previously thought, even after haemorrhage. In intradural spinal cord arteriovenous shunts, embolisation

  20. Prevention and treatment of complications after transjugular intrahepatic portosystemic shunt

    Directory of Open Access Journals (Sweden)

    XUE Hui

    2016-02-01

    Full Text Available The application of transjugular intrahepatic portosystemic shunt (TIPS in the treatment of cirrhotic portal hypertension has been widely accepted both at home and abroad. This article focuses on the fatal complications of TIPS (including intraperitoneal bleeding and acute pulmonary embolism, shunt failure, and recurrent portosystemic hepatic encephalopathy, and elaborates on the reasons for such conditions and related preventive measures, in order to improve the accuracy and safety of intraoperative puncture, reduce common complications such as shunt failure and hepatic encephalopathy, and improve the clinical effect of TIPS in the treatment of cirrhotic portal hypertension.

  1. Cloxacillin and Sodium Fusidate in Management of Shunt Infections

    Science.gov (United States)

    Rao, R.; Webster, A. B. D.; Sunderland, D. R.; Smith, W. F.; Ampalam, S.; Lee, H. A.

    1972-01-01

    The effectiveness of two oral antibiotics, cloxacillin and sodium fusidate, has been evaluated in the treatment of shunt infections among 37 patients allocated at random to two treatment groups. Both proved to be safe bactericidal agents giving adequate serum M.I.C. when taken by mouth. Treatment should always be started on the basis of the clinical presentation without waiting for the bacteriologist's report. The commonest infecting organism is Staphylococcus aureus. Nine shunts were lost in this study, eight through Staphylococcus aureus infection. The nasal carrier state is of considerable importance in perpetuating these shunt infections. PMID:5071699

  2. Leakage Inductance Calculation for Planar Transformers with a Magnetic Shunt

    DEFF Research Database (Denmark)

    Jun, Zhang; Ouyang, Ziwei; Duffy, M. C.

    2013-01-01

    with a magnetic shunt by means of the stored magnetic energy in the primary and secondary sides of the transformer using the magnetomotive force (MMF) variation method, as well as the stored energy in the shunt based on the reluctance model. The detailed calculation method is described. Both the FEA simulation......The magnetic shunt is generally inserted in a planar transformer to increase the leakage inductance which can be utilized as the series inductor in resonant circuits such as the LLC resonant converter. This paper presents a calculation methodology for the leakage inductance of the transformer...

  3. Leakage Inductance Calculation for Planar Transformers with a Magnetic Shunt

    DEFF Research Database (Denmark)

    Zhang, Jun; Ouyang, Ziwei; Duffy, Maeve C.

    2014-01-01

    with a magnetic shunt by means of the stored magnetic energy in the primary and secondary sides of the transformer using the magnetomotive force (MMF) variation method, as well as the stored energy in the shunt based on the reluctance model. The detailed calculation method is described. Both the FEA simulation......The magnetic shunt is generally inserted in a planar transformer to increase the leakage inductance which can be utilized as the series inductor in resonant circuits such as the LLC resonant converter. This paper presents a calculation methodology for the leakage inductance of the transformer...

  4. Current concepts on complications associated with sinus augmentation procedures

    NARCIS (Netherlands)

    Boffano, P.; Forouzanfar, T.

    2014-01-01

    The sinus augmentation, or sinus lift procedure, is an internal augmentation of the maxillary sinus, which is intended to increase the vertical bony dimension in the lateral maxilla to make the placement of dental implants possible. Complication rate associated with maxillary sinus augmentation

  5. Current Concepts on Complications Associated With Sinus Augmentation Procedures

    NARCIS (Netherlands)

    Boffano, P.; Forouzanfar, T.

    2014-01-01

    The sinus augmentation, or sinus lift procedure, is an internal augmentation of the maxillary sinus, which is intended to increase the vertical bony dimension in the lateral maxilla to make the placement of dental implants possible. Complication rate associated with maxillary sinus augmentation

  6. Association between maxillary sinus pathologies and healthy teeth

    Directory of Open Access Journals (Sweden)

    Gina D. Roque-Torres

    2016-02-01

    Full Text Available ABSTRACT INTRODUCTION: The proximity of the roots to the maxillary sinus can create a variety of risks. OBJECTIVE: To evaluate the relationship between the roots of healthy teeth and the maxillary sinus, as well as the occurrence of sinus pathologies. METHODS: Three radiologists analyzed 109 cone beam computed tomography (CBCT images. The Kappa test was used to assess the intra- and inter-rater agreement. The chi-squared test and prevalence ratio were used to test the hypothesis that roots of healthy teeth in the maxillary sinus favored the occurrence of sinus pathologies ( p = 0.01. RESULTS: Intra- and inter-rater agreement ranged from good to excellent. The chi-squared test demonstrated a statistically significant difference ( p = 0.006 between the tooth roots in diseased maxillary sinuses (6.09% and those in normal sinuses (3.43%. The prevalence ratio test showed a statistically significant higher prevalence of tooth roots in diseased sinuses than in normal sinuses ( p < 0.0001. Roots in the maxillary sinus were 1.82 times more associated with diseased sinuses. CONCLUSION: Dental roots in the maxillary sinus are almost twice as likely to be associated with diseased sinuses than normal sinuses. Healthy teeth whose roots are inside the maxillary sinus may induce an inflammatory response in the sinus membrane. It is suspected that dental procedures may exacerbate the condition.

  7. [Conservative therapy of chronic sinusitis].

    Science.gov (United States)

    Reiss, Michael; Reiss, Gilfe

    2012-01-01

    The chronic rhinosinusitis is defined as chronic inflammation of the nose and nasal sinuses, with or without nasal polyps. Patients suffering from chronic rhinosinusitis report about nasal obstruction and secretion, olfactory impairment, head and facial pain. These symptoms cause also considerable impact on quality of life. Therefore, an adequate rhinological diagnostics as well as therapies are essential. This paper reviews the pharmacologic and non-pharmacologic therapy of chronic rhinosinusitis. First choice of therapy should be topical glucocorticoids. The application of glucocorticoids causes anti-inflammatory and certain curative effects. Hypertonic salt solutions improve nasal symptoms. Long-term therapy with oral macrolides might improve median to severe symptoms of chronic rhinosinusitis without nasal polyps. An additional therapy with antihistamines is possible in patients with an allergy. Adaptive desensitization in patients suffering from analgesic-intolerance associating among other with nasal polyps is currently the single causal therapy. Therefore, frequency of endonasal revision surgery is reduced after desensitization.

  8. A case of delayed-onset ventriculo-peritoneal shunt infection with Corynebacterium presented as ascites

    Directory of Open Access Journals (Sweden)

    Tong Yang

    2016-06-01

    Full Text Available Shunt infection is one of the most common complications related to VPS insertion. Most shunt infections occur within the first year of surgery. We present a case of delayed infection 4 years after shunt insertion without intervening shunt manipulation. Our patient presented with recurrent ascites, and cultures of peritoneal fluid and CSF both recovered Corynebacterium afermentans. This case demonstrates that a delayed onset of ascites after shunt insertion can be secondary to infection with uncommon indolent pathogen.

  9. A Rational Approach to Sinus Augmentation: The Low Window Sinus Lift

    Directory of Open Access Journals (Sweden)

    Terry Zaniol

    2017-01-01

    Full Text Available Sinus augmentation is a well-known approach to treating alveolar bone ridge atrophy in the posterior maxilla. The preparation of the lateral window is crucial. Its size, design, and position in the vestibular sinus wall may affect the intra- and postsurgical complication rates and affect the intrasurgical activity of both surgeons and assistants. The present paper describes a rational technique that also exploits the guided surgery approach for design and preparation of a lateral window for sinus augmentation, the Low Window Sinus Lift. To illustrate the use of this approach, a case is presented in which the 50-year-old patient had the left maxillary first molar extracted, followed two months later by sinus augmentation and placement of three implants. One year after delivery of the definitive prosthesis, all three implants were successful, and the prosthesis was fully functional. Controlled studies should be undertaken to assess whether this technique provides significant advantages compared to other sinus augmentation approaches.

  10. How does nose blowing effect the computed tomography of paranasal sinuses in chronic sinusitis?

    Energy Technology Data Exchange (ETDEWEB)

    Savranlar, Ahmet; Uzun, Lokman; Ugur, Mehmet Birol; Mahmutyazicioglu, Kamran; Ozer, Tulay; Gundogdu, Sadi

    2005-02-01

    Objective: Our aim was to determine whether inward or outward movement of the secretions in the paranasal sinuses due to nose blowing after nasal decongestion has any effect on the paranasal sinus computed tomography (CT) images in patients with sinusitis and to asses whether nose blowing may result in misdiagnosis or overdiagnosis in radiological evaluation of sinusitis. Materials and methods: Twenty-four patients with chronic sinusitis were evaluated in an academic tertiary care hospital and data were collected prospectively. After coronal sinus computed tomography scans were performed at 100 mA setting which was half the value of the standard radiation dose suggested by the manufacturer, topical decongestion was applied to each nostril followed by nose blowing 10 min later. Sinus CT scans were then repeated at the same setting. We evaluated the mucosal thickness of medial, lateral, superior and inferior maxillary and frontal sinus walls and the maximal thickness in anterior ethmoidal cells. The measurements prior to and following nose blowing were compared with Wilcoxon signed ranks test. The obtained images were also staged using Lund-McKay staging system separately and the scores were compared with Student's t-test. Results: We observed a tendency towards reduction in mucosal thickness after nose blowing. There were statistically significant differences between maxillary sinus inferior wall and frontal sinus inferior wall mucosal thickness values prior to and after nose blowing. The difference however was very small, about 0.5 mm in magnitude and Lund-McKay score did not change in any of the patients after nose blowing. Conclusion: Nose blowing and topical nasal decongestion does not have any effect on the diagnostic accuracy of sinus CT in chronic sinusitis patients.

  11. Goat Model for Direct Visualizing the Effectiveness of Detaching Sinus Mucosa in Real Time During Crestal Maxillary Sinus Floor Elevation.

    Science.gov (United States)

    Fan, Jiadong; Hu, Pin; Li, Yanfeng; Wang, Fuli; Dong, Xinming; Liu, Bin; Liu, Le; Zhang, Yue; Gu, Xiangmin

    2017-08-01

    The procedure of crestal maxillary sinus floor elevation presents a great challenge to the field of implant dentistry. Due to the limited visualization in this procedure, the effectiveness of detaching sinus mucosa could not be assessed in real time. We recently developed an ex vivo goat sinus model by cutting the goat residual skulls along four lines determined from computerized tomography (CT) scans, extracting the maxillary premolar or molar teeth, and preparing implant socket in the maxilla. The generated ex vivo goat sinus models exposed the maxilla and the whole maxillary sinus mucosa, thus enabling real-time observation of detaching maxillary sinus mucosa via directly visualizing the working situation of sinus lift tool in the models and directly measuring the length of detached mucosa and space volume generated under the elevated sinus mucosa. One commercially available umbrella-shaped sinus lift curette was used to detach the maxillary sinus mucosa to evaluate the effectiveness of the ex vivo goat sinus models. The results showed that this curette could detach the sinus mucosa 3.75 mm in length in the mesiodistal direction and 2.81 mm in the buccal-palatal direction. Moreover, a space volume of 52.7 μl could be created under the elevated sinus mucosa in the goat ex vivo models. All the experimental results suggested that this ex vivo goat sinus model might be useful in the evaluation of improved or newly designed sinus lift tools for elevating the maxillary sinus mucosa via the crestal approach.

  12. The effect of sinus surgery with intensive follow-up on pathogenic sinus bacteria in patients with cystic fibrosis

    DEFF Research Database (Denmark)

    Aanaes, Kasper; von Buchwald, Christian; Hjuler, Thomas

    2013-01-01

    Most patients with cystic fibrosis (CF) have chronic rhinosinusitis; their sinuses are often colonized with bacteria that can initiate and maintain deleterious pulmonary infections. Theoretically, eradication of the sinus bacteria should reduce the frequency of lung infections and thereby reduce...... pulmonary morbidity. This article addressed whether bacteria in CF sinuses are eligible for eradication by sinus surgery and postoperative treatment....

  13. The Monro-Kellie Doctrine in Action: Posterior Reversible Leukoencephalopathy Syndrome Caused by Intracranial Hypotension from Lumboperitoneal Shunt Placement.

    Science.gov (United States)

    Karakis, Ioannis; Nuccio, Audrey H; Amadio, Jordan P; Fountain, Arthur J

    2017-02-01

    Posterior reversible leukoencephalopathy syndrome (PRES) is linked to various etiologies, including most importantly systemic hypertension. Its association with intracranial hypotension (IH), a potential sequela of various neurosurgical procedures, is underrecognized. We report a case of lumboperitoneal shunt-induced IH resulting in PRES with the goal to increase awareness and elaborate on the potential biologic mechanism, based on the Monro-Kellie hypothesis. A 26-year-old woman with acquired immunodeficiency syndrome and epilepsy was admitted for recurrent cryptococcal meningitis and breakthrough seizures. There was radiologic evidence of ventricular enlargement, and opening pressure on serial lumbar punctures was constantly elevated. Owing to persistently elevated, symptomatic intracranial pressure and transient relief with serial lumbar punctures, a lumboperitoneal shunt was placed. The patient subsequently had a breakthrough seizure and became encephalopathic. Repeat head imaging showed reduced ventricular size, engorged venous sinuses, and tonsillar herniation in keeping with IH, coupled with extensive white matter abnormalities in bilateral parieto-occipital lobes indicative of PRES. The patient had an emergent programmable valve placed in the lumboperitoneal shunt to prevent excessive cerebrospinal fluid drainage, leading to clinical and radiologic improvement. Subsequent cerebrospinal fluid leak resulted in recurrent presentation. IH appears to be a distinct cause of PRES not previously reported in the neurosurgical literature. It occurs in susceptible patients, on average 1-5 days after the IH trigger, and seems clinically and radiologically similar to more common hypertensive cases in terms of initial presentation and prognosis. Increased vigilance is required for prompt recognition and management. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Assessment of maxillary sinus wall thickness with paranasal sinus digital tomosynthesis and CT

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Ji Eun; Shim, Sung Shine; Kim, Yoo Kyung; Kong, Kyoung Ae [Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2017-05-15

    This study was performed to compare paranasal sinus tomosynthesis with computed tomography (CT) imaging as a radiologic tool to evaluate the paranasal sinuses, using measurement of the soft tissue thickness of the maxillary sinus. A total of 114 patients with sinusitis who underwent both paranasal sinus digital tomosynthesis (DT) and CT were enrolled in this retrospective study. Two observers independently assessed soft tissue thickness in both maxillary sinus chambers using both DT and CT images. The mean difference in soft tissue thickness measured by each observer was −0.31 mm on CT and 0.15 mm on DT. The mean differences in soft tissue thickness measured with DT and CT were −0.15 by observer 1 and −0.31 by observer 2. Evaluation of the agreement in measurement of soft tissue thickness in the maxillary sinus using DT and CT showed a high intraclass correlation, with the 95% limit of agreement ranging from −3.36 mm to 3.06 mm [intraclass correlation coefficient (ICC), 0.994: p<0.01] for observer 1 and from −5.56 mm to 4.95 mm (ICC, 0.984: p<0.01) for observer 2. As an imaging tool, DT is comparable to CT for assessing the soft tissue thickness of maxillary sinuses in patients with sinusitis.

  15. Scoliosis and Syringomyelia With Chiari Malformation After Lumbar Shunting

    Directory of Open Access Journals (Sweden)

    Hsin-Hung Chen

    2010-07-01

    Full Text Available Unsteady gait was noted in a 2-year-old boy with a lumboperitoneal (LP shunt that had been inserted 1 year earlier for increased head circumference caused by communicating hydrocephalus. Scoliosis was also noted during postoperative follow-up. Magnetic resonance imaging revealed new hindbrain tonsillar herniation and an extensive syrinx from C3 to L1. The malfunctioning LP shunt was removed and posterior fossa decompression with ventriculoperitoneal shunt insertion was performed. The unsteady gait recovered completely and scoliosis improved. Magnetic resonance imaging demonstrated resolution of the syrinx and tonsillar herniation. Acquired Chiari I malformation after LP shunt is well documented; usually, patients have no symptoms. This is the first report to have all the cause and effect mechanisms among syringomyelia, scoliosis and Chiari I malformation in 1 patient. We review the literature and discuss the possible mechanisms.

  16. Effects of an interatrial shunt on rest and exercise hemodynamics

    DEFF Research Database (Denmark)

    Kaye, David; Shah, Sanjiv J; Borlaug, Barry A

    2014-01-01

    of this approach with the use of a previously validated cardiovascular simulation. METHODS AND RESULTS: Rest and exercise hemodynamics data from 2 previous independent studies of patients with HFpEF were simulated. The theoretical effects of a shunt between the right and left atria (diameter up to 12 mm) were...... determined. The interatrial shunt lowered PCWP by ~3 mm Hg under simulated resting conditions (from 10 to 7 mm Hg) and by ~11 mm Hg under simulated peak exercise conditions (from 28 to 17 mm Hg). Left ventricular cardiac output decreased ~0.5 L/min at rest and ~1.3 L/min at peak exercise, with corresponding...... of the conditions tested. CONCLUSIONS: The interatrial shunt reduced left-sided cardiac output with a marked reduction in PCWP. This approach may reduce the propensity for heart failure exacerbations and allow patients to exercise longer, thus attaining higher heart rates and cardiac outputs with the shunt compared...

  17. Clopidogrel in infants with systemic-to-pulmonary-artery shunts

    DEFF Research Database (Denmark)

    Wessel, David L; Berger, Felix; Li, Jennifer S

    2013-01-01

    BACKGROUND: Infants with cyanotic congenital heart disease palliated with placement of a systemic-to-pulmonary-artery shunt are at risk for shunt thrombosis and death. We investigated whether the addition of clopidogrel to conventional therapy reduces mortality from any cause and morbidity related...... to the shunt. METHODS: In a multicenter, double-blind, event-driven trial, we randomly assigned infants 92 days of age or younger with cyanotic congenital heart disease and a systemic-to-pulmonary-artery shunt to receive clopidogrel at a dose of 0.2 mg per kilogram of body weight per day (467 infants...... days of age. RESULTS: The rate of the composite primary end point did not differ significantly between the clopidogrel group (19.1%) and the placebo group (20.5%) (absolute risk difference, 1.4 percentage points; relative risk reduction with clopidogrel, 11.1%; 95% confidence interval, -19.2 to 33.6; P...

  18. Surgical correction of ruptured aneurysms of the sinus of Valsalva using on-pump beating-heart technique

    Directory of Open Access Journals (Sweden)

    Lin Hui

    2010-05-01

    Full Text Available Abstract Background Rupture of aneurysms of the sinus of Valsalva results in abrupt onset of congestive heart failure. On-pump beating-heart surgery may reduce cardiac impairment by maintaining coronary blood flow and avoiding cardioplegia. Herein, we report the operative correction of thirty-one patients of ruptured aneurysms of the sinus of Valsalva, using the on-pump beating-heart technique. Methods Thirty-one patients with ruptured aneurysms of the sinus of Valsalva underwent operative corrections using the on-pump beating-heart technique. In patients with fistula diameter less than 1 cm and no aortic regurgitation, the aorta was unclamped throughout cardiopulmonary bypass(CPB while receiving antegrade heart perfusion. In remainder of patients, retrograde perfusion was used. Results After intracardiac manipulation was complete and the nasopharyngeal temperature was raised to 36-37°C, the patients were smoothly weaned off CPB. There were no early or late postoperative deaths. All patients were in New York Heart Association functional class I at follow-up (range, 0.5-1 year. Mild-to-moderate aortic valve regurgitation was observed in one patient. No recurrence of the left-to-right shunt from ruptured aneurysms of the sinus of Valsalva was observed. Conclusions Beating heart on pump allows adequate examination of the aortic lesion under near-physiologic conditions, allows decrease in ischemia-reperfusion injury and potentially decreases the risk of serious or fatal rhythm disturbances. On-pump beating-heart technique for repair of ruptured aneurysm of sinus of Valsalva is feasible and promising. Antegrade heart perfusion is suitable for patients with a fistula diameter

  19. Difference between Sinusitis and a Cold

    Science.gov (United States)

    ... Ear Nose & Throat Emotional Problems Eyes Fever From Insects or Animals Genitals and Urinary Tract Glands & Growth ... has bacterial sinusitis after examining your child and hearing about the progression of symptoms. In older children, ...

  20. Sphenoid Sinusitis and Migraine-Type Headache

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2002-02-01

    Full Text Available Three case histories of children (ages 10, 12, and 14 years with isolated sphenoid sinusitis who presented with acute, subacute, and chronic headache symptoms resembling migraine are reported from the University of Texas-Houston Medical School.

  1. Systemic corticosteroid therapy for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, Roderick P.; Thompson, Matthew J.; Rovers, Maroeska M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibioticsmay be associated with modest

  2. Systemic corticosteroid therapy for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Rovers, M.M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibiotics may be associated with modest

  3. Maxillary sinus perforation by orthodontic anchor screws

    National Research Council Canada - National Science Library

    Motoyoshi, Mitsuru; Sanuki-Suzuki, Rina; Uchida, Yasuki; Saiki, Akari; Shimizu, Noriyoshi

    2015-01-01

    .... The placement torque and screw mobility of each implant were determined using a torque tester and a Periotest device, and variability in these values in relation to sinus perforation was evaluated...

  4. Osteoma of the skull base and sinuses

    NARCIS (Netherlands)

    Georgalas, Christos; Goudakos, John; Fokkens, Wytske J.

    2011-01-01

    Osteomata of the frontal and ethmoid sinuses have traditionally been surgically removed via external approaches. However, endoscopic techniques have increasingly been used for the surgical management of selected cases. Advances in visualization and instrumentation, as well as the excellent access

  5. Cranial expansion for shunt-induced craniostenosis. Case report ...

    African Journals Online (AJOL)

    Quelques patients atteints de fentes ventriculaires développent une craniosténose shunt induite provoquant une augmentation de la pression intracrânienne pendant que le cerveau se développe peuvant être mal interprété comme un problème de dysfonctionnement de shunt. L'expansion de voûte crânienne a été décrit ...

  6. Neck massage induced dural sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Verma Ashish

    2007-01-01

    Full Text Available Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage.

  7. Presentation and diagnosis of allergic fungal sinusitis.

    Science.gov (United States)

    Zakirullah; Nawaz, Ghareeb; Sattar, Syed Fazle

    2010-01-01

    Allergic fungal sinusitis (AFS) is a form of fungal disease that has recently been considered a distinct clinicopathologic entity. Other forms of fungal sinusitis include acute-fulminant (invasive), chronic indolent (invasive) and mycetoma (non-invasive). Objectives were to assess the presentation and to describe the diagnostic techniques for allergic fungal sinusitis in our setup. Descriptive study was conducted in the Department of ENT and Head & Neck Surgery, Khyber Medical College and Khyber Teaching Hospital, Peshawar from January 2002 to April 2008. Twenty-three cases of allergic fungal sinusitis (ASF) were selected for the study. Data like, name, age, sex, address, clinical features, labs (Eosinophil count) and imaging studies (CT and/or MRI) were recorded, including the pre- and postoperative treatment, operative findings and postoperative results, recurrence of disease were also recorded. Surgical procedures were performed on all cases followed by medical treatment. Study revealed that AFS is a disease of younger age, mainly occurring in 2nd & 3rd decade of life, with male to female ratio 1:1.3. Allergic rhinitis (91%) and nasal polyposis (91%) were important associated factors. Nasal obstruction (96%), nasal discharge (91%), post-nasal discharge (87%) and unilateral multi sinus extension were important clinical features. Increased eosinophil count and increased IgE level was found in 78% cases. Histopathological analysis showed fungal hyphae in all cases and aspergillus was predominant organism on culture. Orbital erosion was seen in 78% and skull base erosion was observed in 9%. Recurrence of disease was seen in nine cases. Allergic fungal sinusitis (AFS) is a disease of young immunocompetent adults. Nasal obstruction, nasal discharge, nasal allergy and proptosis were the most common presentations. Initial diagnosis of allergic fungal sinusitis requires high index of suspicion in patients presenting with chronic rhinosinusitis, such cases should be

  8. Systemic corticosteroid therapy for acute sinusitis

    OpenAIRE

    Venekamp, Roderick P.; Thompson, Matthew J.; Rovers, Maroeska M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibioticsmay be associated with modest benefit for short-term relief of symptoms in adults with severe symptoms of acute sinusitis compared with antibiotics alone. Oral corticosteroids as monotherapy are not associated with improved clinical...

  9. Aberrant gene expression in dogs with portosystemic shunts.

    Directory of Open Access Journals (Sweden)

    Frank G van Steenbeek

    Full Text Available Congenital portosystemic shunts are developmental anomalies of the splanchnic vascular system that cause portal blood to bypass the liver. Large-breed dogs are predisposed for intrahepatic portosystemic shunts (IHPSS and small-breed dogs for extrahepatic portosystemic shunts (EHPSS. While the phenotype resulting from portal bypass of the liver of the two types of shunt is identical, the genotype and molecular pathways involved are probably different. The aim of this study was to gain insight into the pathways involved in the different types of portosystemic shunting. Microarray analysis of mRNA expression in liver tissue from dogs with EHPSS and IHPSS revealed that the expression of 26 genes was altered in either IHPSS or EHPSS samples compared with that in liver samples from control dogs. Quantitative real-time PCR of these genes in 14 IHPSS, 17 EHPSS, and 8 control liver samples revealed a significant differential expression of ACBP, CCBL1, GPC3, HAMP, PALLD, VCAM1, and WEE1. Immunohistochemistry and Western blotting confirmed an increased expression of VCAM1 in IHPSS but its absence in EHPSS, an increased WEE1 expression in IHPSS but not in EHPSS, and a decreased expression of CCBL1 in both shunt types. Regarding their physiologic functions, these findings may indicate a causative role for VCAM1 in EHPSS [corrected] and WEE1 for IHPSS. CCBL1 could be an interesting candidate to study not yet elucidated aspects in the pathophysiology of hepatic encephalopathy.

  10. Use of engineered bone for sinus augmentation.

    Science.gov (United States)

    Beaumont, Christian; Schmidt, Roswitha J; Tatakis, Dimitris N; Zafiropoulos, Gregory-George

    2008-03-01

    Tissue-engineered bone grafts represent an appealing alternative for maxillary sinus augmentation because they eliminate the significant drawbacks associated with extra- and intraoral bone-harvesting procedures. In the present case series, we document the outcomes of sinus augmentation surgery using tissue-engineered bone grafts. Three patients requiring bilateral sinus augmentation received tissue-engineered bone grafts combined with xenograft prior to implant placement. Implants were placed and loaded 6 and 12 months postaugmentation, respectively. Radiographs were taken and clinical examinations were performed preoperatively and at 4, 6, 12, and 18 months postaugmentation. Biopsies were obtained at 4 and 6 months postaugmentation. Standardized orthopantomograms were used to measure the posterior maxilla bone height. None of the patients experienced untoward complications during or following the therapeutic procedures. Ten implants were inserted into the augmented sinuses and loaded. Biopsies revealed a lack of inflammation or pathology; newly formed fibrous bone with osteoblastic activity and xenograft particles was evident. Compared to 4 months postaugmentation, augmented tissue was more mature at 6 months. The postoperative (18 months) bone height in augmented areas was significantly greater than the preoperative height (P bone height. Sinus augmentation using tissue-engineered bone grafts was successful in all three cases, permitting the subsequent insertion and loading of dental implants. The present cases demonstrated the feasibility of using engineered bone for sinus augmentation. Controlled clinical trials will be required to evaluate this new and evolving treatment modality.

  11. Silent sinus syndrome: A traumatic case.

    Science.gov (United States)

    Février, E; Vandersteen, C; Castillo, L; Savoldelli, C

    2017-06-01

    Silent sinus syndrome is an unusual cause of progressive enophthalmos and hypoglobus due to atelectasia of the maxillary sinus associated with osteolysis of the orbital floor. This syndrome is classically idiopathic, but the term is also used to describe traumatic or iatrogenic (surgical orbital decompression) cases. We report the case of a 33-year-old man who presented with a left orbital trauma without functional disorder. Computed tomography (CT) scan revealed a nondisplaced fracture of the left orbital floor. No surgical indication was made. Three months later, the patient presented with progressive enophthalmos. CT revealed a complete lysis of the left orbital floor and a left maxillary sinus atelectasia. The original nondisplaced fracture of the orbital floor was not responsible for enophthalmos but the associated fracture of the left uncinate process that induced the closure of the left maxillary sinus infundibulum. This induced in turn hypoventilation of the sinus and a left orbital floor lysis. Treatment consisted in surgical opening of the maxillary sinus ostium and reconstruction of the orbital floor. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Dural Arteriovenous Fistula Could Be Due to Hemodynamic Disturbance in Dural Physiological Shunts? Histopathological Study and a Case Report.

    Science.gov (United States)

    Nagm, Alhusain; Horiuchi, Tetsuyoshi; Kanaya, Kohei; Hongo, Kazuhiro

    2016-06-01

    Histopathologic studies of dural arteriovenous fistulas (dAVFs) are important for clarifying the pathogenesis. We present a case of Cognard type IV dAVF with detailed histopathologic studies in correlation with radiologic and intraoperative findings. An otherwise asymptomatic 53-year-old man presented with chronic headache. Neurologic examination revealed no abnormalities. Neuroimaging and cerebral catheter angiographic studies disclosed a left frontoparietal dAVF close to the middle third of the superior sagittal sinus, fed by the left superficial temporal and bilateral middle meningeal arteries and draining into ectatic cortical and dural veins. No evidence of superior sagittal sinus thrombosis or occlusion was seen. Intraoperatively, the parietal branch of the left superficial temporal artery penetrated the skull vault to feed the fistula; arterialized cortical and draining dural veins were also noted. Complete obliteration of the dAVF with removal of the affected dura mater was achieved safely. Histopathologic studies in serial sections documented a shunt point between the dural artery and the dural vein within the dura mater and a draining point between the dural and cortical veins. On the basis of clinical, angiographic, intraoperative, and histologic findings in our case, we strongly excluded acquired etiologies. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Programmable shunts and headphones: Are they safe together?

    Science.gov (United States)

    Spader, Heather S; Ratanaprasatporn, Linda; Morrison, John F; Grossberg, Jonathan A; Cosgrove, G Rees

    2015-10-01

    Programmable shunts have a valuable role in the treatment of patients with hydrocephalus, but because a magnet is used to change valve settings, interactions with external magnets may reprogram these shunts. Previous studies have demonstrated the ability of magnetic toys and iPads to erroneously reprogram shunts. Headphones are even more ubiquitous, and they contain an electromagnet for sound projection that sits on the head very close to the shunt valve. This study is the first to look at the magnetic field emissions of headphones and their effect on reprogrammable shunt valves to ascertain whether headphones are safe for patients with these shunts to wear. In this in vitro study of the magnetic properties of headphones and their interactions with 3 different programmable shunts, the authors evaluated Apple earbuds, Beats by Dr. Dre, and Bose QuietComfort Acoustic Noise Cancelling headphones. Each headphone was tested for electromagnetic field emissions using a direct current gaussmeter. The following valves were evaluated: Codman Hakim programmable valve, Medtronic Strata II valve, and Aesculap proGAV. Each valve was tested at distances of 0 to 50 mm (in 5-mm increments) from each headphone. The exposure time at each distance was 1 minute, and 3 trials were performed to confirm results at each valve setting and distance. All 3 headphones generated magnetic fields greater than the respective shunt manufacturer's recommended strength of exposure, but these fields did not persist beyond 5 mm. By 2 cm, the fields levels were below 20 G, well below the Medtronic recommendation of 90 G and the Codman recommendation of 80 G. Because the mechanism for the proGAV is different, there is no recommended gauss level. There was no change in gauss-level emissions by the headphones with changes in frequency and amplitude. Both the Strata and Codman-Hakim valves were reprogrammed by direct contact (distance 0 mm) with the Bose headphones. When a rotation component was added, all

  14. Cranialization of the frontal sinus-the final remedy for refractory chronic frontal sinusitis

    NARCIS (Netherlands)

    van Dijk, J. Marc C.; Wagemakers, Michiel; Korsten-Meijer, Astrid G. W.; Buiter, C. T. Kees; van der Laan, Bernard F. A. M.; Mooij, Jan Jakob A.

    Object. Chronic sinusitis can be a debilitating disease with significant impact on quality of life. Frontal sinusitis has a relatively low prevalence, but complications can be severe due to its anatomical location. After failure of conservative measures, typically endoscopic procedures are performed

  15. Intrauterine shunt for obstructive hydrocephalus--still not ready.

    Science.gov (United States)

    Bruner, Joseph P; Davis, George; Tulipan, Noel

    2006-01-01

    To determine the safety and efficacy of ventriculoamniotic shunt placement through a hysterotomy in the second trimester of pregnancy as treatment for isolated obstructive hydrocephalus. Between 1999 and 2003, four pregnancies with isolated fetal obstructive hydrocephalus in the second trimester were treated at Vanderbilt University Medical Center. Preoperatively, all fetuses underwent serial ultrasonographic examinations and an ultrafast magnetic resonance imaging to confirm isolated aqueductal stenosis. A normal fetal karyotype and negative polymerase chain reaction or culture of the amniotic fluid for cytomegalovirus and toxoplasmosis were obtained. Serial enlargement of the lateral ventricles >1.5 mm/week and fetal macrocephaly were documented. Using epidural and GETA, a standard ultrasmall ventricular catheter and valve were inserted via a hysterotomy. The distal catheter, rather than being inserted into the fetal peritoneum, exited between the fetal scapulae. Patients were discharged home from the hospital, and the remainder of their prenatal care was provided by their local obstetrician. After delivery, the distal drain was converted to a ventriculoperitoneal shunt. Cases were performed at 23 6/7, 25 5/7, 26 4/7, and 26 5/7 weeks. Shunts performed well during pregnancy, and were intact at delivery. Deliveries occurred at 34 1/7, 27 1/7, 28, and 32 4/7 weeks. Birthweights were 2,010, 907, 1,200, and 2,220 g. All Apgar scores were normal. Case 1 developed a neonatal shunt infection, and is now developmentally delayed, with swallowing dysfunction, hearing deficits and a poor pupillary response. Case 2 developed neonatal sepsis and is now developmentally delayed. Case 3 delivered preterm due to chorioamnionitis, and neonatal death occurred from sepsis. Case 4 is developmentally delayed. Ventriculoamniotic shunt can be placed through a hysterotomy, overcoming many of the technical difficulties of earlier percutaneous shunts. However, recent developments in fetal

  16. Attenuation of congenital portosystemic shunt reduces inflammation in dogs.

    Science.gov (United States)

    Tivers, Michael S; Handel, Ian; Gow, Adam G; Lipscomb, Victoria J; Jalan, Rajiv; Mellanby, Richard J

    2015-01-01

    Liver disease is a major cause of morbidity and mortality. One of the most significant complications in patients with liver disease is the development of neurological disturbances, termed hepatic encephalopathy. The pathogenesis of hepatic encephalopathy is incompletely understood, which has resulted in the development of a wide range of experimental models. Congenital portosystemic shunt is one of the most common congenital disorders diagnosed in client owned dogs. Our recent studies have demonstrated that the pathophysiology of canine hepatic encephalopathy is very similar to human hepatic encephalopathy, which provides strong support for the use of dogs with a congenital portosystemic shunt as a naturally occurring model of human hepatic encephalopathy. Specifically, we have demonstrated an important role for ammonia and inflammation in the development of hepatic encephalopathy in dogs with a congenital portosystemic shunt. Despite the apparent importance of inflammation in driving hepatic encephalopathy in dogs, it is unclear whether inflammation resolves following the successful treatment of liver disease. We hypothesized that haematological and biochemical evidence of inflammation, as gauged by neutrophil, lymphocyte and monocyte concentrations together with C-reactive protein concentrations, would decrease following successful treatment of congenital portosystemic shunts in dogs. One hundred and forty dogs with a congenital portosystemic shunt were enrolled into the study. We found that the proportion of dogs with a monocyte concentration above the reference range was significantly greater in dogs with hepatic encephalopathy at time of initial diagnosis. Importantly, neutrophil and monocyte concentrations significantly decreased following surgical congenital portosystemic shunt attenuation. We also found a significant decrease in C-reactive protein concentrations following surgical attenuation of congenital portosystemic shunts. Our study demonstrates that

  17. Relationship among cardiac output, shunt, and inspired O2 concentration.

    Science.gov (United States)

    Wagner, P D; Schaffartzik, W; Prediletto, R; Knight, D R

    1991-12-01

    In comparing gas exchange responses of the methacholine- (MCh) challenged mongrel dog with leukotriene receptor blockers and placebo at different inspiratory O2 fractions (FIO2), we previously noted systematically different values of cardiac output as a function of drug administration and/or FIO2. This confounds identification of the effects of FIO2 and/or drugs on gas exchange, because shunt is well known to vary directly with cardiac output when other factors are equal. Accordingly, in six dogs we examined the dependence of combined shunt and low ventilation-perfusion (VA/Q) blood flow ("shunt") on cardiac output in the MCh-challenged mongrel dog. Two dogs breathed 100% O2, another two breathed room air, and the final pair breathed 12% O2 while cardiac output was altered several times by sequentially opening and closing arteriovenous fistulas every 10 min for approximately 90 min after a standard MCh challenge. On 100% O2, shunt increased by 11.0% of the cardiac output per 1-l/min increase in cardiac output. On room air, the value was 7.4%. With 12% O2 breathing shunt rose by only 2.2% per 1-l/min rise in blood flow. This FIO2 -dependent behavior of the shunt-cardiac output relationship was highly reproducible, both within and between animals. It suggests that the increase in shunt with cardiac output depends more on vascular tone of noninjured areas than on tone of the low VA/Q regions (which are hypoxic at all FIO2 values).

  18. Attenuation of congenital portosystemic shunt reduces inflammation in dogs.

    Directory of Open Access Journals (Sweden)

    Michael S Tivers

    Full Text Available Liver disease is a major cause of morbidity and mortality. One of the most significant complications in patients with liver disease is the development of neurological disturbances, termed hepatic encephalopathy. The pathogenesis of hepatic encephalopathy is incompletely understood, which has resulted in the development of a wide range of experimental models. Congenital portosystemic shunt is one of the most common congenital disorders diagnosed in client owned dogs. Our recent studies have demonstrated that the pathophysiology of canine hepatic encephalopathy is very similar to human hepatic encephalopathy, which provides strong support for the use of dogs with a congenital portosystemic shunt as a naturally occurring model of human hepatic encephalopathy. Specifically, we have demonstrated an important role for ammonia and inflammation in the development of hepatic encephalopathy in dogs with a congenital portosystemic shunt. Despite the apparent importance of inflammation in driving hepatic encephalopathy in dogs, it is unclear whether inflammation resolves following the successful treatment of liver disease. We hypothesized that haematological and biochemical evidence of inflammation, as gauged by neutrophil, lymphocyte and monocyte concentrations together with C-reactive protein concentrations, would decrease following successful treatment of congenital portosystemic shunts in dogs. One hundred and forty dogs with a congenital portosystemic shunt were enrolled into the study. We found that the proportion of dogs with a monocyte concentration above the reference range was significantly greater in dogs with hepatic encephalopathy at time of initial diagnosis. Importantly, neutrophil and monocyte concentrations significantly decreased following surgical congenital portosystemic shunt attenuation. We also found a significant decrease in C-reactive protein concentrations following surgical attenuation of congenital portosystemic shunts. Our study

  19. Prevalence of incidental paranasal sinus opacification in dental paediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae; Jung, Yun Hoa; Nah, Kyung Soo [Department of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2008-12-15

    The purpose of this study was to determine the prevalence of sinus opacification among dental paediatric patients. Two hundred and eight Cone Beam Computed Tomography (CBCT) scans of dental patients under the age of 18 were reviewed for sinus opacification. Patients with any sinus-related signs or symptoms were excluded. The overall prevalence of sinus opacification was 48.1%. The ethmoid (28.4%) and maxillary (27.8%) sinuses were most frequently affected. There were no statistically significant differences for both age and gender. The high prevalence of sinus opacification in asymptomatic children emphasizes the necessity of clinical correlation.

  20. [Diagnosis and treatment of fungal ball rhino-sinusitis].

    Science.gov (United States)

    Nie, Jun; Liu, Fenfang; Zhang, Hanwu; Li, Li

    2013-07-01

    To explore the diagnosis and treatment of the fungal ball rhino-sinusitis. The clinical data of 128 cases with the fungal ball rhino-sinusitis in our hospital between September 2005 and January 2012 were retrospectively analyzed. All patients were accepted nasal endoscopic surgery and followed up after surgery. The diagnosis were confirmed by postoperative pathological examination. The sinus of all patients epithelialized after the surgery from fourth to ninth weeks, one case recurred eight months later. Sinus CT scan and nasal endoscopy were very important to the diagnosis of the fungal ball rhino-sinusitis, and nasal endoscopic surgery is the most important treatment method to fungal ball rhino-sinusitis.

  1. A 10-year experience with the Amatsu tracheoesophageal shunt Experiência de 10 anos com o shunt traqueoesofágico de Amatsu

    Directory of Open Access Journals (Sweden)

    Mauro Becker M. Vieira

    2002-10-01

    Full Text Available Introduction: Since 1991, we have done the tracheoesophageal shunt as described by Amatsu in candidates to a total laryngectomy. Our goal is to provide the patients a better speech rehabilitation that that obtained by the non-surgical techniques, and by doing so, lessen the oncological treatment impact on the patient's quality of life. Aim: This work revises the experience of our institution with the procedure during a 10 years period. Study design: Clinical retrospective. Material and method: We had 54 patients submitted to the procedure, 3 women e 51 men, with ages from 30 to 78 years old and a mean age of 59 years. All had scamous cell carcinoma, 10 from the piriform sinus, 2 from retrocricoide area, 6 from the supraglottis, 1 from the subglottis, 16 from the glottis and 19 were transglottic. According to the AJC staging system, 3 were stage II, 17 were stage III, 24 were stage IV and 10 were not staged. Previous radiotherapy as initial treatment had been done in 18 patients. During the laryngectomy, 33 patients had some type of neck dissection and in 15 of these patients the neck dissection was done bilaterally. A myocutaneous pectoralis major flap was needed in 5 cases and a deltopectoralis flap was used in one case. Postoperative radiotherapy was used in 20 patients. Local infections occurred in 36% of the cases, and all had a good outcome. One patient died in the early postoperative period. Results: Speech rehabilitation by the technique was successful in 70% of the cases. Aspiration occurred in 10 patients and, in 2 of these, the shunt had to be surgically closed. Conclusion: In conclusion, due to its low cost, good results with few complications, the Amatsu tracheoesophageal shunt continues in our service as the main technique for speech rehabilitation after laryngectomy.Introdução: Desde 1991, os autores têm realizado o shunt traqueoesofágico descrito por Amatsu em pacientes submetidos a laringectomia total. A técnica visa

  2. Scalp necrosis overlying a ventriculoperitoneal shunt: a case report and literature review.

    Science.gov (United States)

    Nguyen, Tuyet A; Cohen, Philip R

    2015-10-16

    The use of ventriculoperitoneal (VP) shunts has become ubiquitous in neurosurgery for the treatment of hydrocephalus. VP shunts work by creating a conduit for cerebrospinal fluid (CSF) to flow from the cerebral ventricles to the peritoneum and thus relieving pressure. Although typically safe, VP shunt complications are extremely common, occurring in up to 29% of adult cases and approximately half of pediatric cases. These complications may require patients to undergo several revisions throughout their lifetime Purpose: We describe a man who developed scalp necrosis overlying his VP shunt. We also summarize the potential complications of VP shunts. We discuss the presentation and pathogenesis of scalp necrosis in these patients. A PubMed search of the following terms was performed and relevant citations were assessed: ventriculoperitoneal shunt, VP shunt, shunt complications, scalp necrosis, skin necrosis, ventriculoperitoneal shunt induced scalp necrosis, ventriculoperitoneal shunt induced skin necrosis. A 73-year-old man developed VP shunt-induced scalp necrosis leading to loss of skin overlying the shunt valve. The patient was emergently referred to neurosurgery and admitted for revision of the shunt due to the significant risk for infection. The VP shunt was replaced with an external drain and a skin flap was used to repair the defect. VP shunts are devices that are frequently used for reducing intracranial pressure associated with hydrocephalus. The insertion of the shunt beneath the scalp sets the stage for potential pressure-induced scalp necrosis. The early recognition and diagnosis of VP shunt-induced scalp necrosis is essential to prevent infections and future complications.

  3. Case series of ventriculopleural shunts in adults: a single-center experience.

    Science.gov (United States)

    Craven, Claudia; Asif, Hasan; Farrukh, Amna; Somavilla, Flavia; Toma, Ahmed K; Watkins, Laurence

    2017-06-01

    OBJECTIVE The peritoneal cavity is widely used as the destination of choice for cerebrospinal fluid shunts. Various alternative sites have been used, particularly in the presence of certain contraindications. The pleural cavity has been used; however, a paucity of evidence details ventriculopleural (VPL) shunt survival, complication, and revision rates in adults. The aim of this study was to present a single center's experience with VPL shunts, identifying complication, revision, and survival rates. METHODS A single-center, retrospective case series analysis was conducted for VPL shunt insertions and revisions over a period of 5 years. Demographic as well as clinical data were collected. Ventriculopleural shunt survival was assessed using Kaplan-Meier curves and the log rank (Cox-Mantel) test. RESULTS Twenty-two VPL shunts were inserted in 19 patients. Median survival of the VPL shunts was 14 months. Pathological indication for the VPL shunt did not significantly affect survival. A total of 10 complications was observed: 2 infections, 2 cases of overdrainage, 2 obstructions, 1 distal catheter retraction, 2 symptomatic pleural effusions, and 1 asymptomatic pleural effusion. CONCLUSIONS Ventriculopleural shunting is a safe and viable second-line procedure for cases in which ventriculoperitoneal shunts are unsuitable. While VPL shunts have a high revision rate, their complication rate is comparable to that of VP shunts. Ventriculopleural shunt survival can be improved by careful patient selection and the implementation of a combination of valves with antisiphon devices.

  4. Improvement of psychiatric symptoms in youth following resolution of sinusitis.

    Science.gov (United States)

    Mahony, Talia; Sidell, Douglas; Gans, Hayley; Brown, Kayla; Farhadian, Bahare; Gustafson, Melissa; Sherr, Janell; Thienemann, Margo; Frankovich, Jennifer

    2017-01-01

    Accumulating evidence supports a role for inflammation in psychiatric illness, and the onset or exacerbation of psychiatric symptoms may follow non-CNS infections. Here, we provide the first detailed description of obsessive-compulsive and related psychiatric symptoms arising concurrently with sinusitis. We reviewed the charts of 150 consecutive patients evaluated in our Pediatric Acute-onset Neuropsychiatric Syndromes clinic for documented sinusitis as defined by the American Academy of Pediatrics guidelines. Sinusitis treatments, sinonasal imaging, and neuropsychiatric symptoms before, during, and after sinusitis onset were noted. Patients were included in the final review if they had a clear diagnosis of isolated sinusitis (without concurrent illness and/or immunodeficiency), and were evaluated during an episode of sinusitis. 10/150 (6.6%) patients had isolated sinusitis at the time of their neuropsychiatric deterioration. Eight patients received antibiotics to treat sinusitis, three of whom also received sinus surgery. Neuropsychiatric symptoms improved in all eight patients concurrent with resolution of sinusitis per parent report and clinician assessment. One patient did not follow through with recommended sinus surgery or antibiotics and her psychiatric symptoms persisted. One patient was lost to follow-up. Improvement of psychiatric symptoms correlated with resolution of sinus disease in this retrospective study. Identification, treatment, and resolution of underlying infections, including sinusitis, may have the potential to change the trajectory of some neuropsychiatric illnesses. Randomized clinical trials are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. [Treatment of low-dose erythromycin and sinus displacement on sinusitis in patients with nasopharyngeal carcinoma after radiotherapy].

    Science.gov (United States)

    Wei, Zhenghong; Han, Guang; Li, Bennong

    2011-11-01

    To study the effect of low-dose erythromycin combined with sinus displacement therapy on treating sinusitis in patients with nasopharyngeal carcinoma after radiotherapy. The sinus displacement were used with mixed liquid of metronidazole, protease and dexamethasone, and meantime roxithromycin was orally administered. Effective rate was 97.1% in 35 nasopharyngeal carcinoma patients with sinusitis after radiotherapy. Low-dose erythromycin combined with sinus displacement therapy is effective to treat sinusitis in patients with nasopharyngeal carcinoma after radiotherapy. Its advantages are safe, effective, and easy to do.

  6. Evolution of sinusal and non-sinusal spleens of Mammals

    Directory of Open Access Journals (Sweden)

    Ion Udroiu

    2006-09-01

    Full Text Available Abstract Mammals present different types of spleen. In the past, attempts have been made to define characteristics for a classification of this organ, but the evolutionary process that has led to the splenic types of modern mammals has been poorly investigated. This review categorizes all mammalian spleens studied so far, synthesizing several earlier classification principles and updating them in the light of recent research. The main qualitative features are the type of circulation (closed, open or both and the nature of the venous vessels in the splenic cords (venules or sinuses. The main quantitative feature is the proportion between red and white pulp. Moreover, a phylogeny of this organ is proposed: from a ‘primitive type’ with closed circulation (characteristic of monotremes, insectivores and tree shrews, the spleen has evolved into an ‘archetypal type’ with open circulation (peculiar to mice, gerbils, bats and marsupials. It has subsequently diversified into different models: blood-storing spleens (ungulates and carnivores and defensive spleens (Old World monkeys and the majority of rodents. Riassunto Evoluzione delle milze sinusale e non-sinusale dei mammiferi I mammiferi presentano diversi tipi di milza. Nel passato, sono stati fatti dei tentativi per definire le caratteristiche utili alla classificazione di quest’organo, ma il processo evolutivo che ha portato ai tipi di milza dei mammiferi moderni è stato poco studiato. Questa review classifica tutte le milze dei mammiferi studiate finora, facendo una sintesi dei criteri di classificazione precedenti ed aggiornandoli alla luce delle più recenti ricerche. I principali caratteri qualitativi sono il tipo di circolazione (chiusa, aperta o entrambe e la natura dei vasi venosi nei cordoni splenici (venule o seni. Il principale carattere quantitativo è la proporzione tra la polpa rossa e quella bianca. Inoltre, viene

  7. Coherence properties of a capacitively-shunt flux qubit

    Science.gov (United States)

    Birenbaum, Jeffrey; Sears, Adam; Nugroho, Christopher; Gudmundsen, Ted; Welander, Paul; Yoder, Jonilyn; Kamal, Archana; Gustavsson, Simon; Kerman, Jamie; Oliver, William; Clarke, John

    2014-03-01

    Coherence times for typical flux qubits have plateaued at 5 - 10 μ s for T1 and 1 - 3 μ s for TRamsey. To achieve longer coherence times we study capacitively-shunted flux qubits using high-Q capacitors to individually shunt all four Josephson junctions (JJs). The additional shunt capacitance moves 90 + % of the qubit energy from the lossy capacitance of the JJs into the high-Q shunts while preserving an anharmonicity greater than 100 % and maintaining f01 structure is also flattened providing moderately decreased sensitivity to flux noise. Using high-quality MBE aluminum we fabricate a capacitively-shunted flux qubit inductively coupled to a lumped-element readout resonator. The qubit junctions are deposited via aluminum e-beam evaporation using a bridgeless mask. We characterize the influence of qubit design parameters such as capacitance and geometry on the coherence time of the device. This research was funded in part by the Office of the Director of National Intelligence (ODNI), Intelligence Advanced Research Projects Activity (IARPA), through the Army Research Office.

  8. Syringosubarachnoid shunt as a management for syringohydromyelia in dogs.

    Science.gov (United States)

    Motta, L; Skerritt, G C

    2012-04-01

    To evaluate retrospectively the efficacy of syringosubarachnoid shunt for the management of syringohydromyelia/syringomyelia. Eleven dogs diagnosed with syringohydromyelia/syringomyelia by magnetic resonance imaging associated with Chiari-like malformation underwent placement of a syringosubarachnoid shunt at the cervical (nine dogs) or lumbar (two dogs) spinal cord. In one dog, a suboccipital decompression (foramen magnum decompression) was performed 4 months before inserting a syringosubarachnoid shunt. All dogs were evaluated neurologically a few hours after surgery, 2 weeks and 6 months postoperatively. Retrospectively, cases were assigned a preoperative and postoperative pain score. There were no intra- or peri-operative complications. One dog (9%) was euthanased 5 weeks after surgery. Progressive neurological improvement was observed in nine dogs (81·8%) 2 weeks and 6 months postoperatively. No clinical improvement was seen in another dog (9%). One dog (9%) had replacement of the syringosubarachnoid shunt. Seven dogs (63·6%) were still alive 1 to 4 years (mean, 2·6 years) after surgery. Placement of a syringosubarachnoid shunt in the presence of a sufficiently large syrinx appears to be beneficial in dogs with Chiari-like malformation and associated syringohydromyelia/syringomyelia. © 2012 British Small Animal Veterinary Association.

  9. Central brain herniation in shunted Dandy Walker cyst.

    Science.gov (United States)

    Mandiwanza, Tafadzwa; Kaliaperumal, Chandrasekaran; Caird, John

    2013-06-01

    Dandy-Walker Syndrome (DWS) is a constellation of congenital anomalies of the central nervous system consisting of cerebellar vermis hypoplasia or agenesis, cystic dilatation of the fourth ventricle, enlarged posterior fossa, and a high tentorium. Hydrocephalus is a common occurrence in DWS and its treatment varies between shunting-ventriculoperitoneal or cystoperitoneal or both, endoscopic cyst fenestration, and third ventriculostomy. Chronic cerebral herniation is a known complication of treatment in DWS; however, we present an unusual case of central brain herniation. A 2 year old boy with shunted DWS presented with status epilepticus. Initial CT brain scan showed no increase in ventricle or cyst size; however, tapping the shunt reservoir did not yield any CSF prompting a shunt revision. Postoperatively, he was very slow to wake and subsequently experienced an episode of fixed pupils and extensor posturing. MRI brain demonstrated severe herniation of both thalami through the tentorium. This child had chronic central brain herniation (CCBH) secondary to the shunting of his cyst. To our knowledge, this is the first case of CCBH following treatment of DW cyst.

  10. Model of Shunting Technology Based on System Structure

    Directory of Open Access Journals (Sweden)

    Anton Pepevnik

    2003-09-01

    Full Text Available Railway transport is facing a growing liquidity problem.The major problem in small systems is the detention of wagonsat marshalling yards, which prolongs the time of freight travel.To avoid this problem it is of great importance to search for parametersthat would enable creation of a model of technologythat would provide shorter wagon detention time at stations aswell as optimising the number of marshalling yards for smallsystems. It is at the same time a great opportunity to search for alink between the shunting work in the railway transport and thetheoretical system approach which presents it as a current scientificproblem. In classical technology the shunting work iscarried out with no application of and no regard for the systemapproach. With new shunting systems in the railway transportthe regard for theory of transport systems is crucial as the secondarylevel of classical methods.As already pointed out, from the theoretical point of viewan important contribution will be made to the use of system theoryfor shunting purposes, since the suggested model effectivelyprovides the approach of analysing separate elements in therailway transport structure into integral shunting operations atthe railway stations.

  11. [Surgical treatment for pseudoaneurysm of the sinus of valsalva ruptured into the right atrium after mycotic right coronary artery aneurysm repair;report of a case].

    Science.gov (United States)

    Hirai, Hidekazu; Sasaki, Yasuyuki; Hosono, Mitsuharu; Bito, Yasuyuki; Nakahira, Atsushi; Suehiro, Yasuo; Kaku, Daisuke; Miyabe, Makoto; Suehiro, Shigefumi

    2015-02-01

    A 67-year-old man was admitted to our hospital by ambulance after syncope due to complete A-V block. He had received surgical treatment for mycotic aneurysm of the right coronary artery 3 months before, with patch plasty of the right sinus of Valsalva and bypass grafting to the right coronary artery (RCA) as well as the left anterior descending branch. Computed tomography revealed pseudoaneurysm of the right Valsalva sinus of about 8 cm in diameter and a shunt flow to the right atrium. The previous bypass graft to RCA had been occluded due to compression by the aneurysm. As he was in a shock state, emergency operation was performed. Cardiopulmonary bypass was first established, and after the rectal temperature reached to 26 degrees centigrade, the chest was opened. The pseudoaneurysm burst out when the sternum was re-opened. Under circulatory arrest, the ascending aorta was clamped, and then the circulation was resumed. The previous bovine pericardium patch repairing the Valsalva sinus was detached due to infection, and mural thrombus and pus were observed in the aneurysm. At the bottom of the aneurysm, a fistula connected to the right atrium was found. Debridement around the aneurysm was performed as much as possible. The defect of the Valsalva sinus was repaired with a Dacron patch immersed in gentian violet. The postoperative course was uneventful without any recurrence of infection.

  12. Sigmoid Sinus Diverticulum, Dehiscence, and Venous Sinus Stenosis: Potential Causes of Pulsatile Tinnitus in Patients with Idiopathic Intracranial Hypertension?

    Science.gov (United States)

    Lansley, J A; Tucker, W; Eriksen, M R; Riordan-Eva, P; Connor, S E J

    2017-09-01

    Pulsatile tinnitus is experienced by most patients with idiopathic intracranial hypertension. The pathophysiology remains uncertain; however, transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence have been proposed as potential etiologies. We aimed to determine whether the prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence was increased in patients with idiopathic intracranial hypertension and pulsatile tinnitus relative to those without pulsatile tinnitus and a control group. CT vascular studies of patients with idiopathic intracranial hypertension with pulsatile tinnitus (n = 42), without pulsatile tinnitus (n = 37), and controls (n = 75) were independently reviewed for the presence of severe transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence according to published criteria. The prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence in patients with idiopathic intracranial hypertension with pulsatile tinnitus was compared with that in the nonpulsatile tinnitus idiopathic intracranial hypertension group and the control group. Further comparisons included differing degrees of transverse sinus stenosis (50% and 75%), laterality of transverse sinus stenosis/sigmoid sinus diverticulum/dehiscence, and ipsilateral transverse sinus stenosis combined with sigmoid sinus diverticulum/dehiscence. Severe bilateral transverse sinus stenoses were more frequent in patients with idiopathic intracranial hypertension than in controls (P intracranial hypertension group. Sigmoid sinus dehiscence (right- or left-sided) was also more common in patients with idiopathic intracranial hypertension compared with controls (P = .01), but there was no significant association with pulsatile tinnitus within the idiopathic intracranial hypertension group. While our data corroborate previous studies demonstrating increased prevalence of sigmoid sinus diverticulum/dehiscence and transverse sinus stenosis in

  13. [Surgery of the nose and paranasal sinuses].

    Science.gov (United States)

    Hofer, M; Dacho, A; Dietz, A

    2016-01-01

    A compromised overview of surgical techniques regarding the nose (functional) and para nasal sinus inflammation surgical treatment is exposed in this article. The nasal septum is within the focus for function, form and stability for the nasal structure (especially for tip and back of the nose) and for success of a rhinoplasty. An important role play the lower nasal turbinates regulating nasal air flow and thus having a great effect after turbinate surgery (submucosal resection and lateral fracturing).The endonasal endoscopy is of utmost importance for diagnosis, therapy and detection of recurrence. In severe cases of nasal polyps, functional endoscopic sinus surgery (FESS) remains the ultimate therapy. However, the indication to operate will be carried out after exhaustion of medical treatment. The most important recurrent prophylaxis for rhino sinusitis and nasal polyps is an appropriate post operative nasal care. © Georg Thieme Verlag KG Stuttgart · New York.

  14. [The normative combined therapy for recurrent sinusitis].

    Science.gov (United States)

    Peng, Bengang; Sun, Yiqing; Miao, Xutao; Wang, Xin; Li, Wenjun

    2014-06-01

    To assess the treatment outcome after endoscopic sinus surgery (ESS) in patients with recurrent sinusitis and to research which factors could influence the clinical outcome. Endoscopic sinus surgery was performed in 55 patients. The clinical outcome and epithelization of mucosa after ESS were evaluated by Chinese ENT Association criteria. The total cure rate was 81.82%, effective rate was 92.73%. The mean period of epithelization after operation was 13.2 weeks. No serious complication occurred. The treatment efficacy can be greatly improved by the normative combined therapy which include the standard and orderly perioperative treatment ,the overall shape and nasalization of nasal cavity, postoperative follow-up and clearing cav ity after ESS.

  15. Miller Fisher syndrome with sinus arrest

    Directory of Open Access Journals (Sweden)

    Nobuko Shiraiwa

    2017-08-01

    Full Text Available Dysautonomia in Guillain-Barre syndrome (GBS rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS.

  16. MR-guided endoscopic sinus surgery.

    Science.gov (United States)

    Hsu, L; Fried, M P; Jolesz, F A

    1998-08-01

    We describe an interactive, intraoperative imaging-guided method for performing endoscopic sinus surgery (ESS) within a vertically open MR system. The procedure was performed with intraoperative imaging using a 0.5-T magnet with a 56-cm vertical gap. Interactive control of imaging planes was accomplished by optical tracking with two infrared light-emitting diodes mounted on an aspirator probe. The probe's position defined the location of the orthogonal imaging planes. Twelve patients with varying degrees of sinus disease underwent ESS with MR imaging guidance. Patients had acute and chronic sinusitis, nasal polyposis causing airway obstruction, or tumor requiring tissue biopsy. All procedures were performed with the patients under general anesthesia. The integration of endoscopy with optical tracking and intraoperative interactive imaging allowed localization of anatomic landmarks during ESS. No complications were encountered.

  17. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis: diagnostic criteria.

    Science.gov (United States)

    Uri, N; Ronen, O; Marshak, T; Parpara, O; Nashashibi, M; Gruber, M

    2013-09-01

    Chronic sinusitis is one of the most common otolaryngological diagnoses. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis can easily be misdiagnosed and treated as chronic sinusitis, causing continuing harm. To better identify and characterise these two subgroups of patients, who may suffer from a systemic disease requiring multidisciplinary treatment and prolonged follow up. A retrospective, longitudinal study of all patients diagnosed with allergic fungal sinusitis or eosinophilic mucin rhinosinusitis within one otolaryngology department over a 15-year period. Thirty-four patients were identified, 26 with eosinophilic mucin rhinosinusitis and 8 with allergic fungal sinusitis. Orbital involvement at diagnosis was commoner in allergic fungal sinusitis patients (50 per cent) than eosinophilic mucin rhinosinusitis patients (7.7 per cent; p sinusitis patients. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis have the same clinical presentation but different clinical courses. The role of fungus and the ability to confirm its presence are still problematic issues, and additional studies are required.

  18. An unusual foreign body in the maxillary sinus: Dental impression ...

    African Journals Online (AJOL)

    2015-03-06

    12] The present report presents a case of dental impression material that passed through an oro‑antral fistula while in its plastic form, solidified inside the maxillary sinus, and caused a maxillary sinus infection. Case Report.

  19. Severe bleeding after sinus floor elevation using the transcrestal technique

    DEFF Research Database (Denmark)

    Jensen, Simon Storgard; Eriksen, Jacob; Schiodt, Morten

    2012-01-01

    To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique.......To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique....

  20. Determining the optimal portal blood volume in a shunt before surgery in extrahepatic portal hypertension

    Directory of Open Access Journals (Sweden)

    Yurchuk Vladimir A

    2016-04-01

    Full Text Available The aim of the study: To determine the necessary shunt diameter and assess the optimal portal blood volume in a shunt in children with extrahepatic portal hypertension before the portosystemic shunt surgery. Changes in the liver hemodynamics were studied in 81 children aged from 4 to 7 years with extrahepatic portal hypertension. We established that it is necessary to calculate the shunt diameter and the blood volume in a shunt in patients with extrahepatic portal hypertension before the portosystemic shunt surgery. It allows us to preserve the hepatic portal blood flow and effectively decrease the pressure in the portal system. Portosystemic shunt surgery in patients with extrahepatic portal hypertension performed in accordance with the individualized shunt volume significantly decreases portal pressure, preserves stable hepatic hemodynamics and prevents gastro-esophageal hemorrhage.

  1. Predicting ventriculoperitoneal shunt infection in children with hydrocephalus using artificial neural network.

    Science.gov (United States)

    Habibi, Zohreh; Ertiaei, Abolhasan; Nikdad, Mohammad Sadegh; Mirmohseni, Atefeh Sadat; Afarideh, Mohsen; Heidari, Vahid; Saberi, Hooshang; Rezaei, Abdolreza Sheikh; Nejat, Farideh

    2016-11-01

    The relationships between shunt infection and predictive factors have not been previously investigated using Artificial Neural Network (ANN) model. The aim of this study was to develop an ANN model to predict shunt infection in a group of children with shunted hydrocephalus. Among more than 800 ventriculoperitoneal shunt procedures which had been performed between April 2000 and April 2011, 68 patients with shunt infection and 80 controls that fulfilled a set of meticulous inclusion/exclusion criteria were consecutively enrolled. Univariate analysis was performed for a long list of risk factors, and those with p value artificial neural networks can predict shunt infection with a high level of accuracy in children with shunted hydrocephalus. Also, the contribution of different risk factors in the prediction of shunt infection can be determined using the trained network.

  2. Spatiotemporal complexity of the aortic sinus vortex

    Science.gov (United States)

    Moore, Brandon; Dasi, Lakshmi Prasad

    2014-07-01

    The aortic sinus vortex is a classical flow structure of significant importance to aortic valve dynamics and the initiation and progression of calcific aortic valve disease. We characterize the spatiotemporal characteristics of aortic sinus vortex dynamics in relation to the viscosity of blood analog solution as well as heart rate. High-resolution time-resolved (2 kHz) particle image velocimetry was conducted to capture 2D particle streak videos and 2D instantaneous velocity and streamlines along the sinus midplane using a physiological but rigid aorta model fitted with a porcine bioprosthetic heart valve. Blood analog fluids used include a water-glycerin mixture and saline to elucidate the sensitivity of vortex dynamics to viscosity. Experiments were conducted to record 10 heart beats for each combination of blood analog and heart rate condition. Results show that the topological characteristics of the velocity field vary in timescales as revealed using time bin-averaged vectors and corresponding instantaneous streamlines. There exist small timescale vortices and a large timescale main vortex. A key flow structure observed is the counter vortex at the upstream end of the sinus adjacent to the base (lower half) of the leaflet. The spatiotemporal complexity of vortex dynamics is shown to be profoundly influenced by strong leaflet flutter during systole with a peak frequency of 200 Hz and peak amplitude of 4 mm observed in the saline case. While fluid viscosity influences the length and timescales as well as the introduction of leaflet flutter, heart rate influences the formation of counter vortex at the upstream end of the sinus. Higher heart rates are shown to reduce the strength of the counter vortex that can greatly influence the directionality and strength of shear stresses along the base of the leaflet. This study demonstrates the impact of heart rate and blood analog viscosity on aortic sinus hemodynamics.

  3. Effect of electromagnetic-navigated shunt placement on failure rates: a prospective multicenter study.

    Science.gov (United States)

    Hayhurst, Caroline; Beems, Tjemme; Jenkinson, Michael D; Byrne, Patricia; Clark, Simon; Kandasamy, Jothy; Goodden, John; Nandoe Tewarie, Rishi D S; Mallucci, Conor L

    2010-12-01

    As many as 40% of shunts fail in the first year, mainly due to proximal obstruction. The role of catheter position on failure rates has not been clearly demonstrated. The authors conducted a prospective cohort study of navigated shunt placement compared with standard blind shunt placement at 3 European centers to assess the effect on shunt failure rates. All adult and pediatric patients undergoing de novo ventriculoperitoneal shunt placement were included (patients with slit ventricles were excluded). The first cohort underwent standard shunt placement using anatomical landmarks. All centers subsequently adopted electromagnetic (EM) navigation for routine shunt placements, forming the second cohort. Catheter position was graded on postoperative CT in both groups using a 3-point scale developed for this study: (1) optimal position free-floating in CSF; (2) touching choroid or ventricular wall; or (3) intraparenchymal. Episodes and type of shunt revision were recorded. Early shunt failure was defined as that occurring within 30 days of surgery. Patients with shunts were followed-up for 12 months in the standard group, for a median of 6 months in the EM-navigated group, or until shunt failure. A total of 75 patients were included in the study, 41 with standard shunts and 34 with EM-navigated shunts. Seventy-four percent of navigated shunts were Grade 1 compared with 37% of the standard shunts (p=0.001, chi-square test). There were no Grade 3 placements in the navigated group, but 8 in the standard group, and 75% of these failed. Early shunt failure occurred in 9 patients in the standard group and in 2 in the navigated group, reducing the early revision rate from 22 to 5.9% (p=0.048, Fisher exact test). Early shunt failures were due to proximal obstruction in 78% of standard shunts (7 of 9) and in 50% of EM-navigated shunts (1 of 2). Noninvasive EM image guidance in shunt surgery reduces poor shunt placement, resulting in a significant decrease in the early shunt

  4. [Usefulness of IPC continuous monitoring in shunt dysfunction].

    Science.gov (United States)

    Horcajadas, A; Román, A; Olivares, G; Saura, E; Jorques, A; Cordero, N; Ibáñez, B; Sánchez, C; Roldán, M A

    2011-08-01

    Shunt dysfunction is a common situation in neurosurgery. Often symptoms, physical examination and radiology are not enough to set a diagnosis. ICP continuous monitoring is a safe and reliable tool that provides valuable information about CSF dynamics in these patients. Not only quantitative analysis is needed but also a qualitative one that enables pathological waves identification, because high amplitude B waves are strongly related to shunt dysfunction. In this paper experience about ICP continuous monitoring in patients with shunt dysfunction suspect is presented. Quantitative and qualitative data analysis led to a correct diagnosis, improving all the patients treated according to this criterion. An intraparenchymatous Camino® sensor and neuroPICture software (developed by first author) for data collection and graphic representation were used. Complications related to monitoring were absent and graphics obtained useful for qualitative analysis.

  5. Shunted-Josephson-junction model. II. The nonautonomous case

    DEFF Research Database (Denmark)

    Belykh, V. N.; Pedersen, Niels Falsig; Sørensen, O. H.

    1977-01-01

    The shunted-Josephson-junction model with a monochromatic ac current drive is discussed employing the qualitative methods of the theory of nonlinear oscillations. As in the preceding paper dealing with the autonomous junction, the model includes a phase-dependent conductance and a shunt capacitance...... out. The main objective is to provide a qualitative understanding of the junction behavior, to clarify which kinds of properties may be derived from the shunted-junction model, and to specify the relative arrangement of the important domains in the parameter-space decomposition........ The mathematical discussion makes use of the phase-space representation of the solutions to the differential equation. The behavior of the trajectories in phase space is described for different characteristic regions in parameter space and the associated features of the junction IV curve to be expected are pointed...

  6. The Behaviour of Mistuned Piezoelectric Shunt Systems and Its Estimation

    Directory of Open Access Journals (Sweden)

    M. Berardengo

    2016-01-01

    Full Text Available This paper addresses monoharmonic vibration attenuation using piezoelectric transducers shunted with electric impedances consisting of a resistance and an inductance in series. This type of vibration attenuation has several advantages but suffers from problems related to possible mistuning. In fact, when either the mechanical system to be controlled or the shunt electric impedance undergoes a change in their dynamical features, the attenuation performance decreases significantly. This paper describes the influence of biases in the electric impedance parameters on the attenuation provided by the shunt and proposes an approximated model for a rapid prediction of the vibration damping performance in mistuned situations. The analytical and numerical results achieved within the paper are validated using experimental tests on two different test structures.

  7. [Intrathoracic migration of a ventriculoperitoneal shunt catheter: a case report].

    Science.gov (United States)

    Sánchez-Medina, Yanire; Domínguez-Báez, Jaime; Lazo-Fernández, Eglis; Pérez Del Rosario, Pedro Antonio; Zanabria-Ortiz, Robert

    2015-01-01

    The intrathoracic complications from ventriculoperitoneal shunt placement are very rare. However, they are potentially serious if not treated. We report the case of thoracic migration of a peritoneal catheter after ventriculoperitoneal shunt and we also review the literature references with discussion of the different mechanisms of shunt-tip migration described. No case of previous sternotomy as in our patient has been found published. All reports recommend early catheter repositioning into the peritoneal cavity after diagnosing the migration described, to prevent worse complications. Moreover, it is important to keep in mind that intrathoracic migration can happen and it is necessary to palpate the catheter continuously during passage through subcutaneous tunnelling to prevent it. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  8. Evolution of the paranasal sinuses' anatomy through the ages

    Science.gov (United States)

    Mavrodi, Alexandra

    2013-01-01

    Previously, anatomists considered paranasal sinuses as a mysterious region of the human skull. Historically, paranasal sinuses were first identified by ancient Egyptians and later, by Greek physicians. After a long period of no remarkable improvement in the understanding of anatomy during the Middle Ages, anatomists of the Renaissance period-Leonardo da Vinci and Vesalius-made their own contribution. Nathaniel Highmore's name is also associated with the anatomy of paranasal sinuses as he was first to describe the maxillary sinus. PMID:24386595

  9. A Rare Diabetic Autonomic Neuropathy: Carotid Sinus Hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ahmet Kaya

    2016-03-01

    Full Text Available Carotid sinus hypersensitivity is a common cause of fainting and falls in the elderly, and can be diagnosed by carotid sinus massage. We present a 67-year-old diabetic man who was admitted with hyperglycemia. During thyroid examination, clouding of consciousness occurred with unilateral palpation. Asystole was documented for 4.8 seconds and suspected for 7 seconds upon carotid sinus massage. A cardioverter defibrillator was implanted. Carotid sinus hypersensitivity should be kept in mind when examining diabetic patients.

  10. Incidental sinusitis in a pediatric intensive care unit

    Science.gov (United States)

    Moore, Brooke M.; Kurachek, Stephen C.; Blumberg, Karen; Laguna, Theresa A.; Liu, Meixia; Olson, Erin E.

    2013-01-01

    Objective Intubation is a risk factor for nosocomial sinusitis in adult intensive care patients. Sinusitis in intubated adults can be an occult cause of fever. In children nasal intubation may be associated with a greater risk of sinusitis. No pediatric study has determined the incidence of nosocomial sinusitis in the pediatric intensive care unit (PICU) setting. We hypothesized that within a subset of patients who had head CT imaging: (1) the incidence of sinusitis in PICU patients exceeds the incidence in non-PICU patients; (2) the incidence of sinusitis is greater in PICU patients with a tube (nasotracheal, nasogastric, orotracheal, or orogastric); and (3) nasal tubes confer an increased risk for sinusitis compared to oral tubes. Design Retrospective chart review Setting Independent not-for-profit pediatric healthcare system Patients PICU and non-PICU (inpatients hospitalized on medical-surgical wards) patients referred for head CT Interventions None Measurements and Main Results CT images were evaluated for the presence of a tube and sinusitis. Images were scored using the Lund-MacKay (LM) staging system. Sinusitis was defined as a LM score >3.5. 596 patients were studied; 395 (66.3%) PICU. 197 (50%) PICU versus 69 (34.3%) non-PICU patients had sinusitis (p sinusitis versus 88/248 (35.9%) of those without a tube present (p sinusitis based on tube location (p=0.218). Younger age or the presence of a tube increased the probability of sinusitis (p sinus disease had evidence of sinusitis. This finding raises the concern that sinusitis in PICU patients is common and likely should be considered in the differential diagnosis of fever in PICU patients. PMID:21283043

  11. Mechanisms in adverse reactions to food. The sinuses

    DEFF Research Database (Denmark)

    Høst, A

    1995-01-01

    Food allergy is an extremely rare cause of chronic sinusitis. Mucosal inflammation in chronic sinusitis is rarely caused by allergic reactions to foods but rather viral infections in the upper respiratory tract.......Food allergy is an extremely rare cause of chronic sinusitis. Mucosal inflammation in chronic sinusitis is rarely caused by allergic reactions to foods but rather viral infections in the upper respiratory tract....

  12. The imaging of conditions affecting the cavernous sinus

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Y., E-mail: yenzhitang@doctors.net.u [Royal Free Hospital, Pond Street London NW32QG (United Kingdom); Booth, T.; Steward, M.; Solbach, T.; Wilhelm, T. [Royal Free Hospital, Pond Street London NW32QG (United Kingdom)

    2010-11-15

    The cavernous sinus can be affected by a wide range of conditions including tumours, infection, inflammation, and trauma. Disease in the cavernous sinus can produce characteristic signs and symptoms, which relate to the numerous crucial structures traversing and surrounding the cavernous sinus. Imaging, with the use of different techniques, plays a crucial role in diagnosis and management. The anatomy and imaging of the different disease entities in the cavernous sinus will be reviewed.

  13. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-01-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  14. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-03-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  15. Rhinoplasty and Functional Endoscopic Sinus Surgery

    Directory of Open Access Journals (Sweden)

    George L. Murrell

    2011-01-01

    Full Text Available An increasing number of patients are opting for combining sinus surgery and cosmetic rhinoplasty. The author has been performing rhinoplasty with FESS since April of 1990. The technique and equipment used in early cases is much different than that used in more recent surgeries. Specific advances include high definition monitor, intraoperative navigation system, and powered dissecting instruments. The benefits of these advances are illustrated by a review of the more recent cases performed by the author. Combined rhinoplasty and FESS can be performed with good results (functional and cosmetic and minimal complications. Advances in sinus surgery technique and equipment have made the procedure safer, faster, more precise, and more comfortable.

  16. Rhinoplasty and functional endoscopic sinus surgery.

    Science.gov (United States)

    Murrell, George L

    2011-01-01

    An increasing number of patients are opting for combining sinus surgery and cosmetic rhinoplasty. The author has been performing rhinoplasty with FESS since April of 1990. The technique and equipment used in early cases is much different than that used in more recent surgeries. Specific advances include high definition monitor, intraoperative navigation system, and powered dissecting instruments. The benefits of these advances are illustrated by a review of the more recent cases performed by the author. Combined rhinoplasty and FESS can be performed with good results (functional and cosmetic) and minimal complications. Advances in sinus surgery technique and equipment have made the procedure safer, faster, more precise, and more comfortable.

  17. [Anorexia with sinus bradycardia: a case report].

    Science.gov (United States)

    Wang, Fang-fang; Xu, Ling; Chen, Bao-xia; Cui, Ming; Zhang, Yuan

    2016-02-18

    As anorexia patients always go to the psychiatric clinic, little is concerned about the occurrence of sinus bradycardia in these patients for cardiologists and psychiatrists. The aim of this paper is to discuss the relationship between anorexia and sinus bradycardia, and the feature analysis, differential diagnosis and therapeutic principles of this type of sinus bradycardia. We report a case of sinus bradycardia in an anorexia patient with the clinical manifestations, laboratory exams, auxiliary exams, therapeutic methods, and her prognosis, who was admitted to Peking University Third Hospital recently. The patient was a 19-year-old female, who had the manifestation of anorexia. She lost obvious weight in a short time (about 15 kg in 6 months), and her body mass index was 14.8 kg/m(2). The patient felt apparent palpitation, chest depression and short breath, without dizziness, amaurosis or unconsciousness. Vitals on presentation were notable for hypotension, and bradycardia. The initial exam was significant for emaciation, but without lethargy or lower extremity edema. The electrocardiogram showed sinus bradycardia with her heart rate being 32 beats per minute. The laboratory work -up revealed her normal blood routine, electrolytes and liver function. But in her thyroid function test, the free thyroid (FT) hormones 3 was 0.91 ng/L (2.3-4.2 ng/L),and FT4 was 8.2 ng/L (8.9-18.0 ng/L), which were all lower; yet the thyroid stimulating hormone (TSH) was normal 1.48 IU/mL (0.55-4.78 IU/mL). Ultrasound revealed her normal thyroid. Anorexia is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia patients who lose weight apparently in short time enhance the excitability of the parasympathetic nerve, and inhibit the sympathetic nerve which lead to the appearance of sinus bradycardia, and functional abnormalities of multiple systems such as hypothyroidism. But this kind of sinus

  18. Large radicular cyst in the maxillary sinus.

    Science.gov (United States)

    Sagit, Mustafa; Guler, Sabri; Tasdemir, Arzu; Akf Somdas, Mehmet

    2011-11-01

    Radicular cysts (RCs) are the most common inflammatory jaw cystic lesions that occur infected and necrotic in teeth pulps. They account for more than 50% of all odontogenic cysts. Radicular cysts cause slowly progressive painless swelling. There are no symptoms until they become large. Enucleating the cyst is recommended with primary treatment. Here we describe a patient with a large RC with maxillary sinus involvement who underwent an endonasal endoscopic approach for complete resection. In conclusion, the endonasal endoscopic approach should be kept in mind for the resection of RC with maxillary sinus involvement because of its minimally invasive characteristics.

  19. Epidemiology and definition of inappropriate sinus tachycardia.

    Science.gov (United States)

    Pellegrini, Cara N; Scheinman, Melvin M

    2016-06-01

    Inappropriate sinus tachycardia (IST) is a clinical syndrome lacking formal diagnostic criteria. It is generally defined as an elevated resting heart rate (HR; >90-100 bpm) with an exaggerated response to physical or emotional stress and a clearly sinus mechanism. Clinical manifestations are broad from a complete lack of symptoms to incapacitating incessant tachycardia. Now understood to be relatively prevalent, it is observed to have a generally benign prognosis, though symptoms may persist for years. Whether IST is a single discrete entity or a heterogeneous condition with overlap to other syndromes such as postural orthostatic tachycardia syndrome remains a matter of debate.

  20. Rectal extrusion of the catheter and air ventriculography following bowel perforation in ventriculo-peritoneal shunt

    Energy Technology Data Exchange (ETDEWEB)

    Arico, M.; Podesta, A.F.; Bianchi, E.; Beluffi, G.; Fiori, P.; Chiari, G.; Pezzotta, S.

    1985-01-01

    Ventriculo-peritoneal shunt is frequently carried out in infantile hydrocephalus. The peritoneal shunt has a lower morbidity than ventriculo-atrial shunt and severe complications are uncommon. Abdominal complications include intestinal perforation, shunt migration, inguinal hernia, cerebrospinal fluid pseudocysts and hollow viscus perforation. A few cases of catheter extrusion from the rectum, vagina, umbilicus and urethra have been described. We report a new case of intestinal perforation with rectal extrusion of the catheter associated with a ventriculogram.

  1. Treatment strategy for distal radius fractures with ipsilateral arteriovenous shunts.

    Science.gov (United States)

    Sugiyama, Yoichi; Naito, Kiyohito; Igeta, Yuka; Obata, Hiroyuki; Kaneko, Kazuo; Obayashi, Osamu

    2014-11-01

    To describe our management of 3 patients with chronic renal failure who sustained distal radius fractures in limbs containing dialysis shunts. The 3 patients were 48-61 years old, and 2 of them were men. Because the injured limbs contained arteriovenous shunts, tourniquets were not used. Volar locking plate fixation was applied via the Henry approach. The patients' grip strength; visual analog scale scores; Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores; modified Mayo scores; and their range of wrist joint motion were assessed during the final follow-up examination. In addition, complications and the presence/absence of dysfunction of the forearm shunt were also investigated. The mean duration of the postoperative follow-up period was 9 months (range, 7-10 mo), and the subjects' mean wrist motion values were 75°, 79°, 78°, and 87° during flexion, extension, pronation, and supination, respectively. Grip strength on the affected side as a percentage of that seen on the healthy side ranged from 71% to 90%. The patients' visual analog scale; QuickDASH; and modified Mayo scores were all excellent, and bone union was achieved in all 3 cases. No shunt dysfunction or skin soft tissue complications were noted. Volar locking plate fixation via the Henry approach might be useful for treating distal radius fractures in cases in which an arteriovenous shunt is present in the same limb. Shunt dysfunction and hemorrhaging are of concern during open surgery, but these were not issues in our patients. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Portacaval shunt established in six dogs using magnetic compression technique.

    Directory of Open Access Journals (Sweden)

    Xiaopeng Yan

    Full Text Available BACKGROUND AND AIMS: Installing the transjugular intrahepatic portosystemic shunt for portal hypertension is relatively safe, but complications are still high. To explore a new method of portacaval shunt, the magnetic compression technique was introduced into the shunting procedure. METHODS: A portal-inferior vena cava shunt was performed on 6 male mongrel dogs by two hemocompatible Nd-Fe-B permanent magnets, parent and daughter. The parent magnet was applied to the inferior vena cava guided by a catheter through the femoral vein. The daughter magnet was moved to the anastomosis position on the portal vein with a balloon catheter through the splenic vein. After the daughter magnet reached the target position, the two magnets acted to compress the vessel wall and hold it in place. Five to 7 days later, under X-ray guidance, the magnets were detached from the vessel wall with a rosch-uchida transjugular liver access set. One month later, histological analysis and portal venography were performed. RESULTS: 5-7 days after the first surgery, a mild intimal hyperplasia in the portal vein and the inferior vena cava, and continuity of the vascular adventitia from the portal vein to the inferior vena cava as observed. During the second surgery, the contrast media could be observed flowing from the portal vein into the inferior vena cava. Portal venography revealed that the portosystemic shunt was still present one month after the second surgery. CONCLUSIONS: Magnamosis via a device of novel design was successfully used to establish a portacaval shunt in dogs.

  3. Shunted Piezoelectric Vibration Damping Analysis Including Centrifugal Loading Effects

    Science.gov (United States)

    Min, James B.; Duffy, Kirsten P.; Provenza, Andrew J.

    2011-01-01

    Excessive vibration of turbomachinery blades causes high cycle fatigue problems which require damping treatments to mitigate vibration levels. One method is the use of piezoelectric materials as passive or active dampers. Based on the technical challenges and requirements learned from previous turbomachinery rotor blades research, an effort has been made to investigate the effectiveness of a shunted piezoelectric for the turbomachinery rotor blades vibration control, specifically for a condition with centrifugal rotation. While ample research has been performed on the use of a piezoelectric material with electric circuits to attempt to control the structural vibration damping, very little study has been done regarding rotational effects. The present study attempts to fill this void. Specifically, the objectives of this study are: (a) to create and analyze finite element models for harmonic forced response vibration analysis coupled with shunted piezoelectric circuits for engine blade operational conditions, (b) to validate the experimental test approaches with numerical results and vice versa, and (c) to establish a numerical modeling capability for vibration control using shunted piezoelectric circuits under rotation. Study has focused on a resonant damping control using shunted piezoelectric patches on plate specimens. Tests and analyses were performed for both non-spinning and spinning conditions. The finite element (FE) shunted piezoelectric circuit damping simulations were performed using the ANSYS Multiphysics code for the resistive and inductive circuit piezoelectric simulations of both conditions. The FE results showed a good correlation with experimental test results. Tests and analyses of shunted piezoelectric damping control, demonstrating with plate specimens, show a great potential to reduce blade vibrations under centrifugal loading.

  4. Percutaneous gastrostomy tube placement in patients with ventriculoperitoneal shunts

    Energy Technology Data Exchange (ETDEWEB)

    Sane, S.S.; Towbin, A.; Bergey, E.A.; Kaye, R.D.; Fitz, C.R.; Albright, L.; Towbin, R.B. [Department of Radiology, Children`s Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213 (United States)

    1998-07-01

    Objective. The purpose of this study is to determine the risk of CNS and/or peritoneal infection in children with ventriculoperitoneal shunts in whom a percutaneous gastrostomy tube is placed. Materials and methods. We placed 205 gastrostomy or gastrojejunostomy tubes from January of 1991 to December 1996. Twenty-three patients (10 boys, 13 girls) had ventriculoperitoneal shunts at the time of placement. All shunts were placed at least 1 month prior to placement of the gastrostomy tube. The patients ranged in age from 8 months to 16 years with a mean age of 6 years, 9 months. Patient weight ranged from 2 kg to 60 kg. All 23 children required long-term nutritional support due to severe neurologic impairment. No prophylactic antibiotics were given prior to the procedure. Of the patients, 21/23 had a 14-F Sacks-Vine gastrostomy tube with a fixed terminal retention device inserted, using percutaneous fluoroscopic antegrade technique. Two of the 23 patients had a Ross 14-F Flexi-flo gastrostomy tube which required a retrograde technique due to a small caliber esophagus in these children. Results. All 23 children had technically successful placements of percutaneous gastrostomy (7) or gastrojejunostomy (16) tubes. Of the children, 21/23 (91 %) had no complications from the procedure. Two of 23 (9 %) patients demonstrated signs of peritonitis after placement of their gastrostomy tubes and subsequently had shunt infections. In both, children CSF culture grew gram-positive cocci. The antegrade technique was used in both children who developed peritonitis. Conclusion. Our study indicates children with ventriculoperitoneal shunts who undergo percutaneous gastrostomy are at greater risk for infection and subsequent shunt malfunction. Therefore, we recommend prophylactic antibiotic therapy to cover for skin and oral flora. (orig.) With 1 fig., 7 refs.

  5. Minimally invasive approach for lesions involving the frontal sinus

    African Journals Online (AJOL)

    of the posterior wall of the frontal sinus and allowing the frontal lobe to rest against the anterior wall of the sinus).[1] The objective of surgery is to stop or avoid a potential CSF leak and to avoid the risk of future meningitis. The frontal sinus is usually obliterated during the osteoplastic flap procedure, separating it from the rest ...

  6. Congenital Prepubic Sinus: A Case Report | Harjai | African Journal ...

    African Journals Online (AJOL)

    Congenital Prepubic Sinus: A Case Report. M M Harjai, R Handa, R Kale. Abstract. Congenital prepubic sinus is an exceptional disorder of uncertain origin. These sinuses may represent a variant of epispadiac duplication or dorsal urethral duplication of the urethra.We present a case of isolated blind ending prepubic ...

  7. Different types of fungal sinusitis occurring concurrently: implications for therapy.

    Science.gov (United States)

    Rupa, V; Thomas, Meera

    2013-02-01

    The purpose of this study is to describe the clinical and histopathological features, management and outcome of a series of patients with simultaneous occurrence of invasive and non-invasive fungal sinusitis (mixed fungal sinusitis). The histopathological records of patients with fungal sinusitis seen over the last 6 years were reviewed. The clinical, histopathological, treatment and follow up details of all cases with mixed fungal sinusitis were noted. Six cases of mixed fungal sinusitis with concurrent occurrence of chronic granulomatous fungal sinusitis and allergic fungal sinusitis (AFS) were seen during the study period. Most (83.3 %) had bilateral disease. All patients had undergone prior endoscopic sinus surgery at least once within the previous 2 years. Histopathological features showed predominance of invasive disease in half the patients. Except for one patient who did not report for follow up, all patients with predominant chronic granulomatous fungal sinusitis received systemic antifungal therapy and inhaled steroids. Those with predominant features of AFS received oral and inhaled steroids. Five patients with mixed fungal sinusitis who had follow up ranging from 6 months to 5 years were disease free following treatment. Mixed fungal sinusitis should be recognized by the surgeon and pathologist as a separate category of fungal sinusitis whose treatment depends on accurate histological diagnosis. A good outcome may be expected with appropriate therapy.

  8. Sinusitis associated with nasogastric intubation in 3 horses.

    Science.gov (United States)

    Nieto, Jorge E; Yamout, Sawsan; Dechant, Julie E

    2014-06-01

    Sinusitis has not been reported as a complication of long-term nasogastric intubation in horses. We describe 3 horses that developed nosocomial sinusitis following abdominal surgery with associated perioperative nasogastric intubation. Sinusitis was suspected by the presence of malodorous discharge and confirmed by percussion, upper airway endoscopy, radiographs (n = 3), and bacterial culture (n = 1).

  9. Paranasal sinusitis in the aetiology of orbital cellulitis | Ubah ...

    African Journals Online (AJOL)

    Aim: The purpose of this study was to assess the prevalence of paranasal sinusitis as a cause of orbital cellulitis and to identify the commonest sinus(es) involved in our setting. Methods: A retrospective review of the case notes of 47 patients with orbital cellulitis admitted into the ophthalmic ward of the University College ...

  10. RUPTURE OF SINUS OF VALSALVA ANEURYSM: CASE REPORT ...

    African Journals Online (AJOL)

    hi-tech

    RUPTURE OF SINUS OF VALSALVA ANEURYSM: CASE REPORT. A. G. B. AMOAH, K. FRIMPONG-BOATENG and H. BADDOO. SUMMARY. Sinus of Valsalva aneurysms are uncommon. Aortic sinus aneurysm may be complicated by endocarditis or rupture. A 26 year old native Ghanaian presented with dyspnoea, raised.

  11. Congenital prepubic sinus – A variant of urethral duplication

    African Journals Online (AJOL)

    J.S. Aihole

    2016-08-02

    Aug 2, 2016 ... the anatomical variations of the course of the sinus tract will help in complete excision and hence avoiding ... Association. one of the variations of the dorsal urethral duplication. They usually present with discharge from the sinus. Excision of the sinus tract is ... Histology of the tract showed urothelium.

  12. Post-Traumatic Pneumocele of the Frontal Sinus

    Energy Technology Data Exchange (ETDEWEB)

    Karadag, Demet; Calisir, Cuneyt; Adapinar, Baki [Eskisehir Osmangazi University, Eskisehir (Turkmenistan)

    2008-08-15

    A pneumocele is an abnormal dilatation of a paranasal sinus, most commonly affecting the frontal sinus. Although the etiology of pneumocele is not entirely known, several causative factors have been suggested including trauma, surgery, tumor and infection. We report here a case of post-traumatic pneumocele of the frontal sinus following a head trauma.

  13. Cystoperitoneal shunt for a giant intrathoracic meningocele under local anesthesia.

    Science.gov (United States)

    Tanaka, Kazumi; Shimizu, Kimihiro; Kakegawa, Seiichi; Oshima, Kiyohiro; Takeyoshi, Izumi

    2011-01-01

    Giant intrathoracic meningoceles are extremely rare, and the standard treatment for giant intrathoracic meningoceles remains controversial. We present the case of a patient with giant intrathoracic meningoceles associated with neurofibromatosis type I. Our patient had poor respiratory function because of the giant intrathoracic meningocele, so we performed a cystoperitoneal shunt under local anesthesia. We describe our cystoperitoneal shunt technique using an adjustable-pressure valve. This simple, minimally invasive treatment is a valuable alternative treatment option in patients at high operative risk, especially those with low respiratory function. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Cryptococcal cerebrospinal fluid shunt infection treated with fluconazole

    Directory of Open Access Journals (Sweden)

    Daniel Eymard

    1993-01-01

    Full Text Available A 37-year-old woman with a cadaveric renal allotransplantation required intra-cranial shunting devices after a presumptive episode of tuberculous meningitis. Six months later, she developed a culture-proven cryptococcal meningitis. Without having her ventriculo-auricular shunt removed, she was successfully treated with a short course of amphotericin B (335 mg and flucytosine (nine days followed by prolonged therapy with oral fluconazole (400 mg daily for 72 days. Three years post treatment she had no evidence of relapse, and normal renal graft function.

  15. A Rare Complication of Subdural-peritoneal Shunt: Migration of Catheter Components through the Pelvic Inlet into the Subdural Space.

    Science.gov (United States)

    Çakir, Mürteza; Yilmaz, Atilla; Çalikoğlu, Çağatay

    2017-01-01

    Subdural-peritoneal (SP) shunting is a simple procedure to treat subdural hygromas; however, several rare complications such as shunt migration exist. A 15-year-old boy presented with headache, nausea, and vomiting, and underwent SP shunting for left frontoparietal chronic subdural effusion. Six weeks later, radiographic examinations revealed total migration of the shunt through the pelvic inlet. The migrated shunt was replaced with a new SP shunt. Four weeks later, radiographic examinations revealed shunt migration into the subdural space. The shunt catheter was removed and the subdural effusion was evacuated. Shunt migration may result from pressure differences between the abdomen and the cranium or from head movement, and insufficient fixation and/or large burr holes can facilitate shunt migration. Double firm anchoring and small-sized burr holes can prevent this complication. SP shunt is a simple procedure, and its assumed complications can be prevented through precaution.

  16. Perforation into gut by ventriculoperitoneal shunts: A report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Abdul Hai

    2011-01-01

    Full Text Available We report two cases of gastrointestinal perforation by ventriculoperitoneal (VP shunts and review the literature on the topic. The time interval between shunt surgery and detection of bowel perforation is minimum in infants and increases with age. Sigmoid and transverse colon followed by stomach are the most frequent sites of gastrointestinal perforations by VP shunts.

  17. Antibacterial activity of antibiotic-soaked polyvinylpyrrolidone-grafted silicon elastomer hydrocephalus shunts

    NARCIS (Netherlands)

    Boelens, J. J.; Tan, W. F.; Dankert, J.; Zaat, S. A.

    2000-01-01

    If shunts, inserted for the relief of hydrocephalus, are pretreated with antimicrobials, the incidence of shunt-associated infections (SAI) may be reduced. The duration of the antibacterial activity of shunts, made from conventional silicon elastomer (SE) or from SE grafted with the hydrogel

  18. Posthemorrhagic Hydrocephalus in Newborns: Clinical Characteristics and Role of Ventriculoperitoneal Shunts

    Directory of Open Access Journals (Sweden)

    Inn-Chi Lee

    2009-02-01

    Conclusion: Patients who were shunt-dependent had worse neurodevelopmental outcomes and greater mortality than those without shunts. The results appeared to depend on how far the hydrocephalus had progressed and on the degree of IVH, but the necessity of VP shunts requires reevaluation before they are implanted.

  19. Shoulder tip pain: an under-reported complication of ventriculoperitoneal shunt.

    LENUS (Irish Health Repository)

    Lim, C

    2012-02-03

    Ventriculoperitoneal (VP) shunt insertion is the commonest form of treatment for hydrocephalus. Shoulder tip pain after VP shunt insertion is unusual and has only recently been reported. We present a case of excruciating shoulder tip pain due to diaphragmatic irritation after VP shunt insertion.

  20. Transnasal Marsupialization Using Endoscopic Sinus Surgery for Treatment of Keratocystic Odontogenic Tumor in Maxillary Sinus

    Directory of Open Access Journals (Sweden)

    Masafumi Ohki

    2012-01-01

    Full Text Available Objective. We report the first utilisation of transnasal marsupialization to treat a keratocystic odontogenic tumor in the maxillary sinus of a 37-year-old man. Case Report. A 37-year-old man presented with a nasal discharge and right odontalgia. Computed tomography revealed an expanding cystic lesion with a calcificated wall containing an impacted tooth in the right maxillary sinus. The diagnosis was keratocystic odontogenic tumor. Transnasal marsupialization was performed using endoscopic sinus surgery to enlarge the maxillary ostium and remove a portion of the cystic wall. Pathological findings included lining squamous epithelium and inflammation. The remaining tumor shrank, becoming free of infection after surgery, without proliferation. Conclusion. Transnasal marsupialization using endoscopic sinus surgery is effective in treating keratocystic odontogenic tumors. It offers minimal surgical invasion and reductive change, making it advantageous for complete removal with fewer complications in the bones and surrounding tissue in the case of secondary surgery.

  1. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

    2016-01-15

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  2. Computed tomography of chronic or recurrent paranasal sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Uk; Youn, Eun Kyung; Lee, Young Rae; Kwon, Hae Su [Koryo General Hospital, Seoul (Korea, Republic of)

    1991-09-15

    Since an accurate description on the pathophysiology of the nasal cavity and paranasal sinus (PNS) was established, a detailed evaluation of their anatomic and pathologic status, especially of the ostiomeatal unit, has become important, and computed tomography (CT) has increasingly been used for evaluating chronic sinusitis. This study was undertaken to assess the value of CT in chronic or recurrent paranasal sinusitis and to ascertain the theory of rhinogenic origin as the pathophysiologic basis of sinusitis. We retrospectively analyzed the PNS CT findings of 108 patients with chronic or recurrent sinusitis. The CT scan were obtained in thin-section (3mm or 5mm) coronal and axial planes after contrast medium administration. With respect to the location of the sinusitis, the anterior ethmoid sinus was involved in 98 (91%), maxillary sinus in 93 (86%), frontal sinus in 60 (56%), posterior ethmoid sinus in 35 (32%), and sphenoid sinus in 32 cases (30%). CT finding of the sinusitis consisted of sinus opacification (74%), mucoperiosteal thickening (69%), mucosal enhancement (36%), air-fluid level (18%), and bony wall thickening (11%). Complications included retention cysts (29%), mucoceles (8%), and orbital cellulitis (1%). Obstruction of the ostiomeatal unit was noted in 104 cases (96%), which were composed of inflammatory process, nasal polyps, concha bullosae, inverting papillomas, paradoxic middle turbinates, severe septal deviations, and large ethmoidal bulla. Of the 17 cases with a past history of Caldwell-Luc operation, 15 cases showed obstruction of the ostiomeatal units. We concluded the CT was a very useful modality for evaluating chronic or recurrent sinusitis and for demonstrating the finely detailed pathologic anatomy of the nasal cavity and paranasal sinuses.

  3. High-Flow Arterio-Hepatic Venous Shunt in Hepatocellular Carcinoma: Use of Multi-Electrode Radiofrequency for Shunt Obliteration

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2015-10-15

    Intra-tumoral arterio-hepatic venous shunting (AHVS) poses an impediment to transarterial chemoembolization of liver tumors. Not only does it present a potential hazard for systemic shunting and embolization, but also the altered flow dynamics may also result in poor delivery of drug/embolics to the target tumor bed. Current available techniques to overcome AVHS include arterial embolization (particles, coils, glue, etc.) or temporary venous occlusion using balloons. We hereby illustrate the use of radiofrequency ablation to obliterate a complex AHVS consisting of a varix-like venous aneurysm.

  4. Multiplanar sinus CT: a systematic approach to imaging before functional endoscopic sinus surgery.

    Science.gov (United States)

    Hoang, Jenny K; Eastwood, James D; Tebbit, Christopher L; Glastonbury, Christine M

    2010-06-01

    The purpose of this essay is to present a systematic approach to the use of coronal, axial, and sagittal images for CT evaluation of the sinuses before functional endoscopic sinus surgery (FESS). We present a systematic approach to the use of coronal, axial, and sagittal images in CT evaluation before FESS. Each imaging plane is valuable for displaying anatomic variants, which can predispose a patient to recurrent disease and affect the surgical approach, and critical variants, which can make surgery hazardous.

  5. Sinusitis from Nontuberculous Mycobacteria in Tap Water

    Centers for Disease Control (CDC) Podcasts

    2012-12-21

    Dr. Wellington S. Tichenor. Associate Clinical Professor of Medicine at New York Medical College and in private practice in Manhattan, New York, discusses his investigation of sinusitis from nontuberculous mycobacteria in tap water.  Created: 12/21/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/31/2012.

  6. Osteoblastoma originating from frontoethmoidal sinus causing ...

    African Journals Online (AJOL)

    Cranial computed tomography (CT) showed ground glass density mass that filled left frontal sinus. It extended to frontal region and caused ground glass density changes in adjacent frontal bone causing compression effect on left frontal region [Figure 1]. Cranial magnetic resonance imaging (MRI) examination revealed left ...

  7. Functional endoscopic sinus surgery in pediatric population

    Directory of Open Access Journals (Sweden)

    Farhadi M

    1997-07-01

    Full Text Available This is a report of 30 cases of pediatric functional endoscopic sinus surgery (FESS. 28 of these children had chronic sinusitis and 2 had acute sinusitis the most common chief complaints were: 1 Chronic Rhinorea 2 Nasal obstruction 3 Chronic cough. Systemic predisposing conditions were allergy in 7 pts and immotile cilliasyndrome in 2 pts, all of the procedures were performed under general anesthesia. The most common procedures were: 1 Resection of lateral part of the middle turbinate. 2 Antrostomy of the maxillary sinus. 3 Turbinoplasty of the inf turbinate. 4 Anterior erhnoidectomy, (Messerklinger, Approach. There were no kajor complication and only 3 cases of minor complication (2=regeneration of polipoid tissues, 1 synechia occurred. The duration of follow up was from 6-18 mths recovery occurred in 26 pts. Two of the pts didn't respond because of severe allergy and were referred to immunologist for further therapy 2 others didn't respond appropriately because of immotile cilliasyndrome

  8. Puerperal Superior Sagittal Sinus Thrombosis and Pulmonary ...

    African Journals Online (AJOL)

    Superior sagittal sinus thrombosis is a rare and often misdiagnosed disorder. Its occurrence with pulmonary embolism (PE) .... and prolonged immobilization, hence, the possibility that her PE could have resulted from superior ... been forgotten and was alluded to by Diaz etal., as “a syndrome rediscovered in their report.”[20].

  9. BACTERIOLOGY OF CHRONIC SINUSITIS IN ILORIN, NIGERIA ...

    African Journals Online (AJOL)

    ... (63.6% Coagulase positive and 36.4% Coagulase negative), cultures of patients with chronic sinusitis yielded Staphylococcus aureus (48.1%), Escherichia coli (20.4%), Klebsiella spp. (20.4%), Streptococci (7.4%) and Streptococcus pneumoniae (3.7%). The isolates were 100% sensitive to Ofloxacin, while penicillin was ...

  10. Sinus surgery: optimal surgery, optimal outcome?

    NARCIS (Netherlands)

    Fokkens, Wytske J.

    2016-01-01

    Sinus surgery remains an issue of discussion. We lack data on a number of important issues. In this issue of the journal Jiang et al. show that 67 % of their patients who underwent FESS for CRS had OSAS (of which more than half moderate to severe) but only 38% complained of daytime sleepiness

  11. Actinomycosis in urachal sinus : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Jin Young; Kim, Hee Jin; Ahn, Hee Jeong [Pundang CHA General Hospital, Sungnam (Korea, Republic of)

    1998-06-01

    Primary actinomycosis of the urachal remnants is rare disease, and was not reported in Korean literature. We report the fistulographic and CT findings of a case of actinomycosis in the urachal sinus of a 31 year-old-man. (author). 10 refs., 3 figs.

  12. Seizure Triggered by Sick Sinus Syndrome.

    Science.gov (United States)

    Patel, Nilesh; Majeed, Faisal; Sule, Anupam Ashutosh

    2017-11-04

    Sick sinus syndrome (SSS) is a dysfunction of sinoatrial node resulting in symptomatic bradycardia or sinus pauses causing decreased cardiac output with cerebral hypoperfusion and usually presents as syncope, presyncope or fatigue. The occurrence of a seizure is very rare. A 69-year-old man suffered two episodes of generalised tonic-clonic seizures. MRI and electroencephalogram failed to reveal the cause of seizures. In the emergency room, he experienced presyncope simultaneous to bradycardia and sinus pauses. He was stabilised with atropine and dopamine infusion and underwent definitive therapy with a permanent dual-chamber pacemaker with complete symptom resolution. Diagnostic confounders include convulsive syncope and ictal bradycardia. Syncope may be accompanied by myoclonic jerks (convulsive syncope), but postictal confusion is absent. Bradycardia may be seen during the postictal period (ictal bradycardia syndrome), but protracted sinus dysfunction is not present. Hypoperfusion due to significant SSS triggered seizures in this patient who may have an underlying predisposition. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Chronic Cutaneous Draining Sinus of Dental Origin

    African Journals Online (AJOL)

    or another structure. Fistulas are usually the result of injury or surgery. It can also result from ... to occur as far away from the oral cavity as the chest.[2] Its similarity of presentation to various ... Extra oral sinus of odontogenic origin occurs when the purulent by‑products of dental pulp necrosis spread along the path of least ...

  14. Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: btaslakian@gmail.com [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Faraj, Walid, E-mail: wf07@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Khalife, Mohammad, E-mail: mk12@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); El-Merhi, Fadi, E-mail: fe19@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Saade, Charbel, E-mail: cs39@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Hallal, Ali, E-mail: ah05@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Haydar, Ali, E-mail: ah24@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon)

    2015-08-15

    Highlights: • Portal hypertension is the pathological increase in portal venous pressure. • Surgical portosystemic shunting is an accepted methods to decrease portal venous pressure. • Surgical portosystemic shunts are divided into selective and nonselective. • Shunt thrombosis is a serious complication, resulting in shunt dysfunction. • Imaging is essential in the assessment of the shunt function and anatomy. - Abstract: Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications.

  15. Association of Allergic Rhinitis and Sinusitis with Childhood Asthma.

    Science.gov (United States)

    Chinnakkannan, Selva Kumar; Singh, Meenu; Das, Rashmi Ranjan; Mathew, Joseph L; Saxena, Akshay Kumar

    2017-01-15

    To study the point prevalence of allergic rhinitis and sinusitis in childhood asthma and to examine the relationship among them. In 250 children (age allergic rhinitis was diagnosed by clinical plus nasal eosinophilia criteria, and sinusitis was diagnosed clinically plus confirmation by computerized tomography scan. The point prevalence of allergic rhinitis was 13.6%, and of sinusitis was 2%. On multivariate analysis, allergic rhinitis, sinusitis, and family history were significantly associated with asthma severity. Allergic rhinitis is common in childhood asthama, but sinusitis is rare.

  16. Intraspinal Abscess Associated with Congenital Dermal Sinus: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bom Yi; Jung, Won Sung; Ihn, Yon Kwon [Dept. of Radiology, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2011-05-15

    Dermal sinus tracts are remnants of incomplete neural tube closure. Dermal sinus tracts in the spine range from asymptomatic pits to tracts with significant disease. Congenital spinal dermal sinus tract can produce significant morbidity if not adequately managed. Spinal subdural abscess caused by the spread of an infection within the dermal sinus tract is rare in children. We now described a 3-year-old male who presented with extensive spinal subdural abscess resulting from dermal sinus tract that was low-lying in the sacral area.

  17. Recurrent Syncope Due to Carotid Sinus Hypersensitivity and Sick Sinus Syndrome

    Directory of Open Access Journals (Sweden)

    Feng-Yu Kuo

    2008-10-01

    Full Text Available Syncope is a sudden and brief loss of consciousness with postural tone. Its recovery is usually spontaneous. There are various causes of syncope including cardiac, vascular, neurologic, metabolic and miscellaneous origins. The tracing is usually time-consuming and costly. The diagnosis of carotid sinus syncope may sometimes be difficult since the symptoms are nonspecific, especially in older persons. Here, we report the case of a 72-year-old woman who sought medical attention at our hospital due to repeated syncope episodes over the previous 5 years. Neurologic examinations showed negative results (including brain computed tomography. Twenty-four-hour ambulatory electrocardiogram monitoring showed atrial and ventricular premature contractions only. Electrophysiologic study disclosed prolonged corrected sinus node recovery time (1,737 ms with poor atrioventricular conduction. Drop of blood pressure together with sinus bradycardia developed after left side carotid sinus massage. Both carotid sinus hypersensitivity with sick sinus syndrome contributed to this patient's syncope, and after pacemaker placement together with selective serotonin reuptake inhibitor treatment, she was free from syncope thereafter.

  18. Comparative study between radiofrequency sinus excision and open excision in sacro-coccygeal pilonidal sinus disease.

    Science.gov (United States)

    Gupta, Pravin J

    2005-01-01

    Evaluation of outcome of pilonidal sinus excision using a radiofrequency device and comparing its results with excision and open granulation procedure. Patients with sacro-coccygeal pilonidal sinus disease (n=44) were randomly assigned to undergo either a wide excision and healing by open granulation procedure [WEG] (n=23) or a radiofrequency sinus excision [RSE] (n=21). An Ellman radiofrequency generator was used for RSE. Intra- and postoperative events and outcome data were evaluated and analyzed by Student's unpaired t test and chi(2) test. The significant differences in the two groups WEG and RSE were as follows: mean hospital stay (47 vs. 10 h, p< 0.05), period off work (29 vs. 8 days, p< 0.05), mean analgesic requirement (39 vs. 15 tablets, p< 0.05), time for complete wound healing (84 vs. 49 days, p< 0.05). At the mean follow-up of 30 months, 2 patients from the wide excision and open granulation group and one patient from the radiofrequency sinus excision group developed recurrence. These findings suggest that sinus excision with radiofrequency is a simple and swift procedure. It needs a short hospital stay and is associated with less postoperative pain and early resumption to work. As compared to excision and healing by granulation technique, the radiofrequency sinus excision procedure achieves faster wound healing and a better outcome. Copyright (c) 2005 S. Karger AG, Basel.

  19. Treatment of mild to moderate sinusitis.

    Science.gov (United States)

    Smith, Stephen R; Montgomery, Lynda G; Williams, John W

    2012-03-26

    The National Physicians Alliance (NPA)-initiated a project titled "Promoting Good Stewardship in Clinical Practice" to develop a list of the "Top 5" activities in primary care, where changes in practice could lead simultaneously to higher quality care and better use of finite clinical resources. The treatment of acute mild to moderate sinusitis was selected for the "Top 5" list because it is a common clinical problem. Evidence supports avoiding antibiotics early in the course of the illness, and doing so could markedly reduce costs. We reviewed the results of meta-analyses of randomized controlled trials published in the past 10 years comparing antibiotic treatment with placebo and summarized the evidence regarding the benefits, harms, and costs of antibiotic treatment of acute mild to moderate sinusitis. Sinusitis is one of the most common diagnoses in primary care, accounting for 20 million visits annually in the United States and 15% to 21% of annual antibiotic prescriptions. In randomized controlled trials, cure or improvement 7 to 15 days after beginning treatment was statistically significantly more common among patients assigned to antibiotics compared with placebo, but the differences were small, ranging from a 7% to 14% higher rate of improvement with antibiotics. The rate of complications and recurrence did not differ between those treated with antibiotics and placebo. Adverse effects, primarily diarrhea, were 80% more common in the antibiotic compared with the placebo groups. In addition to adverse effects, overuse of antibiotics can also harm population health by increasing rates of antibiotic resistance Antibiotics should not be prescribed for mild to moderate sinusitis within the first week of the illness. Avoiding antibiotics for acute sinusitis could reduce antibiotic adverse effects, antibiotic resistance, and the cost of health care.

  20. 49 CFR 236.57 - Shunt and fouling wires.

    Science.gov (United States)

    2010-10-01

    ... will be in its most restrictive state, when the circuit is shunted. (b) This rule does not apply to..., DEPARTMENT OF TRANSPORTATION RULES, STANDARDS, AND INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Rules and Instructions...

  1. Anatomical Evidence for Intracardiac Blood Shunting in Marine Turtles

    African Journals Online (AJOL)

    Histological examination of the pulmonary arteries of four species of sea turtles revealed the presence of a muscular sphincter just distal to the origin of the ductus Botalli. This structure has not previously been described. Its presence suggests that right to left intra-cardiac blood shunts may be a feature of diving in sea turtles; ...

  2. [Small-diameter portosystemic shunts: indications and limitations].

    Science.gov (United States)

    Angel Mercado, M; Granados-García, J; Barradas, F; Chan, C; Contreras, J L; Orozco, H; Angel-Mercado, M

    1998-01-01

    Low diameter porto-systemic shunts for the treatment of portal hypertension bleeding have emerged as a consequence of the technical development of vascular grafts (PTFE) that allow the use of a narrow lumen. The experience with this kind of operation at the Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City during a 6-year period is reported. There were twenty-seven patients with good liver function (Child-Pugh A-B) were operated or electively, average Age 47.5 years (range 17-71), twenty three patients with liver cirrhosis, one with portal fibrosis and three with idiopathic portal hypertension. Operative mortality: 4%. Rebleeding: 14%. Postoperative encephalopathy was observed in 14 of 27, three of them being grade III-IV (11%). In the remaining 11 cases, it was mild and easily controlled. Postoperative angiography showed shunt patency in 81% of the cases; in 33% of the cases, portal vein diameter reduction was shown, as well as two cases with portal vein thrombosis. In 77% of the cases, adequate postoperative quality of life was observed. Survival (Kaplan-Meier): 86% at 12 months and 56% at 60 months. These kinds of shunts are a good alternate choice for patients considered for surgery, in which other portal blood flow preserving procedures (selective shunts, devascularization with transection) are not feasible.

  3. Minimally invasive technique for insertion of ventriculopleural shunt catheters.

    Science.gov (United States)

    Richardson, Marlin Dustin; Handler, Michael H

    2013-11-01

    Cerebrospinal fluid diversion to the pleural space has employed various methods to insert the distal catheter into the pleural space. The authors report on a minimally invasive method of pleural catheter insertion that they have developed and have used safely in a small series of patients. Pleural shunt catheters were inserted using a split trochar into the pleural space (technique described in further detail in the article). All cases over the previous 10 years in which this technique was employed were reviewed from the existing electronic medical records. Patient age at insertion, sex, reason for hydrocephalus, early and late complications, valve type, and follow-up were recorded. Fourteen shunt procedures performed in 10 patients were identified. Two small pneumothoraces were detected on routine postoperative imaging and required no intervention. There were 3 late mechanical complications, including migration of a catheter out of the pleural space, catheter fracture at the insertion point, and the need for a longer catheter due to the patient's growth. The authors describe a safe, minimally invasive method for insertion of pleural shunt catheters along with a series of patients who have undergone placement of a pleural shunt catheter using this method without complication directly attributable to the use of this technique.

  4. Temporary vascular shunting in vascular trauma: A 10-year review ...

    African Journals Online (AJOL)

    Five patients with non-viable limbs had the vessel ligated. Conclusions. A TIVS in the damage control setting is both life- and limb-saving. These shunts can be inserted safely in a facility without access to a surgeon with vascular surgery experience if there is uncontrollable bleeding or the delay to definitive vascular surgery ...

  5. Reversible Venting Stitch for Fenestrating Valve-less Glaucoma Shunts.

    Science.gov (United States)

    Akil, Handan; Vu, Priscilla Q; Nguyen, Anhtuan H; Nugent, Alexander; Chopra, Vikas; Francis, Brian A; Tan, James C

    2017-12-01

    The purpose of this is to describe a venting stitch modification for valveless glaucoma aqueous shunts and characterize early postoperative intraocular pressure (IOP) and glaucoma medication use following the modification. Retrospective chart review of 61 sequential patients undergoing Baerveldt glaucoma implant (BGI)-350 implantation at the Doheny Eye Institute. Twenty-four patients received a glaucoma shunt with venting stitch modification (modified BGI) and 37 patients received an unmodified shunt (BGI-only). IOP, number of glaucoma medications, and number of hypotony cases (intraocular pressure ≤5 mm Hg) were compared between the groups. T-tests were used for statistical analysis. At postoperative-day 1, mean IOP was significantly lower compared with preoperatively in the modified BGI group (14 mm Hg; reduced by 51%; P<0.0001) but not the BGI-only group (27 mm Hg; P=0.06). IOP difference between groups persisted till immediately before tube opening (P=0.005) and fewer IOP-lowering medications needed in the modified BGI group (P<0.0001). One case (4.2%) of postoperative hypotony was encountered with BGI modification, which resolved after the stitch was removed in clinic. The venting stitch valveless shunt modification allows for effective, reliable, and safe control of early postoperative IOP.

  6. Visuospatial deficits in children 3 - 7 years old with shunted ...

    African Journals Online (AJOL)

    right parieto-occipital region and may further compound these visuospatial deficitis. The hypomyelination and ... deficits in shunted HCP children aged between 3 and 7 years. School of Psychology, University of Durban- .... following a focal traumatic brain injury had a right-sided monoparesis. However, owing to small ...

  7. Factorial analysis in diagnosis of left-to-right shunts

    Energy Technology Data Exchange (ETDEWEB)

    Villanueva-Meyer, J.; Philippe, L.; Mena, I.

    1985-05-01

    Factor analysis (FA) extracts curves and images from a dynamic study with minimal operator intervention. This study applies FA to the left-to-right (L-R) shunt diagnosis, using it with deconvolution and gamma fitting techniques and comparing it to current procedures. 14 patients with a L-R shunt confirmed by catheterization and 10 normal subjects were studied. A first-pass ventriculogram was gathered in list mode for 25 sec after bolus injection of 15-20 mCi Tc99m. .5 sec frames were created. For FA 3 factors were requested, the dixel size was 4 by 4 pixels and 30 dixels were analyzed. The heart was masked out for the analysis. Three images and curves were obtained: venous input, lungs and background. The lung curve was deconvolved by the venous input curve using the lagged normal algorithm. The unit impulse response was used to obtain a calculated output lung curve. Gamma functions were fitted on this curve and area ratios yielded the Qp/Qs. Only FA with deconvolution separates the shunt patients from the control group with a p <0.001. Qp/Qs for the shunt group was 2.30, SD .54 and the control group was 1.12, SD .07. The best correlation with oximetry was obtained with this technique, r=.87 and SEE .28. The FA lung curve has excellent counting statistics derived from 48% of the total counts, thus the improvement of results.

  8. Synchrony with shunting inhibition in a feedforward inhibitory network.

    Science.gov (United States)

    Talathi, Sachin S; Hwang, Dong-Uk; Carney, Paul R; Ditto, William L

    2010-04-01

    Recent experiments have shown that GABA(A) receptor mediated inhibition in adult hippocampus is shunting rather than hyperpolarizing. Simulation studies of realistic interneuron networks with strong shunting inhibition have been demonstrated to exhibit robust gamma band (20-80 Hz) synchrony in the presence of heterogeneity in the intrinsic firing rates of individual neurons in the network. In order to begin to understand how shunting can contribute to network synchrony in the presence of heterogeneity, we develop a general theoretical framework using spike time response curves (STRC's) to study patterns of synchrony in a simple network of two unidirectionally coupled interneurons (UCI network) interacting through a shunting synapse in the presence of heterogeneity. We derive an approximate discrete map to analyze the dynamics of synchronous states in the UCI network by taking into account the nonlinear contributions of the higher order STRC terms. We show how the approximate discrete map can be used to successfully predict the domain of synchronous 1:1 phase locked state in the UCI network. The discrete map also allows us to determine the conditions under which the two interneurons can exhibit in-phase synchrony. We conclude by demonstrating how the information from the study of the discrete map for the dynamics of the UCI network can give us valuable insight into the degree of synchrony in a larger feed-forward network of heterogeneous interneurons.

  9. Recent trends in the diagnosis and treatment of sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Jorissen, M. [Dept. of E.N.T., Head and Neck Surgery, Univ. Hospital Sint-Rafaeel, Leuven (Belgium)

    1996-04-01

    The almost simultaneous introduction of nasal endoscopy and CT imaging led to better understanding of normal and pathologic function of the paranasal sinuses. Diagnosis and treatment of many paranasal sius diseases improved considerably. Endoscopy and CT are not concurrential; they are complementary, but they have specific strengths and weaknesses, as well as specific indicatons and consideratons. Staging systems for chronic sinusitis are currently used based on CT findings and response to medical therapy. Functional endoscopic sinus surgery (FESS) has become the standard procedure for most surgical cases of chronic sinusitis. Indications for FESS have enlarged beyond chronic sinus problems and even beyond the borders of the sinuses. Functional endoscopic sinus surgery aims to gain maximal result (restoring normal function) with minimal trauma and morbidity. (orig.)

  10. Dentigerous cyst associated with a displaced tooth in the maxillary sinus: an unusual cause of recurrent sinusitis in an adolescent

    Energy Technology Data Exchange (ETDEWEB)

    Prabhu, Sanjay P.; Robson, Caroline D. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Division of Neuroradiology, Boston, MA (United States); Padwa, Bonnie L. [Children' s Hospital Boston and Harvard Medical School, Department of Oral and Maxillofacial Surgery, Boston, MA (United States); Rahbar, Reza [Children' s Hospital Boston and Harvard Medical School, Department of Otolaryngology and Communication Enhancement, Boston, MA (United States)

    2009-10-15

    We report an unusual case of a displaced maxillary molar and associated dentigerous cyst within the maxillary sinus in an adolescent presenting as recurrent sinusitis. Although a rare cause of sinusitis in children, dentigerous cysts should be included in the differential diagnosis for causes of persistent or recurrent sinusitis in this age group. This report provides further evidence for obtaining imaging studies when managing pediatric sinusitis that does not respond to standard antibiotic therapy. We discuss management options for these lesions including the differential diagnoses and need for follow-up. (orig.)

  11. Immunohistochemical changes of maxillary sinus mucosa with underlying adenomatous polyposis

    Directory of Open Access Journals (Sweden)

    Yu. M. Andreychyn

    2017-04-01

    Full Text Available In maxillary sinusitis pathogenesis researchers paid much attention to the role of paranasal sinuses, sinus drainage dysfunctions, mucocyliary transport system disorders in cases of damage of sinuses mucous membranes. Pathohistological, immunohistochemical and morphometric studies of mucosa were conducted. However, to evaluate the local inflammatory response in cases of chronic sinusitis and improvement of individual therapy for the patients, the immunohistochemical studies of the composition of inflammatory immunocyte infiltrates of paranasal sinus mucosa and adenoid vegetations bioptate would be reasonable. The aim of the research was to study the immunohistochemical content of immunocyte infiltrates of paranasal sinuses adenomatous polyps in biopsy samples of patients suffering from chronic sinusitis. Materials and Methods. Paranasal sinuses adenomatous polyps removed during surgery of 22 patients suffering from chronic maxillary sinusitis were studied. Immunohistochemical studies of paraffin sections of the removed polyps were performed using appropriate primary antibodies and visualization systems DAKO EnVision+ System (DAKO, Denmark. Results. During microscopic investigation of paranasal sinuses adenomatous polyps of the patients suffering from chronic sinusitis, moderate and severe immunocyte infiltration of polyp stroma sometimes with focal follicular structures was presented. Immunohistochemical investigation of the cellular composition of these infiltrates proved the presence of CD8+ T-killer cells, CD4+ T-helper cells, CD68+ macrophages as well as single plasma cells. The irregularity of these cells markers expression was determined in dependence of the severity of inflammatory cell infiltration. Conclusions. In the patients with chronic maxillary polyp sinusitis with mild and moderate immunocyte infiltration of paranasal sinus mucosa, among immune cells the CD4+ T-lymphocytes occupied the most relative area in polyp stroma, plasma

  12. Right-to-left shunt with hypoxemia in pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Mastroïanni Bénédicte

    2009-03-01

    Full Text Available Abstract Background Hypoxemia is common in pulmonary hypertension (PH and may be partly related to ventilation/perfusion mismatch, low diffusion capacity, low cardiac output, and/or right-to-left (RL shunting. Methods To determine whether true RL shunting causing hypoxemia is caused by intracardiac shunting, as classically considered, a retrospective single center study was conducted in consecutive patients with precapillary PH, with hypoxemia at rest (PaO2 2 (AaPO2, and with transthoracic contrast echocardiography performed within 3 months. Results Among 263 patients with precapillary PH, 34 patients were included: pulmonary arterial hypertension, 21%; PH associated with lung disease, 47% (chronic obstructive pulmonary disease, 23%; interstitial lung disease, 9%; other, 15%; chronic thromboembolic PH, 26%; miscellaneous causes, 6%. Mean pulmonary artery pressure, cardiac index, and pulmonary vascular resistance were 45.8 ± 10.8 mmHg, 2.2 ± 0.6 L/min/m2, and 469 ± 275 dyn.s.cm-5, respectively. PaO2 in room air was 6.8 ± 1.3 kPa. Qs/Qt was 10.2 ± 4.2%. AaPO2 under 100% oxygen was 32.5 ± 12.4 kPa. Positive contrast was present at transthoracic contrast echocardiography in 6/34 (18% of patients, including only 4/34 (12% with intracardiac RL shunting. Qs/Qt did not correlate with hemodynamic parameters. Patients' characteristics did not differ according to the result of contrast echocardiography. Conclusion When present in patients with precapillary PH, RL shunting is usually not related to reopening of patent foramen ovale, whatever the etiology of PH.

  13. Experimental Comparison of Piezoelectric and Magnetostrictive Shunt Dampers

    Science.gov (United States)

    Asnani, Vivake M.; Deng, Zhangxian; Scheidler, Justin J.; Dapino, Marcelo J.

    2016-01-01

    A novel mechanism called the vibration ring is being developed to enable energy conversion elements to be incorporated into the driveline of a helicopter or other rotating machines. Unwanted vibration is transduced into electrical energy, which provides a damping effect on the driveline. The generated electrical energy may also be used to power other devices (e.g., health monitoring sensors). PZT (piezoceramic) and PMN-30%PT (single crystal) stacks, as well as a Tb_0.3 Dy_0.7 Fe_1.92 (Terfenol-D) rod with a bias magnet array and a pickup coil, were tested as alternative energy conversion elements to use within the vibration ring. They were tuned for broadband damping using shunt resistors, and dynamic compression testing was conducted in a high-speed load frame. Energy conversion was experimentally optimized at 750Hz by tuning the applied bias stress and resistance values. Dynamic testing was conducted up to 1000Hz to determine the effective compressive modulus, shunt loss factor, internal loss factor, and total loss factor. Some of the trends of modulus and internal loss factor versus frequency were unexplained. The single crystal device exhibited the greatest shunt loss factor whereas the Terfenol-D device had the highest internal and total loss factors. Simulations revealed that internal losses in the Terfenol-D device were elevated by eddy current effects, and an improved magnetic circuit could enhance its shunt damping capabilities. Alternatively, the Terfenol-D device may be simplified to utilize only the eddy current dissipation mechanism (no pickup coil or shunt) to create broadband damping.

  14. Cochlear implantation for total deafness after ipsilateral ventriculoperitoneal shunt surgery: technical report.

    Science.gov (United States)

    An, Yong-Hwi; Song, Seong Jun; Yoon, Sang Won; Kim, Jae Hoon; Shim, Hyun Joon

    2011-12-01

    Cochlear implantation (CI) becomes more challenging when a programmable ventriculoperitoneal (VP) shunt is present on the same side of the head. We report a successful ipsilateral CI in a patient who suffered bilateral hearing loss after shunt surgery. We describe the CI case of a 49-year-old woman with an implanted VP shunt device, and perform a retrospective review of the clinical, audiological, and radiological features, surgical techniques, and postoperative functional outcomes. During CI, the magnet in the core of internal antenna of the CI device was positioned approximately 8 cm from the shunt valve so that it would not be affected by the magnetic field of the programmable valve. Although the CI antenna tip and shunt catheter overlapped, we were very careful not to pull the shunt catheter out of position while the musculoperiosteal flap was elevated. The present result suggests that ipsilateral CI is an option for deaf adult patients who have a programmable shunt.

  15. Fuzzy Inference System Approach for Locating Series, Shunt, and Simultaneous Series-Shunt Faults in Double Circuit Transmission Lines.

    Science.gov (United States)

    Swetapadma, Aleena; Yadav, Anamika

    2015-01-01

    Many schemes are reported for shunt fault location estimation, but fault location estimation of series or open conductor faults has not been dealt with so far. The existing numerical relays only detect the open conductor (series) fault and give the indication of the faulty phase(s), but they are unable to locate the series fault. The repair crew needs to patrol the complete line to find the location of series fault. In this paper fuzzy based fault detection/classification and location schemes in time domain are proposed for both series faults, shunt faults, and simultaneous series and shunt faults. The fault simulation studies and fault location algorithm have been developed using Matlab/Simulink. Synchronized phasors of voltage and current signals of both the ends of the line have been used as input to the proposed fuzzy based fault location scheme. Percentage of error in location of series fault is within 1% and shunt fault is 5% for all the tested fault cases. Validation of percentage of error in location estimation is done using Chi square test with both 1% and 5% level of significance.

  16. A new alternative for a transjugular intrahepatic portosystemic shunt: EUS-guided creation of an intrahepatic portosystemic shunt (with video).

    Science.gov (United States)

    Buscaglia, Jonathan M; Dray, Xavier; Shin, Eun Ji; Magno, Priscilla; Chmura, Kevin M; Surti, Vihar C; Dillon, Travis E; Ducharme, Richard W; Donatelli, Gianfranco; Thuluvath, Paul J; Giday, Samuel A; Kantsevoy, Sergey V

    2009-04-01

    Transjugular intrahepatic portosystemic shunt (TIPSS) is an effective treatment for portal hypertension and its associated complications. EUS-guided creation of an intrahepatic portosystemic shunt (IPSS) may become a useful alternative to conventional TIPSS. To assess the feasibility of EUS-guided IPSS creation in a live porcine model. Acute and survival experiments in 50-kg pigs. Under linear-array EUS guidance, the hepatic vein (HV) and then the portal vein (PV) were punctured with a 19-gauge FNA needle. A 0.035-inch guidewire was advanced through the needle into the PV lumen. The needle was exchanged over the wire, a metal stent was deployed under EUS and fluoroscopic guidance, and the distal end of the stent was positioned inside the PV and the proximal end within the HV. Eight animals were euthanized after the procedure, and 2 animals were kept alive for 2 weeks. Successful EUS-guided IPSS creation. Portosystemic shunt placement was successful in all animals. Intrahepatic vascular puncture and stent deployment were technically easy. Portosystemic flow through the shunt was documented by portal venogram and EUS Doppler. Necropsy performed after acute and survival experiments revealed no evidence of bleeding or damage to any intraperitoneal organs. There were no complications during the follow-up period in the 2 animals that were kept alive. Experiments were performed in healthy animals with normal PV pressure. EUS-guided IPSS creation is technically feasible and may become an alternative to the currently used method of TIPSS placement.

  17. Tetralogy of Fallot Surgical Repair: Shunt Configurations, Ductus Arteriosus and the Circle of Willis.

    Science.gov (United States)

    Piskin, Senol; Unal, Gozde; Arnaz, Ahmet; Sarioglu, Tayyar; Pekkan, Kerem

    2017-06-01

    In this study, hemodynamic performance of three novel shunt configurations that are considered for the surgical repair of tetralogy of Fallot (TOF) disease are investigated in detail. Clinical experience suggests that the shunt location, connecting angle, and its diameter can influence the post-operative physiology and the neurodevelopment of the neonatal patient. An experimentally validated second order computational fluid dynamics (CFD) solver and a parametric neonatal diseased great artery model that incorporates the ductus arteriosus (DA) and the full patient-specific circle of Willis (CoW) are employed. Standard truncated resistance CFD boundary conditions are compared with the full cerebral arterial system, which resulted 21, -13, and 37% difference in flow rate at the brachiocephalic, left carotid, and subclavian arteries, respectively. Flow splits at the aortic arch and cerebral arteries are calculated and found to change with shunt configuration significantly for TOF disease. The central direct shunt (direct shunt) has pulmonary flow 5% higher than central oblique shunt (oblique shunt) and 23% higher than modified Blalock Taussig shunt (RPA shunt) while the DA is closed. Maximum wall shear stress (WSS) in the direct shunt configuration is 9 and 60% higher than that of the oblique and RPA shunts, respectively. Patent DA, significantly eliminated the pulmonary flow control function of the shunt repair. These results suggests that, due to the higher flow rates at the pulmonary arteries, the direct shunt, rather than the central oblique, or right pulmonary artery shunts could be preferred by the surgeon. This extended model introduced new hemodynamic performance indices for the cerebral circulation that can correlate with the post-operative neurodevelopment quality of the patient.

  18. Maxillary sinus augmentation using sinus membrane elevation without grafts - A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rakshith Hegde

    2016-01-01

    Full Text Available Implants have a predictable outcome and are the foremost treatment modality for prosthetic rehabilitation of edentulous patients. Due to loss of bone after extraction and pneumatization of maxillary sinus, there is insufficient bone volume for implant placement. The direct maxillary sinus lift procedure has been performed with different grafting materials (autogenous bone grafts, alloplasts, allografts, and xenografts and without grafting material, having new bone formation around the implant. There is no evidence to prove the need for grafting material in all direct sinus lift procedures, hence the need for this review. Previous meta-analysis showed that survival rates of implants placed in grafted maxillary sinuses had similar survival rates whether autogenous, allogenous, or alloplastic grafts were used. This paper aims to review scientific data on the direct sinus elevation technique without use of any grafting material, volume of new bone formed, and also mechanism behind this technique. Articles were searched from 1997 to October 2014 in PubMed, Google Scholar, and Cochrane CENTRAL. The study eligibility criteria were (1 direct sinus lift procedure without any graft material during implant placement and (2 human or animal studies with a minimum follow-up of 6 months or more. Two authors independently scrutinized the literature and if any controversy was raised, third author's opinion was sought to arrive at a mutual consensus for including the study in the review. Due to the heterogeneity across all studies in all study designs, the data were not pooled and a meta-analysis was not performed. Taking into consideration all factors reviewed in this regard along with the outcomes, the direct sinus lift technique without grafting can be suggested as a viable treatment option keeping in mind the limitations involved. The average bone gain was seen across all studies ranging from 2.37 to 10 mm and with an implant survival rate ranging from 79

  19. Osteitis and mucosal inflammation in a rabbit model of sinusitis.

    Science.gov (United States)

    Campos, Carlos Augusto Correia de; Dolci, Eduardo Landini Lutaif; Silva, Leonardo da; Dolci, José Eduardo Lutaif; Campos, Carlos Alberto Herrerias de; Dolci, Ricardo Landini Lutaif

    2015-01-01

    Several experimental studies have shown osteitis after the onset of sinusitis, supporting the idea that bone involvement could participate in the dissemination and perpetuation of this inflammatory disease. However, procedures commonly performed for the induction of sinusitis, such as antrostomies, can trigger sinusitis by themselves. To evaluate osteitis in an animal model of sinusitis that does not violate the sinus directly and verify whether this is limited to the induction side, or if it affects the contralateral side. Experimental study in which sinusitis was produced by inserting an obstructing sponge into the nasal cavity of 20 rabbits. After defined intervals, the animals were euthanized and maxillary sinus samples were removed for semi-quantitative histological analysis of mucosa and bone. Signs of bone and mucosal inflammation were observed, affecting both the induction and contralateral sides. Statistical analysis showed correlation between the intensity of osteitis on both sides, but not between mucosal and bone inflammation on the same side, supporting the theory that inflammation can spread through bone structures, regardless of mucosal inflammation. This study demonstrated that in an animal model of sinusitis that does not disturb the sinus directly osteitis occurs in the affected sinus and that it also affects the contralateral side. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  20. [The role of carbocystein in the treatment of sinusitis].

    Science.gov (United States)

    Dąbrowski, Piotr; Leszczyńska, Małgorzata; Mielcarek-Kuchta, Daniela

    2012-09-01

    Chronic sinusitis is one of the most common presenting complaints of all doctor visits in the United States and Europe, with more than 13% of people affected in any given year. This disease has a wide range of impact on communities. Patients with recurrent or chronic sinusitis report a deteriorative sense of general health and vitality, when compared to general population. In our Department we perform about 600 functional endoscopic sinus surgeries (FESS) per year. Chronic rhinosinusitis represents a spectrum of inflammatory and infectious processes concurrently affecting the nose and paranasal sinuses. Among chronic paranasal sinusitis one must single out paranasal sinusitis with and without polyps. In the paranasal sinusitis patomechanism the blockage of natural ostium plays one of the most important roles. The closure of sinus proper ventilation passages leads to the triggering of many pathological occurrences within mucous membrane of this region. The treatment of paranasal sinusitis is diversified and involves a surgical procedure as well as anti-inflammatory and antiallergic drugs (medications) and mucolytics. Its purpose is to clear the nose through the elimination of bacterial infection, liquidating and removal of lying discharge and the restoration of the proper muco-ciliary transportation, and through this the improvement of local condition and faster recovery. In this work the usage of carboxycysteine to treat paranasal sinus conditions has been presented. Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  1. Infantile maxillary sinus osteomyelitis mimicking orbital cellulitis

    Directory of Open Access Journals (Sweden)

    Nagarajan Krishnan

    2014-01-01

    Full Text Available Periorbital soft tissue swelling may result due to primary orbital pathology or from adjacent facio-maxillary or sino-nasal inflammatory causes. Osteomyelitis of maxilla in the pediatric age group is a rare entity in this era of antibiotics. We present an 11-month-old female infant who was brought with peri-orbital selling and purulent nasal discharge. Computed Tomography showed erosions of the walls of maxillary sinus suggestive of osteomyelitis. Culture of sinus scraping showed Staphylococcus aureus growth and the child improved with intravenous cloxacillin therapy. This case is presented due to the rarity of its presentation in this age group and for awareness to consider this entity in children having fever and peri-orbital swelling.

  2. Maxillary sinusitis caused by Lasiodiplodia theobromae

    Directory of Open Access Journals (Sweden)

    Kindo A

    2010-01-01

    Full Text Available Lasiodiplodia (monotypic comprises a very small proportion of the fungal biota. It is a common plant pathogen in tropical and subtropical regions. Clinical reports on its association with onychomycosis, corneal ulcer and phaeohyphomycosis are available. However, Lasiodiplodia theobromae causing fungal sinusitis has not been reported. We present here a case of fungal sinusitis in a 30-year-old woman, who came to the ENT OPD (out patient department with complaints of intermittent bleeding and nasal discharge from the left side for a week. The patient complained of headache, predominantly on the left side and heaviness on and off since two months. Diagnosis was based on radiological and mycological evidence; the patient underwent endoscopic surgery and was started on antifungal treatment.

  3. LATERAL SINUS THROMBOSIS IN OTOLOGY: A REVIEW

    Directory of Open Access Journals (Sweden)

    B Visavanatha

    2010-09-01

    Full Text Available Lateral sinus thrombosis (LST is usually occurs as a complication of middle ear infection .The involvement of lateral sinus during the course of ear infection was a well known complication in preantibiotic days .The decrease in the incidence of LST is due to the introduction of broad-spectrum antibiotics, early diagnosis and surgical treatment. Now, it is a rare complication of otitis media and poses a serious threat that warrants immediate medical and surgical treatment. The classical clinical picture is often changed by previous antibiotic therapy. An awareness of this rare potentially devastating condition and its varied presentations is necessary for early diagnosis and treatment. LST can also occur after head injury.

  4. The mold conundrum in chronic hyperplastic sinusitis.

    Science.gov (United States)

    Ebbens, Fenna A; Georgalas, Christos; Fokkens, Wytske J

    2009-03-01

    The role of fungi in chronic rhinosinusitis (CRS) is not clear. Fungi can be detected in the nose and paranasal sinuses of virtually all CRS patients; however, they also appear to be present in healthy controls. Various theories attempt to explain the mechanisms by which fungi can exert an effect on sinus mucosa in susceptible individuals. Further studies are necessary to clarify the role of fungi in CRS, which fungal organisms (if any) are pathogenic, and what exactly characterizes the immunologic response to fungi that may result in the development of disease. However, in the absence of convincing immunologic data and evidence of clinical improvement of CRS after antifungal therapy, the case against the fungus remains unproven.

  5. Pretreatment of sinus aspirates with dithiothreitol improves yield of fungal cultures in patients with chronic sinusitis.

    Science.gov (United States)

    Chisholm, Karen M; Getsinger, Diane; Vaughan, Winston; Hwang, Peter H; Banaei, Niaz

    2013-12-01

    Mold pathogens are a leading cause of chronic rhinosinusitis. Successful isolation of mold on culture is helpful in establishing a diagnosis and guiding therapy. Though mucolytic agents are commonly used in European countries, they are not part of everyday use in North America. In this case-control prospective study, we investigated the yield of fungal culture before and after treatment of sinus aspirates with the mucolytic agent dithiothreitol in a United States hospital. Over a 5-month period during 2011-2012, 359 sinus aspirates from 294 patients with symptoms suspicious for chronic sinusitis or allergic fungal sinusitis were collected. Aspirates were cultured on fungal medium before and after treatment with dithiothreitol. Of the 359 pairs of cultures, 62 (17.3%) demonstrated mold growth on at least 1 of the plates, 9 (14.5%) of which grew more than 1 species of mold. A total of 75 molds were identified, 41 (54.7%) of which were successfully cultured only when the mucus was pretreated with dithiothreitol (p sinus cultures after pretreatment of samples with dithiothreitol. Further studies are needed to correlate these findings with clinical outcome. © 2013 ARS-AAOA, LLC.

  6. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

    Energy Technology Data Exchange (ETDEWEB)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China)

    2010-08-15

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  7. Dural venous sinus stenting for medically and surgically refractory idiopathic intracranial hypertension.

    Science.gov (United States)

    Satti, Sudhakar R; Leishangthem, Lakshmi; Spiotta, Alejandro; Chaudry, M Imran

    2017-04-01

    Background Idiopathic intracranial hypertension (IIH) is a syndrome defined by elevated intracranial hypertension without radiographic evidence of a mass lesion in the brain. Dural venous sinus stenosis has been increasingly recognized as a treatable cause, and dural venous sinus stenting (DVSS) is increasingly performed. Methods A 5 year single-center retrospective analysis of consecutive patients undergoing DVSS for medically refractory IIH. Results There were 43 patients with a mean imaging follow-up of 6.5 months and a mean clinical follow-up period of 13.5 months. DVSS was performed as the first procedure for medically refractory IIH in 81.4% of patients, whereas 18.6% of patients included had previously had a surgical procedure (ventriculoperitoneal (VP) shunt or optic nerve sheath fenestration (ONSF)). Headache was present in all patients and after DVSS improved or remained stable in 69.2% and 30.8%, respectively. Visual acuity changes and visual field changes were present in 88.4% and 37.2% of patients, respectively. Visual field improved or remained unchanged in 92%, but worsened in 8% after stenting. There was a stent patency rate of 81.8%, with an 18.2% re-stenosis rate. Of the 43 procedures performed, there was a 100% technical success rate with zero major or minor complications. Conclusion Based on this single-center retrospective analysis, DVSS can be performed with high technical success and low complication rates. A majority of patients presented primarily with headache, and these patients had excellent symptom relief with DVSS alone. Patients presenting with visual symptoms had lower success rates, and this population, if stented, should be carefully followed for progression of symptoms.

  8. Investigation of Lunar Spinels at Sinus Aestuum

    Science.gov (United States)

    Weitz, Catherine M.; Staid, Matthew I.; Gaddis, Lisa R.; Besse, Sebastian; Sunshine, Jessica M.

    2017-10-01

    Sinus Aestuum is the only known location on the Moon where orbital data have detected Fe-and/or Cr-spinel. We analyzed Moon Mineralogy Mapper (M3) visible to near-infrared data of the largest and strongest spinel signatures and determined that these locations always correspond to impact craters. M3 spectra show that at least three types of spinels may be present, all of which exhibit a strong and broad absorption at 2100 nm, and also one of the following: (1) a narrow 700-750 nm absorption, (2) a broad 600-900 nm absorption, or (3) both a weaker 700 nm and stronger 1000 nm absorption. All the spinel detections occur on either larger highland massifs that make up Sinus Aestuum east and west or smaller highland kīpukas and buried highlands within the mare. Almost all of the spinel signatures occur within the mapped pyroclastic dark mantle deposit (DMD). The strong correlation between spinel and DMD distribution on the highlands at Sinus Aestuum is best explained if the spinels were emplaced during the same explosive eruption(s) that deposited the pyroclastics in the Sinus Aestuum DMD. Our observations are most consistent with models of melt-rock reactions in the anorthositic lunar crust that produce contaminated (high-Al) regions within a volcanic dike or magmatic reservoir that was capable of erupting pyroclastic glass beads containing pleonaste spinel [Mg,Fe]Al2O4. Over billions of years, this surface layer of spinels and pyroclastics became heterogeneously mixed into and partially buried within the highland regolith where younger impact craters may sometimes expose it.

  9. Rhinoplasty and Functional Endoscopic Sinus Surgery

    OpenAIRE

    Murrell, George L.

    2011-01-01

    An increasing number of patients are opting for combining sinus surgery and cosmetic rhinoplasty. The author has been performing rhinoplasty with FESS since April of 1990. The technique and equipment used in early cases is much different than that used in more recent surgeries. Specific advances include high definition monitor, intraoperative navigation system, and powered dissecting instruments. The benefits of these advances are illustrated by a review of the more recent cases performed by...

  10. LES OSTEOMES DES SINUS DE LA FACE

    African Journals Online (AJOL)

    9 mai 2013 ... INTRODUCTION. L'ostéome des sinus de la face est une tumeur ostéogé- nique bénigne, rare, d'évolution lente qui reste longtemps asymptomatique. Mais son potentiel agressif est à l'origi- ne de complications neurologiques et orbitaires. On se propose à partir de ce travail de préciser le profil épidé-.

  11. Thrombophlebite du sinus caverneux revelant une tuberculose ...

    African Journals Online (AJOL)

    Les auteurs rapportent une tuberculose maxillo-faciale chez un patient de 50 ans diabètique non insulino-requérrant révélée par une thrombophlébite du sinus caverneux responsable d'une exophtalmie bilatérale monstrueuse avec fonte purulente de l'oeil gauche et d'une parotidomégalie bilatérale réalisant une ...

  12. Sarcoidosis of the nose and paranasal sinuses.

    Science.gov (United States)

    McCaffrey, T V; McDonald, T J

    1983-10-01

    Sarcoidosis is a chronic systemic disease of unknown etiology characterized by non-caseating granulomatous inflammation of various organs. The records of 2319 patients with the diagnosis of sarcoidosis were reviewed to determine the incidence of nasal involvement. Seventeen patients or approximately 1% of the patients with sarcoidosis had histologically proven nasal mucosa involvement. These patients had symptoms of nasal crusting, congestion, epistaxis, pain, or anosmia. The clinical findings in these patients included friable nasal mucosa, nasal polyps, or a characteristic submucosal nodularity. Most patients also had abnormal sinus roentgenograms with either thickening of the sinus mucosa or opacification of the sinuses. Biopsy of the nasal mucosa shows typical non-caseating granulomas, but care must be exercised to exclude other causes of granulomatous inflammation of the nasal mucosa including tuberculosis, fungal infections, and other idiopathic granulomatous diseases such as Wegener's granulomatosis and Churg-Strauss syndrome. The treatment of nasal sarcoidosis has consisted of systemic steroids and in some cases topical beclomethasone dipropionate.

  13. Ventriculoperitoneal shunt complications in a developing country: a single institution experience.

    Science.gov (United States)

    Morina, Qamile; Kelmendi, Fatos; Morina, Arsim; Morina, Dukagjin; Bunjaku, Doruntina

    2013-01-01

    Shunting a hydrocephalus is among the most commonly performed neurosurgical procedures. Hydrocephalus constitute a significant medical problem in terms of urgency and treatment. Shunting of cerebrospinal fluid has dramatically reduced the morbidity and mortality of hydrocephalus, but they have potential complications that may need multiple surgical procedures during a patient's lifespan. We evaluated the following individual characteristics in relation to shunt complication rates: sex, ethnicity, age at the time of the first shunt placement (1 month [neonate], 1 to 12 months [infant], 1 to 18 years [child], 18 years [adult]), hydrocephalus type (spina bifida, congenital excluding spina bifida, communicating, obstructive) and socioeconomic status. In this retrospective study 193 patients were analyzed, unfortunately 27 where lost in the procedure of follow up and 12 died this patients were excluded from studies. Obstructive hydrocephalus (47.9%) was the most common diagnosis followed by communicating hydrocephalus (13.3%). Patients with ventriculoperitoneal shunt that were followed over time in 37% of cases experienced at least one surgical shunt complication during the study period and 13% of patients had multiple shunt complications. The causes for shunt malfunction include shunt infection, obstruction, distal catheter migration, shunt disconnection etc. Neonates and children experienced the highest complication rates. By 5 years of follow-up almost half of the children required a repeat surgical procedure. Children with obstructive hydrocephalus experienced the greatest risk of needing an initial shunt revision. Ventriculoperitoneal shunts constitute a significant medical problem, in terms of both urgency of treatment and economic costs. In conclusion, young infants are at highest risk for CSF shunt revision.

  14. Relationship between clinical sinusitis symptoms and sinus CT severity in pediatric post bone marrow transplant and immunocompetent patients

    Science.gov (United States)

    Arulrajah, Sahayini; Symons, Heather; Cahoon, Elizabeth Khaykin; Tekes, Aylin; Huisman, Thierry A. G. M.

    2014-01-01

    Since typical inflammatory responses may be diminished in children following bone marrow transplant (BMT), computed tomography (CT) imaging of the sinuses has been increasingly ordered to diagnose sinusitis in this group. The objective of this study was to determine the association between clinical sinusitis symptoms and sinus opacification on CT scans in post BMT versus immunocompetent children. Our sample was comprised of 64 post BMT and 86 immunocompetent children with sinus CT scans. CT sinus opacification was scored using the modified Lund–Mackay staging system. The relationship between clinical sinusitis symptoms (rhinorrhea, nasal congestion, cough, headache, and facial pain) and opacification was compared for the two groups. The severity of sinus opacification in the BMT group was significantly higher compared to the immunocompetent group. In combined patient groups the odds ratio (OR) for moderate/severe sinusitis was significantly elevated for rhinorrhea (OR=3.00; 95% confidence interval [CI], 1.27–7.12), cough (OR=2.80; 95% CI, 1.22–6.42), and having either rhinorrhea, nasal congestion, or cough (OR= 4.76; 95% CI, 1.71–13.24). While the immunocompetent group had a greater number of sinusitis symptoms compared to the post BMT group, both groups had a significant increase in the severity on CT with increasing number of symptoms. Conclusion In post BMT patients, our data demonstrated higher odds of moderate/severe sinusitis on CT scans associated with rhinorrhea, cough or nasal congestion. These finding suggest that in post BMT children, detailed sinus history may still play a vital role in the diagnosis of sinusitis. PMID:21904829

  15. Chronic sinusitis and woodworking as risk factors for cancer of the maxillary sinus in northeast Japan.

    Science.gov (United States)

    Shimizu, H; Hozawa, J; Saito, H; Murai, K; Hirata, H; Takasaka, T; Togawa, K; Konno, A; Kimura, Y; Kikuchi, A

    1989-01-01

    In the period 1983 to 1985, 66 patients presented to six Japanese university hospitals with squamous cell carcinoma of the maxillary sinus. Using self-administered questionnaires, a case-control study was conducted to examine history of nasal diseases, occupational exposures, and other possible risk factors for this disease. For each patient, two controls were selected from the general population, matched to the patient by sex, age (+/- 5 years), and district of residence. A history of chronic sinusitis was associated with a 2.3-fold increase in risk (p = 0.05). A high relative risk was also observed in males with an occupational history of woodworking or joinery, particularly when these jobs involved sanding or lathing practices (RR = 7.5, p = 0.02). No association between cigarette smoking and maxillary sinus cancer was observed in this study and no evidence was found that indoor air pollution in the home is involved in cancer development.

  16. Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review

    Science.gov (United States)

    Akhlaghi, Fahimeh; Esmaeelinejad, Mohammad; Safai, Pooria

    2015-01-01

    Context: Maxillary sinusitis is an important issue in dentistry and maxillofacial surgery. This study aims to present a systematic review of etiologies and treatments of odontogenic maxillary sinusitis. Evidence Acquisition: An electronic database search was performed based on related MeSH keywords. Articles published between January 2001 and December 2014 was selected according to the inclusion criteria. The information extracted from various studies was categorized in various tables. Results: The study selected 19 studies. In most studies, oroantral fistula (OAF) was the most common etiology of odontogenic sinusitis. Alpha-hemolytic streptococcus was the most common flora in sinusitis with dental origin. The literature shows that the Caldwell-Luc approach may be the best method for treating sinusitis in cases of displaced teeth. Conclusions: OAF is a common cause of odontogenic maxillary sinusitis and may easily be treated by endoscopy and fistula closure. Maxillofacial surgeons and dentists should consider this problem to avoid misdiagnosis and prevent complications. PMID:26756016

  17. Ocular Manifestations of Bilateral Ethmoidal Sinus Mucopyocele: Case Report

    Directory of Open Access Journals (Sweden)

    Özge Saraç

    2011-10-01

    Full Text Available Mucoceles of the paranasal sinuses are slowly growing, epithelium-lined cystic lesions with sterile content. When the mucocele content becomes infected with a bacterial super-infection, the lesion is defined as mucopyocele. Mucoceles or mucopyoceles are commonly located in the frontal and anterior ethmoidal sinuses and can manifest with ocular signs and symptoms, mostly proptosis. In this report, we demonstrate a case of bilateral ethmoidal mucopyocele in a 53-year-old female who presented with reduced vision, diplopia, and proptosis. Computed tomography (CT scanning of the paranasal sinuses revealed cystic lesions filling the maxillary sinuses and anterior ethmoidal cells bilaterally and causing erosion in the walls of the sinuses. After marsupialization of the mucopyoceles was performed by endoscopic sinus surgery, the symptoms of the patient recovered rapidly. (Turk J Ophthalmol 2011; 41: 354-6

  18. Isolated sphenoid sinus lesions: Experience with a few rare pathologies

    Directory of Open Access Journals (Sweden)

    Nishanth Sadashiva

    2017-01-01

    Full Text Available Introduction: The sphenoid sinus is often neglected because of its difficult access. The deep position of the sphenoid sinus hinders early diagnosis of pathologies in that location. Delayed diagnosis can cause serious complications due to proximity to many important structures. Objectives: The aim of this study is to demonstrate different pathologies which can affect the sphenoid sinus and elucidate the findings. Methods: Cases of isolated sphenoid sinus lesions encountered in the neurosurgical setting which had rare pathologies are discussed. Pathologies such as Langerhans cell histiocytosis, solitary plasmacytoma, chordoma, pituitary adenoma, leiomyosarcoma, fungal infection, and mucocele which appeared primarily in sphenoid sinus are discussed along with their imaging features and pathological findings. Conclusion: Multitude of different pathologies can occur in sphenoid sinus. Detailed preoperative imaging is very helpful, but transnasal biopsy and histological study are required often for definitive diagnosis. The possible advantages of early diagnosis before spread of pathology for prognosis cannot be overemphasized.

  19. Managment of orbital complications of sinusitis

    Directory of Open Access Journals (Sweden)

    Fazil Emre Ozkurt

    2014-10-01

    Full Text Available Purpose: We reported on the clinical approaches of ophthalmology and otorhinolaryngology departments in the treatment of the orbital complications of sinusitis. We also included an in-depth literature review. Methods: We retrospectively reviewed the medical files of 51 patients from January 2008 to January 2014. The records were evaluated for age, gender, type of orbital complications, symptoms, predisposing factors, imaging studies, medical and surgical management, culture results, and follow-up information. SPSS version 15.0 software (Statistical Analysis, The Statistical Package for Social Sciences Inc, Chicago, IL was used for the statistical analysis. Results: Fifty-one patients met the criteria, with available medical records, for the study (29 male, 22 female. Thirty-two (62.7% were diagnosed with preseptal cellulitis and 19 (37.3% with postseptal cellulitis. After a detailed evaluation, 15 were diagnosed with a subperiosteal abscess (SPA, and 4 were diagnosed with orbital cellulitis. The age and gender was similar for the two groups. Five patients with medial SPA were treated with endoscopic sinus surgery, one patient with inferior SPA was treated with external surgery, and six patients with other localizations were treated with a combination of endoscopic sinus surgery and external surgery. All patients presented with periorbital erythema and edema. The length of hospitalization and duration of symptoms were similar in both groups. Visual acuity was between 1/10 to 10/10 (mean 7/10 and statistically significant for preseptal and postseptal cellulitis groups (p<0.001. All patients received intravenous antibiotics upon the first day of admission. Conclusion: Orbital complications of acute sinusitis required intensive follow-up and a multidisciplinary approach. A contrast-enhanced paranasal sinus computerized tomography (CT scan can detect the extent of the infection. An initial trial of intravenosus (IV antibiotics may be appropriate when

  20. Integrating rolling stock scheduling with train unit shunting

    DEFF Research Database (Denmark)

    Haahr, Jørgen Thorlund; Lusby, Richard Martin

    2017-01-01

    In this paper, we consider integrating two important railway optimization problems, in particular the Rolling Stock Scheduling Problem and the Train Unit Shunting Problem. We present two similar branch-and-cut based approaches to solve this integrated problem and, in addition, provide a comparison...... of different approaches to solve the so-called Track Assignment Problem, a subcomponent of the Train Unit Shunting problem. In this analysis we demonstrate, by way of a counter example, the heuristic nature of a previously argued optimal approach. For the integrated problem we analyze the performance...... of the proposed approaches on several real-life case studies provided by DSB S-tog, a suburban train operator in the greater Copenhagen area. Computational results confirm the necessity of the integrated approach; high quality solutions to the integrated problem are obtained on instances where a conventional...

  1. Endoscopic third ventriculostomy has no higher costs than ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Benicio Oton de Lima

    2014-07-01

    Full Text Available Objective: To evaluate the cost of endoscopic third ventriculostomy (ETV compared to ventriculoperitoneal shunt (VPS in the treatment of hydrocephalus in children. Method: We studied 103 children with hydrocephalus, 52 of which were treated with ETV and 51 with VPS in a prospective cohort. Treatment costs were compared within the first year after surgery, including subsequent surgery or hospitalization. Results: Twenty (38.4% of the 52 children treated with VPS needed another procedure due to shunt failure, compared to 11 (21.5% of 51 children in the ETV group. The average costs per patient in the group treated with ETV was USD$ 2,177,66±517.73 compared to USD$ 2,890.68±2,835.02 for the VPS group. Conclusions: In this series there was no significant difference in costs between the ETV and VPS groups.

  2. Failure of a Torkildsen shunt after functioning for 50 years.

    Science.gov (United States)

    Zinn, Pascal O; Bozinov, Oliver; Burkhardt, Jan-Karl; Reisch, Robert; Yaşargil, M Gazi; Bertalanffy, Helmut

    2010-04-01

    Mechanical obstruction is a severe complication of ventricular catheter use. Its incidence was shown to be high in the 1960s and 1970s, with up to 41% of the catheters becoming obstructed within 10 years after surgery. The authors present what is to their knowledge the first reported case of a patient with failure of a Torkildsen shunt after 50 years of functioning. A 60-year-old woman presented with increasing gait ataxia, decline in cognitive functions (including short-term memory loss), and slight urinary incontinence. The diagnosis of hydrocephalus and thus malfunction of the Torkildsen shunt implanted 50 years previously was confirmed by MR images, which revealed a prominent triventricular hydrocephalus. The patient subsequently underwent endoscopic third ventriculostomy (ETV), the current surgical treatment of choice, resulting in total resolution of her neurological symptoms and amelioration of cerebral tissue distension. Decrease in ventricle dilation and success of the ETV were confirmed on postoperative follow-up MR images.

  3. New bone formation in the maxillary sinus without bone grafts.

    Science.gov (United States)

    Sohn, Dong-Seok; Lee, Ji-Soo; Ahn, Mi-Ra; Shin, Hong-In

    2008-09-01

    Various sinus augmentation procedures, using bone substitutes, have been used to place dental implants in the atrophic posterior maxilla. The aim of this article is to evaluate the possibility of new bone formation in the maxillary sinus without a bone graft. Ten patients without significant sinus pathosis were selected for this study. The bony window was prepared in the lateral wall using the ultrasonic piezoelectric bone surgery device (Surgybone, Silfradent srl, Sofia, Italy). The sinus membrane was elevated superiorly and implants were placed simultaneously to maintain the space under the sinus membrane for new bone formation. As the methods of sealing the lateral access window of the sinus, patients were divided into 2 groups. Nonresorbable membrane was used to seal the lateral access window of the maxillary sinus after implant placement in 5 cases (group A). Replaceable bony window was used to seal the lateral wall of the sinus in another 5 cases (group B). Computed tomograms were taken immediately before and after surgery, at the uncovering of the implant, and after a 6 month healing period. A bone biopsy was taken on the previous bony window area to evaluate new bone formation. A total of 21 implants in lengths of 10 to 15 mm (mean, 13 mm) were placed, with an average residual bone height of 5 mm (range, 1-9 mm). All implants remained stable during the study period in clinical evaluations. New bone formation and new sinus floors were found in radiographic and histologic evaluations. The human study showed the capacity of new bone formation in the maxillary sinus with membrane elevation only and simultaneous implant placement beyond the original sinus floor. New bone formation without additional bone graft in the maxillary sinus is revealed from the clinical, radiographic, and histologic results, but furthermore long-term studies are needed to confirm this.

  4. Anatomical description of the sinus in the alpaca (Vicugna pacos)

    OpenAIRE

    Zárate L., Rosse; Laboratorio de Anatomía Animal y Fauna Silvestre, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Navarrete Z., Miluska; Laboratorio de Anatomía Animal y Fauna Silvestre, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Sato S., Alberto; Laboratorio de Anatomía Animal y Fauna Silvestre, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Díaz C., Diego; Laboratorio de Farmacología y Toxicología, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Huanca L., Wilfredo; Laboratorio de Reproducción Animal, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima

    2015-01-01

    The objective of the present study was to describe the macroscopic anatomy of the sinus in the alpaca. Ten skulls of adult alpacas were prepared by the maceration technique, and the description through longitudinal cuts was done using terminology recommended by the Nomina Anatomica Veterinaria. In addition, X-rays with contrast medium were taken to four adult alpacas to determine the relationships of sinus with other anatomical structures. Results showed that the frontal and maxillary sinus w...

  5. Pott's Puffy Tumor Arising from Frontal Sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ji Yeon; Kang, Hyun Koo [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2010-02-15

    Pott's puffy tumor is an extremely rare and potentially life-threatening complication of frontal sinusitis. We report a case of a 64-year-old man who presented at our emergency department with mild tenderness on the glabellar area and diplopia. Computed Tomography (CT) revealed frontal sinusitis and osteomyelitis of the frontal bone. Following sinus trephination and long-term antibiotic therapy, the patient achieved a complete recovery.

  6. Differential diagnosis of allergic rhinitis and sinusitis an expert system

    Energy Technology Data Exchange (ETDEWEB)

    Creider, R.D.; Sundar Singh, P.S. [Texas A& M Univ., Commerce, TX (United States)

    1996-12-31

    Nasal congestion is a common problem for many people. It is a symptom of chronic sinusitis and also a characteristic of allergic rhinitis. Individuals frequently confuse sinusitis and allergic rhinitis. The expert system described below will diagnose the problem to be either rhinitis or sinusitis. In this paper we describe the expert system, the need for such an expert system and the process of developing the system.

  7. Low-grade osteosarcoma of the maxillary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong-Koo [Department of Pathology, College of Medicine, Kyung Hee University, Seoul (Korea); Department of Pathology, Kyung Hee University Hospital, Hoeki-dong, Dongdaemoon-ku, Seoul (Korea); Ryu, Kyung Nam [Department of Diagnostic Radiology, College of Medicine, Kyung Hee University, Seoul (Korea); Park, Hye-Rim; Kim, Duck-Whan [Department of Pathology, College of Medicine, Hallym University, Seoul (Korea); 4

    2003-03-01

    Low-grade osteosarcomas of the paranasal sinus are extremely rare. Most reported cases of maxillary sinus osteosarcoma are high-grade. We present a 51-year-old man with a low-grade osteosarcoma which was histologically difficult to diagnose in isolation since it had bland features. The presence of an aggressive destructive lesion on imaging influenced the final pathological diagnosis as often appears to be the case with this rare tumor. We briefly discuss paranasal sinus osteosarcomas. (orig.)

  8. Lateral window and transalveolar osteotomy sinus lifting technique

    OpenAIRE

    Ruslin, Muhammad

    2011-01-01

    The insertion of dental implants in atrophy maxilla is a complicated issue because no bone support due to expansion of maxillary sinus and atrophy of maxillary ridge alveolar. Surgery by sinus lifting with autogenous bone transplantation has been proven to be an acceptable treatment to get bone support. The lateral window technique and transalveolar osteotomy sinus lifting are the methods to correct the height of inadequate bone in the posterior area of maxilla for preparation of implan denta...

  9. Analysis of new actuation methods for capacitive shunt micro switchs

    OpenAIRE

    Ben Sassi S; Khater M E; Abdel-Rahman E M; Najar F

    2016-01-01

    This work investigates the use of new actuation methods in capacitive shunt micro switches. We formulate the coupled electromechanical problem by taking into account the fringing effects and nonlinearities due to mid-plane stretching. Static analysis is undertaken using the Differential Quadrature Method (DQM) to obtain the pull in voltage which is verified by means of the Finite Element Method (FEM). Based on Galerkin approximation, a single degree of freedom dynamic model is developed and l...

  10. Transient Hemolytic Anemia after Transjugular Intrahepatic Portosystemic Stent Shunt

    OpenAIRE

    Garcia-Rebollo, Sagrario; González-Reimers, Emilio; Santolaria-Fernández, Francisco; Diaz-Romero, Francisco; Rodriguez-Moreno, Fermin; Martinez-Riera, Antonio

    1996-01-01

    Management of variceal bleeding secondary to portal hypertension constitutes a challenging issue, particularly in child's C cirrhotic patients. Recently, transjugular placement of self-expanding metallic stents in the liver (TIPS), creating a shunt between the portal and hepatic branches has provided a safe and promising therapeutic approach in this clinical situation. We report here the case of a 66-year-old male cirrhotic patient who developed a moderately severe clinical picture of a Coomb...

  11. Integrating rolling stock scheduling with train unit shunting

    DEFF Research Database (Denmark)

    Haahr, Jørgen Thorlund; Lusby, Richard Martin

    2017-01-01

    In this paper, we consider integrating two important railway optimization problems, in particular the Rolling Stock Scheduling Problem and the Train Unit Shunting Problem. We present two similar branch-and-cut based approaches to solve this integrated problem and, in addition, provide a comparison......, sequential approach ends in infeasibility. Furthermore, for the considered instances, solutions are typically found within a few minutes, indicating the applicability of the methodology to short-term planning....

  12. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Peritoneo-venous shunt. 876.5955 Section 876.5955 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...—Part I: Evaluation and Testing,’ ” (2) “510(k) Sterility Review Guidance of 2/12/90 (K90-1),” and (3...

  13. Pre-Liver Transplant: Tips Versus Distal Splenorenal Shunt

    Directory of Open Access Journals (Sweden)

    Thomas W. Faust

    1997-01-01

    Full Text Available Recurrent variceal bleeding in liver transplant candidates with end-stage liver disease can complicate or even prohibit a subsequent transplant procedure (OLT. Endoscopic sclero-therapy and medical therapy are considered as first-line management with surgical shunts reserved for refractory situations. Surgical shunts can be associated with a high mortality in this population and may complicate subsequent OLT. The transjugular intrahepatic portosystemic shunt (TIPS has been recommended in these patients as a bridge to OLT. This is a new modality that has not been compared with previously established therapies such as the distal splenorenal shunt (DSRS. In this study we report our experience with 35 liver transplant recipients who had a previous TIPS (18 patients or DSRS (17 patients for variceal bleeding. The TIPS group had a significantly larger proportion of critically ill and Child-Pugh C patients. Mean operating time was more prolonged in the DSRS group (P=0.014 but transfusion requirements were similar. Intraoperative portal vein blood flow measurements averaged 2132±725 ml/min in the TIPS group compared with 1120±351ml/min in the DSRS group (P<0.001. Arterial flows were similar. Mean ICU and hospital stays were similar. There were 3 hospital mortalities in the DSRS group and none in the TIPS group (P=0.1. We conclude that TIPS is a valuable tool in the management of recurrent variceal bleeding prior to liver transplantation. Intra0Perative hemodynamic measurements suggest a theoretical advantage with TIPS. In a group of patients with advanced liver disease we report an outcome that is similar to patients treated with DSRS prior to liver transplantation. The role of TIPS in the treatment of nontransplant candidates remains to be clarified.

  14. Simple evaluation of CT findings in the paranasal sinuses for chronic sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Miyazaki, Makoto [Saiseikai Shiga Hospital, Ritto (Japan); Dejima, Kenji; Hama, Takemitsu; Ishizaka, Shigeyasu; Yasuda, Shigenobu; Fukushima, Kazuto; Murakami, Yasushi; Hisa, Yasuo

    2000-02-01

    The CT scores and scoring for improvement based on them, which we proposed previously, is a simple and highly reproducible method of evaluation of sinus units before and after an operation for chronic sinusitis. We compared this evaluation method with the results of quantitative assay and showed its advantages and disadvantages. The subjects were 258 sinuses in patients who underwent endonasal sinus surgery (ESS) in the department of otolaryngology, Kyoto Prefectural University of Medicine Hospital from April 1996 to April 1997. The subjects were evaluated according to the following 4 grades negligible shadow in the paranasal sinus CT scored 0, less than 50% shadow scored 1, more than 50% of shadow scored 2, and mostly filled with shadow scored 3. Furthermore, the preoperative and postoperative CT scores were compared and the rate of improvement was rated in the following 3 grades: score 0 for unchanged or aggravated subjects, score 1 for subjects showing improved CT score by 1 grade, and score 2 for those showing improved CT score by 2 grades or a postoperative CT score of 0. Quantitative image analysis was input into a personal computer and the ratio occupied by the shadow was calculated, as the shadow ratio. While some discrepancies were seen in parts in the comparison of the quantitative image analysis and CT scores as the former captures minute shadows, a positive correlation was obtained overall. Attention is needed to accurately evaluate small paranasal sinuses such as the frontal sinus, and small amounts of shadow, which are areas where errors may occur. A satisfactory correlation was obtained between the score for the improvement rate and the difference in the shadow ratios before and after surgery. The CT scores and the scores for the improvement rate showed no difference from the results of other evaluation methods reported in the past, and evaluation of similar precision was possible. It was thought that this simple evaluation method of CT findings in

  15. Reflux venous flow in dural sinus and internal jugular vein on 3D time-of-flight MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Jinhee; Kim, Bum-soo; Kim, Bom-yi; Choi, Hyun Seok; Jung, So-Lyung; Ahn, Kook-Jin; Byun, Jae Young [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, School of Medicine, Seoul (Korea, Republic of)

    2013-10-15

    Reflux venous signal on the brain and neck time-of-flight magnetic resonance angiography (TOF MRA) is thought to be related to a compressed left brachiocephalic vein. This study is aimed to assess the prevalence of venous reflux flow in internal jugular vein (IJV), sigmoid sinus/transverse sinus (SS/TS), and inferior petrosal sinus (IPS) on the brain and neck TOF MRA and its pattern. From the radiology database, 3,475 patients (1,526 men, 1,949 women, age range 19-94, median age 62 years) with brain and neck standard 3D TOF MRA at 3 T and 1.5 T were identified. Rotational maximal intensity projection images of 3D TOF MRA were assessed for the presence of reflux flow in IJV, IPS, and SS/TS. Fifty-five patients (1.6 %) had reflux flow, all in the left side. It was more prevalent in females (n = 43/1,949, 2.2 %) than in males (n = 12/1,526, 0.8 %) (p = 0.001). The mean age of patients with reflux flow (66 years old) was older than those (60 years old) without reflux flow (p = 0.001). Three patients had arteriovenous shunt in the left arm for hemodialysis. Of the remaining 52 patients, reflux was seen on IJV in 35 patients (67.3 %). There were more patients with reflux flow seen on SS/TS (n = 34) than on IPS (n = 25). Venous reflux flow on TOF MRA is infrequently observed, and reflux pattern is variable. Because it is exclusively located in the left side, the reflux signal on TOF MRA could be an alarm for an undesirable candidate for a contrast injection on the left side for contrast-enhanced imaging study. (orig.)

  16. A case of repeated intracerebral hemorrhages secondary to ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Jinbing Zhao

    2015-03-01

    Full Text Available Ventriculoperitoneal shunt is a routinely performed treatment in neurosurgical department. Intracerebral hemorrhage, as a complication after shunt catheterization, is really rare but with high mortality. In this study, we reported a case of a 74-year-old man who suffered from repeated intracerebral hemorrhage after ventriculoperitoneal shunt. The first hemorrhage happened 63 h after the 1st surgery, and most hematomas were located in the ipsilateral occipital lobe and intraventricles, along the ventricular catheter. Fresh blood clot casts blocked the external ventricular draining catheter, which was inserted into the right front horn during the 3rd surgery, indicating new intraventricular bleeding happened. A large hematoma in ipsilateral frontal lobe was detected on the 3rd day after the removal of external ventricular draining catheter. Different hemorrhagic locations and time points were encountered on the same case. We discussed the possible causes of repeated hemorrhage for this case, and the pre-operative preparation including risk evaluation in future clinical work.

  17. Executive Function Improvement in Normal Pressure Hydrocephalus Following Shunt Surgery

    Directory of Open Access Journals (Sweden)

    Ezequiel Gleichgerrcht

    2009-01-01

    Full Text Available The aim of this investigation was to evaluate improvement of executive functions after shunt surgery in patients with early normal pressure hydrocephalus (NPH. Patients with NPH were assessed before and after shunt surgery with tests shown to be sensitive to damage to the prefrontal cortex (PFC. Significant differences were found between basal and follow-up performances on the Boston Naming Test, the backwards digits span, Part B of the Trail Making Test, and the number of words produced on the phonological fluency task. In conclusion, our study reveals that patients with NPH who respond positively to continuous slow lumbar cerebral spinal fluid drainage and receive a ventriculoperitoneal shunt implant, improve their performance on tasks of executive function. Due to the high demand for this form of mental processing in real-life complex scenarios, and based on the severe executive deficits present in both demented and non-demented NPH patients, we encourage the assessment of executive functions in this clinical group.

  18. Sinusitis and pneumonia hospitalization after introduction of pneumococcal conjugate vaccine.

    Science.gov (United States)

    Lindstrand, Ann; Bennet, Rutger; Galanis, Ilias; Blennow, Margareta; Ask, Lina Schollin; Dennison, Sofia Hultman; Rinder, Malin Ryd; Eriksson, Margareta; Henriques-Normark, Birgitta; Ortqvist, Ake; Alfvén, Tobias

    2014-12-01

    Streptococcus pneumoniae is a major cause of pneumonia and sinusitis. Pneumonia kills >1 million children annually, and sinusitis is a potentially serious pediatric disease that increases the risk of orbital and intracranial complications. Although pneumococcal conjugate vaccine (PCV) is effective against invasive pneumococcal disease, its effectiveness against pneumonia is less consistent, and its effect on sinusitis is not known. We compared hospitalization rates due to sinusitis, pneumonia, and empyema before and after sequential introduction of PCV7 and PCV13. All children 0 to sinusitis, pneumonia, or empyema in Stockholm County, Sweden, from 2003 to 2012 were included in a population-based study of hospital registry data on hospitalizations due to sinusitis, pneumonia, or empyema. Trend analysis, incidence rates, and rate ratios (RRs) were calculated comparing July 2003 to June 2007 with July 2008 to June 2012, excluding the year of PCV7 introduction. Hospitalizations for sinusitis decreased significantly in children aged 0 to sinusitis and pneumonia in children aged 0 to sinusitis and 19% lower risk of hospitalization for pneumonia in children aged 0 to <2 years, in a comparison of 4 years before and 4 years after vaccine introduction. Copyright © 2014 by the American Academy of Pediatrics.

  19. Neurosurgical transection of the breast: an unexpected extracranial complication of ventriculoperitoneal shunt insertion.

    Science.gov (United States)

    Jakeman, Molly; Jeevan, Ranjeet; Burn, Sasha C; Falder, Sian

    2017-12-01

    Ventriculoperitoneal (VP) shunt placement is among the most common surgical procedures undertaken by neurosurgeons. Complications arising from the thoracic portion of the shunt are relatively rare in comparison with those of the intraventricular and peritoneal portions. Disruption of primary breast development following VP shunt placement has not previously been reported. The authors describe the case of a 15-year-old girl referred to the plastic surgery department with a significant right breast deformity and associated asymmetry following VP shunt placement performed during the neonatal period. The calcified shunt was excised and the breast deformity was corrected surgically through multiple scar tissue releases and restoration of the normal breast parenchymal anatomy via a minimally invasive approach, resulting in an excellent aesthetic outcome. This case highlights the potential for injury to occult breast tissue in pediatric patients undergoing VP shunt placement, which can impair subsequent cosmesis and quality of life.

  20. Chemoembolic Hepatopulmonary Shunt Reduction to Allow Safe Yttrium-90 Radioembolization Lobectomy of Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Gaba, Ron C., E-mail: rgaba@uic.edu [University of Illinois Medical Center at Chicago, Department of Radiology, Section in Interventional Radiology (United States); VanMiddlesworth, Kyle A. [Midwestern University School of Medicine (United States)

    2012-12-15

    Yttrium-90 ({sup 90}Y) radioembolization represents an emerging transcatheter treatment option for the management of hepatocellular carcinoma (HCC). Elevation of the hepatopulmonary shunt fraction risks nontarget radiation to the lungs and may limit the use of {sup 90}Y therapy in patients with locally advanced disease with vascular invasion, who often demonstrate increased shunting. We present two cases in which patients with HCC and portal vein invasion resulting in elevated hepatopulmonary shunt fractions underwent chemoembolic shunt closure to allow safe {sup 90}Y radioembolization. Both patients demonstrated excellent tumor response and patient survival. On this basis, we propose a role for chemoembolic reduction of the lung shunt fraction before {sup 90}Y radioembolization in patients with extensive tumor-related hepatopulmonary shunting.

  1. Valved or valveless ventriculoperitoneal shunting in the treatment of post-haemorrhagic hydrocephalus

    DEFF Research Database (Denmark)

    Andreasen, Trine Hjorslev; Holst, Anders Vedel; Lilja, Alexander

    2016-01-01

    with ventriculoperitoneal shunting at our institution from 1 January 2008 to 31 December 2014 were included in this retrospective population-based consecutive cohort study. Data were collected by retrospectively reviewing medical records. We compared two different shunt modalities (valveless vs valve-regulated), analysing.......3 %, p = 0.02), but a higher rate of overdrainage (10.3 % vs 2.6 %, p = 0.04). CONCLUSION: The use of a valveless shunting for patients with post-haemorrhagic hydrocephalus results in shorter duration of neurosurgical hospitalisation and lower rate of shunt infection, although these advantages should...... be held up against the risk of overdrainage. We propose valveless shunting to be used as first-line shunting strategy in this patient category, with careful follow-up ensuring that these are substituted by a valve-bearing system if necessary....

  2. Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications

    Directory of Open Access Journals (Sweden)

    Fernanda O. de Carvalho

    2014-04-01

    Full Text Available Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus. Objective: To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a “non reliable” peritoneum. Method: From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy. Results: After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far. Conclusion: Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.

  3. Sinus lifting dengan teknik lateral window dan transalveolar osteotomy Lateral window and transalveolar osteotomy sinus lifting technique

    OpenAIRE

    Muhammad Ruslin

    2011-01-01

    The insertion of dental implants in atrophy maxilla is a complicated issue because no bone support due to expansion of maxillary sinus and atrophy of maxillary ridge alveolar. Surgery by sinus lifting with autogenous bone transplantation has been proven to be an acceptable treatment to get bone support. The lateral window technique and transalveolar osteotomy sinus lifting are the methods to correct the height of inadequate bone in the posterior area of maxilla for preparation of ...

  4. [Syringosubarachnoid shunting in treatment of syringomyelia: a literature review and a clinical case report].

    Science.gov (United States)

    Klimov, V S; Gulay, Yu S; Evsyukov, A V; Moysak, G I

    2017-01-01

    In the article, we describe a clinical case of syringomyelia associated with an Arnold-Chiari type 1 malformation, evaluate the efficacy of syringosubarachnoid shunting, and analyze the literature data of domestic and international researchers involved in investigation and treatment of the pathology. Application of syringosubarachnoid shunting in the described case resulted in a clinical improvement in the form of regression of paresis and hypoesthesia, which demonstrated the efficacy of the shunting technique for correction of the syringomyelia symptoms.

  5. Reversibility of intrapulmonary arteriovenous shunts in liver cirrhosis documented by serial radionuclide perfusion lung scans

    Energy Technology Data Exchange (ETDEWEB)

    Chen, N.S.; Barnett, C.A.; Farrer, P.A.

    1984-05-01

    Using serial perfusion lung scans, the opening up and closure of right-to-left intrapulmonary arteriovenous shunts has been documented over a period of several weeks in a patient with chronic alcoholic liver disease. The presence of the shunts correlates well with the severity of hypoxemia and the presence of nodular mottling on chest radiographs. The time course of these changes with clinical status suggests lability and the functional nature of these shunts.

  6. Haematology and coagulation profiles in cats with congenital portosystemic shunts.

    Science.gov (United States)

    Tzounos, Caitlin E; Tivers, Michael S; Adamantos, Sophie E; English, Kate; Rees, Alan L; Lipscomb, Vicky J

    2017-12-01

    Objectives The objectives of this study were, first, to report the haematological parameters and coagulation times for cats with a congenital portosystemic shunt (CPSS) and the influence of surgical shunt attenuation on these parameters; and, second, to identify any association between prolongation in coagulation profiles and incidence of perioperative haemorrhage. Methods This was a retrospective clinical study using client-owned cats with a CPSS. Signalment, shunt type (extra- or intrahepatic), degree of shunt attenuation (complete or partial), haematological parameters, prothrombin time (PT) and activated partial thromboplastin time (aPTT) test results, and occurrence of any perioperative clinical bleeding complications were recorded for cats undergoing surgical treatment of a CPSS at the Royal Veterinary College, UK, between 1994 and 2011. Results Forty-two cats were included. Thirty-six (85.7%) had an extrahepatic CPSS and six (14.3%) had an intrahepatic CPSS. Preoperatively, mean cell volume (MCV) and mean cell haemoglobin (MCH) were below the reference interval (RI) in 32 (76.2%) and 31 (73.8%) cats, respectively. Red blood cell count and mean cell haemoglobin concentration (MCHC) were above the RI in 10 (23.8%) and eight (19.1%) cats, respectively. Postoperatively, there were significant increases in haematocrit ( P = 0.044), MCV ( P = 0.008) and MCH ( P = 0.002). Despite the significant increase in MCV postoperatively, the median MCV postoperatively was below the RI, indicating persistence of microcytosis. Preoperatively, PT was above the upper RI in 14 cats (87.5%), and aPTT was above the upper RI in 11 cats (68.8%). No cat demonstrated a perioperative clinical bleeding complication. Conclusions and relevance Cats with a CPSS are likely to present with a microcytosis, but rarely present with anaemia, leukocytosis or thrombocytopenia. Surgical attenuation of the CPSS results in a significant increase in the HCT and MCV. Coagulation profiles in cats with a

  7. Cerebral regional oxygen saturation monitoring in pediatric malfunctioning shunt patients.

    Science.gov (United States)

    Abramo, Thomas J; Zhou, Chuan; Estrada, Cristina; Drayna, Patrick C; Locklair, Matthew R; Miller, Renee; Pearson, Matthew; Tulipan, Noel; Arnold, Donald H

    2013-02-01

    Shunt malfunction produces increased intracranial pressure causing decreased cerebral regional perfusion and tissue O(2)sat. Cerebral regional oxygen saturation (rSO(2)) by near-infrared spectroscopy represents tissue perfusion and oxygen saturation. Cerebral rSO(2) is used to detect cerebral ischemia in pediatric clinical settings. The objective of the study was to determine the reliability of cerebral rSO(2) in pediatric malfunctioning shunt. A prospective observational study of pediatric patients presented to the pediatric emergency department was conducted. Confirmed malfunctioning shunt subjects had cerebral rSO(2) monitoring. A total of 131 malfunctioning shunt subjects had cerebral rSO(2) monitoring. Patient's central trend and intrasubject variability of cerebral rSO(2) readings for left and right probe and malfunction sites (n = 131) are as follows: Intrasubject left and right rSO(2) Pearson correlation was -0.46 to 0.98 (mean ± SD, 0.35 ± 0.34; median, 0.34; interquartile range, 0.06-0.61). The correlation coefficients of 99 subjects between left and right rSO(2) was significantly different (P < .001), suggesting that intrasubjects' left and right rSO(2) are highly correlated. Sample mean difference between left and right rSO(2) were -1.7% (95% confidence interval [CI], -1.8 to -1.6; P < .001) supporting overall left lower than right. Intraclass correlation for left rSO(2) was 87.4% (95% CI, 87.2%-87.6%), and that for right rSO(2) was 83.8% (95% CI, 83.8%-84%), showing intersubject differences accounting for the variation, and relative to intersubject variation, intrasubjects readings are consistent. Intrasubjects, left and right rSO(2) highly correlate and are asymmetrical. Left and right rSO(2) are consistent in intrasubject with large rSO(2) variations in trend and variability across subjects. This study demonstrates reliable cerebral rSO(2) readings in subjects with malfunctioning shunts, with asymmetrical cerebral rSO(2) hemispheric dynamics within

  8. Eversion carotid endarterectomy without shunt: concerning 1385 consecutive cases.

    Science.gov (United States)

    Ben Ahmed, Sabrina; Daniel, Guillaume; Benezit, Marie; Ribal, Jean-Pierre; Rosset, Eugenio

    2017-08-01

    The aim of this study was to evaluate the perioperative results of eversion carotid endarterectomy (e-CEA) without shunt at 30 days. From January 2004 to December 2013, 1385 e-CEAs were performed in 981 men and 404 women, for 268 hemispheric, 55 ocular and 12 oculopyramidal symptoms of carotid stenosis. The average age was 71.1 years. The contralateral internal carotid artery (ICA) was occluded in 77 cases. All e-CEAs were performed using Vanmaele technique, with blood pressure monitoring and under general anesthesia except in two cases (locoregional anesthesia alone). The need for application of an intra-arterial shunt was evaluated using visual quantification of adequate retrograde ICA pressure based on the quality of back-bleeding from the ICA. If well pulsatile, a shunt was not required. Otherwise, the systolic blood pressure was increased until a good quality ICA back-flow was obtained. Freedom from intra-arterial shunt placement was 100% as a result of estimation and augmentation of arterial perfusion to demonstrate pulsatile perfusion by retrograde ICA filling. A peroperative angiography was performed in 910 cases. All surgical sites were evaluated postoperatively by Duplex imaging. The overall stroke and death rate was 1.3%. Nine (0.7%) patients died perioperatively. The 24 (1.7%) non-fatal neurologic events were ipsilateral: 6 (0.4%) disabling and 9 (0.6%) regressive stroke, 3 (0.2%) permanent and 1 (0.1%) transient ocular ischemia, and 5 (0.4%) transient ischemic attacks. Three (0.2%) patients had a perioperative myocardial infarction. Eleven compressive neck hematomas (0.8%) were reoperated in emergency. E-CEA can be performed safely, as a routine technique, based on the surgeon's evaluation of arterial back-bleeding and an increase in ipsilateral arterial perfusion with standard anesthetic procedures. Also e-CEA may be considered a cost effective method of reducing the frequency of intra-arterial shunt placement and adjuncts used to assess adequate

  9. To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report

    Directory of Open Access Journals (Sweden)

    Rodrigo Ruano

    Full Text Available CONTEXT: Macrocystic adenomatoid malformation of the lung can cause severe mediastinal shift, hydrops and polyhydramnios, thereby increasing the risk of perinatal deaths. After 33 weeks of gestation, repeated puncturing of the cyst is recommended. We present a case in which a cyst-amniotic shunt was placed instead of performing this procedure. CASE REPORT: A cyst-amniotic shunt was placed at 33 weeks of gestation because of a large macrocystic adenomatoid malformation of the lung associated with severe mediastinal shift and polyhydramnios. Although it was confirmed that the catheter was in the correct place, the cyst increased in size again two weeks later, associated with repetition of polyhydramnios. It was postulated that the catheter was blocked, and we chose to place another catheter instead of performing repeated punctures. The cystic volume, polyhydramnios and mediastinal shift regressed progressively. At 38.5 weeks, a 3,310/g male infant was delivered without presenting any respiratory distress. The infant underwent thoracotomy on the 15th day of life. Thus, in the present study, we discuss the possibility of placing a cyst-amniotic shunt instead of performing repeated cystic punctures, even at a gestational age close to full term.

  10. Biofilm-associated infection: the hidden face of cerebrospinal fluid shunt malfunction.

    Science.gov (United States)

    Mounier, Roman; Kapandji, Natacha; Birnbaum, Ron; Cook, Fabrice; Rodriguez, Cristophe; Nebbad, Bibba; Lobo, David; Dhonneur, Gilles

    2016-12-01

    Diagnosis of cerebrospinal fluid (CSF) shunt infection is difficult. Growing evidence links this pattern to biofilm-associated infections (BAI). Biofilm may explain the indolent development of the infection, and the poor efficiency of traditional microbiologic methods. We report the case of a patient admitted for hydrocephalus associated to CSF shunt malfunction. None of the clinical, serum, or CSF laboratory findings were in favor of an infectious process. Only scanning electron microscopy (SEM) revealed the presence of biofilm. Hence, despite a broad CSF shunt infection definition, some infections could remain undiagnosed by the traditional approach. This study is the first to provide some direct evidence for bacterial biofilm-associated CSF shunt infection.

  11. Migration of the abdominal catheter of a ventriculoperitoneal shunt into the mouth: a rare presentation.

    Science.gov (United States)

    Low, Shiong Wen; Sein, Lwin; Yeo, Tseng Tsai; Chou, Ning

    2010-07-01

    A 1-year-old boy with a history of exomphalos and hydrocephalus had surgeries to correct these pathologies. The ventriculopleural (VP(L)) shunt inserted for hydrocephalus was complicated by pleural effusion, for which a ventriculoperitoneal (VP) shunt was inserted on the contralateral side. He subsequently presented with protrusion of the distal VP shunt tip from the mouth due to perforation through the gastrointestinal tract. The child also had a history of peritonitis post-exomphalos repair, which may have predisposed him to this relatively uncommon shunt complication. Probable causes and risk factors of the perforation are discussed.

  12. Effect of bladder augmentation on VP shunt failure rates in spina bifida.

    Science.gov (United States)

    Gonzalez, Dani O; Cooper, Jennifer N; McLeod, Daryl J

    2017-12-11

    Most patients with spina bifida require ventriculoperitoneal (VP) shunt placement. Some also require bladder augmentation, which may increase the risk of VP shunt malfunction and/or failure. The aim of this study was to assess whether bladder augmentation affects the rate of VP shunt failure in this population. Using the Pediatric Health Information System, we studied patients with spina bifida born between 1992 and 2014 who underwent VP shunt placement. Using conditional logistic regression, we compared age- and hospital-matched patients who did and did not undergo a bladder augmentation to determine their difference in rates of VP shunt failure. There were 4192 patients with spina bifida who underwent both surgical closure and VP shunt placement. Of these, 203 patients with bladder augmentation could be matched to 593 patients without bladder augmentation. VP shunt failure occurred within 2 years in 7.7% of patients, the majority of whom were in the group who underwent bladder augmentation (87%). After adjusting for confounders, undergoing bladder augmentation was independently associated with VP shunt failure (HR: 33.5, 95% CI: 13.15-85.44, p< 0.001). Bladder augmentation appears to be associated with VP shunt failure. Additional studies are necessary to better define this relationship and identify risk-reduction techniques.

  13. Incidental sinus abnormalities in 256 patients referred for brain MRI

    Directory of Open Access Journals (Sweden)

    Ghanaati H

    2007-06-01

    Full Text Available Background: Imaging abnormalities in the paranasal sinuses are regularly noted as incidental findings on MRI, however, little is known about their prevalence in the Iranian population. The purpose of this study was to classify these findings in the paranasal sinuses as seen on MRI and to investigate the prevalence, according to site and type of paranasal abnormality. Methods: In this cross-sectional study, the T2-weighted axial MRI of 256 patients with diseases unrelated to their paranasal sinuses were reviewed between May 2002 and June 2003. The findings were categorized according to the anatomic location and the imaging characteristics of the abnormality. The abnormalities recorded included total sinus opacification, mucoperiosteal thickening >5mm, air fluid levels and retention cysts or polyps. Unilateral or bilateral involvement and septal deviation were also noted. A sinus was considered normal if it was fully aerated and no soft-tissue density was apparent within the cavity. Results: Among our cases, 111 (43.5% were male and 145 (56.5% were female. Of these patients, abnormalities in one or more of the sinus groups were found in 110 subjects (42.9%, 55.5% of which were male and 44.5% were female (P=0.001. Maxillary sinus abnormalities were observed in 66.4% of the patients, while ethmoid sinus abnormalities were found in 63.6%. Of the ethmoid abnormalities, 21% were found in the anterior section, 9% in the middle ethmoid, and 8% in the posterior ethmoid. The most common abnormality found was mucosal thickening. Among our cases, 23.4% had septal deviation, which was significantly higher among those with sinusitis (29% versus 19.1%; P<0.01. Of those patients with sinus involvement, 16% were involved in the sphenoid sinus and 5% in the frontal sinus. The results obtained from the patients with sinus abnormality revealed that 85% suffered from cough, nasal obstruction, runny nose, facial pain and post nasal discharge and 24% had been diagnosed

  14. Antibiotics for acute maxillary sinusitis in adults.

    Science.gov (United States)

    Ahovuo-Saloranta, Anneli; Rautakorpi, Ulla-Maija; Borisenko, Oleg V; Liira, Helena; Williams, John W; Mäkelä, Marjukka

    2014-02-11

    Sinusitis is one of the most common diagnoses among adults in ambulatory care, accounting for 15% to 21% of all adult outpatient antibiotic prescriptions. However, the role of antibiotics for sinusitis is controversial. To assess the effects of antibiotics in adults with acute maxillary sinusitis by comparing antibiotics with placebo, antibiotics from different classes and the side effects of different treatments. We searched CENTRAL 2013, Issue 2, MEDLINE (1946 to March week 3, 2013), EMBASE (1974 to March 2013), SIGLE (OpenSIGLE, later OpenGrey (accessed 15 January 2013)), reference lists of the identified trials and systematic reviews of placebo-controlled studies. We also searched for ongoing trials via ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP). We imposed no language or publication restrictions. Randomised controlled trials (RCTs) comparing antibiotics with placebo or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, confirmed or not by imaging or bacterial culture. Two review authors independently screened search results, extracted data and assessed trial quality. We calculated risk ratios (RRs) for differences between intervention and control groups in whether the treatment failed or not. All measures are presented with 95% confidence intervals (CIs). We conducted the meta-analyses using either the fixed-effect or random-effects model. In meta-analyses of the placebo-controlled studies, we combined data across antibiotic classes. Primary outcomes were clinical failure rates at 7 to 15 days and 16 to 60 days follow-up. We used GRADEpro to assess the quality of the evidence. We included 63 studies in this updated review; nine placebo-controlled studies involving 1915 participants (seven of the studies clearly conducted in primary care settings) and 54 studies comparing different classes of antibiotics (10 different comparisons

  15. Treatment for an endosseous implant migrated into the maxillary sinus not causing maxillary sinusitis : Case report

    NARCIS (Netherlands)

    Raghoebar, GM; Vissink, A

    2003-01-01

    Placement of endosseous implants in the maxilla has been proven to be a reliable treatment modality. If there is lack of supporting bone, the placed implant may not have enough primary stability and may migrate into the maxillary sinus. Displaced implants must be removed. If there are no signs of

  16. Olfactory Training in Improving Sense of Smell After Radiation Therapy in Patients With Paranasal Sinus or Nasopharyngeal Cancer

    Science.gov (United States)

    2017-07-11

    Stage 0 Nasopharyngeal Carcinoma; Stage 0 Paranasal Sinus Cancer; Stage I Nasopharyngeal Carcinoma; Stage I Paranasal Sinus Cancer; Stage II Nasopharyngeal Carcinoma; Stage II Paranasal Sinus Cancer; Stage IIA Nasopharyngeal Carcinoma; Stage IIB Nasopharyngeal Carcinoma; Stage III Nasopharyngeal Carcinoma; Stage III Paranasal Sinus Cancer; Stage IV Nasopharyngeal Carcinoma; Stage IV Paranasal Sinus Cancer; Stage IVA Nasopharyngeal Carcinoma; Stage IVA Paranasal Sinus Cancer; Stage IVB Nasopharyngeal Carcinoma; Stage IVB Paranasal Sinus Cancer; Stage IVC Nasopharyngeal Carcinoma; Stage IVC Paranasal Sinus Cancer

  17. Aneurysmal bone cyst of the frontal sinus.

    Science.gov (United States)

    Liu, J H; Newcomer, M T; Murray, A D; Myer, C M

    2001-01-01

    Aneurysmal bone cysts are benign, vascular, cystic osseous tumors. Approximately 2% of all aneurysmal bone cysts are found in the head and neck region, with the most common site being the mandible. We report a case of an aneurysmal bone cyst arising from the frontal sinus in a pediatric patient. The diagnosis was suggested through various radiographic studies, with the final pathologic diagnosis confirmed after tumor excision. Complete en-bloc excision was performed by using a bifrontal craniotomy approach, with immediate reconstruction of the defect by using a split calvarial bone graft.

  18. Naso-sinus chondrosarcoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Ju; Ahn, Kook Jin; Lee, Youn Soo; Paik, Moon Hee; Kim, Jee Young; Hahn, Seong Tai [Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-03-15

    Chondrosarcomas are malignant tumors of the cartilage that rarely involve the sinonasal region. Here, we describe a case of histologically verified naso-sinus chondrosarcoma in a 40-year-old female presenting with nasal stuffiness and anosmia. The tumor presented on computed tomography (CT) as an expanding soft tissue mass with bone destruction and pressure erosion. The magnetic resonance images (MRI) of the tumor demonstrated high signals on T2-weighted images with nodular and papillary enhancement along the periphery on T1-weighted images with contrast enhancement. The presence of these typical imaging features should be very helpful in diagnosing chondrosarcoma involving the sinonasal region.

  19. Incidence and predictors of dural venous sinus pressure gradient in idiopathic intracranial hypertension and non-idiopathic intracranial hypertension headache patients: results from 164 cerebral venograms.

    Science.gov (United States)

    Levitt, Michael R; Hlubek, Randall J; Moon, Karam; Kalani, M Yashar S; Nakaji, Peter; Smith, Kris A; Little, Andrew S; Knievel, Kerry; Chan, Jane W; McDougall, Cameron G; Albuquerque, Felipe C

    2017-02-01

    OBJECTIVE Cerebral venous pressure gradient (CVPG) from dural venous sinus stenosis is implicated in headache syndromes such as idiopathic intracranial hypertension (IIH). The incidence of CVPG in headache patients has not been reported. METHODS The authors reviewed all cerebral venograms with manometry performed for headache between January 2008 and May 2015. Patient demographics, headache etiology, intracranial pressure (ICP) measurements, and radiographic and manometric results were recorded. CVPG was defined as a difference ≥ 8 mm Hg by venographic manometry. RESULTS One hundred sixty-four venograms were performed in 155 patients. There were no procedural complications. Ninety-six procedures (58.5%) were for patients with IIH. The overall incidence of CVPG was 25.6% (42 of 164 procedures): 35.4% (34 of 96 procedures) in IIH patients and 11.8% (8 of 68 procedures) in non-IIH patients. Sixty procedures (36.6%) were performed in patients with preexisting shunts. Seventy-seven patients (49.7%) had procedures preceded by an ICP measurement within 4 weeks of venography, and in 66 (85.7%) of these patients, the ICP had been found to be elevated. CVPG was seen in 8.3% (n = 5) of the procedures in the 60 patients with a preexisting shunt and in 0% (n = 0) of the 11 procedures in the 77 patients with normal ICP (p < 0.001 for both). Noninvasive imaging (MR venography, CT venography) was assessed prior to venography in 112 (68.3%) of 164 cases, and dural venous sinus abnormalities were demonstrated in 73 (65.2%) of these cases; there was a trend toward CVPG (p = 0.07). Multivariate analysis demonstrated an increased likelihood of CVPG in patients with IIH (OR 4.97, 95% CI 1.71-14.47) and a decreased likelihood in patients with a preexisting shunt (OR 0.09, 95% CI 0.02-0.44). CONCLUSIONS CVPG is uncommon in IIH patients, rare in those with preexisting shunts, and absent in those with normal ICP.

  20. A retrospective study of clinical and radiologic outcomes of 69 consecutive maxillary sinus augmentations associated with functional endoscopic sinus surgery.

    Science.gov (United States)

    Falco, Antonello; Amoroso, Cinzia; Berardini, Marco; D'Archivio, Lanfranco

    2015-01-01

    The aim of this clinical investigation was to evaluate the clinical and radiologic outcomes of a single-step surgical procedure that includes functional endoscopic sinus surgery (FESS) and maxillary sinus elevation by the lateral window approach in patients with reversible contraindications to sinus elevation. Thirty-eight patients with insufficient bone height in the posterior maxilla caused by pneumatization of the sinus and with reversible ear-nose-throat (ENT) contraindications to sinus elevation were recruited for this investigation between January 2010 and January 2012. All patients were treated in a single session under general anesthesia for a total of 69 consecutive sinus augmentations. FESS was performed by an ENT specialist, and an oral surgeon carried out sinus elevation through the lateral window approach. Particulate xenograft was used beneath the sinus membrane. Intraoperative and postoperative complications (eg, membrane tears, rhinosinusitis, graft infection or loss) were reported. Nasal endoscopies were performed at 7, 14, and 30 days and 3 months after treatment. After a healing period of 6 months, 137 implants were inserted. Computed tomography scans were performed after 6 months and 1 year. Intraoperative membrane perforation occurred in only one case. No implant failures were recorded during the follow-up period. Radiologic and clinical findings showed the resolution of ENT disease and good bone graft integration after 1 year. A relapse of mucosal thickening observed in some patients did not influence the graft healing. Preliminary rhinosinusal evaluation by an ENT specialist and computed tomography of the ostiomeatal complex are necessary in patients needing maxillary sinus elevation. A single-step approach to FESS and sinus elevation is a predictable technique to manage patients with ENT reversible contraindications to sinus elevation.

  1. Evaluation and management of nosocomial sinusitis in Intensive ...

    African Journals Online (AJOL)

    Hence, an index of suspicion should be kept for nosocomial sinusitis in a case of pyrexia of unknown origin in ICU settings. Conclusion: Nosocomial sinusitis in ICU setting presenting with fever needs to be diagnosed early in patients having risk factors for this entity and should be managed aggressively to prevent life ...

  2. Odontogenic sinusitis: developments in diagnosis, microbiology, and treatment.

    Science.gov (United States)

    Workman, Alan D; Granquist, Eric J; Adappa, Nithin D

    2017-10-27

    Odontogenic causes of sinusitis are frequently missed; clinicians often overlook odontogenic disease whenever examining individuals with symptomatic rhinosinusitis. Conventional treatments for chronic rhinosinusitis (CRS) will often fail in odontogenic sinusitis. There have been several recent developments in the understanding of mechanisms, diagnosis, and treatment of odontogenic sinusitis, and clinicians should be aware of these advances to best treat this patient population. The majority of odontogenic disease is caused by periodontitis and iatrogenesis. Notably, dental pain or dental hypersensitivity is very commonly absent in odontogenic sinusitis, and symptoms are very similar to those seen in CRS overall. Unilaterality of nasal obstruction and foul nasal drainage are most suggestive of odontogenic sinusitis, but computed tomography is the gold standard for diagnosis. Conventional panoramic radiographs are very poorly suited to rule out odontogenic sinusitis, and cannot be relied on to identify disease. There does not appear to be an optimal sequence of treatment for odontogenic sinusitis; the dental source should be addressed and ESS is frequently also necessary to alleviate symptoms. Odontogenic sinusitis has distinct pathophysiology, diagnostic considerations, microbiology, and treatment strategies whenever compared with chronic rhinosinusitis. Clinicians who can accurately identify odontogenic sources can increase efficacy of medical and surgical treatments and improve patient outcomes.

  3. Anthropometrical Profiles Of The Frontal Sinus In Population Of ...

    African Journals Online (AJOL)

    The anthropometrical profiles, function and variation of frontal sinus have been poorly understood. Understanding these are important in sinus operation and in paleontology, to understand the puzzle of the meaning of the supra orbital development. In the present study radiographs of 74 males and 46 females of south east ...

  4. Nasal dermoid sinus in an American cocker spaniel.

    Science.gov (United States)

    Bailey, T R; Holmberg, D L; Yager, J A

    2001-01-01

    An American cocker spaniel was presented for a subcutaneous mass and draining tract located between its eyes. Contrast radiography and surgical excision showed communication of the tract with the left frontal sinus and rostral cerebral dura, respectively. A dermoid sinus was diagnosed by a combination of gross and histologic findings. Images Figure 1. Figure 2. PMID:11265192

  5. Sinus Histiocytosis with Massive Lymphadenopathy | Sinclair-Smith ...

    African Journals Online (AJOL)

    Two cases of a recently described entity, 'sinus histiocytosis with massive lymphadenopathy,' occurring in Black males, are reported. Prominent cervical adenopathy was the main presenting feature in both. Histologically, these nodes were characterised by pronounced proliferation of sinus histiocytes which showed ...

  6. A comparison of two operations for pilonidal sinus disease | Gupta ...

    African Journals Online (AJOL)

    Methods: A total of 28 patients of chronic pilonidal sinus disease were randomised to undergo radiofrequency sinus excision technique (n=14) or excision and marsupialisation (n=14). The demographic data. Postoperative results complications and recurrence were documented for comparison of the results. Patients from ...

  7. Tubercular Sinus of Labia Majora: Rare Case Report

    Science.gov (United States)

    Manoj, Kela; Soma, Mukherjee; Ajay, Lunawat; Ashish, Agrawal; Rakesh, Shishodiya; Paliwal, R. V.

    2008-01-01

    Tuberculosis of the female external genitalia is unusual and primary infection is rare. We report a 50-year-old female patient admitted to Department to Surgery with swelling over left inguinal area with discharging sinus from labia majora to left inguinal crease which was found to be tubercular sinus on histopathology. PMID:18301724

  8. Tubercular Sinus of Labia Majora: Rare Case Report

    OpenAIRE

    Kela Manoj; Mukherjee Soma; Lunawat Ajay; Agrawal Ashish; Shishodiya Rakesh; Paliwal, R. V.

    2008-01-01

    Tuberculosis of the female external genitalia is unusual and primary infection is rare. We report a 50-year-old female patient admitted to Department to Surgery with swelling over left inguinal area with discharging sinus from labia majora to left inguinal crease which was found to be tubercular sinus on histopathology.

  9. SICK SINUS SYNDROME IN PATIENTS WITH ACUTE CEREBROVASCULAR ACCIDENTS

    Directory of Open Access Journals (Sweden)

    E. K. Kazakova

    2015-01-01

    Full Text Available The article presents a clinical case of 2 patients with heart arrhythmias of the sick sinus syndrome type, who were implanted electriccardiac pacemakers in the acute period of cerebrovascular accidents. There were no cardiac complaints in the clinical manifestation, however, a comprehensive assessment confirmed the diagnosis of sick sinus syndrome.

  10. Unilateral ptosis: an uncommon presentation of chronic sinusitis - A ...

    African Journals Online (AJOL)

    Chronic sinusitis is an inflammatory lesion that involves the paranasal sinuses with symptoms and signs that are beyond 12 weeks in duration. It commonly presents with nasal stuffiness, mouth breathing, purulent nasal discharge, post natal drip, snoring, cough, headache, facial fullness, hyposmia, sore throat and halitosis.

  11. Colds, Allergies and Sinusitis - How to Tell the Difference

    Science.gov (United States)

    ... your surroundings, you may be battling allergies or sinusitis. Proper diag- nosis and treatment can lead to quicker recovery and less misery. ... you can take to reduce your risk of sinusitis. Your aller- gist/immunologist ... long-term treatments such as al- lergy shots, medication to control ...

  12. Orbital cellulitis complicating sinusitis: a 15-year review | Nwaorgu ...

    African Journals Online (AJOL)

    Background: Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess.

  13. Paranasal Sinus Mucoceles : Surgical Management In A Nigerian ...

    African Journals Online (AJOL)

    ... out with no complication or recurrence post-operatively. Conclusion: Mucoceles of the paranasal sinuses require appropriate surgical technique for adequate exposure and drainage in order to avoid recurrence. Keywords: Mucoceles, Paranasal sinus, Rhinosinusitis Nigerian Journal of Plastic Surgery Vol. 3 (2) 2007: pp.

  14. Posture-dependent chronotropic effect of carotid sinus massage

    DEFF Research Database (Denmark)

    Møller, M; Oxhøj, H; Mickley, H

    1987-01-01

    The hypertensive carotid sinus can be divided into cardioinhibitory (chronotropic) and vasodepressor components; the former can be evaluated by carotid sinus massage performed in the supine position. We present the case of a patient in whom the abnormal cardioinhibitory response could only be dem...

  15. CT-MPR invaluable in diagnosing odontogenic maxillary sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Hideaki; Shimazu, Kaoru; Kamada, Morito; Shiroyama, Akihiro; Mouri, Daisuke; Yamashita, Masashi; Kawasaki, Yasunori; Koseki, Takakazu; Mouri, Manabu [Osaka Dental Univ. (Japan)

    2001-08-01

    In everyday examination, it is usual to encounter odontogenic maxillary sinusitis patients. Odontogenic maxillary sinusitis is generally best diagnosed by dental X-ray imaging. Many medical facilities not having a dental X-ray unit use coronal computed tomography (CT) images to diagnose odontogenic maxillary sinusitis. Coronal CT imaging causes artifacts, however due to dental prosthesises. Computed tomography-Multiplanar reformation (CT-MPR) imaging has proved useful in evaluating the paranasal sinus because it is not influenced by dental prosthesises. We evaluated the usefulness of CT-MPR for diagnosing odontogenic maxillary sinusitis by retrospectively analyzing 16 patients, with the following results. We couldn't diagnose all cases of odontogenic maxillary sinusitis in posteroanterior and Waters projection images. Panoramic radiography is needed to diagnose odontogenic maxillary sinusitis. Dental X-ray imaging missed some cases, but all cases were diagnosed by CT-MPR imaging, giving a 100% diagnosestic rate. CT-MPR imaging is thus at least as valuable or better than dental X-ray imaging in diagnosing odontogenic maxillary sinusitis. (author)

  16. Hyperthyroidism and sick sinus syndrome, a rare but challenging ...

    African Journals Online (AJOL)

    Hyperthyroidism is usually associated with sinus tachycardia or supraventricular tachyarrhythmias, but rarely with dysfunction of the sinus node or other conduction disturbances. Evidence of bradyarrhythmia in patients with hyperthyroidism is clinically relevant, but the fact that several drugs with negative chronotropic effects ...

  17. Length of Coronary Sinus in a Black Kenyan Population: Correlation ...

    African Journals Online (AJOL)

    The aim of the current study was to determine the length of coronary sinus among black Kenyans. Coronary sinuses of seventy-four hearts (43 males and 31 females) of adult age range (20-70years) black Kenyans obtained during autopsy were studied at the Department of Human Anatomy, University of Nairobi, Kenya.

  18. Tubercular Sinus of Labia Majora: Rare Case Report

    Directory of Open Access Journals (Sweden)

    Kela Manoj

    2008-01-01

    Full Text Available Tuberculosis of the female external genitalia is unusual and primary infection is rare. We report a 50-year-old female patient admitted to Department to Surgery with swelling over left inguinal area with discharging sinus from labia majora to left inguinal crease which was found to be tubercular sinus on histopathology.

  19. Acute pericarditis presenting with sinus bradycardia : A case report

    NARCIS (Netherlands)

    Gosselink, ATM; vandenBerg, MP; Crijns, HJGM

    1997-01-01

    Acute pericarditis is almost invariably associated with sinus tachycardia. Recent-onset chest pain in the presence of (sinus) bradycardia is considered to be associated with an acute ischemic syndrome rather than acute pericarditis. This report describes a patient with acute pericarditis initially

  20. Sex differences in diameter of the coronary sinus ostium: Correlation ...

    African Journals Online (AJOL)

    Diameter of the coronary sinus ostium is important in the designing of cannulation devices used in cardiac resynchronization therapy and percutaneous mitral valve annuloplasty. Population variation of the diameter may account for the failure rate of these procedures. Studies of the coronary sinus ostium from African ...